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Schulz A, Lunkenheimer P, Loidl A. Ionic Conductivity of a Lithium-Doped Deep Eutectic Solvent: Glass Formation and Rotation-Translation Coupling. J Phys Chem B 2024; 128:3454-3462. [PMID: 38564781 DOI: 10.1021/acs.jpcb.4c00412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Deep eutectic solvents with admixed lithium salts are considered as electrolytes in electrochemical devices, such as batteries or supercapacitors. Compared to eutectic mixtures of hydrogen-bond donors and lithium salts, their raw-material costs are significantly lower. Not much is known about glassy freezing and rotational-translation coupling of such systems. Here, we investigate these phenomena by applying dielectric spectroscopy to the widely studied deep eutectic solvent glyceline, to which 1 and 5 mol % LiCl were added. Our study covers a wide temperature range, including a deeply supercooled state. The temperature dependences of the detected dipolar reorientation dynamics and ionic direct current (dc) conductivity reveal the signatures of glassy freezing. In comparison to pure glyceline, the lithium admixture leads to a reduction of ionic conductivity, which is accompanied by a reduction of the rotational dipolar mobility. However, this reduction is much smaller than that for deep eutectic solvents (DESs), where one main component is lithium salt, which we trace back to the lower glass-transition temperatures of lithium-doped DESs. In contrast to pure glyceline, the ionic and dipolar dynamics become increasingly decoupled at low temperatures and obey a fractional Debye-Stokes-Einstein relation, as previously found in other glass-forming liquids. The obtained results demonstrate the relevance of decoupling effects and glass transition to the enhancement of the technically relevant ionic conductivity in such lithium-doped DESs.
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Affiliation(s)
- A Schulz
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86135 Augsburg, Germany
| | - P Lunkenheimer
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86135 Augsburg, Germany
| | - A Loidl
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86135 Augsburg, Germany
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2
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Schulz A, Moch K, Hinz Y, Lunkenheimer P, Böhmer R. Translational and reorientational dynamics in carboxylic acid-based deep eutectic solvents. J Chem Phys 2024; 160:074503. [PMID: 38380750 DOI: 10.1063/5.0189533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/18/2024] [Indexed: 02/22/2024] Open
Abstract
The glass formation and the dipolar reorientational motions in deep eutectic solvents (DESs) are frequently overlooked, despite their crucial role in defining the room-temperature physiochemical properties. To understand the effects of these dynamics on the ionic conductivity and their relation to the mechanical properties of the DES, we conducted broadband dielectric and rheological spectroscopy over a wide temperature range on three well-established carboxylic acid-based natural DESs. These are the eutectic mixtures of choline chloride with oxalic acid (oxaline), malonic acid (maline), and phenylacetic acid (phenylaceline). In all three DESs, we observe signs of a glass transition in the temperature dependence of their dipolar reorientational and structural dynamics, as well as varying degrees of motional decoupling between the different observed dynamics. Maline and oxaline display a breaking of the Walden rule near the glass-transition temperature, while the relation between the dc conductivity and dipolar relaxation time in both maline and phenylaceline is best described by a power law. The glass-forming properties of the investigated systems not only govern the orientational dipolar motions and rheological properties, which are of interest from a fundamental point of view, but they also affect the dc conductivity, even at room temperature, which is of high technical relevance.
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Affiliation(s)
- A Schulz
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86159 Augsburg, Germany
| | - K Moch
- Fakultät Physik, Technische Universität Dortmund, 44221 Dortmund, Germany
| | - Y Hinz
- Fakultät Physik, Technische Universität Dortmund, 44221 Dortmund, Germany
| | - P Lunkenheimer
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86159 Augsburg, Germany
| | - R Böhmer
- Fakultät Physik, Technische Universität Dortmund, 44221 Dortmund, Germany
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3
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Schulz A, Lunkenheimer P, Loidl A. Rotational dynamics, ionic conductivity, and glass formation in a ZnCl2-based deep eutectic solvent. J Chem Phys 2024; 160:054502. [PMID: 38341686 DOI: 10.1063/5.0187729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/15/2024] [Indexed: 02/13/2024] Open
Abstract
Glass formation and reorientational motions are widespread but often-neglected features of deep eutectic solvents although both can be relevant for the technically important ionic conductivity at room temperature. Here, we investigate these properties for two mixtures of ethylene glycol and ZnCl2, which were recently considered superior electrolyte materials for application in zinc-ion batteries. For this purpose, we employed dielectric spectroscopy performed in a broad temperature range, extending from the supercooled state at low temperatures up to the liquid phase around room temperature and beyond. We find evidence for a relaxation process arising from dipolar reorientation dynamics, which reveals the clear signatures of glassy freezing. This freezing also governs the temperature dependence of the ionic dc conductivity. We compare the obtained results with those for deep eutectic solvents that are formed by the same hydrogen-bond donor, ethylene glycol, but by two different salts, choline chloride and lithium triflate. The four materials reveal significantly different ionic and reorientational dynamics. Moreover, we find varying degrees of decoupling of rotational dipolar and translational ionic motions, which can partly be described by a fractional Debye-Stokes-Einstein relation. The typical glass-forming properties of these solvents strongly affect their room-temperature conductivity.
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Affiliation(s)
- A Schulz
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86135 Augsburg, Germany
| | - P Lunkenheimer
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86135 Augsburg, Germany
| | - A Loidl
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86135 Augsburg, Germany
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Fischer B, Gwinner F, Gepp MM, Schulz A, Danz K, Dehne A, Katsen-Globa A, Neubauer JC, Gentile L, Zimmermann H. A highly versatile biopolymer-based platform for the maturation of human pluripotent stem cell-derived cardiomyocytes enables functional analysis in vitro and 3D printing of heart patches. J Biomed Mater Res A 2023; 111:1600-1615. [PMID: 37317666 DOI: 10.1002/jbm.a.37558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 06/16/2023]
Abstract
Human pluripotent stem cell-derived cardiomyocytes (hPSC-CMs) represent a valuable tool for in vitro modeling of the cardiac niche and possess great potential in tissue engineering applications. However, conventional polystyrene-based cell culture substrates have adverse effects on cardiomyocytes in vitro due to the stress applied by a stiff substrate on contractile cells. Ultra-high viscosity alginates offer a unique versatility as tunable substrates for cardiac cell cultures due to their biocompatibility, flexible biofunctionalization, and stability. In this work, we analyzed the effect of alginate substrates on hPSC-CM maturity and functionality. Alginate substrates in high-throughput compatible culture formats fostered a more mature gene expression and enabled the simultaneous assessment of chronotropic and inotropic effects upon beta-adrenergic stimulation. Furthermore, we produced 3D-printed alginate scaffolds with differing mechanical properties and plated hPSC-CMs on the surface of these to create Heart Patches for tissue engineering applications. These exhibited synchronous macro-contractions in concert with more mature gene expression patterns and extensive intracellular alignment of sarcomeric structures. In conclusion, the combination of biofunctionalized alginates and human cardiomyocytes represents a valuable tool for both in vitro modeling and regenerative medicine, due to its beneficial effects on cardiomyocyte physiology, the possibility to analyze cardiac contractility, and its applicability as Heart Patches.
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Affiliation(s)
- B Fischer
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
- Fraunhofer Project Center for Stem Cell Process Engineering, Würzburg, Germany
| | - F Gwinner
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
| | - M M Gepp
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
- Fraunhofer Project Center for Stem Cell Process Engineering, Würzburg, Germany
| | - A Schulz
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
| | - K Danz
- Department of Bioprocessing and Bioanalytics, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
| | - A Dehne
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
| | - A Katsen-Globa
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
| | - J C Neubauer
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
- Fraunhofer Project Center for Stem Cell Process Engineering, Würzburg, Germany
| | - L Gentile
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
| | - H Zimmermann
- Department of Stem Cell & Cryo Technology, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
- Fraunhofer Project Center for Stem Cell Process Engineering, Würzburg, Germany
- Chair for Molecular and Cellular Biotechnology, Saarland University, Gebäude A, Saarbrücken, Germany
- Faculty of Marine Science, Universidad Católica del Norte, Coquimbo, Chile
- Department of Bioprocessing and Bioanalytics, Fraunhofer Institute for Biomedical Engineering, Sulzbach, Germany
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Schuetz C, Gerke J, Ege M, Walter J, Kusters M, Worth A, Kanakry JA, Dimitrova D, Wolska-Kuśnierz B, Chen K, Unal E, Karakukcu M, Pashchenko O, Leiding J, Kawai T, Amrolia PJ, Berghuis D, Buechner J, Buchbinder D, Cowan MJ, Gennery AR, Güngör T, Heimall J, Miano M, Meyts I, Morris EC, Rivière J, Sharapova SO, Shaw PJ, Slatter M, Honig M, Veys P, Fischer A, Cavazzana M, Moshous D, Schulz A, Albert MH, Puck JM, Lankester AC, Notarangelo LD, Neven B. Hypomorphic RAG deficiency: impact of disease burden on survival and thymic recovery argues for early diagnosis and HSCT. Blood 2023; 141:713-724. [PMID: 36279417 PMCID: PMC10082356 DOI: 10.1182/blood.2022017667] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/19/2022] [Accepted: 10/04/2022] [Indexed: 11/20/2022] Open
Abstract
Patients with hypomorphic mutations in the RAG1 or RAG2 gene present with either Omenn syndrome or atypical combined immunodeficiency with a wide phenotypic range. Hematopoietic stem cell transplantation (HSCT) is potentially curative, but data are scarce. We report on a worldwide cohort of 60 patients with hypomorphic RAG variants who underwent HSCT, 78% of whom experienced infections (29% active at HSCT), 72% had autoimmunity, and 18% had granulomas pretransplant. These complications are frequently associated with organ damage. Eight individuals (13%) were diagnosed by newborn screening or family history. HSCT was performed at a median of 3.4 years (range 0.3-42.9 years) from matched unrelated donors, matched sibling or matched family donors, or mismatched donors in 48%, 22%, and 30% of the patients, respectively. Grafts were T-cell depleted in 15 cases (25%). Overall survival at 1 and 4 years was 77.5% and 67.5% (median follow-up of 39 months). Infection was the main cause of death. In univariable analysis, active infection, organ damage pre-HSCT, T-cell depletion of the graft, and transplant from a mismatched family donor were predictive of worse outcome, whereas organ damage and T-cell depletion remained significant in multivariable analysis (hazard ratio [HR] = 6.01, HR = 8.46, respectively). All patients diagnosed by newborn screening or family history survived. Cumulative incidences of acute and chronic graft-versus-host disease were 35% and 22%, respectively. Cumulative incidences of new-onset autoimmunity was 15%. Immune reconstitution, particularly recovery of naïve CD4+ T cells, was faster and more robust in patients transplanted before 3.5 years of age, and without organ damage. These findings support the indication for early transplantation.
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Affiliation(s)
- C. Schuetz
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - J. Gerke
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M. Ege
- Dr. von Hauner Children’s Hospital at Ludwig-Maximilians-Universität, München, Germany
- Helmholtz Zentrum München, Neuherberg, Germany
| | - J. Walter
- Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL
- Division of Allergy and Immunology, Department of Medicine, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
| | - M. Kusters
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
| | - A. Worth
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
| | - J. A. Kanakry
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - D. Dimitrova
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - B. Wolska-Kuśnierz
- Department of Immunology, Children's Memorial Health Institute, Warsaw, Poland
| | - K. Chen
- Division of Allergy and Immunology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
| | - E. Unal
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
| | - M. Karakukcu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
| | - O. Pashchenko
- Department of Immunology, Pirogov Russian National Research Medical University, Moscow, Russia
| | - J. Leiding
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Orlando Health Arnold Pamer Hospital for Children, Orlando, FL
| | - T. Kawai
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - P. J. Amrolia
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - D. Berghuis
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - J. Buechner
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
| | - D. Buchbinder
- Division of Hematology, Children's Hospital of Orange County, Orange, CA
| | - M. J. Cowan
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - A. R. Gennery
- Translational and Clinical Research Institute, Newcastle University, Paediatric Haematopoietic Stem Cell Transplant Unit, Great North Children’s Hospital, Newcastle upon Tyne, United Kingdom
| | - T. Güngör
- Department of Hematology/Oncology/Immunology, Gene-therapy, and Stem Cell Transplantation, University Children’s Hospital Zurich–Eleonore Foundation & Children’s Research Center, Zürich, Switzerland
| | - J. Heimall
- Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
| | - M. Miano
- IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - I. Meyts
- Department of Pediatrics, Department of Microbiology and Immunology, University Hospitals Leuven, Leuven, Belgium
| | - E. C. Morris
- UCL Institute of Immunity & Transplantation, University College London Hospitals NHS Foundation Trust, Royal Free London Hospital NHS Foundation Trust, London, United Kingdom
| | - J. Rivière
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - S. O. Sharapova
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
| | - P. J. Shaw
- Blood Transplant and Cell Therapies, Children’s Hospital at Westmead, Sydney, Australia
| | - M. Slatter
- Paediatric Immunology & HSCT, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
| | - M. Honig
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
| | - P. Veys
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
| | - A. Fischer
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Collège de France, Paris, France
| | - M. Cavazzana
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Département de Biothérapie, Hôpital Universitaire Necker-Enfants Malades, Groupe Hospitalier Paris Centre, Assistance Publique–Hopitaux de Paris, Paris, France
- Centre d’Investigation Clinique Biothérapie, Groupe hospitalier Universitaire paris centre, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France
| | - D. Moshous
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
| | - A. Schulz
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
| | - M. H. Albert
- Pediatric SCT Program, Dr. von Hauner University Children’s Hospital, Ludwig-Maximilians Universität, München, Germany
| | - J. M. Puck
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
| | - A. C. Lankester
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - L. D. Notarangelo
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - B. Neven
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
| | - Inborn Errors Working Party (IEWP) of the European Society for Immunodeficiencies (ESID) and European Society for Blood and Marrow Transplantation (EBMT) and the Primary Immune Deficiency Treatment Consortium (PIDTC)
- Department of Paediatrics, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Dr. von Hauner Children’s Hospital at Ludwig-Maximilians-Universität, München, Germany
- Helmholtz Zentrum München, Neuherberg, Germany
- Division of Allergy and Immunology, Department of Pediatrics, Morsani College of Medicine, University of South Florida, Tampa, FL
- Division of Allergy and Immunology, Department of Medicine, Johns Hopkins All Children’s Hospital, St. Petersburg, FL
- Department of Immunology and Gene therapy, Great Ormond Street Hospital, NHS Foundation trust, London, United Kingdom
- Experimental Transplantation and Immunology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
- Department of Immunology, Children's Memorial Health Institute, Warsaw, Poland
- Division of Allergy and Immunology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Erciyes University, Kayseri, Turkey
- Department of Immunology, Pirogov Russian National Research Medical University, Moscow, Russia
- Division of Allergy and Immunology, Department of Pediatrics, Johns Hopkins University, Orlando Health Arnold Pamer Hospital for Children, Orlando, FL
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- Department of Pediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, The Netherlands
- Department of Pediatric Hematology and Oncology, Oslo University Hospital, Oslo, Norway
- Division of Hematology, Children's Hospital of Orange County, Orange, CA
- Division of Allergy, Immunology, and Blood and Marrow Transplant, Department of Pediatrics, University of California San Francisco, San Francisco, CA
- Translational and Clinical Research Institute, Newcastle University, Paediatric Haematopoietic Stem Cell Transplant Unit, Great North Children’s Hospital, Newcastle upon Tyne, United Kingdom
- Department of Hematology/Oncology/Immunology, Gene-therapy, and Stem Cell Transplantation, University Children’s Hospital Zurich–Eleonore Foundation & Children’s Research Center, Zürich, Switzerland
- Division of Allergy and Immunology, Children’s Hospital of Philadelphia, Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
- IRCCS Istituto Giannina Gaslini, Genova, Italy
- Department of Pediatrics, Department of Microbiology and Immunology, University Hospitals Leuven, Leuven, Belgium
- UCL Institute of Immunity & Transplantation, University College London Hospitals NHS Foundation Trust, Royal Free London Hospital NHS Foundation Trust, London, United Kingdom
- Pediatric Infectious Diseases and Immunodeficiencies Unit, Vall d'Hebron Research Institute, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
- Research Department, Belarusian Research Center for Pediatric Oncology, Hematology and Immunology, Minsk, Belarus
- Blood Transplant and Cell Therapies, Children’s Hospital at Westmead, Sydney, Australia
- Paediatric Immunology & HSCT, Great North Children's Hospital, Newcastle upon Tyne, United Kingdom
- Department of Pediatrics and Adolescent Medicine, Ulm University, Ulm, Germany
- Bone Marrow Transplant Unit, Great Ormond Street Hospital NHS Foundation Trust, London, United Kingdom
- Paediatric Immunology, Department of Immunology, Haematology and Rheumatology, Necker-Enfants Malades, Paris, France
- Institut Imagine, Paris Descartes-Sorbonne Paris Cité University, Paris, France
- Collège de France, Paris, France
- Département de Biothérapie, Hôpital Universitaire Necker-Enfants Malades, Groupe Hospitalier Paris Centre, Assistance Publique–Hopitaux de Paris, Paris, France
- Centre d’Investigation Clinique Biothérapie, Groupe hospitalier Universitaire paris centre, Assistance Publique-Hôpitaux de Paris, INSERM CIC 1416, Paris, France
- Pediatric SCT Program, Dr. von Hauner University Children’s Hospital, Ludwig-Maximilians Universität, München, Germany
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
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Bagheri M, Fuchs PC, Lefering R, Daniels M, Schulz A, The German Burn Registry, Schiefer JL. The BUrn Mortality Prediction (BUMP) Score - An improved mortality prediction score based on data of the German burn registry. Burns 2023; 49:110-119. [PMID: 35210139 DOI: 10.1016/j.burns.2022.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 01/06/2023]
Abstract
BACKGROUND Burn injuries constitute the fourth most common injuries globally. Patient outcomes must be currently assessed to provide appropriate patient care with high quality standards. However, existing mortality prediction scoring methods have been shown to lack accuracy in current burn patient populations. Therefore, this study aimed to validate existing scores using current patient data and assess whether new prediction parameters can provide better accuracy. METHODS A retrospective analysis of the patient data from the German Burn Registry between 2016 and 2019 was performed to evaluate all Abbreviated Burn Severity Index (ABSI) score parameters. All patients over 16 years of age who received intensive care were included. Descriptive statistics and logistic regression analysis were used to identify novel prediction parameters based on the parameters documented at admission and establish a new prediction score, the BUrn Mortality Prediction (BUMP) score. The quality of the new score was subsequently compared to that of the original ABSI, modified ABSI, Galeiras, Revised Baux score and TIMM. The new prediction score was then validated using patient data collected in the German Burn Registry in 2020. RESULTS In total, 7276 patients were included. Age; the presence of at least two comorbidities; burn injuries caused by work-related accidents, traffic accidents and suicide attempts; total burn surface area; inhalation trauma and full-thickness burns were identified as independent significant predictors of mortality (p < 0.001). Additionally, we evaluated new age groups to improve prediction accuracy. The number of comorbidities (p < 0.001) and the aetiology (burns occurring at work [p = 0.028], burns caused by traffic accidents [p < 0.001] or burns due to attempted suicide [p < 0.001]) had a significant influence on mortality. The BUMP score, which was developed based on these parameters, showed the best fitness and showed more accurate mortality prediction than all the above-mentioned scores (area under the receiver operating characteristic curve: 0.947 [0.939-0.954] compared to 0.926 [0.915-0.936], 0.928 [0.918-0.939], 0.937 [0.928-0.947], 0.939 [0.930-0.948], 0.940 [0.932-0.949] respectively). CONCLUSIONS A novel score (BUMP score) was developed for the purpose of external quality assessment of burn centres participating in the German burn registry, where observed and expected outcomes are compared on a hospital level, and for scientifically applications. The clinical impact of this score and its generalisability to other patient populations needs to be evaluated.
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Affiliation(s)
- M Bagheri
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany
| | - P C Fuchs
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany
| | - R Lefering
- Institute for Research in Operative Medicine (IFOM), Faculty of Health, Witten/Herdecke University, Cologne, Germany
| | - M Daniels
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany
| | - A Schulz
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany
| | - The German Burn Registry
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany
| | - J L Schiefer
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany.
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7
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Molitor M, Jimenez MTB, Hahad O, Witzler C, Finger S, Garlapati VS, Rajlic S, Knopp T, Bieler T, Aluia M, Wild J, Lagrange J, Blessing R, Rapp S, Schulz A, Kleinert H, Karbach S, Steven S, Ruf W, Wild P, Daiber A, Münzel T, Wenzel P. Aircraft noise exposure induces pro-inflammatory vascular conditioning and amplifies vascular dysfunction and impairment of cardiac function after myocardial infarction. Cardiovasc Res 2023:7005408. [PMID: 36702626 DOI: 10.1093/cvr/cvad021] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 12/04/2022] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
AIMS Traffic noise may play an important role in the development and deterioration of ischemic heart disease. Thus, we sought to determine the mechanisms of cardiovascular dysfunction and inflammation induced by aircraft noise in a mouse model of myocardial infarction (MI) and in humans with incident MI. METHODS AND RESULTS C57BL/6J mice were exposed to noise alone (average sound pressure level 72 dB; peak level 85 dB) up to 4d, resulting in pro-inflammatory aortic gene expression in the myeloid cell adhesion/diapedesis pathways. Noise alone promoted adhesion and infiltration of inflammatory myeloid cells in vascular/cardiac tissue, paralleled by an increased percentage of leukocytes with a pro-inflammatory, reactive oxygen species (ROS)-producing phenotype and augmented expression of Nox-2/phospho-NFκB in peripheral blood. Ligation of the LAD resulted in worsening of cardiac function, pronounced cardiac infiltration of CD11b+ myeloid cells and Ly6Chigh monocytes and induction of interleukin (IL) 6, IL-1β, CCL-2 and Nox-2, being aggravated by noise exposure prior to MI. MI induced stronger endothelial dysfunction and more pronounced increases in vascular ROS in animals preconditioned with noise. Participants of the population-based Gutenberg Health Cohort Study (median follow-up:11.4y) with incident MI revealed elevated CRP at baseline and worse LVEF after MI in case of a history of noise exposure and subsequent annoyance development. CONCLUSION Aircraft noise exposure before MI substantially amplifies subsequent cardiovascular inflammation and aggravates ischemic heart failure, facilitated by a pro-inflammatory vascular conditioning. Our translational results suggest, that measures to reduce environmental noise exposure will be helpful in improving clinical outcome of subjects with MI.
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Affiliation(s)
- M Molitor
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main
| | - M T Bayo Jimenez
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - O Hahad
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main
| | - C Witzler
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - S Finger
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - V S Garlapati
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main
| | - S Rajlic
- Department of Cardiothoracic and Vascular Surgery, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - T Knopp
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - T Bieler
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - M Aluia
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main
| | - J Wild
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main
| | - J Lagrange
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Université de Lorraine, Inserm, DCAC, Nancy, France; CHRU Nancy, Vandœuvre-lès-Nancy, France
| | - R Blessing
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - S Rapp
- Department of Cardiology, Preventive Medicine, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - A Schulz
- Department of Cardiology, Preventive Medicine, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - H Kleinert
- Department of Pharmacology, Johannes Gutenberg University Medical Center, Mainz, Germany, Langenbeckstraße 1, 55131 Mainz, Germany
| | - S Karbach
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main
| | - S Steven
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main
| | - W Ruf
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main
| | - P Wild
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main
- Department of Cardiology, Preventive Medicine, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
| | - A Daiber
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main
| | - T Münzel
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main
| | - P Wenzel
- Department of Cardiology - Cardiology I, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- Center for Thrombosis and Haemostasis, University Medical Center Mainz, Langenbeckstraße 1, 55131 Mainz, Germany
- German Center for Cardiovascular Research (DZHK), partner site Rhine-Main
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Chung Y, Carr T, Ambrose C, Lindsley A, Collacott H, Schulz A, Desai P, Rane P, Williams M. PATIENT AND CLINICIAN PREFERENCES WITH BIOLOGIC TREATMENTS FOR SEVERE ASTHMA: A DISCRETE CHOICE EXPERIMENT. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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9
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Backhaus SJ, Uzun H, Roesel SF, Schulz A, Lange T, Evertz R, Kutty S, Hasenfus G, Schuster A. Unmasking systolic impairment in HFpEF by cardiovascular magnetic resonance derived hemodynamic force assessment: insights from the HFpEF stress trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The diagnosis of heart failure with preserved ejection fraction (HFpEF) remains challenging. Exercise-stress testing is recommended in case of uncertainty; however, this approach is time-consuming and costly. Since preserved EF does not represent normal systolic function, we evaluated cardiovascular magnetic resonance (CMR) comprehensive cardiac hemodynamic forces (HDF) analyses for an in-depth characterisation of cardiac function at rest.
Methods
The HFpEF Stress Trial (DZHK-17) prospectively recruited 75 patients with exertional dyspnea, preserved EF (≥50%) and signs of diastolic dysfunction (E/e' ≥8) on echocardiography. Patients underwent right heart catheterisation, echocardiography and CMR. 68 patients entered the final study cohort (HFpEF n=34 and non-cardiac dyspnea n=34 according to pulmonary capillary wedge pressure (PCWP)). HDF assessment included left ventricular (LV) longitudinal, systolic peak and impulse, systolic/diastolic transition, E-wave deceleration as well as A-wave acceleration forces. Two patients were lost to 24 months follow-up evaluating cardiovascular mortality and hospitalisation (CVH).
Results
HDF assessment revealed impairment of LV longitudinal force in HFpEF (15.8 vs. 18.3, p=0.035) attributable to impairment of systolic peak (38.6 vs 51.6, p=0.003) and impulse (20.8 vs. 24.5, p=0.009) forces as well as late diastolic filling (−3.8 vs −5.4, p=0.029). Impairment of early diastolic filling could be observed in HFpEF patients identified at rest only but not stress (7.7 vs. 9.9, p=0.004). Impaired systolic peak was associated to CVH (HR 0.95, p=0.016) and superior for CVH prediction compared to LV global longitudinal strain (AUC 0.76 vs. 0.61, p=0.048).
Conclusions
Assessment of HDF reveals impairment of LV systolic and diastolic function in HFpEF. The value of systolic HDF assessment exceeded that of conventional deformation imaging for CVH prediction.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): German Centre for Cardiovascular Research
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Affiliation(s)
- S J Backhaus
- Georg-August University, Department of Cardiology and Pneumology , Göttingen , Germany
| | - H Uzun
- Georg-August University, Department of Cardiology and Pneumology , Göttingen , Germany
| | - S F Roesel
- Georg-August University, Department of Cardiology and Pneumology , Göttingen , Germany
| | - A Schulz
- Georg-August University, Department of Cardiology and Pneumology , Göttingen , Germany
| | - T Lange
- Georg-August University, Department of Cardiology and Pneumology , Göttingen , Germany
| | - R Evertz
- Georg-August University, Department of Cardiology and Pneumology , Göttingen , Germany
| | - S Kutty
- Johns Hopkins University School of Medicine, Taussig Heart Center , Baltimore , United States of America
| | - G Hasenfus
- Georg-August University, Department of Cardiology and Pneumology , Göttingen , Germany
| | - A Schuster
- Georg-August University, Department of Cardiology and Pneumology , Göttingen , Germany
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10
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Schmitt V, Billaudelle AM, Schulz A, Keller K, Hahad O, Troebs SO, Koeck T, Michal M, Schuster AK, Toenges G, Lackner KJ, Prochaska JH, Munzel T, Wild PS. Impact of prediabetes and type 2 diabetes mellitus on cardiac function in the general population. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Prediabetes and type 2 diabetes mellitus (T2DM) are risk factors for heart failure (HF). The association of prediabetes and T2DM to different forms of functional left ventricular impairment and their impact on clinical outcome in the general population needs to be further investigated. In this context, little is known about the prevalences of prediabetes and different HF subtypes in the general population, especially in Europe.
Purpose
To investigate the prevalence and clinical impact of prediabetes and type 2 diabetes mellitus (T2DM) on functional cardiac disorder (FCD).
Methods
The participants of the Gutenberg Health Study sample (15,010 subjects, 35–74 years) were stratified in individuals with euglycaemia, prediabetes and T2DM based on clinical information and HbA1c level. FCD included asymptomatic systolic and diastolic dysfunction, symptomatic systolic and diastolic heart failure, asymptomatic diastolic dysfunction and preserved left ventricular ejection fraction (EF), asymptomatic diastolic dysfunction and reduced EF, asymptomatic preserved diastole and reduced EF, symptomatic heart failure with preserved EF (HFpEF) and symptomatic heart failure with reduced EF HFrEF). Using structured follow-up clinical outcome was assessed.
Results
Overall, 14,870 individuals were included in the present analysis. Among them, 9,426 individuals were categorized in the euglycaemia group, 4,128 participants had prediabetes and in 1,316 individuals T2DM was present. Prevalence of FCD increased from euglycaemia (19.6%) over prediabetes (33.3%) to T2DM (46.8%, p<0.0001). Prevalence of symptomatic HF was increased in patients with T2DM (euglycaemia 2.8%, prediabetes 5.9%, T2DM 11.9%). T2DM was associated with reduced EF (β −0.63, 95% CI −0.99 to −0.26, P=0.00088) and elevated E/E' (β 0.08, 95% CI 0.06 to 0.10, P<0.0001), whereas prediabetes was associated to elevated E/E' (β 0.02, 95% CI 0.01 to 0.03, P=0.0029). Prediabetes and T2DM revealed increased prevalences of FCD (13%, 18%), asymptomatic diastolic dysfunction with preserved EF (prediabetes: 14%, T2DM: 11%), symptomatic heart failure (prediabetes: 46%, T2DM: 70%) and HFpEF (prediabetes: 49%, T2DM: 82%). With prediabetes and T2DM all-cause mortality was elevated in presence and absence of FCD, only T2DM was also a risk factor for cardiovascular mortality with and without FCD. Within a 5-years follow-up, T2DM was an independent risk factor for the development of FCD, asymptomatic diastolic dysfunction with reduced ejection fraction, symptomatic heart failure and HFrEF. Prediabetes was not an independent risk factor for FCD.
Conclusions
In the general population, a high prevalence of asymptomatic FCD is present. Coexisting FCD and prediabetes as well as T2DM result in increased mortality elucidating the need for early detection and prevention of DM development, especially with regard to numerous asymptomatic people concerned. T2DM, but not prediabetes, is a risk factor for incident FCD.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): The Gutenberg Health Study is supported by the government of Rheinland-Pfalz (`Stiftung Rheinland-Pfalz für Innovation'), the research programmes `Wissen schafft Zukunft' and the Centre forTranslational Vascular Biology (CTVB) of the Johannes Gutenberg-University of Mainz, Germany, and its contract with Boehringer Ingelheim and Philips Medical Systems including an unrestricted grant forthe Gutenberg Health Study. P.S.W. and J.H.P. are funded by the Federal Ministry of Education and Research (BMBF 01EO1503). P.S.W. and T.M. are principal investigators of the German Center for Cardiovascular Research (DZHK). P.S.W. is principal investigator of the DIASyM research core (BMBF 161L0217A).
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Affiliation(s)
- V Schmitt
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Mainz , Germany
| | - A M Billaudelle
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center , Mainz , Germany
| | - A Schulz
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center , Mainz , Germany
| | - K Keller
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Mainz , Germany
| | - O Hahad
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Mainz , Germany
| | - S O Troebs
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center , Mainz , Germany
| | - T Koeck
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center , Mainz , Germany
| | - M Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center , Mainz , Germany
| | - A K Schuster
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz , Mainz , Germany
| | - G Toenges
- Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), University Medical Center , Mainz , Germany
| | - K J Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center , Mainz , Germany
| | - J H Prochaska
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center , Mainz , Germany
| | - T Munzel
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz , Mainz , Germany
| | - P S Wild
- Preventive Cardiology and Preventive Medicine, Department of Cardiology, University Medical Center , Mainz , Germany
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11
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Macy M, Cash T, Pinto N, Pressey J, Szalontay L, Furman W, Bukowinski A, Foster J, Friedman G, HaDuong J, Fox E, Weigel B, Grevel J, Huang F, Phelps C, Childs B, Chung J, Chaturvedi S, Schulz A, DuBois S. Phase I dose-escalation study of the pan-PI3 K inhibitor copanlisib in children and adolescents with relapsed/refractory solid tumors. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00878-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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12
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Schulz A, Erbuth A, Boyko M, Vonderbank S, Gürleyen H, Gibis N, Bastian A. Comparison of Ultrasound Measurements for Diaphragmatic Mobility, Diaphragmatic Thickness, and Diaphragm Thickening Fraction with Each Other and with Lung Function in Patients with Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2022; 17:2217-2227. [PMID: 36118281 PMCID: PMC9480595 DOI: 10.2147/copd.s375956] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/22/2022] [Indexed: 12/04/2022] Open
Abstract
Purpose To compare ultrasound measurements of diaphragmatic mobility, diaphragm thickness, and diaphragm thickening fraction with one another and also with lung function parameters in patients with chronic obstructive pulmonary disease (COPD). Patients and Methods We conducted a prospective, observational study from 2015 to 2018. A total of 140 patients were randomly selected for this study. Diaphragmatic thickness was measured at deep expiration and deep inspiration with a linear 10-MHz ultrasound probe. Diaphragm thickening fraction was calculated as the ratio between diaphragm thickness at deep inspiration and end expiratory diaphragm thickness. Diaphragmatic mobility was measured with a 3.5-MHz curved probe. Forced expiratory volume in one second (FEV1), residual lung volume, Pimax, and P0.1max were also measured. Sonographic results were compared to FEV1 and other lung function parameters. Results There was a significant positive correlation between diaphragmatic mobility and the following measurements: FEV1 (P < 0.01), diaphragm thickening fraction (P = 0.013), and lung function parameters reflecting ventilatory muscle strength such as Pimax (P < 0.017) and P0.1/Pimax (P < 0.01). There was a significant negative correlation between diaphragmatic mobility and both residual volume (P < 0.01) and diaphragmatic thickness (P = 0.022). In contrast, there was no correlation between diaphragmatic thickness and FEV1, Pimax, and P0.1/Pimax. Diaphragm thickening fraction had a significant correlation with FEV1 (P = 0.041). Conclusion In patients with COPD, diaphragm mobility measured sonographically correlates with different lung function parameters and also with sonographically measured diaphragm thickness (negative correlation) and diaphragm thickening fraction (positive correlation).
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Affiliation(s)
- Alina Schulz
- Marienkrankenhaus Kassel, Kassel, 34127, Germany
| | | | - Mariya Boyko
- Marienkrankenhaus Kassel, Kassel, 34127, Germany
| | | | | | - Natalie Gibis
- Marienkrankenhaus Kassel, Kassel, 34127, Germany.,Rehaklinik Enns GmbH, Enns, 4470, Austria
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13
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Schulz A. Green methanol, part of Uhde's green technologies. CHEM-ING-TECH 2022. [DOI: 10.1002/cite.202255339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A. Schulz
- thyssenkrupp Industrial Solutions AG Friedrich-Uhde-Str. 2 65812 Bad Soden/Ts Germany
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14
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Legenbauer T, Baldus C, Mokros L, Kretzschmar L, Schulz A, Herdering R, Huhn C, Kaffke L, Schiller S, Daubmann A, Zapf A, Holtmann M, Arnaud N, Thomasius R. Ergebnisse eines achtsamkeitsbasierten Gruppentherapieprogramms zur
Behandlung von Jugendlichen mit Abhängigkeitserkrankungen (IMAC-Mind
Teilprojekt 7). Suchttherapie 2022. [DOI: 10.1055/s-0042-1755981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Affiliation(s)
- T Legenbauer
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - C Baldus
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters,
Hamburg
| | - L Mokros
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - L Kretzschmar
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - A Schulz
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters,
Hamburg
| | - R Herdering
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - C Huhn
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - L Kaffke
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - S Schiller
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters,
Hamburg
| | - A Daubmann
- Institut für Medizinische Biometrie und Epidemiologie,
Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - A Zapf
- Institut für Medizinische Biometrie und Epidemiologie,
Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - M Holtmann
- LWL Universitätsklinikum Hamm der Ruhr-Universität
Bochum, Klinik für Kinder- und Jugendpsychiatrie, Psychotherapie und
Psychosomatik, Hamm
| | - N Arnaud
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters,
Hamburg
| | - R Thomasius
- Deutsches Zentrum für Suchtfragen des Kindes- und Jugendalters,
Hamburg
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15
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Riechmann-Wolf M, Hegewald J, Jankowiak S, Prigge M, Rossnagel K, Drössler S, Nübling M, Romero Starke K, Seidler A, Schulz A, Zahn D, Münzel T, Pfeiffer N, Wild PS, Beutel ME, Gianicolo E, Lackner KJ, Letzel S. Fühlen sich Beschäftigte bei ihrer beruflichen
Rückkehr nach längerer Arbeitsunfähigkeit von ihrem
Arbeitgeber unterstützt? Welche Rolle spielt die
Unternehmensgröße? Ergebnisse aus einer Pilotbefragung innerhalb
der Gutenberg-Gesundheitsstudie. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- M Riechmann-Wolf
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Institut für Arbeits-, Sozial- und Umweltmedizin, Mainz,
Deutschland
| | - J Hegewald
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin,
Deutschland
| | - S Jankowiak
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin,
Deutschland
| | - M Prigge
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin,
Deutschland
| | - K Rossnagel
- Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, Berlin,
Deutschland
| | - S Drössler
- Technische Universität Dresden Medizinische Fakultät,
Institut und Poliklinik für Arbeits- und Sozialmedizin (IPAS), Dresden,
Deutschland
| | - M Nübling
- Freiburger Forschungsstelle für Arbeitswissenschaften GmbH
(FFAW), Freiburg, Deutschland
| | - K Romero Starke
- Technische Universität Dresden Medizinische Fakultät,
Institut und Poliklinik für Arbeits- und Sozialmedizin (IPAS), Dresden,
Deutschland
| | - A Seidler
- Technische Universität Dresden Medizinische Fakultät,
Institut und Poliklinik für Arbeits- und Sozialmedizin (IPAS), Dresden,
Deutschland
| | - A Schulz
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - D Zahn
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - T Münzel
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - N Pfeiffer
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - PS Wild
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - ME Beutel
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - E Gianicolo
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - KJ Lackner
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Mainz, Deutschland
| | - S Letzel
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Institut für Arbeits-, Sozial- und Umweltmedizin, Mainz,
Deutschland
- UNIVERSITÄTSMEDIZIN der Johannes Gutenberg-Universität
Mainz, Präv. Kardiologie und Med. Prävention, Zentrum
für Kardiologie, Mainz, Deutschland
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Vienot A, Vernerey D, Bouard A, Klajer E, Asgarov K, Kim S, Tournigand C, Louvet C, André T, Rousseau B, Wespiser M, Wang Y, Schulz A, Dochy E, Borg C. SO-20 Stanniocalcin 1 (STC1) in patients with refractory colorectal cancer (CRC) treated with regorafenib: An exploratory analysis of the CORRECT trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Prochaska J, Arnold N, Falcke A, Kopp S, Schulz A, Buch G, Moll S, Panova-Noeva M, Jünger C, Eggebrecht L, Pfeiffer N, Beutel M, Binder H, Grabbe S, Lackner K, Ten Cate-Hoek A, Espinola-Klein C, Münzel T, Wild P. Chronic Venous Insufficiency, Cardiovascular Disease, and Mortality: A Population Study. J Vasc Surg Venous Lymphat Disord 2022. [DOI: 10.1016/j.jvsv.2022.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Moreno V, Lin J, Tan D, Lassen U, Leyvraz S, Liu Y, Patel J, Rosen L, Solomon B, Rudolph M, Norenberg R, Schulz A, Fellous M, Brega N, Shen L, Kummar S, Drilon A. 61P Updated efficacy and ctDNA analysis of patients with TRK fusion lung cancer treated with larotrectinib. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Hauck F, Albert MH, Ghosh S, Hönig M, Nennstiel U, Schütz C, Gramer G, Schulz A, Speckmann C. Neugeborenenscreening auf schweren kombinierten Immundefekt. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01426-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Buck F, Wiegers K, Schulz A, Schiestel T. Effect of plasma atmosphere on the oxygen transport of mixed ionic and electronic conducting hollow fiber membranes. J IND ENG CHEM 2021. [DOI: 10.1016/j.jiec.2021.08.044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Heidorn M, Mueller F, Schuch A, Buch G, Velmeden D, Soehne J, Troebs S, Schulz A, Strauch K, Schmidtmann I, Lackner K, Gori T, Muenzel T, Wild P, Prochaska J. Patterns of pulmonary function and mortality in chronic heart failure, results from the MyoVasc study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Preclinical evidence suggests that pulmonary fibrosis due to left heart disease may represent end-organ damage in heart failure (HF). Vice versa, decreased pulmonary function is related to worsening of heart failure in the absence of obstructive airway pattern.
Purpose
This study investigated the relationship between patterns of pulmonary function (i.e. obstruction and restriction) and mortality in chronic HF.
Methods
For the present analysis data from the MyoVasc-study (N=3,289) were analysed. During a five-hour examination in the dedicated study center, systematic phenotyping was performed in a highly standardized setting. Chronic HF was defined as American Heart Association HF Stage C/D. Information on pulmonary function was assessed via body plethysmography (MasterScreen Body, Carefusion, Germany). Participants with forced expiratory ratio <0.7 or COPD were categorized as obstructive, while restriction was defined as reduction in total lung capacity. Information on vital status was obtained via registration offices.
Results
The analysis sample comprised 1,509 individuals with chronic heart failure and information on pulmonary function, of whom 286 had HF with reduced ejection fraction (HFrEF), 559 HF with preserved ejection fraction (HFpEF), and 333 HFpEFborderline. The mean age was 64.6±11.3 years, 38.7% were female. In the sample 124 subjects had pulmonary restriction and 400 individuals had an obstruction. During a median time to follow up of 3.70 (inter quartile range 1.25 to 4.00) years, death occurred in 170 individuals. Among clusters of pulmonary function most participants died in the restriction group (25.0%), followed by pulmonary obstruction (12.2%) and normal pulmonary function (7.3%, P for trend <0.001). Cox- regression analysis adjusted for age, sex and height revealed pulmonary restriction (hazard ratio (HR) 3.00 [95% confidence interval 2.04–4.42], P<0.001] and obstruction (HR 1.61 [1.11–2.35], P=0.01) as predictors of all-cause death. After additional controlling for traditional cardiovascular risk factors and the clinical profile only pulmonary restriction remained an independent predictor of mortality (HRrestriction 2.12 [1.50–3.43]; P=0.002; HRobstruction 1.35 [0.91–2.00]; P=0.10). Among HF phenotypes obstruction was only in individuals with HFpEF an independent predictor of all-cause death (HRHFpEF 2.60 [1.29–5.23]; P=0.007; HRHFpEFborderline 1.58 [0.70–3.57]; P=0.27; HRHFrEF 0.96 [0.52–1.78]; P=0.90), while pulmonary restriction was found to be predictive for death only in subjects with HFpEFborderline (HRHFpEF 2.15 [0.70–6.64]; P=0.18; HRHFpEFborderline: HR 5.47 [2.56–11.68]; P<0.001; HRHFrEF 1.74 [0.88–3.46]; P=0.11)
Conclusion
In chronic heart failure, pulmonary restriction was a stronger predictor of mortality than obstructive airway pattern. The present analysis supports the hypothesis of pulmonary fibrosis as end-organ damage in HF, and may potentially represent a therapeutic target.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): German Center for Cardiovascular Research (DZHK)
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Affiliation(s)
- M Heidorn
- University Medical Center Mainz, Mainz, Germany
| | - F Mueller
- University Medical Center Mainz, Mainz, Germany
| | - A Schuch
- University Medical Center Mainz, Mainz, Germany
| | - G Buch
- University Medical Center Mainz, Mainz, Germany
| | - D Velmeden
- University Medical Center Mainz, Mainz, Germany
| | - J Soehne
- University Medical Center Mainz, Mainz, Germany
| | - S.O Troebs
- University Medical Center Mainz, Mainz, Germany
| | - A Schulz
- University Medical Center Mainz, Mainz, Germany
| | - K Strauch
- University Medical Center Mainz, Mainz, Germany
| | | | - K.J Lackner
- University Medical Center Mainz, Mainz, Germany
| | - T Gori
- University Medical Center Mainz, Mainz, Germany
| | - T Muenzel
- University Medical Center Mainz, Mainz, Germany
| | - P.S Wild
- University Medical Center Mainz, Mainz, Germany
| | - J Prochaska
- University Medical Center Mainz, Mainz, Germany
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Efentakis P, Molitor M, Kossmann S, Bochenek M, Wild J, Lagrange J, Finger S, Jung R, Karbach S, Schaefer K, Schulz A, Wild P, Muenzel T, Wenzel P. Tubulin-folding cofactor E deficiency is associated with vascular dysfunction and endoplasmatic reticulum stress of vascular smooth muscle cells. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Endothelial function assessed via flow mediated dilatation (FMD) has shown to predict risk in individuals with established cardiovascular diseases, whereas its predictive value is uncertain in the setting primary prevention.
Purpose
The aim of the current work was to discover and evaluate novel mediators of vascular dysfunction in the general population and in conditional knock-out transgenic animal models.
Methods
In order to identify novel targets that were negatively correlated with FMD and investigate their contribution in vascular function, a Genome Wide Association Study (GWAS) of 5,000 participants was performed and subsequently immune cell-, endothelial- and vascular smooth muscle cell (VSMCs)-targeted conditional knockout mouse models were generated and characterized.
Results
GWAS analysis revealed that single nucleotide polymorphisms (SNPs) in the tubulin folding cofactor E (TBCE) gene were negatively correlated with FMD and TBCE expression in the peripheral blood mononuclear cells (PBMCs). Myelomonocytic cell-targeted TBCE deficiency did not lead to any vascular dysfunction in vivo in the LysM+Cre+/−TBCEfl/fl mice. Endothelial-targeted TBCE deficiency led to an NLR family pyrin domain containing 3 (NLRP3)-dependent activation of the inflammasome in the endothelial cells of Tie2-ERT2Cre+/−TBCEfl/fl mice. Importantly, VSMC-targeted TBCE deficiency was associated with endothelial dysfunction, increased aortic wall thickness and endoplasmatic reticulum (ER) stress-mediated VSMC hyperproliferation in vivo (SMMHC-ERT2Cre+/−TBCEfl/fl), paralleled by calnexin upregulation. Administration of the blood pressure hormone angiotensin II exacerbated the vascular dysfunction and phenotype. Administration of the ER stress modulator tauroursodeoxycholic acid to the SMMHC-ERT2Cre+/−TBCEfl/fl mice reversed vascular dysfunction, paralleled by induction of Raptor/Beclin-1-dependent autophagy both in vitro and in vivo.
Conclusion
TBCE and tubulin homeostasis in the vascular musculature seem to be novel markers of vascular function and represent a new druggable target for the treatment of ER-stress-mediated vascular dysfunction.
Funding Acknowledgement
Type of funding sources: Foundation. Main funding source(s): This work was supported by grants of the German Federal Ministry for Education and Research (BMBF01EO1003 and BMBF01EO1503), the DFG Major Research Instrumentation Programme (DFG INST 371/47-1 FUGG) as well as the Boehringer Ingelheim Foundation. PW received funds from the German Research Foundation in support of his work (DFG WE4361-4-1 and WE 4361/7-1). KS, TM and PW are PIs of the DZHK.
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Affiliation(s)
- P Efentakis
- National & Kapodistrian University of Athens, Pharmacy, Athens, Greece
| | - M Molitor
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
| | - S Kossmann
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
| | - M Bochenek
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
| | - J Wild
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
| | - J Lagrange
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
| | - S Finger
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
| | - R Jung
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
| | - S Karbach
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
| | - K Schaefer
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
| | - A Schulz
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
| | - P Wild
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
| | - T Muenzel
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
| | - P Wenzel
- Johannes Gutenberg University Mainz (JGU), Department of Cardiology, Mainz, Germany
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Goebel S, Wingerter A, Prochaska JH, Schulz A, Neu MA, Henninger N, Spix C, Beutel M, Lackner KJ, Muenzel T, Lam C, Merzenich H, Faber J, Wild PS. Development of heart failure in long-term survivors of childhood cancer: results from the cvss study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Long-term survivors of childhood cancer (CCS) are at increased risk for cardiovascular sequelae, including heart failure (HF) as the largest non-malignant contributor to excess death. Yet, little is known about the risk factors, mechanisms of cardiac dysfunction and prevalence of different stages of HF in these patients.
Purpose
To investigate the development and prevalence of HF phenotypes in CCS compared to the general population.
Methods
The CVSS study is a prospective single-center cohort study investigating cardiovascular sequelae of CCS. Patients were eligible for the study when they were diagnosed with a neoplasia according to the International Classification of Childhood Cancer (ICCC 3) at an age prior to 15 years between 1980 and 1990, survived more than five years after initial cancer diagnosis and received antineoplastic treatment. Between 2013 and 2016, study individuals underwent a comprehensive, standardized clinical investigation in the CVSS cohort study including echocardiographic examination. HF was categorized as stages A to D according to current HF guidelines of the American Heart Association (AHA). A population-based sample free of cancer (age- and sex matched) serves as control group.
Results
From 1,002 individuals, all CCS with history of chemo- or radiotherapy and no subsequent neoplasia (n=877) were included (mean age 34.2 (±5.5) years, 44.7% (N=392) female). Age at diagnosis was 6.28 years (±4.24) and the mean interval from the date of diagnosis of cancer to the date of completion of baseline examination 28.5±3.2 years. Based on echocardiographic examination, clinical data and biomarker assessment, 26.6% of CCS were diagnosed with HF stage A, 21.1% with HF stage B and 2.1% with symptomatic HF, i.e. HF stage C/D. Importantly, prevalence of different HF stages varied strongly by specific tumor history. Compared to the population, the prevalence ratio (PR) was 1.16 [95% confidence interval 1.02/1.31] for stage A HF and 1.91 [1.63/2.23] for the composite of stage B to D HF in an age- and sex-adjusted Poisson regression model. Multivariable linear regression with the systolic marker left ventricular ejection fraction as dependent variable and adjustment for tumor entities, age, sex, and cardiovascular risk factors (CVRF) revealed a lower EF in patients with history of bone tumors (β −6.0 [−8.1/−3.0]), soft tissue sarcoma (β −2.2 [−4.1/−0.35]), leukemia (β −0.84 [−1.8/0.08]) and renal tumors (β −1.8 [−4.0/0.27]) compared to the population. In contrast, the same model for the diastolic marker E/E', showed an association only with CVRF, but not with tumor entities.
Conclusion
The prevalence of stage B to D HF was significantly higher among long-term CCS in the 3rd to 5th age decade compared to the population and varied strongly by tumor entity. Systolic dysfunction was primarily associated with history of tumor entities, whereas diastolic dysfunction was associated with the higher burden of CVRF in CCS.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This study is funded by the Deutsche Forschungsgemeinschaft (DFG) (SP 1381/2-1&2, FA 1038/2-1&2, WI 3881/2-1&2)
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Affiliation(s)
- S Goebel
- University Medical Center Mainz, Department of Cardiology, Mainz, Germany
| | - A Wingerter
- University Medical Center Mainz, Department of Pediatric Hematology and Oncology, Mainz, Germany
| | - J H Prochaska
- University Medical Center Mainz, Preventive Cardiology and Preventive Medicine, Mainz, Germany
| | - A Schulz
- University Medical Center Mainz, Preventive Cardiology and Preventive Medicine, Mainz, Germany
| | - M A Neu
- University Medical Center Mainz, Department of Pediatric Hematology and Oncology, Mainz, Germany
| | - N Henninger
- University Medical Center Mainz, Department of Pediatric Hematology and Oncology, Mainz, Germany
| | - C Spix
- University Medical Center Mainz, Institute for medical biostatistics, epidemiology and informatics, Mainz, Germany
| | - M Beutel
- University Medical Center Mainz, Clinic for Psychosomatic Medicine and Psychotherapy, Mainz, Germany
| | - K J Lackner
- University Medical Center Mainz, Institute of Clinical Chemistry and Laboratory Medicine, Mainz, Germany
| | - T Muenzel
- University Medical Center Mainz, Department of Cardiology, Mainz, Germany
| | - C Lam
- National University of Singapore, National Heart Center, Singapore, Singapore
| | - H Merzenich
- University Medical Center Mainz, Institute for medical biostatistics, epidemiology and informatics, Mainz, Germany
| | - J Faber
- University Medical Center Mainz, Department of Pediatric Hematology and Oncology, Mainz, Germany
| | - P S Wild
- University Medical Center Mainz, Preventive Cardiology and Preventive Medicine, Mainz, Germany
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Schulz A, Methling K, Lalk M, Eisenbarth A, Keller M, Groschup MH. Ethanol inactivation of orthonairoviruses in ixodid ticks. Exp Appl Acarol 2021; 85:75-81. [PMID: 34542738 PMCID: PMC8486713 DOI: 10.1007/s10493-021-00656-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 09/01/2021] [Indexed: 06/13/2023]
Abstract
Ixodid ticks represent vectors and reservoirs for a broad range of zoonotic pathogens. Collected ticks from field studies are therefore usually stored in ethanol, which in higher concentrations effectively inactivates most of the known tick-borne pathogens. Although commonly practiced as gold standard for inactivation, hardly any scientific data demonstrate that ethanol sufficiently penetrates the comparatively thick cuticula of ticks. Therefore, Amblyomma hebraeum tick pools were stored for 21 days in ethanol (96%). Afterwards, the ethanol was removed and the ticks were homogenized. Quantitative 1H-NMR spectroscopic analysis was applied to determine the residual concentration of ethanol inside the ticks. 1H-NMR spectroscopic analysis revealed that ethanol constituted 28.3-42.6 mg of the total weight of three ticks in the pools (89.9-121.5 mg). In addition, the low-pathogenic Hazara orthonairovirus (HAZV) was used as a cell culture model for this study. The virus was exposed to ethanol concentrations between 0 and 60% and incubated under various temperature conditions for four time periods. Afterwards, the residual virus infectivity was determined by titration. Following ethanol exposure, HAZV did not grow in cells after 9 h of exposure to an ethanol concentration of 25%. These results demonstrate an extremely low ethanol resistance of the virus, which was generally in line with previously reported ethanol inactivation data for Crimean-Congo hemorrhagic fever orthonairovirus (CCHFV). After prolonged storage and impregnation, comparable ethanol concentrations are achieved in the ticks, indicating the suitability of this inactivation method also for Bunyaviruses in ticks. At the very least, a massive virus inactivation can be assumed. Definitive proof of virus inactivation would require a bioassay of ethanol-treated infected ticks under appropriate biosafety conditions.
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Affiliation(s)
- A Schulz
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - K Methling
- Institute of Biochemistry, University of Greifswald, Felix-Hausdorff-Straße 4, 17489, Greifswald, Germany
| | - M Lalk
- Institute of Biochemistry, University of Greifswald, Felix-Hausdorff-Straße 4, 17489, Greifswald, Germany
| | - A Eisenbarth
- Bundeswehrkrankenhaus Hamburg, Abt. XXI, Außenstelle BNITM, Bernhard-Nocht-Str. 74, 20359, Hamburg, Germany
| | - M Keller
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - M H Groschup
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Südufer 10, 17493, Greifswald-Insel Riems, Germany.
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Wirtz M, Brandstetter S, Pawellek M, Dresch C, Schulz A. Measurement of parental competencies in early childhood allergy prevention. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- M Wirtz
- Pädagogische Hochschule Freiburg, Forschungsmethoden
| | - S Brandstetter
- Universität Regensburg, University Children‘s Hospital Regensburg (KUNO)
| | - M Pawellek
- Universität Regensburg, University Children‘s Hospital Regensburg (KUNO)
| | - C Dresch
- Pädagogische Hochschule Freiburg, Forschungsmethoden
| | - A Schulz
- Pädagogische Hochschule Freiburg, Forschungsmethoden
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Schulz A, Lunkenheimer P, Loidl A. Lithium-salt-based deep eutectic solvents: Importance of glass formation and rotation-translation coupling for the ionic charge transport. J Chem Phys 2021; 155:044503. [PMID: 34340372 DOI: 10.1063/5.0055493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Lithium-salt-based deep eutectic solvents, where the only cation is Li+, are promising candidates as electrolytes in electrochemical energy-storage devices, such as batteries. We have performed broadband dielectric spectroscopy on three such systems, covering a broad temperature and dynamic range that extends from the low-viscosity liquid around room temperature down to the glassy state approaching the glass-transition temperature. We detect a relaxational process that can be ascribed to dipolar reorientational dynamics and exhibits the clear signatures of glassy freezing. We find that the temperature dependence of the ionic dc conductivity and its room-temperature value also are governed by the glassy dynamics of these systems, depending, e.g., on the glass-transition temperature and fragility. Compared to the previously investigated corresponding systems, containing choline chloride instead of a lithium salt, both the reorientational and ionic dynamics are significantly reduced due to variations in the glass-transition temperature and the higher ionic potential of the lithium ions. These lithium-based deep eutectic solvents partly exhibit significant decoupling of the dipolar reorientational and the ionic translational dynamics and approximately follow a fractional Debye-Stokes-Einstein relation, leading to an enhancement of the dc conductivity, especially at low temperatures. The presented results clearly reveal the importance of decoupling effects and of the typical glass-forming properties of these systems for the technically relevant room-temperature conductivity.
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Affiliation(s)
- A Schulz
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86135 Augsburg, Germany
| | - P Lunkenheimer
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86135 Augsburg, Germany
| | - A Loidl
- Experimental Physics V, Center for Electronic Correlations and Magnetism, University of Augsburg, 86135 Augsburg, Germany
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Schulz A, Barry Y, Stoek F, Pickin MJ, Ba A, Chitimia-Dobler L, Haki ML, Doumbia BA, Eisenbarth A, Diambar A, Bah MY, Eiden M, Groschup MH. Detection of Crimean-Congo hemorrhagic fever virus in blood-fed Hyalomma ticks collected from Mauritanian livestock. Parasit Vectors 2021; 14:342. [PMID: 34187526 PMCID: PMC8244218 DOI: 10.1186/s13071-021-04819-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 06/02/2021] [Indexed: 11/11/2022] Open
Abstract
Background Crimean-Congo hemorrhagic fever virus (CCHFV) belongs to the genus Orthonairovirus (Nairovididae) and is a (re)emerging tick-borne pathogen. It is endemic in most parts of Africa, Asia and southern Europe, and can cause severe hemorrhagic symptoms in humans, with high fatality rates (5–30%). Methods Hyalomma ticks were collected from four different livestock herds (cattle and camels) in Mauritania in 2018. The tick species were determined morphologically and confirmed molecularly by using the cytochrome oxidase 1 gene marker. For the detection of CCHFV, ticks were tested individually by one-step multiplex real-time reverse-transcriptase quantitative polymerase chain reaction. The small segment of all positive samples was sequenced to determine the CCHFV genotype. Results In total, 39 of the 1523 ticks (2.56%) collected from 63 cattles and 28 camels tested positive for CCHFV. Three Hyalomma species were identified. Hyalomma rufipes had the largest proportion of positivity (5.67%; 16/282), followed by Hyalomma dromedarii (1.89%; 23/1214). No Hyalomma impeltatum tested positive (0%; 0/21). Positive ticks were found in only six out of 91 host animals. Viral sequence analysis revealed the presence of two different CCHFV lineages (Africa I and Africa III). Conclusions In this study, 2.56% of Hyalomma ticks collected from camels and cattle in Mauritania tested positive for CCHFV. However, the true prevalence of CCHFV in unfed ticks may be lower, as a considerable number of ticks may have been passively infected during blood-feeding by co-feeding ticks or due to viremia of the host. The results indicate the need to track the actual area of circulation of this virus. Graphic Abstract Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04819-x.
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Affiliation(s)
- A Schulz
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - Y Barry
- Office National de Recherches et de Développement de l'Elevage (ONARDEL), Nouakchott, Mauritania
| | - F Stoek
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - M J Pickin
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - A Ba
- Office National de Recherches et de Développement de l'Elevage (ONARDEL), Nouakchott, Mauritania
| | - L Chitimia-Dobler
- Bundeswehr Institute of Microbiology, Neuherbergstrasse 11, 80937, Munich, Germany
| | - M L Haki
- Office National de Recherches et de Développement de l'Elevage (ONARDEL), Nouakchott, Mauritania
| | - B A Doumbia
- Ministère du Développement Rural, Nouakchott, Mauritania
| | - A Eisenbarth
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - A Diambar
- Office National de Recherches et de Développement de l'Elevage (ONARDEL), Nouakchott, Mauritania
| | - M Y Bah
- Ministère du Développement Rural, Nouakchott, Mauritania
| | - M Eiden
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald-Insel Riems, Germany
| | - M H Groschup
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17493, Greifswald-Insel Riems, Germany.
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Panova-Noeva M, Schulz A, Köck T, ten Cate V, Wagner B, Rapp S, Lenz M, Zink A, Ghadessi M, Konstantinides S, ten Cate H, Heitmeier S, Wild P. OC-09 Proteomic profiling in cancer-associated VTE. Thromb Res 2021. [DOI: 10.1016/s0049-3848(21)00151-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schulz A, Fuchs P, Heitzmann W, Kanho C, Schiefer J. Our Initial Experience In The Customized Treatment Of Donor Site And Burn Wounds With A New Nanofibrous Temporary Epidermal Layer. Ann Burns Fire Disasters 2021; 34:58-66. [PMID: 34054388 PMCID: PMC8126369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 08/11/2020] [Indexed: 06/12/2023]
Abstract
Recently, electrospinning technology has gained increasing attention for wound care. SpinCare™ electrospun polymer nanofibrous temporary epidermal layer is one of the latest developments in the market. Our objective was to explore the potential use of the new SpinCare™ system for treating burns and wounds. We conducted a single-center prospective observational trial, treating 10 patients with superficial to partial thickness wounds including burn wounds with a nanofibrous dressing. Treatment was evaluated, including procedures, place of injury, treatment times, ease of use etc. Ten superficial to deep dermal wounds were treated successfully. Inexperienced users learned the handling of the device quickly. Covering difficult-to-access wound surfaces was challenging. One leading problem is that the product is nearly opaque once applied on the moist wound. We introduced a standardized 3-day treatment protocol. After application, wounds were covered with a silicon layer for 2 days. The nanofibrous dressing appeared to be suitable following enzymatic debridement in burn wounds. Because there is a risk of wounds drying out under the dressing, the application should probably be limited to superficial and partial thickness wounds if not combined with other treatment options. The electrospun polymer nanofibrous temporary epidermal layer shows promising results in the treatment of superficial to partial thickness wounds including burns. However, minor improvements might help to optimize its usage and thus take full advantage of all existing treatment options.
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Affiliation(s)
- A. Schulz
- Alexandra Schulz MD
Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC)Ostmerheimer Strasse 200, 51109 CologneGermany+49 211 8907 3817+49 211 8907 8314;
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Schulz A, Schiefer J, Fuchs P, Kanho C, Nourah N, Heitzmann W. Does Platelet-Rich Fibrin Enhance Healing Of Burn Wounds? Our First Experiences And Main Pitfalls. Ann Burns Fire Disasters 2021; 34:42-52. [PMID: 34054386 PMCID: PMC8126367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 08/25/2020] [Indexed: 06/12/2023]
Abstract
Recent research found that enzymatic debridement clearly improves long-term scarring in burns. By reducing the spontaneous wound-healing period, scarring might be optimized. The latest publications show that wound healing can be accelerated by the application of platelet-rich fibrin (PRF). However to date no study that evaluates PRF treatment in burn wounds following enzymatic debridement has been published. We conducted a single-center prospective observational trial treating ten patients with partial thickness to deep dermal burns after enzymatic debridement with PRF. After wound treatment, the dressing remained untouched for five days. For wound healing, we compared different dressings and treatment options. Minimum pain and no signs of infection were observed during any of the treatments. Physicians were able to learn the manufacture of PRF quickly. For two early treatments, skin grafting was required. In one case, the dressing was removed too early. In a second case, the wait for spontaneous wound healing was not long enough. After a standardized treatment procedure was set, we found that results were clearly improving. Mean healing time of seven wounds treated with Suprathel® dressing was 18 days (min 9 days, max 21 days). PRF application might be useful to reduce healing time in partial thickness to deep dermal burn wounds that heal spontaneously after enzymatic debridement. Thus, scarring can be improved.
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Affiliation(s)
- A. Schulz
- Alexandra Schulz MD
Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC)Ostmerheimer Strasse 200, 51109 CologneGermany+49 211 8907 3817+49 211 8907 8314
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Daniels M, Becker M, Lefering R, Fuchs P, Demir E, Schulz A, Perbix W, Grigutsch D, Schiefer J. Influence Of Pre-Existing Neurological Illnesses On The Outcome Of Severe Burn Injuries. Ann Burns Fire Disasters 2021; 34:26-32. [PMID: 34054384 PMCID: PMC8126361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 08/31/2020] [Indexed: 06/12/2023]
Abstract
It is known that patients suffering from neurological illnesses have an increased risk of burn injuries. These burns are often very severe and lead to poor outcomes. To date, only a few studies have evaluated the impact of pre-existing neurological illnesses on the outcome of burn injuries. None of them performed a regression analysis regarding specific influence on mortality. Between 1996 and 2016, 1475 patients were admitted to the BICU of a specialized German burn center: 26 had less than 1% TBSA burned and were excluded; 177 had pre-existing neurological disorders (group N). 87 patients with psychological disorders were excluded. 1185 patients without neurological or psychological disorders formed the control group. Length of hospital stay, TBSA and number of operations were analyzed using the chi-squared test and Mann-Whitney U-test. Additionally, mortality was evaluated using the logistic regression analysis adjusted for known outcome predictors. Mean age of the patients in the control group was 41.53 years with a BICU stay of 18 days, TBSA of 18.25% and mortality rate of 12.4%; 23.7% had inhalation injuries. Patients in group N had a mean age of 54.63 years, a BICU stay of 27 days, mean TBSA of 20.97%; 31.1% had inhalation injuries and mortality was 20.3%. Patients with neurological disorders were older and showed higher affected TBSA, higher rates of inhalation injury, mortality and affected TBSA, and a longer stay in the BICU compared to the control group. Nevertheless, pre-existing neurological disorders alone had no significant influence on mortality.
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Affiliation(s)
- M. Daniels
- Clinic of Plastic, Reconstructive, Hand and Burn Surgery, Hospital Cologne Merheim, University of Witten-Herdecke, Germany
| | - M. Becker
- Clinic of Plastic, Reconstructive, Hand and Burn Surgery, Hospital Cologne Merheim, University of Witten-Herdecke, Germany
| | - R. Lefering
- Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne, Germany
| | - P.C. Fuchs
- Clinic of Plastic, Reconstructive, Hand and Burn Surgery, Hospital Cologne Merheim, University of Witten-Herdecke, Germany
| | - E. Demir
- Clinic of Plastic, Reconstructive, Hand and Burn Surgery, Hospital Cologne Merheim, University of Witten-Herdecke, Germany
| | - A. Schulz
- Clinic of Plastic, Reconstructive, Hand and Burn Surgery, Hospital Cologne Merheim, University of Witten-Herdecke, Germany
| | - W. Perbix
- Clinic of Plastic, Reconstructive, Hand and Burn Surgery, Hospital Cologne Merheim, University of Witten-Herdecke, Germany
| | - D. Grigutsch
- Clinic of Anesthesiology, University Hospital Bonn, Germany
| | - J.L. Schiefer
- Clinic of Plastic, Reconstructive, Hand and Burn Surgery, Hospital Cologne Merheim, University of Witten-Herdecke, Germany
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Wirtz MA, Schulz A, Brähler E. Confirmatory and bi-factor analysis of the Short Form Health Survey 8 (SF-8) scale structure in a German general population sample. Health Qual Life Outcomes 2021; 19:73. [PMID: 33658031 PMCID: PMC7931558 DOI: 10.1186/s12955-021-01699-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The SF-8 is a short form of the SF-36 Health Survey, which is used for generic assessment of physical and mental aspects of health-related quality of life (HRQoL). Each of the 8 dimensions of the SF-36 is covered by a single item in the SF-8. The aim of the study was to examine the latent model structure of the SF-8. METHOD One-, two- and three dimensional as well as bi-factor structural models were defined and estimated adopting the ML- as well as the WLSMV-algorithm for ordinal data. The data were collected in a German general population sample (N = 2545 persons). RESULTS A two- (physical and mental health) and a three-dimensional CFA structure (in addition overall health) represent the empirical data information adequately [CFI = .987/.995; SRMR = .024/.014]. If a general factor is added, the resulting bi-factor models provide a further improvement in data fit [CFI = .999/.998; SRMR = .001]. The individual items are much more highly associated with the general HRQoL factor (loadings: .698 to .908) than with the factors physical, mental, and overall health (loadings: -.206 to .566). CONCLUSIONS In the SF-8, each item reflects mainly general HRQoL (general factor) as well as one of the three components physical, mental, and overall health. The findings suggest in particular that the evaluation of the information of the SF-8 items can be validly supplemented by a general value HRQoL.
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Affiliation(s)
- M A Wirtz
- Research Methods, Institute of Everyday Culture, Sports and Health, University of Education Freiburg, Kunzenweg 21, 79117, Freiburg, Germany.
| | - A Schulz
- Research Methods, Institute of Everyday Culture, Sports and Health, University of Education Freiburg, Kunzenweg 21, 79117, Freiburg, Germany
| | - E Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.,Clinic for Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Schiefer J, Perbix W, Grigutsch D, Ribitsch B, Fuchs P, Schulz A. Pre-Hospital Care Of Patients With Severe Burns In Germany: A Review Of 29 Years Of Experience. Ann Burns Fire Disasters 2020; 33:267-275. [PMID: 33708015 PMCID: PMC7894850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/05/2020] [Indexed: 06/12/2023]
Abstract
Despite the high number of burn injuries worldwide, pre-hospital care differs across regions. Data documenting pre-hospital care of severe burn injuries in Germany are scarce. Nevertheless, efficient prehospital care of burn patients is crucial for later outcomes. Therefore, we retrospectively analyzed pre-hospital care in patients admitted to the burn intensive care unit of a specialized burn center in Germany from 1989 to 2018. Approximately one-third of all admitted patients arrived intubated to the burn intensive care unit. Mean total burned surface area was higher in intubated patients than in non-intubated patients. Hypothermia prevention measures were undertaken in most patients. Although cooling was performed in only 36 primarily admitted patients, it did not have an effect on temperature at admission. Instead, in the regression analysis a positive influence on mortality could be found (p=0.03). Inhalation injury was a reason for intubation and corticosteroid therapy. Corticosteroid use declined over the years and had no significant influence on mortality (p=0.38). Inhalation injury could be diagnosed in only 50.68% of patients receiving corticosteroids. Furthermore, especially in recent years, most patients with inhalation injuries did not receive corticosteroids. Although efficient prehospital care is crucial for later outcomes, standard pre-hospital care through first aiders and emergency personnel has not been applied. Therefore, strategies for information exchange, leading to standardized pre-hospital treatment guidelines, should be given high priority with special attention on pre-hospital cooling. In the future, data from registries and surveys can help expand information regarding pre-hospital burn treatment.
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Affiliation(s)
- J.L. Schiefer
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany
| | - W. Perbix
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany
| | - D. Grigutsch
- Clinic of Anesthesiology, University Hospital Bonn, Germany
| | - B. Ribitsch
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany
| | - P.C. Fuchs
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany
| | - A. Schulz
- Clinic for Plastic and Hand Surgery, Burn Care Center, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), Cologne, Germany
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Schiefer JL, Lipensky A, Fuchs PC, Heitzmann W, Schulz A. Re: "Letter to the editor Joppich et al. which was a comment on our paper entitled "Patients' satisfaction with anesthesia in enzymatic debridement from a surgical perspective". Burns 2020; 47:1688-1690. [PMID: 33431286 DOI: 10.1016/j.burns.2020.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 11/19/2020] [Indexed: 11/25/2022]
Affiliation(s)
- J L Schiefer
- Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany
| | - A Lipensky
- Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany
| | - P C Fuchs
- Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany
| | - W Heitzmann
- Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany
| | - A Schulz
- Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany.
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Troebs S, Zitz A, Schwuchow-Thonke S, Schulz A, Heidorn M, Mueller F, Goebel S, Diestelmeier S, Lackner K, Gori T, Muenzel T, Prochaska J, Wild P. Global longitudinal strain predicts outcome in chronic heart failure across American Heart Association stages: results from the MyoVasc study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Global longitudinal strain (GLS) demonstrated a superior prognostic value over left ventricular ejection fraction (LVEF) in acute heart failure (HF). Its prognostic value across American Heart Association (AHA) stages of HF – especially under considering of conventional echocardiographic measures of systolic and diastolic function – has not yet been comprehensively evaluated.
Purpose
To evaluate the prognostic value of GLS for HF-specific outcome across AHA HF stages A to D.
Methods
Data from the MyoVasc-Study (n=3,289) were analysed. Comprehensive clinical phenotyping was performed during a five-hour investigation in a dedicated study centre. GLS was measured offline utilizing QLab 9.0.1 (PHILIPS, Germany) in participants presenting with sinus rhythm during echocardiography. Worsening of HF (comprising transition from asymptomatic to symptomatic HF, HF hospitalization, and cardiac death) was assessed during a structured follow-up with subsequent validation and adjudication of endpoints. AHA stages were defined according to current guidelines.
Results
Complete information on GLS was available in 2,400 participants of whom 2,186 categorized to AHA stage A to D were available for analysis. Overall, 434 individuals were classified as AHA stage A, 629 as stage B and 1,123 as stage C/D. Mean GLS increased across AHA stages of HF: it was lowest in stage A (−19.44±3.15%), −18.01±3.46% in stage B and highest in AHA stage C/D (−15.52±4.64%, P for trend <0.0001). During a follow-up period of 3.0 [1.3/4.0] years, GLS denoted an increased risk for worsening of HF after adjustment for age and sex (hazard ratio, HRGLS [per standard deviation (SD)] 1.97 [95% confidence interval 1.73/2.23], P<0.0001) in multivariable Cox regression analysis. After additional adjustment for cardiovascular risk factors, clinical profile, LVEF and E/E' ratio, GLS was the strongest echocardiographic predictor of worsening of HF (HRGLS [per SD] 1.47 [1.20/1.80], P=0.0002) in comparison to LVEF (HRLVEF [per SD] 1.23 [1.02/1.48], P=0.031) and E/E' ratio (HRE/E' [per SD] 1.12 [0.99/1.26], P=0.083). Interestingly, when stratifying for AHA stages, GLS denoted a similar increased risk for worsening of HF in individuals classified as AHA stage A/B (HRGLS [per SD] 1.63 [1.02/2.61], P=0.039) and in those classified as AHA stage C/D (HRGLS [per SD] 1.95 [1.65/2.29], P<0.0001) after adjustment for age and sex. For further evaluation, Cox regression models with interaction analysis indicated no significant interaction for (i) AHA stage A/B vs C/D (P=0.83) and (ii) NYHA functional class <II vs ≥II in individuals classified as AHA stage C/D (P=0.12).
Conclusions
GLS demonstrated a higher predictive value for worsening of HF than conventional echocardiographic measures of systolic and diastolic function. Interestingly, GLS indicated an increased risk for worsening of HF across AHA stages highlighting its potential value to advance risk prediction in chronic HF.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): German Center for Cardiovascular Research (DZHK), Center for Translational Vascular Biology (CTVB) of the University Medical Center of the Johannes Gutenberg-University Mainz
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Affiliation(s)
- S.O Troebs
- University Medical Center Mainz, Center for Cardiology, Cardiology I, Mainz, Germany
| | - A Zitz
- University Medical Center Mainz, Preventive Cardiology and Preventive Medicine, Centre for Cardiology, Mainz, Germany
| | - S Schwuchow-Thonke
- University Medical Center Mainz, Center for Cardiology, Cardiology I, Mainz, Germany
| | - A Schulz
- University Medical Center Mainz, Preventive Cardiology and Preventive Medicine, Centre for Cardiology, Mainz, Germany
| | - M.W Heidorn
- University Medical Center Mainz, Preventive Cardiology and Preventive Medicine, Centre for Cardiology, Mainz, Germany
| | - F Mueller
- University Medical Center Mainz, Center for Cardiology, Cardiology I, Mainz, Germany
| | - S Goebel
- University Medical Center Mainz, Center for Cardiology, Cardiology I, Mainz, Germany
| | - S Diestelmeier
- University Medical Center Mainz, Center for Cardiology, Cardiology I, Mainz, Germany
| | - K.J Lackner
- University Medical Center Mainz, Institute for Clinical Chemistry and Laboratory Medicine, Mainz, Germany
| | - T Gori
- University Medical Center Mainz, Center for Cardiology, Cardiology I, Mainz, Germany
| | - T Muenzel
- University Medical Center Mainz, Center for Cardiology, Cardiology I, Mainz, Germany
| | - J.H Prochaska
- University Medical Center Mainz, Preventive Cardiology and Preventive Medicine, Centre for Cardiology, Mainz, Germany
| | - P.S Wild
- University Medical Center Mainz, Preventive Cardiology and Preventive Medicine, Centre for Cardiology, Mainz, Germany
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Schmitt V, Remmert AM, Toebs SO, Schulz A, Leuschner A, Arnold N, Koeck T, Panova-Noeva M, Beutel M, Pfeiffer N, Strauch K, Lackner K, Munzel T, Prochaska J, Wild P. Disturbed glucose metabolism and left ventricular geometry in the general population – results from the Gutenberg health study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Prediabetes and type 2 diabetes mellitus (T2DM) have been demonstrated to alter left ventricular geometry and promote left ventricular (LV) hypertrophy (LVH). However, the impact of impaired glucose metabolism on cardiac structure is still not completely understood and controversially discussed.
Purpose
To investigate the impact of prediabetes and T2DM on left ventricular geometry and their potential interaction with LVH in the prediction of survival.
Methods
Data from the Gutenberg Health Study (N=15,010) – a population-based study with highly standardized phenotyping – were analysed. Information was obtained from computer-assisted personal interviews, medical-technical examinations, laboratory measurements in fasting state and echocardiography according to standard operating procedures with detailed quality control. Individuals with other types of diabetes or hyperinsulinemia were excluded from analysis. Study participants aged 35 to 74 years were categorized according to long-term glucose state (HbA1c) into euglycemia, prediabetes and T2DM. LV geometry was assessed according to current guideline recommendations. Multivariable regression analyses were performed to evaluate the association between glucose state and measures of left ventricular geometry. Survival analyses were carried out to assess the prognostic impact dependent on the presence of LVH.
Results
The analysis sample comprised 14,852 individuals aged 55.0±11.1 years (49.5% females). The prevalence of LVH was 10.2% (n=1,227) in euglycaemia, 17.2% in prediabetes and 23.8% in T2DM. Similarly, concentric and eccentric hypertrophy had the highest prevalence in T2DM (13.1% and 10.8%, respectively), followed by prediabetes (9.6% and 8.2%) and euglycaemia (5.7% and 4.5%). In multivariable regression analysis with adjustment for age, sex, traditional cardiovascular risk factors (CVRF), C-reactive protein and LV function, T2DM had a higher impact on relative wall thickness (β: 0.0135 [0.0087; 0.0182]; P<0.0001) and LV mass (β: 5.46 [4.89; 6.03]; P<0.0001) than prediabetes (β-estimaterelative wall thickness 0.00145 [−0.0031; 0.006]; P=0.53; β-estimateLV mass 2.73 [2.19; 3.28]; P<0.0001) compared to euglycemia. During a median follow-up of 9.0 [interquartile range 7.7; 10.4] years, prediabetes did not predict all-cause mortality independent of age, sex and CVRF in Cox regression analysis in individuals without LVH (hazard ratio (HR) 1.15 [0.90; 1.46]; P=0.27) or those with LVH (HR 1.46 [0.97; 2.18]; P=0.069). In comparison, T2DM was a strong and independent predictor of mortality both in absence (HR 1.59 [1.29; 1.96]; P<0.0001) and presence of LVH (HR 2.67 [1.94; 3.66]; P<0.0001).
Conclusions
Although cardiac geometry is altered both in presence of prediabetes and T2DM, only T2DM is a strong predictor of premature mortality in the general population. This merits consideration for future preventive strategies to decrease the burden of cardiovascular disease.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The study was supported by the Federal Ministry of Education and Research (BMBF), the government of Rheinland-Pfalz and the Center for Translational Vascular Biology (CTVB) of the Johannes Gutenberg-University of Mainz, Germany.
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Affiliation(s)
- V.H Schmitt
- University Medical Center of the Johannes Gutenberg University Mainz, Center for Cardiology – Cardiology I/ DZHK, Partner Site Rhine Main/ CTVB, Mainz, Germany
| | - A.-M Remmert
- University Medical Center of the Johannes Gutenberg University Mainz, Preventive Cardiology and Preventive Medicine - Center for Cardiology/ CTVB, Mainz, Germany
| | - S.-O Toebs
- University Medical Center of the Johannes Gutenberg University Mainz, Center for Cardiology – Cardiology I/ DZHK, Partner Site Rhine Main/ CTVB, Mainz, Germany
| | - A Schulz
- University Medical Center of the Johannes Gutenberg University Mainz, Preventive Cardiology and Preventive Medicine - Center for Cardiology/ CTVB, Mainz, Germany
| | - A Leuschner
- University Medical Center of the Johannes Gutenberg University Mainz, Center for Cardiology – Cardiology I/ DZHK, Partner Site Rhine Main/ CTVB, Mainz, Germany
| | - N Arnold
- University Medical Center of the Johannes Gutenberg University Mainz, Preventive Cardiology and Preventive Medicine - Center for Cardiology/ CTVB, Mainz, Germany
| | - T Koeck
- University Medical Center of the Johannes Gutenberg University Mainz, Preventive Cardiology and Preventive Medicine - Center for Cardiology/ CTVB, Mainz, Germany
| | - M Panova-Noeva
- University Medical Center of the Johannes Gutenberg University Mainz, Center for Thrombosis and Hemostasis (CTH)/DZHK Partner Site Rhine Main, Mainz, Germany
| | - M Beutel
- University Medical Center of the Johannes Gutenberg University Mainz, Department of Psychosomatic Medicine and Psychotherapy, Mainz, Germany
| | - N Pfeiffer
- University Medical Center of the Johannes Gutenberg University Mainz, Department of Ophthalmology, Mainz, Germany
| | - K Strauch
- University Medical Center of the Johannes Gutenberg University Mainz, Institute for Medical Biometrics, Epidemiology and Informatics (IMBEI), Mainz, Germany
| | - K.J Lackner
- University Medical Center of the Johannes Gutenberg University Mainz, Institute of Clinical Chemistry and Laboratory Medicine/DZHK Partner Site Rhine Main, Mainz, Germany
| | - T Munzel
- University Medical Center of the Johannes Gutenberg University Mainz, Center for Cardiology–Cardiology I/Center for Thrombosis and Hemostasis/DZHK Partner Site Rhine Main, Mainz, Germany
| | - J.H Prochaska
- University Medical Center of the Johannes Gutenberg University Mainz, Preventive Cardiology and Preventive Medicine/Center for Thrombosis and Hemostasis/DZHK Rhine Main, Mainz, Germany
| | - P.S Wild
- University Medical Center of the Johannes Gutenberg University Mainz, Preventive Cardiology and Preventive Medicine/Center for Thrombosis and Hemostasis/DZHK Rhine Main, Mainz, Germany
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Aab A, Abreu P, Aglietta M, Albury JM, Allekotte I, Almela A, Alvarez Castillo J, Alvarez-Muñiz J, Alves Batista R, Anastasi GA, Anchordoqui L, Andrada B, Andringa S, Aramo C, Araújo Ferreira PR, Asorey H, Assis P, Avila G, Badescu AM, Bakalova A, Balaceanu A, Barbato F, Barreira Luz RJ, Becker KH, Bellido JA, Berat C, Bertaina ME, Bertou X, Biermann PL, Bister T, Biteau J, Blanco A, Blazek J, Bleve C, Boháčová M, Boncioli D, Bonifazi C, Bonneau Arbeletche L, Borodai N, Botti AM, Brack J, Bretz T, Briechle FL, Buchholz P, Bueno A, Buitink S, Buscemi M, Caballero-Mora KS, Caccianiga L, Calcagni L, Cancio A, Canfora F, Caracas I, Carceller JM, Caruso R, Castellina A, Catalani F, Cataldi G, Cazon L, Cerda M, Chinellato JA, Choi K, Chudoba J, Chytka L, Clay RW, Cobos Cerutti AC, Colalillo R, Coleman A, Coluccia MR, Conceição R, Condorelli A, Consolati G, Contreras F, Convenga F, Covault CE, Dasso S, Daumiller K, Dawson BR, Day JA, de Almeida RM, de Jesús J, de Jong SJ, De Mauro G, de Mello Neto JRT, De Mitri I, de Oliveira J, de Oliveira Franco D, de Souza V, De Vito E, Debatin J, Del Río M, Deligny O, Dembinski H, Dhital N, Di Giulio C, Di Matteo A, Díaz Castro ML, Dobrigkeit C, D'Olivo JC, Dorosti Q, Dos Anjos RC, Dova MT, Ebr J, Engel R, Epicoco I, Erdmann M, Escobar CO, Etchegoyen A, Falcke H, Farmer J, Farrar G, Fauth AC, Fazzini N, Feldbusch F, Fenu F, Fick B, Figueira JM, Filipčič A, Fodran T, Freire MM, Fujii T, Fuster A, Galea C, Galelli C, García B, Garcia Vegas AL, Gemmeke H, Gesualdi F, Gherghel-Lascu A, Ghia PL, Giaccari U, Giammarchi M, Giller M, Glombitza J, Gobbi F, Gollan F, Golup G, Gómez Berisso M, Gómez Vitale PF, Gongora JP, González N, Goos I, Góra D, Gorgi A, Gottowik M, Grubb TD, Guarino F, Guedes GP, Guido E, Hahn S, Halliday R, Hampel MR, Hansen P, Harari D, Harvey VM, Haungs A, Hebbeker T, Heck D, Hill GC, Hojvat C, Hörandel JR, Horvath P, Hrabovský M, Huege T, Hulsman J, Insolia A, Isar PG, Johnsen JA, Jurysek J, Kääpä A, Kampert KH, Keilhauer B, Kemp J, Klages HO, Kleifges M, Kleinfeller J, Köpke M, Kukec Mezek G, Lago BL, LaHurd D, Lang RG, Leigui de Oliveira MA, Lenok V, Letessier-Selvon A, Lhenry-Yvon I, Lo Presti D, Lopes L, López R, Lorek R, Luce Q, Lucero A, Machado Payeras A, Malacari M, Mancarella G, Mandat D, Manning BC, Manshanden J, Mantsch P, Marafico S, Mariazzi AG, Mariş IC, Marsella G, Martello D, Martinez H, Martínez Bravo O, Mastrodicasa M, Mathes HJ, Matthews J, Matthiae G, Mayotte E, Mazur PO, Medina-Tanco G, Melo D, Menshikov A, Merenda KD, Michal S, Micheletti MI, Miramonti L, Mockler D, Mollerach S, Montanet F, Morello C, Mostafá M, Müller AL, Muller MA, Mulrey K, Mussa R, Muzio M, Namasaka WM, Nellen L, Nguyen PH, Niculescu-Oglinzanu M, Niechciol M, Nitz D, Nosek D, Novotny V, Nožka L, Nucita A, Núñez LA, Palatka M, Pallotta J, Panetta MP, Papenbreer P, Parente G, Parra A, Pech M, Pedreira F, Pȩkala J, Pelayo R, Peña-Rodriguez J, Perez Armand J, Perlin M, Perrone L, Peters C, Petrera S, Pierog T, Pimenta M, Pirronello V, Platino M, Pont B, Pothast M, Privitera P, Prouza M, Puyleart A, Querchfeld S, Rautenberg J, Ravignani D, Reininghaus M, Ridky J, Riehn F, Risse M, Ristori P, Rizi V, Rodrigues de Carvalho W, Rodriguez Fernandez G, Rodriguez Rojo J, Roncoroni MJ, Roth M, Roulet E, Rovero AC, Ruehl P, Saffi SJ, Saftoiu A, Salamida F, Salazar H, Salina G, Sanabria Gomez JD, Sánchez F, Santos EM, Santos E, Sarazin F, Sarmento R, Sarmiento-Cano C, Sato R, Savina P, Schäfer C, Scherini V, Schieler H, Schimassek M, Schimp M, Schlüter F, Schmidt D, Scholten O, Schovánek P, Schröder FG, Schröder S, Schulz A, Sciutto SJ, Scornavacche M, Shellard RC, Sigl G, Silli G, Sima O, Šmída R, Sommers P, Soriano JF, Souchard J, Squartini R, Stadelmaier M, Stanca D, Stanič S, Stasielak J, Stassi P, Streich A, Suárez-Durán M, Sudholz T, Suomijärvi T, Supanitsky AD, Šupík J, Szadkowski Z, Taboada A, Tapia A, Timmermans C, Tkachenko O, Tobiska P, Todero Peixoto CJ, Tomé B, Torralba Elipe G, Travaini A, Travnicek P, Trimarelli C, Trini M, Tueros M, Ulrich R, Unger M, Urban M, Vaclavek L, Vacula M, Valdés Galicia JF, Valiño I, Valore L, van Vliet A, Varela E, Vargas Cárdenas B, Vásquez-Ramírez A, Veberič D, Ventura C, Vergara Quispe ID, Verzi V, Vicha J, Villaseñor L, Vink J, Vorobiov S, Wahlberg H, Watson AA, Weber M, Weindl A, Wiencke L, Wilczyński H, Winchen T, Wirtz M, Wittkowski D, Wundheiler B, Yushkov A, Zapparrata O, Zas E, Zavrtanik D, Zavrtanik M, Zehrer L, Zepeda A, Ziolkowski M, Zuccarello F. Features of the Energy Spectrum of Cosmic Rays above 2.5×10^{18} eV Using the Pierre Auger Observatory. Phys Rev Lett 2020; 125:121106. [PMID: 33016715 DOI: 10.1103/physrevlett.125.121106] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/31/2020] [Indexed: 06/11/2023]
Abstract
We report a measurement of the energy spectrum of cosmic rays above 2.5×10^{18} eV based on 215 030 events. New results are presented: at about 1.3×10^{19} eV, the spectral index changes from 2.51±0.03(stat)±0.05(syst) to 3.05±0.05(stat)±0.10(syst), evolving to 5.1±0.3(stat)±0.1(syst) beyond 5×10^{19} eV, while no significant dependence of spectral features on the declination is seen in the accessible range. These features of the spectrum can be reproduced in models with energy-dependent mass composition. The energy density in cosmic rays above 5×10^{18} eV is [5.66±0.03(stat)±1.40(syst)]×10^{53} erg Mpc^{-3}.
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Affiliation(s)
- A Aab
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - P Abreu
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Lisboa, Portugal
| | - M Aglietta
- Osservatorio Astrofisico di Torino (INAF), Torino, Italy
- INFN, Sezione di Torino, Torino, Italy
| | - J M Albury
- University of Adelaide, Adelaide, S.A., Australia
| | - I Allekotte
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - A Almela
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Universidad Tecnológica Nacional-Facultad Regional Buenos Aires, Buenos Aires, Argentina
| | | | - J Alvarez-Muñiz
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - R Alves Batista
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - G A Anastasi
- INFN, Sezione di Torino, Torino, Italy
- Università Torino, Dipartimento di Fisica, Torino, Italy
| | - L Anchordoqui
- Department of Physics and Astronomy, Lehman College, City University of New York, Bronx, NY, USA
| | - B Andrada
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - S Andringa
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Lisboa, Portugal
| | - C Aramo
- INFN, Sezione di Napoli, Napoli, Italy
| | | | - H Asorey
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - P Assis
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Lisboa, Portugal
| | - G Avila
- Observatorio Pierre Auger, Malargüe, Argentina
- Observatorio Pierre Auger and Comisión Nacional de Energía Atómica, Malargüe, Argentina
| | - A M Badescu
- University Politehnica of Bucharest, Bucharest, Romania
| | - A Bakalova
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - A Balaceanu
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
| | - F Barbato
- INFN, Sezione di Napoli, Napoli, Italy
- Università di Napoli "Federico II", Dipartimento di Fisica "Ettore Pancini", Napoli, Italy
| | - R J Barreira Luz
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Lisboa, Portugal
| | - K H Becker
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - J A Bellido
- University of Adelaide, Adelaide, S.A., Australia
| | - C Berat
- Université Grenoble Alpes, CNRS, Grenoble Institute of Engineering Université Grenoble Alpes, LPSC-IN2P3, 38000 Grenoble, France, France
| | - M E Bertaina
- INFN, Sezione di Torino, Torino, Italy
- Università Torino, Dipartimento di Fisica, Torino, Italy
| | - X Bertou
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - P L Biermann
- Max-Planck-Institut für Radioastronomie, Bonn, Germany
| | - T Bister
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - J Biteau
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France, France
| | - A Blanco
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Lisboa, Portugal
| | - J Blazek
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - C Bleve
- Université Grenoble Alpes, CNRS, Grenoble Institute of Engineering Université Grenoble Alpes, LPSC-IN2P3, 38000 Grenoble, France, France
| | - M Boháčová
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - D Boncioli
- Università dell'Aquila, Dipartimento di Scienze Fisiche e Chimiche, L'Aquila, Italy
- INFN Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila), Italy
| | - C Bonifazi
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro, RJ, Brazil
| | | | - N Borodai
- Institute of Nuclear Physics PAN, Krakow, Poland
| | - A M Botti
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - J Brack
- Colorado State University, Fort Collins, CO, USA
| | - T Bretz
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - F L Briechle
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - P Buchholz
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Siegen, Germany
| | - A Bueno
- Universidad de Granada and C.A.F.P.E., Granada, Spain
| | - S Buitink
- Vrije Universiteit Brussels, Brussels, Belgium
| | - M Buscemi
- Università di Catania, Dipartimento di Fisica e Astronomia, Catania, Italy
- INFN, Sezione di Catania, Catania, Italy
| | | | - L Caccianiga
- Università di Milano, Dipartimento di Fisica, Milano, Italy
- INFN, Sezione di Milano, Milano, Italy
| | - L Calcagni
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - A Cancio
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Universidad Tecnológica Nacional-Facultad Regional Buenos Aires, Buenos Aires, Argentina
| | - F Canfora
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Science Park, Amsterdam, The Netherlands
| | - I Caracas
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - J M Carceller
- Universidad de Granada and C.A.F.P.E., Granada, Spain
| | - R Caruso
- Università di Catania, Dipartimento di Fisica e Astronomia, Catania, Italy
- INFN, Sezione di Catania, Catania, Italy
| | - A Castellina
- Osservatorio Astrofisico di Torino (INAF), Torino, Italy
- INFN, Sezione di Torino, Torino, Italy
| | - F Catalani
- Universidade de São Paulo, Escola de Engenharia de Lorena, Lorena, SP, Brazil
| | - G Cataldi
- INFN, Sezione di Lecce, Lecce, Italy
| | - L Cazon
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Lisboa, Portugal
| | - M Cerda
- Observatorio Pierre Auger, Malargüe, Argentina
| | - J A Chinellato
- Universidade Estadual de Campinas, IFGW, Campinas, SP, Brazil
| | - K Choi
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - J Chudoba
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - L Chytka
- Palacky University, RCPTM, Olomouc, Czech Republic
| | - R W Clay
- University of Adelaide, Adelaide, S.A., Australia
| | - A C Cobos Cerutti
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), and Universidad Tecnológica Nacional-Facultad Regional Mendoza (CONICET/CNEA), Mendoza, Argentina
| | - R Colalillo
- INFN, Sezione di Napoli, Napoli, Italy
- Università di Napoli "Federico II", Dipartimento di Fisica "Ettore Pancini", Napoli, Italy
| | - A Coleman
- University of Delaware, Department of Physics and Astronomy, Bartol Research Institute, Newark, DE, USA
| | - M R Coluccia
- INFN, Sezione di Lecce, Lecce, Italy
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Lecce, Italy
| | - R Conceição
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Lisboa, Portugal
| | - A Condorelli
- INFN Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila), Italy
- Gran Sasso Science Institute, L'Aquila, Italy
| | - G Consolati
- INFN, Sezione di Milano, Milano, Italy
- Politecnico di Milano, Dipartimento di Scienze e Tecnologie Aerospaziali, Milano, Italy
| | - F Contreras
- Observatorio Pierre Auger, Malargüe, Argentina
- Observatorio Pierre Auger and Comisión Nacional de Energía Atómica, Malargüe, Argentina
| | - F Convenga
- INFN, Sezione di Lecce, Lecce, Italy
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Lecce, Italy
| | - C E Covault
- Case Western Reserve University, Cleveland, OH, USA
- also at Radboud Universtiy Nijmegen, Nijmegen, The Netherlands
| | - S Dasso
- Instituto de Astronomía y Física del Espacio (IAFE, CONICET-UBA), Buenos Aires, Argentina
- Departamento de Física and Departamento de Ciencias de la Atmósfera y los Océanos, FCEyN, Universidad de Buenos Aires and CONICET, Buenos Aires, Argentina
| | - K Daumiller
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - B R Dawson
- University of Adelaide, Adelaide, S.A., Australia
| | - J A Day
- University of Adelaide, Adelaide, S.A., Australia
| | - R M de Almeida
- Universidade Federal Fluminense, EEIMVR, Volta Redonda, RJ, Brazil
| | - J de Jesús
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - S J de Jong
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Science Park, Amsterdam, The Netherlands
| | - G De Mauro
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Science Park, Amsterdam, The Netherlands
| | - J R T de Mello Neto
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro, RJ, Brazil
- Universidade Federal do Rio de Janeiro (UFRJ), Observatório do Valongo, Rio de Janeiro, RJ, Brazil
| | - I De Mitri
- INFN Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila), Italy
- Gran Sasso Science Institute, L'Aquila, Italy
| | - J de Oliveira
- Universidade Federal Fluminense, EEIMVR, Volta Redonda, RJ, Brazil
| | | | - V de Souza
- Universidade de São Paulo, Instituto de Física de São Carlos, São Carlos, SP, Brazil
| | - E De Vito
- INFN, Sezione di Lecce, Lecce, Italy
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Lecce, Italy
| | - J Debatin
- Karlsruhe Institute of Technology, Institute for Experimental Particle Physics (ETP), Karlsruhe, Germany
| | - M Del Río
- Observatorio Pierre Auger and Comisión Nacional de Energía Atómica, Malargüe, Argentina
| | - O Deligny
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France, France
| | - H Dembinski
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - N Dhital
- Institute of Nuclear Physics PAN, Krakow, Poland
| | - C Di Giulio
- Università di Roma "Tor Vergata", Dipartimento di Fisica, Roma, Italy
- INFN, Sezione di Roma "Tor Vergata", Roma, Italy
| | | | - M L Díaz Castro
- Universidade Estadual de Campinas, IFGW, Campinas, SP, Brazil
| | - C Dobrigkeit
- Universidade Estadual de Campinas, IFGW, Campinas, SP, Brazil
| | - J C D'Olivo
- Universidad Nacional Autónoma de México, México, D.F., México
| | - Q Dorosti
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Siegen, Germany
| | - R C Dos Anjos
- Universidade Federal do Paraná, Setor Palotina, Palotina, Brazil
| | - M T Dova
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - J Ebr
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - R Engel
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
- Karlsruhe Institute of Technology, Institute for Experimental Particle Physics (ETP), Karlsruhe, Germany
| | - I Epicoco
- INFN, Sezione di Lecce, Lecce, Italy
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Lecce, Italy
| | - M Erdmann
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | | | - A Etchegoyen
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Universidad Tecnológica Nacional-Facultad Regional Buenos Aires, Buenos Aires, Argentina
| | - H Falcke
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Science Park, Amsterdam, The Netherlands
- Stichting Astronomisch Onderzoek in Nederland (ASTRON), Dwingeloo, The Netherlands
| | - J Farmer
- University of Chicago, Enrico Fermi Institute, Chicago, IL, USA
| | - G Farrar
- New York University, New York, NY, USA
| | - A C Fauth
- Universidade Estadual de Campinas, IFGW, Campinas, SP, Brazil
| | - N Fazzini
- Fermi National Accelerator Laboratory, USA
| | - F Feldbusch
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik, Karlsruhe, Germany
| | - F Fenu
- INFN, Sezione di Torino, Torino, Italy
- Università Torino, Dipartimento di Fisica, Torino, Italy
| | - B Fick
- Michigan Technological University, Houghton, MI, USA
| | - J M Figueira
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - A Filipčič
- Experimental Particle Physics Department, J. Stefan Institute, Ljubljana, Slovenia
- Center for Astrophysics and Cosmology (CAC), University of Nova Gorica, Nova Gorica, Slovenia
| | - T Fodran
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - M M Freire
- Instituto de Física de Rosario (IFIR)-CONICET/U.N.R. and Facultad de Ciencias Bioquímicas y Farmacéuticas U.N.R., Rosario, Argentina
| | - T Fujii
- University of Chicago, Enrico Fermi Institute, Chicago, IL, USA
- now at Hakubi Center for Advanced Research and Graduate School of Science, Kyoto University, Kyoto, Japan
| | - A Fuster
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Universidad Tecnológica Nacional-Facultad Regional Buenos Aires, Buenos Aires, Argentina
| | - C Galea
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - C Galelli
- Università di Milano, Dipartimento di Fisica, Milano, Italy
- INFN, Sezione di Milano, Milano, Italy
| | - B García
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), and Universidad Tecnológica Nacional-Facultad Regional Mendoza (CONICET/CNEA), Mendoza, Argentina
| | - A L Garcia Vegas
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - H Gemmeke
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik, Karlsruhe, Germany
| | - F Gesualdi
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - A Gherghel-Lascu
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
| | - P L Ghia
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France, France
| | - U Giaccari
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
| | | | - M Giller
- University of Łódź, Faculty of Astrophysics, Łódź, Poland
| | - J Glombitza
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - F Gobbi
- Observatorio Pierre Auger, Malargüe, Argentina
| | - F Gollan
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - G Golup
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - M Gómez Berisso
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - P F Gómez Vitale
- Observatorio Pierre Auger, Malargüe, Argentina
- Observatorio Pierre Auger and Comisión Nacional de Energía Atómica, Malargüe, Argentina
| | - J P Gongora
- Observatorio Pierre Auger, Malargüe, Argentina
| | - N González
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - I Goos
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - D Góra
- Institute of Nuclear Physics PAN, Krakow, Poland
| | - A Gorgi
- Osservatorio Astrofisico di Torino (INAF), Torino, Italy
- INFN, Sezione di Torino, Torino, Italy
| | - M Gottowik
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - T D Grubb
- University of Adelaide, Adelaide, S.A., Australia
| | - F Guarino
- INFN, Sezione di Napoli, Napoli, Italy
- Università di Napoli "Federico II", Dipartimento di Fisica "Ettore Pancini", Napoli, Italy
| | - G P Guedes
- Universidade Estadual de Feira de Santana, Feira de Santana, Brazil
| | - E Guido
- INFN, Sezione di Torino, Torino, Italy
- Università Torino, Dipartimento di Fisica, Torino, Italy
| | - S Hahn
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - R Halliday
- Case Western Reserve University, Cleveland, OH, USA
| | - M R Hampel
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - P Hansen
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - D Harari
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - V M Harvey
- University of Adelaide, Adelaide, S.A., Australia
| | - A Haungs
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - T Hebbeker
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - D Heck
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - G C Hill
- University of Adelaide, Adelaide, S.A., Australia
| | - C Hojvat
- Fermi National Accelerator Laboratory, USA
| | - J R Hörandel
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Science Park, Amsterdam, The Netherlands
| | - P Horvath
- Palacky University, RCPTM, Olomouc, Czech Republic
| | - M Hrabovský
- Palacky University, RCPTM, Olomouc, Czech Republic
| | - T Huege
- Vrije Universiteit Brussels, Brussels, Belgium
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - J Hulsman
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - A Insolia
- Università di Catania, Dipartimento di Fisica e Astronomia, Catania, Italy
- INFN, Sezione di Catania, Catania, Italy
| | - P G Isar
- Institute of Space Science, Bucharest-Magurele, Romania
| | | | - J Jurysek
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - A Kääpä
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - K H Kampert
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - B Keilhauer
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - J Kemp
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - H O Klages
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - M Kleifges
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik, Karlsruhe, Germany
| | | | - M Köpke
- Karlsruhe Institute of Technology, Institute for Experimental Particle Physics (ETP), Karlsruhe, Germany
| | - G Kukec Mezek
- Center for Astrophysics and Cosmology (CAC), University of Nova Gorica, Nova Gorica, Slovenia
| | - B L Lago
- Centro Federal de Educação Tecnológica Celso Suckow da Fonseca, Nova Friburgo, Brazil
| | - D LaHurd
- Case Western Reserve University, Cleveland, OH, USA
| | - R G Lang
- Universidade de São Paulo, Instituto de Física de São Carlos, São Carlos, SP, Brazil
| | | | - V Lenok
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - A Letessier-Selvon
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Universités Paris 6 et Paris 7, CNRS-IN2P3, Paris, France
| | - I Lhenry-Yvon
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France, France
| | - D Lo Presti
- Università di Catania, Dipartimento di Fisica e Astronomia, Catania, Italy
- INFN, Sezione di Catania, Catania, Italy
| | - L Lopes
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Lisboa, Portugal
| | - R López
- Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - R Lorek
- Case Western Reserve University, Cleveland, OH, USA
| | - Q Luce
- Karlsruhe Institute of Technology, Institute for Experimental Particle Physics (ETP), Karlsruhe, Germany
| | - A Lucero
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | | | - M Malacari
- University of Chicago, Enrico Fermi Institute, Chicago, IL, USA
| | - G Mancarella
- INFN, Sezione di Lecce, Lecce, Italy
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Lecce, Italy
| | - D Mandat
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - B C Manning
- University of Adelaide, Adelaide, S.A., Australia
| | - J Manshanden
- Universität Hamburg, II. Institut für Theoretische Physik, Hamburg, Germany
| | - P Mantsch
- Fermi National Accelerator Laboratory, USA
| | - S Marafico
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France, France
| | - A G Mariazzi
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - I C Mariş
- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - G Marsella
- INFN, Sezione di Lecce, Lecce, Italy
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Lecce, Italy
| | - D Martello
- INFN, Sezione di Lecce, Lecce, Italy
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Lecce, Italy
| | - H Martinez
- Universidade de São Paulo, Instituto de Física de São Carlos, São Carlos, SP, Brazil
| | | | - M Mastrodicasa
- Università dell'Aquila, Dipartimento di Scienze Fisiche e Chimiche, L'Aquila, Italy
- INFN Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila), Italy
| | - H J Mathes
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - J Matthews
- Louisiana State University, Baton Rouge, LA, USA
| | - G Matthiae
- Università di Roma "Tor Vergata", Dipartimento di Fisica, Roma, Italy
- INFN, Sezione di Roma "Tor Vergata", Roma, Italy
| | - E Mayotte
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - P O Mazur
- Fermi National Accelerator Laboratory, USA
| | - G Medina-Tanco
- Universidad Nacional Autónoma de México, México, D.F., México
| | - D Melo
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - A Menshikov
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik, Karlsruhe, Germany
| | | | - S Michal
- Palacky University, RCPTM, Olomouc, Czech Republic
| | - M I Micheletti
- Instituto de Física de Rosario (IFIR)-CONICET/U.N.R. and Facultad de Ciencias Bioquímicas y Farmacéuticas U.N.R., Rosario, Argentina
| | - L Miramonti
- Università di Milano, Dipartimento di Fisica, Milano, Italy
- INFN, Sezione di Milano, Milano, Italy
| | - D Mockler
- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - S Mollerach
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - F Montanet
- Université Grenoble Alpes, CNRS, Grenoble Institute of Engineering Université Grenoble Alpes, LPSC-IN2P3, 38000 Grenoble, France, France
| | - C Morello
- Osservatorio Astrofisico di Torino (INAF), Torino, Italy
- INFN, Sezione di Torino, Torino, Italy
| | - M Mostafá
- Pennsylvania State University, University Park, PA, USA
| | - A L Müller
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - M A Muller
- Universidade Federal do Rio de Janeiro, Instituto de Física, Rio de Janeiro, RJ, Brazil
- Universidade Estadual de Campinas, IFGW, Campinas, SP, Brazil
- Universidade Federal de Alfenas, Poços de Caldas, Brazil
| | - K Mulrey
- Vrije Universiteit Brussels, Brussels, Belgium
| | - R Mussa
- INFN, Sezione di Torino, Torino, Italy
| | - M Muzio
- New York University, New York, NY, USA
| | - W M Namasaka
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - L Nellen
- Universidad Nacional Autónoma de México, México, D.F., México
| | - P H Nguyen
- University of Adelaide, Adelaide, S.A., Australia
| | - M Niculescu-Oglinzanu
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
| | - M Niechciol
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Siegen, Germany
| | - D Nitz
- Michigan Technological University, Houghton, MI, USA
- Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - D Nosek
- Charles University, Faculty of Mathematics and Physics, Institute of Particle and Nuclear Physics, Prague, Czech Republic
| | - V Novotny
- Charles University, Faculty of Mathematics and Physics, Institute of Particle and Nuclear Physics, Prague, Czech Republic
| | - L Nožka
- Palacky University, RCPTM, Olomouc, Czech Republic
| | - A Nucita
- INFN, Sezione di Lecce, Lecce, Italy
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Lecce, Italy
| | - L A Núñez
- Universidad Industrial de Santander, Bucaramanga, Colombia
| | - M Palatka
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - J Pallotta
- Centro de Investigaciones en Láseres y Aplicaciones, CITEDEF and CONICET, Villa Martelli, Argentina
| | - M P Panetta
- INFN, Sezione di Lecce, Lecce, Italy
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Lecce, Italy
| | - P Papenbreer
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - G Parente
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - A Parra
- Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - M Pech
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - F Pedreira
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - J Pȩkala
- Institute of Nuclear Physics PAN, Krakow, Poland
| | - R Pelayo
- Unidad Profesional Interdisciplinaria en Ingeniería y Tecnologías Avanzadas del Instituto Politécnico Nacional (UPIITA-IPN), México, D.F., México
| | | | - J Perez Armand
- Universidade de São Paulo, Instituto de Física, São Paulo, SP, Brazil
| | - M Perlin
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - L Perrone
- INFN, Sezione di Lecce, Lecce, Italy
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Lecce, Italy
| | - C Peters
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - S Petrera
- INFN Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila), Italy
- Gran Sasso Science Institute, L'Aquila, Italy
| | - T Pierog
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - M Pimenta
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Lisboa, Portugal
| | - V Pirronello
- Università di Catania, Dipartimento di Fisica e Astronomia, Catania, Italy
- INFN, Sezione di Catania, Catania, Italy
| | - M Platino
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - B Pont
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - M Pothast
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Science Park, Amsterdam, The Netherlands
| | - P Privitera
- University of Chicago, Enrico Fermi Institute, Chicago, IL, USA
| | - M Prouza
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - A Puyleart
- Michigan Technological University, Houghton, MI, USA
| | - S Querchfeld
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - J Rautenberg
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - D Ravignani
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - M Reininghaus
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - J Ridky
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - F Riehn
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Lisboa, Portugal
| | - M Risse
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Siegen, Germany
| | - P Ristori
- Centro de Investigaciones en Láseres y Aplicaciones, CITEDEF and CONICET, Villa Martelli, Argentina
| | - V Rizi
- Università dell'Aquila, Dipartimento di Scienze Fisiche e Chimiche, L'Aquila, Italy
- INFN Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila), Italy
| | | | - G Rodriguez Fernandez
- Università di Roma "Tor Vergata", Dipartimento di Fisica, Roma, Italy
- INFN, Sezione di Roma "Tor Vergata", Roma, Italy
| | | | - M J Roncoroni
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - M Roth
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - E Roulet
- Centro Atómico Bariloche and Instituto Balseiro (CNEA-UNCuyo-CONICET), San Carlos de Bariloche, Argentina
| | - A C Rovero
- Instituto de Astronomía y Física del Espacio (IAFE, CONICET-UBA), Buenos Aires, Argentina
| | - P Ruehl
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Siegen, Germany
| | - S J Saffi
- University of Adelaide, Adelaide, S.A., Australia
| | - A Saftoiu
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
| | - F Salamida
- Università dell'Aquila, Dipartimento di Scienze Fisiche e Chimiche, L'Aquila, Italy
- INFN Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila), Italy
| | - H Salazar
- Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - G Salina
- INFN, Sezione di Roma "Tor Vergata", Roma, Italy
| | | | - F Sánchez
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - E M Santos
- Universidade de São Paulo, Instituto de Física, São Paulo, SP, Brazil
| | - E Santos
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - F Sarazin
- Colorado School of Mines, Golden, CO, USA
| | - R Sarmento
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Lisboa, Portugal
| | - C Sarmiento-Cano
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - R Sato
- Observatorio Pierre Auger, Malargüe, Argentina
| | - P Savina
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France, France
- INFN, Sezione di Lecce, Lecce, Italy
- Università del Salento, Dipartimento di Matematica e Fisica "E. De Giorgi", Lecce, Italy
| | - C Schäfer
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | | | - H Schieler
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - M Schimassek
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institute for Experimental Particle Physics (ETP), Karlsruhe, Germany
| | - M Schimp
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - F Schlüter
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - D Schmidt
- Karlsruhe Institute of Technology, Institute for Experimental Particle Physics (ETP), Karlsruhe, Germany
| | - O Scholten
- Vrije Universiteit Brussels, Brussels, Belgium
- KVI-Center for Advanced Radiation Technology, University of Groningen, Groningen, The Netherlands
| | - P Schovánek
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - F G Schröder
- University of Delaware, Department of Physics and Astronomy, Bartol Research Institute, Newark, DE, USA
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - S Schröder
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - A Schulz
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - S J Sciutto
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - M Scornavacche
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - R C Shellard
- Centro Brasileiro de Pesquisas Fisicas, Rio de Janeiro, RJ, Brazil
| | - G Sigl
- Universität Hamburg, II. Institut für Theoretische Physik, Hamburg, Germany
| | - G Silli
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - O Sima
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
- also at Radboud Universtiy Nijmegen, Nijmegen, The Netherlands
| | - R Šmída
- University of Chicago, Enrico Fermi Institute, Chicago, IL, USA
| | - P Sommers
- Pennsylvania State University, University Park, PA, USA
| | - J F Soriano
- Department of Physics and Astronomy, Lehman College, City University of New York, Bronx, NY, USA
| | - J Souchard
- Université Grenoble Alpes, CNRS, Grenoble Institute of Engineering Université Grenoble Alpes, LPSC-IN2P3, 38000 Grenoble, France, France
| | - R Squartini
- Observatorio Pierre Auger, Malargüe, Argentina
| | - M Stadelmaier
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - D Stanca
- "Horia Hulubei" National Institute for Physics and Nuclear Engineering, Bucharest-Magurele, Romania
| | - S Stanič
- Center for Astrophysics and Cosmology (CAC), University of Nova Gorica, Nova Gorica, Slovenia
| | - J Stasielak
- Institute of Nuclear Physics PAN, Krakow, Poland
| | - P Stassi
- Université Grenoble Alpes, CNRS, Grenoble Institute of Engineering Université Grenoble Alpes, LPSC-IN2P3, 38000 Grenoble, France, France
| | - A Streich
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
- Karlsruhe Institute of Technology, Institute for Experimental Particle Physics (ETP), Karlsruhe, Germany
| | - M Suárez-Durán
- Universidad Industrial de Santander, Bucaramanga, Colombia
| | - T Sudholz
- University of Adelaide, Adelaide, S.A., Australia
| | - T Suomijärvi
- Université Paris-Saclay, CNRS/IN2P3, IJCLab, Orsay, France, France
| | - A D Supanitsky
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - J Šupík
- Palacky University, RCPTM, Olomouc, Czech Republic
| | - Z Szadkowski
- University of Łódź, Faculty of High-Energy Astrophysics,Łódź, Poland
| | - A Taboada
- Karlsruhe Institute of Technology, Institute for Experimental Particle Physics (ETP), Karlsruhe, Germany
| | - A Tapia
- Universidad de Medellín, Medellín, Colombia
| | - C Timmermans
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
- Nationaal Instituut voor Kernfysica en Hoge Energie Fysica (NIKHEF), Science Park, Amsterdam, The Netherlands
| | - O Tkachenko
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - P Tobiska
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - C J Todero Peixoto
- Universidade de São Paulo, Escola de Engenharia de Lorena, Lorena, SP, Brazil
| | - B Tomé
- Laboratório de Instrumentação e Física Experimental de Partículas-LIP and Instituto Superior Técnico-IST, Universidade de Lisboa-UL, Lisboa, Portugal
| | - G Torralba Elipe
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - A Travaini
- Observatorio Pierre Auger, Malargüe, Argentina
| | - P Travnicek
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - C Trimarelli
- Università dell'Aquila, Dipartimento di Scienze Fisiche e Chimiche, L'Aquila, Italy
- INFN Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila), Italy
| | - M Trini
- Center for Astrophysics and Cosmology (CAC), University of Nova Gorica, Nova Gorica, Slovenia
| | - M Tueros
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - R Ulrich
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - M Unger
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - M Urban
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - L Vaclavek
- Palacky University, RCPTM, Olomouc, Czech Republic
| | - M Vacula
- Palacky University, RCPTM, Olomouc, Czech Republic
| | | | - I Valiño
- INFN Laboratori Nazionali del Gran Sasso, Assergi (L'Aquila), Italy
- Gran Sasso Science Institute, L'Aquila, Italy
| | - L Valore
- INFN, Sezione di Napoli, Napoli, Italy
- Università di Napoli "Federico II", Dipartimento di Fisica "Ettore Pancini", Napoli, Italy
| | - A van Vliet
- IMAPP, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - E Varela
- Benemérita Universidad Autónoma de Puebla, Puebla, México
| | | | | | - D Veberič
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - C Ventura
- Universidade Federal do Rio de Janeiro (UFRJ), Observatório do Valongo, Rio de Janeiro, RJ, Brazil
| | | | - V Verzi
- INFN, Sezione di Roma "Tor Vergata", Roma, Italy
| | - J Vicha
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - L Villaseñor
- Benemérita Universidad Autónoma de Puebla, Puebla, México
| | - J Vink
- Universiteit van Amsterdam, Faculty of Science, Amsterdam, The Netherlands
| | - S Vorobiov
- Center for Astrophysics and Cosmology (CAC), University of Nova Gorica, Nova Gorica, Slovenia
| | - H Wahlberg
- IFLP, Universidad Nacional de La Plata and CONICET, La Plata, Argentina
| | - A A Watson
- School of Physics and Astronomy, University of Leeds, Leeds, United Kingdom
| | - M Weber
- Karlsruhe Institute of Technology, Institut für Prozessdatenverarbeitung und Elektronik, Karlsruhe, Germany
| | - A Weindl
- Karlsruhe Institute of Technology, Institut für Kernphysik, Karlsruhe, Germany
| | - L Wiencke
- Colorado School of Mines, Golden, CO, USA
| | - H Wilczyński
- Institute of Nuclear Physics PAN, Krakow, Poland
| | - T Winchen
- Vrije Universiteit Brussels, Brussels, Belgium
| | - M Wirtz
- RWTH Aachen University, III. Physikalisches Institut A, Aachen, Germany
| | - D Wittkowski
- Bergische Universität Wuppertal, Department of Physics, Wuppertal, Germany
| | - B Wundheiler
- Instituto de Tecnologías en Detección y Astropartículas (CNEA, CONICET, UNSAM), Buenos Aires, Argentina
| | - A Yushkov
- Institute of Physics of the Czech Academy of Sciences, Prague, Czech Republic
| | - O Zapparrata
- Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - E Zas
- Instituto Galego de Física de Altas Enerxías (IGFAE), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - D Zavrtanik
- Experimental Particle Physics Department, J. Stefan Institute, Ljubljana, Slovenia
- Center for Astrophysics and Cosmology (CAC), University of Nova Gorica, Nova Gorica, Slovenia
| | - M Zavrtanik
- Experimental Particle Physics Department, J. Stefan Institute, Ljubljana, Slovenia
- Center for Astrophysics and Cosmology (CAC), University of Nova Gorica, Nova Gorica, Slovenia
| | - L Zehrer
- Center for Astrophysics and Cosmology (CAC), University of Nova Gorica, Nova Gorica, Slovenia
| | - A Zepeda
- Centro de Investigación y de Estudios Avanzados del IPN (CINVESTAV), México, D.F., México
| | - M Ziolkowski
- Universität Siegen, Fachbereich 7 Physik-Experimentelle Teilchenphysik, Siegen, Germany
| | - F Zuccarello
- Università di Catania, Dipartimento di Fisica e Astronomia, Catania, Italy
- INFN, Sezione di Catania, Catania, Italy
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Janda A, Schuetz C, Heeg M, Minden K, Hedrich CM, Kallinich T, Hinze C, Schulz A, Speth F. [COVID-19: treatment strategies of German-speaking pediatric rheumatologists : Results of an online survey]. Z Rheumatol 2020; 79:710-717. [PMID: 32809050 PMCID: PMC7432543 DOI: 10.1007/s00393-020-00854-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Hintergrund Zuverlässige Daten zu Verlauf und Therapie von COVID-19 („corona virus disease 2019“) bei Kindern mit rheumatischen Erkrankungen unter Immunsuppression fehlen. Ziel der Arbeit Abbildung individueller Strategien der Mitglieder der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR) im Umgang mit COVID-19. Methodik Mittels Online-Umfrage wurden im Mai 2020 das Meinungsbild der GKJR-Mitglieder zum Umgang mit DMARDs („disease-modifying anti-rheumatic drugs“) bei COVID-19-Erkrankung sowie die Bereitschaft zum Einsatz spezieller Therapieansätze bei Patienten mit unterschiedlicher Schwere von COVID-19 erhoben. Ergebnisse Es nahmen 71 Kollegen (27,3 % aller befragten ärztlichen Mitglieder) an der Umfrage teil; davon hatten 28,2 % bereits Patienten mit COVID-19 betreut. Über 95 % der Teilnehmer lehnten eine präventive Anpassung der antirheumatischen Therapie im Rahmen der SARS-CoV-2-Pandemie ab. Bei ambulanten Patienten unter Immunsuppression mit nachgewiesener COVID-19-Erkrankung würden mehr als 50 % der Teilnehmer folgende Therapien aussetzen: intravenöse hoch dosierte Steroide, Cyclophosphamid, Anti-CD20-Antikörper, sowie eine BAFF-, CTLA-4-, TNF-α-Blockade. Hingegen würden nichtsteroidale Antiphlogistika, Hydroxychloroquin (HCQ), orale Steroide, Mycophenolat, IL-1-Blockade sowie Immunglobuline (Ig) von >70 % der Kollegen weiter fortgeführt. Bei stationären Patienten mit COVID-19 würden insgesamt 74,6 % der Kollegen eine COVID-19-gerichtete Therapie erwägen. Bei stabilem Verlauf unter O2-Therapie (Stufe I) würden am häufigsten HCQ (18,3 %), Azithromycin (16,9 %) und Ig (9,9 %) in Betracht gezogen. Bei drohendem (Stufe II) bzw. manifestem Zytokinsturm (Stufe III) würden am häufigsten Anakinra (40,8 % bei Stufe II bzw. 46,5 % bei Stufe III), Tocilizumab (26,8 % bzw. 40,8 %), Steroide (25,4 % bzw. 33,8 %) und Remdesivir (29,6 % bzw. 38,0 %) eingesetzt. Von vielen Kollegen wurde betont, dass die Therapiestrategie individuell und der klinischen Situation entsprechend angepasst werden soll. Diskussion Die Ergebnisse der Online-Umfrage sind vor dem Hintergrund einer aktuell in Deutschland niedrigen Prävalenz von COVID-19 zu sehen und spiegeln somit theoretische Überlegungen der Befragten wider. Da Kinder derzeit nicht im Fokus von prospektiven COVID-19-Studien stehen, scheint der kontinuierliche und kritische kollegiale Fachaustausch bei Therapieentscheidungen umso wichtiger zu sein.
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Affiliation(s)
- A Janda
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Eythstr. 24, 89075, Ulm, Deutschland.
| | - C Schuetz
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Deutschland
| | - M Heeg
- Institut für Immundefizienz und Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Freiburg, Freiburg, Deutschland
| | - K Minden
- Charité Universitätsmedizin Berlin und Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Deutschland
| | - C M Hedrich
- Department of Women's & Children's Health, Institute of Life Course and Medical Sciences, University of Liverpool & Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust Hospital, Liverpool, Großbritannien
| | - T Kallinich
- Charité Universitätsmedizin Berlin und Deutsches Rheuma-Forschungszentrum Berlin, Berlin, Deutschland
| | - C Hinze
- Klinik für Pädiatrische Rheumatologie und Immunologie, Universitätsklinikum Münster, Münster, Deutschland
| | - A Schulz
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Ulm, Eythstr. 24, 89075, Ulm, Deutschland
| | - F Speth
- Zentrum für Geburtshilfe, Kinder- und Jugendmedizin, Sektion Pädiatrische Stammzelltransplantation und Immunologie, Abteilung Kinderrheumatologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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Battaglin F, Zhang W, Skubala A, Arai H, Wang J, Soni S, Wang Y, Köchert K, Schulz A, Teufel M, Millstein J, Lenz H. 465P Single nucleotide polymorphism (SNP) analysis identifies potential prognostic and predictive biomarker in patients (pts) with metastatic colorectal cancer (mCRC) treated with regorafenib in the phase III CORRECT trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Buck F, Wiegers K, Kistner I, Schulz A, Schiestel T. Plasmainduzierte CO
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‐Spaltung mit Sauerstoffabtrennung durch MIEC‐Hohlfasermembranen. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- F. Buck
- Fraunhofer Institut für Grenzflächen- und Bioverfahrenstechnik IGB IFM Nobelstr. 12 70569 Stuttgart Deutschland
| | - K. Wiegers
- Institut für Grenzflächenverfahrenstechnik und Plasmatechnologie Stuttgart Pfaffenwaldring 31 70569 Stuttgart Deutschland
| | - I. Kistner
- Institut für Grenzflächenverfahrenstechnik und Plasmatechnologie Stuttgart Pfaffenwaldring 31 70569 Stuttgart Deutschland
| | - A. Schulz
- Institut für Grenzflächenverfahrenstechnik und Plasmatechnologie Stuttgart Pfaffenwaldring 31 70569 Stuttgart Deutschland
| | - T. Schiestel
- Fraunhofer Institut für Grenzflächen- und Bioverfahrenstechnik IGB IFM Nobelstr. 12 70569 Stuttgart Deutschland
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Schulz A, Wiegers K, Walker M, Tovar G. Erneuerbare Energien für die Salpetersäureproduktion mit einem Mikrowellenplasmabrenner. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A. Schulz
- Universität Stuttgart, Institut für Grenzflächenverfahrenstechnik und Plasmatechnologie IGVP Plasmatechnolgie Pfafffenwaldring 31 70569 Stuttgart Deutschland
| | - K. Wiegers
- Universität Stuttgart, Institut für Grenzflächenverfahrenstechnik und Plasmatechnologie IGVP Plasmatechnolgie Pfafffenwaldring 31 70569 Stuttgart Deutschland
| | - M. Walker
- Universität Stuttgart, Institut für Grenzflächenverfahrenstechnik und Plasmatechnologie IGVP Plasmatechnolgie Pfafffenwaldring 31 70569 Stuttgart Deutschland
| | - G. Tovar
- Universität Stuttgart, Institut für Grenzflächenverfahrenstechnik und Plasmatechnologie IGVP Plasmatechnolgie Pfafffenwaldring 31 70569 Stuttgart Deutschland
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Wiegers K, Kistner I, Buck F, Schiestel T, Schulz A, Walker M, Tovar G. Untersuchungen zur CO
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‐Konversion in einem Mikrowellenplasmabrenner. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- K. Wiegers
- Universität Stuttgart Institut für Grenzflächenverfahrenstechnik und Plasmatechnologie IGVP Pfaffenwaldring 31 70569 Stuttgart Deutschland
| | - I. Kistner
- Universität Stuttgart Institut für Grenzflächenverfahrenstechnik und Plasmatechnologie IGVP Pfaffenwaldring 31 70569 Stuttgart Deutschland
| | - F. Buck
- Fraunhofer Institut für Grenzflächen- und Bioverfahrenstechnik IGB Nobelstr. 12 70569 Stuttgart Deutschland
| | - T. Schiestel
- Fraunhofer Institut für Grenzflächen- und Bioverfahrenstechnik IGB Nobelstr. 12 70569 Stuttgart Deutschland
| | - A. Schulz
- Universität Stuttgart Institut für Grenzflächenverfahrenstechnik und Plasmatechnologie IGVP Pfaffenwaldring 31 70569 Stuttgart Deutschland
| | - M. Walker
- Universität Stuttgart Institut für Grenzflächenverfahrenstechnik und Plasmatechnologie IGVP Pfaffenwaldring 31 70569 Stuttgart Deutschland
| | - G. Tovar
- Universität Stuttgart Institut für Grenzflächenverfahrenstechnik und Plasmatechnologie IGVP Pfaffenwaldring 31 70569 Stuttgart Deutschland
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Boyko M, Vonderbank S, Gürleyen H, Gibis N, Schulz A, Erbuth A, Bastian A. Endoscopic Lung Volume Reduction Results in Improvement of Diaphragm Mobility as Measured by Sonography. Int J Chron Obstruct Pulmon Dis 2020; 15:1465-1470. [PMID: 32606654 PMCID: PMC7319505 DOI: 10.2147/copd.s247526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 05/24/2020] [Indexed: 11/23/2022] Open
Abstract
Background Hyperinflation in patients with pulmonary emphysema is an important cause of reduced diaphragm mobility. We investigated whether endoscopic lung volume reduction (ELVR) could improve diaphragm mobility. Methods Diaphragm mobility data obtained by sonography from 44 patients were compared before and 3–6 months after ELVR therapy with a Spiration™ valve system. These patients were asked whether they wanted this procedure again after they had learned of their treatment outcome; this was a subjective indicator of outcome. Lung function parameters and blood gases were also measured. Results After ELVR, 30 patients (82%) developed atelectasis of ≥50% of the targeted lung lobe. These patients had a diaphragm mobility increase of 28.97 ± 15.93 mm, while the remaining patients experienced an improvement in diaphragm mobility of 16.07 ± 21.17 mm; this difference was significant (p = 0.030). All 30 patients with atelectasis and additional 6 patients without radiologically demonstrated atelectasis perceived an improved outcome after ELVR. Their diaphragm mobility increased by 28.89 ± 17.26 mm. Conversely, the patients with no perceived improvement in outcome had a diaphragm mobility increase of 6.75 ± 12.76 mm; this difference was significant (p = 0.001). Conclusion ELVR can improve diaphragm mobility, and this improvement is correlated with a perceived positive outcome in patients.
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Vonderbank S, Gibis N, Schulz A, Boyko M, Erbuth A, Gürleyen H, Bastian A. Hypercapnia at Hospital Admission as a Predictor of Mortality. Open Access Emerg Med 2020; 12:173-180. [PMID: 32617025 PMCID: PMC7326210 DOI: 10.2147/oaem.s242075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 06/02/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Hypercapnia is an indicator of ventilatory exhaustion. There is some disagreement regarding whether hypercapnia is also a predictor of mortality. In this prospective study, we aimed to investigate whether hypercapnia can predict in-hospital and 1-year mortality rates in patients with dyspnea or pulmonary diseases. Patients and Methods All patients with dyspnea or pulmonary diseases underwent routine blood gas analysis at hospital admission. During the 12-month enrollment period, 2710 patients were enrolled, and 588 patients with hypercapnia at admission were identified. Of the 1626 normocapnic patients, 62 were randomly selected as controls. In-hospital and 1-year mortality rates were determined. Results There were significant increases in mortality rate between acute hypercapnic patients and both chronic hypercapnic patients and normocapnic controls. Their in-hospital mortality rates were 17%, 6.7% and 3.2%, respectively. Their 1-year mortality rates were 32%, 20.2% and 14.5%, respectively. The 1-year mortality rates of hypercapnic patients with different underlying diseases were 24.6% (chronic obstructive pulmonary disease), 28.4% (congestive heart disease), 1.6% (obstructive sleep apnea syndrome/obesity hypoventilation syndrome), 50.9% (pneumonia), 0% (suppressed central respiratory drive, primarily due to opiate abuse) and 22.8% (other conditions). Discussion The 1-year mortality rate of patients with acute hypercapnia at hospital admission was 32%, with significant differences compared to chronic hypercapnic patients (20.2%) and normocapnic patients (14.5%). There was a wide range of 1-year mortality rates between the hypercapnic patients with different underlying diseases.
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Schulz A, Karger A, Bettin B, Eisenbarth A, Sas MA, Silaghi C, Groschup MH. Molecular discrimination of Hyalomma tick species serving as reservoirs and vectors for Crimean-Congo hemorrhagic fever virus in sub-Saharan Africa. Ticks Tick Borne Dis 2020; 11:101382. [PMID: 32008996 DOI: 10.1016/j.ttbdis.2020.101382] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/10/2020] [Accepted: 01/23/2020] [Indexed: 12/17/2022]
Abstract
The species identification of tick vectors of Crimean-Congo hemorrhagic fever virus (CCHFV), especially Hyalomma (H.) species, is a prerequisite to understand the eco-epidemiology of this disease and to reveal vector and virus reservoir species. However, the morphologic species discrimination can be difficult for damaged or blood-fed ticks and in case of species intercrosses. Therefore, we used matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) and restriction fragment length polymorphism (RFLP) analysis to distinguish the most common Hyalomma species from sub-Saharan Africa (H. truncatum, H. rufipes and H. dromedarii). Within the last years, MALDI-TOF MS analysis based on tick leg proteins has been shown to be a reliable method to distinguish several tick species. For this purpose, a reference spectral library of several European, American and African tick species was established. In this study, six different Hyalomma species were tested, all of which were all clearly distinguishable by mass spectrometric analyses. Moreover, MALDI TOF- MS was able to confirm morphologic findings where sequencing provided ambiguous results. In addition, a polymerase chain reaction (PCR) based on the CO1 gene amplification of ticks has been developed for the unequivocal species identification by amplicon sequencing and specific restriction endonuclease cleavage pattern analysis. RFLP proved to be a feasible auxiliary discrimination tool for selected Hyalomma species when access to sequencing methods is not available, as for instance during field studies.
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Affiliation(s)
- A Schulz
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Südufer 10, 17493 Greifswald-Insel Riems, Germany
| | - A Karger
- Friedrich-Loeffler-Institut, Institute of Molecular Virology and Cell Biology, Südufer 10, 17493 Greifswald-Insel Riems, Germany
| | - B Bettin
- Friedrich-Loeffler-Institut, Institute of Molecular Virology and Cell Biology, Südufer 10, 17493 Greifswald-Insel Riems, Germany
| | - A Eisenbarth
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Südufer 10, 17493 Greifswald-Insel Riems, Germany
| | - M A Sas
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Südufer 10, 17493 Greifswald-Insel Riems, Germany
| | - C Silaghi
- Friedrich-Loeffler-Institut, Institute of Infectology, Südufer 10, 17493 Greifswald-Insel Riems, Germany
| | - M H Groschup
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Südufer 10, 17493 Greifswald-Insel Riems, Germany.
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Gibis N, Schulz A, Vonderbank S, Boyko M, Gürleyen H, Schulz X, Bastian A. Sonographically Measured Improvement in Diaphragmatic Mobility and Outcomes Among Patients Requiring Prolonged Weaning from the Ventilator. Open Respir Med J 2020; 13:38-44. [PMID: 31929837 PMCID: PMC6935944 DOI: 10.2174/1874306401913010038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/18/2019] [Accepted: 06/20/2019] [Indexed: 11/23/2022] Open
Abstract
Background: The need of prolonged weaning from the ventilator is a well-known predictor of an unfavorable patients` outcome. Diaphragmatic dysfunction is a serious problem for these patients. We wanted to determine the survival in patients who were already intubated for more than 4 weeks before they were admitted to our weaning unit. In this prospective study, we wanted to investigate if the diaphragmatic function could improve or was related to survival over an 18 months follow up period. Methods: 84 patients were included when they were able to breathe at least 10 minutes over a t-piece and sit upright for at least 5 minutes. The diaphragmatic function was estimated sonographically using the up and downward movement of the lung silhouette. Sonographic follow-ups were performed for over 18 months. The survival rate, outcome and changes in diaphragm mobility were investigated. Results: a) Survival: 49 patients (58%) survived the 18 months follow up period - 30 had a good outcome; 19 needed assistance. b) Survival in relation to diaphragm mobility: If diaphragmatic mobility improved ≥ 15.5 mm on the left side, the probability of survival was 94% with a probability of 76% to have a satisfying outcome. Conclusion: Survival and outcome of prolonged weaning were significantly better when sonographically measured the mobility of left hemidiaphragm improved.
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Affiliation(s)
- N Gibis
- Marienkrankenhaus Kassel, Marburger Str. 85, 34127 Kassel, Germany
| | - A Schulz
- Marienkrankenhaus Kassel, Marburger Str. 85, 34127 Kassel, Germany
| | - S Vonderbank
- Marienkrankenhaus Kassel, Marburger Str. 85, 34127 Kassel, Germany
| | - M Boyko
- Marienkrankenhaus Kassel, Marburger Str. 85, 34127 Kassel, Germany
| | - H Gürleyen
- Marienkrankenhaus Kassel, Marburger Str. 85, 34127 Kassel, Germany
| | - X Schulz
- Department of Medical Statistics, University Medical Center Göttingen, Georg-August-Universität, Humboldtallee 32, 37073 Göttingen, Germany
| | - A Bastian
- Marienkrankenhaus Kassel, Marburger Str. 85, 34127 Kassel, Germany
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Schiefer JL, Lipensky A, Fuchs PC, Heitzmann W, Schulz A. Patients' satisfaction with anesthesia in enzymatic debridement from a surgical perspective. Burns 2020; 46:1073-1082. [PMID: 31901406 DOI: 10.1016/j.burns.2019.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 10/28/2019] [Accepted: 11/05/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Various clinical studies found that enzymatic debridement (EDNX) is superior to tangential excision after severe burns. The current study evaluates patients' satisfaction with pain management in EDNX with special respect to different anesthesia techniques. METHODS Between 2015 and 2016, all patients at a department of plastic surgery were asked to complete a German-wide validated pain questionnaire. In a retrospective study design, satisfaction with pain management was compared between the control group (diagnosis from the whole field of plastic surgery except burns) and the EDNX group (burns treated with EDNX only). Analgosedation, general, regional and local anesthesia were chosen for pain management. RESULTS In the control group 403 patients (153 females, 250 males, medium age 53 years) could be included The EDNX group included 88 patients (20 females, 68 males, medium age 38 years). The mean burn size was 5.3% TBSA. Between 0.5%-10.5% of the surface was treated with EDNX. EDNX patients could be treated under analgosedation and regional anesthesia, by topical anesthesia creme and without any anesthesia. They reported less pain during stress (p = 0.04) and were less frequently affected by motion (p = 0.024) and nausea (<0.001). However, they felt that they need more information about alternative anesthetic treatments (<0.001). CONCLUSION EDNX can be performed sufficiently either under analgosedation, regional or local anesthesia. Thus, side effects of general anesthesia can be reduced and treatment costs can be decreased. However, it was found that neither after topical anesthetic creme nor after hand block pain treatment was sufficient.
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Affiliation(s)
- J L Schiefer
- Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany
| | - A Lipensky
- Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany
| | - P C Fuchs
- Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany
| | - W Heitzmann
- Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany
| | - A Schulz
- Department of Plastic Surgery, Hand Surgery, Burn Center, University of Witten/Herdecke, Cologne-Merheim Medical Center (CMMC), Cologne, Germany.
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Murin P, Weixler V, Romanchenko O, Schulz A, Dehmel F, Miera O, Redlin M, Kuppe H, Cho MY, Photiadis J. Fast-Track Extubation in Infants <7 kg Undergoing Congenital Heart Surgery is a Safe, Feasible, and Cost-Effective Concept: A 5-Year Single-Center Experience. Thorac Cardiovasc Surg 2020. [DOI: 10.1055/s-0040-1705560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Schütz C, Hauck F, Albert MH, Hönig M, Borte S, Wahn V, Schulz A, Nennstiel U, Speckmann C. Neugeborenenscreening auf schwere kombinierte Immundefekte. Monatsschr Kinderheilkd 2019. [DOI: 10.1007/s00112-019-0743-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ten Cate V, Koeck T, Panova-Noeva M, Rapp S, Prochaska JH, Lenz M, Schulz A, Eggebrecht L, Hermanns MI, Heitmeier S, Krahn T, Laux V, Münzel T, Leineweber K, Konstantinides SV, Wild PS. A prospective cohort study to identify and evaluate endotypes of venous thromboembolism: Rationale and design of the Genotyping and Molecular Phenotyping in Venous ThromboEmbolism project (GMP-VTE). Thromb Res 2019; 181:84-91. [PMID: 31374513 DOI: 10.1016/j.thromres.2019.07.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 07/17/2019] [Accepted: 07/21/2019] [Indexed: 01/02/2023]
Abstract
Several clinical, genetic and acquired risk factors for venous thromboembolism (VTE) have been identified. However, the molecular pathophysiology and mechanisms of disease progression remain poorly understood. This is reflected by uncertainties regarding the primary and secondary prevention of VTE and the optimal duration of antithrombotic therapy. A growing body of literature points to clinically relevant differences between VTE phenotypes (e.g. deep vein thrombosis (DVT) versus pulmonary embolism (PE), unprovoked versus provoked VTE). Extensive links to cardiovascular, inflammatory and immune-related morbidities are testament to the complexity of the disease. The GMP-VTE project is a prospective, multi-center cohort study on individuals with objectively confirmed VTE. Sequential data sampling was performed at the time of the acute event and during serial follow-up investigations. Various data levels (e.g. clinical, genetic, proteomic and platelet data) are available for multi-dimensional data analyses by means of advanced statistical, bioinformatic and machine learning methods. The GMP-VTE project comprises n = 663 individuals with acute VTE (mean age: 60.3 ± 15.9 years; female sex: 42.8%). In detail, 28.4% individuals (n = 188) had acute isolated DVT, whereas 71.6% subjects (n = 475) had PE with or without concomitant DVT. In the study sample, 28.9% (n = 129) of individuals with PE and 30.1% (n = 55) of individuals with isolated DVT had a recurrent VTE event at the time of study enrolment. The systems-oriented approach for the comprehensive dataset of the GMP-VTE project may generate new biological insights into the pathophysiology of VTE and refine our current understanding and management of VTE.
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Affiliation(s)
- V Ten Cate
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - T Koeck
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - M Panova-Noeva
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - S Rapp
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - J H Prochaska
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - M Lenz
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Institute of Organismic and Molecular Evolution, Johannes Gutenberg University Mainz, Mainz, Germany
| | - A Schulz
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - L Eggebrecht
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - M I Hermanns
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; School of Chemistry, Biology and Pharmacy, Fresenius University of Applied Sciences, Idstein, Germany
| | | | - T Krahn
- Bayer AG, Wuppertal, Germany
| | - V Laux
- Bayer AG, Wuppertal, Germany
| | - T Münzel
- Center for Cardiology - Cardiology I, University Medical Center of the Johannes Gutenberg University Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, University Medical Center of the Johannes Gutenberg University Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - S V Konstantinides
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Department of Cardiology, Democritus University of Thrace, University General Hospital, Greece
| | - P S Wild
- Preventive Cardiology and Preventive Medicine, Center for Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, University Medical Center of the Johannes Gutenberg University Mainz, Germany.
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