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Eberhart T, Stanley FU, Ricci L, Chirico T, Ferrarese R, Sisti S, Scagliola A, Baj A, Badurek S, Sommer A, Culp-Hill R, Dzieciatkowska M, Shokry E, Sumpton D, D'Alessandro A, Clementi N, Mancini N, Cardaci S. ACOD1 deficiency offers protection in a mouse model of diet-induced obesity by maintaining a healthy gut microbiota. Cell Death Dis 2024; 15:105. [PMID: 38302438 PMCID: PMC10834593 DOI: 10.1038/s41419-024-06483-2] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/03/2024]
Abstract
Aconitate decarboxylase 1 (ACOD1) is the enzyme synthesizing itaconate, an immuno-regulatory metabolite tuning host-pathogen interactions. Such functions are achieved by affecting metabolic pathways regulating inflammation and microbe survival. However, at the whole-body level, metabolic roles of itaconate remain largely unresolved. By using multiomics-integrated approaches, here we show that ACOD1 responds to high-fat diet consumption in mice by promoting gut microbiota alterations supporting metabolic disease. Genetic disruption of itaconate biosynthesis protects mice against obesity, alterations in glucose homeostasis and liver metabolic dysfunctions by decreasing meta-inflammatory responses to dietary lipid overload. Mechanistically, fecal metagenomics and microbiota transplantation experiments demonstrate such effects are dependent on an amelioration of the intestinal ecosystem composition, skewed by high-fat diet feeding towards obesogenic phenotype. In particular, unbiased fecal microbiota profiling and axenic culture experiments point towards a primary role for itaconate in inhibiting growth of Bacteroidaceae and Bacteroides, family and genus of Bacteroidetes phylum, the major gut microbial taxon associated with metabolic health. Specularly to the effects imposed by Acod1 deficiency on fecal microbiota, oral itaconate consumption enhances diet-induced gut dysbiosis and associated obesogenic responses in mice. Unveiling an unrecognized role of itaconate, either endogenously produced or exogenously administered, in supporting microbiota alterations underlying diet-induced obesity in mice, our study points ACOD1 as a target against inflammatory consequences of overnutrition.
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Affiliation(s)
- Tanja Eberhart
- Cancer Metabolism Unit, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Federico Uchenna Stanley
- Cancer Metabolism Unit, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Luisa Ricci
- Cancer Metabolism Unit, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Tiziana Chirico
- Cancer Metabolism Unit, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
| | - Roberto Ferrarese
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, 20100, Italy
- IRCCS San Raffaele Hospital, Milan, 20100, Italy
- Synlab Italia, Castenedolo, BS, Italy
| | - Sofia Sisti
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, 20100, Italy
- IRCCS San Raffaele Hospital, Milan, 20100, Italy
| | - Alessandra Scagliola
- Cancer Metabolism Unit, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy
- Istituto Nazionale di Genetica Molecolare, INGM, "Romeo ed Enrica Invernizzi", Milan, Italy
| | - Andreina Baj
- Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy
| | - Sylvia Badurek
- Preclinical Phenotyping Facility, Vienna BioCenter Core Facilities (VBCF), member of the Vienna BioCenter (VBC), Vienna, Austria
| | - Andreas Sommer
- Next Generation Sequencing Facility, Vienna BioCenter Core Facilities (VBCF), member of the Vienna BioCenter (VBC), Vienna, Austria
| | - Rachel Culp-Hill
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Monika Dzieciatkowska
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | | | | | - Angelo D'Alessandro
- Department of Biochemistry and Molecular Genetics, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Nicola Clementi
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, 20100, Italy
- IRCCS San Raffaele Hospital, Milan, 20100, Italy
| | - Nicasio Mancini
- Laboratory of Medical Microbiology and Virology, Vita-Salute San Raffaele University, Milan, 20100, Italy
- IRCCS San Raffaele Hospital, Milan, 20100, Italy
- Laboratory of Medical Microbiology and Virology, Department of Medicine and Technological Innovation, University of Insubria, Varese, Italy
- Laboratory of Medical Microbiology and Virology, Fondazione Macchi University Hospital, Varese, Italy
| | - Simone Cardaci
- Cancer Metabolism Unit, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, 20132, Milan, Italy.
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Fruelund PZ, Van Dam P, Melgaard J, Soegaard P, Sommer A, Lundbye-Christensen S, Riahi S, Zaremba T, Graff C. Novel non-invasive 12-lead ECG-based imaging method with potential to guide and optimise right ventricular lead implantation. Europace 2022. [DOI: 10.1093/europace/euac053.020] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Svend Andersens Foundation
Karl G Andersens Foundation
Helsefonden
Background
Right ventricular (RV) pacing may induce electrical and mechanical dyssynchrony which may lead to heart failure. Often, the physician aims for lead implantation at the RV septum as this is expected to result in a more physiologic activation compared to alternative RV lead locations. Fluoroscopy, often in combination with QRS morphology derived from the 12-lead ECG, is used to guide lead implantation. However, this method is inaccurate and can result in a non-optimal RV lead location. We present a novel non-invasive method to create patient-specific 3D electrical activation maps from the 12-lead ECG that has potential to support RV lead implantation.
Methods
Data from 34 patients with an implanted dual chamber pacemaker were used. A contrast-enhanced cardiac CT scan showing the RV lead implantation site was obtained as well as recording of a 12-lead ECG during RV pacing together with a 3D photo documenting the ECG electrode positions. Discrete patient-specific torso and heart models were created from the CT scans. Each torso model was merged with the 3D photo for precise placement of the ECG electrodes in relation to the heart (figure 1). Combining the 12-lead ECGs and the heart/torso models, patient-specific 3D electrical activation maps originating from the RV were created using a novel inverse-ECG technique applying electrophysiological rules. The accuracy of the inverse-ECG method was determined by comparing the earliest site of activation from the 3D activation map with the known RV insertion site marked on the CT scan.
Results
Documented by the implanting physician in the medical records, 33 RV leads were estimated to be septal and one apical. Estimated from the CT scan 9 leads were placed septal, 18 apical and 7 on the free wall. The mean geodesic distance between the initial site of activation in the 3D activation map and the marked RV insertion site from CT was 13.6 ±5.7 mm (range 4.3-28.6). The distance for each patient is shown in figure 2. The initial site of activation was constrained to the discrete nodes of the ventricular model whereas the marker for RV lead position was localized freely on the CT scan. The average distance from the RV CT marker to the nearest discrete node was 4.3 ±2.2 mm. Correcting for this error, the geodesic distance between the initial site of activation and RV CT marker was 9.3 ±5.4 mm (range 0.0-24.6). The average time used for 3D activation map computation was 1.1 ±0.4 s per ECG.
Conclusions
We demonstrated a novel non-invasive 12-lead ECG-based method to accurately and effectively localize the RV lead in relation to the ventricular anatomy during RV pacing. Furthermore, we confirmed that the RV lead was often implanted in an unintended position. With further advancements, this method has the potential to support physicians during pacemaker implantation to ensure optimal RV lead positioning. Further studies are needed to confirm the accuracy.
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Affiliation(s)
- PZ Fruelund
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - P Van Dam
- University Medical Center Utrecht, Department of Cardiology, Utrecht, Netherlands (The)
| | - J Melgaard
- Aalborg University, CardioTech Research Group, Department of Health Science and Technology, Faculty of Medicine, Aalborg, Denmark
| | - P Soegaard
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - A Sommer
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | | | - S Riahi
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - T Zaremba
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - C Graff
- Aalborg University, CardioTech Research Group, Department of Health Science and Technology, Faculty of Medicine, Aalborg, Denmark
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Platanitis E, Gruener S, Ravi Sundar Jose Geetha A, Boccuni L, Vogt A, Novatchkova M, Sommer A, Barozzi I, Müller M, Decker T. Interferons reshape the 3D conformation and accessibility of macrophage chromatin. iScience 2022; 25:103840. [PMID: 35243225 PMCID: PMC8857492 DOI: 10.1016/j.isci.2022.103840] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/30/2021] [Accepted: 01/25/2022] [Indexed: 11/30/2022] Open
Abstract
Engagement of macrophages in innate immune responses is directed by type I and type II interferons (IFN-I and IFN-γ, respectively). IFN triggers drastic changes in cellular transcriptomes, executed by JAK-STAT signal transduction and the transcriptional control of interferon-stimulated genes (ISG) by STAT transcription factors. Here, we study the immediate-early nuclear response to IFN-I and IFN-γ in murine macrophages. We show that the mechanism of gene control by both cytokines includes a rapid increase of DNA accessibility and rearrangement of the 3D chromatin contacts particularly between open chromatin of ISG loci. IFN-stimulated gene factor 3 (ISGF3), the major transcriptional regulator of ISG, controlled homeostatic and, most notably, induced-state DNA accessibility at a subset of ISG. Increases in DNA accessibility correlated with the appearance of activating histone marks at surrounding nucleosomes. Collectively our data emphasize changes in the three-dimensional nuclear space and epigenome as an important facet of transcriptional control by the IFN-induced JAK-STAT pathway.
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Affiliation(s)
| | - Stephan Gruener
- Max Perutz Labs, University of Vienna, Vienna, Austria
- Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | | | - Laura Boccuni
- Max Perutz Labs, University of Vienna, Vienna, Austria
| | - Alexander Vogt
- Vienna Biocenter Core Facilities GmbH (VBCF), Vienna, Austria
| | - Maria Novatchkova
- Institute of Molecular Biotechnology of the Austrian Academy of Sciences (IMBA), Vienna, Austria
- Research Institute of Molecular Pathology (IMP), Vienna Biocenter (VBC), Vienna, Austria
| | - Andreas Sommer
- Vienna Biocenter Core Facilities GmbH (VBCF), Vienna, Austria
| | - Iros Barozzi
- Institute of Cancer Research, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | - Mathias Müller
- Institute of Animal Breeding and Genetics, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Thomas Decker
- Max Perutz Labs, University of Vienna, Vienna, Austria
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Robinson R, Roxanis I, Sobhani F, Zormpas-Petridis K, Steel H, Anbalagan S, Sommer A, Gothard L, Khan A, MacNeill F, Melcher A, Yuan Y, Somaiah N. PO-1085 Longitudinal assessment of immune infiltrate in breast cancer treated with neoadjuvant radiotherapy. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07536-8] [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: 10/20/2022]
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5
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Fyenbo D, Sommer A, Noergaard BL, Kronborg MB, Kristensen J, Gerdes C, Jensen HK, Jensen JM, Nielsen JC. No prognostic benefit of multimodality imaging-guided left ventricular lead placement in cardiac resynchronization therapy: Long-term follow-up of the ImagingCRT study. Europace 2021. [DOI: 10.1093/europace/euab116.439] [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: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Aarhus University, the Danish Heart Foundation, Health Research Foundation of Central Denmark Region, and Gangstedfonden.
Background
Observational data indicate that left ventricular (LV) lead placement at the latest contracting region and separate from myocardial scar is associated with improved prognosis in cardiac resynchronization therapy (CRT). In a double-blinded, randomized controlled trial (ImagingCRT), we tested the strategy of multimodality imaging-guided LV lead placement towards the latest mechanically activated non-scarred myocardial segment in CRT. Patients were included between 2011 and 2014 and allocated either to (1) imaging-guided LV lead placement using cardiac computed tomography, 99mTechnetium myocardial perfusion imaging, and speckle-tracking echocardiography (imaging group, n = 89) or to (2) routine LV lead implantation in a posterolateral region with late electrical activation (control group, n = 93). The multimodality imaging-guided strategy was found to reduce proportion of non-responders to CRT after 6 months. Impact on long-term clinical outcome is unknown.
Purpose
To evaluate the long-term effect of individualized multimodality imaging-guided LV lead placement compared to a routine fluoroscopic approach on the composite endpoint of death or heart failure (HF) hospitalization after CRT.
Method
We reviewed follow-up data until November 2020 for all 182 patients included in the ImagingCRT trial for the occurrence of HF hospitalization and all-cause death. Continuous variables are presented as median (interquartile range) or mean ± standard deviation. We used Kaplan-Meier plot and Cox proportional hazard regression analysis (unadjusted) to assess the risk of HF hospitalization and all-cause death, and used log-rank test for comparison between the two groups.
Results
All patients had standard CRT indication (left bundle branch block, New York Heart Association functional class II/ III/ IV 84 [46%]/ 92 [51%]/ 6 [3%], LV ejection fraction 25 ± 6%, QRS width 166 ± 22 milliseconds). Mean age was 70 ± 9 years, and 39 (21%) were female. During a median follow-up period of 6.7 years (3.3–7.9 years), the proportion of patients meeting the composite endpoint of HF hospitalization (n = 45 [25%]) or all-cause death (n = 56 [31%]) was 60% (n = 53) in the imaging group compared with 52% (n = 48) in the control group (hazard ratio [HR] 1.22, 95% confidence interval [CI] 0.83–1.81, p = 0.31) (Figure 1).
Neither the risk of HF hospitalization (HR 1.11, 95% CI 0.62–1.99, p = 0.72) or of all-cause death differed between the two groups (HR 1.23, 95% CI 0.82–1.85, p = 0.32).
Conclusion
An individualized multimodality imaging-guided strategy targeting LV lead placement towards the latest mechanically activated non-scarred myocardial segment during CRT implantation did not reduce the composite outcome of HF hospitalization or all-cause death during long-term follow-up. Abstract Figure 1
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Affiliation(s)
- D Fyenbo
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - A Sommer
- Aalborg University Hospital, Department of Cardiology, Aalborg, Denmark
| | - BL Noergaard
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - MB Kronborg
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - J Kristensen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - C Gerdes
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - HK Jensen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - JM Jensen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - JC Nielsen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
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Agorastos A, Sommer A, Wiedemann K, Demiralay C. Vasopressin surrogate marker copeptin as a potential novel endocrine biomarker for antidepressant treatment response in major depression: A pilot study. Eur Psychiatry 2021. [PMCID: PMC9470906 DOI: 10.1192/j.eurpsy.2021.1213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionMajor depressive disorder (MDD) constitutes the leading cause of disability worldwide. Although efficacious antidepressant pharmacotherapies exist for MDD, only about 40-60% of the patients respond to initial treatment. However, there is still a lack of robustly established and applicable biomarkers for antidepressant response in everyday clinical practice.ObjectivesThis study targets the assessment of the vasopressin (AVP) surrogate marker Copeptin (CoP), as a potential peripheral hypothalamic-level biomarker of antidepressant treatment response in MDD.MethodsWe measured baseline and dynamic levels of plasma CoP along with plasma ACTH and cortisol (CORT) in drug-naive outpatients with MDD before and after overnight manipulation of the hypothalamic-pituitary-adrenal (HPA) axis [i.e., stimulation (metyrapone) and suppression (dexamethasone)] on three consecutive days and their association with treatment response to 4 weeks of escitalopram treatment.ResultsOur findings suggest significantly higher baseline and post-metyrapone plasma CoP levels in future non-responders, a statistically significant invert association between baseline CoP levels and probability of treatment response and a potential baseline plasma CoP cut-off level of above 2.9 pmol/L for future non-response screening. Baseline and dynamic plasma ACTH and CORT levels showed no association with treatment response.ConclusionsThis pilot study provide first evidence in humans that CoP may represent a novel, clinically easily applicable, endocrine biomarker of antidepressant response, based on a single-measurement, cut-off level. These findings, underline the role of the vasopressinergic system in the pathophysiology of MDD and may represent a significant new tool in the clinical and biological phenotyping of MDD enhancing individual-tailored therapies.
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7
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Andre F, Seitz S, Fortner P, Sokiranski R, Gueckel F, Brado M, Sommer A, Goerich J, Buss SJ. Impact of Coronary CT angiography in combination with CAD-RADS on the management of coronary artery disease patients. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeaa356.237] [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
Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): Siemens Healthineers
Introduction
Coronary CT angiography (CCTA) plays an increasing role in the detection and risk stratification of patients with coronary artery disease (CAD). The Coronary Artery Disease – Reporting and Data System (CAD-RADS) allows for standardized classification of CCTA results and, thus, may improve patient management.
Purpose
Aim of this study was to assess the impact of CCTA in combination with CAD-RADS on patient management and to identify the impact of cardiovascular risk factors (CVRF) on CAD severity.
Methods
CCTA was performed on a third-generation dual-source CT scanner in patients, who were referred to a radiology centre by their attending physicians. In a total of 4801 patients, CVRF were derived from medical reports and anamnesis.
Results
The study population consisted of 4770 patients (62.0 (54.0-69.0) years, 2841 males) with CAD (CAD-RADS 1-5), while 31 patients showed no CAD and were excluded from further analyses. Age, male gender and the number of CVRF were associated with more severe CAD stages (all p < 0.001). 3040 patients (63.7 %) showed minimal or mild CAD requiring optimization of CVRF i.e. medical therapy but no further assessment at his time. A group of 266 patients (5.6 %) had a severe CAD defined as CAD-RADS 4B/5. In the multivariate regression analysis, age, male gender, history of smoking, diabetes mellitus and hyperlipidaemia were significant predictors for severe CAD, whereas arterial hypertension and family history of CAD did not reach significance. Of note, a subgroup of 28 patients (10.5 %) with a severe CAD (68.5 (65.5-70.0) years, 26 males, both p = n.s.) had no CVRF.
Conclusions
CCTA in combination with the CAD-RADS allowed for effective risk stratification of CAD patients. The majority of the patients showed non-obstructive CAD and, thus, could be treated conservatively without the need for further CAD assessment. CVRF out of arterial hypertension and family history had an impact on CAD severity reflected in higher CAD-RADs gradings. Of note, a relevant fraction of patients with CAD did not have any CVRF and, thus, may not be covered by risk stratification models.
CAD-RADS n Age (years) Males (%) 1 1453 56.0 (50.0-62.0) 623 (42.9 %) 2 1587 62.0 (55.0-69.0) 918 (57.8 %) 3 1067 66.0 (59.0-71.0) 749 (70.2 %) 4A 397 66.0 (59.0-72.0) 317 (79.8 %) 4B 162 67.0 (61.0-74.0) 139 (85.8 %) 5 104 66.0 (58.5.0-77.0) 95 (91.3 %)
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Affiliation(s)
- F Andre
- University of Heidelberg, Heidelberg, Germany
| | - S Seitz
- Radiology Center Sinsheim-Eberbach-Erbach-Walldorf-Heidelberg, Heidelberg, Germany
| | - P Fortner
- Radiology Center Sinsheim-Eberbach-Erbach-Walldorf-Heidelberg, Heidelberg, Germany
| | - R Sokiranski
- Radiology Center Sinsheim-Eberbach-Erbach-Walldorf-Heidelberg, Heidelberg, Germany
| | - F Gueckel
- Radiology Center Sinsheim-Eberbach-Erbach-Walldorf-Heidelberg, Heidelberg, Germany
| | - M Brado
- Radiology Center Sinsheim-Eberbach-Erbach-Walldorf-Heidelberg, Heidelberg, Germany
| | - A Sommer
- University of Heidelberg, Heidelberg, Germany
| | - J Goerich
- University of Heidelberg, Heidelberg, Germany
| | - SJ Buss
- University of Heidelberg, Heidelberg, Germany
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9
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Schröder H, Brockert AK, Beckers SK, Follmann A, Sommer A, Kork F, Rossaint R, Felzen M. [Appropriate allocation of resources for interhospital transfer in emergency medical service-is a physician in the dispatch center helpful?]. Anaesthesist 2020; 69:726-732. [PMID: 32671429 DOI: 10.1007/s00101-020-00817-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 04/21/2020] [Revised: 06/05/2020] [Accepted: 06/20/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The number of interhospital transfers is constantly increasing because of specialization of medical facilities, capacity balancing between intensive care units as well as earlier rehabilitation procedures. This leads to an increase in requests for emergency physicians to accompany patient transfers. This study investigated whether clarification of interhospital transport by an emergency physician at the dispatch center can optimize the use of emergency services resources. METHOD All transport clarifications performed by a tele-emergency physician between 1 January 2018 and 31 December 2019 were retrospectively analyzed as well as the transport request forms. Furthermore, all data on the number and alarmed rescue resources for interhospital transfers in the city of Aachen from 2013 onwards were exported from the dispatch center databank and included in the evaluation. RESULTS In total 2333 requests for interhospital patient transfers from 2018 and 2019 were analyzed as well as 10,923 transports recorded from 2013 to 2019. The number of patient transfers accompanied by an emergency physician from 2013 to 2019 was significantly reduced from 786 (68.2%) to 495 (30.5%, p > 0.001). The correct resources of rescue vehicles and staff was requested in 1816 cases (77.8%). The urgency of emergency patient transfers was correctly evaluated in 567 (89.2%) cases. In total 526 assignments were carried out without an emergency physician and 315 of these patients were accompanied by a tele-emergency physician during transfer. CONCLUSION The immediate clarification of interhospital transport requests by an emergency physician at the dispatch center leads to a significant reduction in unnecessary medical accompaniment of patient transfers. The choice of an appropriate transfer vehicle and staff should not be left to the requesting hospital physician alone.
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Affiliation(s)
- H Schröder
- Klinik für Anästhesiologie, Medizinische Fakultät, Uniklinik RWTH Aachen, RWTH Aachen University, Aachen, Deutschland.,Aachener Institut für Rettungsmedizin & zivile Sicherheit, Berufsfeuerwehr Aachen, Uniklinik RWTH Aachen & Stadt Aachen, Aachen, Deutschland
| | - A-K Brockert
- Klinik für Anästhesiologie, Medizinische Fakultät, Uniklinik RWTH Aachen, RWTH Aachen University, Aachen, Deutschland.,Aachener Institut für Rettungsmedizin & zivile Sicherheit, Berufsfeuerwehr Aachen, Uniklinik RWTH Aachen & Stadt Aachen, Aachen, Deutschland
| | - S K Beckers
- Klinik für Anästhesiologie, Medizinische Fakultät, Uniklinik RWTH Aachen, RWTH Aachen University, Aachen, Deutschland.,Aachener Institut für Rettungsmedizin & zivile Sicherheit, Berufsfeuerwehr Aachen, Uniklinik RWTH Aachen & Stadt Aachen, Aachen, Deutschland.,Ärztliche Leitung Rettungsdienst, Berufsfeuerwehr Aachen, Stadt Aachen, Stolberger Str. 155, 52068, Aachen, Deutschland
| | - A Follmann
- Klinik für Anästhesiologie, Medizinische Fakultät, Uniklinik RWTH Aachen, RWTH Aachen University, Aachen, Deutschland
| | - A Sommer
- Aachener Institut für Rettungsmedizin & zivile Sicherheit, Berufsfeuerwehr Aachen, Uniklinik RWTH Aachen & Stadt Aachen, Aachen, Deutschland
| | - F Kork
- Klinik für Anästhesiologie, Medizinische Fakultät, Uniklinik RWTH Aachen, RWTH Aachen University, Aachen, Deutschland
| | - R Rossaint
- Klinik für Anästhesiologie, Medizinische Fakultät, Uniklinik RWTH Aachen, RWTH Aachen University, Aachen, Deutschland
| | - M Felzen
- Klinik für Anästhesiologie, Medizinische Fakultät, Uniklinik RWTH Aachen, RWTH Aachen University, Aachen, Deutschland. .,Aachener Institut für Rettungsmedizin & zivile Sicherheit, Berufsfeuerwehr Aachen, Uniklinik RWTH Aachen & Stadt Aachen, Aachen, Deutschland. .,Ärztliche Leitung Rettungsdienst, Berufsfeuerwehr Aachen, Stadt Aachen, Stolberger Str. 155, 52068, Aachen, Deutschland.
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Gnirke A, Beckers SK, Gort S, Sommer A, Schröder H, Rossaint R, Felzen M. [Analgesia in the emergency medical service: comparison between tele-emergency physician and call back procedure with respect to application safety, effectiveness and tolerance]. Anaesthesist 2019; 68:665-675. [PMID: 31489458 DOI: 10.1007/s00101-019-00661-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 02/20/2019] [Revised: 08/19/2019] [Accepted: 08/20/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Acute pain is a common reason for calling emergency medical services (EMS) and can require medication depending on the pain intensity. German EMS personnel feel strong pressure to reduce a patient's pain but are restricted by law. Currently, German federal law only allows the administration of opioid-containing drugs by or on the order of a physician, while in other European countries (e.g. Switzerland and The Netherlands) the administration of opioid-based analgesia by trained and certified paramedics is common practice. Consequently, a patient in Germany experiencing acute pain needs the attendance of an emergency physician in EMS missions. According to international standards pain reduction on the numeric rating scale (NRS) score by ≥2 or a NRS score ≤4 at the end of the patient transport is considered to be adequate. OBJECTIVE Comparison of two different algorithm-based concepts for analgesia with consultation of a physician analyzing the efficacy, tolerance and safety of application. MATERIAL AND METHODS In a retrospective cohort study in two different regions, two physician-supported algorithm-based analgesia concepts, a call back-supported concept (EMS Schleswig-Holstein: RKiSH) and a tele-EMS physician-based concept (EMS Aachen: RDAC), were compared over 2 years. The call back-supported concept is based on specific algorithms and certification of EMS personnel. In Aachen, the tele-EMS physician is integrated into the routine EMS system and includes immediate vital data transmission. RESULTS Over a period of 2 years call back-supported analgesia was administered in 878 cases (2016: 428, 2017: 450) and telemedically assisted analgesia was used in 728 cases (2015: 226, 2016: 502). Call back vs. telemedicine: initial NRS scores were 9 (8-10) and 8 (6-9), respectively (p < 0.0001); NRS scores were reduced by 4 (3-5) and 5 (3-6), respectively (p = 0.0002), leading to mean NRS scores of 4 (3-6) vs. 3 (2-4), respectively (p < 0.0001) at patient handover/emergency room arrival. Clinically relevant pain reduction was achieved in both groups. Complete NRS documentation was conducted in 753 (85.8%) vs. 673 (92.4%) cases, respectively, p = 0. Severe adverse events did not occur in either of the groups. CONCLUSION The administration of analgesia by EMS personnel with teleconsultation of a physician is effective and has a low rate of complications, particularly morphine. Overall, algorithm-based call back-supported as well as telemedically supported analgesia concepts based on regular training improve the management of pain in the prehospital setting. In addition, the resources of the emergency physician remain available for life-threatening emergencies. The training, certification and supervision of EMS personnel is very important in both systems to ensure the best pain management care and patient safety. Adjustments to the federal law on the administration of analgesics would facilitate the realization of algorithm-based concepts by paramedics as pain reduction could be performed with delegation by a medical director without consulting another physician.
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Affiliation(s)
- A Gnirke
- Ärztliche Leitung Rettungsdienst, Rettungsdienst-Kooperation in Schleswig-Holstein, Heide, Deutschland
| | - S K Beckers
- Ärztliche Leitung Rettungsdienst, Berufsfeuerwehr Aachen, Stadt Aachen, Stolberger Str. 155, 52068, Aachen, Deutschland.,Klinik für Anästhesiologie, Medizinische Fakultät, RWTH Aachen University, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - S Gort
- Klinik für Anästhesiologie, Marienhospital Aachen, Aachen, Deutschland
| | - A Sommer
- Klinik für Anästhesiologie, Medizinische Fakultät, RWTH Aachen University, Uniklinik RWTH Aachen, Aachen, Deutschland.,Care and Public Health Research Institute, Universität Maastricht, Maastricht, Niederlande
| | - H Schröder
- Klinik für Anästhesiologie, Medizinische Fakultät, RWTH Aachen University, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - R Rossaint
- Klinik für Anästhesiologie, Medizinische Fakultät, RWTH Aachen University, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - M Felzen
- Ärztliche Leitung Rettungsdienst, Berufsfeuerwehr Aachen, Stadt Aachen, Stolberger Str. 155, 52068, Aachen, Deutschland. .,Klinik für Anästhesiologie, Medizinische Fakultät, RWTH Aachen University, Uniklinik RWTH Aachen, Aachen, Deutschland.
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Simon L, Rabanal FA, Dubos T, Oliver C, Lauber D, Poulet A, Vogt A, Mandlbauer A, Le Goff S, Sommer A, Duborjal H, Tatout C, Probst AV. Genetic and epigenetic variation in 5S ribosomal RNA genes reveals genome dynamics in Arabidopsis thaliana. Nucleic Acids Res 2019. [PMID: 29518237 PMCID: PMC5887818 DOI: 10.1093/nar/gky163] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Organized in tandem repeat arrays in most eukaryotes and transcribed by RNA polymerase III, expression of 5S rRNA genes is under epigenetic control. To unveil mechanisms of transcriptional regulation, we obtained here in depth sequence information on 5S rRNA genes from the Arabidopsis thaliana genome and identified differential enrichment in epigenetic marks between the three 5S rDNA loci situated on chromosomes 3, 4 and 5. We reveal the chromosome 5 locus as the major source of an atypical, long 5S rRNA transcript characteristic of an open chromatin structure. 5S rRNA genes from this locus translocated in the Landsberg erecta ecotype as shown by linkage mapping and chromosome-specific FISH analysis. These variations in 5S rDNA locus organization cause changes in the spatial arrangement of chromosomes in the nucleus. Furthermore, 5S rRNA gene arrangements are highly dynamic with alterations in chromosomal positions through translocations in certain mutants of the RNA-directed DNA methylation pathway and important copy number variations among ecotypes. Finally, variations in 5S rRNA gene sequence, chromatin organization and transcripts indicate differential usage of 5S rDNA loci in distinct ecotypes. We suggest that both the usage of existing and new 5S rDNA loci resulting from translocations may impact neighboring chromatin organization.
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Affiliation(s)
- Lauriane Simon
- GReD, Université Clermont Auvergne, CNRS, INSERM, BP 38, 63001 Clermont-Ferrand, France
| | - Fernando A Rabanal
- Gregor Mendel Institute (GMI), Austrian Academy of Sciences, Vienna BioCenter (VBC), Dr. Bohr-Gasse 3, 1030 Vienna, Austria
| | - Tristan Dubos
- GReD, Université Clermont Auvergne, CNRS, INSERM, BP 38, 63001 Clermont-Ferrand, France
| | - Cecilia Oliver
- Departamento de Genética, Facultad de Biología, Universidad Complutense de Madrid, Madrid 28040, Spain
| | - Damien Lauber
- GReD, Université Clermont Auvergne, CNRS, INSERM, BP 38, 63001 Clermont-Ferrand, France
| | - Axel Poulet
- GReD, Université Clermont Auvergne, CNRS, INSERM, BP 38, 63001 Clermont-Ferrand, France
| | - Alexander Vogt
- Vienna Biocenter Core Facilities GmbH (VBCF), Dr. Bohr-Gasse 3, 1030 Vienna, Austria
| | - Ariane Mandlbauer
- Vienna Biocenter Core Facilities GmbH (VBCF), Dr. Bohr-Gasse 3, 1030 Vienna, Austria
| | - Samuel Le Goff
- GReD, Université Clermont Auvergne, CNRS, INSERM, BP 38, 63001 Clermont-Ferrand, France
| | - Andreas Sommer
- Vienna Biocenter Core Facilities GmbH (VBCF), Dr. Bohr-Gasse 3, 1030 Vienna, Austria
| | - Hervé Duborjal
- Plant Engineering Platform, BIOGEMMA, Route d'Ennezat Centre de Recherche de Chappes, 63720 Chappes, France
| | - Christophe Tatout
- GReD, Université Clermont Auvergne, CNRS, INSERM, BP 38, 63001 Clermont-Ferrand, France
| | - Aline V Probst
- GReD, Université Clermont Auvergne, CNRS, INSERM, BP 38, 63001 Clermont-Ferrand, France
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13
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Lam YL, Lawson JA, Toonder IM, Shadid NH, Sommer A, Veenstra M, van der Kleij AMJ, Ceulen RP, de Haan E, Ibrahim F, van Dooren T, Nieman FH, Wittens CHA. Eight-year follow-up of a randomized clinical trial comparing ultrasound-guided foam sclerotherapy with surgical stripping of the great saphenous vein. Br J Surg 2019; 105:692-698. [PMID: 29652081 DOI: 10.1002/bjs.10762] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/24/2017] [Accepted: 10/20/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND This was an 8-year follow-up of an RCT comparing ultrasound-guided foam sclerotherapy (UGFS) with high ligation and surgical stripping (HL/S) of the great saphenous vein (GSV). METHODS Patients were randomized to UGFS or HL/S of the GSV. The primary outcome was the recurrence of symptomatic GSV reflux. Secondary outcomes were patterns of reflux according to recurrent varices after surgery, Clinical Etiologic Anatomic Pathophysiologic (CEAP) classification, Venous Clinical Severity Score (VCSS) and EuroQol Five Dimensions (EQ-5D™) quality-of-life scores. RESULTS Of 430 patients originally randomized (230 UGFS, 200 HL/S), 227 (52·8 per cent; 123 UGFS, 103 HL/S) were available for analysis after 8 years. The proportion of patients free from symptomatic GSV reflux at 8 years was lower after UGFS than HL/S (55·1 versus 72·1 per cent; P = 0·024). The rate of absence of GSV reflux, irrespective of venous symptoms, at 8 years was 33·1 and 49·7 per cent respectively (P = 0·009). More saphenofemoral junction (SFJ) failure (65·8 versus 41·7 per cent; P = 0·001) and recurrent reflux in the above-knee GSV (72·5 versus 20·4 per cent; P = 0·001) was evident in the UGFS group. The VCSS was worse than preoperative scores in both groups after 8 years; CEAP classification and EQ-5D® scores were similar in the two groups. CONCLUSION Surgical stripping had a technically better outcome in terms of recurrence of GSV and SFJ reflux than UGFS in the long term. Long-term follow-up suggests significant clinical progression of venous disease measured by VCSS in both groups, but less after surgery. Registration number: NCT02304146 (http://www.clinicaltrials.gov).
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Affiliation(s)
- Y L Lam
- Department of Venous Surgery, European Venous Centre, Maastricht, The Netherlands.,Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands
| | - J A Lawson
- Skin and Vein Clinic Oosterwal, Alkmaar, The Netherlands
| | - I M Toonder
- Department of Venous Surgery, European Venous Centre, Maastricht, The Netherlands
| | - N H Shadid
- Department of Dermatology, Haaglanden Medisch Centrum Antoniushove, The Hague, The Netherlands
| | - A Sommer
- Parkwegkliniek Sommer, Maastricht, The Netherlands
| | - M Veenstra
- Department of Dermatology, Rijnstate Hospital, Arnhem, The Netherlands
| | - A M J van der Kleij
- Department of Dermatology, Zuyderland Medisch Centrum, Heerlen, The Netherlands
| | - R P Ceulen
- Ceulen Huidkliniek, Helmond, The Netherlands
| | - E de Haan
- Department of Surgery, Laurentius Hospital, Roermond, The Netherlands
| | - F Ibrahim
- Department of Dermatology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - T van Dooren
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - F H Nieman
- Department of Venous Surgery, European Venous Centre, Maastricht, The Netherlands
| | - C H A Wittens
- Department of Venous Surgery, European Venous Centre, Maastricht, The Netherlands.,Department of Vascular Surgery, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Nordrhein-Westfalen, Aachen, Germany
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Sommer A, Ziegler L, Plewnia C. P25. Time specific neuronal activation and its association with cognitive control over emotions. Clin Neurophysiol 2018. [DOI: 10.1016/j.clinph.2018.04.667] [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: 10/28/2022]
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Sommer A. Kinesin spindle protein inhibitors as novel payload class for ADCs. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy046.019] [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: 11/13/2022] Open
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Sommer A, Kronborg MB, Gerdes C, Kristensen J, Nielsen JC. P331Ventricular paced interlead electrical delay and response to cardiac resynchronization therapy. Europace 2018. [DOI: 10.1093/europace/euy015.143] [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: 11/12/2022] Open
Affiliation(s)
- A Sommer
- Aarhus University Hospital, Skejby, Department of Cardiology, Aarhus, Denmark
| | - M B Kronborg
- Aarhus University Hospital, Skejby, Department of Cardiology, Aarhus, Denmark
| | - C Gerdes
- Aarhus University Hospital, Skejby, Department of Cardiology, Aarhus, Denmark
| | - J Kristensen
- Aarhus University Hospital, Skejby, Department of Cardiology, Aarhus, Denmark
| | - J C Nielsen
- Aarhus University Hospital, Skejby, Department of Cardiology, Aarhus, Denmark
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Stephansen C, Sommer A, Kronborg M, Gerdes C, Kristensen J, Nielsen J. 532Association between right ventricular paced QRS width and response to cardiac resynchronization therapy. Europace 2018. [DOI: 10.1093/europace/euy015.299] [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: 11/13/2022] Open
Affiliation(s)
- C Stephansen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - A Sommer
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - M Kronborg
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - C Gerdes
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - J Kristensen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
| | - J Nielsen
- Aarhus University Hospital, Department of Cardiology, Aarhus, Denmark
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Kronborg MB, Sommer A, Fyenbo DB, Norgaard BL, Gerdes C, Jensen JM, Jensen HK, Kristensen J, Nielsen JC. 269Left ventricular regional remodeling and lead position during CRT. Europace 2018. [DOI: 10.1093/europace/euy015.081] [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: 11/13/2022] Open
Affiliation(s)
- M B Kronborg
- Aarhus university Hospital, Skejby, Aarhus, Denmark
| | - A Sommer
- Aarhus university Hospital, Skejby, Aarhus, Denmark
| | - D B Fyenbo
- Aarhus university Hospital, Skejby, Aarhus, Denmark
| | - B L Norgaard
- Aarhus university Hospital, Skejby, Aarhus, Denmark
| | - C Gerdes
- Aarhus university Hospital, Skejby, Aarhus, Denmark
| | - J M Jensen
- Aarhus university Hospital, Skejby, Aarhus, Denmark
| | - H K Jensen
- Aarhus university Hospital, Skejby, Aarhus, Denmark
| | - J Kristensen
- Aarhus university Hospital, Skejby, Aarhus, Denmark
| | - J C Nielsen
- Aarhus university Hospital, Skejby, Aarhus, Denmark
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Sommer A, Stephansen C, Kronborg MB, Kristensen J, Gerdes C, Nielsen JC. P335Intra-procedural QRS shortening and response to cardiac resynchronization therapy. Europace 2018. [DOI: 10.1093/europace/euy015.146] [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: 11/13/2022] Open
Affiliation(s)
- A Sommer
- Aarhus University Hospital, Skejby, Department of Cardiology, Aarhus, Denmark
| | - C Stephansen
- Aarhus University Hospital, Skejby, Department of Cardiology, Aarhus, Denmark
| | - M B Kronborg
- Aarhus University Hospital, Skejby, Department of Cardiology, Aarhus, Denmark
| | - J Kristensen
- Aarhus University Hospital, Skejby, Department of Cardiology, Aarhus, Denmark
| | - C Gerdes
- Aarhus University Hospital, Skejby, Department of Cardiology, Aarhus, Denmark
| | - J C Nielsen
- Aarhus University Hospital, Skejby, Department of Cardiology, Aarhus, Denmark
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Barz T, Sommer A, Wilms T, Neubauer P, Cruz Bournazou MN. Adaptive optimal operation of a parallel robotic liquid handling station ⁎ ⁎T.B. and A.S. acknowledge partial funding of this project by the Austrian Research Funding Association (FFG) within the programme Bridge in the project modELTES (project No. 851262). M.N.C.B. acknowledge financial support by the German Federal Ministry of Education and Research (BMBF) within the Framework Concept ‘Research for Tomorrow’s Production’ (AUTOBIO). ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.ifacol.2018.04.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Heil A, Lazo Gonzalez E, Hilgenfeld T, Kickingereder P, Bendszus M, Heiland S, Ozga AK, Sommer A, Lux CJ, Zingler S. Lateral cephalometric analysis for treatment planning in orthodontics based on MRI compared with radiographs: A feasibility study in children and adolescents. PLoS One 2017; 12:e0174524. [PMID: 28334054 PMCID: PMC5363936 DOI: 10.1371/journal.pone.0174524] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 03/10/2017] [Indexed: 11/18/2022] Open
Abstract
Objective The objective of this prospective study was to evaluate whether magnetic resonance imaging (MRI) is equivalent to lateral cephalometric radiographs (LCR, “gold standard”) in cephalometric analysis. Methods The applied MRI technique was optimized for short scanning time, high resolution, high contrast and geometric accuracy. Prior to orthodontic treatment, 20 patients (mean age ± SD, 13.95 years ± 5.34) received MRI and LCR. MRI datasets were postprocessed into lateral cephalograms. Cephalometric analysis was performed twice by two independent observers for both modalities with an interval of 4 weeks. Eight bilateral and 10 midsagittal landmarks were identified, and 24 widely used measurements (14 angles, 10 distances) were calculated. Statistical analysis was performed by using intraclass correlation coefficient (ICC), Bland-Altman analysis and two one-sided tests (TOST) within the predefined equivalence margin of ± 2°/mm. Results Geometric accuracy of the MRI technique was confirmed by phantom measurements. Mean intraobserver ICC were 0.977/0.975 for MRI and 0.975/0.961 for LCR. Average interobserver ICC were 0.980 for MRI and 0.929 for LCR. Bland-Altman analysis showed high levels of agreement between the two modalities, bias range (mean ± SD) was -0.66 to 0.61 mm (0.06 ± 0.44) for distances and -1.33 to 1.14° (0.06 ± 0.71) for angles. Except for the interincisal angle (p = 0.17) all measurements were statistically equivalent (p < 0.05). Conclusions This study demonstrates feasibility of orthodontic treatment planning without radiation exposure based on MRI. High-resolution isotropic MRI datasets can be transformed into lateral cephalograms allowing reliable measurements as applied in orthodontic routine with high concordance to the corresponding measurements on LCR.
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Affiliation(s)
- Alexander Heil
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
- * E-mail:
| | | | - Tim Hilgenfeld
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Martin Bendszus
- Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Sabine Heiland
- Division of Experimental Radiology, Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Ann-Kathrin Ozga
- Institute for Medical Biometry and Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Andreas Sommer
- Department of Orthodontics and Dentofacial Orthopaedics, Heidelberg University Hospital, Germany
| | - Christopher J. Lux
- Department of Orthodontics and Dentofacial Orthopaedics, Heidelberg University Hospital, Germany
| | - Sebastian Zingler
- Department of Orthodontics and Dentofacial Orthopaedics, Heidelberg University Hospital, Germany
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Sommer A, Kräling T, Heindel W, Lenzen H. Auswirkungen der neuen Diagnostischen Referenzwerte auf das Mammografie-Screening in Nordrhein-Westfalen. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600436] [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: 10/19/2022]
Affiliation(s)
- A Sommer
- Universitätsklinikum Münster, Referenzzentrum Mammografie Münster, Münster
| | - T Kräling
- Universitätsklinikum Münster, Institut für Klinische Radiologie, Münster
| | - W Heindel
- Universitätsklinikum Münster, Institut für Klinische Radiologie, Münster
| | - H Lenzen
- Universitätsklinikum Münster, Institut für Klinische Radiologie, Münster
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Sommer A, Blendl C, Lenzen H. Unsicherheitsbudget des CDMAM-Prüfverfahrens. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600437] [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: 10/19/2022]
Affiliation(s)
- A Sommer
- Universitätsklinikum Münster, Referenzzentrum Mammografie Münster, Münster
| | - C Blendl
- Technische Hochschule Köln, Institut für Medien- und Phototechnik, Köln
| | - H Lenzen
- Universitätsklinikum Münster, Institut für Klinische Radiologie, Münster
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Zingler S, Sommer A, Sen S, Saure D, Langer J, Guillon O, Lux CJ. Erratum to: Efficiency of powered systems for interproximal enamel reduction (IER) and enamel roughness before and after polishing-an in vitro study. Clin Oral Investig 2016; 20:2323. [PMID: 27221517 DOI: 10.1007/s00784-016-1857-5] [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: 10/21/2022]
Affiliation(s)
- Sebastian Zingler
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Heidelberg, Germany.
| | - Andreas Sommer
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Heidelberg, Germany
| | - Sinan Sen
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Heidelberg, Germany
| | - Daniel Saure
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Jochen Langer
- Institute of Materials Science, Technische Universität Darmstadt, Darmstadt, Germany.,Heraeus Holding GmbH, Hanau, Germany
| | - Olivier Guillon
- Institute of Materials Science, Technische Universität Darmstadt, Darmstadt, Germany.,Forschungszentrum Jülich GmbH, Institute of Energy and Climate Research, Materials Synthesis and Processing, Jülich, Germany
| | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Heidelberg, Germany
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Maessen-Visch MB, Sommer A, De Paepe JA, Neumann HAM. Changes in Microcirculation in Patients with Atrophie Blanche Visualized by Laser Doppler Perfusion Imaging and Transcutaneous Oxygen Measurements. Phlebology 2016. [DOI: 10.1177/026835559801300203] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To quantify differences in microcirculation in atrophie blanche (AB) in patients with chronic venous insufficiency (CVI) and in healthy controls before and after venous occlusion. Design: Prospective study in a single patient group. Setting: Department of Dermatology, University Hospital Maastricht, The Netherlands. Patients and methods: Sixteen patients with CVI and large lesions of AB, 10 patients with CVI without AB and 10 healthy controls were enrolled in the study. Laser Doppler perfusion imaging (LDPI) measurements were performed in and outside large lesions of AB and in healthy controls. Transcutaneous oxygen (Tc Po2) measurements were performed in patients with CVI with and without AB and in healthy controls. Results: Median basal resting flow was higher in AB than in healthy controls (0.67 mV versus 0.21 mV, p = 0.002). The venoarteriolar response (VAR was increased significantly in AB (58% versus 43%, p = 0.04). A significant decrease in Tc Po2 values occurred in AB lesions with 40 mmHg, in CVI skin with 60 mmHg and in healthy controls with 80 mmHg. Conclusion: Basic resting flux in AB measured with LDPI is increased compared with clinically normal skin. The decrease in flux on venous occlusion is larger in AB than in healthy controls.
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Affiliation(s)
- M. B. Maessen-Visch
- Department of Dermatology, University Hospital Maastricht, Maastricht, The Netherlands
| | - A. Sommer
- Department of Dermatology, University Hospital Maastricht, Maastricht, The Netherlands
| | - J. A. De Paepe
- Department of Dermatology, University Hospital Maastricht, Maastricht, The Netherlands
| | - H. A. M. Neumann
- Department of Dermatology, University Hospital Maastricht, Maastricht, The Netherlands
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Wright D, Gobin JP, Bradbury AW, Coleridge-Smith P, Spoelstra H, Berridge D, Wittens CHA, Sommer A, Nelzen O, Chanter D. Varisolve® polidocanol microfoam compared with surgery or sclerotherapy in the management of varicose veins in the presence of trunk vein incompetence: European randomized controlled trial. Phlebology 2016. [DOI: 10.1258/026835506779115807] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective: To compare the safety and efficacy of Varisolve® 1% polidocanol microfoam sclerosant with alternative treatments for patients with varicose veins and trunk vein incompetence. Methods: An open-label, multicentre, prospective trial of 710 patients randomized to receive either Varisolve® or alternative treatment (surgery or sclerotherapy). The endpoint was ultrasound-determined occlusion of trunk vein(s) and elimination of reflux, analysed against a non-inferiority hypothesis. Results: Overall, non-inferiority was demonstrated with 83.4% efficacy for Varisolve® compared with 88.1% for alternative treatment at three months, and the corresponding magnitudes were 78.9 and 80.4% at 12 months. Surgery was superior to Varisolve®, but the success rate of 68.2% for Varisolve® (surgery 87.2%) was poor compared with 93.8% success for Varisolve® achieved in those randomized to Varisolve® or sclerotherapy. Varisolve® was superior to sclerotherapy at 12 months ( P = 0.001). Deep vein thrombosis occurred in 11/437 (2.5%) after Varisolve®, in 1/125 (0.8%) after sclerotherapy and in none after surgery. No pulmonary emboli were detected. Conclusion: Overall, Varisolve® was non-inferior to alternative treatment. Surgery was more efficacious, but Varisolve® caused less pain and patients returned to normal more quickly. The Varisolve® technique is a useful additional treatment for varicose veins and trunk vein incompetence.
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Affiliation(s)
| | - J P Gobin
- Cabinet De Medecine Vasculaire, Lyon, France
| | - A W Bradbury
- University of Birmingham, and Heart of England NHS Foundation Trust, Birmingham, UK
| | | | - H Spoelstra
- Therapeutisch Vascular Centrum, Gavere, Belgium
| | - D Berridge
- Leeds Vascular Institute, The General Infirmary at Leeds, Leeds, UK
| | - C H A Wittens
- Department of Vascular Surgery, Sint Franciscus Gasthuis Kleiweg, Rotterdam, The Netherlands
| | - A Sommer
- Department of Dermatology, University Hospital Maastricht, Maastricht, The Netherlands
| | - O Nelzen
- Vascular Surgery Unit, Department of Surgery, Skaraborg Hospital, Skovde, Sweden
| | - D Chanter
- Statisfaction Statistical Consultancy Ltd, Bexhill on Sea, UK
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Feichtinger J, Hernández I, Fischer C, Hanscho M, Auer N, Hackl M, Jadhav V, Baumann M, Krempl PM, Schmidl C, Farlik M, Schuster M, Merkel A, Sommer A, Heath S, Rico D, Bock C, Thallinger GG, Borth N. Comprehensive genome and epigenome characterization of CHO cells in response to evolutionary pressures and over time. Biotechnol Bioeng 2016; 113:2241-53. [PMID: 27072894 PMCID: PMC5006888 DOI: 10.1002/bit.25990] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [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: 11/29/2015] [Revised: 03/15/2016] [Accepted: 04/07/2016] [Indexed: 01/03/2023]
Abstract
The most striking characteristic of CHO cells is their adaptability, which enables efficient production of proteins as well as growth under a variety of culture conditions, but also results in genomic and phenotypic instability. To investigate the relative contribution of genomic and epigenetic modifications towards phenotype evolution, comprehensive genome and epigenome data are presented for six related CHO cell lines, both in response to perturbations (different culture conditions and media as well as selection of a specific phenotype with increased transient productivity) and in steady state (prolonged time in culture under constant conditions). Clear transitions were observed in DNA‐methylation patterns upon each perturbation, while few changes occurred over time under constant conditions. Only minor DNA‐methylation changes were observed between exponential and stationary growth phase; however, throughout a batch culture the histone modification pattern underwent continuous adaptation. Variation in genome sequence between the six cell lines on the level of SNPs, InDels, and structural variants is high, both upon perturbation and under constant conditions over time. The here presented comprehensive resource may open the door to improved control and manipulation of gene expression during industrial bioprocesses based on epigenetic mechanisms. Biotechnol. Bioeng. 2016;113: 2241–2253. © 2016 The Authors. Biotechnology and Bioengineering Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Julia Feichtinger
- Austrian Center of Industrial Biotechnology, Muthgasse 11, Vienna, 1190, Austria.,Graz University of Technology, Graz, Austria
| | - Inmaculada Hernández
- Austrian Center of Industrial Biotechnology, Muthgasse 11, Vienna, 1190, Austria
| | - Christoph Fischer
- Austrian Center of Industrial Biotechnology, Muthgasse 11, Vienna, 1190, Austria.,Graz University of Technology, Graz, Austria
| | - Michael Hanscho
- Austrian Center of Industrial Biotechnology, Muthgasse 11, Vienna, 1190, Austria
| | - Norbert Auer
- University of Natural Resources and Life Sciences Vienna, Muthgasse 18, Vienna, 1190, Austria
| | - Matthias Hackl
- University of Natural Resources and Life Sciences Vienna, Muthgasse 18, Vienna, 1190, Austria
| | - Vaibhav Jadhav
- Austrian Center of Industrial Biotechnology, Muthgasse 11, Vienna, 1190, Austria
| | - Martina Baumann
- Austrian Center of Industrial Biotechnology, Muthgasse 11, Vienna, 1190, Austria
| | - Peter M Krempl
- Austrian Center of Industrial Biotechnology, Muthgasse 11, Vienna, 1190, Austria.,Graz University of Technology, Graz, Austria
| | - Christian Schmidl
- CeMM Research Center for Molecular Medicine, Austrian Academy of Sciences, Vienna, Austria
| | - Matthias Farlik
- CeMM Research Center for Molecular Medicine, Austrian Academy of Sciences, Vienna, Austria
| | - Michael Schuster
- CeMM Research Center for Molecular Medicine, Austrian Academy of Sciences, Vienna, Austria
| | | | - Andreas Sommer
- Research Institute of Molecular Pathology, Vienna, Austria
| | - Simon Heath
- Center for Genomic Regulation (CRG), Barcelona, Spain
| | - Daniel Rico
- Spanish National Cancer Research Center (CNIO), Madrid, Spain
| | - Christoph Bock
- CeMM Research Center for Molecular Medicine, Austrian Academy of Sciences, Vienna, Austria
| | - Gerhard G Thallinger
- Austrian Center of Industrial Biotechnology, Muthgasse 11, Vienna, 1190, Austria.,Graz University of Technology, Graz, Austria
| | - Nicole Borth
- Austrian Center of Industrial Biotechnology, Muthgasse 11, Vienna, 1190, Austria. .,University of Natural Resources and Life Sciences Vienna, Muthgasse 18, Vienna, 1190, Austria.
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Sommer A. Are you afraid of the dark? Notes on the psychology of belief in histories of science and the occult. Eur J Psychother Couns 2016; 18:105-122. [PMID: 27226762 PMCID: PMC4867875 DOI: 10.1080/13642537.2016.1170062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 03/04/2016] [Indexed: 11/06/2022]
Abstract
The popular view of the inherent conflict between science and the occult has been rendered obsolete by recent advances in the history of science. Yet, these historiographical revisions have gone unnoticed in the public understanding of science and public education at large. Particularly, reconstructions of the formation of modern psychology and its links to psychical research can show that the standard view of the latter as motivated by metaphysical bias fails to stand up to scrutiny. After highlighting certain basic methodological maxims shared by psychotherapists and historians, I will try to counterbalance simplistic claims of a ‘need to believe’ as a precondition of scientific open-mindedness regarding the occurrence of parapsychological phenomena by discussing instances revealing a presumably widespread ‘will to disbelieve’ in the occult. I shall argue that generalized psychological explanations are only helpful in our understanding of history if we apply them in a symmetrical manner.
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Affiliation(s)
- Andreas Sommer
- Churchill College & Department of History and Philosophy of Science, University of Cambridge , Cambridge , UK
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Sommer A. Fehler und Artefakte in der Mammografie. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581257] [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: 10/22/2022]
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Hink P, Sommer A. Physikalische Analysemethoden zur Bewertung der Bildqualität in der digitalen Mammografie. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581621] [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: 10/22/2022]
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Affiliation(s)
- A Sommer
- Klinik für Dermatologie und Allergologie, Ruhr-Universität, Bochum
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Le Maléfan P, Sommer A. Léon Marillier and the veridical hallucination in late-nineteenth- and early-twentieth-century French psychology and psychopathology. Hist Psychiatry 2015; 26:418-432. [PMID: 26574058 DOI: 10.1177/0957154x14562756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Recent research on the professionalization of psychology at the end of the nineteenth century shows how objects of knowledge which appear illegitimate to us today shaped the institutionalization of disciplines. The veridical or telepathic hallucination was one of these objects, constituting a field both of division and exchange between nascent psychology and disciplines known as 'psychic sciences' in France, and 'psychical research' in the Anglo-American context. In France, Leon Marillier (1862-1901) was the main protagonist in discussions concerning the concept of the veridical hallucination, which gave rise to criticisms by mental specialists and psychopathologists. After all, not only were these hallucinations supposed to occur in healthy subjects, but they also failed to correspond to the Esquirolian definition of hallucinations through being corroborated by their representation of external, objective events.
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Zingler S, Sommer A, Sen S, Saure D, Langer J, Guillon O, Lux CJ. Efficiency of powered systems for interproximal enamel reduction (IER) and enamel roughness before and after polishing—an in vitro study. Clin Oral Investig 2015; 20:933-42. [PMID: 26419674 DOI: 10.1007/s00784-015-1585-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 08/30/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Sebastian Zingler
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Heidelberg, Germany.
| | - Andreas Sommer
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Heidelberg, Germany
| | - Sinan Sen
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Heidelberg, Germany
| | - Daniel Saure
- Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
| | - Jochen Langer
- Institute of Materials Science, Technische Universität Darmstadt, Darmstadt, Germany
- Heraeus Holding GmbH, Hanau, Germany
| | - Olivier Guillon
- Institute of Materials Science, Technische Universität Darmstadt, Darmstadt, Germany
- Forschungszentrum Jülich GmbH, Institute of Energy and Climate Research, Materials Synthesis and Processing, Jülich, Germany
| | - Christopher J Lux
- Department of Orthodontics and Dentofacial Orthopaedics, University of Heidelberg, Heidelberg, Germany
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Sommer A. Artefakte in der Mammografie. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550802] [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]
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Sommer A, Entz K, Hink P, Lenzen H. Evaluation der automatischen Ermittlung der Kontrast-Detail-Erkennbarkeit an digitalen Mammografiesystemen. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551200] [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]
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West KP, Sommer A, Palmer A, Schultink W, Habicht JP. Commentary: Vitamin A policies need rethinking. Int J Epidemiol 2015; 44:292-4; discussion 294-6. [DOI: 10.1093/ije/dyu275] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Sommer A, Kronborg MB, Witt CT, Norgaard BL, Nielsen JC. The paced electrocardiogram cannot be used to identify left and right ventricular pacing sites in cardiac resynchronization therapy: validation by cardiac computed tomography. Europace 2014; 17:432-8. [DOI: 10.1093/europace/euu323] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
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Sommer A. Psychical research in the history and philosophy of science. An introduction and review. Stud Hist Philos Biol Biomed Sci 2014; 48 Pt A:38-45. [PMID: 25241025 DOI: 10.1016/j.shpsc.2014.08.004] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 08/07/2014] [Accepted: 08/14/2014] [Indexed: 06/03/2023]
Abstract
As a prelude to articles published in this special issue, I sketch changing historiographical conventions regarding the 'occult' in recent history of science and medicine scholarship. Next, a review of standard claims regarding psychical research and parapsychology in philosophical discussions of the demarcation problem reveals that these have tended to disregard basic primary sources and instead rely heavily on problematic popular accounts, simplistic notions of scientific practice, and outdated teleological historiographies of progress. I conclude by suggesting that rigorous and sensitively contextualized case studies of past elite heterodox scientists may be potentially useful to enrich historical and philosophical scholarship by highlighting epistemologies that have fallen through the crude meshes of triumphalist and postmodernist historiographical generalizations alike.
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Affiliation(s)
- Andreas Sommer
- University of Cambridge, Churchill College & Department of History and Philosophy of Science, UK.
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Merbl Y, Sommer A, Chai O, Aroch I, Zimmerman G, Friedman A, Soreq H, Shamir M. Tumor necrosis factor-α and interleukin-6 concentrations in cerebrospinal fluid of dogs after seizures. J Vet Intern Med 2014; 28:1775-81. [PMID: 25308784 PMCID: PMC4895630 DOI: 10.1111/jvim.12462] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Revised: 06/06/2014] [Accepted: 08/21/2014] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Idiopathic and acquired epilepsy are common in dogs. Up to 30% of these dogs are refractory to pharmacological treatment. Accumulating experimental evidence indicates that brain immune response and presence of inflammatory mediators decrease the threshold for individual seizures and contribute to epileptogenesis. HYPOTHESIS Dogs with seizures have higher cerebrospinal interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentrations compared to dogs with no seizures. METHODS A prospective double blinded study; cerebrospinal fluid (CSF) and serum IL-6, TNF-α and total protein (TP) concentrations were measured by a blinded investigator for the study group and CSF IL-6 and TNF-α levels and TP concentrations were measured in the control group (CG). ANIMALS Dogs presented with seizures that had enough CSF collected to allow analysis were included in the study group. Twelve apparently healthy, quarantined, stray dogs served as control (CG). RESULTS Cerebrospinal fluid TNF-α and IL-6 concentrations were significantly higher (P = .011, P = .039) in dogs with seizures (0 ± 70.66, 0.65 ± 10.93 pg/mL) compared to the CG (0 ± 19, 0.73 ± 0.55 pg/mL). When assessing cytokine concentrations of specifically the idiopathic epilepsy (IE) dogs compared to the CG, only TNF-α concentrations (8.66 ± 62, 0 ± 19 pg/mL) were significantly higher (P = .01). CSF TP concentrations were not significantly higher in the study dogs compared to the CG. CONCLUSIONS AND CLINICAL IMPORTANCE Higher TNF-α and IL-6 concentration in the CSF of dogs with naturally occurring seizures. The higher supports the hypothesis that inflammatory processes through certain mediators play a role in the pathogenesis of seizures in dogs.
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Affiliation(s)
- Y. Merbl
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
| | - A. Sommer
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
| | - O. Chai
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
| | - I. Aroch
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
| | - G. Zimmerman
- Edmond and Lily Safra Center of Brain ScienceHebrew University of JerusalemJerusalemIsrael
| | - A. Friedman
- Department of Life SciencesBen‐Gurion University of the NegevBeer ShevaIsrael
| | - H. Soreq
- Edmond and Lily Safra Center of Brain ScienceHebrew University of JerusalemJerusalemIsrael
- Department of Biological ChemistryAlexander Silberman Institute of Life SciencesHebrew University of JerusalemJerusalemIsrael
| | - M.H. Shamir
- Koret School of Veterinary MedicineHebrew University of JerusalemRehovotIsrael
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Sommer A, Mickler F, Herrmann A, Hermawan A, Bräuchle C, Wagner E, Knyazev P, Ullrich A, Roidl A. 632: Tamoxifen resistance can be overcome by salinomycin treatment. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)50555-2] [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: 10/25/2022]
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Sommer A. Dualenergie, Tomosynthese und Fehleranalyse an Screeningsystemen. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373164] [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: 10/25/2022]
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Krähling T, Sommer A, Heindel W, Lenzen H. Einfluss betreiber- und gerätespezifischer Faktoren auf die Strahlenexposition bei kurativen Mammografien. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373191] [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: 10/25/2022]
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Sommer A, Entz K, Heise P, Heindel W, Lenzen H. Herstellerabhängiger Vergleich der mittleren Parenchymdosis von volldigitalen Mammografie Systemen im Screening. ROFO-FORTSCHR RONTG 2014. [DOI: 10.1055/s-0034-1373190] [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: 10/25/2022]
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Sommer A, Kronborg MB, Norgaard BL, Gerdes C, Mortensen PT, Nielsen JC. Left and right ventricular lead positions are imprecisely determined by fluoroscopy in cardiac resynchronization therapy: a comparison with cardiac computed tomography. Europace 2014; 16:1334-41. [DOI: 10.1093/europace/euu056] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Entz K, Sommer A, Heindel W, Lenzen H. Relationship between detector size and the need for extra images and their effect on radiation exposure in digital mammography screening. ROFO-FORTSCHR RONTG 2014; 186:868-75. [PMID: 24563411 DOI: 10.1055/s-0033-1356429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To determine the number of extra images (EI) that are necessary for imaging large breasts when using a detector smaller than 24 cm × 30 cm and to calculate the additional average glandular dose (AGD) for these images. MATERIALS AND METHODS The screening mammograms taken between 2007 and 2011 were assessed for a photon counting full-field digital mammography (PCM) system (detector size: 24 cm × 26 cm) and a computed radiography (CR) system (24 cm × 30 cm). The number of EI was recorded and the AGD calculated. This AGD was compared with the mean AGD of 47 conventional full-field digital mammography (FFDM) systems. RESULTS A total of 62,466 examinations were analyzed. EI had to be taken in 0.6 % (199/32,766) of all PCM examinations and 0.3 % (90/29 700) of all CR examinations. This corresponded to a total of 327 and 191 EI for the PCM and CR systems, respectively. More than one quarter of the examinations with EI were necessary because the breast was not properly positioned in the original image (PCM 31 %, CR 29 %). The mean AGD per EI was 0.7 ± 0.1 mGy for the PCM and 2.6 ± 1.2 mGy for the CR system. The mean AGD for all breast thicknesses for FFDM was 1.4 ± 0.3 mGy. CONCLUSION In general, large breasts cannot be imaged with just one image per view. The number of examinations where EI are needed is doubled with the 24 cm × 26 cm detector of the PCM system. However, the absolute number is small. The total dose, as the sum of the original and the EI, is equal to the mean AGD of a single image of the FFDM systems and lower than the dose of a single image with the CR system.
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Affiliation(s)
- K Entz
- University Hospital Muenster, Reference Center for Mammography Muenster, Germany, Muenster
| | - A Sommer
- University Hospital Muenster, Reference Center for Mammography Muenster, Germany, Muenster
| | - W Heindel
- University Hospital Muenster, Reference Center for Mammography Muenster, Germany, Muenster
| | - H Lenzen
- University Hospital Muenster, Department of Clinical Radiology, Germany, Muenster
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Sommer A, Schopphoven S, Land I, Blaser D, Sobczak T. Guideline for Determining the Mean Glandular Dose According to DIN 6868-162 and Threshold Contrast Visibility According to the Quality Assurance Guideline for Digital Mammography Systems. ROFO-FORTSCHR RONTG 2014; 186:474-81. [DOI: 10.1055/s-0033-1356284] [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: 10/25/2022]
Affiliation(s)
- A. Sommer
- Physical-technical quality assurance group, Reference Center Muenster for Mammography at the University Hospital Muenster
| | - S. Schopphoven
- Physical-technical quality assurance group, Reference Center for Mammography Southwest in Marburg
| | - I. Land
- Physical-technical quality assurance group, Reference Center for Mammography in Berlin
| | - D. Blaser
- Physical-technical quality assurance group, Reference Center for Mammography in Munich
| | - T. Sobczak
- Physical-technical quality assurance group, Reference Center for Mammography Nord in Oldenburg
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Shadid N, Nelemans P, Lawson J, Sommer A. Predictors of recurrence of great saphenous vein reflux following treatment with ultrasound-guided foamsclerotherapy. Phlebology 2014; 30:194-9. [PMID: 24474721 DOI: 10.1177/0268355514521183] [Citation(s) in RCA: 15] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate which clinical characteristics at baseline are predictive for great saphenous vein recurrence following ultrasound-guided foamsclerotherapy. MATERIAL AND METHODS Data of patients treated for great saphenous vein incompetence with ultrasound-guided foamsclerotherapy were derived from a multicentre prospective randomized controlled trial comparing surgery versus ultrasound-guided foamsclerotherapy with a follow-up of two years. Recurrence of reflux was determined on colour duplex scans at three months, one year and two years. Univariate and multivariate Cox regression analysis was used to evaluate the effect of gender, age, C of CEAP classification, diameter of great saphenous vein, injected foam volume, presence of distal great saphenous vein reflux, presence of reflux in the anterior accessory saphenous vein and Venous Clinical Severity Score on risk of recurrent reflux. RESULTS Two hundred twenty-five patients were available for analysis. Treatment after one single session was successful in 120 patients and recurrence of saphenous reflux was observed in 105 patients within two years during follow-up. Significant associations with risk of recurrence were observed for mid thigh great saphenous vein diameter (HR = 1.012 with 95% CI: 1.002-1.022, p = 0.022) and presence of distal great saphenous vein reflux (HR = 1.882 with 95% CI: 1.029-3.443, p = 0.040). CONCLUSION In conclusion, this prospective study suggests that ultrasound-guided foamsclerotherapy treatment for the proximal great saphenous vein is less effective for patients with a large vein and a refluxing distal great saphenous vein at baseline.
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Affiliation(s)
- N Shadid
- Department of Dermatology, Maastricht University Medical Center, the Netherlands
| | - P Nelemans
- Department of Epidemiology, Maastricht University Medical Center, the Netherlands
| | - J Lawson
- Department of Dermatology, Maastricht University Medical Center and Skin and Vein Clinic, Oosterwal, Alkmaar, the Netherlands
| | - A Sommer
- Department of Dermatology, Dermatology Clinic, Maastricht, the Netherlands
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Abstract
Objective The objective of this study is to evaluate whether and which ‘venous’ symptoms are characteristic for patients affected with chronic venous disease compared to patients with other diseases of the lower limbs (e.g. arthrosis, peripheral arterial disease, spinal disc herniation). Methods A cross-sectional study was performed to compare the frequency of venous symptoms among 76 patients with chronic venous disease and reflux and 74 patients with other diseases of the legs without reflux. The VEINES-Sym of the VEINES-QOL/Sym questionnaire was used to evaluate the frequency of symptoms. Demographic, clinical classification and ultrasound findings were also noted. Results A total of 122 patients were included for analysis (response rate of 87%). Presence of venous symptoms was slightly more often reported in the chronic venous disease group than in the non-chronic venous disease group, but differences were small and statistically non-significant. Severity of chronic venous disease as classified by the CEAP classification was not associated with higher proportions of patients reporting symptoms than in non-chronic venous disease patients, except for swelling ( p = .016) and itching ( p = .007) in C3-C6 patients. The largest difference between the chronic venous disease and non-chronic venous disease group was observed for the time of the day at which symptoms were most intense; patients with chronic venous disease were more likely to experience symptoms at the end of the day ( p < .001). Conclusions The small differences in prevalence of reported ‘venous’ symptoms between chronic venous disease patients and patients with other diseases of the legs suggest that these symptoms may be less specific for patients with chronic venous disease and refluxing veins than is usually assumed.
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Affiliation(s)
- SK Van der Velden
- Department of Dermatology, Erasmus Universal Centre, Rotterdam, The Netherlands
| | - NH Shadid
- Department of Dermatology, Medical Centre Haaglanden, Den Haag, The Netherlands
| | - PJ Nelemans
- Department of Epidemiology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - A Sommer
- Department of Dermatology, Reinaert Clinics, Maastricht, The Netherlands
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Affiliation(s)
- N Shadid
- Department of Dermatology, University Hospital Maastricht and CARIM School of Vascular Research, Maastricht 6202AZ
| | - A Sommer
- Department of Dermatology, Reinaertclinics, Maastricht, The Netherlands
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Abstract
OBJECTIVES To translate from English to Dutch and evaluate the psychometric properties of the VEnous INsufficiency Epidemiological and Economic Studies (VEINES) questionnaire, divided in symptom (VEINES-Sym) and quality of life (VEINES-QOL) subscales. METHODS Standard forward-backward translation method was used to translate the 26 items of the VEINES-QOL/Sym. Eligible patients had to complete a standardized questionnaire. Demographic, venous disease characteristics, clinical venous signs, CEAP (clinical, aetiological, anatomical and pathological elements) classification and ultrasound findings were also noted. If item's scores were in an extreme category in more than 70% of patients a floor or ceiling effect was present. Feasibility of the individual items was considered poor if 5% or more of the responses were missing. The validity was tested by comparing the VEINES-QOL/Sym scores to the Short Form 36 (SF-36) scores and across the different 'CEAP' categories. Confirmatory factor analysis was used to assess the underlying structure of the VEINES-QOL/Sym. RESULTS Sixty-six patients were included (response rate of 72%). None of the 26 items missed <10% of responses, but two showed ceiling effect. Both the VEINES-QOL and VEINES-Sym showed an excellent internal consistency (Cronbach's alpha of 0.88 and 0.81, respectively). The VEINES-QOL demonstrated a good construct validity for the physical component of the SF-36, but not for the mental component (rho = 0.62 and 0.22, respectively), as expected. The VEINES-Sym correlated poorly to both SF-36's components. According to the confirmatory principle axis factoring, only three out of 25 items did not load sufficiently on the factor. CONCLUSIONS The Dutch VEINES-QOL/Sym can be used for health-related quality of life research in varicose veins patients and the evaluation of therapies.
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Affiliation(s)
- S K van der Velden
- Department of Dermatology, Maastricht University Medical Center, Maastricht, The Netherlands
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