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Babbage C, Wagner H, Dowthwaite L, Portillo V, Perez E, Fischer J. Exploring individual's public trust in the NHS Test and Trace System - A pragmatic reflexive thematic analysis. Internet Interv 2024; 36:100740. [PMID: 38634005 PMCID: PMC11021953 DOI: 10.1016/j.invent.2024.100740] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Abstract
Context Digital contact tracing uses automated systems and location technology embedded on smartphone software for efficient identification of individuals exposed to COVID-19. Such systems are only effective with high compliance, yet compliance is mediated by public trust in the system. This work explored the perception of individual's trust and expectation of the broader Test and Trace system in the United Kingdom (UK) with the upcoming release of the National Health Service's (NHS) COVID-19 app as a case example. Methods Twelve adults underwent online semi-structured interviews in August 2020, prior to public availability of the COVID-19 app. Pragmatic reflexive thematic analysis was applied inductively to explore common themes between participants, using an organic and recursive process (Braun & Clarke, 2019). Results Themes highlighted features of the technology that would be perceived to be trustworthy (Theme 1), and concerns relating to i) whether users would comply with a T&T system (Theme 2) and ii) how a T&T system would handle user's personal data (Theme 3). Two further themes built on aspects of automation within a T&T system and its impact on trust (Theme 4) and how the media altered perceptions of the T&T system (Theme 5). Conclusions Participants outlined the need for different user requirements that could be built into the NHS COVID-19 app that would support increased adherence. Concurrently, participants raised questions surrounding personal data and privacy of their data, plus the level of automated versus manual tasks, which impacted perception of trust in the app and wider system. Additionally, themes highlighted that T&T systems do not happen within a vacuum, but within a pre-existing environment influenced by variables such as the media and perception of other's compliance to T&T. Implications Since it's roll-out, controversies surrounding the UK T&T system include concerns about privacy, stigma and uptake. Considering the current piece of work, which anticipated similar concerns prior to public access to COVID-19 app, engaging with the public may have been an important step in improving the perception and compliance with the app. Principles fundamental to patient and public involvement (PPI) and Responsible Research and Innovation (RRI) such as the inclusion of the public in the early development of research and aligning the outcomes of research and innovation with broader societal values and expectations would have been well-applied to this system and should be applied to future autonomous systems requiring high public uptake.
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Affiliation(s)
- C.M. Babbage
- NIHR HealthTech Research Centre in Mental Heath (MindTech), School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - H. Wagner
- School of Computing, Engineering & the Built Environment, Edinburgh Napier University, Edinburgh, United Kingdom
| | - L. Dowthwaite
- Horizon Digital Economy Research, University of Nottingham, Nottingham, United Kingdom
| | - V. Portillo
- Horizon Digital Economy Research, University of Nottingham, Nottingham, United Kingdom
| | - E. Perez
- NIHR HealthTech Research Centre in Mental Heath (MindTech), School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Horizon Digital Economy Research, University of Nottingham, Nottingham, United Kingdom
| | - J. Fischer
- Mixed Reality Lab, School of Computer Science, University of Nottingham, Nottingham, United Kingdom
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Geinitz H, Silberberger E, Spiegl K, Feichtinger J, Wagner H, Hermann P, Bräutigam E, Track C, Weis EM, Venhoda C, Huppert R, Spindelbalker-Renner B, Zauner-Babor G, Nyiri DV, Karasek N, Erdei M, Gheju R, Gruber G, Egger M, Dieplinger B. SARS-CoV-2 vaccination willingness and humoral vaccination response in radiation oncology patients. Vaccine 2024; 42:945-959. [PMID: 38246842 DOI: 10.1016/j.vaccine.2024.01.006] [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: 07/14/2023] [Revised: 11/27/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND SARS-CoV-2 infection has been and, in some parts, still is a threat to oncologic patients, making it crucial to understand perception of vaccination and immunologic responses in this vulnerable patient segment. SARS-CoV-2 vaccines in relation to malignant disease characteristics and therapies have so far not been studied consecutively in larger oncologic patient populations. This study captures SARS-CoV-2 vaccination willingness and humoral immune response in a large consecutive oncologic patient collective at the beginning of 2021. METHODS 1142 patients were consecutively recruited over 5.5 months at a tertiary department for radiation oncology and were assessed for vaccination willingness via a standardized interview. In already vaccinated patients total SARS-CoV-2 S antibody titres against the spike protein (Anti-SARS-CoV-2 S) and were evaluated 35 days or later after the first dose of SARS-CoV-2 vaccine. RESULTS Vaccination willingness was high with a rate of 90 %. The most frequent reasons for rejection were: undecided/potential vaccination after therapy, distrust in the vaccine and fear of interaction with comorbidities. Factors associated with lower vaccination willingness were: worse general condition, lower age and female sex. 80 % of the participants had been previously vaccinated, 8 % reported previous infection and 16 % received vaccination during antineoplastic therapy. In 97.5 % of the vaccinated patients Anti-SARS-CoV-2 S was detected. In a univariable analysis parameters associated with non-conversion were: lower performance status, spread to the local lymphatics (N + ), hematologic disease and diffuse metastases. All patients with oligometastatic disease achieved positive Anti-SARS-CoV-2 S titres. For patients with two vaccinations several risk factors were identified, that were associated with low antibody concentrations. CONCLUSIONS SARS-CoV-2 vaccination willingness among oncologic patients was high in the first months after its availability, and most patients had already received one or two doses. Over 97 % of vaccinated patients had measurable anti-SARS-CoV-2 S titres. Our data supports early identification of low humoral responders after vaccination and could facilitate the design of future oncologic vaccine trials (clinicaltrials.gov Identifier: NCT04918888).
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Affiliation(s)
- Hans Geinitz
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria; Johannes Kepler Universität Linz, Medizinische Fakultät, Krankenhausstraße 5, A-4020 Linz, Austria.
| | - Elisabeth Silberberger
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Kurt Spiegl
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Johann Feichtinger
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Helga Wagner
- Kompetenzzentrum für Klinische Studien (KKS Linz) am Zentrum für Klinische Forschung (ZKF), Johannes Kepler Universität Linz, Medizinische Fakultät, Med Campus I, Gebäude ADM, 8.OG, Krankenhausstraße 5, A-4020 Linz, Austria
| | - Philipp Hermann
- Kompetenzzentrum für Klinische Studien (KKS Linz) am Zentrum für Klinische Forschung (ZKF), Johannes Kepler Universität Linz, Medizinische Fakultät, Med Campus I, Gebäude ADM, 8.OG, Krankenhausstraße 5, A-4020 Linz, Austria
| | - Elisabeth Bräutigam
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Christine Track
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Eva Maria Weis
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Clemens Venhoda
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Roswitha Huppert
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Barbara Spindelbalker-Renner
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Georgine Zauner-Babor
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Dalma Viktoria Nyiri
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Nicola Karasek
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Mercedesz Erdei
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Ruben Gheju
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Georg Gruber
- Department of Radiation Oncology, Ordensklinikum Linz GmbH, Barmherzige Schwestern, Seilerstätte 4, 4010 Linz, Austria
| | - Margot Egger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz and Ordensklinikum Linz, Linz, Austria
| | - Benjamin Dieplinger
- Department of Laboratory Medicine, Konventhospital Barmherzige Brueder Linz and Ordensklinikum Linz, Linz, Austria
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3
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Rauch P, Aichholzer M, Serra C, Zanier O, Staartjes VE, Böhm P, Seyer G, Wagner H, Manakov I, Sonnberger M, Stroh N, Aspalter S, Aufschnaiter-Hiessböck K, Rossmann T, Leibetseder A, Katletz S, Gruber A, Gmeiner M, Stefanits H. From molecular signatures to radiomics: tailoring neurooncological strategies through forecasting of glioma growth. Neurosurg Focus 2024; 56:E5. [PMID: 38301234 DOI: 10.3171/2023.11.focus23685] [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: 09/30/2023] [Accepted: 11/29/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVE Contemporary oncological paradigms for adjuvant treatment of low- and intermediate-grade gliomas are often guided by a limited array of parameters, overlooking the dynamic nature of the disease. The authors' aim was to develop a comprehensive multivariate glioma growth model based on multicentric data, to facilitate more individualized therapeutic strategies. METHODS Random slope models with subject-specific random intercepts were fitted to a retrospective cohort of grade II and III gliomas from the database at Kepler University Hospital (n = 191) to predict future mean tumor diameters. Deep learning-based radiomics was used together with a comprehensive clinical dataset and evaluated on an external prospectively collected validation cohort from University Hospital Zurich (n = 9). Prediction quality was assessed via mean squared prediction error. RESULTS A mean squared prediction error of 0.58 cm for the external validation cohort was achieved, indicating very good prognostic value. The mean ± SD time to adjuvant therapy was 28.7 ± 43.3 months and 16.1 ± 14.6 months for the training and validation cohort, respectively, with a mean of 6.2 ± 5 and 3.6 ± 0.7, respectively, for number of observations. The observed mean tumor diameter per year was 0.38 cm (95% CI 0.25-0.51) for the training cohort, and 1.02 cm (95% CI 0.78-2.82) for the validation cohort. Glioma of the superior frontal gyrus showed a higher rate of tumor growth than insular glioma. Oligodendroglioma showed less pronounced growth, anaplastic astrocytoma-unlike anaplastic oligodendroglioma-was associated with faster tumor growth. Unlike the impact of extent of resection, isocitrate dehydrogenase (IDH) had negligible influence on tumor growth. Inclusion of radiomics variables significantly enhanced the prediction performance of the random slope model used. CONCLUSIONS The authors developed an advanced statistical model to predict tumor volumes both pre- and postoperatively, using comprehensive data prior to the initiation of adjuvant therapy. Using radiomics enhanced the precision of the prediction models. Whereas tumor extent of resection and topology emerged as influential factors in tumor growth, the IDH status did not. This study emphasizes the imperative of advanced computational methods in refining personalized low-grade glioma treatment, advocating a move beyond traditional paradigms.
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Affiliation(s)
- Philip Rauch
- 1Department of Neurosurgery, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - Martin Aichholzer
- 1Department of Neurosurgery, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - Carlo Serra
- 2Department of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Switzerland
- 5Department of Neurosurgery, Machine Intelligence in Clinical Neuroscience (MICN) Lab, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
- 6Department of Neurology, Kepler University Hospital and Johannes Kepler University, Linz, Austria; and
| | - Olivier Zanier
- 5Department of Neurosurgery, Machine Intelligence in Clinical Neuroscience (MICN) Lab, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
- 6Department of Neurology, Kepler University Hospital and Johannes Kepler University, Linz, Austria; and
| | - Victor E Staartjes
- 2Department of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Switzerland
- 5Department of Neurosurgery, Machine Intelligence in Clinical Neuroscience (MICN) Lab, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Switzerland
- 6Department of Neurology, Kepler University Hospital and Johannes Kepler University, Linz, Austria; and
| | - Petra Böhm
- 1Department of Neurosurgery, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - Gregor Seyer
- 7Institute of Statistics, Johannes Kepler University, Linz, Austria
| | - Helga Wagner
- 7Institute of Statistics, Johannes Kepler University, Linz, Austria
| | | | - Michael Sonnberger
- 3Institute of Neuroradiology, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - Nico Stroh
- 1Department of Neurosurgery, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - Stefan Aspalter
- 1Department of Neurosurgery, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | | | - Tobias Rossmann
- 1Department of Neurosurgery, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - Annette Leibetseder
- 6Department of Neurology, Kepler University Hospital and Johannes Kepler University, Linz, Austria; and
| | - Stefan Katletz
- 6Department of Neurology, Kepler University Hospital and Johannes Kepler University, Linz, Austria; and
| | - Andreas Gruber
- 1Department of Neurosurgery, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - Matthias Gmeiner
- 1Department of Neurosurgery, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - Harald Stefanits
- 1Department of Neurosurgery, Kepler University Hospital and Johannes Kepler University, Linz, Austria
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Tan K, Adeniyi OO, Letko A, RuddGarces G, Manz E, Wagner H, Zanolari P, Drögemüller C, Lühken G. Identification of genomic regions associated with differences in fleece type in Huacaya and Suri alpacas (Vicugna pacos). Anim Genet 2024; 55:163-167. [PMID: 37985006 DOI: 10.1111/age.13377] [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: 08/14/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023]
Abstract
The difference in fleece type is the distinguishing trait between the two types of alpacas (Vicugna pacos), Huacaya and Suri. The Suri fleece type has been found to be inherited dominantly over the Huacaya type, resulting in offspring with the Suri phenotype. The aim of our study was to map genomic regions associated with the two different fleece types. In this study, 91 alpacas (54 Huacayas and 37 Suris) from Germany and Switzerland were genotyped using the 76k alpaca SNP array. Only 59k chromosome-localised markers map to the alpaca reference assembly VicPac3.1, and after quality control 49 866 SNPs, were retained for population structure assessment and to conduct a genome-wide association study. Both principal component and neighbour-joining tree analysis showed that the two fleece-type cohorts overlapped rather than forming two distinct clusters. Genome-wide significantly associated markers were observed in the scaffold region of chromosome 16 (NW_021964192.1), which contains a cluster of keratin genes. A haplotype predominantly found in Suri alpacas has been identified which supports dominant inheritance. Variant filtering of nine whole-genome sequenced alpacas from both fleece types in the critical interval of 0.4 Mb did not reveal perfect segregation of either fleece type for specific variants. To our knowledge, this is the first study to use the recently developed species-specific SNP array to identify genomic regions associated with differences in fleece type in alpacas. There are still some limitations, such as the preliminary status of the reference assembly and the incomplete annotation of the alpaca genome.
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Affiliation(s)
- K Tan
- Institute of Animal Breeding and Genetics, Justus Liebig University Giessen, Giessen, Germany
| | - O O Adeniyi
- Institute of Animal Breeding and Genetics, Justus Liebig University Giessen, Giessen, Germany
| | - A Letko
- Institute of Genetics, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - G RuddGarces
- Institute of Animal Breeding and Genetics, Justus Liebig University Giessen, Giessen, Germany
| | - E Manz
- Generatio GmbH, Heidelberg, Germany
| | - H Wagner
- Animal Clinic for Reproduction and Neonatology, Justus Liebig University Giessen, Giessen, Germany
| | - P Zanolari
- Clinic for Ruminants, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - C Drögemüller
- Institute of Genetics, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - G Lühken
- Institute of Animal Breeding and Genetics, Justus Liebig University Giessen, Giessen, Germany
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5
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Kiblboeck S, Oppelt P, Oppelt P, Stein R, Ommer S, Pavlik R, Rall K, Kongrtay K, Wagner H, Hermann P, Trautner PS. Can Classifications Adequately Represent Genital Malformations?: EVA Study ( E SHRE/ESGE | V CUAM | A FS) - A Prospective Multicenter Study to Evaluate the Current Female Genital Malformation Classifications. Geburtshilfe Frauenheilkd 2023; 83:827-834. [PMID: 37564897 PMCID: PMC10410643 DOI: 10.1055/a-2043-9982] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/20/2023] [Indexed: 03/31/2023] Open
Abstract
Introduction Genital malformations are a common clinical occurrence that can be represented using different classifications. Reproducibility is an essential quality characteristic for a classification, and it plays an important role, especially in consultations and the treatment of infertile patients and in obstetric management. The aim of this study is to demonstrate the reproducibility and clinical practicality of three commonly used classifications: the ESHRE/ESGE (European Society of Human Reproduction and Embryology/ European Society for Gynecological Endoscopy), VCUAM (Vagina Cervix Uterus Adnex-associated Malformation), and AFS (American Fertility Society) classifications. Materials and Methods Sixty-five patients with female genital malformations were included in this prospective, multicenter, exploratory, observational study. All participants underwent a clinical examination and a medical interview. The investigators were instructed to classify the presenting malformations according to the ESHRE/ESGE, VCUAM, and AFS classifications using a structured questionnaire. Investigators were asked whether the malformation could be reproducibly classified (yes/no) and about the grade (grade 1-5 from "very good" to "deficient") they would assign to each classification. Classification assessment was queried for vagina, cervix, uterus, adnexa, and associated malformations and was scored from 1 to 5. Results Reproducibility was rated as 80% (n = 52/65), 92.3% (n = 60/65), and 56.9% (n = 37/65) for the ESHRE/ESGE, VCUAM, and AFS classification, respectively. ESHRE/ESGE, VCUAM and AFS were rated as "very good" or "good" for 83.3%, 89.2%, and 10.8% of vaginal malformations; for 75.8%, 87.5%, and 24.2% of cervical malformations; and for 89.7%, 89.5%, and 86.2% of uterine malformations, respectively. VCUAM was rated as "very good" or "good" for 77.8% and 69.6% of adnexal malformations and associated malformations, respectively. ESHRE/ESGE and AFS were rated as "sufficient" or "deficient" for 100% and 75% of adnexal malformations and for 77.3% and 69.6% of associated malformations, respectively. Conclusion The prospective multicenter EVA ( E SHRE/ESGE | V CUAM | A FS) study revealed that the organ-based ESHRE/ESGE and VCUAM classifications of female genital malformations perform better in terms of reproducibility as well as in the assessment of individual compartments than the non-organ-based AFS classification.
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Affiliation(s)
- Stephanie Kiblboeck
- Department of Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University Hospital Linz, Johannes Kepler Universität Linz, Linz, Austria
| | - Peter Oppelt
- Department of Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University Hospital Linz, Johannes Kepler Universität Linz, Linz, Austria
| | - Patricia Oppelt
- Department of Gynecology, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Raimund Stein
- Department of Pediatric, Adolescent and Reconstructive Urology, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, Mannheim,
Germany
| | - Stefanie Ommer
- Department of Pediatric Surgery, University Hospital Jena, Jena, Germany
| | | | - Katharina Rall
- Department of Gynecology and Obstetrics, University Hospital Tübingen, Tübingen, Germany
| | - Kuralay Kongrtay
- Clinical Academic Department of Women’s Health, Corporate fund “University Medical Center”, Astana, Kazakhstan
| | - Helga Wagner
- Department of Applied Statistics, Johannes Kepler University Linz, Linz, Austria
- Center for Clinical Studies (CCS Linz), Johannes Kepler University Linz, Linz, Austria
| | - Philipp Hermann
- Center for Clinical Studies (CCS Linz), Johannes Kepler University Linz, Linz, Austria
| | - Philip Sebastian Trautner
- Department of Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University Hospital Linz, Johannes Kepler Universität Linz, Linz, Austria
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6
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Rauch P, Stefanits H, Aichholzer M, Serra C, Vorhauer D, Wagner H, Böhm P, Hartl S, Manakov I, Sonnberger M, Buckwar E, Ruiz-Navarro F, Heil K, Glöckel M, Oberndorfer J, Spiegl-Kreinecker S, Aufschnaiter-Hiessböck K, Weis S, Leibetseder A, Thomae W, Hauser T, Auer C, Katletz S, Gruber A, Gmeiner M. Deep learning-assisted radiomics facilitates multimodal prognostication for personalized treatment strategies in low-grade glioma. Sci Rep 2023; 13:9494. [PMID: 37302994 DOI: 10.1038/s41598-023-36298-8] [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: 11/29/2022] [Accepted: 05/31/2023] [Indexed: 06/13/2023] Open
Abstract
Determining the optimal course of treatment for low grade glioma (LGG) patients is challenging and frequently reliant on subjective judgment and limited scientific evidence. Our objective was to develop a comprehensive deep learning assisted radiomics model for assessing not only overall survival in LGG, but also the likelihood of future malignancy and glioma growth velocity. Thus, we retrospectively included 349 LGG patients to develop a prediction model using clinical, anatomical, and preoperative MRI data. Before performing radiomics analysis, a U2-model for glioma segmentation was utilized to prevent bias, yielding a mean whole tumor Dice score of 0.837. Overall survival and time to malignancy were estimated using Cox proportional hazard models. In a postoperative model, we derived a C-index of 0.82 (CI 0.79-0.86) for the training cohort over 10 years and 0.74 (Cl 0.64-0.84) for the test cohort. Preoperative models showed a C-index of 0.77 (Cl 0.73-0.82) for training and 0.67 (Cl 0.57-0.80) test sets. Our findings suggest that we can reliably predict the survival of a heterogeneous population of glioma patients in both preoperative and postoperative scenarios. Further, we demonstrate the utility of radiomics in predicting biological tumor activity, such as the time to malignancy and the LGG growth rate.
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Affiliation(s)
- P Rauch
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - H Stefanits
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria.
| | - M Aichholzer
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - C Serra
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland
- Machine Intelligence in Clinical Neuroscience (MICN) Lab, Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
| | - D Vorhauer
- Institute of Statistics, Johannes Kepler University, Linz, Austria
| | - H Wagner
- Institute of Statistics, Johannes Kepler University, Linz, Austria
| | - P Böhm
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - S Hartl
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | | | - M Sonnberger
- Institute of Neuroradiology, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - E Buckwar
- Institute of Stochastics, Johannes Kepler University, Linz, Austria
| | - F Ruiz-Navarro
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - K Heil
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - M Glöckel
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - J Oberndorfer
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - S Spiegl-Kreinecker
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - K Aufschnaiter-Hiessböck
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - S Weis
- Institute of Pathology and Neuropathology, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - A Leibetseder
- Department of Neurology, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - W Thomae
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - T Hauser
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - C Auer
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - S Katletz
- Department of Neurology, Kepler University Hospital and Johannes Kepler University, Linz, Austria
| | - A Gruber
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - M Gmeiner
- Department of Neurosurgery, Kepler University Hospital, Wagner-Jauregg Weg 15, 4020, Linz, Austria
- Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
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7
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Hodzic E, Hasbun R, Granillo A, Tröscher AR, Wagner H, von Oertzen TJ, Wagner JN. Steroids for the treatment of viral encephalitis: a systematic literature review and meta-analysis. J Neurol 2023:10.1007/s00415-023-11715-0. [PMID: 37060361 PMCID: PMC10105360 DOI: 10.1007/s00415-023-11715-0] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/05/2023] [Accepted: 04/06/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND Specific antiviral treatment is only available for a small subset of viral encephalitis (VE). Adjunctive steroids are used, but there is scant evidence evaluating its utility. We present a systematic review and meta-analysis on the outcome of steroid use in VE. METHODS We conducted a systematic literature review and reported it according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Two observational studies from unpublished or partially published data were added. For the meta-analysis, we employed the metaphor package of the statistical software R-4.3.1. RESULTS We screened 378 studies and included 50. 155 patients were added from the Houston and Linz cohorts. Individual data were available for 281 persons, 120 (43%) of whom received steroids. The most common pathogens were herpes simplex virus 1, West Nile virus, and measles. Study designs and patient outcomes were heterogeneous. Only three of the trials report an advantage of steroid therapy. Steroid-induced side effects were scarce. Ten cohorts were included into the meta-analysis. For the pooled data, the null hypothesis could not be rejected (p = 0.245) using a random effects model, i.e., a benefit of steroid treatment on survival in VE could not be shown. CONCLUSIONS Steroids as potent anti-inflammatory agents may act through a reduction of secondary inflammation-mediated damage. Our data do not support the use of steroids in VE. However, multiple shortcomings apply. Standardized controlled trials are needed to investigate optimal dosing and timing of steroid administration and to explore potential subgroups that could benefit.
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Affiliation(s)
- Emira Hodzic
- Institute of Applied Statistics, Johannes Kepler University, Linz, Austria
| | - Rodrigo Hasbun
- Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School, UT Health, Houston, TX, USA
| | - Alejandro Granillo
- Division of Infectious Diseases, Department of Internal Medicine, McGovern Medical School, UT Health, Houston, TX, USA
| | - Anna R Tröscher
- Department of Neurology, Evangelisches Klinikum Gelsenkirchen, Teaching Hospital University Duisburg-Essen, Munckelstrasse 27, 45879, Gelsenkirchen, Germany
| | - Helga Wagner
- Institute of Applied Statistics, Johannes Kepler University, Linz, Austria
| | - Tim J von Oertzen
- Department of Neurology, Evangelisches Klinikum Gelsenkirchen, Teaching Hospital University Duisburg-Essen, Munckelstrasse 27, 45879, Gelsenkirchen, Germany
- Johannes Kepler University, Linz, Austria
| | - Judith N Wagner
- Department of Neurology, Evangelisches Klinikum Gelsenkirchen, Teaching Hospital University Duisburg-Essen, Munckelstrasse 27, 45879, Gelsenkirchen, Germany.
- Johannes Kepler University, Linz, Austria.
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8
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Aspalter S, Stefanits H, Maier CJ, Radl C, Wagner H, Hermann P, Aichholzer M, Stroh N, Gruber A, Senker W. Reduction of spondylolisthesis and restoration of lumbar lordosis after anterior lumbar interbody fusion (ALIF). BMC Surg 2023; 23:66. [PMID: 36973719 PMCID: PMC10045589 DOI: 10.1186/s12893-023-01966-z] [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: 01/06/2023] [Accepted: 03/20/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Anterior lumbar interbody fusion (ALIF) is a well-established surgical treatment option for various diseases of the lumbar spine, including spondylolisthesis. This study aimed to evaluate the postoperative correction of spondylolisthesis and restoration of lumbar and segmental lordosis after ALIF. METHODS Patients with spondylolisthesis who underwent ALIF between 2013 and 2019 were retrospectively assessed. We assessed the following parameters pre-and postoperatively (6-months follow-up): Visual Analogue Scale (VAS) for pain, Oswestry Disability Index (ODI), lumbar lordosis (LL), segmental lordosis (SL), L4/S1 lordosis, and degree of spondylolisthesis. RESULTS 96 patients were included. In 84 cases (87.50%), additional dorsal instrumentation was performed. The most frequent diagnosis was isthmic spondylolisthesis (73.96%). VAS was reduced postoperatively, from 70 to 40, as was ODI (50% to 32%). LL increased from 59.15° to 64.45°, as did SL (18.95° to 28.55°) and L4/S1 lordosis (37.90° to 44.00°). Preoperative spondylolisthesis was 8.90 mm and was reduced to 6.05 mm postoperatively. Relative spondylolisthesis was 21.63% preoperatively and 13.71% postoperatively. All clinical and radiological improvements were significant (all p < 0.001). No significant difference considering the lordosis values nor spondylolisthesis was found between patients who underwent ALIF surgery without dorsal instrumentation and patients who received additional dorsal instrumentation. Venous laceration was the most frequent complication (10.42%). CONCLUSIONS With ALIF, good clinical results and safe and effective reduction of spondylolisthesis and restoration of lordosis can be achieved. Additional dorsal instrumentation does not significantly affect postoperative lordosis or spondylolisthesis. Individual vascular anatomy must be reviewed preoperatively before considering ALIF.
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Affiliation(s)
- Stefan Aspalter
- Department of Neurosurgery, Kepler University Hospital Linz, Johannes Kepler University, Linz, Austria
| | - Harald Stefanits
- Department of Neurosurgery, Kepler University Hospital Linz, Johannes Kepler University, Linz, Austria.
- Department of Neurosurgery, Neuromed Campus, Kepler University Hospital, Wagner-Jauregg Weg 15, Linz, 4020, Austria.
| | - Christoph Johannes Maier
- Department of Neurosurgery, Kepler University Hospital Linz, Johannes Kepler University, Linz, Austria
| | - Christian Radl
- Department of Neurosurgery, Kepler University Hospital Linz, Johannes Kepler University, Linz, Austria
| | - Helga Wagner
- Center for Clinical Studies (CCS Linz), Johannes Kepler University, Linz, Austria
- Department of Medical Statistics and Biometry, Institute of Applied Statistics, Johannes Kepler University, Linz, Austria
| | - Philipp Hermann
- Center for Clinical Studies (CCS Linz), Johannes Kepler University, Linz, Austria
| | - Martin Aichholzer
- Department of Neurosurgery, Kepler University Hospital Linz, Johannes Kepler University, Linz, Austria
| | - Nico Stroh
- Department of Neurosurgery, Kepler University Hospital Linz, Johannes Kepler University, Linz, Austria
| | - Andreas Gruber
- Department of Neurosurgery, Kepler University Hospital Linz, Johannes Kepler University, Linz, Austria
| | - Wolfgang Senker
- Department of Neurosurgery, Kepler University Hospital Linz, Johannes Kepler University, Linz, Austria
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9
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Blessberger H, Lambert T, Nahler A, Hrncic D, Hönig S, Maier J, Rechberger S, Windhager A, Reiter C, Kellermair J, Kammler J, Wagner H, Steinwender C. NT-pro-BNP as a Predictor for Recurrence of Atrial Fibrillation after Primary Cryoballoon Pulmonary Vein Isolation. J Clin Med 2022; 11:jcm11247400. [PMID: 36556020 PMCID: PMC9783297 DOI: 10.3390/jcm11247400] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/06/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022] Open
Abstract
NT-pro-BNP is produced in the cardiac atria and ventricles in response to increased wall stress. It may be a marker of both AF disease progression and co-morbidities that affect success after pulmonary vein isolation (PVI). This single-center retrospective study analyzed the association between pre-procedural NT-pro-BNP serum levels and the long-term outcome after a first-ever PVI in cryo-technique. Patients were followed by searching the hospital information system and conducting structured telephone interviews. Treatment failure was defined as any relapse of atrial fibrillation (AF) occurring 90 days after the index PVI at the earliest. Kaplan−Meier survival curves and Cox proportional hazards models were computed to assess the impact of NT-pro-BNP on AF recurrence. Following 374 patients over a median of 3.8 years (range: 0.25−9.4 years), baseline NT-pro-BNP was associated with the combined endpoint in univariate analysis (HR 1.04 per 100 pg/mL increase, 95% CI: 1.02−1.07, p < 0.001). Results were virtually unchanged in the multivariate model or if the data were log-transformed. Intraprocedural left atrial pressure correlated positively with log NT-pro-BNP. NT-pro-BNP was associated with AF relapse during a long-term follow-up after first-ever cryo-PVI in our cohort of patients with predominantly normal left ventricular function. This lab parameter is easy to obtain and has significant potential to guide treatment decisions.
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Affiliation(s)
- Hermann Blessberger
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Krankenhausstrasse 9, 4021 Linz, Austria
- Correspondence:
| | - Thomas Lambert
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Krankenhausstrasse 9, 4021 Linz, Austria
| | - Alexander Nahler
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Krankenhausstrasse 9, 4021 Linz, Austria
| | - Denis Hrncic
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Krankenhausstrasse 9, 4021 Linz, Austria
| | - Simon Hönig
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Krankenhausstrasse 9, 4021 Linz, Austria
| | - Julian Maier
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Krankenhausstrasse 9, 4021 Linz, Austria
| | - Stefan Rechberger
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Krankenhausstrasse 9, 4021 Linz, Austria
| | - Armin Windhager
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Krankenhausstrasse 9, 4021 Linz, Austria
| | - Christian Reiter
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Krankenhausstrasse 9, 4021 Linz, Austria
| | - Joerg Kellermair
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Krankenhausstrasse 9, 4021 Linz, Austria
| | - Juergen Kammler
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Krankenhausstrasse 9, 4021 Linz, Austria
- Department of Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Helga Wagner
- Institute of Applied Statistics, Johannes Kepler University Linz, 4040 Linz, Austria
| | - Clemens Steinwender
- Department of Cardiology, Kepler University Hospital, Medical Faculty, Johannes Kepler University Linz, Krankenhausstrasse 9, 4021 Linz, Austria
- Department of Internal Medicine II, Paracelsus Medical University, 5020 Salzburg, Austria
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10
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Enzelsberger S, Oppelt P, Nirgianakis K, Seeber B, Drahoňovský J, Wanderer L, Krämer B, Grübling K, Kundu S, Salehin D, Mierzwinski M, Krentel H, Hermann P, Wagner H, Shebl O, Schäfer S. Preoperative application of the Enzian classification for endometriosis (The cEnzian Study): A prospective international multicenter study. BJOG 2022; 129:2052-2061. [PMID: 35596694 PMCID: PMC9796328 DOI: 10.1111/1471-0528.17235] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 04/29/2022] [Accepted: 05/16/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To assess the diagnostic performance of preoperative application of the Enzian classification (cEnzian) using surgical findings as reference standard. DESIGN A prospective international non-interventional study. SETTING Twelve endometriosis centres in four European countries (Austria, Germany, Switzerland and Czech Republic). POPULATION 1062 women with endometriosis surgery. METHODS Extent of endometriosis was preoperatively classified using the cEnzian classification based on gynaecological examination and/or transvaginal ultrasound (TVS) and/or magnetic resonance imaging (MRI). After subsequent surgery, the surgeon classified the intraoperative findings using the Enzian classification. MAIN OUTCOME MEASURES Sensitivity, specificity, PPV, NPV, LR+ , LR- and accuracy were calculated. Conditional frequencies of intraoperative Enzian codings and the corresponding 95% confidence intervals were computed for each preoperative coding and visualised in plots. RESULTS Although overall consistency of cEnzian and Enzian was poor (35.14%, 95% confidence interval 32.26-38.03), high specificities and negative predictive values (NPVs) of the cEnzian compartments could be demonstrated. Looking at the individual parts of the Enzian classification, the poorest diagnostic performance was detected for compartment B and the highest PPVs were found for category 3 lesions (>3 cm), independent of the compartment. CONCLUSIONS Using the Enzian classification in a non-invasive setting is a useful tool providing us with an 'at a glance' summary of the diagnostic workup regarding deep endometriosis with high specificities and NPVs. An attempt to merge the two new endometriosis classification systems (#Enzian and AAGL 2021) seems reasonable taking into consideration the respective advantages of each other.
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Affiliation(s)
- Simon‐Hermann Enzelsberger
- Department of Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University HospitalJohannes Kepler University LinzLinzAustria
| | - Peter Oppelt
- Department of Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University HospitalJohannes Kepler University LinzLinzAustria
| | - Konstantinos Nirgianakis
- Department of Obstetrics and GynecologyUniversity Hospital and University of BernBernSwitzerland
| | - Beata Seeber
- Department of Gynecologic Endocrinology and Reproductive MedicineMedical University of InnsbruckInnsbruckAustria
| | - Jan Drahoňovský
- Institute for the Care of Mother and ChildPragueCzech Republic
| | - Leopold Wanderer
- Department of Gynecology and ObstetricsLandesklinikum MelkMelkAustria
| | - Bernhard Krämer
- Department of GynecologyUniversity Hospital TübingenTübingenGermany
| | | | - Sudip Kundu
- Department Gynaecology and ObstetricsHanover Medical SchoolHannoverGermany
| | - Darius Salehin
- Department of Gynecology and ObstetricsJohanniter Krankenhaus MönchengladbachMönchengladbachGermany
| | - Maciej Mierzwinski
- Department of Gynecology and ObstetricsSt.‐Johannes‐HospitalDortmundGermany
| | - Harald Krentel
- Department of Gynecology, Obstetrics and Gynecological OncologyBethesda Hospital, Academic Teaching HospitalDuisburgGermany
| | - Philipp Hermann
- Center for Clinical StudiesJohannes Kepler University LinzLinzAustria
| | - Helga Wagner
- Center for Clinical StudiesJohannes Kepler University LinzLinzAustria,Institute of Applied StatisticsJohannes Kepler University LinzLinzAustria
| | - Omar Shebl
- Department of Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University HospitalJohannes Kepler University LinzLinzAustria
| | - Sebastian Schäfer
- Department of Gynecology and ObstetricsUniversity Hospital MünsterMünsterGermany
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11
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Pospischil I, Reinhardt C, Bontems O, Salamin K, Fratti M, Blanchard G, Chang YT, Wagner H, Hermann P, Monod M, Hoetzenecker W, Guenova E. Identification of Dermatophyte and Non-Dermatophyte Agents in Onychomycosis by PCR and DNA Sequencing—A Retrospective Comparison of Diagnostic Tools. J Fungi (Basel) 2022; 8:jof8101019. [PMID: 36294584 PMCID: PMC9605175 DOI: 10.3390/jof8101019] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [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] [Received: 08/25/2022] [Revised: 09/14/2022] [Accepted: 09/21/2022] [Indexed: 12/02/2022] Open
Abstract
Rapid and reliable fungal identification is crucial to delineate infectious diseases, and to establish appropriate treatment for onychomycosis. Compared to conventional diagnostic methods, molecular techniques are faster and feature higher accuracy in fungal identification. However, in current clinical practice, molecular mycology is not widely available, and its practical applicability is still under discussion. This study summarizes the results of 16,094 consecutive nail specimens with clinical suspicion of onychomycosis. We performed PCR/sequencing on all primary nail specimens for which conventional mycological diagnostics remained inconclusive. In specimens with a positive direct microscopy but negative or contaminated culture, molecular mycology proved superior and specified a fungal agent in 65% (587/898). In 75% (443/587), the identified pathogen was a dermatophyte. Positive cultures for dermatophytes, yeasts and non-dermatophyte molds (NDMs) were concordant with primary-specimen-DNA PCR/sequencing in 83% (10/12), 34% (22/65) and 45% (76/169), respectively. Among NDMs, agreement was high for Fusarium spp. (32/40; 80%), but low for Penicillium spp. (5/25; 20%) and Alternaria spp. (1/20; 5%). This study underlines the improvement in diagnostic yield by fungal primary-specimen-DNA PCR/sequencing in the event of a negative or contaminated culture, as well as its significance for the diagnosis of dermatophyte and non-dermatophyte onychomycosis. Molecular mycology methods like PCR and DNA sequencing should complement conventional diagnostics in cases of equivocal findings, suspected NDM onychomycosis or treatment-resistant nail pathologies.
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Affiliation(s)
- Isabella Pospischil
- Department of Dermatology, Kepler University Hospital, Johannes Kepler University Linz, 4020 Linz, Austria
- Correspondence: (I.P.); (W.H.); (E.G.)
| | - Charlotte Reinhardt
- Department of Dermatology, Kepler University Hospital, Johannes Kepler University Linz, 4020 Linz, Austria
- Department of Dermatology, Lausanne University Hospital (CHUV) and the Faculty of Biology and Medicine, University of Lausanne, 1007 Lausanne, Switzerland
| | - Olympia Bontems
- Department of Dermatology, Lausanne University Hospital (CHUV) and the Faculty of Biology and Medicine, University of Lausanne, 1007 Lausanne, Switzerland
| | - Karine Salamin
- Department of Dermatology, Lausanne University Hospital (CHUV) and the Faculty of Biology and Medicine, University of Lausanne, 1007 Lausanne, Switzerland
| | - Marina Fratti
- Department of Dermatology, Lausanne University Hospital (CHUV) and the Faculty of Biology and Medicine, University of Lausanne, 1007 Lausanne, Switzerland
| | - Gabriela Blanchard
- Department of Dermatology, Lausanne University Hospital (CHUV) and the Faculty of Biology and Medicine, University of Lausanne, 1007 Lausanne, Switzerland
| | - Yun-Tsan Chang
- Department of Dermatology, Lausanne University Hospital (CHUV) and the Faculty of Biology and Medicine, University of Lausanne, 1007 Lausanne, Switzerland
| | - Helga Wagner
- Center for Clinical Studies (CCS Linz), Johannes Kepler University Linz, 4020 Linz, Austria
- Institute of Applied Statistics, Johannes Kepler University Linz, 4020 Linz, Austria
| | - Philipp Hermann
- Center for Clinical Studies (CCS Linz), Johannes Kepler University Linz, 4020 Linz, Austria
| | - Michel Monod
- Department of Dermatology, Lausanne University Hospital (CHUV) and the Faculty of Biology and Medicine, University of Lausanne, 1007 Lausanne, Switzerland
| | - Wolfram Hoetzenecker
- Department of Dermatology, Kepler University Hospital, Johannes Kepler University Linz, 4020 Linz, Austria
- Correspondence: (I.P.); (W.H.); (E.G.)
| | - Emmanuella Guenova
- Department of Dermatology, Lausanne University Hospital (CHUV) and the Faculty of Biology and Medicine, University of Lausanne, 1007 Lausanne, Switzerland
- Department of Dermatology, University Hospital Zurich and the University of Zurich, 8091 Zurich, Switzerland
- Department of Dermatology, Hospital 12 de Octubre, Medical School, University Complutense, 28040 Madrid, Spain
- Correspondence: (I.P.); (W.H.); (E.G.)
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12
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Enzelsberger SH, Oppelt P, Nirgianakis K, Seeber B, Drahoňovský J, Wanderer L, Krämer B, Grübling KN, Kundu S, Salehin D, Mierzwinski M, Krentel H, Hermann P, Wagner H, Shebl O, Schäfer S. Präoperative Anwendung der Enzian-Klassifikation für Endo metriose (cEnzian): Eine prospektive internationale Multicenter-Studie. Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1750221] [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: 10/17/2022] Open
Affiliation(s)
- S-H Enzelsberger
- Department of Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria
| | - P Oppelt
- Department of Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria
| | - K Nirgianakis
- Department of Obstetrics and Gynecology, University Hospital and University of Bern, Bern, Switzerland
| | - B Seeber
- Department of Gynecologic Endocrinology and Reproductive Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - J Drahoňovský
- Institute for the Care of Mother and Child, Prague, Czech Republic
| | - L Wanderer
- Department of Gynecology and Obstetrics, Landesklinikum Melk, Melk, Austria
| | - B Krämer
- Department of Gynecology, University Hospital Tübingen, Tübingen, Germany
| | - K N Grübling
- Department of Gynecology and Obstetrics, University Hospital Carl Gustav Carus, Dresden, Germany
| | - S Kundu
- Department Gynaecology and Obstetrics, Hanover Medical School, Hannover, Germany
| | - D Salehin
- Department of Gynecology and Obstetrics, Johanniter Krankenhaus Mönchengladbach, Mönchengladbach, Germany
| | - M Mierzwinski
- Department of Gynecology and Obstetrics, St.-Johannes-Hospital, Dortmund, Germany
| | - H Krentel
- Department of Gynecology, Obstetrics and Gynecological Oncology, Bethesda Hospital, Academic Teaching Hospital, Duisburg, Germany
| | - P Hermann
- Center for Clinical Studies, Johannes Kepler University Linz, Linz, Austria
| | - H Wagner
- Center for Clinical Studies, Johannes Kepler University Linz, Linz, Austria
- Institute of Applied Statistics, Johannes Kepler University Linz, Linz, Austria
| | - O Shebl
- Department of Gynecology, Obstetrics and Gynecological Endocrinology, Kepler University Hospital, Johannes Kepler University Linz, Linz, Austria
| | - S Schäfer
- Department of Gynecology and Obstetrics, University Hospital Münster, Münster, Germany
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13
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Pichler U, Schmidbauer E, Hermann P, Wagner H, Bolz M, Mursch‐Edlmayr AS. A comparative study of various prism adaptation forms in the surgical management of esophoria. Acta Ophthalmol 2022; 100:e1010-e1014. [PMID: 34431217 PMCID: PMC9291304 DOI: 10.1111/aos.15004] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/07/2021] [Accepted: 08/04/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the outcome in participants who underwent surgery for esophoria following one of three different methods of preoperative prism adaptation test (PAT). METHODS This prospective, multicentre study was carried out at five eye departments from 2012 to 2019. 116 participants were included and allocated to three groups as per investigator choice: Group 1 (n = 55) had a short prism adaptation period ranging from 1 to 5 hours during their visit at the clinic. Group 2 (n = 36) underwent partial prism correction for at least 4 weeks before surgery. Group 3 (n = 25) underwent full prism correction for at least 4 weeks before surgery. Motoric success was determined by postoperative angle of deviation (AOD), and sensoric success was evaluated with Lang and Bagolini striated lens test. RESULTS A significant increase (p < 0.001) in AOD after PAT was observed in all groups, with no significant difference between groups (distance: p = 0.22; near: p = 0.31). Motoric and sensoric success was comparable between groups 3 months (p = 0.52; p = 0.55) and 1 year (p = 0.53; p = 0.29) after surgery. Prolonged prism adaptation (n = 24) for more than 365 days was not associated with better results. CONCLUSION Our study indicates that the postoperative result is independent from the duration and amount (partial or full correction) of prism adaptation before surgery at least up to one year of follow-up. Prolonged prism adaptation (>365 days) before surgery does not improve the results.
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Affiliation(s)
- Ulrike Pichler
- Department for Ophthalmology Kepler University Hospital Johannes Kepler University Linz Austria
| | - Elke Schmidbauer
- Department for Ophthalmology Kepler University Hospital Johannes Kepler University Linz Austria
| | - Philipp Hermann
- Center for Clinical Studies (CCS Linz) Johannes Kepler University Linz Austria
| | - Helga Wagner
- Center for Clinical Studies (CCS Linz) Johannes Kepler University Linz Austria
- Institute of Applied Statistics Johannes Kepler University Austria
| | - Matthias Bolz
- Department for Ophthalmology Kepler University Hospital Johannes Kepler University Linz Austria
- Johannes Kepler University Linz Austria
| | - Anna Sophie Mursch‐Edlmayr
- Department for Ophthalmology Kepler University Hospital Johannes Kepler University Linz Austria
- Johannes Kepler University Linz Austria
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14
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Senker W, Aspalter S, Radl C, Pichler J, Doppler S, Weis S, Webersinke C, Wagner H, Hermann P, Aichholzer M, Aufschnaiter-Hießböck K, Thomae W, Stroh N, Hauser T, Gruber A. Frequency and characteristics of bacterial and viral low-grade infections of the intervertebral discs: a prospective, observational study. J Orthop Traumatol 2022; 23:15. [PMID: 35303173 PMCID: PMC8933588 DOI: 10.1186/s10195-022-00633-y] [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] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 02/26/2022] [Indexed: 12/03/2022] Open
Abstract
Study design Monocentric, prospective, observational study. Objective The clinical relevance of bacterial colonization of intervertebral discs is controversial. This study aimed to determine a possible relationship between bacterial and viral colonization and low-grade infection of the discs. Methods We investigated 447 disc samples from 392 patients. Microbiological culture was used to examine the samples for bacterial growth, polymerase chain reaction (PCR) was used for detection of herpes simplex virus types 1 and 2 (HSV-1, HSV-2) and Cytomegalovirus (CMV), and histopathological analysis was used to detect signs of inflammation. The results were compared between subgroups organized according to gender, age, location of the samples, surgical approach, preoperative C-reactive protein (CRP), preoperative and 6 months postoperative Oswestry Disability Index (ODI) and Neck Disability Index (NDI), and Modic changes (MC) of the corresponding endplates. Also, we assessed the occurrence of postoperative infections within 6 months. Results Microbiological culture was positive in 38.78% of the analyzed intervertebral discs. Altogether, 180 bacteria were isolated. Coagulase-negative staphylococci (CONS) (23.41%) and Cutibacterium acnes (18.05%) were the most frequently detected microorganisms. None of HSV-1, HSV-2, or CMV were detected. Male patients (p = 0.00036) and cervical segments (p = 0.00001) showed higher rates of positive culture results. Ventral surgical approaches ( p < 0.001) and Type 2 MC (p = 0.0127) were significantly associated with a positive microbiological result ( p< 0.001). Neither pre- nor postoperative ODI and NDI are associated with positive culture results. In 4 (1.02%) patients, postoperative spondylodiscitis occurred. Conclusions With 447 segments from 392 patients, we present one of the largest studies to date. While disc degeneration caused by HSV-1, HSV-2, and CMV seems unlikely, we found positive microbiological culture results in 38.78% of all discs. The role of local skin flora and sample contamination should be the focus of further investigations. Level of Evidence III. Trial registration: The study was registered at ClinicalTrials.gov (ID: NCT04712487, https://www.clinicaltrials.gov/ct2/show/study/NCT04712487). Supplementary Information The online version contains supplementary material available at 10.1186/s10195-022-00633-y.
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Affiliation(s)
- Wolfgang Senker
- Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg Weg 15, 4020, Linz, Austria
| | - Stefan Aspalter
- Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg Weg 15, 4020, Linz, Austria.
| | - Christian Radl
- Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg Weg 15, 4020, Linz, Austria
| | - Josef Pichler
- Department of Internal Medicine, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg Weg 15, 4020, Linz, Austria
| | - Stefan Doppler
- Institute of Pathology and Microbiology, Kepler University Hospital, Johannes Kepler University, Krankenhausstraße 9, 4021, Linz, Austria
| | - Serge Weis
- Institute of Pathology and Neuropathology, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg Weg 15, 4020, Linz, Austria
| | - Christine Webersinke
- Institute of Pathology and Neuropathology, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg Weg 15, 4020, Linz, Austria
| | - Helga Wagner
- Center for Clinical Studies (CCS Linz), Johannes Kepler University, Huemerstrasse 3-5, 4020, Linz, Austria.,Department of Medical Statistics and Biometry, Institute of Applied Statistics, Johannes Kepler University, Altenberger Strasse 69, 4040, Linz, Austria
| | - Philipp Hermann
- Center for Clinical Studies (CCS Linz), Johannes Kepler University, Huemerstrasse 3-5, 4020, Linz, Austria
| | - Martin Aichholzer
- Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg Weg 15, 4020, Linz, Austria
| | - Kathrin Aufschnaiter-Hießböck
- Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg Weg 15, 4020, Linz, Austria
| | - Wolfgang Thomae
- Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg Weg 15, 4020, Linz, Austria
| | - Nico Stroh
- Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg Weg 15, 4020, Linz, Austria
| | - Thomas Hauser
- Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg Weg 15, 4020, Linz, Austria
| | - Andreas Gruber
- Department of Neurosurgery, Kepler University Hospital, Johannes Kepler University, Wagner-Jauregg Weg 15, 4020, Linz, Austria
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15
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Enzelsberger SH, Wetzlmair D, Hermann P, Wagner H, Shebl O, Oppelt P, Trautner PS. Bleeding pattern after medical management of early pregnancy loss with mifepristone–misoprostol and its prognostic value: a prospective observational cohort study. Arch Gynecol Obstet 2021; 306:349-355. [PMID: 34694431 PMCID: PMC9349076 DOI: 10.1007/s00404-021-06291-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/13/2021] [Indexed: 10/26/2022]
Abstract
Abstract
Purpose
To improve counseling of women by reporting bleeding characteristics at home after medical management of an early pregnancy loss (EPL) with mifepristone and misoprostol, and to evaluate occurring bleeding patterns as a prognostic tool.
Methods
This prospective two-center observational cohort study enrolled 197 women who presented with an EPL (embryonic or anembryonic miscarriage) from December 2017 to April 2019 and chose a home-based medical management with 200 mg mifepristone and 800 mcg misoprostol. From the day of mifepristone intake, the strength of vaginal bleeding was recorded daily for 2 weeks by the patient herself using a diary sheet. Treatment success was defined as no histologically confirmed retained products of conception (RPOC) within 3 months. After considering all drop-out criteria, 154 women were included in the analysis.
Results
40.0% of patients (95% CI 30.4–49.6) already reported bleeding onset in the time period between the intake of mifepristone and misoprostol. The median duration of vaginal bleeding including spotting was 13 days. The chance of RPOC was about sixfold (OR 6.06, 95% CI 2.15–17.10) in the group of persistent bleeding after 2 weeks compared to the group with a terminated bleeding at that time. Exploratory regression analysis indicated association of higher serum levels of leukocytes at treatment start with RPOC (p = 0.013).
Conclusions
Terminated bleeding after 2 weeks is a useful indicator for successful medical induction of EPL. Women undergoing medical treatment with mifepristone must be informed about the high frequency of bleeding onset before misoprostol intake.
Clinical trial registration
DRKS—German Clinical Trials Register, ID: DRKS00013515, registration date 05.12.2017. http://www.drks.de/DRKS00013515.
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Nikoloudis A, Wagner H, Machherndl-Spandl S, Buxhofer-Ausch V, Strassl I, Stiefel O, Wipplinger D, Milanov R, Kaynak E, Hasengruber P, Binder M, Weltermann A, Petzer A, Wolf D, Nachbaur D, Clausen J. Relapse Protection Following Early Cytomegalovirus Reactivation after Hematopoietic Stem Cell Transplantation Is Limited to HLA-C Killer Cell Immunoglobulin-Like Receptor Ligand Homozygous Recipients. Transplant Cell Ther 2021; 27:686.e1-686.e9. [PMID: 33991724 DOI: 10.1016/j.jtct.2021.04.028] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 11/29/2022]
Abstract
Although the risk for nonrelapse mortality (NRM) associated with early cytomegalovirus (CMV) reactivation (CMVR) after allogeneic hematopoietic stem cell transplantation (HSCT) is well established, debate is ongoing on whether CMVR may reduce the risk of primary disease relapse. The aim of this study was to evaluate relapse protection following early CMV reactivation after HSCT in the context of the recipient HLA-C killer cell immunoglobulin-like receptor ligands (KIRLs). In this retrospective bicentric study, 406 matched related or unrelated donor transplantations for acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS) were stratified by HLA-C KIRL group (homozygous versus heterozygous) and analyzed separately for the impact of early CMVR on the cumulative incidences of relapse, NRM, and acute and chronic graft-versus-host-disease (GVHD) using landmark and multistate analyses. By landmark analysis of patients alive and relapse-free at 45 days post-HSCT, HLA-C KIRL homozygous recipients (C1/1 or C2/2) had a lower risk of subsequent relapse if CMVR occurred before this landmark (subhazard ratio [sHR], 0.36; P = .002). In contrast, in HLA-C KIRL heterozygous (C1/2) recipients, early CMVR had no impact on subsequent relapse (sHR, 0.88; P = .63). NRM (sHR, 3.31; P < .001) and grade III-IV acute GVHD (sHR, 2.60; P = .04) were significantly increased after early CMVR in the homozygous cohort, but not in the heterozygous cohort (NRM: sHR, 1.23; P = .53; grade III-IV acute GVHD: sHR, 1.40; P = .50). Multivariable landmark analyses and a multistate model confirmed the limitation of the relapse-protective effect of early CMVR to the homozygous cohort. Chronic GVHD and overall survival were not influenced in neither cohort. An antileukemic effect of early CMVR after HSCT for AML/MDS was significant but strictly limited to recipients homozygous for HLA-C KIRL. However, particularly in this cohort, CMVR had an adverse impact on aGVHD and NRM.
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Affiliation(s)
- Alexander Nikoloudis
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria; Medical Faculty, Johannes Kepler University, Linz, Austria.
| | - Helga Wagner
- Department of Applied Statistics: Medical Statistics and Biometry and Competence Center for Clinical Studies, Johannes Kepler University, Linz, Austria
| | - Sigrid Machherndl-Spandl
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria; Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Veronika Buxhofer-Ausch
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria; Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Irene Strassl
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria
| | - Olga Stiefel
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria
| | - Dagmar Wipplinger
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria
| | - Robert Milanov
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria
| | - Emine Kaynak
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria
| | - Petra Hasengruber
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria
| | - Michaela Binder
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria
| | - Ansgar Weltermann
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria; Medical Faculty, Johannes Kepler University, Linz, Austria
| | - Andreas Petzer
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria
| | - Dominik Wolf
- University Hospital of Internal Medicine V, Hematology & Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - David Nachbaur
- University Hospital of Internal Medicine V, Hematology & Oncology, Medical University of Innsbruck, Innsbruck, Austria
| | - Johannes Clausen
- Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz Elisabethinen, Linz, Austria; Medical Faculty, Johannes Kepler University, Linz, Austria
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17
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Reintke J, Brügemann K, Yin T, Wagner H, Wehrend A, Müller A, König S. Associations between minerals and metabolic indicators in maternal blood pre- and postpartum with ewe body condition, methane emissions, and lamb body weight development. Animal 2021; 15:100034. [PMID: 33602579 DOI: 10.1016/j.animal.2020.100034] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 11/20/2022] Open
Abstract
In sheep production, economic efficiency strongly depends on the maternal health and feed efficiency status and on weaning performances of their offspring. Accordingly, an optimal level for the supply with macro- and microelements and the ewe energy status has impact on the fetal development during gestation and on maternal milk production during lactation. Furthermore, this study addressed intergenerational aspects, i.e., on associations between maternal energy metabolism profiles considering the macro- and microelement status, metabolic indicators (e.g. β-hydroxybutyrate (BHB)), body condition and methane (CH4) emissions with lamb BW (LBW) in two sheep breeds. Traits were recorded at the beginning of gestation (ewe traits), at lambing, three weeks postpartum, and at weaning (ewe and lamb traits). Trait recording included CH4 emissions (recorded via laser methane detector (LMD)), ewe BW (EBW), backfat thickness (BFT), and body condition score (BCS) from 46 ewes (24 Merinoland- (ML), 22 Rhönsheep (RH)), and LBW of their 87 (35 ML, 52 RH) purebred lambs. Serum levels of the following ewe blood parameters were determined: calcium (Ca), sodium (Na), potassium (K), phosphate (P), nonesterified fatty acids (NEFA), BHB, glutamate dehydrogenase (GLDH), selenium (Se), copper (Cu), iron (Fe), zinc (Zn), and magnesium (Mg). Mixed models were applied to infer associations between ewe blood parameters with EBW, BFT, BCS, and CH4 and with LBW recorded in offspring. At weaning, a maternal serum Mg level > 1.0 mmol/L was significantly associated with an increase of 13% in LBW in ML, compared to offspring from ML ewes with a serum Mg concentration within the lower reference range (0.8 mmol/L). Furthermore, higher Cu levels were favorably associated with ewe BCS and BFT at weaning in both breeds. In RH ewes, a Se level > 2.4 μmol/l was significantly associated with increased BCS. In the ML breed, high Zn levels during lactation were associated with reduced CH4 emissions. Ewe EBW was significantly larger for ML ewes representing low Ca levels. A low BHB level was associated with decreasing CH4 emissions in RH and ML. Serum levels for Na, K, P, GLDH, and Fe did not significantly affect the traits of interest. Trait associations from the present study indicate the importance of the mineral supply and metabolic status of the ewe with regard to body condition, CH4 emissions, and LBW development, but depending on the breed. Identified associations might contribute to energy efficiency in sheep production systems.
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Affiliation(s)
- J Reintke
- Institute of Animal Breeding and Genetics, University of Giessen, Ludwig St. 21B, 35390 Giessen, Germany.
| | - K Brügemann
- Institute of Animal Breeding and Genetics, University of Giessen, Ludwig St. 21B, 35390 Giessen, Germany
| | - T Yin
- Institute of Animal Breeding and Genetics, University of Giessen, Ludwig St. 21B, 35390 Giessen, Germany
| | - H Wagner
- Clinic for Obstetrics, Gynaecology and Andrology of Large and Small Animals with Veterinary Ambulance, University of Giessen, Frankfurter St. 106, 35392 Giessen, Germany
| | - A Wehrend
- Clinic for Obstetrics, Gynaecology and Andrology of Large and Small Animals with Veterinary Ambulance, University of Giessen, Frankfurter St. 106, 35392 Giessen, Germany
| | - A Müller
- IDEXX Laboratories, Vet Med Labor GmbH, Im Moltengraben 65, 70806 Kornwestheim, Germany
| | - S König
- Institute of Animal Breeding and Genetics, University of Giessen, Ludwig St. 21B, 35390 Giessen, Germany
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18
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Blessberger H, Bergler-Klein J, Graf S, Syeda B, Wagner H, Kammler J, Steinwender C, Binder T. Speckle Tracking-Derived Longitudinal Strain: Validation and Influence of Scanner Settings. Ultrasound Med Biol 2021; 47:154-162. [PMID: 33077338 DOI: 10.1016/j.ultrasmedbio.2020.09.005] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/09/2020] [Accepted: 09/13/2020] [Indexed: 06/11/2023]
Abstract
Speckle tracking-based strain analysis is an evolving technique for the assessment of left ventricular function. We evaluated the influence of machine settings on global longitudinal peak systolic strain (GLPSS) values in an everyday patient population (n = 35). In each patient, the four-chamber view was recorded multiple times with different machine parameters. Ejection fraction ranged between 10% and 76% and correlated well with GLPSS (r = -0.778). GLPSS was not altered systematically by modifications of gain and frame rate. Conversely, higher transducer frequencies (mean effect: 1.102%/MHz, p < 0.001, and 0.662%/MHz, p = 0.033, for harmonic and fundamental imaging frequencies, respectively) and lower sector depth (mean effect: -0.156%/cm, p < 0.001) were associated with a slight-but statistically significant-reduction in absolute GLPSS values. Intra- and inter-observer variability exhibited satisfactory repeatability. GLPSS analysis proved to be reproducible and robust in our patient cohort if common settings for adult echocardiography were applied.
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Affiliation(s)
| | - Jutta Bergler-Klein
- Department of Internal Medicine II-Cardiology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Senta Graf
- Department of Internal Medicine II-Cardiology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Bonni Syeda
- Department of Internal Medicine II-Cardiology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Helga Wagner
- Institute of Applied Statistics, Johannes Kepler University Linz, Linz, Austria
| | - Juergen Kammler
- Department of Cardiology, Kepler University Hospital Linz, Linz, Austria; Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Clemens Steinwender
- Department of Cardiology, Kepler University Hospital Linz, Linz, Austria; Department of Internal Medicine II, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Thomas Binder
- Department of Internal Medicine II-Cardiology, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
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Wiesinger C, Schoeb DS, Stockhammer M, Mirtezani E, Mitterschiffthaler L, Wagner H, Knotzer J, Pauer W. Cerebral oxygenation in 45-degree trendelenburg position for robot-assisted radical prostatectomy: a single-center, open, controlled pilot study. BMC Urol 2020; 20:198. [PMID: 33380323 PMCID: PMC7772899 DOI: 10.1186/s12894-020-00774-4] [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] [Received: 09/03/2020] [Accepted: 11/23/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Within the last decade, robotically-assisted laparoscopic prostatectomy (RALP) has become the standard for treating localized prostate cancer, causing a revival of the 45° Trendelenburg position. In this pilot study we investigated effects of Trendelenburg position on hemodynamics and cerebral oxygenation in patients undergoing RALP. METHODS We enrolled 58 patients undergoing RALP and 22 patients undergoing robot-assisted partial nephrectomy (RAPN) (control group) in our study. Demographic patient data and intraoperative parameters including cerebral oxygenation and cerebral hemodynamics were recorded for all patients. Cerebral function was also assessed pre- and postoperatively via the Mini Mental Status (MMS) exam. Changes in parameters during surgery were modelled by a mixed effects model; changes in the MMS result were evaluated using the Wilcoxon signed rank test. RESULTS Preoperative assessment of patient characteristics, standard blood values and vital parameters revealed no difference between the two groups. CONCLUSIONS Applying a 45° Trendelenburg position causes no difference in postoperative brain function, and does not alter cerebral oxygenation during a surgical procedure lasting up to 5 h. Further studies in larger patient cohorts will have to confirm these findings. TRIAL REGISTRATION German Clinical Trial Registry; DRKS00005094; Registered 12th December 2013-Retrospectively registered; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005094 .
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Affiliation(s)
- Clemens Wiesinger
- Department of Urology, Wels-Grieskirchen Medical-Center, Grieskirchner Straße 42, 4600, Wels, Austria
| | - Dominik Stefan Schoeb
- Department of Urology, Faculty of Medicine, Medical Center - University of Freiburg, Hugstetterstr. 55, 79106, Freiburg, Germany.
| | - Mathias Stockhammer
- Department of Urology, BHB Salzburg, Kajetanerplatz 1, 5010, Salzburg, Salzburg, Austria
| | - Emir Mirtezani
- Department of Urology, Wels-Grieskirchen Medical-Center, Grieskirchner Straße 42, 4600, Wels, Austria
| | - Lukas Mitterschiffthaler
- Department of Anesthesiology and Intensive Care II, Wels-Grieskirchen Medical Center, Grieskirchner Straße 42, 4600, Wels, Austria
| | - Helga Wagner
- Medical Statistics and Biometry, Institute for Applied Statistics, Johannes Kepler University Linz, Altenbergerstrasse 69, 4040, Linz, Austria
| | - Johann Knotzer
- Department of Anesthesiology and Intensive Care II, Wels-Grieskirchen Medical Center, Grieskirchner Straße 42, 4600, Wels, Austria
| | - Walter Pauer
- Department of Urology, Wels-Grieskirchen Medical-Center, Grieskirchner Straße 42, 4600, Wels, Austria
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20
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Ploetner KO, Al Haddad C, Antoniou C, Frank F, Fu M, Kabel S, Llorca C, Moeckel R, Moreno AT, Pukhova A, Rothfeld R, Shamiyeh M, Straubinger A, Wagner H, Zhang Q. Long-term application potential of urban air mobility complementing public transport: an upper Bavaria example. CEAS Aeronaut J 2020; 11:991-1007. [PMID: 33403052 PMCID: PMC7456445 DOI: 10.1007/s13272-020-00468-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 06/10/2020] [Accepted: 08/19/2020] [Indexed: 11/27/2022]
Abstract
In this paper, the required models and methods to analyze and quantify the potential demand for urban air mobility (UAM) complementing public transport and possible impacts were defined and applied to the Munich Metropolitan region. An existing agent-based transport model of the study area were used and extended to cover socio-demographic changes up to the year 2030 and intermodal UAM services. An incremental logit model for UAM was derived to simulate demand for this new mode. An airport access model was developed as well. Three different UAM networks with different numbers of vertiports were defined. Sensitivity studies of ticket fare and structure, flying vehicle cruise speed, passenger process times at vertiports and different Urban Air Mobility networks sizes were performed. For the reference case, UAM accounts for a modal share of 0.5%. The absolute UAM demand is concentrated on very short routes; hence, UAM vehicle flight speed variation shows low UAM demand impacts. Kilometer-based fare, number of UAM vehicles per vertiport and passenger process times at vertiports show a significant impact on UAM demand.
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Affiliation(s)
| | | | - C. Antoniou
- Technical University of Munich, Munich, Germany
| | - F. Frank
- University of Applied Sciences Ingolstadt, Ingolstadt, Germany
| | - M. Fu
- Bauhaus Luftfahrt, Taufkirchen, Germany
| | - S. Kabel
- University of Applied Sciences Ingolstadt, Ingolstadt, Germany
| | - C. Llorca
- Technical University of Munich, Munich, Germany
| | - R. Moeckel
- Technical University of Munich, Munich, Germany
| | | | - A. Pukhova
- Technical University of Munich, Munich, Germany
| | | | | | | | - H. Wagner
- University of Applied Sciences Ingolstadt, Ingolstadt, Germany
| | - Q. Zhang
- Technical University of Munich, Munich, Germany
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21
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Reintke J, Brügemann K, Wagner H, Engel P, Wehrend A, König S. Phenotypic relationships between maternal energy metabolism and lamb body weight development during lactation for pure- and crossbred sheep populations in low and high input production systems. Small Rumin Res 2020. [DOI: 10.1016/j.smallrumres.2019.106037] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Blessberger H, Bergler-Klein J, Graf S, Syeda B, Wagner H, Kammler J, Steinwender C, Binder T. P1540 Imaging parameters vs. operator dependence of global longitudinal strain values. Eur Heart J Cardiovasc Imaging 2020. [DOI: 10.1093/ehjci/jez319.961] [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
Speckle tracking based global longitudinal strain (GLS) values have proven useful in the assessment of subtle changes in left ventricular function. From a clinical point of view, robustness and reliability of measured values are critical to ensure a valid patient assessment and follow-up. However, it is still a matter of debate if imaging parameters systematically alter measured strain values and if these changes are relevant as compared with GLS fluctuations that are caused by different operators or different studies by the same operator.
Methods
In a consecutive everyday patient population (n = 35), we recorded the apical four chamber view several times in each patient with different ultrasound machine settings (modification of gain, frame rate, sector depth, and transducer frequencies) using a commercially available ultrasound imaging system. Furthermore, apical four chamber views with ‘optimized’ imaging settings at the operators’ discretion were recorded by two different observers (obA/obB) in each subject to compute inter- and intra-observer variability. GLS values were calculated offline with a dedicated software. We fitted a linear mixed effects model with random intercept and slope to assess the effect of imaging parameters on GLS and compared the two investigators with Bland-Altman plots.
Results
Ejection fraction ranged between 10% and 76% and was correlated well with GLS (r = -0.78). Neither gain settings (range: -24 to 24 arbitrary units, p = 0.68) nor frame rate (range: 51-113 sec-1, p = 0.77) systematically changed measured GLS values. Conversely, higher sector depth increased (range: 12 to 24 cm, mean effect: -0.16%/cm; 95% CI -0.24% to -0.07%, p < 0.01), and higher transducer imaging frequencies decreased absolute GLS values (range for harmonic imaging: 1.5/3.1 MHz to 2.0/4.3 MHz, mean effect 1.10%/MHz; 95% CI 0.61% to 1.59%, p < 0.01). According to our data, a 12 cm increase of sector depth would translate into an average change of -1.87% GLS (95% CI: -2.87% to -0.86%), whereas a switch of the second harmonic imaging frequency from 3.1 MHz to 4.3 MHz would cause a 1.32% GLS change (95% CI: 0.73% to 1.91%). Intra- and inter-observer variability showed good correlation and limits of agreement (obA: mean difference [MD]: -0.20%; 95% limits of agreement [LOA]: -2.42% to 2.02%, p = 0.86, obB: MD: -0.10%; 95% LOA: -4.28% to 4.07%, p = 0.12, obA vs. obB: MD: -0.53%; 95% LOA: -3.68% to 2.62%, p = 0.92).
Conclusion
Overall, GLS values were robust and reproducible in our cohort of patients. In comparison, potential systematic changes of GLS values caused by modification of imaging parameters (sector depth/transducer frequency) were much less in number than GLS variations caused by different operators or different studies by the same operator.
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Affiliation(s)
- H Blessberger
- Kepler University Hospital Linz, Department of Cardiology, Linz, Austria
| | - J Bergler-Klein
- Medical University of Vienna, Department of Cardiology, Vienna, Austria
| | - S Graf
- Medical University of Vienna, Department of Cardiology, Vienna, Austria
| | - B Syeda
- Medical University of Vienna, Department of Cardiology, Vienna, Austria
| | - H Wagner
- Johannes Kepler University Linz, Institute of Applied Statistics, Linz, Austria
| | - J Kammler
- Kepler University Hospital Linz, Department of Cardiology, Linz, Austria
| | - C Steinwender
- Kepler University Hospital Linz, Department of Cardiology, Linz, Austria
| | - T Binder
- Medical University of Vienna, Department of Cardiology, Vienna, Austria
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Gmeiner M, Wagner H, Schlögl C, van Ouwerkerk WJ, Senker W, Sardi G, Rauch P, Holl K, Gruber A. Adult Outcome in Shunted Pediatric Hydrocephalus: Long-Term Functional, Social, and Neurocognitive Results. World Neurosurg 2019; 132:e314-e323. [DOI: 10.1016/j.wneu.2019.08.167] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/20/2019] [Accepted: 08/22/2019] [Indexed: 12/22/2022]
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24
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Enko D, Wagner H, Kriegshäuser G, Wögerer J, Halwachs-Baumann G, Schnedl WJ, Zelzer S, Fauler G, Mangge H, Markus H, Meinitzer A. Iron status determination in individuals with Helicobacter pylori infection: conventional vs. new laboratory biomarkers. Clin Chem Lab Med 2019; 57:982-989. [PMID: 31154451 DOI: 10.1515/cclm-2018-1182] [Citation(s) in RCA: 5] [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: 11/03/2018] [Accepted: 12/05/2018] [Indexed: 12/28/2022]
Abstract
Background Helicobacter pylori has been associated with iron deficiency (ID). This study is aimed at investigating ID with conventional (ferritin, transferrin saturation [TSAT]) and new biomarkers (soluble transferrin receptor [sTfR], sTfR/log ferritin, reticulocyte hemoglobin content [CHr], hepcidin-25) in patients sub-grouped by the presence or absence of H. pylori infection. Methods In total, 200 consecutive outpatients, who were referred for the H. pylori 13C-urea breath test (13C-UBT), underwent blood testing for ID. Additionally, Thomas-plot (TP)-analyses (sTfR/log ferritin, CHr) were calculated. Results Fifty-three and 147 individuals were found with and without H. pylori infection, respectively. Patients with H. pylori infection showed a higher sTfR concentration (p<0.02) and a higher sTfR/log ferritin ratio (p<0.05). Based on a ferritin <30 μg/L and/or a TSAT <20%, 25/53 (47.2%) patients with H. pylori infection and 63/147 (42.9%) without H. pylori infection showed ID. Based on TP-analyses, 10/53 (18.9%) patients with and 17/147 (11.6%) without H. pylori infection were identified with ID. Completed eradication therapy tended to be associated with functional ID. Conclusions Helicobacter pylori infection was associated with significantly higher plasma sTfR concentrations and sTfR/log ferritin ratios. Patients with H. pylori eradication therapy were more often detected with functional ID compared to patients without eradication therapy, when using the new biomarkers.
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Affiliation(s)
- Dietmar Enko
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Helga Wagner
- Department of Applied Statistics, Johannes Kepler University Linz, Linz, Austria
| | - Gernot Kriegshäuser
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Julia Wögerer
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria
| | | | | | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Günter Fauler
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Herrmann Markus
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria
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Patel J, Lee J, Wagner H, Carbone D, Shanker A, Horn L, Johnson M, Gerber D, Liu J, Das M, Ali Al-Nsour M, Dakhil C, Ramalingam S, Schiller J. MA05.01 E6508: Phase II Study of Immunotherapy with Tecemotide and Bevacizumab after Chemoradiation in Unresectable Stage III NS-NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.349] [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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26
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Fredman D, Ringh M, Svensson L, Hollenberg J, Nordberg P, Djärv T, Hasselqvist-Ax I, Wagner H, Forsberg S, Nord A, Jonsson M, Claesson A. Experiences and outcome from the implementation of a national Swedish automated external defibrillator registry. Resuscitation 2018; 130:73-80. [DOI: 10.1016/j.resuscitation.2018.06.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 05/25/2018] [Accepted: 06/27/2018] [Indexed: 10/28/2022]
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27
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Gegenfurtner FA, Jahn B, Wagner H, Ziegenhain C, Enard W, Geistlinger L, Rädler JO, Vollmar AM, Zahler S. Micropatterning as a tool to identify regulatory triggers and kinetics of actin-mediated endothelial mechanosensing. J Cell Sci 2018; 131:jcs.212886. [PMID: 29724912 DOI: 10.1242/jcs.212886] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 11/03/2017] [Accepted: 04/25/2018] [Indexed: 12/11/2022] Open
Abstract
Developmental processes, such as angiogenesis, are associated with a constant remodeling of the actin cytoskeleton in response to different mechanical stimuli. The mechanosensitive transcription factors MRTF-A (MKL1) and YAP (also known as YAP1) are important mediators of this challenging adaptation process. However, it is as yet unknown whether both pathways respond in an identical or in a divergent manner to a given microenvironmental guidance cue. Here, we use a micropatterning approach to dissect single aspects of cellular behavior in a spatiotemporally controllable setting. Using the exemplary process of angiogenesis, we show that cell-cell contacts and adhesive surface area are shared regulatory parameters of MRTF and YAP on rigid 2D surfaces. By analyzing MRTF and YAP under laminar flow conditions and during cell migration on dumbbell-shaped microstructures, we demonstrate that they exhibit different translocation kinetics. In conclusion, our work promotes the application of micropatterning techniques as a cell biological tool to study mechanosensitive signaling in the context of angiogenesis.
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Affiliation(s)
- Florian A Gegenfurtner
- Ludwig-Maximilians-University Munich, Department of Pharmacy, Center for Drug Research, 81377 Munich, Germany
| | - Berenice Jahn
- Ludwig-Maximilians-University Munich, Department of Pharmacy, Center for Drug Research, 81377 Munich, Germany
| | - Helga Wagner
- ibidi GmbH, Am Klopferspitz 19, 82152 Martinsried, Germany
| | - Christoph Ziegenhain
- Ludwig-Maximilians-University Munich, Department of Biology II, Anthropology and Human Genomics, 82152 Martinsried, Germany
| | - Wolfgang Enard
- Ludwig-Maximilians-University Munich, Department of Biology II, Anthropology and Human Genomics, 82152 Martinsried, Germany
| | - Ludwig Geistlinger
- Ludwig-Maximilians-University Munich, Institute for Informatics, Teaching and Research Unit Bioinformatics, 80333 Munich, Germany
| | - Joachim O Rädler
- Ludwig-Maximilians-University Munich, Faculty of Physics, Soft Condensed Matter Group, 80539 Munich, Germany
| | - Angelika M Vollmar
- Ludwig-Maximilians-University Munich, Department of Pharmacy, Center for Drug Research, 81377 Munich, Germany
| | - Stefan Zahler
- Ludwig-Maximilians-University Munich, Department of Pharmacy, Center for Drug Research, 81377 Munich, Germany
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28
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Enko D, Wagner H, Kriegshäuser G, Brandmayr W, Halwachs-Baumann G, Schnedl WJ, Zelzer S, Mangge H, Meinitzer A. Assessment of tryptophan metabolism and signs of depression in individuals with carbohydrate malabsorption. Psychiatry Res 2018; 262:595-599. [PMID: 28965810 DOI: 10.1016/j.psychres.2017.09.049] [Citation(s) in RCA: 11] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 09/17/2017] [Accepted: 09/21/2017] [Indexed: 01/16/2023]
Abstract
This prospective cross-sectional study aimed to investigate the potential association between primary-adult lactose malabsorption, fructose malabsorption, tryptophan (TRP) metabolism and the presence of depressive signs. Overall 251 patients, who were referred for lactase gene C/T-13910 polymorphism genotyping and fructose hydrogen/methane breath testing, were included. All participants filled out the Beck Depression Inventory (BDI II). Serum concentrations of tryptophan (TRP), kynurenine (KYN), kynuric acid (KYNA), and TRP competing amino acids (leucine, isoleucine, valine, phenylalanine, tyrosine) were measured by high-pressure liquid-chromatography. Logistic regression analysis was performed with lactose malabsorption, fructose malabsorption and all potential biomarkers of TRP metabolism to assess the effect on signs of depression, defined as a BDI II score > 13. Primary-adult lactose malabsorption and fructose malabsorption was detected in 65 (25.90%) and 65 (25.90%) patients, respectively. Fructose malabsorption was significantly associated with BDI II score, whereas no such relationship was found for lactose malabsorption. Serum levels of TRP and TRP metabolites were no predictors of depression. The authors suggest to conduct further prospective longitudinal studies in order to get further insight of associations between carbohydrate malabsorption, biomarkers and mood disorders.
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Affiliation(s)
- Dietmar Enko
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
| | - Helga Wagner
- Department of Applied Statistics, Johannes Kepler University Linz, Linz, Austria.
| | - Gernot Kriegshäuser
- Institute of Clinical Chemistry and Laboratory Medicine, General Hospital Steyr, Steyr, Austria; Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
| | - Wolfgang Brandmayr
- Department of Psychiatry and Psychotherapeutic Medicine, General Hospital Steyr, Steyr, Austria.
| | | | | | - Sieglinde Zelzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
| | - Harald Mangge
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.
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29
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Williams RS, Wagner H. The Isolation and Identification of New Staling Related Compounds from Beer. Journal of the American Society of Brewing Chemists 2018. [DOI: 10.1094/asbcj-36-0027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- R. S. Williams
- Beverage Science Department, Labatt Breweries of Canada Ltd., London, Ontario N6A 4M3
| | - H. Wagner
- Beverage Science Department, Labatt Breweries of Canada Ltd., London, Ontario N6A 4M3
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Abstract
Abstract: In social and economic studies many of the collected variables are measured on a nominal scale, often with a large number of categories. The definition of categories can be ambiguous and different classification schemes using either a finer or a coarser grid are possible. Categorization has an impact when such a variable is included as covariate in a regression model: a too fine grid will result in imprecise estimates of the corresponding effects, whereas with a too coarse grid important effects will be missed, resulting in biased effect estimates and poor predictive performance. To achieve an automatic grouping of the levels of a categorical covariate with essentially the same effect, we adopt a Bayesian approach and specify the prior on the level effects as a location mixture of spiky Normal components. Model-based clustering of the effects during MCMC sampling allows to simultaneously detect categories which have essentially the same effect size and identify variables with no effect at all. Fusion of level effects is induced by a prior on the mixture weights which encourages empty components. The properties of this approach are investigated in simulation studies. Finally, the method is applied to analyse effects of high-dimensional categorical predictors on income in Austria.
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Affiliation(s)
- Gertraud Malsiner-Walli
- Institute for Statistics and Mathematics, Vienna University for Economics and Business, Austria
| | - Daniela Pauger
- Department of Applied Statistics, Johannes Kepler University Linz, Austria
| | - Helga Wagner
- Department of Applied Statistics, Johannes Kepler University Linz, Austria
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Abstract
SummaryThe kinetics of 67Ga accumulation in experimental inflammatory exudates were studied. In six rabbits with 5. aureus induced abscesses, serial samples of exudate and blood were obtained at 1, 2, 4, 24 and 48 hrs after intravenous injection of 67Ga. The accumulation of 67Ga in the inflammatory exudate was slow with an accumulation half-time of 5.5 hrs. The concentration of 67Ga in the abscesses approached that of blood 48 hrs after injection.Analysis of the distribution of 67Ga in the inflammatory exudate revealed that the portion of 67Ga in the cellular fraction (1,600 xg pellet) correlated best with the number of non-viable polymorphonuclear leukocytes (PMN) (r = 0.81). Its correlation with total number of PMN and bacteria was r = 0.69 and r = 0.35, respectively. Autoradiographie studies confirmed that the majority of 67Ga in the cellular fraction of the exudate was associated with non-viable PMN’s.
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32
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Gmeiner M, Wagner H, van Ouwerkerk WJR, Senker W, Holl K, Gruber A. Abdominal Pseudocysts and Peritoneal Catheter Revisions: Surgical Long-Term Results in Pediatric Hydrocephalus. World Neurosurg 2018; 111:e912-e920. [PMID: 29325961 DOI: 10.1016/j.wneu.2018.01.032] [Citation(s) in RCA: 9] [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: 10/30/2017] [Revised: 01/02/2018] [Accepted: 01/04/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE An abdominal pseudocyst (APC) is a distal catheter site-specific failure in patients treated with ventriculoperitoneal shunts. Few studies with more than 10 patients have been reported. The aim of this study was to analyze causes of peritoneal catheter revisions with special emphasis on revisions because of an APC. METHODS Pediatric patients with first shunt operation between 1982 and 1992 were included, and time, cause, and modality of peritoneal catheter revision were determined retrospectively. RESULTS One hundred thirty-eight patients were treated for hydrocephalus, and 112 patients received a peritoneal catheter during the follow-up. An APC was diagnosed in 14 (12.5%) patients, and 28 revisions were needed for its treatment. The rate of shunt infection in patients with APC was 50%, but bacterial examination of the pseudofluid culture revealed infection in only 3 patients. Age at first surgical procedure, type of first surgical procedure, and etiology of hydrocephalus were not associated with APC diagnosis. APC recurred in 4 patients. These patients had a catheter repositioning directly into the peritoneum as first surgical treatment. No recurrences were observed in patients with shunt externalization or replacement of the peritoneal catheter. CONCLUSIONS An APC is a major long-term complication after ventriculoperitoneal shunt treatment. Although a sterile inflammatory response cannot be excluded completely, our results favor the hypothesis of low-level shunt infection. In both cases, the surgical consequences are the same. An infected APC should be treated as a shunt infection. Uninfected patients can be treated with shunt externalization and replacement of only the peritoneal catheter.
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Affiliation(s)
- Matthias Gmeiner
- Kepler University Hospital, Department of Neurosurgery, Linz, Austria.
| | - Helga Wagner
- Department of Applied Statistics, Johannes Kepler University, Linz, Austria
| | - Willem J R van Ouwerkerk
- Department of Neurosurgery, Vrije Universitet University Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Wolfgang Senker
- Kepler University Hospital, Department of Neurosurgery, Linz, Austria
| | - Kurt Holl
- Kepler University Hospital, Department of Neurosurgery, Linz, Austria
| | - Andreas Gruber
- Kepler University Hospital, Department of Neurosurgery, Linz, Austria
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Kienapfel K, Preuschoft H, Wulf A, Wagner H. The biomechanical construction of the horse's body and activity patterns of three important muscles of the trunk in the walk, trot and canter. J Anim Physiol Anim Nutr (Berl) 2017; 102:e818-e827. [DOI: 10.1111/jpn.12840] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 10/11/2017] [Indexed: 11/29/2022]
Affiliation(s)
- K. Kienapfel
- Department of Animal Ecology, Evolution and Biodiversity; Ruhr University Bochum; Bochum Germany
| | - H. Preuschoft
- Anatomical Institute; Ruhr University Bochum; Bochum Germany
| | - A. Wulf
- Institute of Sport and Exercise Science; University of Münster; Münster Germany
| | - H. Wagner
- Institute of Sport and Exercise Science; University of Münster; Münster Germany
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Villagra-Blanco R, Silva LMR, Gärtner U, Wagner H, Failing K, Wehrend A, Taubert A, Hermosilla C. Molecular analyses on Neospora caninum-triggered NETosis in the caprine system. Dev Comp Immunol 2017; 72:119-127. [PMID: 28254622 DOI: 10.1016/j.dci.2017.02.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 02/22/2017] [Accepted: 02/22/2017] [Indexed: 06/06/2023]
Abstract
Neospora caninum is an obligate intracellular protozoan parasite causing serious reproductive disorders in large and small ruminants worldwide. Polymorphonuclear neutrophils (PMN) react against multiple invading pathogens through different mechanisms including the release of neutrophil extracellular traps (NETs). Here, in vitro interactions of caprine PMN and N. caninum tachyzoites were studied. Scanning electron microscopic- and immunofluorescence-analyses demonstrated that caprine PMN undergo NETosis upon contact with tachyzoites of N. caninum, extruding filaments that entrap parasites. Detailed co-localization studies of N. caninum tachyzoite-induced NETs revealed the presence of PMN-derived DNA being decorated with histones (H1, H2A/H2B, H3,H4) and neutrophil elastase (NE) corroborating the molecular characteristics of classical mammalian NETs. As a new result for parasite-induced NETosis, we identified pentraxin and cathepsin B in N. caninum-triggered NETs. Nonetheless, functional inhibition assays revealed that during caprine NET formation triggered by N. caninum different molecular signaling pathways are induced, when compared to other apicomplexan parasites or host species. As such, N. caninum-induced NETosis appears to be influenced by MPO but independent of NADPH oxidase, SOCE, ERK1/2 and p38 MAPK activities. Furthermore, the inhibition of PMN autophagy via blockage of the PI3K-mediated signaling pathway failed to influence tachyzoite-induced NETosis. Since N. caninum-tachyzoites induced caprine NETosis, this effector mechanism should be considered as an early host immune response during acute caprine neosporosis.
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Affiliation(s)
- R Villagra-Blanco
- Institute of Parasitology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Giessen 35392, Germany; Clinic for Obstetrics, Gynecology and Andrology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Giessen 35392, Germany.
| | - L M R Silva
- Institute of Parasitology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Giessen 35392, Germany
| | - U Gärtner
- Institute of Anatomy and Cell Biology, Justus Liebig University Giessen, Giessen 35392, Germany
| | - H Wagner
- Clinic for Obstetrics, Gynecology and Andrology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Giessen 35392, Germany
| | - K Failing
- Unit for Biomathematics and Data Processing, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Giessen 35392, Germany
| | - A Wehrend
- Clinic for Obstetrics, Gynecology and Andrology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Giessen 35392, Germany
| | - A Taubert
- Institute of Parasitology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Giessen 35392, Germany
| | - C Hermosilla
- Institute of Parasitology, Faculty of Veterinary Medicine, Justus Liebig University Giessen, Giessen 35392, Germany
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36
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Wagner H, Boyages J. Abstract P4-18-05: Male breast cancer— infusing a little blue into the sea of pink. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-18-05] [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: 11/16/2022]
Abstract
Abstract
Male breast cancer (MBC) is a rare disease dominated by a sea of pink. Issues faced by men with this disease include delayed diagnosis, lack of male-specific information, stigma about having a "female disease" and often under-treatment.
MBC is often treated as a female breast cancer but differences between the two are starting to emerge. Men are often older at diagnosis and sometimes considered "too old" for more aggressive treatments such as chemotherapy. Drugs such as aromatase inhibitors may not be as effective in men as in women but are often prescribed. Drugs such as tamoxifen can cause side-effects such as weight gain, hot flushes, loss of libido and impotence.
Support for patients with MBC is less advanced than that for female breast cancer. A Man's Pink, a MBC advocacy organization, mission is to promote MBC awareness, increase early detection, optimize and increase the survival rates for men diagnosed with breast cancer. Male Breast Cancer: Taking Control (BC Publishing, Boyages, 2015) empowers patients to understand their diagnosis and treatment.
Apart from incidence data, prognosis and treatment options, this talk will focus on how a website (www.malebreastcancer.ca) dedicated to MBC can help dismiss some of the myths and help overcome stigmata for men facing difficulties at diagnosis, treatment and recovery.
Our goal is to promote awareness to assist with earlier diagnosis and treatment to improve survival rates and the journey for men in their battle with breast cancer.
Citation Format: Wagner H, Boyages J. Male breast cancer— infusing a little blue into the sea of pink [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-18-05.
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Affiliation(s)
- H Wagner
- A Man's Pink (Male Breast Cancer Advocacy Organization), Brooksville, FL; Macquarie University, Sydney, NSW, Australia
| | - J Boyages
- A Man's Pink (Male Breast Cancer Advocacy Organization), Brooksville, FL; Macquarie University, Sydney, NSW, Australia
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Weiss G, Steinacher I, Lamprecht B, Kaiser B, Mikes R, Sator L, Hartl S, Wagner H, Studnicka M. Development and validation of the Salzburg COPD-screening questionnaire (SCSQ): a questionnaire development and validation study. NPJ Prim Care Respir Med 2017; 27:4. [PMID: 28127061 PMCID: PMC5434771 DOI: 10.1038/s41533-016-0005-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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] [Received: 05/26/2016] [Revised: 09/30/2016] [Accepted: 10/25/2016] [Indexed: 12/21/2022] Open
Abstract
Chronic obstructive pulmonary disease prevalence rates are still high. However, the majority of subjects are not diagnosed. Strategies have to be implemented to overcome the problem of under-diagnosis. Questionnaires could be used to pre-select subjects for spirometry and thereby help reducing under-diagnosis. We report a brief, simple, self-administrable and validated chronic obstructive pulmonary disease questionnaire to increase the pre-test probability for chronic obstructive pulmonary disease diagnosis in subjects undergoing confirmatory spirometry. In 2005, we completed the Austrian Burden of Obstructive Lung Disease-study in 1258 subjects aged >40 years. Post-bronchodilator spirometry was performed, and non-reversible airflow limitation defined by FEV1/FVC ratio below the lower limit of normal. Questions from the Salzburg chronic obstructive pulmonary disease screening-questionnaire were selected using a logistic regression model, and risk scores were based on regression-coefficients. A training sub-sample (n = 800) was used to create the score, and a test sub-sample (n = 458) was used to test it. In 2008, an external validation study was done, using the same protocol in 775 patients from primary care. The Salzburg chronic obstructive pulmonary disease screening questionnaire was composed of items related to “breathing problems”, “wheeze”, “cough”, “limitation of physical activity”, and “smoking”. At the >=2 points cut-off of the Salzburg chronic obstructive pulmonary disease screening questionnaire, sensitivity was 69.1% [95%CI: 56.6%; 79.5%], specificity 60.0% [95%CI: 54.9%; 64.9%], the positive predictive value 23.2% [95%CI: 17.7%; 29.7%] and the negative predictive value 91.8% [95%CI: 87.5%; 95.7%] to detect post bronchodilator airflow limitation. The external validation study in primary care confirmed these findings. The Salzburg chronic obstructive pulmonary disease screening questionnaire was derived from the highly standardized Burden of Obstructive Lung Disease study. This validated and easy to use questionnaire can help to increase the efficiency of chronic obstructive pulmonary disease case-finding. Scientists in Austria have developed a brief, simple questionnaire to identify patients likely to have early-stage chronic lung disease. Chronic obstructive pulmonary disease (COPD) is notoriously difficult to diagnose, and the condition often causes irreversible lung damage before it is identified. Finding a simple, cost-effective method of pre-screening patients with suspected early-stage COPD could potentially improve treatment responses and limit the burden of extensive lung function (‘spirometry’) tests on health services. Gertraud Weiss at Paracelsus Medical University, Austria, and co-workers have developed and validated an easy-to-use, self-administered questionnaire that could prove effective for pre-screening patients. The team trialed the five-point Salzburg COPD-screening questionnaire on 1258 patients. Patients scoring 2 points or above on the questionnaire underwent spirometry tests. The questionnaire seems to provide a sensitive and cost-effective way of pre-selecting patients for spirometry referral.
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Affiliation(s)
- Gertraud Weiss
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria.
| | - Ina Steinacher
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria
| | - Bernd Lamprecht
- Department of Pulmonary Medicine, Kepler-University-Hospital, Linz, Austria.,Faculty of Medicine, Johannes-Kepler-University, Linz, Austria
| | - Bernhard Kaiser
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria
| | - Romana Mikes
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria
| | - Lea Sator
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria
| | - Sylvia Hartl
- Ludwig Boltzmann Institute of COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Helga Wagner
- Department for Statistics, University of Linz, Linz, Austria
| | - M Studnicka
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria
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Gmeiner M, Wagner H, Zacherl C, Polanski P, Auer C, van Ouwerkerk WJR, Holl K. Long-term mortality rates in pediatric hydrocephalus-a retrospective single-center study. Childs Nerv Syst 2017; 33:101-109. [PMID: 27766469 DOI: 10.1007/s00381-016-3268-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 07/09/2016] [Accepted: 10/05/2016] [Indexed: 11/29/2022]
Abstract
PURPOSE Very long-term follow-up and outcome are rare for pediatric patients with hydrocephalus and shunt operations. The aim of this study was to determine the long-term mortality rates in these patients. METHODS Pediatric patients with first shunt operation between 1982 and 1992 were included. For each patient, time and cause of death were determined. Further, patients with first operation from 1982 to 1987 were compared to those first operated from 1988 to 1992. RESULTS One-hundred thirty-seven patients were included. Etiologies of hydrocephalus were intraventricular hemorrhage (31.4 %), meningomyelocele (25.5 %), postinfectious (11.7 %), congenital (10.2 %), posterior fossa cyst (8.8 %), aqueductal stenosis (8 %), and others (4.4 %). Overall, 53 patients (38.7 %) died. The percentage of patients surviving 1, 2, 10, and 20 years after first operation were 82.6, 73.6, 69.4, and 65.3 %, respectively. In 23 patients, the cause of death was related to shunt treatment: shunt infection was diagnosed in 18 and acute shunt dysfunction in 5 patients. Mortality was considerably higher for patients with their first operation in time period 1982-1987 compared to time period 1988-1992 (51 versus 25 %). The reduction of mortality was mainly due to an increased survival after shunt infection. Eighty-seven patients survived more than 20 years after initial shunt operation. Of those long-term survivors, three (3.4 %) patients died 22-24 years after first operation. CONCLUSION Mortality in hydrocephalic pediatric patients is high especially in the first postoperative years but is even significant in adult patients with pediatric hydrocephalus. As deaths occur even after 20 years, routine follow-up of long-term survivors remains necessary.
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Affiliation(s)
- Matthias Gmeiner
- Division of Neurosurgery, Kepler-Universitätsklinikum Linz, Wagner-Jauregg-Weg 15A, 4020, Linz, Austria.
| | - Helga Wagner
- Department of Applied Statistics, Johannes Kepler University, Linz, Austria
| | - Christoph Zacherl
- Division of Neurosurgery, Kepler-Universitätsklinikum Linz, Wagner-Jauregg-Weg 15A, 4020, Linz, Austria
| | - Petra Polanski
- Department of Pediatric Surgery, Children's Hospital, Linz, Austria
| | - Christian Auer
- Division of Neurosurgery, Kepler-Universitätsklinikum Linz, Wagner-Jauregg-Weg 15A, 4020, Linz, Austria
| | - Willem J R van Ouwerkerk
- Department of Neurosurgery, Vrije Universitet University Medical Centre Amsterdam, Amsterdam, The Netherlands
| | - Kurt Holl
- Division of Neurosurgery, Kepler-Universitätsklinikum Linz, Wagner-Jauregg-Weg 15A, 4020, Linz, Austria
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Pauciullo A, Gauly M, Cosenza G, Wagner H, Erhardt G. Lama glama α S1-casein: Identification of new polymorphisms in the CSN1S1 gene. J Dairy Sci 2016; 100:1282-1289. [PMID: 27939542 DOI: 10.3168/jds.2016-11918] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 10/17/2016] [Indexed: 11/19/2022]
Abstract
South American camelids have been poorly genetically investigated and little information is available in llamas (Lama glama) regarding the diversity of the caseins at the protein and gene level. Exon skipping and duplication events previously reported in the αS1-casein gene (CSN1S1) led us to investigate the genetic variability at this locus. Seventy-two positive clones for the αS1-casein transcripts were analyzed and randomly sequenced. The comparative analysis of the sequences revealed 2 transitions, c.366A>G and c.690T>C, at the 10th nucleotide of exon 12 and 94 bp of exon 19, respectively. These SNP are responsible for 2 amino acid changes, Ile→Val in position 86 and Tyr→His in position 194 of the mature protein. Both polymorphisms clarify the genetic events behind the protein variants A and B. This result was confirmed by isoelectric focusing analysis of llama milk samples. Quick methods based on PCR-RFLP and allele-specific PCR were set up for allelic discrimination in a population of 128 animals. Based on genotyping results, 4 haplotypes were observed and the estimated frequencies indicated B as the most common haplotype (0.629) in the investigated population. These data add knowledge to the genetic variability of a species little investigated, and open opportunity for new investigation in the field of milk protein for South American camelids, including the possibility, in the future, to select alleles with favorable characteristics.
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Affiliation(s)
- A Pauciullo
- Department of Agricultural, Forest and Food Sciences, University of Turin, 10095, Grugliasco (TO), Italy; Institute for Animal Breeding and Genetics, Justus Liebig University, 35390, Gießen, Germany.
| | - M Gauly
- Faculty of Science and Technology, Free University of Bozen, 39100, Bozen, Italy
| | - G Cosenza
- Department of Agriculture, University of Naples "Federico II" 80055, Portici (NA), Italy
| | - H Wagner
- Department of Obstetrics, Gynaecology and Andrology of Large and Small Animals with ambulance, Justus Liebig University, 35392, Gießen, Germany
| | - G Erhardt
- Institute for Animal Breeding and Genetics, Justus Liebig University, 35390, Gießen, Germany
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Tuanquin L, McDermott D, Mackley H, Holder S, Wagner H, Rosenberg J, Drabick J, Kaag M, Joshi M, Raman J, Merrill S. The Outcomes of Adjuvant Radiation Therapy in Postcystectomy Muscle-Invasive Bladder Cancer. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1329] [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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Pica A, Hrbacek J, Zografos L, Schalenbourg A, Wagner H, Vallat L, Walser M, Schneider R, Weber D. Long-term visual acuity preservation after proton therapy for peri- and parapapillary melanoma patients treated at the Paul Scherrer Institute. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wagner H, Pauger D. Discussion: Bayesian regularization and effect smoothing for categorical predictors. STAT MODEL 2016. [DOI: 10.1177/1471082x16642655] [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: 11/17/2022]
Affiliation(s)
- Helga Wagner
- Department Applied Statistics, Johannes Kepler University in Linz, Austria
| | - Daniela Pauger
- Department Applied Statistics, Johannes Kepler University in Linz, Austria
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Wagner H, Eckmair D. Simulation Studies for Complex Sampling Designs. AJS 2016. [DOI: 10.17713/ajs.v35i4.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Choosing the appropriate variance estimation method in complex surveys is a difficult task since there exist a variety of techniques which usually cannot be compared mathematically. A relatively easy way to accomplish such a comparison is on the basis of simulation studies. Though simulation studies are widely used in statistics, they are not a standard tool for investigating properties of estimators in complex survey sampling designs. In this paper we describe the setup for a simulation study according to the sampling plan of the Austrian Microcensus (AMC), used 1994–2003 which is an example for a very complex sampling plan. To illustrate the proceeding we conducted a simulation study comparing basic variance estimators. Results of the study reveal the extent to which simple variance estimators may underestimate the true sampling error in close to reality situations.
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Stadlober E, Friedl H, Wagner H, Konecny F, Grossmann W, Leopold U, Böhm B, Katzenbeisser W, Schachermayer W, Viertl R. Book Reviews. AJS 2016. [DOI: 10.17713/ajs.v28i1.509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Die Industriestatistik Europas im Umbruch. (M. Müller)Statistik. DerWeg zur Datenanalyse. (L. Fahrmeir, R. Künstler, I. Pigeot, G. Tutz)Einführung in die Stochastik. (R.K.W. Viertl)Probability Theory III. (Y.V. Prokhorov, A.N. Shiryaev)Functional Data Analysis. (J.O. Ramsay, B.W. Silverman)Business Analysis Using Regression. (D.P. Foster, R.A. Stine, R.P. Waterman)Applied Regression Analysis. A Research Tool. (J.O Rawlings , S.G. Pantula, D.A.Dickey )Econometric Analysis of Count Data. (R. Winkelmann)MartingaleMethodes in FinancialModelling. Theory and Applications. (M.Musiela,M. Rutkowski)Conference on Statistical Science Honouring the Bicentennial of Stefano Franscini’sBirth. (C.A.G. Malaguerra, St. Morgenthaler, E.M.D. Ronchetti)
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Schableger K, Pfoser N, Wagner H. Identifikation von Kovariableneinflüssen in der Füllungstherapie. AJS 2016. [DOI: 10.17713/ajs.v36i2.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Um Informationen über die Haltbarkeit von Zahnfüllungen zu erhalten und den Einfluss verschiedener Faktoren zu untersuchen, wurden verschiedene statistische Analysen durchgeführt. Dafür standen in Oberösterreich Daten von rund 3.4 Millionen Zahnfüllungen aus den Jahren 1994 bis 2002 zur Verfügung. Neben einer Schätzung der Überlebensfunktion bzw. der Ausfallrate, wurde der Einfluss verschiedener Kovariablen auf die Lebensdauer der Füllungen in einem Cox-Modell geschätzt. Die im Verhältnis zur vorliegenden Datenmenge geringe Zahl von Kovariablen, legt es nahe, dass die Daten auch unbeobachtete Heterogenität enthalten. Von Interesse ist dabei insbesondere, ob diese auf Effekte der Leistungserbringer, d.h. der behandelnden Ärzte zurückgeführt werden können. Diese Effekte werden durch ein Gamma-Shared-Frailty-Modell geschätzt. Die Ergebnisse führen zu Vorschl ägen einer differenzierteren Honorierung der Füllungstherapie.
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Wagner H. Von PICC bis PORT. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581486] [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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Abstract
An important task in building regression models is to decide which regressors should be included in the final model. In a Bayesian approach, variable selection can be performed using mixture priors with a spike and a slab component for the effects subject to selection. As the spike is concentrated at zero, variable selection is based on the probability of assigning the corresponding regression effect to the slab component. These posterior inclusion probabilities can be determined by MCMC sampling. In this paper we compare the MCMC implementations for several spike and slab priors with regard to posterior inclusion probabilities and their sampling efficiency for simulated data. Further, we investigate posterior inclusion probabilities analytically for different slabs in two simple settings. Application of variable selection with spike and slab priors is illustrated on a data set of psychiatric patients where the goal is to identify covariates affecting metabolism.
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Panossian A, Efferth T, Zacchino S, Georgiev MI, Liu L, Wagner H. Hildebert Wagner Award Laureate announcement December 2015. Phytomedicine 2016; 23:A1-A2. [PMID: 26902411 DOI: 10.1016/j.phymed.2016.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Enko D, Wagner H, Kriegshäuser G, Kimbacher C, Stolba R, Halwachs-Baumann G. Assessment of human iron status: A cross-sectional study comparing the clinical utility of different laboratory biomarkers and definitions of iron deficiency in daily practice. Clin Biochem 2015; 48:891-6. [DOI: 10.1016/j.clinbiochem.2015.05.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 05/08/2015] [Indexed: 02/07/2023]
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Abstract
We consider Bayesian inference for regression models of count data subject to underreporting. For the data generating process of counts as well as the fallible reporting process a joint model is specified, where the outcomes in both processes are related to a set of potential covariates. Identification of the joint model is achieved by additional information provided through validation data and incorporation of variable selection. For posterior inference we propose a convenient Markov chain Monte Carlo (MCMC) sampling scheme which relies on data augmentation and auxiliary mixture sampling techniques for this two-part model. Performance of the method is illustrated for simulated data and applied to analyse real data, collected to estimate risk of cervical cancer death.
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Affiliation(s)
| | - Helga Wagner
- Department of Applied Statistics, Johannes Kepler University, Linz, Austria
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