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Günther R, Wurster CD, Brakemeier S, Osmanovic A, Schreiber-Katz O, Petri S, Uzelac Z, Hiebeler M, Thiele S, Walter MC, Weiler M, Kessler T, Freigang M, Lapp HS, Cordts I, Lingor P, Deschauer M, Hahn A, Martakis K, Steinbach R, Ilse B, Rödiger A, Bellut J, Nentwich J, Zeller D, Muhandes MT, Baum T, Christoph Koch J, Schrank B, Fischer S, Hermann A, Kamm C, Naegel S, Mensch A, Weber M, Neuwirth C, Lehmann HC, Wunderlich G, Stadler C, Tomforde M, George A, Groß M, Pechmann A, Kirschner J, Türk M, Schimmel M, Bernert G, Martin P, Rauscher C, Meyer zu Hörste G, Baum P, Löscher W, Flotats-Bastardas M, Köhler C, Probst-Schendzielorz K, Goldbach S, Schara-Schmidt U, Müller-Felber W, Lochmüller H, von Velsen O, Kleinschnitz C, Ludolph AC, Hagenacker T. Long-term efficacy and safety of nusinersen in adults with 5q spinal muscular atrophy: a prospective European multinational observational study. Lancet Reg Health Eur 2024; 39:100862. [PMID: 38361750 PMCID: PMC10864329 DOI: 10.1016/j.lanepe.2024.100862] [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] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/17/2024]
Abstract
Background Evidence for the efficacy of nusinersen in adults with 5q-associated spinal muscular atrophy (SMA) has been demonstrated up to a period of 16 months in relatively large cohorts but whereas patients reach a plateau over time is still to be demonstrated. We investigated the efficacy and safety of nusinersen in adults with SMA over 38 months, the longest time period to date in a large cohort of patients from multiple clinical sites. Methods Our prospective, observational study included adult patients with SMA from Germany, Switzerland, and Austria (July 2017 to May 2022). All participants had genetically-confirmed, 5q-associated SMA and were treated with nusinersen according to the label. The total Hammersmith Functional Motor Scale Expanded (HFMSE) and Revised Upper Limb Module (RULM) scores, and 6-min walk test (6 MWT; metres), were recorded at baseline and 14, 26, and 38 months after treatment initiation, and pre and post values were compared. Adverse events were also recorded. Findings Overall, 389 patients were screened for eligibility and 237 were included. There were significant increases in all outcome measures compared with baseline, including mean HFMSE scores at 14 months (mean difference 1.72 [95% CI 1.19-2.25]), 26 months (1.20 [95% CI 0.48-1.91]), and 38 months (1.52 [95% CI 0.74-2.30]); mean RULM scores at 14 months (mean difference 0.75 [95% CI 0.43-1.07]), 26 months (mean difference 0.65 [95% CI 0.27-1.03]), and 38 months (mean difference 0.72 [95% CI 0.25-1.18]), and 6 MWT at 14 months (mean difference 30.86 m [95% CI 18.34-43.38]), 26 months (mean difference 29.26 m [95% CI 14.87-43.65]), and 38 months (mean difference 32.20 m [95% CI 10.32-54.09]). No new safety signals were identified. Interpretation Our prospective, observational, long-term (38 months) data provides further real-world evidence for the continuous efficacy and safety of nusinersen in a large proportion of adult patients with SMA. Funding Financial support for the registry from Biogen, Novartis and Roche.
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Affiliation(s)
- René Günther
- Department of Neurology, University Hospital Carl Gustav Carus at Technische Universität Dresden, Dresden, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Dresden, Dresden, Germany
| | | | - Svenja Brakemeier
- Department of Neurology, and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, Essen, Germany
| | - Alma Osmanovic
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | | | - Susanne Petri
- Department of Neurology, Hannover Medical School, Hannover, Germany
| | - Zeljko Uzelac
- Department of Neurology, Ulm University, Ulm, Germany
| | - Miriam Hiebeler
- Friedrich Baur Institute at the Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Simone Thiele
- Friedrich Baur Institute at the Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Maggie C. Walter
- Friedrich Baur Institute at the Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Markus Weiler
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
| | - Tobias Kessler
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Maren Freigang
- Department of Neurology, University Hospital Carl Gustav Carus at Technische Universität Dresden, Dresden, Germany
| | - Hanna Sophie Lapp
- Department of Neurology, University Hospital Carl Gustav Carus at Technische Universität Dresden, Dresden, Germany
| | - Isabell Cordts
- Department of Neurology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Paul Lingor
- Department of Neurology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Marcus Deschauer
- Department of Neurology, Technical University of Munich, School of Medicine, Munich, Germany
| | - Andreas Hahn
- Department of Child Neurology, Justus-Liebig University Gießen, Gießen, Germany
| | - Kyriakos Martakis
- Department of Child Neurology, Justus-Liebig University Gießen, Gießen, Germany
- Department of Pediatrics, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
| | - Robert Steinbach
- Department of Neurology, Jena University Hospital, Jena, Germany
| | - Benjamin Ilse
- Department of Neurology, Jena University Hospital, Jena, Germany
| | | | - Julia Bellut
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Julia Nentwich
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Daniel Zeller
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | | | - Tobias Baum
- Department of Neurology, University Medicine Göttingen, Göttingen, Germany
| | - Jan Christoph Koch
- Department of Neurology, University Medicine Göttingen, Göttingen, Germany
| | - Bertold Schrank
- Department of Neurology, Deutsche Klinik für Diagnostik HELIOS Clinic of Wiesbaden, Wiesbaden, Germany
| | - Sophie Fischer
- Translational Neurodegeneration Section “Albrecht Kossel”, Department of Neurology, University Medical Center Rostock, 18147, Rostock, Germany
| | - Andreas Hermann
- Translational Neurodegeneration Section “Albrecht Kossel”, Department of Neurology, University Medical Center Rostock, 18147, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock/Greifswald, Rostock, Germany
| | - Christoph Kamm
- Department of Neurology, University of Rostock, Rostock, Germany
| | - Steffen Naegel
- Department of Neurology, University Medicine Halle, Halle (Saale), Germany
| | - Alexander Mensch
- Department of Neurology, University Medicine Halle, Halle (Saale), Germany
| | - Markus Weber
- Neuromuscular Diseases Unit/ALS Clinic, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Christoph Neuwirth
- Neuromuscular Diseases Unit/ALS Clinic, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Helmar C. Lehmann
- Department of Neurology and Center for Rare Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Gilbert Wunderlich
- Department of Neurology and Center for Rare Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Christian Stadler
- Department of Neurology, Klinikum Klagenfurt am Wörthersee, Klagenfurt am Wörthersee, Austria
| | - Maike Tomforde
- Department of Neurology, University Hospital Kiel, Kiel, Germany
| | - Annette George
- Department of Pediatric Neurology, Center for Chronically Sick Children, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Martin Groß
- Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
- Department of Neurological Intensive Care and Rehabilitation, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany
| | - Astrid Pechmann
- Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Janbernd Kirschner
- Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthias Türk
- Department of Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Germany
| | - Mareike Schimmel
- Pediatrics and Adolescent Medicine, Faculty of Medicine University Hospital Augsburg, Augsburg, Germany
| | - Günther Bernert
- Department of Pediatrics and Pediatric Neurology, Clinic Favoriten, Vienna, Austria
| | - Pascal Martin
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University Hospitals Tubingen, Tubingen, Germany
| | - Christian Rauscher
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | | | - Petra Baum
- Department of Neurology, University of Leipzig Medical Centre, Leipzig, Germany
| | - Wolfgang Löscher
- Division of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | | | - Cornelia Köhler
- Department of Neuropaediatrics, University Children's Hospital, Ruhr-University Bochum, Bochum, Germany
| | | | - Susanne Goldbach
- Initiative SMA der Deutschen Gesellschaft für Muskelkranke, Freiburg, Germany
| | - Ulrike Schara-Schmidt
- Department of Paediatric Neurology, Center for Neuromuscular Disorders in Children and Adolescents, Center for Translational Neuro- and Behavioral Sciences, University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Wolfgang Müller-Felber
- Department of Neuropediatrics, Dr. v. Haunersche Kinderklinik, University Children's Hospital, Ludwig-Maximilians-Universität München, München, Germany
| | - Hanns Lochmüller
- Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Children's Hospital of Eastern Ontario Research Institute, Division of Neurology, Department of Medicine, The Ottawa Hospital; and Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - Otgonzul von Velsen
- Institute of Medical Informatics, Biometrics, and Epidemiology, University Hospital Essen, Essen, Germany
- Center for Clinical Trials, University Hospital Essen, Essen, Germany
| | - SMArtCARE Study Group
- Department of Neurology, University Hospital Carl Gustav Carus at Technische Universität Dresden, Dresden, Germany
- Department of Neurology, Ulm University, Ulm, Germany
- Department of Neurology, and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, Essen, Germany
- Department of Neurology, Hannover Medical School, Hannover, Germany
- Friedrich Baur Institute at the Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany
- Department of Neurology, Technical University of Munich, School of Medicine, Munich, Germany
- Department of Child Neurology, Justus-Liebig University Gießen, Gießen, Germany
- Department of Pediatrics, Medical Faculty and University Hospital, University of Cologne, Cologne, Germany
- Department of Neurology, Jena University Hospital, Jena, Germany
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
- Department of Neurology, University Medicine Göttingen, Göttingen, Germany
- Department of Neurology, Deutsche Klinik für Diagnostik HELIOS Clinic of Wiesbaden, Wiesbaden, Germany
- Translational Neurodegeneration Section “Albrecht Kossel”, Department of Neurology, University Medical Center Rostock, 18147, Rostock, Germany
- Department of Neurology, University of Rostock, Rostock, Germany
- Department of Neurology, University Medicine Halle, Halle (Saale), Germany
- Neuromuscular Diseases Unit/ALS Clinic, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
- Department of Neurology and Center for Rare Diseases, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
- Department of Neurology, Klinikum Klagenfurt am Wörthersee, Klagenfurt am Wörthersee, Austria
- Department of Neurology, University Hospital Kiel, Kiel, Germany
- Department of Pediatric Neurology, Center for Chronically Sick Children, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Faculty of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
- Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Department of Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg (FAU), Germany
- Pediatrics and Adolescent Medicine, Faculty of Medicine University Hospital Augsburg, Augsburg, Germany
- Department of Pediatrics and Pediatric Neurology, Clinic Favoriten, Vienna, Austria
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University Hospitals Tubingen, Tubingen, Germany
- Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
- Department of Neurology, University Hospital Münster, Münster, Germany
- Department of Neurology, University of Leipzig Medical Centre, Leipzig, Germany
- Division of Neurology, Medical University Innsbruck, Innsbruck, Austria
- Department of Pediatric Neurology, Saarland University Hosptial, Homburg, Germany
- Department of Neuropaediatrics, University Children's Hospital, Ruhr-University Bochum, Bochum, Germany
- Initiative SMA der Deutschen Gesellschaft für Muskelkranke, Freiburg, Germany
- Department of Paediatric Neurology, Center for Neuromuscular Disorders in Children and Adolescents, Center for Translational Neuro- and Behavioral Sciences, University Hospital, University of Duisburg-Essen, Essen, Germany
- Department of Neuropediatrics, Dr. v. Haunersche Kinderklinik, University Children's Hospital, Ludwig-Maximilians-Universität München, München, Germany
- Children's Hospital of Eastern Ontario Research Institute, Division of Neurology, Department of Medicine, The Ottawa Hospital; and Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
- Institute of Medical Informatics, Biometrics, and Epidemiology, University Hospital Essen, Essen, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Dresden, Dresden, Germany
- Clinical Cooperation Unit Neurooncology, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock/Greifswald, Rostock, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Ulm, Ulm, Germany
- Department of Neurological Intensive Care and Rehabilitation, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany
- Center for Clinical Trials, University Hospital Essen, Essen, Germany
| | - Christoph Kleinschnitz
- Department of Neurology, and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, Essen, Germany
| | - Albert C. Ludolph
- Department of Neurology, Ulm University, Ulm, Germany
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Ulm, Ulm, Germany
| | - Tim Hagenacker
- Department of Neurology, and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University Medicine Essen, Essen, Germany
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Platz T, Schmidt-Wilcke T, Groß M, Friederich C, Pohl M. [Certification by the German Society for Neurorehabiliation, DGNR : Performance and quality of the "Centers for weaning from a ventilator in early neurological and neurosurgical rehabilitation"]. Nervenarzt 2024; 95:152-158. [PMID: 37668662 PMCID: PMC10850186 DOI: 10.1007/s00115-023-01540-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/28/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Certification of centers for weaning from a ventilator in neurological neurosurgical early rehabilitation (NNER) by the German Society for Neurorehabilitation (DGNR) is possible since 1 October 2021. OBJECTIVE The results of certification of facilities in the first year after starting the procedure are presented. MATERIAL AND METHODS As part of the certification process 28 criteria are assessed including a set of mandatory characteristics of the facility. The criteria are divided into structural criteria (i = 7), diagnostic criteria (i = 6), personnel criteria (i = 3), internal organization criteria (i = 7), and quality management criteria (i = 5). RESULTS A total of 13 centers were certified in the first year, with a combined total of 283 beds for weaning from a ventilator in the NNER and served 2278 persons to be weaned from a ventilator in the year before certification, with a median of 134 per facility (range 44-414). Only rarely was weaning unsuccessful, requiring conversion to home mechanical ventilation before discharge (invasive home mechanical ventilation median per facility 10 persons, range 2-25; non-invasive home mechanical ventilation median 0 persons, range 0-57). A high level of process and structural quality was documented for the certified centers: across all areas of assessment, the individual certification criteria were met in the vast majority of cases (median degree of complete fulfilment 86%) or met with improvement potentials documented by the auditors (median 11%). CONCLUSION Successful weaning in NNER and a high level of process and structural quality can be demonstrated by the certification results of centers that follow this integrative approach to weaning from a ventilator in a NNER setting.
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Affiliation(s)
- Thomas Platz
- AG Neurorehabilitation, Universitätsmedizin Greifswald, Fleischmannstraße 44, 17475, Greifswald, Deutschland.
- Institut für Neurorehabilitation und Evidenzbasierung, An-Institut der Universität Greifswald, BDH-Klinik Greifswald, Greifswald, Deutschland.
| | - Tobias Schmidt-Wilcke
- Neurologisches Zentrum, Bezirksklinikum Mainkofen, Deggendorf, Deutschland
- Institut für Klinische Neurowissenschaften und Medizinische Psychologie, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Deutschland
| | - Martin Groß
- Evangelisches Krankenhaus Oldenburg, Oldenburg, Deutschland
- Oldenburger Forschungsnetzwerk Notfall- und Intensivmedizin, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland
| | | | - Marcus Pohl
- VAMED Klinik Schloss Pulsnitz, Pulsnitz, Deutschland
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Seipp A, Klausen A, Timmer A, Grimm T, Groß M, Summ O, Otto-Sobotka F. Effect of mechanical insufflation-exsufflation for ineffective cough on weaning duration in diseases of the peripheral or central nervous system (MEDINE): study protocol for a randomised controlled trial in a neurological weaning centre. BMJ Open 2023; 13:e071273. [PMID: 37460261 DOI: 10.1136/bmjopen-2022-071273] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION Patients with neurological or neurosurgical disease can suffer from impaired cough, which may result in life-threatening retention of tracheobronchial secretions, atelectasis, pneumonia and finally death. Due to a lack of alternatives and pathophysiological plausibility, the application of mechanical insufflation-exsufflation (MI-E) has already become international standard care in neuromuscular disease and spinal cord injury although a lack of evidence for efficacy. High-quality studies to support the use of MI-E in neurological and neurosurgical patients during weaning from mechanical ventilation are missing. The goal of this exploratory study is to display the effect size of MI-E intervention on the duration of mechanical ventilation and additional outcomes. METHODS AND ANALYSIS One hundred adult patients with a cough deficiency or retention of secretion admitted to a neurological intensive care unit (ICU) are planned to be recruited for this randomised controlled trial. Patients are randomised 1:1 to receive either MI-E or best standard care. Observation will take place until discharge from the hospital, death or end of the study period. The primary endpoint of this trial is the duration of mechanical ventilation from randomisation until successful weaning. The outcome will be analysed with Kaplan-Meier estimation and competing risks analyses. Secondary endpoint is the proportion of patients with successful weaning. Further outcomes will include the incidence of hospital-acquired pneumonia, mortality, decannulation rate, length of stay on the ICU and the total score of the Glasgow Coma Scale. ETHICS AND DISSEMINATION The study was approved by the Medical Ethics Committee of the University of Oldenburg. The findings of this study will be submitted for publication in a peer-reviewed journal. TRIAL REGISTRATION NUMBER DRKS00020981.
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Affiliation(s)
- Alexander Seipp
- Epidemiology and Biometry, Carl von Ossietzky University of Oldenburg Faculty VI Medicine and Health Sciences, Oldenburg, Germany
| | - Andreas Klausen
- Big Data in Medicine, Carl von Ossietzky University of Oldenburg Faculty VI Medicine and Health Sciences, Oldenburg, Germany
- Oldenburg Research Network Emergency and Intensive Care Medicine (OFNI), Carl von Ossietzky University of Oldenburg Faculty VI Medicine and Health Sciences, Oldenburg, Germany
| | - Antje Timmer
- Epidemiology and Biometry, Carl von Ossietzky University of Oldenburg Faculty VI Medicine and Health Sciences, Oldenburg, Germany
| | - Teresa Grimm
- Department of Neurological Intensive Care and Rehabilitation, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany
- Carl von Ossietzky University of Oldenburg Faculty VI Medicine and Health Sciences, Oldenburg, Germany
| | - Martin Groß
- Department of Neurological Intensive Care and Rehabilitation, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany
- Carl von Ossietzky University of Oldenburg Faculty VI Medicine and Health Sciences, Oldenburg, Germany
| | - Oliver Summ
- Department of Neurological Intensive Care and Rehabilitation, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany
- Carl von Ossietzky University of Oldenburg Faculty VI Medicine and Health Sciences, Oldenburg, Germany
| | - Fabian Otto-Sobotka
- Epidemiology and Biometry, Carl von Ossietzky University of Oldenburg Faculty VI Medicine and Health Sciences, Oldenburg, Germany
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Hornemann D, Marquardt C, Sugg J, Haack C, Rameil P, Fülöpp Z, Buss J, Weigel A, Schmidt-Wilcke T, Summ O, Groß M. [The Respiratory Therapist in Neurology An Evolving Specialization in Germany]. Fortschr Neurol Psychiatr 2023; 91:45-51. [PMID: 35961323 PMCID: PMC9873413 DOI: 10.1055/a-1877-4832] [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] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 04/30/2022] [Indexed: 01/27/2023]
Abstract
In Germany, nurses, physiotherapists and speech and language therapists follow a qualifying training for about 1,5 years to become respiratory therapists (RTs). With respect to neurological illness, RTs diagnose and treat disorders of respiration, cough and swallowing as well as a retention of tracheobronchial secretions. There is an increasing demand for RTs in neurology, in neurointensive care and in neurological and neurosurgical early rehabilitation. The certification of specialized centers for weaning in neurological and neurosurgical early rehabilitation was introduced by the German Society for Neurorehabilitation (DGNR) in 2021. As a certification criterion it includes the employment of a respiratory therapists. In neurological organizations treating critically and severely ill patients, RTs work at an important interdisciplinary intersection of physicians, nurses and therapists. RTs are qualified to train teams, patients and family caregivers and to establish care structures for critically and severely ill neurological patients. Due to the complexity of neurological illnesses RTs working in neurological institutions need specific qualification. Specific training for RTs in neurology and neurorehabilitation might improve care for critically and severely ill neurological patients. Further professionalization of RT in Germany requires standardizing curricula, a professional society for RTs and, finally, academization.
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Affiliation(s)
| | | | | | | | | | - Zsolt Fülöpp
- Universitätsklinikum Schleswig-Holstein, Campus
Lübeck
| | | | | | | | - Oliver Summ
- Evangelisches Krankenhaus Oldenburg
- Oldenburger Forschungsnetzwerk Notfall- und Intensivmedizin (OGNI),
Carl von Ossietzky Universität Oldenburg
| | - Martin Groß
- Evangelisches Krankenhaus Oldenburg
- Oldenburger Forschungsnetzwerk Notfall- und Intensivmedizin (OGNI),
Carl von Ossietzky Universität Oldenburg
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5
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Breznau N, Rinke EM, Wuttke A, Nguyen HHV, Adem M, Adriaans J, Alvarez-Benjumea A, Andersen HK, Auer D, Azevedo F, Bahnsen O, Balzer D, Bauer G, Bauer PC, Baumann M, Baute S, Benoit V, Bernauer J, Berning C, Berthold A, Bethke FS, Biegert T, Blinzler K, Blumenberg JN, Bobzien L, Bohman A, Bol T, Bostic A, Brzozowska Z, Burgdorf K, Burger K, Busch KB, Carlos-Castillo J, Chan N, Christmann P, Connelly R, Czymara CS, Damian E, Ecker A, Edelmann A, Eger MA, Ellerbrock S, Forke A, Forster A, Gaasendam C, Gavras K, Gayle V, Gessler T, Gnambs T, Godefroidt A, Grömping M, Groß M, Gruber S, Gummer T, Hadjar A, Heisig JP, Hellmeier S, Heyne S, Hirsch M, Hjerm M, Hochman O, Hövermann A, Hunger S, Hunkler C, Huth N, Ignácz ZS, Jacobs L, Jacobsen J, Jaeger B, Jungkunz S, Jungmann N, Kauff M, Kleinert M, Klinger J, Kolb JP, Kołczyńska M, Kuk J, Kunißen K, Kurti Sinatra D, Langenkamp A, Lersch PM, Löbel LM, Lutscher P, Mader M, Madia JE, Malancu N, Maldonado L, Marahrens H, Martin N, Martinez P, Mayerl J, Mayorga OJ, McManus P, McWagner K, Meeusen C, Meierrieks D, Mellon J, Merhout F, Merk S, Meyer D, Micheli L, Mijs J, Moya C, Neunhoeffer M, Nüst D, Nygård O, Ochsenfeld F, Otte G, Pechenkina AO, Prosser C, Raes L, Ralston K, Ramos MR, Roets A, Rogers J, Ropers G, Samuel R, Sand G, Schachter A, Schaeffer M, Schieferdecker D, Schlueter E, Schmidt R, Schmidt KM, Schmidt-Catran A, Schmiedeberg C, Schneider J, Schoonvelde M, Schulte-Cloos J, Schumann S, Schunck R, Schupp J, Seuring J, Silber H, Sleegers W, Sonntag N, Staudt A, Steiber N, Steiner N, Sternberg S, Stiers D, Stojmenovska D, Storz N, Striessnig E, Stroppe AK, Teltemann J, Tibajev A, Tung B, Vagni G, Van Assche J, van der Linden M, van der Noll J, Van Hootegem A, Vogtenhuber S, Voicu B, Wagemans F, Wehl N, Werner H, Wiernik BM, Winter F, Wolf C, Yamada Y, Zhang N, Ziller C, Zins S, Żółtak T. Observing many researchers using the same data and hypothesis reveals a hidden universe of uncertainty. Proc Natl Acad Sci U S A 2022; 119:e2203150119. [PMID: 36306328 PMCID: PMC9636921 DOI: 10.1073/pnas.2203150119] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 08/22/2022] [Indexed: 11/25/2022] Open
Abstract
This study explores how researchers' analytical choices affect the reliability of scientific findings. Most discussions of reliability problems in science focus on systematic biases. We broaden the lens to emphasize the idiosyncrasy of conscious and unconscious decisions that researchers make during data analysis. We coordinated 161 researchers in 73 research teams and observed their research decisions as they used the same data to independently test the same prominent social science hypothesis: that greater immigration reduces support for social policies among the public. In this typical case of social science research, research teams reported both widely diverging numerical findings and substantive conclusions despite identical start conditions. Researchers' expertise, prior beliefs, and expectations barely predict the wide variation in research outcomes. More than 95% of the total variance in numerical results remains unexplained even after qualitative coding of all identifiable decisions in each team's workflow. This reveals a universe of uncertainty that remains hidden when considering a single study in isolation. The idiosyncratic nature of how researchers' results and conclusions varied is a previously underappreciated explanation for why many scientific hypotheses remain contested. These results call for greater epistemic humility and clarity in reporting scientific findings.
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Affiliation(s)
- Nate Breznau
- Research Center on Inequality and Social Policy (SOCIUM), University of Bremen, Bremen, 28359, Germany
| | - Eike Mark Rinke
- School of Politics and International Studies, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Alexander Wuttke
- Mannheim Centre for European Social Research, University of Mannheim, 68131 Mannheim, Germany
- Department of Political Science, Ludwig Maximilian University, 80539 Munich, Germany
| | - Hung H. V. Nguyen
- Research Center on Inequality and Social Policy (SOCIUM), University of Bremen, Bremen, 28359, Germany
- Bremen International Graduate School of Social Sciences, 28359 Bremen, Germany
| | - Muna Adem
- Department of Sociology, Indiana University, Bloomington, IN 47405
| | - Jule Adriaans
- Socio-Economic Panel Study (SOEP), German Institute for Economic Research (DIW), 10117 Berlin, Germany
| | - Amalia Alvarez-Benjumea
- Mechanisms of Normative Change, Max Planck Institute for Research on Collective Goods, 53113 Bonn, Germany
| | - Henrik K. Andersen
- Institute of Sociology, Chemnitz University of Technology, 09126 Chemnitz, Germany
| | - Daniel Auer
- Mannheim Centre for European Social Research, University of Mannheim, 68131 Mannheim, Germany
| | - Flavio Azevedo
- Department of Psychology, University of Cambridge, Cambridge, CB23RQ, United Kingdom
| | - Oke Bahnsen
- School of Social Sciences, University of Mannheim, 68159 Mannheim, Germany
| | - Dave Balzer
- Institute of Sociology, Johannes Gutenberg University Mainz, 55128 Mainz, Germany
| | - Gerrit Bauer
- Department of Sociology, Ludwig Maximilian University, 80801 Munich, Germany
| | - Paul C. Bauer
- Mannheim Centre for European Social Research, University of Mannheim, 68131 Mannheim, Germany
| | - Markus Baumann
- Heidelberg University, 69117 Heidelberg, Germany
- Institute for Political Science, Goethe University Frankfurt, 60323 Frankfurt, Germany
| | - Sharon Baute
- Comparative Political Economy, University of Konstanz, 78457 Konstanz, Germany
| | - Verena Benoit
- Department of Political Science, Ludwig Maximilian University, 80539 Munich, Germany
- Faculty of Social Sciences, Economics, and Business Administration, University of Bamberg, 96052 Bamberg, Germany
| | - Julian Bernauer
- Mannheim Centre for European Social Research, University of Mannheim, 68131 Mannheim, Germany
| | - Carl Berning
- Institute for Political Science, Johannes Gutenberg University Mainz, 55099 Mainz, Germany
| | - Anna Berthold
- Faculty of Social Sciences, Economics, and Business Administration, University of Bamberg, 96052 Bamberg, Germany
| | - Felix S. Bethke
- Research Department on Intrastate Conflict, Peace Research Institute Frankfurt, 60329 Frankfurt, Germany
| | - Thomas Biegert
- Department of Social Policy, London School of Economics and Political Science, London, WC2A 2AE, United Kingdom
| | - Katharina Blinzler
- Survey Data Curation, Leibniz Institute for the Social Sciences (GESIS), 50667 Cologne, Germany
| | - Johannes N. Blumenberg
- Knowledge Exchange and Outreach, Leibniz Institute for the Social Sciences (GESIS), 68159 Mannheim, Germany
| | - Licia Bobzien
- Jacques Delors Centre, Hertie School, 10117 Berlin, Germany
| | - Andrea Bohman
- Department of Sociology, Umeå University, 90187 Umeå, Sweden
| | - Thijs Bol
- Social Research Institute, Institute of Education, University College London, London, WC1H 0AL, United Kingdom
- Department of Sociology, University of Amsterdam, 1001 Amsterdam, The Netherlands
| | - Amie Bostic
- Department of Sociology, The University of Texas Rio Grande Valley, Brownsville, TX 78520
| | - Zuzanna Brzozowska
- Vienna Institute of Demography, Austrian Academy of Sciences, 1030 Vienna, Austria
- Austrian National Public Health Institute, Gesundheit Österreich (GÖG), 1030 Vienna, Austria
| | - Katharina Burgdorf
- School of Social Sciences, University of Mannheim, 68159 Mannheim, Germany
| | - Kaspar Burger
- Social Research Institute, Institute of Education, University College London, London, WC1H 0AL, United Kingdom
- Department of Sociology, University of Zurich, 8050 Zurich, Switzerland
- Jacobs Center for Productive Youth, University of Zurich, 8050 Zurich, Switzerland
| | | | - Juan Carlos-Castillo
- Department of Sociology, University of Chile, Santiago, 7800284, Chile
- Center for Social Conflict and Cohesion Studies (COES), Pontificia Universidad Católica de Chile, Santiago, 8331150, Chile
| | - Nathan Chan
- Department of Political Science and International Relations, Loyola Marymount University, Los Angeles, CA 90045
| | - Pablo Christmann
- Data and Research on Society, Leibniz Institute for the Social Sciences, 68159 Mannheim, Germany
| | - Roxanne Connelly
- School of Social and Political Science, University of Edinburgh, Edinburgh, EH8 9LD, United Kingdom
| | | | - Elena Damian
- Lifestyle and Chronic Diseases, Epidemiology and Public Health, Sciensano, 1000 Brussels, Belgium
| | - Alejandro Ecker
- Mannheim Centre for European Social Research, University of Mannheim, 68131 Mannheim, Germany
| | | | - Maureen A. Eger
- Department of Sociology, Umeå University, 90187 Umeå, Sweden
| | - Simon Ellerbrock
- Mannheim Centre for European Social Research, University of Mannheim, 68131 Mannheim, Germany
- School of Social Sciences, University of Mannheim, 68159 Mannheim, Germany
| | | | - Andrea Forster
- Empirical Educational and Higher Education Research, Freie Universität Berlin, 14195 Berlin, Germany
| | - Chris Gaasendam
- Department of Sociology, Center for Sociological Research, KU Leuven, 3000 Leuven, Belgium
| | - Konstantin Gavras
- School of Social Sciences, University of Mannheim, 68159 Mannheim, Germany
| | - Vernon Gayle
- School of Social and Political Science, University of Edinburgh, Edinburgh, EH8 9LD, United Kingdom
| | - Theresa Gessler
- Kulturwissenschaftliche Fakultät, European University Viadrina, 15230 Frankfurt (Oder), Germany
| | - Timo Gnambs
- Educational Measurement, Leibniz Institute for Educational Trajectories, 96047 Bamberg, Germany
| | - Amélie Godefroidt
- Centre for Research on Peace and Development, KU Leuven, 3000 Leuven, Belgium
| | - Max Grömping
- School of Government and International Relations, Griffith University, Nathan, QLD, 4111, Australia
| | - Martin Groß
- Department of Sociology, University of Tübingen, 72074 Tübingen, Germany
| | - Stefan Gruber
- Max Planck Institute for Social Law and Social Policy, 80799 Munich, Germany
| | - Tobias Gummer
- Data and Research on Society, Leibniz Institute for the Social Sciences, 68159 Mannheim, Germany
| | - Andreas Hadjar
- University of Luxembourg, 4365 Esch-sur-Alzette, Luxembourg
- Wirtschafts- und Sozialwissenschaftliches Institut (WSI), Hans Böckler Foundation, 40474 Düsseldorf, Germany
- University of Fribourg, 1700 Fribourg, Switzerland
- Department of Social Sciences, University of Luxembourg, 4366 Esch-sur-Alzette, Luxembourg
| | - Jan Paul Heisig
- University of Groningen, 9712 CP Groningen,The Netherlands
- Research Group "Health and Social Inequality", Berlin Social Science Center (WZB), 10785 Berlin, Germany
| | - Sebastian Hellmeier
- Transformations of Democracy Unit, Berlin Social Science Center (WZB), 10785 Berlin, Germany
| | - Stefanie Heyne
- Mannheim Centre for European Social Research, University of Mannheim, 68131 Mannheim, Germany
| | - Magdalena Hirsch
- Research Unit Migration, Integration, Transnationalization, Berlin Social Science Center (WZB), 10785 Berlin, Germany
| | - Mikael Hjerm
- Department of Sociology, Umeå University, 90187 Umeå, Sweden
| | - Oshrat Hochman
- Data and Research on Society, Leibniz Institute for the Social Sciences, 68159 Mannheim, Germany
| | - Andreas Hövermann
- Wirtschafts- und Sozialwissenschaftliches Institut (WSI), Hans Böckler Foundation, 40474 Düsseldorf, Germany
- German Socio-Economic Panel Survey, 10117 Berlin, Germany
| | - Sophia Hunger
- Center for Civil Society Research, Berlin Social Science Center, 10785 Berlin, Germany
| | - Christian Hunkler
- Berlin Institute for Integration and Migration Research (BIM), Humboldt University Berlin, 10099 Berlin, Germany
| | - Nora Huth
- School of Human and Social Sciences, University of Wuppertal, 42119 Wuppertal, Germany
| | - Zsófia S. Ignácz
- Institute of Sociology, Goethe University Frankfurt, 60323 Frankfurt, Germany
| | - Laura Jacobs
- Department of Political Science, Université Libre de Bruxelles, 1050 Bruxelles, Belgium
| | - Jannes Jacobsen
- Zeppelin University, 88045 Friedrichshafen, Germany
- Cluster "Data-Methods-Monitoring", German Center for Integration and Migration Research (DeZIM),10117 Berlin, Germany
| | - Bastian Jaeger
- Department of Social Psychology, Tilburg University, 5037AB Tilburg, The Netherlands
| | - Sebastian Jungkunz
- Institute for Socio-Economics, University of Duisburg-Essen, 47057 Duisburg, Germany
- Institute of Political Science, University of Münster, 48149 Münster, Germany
- Chair of Political Sociology, University of Bamberg, 96052 Bamberg, Germany
| | - Nils Jungmann
- Survey Data Curation, Leibniz Institute for the Social Sciences (GESIS), 50667 Cologne, Germany
| | - Mathias Kauff
- Department of Psychology, Medical School Hamburg, 20457 Hamburg, Germany
| | - Manuel Kleinert
- Institute of Sociology, Justus Liebig University of Giessen, 35394 Giessen, Germany
| | - Julia Klinger
- Institute of Sociology and Social Psychology, University of Cologne, 50931 Cologne, Germany
| | - Jan-Philipp Kolb
- Federal Statistics Office Germany, Destatis, 65189 Wiesbaden, Germany
| | - Marta Kołczyńska
- Department of Research on Social and Institutional Transformations, Institute of Political Studies of the Polish Academy of Sciences, 00-625 Warsaw, Poland
| | - John Kuk
- Department of Political Science, University of Oklahoma, Norman, OK 73019
| | - Katharina Kunißen
- Institute of Sociology, Johannes Gutenberg University Mainz, 55128 Mainz, Germany
| | | | | | - Philipp M. Lersch
- Socio-Economic Panel Study (SOEP), German Institute for Economic Research (DIW), 10117 Berlin, Germany
- Department of Social Sciences, Humboldt University Berlin, 10099 Berlin, Germany
| | - Lea-Maria Löbel
- Socio-Economic Panel Study (SOEP), German Institute for Economic Research (DIW), 10117 Berlin, Germany
| | - Philipp Lutscher
- Department of Political Science, University of Oslo, 0851 Oslo, Norway
| | - Matthias Mader
- Department of Politics and Public Administration, University of Konstanz, 78457 Konstanz, Germany
| | - Joan E. Madia
- Department of Sociology, Nuffield College, University of Oxford, Oxford, OX1 1JD, United Kingdom
- Institute for the Evaluation of Public Policies, Fondazione Bruno Kessler, 38122 Trento, Italy
| | - Natalia Malancu
- The Institute of Citizenship Studies (InCite), University of Geneva, 1205 Geneva, Switzerland
| | - Luis Maldonado
- Instituto de Sociologia, Pontifical Catholic University of Chile, Santiago, 7820436, Chile
| | - Helge Marahrens
- Department of Sociology, Indiana University, Bloomington, IN 47405
| | - Nicole Martin
- Department of Politics, University of Manchester, Manchester, M19 2JS, United Kingdom
| | - Paul Martinez
- Department of Institutional Research, Western Governors University, Salt Lake City, UT 84107
| | - Jochen Mayerl
- Institute of Sociology, Chemnitz University of Technology, 09126 Chemnitz, Germany
| | - Oscar J. Mayorga
- Department of Sociology, University of California, Los Angeles, CA 90095
| | - Patricia McManus
- Department of Sociology, Indiana University, Bloomington, IN 47405
| | - Kyle McWagner
- Department of Political Science, The University of California, Irvine, CA 92617
| | - Cecil Meeusen
- Department of Sociology, Center for Sociological Research, KU Leuven, 3000 Leuven, Belgium
| | - Daniel Meierrieks
- Research Unit Migration, Integration, Transnationalization, Berlin Social Science Center (WZB), 10785 Berlin, Germany
| | - Jonathan Mellon
- Department of Politics, University of Manchester, Manchester, M19 2JS, United Kingdom
| | - Friedolin Merhout
- Department of Sociology and Centre for Social Data Science, University of Copenhagen, 1353 Copenhagen, Denmark
| | - Samuel Merk
- Department of School Development, University of Education Karlsruhe, 76133 Karlsruhe, Germany
| | - Daniel Meyer
- Department of Education and Social Sciences, University of Cologne, 50931 Cologne, Germany
| | - Leticia Micheli
- Department of Psychology III, Julius-Maximilians University Würzburg, 97070 Würzburg, Germany
| | - Jonathan Mijs
- Department of Sociology, Boston University, Boston, MA 02215
| | - Cristóbal Moya
- Faculty of Sociology, Bielefeld University, 33615 Bielefeld, Germany
| | - Marcel Neunhoeffer
- School of Social Sciences, University of Mannheim, 68159 Mannheim, Germany
| | - Daniel Nüst
- Department of Geosciences, University of Münster, 49149 Münster, Germany
| | - Olav Nygård
- Division of Migration, Ethnicity and Society (REMESO), Linköping University, 60174 Linköping, Sweden
| | - Fabian Ochsenfeld
- Administrative Headquarters, Max Planck Society, 80539 Berlin, Germany
| | - Gunnar Otte
- Institute of Sociology, Johannes Gutenberg University Mainz, 55128 Mainz, Germany
| | | | - Christopher Prosser
- Department of Politics, International Relations and Philosophy, Royal Holloway University of London, London, TW20 0EX, United Kingdom
| | - Louis Raes
- Department of Economics, Tilburg University, 5037AB Tilburg, The Netherlands
| | - Kevin Ralston
- School of Social and Political Science, University of Edinburgh, Edinburgh, EH8 9LD, United Kingdom
| | - Miguel R. Ramos
- Department of Social Policy, Sociology and Criminology, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | - Arne Roets
- Department of Developmental, Personality and Social Psychology, Ghent University, 9000 Ghent, Belgium
| | - Jonathan Rogers
- Division of Social Science, New York University Abu Dhabi, Abu Dhabi, 10276, United Arab Emirates
| | - Guido Ropers
- School of Social Sciences, University of Mannheim, 68159 Mannheim, Germany
| | - Robin Samuel
- University of Luxembourg, 4365 Esch-sur-Alzette, Luxembourg
- Department of Social Sciences, University of Luxembourg, 4366 Esch-sur-Alzette, Luxembourg
| | - Gregor Sand
- Max Planck Institute for Social Law and Social Policy, 80799 Munich, Germany
| | - Ariela Schachter
- Department of Sociology, Washington University in St. Louis, St. Louis, MO 63130
| | - Merlin Schaeffer
- Department of Sociology, University of Copenhagen, 1353 Copenhagen, Denmark
| | - David Schieferdecker
- Institute for Media and Communication Studies, Freie Universität Berlin, 14195 Berlin, Germany
| | - Elmar Schlueter
- Institute of Sociology, Justus Liebig University of Giessen, 35394 Giessen, Germany
| | - Regine Schmidt
- Faculty of Social Sciences, Economics, and Business Administration, University of Bamberg, 96052 Bamberg, Germany
| | - Katja M. Schmidt
- Socio-Economic Panel Study (SOEP), German Institute for Economic Research (DIW), 10117 Berlin, Germany
| | | | | | - Jürgen Schneider
- Tübingen School of Education, University of Tübingen, 72074 Tübingen, Germany
| | - Martijn Schoonvelde
- University College Dublin, Dublin 4, Ireland
- Department of European Languages and Cultures, University of Groningen, 9712 EK Groningen, The Netherlands
| | - Julia Schulte-Cloos
- Robert Schuman Center for Advanced Studies, European University Institute, 50133 Florence, Italy
| | - Sandy Schumann
- Department of Security and Crime Science, University College London, London,WC1E 6BT, United Kingdom
| | - Reinhard Schunck
- School of Human and Social Sciences, University of Wuppertal, 42119 Wuppertal, Germany
| | - Jürgen Schupp
- Socio-Economic Panel Study (SOEP), German Institute for Economic Research (DIW), 10117 Berlin, Germany
| | - Julian Seuring
- Department of Migration, Leibniz Institute for Educational Trajectories, 96047 Bamberg, Germany
| | - Henning Silber
- Department of Survey Design and Methodology, Leibniz Institute for the Social Sciences (GESIS), 68159 Mannheim, Germany
| | - Willem Sleegers
- Department of Social Psychology, Tilburg University, 5037AB Tilburg, The Netherlands
| | - Nico Sonntag
- Institute of Sociology, Johannes Gutenberg University Mainz, 55128 Mainz, Germany
| | | | - Nadia Steiber
- Department of Sociology, University of Vienna, 1090 Vienna, Austria
| | - Nils Steiner
- Institute for Political Science, Johannes Gutenberg University Mainz, 55099 Mainz, Germany
| | | | - Dieter Stiers
- Center for Political Science Research, KU Leuven, 3000 Leuven, Belgium
| | - Dragana Stojmenovska
- Department of Sociology, University of Amsterdam, 1001 Amsterdam, The Netherlands
| | - Nora Storz
- Interdisciplinary Social Science, Utrecht University, 3584 Utrecht, The Netherlands
| | - Erich Striessnig
- Department of Demography, University of Vienna, 1010 Vienna, Austria
| | - Anne-Kathrin Stroppe
- Survey Data Curation, Leibniz Institute for the Social Sciences (GESIS), 50667 Cologne, Germany
| | - Janna Teltemann
- Institute for Social Sciences, University of Hildesheim, 31141 Hildesheim, Germany
| | - Andrey Tibajev
- Division of Migration, Ethnicity and Society (REMESO), Linköping University, 60174 Linköping, Sweden
| | - Brian Tung
- Department of Sociology, Washington University in St. Louis, St. Louis, MO 63130
| | - Giacomo Vagni
- Social Research Institute, Institute of Education, University College London, London, WC1H 0AL, United Kingdom
| | - Jasper Van Assche
- Department of Developmental, Personality and Social Psychology, Ghent University, 9000 Ghent, Belgium
- Center for Social and Cultural Psychology, Université Libre de Bruxelles, 1050 Brussels, Belgium
| | - Meta van der Linden
- Interdisciplinary Social Science, Utrecht University, 3584 Utrecht, The Netherlands
| | | | - Arno Van Hootegem
- Department of Sociology, Center for Sociological Research, KU Leuven, 3000 Leuven, Belgium
| | - Stefan Vogtenhuber
- Education and Employment, Institute for Advanced Studies, University of Vienna, Vienna, 1080 Austria
| | - Bogdan Voicu
- Research Institute for Quality of Life, Romanian Academy, 010071 Bucharest, Romania
- Department of Sociology, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
| | - Fieke Wagemans
- Netherlands Institute for Social Research, 2500 BD The Hague, the Netherlands
- Policy Perspectives, Citizen Perspectives, and Behaviors, Netherlands Institute for Social Research, 2594 The Hague, The Netherlands
| | - Nadja Wehl
- Research Cluster "The Politics of Inequality", University of Konstanz, 78464 Konstanz, Germany
| | - Hannah Werner
- Center for Political Science Research, KU Leuven, 3000 Leuven, Belgium
| | | | - Fabian Winter
- Mechanisms of Normative Change, Max Planck Institute for Research on Collective Goods, 53113 Bonn, Germany
| | - Christof Wolf
- Mannheim Centre for European Social Research, University of Mannheim, 68131 Mannheim, Germany
- School of Social Sciences, University of Mannheim, 68159 Mannheim, Germany
- President, Leibniz Institute for the Social Sciences (GESIS), 68159 Mannheim, Germany
| | - Yuki Yamada
- Faculty of Arts and Science, Kyushu University, Fukuoka, 819-0395, Japan
| | - Nan Zhang
- Mannheim Centre for European Social Research, University of Mannheim, 68131 Mannheim, Germany
| | - Conrad Ziller
- Institute for Socio-Economics, University of Duisburg-Essen, 47057 Duisburg, Germany
- Department of Political Science, University of Duisburg-Essen, 47057 Duisburg, Germany
| | - Stefan Zins
- Institute for Employment Research, Federal Employment Agency, 90478 Nuremberg, Germany
| | - Tomasz Żółtak
- Department of Research on Social and Institutional Transformations, Institute of Political Studies of the Polish Academy of Sciences, 00-625 Warsaw, Poland
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Pechmann A, Behrens M, Dörnbrack K, Tassoni A, Wenzel F, Stein S, Vogt S, Zöller D, Bernert G, Hagenacker T, Schara-Schmidt U, Walter MC, Bertsche A, Vill K, Baumann M, Baumgartner M, Cordts I, Eisenkölbl A, Flotats-Bastardas M, Friese J, Günther R, Hahn A, Horber V, Husain RA, Illsinger S, Jahnel J, Johannsen J, Köhler C, Kölbel H, Müller M, von Moers A, Schwerin-Nagel A, Reihle C, Schlachter K, Schreiber G, Schwartz O, Smitka M, Steiner E, Trollmann R, Weiler M, Weiß C, Wiegand G, Wilichowski E, Ziegler A, Lochmüller H, Kirschner J, Ameshofer L, Andres B, Angelova-Toshkina D, Banholzer D, Bant C, Baum P, Baumann S, Baur U, Becker B, Behring B, Bellut J, Bevot A, Bischofberger J, Bitzan L, Bjelica B, Blankenburg M, Böger S, Bonetti F, Bongartz A, Brakemeier S, Bratka L, Braun N, Braun S, Brauner B, Bretschneider C, Burgenmeister N, Burke B, Cirak S, Dall A, de Vries H, Marina AD, Denecke J, Deschauer M, Dibrani Z, Diebold U, Dondit L, Drebes J, Driemeyer J, Dukic V, Eckenweiler M, Eminger M, Fischer M, Fischer C, Freigang M, Gaiser P, Gangfuß A, Geitmann S, George A, Gosk-Tomek M, Grinzinger S, Gröning K, Groß M, Güttsches AK, Hagenmeyer A, Hartmann H, Haverkamp J, Hiebeler M, Hoevel A, Hoffmann GF, Holtkamp B, Holzwarth D, Homma A, Horneff V, Hörnig C, Hotter A, Hubert A, Huppke P, Jansen E, Jung L, Kaiser N, Kappel S, Katharina B, Koch J, Kölke S, Korschinsky B, Kostede F, Krause K, Küpper H, Lang A, Lange I, Langer T, Lechner Y, Lehmann H, Leypold C, Lingor P, Lipka J, Löscher W, Luiking A, Machetanz G, Malm E, Martakis K, Menzen B, Metelmann M, zu Hörste GM, Montagnese F, Mörtlbauer K, Müller P, Müller A, Müller A, Müschen L, Neuwirth C, Niesert M, Pauschek J, Pernegger E, Petri S, Pilshofer V, Plecko B, Pollok J, Preisel M, Pühringer M, Quinten AL, Raffler S, Ramadan B, Rappold M, Rauscher C, Reckmann K, Reinhardt T, Röder M, Roland-Schäfer D, Roth E, Ruß L, Saffari A, Schimmel M, Schlag M, Schlotter-Weigel B, Schneider J, Schöne-Bake JC, Schorling D, Schreiner I, Schüssler S, Schwarzbach M, Schwippert M, Semmler L, Smuda K, Sprenger-Svacina A, Stadler T, Steffens P, Steuernagel D, Stolte B, Stoltenburg C, Tasch G, Thimm A, Tiefenthaler E, Topakian R, Türk M, van der Stam L, Vettori K, Vollmann P, Vorgerd M, Weiss D, Wenninger S, Werring S, Wessel M, Weyen U, Wider S, Wiebe NO, Wiesenhofer A, Wiethoff S, Wirner C, Wohnrade C, Wunderlich G, Zeller D, Zemlin M, Zobel J. Improved upper limb function in non-ambulant children with SMA type 2 and 3 during nusinersen treatment: a prospective 3-years SMArtCARE registry study. Orphanet J Rare Dis 2022; 17:384. [PMID: 36274155 PMCID: PMC9589836 DOI: 10.1186/s13023-022-02547-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/04/2022] [Indexed: 11/10/2022] Open
Abstract
Background The development and approval of disease modifying treatments have dramatically changed disease progression in patients with spinal muscular atrophy (SMA). Nusinersen was approved in Europe in 2017 for the treatment of SMA patients irrespective of age and disease severity. Most data on therapeutic efficacy are available for the infantile-onset SMA. For patients with SMA type 2 and type 3, there is still a lack of sufficient evidence and long-term experience for nusinersen treatment. Here, we report data from the SMArtCARE registry of non-ambulant children with SMA type 2 and typen 3 under nusinersen treatment with a follow-up period of up to 38 months. Methods SMArtCARE is a disease-specific registry with data on patients with SMA irrespective of age, treatment regime or disease severity. Data are collected during routine patient visits as real-world outcome data. This analysis included all non-ambulant patients with SMA type 2 or 3 below 18 years of age before initiation of treatment. Primary outcomes were changes in motor function evaluated with the Hammersmith Functional Motor Scale Expanded (HFMSE) and the Revised Upper Limb Module (RULM). Results Data from 256 non-ambulant, pediatric patients with SMA were included in the data analysis. Improvements in motor function were more prominent in upper limb: 32.4% of patients experienced clinically meaningful improvements in RULM and 24.6% in HFMSE. 8.6% of patients gained a new motor milestone, whereas no motor milestones were lost. Only 4.3% of patients showed a clinically meaningful worsening in HFMSE and 1.2% in RULM score. Conclusion Our results demonstrate clinically meaningful improvements or stabilization of disease progression in non-ambulant, pediatric patients with SMA under nusinersen treatment. Changes were most evident in upper limb function and were observed continuously over the follow-up period. Our data confirm clinical trial data, while providing longer follow-up, an increased number of treated patients, and a wider range of age and disease severity.
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Grimm T, Groß M, Nater UM, Summ O, Kreutz G. Psychophysiological Effects of Biographical Interventions in People With Unresponsive Wakefulness Syndrome and Minimally Conscious State. Front Neurol 2022; 13:788588. [PMID: 35599728 PMCID: PMC9120535 DOI: 10.3389/fneur.2022.788588] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Background Various music interventions can evoke favorable behavioral responses or physiological reactions in people with disorders of consciousness (DOC), such as coma, unresponsive wakefulness syndrome (UWS), and minimally conscious state (MCS). However, it appears that no study thus far has investigated the effects of music on the endocrine system of people with DOC. Objective This explorative study aimed to investigate the effects of biographical music and biographical language on the physiological and endocrine systems of people with UWS and MCS. Method A cohort of 20 people with DOC (10 women, 10 men; age range 19–77) received 20 min of biographical music and biographical language. Before and afterward, they were exposed to silence. Physiological and hormonal measurements were conducted before, during, and after the interventions. Results Paired t-tests showed a significant decrease of salivary cortisol in the condition with biographical language interventions. Conclusion Biographical interventions can modulate reactions in the endocrine system in people with DOC. Further studies are needed to establish whether and how individuals living with DOC show psychoneuroendocrine responses to music and other arts-based interventions.
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Affiliation(s)
- Teresa Grimm
- Public Health Department of the City of Oldenburg, Oldenburg, Germany
- Department of Music, Faculty of Linguistics and Cultural Studies, Carl von Ossietzky University, Oldenburg, Germany
- *Correspondence: Teresa Grimm
| | - Martin Groß
- Department of Neurological Intensive Care and Rehabilitation, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany
- Research Network on Emergency and Intensive Care Medicine Oldenburg, Faculty of Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany
| | - Urs M. Nater
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Oliver Summ
- Department of Neurological Intensive Care and Rehabilitation, Evangelisches Krankenhaus Oldenburg, Oldenburg, Germany
- Faculty of Medicine and Health Sciences, Carl von Ossietzky University, Oldenburg, Germany
| | - Gunter Kreutz
- Department of Music, Faculty of Linguistics and Cultural Studies, Carl von Ossietzky University, Oldenburg, Germany
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Groß M, Pohl M, Platz T, Schmidt-Wilcke T. [The certification of centers for weaning from mechanical ventilation in neurological and neurosurgical early rehabilitation by the German Society for Neurorehabilitation]. Nervenarzt 2021; 93:828-834. [PMID: 34648055 PMCID: PMC9363321 DOI: 10.1007/s00115-021-01207-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
Die Zertifizierung von Zentren für Beatmungsentwöhnung in der neurologisch-neurochirurgischen Frührehabilitation durch die Deutsche Gesellschaft für Neurorehabilitation (DGNR) ist ab dem 01.10.2021 möglich. Die Zertifizierungskriterien beschreiben ein Anforderungsprofil, das für eine fachgerechte und qualitätsgesicherte Versorgung von Beatmungspatienten in der neurologisch-neurochirurgischen Frührehabilitation (NNFR) steht. Das Zertifikat berücksichtigt die strukturellen Unterschiede der in der NNFR tätigen Einrichtungen und kann sowohl durch Facheinrichtungen als auch durch Frührehabilitationsabteilungen an Akutkrankenhäusern erworben werden. Die Durchführung der Zertifizierung erfolgt analog zur Zertifizierung von Stroke-Units der Deutschen Schlaganfall-Gesellschaft in Zusammenarbeit mit dem TÜV Rheinland. Zunächst sendet die Einrichtung den Erhebungsbogen an den TÜV Rheinland. Anschließend erfolgt die Begehung durch einen vom TÜV Rheinland gestellten leitenden Auditor und einen Fachauditor der DGNR. Deren Bericht wird dem Zertifizierungsausschuss der DGNR vorgelegt zur Erteilung einer Empfehlung oder Ablehnung der Zertifizierung. Die Zertifizierung schafft objektive Kriterien, die die Rolle der Neurologie in der Beatmungsmedizin in Deutschland beschreiben. So erleichtert sie den Dialog mit anderen beatmungsmedizinischen Disziplinen und ebnet den Weg für die Diskussion mit Politikern, Kostenträgern und nicht zuletzt Betroffenenverbänden über Behandlungsinhalte und -kapazitäten.
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Affiliation(s)
- Martin Groß
- Zertifizierungsausschuss der Deutschen Gesellschaft für Neurorehabilitation e. V., Rheinbach, Deutschland.,Oldenburger Forschungsnetzwerk Notfall- und Intensivmedizin, Carl von Ossietzky Universität Oldenburg, Oldenburg, Deutschland.,Evangelisches Krankenhaus Oldenburg, Oldenburg, Deutschland
| | - Marcus Pohl
- Zertifizierungsausschuss der Deutschen Gesellschaft für Neurorehabilitation e. V., Rheinbach, Deutschland.,VAMED Klinik Schloss Pulsnitz, Pulsnitz, Deutschland
| | - Thomas Platz
- Präsidium der Deutschen Gesellschaft für Neurorehabilitation e. V., Rheinbach, Deutschland. .,Institut für Neurorehabilitation und Evidenzbasierung, An-Institut der Universität Greifswald, BDH-Klinik Greifswald gGmbH, Zentrum für NeuroRehabilitation Beatmungs- und Intensivmedizin Querschnittgelähmtenzentrum, Karl-Liebknecht-Ring 26a, 17491, Greifswald, Deutschland. .,Arbeitsgruppe Neurorehabilitation, Universitätsmedizin Greifswald, Greifswald, Deutschland.
| | - Tobias Schmidt-Wilcke
- Zertifizierungsausschuss der Deutschen Gesellschaft für Neurorehabilitation e. V., Rheinbach, Deutschland.,Neurologisches Zentrum, Mainkofen, Deutschland.,Institut für Klinische Neurowissenschaften und Medizinische Psychologie, Heinrich-Heine - Universität Düsseldorf, Düsseldorf, Deutschland
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9
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Sipka T, Peroceschi R, Hassan-Abdi R, Groß M, Ellett F, Begon-Pescia C, Gonzalez C, Lutfalla G, Nguyen-Chi M. Damage-Induced Calcium Signaling and Reactive Oxygen Species Mediate Macrophage Activation in Zebrafish. Front Immunol 2021; 12:636585. [PMID: 33841419 PMCID: PMC8032883 DOI: 10.3389/fimmu.2021.636585] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 12/01/2020] [Accepted: 03/10/2021] [Indexed: 12/24/2022] Open
Abstract
Immediately after a wound, macrophages are activated and change their phenotypes in reaction to danger signals released from the damaged tissues. The cues that contribute to macrophage activation after wounding in vivo are still poorly understood. Calcium signaling and Reactive Oxygen Species (ROS), mainly hydrogen peroxide, are conserved early wound signals that emanate from the wound and guide neutrophils within tissues up to the wound. However, the role of these signals in the recruitment and the activation of macrophages is elusive. Here we used the transparent zebrafish larva as a tractable vertebrate system to decipher the signaling cascade necessary for macrophage recruitment and activation after the injury of the caudal fin fold. By using transgenic reporter lines to track pro-inflammatory activated macrophages combined with high-resolutive microscopy, we tested the role of Ca²⁺ and ROS signaling in macrophage activation. By inhibiting intracellular Ca²⁺ released from the ER stores, we showed that macrophage recruitment and activation towards pro-inflammatory phenotypes are impaired. By contrast, ROS are only necessary for macrophage activation independently on calcium. Using genetic depletion of neutrophils, we showed that neutrophils are not essential for macrophage recruitment and activation. Finally, we identified Src family kinases, Lyn and Yrk and NF-κB as key regulators of macrophage activation in vivo, with Lyn and ROS presumably acting in the same signaling pathway. This study describes a molecular mechanism by which early wound signals drive macrophage polarization and suggests unique therapeutic targets to control macrophage activity during diseases.
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Affiliation(s)
- Tamara Sipka
- LPHI, Univ Montpellier, CNRS, Montpellier, France
| | | | | | - Martin Groß
- LPHI, Univ Montpellier, CNRS, Montpellier, France
| | - Felix Ellett
- Bateson Centre and Department of Infection and Immunity, University of Sheffield, Sheffield, United Kingdom.,BioMEMS Resource Center, Center for Engineering in Medicine and Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
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10
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Rollnik JD, Brocke J, Gorsler A, Groß M, Hartwich M, Pohl M, Schmidt-Wilcke T, Platz T. [Weaning in neurological and neurosurgical early rehabilitation-Results from the "WennFrüh" study of the German Society for Neurorehabilitation]. Nervenarzt 2020; 91:1122-1129. [PMID: 32776234 PMCID: PMC7416590 DOI: 10.1007/s00115-020-00976-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Neurologisch-neurochirurgische Frührehabilitanden sind klinisch oft so schwer betroffen, dass sie neben der frührehabilitativen Behandlung auch von der mechanischen Beatmung entwöhnt werden müssen. In einer Umfrage der Deutschen Gesellschaft für Neurorehabilitation (DGNR) wurden neurologische Weaningzentren gebeten, Informationen zu Strukturmerkmalen ihrer Einrichtung, ihrer personellen und apparativen Ausstattung sowie basierend auf anonymen Daten zu Fallzahl und Behandlungsergebnis zur Verfügung zu stellen. Es nahmen 36 Weaningeinheiten aus 11 Bundesländern mit insgesamt 496 Betten teil. Von 2516 erfassten Weaningfällen im Jahr 2019 wurden 2097 (83,3 %) primär erfolgreich entwöhnt und nur 120 (4,8 %) mussten mit Heimbeatmung entlassen werden. Die Mortalität in dieser Stichprobe lag bei 11,0 % (n = 276). Die Erhebung zeigt, dass das prolongierte Weaning in der neurologisch-neurochirurgischen Frührehabilitation ein wichtiger und erfolgreicher Bestandteil der Versorgung schwerstkranker Patienten darstellt.
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Affiliation(s)
- Jens D Rollnik
- Institut für neurorehabilitative Forschung (InFo), Assoziiertes Institut der Medizinischen Hochschule Hannover (MHH), BDH-Klinik Hessisch Oldendorf gGmbH, Hessisch Oldendorf, Deutschland
| | - Jan Brocke
- Frührehabilitation & Neurointensivmedizin, Neurologisches Zentrum, Segeberger Kliniken GmbH, Bad Segeberg, Deutschland
| | - Anna Gorsler
- Fachkrankenhaus für Neurologische Frührehabilitation, Kliniken Beelitz GmbH, Beelitz, Deutschland
| | - Martin Groß
- Klinik für Neurologische Intensivmedizin und Frührehabilitation, Evangelisches Krankenhaus Oldenburg, Medizinischer Campus Universität Oldenburg, Oldenburg, Deutschland
| | - Michael Hartwich
- Akutklinik für Neurologische Frührehabilitation, Asklepios Schlossberg Klinik Bad König, Bad König, Deutschland
| | - Marcus Pohl
- Fachklinik für Neurologisch-Neurochirurgische Rehabilitation, VAMED Klinik Schloss Pulsnitz GmbH, Pulsnitz, Deutschland
| | - Tobias Schmidt-Wilcke
- St. Mauritius Therapieklinik, Meerbusch, Deutschland.,Institut für Klinische Neurowissenschaften und Medizinische Psychologie, Universitätsklinikum Düsseldorf, Düsseldorf, Deutschland
| | - Thomas Platz
- Institut für Neurorehabilitation und Evidenzbasierung, An-Institut der Universität Greifswald, BDH-Klinik Greifswald gGmbH, Karl-Liebknecht-Ring 26a, 17491, Greifswald, Deutschland. .,AG Neurorehabilitation, Universitätsmedizin Greifswald, Greifswald, Deutschland.
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11
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Summ O, Schute J, Byhahn C, Kahle T, Herrmann M, Schulte C, Bergold MN, Groß M. [COVID-19 pandemic: structured expansion of ventilation capacities using home respirators]. Anaesthesist 2020; 69:323-330. [PMID: 32350543 PMCID: PMC7189831 DOI: 10.1007/s00101-020-00780-z] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Due to the current COVID-19 pandemic there is a need for a rapid increase in intensive care and ventilation capacities. Delivery times for additional intensive care respirators are currently not foreseeable. An option to increase ventilation capacities not only for COVID-19, but for all patients requiring mechanical ventilation is to use home respirators. Home respirators are turbine respirators, so they can usually be operated without high-pressure oxygen connections and can therefore also be used in areas outside the classical intensive care medical infrastructure. Due to their limited technical features, home respirators are not suitable for the treatment of severely affected patients but can be used for weaning after respiratory improvement, which means that intensive care respirators are available again more quickly. Respiratory therapists are specially trained nurses or therapists in the field of out of hospital ventilation and can independently use home ventilation respirators, for example for weaning in the intensive care unit. Thus, they relieve intensive care nursing staff in the pandemic. Due to the COVID-19 pandemic medical students from the Oldenburg University are currently being trained in operating home respirators to provide basic support in the hospital if necessary.
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Affiliation(s)
- O Summ
- Klinik für Neurologische Intensivmedizin und Frührehabilitation, Evangelisches Krankenhaus, Medizinischer Campus Universität Oldenburg, Steinweg 13-17, 26122, Oldenburg, Deutschland
| | - J Schute
- Therapiezentrum, Evangelisches Krankenhaus, Medizinischer Campus Universität Oldenburg, Oldenburg, Deutschland
| | - C Byhahn
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Evangelisches Krankenhaus, Medizinischer Campus Universität Oldenburg, Oldenburg, Deutschland
| | - T Kahle
- Therapiezentrum, Evangelisches Krankenhaus, Medizinischer Campus Universität Oldenburg, Oldenburg, Deutschland
| | - M Herrmann
- Therapiezentrum, Evangelisches Krankenhaus, Medizinischer Campus Universität Oldenburg, Oldenburg, Deutschland
| | - C Schulte
- Therapiezentrum, Evangelisches Krankenhaus, Medizinischer Campus Universität Oldenburg, Oldenburg, Deutschland
| | - M N Bergold
- Klinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Evangelisches Krankenhaus, Medizinischer Campus Universität Oldenburg, Oldenburg, Deutschland
| | - M Groß
- Klinik für Neurologische Intensivmedizin und Frührehabilitation, Evangelisches Krankenhaus, Medizinischer Campus Universität Oldenburg, Steinweg 13-17, 26122, Oldenburg, Deutschland.
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12
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Dongmo S, Stock D, Alexander Kreissl JJ, Groß M, Weixler S, Hagen M, Miyazaki K, Abe T, Schröder D. Implications of Testing a Zinc-Oxygen Battery with Zinc Foil Anode Revealed by Operando Gas Analysis. ACS Omega 2020; 5:626-633. [PMID: 31956811 PMCID: PMC6964293 DOI: 10.1021/acsomega.9b03224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/15/2019] [Indexed: 06/10/2023]
Abstract
Zinc-oxygen batteries are seen as promising energy storage devices for future mobile and stationary applications. Introducing them as secondary battery is hindered by issues at both the anode and cathode. Research efforts were intensified during the past two decades, mainly focusing on catalyst materials for the cathode. Thereby, zinc foil was almost exclusively used as the anode in electrochemical testing in the lab-scale as it is easy to apply and shall yield reproducible results. However, it is well known that zinc metal reacts with water within the electrolyte to form hydrogen. It is not yet clear how the evolution of hydrogen is affecting the performance results obtained thereof. Herein, we extend the studies and the understanding about the evolution of hydrogen at zinc by analyzing the zinc-oxygen battery during operation. By means of electrochemical measurements, operando gas analysis, and anode surface analysis, we elucidate that the rate of the evolution of hydrogen scales with the current density applied, and that the roughness of the anode surface, that is, the pristine state of the zinc foil surface, affects the rate as well. In the end, we propose a link between the evolution of hydrogen and the unwanted impact on the actual electrochemical performance that might go unnoticed during testing. Thereof, we elucidate the consequences that arise for the working principle and the testing of materials for this battery type.
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Affiliation(s)
- Saustin Dongmo
- Institute
of Physical Chemistry, Justus Liebig University
Giessen, Heinrich-Buff-Ring
17, D-35392 Giessen, Germany
- Center
for Materials Research (LaMa), Justus Liebig
University Giessen, Heinrich-Buff-Ring
16, D-35392 Giessen, Germany
| | - Daniel Stock
- Institute
of Physical Chemistry, Justus Liebig University
Giessen, Heinrich-Buff-Ring
17, D-35392 Giessen, Germany
- Center
for Materials Research (LaMa), Justus Liebig
University Giessen, Heinrich-Buff-Ring
16, D-35392 Giessen, Germany
| | | | - Martin Groß
- Fraunhofer
Institute for Chemical Technology ICT, Joseph-von-Fraunhofer-Straße 7, D-76327 Pfinztal, Germany
| | - Sophie Weixler
- Fraunhofer
Institute for Chemical Technology ICT, Joseph-von-Fraunhofer-Straße 7, D-76327 Pfinztal, Germany
| | - Markus Hagen
- Fraunhofer
Institute for Chemical Technology ICT, Joseph-von-Fraunhofer-Straße 7, D-76327 Pfinztal, Germany
| | - Kohei Miyazaki
- Department
of Energy & Hydrocarbon Chemistry, Kyoto
University, Nishikyo-ku, 615-8510 Kyoto, Japan
| | - Takeshi Abe
- Department
of Energy & Hydrocarbon Chemistry, Kyoto
University, Nishikyo-ku, 615-8510 Kyoto, Japan
| | - Daniel Schröder
- Institute
of Physical Chemistry, Justus Liebig University
Giessen, Heinrich-Buff-Ring
17, D-35392 Giessen, Germany
- Center
for Materials Research (LaMa), Justus Liebig
University Giessen, Heinrich-Buff-Ring
16, D-35392 Giessen, Germany
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13
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Steffen A, Jost W, Bäumer T, Beutner D, Degenkolb-Weyers S, Groß M, Grosheva M, Hakim S, Kahl KG, Laskawi R, Lencer R, Löhler J, Meyners T, Rohrbach-Volland S, Schönweiler R, Schröder SC, Schröder S, Schröter-Morasch H, Schuster M, Steinlechner S, Urban R, Guntinas-Lichius O. [Hypersalivation - Update of the S2k guideline (AWMF) in short form]. Laryngorhinootologie 2019; 98:388-397. [PMID: 31167292 DOI: 10.1055/a-0874-2406] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Hypersalivation describes a relatively excessive salivary flow, which wets the patient himself and his surroundings. It may result because of insufficient oro-motor function, dysphagia, decreased central control and coordination. This update presents recent changes and innovation in the treatment of hypersalivation.Multidisciplinary diagnostic and treatment evaluation is recommended already at early stage and focus on dysphagia, saliva aspiration, and oro-motor deficiencies. Clinical screening tools and diagnostics such as fiberoptic endoscopic evaluation of swallowing generate important data on therapy selection and control. Many cases profit from swallowing therapy programmes in order to activate compensation mechanisms as long compliances is given. In children with hypotonic oral muscles, oral stimulation plates can induce a relevant symptom release because of the improved lip closure. The pharmacologic treatment improved for pediatric cases as glycopyrrolate fluid solution (Sialanar®) is now indicated for hypersalivation within the E. U. The injection of botulinum toxin into the salivary glands has shown safe and effective results with long lasting saliva reduction. Here, a phase III trial is completed for Incobotulinum toxin A and, in the U. S., is indicated for the treatment of adult patients with chronic hypersalivation. Surgical treatment should be reserved for isolated cases. External radiation is judged as a safe and effective therapy when using modern 3 D techniques to minimize tissue damage. Therapy effects and symptom severity has to be followed, especially in cases with underlying neurodegenerative disease.
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Affiliation(s)
| | | | - Tobias Bäumer
- Universitätsklinikum Münster Klinik für Psychiatrie und Psychotherapie
| | - Dirk Beutner
- Wissenschaftliches Institut für angewandte HNO-Heilkunde HNO-Praxis Bad Bramstedt
| | | | - Martin Groß
- Evangelische Hochschule Berlin Pflege- und Gesundheitswissenschaften
| | | | | | - Kai G Kahl
- Dr. von Haunersches Kinderspital Ludwig-Maximilians-Universität München Pädiatrische Neurologie und Entwicklungsneurologie
| | - Rainer Laskawi
- Ludwig-Maximilians-Universität München, Medizinische Fakultät, Institut für Phonetik und Sprachverarbeitung
| | - Rebekka Lencer
- Klinikum der Universität München, Klinik für Hals-, Nasen- und Ohrenheilkunde
| | | | - Thekla Meyners
- HELIOS Fachklinik Schleswig, Psychiatry and Psychosomatik Medicine
| | | | | | | | - Sebastian Schröder
- Georg-August-Universität Göttingen, Universitätsmedizin Klinik für Hals-Nasen-Ohrenheilkunde
| | - Heidrun Schröter-Morasch
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Medizinische Fakultät, Studiengang B. Sc. Logopädie
| | - Maria Schuster
- Evangelisches Krankenhaus Oldenburg Klinik für Neurologische Intensivmedizin und Frührehabilitation
| | - Susanne Steinlechner
- Uniklinik Köln Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Hals-Chirurgie Köln
| | - Roland Urban
- Universität zu Lübeck, Klinik für Kiefer- und Gesichtschirurgie
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14
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Steffen A, Jost W, Bäumer T, Beutner D, Degenkolb-Weyers S, Groß M, Grosheva M, Hakim S, Kahl KG, Laskawi R, Lencer R, Löhler J, Meyners T, Rohrbach-Volland S, Schönweiler R, Schröder SC, Schröder S, Schröter-Morasch H, Schuster M, Steinlechner S, Urban R, Guntinas-Lichius O. Hypersalivation: update of the German S2k guideline (AWMF) in short form. J Neural Transm (Vienna) 2019; 126:853-862. [DOI: 10.1007/s00702-019-02000-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 03/27/2019] [Indexed: 12/11/2022]
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15
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Roesner M, Beyer J, Peter Dohm C, Elsner M, Groß M, Meyer A, Mokrusch T, Neunzig HP, Thomas R, Winkler C, Rollnik JD. [Neurological and neurosurgical early rehabilitation in Lower Saxony and Bremen]. Fortschr Neurol Psychiatr 2019; 87:246-254. [PMID: 30865996 DOI: 10.1055/a-0849-9670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION We analyzed the delivery of healthcare services among patients in neurological and neurosurgical early rehabilitation programmes in the German states of Lower Saxony and Bremen. METHODS Patients´applications and admissions for neurological and neurosurgical early rehabilitation in Lower Saxony and Bremen were recorded during a period of two weeks both in November 2015 as well as 2016. The proportion of patients admitted to early rehabilitation within a six-week-period after disease onset was calculated. In addition, factors influencing the probability of admission were investigated. RESULTS Only 45 % of all patients transferred from a primary neurological / neurosurgical unit to an early rehabilitation facility in Lower Saxony / Bremen were successfully admitted. The probability of admission fell when patients were colonized with multi-drug resistant bacteria (21 % in comparison), in particular Methicillin-resistant Staphylococcus aureus (MRSA) with an admission rate of only 13 %. Deleterious effects were also observed in patients dependent on hemodialysis (20 %), or those with a primary diagnosis of polyneuropathy / Guillain-Barré-Syndrome (33 %) or hypoxic brain damage (37 %), as well as patients on mechanical ventilation (37 %). Patients had a higher probability of being admitted with the primary diagnoses of subarachnoid hemorrhage (52 %) or stroke (51 %). Age, Early Rehabilitation Index (ERI), monitoring, presence of tracheostomy, dysphagia, orientation or behavioral disturbances had no influence on the probability of admission, as well as other primary diagnoses or the number of admissions in one or more rehabilitation centers. CONCLUSION Over one-half of the patients applying for admission to neurological / neurosurgical early rehabilitation facilities in Lower Saxony and Bremen were not admitted. Apparently, the capacity of early rehabilitation treatment in these two German states is not optimal.
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Affiliation(s)
- Martin Roesner
- Klinikum Osnabrück, Klinik für Neurologie und neurologische Frührehabilitation
| | | | | | | | | | | | | | | | | | | | - Jens D Rollnik
- Institut für neurorehabilitative Forschung (InFo) der BDH-Klinik Hessisch Oldendorf gGmbH, Assoziiertes Institut der Medizinischen Hochschule Hannover (MHH)
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16
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Lemery F, Piot P, Amatuni G, Boonpornprasert P, Chen Y, Good J, Grigoryan B, Groß M, Krasilinikov M, Lishilin O, Loisch G, Oppelt A, Philipp S, Qian H, Renier Y, Stephan F, Zagorodnov I. Passive Ballistic Microbunching of Nonultrarelativistic Electron Bunches Using Electromagnetic Wakefields in Dielectric-Lined Waveguides. Phys Rev Lett 2019; 122:044801. [PMID: 30768287 DOI: 10.1103/physrevlett.122.044801] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 12/17/2018] [Indexed: 06/09/2023]
Abstract
Temporally modulated electron beams have a wide array of applications ranging from the generation of coherently enhanced electromagnetic radiation to the resonant excitation of electromagnetic wakefields in advanced-accelerator concepts. Likewise producing low-energy ultrashort microbunches could be useful for ultrafast electron diffraction and new accelerator-based light-source concepts. In this Letter we propose and experimentally demonstrate a passive microbunching technique capable of forming a picosecond bunch train at ∼6 MeV. The method relies on the excitation of electromagnetic wakefields as the beam propagates through a dielectric-lined waveguide. Owing to the nonultrarelativistic nature of the beam, the induced energy modulation eventually converts into a density modulation as the beam travels in a following free-space drift. The modulated beam is further accelerated to ∼20 MeV while preserving the imparted density modulation.
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Affiliation(s)
- F Lemery
- Deutsches Elektronen-Synchrotron, Notkestraße 85, 22607 Hamburg, Germany
| | - P Piot
- Northern Illinois Center for Accelerator & Detector Development and Department of Physics, Northern Illinois University, DeKalb Illinois 60115, USA
- Accelerator Physics Center, Fermi National Accelerator Laboratory, Batavia, Illinois 60510, USA
| | - G Amatuni
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
- Center for the Advancement of Natural Discoveries using Light Emission, Yerevan 0040, Armenia
| | - P Boonpornprasert
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
| | - Y Chen
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
| | - J Good
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
| | - B Grigoryan
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
- Center for the Advancement of Natural Discoveries using Light Emission, Yerevan 0040, Armenia
| | - M Groß
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
| | - M Krasilinikov
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
| | - O Lishilin
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
| | - G Loisch
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
| | - A Oppelt
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
| | - S Philipp
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
| | - H Qian
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
| | - Y Renier
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
| | - F Stephan
- Deutsches Elektronen-Synchrotron, Platannenallee 6, 15738 Zeuthen, Germany
| | - I Zagorodnov
- Deutsches Elektronen-Synchrotron, Notkestraße 85, 22607 Hamburg, Germany
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17
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Schwarze M, Groß M, Moritz M, Buchner G, Kapitzki L, Chiappisi L, Gradzielski M. Micellar enhanced ultrafiltration (MEUF) of metal cations with oleylethoxycarboxylate. J Memb Sci 2015. [DOI: 10.1016/j.memsci.2015.01.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Braune S, Groß M, Walter M, Zhou S, Dietze S, Rutschow S, Lendlein A, Tschöpe C, Jung F. Adhesion and activation of platelets from subjects with coronary artery disease and apparently healthy individuals on biomaterials. J Biomed Mater Res B Appl Biomater 2015; 104:210-7. [PMID: 25631281 DOI: 10.1002/jbm.b.33366] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [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: 09/29/2014] [Revised: 12/02/2014] [Accepted: 01/05/2015] [Indexed: 12/30/2022]
Abstract
On the basis of the clinical studies in patients with coronary artery disease (CAD) presenting an increased percentage of activated platelets, we hypothesized that hemocompatibility testing utilizing platelets from healthy individuals may result in an underestimation of the materials' thrombogenicity. Therefore, we investigated the interaction of polymer-based biomaterials with platelets from CAD patients in comparison to platelets from apparently healthy individuals. In vitro static thrombogenicity tests revealed that adherent platelet densities and total platelet covered areas were significantly increased for the low (polydimethylsiloxane, PDMS) and medium (Collagen) thrombogenic surfaces in the CAD group compared to the healthy subjects group. The area per single platelet-indicating the spreading and activation of the platelets-was markedly increased on PDMS treated with PRP from CAD subjects. This could not be observed for collagen or polytetrafluoroethylene (PTFE). For the latter material, platelet adhesion and surface coverage did not differ between the two groups. Irrespective of the substrate, the variability of these parameters was increased for CAD patients compared to healthy subjects. This indicates a higher reactivity of platelets from CAD patients compared to the healthy individuals. Our results revealed, for the first time, that utilizing platelets from apparently healthy donors bears the risk of underestimating the thrombogenicity of polymer-based biomaterials.
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Affiliation(s)
- S Braune
- Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, Teltow, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Teltow and Berlin, Germany
- Institute of Chemistry, University of Potsdam, Potsdam, Germany
| | - M Groß
- Department of Cardiology and Pneumology, Charitè-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - M Walter
- Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, Teltow, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Teltow and Berlin, Germany
- Institute of Chemistry, University of Potsdam, Potsdam, Germany
| | - S Zhou
- Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, Teltow, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Teltow and Berlin, Germany
- Institute of Chemistry, University of Potsdam, Potsdam, Germany
| | - S Dietze
- Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, Teltow, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Teltow and Berlin, Germany
- Institute of Chemistry, University of Potsdam, Potsdam, Germany
| | - S Rutschow
- Department of Cardiology and Pneumology, Charitè-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - A Lendlein
- Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, Teltow, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Teltow and Berlin, Germany
- Institute of Chemistry, University of Potsdam, Potsdam, Germany
| | - C Tschöpe
- Berlin-Brandenburg Center for Regenerative Therapies, Teltow and Berlin, Germany
- Department of Cardiology, Charitè-Universitätsmedizin Berlin, Campus Virchow, Berlin, Germany
| | - F Jung
- Institute of Biomaterial Science, Helmholtz-Zentrum Geesthacht, Teltow, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Teltow and Berlin, Germany
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Jacobs A, Abou-Dakn M, Becker K, Both D, Gatermann S, Gresens R, Groß M, Jochum F, Kühnert M, Rouw E, Scheele M, Strauss A, Strempel AK, Vetter K, Wöckel A. S3-Guidelines for the Treatment of Inflammatory Breast Disease during the Lactation Period: AWMF Guidelines, Registry No. 015/071 (short version) AWMF Leitlinien-Register Nr. 015/071 (Kurzfassung). Geburtshilfe Frauenheilkd 2013; 73:1202-1208. [PMID: 24771901 DOI: 10.1055/s-0033-1360115] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Breastfeeding is widely acknowledged to be the best and most complete form of nutrition for healthy infants born at term and is associated with numerous benefits in terms of infants' health, growth, immunity and development. However, breastfeeding problems often result in early weaning. Standardized treatment recommendations for breastfeeding-related diseases are necessary to optimize the care offered to breastfeeding women. Evidence and consensus based guidelines for the treatment of puerperal mastitis, sore nipples, engorgement and blocked ducts were developed on the initiative of the National Breastfeeding Committee. These guidelines were developed in accordance with the criteria set up by the Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF), the Association of Scientific Medical Societies in Germany. The recommendations were drawn up by an interdisciplinary group of experts and were based on a systematic search and evaluation of the literature but also took clinical experience into account. Additionally good clinical practice (GCP) in terms of expert opinion was formulated in cases where scientific investigations could not be performed or were not aimed for. This article presents a summary of the recommendations of the S3-guidelines.
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Affiliation(s)
- A Jacobs
- Charité - Universitätsmedizin Berlin, Klinik für Dermatologie, Berlin ; Bundesinstitut für Risikobewertung, Abteilung für Lebensmittelsicherheit, Berlin
| | - M Abou-Dakn
- St. Joseph-Krankenhaus Berlin Tempelhof, Klinik für Geburtshilfe und Gynäkologie, Berlin
| | - K Becker
- Universitätsklinikum Münster, Institut für Medizinische Mikrobiologie, Münster
| | | | - S Gatermann
- Ruhr-Universität Bochum, Institut für Hygiene und Mikrobiologie, Bochum
| | | | - M Groß
- Medizinische Hochschule Hannover, Klinik für Frauenheilkunde und Geburtshilfe, Hannover
| | - F Jochum
- Evangelisches Waldkrankenhaus Spandau, Abteilung für Kinder- und Jugendmedizin, Berlin
| | - M Kühnert
- Universität Gießen-Marburg, Klinik für Geburtshilfe und Perinatalmedizin, Marburg
| | | | | | - A Strauss
- Universitätsklinikum Schleswig-Holstein, Campus Kiel, Klinik für Gynäkologie und Geburtshilfe, Kiel
| | | | | | - A Wöckel
- Universitätsklinikum Ulm, Klinik für Frauenheilkunde und Geburtshilfe, Ulm
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Groß M, Boentert M, Niederstadt T. Eine seltene Ursache von starken Kopfschmerzen und B-Symptomatik in der Notaufnahme. KLIN NEUROPHYSIOL 2013. [DOI: 10.1055/s-0032-1327335] [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: 10/27/2022]
Affiliation(s)
- M. Groß
- Klinik für Neurologie, Universitätsklinikum Münster
| | - M. Boentert
- Klinik für Neurologie, Universitätsklinikum Münster
| | - T. Niederstadt
- Institut für Klinische Radiologie, Universitätsklinikum Münster
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Müller K, Wagner P, Groß M, Kotschy-Lang N. Depression, Angst und körperliche Leistungsfähigkeit bei Patienten mit berufsbedingten Lungen- und Atemwegserkrankungen. Pneumologie 2012. [DOI: 10.1055/s-0032-1302897] [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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22
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Dressler D, Groß M, Kappmeier JP, Kelter T, Kulbatzki J, Plümpe D, Schlechter G, Schmidt M, Skutella M, Temme S. On the use of network flow techniques for assigning evacuees to exits. ACTA ACUST UNITED AC 2010. [DOI: 10.1016/j.proeng.2010.07.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ayerle G, Hecker H, Frömke C, Hillemanns P, Groß M. Zusammenhänge zwischen Anwesenheit der Hebamme, Interventionen und dem Outcome der Geburt. Z Geburtshilfe Neonatol 2008; 212:176-82. [DOI: 10.1055/s-2008-1076979] [Citation(s) in RCA: 2] [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: 10/21/2022]
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Groß M, Nagel S, Schütte W. Chemotherapie des fortgeschrittenen nicht kleinzelligen Bronchialkarzinoms (NSCLC) mit Paclitaxel und Carboplatin: wöchentliche- versus 3-wöchentliche Behandlung. Pneumologie 2008. [DOI: 10.1055/s-2008-1074191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Groß M, Rother M, Scheidt B, Glaser S. Die Anwendung der Kohärenzanalyse für das Schlaf-EEG bei Säuglingen mit unterschiedlichem perinatalen Risiko. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Maier W, Höfgen B, Wagner M, Rietschel M, Groß M, von Widdern O, Zobel A. Genetic Analysis of Neurobiological Indicators of Antidepressant Drug Response. Pharmacopsychiatry 2005. [DOI: 10.1055/s-2005-862671] [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: 10/19/2022]
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Rahe-Meyer N, Winterhalter M, Remmers D, Groß M, Scheinichen D, Zuk J, Leuwer M, Piepenbrock S. Neuentwicklung eines Diagnosegeräts zur Messung komplexer Muskelkontraktionen des Menschen. Anasthesiol Intensivmed Notfallmed Schmerzther 2004. [DOI: 10.1055/s-2004-837338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Kristen P, Groß M, Müller T, Reiners C, Dietl J. Sentinel-node (SLN)-Biopsie beim Mama-Ca: Markiert die subareoläre Injektion gleiche Lymphknoten wie die peritumoröse intradermale Applikation? Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-815231] [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] Open
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31
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Groß M, Rainer I, Tranquillini W. Über die Frostresistenz der Fichte mit besonderer Berücksichtigung der Zahl der Gefrierzyklen und der Geschwindigkeit der Temperaturänderung beim Frieren und Auftauen. ACTA ACUST UNITED AC 1991. [DOI: 10.1007/bf02741255] [Citation(s) in RCA: 19] [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] [Indexed: 11/28/2022]
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Groß M, Richter G. Influence of sugars on blue light-induced synthesis of chlorophyll in cultured plant cells. Plant Cell Rep 1982; 1:288-290. [PMID: 24257778 DOI: 10.1007/bf00272642] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/1982] [Indexed: 06/02/2023]
Abstract
In supension cultured tobacco cells only blue light induces and maintains chlorophyll synthesis if the liquid nutrient medium is supplemented with sucrose. The yield per gram fresh weight is closely correlated with the energy fluence rate of blue light, but not with the initial amount of sucrose added to the medium (3-12 g/l). The uptake of sucrose by the cells proceeds with a constant rate over the growth period independently of the initial amount leading within 10-25 days to sucrose-free media. Under these conditions the cells continue to synthesize chlorophyll for about 10 days. This limitation is overcome by adding sucrose to the medium at equal time intervals thus establishing a constant sugar level beyond the growth period. In contrast, glucose as carbon source cannot adequately replace sucrose in inducing and maintaining blue light-induced chlorophyll synthesis. Depending on the initial amount (3-10 g/l) this sugar is rapidly disappearing from the medium within 1-5 days after inoculation of the cells. It apparently serves as a preferential source of energy and carbon skeletons thus suppressing chlorophyll synthesis. On the other hand, glucose combined with sucrose in the medium brings about the characteristic induction and accumulation of chlorophyll in blue light which is observed with sucrose as the sole carbon source.
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Affiliation(s)
- M Groß
- Institut für Botanik, Universität Hannover, Herrenhäuser Straße 2, D-3000, Hannover, Germany
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