1,243 results on '"Noack, A"'
Search Results
2. Hospital admissions and deaths due to acute cardiovascular events during the COVID-19 pandemic in residents of long-term care facilities
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Paul Gellert, Raphael Kohl, Kathrin Jürchott, Betty Noack, Christian Hering, Annabell Gangnus, Elisabeth Steinhagen-Thiessen, Wolfram J. Herrmann, Adelheid Kuhlmey, and Antje Schwinger
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Medicine ,Science - Abstract
Abstract Hospital admissions due to acute cardiovascular events dropped during the COVID-19 pandemic in the general population; however, evidence for residents of long-term care facilities (LTCF) is sparse. We investigated rates of hospital admissions and deaths due to myocardial infarction (MI) and stroke in LTCF residents during the pandemic. Our nationwide cohort study used claims data. The sample comprised 1,140,139 AOK-ensured LTCF residents over 60 years of age (68.6% women; age 85.3 ± 8.5 years) from the largest statutory health insurance in Germany (AOK), which is not representative for all LTCF residents. We included MI and stroke admission and compared numbers of in-hospital deaths from January 2020 to end of April 2021 (i.e., during the first three waves of the pandemic) with the number of incidences in 2015–2019. To estimate incidence risk ratios (IRR), adjusted Poisson regression analyses were applied. During the observation period (2015–2021), there were 19,196 MI and 73,953 stroke admissions. MI admissions declined in the pandemic phase by 22.5% (IRR = 0.68 [CI 0.65–0.72]) compared to previous years. This decline was slightly more pronounced for NSTEMI than for STEMI. MI fatality risks remained comparable across years (IRR = 0.97 [CI95% 0.92–1.02]). Stroke admissions dropped by 15.1% (IRR = 0.75 [CI95% 0.72–0.78]) in the pandemic. There was an elevated case fatality risk for haemorrhagic stroke (IRR = 1.09 [CI95% 1.03–1.15]) but not for other stroke subtypes compared to previous years. This study provides first evidence of declines in MI and stroke admissions and in-hospital deaths among LTCF residents during the pandemic. The figures are alarming given the acute nature of the conditions and the vulnerability of the residents.
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- 2023
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3. Effect of High BMI on Human Bone Marrow–Derived Mesenchymal Stromal Cells
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Qiang Zong, Katrin Bundkirchen, Claudia Neunaber, and Sandra Noack
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Medicine - Abstract
Bone marrow–derived mesenchymal stromal cells (BMSCs) are attractive candidates in tissue engineering and regenerative medicine. Growing evidence has suggested that a high body mass index (BMI) can affect the properties of BMSCs, resulting in a reduced quality of the cells. However, the results are not consistent. Therefore, this study aimed to investigate the influences of high BMI on human BMSCs (hBMSCs). To avoid gender bias, BMSCs from females and males were studied independently. Finally, hBMSCs from 89 females and 152 males were separately divided into the normal BMI group (18.5 kg/m 2 ≤ BMI < 25 kg/m 2 ) and the high BMI group (BMI > 25 kg/m 2 ). The cells were analyzed for the colony-forming potential; proliferation capacity; in vitro adipogenic, osteogenic, and chondrogenic differentiation potentials; and the expression of 32 common surface antigens. The results showed that high BMI did not change the number of colonies at passage 1 in females and males. In contrast, significantly reduced colony numbers at passage 4 (P4) were found in both female and male donors with high BMI. The doubling time of hBMSCs was comparable between the normal and the high BMI groups of females and males. Furthermore, the results of trilineage differentiation did not differ between the different BMI groups of males. In females, the high and the normal BMI groups also showed similar adipogenic and chondrogenic differentiation, while osteogenic differentiation was significantly enhanced in the high-BMI group. Regarding the expression of surface antigens, the expressions of CD200 and SSEA4 on hBMSCs were reduced in the high-BMI group of females and males, respectively. In conclusion, high BMI suppressed the clonogenicity of female and male hBMSCs at P4, improved the in vitro osteogenesis of female hBMSCs, and decreased the expressions of CD200 on hBMSCs in females and SSEA4 in males.
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- 2024
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4. Exact Gaussian processes for massive datasets via non-stationary sparsity-discovering kernels
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Marcus M. Noack, Harinarayan Krishnan, Mark D. Risser, and Kristofer G. Reyes
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Medicine ,Science - Abstract
Abstract A Gaussian Process (GP) is a prominent mathematical framework for stochastic function approximation in science and engineering applications. Its success is largely attributed to the GP’s analytical tractability, robustness, and natural inclusion of uncertainty quantification. Unfortunately, the use of exact GPs is prohibitively expensive for large datasets due to their unfavorable numerical complexity of $$O(N^3)$$ O ( N 3 ) in computation and $$O(N^2)$$ O ( N 2 ) in storage. All existing methods addressing this issue utilize some form of approximation—usually considering subsets of the full dataset or finding representative pseudo-points that render the covariance matrix well-structured and sparse. These approximate methods can lead to inaccuracies in function approximations and often limit the user’s flexibility in designing expressive kernels. Instead of inducing sparsity via data-point geometry and structure, we propose to take advantage of naturally-occurring sparsity by allowing the kernel to discover—instead of induce—sparse structure. The premise of this paper is that the data sets and physical processes modeled by GPs often exhibit natural or implicit sparsities, but commonly-used kernels do not allow us to exploit such sparsity. The core concept of exact, and at the same time sparse GPs relies on kernel definitions that provide enough flexibility to learn and encode not only non-zero but also zero covariances. This principle of ultra-flexible, compactly-supported, and non-stationary kernels, combined with HPC and constrained optimization, lets us scale exact GPs well beyond 5 million data points.
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- 2023
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5. Predicción de la fuerza de prensión manual a partir de indicadores de salud en escolares
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Jessica Pamela Noack Segovia, Roberto Antonio Fuentealba Leyton, and Eduardo Enrique Guzmán Muñoz
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enfermedad crónica ,fuerza de la mano ,modelos lineales ,niño. ,Medicine ,Medicine (General) ,R5-920 - Abstract
Introducción: El aumento exponencial de sobrepeso/obesidad en adolescentes refleja un incremento en los indicadores de morbimortalidad que se expresan en adultos. Existen indicadores de salud que pueden modificarse para evitar futuras enfermedades. Objetivo: Determinar los indicadores que influyen en la fuerza de prensión manual en estudiantes chilenos. Métodos: Diseño observacional, correlacional. La muestra de estudio correspondió a 217 escolares entre 7 a 14 años y se seleccionó por conveniencia. Las variables independientes fueron edad, sexo, índice de masa corporal, índice cintura estatura, perímetro de cintura. Todas las mediciones y recolección de datos se realizaron en un espacio privado donde se encontraban el evaluador y el evaluado. Con los datos se realizó una regresión lineal para establecer qué indicadores predicen la fuerza de prensión manual. Resultados: 3 modelos de regresión lineal fueron significativos. El primer modelo (R2= 0,72; p= 0,001) incluye las variables índices de masa corporal (p= 0,001), perímetro de cintura (p= 0,001) e índice cintura estatura (p= 0,001) ajustados por sexo (p= 0,022) y edad (p= 0,001). El segundo modelo (R2= 0,64; p= 0,001) considera el índice de masa corporal (p= 0,001), sexo (p= 0,016) y edad (p= 0,001). El tercer modelo (R2= 0,61; p= 0,001) involucra el perímetro de cintura (p= 0,002), sexo (p= 0,046) y edad (p= 0,001). Conclusión: La variable fuerza de prensión manual es explicada en un 72 % por la edad, el sexo, el índice de masa corporal, el perímetro de cintura y la relación cintura estatura.
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- 2023
6. A 19 day earth tide measurement with a MEMS gravimeter
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Abhinav Prasad, Richard P. Middlemiss, Andreas Noack, Kristian Anastasiou, Steven G. Bramsiepe, Karl Toland, Phoebe R. Utting, Douglas J. Paul, and Giles D. Hammond
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Medicine ,Science - Abstract
Abstract The measurement of tiny variations in local gravity enables the observation of subterranean features. Gravimeters have historically been extremely expensive instruments, but usable gravity measurements have recently been conducted using MEMS (microelectromechanical systems) sensors. Such sensors are cheap to produce, since they rely on the same fabrication techniques used to produce mobile phone accelerometers. A significant challenge in the development of MEMS gravimeters is maintaining stability over long time periods, which is essential for long term monitoring applications. A standard way to demonstrate gravimeter stability and sensitivity is to measure the periodic elastic distortion of the Earth due to tidal forces—the Earth tides. Here, a 19 day measurement of the Earth tides, with a correlation coefficient to the theoretical signal of 0.975, has been presented. This result demonstrates that this MEMS gravimeter is capable of conducting long-term time-lapse gravimetry, a functionality essential for applications such as volcanology.
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- 2022
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7. Overcoming Language Barriers in Paramedic Care With an App Designed to Improve Communication With Foreign-Language Patients: Nonrandomized Controlled Pilot Study
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Frank Müller, Dominik Schröder, and Eva Maria Noack
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Medicine - Abstract
BackgroundCommunication across language barriers is a particular challenge for health care providers. In emergency medical services, interpreters are mostly not available on rescue scenes, which jeopardizes safe and high-quality medical care. In a cocreative process together with paramedics and software designers, we developed a fixed-phrase translation app with 600 phrases and 18 supported languages that supports paramedics when providing care to foreign-language patients. This paper reports on the results of a pilot study to evaluate the app’s effect on paramedic-patient communication. ObjectiveThis study aims to gain insights into the efficacy and feasibility of a multilingual app that helps paramedics to communicate with patients who are not proficient in the local language. MethodsA 3-armed nonrandomized interventional pilot study was conducted in 4 rescue stations in the German Federal State of Lower Saxony: 3 rural areas and 1 in urban environment. The intervention group comprised rescue missions with patients with limited German language proficiency (LGP) with whom the app was used; control group 1 comprised LGP patients without app usage; and control group 2 consisted of rescue missions with German-speaking patients. For each rescue operation with LGP patients, paramedics filled out questionnaires about the communications with patients. From standardized Rescue Service Case Protocols, we extracted information on patient demographics (age and sex), clinical aspects (preliminary diagnosis and Glasgow Coma Scale), and rescue operation characteristics (time spent on emergency scene and additional dispatch of emergency physicians). The primary outcome was the paramedics’ perceived quality of communication with LGP patients. The secondary outcome was the ability to obtain necessary information from patients and the ability to provide important information to patients. A linear regression model was applied to assess the impact of the app on perceived communication, controlling demographic factors, and severity of illness. ResultsA total of 22 LGP patients were recruited into the intervention group and 122 into control group 1. The control group 2 included 27,212 German-speaking patients. LGP patients were more than 2 decades younger than German-speaking patients. App usage among LGP patients was associated with higher perceived overall quality of communication (0.7 points on a 5-point Likert scale, P=.03). Applying a linear regression model controlling for age, sex, and Glasgow Coma Scale, the quality of communication was associated with an increase of 0.9 points (95% CI 0.2-1.6, P=.01). Compared to either German-speaking patients or LGP patients, paramedics spent 6-7 minutes longer on an emergency scene when the app was used (P=.24). ConclusionsThe use of the app suggests a relevant improvement in communication with patients with limited proficiency in the locally spoken language in paramedic care. The small sample size and the lack of randomization reduce the generalizability of the findings. Trial RegistrationGerman Clinical Trials Register DRKS00016719; https://drks.de/search/de/trial/DRKS00016719
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- 2023
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8. Synoviocytes from pigmented villonodular synovitis are less sensitive to cadmium-induced cell death than synoviocytes from rheumatoid arthritis
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Héléna Farese, Mélissa Noack, and Pierre Miossec
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Medicine ,Science - Abstract
Abstract Pigmented villonodular synovitis (PVNS) is a rare inflammatory articular disease sharing common characteristics with rheumatoid arthritis (RA), notably hyperplasia of the synovium due to a hyperproliferation of synoviocytes, and with cancer owing to mutations of the CSF1/M-CCSF gene. Targeting synovium hyperplasia by the local delivery of Cadmium (Cd) has been already tested in vitro and in vivo models of RA and could be applied to PVNS. PVNS and RA synoviocytes were exposed to low doses of Cd. After different culture time points, a qualitative analysis was done by microscopy and quantitative measurements of apoptosis, cell viability and IL-6 production were carried. IL-6 production by PVNS synovial tissue was also quantified after Cd treatment with or without the presence of pro-inflammatory cytokines (IL-17 + TNF). Addition of Cd induced cell death in both PVNS (1 ppm) and RA (0.1 ppm) synoviocytes, which increased with time and Cd concentrations. Cd increased the percentage of apoptotic cells and decreased cell viability and IL-6 production. In all these experiments, PVNS synoviocytes were tenfold less sensitive to Cd than RA synoviocytes. Cd decreased IL-6 production by PVNS synovial tissue and its effect was enhanced with pro-inflammatory cytokines. In summary, PVNS synoviocytes show resistance to Cd-induced cell death and decreased inflammation. Intra-articular use of Cd could represent a potential therapeutic tool in PVNS.
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- 2022
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9. Care need and dry mouth as risk indicators for impaired taste and smell
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Mara-Zoe Hummelsheim, Stefanie Hamacher, Anna Hagemeier, Michael Johannes Noack, and Anna Greta Barbe
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Medicine ,Science - Abstract
Abstract To identify whether reduced saliva secretion or xerostomia symptoms are risk indicators for impaired taste and smell, depending on age and care needs. This cross-sectional study evaluated taste and smell in patients categorized into different age groups ( years) and different care need, with and without dry mouth. Of the 185 patients included, 119 were classified as “dry mouth” and 66 as “without dry mouth”. Overall, 103 (55.7%) were female and 37 (20%) needed care. There was no difference between “dry mouth” and “without dry mouth” regarding identification of odors or tastes, but a difference in the number of correctly identified odors and tastes in favor of “without care need” patients (p
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- 2021
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10. Reaction mechanism of the farnesyl pyrophosphate C-methyltransferase towards the biosynthesis of pre-sodorifen pyrophosphate by Serratia plymuthica 4Rx13
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Marie Chantal Lemfack, Wolfgang Brandt, Katja Krüger, Alexandra Gurowietz, Jacky Djifack, Jan-Philip Jung, Marius Hopf, Heiko Noack, Björn Junker, Stephan von Reuß, and Birgit Piechulla
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Medicine ,Science - Abstract
Abstract Classical terpenoid biosynthesis involves the cyclization of the linear prenyl pyrophosphate precursors geranyl-, farnesyl-, or geranylgeranyl pyrophosphate (GPP, FPP, GGPP) and their isomers, to produce a huge number of natural compounds. Recently, it was shown for the first time that the biosynthesis of the unique homo-sesquiterpene sodorifen by Serratia plymuthica 4Rx13 involves a methylated and cyclized intermediate as the substrate of the sodorifen synthase. To further support the proposed biosynthetic pathway, we now identified the cyclic prenyl pyrophosphate intermediate pre-sodorifen pyrophosphate (PSPP). Its absolute configuration (6R,7S,9S) was determined by comparison of calculated and experimental CD-spectra of its hydrolysis product and matches with those predicted by semi-empirical quantum calculations of the reaction mechanism. In silico modeling of the reaction mechanism of the FPP C-methyltransferase (FPPMT) revealed a SN2 mechanism for the methyl transfer followed by a cyclization cascade. The cyclization of FPP to PSPP is guided by a catalytic dyad of H191 and Y39 and involves an unprecedented cyclopropyl intermediate. W46, W306, F56, and L239 form the hydrophobic binding pocket and E42 and H45 complex a magnesium cation that interacts with the diphosphate moiety of FPP. Six additional amino acids turned out to be essential for product formation and the importance of these amino acids was subsequently confirmed by site-directed mutagenesis. Our results reveal the reaction mechanism involved in methyltransferase-catalyzed cyclization and demonstrate that this coupling of C-methylation and cyclization of FPP by the FPPMT represents an alternative route of terpene biosynthesis that could increase the terpenoid diversity and structural space.
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- 2021
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11. Potassium ion channels in Camphenol Plus-induced arterial smooth muscle contractile dynamics
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Oscar Rodríguez-Reyes, Robert Patejdl, Thomas K. Noack, and Ana Ibis Bosch-Nuñez
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músculo liso vascular ,tensión muscular ,vasodilatación ,baño de órganos ,medicación intracanal ,iones potasio ,Medicine - Abstract
Introduction: Camphenol Plus is a chlorophenolic derivative commonly used as an intra – duct medication for pulporadicular treatments in Dentistry. Scientific reports about the use of this medication on the role of potassium ion channels in the contractile dynamics of induced arterial smooth muscle are low. Objective: to determine the role of potassium ion channels in the contractile dynamics of Camphenol Plus - induced arterial smooth muscle. Method: a preclinical experimental investigation was performed at the "Oscar Langerdorff" Institute of Physiology, Rostock University Medical Center, Rostock, Germany, between October and December 2018. A total of 30 aortic rings obtained from 10 Wistar rats (n=10) were used. The biological preparations were placed in an organ bath and preactivated with Krebs solution concentrated in potassium ions, afterwards it was recorded the tension developed by the vascular smooth muscle after applying the Camphenol Plus solutions in different time intervals. The Mann-Whitney U test and Wilcoxon test were applied. Results: the 31.4% of vascular smooth muscle was relaxed by the effect of Camphenol Plus after preactivation with Krebs solution concentrated in potassium ions. The greatest decrease in vascular tone occurred between the first and third minutes after the use of the drug solutions prepared at 7 %. Conclusions: the in vitro vasorelaxant effect produced by the Camphenol Plus medication on arterial smooth muscle is mediated by the potassium ion channels sensitive to voltage, calcium and the adenosine triphosphate of the vascular endothelium and sarcolemma.
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- 2022
12. Interprofessional evidence-based counselling programme for complementary and integrative healthcare in patients with cancer: study protocol for the controlled implementation study CCC-Integrativ
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Peter Martus, F Rapp, Hartmut Bertz, A Schmitt, M Hoffmann, B Stein, E Winkler, Stefanie Joos, Barbara Grün, M Wensing, M Reuter, K Muller, J Szecsenyi, A Kestler, Jan Valentini, Daniela Fröhlich, Regina Stolz, Cornelia Mahler, Nadja Klafke, Markus Horneber, Jona Frasch, Klaus Kramer, Katrin Tomaschko-Ubeländer, B Kröger, B Noack, B Wattenberg, E Kaschdailewitsch, H Mauch, K Gauß, K Harder, L Lohmüller, A Seckinger, D Zips, M Busacker-Scharpff, M Krug, S Eismann, B Leicht, C Nagat, C Raff, K Kraus, W Kmietschak, A Battran, A Frohn, B Held, C Perinchery, C Pfister-Jimenéz, H Dürsch, J Bossert, A Kaltenbach, U Boltenhagen, A Behzad, A Leppert, B Broge, C Witte, S Treffert, and AOK Baden-Württemberg
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Medicine - Published
- 2022
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13. Interdisciplinary assessment and management of a patient with a fibrous gingival enlargement of unknown origin: A case report
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Anna Greta Barbe, Gabriele Röhrig, Lena Hieggelke, Michael Johannes Noack, and Sonja Henny Maria Derman
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alpha thalassemia ,folic acid ,gingival enlargement ,plasma cell gingivitis ,sickle cell anemia ,Medicine ,Medicine (General) ,R5-920 - Abstract
Abstract A gingival enlargement of unclear cause could only be diagnosed after interdisciplinary cooperation as plasma cell gingivitis of unknown origin. Interdisciplinary approaches remain crucial when diagnosing rare gum diseases.
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- 2020
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14. Cortisol response under low intensity exercise during cognitive-behavioral therapy is associated with therapeutic outcome in panic disorder-an exploratory study.
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Gloria-Beatrice Wintermann, René Noack, Susann Steudte-Schmiedgen, and Kerstin Weidner
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Medicine ,Science - Abstract
ObjectivesPatients with Panic Disorder (PD) show an abnormal stress-induced functioning of the Hypothalamic-Pituitary-adrenal (HPA)-axis. Different protocols for stress induction are of rather low relevance for the psychotherapeutic treatment. In practice, interoceptive exposure is often realized as Low Intensity Exercise (LIE), as compared to an incremental cycle exercise test to exhaustion. Currently, it is not known, whether LIE displays an effective interoceptive stressor 1.) leading to a significant anxiety induction; 2.) a comparable HPA- and Sympathetic-Adreno-Medullar (SAM)-axis response in both patients and healthy controls; 3.) stress responses under LIE are associated with treatment outcomes.Patients and methodsN = 20 patients with PD and n = 20 healthy controls were exposed to ten minutes of LIE on an exercise bike. LIE was applied as part of the interoceptive exposure, during an intensive Cognitive-Behavioral Therapy (CBT) in a day clinic. Heart rate was monitored and salivary cortisol samples collected. Before and after the LIE, state anxiety/ arousal were assessed. In order to evaluate psychopathology, the Panic and Agoraphobia Scale, Mobility Inventory, Agoraphobic Cognitions Questionnaire and Body Sensations Questionnaire were applied, before (T1) and after five weeks (T2) of an intensive CBT.ResultsLIE led to a significant and similar heart rate increase in both groups. Cortisol decreased over time in both groups, especially in male patients. A higher psychopathology before, and after CBT, was associated with a significantly lower cortisol response under LIE.ConclusionsIn the present study, LIE led to a divergent stress response: while there was a significant heart rate increase, cortisol decreased over time, particularly in male patients. A lower reactivity of the HPA-axis seems to be associated with a lower treatment outcome, which may affect extinction based learning. The findings suggest, that interoceptive stimuli should be designed carefully in order to be potent stressors.
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- 2022
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15. Camphorated p-chlorophenol-induced contractile dynamics in aortic rings of Wistar rats
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Oscar Rodríguez-Reyes, Robert Patejdl, Thomas Noack, Ana Ibis Bosch-Nuñez, and Liset María García-Riza
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músculo liso vascular ,tensión muscular ,vasodilatación ,baño de órganos ,medicación intracanal ,p-clorofenol alcanforado ,Medicine - Abstract
Introduction: camphorated p-chlorophenol is a chlorophenolic derivative commonly used as an intra-oral medication in endodontics. Scientific reports on its effects in arterial vascular smooth muscle and local blood flow regulation are scarce. Objective: to determine the effect of camphorated p-chlorophenol on the contractile dynamics of arterial vascular smooth muscle. Method: an experimental and preclinical research was conducted with the use of 14 aortic rings of Wistar rats. The rings were placed in an organ bath and preactivated with noradrenaline, and the tension developed by the vascular smooth muscle at different time intervals was recorded after induction of camphorated p-chlorophenol. Results: most of the vascular smooth muscle (51.4%) relaxed with the use of camphorated p-chlorophenol. The greatest decrease in vascular tone occurred between the third and fifth minute after use the drug. Wilcoxon rank tests showed significant differences between tension observed at baseline and those recorded at the different time intervals studied. Conclusions: camphorated p-chlorophenol, induces in vitro, relax the arterial smooth muscle through a pharmacomechanical excitation-contraction link, which increases according to the time.
- Published
- 2021
16. Retrospective investigation of organization and examination results of the state examination in restorative dentistry, endodontology and periodontology under simulated conditions in times of Covid-19 compared to standard conditions when treating patients
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Wicht, Michael J., Höfer, Karolin, Derman, Sonja H. M., Noack, M. J., and Barbe, A. Greta
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state examination ,covid-19 ,dentistry ,simulated treatment ,Special aspects of education ,LC8-6691 ,Medicine - Abstract
Objective: Primary outcome of this retrospective study was the comparison of state examination results under simulated treatment conditions in times of Covid-19 versus patient treatment under non-pandemic conditions. Additionally, correlation analysis was performed between students’ self- and examiners’ assessment of the treatment results.Methods: Within 4 hours, 22 examinees each had to place a multi-surface adhesive anterior and posterior restoration, performed an endodontic treatment on a maxillary premolar and a periodontal debridement of one quadrant. All treatments were performed on a model fixed in a phantom head. Compliance with the prescribed hygiene and social distancing guidelines and self-assessment of the practical performance was part of the practical examination as well. One examiner per examination part evaluated anonymously the final results. The historical control was based on the exam results of a cohort from 2019. Mean values (standard deviation), non-parametric correlations (Spearman's Rho) and group comparisons (Mann-Whitney) were calculated for statistical analysis.Results: Examination results under simulated treatment conditions were significantly worse (p
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- 2020
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17. A Multilingual App for Providing Information to SARS-CoV-2 Vaccination Candidates with Limited Language Proficiency: Development and Pilot
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Eva Maria Noack, Jennifer Schäning, and Frank Müller
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language barriers ,limited language proficiency ,migrants ,health equity ,vaccine hesitancy ,SARS-CoV-2 pandemic ,Medicine - Abstract
Language barriers are obstacles in receiving vaccinations against COVID-19. They jeopardize informed consent, vaccination safety, and a positive immunization experience. We have developed a multilingual app to overcome language barriers when dealing with vaccination candidates with a limited proficiency in the locally spoken language. We applied the Spiral Technology Action Research (STAR) model to create the app within a discursive process involving healthcare professionals (HCPs) from vaccination sites, literature searches and guidelines, and field trials at vaccination centers. In a real-world pilot test, we assessed the usability and feedback for further improvement. Our efforts resulted in an app that facilitates communication with vaccination candidates in 40 languages, each with over 500 phrases that can be played back or displayed as text. In the pilot test, the app demonstrated its usability, and was well accepted by the vaccination candidates (n = 20). The app was mainly used to inform about the risks and benefits of the SARS-CoV-2 vaccination. Some HCPs struggled to navigate the comprehensive content and the pilot test exposed the need for additional phrases. The STAR model proved to be flexible in adapting to dynamic pandemic conditions and changing recommendations. This multilingual app overcomes language barriers in healthcare settings, promoting vaccines to migrants with limited language proficiency.
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- 2022
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18. Typhus Group Rickettsiosis, Germany, 2010–2017
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Jessica Rauch, Philip Eisermann, Bernd Noack, Ute Mehlhoop, Birgit Muntau, Johannes Schäfer, and Dennis Tappe
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Rickettsia typhi ,Rickettsia prowazekii ,murine typhus ,epidemic typhus ,travel ,PCR ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
Typhus group rickettsiosis is caused by the vectorborne bacteria Rickettsia typhi and R. prowazekii. R. typhi, which causes murine typhus, the less severe endemic form of typhus, is transmitted by fleas; R. prowazekii, which causes the severe epidemic form of typhus, is transmitted by body lice. To examine the immunology of human infection with typhus group rickettsiae, we retrospectively reviewed clinical signs and symptoms, laboratory changes, and travel destinations of 28 patients who had typhus group rickettsiosis diagnosed by the German Reference Center for Tropical Pathogens, Hamburg, Germany, during 2010–2017. Immunofluorescence assays of follow-up serum samples indicated simultaneous seroconversion of IgM, IgA, and IgG or concurrence in the first serum sample. Cytokine levels peaked during the second week of infection, coinciding with organ dysfunction and seroconversion. For 3 patients, R. typhi was detected by species-specific nested quantitative PCR. For all 28 patients, R. typhi was the most likely causative pathogen.
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- 2018
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19. New Lineage of Lassa Virus, Togo, 2016
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Shannon L.M. Whitmer, Thomas Strecker, Daniel Cadar, Hans-Peter Dienes, Kelly Faber, Ketan Patel, Shelley M. Brown, William G. Davis, John D. Klena, Pierre E. Rollin, Jonas Schmidt-Chanasit, Elisabeth Fichet-Calvet, Bernd Noack, Petra Emmerich, Toni Rieger, Svenja Wolff, Sarah Katharina Fehling, Markus Eickmann, Jan Philipp Mengel, Tilman Schultze, Torsten Hain, William Ampofo, Kofi Bonney, Juliana Naa Dedei Aryeequaye, Bruce Ribner, Jay B. Varkey, Aneesh K. Mehta, G. Marshall Lyon, Gerrit Kann, Philipp De Leuw, Gundolf Schuettfort, Christoph Stephan, Ulrike Wieland, Jochen W.U. Fries, Matthias Kochanek, Colleen S. Kraft, Timo Wolf, Stuart T. Nichol, Stephan Becker, Ute Ströher, and Stephan Günther
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Lassa fever ,Lassa virus ,arenaviruses Old World ,viral hemorrhagic fever ,Togo ,viruses ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
We describe a strain of Lassa virus representing a putative new lineage that was isolated from a cluster of human infections with an epidemiologic link to Togo. This finding extends the known range of Lassa virus to Togo.
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- 2018
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20. Electrical brain stimulation induces dendritic stripping but improves survival of silent neurons after optic nerve damage
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Petra Henrich-Noack, Elena G. Sergeeva, Torben Eber, Qing You, Nadine Voigt, Jürgen Köhler, Sebastian Wagner, Stefanie Lazik, Christian Mawrin, Guihua Xu, Sayantan Biswas, Bernhard A. Sabel, and Christopher Kai-Shun Leung
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Medicine ,Science - Abstract
Abstract Repetitive transorbital alternating current stimulation (rtACS) improves vision in patients with chronic visual impairments and an acute treatment increased survival of retinal neurons after optic nerve crush (ONC) in rodent models of visual system injury. However, despite this protection no functional recovery could be detected in rats, which was interpreted as evidence of “silent survivor” cells. We now analysed the mechanisms underlying this “silent survival” effect. Using in vivo microscopy of the retina we investigated the survival and morphology of fluorescent neurons before and after ONC in animals receiving rtACS or sham treatment. One week after the crush, more neurons survived in the rtACS-treated group compared to sham-treated controls. In vivo imaging further revealed that in the initial post-ONC period, rtACS induced dendritic pruning in surviving neurons. In contrast, dendrites in untreated retinae degenerated slowly after the axonal trauma and neurons died. The complete loss of visual evoked potentials supports the hypothesis that cell signalling is abolished in the surviving neurons. Despite this evidence of “silencing”, intracellular free calcium imaging showed that the cells were still viable. We propose that early after trauma, complete dendritic stripping following rtACS protects neurons from excitotoxic cell death by silencing them.
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- 2017
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21. Long-term survival after coronary bypass surgery with multiple versus single arterial grafts
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Syntax Extended Survival Investigators, Daniel J F M Thuijs, Piroze M. Davierwala, Thilo Noack, Michael J. Mack, David R. Holmes, Friedrich-Wilhelm Mohr, Milan Milojevic, Marie-Claude Morice, Niels J. Verberkmoes, A. Pieter Kappetein, Salil V. Deo, Stuart J. Head, Patrick W. Serruys, L Elisabeth G E Ståhle, and Cardiothoracic Surgery
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Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Coronary Artery Disease ,Lower risk ,Coronary artery disease ,Percutaneous Coronary Intervention ,SDG 3 - Good Health and Well-being ,Internal medicine ,Post-hoc analysis ,medicine ,Humans ,Registries ,Vascular Diseases ,Coronary Artery Bypass ,business.industry ,Proportional hazards model ,Hazard ratio ,General Medicine ,medicine.disease ,Confidence interval ,Treatment Outcome ,Bypass surgery ,Propensity score matching ,Cardiology ,Surgery ,Cardiology and Cardiovascular Medicine ,business - Abstract
OBJECTIVES This study sought to evaluate the long-term differences in survival between multiple arterial grafts (MAG) and single arterial grafts (SAG) in patients who underwent coronary artery bypass grafting (CABG) in the SYNTAX study. METHODS The present analysis included the randomized and registry-treated CABG patients (n = 1509) from the SYNTAX Extended Survival study (SYNTAXES). Patients with only venous (n = 42) or synthetic grafts (n = 1) were excluded. The primary end point was all-cause death at the longest follow-up. Multivariable Cox regression was used to adjust for differences in baseline characteristics. Sensitivity analysis using propensity matching with inverse probability for treatment weights was performed. RESULTS Of the 1466 included patients, 465 (31.7%) received MAG and 1001 (68.3%) SAG. Patients receiving MAG were younger and at lower risk. At the longest follow-up of 12.6 years, all-cause death occurred in 23.6% of MAG and 40.0% of SAG patients [adjusted hazard ratio (HR) 0.74, 95% confidence interval (CI) (0.55–0.98); P = 0.038], which was confirmed by sensitivity analysis. MAG in patients with the three-vessel disease was associated with significant lower unadjusted and adjusted all-cause death at 12.6 years [adjusted HR 0.65, 95% CI (0.44–0.97); P = 0.033]. In contrast, no significance was observed after risk adjustment in patients with the left main disease, with and without diabetes, or among SYNTAX score tertiles. CONCLUSIONS In the present post hoc analysis of all-comers patients from the SYNTAX trial, MAG resulted in markedly lower all-cause death at 12.6-year follow-up compared to a SAG strategy. Hence, this striking long-term survival benefit of MAG over SAG encourages more extensive use of multiple arterial grafting in selected patients with reasonable life expectancy. Trial registration SYNTAXES ClinicalTrials.gov reference: NCT03417050; SYNTAX ClinicalTrials.gov reference: NCT00114972.
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- 2022
22. Manta versus Perclose ProGlide vascular closure device after transcatheter aortic valve implantation: Initial experience from a large European center
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Nicolas Majunke, Holger Thiele, Thilo Noack, David Holzhey, Philipp Kiefer, Johannes Wilde, Sergey Leontyev, Mitsunobu Kitamura, Marcus Sandri, Phillip Hartung, Lisa Crusius, Steffen Desch, Anna Haag, Oliver Dumpies, Michael A. Borger, and Mohamed Abdel-Wahab
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Severe bleeding ,endocrine system ,medicine.medical_specialty ,Transcatheter aortic ,Hemostatic Techniques ,business.industry ,Hemorrhage ,Aortic Valve Stenosis ,General Medicine ,Odds ratio ,Independent predictor ,Confidence interval ,Surgery ,Femoral Artery ,Transcatheter Aortic Valve Replacement ,Treatment Outcome ,Aortic Valve ,Cohort ,Access site ,Humans ,Medicine ,Vascular closure device ,Cardiology and Cardiovascular Medicine ,business ,Vascular Closure Devices - Abstract
Background Vascular and bleeding complications are common after transcatheter aortic valve implantation (TAVI) and are associated with worse outcomes. The plug-based Manta (M) vascular closure device (VCD) is a novel option to achieve haemostasis for large-bore arterial access sites. Objective We aimed to compare vascular and bleeding complications between the M-VCD and the established suture-based Perclose ProGlide (P)-VCD. Methods From February to September 2019 a total of 578 patients underwent transfemoral TAVI at a single high-volume centre. Access site closure was performed using M-VCD in 195 patients (33.7%) and P-VCD in 383 patients (66.3%). We assessed vascular and access site-related complications as well as bleeding events according to the Valve Academic Research Consortium-2 definition. Results Overall vascular complications occurred less frequently in the M-VCD group (10.7% vs. 19.0%, p = 0.011) driven by a significantly lower rate of major vascular events (2.0% vs. 6.5%, p = 0.025). Access site-related complications were significantly less frequent in the M-VCD cohort (10.7% vs. 16.6%, p = 0.048). The M-VCD was associated with significantly lower rates of major (0.5% vs. 4.4%, p = 0.009) and life-threatening bleeding (0% vs. 2.3%, p = 0.032). In multivariable analysis, the use of M-VCD was the only independent predictor of vascular complications (odds ratio 0.54, 95% confidence interval 0.32–0.91, p = 0.022). Conclusions The M-VCD was associated with a reduction of vascular and access-site complications as well as severe bleeding after transfemoral TAVI compared to the P-VCD in this observational study.
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- 2022
23. Combined cCTA and TAVR Planning for Ruling Out Significant CAD
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Matthias Horn, Matthias Gutberlet, Christoph Panknin, Christian Lücke, David Holzhey, Steffen Desch, Sebastian Ebel, Johannes Wilde, Christian Krieghoff, Mohamed Abdel-Wahab, Konrad Pawelka, Philipp Lauten, Patrick Seitz, Michael A. Borger, Katharina Renatus, Philipp Kiefer, Linda Heiser, Sebastian Gottschling, Holger Thiele, Thilo Noack, Robin Gohmann, and Nicolas Majunke
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Coronary angiography ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Computed tomography ,Diagnostic accuracy ,Coronary ct angiography ,Fractional flow reserve ,medicine.disease ,Coronary artery disease ,medicine ,Radiology, Nuclear Medicine and imaging ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objectives To analyze the ability of machine-learning (ML)-based computed tomography (CT)-derived fractional flow reserve (CT-FFR) to further improve the diagnostic performance of coronary...
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- 2022
24. Comparison of a Pure Plug-Based Versus a Primary Suture-Based Vascular Closure Device Strategy for Transfemoral Transcatheter Aortic Valve Replacement: The CHOICE-CLOSURE Randomized Clinical Trial
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Nicolas Majunke, Choice-Closure Investigators, Peter Boekstegers, Marcus Sandri, Ralf Müller, Sven Hohenstein, Holger Thiele, David Holzhey, Thilo Noack, Danilo Obradovic, Anne-Kathrin Funkat, Johannes Wilde, Philipp Hartung, Philipp Kiefer, Mohamed Abdel-Wahab, Mitsunobu Kitamura, Sergey Leontyev, Marc Vorpahl, Steffen Desch, Melchior Seyfarth, Oliver Dumpies, Michael A. Borger, and Johannes Rotta Detto Loria
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Male ,medicine.medical_specialty ,Percutaneous ,medicine.medical_treatment ,Hemorrhage ,law.invention ,Transcatheter Aortic Valve Replacement ,Valve replacement ,Suture (anatomy) ,Randomized controlled trial ,law ,Physiology (medical) ,medicine ,Clinical endpoint ,Humans ,Vascular closure device ,Aged ,Aged, 80 and over ,Peripheral Vascular Diseases ,Hemostasis ,Sutures ,business.industry ,Vascular disease ,Aortic Valve Stenosis ,medicine.disease ,Surgery ,Femoral Artery ,Catheter ,Treatment Outcome ,Aortic Valve ,Cardiology and Cardiovascular Medicine ,business ,Vascular Closure Devices - Abstract
Background: Transcatheter aortic valve replacement is an established treatment option for patients with severe symptomatic aortic stenosis and is most commonly performed through the transfemoral access route. Percutaneous access site closure can be achieved using dedicated plug-based or suture-based vascular closure device (VCD) strategies, but randomized comparative studies are scarce. Methods: The CHOICE-CLOSURE trial (Randomized Comparison of Catheter-based Strategies for Interventional Access Site Closure during Transfemoral Transcatheter Aortic Valve Implantation) is an investigator-initiated, multicenter study, in which patients undergoing transfemoral transcatheter aortic valve replacement were randomly assigned to vascular access site closure using either a pure plug-based technique (MANTA, Teleflex) with no additional VCDs or a primary suture-based technique (ProGlide, Abbott Vascular) potentially complemented by a small plug. The primary end point consisted of access site– or access-related major and minor vascular complications during index hospitalization, defined according to the Valve Academic Research Consortium-2 criteria. Secondary end points included the rate of access site– or access-related bleeding, VCD failure, and time to hemostasis. Results: A total of 516 patients were included and randomly assigned. The mean age of the study population was 80.5±6.1 years, 55.4% were male, 7.6% of patients had peripheral vascular disease, and the mean Society of Thoracic Surgeons score was 4.1±2.9%. The primary end point occurred in 19.4% (50/258) of the pure plug-based group and 12.0% (31/258) of the primary suture-based group (relative risk, 1.61 [95% CI, 1.07–2.44], P =0.029). Access site– or access-related bleeding occurred in 11.6% versus 7.4% (relative risk, 1.58 [95%CI: 0.91–2.73], P =0.133) and device failure in 4.7% versus 5.4% (relative risk, 0.86, [95% CI, 0.40–1.82], P =0.841) in the respective groups. Time to hemostasis was significantly shorter in the pure plug-based group (80 [32–180] versus 240 [174–316] seconds, P Conclusions: Among patients treated with transfemoral transcatheter aortic valve replacement, a pure plug-based vascular closure technique using the MANTA VCD is associated with a higher rate of access site– or access-related vascular complications but a shorter time to hemostasis compared with a primary suture-based technique using the ProGlide VCD. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT04459208.
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- 2022
25. Internationale Konsenserklärung zu Screening, Diagnostik und Behandlung von Jugendlichen und Heranwachsenden mit Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung und gleichzeitigen Störungen durch Substanzgebrauch
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Franz Moggi, Sharon Rabinovitz, Søren Dalsgaard, Wim van den Brink, Ortal Slobodin, Rainer Thomasius, Stephen V. Faraone, Marianne Post, Michiel W van Kernebeek, Florence Vorspan, Falk Kiefer, John Kasinathan, Mathias Luderer, J Antoni Ramos-Quiroga, Wouter G. Staal, Máté Kapitány-Fövény, María C. Vélez-Pastrana, Annabeth P. Groenman, Csaba Barta, Miguel Casas, Renske Spijkerman, Rafael A. González, Gergely Mészáros, Brian Johnson, Heval Ozgen, Michael Kaess, Abu Shafi, Geert Dom, Tobias Banaschewski, Johan Franck, Ilse Truter, Constanza Daigre Blanco, Sabine Vollstädt-Klein, Martin Holtmann, Sharlene Kaye, Giovanni Martinotti, Vincent M. Hendriks, Jesse T Young, Frieda Matthys, Ashmita P Munasur-Naidoo, Arnt S A Schellekens, Alex Begeman, Lara Grau-López, Cleo L. Crunelle, Maija Konstenius, Zsolt Demetrovics, Valsamma Eapen, Moritz Noack, Romain Icick, Amy Yule, Geurt van de Glind, Regina Sala, Malin Hemphälä, Jacomine den Boer, and Frances R. Levin
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,media_common.quotation_subject ,Psychological intervention ,General Medicine ,Abstinence ,medicine.disease ,law.invention ,Cognitive behavioral therapy ,Substance abuse ,Psychiatry and Mental health ,Clinical Psychology ,Randomized controlled trial ,law ,Pediatrics, Perinatology and Child Health ,medicine ,Attention deficit hyperactivity disorder ,Risk factor ,Psychiatry ,business ,Psychosocial ,media_common - Abstract
Zusammenfassung. Hintergrund: Eine Aufmerksamkeitsdefizit-/Hyperaktivitätsstörung (ADHS) im Kindesalter stellt einen Risikofaktor für Substanzmissbrauch und Störungen durch Substanzgebrauch (Substance Use Disorder, SUD) in der Pubertät und dem (frühen) Erwachsenenalter dar. ADHS und SUD treten auch häufig bei therapiesuchenden Jugendlichen auf, was die Diagnosestellung und Therapie erschwert sowie mit schlechten Behandlungsergebnissen verbunden ist. Forschungsergebnisse über die Wirkung der Behandlung von ADHS im Kindesalter auf die Prävention von SUD im Jugendalter sind nicht eindeutig und Studien über die Diagnose und Behandlung von Jugendlichen mit ADHS und SUD sind selten. Daher reicht die verfügbare Evidenz allgemein nicht aus, um starke Behandlungsempfehlungen zu rechtfertigen. Fragestellung: Ziel dieser Arbeit war es, eine Konsenserklärung auf der Grundlage von wissenschaftlichen Daten und klinischen Erfahrungen zu erhalten. Methodik: Es wurde eine modifizierte Delphi-Studie durchgeführt, um basierend auf der Kombination von wissenschaftlichen Daten und klinischer Erfahrung mit einer multidisziplinären Gruppe von 55 Expert_innen aus 17 Ländern einen Konsens zu erzielen. Die Expert_innen wurden gebeten, eine Reihe von Aussagen über die Wirkung der Behandlung von ADHS im Kindesalter auf die SUD bei Jugendlichen sowie über das Screening, die Diagnostik und die Behandlung von Jugendlichen mit komorbidem ADHS und SUD zu bewerten. Ergebnisse: Nach drei iterativen Bewertungsrunden und der Anpassung von 37 Aussagen wurde ein Konsens über 36 dieser Aussagen erzielt, die sechs Bereiche repräsentieren: allgemein ( n = 4), Risiko der Entwicklung einer SUD ( n = 3), Screening und Diagnostik ( n = 7), psychosoziale Behandlung ( n = 5), pharmakologische Behandlung ( n = 11) und komplementäre Behandlungen ( n = 7). Der Einsatz von Routinescreenings auf ADHS wird bei adoleszenten Patient_innen in einer Suchtbehandlung ebenso wie Routinescreenings auf SUD bei jugendlichen Patient_innen mit ADHS in allgemeinpsychiatrischen Therapiesettings empfohlen. Langwirksame Stimulanzien werden als Behandlung der ersten Wahl von ADHS bei Jugendlichen mit gleichzeitiger ADHS und SUD empfohlen. Die Pharmakotherapie sollte vorzugsweise in psychosoziale Behandlung eingebettet werden. Die einzige nichtkonsentierte Aussage betraf die Notwendigkeit von Abstinenz vor Beginn einer pharmakologischen Behandlung bei Jugendlichen mit ADHS und gleichzeitigem SUD. Im Gegensatz zur Mehrheit verlangten einige Expert_innen eine vollständige Abstinenz vor Beginn einer pharmakologischen Behandlung, einige waren gegen die Verwendung von Stimulanzien bei der Behandlung dieser Patient_innen (unabhängig von Abstinenz), während einige sich gegen die alternative Anwendung von Bupropion aussprachen. Schlussfolgerungen: Diese internationale Konsenserklärung kann von Kliniker_innen und Patient_innen zusammen in einem gemeinsamen Entscheidungsprozess genutzt werden, um die besten Interventionen auszuwählen und die bestmöglichen Ergebnisse bei adoleszenten Patient_innen mit gleichzeitiger ADHS und SUD zu erzielen.
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- 2022
26. Single or multiple arterial bypass graft surgery vs. percutaneous coronary intervention in patients with three-vessel or left main coronary artery disease
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Arie Pieter Kappetein, Patrick W. Serruys, Chao Gao, Robert-Jan van Geuns, Piroze M. Davierwala, David R. Holmes, Friedrich W. Mohr, Neil O'Leary, Milan Milojevic, Scot Garg, Daniel J F M Thuijs, Marie-Claude Morice, Hironori Hara, David P. Taggart, Michael J. Mack, Yoshinobu Onuma, Rutao Wang, Mario Gaudino, Masafumi Ono, Thilo Noack, Syntax Extended Survival Investigators, and Cardiothoracic Surgery
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medicine.medical_specialty ,medicine.medical_treatment ,Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] ,Population ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Revascularization ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,Clinical endpoint ,Humans ,Medicine ,030212 general & internal medicine ,Coronary Artery Bypass ,education ,education.field_of_study ,business.industry ,Hazard ratio ,Percutaneous coronary intervention ,Confidence interval ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,Conventional PCI ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures ,Artery - Abstract
Aim The aim of this study was to compare long-term all-cause mortality between patients receiving percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) using multiple (MAG) or single arterial grafting (SAG). Methods and results The current study is a post hoc analysis of the SYNTAX Extended Survival Study, which compared PCI with CABG in patients with three-vessel (3VD) and/or left main coronary artery disease (LMCAD) and evaluated survival with ≥10 years of follow-up. The primary endpoint was all-cause mortality at maximum follow-up (median 11.9 years) assessed in the as-treated population. Of the 1743 patients, 901 (51.7%) underwent PCI, 532 (30.5%) received SAG, and 310 (17.8%) had MAG. At maximum follow-up, all-cause death occurred in 305 (33.9%), 175 (32.9%), and 70 (22.6%) patients in the PCI, SAG, and MAG groups, respectively (P Conclusion Our findings suggest that MAG might be the more desirable configuration for CABG to achieve lower long-term all-cause mortality than PCI in patients with 3VD and/or LMCAD. Trial registration Registered on clinicaltrial.gov. SYNTAXES: NCT03417050 (https://clinicaltrials.gov/ct2/show/NCT03417050); SYNTAX: NCT00114972 (https://www.clinicaltrials.gov/ct2/show/NCT00114972).
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- 2022
27. Intranasal fusion inhibitory lipopeptide prevents direct-contact SARS-CoV-2 transmission in ferrets
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Rory D. de Vries, Sander Herfst, Barry Rockx, Camilla Predella, Rik L. de Swart, Kyle Stearns, Jonathan Khao, Samuel H. Gellman, Anne Moscona, Danny Noack, Gaël McGill, Bart L. Haagmans, N. Valerio Dorrello, Matteo Porotto, Francesca T. Bovier, Christopher A. Alabi, Sudipta Biswas, Jennifer Drew-Bear, Katharina S. Schmitz, de Vries, Rory D, Schmitz, Katharina S, Bovier, Francesca T, Predella, Camilla, Khao, Jonathan, Noack, Danny, Haagmans, Bart L, Herfst, Sander, Stearns, Kyle N, Drew-Bear, Jennifer, Biswas, Sudipta, Rockx, Barry, Mcgill, Gaël, Dorrello, N Valerio, Gellman, Samuel H, Alabi, Christopher A, de Swart, Rik L, Moscona, Anne, Porotto, Matteo, and Virology
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0301 basic medicine ,Multidisciplinary ,Transmission (medicine) ,business.industry ,viruses ,virus diseases ,Lipid bilayer fusion ,Lipopeptide ,Microbio ,Inhibitory postsynaptic potential ,Virology ,In vitro ,03 medical and health sciences ,chemistry.chemical_compound ,030104 developmental biology ,0302 clinical medicine ,chemistry ,Report ,Vero cell ,Viral Fusion Protein Inhibitors ,Medicine ,Nasal administration ,business ,030217 neurology & neurosurgery ,Reports - Abstract
Halting transmission The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike (S) glycoprotein binds to host cells and initiates membrane fusion and cell infection. This stage in the virus life history is currently a target for drug inhibition. De Vries et al. designed highly stable lipoprotein fusion inhibitors complementary to a conserved repeat in the C terminus of S that integrate into host cell membranes and inhibit conformational changes in S necessary for membrane fusion. The authors tested the performance of the lipoproteins as a preexposure prophylactic in a ferret-to-ferret transmission study. Intranasal administration of the peptide 2 days before cohousing with an infected ferret for 24 hours completely protected animals in contact from infection and showed efficacy against mutant viruses. Because ferrets do not get sick from SARS-CoV-2, disease prevention could not be tested in this model. Science, this issue p. 1379, A dimeric form of a SARS-CoV-2–derived lipopeptide is a potent inhibitor of fusion and infection in vitro and transmission in vivo., Containment of the COVID-19 pandemic requires reducing viral transmission. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is initiated by membrane fusion between the viral and host cell membranes, which is mediated by the viral spike protein. We have designed lipopeptide fusion inhibitors that block this critical first step of infection and, on the basis of in vitro efficacy and in vivo biodistribution, selected a dimeric form for evaluation in an animal model. Daily intranasal administration to ferrets completely prevented SARS-CoV-2 direct-contact transmission during 24-hour cohousing with infected animals, under stringent conditions that resulted in infection of 100% of untreated animals. These lipopeptides are highly stable and thus may readily translate into safe and effective intranasal prophylaxis to reduce transmission of SARS-CoV-2.
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- 2021
28. Cytological Effects of Serum Isolated from Polytraumatized Patients on Human Bone Marrow-Derived Mesenchymal Stem Cells
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Sandra Noack, Pascal Gräff, Claudia Neunaber, Katrin Bundkirchen, Christian Krettek, and Yazhou Long
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Pathology ,medicine.medical_specialty ,Article Subject ,business.industry ,Mesenchymal stem cell ,Human bone ,Medicine ,Cell Biology ,business ,Internal medicine ,RC31-1245 ,Molecular Biology ,Research Article - Abstract
Due to their immunomodulatory and regenerative capacity, human bone marrow-derived mesenchymal stem cells (hBMSCs) are promising in the treatment of patients suffering from polytrauma. However, few studies look at the effects of sera from polytraumatized patients on hBMSCs. The aim of this study was to explore changes in hBMSC properties in response to serum from polytrauma patients taken at different time points after the trauma incident. For this, sera from 84 patients with polytrauma (collected between 2010 and 2020 in our department) were used. In order to test the differential influence on hBMSC, sera from the 1st (D1), 5th (D5), and 10th day (D10) after polytrauma were pooled, respectively. As a control, sera from three healthy donors (HS), matched with respect to age and gender to the polytrauma group, were collected. Furthermore, hBMSCs from four healthy donors were used in the experiments. The pooled sera of HS, D1, D5, and D10 were analyzed by multicytokine array for pro-/anti-inflammatory cytokines. Furthermore, the influence of the different sera on hBMSCs with respect to cell proliferation, colony forming unit-fibroblast (CFU-F) assay, cell viability, cytotoxicity, cell migration, and osteogenic and chondrogenic differentiation was analyzed. The results showed that D5 serum significantly reduced hBMSC cell proliferation capacity compared with HS and increased the proportion of dead cells compared with D1. However, the frequency of CFU-F was not reduced in polytrauma groups compared with HS, as well as the other parameters. The serological effect of polytrauma on hBMSCs was related to the time after trauma. It is disadvantageous to use BMSCs in polytraumatized patients at least until the fifth day after polytrauma as obvious cytological changes could be found at that time point. However, it is promising to use hBMSCs to treat polytrauma after five days, combined with the concept of “Damage Control Orthopedics” (DCO).
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- 2021
29. Effektivität stationärer und teilstationärer psychosomatisch-psychotherapeutischer Behandlung
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Peter Joraschky, Ilona Croy, Kerstin Weidner, Anne Coenen, René Noack, Anne-Regina Hirt, Denise Kreßner-Kiel, Andrea Keller, Amalia Hanßke, Christoph Schiling, Julia Schellong, and Silvia Wolff
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Gynecology ,Psychiatry and Mental health ,Clinical Psychology ,medicine.medical_specialty ,business.industry ,medicine ,Day hospital ,Inpatient psychotherapy ,business ,Applied Psychology - Abstract
Zusammenfassung Fragestellung (Teil-)stationäre Psychotherapie ist in Deutschland gut implementiert. Um Wirksamkeitsfaktoren und Effekte besser zu verstehen, sind Effektivitätsstudien notwendig. Diese naturalistische Studie untersucht die Effektivität stationärer und teilstationärer Psychotherapie sowie patientenzentrierte und störungsbezogene Einflussfaktoren auf individuelle Symptomverbesserungen. Methoden Analysiert werden Patient*innen einer psychosomatisch-psychotherapeutischen Universitätsklinik, die in den Jahren 2015 bis 2019 behandelt wurden und das BSI-18 entweder bei Aufnahme und Entlassung (N=1366) oder bei Aufnahme und Dreimonatskatamnese (N=497) ausfüllten. Ergebnisse Die Verbesserungen in der globalen Symptomschwere zeigen moderate Effektstärken. Deskriptiv sind diese größer bei teilstationärer als bei stationärer Behandlung–besonders im Follow-up-Vergleich (direkt nach Entlassung: dstationär=0.401, dteilstationär=0,482; drei Monate nach Entlassung: dstationär=0,403, dteilstationär=0,807). Die teilstationären unterscheiden sich signifikant von den stationären Patient*innen – gering in Alter, Beschäftigungsstatus, Arbeitsfähigkeit und initialen Symptombelastungen, moderat in der Anzahl psychischer Komorbiditäten und stark in ihren Hauptdiagnosen. Soziodemographische Faktoren zeigen keinen, die initiale Symptomschwere einen moderaten positiven und die Anzahl psychischer Komorbiditäten einen komplexen Einfluss auf die Symptomverbesserungen. Diskussion Allgemein bestätigt diese Studie die Wirksamkeit (teil-)stationärer psychosomatischer Therapie. Die Relevanz teilstationärer Angebote wird vor dem Hintergrund von Kosteneffizienz und guter Integration in den Alltag betont, unter Beachtung individueller Behandlungsindikationen.
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- 2021
30. A Rho signaling network links microtubules to PKD controlled carrier transport to focal adhesions
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Stephan A Eisler, Filipa Curado, Gisela Link, Sarah Schulz, Melanie Noack, Maren Steinke, Monilola A Olayioye, and Angelika Hausser
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golgi complex ,RhoGTPase ,microtubules ,vesicle formation ,Medicine ,Science ,Biology (General) ,QH301-705.5 - Abstract
Protein kinase D (PKD) is a family of serine/threonine kinases that is required for the structural integrity and function of the Golgi complex. Despite its importance in the regulation of Golgi function, the molecular mechanisms regulating PKD activity are still incompletely understood. Using the genetically encoded PKD activity reporter G-PKDrep we now uncover a Rho signaling network comprising GEF-H1, the RhoGAP DLC3, and the Rho effector PLCε that regulate the activation of PKD at trans-Golgi membranes. We further show that this molecular network coordinates the formation of TGN-derived Rab6-positive transport carriers delivering cargo for localized exocytosis at focal adhesions.
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- 2018
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31. The long noncoding RNA lncR492 inhibits neural differentiation of murine embryonic stem cells.
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Maria Winzi, Nuria Casas Vila, Maciej Paszkowski-Rogacz, Li Ding, Svenja Noack, Mirko Theis, Falk Butter, and Frank Buchholz
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Medicine ,Science - Abstract
RNA interference (RNAi) screens have been shown to be valuable to study embryonic stem cell (ESC) self-renewal and they have been successfully applied to identify coding as well as noncoding genes required for maintaining pluripotency. Here, we used an RNAi library targeting >640 long noncoding RNAs (lncRNA) to probe for their role in early cell differentiation. Utilizing a Sox1-GFP ESC reporter cell line, we identified the lncRNA lncR492 as lineage-specific inhibitor of neuroectodermal differentiation. Molecular characterization showed that lncR492 interacts with the mRNA binding protein HuR and facilitates its inhibitory function by activation of Wnt signaling. Thus, lncRNAs modulate the fate decision of pluripotent stem cells.
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- 2018
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32. Obesity alters composition and diversity of the oral microbiota in patients with type 2 diabetes mellitus independently of glycemic control.
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Jonathan Tam, Thomas Hoffmann, Sabine Fischer, Stefan Bornstein, Jürgen Gräßler, and Barbara Noack
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Medicine ,Science - Abstract
BACKGROUND AND OBJECTIVE:The involvement of the oral microbiota as a possible link between periodontitis, type 2 diabetes mellitus and obesity is still not well understood. The objective of the study was to investigate if glycemic control and obesity play a role in modulating the composition and diversity of the oral microbial ecology. MATERIAL AND METHODS:A cohort of patients with type 2 diabetes mellitus (n = 18) was recruited. Participants demonstrating improved glycemic control after 3 months (n = 6) were included in a second examination. A full mouth examination was performed to estimate periodontitis severity followed by sample collection (subgingival plaque and saliva). Generation of large sequence libraries was performed using the high-throughput Illumina MiSeq sequencing platform. RESULTS:The majority of participants (94.4%, n = 17) presented with moderate or severe forms of periodontitis. Differences in microbial composition and diversity between obese (BMI ≥ 30 kg/m2) and non-obese (BMI < 30 kg/m2) groups were statistically significant. Cross-sectional and longitudinal approaches failed to reveal statistically significant associations between HbA1c level and species composition or diversity. CONCLUSIONS:Obesity was significantly associated with the oral microbial composition. The impact of glycemic control on oral microbiota, however, could not be assured statistically.
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- 2018
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33. Impact of 0.1% octenidine mouthwash on plaque re-growth in healthy adults: a multi-center phase 3 randomized clinical trial
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Jana Schmidt, Hari Petsos, Dirk Ziebolz, Katrin Lorenz, Barbara Noack, Michael J. Noack, Yvonne Jockel-Schneider, Markus Laky, Stefan Rüttermann, Ulrich Schlagenhauf, Thea Rott, and Christian Wehner
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Octenidine ,Adult ,Saliva ,medicine.medical_specialty ,Mouthrinse ,Pyridines ,Mouthwashes ,Phases of clinical research ,Placebo ,Oral hygiene ,Gastroenterology ,Tooth discoloration ,law.invention ,030207 dermatology & venereal diseases ,03 medical and health sciences ,Gingival index ,0302 clinical medicine ,Randomized controlled trial ,Double-Blind Method ,law ,Statistical significance ,Internal medicine ,Medicine ,Humans ,Discoloration index ,General Dentistry ,business.industry ,Chlorhexidine ,Dental Plaque Index ,030206 dentistry ,Bacterial counts ,Gingivitis ,Dysgeusia ,Anti-Infective Agents, Local ,Plaque index ,Original Article ,Imines ,medicine.symptom ,business - Abstract
Objectives To investigate plaque inhibition of 0.1% octenidine mouthwash (OCT) vs. placebo over 5 days in the absence of mechanical plaque control. Materials and methods For this randomized, placebo-controlled, double-blind, parallel group, multi-center phase 3 study, 201 healthy adults were recruited. After baseline recording of plaque index (PI) and gingival index (GI), collection of salivary samples, and dental prophylaxis, subjects were randomly assigned to OCT or placebo mouthwash in a 3:1 ratio. Rinsing was performed twice daily for 30 s. Colony forming units in saliva were determined before and after the first rinse. At day 5, PI, GI, and tooth discoloration index (DI) were assessed. Non-parametric van Elteren tests were applied with a significance level of p Results Treatment with OCT inhibited plaque formation more than treatment with placebo (PI: 0.36 vs. 1.29; p p = 0.003) and salivary bacterial counts (2.73 vs. placebo 0.24 lgCFU/ml; p p = 0.0011). Mild tongue staining and dysgeusia occurred. Conclusions OCT 0.1% mouthwash inhibits plaque formation over 5 days. It therefore can be recommended when regular oral hygiene is temporarily compromised. Clinical relevance When individual plaque control is compromised, rinsing with octenidine mouthwash is recommended to maintain healthy oral conditions while side effects are limited.
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- 2021
34. Impact of major infections on 10-year mortality after revascularization in patients with complex coronary artery disease
- Author
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Masafumi Ono, Daniel J F M Thuijs, Arie Pieter Kappetein, David R. Holmes, Hideyuki Kawashima, Michael J. Mack, Patrick W. Serruys, Marie-Claude Morice, Piroze M. Davierwala, Friedrich W. Mohr, Yoshinobu Onuma, Hironori Hara, Thilo Noack, Massimo Mancone, and Cardiothoracic Surgery
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Percutaneous coronary intervention ,Subgroup analysis ,Disease ,Coronary Artery Disease ,medicine.disease ,Revascularization ,Coronary artery disease ,medicine.anatomical_structure ,Percutaneous Coronary Intervention ,Treatment Outcome ,Internal medicine ,Conventional PCI ,Risk of mortality ,medicine ,Humans ,Coronary Artery Bypass ,Cardiology and Cardiovascular Medicine ,business ,Vascular Surgical Procedures ,Artery ,Follow-Up Studies - Abstract
Background: The significant interaction between major infection and 5-year mortality after percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) for complex coronary artery disease (CAD) was observed previously. However, the very long-term outcomes beyond 5 years remains unclear. Methods and results: This is a subgroup analysis of the SYNTAX Extended Survival (SYNTAXES) trial, which is the extended follow-up of the randomized SYNTAX trial comparing PCI versus CABG in patients with three-vessel disease (3VD) or left-main CAD (LMCAD). Out of 1517 patients enrolled in the SYNTAX trial with available survival status from 5 to 10 years, 140 patients had experienced major infections and survived at 5 years (major infection group). From 5 to 10 years, the mortality of major infection group was 19.8% whereas the mortality of no major infection group was 15.1% (p = 0.157). After the adjustment of other clinical factors, the risk of mortality from 5 to 10 years did not significantly differ between major infection and no major infection groups (HR: 1.10; 95% CI: 0.62–1.96; p = 0.740). When stratified by the presence or absence of periprocedural major infections, defined as a major infection within 60 days after index procedure, there was also no significant difference in 10-year mortality between two groups (30.8% vs. 24.5%; p = 0.057). Conclusions: Despite the initial association between major infections and 5 years mortality, postprocedural major infection was not evident in the 10 years follow-up, suggesting that the impact of major infection on mortality subsided over time beyond 5 years. Trial registration: SYNTAXES ClinicalTrials.gov reference: NCT03417050 SYNTAX ClinicalTrials.gov reference: NCT00114972
- Published
- 2021
35. Surgical Explantation After TAVR Failure
- Author
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Vinayak N. Bapat, Syed Zaid, Shinichi Fukuhara, Shekhar Saha, Keti Vitanova, Philipp Kiefer, John J. Squiers, Pierre Voisine, Luigi Pirelli, Moritz Wyler von Ballmoos, Michael W.A. Chu, Josep Rodés-Cabau, J. Michael DiMaio, Michael A. Borger, Rudiger Lange, Christian Hagl, Paolo Denti, Thomas Modine, Tsuyoshi Kaneko, Gilbert H.L. Tang, Aditya Sengupta, David Holzhey, Thilo Noack, Katherine B. Harrington, Siamak Mohammadi, Derek R. Brinster, Marvin D. Atkins, Muhanad Algadheeb, Rodrigo Bagur, Nimesh D. Desai, Oliver D. Bhadra, Lenard Conradi, Christian Shults, Lowell F. Satler, Basel Ramlawi, Newell B. Robinson, Lin Wang, George A. Petrossian, Martin Andreas, Paul Werner, Andrea Garatti, Flavien Vincent, Eric Van Belle, Francis Juthier, Lionel Leroux, John R. Doty, Joshua B. Goldberg, Hasan A. Ahmad, Kashish Goel, Ashish S. Shah, Arnar Geirsson, John K. Forrest, Kendra J. Grubb, Sameer Hirji, Pinak B. Shah, Giuseppe Bruschi, Guido Gelpi, Igor Belluschi, Maral Ouzounian, Marc Ruel, Talal Al-Atassi, Joerg Kempfert, Axel Unbehaun, Nicholas M. Van Mieghem, Thijmen W. Hokken, Walid Ben Ali, Reda Ibrahim, Philippe Demers, Alejandro Pizano, Marco Di Eusanio, Filippo Capestro, Rodrigo Estevez-Loureiro, Miguel A. Pinon, Michael H. Salinger, Joshua Rovin, Augusto D'Onofrio, Chiara Tessari, Antonio Di Virgilio, Maurizio Taramasso, Marco Gennari, Andrea Colli, Brian K. Whisenant, Tamim M. Nazif, Neal S. Kleiman, Molly Y. Szerlip, Ron Waksman, Isaac George, Tom C. Nguyen, Francesco Maisano, G. Michael Deeb, Joseph E. Bavaria, Michael J. Reardon, Michael J. Mack, William T. Brinkman, Timothy J. George, Srinivasa Potluri, William H. Ryan, Justin M. Schaffer, Robert L. Smith, Molly Szerlip, Tamim Nazif, Hussein Rahim, Kendra Grubb, Marvin Atkins, Sachin Goel, Neal Kleiman, Michael Reardon, John Doty, Brian Whisenant, Michael Salinger, Lowell Satler, Christian Schults, Susan Fisher, Sophia L. Alexis, Chad A. Kliger, Bruce Rutkin, Pey-Jen Yu, George Petrossian, Newell Robinson, Michael Deeb, Jessica Oakley, Joseph Bavaria, Nimesh Desai, Lisa Walsh, Tom Nguyen, Hasan Ahmad, Joshua Goldberg, David Spielvogel, John Forrest, Michael Chu, Raymond Cartier, Josep Rodes-Cabau, Alain-Philippe Abois, Munir Boodhwani, Alexander Dick, Christopher Glover, Marino Labinaz, Buu-Khanh Lam, Cedric Delhaye, Adeline Delsaux, Tom Denimal, Anaïs Gaul, Mohammad Koussa, Thibault Pamart, Svetlana Sonnabend, Markus Krane, Andrea Munsterer, Michael Borger, Philippe Kiefer, Oliver Bhadra, Len Conradi, Bruno Merlanti, Claudio F. Russo, Claudia Romagnoni, Nicholas Van Mieghem, and Miguel Pinnon
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Mortality rate ,medicine.disease ,Surgery ,Stenosis ,Valve replacement ,Interquartile range ,Concomitant ,medicine ,Endocarditis ,Paravalvular leak ,Cardiology and Cardiovascular Medicine ,business ,Stroke - Abstract
Objectives The aim of this study was to evaluate clinical characteristics, mechanisms of failure, and outcomes of transcatheter aortic valve replacement (TAVR) explantation. Background Surgical explantation following TAVR may be required for structural valve degeneration, paravalvular leak, infection, or other reasons. However, in-depth data on indications and outcomes are lacking. Methods Data from a multicenter, international registry (EXPLANT-TAVR) of patients who underwent TAVR explantation were reviewed retrospectively. Explantations performed during the same admission as initial TAVR were excluded. Clinical and echocardiographic outcomes were evaluated. Median follow-up duration was 6.7 months (interquartile range [IQR]: 1.0-18.8 months) after TAVR explantation and was 97.7% complete at 30 days and 86.1% complete at 1 year. Results From November 2009 to September 2020, 269 patients across 42 centers with a mean age of 72.7 ± 10.4 years underwent TAVR explantation. About one quarter (25.9%) were deemed low surgical risk at index TAVR, and median Society of Thoracic Surgeons risk at TAVR explantation was 5.6% (IQR: 3.2%-9.6%). The median time to explantation was 11.5 months (IQR: 4.0-32.4 months). Balloon-expandable and self-expanding or mechanically expandable valves accounted for 50.9% and 49.1%, respectively. Indications for explantation included endocarditis (43.1%), structural valve degeneration (20.1%), paravalvular leak (18.2%), and prosthesis-patient mismatch (10.8%). Redo TAVR was not feasible because of unfavorable anatomy in 26.8% of patients. Urgent or emergency cases were performed in 53.1% of patients, aortic root replacement in 13.4%, and 54.6% had concomitant cardiac procedures. Overall survival at last follow-up was 76.1%. In-hospital, 30-day, and 1-year mortality rates were 11.9%, 13.1%, and 28.5%, respectively, and stroke rates were 5.9%, 8.6%, and 18.7%, respectively. Conclusions The EXPLANT-TAVR registry reveals that surgical risks associated with TAVR explantation are not negligible and should be taken into consideration in the lifetime management of aortic stenosis.
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- 2021
36. Mitral Valve Surgery After Transcatheter Edge-to-Edge Repair
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Alejandro Pizano, Serdar Akansel, Augusto D'Onofrio, Miguel A. Pinon, Marco Di Eusanio, George Petrossian, Nicholas Dumonteil, Chawannuch Ruaengsri, Guido Ascione, Francesco Massi, Moritz C. Wyler von Ballmoos, Flavien Vincent, Anita W. Asgar, Ana Paula Tagliari, Filippo Capestro, Philippe Demers, Pinak B. Shah, Kendra J. Grubb, Basel Ramlawi, John J. Squiers, Jean-François Obadia, Lionel Leroux, Rebecca T. Hahn, Michele Flagiello, Ryan Kaple, Vinayak Bapat, Guillaume Leurent, Michael W.A. Chu, Tamim Nazif, Michele Triggiani, Matthew A. Romano, Michael A. Borger, Arnar Geirsson, Ashish S. Shah, Gorav Ailawadi, Kashish Goel, Marco Gennari, Gilbert H.L. Tang, Amedeo Anselmi, Paul Werner, Tsuyoshi Kaneko, Keti Vitanova, Shahar Lavi, Markus Krane, Luigi Pirelli, Rüdiger Lange, Martin Andreas, Michael J. Reardon, Christian Hagl, Shekhar Saha, Eric Van Belle, J. Michael DiMaio, Andrea Garatti, Sameer A. Hirji, D. Scott Lim, Maurizio Taramasso, Tom C. Nguyen, Neal S. Kleiman, Erik Bagaev, Tom Denimal, Herve Corbineau, Michael J. Mack, Molly I. Szerlip, Michel Pellerin, Isaac George, Didier Tchetche, Robert L. Smith, Francesco Maisano, Chiara Tessari, Antonio L. Bartorelli, Volkmar Falk, Chad Kliger, Rodrigo Estévez-Loureiro, Marissa Donatelle, Lin Wang, Marvin D. Atkins, Jörg Kempfert, Thomas Modine, Newell Robinson, Joachim Schofer, Oliver D. Bhadra, Paolo Denti, Syed Zaid, Denis Bouchard, Walid Ben Ali, Angie Ghattas, Christina Brinkmann, Muhanad Algadheeb, Thilo Noack, Lenard Conradi, and Florian Fahr
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Mitral regurgitation ,medicine.medical_specialty ,Longitudinal data ,business.industry ,medicine.medical_treatment ,Mortality rate ,Mitral valve replacement ,030204 cardiovascular system & hematology ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Interquartile range ,Mitral valve ,Concomitant ,medicine ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,Mitral valve surgery - Abstract
Objectives The aim of this study was to determine clinical and echocardiographic characteristics, mechanisms of failure, and outcomes of mitral valve (MV) surgery after transcatheter edge-to-edge repair (TEER). Background Although >100,000 mitral TEER procedures have been performed worldwide, longitudinal data on MV surgery after TEER are lacking. Methods Data from the multicenter, international CUTTING-EDGE registry were retrospectively analyzed. Clinical and echocardiographic outcomes were evaluated. Median follow-up duration was 9.0 months (interquartile range [IQR]: 1.2-25.7 months) after MV surgery, and follow-up was 96.1% complete at 30 days and 81.1% complete at 1 year. Results From July 2009 to July 2020, 332 patients across 34 centers underwent MV surgery after TEER. The mean age was 73.8 ± 10.1 years, median Society of Thoracic Surgeons risk for MV repair at initial TEER was 4.0 (IQR: 2.3-7.3), and primary/mixed and secondary mitral regurgitation were present in 59.0% and 38.5%, respectively. The median interval from TEER to surgery was 3.5 months (IQR: 0.5-11.9 months), with overall median Society of Thoracic Surgeons risk of 4.8% for MV replacement (IQR: 2.8%-8.4%). The primary indication for surgery was recurrent mitral regurgitation (33.5%), and MV replacement and concomitant tricuspid surgery were performed in 92.5% and 42.2% of patients, respectively. The 30-day and 1-year mortality rates were 16.6% and 31.3%, respectively. On Kaplan-Meier analysis, the actuarial estimates of mortality were 24.1% at 1 year and 31.7% at 3 years after MV surgery. Conclusions In this first report of the CUTTING-EDGE registry, the mortality and morbidity risks of MV surgery after TEER were not negligible, and only
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- 2021
37. Lectins enhance SARS-CoV-2 infection and influence neutralizing antibodies
- Author
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Antonio Lanzavecchia, Lisa A. Purcell, Young-Jun Park, Nuria Izquierdo-Useros, Siro Bianchi, Stefano Jaconi, Marcel Meury, Maria De Agostini, Exequiel Dellota, Davide Corti, Fabio Benigni, David Veesler, Amalio Telenti, Elisabetta Cameroni, Florian A. Lempp, Herbert W. Virgin, Júlia Vergara-Alert, Martin Montiel-Ruiz, Hannah Kaiser, Jiayi Zhou, Javier Martinez-Picado, Anshu Joshi, Julia Noack, Alexandra C. Walls, Leah Soriaga, and John E. Bowen
- Subjects
chemistry.chemical_classification ,Multidisciplinary ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Cell ,Lectin ,Biology ,Neutralization ,Microbiology ,medicine.anatomical_structure ,Enzyme ,chemistry ,medicine ,biology.protein ,Antibody ,Receptor ,hormones, hormone substitutes, and hormone antagonists ,Function (biology) - Abstract
SARS-CoV-2 infection—which involves both cell attachment and membrane fusion—relies on the angiotensin-converting enzyme 2 (ACE2) receptor, which is paradoxically found at low levels in the respiratory tract1–3, suggesting that there may be additional mechanisms facilitating infection. Here we show that C-type lectin receptors, DC-SIGN, L-SIGN and the sialic acid–binding immunoglobulin-like lectin 1 (SIGLEC1) function as attachment receptors by enhancing ACE2-mediated infection and modulating the neutralizing activity of different classes of spike-specific antibodies. Antibodies to the amino-terminal domain or to the conserved site at the base of the receptor-binding domain, while poorly neutralizing infection of ACE2-overexpressing cells, effectively block lectin-facilitated infection. Conversely, antibodies to the receptor binding motif, while potently neutralizing infection of ACE2-overexpressing cells, poorly neutralize infection of cells expressing DC-SIGN or L-SIGN and trigger fusogenic rearrangement of the spike, promoting cell-to-cell fusion. Collectively, these findings identify a lectin-dependent pathway that enhances ACE2-dependent infection by SARS-CoV-2 and reveal distinct mechanisms of neutralization by different classes of spike-specific antibodies. C-type lectins and SIGLEC1 function as attachment receptors for SARS-CoV-2 and enhance ACE2-mediated infection.
- Published
- 2021
38. Smart-Glass Guided Exposure for Anxiety Disorders: A Proof-of-Concept Study
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Andre Pittig, Jürgen Hoyer, and René Noack
- Subjects
050103 clinical psychology ,business.industry ,medicine.medical_treatment ,05 social sciences ,Exposure therapy ,Usability ,Exposure test ,030227 psychiatry ,Test (assessment) ,03 medical and health sciences ,Clinical Psychology ,0302 clinical medicine ,User experience design ,medicine ,Anxiety ,0501 psychology and cognitive sciences ,Rural area ,medicine.symptom ,Psychology ,business ,Adverse effect ,Clinical psychology - Abstract
Exposure is a highly effective treatment for pathological fear and anxiety, but rarely used in routine care. Issues of practicability and lack of therapists in rural areas are main barriers for the dissemination of exposure. Smartglass devices may enable therapists to guide exposure from their own office via real-time feedback and may thereby increase practicability. The present study explored the technological usability and clinical feasibility of Smartglass-guided exposure in a behavioral approach test in spider-fearful individuals (N = 40). Fearful individuals were asked to start the Smartglass themselves and established a connection to a therapist, who guided the exposure test from afar. Clinical severity of spider fear was assessed via questionnaire. Technological usability was assessed with established measures of usability, user experience, and user acceptance. Exploratory, individual characteristics of exposure were collected (e.g., within-session fear reduction, duration, safety behavior). Overall, fearful individuals (94.9%) and therapists (100%) were able to establish a connection. Usability of Smartglass-guided exposure was evaluated as positive. Within-session fear reduction was large (d = 1.91). Adverse events were minimal. There were, however, some associations between exposure characteristics and usability evaluation (e.g., lower user-friendliness and exposure duration). Two case examples further highlight chances and risks of Smartglass-guided exposure. These findings provide first evidence that Smartglass-guided exposure could be useful in exposure therapy. Smartglass-guided exposure may ultimately help to increase practicability of exposure and increase dissemination, also in rural areas. These findings are promising for future research on the long-term outcome of evidence-based exposure in treatment seeking patients.
- Published
- 2021
39. Pigment epithelium-derived factor: clinical significance in estrogen-dependent tissues and its potential in cancer therapy
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María Liliana Franco-Chuaire, Sandra Ramírez-Clavijo, and Lilian Chuaire-Noack
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Anti-tumorigenesis Antiangiogenesis ,Estrogens ,Estrogen receptors ,Hormonal regulation ,PEDF ,Synthetic peptides ,Medicine - Abstract
Pigment epithelium-derived factor (PEDF) is a glycoprotein that belongs to the family of non-inhibitory serpins. The broad spectrum of PEDF biological activity is evident when considering its effects in promoting cell survival and proliferation, as well as its antiangiogenic, antitumor, and anti-metastatic properties. Although the structural domains of the PEDF gene that mediate such diverse effects and their mechanisms of action have not been completely elucidated, there is a large body of evidence describing their diverse range of activities; this evidence combined with the regulation of PEDF expression by sex steroids and their receptors have led to the idea that PEDF is not only a diagnostic and prognostic marker for certain diseases such as cancer, but is also a potential therapeutic target. In this manner, this paper aims to generally review the regulation of PEDF expression and PEDF interactions, as well as the findings that relate PEDF to the role of estrogens and estrogen receptors. In addition, this manuscript will review major advances toward potential therapeutic applications of PEDF.
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- 2015
40. 49th Rostock Talks on Cardiovascular Function and Hypertension at the University of Rostock, Germany, June 27, 2020
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K. Kisters and T. Noack
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Inorganic Chemistry ,medicine.medical_specialty ,business.industry ,Family medicine ,Clinical Biochemistry ,Medicine ,business ,Biochemistry - Published
- 2022
41. Bacteraemia of oral origin in children—A Systematic review and network meta‐analysis
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Kathrin Kuhr, Georg Plum, Karolin Höfer, Michael J. Noack, Isabelle Graf, Konrad Brockmeier, Anne Adams, and Falk Schwendicke
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Toothbrushing ,medicine.medical_specialty ,business.industry ,Network Meta-Analysis ,Dental Plaque ,Psychological intervention ,Bacteremia ,Odds ratio ,bacterial infections and mycoses ,Gingivitis ,Plaque control ,Oral hygiene ,Clinical trial ,Otorhinolaryngology ,Meta-analysis ,Internal medicine ,Humans ,Medicine ,General anaesthesia ,medicine.symptom ,Child ,business ,General Dentistry - Abstract
Objectives To systematically review the prevalence of bacteraemia, triggered by dental intervention and home oral hygiene practices, in children. The network meta-analysis (NMA) quantitatively compared the risk of bacteraemia triggered by dental extractions and home and professional cleaning procedures. Materials and methods Clinical trials with the outcome 'bacteraemia in children' were searched. The NMA was performed using the frequentist weighted least-squares approach comparing the odds ratios (OR) of different interventions. Results Among 11 of 13 studies, dental treatment was performed under general anaesthesia. In 2,381 patients, bacteraemia occurred in 38.7-56% patients following single-tooth extractions, in 22-46% after manual toothbrushing (MTB), and in 26-78% after power toothbrushing (PTB). When MTB was set as the reference (OR 1), rubber cup polishing showed a slightly higher risk (OR 1.26) of bacteraemia. PTB presented a higher risk (OR 1.79-2.27) than with single-tooth extractions (OR 1.55) but lower than that with multiple extractions (OR 2.55). Conclusion Daily use of MTB and routine professional cleaning were associated with the lowest risk of developing bacteraemia in children with gingivitis, almost as much as with a single-tooth extractions. Improved plaque control with PTB increased the risk of bacteraemia. There is limited evidence on gingivitis-free and systemically-diseased children.
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- 2021
42. Impact of Body Composition Indices on Ten-year Mortality After Revascularization of Complex Coronary Artery Disease (From the Syntax Extended Survival Trial)
- Author
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Yoshinobu Onuma, Mohr W. Friedrich, Hideyuki Kawashima, Daniel J F M Thuijs, Rutao Wang, David R. Holmes, Kuniaki Takahashi, Neil O'Leary, Chao Gao, Thilo Noack, Marie Claude Morice, Masafumi Ono, Stuart J. Head, Hironori Hara, Jan J. Piek, Michael J. Mack, Joanna J. Wykrzykowska, John W. McEvoy, Patrick W. Serruys, Arie Pieter Kappetein, Piroze M. Davierwala, Cardiothoracic Surgery, Graduate School, Cardiology, ACS - Heart failure & arrhythmias, ACS - Atherosclerosis & ischemic syndromes, and ACS - Microcirculation
- Subjects
Male ,medicine.medical_specialty ,Waist ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Revascularization ,Body Mass Index ,Coronary artery disease ,03 medical and health sciences ,Percutaneous Coronary Intervention ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Internal medicine ,Myocardial Revascularization ,medicine ,Humans ,Obesity ,030212 general & internal medicine ,Coronary Artery Bypass ,Mortality ,Aged ,Proportional Hazards Models ,business.industry ,Hazard ratio ,Percutaneous coronary intervention ,Middle Aged ,Prognosis ,medicine.disease ,Confidence interval ,Body Composition ,Cardiology ,Female ,Waist Circumference ,Cardiology and Cardiovascular Medicine ,business ,Body mass index ,Obesity paradox - Abstract
Numerous studies have demonstrated a paradoxical association between higher baseline body mass index (BMI) and lower long-term mortality risk after coronary revascularization, known as the “obesity paradox”, possibly relying on the single use of BMI. The current study is a post-hoc analysis of the SYNTAX Extended Survival (SYNTAXES) trial, which is the extended follow-up of the SYNTAX trial comparing percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) in patients with left-main coronary artery disease (LMCAD) or three-vessel disease (3VD). Patients were stratified according to baseline BMI and/or waist circumference (WC). Out of 1,800 patients, 1,799 (99.9%) and 1,587 (88.2%) had available baseline BMI and WC data, respectively. Of those, 1,327 (73.8%) patients had High BMI (≥25 kg/m2), whereas 705 (44.4%) patients had High WC (>102 cm for men or >88 cm for women). When stratified by both BMI and WC, 10-year mortality risk was significantly higher in patients with Low BMI/Low WC (adjusted hazard ratio [HR]: 1.65; 95% confidence interval [CI]: 1.09 to 2.51), Low BMI/ High WC (adjusted HR: 2.74; 95% CI: 1.12 to 6.69), or High BMI/High WC (adjusted HR: 1.59; 95% CI: 1.11 to 2.27) compared to those with High BMI/Low WC. In conclusion, the “obesity paradox” following coronary revascularization would be driven by low long-term mortality risk of the High BMI/Low WC group. Body composition should be assessed by the combination of BMI and WC in the appropriate evaluation of the long-term risk of obesity in patients with LMCAD or 3VD.
- Published
- 2021
43. Impact of Optimal Medical Therapy on 10-Year Mortality After Coronary Revascularization
- Author
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David R. Holmes, Arie Pieter Kappetein, Hironori Hara, Patrick W. Serruys, Milan Milojevic, Marie-Claude Morice, Syntax Extended Survival Investigators, Masafumi Ono, Daniel J F M Thuijs, Michael J. Mack, Stuart J. Head, Thilo Noack, Piroze M. Davierwala, Yoshinobu Onuma, Friedrich-Wilhelm Mohr, John W. McEvoy, Hideyuki Kawashima, Neil O'Leary, Faisal Sharif, and Cardiothoracic Surgery
- Subjects
medicine.medical_specialty ,Antiplatelet drug ,Statin ,business.industry ,medicine.drug_class ,medicine.medical_treatment ,Percutaneous coronary intervention ,Disease ,030204 cardiovascular system & hematology ,Cardiac surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Internal medicine ,Conventional PCI ,Medicine ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,Medical therapy ,Artery - Abstract
Background: The benefit of optimal medical therapy (OMT) on 5-year outcomes in patients with 3-vessel disease and/or left main disease after percutaneous coronary intervention or coronary artery bypass grafting (CABG) was demonstrated in the randomized SYNTAX (Synergy Between PCI With Taxus and Cardiac Surgery) trial. Objectives: The objective of this analysis is to assess the impact of the status of OMT at 5 years on 10-year mortality after percutaneous coronary intervention or CABG. Methods: This is a subanalysis of the SYNTAXES (Synergy Between PCI With Taxus and Cardiac Surgery Extended Survival) study, which evaluated for up to 10 years the vital status of patients who were originally enrolled in the SYNTAX trial. OMT was defined as the combination of 4 types of medications: at least 1 antiplatelet drug, statin, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, and beta-blocker. After stratifying participants by the number of individual OMT agents at 5 years and randomized treatment, a landmark analysis was conducted to assess the association between treatment response and 10-year mortality. Results: In 1,472 patients, patients on OMT at 5 years had a significantly lower mortality at 10 years compared with those on ≤2 types of medications (13.1% vs 19.9%; adjusted HR: 0.470; 95% CI: 0.292-0.757; P = 0.002) but had a mortality similar to those on 3 types of medications. Furthermore, patients undergoing CABG with the individual OMT agents, antiplatelet drug and statin, at 5 years had lower 10-year mortality than those without. Conclusions: In patients with 3-vessel and/or left main disease undergoing percutaneous coronary intervention or CABG, medication status at 5 years had a significant impact on 10-year mortality. Patients on OMT with guideline-recommended pharmacologic therapy at 5 years had a survival benefit. (Synergy Between PCI With Taxus and Cardiac Surgery: SYNTAX Extended Survival [SYNTAXES]; NCT03417050; Taxus Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries [SYNTAX]; NCT00114972)
- Published
- 2021
44. Nutz- und Bedienbarkeit einer App zur Überwindung von Sprachbarrieren im Rettungsdienst
- Author
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Frank Müller, Eva Hummers, Jennifer Schulze, and Eva Maria Noack
- Subjects
Gynecology ,medicine.medical_specialty ,business.industry ,Migrant ,Originalien ,Emergency medical service ,Geflüchteter ,Multilingual ,Emergency Medicine ,Rettungsdienst ,Benutzerfreundlichkeit ,Medicine ,Smartphone ,Language proficiency ,business ,Migration - Abstract
Zusammenfassung Hintergrund Im Rettungsdienst können, im Gegensatz zum stationären Setting, adäquate Dolmetscher häufig nicht ohne Weiteres hinzugezogen werden. Gleichzeitig erfordern Notfallsituationen aber eine rasche Anamnese und ein Assessment als Basis für jedes therapeutische Handeln. Material und Methoden Eine Smartphone-App, die auf 18 Sprachen eine basale Kommunikation mittels 600 fest eingesprochener unterschiedlicher Phrasen auf 20 Sprachen ermöglicht, wurde über 6 Monate in vier Rettungswachen pilotiert. Abschließend wurde die Nutzbarkeit der App durch das gesamte Rettungsdienstpersonal in einer Fragebogenstudie unter Verwendung des System Usability Scores und des AttrakDiff-Fragebogens bewertet. Ergebnisse Die Rücklaufquote betrug 48,5 % und n = 48 Fragebögen wurden ausgewertet. Das Durchschnittsalter der Befragten betrug 36 Jahre und fast zwei Drittel waren männlichen Geschlechts. Der System Usability Score zeigte im Median 67,5 Punkte, was eine grenzwertig gute Nutzbarkeit zeigte. Im AttrakDiff-Fragebogen zeigte sich die pragmatische Qualität mit durchschnittlich 0,69 (SD 0,86), die hedonische Qualität mit 0,59 (SD 0,58) und die Attraktivität (ATT) mit 0,64 Punkten (SD 0,83). Die Durchschnittswerte zeigen zufriedenstellende Werte jeweils oberhalb der neutral markierenden Grenze von 0. Auffällig zeigte sich, dass in wesentlichen Bewertungskriterien diejenigen Rettungsdienstkräfte, die angaben, die App bereits aktiv im Einsatz mit Patienten genutzt zu haben, die App signifikant besser einschätzten. Diskussion Vor dem Hintergrund, dass es sich bei der untersuchten App um ein komplexes Arbeitswerkzeug handelt, werden die Nutzbarkeit und Attraktivität als insgesamt gut eingeschätzt, wobei in der Nutzung erfahrene Rettungskräfte diese noch positiver einschätzten. Dies könnte auf eine Art Schwellenangst hindeuten, einer bereits durch Sprach- und kulturelle Barrieren geprägten Rettungssituation mit einer ebenfalls recht komplexen Intervention zu begegnen.
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- 2021
45. SARS-CoV-2 Neutralizing Human Antibodies Protect Against Lower Respiratory Tract Disease in a Hamster Model
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Haagmans, Bart L, Noack, Danny, Okba, Nisreen M A, Li, Wentao, Wang, Chunyan, Bestebroer, Theo, de Vries, Rory, Herfst, Sander, de Meulder, Dennis, Verveer, Elwin, van Run, Peter, Lamers, Mart M, Rijnders, Bart, Rokx, Casper, van Kuppeveld, Frank, Grosveld, Frank, Drabek, Dubravka, GeurtsvanKessel, Corine, Koopmans, Marion, Bosch, Berend Jan, Kuiken, Thijs, Rockx, Barry, dI&I I&I-1, Virologie, Virology, Medical Microbiology & Infectious Diseases, Cell biology, dI&I I&I-1, and Virologie
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0301 basic medicine ,medicine.drug_class ,Hamster ,Virus Replication ,Monoclonal antibody ,03 medical and health sciences ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Cricetinae ,Weight Loss ,Major Article ,medicine ,Animals ,Humans ,pneumonia ,Immunology and Allergy ,030212 general & internal medicine ,Neutralizing antibody ,Lung ,COVID-19 Serotherapy ,biology ,SARS-CoV-2 ,business.industry ,Immunization, Passive ,Antibodies, Monoclonal ,COVID-19 ,medicine.disease ,Antibodies, Neutralizing ,Virus Shedding ,hamster ,3. Good health ,Disease Models, Animal ,Titer ,Pneumonia ,AcademicSubjects/MED00290 ,030104 developmental biology ,Infectious Diseases ,Viral replication ,monoclonal antibody ,convalescent plasma ,Monoclonal ,Immunology ,biology.protein ,Antibody ,business - Abstract
Effective clinical intervention strategies for coronavirus disease 2019 (COVID-19) are urgently needed. Although several clinical trials have evaluated use of convalescent plasma containing virus-neutralizing antibodies, levels of neutralizing antibodies are usually not assessed and the effectiveness has not been proven. We show that hamsters treated prophylactically with a 1:2560 titer of human convalescent plasma or a 1:5260 titer of monoclonal antibody were protected against weight loss, had a significant reduction of virus replication in the lungs, and showed reduced pneumonia. Interestingly, this protective effect was lost with a titer of 1:320 of convalescent plasma. These data highlight the importance of screening plasma donors for high levels of neutralizing antibodies. Our data show that prophylactic administration of high levels of neutralizing antibody, either monoclonal or from convalescent plasma, prevent severe SARS-CoV-2 pneumonia in a hamster model, and could be used as an alternative or complementary to other antiviral treatments for COVID-19.
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- 2021
46. 10-Year Follow-Up After Revascularization in Elderly Patients With Complex Coronary Artery Disease
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Friedrich W. Mohr, Hideyuki Kawashima, Kuniaki Takahashi, Syntax Extended Survival Investigators, Faisal Sharif, Arie Pieter Kappetein, Jan J. Piek, Michael J. Mack, J J Wykrzykowska, David R. Holmes, Scot Garg, Marie-Claude Morice, David Cohen, Masafumi Ono, Chao Gao, Daniel J F M Thuijs, Neil O'Leary, Stuart J. Head, Rutao Wang, Yoshinobu Onuma, Hironori Hara, Patrick W. Serruys, Thilo Noack, Piroze M. Davierwala, Graduate School, Cardiology, ACS - Heart failure & arrhythmias, ACS - Atherosclerosis & ischemic syndromes, ACS - Microcirculation, and Cardiothoracic Surgery
- Subjects
long-term outcome ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Revascularization ,THERAPY ,elderly ,Angina ,Coronary artery disease ,03 medical and health sciences ,0302 clinical medicine ,Life Expectancy ,Percutaneous Coronary Intervention ,Quality of life ,SDG 3 - Good Health and Well-being ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Registries ,Coronary Artery Bypass ,CABG ,Aged ,Aged, 80 and over ,OUTCOMES ,business.industry ,Proportional hazards model ,Hazard ratio ,Percutaneous coronary intervention ,SYNTAX ,PCI ,BYPASS GRAFT-SURGERY ,Middle Aged ,medicine.disease ,humanities ,Europe ,Conventional PCI ,North America ,Cardiology ,Quality of Life ,life expectancy, long-term outcome, PCI ,TRIAL ,Female ,Cardiology and Cardiovascular Medicine ,business ,INTERVENTION ,Follow-Up Studies - Abstract
Background: The optimal revascularization strategy for the elderly with complex coronary artery disease remains unclear. Objectives: The goal of this study was to investigate 10-year all-cause mortality, life expectancy, 5-year major adverse cardiac or cerebrovascular events (MACCE), and 5-year quality of life (QOL) after percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) in elderly individuals (>70 years old) with 3-vessel disease (3VD) and/or left main disease (LMD). Methods: In the present pre-specified analysis on age of the SYNTAX Extended Survival study, 10-year all-cause death and 5-year MACCE were compared with Kaplan-Meier estimates and Cox proportional hazards models among elderly or nonelderly patients. Life expectancy was estimated by restricted mean survival time within 10 years, and QOL status according to the Seattle Angina Questionnaire up to 5 years was assessed by linear mixed-effects models. Results: Among 1,800 randomized patients, 575 patients (31.9%) were elderly. Ten-year mortality did not differ significantly between PCI and CABG in elderly (44.1% vs. 41.1%; hazard ratio [HR]: 1.08; 95% confidence interval [CI]: 0.84 to 1.40) and nonelderly patients (21.1% vs. 16.6%; HR: 1.30; 95% CI: 1.00 to 1.69; pinteraction = 0.332). Among elderly patients, 5-year MACCE was comparable between PCI and CABG (39.4% vs. 35.1%; HR: 1.18; 95% CI: 0.90 to 1.56), whereas it was significantly higher in PCI over CABG among nonelderly patients (36.3% vs. 23.0%; HR: 1.69; 95% CI: 1.36 to 2.10; pinteraction = 0.043). There were no significant difference in life expectancy (mean difference: 0.2 years in favor of CABG; 95% CI: −0.4 to 0.7) and 5-year QOL status between PCI and CABG among elderly patients. Conclusions: Elderly patients with 3VD and/or LMD had comparable 10-year all-cause death, life expectancy, 5-year MACCE, and 5-year QOL status irrespective of revascularization mode. (Synergy Between PCI With TAXUS and Cardiac Surgery: SYNTAX Extended Survival [SYNTAXES]; NCT03417050) (SYNTAX Study: TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries [SYNTAX]; NCT00114972)
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- 2021
47. Impact of care level, setting and accommodation costs on a newly developed oral care nursing plan format for elderly patients with care needs – Results from a cross‐sectional study
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Dirk Bleiel, Anna Greta Barbe, Michael J. Noack, and Ina Nitschke
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Cross-sectional study ,media_common.quotation_subject ,Oral Health ,Oral hygiene ,03 medical and health sciences ,0302 clinical medicine ,Documentation ,Ambulatory care ,Nursing ,Hygiene ,Humans ,Medicine ,Dentistry (miscellaneous) ,030212 general & internal medicine ,Aged ,media_common ,Inpatient care ,business.industry ,030206 dentistry ,Oral Hygiene ,Nursing Homes ,stomatognathic diseases ,Housing for the Elderly ,Cross-Sectional Studies ,Mouth Diseases ,business ,Accommodation - Abstract
Objectives A new oral care nursing plan format for improved communication among dentists, nursing staff, and caregivers has been developed in Germany. We aimed to (1) describe this plan, (2) investigate the prevalence of oral health problems among elderly patients with care needs documented by the plan, and outline the recommendations in the plans, and (3) investigate whether the accommodation costs or care needs of patients influenced oral care quality or the need for oral hygiene support documented within the plan. Methods In this cross-sectional trial, oral care nursing plans were collected from outpatient and inpatient care clinics. Items on the oral care nursing plan were divided into three areas (oral health, oral hygiene needs, coordination needs and dental therapy), and were correlated with care level and accommodation costs. Results Oral care nursing plans were collected from seven dentists (N = 747; 94.5% from inpatient, 5.5% from outpatient care). The plans enabled documentation of well-known oral health and hygiene problems among elderly patients. In their current form, the plans provided recommendations for obvious oral hygiene tasks such as toothbrushing or fluoridating, rather than specialized tasks such as nutritional advice or dry mouth asymptomatic therapeutic approaches. While accommodation costs were associated with the need for oral hygiene support (not with oral care condition), the care level influenced both measures. Conclusions The oral care nursing plan can facilitate documentation of oral health and hygiene among elderly individuals with care needs. Further clarification of the plan would help promote careful documentation by dentists.
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- 2021
48. European registry of type A aortic dissection (ERTAAD) - rationale, design and definition criteria
- Author
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Tatu Juvonen, Sidney Chocron, Stefano Mastrobuoni, Christian Detter, Suvitesh Luthra, Mauro Rinaldi, Francesco Onorati, Zein El Dean, Angelo M. Dell’Aquila, Giovanni Mariscalco, Matteo Pettinari, Alessandra Francica, Antonio Fiore, Luisa Ferrante, Antti Vento, Andrea Perrotti, Marek Pol, Laurent de Kerchove, Hakeem Yusuff, Steven Laga, Thierry Folliguet, Cecilia Rossetti, Amer Harky, Fausto Biancari, Thilo Noack, Ugolino Livi, Filip Schlosser, Stefano Forlani, Geoffrey Tsang, Lenard Conradi, Govind Chetty, Mikko Jormalainen, Manoj Kuduvalli, Till Demal, Peter Ivak, Peter Raivio, Mark Field, Igor Vendramin, Christian D. Etz, Marc A.A.M. Schepens, Bart Meuris, Michael A. Borger, UCL - SSS/IREC/CARD - Pôle de recherche cardiovasculaire, UCL - (SLuc) Service de chirurgie cardiovasculaire et thoracique, HUS Heart and Lung Center, University of Helsinki, Department of Surgery, III kirurgian klinikka, and Clinicum
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Male ,Cardiac & Cardiovascular Systems ,Aortic dissection ,Comorbidity ,030204 cardiovascular system & hematology ,law.invention ,Study Protocol ,0302 clinical medicine ,Postoperative Complications ,Clinical Protocols ,Aortic arch ,law ,Risk Factors ,Anesthesiology ,EQUATION ,RD78.3-87.3 ,Hospital Mortality ,Registries ,Stroke ,Aged, 80 and over ,HEMIARCH ,Acute kidney injury ,General Medicine ,Middle Aged ,Prognosis ,Intensive care unit ,3. Good health ,Cardiac surgery ,Aortic Aneurysm ,Europe ,REPLACEMENT ,Cardiothoracic surgery ,Research Design ,Female ,Cardiology and Cardiovascular Medicine ,Life Sciences & Biomedicine ,Pulmonary and Respiratory Medicine ,Adult ,Reoperation ,medicine.medical_specialty ,Stanford type A ,RD1-811 ,03 medical and health sciences ,Aneurysm, Dissecting ,medicine ,Humans ,Adverse effect ,Aged ,Retrospective Studies ,Ascending aorta ,Emergency ,Science & Technology ,INTERNATIONAL REGISTRY ,business.industry ,Correction ,Perioperative ,medicine.disease ,3126 Surgery, anesthesiology, intensive care, radiology ,030228 respiratory system ,Emergency medicine ,Cardiovascular System & Cardiology ,Vascular Grafting ,Surgery ,Human medicine ,business - Abstract
Background Acute Stanford type A aortic dissection (TAAD) is a life-threatening condition. Surgery is usually performed as a salvage procedure and is associated with significant postoperative early mortality and morbidity. Understanding the patient’s conditions and treatment strategies which are associated with these adverse events is essential for an appropriate management of acute TAAD. Methods Nineteen centers of cardiac surgery from seven European countries have collaborated to create a multicentre observational registry (ERTAAD), which will enroll consecutive patients who underwent surgery for acute TAAD from January 2005 to March 2021. Analysis of the impact of patient’s comorbidities, conditions at referral, surgical strategies and perioperative treatment on the early and late adverse events will be performed. The investigators have developed a classification of the urgency of the procedure based on the severity of preoperative hemodynamic conditions and malperfusion secondary to acute TAAD. The primary clinical outcomes will be in-hospital mortality, late mortality and reoperations on the aorta. Secondary outcomes will be stroke, acute kidney injury, surgical site infection, reoperation for bleeding, blood transfusion and length of stay in the intensive care unit. Discussion The analysis of this multicentre registry will allow conclusive results on the prognostic importance of critical preoperative conditions and the value of different treatment strategies to reduce the risk of early adverse events after surgery for acute TAAD. This registry is expected to provide insights into the long-term durability of different strategies of surgical repair for TAAD. Trial registration ClinicalTrials.gov Identifier: NCT04831073.
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- 2021
49. Osteoporosis is accompanied by reduced CD274 expression in human bone marrow-derived mesenchymal stem cells
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Winkelmann M, Bundkirchen C, Gong Z, Zeller An, Sandra Noack, C Neunaber, Christian Krettek, and Selle M
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RD1-811 ,Cell ,Osteoporosis ,Bone Marrow Cells ,Diseases of the musculoskeletal system ,Bone resorption ,B7-H1 Antigen ,Flow cytometry ,Bone remodeling ,Bone Marrow ,Osteogenesis ,Medicine ,Humans ,Wnt Signaling Pathway ,Cells, Cultured ,Retrospective Studies ,mesenchymal stem cells ,Adipogenesis ,medicine.diagnostic_test ,business.industry ,Mesenchymal stem cell ,osteoblasts ,Cell Differentiation ,cd274 ,medicine.disease ,osteoporosis ,medicine.anatomical_structure ,RC925-935 ,Cancer research ,Surgery ,business ,Cell bank - Abstract
Underlying pathomechanisms of osteoporosis are still not fully elucidated. Cell-based therapy approaches pose new possibilities to treat osteoporosis and its complications. The aim of this study was to quantify differences in human bone marrow-derived mesenchymal stem cells (hBMSCs) between healthy donors and those suffering from clinically manifest osteoporosis. Cell samples of seven donors for each group were selected retrospectively from the hBMSC cell bank of the Trauma Department of Hannover Medical School. Cells were evaluated for their adipogenic, osteogenic and chondrogenic differentiation potential, for their proliferation potential and expression of surface antigens. Furthermore, a RT2 Osteoporosis Profiler PCR array, as well as quantitative real-time PCR were carried out to evaluate changes in gene expression. Cultivated hBMSCs from osteoporotic donors showed significantly lower cell surface expression of CD274 (4.98 % ± 2.38 %) than those from the control group (26.03 % ± 13.39 %; p = 0.007), as assessed by flow cytometry. In osteoporotic patients, genes involved in inhibition of the anabolic WNT signalling pathway and those associated with stimulation of bone resorption were significantly upregulated. Apart from these changes, no significant differences were found for the other cell surface antigens, adipogenic, osteogenic and chondrogenic differentiation ability as well as proliferation potential. These findings supported the theory of an influence of CD274 on the regulation of bone metabolism. CD274 might be a promising target for further investigations of the pathogenesis of osteoporosis and of cell-based therapies involving MSCs.
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- 2021
50. Artificial neural networks and pathologists recognize basal cell carcinomas based on different histological patterns
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Emmanuella Guenova, Elisabeth Rumetshofer, Sepp Hochreiter, Markus Hofmarcher, Petar Noack, Martin Kaltenbrunner, Wolfram Hoetzenecker, Guenter Klambauer, Rene Silye, Philipp Tschandl, Harald Kindermann, and Susanne Kimeswenger
- Subjects
0301 basic medicine ,Pathology ,medicine.medical_specialty ,Skin Neoplasms ,Computer science ,Skin tumor ,Pathology and Forensic Medicine ,Machine Learning ,03 medical and health sciences ,0302 clinical medicine ,Text mining ,medicine ,Humans ,Basal cell ,Tumor Identification ,Skin ,Artificial neural network ,business.industry ,Deep learning ,Digital pathology ,Pattern recognition ,3. Good health ,Pathologists ,030104 developmental biology ,Carcinoma, Basal Cell ,030220 oncology & carcinogenesis ,Neural Networks, Computer ,Artificial intelligence ,business ,Area under the roc curve ,Algorithms - Abstract
Recent advances in artificial intelligence, particularly in the field of deep learning, have enabled researchers to create compelling algorithms for medical image analysis. Histological slides of basal cell carcinomas (BCCs), the most frequent skin tumor, are accessed by pathologists on a daily basis and are therefore well suited for automated prescreening by neural networks for the identification of cancerous regions and swift tumor classification. In this proof-of-concept study, we implemented an accurate and intuitively interpretable artificial neural network (ANN) for the detection of BCCs in histological whole-slide images (WSIs). Furthermore, we identified and compared differences in the diagnostic histological features and recognition patterns relevant for machine learning algorithms vs. expert pathologists. An attention-ANN was trained with WSIs of BCCs to identify tumor regions (n = 820). The diagnosis-relevant regions used by the ANN were compared to regions of interest for pathologists, detected by eye-tracking techniques. This ANN accurately identified BCC tumor regions on images of histologic slides (area under the ROC curve: 0.993, 95% CI: 0.990–0.995; sensitivity: 0.965, 95% CI: 0.951–0.979; specificity: 0.910, 95% CI: 0.859–0.960). The ANN implicitly calculated a weight matrix, indicating the regions of a histological image that are important for the prediction of the network. Interestingly, compared to pathologists’ eye-tracking results, machine learning algorithms rely on significantly different recognition patterns for tumor identification (p
- Published
- 2021
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