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51. Parents' Emotional Responses to Early Parenthood.

Author

Sanders, Rachael, Lehmann, Jennifer, and Gardner, Fiona

Subjects
PSYCHOLOGY of parents, SOCIAL constructionism, GROUNDED theory, PARENTHOOD, QUALITATIVE research, EMOTIONAL intelligence
Abstract

Early parenthood is a significant developmental stage that involves abrupt and dramatic changes to a new parent's life. It is thought to be both a stressful and rewarding period, requiring significant adjustment to pre-parenthood lifestyles and routines. This study explores the emotional journey that new parents experience during the early phases of parenthood, examining these with a critical lens and giving consideration to the impacts of social constructions on early parenthood. Thirty parents were interviewed as part of a grounded theory study which uncovered parents' experiences of significant emotional disturbance including self-doubt, isolation and loneliness. Both the role (lack of sleep, frustration) and social expectations and demands contributed to emotional disturbance. Many parents experienced a culture of comparison, competition and judgement that impacted on their emotional well-being, which we believe can be resisted with professional and social supports and the application of critical reflection. [ABSTRACT FROM AUTHOR]

Published
2022
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52. Systemic MCP-1 Levels Derive Mainly From Injured Liver and Are Associated With Complications in Cirrhosis

Author

Queck, Alexander, Bode, Hannah, Uschner, Frank E., Brol, Maximilian J., Graf, Christiana, Schulz, Martin, Jansen, Christian, Praktiknjo, Michael, Schierwagen, Robert, Klein, Sabine, Trautwein, Christian, Wasmuth, Hermann E., Berres, Marie-Luise, Trebicka, Jonel, and Lehmann, Jennifer

Subjects
Male, transjugular intrahepatic portosystemic shunt (TIPS), Kupffer Cells, Immunology, Acute-On-Chronic Liver Failure, Macrophage Activation, Liver Cirrhosis, Experimental, Mice, Inbred C57BL, Mice, acute-on-chronic liver failure (ACLF), Liver, inflammation, monocyte chemotactic protein 1 (MCP-1), Animals, ddc:610, Chemical and Drug Induced Liver Injury, Chemokine CCL2, Original Research, decompensated liver cirrhosis
Abstract

Background and Aims: Monocyte chemotactic protein-1 (MCP-1) is a potent chemoattractant for monocytes. It is involved in pathogenesis of several inflammatory diseases. Hepatic MCP-1 is a readout of macrophage activation. While inflammation is a major driver of liver disease progression, the origin and role of circulating MCP-1 as a biomarker remains unclear. Methods: Hepatic CC-chemokine ligand 2 (CCL2) expression and F4/80 staining for Kupffer cells were measured and correlated in a mouse model of chronic liver disease (inhalative CCl4 for 7 weeks). Next, hepatic RNA levels of CCL2 were measured in explanted livers of 39 patients after transplantation and correlated with severity of disease. Changes in MCP-1 were further evaluated in a rat model of experimental cirrhosis and acute-on-chronic liver failure (ACLF). Finally, we analyzed portal and hepatic vein levels of MCP-1 in patients receiving transjugular intrahepatic portosystemic shunt insertion for complications of portal hypertension. Results: In this mouse model of fibrotic hepatitis, hepatic expression of CCL2 (P = 0.009) and the amount of F4/80 positive cells in the liver (P < 0.001) significantly increased after induction of hepatitis by CCl4 compared to control animals. Moreover, strong correlation of hepatic CCL2 expression and F4/80 positive cells were seen (P = 0.023). Furthermore, in human liver explants, hepatic transcription levels of CCL2 correlated with the MELD score of the patients, and thus disease severity (P = 0.007). The experimental model of ACLF in rats revealed significantly higher levels of MCP-1 plasma (P = 0.028) and correlation of hepatic CCL2 expression (R = 0.69, P = 0.003). Particularly, plasma MCP-1 levels did not correlate with peripheral blood monocyte CCL2 expression. Finally, higher levels of MCP-1 were observed in the hepatic compared to the portal vein (P = 0.01) in patients receiving TIPS. Similarly, a positive correlation of MCP-1 with Child-Pugh score was observed (P = 0.018). Further, in the presence of ACLF, portal and hepatic vein levels of MCP-1 were significantly higher compared to patients without ACLF (both P = 0.039). Conclusion: Circulating levels of MCP-1 mainly derive from the injured liver and are associated with severity of liver disease. Therefore, liver macrophages contribute significantly to disease progression. Circulating MCP-1 may reflect the extent of hepatic macrophage activation.

Published
2020

55. Systemic MCP-1 levels derive mainly from injured liver and are associated with complications in cirrhosis

Author

Queck, Alexander David Roger, Bode, Hannah, Uschner, Frank Erhard, Brol, Maximilian, Graf, Christiana, Schulz, Martin, Jansen, Christian, Praktiknjo, Michael, Schierwagen, Robert, Klein, Sabine, Trautwein, Christian, Wasmuth, Hermann E., Berres, Marie-Luise, Trebicka, Jonel, Lehmann, Jennifer, Queck, Alexander David Roger, Bode, Hannah, Uschner, Frank Erhard, Brol, Maximilian, Graf, Christiana, Schulz, Martin, Jansen, Christian, Praktiknjo, Michael, Schierwagen, Robert, Klein, Sabine, Trautwein, Christian, Wasmuth, Hermann E., Berres, Marie-Luise, Trebicka, Jonel, and Lehmann, Jennifer

Abstract

Background and Aims: Monocyte chemotactic protein-1 (MCP-1) is a potent chemoattractant for monocytes. It is involved in pathogenesis of several inflammatory diseases. Hepatic MCP-1 is a readout of macrophage activation. While inflammation is a major driver of liver disease progression, the origin and role of circulating MCP-1 as a biomarker remains unclear. Methods: Hepatic CC-chemokine ligand 2 (CCL2) expression and F4/80 staining for Kupffer cells were measured and correlated in a mouse model of chronic liver disease (inhalative CCl4 for 7 weeks). Next, hepatic RNA levels of CCL2 were measured in explanted livers of 39 patients after transplantation and correlated with severity of disease. Changes in MCP-1 were further evaluated in a rat model of experimental cirrhosis and acute-on-chronic liver failure (ACLF). Finally, we analyzed portal and hepatic vein levels of MCP-1 in patients receiving transjugular intrahepatic portosystemic shunt insertion for complications of portal hypertension. Results: In this mouse model of fibrotic hepatitis, hepatic expression of CCL2 (P = 0.009) and the amount of F4/80 positive cells in the liver (P < 0.001) significantly increased after induction of hepatitis by CCl4 compared to control animals. Moreover, strong correlation of hepatic CCL2 expression and F4/80 positive cells were seen (P = 0.023). Furthermore, in human liver explants, hepatic transcription levels of CCL2 correlated with the MELD score of the patients, and thus disease severity (P = 0.007). The experimental model of ACLF in rats revealed significantly higher levels of MCP-1 plasma (P = 0.028) and correlation of hepatic CCL2 expression (R = 0.69, P = 0.003). Particularly, plasma MCP-1 levels did not correlate with peripheral blood monocyte CCL2 expression. Finally, higher levels of MCP-1 were observed in the hepatic compared to the portal vein (P = 0.01) in patients receiving TIPS. Similarly, a positive correlation of MCP-1 with Child-Pugh score was observed (P = 0

Published
2020

58. The PREDICT study uncovers three clinical courses of acutely decompensated cirrhosis that have distinct pathophysiology

Author

Trebicka, Jonel, primary, Fernandez, Javier, additional, Papp, Maria, additional, Caraceni, Paolo, additional, Laleman, Wim, additional, Gambino, Carmine, additional, Giovo, Ilaria, additional, Uschner, Frank Erhard, additional, Jimenez, Cesar, additional, Mookerjee, Rajeshwar, additional, Gustot, Thierry, additional, Albillos, Agustin, additional, Bañares, Rafael, additional, Janicko, Martin, additional, Steib, Christian, additional, Reiberger, Thomas, additional, Acevedo, Juan, additional, Gatti, Pietro, additional, Bernal, William, additional, Zeuzem, Stefan, additional, Zipprich, Alexander, additional, Piano, Salvatore, additional, Berg, Thomas, additional, Bruns, Tony, additional, Bendtsen, Flemming, additional, Coenraad, Minneke, additional, Merli, Manuela, additional, Stauber, Rudolf, additional, Zoller, Heinz, additional, Ramos, José Presa, additional, Solè, Cristina, additional, Soriano, Germán, additional, de Gottardi, Andrea, additional, Gronbaek, Henning, additional, Saliba, Faouzi, additional, Trautwein, Christian, additional, Özdogan, Osman Cavit, additional, Francque, Sven, additional, Ryder, Stephen, additional, Nahon, Pierre, additional, Romero-Gomez, Manuel, additional, Van Vlierberghe, Hans, additional, Francoz, Claire, additional, Manns, Michael, additional, Garcia, Elisabet, additional, Tufoni, Manuel, additional, Amoros, Alex, additional, Pavesi, Marco, additional, Sanchez, Cristina, additional, Curto, Anna, additional, Pitarch, Carla, additional, Putignano, Antonella, additional, Moreno, Esau, additional, Shawcross, Debbie, additional, Aguilar, Ferran, additional, Clària, Joan, additional, Ponzo, Paola, additional, Jansen, Christian, additional, Vitalis, Zsuzsanna, additional, Zaccherini, Giacomo, additional, Balogh, Boglarka, additional, Vargas, Victor, additional, Montagnese, Sara, additional, Alessandria, Carlo, additional, Bernardi, Mauro, additional, Ginès, Pere, additional, Jalan, Rajiv, additional, Moreau, Richard, additional, Angeli, Paolo, additional, Arroyo, Vicente, additional, Maschmeier, Miriam, additional, Semela, David, additional, Elkrief, Laure, additional, Elsharkawy, Ahmed, additional, Tornai, Tamas, additional, Tornai, Istvan, additional, Altorjay, Istvan, additional, Antognoli, Agnese, additional, Baldassarre, Maurizio, additional, Gagliardi, Martina, additional, Bertoli, Eleonora, additional, Mareso, Sara, additional, Brocca, Alessandra, additional, Campion, Daniela, additional, Saracco, Giorgio Maria, additional, Rizzo, Martina, additional, Lehmann, Jennifer, additional, Pohlmann, Alessandra, additional, Praktiknjo, Michael, additional, Schierwagen, Robert, additional, Solà, Elsa, additional, Amari, Nesrine, additional, Rodriguez, Miguel, additional, Nevens, Frederik, additional, Clemente, Ana, additional, Jarcuska, Peter, additional, Gerbes, Alexander, additional, Mandorfer, Mattias, additional, Welsch, Christoph, additional, Ciraci, Emanuela, additional, Patel, Vish, additional, Ripoll, Cristina, additional, Herber, Adam, additional, Horn, Paul, additional, Danielsen, Karen Vagner, additional, Gluud, Lise Lotte, additional, Schaapman, Jelte, additional, Riggio, Oliviero, additional, Rainer, Florian, additional, Moritz, Jörg Tobiasch, additional, Mesquita, Mónica, additional, Alvarado-Tapias, Edilmar, additional, Akpata, Osagie, additional, Lykke Eriksen, Peter, additional, Samuel, Didier, additional, Tresson, Sylvie, additional, Strnad, Pavel, additional, Amathieu, Roland, additional, Simón-Talero, Macarena, additional, Smits, Francois, additional, van den Ende, Natalie, additional, Martinez, Javier, additional, Garcia, Rita, additional, Markwardt, Daniel, additional, Rupprechter, Harald, additional, and Engelmann, Cornelius, additional

Published
2020
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64. Systemic MCP-1 Levels Derive Mainly From Injured Liver and Are Associated With Complications in Cirrhosis

Author

Queck, Alexander, primary, Bode, Hannah, additional, Uschner, Frank E., additional, Brol, Maximilian J., additional, Graf, Christiana, additional, Schulz, Martin, additional, Jansen, Christian, additional, Praktiknjo, Michael, additional, Schierwagen, Robert, additional, Klein, Sabine, additional, Trautwein, Christian, additional, Wasmuth, Hermann E., additional, Berres, Marie-Luise, additional, Trebicka, Jonel, additional, and Lehmann, Jennifer, additional

Published
2020
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68. The relationship between theory of mind and mental rotation ability in preschool aged children

Author

Lehmann, Jennifer and Jansen, Petra

Subjects
Neurophysiology and neuropsychology, preschool children, QP351-495, 150 Psychologie, ddc:150, perspective taking, Psychology, theory of mindmental rotationperspective takingpreschool children, theory of mind, mental rotation, BF1-990
Abstract

This study investigates the relationship between two tasks of perspective taking, the social perspective taking ability, namely theory of mind, and the spatial one, namely mental rotation, in preschool aged children. Both abilities develop during preschool age (Frick et al., 2013; Wellmann et al., 2001). We investigated 83 children aged between three and four years regarding their theory of mind and mental rotation ability. A significant correlation between both tasks was found for those children, who were able to solve the mental rotation task. This relation was no longer significant when analyzing the two age groups separately. Due to the small sample size as well as the performance in the mental rotation test more research is needed to investigate this relationship and its role in development.

Published
2019
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69. Relation of injuries and psychological symptoms in amateur soccer players

Author

Jansen, Petra, Lehmann, Jennifer, Fellner, Birgit, Huppertz, Gunnar, Loose, Oliver, Achenbach, Leonard, and Krutsch, Werner

Subjects
ddc:796, 796 Sport, injury, depression, Original Article, anxiety, human activities, self-compassion, amateur soccer players
Abstract

Objectives The first main goal of this study was to investigate the prevalence of depression and anxiety as well as self-compassion in a heterogeneous sample of male amateur soccer players. The second main goal of this study was the examination of the relationship between injuries and psychological factors in amateur soccer players. Methods Players were recruited from German amateur soccer clubs of the fourth to seventh league. 419 soccer players with the mean age of 22.88 years participated in the psychological and the injury assessment at the beginning of the season and at the end, 9 months later. For the psychological assessment, depression and anxiety rate as well as self-compassion was analysed. Furthermore, the frequencies of injuries were registered. Results The results showed that players of the highest amateur league, the fourth league in German soccer, showed significantly higher anxiety values than players from a lower league (p=0.013). There were no differences in depression values dependent on the league. Furthermore, players who suffered from an injury before the start of the season demonstrated higher anxiety values (p=0.027). This result was independent of the respective league. Conclusion The results of this study demonstrate that even in higher amateur soccer the anxiety level of the players varies between soccer players of different leagues. Because an injury before the start of the season influenced the anxiety level, a psychological treatment during injury should be considered. Summary box Even in higher amateur soccer the anxiety level of the players varies between soccer players of different leagues. Psychological factors are also in lower soccer levels related to injuries. The possible relation of psychological and medical issues must be also investigated in amateur soccer players.

Published
2019
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70. Collagen type IV remodelling gender-specifically predicts mortality in decompensated cirrhosis

Author

Lehmann, Jennifer, Praktiknjo, Michael, Nielsen, Mette Juul, Schierwagen, Robert, Meyer, Carsten, Thomas, Daniel, Violi, Francesco, Strassburg, Christian P, Bendtsen, Flemming, Møller, Søren, Krag, Aleksander, Karsdal, Morten Asser, Leeming, Diana Julie, Trebicka, Jonel, Lehmann, Jennifer, Praktiknjo, Michael, Nielsen, Mette Juul, Schierwagen, Robert, Meyer, Carsten, Thomas, Daniel, Violi, Francesco, Strassburg, Christian P, Bendtsen, Flemming, Møller, Søren, Krag, Aleksander, Karsdal, Morten Asser, Leeming, Diana Julie, and Trebicka, Jonel

Abstract

BACKGROUND & AIMS: Remodelling of extracellular matrix is crucial in progressive liver fibrosis. Collagen type III desposition has been shown in acute decompensation. Extratracellular matrix is compiled of deposition of various components. The role of basement membrane collagen type IV in advanced cirrhosis and acute decompensation is unclear and investigated in this study.METHODS: Patients with decompensated cirrhosis from the prospective NEPTUN cohort (ClinicalTrials.gov Identifier: NCT03628807), who underwent transjugular intrahepatic portosystemic shunt procedure were included. Clinical and laboratory parameters, PRO-C4 and C4M levels were measured in blood samples from portal and hepatic veins just before transjugular intrahepatic portosystemic shunt placement.RESULTS: Levels of C4M and PRO-C4 are significantly lower in patients with massive ascites and impaired renal sodium excretion. C4M and PRO-C4 show gender-specific profiles with significantly lower levels in females compared to males. Females with higher C4M levels show higher mortality. By contrast, males with higher C4M levels show lower mortality. In multivariate Cox regression analysis, C4M is an independent predictor of survival in female patients.CONCLUSION: This study shows that markers of collagen type IV remodelling do not accumulate in severe renal dysfunction. Although collagen type IV degradation markers derive from the liver, portal venous C4M levels are relevant for survival. Moreover, it demonstrates that circulating C4M shows gender-specific profiles, which can independently predict survival in female patients with decompensated cirrhosis.

Published
2019

71. Sex specificity of kidney markers to assess prognosis in cirrhotic patients with TIPS

Author

Torner, Maria, Mangal, Adjmal, Scharnagl, Hubert, Jansen, Christian, Praktiknjo, Michael, Queck, Alexander David Roger, Gu, Wenyi, Schierwagen, Robert, Lehmann, Jennifer, Uschner, Frank Erhard, Graf, Christiana, Straßburg, Christian P., Fernandez, Javier, Stojakovic, Tatjana, Woitas, Rainer, Trebicka, Jonel, Torner, Maria, Mangal, Adjmal, Scharnagl, Hubert, Jansen, Christian, Praktiknjo, Michael, Queck, Alexander David Roger, Gu, Wenyi, Schierwagen, Robert, Lehmann, Jennifer, Uschner, Frank Erhard, Graf, Christiana, Straßburg, Christian P., Fernandez, Javier, Stojakovic, Tatjana, Woitas, Rainer, and Trebicka, Jonel

Abstract

Background & Aims: Renal function assessed by creatinine is a key prognostic factor in cirrhotic patients. However, creatinine is influenced by several factors, rendering interpretation difficult in some situations. This is especially important in early stages of renal dysfunction where renal impairment might not be accompanied by an increase in creatinine. Other parameters, such as cystatin C (CysC) and beta‐trace protein (BTP), have been evaluated to fill this gap. However, none of these studies have considered the role of the patient's sex. The present study analysed CysC and BTP to evaluate their prognostic value and differentiate them according to sex. Patients and methods: CysC and BTP were measured in 173 transjugular intrahepatic portosystemic shunt (TIPS)‐patients from the NEPTUN‐STUDY(NCT03628807) and analysed their relationship with mortality and sex. Propensity score for age, MELD, etiology and TIPS indication was used. Results_ Cystatin C and BTP showed excellent correlations with creatinine values at baseline and follow‐up. CysC was an independent predictor of overall mortality (HR = 1.66(1.33‐2.06)) with an AUC of 0.75 and identified a cut‐off of 1.55 mg/L in the whole cohort. Interestingly, CysC was significantly lower in females, also after propensity score matching. In males, the only independent predictor was the creatinine level (HR = 1.54(1.25‐1.58)), while in females CysC levels independently predicted mortality (HR = 3.17(1.34‐7.52)). Conclusion: This study demonstrates for the first time that in TIPS‐patients creatinine predicts mortality in males better than in females, whereas CysC is a better predictor of mortality in females. These results may influence future clinical decisions on therapeutic options for example, allocation for liver transplantation in TIPS‐patients.

Published
2019

72. Left ventricular longitudinal contractility predicts acute‐on‐chronic liver failure development and mortality after transjugular intrahepatic portosystemic shunt

Author

Jansen, Christian, Schröder, Anna, Schueler, Robert, Lehmann, Jennifer, Praktiknjo, Michael, Uschner, Frank Erhard, Schierwagen, Robert, Thomas, Daniel, Monteiro, Sofia, Nickenig, Georg, Straßburg, Christian P., Meyer, Carsten, Arroyo, Vicente, Hammerstingl, Christoph, Trebicka, Jonel, Jansen, Christian, Schröder, Anna, Schueler, Robert, Lehmann, Jennifer, Praktiknjo, Michael, Uschner, Frank Erhard, Schierwagen, Robert, Thomas, Daniel, Monteiro, Sofia, Nickenig, Georg, Straßburg, Christian P., Meyer, Carsten, Arroyo, Vicente, Hammerstingl, Christoph, and Trebicka, Jonel

Abstract

Acute deterioration of liver cirrhosis (e.g., infections, acute‐on‐chronic liver failure [ACLF]) requires an increase in cardiac contractility. The insufficiency to respond to these situations could be deleterious. Left ventricular global longitudinal strain (LV‐GLS) has been shown to reflect left cardiac contractility in cirrhosis better than other parameters and might bear prognostic value. Therefore, this retrospective study investigated the role of LV‐GLS in the outcome after transjugular intrahepatic portosystemic shunt (TIPS) and the development of ACLF. We included 114 patients (48 female patients) from the Noninvasive Evaluation Program for TIPS and Their Follow‐Up Network (NEPTUN) cohort. This number provided sufficient quality and structured follow‐up with the possibility of calculating major scores (Child, Model for End‐Stage Liver Disease [MELD], Chronic Liver Failure Consortium acute decompensation [CLIF‐C AD] scores) and recording of the events (development of decompensation episode and ACLF). We analyzed the association of LV‐GLS with overall mortality and development of ACLF in patients with TIPS. LV‐GLS was independently associated with overall mortality (hazard ratio [HR], 1.123; 95% confidence interval [CI],1.010‐1.250) together with aspartate aminotransferase (HR, 1.009; 95% CI, 1.004‐1.014) and CLIF‐C AD score (HR, 1.080; 95% CI, 1.018‐1.137). Area under the receiver operating characteristic curve (AUROC) analysis for LV‐GLS for overall survival showed higher area under the curve (AUC) than MELD and CLIF‐C AD scores (AUC, 0.688 versus 0.646 and 0.573, respectively). The best AUROC‐determined LV‐GLS cutoff was −16.6% to identify patients with a significantly worse outcome after TIPS at 3 months, 6 months, and overall. LV‐GLS was independently associated with development of ACLF (HR, 1.613; 95% CI, 1.025‐2.540) together with a MELD score above 15 (HR, 2.222; 95% CI, 1.400‐3.528). Conclusion: LV‐GLS is useful for identifying patients at risk of dev

Published
2019

73. The Choice of Sports Affects Mental Rotation Performance in Adolescents

Author

Pietsch, Stefanie, Jansen, Petra, and Lehmann, Jennifer

Subjects
ddc:796, 796 Sport, dancing, soccer, lcsh:RC321-571, egocentric transformations, visual-spatial abilities, sports, lcsh:Neurosciences. Biological psychiatry. Neuropsychiatry, human activities, object-based transformations, Neuroscience, Original Research, mental rotation
Abstract

This study investigates mental rotation performance of adolescent female dancers and soccer players in object-based and egocentric mental rotation tasks using human body stimuli. 60 young females, 30 soccer players, and 30 dancers (not twosome), completed a chronometric mental rotation task with object-based and egocentric transformation of male and female figures, which were displayed either in front or back view. During their sport-specific activity soccer-players and dancers very often have to adapt their movements to the movement of a partner or opponent, soccer-players especially in front view positions. While for soccer-players reaction time (RT) often is crucial for sporting success, dancers mainly focus on the accuracy of their movements. Therefore, we expect significantly faster RTs for soccer players for front view stimuli but no differences between soccer players and dancers for back view stimuli. The main result was that soccer-players showed a significantly shorter RT than dancers for stimuli presented in front view in object based and egocentric transformation. There was no such difference, when the stimuli were presented in the back view. Contrary to literature we didn’t find significantly higher RTs and error rates for stimuli presented in front view compared to back view in general but only for egocentric transformations. The results of this study show that specific sports affect individual aspects of mental rotation performance.

Published
2018

76. Sex specificity of kidney markers to assess prognosis in cirrhotic patients with TIPS

Author

Torner, Maria, primary, Mangal, Adjmal, additional, Scharnagl, Hubert, additional, Jansen, Christian, additional, Praktiknjo, Michael, additional, Queck, Alexander, additional, Gu, Wenyi, additional, Schierwagen, Robert, additional, Lehmann, Jennifer, additional, Uschner, Frank E., additional, Graf, Christiana, additional, Strassburg, Christian P., additional, Fernandez, Javier, additional, Stojakovic, Tatjana, additional, Woitas, Rainer, additional, and Trebicka, Jonel, additional

Published
2019
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78. Significant reduction in heart rate variability is a feature of acute decompensation of cirrhosis and predicts 90-day mortality

Author

Jansen, Christian, primary, Chatterjee, Devnandan Amor, additional, Thomsen, Karen Louise, additional, Al-Kassou, Baravan, additional, Sawhney, Rohit, additional, Jones, Helen, additional, Gallego-Leon, Angela, additional, Lehmann, Jennifer, additional, Pohlmann, Alessandra, additional, Nickenig, Georg, additional, Strassburg, Christian P., additional, Andrié, René, additional, Jalan, Rajiv, additional, Linhart, Markus, additional, Trebicka, Jonel, additional, and Mookerjee, Rajeshwar P., additional

Published
2019
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80. SAT-091-The collagen hormone Endotrophin, a biomarker of type VI collagen formation-is associated with severe decompensation and predicts transplant-free survival in patients with transjugular intrahepatic portosystemic shunt

Author

Nielsen, Mette Juul, primary, Genovese, Federica, additional, Lehmann, Jennifer, additional, Schierwagen, Robert, additional, Jansen, Christian, additional, Praktiknjo, Michael, additional, Leeming, Diana, additional, Karsdal, Morten, additional, and Trebicka, Jonel, additional

Published
2019
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83. Collagen type IV remodelling gender‐specifically predicts mortality in decompensated cirrhosis

Author

Lehmann, Jennifer, primary, Praktiknjo, Michael, additional, Nielsen, Mette Juul, additional, Schierwagen, Robert, additional, Meyer, Carsten, additional, Thomas, Daniel, additional, Violi, Francesco, additional, Strassburg, Christian P., additional, Bendtsen, Flemming, additional, Møller, Søren, additional, Krag, Aleksander, additional, Karsdal, Morten Asser, additional, Leeming, Diana Julie, additional, and Trebicka, Jonel, additional

Published
2019
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85. Left Ventricular Longitudinal Contractility Predicts Acute‐on‐Chronic Liver Failure Development and Mortality After Transjugular Intrahepatic Portosystemic Shunt

Author

Jansen, Christian, primary, Schröder, Anna, additional, Schueler, Robert, additional, Lehmann, Jennifer, additional, Praktiknjo, Michael, additional, Uschner, Frank E., additional, Schierwagen, Robert, additional, Thomas, Daniel, additional, Monteiro, Sofia, additional, Nickenig, Georg, additional, Strassburg, Christian P., additional, Meyer, Carsten, additional, Arroyo, Vicente, additional, Hammerstingl, Christoph, additional, and Trebicka, Jonel, additional

Published
2019
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89. Acute decompensation boosts hepatic collagen type III deposition and deteriorates experimental and human cirrhosis

Author

Praktiknjo, Michael, Lehmann, Jennifer, Nielsen, Mette J, Schierwagen, Robert, Uschner, Frank E, Meyer, Carsten, Thomas, Daniel, Strassburg, Christian P, Bendtsen, Flemming, Møller, Søren, Krag, Aleksander, Karsdal, Morten A, Leeming, Diana J, Trebicka, Jonel, Praktiknjo, Michael, Lehmann, Jennifer, Nielsen, Mette J, Schierwagen, Robert, Uschner, Frank E, Meyer, Carsten, Thomas, Daniel, Strassburg, Christian P, Bendtsen, Flemming, Møller, Søren, Krag, Aleksander, Karsdal, Morten A, Leeming, Diana J, and Trebicka, Jonel

Abstract

Patients with end-stage liver disease develop acute decompensation (AD) episodes, which become more frequent and might develop into acute-on-chronic liver failure (ACLF). However, it remains unknown how AD induces acceleration of liver disease. We hypothesized that remodeling of collagen type III plays a role in the acceleration of liver cirrhosis after AD and analyzed its formation (Pro-C3) and degradation (matrix metalloproteinase-degraded type III collagen [C3M]) markers in animal models and human disease. Bile duct ligation induced different stages of liver fibrosis in rats. Fibrosis development (hydroxyprolin content, sirius red staining, α-smooth muscle actin immunohistochemistry, messenger RNA of profibrotic cytokines), necroinflammation (aminotransferases levels), fibrolysis (matrix metalloproteinase 2 expression and activity, C1M, C4M), and Pro-C3 and C3M were analyzed 2, 3, 4, 5, and 6 weeks after bile duct ligation (n = 5 each group). In 110 patients with decompensated liver cirrhosis who underwent a transjugular intrahepatic portosystemic shunt procedure for AD, clinical and laboratory parameters as well as Pro-C3 and C3M were measured in blood samples from portal and hepatic veins and were collected just before the transjugular intrahepatic portosystemic shunt placement and 1-3 weeks later. Animal studies showed increased markers of collagen type III deposition with fibrosis, necroinflammation, and decompensation of liver cirrhosis, defined as ascites development. Higher Pro-C3 levels were associated with injury, disease severity scores (Model for End-Stage Liver Disease, Child-Pugh, chronic liver failure-C AD), ACLF development, and mortality. C3M decreased with AD and the chronic liver failure-C AD score. Collagen type III deposition ratio increased with the risk of ACLF development and mortality. Conclusion: We show for the first time that AD boosts collagen type III deposition in experimental and human cirrhosis, possibly contributing to the wors

Published
2018

90. Prevention of severe knee injuries in men's elite football by implementing specific training modules.

Author

Krutsch, Werner, Lehmann, Jennifer, Jansen, Petra, Angele, Peter, Fellner, Birgit, Achenbach, Leonard, Krutsch, Volker, Nerlich, Michael, Alt, Volker, and Loose, Oliver

Subjects
*KNEE injury prevention, *WARMUP, *PREVENTION of injury, *SOCCER injuries, *PHYSICAL training & conditioning
Abstract

Purpose: Injury prevention of knee injuries by means of training and warm-up exercises has been investigated in several studies in amateur football. However, the number of investigations in elite football is limited despite the currently higher injury incidence of severe knee injuries. Therefore, the purpose of this study was to investigate whether specifically adapted preventive training modules may reduce severe knee injuries in elite football.Methods: In a prospective controlled cohort study of elite football players in Germany, an injury prevention programme with 5 modules was implemented in the season of 2015-2016. The training modules were specifically adapted to this skill level and based on scientific evidence, team coach preferences, and the specific environment of this playing level. Of the 62 teams taking part in this study, 26 used the new trainings modules and 36 continued their standard programme as a control group. Success of the programme was documented by means of an injury report over one season. The primary outcome was reduction in severe knee injuries.Results: A pre-seasonal investigation had identified five modules to be implemented in the training routine. Postural stability, mobilisation of lower extremity joints, leg and trunk stabilisation, jumping, and landing exercises as well as agility movements were incorporated into the programme to prevent severe knee injuries in elite football. Over the season, the study group (529 players) with the adapted training modules had sustained 52 severe knee injuries (incidence: 0.38 per 1000 h football exposure; prevalence: 9.8%) compared to 108 severe knee injuries in the control group (601 players) using the standard programme (incidence: 0.68 per 1000 h football exposure; prevalence: 18.0%; p < 0.05). The overall injury incidence for any other type of injury was comparable between the two groups (3.3 vs. 3.4 in h 1000 football, n.s.).Conclusion: Appropriate preventive training modules reduce severe knee injuries in elite football significantly. The key for the sustainability of preventive training measures are programmes specifically adapted to the demands of the playing level and to the preferences of the coaches LEVEL OF EVIDENCE: II. [ABSTRACT FROM AUTHOR]

Published
2020
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91. Sex specificity of kidney markers to assess prognosis in cirrhotic patients with TIPS.

Author

Torner, Maria, Mangal, Adjmal, Scharnagl, Hubert, Jansen, Christian, Praktiknjo, Michael, Queck, Alexander, Gu, Wenyi, Schierwagen, Robert, Lehmann, Jennifer, Uschner, Frank E., Graf, Christiana, Strassburg, Christian P., Fernandez, Javier, Stojakovic, Tatjana, Woitas, Rainer, and Trebicka, Jonel

Subjects
PROPENSITY score matching, LIVER transplantation, HUMAN sexuality, KIDNEYS
Abstract

Background & Aims: Renal function assessed by creatinine is a key prognostic factor in cirrhotic patients. However, creatinine is influenced by several factors, rendering interpretation difficult in some situations. This is especially important in early stages of renal dysfunction where renal impairment might not be accompanied by an increase in creatinine. Other parameters, such as cystatin C (CysC) and beta‐trace protein (BTP), have been evaluated to fill this gap. However, none of these studies have considered the role of the patient's sex. The present study analysed CysC and BTP to evaluate their prognostic value and differentiate them according to sex. Patients and methods: CysC and BTP were measured in 173 transjugular intrahepatic portosystemic shunt (TIPS)‐patients from the NEPTUN‐STUDY(NCT03628807) and analysed their relationship with mortality and sex. Propensity score for age, MELD, etiology and TIPS indication was used. Results: Cystatin C and BTP showed excellent correlations with creatinine values at baseline and follow‐up. CysC was an independent predictor of overall mortality (HR = 1.66(1.33‐2.06)) with an AUC of 0.75 and identified a cut‐off of 1.55 mg/L in the whole cohort. Interestingly, CysC was significantly lower in females, also after propensity score matching. In males, the only independent predictor was the creatinine level (HR = 1.54(1.25‐1.58)), while in females CysC levels independently predicted mortality (HR = 3.17(1.34‐7.52)). Conclusion: This study demonstrates for the first time that in TIPS‐patients creatinine predicts mortality in males better than in females, whereas CysC is a better predictor of mortality in females. These results may influence future clinical decisions on therapeutic options for example, allocation for liver transplantation in TIPS‐patients. [ABSTRACT FROM AUTHOR]

Published
2020
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95. Severe abnormal Heart Rate Turbulence Onset is associated with deterioration of liver cirrhosis

Author

Jansen, Christian, primary, Al-Kassou, Baravan, additional, Lehmann, Jennifer, additional, Pohlmann, Alessandra, additional, Chang, Johannes, additional, Praktiknjo, Michael, additional, Nickenig, Georg, additional, Strassburg, Christian P., additional, Schrickel, Jan W., additional, Andrié, René, additional, Linhart, Markus, additional, and Trebicka, Jonel, additional

Published
2018
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96. Fibroblast growth factor 21 is an early predictor of acute‐on‐chronic liver failure in critically ill patients with cirrhosis

Author

Ruiz‐Margáin, Astrid, primary, Pohlmann, Alessandra, additional, Ryan, Patrick, additional, Schierwagen, Robert, additional, Chi‐Cervera, Luis A., additional, Jansen, Christian, additional, Mendez‐Guerrero, Osvely, additional, Flores‐García, Nayelli C., additional, Lehmann, Jennifer, additional, Torre, Aldo, additional, Macías‐Rodríguez, Ricardo Ulises, additional, and Trebicka, Jonel, additional

Published
2018
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98. Increase in liver stiffness after transjugular intrahepatic portosystemic shunt is associated with inflammation and predicts mortality

Author

Jansen, Christian, primary, Möller, Philipp, additional, Meyer, Carsten, additional, Kolbe, Carl Christian, additional, Bogs, Christopher, additional, Pohlmann, Alessandra, additional, Schierwagen, Robert, additional, Praktiknjo, Michael, additional, Abdullah, Zeinab, additional, Lehmann, Jennifer, additional, Thomas, Daniel, additional, Strassburg, Christian P., additional, Latz, Eicke, additional, Mueller, Sebastian, additional, Rössle, Martin, additional, and Trebicka, Jonel, additional

Published
2018
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99. Acute decompensation boosts hepatic collagen type III deposition and deteriorates experimental and human cirrhosis

Author

Praktiknjo, Michael, primary, Lehmann, Jennifer, additional, Nielsen, Mette J., additional, Schierwagen, Robert, additional, Uschner, Frank E., additional, Meyer, Carsten, additional, Thomas, Daniel, additional, Strassburg, Christian P., additional, Bendtsen, Flemming, additional, Møller, Søren, additional, Krag, Aleksander, additional, Karsdal, Morten A., additional, Leeming, Diana J., additional, and Trebicka, Jonel, additional

Published
2018
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