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3. Expected benefits and concerns regarding virtual reality in caring for terminally ill cancer patients – a qualitative interview study

Author

Anja Greinacher, Bernd Alt-Epping, Christina Gerlach, and Cornelia Wrzus

Subjects
Virtual reality, Expected benefits, Concerns, Palliative care, Oncology, Personalized therapy, Special situations and conditions, RC952-1245
Abstract

Abstract Background Many palliative cancer patients require inpatient hospital treatment for medical reasons, which contrasts their frequent desire to be at home. Virtual reality (VR) could be a way of bringing the home environment closer to them. First observations have shown benefits from VR for inpatients in palliative care. The aim of this qualitative, descriptive study was to explore the expectations of in-patients suffering from incurable cancer and their relatives about VR, in particular individualized VR images of the patients’ own home. Methods Semi-structured interviews with inpatients suffering from incurable cancers and their relatives in three medical settings (palliative care, hematology, radiotherapy) of a German university hospital. Qualitative content analysis about expected benefits and concerns regarding VR-videos showing their private home; defining the main topics deductively and the subcategories inductively. We also assessed the patients’ subjective perspective on their remaining time to live to estimate the impact of double awareness on the results. The Patient Advisory Board informed the study protocol and conduct. Results We interviewed 15 patients (8 men; age M = 63.4, SD = 11.34; range 39–82) under palliative care, and four relatives. We organized the interview content in 6 themes (general interest, desired content, non-desired content, expected benefits, concerns, and irregularities) and 26 sub-themes. Most patients and relatives were interested in using VR during hospital treatment. They often preferred viewing nature or tourist sites over seeing their home or family. Reasons could be linked to privacy concerns and the general desire for distraction from the current situation that they specified with their expectation of well-being, a break from the patient-experience, the pursue of curiosity, and the VR evoking fond memories. Conclusion VR seems to be of interest for palliative cancer patients, especially as distraction and relief from their illness. The desired content can be very different, so a choice from a selection of VR-content should be made available. If patients want to see videos of their own home, recordings by relatives instead of study or hospital staff seem to meet the need for privacy. Trial registration Registered at Deutsches Register Klinischer Studien; registration number: DRKS00032172; registration date: 11/07/2023. https://drks.de/search/de/trial/DRKS00032172.

Published
2024
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4. My virtual escape from patient life: a feasibility study on the experiences and benefits of individualized virtual reality for inpatients in palliative cancer care

Author

Christina Gerlach, Laura Haas, Anja Greinacher, Jonah Lantelme, Melanie Guenther, Julia Thiesbonenkamp-Maag, Bernd Alt-Epping, and Cornelia Wrzus

Subjects
Virtual reality, Innovation, Palliative care, Oncology, Hematology, Personalized therapy, Special situations and conditions, RC952-1245
Abstract

Abstract Background Cancer patients benefit from Virtual Reality (VR) in burdensome situations, but evidence is scarce for palliative situations. Based on earlier work in palliative care, individualized VR interventions like seeing the patient’s home may address a patient’s wish to be at home and thus have a greater effect compared to standard VR content. Yet, some patients and relatives may be concerned about their privacy. Also, patient stakeholders raised concerns about triggering depressed mood or homesickness. Aim To test the feasibility and safety of individualized vs. standard 360°video VR interventions in palliative cancer inpatients. Methods Prospective observational study with patient-reported outcome measurement using validated instruments of well-being (MDBF), symptoms and psychosocial burden (IPOS), cybersickness (SSQ), presence experience (SPES), subjective benefit (2 items), content analysis of interviews, and field notes. Individualized VR content was recorded with action camcorder-technology to protect the patients’ privacy. Results Seventeen patients participated, median age 65 years (range 20–82), 9 women (53%), 8 single or widowed (47%), 4 childless (23.5%), 4 academics (23.5%), with a median length of stay of 9 days (1–75) in the hematology (10), palliative care (3), or radiotherapy (2) unit of a German university hospital. Eight patients (53.3%) chose their own home environments or family for individualized VR-content. All participants enjoyed the intervention. Compared to standard VR content the individualized VR tended to have a stronger effect on well-being and emotional touch. It was not inferior in terms of psychosocial burden and cybersickness. No subjective and relevant side effects occurred. The patients well tolerated the assessments. However, most patients demanded a lighter headset and a desire for more interactivity. Conclusions Individualization of VR content shows potential for enhancement of immersion, which improves the VR experience and does not harm in terms of depressed mood or worsening of symptoms. The patients’ and family desire for privacy is feasible with the support of family members who recorded the individualized videos, which is easily manageable today. We suggest a pragmatic randomized clinical trial to compare the effects of individualized vs. standard VR-content. Trial registration Registered at German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS); registration number: DRKS00032172; registration date: 11/07/2023.

Published
2024
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7. The Role of Negative Age Stereotypes and Sociodemographic Factors in the Intention to Leave Among German University Hospital Nursing Staff

Author

Madeleine Helaß Dipl, RN, Anja Greinacher PhD, M.Sc., Andreas Müller PhD, Hans-Christoph Friederich MD, Imad Maatouk MD, and Christoph Nikendei MD

Subjects
Public aspects of medicine, RA1-1270
Abstract

Staff shortages are a global problem in the nursing profession. Negative beliefs about older workers may have detrimental effects on the development and performance capacity of an aging workforce. To date, little is known about the impact of age stereotypes and potential factors on nurses’ intent to leave (ITL). Therefore, the aim of our study was to assess intention to leave and potential predictors (eg, sociodemographic characteristics and age stereotypes) in a large representative sample of nurses in a German university hospital setting. A total of 423 nurses at the University Hospital of Heidelberg participated in a cross-sectional questionnaire study assessing sociodemographic data, age stereotypes using the “Beliefs About Older Workers” questionnaire, and participants’ intentions to leave and give up their profession. Questionnaires were returned by 423 nurses (13.7% response rate). The results revealed that negative age stereotypes were highly prevalent. Significant correlations between age and negative age stereotypes were found, indicating that the younger the nurses were, the more negative their age stereotypes were. Most nurses with negative age stereotypes had no intention to leave their profession; however, the majority of nurses could not imagine working in the profession until they retired. Despite the low response rate, the results of the current study suggest that organizational and societal measures to reduce age stereotypes should be directed at newcomers and young nurses to retain them in the profession in the long term.

Published
2024
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9. Whole-genome analysis of plasma fibrinogen reveals population-differentiated genetic regulators with putative liver roles

Author

Huffman, Jennifer E., Nicholas, Jayna, Hahn, Julie, Heath, Adam S., Raffield, Laura M., Yanek, Lisa R., Brody, Jennifer A., Thibord, Florian, Almasy, Laura, Bartz, Traci M., Bielak, Lawrence F., Bowler, Russell P., Carrasquilla, Germán D., Chasman, Daniel I., Chen, Ming-Huei, Emmert, David B., Ghanbari, Mohsen, Haessler, Jeffrey, Hottenga, Jouke-Jan, Kleber, Marcus E., Le, Ngoc-Quynh, Lee, Jiwon, Lewis, Joshua P., Li-Gao, Ruifang, Luan, Jian'an, Malmberg, Anni, Mangino, Massimo, Marioni, Riccardo E., Martinez-Perez, Angel, Pankratz, Nathan, Polasek, Ozren, Richmond, Anne, Rodriguez, Benjamin A. T., Rotter, Jerome I., Steri, Maristella, Suchon, Pierre, Trompet, Stella, Weiss, Stefan, Zare, Marjan, Auer, Paul, Cho, Michael H., Christofidou, Paraskevi, Davies, Gail, de Geus, Eco, Deleuze, Jean-François, Delgado, Graciela E., Ekunwe, Lynette, Faraday, Nauder, Gögele, Martin, Greinacher, Andreas, Gao, He, Howard, Tom, Joshi, Peter K., Kilpeläinen, Tuomas O., Lahti, Jari, Linneberg, Allan, Naitza, Silvia, Noordam, Raymond, Paüls-Vergés, Ferran, Rich, Stephen S., Rosendaal, Frits R., Rudan, Igor, Ryan, Kathleen A., Souto, Juan Carlos, van Rooij, Frank J. A., Wang, Heming, Zhao, Wei, Becker, Lewis C., Beswick, Andrew, Brown, Michael R., Cade, Brian E., Campbell, Harry, Cho, Kelly, Crapo, James D., Curran, Joanne E., de Maat, Moniek P. M., Doyle, Margaret, Elliott, Paul, Floyd, James S., Fuchsberger, Christian, Grarup, Niels, Guo, Xiuqing, Harris, Sarah E., Hou, Lifang, Kolcic, Ivana, Kooperberg, Charles, Menni, Cristina, Nauck, Matthias, O'Connell, Jeffrey R., Orrù, Valeria, Psaty, Bruce M., Räikkönen, Katri, Smith, Jennifer A., Soria, Jose Manuel, Stott, David J., van Hylckama Vlieg, Astrid, Watkins, Hugh, Willemsen, Gonneke, Wilson, Peter W. F., Ben-Shlomo, Yoav, Blangero, John, Boomsma, Dorret, Cox, Simon R., Dehghan, Abbas, Eriksson, Johan G., Fiorillo, Edoardo, Fornage, Myriam, Hansen, Torben, Hayward, Caroline, Ikram, M. Arfan, Jukema, J. Wouter, Kardia, Sharon L. R., Lange, Leslie A., März, Winfried, Mathias, Rasika A., Mitchell, Braxton D., Mook-Kanamori, Dennis O., Morange, Pierre-Emmanuel, Pedersen, Oluf, Pramstaller, Peter P., Redline, Susan, Reiner, Alexander, Ridker, Paul M., Silverman, Edwin K., Spector, Tim D., Völker, Uwe, Wareham, Nicholas J., Wilson, James F., Yao, Jie, Trégouët, David-Alexandre, Johnson, Andrew D., Wolberg, Alisa S., de Vries, Paul S., Sabater-Lleal, Maria, Morrison, Alanna C., and Smith, Nicholas L.

Published
2024
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10. Use of Intravenous Albumin: A Guideline From the International Collaboration for Transfusion Medicine Guidelines

Author

Flores, Jerome, Frappier, Stéfanie, Hou, Yvette, Jean-Pierre, Lilly, Jomaa, Danny, Kabir, Monisha, Kadota, Leo, Lam, Michelle, Ripsman, David A., Sandarage, Ryan, Staykov, Emiliyan, Venes, Angelica, Wan, Melissa, Al Riyami, Arwa, Allard, Shubha, Brouwers, Melissa, Callum, Jeannie, Daly, James, Denomme, Gregory A., Estcourt, Lise, Fergusson, Dean, Fung, Mark, Green, Laura, Greinacher, Andreas, Hume, Heather, Jug, Rachel, Kaufman, Richard, Kim, Hyungsuk, Louw, Vernon, Matsushita, Tadashi, Murphy, Michael, Pink, Joanne, Robinson, Susan, So-Osman, Cynthia, Stanworth, Simon, Szczepiorkowski, Zbigniew M., Tobian, Aaron, Wood, Erica, Skubas, Nikolaos J., Bathla, Aarti, Keshavarz, Homa, Clark, Edward G., Rochwerg, Bram, Arbous, Sesmu, Bauer, Seth R., China, Louise, Neill, Michael, Paine, Cary, Pavenski, Katerina, Shah, Prakesh S., Shan, Hua, Thevenot, Thierry, Wu, Bovey, and Shehata, Nadine

Published
2024
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14. Epirubicin for the Treatment of Sepsis and Septic Shock (EPOS-1): study protocol for a randomised, placebo-controlled phase IIa dose-escalation trial

Author

Peter Schlattmann, Thomas Lehmann, Tim Rahmel, Johannes Roth, Peter Kranke, Frank M Brunkhorst, Andreas Greinacher, Patrick Meybohm, Philipp Helmer, Stefan Hagel, Florian Rißner, Michael Bauer, Matthias Gründling, Sven-Olaf Kuhn, Christian Fuchs, Luis Ferreira Moita, Frank Bloos, Matthias Michael, Ulrike Schumacher, Matthias Unterberg, Daniel Thomas-Rüddel, Christiane Helbig, Johannes Ehler, Heiko Schenk, Thomas Köcher, Markus Gräler, Ann-Julika Heger, Sebastian Weis, Karen Dlubatz, Jakob Hammersen, Katja Leonhardt, René Markgraf, Franziska Röstel, Nicole Schwarze, Mariann Städtler, Wolfgang Vivas-Varela, Andre Hagedorn, Andrea Wittkowski, Florian Rumpf, Tobias Haas, Sebastian Hottenrott, Eva Kranke, Marianne Neuf, Anke Reppchen, Daniel Röder, and Julius Schmidt

Subjects
Medicine
Abstract

Introduction Sepsis remains the major cause of death among hospitalised patients in intensive care. While targeting sepsis-causing pathogens with source control or antimicrobials has had a dramatic impact on morbidity and mortality of sepsis patients, this strategy remains insufficient for about one-third of the affected individuals who succumb. Pharmacological targeting of mechanisms that reduce sepsis-defining organ dysfunction may be beneficial. When given at low doses, the anthracycline epirubicin promotes tissue damage control and lessens the severity of sepsis independently of the host–pathogen load by conferring disease tolerance to infection. Since epirubicin at higher doses can be myelotoxic, a first dose–response trial is necessary to assess the potential harm of this drug in this new indication.Methods and analysis Epirubicin for the Treatment of Sepsis and Septic Shock-1 is a randomised, double-blind, placebo-controlled phase 2 dose-escalation phase IIa clinical trial to assess the safety of epirubicin as an adjunctive in patients with sepsis. The primary endpoint is the 14-day myelotoxicity. Secondary and explorative outcomes include 30-day and 90-day mortality, organ dysfunction, pharmacokinetic/pharmacodynamic (PK/PD) and cytokine release. Patients will be randomised in three consecutive phases. For each study phase, patients are randomised to one of the two study arms (epirubicin or placebo) in a 4:1 ratio. Approximately 45 patients will be recruited. Patients in the epirubicin group will receive a single dose of epirubicin (3.75, 7.5 or 15 mg/m2 depending on the study phase. After each study phase, a data and safety monitoring board will recommend continuation or premature stopping of the trial. The primary analyses for each dose level will report the proportion of myelotoxicity together with a 95% CI. A potential dose-toxicity association will be analysed using a logistic regression model with dose as a covariate. All further analyses will be descriptive.Ethics and dissemination The protocol is approved by the German Federal Institute for Drugs and Medical Devices. The results will be submitted for publication in peer-reviewed journals.Trial registration number NCT05033808.

Published
2024
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15. My virtual home: needs of patients in palliative cancer care and content effects of individualized virtual reality – a mixed methods study protocol

Author

Christina Gerlach, Anja Greinacher, Bernd Alt-Epping, and Cornelia Wrzus

Subjects
Virtual reality, Palliative care, Oncology, Personalized therapy, Special situations and conditions, RC952-1245
Abstract

Abstract Background The desire to be at home is one of the most important needs of patients with advanced, incurable cancers. However, palliative cancer patients may require inpatient hospital care for medical reasons. Virtual reality (VR) could provide an approximation to the individuals’ home environment. Methods The project consists of 3 parts. All parts are supported by the patient advisory board. In the 1st part of the project, we interview patients, relatives, and the patient advisory board about their wishes and concerns regarding the project. In the 2nd part of the project, patients are offered to view 360° VR videos of their choice (their home, relatives, others if applicable). Effects and side-effects of the intervention are assessed with validated instruments (MIDOS, MDBF, SSQ, SPES). Diagnosis, treatment adherence, medication, and vegetative functionality is determined from the medical records of the patients. In the 3rd part of the project, the results of the study will be discussed with patients, relatives, health care professionals and the patient advisory board regarding implementation. Discussion This study is the first to investigate whether individualized VR videos have additional benefits over generic VR nature videos on symptom relief, well-being, treatment satisfaction, and adherence in patients with palliative cancer care. A strength of the study is that we can incorporate the results of each part of the project into the subsequent project parts. However, the generalizability might be limited as this is a single-centred study. Trial registration Registered at German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS); registration number: DRKS00032172; registration date: 11/07/2023 https://drks.de/search/de/trial/DRKS00032172 .

Published
2023
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18. Anti-platelet factor 4/polyanion antibodies mediate a new mechanism of autoimmunity

Author

Nguyen, Thi-Huong, Medvedev, Nikolay, Delcea, Mihaela, and Greinacher, Andreas

Subjects
Physics - Biological Physics
Abstract

Antibodies recognizing complexes of the chemokine platelet factor 4 (PF4-CXCL4) and polyanions (P) opsonize PF4-coated bacteria hereby mediating bacterial host defense. A subset of these antibodies may activate platelets after binding to PF4-heparin complexes, causing the prothrombotic adverse drug reaction heparin-induced thrombocytopenia (HIT). In autoimmune-HIT, anti-PF4-P-antibodies activate platelets in the absence of heparin. Here we show that antibodies with binding forces of approximately 60-100 pN activate platelets in the presence of polyanions, while a subset of antibodies from autoimmune-HIT patients with binding forces greater than 100 pN binds to PF4 alone in the absence of polyanions. These antibodies with high binding forces cluster PF4-molecules forming antigenic complexes which allow binding of polyanion-dependent anti-PF4-P-antibodies. The resulting immunocomplexes induce massive platelet activation in the absence of heparin. Antibody-mediated changes in endogenous proteins that trigger binding of otherwise non-pathogenic (or cofactor-dependent) antibodies may also be relevant in other antibody-mediated autoimmune disorders.

Published
2020
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19. Rupture Forces among Human Blood Platelets at different Degrees of Activation

Author

Nguyen, Thi-Huong, Palankar, Raghavendra, Bui, Van-Chien, Medvedev, Nikolay, Greinacher, Andreas, and Delcea, Mihaela

Subjects
Physics - Biological Physics
Abstract

Little is known about mechanics underlying the interaction among platelets during activation and aggregation. Although the strength of a blood thrombus has likely major biological importance, no previous study has measured directly the adhesion forces of single platelet-platelet interaction at different activation states. Here, we filled this void first, by minimizing surface mediated platelet activation and second, by generating a strong adhesion force between a single platelet and an AFM cantilever, preventing early platelet detachment. We applied our setup to measure rupture forces between two platelets using different platelet activation states, and blockade of platelet receptors. The rupture force was found to increase proportionally to the degree of platelet activation, but reduced with blockade of specific platelet receptors. Quantification of single platelet-platelet interaction provides major perspectives for testing and improving biocompatibility of new materials; quantifying the effect of drugs on platelet function; and assessing the mechanical characteristics of acquired/inherited platelet defects.

Published
2020
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20. The impact of physiological stress conditions on protein structure and trypsin inhibition of serine protease inhibitor Kazal type 1 (SPINK1) and its N34S variant

Author

Buchholz, Ina, Nagel, Felix, Klein, Annelie, Wagh, Preshit R., Mahajan, Ujjwal M., Greinacher, Andreas, Lerch, Markus M., Mayerle, Julia, and Delcea, Mihaela

Subjects
Quantitative Biology - Biomolecules
Abstract

One of the most common mutations in the serine protease inhibitor Kazal type 1 (SPINK1) gene is the N34S variant which is strongly associated with chronic pancreatitis. Although it is assumed that N34S mutation constitutes a high-risk factor, the underlying pathologic mechanism is still unknown. In the present study, we investigated the impact of physiological stress factors on SPINK1 protein structure and trypsin inhibitor function using biophysical methods. Our circular dichroism spectroscopy data revealed differences in the secondary structure of SPINK1 and N34S mutant suggesting protein structural changes induced by the mutation as an impairment that could be disease-relevant. We further confirmed that both SPINK1 (KD of 0.15 +/- 0.06 nM) and its N34S variant (KD of 0.08 +/- 0.02 nM) have similar binding affinity and inhibitory effect towards trypsin as shown by surface plasmon resonance and trypsin inhibition assay studies, respectively. We found that stress conditions such as altered ion concentrations (i.e. potassium, calcium), temperature shifts, as well as environmental pH lead to insignificant differences in trypsin inhibition between SPINK1 and N34S mutant. However, we have shown that the environmental pH induces structural changes in both SPINK1 constructs in a different manner. Our findings suggest protein structural changes in the N34S variant as an impairment of SPINK1 and environmental pH shift as a trigger that could play a role in disease progression of pancreatitis.

Published
2020
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21. User Experience of Reading in Virtual Reality -- Finding Values for Text Distance, Size and Contrast

Author

Kojić, Tanja, Ali, Danish, Greinacher, Robert, Möller, Sebastian, and Voigt-Antons, Jan-Niklas

Subjects
Computer Science - Multimedia, Computer Science - Human-Computer Interaction
Abstract

Virtual Reality (VR) has an increasing impact on the market in many fields, from education and medicine to engineering and entertainment, by creating different applications that replicate or in the case of augmentation enhance real-life scenarios. Intending to present realistic environments, VR applications are including text that we are surrounded by every day. However, text can only add value to the virtual environment if it is designed and created in such a way that users can comfortably read it. With the aim to explore what values for text parameters users find comfortable while reading in virtual reality, a study was conducted allowing participants to manipulate text parameters such as font size, distance, and contrast. Therefore two different standalone virtual reality devices were used, Oculus Go and Quest, together with three different text samples: Short (2 words), medium (21 words), and long (51 words). Participants had the task of setting text parameters to the best and worst possible value. Additionally, participants were asked to rate their experience of reading in virtual reality. Results report mean values for angular size (the combination of distance and font size) and color contrast depending on the different device used as well as the varying text length, for both tasks. Significant differences were found for values of angular size, depending on the length of the displayed text. However, different device types had no significant influence on text parameters but on the experiences reported using the self-assessment manikin (SAM) scale., Comment: This paper has been accepted for publication in the 2020 Twelfth International Conference on Quality of Multimedia Experience (QoMEX)

Published
2020

22. Impact of Tactile and Visual Feedback on Breathing Rhythm and User Experience in VR Exergaming

Author

Greinacher, Robert, Kojić, Tanja, Meier, Luis, Parameshappa, Rudresha Gulaganjihalli, Möller, Sebastian, and Voigt-Antons, Jan-Niklas

Subjects
Computer Science - Human-Computer Interaction, Computer Science - Multimedia
Abstract

Combining interconnected wearables provides fascinating opportunities like augmenting exergaming with virtual coaches, feedback on the execution of sports activities, or how to improve on them. Breathing rhythm is a particularly interesting physiological dimension since it is easy and unobtrusive to measure and gained data provide valuable insights regarding the correct execution of movements, especially when analyzed together with additional movement data in real-time. In this work, we focus on indoor rowing since it is a popular sport that's often done alone without extensive instructions. We compare a visual breathing indication with haptic guidance in order for athletes to maintain a correct, efficient, and healthy breathing-movement-synchronicity (BMS) while working out. Also, user experience and acceptance of the different modalities were measured. The results show a positive and statistically significant impact of purely verbal instructions and purely tactile feedback on BMS and no significant impact of visual feedback. Interestingly, the subjective ratings indicate a strong preference for the visual modality and even an aversion for the haptic feedback, although objectively the performance benefited most from using the latter., Comment: This paper has been accepted for publication in the 2020 Twelfth International Conference on Quality of Multimedia Experience (QoMEX)

Published
2020

23. Anti-PF4 immunothrombosis without proximate heparin or adenovirus vector vaccine exposure

Author

Schönborn, Linda, Esteban, Olga, Wesche, Jan, Dobosz, Paulina, Broto, Marta, Puig, Sara Rovira, Fuhrmann, Jessica, Torres, Raquel, Serra, Josep, Llevadot, Roser, Palicio, Marta, Wang, Jing Jing, Gordon, Tom Paul, Lindhoff-Last, Edelgard, Hoffmann, Till, Alberio, Lorenzo, Langer, Florian, Boehme, Christian, Biguzzi, Eugenia, Grosse, Leonie, Endres, Matthias, Liman, Thomas, Thiele, Thomas, Warkentin, Theodore E., and Greinacher, Andreas

Published
2023
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26. Multicenter evaluation of light transmission platelet aggregation reagents: communication from the ISTH SSC Subcommittee on Platelet Physiology

Author

Alessi, Marie-Christine, Coxon, Carmen, Ibrahim-Kosta, Manal, Bacci, Monica, Voisin, Sophie, Rivera, José, Greinacher, Andreas, Raster, Johannes, Pulcinelli, Fabio, Devreese, Katrien M.J., Mullier, Francois, McCormick, Aine N., Frontroth, Juan Pablo, Pouplard, Claire, Sachs, Ulrich J., Diaz, Isabelle, Bermejo, Nuria, Camera, Marina, Fontana, Pierre, Bauters, Anne, Stepanian, Alain, Cozzi, Maria R., Sveshnikova, Anastasia N., Faille, Dorothée, Hollon, Wendy, Chitlur, Meera, Casonato, Alessandra, Lasne, Dominique, Lavenu-Bombled, Cécile, Fiore, Mathieu, Hamidou, Bello, Hurtaud-Roux, Marie-Francoise, Saultier, Paul, Goumidi, Louisa, Gresele, Paolo, and Lordkipanidzé, Marie

Published
2023
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29. Trans-ethnic and Ancestry-Specific Blood-Cell Genetics in 746,667 Individuals from 5 Global Populations

Author

Chen, Ming-Huei, Raffield, Laura M, Mousas, Abdou, Sakaue, Saori, Huffman, Jennifer E, Moscati, Arden, Trivedi, Bhavi, Jiang, Tao, Akbari, Parsa, Vuckovic, Dragana, Bao, Erik L, Zhong, Xue, Manansala, Regina, Laplante, Véronique, Chen, Minhui, Lo, Ken Sin, Qian, Huijun, Lareau, Caleb A, Beaudoin, Mélissa, Hunt, Karen A, Akiyama, Masato, Bartz, Traci M, Ben-Shlomo, Yoav, Beswick, Andrew, Bork-Jensen, Jette, Bottinger, Erwin P, Brody, Jennifer A, van Rooij, Frank JA, Chitrala, Kumaraswamynaidu, Cho, Kelly, Choquet, Hélène, Correa, Adolfo, Danesh, John, Di Angelantonio, Emanuele, Dimou, Niki, Ding, Jingzhong, Elliott, Paul, Esko, Tõnu, Evans, Michele K, Floyd, James S, Broer, Linda, Grarup, Niels, Guo, Michael H, Greinacher, Andreas, Haessler, Jeff, Hansen, Torben, Howson, Joanna MM, Huang, Qin Qin, Huang, Wei, Jorgenson, Eric, Kacprowski, Tim, Kähönen, Mika, Kamatani, Yoichiro, Kanai, Masahiro, Karthikeyan, Savita, Koskeridis, Fotis, Lange, Leslie A, Lehtimäki, Terho, Lerch, Markus M, Linneberg, Allan, Liu, Yongmei, Lyytikäinen, Leo-Pekka, Manichaikul, Ani, Martin, Hilary C, Matsuda, Koichi, Mohlke, Karen L, Mononen, Nina, Murakami, Yoshinori, Nadkarni, Girish N, Nauck, Matthias, Nikus, Kjell, Ouwehand, Willem H, Pankratz, Nathan, Pedersen, Oluf, Preuss, Michael, Psaty, Bruce M, Raitakari, Olli T, Roberts, David J, Rich, Stephen S, Rodriguez, Benjamin AT, Rosen, Jonathan D, Rotter, Jerome I, Schubert, Petra, Spracklen, Cassandra N, Surendran, Praveen, Tang, Hua, Tardif, Jean-Claude, Trembath, Richard C, Ghanbari, Mohsen, Völker, Uwe, Völzke, Henry, Watkins, Nicholas A, Zonderman, Alan B, Program, VA Million Veteran, Wilson, Peter WF, Li, Yun, Butterworth, Adam S, Gauchat, Jean-François, Chiang, Charleston WK, and Li, Bingshan

Subjects
Genetics, Good Health and Well Being, Asian People, Genome-Wide Association Study, HEK293 Cells, Humans, Interleukin-7, Mutation, Missense, Phenotype, Polymorphism, Single Nucleotide, White People, VA Million Veteran Program, interleukin-7, genetic architecture, fine-mapping, selective sweeps, polygenic trait score, phenome-wide association study, Biological Sciences, Medical and Health Sciences, Developmental Biology
Abstract

Most loci identified by GWASs have been found in populations of European ancestry (EUR). In trans-ethnic meta-analyses for 15 hematological traits in 746,667 participants, including 184,535 non-EUR individuals, we identified 5,552 trait-variant associations at p < 5 × 10-9, including 71 novel associations not found in EUR populations. We also identified 28 additional novel variants in ancestry-specific, non-EUR meta-analyses, including an IL7 missense variant in South Asians associated with lymphocyte count in vivo and IL-7 secretion levels in vitro. Fine-mapping prioritized variants annotated as functional and generated 95% credible sets that were 30% smaller when using the trans-ethnic as opposed to the EUR-only results. We explored the clinical significance and predictive value of trans-ethnic variants in multiple populations and compared genetic architecture and the effect of natural selection on these blood phenotypes between populations. Altogether, our results for hematological traits highlight the value of a more global representation of populations in genetic studies.

Published
2020

30. The psychological burden of volunteers in psychosocial emergency care - a qualitative interview study

Author

Greinacher, Anja, Cranz, Anna, Jenzer, Julia, Nikendei, Alexander, Kottke, Renate, Wiesbeck, Jürgen, Friederich, Hans-Christoph, and Nikendei, Christoph

Subjects
Social service -- Psychological aspects, Volunteer workers in medical care -- Psychological aspects -- Health aspects, Emergency medical services -- Psychological aspects, Psychology and mental health
Abstract

Psychosocial emergency care personnel provide voluntary psychological support directly after potentially traumatic events. During emergency responses, they experience challenging situations. However, previous quantitative studies suggest that the psychological burden of psychosocial emergency care personnel does not exceed that of the general population. This study aimed to obtain an in-depth analysis of the volunteers' psychological reactions and resources regarding emergency responses. 36 psychosocial emergency care volunteers (12 pre-training, 12 post-training, 12 experienced) were invited to participate in semi-structured interviews. The volunteers were selected from previous cross-sectional and longitudinal studies on secondary traumatization in psychosocial emergency care volunteers. A qualitative content analysis of the transcribed interviews was performed following the principles of summary and inductive category development. We identified 845 codes which we summarized in three overarching categories: (I) reactions to emergency responses, (II) psychosocial emergency care work related resources and (III) experiences and changes in life perspective related to working in psychosocial emergency care. The volunteers described both emotional and physical reactions to emergency responses. While they perceived social support as a key coping resource and reported a greater appreciation of their own lives and their families due to their work, many volunteers also felt increased concern that something could happen to them. The volunteers' reactions and symptoms are reasonable responses to stress and not indicative of serious impairment. Nevertheless, emergency responses are both emotionally and physically challenging. Volunteers should be carefully selected, receive regular supervision and determine the frequency of emergency responses., Author(s): Anja Greinacher [sup.1] [sup.2] , Anna Cranz [sup.1] , Julia Jenzer [sup.1] , Alexander Nikendei [sup.1] [sup.3] , Renate Kottke [sup.4] , Jürgen Wiesbeck [sup.4] , Hans-Christoph Friederich [sup.1] [...]

Published
2022
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31. DNA methylation analysis is used to identify novel genetic loci associated with circulating fibrinogen levels in blood

Author

Hahn, Julie, Bressler, Jan, Domingo-Relloso, Arce, Chen, Ming-Huei, McCartney, Daniel L., Teumer, Alexander, van Dongen, Jenny, Kleber, Marcus E., Aïssi, Dylan, Swenson, Brenton R., Yao, Jie, Zhao, Wei, Huang, Jian, Xia, Yujing, Brown, Michael R., Costeira, Ricardo, de Geus, Eco J.C., Delgado, Graciela E., Dobson, Dre'Von A., Elliott, Paul, Grabe, Hans J., Guo, Xiuqing, Harris, Sarah E., Huffman, Jennifer E., Kardia, Sharon L.R., Liu, Yongmei, Lorkowski, Stefan, Marioni, Riccardo E., Nauck, Matthias, Ratliff, Scott M., Sabater-Lleal, Maria, Spector, Tim D., Suchon, Pierre, Taylor, Kent D., Thibord, Florian, Trégouët, David-Alexandre, Wiggins, Kerri L., Willemsen, Gonneke, Bell, Jordana T., Boomsma, Dorret I., Cole, Shelley A., Cox, Simon R., Dehghan, Abbas, Greinacher, Andreas, Haack, Karin, März, Winfried, Morange, Pierre-Emmanuel, Rotter, Jerome I., Sotoodehnia, Nona, Tellez-Plaza, Maria, Navas-Acien, Ana, Smith, Jennifer A., Johnson, Andrew D., Fornage, Myriam, Smith, Nicholas L., Wolberg, Alisa S., Morrison, Alanna C., and de Vries, Paul S.

Published
2023
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33. EnWG

Author

Elspas, Maximilian Emanuel, primary, Graßmann, Nils, additional, Rasbach, Winfried, additional, Ahnsehl, Sascha, additional, Bartsch, Michael, additional, Baumbach, Antje, additional, Berberich, Christian, additional, Bläß, Daniel, additional, Böhme, Markus, additional, Bourazeri, Konstantina, additional, Brahms, Florian, additional, Brodowski, Christian, additional, Brucker, Guido, additional, Buchmann, Felix, additional, Bunnemann, Jan, additional, Dix, Robert, additional, Eckhardt, Mandy, additional, Ehring, Philipp, additional, Elspas, Maximilian Emanuel, additional, Embacher, Johannes, additional, Engelbert, Julian, additional, Fabritius, Christoph, additional, Fechner, Simon, additional, Feuring, Armin, additional, Frohberg, Christian, additional, Göge, Marc-Stefan, additional, Goldberg, Marc, additional, Görike, Michael, additional, Greinacher, Dominik, additional, Günther, Reinald, additional, Haellmigk, Christian F., additional, Hampel, Christian, additional, Hanl, Stephan, additional, Hansen, Malena, additional, Heinichen, Christian, additional, Höch, Thomas, additional, Höffken, Wolfgang, additional, Höger, Jochen, additional, Höhne, Norman, additional, Jacob, Björn, additional, Joly-Müller, Véronique, additional, Kalwa, Feh, additional, Karb, Manuel, additional, Keilpflug, Michael, additional, Killius, Ulrich Christian, additional, Knauff, Matthias, additional, Lange, Moritz, additional, Langer, Christopher, additional, Langer, Markus, additional, Lerinc, Suzana, additional, Lihs, Christina, additional, Ludwigs, Markus, additional, Meier, Dirk-Henning, additional, Menz, Monika, additional, Meyer, Jost-Hanno, additional, Michaelis, Jana, additional, Müller, Philipp, additional, Pfeifle, Florian, additional, Rauch, Karsten, additional, Rechteren, Cosima, additional, Riese, Christoph, additional, Rohrer, Sebastian, additional, Rosin, Peter, additional, Sack, Julia, additional, Salevic, Marc, additional, Sander, Henrike-Uljane, additional, Sauer, Mirko, additional, Schanko, Ruth, additional, Schellberg, Margret, additional, Schieferdecker, Bernd, additional, Scholze, Gregor, additional, Schreiner, Eva, additional, Siegmann, Matthias, additional, Staebe, Erik, additional, Steinbeck, David, additional, Stelter, Christian, additional, Tittel, Frank, additional, Vöcking, Janna, additional, Wachovius, Martin, additional, Wiemer, Dirk T., additional, Will, Christina, additional, and Zöckler, Jan-Frederik, additional

Published
2023
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38. Understanding thrombosis with thrombocytopenia syndrome after COVID-19 vaccination

Author

Alessandra Buoninfante, Arno Andeweg, Alexander T. Baker, Mitesh Borad, Nigel Crawford, Jean-Michel Dogné, David Garcia-Azorin, Andreas Greinacher, Rita Helfand, Anders Hviid, Stefan Kochanek, Marta López-Fauqued, Ishac Nazy, Anand Padmanabhan, Sue Pavord, Daniel Prieto-Alhambra, Huyen Tran, Ulla Wandel Liminga, and Marco Cavaleri

Subjects
Immunologic diseases. Allergy, RC581-607, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Safety and efficacy of vaccines against the SARS-CoV-2 coronavirus has been demonstrated in clinical trials and next by their real world use through the course of the ongoing COVID-19 pandemic. However, very rare adverse events have been detected post-authorization in certain parts of the world. This meeting report summarizes an EMA workshop’s discussion on the epidemiology, clinical presentation and biology of thrombosis with thrombocytopenia syndrome after adenovirus vector COVID-19 vaccination. General agreement was reached by international regulators, scientists and developers on the steps needed to fill the gaps in the characterization of this new syndrome. In particular, actions should be taken to improve the post-vaccination surveillance activities in low and middle income countries and investigate potential genetic predisposition factors.

Published
2022
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39. The DALPHI annotation framework & how its pre-annotations can improve annotator efficiency

Author

Greinacher, Robert and Horn, Franziska

Subjects
Computer Science - Information Retrieval, Computer Science - Human-Computer Interaction, H.3.4, H.3.5, D.2.2
Abstract

Producing the required amounts of training data for machine learning and NLP tasks often involves human annotators doing very repetitive and monotonous work. In this paper, we present and evaluate our novel annotation framework DALPHI, which facilitates the annotation process by providing the annotator with suggestions generated by an automated, active-learning based assistance system. In a study with 66 participants, we demonstrate on the exemplary task of annotating named entities in text documents that with this assistance system the annotation processes can be improved with respect to the quality and quantity of produced annotations, even if the pre-annotations provided by the assistance system are at a recall level of only 50%., Comment: 5 pages, 4 figures, 1 table

Published
2018

42. Thrombocytopenia and splenic platelet-directed immune responses after IV ChAdOx1 nCov-19 administration

Author

Nicolai, Leo, Leunig, Alexander, Pekayvaz, Kami, Esefeld, Max, Anjum, Afra, Rath, Justina, Riedlinger, Eva, Ehreiser, Vincent, Mader, Magdalena, Eivers, Luke, Hoffknecht, Marie-Louise, Zhang, Zhe, Kugelmann, Daniela, Rossaro, Dario, Escaig, Raphael, Kaiser, Rainer, Polewka, Vivien, Titova, Anna, Petzold, Tobias, Spiekermann, Karsten, Iannacone, Matteo, Thiele, Thomas, Greinacher, Andreas, Stark, Konstantin, and Massberg, Steffen

Published
2022
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44. Genome-wide association study of platelet factor 4/heparin antibodies in heparin-induced thrombocytopenia

Author

Giles, Jason B., Steiner, Heidi E., Rollin, Jerome, Shaffer, Christian M., Momozawa, Yukihide, Mushiroda, Taisei, Inai, Chihiro, Selleng, Kathleen, Thiele, Thomas, Pouplard, Claire, Heddle, Nancy M., Kubo, Michiaki, Miller, Elise C., Martinez, Kiana L., Phillips, Elizabeth J., Warkentin, Theodore E., Gruel, Yves, Greinacher, Andreas, Roden, Dan M., and Karnes, Jason H.

Published
2022
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45. ABO O blood group as a risk factor for platelet reactivity in heparin-induced thrombocytopenia

Author

Karnes, Jason H., Rollin, Jerome, Giles, Jason B., Martinez, Kiana L., Steiner, Heidi E., Shaffer, Christian M., Momozawa, Yukihide, Inai, Chihiro, Bombin, Andrei, Shi, Mingjian, Mosley, Jonathan D., Stanaway, Ian, Selleng, Kathleen, Thiele, Thomas, Mushiroda, Taisei, Pouplard, Claire, Heddle, Nancy M., Kubo, Michiaki, Phillips, Elizabeth J., Warkentin, Theodore E., Gruel, Yves, Greinacher, Andreas, and Roden, Dan M.

Published
2022
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