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1. Intersubband polariton-polariton scattering in a dispersive microcavity

Author

Knorr, M., Manceau, J. M., Mornhinweg, J., Nespolo, J., Biasiol, G., Tran, N. L., Malerba, M., Goulain, P., Lafosse, X., Jeannin, M., Stefinger, M., Carusotto, I., Lange, C., Colombelli, R., and Huber, R.

Subjects
Physics - Optics, Condensed Matter - Mesoscale and Nanoscale Physics
Abstract

The ultrafast scattering dynamics of intersubband polaritons in dispersive cavities embedding GaAs/AlGaAs quantum wells are studied directly within their band structure using a non-collinear pump-probe geometry with phase-stable mid-infrared pulses. Selective excitation of the lower polariton at a frequency of ~25 THz and at a finite in-plane momentum, $k_{||}$, leads to the emergence of a narrowband maximum in the probe reflectivity at $k_{||}=0$. A quantum mechanical model identifies the underlying microscopic process as stimulated coherent polariton-polariton scattering. These results mark an important milestone towards quantum control and bosonic lasing in custom-tailored polaritonic systems in the mid and far-infrared.

Published
2022
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3. Real-time observation of interfering crystal electrons in high-harmonic generation

Author

Hohenleutner, M., Langer, F., Schubert, O., Knorr, M., Huttner, U., Koch, S. W., Kira, M., and Huber, R.

Subjects
Condensed Matter - Mesoscale and Nanoscale Physics, Physics - Optics
Abstract

Accelerating and colliding particles has been a key strategy to explore the texture of matter. Strong lightwaves can control and recollide electronic wavepackets, generating high-harmonic (HH) radiation which encodes the structure and dynamics of atoms and molecules and lays the foundations of attosecond science. The recent discovery of HH generation in bulk solids combines the idea of ultrafast acceleration with complex condensed matter systems and sparks hope for compact solid-state attosecond sources and electronics at optical frequencies. Yet the underlying quantum motion has not been observable in real time. Here, we study HH generation in a bulk solid directly in the time-domain, revealing a new quality of strong-field excitations in the crystal. Unlike established atomic sources, our solid emits HH radiation as a sequence of subcycle bursts which coincide temporally with the field crests of one polarity of the driving terahertz waveform. We show that these features hallmark a novel non-perturbative quantum interference involving electrons from multiple valence bands. The results identify key mechanisms for future solid-state attosecond sources and next-generation lightwave electronics. The new quantum interference justifies the hope for all-optical bandstructure reconstruction and lays the foundation for possible quantum logic operations at optical clock rates.

Published
2016
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4. Response of Root Respiration to Warming and Nitrogen Addition Depends on Tree Species.

Author

Muratore, T. J., Knorr, M. A., Simpson, M. J., Stephens, R. B., Phillips, R. P., and Frey, S. D.

Subjects
*RED oak, *NITROGEN in soils, *SOIL heating, *SOIL respiration, *TEMPERATE forests
Abstract

Roots contribute a large fraction of CO2 efflux from soils, yet the extent to which global change factors affect root‐derived fluxes is poorly understood. We investigated how red maple (Acer rubrum) and red oak (Quercus rubra) root biomass and respiration respond to long‐term (15 years) soil warming, nitrogen addition, or their combination in a temperate forest. We found that ecosystem root respiration was decreased by 40% under both single‐factor treatments (nitrogen addition or warming) but not under their combination (heated × nitrogen). This response was driven by the reduction of mass‐specific root respiration under warming and a reduction in maple root biomass in both single‐factor treatments. Mass‐specific root respiration rates for both species acclimated to soil warming, resulting in a 43% reduction, but were not affected by N addition or the combined heated × N treatment. Notably, the addition of nitrogen to warmed soils alleviated thermal acclimation and returned mass‐specific respiration rates to control levels. Oak roots contributed disproportionately to ecosystem root respiration despite the decrease in respiration rates as their biomass was maintained or enhanced under warming and nitrogen addition. In contrast, maple root respiration rates were consistently higher than oak, and this difference became critical in the heated × nitrogen treatment, where maple root biomass increased, contributing significantly more CO2 relative to single‐factor treatments. Our findings highlight the importance of accounting for the root component of respiration when assessing soil carbon loss in response to global change and demonstrate that combining warming and N addition produces effects that cannot be predicted by studying these factors in isolation. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Measuring personal characteristics in applicants to German medical schools: Piloting an online Situational Judgement Test with an open-ended response format

Author

Knorr, M, Mielke, I, Amelung, D, Safari, M, Gröne, OR, Breil, SM, MacIntosh, A, Knorr, M, Mielke, I, Amelung, D, Safari, M, Gröne, OR, Breil, SM, and MacIntosh, A

Abstract

Objectives: Situational Judgement Tests (SJT) are a cost-efficient method for the assessment of personal characteristics (e.g., empathy, professionalism, ethical thinking) in medical school admission. Recently, complex open-ended response format SJTs have become more feasible to conduct. However, research on their applicability to a German context is missing. This pilot study tests the acceptability, reliability, subgroup differences, and validity of an online SJT with open-ended response format developed in Canada ("Casper").Methods: German medical school applicants and students from Hamburg were invited to take Casper in 2020 and 2021. The test consisted of 12 video- and text-based scenarios, each followed by three open-ended questions. Participants subsequently evaluated their test experience in an online survey. Data on sociodemographic characteristics, other admission criteria (Abitur, TMS, HAM-Nat, HAM-SJT) and study success (OSCE) was available in a central research database (stav). Results: The full sample consisted of 582 participants. Test-takers' global perception of Casper was positive. Internal consistency was satisfactory in both years (alpha =0.73; 0.82) while interrater agreement was moderate (ICC(1,2)=0.54). Participants who were female (d =0.37) or did not have a migration background (d =0.40) received higher scores. Casper scores correlated with HAM-SJT (r =.18) but not with OSCE communication stations performance. The test was also related to Abitur grades (r =-.15), the TMS (r =.18), and HAM-Nat logical reasoning scores (r =.23). Conclusion: This study provides positive evidence for the acceptability, internal consistency, and convergent validity of Casper. The selection and training of raters as well as the scenario content require further observation and adjustments to a German context to improve interrater reliability and predictive validity., Ziele: Situational Judgement Tests (SJTs) sind eine kosteneffiziente Methode zur Beurteilung von persönlichen Eigenschaften (z.B. Empathie, Professionalität, ethisches Denken) bei der Zulassung zum Medizinstudium. Die Durchführung komplexer SJTs mit offenem Antwortformat ist in jüngster Zeit einfacher geworden. Es fehlen jedoch Untersuchungen zu ihrer Anwendbarkeit im deutschen Kontext. Diese Pilotstudie testet die Akzeptanz, Reliabilität, Subgruppenunterschiede und Validität eines in Kanada entwickelten Online-SJTs mit offenem Antwortformat ("Casper").Methoden: Studienbewerber*innen aus Deutschland und Medizinstudierende aus Hamburg wurden eingeladen, Casper in den Jahren 2020 und 2021 zu absolvieren. Der Test bestand aus 12 video- und textbasierten Szenarien, auf die jeweils drei offene Fragen folgten. Die Teilnehmenden bewerteten anschließend ihre Testerfahrung in einer Online-Umfrage. Daten zu soziodemografischen Merkmalen, weiteren Zulassungskriterien (Abitur, TMS, HAM-Nat, HAM-SJT) und zum Studienerfolg (OSCE) waren in einer zentralen Forschungsdatenbank (stav) verfügbar.Ergebnisse: Die Gesamtstichprobe bestand aus 582 Teilnehmenden. Die allgemeine Wahrnehmung von Casper durch die Testteilnehmenden war positiv. Die interne Konsistenz war in beiden Jahren zufriedenstellend (alpha =0,73; 0,82), während die Interrater-Übereinstimmung mäßig war (ICC (1,2)=0,54). Weibliche Teilnehmerinnen (d =0,37) oder Teilnehmende ohne Migrationshintergrund (d =0,40) erzielten höhere Testwerte. Die Casper Testwerte korrelierten mit dem HAM-SJT (r =.18), aber nicht mit der Leistung in OSCE-Kommunikationsstationen. Der Test zeigte auch Zusammenhänge mit der Abiturnote (r =-.15), dem TMS (r =.18) und dem HAM-Nat-Subtest für logisches Denken (r =.23).Schlussfolgerungen: Die Studie liefert positive Belege für die Akzeptanz, interne Konsistenz und konvergente Validität von Casper. Die Auswahl und Schulung der Beurteiler*innen sowie die Inhalte der Szenarien bedürfen weiterer Untersuchu

Published
2024

12. Diagnostic latency in children with inflammatory bowel disease: Results from the German-language patient registry CEDATA-GPGE 2014–2018

Author

Leiz, M, Knorr, M, Moon, K, Tischler, L, de Laffolie, J, and van den Berg, N

Subjects
ddc: 610, Medicine and health
Abstract

Background and state of (inter)national research: Inflammatory bowel diseases (IBD) include Crohn's disease (CD), Ulcerative colitis (UC), and unclassified inflammatory bowel disease (IBD-U). Incidence and prevalence are on the rise worldwide with a steep increase in pediatric onset IBD (PIBD). [for full text, please go to the a.m. URL]

Published
2022
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13. Real-time observation of interfering crystal electrons in high-harmonic generation

Author

Hohenleutner, M., Langer, F., Schubert, O., Knorr, M., Huttner, U., Koch, S.W., Kira, M., and Huber, R.

Subjects
Research, Properties, Particle collisions -- Properties -- Research, Electrons -- Properties -- Research, Collisions (Nuclear physics) -- Properties -- Research
Abstract

Ultrafast time resolution in the few-femtosecond or attosecond regime has provided systematic insight into quantum control of individual atoms (12), molecules (13), and solids (14). A spectacular example has been [...], Acceleration and collision of particles has been a key strategy for exploring the texture of matter. Strong light waves can control and recollide electronic wavepackets, generating high-harmonic radiation that encodes the structure and dynamics of atoms and molecules and lays the foundations of attosecond science (1-3). The recent discovery of high-harmonic generation in bulk solids (4-6) combines the idea of ultrafast acceleration with complex condensed matter systems, and provides hope for compact solid-state attosecond sources (6-8) and electronics at optical frequencies (3, 5, 9, 10). Yet the underlying quantum motion has not so far been observable in real time. Here we study high-harmonic generation in a bulk solid directly in the time domain, and reveal a new kind of strong-field excitation in the crystal. Unlike established atomic sources (1-3, 9, 11), our solid emits high-harmonic radiation as a sequence of subcycle bursts that coincide temporally with the field crests of one polarity of the driving terahertz waveform. We show that these features are characteristic of a non-perturbative quantum interference process that involves electrons from multiple valence bands. These results identify key mechanisms for future solid-state attosecond sources and next-generation light-wave electronics. The new quantum interference process justifies the hope for all-optical band-structure reconstruction and lays the foundation for possible quantum logic operations at optical clock rates.

Published
2015

14. How can patient registries facilitate guideline-based healthcare? A retrospective analysis of the CEDATA-GPGE registry for pediatric inflammatory bowel disease.

Author

Leiz, M., Knorr, M., Moon, K., Tischler, L., Sohrabi, K., Cantez, S., Däbritz, J., de Laffolie, J., van den Berg, N., Buderus, S., Bufler, P., Dammann, S., Hauer, A., Keller, K.-M., Krahl, A., Laaß, M., Lang, T., Posovszky, C., Rodeck, B., and Trenkel, S.

Subjects
*INFLAMMATORY bowel diseases, *GASTROENTEROLOGISTS, *MEDICAL registries, *CHILD health services, *TECHNOLOGICAL innovations, *PEDIATRIC gastroenterology
Abstract

Background: Early diagnosis is mandatory for the medical care of children and adolescents with pediatric-onset inflammatory bowel disease (PIBD). International guidelines ('Porto criteria') of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition recommend medical diagnostic procedures in PIBD. Since 2004, German and Austrian pediatric gastroenterologists document diagnostic and treatment data in the patient registry CEDATA-GPGE on a voluntary basis. The aim of this retrospective study was to analyze whether the registry CEDATA-GPGE reflects the Porto criteria and to what extent diagnostic measures of PIBD according to the Porto criteria are documented. Methods: Data of CEDATA-GPGE were analyzed for the period January 2014 to December 2018. Variables representing the Porto criteria for initial diagnostic were identified and categorized. The average of the number of measures documented in each category was calculated for the diagnoses CD, UC, and IBD-U. Differences between the diagnoses were tested by Chi-square test. Data on possible differences between data documented in the registry and diagnostic procedures that were actually performed were obtained via a sample survey. Results: There were 547 patients included in the analysis. The median age of patients with incident CD (n = 289) was 13.6 years (IQR: 11.2–15.2), of patients with UC (n = 212) 13.1 years (IQR: 10.4–14.8) and of patients with IBD-U (n = 46) 12.2 years (IQR: 8.6–14.7). The variables identified in the registry fully reflect the recommendations by the Porto criteria. Only the disease activity indices PUCAI and PCDAI were not directly provided by participants but calculated from obtained data. The category 'Case history' were documented for the largest part (78.0%), the category 'Imaging of the small bowel' were documented least frequently (39.1%). In patients with CD, the categories 'Imaging of the small bowel' (χ2 = 20.7, Cramer-V = 0.2, p < 0.001) and 'Puberty stage' (χ2 = 9.8, Cramer-V = 0.1, p < 0.05) were documented more often than in patients with UC and IBD-U. Conclusion: The registry fully reproduces the guideline's recommendations for the initial diagnosis of PIBD. The proportion of documented diagnostic examinations varied within the diagnostic categories and between the diagnoses. Despite technological innovations, time and personnel capacities at participating centers and study center are necessary to ensure reliable data entry and to enable researchers to derive important insights into guideline-based care. [ABSTRACT FROM AUTHOR]

Published
2023
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15. Stimulated Non-Collinear Intersubband Polariton-Polariton Scattering in a Dispersive Multi-THz Microcavity

Author

Knorr, M., primary, Manceau, J.M., additional, Mornhinweg, J., additional, Nespolo, J., additional, Biasiol, G., additional, Tran, N.L., additional, Malerba, M., additional, Goulain, P., additional, Lafosse, X., additional, Jeannin, M., additional, Stefinger, M., additional, Carusotto, I., additional, Lange, C., additional, Colombelli, R., additional, and Huber, R., additional

Published
2022
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16. Intersubband Polariton-Polariton Scattering in a Dispersive Microcavity

Author

Knorr, M., primary, Manceau, J. M., additional, Mornhinweg, J., additional, Nespolo, J., additional, Biasiol, G., additional, Tran, N. L., additional, Malerba, M., additional, Goulain, P., additional, Lafosse, X., additional, Jeannin, M., additional, Stefinger, M., additional, Carusotto, I., additional, Lange, C., additional, Colombelli, R., additional, and Huber, R., additional

Published
2022
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25. Attosecond chronoscopy of correlations between Bloch electrons

Author

Freudenstein, J., primary, Borsch, M., additional, Meierhofer, M., additional, Afanasiev, D., additional, Schmid, C. P., additional, Sandner, F., additional, Liebich, M., additional, Girnghuber, A., additional, Knorr, M., additional, Kira, M., additional, and Huber, R., additional

Published
2022
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26. Erfassung von sozialen Kompetenzen im Auswahlprozess: Ein Workshop zur Entwicklung von konstruktbasierten Multiple Mini-Interview Rollenspielen und Situational Judgment Tests

Author

Breil, SM, Geldmacher, T, Knorr, M, and Mielke, I

Subjects
ddc: 610, Medicine and health
Abstract

Lernziel: Neben kognitiven Aspekten (z.B. Abiturnote, Studierfähigkeitstests) wird vermehrt der Einbezug von sozialen und weiteren Kompetenzen (z.B. Durchsetzungsstärke, Warmherzigkeit, Resilienz, Motivation, Ethik) in den Auswahlprozess für Medizinstudierende gefordert. In diesem Workshop [zum vollständigen Text gelangen Sie über die oben angegebene URL]

Published
2021
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29. Analyse leitliniengerechter Diagnostik und Zeit bis zur Diagnose chronisch entzündlicher Darmerkrankungen bei pädiatrischen Patienten: Ergebnisse aus dem deutschsprachigen Patientenregister CEDATA-GPGE 2014-2018

Author

Knorr, M, Moon, K, de Laffolie, J, Sohrabi, K, Schneider, N, Hoffmann, W, and van den Berg, N

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Hintergrund: Zu den chronisch entzündlichen Darmerkrankungen (CED) zählen Morbus Crohn, Colitis ulcerosa und Colitis indeterminata. Ca. 20% der Fälle werden in den ersten zwei Lebensdekaden diagnostiziert [ref:1]. In der praktischen Versorgung bilden die Leitlinien der [zum vollständigen Text gelangen Sie über die oben angegebene URL], 19. Deutscher Kongress für Versorgungsforschung (DKVF)

Published
2020
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31. Impact of atrial fibrillation on outcome in takotsubo syndrome: Data from the international Takotsubo registry

Author

El-Battrawy, I., Cammann, V. L., Kato, K., Szawan, K. A., Di Vece, D., Rossi, A., Wischnewsky, M., Hermes-Laufer, J., Gili, S., Citro, R., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, F., Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Arroja, J. D., Banning, A., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Juhani Airaksinen, K. E., Napp, L. C., Budnik, M., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., Kozel, M., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Kobayashi, Y., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Opolski, G., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, C., Munzel, T., Crea, Filippo, Bax, J. J., Luscher, T. F., Ruschitzka, F., Duru, F., Borggrefe, M., Ghadri, J. R., Akin, I., Templin, C., Galiuto L. (ORCID:0000-0002-6831-479X), Crea F. (ORCID:0000-0001-9404-8846), El-Battrawy, I., Cammann, V. L., Kato, K., Szawan, K. A., Di Vece, D., Rossi, A., Wischnewsky, M., Hermes-Laufer, J., Gili, S., Citro, R., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, F., Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Arroja, J. D., Banning, A., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Juhani Airaksinen, K. E., Napp, L. C., Budnik, M., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., Kozel, M., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Kobayashi, Y., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Opolski, G., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, C., Munzel, T., Crea, Filippo, Bax, J. J., Luscher, T. F., Ruschitzka, F., Duru, F., Borggrefe, M., Ghadri, J. R., Akin, I., Templin, C., Galiuto L. (ORCID:0000-0002-6831-479X), and Crea F. (ORCID:0000-0001-9404-8846)

Abstract

BACKGROUND: Atrial fibrillation (AF) is a major risk factor for mortality. The prevalence, clinical correlates, and prognostic impact of AF in Takotsubo syndrome (TTS) have not yet been investigated in a large patient cohort. This study aimed to investigate the prevalence, clinical correlates, and prognostic impact of AF in patients with TTS. METHODS AND RESULTS: Patients with TTS were enrolled from the International Takotsubo Registry, which is a multinational network with 26 participating centers in Europe and the United States. Patients were dichotomized according to the presence or absence of AF at the time of admission. Of 1584 patients with TTS, 112 (7.1%) had AF. The mean age was higher (P<0.001), and there were fewer women (P=0.046) in the AF than in the non-AF group. Left ventricular ejection fraction was significantly lower (P=0.001), and cardiogenic shock was more often observed (P<0.001) in the AF group. Both in-hospital (P<0.001) and long-term mortality (P<0.001) were higher in the AF group. Multivariable Cox regression analysis revealed that AF was independently associated with higher long-term mortality (hazard ratio, 2.31; 95% CI, 1.50– 3.55; P<0.001). Among patients with AF on admission, 42% had no known history of AF before the acute TTS event, and such patients had comparable in-hospital and long-term outcomes compared with those with a history of AF. CONCLUSIONS: In patients presenting with TTS, AF on admission is significantly associated with increased in-hospital and long-term mortality rates. Whether antiarrhythmics and/or cardioversion are beneficial in TTS with AF should thus be tested in a future trial. REGISTRATION: URL: https://www.clini​caltr​ials.gov; Unique identifier: NCT01947621.

Published
2021

32. Prognostic impact of acute pulmonary triggers in patients with takotsubo syndrome: new insights from the International Takotsubo Registry

Author

Kato, K., Cammann, V. L., Napp, L. C., Szawan, K. A., Micek, J., Dreiding, S., Levinson, R. A., Petkova, V., Wurdinger, M., Patrascu, A., Sumalinog, R., Gili, S., Clarenbach, C. F., Kohler, M., Wischnewsky, M., Citro, R., Vecchione, C., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, Francesca, Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Roffi, M., Banning, A., Wolfrum, M., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Budnik, M., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., El-Battrawy, I., Akin, I., Kozel, M., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Sano, M., Ishibashi, I., Takahara, M., Himi, T., Kobayashi, Y., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Opolski, G., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Borggrefe, M., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, Clara, Munzel, T., Crea, Filippo, Bax, J. J., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Templin, C., D'Ascenzo F., Galiuto L. (ORCID:0000-0002-6831-479X), Di Mario C., Crea F. (ORCID:0000-0001-9404-8846), Kato, K., Cammann, V. L., Napp, L. C., Szawan, K. A., Micek, J., Dreiding, S., Levinson, R. A., Petkova, V., Wurdinger, M., Patrascu, A., Sumalinog, R., Gili, S., Clarenbach, C. F., Kohler, M., Wischnewsky, M., Citro, R., Vecchione, C., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, Francesca, Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Roffi, M., Banning, A., Wolfrum, M., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Budnik, M., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., El-Battrawy, I., Akin, I., Kozel, M., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Sano, M., Ishibashi, I., Takahara, M., Himi, T., Kobayashi, Y., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Opolski, G., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Borggrefe, M., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, Clara, Munzel, T., Crea, Filippo, Bax, J. J., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Templin, C., D'Ascenzo F., Galiuto L. (ORCID:0000-0002-6831-479X), Di Mario C., and Crea F. (ORCID:0000-0001-9404-8846)

Abstract

Aims: Acute pulmonary disorders are known physical triggers of takotsubo syndrome (TTS). This study aimed to investigate prevalence of acute pulmonary triggers in patients with TTS and their impact on outcomes. Methods and results: Patients with TTS were enrolled from the International Takotsubo Registry and screened for triggering factors and comorbidities. Patients were categorized into three groups (acute pulmonary trigger, chronic lung disease, and no lung disease) to compare clinical characteristics and outcomes. Of the 1670 included patients with TTS, 123 (7%) were identified with an acute pulmonary trigger, and 194 (12%) had a known history of chronic lung disease. The incidence of cardiogenic shock was highest in patients with an acute pulmonary trigger compared with those with chronic lung disease or without lung disease (17% vs. 10% vs. 9%, P = 0.017). In-hospital mortality was also higher in patients with an acute pulmonary trigger than in the other two groups, although not significantly (5.7% vs. 1.5% vs. 4.2%, P = 0.13). Survival analysis demonstrated that patients with an acute pulmonary trigger had the worst long-term outcome (P = 0.002). The presence of an acute pulmonary trigger was independently associated with worse long-term mortality (hazard ratio 2.12, 95% confidence interval 1.33–3.38; P = 0.002). Conclusions: The present study demonstrates that TTS is related to acute pulmonary triggers in 7% of all TTS patients, which accounts for 21% of patients with physical triggers. The presence of acute pulmonary trigger is associated with a severe in-hospital course and a worse long-term outcome.

Published
2021

35. Measuring personal characteristics in applicants to German medical schools: Piloting an online Situational Judgement Test with an open-ended response format

Author

Knorr, Mirjana, Mielke, Ina, Amelung, Dorothee, Safari, Mahla, Gröne, Oana R., Breil, Simon M., and MacIntosh, Alexander

Subjects
admission, situational judgement test, personal characteristics, casper, Special aspects of education, LC8-6691, Medicine
Abstract

Objectives: Situational Judgement Tests (SJT) are a cost-efficient method for the assessment of personal characteristics (e.g., empathy, professionalism, ethical thinking) in medical school admission. Recently, complex open-ended response format SJTs have become more feasible to conduct. However, research on their applicability to a German context is missing. This pilot study tests the acceptability, reliability, subgroup differences, and validity of an online SJT with open-ended response format developed in Canada (“Casper”).Methods: German medical school applicants and students from Hamburg were invited to take Casper in 2020 and 2021. The test consisted of 12 video- and text-based scenarios, each followed by three open-ended questions. Participants subsequently evaluated their test experience in an online survey. Data on sociodemographic characteristics, other admission criteria (Abitur, TMS, HAM-Nat, HAM-SJT) and study success (OSCE) was available in a central research database (stav). Results: The full sample consisted of 582 participants. Test-takers’ global perception of Casper was positive. Internal consistency was satisfactory in both years (=0.73; 0.82) while interrater agreement was moderate (ICC(1,2)=0.54). Participants who were female (=0.37) or did not have a migration background (=0.40) received higher scores. Casper scores correlated with HAM-SJT (=.18) but not with OSCE communication stations performance. The test was also related to Abitur grades (=-.15), the TMS (=.18), and HAM-Nat logical reasoning scores (=.23). Conclusion: This study provides positive evidence for the acceptability, internal consistency, and convergent validity of Casper. The selection and training of raters as well as the scenario content require further observation and adjustments to a German context to improve interrater reliability and predictive validity.

Published
2024
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43. Räumliches Vorstellungsvermögen in der Zahnmedizinstudierendenauswahl – Prädiktion von Studienleistungen durch den HAM-MRT

Author

Rudloff, A, Schwibbe, A, and Knorr, M

Subjects
ddc: 610, 610 Medical sciences, Medicine
Abstract

Einleitung: Räumliches Vorstellungsvermögen kann gemäß der Theorie des Fertigkeitserwerbs von Ackerman [ref:1] als Prädiktor praktischer Studienleistungen im Zahnmedizinstudium herangezogen werden [ref:2]. Daher werden seit 2013 verschiedene Testverfahren[zum vollständigen Text gelangen Sie über die oben angegebene URL], Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA), des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ) und der Chirurgischen Arbeitsgemeinschaft Lehre (CAL)

Published
2019
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46. Impact of aspirin on takotsubo syndrome: a propensity score-based analysis of the InterTAK Registry

Author

D'Ascenzo, Francesca, Gili, S., Bertaina, M., Iannaccone, M., Cammann, V. L., Di Vece, D., Kato, K., Saglietto, A., Szawan, K. A., Frangieh, A. H., Boffini, B., Annaratone, M., Sarcon, A., Levinson, R. A., Franke, J., Napp, L. C., Jaguszewski, M., Noutsias, M., Munzel, T., Knorr, M., Heiner, S., Katus, H. A., Burgdorf, C., Schunkert, H., Thiele, H., Bauersachs, J., Tschope, C., Pieske, B. M., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Hasenfuss, G., Karakas, M., Koenig, W., Rottbauer, W., Said, S. M., Braun-Dullaeus, R. C., Banning, A., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Opolski, G., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Crea, Filippo, Dichtl, W., Franz, W. M., Empen, K., Felix, S. B., Delmas, C., Lairez, O., El-Battrawy, I., Akin, I., Borggrefe, M., Horowitz, J. D., Kozel, M., Tousek, P., Widimsky, P., Gilyarova, E., Shilova, A., Gilyarov, M., Biondi-Zoccai, G., Winchester, D. E., Ukena, C., Neuhaus, M., Bax, J. J., Prasad, A., Di Mario, C., Bohm, M., Gasparini, M., Ruschitzka, F., Bossone, E., Citro, R., Rinaldi, M., De Ferrari, G. M., Luscher, T., Ghadri, J. R., Templin, C., D'Ascenzo F., Galiuto L. (ORCID:0000-0002-6831-479X), Crea F. (ORCID:0000-0001-9404-8846), D'Ascenzo, Francesca, Gili, S., Bertaina, M., Iannaccone, M., Cammann, V. L., Di Vece, D., Kato, K., Saglietto, A., Szawan, K. A., Frangieh, A. H., Boffini, B., Annaratone, M., Sarcon, A., Levinson, R. A., Franke, J., Napp, L. C., Jaguszewski, M., Noutsias, M., Munzel, T., Knorr, M., Heiner, S., Katus, H. A., Burgdorf, C., Schunkert, H., Thiele, H., Bauersachs, J., Tschope, C., Pieske, B. M., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Hasenfuss, G., Karakas, M., Koenig, W., Rottbauer, W., Said, S. M., Braun-Dullaeus, R. C., Banning, A., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Opolski, G., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Crea, Filippo, Dichtl, W., Franz, W. M., Empen, K., Felix, S. B., Delmas, C., Lairez, O., El-Battrawy, I., Akin, I., Borggrefe, M., Horowitz, J. D., Kozel, M., Tousek, P., Widimsky, P., Gilyarova, E., Shilova, A., Gilyarov, M., Biondi-Zoccai, G., Winchester, D. E., Ukena, C., Neuhaus, M., Bax, J. J., Prasad, A., Di Mario, C., Bohm, M., Gasparini, M., Ruschitzka, F., Bossone, E., Citro, R., Rinaldi, M., De Ferrari, G. M., Luscher, T., Ghadri, J. R., Templin, C., D'Ascenzo F., Galiuto L. (ORCID:0000-0002-6831-479X), and Crea F. (ORCID:0000-0001-9404-8846)

Abstract

Aims: The aim of the present study was to investigate the impact of aspirin on prognosis in takotsubo syndrome (TTS). Methods and results: Patients from the International Takotsubo (InterTAK) Registry were categorized into two groups based on aspirin prescription at discharge. A comparison of clinical outcomes between groups was performed using an adjusted analysis with propensity score (PS) stratification; results from the unadjusted analysis were also reported to note the effect of the PS adjustment. Major adverse cardiac and cerebrovascular events (MACCE: a composite of death, myocardial infarction, TTS recurrence, stroke or transient ischaemic attack) were assessed at 30-day and 5-year follow-up. A total of 1533 TTS patients with known status regarding aspirin prescription at discharge were included. According to the adjusted analysis based on PS stratification, aspirin was not associated with a lower hazard of MACCE at 30-day [hazard ratio (HR) 1.24, 95% confidence interval (CI) 0.50–3.04, P = 0.64] or 5-year follow-up (HR 1.11, 95% CI 0.78–1.58, P = 0.58). These results were confirmed by sensitivity analyses performed with alternative PS-based methods, i.e. covariate adjustment and inverse probability of treatment weighting. Conclusion: In the present study, no association was found between aspirin use in TTS patients and a reduced risk of MACCE at 30-day and 5-year follow-up. These findings should be confirmed in adequately powered randomized controlled trials. ClinicalTrials.gov Identifier: NCT01947621.

Published
2020

47. Age-Related Variations in Takotsubo Syndrome

Author

Cammann, V. L., Szawan, K. A., Stahli, B. E., Kato, K., Budnik, M., Wischnewsky, M., Dreiding, S., Levinson, R. A., Di Vece, D., Gili, S., Citro, R., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, F., Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Roffi, M., Banning, A., Wolfrum, M., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Napp, L. C., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., El-Battrawy, I., Akin, I., Polednikova, K., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Kobayashi, Y., Shoji, T., Ishibashi, I., Takahara, M., Himi, T., Din, J., Al-Shammari, A., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Borggrefe, M., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, C., Munzel, T., Crea, Filippo, Bax, J. J., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Opolski, G., Templin, C., Galiuto L. (ORCID:0000-0002-6831-479X), Crea F. (ORCID:0000-0001-9404-8846), Cammann, V. L., Szawan, K. A., Stahli, B. E., Kato, K., Budnik, M., Wischnewsky, M., Dreiding, S., Levinson, R. A., Di Vece, D., Gili, S., Citro, R., Bossone, E., Neuhaus, M., Franke, J., Meder, B., Jaguszewski, M., Noutsias, M., Knorr, M., Heiner, S., D'Ascenzo, F., Dichtl, W., Burgdorf, C., Kherad, B., Tschope, C., Sarcon, A., Shinbane, J., Rajan, L., Michels, G., Pfister, R., Cuneo, A., Jacobshagen, C., Karakas, M., Koenig, W., Pott, A., Meyer, P., Roffi, M., Banning, A., Wolfrum, M., Cuculi, F., Kobza, R., Fischer, T. A., Vasankari, T., Airaksinen, K. E. J., Napp, L. C., Dworakowski, R., Maccarthy, P., Kaiser, C., Osswald, S., Galiuto, Leonarda, Chan, C., Bridgman, P., Beug, D., Delmas, C., Lairez, O., Gilyarova, E., Shilova, A., Gilyarov, M., El-Battrawy, I., Akin, I., Polednikova, K., Tousek, P., Winchester, D. E., Galuszka, J., Ukena, C., Poglajen, G., Carrilho-Ferreira, P., Hauck, C., Paolini, C., Bilato, C., Kobayashi, Y., Shoji, T., Ishibashi, I., Takahara, M., Himi, T., Din, J., Al-Shammari, A., Prasad, A., Rihal, C. S., Liu, K., Schulze, P. C., Bianco, M., Jorg, L., Rickli, H., Pestana, G., Nguyen, T. H., Bohm, M., Maier, L. S., Pinto, F. J., Widimsky, P., Felix, S. B., Braun-Dullaeus, R. C., Rottbauer, W., Hasenfuss, G., Pieske, B. M., Schunkert, H., Borggrefe, M., Thiele, H., Bauersachs, J., Katus, H. A., Horowitz, J. D., Di Mario, C., Munzel, T., Crea, Filippo, Bax, J. J., Luscher, T. F., Ruschitzka, F., Ghadri, J. R., Opolski, G., Templin, C., Galiuto L. (ORCID:0000-0002-6831-479X), and Crea F. (ORCID:0000-0001-9404-8846)

Abstract

Background: Takotsubo syndrome (TTS) occurs predominantly in post-menopausal women but is also found in younger patients. Objectives: This study aimed to investigate age-related differences in TTS. Methods: Patients diagnosed with TTS and enrolled in the International Takotsubo Registry between January 2011 and February 2017 were included in this analysis and were stratified by age (younger: ≤50 years, middle-age: 51 to 74 years, elderly: ≥75 years). Baseline characteristics, hospital course, as well as short- and long-term mortality were compared among groups. Results: Of 2,098 TTS patients, 242 (11.5%) patients were ≤50 years of age, 1,194 (56.9%) were 51 to 74 years of age, and 662 (31.6%) were ≥75 years of age. Younger patients were more often men (12.4% vs. 10.9% vs. 6.3%; p = 0.002) and had an increased prevalence of acute neurological (16.3% vs. 8.4% vs. 8.8%; p = 0.001) or psychiatric disorders (14.1% vs. 10.3% vs. 5.6%; p < 0.001) compared with middle-aged and elderly TTS patients. Furthermore, younger patients had more often cardiogenic shock (15.3% vs. 9.1% vs. 8.1%; p = 0.004) and had a numerically higher in-hospital mortality (6.6% vs. 3.6% vs. 5.1%; p = 0.07). At multivariable analysis, younger (odds ratio: 1.60; 95% confidence interval: 0.86 to 3.01; p = 0.14) and older age (odds ratio: 1.09; 95% confidence interval: 0.66 to 1.80; p = 0.75) were not independently associated with in-hospital mortality using the middle-aged group as a reference. There were no differences in 60-day mortality rates among groups. Conclusions: A substantial proportion of TTS patients are younger than 50 years of age. TTS is associated with severe complications requiring intensive care, particularly in younger patients.

Published
2020

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