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Fingerprint Sweat Pore Density in Patients with Oligodontia: A Controlled Clinical Trial
No full textBackground/Objectives: There is a lack of evidence for the relationship between sweat pores and tooth agenesis. The aim of this study was to compare sweat pore density on fingertips between a group of patients with oligodontia and a control group without tooth agenesis. Methods: This parallel-group controlled clinical trial included 28 patients. Fourteen patients (f/m 9/5; mean age 13.5 ± 3.5 years) with ≥6 congenitally missing permanent teeth, excluding third molars (M3), were enrolled in the study group. The matched control group consisted of 14 patients (f/m 9/5; mean age 12.8 ± 1.8 years) without tooth agenesis. Impressions of 168 fingertips (left and right index, middle, and ring fingers) of the participating subjects were taken and examined using a scanning electron microscope with a 5.85 mm × 4.29 mm region of interest at the center of the fingertip. The primary outcome was the pore-to-pore distance (μm) on a dermal ridge, and the secondary outcome was the number of sweat pores per cm2, while pore numbers were adjusted for individual body surface area (BSA). Results: There were no statistically significant differences in age, height, weight, and BSA between the groups. The study group had 11.07 ± 4.03 missing teeth, excluding M3. There was a statistically significant difference (p = 0.006) in the distance between adjacent pores on a dermal ridge between the study and control groups (354.89 ±32.41 μm vs. 340.31 ±39.04 μm). The unadjusted pore numbers showed a statistically significant difference between the groups, but after adjustment for BSA, this difference was no longer present. Conclusions: Patients with oligodontia differed from subjects without tooth agenesis in the distance between two adjacent sweat pores on a dermal ridge. However, the differences were small and of limited clinical significance. Increased pore distance appears to be a better predictor of oligodontia/ectodermal dysplasia than pore number
Herzinsuffizienztherapie bei Patienten mit angeborenen Herzfehlern: Eine landesweite Untersuchung des Stellenwerts von Angiotensin-Rezeptor-Neprilysin- und SGLT2-Inhibitoren
No full textEinleitung: Die Zahl erwachsener Patienten mit angeborenen Herzfehlern und gleichzeitig bestehender Herzinsuffizienz steigt. Ziel der Studie war die Untersuchung der Wirksamkeit von ARNI (Sacubitril/Valsartan) und SGLT2-Inhibitoren in dieser Patientengruppe.
Methodik: Analysiert wurden Krankenkassendaten der BARMER aus den Jahren 2005 bis 2021. Zwei Sub-Studien untersuchten als Endpunkt A die Gesamtmortalität sowie B kardiovaskulär bedingte Krankenhausaufenthalte und Todesfälle.
Ergebnisse: Es wurden 1.334 Patienten eingeschlossen. In beiden Sub-Studien zeigte sich für SGLT2-Inhibitoren eine signifikante Risikoreduktion hinsichtlich beider Endpunkte. Für ARNI ließ sich kein eindeutiger Nutzen nachweisen.
Fazit: SGLT2-Inhibitoren sind mit einer niedrigeren Sterblichkeit und Hospitalisierungsrate assoziiert. Weitere Studien, insbesondere prospektive, sind notwendig
How Large is the Potential of Brain Dead Donors and what Prevents Utilization? A Multicenter Retrospective Analysis at Seven University Hospitals in North Rhine-Westphalia
No full textOrgan donation after brain death is constantly lower in Germany compared to other countries. Instead, representative surveys show a positive attitude towards donation. Why this does not translate into more donations remains questionable. We retrospectively analyzed all potential brain dead donors treated in the university hospitals of Aachen, Bielefeld, Bonn, Essen, Düsseldorf, Cologne and Münster between June 2020 and July 2021. 300 potential brain dead donors were identified. Donation was utilized in 69 cases (23%). Refused consent (n = 190), and failed utilization despite consent (n = 41) were reasons for a donation not realized. Consent was significantly higher in potential donors with a known attitude towards donation (n = 94) compared to a decision by family members (n = 195) (49% vs. 33%, p = 0.012). The potential donor´s age, status of interviewer, and the timing of the interview with decision-makers had no influence on consent rates, and it was comparable between hospitals. Refused consent was the predominant reason for a donation not utilized. Consent rate was lower than in surveys, only a known attitude towards donation had a significant positive influence. This indicates that survey results do not translate well into everyday clinical practice and promoting a previously documented decision on organ donation is important
Impact of COVID-19 School Closures on German High-School Graduates' Perceived Stress: A Structural Equation Modeling Study of Personal and Contextual Resources
No full textCOVID-19 school closures forced German high-school graduates (Abitur 2022 cohort) to prepare for their final examinations with lengthy learning times at home. Guided by transactional stress theory, we tested how personal resources—self-regulated learning (SRL) skills and academic self-efficacy—and contextual resources—perceived teacher support and teacher digital competence—jointly predicted perceived stress during exam preparation. A cross-sectional online survey (June–July 2022) yielded complete data from N = 2379 students (68% female; Mage = 18.3). Six latent constructs were measured with 23 items and showed adequate reliability (0.71 ≤ α/ω ≤ 0.89). A six-factor CFA fit the data acceptably (CFI = 0.909, RMSEA = 0.064). The structural equation model (CFI = 0.935, RMSEA = 0.064) explained 35% of the variance in stress and 23% of the variance in SRL—action. Academic self-efficacy (β = −0.31, p < 0.001), perceived support (β = −0.28, p < 0.001), teacher digital competence (β = −0.08, p < 0.001), COVID-19 learning disruptions (β = +0.13, p < 0.001), and gender (male = 0.32 SD lower stress, p < 0.001) had direct effects on stress. SRL—action's direct path was small and non-significant (β = −0.02). Teacher digital competence also reduced stress indirectly through greater perceived support (standardized indirect β = −0.11, p < 0.001). The results highlight self-efficacy and perceived instructional support as the most potent buffers of pandemic-related stress, whereas cancelled lessons added strain. Boosting teachers' digital pedagogical skills has a dual payoff—raising students' sense of support and lowering their stress
Interplay of spin–orbit and exchange interaction in a ferromagnet/heavy-metal hybrid system: Ni on W(110)
No full textIn a combined experimental and theoretical study, we investigate the interplay of spin–orbit interaction (SOI) and exchange interaction (XI) in the electronic structure of ultrathin Ni films on W(110). Using spin- and angle-resolved inverse photoemission, we observe that the size of the spin splitting of Ni-related exchange-split states differs for opposite magnetization directions. A quenched spin splitting for one of the magnetization directions reveals a contribution of SOI on an equal footing with XI. Using density-functional theory calculations, we explore the underlying mechanisms responsible for the experimentally observed coupling of SOI and XI. We find that a hybridization between adsorbate and substrate states, along with a high probability density of the respective states at the heavy W nuclei, cause the strong influence of SOI on the Ni-related exchange-split states
Klinische und radiologische Ergebnisse nach totalem Femurersatz in der Revisionsendoprothetik
No full textMehrfache Revisionseingriffe von totalen Knie- und Hüftprothesen führen häufig zu erheblichem Knochenverlust. Dies kann zu ausgeprägten Defekten von relevanten Bereichen des Prothesenlagers führen und die Möglichkeit einer angemessenen Schaftverankerung einschränken. In dieser Situation kann ein totaler Femurersatz (TFR) eine Therapievariante zur Rekonstruktion bieten. Diese Studie befasste sich mit der Untersuchung der klinischen Ergebnisse sowie der Identifizierung möglicher Risikofaktoren nach Implantation des TFR im Revisionsfall. Für diese Untersuchung wurden insgesamt 58 Patienten, die ein TFR im Zeitraum von 2006 – 2019 erhielten retrospektiv analysiert. Alle Patientenfälle wiesen einen Nachbeobachtungszeitraum von mindestens 24 Monaten auf. Patienten mit einer primären Implantation oder vorliegenden malignen Grunderkrankung wurden nicht eingeschlossen. Insgesamt erlitten 45 Patienten (78%) eine revisionspflichtige Komplikation. Infektionen zeigten eine hohe Komplikationsrate. Vor einer Versorgung mittels TFR sollten Patienten umfassend über das erhöhte Risiko für Komplikationen aufgeklärt werden
Macrophage invasion into the Drosophila brain requires JAK/STAT-dependent MMP activation in the blood–brain barrier
No full textThe central nervous system is well-separated from external influences by the blood–brain barrier. Upon surveillance, infection or neuroinflammation, however, peripheral immune cells can enter the brain where they often cause detrimental effects. To invade the brain, immune cells not only have to breach cellular barriers, but they also need to traverse associated extracellular matrix barriers. Neither in vertebrates nor in invertebrates is it fully understood how these processes are molecularly controlled. We recently established Drosophila melanogaster as a model to elucidate peripheral immune cell invasion into the brain. Here, we show that neuroinflammation leads to the expression of Unpaired cytokines that activate the JAK/STAT signaling pathway in glial cells of the blood–brain barrier. This in turn triggers the expression of matrix metalloproteinases enabling remodeling of the extracellular matrix enclosing the fly brain and a subsequent invasion of immune cells into the brain. Our study demonstrates conserved mechanisms underlying immune cell invasion of the nervous system in invertebrates and vertebrates and could, thus, further contribute to understanding of JAK/STAT signaling during neuroinflammation
Pacemaker Versus Defibrillator Therapy in Patients Eligible for Cardiac Resynchronisation Therapy: Evidence from the German Device Registry
No full textBackground: According to current guidelines, cardiac resynchronisation therapy (CRT) is recommended in patients with significantly impaired left ventricular systolic function and left bundle branch block. However, the decision between pacemaker (CRT-P) and defibrillator (CRT-D) in patients eligible for CRT remains a matter of debate. Register data have shown a higher all-cause mortality in CRT-P in comparison to patients with a CRT-D. Here, we investigated clinical determinants of the selection of CRT-P vs. CRT-D and clinical outcome in large registry data from a multi-centre ‘real-life’ registry on patients with CRT defibrillator or pacemaker therapy. Methods: The German Device Registry (DEVICE) is a nationwide, prospective registry with one-year follow-up investigating 5451 patients receiving device implantations in 50 German centres. The present analysis of DEVICE focused on all patients from the register receiving cardiac resynchronization therapy. Results: Out of 1603 patients receiving cardiac resynchronisation therapy, 1536 (95.8%) received a CRT defibrillator system and 67 (4.2%) a CRT pacemaker system. Patients in the CRT-P group had a significantly better left ventricular systolic function compared to the CRT-D group (median 35% vs. 25%), and significantly less often had a history of myocardial infarction (9.0% vs. 25.2%). A preexisting pacemaker and a history of stroke/peripheral embolism were identified as determinants for the selection of CRT-P vs. CRT-D. Overall mortality after one-year follow-up was 8.0%. Patients with ischemic cardiomyopathy receiving CRT-P therapy had a higher one-year mortality than patients receiving CRT-D (21.2% vs. 8.9%, p = 0.020). On the other hand, patients with non-ischemic cardiomyopathy did not display differences between these two treatment groups (CRT-P 8.1%, CRT-D 6.6%, p = 0.72). Conclusions: Data from the German device registry show that most patients receiving cardiac synchronization therapy have an implanted CRT-D system. In comparison to patients with CRT-D, those with CRT-P more often had a non-ischemic cardiomyopathy and a preexisting pacemaker system. The outcomes between these two treatment groups were different as regards ischemic cardiomyopathy only