share it - The Open Access and Research Data Repository of the University Libraries in Saxony-Anhalt
Not a member yet
91636 research outputs found
Sort by
Association of preoperative smoking with the occurrence of postoperative pulmonary complications : a post hoc analysis of an observational study in 29 countries
No full textIntroduction:
While smoking has been consistently identified as a significant contributor to postoperative com
plications, the existing literature on its association with postoperative pulmonary complications remains conflicting.
Aim:
We examined the association of preoperative smoking with the occurrence of postoperative pulmonary complications (PPCs).
Methods:
Post hoc analysis of an observational study in 146 hospitals across 29 countries. We included patients at increased risk of PPCs, according to the Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score (≥26 points). The primary endpoint was the occurrence of one or more predefined PPCs in the first five post
operative days, including unplanned postoperative need for supplementary oxygen, respiratory failure,
planned need for invasive ventilation, ARDS, pneumonia and pneumothorax. Secondary endpoints included length of hospital stay and in–hospital mortality. We performed propensity score matching to correct for factors with a known association with postoperative outcomes.
Results:
Out of 2632 patients, 531 (20.2 %) patients were smokers and 2102 (79.8 %) non-smokers. At five days after surgery, 101 (19.0 %) smokers versus 404 (19.2) non–smokers had developed one or more PPCs (P =0.95). Respiratory failure was more common in smokers (5.1 %) than non–smokers (3.0 %) (P =0.02), while rates of other PPCs like need for supplementary oxygen, invasive ventilation, ARDS, pneumonia, or pneumothorax did not differ between the groups. Length of hospital stay and mortality was not different between groups. Propensity score matching did not change the findings.
Conclusion:
The occurrence of PPCs in smokers is not different from non–smokers.
Funding:
This analysis was performed without additional funding. LAS VEGAS was partially funded and endorsed by the European Society of Anaesthesiology through their Clinical Trial Network and the Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Registration:
LAS VEGAS was registered at Clinicaltrials.gov(NCT01601223).
Prior presentation:
Preliminary study results have been presented at the Euroanaesthesia 2024 International Congress, in Munich, Germany
Intraspherulitic melting-temperature distribution of poly(butylene 2,6-naphthalate) containing β′-crystals controlled by secondary crystallization
No full textThe combination of low crystal-growth rate and low nuclei density, as evident, e.g., on hot-crystallization at low melt-supercooling, allows formation of rather large spherulites containing isothermally grown crystals subjected to different times of secondary crystallization, causing an intraspherulitic melting-temperature distribution. As demonstrated on example of the β′-high-temperature-crystal polymorph of poly(butylene 2,6-naphthalate) (PBN), crystals located in the spherulite centers, subjected to annealing during the slow growth of the spherulite, melt at distinctly higher temperature than non-annealed crystals near the spherulite boundary, causing spherulite inward melting. The melting-temperature gradient along the spherulite radius, however, diminishes if all parts of the spherulites are annealed, e.g., after a space-filled spherulitic morphology is achieved, yielding a radius-independent intraspherulitic melting temperature. Otherwise, the intraspherulitic melting-temperature distribution may be preserved/frozen-in by cooling, with implications on properties due to the presence of crystals of different stabilities. Assessing the intraspherulitic melting-temperature distribution required suppression of crystal reorganization on heating, which was achieved by analysis of the heating-rate dependence of melting. These experiments confirmed the initially lower stability of crystals near the spherulite periphery by their enhanced reorganization/stabilization on sufficiently slow heating compared to crystals located in the spherulite center, being less vulnerable for reorganization. In summary, the study highlights the importance of secondary crystallization/annealing on the thermodynamic stability/melting behavior of crystals arranged in a spherulitic semicrystalline superstructure. In addition, the performed study also provides new data about the growth of radial and tangential lamellae in PBN when crystallized at low melt-supercooling
Spike protein-related proteinopathies : a focus on the neurological side of spikeopathies
No full textBackground: The spike protein (SP) is an outward-projecting transmembrane glycoprotein on viral surfaces.
SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), responsible for COVID-19 (Coronavirus Disease
2019), uses SP to infect cells that express angiotensin converting enzyme 2 (ACE2) on their membrane.
Remarkably, SP has the ability to cross the blood-brain barrier (BBB) into the brain and cause cerebral damage
through various pathomechanisms. To combat the COVID-19 pandemic, novel gene-based products have been
used worldwide to induce human body cells to produce SP to stimulate the immune system. This artificial SP also
has a harmful effect on the human nervous system.
Study design: Narrative review.
Objective: This narrative review presents the crucial role of SP in neurological complaints after SARS-CoV-2
infection, but also of SP derived from novel gene-based anti-SARS-CoV-2 products (ASP).
Methods: Literature searches using broad terms such as "SARS-CoV-2", "spike protein", "COVID-19", "COVID-19
pandemic", "vaccines", "COVID-19 vaccines", "post-vaccination syndrome", "post-COVID-19 vaccination syndrome"
and "proteinopathy" were performed using PubMed. Google Scholar was used to search for topic-specific
full-text keywords.
Conclusions: The toxic properties of SP presented in this review provide a good explanation for many of the
neurological symptoms following SARS-CoV-2 infection and after injection of SP-producing ASP. Both SP entities
(from infection and injection) interfere, among others, with ACE2 and act on different cells, tissues and organs.
Both SPs are able to cross the BBB and can trigger acute and chronic neurological complaints. Such SP-associated
pathologies (spikeopathies) are further neurological proteinopathies with thrombogenic, neurotoxic, neuroinflammatory
and neurodegenerative potential for the human nervous system, particularly the central nervous
system. The potential neurotoxicity of SP from ASP needs to be critically examined, as ASPs have been
administered to millions of people worldwide
Advancing the implementation of quality-assured oncological exercise therapy in Germany : protocol for the IMPLEMENT project
No full textBackground:
Although quality-assured oncological exercise therapy (qOET) has proven effective for cancer patients at any stage of treatment and during aftercare, it is not yet incorporated into standard care in Germany and, to the best of our knowledge, in any other country. A collaboration involving eight German research institutions was initiated to investigate the barriers and facilitators to implementation and promote the wider dissemination of qOET for cancer patients across various settings in Germany.
Methods:
The IMPLEMENT project is designed as an exploratory study with a quasi-experimental design and a mixed-methods approach, combining qualitative and quantitative data collection. Institutions involved in the treatment and/or aftercare of cancer patients will be approached to identify key barriers and facilitators of qOET. Based on these findings, a set of implementation strategies (IPS) will be developed, implemented, and evaluated to facilitate the delivery of qOET for cancer patients. We aim to develop a variety of IPS for different contexts: urban settings (e.g. qualifying local aftercare institutions to provide qOET); rural settings (e.g. a hybrid approach for areas with limited access to local qOET services); adult cancer patients (e.g. focussing on patient education); and children and young cancer patients (e.g. offering consultations with training therapy experts). Additionally, interface management, training concepts, digital support, and economic evaluation will be considered to further promote the wider dissemination of qOET. The impact of the IPS will primarily be measured by the reach of qOET, assessed by comparing the number of cancer patients receiving qOET before and after implementation.
Discussion:
The aim of IMPLEMENT is to address key barriers and facilitators for the implementation of qOET in Germany, and to increase the number of cancer patients receiving qOET in the long term. Following the project, successful IPS will be disseminated for broader application. The IMPLEMENT consortium aims to make a significant contribution to the long-term integration of qOET into the standard care of cancer patients in Germany and prospectively for other countries as well
2. Kinder- und Jugendgesundheitsbericht Sachsen-Anhalt. Ergebnisse der "Health Behaviour in School-aged Children" (HBSC)-Studie
No full textIKK Gesund Plu
Immunotherapeutic blockade of CD47 increases virus neutralization antibodies
No full textBackground/Objectives: CD47 is a cell surface glycoprotein moderately expressed in healthy cells and upregulated in cancer and viral infected cells. CD47’s interaction with signal regulatory protein alpha (SIRPα) inhibits phagocytic cells and its interaction with thrombospondin-1 inhibits T cell response. Experimental evidence has revealed that the blockade of CD47 resulted in the increased activation and function of both innate and adaptive immune cells, therefore exerting antitumoral and antiviral effects. Recent studies have shown that the combination of vaccines and immune checkpoint inhibitors could be a promising approach to increasing vaccine immunogenicity. Here, we investigated the vaccinal effect of anti-CD47 antibodies and discussed the possibilities of combining anti-CD47 treatments with vaccines. Methods: Using vesicular stomatitis virus (VSV), a widely used replication-competent vaccine vector, we evaluated the impact of the immunotherapeutic blockade of CD47 on cellular, humoral, and protective immunity. We infected C57BL/6 mice with VSV, treated them with anti-CD47 antibodies or an isotype, and evaluated the total immunoglobulin (Ig), IgG neutralizing antibodies, B cell activation, CD8+ T cell effector function, and survival of the mice. Results: We found that the treatments of anti-CD47 antibodies led to significantly increased Ig and IgG neutralizing antibody levels compared to the isotype treatment. Flow cytometric analysis of B cells revealed no difference in the number of circulating B cells; however, we observed an increased surface expression of CD80 and CD86 in B cells among anti-CD47-treated mice. Further analysis of the impact of CD47 blockade on T immunity revealed a significantly higher percentage of IFN-γ+ CD4 and IFN-γ+ CD8 T cells in anti-CD47-treated mice. Upon infecting mice with a lethal VSV dose, we observed a significantly higher survival rate among the anti-CD47-treated mice compared to control mice. Conclusions: Our results indicate that anti-CD47 treatment induces a stronger cellular and humoral immune response, leading to better protection. As such, immunotherapy by CD47 blockade in combination with vaccines could be a promising approach to improve vaccine efficacy
Can invitation systems increase participation in preventive health screening among adolescents? : an evaluation of a state-wide intervention in Germany using a difference-in-differences analysis of claims data
No full textIn Germany, routine screenings are used to monitor the health and development of children and adolescents, enabling timely discovery and treatment of health issues. One such screening, called J1, is recommended for adolescents aged 12–14 years, but participation is only 43%. In the state of Bavaria, a lack of awareness is the main reason cited for not attending. ‘Your Ticket to J1’ was an invitation system implemented across the state to inform adolescents about the screening. Our study investigated whether this intervention increased J1 participation and if its effects varied by family socioeconomic position (SEP). We used pseudonymized data from a large statutory health insurer from 2016 to 2018 and containing 267 650 observations. To investigate the effect of the intervention, we employed a difference-in-differences analysis at the individual level. Assuming parallel trends at the state level, we compared J1 participation rates between Bavaria and other German states before and after the intervention. We additionally stratified analyses by SEP. The intervention led to an increase in J1 participation by about 1%. In the stratified regressions, the effect size was larger for children from families with a lower SEP. J1 participation increased by about 4% among adolescents whose primary insured parent had the lowest occupational status. A state-wide invitation system had a small but statistically significant positive impact on J1 participation and might reduce socioeconomic inequities in healthcare utilization. Informing adolescents about J1 appears to increase participation, particularly among those from families with a lower SEP
Management of high‑risk acute pulmonary embolism : an emulated target trial analysis
No full textHigh-risk acute pulmonary embolism (PE) is a life-threatening condition necessitating hemodynamic stabilization and rapid restoration of pulmonary perfusion. In this context, evidence regarding the benefit of advanced circulatory support and pulmonary recanalization strategies is still limited. In this observational study, we assessed data of 1060 patients treated for high-risk acute PE with 991 being included in a target trial emulation to investigate all-cause in-hospital mortality estimates with different advanced treatment strategies. The four treatment groups consisted of patients undergoing (I) veno-arterial extracorporeal membrane oxygenation (VA-ECMO) alone (n = 126), (II) intrahospital systemic thrombolysis (SYS) (n = 643), (III) surgical thrombectomy (ST) (n = 49), and (IV) percutaneous catheter-directed treatment (PCDT) (n = 173). VA-ECMO was allowed as bridging to pulmonary recanalization in groups II, III, and IV. Marginal causal contrasts were estimated using the g-formula with logistic regression models as the primary approach. Sensitivity analyses included targeted maximum likelihood estimation (TMLE) with machine learning, inverse probability of treatment weighting (IPTW), as well as variations of estimands, handling of missing values, and a complete target trial emulation excluding the VA-ECMO alone group. In the overall target trial population, the median age was 62.0 years, and 53.3% of patients were male. The estimated probability of in-hospital mortality from the primary target trial intention-to-treat analysis for VA-ECMO alone was 57% (95% confidence interval [CI] 47%; 67%), compared to 48% (95% CI 44%; 53%) for intrahospital SYS, 34% (95%CI 18%; 50%) for ST, and 43% (95% CI 35%; 51%) for PCDT. The mortality risk ratios were largely in favor of any advanced recanalization strategy over VA-ECMO alone. The robustness of these findings was supported by all sensitivity analyses. In the crude outcome analysis, patients surviving to discharge had a high probability of favorable neurologic outcome in all treatment groups. Advanced recanalization by means of SYS, ST, and several promising catheter-directed systems may have a positive impact on short-term survival of patients presenting with high-risk PE compared to the use of VA-ECMO alone as a bridge to recovery
Tūnis wa-Ġānā : tawārīḫ muwāzīya wa-dimūqrāṭīyāt mutabāʿida
No full textالكلمات المفتاحية: غانا، تونس، التحول الديمقراطي، الحكم، التأثير الإقليميKeywords: Ghana, Tunisia, democratisation, governance, regional influenceSchlagworte: Ghana, Tunesien, Demokratisierung, Regierungsführung, regionaler Einflus