55 research outputs found
Emergency diagnoses in the gastrointestinal tract
No full textGerwing M, Eisenblätter M. Notfalldiagnosen im Gastrointestinaltrakt. Die Radiologie . 2024;64(3).Gastrointestinal emergencies are afrequent reason for presentation in the emergency department and involve patients of all ages. The patients must undergo an immediate cross-sectional imaging as in many cases the underlying pathology is alife-threatening condition, which often needs surgical or in some cases also interventional radiological treatment. In this overview, the most important differential diagnoses and their characteristics on cross-sectional imaging are presented. © 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature
Emergency diagnoses in the gastrointestinal tract
No full textGerwing M, Eisenblätter M. Notfalldiagnostik im Gastrointestinaltrakt. Gastroenterologie. 2024.Gastrointestinal emergencies are a frequent reason for presentation in the emergency department and involve patients of all ages. The patients must undergo an immediate cross-sectional imaging as in many cases the underlying pathology is a life-threatening condition, which often needs surgical or in some cases also interventional radiological treatment. In this overview, the most important differential diagnoses and their characteristics on cross-sectional imaging are presented.Gastrointestinale Notfälle sind ein häufiger Grund für eine Vorstellung in der Notaufnahme und betreffen PatientInnen jeden Alters. Die PatientInnen müssen zeitnah einer Schnittbildgebung zugeführt werden, denn bei vielen der zugrunde liegenden Pathologien handelt es sich um lebensbedrohliche Notfälle, welche oftmals operativ, in einigen Fällen auch interventionell-radiologisch therapiert werden müssen. In dieser Übersichtsarbeit werden die wichtigsten Differenzialdiagnosen und deren bildgebende Charakteristika vorgestellt
Work expectations, their fulfillment, and exhaustion among radiologists of all career levels: what can be learned from the example of Germany
No full textAbstract Objectives To evaluate work expectations of radiologists at different career levels, their fulfillment, prevalence of exhaustion, and exhaustion-associated factors. Methods A standardized digital questionnaire was distributed internationally to radiologists of all career levels in the hospital and in ambulatory care via radiological societies and sent manually to 4500 radiologists of the largest German hospitals between December 2020 and April 2021. Statistics were based on age- and gender-adjusted regression analyses of respondents working in Germany (510 out of 594 total respondents). Results The most frequent expectations were “joy at work” (97%) and a “good working atmosphere” (97%), which were considered fulfilled by at least 78%. The expectation of a “structured residency within the regular time interval” (79%) was more frequently judged fulfilled by senior physicians (83%, odds ratio (OR) 4.31 [95% confidence interval (95% CI) 1.95–9.52]), chief physicians (85%, 6.81 [95% CI 1.91–24.29]), and radiologists outside the hospital (88%, 7.59 [95% CI 2.40–24.03]) than by residents (68%). Exhaustion was most common among residents (physical exhaustion: 38%; emotional exhaustion: 36%), in-hospital specialists (29%; 38%), and senior physicians (30%; 29%). In contrast to paid extra hours, unpaid extra hours were associated with physical exhaustion (5–10 extra hours: OR 2.54 [95% CI 1.54–4.19]). Fewer opportunities to shape the work environment were related to a higher probability of physical (2.03 [95% CI 1.32–3.13]) and emotional (2.15 [95% CI 1.39–3.33]) exhaustion. Conclusions While most radiologists enjoy their work, residents wish for more training structure. Ensuring payment of extra hours and employee empowerment may help preventing burnout in high-risk groups. Key Points • Most important work expectations of radiologists who work in Germany are “joy at work,” a “good working atmosphere,” “support for further qualification,” and a “structured residency within the regular time interval,” with the latter containing potential for improvement according to residents. • Physical and emotional exhaustion are common at all career levels except for chief physicians and for radiologists who work outside the hospital in ambulatory care. • Exhaustion as a major burnout criterion is associated with unpaid extra hours and reduced opportunities to shape the work environment
Syntenin Controls Extracellular Vesicle‐Induced Tumour Migration by Regulating the Expression of Adhesion Proteins on Small Extracellular Vesicles
No full textABSTRACT Despite extensive proof for the tumour‐supporting function of cancer‐derived small extracellular vesicles (sEVs), attributions of pathological effects to specific sEV subpopulations are poorly described. In this study, we aimed to characterise a distinct sEV species under the control of Syntenin, a key regulator of endosomal sEV biogenesis, regarding its proteomic cargo and pro‐tumourigenic functions. Using mass spectrometry (MS), we detected 178 down‐ and 236 up‐regulated proteins on sEVs from breast cancer cells upon Syntenin knockout (KO). Pathway enrichment analysis suggested that Syntenin depletion was particularly associated with adhesion‐related processes. Accordingly, sEVs from Syntenin‐deficient 4T1 and MCF‐7 breast cancer cells showed a reduced expression of several focal adhesion and cell–cell junction proteins. Syntenin silencing reduced the Fibronectin‐binding capacity of sEVs from both cell lines, which was mediated by sEV‐associated Integrin alpha‐V/beta‐3 (αVβ3). Compared to sEVs from wildtype cells, Syntenin KO sEVs showed decreased tropism towards the Fibronectin‐rich liver microenvironment in vivo, provided less adhesive support for 4T1 cells and thereby failed to induce cancer cell migration, which appeared to be independent of EV uptake. In summary, this study revealed that Syntenin has a large‐scale effect on the proteomic cargo of sEVs and regulates their adhesive, organotropic and pro‐migratory properties in breast cancer
Standardized diagnosis of gastrointestinal tumors: an update regarding the situation in Germany
No full textGerwing M, Ristow I, Afat S, et al. Standardized diagnosis of gastrointestinal tumors: an update regarding the situation in Germany. RöFo : Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren . 2024.To evaluate the current status of the diagnosis of gastrointestinal tumors in Germany by means of a survey of the oncological imaging working group of the German Radiological Society (DRG) with a focus on the CT protocols being used.Radiologists working in outpatient or inpatient care in Germany were invited. The survey was conducted between 10/2022 and 06/2023 using the SurveyMonkey web tool. Questions related to gastrointestinal cancer were asked with regard to the commonly used imaging modalities, body coverage, and contrast agent phases in CT as well as the use of oral or rectal contrast. The results of the survey were analyzed using descriptive statistics.Clear differences were identified regarding the acquired contrast phases in relation to the place of work - outpatient care, smaller hospitals, maximum care hospitals, or university hospitals. Variances were also recognized regarding oral and rectal contrast. Based on the results and international guidelines, proposals for CT protocols were derived.CT protocols in Germany show a heterogeneous picture regarding acquired contrast phases, as well as oral and rectal contrast for the staging of gastrointestinal cancer. Clear recommendations in the respective guidelines would aid in quality assurance and comparability between different centers. · The examination protocols for the staging of gastrointestinal tumors are heterogeneous in Germany.. · The application of oral and rectal contrast is handled differently at the various radiological centers.. · Standardization of imaging should be targeted.. · Gerwing M, Ristow I, Afat S et al. Standardized diagnosis of gastrointestinal tumors: an update regarding the situation in Germany. Fortschr Rontgenstr 2024; DOI 10.1055/a-2378-6451. Thieme. All rights reserved
Análisis desde la narrativa fílmica del personaje femenino Jo March (Mujercitas, 2019) como representación de la mujer posmoderna
No full textEl objetivo principal del presente trabajo de investigación es la lectura y análisis de Jo March, el personaje principal de la película “Mujercitas” (2019) dirigido por Gretta Gerwing, desde los elementos de la narrativa fílmica como la construcción de personajes y la dirección de arte. Este análisis vendrá motivado con la finalidad de comprobar como es que este personaje representa a la mujer posmoderna, según el concepto del autor Gilles Lipovetsky, aunque desarrollado en un contexto social perteneciente al siglo XIX.The main objective of this research work is the reading and analysis of Jo March, the main character of the film “Little Women” (2019), directed by Gretta Gerwing, from the elements of the filmic narrative such as the construction of characters and the direction of art. This analysis will be motivated in order to verify how this character represents the postmodern woman, according to the concept of the author Gilles Lipovetsky, although developed in a social context belonging to the 19th century.Trabajo de investigació
Imaging-Derived Biomarkers Integrated with Clinical and Laboratory Values Predict Recurrence of Hepatocellular Carcinoma After Liver Transplantation
No full textThi Phuong Thao Hoang,1 Philipp Schindler,2 Nikolaus Börner,3 Max Masthoff,2 Mirjam Gerwing,2 Philippa von Beauvais,2 Enrico N De Toni,4 Christian M Lange,4 Jonel Trebicka,5 Haluk Morgül,6 Max Seidensticker,1 Jens Ricke,1 Andreas Pascher,6 Markus Guba,3 Michael Ingrisch,1 Moritz Wildgruber,1,* Osman Öcal1,* 1Department of Radiology, University Hospital, LMU Munich, Munich, Germany; 2Clinic for Radiology, University Hospital Muenster, Muenster, Germany; 3Department of General, Visceral and Transplantation Surgery, University Hospital, LMU Munich, Munich, Germany; 4Department for Internal Medicine II, University Hospital, LMU Munich, Munich, Germany; 5Department for Internal Medicine B, Universitätsklinikum Münster, Münster, Germany; 6Department of General, Visceral and Transplant Surgery, Universitätsklinikum Münster, Münster, Germany*These authors contributed equally to this workCorrespondence: Osman Öcal, Department of Radiology, University Hospital – LMU Munich, Marchioninistrasse 15, D-81377, München, Germany, Email [email protected]: To investigate the prognostic value of computed tomography (CT) derived imaging biomarkers in hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) and develop a predictive nomogram model.Patients and Methods: This retrospective study included 178 patients with histopathologically confirmed HCC who underwent liver transplantation between 2007 and 2021 at the two academic liver centers. We evaluated dedicated imaging features from baseline multiphase contrast-enhanced CT supplemented by several clinical findings and laboratory parameters. Time-to-recurrence was estimated by Kaplan–Meier analysis. Univariable Cox proportional hazard regression and multivariable Least Absolute Shrinkage and Selection Operator (LASSO) regression were used to assess independent prognostic factors for recurrence. A nomogram model was then built based on the independent factors selected through LASSO regression, to predict the probabilities of HCC recurrence at one, three, and five years.Results: The rate of HCC recurrence after LT was 17.4% (31 of 178). The LASSO analysis revealed six independent predictors associated with an elevated risk of tumor recurrence. These predictors included the presence of peritumoral enhancement, the presence of over three tumor lesions, the largest tumor diameter greater than 3 cm, serum alpha-fetoprotein (AFP) levels exceeding 400 ng/mL, and the presence of a tumor capsule. Conversely, a history of bridging therapies was found to be correlated with a reduced risk of HCC recurrence. In addition, Kaplan-Meier curves showed patients with irregular margin, satellite nodules, or small lesions displayed shorter time-to-recurrence. Our nomogram demonstrated good performance, yielding a C-index of 0.835 and AUC values of 0.86, 0.88, and 0.85 for the predictions of 1-year, 3-year, and 5-year TTR, respectively.Conclusion: Imaging parameters derived from baseline contrast-enhanced CT showing malignant behavior and aggressive growth patterns, along with serum AFP and history of bridging therapies, show potential as biomarkers for predicting HCC recurrence after transplantation.Keywords: hepatocellular carcinoma, transplantation, imaging, recurrenc
To treat or not to treat: A rare case of response to pembrolizumab‐based immunotherapy‐chemotherapy in non‐small cell lung cancer with acute liver failure due to multiple bile duct metastases
No full textReproductive ecology of the Sitka willow (Salix sitchensis ).
No full textSalix sitchensis, Sanson ex Bong, was shown to be ...pollinated by both wind and insect vectors in this study. Vector reliance and efficiency were variable by site as well as year, and pollen limitation was also observed. Asexual propagules had a higher survival rate and abundance compared to seedlings. Low seedling survival, an abundance of asexual propagules, and the presence of linkage disequilibrium suggested that asexual reproduction was occurring. However, all sampled individuals had a unique multilocus genotype and populations had a high level of genetic and genotypic diversity. These factors suggested that sexual reproduction is the dominant strategy in the observed populations of S. sitchensis. High gene flow and non-significant isolation by distance suggested that S. sitchensis exists as a large, continuous, interbreeding population along the sampled waterways in central British Columbia. Successful restoration of riparian habitat is dependent on species specific reproductive information and knowledge of how species interact with other riparian species. The data determined in this study may help future riparian restoration efforts, as the reproductive strategy of a common riparian willow and how it interacted with beavers (Castor canadensis Kuhl) was quantified.The original print copy of this thesis may be available here: http://wizard.unbc.ca/record=b160050
Disfluency in dialogue:an intentional signal from the speaker?
No full textDisfluency is a characteristic feature of spontaneous human speech, commonly seen as a consequence of problems with production. However, the question remains open as to why speakers are disfluent: Is it a mechanical by-product of planning difficulty, or do speakers use disfluency in dialogue to manage listeners' expectations? To address this question, we present two experiments investigating the production of disfluency in monologue and dialogue situations. Dialogue affected the linguistic choices made by participants, who aligned on referring expressions by choosing less frequent names for ambiguous images where those names had previously been mentioned. However, participants were no more disfluent in dialogue than in monologue situations, and the distribution of types of disfluency used remained constant. Our evidence rules out at least a straightforward interpretation of the view that disfluencies are an intentional signal in dialogue
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