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  • 1
    Online Resource
    Online Resource
    Therapie der intraoperativen Hypotonie mit Cafedrin/Theodrenalin vs. Ephedrin : Ergebnisse der HYPOTENS-Studie, einer prospektiven, nationalen, multizentrischen, nicht-interventionellen Untersuchung bei Patienten, die eine Vollnarkose erhalten
    Springer Science and Business Media LLC ; 2021
    In:  Der Anaesthesist Vol. 70, No. 4 ( 2021-04), p. 298-307
    Details
    In: Der Anaesthesist, Springer Science and Business Media LLC, Vol. 70, No. 4 ( 2021-04), p. 298-307
    Abstract: Die medikamentöse Therapie mit Sympathomimetika bildet einen Grundpfeiler der Behandlung relevanter Blutdruckabfälle, so auch der intraoperativen Hypotonie (IOH). Dieses häufige Problem ist mit Endorganschäden assoziiert, wobei Nierenversagen und eine erhöhte Rate kardiovaskulärer Komplikationen am besten dokumentiert sind. Die Datenlage verdeutlicht die Notwendigkeit, dass eine IOH schnell und konsequent therapiert werden muss. Obwohl Cafedrin/Theodrenalin (C/T) in Deutschland häufig in dieser Indikation eingesetzt wird, fehlte bislang ein Wirksamkeitsvergleich mit international verfügbaren Alternativen wie Ephedrin (E). Methoden HYPOTENS ist eine prospektive, nationale, multizentrische (53 Kliniken mit 66 operativen Abteilungen), offene, zweiarmige, nicht-interventionelle Studie zum Vergleich der Wirksamkeit von C/T und E bei der IOH-Therapie unter klinischen Routinebedingungen. Diese Studie beschreibt eine prospektiv definierte Kohorte von Patienten im Alter von ≥50 Jahren mit Komorbiditäten, deren Allgemeinanästhesie mit Propofol und Fentanyl (≥0,2 mg oder Äquivalent) eingeleitet wurde. Alle Patienten hatten intraoperativ eine therapiepflichtige IOH entwickelt und wurden nach dem jeweiligen lokalen Standard mit C/T oder E therapiert. Die primären Studienziele waren Präzision und Schnelligkeit des Blutdruckanstiegs auf einen vor der Behandlung individuell festgelegten Mindest-Zielblutdruck, ohne dabei einen relevanten Anstieg der Herzfrequenz zu verursachen. Die Therapiezufriedenheit der Anästhesisten und die Anzahl zusätzlicher Bolusinjektionen oder weiterer kreislaufstabilisierender Maßnahmen waren sekundäre Endpunkte. Ergebnisse Insgesamt 1496 Patienten wurden protokollgemäß behandelt und ausgewertet. Eine Kreislaufstabilisierung wurde mit beiden Therapieoptionen erreicht. Post-hoc-Analysen zeigen, dass der Blutdruckanstieg unter C/T ausgeprägter war und gleichzeitig weniger zusätzliche Boli der jeweiligen Substanz appliziert und zusätzliche kreislaufstabilisierende Interventionen durchgeführt werden mussten. Die Inzidenz von Tachykardien war in beiden Behandlungsgruppen vergleichbar. Unter E kam es jedoch zu einer dosisabhängigen Erhöhung der Herzfrequenz, während bei den mit C/T behandelten Patienten die Herzfrequenz stabil blieb. Die Therapiezufriedenheit der Anästhesisten war im C/T-Arm höher. Schlussfolgerung Hinsichtlich der Kreislaufstabilisierung war keine der beiden Therapieoptionen überlegen. Post-hoc-Analysen deuten darauf hin, dass C/T unter Routinebedingungen eine zielorientiertere und einfacher zu steuernde Kreislaufstabilisierung ermöglicht. Die seltener erforderlichen erweiterten Therapiemaßnahmen zur ergänzenden IOH-Korrektur stellen einen möglichen Grund für die höhere Anwenderzufriedenheit dar.
    Type of Medium: Online Resource
    ISSN: 0003-2417 , 1432-055X
    URL: Article
    DOI: 10.1007/s00101-020-00877-5
    RVK:
    XA 22100
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 3122926-8
    detail.hit.zdb_id: 1458421-9
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  • 2
    Online Resource
    Online Resource
    Facilitating stress prevention in micro and small-sized enterprises: protocol for a mixed method study to evaluate the effectiveness and implementation process of targeted web-based interventions
    Springer Science and Business Media LLC ; 2022
    In:  BMC Public Health Vol. 22, No. 1 ( 2022-12)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
    Abstract: Workplace-related stress is a major risk factor for mental and physical health problems and related sickness absence and productivity loss. Despite evidence regarding the effectiveness of different workplace-based interventions, the implementation of stress prevention interventions is rare, especially in micro and small-sized enterprises (MSE) with fewer than 50 employees. The joint research project “PragmatiKK” + aims to identify and address the specific barriers to the implementation of stress prevention interventions in MSE. This study protocol describes a mixed method study design to evaluate the effectiveness of adapted stress prevention interventions and the implementation process via an integrated web-based platform (“System P”) specifically targeted at MSE. Methods First, we develop a web-based intervention, which accounts for the specific working conditions in MSE and addresses stress prevention at a structural and behavioral level. Second, we use common methods of implementation research to perform an effect and process evaluation. We analyze the effectiveness of the web-based stress prevention interventions by comparing depressive symptoms at baseline and follow-up (after 6 months and 12 months). Indicators for a successful implementation process include acceptability, adoption, feasibility, reach, dose, and fidelity, which we will measure with quantitative web-based questionnaires and qualitative interviews. We will also analyze the accumulated usage data from the web-based platform. Discussion Collecting data on the implementation process and the effectiveness of a web-based intervention will help to identify and overcome common barriers to stress prevention in MSE. This can improve the mental health of employees in MSE, which constitute more than 90% of all enterprises in Germany. + Full Project Name: „PragmatiKK - Pragmatische Lösungen für die Implementation von Maßnahmen zur Stressprävention in Kleinst- und Kleinbetrieben “(= Pragmatic solutions for the implementation of stress prevention interventions in micro and small-sized enterprises). Trial registration German Register of Clinical Studies (DRKS): DRKS00026154 , date of registration: 2021-09-16.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-022-12921-7
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2041338-5
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  • 3
    Online Resource
    Online Resource
    Long-Term Antibody Response to SARS-CoV-2 in Children
    Springer Science and Business Media LLC ; 2023
    In:  Journal of Clinical Immunology Vol. 43, No. 1 ( 2023-01), p. 46-56
    Details
    In: Journal of Clinical Immunology, Springer Science and Business Media LLC, Vol. 43, No. 1 ( 2023-01), p. 46-56
    Abstract: Almost 2 years into the pandemic and with vaccination of children significantly lagging behind adults, long-term pediatric humoral immune responses to SARS-CoV-2 are understudied. The C19.CHILD Hamburg (COVID-19 Child Health Investigation of Latent Disease) Study is a prospective cohort study designed to identify and follow up children and their household contacts infected in the early 2020 first wave of SARS-CoV-2. We screened 6113 children  〈  18 years by nasopharyngeal swab-PCR in a low-incidence setting after general lockdown, from May 11 to June 30, 2020. A total of 4657 participants underwent antibody testing. Positive tests were followed up by repeated PCR and serological testing of all household contacts over 6 months. In total, the study identified 67 seropositive children (1.44%); the median time after infection at first presentation was 83 days post-symptom onset (PSO). Follow-up of household contacts showed less than 100% seroprevalence in most families, with higher seroprevalence in families with adult index cases compared to pediatric index cases (OR 1.79, P  = 0.047). Most importantly, children showed sustained seroconversion up to 9 months PSO, and serum antibody concentrations persistently surpassed adult levels (ratio serum IgG spike children vs. adults 90 days PSO 1.75, P   〈  0.001; 180 days 1.38, P  = 0.01; 270 days 1.54, P  = 0.001). In a low-incidence setting, SARS-CoV-2 infection and humoral immune response present distinct patterns in children including higher antibody levels, and lower seroprevalence in families with pediatric index cases. Children show long-term SARS-CoV-2 antibody responses. These findings are relevant to novel variants with increased disease burden in children, as well as for the planning of age-appropriate vaccination strategies.
    Type of Medium: Online Resource
    ISSN: 0271-9142 , 1573-2592
    URL: Article
    DOI: 10.1007/s10875-022-01355-w
    RVK:
    XA 10000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2016755-6
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  • 4
    Online Resource
    Online Resource
    Diagnostic Meaning of Urodynamic Studies in Pouch Incontinence: Results of a Small Series
    S. Karger AG ; 2014
    In:  Urologia Internationalis Vol. 92, No. 2 ( 2014), p. 237-241
    Details
    In: Urologia Internationalis, S. Karger AG, Vol. 92, No. 2 ( 2014), p. 237-241
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 To evaluate the meaning of urodynamic parameters in patients with pouch incontinence. 〈 b 〉 〈 i 〉 Materials and Methods: 〈 /i 〉 〈 /b 〉 Thirteen urodynamic studies in patients with an ileal nipple as the efferent segment of an ileocecal pouch or ileum/ileocecal-augmented bladder were performed. The recorded parameters included pouch capacity, leak point pressure/volume, maximum pouch pressure, compliance, static and dynamic closure pressure, and functional length. Three patients suffered from urinary incontinence. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In all cases of incontinent patients, no functional length or static or dynamic closure pressure could be revealed. In 8 of 10 cases of continent patients, a positive functional length as well as static and/or dynamic closure pressure were measured (mean value in continent patients: 15.9 mm, 14.5 cm H 〈 sub 〉 2 〈 /sub 〉 O and 26.5 cm H 〈 sub 〉 2 〈 /sub 〉 O, respectively). In 2 of 3 cases of incontinent patients, the pouch compliance was restricted (21 and 37 ml/cm H 〈 sub 〉 2 〈 /sub 〉 O). The pouch capacity of continent patients was greater than the capacity of incontinent patients (377.4 vs. 185.7 ml). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Positive functional length, static and dynamic closure pressures, and a high pouch capacity with an unrestricted compliance are predictive for pouch continence. They may individually not determine continence, but combining them can. However, the meaning of urodynamic studies in pouch incontinence is not the same as with the urinary bladder.
    Type of Medium: Online Resource
    ISSN: 0042-1138 , 1423-0399
    URL: Article
    DOI: 10.1159/000353417
    RVK:
    XA 10000
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2014
    detail.hit.zdb_id: 1464417-4
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  • 5
    Online Resource
    Online Resource
    SARS-CoV-2 sero-immunity and quality of life in children and adolescents in relation to infections and vaccinations: the IMMUNEBRIDGE KIDS cross-sectional study, 2022
    Springer Science and Business Media LLC ; 2023
    In:  Infection Vol. 51, No. 5 ( 2023-10), p. 1531-1539
    Details
    In: Infection, Springer Science and Business Media LLC, Vol. 51, No. 5 ( 2023-10), p. 1531-1539
    Abstract: The study evaluates the effects on sero-immunity, health status and quality of life of children and adolescents after the upsurge of the Omicron variant in Germany. Methods This multicenter cross-sectional study (IMMUNEBRIDGE Kids) was conducted within the German Network University Medicine (NUM) from July to October 2022. SARS-CoV-2- antibodies were measured and data on SARS-CoV-2 infections, vaccinations, health and socioeconomic factors as well as caregiver-reported evaluation on their children’s health and psychological status were assessed. Results 497 children aged 2–17 years were included. Three groups were analyzed: 183 pre-schoolchildren aged 2–4 years, 176 schoolchildren aged 5–11 years and 138 adolescents aged 12–18 years. Positive antibodies against the S- or N-antigen of SARS-CoV-2 were detected in 86.5% of all participants (70.0% [128/183] of pre-schoolchildren, 94.3% of schoolchildren [166/176] and 98.6% of adolescents [136/138]). Among all children, 40.4% (201/497) were vaccinated against COVID-19 (pre-schoolchildren 4.4% [8/183] , schoolchildren 44.3% [78/176] and adolescents 83.3% [115/138] ). SARS-CoV-2 seroprevalence was lowest in pre-school. Health status and quality of life reported by the parents were very positive at the time of the survey (Summer 2022). Conclusion Age-related differences on SARS-CoV-2 sero-immunity could mainly be explained by differences in vaccination rates based on the official German vaccination recommendations as well as differences in SARS-CoV-2 infection rates in the different age groups. Health status and quality of life of almost all children were very good independent of SARS-CoV-2 infection and/or vaccination. Trial registration German Registry for Clinical Trials Identifier Würzburg: DRKS00025546 (registration: 11.09.2021), Bochum: DRKS00022434 (registration:07.08.2020), Dresden: DRKS 00022455 (registration: 23.07.2020).
    Type of Medium: Online Resource
    ISSN: 0300-8126 , 1439-0973
    URL: Article
    DOI: 10.1007/s15010-023-02052-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2006315-5
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  • 6
    Online Resource
    Online Resource
    Estimates of protection levels against SARS-CoV-2 infection and severe COVID-19 in Germany before the 2022/2023 winter season: the IMMUNEBRIDGE project
    Springer Science and Business Media LLC ; 2023
    In:  Infection
    Details
    In: Infection, Springer Science and Business Media LLC
    Abstract: Despite the need to generate valid and reliable estimates of protection levels against SARS-CoV-2 infection and severe course of COVID-19 for the German population in summer 2022, there was a lack of systematically collected population-based data allowing for the assessment of the protection level in real time. Methods In the IMMUNEBRIDGE project, we harmonised data and biosamples for nine population-/hospital-based studies (total number of participants n  = 33,637) to provide estimates for protection levels against SARS-CoV-2 infection and severe COVID-19 between June and November 2022. Based on evidence synthesis, we formed a combined endpoint of protection levels based on the number of self-reported infections/vaccinations in combination with nucleocapsid/spike antibody responses (“confirmed exposures”). Four confirmed exposures represented the highest protection level, and no exposure represented the lowest. Results Most participants were seropositive against the spike antigen; 37% of the participants ≥ 79 years had less than four confirmed exposures (highest level of protection) and 5% less than three. In the subgroup of participants with comorbidities, 46–56% had less than four confirmed exposures. We found major heterogeneity across federal states, with 4–28% of participants having less than three confirmed exposures. Conclusion Using serological analyses, literature synthesis and infection dynamics during the survey period, we observed moderate to high levels of protection against severe COVID-19, whereas the protection against SARS-CoV-2 infection was low across all age groups. We found relevant protection gaps in the oldest age group and amongst individuals with comorbidities, indicating a need for additional protective measures in these groups.
    Type of Medium: Online Resource
    ISSN: 0300-8126 , 1439-0973
    URL: Article
    DOI: 10.1007/s15010-023-02071-2
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2006315-5
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  • 7
    Online Resource
    Online Resource
    Ecosystem shifts at two mid-Holocene tipping points in the alpine Lake Son Kol (Kyrgyzstan, Central Asia)
    SAGE Publications ; 2020
    In:  The Holocene Vol. 30, No. 10 ( 2020-10), p. 1410-1419
    Details
    In: The Holocene, SAGE Publications, Vol. 30, No. 10 ( 2020-10), p. 1410-1419
    Abstract: Tipping points can be defined as critical ecosystem thresholds that start self-enforced dynamics pushing systems into new stable states. Many lake ecosystems of arid Central Asia are sensitive to hydrological changes as they are located at the intersection of the influence of the dry Siberian Anticyclone and the relatively humid mid-latitude Westerlies, and their sediment records can be used to study past tipping points. We studied subfossil chironomid remains preserved in a ca. 6000-year-long sediment record from the Central Asian lake Son Kol (Central Kyrgyzstan) to reconstruct past ecosystem dynamics. Our results show abrupt transitions from a chironomid fauna dominated by macrophyte-associated, salinity-indicating taxa, to a vegetation-independent fauna, and subsequently to a macrophyte-associated, freshwater-indicating fauna. A comparison of the chironomid-based environmental reconstruction to other proxy indicators from the same record suggests a phase of increased Westerly strength starting about 4900 cal. yr BP. This increase led to enhanced precipitation and sediment fluxes into the lake, which in turn led to high turbidity levels and consequently to a macrophyte collapse causing abrupt changes in the chironomid fauna. At 4300 cal. yr BP, a weakening of the Westerlies in combination with higher lake levels led to lower turbidity and ultimately to the recovery of the macrophyte population and associated changes in the chironomid assemblage. These two sequences of events show how the occurrence of a gradual change in an external trigger (Westerlies) can trigger a cascade of within-lake processes (turbidity, macrophyte density) and may ultimately lead to an abrupt reorganization of the ecosystem (chironomid fauna), providing models for tipping points.
    Type of Medium: Online Resource
    ISSN: 0959-6836 , 1477-0911
    URL: Article
    DOI: 10.1177/0959683620932973
    RVK:
    RA 1000
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2027956-5
    SSG: 14
    SSG: 3,4
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  • 8
    Online Resource
    Online Resource
    Transport in graphene nanostructures
    Springer Science and Business Media LLC ; 2011
    In:  Frontiers of Physics Vol. 6, No. 3 ( 2011-9), p. 271-293
    Details
    In: Frontiers of Physics, Springer Science and Business Media LLC, Vol. 6, No. 3 ( 2011-9), p. 271-293
    Type of Medium: Online Resource
    ISSN: 2095-0462 , 2095-0470
    URL: Article
    DOI: 10.1007/s11467-011-0182-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2011
    detail.hit.zdb_id: 2635767-7
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  • 9
    Online Resource
    Online Resource
    Microcamera Visualisation System to Overcome Specular Reflections for Tissue Imaging
    MDPI AG ; 2023
    In:  Micromachines Vol. 14, No. 5 ( 2023-05-17), p. 1062-
    Details
    In: Micromachines, MDPI AG, Vol. 14, No. 5 ( 2023-05-17), p. 1062-
    Abstract: In vivo tissue imaging is an essential tool for medical diagnosis, surgical guidance, and treatment. However, specular reflections caused by glossy tissue surfaces can significantly degrade image quality and hinder the accuracy of imaging systems. In this work, we further the miniaturisation of specular reflection reduction techniques using micro cameras, which have the potential to act as intra-operative supportive tools for clinicians. In order to remove these specular reflections, two small form factor camera probes, handheld at 10 mm footprint and miniaturisable to 2.3 mm, are developed using different modalities, with line-of-sight to further miniaturisation. (1) The sample is illuminated via multi-flash technique from four different positions, causing a shift in reflections which are then filtered out in a post-processing image reconstruction step. (2) The cross-polarisation technique integrates orthogonal polarisers onto the tip of the illumination fibres and camera, respectively, to filter out the polarisation maintaining reflections. These form part of a portable imaging system that is capable of rapid image acquisition using different illumination wavelengths, and employs techniques that lend themselves well to further footprint reduction. We demonstrate the efficacy of the proposed system with validating experiments on tissue-mimicking phantoms with high surface reflection, as well as on excised human breast tissue. We show that both methods can provide clear and detailed images of tissue structures along with the effective removal of distortion or artefacts caused by specular reflections. Our results suggest that the proposed system can improve the image quality of miniature in vivo tissue imaging systems and reveal underlying feature information at depth, for both human and machine observers, leading to better diagnosis and treatment outcomes.
    Type of Medium: Online Resource
    ISSN: 2072-666X
    URL: Article
    DOI: 10.3390/mi14051062
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2620864-7
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  • 10
    Online Resource
    Online Resource
    Characterization and modeling of acousto-optic signal strengths in highly scattering media
    Optica Publishing Group ; 2019
    In:  Biomedical Optics Express Vol. 10, No. 11 ( 2019-11-01), p. 5565-
    Details
    In: Biomedical Optics Express, Optica Publishing Group, Vol. 10, No. 11 ( 2019-11-01), p. 5565-
    Type of Medium: Online Resource
    ISSN: 2156-7085 , 2156-7085
    URL: Article
    DOI: 10.1364/BOE.10.005565
    Language: English
    Publisher: Optica Publishing Group
    Publication Date: 2019
    detail.hit.zdb_id: 2572216-5
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