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Observation of η_(c)(1S, 2S) and χ_(cJ) decays to 2(π⁺π^(−))η via ψ(3686) radiative transitions
(2024)
Based on 2.7×109 ψ(3686) decays collected with the BESIII detector, the radiative decay ψ(3686)→γ2(π+π−)η is investigated to measure properties of S- and P-wave charmonium states. The branching fraction of the decay ηc(1S)→2(π+π−)η, which is found to have a strong dependence on the interference pattern between ηc(1S) and non-ηc(1S) processes, is measured in both destructive and constructive interference scenarios for the first time. The mass and width of the ηc(1S) are measured to be M=(2984.14±0.13±0.38) MeV/c2 and Γ=(28.82±0.11±0.82) MeV, respectively. Clear signals for the decays of the χcJ(J=0,1,2) and the ηc(2S) to 2(π+π−)η are also observed for the first time, and the corresponding branching fractions are measured. The ratio of the branching fractions between the ηc(2S) and ηc(1S) decays is significantly lower than the theoretical prediction, which might suggest different dynamics in their decays.
A light scalar X0 or vector X1 particles have been introduced as a possible explanation for the (g−2)μ anomaly and dark matter phenomena.
Using (8.998±0.039)×109 $\jpsi$ events collected by the BESIII detector, we search for a light muon philic scalar X0 or vector X1 in the processes J/ψ→μ+μ−X0,1 with X0,1 invisible decays. No obvious signal is found, and the upper limits on the coupling g′0,1 between the muon and the X0,1 particles are set to be between 1.1×10−3 and 1.0×10−2 for the X0,1 mass in the range of 1<M(X0,1)<1000 MeV/c2 at 90% confidence level.
A measurement of the CP-even fraction of the decay D0→π+π−π+π− is performed with a quantum-correlated ψ(3770)→DD¯ data sample collected by the BESIII experiment, corresponding to an integrated luminosity of 2.93 fb−1. Using a combination of CP eigenstates, D→π+π−π0 and D→K0S,Lπ+π− as tagging modes, the CP-even fraction is measured to be F4π+=0.735±0.015±0.005, where the first uncertainty is statistical and the second is systematic. This is the most precise determination of this quantity to date. It provides valuable model-independent input for the measurement of the CKM angle γ with B±→DK± decays, and for time-dependent studies of CP violation and mixing in the D0-D¯0 system.
We present the first observation of the singly Cabibbo-suppressed decay Λ+c→ΛK+π0 with a significance of 5.7σ and the first evidence of Λ+c→ΛK+π+π− decay with a significance of 3.1σ, based on e+e− annihilation data recorded by the BESIII detector at the BEPCII collider. The data correspond to an integrated luminosity of 6.4 fb−1, in the center-of-mass energy range from 4.600 GeV to 4.950 GeV. We determine the branching fractions of Λ+c→ΛK+π0 and Λ+c→ΛK+π+π− relative to their Cabibbo-favored counterparts to be B(Λ+c→ΛK+π0)B(Λ+c→Λπ+π0)=(2.09±0.39stat.±0.07syst.)×10−2 and B(Λ+c→ΛK+π+π−)B(Λ+c→Λπ+π+π−)=(1.13±0.41stat.±0.06syst.)×10−2, respectively. Moreover, by combining our measured result with the world average of B(Λ+c→Λπ+π0), we obtain the branching fraction B(Λ+c→ΛK+π0)=(1.49±0.27stat.±0.05syst.±0.08ref.)×10−3. This result significantly departs from theoretical predictions based on quark SU(3) flavor symmetry, which is underpinned by the presumption of meson pair S-wave amplitude dominance.
Using (448.1 ± 2.9) × 106 ψ(3686) events collected with the BESIII detector at the BEPCII collider, the decay ψ(3686) → Σ⁻Σ‾⁺ is observed for the first time with a branching fraction of (2.82 ± 0.04stat. ± 0.08syst.) × 10−4, and the angular parameter αΣ− is measured to be 0.96 ± 0.09stat. ± 0.03syst..
Measurements of cross section of e⁺e⁻ → pp¯π⁰ at center-of-mass energies between 4.008 and 4.600 GeV
(2017)
Based on e+e− annihilation data samples collected with the BESIII detector at the BEPCII collider at 13 center-of-mass energies from 4.008 to 4.600 GeV, measurements of the Born cross section of e+e− → pp¯π0 are performed. No significant resonant structure is observed in the measured energy dependence of the cross section. The upper limit on the Born cross section of e+e− → Y (4260) → pp¯π0 at the 90% C.L. is determined to be 0.01 pb. The upper limit on the ratio of the branching fractions B(Y (4260)→pp¯π0) B(Y (4260)→π+π− J/ψ) at the 90% C.L. is determined to be 0.02%.
A measurement of the 𝐶𝑃-even fraction of the decay 𝐷0→𝜋+𝜋−𝜋+𝜋− is performed with a quantum-correlated 𝜓(3770)→𝐷¯𝐷 data sample collected by the BESIII experiment, corresponding to an integrated luminosity of 2.93 fb−1. Using a combination of 𝐶𝑃 eigenstates, 𝐷→𝜋+𝜋−𝜋0 and 𝐷→𝐾0𝑆,𝐿𝜋+𝜋− as tagging modes, the 𝐶𝑃-even fraction is measured to be 𝐹4𝜋+=0.735±0.015±0.005, where the first uncertainty is statistical and the second is systematic. This is the most precise determination of this quantity to date. It provides valuable model-independent input for the measurement of the angle 𝛾 of the Cabibbo-Kobayashi-Maskawa matrix with 𝐵±→𝐷𝐾± decays, and for time-dependent studies of 𝐶𝑃 violation and mixing in the 𝐷0−¯𝐷0 system.
The decays of χc2→K+K−π0, KSK±π∓ and π+π−π0 are studied with the ψ(3686) data samples collected with the Beijing Spectrometer (BESIII). For the first time, the branching fractions of χc2→K∗K¯¯¯¯¯, χc2→a±2(1320)π∓/a02(1320)π0 and χc2→ρ(770)±π∓ are measured. Here K∗K¯¯¯¯¯ denotes both K∗±K∓ and K∗0K¯¯¯¯¯0+c.c., and K∗ denotes the resonances K∗(892), K∗2(1430) and K∗3(1780). The observations indicate a strong violation of the helicity selection rule in χc2 decays into vector and pseudoscalar meson pairs. The measured branching fractions of χc2→K∗(892)K¯¯¯¯¯ are more than 20 times larger than that of χc2→ρ(770)±π∓, which implies the effects are largely due to U-spin symmetry breaking, rather than just isospin symmetry breaking in charmonium decays.
We measured the Born cross sections for the process e+e− → ωη′ at 22 center-of-mass energies from 2.000 to 3.080 GeV with the BESIII detector at the BEPCII collider. We observed a resonant structure with a statistical significance of 9.6σ. A Breit-Wigner fit determines its mass to be MR = (2153 ± 30 ± 31) MeV/c2 and its width to be ΓR = (167 ± 77 ± 7) MeV, where the first uncertainties are statistical and the second are systematic.
Based on e+e− collision data collected at center-of-mass energies from 2.000 to 3.080 GeV by the BESIII detector at the BEPCII collider, a partial wave analysis is performed for the process e+e−→K0SK0Lπ0. The results allow the Born cross sections of the process e+e−→K0SK0Lπ0, as well as its subprocesses e+e−→K∗(892)0K¯ and K∗2(1430)0K¯ to be measured. The Born cross sections for e+e−→K0SK0Lπ0 are consistent with previous measurements by BaBar and SND, but with substantially improved precision. The Born cross section lineshape of the process e+e−→K∗(892)0K¯ is consistent with a vector meson state around 2.2 GeV with a statistical significance of 3.2σ. A Breit-Wigner fit determines its mass as MY=(2164.1±9.6±3.1) MeV/c2 and its width as ΓY=(32.4±21.1±1.5) MeV, where the first uncertainties are statistical and the second ones are systematic, respectively.
Based on e+e− collision data collected at center-of-mass energies from 2.000 to 3.080 GeV by the BESIII detector at the BEPCII collider, a partial wave analysis is performed for the process e+e−→K0SK0Lπ0. The results allow the Born cross sections of the process e+e−→K0SK0Lπ0, as well as its subprocesses e+e−→K∗(892)0K¯0 and K∗2(1430)0K¯0 to be measured. The Born cross sections for e+e−→K0SK0Lπ0 are consistent with previous measurements by BaBar, but with substantially improved precision. The Born cross section lineshape of the process e+e−→K∗(892)0K¯0 is consistent with a vector meson state around 2.2 GeV with a significance of 3.2σ. A Breit-Wigner fit determines its mass as MY=(2164.7±9.1±3.1) MeV/c2 and its width as ΓY=(32.4±21.0±1.8) MeV.
We measure the Born cross section for the reaction e+e−→ηhc from s√=4.129 to 4.600~GeV using data sets collected by the BESIII detector running at the BEPCII collider. A resonant structure in the cross section line shape near 4.200~GeV is observed with a statistical significance of 7σ. The parameters of this resonance are measured to be \MeasMass\ and \MeasWidth, where the first uncertainties are statistical and the second systematic.
Using a data sample of (1.0087±0.0044)×1010 𝐽/𝜓 decay events collected with the BESIII detector at the center-of-mass energy of √𝑠=3.097 GeV, we present a search for the hyperon semileptonic decay Ξ0→Σ−𝑒+𝜈𝑒 which violates the Δ𝑆=Δ𝑄 rule. No significant signal is observed, and the upper limit on the branching fraction ℬ(Ξ0→Σ−𝑒+𝜈𝑒) is determined to be 1.6×10−4 at the 90% confidence level. This result improves the previous upper limit result by about one order of magnitude.
Based on (2712.4±14.3)×106 ψ(3686) events, we investigate four hadronic decay modes of the P-wave charmonium spin-singlet state hc(1P1)→h+h−π0/η (h=π or K) via the process ψ(3686)→π0hc at BESIII. The hc→π+π−π0 decay is observed with a significance of 9.6σ after taking into account systematic uncertainties. Evidences for hc→K+K−π0 and hc→K+K−η are found with significances of 3.5σ and 3.3σ, respectively, after considering the systematic uncertainties. The branching fractions of these decays are measured to be B(hc→π+π−π0)=(1.36±0.16±0.14)×10−3, B(hc→K+K−π0)=(3.26±0.84±0.36)×10−4, and B(hc→K+K−η)=(3.13±1.08±0.38)×10−4, where the first uncertainties are statistical and the second are systematic. No significant signal of hc→π+π−η is found, and the upper limit of its decay branching fraction is determined to be B(hc→π+π−η)<4.0×10−4 at 90% confidence level.
By analyzing e+e− annihilation da ta corresponding to an integrated luminosity of 2.93 fb−1 collected at a center-of-mass energy of 3.773 GeV with the \text{BESIII} detector, the first observation of the semileptonic decays D0→K0Sπ−π0e+νe and D+→K0Sπ+π−e+νe is reported. With a dominant hadronic contribution from K1(1270), the branching fractions are measured to be B(D0→K1(1270)−(→K0Sπ−π0)e+νe) = (1.69+0.53−0.46±0.15)×10−4 and B(D+→K¯1(1270)0(→K0Sπ+π−)e+νe) = (1.47+0.45−0.40±0.20)×10−4 with statistical significance of 5.4σ and 5.6σ, respectively. When combined with measurements of the K1(1270)→K+π−π decays, the absolute branching fractions are determined to be B(D0→K1(1270)−e+νe) = (1.05+0.33−0.28±0.12±0.12)×10−3 and B(D+→K¯1(1270)0e+νe) = (1.29+0.40−0.35±0.18±0.15)×10−3. The first and second uncertainties are statistical and systematic, respectively, and the third uncertainties originate from the assumed branching fractions of the K1(1270)→Kππ decays.
A search has been performed for the semileptonic decays D0→K0SK−e+νe, D+→K0SK0Se+νe and D+→K+K−e+νe, using 7.9 fb−1 of e+e− annihilation data collected at the center-of-mass energy s√=3.773 GeV by the BESIII detector operating at the BEPCII collider. No significant signals are observed, and upper limits are set at the 90\% confidence level of 2.13×10−5, 1.54×10−5 and 2.10×10−5 for the branching fractions of D0→K0SK−e+νe, D+→K0SK0Se+νe and D+→K+K−e+νe, respectively.
The decays of χc2→K+K−π0, KSK±π∓ and π+π−π0 are studied with the ψ(3686) data samples collected with the Beijing Spectrometer (BESIII). For the first time, the branching fractions of χc2→K∗K¯¯¯¯¯, χc2→a±2(1320)π∓/a02(1320)π0 and χc2→ρ(770)±π∓ are measured. Here K∗K¯¯¯¯¯ denotes both K∗±K∓ and K∗0K¯¯¯¯¯0+c.c., and K∗ denotes the resonances K∗(892), K∗2(1430) and K∗3(1780). The observations indicate a strong violation of the helicity selection rule in χc2 decays into vector and pseudoscalar meson pairs. The measured branching fractions of χc2→K∗(892)K¯¯¯¯¯ are more than 20 times larger than that of χc2→ρ(770)±π∓, which implies the effects are largely due to U-spin symmetry breaking, rather than just isospin symmetry breaking in charmonium decays.
Using (10087±44)×106 J/ψ events collected with the BESIII detector, numerous Ξ− and Λ decay asymmetry parameters are simultaneously determined from the process J/ψ→Ξ−Ξ¯+→Λ(pπ−)π−Λ¯(n¯π0)π+ and its charge-conjugate channel. The precisions of α0 for Λ→nπ0 and α¯0 for Λ¯→n¯π0 compared to world averages are improved by factors of 4 and 1.7, respectively. The ratio of decay asymmetry parameters of Λ→nπ0 to that of Λ→pπ−, ⟨α0⟩/⟨αΛ−⟩, is determined to be 0.873±0.012+0.011−0.010, where the first and the second uncertainties are statistical and systematic, respectively. The ratio is smaller than unity more than 5σ, which signifies the existence of the ΔI=3/2 transition in Λ for the first time. Beside, we test for CP violation in Ξ−→Λπ− and in Λ→nπ0 with the best precision to date.
Using (10087±44)×106 J/ψ events collected with the BESIII detector, numerous Ξ− and Λ decay asymmetry parameters are simultaneously determined from the process J/ψ→Ξ−Ξ¯+→Λ(pπ−)π−Λ¯(n¯π0)π+ and its charge-conjugate channel. The precisions of α0 for Λ→nπ0 and α¯0 for Λ¯→n¯π0 compared to world averages are improved by factors of 4 and 1.7, respectively. The ratio of decay asymmetry parameters of Λ→nπ0 to that of Λ→pπ−, ⟨α0⟩/⟨αΛ−⟩, is determined to be 0.873±0.012+0.011−0.010, where the first and the second uncertainties are statistical and systematic, respectively. The ratio is smaller than unity, which is predicted by the ΔI=1/2 rule, with a statistical significance of more than 5σ. We test for CP violation in Ξ−→Λπ− and in Λ→nπ0 with the best precision to date.
Based on 7.33 fb−1 of 𝑒+𝑒− collision data collected at center-of-mass energies between 4.128 and 4.226 GeV with the BESIII detector, the experimental studies of the doubly Cabibbo-suppressed decays 𝐷+𝑠→𝐾+𝐾+𝜋− and 𝐷+𝑠→𝐾+𝐾+𝜋−𝜋0 are reported. We determine the absolute branching fraction of 𝐷+𝑠→𝐾+𝐾+𝜋− to be (1.24+0.28−0.26(stat)±0.06(syst))×10−4. No significant signal of 𝐷+𝑠→𝐾+𝐾+𝜋−𝜋0 is observed and the upper limit on its decay branching fraction at 90% confidence level is set to be 1.7×10−4.
Based on 7.33 fb−1 of e+e− collision data collected at center-of-mass energies between 4.128 and 4.226 GeV with the BESIII detector, the experimental studies of the doubly Cabibbo-suppressed decays D+s→K+K+π− and D+s→K+K+π−π0 are reported. We determine the absolute branching fraction of D+s→K+K+π− to be (1.23+0.28−0.25(stat)±0.06(syst)) ×10−4. No significant signal of D+s→K+K+π−π0 is observed and the upper limit on its decay branching fraction at 90\% confidence level is set to be 1.7×10−4.
Based on 4.5 fb−1 of e+e− collision data accumulated at center-of-mass energies between 4599.53 MeV and 4698.82 MeV with the BESIII detector, the decay Λ+c→nK0Sπ+π0 is observed for the first time with a significance of 9.2σ. The branching fraction is measured to be (0.85±0.13±0.03)%, where the first uncertainty is statistical and the second systematic, which differs from the theoretical prediction based on isospin by 4.4σ. This indicates that there may be resonant contributions or some unknown dynamics in this decay.
Measurement of the e+e−→π+π− cross section between 600 and 900 MeV using initial state radiation
(2016)
We extract the e+e− →π+π− cross section in the energy range between 600 and 900 MeV, exploiting the method of initial state radiation. A data set with an integrated luminosity of 2.93 fb−1 taken at a center-of-mass energy of 3.773 GeV with the BESIII detector at the BEPCII collider is used. The cross section is measured with a systematic uncertainty of 0.9%. We extract the pion form factor |Fπ|2 as well as the contribution of the measured cross section to the leading-order hadronic vacuum polarization contribution to (g−2)μ. We find this value to be aππ,LO μ (600–900 MeV) = (368.2 ±2.5stat±3.3sys) ·10−10, which is between the corresponding values using the BaBar or KLOE data.
The decays of χc2→K+K−π0, KSK±π∓ and π+π−π0 are studied with the ψ(3686) data samples collected with the Beijing Spectrometer (BESIII). For the first time, the branching fractions of χc2→K∗K¯¯¯¯¯, χc2→a±2(1320)π∓/a02(1320)π0 and χc2→ρ(770)±π∓ are measured. Here K∗K¯¯¯¯¯ denotes both K∗±K∓ and K∗0K¯¯¯¯¯0+c.c., and K∗ denotes the resonances K∗(892), K∗2(1430) and K∗3(1780). The observations indicate a strong violation of the helicity selection rule in χc2 decays into vector and pseudoscalar meson pairs. The measured branching fractions of χc2→K∗(892)K¯¯¯¯¯ are more than 10 times larger than the upper limit of χc2→ρ(770)±π∓, which is so far the first direct observation of a significant U-spin symmetry breaking effect in charmonium decays.
Using a data sample of (1.0087±0.0044)×1010 J/ψ decay events collected with the BESIII detector at the center-of-mass energy of s√=3.097 GeV, we present a search for the hyperon semileptonic decay Ξ0→Σ−e+νe which violates the ΔS=ΔQ rule. No significant signal is observed, and the upper limit on the branching fraction B(Ξ0→Σ−e+νe) is determined to be 1.6×10−4 at the 90% confidence level. This result improves the previous upper limit result by about one order of magnitude.
Using a data sample of (1.0087±0.0044)×1010 J/ψ decay events collected with the BESIII detector at the center-of-mass energy of s√=3.097 GeV, we present a search for the hyperon semileptonic decay Ξ0→Σ−e+νe which violates the ΔS=ΔQ rule. No significant signal is observed, and the upper limit on the branching fraction B(Ξ0→Σ−e+νe) is determined to be 1.6×10−4 at the 90% confidence level. This result improves the previous upper limit result by about one order of magnitude.
Meeting Abstract (DGU 2003) 67. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie 89. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie 44. Tagung des Berufsverbandes der Fachärzte für Orthopädie Fragestellung Ziel dieser prospektiven Untersuchung ist die Analyse der Funktion und des Outcomes nach distaler Radiusfraktur in Abhängigkeit von Frakturtyp, Therapieform und Begeleitverletzungen. Berücksichtigt wurden diesbezüglich insbesondere auch neuere Implantate wie die volaren winkelstabilen Titanplatten und dorsale low profile Implantate. Methodik Innerhalb von 2 Jahren (01/01 bis 12/02) wurden insgesamt 150 Radiusfrakturen bei 145 Patienten (82 Frauen; 63 Männer) mit einem Durchschnittsalter von 51,8 (17-93) Jahren operativ versorgt. Die operative Versorgung erfolgte in 56,7 % der Fälle mittels volarer Plattenosteosynthese, davon wurde bei 60 % eine winkelstabile Platte eingesetzt. Die übrigen Frakturen wurden durch eine dorsale Platte (8%) bzw. durch Materialkombination Spickdraht/Schrauben und/oder Fixateur externe stabilisiert. Die radiologische und klinische Nachuntersuchung erfolgt frühestens 1 Jahr nach operativer Versorgung. Zusätzlich wird anhand eines Fragebogens der DASH - Score bestimmt. Ergebnisse Nach der AO-Klassifikation fanden sich in 47,7 % Typ A-, 8,6% Typ B- und 55,6% Typ C-Frakturen. Dabei fand sich bei 53,1 % eine relevante Begleitverletzung (Bandverletzungen 14,3 %; Handwurzelfrakturen 3,9 %; distale Ulnafrakturen 10,4%; TFC/Proc. styloideus ulnae 70,1%). Von den 25 bisher untersuchten Patienten (15 Frauen, 10 Männer; Durchschnittsalter: 55,3 Jahre; NU nach: 14 Monaten) waren 32% Typ A-, 20% Typ B- u. 48% Typ C-Frakturen. Die Greifkraft betrug 87,7 % und das Bewegungsausmaß 83,6 % im Vergleich zur Gegenseite. Der durchschnittliche standardisierte DASH-Score betrug 22,6 Punkte (0: optimale Funktion). Bei den mit volarer Platte stabilisierten C-Frakturen (9 der nachuntersuchten Patienten) fand sich ein DASH-Score von 41 Punkten. Die Greifkraft betrug 67,5% und das Bewegungsausmaß 79,6% im Vergleich zur Gegenseite. Bisher konnte weder bei der konventionellen, noch der winkelstabilen Plattenosteosynthese ein radiologischer Korrekturverlust nachgewiesen werden. Bei den Frakturen ohne lokale Begleitverletzungen waren Greifkraft (91% vs. 79,8%), Bewegungsausmaß (89,5% vs. 83,4%) und DASH-Score (16,8 vs. 26,1) besser als bei den Frakturen mit Begleitverletzungen. Schlussfolgerung Bei korrekter Reposition und Stabilisierung, wird der Outcome nach distaler Radiusfraktur neben dem Frakturtyp wesentlich durch die Begleitverletzung mitbestimmt. Daraus resultiert dass eine Verbesserung nur durch eine Optimierung der Therapie der Begleitverletzungen erreichbar ist.
Only a few Methyl-[11C]-l-methionine (MET) positron emission tomography (PET) studies have focused on children and young adults with brain neoplasm. Due to radiation exposure, long scan acquisition time, and the need for sedation in young children MET-PET studies should be restricted to this group of patients when a decision for further therapy is not possible from routine diagnostic procedures alone, e.g., structural imaging. We investigated the diagnostic accuracy of MET-PET for the differentiation between tumorous and non-tumorous lesions in this group of patients. Forty eight MET-PET scans from 39 patients aged from 2 to 21 years (mean 15 ± 5.0 years) were analyzed. The MET tumor-uptake relative to a corresponding control region was calculated. A receiver operating characteristic (ROC) was performed to determine the MET-uptake value that best distinguishes tumorous from non-tumorous brain lesions. A differentiation between tumorous (n = 39) and non-tumorous brain lesions (n = 9) was possible at a threshold of 1.48 of relative MET-uptake with a sensitivity of 83% and a specificity of 92%, respectively. A differentiation between high grade malignant lesions (mean MET-uptake = 2.00 ± 0.46) and low grade tumors (mean MET-uptake = 1.84 ± 0.31) was not possible. There was a significant difference in MET-uptake between the histologically homogeneous subgroups of astrocytoma WHO grade II and anaplastic astrocytoma WHO grade III (P = 0.02). MET-PET might be a useful tool to differentiate tumorous from non-tumorous lesions in children and young adults when a decision for further therapy is difficult or impossible from routine structural imaging procedures alone. Keywords Brain tumor - Children - PET - Methionine - Molecular imaging
Background: The alpha7 nicotinic acetylcholine receptor (Chrna7) plays an essential anti-inflammatory role in immune homeostasis and was recently found on mast cells (MC). Psychosocial stress can trigger MC hyperactivation and increases pro-inflammatory cytokines in target tissues such as the skin. If the cholinergic system (CS) and Chrna7 ligands play a role in these cascades is largely unknown. Objective: To elucidate the role of the CS in the response to psychosocial stress using a mouse-model for stress-triggered cutaneous inflammatory circuits. Methods: Key CS markers (ACh, Ch, SLURP-1, SLURP-2, Lynx1, Chrm3, Chrna7, Chrna9, ChAT, VAChT, Oct3, AChE, and BChE) in skin and its MC (sMC), MC activation, immune parameters (TNFα, IL1β, IL10, TGFβ, HIF1α, and STAT3) and oxidative stress were analyzed in skin from 24 h noise-stressed mice and in cultured MC (cMC) from C57BL/6 or Chrna7-Knockout mice. Results: First, Chrna7 and SLURP-1 mRNA were exclusively upregulated in stressed skin. Second, histomorphometry located Chrna7 and SLURP-1 in nerves and sMC and demonstrated upregulated contacts and increased Chrna7+ sMC in stressed skin, while 5 ng/mL SLURP-1 degranulated cMC. Third, IL1β+ sMC were high in stressed skin, and while SLURP-1 alone had no significant effect on cMC cytokines, it upregulated IL1β in cMC from Chrna7-KO and in IL1β-treated wildtype cMC. In addition, HIF1α+ sMC were high in stressed skin and Chrna7-agonist AR-R 17779 induced ROS in cMC while SLURP-1 upregulated TNFα and IL1β in cMC when HIF1α was blocked. Conclusions: These data infer that the CS plays a role in the regulation of stress-sensitive inflammatory responses but may have a surprising pro-inflammatory effect in healthy skin, driving IL1β expression if SLURP-1 is involved.
Exploiting the natural experiment of the German reunification, we examine how consumers adapt to a new environment in their macroeconomic forecasting. We document that East Germans expect higher in inflation and make larger forecast errors than West
Germans even decades after reunification. Differences in consumption baskets, financial literacy, risk aversion or trust in the central bank cannot fully account for these patterns. We find most support for the explanation that East Germans, who were used to a strong norm of zero inflation, persistently overadjusted the level of their expectations in the face of the initial inflation shock in reunified Germany. Our findings suggest that large changes in the economic environment can permanently impede people's ability to form accurate macroeconomic expectations, with an important role for the interaction of old norms and new experiences around the event.
Introduction: Microsurgery courses, taught external to surgical training programs, are essential for acquiring the high level of technical skill required for clinical proficiency.
Methods: The Frankfurt microsurgery course is a 5-day, intensive course that teaches arterial and venous anastomosis using end-to-end, end-to-side, one-way-up, continuous-suture, and vessel graft techniques. During the course, the instructor records the level of skill (in-course data) achieved by each trainee by assessing anastomosis completion and patency. Demographic information is also collected. Post-course trainees are invited to complete an online survey (post-course data) to get their opinions of the courses’ effectiveness.
Results: The in-course “skill achievement” and post-course “course effectiveness” data are presented below. In-course data: 94.8 and 59.9% of participants completed patent end-to-end arterial and venous anastomoses, respectively, while 85.4% performed a patent end-to-side anastomosis. 96.1 and 57.1% of participants who attempted arterial and venous anastomoses using the one-way-up technique were successful, as were 90.9% of those attempting continuous-suture technique. Patent venous grafts were performed by 54.7% of participants.
Post-course data: All respondents indicated significant improvement of their microsurgical skills after taking the course. 66.7% of respondents considered the full-time presence of the instructor to be the most valuable aspect of the course. All respondents would highly recommend the course to colleagues.
Conclusion: The microcourse significantly increased trainees’ clinical microsurgery skills, confidence, and the number of clinical cases they perform. Of all the anastomosis techniques taught, venous anastomosis and grafting were the most difficult to learn. The presence of a full-time experienced instructor was most important.
Background: Does the dogma of nephron sparing surgery (NSS) still stand for large renal masses? Available studies dealing with that issue are considerably biased often mixing imperative with elective indications for NSS and also including less malignant variants or even benign renal tumors. Here, we analyzed the oncological long-term outcomes of patients undergoing elective NSS or radical tumor nephrectomy (RN) for non-endophytic, large (≥7cm) clear cell renal carcinoma (ccRCC).
Methods: Prospectively acquired, clinical databases from two academic high-volume centers were screened for patients from 1980 to 2010. The query was strictly limited to patients with elective indications. Surgical complications were retrospectively assessed and classified using the Clavien-Dindo-classification system (CDS). Overall survival (OS) and cancer specific survival (CSS) were analyzed using the Kaplan-Meier-method and the log-rank test.
Results: Out of in total 8664 patients in the databases, 123 patients were identified (elective NSS (n = 18) or elective RN (n = 105)) for ≥7cm ccRCC. The median follow-up over all was 102 months (range 3–367 months). Compared to the RN group, the NSS group had a significantly longer median OS (p = 0.014) and median CSS (p = 0.04).
Conclusions: In large renal masses, NSS can be performed safely with acceptable complication rates. In terms of long-term OS and CSS, NSS was at least not inferior to RN. Our findings suggest that NSS should also be performed in patients presenting with renal tumors ≥7cm whenever technically feasible. Limitations include its retrospective nature and the limited availability of data concerning long-term development of renal function in the two groups.
Das Projekt »Digi_Gap – Digitale Lücken in der Lehrkräftebildung schließen« wird von 2020 bis 2023 vom Bundesministerium für Bildung und Forschung im Rahmen der Qualitätsoffensive Lehrerbildung (QLB) gefördert (Fördersumme: 1 678 023 Euro) und umfasst fünf Teilprojekte mit 19 WissenschaftlerInnen aus neun Fachbereichen an der Goethe-Universität. Geleitet wird das Projekt von Prof. Dr. Holger Horz (wissenschaftliche Gesamtprojektleitung) und Dr. Claudia Burger (operative Leitung). An der Goethe-Universität ebenfalls durch die QLB gefördert wird »The Next Level«, das Nachfolgeprojekt von »Level« (»Lehrerbildung vernetzt entwickeln)«, mit dem Digi_Gap inhaltlich und strukturell eng verbunden ist. Das Leitungs- und Koordinationsteam (Leitung: Holger Horz & Claudia Burger; Koordination: Johannes Appel und Annika Kreft) von Digi_Gap hat sich den Fragen des UniReport auch zum aktuellen Thema »Homeschooling« gestellt.
Die Bundesrepublik hat sich 1992 wie viele andere Staaten zum Erhalt der biologischen Vielfalt verpflichtet (Biodiversitätskonvention). Zur Erreichung dieses Zieles fördert das Bundesministerium für Ernährung, Landwirtschaft und Verbraucherschutz (BMELV) u. a. Vorhaben zur Erhaltung und innovativen nachhaltigen Nutzung der biologischen Vielfalt. Grundlage der Förderung ist eine Richtlinie von 2005. Träger entsprechender Projekte ist die Bundesanstalt für Landwirtschaft und Ernährung (BLE). Bereits 2006 hatte die Landschaftsstation zusammen mit dem damaligen Forstamt Bad Driburg einen Projektantrag eingereicht, bei dem es um die Wiederbelebung der Nieder- und Mittelwaldnutzung im Bereich der im Kreis Höxter ehemals zahlreichen Nieder- und Mittelwälder ging (vgl. GRAWE & BÖLKE 2005). Da zunächst nur recht kleine Waldareale in das Vorhaben einbezogen werden sollten, wurde der Antrag abgelehnt. Anfang 2007 fragte die BLE bei der Landschaftsstation an, ob es nicht möglich sei, die Gebietskulisse zu erweitern, da der Projektantrag grundsätzlich als förderfähig angesehen werde. Aufgrund dieser Anfrage erarbeiteten das heutige Regionalforstamt Hochstift und die Landschaftsstation einen neuen Projektantrag mit dem Titel "Mittelwaldähnliche Waldrandgestaltung und -nutzung zur Förderung der Nutzholzarten Stiel-Eiche, Trauben-Eiche und Hainbuche sowie seltener Edellaub- und Nadelgehölze wie Elsbeere, Wacholder oder Eibe", der dann im Herbst des gleichen Jahres durch die BLE bewilligt wurde, so dass bereits im Oktober 2007 mit der Umsetzung des Vorhabens begonnen werden konnte. Vorrangiges naturschutzfachliches Ziel des Vorhabens ist die Förderung der in ihren Beständen im Rückgang befindlichen lichtliebenden Nutzholzarten Trauben-Eiche (Quercus petraea), Stiel-Eiche (Quercus robur), Hainbuche (Carpinus betulus), Feld-Ahorn (Acer campestre), Winter-Linde (Tilia cordata), Elsbeere (Sorbus torminalis), Wacholder (Juniperus communis) und Eibe (Taxus baccata). Die Förderung dieser Baumarten soll im Rahmen einer mittelwaldähnlichen Nutzung von Waldrändern geschehen. Eine ökonomische Inwertsetzung erfolgt im Rahmen einer einmaligen Erstinstandsetzung sowie des nachfolgenden regelmäßigen Einschlages des nachwachsenden Holzes (alle 15-30 Jahre). Das dann eingeschlagene Holz wird zur Energiegewinnung (Hackschnitzel) genutzt.
Introduction. Cancellous bone is frequently used for filling bone defects in a clinical setting. It provides favourable conditions for regenerative cells such as MSC and early EPC. The combination of MSC and EPC results in superior bone healing in experimental bone healing models. Materials and Methods. We investigated the influence of osteogenic culture conditions on the endothelial properties of early EPC and the osteogenic properties of MSC when cocultured on cancellous bone. Additionally, cell adhesion, metabolic activity, and differentiation were assessed 2, 6, and 10 days after seeding.
Results. The number of adhering EPC and MSC decreased over time; however the cells remained metabolically active over the 10-day measurement period. In spite of a decline of lineage specific markers, cells maintained their differentiation to a reduced level. Osteogenic stimulation of EPC caused a decline but not abolishment of endothelial characteristics and did not induce osteogenic gene expression. Osteogenic stimulation of MSC significantly increased their metabolic activity whereas collagen-1α and alkaline phosphatase gene expressions declined. When cocultured with EPC, MSC’s collagen-1α gene expression increased significantly. Conclusion. EPC and MSC can be cocultured in vitro on cancellous bone under osteogenic conditions, and coculturing EPC with MSC stabilizes the latter’s collagen-1α gene expression.
Background: Extremity fracture is frequently seen in multiple traumatized patients. Local post-traumatic inflammatory reactions as well as local and systemic interactions have been described in previous studies. However, trauma severity and its impact on the local immunologic reaction remains unclear. Therefore, fracture-associated local inflammation was investigated in a porcine model of isolated and combined trauma to gain information about the early inflammatory stages.
Material and Methods: Polytrauma (PT) consisted of lung contusion, liver laceration, femur fracture, and controlled hemorrhage. Monotrauma (MT) consisted of femur fracture only. The fracture was operatively stabilized and animals were monitored under ICU-standard for 72 h. Blood, fracture hematoma (FH) as well as muscle samples were collected throughout the experimental period. Levels of local and systemic pro- and anti-inflammatory as well as angiogenetic cytokines were measured by ELISA.
Results: Both groups showed a significant decrease in pro-inflammatory IL-6 in FH over time. However, concentrations in MT were significantly higher than in PT. The IL-8 concentrations initially decreased in FH, but recovered by the end of the observation period. These dynamics were only statistically significant in MT. Furthermore, concentrations measured in muscle tissue showed inverse kinetics compared to those in FH. The IL-10 did not present statistical resilient dynamics over time, although a slight increase in FH was seen by the end of the observation time in the MT group.
Conclusions: Time-dependent dynamics of the local inflammatory response were observed. Trauma severity showed a significant impact, with lower values in pro- as well as angiogenetic mediators. Fracture repair could be altered by these trauma-related changes of the local immunologic milieu, which might serve as a possible explanation for the higher rates of delayed or non-union bone repair in polytraumatised patients.
Introduction: Epoxyeicosatrienoic acids (EETs) are able to enhance angiogenesis and regulate inflammation that is especially important in wound healing under ischemic conditions. Thus, we evaluated the effect of local EET application on ischemic wounds in mice.
Methods: Ischemia was induced by cautherization of two of the three supplying vessels to the mouse ear. Wounding was performed on the ear three days later. Wounds were treated either with 11,12 or 14,15 EET and compared to untreated control and normal wounds. Epithelialization was measured every second day. VEGF, TNF-α, TGF-β, matrix metalloproteinases (MMP), tissue inhibitors of metalloproteinases (TIMP), Ki67, and SDF-1α were evaluated immunohistochemically in wounds on day 3, 6, and 9.
Results: Ischemia delayed wound closure (12.8 days ± 1.9 standard deviation (SD) for ischemia and 8.0 days ± 0.94 SD for control). 11,12 and14,15 EET application ameliorated deteriorated wound healing on ischemic ears (7.6 ± 1.3 SD for 11,12 EET and 9.2 ± 1.4 SD for 14,15 EET). Ischemia did not change VEGF, TNF-α, TGF-β, SDF-1α, TIMP, MMP7 or MMP9 level significantly compared to control. Local application of 11,12 as well as 14,15 EET induced a significant elevation of VEGF, TGF-β, and SDF-1α expression as well as proliferation during the whole phase of wound healing compared to control and ischemia alone.
Conclusion: In summary, EET improve impaired wound healing caused by ischemia as they enhance neovascularization and alter inflammatory response in wounds. Thus elevating lipid mediator level as 11,12 and 14,15 EET in wounds might be a successful strategy for amelioration of deranged wound healing under ischemia.
Delayed wound repair in sepsis is associated with reduced local pro-inflammatory cytokine expression
(2013)
Sepsis is one of the main causes for morbidity and mortality in hospitalized patients. Moreover, sepsis associated complications involving impaired wound healing are common. Septic patients often require surgical interventions that in-turn may lead to further complications caused by impaired wound healing. We established a mouse model to the study delayed wound healing during sepsis distant to the septic focus point. For this reason cecal ligation and puncture (CLP) was combined with the creation of a superficial wound on the mouse ear. Control animals received the same procedure without CPL. Epithelialization was measured every second day by direct microscopic visualization up to complete closure of the wound. As interplay of TNF-α, TGF-β, matrix metalloproteinases (MMP), and tissue inhibitors of metalloproteinases (TIMP) is important in wound healing in general, TNF-α, TGF-β, MMP7, and TIMP1 were assessed immunohistochemical in samples of wounded ears harvested on days 2, 6, 10 and 16 after wounding. After induction of sepsis, animals showed a significant delay in wound epithelialization from day 2 to 12 compared to control animals. Complete wound healing was attained after mean 12.2± standard deviation (SD) 3.0 days in septic animals compared to 8.7± SD 1.7 days in the control group. Septic animals showed a significant reduction in local pro-inflammatory cytokine level of TNF-α on day 2 and day 6 as well as a reduced expression of TGF-β on day 2 in wounds. A significant lower expression of MMP7 as well as TIMP1 was also observed on day 2 after wounding. The induction of sepsis impairs wound healing distant to the septic focus point. We could demonstrate that expression of important cytokines for wound repair is deregulated after induction of sepsis. Thus restoring normal cytokine response locally in wounds could be a good strategy to enhance wound repair in sepsis.
Background: Polytraumatized patients undergo a strong immunological stress upon insult. Phagocytes (granulocytes and monocytes) play a substantial role in immunological defense against bacteria, fungi and yeast, and in the clearance of cellular debris after tissue injury. We have reported a reduced monocytes phagocytic activity early after porcine polytrauma before. However, it is unknown if both phagocyte types undergo those functional alterations, and if there is a pathogen-specific phagocytic behavior. We characterized the phagocytic activity and capacity of granulocytes and monocytes after polytrauma.
Methods: Eight pigs (Sus scrofa) underwent polytrauma consisting of lung contusion, liver laceration, tibial fracture and hemorrhagic shock with fluid resuscitation and fracture fixation with external fixator. Intensive care treatment including mechanical ventilation for 72 h followed. Phagocytic activity and capacity were investigated using an in vitro ex vivo whole blood stimulation phagocytosis assays before trauma, after surgery, 24, 48, and 72 h after trauma. Blood samples were stimulated with Phorbol-12-myristate-13-acetate and incubated with FITC-labeled E. coli, S. aureus or S. cerevisiae for phagocytosis assessment by flow cytometry.
Results: Early polytrauma-induced significant increase of granulocytes and monocytes declined to baseline values within 24 h. Percentage of E. coli-phagocytizing granulocytes significantly decreased after polytrauma and during further intensive care treatment, while their capacity significantly increased. Interestingly, both granulocytic phagocytic activity and capacity of S. aureus significantly decreased after trauma, although a recovery was observed after 24 h and yet was followed by another decrease. The percentage of S. cerevisiae-phagocytizing granulocytes significantly increased after 24 h, while their impaired capacity after surgery and 72 h later was detected. Monocytic E. coli-phagocytizing percentage did not change, while their capacity increased after 24–72 h. After a significant decrease in S. aureus-phagocytizing monocytes after surgery, a significant increase after 24 and 48 h was observed without capacity alterations. No significant changes in S. cerevisiae-phagocytizing monocytes occurred, but their capacity dropped 48 and 72 h.
Conclusion: Phagocytic activity and capacity of granulocytes and monocytes follow a different pattern and significantly change within 72 h after polytrauma. Both phagocytic activity and capacity show significantly different alterations depending on the pathogen strain, thus potentially indicating at certain and possibly more relevant infection causes after polytrauma.
Introduction: In an emergency department, the majority of pediatric trauma patients present because of minor injuries. The aim of this study was to evaluate temporal changes in age-related injury pattern, trauma mechanism, and surgeries in pediatric patients. Methods: This retrospective study included patients < 18 years of age following trauma from 01/2009 to 12/2018 at a level I trauma center. They were divided into two groups: group A (A: 01/2009 to 12/2013) and group B (B: 01/2014 to 12/2018). Injury mechanism, injury pattern, and surgeries were analyzed. As major injuries fractures, dislocations, and organ injuries and as minor injuries contusions and superficial wounds were defined. Results: 23,582 patients were included (58% male, median age 8.2 years). There was a slight increase in patients comparing A (n = 11,557) and B (n = 12,025) with no difference concerning demographic characteristics. Significant more patients (A: 1.9%; B: 2.4%) were admitted to resuscitation room, though the number of multiple injured patients was not significantly different. In A (25.5%), major injuries occurred significantly less frequently than in B (27.0%), minor injuries occurred equally. Extremity fractures were significantly more frequent in B (21.5%) than in A (20.2%), peaking at 8–12 years. Most trauma mechanisms of both groups were constant, with a rising of sport injuries at 8–12 years. Conclusion: Although number of patients increases only slightly over a decade, there was a clear increase in major injuries, particularly extremity fractures, peaking at 8–12 years. At this age also sport accidents significantly increased. At least, admittance to resuscitation room rose but without an increase of multiple injured patients.
Purpose: Despite the high number of patients with phalangeal fractures, evidence-based recommendations for the treatment of specific phalangeal fractures could not be concluded from the literature. The purpose of the present study was to assess current epidemiological data, classification of the fracture type, and mode of treatment.
Methods: This study presents a retrospective review of 261 patients with 283 phalangeal fractures ≥ 18 years of age who were treated in our level I trauma centre between 2017 and 2018. The data were obtained by the analysis of the institution’s database, and radiological examinations.
Results: The average age of the patients was 40.4 years (range 18–98). The ratio of male to female patients was 2.7:1. The two most typical injury mechanisms were crush injuries (33%) and falls (23%). Most phalangeal fractures occurred in the distal phalanx (P3 43%). The 4th ray (D4 29%) was most frequently affected. The P3 tuft fractures, and the middle phalanx (P2) base fractures each accounted for 25% of fracture types. A total of 74% of fractures were treated conservatively, and 26% required surgery, with Kirschner wire(s) (37%) as the preferred surgical treatment. The decision for surgical treatment correlated with the degree of angular and/or rotational deformity, intraarticular step, and sub-/luxation of specific phalangeal fractures, but not with age and gender.
Conclusions: Our findings demonstrated the popularity of conservative treatment of phalangeal fractures, while surgery was only required in properly selected cases. The correct definition of precise fracture pattern in addition to topography is essential to facilitate treatment decision-making.
This paper addresses the development of performance-based assessment items for ICT skills, skills in dealing with information and communication technologies, a construct which is rather broadly and only operationally defined. Item development followed a construct-driven approach to ensure that test scores could be interpreted as intended. Specifically, ICT-specific knowledge as well as problem-solving and the comprehension of text and graphics were defined as components of ICT skills and cognitive ICT tasks (i.e., accessing, managing, integrating, evaluating, creating). In order to capture the construct in a valid way, design principles for constructing the simulation environment and response format were formulated. To empirically evaluate the very heterogeneous items and detect malfunctioning items, item difficulties were analyzed and behavior-related indicators with item-specific thresholds were developed and applied. The 69 item’s difficulty scores from the Rasch model fell within a comparable range for each cognitive task. Process indicators addressing time use and test-taker interactions were used to analyze whether most test-takers executed the intended processes, exhibited disengagement, or got lost among the items. Most items were capable of eliciting the intended behavior; for the few exceptions, conclusions for item revisions were drawn. The results affirm the utility of the proposed framework for developing and implementing performance-based items to assess ICT skills.
Background: Surgical complications are associated with a significant burden to patients and hospitals and are increasingly discussed in recent literature. This cohort study reviewed surgery-related complications in a Level I trauma center. The effect of a complication avoidance care bundle on the rate of surgical complications was analyzed. Methods: All complications (surgical and nonsurgical) that occur in our trauma department are prospectively captured using a standardized documentation form and are discussed and analyzed in a weekly trauma Morbidity and Mortality (M&M) conference. Surgical complication rates are calculated using the annual surgical procedure numbers. Based on discussions in the M&M conference, a complication avoidance care bundle consisting of five measures was established: (1) Improving team situational awareness; (2) reducing operating room traffic by staff members and limiting door-opening events; (3) preoperative screening for infectious foci; (4) adapted preoperative antibiotic prophylaxis in anatomic regions with a high risk of infectious complications; and (5) use of iodine-impregnated adhesive drape. Results: The number of surgical procedures steadily increased over the study years, from 3587 in 2015 to 3962 in 2019 (an increase of 10.5%). Within this 5-year study period, the overall rate of surgical complications was 0.8%. Surgical site infections were the most frequently found complications (n = 40, 24.8% of all surgical complications), followed by screw malposition (n = 20, 12.4%), postoperative dislocations of arthroplasties (n = 18, 11.2%), and suboptimal fracture reduction (n = 18, 11.2%). Following implementation of the complication avoidance care bundle, the overall rate of surgical complications significantly decreased, from 1.14% in the year 2016 to 0.56% in the study year 2019, which represents a reduction of 51% within a 3-year time period. Conclusions: A multimodal strategy targeted at reducing the surgical complication rate can be successfully established based on a transparent discussion of adverse surgical outcomes. The combination of the different preventive measures was associated with reducing the overall complication rate by half within a 3-year time period.
Die Evaluation der studentischen Lehre - Basis für eine leistungsorientierte Mittelvergabe (LOM)?
(2008)
Die Evaluation der medizinischen Ausbildung wird am Fachbereich Medizin der J.W. Goethe – Universität Frankfurt seit 1998 systematisch durchgeführt. Damit ist diese Implementierung deutlich vor den bindenden Bestimmungen der Ärztlichen Approbationsordnung (in Kraft getreten am 01.10.2003) installiert worden. Die Evaluation der studentischen Lehre beinhaltet die Evaluierung sämtlicher Pflichtveranstaltungen (Kurse, Seminare, Praktika) durch einen standardisierten Fragebogen, der am Ende der Lehrpflichtveranstaltung (in jedem Semester) ausgeteilt und nach dem Ausfüllen durch die Studierenden wieder eingesammelt wird.
In dieser Kommunikation belegen wir anhand ausgewählter Beispiele (vom Wintersemester 2003/2004 bis zum Wintersemester 2005/2006), dass die anderen Orts oft vorgetragenen negativen studentischen Bewertungen der vorklinischen Fächer an der J.W. Goethe – Universität nicht zutreffen (Bsp.:Kursus Anatomie I, Makroskopischer Teil, WS 2005/2006: M=1,8, SD=0,86). Die Bewertung der didaktischen Qualität („Lehrstoff wurde gut verständlich präsentiert“) ist bei den meisten vorklinischen Pflichtveranstaltungen zufriedenstellend (Bsp.: Kursus Anatomie I, Makroskopischer Teil, WS 2005/2006: M=2,06, SD=0,94). Aus diesen Ergebnissen schließen wir auf eine positive Rückwirkung des curricularen und didaktischen Umbaus des Medizinstudiums an der Goethe – Universität.
Die Veröffentlichung der Ergebnisse der studentischen Evaluation („Zusammenfassende Beurteilung“) muss dem Umstand Rechnung tragen, dass praxisferne Fächer vielen Studierenden nur schwer zu vermitteln sind. Deswegen wird auf ein Ranking verzichtet. Nach diesen Ergebnissen wird ein Teil der Mittel leistungsorientiert vergeben (im jährlichen Zyklus). Diese leistungsorientierte Mittelvergabe (LOM) (davon 45 Prozent nach der studentischen Evaluation) beträgt 4 Prozent des jeweiligen Grundetats für Forschung und Lehre (Landeszuführung). Eine positive Lehrevaluation kann für eine Klinik/ein Institut einen wesentlich größeren Betrag bedeuten. Das Verfahren ist am Fachbereich akzeptiert.
Purpose: While more advanced COVID-19 necessitates medical interventions and hospitalization, patients with mild COVID-19 do not require this. Identifying patients at risk of progressing to advanced COVID-19 might guide treatment decisions, particularly for better prioritizing patients in need for hospitalization.
Methods: We developed a machine learning-based predictor for deriving a clinical score identifying patients with asymptomatic/mild COVID-19 at risk of progressing to advanced COVID-19. Clinical data from SARS-CoV-2 positive patients from the multicenter Lean European Open Survey on SARS-CoV-2 Infected Patients (LEOSS) were used for discovery (2020-03-16 to 2020-07-14) and validation (data from 2020-07-15 to 2021-02-16).
Results: The LEOSS dataset contains 473 baseline patient parameters measured at the first patient contact. After training the predictor model on a training dataset comprising 1233 patients, 20 of the 473 parameters were selected for the predictor model. From the predictor model, we delineated a composite predictive score (SACOV-19, Score for the prediction of an Advanced stage of COVID-19) with eleven variables. In the validation cohort (n = 2264 patients), we observed good prediction performance with an area under the curve (AUC) of 0.73 ± 0.01. Besides temperature, age, body mass index and smoking habit, variables indicating pulmonary involvement (respiration rate, oxygen saturation, dyspnea), inflammation (CRP, LDH, lymphocyte counts), and acute kidney injury at diagnosis were identified. For better interpretability, the predictor was translated into a web interface.
Conclusion: We present a machine learning-based predictor model and a clinical score for identifying patients at risk of developing advanced COVID-19.
Purpose: The primary treatment goals for advanced-stage thumb carpometacarpal (CMC) joint osteoarthritis are complete pain relief and restoration of thumb strength. The purpose of the present study was to introduce a variation of the abductor pollicis longus (APL) suspension arthroplasty using a single looping of a radial slip from the APL tendon around the flexor carpi radialis (FCR) tendon combined with RegJoint™ interposition and to determine its efficacy in the treatment of thumb CMC joint osteoarthritis.
Methods: Between 2015 and 2017, 21 patients were included. The average age was 60.8 years (range 48–79). The mean follow-up was 27.7 months (range 8–50). Evaluation included pain, radial and palmar abduction, tip pinch and grip strength, and Disabilities of the Arm, Shoulder, and Hand (DASH) score.
Results: Pain averaged 0.3 (range 0–4) at rest and 1.4 (range 0–4) on exertion. The radial and palmar abduction were 97% and 99% compared to the contralateral side. The tip pinch and grip strength were 4.1 kg (range 3–6.5) and 22 kg (range 13.3–40), respectively. The DASH score accounted for 18.5 (range 0.8–41.7).
Conclusion: The modified APL suspension interposition arthroplasty was an efficient and simplified option for the treatment of thumb CMC joint osteoarthritis, with results comparable or better than other published procedures. The APL suspension technique was easy to perform avoiding difficult bone tunneling and incision of the FCR tendon. The RegJoint™ interposition as spacer prevented impingement of the first metacarpal base on the second metacarpal base or the trapezoid bone.
Background: Conversion from calcineurin inhibitor (CNI) therapy to a mammalian target of rapamycin (mTOR) inhibitor following kidney transplantation may help to preserve graft function. Data are sparse, however, concerning the impact of conversion on posttransplant diabetes mellitus (PTDM) or the progression of pre-existing diabetes.
Methods: PTDM and other diabetes-related parameters were assessed post hoc in two large open-label multicenter trials. Kidney transplant recipients were randomized (i) at month 4.5 to switch to everolimus or remain on a standard cyclosporine (CsA)-based regimen (ZEUS, n = 300), or (ii) at month 3 to switch to everolimus, remain on standard CNI therapy or convert to everolimus with reduced-exposure CsA (HERAKLES, n = 497).
Results: There were no significant differences in the incidence of PTDM between treatment groups (log rank p = 0.97 [ZEUS], p = 0.90 [HERAKLES]). The mean change in random blood glucose from randomization to month 12 was also similar between treatment groups in both trials for patients with or without PTDM, and with or without pre-existing diabetes. The change in eGFR from randomization to month 12 showed a benefit for everolimus versus comparator groups in all subpopulations, but only reached significance in larger subgroups (no PTDM or no pre-existing diabetes).
Conclusions: Within the restrictions of this post hoc analysis, including non-standardized diagnostic criteria and limited glycemia laboratory parameters, these data do not indicate any difference in the incidence or severity of PTDM with early conversion from a CsA-based regimen to everolimus, or in the progression of pre-existing diabetes.
Trial registration: clinicaltrials.gov, NCT00154310 (registered September 2005) and NCT00514514 (registered August 2007); EudraCT (2006-007021-32 and 2004-004346-40).
In this explorative study, we investigate how sequences of behaviour are related to success or failure in complex problem‐solving (CPS). To this end, we analysed log data from two different tasks of the problem‐solving assessment of the Programme for International Student Assessment 2012 study (n = 30,098 students). We first coded every interaction of students as (initial or repeated) exploration, (initial or repeated) goal‐directed behaviour, or resetting the task. We then split the data according to task successes and failures. We used full‐path sequence analysis to identify groups of students with similar behavioural patterns in the respective tasks. Double‐checking and minimalistic behaviour was associated with success in CPS, while guessing and exploring task‐irrelevant content was associated with failure. Our findings held for both tasks investigated, from two different CPS measurement frameworks. We thus gained detailed insight into the behavioural processes that are related to success and failure in CPS.
In Bone Tissue Engineering (BTE), autologous bone-regenerative cells are combined with a scaffold for large bone defect treatment (LBDT). Microporous, polylactic acid (PLA) scaffolds showed good healing results in small animals. However, transfer to large animal models is not easily achieved simply by upscaling the design. Increasing diffusion distances have a negative impact on cell survival and nutrition supply, leading to cell death and ultimately implant failure. Here, a novel scaffold architecture was designed to meet all requirements for an advanced bone substitute. Biofunctional, porous subunits in a load-bearing, compression-resistant frame structure characterize this approach. An open, macro- and microporous internal architecture (100 µm–2 mm pores) optimizes conditions for oxygen and nutrient supply to the implant’s inner areas by diffusion. A prototype was 3D-printed applying Fused Filament Fabrication using PLA. After incubation with Saos-2 (Sarcoma osteogenic) cells for 14 days, cell morphology, cell distribution, cell survival (fluorescence microscopy and LDH-based cytotoxicity assay), metabolic activity (MTT test), and osteogenic gene expression were determined. The adherent cells showed colonization properties, proliferation potential, and osteogenic differentiation. The innovative design, with its porous structure, is a promising matrix for cell settlement and proliferation. The modular design allows easy upscaling and offers a solution for LBDT.