Search Results (69)

Background/Objectives: Cerebral vasospasm (CV) is a serious complication of aneurysmal subarachnoid hemorrhage (aSAH). Carotid siphon calcification (CSC) has been associated with a reduced risk of CV. This study investigates the influence of CSC on the clinical and radiographic severity of CV and functional outcome of aSAH. Methods: A total of 475 patients with aSAH treated at the University Hospital Essen (2008–2016) were analyzed retrospectively. CSC was assessed using the Woodcock score. Study endpoints were the CV severity in digital subtraction angiography, presence of CV in transcranial Doppler (TCD) ultra-sonography, occurrence of delayed ischemic neurological deficit (DIND) and the functional outcome at 6 months measured with the modified Rankin scale. Results: CSC was confirmed as an independent predictor for the occurrence (aOR 0.76; 95% CI 0.60–0.97; p = 0.025) and severity (RC −0.14; 95% CI −0.24 to −0.04; p = 0.006) of angiographic CV and development of DIND (aOR 0.76; 95% CI 0.59–0.98; p = 0.034). Only the duration (in days: RC −0.43; 95% CI −0.77 to −0.10; p = 0.010) but not the presence (aOR 0.87; 95% CI 0.68 to 1.11; p = 0.265) and severity (cerebral blood flow, in cm/s: RC +1.57; 95% CI −7.45 to +10.58; p = 0.731) of TCD CV was associated with CSC. Finally, the increasing levels of CSC were related to poorer 6-month functional outcome (RC +0.12; 95% CI +0.05 to +0.18; p < 0.001). Conclusions: CSC appears to be protective against angiographic CV and DIND, but correlates with worse overall outcome, suggesting that atherosclerosis, represented by CSC, affects cerebrovascular regulation and overall prognosis. We suggest careful evaluation of primary imaging studies for markers of atherosclerosis to identify patients at risk for CV and patients with low risk for CV but still at high risk for poor outcome. Full article

This article presents an analysis of the useful energy demand for heating purposes in a single-family, single-storey building with a self-supporting polystyrene structure, which is a relatively niche solution, in relation to a traditional masonry structure with similar partition thickness. The structures considered met the requirements for passive buildings. The analysis was performed on three locations in Europe with a temperate climate, i.e., Kołobrzeg in Poland, Vienna in Austria, and Essen in Germany. The research showed significant savings in the energy demand of the polystyrene structure compared to the masonry structure for each location, ranging from 38% to 52%. Similarly, the heating period was 21% to 38% shorter in individual locations. This shows that polystyrene construction allows for a significant reduction in building energy demand, leading to lower operating costs. Full article

Background: Circulating microRNAs (miRNAs) have emerged as potential biomarkers of platelet reactivity and thrombotic risk. Among them, miR-223-3p regulates P2Y12 receptor expression and may influence response to antiplatelet therapy. This study aimed to evaluate the prognostic value of selected circulating miRNAs in post-stroke patients receiving antiplatelet treatment. Methods: Sixty ischemic stroke survivors were prospectively enrolled and followed for 18 months for recurrent vascular events (stroke, transient ischemic attack, or myocardial infarction). Plasma levels of miR-126-3p, miR-223-3p, miR-24-3p, and miR-199a-5p were quantified using reverse transcription real-time PCR. Clinical data, antiplatelet regimen, statin use, and Essen Stroke Risk Scores (ESRS) were recorded. Logistic regression was applied to identify independent predictors of thrombotic events. Results: Expression of all examined miRNAs differed significantly across treatment groups. The dual antiplatelet therapy (DAPT) group showed the highest levels of miR-126-3p and miR-199a-5p (p < 0.01). Within the statin-naïve DAPT subgroup, lower miR-199a-5p levels (p < 0.001) were observed among patients who experienced ischemic events (n = 7/60; 12%; stroke = 4, TIA = 2, ACS = 1) during 18 months of follow-up. In multivariate analysis, reduced miR-223-3p remained the only independent predictor of recurrent thrombotic events (OR 1.18, 95% CI 1.01–1.37, p = 0.036), independent of ESRS and platelet reactivity. Elevated miR-126-3p and miR-199a-5p were associated with favorable treatment response, particularly among statin users. Conclusions: This study identifies low circulating miR-223-3p as an independent biomarker of thrombotic risk in post-stroke patients, potentially reflecting enhanced platelet activation via P2Y12 signaling. In contrast, higher miR-126-3p and miR-199a-5p levels may indicate more effective antiplatelet response. These findings support the potential utility of miRNA profiling for individualized antiplatelet therapy and long-term risk stratification after ischemic stroke. Full article

Extracted peatlands experience strong hydrological fluctuations due to drainage, vegetation succession, and climatic variability, yet long-term, high-frequency groundwater data remain scarce in Northern Europe. Our dataset presents two years (June 2023–May 2025) of 30-min groundwater table depth (WTD) measurements from six wells installed across contrasting Greenhouse Gass Emission Site Types (GEST 5, 6, 15, 20) in the Kaigu peatlands, central Latvia. Each well was equipped with an automatic pressure transducer (TD-Diver, van Essen Instruments) recording absolute pressure (m H₂O). The dataset also includes metadata on coordinates, installation elevation, well construction, and manual control measurements. All values are unprocessed, i.e., they represent original logger outputs without atmospheric or elevation correction, enabling users to apply their own calibration or referencing methods. This is the first openly available high-frequency extracted peatland groundwater pressure dataset from the Baltic region and provides a foundation for hydrological modelling and rewetting designs. Full article

Background: Psychological impacts of the coronavirus disease 2019 (COVID-19) pandemic on individuals with chronic medical conditions remain understudied. Chronic kidney disease (CKD) is one of the chronic conditions associated with an increased risk of severe COVID-19 outcomes. The aim of this study was to define the psychological burden of individuals with CKD during the COVID-19 pandemic. Methods: In this cross-sectional study, 219 individuals with CKD were recruited from the Nephrology Outpatient Unit at the University Hospital Essen, Germany, and completed anonymous surveys incorporating validated psychological assessment tools for generalized anxiety (GAD-7) and depressive symptoms (PHQ-2), along with self-generated items addressing COVID-19-specific concerns and behavioral changes. These participants were propensity score matched with controls from the general German population. Results: Individuals with CKD exhibited lower levels of generalized anxiety and depressive symptoms compared to the general population. However, they reported significantly greater risk perceptions regarding the likelihood of experiencing symptoms, a severe disease course, and death from COVID-19. COVID-19-related fear and associated behavioral changes were more frequently reported among CKD patients. Adherent and dysfunctional safety behaviors predominated among the CKD cohort. Conclusions: This study underscores psychological challenges faced by individuals with CKD during the COVID-19 pandemic. The increased risk perceptions and fears of severe disease and mortality from COVID-19 emphasize the need for mental health interventions aimed at improving coping strategies alongside physical health management in this vulnerable population. Full article

Radar observations of tropospheric and lower-stratospheric winds and density-normalized momentum flux made in northern Germany with two 53.5 MHz VHF MST radars over a period of one week in August 1986 are presented. One MST radar was a permanent installation, the SOUSY VHF Harz radar, located in the Harz Mountains, and the other temporarily installed about 27 km away from the Harz. The latter radar, the SOUSY VHF Lindau radar, was operated with a limited number of antennas and much-reduced power, making it effectively a tropospheric radar. Unusually, this small radar was successfully operated in Doppler beam steering (DBS) mode to measure winds and density-normalized momentum fluxes after correcting for biases in the beam look directions resulting from its small antenna aperture. We compared the winds and density-normalized upward fluxes in horizontal momentum measured using these two radars. The mean winds show good agreement between the two radars and with winds from radiosondes launched from Essen and Hannover. Density-normalized zonal momentum fluxes are similar in form between the two radars, but do show an offset when calculated over the entire observational period. Because of the agreement in form, the zonal mean flow accelerations calculated from them are similar, and so these results are consistent between the radars even though the topography is quite different. Although the observations were made many years ago, the results we present here are still of interest, because comparisons of closely spaced wind profiling radar observations are still relatively rare, radar measurements of tropospheric and stratospheric momentum fluxes are sparse, and the successful operation of a very small DBS radar operating in the lower VHF band is of particular interest from a technical perspective. Full article

Background/Objectives: The “Palliative Care and Rapid Emergency Screening Tool” (P-CaRES) is used to identify patients with palliative needs in the emergency department. This study aims to translate, adapt, and validate the P-CaRES tool for the German healthcare context. Methods: This is a monocentric, non-interventional, retrospective study conducted in the emergency department of the University Hospital Essen, Germany. After a structured translation process, the tool’s face and content validity were evaluated using questionnaires completed by healthcare workers. Construct validity was established by comparing the results with the German-validated Supportive and Palliative Care Indicators Tool (SPICT). A palliative care physician blinded to the tool, independently assessed the screened patients, and made recommendations on the appropriateness of palliative care referrals. Results: Two hundred eighty-nine emergency department visits were examined. In addition, a total of 26 healthcare professionals were surveyed. 258 screenings were conducted, with P-CaRES identifying 50 positive cases (19.4%). Agreement between SPICT and P-CaRES was 88.4% (kappa: 0.67, 95% confidence interval (CI): [0.56, 0.78]), showing 64.7% sensitivity and 96.8% specificity. Expert comparison yielded 85.5% agreement (kappa: 0.54, 95% CI: [0.41, 0.68]), with 64.0% sensitivity and 90.8% specificity. Face and content validity showed strong agreement regarding the tool’s design, including its comprehensibility, applicability, ease of use, and precision, as well as its usefulness in referring patients to a specialized palliative care team. Conclusions: The study successfully validated a cultural and linguistic equivalent German version of the P-CaRES tool. Further research is necessary to assess the tool’s effectiveness in clinical practice. Full article

Background: Differences in serum creatinine (SCr) between the Jaffe and enzymatic methods affect the detection and staging of chronic kidney disease in kidney transplant recipients (KTRs). However, there are very limited data on the extent to which the detection of acute kidney injury (AKI) is affected, what impact immunosuppression can have and whether a KTR-specific estimated glomerular filtration rate (eGFR) formula is beneficial. Methods: A total of 12,081 parallel Jaffe/enzymatic SCr (eSCr) measurements of adult outpatient KTRs (61% male, median age 53 years) in the same serum sample at the University Hospital Essen (Germany) between January 2020 and October 2023 were evaluated. AKI and CKD were defined according to current KDIGO guidelines. The GFR was estimated using CKD-EPI and KTR-specific formulas. Results: In about 1% of all measurements and 5% of the KTR patients, the SCr difference between the two methods was ≥ 0.3 mg/dl. A total of 81% of these patients were male; the median age was 52 years. High levels of immunosuppression, including when Belatacept was used, did not seem to have a clinically relevant impact on the difference between Jaffe and eSCr. The KTR-specific eGFR formula generally showed a greater agreement between Jaffe and eSCr than the CKD-EPI eGFR formula, but they showed differences in the classification of CKD stages, especially in less severe stages. Conclusions: Clinically relevant SCr differences between Jaffe and SCr are rare and depend on the type of immunosuppression. A KTR-specific eGFR formula could be beneficial in some cases, but there are limitations in less severe CKD stages. Full article

Objective: Evidence on long-term antibody persistence for the rabies vaccine administered using the four-dose Essen regimen is lacking. This study compared antibody persistence for the human diploid cell rabies vaccine (HDCV) administered using the four- versus five-dose Essen intramuscular regimen in post-exposure prophylaxis (PEP). Methods: This prospective cohort study enrolled patients vaccinated with the lyophilized HDCV for PEP who were grouped into four-dose and five-dose Essen groups. Rabies virus-neutralizing antibody (RVNA) detection was performed at 1 year or 3 years after initial vaccination. Results: In total, 180 and 184 patients were included in the four- and five-dose groups, respectively. The 1-year seroconversion (>0.5 IU/mL) rates were similar in the five-dose and four-dose Essen groups (99.2% vs. 98.3%, p = 0.662), as were the 3-year seroconversion rates (98.4% vs. 98.3%, p > 0.999). The median RVNA titer was significantly higher with the five-dose Essen regimen compared with the four-dose Essen regimen at 1 year (2.75 vs. 4.6 IU/mL, p = 0.002), and both groups had similar rates at 3 years (2.00 vs. 3.80 IU/mL, p = 0.443). Multivariable stepwise linear regression analysis showed that the five-dose Essen regimen was independently associated with higher serum RVNA titer compared to the four-dose Essen regimen (β = 0.175, p = 0.001), and 3 years after vaccination, was independently associated with a lower serum RVNA titer compared to 1 year (β = −1.06, p = 0.049). Conclusions: The four- and five-dose Essen regimens effectively produce durable immunogenicity, supporting the feasibility of implementing the four-dose Essen regimen for rabies immunization in China. Full article

Music generation by AI algorithms like Transformer is currently a research hotspot. Existing methods often suffer from issues related to coherence and high computational costs. To address these problems, we propose a novel Transformer-based model that incorporates a gate recurrent unit with root mean square norm restriction (TARREAN). This model improves the temporal coherence of music by utilizing the gate recurrent unit (GRU), which enhances the model’s ability to capture the dependencies between sequential elements. Additionally, we apply masked multi-head attention to prevent the model from accessing future information during training, preserving the causal structure of music sequences. To reduce computational overhead, we introduce root mean square layer normalization (RMS Norm), which smooths gradients and simplifies the calculations, thereby improving training efficiency. The music sequences are encoded using a compound word method, converting them into discrete symbol-event combinations for input into the TARREAN model. The proposed method effectively mitigates discontinuity issues in generated music and enhances generation quality. We evaluated the model using the Essen Associative Code and Folk Song Database, which contains 20,000 folk melodies from Germany, Poland, and China. The results show that our model produces music that is more aligned with human preferences, as indicated by subjective evaluation scores. The TARREAN model achieved a satisfaction score of 4.34, significantly higher than the 3.79 score of the Transformer-XL + REMI model. Objective evaluation also demonstrated a 15% improvement in temporal coherence compared to traditional methods. Both objective and subjective experimental results demonstrate that TARREAN can significantly improve generation coherence and reduce computational costs. Full article

It is imperative that (preservice) teachers engage in continuous reflection on their pedagogical practice to foster their continuous professional development. Teaching videos are therefore used in teacher education programmes to stimulate reflection. The authentic presentation of teaching through videos enables (preservice) teachers to reflect on certain aspects of teaching. To enhance the reflection quality of (preservice) teachers, it is essential that they receive structured support throughout the reflection process. The following article examines the reflection processes of preservice teachers who took part in the FLECTT project (Collegial video-based reflection on teaching in Reflecting Teams) at the University of Duisburg-Essen. During their practical semester, preservice teachers had the opportunity to reflect on videotapes of their own teaching in a collegial reflection setting. As only a few studies have investigated processes of collegial video-based reflection of preservice teachers, the following study addresses this research desideratum and investigates the reflection processes by means of an explorative, qualitative study. The findings suggest that preservice teachers engage intensively with the teaching video. They reflect on their personal experiences and develop new alternative courses of action. However, it seems to be crucial that the participants are familiar with the specific setting in order to be able to participate effectively in the reflection process. In addition, the high level of engagement with the teaching video seems to have an effect on the concentration or fatigue of the preservice teachers. Full article

Background: Deviations in serum creatinine (SCr), due to its determination using a Jaffe or an enzymatic method, have an effect on kidney disease detection and staging. It is not yet clear how large this effect is in kidney transplant recipients (KTRs). SCr measurement differences are of particular importance here to evaluate the graft function. Methods: The results of all parallel SCr measurements (Jaffe and enzymatic method) of adult outpatient KTRs in the same serum sample at the University Hospital Essen (Germany) between January 2020 and October 2023 were evaluated. A Bland–Altman plot with 95% limits of agreement (LoA) was used to assess the difference between the Jaffe and the enzymatic SCr (eSCr). For all patients, we used the CKD-EPI 2009 and EKFC formula, and for patients ≥ 70 years, we also used the BIS1 formula for the determination of eGFR. Results: A total of 12,081 parallel SCr measurements from 1243 KTRs were analyzed, where 61% were male and the median age was 53 years. On average, Jaffe SCr was 0.03 mg/dL higher than eSCr (LoA −0.16; 0.21 mg/dL). On average, the eGFR determined by Jaffe SCr was 1.9 mL/min/1.73 m² lower than the eGFR determined by eSCr (LoA −9.5; 5.7 mL/min/1.73 m²). The comparison of eGFR between the two SCr methods revealed a different CKD stage in 1589 (13%) of all analyzed measurements, most frequently between G2/G3a (41%) and G3a/G3b (24%). When using the EKFC and BIS1 formulas, there were approximately the same number of measurements leading to a different CKD stage. Conclusions: In more than every tenth SCr determination in outpatient KTRs, the difference between the Jaffe and enzymatic methods had an influence on the assignment to a CKD stage. This effect was comparably pronounced for all eGFR formulas applied. Full article

Background/Objectives: Our previous retrospective single-center cohort study found, at 3-year follow-up, a trend toward low tacrolimus trough levels and an increased risk of de novo donor-specific anti-HLA antibodies (DSAs) and of antibody-mediated rejection (ABMR) in CYP3A5-expressing patients. Determining CYP3A5-expression status immediately after renal transplant would allow early genotype-based dosage adjustment of tacrolimus and might prevent the occurrence of de novo DSAs and ABMR, improving transplant outcome. Methods: 160 renal allograft recipients who underwent renal transplant at the University Hospital Essen between May 2019 and May 2022 were genotyped for the CYP3A5 rs776746 polymorphism within the first two weeks after transplant, and genotype-based dose adjustment of tacrolimus was performed for the follow-up of 2 years. Results: CYP3A5 expression was detected in 33 (21%) of the 160 patients. Tacrolimus trough levels were similar in CYP3A5 expressers and nonexpressers over the entire 2-year follow-up period. However, we observed a trend toward slightly higher tacrolimus trough levels in CYP3A5 expressers, who, as expected, required tacrolimus dosages twice as high as did nonexpressers during follow-up. Calcineurin inhibitor (CNI) nephrotoxicity-free survival rates were comparable between CYP3A5 expressers and nonexpressers (p = 0.49). Rejection-free survival rates (p = 0.89), de novo anti-HLA antibody-free survival rates (p = 0.57) and de novo DSA-free survival rates (p = 0.61) did not differ between the two groups. Conclusions: Early detection of CYP3A5-expression status and resultant genotype-based adjustment of tacrolimus dosage after renal transplant protected patients from transplant rejection and de novo DSA formation and was not associated with increased incidence of CNI toxicity among CYP3A5 expressers. Full article

Background: The dental healthcare private sector in Riyadh city has been growing rapidly over the past few years; however, there is a lack of information on the accessibility and spatial distribution of private dental healthcare facilities (PDHFs) in the area. This study aimed to evaluate the spatial distribution of PDHFs in Riyadh city in relation to population density in each sub-municipality. Methods: The current information regarding the number, location, and operability of PDHFs in Riyadh city was obtained from the Ministry of Health. A total of 632 operating PDHFs were included with the precise location plotted on Quantum Geographic Information System software (version 3.32.1, Essen, Germany) using Google Earth. Four levels of buffer zones—1 km, 3 km, 5 km, and >5 km—were determined. The population statistics and mean monthly individual income per district were gathered from Zadd.910ths. Microsoft Excel (version 16.0, Microsoft, Redmond, WA, USA) and RStudio software (version 4.1.3, Posit Software, PBC, Boston, MA, USA) were used for additional data analysis. Results: There was an overall ratio of one PDHF per 9958 residents in Riyadh city. Olaya and Maather sub-municipalities had the largest PDHF-to-population ratios: (1:4566) and (1:4828), respectively. Only 36.3% of the city’s total area was within a 1 km buffer zone from a PDHF. There was an overall weak positive correlation between the number of PDHFs and the total area in each sub-municipality (r = 0.29), and the distribution of PDHFs was uneven corresponding to the area (G* = 0.357). Conclusions: There was an uneven distribution of PDHFs in Riyadh city. Some areas were underserved while others were overserved in several sub-municipalities. Policy-makers and investors are encouraged to target underserved areas rather than areas with significant clustering to improve access to care. Full article

The objective of this study was to investigate the effect of the incorporation of 2, 4 or 6 wt% of amorphous nano- or micro-silica (Aerosil^® OX 50 or Aeroperl^® 300 Pharma (Evonik Operations GmbH, Essen, Germany), respectively) on the net setting time and microhardness of Ketac™ Molar (3M ESPE, St. Paul, MN, USA) and Fuji IX GP^® (GC Corporation, Tokyo, Japan) glass–ionomer cements (GICs) (viz. KM and FIX, respectively). Both silica particles were found to cause a non-linear, dose-dependent reduction in setting time that was within the clinically acceptable limits specified in the relevant international standard (ISO 9917-1:2007). The microhardness of KM was statistically unaffected by blending with 2 or 4 wt% nano-silica at all times, whereas 6 wt% addition decreased and increased the surface hardness at 1 and 21 days, respectively. The incorporation of 4 or 6 wt% nano-silica significantly improved the microhardness of FIX at 1, 14 and 21 days, with no change in this property noted for 2 wt% addition. Micro-silica also tended to enhance the microhardness of FIX, at all concentrations and times, to an extent that became statistically significant for all dosages at 21 days. Conversely, 4 and 6 wt% additions of micro-silica markedly decreased the initial 1-day microhardness of KM, and the 21-day sample blended at 4 wt% was the only specimen that demonstrated a significant increase in this property. Scanning electron microscopy indicated that the nano- and micro-silica particles were well distributed throughout the composite structures of both GICs with no evidence of aggregation or zoning. The specific mechanisms of the interaction of inorganic nanoparticles with the constituents of GICs require further understanding, and a lack of international standardization of the determination of microhardness is problematic in this respect. Full article