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16 pages, 1170 KiB  
Article
Plate and K-Wire Show Advantages to Nailing for Distal Diametaphyseal Radius Fracture in Children: A Retrospective, Two-Center Study
by Frederik Weil, Lucas Fabarius, Luisa Weil, Paul A. Grützner, Michael Boettcher, Christel Weiß and Stefan Studier-Fischer
J. Clin. Med. 2025, 14(13), 4626; https://doi.org/10.3390/jcm14134626 - 30 Jun 2025
Viewed by 397
Abstract
Background/Objectives: Distal forearm fractures are the most common fractures in children. Three surgical techniques are most commonly used at the level of the radial diametaphysis on the distal forearm in children: K-wire, ascending ESIN (elastic stable intramedullary nail) or plate osteosynthesis. The [...] Read more.
Background/Objectives: Distal forearm fractures are the most common fractures in children. Three surgical techniques are most commonly used at the level of the radial diametaphysis on the distal forearm in children: K-wire, ascending ESIN (elastic stable intramedullary nail) or plate osteosynthesis. The aim of this study was to compare these procedures in children with distal diametaphyseal radius fractures regarding operative and functional outcome. Methods: A retrospective study was conducted in two level 1 trauma centers. Children and adolescents aged 2 to 15 years were included. The study period was from January 2010 to December 2022. The hospital information system was used to record patient age, gender, height, weight, fracture location, degree of angular deformity postoperatively, surgical procedure and postoperative complications, which were described in the medical records of the hospital information system. Complications graded by modified Clavien–Dindo–Sink served as the primary outcome. Reduction accuracy, operative and fluoroscopy times, immobilization length and postoperative motion were the secondary endpoints. Results: A total of 213 children were included in the study. K-wire osteosynthesis was performed in 25%, nailing in 19% and volar plate osteosynthesis in 55%. All ESIN were inserted in ascending technique. Complications occurred in 22% of patients and did not differ overall between techniques (p = 0.20). Severe complications were significantly more frequent after ESIN (20%) than after K-wires (7%) or plates (4%) (p = 0.04). Plate fixation achieved the most accurate alignment (≤5° angular deformity in 93% vs. 57% K-wires and 61% ESIN; p < 0.0001) and the fewest late motion restrictions (p = 0.02). K-wire surgery was fastest technique and required the least fluoroscopy, but necessitated the longest postoperative cast. Conclusions: Volar plating combines reliable anatomical reduction with a low rate of major complications and early mobilization, supporting its use in older children whose remodeling potential is limited. K-wires are a swift, minimally invasive option for younger patients, albeit with less precise reduction and prolonged immobilization. Conventional ESIN showed the highest burden of severe complications. Full article
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14 pages, 2282 KiB  
Article
Prognostic Impact of COVID-19 Inflammation Score Response: A Sub-Group Analysis on Critically Ill Patients of the RuxCoFlam Trial
by Manfred Weiss, Jakob Hammersen, Sebastian Rudolphi, Isabell Formann, Karl Träger, Frank G. Rücker, Beate Grüner, Andreas Allgöwer, Sebastian Birndt, Christian Fabisch, Andreas Hochhaus, Konstanze Döhner, Paul La Rosée and Frank Stegelmann
Life 2025, 15(5), 781; https://doi.org/10.3390/life15050781 - 14 May 2025
Viewed by 500
Abstract
This study aims to identify parameters predicting COVID-19 inflammation score (CIS) response and survival probability in critically ill patients with hyperinflammation treated with the Janus kinase (JAK) 1/2 inhibitor ruxolitinib. This is a single arm, non-randomized, open-label, phase-II study for frontline treatment in [...] Read more.
This study aims to identify parameters predicting COVID-19 inflammation score (CIS) response and survival probability in critically ill patients with hyperinflammation treated with the Janus kinase (JAK) 1/2 inhibitor ruxolitinib. This is a single arm, non-randomized, open-label, phase-II study for frontline treatment in adults in the intensive care unit (ICU). Ninety-two critically ill COVID-19 patients with CIS ≥ 10 were treated in the RuxCoFlam trial (NCT04338958) with ruxolitinib between April 2020 and June 2021. Median ICU treatment duration was 15 days (range, 2–73). Out of 81 evaluable patients, 62 (77%) showed CIS reduction ≥ 25% on day 7 (CIS response). In multiple logistic regression analyses, higher CIS on day 0 (odds ratio (OR), 1.56; 95% confidence interval (CI), 1.01–2.41; p = 0.046) and male gender (OR, 4.76; 95% CI, 1.22–16.67; p = 0.024) were significantly associated with CIS response. Sixty-day survival probability was higher in CIS-responders compared to non-responders (74% vs. 32%; p < 0.001). Multiple Cox regression analysis revealed younger age (10-year difference) (hazard ratio (HR), 0.65; 95% CI, 0.46–0.91; p = 0.012) and CIS response (HR, 0.19; 95% CI, 0.08–0.45; p < 0.001) as significant parameters for survival probability. In conclusion, reduced risk of death in CIS-responders underlines the usefulness of CIS for the assessment of hyperinflammatory disorders, such as COVID-19, under JAK1/2 inhibitor therapy. Full article
(This article belongs to the Special Issue Human Health Before, During, and After COVID-19)
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18 pages, 2911 KiB  
Article
Flow Cytometric Assessment of FcγRIIIa-V158F Polymorphisms and NK Cell Mediated ADCC Revealed Reduced NK Cell Functionality in Colorectal Cancer Patients
by Phillip Schiele, Stefan Kolling, Stanislav Rosnev, Charlotte Junkuhn, Anna Luzie Walter, Jobst Christian von Einem, Sebastian Stintzing, Wenzel Schöning, Igor Maximilian Sauer, Dominik Paul Modest, Kathrin Heinrich, Lena Weiss, Volker Heinemann, Lars Bullinger, Marco Frentsch and Il-Kang Na
Cells 2025, 14(1), 32; https://doi.org/10.3390/cells14010032 - 31 Dec 2024
Viewed by 1906
Abstract
Antibody-dependent cell-mediated cytotoxicity (ADCC) by NK cells is a key mechanism in anti-cancer therapies with monoclonal antibodies, including cetuximab (EGFR-targeting) and avelumab (PDL1-targeting). Fc gamma receptor IIIa (FcγRIIIa) polymorphisms impact ADCC, yet their clinical relevance in NK cell functionality remains debated. We developed [...] Read more.
Antibody-dependent cell-mediated cytotoxicity (ADCC) by NK cells is a key mechanism in anti-cancer therapies with monoclonal antibodies, including cetuximab (EGFR-targeting) and avelumab (PDL1-targeting). Fc gamma receptor IIIa (FcγRIIIa) polymorphisms impact ADCC, yet their clinical relevance in NK cell functionality remains debated. We developed two complementary flow cytometry assays: one to predict the FcγRIIIa-V158F polymorphism using a machine learning model, and a 15-color flow cytometry panel to assess antibody-induced NK cell functionality and cancer-immune cell interactions. Samples were collected from healthy donors and metastatic colorectal cancer (mCRC) patients from the FIRE-6-Avelumab phase II study. The machine learning model accurately predicted the FcγRIIIa-V158F polymorphism in 94% of samples. FF homozygous patients showed diminished cetuximab-mediated ADCC compared to VF or VV carriers. In mCRC patients, NK cell dysfunctions were evident as impaired ADCC, decreased CD16 downregulation, and reduced CD137/CD107a induction. Elevated PD1+ NK cell levels, reduced lysis of PDL1-expressing CRC cells and improved NK cell activation in combination with the PDL1-targeting avelumab indicate that the PD1-PDL1 axis contributes to impaired cetuximab-induced NK cell function. Together, these optimized assays effectively identify NK cell dysfunctions in mCRC patients and offer potential for broader application in evaluating NK cell functionality across cancers and therapeutic settings. Full article
(This article belongs to the Special Issue Advances in the Study of Natural Killer (NK) Cells)
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17 pages, 2785 KiB  
Article
Nuclear Magnetic Resonance Treatment Induces ßNGF Release from Schwann Cells and Enhances the Neurite Growth of Dorsal Root Ganglion Neurons In Vitro
by Anda Rad, Lukas Weigl, Bibiane Steinecker-Frohnwieser, Sarah Stadlmayr, Flavia Millesi, Maximilian Haertinger, Anton Borger, Paul Supper, Lorenz Semmler, Sonja Wolf, Aida Naghilou, Tamara Weiss, Hans G. Kress and Christine Radtke
Cells 2024, 13(18), 1544; https://doi.org/10.3390/cells13181544 - 13 Sep 2024
Viewed by 1882
Abstract
Peripheral nerve regeneration depends on close interaction between neurons and Schwann cells (SCs). After nerve injury, SCs produce growth factors and cytokines that are crucial for axon re-growth. Previous studies revealed the supernatant of SCs exposed to nuclear magnetic resonance therapy (NMRT) treatment [...] Read more.
Peripheral nerve regeneration depends on close interaction between neurons and Schwann cells (SCs). After nerve injury, SCs produce growth factors and cytokines that are crucial for axon re-growth. Previous studies revealed the supernatant of SCs exposed to nuclear magnetic resonance therapy (NMRT) treatment to increase survival and neurite formation of rat dorsal root ganglion (DRG) neurons in vitro. The aim of this study was to identify factors involved in transferring the observed NMRT-induced effects to SCs and consequently to DRG neurons. Conditioned media of NMRT-treated (CM NMRT) and untreated SCs (CM CTRL) were tested by beta-nerve growth factor (ßNGF) ELISA and multiplex cytokine panels to profile secreted factors. The expression of nociceptive transient receptor potential vanilloid 1 (TRPV1) channels was assessed and the intracellular calcium response in DRG neurons to high-potassium solution, capsaicin or adenosine triphosphate was measured mimicking noxious stimuli. NMRT induced the secretion of ßNGF and pro-regenerative-signaling factors. Blocking antibody experiments confirmed ßNGF as the main factor responsible for neurotrophic/neuritogenic effects of CM NMRT. The TRPV1 expression or sensitivity to specific stimuli was not altered, whereas the viability of cultured DRG neurons was increased. Positive effects of CM NMRT supernatant on DRG neurons are primarily mediated by increased ßNGF levels. Full article
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17 pages, 1811 KiB  
Article
Effects of Different Types of Intermittent Fasting Interventions on Metabolic Health in Healthy Individuals (EDIF): A Randomised Trial with a Controlled-Run in Phase
by Daniel Herz, Sebastian Karl, Johannes Weiß, Paul Zimmermann, Sandra Haupt, Rebecca Tanja Zimmer, Janis Schierbauer, Nadine Bianca Wachsmuth, Maximilian Paul Erlmann, Tobias Niedrist, Kayvan Khoramipour, Thomas Voit, Sian Rilstone, Harald Sourij and Othmar Moser
Nutrients 2024, 16(8), 1114; https://doi.org/10.3390/nu16081114 - 10 Apr 2024
Cited by 9 | Viewed by 12154
Abstract
The effects of intermittent fasting (IF) on health promotion in the healthy population remain controversial. Therefore, our study aimed to analyse the efficacy and feasibility of different IF protocols and evaluated the effects within a cohort with a controlled-run in phase on the [...] Read more.
The effects of intermittent fasting (IF) on health promotion in the healthy population remain controversial. Therefore, our study aimed to analyse the efficacy and feasibility of different IF protocols and evaluated the effects within a cohort with a controlled-run in phase on the body mass index (BMI) as the primary outcome, the body composition, and metabolic and haematological markers in healthy participants. A total of 25 individuals were randomised into three fasting groups: 16/8 fasting (n = 11), 20/4 fasting (n = 6), and alternate-day fasting (ADF, n = 8). Assessments were conducted at baseline (visit 1), after a four-week controlled-run in phase (visit 2), and after eight weeks of fasting (visit 3). Both the BMI (p = 0.01) and bodyweight (p = 0.01) were significantly reduced in the ADF group, which was not seen in the 16/8 and 20/4 groups (p > 0.05). Adherence was different but not statistically among the groups (16/8: 84.5 ± 23.0%; 20/4: 92.7 ± 9.5%; and ADF: 78.1 ± 33.5%, p = 0.57). Based on our obtained results, the data suggest that some fasting interventions might be promising for metabolic health. However, adherence to the specific fasting protocols remains challenging even for the healthy population. Full article
(This article belongs to the Section Nutrition and Public Health)
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13 pages, 741 KiB  
Article
Effects of Different Fasting Interventions on Cardiac Autonomic Modulation in Healthy Individuals: A Secondary Outcome Analysis of the EDIF Trial
by Paul Zimmermann, Daniel Herz, Sebastian Karl, Johannes W. Weiß, Helmut K. Lackner, Maximilian P. Erlmann, Harald Sourij, Janis Schierbauer, Sandra Haupt, Felix Aberer, Nadine B. Wachsmuth and Othmar Moser
Biology 2023, 12(3), 372; https://doi.org/10.3390/biology12030372 - 26 Feb 2023
Cited by 4 | Viewed by 5453
Abstract
The impact of a fasting intervention on electrocardiographic (ECG) time intervals and heart rate variability (HRV) is a focus that is scarcely analyzed. The main focus of these secondary outcome data was to describe the impact of a different fasting intervention on ECG [...] Read more.
The impact of a fasting intervention on electrocardiographic (ECG) time intervals and heart rate variability (HRV) is a focus that is scarcely analyzed. The main focus of these secondary outcome data was to describe the impact of a different fasting intervention on ECG and HRV analyses. Twenty-seven healthy individuals participated in this study (11 females, aged 26.3 ± 3.8 years, BMI 24.7 ± 3.4 kg/m2), including a pre-intervention controlled run-in period. Participants were randomized to one of the three fasting cohorts: (I) alternate day fasting (ADF, n = 8), (II) 16/8 fasting (16/8 h of fasting/feasting, n = 11) and (III) 20/4 fasting (20/4 h of fasting/feasting, n = 8). An analysis of baseline ECG parameters and HRV parameters following different fasting interventions demonstrated the safety of these interventions without impacting on heart rate variability parameters during Schellong-1 testing, and revealed comparable preserved autonomic cardiac modulation (ACM) independently of the fasting intervention. In conclusion, different short-term fasting interventions demonstrated no safety ECG-based concerns and showed comparable ACM based on ECG and HRV assessments. Finally, our research topic might strengthen the scientific knowledge of intermittent fasting strategies and indicate potential clinically preventive approaches with respect to occurring metabolic disease and obesity in healthy young subjects. Full article
(This article belongs to the Special Issue Cardiovascular Autonomic Function: From Bench to Bedside)
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3 pages, 201 KiB  
Editorial
Post-Intensive Care Syndrome after Critical Illness: An Imperative for Effective Prevention
by Nicolas Paul and Björn Weiss
J. Clin. Med. 2022, 11(20), 6203; https://doi.org/10.3390/jcm11206203 - 21 Oct 2022
Cited by 2 | Viewed by 2218
Abstract
Over the last decades, the importance of intensive care has considerably increased [...] Full article
(This article belongs to the Special Issue Enhancing Recovery after Intensive Care Medicine in Clinical Practice)
8 pages, 768 KiB  
Article
Influence of Rigor Mortis on Tendon Mobility in an Animal Fresh Cadaver Model
by Christoph Luecke, Marc Schnetzke, Christel Weiss, Stefan Studier-Fischer, Thorsten Guehring, Paul A. Gruetzner and Felix Porschke
Biology 2022, 11(10), 1381; https://doi.org/10.3390/biology11101381 - 22 Sep 2022
Cited by 1 | Viewed by 2988
Abstract
(1) Many biomechanical studies are performed using fresh frozen cadavers or embalmed specimens, although the biomechanical characteristics do not match the characteristics of in vivo tendons. Therefore, a fresh in vivo-like cadaver model has been introduced recently. As a limitation for studies with [...] Read more.
(1) Many biomechanical studies are performed using fresh frozen cadavers or embalmed specimens, although the biomechanical characteristics do not match the characteristics of in vivo tendons. Therefore, a fresh in vivo-like cadaver model has been introduced recently. As a limitation for studies with fresh cadavers, rigor mortis must be considered. The aim of this study was to evaluate the impact of the biomechanical properties and time of occurrence of rigor mortis in a fresh cadaver model. (2) For this study, 15 fresh porcine cadaver shoulders were used in an established biomechanical in vitro model to evaluate the onset of rigor mortis. Measurements took place at ten points of time (t1–t10) beginning 103 min post mortem (pm). The mobility of the supraspinatus tendon was measured in Newton (N) with a modified sensor-enhanced arthroscopic grasper. (3) The mean load measured at the time point t1 was 28.0 ± 11.2 N. The first significant decrease of mobility occurred 151 min post mortem (t4) at a mean load of 30.2 ± 13.7 N. From 227 min pm to 317 min pm, there was no further significant increase. (4) Tendon mobility decreases significantly within the first three hours after the killing. Therefore, reliable results can be obtained within 150 min post mortem before the onset of rigor mortis alters the biomechanical properties. Full article
(This article belongs to the Special Issue Innovative Strategies in Musculoskeletal Regeneration)
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6 pages, 220 KiB  
Proceeding Paper
Is the Weissean Surrogate the Latest Philosophical “Development” of the Confucian Ritual?
by Marina Christodoulou
Proceedings 2022, 81(1), 13; https://doi.org/10.3390/proceedings2022081013 - 10 Mar 2022
Viewed by 1339
Abstract
What is meant by ritual (li) in the Confucian tradition—mostly Xunzi—might be said to be the root of three different concepts-“stages” or concept-“developments” in European philosophy. The first stage is the concept of habit, from the Aristotelian “hexis” to Bourdieu’s [...] Read more.
What is meant by ritual (li) in the Confucian tradition—mostly Xunzi—might be said to be the root of three different concepts-“stages” or concept-“developments” in European philosophy. The first stage is the concept of habit, from the Aristotelian “hexis” to Bourdieu’s “habitus”. The second is the sign, as developed by the American Pragmatists and, in Europe, by Saussure. There is a third, relatively recent stage, as I would classify it, which is Paul Weiss’ surrogate. Weiss uses the pragmatist theorization of habit to construct his original concept of the surrogates. The above stages might be chronological in the way they appear (habit, sign, surrogate), but one does not erase the other. They have the same root—which I would like to argue is the ritual—and they build on it, while each differentiates ritual in its own way. They are distinctive concepts but, at the same time, are related to one another. Full article
15 pages, 5914 KiB  
Article
A Decade of Post-Intensive Care Syndrome: A Bibliometric Network Analysis
by Nicolas Paul, Valentina Albrecht, Claudia Denke, Claudia D. Spies, Henning Krampe and Björn Weiss
Medicina 2022, 58(2), 170; https://doi.org/10.3390/medicina58020170 - 23 Jan 2022
Cited by 13 | Viewed by 5004
Abstract
Background and Objectives: In 2012, the umbrella term post-intensive care syndrome (PICS) was introduced to capture functional long-term impairments of survivors of critical illness. We present a bibliometric network analysis of the PICS research field. Materials and Methods: The Web of Science core [...] Read more.
Background and Objectives: In 2012, the umbrella term post-intensive care syndrome (PICS) was introduced to capture functional long-term impairments of survivors of critical illness. We present a bibliometric network analysis of the PICS research field. Materials and Methods: The Web of Science core database was searched for articles published in 2012 or later using ‘post-intensive care syndrome’ and variant spellings. Using VOSviewer, we computed co-authorship networks of countries, institutions, and authors, as well as keyword co-occurrence networks. We determined each country’s relative research effort and Category Normalized Citation Index over time and analyzed the 100 most-cited articles with respect to article type, country of origin, and publishing journal. Results: Our search yielded 379 articles, of which 373 were analyzed. Annual PICS research output increased from 11 (2012) to 95 articles (2020). Most PICS research originates from the US, followed by England, Australia, the Netherlands, and Germany. We found various collaborations between countries, institutions, and authors, with recent collaborative networks of English and Australian institutions. Article keywords cover aspects of cognitive, mental health, and physical impairments, and more recently, COVID-19. Only a few keywords and articles pertained to PICS prevention and treatment. Conclusions: Our analysis of Web of Science-indexed PICS articles highlights the stark increase in PICS research output in recent years, primarily originating from US- and Europe-based authors and institutions. Despite the research field’s growth, knowledge gaps with respect to PICS prevention and treatment remain. Full article
(This article belongs to the Section Intensive Care/ Anesthesiology)
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10 pages, 2205 KiB  
Communication
Peptide-Based Capture of Chikungunya Virus E2 Protein Using Porous Silicon Biosensor
by Rabeb Layouni, Tengfei Cao, Matthew B. Coppock, Paul E. Laibinis and Sharon M. Weiss
Sensors 2021, 21(24), 8248; https://doi.org/10.3390/s21248248 - 10 Dec 2021
Cited by 4 | Viewed by 3182
Abstract
The detection of pathogens presents specific challenges in ensuring that biosensors remain operable despite exposure to elevated temperatures or other extreme conditions. The most vulnerable component of a biosensor is typically the bioreceptor. Accordingly, the robustness of peptides as bioreceptors offers improved stability [...] Read more.
The detection of pathogens presents specific challenges in ensuring that biosensors remain operable despite exposure to elevated temperatures or other extreme conditions. The most vulnerable component of a biosensor is typically the bioreceptor. Accordingly, the robustness of peptides as bioreceptors offers improved stability and reliability toward harsh environments compared to monoclonal antibodies that may lose their ability to bind target molecules after such exposures. Here, we demonstrate peptide-based capture of the Chikungunya virus E2 protein in a porous silicon microcavity biosensor at room temperature and after exposure of the peptide-functionalized biosensor to high temperature. Contact angle measurements, attenuated total reflectance—Fourier transform infrared spectra, and optical reflectance measurements confirm peptide functionalization and selective E2 protein capture. This work opens the door for other pathogenic biomarker detection using peptide-based capture agents on porous silicon and other surface-based sensor platforms. Full article
(This article belongs to the Special Issue Porous Nanomaterials in High Performance Sensors)
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12 pages, 743 KiB  
Article
Outcomes in Critically Ill Patients Sedated with Intravenous Lormetazepam or Midazolam: A Retrospective Cohort Study
by Björn Weiss, David Hilfrich, Gerald Vorderwülbecke, Maria Heinrich, Julius J. Grunow, Nicolas Paul, Jochen Kruppa, Bruno Neuner, Berthold Drexler, Felix Balzer and Claudia D. Spies
J. Clin. Med. 2021, 10(18), 4091; https://doi.org/10.3390/jcm10184091 - 10 Sep 2021
Cited by 7 | Viewed by 3229
Abstract
The benzodiazepine, midazolam, is one of the most frequently used sedatives in intensive care medicine, but it has an unfavorable pharmacokinetic profile when continuously applied. As a consequence, patients are frequently prolonged and more deeply sedated than intended. Due to its distinct pharmacological [...] Read more.
The benzodiazepine, midazolam, is one of the most frequently used sedatives in intensive care medicine, but it has an unfavorable pharmacokinetic profile when continuously applied. As a consequence, patients are frequently prolonged and more deeply sedated than intended. Due to its distinct pharmacological features, including a cytochrome P450-independent metabolization, intravenous lormetazepam might be clinically advantageous compared to midazolam. In this retrospective cohort study, we compared patients who received either intravenous lormetazepam or midazolam with respect to their survival and sedation characteristics. The cohort included 3314 mechanically ventilated, critically ill patients that received one of the two drugs in a tertiary medical center in Germany between 2006 and 2018. A Cox proportional hazards model with mortality as outcome and APACHE II, age, gender, and admission mode as covariates revealed a hazard ratio of 1.75 [95% CI 1.46–2.09; p < 0.001] for in-hospital mortality associated with the use of midazolam. After additionally adjusting for sedation intensity, the HR became 1.04 [95% CI 0.83–1.31; p = 0.97]. Thus, we concluded that excessive sedation occurs more frequently in critically ill patients treated with midazolam than in patients treated with lormetazepam. These findings require further investigation in prospective trials to assess if lormetazepam, due to its ability to maintain light sedation, might be favorable over other benzodiazepines for sedation in the ICU. Full article
(This article belongs to the Special Issue Enhancing Recovery after Intensive Care Medicine in Clinical Practice)
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12 pages, 3657 KiB  
Article
Perioperative Perfusion of Allografts with Anti-Human T-lymphocyte Globulin Does Not Improve Outcome Post Liver Transplantation—A Randomized Placebo-Controlled Trial
by Paul Viktor Ritschl, Julia Günther, Lena Hofhansel, Stefanie Ernst, Susanne Ebner, Arne Sattler, Sascha Weiß, Annemarie Weissenbacher, Rupert Oberhuber, Benno Cardini, Robert Öllinger, Matthias Biebl, Christian Denecke, Christian Margreiter, Thomas Resch, Stefan Schneeberger, Manuel Maglione, Katja Kotsch and Johann Pratschke
J. Clin. Med. 2021, 10(13), 2816; https://doi.org/10.3390/jcm10132816 - 25 Jun 2021
Viewed by 2168
Abstract
Due to the lack of suitable organs transplant surgeons have to accept unfavorable extended criteria donor (ECD) organs. Recently, we demonstrated that the perfusion of kidney organs with anti-human T-lymphocyte globulin (ATLG) prior to transplantation ameliorates ischemia-reperfusion injury (IRI). Here, we report on [...] Read more.
Due to the lack of suitable organs transplant surgeons have to accept unfavorable extended criteria donor (ECD) organs. Recently, we demonstrated that the perfusion of kidney organs with anti-human T-lymphocyte globulin (ATLG) prior to transplantation ameliorates ischemia-reperfusion injury (IRI). Here, we report on the results of perioperative ATLG perfusion in a randomized, single-blinded, placebo-controlled, feasibility trial (RCT) involving 30 liver recipients (LTx). Organs were randomly assigned for perfusion with ATLG/Grafalon® (AP) (n = 16) or saline only (control perfusion = CP) (n = 14) prior to implantation. The primary endpoint was defined as graft function reflected by aspartate transaminase (AST) values at day 7 post-transplantation (post-tx). With respect to the primary endpoint, no significant differences in AST levels were shown in the intervention group at day 7 (AP: 53.0 ± 21.3 mg/dL, CP: 59.7 ± 59.2 mg/dL, p = 0.686). Similarly, exploratory analysis of secondary clinical outcomes (e.g., patient survival) and treatment-specific adverse events revealed no differences between the study groups. Among liver transplant recipients, pre-operative organ perfusion with ATLG did not improve short-term outcomes, compared to those who received placebo perfusion. However, ATLG perfusion of liver grafts was proven to be a safe procedure without the occurrence of relevant adverse events. Full article
(This article belongs to the Special Issue Liver Transplantation: Improving Results under Worsening Conditions)
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14 pages, 2320 KiB  
Article
Conservation Requirements of European Eel (Anquilla anquilla) in a Balkan Catchment
by Paul Meulenbroek, Urban Hammerschmied, Stefan Schmutz, Steven Weiss, Michael Schabuss, Horst Zornig, Spase Shumka and Friedrich Schiemer
Sustainability 2020, 12(20), 8535; https://doi.org/10.3390/su12208535 - 15 Oct 2020
Cited by 17 | Viewed by 3671
Abstract
The European eel (Anquilla anquilla) has been declining throughout its area of distribution, is addressed in several pieces of legislation, and is the target of extensive restoration efforts. Therefore, investigating and conserving natural eel habitats is urgently needed. Large, near-natural rivers [...] Read more.
The European eel (Anquilla anquilla) has been declining throughout its area of distribution, is addressed in several pieces of legislation, and is the target of extensive restoration efforts. Therefore, investigating and conserving natural eel habitats is urgently needed. Large, near-natural rivers have become rare in Europe but the Balkans host some of the extant examples. However, several Balkan rivers–among them the transboundary river Vjosa/Aoos of Albania and Greece–are under threat from planned hydropower constructions. This study synthesizes European eel catch data from four institutions and the results of a recent electrofishing survey. Population density and structure as well as habitat choice were studied at different spatial scales. We calculated densities for each meso-habitat (0–1303 ind./ha) and extrapolated these values across three different hydromorphological channel sections (meandering: 70 ind./ha, braided: 131 ind./ha, constrained: 334 ind./ha), resulting in an overall mean density of 168 ind./ha. Proposed hydropower plants would cut off about 80% of the catchment currently accessible and impact river sections downstream of the dams by disturbing hydrological dynamics. By linking study results to relevant legislation and literature we provide evidence-based data for water management decisions. We call for the Vjosa/Aoos to be protected in order to secure its outstanding conservation value. Full article
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18 pages, 1340 KiB  
Article
Influence of Sedation Level and Ventilation Status on the Diagnostic Validity of Delirium Screening Tools in the ICU—An International, Prospective, Bi-Center Observational Study (IDeAS)
by Flavio E. Nacul, Nicolas Paul, Claudia D. Spies, Henriette Sechting, Thomas Hecht, Jörn S. Dullinger, Sophie K. Piper, Alawi Luetz, Felix S. Balzer, Klaus-Dieter Wernecke, Anna Karinina Sa, Carolina Barros Ferreira da Costa, Lisa Eymold, Chokri Chenitir and Björn Weiss
Medicina 2020, 56(8), 411; https://doi.org/10.3390/medicina56080411 - 13 Aug 2020
Cited by 6 | Viewed by 4295
Abstract
Background and objectives: The use of delirium screening instruments (DSIs) is recommended in critical care practice for a timely detection of delirium. We hypothesize that the patient-related factors “level of sedation” and “mechanical ventilation” impact test validity of DSIs. Materials and Methods: This [...] Read more.
Background and objectives: The use of delirium screening instruments (DSIs) is recommended in critical care practice for a timely detection of delirium. We hypothesize that the patient-related factors “level of sedation” and “mechanical ventilation” impact test validity of DSIs. Materials and Methods: This is a prospective, bi-center observational study (clinicaltrials.gov: NCT01720914). Critically ill patients were screened for delirium daily for up to seven days after enrollment using the Nursing Delirium Screening Scale (Nu-DESC), Intensive Care Delirium Screening Checklist (ICDSC), and Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Reference standard for delirium diagnosis was the neuropsychiatric examination using the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR). Immediately before delirium assessment, ventilation status and sedation levels were documented. Results: 160 patients were enrolled and 151 patients went into final analysis. Delirium incidence was 23.2%. Nu-DESC showed a sensitivity and specificity of 88.5%, a positive predictive value (PPV) of 71.9%, and a negative predictive value (NPV) of 95.8%. ICDSC had a sensitivity of 62.5%, a specificity of 92.4%, a PPV of 71.4%, and a NPV of 89.0%. CAM-ICU showed a sensitivity of 75.0%, a specificity of 94.7%, a PPV of 85.7%, and a NPV of 90.0%. For Nu-DESC and ICDSC, test validity was significantly better for non-sedated patients (Richmond Agitation Sedation Scale (RASS) 0/−1), whereas test validity for CAM-ICU in a severity scale version showed no significant differences for different sedation levels. No DSI showed a significant difference in test validity between noninvasively and invasively ventilated patients. Conclusions: Test validities of DSIs were comparable to previous studies. The observational scores ICDSC and Nu-DESC showed a significantly better performance in awake and drowsy patients (RASS 0/−1) when compared with other sedation levels. Physicians should refrain from sedation whenever possible to avoid suboptimal performance of DSIs. Full article
(This article belongs to the Special Issue Delirium in Critically Ill Patients)
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