Publications by authors named "Jan Schmidt"

285 Publications

Impact of COVID-19 on Czech Dentistry: A Nationwide Cross-Sectional Preliminary Study among Dentists in the Czech Republic.

Int J Environ Res Public Health 2021 08 29;18(17). Epub 2021 Aug 29.

Czech Dental Chamber, Slavojova 270/22, 128 00 Prague, Czech Republic.

This work evaluates the impact of the COVID-19 pandemic on Czech dentistry from March 2020 to March 2021. The assessment was based on questionnaires filled out by 3674 Czech dentists representing 42.6% of practicing dentists in the country. During March-May, 2020 (the first COVID-19 wave), 90.7% of dental practices remained open; however, only 22.8% of the practices continued to operate with no changes, 46.5% had fewer patients, 21.4% treated only acute cases, and 3.8% were closed. During September 2020-May 2021 (the second wave of COVID-19), 96.1% of dental practices remained open, 60.8% operated with no changes, 34.5% had fewer patients, 0.8% treated only acute cases, and 0.5% were closed. The reasons leading to the closure of Czech dental practices during the whole pandemic were a shortage of personal protective equipment (50.5%), a COVID-19 outbreak in the workplace (24.5%), fear of a possible self-infection (24.0%), and quarantine (20.5%). The time range of Czech dental practices closure during the whole pandemic was: 1-2 weeks (49.9%), 2-4 weeks (21.2%), and >1 month (0.8%). The greatest professional difficulties of Czech dentists during the pandemic were crisis operating management (55%), health safety and hygiene concerns (21%), shortage of personal protective equipment (21%), and difficulty working with the protective equipment (15%). In addition, 47.3% of dentists also observed a declining interest in preventive dental care, and 16.9% of them observed worse oral care of patients. These results show that despite the lack of protective equipment, dental care was maintained throughout the pandemic. Additionally, the pandemic negatively affected the patients' approach to dental care, indicating a deterioration in oral health as a possible delayed outcome of the COVID-19 pandemic.
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http://dx.doi.org/10.3390/ijerph18179121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8430605PMC
August 2021

Initial Observation of Factors Interfering with the Treatment of Alveolar Osteitis Using Hyaluronic Acid with Octenidine-A Series of Case Reports.

Biomolecules 2021 08 4;11(8). Epub 2021 Aug 4.

Department of Dentistry, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolská 581, 50005 Hradec Králové, Czech Republic.

Alveolar osteitis (AO) is a common complication following the extraction of the teeth, particularly the lower third molars. It starts within a few days after the extraction and manifests mainly as pain in the extraction site. Several strategies of treatment are available in order to relieve pain and heal the extraction wound. Recently, a novel medical device combining hyaluronic acid (HA) and octenidine (OCT) was introduced for the treatment of AO. This series of case reports aims to summarize the initial clinical experiences with this new device and to highlight factors possibly interfering with this treatment. The medical documentation of five patients with similar initial situations treated for AO with HA + OCT device was analyzed in detail. Smoking and previous treatment with Alveogyl (Septodont, Saint-Maur-des-Fossés, France) were identified as factors interfering with the AO treatment with the HA + OCT device. In three patients without these risk factors, the treatment led to recovery within two or three days. The patient pretreated with Alveogyl and the smoker required six and seven applications of the HA + OCT device, respectively. According to these initial observations, it seems smoking and previous treatment with Alveogyl prolong the treatment of AO using the HA + OCT device that, in turn, shows a rapid effect if these risk factors are not present.
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http://dx.doi.org/10.3390/biom11081157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8391686PMC
August 2021

First Evidence That Nematode Communities in Deadwood Are Related to Tree Species Identity and to Co-Occurring Fungi and Prokaryotes.

Microorganisms 2021 Jul 6;9(7). Epub 2021 Jul 6.

Institute for National and International Plant Health, Julius Kühn Institute (JKI)-Federal Research Centre for Cultivated Plants, 38104 Braunschweig, Germany.

Nematodes represent a diverse and ubiquitous group of metazoans in terrestrial environments. They feed on bacteria, fungi, plants, other nematodes or parasitize a variety of animals and hence may be considered as active members of many food webs. Deadwood is a structural component of forest ecosystems which harbors many niches for diverse biota. As fungi and bacteria are among the most prominent decomposing colonizers of deadwood, we anticipated frequent and diverse nematode populations to co-occur in such ecosystems. However, knowledge about their ability to colonize this habitat is still limited. We applied DNA-based amplicon sequencing (metabarcoding) of the 18S rRNA gene to analyze nematode communities in sapwood and heartwood of decaying logs from 13 different tree species. We identified 247 nematode ASVs (amplicon sequence variants) from 27 families. Most of these identified families represent bacterial and fungal feeders. Their composition strongly depended on tree species identity in both wood compartments. While pH and water content were the only wood properties that contributed to nematodes' distribution, co-occurring fungal and prokaryotic (bacteria and archaea) α- and β-diversities were significantly related to nematode communities. By exploring thirteen different tree species, which exhibit a broad range of wood characteristics, this study provides first and comprehensive insights into nematode diversity in deadwood of temperate forests and indicates connectivity to other wood-inhabiting organisms.
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http://dx.doi.org/10.3390/microorganisms9071454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8304250PMC
July 2021

Iatrogenic Fracture of the Lower Jaw: A Rare Complication of Lower Molar Extraction.

Acta Medica (Hradec Kralove) 2021 ;64(2):101-107

Department of Dentistry, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic.

Iatrogenic mandible fracture is a rare complication of a tooth extraction with an incidence between 0.0033-0.0034%. This study retrospectively analyzes a total of 8 patients who underwent lower molar extraction associated with mandible fracture during tooth removal in the period from April 2006 to March 2019. The assessed parameters were age and sex of patients, method of tooth extraction, side distribution of fracture, type of extracted tooth, the position of a lower third molar, presence of bone pathological lesion formed in connection with a tooth, displacement of bone fragments, and sensory impairment in the innervation area of the mental nerve. The position and impaction of the lower third molars were evaluated according to Pell and Gregory's classification and Winter's classification. One fracture was left-sided, and 7 fractures were right-sided. In 6 cases, Winter's extraction elevator was used. In 7 patients, the mandible fracture was treated surgically by performing stable osteosynthesis with the plates and screws. One patient was treated conservatively. This work analyzes the causes of iatrogenic mandible fractures and provides recommendations to reduce the risk of their occurrence.
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http://dx.doi.org/10.14712/18059694.2021.18DOI Listing
September 2021

The Development of Musculoskeletal Disorders during Undergraduate Dentistry Studies-A Long-Term Prospective Study.

Int J Environ Res Public Health 2021 07 19;18(14). Epub 2021 Jul 19.

Department of Dentistry, Charles University, Faculty of Medicine in Hradec Králové, and University Hospital Hradec Králové, 500 05 Hradec Králové, Czech Republic.

Musculoskeletal disorders (MSDs) frequently occur among dental practitioners and present a significant occupational burden with an early onset in the dentists' career. This study aimed to analyze the five-year development of self-reported overall MSDs among the dentistry students during the course of their studies and to assess the possible influence of the risk as well as protective factors. The questionnaire inquiry was performed among the first-year dentistry students, regarding the occurrence of MSDs and the presence of potential risk and protective factors. The same students were followed, and they filled in the same questionnaire in the middle and at the end of their studies. A total of 73 dentistry students and 28 general medicine students participated. The occurrence of the overall MSDs statistically significantly increased from 30.1% at the beginning of the first year to 45.2% at the end of the fifth year among the dentistry students. The top-level sport was statistically significantly associated with the higher occurrence of MSDs in the fifth year and with the development of new MSDs between the first and the fifth year. This longitudinal prospective evaluation showed a significant increase in the MSDs occurrence among the dentistry students during their studies.
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http://dx.doi.org/10.3390/ijerph18147662DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8303519PMC
July 2021

A Review of Evidence-Based Recommendations for Pericoronitis Management and a Systematic Review of Antibiotic Prescribing for Pericoronitis among Dentists: Inappropriate Pericoronitis Treatment Is a Critical Factor of Antibiotic Overuse in Dentistry.

Int J Environ Res Public Health 2021 06 24;18(13). Epub 2021 Jun 24.

Department of Dentistry, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic.

This work provides a narrative review covering evidence-based recommendations for pericoronitis management (Part A) and a systematic review of antibiotic prescribing for pericoronitis from January 2000 to May 2021 (Part B). Part A presents the most recent, clinically significant, and evidence-based guidance for pericoronitis diagnosis and proper treatment recommending the local therapy over antibiotic prescribing, which should be reserved for severe conditions. The systematic review includes publications analyzing sets of patients treated for pericoronitis and questionnaires that identified dentists' therapeutic approaches to pericoronitis. Questionnaires among dentists revealed that almost 75% of them prescribed antibiotics for pericoronitis, and pericoronitis was among the top 4 in the frequency of antibiotic use within the surveyed diagnoses and situations. Studies involving patients showed that antibiotics were prescribed to more than half of the patients with pericoronitis, and pericoronitis was among the top 2 in the frequency of antibiotic use within the monitored diagnoses and situations. The most prescribed antibiotics for pericoronitis were amoxicillin and metronidazole. The systematic review results show abundant and unnecessary use of antibiotics for pericoronitis and are in strong contrast to evidence-based recommendations summarized in the narrative review. Adherence of dental professionals to the recommendations presented in this work can help rapidly reduce the duration of pericoronitis, prevent its complications, and reduce the use of antibiotics and thus reduce its impact on patients' quality of life, healthcare costs, and antimicrobial resistance development.
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http://dx.doi.org/10.3390/ijerph18136796DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8296928PMC
June 2021

The Effects of Cryogenic Storage on Human Dental Pulp Stem Cells.

Int J Mol Sci 2021 Apr 23;22(9). Epub 2021 Apr 23.

Department of Dentistry, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic.

Dental pulp stem cells (DPSCs) are a type of easily accessible adult mesenchymal stem cell. Due to their ease of access, DPSCs show great promise in regenerative medicine. However, the tooth extractions from which DPSCs can be obtained are usually performed at a period of life when donors would have no therapeutic need of them. For this reason, it is imperative that successful stem cell storage techniques are employed so that these cells remain viable for future use. Any such techniques must result in high post-thaw stem cell recovery without compromising stemness, proliferation, or multipotency. Uncontrolled-rate freezing is not a technically or financially demanding technique compared to expensive and laborious controlled-rate freezing techniques. This study was aimed at observing the effect of uncontrolled-rate freezing on DPSCs stored for 6 and 12 months. Dimethyl sulfoxide at a concentration of 10% was used as a cryoprotective agent. Various features such as shape, proliferation capacity, phenotype, and multipotency were studied after DPSC thawing. The DPSCs did not compromise their stemness, viability, proliferation, or differentiating capabilities, even after one year of cryopreservation at -80 °C. After thawing, they retained their stemness markers and low-level expression of hematopoietic markers. We observed a size reduction in recovery DPSCs after one year of storage. This observation indicates that DPSCs can be successfully used in potential clinical applications, even after a year of uncontrolled cryopreservation.
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http://dx.doi.org/10.3390/ijms22094432DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8122943PMC
April 2021

Study of the Performance of DSSS UAC System Depending on the System Bandwidth and the Spreading Sequence.

Sensors (Basel) 2021 Apr 2;21(7). Epub 2021 Apr 2.

Faculty of Electronics, Telecommunications and Informatics, Gdańsk University of Technology, G. Narutowicza 11/12, 80-233 Gdańsk, Poland.

A signal transmitted in an Underwater Acoustic Communication (UAC) system operating in a shallow-water channel suffers from strong time dispersion due to multipath propagation. This causes the Inter-Symbol Interference (ISI) observed in the received signal, which significantly limits the communication system's reliability and transmission rate. In such propagation conditions, the Direct-Sequence Spread Spectrum (DSSS) method is one of the solutions that make reliable data transmission possible. In systems with one-to-one communication, it ensures communication with a satisfactory Bit Error Rate (BER). Additionally, it makes it possible to implement the Code-Division Multiple Access (CDMA) protocol in underwater acoustic networks. This paper presents the results of simulation and experimental communication tests on a DSSS-based UAC system using three types of spreading sequence, namely m-sequences, Kasami codes and Gold codes, and occupying different bandwidths from 1 kHz to 8 kHz around a carrier frequency equal to 30 kHz. The UAC channel was simulated by impulse responses calculated by the virtual sources method and the UAC chanel models available in the Watermark simulator. The experimental tests were conducted in a model pool. Based on the obtained results, a transmission rate was estimated, which is possible to achieve in strong multipath propagation conditions, assuming reliability expressed as BER less than 0.001.
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http://dx.doi.org/10.3390/s21072484DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8038229PMC
April 2021

Does interprofessional team-training affect nurses' and physicians' perceptions of safety culture and communication practices? Results of a pre-post survey study.

BMC Health Serv Res 2021 Apr 14;21(1):341. Epub 2021 Apr 14.

Institute for Patient Safety, University Hospital of Bonn, Venusberg-Campus 1, 53127, Bonn, Germany.

Background: Many hospitals seek to increase patient safety through interprofessional team-trainings. Accordingly, these trainings aim to strengthen important key aspects such as safety culture and communication. This study was designed to investigate if an interprofessional team-training, administered to a relatively small group of nurses and physicians would promote a change in healthcare professionals' perceptions on safety culture and communication practices throughout the hospital. We further sought to understand which safety culture aspects foster the transfer of trained communication practices into clinical practice.

Methods: We conducted a pre-post survey study using six scales to measure participants' perceptions of safety culture and communication practices. Mean values were compared according to profession and participation in training. Using multiple regression models, the relationship between safety culture and communication practices was determined.

Results: Before and after the training, we found high mean values for all scales. A significant, positive effect was found for the communication practices of the physicians. Participation in the training sessions played a variably relevant role in the communication practices. In addition, the multiple regression analyses showed that specific safety culture aspects have a cross-professional influence on communication practices in the hospital.

Conclusions: This study suggest that interprofessional team-trainings of a small group of professionals can successfully be transferred into clinical practice and indicates the importance of safety culture aspects for such transfer processes. Thus, we recommend the consideration of safety culture aspects before starting a training intervention.
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http://dx.doi.org/10.1186/s12913-021-06137-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8048288PMC
April 2021

The Effect of Cultivation Passaging on the Relative Telomere Length and Proliferation Capacity of Dental Pulp Stem Cells.

Biomolecules 2021 03 20;11(3). Epub 2021 Mar 20.

Department of Dentistry, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, 500 05 Hradec Kralove, Czech Republic.

Telomeres are repetitive nucleoprotein DNA sequences that shorten with each cell division. The stem cells activate telomerase to compensate for the telomere loss. This study aimed to evaluate the effect of cultivation passaging on the relative telomere length and proliferation capacity of dental pulp stem cells. We used ten dental pulp stem cell (DPSC) lineages stored for 12 months using uncontrolled-rate freezing to reach the study's goal. We analyzed their proliferation rate, phenotype using flow cytometry, multipotency, and relative telomere length using a qPCR analysis. We determined the relative telomere length in the added study by performing analysis after one, two, and three weeks of cultivation with no passaging. We documented the telomere attrition with increasing passaging. The shorter the relative telomere length, the lower reached population doublings, and longer population doubling time were observed at the end of the cultivation. We observed the telomere prolongation in DPSCs cultivated for two weeks with no passaging in the added subsequent study. We concluded that excessive proliferation demands on DPSCs during in vitro cultivation result in telomere attrition. We opened the theory that the telomerase might be more efficient during cell cultivation with no passaging. This observation could help in preserving the telomere length during ex vivo DPSC expansion.
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http://dx.doi.org/10.3390/biom11030464DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035981PMC
March 2021

Low Molecular Weight Hyaluronic Acid Effect on Dental Pulp Stem Cells In Vitro.

Biomolecules 2020 12 28;11(1). Epub 2020 Dec 28.

Department of Dentistry, Charles University, Faculty of Medicine in Hradec Kralove and University Hospital, 500 05 Hradec Kralove, Czech Republic.

Hyaluronic acid (HA) and dental pulp stem cells (DPSCs) are attractive research topics, and their combined use in the field of tissue engineering seems to be very promising. HA is a natural extracellular biopolymer found in various tissues, including dental pulp, and due to its biocompatibility and biodegradability, it is also a suitable scaffold material. However, low molecular weight (LMW) fragments, produced by enzymatic cleavage of HA, have different bioactive properties to high molecular weight (HMW) HA. Thus, the impact of HA must be assessed separately for each molecular weight fraction. In this study, we present the effect of three LMW-HA fragments (800, 1600, and 15,000 Da) on DPSCs in vitro. Discrete biological parameters such as DPSC viability, morphology, and cell surface marker expression were determined. Following treatment with LMW-HA, DPSCs initially presented with an acute reduction in proliferation ( < 0.0016) and soon recovered in subsequent passages. They displayed significant size reduction ( = 0.0078, = 0.0019, = 0.0098) while maintaining high expression of DPSC markers (CD29, CD44, CD73, CD90). However, in contrast to controls, a significant phenotypic shift ( < 0.05; CD29, CD34, CD90, CD106, CD117, CD146, CD166) of surface markers was observed. These findings provide a basis for further detailed investigations and present a strong argument for the importance of HA scaffold degradation kinetics analysis.
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http://dx.doi.org/10.3390/biom11010022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7823925PMC
December 2020

Grazing-incidence X-ray diffraction investigation of the coincidence site lattice of the Ge/Si(001) system.

J Appl Crystallogr 2020 Oct 14;53(Pt 5):1212-1216. Epub 2020 Aug 14.

Institute of Electronic Materials and Devices, Leibniz University Hannover, Schneiderberg 32, Hannover, 30167, Germany.

The Ge/Si(001) system has been analysed by grazing-incidence X-ray diffraction on a standard laboratory X-ray diffraction tool. A periodic array of interfacial edge dislocations forms a coincidence site lattice (CSL) which yields equidistantly spaced satellite peaks close to Bragg peaks of the Ge layer and Si substrate. The diffraction behaviour of the CSL was analysed using 2θ/φ scans along [100], [110] and [310] directions as well as azimuthal φ scans which revealed a 90° angular symmetry of the CSL. Additionally, different layer thicknesses, from 10 to 580 nm, were analysed, focusing on the dependence of layer thickness on the glancing angles of the satellite peaks. This method provides the ability to analyse whether or not epitaxially grown layers exhibit a periodic array of dislocations, and gain information about the orientation of the interfacial edge dislocations.
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http://dx.doi.org/10.1107/S1600576720009255DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7534540PMC
October 2020

Irrigation and passive drainage of pancreatic stump after distal pancreatectomy in high-risk patients: an innovative approach to reduce pancreatic fistula.

Langenbecks Arch Surg 2020 Dec 21;405(8):1233-1241. Epub 2020 Oct 21.

Hirslanden Hospitals, Kappelistrasse 7, 8002, Zürich, Switzerland.

Introduction: Postoperative pancreatic fistula (POPF) represents the most common form of morbidity after distal pancreatectomy (DP). The aim of this study was to illustrate an innovative technique of irrigation and passive drainage to reduce clinically relevant POPF (CR-POPF) incidence in high-risk patients undergoing DP.

Material And Methods: Twelve consecutive high-risk patients received irrigation and passive drainage of the pancreatic stump with a Salem sump drainage after DP. The Salem sump was irrigated with 100 ml/h of Ringer solution for 2 postoperative days (POD). In the case of low-drain amylase and lipase levels on POD 3, the irrigation was reduced to 50 ml/h. Persistence of low-drain pancreatic enzymes on POD 4 allowed for interruption of irrigation and subsequent removal of drainage from POD 7 onward in the absence of evidence of any pancreatic fistula.

Results: Overall, 16.6% of the patients experienced a grade 3 or higher surgical complication. We experienced only one case of POPF: the fistula was classified as grade B and it was managed with radiologic drainage of the fluid collection. We did not experience any case of re-operation nor in-hospital mortality.

Conclusions: Irrigation with passive drainage of the pancreatic stump after DP is an interesting approach for CR-POPF prevention in high-risk patients.
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http://dx.doi.org/10.1007/s00423-020-02012-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7686191PMC
December 2020

Structural mechanism for replication origin binding and remodeling by a metazoan origin recognition complex and its co-loader Cdc6.

Nat Commun 2020 08 26;11(1):4263. Epub 2020 Aug 26.

Department of Molecular Biophysics and Biochemistry, Yale University, 260 Whitney Avenue, New Haven, CT, 06520, USA.

Eukaryotic DNA replication initiation relies on the origin recognition complex (ORC), a DNA-binding ATPase that loads the Mcm2-7 replicative helicase onto replication origins. Here, we report cryo-electron microscopy (cryo-EM) structures of DNA-bound Drosophila ORC with and without the co-loader Cdc6. These structures reveal that Orc1 and Orc4 constitute the primary DNA binding site in the ORC ring and cooperate with the winged-helix domains to stabilize DNA bending. A loop region near the catalytic Walker B motif of Orc1 directly contacts DNA, allosterically coupling DNA binding to ORC's ATPase site. Correlating structural and biochemical data show that DNA sequence modulates DNA binding and remodeling by ORC, and that DNA bending promotes Mcm2-7 loading in vitro. Together, these findings explain the distinct DNA sequence-dependencies of metazoan and S. cerevisiae initiators in origin recognition and support a model in which DNA geometry and bendability contribute to Mcm2-7 loading site selection in metazoans.
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http://dx.doi.org/10.1038/s41467-020-18067-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7450096PMC
August 2020

Performance of a convolutional neural network derived from an ECG database in recognizing myocardial infarction.

Sci Rep 2020 05 21;10(1):8445. Epub 2020 May 21.

Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University Düsseldorf, Duesseldorf, Germany.

Artificial intelligence (AI) is developing rapidly in the medical technology field, particularly in image analysis. ECG-diagnosis is an image analysis in the sense that cardiologists assess the waveforms presented in a 2-dimensional image. We hypothesized that an AI using a convolutional neural network (CNN) may also recognize ECG images and patterns accurately. We used the PTB ECG database consisting of 289 ECGs including 148 myocardial infarction (MI) cases to develop a CNN to recognize MI in ECG. Our CNN model, equipped with 6-layer architecture, was trained with training-set ECGs. After that, our CNN and 10 physicians are tested with test-set ECGs and compared their MI recognition capability in metrics F1 (harmonic mean of precision and recall) and accuracy. The F1 and accuracy by our CNN were significantly higher (83 ± 4%, 81 ± 4%) as compared to physicians (70 ± 7%, 67 ± 7%, P < 0.0001, respectively). Furthermore, elimination of Goldberger-leads or ECG image compression up to quarter resolution did not significantly decrease the recognition capability. Deep learning with a simple CNN for image analysis may achieve a comparable capability to physicians in recognizing MI on ECG. Further investigation is warranted for the use of AI in ECG image assessment.
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http://dx.doi.org/10.1038/s41598-020-65105-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242480PMC
May 2020

Ultra-thin passivation layers in Cu(In,Ga)Se thin-film solar cells: full-area passivated front contacts and their impact on bulk doping.

Sci Rep 2020 May 5;10(1):7530. Epub 2020 May 5.

University of Luxembourg, Laboratory for Photovoltaics, Department of Physics and Materials Science, 41 rue du Brill, L-4422, Belvaux, Luxembourg.

In the search for highly transparent and non-toxic alternative front layers replacing state-of-the-art CdS in Cu(In,Ga)Se thin-film solar cells, alternatives rarely exceed reference devices in terms of efficiency. Full-area ultra-thin aluminium oxide tunnelling layers do not require any contact patterning and thus overcome the main drawback of insulating passivation layers. Even a few monolayers of aluminium oxide can be deposited in a controlled manner by atomic layer deposition, they show excellent interface passivation properties, low absorption, and suitable current transport characteristics on test devices. Depositing a ZnO-based transparent front contact, however, results in extremely poor solar cell performance. The issue is not necessarily a low quality of the alternative front layer, but rather the intricate relation between front layer processing and electronic bulk properties in the absorber layer. We identify three challenges critical for the development of novel front passivation approaches: (i) both Cd and Zn impurities beneficially reduce the high native net dopant concentration in the space charge region, (ii) sputter deposition of ZnO damages the passivation layer resulting in increased interface recombination, (iii) thermal treatments of devices with ZnO layer result in substantial Zn diffusion, which can penetrate the full absorber thickness already at moderate temperatures.
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http://dx.doi.org/10.1038/s41598-020-64448-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7200765PMC
May 2020

Clinical significance of precedent asymptomatic non-sustained ventricular tachycardias on subsequent ICD interventions and heart failure hospitalization in primary prevention ICD patients.

Eur J Med Res 2020 Mar 17;25(1). Epub 2020 Mar 17.

Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, Moorenstrasse 5, 40225, Düsseldorf, Germany.

Background: The prognostic implications of non-sustained ventricular tachycardia (NSVT) and their significance as therapeutic targets in patients without prior sustained ventricular arrhythmias remain undetermined. The aim of this study was to investigate the prognostic significance of asymptomatic NSVT in patients who had primary prevention implantable cardioverter-defibrillator (ICD) implantation due to ischemic or non-ischemic cardiomyopathy (ICM, NICM).

Methods: We enrolled 157 consecutive primary prevention ICD patients without previous appropriate ICD therapy (AIT). Patients were allocated to two groups depending on the presence or absence of NSVT in a 6-month period prior to enrollment. The incidence of AIT and unplanned hospitalization due to decompensated heart failure (HF) were assessed during follow-up.

Results: In 51 patients (32%), precedent NSVT was documented. During a median follow-up of 1011 days, AIT occurred in 36 patients (23%) and unplanned HF hospitalization was observed in 32 patients (20%). In precedent NSVT patients, the incidence of AIT and unplanned HF hospitalization was significantly higher as compared to patients without precedent NSVT (AIT: 29/51 [57%] vs. 7/106 [7%], P < 0.001, log-rank; HF hospitalization: 16/51 [31%] vs. 16/106 [15%], P = 0.043, log-rank). Cox-regression demonstrated that precedent NSVT independently predicted AIT (P < 0.0001). In subgroup analyses, precedent NSVT predicted AIT in both ICM and NICM (P < 0.0001, P = 0.020), but predicted HF hospitalization only in patients with ICM (P = 0.0030).

Conclusions: Precedent non-sustained VT in patients with primary prevention ICDs is associated with subsequent appropriate ICD therapies, and is an independent predictor of unplanned heart failure hospitalizations in patients with ischemic cardiomyopathy.
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http://dx.doi.org/10.1186/s40001-020-0401-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7076933PMC
March 2020

Usefulness of Serum Free Thyroxine Concentration to Predict Ventricular Arrhythmia Risk in Euthyroid Patients With Structural Heart Disease.

Am J Cardiol 2020 04 29;125(8):1162-1169. Epub 2020 Jan 29.

Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany; Cardiovascular Research Institute Düsseldorf (CARID), Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany. Electronic address:

The aim of the present study was to determine whether free thyroxine (FT4) and calculated thyroid parameters predict the incidence of ventricular arrhythmias in euthyroid heart failure patients with implantable cardioverter-defibrillators (ICD). In this open-label prospective cohort study, 115 consecutive euthyroid patients (mean age 62.9 ± 1.3 years; 87% male; ischemic cardiomyopathy 63%) scheduled for primary prevention ICD implantation or exchange were enrolled. Serum concentrations of thyrotropin (thyroid-stimulating hormone) and FT4 were measured 1 day before device operation. Primary and secondary end points were defined as occurrence of appropriate ICD therapy (AIT) and cardiovascular death, respectively. During a mean follow-up of 1,191 ± 35 days, 24 patients (21%) experienced AIT, and cardiovascular death was observed in 10 patients (9%). Patients with AIT had higher FT4 concentrations compared with those without AIT (18.9 ± 0.48 vs 16.2 ± 0.22 pmol/L, p <0.001). FT4 was an independent predictor of AIT in an adjusted Cox regression (hazard ratio = 1.47, p <0.001). Kaplan-Meier analysis demonstrated that Jostel's thyroid-stimulating hormone index, reflecting the central component of the hypothalamus-pituitary-thyroid loop, and SPINA-GT as surrogate markers for thyroid's secretory capacity predicted AIT incidences. None of the indices predicted cardiovascular death. In conclusion, FT4 concentration predicts an increased incidence of ventricular arrhythmias in euthyroid patients receiving ICDs for primary prevention. Our data suggest that both impending primary hyperthyroidism and an increased thyroid homeostasis set point may increase the rate of AIT in this patient population.
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http://dx.doi.org/10.1016/j.amjcard.2020.01.019DOI Listing
April 2020

Hyaluronic Acid-Based Medical Device for Treatment of Alveolar Osteitis-Clinical Study.

Int J Environ Res Public Health 2019 10 1;16(19). Epub 2019 Oct 1.

Department of Dentistry, Charles University - Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolská 581, 500 05 Hradec Králové, Czech Republic.

Alveolar Osteitis (AO) is a complication following the extraction of a tooth. AO manifests through localized pain in, and around, the extraction site, where the post-operative blood clot has been disintegrated. The aim of this single cohort study was to evaluate the outcome of a treatment of AO, using a pharmacological device composed of hyaluronic acid and octenidine dihydrochloride. The tested device is a sponge-like material, composed solely of a fully dissoluble medicaments (hyaluronic acid, calcium chloride, and octenidine dihydrochloride). It was designed to serve as a non-toxic, slow-dissolving antiseptic, that adheres to mucosa and obturates the wound. This study includes 58 subjects who were diagnosed with AO. The tested device was administered once daily until local pain subsided to < 20 mm of the Visual Analog Scale (VAS). The treatment was considered effective when the pain subsided to < 20 mm VAS in < 8 days of treatment; as per comparative studies. Our findings provide a statistically significant success rate of 96.0% (95.0% confidence interval of 75.75% to 97.8%) after pharmacological device administrations. No adverse medical effects were detected. Acquired data confirmed that lyophilized hyaluronic acid, combined with octenidine, is effective for the treatment of AO. The results are clinically important as AO is a common complication after third molar extractions.
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http://dx.doi.org/10.3390/ijerph16193698DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801692PMC
October 2019

Diagnostic Nodes of Patient Selection for Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy Among Colorectal Cancer Patients: A Swiss National Multicenter Survey.

Clin Colorectal Cancer 2019 12 26;18(4):e335-e342. Epub 2019 Jun 26.

Department of Radiation Oncology, Kantonsspital St Gallen, St Gallen, Switzerland.

Background: The management of patients with colorectal cancer (CRC) with peritoneal metastases is challenging, and the roles of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are unclear and debated among experts.

Materials And Methods: The experts of the Swiss Peritoneal Cancer Group were contacted and agreed to participate in this analysis. Experts from 9 centers in Switzerland provided their decision algorithms for CRS/HIPEC for patients with or at high risk for peritoneal metastases from CRC. Their responses were converted into decision trees on the basis of objective consensus methodology. The decision trees were used as a basis to identify consensus and discrepancies.

Results: The final treatment algorithms included a total of 5 decision criteria (age, Peritoneal Cancer Index [PCI], extraperitoneal metastases, Peritoneal Surface Disease Severity Score, and various risk factors [RF]) and 2 treatment options (HIPEC, yes or no). HIPEC was never recommended for patients without peritoneal metastases in the absence of RF for peritoneal metastases. For patients with a PCI ≤15 without organ metastases, all centers recommended CRS/HIPEC. There was also a consensus not to perform CRS/HIPEC in elderly patients (80 years and older), those with a PCI >20, and those with unresectable metastases. For patients with a PCI = 16 to 20, there was no consensus.

Conclusion: Multiple decision criteria relevant to all participating centers were identified. Because patient selection for CRS/HIPEC remains difficult, uniform criteria for the term "high risk" for peritoneal metastases and systemic metastases are helpful. Future trials and guidelines should take these criteria into account.
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http://dx.doi.org/10.1016/j.clcc.2019.06.002DOI Listing
December 2019

Clinical safety of the ProMRI implantable cardioverter-defibrillator systems during head and lower lumbar magnetic resonance imaging at 3 T: results of the ProMRI 3T ENHANCED Master study.

Europace 2019 Nov;21(11):1678-1685

Instituts für Diagnostische und Interventionelle Radiologie, Georg-August-Universität, Robert-Koch-Str. 40, Göttingen, Germany.

Aims: There have been no published studies on the safety of magnetic resonance imaging (MRI) at 3 Tesla (3 T) in patients with MRI-conditional implantable cardioverter-defibrillators (ICDs). The aim of this study was to assess clinical safety of the Biotronik ProMRI ICD system during non-diagnostic head and lower lumbar scans under 3 T MRI conditions.

Methods And Results: The study enrolled 129 patients at 12 sites in Australia, Singapore, and Europe. Predefined head and lower lumbar MR scans (total duration ≈30 min) were performed in 112 patients. Three primary endpoints were evaluated from the pre-MRI to the 1-month post-MRI visit: (i) freedom from serious adverse device effects (SADEs) related to MRI (hypothesized to be >90%); (ii) pacing threshold invariance for all leads (geometric mean of the patient-wise ratios for 1 month vs. pre-MRI was hypothesized to be <1.07); and (iii) sensing amplitude invariance (geometric mean of the ratios was hypothesized to be >0.993). No MRI-related SADE occurred (SADE-free rate 100%, 95% confidence interval 95.98-100%). Pacing threshold and sensing amplitudes fulfilled the invariance hypotheses with high statistical significance (P < 0.0013). No threshold increase >0.5 V or sensing amplitude decrease by >50% was observed (secondary endpoints). Lead impedances, battery capacity, and detection and treatment of arrhythmias by ICDs were not affected by MRI scans.

Conclusion: The head and lower lumbar scans under specific 3 T MRI conditions were safe in the investigated MR-conditional ICD systems. There was no evidence of harm to the patients or any negative influence of the MRI scan on the implanted systems.
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http://dx.doi.org/10.1093/europace/euz189DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6826205PMC
November 2019

Improved surface passivation and reduced parasitic absorption in PEDOT:PSS/c-Si heterojunction solar cells through the admixture of sorbitol.

Sci Rep 2019 Jul 5;9(1):9775. Epub 2019 Jul 5.

Institute for Solar Energy Research Hamelin (ISFH), Am Ohrberg 1, 31860, Emmerthal, Germany.

We examine the impact of sorbitol admixture to the hole-conduction polymer PEDOT:PSS [poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate)] on the characteristics of PEDOT:PSS/crystalline silicon heterojunction solar cells. We fabricate solar cells where the PEDOT:PSS layer is deposited as a hole-collecting contact at the cell rear, whereas the electron-collecting front is conventionally processed by means of phosphorus diffusion. Surprisingly, we observe that the admixture of the infrared-transparent sorbitol not only improves the short-circuit density of the solar cells due to the reduction of the infrared parasitic absorption, but also improves the passivation quality of PEDOT:PSS on silicon and hence the open-circuit voltage of the solar cells. The series resistance is not influenced by the admixture of sorbitol up to 4.0 wt.% sorbitol admixture in the PEDOT:PSS dispersion, but shows a pronounced increase for larger sorbitol contents. The optimal sorbitol content concerning efficiency is hence 4.0 wt.%, leading to an energy conversion efficiency of 20.4% at one sun, which is more than 1% absolute higher compared to the efficiency of the reference cells without sorbitol.
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http://dx.doi.org/10.1038/s41598-019-46280-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6611827PMC
July 2019

Cover crops and compost prevent weed seed bank buildup in herbicide-free wheat-potato rotations under conservation tillage.

Ecol Evol 2019 Mar 7;9(5):2715-2724. Epub 2019 Feb 7.

Group of Ecological Plant Protection University of Kassel Witzenhausen Germany.

Weeds are a major constraint affecting crop yields in organic farming and weed seed bank analysis can be an important tool for predicting weed infestation and assessing farming system sustainability.We compared the weed seed banks two and four years after transition from conventional to reduced tillage in organically managed winter wheat-potato cropping sequences in two replicated field trials. Experimental factors were either conventional (CT) with moldboard (25 cm) or reduced tillage (RT) with chisel ploughing (5-15 cm). Dead mulch (8-10 cm), consisting of rye-pea or triticale-vetch mixtures, was additionally applied to potatoes in the RT system. In both systems, one-half of the plots received 5 t (ha/year) dry matter of a commercially sold yard waste compost as an organic amendment. Furthermore, subsidiary crops were grown in both systems, either as legume living mulches undersown in wheat or as cover crops sown after wheat. Prior to sowing the wheat and after potatoes, the soil seed bank from 0 to 12.5 and from 12.5 to 25 cm was sampled and assessed in an unheated glasshouse over nine months.The initial weed seed bank size in the topsoil was uniform (4,420 seedlings m). Two years later, wheat-associated weeds, such as spp., and were 61% higher on average in RT than in CT. This was independent of subsidiary crops used. In contrast, a potato-associated weed that depends on intensive tillage, was reduced by 15% in the mulched RT system compared to CT. When RT was combined with cover crops and compost application, the seed bank did not differ significantly from the CT system.We conclude that subsidiary crops, mulches, and potentially compost are important management tools that contribute to the success of RT in herbicide-free cereal-based systems in temperate climates.
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http://dx.doi.org/10.1002/ece3.4942DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6405492PMC
March 2019

Influence of nanostructure formation on the crystal structure and morphology of epitaxially grown GdO on Si(001).

Acta Crystallogr B Struct Sci Cryst Eng Mater 2019 Feb 23;75(Pt 1):59-70. Epub 2019 Jan 23.

Institute of Electronic Materials and Devices, Leibniz Universität Hannover, Schneiderberg 32, Hannover, 30167, Germany.

The influence of growth conditions on the layer orientation, domain structure and crystal structure of gadolinium oxide (GdO) on silicon (001) has been investigated. GdO was grown at low (250°C) and high (850°C) temperatures with different oxygen partial pressure as well as a temperature ramp up during growth. At low temperature, the cubic bixbyite type of crystal structure with space group Ia{\bar 3} was grown at low oxygen partial pressure. The layers consist of two domains oriented orthogonal to each other. The epitaxial relationships for the two domains were found to be GdO(110)[001]||Si(001)[110] and GdO(110)[001]||Si(001)[{\bar 1}10], respectively. Applying additional oxygen during growth results in a change in crystal and domain structures of the grown layer into the monoclinic SmO-type of structure with space group C2/m with (20\bar 1) orientation and mainly two orthogonal domains with the epitaxial relationship GdO(20\bar 1)[010]||Si(100)〈110〉 and a smooth surface morphology. Some smaller areas have two intermediate azimuthal orientations between these variants, which results in a six-domain structure. The change in crystal structure can be understood based on the Gibbs-Thomson effect caused by the initial nucleation of nanometre-sized islands and its variation in diameter with a change in growth conditions. The crystal structure remains stable even against a temperature ramp up during growth. The layers grown at high temperature exhibit a nanowire-like surface morphology, where the nanowires have a cubic crystal structure and are aligned orthogonal to each other along the 〈110〉 in-plane directions. An increase in oxygen supply results in a reduced length and increased number of nanowires due to lower adatom mobility. The results clearly indicate that both kinetic and thermodynamic factors have a strong impact on the crystal structure, epitaxial relationship and morphology of the grown layers.
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http://dx.doi.org/10.1107/S2052520618017869DOI Listing
February 2019

Characteristics of Human Natal Stem Cells Cultured in Allogeneic Medium.

Braz Dent J 2018 Sep-Oct;29(5):427-434

Department of Histology and Embryology, Charles University, Faculty of Medicine in Hradec Králové, Czech Republic.

Recently, human natal dental pulp stem cells (hNDP-SCs) have been characterized in vitro and it has been shown that they satisfy criteria defining human mesenchymal stromal cells (MSCs), as proposed by the International Society for Cellular Therapy. However, these results were reached in the presence of xenogeneic expansion medium, which has the potential to alter the cells' functional capacity. To determine the validity of the previously reported hNDP-SCs characteristics for human cell therapy, we have cultured hNDP-SCs in allogeneic expansion medium. Two hNDP-SC lineages were isolated from vital natal teeth, donated by a healthy newborn female and cultured in 2% platelet rich plasma (PRP). Analysis of the phenotypic expressions, proliferation rates, viability, telomerase length and in vitro adipogenic, osteogenic and chondrogenic differentiation potentials of two hNDP-SCs lineages (Zn001 and Zn002) were performed. Both lineages displayed similar morphology, proliferation rates, adipogenic, chondrogenic and osteogenic differentiation potential. Telomere shortening by 41.0% and 13.49% occurred from 3rd till 14th passage for lineages Zn001 and Zn002 respectively. Viability of both lineages was higher than 90%. Flow cytometry demonstrated that both lineages were positive to the majority of tested markers, including markers, which were negatively, expressed when hNDP-SCs were cultured previously in xenogeneic medium. Using immune-cytochemistry the cells were shown to express beta III-tubulin, nestin, neurofilaments and Nanog. PRP used as allogeneic medium is suitable for cultivation of hNDP-SCs.
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http://dx.doi.org/10.1590/0103-6440201802388DOI Listing
April 2019

Avoiding inappropriate therapy of single-lead implantable cardioverter-defibrillator by using atrial-sensing electrodes.

J Cardiovasc Electrophysiol 2018 12 5;29(12):1682-1689. Epub 2018 Oct 5.

Department of Cardiology, Pulmonology, and Vascular Medicine, Medical Faculty of the Heinrich Heine University Düsseldorf, Düsseldorf, Germany.

Introduction: The single-chamber implantable cardioverter-defibrillator (ICD) can be associated with more frequent inappropriate therapies compared with dual-chamber ICDs, when they are accompanied by a simpler implantation procedure. The aim of this study was to investigate whether the use of a single-lead ICD system with atrial-sensing electrodes results in a reduction of inappropriate ICD therapy.

Methods And Results: The study population consisted of 212 consecutive patients, who underwent primary prophylactic single-lead ICD implantation at our institute. A ventricular lead with atrial-sensing electrodes was implanted in 77 patients (36%; Group-VDD) and a ventricular lead without atrial-sensing electrodes was implanted in 135 patients (64%; Group-VVI). Procedural and follow-up data were collected in a prospective registry. A higher prevalence of atrial fibrillation was present in Group-VDD. There were no other significant differences in patient baseline characteristics (age, sex, and other comorbidities) or follow-up period between the two groups. The operative parameters including fluoroscopic burden showed no significant differences between Group-VDD and Group-VVI. During a mean follow-up period of 697 ± 392 days, 26 patients (12%) experienced appropriate ICD therapies and 13 patients (6%) suffered inappropriate ICD therapies. The incidence of inappropriate ICD therapies in Group-VDD was significantly lower as compared to that of Group-VVI (1/77 [1%] vs 12/135 [9%]; log-rank, P = 0.028). The incidence of appropriate ICD therapies and the occurrence of device-related complications showed no significant difference between the two groups.

Conclusion: Single-lead ICD with atrial-sensing electrodes shows a lower incidence of inappropriate ICD therapy compared with the absence of atrial-sensing electrodes, without additional operative burden or increased complications.
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http://dx.doi.org/10.1111/jce.13736DOI Listing
December 2018

Fluoroscopy integrating technology in a 3D mapping system during ablation of atrial arrhythmias: first experiences.

Arch Med Sci 2018 Jun 23;14(4):794-800. Epub 2016 Aug 23.

Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University, Medical Center Düsseldorf, Düsseldorf, Germany.

Introduction: Ablation of the cavotricuspid isthmus (CTI) in patients with atrial flutter (AFL) and pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) are both common therapies. As the demand for ablative treatments rises, total radiation exposure times of staff increase concomitantly. Here, we report on our first experiences with a new fluoroscopy integrating system (FIS) integrated into a current 3D mapping system (3DMS).

Material And Methods: The study population consisted of 59 consecutive patients who underwent PVI or CTI ablation (26 and 33 patients with and without FIS respectively). Total procedure time (PT), fluoroscopy exposure time (FT) and dose-area product (DAP) were monitored.

Results: All procedures were successfully completed without major complications. Employing FIS in the PVI group, FT and DAP were both significantly reduced after completing a short learning curve of 6 cases (respectively 361.6 ±181 s vs. 530.3 ±156.7 s, = 0.039; 801.9 ±439.15 cGycm² vs. 1495 ±435.2 cGycm², = 0.002). Mean PT was not significantly affected (121 ±26.7 min vs. 135.6 ±23.2 min, = 0.21). The same holds true for CTI ablation: FT (99.29 ±51.4 s vs. 153.9 ±76.6 s, = 0.022) and DAP (269 ±128.7 cGycm² vs. 524.3 ±288.4 cGycm², = 0.002) were significantly reduced, leaving PT not significantly affected (29.5 ±10 min vs. 35.2 ±16.3 min, = 0.23).

Conclusions: The introduction of the new FIS with a current 3DMS results in a significant reduction of both the total FT and DAP without affecting PT. The initial learning curve for adopting this method is considerably short.
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http://dx.doi.org/10.5114/aoms.2016.61944DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6040117PMC
June 2018

Higher-Order Inter-chromosomal Hubs Shape 3D Genome Organization in the Nucleus.

Cell 2018 07 7;174(3):744-757.e24. Epub 2018 Jun 7.

Division of Biology and Biological Engineering, California Institute of Technology, Pasadena, CA 91125, USA. Electronic address:

Eukaryotic genomes are packaged into a 3-dimensional structure in the nucleus. Current methods for studying genome-wide structure are based on proximity ligation. However, this approach can fail to detect known structures, such as interactions with nuclear bodies, because these DNA regions can be too far apart to directly ligate. Accordingly, our overall understanding of genome organization remains incomplete. Here, we develop split-pool recognition of interactions by tag extension (SPRITE), a method that enables genome-wide detection of higher-order interactions within the nucleus. Using SPRITE, we recapitulate known structures identified by proximity ligation and identify additional interactions occurring across larger distances, including two hubs of inter-chromosomal interactions that are arranged around the nucleolus and nuclear speckles. We show that a substantial fraction of the genome exhibits preferential organization relative to these nuclear bodies. Our results generate a global model whereby nuclear bodies act as inter-chromosomal hubs that shape the overall packaging of DNA in the nucleus.
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http://dx.doi.org/10.1016/j.cell.2018.05.024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6548320PMC
July 2018

Serum Caspase-Cleaved Cytokeratin (M30) Indicates Severity of Liver Dysfunction and Predicts Liver Outcome.

Ann Transplant 2018 Jun 8;23:393-400. Epub 2018 Jun 8.

Department of General, Visceral, and Transplant Surgery, University of Heidelberg, Heidelberg, Germany.

BACKGROUND The Model for End-Stage Liver Disease (MELD) score is a well-established tool for assessing hepatic failure. The present retrospective study investigated whether serum keratin 18 (M65) and caspase-cleaved cytokeratin (M30) were associated with liver dysfunction and post-transplant graft failure. MATERIAL AND METHODS A total of 147 patients with liver cirrhosis were categorized into 2 groups according to their baseline MELD score (group I: MELD score <20, n=87, and group II: MELD score ≥20, n=60). Serum M65 and M30 levels were measured by ELISA. RESULTS Cirrhotic patients had significantly higher serum M65 and M30 levels than healthy controls (p<0.0001). Serum M65 was correlated with the MELD score and serum bilirubin (p≤0.007) and serum M30 was correlated with the MELD score, international normalized ratio, and serum bilirubin (p≤0.001). Group II had significantly higher serum M65 and M30 levels than group I (M65, p=0.025 and M30, p<0.001). Patients who lost the allograft during the first post-transplant year had significantly higher serum M30 levels than patients with a graft survival of >1 year (p=0.004). In the regression analysis, serum M30 was associated with the MELD score (odds ratio [OR]=2.545, p=0.005), serum bilirubin (OR=2.605, p=0.005) and 1-year graft loss (OR=3.61, p=0.006). CONCLUSIONS Our data indicate that serum M30 levels reflect the degree of liver dysfunction and can predict 1-year graft loss.
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http://dx.doi.org/10.12659/AOT.908031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248295PMC
June 2018

Reduced heart rate response after premature ventricular contraction depending on severity of atrial fibrillation symptoms - Analysis on heart rate turbulence in atrial fibrillation patients.

Int J Cardiol Heart Vasc 2018 Mar 26;18:33-38. Epub 2018 Feb 26.

Division of Cardiology, Respiratory and Vascular Medicine, University Duesseldorf, Medical Faculty, Moorenstr. 5, 40225 Duesseldorf, Germany.

Background: The severity of symptoms during atrial fibrillation (AF) may be influenced by heart rate and blood pressure variation, due to irregular beats and the related adaptations in baroreflex sensitivity. This study investigated whether heart rate turbulence (HRT) as a reflection of baroreflex sensitivity is related to symptom severity during AF.

Method: Ninety-seven patients (pts) who underwent electrophysiological study were enrolled. Consecutive 56 pts had paroxysmal AF (21 with milder symptoms [EHRA I or II; Group-M], 35 with severe symptoms [EHRA III or IV; Group-S]), and 41 age-matched controls without AF were included. After delivering a single ventricular extrastimulus during sinus rhythm and repeating the process 10 times, the quantification of HRT was performed by measuring turbulence onset (TO: heart rate acceleration) and turbulence slope (TS: rate of heart rate deceleration).

Results: Group-M pts showed significantly diminished TO as compared to controls and Group-S pts (P = 0.012). There was no significant difference of the TS between the 3 groups. Given that a TO ≥ 0% or TS ≤ 2.5 ms/RR was considered abnormal, Group-M pts showed significantly higher incidences of abnormal HRT as compared to controls and Group-S pts (71% vs 40% vs 21%, respectively, P = 0.0012). Regression analysis demonstrated an independent and significant association between a diminished TO and milder AF symptoms (P < 0.05).

Conclusions: The usual heart rate acceleration after premature ventricular contraction is significantly diminished in pts with milder AF symptoms as compared to pts with severe AF symptoms. The mechanism of association between this diminished response and symptoms should be further investigated.
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http://dx.doi.org/10.1016/j.ijcha.2018.02.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5988479PMC
March 2018
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