Publications by authors named "Stefanie Walter"

15 Publications

  • Page 1 of 1

Tumor patients' fears and worries and perceived changes of specific attitudes, perceptions and behaviors due to the COVID-19 pandemic are still relevant.

J Cancer Res Clin Oncol 2021 Jun 6;147(6):1673-1683. Epub 2021 Mar 6.

Department of Otolaryngology, Palliative Care Unit, Südharz Klinikum Nordhausen, Nordhausen, Germany.

Objective: During the COVID-19 pandemic, tumor patients not only perceived fears and worries but were experiencing also positive changes as the perception of nature and silence, moments of wondering awe, and more intense relationships. We intended to analyze whether these perceptions may differ between patients from waves 1 and 2 of the pandemic.

Methods: Cross-sectional study at two time periods (May to June, sample 1) and September to November 2020 (sample 2) with standardized questionnaires (i.e. WHO-5, MLQ, PCQ-12).

Results: Patients from sample 1 (n = 292) and sample 2 (n = 221) did not differ with respect to gender, age, partner or tumor status. Most are still "irritated by statements about danger and course of the infection" (58%) and are "worrying to be infected and to have complicated course of disease" (55%). Neither their well-being nor meaning in life nor fears and worries were significantly different. In sample 2 patients, Worrying reflections and loneliness scored significantly lower, while their Perception of nature and silence was lower in trend only; more intense relationships are still relevant. Moments of wondering awe and religious trust were perceived less often during wave 2. Particularly religious patients scored stronger for Perception of nature and silence and Worrying reflections and loneliness.

Conclusion: Oncologists/psychologist have to know that patients' situation has not changed within the time of pandemic and that they still require information, close support and encouragement to rely on their resources to cope. Perceived changes are reflecting coping strategies that could be trained to increase patients' resilience during further pandemic waves.
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http://dx.doi.org/10.1007/s00432-021-03573-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7936591PMC
June 2021

Take care or "German Angst"? Lessons from cancer care during COVID-19 pandemic in spring 2020.

J Cancer Res Clin Oncol 2021 Jan 2. Epub 2021 Jan 2.

Department of Hematooncology, University Hospital, Jena, Germany.

Objective: While the second wave of COVID-19 has started in Europe, data are still missing on the consequences of the first one for patients with cancer. The aim of our study was to learn more about the experiences of German patients and staff in the oncology services.

Materials And Methods: An anonymous online survey was conducted among cancer patients and their therapists (physicians, medical staff, psychologists, spiritual care givers) in Germany between April and May 2020 asking about burden, fears, and perceived changes in German oncology service system. Besides answer frequencies of different stakeholders, uni- and multivariate analyses were performed for selected items to identify areas of high impact.

Results: In total 752 participants were included. All groups have identified high mental burden as central problem. A majority was confused about varying information policies and strategies against the pandemic. Patient reported restricted visits, isolation and delay of treatment as central fears and problems. The majority of fears could be coped by the health care workers. The patients describe processes at the oncology services during the first wave. Personal experiences with COVID-19 have had no influence on the felt burden of the patients. Physicians, medical staff, psychologists and spiritual care givers were extremely stressed but repressed their own burden. They await financial, physical and mental problems for their own future.

Conclusions: The presented personal views and experiences allow focusing the discussions about heath care systems during the on-going pandemic. Support for health care workers, as much routine as possible in oncology services, and transparency in information will be the keys for good management in futural situations of crisis.
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http://dx.doi.org/10.1007/s00432-020-03492-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776312PMC
January 2021

Assessment of Self-Efficacy as a Way to Help Identify Cancer Patients Who Might Benefit from Self-Help Group Attendance?

Cancer Invest 2021 Feb 6;39(2):133-143. Epub 2021 Jan 6.

Klinik für Innere Medizin, Universitätsklinikum Jena, Jena, Germany.

Participating in patient self-help groups is highly recommended to patients in cancer care. Yet, engagement is relatively rare. A total of 253 patients participated in our study conducted as a paper-and-pencil questionnaire. A binominal logistic regression, with interest in participation in self-help groups being the dependent variable, was run. General interest in self-help was high among the respondents. Female gender, higher age, higher education and low self-efficacy were found to significantly predict interest in self-help. Patients reported a lack of information provided by medical professionals. Self-efficacy as a predictor might contribute to characterizing patients who might benefit from self-help group participation.
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http://dx.doi.org/10.1080/07357907.2020.1867996DOI Listing
February 2021

[Oncology Services for Patients with Head Neck Cancer during Corona-Times - Patients' Perspective].

Laryngorhinootologie 2021 02 14;100(2):104-110. Epub 2020 Dec 14.

Professur für Lebensqualität, Spiritualität und Coping, Universität Witten-Herdecke, Witten, Germany.

Objective: COVID-19 pandemic has impact on the oncology service system for tumor patients. What is the view of head and neck cancer patients (HNC) on this situation and which coping strategies were developed?

Material & Methods: In study 1 PRIO asked 433 tumor patients regarding their impressions/fears during the lockdown between April 15 and May 15, 2020 (online, standardized questionnaire). In 2 study 292 tumor patients reported their pandemic-induced perceived changes and coping strategies by established questionnaires (WHO-5, MLQ, GrAw-7). An analysis of the HNC-data obtained by standardized questionnaires was performed.

Results: Study 1 had 91 HNC, study 2-84 HNC. Study 1 shows high stress levels for the majority of HNC (53,8 %). Personal fears regarding the own disease and therapies (39.6 %) are a central problem. The participants await physical (24.7 %) as well as psychological (21.3 %) consequences due to the pandemic and its current management. During the lockdown the isolation (banned visitors at any hospital) was discussed as critical main point by 58.5 % of HNC patients. Study 2 (after lockdown) underlined the mental stress caused by pandemic. Intensified relations within the families (58/100 points) as well as more intensive experience of nature and silence (58/60 points) are the most perceived changes in corona-times. HNC showed increased own inactivity (MLQ) and depressed well-being (WHO-5) and attention to the moment (GrAw-7).

Conclusions: HNC patients have had high burden and fears due to the COVID-19 pandemic in spring 2020. Their views are important for further strategies to organize and stabilize the oncology service system during further pandemic periods.
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http://dx.doi.org/10.1055/a-1327-4234DOI Listing
February 2021

Tumor Patients´ Perceived Changes of Specific Attitudes, Perceptions, and Behaviors Due to the COVID-19 Pandemic and Its Relation to Reduced Wellbeing.

Front Psychiatry 2020 9;11:574314. Epub 2020 Oct 9.

Working Group "Prevention and Integrative Oncology" (PRIO) in the German Cancer Society, Berlin, Germany.

Background: During the COVID-19 pandemic, the Working Group "Prevention and Integrative Oncology" (PRIO) in the German Cancer Society has initiated flash interviews and surveys. One of these stated increasing rates of fears and mental stress of tumor patients. Now we aimed to analyze whether tumor patients did perceive changes in their attitudes and behaviors related to their relationships, awareness of nature and quietness, interest in spiritual issues, or feelings of worries and isolation. A further point of interest was how these perceived changes could be predicted, either by meaning in life, spirituality as a resource to cope, perceived fears and worries, or particularly by their wellbeing.

Materials And Methods: Online survey with standardized questionnaires (i.e., WHO-Five Well-being Index (WHO5), Meaning in Life Questionnaire (MLQ), Spiritual and Religious Attitudes to cope with illness (SpREUK-15), Gratitude/Awe scale (GrAw-7)) among 292 tumor patients (72% men; mean age 66.7 ± 10.8 years; 25% < 60 years, 33% 60-70 years, 41% > 70 years) from Germany between May 6 to June 10, 2020.

Results: Patients´ wellbeing (WHO5) scores were in the lower range (14.7 ± 6.0); 35% scored < 13, indicating depressive states. Wellbeing was significantly higher in older persons and lower in younger ones (F=11.1, p<.0001). Most were irritated by different statements about the danger and the course of the corona infection in the public media (60%), and 57% were worrying to be infected and to have a complicated course of disease. Because of the restrictions, patients noticed changes in their attitudes and behaviors (measured with the 12-item ): 1) (Cronbach´s alpha = .82), 2) (Cronbach´s alpha = .80), 3) (Cronbach´s alpha = .91), 4) (Cronbach´s alpha = .64). These perceptions of change were similar in women and men, age groups and also with respect to tumor stages. Regression analyses revealed that the factor was predicted best by patients´ ability to value and experience the 'wonder' of the present moment (in terms of wondering awe and gratitude) and by patients´ search for meaning in life. The factor was predicted best by their search for meaning in life and by feelings of being under pressure because of the Corona pandemic. was predicted best by search for an access to a spiritual source and by frequency of praying. were explained with weak predictive power by patients´ ability to reflect life concerns. Patients´ wellbeing during the Corona pandemic was predicted (R =.57) by a mix of disease and pandemic related stressor, and by available resources (meaning in life and religious trust).

Conclusion: In this study among tumor patients from a secular society the topics meaning in life, having (religious) trust, stable relationships, mindful encounter with nature, and times of reflection were found to be of importance. To overcome tumor patients´ feelings of isolation, depressive states, and insecurity about future perspectives, further support is needed, particularly in their socio-spatial surrounding. These are the domains of psychotherapy and spiritual care. The planned integration of structured access to spiritual care seems to be important, not only for the field of cancer care. As the findings refer to patients´ self-perceptions, longitudinal studies are required to substantiate these perceived changes.
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http://dx.doi.org/10.3389/fpsyt.2020.574314DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7581913PMC
October 2020

Determination of the Dielectric Properties of Storage Materials for Exhaust Gas Aftertreatment Using the Microwave Cavity Perturbation Method.

Sensors (Basel) 2020 Oct 23;20(21). Epub 2020 Oct 23.

Bayreuth Engine Research Center (BERC), Department of Functional Materials, University of Bayreuth, 95440 Bayreuth, Germany.

Recently, a laboratory setup for microwave-based characterization of powder samples at elevated temperatures and different gas atmospheres was presented. The setup is particularly interesting for investigations on typical materials for exhaust gas aftertreatment. By using the microwave cavity perturbation method, where the powder is placed inside a cavity resonator, the change of the resonant properties provides information about changes in the dielectric properties of the sample. However, determining the exact complex permittivity of the powder samples is not simple. Up to now, a simplified microwave cavity perturbation theory had been applied to estimate the bulk properties of the powders. In this study, an extended approach is presented which allows to determine the dielectric properties of the powder materials more correctly. It accounts for the electric field distribution in the resonator, the depolarization of the sample and the effect of the powder filling. The individual method combines findings from simulations and recognized analytical approaches and can be used for investigations on a wide range of materials and sample geometries. This work provides a more accurate evaluation of the dielectric powder properties and has the potential to enhance the understanding of the microwave behavior of storage materials for exhaust gas aftertreatment, especially with regard to the application of microwave-based catalyst state diagnosis.
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http://dx.doi.org/10.3390/s20216024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7660336PMC
October 2020

Oncology services in corona times: a flash interview among German cancer patients and their physicians.

J Cancer Res Clin Oncol 2020 Oct 15;146(10):2713-2715. Epub 2020 May 15.

Department of Internal Medicine II, University Hospital Jena, Jena, Germany.

Objective: Public discussion and health-care systems worldwide have been focusing on the COVID-19 pandemic. Does it have an impact on cancer care today?

Materials And Methods: The PRIO ("Prevention and Integrative Oncology") Working Group (German Cancer Society) has initiated an online survey for physicians, medical staff and patients on April 16, 2020. Between April 16 and April 19, 47 doctors and 146 patients filled in the questionnaires. The survey is ongoing. We present the first data.

Results: A majority of German patients (76%) and physicians (71%) report moderate or high restriction in their daily life. A minority (patients 25%, physicians 13%) was not worried that necessary treatments or diagnostics were restricted. Organizing cancer care needs more time and efforts for 56% of all reporting doctors. 98% of all oncologists think that restriction of family visits has a negative impact on the mental health of cancer patients. Half of all participants (patients 43%, physicians 47%) expect negative consequences on the physical status of our patients. Patients feel the existing emotional stress in 34% of their physicians. 52% of physicians fear mental and/or physical longtime consequences for themselves.

Conclusion: There is a high level of mental and physical stress triggered by the present COVID-19 management. After only a few weeks, human resources are limited. They will be the most important key for further health-care services for patients with cancer and other chronic diseases.
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http://dx.doi.org/10.1007/s00432-020-03249-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226710PMC
October 2020

Modelling the Influence of Different Soot Types on the Radio-Frequency-Based Load Detection of Gasoline Particulate Filters.

Sensors (Basel) 2020 May 6;20(9). Epub 2020 May 6.

Bayreuth Engine Research Center (BERC), Department of Functional Materials, University of Bayreuth, 95447 Bayreuth, Germany.

Gasoline particulate filters (GPFs) are an appropriate means to meet today's emission standards. As for diesel applications, GPFs can be monitored via differential pressure sensors or using a radio-frequency approach (RF sensor). Due to largely differing soot properties and engine operating modes of gasoline compared to diesel engines (e.g., the possibility of incomplete regenerations), the behavior of both sensor systems must be investigated in detail. For this purpose, extensive measurements on engine test benches are usually required. To simplify the sensor development, a simulation model was developed using COMSOL Multiphysics that not only allowed for calculating the loading and regeneration process of GPFs under different engine operating conditions but also determined the impact on both sensor systems. To simulate the regeneration behavior of gasoline soot accurately, an oxidation model was developed. To identify the influence of different engine operating points on the sensor behavior, various samples generated at an engine test bench were examined regarding their kinetic parameters using thermogravimetric analysis. Thus, this compared the accuracy of soot mass determination using the RF sensor with the differential pressure method. By simulating a typical driving condition with incomplete regenerations, the effects of the soot kinetics on sensor accuracy was demonstrated exemplarily. Thereby, the RF sensor showed an overall smaller mass determination error, as well as a lower dependence on the soot kinetics.
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http://dx.doi.org/10.3390/s20092659DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7248741PMC
May 2020

Scientific networks on Twitter: Analyzing scientists' interactions in the climate change debate.

Public Underst Sci 2019 08 26;28(6):696-712. Epub 2019 Apr 26.

University of Hamburg, Germany.

Scientific issues requiring urgent societal actions-such as climate change-have increased the need for communication and interaction between scientists and other societal actors. Social media platforms facilitate such exchanges. This study investigates who scientists interact with on Twitter, and whether their communication differs when engaging with actors beyond the scientific community. We focus on the climate change debate on Twitter and combine network analysis with automated content analysis. The results show that scientists interact most intensively with their peers, but also communication beyond the scientific community is important. The findings suggest that scientists adjust their communication style to their audience: They use more neutral language when communicating with other scientists, and more words expressing negative emotions when communicating with journalists, civil society, and politicians. Likewise, they stress certainty more when communicating with politicians, indicating that scientists use language strategically when communicating beyond the scientific community.
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http://dx.doi.org/10.1177/0963662519844131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323776PMC
August 2019

Exclusion from spheroid formation identifies loss of essential cell-cell adhesion molecules in colon cancer cells.

Sci Rep 2018 01 18;8(1):1151. Epub 2018 Jan 18.

Institute of Medical Genetics, Medical University of Vienna, Währinger Straße 10, A-1090, Vienna, Austria.

Many cell lines derived from solid cancers can form spheroids, which recapitulate tumor cell clusters and are more representative of the in vivo situation than 2D cultures. During spheroid formation, a small proportion of a variety of different colon cancer cell lines did not integrate into the sphere and lost cell-cell adhesion properties. An enrichment protocol was developed to augment the proportion of these cells to 100% purity. The basis for the separation of spheroids from non-spheroid forming (NSF) cells is simple gravity-sedimentation. This protocol gives rise to sub-populations of colon cancer cells with stable loss of cell-cell adhesion. SW620 cells lacked E-cadherin, DLD-1 cells lost α-catenin and HCT116 cells lacked P-cadherin in the NSF state. Knockdown of these molecules in the corresponding spheroid-forming cells demonstrated that loss of the respective proteins were indeed responsible for the NSF phenotypes. Loss of the spheroid forming phenotype was associated with increased migration and invasion properties in all cell lines tested. Hence, we identified critical molecules involved in spheroid formation in different cancer cell lines. We present here a simple, powerful and broadly applicable method to generate new sublines of tumor cell lines to study loss of cell-cell adhesion in cancer progression.
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http://dx.doi.org/10.1038/s41598-018-19384-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5773514PMC
January 2018

Planar Microstrip Ring Resonators for Microwave-Based Gas Sensing: Design Aspects and Initial Transducers for Humidity and Ammonia Sensing.

Sensors (Basel) 2017 Oct 24;17(10). Epub 2017 Oct 24.

Department of Functional Materials, University of Bayreuth, 95447 Bayreuth, Germany.

A planar microstrip ring resonator structure on alumina was developed using the commercial FEM software COMSOL. Design parameters were evaluated, eventually leading to an optimized design of a miniaturized microwave gas sensor. The sensor was covered with a zeolite film. The device was successfully operated at around 8.5 GHz at room temperature as a humidity sensor. In the next step, an additional planar heater will be included on the reverse side of the resonator structure to allow for testing of gas-sensitive materials under sensor conditions.
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http://dx.doi.org/10.3390/s17102422DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5677052PMC
October 2017

Symbiotic Fungi Control Plant Root Cortex Development through the Novel GRAS Transcription Factor MIG1.

Curr Biol 2016 10 15;26(20):2770-2778. Epub 2016 Sep 15.

Molecular Phytopathology, Botanical Institute, Karlsruhe Institute of Technology (KIT), Fritz Haber-Weg 4, 76131 Karlsruhe, Germany. Electronic address:

In an approaching scenario of soil nutrient depletion, root association with soil microorganisms can be key for plant health and sustainability [1-3]. Symbiotic arbuscular mycorrhizal (AM) fungi are major players in helping plants growing under nutrient starvation conditions. They provide plants with minerals like phosphate and, furthermore, act as modulators of plant growth altering the root developmental program [4, 5]. However, the precise mechanisms involved in this latter process are not well understood. Here, we show that AM fungi are able to modulate root cortex development in Medicago truncatula by activating a novel GRAS-domain transcription factor, MIG1, that determines the size of cortical root cells. MIG1 expression peaks in arbuscule-containing cells, suggesting a role in cell remodeling during fungal accommodation. Roots ectopically expressing MIG1 become thicker due to an increase in the number and width of cortical cells. This phenotype is fully counteracted by gibberellin (GA) and phenocopied with a GA biosynthesis inhibitor or by expression of a dominant DELLA (Δ18DELLA1) protein. MIG1 downregulation leads to malformed arbuscules, a phenotype rescued by Δ18DELLA1, suggesting that MIG1 intersects with the GA signaling to control cell morphogenesis through DELLA1. DELLA1 was shown to be a central node controlling arbuscule branching [6-8]. Now we provide evidence that, together with MIG1, DELLA1 is responsible for radial cortical cell expansion during arbuscule development. Our data point toward DELLA proteins being not only longitudinal root growth repressors [9] but also positive regulators of cortical radial cell expansion, extending the knowledge of how DELLAs control root growth.
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http://dx.doi.org/10.1016/j.cub.2016.07.059DOI Listing
October 2016

Comparison of cancer cells in 2D vs 3D culture reveals differences in AKT-mTOR-S6K signaling and drug responses.

J Cell Sci 2017 01 23;130(1):203-218. Epub 2016 Sep 23.

Institute of Medical Genetics, Medical University of Vienna, Währinger Straße 10, Vienna A-1090, Austria

Three-dimensional (3D) cancer models are used as preclinical systems to mimic physiologic drug responses. We provide evidence for strong changes of proliferation and metabolic capacity in three dimensions by systematically analyzing spheroids of colon cancer cell lines. Spheroids showed relative lower activities in the AKT, mammalian target of rapamycin (mTOR) and S6K (also known as RPS6KB1) signaling pathway compared to cells cultured in two dimensions. We identified spatial alterations in signaling, as the level of phosphorylated RPS6 decreased from the spheroid surface towards the center, which closely coordinated with the tumor areas around vessels in vivo These 3D models displayed augmented anti-tumor responses to AKT-mTOR-S6K or mitogen-activated protein kinase (MAPK) pathway inhibition compared to those in 2D models. Inhibition of AKT-mTOR-S6K resulted in elevated ERK phosphorylation in 2D culture, whereas under these conditions, ERK signaling was reduced in spheroids. Inhibition of MEK1 (also known as MAP2K1) led to decreased AKT-mTOR-S6K signaling in 3D but not in 2D culture. These data indicate a distinct rewiring of signaling in 3D culture and during treatment. Detached tumor-cell clusters in vessels, in addition to circulating single tumor cells, play a putative role in metastasis in human cancers. Hence, the understanding of signaling in spheroids and the responses in the 3D models upon drug treatment might be beneficial for anti-cancer therapies.
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http://dx.doi.org/10.1242/jcs.188102DOI Listing
January 2017

Alternative splicing - an elegant way to diversify the function of repeat-containing effector proteins?

New Phytol 2016 10;212(2):306-9

Molecular Phytopathology Department, Botanical Institute, Karlsruhe Institute of Technology, Hertzstrasse 16, D-76187, Karlsruhe, Germany.

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http://dx.doi.org/10.1111/nph.14157DOI Listing
October 2016

Increased complexity in carcinomas: Analyzing and modeling the interaction of human cancer cells with their microenvironment.

Semin Cancer Biol 2015 Dec 28;35:107-24. Epub 2015 Aug 28.

Institute of Medical Genetics, Medical University of Vienna, Währinger Straße 10, A-1090 Vienna, Austria. Electronic address:

Solid cancers are not simple accumulations of malignant tumor cells but rather represent complex organ-like structures. Despite a more chaotic general appearance as compared to the highly organized setup of healthy tissues, cancers still show highly differentiated structures and a close interaction with and dependency on the interwoven connective tissue. This complexity within cancers is not known in detail at the molecular level so far. The first part of this article will shortly describe the technology and strategies to quantify and dissect the heterogeneity in human solid cancers. Moreover, there is urgent need to better understand human cancer biology since the development of novel anti-cancer drugs is far from being efficient, predominantly due to the scarcity of predictive preclinical models. Hence, in vivo and in vitro models were developed, which better recapitulate the complexity of human cancers, by their intrinsic three-dimensional nature and the cellular heterogeneity and allow functional intervention for hypothesis testing. Therefore, in the second part 3D in vitro cancer models are presented that analyze and depict the heterogeneity in human cancers. Advantages and drawbacks of each model are highlighted and their suitability to preclinical drug testing is discussed.
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http://dx.doi.org/10.1016/j.semcancer.2015.08.007DOI Listing
December 2015