@phdthesis{VuXuan2008,
  author    = {Vu Xuan, Nghia},
  title     = {Generation of tools to investigate Chikungunya virus},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-28993},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2008},
  abstract  = {CHIKV is the prototype of Alphaviruses and it causes an acute febrile illness with rash, severely painful arthralgias, and sometimes arthritis. While CHIKV has first been identified in the 1950s in Africa, recent outbreaks of CHIKV in the islands of the Indian Ocean and particular in Italia have re-drawn attention to CHIKV. In the past CHIKV disease was considered self-limiting and non-fatal. However, a number of deaths on Reunion (Anonym, 2006) during the outbreak, which was affected directly or indirectly by CHIKV, have changed this view. To defeat CHIKV outbreaks diagnostic tools and anti CHIKV therapies are urgently needed. In this thesis, we generated tools to investigate CHIKV at the molecular level by serological tests. CHIKV was isolated from a German woman who was infected during her holidays on the Mauritius Island. To characterize this viral isolate the complete viral genome was amplified by PCR and molecular cloned. In order to analyse antibody responses of infected individuals some of the structural and non-structural genes were subcloned in bacterial expression vectors. The NSP2, proteinase, capsid, E1 and E2 were subsequently expressed in E.coli using purified successfully. In this thesis, the structural proteins were used to develop a screening test for anti-CHIKV antibodies in patient derived serum samples. These tests were evaluated with pre-characterized anti-CHIKV sera (30 samples) obtained from the BNI Hamburg and 100 serum samples from German blood donors used as negative controls. Immunoblotting analysis revealed that up to 77\% of precharacterised positive sera could recognize the recombinant proteins and there were no detectable reactivity of CHIKV-negative German donor sera. The recombinant proteins were also recognized by 71.4\% of positive sera in the newly established ELISA. In order to go further in analyses of the results, an in house IFA was performed. Positive sera (21 samples) were used. The results showed that all of them reacted positive, but this assay was less sensitive than the IFA from BNI. In comparison with the IFA result from BNI Hamburg, the results were not congruent in all test performed. This could be due to various drawbacks of the tests. A cross reaction in Alphaviruses and the different strains are mentioned as well as the denatured forms of the structural proteins. Besides the main structural proteins (E1, E2 and C), other proteins such as non-structural proteins, uncleaved precursor proteins could participate in the different outcomes of serological assays. In order to go further in the CHIKV diagnoses, the CHIKV recombinant proteins were applied to screen the anti-CHIKV antibodies in the Vietnamese population, who are considered to live in the high risk regions. In serological tests, 158 sera of Vietnamese donors were incubated with the recombinant proteins or the fixed CHIKV infected cells. The results showed that 24\% of Vietnamese donor sera recognized the recombinant proteins in immunoblot assay, while 36\% scored positive in the ELISA assay. In IFA, the sera considered positive were 11.4\%. While some discrepancies in serological tests were found, these results showed that the ratio of CHIKV-positive sera seem to be equal to the other regions in the world, which are affected by CHIKV. It is suggested that CHIKV infection in Vietnam has been repeatedly misdiagnosed. This study cohort consisted only of samples originating from Hanoi area of Northern Vietnam, thus, future studies should expand to include samples from other Vietnam areas. To do this the various subtypes of the virus in the different regions should be isolated and the sequences of these viruses should be well characterized.},
  subject      = {Viren},
  language  = {en}
}
@article{SchwerdtleKanisKahletal.2012,
  author    = {Schwerdtle, Barbara and Kanis, Julia and Kahl, Lena and K{\"u}bler, Andrea and Schlarb, Angelika A.},
  title     = {Children's Sleep Comic: development of a new diagnostic tool for children with sleep disorders [original research]},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-75722},
  year      = {2012},
  abstract  = {Background: A solid diagnosis of sleep disorders in children should include both self-ratings and parent ratings. However, there are few standardized self-assessment instruments to meet this need. The Children's Sleep Comic is an adapted version of the unpublished German questionnaire "Freiburger Kinderschlafcomic" and provides pictures for items and responses. Because the drawings were outdated and allowed only for qualitative analysis, we revised the comic, tested its applicability in a target sample, and suggest a procedure for quantitative analysis. Methods: All items were updated and pictures were newly drawn. We used a sample of 201 children aged 5-10 years to test the applicability of the Children's Sleep Comic in young children and to run a preliminary analysis. Results: The Children's Sleep Comic comprises 37 items covering relevant aspects of sleep disorders in children. Application took on average 30 minutes. The procedure was well accepted by the children, as reflected by the absence of any dropouts. First comparisons with established questionnaires indicated moderate correlations. Conclusion: The Children's Sleep Comic is appropriate for screening sleep behavior and sleep problems in children. The interactive procedure can foster a good relationship between the investigator and the child, and thus establish the basis for successful intervention if necessary.},
  subject      = {Psychologie},
  language  = {en}
}
@phdthesis{Lau2021,
  author    = {Lau, Kolja},
  title     = {Diastolische Herzfunktion und ihre Vorhersagekraft auf das Langzeit{\"u}berleben bei HerzinsuffizienzpatientInnen mit mittelgradiger oder reduzierter linksventrikul{\"a}rer Ejektionsfraktion},
  doi       = {10.25972/OPUS-24170},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-241704},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Diese retrospektive Auswertung von PatientInnendaten der kardiologischen Ambulanz des Universit{\"a}tsklinikums W{\"u}rzburg konnte zeigen, dass die Bestimmung der diastolischen Dysfunktion prognostisch relevante Informationen enth{\"a}lt. Das Studienkollektiv wurde anhand der gemessenen Ejektionsfraktion in die zwei Untersuchungsgruppen HFrEF und HFmrEF eingeteilt. Diese zwei Untersuchungsgruppen wurden anhand ihrer klinisch und echokardiographisch bestimmten Charakteristika verglichen. Anschließend wurden drei diastolische Parameter (E/e', LAVi und TRVmax) auf ihre prognostische Relevanz untersucht. Die abschließende Untersuchung gruppierte die PatientInnen anhand der Schwere ihrer diastolischen Dysfunktion (mild / moderat / schwer) und untersuchte ebenfalls das Langzeit{\"u}berleben. Die HFmrEF-Gruppe zeigte {\"a}hnliche klinische Charakteristika wie die HFrEF-Gruppe. Eine isch{\"a}mische Genese der Herzinsuffizienz wurde in der HFmrEF-Gruppe im Vergleich zur HFrEF-Gruppe h{\"a}ufiger beobachtet. Die {\"U}berlebenszeitanalysen konnten bei PatientInnen in der HFmrEF-Gruppe zeigen, dass ein dilatierter linker Vorhof (LAVi) oder eine große Regurgitation {\"u}ber der Trikuspidalklappe (TRVmax) mit einer schlechten Prognose einhergehen. Bei HFrEF-PatientInnen hingegen konnte dies nicht nachgewiesen werden. Hier zeigte sich, dass insbesondere der Parameter E/e'septal prognostisch relevante Informationen enth{\"a}lt. Die Auswertung der Untersuchungsgruppen nach Einteilung anhand der Schwere der diastolischen Dysfunktion konnte die gefunden Effekte best{\"a}tigen. Eine moderate bis schwere diastolische Dysfunktion war mit einer signifikant schlechteren Prognose behaftet, und zwar sowohl in der HFrEF- wie auch in der HFmrEF-Gruppe. Die gefunden Ergebnisse zeigen, dass die diastolische Dysfunktion auch bei PatientInnen mit einer systolischen Herzinsuffizienz wichtige prognostische Informationen enthalten. In der klinischen Routine sollte die echokardiographische Bestimmung der diastolischen Herzfunktion standardm{\"a}ßig durchgef{\"u}hrt werden. Die Ergebnisse k{\"o}nnten nicht nur in der Diagnostik zur Kategorisierung der PatientInnen und Bestimmung der Prognose, sondern auch hinsichtlich der Therapie von großem zuk{\"u}nftigem Nutzen sein. Hierzu sollten perspektivisch vor allem therapeutische Aspekte in prospektiven, idealerweise randomisierten Studien untersucht werden, welche sich auf die Erkenntnisse dieser Arbeit beziehen.},
  subject      = {Herzinsuffizienz},
  language  = {de}
}