@phdthesis{Riegler2022, author = {Riegler, David}, title = {Emergent phenomena in strongly correlated electron systems: Auxiliary particle approach to the many-body problem}, doi = {10.25972/OPUS-27473}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-274737}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2022}, abstract = {Emergent phenomena in condensed matter physics like, e.g., magnetism, superconductivity, or non-trivial topology often come along with a surprise and exert great fascination to researchers up to this day. Within this thesis, we are concerned with the analysis of associated types of order that arise due to strong electronic interactions and focus on the high-\(T_c\) cuprates and Kondo systems as two prime candidates. The underlying many-body problem cannot be solved analytically and has given rise to the development of various approximation techniques to tackle the problem. In concrete terms, we apply the auxiliary particle approach to investigate tight-binding Hamiltonians subject to a Hubbard interaction term to account for the screened Coulomb repulsion. Thereby, we adopt the so-called Kotliar-Ruckenstein slave-boson representation that reduces the problem to non-interacting quasiparticles within a mean-field approximation. Part I provides a pedagogical review of the theory and generalizes the established formalism to encompass Gaussian fluctuations around magnetic ground states as a crucial step to obtaining novel results. Part II addresses the two-dimensional one-band Hubbard model, which is known to approximately describe the physics of the high-\(T_c\) cuprates that feature high-temperature superconductivity and various other exotic quantum phases that are not yet fully understood. First, we provide a comprehensive slave-boson analysis of the model, including the discussion of incommensurate magnetic phases, collective modes, and a comparison to other theoretical methods that shows that our results can be massively improved through the newly implemented fluctuation corrections. Afterward, we focus on the underdoped regime and find an intertwining of spin and charge order signaled by divergences of the static charge susceptibility within the antiferromagnetic domain. There is experimental evidence for such inhomogeneous phases in various cuprate materials, which has recently aroused interest because such correlations are believed to impact the formation of Cooper pairs. Our analysis identifies two distinct charge-ordering vectors, one of which can be attributed to a Fermi-surface nesting effect and quantitatively fits experimental data in \(\mathrm{Nd}_{2-\mathrm{x}}\mathrm{Ce}_\mathrm{x}\mathrm{CuO}_4\) (NCCO), an electron-doped cuprate compound. The other resembles the so-called Yamada relation implying the formation of periodic, double-occupied domain walls with a crossover to phase separation for small dopings. Part III investigates Kondo systems by analyzing the periodic Anderson model and its generalizations. First, we consider Kondo metals and detect weakly magnetized ferromagnetic order in qualitative agreement with experimental observations, which hinders the formation of heavy fermions. Nevertheless, we suggest two different parameter regimes that could host a possible Kondo regime in the context of one or two conduction bands. The part is concluded with the study of topological order in Kondo insulators based on a three-dimensional model with centrosymmetric spin-orbit coupling. Thereby, we classify topologically distinct phases through appropriate \(\mathbb{Z}_2\) invariants and consider paramagnetic and antiferromagnetic mean-field ground states. Our model parameters are chosen to specifically describe samarium hexaboride (\(\mbox{SmB}_6\)), which is widely believed to be a topological Kondo insulator, and we identify topologically protected surface states in agreement with experimental evidence in that material. Moreover, our theory predicts the emergence of an antiferromagnetic topological insulator featuring one-dimensional hinge-states as the signature of higher-order topology in the strong coupling regime. While the nature of the true ground state is still under debate, corresponding long-range magnetic order has been observed in pressurized or alloyed \(\mbox{SmB}_6\), and recent experimental findings point towards non-trivial topology under these circumstances. The ability to understand and control topological systems brings forth promising applications in the context of spintronics and quantum computing.}, subject = {Elektronenkorrelation}, language = {en} } @article{TuetuencueOlmaKunzeetal.2022, author = {T{\"u}t{\"u}nc{\"u}, Serdar and Olma, Manuel and Kunze, Claudia and Dietzel, Joanna and Schurig, Johannes and Fiessler, Cornelia and Malsch, Carolin and Haas, Tobias Eberhard and Dimitrijeski, Boris and Doehner, Wolfram and Hagemann, Georg and Hamilton, Frank and Honermann, Martin and Jungehulsing, Gerhard Jan and Kauert, Andreas and Koennecke, Hans-Christian and Mackert, Bruno-Marcel and Nabavi, Darius and Nolte, Christian H. and Reis, Joschua Mirko and Schmehl, Ingo and Sparenberg, Paul and Stingele, Robert and V{\"o}lzke, Enrico and Waldschmidt, Carolin and Zeise-Wehry, Daniel and Heuschmann, Peter U. and Endress, Matthias and Haeusler, Karl Georg}, title = {Off-label-dosing of non-vitamin K-dependent oral antagonists in AF patients before and after stroke: results of the prospective multicenter Berlin Atrial Fibrillation Registry}, series = {Journal of Neurology}, volume = {269}, journal = {Journal of Neurology}, number = {1}, issn = {1432-1459}, doi = {10.1007/s00415-021-10866-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266969}, pages = {470-480}, year = {2022}, abstract = {Aims We aimed to analyze prevalence and predictors of NOAC off-label under-dosing in AF patients before and after the index stroke. Methods The post hoc analysis included 1080 patients of the investigator-initiated, multicenter prospective Berlin Atrial Fibrillation Registry, designed to analyze medical stroke prevention in AF patients after acute ischemic stroke. Results At stroke onset, an off-label daily dose was prescribed in 61 (25.5\%) of 239 NOAC patients with known AF and CHA2DS2-VASc score ≥ 1, of which 52 (21.8\%) patients were under-dosed. Under-dosing was associated with age ≥ 80 years in patients on rivaroxaban [OR 2.90, 95\% CI 1.05-7.9, P = 0.04; n = 29] or apixaban [OR 3.24, 95\% CI 1.04-10.1, P = 0.04; n = 22]. At hospital discharge after the index stroke, NOAC off-label dose on admission was continued in 30 (49.2\%) of 61 patients. Overall, 79 (13.7\%) of 708 patients prescribed a NOAC at hospital discharge received an off-label dose, of whom 75 (10.6\%) patients were under-dosed. Rivaroxaban under-dosing at discharge was associated with age ≥ 80 years [OR 3.49, 95\% CI 1.24-9.84, P = 0.02; n = 19]; apixaban under-dosing with body weight ≤ 60 kg [OR 0.06, 95\% CI 0.01-0.47, P < 0.01; n = 56], CHA2DS2-VASc score [OR per point 1.47, 95\% CI 1.08-2.00, P = 0.01], and HAS-BLED score [OR per point 1.91, 95\% CI 1.28-2.84, P < 0.01]. Conclusion At stroke onset, off-label dosing was present in one out of four, and under-dosing in one out of five NOAC patients. Under-dosing of rivaroxaban or apixaban was related to old age. In-hospital treatment after stroke reduced off-label NOAC dosing, but one out of ten NOAC patients was under-dosed at discharge.}, language = {en} } @article{KrausHackenbergShehataDieleretal.2022, author = {Kraus, Fabian and Hackenberg, Stephan and Shehata-Dieler, Wafaa and Hagen, Rudolf}, title = {High-sensitivity FEES\(^{®}\) with the professional image enhancement technology "PIET"}, series = {European Archives of Oto-Rhino-Laryngology}, volume = {279}, journal = {European Archives of Oto-Rhino-Laryngology}, number = {1}, issn = {1434-4726}, doi = {10.1007/s00405-021-07067-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266822}, pages = {293-298}, year = {2022}, abstract = {Purpose Flexible endoscopic evaluation of swallowing (FEES\(^{®}\)) is a standard diagnostic tool in dysphagia. The combination of FEES® and narrow band light (narrow band imaging; NBI) provides a more precise and detailed investigation method. So far, this technique could only be performed with the NBI illumination. The new version of the "professional image enhancement technique" (PIET) provides another image enhancing system. This study investigates the eligibility of PIET in the FEES\(^{®}\) procedure. Methods Both techniques, NBI and PIET, were compared using a target system. Furthermore, the image enhancement during FEES\(^{®}\) was performed and recorded with the two systems during daily routine. Results Performing an image enhancement during FEES\(^{®}\) is possible with both systems PIET and NBI. On the target system, the contrast of the PIET showed a brighter and a more detailed picture. In dysphagia patients, no difference between PIET and NBI was detected. Conclusion PIET proved to be non-inferior to NBI during image enhancement FEES\(^{®}\). So far, image enhancement FEES\(^{®}\) was exclusively connected to NBI. With the PIET system, an alternative endoscopy technology is available for certain indications.}, language = {en} } @article{GehrkeScherzadHagenetal.2022, author = {Gehrke, Thomas and Scherzad, Agmal and Hagen, Rudolf and Hackenberg, Stephan}, title = {Deep neck infections with and without mediastinal involvement: treatment and outcome in 218 patients}, series = {European Archives of Oto-Rhino-Laryngology}, volume = {279}, journal = {European Archives of Oto-Rhino-Laryngology}, number = {3}, issn = {1434-4726}, doi = {10.1007/s00405-021-06945-9}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266814}, pages = {1585-1592}, year = {2022}, abstract = {Purpose Infections of the deep neck, although becoming scarcer due to the widespread use of antibiotics, still represent a dangerous and possibly deadly disease, especially when descending into the mediastinum. Due to the different specialities involved in the treatment and the heterogenous presentation of the disease, therapeutic standard is still controversial. This study analyzes treatment and outcome in these patients based on a large retrospective review and proposes a therapeutic algorithm. Methods The cases of 218 adult patients treated with deep neck abscesses over a 10-year period at a tertiary university hospital were analyzed retrospectively. Clinical, radiological, microbiological and laboratory findings were compared between patients with and without mediastinal involvement. Results Forty-five patients (20.64\%) presented with abscess formation descending into the mediastinum. Those patients had significantly (all items p < 0.0001) higher rates of surgical interventions (4.27 vs. 1.11) and tracheotomies (82\% vs. 3.4\%), higher markers of inflammation (CRP 26.09 vs. 10.41 mg/dl), required more CT-scans (3.58 vs. 0.85), longer hospitalization (39.78 vs 9.79 days) and more frequently needed a change in antibiotic therapy (44.44\% vs. 6.40\%). Multi-resistant pathogens were found in 6.67\% vs. 1.16\%. Overall mortality rate was low with 1.83\%. Conclusion Despite of the high percentage of mediastinal involvement in the present patient collective, the proposed therapeutic algorithm resulted in a low mortality rate. Frequent CT-scans, regular planned surgical revisions with local drainage and lavage, as well as an early tracheotomy seem to be most beneficial regarding the outcome.}, language = {en} } @article{MuellerGraffIlgenSchendzielorzetal.2022, author = {M{\"u}ller-Graff, Franz-Tassilo and Ilgen, Lukas and Schendzielorz, Philipp and Voelker, Johannes and Taeger, Johannes and Kurz, Anja and Hagen, Rudolf and Neun, Tilmann and Rak, Kristen}, title = {Implementation of secondary reconstructions of flat-panel volume computed tomography (fpVCT) and otological planning software for anatomically based cochlear implantation}, series = {European Archives of Oto-Rhino-Laryngology}, volume = {279}, journal = {European Archives of Oto-Rhino-Laryngology}, number = {5}, issn = {1434-4726}, doi = {10.1007/s00405-021-06924-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266798}, pages = {2309-2319}, year = {2022}, abstract = {Purpose For further improvements in cochlear implantation, the measurement of the cochlear duct length (CDL) and the determination of the electrode contact position (ECP) are increasingly in the focus of clinical research. Usually, these items were investigated by multislice computed tomography (MSCT). The determination of ECP was only possible by research programs so far. Flat-panel volume computed tomography (fpVCT) and its secondary reconstructions (fpVCT\(_{SECO}\)) allow for high spatial resolution for the visualization of the temporal bone structures. Using a newly developed surgical planning software that enables the evaluation of CDL and the determination of postoperative ECP, this study aimed to investigate the combination of fpVCT and otological planning software to improve the implementation of an anatomically based cochlear implantation. Methods Cochlear measurements were performed utilizing surgical planning software in imaging data (MSCT, fpVCT and fpVCT\(_{SECO}\)) of patients with and without implanted electrodes. Results Measurement of the CDL by the use of an otological planning software was highly reliable using fpVCT\(_{SECO}\) with a lower variance between the respective measurements compared to MSCT. The determination of the inter-electrode-distance (IED) between the ECP was improved in fpVCT\(_{SECO}\) compared to MSCT. Conclusion The combination of fpVCT\(_{SECO}\) and otological planning software permits a simplified and more reliable analysis of the cochlea in the pre- and postoperative setting. The combination of both systems will enable further progress in the development of an anatomically based cochlear implantation.}, language = {en} } @article{RajeswaranTavoraVieiraMertensetal.2022, author = {Rajeswaran, Ranjith and Tavora-Vieira, Dayse and Mertens, Griet and Dillon, Margaret and Narayan, Saranya and Kameswaran, Mohan and Kurz, Anja}, title = {Audiological practice and COVID-19: recommendations that audiological centers can use to maintain the safety and quality of service-expert opinion}, series = {European Archives of Oto-Rhino-Laryngology}, volume = {279}, journal = {European Archives of Oto-Rhino-Laryngology}, number = {3}, issn = {1434-4726}, doi = {10.1007/s00405-021-06766-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266774}, pages = {1251-1256}, year = {2022}, abstract = {Purpose Audiology is an essential service for some patient groups and some interventions. This article sets forth experience-based recommendations for how audiological centers can continue to safely and effectively function during COVID-19. Methods The recommendations are the result of panel discussion and are based on the clinical experience of the panelists/authors. Results The recommendations cover which patient groups and which interventions should be treated when and whether this can be performed in the clinic or remotely; how to maintain the safety of workplace via optimizing patient flow within the clinic and the sanitation of rooms and equipment; and overcoming communication challenges that COVID-19 intensifies. Conclusion For essential audiological services to continue under COVID-19, safety measures must be implemented and maintained, and treatment and communication strategies must be adapted to offset communication difficulties due to personal protective equipment (PPE) and social distancing and to bolster patient confidence. In short, it is vital that staff feel safe, that patients either feel the clinic is safe enough to visit or that remote treatment may be an option, and that clinics and patients have a broad agreement on the urgency of any needed service. We hope that these recommendations help clinics effectively accomplish these goals.}, language = {en} } @article{KieselBeyersKaliszetal.2022, author = {Kiesel, Matthias and Beyers, Inga and Kalisz, Adam and W{\"o}ckel, Achim and Herbert, Saskia-Laureen and Curtaz, Carolin and Diessner, Joachim and Joukhadar, Ralf and Wulff, Christine}, title = {Introducing a novel model for simulating large loop excision of the transformation zone (LLETZ) using 3D printing technique}, series = {Archives of Gynecology and Obstetrics}, volume = {305}, journal = {Archives of Gynecology and Obstetrics}, number = {3}, issn = {1432-0711}, doi = {10.1007/s00404-021-06209-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266739}, pages = {703-712}, year = {2022}, abstract = {Purpose Electrosurgery is the gold-standard procedure for the treatment of cervical dysplasia. The quality of the outcome depends on the accuracy of performance, which underlines the role of adequate training of surgeons, especially, as this procedure is often performed by novice surgeons. According to our knowledge, medical simulation has up until now lacked a model, which focuses on realistically simulating the treatment of cervical dysplasia with the concerning anatomy. Methods and Result In our work, we present a model created using 3D printing for holistically simulating diagnostic, as well as surgical interventions of the cervix, as realistically as possible. Conclusion This novel simulator is compared to an existing model and both are evaluated. By doing so, we aim to provide novice gynecologists with standardized and high-quality simulation models for practicing to improve their proficiency.}, language = {en} } @article{GuederWilkesmannScholzetal.2022, author = {G{\"u}der, G{\"u}lmisal and Wilkesmann, Joana and Scholz, Nina and Leppich, Robert and D{\"u}king, Peter and Sperlich, Billy and Rost, Christian and Frantz, Stefan and Morbach, Caroline and Sahiti, Floran and Stefenelli, Ulrich and Breunig, Margret and St{\"o}rk, Stefan}, title = {Establishing a cardiac training group for patients with heart failure: the "HIP-in-W{\"u}rzburg" study}, series = {Clinical Research in Cardiology}, volume = {111}, journal = {Clinical Research in Cardiology}, issn = {1861-0692}, doi = {10.1007/s00392-021-01892-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266678}, pages = {406-415}, year = {2022}, abstract = {Background Exercise training in heart failure (HF) is recommended but not routinely offered, because of logistic and safety-related reasons. In 2020, the German Society for Prevention\&Rehabilitation and the German Society for Cardiology requested establishing dedicated ""HF training groups."" Here, we aimed to implement and evaluate the feasibility and safety of one of the first HF training groups in Germany. Methods Twelve patients (three women) with symptomatic HF (NYHA class II/III) and an ejection fraction ≤ 45\% participated and were offered weekly, physician-supervised exercise training for 1 year. Patients received a wrist-worn pedometer (M430 Polar) and underwent the following assessments at baseline and after 4, 8 and 12 months: cardiopulmonary exercise test, 6-min walk test, echocardiography (blinded reading), and quality of life assessment (Kansas City Cardiomyopathy Questionnaire, KCCQ). Results All patients (median age [quartiles] 64 [49; 64] years) completed the study and participated in 76\% of the offered 36 training sessions. The pedometer was worn ≥ 1000 min per day over 86\% of the time. No cardiovascular events occurred during training. Across 12 months, NT-proBNP dropped from 986 pg/ml [455; 1937] to 483 pg/ml [247; 2322], and LVEF increased from 36\% [29;41] to 41\% [32;46]\%, (p for trend = 0.01). We observed no changes in exercise capacity except for a subtle increase in peak VO2\% predicted, from 66.5 [49; 77] to 67 [52; 78]; p for trend = 0.03. The physical function and social limitation domains of the KCCQ improved from 60 [54; 82] to 71 [58; 95, and from 63 [39; 83] to 78 [64; 92]; p for trend = 0.04 and = 0.01, respectively. Positive trends were further seen for the clinical and overall summary scores. Conclusion This pilot study showed that the implementation of a supervised HF-exercise program is feasible, safe, and has the potential to improve both quality of life and surrogate markers of HF severity. This first exercise experiment should facilitate the design of risk-adopted training programs for patients with HF.}, language = {en} } @phdthesis{Boetzl2022, author = {B{\"o}tzl, Fabian Alexander}, title = {The influence of crop management and adjacent agri-environmental scheme type on natural pest control in differently structured landscapes}, doi = {10.25972/OPUS-24140}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-241400}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2022}, abstract = {Summary Chapters I \& II: General Introduction \& General Methods Agriculture is confronted with a rampant loss of biodiversity potentially eroding ecosystem service potentials and adding up to other stressors like climate change or the consequences of land-use change and intensive management. To counter this 'biodiversity crisis', agri-environment schemes (AES) have been introduced as part of ecological intensification efforts. These AES combine special management regimes with the establishment of tailored habitats to create refuges for biodiversity in agricultural landscapes and thus ensure biodiversity mediated ecosystem services such as pest control. However, little is known about how well different AES habitats fulfil this purpose and whether they benefit ecosystem services in adjacent crop fields. Here I investigated how effective different AES habitats are for restoring biodiversity in different agricultural landscapes (Chapter V) and whether they benefit natural pest control in adjacent oilseed rape (Chapter VI) and winter cereal fields (Chapter VII). I recorded biodiversity and pest control potentials using a variety of different methods (Chapters II, V, VI \& VII). Moreover, I validated the methodology I used to assess predator assemblages and predation rates (Chapters III \& IV). Chapter III: How to record ground dwelling predators? Testing methodology is critical as it ensures scientific standards and trustworthy results. Pitfall traps are widely used to record ground dwelling predators, but little is known about how different trap types affect catches. I compared different types of pitfall traps that had been used in previous studies in respect to resulting carabid beetle assemblages. While barrier traps collected more species and deliver more complete species inventories, conventional simple pitfall traps provide reliable results with comparatively little handling effort. Placing several simple pitfall traps in the field can compensate the difference while still saving handling effort.   Chapter IV: How to record predation rates? A plethora of methods has been proposed and used for recording predation rates, but these have rarely been validated before use. I assessed whether a novel approach to record predation, the use of sentinel prey cards with glued on aphids, delivers realistic results. I compared different sampling efforts and showed that obtained predation rates were similar and could be linked to predator (carabid beetle) densities and body-sizes (a proxy often used for food intake rates). Thus, the method delivers reliable and meaningful predation rates. Chapter V: Do AES habitats benefit multi-taxa biodiversity? The main goal of AES is the conservation of biodiversity in agricultural landscapes. I investigated how effectively AES habitats with different temporal continuity fulfil this goal in differently structured landscapes. The different AES habitats investigated had variable effects on local biodiversity. Temporal continuity of AES habitats was the most important predictor with older, more temporally continuous habitats harbouring higher overall biodiversity and different species assemblages in most taxonomic groups than younger AES habitats. Results however varied among taxonomic groups and natural enemies were equally supported by younger habitats. Semi-natural habitats in the surrounding landscape and AES habitat size were of minor importance for local biodiversity and had limited effects. This stresses that newly established AES habitats alone cannot restore farmland biodiversity. Both AES habitats as well as more continuous semi-natural habitats synergistically increase overall biodiversity in agricultural landscapes. Chapter VI: The effects of AES habitats on predators in adjacent oilseed rape fields Apart from biodiversity conservation, ensuring ecosystem service delivery in agricultural landscapes is a crucial goal of AES. I therefore investigated the effects of adjacent AES habitats on ground dwelling predator assemblages in oilseed rape fields. I found clear distance decay effects from the field edges into the field centres on both richness and densities of ground dwelling predators. Direct effects of adjacent AES habitats on assemblages in oilseed rape fields however were limited and only visible in functional traits of carabid beetle assemblages. Adjacent AES habitats doubled the proportion of predatory carabid beetles indicating a beneficial role for pest control. My results show that pest control potentials are largest close to the field edges and beneficial effects are comparably short ranged. Chapter VII: The effects of AES habitats on pest control in adjacent cereal fields Whether distance functions and potential effects of AES habitats are universal across crops is unknown. Therefore, I assessed distance functions of predators, pests, predation rates and yields after crop rotation in winter cereals using the same study design as in the previous year. Resulting distance functions were not uniform and differed from those found in oilseed rape in the previous year, indicating that the interactions between certain adjacent habitats vary with habitat and crop types. Distance functions of cereal-leaf beetles (important cereal pests) and parasitoid wasps were moreover modulated by semi-natural habitat proportion in the surrounding landscapes. Field edges buffered assemblage changes in carabid beetle assemblages over crop rotation confirming their important function as refuges for natural enemies. My results emphasize the beneficial role of field edges for pest control potentials. These findings back the calls for smaller field sizes and more diverse, more heterogeneously structured agricultural landscapes. Chapter VIII: General Discussion Countering biodiversity loss and ensuring ecosystem service provision in agricultural landscapes is intricate and requires strategic planning and restructuring of these landscapes. I showed that agricultural landscapes could benefit maximally from (i) a mixture of AES habitats and semi-natural habitats to support high levels of overall biodiversity and from (ii) smaller continuously managed agricultural areas (i.e. smaller field sizes or the insertion of AES elements within large fields) to maximize natural pest control potentials in crop fields. I propose a mosaic of younger AES habitats and semi-natural habitats to support ecosystem service providers and increase edge density for ecosystem service spillover into adjacent crops. The optimal extent and density of this network as well as the location in which AES and semi-natural habitats interact most beneficially with adjacent crops need further investigation. My results provide a further step towards more sustainable agricultural landscapes that simultaneously allow biodiversity to persist and maintain agricultural production under the framework of ecological intensification.}, subject = {{\"O}kologie}, language = {en} } @phdthesis{Wohlfart2022, author = {Wohlfart, Jonas}, title = {Analysis of Drug Impurities by Means of Chromatographic Methods: Targeted and Untargeted Approaches}, doi = {10.25972/OPUS-27387}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-273878}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2022}, abstract = {The presented works aimed on the analysis of new impurities in APIs and medicinal products. Different subtypes of LC were coupled to suitable detection methods, i.e. UV and various MS techniques, depending on the chemical natures of the analytes and the analytical task. Unexpected impurities in medicinal products and APIs caused several scandals in the past, concomitant with fatalities or severe side effects in human and veterinary patients. The detection of nitrosamines in sartans led to the discovery of nitrosamines in various other drugs, of which the antibiotic rifampicin was analyzed in this work. An examination of the synthesis of rifampicin revealed a high potential for the formation of 4-methyl-1-nitrosopiperazine (MeNP). An LC-MS/HRMS method suitable for the quantification of MeNP was applied in the analysis of drugs collected from Brazil, Comoros, India, Nepal, and Tanzania, where a single dose of rifampicin is used in the post-exposure prophylaxis of leprosy. All batches were contaminated with MeNP, ranging from 0.7-5.1 ppm. However, application of rifampicin containing up to 5 ppm MeNP was recommended by the regulatory authorities for the post-exposure prophylaxis of leprosy. In the 1990s the aminoglycoside antibiotic gentamicin attracted attention after causing fatalities in the USA, but the causative agent was never identified unequivocally. The related substance sisomicin was recognized as a lead impurity by the Holzgrabe lab at the University of W{\"u}rzburg: sisomicin was accompanied by a variety of other impurities and batches containing sisomicin had caused the fatalities. In 2016, anaphylactic reactions were reported after application of gentamicin. A contamination of the medicinal products with histamine, an impurity of the raw material fish peptone used upon the production, could be identified as the cause of the adverse effects. Batches of gentamicin sulfate, which had been stored at the University of W{\"u}rzburg since the earlier investigations, were analyzed regarding their contamination with histamine to determine whether the biogenic amine was responsible for the 1990s fatalities as well. Furthermore, a correlation with the lead impurity sisomicin was checked. Histamine could be detected in all analyzed batches, but at a lower level than in the batches responsible for the anaphylactic reactions. Moreover, there is no correlation of histamine with the lead impurity sisomicin. Hence, the causative agent for the 1990s fatalities was not histamine and remains unknown. Another source of impurities is the reaction of APIs with excipients, e.g. the esterification of naproxen with PEG 600 in soft gel capsules. The influence of the formulation's composition on this reaction was investigated by means of LC-UV. Therefore, the impurity naproxen-PEG-ester (NPEG) was synthesized and used for the development of a method suitable for the analysis of soft gel capsule formulations. Different formulations were stressed for 7 d at 60 °C and the relative amount of NPEG was determined. The formation of NPEG was influenced by the concentrations of water and lactic acid, the pH, and the drug load of the formulation, which can easily be explained by the chemistry behind esterification reactions. Keeping in mind the huge variety of sources of impurities, it might be impossible to predict all potential impurities of a drug substance/product. Targeted and untargeted approaches were combined in the impurity profiling of bisoprolol fumarate. Eight versions of an LC-HRMS method were developed to enable the detection of a maximum number of impurities: an acidic and a basic buffered LC was coupled to MS detection applying ESI and APCI, both in positive in negative mode. MS and MS/MS data were acquired simultaneously by information dependent acquisition. In the targeted approach, potential impurities were derived from a reaction matrix based on the synthesis route of the API, while the untargeted part was based on general unknown comparative screening to identify additional signals. 18 and 17 impurities were detected in the targeted and the untargeted approach, respectively. The molecular formulae were assessed based on the exact mass and the isotope pattern. Theoretical fragment spectra generated by in silico fragmentation were matched with experimental data to estimate the plausibility of proposed/elucidated structures. Moreover, the detected impurities were quantified with respect to an internal standard.}, subject = {LC-MS}, language = {en} }