@phdthesis{Haas2012, author = {Haas, Katrin}, title = {Charakterisierung der Versorgungsqualit{\"a}t beim akuten ST-Hebungsmyokardinfarkt im Herzinfarktnetz Mainfranken zu Beginn der Netzwerkbildung}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-80388}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2012}, abstract = {Ziele: Evaluierung der Versorgungslage von Patienten mit akutem ST-Hebungsinfarkt im 2007 neu gegr{\"u}ndeten Herzinfarktnetz Mainfranken und Vergleich von Ist-Zustand und Leitlinienempfehlungen. Analyse der Behandlungszeiten und Identifizierung von Verbesserungsm{\"o}glichkeiten im Netzwerk. Dar{\"u}ber hinaus sollte untersucht werden, ob Feedbackveranstaltungen als Qualit{\"a}tsmanagement-Intervention die Behandlungszeiten im Laufe des Untersuchungszeitraumes verbessern. Methoden: Von Oktober 2007 bis Dezember 2008 wurden verschiedene Basisdaten sowie die Daten der Rettungs- und Therapiekette von Patienten mit akutem ST-Hebungsinfarkt (Symptomdauer <12h), die in der Medizinischen Klinik und Poliklinik I des Universit{\"a}tsklinikums W{\"u}rzburg mit dem Ziel einer PCI akut-koronarangiographiert wurden, im Rahmen der multizentrischen FiTT-STEMI-Studie prospektiv erfasst. Im Untersuchungszeitraum wurden die analysierten Daten alle drei Monate im Rahmen einer Feedbackveranstaltung allen Beteiligten der Rettungs- und Therapiekette demonstriert. Ergebnisse: Im genannten Zeitraum konnten 188 Patienten in die Studie eingeschlossen werden (19\% weiblich, 81\% m{\"a}nnlich), wovon 85\% eine PCI im Anschluss an die Koronarangiographie erhielten. Das mittlere Alter betrug 62±12 Jahre, 15\% der Patienten waren {\"u}ber 75 Jahre. Der mittlere TIMI-Risk-Score lag bei 3,7 Punkten. Die intrahospitale Letalit{\"a}t lag bei 6,9\%. Die Pr{\"a}hospitalzeit betrug im Median 120min; es ergab sich keine signifikante Ver{\"a}nderung {\"u}ber die Quartale. Ein Sekund{\"a}rtransport bzw. ein pr{\"a}hospitaler Kontakt zum Hausarzt verl{\"a}ngerten die Pr{\"a}hospitalzeit im Median um 173 bzw. 57min. Die Door-to-balloon(D2B)-Zeit betrug im Gesamtuntersuchungszeitraum im Median 76min, nur 33\% der Patienten erreichten eine leitliniengerechte D2B-Zeit von <60min. Die meiste Zeit innerhalb der D2B-Zeit entfiel auf die Zeit vom Erreichen der PCI-Klinik bis zum Herzkatheterlabor (Door-to-cath-Zeit). Die Verk{\"u}rzung der D2B-Zeit von 80min im ersten auf 70min im f{\"u}nften Quartal war statistisch nicht signifikant. Die Contact-to-balloon(C2B)-Zeit betrug im Gesamtuntersuchungszeitraum im Median 139min und konnte innerhalb des Untersuchungszeitraums statistisch signifikant von 164min im ersten auf 112min im f{\"u}nften Quartal gesenkt werden. Dadurch konnte die Anzahl der leitliniengerecht behandelten Patienten (C2B-Zeit<120min) von 15 auf 58\% im Gesamtkollektiv bzw. 24 auf 63\% bei Patienten mit Prim{\"a}rtransport erh{\"o}ht werden. Schlussfolgerung: Das Patientenkollektiv des Herzinfarktnetzes Mainfranken entsprach bez{\"u}glich der Basischarakteristika dem anderer nationaler und internationaler Register. Da eine PCI innerhalb von 120min nach medizinischem Erstkontakt als bestm{\"o}gliche Therapie beim ST-Hebungsinfarkt angesehen wird und trotz der Verbesserung im Untersuchungszeitraum im f{\"u}nften Quartal nur 58\% der Patienten eine PCI in diesem Zeitintervall erhielten, sollten alle Anstrengungen unternommen werden die D2B- und C2B-Zeiten im Herzinfarktnetz weiter zu verk{\"u}rzen. Hierf{\"u}r sollte eine Direkt{\"u}bergabe im Herzkatheterlabor erm{\"o}glicht werden, da die Door-to-cath-Zeit in W{\"u}rzburg im Median 36 bis 48min in Anspruch nahm. Dar{\"u}ber hinaus sollte durch Aufkl{\"a}rungs- und Informationsarbeit sowie Schulungen f{\"u}r Rettungspersonal und Patienten versucht werden einen Sekund{\"a}rtransport oder Hausarztkontakt sowie ein verz{\"o}gertes Alarmieren des Rettungsdienstes zu vermeiden, da sich hierdurch die Pr{\"a}hospitalzeit massiv verl{\"a}ngerte. Inwieweit die im Untersuchungszeitraum gezeigte Verk{\"u}rzung der Zeiten mit den durchgef{\"u}hrten Feedbackveranstaltungen zusammenh{\"a}ngt bleibt ungewiss, da die Ver{\"a}nderung auch durch die Etablierung des neu gegr{\"u}ndeten Netzwerks an sich bedingt sein kann.}, subject = {Herzinfarkt}, language = {de} } @article{PetersHempAppelhansetal.2016, author = {Peters, Marcell K. and Hemp, Andreas and Appelhans, Tim and Behler, Christina and Classen, Alice and Detsch, Florian and Ensslin, Andreas and Ferger, Stefan W. and Frederiksen, Sara B. and Gebert, Frederike and Haas, Michael and Helbig-Bonitz, Maria and Hemp, Claudia and Kindeketa, William J. and Mwangomo, Ephraim and Ngereza, Christine and Otte, Insa and R{\"o}der, Juliane and Rutten, Gemma and Costa, David Schellenberger and Tardanico, Joseph and Zancolli, Giulia and Deckert, J{\"u}rgen and Eardley, Connal D. and Peters, Ralph S. and R{\"o}del, Mark-Oliver and Schleuning, Matthias and Ssymank, Axel and Kakengi, Victor and Zhang, Jie and B{\"o}hning-Gaese, Katrin and Brandl, Roland and Kalko, Elisabeth K.V. and Kleyer, Michael and Nauss, Thomas and Tschapka, Marco and Fischer, Markus and Steffan-Dewenter, Ingolf}, title = {Predictors of elevational biodiversity gradients change from single taxa to the multi-taxa community level}, series = {Nature Communications}, volume = {7}, journal = {Nature Communications}, doi = {10.1038/ncomms13736}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-169374}, year = {2016}, abstract = {The factors determining gradients of biodiversity are a fundamental yet unresolved topic in ecology. While diversity gradients have been analysed for numerous single taxa, progress towards general explanatory models has been hampered by limitations in the phylogenetic coverage of past studies. By parallel sampling of 25 major plant and animal taxa along a 3.7 km elevational gradient on Mt. Kilimanjaro, we quantify cross-taxon consensus in diversity gradients and evaluate predictors of diversity from single taxa to a multi-taxa community level. While single taxa show complex distribution patterns and respond to different environmental factors, scaling up diversity to the community level leads to an unambiguous support for temperature as the main predictor of species richness in both plants and animals. Our findings illuminate the influence of taxonomic coverage for models of diversity gradients and point to the importance of temperature for diversification and species coexistence in plant and animal communities.}, language = {en} } @article{SedaghatHamedaniRebsKayvanpouretal.2022, author = {Sedaghat-Hamedani, Farbod and Rebs, Sabine and Kayvanpour, Elham and Zhu, Chenchen and Amr, Ali and M{\"u}ller, Marion and Haas, Jan and Wu, Jingyan and Steinmetz, Lars M. and Ehlermann, Philipp and Streckfuss-B{\"o}meke, Katrin and Frey, Norbert and Meder, Benjamin}, title = {Genotype complements the phenotype: identification of the pathogenicity of an LMNA splice variant by nanopore long-read sequencing in a large DCM family}, series = {International Journal of Molecular Sciences}, volume = {23}, journal = {International Journal of Molecular Sciences}, number = {20}, issn = {1422-0067}, doi = {10.3390/ijms232012230}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-290415}, year = {2022}, abstract = {Dilated cardiomyopathy (DCM) is a common cause of heart failure (HF) and is of familial origin in 20-40\% of cases. Genetic testing by next-generation sequencing (NGS) has yielded a definite diagnosis in many cases; however, some remain elusive. In this study, we used a combination of NGS, human-induced pluripotent-stem-cell-derived cardiomyocytes (iPSC-CMs) and nanopore long-read sequencing to identify the causal variant in a multi-generational pedigree of DCM. A four-generation family with familial DCM was investigated. Next-generation sequencing (NGS) was performed on 22 family members. Skin biopsies from two affected family members were used to generate iPSCs, which were then differentiated into iPSC-CMs. Short-read RNA sequencing was used for the evaluation of the target gene expression, and long-read RNA nanopore sequencing was used to evaluate the relevance of the splice variants. The pedigree suggested a highly penetrant, autosomal dominant mode of inheritance. The phenotype of the family was suggestive of laminopathy, but previous genetic testing using both Sanger and panel sequencing only yielded conflicting evidence for LMNA p.R644C (rs142000963), which was not fully segregated. By re-sequencing four additional affected family members, further non-coding LMNA variants could be detected: rs149339264, rs199686967, rs201379016, and rs794728589. To explore the roles of these variants, iPSC-CMs were generated. RNA sequencing showed the LMNA expression levels to be significantly lower in the iPSC-CMs of the LMNA variant carriers. We demonstrated a dysregulated sarcomeric structure and altered calcium homeostasis in the iPSC-CMs of the LMNA variant carriers. Using targeted nanopore long-read sequencing, we revealed the biological significance of the variant c.356+1G>A, which generates a novel 5′ splice site in exon 1 of the cardiac isomer of LMNA, causing a nonsense mRNA product with almost complete RNA decay and haploinsufficiency. Using novel molecular analysis and nanopore technology, we demonstrated the pathogenesis of the rs794728589 (c.356+1G>A) splice variant in LMNA. This study highlights the importance of precise diagnostics in the clinical management and workup of cardiomyopathies.}, language = {en} } @article{SedaghatHamedaniRebsElBattrawyetal.2021, author = {Sedaghat-Hamedani, Farbod and Rebs, Sabine and El-Battrawy, Ibrahim and Chasan, Safak and Krause, Tobias and Haas, Jan and Zhong, Rujia and Liao, Zhenxing and Xu, Qiang and Zhou, Xiaobo and Akin, Ibrahim and Zitron, Edgar and Frey, Norbert and Streckfuss-B{\"o}meke, Katrin and Kayvanpour, Elham}, title = {Identification of SCN5a p.C335R variant in a large family with dilated cardiomyopathy and conduction disease}, series = {International Journal of Molecular Sciences}, volume = {22}, journal = {International Journal of Molecular Sciences}, number = {23}, issn = {1422-0067}, doi = {10.3390/ijms222312990}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-284442}, year = {2021}, abstract = {Introduction: Familial dilated cardiomyopathy (DCM) is clinically variable and has been associated with mutations in more than 50 genes. Rapid improvements in DNA sequencing have led to the identification of diverse rare variants with unknown significance (VUS), which underlines the importance of functional analyses. In this study, by investigating human-induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs), we evaluated the pathogenicity of the p.C335R sodium voltage-gated channel alpha subunit 5 (SCN5a) variant in a large family with familial DCM and conduction disease. Methods: A four-generation family with autosomal dominant familial DCM was investigated. Next-generation sequencing (NGS) was performed in all 16 family members. Clinical deep phenotyping, including endomyocardial biopsy, was performed. Skin biopsies from two patients and one healthy family member were used to generate human-induced pluripotent stem cells (iPSCs), which were then differentiated into cardiomyocytes. Patch-clamp analysis with Xenopus oocytes and iPSC-CMs were performed. Results: A SCN5a variant (c.1003T>C; p.C335R) could be detected in all family members with DCM or conduction disease. A novel truncating TTN variant (p.Ser24998LysfsTer28) could also be identified in two family members with DCM. Family members with the SCN5a variant (p.C335R) showed significantly longer PQ and QRS intervals and lower left ventricular ejection fractions (LV-EF). All four patients who received CRT-D were non-responders. Electrophysiological analysis with Xenopus oocytes showed a loss of function in SCN5a p.C335R. Na\(^+\) channel currents were also reduced in iPSC-CMs from DCM patients. Furthermore, iPSC-CM with compound heterozygosity (SCN5a p.C335R and TTNtv) showed significant dysregulation of sarcomere structures, which may be contributed to the severity of the disease and earlier onset of DCM. Conclusion: The SCN5a p.C335R variant is causing a loss of function of peak INa in patients with DCM and cardiac conduction disease. The co-existence of genetic variants in channels and structural genes (e.g., SCN5a p.C335R and TTNtv) increases the severity of the DCM phenotype.}, language = {en} } @article{ZieglerMeyerOtteetal.2022, author = {Ziegler, Alice and Meyer, Hanna and Otte, Insa and Peters, Marcell K. and Appelhans, Tim and Behler, Christina and B{\"o}hning-Gaese, Katrin and Classen, Alice and Detsch, Florian and Deckert, J{\"u}rgen and Eardley, Connal D. and Ferger, Stefan W. and Fischer, Markus and Gebert, Friederike and Haas, Michael and Helbig-Bonitz, Maria and Hemp, Andreas and Hemp, Claudia and Kakengi, Victor and Mayr, Antonia V. and Ngereza, Christine and Reudenbach, Christoph and R{\"o}der, Juliane and Rutten, Gemma and Schellenberger Costa, David and Schleuning, Matthias and Ssymank, Axel and Steffan-Dewenter, Ingolf and Tardanico, Joseph and Tschapka, Marco and Vollst{\"a}dt, Maximilian G. R. and W{\"o}llauer, Stephan and Zhang, Jie and Brandl, Roland and Nauss, Thomas}, title = {Potential of airborne LiDAR derived vegetation structure for the prediction of animal species richness at Mount Kilimanjaro}, series = {Remote Sensing}, volume = {14}, journal = {Remote Sensing}, number = {3}, issn = {2072-4292}, doi = {10.3390/rs14030786}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-262251}, year = {2022}, abstract = {The monitoring of species and functional diversity is of increasing relevance for the development of strategies for the conservation and management of biodiversity. Therefore, reliable estimates of the performance of monitoring techniques across taxa become important. Using a unique dataset, this study investigates the potential of airborne LiDAR-derived variables characterizing vegetation structure as predictors for animal species richness at the southern slopes of Mount Kilimanjaro. To disentangle the structural LiDAR information from co-factors related to elevational vegetation zones, LiDAR-based models were compared to the predictive power of elevation models. 17 taxa and 4 feeding guilds were modeled and the standardized study design allowed for a comparison across the assemblages. Results show that most taxa (14) and feeding guilds (3) can be predicted best by elevation with normalized RMSE values but only for three of those taxa and two of those feeding guilds the difference to other models is significant. Generally, modeling performances between different models vary only slightly for each assemblage. For the remaining, structural information at most showed little additional contribution to the performance. In summary, LiDAR observations can be used for animal species prediction. However, the effort and cost of aerial surveys are not always in proportion with the prediction quality, especially when the species distribution follows zonal patterns, and elevation information yields similar results.}, language = {en} }