11547
2014
eng
1441-1447
9
99
article
1
2015-07-07
--
--
Distinct characteristics of e13a2 versus e14a2 BCR-ABL1 driven chronic myeloid leukemia under first-line therapy with imatinib
The vast majority of chronic myeloid leukemia patients express a BCR-ABL1 fusion gene mRNA encoding a 210 kDa tyrosine kinase which promotes leukemic transformation. A possible differential impact of the corresponding BCR-ABL1 transcript variants e13a2 ("b2a2") and e14a2 ("b3a2") on disease phenotype and outcome is still a subject of debate. A total of 1105 newly diagnosed imatinib-treated patients were analyzed according to transcript type at diagnosis (e13a2, n=451; e14a2, n=496; e13a2+e14a2, n=158). No differences regarding age, sex, or Euro risk score were observed. A significant difference was found between e13a2 and e14a2 when comparing white blood cells (88 vs. 65 x 10(9)/L, respectively; P<0.001) and platelets (296 vs. 430 x 109/L, respectively; P<0.001) at diagnosis, indicating a distinct disease phenotype. No significant difference was observed regarding other hematologic features, including spleen size and hematologic adverse events, during imatinib-based therapies. Cumulative molecular response was inferior in e13a2 patients (P=0.002 for major molecular response; P<0.001 for MR4). No difference was observed with regard to cytogenetic response and overall survival. In conclusion, e13a2 and e14a2 chronic myeloid leukemia seem to represent distinct biological entities. However, clinical outcome under imatinib treatment was comparable and no risk prediction can be made according to e13a2 versus e14a2 BCR-ABL1 transcript type at diagnosis. (clinicaltrials.gov identifier: 00055874)
Haematologica
10.3324/haematol.2013.096537
1592-8721
24837466
urn:nbn:de:bvb:20-opus-115476
Haematologica 2014 99(9) 1441-1447. DOI 10.3324/haematol.2013.096537
Deutsches Urheberrecht
Benjamin Hanfstein
Michael Lauseker
Rüdiger Hehlmann
Susanne Saussele
Philipp Erben
Christian Dietz
Alice Fabarius
Ulrike Proetel
Susanne Schnittger
Claudia Haferlach
Stefan W. Krause
Jörg Schubert
Hermann Einsele
Mathias Hänel
Jolanta Dengler
Christiane Falge
Lothar Kanz
Andreas Neubauer
Michael Kneba
Frank Stengelmann
Michael Pfreundschuh
Cornelius F. Waller
Karsten Spiekerman
Gabriela M. Baerlocher
Markus Pfirrmann
Joerg Hasford
Wolf-Karsten Hofmann
Andreas Hochhaus
Martin C. Müller
eng
uncontrolled
chronic myelogenous leukemia
eng
uncontrolled
polymerase-chain-reaktion
eng
uncontrolled
hybrid messenger RNA
eng
uncontrolled
chronic phase
eng
uncontrolled
cytogenetic response
eng
uncontrolled
no correlation
eng
uncontrolled
ABL gene
eng
uncontrolled
transcripts
eng
uncontrolled
breakpoint
eng
uncontrolled
survival
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik II
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/11547/051_Hanfstein_Haematologica_full.pdf
https://opus.bibliothek.uni-wuerzburg.de/files/11547/051_Hanfstein_Haematologica.pdf
22752
2018
eng
1222-1228
5
32
article
1
2021-02-25
--
--
Defining therapy goals for major molecular remission in chronic myeloid leukemia: results of the randomized CML Study IV
Major molecular remission (MMR) is an important therapy goal in chronic myeloid leukemia (CML). So far, MMR is not a failure criterion according to ELN management recommendation leading to uncertainties when to change therapy in CML patients not reaching MMR after 12 months. At monthly landmarks, for different molecular remission status Hazard ratios (HR) were estimated for patients registered to CML study IV who were divided in a learning and a validation sample. The minimum HR for MMR was found at 2.5 years with 0.28 (compared to patients without remission). In the validation sample, a significant advantage for progression-free survival (PFS) for patients in MMR could be detected (p-value 0.007). The optimal time to predict PFS in patients with MMR could be validated in an independent sample at 2.5 years. With our model we provide a suggestion when to define lack of MMR as therapy failure and thus treatment change should be considered. The optimal response time for 1% BCR-ABL at about 12-15 months was confirmed and for deep molecular remission no specific time point was detected. Nevertheless, it was demonstrated that the earlier the MMR is achieved the higher is the chance to attain deep molecular response later.
Leukemia
10.1038/s41375-018-0055-7
urn:nbn:de:bvb:20-opus-227528
publish
Leukemia (2018) 32:1222–1228
true
true
CC BY-NC-SA: Creative-Commons-Lizenz: Namensnennung, Nicht kommerziell, Weitergabe unter gleichen Bedingungen 4.0 International
Susanne Saussele
Ruediger Hehlmann
Alice Fabarius
Sabine Jeromin
Ulrike Proetel
Sebastien Rinaldetti
Katharina Kohlbrenner
Hermann Einsele
Christine Falge
Lothar Kanz
Andreas Neubauer
Michael Kneba
Frank Stegelmann
Michael Pfreundschuh
Cornelius F. Waller
Elisabeth Oppliger Leibundgut
Dominik Heim
Stefan W. Krause
Wolf-Karsten Hofmann
Joerg Hasford
Markus Pfirrmann
Martin C. Müller
Andreas Hochhaus
Michael Lauseker
eng
uncontrolled
Chronic myeloid leukaemia
eng
uncontrolled
Molecularly targeted therapy
eng
uncontrolled
Risk factors
eng
uncontrolled
Risk factors
eng
uncontrolled
Translational research
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik II
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/22752/Defining_therapy_goals.pdf
17201
2017
eng
363-377
4
26
article
1
2018-11-16
--
--
Decadal and multi-year predictability of the West African monsoon and the role of dynamical downscaling
West African summer monsoon precipitation is characterized by distinct decadal variability. Due to its welldocumented link to oceanic boundary conditions in various ocean basins it represents a paradigm for decadal predictability. In this study, we reappraise this hypothesis for several sub-regions of sub-Saharan West Africa using the new German contribution to the coupled model intercomparison project phase 5 (CMIP5) near-term prediction system.
In addition, we assume that dynamical downscaling of the global decadal predictions leads to an enhanced predictive skill because enhanced resolution improves the atmospheric response to oceanic forcing and landsurface feedbacks. Based on three regional climate models, a heterogeneous picture is drawn: none of the regional climate models outperforms the global decadal predictions or all other regional climate models in every region nor decade. However, for every test case at least one regional climate model was identified which outperforms the global predictions. The highest predictive skill is found in the western and central Sahel Zone with correlation coefficients and mean-square skill scores exceeding 0.9 and 0.8, respectively.
Meteorologische Zeitschrift
10.1127/metz/2017/0811
urn:nbn:de:bvb:20-opus-172018
Meteorologische Zeitschrift (2017) 26:4, 363-377. https://doi.org/10.1127/metz/2017/0811
Heiko Paeth
Andreas Paxian
Dimitry V. Sein
Daniela Jacob
Hans-Jürgen Panitz
Michael Warscher
Andreas H. Fink
Harald Kunstmann
Marcus Breil
Thomas Engel
Andreas Krause
Julian Toedter
Bodo Ahrens
eng
uncontrolled
geography
eng
uncontrolled
decadal predictability
eng
uncontrolled
West Africa
eng
uncontrolled
monsoon rainfall
eng
uncontrolled
dynamical downscaling
Geschichte und Geografie
open_access
Institut für Geographie und Geologie
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/17201/Paeth_Decadal_and_multi_year_predictability_of_the_West_African_monsoon_87336.pdf
5614
2010
eng
article
1
2012-02-24
--
--
Gene expression analysis after receptor tyrosine kinase activation reveals new potential melanoma proteins
Background: Melanoma is an aggressive tumor with increasing incidence. To develop accurate prognostic markers and targeted therapies, changes leading to malignant transformation of melanocytes need to be understood. In the Xiphophorus melanoma model system, a mutated version of the EGF receptor Xmrk (Xiphophorus melanoma receptor kinase) triggers melanomagenesis. Cellular events downstream of Xmrk, such as the activation of Akt, Ras, B-Raf or Stat5, were also shown to play a role in human melanomagenesis. This makes the elucidation of Xmrk downstream targets a useful method for identifying processes involved in melanoma formation. Methods: Here, we analyzed Xmrk-induced gene expression using a microarray approach. Several highly expressed genes were confirmed by realtime PCR, and pathways responsible for their induction were revealed using small molecule inhibitors. The expression of these genes was also monitored in human melanoma cell lines, and the target gene FOSL1 was knocked down by siRNA. Proliferation and migration of siRNA-treated melanoma cell lines were then investigated. Results: Genes with the strongest upregulation after receptor activation were FOS-like antigen 1 (Fosl1), early growth response 1 (Egr1), osteopontin (Opn), insulin-like growth factor binding protein 3 (Igfbp3), dual-specificity phosphatase 4 (Dusp4), and tumor-associated antigen L6 (Taal6). Interestingly, most genes were blocked in presence of a SRC kinase inhibitor. Importantly, we found that FOSL1, OPN, IGFBP3, DUSP4, and TAAL6 also exhibited increased expression levels in human melanoma cell lines compared to human melanocytes. Knockdown of FOSL1 in human melanoma cell lines reduced their proliferation and migration. Conclusion: Altogether, the data show that the receptor tyrosine kinase Xmrk is a useful tool in the identification of target genes that are commonly expressed in Xmrk-transgenic melanocytes and melanoma cell lines. The identified molecules constitute new possible molecular players in melanoma development. Specifically, a role of FOSL1 in melanomagenic processes is demonstrated. These data are the basis for future detailed analyses of the investigated target genes.
urn:nbn:de:bvb:20-opus-67900
6790
BMC CANCER (2010) 10, DOI: 10.1186/1471-2407-10-386
Janka Teutschbein
Johannes M. Haydn
Birgit Samans
Michael Krause
Martin Eilers
Manfred Schartl
Svenja Meierjohann
eng
uncontrolled
Melanoma
Medizin und Gesundheit
open_access
Theodor-Boveri-Institut für Biowissenschaften
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/5614/Meierjohann_1471_2407_10_386.pdf
12157
2014
eng
1167-76
7
93
article
for the German Chronic Myeloid Leukemia Study Group, and the Schweizerische Arbeitsgemeinschaft für Klinische Krebsforschung (SAKK)
1
2015-11-02
--
--
Older patients with chronic myeloid leukemia (≥65 years) profit more from higher imatinib doses than younger patients: a subanalysis of the randomized CML-Study IV
The impact of imatinib dose on response rates and survival in older patients with chronic myeloid leukemia in chronic phase has not been studied well. We analyzed data from the German CML-Study IV, a randomized five-arm treatment optimization study in newly diagnosed BCR-ABL-positive chronic myeloid leukemia in chronic phase. Patients randomized to imatinib 400 mg/day (IM400) or imatinib 800 mg/day (IM800) and stratified according to age (≥65 years vs. <65 years) were compared regarding dose, response, adverse events, rates of progression, and survival. The full 800 mg dose was given after a 6-week run-in period with imatinib 400 mg/day. The dose could then be reduced according to tolerability. A total of 828 patients were randomized to IM400 or IM800. Seven hundred eighty-four patients were evaluable (IM400, 382; IM800, 402). One hundred ten patients (29 %) on IM400 and 83 (21 %) on IM800 were ≥65 years. The median dose per day was lower for patients ≥65 years on IM800, with the highest median dose in the first year (466 mg/day for patients ≥65 years vs. 630 mg/day for patients <65 years). Older patients on IM800 achieved major molecular remission and deep molecular remission as fast as younger patients, in contrast to standard dose imatinib with which older patients achieved remissions much later than younger patients. Grades 3 and 4 adverse events were similar in both age groups. Five-year relative survival for older patients was comparable to that of younger patients. We suggest that the optimal dose for older patients is higher than 400 mg/day. ClinicalTrials.gov identifier: NCT00055874
Annals of Hematology
10.1007/s00277-014-2041-0
0939-5555
24658964
urn:nbn:de:bvb:20-opus-121574
Annals of Hematology (2014) 93:1167–1176 DOI 10.1007/s00277-014-2041-0
Ulrike Proetel
Nadine Pletsch
Michael Lauseker
Martin C. Müller
Benjamin Hanfstein
Stefan W. Krause
Lida Kalmanti
Annette Schreiber
Dominik Heim
Gabriela M. Baerlocher
Wolf-Karsten Hofmann
Elisabeth Lange
Hermann Einsele
Martin Wernli
Stephan Kremers
Rudolf Schlag
Lothar Müller
Mathias Hänel
Hartmut Link
Bernd Hertenstein
Markus Pfirrmann
Andreas Hochhaus
Joerg Hasford
Rüdiger Hehlmann
Susanne Saußele
eng
uncontrolled
chronic myeloid leukemia
eng
uncontrolled
older patients
eng
uncontrolled
different imatinib dose regimens
eng
uncontrolled
early applied higher imatinib dosages
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik II
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/12157/053_Proetel_Annals_of_Hematology.pdf
9692
2013
eng
article
1
--
--
--
LIN9, a Subunit of the DREAM Complex, Regulates Mitotic Gene Expression and Proliferation of Embryonic Stem Cells
The DREAM complex plays an important role in regulation of gene expression during the cell cycle. We have previously shown that the DREAM subunit LIN9 is required for early embryonic development and for the maintenance of the inner cell mass in vitro. In this study we examined the effect of knocking down LIN9 on ESCs. We demonstrate that depletion of LIN9 alters the cell cycle distribution of ESCs and results in an accumulation of cells in G2 and M and in an increase of polyploid cells. Genome-wide expression studies showed that the depletion of LIN9 results in downregulation of mitotic genes and in upregulation of differentiation-specific genes. ChIP-on chip experiments showed that mitotic genes are direct targets of LIN9 while lineage specific markers are regulated indirectly. Importantly, depletion of LIN9 does not alter the expression of pluripotency markers SOX2, OCT4 and Nanog and LIN9 depleted ESCs retain alkaline phosphatase activity. We conclude that LIN9 is essential for proliferation and genome stability of ESCs by activating genes with important functions in mitosis and cytokinesis.
PLoS ONE
10.1371/journal.pone.0062882
urn:nbn:de:bvb:20-opus-96922
In: PLoS One (2013) 8: 5, doi:10.1371/journal.pone.0062882
Stefan Gaubatz
Jasmina Esterlechner
Nina Reichert
Fabian Iltzsche
Michael Krause
Florian Finkernagel
eng
uncontrolled
cell cycle
eng
uncontrolled
cell division
eng
uncontrolled
cell differentation
eng
uncontrolled
DNA-binding proteins
eng
uncontrolled
gene expression
eng
uncontrolled
gene regulation
eng
uncontrolled
gene targeting
eng
uncontrolled
microarrays
eng
uncontrolled
pluripotency
Biowissenschaften; Biologie
open_access
Theodor-Boveri-Institut für Biowissenschaften
Förderzeitraum 2013
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/9692/Gaubatz_journal.pone.0062882.pdf
23673
2021
eng
9
13
article
1
--
2021-04-26
--
Loss-of-function mutations of BCOR are an independent marker of adverse outcomes in intensively treated patients with acute myeloid leukemia
Acute myeloid leukemia (AML) is characterized by recurrent genetic events. The BCL6 corepressor (BCOR) and its homolog, the BCL6 corepressor-like 1 (BCORL1), have been reported to be rare but recurrent mutations in AML. Previously, smaller studies have reported conflicting results regarding impacts on outcomes. Here, we retrospectively analyzed a large cohort of 1529 patients with newly diagnosed and intensively treated AML. BCOR and BCORL1 mutations were found in 71 (4.6%) and 53 patients (3.5%), respectively. Frequently co-mutated genes were DNTM3A, TET2 and RUNX1. Mutated BCORL1 and loss-of-function mutations of BCOR were significantly more common in the ELN2017 intermediate-risk group. Patients harboring loss-of-function mutations of BCOR had a significantly reduced median event-free survival (HR = 1.464 (95%-Confidence Interval (CI): 1.005–2.134), p = 0.047), relapse-free survival (HR = 1.904 (95%-CI: 1.163–3.117), p = 0.01), and trend for reduced overall survival (HR = 1.495 (95%-CI: 0.990–2.258), p = 0.056) in multivariable analysis. Our study establishes a novel role for loss-of-function mutations of BCOR regarding risk stratification in AML, which may influence treatment allocation.
Cancers
2072-6694
10.3390/cancers13092095
urn:nbn:de:bvb:20-opus-236735
2021-05-03T18:32:27+00:00
sword
swordwue
attachment; filename=deposit.zip
dc3f35ae8ed1fb85a3af2b7df56e410e
Cancers (2021) 13:9, 2095. https://doi.org/10.3390/cancers13092095
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Jan-Niklas Eckardt
Sebastian Stasik
Michael Kramer
Christoph Röllig
Alwin Krämer
Sebastian Scholl
Andreas Hochhaus
Martina Crysandt
Tim H. Brümmendorf
Ralph Naumann
Björn Steffen
Volker Kunzmann
Hermann Einsele
Markus Schaich
Andreas Burchert
Andreas Neubauer
Kerstin Schäfer-Eckart
Christoph Schliemann
Stefan W. Krause
Regina Herbst
Mathias Hänel
Norbert Frickhofen
Richard Noppeney
Ulrich Kaiser
Claudia D. Baldus
Martin Kaufmann
Zdenek Rácil
Uwe Platzbecker
Wolfgang E. Berdel
Jiří Mayer
Hubert Serve
Carsten Müller-Tidow
Gerhard Ehninger
Friedrich Stölzel
Frank Kroschinsky
Johannes Schetelig
Martin Bornhäuser
Christian Thiede
Jan Moritz Middeke
eng
uncontrolled
acute myeloid leukemia
eng
uncontrolled
BCOR
eng
uncontrolled
BCORL1
eng
uncontrolled
loss-of-function
eng
uncontrolled
risk stratification
eng
uncontrolled
survival
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik II
Import
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/23673/cancers-13-02095-v2.pdf
21406
2019
eng
1035
1042
11
62
article
1
--
--
--
Aspergillus specific nested PCR from the site of infection is superior to testing concurrent blood samples in immunocompromised patients with suspected invasive aspergillosis
Invasive aspergillosis (IA) is a severe complication in immunocompromised patients. Early diagnosis is crucial to decrease its high mortality, yet the diagnostic gold standard (histopathology and culture) is time‐consuming and cannot offer early confirmation of IA. Detection of IA by polymerase chain reaction (PCR) shows promising potential. Various studies have analysed its diagnostic performance in different clinical settings, especially addressing optimal specimen selection. However, direct comparison of different types of specimens in individual patients though essential, is rarely reported. We systematically assessed the diagnostic performance of an Aspergillus‐specific nested PCR by investigating specimens from the site of infection and comparing it with concurrent blood samples in individual patients (pts) with IA. In a retrospective multicenter analysis PCR was performed on clinical specimens (n = 138) of immunocompromised high‐risk pts (n = 133) from the site of infection together with concurrent blood samples. 38 pts were classified as proven/probable, 67 as possible and 28 as no IA according to 2008 European Organization for Research and Treatment of Cancer/Mycoses Study Group consensus definitions. A considerably superior performance of PCR from the site of infection was observed particularly in pts during antifungal prophylaxis (AFP)/antifungal therapy (AFT). Besides a specificity of 85%, sensitivity varied markedly in BAL (64%), CSF (100%), tissue samples (67%) as opposed to concurrent blood samples (8%). Our results further emphasise the need for investigating clinical samples from the site of infection in case of suspected IA to further establish or rule out the diagnosis.
Mycoses
10.1111/myc.12983
urn:nbn:de:bvb:20-opus-214065
swordwue
2020-10-19T17:22:26+00:00
attachment; filename=deposit.zip
7d3fec6e6e81c0b5a398cb1a2a3c0505
Mycoses 2019, 62(11):1035-1042. DOI: 10.1111/myc.12983
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Tobias Boch
Birgit Spiess
Werner Heinz
Oliver A. Cornely
Rainer Schwerdtfeger
Joachim Hahn
Stefan W. Krause
Matthias Duerken
Hartmut Bertz
Stefan Reuter
Michael Kiehl
Bernd Claus
Peter Markus Deckert
Wolf‐Karsten Hofmann
Dieter Buchheidt
Mark Reinwald
eng
uncontrolled
antifungal
eng
uncontrolled
aspergillosis
eng
uncontrolled
BAL
eng
uncontrolled
blood
eng
uncontrolled
cerebrospinal fluid
eng
uncontrolled
comparison
eng
uncontrolled
PCR
eng
uncontrolled
Aspergillus
Medizin und Gesundheit
open_access
Medizinische Klinik und Poliklinik II
Import
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/21406/MYC_MYC12983.pdf
26917
2021
eng
2187–2211
8
110
article
1
--
--
--
Density-based weighting for imbalanced regression
In many real world settings, imbalanced data impedes model performance of learning algorithms, like neural networks, mostly for rare cases. This is especially problematic for tasks focusing on these rare occurrences. For example, when estimating precipitation, extreme rainfall events are scarce but important considering their potential consequences. While there are numerous well studied solutions for classification settings, most of them cannot be applied to regression easily. Of the few solutions for regression tasks, barely any have explored cost-sensitive learning which is known to have advantages compared to sampling-based methods in classification tasks. In this work, we propose a sample weighting approach for imbalanced regression datasets called DenseWeight and a cost-sensitive learning approach for neural network regression with imbalanced data called DenseLoss based on our weighting scheme. DenseWeight weights data points according to their target value rarities through kernel density estimation (KDE). DenseLoss adjusts each data point’s influence on the loss according to DenseWeight, giving rare data points more influence on model training compared to common data points. We show on multiple differently distributed datasets that DenseLoss significantly improves model performance for rare data points through its density-based weighting scheme. Additionally, we compare DenseLoss to the state-of-the-art method SMOGN, finding that our method mostly yields better performance. Our approach provides more control over model training as it enables us to actively decide on the trade-off between focusing on common or rare cases through a single hyperparameter, allowing the training of better models for rare data points.
Machine Learning
1573-0565
10.1007/s10994-021-06023-5
urn:nbn:de:bvb:20-opus-269177
publish
Machine Learning 2021, 110(8):2187–2211. DOI: 10.1007/s10994-021-06023-5
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Michael Steininger
Konstantin Kobs
Padraig Davidson
Anna Krause
Andreas Hotho
eng
uncontrolled
supervised learning
eng
uncontrolled
imbalanced regression
eng
uncontrolled
cost-sensitive learning
eng
uncontrolled
sample weighting
eng
uncontrolled
Kerneldensity estimation
Datenverarbeitung; Informatik
open_access
Institut für Informatik
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/26917/Steininger_Machine.pdf
23504
2021
deu
832–838
124
article
Komitee Frakturen der Deutschen Kniegesellschaft (DKG)
1
2021-04-21
--
--
Aktueller Versorgungsstandard von Patellafrakturen in Deutschland
Hintergrund
Die Versorgung von Patellafrakturen ist technisch anspruchsvoll. Auch wenn die radiologischen Ergebnisse zumeist zufriedenstellend sind, deckt sich dies häufig nicht mit der subjektiven Einschätzung der Patienten. Die klassische Versorgung mittels Drahtzuggurtung weist einige Komplikationen auf. Die winkelstabile Plattenosteosynthese hat sich in den letzten Jahren biomechanisch als vorteilhaft erwiesen.
Fragestellung
Von wem werden Patellafrakturen in Deutschland versorgt? Wie sieht der aktuelle Versorgungsstandard aus? Haben sich „moderne“ Osteosyntheseformen durchgesetzt? Was sind die häufigsten Komplikationen?
Material und Methoden
Die Mitglieder der Deutschen Gesellschaft für Orthopädie und Unfallchirurgie sowie der Deutschen Kniegesellschaft wurden aufgefordert, an einer Onlinebefragung teilzunehmen.
Ergebnisse
Insgesamt wurden 511 komplett ausgefüllte Fragebogen ausgewertet. Die Befragten sind zum größten Teil auf Unfallchirurgie spezialisiert (51,5 %) und verfügen über langjährige Berufserfahrung in Traumazentren. Die Hälfte der Operateure versorgt ≤5 Patellafrakturen jährlich. In knapp 40 % der Fälle wird die präoperative Bildgebung um eine Computertomographie ergänzt. Die klassische Zuggurtung ist noch die bevorzugte Osteosyntheseform bei allen Frakturtypen (Querfraktur 52 %, Mehrfragmentfrakturen 40 %). Bei Mehrfragmentfrakturen entscheiden sich 30 % der Operateure für eine winkelstabile Plattenosteosynthese. Bei Beteiligung des kaudalen Pols dient als zusätzliche Sicherung die McLaughlin-Schlinge (60 %).
Diskussion
Der Versorgungsstandard von Patellafrakturen in Deutschland entspricht weitgehend der aktualisierten S2e-Leitlinie. Nach wie vor wird die klassische Zuggurtungsosteosynthese als Verfahren der Wahl genutzt. Weitere klinische (Langzeit‑)Studien werden benötigt, um die Vorteile der winkelstabilen Plattenosteosynthese zu verifizieren.
Background
The treatment of patella fractures is technically demanding. Although the radiological results are mostly satisfactory, this often does not correspond to the subjective assessment of the patients. The classical treatment with tension band wiring with K‑wires has several complications. Fixed-angle plate osteosynthesis seems to be biomechanically advantageous.
Objective
Who is treating patella fractures in Germany? What is the current standard of treatment? Have modern forms of osteosynthesis become established? What are the most important complications?
Material and methods
The members of the German Society for Orthopedics and Trauma Surgery and the German Knee Society were asked to participate in an online survey.
Results
A total of 511 completed questionnaires were evaluated. Most of the respondents are specialized in trauma surgery (51.5%), have many years of professional experience and work in trauma centers. Of the surgeons 50% treat ≤5 patella fractures annually. In almost 40% of the cases preoperative imaging is supplemented by computed tomography. The classical tension band wiring with K‑wires is still the preferred form of osteosynthesis for all types of fractures (transverse fractures 52%, comminuted fractures 40%). In the case of comminuted fractures 30% of the surgeons choose fixed-angle plate osteosynthesis. If the inferior pole is involved a McLaughlin cerclage is used for additional protection in 60% of the cases.
Discussion
The standard of care for patella fractures in Germany largely corresponds to the updated S2e guidelines. Tension band wiring is still the treatment of choice. Further (long-term) clinical studies are needed to verify the advantages of fixed-angle plates.
Der Unfallchirurg
Current treatment standard for patella fractures in Germany
0177-5537
10.1007/s00113-020-00939-8
urn:nbn:de:bvb:20-opus-235047
publish
Unfallchirurg 124, 832–838 (2021). https://doi.org/10.1007/s00113-020-00939-8
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Kai Fehske
Markus T. Berninger
Lena Alm
Reinhard Hoffmann
Johannes Zellner
Clemens Kösters
Stefan Barzen
Michael J. Raschke
Kaywan Izadpanah
Elmar Herbst
Christoph Domnick
Jan Philipp Schüttrumpf
Matthias Krause
deu
uncontrolled
Kniegelenk
deu
uncontrolled
Winkelstabile Platte
deu
uncontrolled
Klassische Zuggurtung
deu
uncontrolled
Versorgungsstrategien
deu
uncontrolled
Umfrage
eng
uncontrolled
knee joint
eng
uncontrolled
fixed-angle plate
eng
uncontrolled
tension band wiring
eng
uncontrolled
treatment strategy
eng
uncontrolled
survey
Medizin und Gesundheit
open_access
Klinik und Poliklinik für Unfall-, Hand-, Plastische und Wiederherstellungschirurgie (Chirurgische Klinik II)
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/23504/Fehske2021_Article_AktuellerVersorgungsstandardVo.pdf
32421
2023
eng
136–166
1
37
article
1
--
--
--
ConvMOS: climate model output statistics with deep learning
Climate models are the tool of choice for scientists researching climate change. Like all models they suffer from errors, particularly systematic and location-specific representation errors. One way to reduce these errors is model output statistics (MOS) where the model output is fitted to observational data with machine learning. In this work, we assess the use of convolutional Deep Learning climate MOS approaches and present the ConvMOS architecture which is specifically designed based on the observation that there are systematic and location-specific errors in the precipitation estimates of climate models. We apply ConvMOS models to the simulated precipitation of the regional climate model REMO, showing that a combination of per-location model parameters for reducing location-specific errors and global model parameters for reducing systematic errors is indeed beneficial for MOS performance. We find that ConvMOS models can reduce errors considerably and perform significantly better than three commonly used MOS approaches and plain ResNet and U-Net models in most cases. Our results show that non-linear MOS models underestimate the number of extreme precipitation events, which we alleviate by training models specialized towards extreme precipitation events with the imbalanced regression method DenseLoss. While we consider climate MOS, we argue that aspects of ConvMOS may also be beneficial in other domains with geospatial data, such as air pollution modeling or weather forecasts.
Data Mining and Knowledge Discovery
1384-5810
10.1007/s10618-022-00877-6
urn:nbn:de:bvb:20-opus-324213
@articleSteininger.2023, author = Steininger, Michael and Abel, Daniel and Ziegler, Katrin and Krause, Anna and Paeth, Heiko and Hotho, Andreas, year = 2023, title = ConvMOS: climate model output statistics with deep learning, pages = 136–166, volume = 37, number = 1, issn = 1384-5810, journal = Data Mining and Knowledge Discovery, doi = 10.1007/s10618-022-00877-6
md5:5eb852c46fe22ef1a670832af36581b0
2023-08-12T10:06:31+00:00
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bibtex
64d759a771d867.56101128
Data Mining and Knowledge Discovery (2023) 37:1, S. 136–166. DOI: 10.1007/s10618-022-00877-6
false
true
CC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International
Michael Steininger
Daniel Abel
Katrin Ziegler
Anna Krause
Heiko Paeth
Andreas Hotho
deu
swd
Klima
deu
swd
Modell
deu
swd
Deep learning
deu
swd
Neuronales Netz
eng
uncontrolled
climate
eng
uncontrolled
neural networks
eng
uncontrolled
model output statistics
Datenverarbeitung; Informatik
Spezielle Computerverfahren
Geologie, Hydrologie, Meteorologie
open_access
Institut für Informatik
Institut für Geographie und Geologie
OpenAIRE
Universität Würzburg
https://opus.bibliothek.uni-wuerzburg.de/files/32421/s10618-022-00877-6.pdf