TY - JOUR A1 - Zhou, Xiang A1 - Rasche, Leo A1 - Kortüm, K. Martin A1 - Danhof, Sophia A1 - Hudecek, Michael A1 - Einsele, Hermann T1 - Toxicities of Chimeric Antigen Receptor T Cell Therapy in Multiple Myeloma: An Overview of Experience From Clinical Trials, Pathophysiology, and Management Strategies JF - Frontiers in Immunology N2 - In the last few years, monoclonal antibodies (mAbs) such as elotuzumab and daratutumab have brought the treatment of multiple myeloma (MM) into the new era of immunotherapy. More recently, chimeric antigen receptor (CAR) modified T cell, a novel cellular immunotherapy, has been developed for treatment of relapsed/refractory (RR) MM, and early phase clinical trials have shown promising efficacy of CAR T cell therapy. Many patients with end stage RRMM regard CAR T cell therapy as their “last chance” and a “hope of cure”. However, severe adverse events (AEs) and even toxic death related to CAR T cell therapy have been observed. The management of AEs related to CAR T cell therapy represents a new challenge, as the pathophysiology is not fully understood and there is still no well-established standard of management. With regard to CAR T cell associated toxicities in MM, in this review, we will provide an overview of experience from clinical trials, pathophysiology, and management strategies. KW - CAR T cell KW - clinical trial KW - multiple myeloma KW - toxicity KW - pathophysiology KW - management Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-219911 SN - 1664-3224 VL - 11 ER - TY - JOUR A1 - Thorn, Simon A1 - Chao, Anne A1 - Georgiev, Konstadin B. A1 - Müller, Jörg A1 - Bässler, Claus A1 - Campbell, John L. A1 - Jorge, Castro A1 - Chen, Yan-Han A1 - Choi, Chang-Yong A1 - Cobb, Tyler P. A1 - Donato, Daniel C. A1 - Durska, Ewa A1 - Macdonald, Ellen A1 - Feldhaar, Heike A1 - Fontaine, Jospeh B. A1 - Fornwalt, Paula J. A1 - Hernández Hernández, Raquel María A1 - Hutto, Richard L. A1 - Koivula, Matti A1 - Lee, Eun-Jae A1 - Lindenmayer, David A1 - Mikusinski, Grzegorz A1 - Obrist, Martin K. A1 - Perlík, Michal A1 - Rost, Josep A1 - Waldron, Kaysandra A1 - Wermelinger, Beat A1 - Weiß, Ingmar A1 - Zmihorski, Michal A1 - Leverkus, Alexandro B. T1 - Estimating retention benchmarks for salvage logging to protect biodiversity JF - Nature Communications N2 - Forests are increasingly affected by natural disturbances. Subsequent salvage logging, a widespread management practice conducted predominantly to recover economic capital, produces further disturbance and impacts biodiversity worldwide. Hence, naturally disturbed forests are among the most threatened habitats in the world, with consequences for their associated biodiversity. However, there are no evidence-based benchmarks for the proportion of area of naturally disturbed forests to be excluded from salvage logging to conserve biodiversity. We apply a mixed rarefaction/extrapolation approach to a global multi-taxa dataset from disturbed forests, including birds, plants, insects and fungi, to close this gap. We find that 757% (mean +/- SD) of a naturally disturbed area of a forest needs to be left unlogged to maintain 90% richness of its unique species, whereas retaining 50% of a naturally disturbed forest unlogged maintains 73 +/- 12% of its unique species richness. These values do not change with the time elapsed since disturbance but vary considerably among taxonomic groups. Salvage logging has become a common practice to gain economic returns from naturally disturbed forests, but it could have considerable negative effects on biodiversity. Here the authors use a recently developed statistical method to estimate that ca. 75% of the naturally disturbed forest should be left unlogged to maintain 90% of the species unique to the area. KW - natural disturbance KW - bird communities KW - forest KW - management KW - beetle KW - conservation KW - windthrow KW - diversity KW - impact KW - fire Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-230512 VL - 11 ER - TY - JOUR A1 - Taubenböck, H A1 - Wurm, M A1 - Netzband, M A1 - Zwenzner, H A1 - Roth, A A1 - Rahman, A A1 - Dech, S T1 - Flood risks in urbanized areas - multi-sensoral approaches using remotely sensed data for risk assessment JF - NATURAL HAZARDS AND EARTH SYSTEM SCIENCES N2 - Estimating flood risks and managing disasters combines knowledge in climatology, meteorology, hydrology, hydraulic engineering, statistics, planning and geography - thus a complex multi-faceted problem. This study focuses on the capabilities of multi-source remote sensing data to support decision-making before, during and after a flood event. With our focus on urbanized areas, sample methods and applications show multi-scale products from the hazard and vulnerability perspective of the risk framework. From the hazard side, we present capabilities with which to assess flood-prone areas before an expected disaster. Then we map the spatial impact during or after a flood and finally, we analyze damage grades after a flood disaster. From the vulnerability side, we monitor urbanization over time on an urban footprint level, classify urban structures on an individual building level, assess building stability and quantify probably affected people. The results show a large database for sustainable development and for developing mitigation strategies, ad-hoc coordination of relief measures and organizing rehabilitation. KW - damage assessment disaster KW - satellite data KW - management KW - radar KW - inundation KW - disaster KW - sar KW - gis KW - integration KW - earthquake Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-139605 VL - 11 IS - 2 ER - TY - JOUR A1 - Steppuhn, Henriette A1 - Langen, Ute A1 - Scheidt-Nave, Christa A1 - Keil, Thomas T1 - Major comorbid conditions in asthma and association with asthma-related hospitalizations and emergency department admissions in adults: results from the German national health telephone interview survey (GEDA) 2010 JF - BMC Pulmonary Medicine N2 - Background: It remains unclear to what extent asthma in adults is linked to allergic rhinitis (AR), gastroesophageal reflux disease (GERD), and acetylsalicylic acid exacerbated respiratory disease (AERD), and how these comorbidities may affect asthma outcomes in the general population. We therefore aimed to assess the prevalence of these major comorbidities among adults with asthma and examine their impact on asthma exacerbations requiring hospital care. Methods: A total of 22,050 adults 18 years and older were surveyed in the German National Health Telephone Interview Survey (GEDA) 2010 using a highly standardized computer-assisted interview technique. The study population comprised participants with self-reported physician-diagnosed asthma, among which the current (last 12 months) prevalence of AR and GERD-like symptoms (GERS), and life-time prevalence of AERD was estimated. Weighted bivariate analyses and logistic regression models were applied to assess the association of each comorbid condition with the asthma outcome (any self-reported asthma-related hospitalization and/or emergency department (ED) admission in the past year). Results: Out of 1,136 adults with asthma, 49.6% had GERS and 42.3% had AR within the past 12 months; 14.0% met the criteria of AERD, and 75.7% had at least one out of the three conditions. Overall, the prevalence of at least one exacerbation requiring emergency room or hospital admission within the past year was 9.0%. Exacerbation prevalence was higher among participants with comorbidities than among those without (9.8% vs. 8.2% for GERS; 11.2% vs. 7.6% for AR, and 22.2% vs. 7.0% for AERD), but only differences in association with AERD were statistically significant. A strong association between asthma exacerbation and AERD persisted in multivariable logistic regression analyses adjusting for sex, age group, level of body mass index, smoking status, educational attainment, and duration of asthma: odds ratio (OR) = 4.5, 95% confidence interval (CI) = 2.5-8.2. Conclusions: Data from this large nation-wide study provide evidence that GERS, AR and AERD are all common comorbidities among adults with asthma. Our data underline the public health and clinical impact of asthma with complicating AERD, contributing considerably to disease-specific hospitalization and/or ED admission in a defined asthma population, and emphasize the importance of its recognition in asthma care. KW - management KW - update KW - impact KW - risk KW - severity KW - prevalence KW - clinical-practice KW - aspirin sensitivity KW - allergic rhinitis KW - exacebrated respiratory-disease KW - gastroesophageal reflux disease KW - gastroesophageal reflux KW - hospitalization KW - national health survey KW - acetylsalicylic acid exacerbated respiratory disease KW - adult KW - aspirin-induced asthma KW - asthma Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-122121 VL - 13 IS - 46 ER - TY - JOUR A1 - Sherif, Mohammad A. A1 - Herold, Joerg A1 - Voelker, Wolfram A1 - Maniuc, Octavian A1 - Ertl, Georg A1 - Praast, Christian A1 - Braun-Dullaeus, Ruediger Christian T1 - Feasibility of a new method using two-dimensional transesophageal echocardiography for aortic annular sizing in patients undergoing transcatheter aortic valve implantation; a case-control study JF - BMC Cardiovascular Disorders N2 - Background: Accurate preoperative assessment of the aortic annulus dimension is crucial for successful transcatheter aortic valve implantation (TAVI). In this study we validated a new method using two-dimensional transesophageal echocardiography (2D-TEE) for measurement of the aortic annulus prior to TAVI. Methods: We analysed 124 patients who underwent successful TAVI using a self-expandable prosthesis, divided equally into two groups; in the study group we used the cross sectional short axis 2D-TEE for measurement of the aortic annulus and in the control group we used the long axis 2D-TEE. Results: Both groups were comparable regarding the clinical parameters. On the other hand, patients in the study group had less left ventricular ejection fraction (38.9 % versus 45.6 %, p = 0.01). The aortic valve annulus was, although not statistically significant, smaller in the study group (21.58 versus 23.28 mm, p = 0.25). Post procedural quantification of the aortic regurgitation revealed that only one patient in both groups had severe aortic regurgitation (AR), in this patient the valve was implanted deep. The incidence of significant AR was higher in the control group (29.0 % versus 12.9 %, p = 0.027). Conclusions: Sizing of the aortic valve annulus using cross-sectional 2D-TEE offers a safe and plausible method for patients undergoing TAVI using the self-expandable prosthesis and is significantly superior to using long axis 2D-TEE. KW - paravalvular regurgitation KW - multicenter KW - management KW - sizing KW - echocardiography KW - replacement KW - tomography KW - guidelines KW - outcomes KW - impact KW - recommendations KW - stenosis KW - TAVI Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-148328 VL - 15 IS - 78 ER - TY - JOUR A1 - Reinermann, Sophie A1 - Asam, Sarah A1 - Gessner, Ursula A1 - Ullmann, Tobias A1 - Kuenzer, Claudia T1 - Multi-annual grassland mowing dynamics in Germany BT - spatio-temporal patterns and the influence of climate, topographic and socio-political conditions JF - Frontiers in Environmental Science N2 - Introduction: Grasslands cover one third of the agricultural area in Germany and are mainly used for fodder production. However, grasslands fulfill many other ecosystem functions, like carbon storage, water filtration and the provision of habitats. In Germany, grasslands are mown and/or grazed multiple times during the year. The type and timing of management activities and the use intensity vary strongly, however co-determine grassland functions. Large-scale spatial information on grassland activities and use intensity in Germany is limited and not openly provided. In addition, the cause for patterns of varying mowing intensity are usually not known on a spatial scale as data on the incentives of farmers behind grassland management decisions is not available. Methods: We applied an algorithm based on a thresholding approach utilizing Sentinel-2 time series to detect grassland mowing events to investigate mowing dynamics in Germany in 2018–2021. The detected mowing events were validated with an independent dataset based on the examination of public webcam images. We analyzed spatial and temporal patterns of the mowing dynamics and relationships to climatic, topographic, soil or socio-political conditions. Results: We found that most intensively used grasslands can be found in southern/south-eastern Germany, followed by areas in northern Germany. This pattern stays the same among the investigated years, but we found variations on smaller scales. The mowing event detection shows higher accuracies in 2019 and 2020 (F1 = 0.64 and 0.63) compared to 2018 and 2021 (F1 = 0.52 and 0.50). We found a significant but weak (R2 of 0–0.13) relationship for a spatial correlation of mowing frequency and climate as well as topographic variables for the grassland areas in Germany. Further results indicate a clear value range of topographic and climatic conditions, characteristic for intensive grassland use. Extensive grassland use takes place everywhere in Germany and on the entire spectrum of topographic and climatic conditions in Germany. Natura 2000 grasslands are used less intensive but this pattern is not consistent among all sites. Discussion: Our findings on mowing dynamics and relationships to abiotic and socio-political conditions in Germany reveal important aspects of grassland management, including incentives of farmers. KW - remote sensing KW - Sentinel-2 KW - time series KW - cutting KW - management KW - pasture KW - meadow KW - Earth observation Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-320700 SN - 2296-665X VL - 11 ER - TY - JOUR A1 - Paschke, Ralf A1 - Lincke, Thomas A1 - Müller, Stefan P. A1 - Kreissl, Michael C. A1 - Dralle, Henning A1 - Fassnacht, Martin T1 - The Treatment of Well-Differentiated Thyroid Carcinoma JF - Deutsches Ärzteblatt International N2 - Background: Recent decades have seen a rise in the incidence of well-differentiated (mainly papillary) thyroid carcinoma around the world. In Germany, the age-adjusted incidence of well-differentiated thyroid carcinoma in 2010 was 3.5 per 100 000 men and 8.7 per 100 000 women per year. Method: This review is based on randomized, controlled trials and multicenter trials on the treatment of well-differentiated thyroid carcinoma that were retrieved by a selective literature search, as well as on three updated guidelines issued in the past two years. Results: The recommended extent of surgical resection depends on whether the tumor is classified as low-risk or high-risk, so that papillary microcar cinomas, which carry a highly favorable prognosis, will not be overtreated. More than 90% of localized, well-differentiated thyroid carcinomas can be cured with a combination of surgery and radioactive iodine therapy. Radio active iodine therapy is also effective in the treatment of well-differentiated thyroid carcinomas with distant metastases, yielding a 10-year survival rate of 90%, as long as there is good iodine uptake and the tumor goes into remission after treatment; otherwise, the 10-year survival rate is only 10%. In the past two years, better treatment options have become available for radioactive-iodine-resistant thyroid carcinoma. Phase 3 studies of two different tyrosine kinase inhibitors have shown that either one can markedly prolong progression-free survival, but not overall survival. Their more common clinically significant side effects are hand-foot syndrome, hypertension, diarrhea, proteinuria, and weight loss. Conclusion: Slow tumor growth, good resectability, and susceptibility to radioactive iodine therapy lend a favorable prognosis to most cases of well-differentiated thyroid carcinoma. The treatment should be risk-adjusted and interdisciplinary, in accordance with the current treatment guidelines. Even metastatic thyroid carcinoma has a favorable prognosis as long as there is good iodine uptake. The newly available medical treatment options for radioactive-iodine-resistant disease need to be further studied. KW - BRAF(V600E) mutation KW - distant metastases KW - papillary KW - guidelines KW - surgery KW - dissection KW - management KW - association KW - cancer KW - radioiodine therapy Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-151636 VL - 112 SP - 452 EP - 458 ER - TY - JOUR A1 - Oervoessy, Noemi A1 - Koroesi, Adam A1 - Batary, Peter A1 - Vozar, Agnes A1 - Peregovits, Laszlo T1 - Habitat Requirements of the Protected Southern Festoon (Zerynthia Polysena); Adult, Egg and Larval Distribution in a Highly Degraded Habitat Complex JF - Acta Zoologica Academiae Scientiarum Hungaricae N2 - Habitat quality affects the presence and size of butterfly populations. Resources for all life stages must be found in a given or few habitat patches. Southern festoon (Zerynthia polyxena) is a vulnerable, but locally abundant species in Hungary. The larva requires birthwort (Aristolochia clematitis) as food plant. We examined the small scale habitat use of adults and distribution of eggs and larvae among different vegetation types to reveal the requirements of the species in all life stages. Transect counts were conducted in a tree plantation complex comprising four types of vegetation. Number (+/- SE) of adults, eggs and larvae were lowest in poplar plantation (adult 0.3 +/- 0.2, egg 1.1 +/- 1.1, larva 0.6 +/- 0.3). Medium amount of butterflies were observed in open (adult 8.3 +/- 2.9, egg 3.1 +/- 2.6, larva 3.1 +/- 1.9) and black-locust (adult 9.4 +/- 4.2, egg 12.7 +/- 4.9, larva 4.1 +/- 1.1) habitat. Number of butterflies was highest in hummocks (adult 13.5 +/- 1.5, egg 12.9 +/- 5.7, larva 8.4 +/- 2.1). Adults avoided bare ground. We encountered most eggs in dense food plant patches with high plants. Food plant height also positively influenced the occurrence of the larvae. Although distribution of adults and juvenile forms showed quite similar patterns, we could also reveal some differences that caused by different environmental conditions in distinct vegetation types. Our study stresses the importance of habitat quality, which affects population size of butterflies even in a highly degraded habitat complex. KW - habitat quality KW - resource use KW - life stage KW - butterfly euphydryas-aurinia KW - ecology KW - metapopulation KW - conservation KW - quality KW - management KW - population KW - nympahlidae KW - fragmented landscapes KW - lepidoptera KW - tree plantations KW - habitat patch Y1 - 2014 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-117810 VL - 60 IS - 4 ER - TY - JOUR A1 - Lückerath, Katharina A1 - Lapa, Constantin A1 - Albert, Christa A1 - Herrmann, Ken A1 - Jörg, Gerhard A1 - Samnick, Samuel A1 - Einsele, Herrmann A1 - Knop, Stefan A1 - Buck, Andreas K. T1 - \(^{11}\)C-Methionine-PET: a novel and sensitive tool for monitoring of early response to treatment in multiple myeloma JF - Oncotarget N2 - Multiple myeloma (MM) remains an essentially incurable hematologic malignancy. However, new treatment modalities and novel drugs have been introduced and thus additional tools for therapy monitoring are increasingly needed. Therefore, we evaluated the radiotracers \(^{11}\)C-Methionine (paraprotein-biosynthesis) and \(^{18}\)F-FDG (glucose-utilization) for monitoring response to anti-myeloma-therapy and outcome prediction. Influence of proteasome-inhibition on radiotracer-uptake of different MM cell-lines and patient-derived CD138\(^{+}\) plasma cells was analyzed and related to tumor-biology. Mice xenotransplanted with MM. 1S tumors underwent MET- and FDG-\(\mu\)PET. Tumor-to-background ratios before and after 24 h, 8 and 15 days treatment with bortezomib were correlated to survival. Treatment reduced both MET and FDG uptake; changes in tracer-retention correlated with a switch from high to low CD138-expression. In xenotransplanted mice, MET-uptake significantly decreased by 30-79% as early as 24 h after bortezomib injection. No significant differences were detected thus early with FDG. This finding was confirmed in patient-derived MM cells. Importantly, early reduction of MET-but not FDG-uptake correlated with improved survival and reduced tumor burden in mice. Our results suggest that MET is superior to FDG in very early assessment of response to anti-myeloma-therapy. Early changes in MET-uptake have predictive potential regarding response and survival. MET-PET holds promise to individualize therapies in MM in future. KW - positron emission tomography KW - imaging techniques KW - experience KW - \(^{11}\)C-Methionine-PET KW - treatment response KW - molecular imaging KW - multiple myeloma KW - management KW - \(^{18}\)F-FDG PET/CT KW - bone disease KW - stem-cell transplantation KW - esophagogastric junction Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-148688 VL - 6 IS - 10 ER - TY - JOUR A1 - Lock, J. F. A1 - Ungeheuer, L. A1 - Borst, P. A1 - Swol, J. A1 - Löb, S. A1 - Brede, E. M. A1 - Röder, D. A1 - Lengenfelder, B. A1 - Sauer, K. A1 - Gremer, C. - T. T1 - Markedly increased risk of postoperative bleeding complications during perioperative bridging anticoagulation in general and visceral surgery JF - Perioperative Medicine N2 - Background Increasing numbers of patients receiving oral anticoagulants are undergoing elective surgery. Low molecular weight heparin (LMWH) is frequently applied as bridging therapy during perioperative interruption of anticoagulation. The aim of this study was to explore the postoperative bleeding risk of patients receiving surgery under bridging anticoagulation. Methods We performed a monocentric retrospective two-arm matched cohort study. Patients that received perioperative bridging anticoagulation were compared to a matched control group with identical surgical procedure, age, and sex. Emergency and vascular operations were excluded. The primary endpoint was the incidence of major postoperative bleeding. Secondary endpoints were minor postoperative bleeding, thromboembolic events, length of stay, and in-hospital mortality. Multivariate analysis explored risk factors of major postoperative bleeding. Results A total of 263 patients in each study arm were analyzed. The patient cohort included the entire field of general and visceral surgery including a large proportion of major oncological resections. Bridging anticoagulation increased the postoperative incidence of major bleeding events (8% vs. 1%; p < 0.001) as well as minor bleeding events (14% vs. 5%; p < 0.001). Thromboembolic events were equally rare in both groups (1% vs. 2%; p = 0.45). No effect on mortality was observed (1.5% vs. 1.9%). Independent risk factors of major postoperative bleeding were full-therapeutic dose of LMWH, renal insufficiency, and the procedure-specific bleeding risk. Conclusion Perioperative bridging anticoagulation, especially full-therapeutic dose LMWH, markedly increases the risk of postoperative bleeding complications in general and visceral surgery. Surgeons should carefully consider the practice of routine bridging. KW - low molecular heparin KW - atrial fibrillation KW - postoperative bleeding KW - thromboembolism KW - anticoagulation KW - bridging KW - antithrombotic therapy KW - warfarin interruption KW - oral anticoagulants KW - management Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-230690 VL - 9 ER -