TY - JOUR A1 - Eckardt, Jan-Niklas A1 - Stasik, Sebastian A1 - Kramer, Michael A1 - Röllig, Christoph A1 - Krämer, Alwin A1 - Scholl, Sebastian A1 - Hochhaus, Andreas A1 - Crysandt, Martina A1 - Brümmendorf, Tim H. A1 - Naumann, Ralph A1 - Steffen, Björn A1 - Kunzmann, Volker A1 - Einsele, Hermann A1 - Schaich, Markus A1 - Burchert, Andreas A1 - Neubauer, Andreas A1 - Schäfer-Eckart, Kerstin A1 - Schliemann, Christoph A1 - Krause, Stefan W. A1 - Herbst, Regina A1 - Hänel, Mathias A1 - Frickhofen, Norbert A1 - Noppeney, Richard A1 - Kaiser, Ulrich A1 - Baldus, Claudia D. A1 - Kaufmann, Martin A1 - Rácil, Zdenek A1 - Platzbecker, Uwe A1 - Berdel, Wolfgang E. A1 - Mayer, Jiří A1 - Serve, Hubert A1 - Müller-Tidow, Carsten A1 - Ehninger, Gerhard A1 - Stölzel, Friedrich A1 - Kroschinsky, Frank A1 - Schetelig, Johannes A1 - Bornhäuser, Martin A1 - Thiede, Christian A1 - Middeke, Jan Moritz T1 - Loss-of-function mutations of BCOR are an independent marker of adverse outcomes in intensively treated patients with acute myeloid leukemia JF - Cancers N2 - 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. KW - acute myeloid leukemia KW - BCOR KW - BCORL1 KW - loss-of-function KW - risk stratification KW - survival Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-236735 SN - 2072-6694 VL - 13 IS - 9 ER - TY - JOUR A1 - Bechtle, Philip A1 - Camargo-Molina, José Eliel A1 - Desch, Klaus A1 - Dreiner, Herbert K. A1 - Hamer, Matthias A1 - Krämer, Michael A1 - O'Leary, Ben A1 - Porod, Werner A1 - Sarrazin, Björn A1 - Stefaniak, Tim A1 - Uhlenbrock, Mathias A1 - Wienemann, Peter T1 - Killing the cMSSM softly JF - The European Physical Journal C N2 - We investigate the constrained Minimal Supersymmetric Standard Model (cMSSM) in the light of constraining experimental and observational data from precision measurements, astrophysics, direct supersymmetry searches at the LHC and measurements of the properties of the Higgs boson, by means of a global fit using the program Fittino. As in previous studies, we find rather poor agreement of the best fit point with the global data. We also investigate the stability of the electro-weak vacuum in the preferred region of parameter space around the best fit point. We find that the vacuum is metastable, with a lifetime significantly longer than the age of the Universe. For the first time in a global fit of supersymmetry, we employ a consistent methodology to evaluate the goodness-of-fit of the cMSSM in a frequentist approach by deriving p values from large sets of toy experiments. We analyse analytically and quantitatively the impact of the choice of the observable set on the p value, and in particular its dilution when confronting the model with a large number of barely constraining measurements. Finally, for the preferred sets of observables, we obtain p values for the cMSSM below 10 %, i.e. we exclude the cMSSM as a model at the 90 % confidence level. KW - Dark Matter KW - Higgs Boson KW - Higgs Mass KW - Supersymmetry Breaking KW - Light Supersymmetric Particle Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-165045 VL - 76 IS - 96 ER - TY - JOUR A1 - Dörhöfer, Lena A1 - Lammert, Alexander A1 - Krane, Vera A1 - Gorski, Mathias A1 - Banas, Bernhard A1 - Wanner, Christoph A1 - Krämer, Bernhard K. A1 - Heid, Iris M. A1 - Böger, Carsten A. T1 - Study design of DIACORE (DIAbetes COhoRtE) - a cohort study of patients with diabetes mellitus type 2 JF - BMC Medical Genetics N2 - Background: Diabetes mellitus type 2 (DM2) is highly associated with increased risk for chronic kidney disease (CKD), end stage renal disease (ESRD) and cardiovascular morbidity. Epidemiological and genetic studies generate hypotheses for innovative strategies in DM2 management by unravelling novel mechanisms of diabetes complications, which is essential for future intervention trials. We have thus initiated the DIAbetes COhoRtE study (DIACORE). Methods: DIACORE is a prospective cohort study aiming to recruit 6000 patients of self-reported Caucasian ethnicity with prevalent DM2 for at least 10 years of follow-up. Study visits are performed in University-based recruiting clinics in Germany using standard operating procedures. All prevalent DM2 patients in outpatient clinics surrounding the recruiting centers are invited to participate. At baseline and at each 2-year follow-up examination, patients are subjected to a core phenotyping protocol. This includes a standardized online questionnaire and physical examination to determine incident micro-and macrovascular DM2 complications, malignancy and hospitalization, with a primary focus on renal events. Confirmatory outcome information is requested from patient records. Blood samples are obtained for a centrally analyzed standard laboratory panel and for biobanking of aliquots of serum, plasma, urine, mRNA and DNA for future scientific use. A subset of the cohort is subjected to extended phenotyping, e. g. sleep apnea screening, skin autofluorescence measurement, non-mydriatic retinal photography and non-invasive determination of arterial stiffness. Discussion: DIACORE will enable the prospective evaluation of factors involved in DM2 complication pathogenesis using high-throughput technologies in biosamples and genetic epidemiological studies. KW - chronic kidney-disease KW - stage renal-disease KW - glomerular-filtration-rate KW - genome-wide association KW - blood-glucose control KW - genetics KW - serum creatinine KW - cardiovascular disease KW - replacement therapy KW - United States KW - risk factors KW - diabetes mellitus type 2 KW - diabetic nephropathy KW - end stage renal disease KW - cardiovascular morbidity KW - diabetes complications KW - epidemiology Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-122040 SN - 1471-2350 VL - 14 IS - 25 ER - TY - JOUR A1 - Bechtle, Philip A1 - Bringmann, Torsten A1 - Desch, Klaus A1 - Dreiner, Herbi A1 - Hamer, Matthias A1 - Hensel, Carsten A1 - Krämer, Michael A1 - Nguyen, Nelly A1 - Porod, Werner A1 - Prudent, Xavier A1 - Sarrazin, Björn A1 - Uhlenbrock, Mathias A1 - Wienemann, Peter T1 - Constrained supersymmetry after two years of LHC data: a global view with Fittino JF - Journal of High Energy Physics N2 - We perform global fits to the parameters of the Constrained Minimal Super-symmetric Standard Model (CMSSM) and to a variant with non-universal Higgs masses (NUHM1). In addition to constraints from low-energy precision observables and the cosmological dark matter density, we take into account the LHC exclusions from searches in jets plus missing transverse energy signatures with about 5 fb\(^{−1}\) of integrated luminosity. We also include the most recent upper bound on the branching ratio B\(_s\)  → μμ from LHCb. Furthermore, constraints from and implications for direct and indirect dark matter searches are discussed. The best fit of the CMSSM prefers a light Higgs boson just above the experimentally excluded mass. We find that the description of the low-energy observables, (g − 2)\(_μ\) in particular, and the non-observation of SUSY at the LHC become more and more incompatible within the CMSSM. A potential SM-like Higgs boson with mass around 126 GeV can barely be accommodated. Values for B(B\(_s\)→μμ) just around the Standard Model prediction are naturally expected in the best fit region. The most-preferred region is not yet affected by limits on direct WIMP searches, but the next generation of experiments will probe this region. Finally, we discuss implications from fine-tuning for the best fit regions. KW - supersymmetry phenomenology Y1 - 2012 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-129573 VL - 06 IS - 098 ER - TY - JOUR A1 - Carsten A., Böger A1 - Gorski, Mathias A1 - Li, Man A1 - Hoffmann, Michael M. A1 - Huang, Chunmei A1 - Yang, Qiong A1 - Teumer, Alexander A1 - Krane, Vera A1 - O'Seaghdha, Conall M. A1 - Kutalik, Zoltán A1 - Wichmann, H.-Erich A1 - Haak, Thomas A1 - Boes, Eva A1 - Coassin, Stefan A1 - Coresh, Josef A1 - Kollerits, Barbara A1 - Haun, Margot A1 - Paulweber, Bernhard A1 - Köttgen, Anna A1 - Li, Guo A1 - Shlipak, Michael G. A1 - Powe, Neil A1 - Hwang, Shih-Jen A1 - Dehghan, Abbas A1 - Rivadeneira, Fernando A1 - Uitterlinden, André A1 - Hofman, Albert A1 - Beckmann, Jacques S. A1 - Krämer, Bernhard K. A1 - Witteman, Jacqueline A1 - Bochud, Murielle A1 - Siscovick, David A1 - Rettig, Rainer A1 - Kronenberg, Florian A1 - Wanner, Christoph A1 - Thadhani, Ravi I. A1 - Heid, Iris M. A1 - Fox, Caroline S. A1 - Kao, W.H. T1 - Association of eGFR-Related Loci Identified by GWAS with Incident CKD and ESRD JF - PLoS Genetics N2 - Family studies suggest a genetic component to the etiology of chronic kidney disease (CKD) and end stage renal disease (ESRD). Previously, we identified 16 loci for eGFR in genome-wide association studies, but the associations of these single nucleotide polymorphisms (SNPs) for incident CKD or ESRD are unknown. We thus investigated the association of these loci with incident CKD in 26,308 individuals of European ancestry free of CKD at baseline drawn from eight population-based cohorts followed for a median of 7.2 years (including 2,122 incident CKD cases defined as eGFR < 60ml/min/1.73m(2) at follow-up) and with ESRD in four case-control studies in subjects of European ancestry (3,775 cases, 4,577 controls). SNPs at 11 of the 16 loci (UMOD, PRKAG2, ANXA9, DAB2, SHROOM3, DACH1, STC1, SLC34A1, ALMS1/NAT8, UBE2Q2, and GCKR) were associated with incident CKD; p-values ranged from p = 4.1e-9 in UMOD to p = 0.03 in GCKR. After adjusting for baseline eGFR, six of these loci remained significantly associated with incident CKD (UMOD, PRKAG2, ANXA9, DAB2, DACH1, and STC1). SNPs in UMOD (OR = 0.92, p = 0.04) and GCKR (OR = 0.93, p = 0.03) were nominally associated with ESRD. In summary, the majority of eGFR-related loci are either associated or show a strong trend towards association with incident CKD, but have modest associations with ESRD in individuals of European descent. Additional work is required to characterize the association of genetic determinants of CKD and ESRD at different stages of disease progression. KW - Chronic Kidney-disease KW - Stage renal-disease KW - Glomerular-filtration-rate KW - Diabetic-nephropathy KW - General-population KW - African-americans KW - Risk KW - Progression KW - Mortality KW - Variants Y1 - 2011 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-133758 VL - 7 IS - 9 ER - TY - THES A1 - Krämer, Mathias T1 - Binokulare Steigerung und geschlechtsspezifische Unterschiede im multifokalen VEP mit Mehrkanal-Messung T1 - Binocular enhancement and gender differences in multifocal VEP with multichannel-recording N2 - Das VEP ist eine Methode, die schon lange im klinischen Alltag genutzt wird, im Gegensatz zum relativ neuen, noch nicht etablierten mfVEP. Beide erfassen Potenziale, die in der Sehrinde im Occipitallappen erzeugt werden. Um Normalwerte des VEP und mfVEP zu erlangen bedarf es der Funktion des gesamten Sehsystems. Funktionsstörungen des Sehsystems führen zu Veränderungen im VEP und mfVEP. Dadurch können Ausfälle, wie z.B. beim Glaukom, auch mittels mfVEP erkannt werden. Für unsere Experimente wurden bei 30 Normalpersonen sowohl VEP als auch mfVEP abgeleitet. Dies erfolgte neben monokularer Messung auch binokular. Das VEP zeigte die in der Literatur beschriebenen Werte. Jedoch konnte nur eine geringe, nicht signifikante Steigerung binokularer Messungen gefunden werden. Es konnten bei den Messungen keine Unterschiede zwischen den monokularen und binokularen Latenzen ermittelt werden. Der erstmalige Vergleich binokularer und monokularer mfVEP lieferte eine Steigerung der Binokularantwort, wie sie in der Literatur beim VEP ähnlich beschrieben ist. Die durchgeführten Vergleiche des Faktors R in unterschiedlichen topographischen Regionen ergaben ein einheitliches Verhalten des gesamten Gesichtsfeldes auf binokulare Reizung. Die Latenzen der binokularen Messungen waren kürzer. Es konnte aber bezüglich der Latenzen keine Signifikanz im Vergleich mit monokularer Messung erzielt werden, anders als in der Literatur beschrieben. Der Vergleich zwischen beiden elektrophysiologischen Methoden VEP und mfVEP ergab eine ca. drei mal höhere Amplitude des VEP. Das mfVEP zeigte dabei kürzere Latenzen. Erklärbar könnte dieses Phänomen durch die Adaptation des Sehsystems beim mfVEP sein, es können jedoch auch retinale Mechanismen eine Rolle spielen. Das mfVEP lieferte die in der Literatur beschriebenen Asymmetrien von oberem und unterem Halbfeld und anderen Besonderheiten bei Normalpersonen, wie die unterschiedlichen geschlechtsabhängigen Amplitudenhöhen der weiblichen und männlichen Probanden. Zur besseren Auswertung der 60 Felder des mfVEP bot sich eine Sechs-Sektoren-Mittelung an, da so einheitliche Kurven miteinander verrechnet wurden. Es zeigten sich spiegelbildliche aber auch in der Form unterschiedliche Kurven mit Latenzunterschieden vor allem in den beiden mittleren Sektoren (oben und unten), aber auch zwischen den mittleren und lateralen Sektoren, was durch die Faltung der Gehirnrinde erklärbar ist. Anhand des Signal-Rausch-Verhältnisses (SNR) konnten die Einzelantworten des mfVEP auf statistische Signifikanz geprüft und zusammen mit Mehrkanal-Messung und 20-Felder-Mittelung Normalwerte errechnet werden, bei denen bis zu 94 % der Einzelantworten des monokularen mfVEP als signifikant erkannt wurden. Zusätzlich erreichte man mit dieser Auswertungstechnik ein EEG-skaliertes mfVEP. Geschlechtsspezifische Unterschiede des mfVEP konnten damit ausgeglichen werden. Unsere Versuche zeigen das große Potential des mfVEP auf. Vor allem die Mehrkanal-Messungen bieten einen großen Informationsgewinn. Eine Mittelung des mfVEP zu weniger Feldern (z.B. 20) bietet als Vereinfachung einen Kompromiss aus geringerer Auflösung aber höheren Antworten. Eine zukünftige Kombination der Objektivierung von Einzelantworten mit größeren Reizfeldern (Sektoren oder 20 Felder) oder dem Nutzen von Muster-gepulstem mfVEP kann zu weiteren Verbesserungen beim Erreichen eines objektiven Standards für Normalpersonen führen, welcher gut als Basis für die klinische Etablierung des mfVEP dienen könnte. N2 - The VEP is a method which has been used for a long time in clinical life, in contrast to the relatively new, not yet established mfVEP. Both measure potentials which are generated in the visual cortex in the occipital lobe. To attain normal values of the VEP and mfVEP, the function of the whole visual system is required. Malfunctions of the visual system lead to changes in the VEP and mfVEP and can be discovered, as for example with the glaucoma, also by means of mfVEP. For our experiments VEP as well as mfVEP were derived with 30 normal persons. Besides monocular measurement this happened also binocularly. The VEP showed the values described in literature. However, only one low, not significant increase of binocular measurements could be found. In the recordings no differences could be determined between monocular and binocular latencies. The first-time comparison of binocular and monocular mfVEP delivered an increase of the binocular answer as it is similarly described in literature for VEP. Comparisons of the factor R in different topographic regions proved a uniform behaviour of the whole visual field on binocular stimulation. The latencies of binocular recordings were shorter. However, there was no significance concerning the latencies in comparison to monocular recordings, in contrast to earlier literature. The comparison between both electro-physiological methods VEP and mfVEP proved an approx. three times higher amplitude of the VEP. Besides, mfVEP showed shorter latencies. This phenomenon could be explained by the adaptation of the visual system with mfVEP, or maybe it is due to retinal mechanisms. MfVEP delivered asymmetries described in literature of upper and lower half field and other specific features with normal persons, like the different amplitude heights dependent on gender. For better evaluation of the 60 fields of the mfVEP a six-sector-summation seems adequate, because uniform curves were settled with each other this way. Mirror-inverted curves appeared that were different in form, with latency differencies particularly in both middle sectors (on top and below), but also between the middle and lateral sectors which can be explained by the folds of the cerebral cortex. With the help of the signal-to-noise-ratio (SNR) the single answers mfVEP could be checked for statistical significance, and together with multi-channel recording and summation to 20 fields normal values could be calculated, with which up to 94% of the single answers of the monocular mfVEP were recognised as significant. In addition, with this evaluation technology an EEG-scaled mfVEP was reached. Gender specific differences of the mfVEP could be compensated. Our attempts indicate the big potential of the mfVEP. Above all, the multichannel-recording offers additional profit of information. A summation of the single mfVEPs to less fields (e.g. 20) offers the compromise of less resolution as simplification, however, with higher answers. A future combination of the objective validation of single answers with larger stimulation fields (sectors or 20 fields) or the use of pattern-pulsed mfVEP can lead to other improvements with the achievement of an objective standard for normal persons who could well serve as a base for the clinical establishment of the mfVEP. KW - multifokales VEP (mfVEP) KW - binokulare Steigerung KW - binokulares VEP geschlechtsspezifische Unterschiede KW - Signal-Rausch-Verhältnis KW - Mehrkanal-Messun KW - multifocal VEP (mfVEP) KW - binocular enhancement KW - binocular VEP KW - gender differences KW - signal-to-noise-ratio KW - multichannel-recording Y1 - 2005 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-21932 ER - TY - JOUR A1 - Gabriel, Katharina M. A. A1 - Jírů-Hillmann, Steffi A1 - Kraft, Peter A1 - Selig, Udo A1 - Rücker, Victoria A1 - Mühler, Johannes A1 - Dötter, Klaus A1 - Keidel, Matthias A1 - Soda, Hassan A1 - Rascher, Alexandra A1 - Schneider, Rolf A1 - Pfau, Mathias A1 - Hoffmann, Roy A1 - Stenzel, Joachim A1 - Benghebrid, Mohamed A1 - Goebel, Tobias A1 - Doerck, Sebastian A1 - Kramer, Daniela A1 - Haeusler, Karl Georg A1 - Volkmann, Jens A1 - Heuschmann, Peter U. A1 - Fluri, Felix T1 - Two years' experience of implementing a comprehensive telemedical stroke network comprising in mainly rural region: the Transregional Network for Stroke Intervention with Telemedicine (TRANSIT-Stroke) JF - BMC Neurology N2 - Background Telemedicine improves the quality of acute stroke care in rural regions with limited access to specialized stroke care. We report the first 2 years' experience of implementing a comprehensive telemedical stroke network comprising all levels of stroke care in a defined region. Methods The TRANSIT-Stroke network covers a mainly rural region in north-western Bavaria (Germany). All hospitals providing acute stroke care in this region participate in TRANSIT-Stroke, including four hospitals with a supra-regional certified stroke unit (SU) care (level III), three of those providing teleconsultation to two hospitals with a regional certified SU (level II) and five hospitals without specialized SU care (level I). For a two-year-period (01/2015 to 12/2016), data of eight of these hospitals were available; 13 evidence-based quality indicators (QIs) related to processes during hospitalisation were evaluated quarterly and compared according to predefined target values between level-I- and level-II/III-hospitals. Results Overall, 7881 patients were included (mean age 74.6 years +/- 12.8; 48.4% female). In level-II/III-hospitals adherence of all QIs to predefined targets was high ab initio. In level-I-hospitals, three patterns of QI-development were observed: a) high adherence ab initio (31%), mainly in secondary stroke prevention; b) improvement over time (44%), predominantly related to stroke specific diagnosis and in-hospital organization; c) no clear time trends (25%). Overall, 10 out of 13 QIs reached predefined target values of quality of care at the end of the observation period. Conclusion The implementation of the comprehensive TRANSIT-Stroke network resulted in an improvement of quality of care in level-I-hospitals. KW - pilot project KW - care tempis KW - ischemic stroke KW - thrombolysis KW - areas KW - time KW - hospitals KW - mortality KW - outcomes KW - quality Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-229214 VL - 20 ER -