@article{ElHelouBiegnerBodeetal.2019, author = {El-Helou, Sabine M. and Biegner, Anika-Kerstin and Bode, Sebastian and Ehl, Stephan R. and Heeg, Maximilian and Maccari, Maria E. and Ritterbusch, Henrike and Speckmann, Carsten and Rusch, Stephan and Scheible, Raphael and Warnatz, Klaus and Atschekzei, Faranaz and Beider, Renata and Ernst, Diana and Gerschmann, Stev and Jablonka, Alexandra and Mielke, Gudrun and Schmidt, Reinhold E. and Sch{\"u}rmann, Gesine and Sogkas, Georgios and Baumann, Ulrich H. and Klemann, Christian and Viemann, Dorothee and Bernuth, Horst von and Kr{\"u}ger, Renate and Hanitsch, Leif G. and Scheibenbogen, Carmen M. and Wittke, Kirsten and Albert, Michael H. and Eichinger, Anna and Hauck, Fabian and Klein, Christoph and Rack-Hoch, Anita and Sollinger, Franz M. and Avila, Anne and Borte, Michael and Borte, Stephan and Fasshauer, Maria and Hauenherm, Anja and Kellner, Nils and M{\"u}ller, Anna H. and {\"U}lzen, Anett and Bader, Peter and Bakhtiar, Shahrzad and Lee, Jae-Yun and Heß, Ursula and Schubert, Ralf and W{\"o}lke, Sandra and Zielen, Stefan and Ghosh, Sujal and Laws, Hans-Juergen and Neubert, Jennifer and Oommen, Prasad T. and H{\"o}nig, Manfred and Schulz, Ansgar and Steinmann, Sandra and Klaus, Schwarz and D{\"u}ckers, Gregor and Lamers, Beate and Langemeyer, Vanessa and Niehues, Tim and Shai, Sonu and Graf, Dagmar and M{\"u}glich, Carmen and Schmalzing, Marc T. and Schwaneck, Eva C. and Tony, Hans-Peter and Dirks, Johannes and Haase, Gabriele and Liese, Johannes G. and Morbach, Henner and Foell, Dirk and Hellige, Antje and Wittkowski, Helmut and Masjosthusmann, Katja and Mohr, Michael and Geberzahn, Linda and Hedrich, Christian M. and M{\"u}ller, Christiane and R{\"o}sen-Wolff, Angela and Roesler, Joachim and Zimmermann, Antje and Behrends, Uta and Rieber, Nikolaus and Schauer, Uwe and Handgretinger, Rupert and Holzer, Ursula and Henes, J{\"o}rg and Kanz, Lothar and Boesecke, Christoph and Rockstroh, J{\"u}rgen K. and Schwarze-Zander, Carolynne and Wasmuth, Jan-Christian and Dilloo, Dagmar and H{\"u}lsmann, Brigitte and Sch{\"o}nberger, Stefan and Schreiber, Stefan and Zeuner, Rainald and Ankermann, Tobias and Bismarck, Philipp von and Huppertz, Hans-Iko and Kaiser-Labusch, Petra and Greil, Johann and Jakoby, Donate and Kulozik, Andreas E. and Metzler, Markus and Naumann-Bartsch, Nora and Sobik, Bettina and Graf, Norbert and Heine, Sabine and Kobbe, Robin and Lehmberg, Kai and M{\"u}ller, Ingo and Herrmann, Friedrich and Horneff, Gerd and Klein, Ariane and Peitz, Joachim and Schmidt, Nadine and Bielack, Stefan and Groß-Wieltsch, Ute and Classen, Carl F. and Klasen, Jessica and Deutz, Peter and Kamitz, Dirk and Lassy, Lisa and Tenbrock, Klaus and Wagner, Norbert and Bernbeck, Benedikt and Brummel, Bastian and Lara-Villacanas, Eusebia and M{\"u}nstermann, Esther and Schneider, Dominik T. and Tietsch, Nadine and Westkemper, Marco and Weiß, Michael and Kramm, Christof and K{\"u}hnle, Ingrid and Kullmann, Silke and Girschick, Hermann and Specker, Christof and Vinnemeier-Laubenthal, Elisabeth and Haenicke, Henriette and Schulz, Claudia and Schweigerer, Lothar and M{\"u}ller, Thomas G. and Stiefel, Martina and Belohradsky, Bernd H. and Soetedjo, Veronika and Kindle, Gerhard and Grimbacher, Bodo}, title = {The German national registry of primary immunodeficiencies (2012-2017)}, series = {Frontiers in Immunology}, volume = {10}, journal = {Frontiers in Immunology}, doi = {10.3389/fimmu.2019.01272}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-226629}, year = {2019}, abstract = {Introduction: The German PID-NET registry was founded in 2009, serving as the first national registry of patients with primary immunodeficiencies (PID) in Germany. It is part of the European Society for Immunodeficiencies (ESID) registry. The primary purpose of the registry is to gather data on the epidemiology, diagnostic delay, diagnosis, and treatment of PIDs. Methods: Clinical and laboratory data was collected from 2,453 patients from 36 German PID centres in an online registry. Data was analysed with the software Stata® and Excel. Results: The minimum prevalence of PID in Germany is 2.72 per 100,000 inhabitants. Among patients aged 1-25, there was a clear predominance of males. The median age of living patients ranged between 7 and 40 years, depending on the respective PID. Predominantly antibody disorders were the most prevalent group with 57\% of all 2,453 PID patients (including 728 CVID patients). A gene defect was identified in 36\% of patients. Familial cases were observed in 21\% of patients. The age of onset for presenting symptoms ranged from birth to late adulthood (range 0-88 years). Presenting symptoms comprised infections (74\%) and immune dysregulation (22\%). Ninety-three patients were diagnosed without prior clinical symptoms. Regarding the general and clinical diagnostic delay, no PID had undergone a slight decrease within the last decade. However, both, SCID and hyper IgE-syndrome showed a substantial improvement in shortening the time between onset of symptoms and genetic diagnosis. Regarding treatment, 49\% of all patients received immunoglobulin G (IgG) substitution (70\%-subcutaneous; 29\%-intravenous; 1\%-unknown). Three-hundred patients underwent at least one hematopoietic stem cell transplantation (HSCT). Five patients had gene therapy. Conclusion: The German PID-NET registry is a precious tool for physicians, researchers, the pharmaceutical industry, politicians, and ultimately the patients, for whom the outcomes will eventually lead to a more timely diagnosis and better treatment.}, language = {en} } @article{WaechtlerKuebelBarthelmesetal.2016, author = {W{\"a}chtler, Maria and K{\"u}bel, Joachim and Barthelmes, Kevin and Winter, Andreas and Schmiedel, Alexander and Pascher, Torbj{\"o}rn and Lambert, Christoph and Schubert, Ulrich S. and Dietzek, Benjamin}, title = {Energy transfer and formation of long-lived \(^3\)MLCT states in multimetallic complexes with extended highly conjugated bis-terpyridyl ligands}, series = {Physical Chemistry Chemical Physics}, volume = {18}, journal = {Physical Chemistry Chemical Physics}, number = {4}, doi = {10.1039/c5cp04447b}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-191041}, pages = {2350-2360}, year = {2016}, abstract = {Multimetallic complexes with extended and highly conjugated bis-2,2':6',2''-terpyridyl bridging ligands, which present building blocks for coordination polymers, are investigated with respect to their ability to act as light-harvesting antennae. The investigated species combine Ru(II)- with Os(II)- and Fe(II)-terpyridyl chromophores, the latter acting as energy sinks. Due to the extended conjugated system the ligands are able to prolong the lifetime of the \(^3\)MLCT states compared to unsubstituted terpyridyl species by delocalization and energetic stabilization of the \(^3\)MLCT states. This concept is applied for the first time to Fe(II) terpyridyl species and results in an exceptionally long lifetime of 23 ps for the Fe(II) \(^3\)MLCT state. While partial energy (>80\%) transfer is observed between the Ru(II) and Fe(II) centers with a time-constant of 15 ps, excitation energy is transferred completely from the Ru(II) to the Os(II) center within the first 200 fs after excitation.}, language = {en} } @article{AtanasovBenkertThelenetal.2013, author = {Atanasov, Georgi and Benkert, Christoph and Thelen, Armin and Tappe, Dennis and Frosch, Matthias and Teichmann, Dieter and Barth, Thomas F. E. and Wittekind, Christian and Schubert, Stefan and Jonas, Sven}, title = {Alveolar echinococcosis-spreading disease challenging clinicians: A case report and literature review}, series = {World Journal of Gastroenterology}, volume = {19}, journal = {World Journal of Gastroenterology}, number = {26}, doi = {10.3748/wjg.v19.i26.4257}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-131525}, pages = {4257-4261}, year = {2013}, abstract = {Human alveolar echinococcosis (AE) is a potentially deadly disease; recent studies have shown that the endemic area of Echinococcus multilocularis, its causative agent, is larger than previously known. This disease has low prevalence and remains underreported in Europe. Emerging clinical data show that diagnostic difficulties are still common. We report on a 76-year old patient suffering from AE lesions restricted to the left lobe of the liver who underwent a curative extended left hemihepatectomy. Prior to the resection a liver biopsy under the suspicion of an atypical malignancy was performed. After the intervention he developed a pseudoaneurysm of the hepatic artery that was successfully coiled. Surprisingly, during surgery, the macroscopic appearance of the tumour revealed a growth pattern that was rather typical for cystic echinococcosis (CE), i.e., a gross tumour composed of multiple large vesicles with several centimeters in diameter. In addition, there were neither extensive adhesions nor infiltrations of the neighboring pancreas and diaphragm as was expected from previous imaging results. The unexpected diagnosis of AE was confirmed by definite histopathology, specific polymerase chain reaction and serology results. This is a rare case of unusual macroscopic presentation of AE that posed immense diagnostic challenges and had an eventful course. To our knowledge this is the first case of an autochthonous infection in this particular geographic area of Germany, the federal state of Saxony. This report may provide new hints for an expanding area of risk for AE and emphasizes the risk of complications in the scope of diagnostic procedures and the limitations of modern radiological imaging.}, language = {en} } @phdthesis{Schubert2002, author = {Schubert, Christoph}, title = {Die Masernepidemie in Ansbach 1992/93 : epidemiologische Untersuchungen und Berechnungen zur Impfwirksamkeit}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-7901}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2002}, abstract = {In der vorliegenden Studie wurde die Ansbacher Masernepidemie der Jahre 1992/93 retrospektiv epidemiologisch ausgewertet und Berechnungen zur Impfwirksamkeit erstellt. Daten {\"u}ber Komplikationen, die Alters- und Geschlechtsverteilung sowie den Impfstatus von 530 an Masern erkrankten Personen wurden {\"u}ber ein Fragebogenverfahren oder durch direkte Befragung von 85 kontaktierten Allgemein- und Kinder{\"a}rzte anonym gewonnen. Es waren haupts{\"a}chlich Kinder und Jugendliche bis 17 Jahren erkrankt, mit einem kontinuierlichen Ansteigen der Inzidenz bis 14 Jahren. Die Epidemie war deutlich m{\"a}dchenwendig. 18,7\% der Patienten waren mit einem Masernlebendimpfstoff geimpft worden. In 16,7\% aller F{\"a}lle traten Komplikationen auf, am h{\"a}ufigsten waren Otitis media (10,3\%) und Pneumonie (5,0\%). Ein ungeimpfter 17j{\"a}hriger Patient verstarb an einer Masernenzephalitis. Sieben Patienten mussten hospitalisiert werden (1,4\%). Bis auf die Konstellation „geimpft+m{\"a}nnlich+Pneumonie", die signifikant h{\"a}ufiger auftrat, fanden sich keine Zusammenh{\"a}nge zwischen Alter, Geschlecht, Impfstatus und Komplikationen. Bei der Berechnung der Impfeffektivit{\"a}t zeigte sich, dass die Impfwirksamkeit bei {\"a}lteren Patienten deutlich geringer war als bei j{\"u}ngeren. {\"U}ber ein weiterentwickeltes mathematisches Modell wurde das Impfversagen in Abh{\"a}ngigkeit von der Zeit seit der Impfung analysiert. Daraus ergab sich ein prim{\"a}res Impfversagen von ca. 6\%. Außerdem ist anzunehmen, dass es bei einem Drittel der Geimpften innerhalb von 14 Jahren zu einem sekund{\"a}ren Impfversagen kam. Letztere Aussage ist jedoch nur zul{\"a}ssig, wenn man annimmt, dass das prim{\"a}re Impfversagen seit Impfbeginn konstant blieb. Die Ursachen f{\"u}r die Epidemie in Ansbach sind eindeutig die zu geringen Immuni-sierungsraten.}, language = {de} } @article{SlaninaHeblingHaucketal.2012, author = {Slanina, Heiko and Hebling, Sabrina and Hauck, Christoph R. and Schubert-Unkmeir, Alexandra}, title = {Cell Invasion by Neisseria meningitidis Requires a Functional Interplay between the Focal Adhesion Kinase, Src and Cortactin}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-75354}, year = {2012}, abstract = {Entry of Neisseria meningitidis (the meningococcus) into human brain microvascular endothelial cells (HBMEC) is mediated by fibronectin or vitronectin bound to the surface protein Opc forming a bridge to the respective integrins. This interaction leads to cytoskeletal rearrangement and uptake of meningococci. In this study, we determined that the focal adhesion kinase (FAK), which directly associates with integrins, is involved in integrin-mediated internalization of N. meningitidis in HBMEC. Inhibition of FAK activity by the specific FAK inhibitor PF 573882 reduced Opc-mediated invasion of HBMEC more than 90\%. Moreover, overexpression of FAK mutants that were either impaired in the kinase activity or were not capable of autophosphorylation or overexpression of the dominant-negative version of FAK (FRNK) blocked integrin-mediated internalization of N. meningitidis. Importantly, FAK-deficient fibroblasts were significantly less invaded by N. meningitidis. Furthermore, N. meningitidis induced tyrosine phosphorylation of several host proteins including the FAK/Src complex substrate cortactin. Inhibition of cortactin expression by siRNA silencing and mutation of critical amino acid residues within cortactin, that encompass Arp2/3 association and dynamin binding, significantly reduced meningococcal invasion into eukaryotic cells suggesting that both domains are critical for efficient uptake of N. meningitidis into eukaryotic cells. Together, these results indicate that N. meningitidis exploits the integrin signal pathway for its entry and that FAK mediates the transfer of signals from activated integrins to the cytoskeleton. A cooperative interplay between FAK, Src and cortactin then enables endocytosis of N. meningitidis into host cells.}, subject = {Medizin}, language = {en} } @article{HaggMayrMannigetal.2018, author = {Hagg, Wilfried and Mayr, Elisabeth and Mannig, Birgit and Reyers, Mark and Schubert, David and Pinto, Joaquim G. and Peters, Juliane and Pieczonka, Tino and Juen, Martin and Bolch, Tobias and Paeth, Heiko and Mayer, Christoph}, title = {Future climate change and its impact on runoff generation from the debris-covered Inylchek glaciers, Central Tian Shan, Kyrgyzstan}, series = {Water}, volume = {10}, journal = {Water}, number = {11}, issn = {2073-4441}, doi = {10.3390/w10111513}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-197592}, pages = {1513}, year = {2018}, abstract = {The heavily debris-covered Inylchek glaciers in the central Tian Shan are the largest glacier system in the Tarim catchment. It is assumed that almost 50\% of the discharge of Tarim River are provided by glaciers. For this reason, climatic changes, and thus changes in glacier mass balance and glacier discharge are of high impact for the whole region. In this study, a conceptual hydrological model able to incorporate discharge from debris-covered glacier areas is presented. To simulate glacier melt and subsequent runoff in the past (1970/1971-1999/2000) and future (2070/2071-2099/2100), meteorological input data were generated based on ECHAM5/MPI-OM1 global climate model projections. The hydrological model HBV-LMU was calibrated by an automatic calibration algorithm using runoff and snow cover information as objective functions. Manual fine-tuning was performed to avoid unrealistic results for glacier mass balance. The simulations show that annual runoff sums will increase significantly under future climate conditions. A sensitivity analysis revealed that total runoff does not decrease until the glacier area is reduced by 43\%. Ice melt is the major runoff source in the recent past, and its contribution will even increase in the coming decades. Seasonal changes reveal a trend towards enhanced melt in spring, but a change from a glacial-nival to a nival-pluvial runoff regime will not be reached until the end of this century.}, language = {en} } @article{BohmannKurkaduMesnildeRochemontetal.2019, author = {Bohmann, Ferdinand O. and Kurka, Natalia and du Mesnil de Rochemont, Richard and Gruber, Katharina and Guenther, Joachim and Rostek, Peter and Rai, Heike and Zickler, Philipp and Ertl, Michael and Berlis, Ansgar and Poli, Sven and Mengel, Annerose and Ringleb, Peter and Nagel, Simon and Pfaff, Johannes and Wollenweber, Frank A. and Kellert, Lars and Herzberg, Moriz and Koehler, Luzie and Haeusler, Karl Georg and Alegiani, Anna and Schubert, Charlotte and Brekenfeld, Caspar and Doppler, Christopher E. J. and Onur, Oezguer A. and Kabbasch, Christoph and Manser, Tanja and Pfeilschifter, Waltraud}, title = {Simulation-based training of the rapid evaluation and management of acute stroke (STREAM) — a prospective single-arm multicenter trial}, series = {Frontiers in Neurology}, volume = {10}, journal = {Frontiers in Neurology}, issn = {1664-2295}, doi = {10.3389/fneur.2019.00969}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-369239}, year = {2019}, abstract = {Introduction: Acute stroke care delivered by interdisciplinary teams is time-sensitive. Simulation-based team training is a promising tool to improve team performance in medical operations. It has the potential to improve process times, team communication, patient safety, and staff satisfaction. We aim to assess whether a multi-level approach consisting of a stringent workflow revision based on peer-to-peer review and 2-3 one-day in situ simulation trainings can improve acute stroke care processing times in high volume neurocenters within a 6 months period. Methods and Analysis: The trial is being carried out in a pre-test-post-test design at 7 tertiary care university hospital neurocenters in Germany. The intervention is directed at the interdisciplinary multiprofessional stroke teams. Before and after the intervention, process times of all direct-to-center stroke patients receiving IV thrombolysis (IVT) and/or endovascular therapy (EVT) will be recorded. The primary outcome measure will be the "door-to-needle" time of all consecutive stroke patients directly admitted to the neurocenters who receive IVT. Secondary outcome measures will be intervention-related process times of the fraction of patients undergoing EVT and effects on team communication, perceived patient safety, and staff satisfaction via a staff questionnaire. Interventions: We are applying a multi-level intervention in cooperation with three "STREAM multipliers" from each center. First step is a central meeting of the multipliers at the sponsor's institution with the purposes of algorithm review in a peer-to-peer process that is recorded in a protocol and an introduction to the principles of simulation training and debriefing as well as crew resource management and team communication. Thereafter, the multipliers cooperate with the stroke team trainers from the sponsor's institution to plan and execute 2-3 one-day simulation courses in situ in the emergency department and CT room of the trial centers whereupon they receive teaching materials to perpetuate the trainings. Clinical Trial Registration: STREAM is a registered trial at https://clinicaltrials.gov/ct2/show/NCT03228251.}, language = {en} }