@article{HeinzWildEidmannetal.2023,
  author    = {Heinz, Tizian and Wild, Moritz and Eidmann, Annette and Weißenberger, Manuel and Rak, Dominik and Nedopil, Alexander Johannes and Rudert, Maximilian and Stratos, Ioannis},
  title     = {Impact of COVID-19 on fracture incidence in germany: a comparative age and gender analysis of pre- and post-outbreak periods},
  series = {Healthcare},
  volume    = {11},
  journal   = {Healthcare},
  number    = {15},
  issn      = {2227-9032},
  doi       = {10.3390/healthcare11152139},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-362686},
  year      = {2023},
  abstract  = {In March 2020, Germany imposed a nationwide lockdown to curb the spread of COVID-19, prompting questions about the impact on the incidence of common fractures. This study examined 15 fracture types in pre-outbreak (2010-2019) and post-outbreak (2020-2021) periods, using data categorized by age (18-64 years, 65 years) and sex (male, female). Linear regression assessed annual growth rates, and mean fracture numbers were compared across periods for significant differences. Results indicated a positive correlation between fracture incidence rates and time for various types, such as cervical, thoracic, lumbar, and pelvic spine fractures, rib fractures, femoral neck, pertrochanteric femur, femoral shaft, and ankle fractures. Frequencies of proximal humerus, distal radius, femoral neck, pertrochanteric femur, femoral shaft, and ankle fractures in 2020 and 2021 were within predicted ranges from previous years. However, rib fractures and spinal fractures (cervical, thoracic, lumbar, and pelvic spine) occurred less frequently during this time. Notably, this study found a consistent decline in most fracture types for individuals aged 18-64 after the pandemic's onset, while the fracture incidence of hip fractures, often referred to as fragility fractures, for those over 65 remained unchanged. Fibula fractures showed the most considerable decrease in both age groups. In conclusion, the COVID-19 pandemic substantially impacted fracture incidence, with lower rates among individuals under 65 and unchanged fragility fractures in the elderly population.},
  language  = {en}
}
@article{EidmannHeinzOberfeldetal.2023,
  author    = {Eidmann, Annette and Heinz, Tizian and Oberfeld, Jan and Weißenberger, Manuel and Rudert, Maximilian and Stratos, Ioannis},
  title     = {Epidemiology and trends in cartilage surgery of the foot and ankle in Germany: an analysis of national healthcare billing and reporting data from 2006 to 2020},
  series = {Medicina},
  volume    = {59},
  journal   = {Medicina},
  number    = {7},
  issn      = {1648-9144},
  doi       = {10.3390/medicina59071256},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-362835},
  year      = {2023},
  abstract  = {Background and objectives: Cartilage surgery constitutes a standard intervention in foot and ankle procedures. Currently, there is a lack of epidemiological data on its frequency, age distribution, and surgical options for cartilage surgery. This study aimed to investigate the current landscape of cartilage surgery in Germany and identify the most common procedures from an epidemiological standpoint. Materials and methods: Medical billing and reporting data from the Federal Statistical Office of Germany, encompassing the period 2006-2020, was examined, including all foot and ankle cartilage surgical procedures (summarized under OPS codes 5-812 and 5-801). The dataset incorporated information on the affected joint, patient age and sex, and surgery type. Each surgical procedure was categorized as "debridement", "regeneration" or "refixation". Linear and nonlinear regression analyses were employed, with a statistical significance threshold of 0.05. Results: From the total of 136,501 procedures conducted during the study period, the most frequently performed interventions were microfracture (58,252) and chondroplasty (56,135), and thus, debridement procedures were in the leading position. The use of acellular membranes was the most used regenerative technique (n = 11,414). At the ankle joint, interventions were mostly arthroscopic and in men, while foot cartilage surgeries were preferably performed via open surgery and mostly in women. Age distribution analysis revealed two primary peaks: the first in the 20-25-year-old group (ankle and foot) and the second in the 45-50-year-old group (ankle) and 55-60-year-old group (foot). Refixation and regenerative procedures were more frequent among younger individuals, while debriding procedures were more frequent among older individuals. Regenerative procedures, particularly in the ankle, significantly increased over time. Conclusions: Cartilage surgery of the foot and ankle was common, with two primary age groups predominantly affected. Notably, recent years have witnessed a considerable rise in cartilage regenerative procedures.},
  language  = {en}
}
@phdthesis{Dereser2024,
  author    = {Dereser, Katharina},
  title     = {Real World Next Generation M³P Panel-Sequenzierung f{\"u}r die personalisierte Therapie des Multiplen Myeloms},
  doi       = {10.25972/OPUS-35264},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-352644},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {Obwohl es in den letzten 10-15 Jahren gelang, multiple MM-Genome mittels NGS auf eine kosteneffiziente Art und mit geringem Zeit- und Materialaufwand zu sequenzieren und hierdurch zum Teil bahnbrechende Erkenntnisse gewonnen werden konnten, sind molekulargenetische Untersuchungen im diagnostischen Workflow des MMs bisher nicht ausreichend implementiert, um eine personalisierte Therapieentscheidung zu erm{\"o}glichen. Vor diesem Hintergrund wurde in der vorliegenden Arbeit eine Gruppe an Patienten mit NDMM und RRMM anhand klinischer Parameter charakterisiert und durch Verwendung des M³P-Panels auf das Vorliegen bestimmter molekulargenetischer Ver{\"a}nderungen untersucht. Zusammenfassend l{\"a}sst sich sagen, dass unsere Analyse die bisher ver{\"o}ffentliche M³P-Pr{\"a}valenz in MM-Tumorproben best{\"a}tigt. Zu den am h{\"a}ufigsten mutierten Genen geh{\"o}rten KRAS, NRAS, DIS3, ATM und BRAF. In der Gruppe der Patienten mit NRAS-Mutation oder del17p war die Zahl der relevanten Mutationen deutlich h{\"o}her als ohne Vorliegen der entsprechenden Ver{\"a}nderung. Der Nachweis eines Double-Hit-Myeloms war erwartungsgem{\"a}ß der st{\"a}rkste ung{\"u}nstige Faktor in unserer Kohorte. Unter den Patienten mit CRBN-Mutation waren alle IMiD-vorbehandelt und zeigten im Verlauf eine Refrakt{\"a}rit{\"a}t gegen{\"u}ber dieser Substanzgruppe auf. Bez{\"u}glich der {\"U}berlebensanalysen best{\"a}tigten unsere Ergebnisse bereits bekannte prognostische Risikofaktoren wie Hochrisikozytogenetik, insbesondere del17p und gain1q, eine TP53-Mutation sowie ISS- und R-ISS-Stadium III. Die Ergebnisse der Mutationsanalysen dieser Arbeit verdeutlichen den großen wissenschaftlichen und therapeutischen Nutzen, der von molekulargenetischen Untersuchungen ausgeht. Zuk{\"u}nftig werden auch beim MM Therapieentscheidungen auf Grundlage genetischer Diagnostik getroffen werden, mit dem Ziel die Behandlung f{\"u}r MM-Patienten weiter zu verbessern.},
  subject      = {Plasmozytom},
  language  = {de}
}
@phdthesis{MeyerSautter2024,
  author    = {Meyer-Sautter, Pascal Willy},
  title     = {Evaluation der postoperativen empirischen antibiotischen Therapie intraabdomineller Infektionen aus Sicht des Antimicrobical Stewardships (AMS)},
  doi       = {10.25972/OPUS-35920},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-359201},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {Ziele: Das Ziel dieser Dissertation ist es, die empirischen antibiotische Therapien (PAT) bei komplizierten intraabdominellen Infektionen (cIAI) in den Jahren 2016 - 2018 in einem großen deutschen Maximalversorger zu evaluieren. Aktuelle Studien legen nahe, dass viele Patienten keine Nachteile durch k{\"u}rzere Therapien mit schmaler wirksamen Antibiotika oder das vermeiden einer nicht notwendigen antibiotischen Therapie haben. Methoden: Es wurde eine retrospektive Kohortenstudie durch Analyse von elektronischen Patientenakten an einem 1500-Betten-Universit{\"a}tsklinikum in Deutschland durchgef{\"u}hrt, bei der die Dauer der Antibiotikatherapie nach Notfalloperationen erhoben und mit antibiotischen Leitlinien durch die hausinterne Antibiotic-Stewardship-Abteilung (AMS) verglichen. Ergebnisse: 767 Patienten konnten eingeschlossen werden, davon erhielten 404 (52.7\%) eine PAT. Die Gesamtanzahl der Therapietage pro 100 Patiententagen ging von 47,0 auf 42,2 Tage zur{\"u}ck (p = 0,035) ohne einen Anstieg an Komplikationen. Patienten ohne Sepsis, bei denen eine initiale chirurgischer Fokuskontrolle m{\"o}glich war profitierten nicht von einer Therapiedauer {\"u}ber 4 Tage (160 vs 100 Patienten). Bei Patienten, bei denen diese Bedingungen nicht gegeben waren, zeigte sich ebenfalls kein Vorteil bei l{\"a}ngeren Behandlungen ({\"u}ber >7 Tage, 74 lang vs. 32 kurz behandelte Patienten). Es zeigte sich ebenfalls kein Vorteil von empirischen Therapien mit Carbapenem statt mit Piperacillin-Tazobactam (n=51 C vs n=40 vs Pip/Taz). Schlussfolgerung: Die Reduktion unn{\"o}tiger, zu breiter und zu langer antibiotischer Therapien bei cIAI ist ohne einen Anstieg der postoperativen Komplikationen m{\"o}glich. Weitere RCTs sind notwendig, um das Wissen um sichere Behandlungen zu vergr{\"o}ßern.},
  subject      = {Bakterielle Infektion},
  language  = {de}
}
@phdthesis{Kusan2024,
  author    = {Kusan, Simon Ferdinand},
  title     = {Keimspektrum und antibiotische Therapie bei Morbus Crohn-assoziierten Abszessen : Eine retrospektive monozentrische Analyse},
  doi       = {10.25972/OPUS-35946},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-359467},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {In dieser monozentrischen retrospektiven Analyse wurde das Keimspektrum und die antibiotische Therapie bei Morbus Crohn- assoziierten Abszessen untersucht.},
  subject      = {Antibiotikum},
  language  = {de}
}
@phdthesis{Knorr2024,
  author    = {Knorr, Susanne},
  title     = {Pathophysiology of early-onset isolated dystonia in a DYT-TOR1A rat model with trauma-induced dystonia-like movements},
  doi       = {10.25972/OPUS-20609},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-206096},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {Early-onset torsion dystonia (DYT-TOR1A, DYT1) is an inherited hyperkinetic movement disorder caused by a mutation of the TOR1A gene encoding the torsinA protein. DYT-TOR1A is characterized as a network disorder of the central nervous system (CNS), including predominantly the cortico-basal ganglia-thalamo-cortical loop resulting in a severe generalized dystonic phenotype. The pathophysiology of DYTTOR1A is not fully understood. Molecular levels up to large-scale network levels of the CNS are suggested to be affected in the pathophysiology of DYT-TOR1A. The reduced penetrance of 30\% - 40\% indicates a gene-environmental interaction, hypothesized as "second hit". The lack of appropriate and phenotypic DYT-TOR1A animal models encouraged us to verify the "second hit" hypothesis through a unilateral peripheral nerve trauma of the sciatic nerve in a transgenic asymptomatic DYT-TOR1A rat model (∆ETorA), overexpressing the human mutated torsinA protein. In a multiscale approach, this animal model was characterized phenotypically and pathophysiologically. Nerve-injured ∆ETorA rats revealed dystonia-like movements (DLM) with a partially generalized phenotype. A physiomarker of human dystonia, describing increased theta oscillation in the globus pallidus internus (GPi), was found in the entopeduncular nucleus (EP), the rodent equivalent to the human GPi, of nerve-injured ∆ETorA rats. Altered oscillation patterns were also observed in the primary motor cortex. Highfrequency stimulation (HFS) of the EP reduced DLM and modulated altered oscillatory activity in the EP and primary motor cortex in nerve-injured ∆ETorA rats. Moreover, the dopaminergic system in ∆ETorA rats demonstrated a significant increased striatal dopamine release and dopamine turnover. Whole transcriptome analysis revealed differentially expressed genes of the circadian clock and the energy metabolism, thereby pointing towards novel, putative pathways in the pathophysiology of DYTTOR1A dystonia. In summary, peripheral nerve trauma can trigger DLM in genetically predisposed asymptomatic ΔETorA rats leading to neurobiological alteration in the central motor network on multiple levels and thereby supporting the "second hit" hypothesis. This novel symptomatic DYT-TOR1A rat model, based on a DYT-TOR1A genetic background, may prove as a valuable chance for DYT-TOR1A dystonia, to further investigate the pathomechanism in more detail and to establish new treatment strategies.},
  subject      = {Dystonie},
  language  = {en}
}
@phdthesis{PenaMosca2024,
  author    = {Pe{\~n}a Mosca, Mar{\´i}a Josefina},
  title     = {Local regulation of T-cell immunity in the intestinal mucosa},
  doi       = {10.25972/OPUS-35266},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-352665},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {After priming in Peyer's patches (PPs) and mesenteric lymph nodes (mLN) T- cells infiltrate the intestine through lymphatic draining and homing through the bloodstream. However, we found that in mouse models of acute graft-versus-host disease (GvHD), a subset of alloreactive T-cells directly migrates from PPs to the adjacent intestinal lamina propria (LP), bypassing the normal lymphatic drainage and vascular trafficking routes. Notably, this direct migration occurred in irradiated and unirradiated GvHD models, indicating that irradiation is not a prerequisite for this observed behavior. Next, we established a method termed serial intravascular staining (SIVS) in mouse models to systematically investigate the trafficking and migration of donor T- cells in the early stages of acute GvHD initiation. We found that the direct migration of T-cells from PPs to LP resulted in faster recruitment of cells after allogeneic hematopoietic cell transplantation (allo-HCT). These directly migrating T-cells were found to be in an activated and proliferative state, exhibiting a TH1/TH17-like phenotype and producing cytokines such as IFN-γ and TNF-α. Furthermore, we observed that the directly migrating alloreactive T-cells expressed specific integrins (α4+, αE+) and chemokine receptors (CxCR3+, CCR5+, and CCR9+). Surprisingly, blocking these integrins and chemokine-coupled receptors did not hinder the direct migration of T- cells from PPs to LP, suggesting the involvement of alternative mechanisms. Previous experiments ruled out the involvement of S1PR1 and topographical features of macrophages, leading us to hypothesize that mediators of cytoskeleton reorganization, such as Coro1a, Dock2, or Cdc42, may play a role in this unique migration process. Additionally, we observed that directly migrating T-cells created a local inflammatory microenvironment, which attracts circulating T-cells. Histological analysis confirmed that alloreactive PPs-derived T-cells and bloodborne T-cells colocalized. We employed two experimental approaches, including either photoconversion of T-cells in PPs or direct transfer of activated T-cells into the vasculature, to demonstrate this colocalization. We hypothesize that cytokines released by migrating T-cells, such as IFN-γ and TNF-α, may play a role in recruiting T-cells from the vasculature, as inhibiting chemokine-coupled receptors did not impair recruitment.},
  subject      = {T-Lymphozyt},
  language  = {en}
}
@article{RighessoTerekhovGoetzetal.2021,
  author    = {Righesso, L. A. R. and Terekhov, M. and G{\"o}tz, H. and Ackermann, M. and Emrich, T. and Schreiber, L. M. and M{\"u}ller, W. E. G. and Jung, J. and Rojas, J. P. and Al-Nawas, B.},
  title     = {Dynamic contrast-enhanced magnetic resonance imaging for monitoring neovascularization during bone regeneration — a randomized in vivo study in rabbits},
  series = {Clinical Oral Investigations},
  volume    = {25},
  journal   = {Clinical Oral Investigations},
  number    = {10},
  issn      = {1432-6981},
  doi       = {10.1007/s00784-021-03889-6},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307614},
  pages     = {5843-5854},
  year      = {2021},
  abstract  = {Objectives Micro-computed tomography (μ-CT) and histology, the current gold standard methods for assessing the formation of new bone and blood vessels, are invasive and/or destructive. With that in mind, a more conservative tool, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), was tested for its accuracy and reproducibility in monitoring neovascularization during bone regeneration. Additionally, the suitability of blood perfusion as a surrogate of the efficacy of osteoplastic materials was evaluated. Materials and methods Sixteen rabbits were used and equally divided into four groups, according to the time of euthanasia (2, 3, 4, and 6 weeks after surgery). The animals were submitted to two 8-mm craniotomies that were filled with blood or autogenous bone. Neovascularization was assessed in vivo through DCE-MRI, and bone regeneration, ex vivo, through μ-CT and histology. Results The defects could be consistently identified, and their blood perfusion measured through DCE-MRI, there being statistically significant differences within the blood clot group between 3 and 6 weeks (p = 0.029), and between the former and autogenous bone at six weeks (p = 0.017). Nonetheless, no significant correlations between DCE-MRI findings on neovascularization and μ-CT (r =-0.101, 95\% CI [-0.445; 0.268]) or histology (r = 0.305, 95\% CI [-0.133; 0.644]) findings on bone regeneration were observed. Conclusions These results support the hypothesis that DCE-MRI can be used to monitor neovascularization but contradict the premise that it could predict bone regeneration as well.},
  language  = {en}
}
@article{LenzPahlHaucketal.2021,
  author    = {Lenz, Dominic and Pahl, Jens and Hauck, Fabian and Alameer, Seham and Balasubramanian, Meena and Baric, Ivo and Boy, Nikolas and Church, Joseph A. and Crushell, Ellen and Dick, Anke and Distelmaier, Felix and Gujar, Jidnyasa and Indolfi, Giuseppe and Lurz, Eberhard and Peters, Bianca and Schwerd, Tobias and Serranti, Daniele and K{\"o}lker, Stefan and Klein, Christoph and Hoffmann, Georg F. and Prokisch, Holger and Greil, Johann and Cerwenka, Adelheid and Giese, Thomas and Staufner, Christian},
  title     = {NBAS Variants Are Associated with Quantitative and Qualitative NK and B Cell Deficiency},
  series = {Journal of Clinical Immunology},
  volume    = {41},
  journal   = {Journal of Clinical Immunology},
  number    = {8},
  issn      = {0271-9142},
  doi       = {10.1007/s10875-021-01110-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308362},
  pages     = {1781-1793},
  year      = {2021},
  abstract  = {Purpose Biallelic pathogenic NBAS variants manifest as a multisystem disorder with heterogeneous clinical phenotypes such as recurrent acute liver failure, growth retardation, and susceptibility to infections. This study explores how NBAS-associated disease affects cells of the innate and adaptive immune system. Methods Clinical and laboratory parameters were combined with functional multi-parametric immunophenotyping methods in fifteen NBAS-deficient patients to discover possible alterations in their immune system. Results Our study revealed reduced absolute numbers of mature CD56dim natural killer (NK) cells. Notably, the residual NK cell population in NBAS-deficient patients exerted a lower potential for activation and degranulation in response to K562 target cells, suggesting an NK cell-intrinsic role for NBAS in the release of cytotoxic granules. NBAS-deficient NK cell activation and degranulation was normalized upon pre-activation by IL-2 in vitro, suggesting that functional impairment was reversible. In addition, we observed a reduced number of na{\"i}ve B cells in the peripheral blood associated with hypogammaglobulinemia. Conclusion In summary, we demonstrate that pathogenic biallelic variants in NBAS are associated with dysfunctional NK cells as well as impaired adaptive humoral immunity.},
  language  = {en}
}
@article{EstradaKrebbersVossetal.2018,
  author    = {Estrada, Veronica and Krebbers, Julia and Voss, Christian and Brazda, Nicole and Blazyca, Heinrich and Illgen, Jennifer and Seide, Klaus and J{\"u}rgens, Christian and M{\"u}ller, J{\"o}rg and Martini, Rudolf and Trieu, Hoc Khiem and M{\"u}ller, Hans Werner},
  title     = {Low-pressure micro-mechanical re-adaptation device sustainably and effectively improves locomotor recovery from complete spinal cord injury},
  series = {Communications Biology},
  volume    = {1},
  journal   = {Communications Biology},
  doi       = {10.1038/s42003-018-0210-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-227357},
  year      = {2018},
  abstract  = {Traumatic spinal cord injuries result in impairment or even complete loss of motor, sensory and autonomic functions. Recovery after complete spinal cord injury is very limited even in animal models receiving elaborate combinatorial treatments. Recently, we described an implantable microsystem (microconnector) for low-pressure re-adaption of severed spinal stumps in rat. Here we investigate the long-term structural and functional outcome following microconnector implantation after complete spinal cord transection. Re-adaptation of spinal stumps supports formation of a tissue bridge, glial and vascular cell invasion, motor axon regeneration and myelination, resulting in partial recovery of motor-evoked potentials and a thus far unmet improvement of locomotor behaviour. The recovery lasts for at least 5 months. Despite a late partial decline, motor recovery remains significantly superior to controls. Our findings demonstrate that microsystem technology can foster long-lasting functional improvement after complete spinal injury, providing a new and effective tool for combinatorial therapies.},
  language  = {en}
}
@article{HollaenderSchwenderBoehmeetal.2021,
  author    = {Holl{\"a}nder, Olivia and Schwender, Kristina and B{\"o}hme, Petra and Fleckhaus, Jan and Haas, Cordula and Han, Yang and Heidorn, Frank and Klein-Unseld, Rachel and Lichtenwald, Julia and Naue, Jana and Neubauer, Jacqueline and Poetsch, Micaela and Schneider, Peter M. and Wagner, Wolfgang and Vennemann, Marielle},
  title     = {Forensische DNA-Methylierungsanalyse},
  series = {Rechtsmedizin},
  volume    = {31},
  journal   = {Rechtsmedizin},
  number    = {3},
  organization    = {Arbeitsgemeinschaft Molekulare Alterssch{\"a}tzung der Deutschen Gesellschaft f{\"u}r Rechtsmedizin (DGRM)},
  issn      = {0937-9819},
  doi       = {10.1007/s00194-021-00492-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307131},
  pages     = {192-201},
  year      = {2021},
  abstract  = {Die quantitative Analyse der relativen DNA-Methylierung gilt als eine der vielversprechendsten Methoden der molekularen Alterssch{\"a}tzung. Viele Studien der letzten Jahre identifizierten geeignete Positionen im Genom, deren DNA-Methylierung sich altersabh{\"a}ngig ver{\"a}ndert. F{\"u}r den Einsatz dieser Methode in der Routine- bzw. Fallarbeit ist es von großer Bedeutung, angewandte Analysetechniken zu validieren. Als ein Teilaspekt dieser Validierung sollte die Vergleichbarkeit der Analyseergebnisse zur DNA-Methylierung mithilfe der Mini- und Pyrosequenzierung zwischen verschiedenen Laboren evaluiert werden. Die Arbeitsgruppe „Molekulare Alterssch{\"a}tzung" der Deutschen Gesellschaft f{\"u}r Rechtsmedizin (DGRM) f{\"u}hrte hierzu den ersten, technischen Ringversuch durch, der 4 Positionen in den Genen PDE4C, EDARADD, SST und KLF14 umfasste. Diese Marker waren in vorangegangenen Studien als altersabh{\"a}ngige Biomarker charakterisiert worden. Am Ringversuch nahmen 12 Labore teil, wobei jedes die Wahl zwischen der Minisequenzierung und/oder der Pyrosequenzierung f{\"u}r die quantitative Methylierungsanalyse hatte. Jedem teilnehmenden Labor wurden Blut- und Speichelproben von 3 Personen unterschiedlichen Alters {\"u}bersandt. Die Wahl der Reagenzien f{\"u}r die Probenbearbeitung wurde den Teilnehmern freigestellt. Die Ergebnisse der Minisequenzierung zeigten systematische Abweichungen zwischen den Laboren, die am ehesten auf die Verwendung unterschiedlicher Reagenzien und Analyseplattformen zur{\"u}ckzuf{\"u}hren sein k{\"o}nnen. Die Resultate der Pyrosequenzierung hingegen wiesen nicht auf systematische Abweichungen zwischen den Laboren hin, hier zeigte sich jedoch die Tendenz einer markerabh{\"a}ngigen Abweichung. Dar{\"u}ber hinaus konnten Unterschiede hinsichtlich technischer Probleme zwischen Laboren mit mehr Erfahrung in der jeweiligen Sequenzierungsmethode und Laboren mit weniger Erfahrung festgestellt werden. Sowohl die Beobachtung von systematischen als auch die von markerabh{\"a}ngigen Abweichungen l{\"a}sst den Schluss zu, dass eine {\"U}bertragung von Analysemethoden zwischen Laboren grunds{\"a}tzlich m{\"o}glich ist, eine Anpassung des jeweiligen Modells zur Alterssch{\"a}tzung jedoch notwendig sein kann.},
  language  = {de}
}
@article{ElMeseryRosenthalRauertWunderlichetal.2019,
  author    = {El-Mesery, Mohamed and Rosenthal, Tina and Rauert-Wunderlich, Hilka and Schreder, Martin and St{\"u}hmer, Thorsten and Leich, Ellen and Schlosser, Andreas and Ehrenschwender, Martin and Wajant, Harald and Siegmund, Daniela},
  title     = {The NEDD8-activating enzyme inhibitor MLN4924 sensitizes a TNFR1+ subgroup of multiple myeloma cells for TNF-induced cell death},
  series = {Cell Death \& Disease},
  volume    = {10},
  journal   = {Cell Death \& Disease},
  doi       = {10.1038/s41419-019-1860-2},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-226666},
  year      = {2019},
  abstract  = {The NEDD8-activating enzyme (NAE) inhibitor MLN4924 inhibits cullin-RING ubiquitin ligase complexes including the SKP1-cullin-F-box E3 ligase βTrCP. MLN4924 therefore inhibits also the βTrCP-dependent activation of the classical and the alternative NFĸB pathway. In this work, we found that a subgroup of multiple myeloma cell lines (e.g., RPMI-8226, MM.1S, KMS-12BM) and about half of the primary myeloma samples tested are sensitized to TNF-induced cell death by MLN4924. This correlated with MLN4924-mediated inhibition of TNF-induced activation of the classical NFκB pathway and reduced the efficacy of TNF-induced TNFR1 signaling complex formation. Interestingly, binding studies revealed a straightforward correlation between cell surface TNFR1 expression in multiple myeloma cell lines and their sensitivity for MLN4924/TNF-induced cell death. The cell surface expression levels of TNFR1 in the investigated MM cell lines largely correlated with TNFR1 mRNA expression. This suggests that the variable levels of cell surface expression of TNFR1 in myeloma cell lines are decisive for TNF/MLN4924 sensitivity. Indeed, introduction of TNFR1 into TNFR1-negative TNF/MLN4924-resistant KMS-11BM cells, was sufficient to sensitize this cell line for TNF/MLN4924-induced cell death. Thus, MLN4924 might be especially effective in myeloma patients with TNFR1+ myeloma cells and a TNFhigh tumor microenvironment.},
  language  = {en}
}
@article{AdolphFleischhackGaabetal.2021,
  author    = {Adolph, Jonas E. and Fleischhack, Gudrun and Gaab, Christine and Mikasch, Ruth and Mynarek, Martin and Rutkowski, Stefan and Sch{\"u}ller, Ulrich and Pfister, Stefan M. and Pajtler, Kristian W. and Milde, Till and Witt, Olaf and Bison, Brigitte and Warmuth-Metz, Monika and Kortmann, Rolf-Dieter and Dietzsch, Stefan and Pietsch, Torsten and Timmermann, Beate and Tippelt, Stephan},
  title     = {Systemic chemotherapy of pediatric recurrent ependymomas: results from the German HIT-REZ studies},
  series = {Journal of Neuro-Oncology},
  volume    = {155},
  journal   = {Journal of Neuro-Oncology},
  number    = {2},
  organization    = {German GPOH HIT-Network},
  issn      = {0167-594X},
  doi       = {10.1007/s11060-021-03867-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308302},
  pages     = {193-202},
  year      = {2021},
  abstract  = {Purpose Survival in recurrent ependymoma (EPN) depends mainly on the extent of resection achieved. When complete resection is not feasible, chemotherapy is often used to extend progression-free and overall survival. However, no consistent effect of chemotherapy on survival has been found in patients with recurrent EPN. Methods Systemic chemotherapeutic treatment of 138 patients enrolled in the German HIT-REZ-studies was analyzed. Survival depending on the use of chemotherapy, disease-stabilization rates (RR), duration of response (DOR) and time to progression (TTP) were estimated. Results Median age at first recurrence was 7.6 years (IQR: 4.0-13.6). At first recurrence, median PFS and OS were 15.3 (CI 13.3-20.0) and 36.9 months (CI 29.7-53.4), respectively. The Hazard Ratio for the use of chemotherapy in local recurrences in a time-dependent Cox-regression analysis was 0.99 (CI 0.74-1.33). Evaluable responses for 140 applied chemotherapies were analyzed, of which sirolimus showed the best RR (50\%) and longest median TTP [11.51 (CI 3.98; 14.0) months] in nine patients, with the strongest impact found when sirolimus was used as a monotherapy. Seven patients with progression-free survival > 12 months after subtotal/no-resection facilitated by chemotherapy were found. No definitive survival advantage for any drug in a specific molecularly defined EPN type was found. Conclusion No survival advantage for the general use of chemotherapy in recurrent EPN was found. In cases with incomplete resection, chemotherapy was able to extend survival in individual cases. Sirolimus showed the best RR, DOR and TTP out of all drugs analyzed and may warrant further investigation.},
  language  = {en}
}
@article{DornquastReinholdSolaketal.2022,
  author    = {Dornquast, Christina and Reinhold, Thomas and Solak, Saliha and Durak, Melike and Becher, Heiko and Riens, Burgi and Icke, Katja and Danquah, Ina and Willich, Stefan N. and Keil, Thomas and Krist, Lilian},
  title     = {Strategies to Enhance Retention in a Cohort Study Among Adults of Turkish Descent Living in Berlin},
  series = {Journal of Immigrant and Minority Health},
  volume    = {24},
  journal   = {Journal of Immigrant and Minority Health},
  number    = {5},
  doi       = {10.1007/s10903-021-01309-1},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-344776},
  pages     = {1309-1317},
  year      = {2022},
  abstract  = {Retention is important for statistical power and external validity in long-term cohort studies. The aims of our study were to evaluate different retention strategies within a cohort study of adults of Turkish descent in Berlin, Germany, and to compare participants and non-participants. In 2011-2012, a population-based study was conducted among adults of Turkish descent to primarily examine recruitment strategies. 6 years later, the participants were re-contacted and invited to complete a self-report questionnaire regarding their health status, health care utilization, and satisfaction with medical services. The retention strategy comprised letters in both German and Turkish, phone calls, and home visits (by bilingual staff). We calculated the response rate and retention rate, using definitions of the American Association for Public Opinion Research, as well as the relative retention rate for each level of contact. Associations of baseline recruitment strategy, sociodemographic, migration-related and health-related factors with retention were investigated by logistic regression analysis. Of 557 persons contacted, 249 (44.7\%) completed the questionnaire. This was 50.1\% of those whose contact information was available. The relative retention rate was lowest for phone calls (8.9\%) and highest for home visits (18.4\%). Participants were more often non-smokers and German citizens than non-participants. For all remaining factors, no association with retention was found. In this study, among adults of Turkish descent, the retention rate increased considerably with every additional level of contact. Implementation of comprehensive retention strategies provided by culturally matched study personnel may lead to higher validity and statistical power in studies on migrant health issues.},
  language  = {en}
}
@article{AmerellerDeutschbeinJoshietal.2022,
  author    = {Amereller, Felix and Deutschbein, Timo and Joshi, Mamta and Schopohl, Jochen and Schilbach, Katharina and Detomas, Mario and Duffy, Leo and Carroll, Paul and Papa, Sophie and St{\"o}rmann, Sylv{\`e}re},
  title     = {Differences between immunotherapy-induced and primary hypophysitis—a multicenter retrospective study},
  series = {Pituitary},
  volume    = {25},
  journal   = {Pituitary},
  number    = {1},
  issn      = {1386-341X},
  doi       = {10.1007/s11102-021-01182-z},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308704},
  pages     = {152-158},
  year      = {2022},
  abstract  = {Objective Immune checkpoint inhibitors can cause various immune-related adverse events including secondary hypophysitis. We compared clinical characteristics of immunotherapy-induced hypophysitis (IIH) and primary hypophysitis (PH) Design Retrospective multicenter cohort study including 56 patients with IIH and 60 patients with PH. Methods All patients underwent extensive endocrine testing. Data on age, gender, symptoms, endocrine dysfunction, MRI, immunotherapeutic agents and autoimmune diseases were collected. Results Median time of follow-up was 18 months in IIH and 69 months in PH. The median time from initiation of immunotherapy to IIH diagnosis was 3 months. IIH affected males more frequently than PH (p < 0.001) and led to more impaired pituitary axes in males (p < 0.001). The distribution of deficient adenohypophysial axes was comparable between both entities, however, central hypocortisolism was more frequent (p < 0.001) and diabetes insipidus considerably less frequent in IIH (p < 0.001). Symptoms were similar except that visual impairment occurred more rarely in IIH (p < 0.001). 20 \% of IIH patients reported no symptoms at all. Regarding MRI, pituitary stalk thickening was less frequent in IIH (p = 0.009). Concomitant autoimmune diseases were more prevalent in PH patients before the diagnosis of hypophysitis (p = 0.003) and more frequent in IIH during follow-up (p = 0.002). Conclusions Clinically, IIH and PH present with similar symptoms. Diabetes insipidus very rarely occurs in IIH. Central hypocortisolism, in contrast, is a typical feature of IIH. Preexisting autoimmunity seems not to be indicative of developing IIH.},
  language  = {en}
}
@phdthesis{Kruse2024,
  author    = {Kruse, Daniel},
  title     = {Quantitative Analyse histologischer Aufnahmen der Haut},
  doi       = {10.25972/OPUS-35294},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-352946},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {Diese Arbeit hatte zum Ziel quantitative Analysen histologischer Aufnahmen der Haut nach unterschiedlichen Gesichtspunkten zu etablieren. Im ersten Abschnitt wurde die bildgest{\"u}tzte Quantifizierung der epidermalen Histomorphologie untersucht. Nach Sichtung und Beurteilung von 2145 hochaufl{\"o}senden Fotografien HE-gef{\"a}rbter Epidermis- und Vollhautmodellen jeglichen Zustands, wurde der BSGC-Score als Facettenklassifikation mit seinen insgesamt 40 Beurteilungskriterien aufgestellt. Die unterschiedlichen epidermalen Strata wurden mit Wichtungsfaktoren belegt. Die Bewertungskategorien sind mit einem Ampelsystem unterlegt. Eine Befundungsformel wurde aufgestellt. Weitere Bestandteile des BSGC-Scores sind eine Anleitung mit Bildbeilage sowie Dokumentationselemente. Die Anwendung erfolgte erfolgreich im Rahmen der Qualit{\"a}tssicherung an Chargentests und zur Verlaufsbeurteilung eines In-vitro-Verbrennungsmodells aus humaner Epidermis durch Schneider et al. (2021) Der BSGC-Score dient als z{\"u}gig durchf{\"u}hrbares Evaluationstool zur Befundung von In-vitro-Epidermismodellen und nicht als diagnostisches Mittel. Der zweite Abschnitt besch{\"a}ftigt sich mit der Vaskularisierung als Parameter der kutanen Wundheilung. Es wurden aSMA-IF-gef{\"a}rbte Abbildungen porciner Verwundungsmodelle betrachtet und nach der Entfernung dr{\"u}siger Strukturen Gef{\"a}ßanschnitte zu Beginn manuell ausgez{\"a}hlt. Hieraus wurden die n{\"o}tigen Einstellungen f{\"u}r die Bildbearbeitungssoftware ImageJ ermittelt und die Abbildungen dieser anschließend zugef{\"u}hrt. Es erfolgte die automatisierte Quantifizierung elliptischer Formationen mit einer Gr{\"o}ße ≥ 30 Pixel. Im n{\"a}chsten Schritt wurden die Abbildungen in die Bereiche Wundrand, Wundgrund und Wundheilung unterteilt. In dem Bereich Wundheilung zeigte sich eine signifikant gr{\"o}ßere Revaskularisierung als in Wundgrund. Abschließend erfolgte der Vergleich sekund{\"a}rer Wundauflagen. Der Vergleich der Quotienten Wundheilung/Wundgrund nicht-okklusiver und okklusiver Wundauflagen zeigte keinen signifikanten Unterschied in der Neovaskularisierung. Die isolierte Betrachtung der Revaskularisierung als einzelner Prozess der Wundheilung kann nicht als generelles Kriterium f{\"u}r die Gesamtbeurteilung dienen. Hier findet die gew{\"a}hlte Methodik ihre Limitation. Zuk{\"u}nftige Anwendungsbereiche des BSGC-Scores sind die Ausweitung auf Vollhautmodelle und andere Verwundungsmodalit{\"a}ten. Eine automatisierte und durch eine KI-gest{\"u}tzte Befundung ist ebenfalls aufgrund des zugrundeliegenden umfangreichen Datensatzes denkbar. Auch kann eine automatisierte softwaregest{\"u}tzte Quantifizierung der Vaskularisierung als {\"u}berblickende und z{\"u}gige Beurteilung der Wundheilung sinnvoll erscheinen.},
  subject      = {Wundheilung},
  language  = {de}
}
@phdthesis{RombachgebGrosso2024,
  author    = {Rombach [geb. Grosso], Franziska},
  title     = {Der Interaktionsrezeptor des Masernvirus auf h{\"a}matopoetischen Zellen},
  doi       = {10.25972/OPUS-35339},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-353394},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2024},
  abstract  = {Das Masernvirus (MV) kann in Erkrankten eine schwere, langanhaltende Immunsuppression verursachen, wodurch Infektionen mit opportunistischen Pathogenen beg{\"u}nstigt werden. Diese basiert auf einer Paralyse der h{\"a}matopoetischen Zellen, welche das Virus durch Kontakt eines viralen Glykoproteinkomplexes zu einem unbekannten RezeptorX auf der Zell- Oberfl{\"a}che induzieren kann. Kerncharakterisitika hiervon sind unter anderem die Herabregulation der Akt-Kinase-Phosphorylierung, die Inhibition der zellul{\"a}ren Proliferation und die Aktivierung der neutralen Sphingomyelinase 2 (NSM2). In einem kinetischen Phosphoproteom konnten zwei potentielle Interaktionsrezeptoren des MV identifiziert werden: CD43 und P2X3. Das hochglykosylierte Oberfl{\"a}chenmolek{\"u}l CD43 ist auf h{\"a}matopoetischen Zellen ubiquit{\"a}r exprimiert und reguliert in T-Zellen deren {\"U}berleben, Proliferation, Aktivierung, Migration und Adh{\"a}sion. P2X3 wird in h{\"a}matopoetischen Zellen nur in geringem Maße exprimiert. Seine funktionelle Bedeutung ist in diesem Kompartiment nicht bekannt. Beide Kandidaten wurden mittels CRISPR/Cas9 Verfahren einzeln oder kombiniert aus Jurkat-T-Zellen ablatiert, welche nachfolgend nach MV-Kontakt hinsichtlich der oben erw{\"a}hnten MV-modulierten Parameter getestet wurden. Zus{\"a}tzlich wurden iso- und allosterische P2X3-Inhibitoren an prim{\"a}ren und Jurkat-T-Zellen verwendet, um dessen Rolle in Ca2+-Mobilisierung und Proliferation nach T-Zell-Rezeptor Co-Stimulation zu analysieren. Die genetische Depletion beider Rezeptor-Kandidaten verringerte die Effekte des MV auf alle getesteten Parameter signifikant, was darauf hindeutet, dass beide Proteine entscheidend an der T-Zell-Suppression beteiligt sind. W{\"a}hrend die isosterische Inhibition von P2X3 keinen Effekt hatte, wurde die Proliferation prim{\"a}rer T-Zellen durch dessen allosterische Inhibition vor Co-Stimulation fast verdoppelt und die Effizienz der Ca2+-Mobilisierung in Jurkat- und prim{\"a}ren T-Zellen signifikant erh{\"o}ht. In P2X3-depletierten Jurkat-Zellen hingegen war die Ca2+-Mobilisierung nach Stimulation signifikant geringer als in WT-Zellen. In dieser Arbeit konnten zwei wichtige Mediatoren der MV induzierten T-Zell-Suppression identifiziert werden. Vor allem P2X3, dessen Expression, Regulation und funktionelle Bedeutung im h{\"a}matopoetischen Kompartiment noch nicht erforscht wurde, k{\"o}nnte ein vielversprechender Kandidat f{\"u}r eine antivirale Therapie darstellen, da ein klinisch getesteter P2X3-Inhibitor bereits verf{\"u}gbar ist.},
  subject      = {Masernvirus},
  language  = {de}
}
@article{MerzenichBaakenSchmidtetal.2022,
  author    = {Merzenich, Hiltrud and Baaken, Dan and Schmidt, Marcus and Bekes, Inga and Schwentner, Lukas and Janni, Wolfgang and Woeckel, Achim and Bartkowiak, Detlef and Wiegel, Thomas and Blettner, Maria and Wollschl{\"a}ger, Daniel and Schmidberger, Heinz},
  title     = {Cardiac late effects after modern 3D-conformal radiotherapy in breast cancer patients: a retrospective cohort study in Germany (ESCaRa)},
  series = {Breast Cancer Research and Treatment},
  volume    = {191},
  journal   = {Breast Cancer Research and Treatment},
  number    = {1},
  issn      = {0167-6806},
  doi       = {10.1007/s10549-021-06412-3},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-308606},
  pages     = {147-157},
  year      = {2022},
  abstract  = {Purpose Radiotherapy (RT) was identified as a risk factor for long-term cardiac effects in breast cancer patients treated until the 1990s. However, modern techniques reduce radiation exposure of the heart, but some exposure remains unavoidable. In a retrospective cohort study, we investigated cardiac mortality and morbidity of breast cancer survivors treated with recent RT in Germany. Methods A total of 11,982 breast cancer patients treated between 1998 and 2008 were included. A mortality follow-up was conducted until 06/2018. In order to assess cardiac morbidity occurring after breast cancer treatment, a questionnaire was sent out in 2014 and 2019. The effect of breast cancer laterality on cardiac mortality and morbidity was investigated as a proxy for radiation exposure. We used Cox Proportional Hazards regression analysis, taking potential confounders into account. Results After a median follow-up time of 11.1 years, there was no significant association of tumor laterality with cardiac mortality in irradiated patients (hazard ratio (HR) for left-sided versus right-sided tumor 1.09; 95\% confidence interval (CI) 0.85-1.41). Furthermore, tumor laterality was not identified as a significant risk factor for cardiac morbidity (HR = 1.05; 95\%CI 0.88-1.25). Conclusions Even though RT for left-sided breast cancer on average incurs higher radiation dose to the heart than RT for right-sided tumors, we found no evidence that laterality is a strong risk factor for cardiac disease after contemporary RT. However, larger sample sizes, longer follow-up, detailed information on individual risk factors and heart dose are needed to assess clinically manifest late effects of current cancer therapy.},
  language  = {en}
}
@article{KosmalaGruschwitzVeldhoenetal.2020,
  author    = {Kosmala, Aleksander and Gruschwitz, Philipp and Veldhoen, Simon and Weng, Andreas Max and Krauss, Bernhard and Bley, Thorsten Alexander and Petritsch, Bernhard},
  title     = {Dual-energy CT angiography in suspected pulmonary embolism: influence of injection protocols on image quality and perfused blood volume},
  series = {The International Journal of Cardiovascular Imaging},
  volume    = {36},
  journal   = {The International Journal of Cardiovascular Imaging},
  number    = {10},
  issn      = {1569-5794},
  doi       = {10.1007/s10554-020-01911-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-314739},
  pages     = {2051-2059},
  year      = {2020},
  abstract  = {Abstract To compare intravenous contrast material (CM) injection protocols for dual-energy CT pulmonary angiography (CTPA) in patients with suspected acute pulmonary embolism with regard to image quality and pulmonary perfused blood volume (PBV) values. A total of 198 studies performed with four CM injection protocols varying in CM volume and iodine delivery rates (IDR) were retrospectively included: (A) 60 ml at 5 ml/s (IDR = 1.75gI/s), (B) 50 ml at 5 ml/s (IDR = 1.75gI/s), (C) 50 ml at 4 ml/s (IDR = 1.40gI/s), (D) 40 ml at 3 ml/s (IDR = 1.05gI/s). Image quality and PBV values at different resolution settings were compared. Pulmonary arterial tract attenuation was highest for protocol A (397 ± 110 HU; p vs. B = 0.13; vs. C = 0.02; vs. D < 0.001). CTPA image quality of protocol A was rated superior compared to protocols B and D by reader 1 (p = 0.01; < 0.001), and superior to protocols B, C and D by reader 2 (p < 0.001; 0.02; < 0.001). Otherwise, there were no significant differences in CTPA quality ratings. Subjective iodine map ratings did not vary significantly between protocols A, B, and C. Both readers rated protocol D inferior to all other protocols (p < 0.05). PBV values did not vary significantly between protocols A and B at resolution settings of 1, 4 and 10 (p = 0.10; 0.10; 0.09), while otherwise PBV values displayed a decreasing trend from protocol A to D (p < 0.05). Higher CM volume and IDR are associated with superior CTPA and iodine map quality and higher absolute PBV values.},
  language  = {en}
}
@article{OhlmannBoemickeBehnischetal.2022,
  author    = {Ohlmann, Brigitte and B{\"o}micke, Wolfgang and Behnisch, Rouven and Rammelsberg, Peter and Schmitter, Marc},
  title     = {Variability of sleep bruxism — findings from consecutive nights of monitoring},
  series = {Clinical Oral Investigations},
  volume    = {26},
  journal   = {Clinical Oral Investigations},
  number    = {4},
  issn      = {1436-3771},
  doi       = {10.1007/s00784-021-04314-8},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-307645},
  pages     = {3459-3466},
  year      = {2022},
  abstract  = {Objectives To determine sleep bruxism (SB) behavior during five consecutive nights and to identify correlations between SB episodes per hour (SB index) and sleep-time masseter-muscle activity (sMMA). Material and methods Thirty-one participants were included in the study. Of these, 10 were classified as sleep bruxers (group SB-1) and nine as non-sleep bruxers (group non-SB). The bruxism status of these 19 patients was identified by means of questionnaires, an assessment of clinical symptoms, and electromyographic/electrocardiographic data (Bruxoff® device). The remaining 12 participants were also identified as bruxers, but based exclusively on data from the Bruxoff device (group SB-2). Data analysis included descriptive statistics and Spearman's correlation to assess the relationship between the SB index and sMMA. Results Participants in group SB-1 showed an overall mean SB index of 3.1 ± 1.6 and a mean total sMMA per night of 62.9 ± 38.3. Participants in group SB-2 had an overall mean SB index of 2.7 ± 1.5 and a mean total sMMA of 56.0 ± 29.3. In the non-SB group, participants showed an overall mean SB index of 0.8 ± 0.5 and a mean total sMMA of 56.8 ± 30.3. Spearman's correlation yielded values of - 0.27 to 0.71 for the correlation between sMMA and SB index. Conclusions The data revealed variable SB activity and the absence of a reliable correlation between sMMA and the SB index. Clinical relevance The high variation in SB activity and lack of correlation between sMMA and the SB index should be considered when diagnosing SB. Trial registration Clinical Trials [NIH], clinical trial no. NCT03039985.},
  language  = {en}
}