TY  - JOUR
A1  - Barlinn, J.
A1  - Winzer, S.
A1  - Worthmann, H.
A1  - Urbanek, C.
A1  - Häusler, K. G.
A1  - Günther, A.
A1  - Erdur, H.
A1  - Görtler, M.
A1  - Busetto, L.
A1  - Wojciechowski, C.
A1  - Schmitt, J.
A1  - Shah, Y.
A1  - Büchele, B.
A1  - Sokolowski, P.
A1  - Kraya, T.
A1  - Merkelbach, S.
A1  - Rosengarten, B.
A1  - Stangenberg-Gliss, K.
A1  - Weber, J.
A1  - Schlachetzki, F.
A1  - Abu-Mugheisib, M.
A1  - Petersen, M.
A1  - Schwartz, A.
A1  - Palm, F.
A1  - Jowaed, A.
A1  - Volbers, B.
A1  - Zickler, P.
A1  - Remi, J.
A1  - Bardutzky, J.
A1  - Bösel, J.
A1  - Audebert, H. J.
A1  - Hubert, G. J.
A1  - Gumbinger, C.
T1  - Telemedizin in der Schlaganfallversorgung – versorgungsrelevant für Deutschland
T1  - Telemedicine in stroke—pertinent to stroke care in Germany
JF  - Der Nervenarzt
N2  - Hintergrund und Ziel
Telemedizinische Schlaganfall-Netzwerke tragen dazu bei, die Schlaganfallversorgung und insbesondere den Zugang zu zeitkritischen Schlaganfalltherapien in vorrangig strukturschwachen, ländlichen Regionen zu gewährleisten. Ziel ist eine Darstellung der Nutzungsfrequenz und regionalen Verteilung dieser Versorgungsstruktur.

Methoden
Die Kommission „Telemedizinische Schlaganfallversorgung“ der Deutschen Schlaganfall-Gesellschaft führte eine Umfragestudie in allen Schlaganfall-Netzwerken durch.

Ergebnisse
In Deutschland sind 22 telemedizinische Schlaganfall-Netzwerke aktiv, welche insgesamt 43 Zentren (pro Netzwerk: Median 1,5, Interquartilsabstand [IQA] 1–3) sowie 225 Kooperationskliniken (pro Netzwerk: Median 9, IQA 4–17) umfassen und an einem unmittelbaren Zugang zur Schlaganfallversorgung für 48 Mio. Menschen teilhaben. Im Jahr 2018 wurden 38.211 Telekonsile (pro Netzwerk: Median 1340, IQA 319–2758) durchgeführt. Die Thrombolyserate betrug 14,1 % (95 %-Konfidenzintervall 13,6–14,7 %), eine Verlegung zur Thrombektomie wurde bei 7,9 % (95 %-Konfidenzintervall 7,5–8,4 %) der ischämischen Schlaganfallpatienten initiiert. Das Finanzierungssystem ist uneinheitlich mit einem Vergütungssystem für die Zentrumsleistungen in nur drei Bundesländern.

Diskussion
Etwa jeder 10. Schlaganfallpatient wird telemedizinisch behandelt. Die telemedizinischen Schlaganfall-Netzwerke erreichen vergleichbar hohe Lyseraten und Verlegungen zur Thrombektomie wie neurologische Stroke-Units und tragen zur Sicherstellung einer flächendeckenden Schlaganfallversorgung bei. Eine netzwerkübergreifende Sicherstellung der Finanzierung und einheitliche Erhebung von Qualitätssicherungsdaten haben das Potenzial diese Versorgungsstruktur zukünftig weiter zu stärken.
N2  - Background and objective
Telemedical stroke networks improve stroke care and provide access to time-dependent acute stroke treatment in predominantly rural regions. The aim is a presentation of data on its utility and regional distribution.

Methods
The working group on telemedical stroke care of the German Stroke Society performed a survey study among all telestroke networks.

Results
Currently, 22 telemedical stroke networks including 43 centers (per network: median 1.5, interquartile range, IQR, 1–3) as well as 225 cooperating hospitals (per network: median 9, IQR 4–17) operate in Germany and contribute to acute stroke care delivery to 48 million people. In 2018, 38,211 teleconsultations (per network: median 1340, IQR 319–2758) were performed. The thrombolysis rate was 14.1% (95% confidence interval 13.6–14.7%) and transfer for thrombectomy was initiated in 7.9% (95% confidence interval 7.5–8.4%) of ischemic stroke patients. Financial reimbursement differs regionally with compensation for telemedical stroke care in only three federal states.

Conclusion
Telemedical stroke care is utilized in about 1 out of 10 stroke patients in Germany. Telemedical stroke networks achieve similar rates of thrombolysis and transfer for thrombectomy compared with neurological stroke units and contribute to stroke care in rural regions. Standardization of network structures, financial assurance and uniform quality measurements may further strengthen the importance of telestroke networks in the future.
KW  - Schlaganfall
KW  - Stroke-Unit
KW  - Telemedizin
KW  - Schlaganfall-Netzwerk
KW  - Umfragestudie
KW  - stroke
KW  - stroke unit
KW  - telemedicine
KW  - stroke networks
KW  - survey
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-307752
SN  - 0028-2804
SN  - 1433-0407
VL  - 92
IS  - 6
ER  - 
TY  - JOUR
A1  - Trafimow, David
A1  - Amrhein, Valentin
A1  - Areshenkoff, Corson N.
A1  - Barrera-Causil, Carlos J.
A1  - Beh, Eric J.
A1  - Bilgiç, Yusuf K.
A1  - Bono, Roser
A1  - Bradley, Michael T.
A1  - Briggs, William M.
A1  - Cepeda-Freyre, Héctor A.
A1  - Chaigneau, Sergio E.
A1  - Ciocca, Daniel R.
A1  - Correa, Juan C.
A1  - Cousineau, Denis
A1  - de Boer, Michiel R.
A1  - Dhar, Subhra S.
A1  - Dolgov, Igor
A1  - Gómez-Benito, Juana
A1  - Grendar, Marian
A1  - Grice, James W.
A1  - Guerrero-Gimenez, Martin E.
A1  - Gutiérrez, Andrés
A1  - Huedo-Medina, Tania B.
A1  - Jaffe, Klaus
A1  - Janyan, Armina
A1  - Karimnezhad, Ali
A1  - Korner-Nievergelt, Fränzi
A1  - Kosugi, Koji
A1  - Lachmair, Martin
A1  - Ledesma, Rubén D.
A1  - Limongi, Roberto
A1  - Liuzza, Marco T.
A1  - Lombardo, Rosaria
A1  - Marks, Michael J.
A1  - Meinlschmidt, Gunther
A1  - Nalborczyk, Ladislas
A1  - Nguyen, Hung T.
A1  - Ospina, Raydonal
A1  - Perezgonzalez, Jose D.
A1  - Pfister, Roland
A1  - Rahona, Juan J.
A1  - Rodríguez-Medina, David A.
A1  - Romão, Xavier
A1  - Ruiz-Fernández, Susana
A1  - Suarez, Isabel
A1  - Tegethoff, Marion
A1  - Tejo, Mauricio
A1  - van de Schoot, Rens
A1  - Vankov, Ivan I.
A1  - Velasco-Forero, Santiago
A1  - Wang, Tonghui
A1  - Yamada, Yuki
A1  - Zoppino, Felipe C. M.
A1  - Marmolejo-Ramos, Fernando
T1  - Manipulating the Alpha Level Cannot Cure Significance Testing
JF  - Frontiers in Psychology
N2  - We argue that making accept/reject decisions on scientific hypotheses, including a recent call for changing the canonical alpha level from p = 0.05 to p = 0.005, is deleterious for the finding of new discoveries and the progress of science. Given that blanket and variable alpha levels both are problematic, it is sensible to dispense with significance testing altogether. There are alternatives that address study design and sample size much more directly than significance testing does; but none of the statistical tools should be taken as the new magic method giving clear-cut mechanical answers. Inference should not be based on single studies at all, but on cumulative evidence from multiple independent studies. When evaluating the strength of the evidence, we should consider, for example, auxiliary assumptions, the strength of the experimental design, and implications for applications. To boil all this down to a binary decision based on a p-value threshold of 0.05, 0.01, 0.005, or anything else, is not acceptable.
KW  - statistical significance
KW  - null hypothesis testing
KW  - p-value
KW  - significance testing
KW  - decision making
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-189973
SN  - 1664-1078
VL  - 9
IS  - 699
ER  - 
TY  - JOUR
A1  - Gröbner, Susanne N.
A1  - Worst, Barbara C.
A1  - Weischenfeldt, Joachim
A1  - Buchhalter, Ivo
A1  - Kleinheinz, Kortine
A1  - Rudneva, Vasilisa A.
A1  - Johann, Pascal D.
A1  - Balasubramanian, Gnana Prakash
A1  - Segura-Wang, Maia
A1  - Brabetz, Sebastian
A1  - Bender, Sebastian
A1  - Hutter, Barbara
A1  - Sturm, Dominik
A1  - Pfaff, Elke
A1  - Hübschmann, Daniel
A1  - Zipprich, Gideon
A1  - Heinold, Michael
A1  - Eils, Jürgen
A1  - Lawerenz, Christian
A1  - Erkek, Serap
A1  - Lambo, Sander
A1  - Waszak, Sebastian
A1  - Blattmann, Claudia
A1  - Borkhardt, Arndt
A1  - Kuhlen, Michaela
A1  - Eggert, Angelika
A1  - Fulda, Simone
A1  - Gessler, Manfred
A1  - Wegert, Jenny
A1  - Kappler, Roland
A1  - Baumhoer, Daniel
A1  - Stefan, Burdach
A1  - Kirschner-Schwabe, Renate
A1  - Kontny, Udo
A1  - Kulozik, Andreas E.
A1  - Lohmann, Dietmar
A1  - Hettmer, Simone
A1  - Eckert, Cornelia
A1  - Bielack, Stefan
A1  - Nathrath, Michaela
A1  - Niemeyer, Charlotte
A1  - Richter, Günther H.
A1  - Schulte, Johannes
A1  - Siebert, Reiner
A1  - Westermann, Frank
A1  - Molenaar, Jan J.
A1  - Vassal, Gilles
A1  - Witt, Hendrik
A1  - Burkhardt, Birgit
A1  - Kratz, Christian P.
A1  - Witt, Olaf
A1  - van Tilburg, Cornelis M.
A1  - Kramm, Christof M.
A1  - Fleischhack, Gudrun
A1  - Dirksen, Uta
A1  - Rutkowski, Stefan
A1  - Frühwald, Michael
A1  - Hoff, Katja von
A1  - Wolf, Stephan
A1  - Klingebeil, Thomas
A1  - Koscielniak, Ewa
A1  - Landgraf, Pablo
A1  - Koster, Jan
A1  - Resnick, Adam C.
A1  - Zhang, Jinghui
A1  - Liu, Yanling
A1  - Zhou, Xin
A1  - Waanders, Angela J.
A1  - Zwijnenburg, Danny A.
A1  - Raman, Pichai
A1  - Brors, Benedikt
A1  - Weber, Ursula D.
A1  - Northcott, Paul A.
A1  - Pajtler, Kristian W.
A1  - Kool, Marcel
A1  - Piro, Rosario M.
A1  - Korbel, Jan O.
A1  - Schlesner, Matthias
A1  - Eils, Roland
A1  - Jones, David T. W.
A1  - Lichter, Peter
A1  - Chavez, Lukas
A1  - Zapatka, Marc
A1  - Pfister, Stefan M.
T1  - The landscape of genomic alterations across childhood cancers
JF  - Nature
N2  - Pan-cancer analyses that examine commonalities and differences among various cancer types have emerged as a powerful way to obtain novel insights into cancer biology. Here we present a comprehensive analysis of genetic alterations in a pan-cancer cohort including 961 tumours from children, adolescents, and young adults, comprising 24 distinct molecular types of cancer. Using a standardized workflow, we identified marked differences in terms of mutation frequency and significantly mutated genes in comparison to previously analysed adult cancers. Genetic alterations in 149 putative cancer driver genes separate the tumours into two classes: small mutation and structural/copy-number variant (correlating with germline variants). Structural variants, hyperdiploidy, and chromothripsis are linked to TP53 mutation status and mutational signatures. Our data suggest that 7–8% of the children in this cohort carry an unambiguous predisposing germline variant and that nearly 50% of paediatric neoplasms harbour a potentially druggable event, which is highly relevant for the design of future clinical trials.
KW  - cancer genomics
KW  - oncogenesis
KW  - paediatric cancer
KW  - predictive markers
KW  - translational research
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-229579
VL  - 555
ER  - 
TY  - JOUR
A1  - Mayer, Matthias
A1  - Rabindranath, Raman
A1  - Börner, Juliane
A1  - Hörner, Eva
A1  - Bentz, Alexander
A1  - Salgado, Josefina
A1  - Han, Hong
A1  - Böse, Holger
A1  - Probst, Jörn
A1  - Shamonin, Mikhail
A1  - Monkman, Gereth J.
A1  - Schlunck, Günther
T1  - Ultra-Soft PDMS-Based Magnetoactive Elastomers as Dynamic Cell Culture Substrata
JF  - PLOS ONE
N2  - Mechanical cues such as extracellular matrix stiffness and movement have a major impact on cell differentiation and function. To replicate these biological features in vitro, soft substrata with tunable elasticity and the possibility for controlled surface translocation are desirable. Here we report on the use of ultra-soft (Young's modulus <100 kPa) PDMS-based magnetoactive elastomers (MAE) as suitable cell culture substrata. Soft non-viscous PDMS (<18 kPa) is produced using a modified extended crosslinker. MAEs are generated by embedding magnetic microparticles into a soft PDMS matrix. Both substrata yield an elasticity-dependent (14 vs. 100 kPa) modulation of alpha-smooth muscle actin expression in primary human fibroblasts. To allow for static or dynamic control of MAE material properties, we devise low magnetic field (approximate to 40 mT) stimulation systems compatible with cell-culture environments. Magnetic field-instigated stiffening (14 to 200 kPa) of soft MAE enhances the spreading of primary human fibroblasts and decreases PAX-7 transcription in human mesenchymal stem cells. Pulsatile MAE movements are generated using oscillating magnetic fields and are well tolerated by adherent human fibroblasts. This MAE system provides spatial and temporal control of substratum material characteristics and permits novel designs when used as dynamic cell culture substrata or cell culture-coated actuator in tissue engineering applications or biomedical devices.
KW  - elastic magnetic-materials
KW  - smooth muscle actin
KW  - magnetorheological elastomers
KW  - adhesion
KW  - mechanotransduction
KW  - stiffness
KW  - tension
KW  - mechanics
KW  - hydrogels
KW  - behavior
Y1  - 2013
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-128246
SN  - 1932-6203
VL  - 8
IS  - 10
ER  - 
TY  - JOUR
A1  - Horrer, Günther
A1  - Krahfuß, Mirjam J.
A1  - Lubitz, Katharina
A1  - Krummenacher, Ivo
A1  - Braunschweig, Holger
A1  - Radius, Udo
T1  - N-Heterocyclic Carbene and Cyclic (Alkyl)(amino)carbene Complexes of Titanium(IV) and Titanium(III)
JF  - European Journal of Inorganic Chemistry
N2  - The reaction of one and two equivalents of the N ‐heterocyclic carbene IMes [IMes = 1,3‐bis(2,4,6‐trimethyl‐phenyl)imidazolin‐2‐ylidene] or the cyclic (alkyl)(amino)carbene cAAC\(^{Me}\) [cAAC\(^{Me}\) = 1‐(2,6‐diisopropyl‐phenyl)‐3,3,5,5‐tetra‐methylpyrrolidin‐2‐ylidene] with [TiCl\(_{4}\)] in n ‐hexane results in the formation of mono‐ and bis‐carbene complexes [TiCl\(_{4}\)(IMes)] 1 , [TiCl\(_{4}\)(IMes)2] 2 , [TiCl\(_{4}\)(cAAC\(^{Me}\))] 3 , and [TiCl\(_{4}\)(cAAC\(^{Me}\))\(_{2}\)] 4 , respectively. For comparison, the titanium(IV) NHC complex [TiCl\(_{4}\)(Ii Pr\(^{Me}\))] 5 (Ii Pr\(^{Me}\) = 1,3‐diisopropyl‐4,5‐dimethyl‐imidazolin‐2‐ylidene) has been synthesized and structurally characterized. The reaction of [TiCl\(_{4}\)(IMes)] 1 with PMe\(_{3}\) affords the mixed substituted complex [TiCl\(_{4}\)(IMes)(PMe\(_{3}\))] 6 . The reactions of [TiCl\(_{3}\)(THF)\(_{3}\)] with two equivalents of the carbenes IMes and cAAC\(^{Me}\) in n ‐hexane lead to the clean formation of the titanium(III) complexes [TiCl\(_{3}\)(IMes)\(_{2}\)] 7 and [TiCl\(_{3}\)(cAAC\(^{Me}\))\(_{2}\)] 8 . Compounds 1 –8 have been completely characterized by elemental analysis, IR and multinuclear NMR spectroscopy and for 2 –5 , 7 and 8 by X‐ray diffraction. Magnetometry in solution, EPR and UV/Vis spectroscopy and DFT calculations performed on 7 and 8 are indicative of a predominantly metal‐centered d\(^{1}\)‐radical in both cases.
KW  - N-heterocyclic carbenes
KW  - carbene ligands
KW  - Titanium
KW  - structure elucidation
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-208725
VL  - 2020
IS  - 3
ER  - 
TY  - JOUR
A1  - Vollmuth, Christoph
A1  - Muljukov, Olga
A1  - Abu-Mugheisib, Mazen
A1  - Angermeier, Anselm
A1  - Barlinn, Jessica
A1  - Busetto, Loraine
A1  - Grau, Armin J.
A1  - Günther, Albrecht
A1  - Gumbinger, Christoph
A1  - Hubert, Nikolai
A1  - Hüttemann, Katrin
A1  - Klingner, Carsten
A1  - Naumann, Markus
A1  - Palm, Frederick
A1  - Remi, Jan
A1  - Rücker, Viktoria
A1  - Schessl, Joachim
A1  - Schlachetzki, Felix
A1  - Schuppner, Ramona
A1  - Schwab, Stefan
A1  - Schwartz, Andreas
A1  - Trommer, Adrian
A1  - Urbanek, Christian
A1  - Volbers, Bastian
A1  - Weber, Joachim
A1  - Wojciechowski, Claudia
A1  - Worthmann, Hans
A1  - Zickler, Philipp
A1  - Heuschmann, Peter U.
A1  - Haeusler, Karl Georg
A1  - Hubert, Gordian Jan
T1  - Impact of the coronavirus disease 2019 pandemic on stroke teleconsultations in Germany in the first half of 2020
JF  - European Journal of Neurology
N2  - Background and purpose
The effects of the coronavirus disease 2019 (COVID-19) pandemic on telemedical care have not been described on a national level. Thus, we investigated the medical stroke treatment situation before, during, and after the first lockdown in Germany.

Methods
In this nationwide, multicenter study, data from 14 telemedical networks including 31 network centers and 155 spoke hospitals covering large parts of Germany were analyzed regarding patients' characteristics, stroke type/severity, and acute stroke treatment. A survey focusing on potential shortcomings of in-hospital and (telemedical) stroke care during the pandemic was conducted.

Results
Between January 2018 and June 2020, 67,033 telemedical consultations and 38,895 telemedical stroke consultations were conducted. A significant decline of telemedical (p < 0.001) and telemedical stroke consultations (p < 0.001) during the lockdown in March/April 2020 and a reciprocal increase after relaxation of COVID-19 measures in May/June 2020 were observed. Compared to 2018–2019, neither stroke patients' age (p = 0.38), gender (p = 0.44), nor severity of ischemic stroke (p = 0.32) differed in March/April 2020. Whereas the proportion of ischemic stroke patients for whom endovascular treatment (14.3% vs. 14.6%; p = 0.85) was recommended remained stable, there was a nonsignificant trend toward a lower proportion of recommendation of intravenous thrombolysis during the lockdown (19.0% vs. 22.1%; p = 0.052). Despite the majority of participating network centers treating patients with COVID-19, there were no relevant shortcomings reported regarding in-hospital stroke treatment or telemedical stroke care.

Conclusions
Telemedical stroke care in Germany was able to provide full service despite the COVID-19 pandemic, but telemedical consultations declined abruptly during the lockdown period and normalized after relaxation of COVID-19 measures in Germany.
KW  - COVID-19
KW  - SARS-CoV- 2
KW  - stroke
KW  - telemedicine
KW  - survey
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-259396
VL  - 28
IS  - 10
ER  - 
TY  - JOUR
A1  - Vogel, P.
A1  - Rückert, M. A.
A1  - Greiner, C.
A1  - Günther, J.
A1  - Reichl, T.
A1  - Kampf, T.
A1  - Bley, T. A.
A1  - Behr, V. C.
A1  - Herz, S.
T1  - iMPI: portable human-sized magnetic particle imaging scanner for real-time endovascular interventions
JF  - Scientific Reports
N2  - Minimally invasive endovascular interventions have become an important tool for the treatment of cardiovascular diseases such as ischemic heart disease, peripheral artery disease, and stroke. X-ray fluoroscopy and digital subtraction angiography are used to precisely guide these procedures, but they are associated with radiation exposure for patients and clinical staff. Magnetic Particle Imaging (MPI) is an emerging imaging technology using time-varying magnetic fields combined with magnetic nanoparticle tracers for fast and highly sensitive imaging. In recent years, basic experiments have shown that MPI has great potential for cardiovascular applications. However, commercially available MPI scanners were too large and expensive and had a small field of view (FOV) designed for rodents, which limited further translational research. The first human-sized MPI scanner designed specifically for brain imaging showed promising results but had limitations in gradient strength, acquisition time and portability. Here, we present a portable interventional MPI (iMPI) system dedicated for real-time endovascular interventions free of ionizing radiation. It uses a novel field generator approach with a very large FOV and an application-oriented open design enabling hybrid approaches with conventional X-ray-based angiography. The feasibility of a real-time iMPI-guided percutaneous transluminal angioplasty (PTA) is shown in a realistic dynamic human-sized leg model.
KW  - biomedical engineering
KW  - electrical and electronic engineering
KW  - imaging
KW  - three-dimensional imaging
Y1  - 2023
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357794
VL  - 13
ER  -