TY - JOUR A1 - Jobs, Alexander A1 - Vonthein, Reinhard A1 - König, Inke R. A1 - Schäfer, Jane A1 - Nauck, Matthias A1 - Haag, Svenja A1 - Fichera, Carlo Federico A1 - Stiermaier, Thomas A1 - Ledwoch, Jakob A1 - Schneider, Alisa A1 - Valentova, Miroslava A1 - von Haehling, Stephan A1 - Störk, Stefan A1 - Westermann, Dirk A1 - Lenz, Tobias A1 - Arnold, Natalie A1 - Edelmann, Frank A1 - Seppelt, Philipp A1 - Felix, Stephan A1 - Lutz, Matthias A1 - Hedwig, Felix A1 - Borggrefe, Martin A1 - Scherer, Clemens A1 - Desch, Steffen A1 - Thiele, Holger T1 - Inferior vena cava ultrasound in acute decompensated heart failure: design rationale of the CAVA‐ADHF‐DZHK10 trial JF - ESC Heart Failure N2 - Aims Treating patients with acute decompensated heart failure (ADHF) presenting with volume overload is a common task. However, optimal guidance of decongesting therapy and treatment targets are not well defined. The inferior vena cava (IVC) diameter and its collapsibility can be used to estimate right atrial pressure, which is a measure of right‐sided haemodynamic congestion. The CAVA‐ADHF‐DZHK10 trial is designed to test the hypothesis that ultrasound assessment of the IVC in addition to clinical assessment improves decongestion as compared with clinical assessment alone. Methods and results CAVA‐ADHF‐DZHK10 is a randomized, controlled, patient‐blinded, multicentre, parallel‐group trial randomly assigning 388 patients with ADHF to either decongesting therapy guided by ultrasound assessment of the IVC in addition to clinical assessment or clinical assessment alone. IVC ultrasound will be performed daily between baseline and hospital discharge in all patients. However, ultrasound results will only be reported to treating physicians in the intervention group. Treatment target is relief of congestion‐related signs and symptoms in both groups with the additional goal to reduce the IVC diameter ≤21 mm and increase IVC collapsibility >50% in the intervention group. The primary endpoint is change in N‐terminal pro‐brain natriuretic peptide from baseline to hospital discharge. Secondary endpoints evaluate feasibility, efficacy of decongestion on other scales, and the impact of the intervention on clinical endpoints. Conclusions CAVA‐ADHF‐DZHK10 will investigate whether IVC ultrasound supplementing clinical assessment improves decongestion in patients admitted for ADHF. KW - acute decompensated heart failure KW - inferior vena cava KW - congestion KW - NT‐proBNP KW - ultrasound Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-212692 VL - 7 IS - 3 SP - 973 EP - 983 ER - TY - JOUR A1 - Vainio, Rami A1 - Valtonen, Eino A1 - Heber, Bernd A1 - Malandraki, Olga E. A1 - Papaioannou, Athanasios A1 - Klein, Karl-Ludwig A1 - Afanasiev, Alexander A1 - Agueda, Neus A1 - Aurass, Henry A1 - Battarbee, Markus A1 - Braune, Stephan A1 - Dröge, Wolfgang A1 - Ganse, Urs A1 - Hamadache, Clarisse A1 - Heynderickx, Daniel A1 - Huttunen-Heikinmaa, Kalle A1 - Kiener, Jürgen A1 - Kilian, Patrick A1 - Kopp, Andreas A1 - Kouloumvakos, Athanasios A1 - Maisala, Sami A1 - Mishev, Alexander A1 - Miteva, Rosita A1 - Nindos, Alexander A1 - Oittinen, Tero A1 - Raukunen, Osku A1 - Riihonen, Esa A1 - Rodriguez-Gasen, Rosa A1 - Saloniemi, Oskari A1 - Sanahuja, Blai A1 - Scherer, Renate A1 - Spanier, Felix A1 - Tatischeff, Vincent A1 - Tziotziou, Kostas A1 - Usoskin, Ilya G. A1 - Vilmer, Nicole T1 - The first SEPServer event catalogue similar to ~68-MeV solar proton events observed at 1 AU in 1996-2010 JF - Journal of Space Weather and Space Climate N2 - SEPServer is a three-year collaborative project funded by the seventh framework programme (FP7-SPACE) of the European Union. The objective of the project is to provide access to state-of-the-art observations and analysis tools for the scientific community on solar energetic particle (SEP) events and related electromagnetic (EM) emissions. The project will eventually lead to better understanding of the particle acceleration and transport processes at the Sun and in the inner heliosphere. These processes lead to SEP events that form one of the key elements of space weather. In this paper we present the first results from the systematic analysis work performed on the following datasets: SOHO/ERNE, SOHO/EPHIN, ACE/EPAM, Wind/WAVES and GOES X-rays. A catalogue of SEP events at 1 AU, with complete coverage over solar cycle 23, based on high-energy (similar to 68-MeV) protons from SOHO/ERNE and electron recordings of the events by SOHO/EPHIN and ACE/EPAM are presented. A total of 115 energetic particle events have been identified and analysed using velocity dispersion analysis (VDA) for protons and time-shifting analysis (TSA) for electrons and protons in order to infer the SEP release times at the Sun. EM observations during the times of the SEP event onset have been gathered and compared to the release time estimates of particles. Data from those events that occurred during the European day-time, i.e., those that also have observations from ground-based observatories included in SEPServer, are listed and a preliminary analysis of their associations is presented. We find that VDA results for protons can be a useful tool for the analysis of proton release times, but if the derived proton path length is out of a range of 1 AU < s less than or similar to 3 AU, the result of the analysis may be compromised, as indicated by the anti-correlation of the derived path length and release time delay from the associated X-ray flare. The average path length derived from VDA is about 1.9 times the nominal length of the spiral magnetic field line. This implies that the path length of first-arriving MeV to deka-MeV protons is affected by interplanetary scattering. TSA of near-relativistic electrons results in a release time that shows significant scatter with respect to the EM emissions but with a trend of being delayed more with increasing distance between the flare and the nominal footpoint of the Earth-connected field line. KW - radio emissions (dynamic) KW - projects KW - advanced composition explorer KW - wind spacecraft KW - stereo mission KW - alpha monitor KW - electron KW - plasma KW - radio KW - spectrometer KW - heliosphere KW - instrument KW - radiation KW - flares Y1 - 2013 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-122847 SN - 2115-7251 VL - 3 IS - A12 ER - TY - THES A1 - Schenkhoff, Felix Stephan T1 - Herstellung und Charakterisierung multifunktioneller Fusionsproteine des membranständigen Fas-Liganden und des membranständigen CD40-Liganden T1 - Development and Characterization of multifunctional fusionproteins of the membranous Fas-ligand and of the membranous CD40-ligand N2 - TNF-Liganden liegen primär in membranständiger Form mit trimerer Struktur vor und die meisten von ihnen können sekundär durch Metalloproteasen in lösliche trimere Liganden prozessiert werden. Während membranständige Formen der TNF-Liganden ihre korrespondierenden Rezeptoren aktivieren können, sind die löslichen Varianten einzelner TNF-Liganden unterschiedlich aktiv beziehungsweise inaktiv an den korrespondierenden Rezeptoren, obwohl sie ebenfalls zur Bindung in der Lage sind. Dies konnte bereits in Studien für TNF und TRAIL gezeigt werden. Die Unterschiede zwischen löslichen Varianten und der membranständigen Form des Liganden betreffen sowohl die Rezeptorselektivität als auch den Aktivierungsgrad am Rezeptor bis hin zu völliger Inaktivität der löslichen Form. Unterschiede finden sich jedoch nicht nur hinsichtlich der Aktivität, sondern auch in der Interaktion des Liganden mit dem Rezeptor. Für die membranständige und die lösliche Form von FasL konnten Unterschiede in der Notwendigkeit intrazellulärer Signalmoleküle bei der Ausbildung Ligand-induzierter Rezeptorsignalcluster gezeigt werden. Für die lösliche und membranständige Form des CD40L werden eine unterschiedliche Rezeptorinternalisierung und eine unterschiedliche Rekrutierung von TRAF-Molekülen angenommen. Bisherige Arbeiten zur Untersuchung der Rezeptor-Ligand-Interaktion stützen sich meist auf lösliche Varianten von TNF-Liganden, die durch artifizielle Multimerisierung oder Antikörper-induzierte Quervernetzung sekundär aktiviert werden müssen. Um für die Untersuchung der Rezeptor-Ligand-Interaktion in Zukunft realitätsnähere Bedingungen zu schaffen, sollten im Rahmen dieser Arbeit multifunktionelle Fusionsproteine des membranständigen FasL und CD40L hergestellt und charakterisiert werden. Die Fusionsproteine wurden im Rahmen der Klonierung so konstruiert, dass von der aminoterminalen Seite beginnend eine GST-Domäne, ein Flag-Tag, ein YFP-Tag und abschließend die vollständige membranständige Form des Liganden (FasL oder CD40L) aneinander gefügt wurden. In FACS-Analysen konnte sowohl die Funktion des YFP-Tag als auch die korrekte Expression des Liganden an der Zelloberfläche durch spezifische Antikörperfärbung nachgewiesen werden. Die funktionelle Aktivität der Liganden wurde durch IL-8-Induktion gezeigt, die eine Aktivierung des NFB-Signalweges durch die GST-Fusionsproteine des membranständigen FasL und des membranständigen CD40L beweist. Im Rahmen von Immunopräzipitationen wurde die Möglichkeit der Detektion der Fusionsproteine über ihr Flag-Tag getestet. Für das in GST-pull-down-Assays genauer untersuchte membranständige GST-Flag-YFP-CD40L-Fusionsprotein gelang eine Koimmunopräzipitation mit dem im Rezeptorkomplex gebundenen TRAF2. Für dieses in der Signaltransduktion des CD40 entscheidende Molekül konnte seine transiente Interaktion mit dem Rezeptorsignalkomplex sowie eine Veränderung in der Assoziation an den Rezeptor durch TNF-abhängige TRAF1-Induktion gezeigt werden. Im Zusammenhang der mit der Rezeptoraktivierung oftmals gleichgesetzten Bildung von Rezeptorsignalclustern durch den entsprechenden TNF-Liganden war die Beobachtung interessant, dass das Konstrukt GST-Flag-YFP-CD40L im Gegensatz zum analog konstruierten GST-Flag-YFP-FasL nicht in der Lage war, Signalcluster des korrespondierenden Rezeptors zu erzeugen, aber dennoch fähig war, eine Rezeptoraktivierung zu bewirken. Hinsichtlich der Untersuchung von Unterschieden in der Rezeptor-Ligand-Interaktion von löslichen und membranständigen Formen sind für FasL und CD40L noch viele Fragen offen, die beispielsweise auch die Stabilität von Rezeptorsignalclustern betreffen. Die in dieser Arbeit erzeugten und charakterisierten multifunktionellen Fusionsproteine sollten helfen, neue Erkenntnisse bezüglich der molekularen Grundlagen der Rezeptor-Ligand-Interaktion zu erzielen. N2 - TNF ligands primary are membranous ligands with a trimeric structure and the most of them can be cleaved to soluble trimeric forms by metalloproteases secondarily. While membranous forms of TNF ligands can activate their corresponding receptors, soluble variants ot some TNF ligands are insufficient for full activity or totally inactive. Nevertheless these variants are able to bind the corresponding receptor properly. This already could be shown in experiments with TNF and TRAIL. The differences between soluble variants and the membranous form of TNF ligands concern their receptor selectivity as well as their degree of activity at the receptor. There also are differences regarding the interaction itself between ligand and receptor. Comparing the membranous and the soluble form of Fas ligand there could be shown differences in terms of dependency for intracellular signaling moleculs regarding the formation of ligand induced clustering of the receptor. The soluble and the membranous form of CD40 ligand are supposed to have differences in receptor internalization and recruting of TRAF molecules. Previous research concentrating on receptor ligand interactions often is based on soluble variants of TNF ligands that have to be activated by artificial multimerization or antibody dependent aggregation. To provide more realistic conditions for the analysis of receptor ligand interactions, multifunctional fusionproteins of the membranous Fas ligand and the membranous CD40 ligand should be developed and characterized in this dissertation. Starting from the N-terminal end the fusionproteins contain a GST-domain, a Flag-tag, a YFP-tag and the complete membranous form of the ligand. In FACS analysis the activity of the YFP-tag as well as the correct expression of the ligand on the cell membrane could be demonstrated by specific antibody staining. The functional activity of the ligand itself has been shown by IL-8-induction, that proves the sucessful activation of the NFB signaling pathway by GST-fusionproteins of the membranous Fas ligand and the membranous CD40 ligand. In the context of immunoprecipitations the possibility of detection of the fusionproteins by Flag-tag has been tested. Concerning the GST-pull-down-assays of the fusionprotein GST-Flag-YFP-CD40L a coimmunoprecipitation with the intracellular adaptor protein TRAF2 could be shown. A transient interaction of TRAF2 with the receptor signaling complex as well as a change of its association with the receptor by TNF-induced TRAF1 upregulation also could be demonstrated. In context with the formation of high molecular receptor clusters that are often equated with receptor activation the observation was interesting that GST-Flag-YFP-CD40L in contrast to the analogous constructed GST-Flag-YFP-FasL could not induce signalling cluster of the corresponding receptor, but still was able to induce receptor activation. Regarding the analysis of differences in receptor ligand interaction between soluble and membranous forms of Fas ligand and CD40 ligand there are still many questions that have to be answered, e.g. in terms of stability of induced receptor clustering. The multifunctional fusionproteins provided by this dissertation shall contribute to gain new findings in respect of molecular fundamentals of the receptor ligand interaction. KW - Tumor-Necrose-Faktor KW - Entzündung KW - Apoptose KW - TNF-Superfamilie KW - CD40-Ligand KW - Fas-Ligand KW - Rezeptorsignalkomplexe KW - TNF superfamily KW - CD40L KW - FasL KW - receptor cluster Y1 - 2007 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-25978 SN - xxx ER - TY - JOUR A1 - Schlottmann, Elisabeth A1 - Schicke, David A1 - Krüger, Felix A1 - Lingnau, Benjamin A1 - Schneider, Christian A1 - Höfling, Sven A1 - Lüdge, Kathy A1 - Porte, Xavier A1 - Reitzenstein, Stephan T1 - Stochastic polarization switching induced by optical injection in bimodal quantum-dot micropillar lasers JF - Optics Express N2 - Mutual coupling and injection locking of semiconductor lasers is of great interest in non-linear dynamics and its applications for instance in secure data communication and photonic reservoir computing. Despite its importance, it has hardly been studied in microlasers operating at mu W light levels. In this context, vertically emitting quantum dot micropillar lasers are of high interest. Usually, their light emission is bimodal, and the gain competition of the associated linearly polarized fundamental emission modes results in complex switching dynamics. We report on selective optical injection into either one of the two fundamental mode components of a bimodal micropillar laser. Both modes can lock to the master laser and influence the non-injected mode by reducing the available gain. We demonstrate that the switching dynamics can be tailored externally via optical injection in very good agreement with our theory based on semi-classical rate equations. (C) 2019 Optical Society of America under the terms of the OSA Open Access Publishing Agreement KW - Nonlinear Dynamics KW - Bistability KW - Generation KW - Subject KW - Regimes KW - Physics KW - Vcsels Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-228603 VL - 27 IS - 20 ER - TY - JOUR A1 - Hagspiel, Stephan A1 - Fantuzzi, Felipe A1 - Dewhurst, Rian D. A1 - Gärtner, Annalena A1 - Lindl, Felix A1 - Lamprecht, Anna A1 - Braunschweig, Holger T1 - Addukte des Stammboraphosphaketens H\(_{2}\)BPCO und deren Insertionsreaktionen mittels Decarbonylierung JF - Angewandte Chemie N2 - Die ersten Beispiele für Lewis-Basen-Addukte des Stammboraphosphaketens H\(_{2}\)B-PCO und ihre cyclischen Dimere wurden hergestellt. Eines dieser Addukte zeigt unter milden Bedingungen eine Decarbonylierung und anschließende Insertion des Phosphinidens in die B-C-Bindung eines Borols, was in der Bildung sehr seltener Beispiele für 1,2-Phosphaborinine, B,P-Isostere von Benzol, resultiert. Die starken Donoreigenschaften dieser 1,2-Phosphaborinine wurden durch die Synthese ihrer π-Komplexe mit Metallen der Gruppe 6 bestätigt. KW - Bor KW - Decarbonylierung KW - Heterocyclen KW - Ketene KW - Phosphor Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-244803 VL - 133 IS - 24 SP - 13780 EP - 13784 ER - TY - JOUR A1 - Hagspiel, Stephan A1 - Fantuzzi, Felipe A1 - Dewhurst, Rian D. A1 - Gärtner, Annalena A1 - Lindl, Felix A1 - Lamprecht, Anna A1 - Braunschweig, Holger T1 - Adducts of the parent boraphosphaketene H\(_2\)BPCO and their decarbonylative insertion chemistry JF - Angewandte Chemie International Edition N2 - The first examples of Lewis base adducts of the parent boraphosphaketene (H\(_2\)B-PCO) and their cyclodimers are prepared. One of these adducts is shown to undergo mild decarbonylation and phosphinidene insertion into a B−C bond of a borole, forming very rare examples of 1,2-phosphaborinines, B/P isosteres of benzene. The strong donor properties of these 1,2-phosphaborinines are confirmed by the synthesis of their π complexes with the Group 6 metals. KW - inorganic chemistry KW - phosphorus KW - boron KW - decarbonylation KW - heterocycles KW - ketenes Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-256470 VL - 60 IS - 24 ER - TY - JOUR A1 - Heinz, Tizian A1 - Meller, Felix A1 - Luetkens, Karsten Sebastian A1 - Horas, Konstantin A1 - Schäfer, Thomas A1 - Rudert, Maximilian A1 - Reppenhagen, Stephan A1 - Weißenberger, Manuel T1 - Can the MRI based AMADEUS score accurately assess pre-surgery chondral defect severity according to the ICRS arthroscopic classification system? JF - Journal of Experimental Orthopaedics N2 - Purpose The AMADEUS (Area Measurement And DEpth and Underlying Structures) scoring and grading system has been proposed for the MRI based evaluation of untreated focal chondral defects around the knee. The clinical practicability, its correlation with arthroscopically assessed grading systems (ICRS – International Cartilage Repair Society) and thereby its clinical value in terms of decision making and guiding prognosis was yet to determine. Methods From 2008 to 2019 a total of 89 individuals were indicated for high tibial valgus osteotomy (HTO) due to tibial varus deformity and concomitant chondral defects of the medial compartment of the knee. All patients received a preoperative MRI (1.5 Tesla or 3.0 Tesla) and pre-osteotomy diagnostic arthroscopy. Chondral defects of the medial compartment were scored and graded with the MRI based AMADEUS by three independent raters and compared to arthroscopic defect grading by the ICRS system. Interrater and intrarater reliability as well as correlation analysis with the ICRS classification system were assessed. Results Intraclass correlation coefficients for the various subscores of the AMADEUS showed an overall good to excellent interrater agreement (min: 0.26, max: 0.80). Intrarater agreement turned out to be substantially inferior (min: 0.08, max: 0.53). Spearman correlation revealed an overall moderate correlative association of the AMADEUS subscores with the ICRS classification system, apart from the defect area subscore. Sensitivity of the AMADEUS to accurately identify defect severity according to the ICRS was 0.7 (0.69 for 3.0 Tesla MRI, 0.67 for 1.5 Tesla MRI). The mean AMADEUS grade was 2.60 ± 0.81 and the mean ICRS score 2.90 ± 0.63. Conclusions Overall, the AMADEUS with all its subscores shows moderate correlation with the arthroscopic chondral grading system according to ICRS. This suggests that chondral defect grading by means of the MRI based AMADEUS is well capable of influencing and guiding treatment decisions. Interrater reliability shows overall good agreement. KW - MRI KW - knee KW - cartilage defect KW - grading system of chondral defects KW - AMADEUS KW - ICRS Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-300781 SN - 2197-1153 VL - 9 IS - 1 ER - TY - JOUR A1 - Kühnisch, Jirko A1 - Herbst, Christopher A1 - Al‐Wakeel‐Marquard, Nadya A1 - Dartsch, Josephine A1 - Holtgrewe, Manuel A1 - Baban, Anwar A1 - Mearini, Giulia A1 - Hardt, Juliane A1 - Kolokotronis, Konstantinos A1 - Gerull, Brenda A1 - Carrier, Lucie A1 - Beule, Dieter A1 - Schubert, Stephan A1 - Messroghli, Daniel A1 - Degener, Franziska A1 - Berger, Felix A1 - Klaassen, Sabine T1 - Targeted panel sequencing in pediatric primary cardiomyopathy supports a critical role of TNNI3 JF - Clinical Genetics N2 - The underlying genetic mechanisms and early pathological events of children with primary cardiomyopathy (CMP) are insufficiently characterized. In this study, we aimed to characterize the mutational spectrum of primary CMP in a large cohort of patients ≤18 years referred to a tertiary center. Eighty unrelated index patients with pediatric primary CMP underwent genetic testing with a panel‐based next‐generation sequencing approach of 89 genes. At least one pathogenic or probably pathogenic variant was identified in 30/80 (38%) index patients. In all CMP subgroups, patients carried most frequently variants of interest in sarcomere genes suggesting them as a major contributor in pediatric primary CMP. In MYH7, MYBPC3, and TNNI3, we identified 18 pathogenic/probably pathogenic variants (MYH7 n = 7, MYBPC3 n = 6, TNNI3 n = 5, including one homozygous (TNNI3 c.24+2T>A) truncating variant. Protein and transcript level analysis on heart biopsies from individuals with homozygous mutation of TNNI3 revealed that the TNNI3 protein is absent and associated with upregulation of the fetal isoform TNNI1. The present study further supports the clinical importance of sarcomeric mutation—not only in adult—but also in pediatric primary CMP. TNNI3 is the third most important disease gene in this cohort and complete loss of TNNI3 leads to severe pediatric CMP. KW - cardiomyopathy KW - genetics KW - pediatrics KW - sarcomere KW - TNNI3 Y1 - 2019 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-213958 VL - 96 IS - 6 SP - 549 EP - 559 ER - TY - JOUR A1 - Herrmann, Johannes A1 - Lotz, Christopher A1 - Karagiannidis, Christian A1 - Weber-Carstens, Steffen A1 - Kluge, Stefan A1 - Putensen, Christian A1 - Wehrfritz, Andreas A1 - Schmidt, Karsten A1 - Ellerkmann, Richard K. A1 - Oswald, Daniel A1 - Lotz, Gösta A1 - Zotzmann, Viviane A1 - Moerer, Onnen A1 - Kühn, Christian A1 - Kochanek, Matthias A1 - Muellenbach, Ralf A1 - Gaertner, Matthias A1 - Fichtner, Falk A1 - Brettner, Florian A1 - Findeisen, Michael A1 - Heim, Markus A1 - Lahmer, Tobias A1 - Rosenow, Felix A1 - Haake, Nils A1 - Lepper, Philipp M. A1 - Rosenberger, Peter A1 - Braune, Stephan A1 - Kohls, Mirjam A1 - Heuschmann, Peter A1 - Meybohm, Patrick T1 - Key characteristics impacting survival of COVID-19 extracorporeal membrane oxygenation JF - Critical Care N2 - Background Severe COVID-19 induced acute respiratory distress syndrome (ARDS) often requires extracorporeal membrane oxygenation (ECMO). Recent German health insurance data revealed low ICU survival rates. Patient characteristics and experience of the ECMO center may determine intensive care unit (ICU) survival. The current study aimed to identify factors affecting ICU survival of COVID-19 ECMO patients. Methods 673 COVID-19 ARDS ECMO patients treated in 26 centers between January 1st 2020 and March 22nd 2021 were included. Data on clinical characteristics, adjunct therapies, complications, and outcome were documented. Block wise logistic regression analysis was applied to identify variables associated with ICU-survival. Results Most patients were between 50 and 70 years of age. PaO\(_{2}\)/FiO\(_{2}\) ratio prior to ECMO was 72 mmHg (IQR: 58–99). ICU survival was 31.4%. Survival was significantly lower during the 2nd wave of the COVID-19 pandemic. A subgroup of 284 (42%) patients fulfilling modified EOLIA criteria had a higher survival (38%) (p = 0.0014, OR 0.64 (CI 0.41–0.99)). Survival differed between low, intermediate, and high-volume centers with 20%, 30%, and 38%, respectively (p = 0.0024). Treatment in high volume centers resulted in an odds ratio of 0.55 (CI 0.28–1.02) compared to low volume centers. Additional factors associated with survival were younger age, shorter time between intubation and ECMO initiation, BMI > 35 (compared to < 25), absence of renal replacement therapy or major bleeding/thromboembolic events. Conclusions Structural and patient-related factors, including age, comorbidities and ECMO case volume, determined the survival of COVID-19 ECMO. These factors combined with a more liberal ECMO indication during the 2nd wave may explain the reasonably overall low survival rate. Careful selection of patients and treatment in high volume ECMO centers was associated with higher odds of ICU survival. KW - Covid-19 KW - extracorporeal membrane oxygenation (ECMO) KW - intensive care unit Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-299686 VL - 26 IS - 1 ER - TY - JOUR A1 - Heinz, Tizian A1 - Meller, Felix A1 - Luetkens, Karsten Sebastian A1 - Anderson, Philip Mark A1 - Stratos, Ioannis A1 - Horas, Konstantin A1 - Rudert, Maximilian A1 - Reppenhagen, Stephan A1 - Weißenberger, Manuel T1 - The AMADEUS score is not a sufficient predictor for functional outcome after high tibial osteotomy JF - Journal of Experimental Orthopaedics N2 - Purpose The Area Measurement And Depth Underlying Structures (AMADEUS) classification system has been proposed as a valuable tool for magnetic resonance (MR)-based grading of preoperatively encountered chondral defects of the knee joint. However, the potential relationship of this novel score with clinical data was yet to determine. It was the primary intention of this study to assess the correlative relationship of the AMADEUS with patient reported outcome scores in patients undergoing medial open-wedge high tibial valgus osteotomy (HTO). Furthermore, the arthroscopic ICRS (International Cartilage Repair Society) grade evaluation was tested for correlation with the AMADEUS classification system. Methods This retrospective, monocentric study found a total of 70 individuals that were indicated for HTO due to degenerative chondral defects of the medial compartment between 2008 and 2019. A preoperative MR image as well as a pre-osteotomy diagnostic arthroscopy for ICRS grade evaluation was mandatory for all patients. The Knee Osteoarthritis Outcome Score (KOOS) including its five subscale scores (KOOS-ADL, KOOS-QOL, KOOS-Sports, KOOS-Pain, KOOS-Symptoms) was obtained preoperatively and at a mean follow-up of 41.2 ± 26.3 months. Preoperative chondral defects were evaluated using the AMADEUS classification system and the final AMADEUS scores were correlated with the pre- and postoperative KOOS subscale sores. Furthermore, arthroscopic ICRS defect severity was correlated with the AMADEUS classification system. Results There was a statistically significant correlation between the AMADEUS BME (bone marrow edema) subscore and the KOOS Symptoms subscore at the preoperative visit (r = 0.25, p = 0.04). No statistically significant monotonic association between the AMADEUS total score and the AMADEUS grade with pre- and postoperative KOOS subscale scores were found. Intraoperatively obtained ICRS grade did reveal a moderate correlative relation with the AMADEUS total score and the AMADEUS grade (r = 0.28, p = 0.02). Conclusions The novel AMADEUS classification system largely lacks correlative capacity with patient reported outcome measures in patients undergoing HTO. The MR tomographic appearance of bone marrow edema is the only parameter predictive of the clinical outcome at the preoperative visit. KW - cartilage KW - AMADEUS KW - KOOS KW - knee KW - high tibial osteotomy KW - chondral defect KW - osteoarthritis KW - PROM KW - correlation Y1 - 2023 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-357765 VL - 10 ER -