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Item type: Item , Compound events in Germany in 2018: drivers and case studies(2025) Xoplaki, Elena; Ellsäßer, Florian; Grieger, Jens; Nissen, Katrin M.; Pinto, Joaquim G.; Augenstein, Markus; Chen, Ting-Chen; Feldmann, Hendrik; Friederichs, Petra; Gliksman, Daniel; Goulier, Laura; Haustein, Karsten; Heinke, Jens; Jach, Lisa; Knutzen, Florian; Kollet, Stefan; Luterbacher, Jürg; Luther, Niklas; Mohr, Susanna; Mudersbach, Christoph; Müller, Christoph; Rousi, Efi; Simon, Felix; Suarez-Gutierrez, Laura; Szemkus, Svenja; Vallejo-Bernal, Sara M.; Vlachopoulos, Odysseas; Wolf, FrederikEurope frequently experiences a wide range of extreme events and natural hazards, including heatwaves, extreme precipitation, droughts, cold spells, windstorms, and storm surges. Many of these events do not occur as single extreme events but rather show a multivariate character, known as compound events. We investigate the interactions between extreme weather events, their characteristics, and changes in their intensity and frequency, as well as uncertainties in the past, present, and future. We also explore their impacts on various socio-economic sectors in Germany and central Europe. This contribution highlights several case studies with special focus on 2018, a year marked by an exceptional sequence of compound events across large parts of Europe, resulting in severe impacts on human lives, ecosystems, and infrastructure. We provide new insights into the drivers of spatially and temporally compound events, such as heat and drought, and heavy precipitation combined with extreme winds, and their adverse effects on ecosystems and society, using large-scale atmospheric patterns. We also examine the interannual influence of droughts on surface water and the impact of water scarcity and heatwaves on agriculture and forests. We assess projected changes in compound events at different current and future global surface temperature levels, demonstrating the need for improved quantification of future extreme events to support adaptation planning. Finally, we address research gaps and future directions, stressing the importance of defining composite events primarily in terms of their impacts prior to their statistical characterisation.Item type: Item , The Brons-Mulié analysis as a decision-making tool for preoperative surgical simulation in orthognatic surgery(2025) Böttger, Sebastian; Nowak, Yannick; Windhorst, Anita Cornelia; Klaus, Katharina; Ruf, Sabine; Bäcker, Christina; Schraml, Eva May; Danevitch, Nina; Mulié, Rob; Howaldt, Hans-Peter; Attia, SamehObjectives: Sufficient preoperative planning represents an essential component for the success of orthognathic surgery. Using various analysis methods, dysmorphic areas can be reliably identified and addressed during the planning procedure. Methods: Brons-Mulié analysis was used to examine profile photographs before and after orthognathic surgery. The attainment of normal values was interpreted as the achievement of facial harmony of the various facial proportions. By comparing the pre- and postoperative analysis, a control of the outcome quality of the orthognathic procedures was performed. Results: In a total of 160 patients aged 13 to 61 years, the preoperative analysis could be compared with the postoperative Brons-Mulié analysis. Postoperative, facial harmony was found for the vertical dimension in 99 cases (62%), for the upper lip dimension in 95 cases (59%), for the lower lip dimension in 138 cases (86%), and for the chin dimension in 118 cases (74%). This corresponded to an improvement of 20% in the vertical dimension, of 27% in the area of the lower lip and of 6% in the area of the chin. The upper lip area showed a slight deterioration of 7%. Conclusion: Despite preoperative planning of orthognathic surgery with Brons-Mulié analysis, postoperative results show an overall improvement but not perfection. Even by applying the method, it remains a challenge to achieve perfect facial harmony.Item type: Item , Die perioperative Änderung des berechneten Erythrozytenvolumens in Abhängigkeit von patientenindividuellen Prädiktoren bei endoprothetischem Hüftgelenksersatz(2024) Schwarzach, SimonDie elektive Implantation einer Hüftendoprothese ist in Deutschland einer der am häu-figsten durchgeführten operativen Eingriffe. Hierbei kommt es regelhaft zu einem rele-vanten BV mit einem erhöhten Anämie- und Transfusionsrisiko. Zur Etablierung und Verbesserung eines individuellen Transfusionsregimes ist es not-wendig, die Patientinnen und Patienten mit einem erhöhten Transfusionsrisiko bereits präoperativ zu erkennen. Hierzu zählt auch eine Abschätzung des zu erwartenden BV. In der vorliegenden Arbeit wurden perioperative patientenindividuelle Faktoren und ihr Einfluss auf den perioperativen BV untersucht. Des Weiteren wurde analysiert, in-wieweit die Schätzung des intraoperativen BV durch die Anästhesistin oder den Anäs-thesisten den tatsächlichen perioperativen BV erfasst. Auf Grundlage des berechneten verlorenen EZV erfolgte bei 69 Patientinnen und Patienten die Analyse dieser Faktoren im Hinblick auf ihren prädiktiven Wert für einen erhöhten perioperativen Erythrozytenverlust. Für Patientinnen und Patienten mit einem präoperativen EZV über 1800 ml, männliche Personen, einen präoperativen Hb-Wert höher als 14 g/dl und ein Alter unter 70 Jahren zeigte sich ein signifikant erhöhter berechneter perioperativer BV (p < 0.01). Für präoperative Thrombozytenkozentrationen über 260 Tsd./µl und eine OP-Zeit über 70 Minuten ergab sich ein signifikant erhöhter berechneter perioperativer BV (p < 0.05). Für die Blutgruppen, die ASA-Klassifikation, den BMI und das Anästhesieverfahren war kein signifikant erhöhter berechneter perioperativer BV festzustellen (p > 0.05). Der perioperative BV ist gegenüber der intraoperativen Schätzung um den Faktor 3 größer, die Schätzung korreliert nur schwach mit dem perioperativen BV und unter-schätzt diesen. Das präoperative EZV ist, bei Berücksichtigung weiterer patientenindividueller Daten, im Vergleich zum präoperativen Hb-Wert besser geeignet, den perioperativen BV voraus-zusagen. Die Ergebnisse der vorliegenden Arbeit tragen dazu bei, den zu erwartenden periopera-tiven BV bei der Implantation einer Hüftendoprothese besser abschätzen zu können, und leisten so einen Beitrag zur Etablierung eines individuellen Transfusionsregimes. In zukünftigen Arbeiten sollte in einer größeren Studienpopulation der prädiktive Einfluss von patientenindividuellen Faktoren auf den perioperativen BV bei endoprothetischem Hüftgelenksersatz weiter untersucht werden.Item type: Item , On the 21 Card Trick and Verini's Lost Trick(2026-01-15) Gruber, Hermann; Holzer, MarkusWe provide a necessary and sufficient condition for the solvability of generalized variants of the twenty-one card trick (21CT). The 21CT works by dealing the cards into three stacks several times and, after the spectator identifies the stack containing their card each round, arranging the stacks so the performer always knows where the chosen card ends up for the final reveal. Our analysis extends to any number of cards, arranged in multiple stacks, with an arbitrary number of cards per stack and an arbitrary number of iterations of dealing into stacks. We also allow for flexible collection of the stacks induced by face-down or face-up dealing of the deck of cards, ensuring that the unknown card appears at a predetermined position within the deck. Notably, this also allows us to analyze the historically first card trick to appear in print, proposed by Verini in 1542---a lost card trick that was rediscovered only recently: it turns out that the trick does not work. But, we also demonstrate how it can be fixed.Item type: Item , Extracellular RNA drives TNF-a/TNF-receptor-1 mediated cardiac ischemia/reperfusion injury: Mechanistic insights and therapeutic potential of RNase1(2025) Cabrera-Fuentes, Hector A.; Ruiz-Meana, Marisol; Barreto, Guillermo; Serebruany, Victor L.; Sánchez-Vega, Jose T.; Pérez-Campos, Eduardo; Kostin, Sawa; Böning, Andreas; Jarquín González, Efrén Emmanuel; Al-Suhaimi, Ebtesam A.; Rodriguez-Montesinos, Julian; Inserte, Javier; Pedretti, Sarah; Yap, Jonathan; Irei, Jason; Sedding, Daniel G.; Lecour, Sandrine; Liehn, Elisa A.; Garcia-Dorado, David; Hausenloy, Derek J.; Boisvert, William A.; Preissner, Klaus T.Myocardial ischemia/reperfusion (I/R) injury causes cardiomyocyte death and exacerbates inflammation. Emerging evidence implicates extracellular RNA (eRNA) and tumor necrosis factor-α (TNF-α) as key mediators. We hypothesize that eRNA released from ischemic cardiomyocytes amplifies I/R injury via TNF-α/TNF-receptor- 1 (TNF-R1) signaling, and that hydrolysis of eRNA by RNase1 can attenuate I/R injury by disrupting this pathway. Here, we investigated the mechanistic role of eRNA and its interplay with TNF-α signaling in cardiac I/ R injury, and evaluated the therapeutic potential of RNase1 and cyclosporine-A (CsA). In ST-segment elevation myocardial infarction patients, plasma eRNA levels were significantly elevated 2 h post-percutaneous coronary intervention (PCI), correlating positively with Creatine Kinase (CK). In murine I/R and hypoxia/reoxygenation models, eRNA released from stressed cardiomyocytes acted as a damage-associated molecular pattern, triggering TNF-α shedding via TACE/ADAM17 and activating TNF-R1-mediated inflammation, mPTP opening, and cell death. Genetic deletion of TNF-α or TNF-R1 abrogated eRNA-induced cytotoxicity, while TNF-receptor- 2 (TNF- R2) deficiency exacerbated injury. Pharmacological inhibition of TACE with TAPI suppressed TNF-α release and preserved cell viability. RNase1 effectively degraded eRNA, blocking upstream pro-inflammatory signaling, whereas CsA preserved mitochondrial integrity by preventing mPTP opening. Notably, RNase1 and CsA showed synergistic protection in vivo when administered at reperfusion, significantly reducing myocardial infarct size. These findings identify eRNA as both a biomarker and pathogenic mediator of myocardial I/R injury, and support a dual-targeted strategy using RNase1 and CsA to interrupt the TNF-α/TNF-R1-driven inflammatory and mito chondrial death pathways. Targeting both upstream inflammatory and downstream mitochondrial mechanisms represents a promising cardioprotective intervention for acute myocardial infarction.