Welcome to JLUpub

Communities in JLUpub

Select a community to browse its collections.

Now showing 1 - 2 of 2

JLUdata
Forschungsdatenrepositorium
JLUdocs
Schriftenrepositorium

Recent Submissions

Kriterien und Prädiktoren prognoserelevanter Inflammationsreaktion nach aortokoronarer Bypass-Operation bei Patienten mit oder ohne akuten Myokardinfarkt
(2025) Gonsior, Julia
Ziel: Nach herzchirurgischen CABG Eingriffen ist vermehrt mit einer überschießenden inflammatorisch-vasoplegischen Reaktion zu rechnen. Bisher werden in der Literatur die beiden Krankheitsbilder des SIRS und des vasoplegischen Syndroms getrennt betrachtet. Aus klinischer Erfahrung scheint der postoperative Krankheitsverlauf jedoch eher eine Überschneidung aufzuweisen. Zahlreiche Studien versuchen mithilfe von Prädiktoren und Risikofaktoren, peri- sowie postoperative Maßnahmen und Therapieoptionen zu detektieren und somit zu verbessern, um folglich die erhöhte Mortalitätsrate zu senken. Mithilfe einer neuen Kriterienkombination sollen die beiden Krankheitsbilder zu einem neuen definiert werden, Inflammatorisch-vasoplegische Reaktion (IVR). Material und Methodik: Diese Arbeit untersucht im Rahmen einer retrospektiven Analyse Daten von 200 Patient*innen, die sich im Zeitraum von 2008-2016 einer CABG-OP unterziehen mussten. Rund die Hälfte dieser Patient*innen erlitten kurz vor dem operativen Eingriff einen Myokardinfarkt, die andere Hälfte nicht. Mithilfe eines kombinierten Endpunkts war es das Ziel, beide Krankheitsbilder, vasoplegisches Syndrom und SIRS, in einem prognoserelevantem schlechten Outcome kombinieren. Mit diesem Outcome wurden in einer univariaten Analyse signifikante Prädiktoren ermittelt. Anschließend wurden die Prädiktoren anhand klinischer Relevanz und vorbestehender Evidenz kombiniert, um deren unabhängigen Einfluss auf die Zielvariable in einer multivariaten logistischen Regressionsanalyse zu bestimmen. Basierend auf den signifikant assoziierten Risikofaktoren wurde eine ROC-Analyse durchgeführt, um Cut-off-Werte hinsichtlich ihrer diagnostischen Trennschärfe zu identifizieren. Die drei aussagekräftigsten Variablen wurden zu einer neuen Arbeitsdefinition zusammengefügt, deren diskriminative Leistungsfähigkeit in einer weiteren ROC-Analyse überprüft wurde. Ergebnisse: Die aus der multivariaten Analyse hervorgehenden unabhängigen Risikofaktoren zeigten eine signifikante Assoziation zwischen dem schlechten Outcome und dem Serumlaktat 12h post-OP (OR 1,15 [1,02;1,31] p=0,024), dem CRP-Wert 1d post-OP (0,99 [0.98;1.00] p=0,010) und der Reintubation/ fehlenden Extubation (OR 12,81[4,05;40,52] p<0,001). Prädiktoren aus der univariaten Analyse, wie die HLM-Zeit, GFR 3d post-OP oder präoperatives VHF, konnten ihren signifikanten Zusammenhang in der multivariaten Analyse nicht beibehalten. Die in der ROC-Analyse ermittelten Cut-off-Werte ergaben für das Serumlaktat einen Wert von >1,5 mmol/L und das CRP >67,4 mg/dl. Der AUC-Wert für das Serumlaktat zeigte eine etwas stärkere Prädiktivität von 0,686 im Vergleich zum CRP; AUC=0,643. Für die ROC-Analyse der kombinierten Variablen der neuen Arbeitsdefinition lag der Schwellenwert nach Youden bei 0,125, die Sensitivität lag bei 93,3% und die Spezifität bei 21,3%. Die Bedingungen der neuen IVR-Definition wurden von 171 Patient*innen erfüllt, darunter erlitten 112 (65%) Patient*innen präoperativ einen Myokardinfarkt. Schlussfolgerung: Um die beiden Krankheitsbilder, vasoplegisches Syndrom und SIRS zu vereinen, sind erste Fortschritte erzielt worden. Die neue IVR-Arbeitsdefinition zeigt in der ROC-Analyse eine gute Diskriminierungsfähigkeit. Detektierte Risikofaktoren stimmten in weiten Teilen mit vorbestehender Evidenz überein. Diese Übereinstimmung bezieht sich auf das vasoplegische Syndrom oder das SIRS, da bisher keine Veröffentlichung mit Kombination beider Entitäten vorliegt. Auffällig war der hohe Anteil an Patient*innen, die präoperativ einen Myokardinfarkt erlitten und eine IVR aufwiesen. Die neue IVR-Definition bietet eine gute Basis, um weitere Studien und Untersuchungen anzuschließen, auch wenn IVR und die Bestimmung des schlechten Outcomes weiterentwickelt werden dürfen.
D2.5 Synthesis report on factors influencing dietary behaviour at the micro, meso and macro level
(2024) Joanes, Tina; Candel, Jeroen; Chang, Betty; Devine, Lauren; Elliot, Patrick; Kiel, Tom; Mathijs, Erik; O'Sullivan, Aifric; Reipurth, Malou; Valin, Nina; Vespa, Francesca; Gwozdz, Wencke
Somatic symptom disorder and the role of epistemic trust, personality functioning and child abuse: Results from a population-based representative German sample
(2025) Kampling, Hanna; Riedl, David; Lampe, Astrid; Nolte, Tobias; Brähler, Elmar; Ernst, Mareike; Fegert, Jörg M.; Geisel, Tobias; Hettich-Damm, Nora; Jud, Andreas; Zara, Sandra; Kruse, Johannes
Background: A growing body of evidence explored symptom burden of somatic symptom disorder (SSD) and its complex etiology involving psychosocial aspects. Child abuse has been linked to numerous psychopathologies including somatic symptoms as well as impaired personality functioning and disruptions in epistemic trust. This work aims to investigate personality functioning and epistemic trust in the association between child abuse and somatic symptom burden. Methods: We conducted structural equation modelling (SEM) using representative data of the German population (N = 2436). Personality functioning (OPD-SQS) was applied as a mediator between retrospectively recalled child abuse (ICAST-R) and somatic symptom burden (SSS-8, SSD-12, 6 month time criterion), while epistemic trust was added as a predictor of personality functioning. Results: 6.8 % (n = 166) of participants self-reported SSD. Prevalence of child abuse (53.6 % vs. 31.7 %; χ2 = 33.44, p < .001) was significantly higher among those with SSD. Child abuse was significantly associated with somatic symptom burden (criterion A: β = 0.23, 95 %-CI: 0.19–0.27, p < .001; criterion B (β = 0.24, 95 %-CI: 0.20–0.28, p < .001) and explained 6 % and 5 % of its variance respectively. Adding personality functioning as a mediator increased the explained variance to 28 % for both somatic symptom burden criterion A and B. Including epistemic trust further increased the explained variance of personality functioning (from 15 to 36 %). Limitations: All assessments and results are based on self-report and cross-sectional data. Conclusions: Impairments in personality functioning and disruptions in epistemic trust might play an important role in experiencing symptoms of SSD. Both domains thus present new avenues for treatment improvement and further research in patients with SSD.
A cross-sectional data on women’s empowerment, crop diversification, and nutrition in Benin
(2026-07-08) Akonkwa, Dieu-Merci Nyamuhirwa; Bodjrenou, Fifali Sam Ulrich; Teuber, Ramona
We present cross-sectional data from 558 households in South Benin collected in October 2024. Using a multistage sampling approach, the survey was implemented in three municipalities: Kpomassè, Torri-bossito, and Zè, covering 56 villages. Women were the targeted respondents. We relied on computer-assisted and imagery-assisted personal interviews to collect data on seven modules, including the Abbreviated Women’s Empowerment in Agriculture Index (A-WEAI), household-level crop diversification, and nutrition (dietary diversity, the Food Insecurity Experience Scale, and anthropometric measures). The participants' names, telephone numbers, and geo coordinates were removed to comply with ethics requirements and the informed consent signed by the participants.
Role of lipofibroblasts in alveolar regeneration after viral infection
(2025) Kiliaris, Georgios
As of today, pneumonia induced ARDS has a very high mortality rate with effective treatments being extremely limited. One of the main features of ARDS is the presence of oedema in the airspace of the lung which happens because of the damage inflicted on the tight junctions of the alveolar epithelial cells resulting in the collapse of the alveoli. During homeostasis, it is already known that alveolar fibroblasts 1 (AF1) or lipofibroblasts, are in a very close proximity with the alveolar type 2 (AT2) cells providing them with lipid droplets and therefore supporting them with surfactant production. So, a strong communication between the mesenchyme (AF1 cells) and the alveolar epithelium (AT2 cells) is in effect during homeostatic conditions. Our bulk RNA sequencing data from the mesenchyme of the lung in mock and infected wild type mice (7- and 14-days post infection), showed that the differences in the transcriptomic profile of the 7 d.p.i. mice compared to the control were significant, and between the 14 d.p.i. mice and mock relatively similar, indicating that at 14 d.p.i. the lung was recovering. Importantly, when we looked at the top 100 upregulated genes between days 7 and 14, we noticed several genes associated with AF1 being upregulated 14 d.p.i.. The same genes were also significantly downregulated 7 d.p.i. compared to the mock mice. Following that, we performed a GSEA analysis for the AF1 signature in both day 7 and 14 and that confirmed the loss of AF1 signature 7 d.p.i. and its recovery at 14 d.p.i.. To follow the fate of AF1, we used the Fgf10CreERT2;tdTomatoflox line to lineage trace them and since we have previously shown that metformin can act on the AF1 and have a positive impact on the resolution of bleomycin induced fibrosis in mice, we used metformin as a therapeutic factor. Our data revealed that mice treated with metformin were doing better after infection with significantly less damage present on the lung. We could also observe the loss of the lineage after infection and its restoration after treatment with metformin with the AF1 regaining their lipogenic phenotype. Our single cell RNA sequencing data, also showed us that metformin was able to alter the transcriptomic profile of the lineage traced cells with pathways such as mTOR, cGMP- PKG and AMPK being upregulated and processes such as alveolar development and 59 morphogenesis being enriched. Our results were confirmed in our murine and human PCLS infection model with AF1 markers and, most importantly, AT1 and AT2 markers being upregulated after metformin treatment. Single cell RNA sequencing analysis on the SftpcCre-ERT2;tdTomatoflox lineage traced mice, a line that trace the fate of the AT2 cells, also showed that metformin can accelerate the differentiation of AT2 cells through ADIs to AT1 cells. Integrating the Fgf10Cre-ERT2;tdTomatoflox and SftpcCre-ERT2;tdTomatoflox single cell RNA sequencing data sets, gave us the opportunity to study the dynamics in the intercellular communication between AF1 and AT2. Thus, after performing a comprehensive CellChat analysis, we were able to identify GDF10 and HH as unique pathways of interaction between AF1 and AT2 after treatment with metformin. Quantitative PCR analysis on the murine and human PCLS infection models confirmed the upregulation of GDF10 after treatment with metformin. Also, treating murine PCLS with recombinant GDF10 after infection, showed upregulation of AT1 and AT2 markers further strengthening the idea that GDF10 is important for lung regeneration after influenza-induced lung injury. Importantly, when we studied the human lung cell atlas, we observed a significant downregulation of the AF1 signature and on the expression of GDF10 in the SARS- CoV-2 patients data compared with the donors. The downregulation of GDF10 was also confirmed when we performed in situ hybridization in three different IAV-induced ARDS patients compared to three different donors. With these data, we were able to show the relevance of our murine based results to the human pathological conditions.