@article{ZhenLiangStaatetal.2024, author = {Zhen, Manghao and Liang, Yunpei and Staat, Manfred and Li, Quanqui and Li, Jianbo}, title = {Discontinuous fracture behaviors and constitutive model of sandstone specimens containing non-parallel prefabricated fissures under uniaxial compression}, series = {Theoretical and Applied Fracture Mechanics}, volume = {131}, journal = {Theoretical and Applied Fracture Mechanics}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0167-8442}, doi = {10.1016/j.tafmec.2024.104373}, pages = {Artikel 104373}, year = {2024}, abstract = {The deformation and damage laws of non-homogeneous irregular structural planes in rocks are the basis for studying the stability of rock engineering. To investigate the damage characteristics of rock containing non-parallel fissures, uniaxial compression tests and numerical simulations were conducted on sandstone specimens containing three non-parallel fissures inclined at 0°, 45° and 90° in this study. The characteristics of crack initiation and crack evolution of fissures with different inclinations were analyzed. A constitutive model for the discontinuous fractures of fissured sandstone was proposed. The results show that the fracture behaviors of fissured sandstone specimens are discontinuous. The stress-strain curves are non-smooth and can be divided into nonlinear crack closure stage, linear elastic stage, plastic stage and brittle failure stage, of which the plastic stage contains discontinuous stress drops. During the uniaxial compression test, the middle or ends of 0° fissures were the first to crack compared to 45° and 90° fissures. The end with small distance between 0° and 45° fissures cracked first, and the end with large distance cracked later. After the final failure, 0° fissures in all specimens were fractured, while 45° and 90° fissures were not necessarily fractured. Numerical simulation results show that the concentration of compressive stress at the tips of 0°, 45° and 90° fissures, as well as the concentration of tensile stress on both sides, decreased with the increase of the inclination angle. A constitutive model for the discontinuous fractures of fissured sandstone specimens was derived by combining the logistic model and damage mechanic theory. This model can well describe the discontinuous drops of stress and agrees well with the whole processes of the stress-strain curves of the fissured sandstone specimens.}, language = {en} } @article{HacklBuessKammerlohretal.2021, author = {Hackl, Michael and Buess, Eduard and Kammerlohr, Sandra and Nacov, Julia and Staat, Manfred and Leschinger, Tim and M{\"u}ller, Lars P. and Wegmann, Kilian}, title = {A "comma sign"-directed subscapularis repair in anterosuperior rotator cuff tears yields biomechanical advantages in a cadaveric model}, series = {The american journal of sports medicine}, volume = {49}, journal = {The american journal of sports medicine}, number = {12}, publisher = {Sage}, address = {London}, issn = {1552-3365}, doi = {10.1177/03635465211031506}, pages = {3212 -- 3217}, year = {2021}, abstract = {Background: Additional stabilization of the "comma sign" in anterosuperior rotator cuff repair has been proposed to provide biomechanical benefits regarding stability of the repair. Purpose: This in vitro investigation aimed to investigate the influence of a comma sign-directed reconstruction technique for anterosuperior rotator cuff tears on the primary stability of the subscapularis tendon repair. Study Design: Controlled laboratory study. Methods: A total of 18 fresh-frozen cadaveric shoulders were used in this study. Anterosuperior rotator cuff tears (complete full-thickness tear of the supraspinatus and subscapularis tendons) were created, and supraspinatus repair was performed with a standard suture bridge technique. The subscapularis was repaired with either a (1) single-row or (2) comma sign technique. A high-resolution 3D camera system was used to analyze 3-mm and 5-mm gap formation at the subscapularis tendon-bone interface upon incremental cyclic loading. Moreover, the ultimate failure load of the repair was recorded. A Mann-Whitney test was used to assess significant differences between the 2 groups. Results: The comma sign repair withstood significantly more loading cycles than the single-row repair until 3-mm and 5-mm gap formation occurred (P≤ .047). The ultimate failure load did not reveal any significant differences when the 2 techniques were compared (P = .596). Conclusion: The results of this study show that additional stabilization of the comma sign enhanced the primary stability of subscapularis tendon repair in anterosuperior rotator cuff tears. Although this stabilization did not seem to influence the ultimate failure load, it effectively decreased the micromotion at the tendon-bone interface during cyclic loading. Clinical Relevance: The proposed technique for stabilization of the comma sign has shown superior biomechanical properties in comparison with a single-row repair and might thus improve tendon healing. Further clinical research will be necessary to determine its influence on the functional outcome.}, language = {en} } @article{SchierenKleinschmidtSchmutzetal.2019, author = {Schieren, Mark and Kleinschmidt, Joris and Schmutz, Axel and Loop, Torsten and Gatzweiler, Karl-Heinz and Staat, Manfred and Wappler, Frank and Defosse, Jerome}, title = {Comparison of forces acting on maxillary incisors during tracheal intubation with different laryngoscopy techniques: a blinded manikin study}, series = {Anaesthesia}, volume = {74}, journal = {Anaesthesia}, number = {12}, publisher = {Wiley-Blackwell}, address = {Oxford}, isbn = {1365-2044}, doi = {10.1111/anae.14815}, year = {2019}, language = {en} } @article{Staat2021, author = {Staat, Manfred}, title = {An extension strain type Mohr-Coulomb criterion}, series = {Rock mechanics and rock engineering}, volume = {54}, journal = {Rock mechanics and rock engineering}, number = {12}, publisher = {Springer Nature}, address = {Cham}, issn = {1434-453X}, doi = {10.1007/s00603-021-02608-7}, pages = {6207 -- 6233}, year = {2021}, abstract = {Extension fractures are typical for the deformation under low or no confining pressure. They can be explained by a phenomenological extension strain failure criterion. In the past, a simple empirical criterion for fracture initiation in brittle rock has been developed. In this article, it is shown that the simple extension strain criterion makes unrealistic strength predictions in biaxial compression and tension. To overcome this major limitation, a new extension strain criterion is proposed by adding a weighted principal shear component to the simple criterion. The shear weight is chosen, such that the enriched extension strain criterion represents the same failure surface as the Mohr-Coulomb (MC) criterion. Thus, the MC criterion has been derived as an extension strain criterion predicting extension failure modes, which are unexpected in the classical understanding of the failure of cohesive-frictional materials. In progressive damage of rock, the most likely fracture direction is orthogonal to the maximum extension strain leading to dilatancy. The enriched extension strain criterion is proposed as a threshold surface for crack initiation CI and crack damage CD and as a failure surface at peak stress CP. Different from compressive loading, tensile loading requires only a limited number of critical cracks to cause failure. Therefore, for tensile stresses, the failure criteria must be modified somehow, possibly by a cut-off corresponding to the CI stress. Examples show that the enriched extension strain criterion predicts much lower volumes of damaged rock mass compared to the simple extension strain criterion.}, language = {en} } @article{BayerTemizArtmannDigeletal.2020, author = {Bayer, Robin and Temiz Artmann, Ayseg{\"u}l and Digel, Ilya and Falkenstein, Julia and Artmann, Gerhard and Creutz, Till and Hescheler, J{\"u}rgen}, title = {Mechano-pharmacological testing of L-Type Ca²⁺ channel modulators via human vascular celldrum model}, series = {Cellular Physiology and Biochemistry}, volume = {54}, journal = {Cellular Physiology and Biochemistry}, publisher = {Cell Physiol Biochem Press}, address = {D{\"u}sseldorf}, issn = {1421-9778}, doi = {10.33594/000000225}, pages = {371 -- 383}, year = {2020}, abstract = {Background/Aims: This study aimed to establish a precise and well-defined working model, assessing pharmaceutical effects on vascular smooth muscle cell monolayer in-vitro. It describes various analysis techniques to determine the most suitable to measure the biomechanical impact of vasoactive agents by using CellDrum technology. Methods: The so-called CellDrum technology was applied to analyse the biomechanical properties of confluent human aorta muscle cells (haSMC) in monolayer. The cell generated tensions deviations in the range of a few N/m² are evaluated by the CellDrum technology. This study focuses on the dilative and contractive effects of L-type Ca²⁺ channel agonists and antagonists, respectively. We analyzed the effects of Bay K8644, nifedipine and verapamil. Three different measurement modes were developed and applied to determine the most appropriate analysis technique for the study purpose. These three operation modes are called, particular time mode" (PTM), "long term mode" (LTM) and "real-time mode" (RTM). Results: It was possible to quantify the biomechanical response of haSMCs to the addition of vasoactive agents using CellDrum technology. Due to the supplementation of 100nM Bay K8644, the tension increased approximately 10.6\% from initial tension maximum, whereas, the treatment with nifedipine and verapamil caused a significant decrease in cellular tension: 10nM nifedipine decreased the biomechanical stress around 6,5\% and 50nM verapamil by 2,8\%, compared to the initial tension maximum. Additionally, all tested measurement modes provide similar results while focusing on different analysis parameters. Conclusion: The CellDrum technology allows highly sensitive biomechanical stress measurements of cultured haSMC monolayers. The mechanical stress responses evoked by the application of vasoactive calcium channel modulators were quantified functionally (N/m²). All tested operation modes resulted in equal findings, whereas each mode features operation-related data analysis.}, language = {en} } @article{UysalCreutzFiratetal.2022, author = {Uysal, Karya and Creutz, Till and Firat, Ipek Seda and Artmann, Gerhard and Teusch, Nicole and Temiz Artmann, Ayseg{\"u}l}, title = {Bio-functionalized ultra-thin, large-area and waterproof silicone membranes for biomechanical cellular loading and compliance experiments}, series = {Polymers}, volume = {14}, journal = {Polymers}, number = {11}, publisher = {MDPI}, address = {Basel}, issn = {2073-4360}, pages = {2213}, year = {2022}, abstract = {Biocompatibility, flexibility and durability make polydimethylsiloxane (PDMS) membranes top candidates in biomedical applications. CellDrum technology uses large area, <10 µm thin membranes as mechanical stress sensors of thin cell layers. For this to be successful, the properties (thickness, temperature, dust, wrinkles, etc.) must be precisely controlled. The following parameters of membrane fabrication by means of the Floating-on-Water (FoW) method were investigated: (1) PDMS volume, (2) ambient temperature, (3) membrane deflection and (4) membrane mechanical compliance. Significant differences were found between all PDMS volumes and thicknesses tested (p < 0.01). They also differed from the calculated values. At room temperatures between 22 and 26 °C, significant differences in average thickness values were found, as well as a continuous decrease in thicknesses within a 4 °C temperature elevation. No correlation was found between the membrane thickness groups (between 3-4 µm) in terms of deflection and compliance. We successfully present a fabrication method for thin bio-functionalized membranes in conjunction with a four-step quality management system. The results highlight the importance of tight regulation of production parameters through quality control. The use of membranes described here could also become the basis for material testing on thin, viscous layers such as polymers, dyes and adhesives, which goes far beyond biological applications.}, language = {en} } @article{UysalFiratCreutzetal.2022, author = {Uysal, Karya and Firat, Ipek Serat and Creutz, Till and Aydin, Inci Cansu and Artmann, Gerhard and Teusch, Nicole and Temiz Artmann, Ayseg{\"u}l}, title = {A novel in vitro wound healing assay using free-standing, ultra-thin PDMS membranes}, series = {membranes}, volume = {2023}, journal = {membranes}, number = {13(1)}, publisher = {MDPI}, address = {Basel}, doi = {10.3390/membranes13010022}, pages = {Artikel 22}, year = {2022}, abstract = {Advances in polymer science have significantly increased polymer applications in life sciences. We report the use of free-standing, ultra-thin polydimethylsiloxane (PDMS) membranes, called CellDrum, as cell culture substrates for an in vitro wound model. Dermal fibroblast monolayers from 28- and 88-year-old donors were cultured on CellDrums. By using stainless steel balls, circular cell-free areas were created in the cell layer (wounding). Sinusoidal strain of 1 Hz, 5\% strain, was applied to membranes for 30 min in 4 sessions. The gap circumference and closure rate of un-stretched samples (controls) and stretched samples were monitored over 4 days to investigate the effects of donor age and mechanical strain on wound closure. A significant decrease in gap circumference and an increase in gap closure rate were observed in trained samples from younger donors and control samples from older donors. In contrast, a significant decrease in gap closure rate and an increase in wound circumference were observed in the trained samples from older donors. Through these results, we propose the model of a cell monolayer on stretchable CellDrums as a practical tool for wound healing research. The combination of biomechanical cell loading in conjunction with analyses such as gene/protein expression seems promising beyond the scope published here.}, language = {en} } @article{TemizArtmannKurulgandemirciFıratetal.2021, author = {Temiz Artmann, Ayseg{\"u}l and Kurulgan demirci, Eylem and F{\i}rat, Ipek Seda and Oflaz, Hakan and Artmann, Gerhard}, title = {Recombinant activated protein C (rhAPC) affects lipopolysaccharide-induced mechanical compliance changes and beat frequency of mESC-derived cardiomyocyte monolayers}, series = {SHOCK}, journal = {SHOCK}, publisher = {Wolters Kluwer}, address = {K{\"o}ln}, issn = {1540-0514}, doi = {10.1097/SHK.0000000000001845}, year = {2021}, language = {en} } @article{GossmannFrotscherLinderetal.2016, author = {Goßmann, Matthias and Frotscher, Ralf and Linder, Peter and Bayer, Robin and Epple, U. and Staat, Manfred and Temiz Artmann, Ayseg{\"u}l and Artmann, Gerhard}, title = {Mechano-pharmacological characterization of cardiomyocytes derived from human induced pluripotent stem cells}, series = {Cellular physiology and biochemistry}, volume = {38}, journal = {Cellular physiology and biochemistry}, number = {3}, publisher = {Karger}, address = {Basel}, issn = {1421-9778 (Online)}, doi = {10.1159/000443124}, pages = {1182 -- 1198}, year = {2016}, abstract = {Background/Aims: Common systems for the quantification of cellular contraction rely on animal-based models, complex experimental setups or indirect approaches. The herein presented CellDrum technology for testing mechanical tension of cellular monolayers and thin tissue constructs has the potential to scale-up mechanical testing towards medium-throughput analyses. Using hiPS-Cardiac Myocytes (hiPS-CMs) it represents a new perspective of drug testing and brings us closer to personalized drug medication. Methods: In the present study, monolayers of self-beating hiPS-CMs were grown on ultra-thin circular silicone membranes and deflect under the weight of the culture medium. Rhythmic contractions of the hiPS-CMs induced variations of the membrane deflection. The recorded contraction-relaxation-cycles were analyzed with respect to their amplitudes, durations, time integrals and frequencies. Besides unstimulated force and tensile stress, we investigated the effects of agonists and antagonists acting on Ca²⁺ channels (S-Bay K8644/verapamil) and Na⁺ channels (veratridine/lidocaine). Results: The measured data and simulations for pharmacologically unstimulated contraction resembled findings in native human heart tissue, while the pharmacological dose-response curves were highly accurate and consistent with reference data. Conclusion: We conclude that the combination of the CellDrum with hiPS-CMs offers a fast, facile and precise system for pharmacological, toxicological studies and offers new preclinical basic research potential.}, language = {en} } @article{ArinkinDigelPorstetal.2014, author = {Arinkin, Vladimir and Digel, Ilya and Porst, Dariusz and Temiz Artmann, Ayseg{\"u}l and Artmann, Gerhard}, title = {Phenotyping date palm varieties via leaflet cross-sectional imaging and artificial neural network application}, series = {BMC bioinformatics}, volume = {15}, journal = {BMC bioinformatics}, number = {55}, issn = {1471-2105}, doi = {10.1186/1471-2105-15-55}, pages = {1 -- 8}, year = {2014}, abstract = {Background True date palms (Phoenix dactylifera L.) are impressive trees and have served as an indispensable source of food for mankind in tropical and subtropical countries for centuries. The aim of this study is to differentiate date palm tree varieties by analysing leaflet cross sections with technical/optical methods and artificial neural networks (ANN). Results Fluorescence microscopy images of leaflet cross sections have been taken from a set of five date palm tree cultivars (Hewlat al Jouf, Khlas, Nabot Soltan, Shishi, Um Raheem). After features extraction from images, the obtained data have been fed in a multilayer perceptron ANN with backpropagation learning algorithm. Conclusions Overall, an accurate result in prediction and differentiation of date palm tree cultivars was achieved with average prediction in tenfold cross-validation is 89.1\% and reached 100\% in one of the best ANN.}, language = {en} } @article{MiciliValterOflazetal.2013, author = {Micili, Serap C. and Valter, Markus and Oflaz, Hakan and Ozogul, Candan and Linder, Peter and F{\"o}ckler, Nicole and Artmann, Gerhard and Digel, Ilya and Temiz Artmann, Ayseg{\"u}l}, title = {Optical coherence tomography : a potential tool to predict premature rupture of fetal membranes}, series = {Proceedings of the Institution of Mechanical Engineers. Part H : Journal of engineering in medicine}, volume = {Vol. 227}, journal = {Proceedings of the Institution of Mechanical Engineers. Part H : Journal of engineering in medicine}, number = {No. 4}, publisher = {Sage}, address = {London}, issn = {0046-2039 (Print) ; 2041-3033 (E-Journal)}, pages = {393 -- 401}, year = {2013}, language = {en} } @article{SeifarthGrosseGrossmannetal.2017, author = {Seifarth, Volker and Grosse, Joachim O. and Grossmann, Matthias and Janke, Heinz Peter and Arndt, Patrick and Koch, Sabine and Epple, Matthias and Artmann, Gerhard and Temiz Artmann, Ayseg{\"u}l}, title = {Mechanical induction of bi-directional orientation of primary porcine bladder smooth muscle cells in tubular fibrin-poly(vinylidene fluoride) scaffolds for ureteral and urethral repair using cyclic and focal balloon catheter stimulation}, series = {Journal of Biomaterials Applications}, volume = {32}, journal = {Journal of Biomaterials Applications}, number = {3}, publisher = {Sage}, address = {London}, issn = {1530-8022}, doi = {10.1177/0885328217723178}, pages = {321 -- 330}, year = {2017}, language = {en} } @article{SeifarthGossmannGrosseetal.2015, author = {Seifarth, Volker and Goßmann, Matthias and Grosse, J. O. and Becker, C. and Heschel, I. and Artmann, Gerhard and Temiz Artmann, Ayseg{\"u}l}, title = {Development of a Bioreactor to Culture Tissue Engineered Ureters Based on the Application of Tubular OPTIMAIX 3D Scaffolds}, series = {Urologia Internationalis}, volume = {2015}, journal = {Urologia Internationalis}, number = {95}, publisher = {Karger}, address = {Basel}, issn = {0042-1138}, doi = {10.1159/000368419}, pages = {106 -- 113}, year = {2015}, language = {en} } @article{AngermannGuenthnerHanssenetal.2022, author = {Angermann, Susanne and G{\"u}nthner, Roman and Hanssen, Henner and Lorenz, Georg and Braunisch, Matthias C. and Steubl, Dominik and Matschkal, Julia and Kemmner, Stephan and Hausinger, Renate and Block, Zenonas and Haller, Bernhard and Heemann, Uwe and Kotliar, Konstantin and Grimmer, Timo and Schmaderer, Christoph}, title = {Cognitive impairment and microvascular function in end-stage renal disease}, series = {International Journal of Methods in Psychiatric Research (MPR)}, volume = {31}, journal = {International Journal of Methods in Psychiatric Research (MPR)}, number = {2}, publisher = {Wiley}, issn = {1049-8931 (Print)}, doi = {10.1002/mpr.1909}, pages = {1 -- 10}, year = {2022}, abstract = {Objective Hemodialysis patients show an approximately threefold higher prevalence of cognitive impairment compared to the age-matched general population. Impaired microcirculatory function is one of the assumed causes. Dynamic retinal vessel analysis is a quantitative method for measuring neurovascular coupling and microvascular endothelial function. We hypothesize that cognitive impairment is associated with altered microcirculation of retinal vessels. Methods 152 chronic hemodialysis patients underwent cognitive testing using the Montreal Cognitive Assessment. Retinal microcirculation was assessed by Dynamic Retinal Vessel Analysis, which carries out an examination recording retinal vessels' reaction to a flicker light stimulus under standardized conditions. Results In unadjusted as well as in adjusted linear regression analyses a significant association between the visuospatial executive function domain score of the Montreal Cognitive Assessment and the maximum arteriolar dilation as response of retinal arterioles to the flicker light stimulation was obtained. Conclusion This is the first study determining retinal microvascular function as surrogate for cerebral microvascular function and cognition in hemodialysis patients. The relationship between impairment in executive function and reduced arteriolar reaction to flicker light stimulation supports the involvement of cerebral small vessel disease as contributing factor for the development of cognitive impairment in this patient population and might be a target for noninvasive disease monitoring and therapeutic intervention.}, language = {en} } @article{KotliarOrtnerConradietal.2022, author = {Kotliar, Konstantin and Ortner, Marion and Conradi, Anna and Hacker, Patricia and Hauser, Christine and G{\"u}nthner, Roman and Moser, Michaela and Muggenthaler, Claudia and Diehl-Schmid, Janine and Priller, Josef and Schmaderer, Christoph and Grimmer, Timo}, title = {Altered retinal cerebral vessel oscillation frequencies in Alzheimer's disease compatible with impaired amyloid clearance}, series = {Neurobiology of Aging}, volume = {120}, journal = {Neurobiology of Aging}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0197-4580}, doi = {10.1016/j.neurobiolaging.2022.08.012}, pages = {117 -- 127}, year = {2022}, abstract = {Retinal vessels are similar to cerebral vessels in their structure and function. Moderately low oscillation frequencies of around 0.1 Hz have been reported as the driving force for paravascular drainage in gray matter in mice and are known as the frequencies of lymphatic vessels in humans. We aimed to elucidate whether retinal vessel oscillations are altered in Alzheimer's disease (AD) at the stage of dementia or mild cognitive impairment (MCI). Seventeen patients with mild-to-moderate dementia due to AD (ADD); 23 patients with MCI due to AD, and 18 cognitively healthy controls (HC) were examined using Dynamic Retinal Vessel Analyzer. Oscillatory temporal changes of retinal vessel diameters were evaluated using mathematical signal analysis. Especially at moderately low frequencies around 0.1 Hz, arterial oscillations in ADD and MCI significantly prevailed over HC oscillations and correlated with disease severity. The pronounced retinal arterial vasomotion at moderately low frequencies in the ADD and MCI groups would be compatible with the view of a compensatory upregulation of paravascular drainage in AD and strengthen the amyloid clearance hypothesis.}, language = {en} } @article{NeumaierWeissVeldemanetal.2021, author = {Neumaier, Felix and Weiss, Miriam and Veldeman, Michael and Kotliar, Konstantin and Wiesmann, Martin and Schulze-Steinen, Henna and H{\"o}llig, Anke and Clusmann, Hans and Schubert, Gerrit Alexander and Albanna, Walid}, title = {Changes in endogenous daytime melatonin levels after aneurysmal subarachnoid hemorrhage - preliminary findings from an observational cohort study}, series = {Clinical Neurology and Neurosurgery}, volume = {208}, journal = {Clinical Neurology and Neurosurgery}, number = {Article No.: 106870}, publisher = {Elsevier}, address = {Amsterdam}, issn = {0303-8467}, doi = {10.1016/j.clineuro.2021.106870}, year = {2021}, abstract = {Aneurysmal subarachnoid hemorrhage (aSAH) is associated with early and delayed brain injury due to several underlying and interrelated processes, which include inflammation, oxidative stress, endothelial, and neuronal apoptosis. Treatment with melatonin, a cytoprotective neurohormone with anti-inflammatory, anti-oxidant and anti-apoptotic effects, has been shown to attenuate early brain injury (EBI) and to prevent delayed cerebral vasospasm in experimental aSAH models. Less is known about the role of endogenous melatonin for aSAH outcome and how its production is altered by the pathophysiological cascades initiated during EBI. In the present observational study, we analyzed changes in melatonin levels during the first three weeks after aSAH.}, language = {en} } @article{AlnemerKotliarNeuhausetal.2023, author = {Alnemer, Momin Sami Mohammad and Kotliar, Konstantin and Neuhaus, Valentin and Pape, Hans-Christoph and Ciritsis, Bernhard D.}, title = {Cost-effectiveness analysis of surgical proximal femur fracture prevention in elderly: a Markov cohort simulation model}, series = {Cost Effectiveness and Resource Allocation}, journal = {Cost Effectiveness and Resource Allocation}, number = {21, Article number: 77}, publisher = {Springer Nature}, issn = {1478-7547}, doi = {10.1186/s12962-023-00482-4}, pages = {12 Seiten}, year = {2023}, abstract = {Background Hip fractures are a common and costly health problem, resulting in significant morbidity and mortality, as well as high costs for healthcare systems, especially for the elderly. Implementing surgical preventive strategies has the potential to improve the quality of life and reduce the burden on healthcare resources, particularly in the long term. However, there are currently limited guidelines for standardizing hip fracture prophylaxis practices. Methods This study used a cost-effectiveness analysis with a finite-state Markov model and cohort simulation to evaluate the primary and secondary surgical prevention of hip fractures in the elderly. Patients aged 60 to 90 years were simulated in two different models (A and B) to assess prevention at different levels. Model A assumed prophylaxis was performed during the fracture operation on the contralateral side, while Model B included individuals with high fracture risk factors. Costs were obtained from the Centers for Medicare \& Medicaid Services, and transition probabilities and health state utilities were derived from available literature. The baseline assumption was a 10\% reduction in fracture risk after prophylaxis. A sensitivity analysis was also conducted to assess the reliability and variability of the results. Results With a 10\% fracture risk reduction, model A costs between \$8,850 and \$46,940 per quality-adjusted life-year (\$/QALY). Additionally, it proved most cost-effective in the age range between 61 and 81 years. The sensitivity analysis established that a reduction of ≥ 2.8\% is needed for prophylaxis to be definitely cost-effective. The cost-effectiveness at the secondary prevention level was most sensitive to the cost of the contralateral side's prophylaxis, the patient's age, and fracture treatment cost. For high-risk patients with no fracture history, the cost-effectiveness of a preventive strategy depends on their risk profile. In the baseline analysis, the incremental cost-effectiveness ratio at the primary prevention level varied between \$11,000/QALY and \$74,000/QALY, which is below the defined willingness to pay threshold. Conclusion Due to the high cost of hip fracture treatment and its increased morbidity, surgical prophylaxis strategies have demonstrated that they can significantly relieve the healthcare system. Various key assumptions facilitated the modeling, allowing for adequate room for uncertainty. Further research is needed to evaluate health-state-associated risks.}, language = {en} } @article{KuchlerGuenthnerRibeiroetal.2023, author = {Kuchler, Timon and G{\"u}nthner, Roman and Ribeiro, Andrea and Hausinger, Renate and Streese, Lukas and W{\"o}hnl, Anna and Kesseler, Veronika and Negele, Johanna and Assali, Tarek and Carbajo-Lozoya, Javier and Lech, Maciej and Adorjan, Kristina and Stubbe, Hans Christian and Hanssen, Henner and Kotliar, Konstantin and Haller, Berhard and Heemann, Uwe and Schmaderer, Christoph}, title = {Persistent endothelial dysfunction in post-COVID-19 syndrome and its associations with symptom severity and chronic inflammation}, volume = {26}, publisher = {Springer Nature}, address = {Dordrecht}, doi = {10.1007/s10456-023-09885-6}, pages = {547 -- 563}, year = {2023}, abstract = {Background Post-COVID-19 syndrome (PCS) is a lingering disease with ongoing symptoms such as fatigue and cognitive impairment resulting in a high impact on the daily life of patients. Understanding the pathophysiology of PCS is a public health priority, as it still poses a diagnostic and treatment challenge for physicians. Methods In this prospective observational cohort study, we analyzed the retinal microcirculation using Retinal Vessel Analysis (RVA) in a cohort of patients with PCS and compared it to an age- and gender-matched healthy cohort (n = 41, matched out of n = 204). Measurements and main results PCS patients exhibit persistent endothelial dysfunction (ED), as indicated by significantly lower venular flicker-induced dilation (vFID; 3.42\% ± 1.77\% vs. 4.64\% ± 2.59\%; p = 0.02), narrower central retinal artery equivalent (CRAE; 178.1 [167.5-190.2] vs. 189.1 [179.4-197.2], p = 0.01) and lower arteriolar-venular ratio (AVR; (0.84 [0.8-0.9] vs. 0.88 [0.8-0.9], p = 0.007). When combining AVR and vFID, predicted scores reached good ability to discriminate groups (area under the curve: 0.75). Higher PCS severity scores correlated with lower AVR (R = - 0.37 p = 0.017). The association of microvascular changes with PCS severity were amplified in PCS patients exhibiting higher levels of inflammatory parameters. Conclusion Our results demonstrate that prolonged endothelial dysfunction is a hallmark of PCS, and impairments of the microcirculation seem to explain ongoing symptoms in patients. As potential therapies for PCS emerge, RVA parameters may become relevant as clinical biomarkers for diagnosis and therapy management.}, language = {en} } @article{KuertenKotliarFuestetal.2021, author = {Kuerten, David and Kotliar, Konstantin and Fuest, Matthias and Walter, Peter and Hollstein, Muriel and Plange, Niklas}, title = {Does hemispheric vascular regulation differ significantly in glaucoma patients with altitudinal visual field asymmetry? A single-center, prospective study}, series = {International Ophthalmology}, volume = {41}, journal = {International Ophthalmology}, number = {41}, editor = {Neri, Piergiorgio}, publisher = {Springer}, address = {Berlin}, isbn = {1573-2630}, doi = {10.1007/s10792-021-01876-0}, pages = {3109 -- 3119}, year = {2021}, abstract = {Purpose Vascular risk factors and ocular perfusion are heatedly discussed in the pathogenesis of glaucoma. The retinal vessel analyzer (RVA, IMEDOS Systems, Germany) allows noninvasive measurement of retinal vessel regulation. Significant differences especially in the veins between healthy subjects and patients suffering from glaucoma were previously reported. In this pilot-study we investigated if localized vascular regulation is altered in glaucoma patients with altitudinal visual field defect asymmetry. Methods 15 eyes of 12 glaucoma patients with advanced altitudinal visual field defect asymmetry were included. The mean defect was calculated for each hemisphere separately (-20.99 ± 10.49 pro- found hemispheric visual field defect vs -7.36 ± 3.97 dB less profound hemisphere). After pupil dilation, RVA measurements of retinal arteries and veins were conducted using the standard protocol. The superior and inferior retinal vessel reactivity were measured consecutively in each eye. Results Significant differences were recorded in venous vessel constriction after flicker light stimulation and overall amplitude of the reaction (p \ 0.04 and p \ 0.02 respectively) in-between the hemispheres spheres. Vessel reaction was higher in the hemisphere corresponding to the more advanced visual field defect. Arterial diameters reacted similarly, failing to reach statistical significance. Conclusion Localized retinal vessel regulation is significantly altered in glaucoma patients with asymmetri altitudinal visual field defects. Veins supplying the hemisphere concordant to a less profound visual field defect show diminished diameter changes. Vascular dysregulation might be particularly important in early glaucoma stages prior to a significant visual field defect.}, language = {en} } @article{AlbannaConzenWeissetal.2021, author = {Albanna, Walid and Conzen, Catharina and Weiss, Miriam and Seyfried, Katharina and Kotliar, Konstantin and Schmidt, Tobias Philip and Kuerten, David and Hescheler, J{\"u}rgen and Bruecken, Anne and Schmidt-Trucks{\"a}ss, Arno and Neumaier, Felix and Wiesmann, Martin and Clusmann, Hans and Schubert, Gerrit Alexander}, title = {Non-invasive assessment of neurovascular coupling after aneurysmal subarachnoid hemorrhage: a prospective observational trial using retinal vessel analysis}, series = {Frontiers in Neurology}, volume = {12}, journal = {Frontiers in Neurology}, number = {12}, issn = {1664-2295}, doi = {10.3389/fneur.2021.690183}, pages = {1 -- 15}, year = {2021}, abstract = {Delayed cerebral ischemia (DCI) is a common complication after aneurysmal subarachnoid hemorrhage (aSAH) and can lead to infarction and poor clinical outcome. The underlying mechanisms are still incompletely understood, but animal models indicate that vasoactive metabolites and inflammatory cytokines produced within the subarachnoid space may progressively impair and partially invert neurovascular coupling (NVC) in the brain. Because cerebral and retinal microvasculature are governed by comparable regulatory mechanisms and may be connected by perivascular pathways, retinal vascular changes are increasingly recognized as a potential surrogate for altered NVC in the brain. Here, we used non-invasive retinal vessel analysis (RVA) to assess microvascular function in aSAH patients at different times after the ictus.}, language = {en} }