Publications by authors named "Alexander Koch"

Background: Radiotherapy is essential for treating head and neck cancer but often leads to severe toxicity. Traditional predictors include anatomical location, tumor extent, and dosimetric data. Recently, biomarkers have been explored to better predict and understand toxicity.

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  • ACLF is a complex condition characterized by acute worsening of liver disease and organ failure, prompting this study to create a machine learning model to predict patient mortality in the ICU.
  • The research analyzed data from 206 ICU patients at RWTH Aachen University Hospital and developed a predictive model using logistic regression, achieving an impressive accuracy with an AUROC of 0.96.
  • The resulting Aachen ACLF ICU (ACICU) score outperforms existing mortality predictors and provides a user-friendly tool for assessing the likelihood of mortality in critically ill patients with ACLF.
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  • Acute pancreatitis (AP) is a leading cause of hospital admissions, increasing healthcare costs and requiring intensive medical management, particularly for severe cases (SAP), which can be life-threatening.
  • Managing SAP involves a multidisciplinary team, including various specialists, to ensure comprehensive care and improve patient outcomes through continuous collaboration.
  • The review discusses the latest diagnostic and treatment strategies for SAP, covering risk assessment, fluid management, nutrition, and interventions for complications, while emphasizing the importance of integrating new evidence into clinical practice.
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The circle of Willis (CoW) is a network of cerebral arteries with significant inter-individual anatomical variations. Deep learning has been used to characterize and quantify the status of the CoW in various applications for the diagnosis and treatment of cerebrovascular disease. In medical imaging, the performance of deep learning models is limited by the diversity and size of training datasets.

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Background: Evidence on the benefits of fiber-supplemented enteral nutrition (EN) in critically ill patients is inconsistent, and critical care nutrition guidelines lack recommendations based on high-quality evidence. This systematic review and meta-analysis (SRMA) aims to provide a current synthesis of the literature on this topic.

Methods: For this SRMA of randomized controlled trials (RCT), electronic databases (MEDLINE, EMBASE, CENTRAL) were searched systematically from inception to January 2024 and updated in June 2024.

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Background: Adiponectin, an adipokine with anti-inflammatory properties, has been implicated in various liver diseases. This study aimed to elucidate the prognostic value of serum adiponectin levels in critically ill patients with liver disease.

Methods: This observational study included 161 critically ill patients admitted to the medical ICU of RWTH Aachen University Hospital due to acute liver failure or decompensated advanced chronic liver disease.

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Proprotein convertase subtilisin/kexin type 9 (PCSK9) regulates plasma low-density lipoprotein cholesterol (LDL-C) levels by promoting hepatic LDL receptor (LDL-R) degradation. We previously identified and optimized 13-mer cyclic peptides that bind to a novel, induced-fit pocket adjacent to the binding interface of PCSK9 and LDL-R and effectively disrupted the PCSK9/LDL-R protein-protein interaction (PPI) both in vitro and in vivo. However this series of large cyclic peptides required charged groups for function and lacked oral bioavailability in rodents.

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Background: Most patients undergoing bariatric surgery demonstrate elements of the metabolic syndrome (MetS) and can therefore be diagnosed with metabolically unhealthy obesity (MUO). Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) as hepatic manifestations of the MetS occur in many patients with obesity, but their leverage on postoperative improvement to Metabolic Health (MH), defined as absence of any metabolic comorbidity, remains unclear.

Objectives: The aim of this study was to assess the influence of liver health status, operative procedure, and sex on postoperative switch from a MUO to an MH phenotype.

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Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) affects approximately 20%-30% of the general population and is linked to high-caloric western style diet. However, there are little data that specific nutrients might help to prevent steatosis.

Methods: We analysed the UK Biobank (ID 71300) 24 h-nutritional assessments and investigated the association between nutrient intake calculated from food questionnaires and hepatic steatosis indicated by imaging or ICD10-coding.

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  • Differentiating acute liver failure (ALF) from acute-on-chronic liver failure (ACLF) is crucial for organ transplant referrals and urgency, particularly in patients with new liver disease.
  • A study measuring serum leptin levels in 160 critically ill liver disease patients found that ALF patients had significantly higher leptin concentrations compared to those with ACLF or decompensated advanced chronic liver disease (dACLD).
  • Serum leptin levels below 56 pg/mL were very effective in ruling out ALF, with a negative predictive value of 98.8%, and the leptin levels remained stable over the first 48 hours of ICU treatment.
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Diagnostic routine and knowledge about the therapy regimes of infectious diseases like malaria gain in importance due to globalization, global warming, and increasing numbers of refugees. We report a case of a 66-year-old patient who presented with severe abdominal pain, most prominent in the left upper abdomen. He was recently hospitalized with severe falciparum malaria, diagnosed after returning from a trip around the world.

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The kidney injury molecule (KIM)-1 is shed from proximal tubular cells in acute kidney injury (AKI), relaying tubular epithelial proliferation. Additionally, KIM-1 portends complex immunoregulation and is elevated after exposure to lipopolysaccharides. It thus may represent a biomarker in critical illness, sepsis, and sepsis-associated AKI (SA-AKI).

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We present the case of a 60-year-old male patient who was admitted to our hospital after experiencing a syncopal episode. First ECGs showed sinus rhythm with polymorphic premature ventricular complexes and later ventricular tachycardia with a left bundle branch block morphology were recorded. Imaging with TEE and MRI revealed a space-occupying lesion in the left ventricle, which was ultimately identified as a rare cardiac metastasis of renal cell carcinoma.

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Critical illness and sepsis may cause organ failure and are recognized as mortality drivers in hospitalized patients. Neuropilin-1 (NRP-1) is a multifaceted transmembrane protein involved in the primary immune response and is expressed in immune cells such as T and dendritic cells. The soluble form of NRP-1 (sNRP-1) acts as an antagonist to NRP-1 by scavenging its ligands.

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  • Primary biliary cholangitis (PBC) is a chronic liver disease that can lead to serious complications like fibrosis and cirrhosis; this study examines its effects on health outcomes and metabolic changes in a UK population.
  • The study involved 454 PBC patients and 908 matched controls, analyzing metabolic profiles and comorbidities, showing that PBC patients experienced higher rates of several diseases and almost triple the mortality rate compared to controls.
  • Findings suggest early detection and treatment of PBC could improve patient outcomes, as morbidity in PBC isn't solely linked to liver disease severity, highlighting the complex health impacts of this condition.
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Health-related quality of life (HRQoL) has recently gained importance as treatment options for tumors of the upper GI tract lead to improved long-term survival. HRQoL is often estimated by physicians even though their reliability and the impact of outside factors such as contact time and level of medical education is unclear. Therefore, in this study we investigated the correlation between physicians', students', and patients' assessment of HRQoL.

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We present an experiment on the immediate and lasting effects of reminder nudges in a complex environment. In the study, 1,542 subjects face a setting where, within a brief time frame, they have to pay attention to and perform multiple actions in a computer game. The experiment investigates i) the effect of reminders on the reminded actions and their spillovers on nonreminded actions; ii) spillovers between multiple nudges when the number of reminded actions is increased; and iii) intertemporal spillovers from having been exposed to reminders on actions after reminders are withdrawn.

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In Germany, physicians qualify for emergency medicine by combining a specialty medical training-e.g. internal medicine-with advanced training in emergency medicine according to the statutes of the State Chambers of Physicians largely based upon the Guideline Regulations on Specialty Training of the German Medical Association.

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Facing increasing economization in the health care sector, clinicians have to adapt not only to the ever-growing economic challenges, but also to a patient-oriented health care. Treatment costs are the most important variable for optimizing success when facing scarce human resources, increasing material- and infrastructure costs in general, as well as low revenue flexibility due to flat rates per case in Germany, the so-called Diagnosis-Related Groups (DRG). University hospitals treat many patients with particularly serious illnesses.

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(1) Background: Health-related quality of life (HRQoL) gains importance as novel treatment options for individuals with esophagogastric tumors to improve long-term survival. Impaired HRQoL has been shown to be a predictor of overall survival. Sarcopenia is a known prognostic factor for postoperative complications.

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Semaphorin 4D (Sema4D), also known as CD100, is a multifunctional transmembrane protein with immunoregulatory functions. Upon the activation of immune cells, soluble Semaphorin 4D (sSema4D) is proteolytically cleaved from the membrane by metalloproteinases. sSema4D levels are elevated in various (auto-)inflammatory diseases.

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Minimal-invasive resection of the esophagus for esophageal cancer has led to a relevant decrease in postoperative morbidity. Postoperatively, patients still suffer from surgical and adjuvant therapy-related symptoms impairing nutrition and quality of life. The aim of this study was to evaluate the nutritional status and associated symptoms six months after esophagectomy.

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Midkine (Mdk) is a multifunctional protein involved in inflammatory processes. Hence, circulating Mdk is increased in sepsis and has been previously suggested as a potential biomarker in these patients. The aim of this study was to elucidate the role of Mdk serum concentrations in critical illness and sepsis and to verify its value as a prognostic biomarker.

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Many modern automated vehicle sensor systems use light detection and ranging (LiDAR) sensors. The prevailing technology is scanning LiDAR, where a collimated laser beam illuminates objects sequentially point-by-point to capture 3D range data. In current systems, the point clouds from the LiDAR sensors are mainly used for object detection.

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Synopsis of recent research by authors named "Alexander Koch"

  • - Alexander Koch's research primarily focuses on the intersection of inflammation, signaling pathways, and measurement technologies in disease contexts, particularly sepsis and renal health.
  • - His studies explore mechanisms such as the role of sphingosine 1-phosphate (S1P) in promoting cyclooxygenase (COX)-2 expression, and the implications of serum biomarkers like asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA) in critically ill patients.
  • - Koch also contributes to developments in imaging techniques, specifically hyperspectral fluorescence imaging, and evaluates clinical interventions for improving health outcomes in older adults, underscoring his diverse approach to biomedical research.