Publications by authors named "Groll A"

Feature engineering is of critical importance in the field of Data Science. While any data scientist knows the importance of rigorously preparing data to obtain good performing models, only scarce literature formalizes its benefits. In this work, we present the method of Statistically Enhanced Learning (SEL), a formalization framework of existing feature engineering and extraction tasks in Machine Learning (ML).

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Aspergillus and Candida are ubiquitous fungi included in the group of high priority in the World Health Organization list of fungal pathogens. They are found in various ecosystems and the environmental role in increasing the resistance to antifungals has been shown. Thus, we aimed to determine the occurrence of Aspergillus spp.

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: Empirical antibacterial therapy for febrile neutropenia reduces mortality due to Gram-negative blood stream infections (BSIs). Pediatric guidelines recommend monotherapy with an antipseudomonal beta-lactam or a carbapenem and to add a second anti-Gram-negative agent in selected situations. We evaluated the changes in the proportions of resistance of beta-lactam monotherapies vs.

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Purpose: Musculoskeletal sarcomas are a rare group of malignant neoplasms, accounting for approximately 12 % of all malignant neoplasms among children. Childhood cancer outcomes vary between developed and developing countries due to financial and educational inequalities. Telemedicine programs have a huge impact on the quality of cancer care, helping to optimize resources for better cancer care in a resource-limited setting.

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Article Synopsis
  • Invasive aspergillosis (IA) and mucormycosis (IM) significantly affect severely ill patients, prompting the approval of isavuconazonium sulfate for treating these fungal infections in both adults and recently in children.
  • A phase 2 study involved 31 pediatric patients across multiple countries, revealing a 54.8% overall response rate to treatment and a low 6.5% all-cause case fatality at 42 days.
  • Although 93.5% of participants experienced treatment-emergent adverse events (TEAEs), the drug was generally well tolerated, and dosing conformed to safety standards previously established in adult studies.
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Medically important pathogenic fungi invade vertebrate tissue and are considered primary when part of their nature life cycle is associated with an animal host and are usually able to infect immunocompetent hosts. Opportunistic fungal pathogens complete their life cycle in environmental habitats or occur as commensals within or on the vertebrate body, but under certain conditions can thrive upon infecting humans. The extent of host damage in opportunistic infections largely depends on the portal and modality of entry as well as on the host's immune and metabolic status.

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  • Recent guidelines suggest using quantitative PCR (qPCR) to guide early treatment for toxoplasmosis in patients who received allogeneic hematopoietic cell transplantation (allo-HCT).
  • A study analyzing qPCR data from 85 patients found that higher initial parasitic loads were linked to slower clearance and increased mortality risk if patients didn't reach negativity within ten days.
  • The findings indicate that monitoring qPCR kinetics can help clinicians identify high-risk patients, prompting potential adjustments to their treatment if necessary.
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In this work, a method to regularize Cox frailty models is proposed that accommodates time-varying covariates and time-varying coefficients and is based on the full likelihood instead of the partial likelihood. A particular advantage of this framework is that the baseline hazard can be explicitly modeled in a smooth, semiparametric way, for example, via P-splines. Regularization for variable selection is performed via a lasso penalty and via group lasso for categorical variables while a second penalty regularizes wiggliness of smooth estimates of time-varying coefficients and the baseline hazard.

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Simultaneous positron emission tomography (PET)/magnetic resonance imaging provides concurrent information about anatomic, functional, and molecular changes in disease. We are developing a second generation MR-compatible RF-penetrable TOF-PET insert. The insert has a smaller scintillation crystal size and ring diameter compared to clinical whole-body PET scanners, resulting in higher spatial resolution and sensitivity.

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Background: Invasive fungal disease (IFD) causes morbidity and mortality in immunocompromised hosts (ICHs). Based on increasing recognition of the impact of IFD on human disease, a recent WHO priority list identified key areas of need.

Objectives: This review examines changes in the epidemiology of IFD, in particular the emergence of antifungal-resistant pathogens and the current availability of rapid diagnostic tests and antifungal treatment options.

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Purpose: Cardiopulmonary exercise testing (CPET) is considered the gold standard for assessing cardiorespiratory fitness. To ensure consistent performance of each test, it is necessary to adapt the power increase of the test protocol to the physical characteristics of each individual. This study aimed to use machine learning models to determine individualized ramp protocols based on non-exercise features.

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Background: Data on antifungal prescribing in neonatal patients are limited to either single-center or single-country studies or to 1-day recording. Therefore, we assessed antifungal longitudinal usage in neonatal units (NUs) within Europe.

Methods: CALYPSO, a prospective weekly point prevalence study on antifungal drug usage in NUs in 18 hospitals (8 European countries), was conducted in 2020 during a 12-week period.

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Background: Infections are a major cause of morbidity in children with primary or secondary immunodeficiency, and have a negative impact on overall outcome.

Objectives: This narrative review presents select paediatric-specific aspects regarding the clinical impact, diagnosis, management, and follow-up of infectious complications in patients with primary and secondary immunodeficiencies.

Sources: PubMed until January 2024 and searched references in identified articles including the search terms: infection, immunodeficiency or cancer, diagnostics, antimicrobial agents, bacteria or fungus or virus, and follow-up.

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Article Synopsis
  • Researchers studied 284 young children in South Africa who started HIV treatment early to see how well they could control the virus after treatment.
  • About 84% of these kids managed to hide the virus while on treatment, but only 32% were still virus-free after more than 3 years.
  • Some boys were able to stay virus-free even after stopping their treatment for months, which might be linked to differences in how boys and girls' immune systems respond to the virus.
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  • - The rising rate of invasive fungal infections (IFIs) in Germany poses a serious health issue, particularly for immunocompromised patients, and is complicated by diagnostic challenges and increasing antifungal resistance.
  • - A survey of 58 hospitals revealed that while many facilities have adequate diagnostic tools, there are significant differences in resources, particularly for high-risk patients, with specialized hospitals offering better access to necessary services.
  • - The study emphasizes the need for improved diagnostic and treatment practices for IFIs to enhance patient outcomes, highlighting the importance of ongoing research and collaboration in this field.
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Systemic antifungal therapy is critical for reducing the mortality from many invasive and chronic fungal infections. Triazole antifungals are the most frequently prescribed antifungals but require attention to dosing and drug interactions. Nearly 600 severe drug-drug interactions and over 1100 moderate interactions requiring dose modifications are described or anticipated with systemic antifungal agents (see https://www.

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Article Synopsis
  • Fungal infections are becoming more common because more people are at risk and climate change is affecting health.
  • There are only a few types of antifungal medicines available, and they have problems like resistance from fungi and side effects that need close monitoring.
  • Scientists are exploring new antifungal options, including inhaled treatments and ways to boost the immune system, to better fight these infections and understand issues like drug resistance.
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Pneumocystis jirovecii can cause life-threatening pneumonia (PjP), and patients with haematological malignancies are at high risk of this infection. Prophylactic measures have significantly decreased morbidity and mortality, but there is a paucity of contemporary data on the incidence and clinical course of PjP in well-defined and homogenous patient populations, such as children suffering from acute lymphoblastic leukaemia (ALL). In the multi-international trial AIEOP-BFM ALL2009, PjP was diagnosed in six children (incidence 1/1000) and was associated with insufficient prophylaxis in five of them.

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mRNA vaccine technologies introduced following the SARS-CoV-2 pandemic have highlighted the need to better understand the interaction of adjuvants and the early innate immune response. Type I interferon (IFN-I) is an integral part of this early innate response that primes several components of the adaptive immune response. Women are widely reported to respond better than men to tri- and quadrivalent influenza vaccines.

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Background: Vaccination against SARS-CoV-2 is recommended for cancer patients. However, long-term data on the effectiveness in the pediatric setting are lacking.

Methods: Pediatric patients < 18 years on active treatment for cancer and without prior SARS-CoV-2 infection received three doses of an mRNA vaccine.

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Cryptococcosis is a major worldwide disseminated invasive fungal infection. Cryptococcosis, particularly in its most lethal manifestation of cryptococcal meningitis, accounts for substantial mortality and morbidity. The breadth of the clinical cryptococcosis syndromes, the different patient types at-risk and affected, and the vastly disparate resource settings where clinicians practice pose a complex array of challenges.

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Introduction: Letermovir is a cytomegalovirus (CMV) terminase complex inhibitor approved for prophylaxis of CMV infection and disease in adult CMV-seropositive allogeneic hematopoietic cell transplantation (allo-HCT) recipients (R+). We report pharmacokinetics (PK), safety, and efficacy of letermovir in adolescent (12-18 years) allogeneic HCT recipients from an ongoing clinical study.

Methods: In this phase 2b, multicenter, open-label study (NCT03940586), 28 adolescents received 480 mg letermovir [240 mg with cyclosporin A (CsA)] once daily orally or intravenously.

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Background: Seroprevalence studies have shown that 70% of children are exposed to Cryptococcus , the most common cause of meningitis in people living with human immunodeficiency virus (HIV), but reported pediatric disease prevalence is much lower than in adults.

Methods: PubMed and Ovid Global Health databases were searched with the terms "cryptococcosis," "cryptococcal meningitis," " Cryptococcus neoformans " or " Cryptococcus gattii ." All studies reporting pediatric specific data in the English language from 1980 up until December 2022 were included.

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