Responsiveness to second and third dose of mRNA COVID-19 vaccination in adolescent and young adult heart transplant recipients.

Background: Third-dose mRNA COVID-19 vaccine is currently recommended in the United States for SOT recipients based in part on data showing diminished immune response, including Ab production, after a two-dose regimen. Data on vaccine response in adolescent and young adult SOT recipients are limited, including no data reported on third-dose responsiveness.

Methods: Results of serologic testing in a convenience sample of 28 vaccinated adolescent and young adult HT recipients at a single institution were collected from the medical record and summarized.

Early findings after integration of donor-derived cell-free DNA into clinical care following pediatric heart transplantation.

Background: Endomyocardial biopsy (EMB) is costly and discomforting yet remains a key component of surveillance after pediatric heart transplantation (HT). Donor-derived cell-free DNA (dd-cfDNA) has been histologically validated with high negative predictive value, offering an alternative to surveillance EMB (sEMB).

Methods: We implemented an alternative surveillance protocol using commercially available dd-cfDNA assays in place of sEMB after pediatric HT.

Oncological colorectal surgery during the COVID-19pandemic-a national survey.

Purpose: The aim of this study was to clarify the surgical supply situation of oncological colorectal patients in Germany during limitations of the OR caseload due to the COVID-19 pandemic.

Methods: Between 11th and 19th April 2020, all members of a consortium of German colorectal cancer centers were invited to participate in a web-based survey on the current status of surgical care situation of colorectal cancer patients in Germany.

Results: A total of 112 colorectal surgeons of 101 German hospitals participated in the survey.

Mathematical modelling in cell migration: tackling biochemistry in changing geometries.

Directed cell migration poses a rich set of theoretical challenges. Broadly, these are concerned with (1) how cells sense external signal gradients and adapt; (2) how actin polymerisation is localised to drive the leading cell edge and Myosin-II molecular motors retract the cell rear; and (3) how the combined action of cellular forces and cell adhesion results in cell shape changes and net migration. Reaction-diffusion models for biological pattern formation going back to Turing have long been used to explain generic principles of gradient sensing and cell polarisation in simple, static geometries like a circle.

[Implementation of a fast track program : Challenges and solution approaches].

Background: For more than a decade the evolving concept of fast track surgery has been implemented, predominantly in colorectal surgery. The practice of fast track surgery has yielded excellent results concerning reduction of postoperative complications and hospital stay and has been shown to increase patient satisfaction; however, several studies have shown a sometimes alarmingly low rate of implementation of the individual fast track measures and the rate is a maximum of 44%.

Objective: In this review, obstacles for implementation of fast track surgery are investigated.

[Obstacles and facilitators of conducting studies - the perspective of colorectal cancer centers' coordinators].

Introduction: Clinical trials and health services research are crucial pillars for improving patient care. This paper examines factors inhibiting and promoting the study activity and the knowledge and use of trial registries (e. g.

Parameter identification problems in the modelling of cell motility.

We present a novel parameter identification algorithm for the estimation of parameters in models of cell motility using imaging data of migrating cells. Two alternative formulations of the objective functional that measures the difference between the computed and observed data are proposed and the parameter identification problem is formulated as a minimisation problem of nonlinear least squares type. A Levenberg-Marquardt based optimisation method is applied to the solution of the minimisation problem and the details of the implementation are discussed.

[Certified stomach cancer centres as seen by their directors: results of a questionaire to key personnel].

Since 2003 the German Cancer Society (Deutsche Krebsgesellschaft, DKG) has been certifying specific organ cancer centers in Germany. After 8 years activity, there are now more than 600 certified cancer centres that, as required by the national cancer plan, enable "oncological management at an assured quality level" in Germany. Anmong them are more than 200 certified centres for stomach cancer, that treat about 25 % of all newly diagnosed cases of stomach cancer.

Modelling cell motility and chemotaxis with evolving surface finite elements.

We present a mathematical and a computational framework for the modelling of cell motility. The cell membrane is represented by an evolving surface, with the movement of the cell determined by the interaction of various forces that act normal to the surface. We consider external forces such as those that may arise owing to inhomogeneities in the medium and a pressure that constrains the enclosed volume, as well as internal forces that arise from the reaction of the cells' surface to stretching and bending.

Phase-field model for multiphase systems with preserved volume fractions.

We report on an interesting formulation of a phase-field model which incorporates a description of individual phases and particles with preserved volume evolving in a system of multiple phases such that the interfacial energy decreases. In our model, an antiforcing free energy density is defined to fulfill constraints on selected volume fractions by counterbalancing phase changes. Phases are defined as regions with energy bearing boundaries that may differ in their physical states, i.

Perioperative prophylaxis with granulocyte colony-stimulating factor (G-CSF) in high-risk colorectal cancer patients for an improved recovery: A randomized, controlled trial.

Background: We aimed to improve the postoperative outcome of high-risk patients (American Society of Anesthesiologists class 3 and 4) recovering from colorectal cancer surgery by using recombinant human G-CSF (filgrastim) as perioperative prophylaxis.

Methods: In a double-blinded, placebo-controlled trial, 80 patients undergoing left-sided colorectal resection were randomized to filgrastim or placebo. Filgrastim (5 mug/kg) or placebo was administered in the afternoon on day -1, 0, and +1 relative to the operation.

Exploring the relationship between hydrologic parameters and nutrient loads using digital elevation model and GIS - a case study from Sugarcreek headwaters, Ohio, U.S.A.

Ohio is typical among the Midwestern and Eastern United States with high levels of water pollutants, the main sources being from agriculture. In this study, we used a digital elevation model in conjunction with hydrological indices to determine the role of landscape complexity affecting the spatial and temporal variation in pollutant levels, in one of the most impaired headwater streams in Ohio. More than eighty five percent of the study area is dominated by agriculture.

Neuroendocrine tumours (carcinoids) of the appendix.

Neuroendocrine tumours (NETs) of the appendix (formerly 'carcinoids') are rare and are usually detected incidentally after appendectomy. Histopathologically they derive from a subepithelial cell population, which is different from NETs in other sites. They are preferentially located at the tip of the appendix.

Multicomponent alloy solidification: phase-field modeling and simulations.

A general formulation of phase-field models for nonisothermal solidification in multicomponent and multiphase alloy systems is derived from an entropy functional in a thermodynamically consistent way. General expressions for the free energy densities, for multicomponent diffusion coefficients, and for both weak and faceted types of surface energy and kinetic anisotropy are possible. A three-dimensional simulator is developed to show the capability of the model to describe phase transitions, complex microstructure formation, and grain growth in polycrystalline textures.

Dependence of positive effects of granulocyte colony-stimulating factor on the antibiotic regimen: evaluation in rats with polymicrobial peritonitis.

We tested the hypothesis that the ability of granulocyte colony-stimulating factor (G-CSF) to prevent death from fecal peritonitis is influenced by the composition of the antibiotic regimen with which it is administered. We used a rodent model of polymicrobial peritoneal contamination and infection and the concept of clinical modeling randomized trials (CMRTs), which includes the conditions of randomized, clinical trials and complex clinical interventions (e.g.

Antibiotic prophylaxis influences cardiovascular stability in complicated surgery.

Objective: Antibiotic prophylaxis is used in many surgical procedures but there are frequent cardiovascular instabilities following antibiotics in perioperative period. A clinic modelling randomised trial (CMRT) in pigs was developed to compare the effects of 2 commonly used antibiotic combinations on cardiovascular stability during major surgery.

Materials And Methods: Thirty pigs (both sexes) were randomised into 3 groups, receiving either saline (placebo), co-amoxiclav or cefuroxime/metronidazole in clinically relevant doses as antibiotic prophylaxis.

Quality of life profile: from measurement to clinical application.

Quality of life (QoL) can be assessed in an accurate, valid and reliable way by means of standardized QoL questionnaires and is an important endpoint in clinical trials today. The aim of this study is to implement quality of life as a diagnostic tool for problem-oriented follow-up care of cancer patients. This is done in the framework of an intervention study in the area of regional health care research using qualitative analysis and the methodological concept of barrier analysis.

Early and late histamine release induced by albumin, hetastarch and polygeline: some unexpected findings.

Objective: The perioperative use of colloidal plasma substitutes is still under discussion. We therefore conducted a prospective randomised study with three commonly used plasma substitutes to examine their histamine releasing effects in 21 volunteers. MATERIAL OR SUBJETS: 21 male volunteers were enrolled in this prospective, randomised, controlled clinical study.

[Reduction of cardiovascular disorders by preventive perioperative antihistamine administration in general surgery: are the drugs interchangeable?].

In clinical reality the drugs used for H1/H2-prophylaxis are not restricted to the combination of dimetinden/cimetidine, also only for this combination the effectiveness for preventing severe cardiorespiratory disturbances is proven in a randomised controlled clinical trial. However, it is almost impossible to conduct such an extended clinical trial in order to check all possible combinations. Instead of this, we developed a complex animal model featuring clinical variability and the principles of a well conducted randomised controlled clinical trial (CMRT = clinic modelling randomised trials), to evaluate different H1/H2 combinations.

[Heterologous transplantation of human parathyroid glands after microencapsulation with clinically suitable alginate : long-term function without immunosuppression in the animal model].

The role of parathyroid transplantation for the therapy of permanent hypoparathyroidism is undisputed. Because the parathyroid hormone deficiency syndromee rarely every is a vital thread to patients affected, systemic immunosuppression for transplant recipients is not justified. A technique of microencapsulation was modified for transplantation of parathyroid tissue.

[Effect of perioperative antibiotic prophylaxis on hemodynamic stability during surgery: detection of complex interaction in a simulated clinical randomized animal study].

In a clinic modelling randomised trial (CMRT) in three groups of 10 land-race pietren pigs each it could be shown that the influence of prophylactic antibiotic administration on intraoperative hemodynamic stability and histamine release is only evident, if by stepwise addition of complicating factors the overall complexity of the experimental setting is increased. Different antibiotic regimen for prophylaxis significantly affected the incidence of cardiovascular instabilities only after relevant blood loss, restoration of circulation and subsequent submaximal induction of anaphylactoid reactions by the histamine liberator Polymyxin B. In conclusion, preclinical testing of therapeutic agents in complex clinic modelling randomised trials should be mandatory to avoid the possible hazards of misconducted clinical trials.

Granulocyte colony-stimulating factor but not peritoneal lavage increases survival rate after experimental abdominal contamination and infection.

Background: The value of peritoneal lavage for intra-abdominal contamination and infection has never been proven scientifically. In contrast, the stimulation of host defence mechanisms with cytokines such as granulocyte colony-stimulating factor (G-CSF) has appeared promising in recent clinical trials.

Methods: Clinic modelling randomized trials (CMRTs), which model the complexity of the clinical reality, were used in rats in which peritoneal contamination and infection (PCI) was produced with human stool bacteria.

[Surgical therapy of rectal carcinoma. Portrayal of the current health care status within the scope of a district quality assurance study].

Unlabelled: In an era of economic pressure, patient's participation in decision-making and evidence-based medicine, the need for quality assurance of medical processes in daily routine becomes increasingly important. The aim of this quality assessment study is to demonstrate the real state of surgical care of patients with rectal carcinoma in the context of a field study on quality management in oncology.

Methods: Prolective cohort-study, small-area-analysis.

Nasogastric tube versus gastrostomy tube for gastric decompression in abdominal surgery: a prospective, randomized trial comparing patients' tube-related inconvenience.

Background: Perioperative decompression of the stomach is still a common procedure and can be achieved using either nasogastric tubes (NTs) or gastrostomy tubes (GTs). While both procedures appear to be equally effective, some authors believe that NTs are less convenient for patients than GTs. However, to date, no reliable prospective data are available on this issue.