20 research outputs found

    Health-Related Quality of Life and Mental Health after Surgical Treatment of Hepatocellular Carcinoma in the Era of Minimal-Invasive Surgery: Resection versus Transplantation

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    Laparoscopic liver resection (LLR) is an increasingly relevant treatment option for patients with resectable hepatocellular carcinoma (HCC). Orthotopic liver transplantation (OLT) has been considered optimal treatment for HCC in cirrhosis, but is challenged by rising organ scarcity. While health-related quality of life (HRQoL) and mental health are well-documented after OLT, little is known about HRQoL in HCC patients after LLR. We identified all HCC patients who underwent LLR at our hospital between 2014 and 2018. HRQoL and mental health were assessed using the Short Form 36 and the Hospital Anxiety and Depression Scale, respectively. Outcomes were compared to a historic cohort of HCC patients after OLT. Ninety-eight patients received LLR for HCC. Postoperative morbidity was 25% with 17% minor complications. LLR patients showed similar overall HRQoL and mental health to OLT recipients, except for lower General Health (p = 0.029) and higher anxiety scores (p = 0.010). We conclude that LLR can be safely performed in patients with HCC, with or without liver cirrhosis. The postoperative HRQoL and mental health are comparable to that of OLT recipients in most aspects. LLR should thus always be considered an alternative to OLT, especially in times of organ shortage

    Reactivity of Isocyanate-Functionalized Lignins: A Key Factor for the Preparation of Lignin-Based Polyurethanes

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    Using isocyanate-functionalized Kraft lignin as a reactive macromonomer for the preparation of polyurethane foams by a prepolymer technique is a well-known strategy to incorporate the biomacromolecule into a higher value polymer material. However, as of today the mechanical properties of the resulting materials are still insufficient for a number of possible applications. One reason for this limitation is that the reaction pathway and the morphological arrangement of such foams is of uttermost complexity and depends on a large number of influencing material-intrinsic factors. One important parameter is the reactivity of the functionalized lignin, which has a great impact on the interphase reaction kinetics and thus, on the geometry and mechanical properties of the resulting polyurethane foams. The reactivity is implied, amongst others, by the electron affinity of the isocyanate moiety. Herein, we investigate the reactivity of Kraft lignin modified with different commercially used isocyanates in the reaction with conventional polyols. Therefore, differently reactive prepolymers were synthesized, characterized and polyurethane foams were prepared thereof by using these compounds and the foam formation kinetics, morphological as well as mechanical properties were investigated. Finally, the results were supported by quantum mechanical calculations of the electron affinities of representative model compounds for the lignin-based prepolymers. This work gives rise to a better understanding of the effect of the reactivity and isocyanate structure linked to Kraft lignin on the polyurethane formation and enables rational choice of the isocyanate for pre-functionalization of lignin to prepare materials with better mechanical performance

    Fallvignetten und didaktische Muster. Forschungsartefakte im Kontext von Open Educational Resources und Practices

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    Lehrpraxis an der Hochschule ist eine Black Box – wie genau Hochschullehrende in Seminaren, Vorlesungen und Übungen agieren, bleibt weitgehend verborgen. Das Sichtbarmachen der Praxis und die Beleuchtung dieser Black Box ist ein zentrales Anliegen hochschuldidaktischer Forschung. Gleichzeitig werden mit Open Educational Resources (OER) und Open Educational Practices (OEP) neue Anforderungen an die Hochschulbildung herangetragen, wobei Deimann (2018) mangelnde Forschung zu diesen Themen beklagt. Zudem ist festzustellen, dass praxisbezogene Ergebnisse didaktischer Forschungsprojekte hĂ€ufig nur dann als OER gelabelt werden, wenn sie von Anfang an, bspw. durch Förderlinien, als solche angelegt wurden. Im Rahmen dieses Kurzpapers möchten wir zwei Artefakte (Fallvignetten und didaktische Entwurfsmuster) aus den Forschungsprojekten FideS Transfer und OPTion vorstellen und auf ihre Eignung als OER bzw. im Hinblick auf OEP untersuchen. Diese sind als offenes Lernmaterial, aber nicht explizit als OER konzipiert worden. Wie im Folgenden dargelegt wird, sind sie dennoch gut geeignet, um die Etablierung von OEP zu unterstĂŒtzen. Dieser Beitrag ist als Impulsgeber fĂŒr die Reflexion ĂŒber Forschungsartefakte als OER und OEP Produkte zu verstehen und macht auf die Problematik der Definitionen in Hinblick auf typische Produktionsbedingungen in hochschuldidaktischen Forschungskontexten aufmerksam. (DIPF/Orig.

    "ChatGPT and me" Erste Ergebnisse der quantitativen Auswertung einer Umfrage ĂŒber die LebensrealitĂ€t mit generativer KI an der UniversitĂ€t Hamburg

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    Im Kontext des Digital and Data Literacy in Teaching Projektes (DDLitLab) wurde im Juli eine Online-Umfrage zum Einsatz generativer KI an der UniversitĂ€t Hamburg durchgefĂŒhrt. Über 1.500 Mitglieder der UniversitĂ€t Hamburg haben sich beteiligt und dadurch erste Einblicke in die neue LebensrealitĂ€t mit generativer KI an der Hochschule ermöglicht. Der vorliegende Forschungsbericht enthĂ€lt die Auswertung der quantitativen Daten. Einstellungen und Nutzungsverhalten werden nach den unterschiedlichen Personengruppen „Studierende“, „Lehrende“ und „Sonstige“ aufgeschlĂŒsselt prĂ€sentiert, weiterhin wird auf Unterschiede von Altersgruppen und FakultĂ€tszugehörigkeiten eingegangen

    Reactivity of Isocyanate-Functionalized Lignins: A Key Factor for the Preparation of Lignin-Based Polyurethanes

    No full text
    Using isocyanate-functionalized Kraft lignin as a reactive macromonomer for the preparation of polyurethane foams by a prepolymer technique is a well-known strategy to incorporate the biomacromolecule into a higher value polymer material. However, as of today the mechanical properties of the resulting materials are still insufficient for a number of possible applications. One reason for this limitation is that the reaction pathway and the morphological arrangement of such foams is of uttermost complexity and depends on a large number of influencing material-intrinsic factors. One important parameter is the reactivity of the functionalized lignin, which has a great impact on the interphase reaction kinetics and thus, on the geometry and mechanical properties of the resulting polyurethane foams. The reactivity is implied, amongst others, by the electron affinity of the isocyanate moiety. Herein, we investigate the reactivity of Kraft lignin modified with different commercially used isocyanates in the reaction with conventional polyols. Therefore, differently reactive prepolymers were synthesized, characterized and polyurethane foams were prepared thereof by using these compounds and the foam formation kinetics, morphological as well as mechanical properties were investigated. Finally, the results were supported by quantum mechanical calculations of the electron affinities of representative model compounds for the lignin-based prepolymers. This work gives rise to a better understanding of the effect of the reactivity and isocyanate structure linked to Kraft lignin on the polyurethane formation and enables rational choice of the isocyanate for pre-functionalization of lignin to prepare materials with better mechanical performance

    Clinical and magnetic resonance imaging outcome predictors in pediatric anti–N‐methyl‐D‐aspartate receptor encephalitis

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    Objective: To evaluate disease symptoms, and clinical and magnetic resonance imaging (MRI) findings and to perform longitudinal volumetric MRI analyses in a European multicenter cohort of pediatric anti-N-methyl-D-aspartate receptor encephalitis (NMDARE) patients. Methods: We studied 38 children with NMDARE (median age = 12.9 years, range =1-18) and a total of 82 MRI scans for volumetric MRI analyses compared to matched healthy controls. Mixed-effect models and brain volume z scores were applied to estimate longitudinal brain volume development. Ordinal logistic regression and ordinal mixed models were used to predict disease outcome and severity. Results: Initial MRI scans showed abnormal findings in 15 of 38 (39.5%) patients, mostly white matter T2/fluid-attenuated inversion recovery hyperintensities. Volumetric MRI analyses revealed reductions of whole brain and gray matter as well as hippocampal and basal ganglia volumes in NMDARE children. Longitudinal mixed-effect models and z score transformation showed failure of age-expected brain growth in patients. Importantly, patients with abnormal MRI findings at onset were more likely to have poor outcome (Pediatric Cerebral Performance Category score > 1, incidence rate ratio = 3.50, 95% confidence interval [CI] = 1.31-9.31, p = 0.012) compared to patients with normal MRI. Ordinal logistic regression models corrected for time from onset confirmed abnormal MRI at onset (odds ratio [OR] = 9.90, 95% CI = 2.51-17.28, p = 0.009), a presentation with sensorimotor deficits (OR = 13.71, 95% CI = 2.68-24.73, p = 0.015), and a treatment delay > 4 weeks (OR = 5.15, 95% CI = 0.47-9.82, p = 0.031) as independent predictors of poor clinical outcome. Interpretation: Children with NMDARE exhibit significant brain volume loss and failure of age-expected brain growth. Abnormal MRI findings, a clinical presentation with sensorimotor deficits, and a treatment delay > 4 weeks are associated with worse clinical outcome. These characteristics represent promising prognostic biomarkers in pediatric NMDARE. ANN NEUROL 202

    Supply of protein feed to young pigs and chickens in organic farming

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    Supplying monogastric livestock with amino acids is a key challenge in animal husbandry. In organic farming, the challenges are even higher due to legislative restrictions on the use of high-quality protein feed and especially synthetic amino acids, the latter being common practice in conventional livestock production. For this reason, there are currently derogations that allow the use of non-organically produced protein feed to a limited extent. These exemptions have been increasingly restricted in recent years. Under current EU law, it is still permitted to mix non-organic protein feed into the diet of young poultry and pigs weighing less than 35 kg up to a proportion of 5% in feed (dry matter) from agricultural sources if there is a proven lack of availability of organically produced protein feed. Until this derogation expires in 2026, all EU member states are required to prepare an annual report on the use and availability of organically produced protein feed. In addition, it is crucial to know the amino acid requirements of the animals, which protein feeds are available to meet these requirements and the effects on animal welfare and health, if the supply of amino acids is insufficient. Amino acid requirement depends on genetics, age, performance (predisposition) and husbandry conditions (exercise, climate, immune system, etc.). It is therefore difficult to determine exact requirements for each animal. Intake and bioavailability of amino acids also depend on the feeding regimen (feed used, ratio to energy and other nutrients, etc.). There are numerous studies that show that the potential to supply pigs with 100% organic feed without negative effects on animal welfare and health under good husbandry conditions. An extended suckling period and an optimized rearing feed after weaning can be important factors. For chickens, the challenge is particularly great in the early rearing phase, as they place high demands on protein quality during this period, regardless of the direction of use.Die Versorgung von monogastrischen Nutztieren mit AminosĂ€uren ist eine zentrale Herausforderung in der Tierhaltung. Werden die Tiere unter den Bedingungen des Ökologischen Landbaus gehalten, wird die Versorgung durch Restriktionen bezĂŒglich des Einsatzes hochwertiger Proteinfuttermittel und synthetischer AminosĂ€uren, die in der nicht-ökologischen Erzeugung ĂŒblicherweise eingesetzt werden, weiter erschwert. Aus diesem Grund gibt es derzeit Ausnahmegenehmigungen, die den Einsatz nicht-ökologisch erzeugter Proteinfuttermittel in einem geringen Umfang erlauben. Diese Ausnahmegenehmigungen wurden in den letzten Jahren immer weiter eingeschrĂ€nkt. Derzeit ist es nach geltendem EU-Recht bei nachgewiesen fehlender VerfĂŒgbarkeit von Proteinfuttermitteln aus ökologischer Erzeugung noch erlaubt, in die Ration von JunggeflĂŒgel und Schweinen, die unter 35 kg wiegen, nicht-ökologische Proteinfuttermittel bis zu einem Anteil von 5 % einzumischen (bezogen auf die Trockensubstanz der Futtermittel landwirtschaftlichen Ursprungs). Bis zum Auslaufen dieser Ausnahmegenehmigung im Jahr 2026 wird jĂ€hrlich von allen Mitgliedsstaaten der EU ein Bericht zum Einsatz bzw. der VerfĂŒgbarkeit von ökologisch erzeugten Proteinfuttermitteln erstellt. ZusĂ€tzlich ist es relevant, zu wissen, welcher Bedarf an AminosĂ€uren fĂŒr die Tiere besteht, welche Proteinfuttermittel es zur Deckung dieses Bedarfes gibt und welche Effekte auf das Tierwohl inklusive der Tiergesundheit bei einer nicht ausreichenden (bedarfsgerechten) Versorgung mit AminosĂ€uren zu erwarten sind. In diesem Working Paper sind Informationen zu diesen Themen zusammengestellt. Der Bedarf an AminosĂ€uren ist abhĂ€ngig von der Genetik, Alter, Leistung bzw. Leistungsveranlagung und Haltungsbedingungen (Bewegung, Klima, Immunsystem, u. a.). Es ist daher schwierig, exakte Bedarfsangaben fĂŒr jedes Tier zu ermitteln. Die Aufnahme und VerfĂŒgbarkeit der AminosĂ€uren ist zudem abhĂ€ngig vom FĂŒtterungsregime (eingesetzte Futtermittel, VerhĂ€ltnis zu Energie und anderen NĂ€hrstoffen, etc.). Es gibt zahlreiche Studien, die zeigen, dass die Versorgung von Schweinen mit 100%-Biofutter ohne negative Auswirkungen auf das Tierwohl unter guten Haltungsbedingungen möglich ist. Eine verlĂ€ngerte SĂ€ugezeit und ein angepasstes Aufzuchtfutter nach dem Absetzen können wichtige Stellschrauben sein. Bei HĂŒhnern ist die Herausforderung vor allem in der frĂŒhen Aufzuchtphase groß, da sie in diesem Zeitraum unabhĂ€ngig von der Nutzungsrichtung hohe AnsprĂŒche an die ProteinqualitĂ€t stellen
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