Friedrich-Alexander University Research Articles

Support after return to alcohol use: a mixed-methods study on how abstinence motivation and app use change after return to alcohol use in an app-based aftercare intervention for individuals with alcohol use disorder

BackgroundAs the return to alcohol use in individuals with alcohol use disorder (AUD) is common during treatment and recovery, it is important that abstinence motivation is maintained after such critical incidences. Our study aims to explore how individuals with AUD participating in an app-based intervention with telephone coaching after inpatient treatment perceived their abstinence motivation after the return to alcohol use, whether their app use behavior was affected and to identify helpful factors to maintain abstinence motivation.MethodsUsing a mixed-methods approach, ten participants from the intervention group of the randomized controlled trial SmartAssistEntz who returned to alcohol use and recorded this in the app Appstinence, a smartphone application with telephone coaching designed for individuals with AUD, were interviewed about their experiences. The interviews were recorded, transcribed and coded using qualitative content analysis. App use behavior was additionally examined by using log data.ResultsOf the ten interviewees, seven reported their abstinence motivation increased after the return to alcohol use. Reasons included the reminder of negative consequences of drinking, the desire to regain control of their situation as well as the perceived support provided by the app. App data showed that app use remained stable after the return to alcohol use with an average of 58.70 days of active app use (SD = 25.96, Mdn = 58.50, range = 24–96, IQR = 44.25) after the return to alcohol use which was also indicated by the participants’ reported use behavior.ConclusionsThe findings of the study tentatively suggest that the app can provide support to individuals after the return to alcohol use to maintain and increase motivation after the incidence. Future research should (1) focus on specifically enhancing identification of high risk situations and reach during such critical incidences, (2) actively integrate the experience of the return to alcohol use into app-based interventions to better support individuals in achieving their personal AUD behavior change goals, and (3) investigate what type of support individuals might need who drop out of the study and intervention and discontinue app use altogether.Trial registrationThe primary evaluation study is registered in the German Clinical Trials Register (DRKS, registration number DRKS00017700) and received approval of the ethical committee of the Friedrich-Alexander University Erlangen-Nuremberg (193_19 B).

Effects of high-intensity training on fatty infiltration in paraspinal muscles in elderly males with osteosarcopenia – the randomized controlled FrOST study

BackgroundOsteosarcopenia is a common geriatric syndrome with an increasing prevalence with age, leading to secondary diseases and complex consequences such as falls and fractures, as well as higher mortality and frailty rates. There is a great need for prevention and treatment strategies.MethodsIn this analysis, we used magnetic resonance imaging (MRI) data from the randomised controlled FrOST trial, which enrolled community-dwelling osteosarcopenic men aged > 72 years randomly allocated to 16 months of twice-weekly high-intensity resistance training (HIRT) or a non-training control group. MR Dixon imaging was used to quantify the effects of HIRT on muscle fat infiltration in the paraspinal muscles, determined as changes in muscle tissue, fat faction and intermuscular adipose tissue (IMAT) in the erector spinae and psoas major muscles. Intention-to-treat analysis with multiple imputation was used to analyse the data set.ResultsAfter 16 months of intervention, 15 men from the HIRT and 16 men from the CG were included in the MRI analysis. In summary, no positive effects on the fat infiltration of the erector spinae and psoas major muscles were observed.ConclusionsThe previously reported positive effects on lumbar spine bone mineral density (BMD) suggest that mechanotransduction induces tropic effects on bone, but that fat infiltration of the erector spinae and psoas major muscles are either irreversible or, for some unknown reason, resistant to exercise. Because of the beneficial effects on spinal BMD, HIRT is still recommended in osteosarcopenic older men, but further research is needed to confirm appropriate age-specific training exercises for the paraspinal muscles. The potential of different MRI sequences to quantify degenerative and metabolic changes in various muscle groups must be better characterized.Trial registrationsFrOST was approved by the University Ethics Committee of the Friedrich-Alexander University of Erlangen-Nürnberg (number 67_15b and 4464b) and the Federal Office for Radiation Projection (BfS, number Z 5–2,246,212 – 2017–002). Furthermore, it fully complies with the Declaration of Helsinki and is registered at ClinicalTrials.gov: NCT03453463 (05/03/2018). JAMA 310:2191–2194, 2013.

Aerodynamic Analysis of Low-Pressure Axial Fans Installed in Parallel

Abstract Ducted rotor-only low-pressure axial fans play an integral role in automotive thermal management. The tightly packed under-hood region and down-stream heat-exchanger shape limit the fan diameter. In order to circumvent this limitation, multiple cooling fans of small diameters are tightly packaged and placed in parallel. Currently, there is limited scientific work, that study the aerodynamics of low-pressure axial fans when installed in parallel. This work aims to quantify the aerodynamic performance and the flow-field as a result of installing low-pressure axial fans in parallel through computational fluid dynamics (CFD). Publicly available experimental data from Friedrich-Alexander University is used for the validation of the numerical setup. Three-dimensional, full-annulus, unsteady Reynolds-averaged Navier-Stokes (URANS) analysis has been performed for both a single-fan and two-fans installed in parallel and their respective aerodynamic performance has been compared for the operation condition identified as the best efficiency point in experiments. Only small differences are observed in the overall aerodynamic performance of the two-fans in parallel compared to a single-fan. A circumferential nonuniformity in the form of a local high-pressure zone at the inlet of the fan is observed when the two-fans are placed in parallel. The resulting circumferential nonuniformity is quantified, both in space and time. A strong correlation is found between the pressure fields of the two-fans installed in parallel.

Current issues and future directions in engineering ethics education

This paper reports on engineering ethics education (EEE)-related issues based on a comparison of three technical universities: Budapest University of Technology and Economics, Friedrich-Alexander University, and Istanbul Technical University. Besides the presentation of the current state of EEE, future challenges are also discussed.

PLANNING AND DEVELOPING AN ONLINE ENGLISH WRITING COURSE FOR COMPUTER SCIENCE: A PRACTICAL GUIDE

An online English course for computer science students at the B2 level was conceptualized for the E-learning institution Virtuelle Hochschule Bayern between Friedrich-Alexander University Erlangen-Nuremberg and the Technische Hochschule Nuremberg Georg Simon Ohm. The course consists of four separate modules that cumulatively target writing and language skills relevant to computer science students. Individual assessments at the end of each module serve as a review. Further, students write keystone pieces throughout the course that constitute a writing portfolio. The students’ written pieces are targeted assignments that encapsulate both the writing and the language skills addressed in each module. For instructors, these provide insight into how well students acquired the requisite skills. The writing skills cover online writing tools (COCA, AntConc, OneLook, Quillbot), software documentation, expository text based on pseudocode, and finally, summarizing/paraphrasing tools. These are reinforced through language skills that either have greater prominence in the computer science field or are frequently used for the respective writing skills. Comma and hyphen rules, maintaining objectivity in writing, describing data in figures, and embedded clauses in English are some of the language skills covered. For materials development, a combination of corpus and AI writing tools were implemented to analyse and modify authentic scientific literature. Examples, keywords, and patterns of writing taken from authentic texts were modified to create exercises relevant to topics presented in the modules. The course provides strong didactic support for instructors whose aim is to facilitate a more natural set of writing tasks and students' ability to apply the learned skills beyond the classroom.

Anti‐SARS‐CoV‐2 Inhibitory Profile of New Quinoline Compounds in Cell Culture‐Based Infection Models

Invited for the cover of this issue are Manfred Marschall, Svetlana B. Tsogoeva and co‐workers at Friedrich‐Alexander University of Erlangen–Nürnberg. The image depicts a new anti‐SARS‐CoV‐2 compound in front of SARS‐CoV‐2 viruses. Read the full text of the article at 10.1002/chem.202103861.

Transplant Ureteral Stenosis after Renal Transplantation: Risk Factor Analysis

Introduction: The results of kidney transplants have improved dramatically in recent years, leading to reduced morbidity and mortality. Despite continuous improvements, urological complications occur at a rate of 2.6%–15%. Ureteral stenosis of graft ureters is the most common complication, with a probability of 0.5%–6.3%. This study aimed to determine the incidence of ureteral stenosis after kidney transplantation and identify risk factors that distinguish transplant patients with and without ureteral stenosis. Methods: This study retrospectively analyzed patients who had undergone kidney transplantation at the Department of Urology of the Friedrich-Alexander University Erlangen-Nuremberg between 2001 and 2015. Forty-seven patients developed ureteral stenosis during the operation. Most of the ureteral stenosis cases occurred in the first 4 months after transplantation. Kaplan-Meier analysis and the log-rank test were used to calculate the cumulative risk, and the Mann-Whitney U test was used nonparametrically. The significance level was set at p < 0.05. Results: Statistical analysis showed that residual diuresis (p = 0.008), cold ischemia time (CIT) (p = 0.040), the body mass index (p = 0.027), and donor serum creatinine value (p = 0.039) showed a significantly different distribution between recipients with or without ureteral stenosis after kidney transplantation. In multivariate Cox’s regression modeling, residual diuresis and the donor serum creatinine level were identified as the only independent predictors of patients’ stenosis-free survival. Conclusion: Urological complications not diagnosed and treated in time endanger the success of kidney transplantation. After evaluating the kidney transplantation data of the patients at the Transplant Center Erlangen-Nuremberg from 2001 to 2015, residual diuresis, CIT, the body mass index, and donor serum creatinine value were found to influence the development of ureteral stenosis.

SARS-CoV-2 worldwide replication drives rapid rise and selection of mutations across the viral genome: a time-course study - potential challenge for vaccines and therapies.

Scientists and the public were alarmed at the first large viral variant of SARS‐CoV‐2 reported in December 2020. We have followed the time course of emerging viral mutants and variants during the SARS‐CoV‐2 pandemic in ten countries on four continents. We examined > 383,500 complete SARS‐CoV‐2 nucleotide sequences in GISAID (Global Initiative of Sharing All Influenza Data) with sampling dates extending until April 05, 2021. These sequences originated from ten different countries: United Kingdom, South Africa, Brazil, United States, India, Russia, France, Spain, Germany, and China. Among the 77 to 100 novel mutations, some previously reported mutations waned and some of them increased in prevalence over time. VUI2012/01 (B.1.1.7) and 501Y.V2 (B.1.351), the so‐called UK and South Africa variants, respectively, and two variants from Brazil, 484K.V2, now called P.1 and P.2, increased in prevalence. Despite lockdowns, worldwide active replication in genetically and socio‐economically diverse populations facilitated selection of new mutations. The data on mutant and variant SARS‐CoV‐2 strains provided here comprise a global resource for easy access to the myriad mutations and variants detected to date globally. Rapidly evolving new variant and mutant strains might give rise to escape variants, capable of limiting the efficacy of vaccines, therapies, and diagnostic tests.

Long-term recurrence rates of actinic keratosis: A systematic review and pooled analysis of randomized controlled trials

Long-term recurrence rates of actinic keratosis: A systematic review and pooled analysis of randomized controlled trials

Weight-bearing CT for Knee Osteoarthritis Assessment: A Story Unfolds

Weight-bearing CT for Knee Osteoarthritis Assessment: A Story Unfolds

Interfaces and Applications

Interfaces and Applications

Differences in and Prognostic Value of Quality of Life Data in Rectal Cancer Patients with and without Distant Metastases.

(1) Background: Individualization of treatment is a major challenge in oncology and requires a variety of predictive and prognostic parameters. In addition to tumor biology analyses, baseline health-related quality of life might be a valid tool to predict overall survival. This study was conducted to evaluate the prognostic relevance of baseline quality of life data in patients with rectal cancer. In this context, differences between patients with and without distant metastases were of particular interest. (2) Methods: Our cohort included 258 patients with rectal cancer treated in the radiotherapy department of the University Hospital Erlangen. Patients completed the European Organisation for Research and Treatment of Cancer (EORTC) core quality of life questionnaire (QLQ C30) and colorectal cancer questionnaire (CR38). Clinical and survival data were provided by the Gießener Tumor Documentation System (GTDS) of the Comprehensive Cancer Center Erlangen-EMN (CCC, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany). Statistical analyses were performed using Kaplan–Meier analyses and univariate and multivariate Cox regression. (3) Results: A cohort of 258 patients with rectal adenocarcinoma was analyzed including 50 patients (19.4%) with metastatic disease. No differences were observed between patients with and without distant metastases in most areas of quality of life studied, with the exception of physical function, loss of appetite, chemotherapy side effects and weight loss. Gender, baseline physical function, sexual function, diarrhea, and weight loss over time had a prognostic value in the entire cohort. Appetite loss was an additional prognostic parameter in patients with distant metastases. (4) Conclusions: The quality of life of patients with metastatic disease differed only slightly from non-metastatic patients. Health-related quality of life data provide prognostic information for patients with rectal cancer.

Back Cover

Advanced Engineering MaterialsVolume 22, Issue 9 2070039 Back CoverFree Access Back Cover First published: 22 September 2020 https://doi.org/10.1002/adem.202070039AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Graphical Abstract The covers are composed by Mr. Christian Harnoth (www.zur-gestaltung.de) with the input of the guest editors and Mr. Florian Majcen. The back cover shows the names of the institutes of the department of materials science and engineering (MSE) at the Friedrich-Alexander University of Erlangen-Nürnberg (FAU), (www.ww.tf.fau.de). Volume22, Issue9Special Issue: Materials Science and Engineering at Friedrich-Alexander University of Erlangen-Nürnberg (FAU) September 20202070039 RelatedInformation

Letter by Kallmünzer et al Regarding Article, “Safety of Intravenous Thrombolysis Among Patients Taking Direct Oral Anticoagulants: a Systematic Review and Meta-Analysis”

HomeStrokeVol. 51, No. 7Letter by Kallmünzer et al Regarding Article, “Safety of Intravenous Thrombolysis Among Patients Taking Direct Oral Anticoagulants: a Systematic Review and Meta-Analysis” Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toFree AccessLetterPDF/EPUBLetter by Kallmünzer et al Regarding Article, “Safety of Intravenous Thrombolysis Among Patients Taking Direct Oral Anticoagulants: a Systematic Review and Meta-Analysis” Bernd Kallmünzer, MD, Michael Pott, MD and Stefan Schwab, MD Bernd KallmünzerBernd Kallmünzer https://orcid.org/0000-0003-3552-6742 Department of Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Germany (B.K., S.S.). Department of Neurology, Klinikum Bayreuth GmbH, Bayreuth, Germany. Search for more papers by this author , Michael PottMichael Pott Search for more papers by this author and Stefan SchwabStefan Schwab Department of Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Germany (B.K., S.S.). Department of Neurology, Klinikum Bayreuth GmbH, Bayreuth, Germany. Search for more papers by this author Originally published16 Jun 2020https://doi.org/10.1161/STROKEAHA.120.029631Stroke. 2020;51:e130–e131To the Editor:With great interest we read the article “Safety of Intravenous Thrombolysis Among Patients Taking Direct Oral Anticoagulants” by Shahjouei et al.1 Before the use of rtPA in patients on oral anticoagulation, it seems reasonable to use antidots for anticoagulation reversal. Andexanet alfa, a recombinant form of the human factor Xa, rapidly reduces the anticoagulatory effect of factor Xa inhibitors2 and was recently approved for emergent reversal of oral anticoagulation in patients on treatment with apixaban or rivaroxaban.Recently, a 77-year-old woman presented to a German hospital with an acute ischemic stroke causing serious left-sided hemiparesis and dysarthria 2 hours after symptom onset. Computed tomography angiography confirmed an occlusion of the right medial cerebral artery at the proximal segment. The condition demanded an immediate treatment with alteplase followed by the transfer to a neurovascular center for mechanical thrombectomy. The patient suffered from permanent atrial fibrillation and used apixab (5 mg b.i.d.) for the prevention of thromboembolism. She had taken the last dose of apixaban 3 hours before admission. A chromogenic assay found the calibrated antifactor Xa activity being elevated to 188 ng/mL, which formally contradicted the use of recombinant tissue plasminogen activitor (r-tPA). Therefore, it was decided to reverse the effect of apixaban before intravenous thrombolysis: The patient received an intravenous bolus of 400 mg andexanet alfa at a target rate of 30 mg/minute. A continuous infusion of 480 mg followed for 2 hours, resulting in a total dose of 880 mg andexanet alfa. Treatment with alteplase was initiated as soon as the andexanet alfa bolus had been administered. r-tPA total dose was 90 mg (9 mg bolus followed by a 1-hour infusion of 81 mg) and the patient started immediate transfer to the thrombectomy center. On arrival, her neurological symptoms had markedly improved. The MCA occlusion showed complete recanalization before endovascular treatment. Ten hours after symptom onset, the anti-factor Xa activity had spontaneously increased to 277 ng/mL and remained elevated during the first days. No hemorrhagic complications occurred. The estimated glomerular filtration rate was 58 mL/minute.The use of alteplase in patients on treatment with direct oral anticoagulants has not been firmly established.1 For dabigatran, it seems feasible to reverse the anticoagulant by idarucizumab before the initiation of intravenous thrombolysis.3 Unlike idarucizumab, the characteristics of andexanet alfa result in an incomplete and only transient reduction of the antithrombotic activity.2,4 Consistently, a rebound even beyond the level on admission occurred in this patient at 10 hours after symptom onset. As the frequency of hemorrhagic complications raises with higher anticoagulant peak levels,5 this secondary increase will caution the clinician about an elevated risk of r-tPA associated bleeding, despite the use of Andexanet alfa.AcknowledgmentsWe thank Professor Erwin Strasser, Department for Hemostaseology and Transfusion Medicine, University Hospital Erlangen, for the measurements of the anti-Factor Xa Activitity.DisclosuresDr Kallmünzer reports speaker honoraria from BMS Pfizer, Daiichi Sankyo, Bayer AG and Medtronic, outside the submitted work. Dr Schwab reports speaker honoria and travel grants from Boehringer Ingelheim, Pfizer, Daiichi Sankyo. The other authors report no conflicts.FootnotesFor Disclosures, see page e130.

A Comprehensive Study on Tetraaryltetrabenzoporphyrins.

Invited for the cover of this issue are the groups of Lungerich and Jux at the Friedrich-Alexander University Erlangen-Nuernberg. The image depicts the synthetic feasibility with a "TATBP tuning shop", which shows the change of the four meso aryl substituents to modify the performance of the molecule. Read the full text of the article at 10.1002/chem.201904718.

Correction to “ARIA guideline 2019: treatment of allergic rhinitis in the German health system”

Correction to: Allergo J Int 2019 https://doi.org/10.1007/s40629-019-00110-9 Affiliation and disclaimer have been misrepresented and are hereby corrected: Vera Mahler: Affiliation: Med. Faculty, Friedrich-Alexander-University (FAU) Erlangen-Nurnberg, Germany. Disclaimer: The views expressed in this …

SC17 student cluster competition, Team Technical University of Munich and Friedrich–Alexander University Erlangen–Nürnberg: Reproducing vectorization of the Tersoff multi-body potential on the Intel Broadwell architecture

Abstract Markus Hohnerbach et al., describe optimizations for calculating the potential of a bond between two atoms that depends on their neighboring atoms in “The Vectorization of the Tersoff Multi-Body Potential: An Exercise in Performance Portability”. In this paper we present the results of our team’s effort to reproduce the claims made by Markus Hohnerbach et al., on an Intel Broadwell architecture at the SC17 Student Cluster Competition. We first demonstrate that these optimizations result in no relevant loss of precision using types with different floating point representations and then compare their respective runtime. Lastly, we show the scalability of the double precision version of the algorithm by using an increasing number of threads.

Stability of Odd- Versus Even-Electron Gas-Phase (Quasi)Molecular Ions Derived from Pyridine-Substituted N-Heterotriangulenes.

Invited for this month's cover are the collaborating groups at the Friedrich-Alexander University Erlangen-Nürnberg (FAU), Germany and at the Max-Planck-Institut für Kohlenforschung, Germany. The cover picture shows the symbiosis of quantum chemical theory and gas-phase collision experiment investigating the influence of the electronic state on stability of the radical cation ([M]+ . ) and protonated triangulene ([M+H]+ ). The dissociation of the radical cation requires less energy due to the formation of an energetically favored extended aromatic π-system. Read the full text of the article at 10.1002/cplu.201600416.

Konsultationskompetenz als Element in der allgemeinmedizinischen Weiterbildung in Deutschland – eine qualitative Befragung

IntroductionThe consultation is at the heart of general practice. It is the central setting through which primary care is delivered. The competency requirements are laid down internationally by competency-based curricula for undergraduate and postgraduate education. So far, there is no competency-based vocational training to develop consultation skills in general practice in Germany. The study describes experiences with consultation skills training as an element of general practice training as reported by trainees and trainers in Germany. MethodsA qualitative and exploring approach was chosen because there is little experience with the German situation. We conducted structured focus group interviews with trainees and trainers, respectively. We recruited all participants by e-mail via the mail distributor „Junge Allgemeinmedizin Deutschland“ (JADE, a trainee and junior GP organization) and the academic teachers of the Friedrich-Alexander University Erlangen-Nürnberg. Altogether, four focus group interviews with three to five participants were conducted, varying in length from 25 to 65minutes. All interviews were recorded digitally and transcribed verbatim. Then a qualitative content analysis was performed. ResultsThe statements of the ten trainees and five trainers mapped a system of four main categories: (a) association with the term consultation, (b) parts of a consultation, (c) competencies required for professional practice, (d) consultation skills training as an element of vocational training. Overall, all participants regarded the consultation as the most important element in general practice. Important content of consultations is to build a relationship with the patient, gather information, conduct physical examinations and achieve informed consent on further proceedings. All participants agreed that physicians need different sets of competencies: medical expertise, communication skills, examination skills and professionalism. Finally, there was a broad consensus that a competency-based general practice training to support the development of consultation skills is lacking in Germany. The majority acknowledged the need for change. ConclusionSo far, the consultation skills development within the general practice training in Germany is regarded as deficient. Both trainees and trainers have stressed the importance of change in vocational training. With the new competency-based curriculum for general practice in Germany and the associated development of supporting tools important prerequisites have been provided.

Rural America

This volume comprises five keynote addresses and sixteen selected workshop papers from the sixtieth annual conference of the German Association for American Studies, held in 2013 at the Friedrich-Alexander University Erlangen-Nürnberg. A final section, an artistic appendix, reprints Stewart O'Nan's short story “Calling,” and a portfolio of images from the 2008 Heartlands: Sketches of Rural America project by the Austrian photographer Andreas Horvath. In their introduction, the editors Antje Kley and Heike Paul set up “five ways of thinking about rural America”: as the historical predecessor of the later urban nation; as a persistent allegorical image of America at large; as a collection of “culturally specific milieus contrasting with urban or metropolitan spaces”; as an aggregation of larger geographic regions; and as the subject of critical regionalist reflection (pp. 9, 5). Those categories are rich but even so cannot do justice to the array of suggestive work presented here. I learned from each of the essays not only because of what they said about their topics but also because of their varied methods and theoretical perspectives. In a brief review, it is not possible to give much detail. I especially recommend the pieces dealing with music (whether that of Johnny Cash or Kurt Weill); film (the western, the conservative agitprop piece Fire from the Heartland [2010] or The Horse Whisperer [1998]); and, more generally, those that take up a wide variety of textual works (from Charles Brockden Brown's Arthur Mervyn [1799] to James Weldon Johnson's The Autobiography of an Ex-Colored Man [1912], with stops along the way at John Rollin Ridge's The Life and Adventures of Joaquin Murieta [1854], Henry David Thoreau's Walden [1854], and a sort of coda concerned with Jane Smiley's A Thousand Acres [1991]). Even these glimpses fail to do justice to the collective richness.