2024-03-28T11:45:15Zhttp://repository.helmholtz-hzi.de/oai/requestoai:repository.helmholtz-hzi.de:10033/2676342019-08-30T11:25:43Zcom_10033_267632com_10033_211390col_10033_267633
Health-related locus of control and health behaviour among university students in North Rhine Westphalia, Germany.
Helmer, Stefanie M
Krämer, Alexander
Mikolajczyk, Rafael
Bremen Institute for Epidemiology and Prevention Research, University of Bremen, Bremen, Germany. rafael.mikolajczyk@helmholtz-hzi.de.
ABSTRACT:
2013-01-30T09:07:27Z
2013-01-30T09:07:27Z
2012
Article
Health-related locus of control and health behaviour among university students in North Rhine Westphalia, Germany. 2012, 5:703 BMC Res Notes
1756-0500
23273039
10.1186/1756-0500-5-703
http://hdl.handle.net/10033/267634
BMC research notes
en
Archived with thanks to BMC research notes
oai:repository.helmholtz-hzi.de:10033/2885952019-08-30T11:32:41Zcom_10033_267632com_10033_211390col_10033_267633
Comorbidities in ADHD children treated with methylphenidate: a database study.
Kraut, Angela A
Langner, Ingo
Lindemann, Christina
Banaschewski, Tobias
Petermann, Ulrike
Petermann, Franz
Mikolajczyk, Rafael
Garbe, Edeltraut
Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
Methylphenidate (MPH) is the most common drug treatment of attention deficit / hyperactivity disorder (ADHD) in children. Treatment with MPH is contraindicated in the presence of certain psychiatric, cerebro- and cardiovascular conditions. We assessed MPH treatment prevalence and incidence and the frequency of comorbid conditions related to these contraindications in new MPH users compared to a control group without ADHD and ADHD medication.
2013-05-07T12:45:54Z
2013-05-07T12:45:54Z
2013
Article
Comorbidities in ADHD children treated with methylphenidate: a database study. 2013, 13:11 BMC Psychiatry
1471-244X
23294623
10.1186/1471-244X-13-11
http://hdl.handle.net/10033/288595
BMC psychiatry
en
Archived with thanks to BMC psychiatry
oai:repository.helmholtz-hzi.de:10033/2935832019-08-30T11:33:29Zcom_10033_267632com_10033_211390col_10033_267633
Regional variation in caesarean deliveries in Germany and its causes.
Mikolajczyk, Rafael
Schmedt, Niklas
Zhang, Jun
Lindemann, Christina
Langner, Ingo
Garbe, Edeltraut
Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany. Rafael.mikolajczyk@helmholtz-hzi.de.
Determinants of regional variation in caesarean sections can contribute explanations for the observed overall increasing trend of caesarean sections. We assessed which mechanism explains the higher rate of caesarean sections in the former West than East Germany: a more liberal use of caesarean sections in the case of relative indications or more common caesarean sections without indications.
2013-06-07T12:41:50Z
2013-06-07T12:41:50Z
2013
Article
Regional variation in caesarean deliveries in Germany and its causes. 2013, 13:99 BMC Pregnancy Childbirth
1471-2393
23634820
10.1186/1471-2393-13-99
http://hdl.handle.net/10033/293583
BMC pregnancy and childbirth
en
Archived with thanks to BMC pregnancy and childbirth
oai:repository.helmholtz-hzi.de:10033/3014302019-08-30T11:35:39Zcom_10033_267632com_10033_211390col_10033_267633
Evaluation of pregnancy outcome records in the German Pharmacoepidemiological Research Database (GePaRD).
Mikolajczyk, Rafael
Kraut, Aa
Garbe, E
Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Helmholtz Centre for Infection Research, Braunschweig, Germany; Medical School Hannover, Hannover, Germany.
Routine health care data are a valuable source for the assessment of risks of drugs during pregnancy. Therefore, the aim of the current analysis was the evaluation of pregnancy outcome records in German health insurance data.
2013-09-11T09:51:27Z
2013-09-11T09:51:27Z
2013-08
Article
Evaluation of pregnancy outcome records in the German Pharmacoepidemiological Research Database (GePaRD). 2013, 22 (8):873-80 Pharmacoepidemiol Drug Saf
1099-1557
23733705
10.1002/pds.3467
http://hdl.handle.net/10033/301430
Pharmacoepidemiology and drug safety
en
Archived with thanks to Pharmacoepidemiology and drug safety
oai:repository.helmholtz-hzi.de:10033/3045712019-08-30T11:37:00Zcom_10033_267632com_10033_211390col_10033_267633col_10033_267633
Twin and sibling studies using health insurance data: the example of attention deficit/hyperactivity disorder (ADHD).
Langner, Ingo
Garbe, Edeltraut
Banaschewski, Tobias
Mikolajczyk, Rafael
Department of Clinical Epidemiology, Leibniz-Institute for Prevention Research and Epidemiology, BIPS GmbH, Bremen, Germany.
Twin studies are used to assess the contribution of genetic factors to the aetiology of diseases. To show the feasibility of such research on the basis of health insurance data, we analysed twin and sibling data on the attention deficit/hyperactivity disorder (ADHD) in the German Pharmacoepidemiological Research Database (GePaRD).
2013-10-24T11:04:05Z
2013-10-24T11:04:05Z
2013
Article
Twin and sibling studies using health insurance data: the example of attention deficit/hyperactivity disorder (ADHD). 2013, 8 (4):e62177 PLoS ONE
1932-6203
23637997
10.1371/journal.pone.0062177
http://hdl.handle.net/10033/304571
PloS one
en
Archived with thanks to PloS one
oai:repository.helmholtz-hzi.de:10033/3056812019-08-30T11:37:00Zcom_10033_267632com_10033_211390col_10033_267633
Incidence, prevalence, and antithrombotic management of atrial fibrillation in elderly Germans.
Ohlmeier, Christoph
Mikolajczyk, Rafael T
Haverkamp, Wilhelm
Garbe, Edeltraut
Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, D - 28359 Bremen, Germany.
Data on the epidemiology of atrial fibrillation (AF) and its antithrombotic management in elderly populations are scarce. The aims of this study were to estimate the incidence and prevalence of AF in the elderly in Germany and to describe antithrombotic management of AF cases.
2013-11-22T12:09:00Z
2013-11-22T12:09:00Z
2013-10
Article
Incidence, prevalence, and antithrombotic management of atrial fibrillation in elderly Germans. 2013, 15 (10):1436-44 Europace
1532-2092
23487542
10.1093/europace/eut048
http://hdl.handle.net/10033/305681
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
en
Archived with thanks to Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
oai:repository.helmholtz-hzi.de:10033/3060852019-08-30T11:27:16Zcom_10033_267632com_10033_211390col_10033_267633
Changes in incidence of anogenital warts diagnoses after the introduction of human papillomavirus vaccination in Germany-an ecologic study.
Mikolajczyk, Rafael
Kraut, Angela A
Horn, Johannes
Schulze-Rath, Renate
Garbe, Edeltraut
BIPS-Institute for Epidemiology and Prevention Research, Bremen, Germany. miko@bips.uni-bremen.de
Adolescent
Adult
Age Distribution
Aged
Alphapapillomavirus
Child
Cohort Studies
Condylomata Acuminata
Databases, Factual
Female
Germany
Humans
Incidence
Male
Middle Aged
Papillomavirus Vaccines
Poisson Distribution
Sex Distribution
Time Factors
Vaccination
Young Adult
In a large health insurance database in Germany, incidence of anogenital warts among 15- to 19-year-old females decreased from 316/100,000 person-years in 2007 to 242 in 2008 (23% reduction, P = 0.0001). The decrease started between the first and second quarter of 2007 (human papillomavirus vaccination was introduced in March 2007).
2013-12-02T12:07:50Z
2013-12-02T12:07:50Z
2013-01
Article
Changes in incidence of anogenital warts diagnoses after the introduction of human papillomavirus vaccination in Germany-an ecologic study. 2013, 40 (1):28-31 Sex Transm Dis
1537-4521
23250300
10.1097/OLQ.0b013e3182756efd
http://hdl.handle.net/10033/306085
Sexually transmitted diseases
en
Archived with thanks to Sexually transmitted diseases
oai:repository.helmholtz-hzi.de:10033/3220692019-08-30T11:30:52Zcom_10033_267632com_10033_211390col_10033_267633
Autoimmune thyroiditis as a risk factor for stroke: A historical cohort study
Karch, André
Thomas, S. L.
Research group epidemiological and statistical methods, Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany
2014-06-20T13:39:33Z
2014-06-20T13:39:33Z
2014-06-20
Article
Autoimmune thyroiditis as a risk factor for stroke: A historical cohort study 2014, 82 (18):1643 Neurology
0028-3878
1526-632X
10.1212/WNL.0000000000000377
http://hdl.handle.net/10033/322069
Neurology
http://www.neurology.org/cgi/doi/10.1212/WNL.0000000000000377
Archived with thanks to Neurology
oai:repository.helmholtz-hzi.de:10033/3363332019-08-30T11:36:33Zcom_10033_267632com_10033_211390col_10033_267633
Diagnostic profiles of patients with late-onset Creutzfeldt-Jakob disease differ from those of younger Creutzfeldt-Jakob patients: a historical cohort study using data from the German National Reference Center.
Karch, André
Raddatz, Lena Maria
Ponto, Claudia
Hermann, Peter
Summers, David
Zerr, Inga
Department of Neurology, National Reference Center for TSE, Clinical Dementia Center, University Medical School Göttingen, Göttingen, Germany, andre.karch@helmholtz-hzi.de.
In contrast to other neurodegenerative diseases, sporadic Creutzfeldt-Jakob disease (sCJD) is rarely diagnosed in patients older than 75 years. Data describing the characteristics of sCJD in the very old are rare and inconclusive. Therefore, a historical cohort study was designed to evaluate clinical, cerebrospinal fluid (CSF), electroencephalography (EEG), and magnetic resonance imaging (MRI) features of this group. Patients older than 75 years identified via the German surveillance program from 2001 to 2012 (n = 73) were compared to a random subsample of sCJD patients younger than 75 (n = 73) from the same time period using an historical cohort design. Older patients showed a faster disease progression represented by an earlier point of diagnosis and a shorter survival time (p < 0.001). In the early stages of disease, older patients presented slightly more often with dementia (p = 0.127) or dysarthria (p = 0.238), whereas disorders of the extrapyramidal (p = 0.056) and visual system (p = 0.015) were more common in the younger group. Atypical MRI profiles such as MRI lesions restricted to one hemisphere (p < 0.001) or cortical lesions only (p = 0.258) were found more frequently in patients older than 75 years, whereas typical cortical and basal ganglia hyperintensities were more common in the younger group (p = 0.001). We demonstrated for the first time that patients with late-onset sCJD differ from younger sCJD patients with respect to MRI profiles and initial clinical presentation, but not among CSF markers. Misclassification of Creutzfeldt-Jakob disease cases in patients older than 75 years seems likely due to atypical clinical and radiological presentation. This might contribute to lower sCJD incidence rates in this age group.
2014-11-28T15:56:24Z
2014-11-28T15:56:24Z
2014-05
Article
Diagnostic profiles of patients with late-onset Creutzfeldt-Jakob disease differ from those of younger Creutzfeldt-Jakob patients: a historical cohort study using data from the German National Reference Center. 2014, 261 (5):877-83 J. Neurol.
1432-1459
24570280
10.1007/s00415-014-7283-1
http://hdl.handle.net/10033/336333
Journal of neurology
en
oai:repository.helmholtz-hzi.de:10033/3387252019-08-30T11:36:05Zcom_10033_267632com_10033_211390col_10033_267633
Evaluating methods for intersectoral comparison of quality of care. A routine data analysis of elective percutaneous coronary interventions.
Ohlmeier, C
Linder, R
Enders, D
Mikolajczyk, Rafael
Haverkamp, W
Horenkamp-Sonntag, D
Garbe, E
Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany.
To compare the quality of care regarding the use of elective percutaneous coronary interventions (PCIs) in the inpatient and outpatient setting and to evaluate different methods of confounder control in this context.
2015-01-23T13:56:55Z
2015-01-23T13:56:55Z
2014
Article
Evaluating methods for intersectoral comparison of quality of care. A routine data analysis of elective percutaneous coronary interventions. 2014, 53 (4):269-77 Methods Inf Med
0026-1270
25077437
10.3414/ME13-01-0132
http://hdl.handle.net/10033/338725
Methods of information in medicine
en
oai:repository.helmholtz-hzi.de:10033/3440442019-08-30T11:36:05Zcom_10033_267632com_10033_211390col_10033_267633
Trajectories of injecting behavior in the Amsterdam Cohort Study among drug users.
Mikolajczyk, Rafael
Horn, Johannes
Prins, Maria
Wiessing, Lucas
Kretzschmar, Mirjam
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Injecting frequency among people who inject drugs (IDU) can change along distinct trajectories, which can reflect on incidence of HIV and HCV infections. We aimed at assessing these patterns of longitudinal changes, their predictors and their association with the incidence of HIV and HCV.
2015-02-02T15:37:46Z
2015-02-02T15:37:46Z
2014-11-01
Article
Trajectories of injecting behavior in the Amsterdam Cohort Study among drug users. 2014, 144:141-7 Drug Alcohol Depend
1879-0046
25248472
10.1016/j.drugalcdep.2014.08.020
http://hdl.handle.net/10033/344044
Drug and alcohol dependence
en
oai:repository.helmholtz-hzi.de:10033/3440822019-08-30T11:31:20Zcom_10033_267632com_10033_211390col_10033_267633
Standardized surveillance of prion diseases in resource-poor settings is crucial for individual patient-care as well as for decision-making of healthcare authorities.
Karch, André
2015-02-03T13:54:04Z
2015-02-03T13:54:04Z
2015-01
Article
Standardized surveillance of prion diseases in resource-poor settings is crucial for individual patient-care as well as for decision-making of healthcare authorities. 2015, 6 (1):4-5 J Neurosci Rural Pract
0976-3147
25552842
10.4103/0976-3147.143164
http://hdl.handle.net/10033/344082
Journal of neurosciences in rural practice
en
oai:repository.helmholtz-hzi.de:10033/3468732019-08-30T11:36:32Zcom_10033_267632com_10033_211390col_10033_267633
Effect of beta-blocker therapy on the risk of infections and death after acute stroke--a historical cohort study.
Maier, Ilko L
Karch, André
Mikolajczyk, Rafael
Bähr, Mathias
Liman, Jan
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Infections are a frequent cause for prolonged hospitalization and increased mortality after stroke. Recent studies revealed a stroke-induced depression of the peripheral immune system associated with an increased susceptibility for infections. In a mice model for stroke, this immunosuppressive effect was reversible after beta-blocker administration. The aim of our study was to investigate the effect of beta-blocker therapy on the risk of infections and death after stroke in humans.
2015-03-19T13:02:11Z
2015-03-19T13:02:11Z
2015
Article
Effect of beta-blocker therapy on the risk of infections and death after acute stroke--a historical cohort study. 2015, 10 (2):e0116836 PLoS ONE
1932-6203
25643360
10.1371/journal.pone.0116836
http://hdl.handle.net/10033/346873
PloS one
en
oai:repository.helmholtz-hzi.de:10033/5569452019-08-30T11:26:42Zcom_10033_267632com_10033_211390col_10033_267633
Systematic review of models assessing the economic value of routine varicella and herpes zoster vaccination in high-income countries.
Damm, Oliver
Ultsch, Bernhard
Horn, Johannes
Mikolajczyk, Rafael
Greiner, Wolfgang
Wichmann, Ole
A systematic review was conducted to assess the cost-effectiveness of routine varicella and herpes zoster (HZ) vaccination in high-income countries estimated by modelling studies.
2015-06-15T14:44:32Z
2015-06-15T14:44:32Z
2015
Article
Systematic review of models assessing the economic value of routine varicella and herpes zoster vaccination in high-income countries. 2015, 15:533 BMC Public Health
1471-2458
26041469
10.1186/s12889-015-1861-8
http://hdl.handle.net/10033/556945
BMC public health
en
oai:repository.helmholtz-hzi.de:10033/5604942019-08-30T11:28:23Zcom_10033_267632com_10033_211390col_10033_267633
An adjustable fetal weight standard for twins: a statistical modeling study.
Zhang, Jun
Mikolajczyk, Rafael
Lei, Xiaoping
Sun, Luming
Yu, Hongping
Cheng, Weiwei
Helmholtz Centre for Infection Research, Inhoffenstraße 7, 38124 Braunschweig, Germany.
It is a common practice to use a singleton fetal growth standard to assess twin growth. We aim to create a twin fetal weight standard which is also adjustable for race/ethnicity and other factors.
2015-07-15T14:24:02Z
2015-07-15T14:24:02Z
2015
Article
An adjustable fetal weight standard for twins: a statistical modeling study. 2015, 13:159 BMC Med
1741-7015
26141190
10.1186/s12916-015-0401-9
http://hdl.handle.net/10033/560494
BMC medicine
en
oai:repository.helmholtz-hzi.de:10033/5763072019-08-30T11:28:23Zcom_10033_267632com_10033_211390col_10033_267633
Mortality in the German Pharmacoepidemiological Research Database (GePaRD) compared to national data in Germany: results from a validation study.
Ohlmeier, Christoph
Langner, Ingo
Hillebrand, Kathrin
Schmedt, Niklas
Riedel, Oliver
Garbe, Edeltraut
Electronic healthcare databases are of increasing importance in health research and mortality is one of the most relevant outcomes. However, data in these databases need to be validated, since they are often generated for reimbursement purposes. The aims of this study were to compare mortality figures from the German Pharmacoepidemiological Research Database (GePaRD) on an aggregated level with external data from the Federal Statistical Office of Germany (FSOG) and to assess consistency of records of death from core data and hospital data within GePaRD.
2015-09-02T13:29:58Z
2015-09-02T13:29:58Z
2015
Article
Mortality in the German Pharmacoepidemiological Research Database (GePaRD) compared to national data in Germany: results from a validation study. 2015, 15:570 BMC Public Health
1471-2458
26087768
10.1186/s12889-015-1943-7
http://hdl.handle.net/10033/576307
BMC public health
en
oai:repository.helmholtz-hzi.de:10033/6211462019-08-30T11:31:23Zcom_10033_267632com_10033_211390col_10033_267633
A feasibility trial to examine the social norms approach for the prevention and reduction of licit and illicit drug use in European University and college students
Pischke, Claudia R
Zeeb, Hajo
van Hal, Guido
Vriesacker, Bart
McAlaney, John
Bewick, Bridgette M
Akvardar, Yildiz
Guillén-Grima, Francisco
Orosova, Olga
Salonna, Ferdinand
Kalina, Ondrej
Stock, Christiane
Helmer, Stefanie M
Mikolajczyk, Rafael T
Abstract Background Incorrect perceptions of high rates of peer alcohol and tobacco use are predictive of increased personal use in student populations. Correcting misperceptions by providing feedback has been shown to be an effective intervention for reducing licit drug use. It is currently unknown if social norms interventions are effective in preventing and reducing illicit drug use in European students. The purpose of this paper is to describe the design of a multi-site cluster controlled trial of a web-based social norms intervention aimed at reducing licit and preventing illicit drug use in European university students. Methods/Design An online questionnaire to assess rates of drug use will be developed and translated based on existing social norms surveys. Students from sixteen universities in seven participating European countries will be invited to complete the questionnaire. Both intervention and control sites will be chosen by convenience. In each country, the intervention site will be the university that the local principal investigator is affiliated with. We aim to recruit 1000 students per site (baseline assessment). All participants will complete the online questionnaire at baseline. Baseline data will be used to develop social norms messages that will be included in a web-based intervention. The intervention group will receive individualized social norms feedback. The website will remain online during the following 5 months. After five months, a second survey will be conducted and effects of the intervention on social norms and drug use will be measured in comparison to the control site. Discussion This project is the first cross-national European collaboration to investigate the feasibility of a social norms intervention to reduce licit and prevent illicit drug use among European university students. Final trial registration number DRKS00004375 on the ‘German Clinical Trials Register’.
2017-10-25T09:52:19Z
2017-10-25T09:52:19Z
2012-10-18
2015-09-04T08:22:17Z
Journal Article
BMC Public Health. 2012 Oct 18;12(1):882
http://dx.doi.org/10.1186/1471-2458-12-882
http://hdl.handle.net/10033/621146
en
Pischke et al.; licensee BioMed Central Ltd.
oai:repository.helmholtz-hzi.de:10033/6207892019-08-30T11:37:44Zcom_10033_267632com_10033_211390col_10033_267633
Health-related locus of control and health behaviour among university students in North Rhine Westphalia, Germany
Helmer, Stefanie M
Krämer, Alexander
Mikolajczyk, Rafael
Abstract Background Health control beliefs were postulated to be associated with health behaviour. However, the results of studies assessing these associations suggest that they might not be universal. Among young adults associations have been reported, but the evidence is limited. The objective of this analysis was to re-examine these associations in a sample of university students in Germany. Findings Data from a multicentre cross-sectional study among university students in North Rhine-Westphalia, Germany was used (N=3,306). The Multidimensional Health Locus of Control Scale with three dimensions (one internal and two external) and six aspects of health behaviour (smoking habits, alcohol use, drug consumption, being over-/ or underweight, physical activity, and importance of healthy nutrition) were evaluated. Students with stronger internal locus of control paid more attention to healthy nutrition and displayed a higher level of physical activity. Individuals with a stronger belief in health professionals were less likely to use drugs and paid more attention to healthy nutrition. Furthermore, higher scores in the second external locus of control dimension (beliefs in luck or chance) were associated with a higher likelihood of current smoking, lower physical activity and less attention to healthy nutrition. Conclusions Students engaged more strongly in unhealthy behaviour if they believed that luck determines health. In contrast, believing in having control over one’s own health was associated with more healthy behaviour. These findings support the need to consider health control beliefs while designing preventive strategies in this specific population.
2017-01-27T11:51:23Z
2017-01-27T11:51:23Z
2012-12-29
2015-09-04T08:25:55Z
BMC Research Notes. 2012 Dec 29;5(1):703
http://dx.doi.org/10.1186/1756-0500-5-703
http://hdl.handle.net/10033/620789
en
Helmer et al.; licensee BioMed Central Ltd.
oai:repository.helmholtz-hzi.de:10033/6207532018-06-13T07:23:02Zcom_10033_267632com_10033_211390col_10033_267633
Mortality in the German Pharmacoepidemiological Research Database (GePaRD) compared to national data in Germany: results from a validation study
Ohlmeier, Christoph
Langner, Ingo
Hillebrand, Kathrin
Schmedt, Niklas
Mikolajczyk, Rafael
Riedel, Oliver
Garbe, Edeltraut
Abstract Background Electronic healthcare databases are of increasing importance in health research and mortality is one of the most relevant outcomes. However, data in these databases need to be validated, since they are often generated for reimbursement purposes. The aims of this study were to compare mortality figures from the German Pharmacoepidemiological Research Database (GePaRD) on an aggregated level with external data from the Federal Statistical Office of Germany (FSOG) and to assess consistency of records of death from core data and hospital data within GePaRD. Methods The study population comprised insurants of four statutory health insurances providing data for GePaRD with either continuous insurance coverage from January 1st to December 31st 2006 or until death. The sex-specific mortality rate, stratified and standardized by age, and the percentage of hospital deaths among all deaths was compared with data from the FSOG. Furthermore, the agreement between the dates of death according to hospital data and core data was assessed within GePaRD. Results The study population comprised 12,033,622 insurants. Compared to FSOG data, the age-standardised mortality rate in GePaRD was 21 % and 29 % lower in women and men, respectively. Regional analyses also indicated lower mortality rates in all federal states except for Bremen, where the age-standardised mortality rate was similar to FSOG data for both sexes. The percentage of hospital deaths among all deaths corresponded well with external data. The proportion of inpatient deaths also recorded in the health insurance core data was 98.5 %. Furthermore, 94 % of dates of death documented in hospital agreed with the dates of death according to the health insurance core data. Conclusions The lower mortality rates in almost all federal states might result from the higher socioeconomic status of the GePaRD study population compared to the overall population in Germany. In the federal state of Bremen, where socioeconomic representativeness is higher due to additional inclusion of two local health insurances, the mortality rates were in good accordance with external data. Agreement of the percentage of hospital deaths among all deaths between GePaRD and national statistics suggested completeness of outpatient mortality information.
2017-01-27T08:28:09Z
2017-01-27T08:28:09Z
2015-06-20
2015-09-04T08:29:23Z
Journal Article
BMC Public Health. 2015 Jun 20;15(1):570
http://dx.doi.org/10.1186/s12889-015-1943-7
http://hdl.handle.net/10033/620753
en
Ohlmeier et al.
oai:repository.helmholtz-hzi.de:10033/6207192019-08-30T11:36:05Zcom_10033_267632com_10033_211390col_10033_267633
What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies
Betran, Ana P
Torloni, Maria R
Zhang, Jun
Ye, Jiangfeng
Mikolajczyk, Rafael
Deneux-Tharaux, Catherine
Oladapo, Olufemi T
Souza, João P
Tunçalp, Özge
Vogel, Joshua P
Gülmezoglu, Ahmet M
Abstract In 1985, WHO stated that there was no justification for caesarean section (CS) rates higher than 10–15 % at population-level. While the CS rates worldwide have continued to increase in an unprecedented manner over the subsequent three decades, concern has been raised about the validity of the 1985 landmark statement. We conducted a systematic review to identify, critically appraise and synthesize the analyses of the ecologic association between CS rates and maternal, neonatal and infant outcomes. Four electronic databases were searched for ecologic studies published between 2000 and 2014 that analysed the possible association between CS rates and maternal, neonatal or infant mortality or morbidity. Two reviewers performed study selection, data extraction and quality assessment independently. We identified 11,832 unique citations and eight studies were included in the review. Seven studies correlated CS rates with maternal mortality, five with neonatal mortality, four with infant mortality, two with LBW and one with stillbirths. Except for one, all studies were cross-sectional in design and five were global analyses of national-level CS rates versus mortality outcomes. Although the overall quality of the studies was acceptable; only two studies controlled for socio-economic factors and none controlled for clinical or demographic characteristics of the population. In unadjusted analyses, authors found a strong inverse relationship between CS rates and the mortality outcomes so that maternal, neonatal and infant mortality decrease as CS rates increase up to a certain threshold. In the eight studies included in this review, this threshold was at CS rates between 9 and 16 %. However, in the two studies that adjusted for socio-economic factors, this relationship was either weakened or disappeared after controlling for these confounders. CS rates above the threshold of 9–16 % were not associated with decreases in mortality outcomes regardless of adjustments. Our findings could be interpreted to mean that at CS rates below this threshold, socio-economic development may be driving the ecologic association between CS rates and mortality. On the other hand, at rates higher than this threshold, there is no association between CS and mortality outcomes regardless of adjustment. The ecological association between CS rates and relevant morbidity outcomes needs to be evaluated before drawing more definite conclusions at population level.
2017-01-17T10:01:28Z
2017-01-17T10:01:28Z
2015-06-21
2015-09-04T08:29:09Z
Journal Article
Reproductive Health. 2015 Jun 21;12(1):57
http://dx.doi.org/10.1186/s12978-015-0043-6
http://hdl.handle.net/10033/620719
en
Betran et al.
oai:repository.helmholtz-hzi.de:10033/6207002019-08-30T11:32:16Zcom_10033_267632com_10033_211390col_10033_267633
An adjustable fetal weight standard for twins: a statistical modeling study
Zhang, Jun
Mikolajczyk, Rafael
Lei, Xiaoping
Sun, Luming
Yu, Hongping
Cheng, Weiwei
Abstract Background It is a common practice to use a singleton fetal growth standard to assess twin growth. We aim to create a twin fetal weight standard which is also adjustable for race/ethnicity and other factors. Methods Over half a million twin births of low risk pregnancies in the US, from 1995 to 2004, were used to construct a fetal weight standard. We used the Hadlock’s fetal growth standard and the proportionality principle to make the standard adjustable for other factors such as race/ethnicity. We validated the standard in different race/ethnicities in the US and against previously published curves from around the world. Results The adjustable fetal weight standard has an excellent match with the observed birthweight data in non-Hispanic White, non-Hispanic Black, Hispanics, and Asian from 24 to 38 weeks gestation. It also had a very good fit with cross-sectional data from Australia and Norway, and a longitudinal standard from Brazil. However, our model-based 10th and 90th percentiles differed substantially from studies in Japan and US that used the last menstrual period for estimate of gestational age. Conclusion The adjustable fetal weight standard for twins is a flexible tool and can be used in different populations.
2017-01-13T09:52:44Z
2017-01-13T09:52:44Z
2015-07-03
2015-09-04T08:31:04Z
Journal Article
BMC Medicine. 2015 Jul 03;13(1):159
http://dx.doi.org/10.1186/s12916-015-0401-9
http://hdl.handle.net/10033/620700
en
Zhang et al.
oai:repository.helmholtz-hzi.de:10033/5772422019-08-30T11:34:48Zcom_10033_267632com_10033_211390col_10033_267633
Cerebrospinal fluid tau levels are a marker for molecular subtype in sporadic Creutzfeldt-Jakob disease.
Karch, André
Hermann, Peter
Ponto, Claudia
Schmitz, Matthias
Arora, Amandeep
Zafar, Saima
Llorens, Franc
Müller-Heine, Annika
Zerr, Inga
Helmholtz Centre for infection research, Inhoffenstr. 7, D-38124 Braunschweig, Germany.
The molecular subtype of sporadic Creutzfeldt-Jakob disease (sCJD) is an important prognostic marker for patient survival. However, subtype determination is not possible during lifetime. Because the rate of disease progression is associated with the molecular subtype, this study aimed at investigating if total tau, a marker of neuronal death, allows premortem diagnosis of molecular subtype when codon 129 genotype is known. Two hundred ninety-six sCJD patients were tested for their cerebrospinal fluid total tau level at the time of diagnosis and were investigated for their sCJD subtype postmortem. There was a significant association between tau levels and the prion protein type in patients with codon 129 MM (p < 0.001), MV (p = 0.004), and VV (p = 0.001) genotype. Receiver operating characteristic analyses showed values of area under the curve of 0.76-0.80 for the different genotypes indicating a good diagnostic validity of the test. Total tau can be used as a diagnostic test for the assessment of prion protein type when codon 129 genotype is known. It provides valuable information for physicians and next of kin about the further course of disease.
2015-09-14T13:58:08Z
2015-09-14T13:58:08Z
2015-05
Article
Cerebrospinal fluid tau levels are a marker for molecular subtype in sporadic Creutzfeldt-Jakob disease. 2015, 36 (5):1964-8 Neurobiol. Aging
1558-1497
25749129
10.1016/j.neurobiolaging.2015.01.021
http://hdl.handle.net/10033/577242
Neurobiology of aging
en
oai:repository.helmholtz-hzi.de:10033/5794712019-08-30T11:30:58Zcom_10033_267632com_10033_211390col_10033_267633
Clustering of developmental delays in Bavarian preschool children - a repeated cross-sectional survey over a period of 12 years.
Stich, Heribert L
Krämer, Alexander
Mikolajczyk, Rafael
Child, Preschool
Cluster Analysis
Cross-Sectional Studies
Developmental Disabilities
Female
Germany
Humans
Male
Time Factors
While most children display a normal development, some children experience developmental delays compared to age specific development milestones assessed during school entry examination. Data exist on prevalence of delays in single areas, but there is lack of knowledge regarding the clustering patterns of developmental delays and their determinants.
2015-10-08T10:00:10Z
2015-10-08T10:00:10Z
2014
Article
Clustering of developmental delays in Bavarian preschool children - a repeated cross-sectional survey over a period of 12 years. 2014, 14:18 BMC Pediatr
1471-2431
24450504
10.1186/1471-2431-14-18
http://hdl.handle.net/10033/579471
BMC pediatrics
en
oai:repository.helmholtz-hzi.de:10033/5820652019-08-30T11:31:49Zcom_10033_267632com_10033_211390col_10033_267633
Ebola risk perception in Germany, 2014.
Rübsamen, Nicole
Castell, Stefanie
Horn, Johannes
Karch, André
Ott, Jördis J
Raupach-Rosin, Heike
Zoch, Beate
Krause, Gerard
Mikolajczyk, Rafael T
Helmholtz Centre for infection research, Inhoffenstr. 7, D-38124 Braunschweig, Germany.
Ebola virus disease (EVD) outbreaks have occurred during the past 5 decades, but none has affected European countries like the 2014 epidemic in West Africa. We used an online questionnaire to investigate risk perceptions in Germany during this epidemic peak. Our questionnaire covered risk perceptions, knowledge about transmission routes, media use, reactions to the outbreak, attitudes toward measures to prevent the spread of EVD and vaccination against EVD, and willingness to volunteer for aid missions. Of 974 participants, 29% indicated that they worried about EVD, 4% correctly stated virus transmission routes, and 75% incorrectly rated airborne transmission and transmission by asymptomatic patients as possible. Many indicated that if a patient were flown to Germany for treatment in a nearby hospital, they would adapt preventive behavior. Although most participants were not worried about EVD at the current stage of the epidemic, misperceptions regarding transmission were common and could trigger inappropriate behavior changes.
2015-11-11T14:34:16Z
2015-11-11T14:34:16Z
2015-06
Article
Ebola risk perception in Germany, 2014. 2015, 21 (6):1012-8 Emerging Infect. Dis.
1080-6059
25989020
10.3201/eid2106.150013
http://hdl.handle.net/10033/582065
Emerging infectious diseases
en
oai:repository.helmholtz-hzi.de:10033/5823332019-08-30T11:34:48Zcom_10033_267632com_10033_211390col_10033_267633
Feasibility of a birth cohort study dedicated to assessing acute infections using symptom diaries and parental collection of biomaterials.
Zoch, Beate
Karch, André
Dreesman, Johannes
Monazahian, Masyar
Baillot, Armin
Mikolajczyk, Rafael
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
A birth cohort dedicated to studying infections in early childhood may be assisted by parental recording of symptoms on a daily basis and a collection of biomaterials. We aimed at testing the feasibility of this approach for use in a long-term study focusing on infections in children in Germany.
2015-11-18T09:13:25Z
2015-11-18T09:13:25Z
2015
Article
Feasibility of a birth cohort study dedicated to assessing acute infections using symptom diaries and parental collection of biomaterials. 2015, 15:436 BMC Infect. Dis.
1471-2334
26493700
10.1186/s12879-015-1189-0
http://hdl.handle.net/10033/582333
BMC infectious diseases
en
oai:repository.helmholtz-hzi.de:10033/5928272019-08-30T11:36:04Zcom_10033_267632com_10033_211390col_10033_267633
Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data.
Ye, J
Zhang, J
Mikolajczyk, Rafael
Torloni, M R
Gülmezoglu, A M
Betran, A P
Helmholtz Centre for Infectoion Research; Inhoffenstr.7 38124 Braunschweig; Germany.
Caesarean section was initially performed to save the lives of the mother and/or her baby. Caesarean section rates have risen substantially worldwide over the past decades. In this study, we set out to compile all available caesarean section rates worldwide at the country level, and to identify the appropriate caesarean section rate at the population level associated with the minimal maternal and neonatal mortality.
2016-01-05T12:14:51Z
2016-01-05T12:14:51Z
2015-08-24
Article
Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data. 2015: BJOG
1471-0528
26331389
10.1111/1471-0528.13592
http://hdl.handle.net/10033/592827
BJOG : an international journal of obstetrics and gynaecology
ENG
oai:repository.helmholtz-hzi.de:10033/5931002019-08-30T11:36:32Zcom_10033_267632com_10033_211390col_10033_267633
Individual development of preschool children-prevalences and determinants of delays in Germany: a cross-sectional study in Southern Bavaria.
Stich, Heribert L
Baune, Bernhard Th
Caniato, Riccardo N
Mikolajczyk, Rafael
Krämer, Alexander
Age Factors
Child
Child, Preschool
Cross-Sectional Studies
Developmental Disabilities
Emigrants and Immigrants
Female
Germany
Humans
Logistic Models
Male
Multivariate Analysis
Prevalence
Psychological Tests
Risk Factors
Sex Factors
Even minor abnormalities of early child development may have dramatic long term consequences. Accurate prevalence rates for a range of developmental impairments have been difficult to establish. Since related studies have used different methodological approaches, direct comparisons of the prevalence of developmental delays are difficult. The understanding of the key factors affecting child development, especially in preschool aged children remains limited. We used data from school entry examinations in Bavaria to measure the prevalence of developmental impairments in pre-school children beginning primary school in 1997-2009.
2016-01-08T15:10:17Z
2016-01-08T15:10:17Z
2012
Article
Individual development of preschool children-prevalences and determinants of delays in Germany: a cross-sectional study in Southern Bavaria. 2012, 12:188 BMC Pediatr
1471-2431
23216820
10.1186/1471-2431-12-188
http://hdl.handle.net/10033/593100
BMC pediatrics
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/5954362019-08-30T11:36:32Zcom_10033_267632com_10033_211390col_10033_267633
A feasibility trial to examine the social norms approach for the prevention and reduction of licit and illicit drug use in European University and college students.
Pischke, Claudia R
Zeeb, Hajo
van Hal, Guido
Vriesacker, Bart
McAlaney, John
Bewick, Bridgette M
Akvardar, Yildiz
Guillén-Grima, Francisco
Orosova, Olga
Salonna, Ferdinand
Kalina, Ondrej
Stock, Christiane
Helmer, Stefanie M
Mikolajczyk, Rafael T
Helmholtz Centre for infection research, Inhoffenstr. 7, D-38124 Braunschweig, Germany.
Adolescent
Adult
Feasibility Studies
Female
Germany
Health Knowledge, Attitudes, Practice
Health Promotion
Humans
Male
Social Environment
Street Drugs
Students
Substance-Related Disorders
Surveys and Questionnaires
Treatment Outcome
Universities
Young Adult
Incorrect perceptions of high rates of peer alcohol and tobacco use are predictive of increased personal use in student populations. Correcting misperceptions by providing feedback has been shown to be an effective intervention for reducing licit drug use. It is currently unknown if social norms interventions are effective in preventing and reducing illicit drug use in European students. The purpose of this paper is to describe the design of a multi-site cluster controlled trial of a web-based social norms intervention aimed at reducing licit and preventing illicit drug use in European university students.
2016-02-02T12:50:48Z
2016-02-02T12:50:48Z
2012
Article
A feasibility trial to examine the social norms approach for the prevention and reduction of licit and illicit drug use in European University and college students. 2012, 12:882 BMC Public Health
1471-2458
23075043
10.1186/1471-2458-12-882
http://hdl.handle.net/10033/595436
BMC public health
en
oai:repository.helmholtz-hzi.de:10033/6008472019-08-30T11:26:13Zcom_10033_267632com_10033_211390col_10033_267633
Proposing an empirically justified reference threshold for blood culture sampling rates in intensive care units.
Karch, André
Castell, Stefanie
Schwab, Frank
Geffers, Christine
Bongartz, Hannah
Brunkhorst, Frank M
Gastmeier, Petra
Mikolajczyk, Rafael
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Blood
Critical Care
Epidemiological Monitoring
Humans
Intensive Care Units
Microbiological Techniques
Sepsis
Specimen Handling
Early and appropriate blood culture sampling is recommended as a standard of care for patients with suspected bloodstream infections (BSI) but is rarely taken into account when quality indicators for BSI are evaluated. To date, sampling of about 100 to 200 blood culture sets per 1,000 patient-days is recommended as the target range for blood culture rates. However, the empirical basis of this recommendation is not clear. The aim of the current study was to analyze the association between blood culture rates and observed BSI rates and to derive a reference threshold for blood culture rates in intensive care units (ICUs). This study is based on data from 223 ICUs taking part in the German hospital infection surveillance system. We applied locally weighted regression and segmented Poisson regression to assess the association between blood culture rates and BSI rates. Below 80 to 90 blood culture sets per 1,000 patient-days, observed BSI rates increased with increasing blood culture rates, while there was no further increase above this threshold. Segmented Poisson regression located the threshold at 87 (95% confidence interval, 54 to 120) blood culture sets per 1,000 patient-days. Only one-third of the investigated ICUs displayed blood culture rates above this threshold. We provided empirical justification for a blood culture target threshold in ICUs. In the majority of the studied ICUs, blood culture sampling rates were below this threshold. This suggests that a substantial fraction of BSI cases might remain undetected; reporting observed BSI rates as a quality indicator without sufficiently high blood culture rates might be misleading.
2016-03-08T10:07:42Z
2016-03-08T10:07:42Z
2015-02
Article
Proposing an empirically justified reference threshold for blood culture sampling rates in intensive care units. 2015, 53 (2):648-52 J. Clin. Microbiol.
1098-660X
25520442
10.1128/JCM.02944-14
http://hdl.handle.net/10033/600847
Journal of clinical microbiology
en
oai:repository.helmholtz-hzi.de:10033/6050142019-08-30T11:30:58Zcom_10033_267632com_10033_211390col_10033_267633
Bloodstream infections, antibiotic resistance and the practice of blood culture sampling in Germany: study design of a Thuringia-wide prospective population-based study (AlertsNet).
Karch, André
Schmitz, Roland P
Rißner, Florian
Castell, Stefanie
Töpel, Sandra
Jakob, Matthias
Brunkhorst, Frank M
Mikolajczyk, Rafael
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Bloodstream infections are a major cause of death worldwide; blood culture (BC) sampling remains the most important tool for their diagnosis. Current data suggest that BC rates in German hospitals are considerably lower than recommended; this points to shortfalls in the application of microbiological analyses. Since early and appropriate BC diagnostics are associated with reduced case fatality rates and a shorter duration of antimicrobial therapy, a multicomponent study for the improvement of BC diagnostics was developed.
2016-04-11T12:00:00Z
2016-04-11T12:00:00Z
2015
Article
Bloodstream infections, antibiotic resistance and the practice of blood culture sampling in Germany: study design of a Thuringia-wide prospective population-based study (AlertsNet). 2015, 5 (12):e009095 BMJ Open
2044-6055
26671957
10.1136/bmjopen-2015-009095
http://hdl.handle.net/10033/605014
BMJ open
en
oai:repository.helmholtz-hzi.de:10033/6060482019-08-30T11:32:16Zcom_10033_267632com_10033_211390col_10033_267633
Incidence, prevalence and 1-year all-cause mortality of heart failure in Germany: a study based on electronic healthcare data of more than six million persons.
Ohlmeier, Christoph
Mikolajczyk, Rafael T
Frick, Johann
Prütz, Franziska
Haverkamp, Wilhelm
Garbe, Edeltraut
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Heart failure (HF) continues to be a leading cause of morbidity and mortality in industrialized countries. Data on the epidemiology of HF are largely lacking for Germany. The aims of this study were to estimate the incidence and prevalence of HF in Germany, to estimate 1-year all-cause mortality in patients who received their first diagnosis of HF in hospital and to assess related risk factors.
2016-04-20T11:35:15Z
2016-04-20T11:35:15Z
2015-08
Article
Incidence, prevalence and 1-year all-cause mortality of heart failure in Germany: a study based on electronic healthcare data of more than six million persons. 2015, 104 (8):688-96 Clin Res Cardiol
1861-0692
25777937
10.1007/s00392-015-0841-4
http://hdl.handle.net/10033/606048
Clinical research in cardiology : official journal of the German Cardiac Society
en
oai:repository.helmholtz-hzi.de:10033/6077312019-08-30T11:24:31Zcom_10033_267632com_10033_211390col_10033_267633
Predictors of the patient-centered outcomes of surgical carpal tunnel release - a prospective cohort study.
Conzen, Catharina
Conzen, Michael
Rübsamen, Nicole
Mikolajczyk, Rafael
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Carpal tunnel syndrome (CTS) causes a substantial burden of disease in society. While CTS can be resolved by surgical carpal tunnel release, it still remains unclear as to what degree outcomes depend on patients' characteristics. This study assesses patient-centered outcomes after surgical carpal tunnel release in a large outpatient clinic in Germany.
2016-05-03T08:59:29Z
2016-05-03T08:59:29Z
2016
Article
Predictors of the patient-centered outcomes of surgical carpal tunnel release - a prospective cohort study. 2016, 17 (1):190 BMC Musculoskelet Disord
1471-2474
27121725
10.1186/s12891-016-1046-3
http://hdl.handle.net/10033/607731
BMC musculoskeletal disorders
en
oai:repository.helmholtz-hzi.de:10033/6077382019-08-30T11:28:23Zcom_10033_267632com_10033_211390col_10033_267633
Care for MRSA carriers in the outpatient sector: a survey among MRSA carriers and physicians in two regions in Germany.
Raupach-Rosin, Heike
Rübsamen, Nicole
Szkopek, Sebastian
Schmalz, Oliver
Karch, André
Mikolajczyk, Rafael T
Castell, Stefanie
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Little is known about the management of methicillin-resistant Staphylococcus aureus (MRSA) carriers in the German outpatient sector and about the impact of MRSA on their daily life. Reimbursement for MRSA related costs in the German outpatient sector is available since 2012, but its impact has not been studied yet. The aim of the study was to analyze the outpatient management of MRSA carriers from both, physicians' and MRSA carriers' perspective.
2016-05-03T13:32:03Z
2016-05-03T13:32:03Z
2016
Article
Care for MRSA carriers in the outpatient sector: a survey among MRSA carriers and physicians in two regions in Germany. 2016, 16 (1):184 BMC Infect. Dis.
1471-2334
27112442
10.1186/s12879-016-1503-5
http://hdl.handle.net/10033/607738
BMC infectious diseases
en
oai:repository.helmholtz-hzi.de:10033/6144442019-08-30T11:31:23Zcom_10033_267632com_10033_211390col_10033_267633
What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies.
Betran, Ana Pilar
Torloni, Maria Regina
Zhang, Jun
Ye, Jiangfeng
Mikolajczyk, Rafael T
Deneux-Tharaux, Catherine
Oladapo, Olufemi Taiwo
Souza, João Paulo
Tunçalp, Özge
Vogel, Joshua Peter
Gülmezoglu, Ahmet Metin
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Cesarean Section
Cross-Sectional Studies
Female
Humans
Infant
Infant Mortality
Infant, Newborn
Maternal Mortality
Morbidity
Pregnancy
Pregnancy Outcome
Socioeconomic Factors
World Health Organization
In 1985, WHO stated that there was no justification for caesarean section (CS) rates higher than 10-15% at population-level. While the CS rates worldwide have continued to increase in an unprecedented manner over the subsequent three decades, concern has been raised about the validity of the 1985 landmark statement. We conducted a systematic review to identify, critically appraise and synthesize the analyses of the ecologic association between CS rates and maternal, neonatal and infant outcomes. Four electronic databases were searched for ecologic studies published between 2000 and 2014 that analysed the possible association between CS rates and maternal, neonatal or infant mortality or morbidity. Two reviewers performed study selection, data extraction and quality assessment independently. We identified 11,832 unique citations and eight studies were included in the review. Seven studies correlated CS rates with maternal mortality, five with neonatal mortality, four with infant mortality, two with LBW and one with stillbirths. Except for one, all studies were cross-sectional in design and five were global analyses of national-level CS rates versus mortality outcomes. Although the overall quality of the studies was acceptable; only two studies controlled for socio-economic factors and none controlled for clinical or demographic characteristics of the population. In unadjusted analyses, authors found a strong inverse relationship between CS rates and the mortality outcomes so that maternal, neonatal and infant mortality decrease as CS rates increase up to a certain threshold. In the eight studies included in this review, this threshold was at CS rates between 9 and 16%. However, in the two studies that adjusted for socio-economic factors, this relationship was either weakened or disappeared after controlling for these confounders. CS rates above the threshold of 9-16% were not associated with decreases in mortality outcomes regardless of adjustments. Our findings could be interpreted to mean that at CS rates below this threshold, socio-economic development may be driving the ecologic association between CS rates and mortality. On the other hand, at rates higher than this threshold, there is no association between CS and mortality outcomes regardless of adjustment. The ecological association between CS rates and relevant morbidity outcomes needs to be evaluated before drawing more definite conclusions at population level.
2016-06-23T13:35:01Z
2016-06-23T13:35:01Z
2015
Article
What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies. 2015, 12:57 Reprod Health
1742-4755
26093498
10.1186/s12978-015-0043-6
http://hdl.handle.net/10033/614444
Reproductive health
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6205632019-08-30T11:30:58Zcom_10033_267632com_10033_211390col_10033_267633
Top 25 Global Causes of Disability-Adjusted Life-Years (DALYs) in Children Younger Than 5 Years, Both Sexes, 1990 and 2013
The Global Burden of Disease Pediatrics Collaboration
Karch, André
et al.
Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave, Ste 600, Seattle, WA 98121
mportance The literature focuses on mortality among children younger than 5 years. Comparable information on nonfatal health outcomes among these children and the fatal and nonfatal burden of diseases and injuries among older children and adolescents is scarce. Objective To determine levels and trends in the fatal and nonfatal burden of diseases and injuries among younger children (aged <5 years), older children (aged 5-9 years), and adolescents (aged 10-19 years) between 1990 and 2013 in 188 countries from the Global Burden of Disease (GBD) 2013 study. Evidence Review Data from vital registration, verbal autopsy studies, maternal and child death surveillance, and other sources covering 14 244 site-years (ie, years of cause of death data by geography) from 1980 through 2013 were used to estimate cause-specific mortality. Data from 35 620 epidemiological sources were used to estimate the prevalence of the diseases and sequelae in the GBD 2013 study. Cause-specific mortality for most causes was estimated using the Cause of Death Ensemble Model strategy. For some infectious diseases (eg, HIV infection/AIDS, measles, hepatitis B) where the disease process is complex or the cause of death data were insufficient or unavailable, we used natural history models. For most nonfatal health outcomes, DisMod-MR 2.0, a Bayesian metaregression tool, was used to meta-analyze the epidemiological data to generate prevalence estimates. Findings Of the 7.7 (95% uncertainty interval [UI], 7.4-8.1) million deaths among children and adolescents globally in 2013, 6.28 million occurred among younger children, 0.48 million among older children, and 0.97 million among adolescents. In 2013, the leading causes of death were lower respiratory tract infections among younger children (905 059 deaths; 95% UI, 810 304-998 125), diarrheal diseases among older children (38 325 deaths; 95% UI, 30 365-47 678), and road injuries among adolescents (115 186 deaths; 95% UI, 105 185-124 870). Iron deficiency anemia was the leading cause of years lived with disability among children and adolescents, affecting 619 (95% UI, 618-621) million in 2013. Large between-country variations exist in mortality from leading causes among children and adolescents. Countries with rapid declines in all-cause mortality between 1990 and 2013 also experienced large declines in most leading causes of death, whereas countries with the slowest declines had stagnant or increasing trends in the leading causes of death. In 2013, Nigeria had a 12% global share of deaths from lower respiratory tract infections and a 38% global share of deaths from malaria. India had 33% of the world’s deaths from neonatal encephalopathy. Half of the world’s diarrheal deaths among children and adolescents occurred in just 5 countries: India, Democratic Republic of the Congo, Pakistan, Nigeria, and Ethiopia. Conclusions and Relevance Understanding the levels and trends of the leading causes of death and disability among children and adolescents is critical to guide investment and inform policies. Monitoring these trends over time is also key to understanding where interventions are having an impact. Proven interventions exist to prevent or treat the leading causes of unnecessary death and disability among children and adolescents. The findings presented here show that these are underused and give guidance to policy makers in countries where more attention is needed.
2016-10-25T14:32:57Z
2016-10-25T14:32:57Z
2016-10-25
Article
Global Burden of Disease Pediatrics Collaboration. Global and National Burden of Diseases and Injuries Among Children and Adolescents Between 1990 and 2013: Findings From the Global Burden of Disease 2013 Study. JAMA Pediatr. 2016;170(3):267-287. doi:10.1001/jamapediatrics.2015.4276
2168-6211
26810619
10.1001/jamapediatrics.2015.4276
http://hdl.handle.net/10033/620563
JAMA Pediadrics
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
JAMA Network
oai:repository.helmholtz-hzi.de:10033/6205422019-08-30T11:27:16Zcom_10033_267632com_10033_211390col_10033_267633
Measuring inter-rater reliability for nominal data - which coefficients and confidence intervals are appropriate?
Zapf, Antonia
Castell, Stefanie
Morawietz, Lars
Karch, André
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Reliability of measurements is a prerequisite of medical research. For nominal data, Fleiss' kappa (in the following labelled as Fleiss' K) and Krippendorff's alpha provide the highest flexibility of the available reliability measures with respect to number of raters and categories. Our aim was to investigate which measures and which confidence intervals provide the best statistical properties for the assessment of inter-rater reliability in different situations.
2016-10-07T10:52:37Z
2016-10-07T10:52:37Z
2016
Article
Measuring inter-rater reliability for nominal data - which coefficients and confidence intervals are appropriate? 2016, 16:93 BMC Med Res Methodol
1471-2288
27495131
10.1186/s12874-016-0200-9
http://hdl.handle.net/10033/620542
BMC medical research methodology
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6205542019-08-30T11:33:57Zcom_10033_267632com_10033_211390col_10033_267633
Alcohol Drinking in University Students Matters for Their Self-Rated Health Status: A Cross-sectional Study in Three European Countries.
Mikolajczyk, Rafael T
Sebena, Rene
Warich, Julia
Naydenova, Vihra
Dudziak, Urszula
Orosova, Olga
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Alcohol drinking was linked to self-rated health in different populations, but the observed association was inconsistent. We studied the association among university students across three European countries with different patterns of drinking.
2016-10-18T13:23:00Z
2016-10-18T13:23:00Z
2016
Article
Alcohol Drinking in University Students Matters for Their Self-Rated Health Status: A Cross-sectional Study in Three European Countries. 2016, 4:210 Front Public Health
27730122
10.3389/fpubh.2016.00210
http://hdl.handle.net/10033/620554
Frontiers in public health
ENG
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6206482019-08-30T11:27:46Zcom_10033_267632com_10033_211390col_10033_267633
Infection prevention at preschool age - What is reasonable? [Infektionsprävention im Kindergartenalter -Was ist sinnvoll?]
Schlinkmann, K.M.
Raupach-Rosin, H.
Hübner, J.,
Akute respiratorische und gastrointestinale Infektionen stellen die am weitesten verbreiteten Infektionserkrankungen im Kindesalter dar und generieren hohe Kosten. Bezüglich des Immunsystems ist neben der Infektionsabwehr auch die Immuntoleranz zu beachten. Daraus ergibt sich die Frage nach einer Ausgestaltung der Infektionsprävention, bei der negative Effekte auf die Immuntoleranz vermieden werden. Eine Handreichung dazu bieten die Hygienehypothese und die „old friends“ Theorie, die die Unterschiede in der Rolle der Pathogene für die Entwicklung des Immunsystems mit der gemeinsamen Evolution erklärt. Daraus lassen sich Implikationen für die Infektionsprävention ableiten: Bezüglich der Mikroorganismen, die für die Ausbildung der Toleranz verantwortlich sind (sog. old friends, z.B. Mikroorganismen, die das Mikrobiom bilden), können sich übertriebene Hygienemaßnahmen negativ auswirken. Pathogene, die eine dauerhafte Immunität auslösen oder tödlich verlaufen können (sog. crowd infections, z.B. Masern) haben diese Rolle nicht – angesichts der Risiken sollte hier eine spezifische Prävention mittels Impfung erfolgen. Die meisten akuten respiratorischen und gastrointestinalen Infektionen fallen in eine weitere Gruppe ohne bleibende Immunantwort (z.B. Rhinovirusinfektionen), deren Rolle für die Immuntoleranz bisher unklar ist. Für diese Infektionen können unspezifische Präventionsmaßnahmen eingesetzt werden. Gesicherte Evidenz liegt für die Effektivität von Handhygiene sowie von Barriere- und Isolationsmaßnahmen zur Verhinderung der Infektionsübertragung vor. Hingegen gibt es für Maßnahmen zur Stärkung der Immunität keine oder bestenfalls kontroverse Evidenz. Der traditionelle Zusammenhang zwischen Kälte und Erkältung erscheint fraglich und daher auch die Bedeutsamkeit der entsprechenden Präventionsmaßnahmen. Unklar ist, in welchem Umfang einzelne Maßnahmen von Eltern eingesetzt werden, und ob die Exposition gegenüber den leichten akuten Infektionen doch immunologisch eine Rolle spielt. 2
2016-12-08T11:34:46Z
2016-12-08T11:34:46Z
2016-01
2016-12-08
Article
http://hdl.handle.net/10033/620648
de
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6206922019-08-30T11:35:13Zcom_10033_267632com_10033_211390com_10033_620659com_10033_311308col_10033_267633col_10033_620661col_10033_620721
Analysis of Practical Identifiability of a Viral Infection Model.
Nguyen, Van Kinh
Klawonn, Frank
Mikolajczyk, Rafael
Hernandez-Vargas, Esteban Abelardo
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Mathematical modelling approaches have granted a significant contribution to life sciences and beyond to understand experimental results. However, incomplete and inadequate assessments in parameter estimation practices hamper the parameter reliability, and consequently the insights that ultimately could arise from a mathematical model. To keep the diligent works in modelling biological systems from being mistrusted, potential sources of error must be acknowledged. Employing a popular mathematical model in viral infection research, existing means and practices in parameter estimation are exemplified. Numerical results show that poor experimental data is a main source that can lead to erroneous parameter estimates despite the use of innovative parameter estimation algorithms. Arbitrary choices of initial conditions as well as data asynchrony distort the parameter estimates but are often overlooked in modelling studies. This work stresses the existence of several sources of error buried in reports of modelling biological systems, voicing the need for assessing the sources of error, consolidating efforts in solving the immediate difficulties, and possibly reconsidering the use of mathematical modelling to quantify experimental data.
2017-01-11T09:39:52Z
2017-01-11T09:39:52Z
2016
Article
Analysis of Practical Identifiability of a Viral Infection Model. 2016, 11 (12):e0167568 PLoS ONE
1932-6203
28036339
10.1371/journal.pone.0167568
http://hdl.handle.net/10033/620692
PloS one
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6208842019-08-30T11:29:47Zcom_10033_267632com_10033_211390col_10033_267633
Deficits in knowledge, attitude, and practice towards blood culture sampling: results of a nationwide mixed-methods study among inpatient care physicians in Germany.
Raupach-Rosin, Heike
Duddeck, Arne
Gehrlich, Maike
Helmke, Charlotte
Huebner, Johannes
Pletz, Mathias W
Mikolajczyk, Rafael T
Karch, André
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Blood culture (BC) sampling rates in Germany are considerably lower than recommended. Aim of our study was to assess knowledge, attitudes, and practice of physicians in Germany regarding BC diagnostics.
2017-04-04T13:41:40Z
2017-04-04T13:41:40Z
2017-02-15
Article
Deficits in knowledge, attitude, and practice towards blood culture sampling: results of a nationwide mixed-methods study among inpatient care physicians in Germany. 2017 Infection
1439-0973
28205159
10.1007/s15010-017-0990-7
http://hdl.handle.net/10033/620884
Infection
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6208922019-08-30T11:29:47Zcom_10033_267632com_10033_211390com_10033_620601col_10033_267633col_10033_211409col_10033_620603
Comparison of response patterns in different survey designs: a longitudinal panel with mixed-mode and online-only design.
Rübsamen, Nicole
Akmatov, Manas K
Castell, Stefanie
Karch, André
Mikolajczyk, Rafael T
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Increasing availability of the Internet allows using only online data collection for more epidemiological studies. We compare response patterns in a population-based health survey using two survey designs: mixed-mode (choice between paper-and-pencil and online questionnaires) and online-only design (without choice).
2017-04-07T10:09:11Z
2017-04-07T10:09:11Z
2017
Article
Comparison of response patterns in different survey designs: a longitudinal panel with mixed-mode and online-only design. 2017, 14:4 Emerg Themes Epidemiol
28344629
10.1186/s12982-017-0058-2
http://hdl.handle.net/10033/620892
Emerging themes in epidemiology
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6209122019-08-30T11:31:49Zcom_10033_267632com_10033_211390col_10033_267633
Current and future effects of varicella and herpes zoster vaccination in Germany - Insights from a mathematical model in a country with universal varicella vaccination.
Horn, Johannes
Karch, André
Damm, Oliver
Kretzschmar, Mirjam E
Siedler, Anette
Ultsch, Bernhard
Weidemann, Felix
Wichmann, Ole
Hengel, Hartmut
Greiner, Wolfgang
Mikolajczyk, Rafael T
Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Varicella zoster virus (VZV) is primarily known for causing varicella in childhood, but can reactivate again as herpes zoster (HZ) after a period of latency, mainly in persons older than 50 years. Universal varicella vaccination was introduced in Germany in 2004, while HZ vaccination has not been recommended yet. We aimed to quantify the potential long-term effects of universal childhood varicella vaccination and HZ vaccination of the elderly on varicella and HZ incidence in Germany over a time horizon of 100 years, using a transmission model calibrated to pre-vaccination data and validated against early post-vaccination data. Using current vaccination coverage rates of 87% (64%) with one (two) varicella vaccine dose(s), the model predicts a decrease in varicella cases by 89% for the year 2015. In the long run, the incidence reduction will stabilize at about 70%. Under the assumption of the boosting hypothesis of improved HZ protection caused by exposure to VZV, the model predicts a temporary increase in HZ incidence of up to 20% for around 50 years. HZ vaccination of the elderly with an assumed coverage of 20% has only limited effects in counteracting this temporary increase in HZ incidence. However, HZ incidence is shown to decrease in the long-term by 58% as vaccinated individuals get older and finally reach age-classes with originally high HZ incidence. Despite substantial uncertainties around several key variables, the model's results provide valuable insights that support decision-making regarding national VZV vaccination strategies.
2017-05-08T13:19:47Z
2017-05-08T13:19:47Z
2016-07-02
Article
Current and future effects of varicella and herpes zoster vaccination in Germany - Insights from a mathematical model in a country with universal varicella vaccination. 2016, 12 (7):1766-76 Hum Vaccin Immunother
2164-554X
26835890
10.1080/21645515.2015.1135279
http://hdl.handle.net/10033/620912
Human vaccines & immunotherapeutics
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6209202019-08-30T11:29:47Zcom_10033_267632com_10033_211390col_10033_267633
Incidence and comparison of retrospective and prospective data on respiratory and gastrointestinal infections in German households.
Schlinkmann, Kristin Maria
Bakuli, Abhishek
Mikolajczyk, Rafael T
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Acute respiratory infections (ARI) and acute gastrointestinal infections (AGI) are the most common childhood infections, and corresponding data can either be collected prospectively or retrospectively. The aim of this study was to estimate the incidence of respiratory and gastrointestinal episodes in German households with children attending day care and to compare results of prospective and retrospective data collection.
2017-05-17T09:39:00Z
2017-05-17T09:39:00Z
2017-05-11
Article
Incidence and comparison of retrospective and prospective data on respiratory and gastrointestinal infections in German households. 2017, 17 (1):336 BMC Infect. Dis.
1471-2334
28490316
10.1186/s12879-017-2434-5
http://hdl.handle.net/10033/620920
BMC infectious diseases
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6209232019-08-30T11:29:47Zcom_10033_267632com_10033_211390col_10033_267633
Transcranial doppler sonography is not a valid diagnostic tool for detection of basilar artery stenosis or in-stent restenosis: a retrospective diagnostic study.
Koh, Woori
Kallenberg, Kai
Karch, André
Frank, Tobias
Knauth, Michael
Bähr, Mathias
Liman, Jan
Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
There are contradictory reports concerning the validity of transcranial sonography (TCD and TCCS) for examinations of the basilar artery. Here we investigated sensitivity and specificity of transcranial sonography for the detection of basilar artery stenosis and in-stent-restenosis compared to cerebral angiography.
2017-05-17T13:43:28Z
2017-05-17T13:43:28Z
2017-05-11
Article
Transcranial doppler sonography is not a valid diagnostic tool for detection of basilar artery stenosis or in-stent restenosis: a retrospective diagnostic study. 2017, 17 (1):89 BMC Neurol
1471-2377
28490351
10.1186/s12883-017-0872-8
http://hdl.handle.net/10033/620923
BMC neurology
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6209252019-08-30T11:31:23Zcom_10033_267632com_10033_211390col_10033_267633
Deciding on the mode of birth after a previous caesarean section - An online survey investigating women's preferences in Western Switzerland.
Bonzon, Magali
Gross, Mechthild M
Karch, André
Grylka-Baeschlin, Susanne
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
promoting vaginal births after caesarean section (VBAC) for eligible women and increasing rates of successful VBACs are the best strategies to reduce the number of repeat caesarean sections (CS). Knowledge of factors that are associated with women's decision-making around mode of birth after CS is important when developing strategies to promote VBAC. This study assessed which factors are associated with women's preferences for VBAC versus elective repeat caesarean section (ERCS) in a new pregnancy after one previous caesarean in Switzerland.
2017-05-22T10:59:58Z
2017-05-22T10:59:58Z
2017-04-21
Article
Deciding on the mode of birth after a previous caesarean section - An online survey investigating women's preferences in Western Switzerland. 2017, 50:219-227 Midwifery
1532-3099
28478374
10.1016/j.midw.2017.04.005
http://hdl.handle.net/10033/620925
Midwifery
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6209332019-08-30T11:29:47Zcom_10033_267632com_10033_211390col_10033_267633
Early versus Late Admission to Labor Affects Labor Progression and Risk of Cesarean Section in Nulliparous Women.
Mikolajczyk, Rafael T
Zhang, Jun
Grewal, Jagteshwar
Chan, Linda C
Petersen, Antje
Gross, Mechthild M
Helmholtz Centre of infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Rates of cesarean section increase worldwide, and the components of this increase are partially unknown. A strong role is prescribed to dystocia, and at the same time, the diagnosis of dystocia is highly subjective. Previous studies indicated that risk of cesarean is higher when women are admitted to the hospital early in the labor.
2017-06-06T10:50:32Z
2017-06-06T10:50:32Z
2016
Article
Early versus Late Admission to Labor Affects Labor Progression and Risk of Cesarean Section in Nulliparous Women. 2016, 3:26 Front Med (Lausanne)
27446924
10.3389/fmed.2016.00026
http://hdl.handle.net/10033/620933
Frontiers in medicine
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6209542019-08-30T11:26:13Zcom_10033_267632com_10033_211390com_10033_620644col_10033_267633col_10033_620647
Sociodemographic determinants of spatial disparities in early childhood caries: An ecological analysis in Braunschweig, Germany.
Meyer, Frederic
Karch, André
Schlinkmann, Kristin Maria
Dreesman, Johannes
Horn, Johannes
Rübsamen, Nicole
Sudradjat, Henny
Schubert, Rainer
Mikolajczyk, Rafael T
Helmholtz Centre for infection research, Inhoffenstr.7, 38124 Braunschweig, Germany.
To identify spatial disparities in dental caries experience (measured by dmft (decayed missing filled teeth) index) of children in the city of Braunschweig and to evaluate whether these disparities can be explained by sociodemographic characteristics.
2017-06-15T12:59:58Z
2017-06-15T12:59:58Z
2017-05-26
Article
Sociodemographic determinants of spatial disparities in early childhood caries: An ecological analysis in Braunschweig, Germany. 2017 Community Dent Oral Epidemiol
1600-0528
28547864
10.1111/cdoe.12308
http://hdl.handle.net/10033/620954
Community dentistry and oral epidemiology
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6210162019-08-30T11:33:30Zcom_10033_267632com_10033_211390col_10033_267633
Structure of the Escherichia coli ProQ RNA-binding protein.
Gonzalez, Grecia M
Hardwick, Steven W
Maslen, Sarah L
Skehel, J Mark
Holmqvist, Erik
Vogel, Jörg
Bateman, Alex
Luisi, Ben F
Broadhurst, R William
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
3' Untranslated Regions
Binding Sites
Escherichia coli Proteins
Host Factor 1 Protein
Models, Molecular
Nuclear Magnetic Resonance, Biomolecular
Protein Domains
RNA-Binding Proteins
The protein ProQ has recently been identified as a global small noncoding RNA-binding protein in Salmonella, and a similar role is anticipated for its numerous homologs in divergent bacterial species. We report the solution structure of Escherichia coli ProQ, revealing an N-terminal FinO-like domain, a C-terminal domain that unexpectedly has a Tudor domain fold commonly found in eukaryotes, and an elongated bridging intradomain linker that is flexible but nonetheless incompressible. Structure-based sequence analysis suggests that the Tudor domain was acquired through horizontal gene transfer and gene fusion to the ancestral FinO-like domain. Through a combination of biochemical and biophysical approaches, we have mapped putative RNA-binding surfaces on all three domains of ProQ and modeled the protein's conformation in the apo and RNA-bound forms. Taken together, these data suggest how the FinO, Tudor, and linker domains of ProQ cooperate to recognize complex RNA structures and serve to promote RNA-mediated regulation.
2017-07-21T08:29:01Z
2017-07-21T08:29:01Z
2017-05
Article
Structure of the Escherichia coli ProQ RNA-binding protein. 2017, 23 (5):696-711 RNA
1469-9001
28193673
10.1261/rna.060343.116
http://hdl.handle.net/10033/621016
RNA (New York, N.Y.)
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6210212019-08-22T12:38:22Zcom_10033_267632com_10033_211390col_10033_267633
Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015.
Child Mortality
Communicable Diseases
Global Health
Humans
Infant
Infant Mortality
Malaria
Stillbirth
Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly, highlighting a crucial need to further examine potential drivers of accelerated or slowed decreases in child mortality. The Global Burden of Disease 2015 Study (GBD 2015) provides an analytical framework to comprehensively assess these trends for under-5 mortality, age-specific and cause-specific mortality among children under 5 years, and stillbirths by geography over time.
2017-07-26T14:14:57Z
2017-07-26T14:14:57Z
2016-10-08
Article
Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. 2016, 388 (10053):1725-1774 Lancet
1474-547X
27733285
10.1016/S0140-6736(16)31575-6
http://hdl.handle.net/10033/621021
Lancet (London, England)
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6210222019-08-30T11:34:22Zcom_10033_267632com_10033_211390col_10033_267633
Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.
GBD 2015 Child Mortality Collaborators
Karch, A.
Bayes Theorem
Cost of Illness
Disabled Persons
Global Health
Humans
Incidence
Prevalence
Quality-Adjusted Life Years
Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to non-communicable diseases (NCDs) more common in adults. For the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015), we estimated the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015.
2017-07-28T09:45:06Z
2017-07-28T09:45:06Z
2016
Article
Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. 2016, 388 (10053):1545-1602 Lancet
1474-547X
27733282
10.1016/S0140-6736(16)31678-6
http://hdl.handle.net/10033/621022
Lancet (London, England)
en
oai:repository.helmholtz-hzi.de:10033/6210562019-08-30T11:34:48Zcom_10033_267632com_10033_211390col_10033_267633
Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015.
GBD 2015 Mortality and Causes of Death Collaborators
Karch, André
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Cause of Death
Communicable Diseases
Global Health
Humans
Life Expectancy
Mortality
Mortality, Premature
Improving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures.
2017-08-16T08:56:57Z
2017-08-16T08:56:57Z
2016-10-08
Article
Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015. 2016, 388 (10053):1459-1544 Lancet
1474-547X
27733281
10.1016/S0140-6736(16)31012-1
http://hdl.handle.net/10033/621056
Lancet (London, England)
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6210792019-08-30T11:31:49Zcom_10033_267632com_10033_211390col_10033_267633
Association between Embolic Stroke Patterns, ESUS Etiology, and New Diagnosis of Atrial Fibrillation: A Secondary Data Analysis of the Find-AF Trial.
Maier, Ilko L
Schregel, Katharina
Karch, André
Weber-Krueger, Mark
Mikolajczyk, Rafael T
Stahrenberg, Raoul
Gröschel, Klaus
Bähr, Mathias
Knauth, Michael
Psychogios, Marios-Nikos
Wachter, Rolf
Liman, Jan
Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Background. Atrial fibrillation (AF) is an important cause of embolic stroke of undetermined source (ESUS). Imaging-patterns like multiple infarcts, simultaneous involvement of different circulations, infarcts of different ages, and isolated cortical infarcts are likely to indicate cardioembolic stroke. The aim of our study was to evaluate the association between embolic stroke patterns, ESUS, and the new diagnosis of AF. Methods. Stroke etiology and imaging characteristics from patients included in the Find-AF study were obtained. Embolic stroke patterns in CT- or MR-imaging were correlated with the diagnosis of ESUS as well as the short- (on baseline ECG and during 7-day Holter) and long-term (12-month follow-up) diagnosis of AF. Results. From 281 patients included in the Find-AF study, 127 (45.2%) patients with ischemic lesions detected in CT or MRI were included. 26 (20.5%) of these patients had ESUS. At least one embolic stroke pattern was detected in 67 (52.7%) patients. Embolic stroke patterns were not associated with ESUS (OR 1.57, 0.65-3.79, p = 0.317), the short-term (OR 0.64, 0.26-1.58, p = 0.327) or long-term diagnosis of AF (OR 0.72, 0.31-1.68, p = 0.448). Conclusions. This secondary data analysis of the Find-AF study could not provide evidence for an association between embolic stroke patterns, ESUS, and the new diagnosis of AF.
2017-08-29T12:08:37Z
2017-08-29T12:08:37Z
2017
Article
Association between Embolic Stroke Patterns, ESUS Etiology, and New Diagnosis of Atrial Fibrillation: A Secondary Data Analysis of the Find-AF Trial. 2017, 2017:1391843 Stroke Res Treat
2090-8105
28536667
10.1155/2017/1391843
http://hdl.handle.net/10033/621079
Stroke research and treatment
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6211012019-08-30T11:30:32Zcom_10033_267632com_10033_211390col_10033_267633
Evaluation of vaccination herd immunity effects for anogenital warts in a low coverage setting with human papillomavirus vaccine-an interrupted time series analysis from 2005 to 2010 using health insurance data.
Thöne, Kathrin
Horn, Johannes
Mikolajczyk, Rafael T
Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Shortly after the human papillomavirus (HPV) vaccine recommendation and hence the reimbursement of vaccination costs for the respective age groups in Germany in 2007, changes in the incidence of anogenital warts (AGWs) were observed, but it was not clear at what level the incidence would stabilize and to what extent herd immunity would be present. Given the relatively low HPV vaccination coverage in Germany, we aimed to assess potential vaccination herd immunity effects in the German setting.
2017-09-11T11:46:45Z
2017-09-11T11:46:45Z
2017-08-14
Article
Evaluation of vaccination herd immunity effects for anogenital warts in a low coverage setting with human papillomavirus vaccine-an interrupted time series analysis from 2005 to 2010 using health insurance data. 2017, 17 (1):564 BMC Infect. Dis.
1471-2334
28806926
10.1186/s12879-017-2663-7
http://hdl.handle.net/10033/621101
BMC infectious diseases
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6211152019-08-30T11:37:24Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409
Factors associated with attrition in a longitudinal online study: results from the HaBIDS panel.
Rübsamen, Nicole
Akmatov, Manas K
Castell, Stefanie
Karch, André
Mikolajczyk, Rafael T
Hemholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Knowing about predictors of attrition in a panel is important to initiate early measures against loss of participants. We investigated attrition in both early and late phase of an online panel with special focus on preferences regarding mode of participation.
2017-09-22T08:45:58Z
2017-09-22T08:45:58Z
2017-08-31
Article
Factors associated with attrition in a longitudinal online study: results from the HaBIDS panel. 2017, 17 (1):132 BMC Med Res Methodol
1471-2288
28859617
10.1186/s12874-017-0408-3
http://hdl.handle.net/10033/621115
BMC medical research methodology
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6211172019-08-30T11:37:24Zcom_10033_267632com_10033_211390col_10033_267633
Cost-effectiveness of human papillomavirus vaccination in Germany.
Damm, Oliver
Horn, Johannes
Mikolajczyk, Rafael T
Kretzschmar, Mirjam E E
Kaufmann, Andreas M
Deleré, Yvonne
Ultsch, Bernhard
Wichmann, Ole
Krämer, Alexander
Greiner, Wolfgang
Hemholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
The aim of this study was to assess the cost-effectiveness of human papillomavirus (HPV) vaccination in addition to the current cervical cancer screening programme in Germany using a dynamic transmission model.
2017-09-22T09:49:34Z
2017-09-22T09:49:34Z
2017
Article
Cost-effectiveness of human papillomavirus vaccination in Germany. 2017, 15:18 Cost Eff Resour Alloc
1478-7547
28878573
10.1186/s12962-017-0080-9
http://hdl.handle.net/10033/621117
Cost effectiveness and resource allocation : C/E
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6211772019-08-30T11:28:23Zcom_10033_267632com_10033_211390col_10033_267633
Effect of Disease Definition on Perceived Burden of Acute Respiratory Infections in Children: A Prospective Cohort Study Based on Symptom Diaries.
Zoch, Beate
Günther, Annette
Karch, André
Mikolajczyk, Rafael T
Helmholtz-Zentrum für Infektionsfrschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Acute Disease
Child, Preschool
Humans
Infant
Medical Records
Prospective Studies
Respiratory Tract Infections
Acute respiratory infections (ARIs) are among the most frequent childhood diseases in Western countries. Assessment of ARI episodes for research purposes is usually based on parent-administered retrospective questionnaires or prospective symptom diaries. The aim of our analysis was to compare the effect of ARI definitions on the corresponding disease burden in a prospective cohort study using symptom diaries.
2017-11-16T14:23:51Z
2017-11-16T14:23:51Z
2017-10
Article
Effect of Disease Definition on Perceived Burden of Acute Respiratory Infections in Children: A Prospective Cohort Study Based on Symptom Diaries. 2017, 36 (10):956-961 Pediatr. Infect. Dis. J.
1532-0987
28399058
10.1097/INF.0000000000001604
http://hdl.handle.net/10033/621177
The Pediatric infectious disease journal
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6211882019-08-30T11:33:57Zcom_10033_267632com_10033_211390col_10033_267633
The Risk of Hospitalizations with Injury Diagnoses in a Matched Cohort of Children and Adolescents with and without Attention Deficit/Hyperactivity Disorder in Germany: A Database Study.
Lindemann, Christina
Langner, Ingo
Banaschewski, Tobias
Garbe, Edeltraut
Mikolajczyk, Rafael T
Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr.7, 38124 Braunschweig, Germany.
Attention deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric disorder in children and adolescents worldwide, and children with ADHD have elevated risk of injuries. Our aim was to assess the risk of hospitalizations with injury diagnoses and their various subtypes in children and adolescents with newly diagnosed ADHD compared to those without ADHD, as well as to study sex effects on this risk in the setting of the German health care system.
2017-11-29T15:31:56Z
2017-11-29T15:31:56Z
2017
Article
The Risk of Hospitalizations with Injury Diagnoses in a Matched Cohort of Children and Adolescents with and without Attention Deficit/Hyperactivity Disorder in Germany: A Database Study. 2017, 5:220 Front Pediatr
2296-2360
29114538
10.3389/fped.2017.00220
http://hdl.handle.net/10033/621188
Frontiers in pediatrics
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6212552019-08-30T11:28:51Zcom_10033_267632com_10033_211390com_10033_311308col_10033_267633col_10033_211409col_10033_620721
Effects of pathogen dependency in a multi-pathogen infectious disease system including population level heterogeneity - a simulation study.
Bakuli, Abhishek
Klawonn, Frank
Karch, André
Mikolajczyk, Rafael T
Helmholtz-Zentrum für Infektionsforschung, GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Increased computational resources have made individual based models popular for modelling epidemics. They have the advantage of incorporating heterogeneous features, including realistic population structures (like e.g. households). Existing stochastic simulation studies of epidemics, however, have been developed mainly for incorporating single pathogen scenarios although the effect of different pathogens might directly or indirectly (e.g. via contact reductions) effect the spread of each pathogen. The goal of this work was to simulate a stochastic agent based system incorporating the effect of multiple pathogens, accounting for the household based transmission process and the dependency among pathogens.
2018-01-24T15:11:28Z
2018-01-24T15:11:28Z
2017-12-13
Article
Effects of pathogen dependency in a multi-pathogen infectious disease system including population level heterogeneity - a simulation study. 2017, 14 (1):26 Theor Biol Med Model
1742-4682
29237462
10.1186/s12976-017-0072-7
http://hdl.handle.net/10033/621255
Theoretical biology & medical modelling
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6212562019-08-30T11:33:57Zcom_10033_267632com_10033_211390col_10033_267633
Population-level impact, herd immunity, and elimination after human papillomavirus vaccination: a systematic review and meta-analysis of predictions from transmission-dynamic models.
Brisson, Marc
Bénard, Élodie
Drolet, Mélanie
Bogaards, Johannes A
Baussano, Iacopo
Vänskä, Simopekka
Jit, Mark
Boily, Marie-Claude
Smith, Megan A
Berkhof, Johannes
Canfell, Karen
Chesson, Harrell W
Burger, Emily A
Choi, Yoon H
De Blasio, Birgitte Freiesleben
De Vlas, Sake J
Guzzetta, Giorgio
Hontelez, Jan A C
Horn, Johannes
Jepsen, Martin R
Kim, Jane J
Lazzarato, Fulvio
Matthijsse, Suzette M
Mikolajczyk, Rafael T
Pavelyev, Andrew
Pillsbury, Matthew
Shafer, Leigh Anne
Tully, Stephen P
Turner, Hugo C
Usher, Cara
Walsh, Cathal
Helmholtz Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Modelling studies have been widely used to inform human papillomavirus (HPV) vaccination policy decisions; however, many models exist and it is not known whether they produce consistent predictions of population-level effectiveness and herd effects. We did a systematic review and meta-analysis of model predictions of the long-term population-level effectiveness of vaccination against HPV 16, 18, 6, and 11 infection in women and men, to examine the variability in predicted herd effects, incremental benefit of vaccinating boys, and potential for HPV-vaccine-type elimination.
2018-01-29T13:52:41Z
2018-01-29T13:52:41Z
2016-11
Article
Population-level impact, herd immunity, and elimination after human papillomavirus vaccination: a systematic review and meta-analysis of predictions from transmission-dynamic models. 2016, 1 (1):e8-e17 Lancet Public Health
2468-2667
29253379
10.1016/S2468-2667(16)30001-9
http://hdl.handle.net/10033/621256
The Lancet. Public health
en
'info:eu-repo/grantAgreement/EC/FP7/ 603019
openAccess
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6212862019-08-30T11:31:23Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409
["I cannot kiss my wife"- An Analysis of Daily Experiences of MRSA-carriers].
Raupach-Rosin, H
Klett-Tammen, C J
Schmalz, O
Karch, A
Castell, S
Mikolajczyk, Rafael T
Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Activities of Daily Living
Adult
Carrier State
Female
Focus Groups
Germany
Health Services Accessibility
Humans
Male
Methicillin-Resistant Staphylococcus aureus
Middle Aged
Social Isolation
Staphylococcal Infections
Stereotyping
Objectives: There are no data available on the quality of care after discharge from hospital and only limited data are available on the psychosocial effects of being an MRSA carrier within the German health system.Methods:Patients who tested positive for MRSA in the previous year were invited to take part in focus groups.Results:2 focus groups with a total of 9 MRSA-carriers were conducted. The level of knowledge about MRSA differed between participants. In some cases, lack of information led to uncertainty and inappropriate measures to counteract MRSA. Some participants restricted their social contacts, especially to children, in order to prevent transmission. Patients experienced stigmatization in the health care system more often in inpatient care than in the outpatient sector. Only in a few cases both eradication therapy and swabs for control purposes were carried out.Conclusions:Information about the appropriate treatment and management of MRSA should be made available to patients more easily; in particular, patients need to be informed that MRSA is no threat to healthy individuals. Despite the desire of MRSA-carriers to become MRSA negative, treatment and control of MRSA seem to have low priority in the ambulant health care sector in Germany.
2018-02-19T15:14:45Z
2018-02-19T15:14:45Z
2016-12
Article
["I cannot kiss my wife"- An Analysis of Daily Experiences of MRSA-carriers]. 2016, 78 (12):822-827 Gesundheitswesen
1439-4421
26551853
10.1055/s-0035-1559710
http://hdl.handle.net/10033/621286
Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))
ger
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6213202019-08-30T11:33:57Zcom_10033_267632com_10033_211390col_10033_267633
Partial verification bias and incorporation bias affected accuracy estimates of diagnostic studies for biomarkers that were part of an existing composite gold standard.
Karch, Annika
Koch, Armin
Zapf, Antonia
Zerr, Inga
Karch, André
Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Autopsy
Bias
Biomarkers
Computer Simulation
Creutzfeldt-Jakob Syndrome
Diagnostic Tests, Routine
Humans
Reference Standards
Reproducibility of Results
Sensitivity and Specificity
To investigate how choice of gold standard biases estimates of sensitivity and specificity in studies reassessing the diagnostic accuracy of biomarkers that are already part of a lifetime composite gold standard (CGS).
2018-03-12T15:04:42Z
2018-03-12T15:04:42Z
2016-10
Article
Partial verification bias and incorporation bias affected accuracy estimates of diagnostic studies for biomarkers that were part of an existing composite gold standard. 2016, 78:73-82 J Clin Epidemiol
1878-5921
27107877
10.1016/j.jclinepi.2016.03.022
http://hdl.handle.net/10033/621320
Journal of clinical epidemiology
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6213622019-08-30T11:36:59Zcom_10033_267632com_10033_211390col_10033_267633
Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany - a mathematical modelling study.
Horn, Johannes
Damm, Oliver
Greiner, Wolfgang
Hengel, Hartmut
Kretzschmar, Mirjam E
Siedler, Anette
Ultsch, Bernhard
Weidemann, Felix
Wichmann, Ole
Karch, André
Mikolajczyk, Rafael T
elmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Adolescent
Adult
Aged
Aged, 80 and over
Chickenpox
Chickenpox Vaccine
Child
Demography
Emigration and Immigration
Germany
Herpes Zoster
Herpes Zoster Vaccine
Humans
Immunization Programs
Incidence
Male
Middle Aged
Models, Theoretical
Population Dynamics
Vaccination
Young Adult
Epidemiological studies suggest that reduced exposure to varicella might lead to an increased risk for herpes zoster (HZ). Reduction of exposure to varicella is a consequence of varicella vaccination but also of demographic changes. We analyzed how the combination of vaccination programs and demographic dynamics will affect the epidemiology of varicella and HZ in Germany over the next 50 years.
2018-04-30T11:28:18Z
2018-04-30T11:28:18Z
2018
Article
Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany - a mathematical modelling study. 2018, 16 (1):3 BMC Med
1741-7015
29316913
10.1186/s12916-017-0983-5
http://hdl.handle.net/10033/621362
BMC medicine
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6213762019-08-30T11:33:57Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409
Poor knowledge of vaccination recommendations and negative attitudes towards vaccinations are independently associated with poor vaccination uptake among adults - Findings of a population-based panel study in Lower Saxony, Germany.
Akmatov, Manas K
Rübsamen, Nicole
Deyneko, Igor V
Karch, André
Mikolajczyk, Rafael T
Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
The aims of this study were to (a) assess knowledge of official vaccination recommendations and attitudes towards vaccinations among adults and (b) examine their association with vaccination uptake among adults.
2018-05-22T13:58:52Z
2018-05-22T13:58:52Z
2018
Article
Poor knowledge of vaccination recommendations and negative attitudes towards vaccinations are independently associated with poor vaccination uptake among adults - Findings of a population-based panel study in Lower Saxony, Germany. 2018, 36 (18):2417-2426 Vaccine
1873-2518
29602700
10.1016/j.vaccine.2018.03.050
http://hdl.handle.net/10033/621376
Vaccine
en
http://creativecommons.org/licenses/by-nc-sa/4.0/
oai:repository.helmholtz-hzi.de:10033/6214292019-08-30T11:28:47Zcom_10033_267632com_10033_211390col_10033_267633
Effects of Workflow Optimization in Endovascularly Treated Stroke Patients - A Pre-Post Effectiveness Study.
Schregel, Katharina
Behme, Daniel
Tsogkas, Ioannis
Knauth, Michael
Maier, Ilko
Karch, André
Mikolajczyk, Rafael T
Hinz, José
Liman, Jan
Psychogios, Marios-Nikos
Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Endovascular treatment of acute ischemic stroke has become standard of care for patients with large artery occlusion. Early restoration of blood flow is crucial for a good clinical outcome. We introduced an interdisciplinary standard operating procedure (SOP) between neuroradiologists, neurologists and anesthesiologists in order to streamline patient management. This study analyzes the effect of optimized workflow on periprocedural timings and its potential influence on clinical outcome. Data were extracted from a prospectively maintained university hospital stroke database. The standard operating procedure was established in February 2014. Of the 368 acute stroke patients undergoing endovascular treatment between 2008 and 2015, 278 patients were treated prior to and 90 after process optimization. Outcome measures were periprocedural time intervals and residual functional impairment. After implementation of the SOP, time from symptom onset to reperfusion was significantly reduced (median 264 min prior and 211 min after SOP-introduction (IQR 228-32 min and 161-278 min, respectively); P<0.001). Especially faster supply of imaging and prompt transfer of patients to the angiography suite contributed to this effect. Time between hospital admission and groin puncture was reduced by half after process optimization (median 64 min after versus 121 min prior to SOP-introduction (IQR 54-77 min and 96-161 min, respectively); P<0.001). Clinical outcome was significantly better after workflow optimization as measured with the modified Rankin Scale (common odds ratio (OR) 0.56; 95% CI 0.32-0.98; P = 0.038). Optimization of workflow and interdisciplinary teamwork significantly improved the outcome of patients with acute ischemic stroke due to a significant reduction of in-hospital examination, transportation, imaging and treatment times.
2018-07-24T12:05:10Z
2018-07-24T12:05:10Z
2016-01-01
Article
1932-6203
28036401
10.1371/journal.pone.0169192
http://hdl.handle.net/10033/621429
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0169192
Attribution-NonCommercial-ShareAlike 3.0 United States
http://creativecommons.org/licenses/by-nc-sa/3.0/us/
PloS one
oai:repository.helmholtz-hzi.de:10033/6214352019-08-30T11:34:19Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409
Antibiotic use on paediatric inpatients in a teaching hospital in the Gambia, a retrospective study.
Chaw, Pa Saidou
Schlinkmann, Kristin Maria
Raupach-Rosin, Heike
Karch, André
Pletz, Mathias W
Huebner, Johannes
Nyan, Ousman
Mikolajczyk, Rafael
Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Antibiotic resistance
Antibiotic stewardship
Antibiotic use
Microbiology
Paediatrics
Antibiotics are useful but increasing resistance is a major problem. Our objectives were to assess antibiotic use and microbiology testing in hospitalized children in the Gambia. We conducted a retrospective analysis of paediatric inpatient data at The Edward Francis Small Teaching Hospital in Banjul, The Gambia. We extracted relevant data from the admission folders of all patients (aged > 28 days to 15 years) admitted in 2015 (January-December), who received at least one antibiotic for 24 h. We also reviewed the microbiology laboratory record book to obtain separate data for the bacterial isolates and resistance test results of all the paediatric inpatients during the study period. Over half of the admitted patients received at least one antibiotic during admission (496/917) with a total consumption of 670.7 Days of Antibiotic Therapy/1000 Patient-Days. The clinical diagnoses included an infectious disease for 398/496, 80.2% of the patients on antibiotics, pneumonia being the most common (184/496, 37.1%). There were 51 clinically relevant bacterial isolates, More than half of the admitted patients received antibiotics. The reported antibiotic resistance was highest to the most commonly used antibiotics such as ampicillin. Efforts to maximize definitive antibiotic indication such as microbiological testing prior to start of antibiotics should be encouraged where possible for a more rational antibiotic use.
2018-08-07T08:36:02Z
2018-08-07T08:36:02Z
2018-01-01
Article
2047-2994
30026940
10.1186/s13756-018-0380-7
http://hdl.handle.net/10033/621435
en
Attribution-NonCommercial-ShareAlike 3.0 United States
http://creativecommons.org/licenses/by-nc-sa/3.0/us/
Antimicrobial resistance and infection control
oai:repository.helmholtz-hzi.de:10033/6214632021-08-13T14:41:55Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409
Changes in risk perceptions during the 2014 Ebola virus disease epidemic: results of two consecutive surveys among the general population in Lower Saxony, Germany.
Obenauer, Julie
Rübsamen, Nicole
Garsevanidze, Ekaterine
Karch, André
Mikolajczyk, Rafael T
Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Ebola virus disease
Knowledge
Risk perception
The Ebola virus disease (EVD) outbreak 2014 received extensive news media coverage, which faded out before the outbreak ended. News media coverage impacts risk perception; it is, however, unclear if the components of risk perception (affective and cognitive responses) change differently over time. In an online panel, we asked participants (n = 1376) about EVD risk perceptions at the epidemic's peak (November 2014) and after news media coverage faded out (August 2015). We investigated worry (affective response), perceived likelihood of infection, perceived personal impact, and coping efficacy (dimensions of cognitive response), and knowledge about transmission. Differences between the surveys with respect to manifestations of affective and cognitive dimensions were tested using the Wilcoxon signed-rank test. The association between individual change in knowledge and worries about EVD in the first survey was investigated using linear regression. In November 2014, the survey was filled in by 974 participants. Ten months later, 662 of them were still members of the online panel and were invited to the follow-up survey. Among the 620 respondents, affective response decreased between the surveys. Knowledge about EVD also decreased; however, participants worried about EVD in 2014 had increased knowledge in 2015. Perceived likelihood of infection decreased over time, while perceived personal impact and coping efficacy did not. Risk communication appealing to cognitive reactions by informing clearly on the risk of infection in unaffected countries may decrease inappropriate behaviors.
2018-09-03T11:31:20Z
2018-09-03T11:31:20Z
2018-05-15
Review
1471-2458
29764410
10.1186/s12889-018-5543-1
http://hdl.handle.net/10033/621463
Attribution-NonCommercial-ShareAlike 3.0 United States
http://creativecommons.org/licenses/by-nc-sa/3.0/us/
BMC public health
oai:repository.helmholtz-hzi.de:10033/6214882019-08-30T11:29:45Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409
Immune monitoring after pediatric liver transplantation - the prospective ChilSFree cohort study.
Goldschmidt, Imeke
Karch, André
Mikolajczyk, Rafael
Mutschler, Frauke
Junge, Norman
Pfister, Eva Doreen
Möhring, Tamara
d'Antiga, Lorenzo
McKiernan, Patrick
Kelly, Deirdre
Debray, Dominique
McLin, Valérie
Pawlowska, Joanna
Hierro, Loreto
Daemen, Kerstin
Keil, Jana
Falk, Christine
Baumann, Ulrich
Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Immune monitoring
Paediatric liver transplantation
Rejection
Although trough levels of immunosuppressive drugs are largely used to monitor immunosuppressive therapy after solid organ transplantation, there is still no established tool that allows for a validated assessment of functional degree of immunosuppression or the identification of clinically relevant over- or under-immunosuppression, depending on graft homeostasis. Reliable non-invasive markers to predict biopsy proven acute rejection (BPAR) do not exist. Literature data suggest that longitudinal measurements of immune markers might be predictive of BPAR, but data in children are scarce. We therefore propose an observational prospective cohort study focusing on immune monitoring in children after liver transplantation. We aim to describe immune function in a cohort of children before and during the first year after liver transplantation and plan to investigate how the immune function profile is associated with clinical and laboratory findings. In an international multicenter prospective approach, children with end-stage liver disease who undergo liver transplantation are enrolled to the study and receive extensive immune monitoring before and at 1, 2, 3, 4 weeks and 3, 6, 12 months after transplantation, and whenever a clinically indicated liver biopsy is scheduled. Blood samples are analyzed for immune cell numbers and circulating levels of cytokines, chemokines and factors of angiogenesis reflecting immune cell activation. Statistical analysis will focus on the identification of trajectorial patterns of immune reactivity predictive for systemic non-inflammatory states, infectious complications or BPAR using joint modelling approaches. The ChilSFree study will help to understand the immune response after pLTx in different states of infection or rejection. It may provide insight into response mechanisms eventually facilitating immune tolerance towards the graft. Our analysis may yield an applicable immune panel for non-invasive early detection of acute cellular rejection, with the prospect of individually tailoring immunosuppressive therapy. The international collaborative set-up of this study allows for an appropriate sample size which is otherwise difficult to achieve in the field of pediatric liver transplantation.
2018-09-18T13:46:58Z
2018-09-18T13:46:58Z
2018-05-16
Article
1471-230X
29769027
10.1186/s12876-018-0795-x
http://hdl.handle.net/10033/621488
Attribution-NonCommercial-ShareAlike 3.0 United States
http://creativecommons.org/licenses/by-nc-sa/3.0/us/
BMC gastroenterology
oai:repository.helmholtz-hzi.de:10033/6214662019-08-30T11:27:13Zcom_10033_267632com_10033_211390col_10033_267633
Global, regional, and national levels and causes of maternal mortality during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013.
Kassebaum, Nicholas J
Bertozzi-Villa, Amelia
Coggeshall, Megan S
Shackelford, Katya A
Steiner, Caitlyn
Heuton, Kyle R
Gonzalez-Medina, Diego
Barber, Ryan
Huynh, Chantal
Dicker, Daniel
Templin, Tara
Wolock, Timothy M
Ozgoren, Ayse Abbasoglu
Abd-Allah, Foad
Abera, Semaw Ferede
Abubakar, Ibrahim
Achoki, Tom
Adelekan, Ademola
Ademi, Zanfina
Adou, Arsène Kouablan
Adsuar, José C
Agardh, Emilie E
Akena, Dickens
Alasfoor, Deena
Alemu, Zewdie Aderaw
Alfonso-Cristancho, Rafael
Alhabib, Samia
Ali, Raghib
Al Kahbouri, Mazin J
Alla, François
Allen, Peter J
AlMazroa, Mohammad A
Alsharif, Ubai
Alvarez, Elena
Alvis-Guzmán, Nelson
Amankwaa, Adansi A
Amare, Azmeraw T
Amini, Hassan
Ammar, Walid
Antonio, Carl A T
Anwari, Palwasha
Arnlöv, Johan
Arsenijevic, Valentina S Arsic
Artaman, Ali
Asad, Majed Masoud
Asghar, Rana J
Assadi, Reza
Atkins, Lydia S
Badawi, Alaa
Balakrishnan, Kalpana
Basu, Arindam
Basu, Sanjay
Beardsley, Justin
Bedi, Neeraj
Bekele, Tolesa
Bell, Michelle L
Bernabe, Eduardo
Beyene, Tariku J
Bhutta, Zulfiqar
Bin Abdulhak, Aref
Blore, Jed D
Basara, Berrak Bora
Bose, Dipan
Breitborde, Nicholas
Cárdenas, Rosario
Castañeda-Orjuela, Carlos A
Castro, Ruben Estanislao
Catalá-López, Ferrán
Cavlin, Alanur
Chang, Jung-Chen
Che, Xuan
Christophi, Costas A
Chugh, Sumeet S
Cirillo, Massimo
Colquhoun, Samantha M
Cooper, Leslie Trumbull
Cooper, Cyrus
da Costa Leite, Iuri
Dandona, Lalit
Dandona, Rakhi
Davis, Adrian
Dayama, Anand
Degenhardt, Louisa
De Leo, Diego
del Pozo-Cruz, Borja
Deribe, Kebede
Dessalegn, Muluken
deVeber, Gabrielle A
Dharmaratne, Samath D
Dilmen, Uğur
Ding, Eric L
Dorrington, Rob E
Driscoll, Tim R
Ermakov, Sergei Petrovich
Esteghamati, Alireza
Faraon, Emerito Jose A
Farzadfar, Farshad
Felicio, Manuela Mendonca
Fereshtehnejad, Seyed-Mohammad
de Lima, Graça Maria Ferreira
Forouzanfar, Mohammad H
França, Elisabeth B
Gaffikin, Lynne
Gambashidze, Ketevan
Gankpé, Fortuné Gbètoho
Garcia, Ana C
Geleijnse, Johanna M
Gibney, Katherine B
Giroud, Maurice
Glaser, Elizabeth L
Goginashvili, Ketevan
Gona, Philimon
González-Castell, Dinorah
Goto, Atsushi
Gouda, Hebe N
Gugnani, Harish Chander
Gupta, Rahul
Gupta, Rajeev
Hafezi-Nejad, Nima
Hamadeh, Randah Ribhi
Hammami, Mouhanad
Hankey, Graeme J
Harb, Hilda L
Havmoeller, Rasmus
Hay, Simon I
Pi, Ileana B Heredia
Hoek, Hans W
Hosgood, H Dean
Hoy, Damian G
Husseini, Abdullatif
Idrisov, Bulat T
Innos, Kaire
Inoue, Manami
Jacobsen, Kathryn H
Jahangir, Eiman
Jee, Sun Ha
Jensen, Paul N
Jha, Vivekanand
Jiang, Guohong
Jonas, Jost B
Juel, Knud
Kabagambe, Edmond Kato
Kan, Haidong
Karam, Nadim E
Karch, André
Karema, Corine Kakizi
Kaul, Anil
Kawakami, Norito
Kazanjan, Konstantin
Kazi, Dhruv S
Kemp, Andrew H
Kengne, Andre Pascal
Kereselidze, Maia
Khader, Yousef Saleh
Khalifa, Shams Eldin Ali Hassan
Khan, Ejaz Ahmed
Khang, Young-Ho
Knibbs, Luke
Kokubo, Yoshihiro
Kosen, Soewarta
Defo, Barthelemy Kuate
Kulkarni, Chanda
Kulkarni, Veena S
Kumar, G Anil
Kumar, Kaushalendra
Kumar, Ravi B
Kwan, Gene
Lai, Taavi
Lalloo, Ratilal
Lam, Hilton
Lansingh, Van C
Larsson, Anders
Lee, Jong-Tae
Leigh, James
Leinsalu, Mall
Leung, Ricky
Li, Xiaohong
Li, Yichong
Li, Yongmei
Liang, Juan
Liang, Xiaofeng
Lim, Stephen S
Lin, Hsien-Ho
Lipshultz, Steven E
Liu, Shiwei
Liu, Yang
Lloyd, Belinda K
London, Stephanie J
Lotufo, Paulo A
Ma, Jixiang
Ma, Stefan
Machado, Vasco Manuel Pedro
Mainoo, Nana Kwaku
Majdan, Marek
Mapoma, Christopher Chabila
Marcenes, Wagner
Marzan, Melvin Barrientos
Mason-Jones, Amanda J
Mehndiratta, Man Mohan
Mejia-Rodriguez, Fabiola
Memish, Ziad A
Mendoza, Walter
Miller, Ted R
Mills, Edward J
Mokdad, Ali H
Mola, Glen Liddell
Monasta, Lorenzo
de la Cruz Monis, Jonathan
Hernandez, Julio Cesar Montañez
Moore, Ami R
Moradi-Lakeh, Maziar
Mori, Rintaro
Mueller, Ulrich O
Mukaigawara, Mitsuru
Naheed, Aliya
Naidoo, Kovin S
Nand, Devina
Nangia, Vinay
Nash, Denis
Nejjari, Chakib
Nelson, Robert G
Neupane, Sudan Prasad
Newton, Charles R
Ng, Marie
Nieuwenhuijsen, Mark J
Nisar, Muhammad Imran
Nolte, Sandra
Norheim, Ole F
Nyakarahuka, Luke
Oh, In-Hwan
Ohkubo, Takayoshi
Olusanya, Bolajoko O
Omer, Saad B
Opio, John Nelson
Orisakwe, Orish Ebere
Pandian, Jeyaraj D
Papachristou, Christina
Park, Jae-Hyun
Caicedo, Angel J Paternina
Patten, Scott B
Paul, Vinod K
Pavlin, Boris Igor
Pearce, Neil
Pereira, David M
Pesudovs, Konrad
Petzold, Max
Poenaru, Dan
Polanczyk, Guilherme V
Polinder, Suzanne
Pope, Dan
Pourmalek, Farshad
Qato, Dima
Quistberg, D Alex
Rafay, Anwar
Rahimi, Kazem
Rahimi-Movaghar, Vafa
ur Rahman, Sajjad
Raju, Murugesan
Rana, Saleem M
Refaat, Amany
Ronfani, Luca
Roy, Nobhojit
Pimienta, Tania Georgina Sánchez
Sahraian, Mohammad Ali
Salomon, Joshua A
Sampson, Uchechukwu
Santos, Itamar S
Sawhney, Monika
Sayinzoga, Felix
Schneider, Ione J C
Schumacher, Austin
Schwebel, David C
Seedat, Soraya
Sepanlou, Sadaf G
Servan-Mori, Edson E
Shakh-Nazarova, Marina
Sheikhbahaei, Sara
Shibuya, Kenji
Shin, Hwashin Hyun
Shiue, Ivy
Sigfusdottir, Inga Dora
Silberberg, Donald H
Silva, Andrea P
Singh, Jasvinder A
Skirbekk, Vegard
Sliwa, Karen
Soshnikov, Sergey S
Sposato, Luciano A
Sreeramareddy, Chandrashekhar T
Stroumpoulis, Konstantinos
Sturua, Lela
Sykes, Bryan L
Tabb, Karen M
Talongwa, Roberto Tchio
Tan, Feng
Teixeira, Carolina Maria
Tenkorang, Eric Yeboah
Terkawi, Abdullah Sulieman
Thorne-Lyman, Andrew L
Tirschwell, David L
Towbin, Jeffrey A
Tran, Bach X
Tsilimbaris, Miltiadis
Uchendu, Uche S
Ukwaja, Kingsley N
Undurraga, Eduardo A
Uzun, Selen Begüm
Vallely, Andrew J
van Gool, Coen H
Vasankari, Tommi J
Vavilala, Monica S
Venketasubramanian, N
Villalpando, Salvador
Violante, Francesco S
Vlassov, Vasiliy Victorovich
Vos, Theo
Waller, Stephen
Wang, Haidong
Wang, Linhong
Wang, XiaoRong
Wang, Yanping
Weichenthal, Scott
Weiderpass, Elisabete
Weintraub, Robert G
Westerman, Ronny
Wilkinson, James D
Woldeyohannes, Solomon Meseret
Wong, John Q
Wordofa, Muluemebet Abera
Xu, Gelin
Yang, Yang C
Yano, Yuichiro
Yentur, Gokalp Kadri
Yip, Paul
Yonemoto, Naohiro
Yoon, Seok-Jun
Younis, Mustafa Z
Yu, Chuanhua
Jin, Kim Yun
El Sayed Zaki, Maysaa
Zhao, Yong
Zheng, Yingfeng
Zhou, Maigeng
Zhu, Jun
Zou, Xiao Nong
Lopez, Alan D
Naghavi, Mohsen
Murray, Christopher J L
Lozano, Rafael
The fifth Millennium Development Goal (MDG 5) established the goal of a 75% reduction in the maternal mortality ratio (MMR; number of maternal deaths per 100,000 livebirths) between 1990 and 2015. We aimed to measure levels and track trends in maternal mortality, the key causes contributing to maternal death, and timing of maternal death with respect to delivery. We used robust statistical methods including the Cause of Death Ensemble model (CODEm) to analyse a database of data for 7065 site-years and estimate the number of maternal deaths from all causes in 188 countries between 1990 and 2013. We estimated the number of pregnancy-related deaths caused by HIV on the basis of a systematic review of the relative risk of dying during pregnancy for HIV-positive women compared with HIV-negative women. We also estimated the fraction of these deaths aggravated by pregnancy on the basis of a systematic review. To estimate the numbers of maternal deaths due to nine different causes, we identified 61 sources from a systematic review and 943 site-years of vital registration data. We also did a systematic review of reports about the timing of maternal death, identifying 142 sources to use in our analysis. We developed estimates for each country for 1990-2013 using Bayesian meta-regression. We estimated 95% uncertainty intervals (UIs) for all values. 292,982 (95% UI 261,017-327,792) maternal deaths occurred in 2013, compared with 376,034 (343,483-407,574) in 1990. The global annual rate of change in the MMR was -0·3% (-1·1 to 0·6) from 1990 to 2003, and -2·7% (-3·9 to -1·5) from 2003 to 2013, with evidence of continued acceleration. MMRs reduced consistently in south, east, and southeast Asia between 1990 and 2013, but maternal deaths increased in much of sub-Saharan Africa during the 1990s. 2070 (1290-2866) maternal deaths were related to HIV in 2013, 0·4% (0·2-0·6) of the global total. MMR was highest in the oldest age groups in both 1990 and 2013. In 2013, most deaths occurred intrapartum or postpartum. Causes varied by region and between 1990 and 2013. We recorded substantial variation in the MMR by country in 2013, from 956·8 (685·1-1262·8) in South Sudan to 2·4 (1·6-3·6) in Iceland. Global rates of change suggest that only 16 countries will achieve the MDG 5 target by 2015. Accelerated reductions since the Millennium Declaration in 2000 coincide with increased development assistance for maternal, newborn, and child health. Setting of targets and associated interventions for after 2015 will need careful consideration of regions that are making slow progress, such as west and central Africa.
2018-09-04T09:50:39Z
2018-09-04T09:50:39Z
2014-09-13
Article
1474-547X
24797575
10.1016/S0140-6736(14)60696-6
http://hdl.handle.net/10033/621466
Attribution-NonCommercial-ShareAlike 3.0 United States
http://creativecommons.org/licenses/by-nc-sa/3.0/us/
Lancet (London, England)
oai:repository.helmholtz-hzi.de:10033/6214792019-08-30T11:29:45Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409
Survival of children after liver transplantation for hepatocellular carcinoma.
Baumann, Ulrich
Adam, René
Duvoux, Christophe
Mikolajczyk, Rafael T
Karam, Vincent
D'Antiga, Lorenzo
Chardot, Christophe
Coker, Ahmet
Colledan, Michele
Ericzon, Bo-Goran
Line, Pål Dag
Hadzic, Nedim
Isoniemi, Helena
Klempnauer, Jürgen L
Reding, Raymond
McKiernan, Patrick J
McLin, Valérie
Paul, Andreas
Salizzoni, Mauro
Furtado, Emanuel San Bento
Schneeberger, Stefan
Karch, André
the European Liver and Intestine Transplant Association
Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.
Hepatocellular carcinoma (HCC) in childhood differs from adult HCC because it is often associated with inherited liver disease. It is, however, unclear whether liver transplantation (LT) for HCC in childhood with or without associated inherited disease has a comparable outcome to adult HCC. On the basis of data from the European Liver Transplant Registry (ELTR), we aimed to investigate if there are differences in patient and graft survival after LT for HCC between children and adults and between patients with underlying inherited versus noninherited liver disease, respectively. We included all 175 children who underwent LT for HCC and were enrolled in ELTR between 1985 and 2012. Of these, 38 had an associated inherited liver disease. Adult HCC patients with (n = 79) and without (n = 316, matched by age, sex, and LT date) inherited liver disease served as an adult comparison population. We used multivariable piecewise Cox regression models with shared frailty terms (for LT center) to compare patient and graft survival between the different HCC groups. Survival analyses demonstrated a superior longterm survival of children with inherited liver disease when compared with children with HCC without inherited liver disease (hazard ratio [HR], 0.29; 95% CI, 0.10-0.90; P = 0.03) and adults with HCC with inherited liver disease (HR, 0.27; 95% CI, 0.06-1.25; P = 0.09). There was no survival difference between adults with and without inherited disease (HR, 1.05; 95% CI, 0.66-1.66; P = 0.84). In conclusion, the potential survival advantage of children with an HCC based on inherited disease should be acknowledged when considering transplantation and prioritization for these patients. Further prospective studies accounting for tumor size and extension at LT are necessary to fully interpret our findings. Liver Transplantation 24 246-255 2018 AASLD.
2018-09-13T14:48:10Z
2018-09-13T14:48:10Z
2018-01-01
Article
1527-6473
29222922
10.1002/lt.24994
http://hdl.handle.net/10033/621479
Attribution-NonCommercial-ShareAlike 3.0 United States
http://creativecommons.org/licenses/by-nc-sa/3.0/us/
Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
oai:repository.helmholtz-hzi.de:10033/6215652019-08-30T11:29:42Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke.
Schregel, Katharina
Behme, Daniel
Tsogkas, Ioannis
Knauth, Michael
Maier, Ilko
Karch, André
Mikolajczyk, Rafael T
Bähr, Mathias
Schäper, Jörn
Hinz, José
Liman, Jan
Psychogios, Marios-Nikos
HZI,Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7,38124 Braunschweig, Germany.
This manuscript describes a streamlined protocol for the management of patients with acute ischemic stroke, which aims at the minimization of time from hospital admission to reperfusion. Rapid restoration of cerebral blood flow is essential for the outcomes of patients with acute ischemic stroke. Endovascular treatment (EVT) has become the standard of care to accomplish this in patients with acute stroke due to large vessel occlusion (LVO). To achieve reperfusion of ischemic brain regions as fast as possible, all in-hospital time delays have to be carefully avoided. Therefore, management of patients with acute ischemic stroke was optimized with an interdisciplinary standard operating procedure (SOP). Stroke neurologists, diagnostic as well as interventional neuroradiologists, and anesthesiologists streamlined all necessary processes from patient admission and diagnosis to EVT of eligible patients. Target times for every step were established. Actually achieved times were prospectively recorded along with clinical data and imaging scores for all endovascularly treated stroke patients. These data were regularly analyzed and discussed in interdisciplinary team meetings. Potential issues were evaluated and all staff involved was trained to adhere to the SOP. This streamlined patient management approach and enhanced interdisciplinary collaboration reduced time from patient admission to reperfusion significantly and was accompanied by a beneficial effect on clinical outcomes.
2018-11-14T14:17:44Z
2018-11-14T14:17:44Z
2018-01-18
Article
1940-087X
29443076
10.3791/56397
http://hdl.handle.net/10033/621565
PMC5908663
Attribution-NonCommercial-ShareAlike 3.0 United States
http://creativecommons.org/licenses/by-nc-sa/3.0/us/
Journal of visualized experiments : JoVE
oai:repository.helmholtz-hzi.de:10033/6217532019-08-30T11:32:11Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409
Development and validation of a diagnostic model for early differentiation of sepsis and non-infectious SIRS in critically ill children - a data-driven approach using machine-learning algorithms.
Lamping, Florian
Jack, Thomas
Rübsamen, Nicole
Sasse, Michael
Beerbaum, Philipp
Mikolajczyk, Rafael T
Boehne, Martin
Karch, André
HZI, Helmholtz Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig Germany.
Diagnosis
Intensive care unit
Pediatric
Random Forest
SIRS
Sepsis
BACKGROUND:
Since early antimicrobial therapy is mandatory in septic patients, immediate diagnosis and distinction from non-infectious SIRS is essential but hampered by the similarity of symptoms between both entities. We aimed to develop a diagnostic model for differentiation of sepsis and non-infectious SIRS in critically ill children based on routinely available parameters (baseline characteristics, clinical/laboratory parameters, technical/medical support).
METHODS:
This is a secondary analysis of a randomized controlled trial conducted at a German tertiary-care pediatric intensive care unit (PICU). Two hundred thirty-eight cases of non-infectious SIRS and 58 cases of sepsis (as defined by IPSCC criteria) were included. We applied a Random Forest approach to identify the best set of predictors out of 44 variables measured at the day of onset of the disease. The developed diagnostic model was validated in a temporal split-sample approach.
RESULTS:
A model including four clinical (length of PICU stay until onset of non-infectious SIRS/sepsis, central line, core temperature, number of non-infectious SIRS/sepsis episodes prior to diagnosis) and four laboratory parameters (interleukin-6, platelet count, procalcitonin, CRP) was identified in the training dataset. Validation in the test dataset revealed an AUC of 0.78 (95% CI: 0.70-0.87). Our model was superior to previously proposed biomarkers such as CRP, interleukin-6, procalcitonin or a combination of CRP and procalcitonin (maximum AUC = 0.63; 95% CI: 0.52-0.74). When aiming at a complete identification of sepsis cases (100%; 95% CI: 87-100%), 28% (95% CI: 20-38%) of non-infectious SIRS cases were assorted correctly.
CONCLUSIONS:
Our approach allows early recognition of sepsis with an accuracy superior to previously described biomarkers, and could potentially reduce antibiotic use by 30% in non-infectious SIRS cases. External validation studies are necessary to confirm the generalizability of our approach across populations and treatment practices.
2019-04-17T13:00:23Z
2019-04-17T13:00:23Z
2018-03-15
Article
BMC Pediatr. 2018 Mar 15;18(1):112. doi: 10.1186/s12887-018-1082-2
1471-2431
29544449
10.1186/s12887-018-1082-2
http://hdl.handle.net/10033/621753
BMC Pediatrics
en
Attribution-NonCommercial-ShareAlike 4.0 International
http://creativecommons.org/licenses/by-nc-sa/4.0/
BioMedCentral
BMC pediatrics
oai:repository.helmholtz-hzi.de:10033/6217962019-08-30T11:35:09Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409
Knowledge on Antibiotic Use, Self-Reported Adherence to Antibiotic Intake, and Knowledge on Multi-Drug Resistant Pathogens - Results of a Population-Based Survey in Lower Saxony, Germany.
Raupach-Rosin, Heike
Rübsamen, Nicole
Schütte, Gesa
Raschpichler, Gabriele
Chaw, Pa Saidou
Mikolajczyk, Rafael T
HZI,Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7,38124 Braunschweig, Germany.
MDR-pathogens
adherence
antibiotic resistance
antibiotic use
compliance
public knowledge
Introduction: Assessment of public awareness on antibiotic use and resistance can identify key issues for campaigns addressing these problems. Our aim was to assess the knowledge, attitudes, and practice (KAP) related to antibiotic use and multi-drug resistant (MDR) pathogens in a general population in Germany.
Methods: We conducted a KAP survey on antibiotics and on MDR pathogens using an online panel recruited from the general population, which was established using stratified random sampling from the population registry in four districts in Lower Saxony, Germany.
Results: In the 12 months preceding the survey, 32.3% of the participants had received at least one prescription for antibiotics, 95.7% reported to follow the recommendations of prescribers, and 10.3% reported to stop taking antibiotics as soon as they feel better. Up to 94.9% of the participants had heard of MDR pathogens, 42.7% reported to know somebody who had been tested positive for it, 0.8% had an infection with it, and 37.2% were worried of contracting it. In case of contact with a carrier of MDR pathogens, over 90% would increase hand hygiene and 0.8% would avoid the carrier completely. Participants considered health care workers (75.1%) and everybody in society (87.8%) to be responsible for combating the spread of MDR pathogens.
Conclusion: There is a high reported exposure to antibiotics and awareness of the problem of MDR pathogens. Despite personal worries, most of the participants indicated a reasonable, non-stigmatizing behavior toward carriers of MDR pathogens, and that every individual was responsible to avoid their spread.
2019-06-04T11:07:10Z
2019-06-04T11:07:10Z
2019-01-01
Article
Front Microbiol. 2019 Apr 12;10:776. doi: 10.3389/fmicb.2019.00776. eCollection 2019.
1664-302X
31031737
10.3389/fmicb.2019.00776
http://hdl.handle.net/10033/621796
Frontiers in Microbiology
en
Attribution-NonCommercial-ShareAlike 4.0 International
http://creativecommons.org/licenses/by-nc-sa/4.0/
Frontiers
Frontiers in microbiology
oai:repository.helmholtz-hzi.de:10033/6227072021-01-29T01:51:14Zcom_10033_267632com_10033_211390com_10033_620589com_10033_620652com_10033_620533col_10033_621891col_10033_620666col_10033_267633col_10033_211409col_10033_620590
Cohort Profile: The LoewenKIDS Study - life-course perspective on infections, the microbiome and the development of the immune system in early childhood.
Gottschick, Cornelia
Raupach-Rosin, Heike
Langer, Susan
Hassan, Lamiaa
Horn, Johannes
Dorendorf, Evelyn
Caputo, Mahrrouz
Bittner, Martina
Beier, Lea
Rübsamen, Nicole
Schlinkmann, Kristin
Zoch, Beate
Guzman, Carlos A
Hansen, Gesine
Heselich, Valerie
Holzapfel, Eva
Hübner, Johannes
Pietschmann, Thomas
Pieper, Dietmar H
Pletz, Mathias
Riese, Peggy
Schmidt-Pokrzywniak, Andrea
Hartwig, Saskia
von Kaisenberg, Constantin
Aydogdu, Mustafa
Buhles, Matthias
Dressler, Frank
Eberl, Wolfgang
Haase, Roland
Edler von Koch, Franz
Feidicker, Susanne
Frambach, Torsten
Franz, Heiko G B
Guthmann, Florian
Koch, Hans G
Seeger, Sven
Oberhoff, Carsten
Pauker, Wladimir
Petry, Karl U
Schild, Ralf L
Tchirikov, Michael
Röhrig, Eckhard
Karch, André
Mikolajczyk, Rafael
HZI,Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7,38124 Braunschweig, Germany.;TWINCORE, Zentrum für experimentelle und klinische Infektionsforschung GmbH,Feodor-Lynen Str. 7, 30625 Hannover, Germany.
[Noabstract available]
2021-01-28T11:02:51Z
2021-01-28T11:02:51Z
2019-02-27
Article
Int J Epidemiol. 2019 Aug 1;48(4):1042-1043h. doi: 10.1093/ije/dyz001.
30815674
10.1093/ije/dyz001
http://hdl.handle.net/10033/622707
1464-3685
International journal of epidemiology
PMC7108547
en
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7108547/
Attribution-NonCommercial-ShareAlike 4.0 International
http://creativecommons.org/licenses/by-nc-sa/4.0/
Oxford Academic
48
4
1042
1043h
International journal of epidemiology
England