2024-03-29T12:13:38Zhttp://repository.helmholtz-hzi.de/oai/requestoai:repository.helmholtz-hzi.de:10033/2676342019-08-30T11:25:43Zcom_10033_267632com_10033_211390col_10033_267633Health-related locus of control and health behaviour among university students in North Rhine Westphalia, Germany.Helmer, Stefanie MKrämer, AlexanderMikolajczyk, RafaelBremen Institute for Epidemiology and Prevention Research, University of Bremen, Bremen, Germany. rafael.mikolajczyk@helmholtz-hzi.de.ABSTRACT:2013-01-302013-01-302012ArticleHealth-related locus of control and health behaviour among university students in North Rhine Westphalia, Germany. 2012, 5:703 BMC Res Notes1756-05002327303910.1186/1756-0500-5-703http://hdl.handle.net/10033/267634BMC research notesenArchived with thanks to BMC research notesoai:repository.helmholtz-hzi.de:10033/2885952019-08-30T11:32:41Zcom_10033_267632com_10033_211390col_10033_267633Comorbidities in ADHD children treated with methylphenidate: a database study.Kraut, Angela ALangner, IngoLindemann, ChristinaBanaschewski, TobiasPetermann, UlrikePetermann, FranzMikolajczyk, RafaelGarbe, EdeltrautDepartment 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.2013-05-072013-05-072013ArticleComorbidities in ADHD children treated with methylphenidate: a database study. 2013, 13:11 BMC Psychiatry1471-244X2329462310.1186/1471-244X-13-11http://hdl.handle.net/10033/288595BMC psychiatryenArchived with thanks to BMC psychiatryoai:repository.helmholtz-hzi.de:10033/2935832019-08-30T11:33:29Zcom_10033_267632com_10033_211390col_10033_267633Regional variation in caesarean deliveries in Germany and its causes.Mikolajczyk, RafaelSchmedt, NiklasZhang, JunLindemann, ChristinaLangner, IngoGarbe, EdeltrautDepartment 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.2013-06-072013-06-072013ArticleRegional variation in caesarean deliveries in Germany and its causes. 2013, 13:99 BMC Pregnancy Childbirth1471-23932363482010.1186/1471-2393-13-99http://hdl.handle.net/10033/293583BMC pregnancy and childbirthenArchived with thanks to BMC pregnancy and childbirthoai:repository.helmholtz-hzi.de:10033/3014302019-08-30T11:35:39Zcom_10033_267632com_10033_211390col_10033_267633Evaluation of pregnancy outcome records in the German Pharmacoepidemiological Research Database (GePaRD).Mikolajczyk, RafaelKraut, AaGarbe, ELeibniz 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.2013-09-112013-09-112013-08ArticleEvaluation of pregnancy outcome records in the German Pharmacoepidemiological Research Database (GePaRD). 2013, 22 (8):873-80 Pharmacoepidemiol Drug Saf1099-15572373370510.1002/pds.3467http://hdl.handle.net/10033/301430Pharmacoepidemiology and drug safetyenArchived with thanks to Pharmacoepidemiology and drug safetyoai:repository.helmholtz-hzi.de:10033/3045712019-08-30T11:37:00Zcom_10033_267632com_10033_211390col_10033_267633col_10033_267633Twin and sibling studies using health insurance data: the example of attention deficit/hyperactivity disorder (ADHD).Langner, IngoGarbe, EdeltrautBanaschewski, TobiasMikolajczyk, RafaelDepartment 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).2013-10-242013-10-242013ArticleTwin and sibling studies using health insurance data: the example of attention deficit/hyperactivity disorder (ADHD). 2013, 8 (4):e62177 PLoS ONE1932-62032363799710.1371/journal.pone.0062177http://hdl.handle.net/10033/304571PloS oneenArchived with thanks to PloS oneoai:repository.helmholtz-hzi.de:10033/3056812019-08-30T11:37:00Zcom_10033_267632com_10033_211390col_10033_267633Incidence, prevalence, and antithrombotic management of atrial fibrillation in elderly Germans.Ohlmeier, ChristophMikolajczyk, Rafael THaverkamp, WilhelmGarbe, EdeltrautDepartment 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.2013-11-222013-11-222013-10ArticleIncidence, prevalence, and antithrombotic management of atrial fibrillation in elderly Germans. 2013, 15 (10):1436-44 Europace1532-20922348754210.1093/europace/eut048http://hdl.handle.net/10033/305681Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of CardiologyenArchived 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 Cardiologyoai:repository.helmholtz-hzi.de:10033/3060852019-08-30T11:27:16Zcom_10033_267632com_10033_211390col_10033_267633Changes in incidence of anogenital warts diagnoses after the introduction of human papillomavirus vaccination in Germany-an ecologic study.Mikolajczyk, RafaelKraut, Angela AHorn, JohannesSchulze-Rath, RenateGarbe, EdeltrautBIPS-Institute for Epidemiology and Prevention Research, Bremen, Germany. miko@bips.uni-bremen.deIn 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).2013-12-022013-12-022013-01ArticleChanges 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 Dis1537-45212325030010.1097/OLQ.0b013e3182756efdhttp://hdl.handle.net/10033/306085Sexually transmitted diseasesenArchived with thanks to Sexually transmitted diseasesoai:repository.helmholtz-hzi.de:10033/3220692019-08-30T11:30:52Zcom_10033_267632com_10033_211390col_10033_267633Autoimmune thyroiditis as a risk factor for stroke: A historical cohort studyKarch, AndréThomas, S. L.Research group epidemiological and statistical methods, Helmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany2014-06-202014-06-202014-06-20ArticleAutoimmune thyroiditis as a risk factor for stroke: A historical cohort study 2014, 82 (18):1643 Neurology0028-38781526-632X10.1212/WNL.0000000000000377http://hdl.handle.net/10033/322069Neurologyhttp://www.neurology.org/cgi/doi/10.1212/WNL.0000000000000377Archived with thanks to Neurologyoai:repository.helmholtz-hzi.de:10033/3363332019-08-30T11:36:33Zcom_10033_267632com_10033_211390col_10033_267633Diagnostic 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, AndréRaddatz, Lena MariaPonto, ClaudiaHermann, PeterSummers, DavidZerr, IngaDepartment 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.2014-11-282014-11-282014-05ArticleDiagnostic 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.1432-14592457028010.1007/s00415-014-7283-1http://hdl.handle.net/10033/336333Journal of neurologyenoai:repository.helmholtz-hzi.de:10033/3387252019-08-30T11:36:05Zcom_10033_267632com_10033_211390col_10033_267633Evaluating methods for intersectoral comparison of quality of care. A routine data analysis of elective percutaneous coronary interventions.Ohlmeier, CLinder, REnders, DMikolajczyk, RafaelHaverkamp, WHorenkamp-Sonntag, DGarbe, ELeibniz 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.2015-01-232015-01-232014ArticleEvaluating methods for intersectoral comparison of quality of care. A routine data analysis of elective percutaneous coronary interventions. 2014, 53 (4):269-77 Methods Inf Med0026-12702507743710.3414/ME13-01-0132http://hdl.handle.net/10033/338725Methods of information in medicineenoai:repository.helmholtz-hzi.de:10033/3440442019-08-30T11:36:05Zcom_10033_267632com_10033_211390col_10033_267633Trajectories of injecting behavior in the Amsterdam Cohort Study among drug users.Mikolajczyk, RafaelHorn, JohannesPrins, MariaWiessing, LucasKretzschmar, MirjamHelmholtz 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.2015-02-022015-02-022014-11-01ArticleTrajectories of injecting behavior in the Amsterdam Cohort Study among drug users. 2014, 144:141-7 Drug Alcohol Depend1879-00462524847210.1016/j.drugalcdep.2014.08.020http://hdl.handle.net/10033/344044Drug and alcohol dependenceenoai:repository.helmholtz-hzi.de:10033/3440822019-08-30T11:31:20Zcom_10033_267632com_10033_211390col_10033_267633Standardized surveillance of prion diseases in resource-poor settings is crucial for individual patient-care as well as for decision-making of healthcare authorities.Karch, André2015-02-032015-02-032015-01ArticleStandardized 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 Pract0976-31472555284210.4103/0976-3147.143164http://hdl.handle.net/10033/344082Journal of neurosciences in rural practiceenoai:repository.helmholtz-hzi.de:10033/3468732019-08-30T11:36:32Zcom_10033_267632com_10033_211390col_10033_267633Effect of beta-blocker therapy on the risk of infections and death after acute stroke--a historical cohort study.Maier, Ilko LKarch, AndréMikolajczyk, RafaelBähr, MathiasLiman, JanHelmholtz 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.2015-03-192015-03-192015ArticleEffect of beta-blocker therapy on the risk of infections and death after acute stroke--a historical cohort study. 2015, 10 (2):e0116836 PLoS ONE1932-62032564336010.1371/journal.pone.0116836http://hdl.handle.net/10033/346873PloS oneenoai:repository.helmholtz-hzi.de:10033/5569452019-08-30T11:26:42Zcom_10033_267632com_10033_211390col_10033_267633Systematic review of models assessing the economic value of routine varicella and herpes zoster vaccination in high-income countries.Damm, OliverUltsch, BernhardHorn, JohannesMikolajczyk, RafaelGreiner, WolfgangWichmann, OleA 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.2015-06-152015-06-152015ArticleSystematic review of models assessing the economic value of routine varicella and herpes zoster vaccination in high-income countries. 2015, 15:533 BMC Public Health1471-24582604146910.1186/s12889-015-1861-8http://hdl.handle.net/10033/556945BMC public healthenoai:repository.helmholtz-hzi.de:10033/5604942019-08-30T11:28:23Zcom_10033_267632com_10033_211390col_10033_267633An adjustable fetal weight standard for twins: a statistical modeling study.Zhang, JunMikolajczyk, RafaelLei, XiaopingSun, LumingYu, HongpingCheng, WeiweiHelmholtz 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.2015-07-152015-07-152015ArticleAn adjustable fetal weight standard for twins: a statistical modeling study. 2015, 13:159 BMC Med1741-70152614119010.1186/s12916-015-0401-9http://hdl.handle.net/10033/560494BMC medicineenoai:repository.helmholtz-hzi.de:10033/5763072019-08-30T11:28:23Zcom_10033_267632com_10033_211390col_10033_267633Mortality in the German Pharmacoepidemiological Research Database (GePaRD) compared to national data in Germany: results from a validation study.Ohlmeier, ChristophLangner, IngoHillebrand, KathrinSchmedt, NiklasRiedel, OliverGarbe, EdeltrautElectronic 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.2015-09-022015-09-022015ArticleMortality in the German Pharmacoepidemiological Research Database (GePaRD) compared to national data in Germany: results from a validation study. 2015, 15:570 BMC Public Health1471-24582608776810.1186/s12889-015-1943-7http://hdl.handle.net/10033/576307BMC public healthenoai:repository.helmholtz-hzi.de:10033/6211462019-08-30T11:31:23Zcom_10033_267632com_10033_211390col_10033_267633A feasibility trial to examine the social norms approach for the prevention and reduction of licit and illicit drug use in European University and college studentsPischke, Claudia RZeeb, Hajovan Hal, GuidoVriesacker, BartMcAlaney, JohnBewick, Bridgette MAkvardar, YildizGuillén-Grima, FranciscoOrosova, OlgaSalonna, FerdinandKalina, OndrejStock, ChristianeHelmer, Stefanie MMikolajczyk, Rafael TAbstract 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’.2017-10-252017-10-252012-10-182015-09-04Journal ArticleBMC Public Health. 2012 Oct 18;12(1):882http://dx.doi.org/10.1186/1471-2458-12-882http://hdl.handle.net/10033/621146enPischke et al.; licensee BioMed Central Ltd.oai:repository.helmholtz-hzi.de:10033/6207892019-08-30T11:37:44Zcom_10033_267632com_10033_211390col_10033_267633Health-related locus of control and health behaviour among university students in North Rhine Westphalia, GermanyHelmer, Stefanie MKrämer, AlexanderMikolajczyk, RafaelAbstract 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.2017-01-272017-01-272012-12-292015-09-04BMC Research Notes. 2012 Dec 29;5(1):703http://dx.doi.org/10.1186/1756-0500-5-703http://hdl.handle.net/10033/620789enHelmer et al.; licensee BioMed Central Ltd.oai:repository.helmholtz-hzi.de:10033/6207532018-06-13T07:23:02Zcom_10033_267632com_10033_211390col_10033_267633Mortality in the German Pharmacoepidemiological Research Database (GePaRD) compared to national data in Germany: results from a validation studyOhlmeier, ChristophLangner, IngoHillebrand, KathrinSchmedt, NiklasMikolajczyk, RafaelRiedel, OliverGarbe, EdeltrautAbstract 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.2017-01-272017-01-272015-06-202015-09-04Journal ArticleBMC Public Health. 2015 Jun 20;15(1):570http://dx.doi.org/10.1186/s12889-015-1943-7http://hdl.handle.net/10033/620753enOhlmeier et al.oai:repository.helmholtz-hzi.de:10033/6207192019-08-30T11:36:05Zcom_10033_267632com_10033_211390col_10033_267633What is the optimal rate of caesarean section at population level? A systematic review of ecologic studiesBetran, Ana PTorloni, Maria RZhang, JunYe, JiangfengMikolajczyk, RafaelDeneux-Tharaux, CatherineOladapo, Olufemi TSouza, João PTunçalp, ÖzgeVogel, Joshua PGülmezoglu, Ahmet MAbstract 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.2017-01-172017-01-172015-06-212015-09-04Journal ArticleReproductive Health. 2015 Jun 21;12(1):57http://dx.doi.org/10.1186/s12978-015-0043-6http://hdl.handle.net/10033/620719enBetran et al.oai:repository.helmholtz-hzi.de:10033/6207002019-08-30T11:32:16Zcom_10033_267632com_10033_211390col_10033_267633An adjustable fetal weight standard for twins: a statistical modeling studyZhang, JunMikolajczyk, RafaelLei, XiaopingSun, LumingYu, HongpingCheng, WeiweiAbstract 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.2017-01-132017-01-132015-07-032015-09-04Journal ArticleBMC Medicine. 2015 Jul 03;13(1):159http://dx.doi.org/10.1186/s12916-015-0401-9http://hdl.handle.net/10033/620700enZhang et al.oai:repository.helmholtz-hzi.de:10033/5772422019-08-30T11:34:48Zcom_10033_267632com_10033_211390col_10033_267633Cerebrospinal fluid tau levels are a marker for molecular subtype in sporadic Creutzfeldt-Jakob disease.Karch, AndréHermann, PeterPonto, ClaudiaSchmitz, MatthiasArora, AmandeepZafar, SaimaLlorens, FrancMüller-Heine, AnnikaZerr, IngaHelmholtz 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.2015-09-142015-09-142015-05ArticleCerebrospinal fluid tau levels are a marker for molecular subtype in sporadic Creutzfeldt-Jakob disease. 2015, 36 (5):1964-8 Neurobiol. Aging1558-14972574912910.1016/j.neurobiolaging.2015.01.021http://hdl.handle.net/10033/577242Neurobiology of agingenoai:repository.helmholtz-hzi.de:10033/5794712019-08-30T11:30:58Zcom_10033_267632com_10033_211390col_10033_267633Clustering of developmental delays in Bavarian preschool children - a repeated cross-sectional survey over a period of 12 years.Stich, Heribert LKrämer, AlexanderMikolajczyk, RafaelWhile 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.2015-10-082015-10-082014ArticleClustering of developmental delays in Bavarian preschool children - a repeated cross-sectional survey over a period of 12 years. 2014, 14:18 BMC Pediatr1471-24312445050410.1186/1471-2431-14-18http://hdl.handle.net/10033/579471BMC pediatricsenoai:repository.helmholtz-hzi.de:10033/5820652019-08-30T11:31:49Zcom_10033_267632com_10033_211390col_10033_267633Ebola risk perception in Germany, 2014.Rübsamen, NicoleCastell, StefanieHorn, JohannesKarch, AndréOtt, Jördis JRaupach-Rosin, HeikeZoch, BeateKrause, GerardMikolajczyk, Rafael THelmholtz 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.2015-11-112015-11-112015-06ArticleEbola risk perception in Germany, 2014. 2015, 21 (6):1012-8 Emerging Infect. Dis.1080-60592598902010.3201/eid2106.150013http://hdl.handle.net/10033/582065Emerging infectious diseasesenoai:repository.helmholtz-hzi.de:10033/5823332019-08-30T11:34:48Zcom_10033_267632com_10033_211390col_10033_267633Feasibility of a birth cohort study dedicated to assessing acute infections using symptom diaries and parental collection of biomaterials.Zoch, BeateKarch, AndréDreesman, JohannesMonazahian, MasyarBaillot, ArminMikolajczyk, RafaelHelmholtz 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.2015-11-182015-11-182015ArticleFeasibility of a birth cohort study dedicated to assessing acute infections using symptom diaries and parental collection of biomaterials. 2015, 15:436 BMC Infect. Dis.1471-23342649370010.1186/s12879-015-1189-0http://hdl.handle.net/10033/582333BMC infectious diseasesenoai:repository.helmholtz-hzi.de:10033/5928272019-08-30T11:36:04Zcom_10033_267632com_10033_211390col_10033_267633Association between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data.Ye, JZhang, JMikolajczyk, RafaelTorloni, M RGülmezoglu, A MBetran, A PHelmholtz 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.2016-01-052016-01-052015-08-24ArticleAssociation between rates of caesarean section and maternal and neonatal mortality in the 21st century: a worldwide population-based ecological study with longitudinal data. 2015: BJOG1471-05282633138910.1111/1471-0528.13592http://hdl.handle.net/10033/592827BJOG : an international journal of obstetrics and gynaecologyoai:repository.helmholtz-hzi.de:10033/5931002019-08-30T11:36:32Zcom_10033_267632com_10033_211390col_10033_267633Individual development of preschool children-prevalences and determinants of delays in Germany: a cross-sectional study in Southern Bavaria.Stich, Heribert LBaune, Bernhard ThCaniato, Riccardo NMikolajczyk, RafaelKrämer, AlexanderEven 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 1997-2009.2016-01-082016-01-082012ArticleIndividual development of preschool children-prevalences and determinants of delays in Germany: a cross-sectional study in Southern Bavaria. 2012, 12:188 BMC Pediatr1471-24312321682010.1186/1471-2431-12-188http://hdl.handle.net/10033/593100BMC pediatricsenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/5954362019-08-30T11:36:32Zcom_10033_267632com_10033_211390col_10033_267633A 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 RZeeb, Hajovan Hal, GuidoVriesacker, BartMcAlaney, JohnBewick, Bridgette MAkvardar, YildizGuillén-Grima, FranciscoOrosova, OlgaSalonna, FerdinandKalina, OndrejStock, ChristianeHelmer, Stefanie MMikolajczyk, Rafael THelmholtz Centre for infection research, Inhoffenstr. 7, D-38124 Braunschweig, Germany.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.2016-02-022016-02-022012ArticleA 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 Health1471-24582307504310.1186/1471-2458-12-882http://hdl.handle.net/10033/595436BMC public healthenoai:repository.helmholtz-hzi.de:10033/6008472019-08-30T11:26:13Zcom_10033_267632com_10033_211390col_10033_267633Proposing an empirically justified reference threshold for blood culture sampling rates in intensive care units.Karch, AndréCastell, StefanieSchwab, FrankGeffers, ChristineBongartz, HannahBrunkhorst, Frank MGastmeier, PetraMikolajczyk, RafaelHelmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.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.2016-03-082016-03-082015-02ArticleProposing an empirically justified reference threshold for blood culture sampling rates in intensive care units. 2015, 53 (2):648-52 J. Clin. Microbiol.1098-660X2552044210.1128/JCM.02944-14http://hdl.handle.net/10033/600847Journal of clinical microbiologyenoai:repository.helmholtz-hzi.de:10033/6050142019-08-30T11:30:58Zcom_10033_267632com_10033_211390col_10033_267633Bloodstream infections, antibiotic resistance and the practice of blood culture sampling in Germany: study design of a Thuringia-wide prospective population-based study (AlertsNet).Karch, AndréSchmitz, Roland PRißner, FlorianCastell, StefanieTöpel, SandraJakob, MatthiasBrunkhorst, Frank MMikolajczyk, RafaelHelmholtz 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.2016-04-112016-04-112015ArticleBloodstream 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 Open2044-60552667195710.1136/bmjopen-2015-009095http://hdl.handle.net/10033/605014BMJ openenoai:repository.helmholtz-hzi.de:10033/6060482019-08-30T11:32:16Zcom_10033_267632com_10033_211390col_10033_267633Incidence, 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, ChristophMikolajczyk, Rafael TFrick, JohannPrütz, FranziskaHaverkamp, WilhelmGarbe, EdeltrautHelmholtz 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.2016-04-202016-04-202015-08ArticleIncidence, 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 Cardiol1861-06922577793710.1007/s00392-015-0841-4http://hdl.handle.net/10033/606048Clinical research in cardiology : official journal of the German Cardiac Societyenoai:repository.helmholtz-hzi.de:10033/6077312019-08-30T11:24:31Zcom_10033_267632com_10033_211390col_10033_267633Predictors of the patient-centered outcomes of surgical carpal tunnel release - a prospective cohort study.Conzen, CatharinaConzen, MichaelRübsamen, NicoleMikolajczyk, RafaelHelmholtz 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.2016-05-032016-05-032016ArticlePredictors of the patient-centered outcomes of surgical carpal tunnel release - a prospective cohort study. 2016, 17 (1):190 BMC Musculoskelet Disord1471-24742712172510.1186/s12891-016-1046-3http://hdl.handle.net/10033/607731BMC musculoskeletal disordersenoai:repository.helmholtz-hzi.de:10033/6077382019-08-30T11:28:23Zcom_10033_267632com_10033_211390col_10033_267633Care for MRSA carriers in the outpatient sector: a survey among MRSA carriers and physicians in two regions in Germany.Raupach-Rosin, HeikeRübsamen, NicoleSzkopek, SebastianSchmalz, OliverKarch, AndréMikolajczyk, Rafael TCastell, StefanieHelmholtz 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.2016-05-032016-05-032016ArticleCare 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.1471-23342711244210.1186/s12879-016-1503-5http://hdl.handle.net/10033/607738BMC infectious diseasesenoai:repository.helmholtz-hzi.de:10033/6144442019-08-30T11:31:23Zcom_10033_267632com_10033_211390col_10033_267633What is the optimal rate of caesarean section at population level? A systematic review of ecologic studies.Betran, Ana PilarTorloni, Maria ReginaZhang, JunYe, JiangfengMikolajczyk, Rafael TDeneux-Tharaux, CatherineOladapo, Olufemi TaiwoSouza, João PauloTunçalp, ÖzgeVogel, Joshua PeterGülmezoglu, Ahmet MetinHelmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.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.2016-06-232016-06-232015ArticleWhat is the optimal rate of caesarean section at population level? A systematic review of ecologic studies. 2015, 12:57 Reprod Health1742-47552609349810.1186/s12978-015-0043-6http://hdl.handle.net/10033/614444Reproductive healthenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6205632019-08-30T11:30:58Zcom_10033_267632com_10033_211390col_10033_267633Top 25 Global Causes of Disability-Adjusted Life-Years (DALYs) in Children Younger Than 5 Years, Both Sexes, 1990 and 2013The Global Burden of Disease Pediatrics CollaborationKarch, Andréet al.Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Ave, Ste 600, Seattle, WA 98121mportance 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.2016-10-252016-10-252016-10-25ArticleGlobal 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.2015.42762168-62112681061910.1001/jamapediatrics.2015.4276http://hdl.handle.net/10033/620563JAMA Pediadricsenhttp://creativecommons.org/licenses/by-nc-sa/4.0/JAMA Networkoai:repository.helmholtz-hzi.de:10033/6205422019-08-30T11:27:16Zcom_10033_267632com_10033_211390col_10033_267633Measuring inter-rater reliability for nominal data - which coefficients and confidence intervals are appropriate?Zapf, AntoniaCastell, StefanieMorawietz, LarsKarch, AndréHelmholtz 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.2016-10-072016-10-072016ArticleMeasuring inter-rater reliability for nominal data - which coefficients and confidence intervals are appropriate? 2016, 16:93 BMC Med Res Methodol1471-22882749513110.1186/s12874-016-0200-9http://hdl.handle.net/10033/620542BMC medical research methodologyenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6205542019-08-30T11:33:57Zcom_10033_267632com_10033_211390col_10033_267633Alcohol Drinking in University Students Matters for Their Self-Rated Health Status: A Cross-sectional Study in Three European Countries.Mikolajczyk, Rafael TSebena, ReneWarich, JuliaNaydenova, VihraDudziak, UrszulaOrosova, OlgaHelmholtz 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.2016-10-182016-10-182016ArticleAlcohol Drinking in University Students Matters for Their Self-Rated Health Status: A Cross-sectional Study in Three European Countries. 2016, 4:210 Front Public Health2773012210.3389/fpubh.2016.00210http://hdl.handle.net/10033/620554Frontiers in public healthhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6206482019-08-30T11:27:46Zcom_10033_267632com_10033_211390col_10033_267633Infection 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. 22016-12-082016-12-082016-012016-12-08Articlehttp://hdl.handle.net/10033/620648dehttp://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_620721Analysis of Practical Identifiability of a Viral Infection Model.Nguyen, Van KinhKlawonn, FrankMikolajczyk, RafaelHernandez-Vargas, Esteban AbelardoHelmholtz 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.2017-01-112017-01-112016ArticleAnalysis of Practical Identifiability of a Viral Infection Model. 2016, 11 (12):e0167568 PLoS ONE1932-62032803633910.1371/journal.pone.0167568http://hdl.handle.net/10033/620692PloS oneenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6208842019-08-30T11:29:47Zcom_10033_267632com_10033_211390col_10033_267633Deficits in knowledge, attitude, and practice towards blood culture sampling: results of a nationwide mixed-methods study among inpatient care physicians in Germany.Raupach-Rosin, HeikeDuddeck, ArneGehrlich, MaikeHelmke, CharlotteHuebner, JohannesPletz, Mathias WMikolajczyk, Rafael TKarch, AndréHelmholtz 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.2017-04-042017-04-042017-02-15ArticleDeficits in knowledge, attitude, and practice towards blood culture sampling: results of a nationwide mixed-methods study among inpatient care physicians in Germany. 2017 Infection1439-09732820515910.1007/s15010-017-0990-7http://hdl.handle.net/10033/620884Infectionenhttp://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_620603Comparison of response patterns in different survey designs: a longitudinal panel with mixed-mode and online-only design.Rübsamen, NicoleAkmatov, Manas KCastell, StefanieKarch, AndréMikolajczyk, Rafael THelmholtz 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).2017-04-072017-04-072017ArticleComparison of response patterns in different survey designs: a longitudinal panel with mixed-mode and online-only design. 2017, 14:4 Emerg Themes Epidemiol2834462910.1186/s12982-017-0058-2http://hdl.handle.net/10033/620892Emerging themes in epidemiologyenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6209122019-08-30T11:31:49Zcom_10033_267632com_10033_211390col_10033_267633Current and future effects of varicella and herpes zoster vaccination in Germany - Insights from a mathematical model in a country with universal varicella vaccination.Horn, JohannesKarch, AndréDamm, OliverKretzschmar, Mirjam ESiedler, AnetteUltsch, BernhardWeidemann, FelixWichmann, OleHengel, HartmutGreiner, WolfgangMikolajczyk, Rafael THelmholtz-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.2017-05-082017-05-082016-07-02ArticleCurrent 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 Immunother2164-554X2683589010.1080/21645515.2015.1135279http://hdl.handle.net/10033/620912Human vaccines & immunotherapeuticsenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6209202019-08-30T11:29:47Zcom_10033_267632com_10033_211390col_10033_267633Incidence and comparison of retrospective and prospective data on respiratory and gastrointestinal infections in German households.Schlinkmann, Kristin MariaBakuli, AbhishekMikolajczyk, Rafael THelmholtz 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.2017-05-172017-05-172017-05-11ArticleIncidence and comparison of retrospective and prospective data on respiratory and gastrointestinal infections in German households. 2017, 17 (1):336 BMC Infect. Dis.1471-23342849031610.1186/s12879-017-2434-5http://hdl.handle.net/10033/620920BMC infectious diseasesenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6209232019-08-30T11:29:47Zcom_10033_267632com_10033_211390col_10033_267633Transcranial doppler sonography is not a valid diagnostic tool for detection of basilar artery stenosis or in-stent restenosis: a retrospective diagnostic study.Koh, WooriKallenberg, KaiKarch, AndréFrank, TobiasKnauth, MichaelBähr, MathiasLiman, JanHelmholtz-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.2017-05-172017-05-172017-05-11ArticleTranscranial 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 Neurol1471-23772849035110.1186/s12883-017-0872-8http://hdl.handle.net/10033/620923BMC neurologyenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6209252019-08-30T11:31:23Zcom_10033_267632com_10033_211390col_10033_267633Deciding on the mode of birth after a previous caesarean section - An online survey investigating women's preferences in Western Switzerland.Bonzon, MagaliGross, Mechthild MKarch, AndréGrylka-Baeschlin, SusanneHelmholtz 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.2017-05-222017-05-222017-04-21ArticleDeciding on the mode of birth after a previous caesarean section - An online survey investigating women's preferences in Western Switzerland. 2017, 50:219-227 Midwifery1532-30992847837410.1016/j.midw.2017.04.005http://hdl.handle.net/10033/620925Midwiferyenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6209332019-08-30T11:29:47Zcom_10033_267632com_10033_211390col_10033_267633Early versus Late Admission to Labor Affects Labor Progression and Risk of Cesarean Section in Nulliparous Women.Mikolajczyk, Rafael TZhang, JunGrewal, JagteshwarChan, Linda CPetersen, AntjeGross, Mechthild MHelmholtz 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.2017-06-062017-06-062016ArticleEarly versus Late Admission to Labor Affects Labor Progression and Risk of Cesarean Section in Nulliparous Women. 2016, 3:26 Front Med (Lausanne)2744692410.3389/fmed.2016.00026http://hdl.handle.net/10033/620933Frontiers in medicineenhttp://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_620647Sociodemographic determinants of spatial disparities in early childhood caries: An ecological analysis in Braunschweig, Germany.Meyer, FredericKarch, AndréSchlinkmann, Kristin MariaDreesman, JohannesHorn, JohannesRübsamen, NicoleSudradjat, HennySchubert, RainerMikolajczyk, Rafael THelmholtz 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.2017-06-152017-06-152017-05-26ArticleSociodemographic determinants of spatial disparities in early childhood caries: An ecological analysis in Braunschweig, Germany. 2017 Community Dent Oral Epidemiol1600-05282854786410.1111/cdoe.12308http://hdl.handle.net/10033/620954Community dentistry and oral epidemiologyenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6210162019-08-30T11:33:30Zcom_10033_267632com_10033_211390col_10033_267633Structure of the Escherichia coli ProQ RNA-binding protein.Gonzalez, Grecia MHardwick, Steven WMaslen, Sarah LSkehel, J MarkHolmqvist, ErikVogel, JörgBateman, AlexLuisi, Ben FBroadhurst, R WilliamHelmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.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.2017-07-212017-07-212017-05ArticleStructure of the Escherichia coli ProQ RNA-binding protein. 2017, 23 (5):696-711 RNA1469-90012819367310.1261/rna.060343.116http://hdl.handle.net/10033/621016RNA (New York, N.Y.)enhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6210212019-08-22T12:38:22Zcom_10033_267632com_10033_211390col_10033_267633Global, 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.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.2017-07-262017-07-262016-10-08ArticleGlobal, 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 Lancet1474-547X2773328510.1016/S0140-6736(16)31575-6http://hdl.handle.net/10033/621021Lancet (London, England)enhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6210222019-08-30T11:34:22Zcom_10033_267632com_10033_211390col_10033_267633Global, 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 CollaboratorsKarch, A.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 2015.2017-07-282017-07-282016ArticleGlobal, 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 Lancet1474-547X2773328210.1016/S0140-6736(16)31678-6http://hdl.handle.net/10033/621022Lancet (London, England)enoai:repository.helmholtz-hzi.de:10033/6210562019-08-30T11:34:48Zcom_10033_267632com_10033_211390col_10033_267633Global, 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 CollaboratorsKarch, AndréHelmholtz Centre for infection research, Inhoffenstr. 7, 38124 Braunschweig, Germany.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.2017-08-162017-08-162016-10-08ArticleGlobal, 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 Lancet1474-547X2773328110.1016/S0140-6736(16)31012-1http://hdl.handle.net/10033/621056Lancet (London, England)enhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6210792019-08-30T11:31:49Zcom_10033_267632com_10033_211390col_10033_267633Association between Embolic Stroke Patterns, ESUS Etiology, and New Diagnosis of Atrial Fibrillation: A Secondary Data Analysis of the Find-AF Trial.Maier, Ilko LSchregel, KatharinaKarch, AndréWeber-Krueger, MarkMikolajczyk, Rafael TStahrenberg, RaoulGröschel, KlausBähr, MathiasKnauth, MichaelPsychogios, Marios-NikosWachter, RolfLiman, JanHelmholtz 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.2017-08-292017-08-292017ArticleAssociation 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 Treat2090-81052853666710.1155/2017/1391843http://hdl.handle.net/10033/621079Stroke research and treatmentenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6211012019-08-30T11:30:32Zcom_10033_267632com_10033_211390col_10033_267633Evaluation 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, KathrinHorn, JohannesMikolajczyk, Rafael THelmholtz-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.2017-09-112017-09-112017-08-14ArticleEvaluation 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.1471-23342880692610.1186/s12879-017-2663-7http://hdl.handle.net/10033/621101BMC infectious diseasesenhttp://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_211409Factors associated with attrition in a longitudinal online study: results from the HaBIDS panel.Rübsamen, NicoleAkmatov, Manas KCastell, StefanieKarch, AndréMikolajczyk, Rafael THemholtz-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.2017-09-222017-09-222017-08-31ArticleFactors associated with attrition in a longitudinal online study: results from the HaBIDS panel. 2017, 17 (1):132 BMC Med Res Methodol1471-22882885961710.1186/s12874-017-0408-3http://hdl.handle.net/10033/621115BMC medical research methodologyenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6211172019-08-30T11:37:24Zcom_10033_267632com_10033_211390col_10033_267633Cost-effectiveness of human papillomavirus vaccination in Germany.Damm, OliverHorn, JohannesMikolajczyk, Rafael TKretzschmar, Mirjam E EKaufmann, Andreas MDeleré, YvonneUltsch, BernhardWichmann, OleKrämer, AlexanderGreiner, WolfgangHemholtz-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.2017-09-222017-09-222017ArticleCost-effectiveness of human papillomavirus vaccination in Germany. 2017, 15:18 Cost Eff Resour Alloc1478-75472887857310.1186/s12962-017-0080-9http://hdl.handle.net/10033/621117Cost effectiveness and resource allocation : C/Eenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6211772019-08-30T11:28:23Zcom_10033_267632com_10033_211390col_10033_267633Effect of Disease Definition on Perceived Burden of Acute Respiratory Infections in Children: A Prospective Cohort Study Based on Symptom Diaries.Zoch, BeateGünther, AnnetteKarch, AndréMikolajczyk, Rafael THelmholtz-Zentrum für Infektionsfrschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.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.2017-11-162017-11-162017-10ArticleEffect 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.1532-09872839905810.1097/INF.0000000000001604http://hdl.handle.net/10033/621177The Pediatric infectious disease journalenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6211882019-08-30T11:33:57Zcom_10033_267632com_10033_211390col_10033_267633The 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, ChristinaLangner, IngoBanaschewski, TobiasGarbe, EdeltrautMikolajczyk, Rafael THelmholtz-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.2017-11-292017-11-292017ArticleThe 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 Pediatr2296-23602911453810.3389/fped.2017.00220http://hdl.handle.net/10033/621188Frontiers in pediatricsenhttp://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_620721Effects of pathogen dependency in a multi-pathogen infectious disease system including population level heterogeneity - a simulation study.Bakuli, AbhishekKlawonn, FrankKarch, AndréMikolajczyk, Rafael THelmholtz-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.2018-01-242018-01-242017-12-13ArticleEffects of pathogen dependency in a multi-pathogen infectious disease system including population level heterogeneity - a simulation study. 2017, 14 (1):26 Theor Biol Med Model1742-46822923746210.1186/s12976-017-0072-7http://hdl.handle.net/10033/621255Theoretical biology & medical modellingenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6212562019-08-30T11:33:57Zcom_10033_267632com_10033_211390col_10033_267633Population-level impact, herd immunity, and elimination after human papillomavirus vaccination: a systematic review and meta-analysis of predictions from transmission-dynamic models.Brisson, MarcBénard, ÉlodieDrolet, MélanieBogaards, Johannes ABaussano, IacopoVänskä, SimopekkaJit, MarkBoily, Marie-ClaudeSmith, Megan ABerkhof, JohannesCanfell, KarenChesson, Harrell WBurger, Emily AChoi, Yoon HDe Blasio, Birgitte FreieslebenDe Vlas, Sake JGuzzetta, GiorgioHontelez, Jan A CHorn, JohannesJepsen, Martin RKim, Jane JLazzarato, FulvioMatthijsse, Suzette MMikolajczyk, Rafael TPavelyev, AndrewPillsbury, MatthewShafer, Leigh AnneTully, Stephen PTurner, Hugo CUsher, CaraWalsh, CathalHelmholtz 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.2018-01-292018-01-292016-11ArticlePopulation-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 Health2468-26672925337910.1016/S2468-2667(16)30001-9http://hdl.handle.net/10033/621256The Lancet. Public healthen'info:eu-repo/grantAgreement/EC/FP7/ 603019http://creativecommons.org/licenses/by-nc-sa/4.0/openAccessoai: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, HKlett-Tammen, C JSchmalz, OKarch, ACastell, SMikolajczyk, Rafael THelmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.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.2018-02-192018-02-192016-12Article["I cannot kiss my wife"- An Analysis of Daily Experiences of MRSA-carriers]. 2016, 78 (12):822-827 Gesundheitswesen1439-44212655185310.1055/s-0035-1559710http://hdl.handle.net/10033/621286Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany))enhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6213202019-08-30T11:33:57Zcom_10033_267632com_10033_211390col_10033_267633Partial verification bias and incorporation bias affected accuracy estimates of diagnostic studies for biomarkers that were part of an existing composite gold standard.Karch, AnnikaKoch, ArminZapf, AntoniaZerr, IngaKarch, AndréHelmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.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).2018-03-122018-03-122016-10ArticlePartial 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 Epidemiol1878-59212710787710.1016/j.jclinepi.2016.03.022http://hdl.handle.net/10033/621320Journal of clinical epidemiologyenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6213622019-08-30T11:36:59Zcom_10033_267632com_10033_211390col_10033_267633Influence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany - a mathematical modelling study.Horn, JohannesDamm, OliverGreiner, WolfgangHengel, HartmutKretzschmar, Mirjam ESiedler, AnetteUltsch, BernhardWeidemann, FelixWichmann, OleKarch, AndréMikolajczyk, Rafael Telmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.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.2018-04-302018-04-302018ArticleInfluence of demographic changes on the impact of vaccination against varicella and herpes zoster in Germany - a mathematical modelling study. 2018, 16 (1):3 BMC Med1741-70152931691310.1186/s12916-017-0983-5http://hdl.handle.net/10033/621362BMC medicineenhttp://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_211409Poor 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 KRübsamen, NicoleDeyneko, Igor VKarch, AndréMikolajczyk, Rafael THelmholtz-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.2018-05-222018-05-222018ArticlePoor 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 Vaccine1873-25182960270010.1016/j.vaccine.2018.03.050http://hdl.handle.net/10033/621376Vaccineenhttp://creativecommons.org/licenses/by-nc-sa/4.0/oai:repository.helmholtz-hzi.de:10033/6214292019-08-30T11:28:47Zcom_10033_267632com_10033_211390col_10033_267633Effects of Workflow Optimization in Endovascularly Treated Stroke Patients - A Pre-Post Effectiveness Study.Schregel, KatharinaBehme, DanielTsogkas, IoannisKnauth, MichaelMaier, IlkoKarch, AndréMikolajczyk, Rafael THinz, JoséLiman, JanPsychogios, Marios-NikosHelmholtz-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.2018-07-242018-07-242016-01-01Article1932-62032803640110.1371/journal.pone.0169192http://hdl.handle.net/10033/621429http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0169192http://creativecommons.org/licenses/by-nc-sa/3.0/us/Attribution-NonCommercial-ShareAlike 3.0 United Statesoai:repository.helmholtz-hzi.de:10033/6214352019-08-30T11:34:19Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409Antibiotic use on paediatric inpatients in a teaching hospital in the Gambia, a retrospective study.Chaw, Pa SaidouSchlinkmann, Kristin MariaRaupach-Rosin, HeikeKarch, AndréPletz, Mathias WHuebner, JohannesNyan, OusmanMikolajczyk, RafaelHelmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.Antibiotic resistanceAntibiotic stewardshipAntibiotic useMicrobiologyPaediatricsAntibiotics 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.2018-08-072018-08-072018-01-01Article2047-29943002694010.1186/s13756-018-0380-7http://hdl.handle.net/10033/621435enhttp://creativecommons.org/licenses/by-nc-sa/3.0/us/Attribution-NonCommercial-ShareAlike 3.0 United Statesoai:repository.helmholtz-hzi.de:10033/6214632021-08-13T14:41:55Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409Changes in risk perceptions during the 2014 Ebola virus disease epidemic: results of two consecutive surveys among the general population in Lower Saxony, Germany.Obenauer, JulieRübsamen, NicoleGarsevanidze, EkaterineKarch, AndréMikolajczyk, Rafael THelmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.Ebola virus diseaseKnowledgeRisk perceptionThe 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.2018-09-032018-09-032018-05-15Review1471-24582976441010.1186/s12889-018-5543-1http://hdl.handle.net/10033/621463http://creativecommons.org/licenses/by-nc-sa/3.0/us/Attribution-NonCommercial-ShareAlike 3.0 United Statesoai:repository.helmholtz-hzi.de:10033/6214882019-08-30T11:29:45Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409Immune monitoring after pediatric liver transplantation - the prospective ChilSFree cohort study.Goldschmidt, ImekeKarch, AndréMikolajczyk, RafaelMutschler, FraukeJunge, NormanPfister, Eva DoreenMöhring, Tamarad'Antiga, LorenzoMcKiernan, PatrickKelly, DeirdreDebray, DominiqueMcLin, ValériePawlowska, JoannaHierro, LoretoDaemen, KerstinKeil, JanaFalk, ChristineBaumann, UlrichHelmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig, Germany.Immune monitoringPaediatric liver transplantationRejectionAlthough 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.2018-09-182018-09-182018-05-16Article1471-230X2976902710.1186/s12876-018-0795-xhttp://hdl.handle.net/10033/621488http://creativecommons.org/licenses/by-nc-sa/3.0/us/Attribution-NonCommercial-ShareAlike 3.0 United Statesoai:repository.helmholtz-hzi.de:10033/6214662019-08-30T11:27:13Zcom_10033_267632com_10033_211390col_10033_267633Global, 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 JBertozzi-Villa, AmeliaCoggeshall, Megan SShackelford, Katya ASteiner, CaitlynHeuton, Kyle RGonzalez-Medina, DiegoBarber, RyanHuynh, ChantalDicker, DanielTemplin, TaraWolock, Timothy MOzgoren, Ayse AbbasogluAbd-Allah, FoadAbera, Semaw FeredeAbubakar, IbrahimAchoki, TomAdelekan, AdemolaAdemi, ZanfinaAdou, Arsène KouablanAdsuar, José CAgardh, Emilie EAkena, DickensAlasfoor, DeenaAlemu, Zewdie AderawAlfonso-Cristancho, RafaelAlhabib, SamiaAli, RaghibAl Kahbouri, Mazin JAlla, FrançoisAllen, Peter JAlMazroa, Mohammad AAlsharif, UbaiAlvarez, ElenaAlvis-Guzmán, NelsonAmankwaa, Adansi AAmare, Azmeraw TAmini, HassanAmmar, WalidAntonio, Carl A TAnwari, PalwashaArnlöv, JohanArsenijevic, Valentina S ArsicArtaman, AliAsad, Majed MasoudAsghar, Rana JAssadi, RezaAtkins, Lydia SBadawi, AlaaBalakrishnan, KalpanaBasu, ArindamBasu, SanjayBeardsley, JustinBedi, NeerajBekele, TolesaBell, Michelle LBernabe, EduardoBeyene, Tariku JBhutta, ZulfiqarBin Abdulhak, ArefBlore, Jed DBasara, Berrak BoraBose, DipanBreitborde, NicholasCárdenas, RosarioCastañeda-Orjuela, Carlos ACastro, Ruben EstanislaoCatalá-López, FerránCavlin, AlanurChang, Jung-ChenChe, XuanChristophi, Costas AChugh, Sumeet SCirillo, MassimoColquhoun, Samantha MCooper, Leslie TrumbullCooper, Cyrusda Costa Leite, IuriDandona, LalitDandona, RakhiDavis, AdrianDayama, AnandDegenhardt, LouisaDe Leo, Diegodel Pozo-Cruz, BorjaDeribe, KebedeDessalegn, MulukendeVeber, Gabrielle ADharmaratne, Samath DDilmen, UğurDing, Eric LDorrington, Rob EDriscoll, Tim RErmakov, Sergei PetrovichEsteghamati, AlirezaFaraon, Emerito Jose AFarzadfar, FarshadFelicio, Manuela MendoncaFereshtehnejad, Seyed-Mohammadde Lima, Graça Maria FerreiraForouzanfar, Mohammad HFrança, Elisabeth BGaffikin, LynneGambashidze, KetevanGankpé, Fortuné GbètohoGarcia, Ana CGeleijnse, Johanna MGibney, Katherine BGiroud, MauriceGlaser, Elizabeth LGoginashvili, KetevanGona, PhilimonGonzález-Castell, DinorahGoto, AtsushiGouda, Hebe NGugnani, Harish ChanderGupta, RahulGupta, RajeevHafezi-Nejad, NimaHamadeh, Randah RibhiHammami, MouhanadHankey, Graeme JHarb, Hilda LHavmoeller, RasmusHay, Simon IPi, Ileana B HerediaHoek, Hans WHosgood, H DeanHoy, Damian GHusseini, AbdullatifIdrisov, Bulat TInnos, KaireInoue, ManamiJacobsen, Kathryn HJahangir, EimanJee, Sun HaJensen, Paul NJha, VivekanandJiang, GuohongJonas, Jost BJuel, KnudKabagambe, Edmond KatoKan, HaidongKaram, Nadim EKarch, AndréKarema, Corine KakiziKaul, AnilKawakami, NoritoKazanjan, KonstantinKazi, Dhruv SKemp, Andrew HKengne, Andre PascalKereselidze, MaiaKhader, Yousef SalehKhalifa, Shams Eldin Ali HassanKhan, Ejaz AhmedKhang, Young-HoKnibbs, LukeKokubo, YoshihiroKosen, SoewartaDefo, Barthelemy KuateKulkarni, ChandaKulkarni, Veena SKumar, G AnilKumar, KaushalendraKumar, Ravi BKwan, GeneLai, TaaviLalloo, RatilalLam, HiltonLansingh, Van CLarsson, AndersLee, Jong-TaeLeigh, JamesLeinsalu, MallLeung, RickyLi, XiaohongLi, YichongLi, YongmeiLiang, JuanLiang, XiaofengLim, Stephen SLin, Hsien-HoLipshultz, Steven ELiu, ShiweiLiu, YangLloyd, Belinda KLondon, Stephanie JLotufo, Paulo AMa, JixiangMa, StefanMachado, Vasco Manuel PedroMainoo, Nana KwakuMajdan, MarekMapoma, Christopher ChabilaMarcenes, WagnerMarzan, Melvin BarrientosMason-Jones, Amanda JMehndiratta, Man MohanMejia-Rodriguez, FabiolaMemish, Ziad AMendoza, WalterMiller, Ted RMills, Edward JMokdad, Ali HMola, Glen LiddellMonasta, Lorenzode la Cruz Monis, JonathanHernandez, Julio Cesar MontañezMoore, Ami RMoradi-Lakeh, MaziarMori, RintaroMueller, Ulrich OMukaigawara, MitsuruNaheed, AliyaNaidoo, Kovin SNand, DevinaNangia, VinayNash, DenisNejjari, ChakibNelson, Robert GNeupane, Sudan PrasadNewton, Charles RNg, MarieNieuwenhuijsen, Mark JNisar, Muhammad ImranNolte, SandraNorheim, Ole FNyakarahuka, LukeOh, In-HwanOhkubo, TakayoshiOlusanya, Bolajoko OOmer, Saad BOpio, John NelsonOrisakwe, Orish EberePandian, Jeyaraj DPapachristou, ChristinaPark, Jae-HyunCaicedo, Angel J PaterninaPatten, Scott BPaul, Vinod KPavlin, Boris IgorPearce, NeilPereira, David MPesudovs, KonradPetzold, MaxPoenaru, DanPolanczyk, Guilherme VPolinder, SuzannePope, DanPourmalek, FarshadQato, DimaQuistberg, D AlexRafay, AnwarRahimi, KazemRahimi-Movaghar, Vafaur Rahman, SajjadRaju, MurugesanRana, Saleem MRefaat, AmanyRonfani, LucaRoy, NobhojitPimienta, Tania Georgina SánchezSahraian, Mohammad AliSalomon, Joshua ASampson, UchechukwuSantos, Itamar SSawhney, MonikaSayinzoga, FelixSchneider, Ione J CSchumacher, AustinSchwebel, David CSeedat, SorayaSepanlou, Sadaf GServan-Mori, Edson EShakh-Nazarova, MarinaSheikhbahaei, SaraShibuya, KenjiShin, Hwashin HyunShiue, IvySigfusdottir, Inga DoraSilberberg, Donald HSilva, Andrea PSingh, Jasvinder ASkirbekk, VegardSliwa, KarenSoshnikov, Sergey SSposato, Luciano ASreeramareddy, Chandrashekhar TStroumpoulis, KonstantinosSturua, LelaSykes, Bryan LTabb, Karen MTalongwa, Roberto TchioTan, FengTeixeira, Carolina MariaTenkorang, Eric YeboahTerkawi, Abdullah SuliemanThorne-Lyman, Andrew LTirschwell, David LTowbin, Jeffrey ATran, Bach XTsilimbaris, MiltiadisUchendu, Uche SUkwaja, Kingsley NUndurraga, Eduardo AUzun, Selen BegümVallely, Andrew Jvan Gool, Coen HVasankari, Tommi JVavilala, Monica SVenketasubramanian, NVillalpando, SalvadorViolante, Francesco SVlassov, Vasiliy VictorovichVos, TheoWaller, StephenWang, HaidongWang, LinhongWang, XiaoRongWang, YanpingWeichenthal, ScottWeiderpass, ElisabeteWeintraub, Robert GWesterman, RonnyWilkinson, James DWoldeyohannes, Solomon MeseretWong, John QWordofa, Muluemebet AberaXu, GelinYang, Yang CYano, YuichiroYentur, Gokalp KadriYip, PaulYonemoto, NaohiroYoon, Seok-JunYounis, Mustafa ZYu, ChuanhuaJin, Kim YunEl Sayed Zaki, MaysaaZhao, YongZheng, YingfengZhou, MaigengZhu, JunZou, Xiao NongLopez, Alan DNaghavi, MohsenMurray, Christopher J LLozano, RafaelThe 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.2018-09-042018-09-042014-09-13Article1474-547X2479757510.1016/S0140-6736(14)60696-6http://hdl.handle.net/10033/621466http://creativecommons.org/licenses/by-nc-sa/3.0/us/Attribution-NonCommercial-ShareAlike 3.0 United Statesoai:repository.helmholtz-hzi.de:10033/6214792019-08-30T11:29:45Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409Survival of children after liver transplantation for hepatocellular carcinoma.Baumann, UlrichAdam, RenéDuvoux, ChristopheMikolajczyk, Rafael TKaram, VincentD'Antiga, LorenzoChardot, ChristopheCoker, AhmetColledan, MicheleEriczon, Bo-GoranLine, Pål DagHadzic, NedimIsoniemi, HelenaKlempnauer, Jürgen LReding, RaymondMcKiernan, Patrick JMcLin, ValériePaul, AndreasSalizzoni, MauroFurtado, Emanuel San BentoSchneeberger, StefanKarch, Andréthe European Liver and Intestine Transplant AssociationHelmholtz-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.2018-09-132018-09-132018-01-01Article1527-64732922292210.1002/lt.24994http://hdl.handle.net/10033/621479http://creativecommons.org/licenses/by-nc-sa/3.0/us/Attribution-NonCommercial-ShareAlike 3.0 United Statesoai:repository.helmholtz-hzi.de:10033/6215652019-08-30T11:29:42Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409Optimized Management of Endovascular Treatment for Acute Ischemic Stroke.Schregel, KatharinaBehme, DanielTsogkas, IoannisKnauth, MichaelMaier, IlkoKarch, AndréMikolajczyk, Rafael TBähr, MathiasSchäper, JörnHinz, JoséLiman, JanPsychogios, Marios-NikosHZI,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.2018-11-142018-11-142018-01-18Article1940-087X2944307610.3791/56397http://hdl.handle.net/10033/621565PMC5908663http://creativecommons.org/licenses/by-nc-sa/3.0/us/Attribution-NonCommercial-ShareAlike 3.0 United Statesoai:repository.helmholtz-hzi.de:10033/6217532019-08-30T11:32:11Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409Development 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, FlorianJack, ThomasRübsamen, NicoleSasse, MichaelBeerbaum, PhilippMikolajczyk, Rafael TBoehne, MartinKarch, AndréHZI, Helmholtz Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7, 38124 Braunschweig Germany.DiagnosisIntensive care unitPediatricRandom ForestSIRSSepsisBACKGROUND:
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.2019-04-172019-04-172018-03-15ArticleBMC Pediatr. 2018 Mar 15;18(1):112. doi: 10.1186/s12887-018-1082-21471-24312954444910.1186/s12887-018-1082-2http://hdl.handle.net/10033/621753BMC Pediatricsenhttp://creativecommons.org/licenses/by-nc-sa/4.0/Attribution-NonCommercial-ShareAlike 4.0 InternationalBioMedCentraloai:repository.helmholtz-hzi.de:10033/6217962019-08-30T11:35:09Zcom_10033_267632com_10033_211390col_10033_267633col_10033_211409Knowledge 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, HeikeRübsamen, NicoleSchütte, GesaRaschpichler, GabrieleChaw, Pa SaidouMikolajczyk, Rafael THZI,Helmholtz-Zentrum für Infektionsforschung GmbH, Inhoffenstr. 7,38124 Braunschweig, Germany.MDR-pathogensadherenceantibiotic resistanceantibiotic usecompliancepublic knowledgeIntroduction: 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.2019-06-042019-06-042019-01-01ArticleFront Microbiol. 2019 Apr 12;10:776. doi: 10.3389/fmicb.2019.00776. eCollection 2019.1664-302X3103173710.3389/fmicb.2019.00776http://hdl.handle.net/10033/621796Frontiers in Microbiologyenhttp://creativecommons.org/licenses/by-nc-sa/4.0/Attribution-NonCommercial-ShareAlike 4.0 InternationalFrontiersoai: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_620590Cohort Profile: The LoewenKIDS Study - life-course perspective on infections, the microbiome and the development of the immune system in early childhood.Gottschick, CorneliaRaupach-Rosin, HeikeLanger, SusanHassan, LamiaaHorn, JohannesDorendorf, EvelynCaputo, MahrrouzBittner, MartinaBeier, LeaRübsamen, NicoleSchlinkmann, KristinZoch, BeateGuzman, Carlos AHansen, GesineHeselich, ValerieHolzapfel, EvaHübner, JohannesPietschmann, ThomasPieper, Dietmar HPletz, MathiasRiese, PeggySchmidt-Pokrzywniak, AndreaHartwig, Saskiavon Kaisenberg, ConstantinAydogdu, MustafaBuhles, MatthiasDressler, FrankEberl, WolfgangHaase, RolandEdler von Koch, FranzFeidicker, SusanneFrambach, TorstenFranz, Heiko G BGuthmann, FlorianKoch, Hans GSeeger, SvenOberhoff, CarstenPauker, WladimirPetry, Karl USchild, Ralf LTchirikov, MichaelRöhrig, EckhardKarch, AndréMikolajczyk, RafaelHZI,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]2021-01-282021-01-282019-02-27ArticleInt J Epidemiol. 2019 Aug 1;48(4):1042-1043h. doi: 10.1093/ije/dyz001.3081567410.1093/ije/dyz001http://hdl.handle.net/10033/6227071464-3685International journal of epidemiologyPMC7108547enhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7108547/http://creativecommons.org/licenses/by-nc-sa/4.0/Attribution-NonCommercial-ShareAlike 4.0 InternationalOxford Academic