FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version 1.0

The aim of this guideline is to provide a minimum standard for the acquisition and interpretation of PET and PET/CT scans with [18F]-fluorodeoxyglucose (FDG). This guideline will therefore address general information about [18F]-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) and is provided to help the physician and physicist to assist to carrying out, interpret, and document quantitative FDG PET/CT examinations, but will concentrate on the optimisation of diagnostic quality and quantitative information

Authors', Institutions' and Countries' rankings in regional and urban science : an analysis for nine top international journals from 1991 to 2000

This paper examines the most productive authors, institutions and countries in regional and urban science from 1991 to 2000 using information on published articles (and pages) from a sample of widely recognized journals in this field: ARS, JUE, JRS, IJURR, IRSR, PRS, RSUE, RS and US. We also consider the relation between the country of the institution named in articles and the country in which the journal is published, in order to know if there are a home publication bias in regional and urban science. Analysis was made for the whole decade and by subperiods, this allowed us to make a more dynamic interpretation of the results- El siguiente artículo examina los autores, instituciones y paises más productivos en la ciencia regional y urbana desde 1991 hasta 2000 usando información sobre artículos publicados de una muestra de revistas ampliamente reconocida en este campo: ARS, JUE, JRS, IJURR, IRSR, PRS, RSUE, RS y US. También se analiza la relación existente entre el país de la institución en que el autor desarrolla su investigación y el país de edición de las revistas donde se publican los trabajos con el objetivo de analizar si existe ¿sesgo doméstico¿. El análisis se realiza para toda la década y por subperíodos lo que permite una interpretación dinámica de los resultado

Der Brandenburger Modellstudiengang Medizin - Aus dem Land für das Land

The Brandenburg Medical School "Theodor Fontane" (MHB) was founded in 2014 by municipal and non-profit institutions in Bernau, Brandenburg an der Havel and Neuruppin to train more physicians for the non-metropolitan region of Brandenburg. Since the 2015 summer term, 48 medical students have been enrolled each year, accepted through the university's own selection process in which the score on the German school-leaving exam (Abitur) and time spent on the waiting list play subordinate roles. Tuition fees can be partially financed through scholarship agreements with regional hospitals if the applicants commit themselves to medical specialist training (Facharztweiterbildung) at a particular hospital. The main places of study are Neuruppin and Brandenburg an der Havel; there is a decentralized study phase from the eighth to tenth semester of study. The Brandenburg Reformed Medical Curriculum (BMM) complies with the model clause contained in the German regulations governing the licensing of medical doctors (ÄAppO) . The curriculum is based on problem-based learning (PBL) and focused on competencies and consists of integrated interdisciplinary modules that combine, from the very beginning, basic sciences with clinical and theoretical medical subjects. The focus on general practice is visible in the regularly held "Practical Days" (Praxistag) during which second-year students and above have the opportunity to observe at participating medical practices and familiarize themselves with primary care in Brandenburg. A special focus of BMM is on the acquisition and development of communication and interpersonal skills. These are imparted through a longitudinal curriculum referred to as "Teamwork, Reflection, Interaction, Communication" (TRIK). High value is placed on critical thinking and scientific scholarship and this is reflected in an eight-week academic placement in which the students independently write a research paper. Several different teaching formats ensure that, along with learning specific subjects, sustained personal development can also take place. BMM's decentralized study phase starting in the eighth semester represents a special part of the curriculum in which students complete their clinical training in small groups at selected cooperating hospitals in Brandenburg. This phase encompasses not only hospital placements and other local patient-centered courses, but also centralized instruction via video conferencing to assure that basic sciences and clinical theory continue to be covered. Knowledge- and performance-based semester assessments, in particular OSCEs, reinforce the practical aspects of the training. These replace the M1 state medical examination in the first study phase. The first medical students are now in their ninth semester as of April 2019, making it still too early for final evaluations. The curriculum, successfully implemented to date, already satisfies core requirements of the Master Plan 2020 for undergraduate medical education (Masterplan Medizinstudium 2020) with the curriculum's organization and structure, curricular content, assessment formats and student admission process. With its decentralized structure, BMM specifically addresses the social and health policy challenges facing rural regions of Brandenburg. This is the first curriculum that has taken on the improvement of healthcare in rural regions as its central aim.Die Medizinische Hochschule Brandenburg Theodor Fontane (MHB) wurde 2014 von kommunalen und gemeinnützigen Trägern in Bernau, Brandenburg an der Havel und Neuruppin gegründet, um mehr Ärztinnen und Ärzte für die Non-Metropolen-Region Brandenburg auszubilden. Seit dem Sommersemester 2015 werden jährlich 48 Medizinstudierende aufgenommen, die über ein eigenes Auswahlverfahren ausgewählt werden, in dem Abiturnote und Wartezeit eine nachrangige Rolle spielen. Studiengebühren können durch Stipendienverträge mit regionalen Kliniken teilfinanziert werden, wenn sich die Bewerber/innen zur Weiterbildung in der Klinik verpflichten. Das Studium findet überwiegend an den Standorten Neuruppin und Brandenburg an der Havel statt, im 8. bis 10. Semester folgt ein dezentraler Studienabschnitt. Der Brandenburger Modellstudiengang Medizin (BMM) folgt der Modellklausel der ÄAppO. Das Curriculum ist POL-basiert und Kompetenz-orientiert und besteht aus integrierten interdisziplinären Modulen, die von Anfang an Grundlagen-, klinisch-theoretische und klinische Fächer zusammenbringen. Der Fokus auf Allgemeinmedizin schlägt sich unter anderem im regelmäßigen "Praxistag" nieder, an dem die Studierenden ab dem 2. Semester bei niedergelassenen Lehrärztinnen und -ärzten hospitieren und über eine Integration in den Praxis-Alltag die ambulante Versorgung im Land Brandenburg kennen lernen. Ein besonderer Schwerpunkt des BMM liegt auf Erwerb und Förderung kommunikativer und sozialer Kompetenzen. Diese werden durch ein Längsschnittcurriculum "Teamarbeit, Reflexion, Interaktion, Kommunikation" (TRIK) vermittelt. Dem wissenschaftlichen Denken und Arbeiten wird ein hoher Stellenwert beigemessen, der sich unter anderem in einem achtwöchigen Wissenschaftspraktikum niederschlägt, in dem die Studierenden eine eigenständige Forschungsarbeit erstellen. Mehrere Lehrformate stellen sicher, dass neben dem "Fach"-Unterricht eine nachhaltige Persönlichkeitsentwicklung stattfinden kann. Eine Besonderheit des BMM stellt das dezentrale Studium ab dem 8. Semester dar, in dem die Studierenden in Kleingruppen an ausgewählten kooperierenden Kliniken in Brandenburg ihre klinische Ausbildung absolvieren. Dieser Abschnitt umfasst neben Stationspraktika und weiteren lokalen Patienten-nahen Lehrangeboten auch zentralen Unterricht, der über ein Videokonferenznetzwerk realisiert wird und die weitere Beteiligung der Grundlagen- und klinisch-theoretischen Fächer sicherstellt. Wissens- und Performanz-basierte Semesterabschlussprüfungen unterstützen, insbesondere durch OSCEs, die Praxis-Orientierung der Ausbildung. Sie ersetzen im ersten Studienabschnitt die M1-Staatsprüfung. Die ersten Medizinstudierenden sind ab April 2019 im 9. Fachsemester, so dass es für abschließende Beurteilungen noch zu früh ist. Das bisher erfolgreich etablierte Curriculum erfüllt bereits heute in Bezug auf Aufbau des Studiengangs, Ausbildungsinhalte, Prüfungsformate und Studierendenauswahl zentrale Forderungen des "Masterplans Medizinstudium 2020". Mit seiner dezentralen Struktur adressiert der BMM spezifisch die gesellschaftlichen und gesundheitspolitischen Herausforderungen der Non-Metropolen-Region Brandenburg. Er ist der erste Studiengang, der es sich zentral zur Aufgabe macht, die ärztliche Versorgung in ländlichen Regionen zu verbessern

Clinical and immunologic effects of maraviroc in progressive multifocal leukoencephalopathy

Progressive multifocal leukoencephalopathy (PML) is a rare but generally fatal disease due to JC virus (JCV) reactivation, mainly occurring in immunosuppressed patients.(1) Therapeutic options are limited to blocking glial cell infection by mirtazapine or restoring cell-mediated immunity to acquire viral control.(2

Test of a new standard for fluorine determination with PIGE

The fluorine concentration of chemically enriched hydroxylapatite (Ca10(PO4)6(OH)2) was measured by means of PIGE using the nuclear reactions F-19(p, p' gamma)F-19 and F-19(p, alpha-gamma)O-16. The experiments were done in-two runs with 1.68 and 2.15 MeV proton incidence. The results determined with inelastic scattering are in good agreement in the two runs. The samples are suitable as new fluorine standards in the ppm region to study the fluorine content in tooth enamel

Maraviroc Intensification Improves Endothelial Function in Abacavir-Treated Patients, an Open-Label Randomized Cross-Over Pilot Study

BACKGROUND: The increased risk of abacavir in cardiovascular disease (CVD) in HIV-infected patients is still being debated. Maraviroc, a CCR5 blocker, has been shown to decrease immune activation and monocyte infiltration in atherosclerotic plaques in murine experiments. Therefore, we examined the effect of maraviroc intensification on flow-mediated dilatation (FMD) in abacavir-treated HIV-infected patients and its effect on immunological and inflammatory parameters. METHODS: A open-label prospective crossover study with a duration of 16 weeks: 8 weeks of intervention (maraviroc intensification) and 8 weeks of control (unchanged cART regimen). FMD, HIV-specific variables, expression of HIV co-receptors, markers of inflammation and coagulation and cellular markers of immune activation were measured at weeks 0, 8 and 16. The changes (Δ) in these variables were compared between intervention and control periods using non-parametric tests. To evaluate the relation with the change in FMD, linear regression modeling was used. RESULTS: Twenty-one male patients with suppressed plasma HIV-RNA, on cART, had a known HIV infection for 9.2 years (IQR 6.9-13.5) with abacavir use for 6.5 years (2.8-9.3). A significantly increased FMD of 0.73% (IQR -0.25 to 1.70) was seen after maraviroc intensification compared to a decrease of -0.42% (IQR -1.89 to 0.25; p = 0.049) in the control period. There was a negative relation between ΔFMD with ΔD-dimer (β -22.70, 95% CI -39.27; -6.13, p = 0.011) and ΔCD95+ CD4+ T cells (β -0.16, 95% CI -0.28; -0.04, p = 0.013), adjusted for age and duration of HIV. CONCLUSION: Maraviroc intensification modestly improves endothelial function in HIV-infected patients on an abacavir-containing regimen. TRIAL REGISTRATION: NCT01389063

Maraviroc Intensification Improves Endothelial Function in Abacavir-Treated Patients, an Open-Label Randomized Cross-Over Pilot Study

BACKGROUND: The increased risk of abacavir in cardiovascular disease (CVD) in HIV-infected patients is still being debated. Maraviroc, a CCR5 blocker, has been shown to decrease immune activation and monocyte infiltration in atherosclerotic plaques in murine experiments. Therefore, we examined the effect of maraviroc intensification on flow-mediated dilatation (FMD) in abacavir-treated HIV-infected patients and its effect on immunological and inflammatory parameters. METHODS: A open-label prospective crossover study with a duration of 16 weeks: 8 weeks of intervention (maraviroc intensification) and 8 weeks of control (unchanged cART regimen). FMD, HIV-specific variables, expression of HIV co-receptors, markers of inflammation and coagulation and cellular markers of immune activation were measured at weeks 0, 8 and 16. The changes (Δ) in these variables were compared between intervention and control periods using non-parametric tests. To evaluate the relation with the change in FMD, linear regression modeling was used. RESULTS: Twenty-one male patients with suppressed plasma HIV-RNA, on cART, had a known HIV infection for 9.2 years (IQR 6.9-13.5) with abacavir use for 6.5 years (2.8-9.3). A significantly increased FMD of 0.73% (IQR -0.25 to 1.70) was seen after maraviroc intensification compared to a decrease of -0.42% (IQR -1.89 to 0.25; p = 0.049) in the control period. There was a negative relation between ΔFMD with ΔD-dimer (β -22.70, 95% CI -39.27; -6.13, p = 0.011) and ΔCD95+ CD4+ T cells (β -0.16, 95% CI -0.28; -0.04, p = 0.013), adjusted for age and duration of HIV. CONCLUSION: Maraviroc intensification modestly improves endothelial function in HIV-infected patients on an abacavir-containing regimen. TRIAL REGISTRATION: NCT01389063

Public Health Leadership in a VUCA World Environment: Lessons Learned during the Regional Emergency Rollout of SARS-CoV-2 Vaccinations in Heidelberg, Germany, during the COVID-19 Pandemic

The purpose of this work is to share methods used and lessons learned during a comprehensive inter-institutional pandemic disaster response in Heidelberg, Germany, conveying experiences of the regional SARS-CoV-2 vaccination rollout campaign for up to 1,000,000 vaccines in the year 2020. In this volatile, uncertain, complex, and ambiguous (VUCA) environment, the following five strategic elements were pertinent for institutional arrangements so that specific contributions of the various project partners would be available fast without the necessity of extensive negotiations or information exchange: (1) robust mandate, (2) use of established networks, (3) fast onboarding and securing of commitment of project partners, (4) informed planning of supply capacity, and (5) securing the availability of critical items. Planning tools included analyses through a VUCA lens, analyses of stakeholders and their management, possible failures, and management of main risks including mitigation strategies. The method of the present analysis (VUCA factors combined with analyses of possible failures, and management of stakeholders and risks) can theoretically be adjusted to any public health care emergency anywhere across the globe. Lessons learned include ten tactical leadership priorities and ten major pitfalls