Estimation of Health-State Utility Values and Factors Driving Health-Related Quality of Life in People Living with HIV and AIDS and Receiving cART in Germany: Baseline Analysis of a Cohort Study

HIV has become a chronic disease since widespread of combined antiretroviral therapy (cART). Understanding the influence of therapeutic and preventive interventions on health-related quality of life (HRQoL) of people living with HIV and AIDS (PLWHA) is important. Information about health state utilities and HRQoL in PLWHA after the introduction of cART is limited, especially in Germany. The study aims to estimate and describe health state utilities and HRQoL in PLWHA in Germany and explore the effects of patient characteristics, clinical and treatment factors. Utilities and HRQoL in PLWHA in Germany were measured with the generic EQ-5D-3L questionnaire. Health state utilities were calculated based on the EQ-5D descriptive system using the German EQ-5D-3L time trade-off (TTO) value set. HRQoL was calculated based on the EQ visual analogue scale (EQ-VAS). Extensive descriptive analyses were performed to represent utility values for different groups of the patients. Generalized linear models (GLMs) with beta-inflated distributions were used to determine patient characteristics and clinical factors that influence TTO utilities and VAS scores. 1056 PLWHA completed the EQ-5D-3L questionnaires at the beginning of the study. The mean TTO utility value is 0.912 (SD ± 0.154), and the mean VAS HRQoL is 84.32 (SD ± 18.55). “Anxiety/depression” and “pain/physical discomfort” are the most affected dimensions. A longer period of living with HIV, a lower CD4-cell count, having symptomatic HIV or AIDS and an increased number of changes in therapy are associated with decreased utilities and a lower probability of having HRQoL of perfect health. No significant effect of duration of regimen was found. Depression significantly decreases TTO utility values. Higher education, full-time employment and female gender are associated with higher utilities. The resulted EQ-VAS values for PLWHA in Germany are comparable with EQ-VAS estimates for the general population. The obtained estimates can be used as inputs for health economic evaluations of HIV-interventions. Addressing anxiety and depression may reduce the quality of life impairment in PLWHA. Impact of comorbidities needs further investigation. © 2021, The Author(s)

Population with an increased risk of severe COVID-19 in Germany.

Only a minority of people who test positive for COVID-19 develop a severe or critical form of the disease. Many of these have risk factors such as old age or pre-existing conditions and, therefore, are at the focus of protective measures. This article determines the number of people at risk in Germany and differentiates them according to age, sex, education, household type and federal state. The analyses presented here are based on data from the German Health Update (GEDA) 2019/2020-EHIS, which was carried out as a nationwide cross-sectional telephone-based survey between April 2019 and October 2020. The definition of being at increased risk of severe COVID-19 is primarily based on a respondent’s age and the presence of pre-existing conditions. Around 36.5 million people in Germany are at an increased risk of developing severe COVID-19. Of these, 21.6 million belong to the high-risk group. An above-average number of people at risk live alone. The prevalence of an increased risk is higher among middle-aged men than among women of the same age, and significantly higher among people with a low level of education than among people with a high level of education. The highest proportion of people with an increased risk live in Saarland and in the eastern German federal states. When fighting the pandemic, it is important to account for the fact that more than half of the population aged 15 or over is at increased risk of severe illness. Moreover, the regional differences in risk burden should be taken into account when planning interventions

Optical Properties of Pentacene and Perfluoropentacene Thin Films

The optical properties of pentacene (PEN) and perfluoropentacene(PFP) thin films on various SiO2 substrates were studied using variable angle spectroscopic ellipsometry. Structural characterization was performed using X-ray reflectivity and atomic force microscopy. A uniaxial model with the optic axis normal to the sample surface was used to analyze the ellipsometry data. A Strong optical anisotropy was observed and enabled the direction of the transition dipole of the absorption bands to be determined. Furthermore, comparison of the optical constants of PEN and PFP thin films with the absorption spectra of the monomers in solution shows significant changes due to the crystalline environment. Relative to the monomer spectrum the HOMO-LUMO transition observed in PEN (PFP) thin film is reduced by 210 meV (280 meV). Surprisingly, a second absorption band in the PFP thin film shows a slight blueshift (40 meV) compared to the spectrum of the monomer with its transition dipole perpendicular to that of the first absorption band.Comment: 6 pages, 6 figures, submitted to J. Chem. Phy

The impact of the AO foundation on fracture care : an evaluation of 60 years AO foundation

Objectives Sixty years ago, the Association of Osteosynthesis (AO) was founded with the aim to improve fracture treatment and has since grown into one of the largest medical associations worldwide. Aim of this study was to evaluate AO's impact on science, education, patient care and the MedTech business. Design/methods Impact evaluations were conducted as appropriate for the individual domains: Impact on science was measured by analyzing citation frequencies of publications promoted by AO. Impact on education was evaluated by analyzing the evolution of number and location of AO courses. Impact on patient care was evaluated with a health economic model analyzing cost changes and years of life gained through the introduction of osteosynthesis in 17 high-income countries (HICs). Impact on MedTech business was evaluated by analyzing sales data of AO-associated products. Results Thirty-five AO papers and 2 major AO textbooks are cited at remarkable frequencies in high ranking journals with up to 2000 citations/year. The number of AO courses steadily increased with a total of 645'000 participants, 20‘000 teaching days and 2‘500 volunteer faculty members so far. The introduction of osteosynthesis saved at least 925 billion Swiss Francs [CHF] in the 17 HICs analyzed and had an impact on avoiding premature deaths comparable to the use of antihypertensive drugs. AO-associated products generated sales of 55 billion CHF. Conclusion AO's impact on science, education, patient care, and the MedTech business was significant because AO addressed hitherto unmet needs by combining activities that mutually enriched and reinforced each other

Investigating 2MASS J06593158-0405277: AN FUor Burst in a Triple System?

articleFUor outbursts in young stellar objects are the most dramatic events among episodic accretion phenomena. The origin of these bursts is not clear: disk instabilities and/or disk perturbations by an external body being the most viable hypotheses. Here, we report our Very Large Telescope/SINFONI high angular resolution AO-assisted observations of 2MASS J06593158-0405277, which is undergoing a recently discovered FUor outburst. Our observations reveal the presence of an extended disk-like structure around the FUor, a very low-mass companion (2MASS J06593158-0405277B) at ~100 AU in projection, and, possibly, a third closer companion at ~11 AU. These sources appear to be young, displaying accretion signatures. Assuming the components are physically linked, 2MASS J06593158-0405277 would then be one of the very few triple systems observed in FUors.Science Foundation IrelandSTFC Ernest RutherfordMarie Curie CI

Epithelial restitution in 3D - Revealing biomechanical and physiochemical dynamics in intestinal organoids via fs laser nanosurgery

Intestinal organoids represent a three-dimensional cell culture system mimicking the mammalian intestine. The application of single-cell ablation for defined wounding via a femtosecond laser system within the crypt base allowed us to study cell dynamics during epithelial restitution. Neighboring cells formed a contractile actin ring encircling the damaged cell, changed the cellular aspect ratio, and immediately closed the barrier. Using traction force microscopy, we observed major forces at the ablation site and additional forces on the crypt sides. Inhibitors of the actomyosin-based mobility of the cells led to the failure of restoring the barrier. Close to the ablation site, high-frequency calcium flickering and propagation of calcium waves occured that synchronized with the contraction of the epithelial layer. We observed an increased signal and nuclear translocation of YAP-1. In conclusion, our approach enabled, for the first time, to unveil the intricacies of epithelial restitution beyond in vivo models by employing precise laser-induced damage in colonoids

Einfluss von Impfungen und Kontaktreduktionen auf die dritte Welle der SARS-CoV-2-Pandemie und perspektivische Rückkehr zu prä-pandemischem Kontaktverhalten

Das im Epidemiologischen Bulletin 13/2021 vorgestellte mathematische Modell schätzt die voraussichtlichen Effekte der COVID-19-Impfung in der Bevölkerung in Deutschland und vergleicht mögliche Strategien zur Priorisierung einzelner Bevölkerungsgruppen bei Knappheit der verfügbaren Impfstoffdosen. Das Modell ermöglicht nicht nur die Abbildung des aktuellen Infektionsgeschehens, sondern kann über Fragestellungen zur Impfstrategie hinaus auch Strategien zur Lockerung der bestehenden bzw. die Wiederaufnahme von Kontaktbeschränkungen analysieren. Dabei können saisonale Effekte auf die Übertragung von SARS-CoV-2 sowie der Einfluss neuer Virusvarianten berücksichtigt werden

Bulk Metallic Glass based Tool-Making Process Chain for Micro- and Nano- Replication

Existing and emerging micro-engineered products tend to integrate a multitude of functionalities into single enclosures/packages. Such functions generally require different length scale features. In practice, devices having complex topographies, which incorporate different length scale features cannot be produced by employing a single fabrication technology but by innovatively, integrating several different complementary manufacturing techniques in the form of a process chain. In order to design novel process chains that enable such function and length scale integration into miniaturised devices, it is required to utilise materials that are compatible with the various component manufacturing processes in such chains. At the same time, these materials should be able to satisfy the functional requirements of the produced devices. One family of materials, which can potentially fulfil these criteria, is bulk metallic glasses (BMGs). In particular, the absence of grain boundaries in BMGs makes them mechanically and chemically homogeneous for processing at all length scales down to a few nanometres. In this context, this research presents an experimental study to validate a novel process chain. It utilizes three complementary technologies for producing a Zr-based BMG replication master for a microfluidic device that incorporates micro and nano scale features. Then, to validate the viability of the fabricated BMG masters, they are utilized for serial replication of the microfluidic device by employing micro-injection moulding

Impact of osteosynthesis in fracture care : a cost comparison study

Aim: To estimate the health economic impact of osteosynthesis (OS) in fracture care over six decades in 17 high-income countries. Patients & methods: Applying a decision tree model, we assumed a hypothetical absence of OS and compared OS (intervention) with conservative treatment (CONS; comparator). We included patients with femur, tibia and radius fractures (age <65 years) and for proximal femur fractures also elderly patients (≥70 years). Results: We estimated savings in direct and indirect costs of 855 billion Swiss francs in the working age population in addition to 4.6 million years of life gained. In the elderly population, 69 billion Swiss francs were saved in direct costs of proximal femur fractures in addition to 73 million years of life gained. Conclusion: OS contributed to maximize health gains of society