Epidemiology of common infectious diseases before and during the COVID-19 pandemic in Bavaria, Germany, 2016 to 2021: an analysis of routine surveillance data

Background Unprecedented non-pharmaceutical interventions to control the COVID-19 pandemic also had an effect on other infectious diseases. Aim We aimed to determine their impact on transmission and diagnosis of notifiable diseases other than COVID-19 in Bavaria, Germany, in 2020 and 2021. Methods We compared weekly cases of 15 notifiable infectious diseases recorded in Bavaria between 1 January 2016 and 31 December 2021 in time series analyses, median age and time-to-diagnosis using Wilcoxon rank sum test and hospitalisation rates using univariable logistic regression during three time periods: pre-pandemic (weeks 1 2016–9 2020), pandemic years 1 (weeks 10–52 2020) and 2 (2021). Results Weekly case numbers decreased in pandemic year 1 for all diseases assessed except influenza, Lyme disease and tick-borne encephalitis; markedly for norovirus gastroenteritis (IRR = 0.15; 95% CI: 0.12–0.20) and pertussis (IRR = 0.22; 95% CI: 0.18–0.26). In pandemic year 2, influenza (IRR = 0.04; 95% CI: 0.02–0.09) and pertussis (IRR = 0.11; 95% CI: 0.09–0.14) decreased markedly, but also chickenpox, dengue fever, Haemophilus influenzae invasive infection, hepatitis C, legionellosis, noro- and rotavirus gastroenteritis and salmonellosis. For enterohaemorrhagic Escherichia coli infections, median age decreased in pandemic years 1 and 2 (4 years, interquartile range (IQR): 1–32 and 3 years, IQR: 1–18 vs 11 years, IQR: 2–42); hospitalisation proportions increased in pandemic year 1 (OR = 1.60; 95% CI: 1.08–2.34). Conclusion Reductions for various infectious diseases and changes in case characteristics in 2020 and 2021 indicate reduced transmission of notifiable diseases other than COVID-19 due to interventions and under-detection.Peer Reviewe

Hypophosphatemia after high-dose iron repletion with ferric carboxymaltose and ferric derisomaltose-the randomized controlled HOMe aFers study

Background In patients with iron deficiency anemia, ferric carboxymaltose (FCM) and ferric derisomaltose (FDI) allow high-dose iron repletion. While FCM is reported to induce hypophosphatemia, the frequency of hypophosphatemia after an equivalent dosage of FDI had not been assessed prospectively. Methods In the prospective, single-center, double-blind HOMe aFers study, 26 women with iron deficiency anemia (hemoglobin < 12 g/dL plus either plasma ferritin ≤ 100 ng/mL or a plasma ferritin ≤ 300 ng/mL and transferrin saturation (TSAT) ≤ 30%) were randomized to a single intravenous infusion of 20 mg/kg body weight (up to a maximum of 1000 mg) FCM or FDI. The primary endpoint was the incidence of hypophosphatemia (plasma phosphorus levels < 2.0 mg/dL at day 1, day 7 ± 2, and/or day 35 ± 2 after the infusion). In order to investigate potential skeletal and cardiovascular implications, we assessed changes in other components of mineral and bone metabolism, left ventricular function, and arrhythmias. Results Hypophosphatemia occurred more frequently in women treated with FCM (9 out of 12 [75%]) than in those treated with FDI (1 out of 13 [8%]; p = 0.001). Within 24 h after iron supplementation, women in the FCM group had significant higher plasma intact FGF23 (p < 0.001) and lower plasma 1.25-dihydroxyvitamin D (p < 0.001). As an indicator of urinary phosphorus losses, urinary fractional phosphorus excretion was higher in the FCM group (p = 0.021 at day 7 ± 2 after iron supplementation). We did not observe differences in skeletal and cardiovascular markers, potentially because of the limited number of participants. Conclusions While both FCM and FDI provide efficient iron repletion in participants with iron deficiency anemia, FCM induced hypophosphatemia more often than FDI. Trial registration Clinical Trials.gov NCT02905539. Registered on 8 September 2016. 2015-004808-36 (EudraCT Number) U1111-1176-4563 (WHO Universal Trial Number) DRKS00010766 (Deutsches Register Klinischer Studien

Ökonomie der alternativen Milchvermarktung: Ökonomische Berechnungen zu beispielhaften Lösungen in der alternativen Milchvermarktung

Der vorliegende Bericht schafft die erforderliche Datengrundlage für ökonomische Bewertungen der alternativen Milcherzeugung, -verarbeitung und -vermarktung. Er unterteilt sich in einen ökonomischen und einen analytischen Teil. Im ersten Teil wird die Herstellung von Heumilch, Weidemilch und Bio-Milch als alternative Produktionsweisen ökonomisch bewertet, die Produktionskosten von Trinkmilch, Joghurt und Hartkäse ermittelt sowie die Direktvermarktung und Vermarktung über den regionalen LEH ökonomisch betrachtet. Als Datengrundlage diente hierzu die Erhebung der Produktionskosten auf sächsischen Milchbetrieben. Redaktionsschluss: 30.11.202

Immunoadsorption for Treatment of Patients with Suspected Alzheimer Dementia and Agonistic Autoantibodies against Alpha1a-Adrenoceptor—Rationale and Design of the IMAD Pilot Study

Background: agonistic autoantibodies (agAABs) against G protein-coupled receptors (GPCR) have been linked to cardiovascular disease. In dementia patients, GPCR-agAABs against the &alpha;1- and &szlig;2-adrenoceptors (&alpha;1AR- and &szlig;2AR) were found at a prevalence of 50%. Elimination of agAABs by immunoadsorption (IA) was successfully applied in cardiovascular disease. The IMAD trial (Efficacy of immunoadsorption for treatment of persons with Alzheimer dementia and agonistic autoantibodies against alpha1A-adrenoceptor) investigates whether the removal of &alpha;1AR-AABs by a 5-day IA procedure has a positive effect (improvement or non-deterioration) on changes of hemodynamic, cognitive, vascular and metabolic parameters in patients with suspected Alzheimer&rsquo;s clinical syndrome within a one-year follow-up period. Methods: the IMAD trial is designed as an exploratory monocentric interventional trial corresponding to a proof-of-concept phase-IIa study. If cognition capacity of eligible patients scores 19&ndash;26 in the Mini Mental State Examination (MMSE), patients are tested for the presence of agAABs by an enzyme-linked immunosorbent assay (ELISA)-based method, followed by a bioassay-based confirmation test, further screening and treatment with IA and intravenous immunoglobulin G (IgG) replacement. We aim to include 15 patients with IA/IgG and to complete follow-up data from at least 12 patients. The primary outcome parameter of the study is uncorrected mean cerebral perfusion measured in mL/min/100 gr of brain tissue determined by magnetic resonance imaging with arterial spin labeling after 12 months. Conclusion: IMAD is an important pilot study that will analyze whether the removal of &alpha;1AR-agAABs by immunoadsorption in &alpha;1AR-agAAB-positive patients with suspected Alzheimer&rsquo;s clinical syndrome may slow the progression of dementia and/or may improve vascular functional parameters

Low-dose betamethasone-acetate for fetal lung maturation in preterm sheep

BackgroundAntenatal steroids are standard of care for women who are at risk of preterm delivery; however, antenatal steroid dosing and formulation have not been evaluated adequately. The standard clinical 2-dose treatment with betamethasone-acetate+betamethasone-phosphate is more effective than 2 doses of betamethasone-phosphate for the induction of lung maturation in preterm fetal sheep. We hypothesized that the slowly released betamethasone-acetate component induces similar lung maturation to betamethasone-phosphate+betamethasone-acetate with decreased dose and fetal exposure.ObjectiveThe purpose of this study was to investigate pharmacokinetics and fetal lung maturation of antenatal betamethasone-acetate in preterm fetal sheep.Study designGroups of 10 singleton-pregnant ewes received 1 or 2 intramuscular doses 24 hours apart of 0.25 mg/kg/dose of betamethasone-phosphate+betamethasone-acetate (the standard of care dose) or 1 intramuscular dose of 0.5 mg/kg, 0.25 mg/kg, or 0.125 mg/kg of betamethasone-acetate. Fetuses were delivered 48 hours after the first injection at 122 days of gestation (80% of term) and ventilated for 30 minutes, with ventilator settings, compliance, vital signs, and blood gas measurements recorded every 10 minutes. After ventilation, we measured static lung pressure-volume curves and sampled the lungs for messenger RNA measurements. Other groups of pregnant ewes and fetuses were catheterized and treated with intramuscular injections of betamethasone-phosphate 0.125 mg/kg, betamethasone-acetate 0.125 mg/kg, or betamethasone-acetate 0.5 mg/kg. Maternal and fetal betamethasone concentrations in plasma were measured for 24 hours.ResultsAll betamethasone-treated groups had increased messenger RNA expression of surfactant proteins A, B, and C, ATP-binding cassette subfamily A member 3, and aquaporin-5 compared with control animals. Treatment with 1 dose of intramuscular betamethasone-acetate 0.125mg/kg improved dynamic and static lung compliance, gas exchange, and ventilation efficiency similarly to the standard treatment of 2 doses of 0.25 m/kg of betamethasone-acetate+betamethasone-phosphate. Betamethasone-acetate 0.125 mg/kg resulted in lower maternal and fetal peak plasma concentrations and decreased fetal exposure to betamethasone compared with betamethasone-phosphate 0.125 mg/kg.ConclusionA single dose of betamethasone-acetate results in similar fetal lung maturation as the 2-dose clinical formulation of betamethasone-phosphate+betamethasone-acetate with decreased fetal exposure to betamethasone. A lower dose of betamethasone-acetate may be an effective alternative to induce fetal lung maturation with less risk to the fetus

The Assembly History of Disk Galaxies: I - The Tully-Fisher Relation to z~1.3 from Deep Exposures with DEIMOS

We present new measures of the evolving scaling relations between stellar mass, luminosity and rotational velocity for a morphologically-inclusive sample of 129 disk-like galaxies with z_AB<22.5 in the redshift range 0.2<z<1.3, based on spectra from DEIMOS on the Keck II telescope, multi-color HST ACS photometry, and ground-based Ks-band imaging. A unique feature of our survey is the extended spectroscopic integration times, leading to significant improvements in determining characteristic rotational velocities for each galaxy. Rotation curves are reliably traced to the radius where they begin to flatten for ~90% of our sample, and we model the HST-resolved bulge and disk components in order to accurately de-project our measured velocities, accounting for seeing and dispersion. We demonstrate the merit of these advances by recovering an intrinsic scatter on the stellar mass Tully-Fisher relation a factor of 2-3 less than in previous studies at intermediate redshift and comparable to that of locally-determined relations. With our increased precision, we find the relation is well-established by ~1, with no significant evolution to ~0.3, \DeltaM_stellar ~ 0.04+/-0.07 dex. A clearer trend of evolution is seen in the B-band Tully-Fisher relation corresponding to a decline in luminosity of \DeltaM_B ~ 0.85+/-0.28 magnitudes at fixed velocity over the same redshift range, reflecting the changes in star formation over this period. As an illustration of the opportunities possible when gas masses are available for a sample such as ours, we show how our dynamical and stellar mass data can be used to evaluate the likely contributions of baryons and dark matter to the assembly history of spiral galaxies.Comment: 22 pages, 11 figures, Accepted for publication in the Astrophysical Journa