Charmonium potentials: Matching perturbative and lattice QCD

Central and spin-spin potentials for charmonium, constructed from Nambu-Bethe-Salpeter amplitudes in lattice simulations of full QCD, are matched with results from perturbative QCD at an appropriate distance scale. This matching is made possible by defining the perturbative potentials through Fourier transforms with a low-momentum cutoff. The central (spin-independent) potential is compared with potentials derived from an expansion in powers of the inverse quark mass. A well-controlled continuation of the charmonium spin-spin potential from lattice QCD to short distances is performed. The mass splittings of the charmonium singlet and triplet states below the open charm threshold, obtained from the matched spin-spin potential, are in good agreement with the experimental values.Comment: 5 pages, 4 figures. v2: published version, minor change

Cost Evaluation of a Model for Integrated Care of Seriously Mentally Ill Patients

Background: The model for integrated care (IC) of those seriously mentally ill patients insured with the DAK-Gesundheit health insurance and various Betriebskrankenkassen (members of the VAG Mitte) from the regions Berlin, Brandenburg, Lower Saxony and Bremen allows a complex treatment in the outpatient setting which consists of psychiatrists, general practitioners and clinicians, psychiatric nursing, sociotherapy (only in Berlin), internal medicine quality circles, orientation on treatment guidelines and conceptual consensus with the relevant care clinics. The aim of the evaluation is to illustrate the health economic effects of IC. Methods: In the period from 2006 to 2010 insured members of the DAK-Gesundheit and other involved health insurance companies with a serious mental illness, a significant impairment of social functioning and the need to be treated to avoid or substitute an in-hospital stay were included in the integrated care. The cost perspective was that of the statutory health insurance companies. For the health economic evaluation, the utilisation of continuous IC over 18 months was compared to the last 18 months prior to the inclusion in IC. The clinical findings were gathered quarterly during the IC using CGI (Clinical Global Impressions) and GAF (Global Assessment of Functioning Scale). Results: A total of 1 364 patients receiving IC in 66 doctor's practices were documented (of those, 286 had diagnoses of ICD-10 F2, 724 ICD-10 F32-F39). The median age was 48.8 years, 69% were female. 24% had their own source of income, 40% were on the pension, and the rest of the patients were receiving transfer benefits in some form. In 54% of the cases IC was used to avoid an in-hospital stay, in 46% of the cases to substitute an in-hospital stay. The degree of the CGI was 5.5 on average at the time of inclusion and the GAF score was 36.5 on average. The 226 patients with continuous documentation over 18 months were included in the health economic analysis. The number of days spent in hospital was lower during the IC period as compared to the 18 months prior to IV (11.8 vs. 28.6 days, p<0.001), the inpatient costs were lower (5 929 ± 13 837 Euro vs. 2 458 ± 6 940 Euro, p<0.001), the total was not significantly changed (7 777 ± 14 263 Euro vs. 7 321 ± 7 910 Euro, p=0.65). The substantial reduction of inpatient costs was compensated by the additional costs for medication and the costs of the complex outpatient care. Results were comparable for the 2 subgroups of schizophrenic/schizoaffective (n=66, 40.9 vs. 17.9 days, p=0.03; inpatient cost 9 009 ± 15 677 Euro vs. 3 650 ± 8 486 Euro, p=0.02; total expenditures 11 789 ± 15 975 Euro vs. 9 623 ± 9 262 Euro, p=0.33) and unipolar depressive patients (n=90, 29.8 vs. 9.8 days, p=0.006; inpatient cost 5 664 ± 14 921 Euro vs. 1 967 ± 5 276 Euro, p=0.02; total expenditures 7 146 ± 15 164 Euro vs. 6 234 ± 6 292 Euro, p=0.57). Conclusion: The IC was able to considerably reduce the utilisation of inpatient treatment through offering a complex range of services in the outpatient setting and allowed for a weight-shift in a low-threshold comprehensive care structure without an increase in costs from the statutory health insurance companies' perspective. For a detailed description of clinical effects further studies are required.Hintergrund: Das Modell der Integrierten Versorgung (IV) schwer psychisch Kranker für Versicherte der DAK-Gesundheit und verschiedener Betriebskrankenkassen (Mitglieder der BKK VAG Mitte) der Regionen Berlin, Brandenburg, Niedersachsen und Bremen ermöglicht eine ambulante Komplexbehandlung bestehend aus psychiatrischen Fachärzten, Haus- und Klinikärzten, psychiatrischer Fachpflege, Soziotherapie (nur Berlin), innerärztliche Qualitätszirkelarbeit, Orientierung an Behandlungspfaden und konzeptioneller Abstimmung mit den zuständigen Versorgungskliniken. Ziel der Evaluation war die Darstellung der gesundheitsökonomischen Auswirkungen der IV. Methodik: Im Zeitraum zwischen 2006 und 2010 wurden Versicherte der DAK-Gesundheit und der beteiligten Betriebskrankenkassen mit einer schweren psychischen Erkrankung, einer deutlichen Beeinträchtigung des sozialen Funktionsniveaus und der Erfordernis einer krankenhausvermeidenden oder krankenhausersetzenden Behandlung in die IV eingeschlossen. Die Kostenperspektive war diejenige der Gesetzlichen Krankenversicherung. Für die gesundheitsökonomische Auswertung wurde die Inanspruchnahme über 18 Monate kontinuierliche IV-Behandlung mit den letzten 18 Monaten vor Einschluss in die IV verglichen. Der klinische Befund wurde während der IV quartalsweise mit globaler Schweregrad- (CGI) und Funktionsbeurteilung (GAF) erhoben. Ergebnisse: Insgesamt wurden 1.364 Patienten mit IV-Behandlung in 66 Arztpraxen dokumentiert (davon 286 ICD-10 F2, 724 ICD-10 F32-F39). Das Durchschnittsalter betrug 48,8 Jahre, 69 % waren weiblich. 24 % verfügten über ein eigenes Einkommen, 40 % bezogen Rente, die übrigen Patienten Transferleistungen verschiedener Art. In 54 % der Fälle wurde IV klinikvermeidend, in 46 % klinikersetzend eingesetzt. Der CGI-Schweregrad betrug bei Einschluss durchschnittlich 5,4, der GAF-Score 36,5. In die gesundheitsökonomische Analyse wurden die 226 Patienten mit kontinuierlicher Dokumentation über 18 Monate eingeschlossen. Die Anzahl der Krankenhaustage war in 18 Monaten während IV niedriger als in 18 Monaten vor IV (11,8 vs. 28,6 Tage, p < 0,001), die Ausgaben für stationäre Behandlung signifikant geringer (5.929 ± 13.837 Euro vs. 2.458 ± 6.940 Euro, p < 0,001), die Gesamtausgaben veränderten sich jedoch nicht signifikant (7.777 ± 14.263 Euro vs. 7.321 ± 7.910 Euro, p = 0,65). Die erhebliche Einsparung bei den stationären Ausgaben wurde durch die Mehrausgaben bei Medikamenten und die Ausgaben der ambulanten Komplexleistungen kompensiert. Analoge Ergebnisse erbrachte die Analyse der 2 Subgruppen der Patienten mit Schizophrenie/ schizoaffektiver Störung (n = 66, 40,9 vs. 17,9 Tage, p = 0,03; stationäre Ausgaben 9.009 ± 15.677 Euro vs. 3.650 ± 8.486 Euro, p = 0,02; Gesamtausgaben 11.789 ± 15.975 Euro vs. 9.623 ± 9.262 Euro, p = 0,33) und mit unipolarer Depression (n = 90, 29,8 vs. 9,8 Tage, p = 0,006; stationäre Ausgaben 5.664 ± 14.921 Euro vs. 1.967 ± 5.276 Euro, p = 0,02; Gesamtausgaben 7.146 ± 15.164 Euro vs. 6.234 ± 6.292 Euro, p = 0,57). Schlussfolgerung: Das IV-Modell konnte durch ein komplexes ambulantes Leistungsangebot die stationäre Inanspruchnahme deutlich senken und eine Gewichtsverlagerung in eine niedrigschwellige umfassende Versorgungsstruktur realisieren, ohne dass dies aus GKV-Perspektive mit einer Kostensteigerung verbunden war. Für eine detaillierte Darstellung klinischer Effekte sind weitere Studien erforderlich

Experimental conditions improving in-solution target enrichment for ancient DNA

High-throughput sequencing has dramatically fostered ancient DNA research in recent years. Shotgun sequencing, however, does not necessarily appear as the best-suited approach due to the extensive contamination of samples with exogenous environmental microbial DNA. DNA capture-enrichment methods represent cost-effective alternatives that increase the sequencing focus on the endogenous fraction, whether it is from mitochondrial or nuclear genomes, or parts thereof. Here, we explored experimental parameters that could impact the efficacy of MYbaits in-solution capture assays of ~5000 nuclear loci or the whole genome. We found that varying quantities of the starting probes had only moderate effect on capture outcomes. Starting DNA, probe tiling, the hybridization temperature and the proportion of endogenous DNA all affected the assay, however. Additionally, probe features such as their GC content, number of CpG dinucleotides, sequence complexity and entropy and self-annealing properties need to be carefully addressed during the design stage of the capture assay. The experimental conditions and probe molecular features identified in this study will improve the recovery of genetic information extracted from degraded and ancient remains.No Full Tex