Adaptive Nutzenbewertung für Untersuchungs- und Behandlungsmethoden mit Medizinprodukten hoher Klassen

Das GKV-VSG führte erstmalig die Nutzenbewertung von Untersuchungs- und Behandlungsmethoden mit Medizinprodukten hoher Klassen und invasivem Charakter ein. Zukünftig wird die Entscheidung über die Erstattungsfähigkeit von der Dokumentation von Nutzen und Schaden abhängig sein. Grundsätzlich kann die Nutzenbewertung in drei Phasen unterteilt werden: Messen von kausalen Effekten einer Intervention, Bewertung der gemessenen Effekte und Entscheidung über die Erstattungsfähigkeit eines aggregierten Gesamtnutzens. Um den Anforderungen zu begegnen, stellen adaptive Studiendesigns, die multikriterielle Entscheidungsanalyse und die adaptive Nutzenbewertung ein zukunftsfähiges Konzept für einen schnellen Zugang von Patienten zu innovativen Behandlungsmethoden bei hoher Qualität und Sicherheit dar

The Relations of Children’s Dispositional Prosocial Behavior to Emotionality, Regulation, and Social Functioning

The purpose of this study was to examine the relations of a measure of children’s dispositional prosocial behavior (i.e., peer nominations) to individual differences in children’s negative emotionality, regulation, and social functioning. Children with prosocial reputations tended to be high in constructive social skills (i.e., socially appropriate behavior and constructive coping) and attentional regulation, and low in negative emotionality. The relations of children’s negative emotionality to prosocial reputation were moderated by level of dispositional attentional regulation. In addition, the relations of prosocial reputation to constructive social skills and parent-reported negative emotionality (for girls) increased with age. Vagal tone, a marker of physiological regulation, was negatively related to girls’ prosocial reputation

Steady and Stable: Numerical Investigations of Nonlinear Partial Differential Equations

Excerpt: Mathematics is a language which can describe patterns in everyday life as well as abstract concepts existing only in our minds. Patterns exist in data, functions, and sets constructed around a common theme, but the most tangible patterns are visual. Visual demonstrations can help undergraduate students connect to abstract concepts in advanced mathematical courses. The study of partial differential equations, in particular, benefits from numerical analysis and simulation

Chemical Toxicity Correlations For Several Fish Species Based on the Abraham Solvation Parameter Model

Article on chemical toxicity correlations for several fish species based on the Abraham solvation parameter model

Characterization and genomic analysis of chromate resistant and reducing Bacillus cereus strain SJ1

<p>Abstract</p> <p>Background</p> <p>Chromium is a toxic heavy metal, which primarily exists in two inorganic forms, Cr(VI) and Cr(III). Chromate [Cr(VI)] is carcinogenic, mutational, and teratogenic due to its strong oxidizing nature. Biotransformation of Cr(VI) to less-toxic Cr(III) by chromate-resistant and reducing bacteria has offered an ecological and economical option for chromate detoxification and bioremediation. However, knowledge of the genetic determinants for chromate resistance and reduction has been limited so far. Our main aim was to investigate chromate resistance and reduction by <it>Bacillus cereus </it>SJ1, and to further study the underlying mechanisms at the molecular level using the obtained genome sequence.</p> <p>Results</p> <p><it>Bacillus cereus </it>SJ1 isolated from chromium-contaminated wastewater of a metal electroplating factory displayed high Cr(VI) resistance with a minimal inhibitory concentration (MIC) of 30 mM when induced with Cr(VI). A complete bacterial reduction of 1 mM Cr(VI) was achieved within 57 h. By genome sequence analysis, a putative chromate transport operon, <it>chrIA</it>1, and two additional <it>chrA </it>genes encoding putative chromate transporters that likely confer chromate resistance were identified. Furthermore, we also found an azoreductase gene <it>azoR </it>and four nitroreductase genes <it>nitR </it>possibly involved in chromate reduction. Using reverse transcription PCR (RT-PCR) technology, it was shown that expression of adjacent genes <it>chrA</it>1 and <it>chrI </it>was induced in response to Cr(VI) but expression of the other two chromate transporter genes <it>chrA</it>2 and <it>chrA</it>3 was constitutive. In contrast, chromate reduction was constitutive in both phenotypic and gene expression analyses. The presence of a resolvase gene upstream of <it>chrIA</it>1, an arsenic resistance operon and a gene encoding Tn7-like transposition proteins ABBCCCD downstream of <it>chrIA</it>1 in <it>B. cereus </it>SJ1 implied the possibility of recent horizontal gene transfer.</p> <p>Conclusion</p> <p>Our results indicate that expression of the chromate transporter gene <it>chrA</it>1 was inducible by Cr(VI) and most likely regulated by the putative transcriptional regulator ChrI. The bacterial Cr(VI)-resistant level was also inducible. The presence of an adjacent arsenic resistance gene cluster nearby the <it>chrIA</it>1 suggested that strong selective pressure by chromium and arsenic could cause bacterial horizontal gene transfer. Such events may favor the survival and increase the resistance level of <it>B. cereus </it>SJ1.</p

Therapeutic implications of improved molecular diagnostics for rare CNS-embryonal tumor entities: results of an international, retrospective study

BACKGROUND: Only few data are available on treatment-associated behavior of distinct rare CNS-embryonal tumor entities previously treated as "CNS-primitive neuroectodermal tumors" (CNS-PNET). Respective data on specific entities, including CNS neuroblastoma, FOXR2 activated (CNS NB-FOXR2), and embryonal tumor with multi-layered rosettes (ETMR) are needed for development of differentiated treatment strategies. METHODS: Within this retrospective, international study, tumor samples of clinically well-annotated patients with the original diagnosis of CNS-PNET were analyzed using DNA methylation arrays (n=307). Additional cases (n=66) with DNA methylation pattern of CNS NB-FOXR2 were included irrespective of initial histological diagnosis. Pooled clinical data (n=292) were descriptively analyzed. RESULTS: DNA methylation profiling of "CNS-PNET" classified 58(19%) cases as ETMR, 57(19%) as HGG, 36(12%) as CNS NB-FOXR2, and 89(29%) cases were classified into 18 other entities. Sixty-seven (22%) cases did not show DNA methylation patterns similar to established CNS tumor reference classes. Best treatment results were achieved for CNS NB-FOXR2 patients (5-year PFS: 63%±7%, OS: 85%±5%, n=63), with 35/42 progression-free survivors after upfront craniospinal irradiation (CSI) and chemotherapy. The worst outcome was seen for ETMR and HGG patients with 5-year PFS of 18%±6% and 22%±7%, and 5-year OS of 24%±6% and 25%±7%, respectively. CONCLUSION: The historically reported poor outcome of CNS-PNET patients becomes highly variable when tumors are molecularly classified based on DNA methylation profiling. Patients with CNS NB-FOXR2 responded well to current treatments and a standard-risk-CSI based regimen may be prospectively evaluated. The poor outcome of ETMR across applied treatment strategies substantiates the necessity for evaluation of novel treatments

The impact of large scale licensing examinations in highly developed countries: a systematic review

BACKGROUND: To investigate the existing evidence base for the validity of large-scale licensing examinations including their impact. METHODS: Systematic review against a validity framework exploring: Embase (Ovid Medline); Medline (EBSCO); PubMed; Wiley Online; ScienceDirect; and PsychINFO from 2005 to April 2015. All papers were included when they discussed national or large regional (State level) examinations for clinical professionals, linked to examinations in early careers or near the point of graduation, and where success was required to subsequently be able to practice. Using a standardized data extraction form, two independent reviewers extracted study characteristics, with the rest of the team resolving any disagreement. A validity framework was used as developed by the American Educational Research Association, American Psychological Association, and National Council on Measurement in Education to evaluate each paper’s evidence to support or refute the validity of national licensing examinations. RESULTS: 24 published articles provided evidence of validity across the five domains of the validity framework. Most papers (n = 22) provided evidence of national licensing examinations relationships to other variables and their consequential validity. Overall there was evidence that those who do well on earlier or on subsequent examinations also do well on national testing. There is a correlation between NLE performance and some patient outcomes and rates of complaints, but no causal evidence has been established. CONCLUSIONS: The debate around licensure examinations is strong on opinion but weak on validity evidence. This is especially true of the wider claims that licensure examinations improve patient safety and practitioner competence