System-size dependence of strangeness production in high-energy A+A collisions and percolation of strings

We argue that the shape of the system-size dependence of strangeness production in nucleus-nucleus collisions can be understood in a picture that is based on the formation of clusters of overlapping strings. A string percolation model combined with a statistical description of the hadronization yields a quantitative agreement with the data at sqrt s_NN = 17.3 GeV. The model is also applied to RHIC energies

Evidence-based indications for the planning of PET or PET/CT capacities are needed

Purpose To identify evidence-based indications for PET/PET–CT scans in support of facilities planning and to describe a pilot project in which this information was applied for an investment decision in an Austrian region. The study updates a Health Technology Assessment (HTA) report (2015) on oncological indications, extending it to neurological indications and inflammatory disorders. Methods A systematic literature search to identify HTA reports, evidence-based guidelines, and systematic reviews/meta-analyses (SR/MA) was performed, supplemented by a manual search for professional society recommendations and explicit “not-to-do’s”. A needs-assessment was conducted in the context of the pilot study on investing in an additional PET–CT scanner in the Austrian region of Carinthia. Results Overall recommendations for indications as well as non-recommendations for the three areas (oncology, neurology, and inflammatory disorders) were compiled from the 2015 PET–HTA report and expanded for a final total of ten HTA, comprising 234 (positive and negative) recommendations from professional societies and databases, and supplemented by findings from 23 SR/MA. For the investment decision pilot study in Carinthia, 1762 PET scans were analyzed; 77.8% were assigned to the category “recommended evidence-based indications” (54.7%), “not recommended” (1.8%) or “contradictory recommendations” (21.3%). The remaining could not be assigned to any of the three categories. Conclusions The piloting of PET capacity planning using evidence-based information is a first of its kind in the published literature. On one hand, the high number of PET scans that could not be ascribed to any of the categories identified limits to the instructive power of the study to use evidence-based indication lists as the basis for a needs-assessment investment planning. On the other hand, this study reveals how there is a need to improve indication coding for enhanced capacity planning of medical services. Overall recommendations identified can serve as needs-based and evidence-based decision support for PET/PET–CT service provision

Defining benefit catalogues and entitlements to health care in Germany: Decision makers, decision criteria and taxonomy of catalogues

This paper studies the politico-economic reasons for the refusal of a proposed compulsory flood insurance scheme in Germany. It provides the rationale for such scheme and outlines the basic features of a market-orientated design. The main reasons for the political down-turn of this proposal were the (mis)perceived costs of a state guarantee, legal objections against a compulsory insurance, distributional conflicts between the federal government and the German states (Länder) on the implied administrative costs and the well-known samariter dilemma of ad-hoc disaster relief. The focus on pure market solutions proved to be an ineffective strategy for policy advice in this field. -- Während die Rahmenbedingungen für das deutsche Gesundheitssystem vom Gesetzgeber vorgegeben werden, obliegt die Bestimmung einzelner Leistungen bzw. Leistungsinhalte den Entscheidungsträgern der Selbstverwaltung. Dabei variiert die Genauigkeit der Leistungsdefinition zwischen verschiedenen Sektoren und Ausgabenträgern. Während die Leistungen einiger Ausgabenträger nur implizit definiert sind, ist der Leistungsumfang anderer Ausgabenträger bereits explizit als Leistungskatalog formuliert. Dabei orientiert sich die Mehrheit der Ausgabenträger an dem Leistungsumfang der gesetzlichen Krankenversicherung (GKV) und überträgt diesen in den eigenen Bereich. Im Rahmen der GKV, die ca. 88% der Bevölkerung versichert und 56,9% der Gesundheitsausgaben trägt, bestimmen verschiedene Kataloge zusammen mit den Richtlinien des Gemeinsamen Bundesausschusses den Leistungsumfang. Die Leistungen, der Aufbau und der Inhalt der Leistungskataloge, die an der Definition der Kataloge beteiligten Akteure, sowie die Entscheidungskriterien für die Aufnahme neuer Leistungen in die Leistungskataloge der Sozialversicherungen werden in diesem Zusammenhang ausführlich dargestellt und analysiert.

Reciprocal t(9;22) ABL/BCR fusion proteins: leukemogenic potential and effects on B cell commitment

Background: t(9;22) is a balanced translocation, and the chromosome 22 breakpoints (Philadelphia chromosome – Ph+) determine formation of different fusion genes that are associated with either Ph+ acute lymphatic leukemia (Ph+ ALL) or chronic myeloid leukemia (CML). The "minor" breakpoint in Ph+ ALL encodes p185BCR/ABL from der22 and p96ABL/BCR from der9. The "major" breakpoint in CML encodes p210BCR/ABL and p40ABL/BCR. Herein, we investigated the leukemogenic potential of the der9-associated p96ABL/BCR and p40ABL/BCR fusion proteins and their roles in the lineage commitment of hematopoietic stem cells in comparison to BCR/ABL. Methodology: All t(9;22) derived proteins were retrovirally expressed in murine hematopoietic stem cells (SL cells) and human umbilical cord blood cells (UCBC). Stem cell potential was determined by replating efficiency, colony forming - spleen and competitive repopulating assays. The leukemic potential of the ABL/BCR fusion proteins was assessed by in a transduction/transplantation model. Effects on the lineage commitment and differentiation were investigated by culturing the cells under conditions driving either myeloid or lymphoid commitment. Expression of key factors of the B-cell differentiation and components of the preB-cell receptor were determined by qRT-PCR. Principal Findings: Both p96ABL/BCR and p40ABL/BCR increased proliferation of early progenitors and the short term stem cell capacity of SL-cells and exhibited own leukemogenic potential. Interestingly, BCR/ABL gave origin exclusively to a myeloid phenotype independently from the culture conditions whereas p96ABL/BCR and to a minor extent p40ABL/BCR forced the B-cell commitment of SL-cells and UCBC. Conclusions/Significance: Our here presented data establish the reciprocal ABL/BCR fusion proteins as second oncogenes encoded by the t(9;22) in addition to BCR/ABL and suggest that ABL/BCR contribute to the determination of the leukemic phenotype through their influence on the lineage commitment

AHNAK and inflammatory markers predict poor survival in laryngeal carcinoma.

AHNAK/Desmoyokin is a giant protein which has been recently linked to reorganization of the actin cytoskeleton, cellular migration and invasion. Here, we investigated the role of AHNAK in the pathophysiology of larynx carcinoma-one of the major subtypes of head and neck cancer. To this end, we analysed AHNAK expression in tumor tissues from 83 larynx carcinoma patients in relation to overall survival. We found that tumoral AHNAK overexpression significantly associated with poor survival of these patients both in univariate and multivariate analysis. In further studies, we combined the prognostic value of AHNAK with selected markers of inflammation, such as macrophage migration inhibitory factor (MIF) and tumor-infiltrating neutrophils (CD66b-positive cells). Both MIF and neutrophils have been linked to enhanced tumoral migration and poor clinical outcome in patients with orohypopharynx carcinoma-another major subtype of head and neck cancer. Interestingly, we found that synchronous high levels of AHNAK and MIF or AHNAK and neutrophils, respectively, were stronger predictors of poor survival than AHNAK alone. Synchronous high levels of all three markers were the strongest predictors of poor survival in our patient cohort. Taken together, our findings propose novel strategies for an accurate prognosis in larynx carcinoma and suggest potential mechanisms of inflammation-mediated tumor progression

Epidemic Spread of a Single Clone of Methicillin-Resistant Staphylococcus aureus among Injection Drug Users in Zurich, Switzerland

We describe an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) among injection drug users (IDUs). From August 1994 through December 1999, we registered 31 IDUs with MRSA infections (12 with soft-tissue infection, 7 with pneumonia [fatal in 1], 7 with endocarditis [fatal in 1], 2 with osteomyelitis, 2 with septic arthritis, and 1 with ulcerative tonsillitis), with a marked increase in the number of IDUs registered during 1998 and 1999. Of 31 patients, 15 (48%) were infected with human immunodeficiency virus. A point-prevalence study among IDUs who frequented outpatient facilities in Zurich revealed an MRSA carriage rate of 10.3% (range, 0%-28.6%) in various facilities. In all but 1 case, pulsed-field gel electrophoresis banding patterns of isolates obtained from these patients were indistinguishable from isolates of the initial 31 IDUs registered. Risk factors for MRSA carriage were disability and prior hospitalization in a hospice. In summary, MRSA became endemic in IDUs in Zurich as a result of the spread of a single clone. This clone caused major morbidity and was responsible for a lethal outcome in 2 case