181 research outputs found

    Panelerhebungen der amtlichen Statistik als Datenquellen für die Sozialwissenschaften

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    Paneldaten haben gegenüber Querschnittsdaten zahlreiche Vorteile. Amtliche Daten sind zudem eine wichtige Quelle für die Sozial- und Wirtschaftswissenschaften. Viele amtliche Datenerhebungen sind als Panel konzipiert und durchgeführt oder können zu Panels zusammengefügt werden. Diese Arbeit gibt eine Übersicht über die Panelerhebungen oder zu Panels aufbereiteten Einzeldatensätze der deutschen amtlichen Statistik und beschreibt Erhebungsinhalte, Stichprobe sowie Zugangsmöglichkeiten. Panel data have numerous advantages to cross sectional data. Data from official statistical offices (and other public authorities) are a valuable data source for the social and economic sciences. Many of these data originally are panel data (or can be combined to form panel data). This article gives an overview over panel surveys and panel data conducted by German public authorities, describing topic and contents, sampling and access to these data.Paneldaten, amtliche Statistik, Datenzugang panel data, offcial statistics, data access

    A single immunization with a recombinant canine adenovirus expressing the rabies virus G protein confers protective immunity against rabies in mice

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    AbstractRabies vaccines based on live attenuated rabies viruses or recombinant pox viruses expressing the rabies virus (RV) glycoprotein (G) hold the greatest promise of safety and efficacy, particularly for oral immunization of wildlife. However, while these vaccines induce protective immunity in foxes, they are less effective in other animals, and safety concerns have been raised for some of these vaccines. Because canine adenovirus 2 (CAV2) is licensed for use as a live vaccine for dogs and has an excellent efficacy and safety record, we used this virus as an expression vector for the RVG. The recombinant CAV2-RV G produces virus titers similar to those produced by wild-type CAV2, indicating that the RVG gene does not affect virus replication. Comparison of RVG expressed by CAV2-RV G with that of vaccinia-RV G recombinant virus (V-RG) revealed similar amounts of RV G on the cell surface. A single intramuscular or intranasal immunization of mice with CAV2-RVG induced protective immunity in a dose-dependent manner, with no clinical signs or discomfort from the virus infection regardless of the route of administration or the amount of virus

    Panelerhebungen der amtlichen Statistik als Datenquellen für die Sozialwissenschaften

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    Panel data have numerous advantages to cross sectional data. Data from official statistical offices (and other public authorities) are a valuable data source for the social and economic sciences. Many of these data originally are panel data (or can be combined to form panel data). This article gives an overview over panel surveys and panel data conducted by German public authorities, describing topic and contents, sampling and access to these data.Paneldaten haben gegenüber Querschnittsdaten zahlreiche Vorteile. Amtliche Daten sind zudem eine wichtige Quelle für die Sozial- und Wirtschaftswissenschaften. Viele amtliche Datenerhebungen sind als Panel konzipiert und durchgeführt oder können zu Panels zusammengefügt werden. Diese Arbeit gibt eine Übersicht über die Panelerhebungen oder zu Panels aufbereiteten Einzeldatensätze der deutschen amtlichen Statistik und beschreibt Erhebungsinhalte, Stichprobe sowie Zugangsmöglichkeiten

    Measurement of fractional flow reserve to guide decisions for percutaneous coronary intervention

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    Background Coronary artery disease (CAD) is one of the leading causes of premature death in Germany. Percutaneous coronary interventions (PCI) are frequently performed in patients with angiographically intermediate stenoses. However, the necessity of PCI has not been proven for all patients. Pressure-based fractional flow reserve (FFR) is an invasive test that can be used to assess the functional significance of intermediate coronary stenoses in order to guide decisions on PCI. Objectives This health technology assessment (HTA) aims to evaluate (1) the diagnostic accuracy, (2) the risk-benefit trade-off and (3) the long-term cost-effectiveness of FFR measurement to guide the decision on PCI in patients with stable angina pectoris and intermediate coronary stenoses. Methods We performed a literature search in medical and HTA databases. We used the DIMDI instruments (DIMDI = Deutsches Institut für Medizinische Dokumentation und Information/German Institute for Medical Information and Documentation) to assess study quality and to extract and summarize the information in evidence tables. We performed a meta-analysis to calculate the pooled overall estimate for sensitivity and specificity of FFR with 95% confidence intervals (95% CI). Individual studies' case numbers were used as weights. The influence of single studies and important covariates on the results was tested in sensitivity analyses. We developed the German Coronary Artery Disease Outcome Model (German CADOM), a decision-analytic Markov model, to estimate the long-term effectiveness and cost-effectiveness of FFR measurement in the context of the German healthcare system. Results Our literature search identified twelve studies relevant to this HTA-report including ten diagnostic accuracy studies of FFR measurement, one randomized clinical trial (RCT) investigating the clinical benefits of this technique as well as one economic evaluation. Pooled estimates for sensitivity and specificity were 81.7% (95% CI: 77.0-85.7%) and 78.7% (95% CI: 74.3-82.7%). Sensitivity analyses indicated robust results. The RCT investigating the efficacy of an FFR-based treatment strategy provided evidence of the advantages of this strategy for patients with respect to freedom from angina and major adverse cardiac events. The published cost-effectiveness study demonstrates that the FFR-based strategy is cost-saving in the US context. Based on our own decision analysis for the German context, the FFR-based strategy improves (quality-adjusted) life-expectancy when compared to universal PCI and is cost-effective in the German healthcare context. This HTA is limited by the use of poor gold standards in several of the included diagnostic studies as well as the ongoing advance of technology and treatment options in interventional cardiology. Results of the decision analysis are limited by the necessary underlying assumptions and the uncertainty regarding long-term mortality reduction associated with PCI. Further research should focus on the acquisition of long-term data for disease progression in patients with and without functional coronary stenoses as well as the benefits and risks of PCI. Conclusions Based on actual evidence and our decision analysis, the use of FFR measurement to guide the decision on PCI should lead to better short- and long-term clinical outcomes in patients with stable angina and single-vessel disease without documented myocardial ischemia and it should provide a cost-effective use of resources in the German healthcare system. FFR measurement should be introduced in routine clinical practice. However, appropriate reimbursement strategies are necessary to avoid wrong incentives.Hintergrund Die koronare Herzkrankheit gehört zu den wichtigsten Mortalitätsursachen in Deutschland. Es wird zunehmend bezweifelt, ob alle der zahlreich durchgeführten perkutanen Koronarinterventionen (PCI) bei angiographisch mittelgradigen Stenosen medizinisch sinnvoll und notwendig sind. Für die Abwägung von medizinischem Nutzen, Risiko und Kosten zwischen PCI und medikamentöser Behandlung kann die druckbasierte Messung der koronaren fraktionierten Flussreserve (FFR) eine wichtige Entscheidungshilfe sein. Ziele Dieses Health Technology Assessment (HTA) dient der Bewertung (1) der diagnostischen Genauigkeit, (2) der Nutzen-Risiko-Abschätzung und (3) der Langzeitkosteneffektivität der FFR zur Indikationsstellung der PCI bei stabiler Angina pectoris und angiographisch mittelgradigen Stenosen. Methoden Es erfolgte eine Literaturrecherche in medizinischen und HTA-Datenbanken. Relevante Literaturstellen wurden mit Hilfe des DIMDI-Instrumentariums (DIMDI = Deutsches Institut für Medizinische Dokumentation und Information) auf Studienqualität geprüft, die Ergebnisse wurden systematisch beschrieben und in Evidenztabellen zusammenfassend dargestellt. Im Rahmen einer Metaanalyse wurden die gepoolten Schätzer für Sensitivität und Spezifität der FFR mit 95%-Konfidenzintervallen (95% KI) berechnet. Potenzielle Einflussfaktoren der Testgüte wurden in Sensitivitätsanalysen untersucht. Für die Bestimmung der klinischen und gesundheitsökonomischen Langzeitkonsequenzen der FFR-Messung im Kontext des deutschen Gesundheitssystems wurde ein entscheidungsanalytisches Markov-Modell entwickelt, das German Coronary Artery Disease Outcome Model (German CADOM). Ergebnisse Die Literaturrecherche ergab insgesamt zwölf relevante Studien: zehn Studien zur diagnostischen Testgüte von FFR, eine randomisierte klinische Studie (RCT) zum medizinischen Nutzen und eine gesundheitsökonomische Evaluation. Die gepoolte Sensitivität von FFR beträgt 81,7% (95% KI: 77,0-85,7%), die gepoolte Spezifität 78,7% (95% KI: 74,3-82,7%). Sensitivitätsanalysen deuten auf robuste Ergebnisse hin. Das RCT zum klinischen Nutzen einer FFR-basierten Behandlungsstrategie zeigt Vorteile für Patienten hinsichtlich Anginafreiheit und schwerwiegender kardialer Ereignisse. Die publizierte gesundheitsökonomische Evaluation deutet darauf hin, dass die FFR-Messung im US-amerikanischen Kontext kostensparend ist. Basierend auf den Ergebnissen des deutschen Entscheidungsmodells (German CADOM) führt die FFR-basierte Strategie zu einer höheren (qualitätsadjustierten) Lebenserwartung und ist im Kontext des deutschen Gesundheitssystems kosteneffektiv. Dieser HTA-Bericht ist limitiert durch die Verwendung eingeschränkter Goldstandards in einigen diagnostischen Studien sowie durch die fortwährende Weiterentwicklung von Technologie und Behandlungsmöglichkeiten in der interventionellen Kardiologie. Die Aussagen der Entscheidungsanalyse werden eingeschränkt durch die verwendeten Annahmen und Unsicherheit zur Wirksamkeit der PCI bezüglich Langzeitmortalität. Forschungsbedarf besteht in der Erhebung und Auswertung von Langzeitdaten zur Krankheitsprogression bei Patienten mit und ohne funktioneller Stenose sowie zu Nutzen und Risiken der PCI. Schlussfolgerungen und Empfehlungen Basierend auf der aktuellen Evidenz und der entscheidungsanalytischen Modellierung ist davon auszugehen, dass bei Patienten mit stabiler Angina pectoris und Eingefäßerkrankung ohne kardialen Ischämienachweis die FFR-Messung zur Indikationsstellung der PCI zu verbesserten kurz- und langfristigen klinischen Ergebnissen führt sowie einen kosteneffektiven Einsatz von Ressourcen im deutschen Gesundheitssystem darstellt. Ein breiterer Einsatz der FFR-Messung erscheint sinnvoll, erfordert jedoch die Vereinbarung angemessener Entgelte zur Vermeidung möglicher Fehlanreize und Fehlsteuerungen

    Evaluation of rate law approximations in bottom-up kinetic models of metabolism.

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    BackgroundThe mechanistic description of enzyme kinetics in a dynamic model of metabolism requires specifying the numerical values of a large number of kinetic parameters. The parameterization challenge is often addressed through the use of simplifying approximations to form reaction rate laws with reduced numbers of parameters. Whether such simplified models can reproduce dynamic characteristics of the full system is an important question.ResultsIn this work, we compared the local transient response properties of dynamic models constructed using rate laws with varying levels of approximation. These approximate rate laws were: 1) a Michaelis-Menten rate law with measured enzyme parameters, 2) a Michaelis-Menten rate law with approximated parameters, using the convenience kinetics convention, 3) a thermodynamic rate law resulting from a metabolite saturation assumption, and 4) a pure chemical reaction mass action rate law that removes the role of the enzyme from the reaction kinetics. We utilized in vivo data for the human red blood cell to compare the effect of rate law choices against the backdrop of physiological flux and concentration differences. We found that the Michaelis-Menten rate law with measured enzyme parameters yields an excellent approximation of the full system dynamics, while other assumptions cause greater discrepancies in system dynamic behavior. However, iteratively replacing mechanistic rate laws with approximations resulted in a model that retains a high correlation with the true model behavior. Investigating this consistency, we determined that the order of magnitude differences among fluxes and concentrations in the network were greatly influential on the network dynamics. We further identified reaction features such as thermodynamic reversibility, high substrate concentration, and lack of allosteric regulation, which make certain reactions more suitable for rate law approximations.ConclusionsOverall, our work generally supports the use of approximate rate laws when building large scale kinetic models, due to the key role that physiologically meaningful flux and concentration ranges play in determining network dynamics. However, we also showed that detailed mechanistic models show a clear benefit in prediction accuracy when data is available. The work here should help to provide guidance to future kinetic modeling efforts on the choice of rate law and parameterization approaches

    Intravenous Inoculation of a Bat-Associated Rabies Virus Causes Lethal Encephalopathy in Mice through Invasion of the Brain via Neurosecretory Hypothalamic Fibers

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    The majority of rabies virus (RV) infections are caused by bites or scratches from rabid carnivores or bats. Usually, RV utilizes the retrograde transport within the neuronal network to spread from the infection site to the central nervous system (CNS) where it replicates in neuronal somata and infects other neurons via trans-synaptic spread. We speculate that in addition to the neuronal transport of the virus, hematogenous spread from the site of infection directly to the brain after accidental spill over into the vascular system might represent an alternative way for RV to invade the CNS. So far, it is unknown whether hematogenous spread has any relevance in RV pathogenesis. To determine whether certain RV variants might have the capacity to invade the CNS from the periphery via hematogenous spread, we infected mice either intramuscularly (i.m.) or intravenously (i.v.) with the dog-associated RV DOG4 or the silver-haired bat-associated RV SB. In addition to monitoring the progression of clinical signs of rabies we used immunohistochemistry and quantitative reverse transcription polymerase chain reaction (qRT-PCR) to follow the spread of the virus from the infection site to the brain. In contrast to i.m. infection where both variants caused a lethal encephalopathy, only i.v. infection with SB resulted in the development of a lethal infection. While qRT-PCR did not reveal major differences in virus loads in spinal cord or brain at different times after i.m. or i.v. infection of SB, immunohistochemical analysis showed that only i.v. administered SB directly infected the forebrain. The earliest affected regions were those hypothalamic nuclei, which are connected by neurosecretory fibers to the circumventricular organs neurohypophysis and median eminence. Our data suggest that hematogenous spread of SB can lead to a fatal encephalopathy through direct retrograde invasion of the CNS at the neurovascular interface of the hypothalamus-hypophysis system. This alternative mode of virus spread has implications for the post exposure prophylaxis of rabies, particularly with silver-haired bat-associated RV

    Post-LS3 Experimental Options in ECN3

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    The Experimental Cavern North 3 (ECN3) is an underground experimental cavern on the CERN Pr\'evessin site. ECN3 currently hosts the NA62 experiment, with a physics programme devoted to rare kaon decays and searches of hidden particles approved until Long Shutdown 3 (LS3). Several options are proposed on the longer term in order to make best use of the worldwide unique potential of the high-intensity/high-energy proton beam extracted from the Super Proton Synchrotron (SPS) in ECN3. The current status of their study by the CERN Physics Beyond Colliders (PBC) Study Group is presented, including considerations on beam requirements and upgrades, detector R&D and construction, schedules and cost, as well as physics potential within the CERN and worldwide landscape.Comment: 113 pages, 39 figure

    White matter disturbances in major depressive disorder : a coordinated analysis across 20 international cohorts in the ENIGMA MDD working group

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    Altres ajuts: The ENIGMA-Major Depressive Disorder working group gratefully acknowledges support from the NIH Big Data to Knowledge (BD2K) award (U54 EB020403 to PMT) and NIH grant R01 MH116147 (PMT). LS is supported by an NHMRC MRFF Career Development Fellowship (APP1140764). We wish to acknowledge the patients and control subjects that have particiaped int the study. We thank Rosa Schirmer, Elke Schreiter, Reinhold Borschke and Ines Eidner for image acquisition and data preparation, and Anna Oliynyk for quality checks. We thank Dorothee P. Auer and F. Holsboer for initiation of the RUD study. We wish to acknowledge the patients and control subjects that have particiaped int the study. We thank Rosa Schirmer, Elke Schreiter, Reinhold Borschke and Ines Eidner for image acquisition and data preparation, and Anna Oliynyk for quality checks. We thank Dorothee P. Auer and F. Holsboer for initiation of the RUD study. NESDA: The infrastructure for the NESDA study (www.nesda.nl) is funded through the Geestkracht program of the Netherlands Organisation for Health Research and Development (Zon-Mw, grant number 10-000-1002) and is supported by participating universities (VU University Medical Center, GGZ inGeest, Arkin, Leiden University Medical Center, GGZ Rivierduinen, University Medical Center Groningen) and mental health care organizations, see www.nesda.nl. M-JvT was supported by a VENI grant (NWO grant number 016.156.077). UCSF: This work was supported by the Brain and Behavior Research Foundation (formerly NARSAD) to TTY; the National Institute of Mental Health (R01MH085734 to TTY; K01MH117442 to TCH) and by the American Foundation for Suicide Prevention (PDF-1-064-13) to TCH. Stanford: This work was supported by NIMH Grants R01MH59259 and R37101495 to IHG. MS is partially supported by an award funded by the Phyllis and Jerome Lyle Rappaport Foundation. Muenster: This work was funded by the German Research Foundation (SFB-TRR58, Projects C09 and Z02 to UD) and the Interdisciplinary Center for Clinical Research (IZKF) of the medical faculty of Münster (grant Dan3/012/17 to UD). Marburg: This work was funded by the German Research Foundation (DFG, grant FOR2107 DA1151/5-1 and DA1151/5-2 to UD; KI 588/ 14-1, KI 588/14-2 to TK; KR 3822/7-1, KR 3822/7-2 to AK; JA 1890/ 7-1, JA 1890/7-2 to AJ). IMH-MDD: This work was supported by the National Healthcare Group Research Grant (SIG/15012) awarded to KS. Barcelona: This study was funded by two grants of the Fondo de Investigación Sanitaria from the Instituto de Salud Carlos III, by the Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM). The author is funded through 'Miguel Servet' research contract (CP16-0020), co-financed by the European Regional Development Fund (ERDF) (2016-2019). QTIM: We thank the twins and singleton siblings who gave generously of their time to participate in the QTIM study. We also thank the many research assistants, radiographers, and IT support staff for data acquisition and DNA sample preparation. This study was funded by White matter disturbances in major depressive disorder: a coordinated analysis across 20 international. . . 1521 the National Institute of Child Health & Human Development (RO1 HD050735); National Institute of Biomedical Imaging and Bioengineering (Award 1U54EB020403-01, Subaward 56929223); National Health and Medical Research Council, Australia (Project Grants 496682, 1009064). NIH ENIGMA-BD2K U54 EB020403 (Thompson); R01 MH117601 (Jahanshad/Schmaal). Magdeburg: M.L. and M.W. are funded by SFB 779. Bipolar Family Study: This study has received funding from the European Community's Seventh Framework Programme (FP7/2007-2013). This paper reflects only the author's views and the European Union is not liable for any use that may be made of the information contained therein. This work was also supported by a Wellcome Trust Strategic Award (104036/Z/14/Z). Minnesota Adolescent Depression Study: The study was funded by the National Institute of Mental Health (K23MH090421), the National Alliance for Research on Schizophrenia and Depression, the University of Minnesota Graduate School, the Minnesota Medical Foundation, and the Biotechnology Research Center (P41 RR008079 to the Center for Magnetic Resonance Research), University of Minnesota, and the Deborah E. Powell Center for Women's Health Seed Grant, University of Minnesota. Dublin: This study was supported by Science Foundation Ireland through a Stokes Professorhip grant to TF. MPIP: The MPIP Sample comprises patients included in the Recurrent Unipolar Depression (RUD) Case-Control study at the clinic of the Max Planck Institute of Psychiatry, Munich, German. The RUD study was supported by GlaxoSmithKline.Alterations in white matter (WM) microstructure have been implicated in the pathophysiology of major depressive disorder (MDD). However, previous findings have been inconsistent, partially due to low statistical power and the heterogeneity of depression. In the largest multi-site study to date, we examined WM anisotropy and diffusivity in 1305 MDD patients and 1602 healthy controls (age range 12-88 years) from 20 samples worldwide, which included both adults and adolescents, within the MDD Working Group of the Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) consortium. Processing of diffusion tensor imaging (DTI) data and statistical analyses were harmonized across sites and effects were meta-analyzed across studies. We observed subtle, but widespread, lower fractional anisotropy (FA) in adult MDD patients compared with controls in 16 out of 25 WM tracts of interest (Cohen's d between 0.12 and 0.26). The largest differences were observed in the corpus callosum and corona radiata. Widespread higher radial diffusivity (RD) was also observed (all Cohen's d between 0.12 and 0.18). Findings appeared to be driven by patients with recurrent MDD and an adult age of onset of depression. White matter microstructural differences in a smaller sample of adolescent MDD patients and controls did not survive correction for multiple testing. In this coordinated and harmonized multisite DTI study, we showed subtle, but widespread differences in WM microstructure in adult MDD, which may suggest structural disconnectivity in MDD
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