The incidence of infantile hypertrophic pyloric stenosis nearly halved from 2005 to 2017 : analysis of German administrative data

Purpose Some paediatric surgical diseases showed a declining incidence in recent years, among which hypertrophic pyloric stenosis has been particularly striking shortly in the years after the millennium. We aimed to assess whether this development continued over the following decade, as it might offer the chance to better understand the underlying reasons. Methods We analysed data files obtained from the German federal statistics office for principal diagnosis of hypertrophic pyloric stenosis and pyloromyotomies from 2005 to 2017. Changes over time were assessed via linear regression for incidences per 1000 live births. Results In the respective time interval, there were a mean of 1009 pyloromyotomies (95% CI 906–1112) per year, of which a mean of 835 (95% CI 752–917) were performed in boys. The incidence of hypertrophic pyloric stenosis per 1000 live births almost halved between 2005 and 2017: it decreased by 0.12 pylorotomies annually (95% CI 0.09–0.14; P < 0.0001) in boys—from a maximum of 2.96 to a minimum of 1.63–and 0.03 pyloromyotomies annually (95% CI 0.02–0.04; P < 0.0001) in girls—from a maximum of 0.64 to a minimum of 0.28. There was considerable regional variation in incidences between the German länder. Conclusion The decreasing incidence of hypertrophic pyloric stenosis noted around the millenium continued into the following decades. The underlying reasons are unclear, which should prompt further research on the subject matter

O proletariado, a esperança e o sonho de uma vida boa

This paper discusses the subject of the hope of the working class in Brazil in our time, considering the struggles of the union movement for better work conditions and payment, and the role of knowledge production specific to this process. The principal point of reference for this discussion is the proletarian dream of a good life and the responsibility of the present generation of union leaders in the education of young workers in the sense of building a utopia for the transformation of society.O texto discute o conteúdo da esperança da classe trabalhadora no Brasil de nossos dias, considerando as lutas do movimento sindical por melhores condições de trabalho e remuneração e o papel da produção de conhecimento próprio nesse processo. Essa discussão tem como ponto de referência principal o sonho proletário de uma vida boa e a responsabilidade da atual geração de dirigentes sindicais na formação de jovens trabalhadores no sentido da construção de uma utopia para a transformação da sociedade

Die DDR als Ziel der Geschichte? Historische und individuelle Entwicklung in Franz Fühmanns Erzählband "Das Judenauto" // The German Democratic Republic as the Telos of History? Historical and Individual Development in Franz Fühmann\u27s "The Jew Car"

Bisher wurde Franz Fühmanns Erzählband "Das Judenauto" zumeist als teleologischer Text gedeutet, in der die DDR als Realisierung der individuellen und gesellschaftlichen Selbstfindung und -verwirklichung erscheint, und daran anschließend, je nach politischem Standpunkt der Interpreten, positiv oder negativ bewertet. Im vorliegenden Beitrag wird die Frage, ob die DDR im "Judenauto" tatsächlich als ideales Ziel der persönlichen und historischen Entwicklung erscheint, differenziert beantwortet. Die Analyse leitmotivisch vorgetragener Kategorien – etwa der des ‚Wissens’ – sowie die Identifikation von Leerstellen weisen darauf hin, dass die von Fühmann im "Judenauto" gewählte Darstellungsweise die DDR als von Beginn an prekäres System vorführt. Franz Fühmann’s short story collection "The Jew Car" has often been interpreted as a teleological text in which the GDR appears as the realization of individual and social self-discovery and self-realization and subsequently evaluated either positively or negatively (depending on the political standpoint of the critic). This article offers a differentiated answer to the question whether the GDR in "The Jew Car" can truly be considered an ideal goal of individual and historical development. The analysis of frequently recurring categories, such as the one of ‘knowledge’, as well as the identification of the text’s blanks and silences suggest that Fühmann’s portrayal of the GDR is a precarious one from the beginning

DESENVOLVIMENTO DA PROTEÇÃO SOCIAL E TRANSFORMAÇÕES NO WELFARE STATE PÓS-INDUSTRIAL

Este artigo sintetiza o capítulo inicial da Tese “Política Social para Idosos no Brasil: o Benefício de Prestação Continuada e a Seguridade Social”, desenvolvida para Doutoramento no Programa de Estudos Pós-Graduados em Política Social da Universidade Federal Fluminense - RJ. O capítulo revisa o conceito e a evolução da proteção social até o desenvolvimento do welfare state e as transformações deste diante das sucessivas crises de capital

A systematic review of necrotising fasciitis in children from its first description in 1930 to 2018

Necrotising fasciitis is a rapidly progressing soft-tissue infection with a low incidence that carries a relevant risk of morbidity and mortality. Although necrotising fasciitis is often fatal in adults, its case fatality rate seems to be lower in children. A highly variable clinical presentation makes the diagnosis challenging, which often results in misdiagnosis and time-delay to therapy

Suas, BPC e pessoas com deficiência:: análise a partir de municípios fluminenses

Esse trabalho apresenta conclusões iniciais a partir de um recorte da pesquisa intitulada “Assistência Social e a Construção de Direitos no Estado do Rio de Janeiro: avaliação a partir da experiência do Benefício de Prestação Continuada - BPC”, que tem como objetivo avaliar o processo de construção da Assistência Social neste Estado através de um de seus principais benefícios, o BPC. Com o recorte focado na situação da Pessoa Com Deficiência que recebe o BPC, procuramos estudar como tem se dado a incorporação desse benefício e de seus beneficiários pelo Sistema Único da Assistência Social (Suas). Apresentamos parte dos resultados de entrevistas feitas com estes beneficiários em 21 municípios fluminenses, que nos permitem traçar um perfil desse beneficiário e analisar sua relação com a Assistência Social de seu município na condição de beneficiário do BPC.&nbsp

Tracheal bifurcation located at proximal third of oesophageal length in Sprague Dawley rats of all ages

Levrat’s rat model is often the first choice for basic studies of oesophageal adenocarcinoma. The position of the tracheal bifurcation represents the preferred location for the high-intrathoracic anastomosis following oesophagectomy for cancer and is thus of importance in basic research of oesophageal adenocarcinoma. In addition, it is also the typical location for trachea-oesophageal fistulae in congenital oesophageal atresia and its rat model. We thus analysed whether the position of the tracheal bifurcation would be affected by a rat’s growth throughout life. We analysed absolute and relative carinal position of the tracheal bifurcation and its relationship to oesophageal length in two cohorts of Sprague Dawley rats (RjHan:SD) of both sexes: one consisted of 30 eight-week old rats and the other of 20 rats aged between 15 and 444 days. We analysed their relationship by Pearson’s r and univariate linear regression. Bootstrap confidence intervals were calculated for all calculated coefficients. Absolute carinal position correlated with oesophageal length in the eight-week old cohort (r=0.4, 95% CI: 0.08-0.71, p=0.015) and those of different ages (r=0.92, 95% CI: 0.77-0.96, p=0.0066). Absolute carinal position increased with oesophageal length in both cohorts (F(1,28)=5.56; p=0.0256 and F(1,18)=94.93; p&lt;0.0001 respectively). Consequently, relative tracheal bifurcation position was not influenced by oesophageal length in both cohorts (F(1,28)=2.49; p=0.1257 and F(1,18)=1.92; p=0.183). Absolute carinal position increased with oesophageal length, but relative position remained constant at around 30% of proximal oesophageal length throughout life

Jungen sterben häufiger an nekrotisierender Enterokolitis : Ergebnisse der deutschlandweiten Krankenhausstatistik von 2000 bis 2017

HINTERGRUND In den letzten Jahren verringerte sich die frühgeburtliche Morbidität und Mortalität über Ländergrenzen hinweg deutlich. Allen Untersuchungen gemeinsam ist aber eine höhere Betroffenheit und Sterblichkeit von Jungen gegenüber Mädchen, insbesondere bei der nekrotisierenden Enterokolitis. FRAGESTELLUNG Besteht in Deutschland auf Basis der amtlichen Krankenhausstatistik eine höhere Inzidenz oder Sterblichkeit von Jungen an nekrotisierender Enterokolitis? MATERIAL UND METHODEN Die Autoren werteten die Diagnosedaten der amtlichen Krankenhausstatistik für die Jahre 2000–2017 für die Hauptdiagnose P77 – nekrotisierende Enterokolitis –, getrennt nach Geschlechtern und Überleben, aus. Der Zusammenhang zwischen Geschlecht und Versterben resp. Erkrankungshäufigkeit wurde mittels einseitigem χ2-Test auf ein höheres Risiko für Jungen untersucht. ERGEBNISSE Zwischen 2000 und 2017 hatten 3119 Frühgeborene die Hauptdiagnose nekrotisierende Enterokolitis, davon 1769 Jungen (0,27 ‰ der männlichen Lebendgeburten) und 1350 Mädchen (0,22 ‰ der weiblichen Lebendgeburten). Jungen haben ein höheres Risiko, an nekrotisierender Enterokolitis zu erkranken (relatives Risiko 1,24, 95 %-Konfidenzintervall: 1,17–∞, p < 0,001) und zu versterben (relatives Risiko 1,25, 95 %-Konfidenzintervall: 1,02–∞, p = 0,036). DISKUSSION Jungen erkranken und sterben häufiger an nekrotisierender Enterokolitis als Mädchen. Allerdings erfasst die amtliche Statistik nicht die leichteren Fälle einer nekrotisierenden Enterokolitis, da nur die Hauptdiagnose erfasst wird. Überdies ermöglicht die amtliche Statistik keine Adjustierung für verzerrende Faktoren. Die sekundäre Datennutzung der Qualitätssicherungsdaten der Neonatalerhebung könnte eine detailliertere Untersuchung dieser Fragestellung ermöglichen.Untersuchung dieser Fragestellung ermöglichen

Neural simulation pipeline: Enabling container-based simulations on-premise and in public clouds

In this study, we explore the simulation setup in computational neuroscience. We use GENESIS, a general purpose simulation engine for sub-cellular components and biochemical reactions, realistic neuron models, large neural networks, and system-level models. GENESIS supports developing and running computer simulations but leaves a gap for setting up today's larger and more complex models. The field of realistic models of brain networks has overgrown the simplicity of earliest models. The challenges include managing the complexity of software dependencies and various models, setting up model parameter values, storing the input parameters alongside the results, and providing execution statistics. Moreover, in the high performance computing (HPC) context, public cloud resources are becoming an alternative to the expensive on-premises clusters. We present Neural Simulation Pipeline (NSP), which facilitates the large-scale computer simulations and their deployment to multiple computing infrastructures using the infrastructure as the code (IaC) containerization approach. The authors demonstrate the effectiveness of NSP in a pattern recognition task programmed with GENESIS, through a custom-built visual system, called RetNet(8 × 5,1) that uses biologically plausible Hodgkin–Huxley spiking neurons. We evaluate the pipeline by performing 54 simulations executed on-premise, at the Hasso Plattner Institute's (HPI) Future Service-Oriented Computing (SOC) Lab, and through the Amazon Web Services (AWS), the biggest public cloud service provider in the world. We report on the non-containerized and containerized execution with Docker, as well as present the cost per simulation in AWS. The results show that our neural simulation pipeline can reduce entry barriers to neural simulations, making them more practical and cost-effective

Habitual physical activity in patients born with oesophageal atresia: a multicenter cross-sectional study and comparison to a healthy reference cohort matched for gender and age

Oesophageal atresia (EA) is associated with life-long gastrointestinal and respiratory morbidity and other associated malformations. The aim of this study is to compare physical activity (PA) levels of children and adolescents with and without EA. A validated questionnaire (MoMo-PAQ) was used to evaluate PA in EA patients EA (4–17 years), who were randomly matched for gender and age (1:5) with a representative sample of the Motorik-Modul Longitudinal Study (n = 6233). Sports activity per week (sports index) and minutes of moderate to vigorous physical activity per week (MVPA minutes) were calculated. Correlations between PA and medical factors were analysed. In total, 104 patients and 520 controls were included. Children with EA were significantly less active at higher intensities (mean MPVA minutes 462; 95% confidence interval (CI): 370–554) compared to controls (626; 95% CI: 576–676), although there was no statistically significant difference in the sports index (187; 95% CI: 156–220 versus 220; 95% CI: 203–237). A lower mean weight-for-age and height-for-age, additional urogenital (r =  − 0.20, p = 0.04) or anorectal malformation (r =  − 0.24, p = 0.01) were associated with fewer MVPA minutes. For other medical factors (prematurity, type of repair, congenital heart disease, skeletal malformation or symptom load), no statistically significant association with PA was found. Conclusion: EA patients participated in PA at a similar level but lower intensities compared to the reference cohort. PA in EA patients was largely independent of medical factors