One-day point prevalence of emerging bacterial pathogens in four secondary and five tertiary care German hospitals – results from a pilot study of the German Society for Hospital Hygiene (Deutsche Gesellschaft für Krankenhaushygiene, DGKH)

Objective: Data on the prevalence of emerging bacterial pathogens like extended-spectrum-lactamase-building (ESBL) Gram negative organisms, multiresistant Pseudomonas and Acinetobacter species or toxin-building Clostridium difficile in German hospitals are sparse. To provide data for different regions in Germany, a one-day point prevalence study with five tertiary care hospitals and four secondary care hospitals was conducted on the 10th of February 2010

An Investigation Of Cost-Benefit Dimensions Of 5G Networks For Agricultural Applications

The agricultural industry is facing unprecedented challenges in meeting the growing demand for food while minimizing its impact on the environment. To address these challenges, the industry is embracing technological advancements such as 5G networks to improve efficiency and productivity. However, the benefits of 5G technology must be weighed against the costs of implementing a suitable network. This paper presents cost-benefit dimensions that are needed to assess the economic feasibility of implementing 5G networks for several agricultural applications. The paper describes the costs of deploying and maintaining a 5G network and the benefits of several 5G-specific use cases, including precision agriculture, livestock monitoring, and swarm robotics. Using industry reports and case studies, the model quantifies the benefits of 5G networks, such as enabling new digital agricultural processes, increased productivity, and improved sustainability. It also considers the costs associated with equipment and infrastructure, as well as the challenges of deploying a network in rural areas. The results demonstrate that 5G networks can provide significant benefits to agricultural businesses and provide an overview about the cost factors. Both benefit and cost dimensions are analyzed for the 5G-specific agricultural use cases

Specification of 5G networks for agricultural use cases using the example of harvesters operated by swarm robotics

Feeding the growing world population is a scientific and economic challenge. The target variables to be optimised are the yield that can be produced on a given area and the reduction of the resources used for this purpose. High-wage countries are faced with the problem that the use of personnel is a significant cost driver. Developing countries, on the other hand, usually operate on much smaller field sizes, so that the work in the field is still strongly characterised by manual labour. One solution to meet these challenges is the use of smaller autonomous harvesting robots. These can be networked into a swarm of machines to work even larger fields. The networking of autonomous agricultural machines is a key use case for rural 5G networks. 5G technology can offer many advantages over older mobile communications standards and therefore make use cases more efficient or enable new ones. Various use cases are also conceivable in the field of agriculture, yet it is unclear how 5G networks can and must be specified for this purpose. In this paper, using the example of 5G-connected harvesters powered by swarm robotics, we present the challenges that have arisen and the specification that has been developed

A symptom-related monitoring program following pulmonary embolism for the early detection of CTEPH: a prospective observational registry study

Background Chronic thromboembolic pulmonary hypertension (CTEPH) is a long-term complication following an acute pulmonary embolism (PE). It is frequently diagnosed at advanced stages which is concerning as delayed treatment has important implications for favourable clinical outcome. Performing a follow-up examination of patients diagnosed with acute PE regardless of persisting symptoms and using all available technical procedures would be both cost-intensive and possibly ineffective. Focusing diagnostic procedures therefore on only symptomatic patients may be a practical approach for detecting relevant CTEPH. This study aimed to evaluate if a follow-up program for patients with acute PE based on telephone monitoring of symptoms and further examination of only symptomatic patients could detect CTEPH. In addition, we investigated the role of cardiopulmonary exercise testing (CPET) as a diagnostic tool. Methods In a prospective cohort study all consecutive patients with newly diagnosed PE (n=170, 76 males, 94 females within 26 months) were recruited according to the inclusion and exclusion criteria. Patients were contacted via telephone and asked to answer standardized questions relating to symptoms. At the time of the final analysis 130 patients had been contacted. Symptomatic patients underwent a structured evaluation with echocardiography, CPET and complete work-up for CTEPH. Results 37.7%, 25.5% and 29.3% of the patients reported symptoms after three, six, and twelve months respectively. Subsequent clinical evaluation of these symptomatic patients saw 20.4%, 11.5% and 18.8% of patients at the respective three, six and twelve months time points having an echocardiography suggesting pulmonary hypertension (PH). CTEPH with pathological imaging and a mean pulmonary artery pressure (mPAP) ≥ 25 mm Hg at rest was confirmed in eight subjects. Three subjects with mismatch perfusion defects showed an exercise induced increase of PAP without increasing pulmonary artery occlusion pressure (PAOP). Two subjects with pulmonary hypertension at rest and one with an exercise induced increase of mPAP with normal PAOP showed perfusion defects without echocardiographic signs of PH but a suspicious CPET. Conclusion A follow-up program based on telephone monitoring of symptoms and further structured evaluation of symptomatic subjects can detect patients with CTEPH. CPET may serve as a complementary diagnostic tool

Competitividade e dimensões culturais: uma análise a partir dos blocos econômicos União Europeia e Unasul

The twentieth century has witnessed the formation of various alliances and trade blocs among nations. These alliances have often been more based on geographic and economic proximity than on cultural similarity. However, culture might be an essential factor in the explanation of some discrepancies between countries of the same trade bloc, such as the competitiveness indicators. Therefore, this study aims to analyze the relationship between national culture and the competitiveness index of nations, in the context of UNASUR and the European Union. By means of correlation analysis and clustering (K-means), it was possible to identify a strong correlation between the dimensions of national culture proposed by Hofstede and the nations’ competitiveness indicators. Most countries in South America have great similarities in cultural dimensions and form a single cluster, while countries in the European Union have higher distinctions and are separated into two distinct clusters. Finally, MANOVA tests applied on the clusters reveal that the differences found in relation to the dimensions of national culture are also reflected in the market efficiency indicators of the countries. Thus, the results taken together suggest the need to consider the impact exerted by the culture on the competitiveness of nations.O século XX testemunhou a formação de alianças e blocos econômicos entre as nações, frequentemente embasadas pelas proximidades geográficas e pelos aspectos econômicos do que culturais. Entretanto, a cultura pode ser vista como um aspecto essencial, no sentido de explicar algumas discrepâncias existentes, até mesmo, entre países de um mesmo bloco, como por exemplo, os índices de competitividade. Assim, este estudo busca analisar os aspectos da cultura nacional e da competitividade entre os países, no contexto da Unasul e da União Europeia. Através de análises de correlação e de cluster (K-means), verificou-se forte correlação entre as dimensões de cultura nacional propostas por Hofstede e os respectivos índices de competitividade. A maioria dos países da América do Sul apresenta grandes similaridades nas dimensões culturais, formando um único cluster, enquanto os países da União Europeia apresentam maiores diferenças e se separam em dois clusters distintos. Por fim, testes MANOVA aplicados sobre os clusters encontrados revelam que as diferenças em relação às dimensões de cultura nacional se refletem também nos índices de eficiência de mercado dos países. Desta forma, os resultados em conjunto apontam a necessidade de se considerar o impacto exercido pela cultura sobre a competitividade

Changes of hemodynamic and cerebral oxygenation after exercise in normobaric and hypobaric hypoxia: associations with acute mountain sickness

Objective: Normobaric (NH) and hypobaric hypoxia (HH) are associated with acute mountain sickness (AMS) and cognitive dysfunction. Only few variables, like heart-rate-variability, are correlated with AMS. However, prediction of AMS remains difficult. We therefore designed an expedition-study with healthy volunteers in NH/HH to investigate additional non-invasive hemodynamic variables associated with AMS.Methods: Eleven healthy subjects were examined in NH (FiO(2) 13.1%;equivalent of 3.883m a.s.l;duration 4h) and HH (3.883ma.s.l.;duration 24h) before and after an exercise of 120min. Changes in parameters of electrical cardiometry (cardiac index (CI), left-ventricular ejection time (LVET), stroke volume (SV), index of contractility (ICON)), near-infrared spectroscopy (cerebral oxygenation, rScO(2)), Lake-Louise-Score (LLS) and cognitive function tests were assessed. One-Way-ANOVA, Wilcoxon matched-pairs test, Spearman's-correlation-analysis and Student's t-test were performed.Results: HH increased heart rate (HR), mean arterial pressure (MAP) and CI and decreased LVET, SV and ICON, whereas NH increased HR and decreased LVET. In both NH and HH cerebral oxygenation decreased and LLS increased significantly. After 24h in HH, 6 of 11 subjects (54.6%) developed AMS. LLS remained increased until 24h in HH, whereas cognitive function remained unaltered. In HH, HR and LLS were inversely correlated (r=-0.692;p<0.05). More importantly, the rScO2-decrease after exercise in NH significantly correlated with LLS after 24h in HH (r=-0.971;p<0.01) and rScO2 correlated significantly with HR (r=0.802;p<0.01), CI (r=0.682;p<0.05) and SV (r=0.709;p<0.05) after exercise in HH.Conclusion: sBoth acute NH and HH altered hemodynamic and cerebral oxygenation and induced AMS. Subjects, who adapted their CI had higher rScO2 and lower LLS. Furthermore, rScO2 after exercise under normobaric conditions was associated with AMS at high altitudes

Communicable Diseases Prioritized for Surveillance and Epidemiological Research: Results of a Standardized Prioritization Procedure in Germany, 2011

To establish strategic priorities for the German national public health institute (RKI) and guide the institute's mid-term strategic decisions, we prioritized infectious pathogens in accordance with their importance for national surveillance and epidemiological research.We used the Delphi process with internal (RKI) and external experts and a metric-consensus approach to score pathogens according to ten three-tiered criteria. Additional experts were invited to weight each criterion, leading to the calculation of a median weight by which each score was multiplied. We ranked the pathogens according to the total weighted score and divided them into four priority groups.., Respiratory syncytial virus or Hantavirus) indicate a possible under-recognised importance within the current German public health framework. A process to strengthen respective surveillance systems and research has been started. The prioritization methodology has worked well; its modular structure makes it potentially useful for other settings

Differential predictors for alcohol use in adolescents as a function of familial risk

Abstract: Traditional models of future alcohol use in adolescents have used variable-centered approaches, predicting alcohol use from a set of variables across entire samples or populations. Following the proposition that predictive factors may vary in adolescents as a function of family history, we used a two-pronged approach by first defining clusters of familial risk, followed by prediction analyses within each cluster. Thus, for the first time in adolescents, we tested whether adolescents with a family history of drug abuse exhibit a set of predictors different from adolescents without a family history. We apply this approach to a genetic risk score and individual differences in personality, cognition, behavior (risk-taking and discounting) substance use behavior at age 14, life events, and functional brain imaging, to predict scores on the alcohol use disorders identification test (AUDIT) at age 14 and 16 in a sample of adolescents (N = 1659 at baseline, N = 1327 at follow-up) from the IMAGEN cohort, a longitudinal community-based cohort of adolescents. In the absence of familial risk (n = 616), individual differences in baseline drinking, personality measures (extraversion, negative thinking), discounting behaviors, life events, and ventral striatal activation during reward anticipation were significantly associated with future AUDIT scores, while the overall model explained 22% of the variance in future AUDIT. In the presence of familial risk (n = 711), drinking behavior at age 14, personality measures (extraversion, impulsivity), behavioral risk-taking, and life events were significantly associated with future AUDIT scores, explaining 20.1% of the overall variance. Results suggest that individual differences in personality, cognition, life events, brain function, and drinking behavior contribute differentially to the prediction of future alcohol misuse. This approach may inform more individualized preventive interventions