Routinedaten aus der medizinischen Versorgung für die Notaufnahme-Surveillance: 1,5 Jahre Notaufnahme-Situationsreport

SUMO ist ein am Robert Koch-Institut entwickeltes und betriebenes System, welches Gesundheitsdaten für Public Health-Surveillance verarbeitet und bereitstellt. Der Notaufnahme-Situationsreport enthält Daten der Routinedokumentation aus einer Auswahl deutscher Notaufnahmen und bildet die aktuelle Inanspruchnahme dieser Notaufnahmen ab.SUMO is a system that has been developed and implemented at the Robert Koch Institute. It processes and provides health data for surveillance and public health research. The Emergency Department Situation Report presents data from the routine documentation of selected emergency departments in Germany, and shows the current utilisation of those emergency departments

The impact of a qualified medical documentation assistant on trauma room management

Purpose!#!To improve quality of trauma room management, intra- and inter-hospital benchmarking are important tools. However, primary data quality is crucial for benchmarking reliability. In this study, we analyzed the effect of a medical documentation assistant on documentation completeness in trauma room management in comparison to documentation by physicians involved in direct patient treatment.!##!Methods!#!We included all patients treated in the trauma room from 2016/01/01 to 2016/12/31 that were documented with the trauma module of the German Emergency Department Medical Record V2015.1. We divided the data into documentation by medical documentation assistant (DA, 07:00 to 17:00), physician in daytime (PD, 07:00 to 17:00), and physician at night (PN, 17:00 to 07:00). Data were analyzed for completeness (primary outcome parameter) as well as diagnostic intervals.!##!Results!#!There was a significant increase in complete recorded data for DA (74.5%; IQR 14.5%) compared to PD (26.9%; IQR 18.7%; p < 0.001) and PN (30.8%; IQR 18.9; p < 0.001). The time to whole-body computed tomography (WBCT) significantly decreased for DA (19 min; IQR 8.3) compared to PD (24 min; IQR 12.8; p = 0.007) or PN (24.5 min; IQR 10.0; p = 0.001).!##!Conclusion!#!In presence of a qualified medical documentation assistant, data completeness and time to WBCT improved significantly. Therefore, utilizing a professional DA in the trauma room appears beneficial for data quality and time management

Helicobacter pylori vacA genotype is a predominant determinant of immune response to Helicobacter pylori CagA.

To evaluate the frequency of Helicobacter pylori (H. pylori) CagA antibodies in H. pylori infected subjects and to identify potential histopathological and bacterial factors related to H. pylori CagA-immune response

Inanspruchnahme deutscher Notaufnahmen während der COVID-19-Pandemie – der Notaufnahme-Situationsreport (SitRep)

Inanspruchnahme deutscher Notaufnahmen während der COVID-19-Pandemie – der Notaufnahme-Situationsreport (SitRep) Das AKTIN-Notaufnahmeregister stellt dem RKI in täglichen Datenlieferungen seit dem 20.3.2020 anonymisierte und standardisierte Routinedatendaten aus Notaufnahmen zur Verfügung. Während der COVID-19-Pandemie können diese Daten genutzt werden, um die Inanspruchnahme von Notaufnahmen zu beobachten. Am RKI wurde dafür ein wöchentlicher Notaufnahme-Situationsreport etabliert. Die Methoden und Verfügbarkeit der Routinedaten aus Notaufnahmen sind im Epidemiologischen Bulletin 27/2020 beschrieben

Neural networks learning structure in temporal signals

Cortical networks are strongly recurrent, and neurons have intrinsic temporal dynamics. This sets them apart from deep feed-forward networks. Despite the tremendous progress in the application of feed-forward networks and their theoretical understanding, it remains unclear how the interplay of recurrence and non-linearities in recurrent cortical networks contributes to their function. The purpose of this work is to present a solvable recurrent network model that links to feed forward networks. By perturbative methods we transform the time-continuous,recurrent dynamics into an effective feed-forward structure of linear and non-linear temporal kernels. The resulting analytical expressions allow us to build optimal time-series classifiers from random reservoir networks. Firstly, this allows us to optimize not only the readout vectors, but also the input projection, demonstrating a strong potential performance gain. Secondly, the analysis exposes how the second order stimulus statistics is a crucial element that interacts with the non-linearity of the dynamics and boosts performance

Evaluation of outcome relevance of quality indicators in the emergency department (ENQuIRE): study protocol for a prospective multicentre cohort study

Introduction Quality of emergency department (ED) care affects patient outcomes substantially. Quality indicators (QIs) for ED care are a major challenge due to the heterogeneity of patient populations, health care structures and processes in Germany. Although a number of quality measures are already in use, there is a paucity of data on the importance of these QIs on medium-term and long-term outcomes. The evaluation of outcome relevance of quality indicators in the emergency department study (ENQuIRE) aims to identify and investigate the relevance of QIs in the ED on patient outcomes in a 12-month follow-up.Methods and analysis The study is a prospective non-interventional multicentre cohort study conducted in 15 EDs throughout Germany. Included are all patients in 2019, who were ≥18 years of age, insured at the Techniker Krankenkasse (statutory health insurance (SHI)) and gave their written informed consent to the study.The primary objective of the study is to assess the effect of selected quality measures on patient outcome. The data collected for this purpose comprise medical records from the ED treatment, discharge (claims) data from hospitalised patients, a patient questionnaire to be answered 6–8 weeks after emergency admission, and outcome measures in a 12-month follow-up obtained as claims data from the SHI.Descriptive and analytical statistics will be applied to provide summaries about the characteristics of QIs and associations between quality measures and patient outcomes.Ethics and dissemination Approval of the leading ethics committee at the Medical Faculty of the University of Magdeburg (reference number 163/18 from 19 November 2018) has been obtained and adapted by responsible local ethics committees.The findings of this work will be disseminated by publication of peer-reviewed manuscripts and presentations as conference contributions (abstracts, poster or oral presentations).Moreover, results will be discussed with clinical experts and medical associations before being proposed for implementation into the quality management of EDs.Trial registration number German Clinical Trials Registry (DRKS00015203); Pre-results

Diverse Functional Properties of Wilson Disease ATP7B Variants

BACKGROUND & AIMS: Wilson disease is a severe disorder of copper metabolism caused by mutations in ATP7B, which encodes a copper-transporting adenosine triphosphatase. The disease presents with a variable phenotype that complicates the diagnostic process and treatment. Little is known about the mechanisms that contribute to the different phenotypes of the disease. METHODS: We analyzed 28 variants of ATP7B from patients with Wilson disease that affected different functional domains; the gene products were expressed using the baculovirus expression system in Sf9 cells. Protein function was analyzed by measuring catalytic activity and copper ((64)Cu) transport into vesicles. We studied intracellular localization of variants of ATP7B that had measurable transport activities and were tagged with green fluorescent protein in mammalian cells using confocal laser scanning microscopy. RESULTS: Properties of ATP7B variants with pathogenic amino-acid substitution varied greatly even if substitutions were in the same functional domain. Some variants had complete loss of catalytic and transport activity, whereas others lost transport activity but retained phosphor-intermediate formation or had partial losses of activity. In mammalian cells, transport-competent variants differed in stability and subcellular localization. CONCLUSIONS: Variants in ATP7B associated with Wilson disease disrupt the protein's transport activity, result in its mislocalization, and reduce its stability. Single assays are insufficient to accurately predict the effects of ATP7B variants the function of its product and development of Wilson disease. These findings will contribute to our understanding of genotype-phenotype correlation and mechanisms of disease pathogenesis