Untersuchung der ophthalmologischen und zahnärztlichen Erkrankungsmuster der immigrierten mediterranen Bevölkerung im Vergleich zur heimischen Bevölkerung

Ziel dieser Arbeit ist es, aus dem ophthalmologischen und dem zahnärztlichen Patientengut der Uni Münster, die per Zufallsprinzip ausgesucht wurden, die unterschiedlichen Erkrankungsmuster zu ermitteln. Es sollten die Erkrankungshäufigkeiten bzw. -muster der einzelnen ausländischen Bevölkerungsgruppen mit denen der einheimischen Bevölkerung verglichen werden. Im ophthalmologischen Patientenkollektiv war die heimische Bevölkerung häufig in der 7. und 8. Lebensdekade vertreten, wohingegen die gesamten Immigranten am Häufigsten in der 3. Lebensdekade vertreten waren. Die Erkrankungen der heimischen Bevölkerung waren geprägt durch die Alterserscheinungen und die der mediterranen Bevölkerung durch Unfälle und Verletzungen. Die Auswertungen der zahnmedizinischen Daten ergaben, dass sowohl die heimische als auch die mediterranen Bevölkerungsgruppen überwiegend in der 3. Lebensdekade die Zahnklinik im Notdienst aufsuchten. Hierbei zeigte sich kein typisches Erkrankungsmuster

Comparison of the outcome of kidney transplantation after pulsatile or continuous ex vivo hypothermic machine perfusion of kidneys donated after cardiac death: analysis of kidney pairs

Background Hypothermic machine perfusion is used to improve renal perfusion and reduce the rate of early and late graft dysfunction. It has been used in our unit since 2001. It has two modes of flow: continuous or pulsatile. The aim of this study is to compare the modes of perfusion in terms of perfusion-related parameters, graft survival and estimated glomerular filtration rate. Methods All donation after cardiac death kidneys between 2002 and 2014 were reviewed. Sixty-four pairs of kidneys were identified of which one kidney underwent pulsatile and the other continuous perfusion. Machine parameters including resistance and perfusion flow index levels at 0, 1, 2, 3, 4 hours were recorded and glutathione S-transferase measured in perfusate. Delayed graft function frequency, estimated glomerular filtration rate from the 1st week of transplantation until 5th year and graft survival rates were determined. Results Machine parameters were similar at all time points. Delayed graft function frequency, estimated glomerular filtration rates and graft survival were equivalent irrespective of perfusion mode. Conclusion Pulsatile perfusion may be regarded as more physiological. However, we could not identify differences in short or long term outcomes following transplantation of kidneys from the same donor that had been perfused under pulsatile or continuous conditions

A stochastic programming approach for chemotherapy appointment scheduling

Chemotherapy appointment scheduling is a challenging problem due to the uncertainty in pre-medication and infusion durations. In this paper, we formulate a two-stage stochastic mixed integer programming model for the chemotherapy appointment scheduling problem under limited availability and number of nurses and infusion chairs. The objective is to minimize the expected weighted sum of nurse overtime, chair idle time, and patient waiting time. The computational burden to solve real-life instances of this problem to optimality is significantly high, even in the deterministic case. To overcome this burden, we incorporate valid bounds and symmetry breaking constraints. Progressive hedging algorithm is implemented in order to solve the improved formulation heuristically. We enhance the algorithm through a penalty update method, cycle detection and variable fixing mechanisms, and a linear approximation of the objective function. Using numerical experiments based on real data from a major oncology hospital, we compare our solution approach with several scheduling heuristics from the relevant literature, generate managerial insights related to the impact of the number of nurses and chairs on appointment schedules, and estimate the value of stochastic solution to assess the significance of considering uncertainty

Optimization of a GCaMP calcium indicator for neural activity imaging

© The Author(s), 2012. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Journal of Neuroscience 32 (2012): 13819-13840, doi:10.1523/JNEUROSCI.2601-12.2012.Genetically encoded calcium indicators (GECIs) are powerful tools for systems neuroscience. Recent efforts in protein engineering have significantly increased the performance of GECIs. The state-of-the art single-wavelength GECI, GCaMP3, has been deployed in a number of model organisms and can reliably detect three or more action potentials in short bursts in several systems in vivo. Through protein structure determination, targeted mutagenesis, high-throughput screening, and a battery of in vitro assays, we have increased the dynamic range of GCaMP3 by severalfold, creating a family of “GCaMP5” sensors. We tested GCaMP5s in several systems: cultured neurons and astrocytes, mouse retina, and in vivo in Caenorhabditis chemosensory neurons, Drosophila larval neuromuscular junction and adult antennal lobe, zebrafish retina and tectum, and mouse visual cortex. Signal-to-noise ratio was improved by at least 2- to 3-fold. In the visual cortex, two GCaMP5 variants detected twice as many visual stimulus-responsive cells as GCaMP3. By combining in vivo imaging with electrophysiology we show that GCaMP5 fluorescence provides a more reliable measure of neuronal activity than its predecessor GCaMP3. GCaMP5 allows more sensitive detection of neural activity in vivo and may find widespread applications for cellular imaging in general.A.F. has been supported by a European Molecular Biology Organization long-term fellowship. Work in H.B.’s laboratory was funded by the National Institutes of Health (NIH) Nanomedicine Development Center “Optical Control of Biological Function,” and work in S.S.-H.W.’s laboratory was funded by NIH R01 NS045193

A new approach to treatment of resistant gram-positive infections: potential impact of targeted IV to oral switch on length of stay

BACKGROUND: Patients prescribed intravenous (IV) glycopeptides usually remain in hospital until completion of this treatment. Some of these patients could be discharged earlier if a switch to an oral antibiotic was made. This study was designed to identify the percentage of inpatients currently prescribed IV glycopeptides who could be discharged earlier if a switch to an oral agent was used, and to estimate the number of bed days that could be saved. We also aimed to identify the patient group(s) most likely to benefit, and to estimate the number of days of IV therapy that could be prevented in patients who remained in hospital. METHODS: Patients were included if they were prescribed an IV glycopeptide for 5 days or more. Predetermined IV to oral antibiotic switch criteria and discharge criteria were applied. A multiple logistic regression model was used to identify the characteristics of the patients most likely to be suitable for earlier discharge. RESULTS: Of 211 patients, 62 (29%) could have had a reduced length of stay if they were treated with a suitable oral antibiotic. This would have saved a total of 649 inpatient days (median 5 per patient; range 1–54). A further 31 patients (15%) could have switched to oral therapy as an inpatient thus avoiding IV line use. The patients most likely to be suitable for early discharge were those with skin and soft tissue infection, under the cardiology, cardiothoracic surgery, orthopaedics, general medical, plastic surgery and vascular specialities, with no high risk comorbidity and less than five other regularly prescribed drugs. CONCLUSION: The need for glycopeptide therapy has a significant impact on length of stay. Effective targeting of oral antimicrobials could reduce the need for IV access, allow outpatient treatment and thus reduce the length of stay in patients with infections caused by antibiotic resistant gram-positive bacteria

Scientometric Analysis and Combined Density-Equalizing Mapping of Environmental Tobacco Smoke (ETS) Research

Background: Passive exposure to environmental tobacco smoke (ETS) is estimated to exert a major burden of disease. Currently, numerous countries have taken legal actions to protect the population against ETS. Numerous studies have been conducted in this field. Therefore, scientometric methods should be used to analyze the accumulated data since there is no such approach available so far. Methods and Results: A combination of scientometric methods and novel visualizing procedures were used, including density-equalizing mapping and radar charting techniques. 6,580 ETS-related studies published between 1900 and 2008 were identified in the ISI database. Using different scientometric approaches, a continuous increase of both quantitative and qualitative parameters was found. The combination with density-equalizing calculations demonstrated a leading position of the United States (2,959 items published) in terms of quantitative research activities. Charting techniques demonstrated that there are numerous bi- and multilateral networks between different countries and institutions in this field. Again, a leading position of American institutions was found. Conclusions: This is the first comprehensive scientometric analysis of data on global scientific activities in the field o