Bibliotheken privater Krankenhausketten in Deutschland : ein kritischer Situationsbericht

Die deutsche Krankenhauslandschaft ist derzeit in einem umfassenden Wandel begriffen. In Zeiten knapper werdender Ressourcen, einer ausgeprägten Trägerpluralität und einer umstrittenen Krankenhausfinanzierung überrollt eine Privatisierungswelle nicht nur einzelne Leistungserbringer sondern den gesamten Markt. Der Krankenhausbereich nimmt zusehends an Wettbewerb und am Gewinn orientierte Züge an, der Patient mutiert zum Kunden und es lässt sich eine starke Bildung und vor allem Ausbreitung von Krankenhausketten beobachten. Im Kontext dieser Veränderungen wird die aktuelle Situation von Krankenhausbibliotheken dargestellt. Eine Skizzierung des deutschen Krankenhauswesens sowie eine Marktsichtung aktuell expandierender Krankenhausketten geht der Darstellung voraus, um die die Krankenhausbibliotheken umgebenden Strukturen zu beleuchten. Anschließend wird die derzeitige Situation speziell der Krankenhausbibliotheken deutscher privater Krankenhausketten mittels einer Befragung analysiert. Die Ergebnisse lassen eine weitere Zuspitzung der ohnehin konfliktträchtigen Situation erahnen. Ein Vergleich zwischen den Darstellungen und Aussagen der Krankenhausketten in Geschäftsberichten, Unternehmensbroschüren und Homepages mit den Umfrageergebnissen macht deutlich, wie sehr Theorie und Praxis in Ansehen, Aufgaben und Stellenwert der betroffenen Krankenhausbibliotheken differenzieren. Vor diesem Hintergrund sind die abschließenden Überlegungen zur generellen Rolle von Krankenhausbibliotheken innerhalb der privaten Krankenhausketten in Deutschland sowie des Krankenhausbibliothekswesens allgemein heute und in Zukunft zu sehen

Integrated Collection of Stem Cell Bank Data, a Data Portal for Standardized Stem Cell Information

世界中で樹立されたiPS細胞の数や疾患の種類が明らかに. 京都大学プレスリリース. 2021-03-19.The past decade has witnessed an extremely rapid increase in the number of newly established stem cell lines. However, due to the lack of a standardized format, data exchange among stem cell line resources has been challenging, and no system can search all stem cell lines across resources worldwide. To solve this problem, we have developed the Integrated Collection of Stem Cell Bank data (ICSCB) (http://icscb.stemcellinformatics.org/), the largest database search portal for stem cell line information, based on the standardized data items and terms of the MIACARM framework. Currently, ICSCB can retrieve >16, 000 cell lines from four major data resources in Europe, Japan, and the United States. ICSCB is automatically updated to provide the latest cell line information, and its integrative search helps users collect cell line information for over 1, 000 diseases, including many rare diseases worldwide, which has been a formidable task, thereby distinguishing itself from other database search portals

Identification of genetic variants associated with Huntington's disease progression: a genome-wide association study

Background Huntington's disease is caused by a CAG repeat expansion in the huntingtin gene, HTT. Age at onset has been used as a quantitative phenotype in genetic analysis looking for Huntington's disease modifiers, but is hard to define and not always available. Therefore, we aimed to generate a novel measure of disease progression and to identify genetic markers associated with this progression measure. Methods We generated a progression score on the basis of principal component analysis of prospectively acquired longitudinal changes in motor, cognitive, and imaging measures in the 218 indivduals in the TRACK-HD cohort of Huntington's disease gene mutation carriers (data collected 2008–11). We generated a parallel progression score using data from 1773 previously genotyped participants from the European Huntington's Disease Network REGISTRY study of Huntington's disease mutation carriers (data collected 2003–13). We did a genome-wide association analyses in terms of progression for 216 TRACK-HD participants and 1773 REGISTRY participants, then a meta-analysis of these results was undertaken. Findings Longitudinal motor, cognitive, and imaging scores were correlated with each other in TRACK-HD participants, justifying use of a single, cross-domain measure of disease progression in both studies. The TRACK-HD and REGISTRY progression measures were correlated with each other (r=0·674), and with age at onset (TRACK-HD, r=0·315; REGISTRY, r=0·234). The meta-analysis of progression in TRACK-HD and REGISTRY gave a genome-wide significant signal (p=1·12 × 10−10) on chromosome 5 spanning three genes: MSH3, DHFR, and MTRNR2L2. The genes in this locus were associated with progression in TRACK-HD (MSH3 p=2·94 × 10−8 DHFR p=8·37 × 10−7 MTRNR2L2 p=2·15 × 10−9) and to a lesser extent in REGISTRY (MSH3 p=9·36 × 10−4 DHFR p=8·45 × 10−4 MTRNR2L2 p=1·20 × 10−3). The lead single nucleotide polymorphism (SNP) in TRACK-HD (rs557874766) was genome-wide significant in the meta-analysis (p=1·58 × 10−8), and encodes an aminoacid change (Pro67Ala) in MSH3. In TRACK-HD, each copy of the minor allele at this SNP was associated with a 0·4 units per year (95% CI 0·16–0·66) reduction in the rate of change of the Unified Huntington's Disease Rating Scale (UHDRS) Total Motor Score, and a reduction of 0·12 units per year (95% CI 0·06–0·18) in the rate of change of UHDRS Total Functional Capacity score. These associations remained significant after adjusting for age of onset. Interpretation The multidomain progression measure in TRACK-HD was associated with a functional variant that was genome-wide significant in our meta-analysis. The association in only 216 participants implies that the progression measure is a sensitive reflection of disease burden, that the effect size at this locus is large, or both. Knockout of Msh3 reduces somatic expansion in Huntington's disease mouse models, suggesting this mechanism as an area for future therapeutic investigation

Pulmonary magnetic resonance-guided online adaptive radiotherapy of locally advanced: the PUMA trial

Abstract Background Patients with locally-advanced non-small-cell lung cancer (LA-NSCLC) are often ineligible for surgery, so that definitive chemoradiotherapy (CRT) represents the treatment of choice. Nevertheless, long-term tumor control is often not achieved. Intensification of radiotherapy (RT) to improve locoregional tumor control is limited by the detrimental effect of higher radiation exposure of thoracic organs-at-risk (OAR). This narrow therapeutic ratio may be expanded by exploiting the advantages of magnetic resonance (MR) linear accelerators, mainly the online adaptation of the treatment plan to the current anatomy based on daily acquired MR images. However, MR-guidance is both labor-intensive and increases treatment times, which raises the question of its clinical feasibility to treat LA-NSCLC. Therefore, the PUMA trial was designed as a prospective, multicenter phase I trial to demonstrate the clinical feasibility of MR-guided online adaptive RT in LA-NSCLC. Methods Thirty patients with LA-NSCLC in stage III A-C will be accrued at three German university hospitals to receive MR-guided online adaptive RT at two different MR-linac systems (MRIdian Linac®, View Ray Inc. and Elekta Unity®, Elekta AB) with concurrent chemotherapy. Conventionally fractioned RT with isotoxic dose escalation up to 70 Gy is applied. Online plan adaptation is performed once weekly or in case of major anatomical changes. Patients are followed-up by thoracic CT- and MR-imaging for 24 months after treatment. The primary endpoint is twofold: (1) successfully completed online adapted fractions, (2) on-table time. Main secondary endpoints include adaptation frequency, toxicity, local tumor control, progression-free and overall survival. Discussion PUMA aims to demonstrate the clinical feasibility of MR-guided online adaptive RT of LA-NSCLC. If successful, PUMA will be followed by a clinical phase II trial that further investigates the clinical benefits of this approach. Moreover, PUMA is part of a large multidisciplinary project to develop MR-guidance techniques. Trial registration ClinicalTrials.gov: NCT05237453

Prevention of Cervical Cancer: Guideline of the DGGG and the DKG (S3 Level, AWMF Register Number 015/027OL, December 2017) - Part 1 with Introduction, Screening and the Pathology of Cervical Dysplasia.

AIMS Annual opportunistic screening for cervical carcinoma has been carried out in Germany since 1971. The creation of this S3 guideline meets an important need, outlined in the National Cancer Plan, with regard to screening for cervical cancer, as the guideline aims to provide important information and support for planned organized screening for cervical cancer in&nbsp;Germany. METHODS With the financial support of German Cancer Aid, 21 professional societies developed evidence-based statements and recommendations (classified using the GRADE system) for the screening, management and treatment of precancerous conditions of the cervix. Two independent scientific institutes compiled systematic reviews for this&nbsp;guideline. RECOMMENDATIONS The first part of this short summary presents the pathological basis and considers various questions related to screening for cervical cancer. As also reported in earlier reviews, the meta-analysis by Kleijnen Systematic Reviews showed that HPV-based screening offers better protection against invasive cervical cancer compared to cytology-based screening. The authors of this guideline therefore recommend&#8239;—&thinsp;in accordance with the guideline of the Joint National Committee of Germany (Gemeinsamer Bundesauschuss, G-BA)&#8239;—&thinsp;that women aged 35 and above should be examined at regular intervals (at least every 3 years) and undergo HPV-based screening. Co-testing can also be carried out. Women between the ages of 20 and 35 should have cytological screening every 2&nbsp;years.</p

Prevention of Cervical Cancer: Guideline of the DGGG and the DKG (S3 Level, AWMF Register Number 015/027OL, December 2017) - Part 2 on Triage, Treatment and Follow-up.

EN AIMS Annual opportunistic screening for cervical carcinoma has been done in Germany since 1971. The creation of this S3 guideline meets an important need, outlined in the National Cancer Plan, with regard to screening for cervical cancer, as this guideline aims to provide important information and support for planned organized screening for cervical cancer in&nbsp;Germany. METHODS With the financial support of German Cancer Aid, 21 professional societies developed evidence-based statements and recommendations (classified using the GRADE system) for the screening, management and treatment of precancerous conditions of the cervix. Two independent scientific institutes compiled systematic reviews for this&nbsp;guideline. RECOMMENDATIONS The second part of this short summary deals with the triage, treatment and follow-up care of cervical dysplasia. With regard to those women who do not participate in screening, the guideline authors recommend sending out repeat invitation letters or an HPV self-collection kit. Colposcopy should be carried out for further investigation if cytology findings are Pap II-p and HPV test results are positive or if the results of an HPV 16 or HPV 18 screening test are positive. A single abnormal Pap smear should be triaged and investigated using HPV testing or p16/Ki67 dual&nbsp;staining. &nbsp; FR OBJECTIFS dépistage opportuniste annuel pour le cancer du col utérin a été fait en Allemagne depuis 1971. La création de cette ligne directrice S3 répond au besoin important, indiqué dans le Plan national du cancer en ce qui concerne le dépistage du cancer du col de l’ utérus, comme cette directive vise à fournir des informations importantes et Soutien au dépistage organisé du cancer du col utérin en&nbsp;Allemagne. MÉTHODES avec le soutien financier de German Cancer Aid, 21 sociétés professionnelles ont élaboré des déclarations et des recommandations fondées sur des preuves pour le dépistage, la gestion et le traitement des affections précancéreuses du col de l&#8217;utérus. Deux instituts scientifiques indépendants ont compilé des revues systématiques pour cette&nbsp;directive. RECOMMENDATIONS La deuxième partie du triage, du traitement et des soins de suivi de la dysplasie cervicale. Lors du dépistage, les auteurs des lignes directrices ou les envoyer à un kit de collecte automatique du VPH. Les tests de dépistage HPP 16 ou HPV 18 sont positifs. Un seul frottis anormal doit être testé et testé avec le test HPV ou la coloration double p16 /&nbsp;Ki67.</p

Finanzmärkte - Unternehmungen - Informationen: Ergebnisse des Projektes im Wintersemester 2017/2018 und 2018/2019

Der vorliegende Beitrag der Wirtschaftswissenschaftlichen Schriften ist ein Sammelband, der die Beiträge der Studierenden des 2. Fachsemesters im Masterstudiengang General Management aus den beiden Wintersemestern 2017/2018 und 2018/19 umfasst, er enthält somit die Arbeiten aus zwei aufeinanderfolgenden Jahren. Die Einzelbeiträge wurden jeweils in einer zwei Monate dauernden Projektarbeit im Herbst 2017 bzw. 2018 erarbeitet und im Januar des darauffolgenden Jahres präsentiert. Im Wintersemester 2017/2018 lag der Schwerpunkt auf Mergers & Akquisitions. Zur Ergänzung standen auch einige Themen zur Auswahl, die sich mit Finanzmarktprodukten, der internationalen Finanzkrise und speziellen Wirtschaftsthemen befassten. Insgesamt hatten die Studenten die Auswahl aus 18 Themen, wovon letztlich sieben Themen bearbeitet wurden. Im Wintersemester 2018/2019 gab es die Schwerpunkte Genossenschaftswesen und Zulieferindustrie. Hier fanden von den vorgeschlagenen 17 Themen acht Problemstellungen eine Bearbeitung. Das Besondere dieser Ausarbeitungen liegt darin, dass sie in Form eines journalistischen Artikels aufgebaut sind und die Autoren als Gruppe (in der Regel 3 Personen) die Aufgabe hatten, eine auch für Nichtfachleute geeignete Form der Darstellung zu finden. Besonderer Wert wurde auch auf einen gut lesbaren Schreibstil und die Vielfalt der Gestaltungsformen gelegt. Die Arbeiten liegen hier in der Originalversion vor und wurden nicht redigiert. Die Fakten wurden nach bestem Wissen ermittelt, jedoch besteht kein Anspruch auf Richtigkeit und Vollständigkeit

Genome-wide association study in essential tremor identifies three new loci

We conducted a genome-wide association study of essential tremor, a common movement disorder characterized mainly by a postural and kinetic tremor of the upper extremities. Twin and family history studies show a high heritability for essential tremor. The molecular genetic determinants of essential tremor are unknown. We included 2807 patients and 6441 controls of European descent in our two-stage genome-wide association study. The 59 most significantly disease-associated markers of the discovery stage were genotyped in the replication stage. After Bonferroni correction two markers, one (rs10937625) located in the serine/threonine kinase STK32B and one (rs17590046) in the transcriptional coactivator PPARGC1A were associated with essential tremor. Three markers (rs12764057, rs10822974, rs7903491) in the cell-adhesion molecule CTNNA3 were significant in the combined analysis of both stages. The expression of STK32B was increased in the cerebellar cortex of patients and expression quantitative trait loci database mining showed association between the protective minor allele of rs10937625 and reduced expression in cerebellar cortex. We found no expression differences related to disease status or marker genotype for the other two genes. Replication of two lead single nucleotide polymorphisms of previous small genome-wide association studies (rs3794087 in SLC1A2, rs9652490 in LINGO1) did not confirm the association with essential tremor

Genome-wide association study in essential tremor identifies three new loci

We conducted a genome-wide association study of essential tremor, a common movement disorder characterized mainly by a postural and kinetic tremor of the upper extremities. Twin and family history studies show a high heritability for essential tremor. The molecular genetic determinants of essential tremor are unknown. We included 2807 patients and 6441 controls of European descent in our two-stage genome-wide association study. The 59 most significantly disease-associated markers of the discovery stage were genotyped in the replication stage. After Bonferroni correction two markers, one (rs10937625) located in the serine/threonine kinase STK32B and one (rs17590046) in the transcriptional coactivator PPARGC1A were associated with essential tremor. Three markers (rs12764057, rs10822974, rs7903491) in the cell-adhesion molecule CTNNA3 were significant in the combined analysis of both stages. The expression of STK32B was increased in the cerebellar cortex of patients and expression quantitative trait loci database mining showed association between the protective minor allele of rs10937625 and reduced expression in cerebellar cortex. We found no expression differences related to disease status or marker genotype for the other two genes. Replication of two lead single nucleotide polymorphisms of previous small genome-wide association studies (rs3794087 in SLC1A2, rs9652490 in LINGO1) did not confirm the association with essential tremor