Can risk area designation help increase vaccination coverage for Tick-Borne Encephalitis? Evidence from German claims data

BACKGROUND AND OBJECTIVES

Although vaccine preventable, the incidence of tick-borne encephalitis (TBE) increased in Germany from 2001 to 2021 by on average 2% each year, with a peak of more than 700 TBE infections documented in 2020. TBE-risk areas, as designated by district based on incidence of human cases, expanded north- and northeastward, present in 11 of the 16 Federal States as of 2022. Using claims data from a German statutory health insurance in the Federal States of Saxony and Thuringia (AOK PLUS), we aimed to assess whether official assignment of a district to a risk area had an impact on vaccination rates in Germany.

METHODS

The data covered the period from 01/01/2010 to 31/12/2018 and included information on vaccine administrations from outpatient physicians. Yearly incident vaccination rates were reported overall and by district. To investigate the association between a new designation of an incident TBE-risk area and vaccination rates, a difference-in-difference analysis was conducted.

RESULTS

Overall, the incident vaccination rates increased from 6.2 to 9.5 per 1,000 person-years between 2012 and 2018, with a peak of 12.2 in 2015. While districts that had been risk-areas for the whole study period had always a higher vaccination rate compared to districts that were never categorized as risk areas, the increase between 2012 and 2018 was comparable in the two groups (3.0 and 3.2 per 1,000 person-years, respectively). In contrast, districts that were newly designated risk districts during the study period experienced a significantly larger increase in vaccination rates, going from 5.8 to 14.7 per 1,000 person-years between 2012 and 2018, with a peak of 19.6 in 2015.

CONCLUSION

The results suggest that the new designation of a district as risk area has a significant positive impact on vaccination rates, which is strongest immediately after designation of risk area.

Assessing the chemical anthropocene - Development of the legacy pollution fingerprint in the North Sea during the last century

The North Sea and its coastal zones are heavily impacted by anthropogenic activities, which has resulted in significant chemical pollution ever since the beginning of the industrialization in Europe during the 19th century. In order to assess the chemical Anthropocene, natural archives, such as sediment cores, can serve as a valuable data source to reconstruct historical emission trends and to verify the effectiveness of changing environmental legislation. In this study, we investigated 90 contaminants covering inorganic and organic pollutant groups analyzed in a set of sediment cores taken in the North Seas' main sedimentation area (Skagerrak). We thereby develop a chemical pollution fingerprint that records the constant input of pollutants over time and illustrates their continued great relevance for the present. Additionally, samples were radiometrically dated and PAH and PCB levels in porewater were determined using equilibrium passive sampling. Furthermore, we elucidated the origin of lead (Pb) contamination utilizing non-traditional stable isotopic analysis. Our results reveal three main findings: 1. for all organic contaminant groups covered (PAHs, OCPs, PCBs, PBDEs and PFASs) as well as the elements lead (Pb) and titanium (Ti), determined concentrations decreased towards more recent deposited sediment. These decreasing trends could be linked to the time of introductions of restrictions and bans and therefor our results confirm, amongst possible other factors, the effectiveness of environmental legislation by revealing a successive change in contamination levels over the decades. 2. concentration trends for ΣPAH and ΣPCB measured in porewater correspond well with the ones found in sediment which suggests that this method can be a useful expansion to traditional bulk sediment analysis to determine the biologically available pollutant fraction. 3. Arsenic (As) concentrations were higher in younger sediment layers, potentially caused by emissions of corroded warfare material disposed in the study area after WW II.

Stochastic Interpolation of Sparsely Sampled Time Series via Multipoint Fractional Brownian Bridges

We propose and test a method to interpolate sparsely sampled signals by a stochastic process with a broad range of spatial and/or temporal scales. To this end, we extend the notion of a fractional Brownian bridge, defined as fractional Brownian motion with a given scaling (Hurst) exponent H and with prescribed start and end points, to a bridge process with an arbitrary number of intermediate and nonequidistant points. Determining the optimal value of the Hurst exponent H_{opt}, appropriate to interpolate the sparse signal, is a very important step of our method. We demonstrate the validity of our method on a signal from fluid turbulence in a high Reynolds number flow and discuss the implications of the non-self-similar character of the signal. The method introduced here could be instrumental in several physical problems, including astrophysics, particle tracking, and specific tailoring of surrogate data, as well as in domains of natural and social sciences.

Selection signatures for high-altitude adaptation in ruminants

High-altitude areas are important socio-economical habitats with ruminants serving as a major source of food and commodities for humans. Living at high altitude, however, is extremely challenging, predominantly due to the exposure to hypoxic conditions, but also because of cold temperatures and limited feed for livestock. To survive in high-altitude environments over the long term, ruminants have evolved adaptation strategies, e.g. physiological and morphological modifications, which allow them to cope with these harsh conditions. Identification of such selection signatures in ruminants may contribute to more informed breeding decisions, and thus improved productivity. Moreover, studying the genetic background of altitude adaptation in ruminants provides insights into a common molecular basis across species and thus a better understanding of the physiological basis of this adaptation. In this paper, we review the major effects of high altitude on the mammalian body and highlight some of the most important short-term (coping) and genetically evolved (adaptation) physiological modifications. We then discuss the genetic architecture of altitude adaptation and target genes that show evidence of being under selection based on recent studies in various species, with a focus on ruminants. The yak is presented as an interesting native species that has adapted to the high-altitude regions of Tibet. Finally, we conclude with implications and challenges of selection signature studies on altitude adaptation in general. We found that the number of studies on genetic mechanisms that enable altitude adaptation in ruminants is growing, with a strong focus on identifying selection signatures, and hypothesise that the investigation of genetic data from multiple species and regions will contribute greatly to the understanding of the genetic basis of altitude adaptation.

Accuracy of genotype imputation in Labrador Retrievers

The dog is a valuable model species for the genetic analysis of complex traits, and the use of genotype imputation in dogs will be an important tool for future studies. It is of particular interest to analyse the effect of factors like single nucleotide polymorphism (SNP) density of genotyping arrays and relatedness between dogs on imputation accuracy due to the acknowledged genetic and pedigree structure of dog breeds. In this study, we simulated different genotyping strategies based on data from 1179 Labrador Retriever dogs. The study involved 5826 SNPs on chromosome 1 representing the high density (HighD) array; the low-density (LowD) array was simulated by masking different proportions of SNPs on the HighD array. The correlations between true and imputed genotypes for a realistic masking level of 87.5% ranged from 0.92 to 0.97, depending on the scenario used. A correlation of 0.92 was found for a likely scenario (10% of dogs genotyped using HighD, 87.5% of HighD SNPs masked in the LowD array), which indicates that genotype imputation in Labrador Retrievers can be a valuable tool to reduce experimental costs while increasing sample size. Furthermore, we show that genotype imputation can be performed successfully even without pedigree information and with low relatedness between dogs in the reference and validation sets. Based on these results, the impact of genotype imputation was evaluated in a genome-wide association analysis and genomic prediction in Labrador Retrievers.

Waste Heat Energy Harvesting by use of BaTiO3 for Pyroelectric Hydrogen Generation

The generation of hydrogen as a chemical energy storage for power generation via fuel cells or for the synthesis of fuels has attained a strong interest in recent years. By way of example this is realized using electrolysis of water with the help of excess electricity of wind power plants. However with low temperature grade waste heat as it could be found in many industrial and household applications, there is another source of usable energy for this purpose. In a first pragmatic experimentation we investigated the pyroelectric effect of ferroelectric BaTiO3 combined with a temperature cycling to generate hydrogen from water. Therefore, single crystals ground to powder were brought into contact with distilled water and set to a cyclical temperature change from 40 °C to 70 °C. With the help of a highly selective and sensitive measuring system based on a coulometric solid electrolyte detector we could provide a first indication of pyroelectric generated hydrogen by a fraction of 300 Vol.-ppb in the sample gas.

Surgical and Functional Outcomes Following Buried Penis Repair With Limited Panniculectomy and Split-thickness Skin Graft

OBJECTIVE

To report surgical and functional outcomes of buried penis surgery.

METHODS

Outcomes following buried penis surgery at the University of Washington were assessed from June 1, 2005 to June 1, 2016. Patient demographic and surgical data were abstracted from a retrospective chart review. All patients were attempted to be contacted by phone for long-term follow-up. Uni- and multivariate analysis was performed to evaluate for association with any complication.

RESULTS

A total of 42 men underwent buried penis repair surgery (mean short-term follow-up 8.1 months). There was an overall 33% 90-day complication rate (21 events). In univariate analysis, body mass index (BMI; P = .02) and no history of gastric bypass (P = .03) were significant predictors of any complication. In multivariate analysis, only BMI remained significant (odds ratio 1.1 for each increase in unit of BMI, 95% confidence interval 1.01-1.27). Twenty-seven patients were reached for long-term follow-up (mean 39 months). Patients reported improvements in every functional domain that was assessed. Of the patients, 85% reported they would undergo buried penis surgery again, 74% that surgery led to a positive change in their lives, and 85% that the surgery had remained a long-term success.

CONCLUSION

Surgical correction of buried penis with penile split-thickness skin graft and limited panniculectomy is well tolerated and results in functional, long-term improvements. BMI is associated with an increased likelihood of a complication following surgery.

Severe soft tissue injuries of the upper extremity in motor vehicle crashes involving partial ejection: the protective role of side curtain airbags

INTRODUCTION

Partial ejection (PE) of the upper extremity (UE) can occur in a motor vehicle crash (MVC) resulting in complex and severe soft tissue injuries (SSTI). This study evaluated the relationship between partial ejection and UE injuries, notably SSTIs, in MVCs focusing on crash types and characteristics, and further examined the role of side curtain airbags (SCABs) in the prevention of partial ejection and reducing SSTI of the UE.

METHODS

Weighted data was analyzed from the National Automotive Sampling System Crashworthiness Data System (NASS-CDS) from 1993 to 2012. Logistic regression models were used to assess the relationship of PE with SSTI of the UE and the effect of SCABs in both nearside impacts and rollover collisions. Crash Injury Research and Engineering Network (CIREN) case studies illustrated PE involving SSTI of the UE, and long term treatment.

RESULTS

Rollover and nearside impact collisions had the highest percentages of partial ejection, with over half occurring in rollover collisions. Annually over 800 SSTIs of the UE occurred in all MVCs. For nearside lateral force impacts, a multivariable analysis adjusting for belt use and delta V showed a 15 times (OR 15.35, 95% CI 4.30, 54.79) greater odds of PE for occupants without SCABs compared to those with a SCAB deployment. No occupants (0 of 51,000) sustained a SSTI of the UE when a SCAB deployed in nearside impacts, compared to 0.01% (114 of 430,000) when SCABs were unavailable or did not deploy. In rollover collisions, a multivariable analysis adjusted for number of quarter turns and belt use showed 3 times the odds (OR 3.02, 95% CI 1.22, 7.47) of PE for occupants without SCABs compared to those with a SCAB deployment. Just 0.17% (32 of 19,000) of the occupants sustained a SSTI of the UE in rollovers with a SCAB deployment, compared to 0.53% (2294 of 431,000) of the occupants when SCABs were unavailable or did not deploy. CIREN case studies illustrated the injury causation of SSTI of the UE due to partial ejection, and the long term treatment and medical costs associated with a SSTI to the UE.

CONCLUSIONS

The majority of severe soft tissue injuries (SSTI) of the upper extremity (UE) involved partial ejection out the nearside window of outboard seated occupants in nearside impacts and rollover collisions. Real world case studies showed that SSTIs of the upper extremity require extensive treatment, extended hospitalization and are costly. Occupants without a side curtain airbag (SCAB) deployment had an increase in the odds of partial ejection. SCAB deployments provided protection against partial ejection and prevented SSTIs of the UE, with none occurring in nearside impacts, and a small percentage and reduction occurring in rollover collisions compared to those where SCABs were unavailable or did not deploy.

Soft Tissue Coverage of the Hand and Upper Extremity: The Reconstructive Elevator

Soft tissue reconstruction of the upper extremity is a complex topic because every defect has multiple potential solutions. Whereas the often-cited reconstructive ladder advised selection of the simplest reconstruction of the defect, the newer concept of the reconstructive elevator allows freedom to choose a more complex reconstruction to account for specialized function and aesthetic outcome. An algorithm for assessment of the defect is presented and demonstrated in this review, using 6 case examples to highlight key concepts. Representative flaps are presented and a discussion of functional and aesthetic outcomes is undertaken to provide a framework for achieving the patient's and surgeon's goals of reconstruction.

Characterization of azimuthal and radial velocity fields induced by rotors in flows with a low Reynolds number

We theoretically and experimentally investigate the flow field that emerges from a rodlike microrotor rotating about its center in a nonaxisymmetric manner. A simple theoretical model is proposed that uses a superposition of two rotlets as a fundamental solution to the Stokes equation. The predictions of this model are compared to measurements of the azimuthal and radial microfluidic velocity field components that are induced by a rotor composed of fused microscopic spheres. The rotor is driven magnetically and the fluid flow is measured with the help of a probe particle fixed by an optical tweezer. We find considerable deviations of the mere azimuthal flow pattern induced by a single rotating sphere as it has been reported by Di Leonardo et al. [Phys. Rev. Lett. 96, 134502 (2006)]. Notably, the presence of a radial velocity component that manifests itself by an oscillation of the probe particle with twice the rotor frequency is observed. These findings open up a way to discuss possible radial transport in microfluidic devices.

Genetics of cattle temperament and its impact on livestock production and breeding – a review

Abstract. Cattle temperament, which describes individual behaviour differences with regard to a stressor or environmental challenge, is known for its impact on working safety, adaptability to new housing conditions, animal productivity and for evaluation of animal welfare. However, successful use of temperament in animal breeding and husbandry to improve keeping conditions in general or animal welfare in particular, requires the availability of informative and reproducible phenotypes and knowledge about the genetic modulation of these traits. However, the knowledge about genetic influences on cattle temperament is still limited. In this review, an outline is given for the interdependence between production systems and temperament as well as for the phenotyping of cattle temperament based on both behaviour tests and observations of behaviour under production conditions. In addition, the use of temperament as a selection criterion is discussed.

Generalized vortex model for the inverse cascade of two-dimensional turbulence

We generalize Kirchhoff's point vortex model of two-dimensional fluid motion to a rotor model which exhibits an inverse cascade by the formation of rotor clusters. A rotor is composed of two vortices with like-signed circulations glued together by an overdamped spring. The model is motivated by a treatment of the vorticity equation representing the vorticity field as a superposition of vortices with elliptic Gaussian shapes of variable widths, augmented by a suitable forcing mechanism. The rotor model opens up the way to discuss the energy transport in the inverse cascade on the basis of dynamical systems theory.

Differences in treatment of digital amputation injuries based on community transfer versus tertiary initial presentation

BACKGROUND

The purpose of this paper is to compare a group of patients with upper extremity amputation injuries who presented to a tertiary referral center without having been previously seen at another hospital versus a group of patients who was transferred from another facility. We hypothesize that transferred patients will generally undergo more complex treatments, that some transferred patients will be treated in the ER with simple treatments (thereby perhaps not requiring transfer), and that transferred patients will be less likely to have insurance coverage.

METHODS

All patients who presented to our ER from January 1, 2007 to December 31, 2008 with the classification of hand and finger amputation were included. Data collected included whether or not the patient was transferred from another institution, age, mechanism of injury, partial versus total amputation, location treated, transportation method, general treatment classification, type of insurance, and month of presentation.

RESULTS

No statistical difference was found between patients who were transferred versus those who were not with respect to age, sex, mechanism, whether the amputation was partial versus complete, or insurance coverage. Statistical differences were noted between the subset of patients who was transferred versus those who were not with respect to treatment location, method of transportation, and treatment.

CONCLUSIONS

Patients transferred to our institution required significantly more complex treatments and were significantly more likely to be treated in the operating room. A small but significant group of patients was treated in the ER or required relatively simple treatments after transfer. Our hypothesis that a higher percentage of patients transferred to our institution would have less insurance coverage was not supported by the data. Tertiary centers can expect to continue receiving a steady stream of amputation referrals.