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Rheinbaben F, Köhnlein J, Schmidt N, Hildebrandt C, Werner S. To reduce cytotoxicity when testing the virucidal activity of chemical disinfectants and biocides: The "T-25 method" as an alternative to "large-volume-plating". Heliyon 2023; 9:e20728. [PMID: 37876415 PMCID: PMC10590779 DOI: 10.1016/j.heliyon.2023.e20728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 09/28/2023] [Accepted: 10/04/2023] [Indexed: 10/26/2023] Open
Abstract
When testing the virucidal activity of biocides, the non-inactivated residual virus is titrated on cell cultures by the end point dilution method on 96-well tissue culture plates. However, residues of the biocide to be tested also come into contact with the cell cultures in varying concentrations and thus can lead to cytotoxic effects even at high levels of dilution. In the European standards for testing biocides, in particular disinfectants, methods such as Large-Volume-Plating (LVP) method and, in some guidelines, gel filtration procedures are described for reducing cytotoxic effects in the case of highly cytotoxic products, if the classical dilution method proves to be impractical. In order to enable the testing of highly cytotoxic biocides for their activity against viruses, an alternative method for reducing cytotoxicity is introduced, which is based on a procedure of isolating infectious viruses from cytotoxic patients' materials such as stool and can be applied when the other methods fail.
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Affiliation(s)
| | | | | | | | - S. Werner
- HygCen Germany GmbH, Schwerin, Germany
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2
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Vorderwülbecke G, Spies C, von Heymann C, Kruppa J, Fürstenau D, Kaufner L, Werner S, Höft M, Balzer F. [The costs of preoperative anemia in hip joint revision surgery]. Anaesthesiologie 2023; 72:13-20. [PMID: 36378326 PMCID: PMC9852200 DOI: 10.1007/s00101-022-01211-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 08/09/2022] [Accepted: 09/06/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Anemia is highly prevalent in patients before hip joint revision surgery (HJRS) and is associated with an increased complication rate. This paper is the first to investigate costs, real diagnosis-related group (DRG) revenues and case coverage of preoperative anemia in elective HJRS. METHODS Medical data, transfusions, costs, and revenues of all patients undergoing HJRS at two campuses of the Charité -Universitätsmedizin Berlin between 2010 and 2017 were used for subgroup analyses and linear regressions. RESULTS Of 1187 patients included 354 (29.8%) showed preoperative anemia. A total of 565 (47.6%) patients were transfused with a clear predominance of anemic patients (72.6% vs. 37.0%, p < 0.001). Costs (12,318€ [9027;20,044€] vs. 8948€ [7501;11,339€], p < 0.001) and revenues (11,788€ [8992;16,298€] vs. 9611€ [8332;10,719€], p < 0.001) were higher for preoperatively anemic patients and the coverage was deficient (-1170€ [-4467;1238€] vs. 591€ [-1441;2103€], p < 0.001). In anemic patients, case contribution margins decreased with increasing transfusion rates (p ≤ 0.001). Comorbidities had no significant economic impact. CONCLUSION Preoperative anemia and perioperative transfusions in HJRS are associated with increased treatment costs and a financial undercoverage for healthcare providers and health insurance companies. Concepts for the treatment of preoperative anemia (e.g. patient blood management) could reduce treatment costs in the medium term.
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Affiliation(s)
- Gerald Vorderwülbecke
- grid.6363.00000 0001 2218 4662Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité – Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Berlin, Deutschland
| | - Claudia Spies
- grid.6363.00000 0001 2218 4662Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité – Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Berlin, Deutschland
| | - Christian von Heymann
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité - Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Berlin, Deutschland. .,Klinik für Anästhesie, Intensivmedizin, Notfallmedizin und Schmerztherapie, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249, Berlin, Deutschland.
| | - Jochen Kruppa
- grid.6363.00000 0001 2218 4662Institut für Biometrie und Klinische Epidemiologie, Charité – Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Berlin, Deutschland
| | - Daniel Fürstenau
- grid.4655.20000 0004 0417 0154Department of Digitalization, Copenhagen Business School, Copenhagen, Dänemark ,grid.7468.d0000 0001 2248 7639Institut für Medizinische Informatik, Charité – Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Campus Charité Mitte, Charitéplatz 1, 10117 Berlin, Deutschland
| | - Lutz Kaufner
- grid.6363.00000 0001 2218 4662Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité – Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Berlin, Deutschland
| | - Sven Werner
- grid.6363.00000 0001 2218 4662Geschäftsbereich Unternehmenscontrolling – Klinikcontrolling, Charité – Universitätsmedizin Berlin, Berlin, Deutschland
| | - Moritz Höft
- grid.6363.00000 0001 2218 4662Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité – Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Berlin, Deutschland
| | - Felix Balzer
- Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin, Charité - Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Berlin, Deutschland. .,Institut für Medizinische Informatik, Charité - Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Campus Charité Mitte, Charitéplatz 1, 10117, Berlin, Deutschland.
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Yerly L, Bavastro CP, Di Domizio J, Wyss T, Tissot S, Cangkrama M, Gilliet M, Werner S, Kuonen F. 432 Integrated multi-omics reveals cellular and molecular interactions governing the invasive niche of basal cell carcinoma. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.09.446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Böttner J, Büttner P, Werner S, Borger M, Thiele H, Schlotter F. Sex-specific features of human fibro-calcific aortic valve disease. Atherosclerosis 2022. [DOI: 10.1016/j.atherosclerosis.2022.06.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bodensohn R, Werner S, Reis J, Pazos Escudero M, Kaempfel A, Hadi I, Forbrig R, Manapov F, Corradini S, Belka C, Theurich S, Heinzerling L, Schlaak M, Niyazi M. PO-1159 Stereotactic radiosurgery and combined immunotherapy with ipilimumab and nivolumab for melanoma brain metastases. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)03123-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Pratsch C, Rehbein S, Werner S, Guttmann P, Stiel H, Schneider G. X-ray Fourier transform holography with beam shaping optical elements. Opt Express 2022; 30:15566-15574. [PMID: 35473273 DOI: 10.1364/oe.453747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 04/03/2022] [Indexed: 06/14/2023]
Abstract
Holography is a powerful method for achieving 3D images of objects. Extending this method to short wavelengths potentially offers significantly higher resolution than visible light holography. However, current X-ray holography setups employ nanoscale pinholes to form the reference wave. This approach is relatively inefficient and limited to very small sample size. Here, we propose a new setup for X-ray holography based on a binary diffractive optical element (DOE), which forms at the same time the object illumination and the reference wave. This optic is located separately from the sample plane, which permits investigation of larger sample areas. Using an extended test sample, we demonstrate a resolution of 90 nm (half-pitch) at an undulator beamline at BESSY II. The new holography setup can be directly transferred to free electron laser sources enabling time-resolved nanoscale imaging for ultra-fast processes.
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Spiesecke P, Reinhold T, Wehrenberg Y, Werner S, Maxeiner A, Busch J, Fischer T, Hamm B, Lerchbaumer MH. Cost‐effectiveness analysis of multiple imaging modalities in diagnosis and follow‐up of intermediate complex cystic renal lesions. BJU Int 2021; 128:575-585. [DOI: 10.1111/bju.15353] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
| | - Thomas Reinhold
- Institute of Social Medicine, Epidemiology, and Health Economics
| | | | | | - Andreas Maxeiner
- Department of Urology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Jonas Busch
- Department of Urology Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
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Meyer F, Engel A, Riepen B, Schumacher U, Dubrovska A, Petersen C, Peitzsch C, Hein L, Werner S, Wikmann H, Rothkamm K, Borgmann K. OC-0207: Avoidance of DNA replication stress leads to radioresistance in stem cell-like TNBC. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00231-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gadomski T, Werner S, McNeil F, Khan A, Gorton M, Villella J, Pereira E. Implementation of an enhanced recovery after surgery protocol and patterns of opiate use. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Werner S, Gadomski T, McNeil F, Villella J, Pereira E. Incorporation of a sentinel lymph node mapping algorithm in patients with clinical stage I endometrial cancer. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Seidel S, Werner S, Eibl D. CFD for stirred bioreactors: Analysis of different multiphase models to determine oxygen mass transfer. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S. Seidel
- Zürich University of Applied Sciences Institute of Chemistry and Biotechnology Grüentalstr. 14 8820 Wädenswil Switzerland
| | - S. Werner
- Zürich University of Applied Sciences Institute of Chemistry and Biotechnology Grüentalstr. 14 8820 Wädenswil Switzerland
| | - D. Eibl
- Zürich University of Applied Sciences Institute of Chemistry and Biotechnology Grüentalstr. 14 8820 Wädenswil Switzerland
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12
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Kaiser M, Schuhmann T, Werner S, Freund H. Multilevel reactor design for methanol synthesis. CHEM-ING-TECH 2020. [DOI: 10.1002/cite.202055215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- M. Kaiser
- Friedrich-Alexander-Universität Erlangen-Nürnberg Chemische Reaktionstechnik / Katalytische Reaktoren und Prozesstechnik Cauerstr. 3 91058 Erlangen Deutschland
| | - T. Schuhmann
- Air Liquide Global E&C Solutions Germany GmbH Olof-Palme-Str. 35 60439 Frankfurt am Main Germany
| | - S. Werner
- Clariant Produkte (Deutschland) GmbH BU Catalysts Semmelweißstr. 1 82152 Planegg Germany
| | - H. Freund
- Friedrich-Alexander-Universität Erlangen-Nürnberg Chemische Reaktionstechnik / Katalytische Reaktoren und Prozesstechnik Cauerstr. 3 91058 Erlangen Deutschland
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Raakow J, Aydin M, Kilian M, Köhler A, Werner S, Pratschke J, Fikatas P. [Elective treatment of inguinal hernia in university surgery-an economic challenge]. Chirurg 2020; 90:1011-1018. [PMID: 31359111 DOI: 10.1007/s00104-019-1008-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Elective and emergency inguinal hernia surgery is a central task for general and abdominal surgeons. As a standard procedure it is regarded as having a relatively low income in the German diagnosis-related groups (DRG) system. This can lead to an economic imbalance, especially in a cost-intensive environment of a university hospital. The aim of this analysis was to investigate the influence of clinical factors on costs and the contribution margin as well as the overall economic evaluation of elective inguinal hernia surgery at a university hospital. MATERIAL AND METHODS All patients undergoing elective inguinal hernia surgery at two locations of the Charité University Medicine Berlin in 2014 and 2015 were included in the analysis. The influence of clinical, patient and surgical factors on the economic outcome of the cases was evaluated. RESULTS A total of 419 patients were included, mostly after a Lichtenstein operation (44.9%) and laparoscopic transabdominal preperitoneal (TAPP) surgery (53.9%). The greatest impact on the economic outcome was the occurrence of postoperative complications. Also, a patient clinical complexity level (PCCL) value of >1, more than 8 encoded secondary diagnoses and a duration of hospital stay of less than 2 days had a significantly negative impact on the contribution margin. Overall, elective inguinal hernia surgery led to a negative contribution margin of € 651 per case. CONCLUSION Elective inguinal hernia surgery in the environment of a university hospital has a high financial deficit; however, since a complete discontinuation of this treatment is not an alternative multifactorial approaches are required to improve the economic outcome.
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Affiliation(s)
- J Raakow
- Chirurgische Klinik, Charité - Universitätsmedizin Berlin, Gliedkörperschaft der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Charité Campus Mitte, Charité Campus Virchow, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - M Aydin
- Chirurgische Klinik, Charité - Universitätsmedizin Berlin, Gliedkörperschaft der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Charité Campus Mitte, Charité Campus Virchow, Charitéplatz 1, 10117, Berlin, Deutschland
| | - M Kilian
- Chirurgische Klinik, Charité - Universitätsmedizin Berlin, Gliedkörperschaft der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Charité Campus Mitte, Charité Campus Virchow, Charitéplatz 1, 10117, Berlin, Deutschland.,Abteilung für Allgemein- und Viszeralchirurgie, Evangelische Elisabeth Klinik, Lützowstr. 26, 10785, Berlin, Deutschland
| | - A Köhler
- Chirurgische Klinik, Charité - Universitätsmedizin Berlin, Gliedkörperschaft der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Charité Campus Mitte, Charité Campus Virchow, Charitéplatz 1, 10117, Berlin, Deutschland
| | - S Werner
- Geschäftsbereich Unternehmenscontrolling, Charité - Universitätsmedizin Berlin, Gliedkörperschaft der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Deutschland
| | - J Pratschke
- Chirurgische Klinik, Charité - Universitätsmedizin Berlin, Gliedkörperschaft der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Charité Campus Mitte, Charité Campus Virchow, Charitéplatz 1, 10117, Berlin, Deutschland
| | - P Fikatas
- Chirurgische Klinik, Charité - Universitätsmedizin Berlin, Gliedkörperschaft der Freien Universität Berlin und der Humboldt-Universität zu Berlin, Charité Campus Mitte, Charité Campus Virchow, Charitéplatz 1, 10117, Berlin, Deutschland
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Vaitsiakhovich T, Coleman CI, Kleinjung F, Kloss S, Vardar B, Werner S, Schaefer B. P4746Worsening of renal function in atrial fibrillation patients with stage 3 or 4 chronic kidney disease treated with warfarin or rivaroxaban - evidence from the real-world CALLIPER study in the US claims. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Anticoagulation therapy with vitamin K antagonists (e.g. warfarin) has recently been shown to contribute to the accelerated vascular calcification and worsening of renal function. Therefore, it is compelling to investigate the impact of different oral anticoagulants (OACs) on kidney function in non-valvular atrial fibrillation (NVAF) patients. Common co-morbidities in these patients are chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM), which might be presented at the OAC therapy initiation.
Purpose
The overall objective of the CALLIPER study was to evaluate the effectiveness and safety of the reduced dose rivaroxaban (15 mg once daily) as compared to warfarin in NVAF patients with renal dysfunction in real-world setting. In particular, we evaluated the risk of worsening of renal function in NVAF patients with CKD stage 3 and 4 at baseline (1 year prior to the cohort entry). Additionally, a sub-group analysis of patients with T2DM was performed. We defined worsening of renal function as progression to CKD stage 5, kidney failure or need for dialysis.
Methods
Individual level data of warfarin- and rivaroxaban-naïve NVAF patients from the MarketScan database for the years 2012 through 2017 were used. Patients with moderate-to-severe CKD (stage 3 and 4) were included in the study cohort and were followed until progression to CKD 5, kidney failure or dialysis, OAC discontinuation/switch, insurance disenrollment or end of data availability. A comparative analysis evaluating the hazard ratios (HRs) with the corresponding 95% confidence intervals (CIs) under warfarin or rivaroxaban treatment was performed using Cox regression. A stabilized inverse probability of treatment weighting was used to adjust for imbalances in baseline patient characteristics.
Results
We identified 5,906 warfarin- and 1,466 rivaroxaban-naïve patients with NVAF and CKD stage 3 and 4, of which 60% were male, median (25–75% range) age=79 (71- 84) years, CHADS2 score=2.67 (2.00- 3.50), CHA2DS2-VASc score=4.43 (3.40–5.62), modified HAS-BLED score=3.00 (2.40 - 3.65). T2DM was present in more than 50% of patients (Table), namely, in 3,160 warfarin- and 746 rivaroxaban-users. Hazard ratios and 95% CI for worsening of renal function were evaluated at 0.53 (0.35; 0.78) in the main cohort and 0.50 (0.30; 0.83) in the T2DM sub-group, meaning that rivaroxaban was associated with a significant 47% and 50% risk reduction of this outcome in NVAF patients with CKD stage 3 and 4 with and without T2DM, respectively.
Conclusion
The reduced dose of rivaroxaban has appeared to lower significantly the risk of worsening of renal function versus warfarin in NVAF patients with CKD stage 3 and 4 present at the OAC therapy initiation. The conclusion holds true for the patients with the co-morbid T2DM. This evidence was generated by the CALLIPER study using one of the largest US administrative claims database.
Acknowledgement/Funding
CI Coleman has received research grants from Bayer AG
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Affiliation(s)
| | - C I Coleman
- School of Pharmacy University of Connecticut, Hartford, United States of America
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Werner S. Service use and perceptions of service effectiveness by parents of individuals with intellectual disabilities: comparing Jewish and Arab Israeli parental caregivers. J Intellect Disabil Res 2019; 63:957-968. [PMID: 30775831 DOI: 10.1111/jir.12611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND The relationship between ethnicity, service use and perceptions of service effectiveness is inconclusive. This study examined differences in service use and perceptions of service effectiveness between Israeli Jewish (Jewish) and Israeli Arab (Arab) parental caregivers of individuals with intellectual disabilities and dual diagnosis of psychopathology. METHODS Parental caregivers (n = 186) of individuals with intellectual disabilities or dual diagnosis, aged 10 to 30 years, completed a self-report questionnaire. RESULTS Arab parental caregivers perceived health services to be more accessible than did Jewish caregivers, but there was no difference between the two groups in the use of the services. Overall, greater enabling factors and accessibility were associated with higher use of education and social services. No differences were found between the groups in their perceptions of service effectiveness. CONCLUSION Arab family caregivers use education and social services less than do their Jewish peers, possibly because they have fewer enabling resources. The finding that both groups reported similar use of health services may be explained by a shared perception that informal help may not be suitable for dealing with situations of psychopathology. The similar perceptions of service effectiveness may be explained by extensive services available in Israel, to the satisfaction of both groups, or by the fact that participants perceived these services as their only alternative, and therefore fear losing them.
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Affiliation(s)
- S Werner
- Paul Baerwald School of Social Work and Social Welfare and the Center for Disability Studies, Hebrew University of Jerusalem, Jerusalem, Israel
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Gemein S, Gebel J, Christiansen B, Martiny H, Vossebein L, Brill FHH, Decius M, Eggers M, Koburger-Janssen T, Meckel M, Werner S, Hunsinger B, Selhorst T, Kampf G, Exner M. Interlaboratory reproducibility of a test method following 4-field test methodology to evaluate the susceptibility of Clostridium difficile spores. J Hosp Infect 2019; 103:78-84. [PMID: 31199936 DOI: 10.1016/j.jhin.2019.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/21/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Sporicidal surface disinfection is recommended to control transmission of Clostridium difficile in healthcare facilities. EN 17126 provides a method to determine the sporicidal activity in suspension and has been approved as a European standard. In addition, a sporicidal surface test has been proposed. AIM To determine the interlaboratory reproducibility of a test method for evaluating the susceptibility of a C. difficile spore preparation to a biocidal formulation following the 4-field test (EN 16615 methodology). METHODS Nine laboratories participated. C. difficile NCTC 13366 spores were used. Glutaraldehyde (1% and 6%; 15 min) and peracetic acid (PAA; 0.01% and 0.04%; 15 min) were used to determine the spores' susceptibility in suspension in triplicate. FINDINGS One-percent glutaraldehyde revealed a mean decimal log10 reduction of 1.03 with variable results in the nine laboratories (0.37-1.49) and a reproducibility of 0.38. The effect of 6% glutaraldehyde was stronger (mean: 2.05; range: 0.96-4.29; reproducibility: 0.86). PAA revealed similar results. An exemplary biocidal formulation based on 5% PAA was used at 0.5% (non-effective concentration) and 4% (effective concentration) to determine the sporicidal efficacy (4-field test) under clean conditions in triplicate with a contact time of 15 min. When used at 0.5% it demonstrated an overall log10 reduction of 2.68 (range: 2.35-3.57) and at 4% of 4.61 (range: 3.82-5.71). The residual contamination on the three primarily uncontaminated test fields was <50 cfu/25 cm2 in one out of nine laboratories (0.5%) and in seven out of nine laboratories (4%). CONCLUSION The interlaboratory reproducibility seems to be robust.
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Affiliation(s)
- S Gemein
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany; VAH Ring Trial Steering Gremium of the Association for Applied Hygiene (VAH), Bonn, Germany.
| | - J Gebel
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany; VAH Ring Trial Steering Gremium of the Association for Applied Hygiene (VAH), Bonn, Germany; Disinfectant Commission 4+4-Group of the Association for Applied Hygiene (VAH), Bonn, Germany
| | - B Christiansen
- Disinfectant Commission 4+4-Group of the Association for Applied Hygiene (VAH), Bonn, Germany; ZE Medizinaluntersuchungsamt und Hygiene, University Hospital Schleswig Holstein, Kiel, Germany
| | - H Martiny
- VAH Ring Trial Steering Gremium of the Association for Applied Hygiene (VAH), Bonn, Germany; Disinfectant Commission 4+4-Group of the Association for Applied Hygiene (VAH), Bonn, Germany
| | - L Vossebein
- Disinfectant Commission 4+4-Group of the Association for Applied Hygiene (VAH), Bonn, Germany; University of Applied Sciences Niederrhein, Mönchengladbach, Germany
| | - F H H Brill
- Dr Brill + Partner GmbH, Institut für Hygiene und Mikrobiologie, Hamburg, Germany
| | - M Decius
- ZE Medizinaluntersuchungsamt und Hygiene, University Hospital Schleswig Holstein, Kiel, Germany
| | - M Eggers
- Labor Prof. Gisela Enders MVZ GbR, Stuttgart, Germany
| | | | - M Meckel
- IKI Institut für Krankenhaushygiene und Infektionskontrolle GmbH, Gießen, Germany
| | - S Werner
- HygCen Germany GmbH, Schwerin, Germany
| | - B Hunsinger
- VAH Ring Trial Steering Gremium of the Association for Applied Hygiene (VAH), Bonn, Germany
| | - T Selhorst
- Institut für Tierwissenschaften, Präventives Gesundheitsmanagement, University Bonn, Germany
| | - G Kampf
- Institute for Hygiene and Environmental Medicine, University Medicine Greifswald, Greifswald, Germany
| | - M Exner
- Institute for Hygiene and Public Health, University Hospital Bonn, Bonn, Germany
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Wabitsch S, Kästner A, Haber PK, Feldbrügge L, Winklmann T, Werner S, Pratschke J, Schmelzle M. Laparoscopic versus open hemihepatectomy-a cost analysis after propensity score matching. Langenbecks Arch Surg 2019; 404:469-475. [PMID: 31065781 DOI: 10.1007/s00423-019-01790-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/23/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Cost efficiency is important for hospitals in order to provide high-quality health care for all patients. As hemihepatectomies are increasingly being performed laparoscopically, the aims of this study were to evaluate the costs of laparoscopic hemihepatectomy and to compare them to conventional open techniques. PATIENTS AND METHODS This is a retrospective analysis of clinical outcomes and financial calculations of all patients who underwent hemihepatectomy between January 2015 and December 2016 at the Department of Surgery, Campus Charité Mitte and Campus Charité Virchow-Klinikum, Berlin, Germany, being allocated to the DRG (diagnosis-related group) H01A (complex operations of the liver and pancreas with complex intensive care treatment) or H01B (operations of the liver and pancreas without complex intensive care treatment). To overcome selection bias, a 1:1 propensity score matching (PSM) analysis was performed. RESULTS After PSM, a total of 64 patients were identified; 32 patients underwent laparoscopic hemihepatectomy (LH); and 32 patients received open hemihepatectomy (OH). After PSM, no significant differences were observed in clinical baseline characteristics. The duration of surgery was significantly longer for patients undergoing LH compared to OH (LH, 334 min, 186-655 min; OH, 274 min, 176-454 min; p = 0.005). Patients in the LH group had a significantly shortened median hospital stay of 5 d, when compared to OH (LH, 9.5 d, 3-35 d; OH, 14.5 d, 7-37d; p = 0.005). We observed a significant higher rate of postoperative complication in the OH group (p = 0.022). Cost analysis showed median overall costs of 17,369.85€ in the LH group and 16,103.64€ in the OH group (p = 0.390). CONCLUSION Our data suggest that higher intraoperative costs of laparoscopic liver surgery, e.g., for surgical devices and due to longer operation times, are compensated by fewer postoperative complications and consecutive shorter length of stay when compared with OH.
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Affiliation(s)
- S Wabitsch
- Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - A Kästner
- Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - P K Haber
- Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - L Feldbrügge
- Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - T Winklmann
- Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - S Werner
- Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - J Pratschke
- Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Moritz Schmelzle
- Department of Surgery, Campus Charité Mitte and Campus Virchow-Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
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Kandziora JH, van Toulon N, Sobral P, Taylor HL, Ribbink AJ, Jambeck JR, Werner S. The important role of marine debris networks to prevent and reduce ocean plastic pollution. Mar Pollut Bull 2019; 141:657-662. [PMID: 30955781 DOI: 10.1016/j.marpolbul.2019.01.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 01/20/2019] [Accepted: 01/21/2019] [Indexed: 06/09/2023]
Abstract
Societal change is needed to prevent and reduce the growth in the amount of solid waste entering the sea. Marine debris networks cover a broad range of activities in order to protect our oceans. By following a common vision and a collective systematic approach they are capable of creating synergies between all relevant stakeholders that result in reducing the flow of waste into our oceans. Thus, they are key to achieving the Sustainable Development Goals. During the 6th International Marine Debris Conference in San Diego in 2018, different marine debris networks from different parts of the world presented their activities, achievements and challenges. This led to network representatives agreeing to collaborate as members of an International Waste Platform. This platform aims to harmonize objectives, share knowledge, join forces and help new networks to emerge.
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Affiliation(s)
- J H Kandziora
- Indonesian Waste Platform, Germany; International Waste Platform.
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Heim C, Ebel N, Schubert W, Werner S, Kondruweit M, Tandler R, Weyand M. Patient-Tailored Silicone Plug for HeartMate 3 Left Ventricular Assist Device Explantation. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- C. Heim
- Universität Erlangen-Nürnberg, Herzchirurgie, Erlangen, Germany
| | - N. Ebel
- Universität Erlangen-Nürnberg, Herzchirurgie, Erlangen, Germany
| | - W. Schubert
- Universität Erlangen-Nürnberg, Lehrstuhl für Polymerwerkstoffe, Erlangen, Germany
| | - S. Werner
- Universität Erlangen-Nürnberg, Lehrstuhl für Polymerwerkstoffe, Erlangen, Germany
| | - M. Kondruweit
- Universität Erlangen-Nürnberg, Herzchirurgie, Erlangen, Germany
| | - R. Tandler
- Universität Erlangen-Nürnberg, Herzchirurgie, Erlangen, Germany
| | - M. Weyand
- Universität Erlangen-Nürnberg, Herzchirurgie, Erlangen, Germany
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Kramer TS, Remschmidt C, Werner S, Behnke M, Schwab F, Werner G, Gastmeier P, Leistner R. The importance of adjusting for enterococcus species when assessing the burden of vancomycin resistance: a cohort study including over 1000 cases of enterococcal bloodstream infections. Antimicrob Resist Infect Control 2018; 7:133. [PMID: 30459945 PMCID: PMC6234683 DOI: 10.1186/s13756-018-0419-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 10/11/2018] [Indexed: 01/27/2023] Open
Abstract
Background Infections caused by vancomycin-resistant enterococci (VRE) are on the rise worldwide. Few studies have tried to estimate the mortality burden as well as the financial burden of those infections and found that VRE are associated with increased mortality and higher hospital costs. However, it is unclear whether these worse outcomes are attributable to vancomycin resistance only or whether the enterococcal species (Enterococcus faecium or Enterococcus faecalis) play an important role. We therefore aimed to determine the burden of enterococci infections attributable to vancomycin resistance and pathogen species (E. faecium and E. faecalis) in cases of bloodstream infection (BSI). Methods We conducted a retrospective cohort study on patients with BSI caused by Enterococcus faecium or Enterococcus faecalis between 2008 and 2015 in three tertiary care hospitals. Data was collected on true hospital costs (in €), length of stay (LOS), basic demographic parameters, and underlying diseases including the results of the Charlson comorbidity index (CCI). We used univariate and multivariable regression analyses to compare risk factors for in-hospital mortality and length of stay (i) between vancomycin-susceptible E. faecium- (VSEm) and vancomycin-susceptible E. faecalis- (VSEf) cases and (ii) between vancomycin-susceptible E. faecium- (VSEm) and vancomycin-resistant E. faecium-cases (VREm). We calculated total hospital costs for VSEm, VSEf and VREm. Results Overall, we identified 1160 consecutive cases of BSI caused by enterococci: 596 (51.4%) cases of E. faecium BSI and 564 (48.6%) cases of E. faecalis BSI. 103 cases of E. faecium BSI (17.3%) and 1 case of E. faecalis BSI (0.2%) were infected by vancomycin-resistant isolates. Multivariable analyses revealed (i) that in addition to different underlying diseases E. faecium was an independent risk factor for in-hospital mortality and prolonged hospital stay and (ii) that vancomycin-resistance did not further increase the risk for the described outcomes among E. faecium-isolates. However, the overall hospital costs were significantly higher in VREm-BSI cases as compared to VSEm- and VSEf-BSI cases (80,465€ vs. 51,365€ vs. 31,122€ p < 0.001). Conclusion Our data indicates that in-hospital mortality and infection-attributed hospital stay in enterococci BSI might rather be influenced by Enterococcus species and underlying diseases than by vancomycin resistance. Therefore, future studies should consider adjusting for Enterococcus species in addition to vancomycin resistance in order to provide a conservative estimate for the burden of VRE infections. Electronic supplementary material The online version of this article (10.1186/s13756-018-0419-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tobias Siegfried Kramer
- 1Charité Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany.,National Reference Center for the Surveillance of Nosocomial Infections, Berlin, Germany
| | - Cornelius Remschmidt
- 1Charité Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany.,National Reference Center for the Surveillance of Nosocomial Infections, Berlin, Germany
| | - Sven Werner
- 3Department of Medical and Financial Controlling, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Behnke
- 1Charité Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany.,National Reference Center for the Surveillance of Nosocomial Infections, Berlin, Germany
| | - Frank Schwab
- 1Charité Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany.,National Reference Center for the Surveillance of Nosocomial Infections, Berlin, Germany
| | - Guido Werner
- 4Robert Koch Institute, FG13 Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany.,National Reference Centre for Staphylococci and Enterococci, Berlin, Germany
| | - Petra Gastmeier
- 1Charité Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany.,National Reference Center for the Surveillance of Nosocomial Infections, Berlin, Germany
| | - Rasmus Leistner
- 1Charité Universitätsmedizin Berlin, Institute of Hygiene and Environmental Medicine, Berlin, Germany.,National Reference Center for the Surveillance of Nosocomial Infections, Berlin, Germany
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Affiliation(s)
- C Kofahl
- Universitätsklinikum Hamburg-Eppendorf, Institut für Medizinische Soziologie, Hamburg, Deutschland
| | - M Haack
- Medizinische Hochschule Hannover, Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Hannover, Deutschland
| | - S Nickel
- Universitätsklinikum Hamburg-Eppendorf, Institut für Medizinische Soziologie, Hamburg, Deutschland
| | - S Werner
- Universitätsklinikum Hamburg-Eppendorf, Institut für Medizinische Soziologie, Hamburg, Deutschland
| | - G Seidel
- Medizinische Hochschule Hannover, Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Hannover, Deutschland
| | - O Knesebeck
- Universitätsklinikum Hamburg-Eppendorf, Institut für Medizinische Soziologie, Hamburg, Deutschland
| | - ML Dierks
- Medizinische Hochschule Hannover, Institut für Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Hannover, Deutschland
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Dhejne C, Görts Öberg K, Arver S, Kardell M, Werner S, Landén M. 161 Gender congruence and psychiatric morbidity after gender-affirming health care: Relation to childhood adversities and adult stressful life events. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2018.04.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Stewart I, Ilie D, Zamyatin A, Werner S, Torshizi MF, Knottenbelt WJ. Committing to quantum resistance: a slow defence for Bitcoin against a fast quantum computing attack. R Soc Open Sci 2018; 5:180410. [PMID: 30110420 PMCID: PMC6030263 DOI: 10.1098/rsos.180410] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 05/22/2018] [Indexed: 06/08/2023]
Abstract
Quantum computers are expected to have a dramatic impact on numerous fields due to their anticipated ability to solve classes of mathematical problems much more efficiently than their classical counterparts. This particularly applies to domains involving integer factorization and discrete logarithms, such as public key cryptography. In this paper, we consider the threats a quantum-capable adversary could impose on Bitcoin, which currently uses the Elliptic Curve Digital Signature Algorithm (ECDSA) to sign transactions. We then propose a simple but slow commit-delay-reveal protocol, which allows users to securely move their funds from old (non-quantum-resistant) outputs to those adhering to a quantum-resistant digital signature scheme. The transition protocol functions even if ECDSA has already been compromised. While our scheme requires modifications to the Bitcoin protocol, these can be implemented as a soft fork.
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Affiliation(s)
- I. Stewart
- Centre for Cryptocurrency Research and Engineering, Imperial College London, London, UK
| | - D. Ilie
- Centre for Cryptocurrency Research and Engineering, Imperial College London, London, UK
| | - A. Zamyatin
- Centre for Cryptocurrency Research and Engineering, Imperial College London, London, UK
- SBA Research, 1, Vienna, Austria
| | - S. Werner
- Centre for Cryptocurrency Research and Engineering, Imperial College London, London, UK
| | - M. F. Torshizi
- Centre for Cryptocurrency Research and Engineering, Imperial College London, London, UK
| | - W. J. Knottenbelt
- Centre for Cryptocurrency Research and Engineering, Imperial College London, London, UK
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Muzumdar S, Hiebert H, Haertel E, Bloch W, Werner S, Schäfer M. 1312 Nrf2 activation enhances the healing of cutaneous wounds through the activation of hair follicle stem cells. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.1329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Dix M, Adams V, Klaeske K, Bowen S, Werner S, Garbade J, Emrich F, Lehmann S, Jawad K, Borger M, Dieterlen M. Ischemic HeartFailure Induces Simultaneous Downregulation of Myocardial E3 Ligases. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Dix M, Adams V, Klaeske K, Bowen S, Werner S, Garbade J, Emrich F, Lehmann S, Jawad K, Borger M, Dieterlen MT. Induction of Simultaneous Downregulation of Myocardial E3 Ligases in Ischemic Heart Failure. Thorac Cardiovasc Surg 2018. [DOI: 10.1055/s-0038-1627913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- M. Dix
- Clinic for Cardiac Surgery, Heart Centre Leipzig - University Leipzig, Leipzig, Germany
| | - V. Adams
- Clinic for Cardiology, Heart Centre Leipzig - University Leipzig, Leipzig, Germany
| | - K. Klaeske
- Clinic for Cardiac Surgery, Heart Centre Leipzig - University Leipzig, Leipzig, Germany
| | - S. Bowen
- Clinic for Cardiology, Heart Centre Leipzig - University Leipzig, Leipzig, Germany
| | - S. Werner
- Clinic for Cardiology, Heart Centre Leipzig - University Leipzig, Leipzig, Germany
| | - J. Garbade
- Clinic for Cardiac Surgery, Heart Centre Leipzig - University Leipzig, Leipzig, Germany
| | - F. Emrich
- Clinic for Cardiac Surgery, Heart Centre Leipzig - University Leipzig, Leipzig, Germany
| | - S. Lehmann
- Clinic for Cardiac Surgery, Heart Centre Leipzig - University Leipzig, Leipzig, Germany
| | - K. Jawad
- Clinic for Cardiac Surgery, Heart Centre Leipzig - University Leipzig, Leipzig, Germany
| | - M. Borger
- Clinic for Cardiac Surgery, Heart Centre Leipzig - University Leipzig, Leipzig, Germany
| | - M.-T. Dieterlen
- Clinic for Cardiac Surgery, Heart Centre Leipzig - University Leipzig, Leipzig, Germany
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Werner S. Can interpersonal contact help improve attitudes toward soldiers with intellectual disability? An Israeli study. J Intellect Disabil Res 2017; 61:1162-1173. [PMID: 29154488 DOI: 10.1111/jir.12439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 09/15/2017] [Accepted: 10/11/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND It has been argued that interpersonal contact is the best intervention for reducing negative attitudes and discrimination toward individuals with intellectual disabilities (ID). In Israel, the Equal in Uniform project makes it possible for individuals with ID to serve alongside soldiers without ID in ordinary military units in the Israeli Defense Forces. The project provided the opportunity to examine the effect of contact on the attitudes of soldiers without ID. METHODS Data analyses are based on data collected from 220 soldiers without ID via a self-administered questionnaire based on the Multidimensional Attitudes Scale. Of these, 138 were in contact with soldiers with ID as part of the project. RESULTS A mediation model showed that the impact of contact with a soldier with ID on withdrawal behaviour was mediated by cognitive attributions and negative affect. Contact was directly associated with prosocial behaviour. DISCUSSION Results support the importance of contact between soldiers with and without ID to bring about improved attitudes toward the former.
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Affiliation(s)
- S Werner
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
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Muzumdar S, Hiebert H, Haertel E, Bloch W, Werner S, Schäfer M. 668 Activation of Nrf2 promotes wound healing by expansion of hair follicle stem cell populations. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rathmayer M, Heinlein W, Reiß C, Albert JG, Akoglu B, Braun M, Brechmann T, Gölder SK, Lankisch T, Messmann H, Schneider A, Wagner M, Dollhopf M, Gundling F, Röhling M, Haag C, Dohle I, Werner S, Lammert F, Fleßa S, Wilke MH, Schepp W, Lerch MM. [Cost assessment for endoscopic procedures in the German diagnosis-related-group (DRG) system - 5 year cost data analysis of the German Society of Gastroenterology project]. Z Gastroenterol 2017; 55:1038-1051. [PMID: 28902372 DOI: 10.1055/s-0043-118350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Background In the German hospital reimbursement system (G-DRG) endoscopic procedures are listed in cost center 8. For reimbursement between hospital departments and external providers outdated or incomplete catalogues (e. g. DKG-NT, GOÄ) have remained in use. We have assessed the cost for endoscopic procedures in the G-DRG-system. Methods To assess the cost of endoscopic procedures 74 hospitals, annual providers of cost-data to the Institute for the Hospital Remuneration System (InEK) made their data (2011 - 2015; § 21 KHEntgG) available to the German-Society-of-Gastroenterology (DGVS) in anonymized form (4873 809 case-data-sets). Using cases with exactly one endoscopic procedure (n = 274 186) average costs over 5 years were calculated for 46 endoscopic procedure-tiers. Results Robust mean endoscopy costs ranged from 230.56 € for gastroscopy (144 666 cases), 276.23 € (n = 32 294) for a simple colonoscopy, to 844.07 € (n = 10 150) for ERCP with papillotomy and plastic stent insertion and 1602.37 € (n = 967) for ERCP with a self-expanding metal stent. Higher costs, specifically for complex procedures, were identified for University Hospitals. Discussion For the first time this catalogue for endoscopic procedure-tiers, based on § 21 KHEntgG data-sets from 74 InEK-calculating hospitals, permits a realistic assessment of endoscopy costs in German hospitals. The higher costs in university hospitals are likely due to referral bias for complex cases and emergency interventions. For 46 endoscopic procedure-tiers an objective cost-allocation within the G-DRG system is now possible. By international comparison the costs of endoscopic procedures in Germany are low, due to either greater efficiency, lower personnel allocation or incomplete documentation of the real expenses.
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Affiliation(s)
| | | | | | - Jörg G Albert
- Abteilung Innere Medizin I mit Schwerpunkt Gastroenterologie, Robert-Bosch-Krankenhaus, Stuttgart
| | - Bora Akoglu
- Medizinische Klinik, St. Marienkrankenhaus, Frankfurt
| | | | | | | | - Tim Lankisch
- Klinik für Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover
| | | | - Arne Schneider
- Klinik für Gastroenterologie, Hepatologie und Gastroenterologische Onkologie, Städt. Klinikum München - Klinikum Bogenhausen
| | - Martin Wagner
- Universitätsklinikum Ulm, Klinik für Innere Medizin I
| | - Markus Dollhopf
- Klinik für Gastroenterologie und Hepatologie Klinikum Neuperlach, München
| | - Felix Gundling
- Klinik für Gastroenterologie, Hepatologie und Gastroenterologische Onkologie, Städt. Klinikum München - Klinikum Bogenhausen
| | - Michael Röhling
- Klinik für Gastroenterologie und interventionelle Endoskopie, Krankenhaus Barmherzige Brüder, Regensburg
| | - Cornelie Haag
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Dresden
| | | | | | - Frank Lammert
- Klinik für Innere Medizin II, Universitätsklinikum des Saarlandes, Homburg
| | - Steffen Fleßa
- Lehrstuhl für Allgemeine Betriebswirtschaftslehre und Gesundheitsmanagement, Universität Greifswald
| | | | - Wolfgang Schepp
- Klinik für Gastroenterologie, Hepatologie und Gastroenterologische Onkologie, Städt. Klinikum München - Klinikum Bogenhausen
| | - Markus M Lerch
- Klinik und Poliklinik für Innere Medizin A, Universitätsmedizin Greifswald
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Nickel S, Werner S, dem Knesebeck O, Kofahl C. Gesundheitskompetenz und Selbstmanagement bei Angehörigengruppen demenzerkrankter Menschen. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- S Nickel
- Universitätsklinikum Hamburg-Eppendorf, Institut für Medizinische Soziologie, Hamburg
| | - S Werner
- Universitätsklinikum Hamburg-Eppendorf, Institut für Medizinische Soziologie, Hamburg
| | - O dem Knesebeck
- Universitätsklinikum Hamburg-Eppendorf, Institut für Medizinische Soziologie, Hamburg
| | - C Kofahl
- Universitätsklinikum Hamburg-Eppendorf, Institut für Medizinische Soziologie, Hamburg
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Werner S, Yalon-Chamovitz S, Tenne Rinde M, Heymann AD. Principles of effective communication with patients who have intellectual disability among primary care physicians. Patient Educ Couns 2017; 100:1314-1321. [PMID: 28190542 DOI: 10.1016/j.pec.2017.01.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 12/14/2016] [Accepted: 01/28/2017] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Examine physicians' implementation of effective communication principles with patients with intellectual disabilities (ID) and its predictors. METHODS Focus groups helped construct a quantitative questionnaire. The questionnaire (completed by 440 physicians) examined utilization of effective communication principles, attitudes toward individuals with ID, subjective knowledge and number of patients with ID. RESULTS Subjective knowledge of ID and more patients with ID increased utilization of effective communication principles. Provision of knowledge that allows patients to make their own medical decisions was predicted by more patients with ID, lower attitudes that treatment of this population group is not desirable, less negative affect and greater perception that treatment of this group is part of the physician's role. Effective preparation of patients with ID for treatment was predicted by higher perception of treatment of this group as part of the physician's role, lower perception of this field as undesirable and higher perception of these individuals as unable to make their own choice. Simplification of information was predicted by a greater perception of treatment of this group as part of the physician's role and more negative affect. CONCLUSION Greater familiarity may enhance care for these patients. PRACTICE IMPLICATIONS Increase exposure to patients with ID within training.
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Affiliation(s)
- S Werner
- Paul Baerwald School of Social Work and Social Welfare, Center for Disability Studies, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - S Yalon-Chamovitz
- The Department of Occupational Therapy, Ono Academic College, Kiryat-Ono, Israel
| | - M Tenne Rinde
- The Department of Occupational Therapy, Ono Academic College, Kiryat-Ono, Israel
| | - A D Heymann
- The Department of Family Medicine, The Sackler Faculty of Medicine, University of Tel Aviv, Tel-Aviv, Israel
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Araten-Bergman T, Werner S. Social workers' attributions towards individuals with dual diagnosis of intellectual disability and mental illness. J Intellect Disabil Res 2017; 61:155-167. [PMID: 27283246 DOI: 10.1111/jir.12300] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 02/15/2016] [Accepted: 05/06/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND The present study aimed to explore the applicability of the attribution model to social workers' attributions towards clients with dual diagnosis of intellectual disability and psychiatric illness. Specifically, the study examined the relations between social workers' attribution of responsibility, causality, stereotypes of dangerousness, their emotional reactions and behavioural reactions towards clients with dual diagnosis. METHOD Social workers (N = 279) completed questionnaires measuring attributions of responsibility, causation and dangerousness, and reported on their emotional and behavioural reactions to clients diagnosed with DD. RESULTS Most social workers reported high levels of helping behaviours. The strongest predictor of discriminatory behaviours was the stereotype of dangerousness. Social workers who reported feeling less anger and more pity towards clients with DD tended to report higher levels of helping behaviour. But contrary to attribution theory, fear and anger did not predict discriminatory behaviours. CONCLUSION The results are discussed in relation to the core values of social work and to professional identity.
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Affiliation(s)
| | - S Werner
- Hebrew University of Jerusalem, Paul Baerwald School of Social Work and Social Welfare, Jerusalem, Israel
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Srivastava A, Serban M, Werner S, Schwartz BA, Kessler CM. Efficacy and safety of a VWF/FVIII concentrate (wilate®) in inherited von Willebrand disease patients undergoing surgical procedures. Haemophilia 2016; 23:264-272. [PMID: 28026130 DOI: 10.1111/hae.13106] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2016] [Indexed: 01/19/2023]
Affiliation(s)
- A. Srivastava
- Department of Haematology; Christian Medical College; Vellore India
| | - M. Serban
- University Emergency Pediatric Hospital Louis Turcanu; Timisoara Romania
| | - S. Werner
- Octapharma Clinical Research; Hoboken NJ USA
| | | | - C. M. Kessler
- Hemophilia and Thrombosis Comprehensive Treatment Center and the Division of Coagulation; Georgetown University Medical Center; Washington DC USA
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Rheinbaben F, Köhnlein J, Naujox K, Werner S. Zur antimikrobiellen und viruziden Wirkung eines Hals- und Rachensprays auf der Basis von Hexamidin. Krankenhaushyg Infektionsverhut 2016; 38:231-234. [PMID: 32288162 PMCID: PMC7146769 DOI: 10.1016/j.khinf.2016.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Antiseptika zur Anwendung auf den Schleimhäuten des Rachenraums dienen nicht nur der Behandlung akuter Symptome bei mikrobiellen oder viralen Infektionen. Zunehmend ist die Anwendung von Antiseptika die einzige noch verbleibende Alternative, wenn auf die Verwendung von Antibiotika verzichtet werden soll oder muss. Dies gilt insbesondere für die Sanierung von MRSA-Trägern. Die Auswahl an geeigneten Wirkstoffen wie auch an verfügbaren Präparaten zur Anwendung auf Schleimhautoberflächen ist begrenzt, und viele von ihnen weisen nicht die erforderliche antimikrobielle oder viruzide Wirksamkeit auf. Ziel der vorgestellten Untersuchung war daher die Überprüfung der antibakteriellen und viruziden Wirkung eines kommerziellen Präparats, basierend auf der Substanz Hexamidindiisetionat. Die Ergebnisse haben gezeigt, dass die Substanz, in einer Dosierung von 1 mg /1 g Lösung und konfektioniert als Rachenspray, eine gute mikrobiostatische und levurostatische Wirksamkeit aufweist. Eine viruzide oder antivirale Wirkung konnte dagegen bei dieser Dosierung nicht gefunden werden.
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Affiliation(s)
- F.v. Rheinbaben
- Korrespondenzautor: PD Dr. rer. Nat. Dr. med. habil. Friedrich von Rheinbaben,HygCen Germany GmbH,Bornhövedstraße 78,19055 Schwerin.Tel.: +49 (0) 385 5682 65; Fax: +49 (0) 385 5682 67.
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Svensson K, Eckerman M, Alricsson M, Magounakis T, Werner S. MUSCLE INJURIES OF THE DOMINANT OR NON-DOMINANT LEG IN MALE FOOTBALL PLAYERS AT ELITE LEVEL. Br J Sports Med 2016. [DOI: 10.1136/bjsports-2016-096952.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hanser T, Barber C, Marchaland JF, Werner S. Applicability domain: towards a more formal definition. SAR QSAR Environ Res 2016; 27:893-909. [PMID: 27827546 DOI: 10.1080/1062936x.2016.1250229] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 10/16/2016] [Indexed: 06/06/2023]
Abstract
In recent years the applicability domain (AD) of a prediction system has become an important concern in (Q)SAR modelling, especially in the context of human safety assessment. Today AD is an active research topic, and many methods have been designed to estimate the adequacy of a model and the confidence in its outcome for a given prediction task. Unfortunately, the wide spectrum of techniques developed for this purpose is based on various definitions of the concept of AD, often taking into account different types of information. This variety of methodologies confuses the end users and makes the comparison of the AD for different models almost impossible. In this article, we demonstrate that AD is not a monolithic concept and can be broken down into three well-defined sub-domains assessing confidence at the model, prediction and decision levels, respectively. By leveraging this separation of concerns we have an opportunity to clarify, formalize and extend the definition of AD. We propose a framework that captures this new vision with the aim to initiate a global effort to converge towards a common AD definition within the (Q)SAR community.
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Affiliation(s)
- T Hanser
- a Research Group, Lhasa Limited (UK) , Leeds , UK
| | - C Barber
- a Research Group, Lhasa Limited (UK) , Leeds , UK
| | | | - S Werner
- a Research Group, Lhasa Limited (UK) , Leeds , UK
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Köhnlein J, Rheinbaben F, Werner S. Untersuchungen zur mikrobistatischen, viruziden und antiviralen Wirksamkeit eines antiseptischen Präparates basierend auf Amylmetacresol, 2,4-Dichlorbenzylalkohol und Levomenthol. Krankenhaushyg Infektionsverhut 2016; 38:203-207. [PMID: 32288161 PMCID: PMC7146804 DOI: 10.1016/j.khinf.2016.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In der vorliegenden Arbeit wurde die viruzide, antivirale und antimikrobielle Wirkung einer Wirkstoffmischung aus 2,4-Dichlorbenzylalkohol, Amylmetacresol und Levomenthol untersucht. Die Prüfung der viruziden Wirkung erfolgte entsprechend der Leitlinie der Deutschen Vereinigung zur Bekämpfung der Viruskrankeiten (DVV) mit Hilfe von Vaccinia-, Adeno- und Poliovirus. Zur Untersuchung der antiviralen Wirkung wurden Interferenztests mit Coronavirus auf PT-Zellen durchgeführt. Zur Prüfung der bakteriostatischen und levurostatischen Wirkung dienten Agardiffusionstests mit Staphylococcus aureus sowie ein multiresistenter Stamm dieses Keims (MRSA), ferner Klebsiella pneumoniae, Streptococcus pyogenes und Candida albicans . Gegenüber Vacciniavirus konnte eine Wirkung gemessen werden, die mit einem Reduktionsfaktor von > 4 log-Stufen die Kriterien eines Desinfektionsmittels für Schleimhautoberflächen erfüllt und so eine umfassende Wirkung gegen andere behüllte Viren nahelegt. Gegenüber unbehüllten Viren erwies sich die Formulierung dagegen als nicht wirksam. Ebenso konnten keine antivirale und damit intrazelluläre Wirkung nachgewiesen werden. Die unverdünnte Wirkstofflösung zeigte gegenüber allen geprüften Bakterienstämmen, insbesondere jedoch gegenüber S. aureus sowie gegenüber dem MRSA-Stamm eine deutliche Wirkung, vor allem jedoch gegenüber C. albicans. Die Ergebnisse legen nahe, dass die Rezepturkomponenten der geprüften Wirkstoffmischung zur Erzielung einer antiseptischen Wirksamkeit in Dosierung wie im Mischungsverhältnis optimal eingestellt sind. Die gemessene Wirkung scheint rein topischer Natur zu sein. Die nicht nachweisbare antivirale Wirkung lässt das Eindringen der Wirkstoffe in Schleimhautzellen als unwahrscheinlich erscheinen.
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Muzumdar S, Hiebert H, Haertel E, Bloch W, Werner S, Schäfer M. 551 Nrf2 activation enhances cutaneous wound healing by expansion of hair follicle stem cell populations. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.06.575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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K Singh V, Werner S, Hackstein H, Lennerz V, Reiter A, Wölfel T, Damm-Welk C, Woessmann W. Analysis of nucleophosmin-anaplastic lymphoma kinase (NPM-ALK)-reactive CD8(+) T cell responses in children with NPM-ALK(+) anaplastic large cell lymphoma. Clin Exp Immunol 2016; 186:96-105. [PMID: 27414060 DOI: 10.1111/cei.12842] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2016] [Indexed: 01/06/2023] Open
Abstract
Cellular immune responses against the oncoantigen anaplastic lymphoma kinase (ALK) in patients with ALK-positive anaplastic large cell lymphoma (ALCL) have been detected using peptide-based approaches in individuals preselected for human leucocyte antigen (HLA)-A*02:01. In this study, we aimed to evaluate nucleophosmin (NPM)-ALK-specific CD8(+) T cell responses in ALCL patients ensuring endogenous peptide processing of ALK antigens and avoiding HLA preselection. We also examined the HLA class I restriction of ALK-specific CD8(+) T cells. Autologous dendritic cells (DCs) transfected with in-vitro-transcribed RNA (IVT-RNA) encoding NPM-ALK were used as antigen-presenting cells for T cell stimulation. Responder T lymphocytes were tested in interferon-gamma enzyme-linked immunospot (ELISPOT) assays with NPM-ALK-transfected autologous DCs as well as CV-1 in Origin with SV40 genes (COS-7) cells co-transfected with genes encoding the patients' HLA class I alleles and with NPM-ALK encoding cDNA to verify responses and define the HLA restrictions of specific T cell responses. NPM-ALK-specific CD8(+) T cell responses were detected in three of five ALK-positive ALCL patients tested between 1 and 13 years after diagnosis. The three patients had also maintained anti-ALK antibody responses. No reactivity was detected in samples from five healthy donors. The NPM-ALK-specific CD8(+) T cell responses were restricted by HLA-C-alleles (C*06:02 and C*12:02) in all three cases. This approach allowed for the detection of NPM-ALK-reactive T cells, irrespective of the individual HLA status, up to 9 years after ALCL diagnosis.
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Affiliation(s)
- V K Singh
- Department of Pediatric Hematology and Oncology
| | - S Werner
- Department of Pediatric Hematology and Oncology
| | - H Hackstein
- Institute of Clinical Immunology and Transfusion Medicine, Justus-Liebig-University, Giessen, Germany
| | - V Lennerz
- Department of Internal Medicine III, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - A Reiter
- Department of Pediatric Hematology and Oncology
| | - T Wölfel
- Department of Internal Medicine III, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - C Damm-Welk
- Department of Pediatric Hematology and Oncology
| | - W Woessmann
- Department of Pediatric Hematology and Oncology
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Köhnlein J, Rheinbaben FV, Werner S. Zur antimikrobiellen und viruziden Wirksamkeit von Octenidin-Lutschtabletten. Krankenhaushyg Infektionsverhut 2016; 38:165-173. [PMID: 32288160 PMCID: PMC7146768 DOI: 10.1016/j.khinf.2016.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Die Verwendung von Octenidin in der Darreichungsform als Lutschtablette wurde erst 2004 patentiert. Das antivirale, viruzide und vor allem antimikrobielle Wirkungsspektrum der Substanz ist vergleichsweise breit und für die Substanz in Monopräparaten noch wenig untersucht. Die bislang vorliegenden Daten unterstreichen jedoch die vielfältigen Möglichkeiten der prophylaktischen und therapeutischen Anwendung der Substanz und legen die Applikation als flankierende Maßnahme z. B. bei der Dekolonisation Antibiotika-resistenter (MRSA) Carrier nahe.
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Werner S, Langer HE. Fluoreszenzoptische Bildgebung. AKTUEL RHEUMATOL 2016. [DOI: 10.1055/s-0042-105952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
ZusammenfassungICG-gestützte fluoreszenzoptische Bildgebung (fluoreszenzoptisches Imaging, FOI) ist eine neuere Technologie zur Entzündungsdiagnostik. Mit der Darstellung von (Neo)Angiogenese, Hypervaskularisation, Hyperämie und veränderter Kapillarpermeabilität stützt sie sich auf frühe pathomorphologische Veränderungen in der Pathogenese einer Arthritis. Umfangreiche Validierungsstudien gegenüber Arthrosonografie einschließlich Power-Doppler-Sonografie und MRT zeigen eine hohe Sensitivität und Spezifität. Die Methode erweitert das diagnostische Armamentarium insbesondere bei der Früharthritisdiagnostik, der Differenzialdiagnostik, der Verlaufsbeurteilung und beim Therapiemonitoring entzündlich-rheumatischer Erkrankungen und in der Kinderrheumatologie und eröffnet zum Teil neue diagnostische Fenster. Als lichtoptisches, fluorophor-gestütztes, mikroangiografisches Verfahren verwendet FOI andere physikalische Grundlagen als die herkömmliche Bildgebung und tritt damit nicht als konkurrierende Methode auf, sondern ergänzt die konventionellen Techniken in einem bislang nicht abgedeckten, speziellen diagnostischen Bereich.
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Affiliation(s)
- S. Werner
- Arbeitsgruppe Bildgebung, Medizinische Klinik mit Schwerpunkt Rheumatologie u. Klinische Immunologie (einschl. Arbeitsbereich Physikalische Medizin CBF/CCM), Charite Universitatsmedizin Berlin, Berlin
| | - H.-E. Langer
- RHIO (Rheumatologie, Immunologie, Osteologie) Düsseldorf, Düsseldorf
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Chatelain R, Wiemann O, Werner S, Langer HE. ICG-gestützte fluoreszenzoptische Bildgebung: ein neues diagnostisches Verfahren zur Früherkennung und Therapiekontrolle bei Psoriasis-Arthritis. Akt Dermatol 2016. [DOI: 10.1055/s-0042-106283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- R. Chatelain
- Dermatologische Klinik, Evangelisches Krankenhaus Düsseldorf
| | - O. Wiemann
- Dermatologische Klinik, Evangelisches Krankenhaus Düsseldorf
| | - S. Werner
- Dermatologische Klinik, Evangelisches Krankenhaus Düsseldorf
| | - H.-E. Langer
- Dermatologische Klinik, Evangelisches Krankenhaus Düsseldorf
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Tranaeus U, Heintz E, Johnson U, Forssblad M, Werner S. Injuries in Swedish floorball: a cost analysis. Scand J Med Sci Sports 2016; 27:508-513. [PMID: 27038298 DOI: 10.1111/sms.12675] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2016] [Indexed: 11/28/2022]
Abstract
The epidemiology of sport injuries is well documented. However, the costs are rarely discussed. Previous studies have presented such costs in specific sports or localization. No study has investigated the costs related to injuries in elite floorball. Thus, the aim of this study was to estimate cost of injuries in Swedish elite floorball players. During 1 year, 346 floorball players were prospectively followed. All time-loss injures were recorded. The injured players were asked to complete a questionnaire regarding their costs tied to the injury. Mean costs were calculated by multiplying the total resource use with the collected unit costs and dividing these total costs with the number of injuries as well as players. The results showed that the average cost per injury increased with the level of severity and ranged from 332 to 2358 Euros. The mild and moderate overuse injuries were costlier than the corresponding traumatic injuries. However, the severe traumatic injuries were associated with higher costs than overuse injuries. Knee injuries were the costliest. Our results indicate that there are costs to be saved, if floorball injuries can be avoided. They should be of interest to decision makers deciding whether to invest in preventive interventions.
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Affiliation(s)
- U Tranaeus
- Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - E Heintz
- Swedish Council on Health Technology Assessment, Stockholm, Sweden.,Center for Medical Technology Assessment, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - U Johnson
- Center of Research on Welfare, Health and Sport, Halmstad University, Halmstad, Sweden
| | - M Forssblad
- Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - S Werner
- Stockholm Sports Trauma Research Center, Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
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Bettencourt-Dias M, Jana SC, Machado P, Rocha J, Mendonça S, Werner S. The architectural landscape of diverse ciliary functions. Cilia 2015. [PMCID: PMC4518624 DOI: 10.1186/2046-2530-4-s1-o13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Werner S. Public stigma in intellectual disability: do direct versus indirect questions make a difference? J Intellect Disabil Res 2015; 59:958-969. [PMID: 26040193 DOI: 10.1111/jir.12207] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 01/13/2015] [Accepted: 05/14/2015] [Indexed: 06/04/2023]
Abstract
BACKGROUND Stigma may negatively impact individuals with intellectual disabilities (ID). However, most studies in the field have been based on the use of direct measurement methods for assessing stigma. This study examined public stigma towards individuals with ID within a representative sample of the Israeli public by comparing direct versus indirect questioning. METHODS Vignette methodology was utilised with two questionnaire versions. In the direct questionnaire (n = 306), the participants were asked how they would think, feel and behave if a man with ID asked them a question in a public place. In the indirect questionnaire (n = 301), the participants were asked to report how a hypothetical 'other man' would think, feel and behave in the same situation. RESULTS Higher levels of stigma were reported among participants that answered the indirect questionnaire version. Furthermore, among those participants that answered the indirect questionnaire version, subjective knowledge of ID was a less important correlate of stigma than for those participants that answered the direct questionnaire. CONCLUSION Several explanations are suggested for the finding that indirect questioning elicits more negative stigmatic attitudes. Among others, indirect questioning may be a more appropriate methodology for eliciting immediate beliefs. Furthermore, the results call for implementing a comprehensive, multi-level programme to change stigma.
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Affiliation(s)
- S Werner
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
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Seidel G, Haack M, Kramer S, Kofahl C, Werner S, Nickel S, dem Knesebeck OV, Dierks ML. Partizipative Forschung und Rekrutierungspfade in der Selbsthilfeforschung der SHILD-Studie. Gesundheitswesen 2015. [DOI: 10.1055/s-0035-1563131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Unseld M, Kornek G, Werner S, Guenther S, Christoph Z, Gerald P. 2299 Nab-paclitaxel as second-line treatment in advanced biliary cancer. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31215-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Werner S, Shulman C. Does type of disability make a difference in affiliate stigma among family caregivers of individuals with autism, intellectual disability or physical disability? J Intellect Disabil Res 2015; 59:272-283. [PMID: 24761747 DOI: 10.1111/jir.12136] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/21/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Studies have shown that beyond public and self stigma, stigma can also impact family members. Only scant research has examined the internalised aspects of stigma, known as affiliate stigma, among family caregivers of individuals with disabilities. This study examined affiliate stigma among family caregivers of individuals with developmental disabilities via a comparison between caregivers of individuals with intellectual disabilities (ID), autism spectrum disorders (ASD) and physical disabilities (PD) in Israel. METHODS Family caregivers (n = 171) of individuals with developmental disabilities, mainly ID (22.4%), ASD (32.9%) and PD (27.1%), completed a self-report structured questionnaire including the Affiliate Stigma Scale and background variables. RESULTS Results supported a one-factor structure for the Affiliate Stigma Scale. Overall, affiliate stigma was relatively low in this sample, but was found to be higher among caregivers of individuals with ASD when compared with caregivers of individuals with ID or PD. CONCLUSION Findings from this study point to the importance of supporting caregivers of individuals with ASD to decrease their feelings of stigma. It is also important to further develop scales measuring affiliate stigma in order to capture the multi-dimensional nature of the concept.
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Affiliation(s)
- S Werner
- Paul Baerwald School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
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Pachowsky ML, Werner S, Marlovits S, Stelzeneder D, Renner N, Trattnig S, Welsch GH. 3D-isotropic high-resolution morphological imaging and quantitative T2 mapping as biomarkers for gender related differences after matrix-associated autologous chondrocyte transplantation (MACT). J Orthop Res 2014; 32:1341-8. [PMID: 25042251 DOI: 10.1002/jor.22682] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 06/10/2014] [Indexed: 02/04/2023]
Abstract
The aim of this study was to determine in vivo high-resolution morphological and biochemical gender related differences in cartilage repair tissue (MACT). Forty patients were examined clinically and by MR scans at 3T-MRI (coronal 3D True-FISP sequence for morphologic assessment and multi-echo spin-echo T2-mapping for biochemical assessment of healthy cartilage and MACT cartilage). Mean T2 values in repair tissue in the deep zone showed significantly shorter T2 times in females (p = 0.009, female 43.5 ± 9.8 vs. male 48.2 ± 7.7 ms). The superficial zone showed higher T2 values than the deep zone in both the groups (female 48.5 ± 9.8, males 52.6 ± 11.0 ms) without significant difference between female and male patients. Native control cartilage showed no statistically significant differences for T2 between females and males. The subdivisions "structure of the repair tissue" and "subchondral bone" of the MOCART score showed statistically significant differences between females and males (p = 0.026 and p = 0.007) as well as the Lysholm score (p = 0.03). Our investigations revealed differences between female and male patients after MACT of the knee in clinical outcome and advanced morphological and biochemical MRI. The presented imaging biomarkers can depict subtle changes after cartilage regeneration procedures and might help to understand gender related differences after cartilage repair procedures.
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Affiliation(s)
- Milena L Pachowsky
- High Field MR Centre, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria; Department of Trauma and Orthopaedic Surgery, University Hospital of Erlangen, Erlangen, Germany
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