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.
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.
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.
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.
Objectives
Use claims data to assess healthcare resource utilization (HCRU) and cost for patients with ulcerative colitis (UC) who had surgery and patients who did not.
Methods
UC patients from a ...German health insurance were included between 01/01/2010–31/12/2017. Patients with proctocolectomy or colectomy between 01/07/2010 and 31/12/2014 were identified, and surgery date was set as index. For patients with IPAA, the last surgery in the 6 months was taken as index. Non-surgery patients received random index. After propensity score matching, UC-related HCRU and cost were observed for three years post-index.
Results
Of 21,392 UC patients, 85 underwent surgery and 2655 did not. After matching, 76 were included in the surgery group and 114 in the non-surgery group. Matched cohorts did not differ in baseline characteristics and mortality rates where high in both groups (21.1% and 29.0%, respectively). The percentage of patients with at least one hospitalization in the follow-up period was higher in the surgery (53.9%) compared to the non-surgery group (25.4%,
p
<0.001). In contrast, the number of outpatient prescriptions of UC-related drugs in the non-surgery group (11.2) was almost twice as large as in the surgery group (5.8,
p
<0.001). Hospitalization cost was 4.6 times higher in the surgery (1955.5€) than in the non-surgery group (419.6€,
p
<0.001). Medication cost was three times higher in the non-surgery group (6519€) compared to the surgery group (2151.7€,
p
<0.001).
Conclusions
Based on hospitalizations, outpatient visits, and medical treatment, results show a considerable patient burden in UC from surgery complications or disease exacerbation in case of colectomy.
Large eddy simulations of pulverised coal combustion (PCC-LES) stabilised on a laboratory-scale piloted jet burner are carried out. The joint simulation effort of three research groups at Freiberg ...University (FG), Imperial College (IC) and Stuttgart University (ST) is presented, and the details of the comprehensive coal combustion models and their numerical implementation in three different computer programs are discussed. The (standard) coal sub-models and parameters used by the different groups are unified wherever possible. Differences amongst the groups are a different code basis and an Eulerian treatment of the coal particles by IC, while FG and ST use the Lagrangian framework for particle transport. The flow modelling is first validated for the corresponding non-reacting case and all LES calculations accurately capture the experimental trends. Velocity field statistics for the PCC case are in good accordance with the experimental evidence, but scalar statistics illustrate the complexity of coal combustion modelling. The results show notable differences amongst the groups that cannot only be attributed to the different treatment of the particle phase, and they highlight the difficulty to assess and interpret the quality of specific modelling approaches, and a need for further work by the research community. The present study is the first to compare three originally independent transient coal simulations and a step towards comprehensive PCC-LES.
Background and aims
While a minority of inflammatory bowel disease (IBD) patients receives biologics in Germany, little is known about therapeutic needs of patients receiving non-biologic therapies. ...This study aimed to identify indicators of active disease/steroid dependency in patients with moderate to severe Crohn’s disease (CD) and ulcerative colitis (UC) treated with conventional therapies and to describe health care resource use (HCRU)/cost.
Methods
CD/UC patients treated with immunosuppressants (IS) and/or systemic or locally acting oral corticosteroids (CS) were identified in German claims data (2013–2017) and followed for 12 months post-therapy start. Indicators of active disease/steroid dependency during follow-up period were (i) ≥ 2 prescriptions of CS (sensitivity ≥ 4) or (ii) ≥ 1 IBD-related surgery or (iii) > 7 days IBD-related hospitalization(s).
Results
Of 9871 included IBD patients (5170 CD, 4701 UC), 25.7%/19.9% (CD/UC) received ≥ 2 prescriptions of CS (sensitivity, 17.4%/15.7%) (i), 3.2% experienced IBD-related surgeries (ii), and 2.5% > 7 days of hospitalizations (iii). Altogether, 44.4% had indicators of active disease/steroid dependency (sensitivity, 23.9%). Among patients with active disease/steroid dependency, 78.0% received CS monotherapy at baseline. Of these, 89.6% received a CS monotherapy in the follow-up period, too. Proportionally, fewer patients with CS monotherapy (57.4%) than IS therapy (91.0%) visited a specialist. HCRU/cost per patient year was significantly higher in patients with than without active disease/steroid dependency.
Conclusions
A substantial percentage of biologic-naïve IBD patients suffers from active disease/steroid dependency. The majority receives a monotherapy with systemic CS. Referral to gastroenterologists for treatment optimization is recommended, also because active disease/steroid dependency is associated with increased HCRU/cost.
The high arsenic content of the flotation concentrate obtained from a gold-bearing enargite ore for pyrometallurgical processing strongly diminishes its market value. An investigation has been ...carried out for selectively leaching arsenic from enargite–luzonite minerals using alkaline Na
2S solutions. By suitably adjusting the main reaction conditions almost 98% arsenic was leached, as well as part of the gold, particularly with high Na
2S concentrations. Copper was not lost from the solid phase in which the enargite is converted into a new species with the chemical formula Cu
1.5S.
Ambient concentrations, congener patterns and multi-media distribution of PCDD/Fs and PCBs were determined in air, water, sediment and mussels in a semi-enclosed marine ecosystem (Thau lagoon, ...France). ∑2,3,7,8-PCDD/F and ∑7ICES PCB air concentrations (0.2–1.4 and 31–57
pg m
−3, respectively) were typical of rural areas. Concentrations in the water column were very low for PCDD/Fs (163–476
fg L
−1) and low for PCBs (138–708
pg L
−1). PCDD/F and PCB concentrations found in surface sediment (0.15–1.6 and 2.5–33
ng g
−1 d.w., respectively) and mussel (13–21
pg g
−1 d.w. and 10–39
ng g
−1 d.w., respectively) were medium levels. PCDD/F congener patterns observed in air, water particulate phase and sediments were similar suggesting direct coupling among these compartments and atmospheric inputs of PCDD/Fs into the lagoon. Conversely, for the same set of samples, similar patterns were not observed for PCBs in the mentioned compartments.
Multi-media ambient concentrations and distribution of PCDD/Fs and PCBs in Thau Lagoon provide insight into the POPs behavior in semi-enclosed marine ecosystems.
La investigación arqueológica regional enfocada en el paisaje fue realizada en el sector meridional del partido de Punta Indio (noreste de la provincia de Buenos Aires, Argentina). En este sector de ...722 km2, que contaba con escasos antecedentes arqueológicos, se realizaron prospecciones en las cuales fueron registrados los sitios Los Tres Ombúes, El Puesto, Don Enrique y Corral del Indio. La integración de los datos obtenidos posibilitó la comprensión del sector como parte del paisaje habitado por grupos cazadores-recolectores en momentos del Holoceno tardío (1110-260 años C14 AP; 982-1796 años cal.), con una notoria participación en redes regionales de interacción social. Este artículo tiene por objetivo, por una parte, presentar el análisis de la información espacial resultante del abordaje arqueológico del sector meridional del partido de Punta Indio y su integración regional, realizado mediante Sistemas de Información Geográfica (SIG); por otra parte, discutir su aporte al estudio del paisaje arqueológico del Holoceno tardío en el noreste de la provincia de Buenos Aires (Argentina). El análisis implicó tres escalas: el sitio arqueológico, el sector de estudio y la escala regional (recorte espacial de 12.000 km2). En primer lugar, se abordaron la visibilidad y la accesibilidad al entorno inmediato para cada sitio. También se establecieron áreas de tránsito que permitieron indagar la movilidad en el sector y para una escala más amplia, lo cual implicó integrar los resultados obtenidos con el conocimiento arqueológico relativo a las áreas vecinas. Asimismo, fue realizada una evaluación multicriterio de alcance regional, la cual permitió generar un modelo actualístico de aptitud respecto a la localización de los lugares habitados. Se destaca el aporte de los SIG al estudio arqueológico de los grupos cazadores-recolectores en contextos de tierras bajas, al propiciar la interpretación de las estrategias para habitar el paisaje implementadas por dichos grupos.
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