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Background
Chronic obstructive pulmonary disease (COPD) causes significant morbidity and mortality worldwide. Estimation of incidence, prevalence and disease burden through routine insurance data is challenging because of under-diagnosis and under-treatment, particularly for early stage disease in health care systems where outpatient International Classification of Diseases (ICD) diagnoses are not collected. This poses the question of which criteria are commonly applied to identify COPD patients in claims datasets in the absence of ICD diagnoses, and which information can be used as a substitute. The aim of this systematic review is to summarize previously reported methodological approaches for the identification of COPD patients through routine data and to compile potential criteria for the identification of COPD patients if ICD codes are not available.
Methods
A systematic literature review was performed in Medline via PubMed and Google Scholar from January 2000 through October 2018, followed by a manual review of the included studies by at least two independent raters. Study characteristics and all identifying criteria used in the studies were systematically extracted from the publications, categorized, and compiled in evidence tables.
Results
In total, the systematic search yielded 151 publications. After title and abstract screening, 38 publications were included into the systematic assessment. In these studies, the most frequently used (22/38) criteria set to identify COPD patients included ICD codes, hospitalization, and ambulatory visits. Only four out of 38 studies used methods other than ICD coding. In a significant proportion of studies, the age range of the target population (33/38) and hospitalization (30/38) were provided. Ambulatory data were included in 24, physician claims in 22, and pharmaceutical data in 18 studies. Only five studies used spirometry, two used surgery and one used oxygen therapy.
Conclusions
A variety of different criteria is used for the identification of COPD from routine data. The most promising criteria set in data environments where ambulatory diagnosis codes are lacking is the consideration of additional illness-related information with special attention to pharmacotherapy data. Further health services research should focus on the application of more systematic internal and/or external validation approaches.
Content-Gestaltung und Einsatzmöglichkeiten von Augmented Reality in Öffentlichen Bibliotheken
(2019)
Augmented Reality (AR), die Erweiterung der Realität durch computergenerierte Zusatzobjekte, kommt bisher hauptsächlich in Wissenschaftlichen Bibliotheken (WB) zum Einsatz. Diese Arbeit beschäftigt sich deshalb mit den Einsatzmöglichkeiten von AR in Öffentlichen Bibliotheken (ÖB). Betrachtet wird dabei die Realisierung von AR über eigenständig gestalteten Content mittels Anbietern im Internet und dazugehörigen Browser-Apps. Dies stellt eine kostengünstige und barrierefreie Alternative zur Programmierung von Apps dar. Dafür wird zunächst ein theoretischer Überblick gegeben, indem AR definiert wird und die technischen Grundlagen, wie Trackingverfahren und Interfaces, erläutert werden. Darauf folgen, zur Un-termauerung der Diskrepanz zwischen WB und ÖB, Beispiele für umgesetzte Projekte aus beiden Sparten. Anschließend wird auf die allgemeinen Einsatzgebiete und Potenziale von AR sowie die Aufgaben von ÖBs eingegangen. Die daraus abgeleiteten Einsatzmöglichkeiten von AR für Öffentliche Bibliotheken, Navigation und Orientierung, Bestandserweiterung, Veranstaltungen, Öffentlichkeitsarbeit/Marketing/Werbung sowie Informationskompetenz, werden erläutert. Zur Content-Gestaltung werden zunächst Grundvoraussetzungen genannt und die Funktionsweise der AR-Anbieter im Internet erklärt. Im Anschluss werden die Anbieter Blippar, HP Reveal, Layar, ROAR, Wikitude und Zappar, auf Grundlage eines zuvor erstellten Kriterienkatalogs, hinsichtlich ihres Funktionsumfangs verglichen. Im Ergebnis zeigt sich, dass sich die Anbieter zwar alle ähneln, bezüglich spezieller Funktionen und Kosten aber unterscheiden. Am besten schneidet dabei Zappar ab. Ergänzend werden danach die verschiedenen Arten von Content näher betrachtet. Zur Veranschaulichung der leichten Realisierbarkeit von AR werden zwei praktische Beispiele umgesetzt. Zum Abschluss werden Grenzen und Probleme, auch aus rechtlicher Perspektive, betrachtet. Diese schränken die Content-Gestaltung und die Einsatzmöglichkeiten nur wenig ein, womit die Content-Gestaltung von AR für den Einsatz in ÖBs sehr gut geeignet ist.
Objective
To revise the German guidelines and recommendations for ensuring Good Epidemiological Practice (GEP) that were developed in 1999 by the German Society for Epidemiology (DGEpi), evaluated and revised in 2004, supplemented in 2008, and updated in 2014.
Methods
The executive board of the DGEpi tasked the third revision of the GEP. The revision was arrived as a result of a consensus-building process by a working group of the DGEpi in collaboration with other working groups of the DGEpi and with the German Association for Medical Informatics, Biometry and Epidemiology, the German Society of Social Medicine and Prevention (DGSMP), the German Region of the International Biometric Society (IBS-DR), the German Technology, Methods and Infrastructure for Networked Medical Research (TMF), and the German Network for Health Services Research (DNVF). The GEP also refers to related German Good Practice documents (e.g. Health Reporting, Cartographical Practice in the Healthcare System, Secondary Data Analysis).
Results
The working group modified the 11 guidelines (after revision: 1 ethics, 2 research question, 3 study protocol and manual of operations, 4 data protection, 5 sample banks, 6 quality assurance, 7 data storage and documentation, 8 analysis of epidemiological data, 9 contractual framework, 10 interpretation and scientific publication, 11 communication and public health) and modified and supplemented the related recommendations. All participating scientific professional associations adopted the revised GEP.
Conclusions
The revised GEP are addressed to everyone involved in the planning, preparation, execution, analysis, and evaluation of epidemiological research, as well as research institutes and funding bodies.
Background: Compromised immune function, associated with human immune deficiency virus (HIV) infection, is improved by antiretroviral therapy (ART) which also decreases bone mineral density (BMD), and possibly the quality of life (QoL). However, physical (aerobic/resistance) exercises, were reported to induce reverse effects in uninfected individuals and were appraised in the literature for evidence of similar benefits in people living with HIV/AIDS(PLWHA). The main study objective was to evaluate the impact of physical (aerobic and resistance) exercises on CD4+ count,
BMD and QoL in PLWHA.
Methods: A systematic review was conducted using the Cochrane Collaboration protocol. Searching databases, up to June 2017, only randomized control trials investigating the effects of either aerobic, resistance or a combination of both exercise types with a control/other intervention(s) for a period of at least 4 weeks among adults living with HIV, were included. Two independent reviewers determined the eligibility of the studies. Data were extracted and risk of bias (ROB) was assessed with the Cochrane Collaboration ROB tool. Meta-analyses were conducted using random effect models using the Review Manager (RevMan) computer software.
Results: Nineteen studies met inclusion criteria(n = 491 participants at study completion) comprising male and female with age range 22–66 years. Two meta-analyses across 13 sub-group comparisons were performed. However, there were no RCTs on the impact of physical exercises on BMD in PLWHA. The result showed no significant change in CD4+ count unlike a significant effect of 5.04 point (95%CI:-8.49,-3.74,p = 0.00001) for role activity limitation due to physical health (QoL sub-domain). Overall, the GRADE evidence for this review was of moderate quality.
Conclusions: There was evidence that engaging in moderate intensity aerobic exercises (55–85% Maximum heart rate-MHR), for 30–60 min, two to five times/week for 6–24 weeks significantly improves role activity limitation due to physical health problems, otherwise physical(aerobic or/and resistance) exercises have no significant effects on CD4+ count and other domains of QoL. Also, there is lack of evidence on the impact of exercises on BMD in PLWHA due to the paucity of RCTs. The moderate grade evidence for this review suggests that further research may likely have an important impact on our confidence in the estimate of effects and may change the estimate.
Background: Available preliminary data on menopause does not relate changes in body fat mass (BFM) and handgrip strength (HGS) (an indicator of body/muscle strength) to gait parameters.
Objective: To determine the relationship between BFM, HGS and gait parameters, namely, stride length (SL) (an indicator of walking balance/postural stability), stride frequency (SF), and velocity (V) (gait out- put), to guide gait training.
Methods: Ninety consenting (45 postmenopausal and 45 premenopausal) female staffof the University of Nigeria Teaching Hospital, Enugu, were randomly selected and assessed for BFM and HGS with a hydration monitor and dynamometer, respectively, in an observational study. The mean of 2 trials of the number of steps and time taken to cover a 10-m distance at normal speed was used to calculate SF, SL, and V. Data were analyzed using an independent t test and a Pearson correlation coefficient at P < 0.05.
Results: Premenopausal (BFM = 42.93% [12.61%], HGS = 27.89 [7.52] kg, stride ratio = 1.43, and velocity = 1.04 [0.01] m/sec) and postmenopausal (BFM = 41.55% [12.71%], HGS = 30.91 [7.07] kg, stride ratio = 1.44, and velocity = 1.06 [0.01] m/sec) women showed no significant differences in gait output/velocity ( t = 0.138; P = 0.89; d = 0.029). At postmenopause, BFM was significantly and negatively ( r = –0.369; r 2 = 0.1362; P = 0.013) correlated with SL, whereas HGS was positively and significantly ( r = 0.323; r 2 = 0.104; P = 0.030) correlated with gait output at premenopause.
Conclusions: BFM may adversely influence walking balance at postmenopause, whereas HGS may enhance gait output at premenopause but not postmenopause. Therefore, muscle strengthening alone may not enhance gait output in postmenopausal women without balance training.
Background
In the past years, it became apparent that health status and performance differ considerably within dairy farms in Northern Germany. In order to obtain clues with respect to possible causes of these differences, a case-control study was performed. Case farms, which showed signs of health and performance problems, and control farms, which had none of these signs, were compared. Risk factors from different areas such as health management, housing, hygiene and nutrition were investigated as these are known to be highly influential. The aim of this study was to identify major factors within these areas that have the strongest association with health and performance problems of dairy herds in Northern Germany.
Results
In the final model, a lower energy density in the roughage fraction of the diet, more pens with dirty lying areas and a low ratio of cows per watering spaces were associated with a higher risk for herd health problems. Moreover, case farms were affected by infections with intestinal parasites, lungworms, liver flukes and Johne’s Disease numerically more often than control farms. Case farms more often had pens with raised cubicles compared to the deep bedded stalls or straw yards found in control farms. In general, the hygiene of the floors and beddings was worse in case farms. Concerning nutrition, the microbiological and sensory quality of the provided silages was often insufficient, even in control farms. Less roughage was provided to early lactating cows and the feed was pushed to the feeding fence less frequently in case farms than in control farms.
Conclusions
The results show that milk yield and health status were associated with various factors from different areas stressing the importance of all aspects of management for good animal health and performance. Moreover, this study confirmed well-known risk factors for health problems and performance losses. These should better be taken heed of in herd health management.
In the present paper we sketch an automated procedure to compare different versions of a contract. The contract texts used for this purpose are structurally differently composed PDF files that are converted into structured XML files by identifying and classifying text boxes. A classifier trained on manually annotated contracts achieves an accuracy of 87% on this task. We align contract versions and classify aligned text fragments into different similarity classes that enhance the manual comparison of changes in document versions. The main challenges are to deal with OCR errors and different layout of identical or similar texts. We demonstrate the procedure using some freely available contracts from the City of Hamburg written in German. The methods, however, are language agnostic and can be applied to other contracts as well.
For the analysis of contract texts, validated model texts, such as model clauses, can be used to identify used contract clauses. This paper investigates how the similarity between titles of model clauses and headings extracted from contracts can be computed, and which similarity measure is most suitable for this. For the calculation of the similarities between title pairs we tested various variants of string similarity and token based similarity. We also compare two additional semantic similarity measures based on word embeddings using pre-trained embeddings and word embeddings trained on contract texts. The identification of the model clause title can be used as a starting point for the mapping of clauses found in contracts to verified clauses.
Die Anzahl an mit dem HI-Virus Neuinfizierten sinkt aufgrund der stetig voranschreitenden Forschung im Bereich der Therapie der HIV-Infektion kontinuierlich. Durch die erforschten HIV-Medikamente, wie zum Beispiel Biktarvy®, Atripla®, Eviplera® oder Genvoya® kann bei nicht vorliegenden Resistenzen oftmals ein bemerkenswerter Therapieerfolg erzielt werden. Doch der Therapieerfolg wird von vielen verschiedenen Faktoren beeinflusst. Um dies genauer zu analysieren, handelt die vorliegende Bachelorarbeit von der Untersuchung des Einflusses verschiedener Parameter auf den Therapieerfolg von HIV-Infizierten. Da es zahlreiche Einflussfaktoren gibt, wurde eine engere Auswahl getroffen. In dieser Arbeit wurde daher der Einfluss von dem Geschlecht, der Therapiekombination, der Altersgruppe, den vergangenen Jahren seit der gestellten Diagnose sowie der Dauer der bereits eingenommenen Therapie auf die Laborwerte „Viruslast“ und „CD4-Zellzahl“ untersucht. Ziel der Bachelorarbeit war es, mehr Daten zu gewinnen, die Ergebnisse des Einflusses der soeben genannten Kenngrößen enthalten. Für die statistische Vergleichsanalyse wurden Daten aus der seit knapp 20 Jahren bestehenden HIV-Datenbank der Medizinischen Hochschule Hannover, Abteilung Rheumatologie und Immunologie, herangezogen. Um die Ergebnisse dieser Bachelorarbeit zusammenzufassen, lässt sich resümieren, dass bei mehr als der Hälfte der Patienten, genauer gesagt bei 51 anhand der Viruslast und 57 von je 72 Patienten anhand der CD4-Zellen, ein Therapieerfolg erzielt werden konnte. Vor allem bei den Einflussgrößen Geschlecht und Therapiekombination konnte ein bemerkenswerter Einfluss auf den Therapieerfolg festgestellt werden. Bei den weiteren Parametern Altersgruppe, Diagnosedauer und Therapiedauer ist kein statistisch signifikanter Unterschied ermittelt worden.