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As one of the first Direct Acting Antivirals (DAA), the protease inhibitor Telaprevir (TVR) was available in the European Union from 9/2011 until 9/2016 as a new treatment option for chronic Hepatitis C.Aim. To assess the implementation of therapy stopping rules or shortening of the treatment and their impact on sustained virological response (SVR), as well as the safety and efficacy of the TVR-based therapy during routine daily treatment of patients in Germany.Materials and Methods. 802 patients were assessed (272 treatment naïve, 520 pre-treated) in the noninterventional, multi-center study.Results. 56.6 % of the patients achieved SVR. SVR rate was higher in patients with relapse after previous treatment (68.0 %) than in patients with a previous null-response (31.1 %) and in previously untreated patients (58.1 %). Stopping rule conditions were fulfilled by 3.2 % of patients and it was implemented in 65.4 % of these. 34.3 % of the patients fulfilled the conditions for a therapy shortening. This rule was adhered to in 48.4 % of these, in 34.5 % it was not adhered to. Thus recommendations were not always being followed. Therapy shortening was considered more frequently in previously untreated (54.8 %) than for previously treated patients (24.2 %). Stopping rule application but not shortened treatment reduced therapy costs.Conclusion. The TVR-based therapy represented a breakthrough at that time. Further DAAs have been added as therapeutic options since, increasing the complexity of treatment choice and correct implementation. They represent both an opportunity and a challenge for all those involved.As one of the first Direct Acting Antivirals (DAA), the protease inhibitor Telaprevir (TVR) was available in the European Union from 9/2011 until 9/2016 as a new treatment option for chronic Hepatitis C.Aim. To assess the implementation of therapy stopping rules or shortening of the treatment and their impact on sustained virological response (SVR), as well as the safety and efficacy of the TVR-based therapy during routine daily treatment of patients in Germany.Materials and Methods. 802 patients were assessed (272 treatment naïve, 520 pre-treated) in the noninterventional, multi-center study.Results. 56.6 % of the patients achieved SVR. SVR rate was higher in patients with relapse after previous treatment (68.0 %) than in patients with a previous null-response (31.1 %) and in previously untreated patients (58.1 %). Stopping rule conditions were fulfilled by 3.2 % of patients and it was implemented in 65.4 % of these. 34.3 % of the patients fulfilled the conditions for a therapy shortening. This rule was adhered to in 48.4 % of these, in 34.5 % it was not adhered to. Thus recommendations were not always being followed. Therapy shortening was considered more frequently in previously untreated (54.8 %) than for previously treated patients (24.2 %). Stopping rule application but not shortened treatment reduced therapy costs.Conclusion. The TVR-based therapy represented a breakthrough at that time. Further DAAs have been added as therapeutic options since, increasing the complexity of treatment choice and correct implementation. They represent both an opportunity and a challenge for all those involved.
Molecular surveillance of carbapenem-resistant gram-negative bacteria in liver transplant candidates
(2021)
Background: Carbapenem-resistant Gram-negative bacteria (CRGN) cause life-threatening infections due to limited antimicrobial treatment options. The occurrence of CRGN is often linked to hospitalization and antimicrobial treatment but remains incompletely understood. CRGN are common in patients with severe illness (e.g., liver transplantation patients). Using whole-genome sequencing (WGS), we aimed to elucidate the evolution of CRGN in this vulnerable cohort and to reconstruct potential transmission routes.
Methods: From 351 patients evaluated for liver transplantation, 18 CRGN isolates (from 17 patients) were analyzed. Using WGS and bioinformatic analysis, genotypes and phylogenetic relationships were explored. Potential epidemiological links were assessed by analysis of patient charts.
Results: Carbapenem-resistant (CR) Klebsiella pneumoniae (n=9) and CR Pseudomonas aeruginosa (n=7) were the predominating pathogens. In silico analysis revealed that 14/18 CRGN did not harbor carbapenemase-coding genes, whereas in 4/18 CRGN, carbapenemases (VIM-1, VIM-2, OXA-232, and OXA-72) were detected. Among all isolates, there was no evidence of plasmid transfer-mediated carbapenem resistance. A close phylogenetic relatedness was found for three K. pneumoniae isolates. Although no epidemiological context was comprehensible for the CRGN isolates, evidence was found that the isolates resulted of a transmission of a carbapenem-susceptible ancestor before individual radiation into CRGN.
Conclusion: The integrative epidemiological study reveals a high diversity of CRGN in liver cirrhosis patients. Mutation of carbapenem-susceptible ancestors appears to be the dominant way of CR acquisition rather than in-hospital transmission of CRGN or carbapenemase-encoding genetic elements. This study underlines the need to avoid transmission of carbapenem-susceptible ancestors in vulnerable patient cohorts.
Neurowissenschaftler fordern einen illusionslosen Umgang mit Begriffen wie Willensfreiheit und Bewusstsein. Philosophen kritisieren offen die Thesen von Hirnforschern. Stehen sich diese Positionen unversöhnlich gegenüber? Wo gibt es Möglichkeiten einer Annäherung, gar einer Kooperation? Der Religionsphilosoph Prof. Dr. Thomas M. Schmidt und der Biologe Stefan Kieß loten die Situation in Frankfurt aus; ihre Gesprächspartner sind der Hirnforscher Prof. Dr. Wolf Singer (links), Direktor am Max-Planck-Institut für Hirnforschung, und Prof. Dr. Marcus Willaschek (rechts), Philosoph an der Universität Frankfurt.
New results from the energy scan programme of NA49, in particular kaon production at 30 AGeV and phi production at 40 and 80 AGeV are presented. The K+/pi+ ratio shows a pronounced maximum at 30 AGeV; the kaon slope parameters are constant at SPS energies. Both findings support the scenario of a phase transition at about 30 AGeV beam energy. The phi/pi ratio increases smoothly with beam energy, showing an energy dependence similar to K-/pi-. The measured particle yields can be reproduced by a hadron gas model, with chemical freeze-out parameters on a smooth curve in the T-muB plane. The transverse spectra can be understood as resulting from a rapidly expanding, locally equilibrated source. No evidence for an earlier kinetic decoupling of heavy hyperons is found.
Directed and elliptic flow of charged pions and protons in Pb + Pb collisions at 40 and 158 A GeV
(2003)
Directed and elliptic flow measurements for charged pions and protons are reported as a function of transverse momentum, rapidity, and centrality for 40 and 158A GeV Pb + Pb collisions as recorded by the NA49 detector. Both the standard method of correlating particles with an event plane, and the cumulant method of studying multiparticle correlations are used. In the standard method the directed flow is corrected for conservation of momentum. In the cumulant method elliptic flow is reconstructed from genuine 4, 6, and 8-particle correlations, showing the first unequivocal evidence for collective motion in A+A collisions at SPS energies.
Das Herbarium des Pfarrers Adolf Becker, gesammelt zwischen 1833 und 1863, wurde nachbestimmt. Bei der Mehrzahl der etwa 200 mit Fundorten versehenen Belege handelt es sich um Kulturpflanzen, die vornehmlich in Parkanlagen von Bad Homburg v. d. Höhe und Okarben gesammelt wurden. Diese geben einen Eindruck von den erstaunlich reichhaltigen Bepflanzungen jener Zeit. 81 von uns als Wildpflanzen klassifizierte Arten wurden zumeist um Okarben gesammelt. Wegen ihres Rückganges oder aktuellen Fehlens sind die Belege von Apium graveolens, A. nodiflorum, Juncus gerardii, Nigella arvensis und Oenanthe fistulosa bemerkenswert.
The blue pine wood borer (Phaenops cyanea) and the black pine sawyer beetle (Monochamus galloprovincialis) (Fig. 1) both are pests of the white pine (Pinus silvestris) and other Pinus species. Both insects have nearly the same demands regarding their breeding site. Larval development requires a fresh, unwilted inner bark. An infestation occurs on freshly cut trees or on trees suffering from stress (e.g. after dry seasons, loss of needles caused by feeding caterpillars or damage by forest fires). Phaenops cyanea detects susceptible pines by their volatile emissions (SCHÜTZ et al. 2004) and is able to infest the trees already at a low stress level. During feeding the larvae avoid the resin ducts of the tree and thus evade the oleoresin defence. The beetle is endemic in Europe and – under favourable climatic conditions – can cause substantial damage to pine forests. It is the most significant bark-breeding beetle of white pine in the lowlands of north-eastern Germany. Monochamus galloprovincialis is found in Europe and northern Africa. The larvae tend to a more copious feeding which makes them more susceptible to the oleoresin defence of the tree. Thus, M. galloprovincialis prefers trees that are weakened by a higher degree of stress. The economic damage caused by feeding of thebeetle is low. However, the beetle has gained a special attention of forest scientists because of its association with the nematode Bursaphelenchus xylophilus which is causing the pine wilt disease (PWD) in Pinus. The only outbreak of the PWD within Europe is limited to an area of 258.000 ha in Portugal. (MOTA et al. 1999).
Buchbesprechungen
(2020)
Es werden folgende Publikation rezensiert: Jürgen Feder 2016: Feders phantastische Stadtpflanzen; Paar et al. 2018: Waldzustandsbericht 2018; Gerald Parolly & Jens G. Rohwer (Herausgeber) 2019: Die Flora Deutschlands und angrenzender Länder. Ein Buch zum Bestimmen aller wildwachsenden und häufig kultivierten Gefäßpflanzen; Marcus Schmidt & Peter Meyer 2018: Hessische Naturwaldreservate im Portrait. Wattenberg und Hundsberg; Indra Starke-Ottich & Georg Zizka 2019: Stadtnatur in Frankfurt – vielfältig, schützenswert, notwendig; Technische Universität Ilmenau (Herausgeber) 2020: Flora Incognita.
Prospective welfare analysis - extending willingness-to-pay assessment to embrace sustainability
(2022)
In this paper we outline how a future change in consumers’ willingness-to-pay can be accounted for in a consumer welfare effects analysis in antitrust. Key to our solution is the prediction of preferences of new consumers and changing preferences of existing consumers in the future. The dimension of time is inextricably linked with that of sustainability. Taking into account the welfare of future cohorts of consumers, concerns for sustainability can therefore be integrated into the consumer welfare paradigm to a greater extent. As we argue in this paper, it is expedient to consider changes in consumers’ willingness-to-pay, in particular if society undergoes profound changes in such preferences, e.g., caused by an increase in generally available information on environmental effects of consumption, and a rising societal awareness about how consumption can have irreversible impacts on the environment. We offer suggestions on how to conceptionalize and operationalize the projection of such consumers’ changing preferences in a “prospective welfare analysis”. This increases the scope of the consumer welfare paradigm and can help to solve conceptual issues regarding the integration of sustainability into antitrust enforcement while keeping consumer surplus as a quantitative gauge.