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1.
J Chem Phys ; 153(6): 064104, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-35287439

RESUMO

The Open Knowledgebase of Interatomic Models (OpenKIM) is a framework intended to facilitate access to standardized implementations of interatomic models for molecular simulations along with computational protocols to evaluate them. These protocols include tests to compute material properties predicted by models and verification checks to assess their coding integrity. While housing this content in a unified, publicly available environment constitutes a major step forward for the molecular modeling community, it further presents the opportunity to understand the range of validity of interatomic models and their suitability for specific target applications. To this end, OpenKIM includes a computational pipeline that runs tests and verification checks using all available interatomic models contained within the OpenKIM Repository at https://openkim.org. The OpenKIM Processing Pipeline is built on a set of Docker images hosted on distributed, heterogeneous hardware and utilizes open-source software to automatically run test-model and verification check-model pairs and resolve dependencies between them. The design philosophy and implementation choices made in the development of the pipeline are discussed as well as an example of its application to interatomic model selection.

2.
Internist (Berl) ; 55(4): 470-7, 2014 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-24577343

RESUMO

BACKGROUND: Integrated treatment pathways are an appropriate means for increasing the quality of treatment and outcome via process optimization. Taking the POLIKUM Health Centers as an example, we intend to demonstrate how the implementation can be effected for the indication of anemia. METHOD: The development and implementation were executed by an interdisciplinary workgroup in several workshops. In addition, the diagnoses and hemoglobin values of all patients with requests for hemograms were obtained and analyzed at two locations. RESULTS: Developing the pathway required significantly greater efforts than initially planned. The biggest challenge was to adequately map the complexity of the different forms of anemia and, concomitantly, to design a pathway that can actually be realized in everyday life. Moreover, evaluation of the patient data demonstrated that there are a large number of cases where existing anemias are not reflected in the respective diagnoses. CONCLUSION: While the ultimate effects of the new pathway cannot yet be assessed conclusively, it was possible to obtain valuable findings for practical use even at this point. Despite the limitations of the sample, the surprisingly high number of undetected anemias should give physicians cause for taking diagnostic measures even in patients with mild anemia.


Assuntos
Anemia Ferropriva/terapia , Centros Comunitários de Saúde/organização & administração , Comportamento Cooperativo , Prestação Integrada de Cuidados de Saúde/organização & administração , Implementação de Plano de Saúde/organização & administração , Comunicação Interdisciplinar , Medicina Interna/organização & administração , Algoritmos , Anemia Ferropriva/diagnóstico , Procedimentos Clínicos/organização & administração , Alemanha , Hemoglobinometria , Humanos , Melhoria de Qualidade/organização & administração
3.
Gesundheitswesen ; 76(4): e7-e13, 2014 Apr.
Artigo em Alemão | MEDLINE | ID: mdl-24081570

RESUMO

OBJECTIVES: On 01 January 2011 the bill for the reorganisation of the pharmaceutical market became effective. Since that time there is a European reference pricing (ERP) system for vaccines in order to bring down the German vaccine prices to an assumed lower European level. This study describes the implementation, functioning and effect of this new system. For influenza vaccines the impact of ERP on the price level and spread of prices is analysed. METHODS: The description of the mechanism is based on the law and corresponding regulations of the head association of sickness funds (GKV-SV). The analysis of vaccine prices is based on the data of the i:data report (status of 01 September 2011) of ifap Service Institute. RESULTS: The European reference price is calculated as the average price of the manufacturer-selling-prices of the corresponding vaccine in the 4 countries of the European Union whose gross national income comes closest to the German one and in which the vaccine is distributed. The relied prices are weighted by sales and purchasing power parities of the respective countries. This analysis suggests that in particular the practical implementation of the reference price system should be further improved and specified. The calculation of the reference prices should ensure price comparability. In addition, significant problems remain in the deduction of discounts, because no distinction is made in the documentation of vaccinating doctors, whether vaccination was performed as a compulsory or statutory benefit. The comparison of the manufacturer-selling-prices of individual influenza vaccines with the corresponding reference prices shows an enlargement of the existing price differences, which have evolved in a competitive environment, after the implementation of the reference pricing -system. CONCLUSIONS: There is still a need for improvement in implementing the reference pricing system. In the most competitive vaccine market of influenza vaccines, the ERP-system lowers the prices, but seems to distort the market prices.


Assuntos
Custos e Análise de Custo/legislação & jurisprudência , Honorários e Preços/legislação & jurisprudência , Política de Saúde/economia , Política de Saúde/legislação & jurisprudência , Vacinas contra Influenza/economia , Vacinas contra Influenza/provisão & distribuição , Legislação de Medicamentos/economia , Comércio , Controle de Custos , Custos e Análise de Custo/economia , Europa (Continente) , União Europeia , Alemanha , Valores de Referência
6.
Value Health ; 17(7): A548-9, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27201781
7.
Chirurg ; 84(5): 426-32, 2013 May.
Artigo em Alemão | MEDLINE | ID: mdl-23519380

RESUMO

INTRODUCTION: In clinical practice there are medical and economic reasons against the thoughtless use of packed red blood cells (rbc). Therefore, in searching for alternatives (therapy of anemia) the total costs of allogeneic blood transfusions must be considered. Using a practical example this article depicts the actual costs and possible alternatives from the point of view of a hospital in Germany. METHOD: To determine the total costs of allogeneic blood transfusions the actual resource consumption associated with blood transfusions was collated and analyzed at the St. Marien-Hospital in Vechta. RESULTS: The authors were able to show that the actual procurement costs (average. 97 EUR) represent only 55 % of the total costs of 176 EUR. The additional expenses are allocated to personnel (78 %) and materials (22 %). Alternatives, such as i.v. iron substitution or stimulation of erythropoesis might be the more economical solution especially if only purchase prices are compared and the total costs of allogeneic blood transfusions are not considered. DISCUSSION: Analyzing a single hospital limits generalization of the results; however, in the international context the results can be recognized as plausible. So far there have been no comprehensive studies on the true costs of blood preparations, therefore, this article represents a first starting point for closing this gap by conducting additional studies.


Assuntos
Anemia Ferropriva/terapia , Transfusão de Sangue/economia , Custos de Cuidados de Saúde/estatística & dados numéricos , Custos Hospitalares/estatística & dados numéricos , Programas Nacionais de Saúde/economia , Procedimentos Cirúrgicos Operatórios/economia , Anemia Ferropriva/diagnóstico , Anemia Ferropriva/economia , Transfusão de Sangue/estatística & dados numéricos , Controle de Custos/economia , Custos e Análise de Custo/economia , Transfusão de Eritrócitos/economia , Transfusão de Eritrócitos/estatística & dados numéricos , Alemanha , Hemoglobinometria/economia , Hemoglobinometria/estatística & dados numéricos , Humanos , Projetos Piloto , Cuidados Pré-Operatórios/economia , Cuidados Pré-Operatórios/estatística & dados numéricos , Revisão da Utilização de Recursos de Saúde/economia , Revisão da Utilização de Recursos de Saúde/estatística & dados numéricos
8.
Verh Dtsch Ges Pathol ; 89: 191-4, 2005.
Artigo em Alemão | MEDLINE | ID: mdl-18035690

RESUMO

Previous molecular cytogenetic studies in breast cancer revealed numerous chromosomal changes and identified alterations involving the chromosomes 1 and 16 as early incidents in mammary carcinogenesis. Since both chromosomes reveal pericentromeric heterochromatic areas, these chromosomal alterations might result from instable heterochromatin caused by DNA hypomethylation. In the present study, we investigated whether hyperplastic and neoplastic lesions of the breast differ regarding the distance between the heterochromatic areas of chromosomes 1 and 16 within the nuclei. We hybridized differently fluorescence-labeled DNA samples specific for the heterochromatic regions of chromosomes 1 and 16 to formalin-fixed tissue sections. Histological classification of the lesions was supported by immunohistochemical staining using cytokeratin-specific antibodies. The methylation state of the heterochromatic regions was tested by staining with an antibody specific for methylated cytidin. Our results revealed an increased frequency of paired intranuclear signals specific for chromosomes 1 and 16 in neoplastic lesions (atypical ductal hyperplasia, ductal carcinoma in situ) compared to ductal hyperplasia and normal glandular epithelium. Staining with the methylation-specific antibody reavealed a weaker staining in neoplastic lesions compared to hyperplastic lesions and normal cells. We conclude that atypic ductal hyperplasia represents the histomorphological equivalent for the beginning of tumor genome evolution that progresses in ductal carcinoma in situ and infiltrating carcinoma.


Assuntos
Neoplasias da Mama/patologia , Mama/patologia , Núcleo Celular/patologia , Metilação de DNA , Heterocromatina/patologia , Hiperplasia/patologia , Lesões Pré-Cancerosas/patologia , Neoplasias da Mama/genética , Mapeamento Cromossômico , DNA de Neoplasias/genética , Feminino , Heterocromatina/genética , Humanos , Hibridização in Situ Fluorescente
9.
Clin Exp Immunol ; 117(2): 316-23, 1999 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-10444264

RESUMO

Increased production of proinflammatory cytokines, including tumour necrosis factor-alpha (TNF-alpha), IL-1beta, IL-6 and IL-8, has been demonstrated in Helicobacter pylori-associated gastric mucosal inflammation. IL-12, a newly characterized cytokine, is thought to be a key mediator in host responses to bacterial infections. The aim of this study was to investigate differences in cytokine patterns between H. pylori-positive and -negative gastritis and normal mucosa. Secretion of IL-12, TNF-alpha, IL-1beta, IL-6, IL-8 and IL-10 was measured in 176 patients with chronic gastritis in whole biopsy cultures. Gastritis was graded for chronic inflammation or acute inflammatory activity, respectively, according to the Sydney system. Biopsies with similar scores were matched for analysis from H. pylori-infected and non-infected patients. Secretion of IL-12 was significantly increased in H. pylori-associated gastritis in comparison with H. pylori-negative gastritis (P < 0.0001). In contrast, secretion of TNF-alpha, IL-1beta, IL-6, and IL-8 correlated with the degree of inflammation but was not different between H. pylori-positive and -negative patients. Moreover, IL-10 secretion was found to be higher in H. pylori-positive than in H. pylori-negative patients. IL-12 may play a specific role in H. pylori-associated gastric disease, whereas production of the proinflammatory cytokines TNF-alpha, IL-1beta, IL-6 and IL-8 does not seem to be restricted to H. pylori-induced inflammation. The contra-inflammatory cytokine IL-10 may be a contributor to the chronicity of H. pylori-associated gastritis by impairing clearance of the pathogen.


Assuntos
Gastrite/imunologia , Gastrite/microbiologia , Infecções por Helicobacter/imunologia , Helicobacter pylori/imunologia , Interleucina-12/biossíntese , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos de Bactérias/sangue , Proteínas de Bactérias/sangue , Doença Crônica , Feminino , Mucosa Gástrica/imunologia , Mucosa Gástrica/patologia , Gastrite/patologia , Infecções por Helicobacter/microbiologia , Infecções por Helicobacter/patologia , Humanos , Interleucina-1/biossíntese , Interleucina-1/metabolismo , Interleucina-10/metabolismo , Interleucina-12/metabolismo , Interleucina-6/biossíntese , Interleucina-6/metabolismo , Interleucina-8/biossíntese , Interleucina-8/metabolismo , Masculino , Pessoa de Meia-Idade , Fator de Necrose Tumoral alfa/biossíntese , Fator de Necrose Tumoral alfa/metabolismo
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