Correction to: Economic evaluation of AbobotulinumtoxinA vs OnabotulinumtoxinA in real-life clinical management of cervical dystonia.

[This corrects the article DOI: 10.1186/s40734-020-0083-0.].

Economic evaluation of AbobotulinumtoxinA vs OnabotulinumtoxinA in real-life clinical management of cervical dystonia.

BACKGROUND: Botulinum neurotoxins type A (BoNT-As) are commonly used treatments for cervical dystonia (CD). Clinical trials have demonstrated the benefits of them in these patients, but data from real-life clinical practice as well as comparative data on the cost and outcome of different BoNT-A formulations are limited. The aim of this study was to compare abobotulinumtoxinA (aboBoNT-A) and onabotulinumtoxinA (onaBoNT-A) on their clinical outcomes and drug costs in real-life clinical practice. METHODS: This analysis included 356 adult patients with idiopathic CD treated with aboBoNT-A (n = 253) or onaBoNT-A (n = 103) from 38 centres across Europe and Australia (NCT00833196). The clinical outcome measures were treatment responses, changes in TWSTRS scores and changes in health utility scores from baseline to study visit 2 and 3. Health utility score was mapped from the TWSTRS total scale, using a previous publication. Costs included drug cost for France. RESULTS: The aboBoNT-A treated group had 2.06 (95% CI: 1.15 to 3.69) times higher odds of achieving treatment response than the onaBoNT-A treated group. The adjusted mean change in TWSTRS total score from baseline to visit 3 were - 6.42 (95% CI: - 7.52 to - 5.33) for aboBoNT-A and - 3.94 (95% CI: - 5.68 to - 2.2) for onaBoNT-A, with a difference of - 2.48 (95% CI: - 4.57 to - 0.39). The corresponding difference in the adjusted mean change for health utility score was 0.008 (95% CI: 0.001 to 0.014). Mean treatment costs for aboBoNT-A and onaBoNT-A were 314.1 (95% CI: 299.1 to 329.0) and 346.6 (95% CI: 322.9 to 370.4) Euros, respectively. CONCLUSIONS: This comparative analysis indicated that treatment with aboBoNT-A may be less costly and lead to improved clinical outcomes when compared with onaBoNT-A, from a French healthcare system perspective. Additional comparative clinical data from larger patient cohorts, as well as more information about cost consequences of an improvement in clinical outcome would be of value to further confirm the findings.

29Si{27Al} TRAPDOR MAS NMR to distinguish Qn(mAl) sites in aluminosilicates. Test case: Faujasite-type zeolites.

29Si{27Al} TRAPDOR MAS NMR was applied to two faujasite-type zeolites with Si/Al ratios of 1.3 (Na-X) and 2.7 (Na-Y). The aim of this test study is to show that different Q4(mAl) sites (m =4, 3, 2, 1) can be distinguished by differently strong TRAPDOR effects (ΔS/S0). Indeed, it was found that the TRAPDOR effect depends on the number m of AlO4 units connected to the Q4 silicon tetrahedrons. For Na-X, the measured ΔS/S0 values are 1 : 0.81 : 0.56 for Q4(4Al), Q4(3Al) and Q4(2Al), respectively (normalized to Q4(4Al)). The corresponding ΔS/S0 values are the same for Na-Y within the error bars, although the silicon sites are different: Q4(3Al), Q4(2Al) and Q4(1Al) and now normalized to Q4(3Al) as no Q4(4Al) is present. Nevertheless, the proposed method opens up the possibility to distinguish overlapping 29Si NMR signals of the Qn(mAl) sites in amorphous materials as the main goal of these investigations.

[Social Differences in Physical Activity among Adolescents in Germany: Analyses Based on Information Concerning the Metabolic Equivalent of Task (MET)]. / Soziale Unterschiede in der körperlich-sportlichen Aktivität bei Jugendlichen: Analyse der MoMo-Daten mithilfe der metabolischen Äquivalente (MET).

Introduction: Energy consumption, i. e., the metabolic equivalent of task (MET), provides a precise assessment of physical activity (PA). Studies on social inequalities of PA have hardly used this possibility, however. Methods: The analyses are based on the 'Motorik-Modul (MoMo) of the KiGGS study (German Health Interview and Examination Survey for Children and Adolescents) conducted between 2003 and 2006 (n=1 757; age group 11-17 years). PA has been assessed in 3 settings (sport club in school, other sport club, leisure time). 3 dependent variables were distinguished by combining the following criteria: at least 21 MET-hours per week, intensity between 3 and 6 METs, at least 7 hours a week. The main independent variables are: type of school and socioeconomic status (SES) of the parents. 'Two part models' have been used to assess social difference in PA among those who are physically active. Results: PA is much more common in the higher SES groups. Looking at the MET-hours, though, there are just little differences among those who are physically active (regressions coefficient for low vs. high SES: 1.15; 95% conf. interv. 0.99-1.33). Conclusion: Social differences can be seen mainly for the proportion of adolescents being physically active, not for the extent of PA among those who are physically active. Therefore, the central request should be to increase the proportion of adolescents performing any PA in the low SES group.

[Widening health inequalities? Time trends concerning self-rated health, smoking and obesity between 1984/1985 and 1999/2000 among adults in Augsburg]. / Nimmt die gesundheitliche Ungleichheit zu? : Trends beim subjektiven Gesundheitszustand, beim Rauchen und bei Adipositas zwischen 1984/85 und 1999/2000 bei Erwachsenen in Augsburg.

The analyses focused on time trends in health inequalities in the 25 to 64-year-old population of Augsburg. The analyses are based on four independent cross-sectional surveys from the MONICA/KORA study covering 15 years: 1984/1985 (n = 4,022), 1989/1990 (n = 3,966), 1994/1995 (n = 3,916) and 1999/2000 (n = 3,492). Socioeconomic status (SES) was assessed by educational level and per capita household income with separate analyses for each of these two variables. Both absolute and relative health inequalities were calculated. The results showed that inequalities in self-rated health did not change very much (with some indications for increasing inequalities). However, concerning smoking the results clearly pointed towards increasing health inequalities (for example concerning relative inequalities among women by educational level: significant increase from survey to survey of about 20 %). The prevalence of obesity was increased in all SES groups but the inequalities did not change very much. These time trends show that the efforts aimed at reducing health inequalities should be intensified.

Medication costs by glucose tolerance stage in younger and older women and men: results from the population-based KORA survey in Germany.

To estimate medication costs in individuals with diagnosed diabetes, undetected diabetes, impaired glucose regulation and normal blood glucose values in a population-based sample by age and sex.Using the KORA F4 follow-up survey, conducted in 2006-2008 (n=2611, age 40-82 years), we identified individuals' glucose tolerance status by means of an oral glucose tolerance test. We assessed all medications taken regularly, calculated age-sex specific medication costs and estimated cost ratios for total, total without antihyperglycemic drugs, and cardiovascular medication, using multiple 2-part regression models.Compared to individuals with normal glucose values, costs were increased in known diabetes, undetected diabetes and impaired glucose regulation, which was more pronounced in participants aged 40-59 years than in those aged 60-82 years (cost ratios for all medications: 40-59 years: 2.85; 95%-confidence interval: 1.78-4.54, 2.00; 1.22-3.29 and 1.53; 1.12-2.09; 60-82 years: 2.04; 1.71-2.43, 1.17; 0.90-1.51 and 1.09; 0.94-1.28). Compared to individuals with diagnosed diabetes, costs were significantly lower among individuals with impaired glucose regulation across all age and sex strata, also when antihyperglycemic medication was excluded (40-59 years: 0.60; 0.36-0.98, 60-82 years: 0.74; 0.60-0.90; men: 0.72; 0.56-0.93; women: 0.72; 0.54-0.96).We could quantify age- and sex-specific medication costs and cost ratios in individuals with diagnosed diabetes, undetected diabetes and impaired glucose regulation compared to those with normal glucose values, using data of a population-based sample, with oral glucose tolerance test-based identification of diabetes states. These results may help to validly estimate cost-effectiveness of screening and early treatment or prevention of diabetes.

[Second victim : Critical incident stress management in clinical medicine]. / "Second victim" : "Critical incident stress management" in der klinischen Medizin.

BACKGROUND: Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. METHODS: A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. RESULTS: In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. CONCLUSIONS: The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.

The impact of regional deprivation and individual socio-economic status on the prevalence of Type 2 diabetes in Germany. A pooled analysis of five population-based studies.

AIM: Our objective was to test the hypothesis that the prevalence of Type 2 diabetes increases with increasing regional deprivation even after controlling for individual socio-economic status. METHODS: We pooled cross-sectional data from five German population-based studies. The data set contained information on n = 11,688 study participants (men 50.1%) aged 45-74 years, of whom 1008 people had prevalent Type 2 diabetes (men 56.2%). Logistic multilevel regression was performed to estimate odds ratios (OR) and 95% confidence intervals (CI) for diabetes prevalence. We controlled for sex, age and lifestyle risk factors, individual socio-economic status and regional deprivation, based on a new small-area deprivation measure, the German Index of Multiple Deprivation. RESULTS: Adjusted for sex, age, body mass index (BMI), physical activity, smoking status and alcohol consumption, the prevalence of Type 2 diabetes showed a stepwise increase in risk with increasing area deprivation [OR 1.88 (95% CI 1.16-3.04) in quintile 4 and OR 2.14 (95% CI 1.29-3.55) in quintile 5 compared with the least deprived quintile 1], even after controlling for individual socio-economic status. Focusing on individual socio-economic status alone, the risk of having diabetes was significantly higher for low compared with medium or high educational level [OR 1.46 (95% CI 1.24-1.71)] and for the lowest compared with the highest income group [OR 1.53 (95% CI 1.18-1.99)]. CONCLUSION: Regional deprivation plays a significant part in the explanation of diabetes prevalence in Germany independently of individual socio-economic status. The results of the present study could help to target public health measures in deprived regions.

Pre- and post-pandemic prevalence of antibodies to the 2009 pandemic influenza A (H1N1) virus in Austrian adults.

Antibody prevalence to the 2009 pandemic influenza A (H1N1) virus was determined in a sample of the Austrian population to assess the post-pandemic seropositivity rate, the infection attack rate, and the proportion of subclinical infections during the 2009/2010 influenza pandemic in Austrian adults. A total of 480 sera from individuals aged between 18 and 57 years from all nine federal states of Austria were collected between April and June 2010. Information on demographic characteristics, vaccination history, and history of suspected or verified influenza virus infection was ascertained. Antibodies were determined using a commercial ELISA and compared with 80 age-matched adult sera collected before the pandemic began. The overall seropositivity rate was 28% and was highest among young adults aged 18-29 years, followed by adults aged 50-57 years. Among seropositive unvaccinated individuals, infection was asymptomatic in more than 80%. Extrapolation to the overall Austrian adult population indicates that more than 1.3 million persons aged 18-57 years became infected in 2009. Compared with the pre-pandemic seropositivity rate, the infection rate was highest among young adults but low in those aged 30-57 years. Among 69 individuals previously vaccinated with the 2009 pandemic influenza A (H1N1) virus, 71% had specific antibodies. The study demonstrates that infection rates based on surveillance of clinical cases considerably underestimated the infection attack rate during the 2009 H1N1 pandemic in Austria and that vaccination against this virus elicited long-lasting seropositivity in more than 70% of adults.

Investigation of sodium cations in dehydrated zeolites LSX, X, and Y by 23Na off-resonance RIACT triple-quantum and high-speed MAS NMR spectroscopy.

We investigated by two-dimensional 23Na ORIACT MQMAS NMR and one-dimensional 23Na high-speed MAS NMR spectroscopy a homologous series of dehydrated zeolites with faujasite structure. The framework silicon to aluminum ratios varied between 1.06 and 2.60. In the case of zeolites Y (nSi/nAl = 2.60), we studied materials with sodium exchange degrees between 0 and 95%. The recently introduced ORIACT method (Caldarelli, S.; Ziarelli, F. J. Am. Chem. Soc. 2000, 122, 12015) significantly improved the resolution of the MQMAS spectra, in comparison with earlier studies. It was thus possible to extract meaningful quadrupole parameters by MQMAS NMR, which were used as a starting point for the simulation of 1D MAS NMR spectra to obtain more accurate values of the NMR parameters and site occupancy. We were able to show by this approach that in zeolite NaLSX the SI positions in the hexagonal prisms are occupied by sodium cations. For the homologous series of zeolites Y, it was found that sodium cations located at SII positions are the easiest to be substituted by ammonium ions through the exchange process.

In situ IR, NMR, EPR, and UV/Vis Spectroscopy: Tools for New Insight into the Mechanisms of Heterogeneous Catalysis.

The development of new solid catalysts for use in industrial chemistry has hitherto been based to a large extent upon the empirical testing of a wide range of different materials. In only a few exceptional cases has success been achieved in understanding the overall, usually very complex mechanism of the chemical reaction through the elucidation of individual intermediate aspects of a heterogeneously catalyzed reaction. With the modern approach of combinatorial catalysis it is now possible to prepare and test much more rapidly a wide range of different materials within a short time and thus find suitable catalysts or optimize their chemical composition. Our understanding of the mechanisms of reactions catalyzed by these materials must be developed, however, by spectroscopic investigations on working catalysts under conditions that are as close as possible to practice (temperature, partial pressures of the reactants, space velocity). This demands the development and the application of new techniques of in situ spectroscopy. This review will show how this objective is being achieved. By the term in situ (Lat.: in the original position) is meant the investigation of the chemical reactions which are taking place as well as the changes in the working catalysts directly in the spectrometer.

Dopamine induces the expression of heme oxygenase-1 by human endothelial cells in vitro.

BACKGROUND: In a retrospective study of the kidney transplantations performed at our institution, we found that the administration of dopamine (DA) to the organ donors resulted in a significant improvement of long-term organ survival of the retrieved kidneys. To study the mechanisms underlying the organ protection associated with the administration of DA prior to transplantation, we questioned whether DA induces the antioxidative enzyme heme oxygenase-1 (HO-1) in cultured endothelial cells. METHODS: Human umbilical vein endothelial cells (HUVECs) in culture were incubated with varying concentrations of DA for different time periods. Cells were subsequently assessed for the expression of HO-1 by Western blot and semiquantitative reverse transcription-polymerase chain reaction (RT-PCR). RESULTS: The presence of DA resulted in a dose- and time-dependent up-regulation of HO-1 both on RNA and protein level, whereas HO-1 was barely detectable under basal conditions. RT-PCR indicated the increased presence of HO-1 messenger RNA after 2 hours of incubation with DA, which peaked after 24 hours. The induction of HO-1 antigen was detectable after eight hours, as visualized by Western blot analysis. The addition of the antioxidant agents ascorbic acid and N-acetyl-cysteine both lead to dose-dependent inhibition of DA-mediated HO-1 induction. DA-mediated up-regulation of HO-1 was not influenced by the addition of either the D2-receptor antagonist haloperidol or the D1-receptor antagonist SCH 23390. CONCLUSION: We conclude that DA induces the expression of the protective enzyme HO-1 in cultured endothelial cells by an oxidative mechanism. These findings may explain the beneficial effect of DA administration to kidney donors and indicate the potential role of DA in organ preconditioning.

Short-term bioeffects of an infrared pulsed laser device on burned rat skin monitored by transverse relaxation times (NMR).

BACKGROUND AND OBJECTIVE: The aim of this study was to determine whether the application of an infrared pulsed laser device (IPLD) on the burned skin of rats induced significant changes in the water dynamics of the burned tissues as measured by nuclear magnetic resonance (NMR) at a proton frequency of 90 MHz by using transverse relaxation times (T2, I/T2). STUDY DESIGN/MATERIALS AND METHODS: Seven groups (GI-GVII), each consisting of four albino rats (Sprague-Dawley), of 12-14 weeks of age were used in the experiment. Rats in GI-GVI were anesthetized and burned with a hot tip. GI, GIII, GV were not irradiated. GII, GIV, GVI were irradiated at 0 hours; 0 and 24 hours; and 0, 24, and 48 hours, respectively. Rats in GVII served as controls and were neither burned nor irradiated. Samples from all groups were obtained and monitored by NMR by using transverse relaxation times (T2 and 1/T2). An unpaired Student's t-test and a one-way analysis of variance (ANOVA I) were preformed on the mean values obtained (T2, 1/T2). The statistical design was chosen to give a 95% power of contrast 1-beta (1/T2). The modulated beam of the IPLD used is composed of two superposed waves; a carrier wave (3 MHz), and a drive force wave in the near infrared (904 nm, f = 1014 Hz). A dose of 1.5 x 10(3) J/M2 per session was applied by placing the IPLD directly over the burned tissue by using a top-hat distribution. RESULTS: The results of a t-test on the T2 and 1/T2 values did not show statistically significant differences at 0 and 24 hours between the irradiated groups, the nonirradiated groups, and the nonburned nonirradiated (control) group. Nonetheless, at 48 hours after the burn, we found a statistically significant difference in the 1/T2 values for the irradiated specimens compared with the nonirradiated specimens and the control group. Furthermore, the variance of the 1/T2 values as a function of time showed a tendency to decrease significantly only for the irradiated specimens. CONCLUSION: These findings show possible effects on the water dynamics of burned rat tissue in a short term as a result of the IPLD's application.

Syntheses and ligating properties of molybdocene alkoxides-the first heterodimetallic alkoxide containing molybdenum and bismuth.

Fluorinated alkoxide ligands RO(-) (R=CH(CF3 )2 ) are the key to the isolation of compounds of the type [Cp2 Mo(OR)2 ]. When electron-donating groups R are employed, the Mo(OR)2 moiety can, and necessarily has to, serve as a ligand for Lewis acidic fragments, allowing the isolation and structural characterization of the first heterodimetallic alkoxide containing a Bi and a Mo center (1).

Two-dimensional triple-quantum 23Na MAS NMR spectroscopy of sodium cations in dehydrated zeolites.

Two-dimensional triple-quantum (2D-3Q) 23Na MAS NMR spectroscopy has been applied for the investigation of sodium cations in dehydrated zeolites NaY, NaEMT, NaZSM-5 and NaMOR. The experiments have shown that the new 2D-3Q technique allows the determination of the isotropic chemical shifts and quadrupolar couplings of sodium cations with SOQE (second-order quadrupolar effect) parameters of up to ca. 4 MHz. In the present work, SOQE parameters of 1.0-1.2 MHz were found for sodium cations located at positions SI in the hexagonal prisms of dehydrated zeolites NaY and NaEMT. The sodium cations located in the 10-ring and 12-ring channels of dehydrated zeolites NaZSM-5 and NaMOR, respectively, are characterized by a SOQE parameter of 2.0 MHz while a value of 3.1 MHz was determined for sodium cations in the sidepockets of the channels in dehydrated NaMOR.

Characterisation of sodium cations in dehydrated zeolite NaX by 23Na NMR spectroscopy.

23Na MAS, 2D nutation MAS, and DOR NMR spectroscopy has been applied to characterise the location of sodium cations in dehydrated zeolite NaX (Si/Al = 1.23). The 23Na MAS NMR spectra recorded at three different magnetic field strengths were decomposed by computer simulation into five lines, which were attributed to five crystallographically distinct cation sites known from X-ray diffraction studies. The assignments of the lines follow from electric field gradient calculations at the 23Na nuclei applying a simple point charge model based on crystal structure data. A weak Gaussian line at low field (delta iso = -6 ppm) is assigned to sodium cations at site I, two broad quadrupole patterns at the high-field side of the spectra are attributed to site I' (delta iso = -19 ppm, QCC = 5.2 MHz, eta = 0) and site II cations (delta iso = -15 ppm, QCC = 4.6 MHz, eta = 0), and two quadrupolar lines dominating the central region of the spectra originate from Na+ at two different III' sites (delta iso = -13 and -29 ppm, QCC = 2.6 and 1.6 MHz, eta = 0.7 and 0.9, respectively). Na+ ions located on a second I' site could be identified from the DOR NMR spectra. The line assignment is further corroborated by the reasonable agreement of the site occupancies estimated from the line intensities with those determined by X-ray diffraction. In addition, sodium site populations of five dehydrated zeolites NaX and NaY with Si/Al ratios between 1.09 and 4.0 were derived from the 23Na MAS NMR spectra.

Multinuclear solid-state NMR studies of acidic and non-acidic hydroxyl protons in zeolites.

Among the variety of experimental techniques used for the characterization of aluminosilicate and aluminophosphate-based molecular sieves, NMR spectroscopy has the advantage of providing detailed information on local bonding and solid-state interactions. In the last 15 years, NMR has been used to study zeolitic frameworks, catalytic active centres, adsorbed probe molecules and their chemical interactions. This paper reviews multinuclear solid-state NMR studies of Brønsted acid sites in zeolites. The main topics are the formation, accessibility and localization of hydroxyl protons, dehydroxylation of zeolites, the interaction of hydroxyl protons with probe molecules, and the geometry and parameters of the local structure of OH groups in these materials.