Why do patients having coronary artery bypass grafts have different costs or length of stay? : An analysis across ten European countries

We analyse variations in costs or lengths of stay (LoS) for 66,587 patients from ten European countries receiving a coronary artery bypass graft (CABG) procedure. In five of these countries, variations in cost are analysed using log-linear models. In the other five countries, negative binomial regression models are used to explore variations in LoS. We compare how well each country’s Diagnosis Related Group (DRG) system and a set of patient-level characteristics explain these variations. The most important explanatory factors are the total number of diagnoses and procedures, although no clear effects are evident for our CABG-specific diagnostic and procedural variables. Wound infections significantly increase length of stay and costs in all countries. There is no evidence that countries using larger numbers of DRGs to group CABG patients were better at explaining variations in cost or LoS. However, refinements to the construction of DRGs to group CABG patients might recognise first and subsequent CABGs or other specific surgical procedures, such as multiple valve repair

Schulbücher und Lektüre in der vormodernen Unterrichtpraxis

Voir le rapport en français sur ce colloque : Jean-Luc Le Cam, « Schulbücher und Lektüren in der vormodernen Unterrichtspraxis / Manuels scolaires et lectures dans la pratique d’enseignement à l’époque moderne », Revue de l'IFHA [En ligne], 4 | 2012, mis en ligne le 14 février 2013, consulté le 17 juin 2015. URL : http://ifha.revues.org/380International audienceUne historienne des sciences de l'éducation (Prof. Dr. Stephanie HELLEKAMPS, Münster), un historien moderniste (Jean-Luc LE CAM, Brest) et une historienne de la théologie (Prof. Dr. Anne CONRAD, Sarrebruck), ont réuni 14 spécialistes en provenance d'Allemagne, de France, de Hollande et de Tchéquie, représentant diverses disciplines, en premier l’histoire et les sciences de l’éducation, mais aussi les études littéraires, philologiques et théologiques pour explorer l’histoire des manuels et des lectures scolaires dans le contexte des pratiques éducatives et d’enseignement de l’époque médiévale et moderne.Abandonnant une vision fondée essentiellement sur les documents normatifs ou les discours d’intention des auteurs de manuels et livres utilisés dans l'enseignement, vision en outre souvent focalisée sur les plus célèbres, cet ouvrage interroge la façon dont le livre s'insérait à la fin du Moyen Âge et au début de l'époque moderne dans les pratiques pédagogiques et comment il les modifiait éventuellement. Ceci reprend, mais dans une autre optique que précédemment, les questions de savoir comment était défini et pratiqué dans la réalité le canon des lectures scolaires et extrascolaires, mais aussi comment les institutions diverses et les éditeurs-imprimeurs intervenaient dans la mise en œuvre de ce programme. Le regard s’élargit donc à toute littérature utilisée à l’école, y compris celle qui ne se concevait pas initialement à cet usage, mais aussi aux lectures pratiquées en dehors de l’école dans une finalité d’enseignement domestique ou d’autodidaxie, ce qui permet d’inclure les pratiques d’élites non scolarisées, non seulement nobiliaires mais aussi féminines. Il en ressort le constat de la nécessité d’un recours à des approches variées croisant les sources pour traiter au mieux de cette question difficile. Ce colloque rappelle aussi la dimension économique et sociale de ces problèmes, trop souvent oubliée par l’historiographie. Il contribue enfin à remettre en cause une vision qui sépare trop nettement, en leur attribuant des logiques différentes, le recours au livre, la transmission manuscrite, l’oralité du cours et la mémorisation des textes, activités qui semblent s’intégrer plus étroitement dans les anciennes pratiques pédagogiques

Serial interactome capture of the human cell nucleus

Novel RNA-guided cellular functions are paralleled by an increasing number of RNA-binding proteins (RBPs). Here we present ‘serial RNA interactome capture’ (serIC), a multiple purification procedure of ultraviolet-crosslinked poly(A)–RNA–protein complexes that enables global RBP detection with high specificity. We apply serIC to the nuclei of proliferating K562 cells to obtain the first human nuclear RNA interactome. The domain composition of the 382 identified nuclear RBPs markedly differs from previous IC experiments, including few factors without known RNA-binding domains that are in good agreement with computationally predicted RNA binding. serIC extends the number of DNA–RNA-binding proteins (DRBPs), and reveals a network of RBPs involved in p53 signalling and double-strand break repair. serIC is an effective tool to couple global RBP capture with additional selection or labelling steps for specific detection of highly purified RBPs

Using the Web to Collect Data on Sensitive Behaviours: A Study Looking at Mode Effects on the British National Survey of Sexual Attitudes and Lifestyles.

BACKGROUND: Interviewer-administered surveys are an important method of collecting population-level epidemiological data, but suffer from declining response rates and increasing costs. Web surveys offer more rapid data collection and lower costs. There are concerns, however, about data quality from web surveys. Previous research has largely focused on selection biases, and few have explored measurement differences. This paper aims to assess the extent to which mode affects the responses given by the same respondents at two points in time, providing information on potential measurement error if web surveys are used in the future. METHODS: 527 participants from the third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3), which uses computer assisted personal interview (CAPI) and self-interview (CASI) modes, subsequently responded to identically-worded questions in a web survey. McNemar tests assessed whether within-person differences in responses were at random or indicated a mode effect, i.e. higher reporting of more sensitive responses in one mode. An analysis of pooled responses by generalized estimating equations addressed the impact of gender and question type on change. RESULTS: Only 10% of responses changed between surveys. However mode effects were found for about a third of variables, with higher reporting of sensitive responses more commonly found on the web compared with Natsal-3. CONCLUSIONS: The web appears a promising mode for surveys of sensitive behaviours, most likely as part of a mixed-mode design. Our findings suggest that mode effects may vary by question type and content, and by the particular mix of modes used. Mixed-mode surveys need careful development to understand mode effects and how to account for them

Sediment properties, biota and local habitat structure explain variation in the erodibility of coastal sediments

Sediment resuspension is a frequent phenomenon in coastal areas and a key driver for many ecosystem functions. Sediment resuspension is often linked to biological and anthropogenic activities, which in combination with hydrodynamic forcing initiate sediment erosion and resuspension, if the erosion threshold (tau(c)) is exceeded. Despite its importance to ecosystem functions very few studies have provided measurements on natural assemblages for subtidal sediments. The aim of this study was to determinate key environmental variables regulating sediment resuspension potential across a sedimentary gradient in a subtidal coastal environment. In order to explore this, we sampled 16 sites encompassing a wide variety in environmental variables (e.g., grain size distribution, macrofaunal communities, vegetation) in the Gulf of Finland, Baltic Sea. A core-based erosion device (EROMES) was used to determine sediment resuspension potential measures of erosion threshold, erosion rate (ER), and erosion constant (m(e)). Based on abiotic and biotic properties sampled, sediments diverged into two distinct groups; cohesive (muddy) and noncohesive (sandy) sediments. Results showed that abiotic sediment properties explained 38-53% and 15-36% of the total variation in resuspension potential measures in muddy and sandy sediments, respectively. In cumulative models, biota accounted for 12-26% and 6-24% to the total variation in muddy and sandy sediments, respectively. Sediment erodibility and resuspension potential of natural sediments is highly variable from local habitats to a larger seascape scale. Our results underline the importance of biota to resuspension potential measures in spatially variable environments.Peer reviewe

Proportion of Osteoporotic Women Remaining at Risk for Fracture Despite Adherence to Oral Bisphosphonates

Background Adherence to oral bisphosphonates is often low, but even adherent patients may remain at elevated fracture risk. The goal of this study was to estimate the proportion of bisphosphonate-adherent women remaining at high risk of fracture. Methods A retrospective cohort of women aged 50 years and older, adherent to oral bisphosphonates for at least two years was identified, and data were extracted from a multi-system health information exchange. Adherence was defined as having a dispensed medication possession ratio ≥ 0.8. The primary outcome was clinical occurrence of: low trauma fracture (months 7–36), persistent T-score ≤ − 2.5 (months 13–36), decrease in bone mineral density (BMD) at any skeletal site ≥ 5%, or the composite of any one of these outcomes. Results Of 7435 adherent women, 3110 had either pre- or post-adherent DXA data. In the full cohort, 7% had an incident osteoporotic fracture. In 601 women having both pre- and post-adherent DXA to evaluate BMD change, 6% had fractures, 22% had a post-treatment T-score ≤ − 2.5, and 16% had BMD decrease by ≥ 5%. The composite outcomes occurred in 35%. Incident fracture was predicted by age, previous fracture, and a variety of co-morbidities, but not by race, glucocorticoid treatment or type of bisphosphonate. Conclusion Despite bisphosphonate adherence, 7% had incident osteoporotic fractures and 35% had either fracture, decreases in BMD, or persistent osteoporotic BMD, representing a substantial proportion of treated patients in clinical practices remaining at risk for future fractures. Further studies are required to determine the best achievable goals for osteoporosis therapy, and which patients would benefit from alternate therapies

Astro2020 Science White Paper: Triggered High-Priority Observations of Dynamic Solar System Phenomena

Unexpected dynamic phenomena have surprised solar system observers in the past and have led to important discoveries about solar system workings. Observations at the initial stages of these events provide crucial information on the physical processes at work. We advocate for long-term/permanent programs on ground-based and space-based telescopes of all sizes - including Extremely Large Telescopes (ELTs) - to conduct observations of high-priority dynamic phenomena, based on a predefined set of triggering conditions. These programs will ensure that the best initial dataset of the triggering event are taken; separate additional observing programs will be required to study the temporal evolution of these phenomena. While not a comprehensive list, the following are notional examples of phenomena that are rare, that cannot be anticipated, and that provide high-impact advances to our understandings of planetary processes. Examples include: new cryovolcanic eruptions or plumes on ocean worlds; impacts on Jupiter, Saturn, Uranus, or Neptune; extreme eruptions on Io; convective superstorms on Saturn, Uranus, or Neptune; collisions within the asteroid belt or other small-body populations; discovery of an interstellar object passing through our solar system (e.g. 'Oumuamua); and responses of planetary atmospheres to major solar flares or coronal mass ejections.Comment: Astro2020 white pape

Identification of rhabdoviral sequences in oropharyngeal swabs from German and Danish bats

BACKGROUND: In the frame of active lyssavirus surveillance in bats, oropharyngeal swabs from German (N = 2297) and Danish (N = 134) insectivorous bats were investigated using a newly developed generic pan-lyssavirus real-time reverse transcriptase PCR (RT-qPCR). FINDINGS: In total, 15 RT-qPCR positive swabs were detected. Remarkably, sequencing of positive samples did not confirm the presence of bat associated lyssaviruses but revealed nine distinct novel rhabdovirus-related sequences. CONCLUSIONS: Several novel rhabdovirus-related sequences were detected both in German and Danish insectivorous bats. The results also prove that the novel generic pan-lyssavirus RT-qPCR offers a very broad detection range that allows the collection of further valuable data concerning the broad and complex diversity within the family Rhabdoviridae

Inflammatory and Angiogenic Factors at Mid-Pregnancy Are Associated with Spontaneous Preterm Birth in a Cohort of Tanzanian Women.

Preterm birth (PTB) is the leading cause of perinatal mortality worldwide, with the greatest burden occurring in resource-constrained settings. Based on the hypothesis that altered placental angiogenesis and inflammation early in pregnancy lead to PTB, we examined whether levels of inflammatory and angiogenic mediators, measured early in pregnancy, were predictive of spontaneous PTB (sPTB).\ud Plasma samples were collected from a prospective cohort of primigravid Tanzanian women between 12-27 weeks gestation. A panel of 18 markers was screened on a training cohort of 426 women. Markers associated with sPTB in the training cohort were repeated in a test cohort of 628 women. All markers were measured by ELISA. In both the training and test cohorts plasma levels of IL-18BP, sICAM-1, sEndoglin and CHI3L1 were elevated and Leptin was lower at enrollment in women who subsequently experienced sPTB. In multivariate analysis women with plasma levels of CHI3L1, C5a, sICAM-1, AngptL3, sEndgolin, sFlt-1 and IL-18BP in the highest quartile had an increased risk of sPTB compared with those in the lowest quartile. Women with Leptin and Ang2 in the highest quartile had a reduced risk of sPTB compared with women in the lowest quartile. Levels of angiogenic and inflammatory mediators measured at mid-pregnancy were associated with subsequent sPTB. These findings provide insight into mechanisms underlying sPTB and suggest biomarkers that may have clinical utility in risk-stratifying pregnancies