Klein

The United Nations Convention on the Rights of the Child not only grants comprehensive rights to children via international law, it also constitutes a legally binding framework under German federal law. With respect to health care, the convention establishes the "right of the child to the enjoyment of the highest attainable standard of health" and the principle that "the best interests of the child shall be a primary consideration" in all actions undertaken by public or private institutions. Here, some fundamental aspects of the convention and the monitoring of its implementation are summarized and current challenges in paediatric medicine in Germany are discussed in light of the convention...

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Objectives: To systematically classify the clinical impact of computerized clinical decision support systems (CDSSs) in inpatient care. Materials and Methods: Medline, Cochrane Trials, and Cochrane Reviews were searched for CDSS studies that assessed patient outcomes in inpatient settings. For each study, 2 physicians independently mapped patient outcome effects to a predefined medical effect score to assess the clinical impact of reported outcome effects. Disagreements were measured by using weighted kappa and solved by consensus...

[This corrects the article DOI: 10.1371/journal.pone.0184832.].

BACKGROUND: Office-based buprenorphine treatment promises to expand effective treatment for opioid use disorder. Unfortunately, patients may be lost during engagement, before induction with medication. Few data are available regarding rates and predictors of successfully reaching induction. METHODS: The sample included 100 consecutive patients seeking treatment in 2016 at an office-based buprenorphine treatment program in an urban, academic primary care clinic. Patients completed phone intake, nurse visit and physician visit prior to induction...

NMR is a widely used analytical technique with a growing number of repositories available. As a result, demands for a vendor-agnostic, open data format for long-term archiving of NMR data have emerged with the aim to ease and encourage sharing, comparison and reuse of NMR data. Here we present nmrML, an open XML-based exchange and storage format for NMR spectral data. The nmrML format is intended to be fully compatible with existing NMR data for chemical, biochemical and metabolomics experiments. nmrML can capture raw NMR data, spectral data acquisition parameters and, where available, spectral metadata such as chemical structures associated with spectral assignments...

This study examined whether the Structured Clinical Interview for DSM (SCID), a widely used semistructured interview designed to assess psychopathology categorically, can be adapted to identify reliable and valid severity dimensions of psychopathology. The present study also examined whether these severity dimensions have better psychometric properties (internal consistency, test-retest reliability, and concurrent and predictive validity) than categorical diagnoses. Participants (N = 234) were recruited from the community and clinics...

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OBJECTIVE: We investigated the effectiveness of ketamine as a primary therapy for prehospital profound agitation. METHODS: This was a prospective observational study of patients receiving 5mg/kg of intramuscular ketamine for profound agitation, defined as a score of +4 on the Altered Mental Status Scale (AMSS), a validated ordinal scale of agitation from -4 (unresponsive) to +4 (most agitated). The primary outcome was time to adequate sedation (AMSS<+1). Secondary outcomes included need for additional sedatives, intubation frequency, complications associated with ketamine, and mortality...

OBJECTIVE: To present methodological issues that can arise with the assessment of the risk of a second primary cancer (SPC) occurring in the same site as a first cancer using registry data. MATERIAL AND METHODS: Data from ten French cancer registries were used, including data for patients with a first prostate cancer (in males), breast cancer (in females), and colon, lung and kidney cancer (in both sexes) diagnosed between 1989 and 2004. Standardized incidence ratios (SIRs) of SPC were computed by excluding, or not, the risk of an SPC at the same site...

Store-operated Ca(2+) entry (SOCE) is the main Ca(2+) influx pathway in lymphocytes and is essential for T cell function and adaptive immunity. SOCE is mediated by Ca(2+) release-activated Ca(2+) (CRAC) channels that are activated by stromal interaction molecule (STIM) 1 and STIM2. SOCE regulates many Ca(2+)-dependent signaling molecules, including calcineurin, and inhibition of SOCE or calcineurin impairs antigen-dependent T cell proliferation. We here report that SOCE and calcineurin regulate cell cycle entry of quiescent T cells by controlling glycolysis and oxidative phosphorylation...

PURPOSE: This paper describes the development of quality indicators for an external statutory and cross-sectoral quality assurance (QA) procedure in the context of the German health care system for adult patients suffering from schizophrenia, schizotypal and delusional disorders (F20-F29). METHODS: Indicators were developed by a modified RAND/UCLA Appropriateness Method with 1) the compilation of an indicator register based on a systematic literature search and analyses of health care claims data, 2) the selection of indicators by an expert panel that rated them for relevance and for feasibility regarding implementation...

Background: Protection against herpes zoster (HZ) induced by the live-attenuated zoster vaccine Zostavax (ZVL) wanes within 3-7 years. Re-vaccination may renew protection. We assessed whether (re)-vaccination with the adjuvanted HZ subunit vaccine candidate (HZ/su) induced comparable immune responses in previous ZVL-recipients and ZVL-naïve individuals (HZ-NonVac). Methods: In an open-label, multicenter study (NCT02581410), adults ≥65 years of age, vaccinated with ZVL ≥5 years previously (HZ-PreVac), were matched to HZ-NonVac adults...

The numerous γ-aminobutyric acid type A receptor (GABAAR) subtypes are differentially expressed and mediate distinct functions at neuronal level. In this study we have investigated GABAAR-mediated modulation of the spontaneous activity patterns of primary neuronal networks from murine frontal cortex by characterizing the effects induced by a wide selection of pharmacological tools at a plethora of activity parameters in microelectrode array (MEA) recordings. The basic characteristics of the primary cortical neurons used in the recordings were studied in some detail, and the expression levels of various GABAAR subunits were investigated by western blotting and RT-qPCR...

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Kleine-Levin syndrome (KLS) is a rare disorder (around 1.5 cases per million population), often presenting with triad of recurrent episodes of hypersomnia, hyperphagia, and hypersexuality. However, cases of atypical KLS with features opposite to that being commonly reported are often misdiagnosed as psychosis and present as a diagnostic challenge for the physicians, psychiatrists, and neurologists. We describe a case of atypical KLS which was misdiagnosed as unspecified nonorganic psychosis previously, highlighting the various points which would be helpful in identifying and diagnosing cases of atypical KLS in future...

Pericardial diseases represent diverse conditions, ranging from painful inflammatory states, such as acute pericarditis, to life-threatening tamponade and chronic heart failure due to constrictive pericarditis. Multimodality cardiovascular imaging plays important roles in diagnosis and management of pericardial conditions. This review provides a clinical update on multimodality cardiovascular imaging of the pericardium, incorporating echocardiography, multidetector computed tomography, and cardiac magnetic resonance imaging, focusing on guiding clinicians about when each cardiac imaging modality should be used in each relevant pericardial condition...

OBJECTIVES: Weaning from mechanical ventilation after liver transplant can be demanding. In selected cases, tracheostomy is helpful. The optimal timing for tracheostomy in ventilator-dependent liver transplant recipients is not well known. MATERIALS AND METHODS: We retrospectively analyzed data of 447 patients who had undergone liver transplant in our hospital. Thirty-nine patients who had high risk of prolonged mechanical ventilation according to the Respiratory Risk Score were identified from 95 patients who received tracheostomy after liver transplant...

Compared to sugars, a major advantage of using glycerol as a feedstock for industrial bioprocesses is the fact that this molecule is more reduced than sugars. A compound whose biotechnological production might greatly profit from the substrate's higher reducing power is 1,2-propanediol (1,2-PDO). Here we present a novel metabolic engineering approach to produce 1,2-PDO from glycerol in S. cerevisiae. Apart from implementing the heterologous methylglyoxal (MG) pathway for 1,2-PDO formation from dihydroxyacetone phosphate (DHAP) and expressing a heterologous glycerol facilitator, the employed genetic modifications included the replacement of the native FAD-dependent glycerol catabolic pathway by the `DHA pathway´ for delivery of cytosolic NADH and the reduction of triosephosphate isomerase (TPI) activity for increased precursor (DHAP) supply...

Allosteric integrase inhibitors (ALLINIs) bind to the lens epithelial-derived growth factor (LEDGF) pocket on HIV-1 integrase (IN) and possess potent antiviral effects. Rather than blocking proviral integration, ALLINIs trigger IN conformational changes that have catastrophic effects on viral maturation, rendering the virions assembled in the presence of ALLINIs non-infectious. A high-throughput screen for compounds that disrupt the IN·LEDGF interaction was executed, and extensive triage led to the identification of a t-butylsulfonamide series, as exemplified by 1...