Development of Quality Indicators to Evaluate the Quality of Care for People with Differences of Sex Development.

Introduction: Achieving evidence-based, high-quality medical care is the overarching goal of healthcare quality management. Quality indicators (QIs) serve as proxies to show whether good quality is reached or not. This article describes the development of QI for the evaluation of healthcare quality in the area of differences of sex development (DSD).

[Analysis of factors influencing outpatient paediatric antibiotic prescriptions in Bielefeld from 2015 to 2018].

Background: There are significant regional differences in antibiotic prescribing behaviour. The reasons for this are still largely unknown. Beneath demographic and morbidity-related factors, doctor-specific or "cultural" factors may also play a role.

Use of Metadata-Driven Approaches for Data Harmonization in the Medical Domain: Scoping Review.

Background: Multisite clinical studies are increasingly using real-world data to gain real-world evidence. However, due to the heterogeneity of source data, it is difficult to analyze such data in a unified way across clinics. Therefore, the implementation of Extract-Transform-Load (ETL) or Extract-Load-Transform (ELT) processes for harmonizing local health data is necessary, in order to guarantee the data quality for research.

Contributing and limiting factors to guideline-adherent therapy in senior and elderly breast cancer patients: a questionnaire-based cross-sectional study using clinical and cancer registry data in Germany.

Purpose: Elderly cancer patients are less likely to be treated in accordance with evidence-based guideline recommendations. This study examines patient-related factors associated with deviations from guideline recommendations.

Methods: Using medical documentation and cancer registry data, we investigated the treatment courses of female breast cancer patients aged 50 and older in Germany regarding compliance with German guidelines.

Physicians' perspectives on family caregivers' roles in elderly cancer patients' therapies: a qualitative, interview-based study.

Purpose: Clinical communication and facilitating informed and sound medical decisions become challenging as patients age and suffer from age-associated impairments. Family caregivers are perceived as essential actors in addressing these challenges. Here, we explore physicians' perspectives on family caregivers' roles and their involvement in consultations and therapy decision-making situations of elderly cancer patients.

Study results from journals with a higher impact factor are closer to "truth": a meta-epidemiological study.

Background: Scientists, physicians, and the general public legitimately expect scholarly publications to give true answers to study questions raised. We investigated whether findings from studies published in journals with higher Journal Impact Factors (JIFs) are closer to truth than findings from studies in less-cited journals via a meta-epidemiological approach.

Methods: We screened intervention reviews from the Cochrane Database of Systematic Reviews (CDSR) and sought well-appraised meta-analyses.

The role of family confidants and caregivers in the care of older cancer patients: Extending the concept of "shared decision-making".

Background And Aims: Family caregivers play an important role in assisting their family members with cancer, but their influence on the treatment decision-making process has not yet been adequately investigated. This exploratory study approached this topic via reconstructive methodology, focusing on assessing patient-caregiver relationships.

Methods: We conducted semi-structured interviews with 37 mostly elderly cancer patients (median age: 74 years) about the context of their diagnosis, treatment decision, and family support.

Comparison of Electron and Ion Emission from Xenon Cluster-Induced Ignition of Helium Nanodroplets.

The charging dynamics of helium droplets driven by embedded xenon cluster ignition in strong laser fields is studied by comparing the abundances of helium and highly charged Xe ions to the electron signal. Femtosecond pump-probe experiments show that near the optimal delay for highly charged xenon the electron yield increases, especially at low energies. The electron signature can be traced back to the ionization of the helium environment by Xe seed electrons.

Kinetic energy distribution of multiply charged ions in Coulomb explosion of Xe clusters.

We report on the calculations of kinetic energy distribution (KED) functions of multiply charged, high-energy ions in Coulomb explosion (CE) of an assembly of elemental Xe(n) clusters (average size (n) = 200-2171) driven by ultra-intense, near-infrared, Gaussian laser fields (peak intensities 10(15) - 4 × 10(16) W cm(-2), pulse lengths 65-230 fs). In this cluster size and pulse parameter domain, outer ionization is incomplete∕vertical, incomplete∕nonvertical, or complete∕nonvertical, with CE occurring in the presence of nanoplasma electrons. The KEDs were obtained from double averaging of single-trajectory molecular dynamics simulation ion kinetic energies.

Extreme dynamics and energetics of Coulomb explosion of Xe clusters.

Unique features of Coulomb explosion (CE) of many-electron elemental Xe(n) (n = 13-2171) clusters driven by ultraintense and ultrashort near-infrared laser pulses (peak intensities 10(15)-10(20) W cm(-2) and pulse lengths of 10-100 fs) manifest ion dynamics and energetics in the extreme, with ultrafast (5-15 A fs(-1)) velocities and ultrahigh (keV-1 MeV) energies. Relations were established between the CE attributes, obtained from molecular dynamics simulations and from electrostatic models, and the extreme cluster inner ionization levels (5-36 per ion), in conjunction with the laser parameters required for the attainment of complete outer ionization, which was approximated by cluster vertical ionization (CVI) initial conditions. Interrelationship between electron dynamics and nuclear dynamics stems from the effects of the laser pulse length on the energetics and from the characterization of the border radius for complete outer ionization.

Extreme ionization of Xe clusters driven by ultraintense laser fields.

We applied theoretical models and molecular dynamics simulations to explore extreme multielectron ionization in Xe(n) clusters (n=2-2171, initial cluster radius R(0)=2.16-31.0 A) driven by ultraintense infrared Gaussian laser fields (peak intensity I(M)=10(15)-10(20) W cm(-2), temporal pulse length tau=10-100 fs, and frequency nu=0.

Cluster dynamics transcending chemical dynamics toward nuclear fusion.

Ultrafast cluster dynamics encompasses femtosecond nuclear dynamics, attosecond electron dynamics, and electron-nuclear dynamics in ultraintense laser fields (peak intensities 10(15)-10(20) W.cm(-2)). Extreme cluster multielectron ionization produces highly charged cluster ions, e.

Femtosecond time-resolved geometry relaxation and ultrafast intramolecular energy redistribution in Ag2Au.

The ultrafast dynamics of the bimetallic cluster Ag2Au is investigated by pump-probe negative ion-to-neutral-to-positive ion (NeNePo) spectroscopy. Preparation of the neutral cluster in a highly nonequilibrium state by electron detachment from the mass-selected anion, and subsequent probing of the neutral nuclear dynamics through two-photon ionization to the cationic state, leads to strongly probe-energy-dependent transient cation-abundance signals. The origin of this pronounced time and wavelength dependence of the ionization probability on the femtosecond scale is revealed by ab initio theoretical simulations of the transient spectra.

Reactions of Selected Bismuth Oxide Cluster Cations with Propene.

Bismuth oxide cluster ions are reduced by propene in exactly the same way as solid bismuth oxide (Bi O ), which is used as a catalyst. Even in the case of the smallest bismuth oxide cluster ions, such as the Bi O isomer shown in the picture, the supposedly unreactive bridging oxygen atom can participate in the alkene oxidation.