Background: Segmenting the population into homogenous groups according to their healthcare needs may help to understand the population's demand for healthcare services and thus support health systems to properly allocate healthcare resources and plan interventions. It may also help to reduce the fragmented provision of healthcare services. The aim of this study was to apply a data-driven utilisation-based cluster analysis to segment a defined population in the south of Germany.
View Article and Find Full Text PDFObjectives: Evidence-based decision-making is the sine qua non for safe and effective patient care and the long-term functioning of health systems. Since 2020 Digital Health Applications (DiHA) in Germany have been undergoing a systematic pathway to be reimbursed by statutory health insurance (SHI) which is attracting attention in other European countries. We therefore investigate coverage decisions on DiHA and the underlying evidence on health care effects, which legally include both medical outcomes and patient-centred structural and procedural outcomes.
View Article and Find Full Text PDFIn Germany, some digital health applications (DiHA) became reimbursable through the statutory health insurance system with the adoption of the Digital Healthcare Act in 2019. Approaches and concepts for the German care context were developed in an iterative process, based on existing concepts from international experience. A DiHA categorization was developed that could be used as a basis to enable the creation of a reimbursed DiHA repository, and to derive evidence requirements for coverage and reimbursement for each DiHA.
View Article and Find Full Text PDFBackground: Innovative medical technologies are commonly associated with positive expectations. At the time of their introduction into care, there is often little evidence available regarding their benefits and harms. Accordingly, some innovative medical technologies with a lack of evidence are used widely until or even though findings of adverse events emerge, while others with study results supporting their safety and effectiveness remain underused.
View Article and Find Full Text PDFDermal paraneoplastic syndromes are non-malignant disorders, caused indirectly by the increase in growth factors or as immunological reactions, which lead to a variety of inflammatory, hyperkeratotic or proliferative skin reactions. They can occur as facultative or obligate paraneoplastic dermatoses, which are associated with oncological processes (solid tumours or hematologic diseases). The recognition of paraneoplastic skin disorders can accelerate proper diagnosis and determine better prognosis for the patient and is also important to clinicians because it is often the first symptom of life-threatening malignancies.
View Article and Find Full Text PDFBackground: Only a few telemedicine applications have made their way into regular care. One reason is the lack of acceptance of telemedicine by potential end users.
Objective: The aim of this systematic review was to identify theoretical predictors that influence the acceptance of telemedicine.
J Anim Physiol Anim Nutr (Berl)
October 2002
In contrast to supplemented microbial phytases, considerably lower cereal phytase activities were found after application of an enzyme solution extracted in citrate/NaOH buffer (pH 5.5) for 1 h as compared with the direct incubation of the plant material. Differences between both methods obtained were 70% for wheat and spelt and 50% for barley and rye.
View Article and Find Full Text PDFJ Anim Physiol Anim Nutr (Berl)
December 2001
Hydrolysis of phytate in the stomach and the small intestine as influenced by intrinsic plant (wheat) and supplemented microbial phytase (Aspergillus niger) were investigated with six minipigs (40-50 kg initial body weight) fitted with re-entrant cannulas in the duodenum, 30 cm posterior to the pylorus (animals 1, 4, 5 and 6) and ileocecal re-entrant cannulas, 5 cm prior the ileocecal junction (animals 1, 2 and 3), respectively. Dietary treatments were as follows: (1) diet 1, a corn-based diet [43 U phytase/kg dry matter (DM)]; (2) diet 2, diet 1 supplemented with microbial phytase (818 U/kg DM); and (3) diet 3, a wheat-based diet (1192 U/kg DM). At 07 30 h and 19 30 h, each animal was fed 350 g diet mixed with 1050 ml de-ionized water.
View Article and Find Full Text PDFHydrolysis of phytate in the stomach and the small intestine as influenced by intrinsic plant (wheat) and supplemented microbial phytase (A. niger) were investigated with six minipigs (40-50 kg initial BW) fitted with re-entrant cannulas in the duodenum, 30 cm posterior to the pylorus (animals 1, 4, 5, and 6) and ileocecal re-entrant cannulas, 5 cm prior the ileocecal junction (animals 1, 2, and 3), respectively. Dietary treatments were as follows: (1) diet 1, a corn-based diet (43 U phytase/kg DM); (2) diet 2, diet 1 supplemented with microbial phytase (818 U/kg DM) and (3) diet 3, a wheat-based diet (1192 U/kg DM).
View Article and Find Full Text PDFHydrolysis of phytate in the stomach and the small intestine as influenced by intrinsic plant (wheat) and supplemented microbial phytase (A. niger) were investigated with six minipigs (40-50 kg initial BW) fitted with re-entrant-cannulas in the duodenum, 30 cm posterior to the pylorus (animals 1, 4, 5, and 6) and ileocecal re-entrant cannulas, 5 cm prior the ileocecal junction (animals 1, 2, and 3), respectively. Dietary treatments were as follows: (1) diet 1, a corn-based diet (43 U Phytase/kg DM); (2) diet 2, diet 1 supplemented with microbial phytase (818 U/kg DM) and (3) diet 3, a wheat-based diet (1192 U/kg DM).
View Article and Find Full Text PDFA total of 72 barrows (initial body weight 16.7 kg) was used, to evaluate the influence of microbial phytase supplementation alone or in combination with calcium to barley soybean meal diets on the accumulation of cadmium (Cd) in kidney, liver, muscle, brain and bone. The control group received the basal diet with 6 g Ca and a low native Cd concentration of 0.
View Article and Find Full Text PDFBiol Trace Elem Res
December 1999
The objective of this study was to investigate the influence of microbial phytase and calcium supplementation to diets for growing pigs on the retention of lead in the kidney, liver, muscle, brain, and bone (phalanx 1). The experiments were carried out with barrows over the body weight range from 17 to 50 kg. The average lead concentration of the diets was 1.
View Article and Find Full Text PDFKnowledge concerning the genotoxicity of inorganic metal compounds in the SOS chromotest is limited. Up to now, only Cr(VI), Sn(II) and the platinum antitumor compound cisplatin(II) were shown to be genotoxic in this test system. However, for Cr(VI) and Sn(II), a positive reaction could only be achieved in cytotoxic dose ranges.
View Article and Find Full Text PDFPlatinum and palladium belong to the group of platinum elements and thus share many chemical properties. Platinum coordination complexes are known to be carcinogenic and genotoxic in mammalian and bacterial cells. However, little is known about palladium genotoxicity.
View Article and Find Full Text PDFIn a 2 x 3 factorial arrangement with 30 male castrates (German Landrace; 13.7 +/- 1.7 kg b.
View Article and Find Full Text PDFZ Tierphysiol Tierernahr Futtermittelkd
February 1984
In growing castrated pigs changes in the postprandial plasma zinc values were found to be inversely related to the zinc status of the animals. In pigs prefed with a moderate zinc diet (25 ppm) postprandial plasma zinc values increased, whereas in pigs prefed with a high zinc diet (150 ppm) values decreased after intake of a meal containing 150 ppm of zinc. It is considered that the presence of metallothioneine in the liver, which depends upon the zinc status, is responsible for this effect.
View Article and Find Full Text PDFZ Tierphysiol Tierernahr Futtermittelkd
October 1982
In growing male pigs fitted with jugular catheters, changes in plasma zinc concentrations were followed up to 330 min postprandially. In pigs with normal fasting zinc values (greater than 70 micrograms/100 ml) plasma levels decreased significantly (p less than 0.05) up to 35% below, whereas in pigs with lowered fasting values plasma level increased up to 36% above the respective fasting values within 120 and 180 min after feed intake.
View Article and Find Full Text PDFZ Tierphysiol Tierernahr Futtermittelkd
October 1974