scholarly journals Adoption of large-scale medical equipment: the impact of competition in the German inpatient sector

2021 ◽  
Author(s):  
Marie Dreger ◽  
Hauke Langhoff ◽  
Cornelia Henschke
Keyword(s):  
Medical Equipment ◽  
Large Scale ◽  
Probability Model ◽  
Population Based ◽  
Hospital Size ◽  
Positron Emission ◽  
State Subsidies ◽  
Linear Probability ◽  
The Impact ◽  
Pet Scanners

AbstractThe availability of large-scale medical equipment such as computed tomography (CT), magnet resonance imaging (MRI) and positron emission tomography (PET) scanners has increased rapidly worldwide over the last decades. Among OECD countries, Germany ranks high according to the number of imaging technologies and their applications per inhabitant. In contrast to other countries, there is no active governmental planning of large-scale medical equipment. We therefore investigated whether and how the adoption and distribution of CT, MRI and PET scanners in the German inpatient sector is subject to competition. Using a linear-probability model, we additionally examined the impact of regional, hospital- and population-based factors. In summary, our results indicate that the adoption rate by hospital sites decreases with the number of other sites being already equipped with the respective device and their proximity. However, the effect presumably depends on the technologies’ stage within the diffusion process. No influence regarding the amount of state subsidies could be identified. Furthermore, hospital size and university status strongly affect the adoption.

scholarly journals Multi-GPU approach to global induction of classification trees for large-scale data mining

2021 ◽  
Author(s):  
Krzysztof Jurczuk ◽  
Marcin Czajkowski ◽  
Marek Kretowski
Keyword(s):  
Data Mining ◽  
Large Scale ◽  
Real Life ◽  
Population Based ◽  
Tree Structure ◽  
Global Approach ◽  
Data Parallel ◽  
Large Scale Data ◽  
The Impact ◽  
Scale Data

AbstractThis paper concerns the evolutionary induction of decision trees (DT) for large-scale data. Such a global approach is one of the alternatives to the top-down inducers. It searches for the tree structure and tests simultaneously and thus gives improvements in the prediction and size of resulting classifiers in many situations. However, it is the population-based and iterative approach that can be too computationally demanding to apply for big data mining directly. The paper demonstrates that this barrier can be overcome by smart distributed/parallel processing. Moreover, we ask the question whether the global approach can truly compete with the greedy systems for large-scale data. For this purpose, we propose a novel multi-GPU approach. It incorporates the knowledge of global DT induction and evolutionary algorithm parallelization together with efficient utilization of memory and computing GPU’s resources. The searches for the tree structure and tests are performed simultaneously on a CPU, while the fitness calculations are delegated to GPUs. Data-parallel decomposition strategy and CUDA framework are applied. Experimental validation is performed on both artificial and real-life datasets. In both cases, the obtained acceleration is very satisfactory. The solution is able to process even billions of instances in a few hours on a single workstation equipped with 4 GPUs. The impact of data characteristics (size and dimension) on convergence and speedup of the evolutionary search is also shown. When the number of GPUs grows, nearly linear scalability is observed what suggests that data size boundaries for evolutionary DT mining are fading.

scholarly journals The impact of C-reactive protein levels on headache frequency in the HUNT study 2006–2008

BMC Neurology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Knut Hagen ◽  
Lars Jacob Stovner ◽  
Kristian Bernhard Nilsen ◽  
Espen Saxhaug Kristoffersen ◽  
Bendik Slagsvold Winsvold
Keyword(s):  
Migraine With Aura ◽  
Large Scale ◽  
Population Based ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Population Based Study ◽  
Reactive Protein ◽  
Scale Population ◽  
Hs Crp ◽  
The Impact

Abstract Background Increased high sensitivity C- reactive protein (hs-CRP) levels have been found in many earlier studies on migraine, and recently also in persons with migraine and insomnia. The aim of this study was to see whether these findings could be reproduced in a large-scale population-based study. Methods A total of 50,807 (54%) out of 94,194 invited aged ≥20 years or older participated in the third wave of the Nord-Trøndelag Health Study study performed in 2006–2008. Among these, 38,807 (41%) had valid measures of hs-CRP and answered questions on headache and insomnia. Elevated hs-CRP was defined as > 3.0 mg/L. The cross-sectional association with headache was estimated by multivariate analyses using multiple logistic regression. The precision of the odds ratio (OR) was assessed with 95% confidence interval (CI). Results In the fully adjusted model, elevated hs-CRP was associated with migraine (OR 1.14, 95% CI 1.04–1.25) and migraine with aura (OR 1.15, 95% CI 1.03–1.29). The association was strongest among individuals with headache ≥15 days/month for any headache (OR 1.26, 95% CI 1.08–1.48), migraine (OR 1.62, 95% CI 1.21–2.17), and migraine with aura (OR 1.84, 95% CI 1.27–2.67). No clear relationship was found between elevated hs-CRP and headache less than 7 days/month or with insomnia. Conclusions Cross-sectional data from this large-scale population-based study showed that elevated hs-CRP was associated with headache ≥7 days/month, especially evident for migraine with aura.

The impact of a large-scale population-based asthma management program on pediatric asthma patients and their caregivers

2003 ◽  
Vol 90 (3) ◽  
pp. 308-315 ◽  
Author(s):  
Archelle Georgiou ◽  
Deborah A. Buchner ◽  
Daniel H. Ershoff ◽  
Kristin M. Blasko ◽  
Linda V. Goodman ◽  
...  
Keyword(s):  
Large Scale ◽  
Asthma Management ◽  
Pediatric Asthma ◽  
Population Based ◽  
Management Program ◽  
Scale Population ◽  
Asthma Patients ◽  
The Impact

scholarly journals Systems-based approach for optimization of a scalable bacterial ST mapping assembly-free algorithm

2021 ◽  
Author(s):  
Natasha Pavlovikj ◽  
Joao Carlos Gomes-Neto ◽  
Jitender S. Deogun ◽  
Andrew K. Benson
Keyword(s):  
Large Scale ◽  
Population Genomics ◽  
Bacterial Pathogens ◽  
Population Based ◽  
Species Level ◽  
Epidemiological Surveillance ◽  
Time Data ◽  
Bacterial Populations ◽  
Genomic Epidemiology ◽  
The Impact

Epidemiological surveillance of bacterial pathogens requires real-time data analysis with a fast turn-around, while aiming at generating two main outcomes: 1) Species level identification; and 2) Variant mapping at different levels of genotypic resolution for population-based tracking, in addition to predicting traits such as antimicrobial resistance (AMR). With the recent advances and continual dissemination of whole-genome sequencing technologies, large-scale population-based genotyping of bacterial pathogens has become possible. Since bacterial populations often present a high degree of clonality in the genomic backbone (i.e., low genetic diversity), the choice of genotyping scheme can even facilitate the understanding of ancestral relationships and can be used for prediction of co-inherited traits such as AMR. Multi-locus sequence typing (MLST) fits that purpose and can identify sequence types (ST) based on seven ubiquitous genome-scattered loci that aid in genotyping isolates beneath the species level. ST-based mapping also standardizes genotyping across laboratories and can be consistently used worldwide. However, ST-based algorithms, when using Illumina paired-end sequences, often rely on genome assembly prior to classification. That hinders rapid genotyping and scalability which are essential aspects of genomic epidemiology. stringMLST is a kmer-based ST method with the capacity to solve both hurdles. Yet, a comprehensive scalable comparison of its use in contrast to a standard MLST program for a wide array of phylogenetically divergent Public Health-relevant bacterial pathogens is lacking. Herein, we first demonstrated that stringMLST is a fast tool that can be deployed for ST-based epidemiological inquiries of bacterial populations. Additionally, we systematically evaluated and showed the impact of genome-intrinsic and -extrinsic features, as well as the optimal kmer length in maximizing the performance of stringMLST on species-by-species basis, and highlighted a few instances where this program may not be applicable in its current format. Furthermore, we integrated stringMLST as part of our freely available and scalable hierarchical-based population genomics platform called ProkEvo. Besides facilitating automatable and reproducible bacterial population guided analysis, ProkEvo now offers a rapidly deployable genomic epidemiology tool for ST mapping, with specific guidance on how to optimize its performance, that can be widely applicable by microbiological laboratories and epidemiological agencies.

scholarly journals Public policy and economic dynamics of COVID-19 spread: A mathematical modeling study

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244174
Author(s):  
Uri Goldsztejn ◽  
David Schwartzman ◽  
Arye Nehorai
Keyword(s):  
Mathematical Modeling ◽  
Large Scale ◽  
Population Based ◽  
Disease Spread ◽  
Economic Damage ◽  
Baseline Scenario ◽  
Economic Output ◽  
Economic Vulnerability ◽  
Restrictive Measures ◽  
The Impact

With the COVID-19 pandemic infecting millions of people, large-scale isolation policies have been enacted across the globe. To assess the impact of isolation measures on deaths, hospitalizations, and economic output, we create a mathematical model to simulate the spread of COVID-19, incorporating effects of restrictive measures and segmenting the population based on health risk and economic vulnerability. Policymakers make isolation policy decisions based on current levels of disease spread and economic damage. For 76 weeks in a population of 330 million, we simulate a baseline scenario leaving strong isolation restrictions in place, rapidly reducing isolation restrictions for non-seniors shortly after outbreak containment, and gradually relaxing isolation restrictions for non-seniors. We use 76 weeks as an approximation of the time at which a vaccine will be available. In the baseline scenario, there are 235,724 deaths and the economy shrinks by 34.0%. With a rapid relaxation, a second outbreak takes place, with 525,558 deaths, and the economy shrinks by 32.3%. With a gradual relaxation, there are 262,917 deaths, and the economy shrinks by 29.8%. We also show that hospitalizations, deaths, and economic output are quite sensitive to disease spread by asymptomatic people. Strict restrictions on seniors with very gradual lifting of isolation for non-seniors results in a limited number of deaths and lesser economic damage. Therefore, we recommend this strategy and measures that reduce non-isolated disease spread to control the pandemic while making isolation economically viable.

scholarly journals Physical Activity Is Associated With Lower Long-Term Incidence of Anxiety in a Population-Based, Large-Scale Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Martina Svensson ◽  
Lena Brundin ◽  
Sophie Erhardt ◽  
Ulf Hållmarker ◽  
Stefan James ◽  
...  
Keyword(s):  
Physical Activity ◽  
Physical Performance ◽  
Lower Risk ◽  
Large Scale ◽  
Population Based ◽  
Patient Registries ◽  
Swedish Population ◽  
Increased Risk ◽  
Observational Study Design ◽  
The Impact

Physical activity may prevent anxiety, but the importance of exercise intensity, sex-specific mechanisms, and duration of the effects remains largely unknown. We used an observational study design to follow 395,369 individuals for up to 21 years to investigate if participation in an ultralong-distance cross-country ski race (Vasaloppet, up to 90 km) was associated with a lower risk of developing anxiety. Skiers in the race and matched non-skiers from the general population were studied after participation in the race using the Swedish population and patient registries. Skiers (n = 197,685, median age 36 years, 38% women) had a significantly lower risk of developing anxiety during the follow-up compared to non-skiers (adjusted hazard ratio, HR 0.42). However, among women, higher physical performance (measured as the finishing time to complete the race, a proxy for higher exercise dose) was associated with an increased risk of anxiety compared to slower skiing women (HR 2.00). For men, the finishing time of the race did not significantly impact the risk of anxiety. Our results support the recommendations of engaging in physical activity to decrease the risk of anxiety in both men and women. The impact of physical performance level on the risk of anxiety requires further investigations among women.

Pretreatment steroid use and completion of immunotherapy: A population-based study.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 9567-9567
Author(s):  
Grace L. Lu-Yao ◽  
Nikita Nikita ◽  
Jennifer Maria Johnson ◽  
Scott W. Keith ◽  
Kuang-Yi Wen ◽  
...  
Keyword(s):  
Large Scale ◽  
Negative Impact ◽  
Population Based ◽  
Steroid Use ◽  
Population Based Study ◽  
Prevalence Estimates ◽  
Melanoma Patients ◽  
Pre Treatment ◽  
The Impact ◽  
The Relationship

9567 Background: The relationship between immunosuppressants and immunotherapy (IO) is an active area of research. Here we study the impact of pre-treatment steroid use on the completion of ipilimumab (ipi) therapy. Methods: This population-based study identified patients diagnosed with melanoma and treated with ipi (brand name Yervoy) in 2010-2014 from the linked Surveillance, Epidemiology and End Result-Medicare files. “Completion of IO on time” was defined as receiving 4 cycles of IO within 90 days. Otherwise, the patients were considered to have delayed or incomplete IO. The frequencies of patients completing each dose, up to 4 doses were tabulated. Exact Clopper-Pearson 95% confidence intervals (CI) were computed for prevalence estimates. A crude relative risk (RR) for completing IO was calculated. Results: We identified 1,205 melanoma patients treated with ipi with a median age of 71 years. Among 709 patients with no pre-treatment steroids, 35.7% had completed 4th dose of IO, compared to 20.3% of patients who received pre-treatment steroids within 1 month of IO (Table). In these patients, having no exposure to steroids in the year prior to initiating IO was associated with a 28% increased probability of completing the IO regimen (RR=1.28, 95% CI: 1.07-1.53). Conclusions: This large scale real-world study demonstrated both the overall completion rate of ipi in melanoma patients as well as the negative impact of pre-treatment steroids on rate of treatment completion. Further studies on treatment outcomes associated with pre-IO steroids use are warranted. [Table: see text]

scholarly journals The impact of C-reactive protein levels on headache frequency. The HUNT Study 2006-2008

2019 ◽  
Author(s):  
Knut Hagen ◽  
Lars Jacob Stovner ◽  
Kristian Bernhard Nilsen ◽  
Espen Saxhaug Kristoffersen ◽  
Bendik Slagsvold Winsvold
Keyword(s):  
Migraine With Aura ◽  
Large Scale ◽  
Population Based ◽  
C Reactive Protein ◽  
Cross Sectional ◽  
Population Based Study ◽  
Reactive Protein ◽  
Scale Population ◽  
Hs Crp ◽  
The Impact

Abstract Background Increased high sensitivity C- reactive protein (hs-CRP) levels have been found in many earlier studies on migraine, and recently also in persons with migraine and insomnia. The aim of this study was to see whether these findings could be reproduced in a large-scale population-based study. Methods A total of 50,807 (54%) out of 94,194 invited aged ≥ 20 years or older participated in the third wave of the Nord-Trøndelag Health Study study performed in 2006-2008. Among these, 38,807 (41%) had valid measures of hs-CRP and answered questions on headache and insomnia. Elevated hs-CRP was defined as >3.0 mg/L. The cross-sectional association with headache was estimated by multivariate analyses using multiple logistic regression. The precision of the odds ratio (OR) was assessed with 95% confidence interval (CI). Results In the fully adjusted model, elevated hs-CRP was associated with migraine (OR 1.14, 95% CI 1.04-1.25) and migraine with aura (OR 1.15, 95% CI 1.03-1.29). The association was strongest among individuals with headache ≥ 15 days/month for any headache (OR 1.26, 95% CI 1.08-1.48), migraine (OR 1.62, 95% CI 1.21-2.17), and migraine with aura (OR 1.84, 95% CI 1.27-2.67). No clear relationship was found between elevated hs-CRP and headache less than 7 days/month or with insomnia. Conclusions Cross-sectional data from this large-scale population-based study showed that elevated hs-CRP was associated with headache ≥ 7 days/month, especially evident for migraine with aura.

The effect of welfare reform on the health of the unemployed: evidence from a natural experiment in Germany

2020 ◽  
Vol 74 (3) ◽  
pp. 211-218
Author(s):  
Faraz V Shahidi ◽  
Carles Muntaner ◽  
Ketan Shankardass ◽  
Carlos Quiñonez ◽  
Arjumand Siddiqi
Keyword(s):  
Panel Study ◽  
Population Based ◽  
Welfare Benefits ◽  
Percentage Point Increase ◽  
Self Rated Health ◽  
Hartz Iv ◽  
Policy Measures ◽  
Linear Probability ◽  
The Unemployed ◽  
The Impact

BackgroundOver the past several decades, governments have enacted far-reaching reforms aimed at reducing the generosity and coverage of welfare benefits. Prior literature suggests that these policy measures may have deleterious effects on the health of populations. In this study, we evaluate the impact of one of the largest welfare reforms in recent history—the 2005 Hartz IV reform in Germany—with a focus on estimating its effect on the health of the unemployed.MethodsWe employed a quasi-experimental difference-in-differences (DID) design using population-based data from the German Socio-Economic Panel Study, covering the period between 1994 and 2016. We applied DID linear probability modelling to examine the association between the Hartz IV reform and poor self-rated health, adjusting for a range of demographic and socioeconomic confounders.ResultsThe Hartz IV reform was associated with a 3.6 (95% CI 0.9 to 6.2) percentage point increase in the prevalence of poor self-rated health among unemployed persons affected by the reform relative to similar but unaffected controls. This negative association appeared immediately following the implementation of the reform and has persisted over time.ConclusionGovernments in numerous European and North American jurisdictions have introduced measures to further diminish the generosity and coverage of welfare benefits. In line with growing concerns over the potential consequences of austerity and associated policy measures, our findings suggest that these reform efforts pose a threat to the health of socioeconomically disadvantaged populations.

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