Age-specific contribution of contacts to transmission of SARS-CoV-2 in Germany.

Current estimates of pandemic SARS-CoV-2 spread in Germany using infectious disease models often do not use age-specific infection parameters and are not always based on age-specific contact matrices of the population. They also do usually not include setting- or pandemic phase-based information from epidemiological studies of reported cases and do not account for age-specific underdetection of reported cases. Here, we report likely pandemic spread using an age-structured model to understand the age- and setting-specific contribution of contacts to transmission during different phases of the COVID-19 pandemic in Germany. We developed a deterministic SEIRS model using a pre-pandemic contact matrix. The model was optimized to fit age-specific SARS-CoV-2 incidences reported by the German National Public Health Institute (Robert Koch Institute), includes information on setting-specific reported cases in schools and integrates age- and pandemic period-specific parameters for underdetection of reported cases deduced from a large population-based seroprevalence studies. Taking age-specific underreporting into account, younger adults and teenagers were identified in the modeling study as relevant contributors to infections during the first three pandemic waves in Germany. For the fifth wave, the Delta to Omicron transition, only age-specific parametrization reproduces the observed relative and absolute increase in pediatric hospitalizations in Germany. Taking into account age-specific underdetection did not change considerably how much contacts in schools contributed to the total burden of infection in the population (up to 12% with open schools under hygiene measures in the third wave). Accounting for the pandemic phase and age-specific underreporting is important to correctly identify those groups of the population in which quarantine, testing, vaccination, and contact-reduction measures are likely to be most effective and efficient. Age-specific parametrization is also highly relevant to generate informative age-specific output for decision makers and resource planers.

A video based benchmark data set (ENDOTEST) to evaluate computer-aided polyp detection systems.

BACKGROUND AND AIMS: Computer-aided polyp detection (CADe) may become a standard for polyp detection during colonoscopy. Several systems are already commercially available. We report on a video-based benchmark technique for the first preclinical assessment of such systems before comparative randomized trials are to be undertaken. Additionally, we compare a commercially available CADe system with our newly developed one. METHODS: ENDOTEST consisted in the combination of two datasets. The validation dataset contained 48 video-snippets with 22,856 manually annotated images of which 53.2% contained polyps. The performance dataset contained 10 full-length screening colonoscopies with 230,898 manually annotated images of which 15.8% contained a polyp. Assessment parameters were accuracy for polyp detection and time delay to first polyp detection after polyp appearance (FDT). Two CADe systems were assessed: a commercial CADe system (GI-Genius, Medtronic), and a self-developed new system (ENDOMIND). The latter being a convolutional neuronal network trained on 194,983 manually labeled images extracted from colonoscopy videos recorded in mainly six different gastroenterologic practices. RESULTS: On the ENDOTEST, both CADe systems detected all polyps in at least one image. The per-frame sensitivity and specificity in full colonoscopies was 48.1% and 93.7%, respectively for GI-Genius; and 54% and 92.7%, respectively for ENDOMIND. Median FDT of ENDOMIND with 217 ms (Inter-Quartile Range(IQR)8-1533) was significantly faster than GI-Genius with 1050 ms (IQR 358-2767, p = 0.003). CONCLUSIONS: Our benchmark ENDOTEST may be helpful for preclinical testing of new CADe devices. There seems to be a correlation between a shorter FDT with a higher sensitivity and a lower specificity for polyp detection.

Targeted COVID-19 Vaccination (TAV-COVID) Considering Limited Vaccination Capacities-An Agent-Based Modeling Evaluation.

(1) Background: The Austrian supply of COVID-19 vaccine is limited for now. We aim to provide evidence-based guidance to the authorities in order to minimize COVID-19-related hospitalizations and deaths in Austria. (2) Methods: We used a dynamic agent-based population model to compare different vaccination strategies targeted to the elderly (65 ≥ years), middle aged (45-64 years), younger (15-44 years), vulnerable (risk of severe disease due to comorbidities), and healthcare workers (HCW). First, outcomes were optimized for an initially available vaccine batch for 200,000 individuals. Second, stepwise optimization was performed deriving a prioritization sequence for 2.45 million individuals, maximizing the reduction in total hospitalizations and deaths compared to no vaccination. We considered sterilizing and non-sterilizing immunity, assuming a 70% effectiveness. (3) Results: Maximum reduction of hospitalizations and deaths was achieved by starting vaccination with the elderly and vulnerable followed by middle-aged, HCW, and younger individuals. Optimizations for vaccinating 2.45 million individuals yielded the same prioritization and avoided approximately one third of deaths and hospitalizations. Starting vaccination with HCW leads to slightly smaller reductions but maximizes occupational safety. (4) Conclusion: To minimize COVID-19-related hospitalizations and deaths, our study shows that elderly and vulnerable persons should be prioritized for vaccination until further vaccines are available.

Optimal control of a multi-patch Dengue model under the influence of Wolbachia bacterium.

In this work, a multi-patch model for dengue transmission dynamics including the bacterium Wolbachia is studied and by that the control efforts to minimize the disease spread by host and vector control are investigated. The multi-patch system models the host movement within the patches which coupled via a residence-time budgeting matrix P. Numerical results confirm that the control mechanism embedded in incidence rates of the disease transmission, effectively reduce the spread of the disease.

Effect of a Single Aspirin Dose Prior to Fecal Immunochemical Testing on Test Sensitivity for Detecting Advanced Colorectal Neoplasms: A Randomized Clinical Trial.

Importance: Fecal immunochemical tests for hemoglobin are widely used for colorectal cancer (CRC) screening. Observational studies suggested that sensitivity of fecal immunochemical tests for detecting advanced neoplasms could be increased by acetylsalicylic acid (aspirin), especially among men. Objective: To evaluate the potential to increase sensitivity of fecal immunochemical tests by administering a single 300-mg oral aspirin dose 2 days before stool sampling. Design, Setting, and Participants: A randomized, placebo-controlled, double-blind trial was conducted in 14 gastroenterology practices and 4 hospitals in Germany, and included 2422 men and women aged 40 to 80 years scheduled for colonoscopy, with no recent use of aspirin or other drugs with antithrombotic effects (enrollment from June 2013 to November 2016, and final follow-up January 27, 2017). Interventions: Administration of a single tablet containing 300 mg of aspirin (n = 1208) or placebo (n = 1214) 2 days before fecal sampling for fecal immunochemical test. Main Outcome and Measures: The primary outcome was sensitivity of a quantitative fecal immunochemical test at 2 predefined cutoffs (10.2 and 17-µg Hb/g stool) for detecting advanced neoplasms (colorectal cancer or advanced adenoma). Results: Among 2422 randomized patients (mean [SD] age, 59.6 [7.9] years; 1219, 50%, men), 2134 were included in the analysis (78% for primary screening colonoscopy, 22% for diagnostic colonoscopy). Advanced neoplasms were identified in 224 participants (10.5%), including 8 participants (0.4%) with CRC and 216 participants (10.1%) with advanced adenoma. Sensitivity was 40.2% in the aspirin group and 30.4% in the placebo group (difference 9.8%, 95% CI, -3.1% to 22.2%, P = .14) at cutoff 10.2-µg Hb/g stool and 28.6% in the aspirin and 22.5% in the placebo group (difference 6.0%, 95% CI, -5.7% to 17.5%, P = .32) at cutoff 17-µg Hb/g stool. Conclusions and Relevance: Among adults aged 40 to 80 years not using aspirin or other antithrombotic medications, administration of a single dose of oral aspirin prior to fecal immunochemical testing, compared with placebo, did not significantly increase test sensitivity for detecting advanced colorectal neoplasms at 2 predefined cutoffs of a quantitative fecal immunochemical test. Trial registration: Deutsches Register Klinischer Studien Identifier: DRKS00003252; EudraCT Identifier: 2011-005603-32/DE.

Integral representation of generalized grey Brownian motion.

In this paper, we investigate the representation of a class of non-Gaussian processes, namely generalized grey Brownian motion, in terms of a weighted integral of a stochastic process which is a solution of a certain stochastic differential equation. In particular, the underlying process can be seen as a non-Gaussian extension of the Ornstein-Uhlenbeck process, hence generalizing the representation results of Muravlev, Russian Math. Surveys 66 (2), 2011 as well as Harms and Stefanovits, Stochastic Process. Appl. 129, 2019 to the non-Gaussian case.

Structural Properties of Al-O Monolayers in SiO2 on Silicon and the Maximization of Their Negative Fixed Charge Density.

Al2O3 on Si is known to form an ultrathin interfacial SiO2 during deposition and subsequent annealing, which creates a negative fixed charge ( Qfix) that enables field-effect passivation and low surface recombination velocities in Si solar cells. Various concepts were suggested to explain the origin of this negative Qfix. In this study, we investigate Al-O monolayers (MLs) from atomic layer deposition (ALD) sandwiched between deliberately grown/deposited SiO2 films. We show that the Al atoms have an ultralow diffusion coefficient (∼4 × 10-18 cm2/s at 1000 °C), are deposited at a constant rate of ∼5 × 1014 Al atoms/(cm2 cycle) from the first ALD cycle, and are tetrahedral O-coordinated because the adjacent SiO2 imprints its tetrahedral near-order and bond length into the Al-O MLs. By variation in the tunnel-SiO2 thickness and the number of Al-O MLs, we demonstrate that the tetrahedral coordination alone is not sufficient for the formation of Qfix but that a SiO2/Al2O3 interface within a tunneling distance from the substrate must be present. The Al-induced acceptor states at these interfaces have energy levels slightly below the Si valence band edge and require charging by electrons from either the Si substrate or from Si/SiO2 dangling bonds to create a negative Qfix. Hence, tunneling imposes limitations for the SiO2 and Al2O3 layer thicknesses. In addition, Coulomb repulsion between the charged acceptor states results in an optimum number of Al-O MLs, i.e., separation of both interfaces. We achieve maximum negative Qfix of ∼5 × 1012 cm-2 (comparable to thick ALD-Al2O3 on Si) with ∼1.7 nm tunnel-SiO2 and just seven ALD-Al2O3 cycles (∼8 Å) after optimized annealing at 850 °C for 30 s. The findings are discussed in the context of a passivating, hole-selective tunnel contact for high-efficiency Si solar cells.

Absence of free carriers in silicon nanocrystals grown from phosphorus- and boron-doped silicon-rich oxide and oxynitride.

Phosphorus- and boron-doped silicon nanocrystals (Si NCs) embedded in silicon oxide matrix can be fabricated by plasma-enhanced chemical vapour deposition (PECVD). Conventionally, SiH4 and N2O are used as precursor gasses, which inevitably leads to the incorporation of ≈10 atom % nitrogen, rendering the matrix a silicon oxynitride. Alternatively, SiH4 and O2 can be used, which allows for completely N-free silicon oxide. In this work, we investigate the properties of B- and P-incorporating Si NCs embedded in pure silicon oxide compared to silicon oxynitride by atom probe tomography (APT), low-temperature photoluminescence (PL), transient transmission (TT), and current-voltage (I-V) measurements. The results clearly show that no free carriers, neither from P- nor from B-doping, exist in the Si NCs, although in some configurations charge carriers can be generated by electric field ionization. The absence of free carriers in Si NCs ≤5 nm in diameter despite the presence of P- or B-atoms has severe implications for future applications of conventional impurity doping of Si in sub-10 nm technology nodes.

Boron-Incorporating Silicon Nanocrystals Embedded in SiO2: Absence of Free Carriers vs. B-Induced Defects.

Boron (B) doping of silicon nanocrystals requires the incorporation of a B-atom on a lattice site of the quantum dot and its ionization at room temperature. In case of successful B-doping the majority carriers (holes) should quench the photoluminescence of Si nanocrystals via non-radiative Auger recombination. In addition, the holes should allow for a non-transient electrical current. However, on the bottom end of the nanoscale, both substitutional incorporation and ionization are subject to significant increase in their respective energies due to confinement and size effects. Nevertheless, successful B-doping of Si nanocrystals was reported for certain structural conditions. Here, we investigate B-doping for small, well-dispersed Si nanocrystals with low and moderate B-concentrations. While small amounts of B-atoms are incorporated into these nanocrystals, they hardly affect their optical or electrical properties. If the B-concentration exceeds ~1 at%, the luminescence quantum yield is significantly quenched, whereas electrical measurements do not reveal free carriers. This observation suggests a photoluminescence quenching mechanism based on B-induced defect states. By means of density functional theory calculations, we prove that B creates multiple states in the bandgap of Si and SiO2. We conclude that non-percolated ultra-small Si nanocrystals cannot be efficiently B-doped.

Molecular Epidemiology of Carbapenem-Resistant Acinetobacter Baumannii Complex Isolates from Patients that were Injured During the Eastern Ukrainian Conflict.

This study addressed carbapenem-resistant Acinetobacter baumannii complex (ABC) isolates from patients that were injured during the military conflict in the Eastern Ukraine and treated at German Armed Forces Hospitals in 2014 and 2015. Clonal diversity of the strains and potential ways of transmission were analyzed. Patients with one or several isolation events of carbapenem-resistant ABC were included. Isolates were characterized by VITEK II-based identification and resistance testing, molecular screening for frequent carbapenemase genes, and DiversiLab rep-PCR-based typing. Available clinical information of the patients was assessed. From 21 young male Ukrainian patients with battle injuries, 32 carbapenem- and fluoroquinolone-resistant ABC strains were isolated. Four major clonal clusters were detected. From four patients (19%), ABC isolates from more than one clonal cluster were isolated. The composition of the clusters suggested transmission events prior to the admission to the German hospitals. The infection and colonization pressure in the conflict regions of the Eastern Ukraine with ABC of low clonal diversity is considerable. Respective infection risks have to be considered in case of battle-related injuries in these regions. The low number of local clones makes any molecular exclusion of transmission events difficult.

Precise in situ etch depth control of multilayered III-V semiconductor samples with reflectance anisotropy spectroscopy (RAS) equipment.

Reflectance anisotropy spectroscopy (RAS) equipment is applied to monitor dry-etch processes (here specifically reactive ion etching (RIE)) of monocrystalline multilayered III-V semiconductors in situ. The related accuracy of etch depth control is better than 16 nm. Comparison with results of secondary ion mass spectrometry (SIMS) reveals a deviation of only about 4 nm in optimal cases. To illustrate the applicability of the reported method in every day settings for the first time the highly etch depth sensitive lithographic process to form a film lens on the waveguide ridge of a broad area laser (BAL) is presented. This example elucidates the benefits of the method in semiconductor device fabrication and also suggests how to fulfill design requirements for the sample in order to make RAS control possible.

["Dear Max, how much we are one, I was only clearly aware the day after leaving my last letter to you." Max Horkheimer and Karl Landauer as the first psychoanalyst at the Frank­furt Institute for Social Research]. / "Lieber Max, wie sehr wir eins sind, wurde mir erst am Tag nach Abgang meines letzten Briefes an Dich klar." Max Horkheimer und Karl Landauer als erster Psychoanalytiker am Frankfurter Institut für Sozialforschung.

The Frankfurt School is known to be the first institution in Germany that in 1929 has officially related psychoanalysis to a university. The most important person in this process was Karl Landauer. With him Fromm, Horkheimer and others completed their training analyzes, he decisively worked in the Institute and the first volumes of the Journal of Social Research. Landauer and Horkheimer regularly ex­change information in the time of emigration and discuss their texts together. Landauer is also responsible for the reception of psychoanalysis in Horkheimer's further programs he writes for the Institute, as in his programmatic essay "Egoism and freedom-movement" from 1936. When he was murdered in concentration camp in 1945, it was a great per­sonal and theoretical loss for Horkheimer which he hardly could overcome. Also the known dispute between Adorno and Fromm at the Institute for Social Research has as a backbone an old rivalry between the psychoanalytic institutes from Berlin and Frankfurt, which is exacerbated during the emigration and the Gleichschaltung in fascist Germany.

Intracranial hemorrhage and other symptoms in infants associated with human parechovirus in Vienna, Austria.

The human parechovirus (HPeV), mainly genotype 3, may cause severe illness in young infants and neonates, including sepsis-like illness and central nervous system (CNS) infection. We lack data concerning the impact and symptoms of HPeV infection in infants in Austria. The aim of the study is to evaluate the spectrum of symptoms and findings in infants with the parechovirus in Vienna and its environs. Patients younger than 3 months of age, with clinically suspected sepsis-like illness or CNS infection and a positive polymerase chain reaction (PCR) for HPeV, were included in the study. Medical records were analyzed retrospectively. Twenty patients were included in the study from 2009 to 2013. The most frequent manifestations were fever and neurological symptoms (89 and 80 %, respectively). Fifty percent of the infants had white blood cell counts out of range. The most notable aspect was cerebral hemorrhage in three neonates, which has not been reported earlier in association with HPeV infection. CONCLUSION: In Austria, HPeV is a relevant pathogen in sepsis-like disease in infants. The clinical presentation is similar to that described in other studies; cerebral hemorrhage is a new aspect. WHAT IS KNOWN: • Parechovirus infection can cause severe illness in infants. • Symptoms have been described to involve all organs; sepsis-like signs, fever, and irritability are most frequent. WHAT IS NEW: • Also in Austria, HPeV plays an important role in severe illnesses in infants. • Severe intracranial hemorrhage is described as a new finding.

Agenesis of the Corpus Callosum and Skeletal Deformities in Two Unrelated Patients: Analysis via MRI and Radiography.

Purpose. Mental retardation, mild to severe epilepsy and cerebral palsy often of hemiplegic type are common accompaniments in patients with agenesis/hypoplasia of the corpus callosum. Skeletal deformities of bilateral radiohumeral synostosis, brachydactyly, bilateral elbow dislocation, talipes equinovarus, and juxtacalcaneal accessory bones have been encountered in two unrelated children with agenesis of the corpus callosum. Methods. We report on two unrelated children who presented with the full clinical criteria of agenesis of the corpus callosum. Strikingly, both presented with variable upper and lower limb deformities. The clinical features, radiographic and MRI findings in our current patients, have been compared with previously reported cases identified through a PubMed literature review. Results. Bilateral radiohumeral synostosis associated with pyruvate dehydrogenase deficiency has been encountered in one patient. The other patient manifested bilateral elbow dislocation, coxa valga, talipes equinovarus, and bilateral juxtacalcaneal accessory bones. Conclusion. The constellation of malformation complexes in our current patients have the hitherto not been reported and expanding the spectrum of skeletal deformities in connection with agenesis of the corpus callosum.

Food and drinking water hygiene and intestinal protozoa in deployed German soldiers.

This report analyzes the occurrence of Cryptosporidium spp., E. histolytica, and G. intestinalis in stool of returnees from military deployments and the impact of hygiene precautions. Between 2007 and 2010, stool samples of 830 returnees that were obtained 8-12 weeks after military deployments in Afghanistan, Uzbekistan, the Balkans, Democratic Republic of the Congo/Gabonese Republic, and Sudan and 292 control samples from non-deployed soldiers were analyzed by PCR for Cryptosporidium spp., E. histolytica, G. intestinalis, and the commensal indicator of fecal contamination E. dispar. Data on hygiene precautions were available. The soldiers were questioned regarding gastrointestinal and general symptoms. Among 1122 stool samples, 18 were positive for G. intestinalis, 10 for E. dispar, and no-one for Cryptosporidium spp. and E. histolytica. An increased risk of acquiring chronic parasitic infections in comparison with non-deployed controls was demonstrated only for G. intestinalis in Sudan, where standardized food and drinking water hygiene precautions could not be implemented. Standard food and drinking water hygiene precautions in the context of screened military field camps proved to be highly reliable in preventing food-borne and water-borne chronic infections and colonization by intestinal protozoa, leading to detection proportions similar to those in non-deployed controls.

Chemical and structural characterisation of DGEBA-based epoxies by time of flight secondary ion mass spectrometry (ToF-SIMS) as a preliminary to polymer interphase characterisation.

Time-of-flight secondary ion mass spectrometry (ToF-SIMS) has become a powerful tool in the field of surface analysis since it provides information about the top few monolayers of a sample, i.e. on the chemical composition of the sample surface. Thus, the general question arises whether a surface-sensitive technique like ToF-SIMS would be appropriate to detect systematic chemical and/or structural changes in organic bulk polymers caused by varying a chemical content of the initial components or by tracking, e.g. curing processes in such materials. It is shown that careful sample preparation and the use of multivariate methods permit the quantitative acquisition of chemical and structural information about bulk polymers from the secondary ion signals. The hardener concentration and a cross-linking coefficient in diglycidyl ether of bisphenol A based epoxies were determined by ToF-SIMS measurements on samples with different resin to hardener ratio and varying curing time. In future work, we will use the developed method to investigate the local composition of adhesively bonded joints. In particular, the mapping of the chemical and structural properties in the so-called interphase will then be of interest.

A degradation-sensitive anionic trypsinogen (PRSS2) variant protects against chronic pancreatitis.

Chronic pancreatitis is a common inflammatory disease of the pancreas. Mutations in the genes encoding cationic trypsinogen (PRSS1) and the pancreatic secretory trypsin inhibitor (SPINK1) are associated with chronic pancreatitis. Because increased proteolytic activity owing to mutated PRSS1 enhances the risk for chronic pancreatitis, mutations in the gene encoding anionic trypsinogen (PRSS2) may also predispose to disease. Here we analyzed PRSS2 in individuals with chronic pancreatitis and controls and found, to our surprise, that a variant of codon 191 (G191R) is overrepresented in control subjects: G191R was present in 220/6,459 (3.4%) controls but in only 32/2,466 (1.3%) affected individuals (odds ratio 0.37; P = 1.1 x 10(-8)). Upon activation by enterokinase or trypsin, purified recombinant G191R protein showed a complete loss of trypsin activity owing to the introduction of a new tryptic cleavage site that renders the enzyme hypersensitive to autocatalytic proteolysis. In conclusion, the G191R variant of PRSS2 mitigates intrapancreatic trypsin activity and thereby protects against chronic pancreatitis.

Specialized DNA arrays for the differentiation of pancreatic tumors.

PURPOSE: Malignant tumors of the pancreas are frequently indistinguishable from inflammatory tumors arising in the context of a chronic pancreatitis with the use of conventional imaging techniques. Thus, cytologic analysis of cells obtained by abdominal ultrasound, computed tomography, or endoscopic ultrasound-guided fine needle aspiration biopsy is required for diagnosis. However, the reliability of cytologic analyses of pancreatic fine needle aspirates remains unsatisfactory, with a diagnostic accuracy of < or =80%. The purpose of the current study was therefore to develop a novel diagnostic approach based on expression profiling of biopsy material using a specialized diagnostic cDNA array. EXPERIMENTAL DESIGN: Previous gene expression profiling studies were reevaluated to design a 558-feature diagnostic array. Minimal amounts of residual material from pancreatic cytology samples as well as surgically resected tumor and control tissue specimens were analyzed using the diagnostic array and a newly developed statistical classification system. RESULTS AND CONCLUSIONS: Our diagnostic approach resulted in 95% accurate differentiation between ductal adenocarcinomas and nonmalignant tumors of the pancreas. The diagnostic array, in conjunction with conventional diagnostic procedures, is thus suitable to significantly improve the reliability of pancreatic cancer diagnostics and can be expected to become a valuable new tool in the routine workup of suspect masses in the pancreas.

Prevalence of familial pancreatic cancer in Germany.

Based on several case-control studies, it has been estimated that familial aggregation and genetic susceptibility play a role in up to 10% of patients with pancreatic cancer, although conclusive epidemiologic data are still lacking. Therefore, we evaluated the prevalence of familial pancreatic cancer and differences to its sporadic form in a prospective multicenter trial. A total of 479 consecutive patients with newly diagnosed, histologically confirmed adenocarcinoma of the pancreas were prospectively evaluated regarding medical and family history, treatment and pathology of the tumour. A family history for pancreatic cancer was confirmed whenever possible by reviewing the tumour specimens and medical reports. Statistical analysis was performed by calculating odds ratios, regression analysis with a logit-model and the Kaplan-Meier method. Twenty-three of 479 (prevalence 4.8%, 95% CI 3.1-7.1) patients reported at least 1 first-degree relative with pancreatic cancer. The familial aggregation could be confirmed by histology in 5 of 23 patients (1.1%, 95% CI 0.3-2.4), by medical records in 9 of 23 patients (1.9%, 95% CI 0.9-3.5) and by standardized interviews of first-degree relatives in 17 of 23 patients (3.5%, 95% CI 2.1-5.6), respectively. There were no statistical significant differences between familial and sporadic pancreatic cancer cases regarding sex ratio, age of onset, presence of diabetes mellitus and pancreatitis, tumour histology and stage, prognosis after palliative or curative treatment as well as associated tumours in index patients and families, respectively. The prevalence of familial pancreatic cancer in Germany is at most 3.5% (range 1.1-3.5%) depending on the mode of confirmation of the pancreatic carcinoma in relatives. This prevalence is lower than so far postulated in the literature. There were no significant clinical differences between the familial and sporadic form of pancreatic cancer.

[Breast feeding support, incidence of breastfeeding and duration of breast feeding in a Vienna perinatal center]. / Stillberatung, Stillhäufigkeit und Stilldauer in einem Wiener Perinatalzentrum.

AIMS: Evaluation of factors influencing the incidence and duration of breastfeeding. METHODS: In a retrospective study we sent a questionnaire to the parents of 1518 infants born consecutively in the Center of Perinatology at the Danube Hospital, Vienna, during a 10 months period. The questionnaire consisted of items addressing duration of breastfeeding, time of initiation of formula supplement, support in breastfeeding and the time mothers were provided with information on breastfeeding. Data on mothers age, parity, mode of delivery, duration of pregnancy and infants birth weight were taken from the records. RESULTS: 95% of mothers began breastfeeding, 56% continued breastfeeding for more than 5 months. The impression or fact of no support was associated with a higher rate of not breastfeeding (p < 0.001). "Little support" was associated with a higher rate of terminating breastfeeding during the first three months and with a lower rate of breastfeeding for more than 5 months (p < 0.01). Provided information on breastfeeding shows no effect on the duration of breastfeeding, but "no information" corresponds with not breastfeeding (p < 0.01). Mothers who got repeated information breastfed longer (p < 0.01). The number of mothers who did not breastfeed and was higher among three or multipare compared to primipare (p < 0.025). They also breastfed shorter (p < 0.05). Mothers under 20 years of age more often terminated breastfeeding in the first month (p < 0.001). Low birth weight (< 2000 g) and caesarean sectio increased the number of mothers who did not breastfeed (p < 0.001). CONCLUSIONS: Repeated information and individual support increases the number of breastfeeding mothers and the duration of breastfeeding. Additional support should be provided for mothers under 20 years of age, three and multiparae and mothers after caesarean sectio.