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1.
Epidemiol Infect ; 149: e213, 2021 09 22.
Article in English | MEDLINE | ID: mdl-34549699

ABSTRACT

This study aims at providing estimates on the transmission risk of SARS-CoV-2 in schools and day-care centres. We calculated secondary attack rates (SARs) using individual-level data from state-wide mandatory notification of index cases in educational institutions, followed by contact tracing and PCR-testing of high-risk contacts. From August to December 2020, every sixth of overall 784 independent index cases was associated with secondary cases in educational institutions. Monitoring of 14 594 institutional high-risk contacts (89% PCR-tested) of 441 index cases during quarantine revealed 196 secondary cases (SAR 1.34%, 0.99-1.78). SARS-CoV-2 infection among high-risk contacts was more likely around teacher-indexes compared to student-/child-indexes (incidence rate ratio (IRR) 3.17, 1.79-5.59), and in day-care centres compared to secondary schools (IRR 3.23, 1.76-5.91), mainly due to clusters around teacher-indexes in day-care containing a higher mean number of secondary cases per index case (142/113 = 1.26) than clusters around student-indexes in schools (82/474 = 0.17). In 2020, SARS-CoV-2 transmission risk in educational settings was low overall, but varied strongly between setting and role of the index case, indicating the chance for targeted intervention. Surveillance of SARS-CoV-2 transmission in educational institutions can powerfully inform public health policy and improve educational justice during the pandemic.


Subject(s)
COVID-19/epidemiology , COVID-19/transmission , Child Day Care Centers/statistics & numerical data , Schools/statistics & numerical data , Adolescent , Adult , COVID-19/diagnosis , COVID-19/prevention & control , Child , Child, Preschool , Contact Tracing , Epidemiological Monitoring , Germany/epidemiology , Humans , Incidence , Mandatory Reporting , Risk , SARS-CoV-2/isolation & purification
2.
Neurosurg Rev ; 44(5): 2707-2715, 2021 Oct.
Article in English | MEDLINE | ID: mdl-33354749

ABSTRACT

Recent data suggest that the type of anesthesia used during the resection of solid tumors impacts the long-term survival of patients favoring total-intravenous-anesthesia (TIVA) over inhalative-anesthesia (INHA). Here we sought to query this impact on survival in patients undergoing resection of glioblastoma (GBM). All patients receiving elective resection of a newly diagnosed, isocitrate-dehydrogenase-1-(IDH1)-wildtype GBM under general anesthesia between January 2010 and June 2017 in the Department of Neurosurgery, Heidelberg University Hospital, were included. Patients were grouped according to the applied anesthetic technique. To adjust for potential prognostic confounders, patients were matched in a 1:2 ratio (TIVA vs. INHA), taking into account the known prognostic factors: age, extent of resection, O-6-methylguanine-DNA-methyltransferase-(MGMT)-promoter-methylation-status, pre-operative Karnofsky-performance-index and adjuvant radio- and chemotherapy. The primary endpoint was progression-free-survival (PFS) and the secondary endpoint was overall-survival (OS). In the study period, 576 patients underwent resection of a newly diagnosed, IDH-wildtype GBM. Patients with incomplete follow-up-data, on palliative treatment, having emergency or awake surgery; 54 patients remained in the TIVA-group and 417 in the INHA-group. After matching, 52 patients remained in the TIVA-group and 92 in the INHA-group. Median PFS was 6 months in both groups. The median OS was 13.5 months in the TIVA-group and 13.0 months in the INHA-group. No significant survival differences associated with the type of anesthesia were found either before or after adjustment for known prognostic factors. This retrospective study supports the notion that the current anesthetic approaches employed during the resection of IDH-wildtype GBM do not impact patient survival.


Subject(s)
Brain Neoplasms , Glioblastoma , Anesthetics, Intravenous , Anesthetists , Brain Neoplasms/drug therapy , Brain Neoplasms/surgery , DNA Modification Methylases , DNA Repair Enzymes , Glioblastoma/drug therapy , Glioblastoma/surgery , Humans , Prognosis , Retrospective Studies , Wakefulness
3.
Nano Lett ; 13(5): 1883-9, 2013 May 08.
Article in English | MEDLINE | ID: mdl-23600364

ABSTRACT

Three-dimensional coherent diffraction patterns of an isolated, single-crystalline Ag/Au core-shell nanowire were recorded at different X-ray beam energies close to the Au LIII absorption edge. Two-dimensional slices of the three-dimensional diffraction pattern, with the diffraction vector oriented perpendicular to the wire axis, were investigated in detail. In reciprocal space, facet streaks with thickness fringes were clearly observed in the two-dimensional diffraction patterns, from which the shape and size of the corresponding cross sections of the nanowire could be revealed. Comparison with simulated diffraction patterns exhibited the coherency strain field in the nanowire. During in situ annealing at temperatures which would lead to significant intermixing by volume diffusion in bulk material, according to literature data, a core-shell morphology was preserved; that is, intermixing in the nanowire was pronouncedly decelerated compared to bulk diffusion.

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