Danube University Krems

About: Danube University Krems is a education organization based out in Krems, Niederösterreich, Austria. It is known for research contribution in the topics: Stroke & Population. The organization has 498 authors who have published 1572 publications receiving 68797 citations.

Impact of timing of surgery in elderly hip fracture patients: a systematic review and meta-analysis

Abstract: We aimed to assess the impact of timing of surgery in elderly patients with acute hip fracture on morbidity and mortality We systematically searched MEDLINE, the Cochrane Library, Embase, PubMed, and trial registries from 01/1997 to 05/2017, as well as reference lists of relevant reviews, archives of orthopaedic conferences, and contacted experts Eligible studies had to be randomised controlled trials (RCTs) or prospective cohort studies, including patients 60 years or older with acute hip fracture Two authors independently assessed study eligibility, abstracted data, and critically appraised study quality We conducted meta-analyses using the generic inverse variance model We included 28 prospective observational studies reporting data of 31,242 patients Patients operated on within 48 hours had a 20% lower risk of dying within 12 months (risk ratio (RR) 080, 95% confidence interval (CI) 066–097) No statistical significant different mortality risk was observed when comparing patients operated on within or after 24 hours (RR 082, 95% CI 067–101) Adjusted data demonstrated fewer complications (8% vs 17%) in patients who had early surgery, and increasing risk for pressure ulcers with increased time of delay in another study Early hip surgery within 48 hours was associated with lower mortality risk and fewer perioperative complications

Indolepropionic acid and novel lipid metabolites are associated with a lower risk of type 2 diabetes in the Finnish Diabetes Prevention Study

Abstract: Wide-scale profiling technologies including metabolomics broaden the possibility of novel discoveries related to the pathogenesis of type 2 diabetes (T2D). By applying non-targeted metabolomics approach, we investigated here whether serum metabolite profile predicts T2D in a well-characterized study population with impaired glucose tolerance by examining two groups of individuals who took part in the Finnish Diabetes Prevention Study (DPS); those who either early developed T2D (n = 96) or did not convert to T2D within the 15-year follow-up (n = 104). Several novel metabolites were associated with lower likelihood of developing T2D, including indole and lipid related metabolites. Higher indolepropionic acid was associated with reduced likelihood of T2D in the DPS. Interestingly, in those who remained free of T2D, indolepropionic acid and various lipid species were associated with better insulin secretion and sensitivity, respectively. Furthermore, these metabolites were negatively correlated with low-grade inflammation. We replicated the association between indolepropionic acid and T2D risk in one Finnish and one Swedish population. We suggest that indolepropionic acid, a gut microbiota-produced metabolite, is a potential biomarker for the development of T2D that may mediate its protective effect by preservation of β-cell function. Novel lipid metabolites associated with T2D may exert their effects partly through enhancing insulin sensitivity.

Increasing collaboration and participation in smart city governance: a cross-case analysis of smart city initiatives

Abstract: This study addresses the concept of smart governance in the context of smart cities, with a focus on analyzing the phenomenon of smart collaboration. Relying on the existing collaboration and parti...

Grading the Strength of a Body of Evidence When Assessing Health Care Interventions for the Effective Health Care Program of the Agency for Healthcare Research and Quality: An Update

Abstract: Systematic reviews are essential tools for summarizing information to help users make well-informed decisions about health care options. The Evidence-based Practice Center (EPC) program, supported by the Agency for Healthcare Research and Quality (AHRQ), produces substantial numbers of such reviews, including those that explicitly compare two or more clinical interventions (sometimes termed comparative effectiveness reviews). These reports synthesize a body of literature; the ultimate goal is to help clinicians, policymakers, and patients make well-considered decisions about health care. The goal of strength of evidence assessments is to provide clearly explained, well-reasoned judgments about reviewers’ confidence in their systematic review conclusions so that decisionmakers can use them effectively.Beginning in 2007, AHRQ supported a cross-EPC set of work groups to develop guidance on major elements of designing, conducting, and reporting systematic reviews. Together the materials form the EPC Methods Guide for Effectiveness and Comparative Effectiveness Reviews; one chapter focused on grading the strength of evidence. This chapter updates the original EPC strength of evidence approach, presenting findings and recommendations of a work group with experience in applying previous guidance; it should be considered current guidance for EPCs. The guidance applies primarily to systematic reviews of drugs, devices, and other preventive and therapeutic interventions; it may apply to exposures (characteristics or risk factors that are determinants of health outcomes) and broader health services research questions. It does not address reviews of medical tests.EPC reports support the work of many decisionmakers, but EPCs do not themselves develop recommendations or practice guidelines. In particular, we limit our grading strength of evidence approach to individual outcomes. Unlike grading systems that were designed to be used more directly by specific decisionmakers,– we do not develop global summary judgments of the relative benefits and harms of treatment comparisons.We briefly explore the rationale for grading strength of evidence, define domains of concern, and describe our recommended grading system for systematic reviews. The aims of this guidance are twofold: (1) to foster appropriate consistency and transparency in the methods that different EPCs use to grade strength of evidence and (2) to facilitate users’ interpretations of those grades for guideline development or other decisionmaking tasks. Because this field is rapidly evolving, future revisions are anticipated; they will reflect our increasing understanding and experience with the methodology.

Big data in the policy cycle: Policy decision making in the digital era

Abstract: Although of high relevance to political science, the interaction between technological change and political change in the era of Big Data remains somewhat of a neglected topic. Most studies focus on the concept of e-government and e-governance, and on how already existing government activities performed through the bureaucratic body of public administration could be improved by technology. This article attempts to build a bridge between the field of e-governance and theories of public administration that goes beyond the service delivery approach that dominates a large part of e-government research. Using the policy cycle as a generic model for policy processes and policy development, a new look on how policy decision making could be conducted on the basis of ICT and Big Data is presented in this article.