TY - JOUR A1 - Hamouda, Khaled A1 - Oezkur, Mehmet A1 - Sinha, Bhanu A1 - Hain, Johannes A1 - Menkel, Hannah A1 - Leistner, Marcus A1 - Leyh, Rainer A1 - Schimmer, Christoph T1 - Different duration strategies of perioperative antibiotic prophylaxis in adult patients undergoing cardiac surgery: an observational study JF - Journal of Cardiothoracic Surgery N2 - Background All international guidelines recommend perioperative antibiotic prophylaxis (PAB) should be routinely administered to patients undergoing cardiac surgery. However, the duration of PAB is heterogeneous and controversial. Methods Between 01.01.2011 and 31.12.2011, 1096 consecutive cardiac surgery patients were assigned to one of two groups receiving PAB with a second-generation cephalosporin for either 56 h (group I) or 32 h (group II). Patients’ characteristics, intraoperative data, and the in-hospital follow-up were analysed. Primary endpoint was the incidence of surgical site infection (deep and superficial sternal wound-, and vein harvesting site infection; DSWI/SSWI/VHSI). Secondary endpoints were the incidence of respiratory-, and urinary tract infection, as well as the mortality rate. Results 615/1096 patients (56,1%) were enrolled (group I: n = 283 versus group II: n = 332). There were no significant differences with regard to patient characteristics, comorbidities, and procedure-related variables. No statistically significant differences were demonstrated concerning primary and secondary endpoints. The incidence of DSWI/SSWI/VHSI were 4/283 (1,4%), 5/283 (1,7%), and 1/283 (0,3%) in group I versus 6/332 (1,8%), 9/332 (2,7%), and 3/332 (0,9%) in group II (p = 0,76/0,59/0,63). In univariate analyses female gender, age, peripheral arterial obstructive disease, operating-time, ICU-duration, transfusion, and respiratory insufficiency were determinants for nosocomial infections (all ≤ 0,05). Subgroup analyses of these high-risk patients did not show any differences between the two regimes (all ≥ 0,05). Conclusions Reducing the duration of PAB from 56 h to 32 h in adult cardiac surgery patients was not associated with an increase of nosocomial infection rate, but contributes to reduce antibiotic resistance and health care costs. KW - nosocomial infection KW - cardiac surgery KW - antibiotic prophylaxis Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-124977 VL - 10 IS - 25 ER - TY - THES A1 - Hain, Johannes T1 - Valuation Algorithms for Structural Models of Financial Networks T1 - Algorithmen zur Bestimmung von Gleichgewichtslösungen in Finanzsystemen mit Kapitalverflechtung N2 - The thesis focuses on the valuation of firms in a system context where cross-holdings of the firms in liabilities and equities are allowed and, therefore, systemic risk can be modeled on a structural level. A main property of such models is that for the determination of the firm values a pricing equilibrium has to be found. While there exists a small but growing amount of research on the existence and the uniqueness of such price equilibria, the literature is still somewhat inconsistent. An example for this fact is that different authors define the underlying financial system on differing ways. Moreover, only few articles pay intense attention on procedures to find the pricing equilibria. In the existing publications, the provided algorithms mainly reflect the individual authors' particular approach to the problem. Additionally, all existing methods do have the drawback of potentially infinite runtime. For these reasons, the objects of this thesis are as follows. First, a definition of a financial system is introduced in its most general form in Chapter 2. It is shown that under a fairly mild regularity condition the financial system has a unique existing payment equilibrium. In Chapter 3, some extensions and differing definitions of financial systems that exist in literature are presented and it is shown how these models can be embedded into the general model from the proceeding chapter. Second, an overview of existing valuation algorithms to find the equilibrium is given in Chapter 4, where the existing methods are generalized and their corresponding mathematical properties are highlighted. Third, a complete new class of valuation algorithms is developed in Chapter 4 that includes the additional information whether a firm is in default or solvent under a current payment vector. This results in procedures that are able find the solution of the system in a finite number of iteration steps. In Chapter 5, the developed concepts of Chapter 4 are applied to more general financial systems where more than one seniority level of debt is present. Chapter 6 develops optimal starting vectors for non-finite algorithms and Chapter 7 compares the existing and the new developed algorithms concerning their efficiency in an extensive simulation study covering a wide range of possible settings for financial systems. N2 - Die vorliegende Dissertation hat die Unternehmensbewertung in Finanzsystemen mit Fremd- und Eigenkapitalverflechtung zum Thema. Die zentrale Eigenschaft dieser Modelle ist, dass zur Bestimmung der Firmenwerte eine Gleichgewichtslösung ermittelt werden muss. Die Zahl der Veröffentlichungen mit dem Schwerpunkt des Nachweises von Existenz- und Eindeutigkeitsaussagen der Gleichgewichte steigt zwar stetig an, allerdings ist die Fachliteratur in diesem Bereich teilweise noch sehr inkonsistent. Beispielsweise existieren je nach Autor unterschiedliche Vorgehensweisen, das zugrunde liegende Finanzsystem zu definieren. Darüber hinaus schenken nur wenige Fachartikel der Frage Beachtung, wie die Lösungsgleichgewichte genau bestimmt werden können. Zuletzt weisen die bereits entwickelten Verfahren den Nachteil auf, dass Sie womöglich unendlich viele Iterationsschritte benötigen bis die gesuchte Lösung exakt erreicht wird. Aus diesen Gründen beinhaltet die vorliegende Dissertation folgende Themen. Im ersten Schritt wird in Kapitel 2 eine möglichst allgemeine Definition eines Finanzsystems eingeführt. Es wird gezeigt dass unter nicht allzu strengen Voraussetzungen die Gleichgewichtslösung dieses Systems eindeutig bestimmt ist. In Kapitel 3 werden in der Fachliteratur zu diesem Thema zu findende Erweiterungen und abweichende Definitionen des Systems vorgestellt und wie diese in das allgemeine Modell aus dem vorherigen Kapitel eingebettet werden können. Danach wird in Kapitel 4 ein Überblick über bereits entwickelte Lösungsverfahren gegeben, wobei die existierenden Prozeduren in ihrem Vorgehen verallgemeinert und deren zugehörige mathematische Eigenschaften aufgezeigt werden. Des weiteren wird im gleichen Kapitel eine komplett neue Klasse von Lösungsverfahren entwickelt, die noch die zusätzliche Information verarbeiten, ob eine Firma für einen gegebenen Zahlungsvektor solvent oder insolvent ist. Als Folge dieses Ansatzes sind diese Algorithmen in der Lage, die exakte Gleichgewichtslösung des Systems in endlich vielen Schritten zu finden. In Kapitel 5 werden die entworfenen Konzepte dann für Finanzsysteme angewendet, in denen mehr als nur eine Schulden-Seniorität berücksichtigt wird. Kapitel 6 leitet optimale Startvektoren der nicht-endlichen Verfahren her und Kapitel 7 vergleicht die bereits existierenden und alle neu entwickelten Lösungsverfahren bezüglich ihrer Laufzeiteffizienz im Rahmen einer ausführlichen Simulationsstudie. KW - Risikomanagement KW - Finanzmathematik KW - Financial Networks KW - Counterparty Risk KW - Numerical Asset Valuation KW - Systemic Risk KW - Structrual Model KW - Unternehmensbewertung KW - Kapitalverflechtung KW - Finanzielle Netzwerke KW - Systemisches Risiko Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-128108 ER - TY - JOUR A1 - Matlach, Juliane A1 - Dhillon, Christine A1 - Hain, Johannes A1 - Schlunck, Günther A1 - Grehn, Franz A1 - Klink, Thomas T1 - Trabeculectomy versus canaloplasty (TVC study) in the treatment of patients with open-angle glaucoma: a prospective randomized clinical trial JF - Acta Ophthalmologica N2 - Purpose: To compare the outcomes of canaloplasty and trabeculectomy in open-angle glaucoma. Methods: This prospective, randomized clinical trial included 62 patients who randomly received trabeculectomy (n = 32) or canaloplasty (n = 30) and were followed up prospectively for 2 years. Primary endpoint was complete (without medication) and qualified success (with or without medication) defined as an intraocular pressure (IOP) of ≤18 mmHg (definition 1) or IOP ≤21 mmHg and ≥20% IOP reduction (definition 2), IOP ≥5 mmHg, no vision loss and no further glaucoma surgery. Secondary endpoints were the absolute IOP reduction, visual acuity, medication, complications and second surgeries. Results: Surgical treatment significantly reduced IOP in both groups (p < 0.001). Complete success was achieved in 74.2% and 39.1% (definition 1, p = 0.01), and 67.7% and 39.1% (definition 2, p = 0.04) after 2 years in the trabeculectomy and canaloplasty group, respectively. Mean absolute IOP reduction was 10.8 ± 6.9 mmHg in the trabeculectomy and 9.3 ± 5.7 mmHg in the canaloplasty group after 2 years (p = 0.47). Mean IOP was 11.5 ± 3.4 mmHg in the trabeculectomy and 14.4 ± 4.2 mmHg in the canaloplasty group after 2 years. Following trabeculectomy, complications were more frequent including hypotony (37.5%), choroidal detachment (12.5%) and elevated IOP (25.0%). Conclusions: Trabeculectomy is associated with a stronger IOP reduction and less need for medication at the cost of a higher rate of complications. If target pressure is attainable by moderate IOP reduction, canaloplasty may be considered for its relative ease of postoperative care and lack of complications. KW - months follow-up KW - surgical outcomes KW - mitomycin C KW - canaloplasty KW - open-angle glaucoma KW - trabeculectomy KW - glaucoma surgery KW - series KW - phacocanaloplasty KW - phacotrabeculectomy KW - canal surgery KW - cataract surgery KW - flexible microcatheter KW - circumferential viscodilation Y1 - 2015 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-149263 VL - 93 ER -