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1.  Managing work–family conflict in the medical profession: working conditions and individual resources as related factors 
BMJ Open  2015;5(4):e006871.
Objectives
This study developed and tested a research model that examined the effects of working conditions and individual resources on work–family conflict (WFC) using data collected from physicians working at German clinics.
Material and methods
This is a cross-sectional study of 727 physicians working in German hospitals. The work environment, WFC and individual resources were measured by the Copenhagen Psychosocial Questionnaire, the WFC Scale, the Brief Resilient Coping Scale and the Questionnaire for Self-efficacy, Optimism and Pessimism. Descriptive, correlation and linear regression analyses were applied.
Results
Clinical doctors working in German hospitals perceived high levels of WFC (mean=76). Sociodemographic differences were found for age, marital status and presence of children with regard to WFC. No significant gender differences were found. WFCs were positively related to high workloads and quantitative job demands. Job resources (eg, influence at work, social support) and personal resources (eg, resilient coping behaviour and self-efficacy) were negatively associated with physicians’ WFCs. Interaction terms suggest that job and personal resources buffer the effects of job demands on WFC.
Conclusions
In this study, WFC was prevalent among German clinicians. Factors of work organisation as well as factors of interpersonal relations at work were identified as significant predictors for WFC. Our results give a strong indication that both individual and organisational factors are related to WFC. Results may play an important role in optimising clinical care. Practical implications for physicians’ career planning and recommendations for future research are discussed.
doi:10.1136/bmjopen-2014-006871
PMCID: PMC4420985  PMID: 25941177
SOCIAL MEDICINE; HEALTH SERVICES ADMINISTRATION & MANAGEMENT; MENTAL HEALTH; OCCUPATIONAL & INDUSTRIAL MEDICINE
2.  Tobacco smoke particles and indoor air quality (ToPIQ-II) – a modified study protocol and first results 
Background
Environmental tobacco smoke (ETS)-associated particulate matter (PM) has to be seen as an independent health hazard and needs to be discussed separately from the already well-known toxic and carcinogenic compounds contained in cigarette smoke. We believe that brand-specific amounts of PM are of public interest and should be investigated.
Methods
An automatic environmental tobacco smoke emitter was developed and placed into a glass-chamber to generate cigarette smoke as reliably as possible. Cigarettes were smoked automatically according to a standardized protocol. Mean concentrations (Cmean) and area under the curve (AUC) of PM2.5 released by the brands P&S, Virginia (without filter) and the 3R4F standard research cigarette of the University of Kentucky, USA, were measured and compared with each other.
Results
Cmean PM2.5 of 3R4F reference was 1,725 μg/m3, for P&S: 1,982 μg/m3 and for Virginia without filter: 1,525 μg/m3. AUC PM2.5 for 3R4F reference was: 527,644 μg/m3×sec, for P&S: 606,171 μg/m3×sec, and for Virginia without filter: 464,788 μg/m3×sec.
Conclusions
Our modified ToPIQ-II study protocol shows significant brand-specific differences in the amounts of PM2.5 released by cigarettes into the environment, when compared to 3R4F reference cigarettes. We believe that information about PM-release of all relevant brands in relation to reference cigarettes should be published. In the light of PM as an independent risk factor for morbidity and mortality, this may serve as a basis for further epidemiologic investigations.
doi:10.1186/s12995-015-0047-8
PMCID: PMC4339475  PMID: 25717342
Particulate matter; Cigarettes; Automatic environmental tobacco smoke emitter
3.  Annual acknowledgement of manuscript reviewers 
Contributing reviewers
The editors of Journal of Occupational Medicine and Toxicology would like to thank all our reviewers who have contributed to the journal in Volume 9 (2014).
doi:10.1186/s12995-015-0045-x
PMCID: PMC4319229  PMID: 25663843
4.  Medical work assessment in German hospitals: a study protocol of a movement sequence analysis (MAGRO-MSA) 
Background
Medical doctors are essential for the German public and occupational health system. They ensure the productivity of German society by enabling people to regain and recover their health. That is why the physicians’ health and hence their productivity require special attention. Musculoskeletal disorders have a high prevalence in this work area. As a consequence, movement sequences, range of motions, and body postures of physicians in the course of the working day are in focus of this research project.
Methods
For this investigation 21 male or female junior physicians of various conservative medical disciplines will be covered. Data will be collected over one working day (approx. 9 hours). The CUELA system attached to the test person’s body detects body posture and/or movements. This biomechanical measurement system ensures a locomotor and posture analysis that includes movement sequences, movement intensity, and range of motions to qualify the work tasks. For data analysis intra- and inter-professional comparisons are chosen.
Conclusions
Working movement sequence analysis of physicians by means of the CUELA system is exclusive and novel in its focus. Up to now, knowledge of the working tasks of medical doctors has only been acquired by real-time observation approaches to work activity. In addition to this method of analysis, the CUELA system is able to record quantified biomechanical data about musculoskeletal loads of ordinary working tasks. Workloads and activities of physicians can be improved by ergonomic work design to reduce musculoskeletal disorders by utilizing the data collected. The healthcare system in Germany will thus be optimized by improving medical doctors’ health. Consequently, MAGRO-MSA will also be used for other healthcare professions such as nurses and physicians assistants.
doi:10.1186/s12995-014-0040-7
PMCID: PMC4298873  PMID: 25606049
Body posture; CUELA system; Movement sequence; Physicians’ health; Range of motions; Working task
5.  Brand Cigarillos — A Cheap and Less Harmful Alternative to Cigarettes? Particulate Matter Emissions Suggest Otherwise 
Background: Environmental tobacco smoke (ETS)-associated particulate matter (PM) constitutes a considerable health risk for passive smokers. It ought to be assessed separately from the other known toxic compounds of tobacco smoke. Brand-specific differences between cigarettes and particularly between cigarettes and favorably taxed cigarillos, are of public interest and therefore worth being investigated. Methods: An automatic environmental tobacco smoke emitter (AETSE) was developed to generate cigarette and cigarillo smoke in a reliable and reproducible way. John Player Special (JPS) Red cigarettes, JPS filter cigarillos and 3R4F standard research cigarettes were smoked automatically in a 2.88 m3 glass chamber according to a standardized protocol until 5 cm from the top were burned down. Results: Mean concentrations (Cmean) and area of the curve (AUC) of PM2.5 were measured and compared. Cmean PM2.5 were found to be 804 µg/m3 for 3R4F reference cigarettes, 1633 µg/m3 for JPS cigarettes, and 1059 µg/m3 for JPS filter cigarillos. AUC PM2.5-values are 433,873 µg/m3×s for 3R4F reference cigarettes, 534,267 µg/m3×s for JPS Red cigarettes and 782,850 µg/m3×s for JPS filter cigarillos. Conclusion: Potential brand-specific differences of ETS-associated PM emissions among brands of cigarettes, and between cigarettes and cigarillos of the same brand and size should be investigated and published. Information about relative PM-emissions should be printed on the package.
doi:10.3390/ijerph120100428
PMCID: PMC4306871  PMID: 25568972
particulate matter; tobacco; smoke; cigarette; cigarillo
6.  Curare - A Curative Poison: A Scientometric Analysis 
PLoS ONE  2014;9(11):e112026.
Introduction
Curare is one of the best-examined neurotoxins of the world, which has empirically been used for centuries by American Indigenes. Research on curare has been performed much later, a global scientometric analysis on curare research or its derivates does not yet exist. This bibliometric analysis is part of the global NewQis-project and should illuminate both toxic and historic issues of research on curare.
Methods
The ISI Web of Science was searched for data covering 1900 to 2013 using a term which included as many original articles on curare as possible. 3,867 articles were found and analyzed for common bibliometric items such as the number of citations, language of the articles or the (modified) Hirsch-Index (h-index). Results are illustrated utilizing modern density equalizing map projections (DEMP) or beam diagrams.
Results
Most publications were located in North America and Europe. The USA has the highest number of publications as well as the highest h-index. The number of publications overall rose until the late 1990s and later decreased. Furthermore, sudden increases of research activity are ascribable to historic events, like the first use of curare as muscle relaxant during surgery.
Discussion
This scientometric analysis of curare research reflects several tendencies as previously seen in other bibliometric investigations, i.e. the scientific quality standard of North America and Europe. Research on curare decreased however, due to the declining attention towards this muscle relaxant. This work exemplifies also how scientometric methods can be used to illuminate historic circumstances immediately stimulating scientific research.
doi:10.1371/journal.pone.0112026
PMCID: PMC4237325  PMID: 25409503
7.  Bacterial Meningitis: A Density-Equalizing Mapping Analysis of the Global Research Architecture 
Bacterial meningitis is caused by a variety of pathogens and displays an important public health threat all over the world. Despite the necessity to develop customized public health-related research projects, a thorough study of global meningitis research is not present, so far. Therefore, the aim of this study was a combined density-equalizing and scientometric study. To evaluate the scientific efforts of bibliometric methods, density-equalizing algorithms and large-scale data analysis of the Web of Science were applied in the period between 1900 and 2007. From this, 7998 publications on bacterial meningitis have been found. With a number of 2698, most publications have been written by U.S. authors, followed by the UK (912), Germany (749) and France (620). This dominance can also be shown in the international cooperation. The specific citation analyses reveal that the nation with the highest average citation rate (citations per publications) was Norway (26.36), followed by Finland (24.16) and the U.S. (24.06). This study illustrates the architecture of global research on bacterial meningitis and points to the need for customized research programs with a focus on local public health issues in countries with a low development index, but high incidences, to target this global public health problem.
doi:10.3390/ijerph111010202
PMCID: PMC4210975  PMID: 25272079
bacterial meningitis; acute meningitis; scientometric analysis; density equalizing mapping
8.  MRSA: A Density-Equalizing Mapping Analysis of the Global Research Architecture 
Methicillin-resistant Staphylococcus aureus (MRSA) has evolved as an alarming public health thread due to its global spread as hospital and community pathogen. Despite this role, a scientometric analysis has not been performed yet. Therefore, the NewQIS platform was used to conduct a combined density-equalizing mapping and scientometric study. As database, the Web of Science was used, and all entries between 1961 and 2007 were analyzed. In total, 7671 entries were identified. Density equalizing mapping demonstrated a distortion of the world map for the benefit of the USA as leading country with a total output of 2374 publications, followed by the UK (1030) and Japan (862). Citation rate analysis revealed Portugal as leading country with a rate of 35.47 citations per article, followed by New Zealand and Denmark. Country cooperation network analyses showed 743 collaborations with US-UK being most frequent. Network citation analyses indicated the publications that arose from the cooperation of USA and France as well as USA and Japan as the most cited (75.36 and 74.55 citations per collaboration article, respectively). The present study provides the first combined density-equalizing mapping and scientometric analysis of MRSA research. It illustrates the global MRSA research architecture. It can be assumed that this highly relevant topic for public health will achieve even greater dimensions in the future.
doi:10.3390/ijerph111010215
PMCID: PMC4210976  PMID: 25272080
methicillin-resistant Staphylococcus aureus; MRSA; antibiotic resistance; density-equalizing mapping; scientometrics; public health
9.  Effectiveness of Low Emission Zones: Large Scale Analysis of Changes in Environmental NO2, NO and NOx Concentrations in 17 German Cities 
PLoS ONE  2014;9(8):e102999.
Background
Low Emission Zones (LEZs) are areas where the most polluting vehicles are restricted from entering. The effectiveness of LEZs to lower ambient exposures is under debate. This study focused on LEZs that restricted cars of Euro 1 standard without appropriate retrofitting systems from entering and estimated LEZ effects on NO2, NO, and NOx ( = NO2+NO).
Methods
Continuous half-hour and diffuse sampler 4-week average NO2, NO, and NOx concentrations measured inside and outside LEZs in 17 German cities of 6 federal states (2005–2009) were analysed as matched quadruplets (two pairs of simultaneously measured index values inside LEZ and reference values outside LEZ, one pair measured before and one after introducing LEZs with time differences that equal multiples of 364 days) by multiple linear and log-linear fixed-effects regression modelling (covariables: e.g., wind velocity, amount of precipitation, height of inversion base, school holidays, truck-free periods). Additionally, the continuous half-hour data was collapsed into 4-week averages and pooled with the diffuse sampler data to perform joint analysis.
Results
More than 3,000,000 quadruplets of continuous measurements (half-hour averages) were identified at 38 index and 45 reference stations. Pooling with diffuse sampler data from 15 index and 10 reference stations lead to more than 4,000 quadruplets for joint analyses of 4-week averages. Mean LEZ effects on NO2, NO, and NOx concentrations (reductions) were estimated to be at most −2 µg/m3 (or −4%). The 4-week averages of NO2 concentrations at index stations after LEZ introduction were 55 µg/m3 (median and mean values) or 82 µg/m3 (95th percentile).
Conclusions
This is the first study investigating comprehensively the effectiveness of LEZs to reduce NO2, NO, and NOx concentrations controlling for most relevant potential confounders. Our analyses indicate that there is a statistically significant, but rather small reduction of NO2, NO, and NOx concentrations associated with LEZs.
doi:10.1371/journal.pone.0102999
PMCID: PMC4130490  PMID: 25115911
10.  Education Against Tobacco (EAT): a quasi-experimental prospective evaluation of a programme for preventing smoking in secondary schools delivered by medical students: a study protocol 
BMJ Open  2014;4(7):e004909.
Introduction
A survey conducted by the German Federal Centre for Health Education in 2012 showed that 35.2% of all young adults (18–25 years) and 12.0% of all adolescents (12–17 years) in Germany are regular cigarette smokers. Most smoked their first cigarette in early adolescence. We recently reported a significantly positive short-term effect of a physician-delivered school-based smoking prevention programme on the smoking behaviour of schoolchildren in Germany. However, physician-based programmes are usually very expensive. Therefore, we will evaluate and optimise Education against Tobacco (EAT), a widespread, low-cost programme delivered by about 400 medical students from 16 universities in Germany.
Methods and analysis
A prospective quasi-experimental study design with two measurements at baseline (t1) and 6 months post-intervention (t2) to investigate an intervention in 10–15-year-olds in grades 6–8 at German secondary schools. The intervention programme consists of two 60-min school-based medical-student-delivered modules with (module 1) and without the involvement of patients with tobacco-related diseases and control groups (no intervention). The study questionnaire measuring smoking status (water pipe and cigarette smoking), smoking-related cognitions, and gender, social and cultural aspects was designed and pre-tested in advance. The primary end point is the prevalence of smokers and non-smokers in the two study arms at 6 months after the intervention. The percentage of former smokers and new smokers in the two groups and the measures of smoking behaviour will be studied as secondary outcome measures.
Ethics and dissemination
In accordance with Good Epidemiologic Practice (GEP) guidelines, the study protocol was submitted for approval by the responsible ethics committee, which decided that the study does not need ethical approval (Goethe University, Frankfurt-Main, Germany). Findings will be disseminated in peer-reviewed journals, at conferences, within our scientific advisory board and through medical students within the EAT project.
doi:10.1136/bmjopen-2014-004909
PMCID: PMC4120302  PMID: 25059969
smoking prevention; schools; tobacco prevention; medical students; adolescent smoking; school-based prevention
11.  Global Research on Smoking and Pregnancy—A Scientometric and Gender Analysis 
The exposure to tobacco smoke during pregnancy is considered to be amongst the most harmful avoidable risk factors. In this scientometric and gender study scientific data on smoking and pregnancy was analyzed using a variety of objective scientometric methods like the number of scientific contributions, the number of citations and the modified h-index in combination with gender-specific investigations. Covering a time period from 1900 to 2012, publishing activities of 27,955 authors, institutions and countries, reception within the international scientific community and its reactions were analyzed and interpreted. Out of 10,043 publications the highest number of scientific works were published in the USA (35.5%), followed by the UK (9.9%) and Canada (5.3%). These nations also achieve the highest modified h-indices of 128, 79 and 62 and the highest citation rates of 41.4%, 8.6% and 5.3%, respectively. Out of 12,596 scientists 6,935 are female (55.1%), however they account for no more than 49.7% of publications (12,470) and 42.8% of citations (172,733). The highest percentage of female experts about smoking and pregnancy is found in Australasia (60.7%), while the lowest is found in Asia (41.9%). The findings of the study indicate an increase in gender equality as well as in quantity and quality of international scientific research about smoking and pregnancy in the future.
doi:10.3390/ijerph110605792
PMCID: PMC4078548  PMID: 24879489
bibliometry; cigarette; citation; gender studies; pregnancy; scientometry; smoking
12.  Airborne particulate matter in public transport: a field study at major intersection points in Frankfurt am Main (Germany) 
Background
Chronic particulate matter (PM) exposure is correlated to various health effects, even at low amounts. WHO has defined PM concentration limits as daily and annual mean values which were made legally binding in the European Union. While many studies have focused on PM concentrations in special environments, little is known about the average PM- exposure for both employees and passengers in the German public transportation system.
Methods
Particulate matter (PM10, PM2.5, PM1) – concentrations were monitored for 30 minutes at 15 different areas in Frankfurt am Main with major public traffic. Maximum and mean concentrations and, as a surrogate for the inhaled dosage, the Area Under the Curve (AUC) for 15 minutes of exposure were calculated.
Results
The WHO limits for PM10 and PM2.5 were exceeded at nearly all times and areas. Highest maximum concentrations were found at underground stations, subterranean railway stations and subterranean shopping arcades with much lower values obtained at surface points. In one measurement at a surface test point smokers who neglected the non-smoking policy could be identified as a major cause for a at least temporary strong increase of PM-load as seen in high maximum values and normal averages.
Conclusions
Subterranean areas have high particulate matter contamination exceeding WHO limits. Improvement may be achieved by increased ventilation. Subterranean shops and kiosks, being workplaces with long term exposure, should be equipped with external air supply. The non- smoking policy of the “Deutsche Bahn” for public spaces should be enforced.
doi:10.1186/1745-6673-9-13
PMCID: PMC3991908  PMID: 24716779
13.  Variants in CPA1 are strongly associated with early-onset chronic pancreatitis 
Nature genetics  2013;45(10):1216-1220.
Chronic pancreatitis is an inflammatory disorder of the pancreas. We analyzed CPA1 encoding carboxypeptidase A1 in subjects with non-alcoholic chronic pancreatitis and controls in a German discovery cohort and three replication cohorts. Functionally impaired variants were present in 29/944 (3.1%) German patients and in 5/3,938 (0.1%) controls (odds ratio [OR] = 24.9; P = 1.5 × 10-16). The association was strongest in subjects aged ≤10 years (9.7%; OR = 84.0; P = 4.1 × 10-24). In the replication cohorts, defective CPA1 variants were observed in 8/600 (1.3%) patients and in 9/2,432 (0.4%) controls from Europe (P = 0.01), in 5/230 (2.2%) patients and 0/264 controls from India (P = 0.02), and in 5/247 (2.0%) patients but 0/341 controls from Japan (P = 0.013). The mechanism of increased pancreatitis risk by CPA1 variants may involve misfolding-induced endoplasmic reticulum stress rather than elevated trypsin activity as seen with other genetic risk factors.
doi:10.1038/ng.2730
PMCID: PMC3909499  PMID: 23955596
14.  Silicosis: geographic changes in research: an analysis employing density-equalizing mapping 
Background
A critical evaluation of scientific efforts is needed in times of modified evaluation criteria for academic personnel and institutions.
Methods
Using scientometric benchmark procedures and density-equalizing mapping, we analysed the global scientific efforts on “silicosis” of the last 92 years focusing on geographical changes within the last 30 years, specifying the most productive authors, institutions, countries and the most successful cooperations.
Results
The USA as the most productive supplier have established their position as center of international cooperation, followed in considerable distance by the United Kingdom, Germany and China. Asian countries, particularly China, catch up and are expected to excel the USA still in this decade.
Conclusion
The combination of scientometric procedures with density-equalizing mapping reveals a distinct global pattern of research productivity and citation activity. Modified h-index, citationrate and impact factor have to be discussed critically due to distortion by bias of self-citation, language and co-authorship.
doi:10.1186/1745-6673-9-2
PMCID: PMC3906744  PMID: 24438527
Silicosis; Scientometria; Density-equalizing mapping; H-Index; Citationrate
15.  Occupational accidents in professional dance with focus on gender differences 
Background
Classical dance comprises gender specific movement tasks. There is a lack of studies which investigate work related traumatic injuries in terms of gender specific differences in detail.
Objective
To define gender related differences of occupational accidents.
Methods
Basis for the evaluation were occupational injuries of professional dancers from three (n = 785; f: n = 358, m: n = 427) state theatres.
Results
The incidence rate (0.36 per year) was higher in males (m: 0.45, f: 0.29). There were gender specific differences as to the localizations of injuries, particularly the spine region (m: 17.3%, f: 9.8%, p = 0.05) and ankle joint (m: 23.7%, f: 35.5%, p = 0.003). Compared to male dancers, females sustained more injuries resulting from extrinsic factors. Significant differences could specifically be observed with dance floors (m: 8.8%, f: 15.1%, p = 0.02). There were also significant gender differences observed with movement vocabulary.
Conclusion
The clearly defined gender specific movement activities in classical dance are reflected in occupational accidents sustained. Organisational structures as well as work environment represent a burden likewise to male and female dancers. The presented differences support the development of gender specific injury prevention measures.
doi:10.1186/1745-6673-8-35
PMCID: PMC3878499  PMID: 24341391
Traumatic injury; Dancer; Ballet; Male; Female
16.  Work-related complaints and diseases of physical therapists – protocol for the establishment of a “Physical Therapist Cohort” (PTC) in Germany 
Background
Only few studies deal with the workload of physical therapists and the health consequences, although this occupational group is quite important for the health care system in many industrialized countries (e.g. ca. 136 000 people are currently employed as physical therapists in Germany). Therefore, the current state of knowledge of work-related diseases and disorders of physical therapists is insufficient. The aim of the "Physical Therapist Cohort" (PTC) study is to analyze the association between work-related exposures and diseases among physical therapists in Germany. This article describes the protocol of the baseline assessment of the PTC study.
Methods/Design
A cross-sectional study will be conducted as baseline assessment and will include a representative random sample of approximately 300 physical therapists employed in Germany (exposure group), and a population-based comparison group (n = 300). The comparison group will comprise a sample of working aged (18–65 years) inhabitants of a German city. Variables of interest will be assessed using a questionnaire manual including questions regarding musculoskeletal, dermal, and infectious diseases and disorders as well as psychosocial exposures, diseases and disorders. In addition to subjective measures, a clinical examination will be used to objectify the questionnaire-based results (n = 50).
Discussion
The study, which includes extensive data collection, provides a unique opportunity to study the prospective association of work-related exposures and associated complaints of physical therapists. Baseline results will give first clues with regard to whether and how prevalent main exposures of physiotherapeutic work and typical work areas of physical therapists are associated with the development of work-related diseases. Thereby, this baseline assessment provides the basis for further investigations to examine causal relationships in accordance with a longitudinal design.
doi:10.1186/1745-6673-8-34
PMCID: PMC3878737  PMID: 24330548
Study protocol; Cohort study; Physical therapist; Occupational exposure; Occupational health; Occupational disease
17.  Gold nanoparticles: recent aspects for human toxicology 
Nanoparticles (particles sized between 1 and 100 nanometers) are more and more used in all fields of science and medicine for their physicochemical properties. As gold has traditionally been considered as chemically inert and biocompatible, in particular, gold nanoparticles have been established as valuable tools in several areas of biomedical research. But in contrast to the multitude of studies that addressed the clinical use of gold nanoparticles, only little is known about potential toxicological effects such as induction of inflammatory immune responses, possible apoptotic cell death or developmental growth inhibition in embryos. Therefore the present study performed a systematic review of toxicological data, especially experimentally acquired data concerning in-vivo-toxicity, published in the PubMed. It can be stated that the data in this area of research is still largely limited. Especially, knowledge about size-, charge- and surface-chemistry dependent in-vivo-toxicity is needed to predict the hazard potential of auric nanoparticles (AuNPs) for humans.
doi:10.1186/1745-6673-8-32
PMCID: PMC4029541  PMID: 24330512
Gold; Auric nanoparticles; Toxicology; In-vivo
18.  Yellow fever disease: density equalizing mapping and gender analysis of international research output 
Parasites & Vectors  2013;6:331.
Background
A number of scientific papers on yellow fever have been published but no broad scientometric analysis on the published research of yellow fever has been reported.
The aim of the article based study was to provide an in-depth evaluation of the yellow fever field using large-scale data analysis and employment of bibliometric indicators of production and quantity.
Methods
Data were retrieved from the Web of Science database (WoS) and analyzed as part of the NewQis platform. Then data were extracted from each file, transferred to databases and visualized as diagrams. Partially by means of density-equalizing mapping makes the findings clear and emphasizes the output of the analysis.
Results
In the study period from 1900 to 2012 a total of 5,053 yellow fever-associated items were published by 79 countries. The United States (USA) having the highest publication rate at 42% (n = 751) followed by far from Brazil (n = 203), France (n = 149) and the United Kingdom (n = 113). The most productive journals are the “Public Health Reports”, the “American Journal of Tropical Medicine and Hygiene” and the “Journal of Virology”. The gender analysis showed an overall steady increase of female authorship from 1950 to 2011. Brazil is the only country of the five most productive countries with a higher proportion of female scientists.
Conclusions
The present data shows an increase in research productivity over the entire study period, in particular an increase of female scientists. Brazil shows a majority of female authors, a fact that is confirmed by other studies.
doi:10.1186/1756-3305-6-331
PMCID: PMC3843536  PMID: 24245856
19.  Transcriptional down-regulation of suppressor of cytokine signaling (SOCS)-3 in chronic obstructive pulmonary disease 
Background
Tobacco is a leading environmental factor in the initiation of respiratory diseases and causes chronic obstructive pulmonary disease (COPD). Suppressor of cytokine signaling (SOCS) family members are involved in the pathogenesis of many inflammatory diseases and SOCS-3 has been shown to play an important role in the regulation, onset and maintenance of airway allergic inflammation indicating that SOCS-3 displays a potential therapeutic target for anti-inflammatory respiratory drugs development. Since chronic obstructive pulmonary disease (COPD) is also characterized by inflammatory changes and airflow limitation, the present study assessed the transcriptional expression of SOCS-3 in COPD.
Methods
Real-time PCR was performed to assess quantitative changes in bronchial biopsies of COPD patients in comparison to unaffected controls.
Results
SOCS-3 was significantly down-regulated in COPD at the transcriptional level while SOCS-4 and SOCS-5 displayed no change.
Conclusions
It can be concluded that the presently observed inhibition of SOCS-3 mRNA expression may be related to the dysbalance of cytokine signaling observed in COPD.
doi:10.1186/1745-6673-8-29
PMCID: PMC4015747  PMID: 24138793
Chronic obstructive airway disease; Lung; SOCS; Cytokine; Airways
20.  Expression of VPAC1 in a murine model of allergic asthma 
Vasoactive intestinal polypeptide (VIP) is a putative neurotransmitter of the inhibitory non-adrenergic non-cholinergic nervous system and influences the mammalian airway function in various ways. Hence known for bronchodilatory, immunomodulatory and mucus secretion modulating effects by interacting with the VIP receptors VPAC1 and VPAC2, it is discussed to be a promising target for pharmaceutical intervention in common diseases such as COPD and bronchial asthma. Here we examined the expression and transcriptional regulation of VPAC1 in the lungs of allergic mice using an ovalbumin (OVA) -induced model of allergic asthma. Mice were sensitized to OVA and challenged with an OVA aerosol. In parallel a control group was sham sensitized with saline. VPAC1 expression was examined using RT-PCR and real time-PCR studies were performed to quantify gene transcription. VPAC1 mRNA expression was detected in all samples of OVA-sensitized and challenged animals and control tissues. Further realtime analysis did not show significant differences at the transcriptional level.
Although the present studies did not indicate a major transcriptional regulation of VPAC1 in states of allergic airway inflammation, immunomodulatory effects of VPAC1 might still be present due to regulations at the translational level.
doi:10.1186/1745-6673-8-28
PMCID: PMC3852716  PMID: 24107483
VIP; VPAC1; Neurotransmitter; Asthma; Allergy
21.  Influenza: a scientometric and density-equalizing analysis 
BMC Infectious Diseases  2013;13:454.
Background
Novel influenza in 2009 caused by H1N1, as well as the seasonal influenza, still are a challenge for the public health sectors worldwide. An increasing number of publications referring to this infectious disease make it difficult to distinguish relevant research output. The current study used scientometric indices for a detailed investigation on influenza related research activity and the method of density equalizing mapping to make the differences of the overall research worldwide obvious. The aim of the study was to compare scientific effort over the time as well as geographical distribution including the cooperation on national and international level.
Methods
Therefore, publication data was retrieved from Web of Science (WoS) of Thomson Scientific. Subsequently the data was analysed in order to show geographical distributions and the development of the research output over the time.
The query retrieved 51,418 publications that are listed in WoS for the time interval from 1900 to 2009. There is a continuous increase in research output and general citation activity especially since 1990.
Results
The identified all in all 51,418 publications were published by researchers from 151 different countries. Scientists from the USA participate in more than 37 percent of all publications, followed by researchers from the UK and Germany with more than five percent. In addition, the USA is in the focus of international cooperation.
In terms of number of publications on influenza, the Journal of Virology ranks first, followed by Vaccine and Virology. The highest impact factor (IF 2009) in this selection can be established for The Lancet (30.75). Robert Webster seems to be the most prolific author contributing the most publications in the field of influenza.
Conclusions
This study reveals an increasing and wide research interest in influenza. Nevertheless, citation based-declaration of scientific quality should be considered critically due to distortion by self-citation and co-authorship.
doi:10.1186/1471-2334-13-454
PMCID: PMC3851602  PMID: 24079616
22.  Perception of stress-related working conditions in hospitals (iCept-study): a comparison between physicians and medical students 
Background
The students’ perception of working conditions in hospitals hasn’t been subject of research in Germany so far. However the perception plays an important role talking about the sustainability of working conditions. The iCept Study wants to examine the perception of medical students compared to the perception of practicing physicians.
Methods/design
The perception will be investigated with a redesigned questionnaire based upon two established and validated questionnaires. The two samples built for this study (students and physician) will be chosen from members of the labor union Marburger Bund. The iCept-Study is designed as an anonymized online-survey.
Discussion
The iCept-Study is thought to be the basis of ongoing further investigations regarding the perception of working conditions in hospitals. The results shall serve the facilitation of improving working conditions.
doi:10.1186/1745-6673-8-3
PMCID: PMC3629707  PMID: 23442606
Perception; Stress; Working conditions; Hospital; Student
23.  Mobile air quality studies (MAQS) in inner cities: particulate matter PM10 levels related to different vehicle driving modes and integration of data into a geographical information program 
Background
Particulate matter (PM) is assumed to exert a major burden on public health. Most studies that address levels of PM use stationary measure systems. By contrast, only few studies measure PM concentrations under mobile conditions to analyze individual exposure situations.
Methods
By combining spatial-temporal analysis with a novel vehicle-mounted sensor system, the present Mobile Air Quality Study (MAQS) aimed to analyse effects of different driving conditions in a convertible vehicle. PM10 was continuously monitored in a convertible car, driven with roof open, roof closed, but windows open, or windows closed.
Results
PM10 values inside the car were nearly always higher with open roof than with roof and windows closed, whereas no difference was seen with open or closed windows. During the day PM10 values varied with high values before noon, and occasional high median values or standard deviation values due to individual factors. Vehicle speed in itself did not influence the mean value of PM10; however, at traffic speed (10 – 50 km/h) the standard deviation was large. No systematic difference was seen between PM10 values in stationary and mobile cars, nor was any PM10 difference observed between driving within or outside an environmental (low emission) zone.
Conclusions
The present study has shown the feasibility of mobile PM analysis in vehicles. Individual exposure of the occupants varies depending on factors like time of day as well as ventilation of the car; other specific factors are clearly identifiably and may relate to specific PM10 sources. This system may be used to monitor individual exposure ranges and provide recommendations for preventive measurements. Although differences in PM10 levels were found under certain ventilation conditions, these differences are likely not of concern for the safety and health of passengers.
doi:10.1186/1745-6673-7-20
PMCID: PMC3539871  PMID: 23031208
24.  Acute Injuries in Student Circus Artists with Regard to Gender Specific Differences 
Asian Journal of Sports Medicine  2012;3(3):153-160.
Purpose
Student circus artists train as both artists and athletes with their bodies holding the key to professional success. The daily training load of student circus artists is often associated with maximum physical and psychological stress with injuries posing a threat to a potential professional career. The purpose of this study is the differentiated analysis and evaluation of work accidents in order to initiate the development of injury preventive programs.
Methods
The 17 years of data were obtained from standardized anonymous work accident records of the Berlin State Accident Insurance (UKB) as well as a State Artist Educational School (n = 169, Male: 70; Female: 99) from student artists. Evaluation and descriptive statistics were conducted with Excel 2007 and PASW Statistics 18.
Results
The injury risk seems to be relatively low (0.3 injuries/1000h). There are gender specific differences as to the location of injuries. Only 7% of the accidents demand a break of more than 3 days. Injury patterns vary depending on the activity and the employment of props/equipment. 75.2% of work accidents have multifactorial and 24.8% exogenous causes.
Conclusions
Because physical fitness is all important in the circus arts there are numerous options for injury prevention programs that should be realized subject to gender-specific differences. Follow-ups on chronic complaints and a more individual approach are indispensable due to the very specific activities in the circus arts.
PMCID: PMC3445642  PMID: 23012634
Performing Artists; Occupational Accidents; Sex; Prevention
25.  Particulate matter (PM) 2.5 levels in ETS emissions of a Marlboro Red cigarette in comparison to the 3R4F reference cigarette under open- and closed-door condition 
Introduction
Potential health damage by environmental emission of tobacco smoke (environmental tobacco smoke, ETS) has been demonstrated convincingly in numerous studies. People, especially children, are still exposed to ETS in the small space of private cars. Although major amounts of toxic compounds from ETS are likely transported into the distal lung via particulate matter (PM), few studies have quantified the amount of PM in ETS.
Study aim
The aim of this study was to determine the ETS-dependent concentration of PM from both a 3R4F reference cigarette (RC) as well as a Marlboro Red brand cigarette (MRC) in a small enclosed space under different conditions of ventilation to model car exposure.
Method
In order to create ETS reproducibly, an emitter (ETSE) was constructed and mounted on to an outdoor telephone booth with an inner volume of 1.75 m3. Cigarettes were smoked under open- and closed-door condition to imitate different ventilation scenarios. PM2.5 concentration was quantified by a laser aerosol spectrometer (Grimm; Model 1.109), and data were adjusted for baseline values. Simultaneously indoor and outdoor climate parameters were recorded. The time of smoking was divided into the ETS generation phase (subset “emission”) and a declining phase of PM concentration (subset “elimination”); measurement was terminated after 10 min. For all three time periods the average concentration of PM2.5 (Cmean-PM2.5) and the area under the PM2.5 concentration curve (AUC-PM2.5) was calculated. The maximum concentration (Cmax-PM2.5) was taken from the total interval.
Results
For both cigarette types open-door ventilation reduced the AUC-PM2.5 (RC: from 59 400 ± 14 600 to 5 550 ± 3 900 μg*sec/m3; MRC: from 86 500 ± 32 000 to 7 300 ± 2 400 μg*sec/m3; p < 0.001) and Cmean-PM2.5 (RC: from 600 ± 150 to 56 ± 40 μg/m3, MRC from 870 ± 320 to 75 ± 25 μg/m3; p < 0.001) by about 90%. Cmax-PM2.5 was reduced by about 80% (RC: from 1 050 ± 230 to 185 ± 125 μg/m3; MRC: from 1 560 ±500 μg/m3 to 250 ± 85 μg/m3; p < 0.001). In the subset “emission” we identified a 78% decrease in AUC-PM2.5 (RC: from 18 600 ± 4 600 to 4 000 ± 2 600 μg*sec/m3; MRC: from 26 600 ± 7 200 to 5 800 ± 1 700 μg*sec/m3; p < 0.001) and Cmean-PM2.5 (RC: from 430 ± 108 to 93 ± 60 μg/m3; MRC: from 620 ± 170 to 134 ± 40 μg/m3; p < 0.001). In the subset “elimination” we found a reduction of about 96–98% for AUC-PM2.5 (RC: from 40 800 ± 11 100 to 1 500 ± 1 700 μg*sec/m3; MRC: from 58 500 ± 25 200 to 1 400 ± 800 μg*sec/m3; p < 0.001) and Cmean-PM2.5 (RC: from 730 ± 200 to 27 ± 29 μg/m3; MRC: from 1 000 ± 450 to 26 ± 15 μg/m3; p < 0.001). Throughout the total interval Cmax-PM2.5 of MRC was about 50% higher (1 550 ± 500 μg/m3) compared to RC (1 050 ± 230 μg/m3; p < 0.05). For the subset “emission” - but not for the other periods - AUC-PM2.5 for MRC was 43% higher (MRC: 26 600 ± 7 200 μg*sec/m3; RC: 18 600 ± 4 600 μg*sec/m3; p < 0.05) and 44% higher for Cmean-PM2.5 (MRC: 620 ± 170 μg/m3; RC: 430 ± 108 μg/m3; p < 0.05).
Conclusion
This method allows reliable quantification of PM2.5-ETS exposure under various conditions, and may be useful for ETS risk assessment in realistic exposure situations. The findings demonstrate that open-door condition does not completely remove ETS from a defined indoor space of 1.75 m3. Because there is no safe level of ETS exposure ventilation is not adequate enough to prevent ETS exposure in confined spaces, e.g. private cars. Additionally, differences in the characteristics of cigarettes affect the amount of ETS particle emission and need to be clarified by ongoing investigations.
doi:10.1186/1745-6673-7-14
PMCID: PMC3494543  PMID: 22735100

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