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The Bündnis Junger Ärztinnen und Ärzte (BJÄ, Alliance of Young Physicians in Germany) has presented a position paper (PP) on Postgraduate Medical Education (PGME) against the background of an unfolding hospital reform in Germany, and they describe existing deficits of PGME in Germany. Based on this, demands were made of legislators, employers and medical associations which could result in a sweeping reformation of PGME. Hospital reforms can only be accomplished with well trained and motivated physicians. In this respect the BJÄ regards the reform of hospitals and the health-care system as a chance for a reform of PGME, which is long overdue. Legislative competence for PGME lies with the States of the Federal Republic of Germany and this warrants an adjustment of state medical association laws to accommodate the demands of the BJÄ. Generally PGME must be taken into consideration in all health-care legislation, in analogy to the meanwhile globally adopted principle of "Health in all Politics (HiAP)". The BJÄ has made every endeavour to produce this PP. The responsible stakeholders and actors in the health-care system would be well-advised to take the position paper seriously with a dwindling physician work force in hospitals and serious quality deficits in PGME. Hence, the BJÄ must be comprehensively supported. They need congenial partners to define the scientific foundation of all their demands, to test their application under real life conditions in hospital and outpatient care, to pursue research on the impact on patient care and on the intended transformation of the health-care system. This might best be accomplished by partnering with a scientific Association for Postgraduate Medical Education as has been the case in many countries for decades. [ABSTRACT FROM AUTHOR]

This essay explores the material imperatives of nineteenth-century statistical ambition, at a time when the nature of paper itself underwent rapid change. It expands the concept of paper technologies to include knowledge about the materials themselves, as well as the infrastructures, techniques, and agreements that made it possible for the right kind of paper to be made available for particular purposes. Taking the production of the forms for the Prussian census as a case in point, it argues that the enumeration effort of Prussian census statisticians went far beyond designing a form, collecting information, noting and compiling figures, or creating tables. Paper knowledge to define and control the material substance of the forms mattered as much as political impetus and statistical methods in getting the census right. [ABSTRACT FROM AUTHOR]

The current situation in Germany is characterised by significant differences between the two types of higher education institutions offering bachelor's degree programmes in midwifery at both universities of applied sciences and universities. These differences are noticeable in admission procedures, resource allocation, content focus and competence assessment at the respective institutions, which in turn result in heterogeneous study experiences. This article highlights the challenges currently facing bachelor degree programmes and the academic qualification of midwives, and identifies future requirements for the development of degree programmes in theory and practice as well as theory-practice transfer, and assessment formats. Furthermore, this article covers the content-related and structural-organisational requirements to develop in-depth academic skills grounded in theory teaching, the facilitation of clinical placements at an academic level, the training of qualified practical instructors and the development of applicable competence-based assessment formats, especially for the state exam. The development of a standardised, high-quality academic education for midwives in Germany requires networking of the different academic sites/locations to exchange experiences in teaching/learning and assessment formats. Furthermore, it can facilitate the development of a standardised competence-oriented model and core curriculum as well as the definition of quality criteria and standards for study programmes of midwifery science. The Midwifery Science Committee (AHW) in the DACH Assoviation for Medical Education (GMA) offers an optimal platform for cooperation between the different universities. The existing challenges for the further professional development of midwives can only be overcome by collaboration and pooled expertise. [ABSTRACT FROM AUTHOR]

The objective of academic training is to prepare midwives as independent healthcare professionals to make a substantial contribution to the healthcare of women in their reproductive years as well as to the health of their children and families. This article therefore describes the professional and educational requirements derived from the legal midwifery competencies within the new midwifery act. Furthermore, it identifies the conditions that need to be established to enable midwives in Germany to practise to their full scope in compliance with statutory responsibilities. Educational science, academic efforts, policymaking and accompanying research should work in synergy. This in turn enables midwives to achieve the maximum scope of their skills, with the objective of promoting physiological pregnancies and births. Consequently, it can strengthen early parenthood in alignment with the national health objectives of "health around childbirth". The academisation of the midwifery profession presents a profound opportunity for professional development in Germany. It is essential that midwives receive training based on the principles of educational science and care structures that are yet to be developed. This can enable them to perform within the wide range of their professional tasks to the highest standards, thereby ensuring the optimal care of their clients. Moreover, there is a chance to implement sustainable improvements in healthcare provision for women and their families during the reproductive phase and the period of parenthood in Germany. [ABSTRACT FROM AUTHOR]

Ultrasound practice is a longstanding tradition for radiology departments, being part of the family of imaging techniques. Ultrasound is widely practiced by non-radiologists but becoming less popular within radiology. The position of ultrasound in radiology is reviewed, and a possible long-term solution to manage radiologist expectations is proposed. An international group of experts in the practice of ultrasound was invited to describe the current organisation of ultrasound within the radiology departments in their own countries and comment on the interaction with non-radiologists and training arrangements. Issues related to regulation, non-medical practitioners, and training principles are detailed. A consensus view was sought from the experts regarding the position of ultrasound within radiology, with the vision of the best scenario for the continuing dominance of radiologists practising ultrasound. Comments were collated from nine different countries. Variable levels of training, practice, and interaction with non-radiologist were reported, with some countries relying on non-physician input to manage the service. All experts recognised there was a diminished desire to practice ultrasound by radiologists. Models varied from practising solely ultrasound and no other imaging techniques to radiology departments being central to the practice of ultrasound by radiologists and non-radiologist, housed within radiology. The consensus view was that the model favoured in select hospitals in Germany would be the most likely setup for ultrasound radiologist to develop and maintain practice. The vision for 20 years hence is for a central ultrasound section within radiology, headed by a trained expert radiologist, with non-radiologist using the facilities. Critical relevance statement The future of ultrasound within the radiology department should encompass all ultrasound users, with radiologists expert in ultrasound, managing the ultrasound section within the radiology department. The current radiology trainees must learn of the importance of ultrasound as a component of the 'holistic' imaging of the patient. Key points: 1. Ultrasound imaging within radiology departments precedes the introduction of CT and MR imaging and was first used over 50 years ago. 2. Non-radiology practitioners deploy ultrasound examinations to either 'problem solve' or perform a comprehensive ultrasound examination; radiologists provide comprehensive examinations or use ultrasound to direct interventional procedures. 3. Radiology does not 'own' ultrasound, but radiologists are best placed to offer a comprehensive patient-focused imaging assessment. 4. A vision of the future of ultrasound within the radiology department is encompassing all ultrasound users under radiologists who are experts in ultrasound, positioned within the radiology department. 5. The current radiology trainee must be aware of the importance of ultrasound as a component of the 'holistic' imaging of the patient. [ABSTRACT FROM AUTHOR]

In the wake of local initiatives and developmental funding programs, interprofessionality is now included in national curricula in the German-speaking countries. Based on the 3P model (presage, process, product), this position paper presents the development of interprofessional education in recent years in Germany, Austria and Switzerland and places it in an international context. Core aspects as legal frameworks, including amendments to occupational regulations as well as the formation of networks and faculty development are basic requirements for interprofessional education. New topics and educational settings take shape in the process of interprofessional education: patient perspectives and teaching formats, such as online courses, become more important or are newly established. The influence of the COVID-19 pandemic on interprofessional education is explored as well. Among many new interprofessional courses, particularly the implementation of interprofessional training wards in Germany and Switzerland are positive examples of successful interprofessional education. The objective of interprofessional education continues to be the acquisition of interprofessional competencies. The main focus is now centered on evaluating this educational format and testing for the corresponding competencies. In the future, more capacities will be required for interprofessional continuing education and post-graduate education. Structured research programs are essential to ascertain the effects of interprofessional education in the German-speaking countries. In this position paper the GMA committee on interprofessional education encourages further advancement of this topic and expresses the aim to continue cooperating with other networks to strengthen and intensify interprofessional education and collaboration in healthcare. [ABSTRACT FROM AUTHOR]

Background: A large part of the population in Germany makes use of naturopathic, complementary and integrative medical treatments. There are now numerous scientific studies that provide evidence of efficacy for certain indications. At German medical faculties, selected procedures and their application are taught within the cross-sectoral unit called QB 12 and some elective courses, with a focus on specific aspects are offered. So far, however, there has been no structured curriculum that longitudinally anchors teaching across medical studies and enables all students to consider naturopathic and complementary medical options for patient care later on and to integrate them effectively into the diagnostic and treatment process. Objective: The aim of this position paper is to show the relevance of this topic for medical education, to clarify terminology and to present core competencies and possible implementation options for training. Method: The Integrative Medicine and Perspective Pluralism Committee of the German Association for Medical Education developed this position paper in a multi-stage consensual process, in cooperation with the Forum of University Work Groups on Naturopathic Treatment and Complementary Medicine. Results: First, different umbrella terms were discussed and an existing definition of integrative medicine and health was chosen for subsequent use. Building on this step, the status of education and its scientific foundation in Germany was considered in an international context. In the next step, a competency profile for medical training, consisting of seven areas of competency, was developed and described in detail with regard to naturopathic, complementary and integrative medicine. Implementation options were identified using possible starting points in the curriculum and using established examples of best practice. Conclusion: Despite different priorities at each faculty, it was possible to find an agreement on the development of competencies and anchoring them in medical education on the basis of a common definition of terms. Currently, the implementation in the mandatory and elective areas is very heterogeneous. As part of the current revision of the Medical Licensure Act, there are many possible starting points for the integration of naturopathic and complementary medical teaching content, especially in interprofessional and general practice courses. The implementation and accompanying research of targeted teaching settings should lay the foundations for a long-term and binding integration into medical education. Overall, it is clear that medical education in the field of naturopathy and complementary and integrative medicine has the potential to develop comprehensive core medical competencies. [ABSTRACT FROM AUTHOR]

Veterinarians have to face many communicative challenges in their professional capacity. Successful professional communication increases satisfaction among pet owners, staff members and colleagues, and ultimately also the veterinarians' own satisfaction. On the other hand, unsuccessful communication can easily lead to rejection, distrust and dissatisfaction. However, communicative skills are not explicitly taught as part of the compulsory courses in veterinary medicine in Germany. The position paper of the GMA Veterinary Medicine Committee and the DVG work group Didactics and Communication Competence describes the importance of successful communication for working veterinarians as well as the training situation in Germany and addresses topics that are often discussed in connection with the implementation. The authors come to the conclusion that there is both a necessity and a possibility for the introduction of communicative training contentand provide recommendations thatare intended to support the sustainable introduction of courses and exams to develop the communicative skills of veterinary students. [ABSTRACT FROM AUTHOR]

Having teaching staff with didactic qualifications in university teaching leads to a measurable improvement in academic skills among students. Previous recommendations on the type and scope of medical didactic qualification measures primarily apply to teaching staff at university and in-patient settings. The situation of primary care medicine, which often employs external lecturers and whose teaching takes place to a considerable extent in decentralized training facilities (teaching practices) is not adequately addressed. Taking into account a survey on the status quo at higher education institutions for General Practice in Germany, recommendations for min- imum standards are made, based on national and international recom- mendations on the content and scope of medical didactic qualification measures. These recommendations include preliminary work by the Personnel and Organizational Development in Teaching (POiL) Committee of the Society for Medical Education (GMA), the MedicalTeachingNetwork (MDN), the Society of University Teaching Staff in General Medicine (GHA) as well as the experiences of the committee members, who hail from the field of general medicine, internal medicine and pediatrics amongst others. [ABSTRACT FROM AUTHOR]

Recent research in economics and sociology demonstrates the existence of significant occupational segregation by sexual orientation and gender identity and differences in a range of labor market outcomes, such as hiring chances, earnings, and leadership positions. In this paper, we examine one possible cause of these differences that is associated with the disadvantaged position of sexual and gender minorities in the labor market: LGBTQ* individuals' choices aimed at avoiding possible discrimination. This paper examines LGBTQ* people's relative importance of income, time, promotion prospects, an LGBTQ*-friendly work environment, and diversity management in the decision for or against a job. Based on a discrete choice experiment conducted in a large online sample recruited through social media in Germany (N = 4,507), an LGBTQ*-friendly work climate accounted, on average, for 33.8 percent of respondents' decisions which is comparable with the relative importance of income. Overtime, a diversity management on company level and promotion prospects are less important in the job decision process of LGBTQ* people. While the results show only small differences by sexual orientation, they show group-specific preferences by gender identity. An LGBTQ*-friendly work climate is more important for cisgender women of the LGBTQ* community and gender minorities than for cisgender men of the LGBTQ* community. In contrast, income is less important for gender minorities and cisgender women of the LGBTQ* community than for cisgender men of the LGBTQ* community. [ABSTRACT FROM AUTHOR]

The importance and urgency of IPLE (intellectual property literacy education) are increasingly prominent. This paper aims to build an IPLE mode to provide support for the talent cultivation in university libraries facing opportunities and challenges in the service transformation period. The IPLE mode and content of the Regional Patent Information Centers (PIZ Regional Centers) in German universities and university libraries are studied through network research, literature research, and comparative analysis. Based on the practical experience, educational characteristics and advantages, this paper constructs an IPLE mode of university library that includes six modules. Building the IPLE mode of university libraries can provide reference for university libraries in the work of IPLE, and gradually form an IPLE system that meets the needs of users' training, conforms to the university's talent training objectives, and improves the development plan of the university libraries. [ABSTRACT FROM AUTHOR]

We examine the price ambivalence of low quality waste paper (grades 1.02 and 1.04) on the German market. Since 1990 the price of these grades is at times positive and at times negative. The underlying reason is the combination of three institutional and technical characteristics of the market: (i) As a result of waste management legislation the supply of waste paper is mostly independent of its price and its demand. Supply is bounded from below by collection and utilization quotas fixed by the Regulation on Packaging Waste enacted in 1991. (ii) The only alternative to costly disposal of waste paper by dumping or incineration is its use as a secondary resource in the production of new paper, as only the paper industry is capable of using waste paper in a productive manner in significant amount. (iii) Yet, its use as a substitute for primary inputs is technically limited. In this article, we describe the technical and institutional conditions leading to price ambivalence and discuss the consequences for supply, demand and trade of waste paper. [Copyright &y& Elsevier]

Soil and soil biodiversity are often a neglected component in assessments of ecosystems and their services. One of the reasons is the increasing complexity of scientific investigation of biotic and abiotic interactions and mechanisms from soil biodiversity and soil components via ecosystem structures, processes, and functions that finally provide specific ecosystem services for human well-being. In particular, soil-related cultural ecosystem services are missing in the publications on interactions. We tested this hypothesis by using a systematic literature analysis and taking Germany as a case study. The findings revealed a huge research gap. Among 2104 peer-reviewed scientific papers, covering all types of soil-related ecosystem services, only 28 publications were related to soil-related cultural ecosystem services in Germany. Furthermore, the terminological awareness of "ecosystem services" is still limited. The following five main categories for cultural soil-related ecosystem services were identified: (1) place of sense, (2) spiritual value, (3) recreation, (4) forecasts and measures, and (5) soil as an archive. Soil as an archive was further divided into storage, archaeological site, and reconstruction of the past. By highlighting the importance of cultural soil-related ecosystem services and their interactions with soil biodiversity, this study underlines the urgent need to better consider soil biodiversity and soil processes in ecosystem service assessments. This systemic and interdisciplinary approach increases also the societal and political relevance of soil. [ABSTRACT FROM AUTHOR]

The article discusses a November 2008 further education conference at the Carl von Ossietzky Provincial and University Library in Hamburg, Germany on the theme "So That Paper Persists... Experiences With Mass Deacidification." The rationale, methodology, scope, and evaluated results of paper deacidification projects in various German libraries were reviewed.

Bibliometric indices are a widely used measure of research impact. The aim of the current study was to identify and characterise the top one hundred most-cited research articles in the topic of chronotype research. A search of the Thomson Reuters Web of Science database returned 974 eligible articles (published between 1990 and 2016). Citations for the 100 most-cited articles ranged between 438 and 29. The most represented journal was Chronobiology International (n = 30). Nearly 50% of articles originated in Germany and the U.S. The bibliometrics reported identify key publications and provide insight into trends within the topic of chronotype research. [ABSTRACT FROM AUTHOR]

The emerging energy transition is particularly described as a move towards a cleaner, lower-carbon system. In the context of the global shift towards sustainable energy sources, this paper reviews the potential and roadmap for hydrogen energy as a crucial component of the clean energy landscape. The primary objective is to present a comprehensive literature overview, illuminating key themes, trends, and research gaps in the scientific discourse concerning hydrogen production and energy policy. This review focuses particularly on specified geographic contexts, with an emphasis on understanding the unique energy policies related to renewable energy in Brazil, Austria, and Germany. Given their distinct social systems and developmental stages, this paper aims to delineate the nuanced approaches these countries adopt in their pursuit of renewable energy and the integration of hydrogen within their energy frameworks. Brazil exhibits vast renewable energy potential, particularly in wind and solar energy sectors, positioning itself for substantial growth in the coming years. Germany showcases a regulatory framework that promotes innovation and technological expansion, reflecting its highly developed social system and commitment to transitioning away from fossil fuels. Austria demonstrates dedication to decarbonization, particularly through the exploration of biomethane for residential heating and cooling. [ABSTRACT FROM AUTHOR]

This paper asks the question, 'What does Islamic education mean for the 21st century university?' To begin with, the paper addresses the modern university as an institution facing numerous challenges, which can be conceived of by understanding the nature of the 'academic imagination'. In so doing, this argument draws on the fundamental elements of thought itself by foregrounding imagination as a primary route by which knowledge is conceived, created and disseminated. At root, it is an argument that suggests that to understand the university is to apprehend its imaginative functions. 'Problems of the imagination' are thereafter defined as 'depth perception', 'vertigo' and 'paralysis', respectively. In light of these challenges, the rise of Centers of Islamic Theology in Germany, and Islamic education as a discipline in particular, are considered as uncharted paths towards a discussion of the dilemmas of contemporary academia. Methodologically, the paper is a philosophical reflection on the role of the future of the university and the place of Islamic Theology and Islamic education therein. As such, use of the contemporary literature on higher education, as well as classical works on Islamic education, shall be employed for the purposes of the argument. In so doing, this paper turns the normative discussion of contemporary Islamic education on its head: from how we may make room for such education in the modern university, to consider how its presence may help the institution and its imaginative conundrums. [ABSTRACT FROM AUTHOR]

Introduction: Medical quality indicators (QI) are important tools in the evaluation of medical quality. Their development is subject to specific methodological requirements, which include practical applicability. This is especially true for intensive care medicine with its complex processes and their interactions. This methods paper presents the status quo and shows necessary methodological developments for intensive care QI. For this purpose, a cooperation with the Association of the Scientific Medical Societies' Institute for Medical Knowledge Management (AWMF-IMWi) was established. Methodology: Review of published German manuals for QI development from guidelines and narrative review of quality indicators with a focus on evidence and consensus-based guideline recommendations. Future methodological adaptations of indicator development for improved operationalization, measurability and pilot testing are presented, and a development process is proposed. Results: The development of intensive care quality indicators in Germany is based on an established process. In the future, additional evaluation criteria (QUALIFY criteria) will be applied to assess the evidence base. In addition, a continuous exchange between the national steering committee of the DIVI responsible for QI development and guideline development groups involved in intensive care medicine is planned. Conclusion: Intensive care quality indicators will have to meet improved methodological requirements in the future by means of an improved development process. Future QI development is intended to improve the structure of the development process, with a focus on scientific evidence and a link to guideline projects. This is intended to achieve the goal of a broad application of QI and to further evaluate its relevance for patient outcome and performance of institutions. [ABSTRACT FROM AUTHOR]

The global trend in manufacturing has shifted from a manufacturing-centric process toward a user-centric process. This has resulted in a shorter lifespan and a high product replacement rate of any consumer product. Germany has introduced the concept of Industry Revolution 4.0 (IR 4.0) to convert manufacturing processes and mechanisms into cyber-physical systems (CPS). Digital factory, being the first step into CPS and IR4.0, is being targeted as the most important evolution of the manufacturing industry. This paper defines digital factories and their differences between other similar domains such as smart factories, CPS, and virtual factories. The requirements and goals of a digital factory are explained in detail to facilitate future digital factory tool developments. Furthermore, the current challenges faced in the implementation of the digital factory are proposed to be approached by adapting an interoperable virtual reality technology. This paper emphasizes the usage of virtual reality (VR) in simulating a digital factory that aids in the decision-making and efficient operation of a manufacturing facility. Furthermore, recommendations gathered from previous studies for developing VR-based digital factory tools are also explained in detail in this paper. [ABSTRACT FROM AUTHOR]

Events as urban development formats have been relevant strategies for cities for several decades. They may have diverse economic, political, social and ecological effects on the host cities and are accordingly used in a variety of ways and closely linked to urban development and renewal. Complex processes can be identified in the context of the application, planning, implementation and after-use of an event. Furthermore, the planning of events is subject to an extensive multilevel governance of actor constellations and interactions. Against this background, in this paper we introduce a multi-level governance phase framework for formats of event-led urban development in order to create a better understanding of the structures and processes involved. For this purpose, we first use regional garden shows as a case study, which are event formats with a focus on small and medium-sized cities in Germany and on the (further) development of urban green spaces. We then generalize the framework using the governance capacity concept for events and approaches of event-led urban development. The model is well suited to illustrate the relevance of different actors in the process as well as the complexity of diverse processes that occur in the course of event planning. [ABSTRACT FROM AUTHOR]

Background: The birth experience plays a pivotal role in the mother´s mental well-being and has a crucial effect on the mother-child bond. Unanticipated medical interventions, including fundal pressure, episiotomy, assisted vaginal delivery (AVD), or unplanned cesarean section (CS) during labor, may adversely affect the birth experience. The objective of this study is to identify factors contributing to the diminished evaluation of the birth experience after assessing the prevalence of unplanned obstetrical interventions in Germany. Methods: For this cross-sectional analysis, 4000 mothers whose children were born 8 or 12 months before were asked about their birth experience via a paper-based questionnaire. Overall 1102 mothers participated in the study, representing a response rate of 27.6%. The revised Childbirth Experience Questionnaire (CEQ2) was used to measure the childbirth experience. In addition to descriptive and bivariate analyses using the Wilcoxon rank-sum test and Kruskal-Wallis-test, we calculated multivariate linear regression models for each dimension of the CEQ2. Results: In general, the participants evaluated their childbirth experience favorably, assigning an average rating of 3.09 on a scale ranging from 1 to 4. Women who experienced fundal pressure, an AVD, or an unplanned CS rated their birth experience significantly worse compared to women who gave birth without interventions. Unplanned CSs received the lowest ratings for "personal capability" and "perceived safety," and an AVD resulted in lower scores for "professional support" and "participation." However, the interventions we studied did not account for much of the variation in how the childbirth experience plays out for different individuals. Conclusion: Obstetric interventions have a significant effect on different dimensions of the birth experience. If a high level of birth satisfaction is to be achieved, it is important to know which dimension of satisfaction is affected by the intervention so that explicit measures, like fostering communication, participation or safety can be taken to promote improvement. German Clinical Trial Register: DRKS00029214, retrospectively registered (Registration Date 22.06.2023). [ABSTRACT FROM AUTHOR]

Background: Mild cognitive impairment (MCI) involves cognitive decline beyond typical age-related changes, but without significant daily activity disruption. It can encompass various cognitive domains as the causes of MCI are diverse. MCI as well as frequent comorbid neuropsychiatric conditions like depression and anxiety affect individuals' quality of life. Early interventions are essential, and computerized cognitive training (cCT) is an established treatment method. This paper presents the protocol for the NeuroNation MED Effectiveness Study, evaluating the self-administered mobile cCT intervention ("NeuroNation MED") in individuals with MCI to assess training effects on cognitive domains, health competence, neuropsychiatric symptoms, psychological well-being, and the general application usability. Methods: This study protocol presents a single-blinded multicenter randomized controlled trial that will be carried out in six study centers in Germany and Luxembourg. We included adults with MCI (existing F06.7 ICD-10-GM diagnosis and TICS ≥ 21 and ≤ 32). The intervention group will use a mobile, multi-domain cCT ("NeuroNation MED") for 12 weeks. Meanwhile, the wait list control group will receive standard medical care or no care. The eligibility of volunteers will be determined through a telephone screening. After completion of the baseline examination, patients will be randomly assigned to one of the experimental conditions in a 2:1 ratio. In total, 286 participants will be included in this study. The primary outcome is the change of cognitive performance measured by the index score of the screening module of the Neuropsychological Assessment Battery. Secondary outcomes are changes in the Cognitive Failures Questionnaire, Hospital Anxiety and Depression Scale, Health-49, Health Literacy Questionnaire, among others. All of the primary and secondary outcomes will be assessed at baseline and after the 12-week post-allocation period. Furthermore, the intervention group will undergo an assessment of the System Usability Scale, and the training data of the NeuroNation MED application will be analyzed. Discussion: This study aims to assess the effectiveness of a mobile self-administered cCT in enhancing cognitive abilities among individuals diagnosed with MCI. Should the findings confirm the effectiveness of the NeuroNation MED app, it may confer possible benefits for the care management of patients with MCI, owing to the accessibility, cost-effectiveness, and home-based setting it provides. Specifically, the cCT program could provide patients with personalized cognitive training, educational resources, and relaxation techniques, enabling participants to independently engage in cognitive training sessions at home without further supervision. Trial registration: German Clinical Trials Register DRKS00025133. Registered on November 5, 2021. [ABSTRACT FROM AUTHOR]

Rarely has a chemical elicited as much controversy as dichloroacetate (DCA). DCA was initially considered a dangerous toxic industrial waste product, then a potential treatment for lactic acidosis. However, the main controversies started in 2008 when DCA was found to have anti-cancer effects on experimental animals. These publications showed contradictory results in vivo and in vitro such that a thorough consideration of this compound's in cancer is merited. Despite 50 years of experimentation, DCA's future in therapeutics is uncertain. Without adequate clinical trials and health authorities' approval, DCA has been introduced in off-label cancer treatments in alternative medicine clinics in Canada, Germany, and other European countries. The lack of well-planned clinical trials and its use by people without medical training has discouraged consideration by the scientific community. There are few thorough clinical studies of DCA, and many publications are individual case reports. Case reports of DCA's benefits against cancer have been increasing recently. Furthermore, it has been shown that DCA synergizes with conventional treatments and other repurposable drugs. Beyond the classic DCA target, pyruvate dehydrogenase kinase, new target molecules have also been recently discovered. These findings have renewed interest in DCA. This paper explores whether existing evidence justifies further research on DCA for cancer treatment and it explores the role DCA may play in it. [ABSTRACT FROM AUTHOR]

The promises and risks of Artificial Intelligence permeate current policy statements and have attracted much attention by AI governance research. However, most analyses focus exclusively on AI policy on the national and international level, overlooking existing federal governance structures. This is surprising because AI is connected to many policy areas, where the competences are already distributed between the national and subnational level, such as research or economic policy. Addressing this gap, this paper argues that more attention should be dedicated to subnational efforts to shape AI and asks which themes are discussed in subnational AI policy documents with a case study of Germany's 16 states. Our qualitative analysis of 34 AI policy documents issued on the subnational level demonstrates that subnational efforts focus on knowledge transfer between research and industry actors, the commercialization of AI, different economic identities of the German states, and the incorporation of ethical principles. Because federal states play an active role in AI policy, analysing AI as a policy issue on different levels of government is necessary and will contribute to a better understanding of the developments and implementations of AI strategies in different national contexts. [ABSTRACT FROM AUTHOR]

The question of whether 21st-century urbanization dynamics are leading to a suburbanization of poverty in Western city regions has been on the agenda of spatial researchers and housing policymakers for over a decade now. Persistent reurbanization trends are putting increased pressure on innercity housing markets, resulting in affordability problems for low-income households. Evidence from the US and the UK shows that financing mechanisms in the real estate sector were severely disrupted in the aftermath of the financial crisis in 2009 and subsequent years, with many households losing their homes and being forced to move. Though social security systems and social housing policies generally have a moderating effect, they vary widely across Western countries. Against this background, this paper presents three spatial observation methods tailored to the spatial analysis of poverty concentrations in Germany. The methods are based on three popular conceptualizations of poverty: material poverty, relative poverty, and the concept of neighbourhood deprivation. The main novelty presented in this paper is a cold-spot analysis of purchasing power in 33 city regions using interactive map visualizations and complemented by socioeconomic indicators. Expert feedback verifies the validity of the approach which addresses a 'blind spot' in assessing poverty in Germany, where many low-income households are increasingly exposed to risks of poverty despite not qualifying for social benefits. [ABSTRACT FROM AUTHOR]

The paper analyses implications and challenges of Germany's upcoming military deployment in Lithuania. A permanent stationing of brigade-sized military unit on NATO's Eastern frontier represents a major change in its force posture and a significant shift in Germany's defence policy. Despite the official German position that the implementation of its military commitments is contingent on Lithuania's timely improvement of its host nation support infrastructure, the paper suggests that the speed, quantity, and structure of Germany's deployment also depends on the progress made in rearming the Bundeswehr and its defence policy priorities. [ABSTRACT FROM AUTHOR]

Background: Currently, more than 30,200,000 COVID-19 cases have been diagnosed in Germany alone. However, data regarding prevalence of COVID-19 in children, both in Germany and internationally, are sparse. We sought to evaluate the number of infected children by measuring IgG antibodies. Methods: Oropharyngeal swabs were collected between December 2020 and August 2021 to measure SARS-CoV-2, and capillary blood for the detection of SARS-CoV-2 antibodies (by rapid test NADAL® and filter paper test Euroimmun® ELISA); venous blood was taken for validation (Roche® ECLIA and recomLine Blot) in 365 German children aged 3–16 years from 30 schools and preschools. We used multiple serological tests because the filter paper test Euroimmun® ELISA performs better in terms of sensitivity and specificity than the rapid test NADAL®. The Roche® ECLIA test is used to detect SARS-CoV-2 spike protein, and the recomLine Blot test is used to rule out the possibility of infection by seasonal SARS-viruses and to test for specific SARS-CoV-2 proteins (NP, RBD and S1). In addition, one parent each (n = 336), and 4–5 teachers/caregivers (n = 90) per institution were tested for IgG antibodies from capillary blood samples. The total study duration was 4 months per child, including the first follow-up after 2 months and the second after 4 months. Results: Of 364 children tested at baseline, 3.6% (n = 13) were positive for SARS-CoV-2 IgG antibodies using Euroimmun® ELISA. Seven children reported previously testing positive for SARS-CoV-2; each of these was confirmed by the Roche® Anti-SARS-CoV-2-ECLIA (antibody to spike protein 1) test. SARS-CoV-2 IgG antibodies persisted over a 4-month period, but levels decreased significantly (p = 0.004) within this timeframe. The median IgG values were 192.0 BAU/ml [127.2; 288.2], 123.6 BAU/ml [76.6; 187.7] and 89.9 BAU/ml [57.4; 144.2] at baseline, 2 months and 4 months after baseline, respectively. During the study period, no child tested positive for SARS-CoV-2 by oropharyngeal swab. A total of 4.3% of all parents and 3.7% of teachers/caregivers tested positive for IgG antibodies by Euroimmun® ELISA at baseline. Conclusion: We noted a rather low seroprevalence in children despite an under-reporting of SARS-CoV-2 infections. Measurement of IgG antibodies derived from capillary blood appears to be a valid tool to detect asymptomatic infections in children. However, no asymptomatic active infection was detected during the study period of 4 months in the whole cohort. Further data on SARS-CoV-2 infections in children are needed, especially in the group of <5-year-olds, as there is currently no licensed vaccine for this age group in Germany. The Robert Koch Institute's Standing Commission on Vaccination (STIKO) recommended COVID-19 vaccination for 12–17 and 5–11 year olds in August 2021 and May 2022 respectively. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Our aim was to report the first known incidence of U.S. butter contamination with extremely high levels of polybrominated diphenyl ethers (PBDEs). METHODS: Ten butter samples were individually analyzed for PBDEs. One of the samples and its paper wrapper contained very high levels of higher-brominated PBDEs. Dietary estimates were calculated using the 2007 U.S. Department of Agriculture Loss-Adjusted Food Availability data, excluding the elevated sample. RESULTS: The highly contaminated butter sample had a total upper bound PBDE level of 42,252 pg/g wet weight (ww). Levels of brominated diphenyl ether (BDE)-206, -207, and -209 were 2,000, 2,290, and 37,600 pg/g ww, respectively. Its wrapping paper contained a total upper-bound PBDE concentration of 804,751 pg/g ww, with levels of BDE-206, -207, and -209 of 51,000, 11,700, and 614,000 pg/g, respectively. Total PBDE levels in the remaining nine butter samples ranged from 180 to 1,212 pg/g, with geometric mean of 483 and median of 284 pg/g. Excluding the outlier, total PBDE daily intake from all food was 22,764 pg/day, lower than some previous U.S. dietary intake estimates. CONCLUSION: Higher-brominated PBDE congeners were likely transferred from contaminated wrapping paper to butter. A larger representative survey may help determine how frequently PBDE contamination occurs. Sampling at various stages in food production may identify contamination sources and reduce risk. [ABSTRACT FROM AUTHOR]

In scholarly debates, Ludwik Fleck's post-war paper 'Problemy naukoznawstwa [Problems of the Science of Science]', published in 1946, has been taken unanimously to illustrate the epistemology expounded in his monograph Genesis and Development of a Scientific Fact. The paper has also been seen to support parts of the received view of Fleck, notably that he manufactured an anti-typhus vaccine while imprisoned in Buchenwald. However, a different narrative emerges when comparing Fleck's paper with other accounts, also published in 1946 and written by other prisoners alluded to by Fleck in his paper. The situation is further complicated by four papers, published in prestigious scientific journals between 1942 and 1945, by the German medical leader of the typhus studies accounted for by Fleck. In addition, a thus-far neglected paper by Fleck, published in 1946 and summarizing his observations on typhus, discloses his role in the Buchenwald studies. Despite the obvious difficulties with tracing the history behind these works, notably the one on Nazi science, the contention is that what was attempted in Buchenwald in the name of science amounted to pseudoscience. This conclusion is amply supported not only by the accounts given by Fleck's fellow prisoners, but also by his own post-war paper on typhus. Based on the above findings, it is suggested that the mythology about Fleck, established in the 1980s, has been accomplished by a selective reading of his papers and also that the role played by Fleck was more complex than has so far been contemplated. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia is a complex neuropsychiatric disorder of unclear etiology. The strongest known genetic risk factor is the 22q11.2 microdeletion. Research has yet to confirm which genes within the deletion region are implicated in schizophrenia. The minimal 1.5 megabase deletion contains MIR185, which encodes microRNA 185. Methods: We determined miR-185 expression in embryonic and adult mouse brains. Common and rare variants at this locus were then investigated using a human genetics approach. First, we performed gene-based analyses for MIR185 common variants and target genes using Psychiatric Genomics Consortium genome-wide association data. Second, MIR185 was resequenced in German patients (n = 1000) and controls (n = 500). We followed up promising variants by genotyping an additional European sample (patients, n = 3598; controls, n = 4082). Results: In situ hybridization in mice revealed miR-185 expression in brain regions implicated in schizophrenia. Gene-based tests revealed association between common variants in 3 MIR185 target genes (ATAT1, SH3PXD2A, NTRK3) and schizophrenia. Further analyses in mice revealed overlapping expression patterns for these target genes and miR185. Resequencing identified 2 rare patient-specific novel variants flanking MIR185. However, follow-up genotyping provided no further evidence of their involvement in schizophrenia. Limitations: Power to detect rare variant associations was limited. Conclusion: Human genetic analyses generated no evidence of the involvement of MIR185 in schizophrenia. However, the expression patterns of miR-185 and its target genes in mice, and the genetic association results for the 3 target genes, suggest that further research into the involvement of miR-185 and its downstream pathways in schizophrenia is warranted. [ABSTRACT FROM AUTHOR]

The German engineer H.A. Janssen gave one of the first accounts of the often peculiar behavior of granular material in a paper published in German in 1895. From simple experiments with corn he inferred the saturation of pressure with height in a granular system. Subsequently, Janssen derived the equivalent of the barometric formula for granular material from the main assumption that the walls carry part of the weight. The following is a translation of this article. The wording is chosen as close as possible to the original. While drawings are copied from the original, figures displaying data are redone for better readability. The translation is complemented by some bibliographical notes and an assessment of earlier work, wherein Hagen predicted the saturation of pressure with depth in 1852, and Huber-Burnand demonstrated that saturation qualitatively as early as in 1829. We conclude with a brief discussion of more recent developments resting on Janssen's work. [ABSTRACT FROM AUTHOR]

The motivation for this paper comes from the recognition that our understanding of specialisation might be too simplistic and that the dichotomy of specialisation and diversification could be outdated not reflecting the richness of real complex economic and technological relations among industries. Drawing on a qualitative study of the Hamburg Aviation (HAv) cluster, this paper discusses the peculiarities of a cluster profile in the digital time - the age of Industry 4.0 (I4.0), touching upon the issues of cluster structure and the complexity of production, synchronising specialisation with diversification, branching, and bridging, and the I4.0 attributes facilitating complementarity. The final research proposal, which is empirically embedded in the studied context, states that related variety encompassing both 'specialisation in diversification' and 'diversification within specialisation' can be further developed by a blending process. This can lead to branching and is modulated by the universal character of the I4.0 and a problem-solving attitude. It takes the form of an additive (new entries) or multiplicative (spinoffs) evolution, and, ultimately, owing to the complementarity, it can provide sustainable competitive advantages. [ABSTRACT FROM AUTHOR]

Electric stimulation via a cochlear implant (CI) enables people with severe-to-profound sensorineural hearing loss to regain speech understanding and music appreciation and, thus, allow them to actively engage in social life. Three main manufacturers (CochlearTM, MED-ELTM, and Advanced BionicsTM "AB") have been offering CI systems, thus challenging CI recipients and otolaryngologists with a difficult decision as currently no comprehensive overview or meta-analysis on performance outcomes following CI implantation is available. The main goals of this scoping review were to (1) map the literature on speech and music performance outcomes and to (2) find whether studies have performed outcome comparisons between devices of different manufacturers. To this end, a literature search was conducted to find studies that address speech and music outcomes in CI recipients. From a total of 1592 papers, 188 paper abstracts were analyzed and 147 articles were found suitable for an examination of full text. From these, 42 studies were included for synthesis. A total of 16 studies used the consonant-nucleus-consonant (CNC) word recognition test in quiet at 60 db SPL. We found that aside from technical comparisons, very few publications compared speech outcomes across manufacturers of CI systems. However, evidence suggests that these data are available in large CI centers in Germany and the US. Future studies should therefore leverage large data cohorts to perform such comparisons, which could provide critical evaluation criteria and assist both CI recipients and otolaryngologists to make informed performance-based decisions. [ABSTRACT FROM AUTHOR]

By analysing the childcaring experiences of female skilled workers from South Korea (hereafter, Korea) in Germany, this paper maintains that the challenges in labour market participation for highly skilled women, and especially those with children, should be understood in the context of their encounters with similar and different care and employment regimes between their home and host countries. On the theoretical level, this research confirms the argument that the migration of highly skilled workers should be contextualized not from a neoclassical perspective in which the maximization of economic profits takes priority, but from an institutional point of view in which social and cultural norms, practices, and policies in both the home and host societies are taken into consideration. Specifically, through a series of in-depth interviews conducted with skilled female migrants from Korea, this paper highlights the significance of taking the function of similar and different caring and employment regimes into account in explaining the challenges faced by highly skilled migrant women in labour market participation. On the empirical level, this paper sheds light on the migration experiences of skilled women from Asia as well as the (dis)integration processes of newcomers from third-national countries in Germany, with a focus on female migrants from Korea. [ABSTRACT FROM AUTHOR]

Purpose: In Germany, children diagnosed with cancer survive their initial disease in more than 80%, and the majority will become long‐term survivors. Around the age of 18, survivors are transferred to adult healthcare. The transition can be a critical period in the process of care at which many childhood cancer survivors discontinue to participate in regular follow‐up care. Hence, the objective of the paper was to explore (a) survivors' attitudes towards pediatric follow‐up care and (b) their concerns regarding the transition process to draw conclusions for optimizing pediatric care and transition processes. Methods: We conducted semi‐structured interviews with 21 adolescent childhood cancer survivors between the ages of 14 and 20. The survivors were recruited via a pediatric oncology department of a university hospital in Germany. Based on the principles of qualitative content analysis, a deductive‐inductive method according to Kuckartz was applied. Results: Based on the interview guide and derived from the exploratory research questions, two key categories were generated: (a) Survivors' attitudes towards pediatric follow‐up care, which encompasses all formal and emotional aspects of survivors regarding follow‐up care, and (b) their concerns regarding transition from pediatric to adult healthcare, where hindering and facilitating factors for a successful transition occur. Our results show high satisfaction among survivors with follow‐up care. Nevertheless, they wish to be more integrated into processes and the organization of their follow‐up care. Most adolescent survivors do not feel ready for transition. Conclusion: The integration of survivors into the organization processes and routines, and the promotion of emotional detachment from pediatric health care professionals (HCPs) are important to reduce concerns and uncertainties of adolescent survivors regarding the transition process and to promote subjective readiness for transition. To gain confidence in the adult healthcare, it is crucial to provide tailored education depending on individual requirements and needs and to build trusting relationships between survivors and adult HCPs. [ABSTRACT FROM AUTHOR]

In Germany, there are over 32,000 schools, representing great potential for climate protection. On the one hand, this applies to educational work, as understanding the effects of climate change and measures to reduce GHG emissions is an important step to empower students with knowledge and skills. On the other hand, school buildings are often in bad condition, energy is wasted, and the possibilities for using renewable energies are hardly used. In our "Schools4Future" project, we enabled students and teachers to draw up their own CO2 balances, identify weaknesses in the building, detect wasted electricity, and determine the potential for using renewable energies. Emissions from the school cafeteria, school trips, and paper consumption could also be identified. The fact that the data can be collected by the students themselves provides increased awareness of the contribution made to the climate balance by the various school areas. The most climate-friendly school emits 297 kg whilst the school with the highest emissions emits over one ton CO2 per student and year. Our approach is suitable to qualify students in the sense of citizen science, carry out a scientific investigation, experience self-efficacy through one's own actions, and engage politically regarding their concerns. [ABSTRACT FROM AUTHOR]

Citizen participation has played an increasingly relevant role in spatial planning and development aiming to shape sustainable and innovative processes since the 1970s. Nevertheless, analogue participation is associated with various problems, such as social selectivity and a loss of civic trust in administration and politics. Against this background, high expectations lie in the development of digital participation formats, which have significantly changed the participation landscape. Despite the rapid development of digital participation based on new technologies and external factors such as the Covid- 19 pandemic, there is still a lack of comprehensive empirical studies on spatial patterns and determinants. Therefore, the aim of the paper is to give an overview of the patterns, methods and determinants of digital and multi-channel participation in Germany. We comprehensively investigated digital and multi-channel participation processes on the websites of German cities and districts -- about 4,000 approaches in total. The results show spatial disparities in digital participation processes. While the availability of broadband internet and public debt do not significantly influence the digital participation density in districts and cities, low election turnouts go along with high densities. This suggests that the administrations are responding to political disinterest with digital participation. The results also indicate that digital participation can be less socially selective, as high shares of population without German citizenship, highmigration rates and low employment rates have significant positive effects on digital participation. [ABSTRACT FROM AUTHOR]

This paper describes the technical specifications of the extensions made to the middle-atmospheric lidar facility at the Leibniz Institute of Atmospheric Physics in Kühlungsborn, Germany (54.12° N, 11.77° E). The upgrade complements the existing daylight-capable Rayleigh–Mie–Raman (RMR) temperature lidar with a nighttime-only RMR wind–temperature lidar. The new system comprises an independent lidar with laser, telescopes, and detectors, which is synchronized with and adapted to the (old) temperature lidar. As a result, with the combination of RMR lidars the atmosphere is probed with three (vertical and tilted) beams. This work intends to highlight the recent innovations in the construction of a Doppler–Rayleigh lidar system using the single-edge iodine-cell technique, which allows for the simultaneous measurement of wind, temperature, and aerosols. We will detail supporting subsystems that allow for a high degree of lidar automation and concisely provide key technical information about the system that will support readers in the development of additional RMR wind–temperature lidar systems. We show an example of time-resolved temperature and wind soundings reaching up to ∼ 90 km. These data agree well with ECMWF-IFS profiles between 35 and ∼ 50 km but show a much larger variability above. In the companion article, we will present the algorithm design and uncertainty budgets associated with the data processing chain. [ABSTRACT FROM AUTHOR]

This paper studies the effect of air pollution on voting outcomes. We use data from 60 federal and state elections in Germany from 2000 to 2018 and exploit plausibly exogenous fluctuations in ambient air pollution within counties across election dates. Higher air pollution on election day shifts votes away from incumbent parties and toward opposition parties. An increase in the concentration of particulate matter (PM10) by 10 g/m3--around two within-county SDs--reduces the vote share of incumbent parties by two percentage points, which is equivalent to 4% of the mean vote share. We generalize these findings by documenting similar effects with data from a weekly opinion poll and a large-scale panel survey. We provide further evidence that poor air quality leads to more negative emotions such as anger, worry, and unhappiness, which, in turn, may reduce the support for the political status quo. Overall, these results suggest that poor air quality affects decision-making in the population at large, including consequential political decisions. [ABSTRACT FROM AUTHOR]

With the world population growth, energy consumption and the rapid development of industrial economy, a large amount of carbon emissions has brought destruction and threats to the earth's environment on which human beings depend. The development of low-carbon economy has become the consensus of governments all over the world and has been vigorously advocated & promoted. This paper focuses on the top five global GDP nations in 2022: The United States, China, Japan, Germany, and Britain. A comprehensive evaluation index system of urban low-carbon economic development level is constructed from four dimensions: economic development level, environmental quality, energy consumption emission intensity and social development speed by using literature review and field interview. The evaluation measures are determined using the TOPSIS evaluation method with entropy weight and the grey relational model, providing a comprehensive assessment of the low-carbon economy's development level in these five countries." Judging from the comprehensive evaluation score, the overall development of low-carbon economy in American cities is in good condition and has reached the development standard of low-carbon economy; Germany and Japan rank second and third, and they are low-carbon economies. Britain ranks fourth in comprehensive evaluation, although it belongs to a low-carbon economy country, but there is still a certain gap with Germany and Japan; There is still a big gap between China and the other four countries. Based on the measurement and evaluation outcomes, it presents recommendations and strategies to foster the growth of low-carbon economies, offering valuable insights for the advancement of such economies across different nations. The research results guide countries all over the world to reduce carbon emissions in the process of economic development, protect the earth environment on which human beings depend, and make a better tomorrow for sustainable development. [ABSTRACT FROM AUTHOR]

In contemporary times, the utilization of liquid organic hydrogen carriers (LOHCs) has gained prominence due to their high volumetric storage density and material properties closely resembling conventional fuels. Numerous countries are incorporating LOHCs in hydrogen demonstration initiatives, encompassing applications such as hydrogen refueling stations, hydrogen-powered ships, and trains. This paper conducts a comprehensive review of seventeen LOHC projects, spanning Germany, Europe, and other nations, presenting detailed project specifications. This review includes information on project consortiums, funding sources, covered supply chains, transport modalities, and employed technologies. Through a global evaluation of LOHC projects, this review underscores the promising and competitive nature of LOHCs as a viable option for the large-scale and long-distance storage and transportation of hydrogen. The future development of this field is discussed at in the last section. [ABSTRACT FROM AUTHOR]

Background: Establishing successful lactation in mothers of very low birth weight (VLBW, <1500g) infants requires structured lactation support. Little is known about mothers' perspectives on lactation support in German neonatal intensive care units (NICUs). Methods: This paper features a convergent mixed-method approach that includes a retrospective, cross-sectional questionnaire and interview data to showcase mothers' perceptions of lactation support in NICUs. Content analysis of the interviews (n = 12) and a descriptive analysis of quantitative data (n = 533) were performed to illustrate the current status and need for lactation support in German NICUs. Results: The results show that lactation support in German NICUs is often inadequate and does not comply with recommendations based on the existing literature to encourage pumping and breastfeeding in mothers. The data imply that even if lactation is successfully initiated in most cases, it is often not maintained over time, which may be due to a lack of personal support and consistent information. Conclusion: The overall structures and institutional guidelines for lactation support should be encouraged to promote nutrition with mother´s own milk in German NICUs. [ABSTRACT FROM AUTHOR]

Several northern European countries have announced ambitious plans to become carbon neutral already before the year 2050. Recent research has, however, highlighted how potential bottlenecks in raw material and resource availability could significantly delay or hinder wind and solar photovoltaic (PV) expansion and continued biomass usage in parts of Europe. To address this issue, this paper assesses how exposed the national energy and climate plans (NECPs) of Finland, Estonia, Germany, Sweden, and Denmark are to resource limitations and techno-economic risks by reviewing and analysing 2030 NECP targets compared to statistical energy use data in these countries. The results indicate that the NECPs of Denmark and Germany are particularly exposed to risks related to global raw material availability, as Denmark plans to rapidly grow the share of wind and solar PV in electricity generation to 81% and 13% by 2030, respectively, followed by Germany, which outlines a 39% and 16% share of wind and solar PV in its national climate strategy. The NECPs of Finland and Germany are also shown to be vulnerable to limitations in biomass availability, as there is a significant disparity between the projected biomass usage and legally binding European Union (EU) targets for land use, land use change, and forestry (LULUCF) sector emissions in 2030 in these countries. [ABSTRACT FROM AUTHOR]

The paper departs from the observation that the role of migrant organisations (MOs) in Germany has changed significantly since the strong influx of refugees in 2015/16. As a result of this specific historical situation, it seems that MOs were able to strengthen their position as important civil society and integration policy actors and reduce reservations about them. While there has been growing attention on MOs' civic and social contributions, both in public and academic debates, this article also highlights the risks of failure and inflated expectations and the often rather fragile structures of MOs. Thus, the article aims to broaden the view on MOs by focusing on aspects which have been neglected in the course of recent public and academic interest and rather optimistic perceptions. The methodological approach is one of "embedded research": the author has been a senior executive of one of the largest German MOs for six years and, at the same time, a migration researcher for many years. From this special inside/outside view, an ambivalent picture emerges: despite a significantly greater appreciation of the achievements of MOs and much verbal recognition, there is a clear lack of the necessary material/structural support, jeopardising the sustainability and viability of many MOs. [ABSTRACT FROM AUTHOR]

Background: Germany's medical specialist shortage is an acute challenge, especially in the rehabilitation segment. One countermeasure is to recruit foreign trained physicians (FTP), but the high turnover of FTP is a burden on the departments that train them and integrate them professionally. Preliminary research showed that currently one in three physician positions in German Pension Insurance (DRV) contract facilities is filled by FTP.This paper examines factors related to turnover intention of FTP in German rehabilitative departments. Methodology: In spring 2022, we surveyed FTP across all inpatient and outpatient rehabilitation departments under the German Pension Insurance, using a two-stage cross-sectional approach. We conducted an online survey of FTP and developed a specialized questionnaire that captured sociodemographic, occupation related and professional biographical data, turnover intention, satisfaction, difficulties with professional integration and departmental structural characteristics. To analyze retention within the rehabilitation field, we used a measure of turnover intention, taking into account the direction of potential turnover, residency requirements and considerations of returning to the rehabilitation field. The data was evaluated in a subgroup analysis comparing FTP with and without turnover intention using Fisher's exact tests. Results: The sample includes n = 145 FTP, 119 stating no turnover intention and 27 with turnover intention. More than half of FTP with turnover intention wished to move to an acute care hospital. FTP with turnover intention are comparatively younger and came to Germany and were employed in the rehabilitation departments more recently, indicating an earlier career stage. Besides, career-related and regional factors show the strongest relation to turnover intention. Discussion and conclusion: The results reveal a group of "established FTP" whose professional integration has been successfully completed. FTP with turnover intention are comparatively younger, career-oriented physicians for whom work in a rehabilitative facility is a career springboard to gain a foothold in acute care clinics. A limitation is that FTP with turnover intention are difficult to reach and may be underrepresented in our sample. [ABSTRACT FROM AUTHOR]

Status or relative concerns (as in the idiom 'keeping up with the Joneses') can lead to negative feelings such as stress and anxiety. One key question is whether these concerns relate to daily smoking behaviour. The conjecture is that status concerns and the accompanying stress and anxiety might be associated with a higher likelihood of smoking and a higher number of cigarettes smoked, generating a higher instant physical reward and reducing the stress and anxiety. The literature aiming to identify this relationship focuses mostly on a single cross section of individuals, ignoring potential differences in unobserved characteristics of smokers and non-smokers (e.g., genetic factors, personality differences, parental smoking during childhood). This paper investigates the role of unobserved individual characteristics on this relationship, which has not been done in previous studies. Using a long panel data of smoking information in Germany and a variety of panel data model specifications, we show that there is no statistically significant association between relative income concerns and the likelihood of smoking or the number of cigarettes smoked among the overall population. We find a positive and significant relationship only among people who smoked at least one cigarette in the past. A 10% appreciation in the income of comparable other individuals relates to about 3.5 more cigarettes per month among these people. Importantly, failing to allow for the unobserved influences of smoking leads to three times larger estimates than when using models with unobserved factors correlating to the income and smoking behaviour. The results are robust with respect to alternative assumptions and specifications where we use different functional forms of unobserved heterogeneity, definitions of relative concerns, incomes, and reference groups. [ABSTRACT FROM AUTHOR]

Background: Germany has the highest per capita health care spending among EU member states, but its hospitals face pressure to generate profits independently due to the government's withdrawal of investment cost coverage. The diagnosis related groups (DRG) payment system was implemented to address the cost issue, challenging hospital physicians to provide services within predefined prices and an economic target corridor to reduce costs. This study examines the extent of cost awareness among medical personnel in German hospitals and its influencing factors. Methods: We developed an online survey in which participants across all specialties in hospitals estimated the prices in euros of four common interventions and answered questions about their human capital and perceived stress on the workplace. As a measure of cost awareness, we used the probability of estimating the prices correctly within a reasonable margin. We employed logit logistic regression estimators to identify influencing factors in a sample of 86 participants. Results: The results revealed that most of the respondents were unaware of the costs of common interventions. General human capital, acquired through prior education, and job-specific human capital had no influence on cost awareness, whereas domain-specific human capital, that is, gaining economic knowledge based on self-interest, had a positive nonlinear effect on cost awareness. Furthermore, an increased stress level negatively influenced cost awareness. Conclusions: This paper is the first of its kind for the German health care sector that contributes responses to the question whether health care professionals in German hospitals have cost awareness and if not, what reasons lie behind this lack of knowledge. Our findings show that the cost awareness desired by the introduction of the DRG system has yet to be achieved by medical personnel. [ABSTRACT FROM AUTHOR]

Background: Germany has the highest per capita health care spending among EU member states, but its hospitals face pressure to generate profits independently due to the government's withdrawal of investment cost coverage. The diagnosis related groups (DRG) payment system was implemented to address the cost issue, challenging hospital physicians to provide services within predefined prices and an economic target corridor to reduce costs. This study examines the extent of cost awareness among medical personnel in German hospitals and its influencing factors. Methods: We developed an online survey in which participants across all specialties in hospitals estimated the prices in euros of four common interventions and answered questions about their human capital and perceived stress on the workplace. As a measure of cost awareness, we used the probability of estimating the prices correctly within a reasonable margin. We employed logit logistic regression estimators to identify influencing factors in a sample of 86 participants. Results: The results revealed that most of the respondents were unaware of the costs of common interventions. General human capital, acquired through prior education, and job-specific human capital had no influence on cost awareness, whereas domain-specific human capital, that is, gaining economic knowledge based on self-interest, had a positive nonlinear effect on cost awareness. Furthermore, an increased stress level negatively influenced cost awareness. Conclusions: This paper is the first of its kind for the German health care sector that contributes responses to the question whether health care professionals in German hospitals have cost awareness and if not, what reasons lie behind this lack of knowledge. Our findings show that the cost awareness desired by the introduction of the DRG system has yet to be achieved by medical personnel. [ABSTRACT FROM AUTHOR]

The energy sector faces a pressing need for significant transformation to curb CO2 emissions. For instance, Czechia and Germany have taken steps to phase out fossil thermal power plants by 2038, opting instead for a greater reliance on variable renewable energy sources like wind and solar power. Nonetheless, thermal power plants will still have roles, too. While the conventional multistage axial turbine design has been predominant in large-scale power plants for the past century, it is unsuitable for small-scale decentralized projects due to complexity and cost. To address this, the study investigates less common turbine types, which were discarded as they demonstrated lower efficiency. One design is the Elektra turbine, characterized by its velocity compounded radial re-entry configuration. The Elektra turbine combines the advantages of volumetric expanders (the low rotational speed requirement) with the advantages of a turbine (no rubbing seals, no lubrication in the working fluid, wear is almost completely avoided). Thus, the research goal of the authors is the implementation of a 10 kW-class ORC turbine driving a cost-effective off-the-shelf 3000 rpm generator. The paper introduces the concept of the Elektra turbine in comparison to other turbines and proposes this approach for an ORC working fluid. In the second part, the 1D design and 3D–CFD optimization of the 7 kW Elektra turbine working with Hexamethyldisiloxane (MM) is performed. Finally, CFD efficiency characteristics of various versions of the Elektra are presented and critically discussed regarding the originally defined design approach. The unsteady CFD calculation of the final Elektra version showed 46% total-to-static isentropic efficiency. [ABSTRACT FROM AUTHOR]

This paper examines the current and prospective greenhouse gas (GHG) emissions of e-fuels produced via electrolysis and Fischer–Tropsch synthesis (FTS) for the years 2021, 2030, and 2050 for use in Germany. The GHG emissions are determined by a scenario approach as a combination of a literature-based top-down and bottom-up approach. Considered process steps are the provision of feedstocks, electrolysis (via solid oxide co-electrolysis; SOEC), synthesis (via Fischer–Tropsch synthesis; FTS), e-crude refining, eventual transport to, and use in Germany. The results indicate that the current GHG emissions for e-fuel production in the exemplary export countries Saudi Arabia and Chile are above those of conventional fuels. Scenarios for the production in Germany lead to current GHG emissions of 2.78–3.47 kgCO2-eq/L e-fuel in 2021 as the reference year and 0.064–0.082 kgCO2-eq/L e-fuel in 2050. With a share of 58–96%, according to the respective scenario, the electrolysis is the main determinant of the GHG emissions in the production process. The use of additional renewable energy during the production process in combination with direct air capture (DAC) are the main leverages to reduce GHG emissions. [ABSTRACT FROM AUTHOR]