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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]

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]

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]

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]

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]

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]

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]

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 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]

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]

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]

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]

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]

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]

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]

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]

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 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]

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]

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]

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]

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 quantification of emissions of greenhouse gases and air pollutants through the inversion of plumes in satellite images remains a complex problem that current methods can only assess with significant uncertainties. The anticipated launch of the CO2M (Copernicus Anthropogenic Carbon Dioxide Monitoring) satellite constellation in 2026 is expected to provide high-resolution images of CO2 (carbon dioxide) column-averaged mole fractions (XCO2), opening up new possibilities. However, the inversion of future CO2 plumes from CO2M will encounter various obstacles. A challenge is the low CO2 plume signal-to-noise ratio due to the variability in the background and instrumental errors in satellite measurements. Moreover, uncertainties in the transport and dispersion processes further complicate the inversion task. To address these challenges, deep learning techniques, such as neural networks, offer promising solutions for retrieving emissions from plumes in XCO2 images. Deep learning models can be trained to identify emissions from plume dynamics simulated using a transport model. It then becomes possible to extract relevant information from new plumes and predict their emissions. In this paper, we develop a strategy employing convolutional neural networks (CNNs) to estimate the emission fluxes from a plume in a pseudo- XCO2 image. Our dataset used to train and test such methods includes pseudo-images based on simulations of hourly XCO2 , NO2 (nitrogen dioxide), and wind fields near various power plants in eastern Germany, tracing plumes from anthropogenic and biogenic sources. CNN models are trained to predict emissions from three power plants that exhibit diverse characteristics. The power plants used to assess the deep learning model's performance are not used to train the model. We find that the CNN model outperforms state-of-the-art plume inversion approaches, achieving highly accurate results with an absolute error about half of that of the cross-sectional flux method and an absolute relative error of ∼ 20 % when only the XCO2 and wind fields are used as inputs. Furthermore, we show that our estimations are only slightly affected by the absence of NO2 fields or a detection mechanism as additional information. Finally, interpretability techniques applied to our models confirm that the CNN automatically learns to identify the XCO2 plume and to assess emissions from the plume concentrations. These promising results suggest a high potential of CNNs in estimating local CO2 emissions from satellite images. [ABSTRACT FROM AUTHOR]

During the COVID‐19 pandemic, national triage guidelines were developed to address the anticipated shortage of life‐saving resources, should ICU capacities be overloaded. Rationing and triage imply that in addition to individual patient interests, interests of population health have to be integrated. The transfer of theoretical and empirical knowledge into feasible and useful practice models and their implementation in clinical settings need to be improved. This paper analyzes how triage protocols could translate abstract theories of distributive justice into concrete material and procedural criteria for rationing intensive care resources during a pandemic. We reconstruct the development and implementation of a rationing protocol at a German university hospital: describing the ethical challenge of triage, clarifying the aspirational norms, and summarizing specific norms of fair triage and allocation for developing an institutional policy and practice model and implementing it. We reflect on how critical topics are seen by clinicians and what helped manage the perceived burdens of the triage dilemma. We analyze what can be learned from this debate regarding the difficult issues around triage protocols and their potential implementation into clinical settings. Analyzing the ought‐to‐is gap of triage, integrating abstract ethical principles into practical concepts, and evaluating those should clarify the benefits and risks of different allocation options. We seek to inform debates on triage concepts and policies to ensure the best possible treatment and fair allocation of resources as well as to help protect patients and professionals in worst‐case scenarios. [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]

This paper presents the preliminary results of an investigation on the unexplored topic of polychromy on provincial stone sculptures from the Roman provinces in Germania through the innovative application of heritage materials science techniques. A group of three life-sized statues dating to the 1st Century CE recovered from Ingelheim, near Mainz, retains remarkably well-preserved traces of pigments. These are ripe for emerging non-invasive technologies supplemented by micro-sampling to validate results and provide information relating to mixing and layering not available to the naked eye. The most strikingly visible areas of extant polychromy were retained on the sculpture of a young woman, reported on here as the first phase of this programme of research. The results suggest that the statue was originally covered in a gypsum layer before the application of complex and diverse recipes of pigment applied as mixtures and in layers to create required hues and shadowing on sculpted features. The palette includes ochres and green earth mixed with small amounts of minium (red lead), realgar and lapis lazuli (ultramarine blue) added to create skin tones, and a vibrant blue-green tunic created from Egyptian blue, bone black, ochres, cinnabar and green earth; the palla and peplos contained ochres, bone black, and orpiment, and mixes of these created the detail of coloured jewellery. Of great interest was the detection of bone black on many features, particularly as a shading agent to enhance sculpted features, such as folds in cloth, providing a more realistic and flowing articulation. This is a revolutionary observation that provides previously unexplored insights into artistic polychromic practice in Antiquity. [ABSTRACT FROM AUTHOR]

Our paper analyzes the role of public employment agencies in job matching, in particular the effects of the restructuring of the Federal Employment Agency in Germany (Hartz III labor market reform) for aggregate matching and unemployment. Based on two microeconomic datasets, we show that the market share of the Federal Employment Agency as job intermediary declined after the Hartz reforms. We propose a macroeconomic model of the labor market with a private and a public search channel and fit the model to various dimensions of the data. We show that direct intermediation activities of the Federal Employment Agency did not contribute to the decline in unemployment in Germany. By contrast, improved activation of unemployed workers reduced unemployed by 0.8 percentage points. Through the lens of an aggregate matching function, more activation is associated with a larger matching efficiency. [ABSTRACT FROM AUTHOR]

Reducing the heat demand of existing buildings is an essential prerequisite for achieving a greenhouse gas-neutral energy supply. Numerous studies and open-source tools deal with heat demand mapping. It is not uncommon that estimated heat demands deviate from real heat consumption, so existing approaches should be improved by including in-depth building information. Some tools have recognised this problem and offer built-in functions for factoring various parameters into their assessments. Nevertheless, the necessary information is usually missing and should be obtained first. In this paper, we analyse the impact of thermal refurbishment and climate on building heat demand; hence, generate public datasets with corresponding key figures for each building type in different efficiency states and years. Accounting for already performed refurbishments in methodologies for assessing the actual state heat demand for cities will result in a reduction of at least 8% up to more than 21%, depending on whether conventional or passive house components were installed. As a result of climatic differences within Germany, a building's heat demand can be up to 39% higher or up to 21% lower than the heat demand of an identical building in the reference climate of Germany. By further developing the approaches of the tools Hotmaps and Heat Cadastre Hamburg, we could improve the estimated heat demand of Hamburg to a value approximating the real consumption. [ABSTRACT FROM AUTHOR]

Purpose: Patients' adherence to the prescribed therapy is influenced by several personal and social factors. However, existing studies have mostly focused on individual aspects. We took a holistic approach to develop a higher-level impact factor model. Patients and Methods: In this independent, non-interventional, cross-sectional and anonymous study design the pharmacist recruited patients who entered the pharmacy and handed in a prescription for a blood pressure medication. The patients received a paper questionnaire with a stamped return envelope to volunteer participation. A total of 476 patients in Germany who reported having at least high normal blood pressure according to the Global Hypertension Practice Guidelines were surveyed. In this study, each patient received an average of 2.49 antihypertensive prescriptions and 7.9% of all patients received a fixed-dose combination. Partial least squares structural equation modeling was performed for model analytics since it enables robust analysis of complex relationships. Results: Emotional attitude, behavioral control, and therapy satisfaction directly explained 65% of therapy adherence. The predictive power of the out-of-sample model for the Q2-statistic was significant. The patient's overall therapy satisfaction determined medication adherence. The medication scheme's complexity also influenced the adherence levels. Therapy satisfaction was significantly shaped by the complexity of the medication scheme, behavioral control, and emotional attitude. The results demonstrated the superior performance of fixed-dose combinations against combinations of mono-agents according to the adherence level. Additionally, patient-physician and patient-pharmacist relationships influenced behavioral control of medication therapy execution. According to the A14-scale to measure the level of adherence, 49.6% of patients were classified as adherent and the remainder as non-adherent. Conclusion: The results enable healthcare stakeholders to target attractive variables for intervention to achieve maximum effectiveness. Moreover, the proven predictive power of the model framework enables clinicians to make predictions about the adherence levels of their hypertensive patients. [ABSTRACT FROM AUTHOR]

Background: The incidence of inflammatory bowel disease (IBD) in children is on the increase worldwide. Growth disorders are common in pediatric patients with inflammatory bowel disease. The aim of this paper is to investigate anthropometric indicators, including height and weight in children with inflammatory bowel disease in Saxony, one of the German federal states, and to evaluate growth trends in patients by comparing their height and weight with that of healthy children in Germany. Methods: In Saxony, all children and adolescents with IBD were registered in the Saxon Pediatric IBD Registry from 2000 to 2014. The data used are therefore based on a total area-wide survey over 15 years. For this study, 421 datasets of children and adolescents aged 0–14 years with Crohn's disease (CD) (n = 291) or ulcerative colitis (UC) (n = 130) were analyzed. Z-score and percentile calculations were used to compare differences between IBD patients and the general population. Results: The children with CD or UC (both sexes) had a significant lower weight at diagnosis (the mean weight z-score had negative values) versus the general population. The weight values lay mostly below P50 (the 50th percentile, median), more precisely, mostly between P10 and P50 of the body weight child growth curve for corresponding sexes (KiGGS 2003–2006). The height values of both sexes at diagnosis lay also mostly below P50 (the 50th percentile, median) of the child body growth curve for corresponding sexes (KiGGS 2003–2006), i.e. the mean height z-score was negative. But only the children with CD had a significant lower height, more precisely, mostly between P25 and P50 versus the general population (KIGGS). For children with UC the difference was not significant. Conclusion: In pediatric patients with IBD the possibility of growth disturbance, mainly in the form of weight retardation, is very probable. [ABSTRACT FROM AUTHOR]

Based on a review of existing research on adaptive capacity, we identify a research gap in theorizing institutions, power structures, and agency in municipal climate change adaptation processes. Drawing on sociological institutionalism, governmentality, and communicative planning theory, we use post-structuralist concepts of power to to elucidate the collective (de-)mobilization of existing stocks of capacities within municipal institutions of adaptation with a focus on structural power and agency in participation processes. The concept of reflexive capacity is introduced as the ability of organizations such as municipal administrations to incorporate diverse stakeholders and knowledge into decision-making processes in a local context, which is derived from the relationship of power with with power over. The emergence and transformation of reflexive capacity are illustrated and discussed with one case study municipality in Germany, revealing the potential of this concept for the analysis of participation in adaptation processes and the power structures that are inherent to them. In the paper, we incorporate the concept of reflexive capacity with established concepts of adaptive capacity, creating an integrated framework termed institutional adaptive capacity. The analysis concludes that examining power structures and agency in the context of climate change adaptation explains how capacity stocks and individual psychosocial capacity mobilization are institutionally embedded and influenced by reflexive capacity. We argue that the consideration of power structures and agency can provide a complementary approach to explaining adaptive capacity and call for further transdisciplinary empirical research on this topic in different settings of state-initiated adaptation processes. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to analyze the differences related to work values and attitudes toward the technology of Generation Z in Brazil and Germany. Method: The proposed hypotheses were tested in a survey of 122 Brazilian and German participants. The data were analyzed using t-test and logistic regression models. Main Results: The results present differences between Brazilian and German Generation Z, challenging the literature that analyzes Generation Z as a global generation and reinforcing cultural differences between nationalities. The Brazilian sample presents more instrumental and prestige work values and is more positive and less negative regarding technology than the German sample. Relevance/Originality: The paper’s contribution provides evidence of Generation Z’s differences according to nationalities relevant to shaping their relationship with work and technology. The analysis of both constructs is interesting nowadays because of their interrelationship and the current changes in global work boundaries. Theoretical/Methodological Contributions: The literature predominantly presents that Generation Z is a global generation. Comparing participants from two countries with different levels of development provides an insight into their differences regarding work values and attitudes, which can be valuable for business management literature. Practical/Social Contributions: Recommendations for businesses are provided to improve attraction and retention strategies to tackle the shortage of skilled workers. This implies management strategies for firms with multicultural teams. [ABSTRACT FROM AUTHOR]

This paper reports the motivations of middle-class Asian students who choose German universities of applied sciences under the third wave of international student mobility. It aims to provide a comprehensive understanding of the students' qualitative experiences in Asian countries that influenced their preference for German universities of applied sciences and their expectations of their German degree as cultural capital. The research analyzes the family, school, peer experiences of 23 Asian students currently enrolled in a German university of applied sciences to understand their motivations for choosing this type of institution and Germany. The findings reveal that the cultural capital that influenced their choice includes differentiation strategies of middle-class students, reasonable education investment choices of Asian students, and the use of a German degree as a trump card in the labor market. The study provides implications for the development of international higher education by connecting Asian students' aspirations for global cultural capital to a complex and atypical structure that encompasses global, national, and individual dimensions simultaneously. [ABSTRACT FROM AUTHOR]

In line with the European Commission's target, land take in Germany has to be reduced to net zero by 2050. This not only presupposes greater inner urban development and more efficient development outside existing settlements, but also puts a greater planning and political focus on renaturation. The aim of this paper is to investigate the implementation of no net land take policy using the example of the highly dense and urbanised federal state of North Rhine-Westphalia in Germany. Based on an online survey, the current and potential use of (planning) instruments to implement this policy in all 396 municipalities in North Rhine-Westphalia was investigated. The findings suggest that the municipalities are not yet in a position to consistently implement no net land take. Particularly in the field of renaturation, this is often due to a lack of experience and uncertainties in the use of the existing (planning) instruments, but also to lacking awareness of the problem and a lack of political and social acceptance for higher housing densities. Since the necessary instruments are defined in current legislation and the concepts for implementation are generally known, it is important to support municipalities in using the available instruments and concepts even without direct pressure to act. [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]

Visibility observations and accurate forecasts are essential in meteorology, requiring a dense network of observation stations. This paper investigates image processing techniques for object detection and visibility determination using static cameras. It proposes a comprehensive method that includes image preprocessing, landmark identification, and visibility estimation, mirroring the observation process of professional meteorological observers. This study validates the visibility observation procedure using the k-nearest neighbors machine learning method across six locations, including four in the Czech Republic, one in the USA, and one in Germany. By comparing our results with professional observations, the paper demonstrates the suitability of the proposed method for operational application, particularly in foggy and low visibility conditions. This versatile method holds potential for adoption by meteorological services worldwide. [ABSTRACT FROM AUTHOR]

Real-time surveillance is a crucial element in the response to infectious disease outbreaks. However, the interpretation of incidence data is often hampered by delays occurring at various stages of data gathering and reporting. As a result, recent values are biased downward, which obscures current trends. Statistical nowcasting techniques can be employed to correct these biases, allowing for accurate characterization of recent developments and thus enhancing situational awareness. In this paper, we present a preregistered real-time assessment of eight nowcasting approaches, applied by independent research teams to German 7-day hospitalization incidences during the COVID-19 pandemic. This indicator played an important role in the management of the outbreak in Germany and was linked to levels of non-pharmaceutical interventions via certain thresholds. Due to its definition, in which hospitalization counts are aggregated by the date of case report rather than admission, German hospitalization incidences are particularly affected by delays and can take several weeks or months to fully stabilize. For this study, all methods were applied from 22 November 2021 to 29 April 2022, with probabilistic nowcasts produced each day for the current and 28 preceding days. Nowcasts at the national, state, and age-group levels were collected in the form of quantiles in a public repository and displayed in a dashboard. Moreover, a mean and a median ensemble nowcast were generated. We find that overall, the compared methods were able to remove a large part of the biases introduced by delays. Most participating teams underestimated the importance of very long delays, though, resulting in nowcasts with a slight downward bias. The accompanying prediction intervals were also too narrow for almost all methods. Averaged over all nowcast horizons, the best performance was achieved by a model using case incidences as a covariate and taking into account longer delays than the other approaches. For the most recent days, which are often considered the most relevant in practice, a mean ensemble of the submitted nowcasts performed best. We conclude by providing some lessons learned on the definition of nowcasting targets and practical challenges. Author summary: Current trends in epidemiological indicators are often obscured by the fact that recent values are still incomplete. This is due to reporting delays and other types of delays. Statistical nowcasting methods can be used to account for these biases and reveal yet unobserved trends, thereby improving situational awareness and supporting public health decision-making. While numerous methods exist for this purpose, little is known about their behavior in real-time settings and their relative performance. In this paper, we compared eight different nowcasting methods in an application to COVID-19 hospitalization incidences in Germany from November 2021 to April 2022. Additionally, we combined the predictions of these methods to create so-called ensemble nowcasts. Our findings indicate that while all methods yielded practically useful results, some systematic biases in nowcasts occurred and the remaining uncertainty was generally underestimated. Combined ensemble nowcasts showed promising performance relative to individual models and thus represent a promising avenue for future research. [ABSTRACT FROM AUTHOR]

The widely recognised Energiewende, ("energy transition") in Germany has lost its original momentum. We therefore address the question of how the transition process to a new energy system can be reignited. To do so, we developed the "5Ds approach", which lays the groundwork for a process analysis and the identification of important catalysts and barriers. Focusing on the five major fields required for the energy transition, we analyse the effects of: (1) Decarbonisation: How can efficiency and renewable energies be expanded successfully? (2) Digitalisation: Which digital solutions facilitate this conversion and would be suitable as sustainable business models? (3) Decentralisation: How can potential decentralised energy and efficiency opportunities be developed? (4) Democratisation: How can participation be strengthened in order to foster acceptance (and prevent "yellow vest" protests, etc.)? (5) Diversification of service: Which services can make significant contributions in the context of flexible power generation, demand-side management, storage and grids? Our paper comes to the conclusion that German policy efforts in the "5D" fields have been implemented very differently. Particularly with regard to democratisation, the opportunities for genuine participation among the different social actors must be further strengthened to get the Energiewende back on track. New market models are needed to meet the challenges of the energy transition and to increase the performance of "5D" through economic incentives. [ABSTRACT FROM AUTHOR]

Background: Some of the advantages of implementing electronic emergency department information systems (EDIS) are improvements in data availability and simplification of statistical evaluations of emergency department (ED) treatments. However, for multi-center evaluations, standardized documentation is necessary. The AKTIN project ("National Emergency Department Register: Improvement of Health Services Research in Acute Medicine in Germany") has used the "German Emergency Department Medical Record" (GEDMR) published by the German Interdisciplinary Association of Intensive and Emergency Care as the documentation standard for its national data registry.Methods: Until March 2016 the documentation standard in ED was the pen-and-paper version of the GEDMR. In April 2016 we implemented the GEDMR in a timeline-based EDIS. Related to this, we compared the availability of structured treatment information of traumatological patients between pen-and-paper-based and electronic documentation, with special focus on the treatment time.Results: All 796 data fields of the 6 modules (basic data, severe trauma, patient surveillance, anesthesia, council, neurology) were adapted for use with the existing EDIS configuration by a physician working regularly in the ED. Electronic implementation increased availability of structured anamnesis and treatment information. However, treatment time was increased in electronic documentation both immediately (2:12 ± 0:04 h; n = 2907) and 6 months after implementation (2:18 ± 0:03 h; n = 4778) compared to the pen-and-paper group (1:43 ± 0:02 h; n = 2523; p < 0.001).Conclusions: We successfully implemented standardized documentation in an EDIS. The availability of structured treatment information was improved, but treatment time was also increased. Thus, further work is necessary to improve input time. [ABSTRACT FROM AUTHOR]

Formulating energy policies at national, European, and global levels is extremely challenging. The move away from fossil fuels is associated with a variety of technological, economic, and social implications, each of which is subject to dynamic changes and societal scrutiny and can hardly be predicted with certainty. Therefore, a fact-based assessment for the path to a sustainable green energy future is sought out in this paper, using the road-based mobility sector of the Federal Republic of Germany as an example. The analysis performed in this paper is built on publicly accessible, reputable sources like DESTATIS and EUROSTAT. In addition, some very simple calculations were made, e.g., on the potential for wind and photovoltaic energy within Germany. Such an analysis needs to start with the overall energy consumption of any one country. A basic assumption of the paper is that the energy system of the future will be based to a large extent on electricity and its storage in chemical energy. It is assumed that, in addition to hydrogen, liquid energy sources will play a significant role due to the simplicity of their logistics and the subsequent implications on cost. Examples of green, electricity-based fuels with great potential are methanol, methane, and ammonia. Additionally, biomass plays an important role, either for direct use as a fuel or as a source of non-fossil carbon. Today, biofuels, i.e., biodiesel and bioethanol, deliver the largest contribution to climate protection in the EU transport sector. The main goal—the reduction of greenhouse gas emissions—often collides with geopolitical circumstances or national political necessities. This includes, for example, the current world market situation and its national impacts caused by the Russian attack on Ukraine. The prospect for a green, sustainable, and defossilized energy supply are discussed in this context. The paper concludes that a defossilized world energy supply and trade based on renewable electricity and its derivatives, eHydrogen and refuels, and on biomass, is feasible. [ABSTRACT FROM AUTHOR]