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The 2023 edition of the International Chemistry Olympiad, a world-wide chemistry competition for high-school students, was held in Zürich, Switzerland. The Swiss delegation earned an honourable mention.

The reading of Arnold Hauser´s work, in particular his book Der Manierismus, written in 1964, that deals with Spanish literature, allows us to overcome the usual classifications found in manuals of this area based only on chronological data. Hauser calls "Mannerism" the crisis of the Renaissance, distinguishing it from European Baroque movements. Some of the Spanish authors and their works from the sixteenth and seventeenth centuries respond to the characteristics of Mannerism, if one takes into account their perspectivism, the presence of paradox, their cerebral construction, the discovery of the modern reader, their autonomy as literary works, the overcoming of the classical genders, the use of dialog, etc, and can, therefore, be seen as the basis of the literary Modernity.

El presente artículo es una breve aproximación al contexto legal y político de las comunidades judías catalanas entre 1240 y 1391. A través del uso combinado de fuentes hebreas y cristianas, se ofrecerá una síntesis de la compleja red de factores, reglas y teorías que moldearon el ecosistema social de las comunidades hebreas en Cataluña. En este sentido, el autogobierno comunal era el resultado de la convergencia entre la legislación real y la producción normativa y teórica de las comunidades. Nuestro objetivo es presentar el carácter poliédrico de esta realidad a través de los privilegios concedidos por los monarcas aragoneses a sus súbditos judíos, los modelos políticos desarrollados por los intelectuales hebreos, la legislación interna de las comunidades y el conjunto de factores sociales e históricos que impulsaron la evolución del sistema comunal.

Time-Of-Flight (TOF) computations are needed in all ultrasound imaging methods. In Non Destructive Testing (NDT), where ultrasound inspections are frequently done using a coupling medium between the transducer and the test piece, wave refraction complicates TOF computations and iterative methods are needed, which hinders frame rate. For fast imaging simple approximation methods are needed. In this work we propose a TOF fast approximation method for the particular case of sub-surface imaging.

Estimating integrated variance, using high frequency data, requires modelling experience and data crunching skills. Although intraday returns have attracted much attention in recent years, handling these data is challenging because of their unique characteristics. When dealing with ultra-high frequency or tick-by-tick observations the enormous amount of data needs to be processed prior to estimation of integrated variance for two reasons: eliminating microstructure noise and finding appropriate unbiased estimator. This paper contributes to the existing literature in a two ways. First, we propose how to handle quality issues of the high frequency data due to non-frequent trading and lower liquidity of emerging markets. Second, we find the optimal sampling frequency at slow time scale that should be used to obtain two-time scale estimator of integrated variance for each emerging market under consideration: Romania, Hungary, Bulgaria and Croatia. Empirical results indicate that intraday returns should be sampled every 7 to 10 minutes at slow time scale while the fast time scale should be fixed at the highest possible frequency. Realized variance estimator at the fast time scale mostly overestimates the integrated variance on all stock markets except Bulgaria; on average between 70% and 90% of the time. Moreover, the robustness of the results with respect to the price jumps has been verified for Romania and Hungary, unlike Croatia and Bulgaria, for which we recommend a robust version of two-time scale estimator of integrated variance within truncation technique. It is additionally found that intraday returns should be sampled more frequently in a highly volatile periods. These findings offer valuable information to market participants, as they are able to apply the most accurate ex-post volatility measure, as unbiased and consistent estimate of integrated variance.

In February 2016 seven German judges and public prosecutors of the judiciary of Baden- Württemberg and Rheinland-Pfalz had the great opportunity of a ten-day-visit to either Rwanda or the Democratic Republic of Congo (DRC) and a joint conference on “Require- ments for an Independent and Effective Judiciary” in Nairobi, Kenya. The whole visit was part of an exchange programme between young lawyers from Central and East Africa and the judiciary of Baden-Württemberg and Rheinland-Pfalz. From 5 to 18 October 2014 sev- en African lawyers (prosecutors, advocates and a judge) from Burundi, Rwanda and the DRC had already come to Stuttgart, Germany.1 The exchange programme was organized and coordinated by Professor Hartmut Hamann of the African Law Association and the Robert Bosch Foundation in cooperation with the competent Ministries of State and Justice of Baden-Württemberg and Rheinland-Pfalz.2 During the first part of the visit, four mem- bers of the German delegation went to Lubumbashi, DRC, while the other three members travelled to Kigali, Rwanda. The second part of the visit brought the German participants, their African exchange partners and other young lawyers from Central and East Africa to- gether in a conference in Nairobi, Kenya.

L’apprentissage des discours de spécialité demande la maîtrise de lexiques, mais aussi la reconnaissance d’une situation de communication, à savoir les conventions textuelles d’une communauté de discours. La linguistique de corpus appliquée à l’étude des genres, a montré sa validité et sa pertinence pour l’étude du lexique et d’autres caractéristiques linguistiques et textuelles de genres différents. Cet article présente la construction du corpus spécialisé ENERWAL, consacré au secteur de l’énergie en Région wallonne et visant deux publics (professionnels vs. grand public). Nous illustrons quelques exemples concernant des caractéristiques morphologiques, syntaxiques, phraséologiques et discursives des genres d’ENERWAL. Chaque exemple présente des suggestions pratiques et des aspects critiques qui concernant ces caractéristiques ainsi que l’emploi d’un corpus spécialisé en vue d’une prise de conscience de la part des apprenants en salle de cours.

A specter is haunting Europe – the specter of separatism. Scotland, Catalonia, Flanders, South Tyrol – all these regions have separatist movements pursuing independence from their current National State. The breakup of an EU Member State no longer seems impossible. To date, it is unclear what impact this would have on the EU membership of the new entities (with consequences for the character of citizenship, voting rights in the council, number of MEPs etc.) that emerge from the old States. The common rules of Public International Law governing the succession of States are insufficient in the case of a succession of States in the EU. Although the Treaties do not provide for such a situation and the past 60 years of European history offer only a few and not really persuasive precedents, the nature of the EU as a joint association of sovereign States (“Staatenverbund”) demands a special approach: A separated State will neither be automatically excluded from the EU nor will it automatically become a new Member State.

Presentazione del volume "L’Africa Romana 20", Atti del XX Convegno Internazionale di studi “L’Africa romana. Momenti di continuità e rottura: bilancio di trent’anni di convegni” (Alghero - Porto Conte Ricerche, 26-29 settembre 2013). A cura di Paola Ruggeri (con la collaborazione di Maria Bastiana Cocco, Alberto Gavini, Edgardo Badaracco, Pierpaolo Longu). I-III, Carocci Editore, Roma 2015. Roma, 12 maggio 2016 – Istituto Nazionale di Studi Romani, Piazza Cavalieri di Malta, 2 per iniziativa di: Centro di Studi Interdisciplinari sulle province romane dell’Università di Sassari Istituto Nazionale di Studi Romani Programma * Saluto di Paolo Sommella, Presidente dell’Istituto Nazionale di Studi Romani * Saluto di Marco Milanese, Direttore del Dipartimento di Storia, Scienze dell’Uomo e della Formazione dell’Università di Sassari * Introduzione di Attilio Mastino, coordinatore del Dottorato di ricerca in Archeologia, Dipartimento di Storia, Scienze dell’Uomo e della Formazione dell’Università di Sassari * Presentazione di Sergio Ribichini, Istituto per la Conservazione e Valorizzazione dei Beni Culturali, CNR - Roma * Presentazione di Isabel Rodà de Llanza, Universitat Autònoma de Barcelona, Departement de Ciències de l’Antiguitat i de l’Edat Mitjana ° Conclusioni di Mario Mazza, Accademia Nazionale dei Lincei

El art culo cuestiona la tesis hist rica de la construcci n de sujeto moderno en Am rica Latina en los marcos de la democracia liberal, dado que los procesos de incorporaci n del hombre americano al mundo occidental se han presentado de forma contradictoria y ambigua en medio de los debates sobre la formaci n de las categor as de ciudadan a , de democracia y de sociedad civil , lo que lleva a pensar en la naturaleza de los movimientos y representaciones sociales actuales en Am rica Latina, pero tambi n en las pr cticas sociales cotidianas que incluyen lo ideol gico y lo pol tico institucional.

The Middle East and North Africa (MENA) can be considered as the most water-scarce regions of the world and thus affecting the status of vegetation in this zone. Normalized Difference Vegetation Index (NDVI) datasets are used worldwide for large-area mapping and monitoring. Time series analysis techniques are used to define, evaluate, and monitor vegetation dynamics and variability using up-to-date remote sensing datasets. This study assesses vegetation degradation in the Arab countries using the SPOT Vegetation derived NDVI time series data of remotely sensed imageries for the time period between 1999 and 2012. Five classes were identified: Hot spot, negative change, no change, positive change and bright spot areas. Results indicate a severe decrease in the vegetation cover in almost 553 000 km2 of the total Arab region surface. On the other hand, only less than 1% of the region witnessed positive ‎changes in the vegetation cover. The positive and bright spot areas are mainly located in Algeria and Egypt, as well as in the southern part of Somalia and Iraq. Negative change and hot spot areas were found to be wide spreading all over the Arab countries, irrespective of the location, climate and topography. In addition, it is found that the vegetation changes in these regions are mainly related to human activities and decisions; climate change plays only a secondary role in the MENA region.

The present paper stresses from a philological and anthropological point of view Machiavelli’s potential for thinking and practicing democracy in modern times. The first part disputes some Machiavellian myths, philologically demonstrating for example that Machiavelli never thought that ‘end justifies the means’. The second part brings to light the anthropological fundamentals of Machiavelli’s theory of political conflicts: special attention is paid to the doctrine of the opposite tendencies within the political bodies (the wish to command and the wish not to obey, the desire of oppressing and that of not to be oppressed) as well as to the theory of anthropological roots of ambition. The third and final part compares Machiavelli’s anthropological theory of political conflicts with both Marx’s economic interpretation of political conflicts and German philosophical anthropological explanation of human nature (Gehlen, Scheler, Plessner).

The juridical reflection on origins clearly took place in a context dominated by a culture that was both of theological extraction and rhetorical formation. The »textual« culture of the theologians soon became the practice of interpretation of the jurists, who substituted the Justinian text for the Biblical one in their exegetic attitudes, but who nevertheless – at least initially– maintained intact the essentially rhetorical nature of their interpretative accessus to the textus of the Justinian corpus. It was with that interpretative tendency that the central role reserved for the maxim »nomina sunt consequentia rerum« emerged, which postulated the existence of a system of necessary correspondences between the nomina iuris and empirical reality which the jurist strove to fit into the interpretative structure of his own analytic discourse. Originally, mediaeval man considered the nomina iuris as the immediate and direct consequence of their ontological basis. To his eyes, the names of things were precisely the key to the privileged awareness of reality; knowing single physical entities meant first discovering their names. This also held true for the activity of the jurist, who essentially depended precisely on the nomina iuris of his work of constructing a normative system.Besides, the etymological logic of the mediaeval derivatores, from the Pisan Uggucione to the Genoese Balbi, to Papias vocabulista, had as its characteristic note precisely this essential basis in the field of sensory perception: the process of making names was not simply a formal, linguistic matter but was above all material and concrete. As in the hierarchy of being one thing derived from another, and similarly, consequently – and almost as a mirror image – in the structure of the language one name derived from another.The derivatio was the final fruit of the specific mutation of practical reality, the organisation of which was expressed in each single nomen. And the names were considered real and proper »normative objects«, as they might be called, which functioned as in the world of things and everyday experience.And the premise of that embryo of ideology lay precisely in this: that the jurist and the rhetorician, while »etymologising« and discussing the nomina iuris, seemed rather to be describing the autonomous semantic content of the nomina themselves, while in reality they were manipulating them – and without excessive scruples – and so were passing off as objective and incontrovertible normative prescription what was, in truth, the pure fruit of their conceptual elaborations.

Rezensiertes Werk:Petra Schulte, »Scripturae publicae creditur«. Das Vertrauen in Notariatsurkunden im kommunalen Italien des 12. und 13. Jahrhunderts (Bibliothek des Deutschen Historischen Instituts in Rom, Bd. 101), Tübingen: Niemeyer 2003, XII, 362 S., ISBN 3-484-82101-9

In"Lingua nostra" (XLII, 1981, pp. 43-44) mi sono occupato degli aspetti linguistici ed espressivi dei casi di coordinazio­ ne di indicativa e congiuntivo in proposizioni dipendenti, ri­ scontrati nelle satire di Ludovico Ariosto: essi, tutti, trova­ no conferma testuale nella recente edizione critica, a cura di Cesare Segre, pubblicata nella collana mondadoriana di tutte le opere ariostesche (vol. III, Hilano 1984). Qualcosa tuttavia si può ora aggiungere e osservare più largamente, tenendo canto dell' apparato posto a piè di pagina, che viene a dimostrare ancora una volta la possibilita (che qui si presenta anche come "variantistica") di usi alternativi di indicativa e congiun­tivo in determinati sintagmi, tendendosi nel nostro caso speci­ fico in genere, con la diversa o mutata lezione, a un pareggia­ mento modale con conseguente livellamento a scapito di funzioni o valori espressivi. Alla compresenza articolat.i dei modi diver­si, alla più generale tendenza al congiuntivo, ben è affidata la "sottigliezza" formale, stilistica ed espressiva della poesia ariostesca.

Fuchs endothelial corneal dystrophy (FECD) is a genetic and age-associated corneal disease characterized by an accelerated loss of corneal endothelial cells and an increased subendothelial deposition of extracellular matrix (ECM). Clinically, advanced disease leads to corneal edema with subsequent reduction in visual acuity. In the majority of patients with advanced FECD, a fibrillar layer (FL) appears on the posterior corneal surface. This FL is mostly localized in the inferotemporal corneal quadrant, marks areas with significantly reduced endothelial cell density and increased corneal thickness in the sense of edema and can be visualized and measured using Scheimpflug backscatter analysis due to increased backscatter. FECD is currently the most common indication for corneal transplantation worldwide, usually in the form of Descemet membrane endothelial keratoplasty (DMEK). New treatment approaches include variations of DMEK surgery such as hemi- or quarter DMEK with individualized and smaller grafts or Descemet membrane stripping only (DSO). In the future, clinical imaging of the FL as a particularly affected endothelial area could be important for FECD progression assessment and planning of surgical interventions. This article provides an overview of the current state of research on the clinical aspects, pathogenesis, fibrillar layer and individualized treatment of FECD., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Derotational osteotomies of the proximal tibia and distal femur are a common surgical treatment option in patients with a congenital or posttraumatic torsional deformity. Clinically, these patients present with isolated anterior knee pain alone or in in combination with patellofemoral instability. Since the combination of femoral and tibial deformity is common (quotation Cooke), a combined surgical treatment is needed for these cases. This includes high tibial derotational and a distal femoral osteotomy, stabilised by a plate respectively. The current video shows the technique of this combined osteotomy assisted by external fixateur and the tibial approach with tibialis anterior fasciectomy and neurolysis of the peroneal nerve., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: The primary therapeutic approach for severe secondary mitral regurgitation (MR) in combination with atrial fibrillation is often not clear., Objectives/methods: To create a therapeutic guideline for daily clinical practice based on a case report as well as basic literature., Results: If a functional component is suspected, restoration of sinus rhythm may lead to a significant improvement in MR. The extent of the improvement and the time required to achieve this improvement are often difficult to predict., Conclusions: The involvement of an electrophysiologist is recommended in order to assess the likelihood of successful long-term rhythm control aimed at improving MR. In unclear cases, cardioversion combined with short-term administration of antiarrhythmic medication may be useful to demonstrate potential improvement of MR in sinus rhythm., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background: Globally, stroke is considered the second most common cause of death. According to the German Federal Statistical Office, 33.6% of mortality was due to cardiovascular diseases, making them the most prevalent cause of death., Problem: Specifically, cerebral infarctions were recorded as the cause in over 16,000 cases. These figures underscore the significant role that cerebrovascular diseases play in Germany's mortality statistics. Notably, about 80% of strokes are ischemic. Moreover, one-fifth of all strokes result from extracranial carotid stenosis. The increase in stroke risk with advancing age, especially among men, is particularly striking. This trend highlights the growing importance of efficient stroke prevention and treatment in an aging society., Conclusion: Open surgical therapy, as a crucial treatment method, is increasingly important, especially as an emergency intervention. Its role in modern medicine emphasizes the urgency of prioritizing this life-saving procedure in healthcare and making it widely available., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Patellar dislocations in flexion, which occurs permanently with every movement, is the most serious manifestation of patellofemoral malalignment. Surgical approaches to correct this problem have been mostly unsuccessful. In a new therapeutic approach, the concave posterior surface of the patella, which slides on the hypoplastic lateral condyle as if guided by splints, is seen as the main pathology. The appropriate surgical strategy is trochleoplasty, combined with closed wedge patellar osteotomy, tuberosity medialisation, procedure for lengthening lateral retinaculum and MPFL plasty with the quadriceps tendon. In the case of a 13-year-old female patient presented here, this procedure leads to permanent stability in a symptom-free knee joint on both sides., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Objective: Reinforcement and sustainability of sports and exercise therapy in inpatient depression treatment., Methods: Randomized controlled study with 3 measurement times: t 0 admission to the study, t 1 after four weeks, t 2 two months after discharge. 96 inpatients with depressive disorders (ICD-10 F32, F33) were randomly assigned to an intervention group (IG) or a control group (KG). In addition to sports and exercise therapy (KG), the IG received an educational and motivational session on the importance of sports and exercise, as well as a motivational final discussion., Results: Endurance performance and physical fitness improved more significantly in the IG than in the CG over the 3 measurement times. The motivational final discussion was rated as more helpful., Discussion: The intervention was well accepted by the patients and partially increased the effects of sports and exercise therapy. Not only psychological aspects of depression treatment were influenced, but also measurable physical effects., Conclusion: The practical and time-efficient motivational intervention in inpatient psychiatric care can complement sports and exercise therapy for depressive patients., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

We present the case of a preventive tibial plateau flexion osteotomy in an adolescent patient who had a reduced posterior slope of the tibial plateau. The patient was asymptomatic and without instability at the time. However, magnetic resonance imaging (MRI) showed a dysmorphic posterior cruciate ligament, which was interpreted as an indication for osteotomy. This article demonstrates the surgical technique and postoperative outcome. The postoperative MRI shows a reorganization of the posterior cruciate ligament into a physiological ligament appearance., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Thieme. All rights reserved.)

Background: Prostate cancer is one of the most common cancers in men in Europe. Several classes of agents can be considered for the treatment of metastatic prostate carcinoma, and their use is supported by extensive guidelines. In the treatment of metastatic castration-resistant prostate cancer (mCRPC), it is currently unclear which sequence of systemic therapies is most effective. Currently approved system therapies in the castration-resistant setting generally include hormone-manipulating agents, taxane-based chemotherapies, radioactive agents, or inhibitiors of DNA repair mechanisms. This study aims to summarize real world data of mCRPC therapy., Methods: Retrospectively, 90 mCRPC patients undergoing treatment at the University Hospital Schleswig-Holstein, Lübeck Campus between February 2006 and March 2020 were identified. The patient data were analyzed for their treatment sequence and disease progression. Due to the inclusion period, the mCRPC therapy sequences studied were limited to: Abiraterone, Cabazitaxel, Docetaxel, Enzalutamide, Lutetium-177-PSMA and Radium-223. The analysis includes the therapy sequences and their duration, clinical information of the respective cohort, overall and cancer-specific survival (OS/CSS) as well as time to second-line therapy in relation to the respective first-line therapy., Results: Approximately two-thirds of patients underwent a true therapy sequence (at least two of the drugs listed above), with this proportion halving by the third line.The majority of patients received the sequence (first/second line) abiraterone/docetaxel (n=13), followed by docetaxel/abiraterone (n=12) and abiraterone/enzalutamid (n=10) and docetaxel/docetaxel (n=8).Within the different docetaxel sequences, first-line (mean 4.7 months ± SD 3.1; median 4.0) and rechallenge (mean 5.3 months ± SD 5.9; median 3.0) therapy durations were the longest. The subjective side effect rate of docetaxel was lower in the second line, so that a better tolerability can be assumed here.The abiraterone/docetaxel sequence was used mainly in patients with metachronous metastases. Among the different sequences of abiraterone, first-line (mean 10.8 months ± SD 10.2; median 9.0) and second-line (mean 10.6 months ± SD 9.0; median 7.0) therapy durations were the longest.The sequence abiraterone/enzalutamide was prescribed mainly to older patients with synchronous metastases. Among the different enzalutamide sequences first-line (mean 9.6 months ± SD 7.1; median 7.0) and rechallenge (mean 11.0 ± SD 0.0; median 11.0) therapy durations were the longest.In contrast, the sequence docetaxel/docetaxel was used mainly in younger patients with a high initial PSA.The evaluation shows a trend that both abiraterone and enzalutamide can account for a survival advantage in the first line., Conclusion: Ultimately, an optimal treatment sequence cannot be confidently derived from these data.However, it was found that only a small proportion of patients underwent fourth- or even fifth-line treatment at all. Thus, the focus on first- and second-line in this study seems reasonable. It could be shown in a trend that docetaxel as first-line therapy seems to be disadvantegous regarding OS as well as CSS when compared to abiraterone or enzalutamide. However, due to the small number of patients in this study, a clear significance cannot be derived. Moreover, the subjectively better tolerability of docetaxel in the second-line setting could provide an impetus for treatment planning in multimorbid elderly patients in the future. The sequence abiraterone/docetaxel may offer a beneficial option for initial mCRPC therapy., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

The Kasabach-Merrit syndrome is characterized as the association of a vascular tumor, typically a caposiform hemangioendothelioma and rarely a tufted hemangioma, and a severe consumptive coagulopathy with potentially life-threatening thrombocytopenia. The severe coagulopathy with increased bleeding tendency must be considered before invasive procedures and often requires repeated platelet concentrate substitutions. We present a case of a mature male neonate with Kasabach-Merritt- Syndrome as well as VACTERL association. The VACTERL association describes a group of malformations. Our patient presented with anal atresia combined with tethered cord, and left renal agenesis. The VACTERL association as well as Kasabach-Merritt syndrome were found to be independent pathologies within this patient. A common occurrence or an association with each other has not been described in the literature so far. The challenging coagulation setting due to severe thrombocytopenia complicated the surgical management so far. Finally, mTOR-inhibitor sirolimus was successful in terms of tumor reduction and especially reduction of platelet consumption., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

The processing of the retrospective data pool for ophthalmology holds huge potential, especially for the research sector. "Big Data" enables medical science to draw conclusions for the future from historical data. Based on the evaluation of such data, algorithms could be trained, for instance, that are capable of making decisions with the help of artificial intelligence. As a result, the medical decision-making process on certain issues could be accelerated, enriched in qualitative and quantitative terms, or even completely be taken over. Ophthalmology is a rapidly evolving field. Due to the multitude of partly automated medical imaging technologies and the predestined accessibility of the eye for such technologies, ophthalmology, similarly to radiology or dermatology, is well suited for artificial intelligence-assisted image data analysis and the frequently associated initiation of diagnosis and therapy. Meanwhile, numerous studies exist based on AI-assisted image data analysis of ophthalmological image data. To the extent that the algorithms filter out results from the data pools by means of calculation rules and are even capable of making independent decisions on the basis of decision trees, the enormous benefit and, simultaneously, the profit for scientific research is quite obvious. Accordingly, it would be desirable to have unrestricted and comprehensive possibility of corresponding data processing of these health data for ophthalmological research. In spite of the potential for ophthalmology, for which there is only fragmentary evidence, the question of practical feasibility arises. In particular, the legal requirements and limits of European and national data protection law must be taken into account, prior to any unreflected processing of personal (health) data. Only by doing so can we circumvent existing obstacles and pitfalls, which can lead to severe fines. Most important are to date the requirements of two legal texts: The General Data Protection Regulation (GDPR) and the Federal Data Protection Act (BDSG). This article provides an overview of the relevant legal requirements applicable in the field of ophthalmology and highlights the major pitfalls and implementation requirements., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht./The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

The case of a 43-year-old male patient is described, who suffered several injuries due to a traffic accident, including a distraction injury to the thoracic spine. A specific feature of this case was the existing spondylodesis with material fracture and secondary loss of reduction. Due to this, the guidewires of the pedicle screws were placed in a navigation pattern in the absence of adjustable pedicles and an abnormal screw corridor. This guarantees an optimal positioning with associated patient safety., (© 2024. The Author(s).)

The training of artificial intelligence (AI) is becoming increasingly popular. More and more studies on lamellar keratoplasty are also being published. In particular, the possibility of non-invasive and high-resolution imaging technology of optical coherence tomography predestines lamellar keratoplasty for the application of AI. Although it is technically easy to perform, there are only a few studies on the use of AI to optimise lamellar keratoplasty. The existing studies focus primarily on the prediction probability of rebubbling in DMEK and DSAEK and on their graft adherence, as well as on the formation of a big bubble in DALK. In addition, the automated recording of routine parameters such as corneal oedema, endothelial cell density or the size of the graft detachment is now possible using AI. The optimisation of lamellar keratoplasty using AI holds great potential. Nevertheless, there are limitations to the published algorithms, in that they can only be transferred between centres, surgeons and different device manufacturers to a limited extent., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht./The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

The ankle fracture - the most common fracture of the lower extremities - is usually due to pro- and supination trauma and is commonly challenging for junior doctors of orthopaedics and traumatology. To accomplish sufficient surgical results, it is necessary to have surgical experience, not only because of the surrounding fragile soft tissue, but also due to the specific anatomical structures surrounding the ankle joint and the postsurgical biomechanical stress to osteosynthesis. In the following video, the most relevant steps of surgery as well as some useful tips and tricks are mentioned. The intention of the video is to convey to junior orthopaedic surgeons the most important surgical steps for their clinical daily routine., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

The mental health of refugees is influenced by a variety of pre-, peri- and postmigratory factors. It remains largely unclear how social determinants influence the utilization of psychiatric-psychotherapeutic treatment. We applied a questionnaire survey to 189 refugees from a clinical sample in a psychiatric hospital and from a control sample, which was not in treatment. The influence of social factors on psychopathology and utilization of care was analyzed by means of a CHAID algorithm. The total sample was highly stressed (54% PTSD and 41.4% depression symptoms). Patients were more severely affected in all psychometric scales as well as in traumatization and they were less able to draw on resources such as a social network or residence permit. The strongest predictor for psychotherapeutic-psychiatric treatment was social isolation in the living environment. For patients, the lack of a work permit was the strongest predictor of depression symptoms. The results point to the importance of postmigratory social determinants for the mental health of refugees. In particular, stable social relationships, together with formal factors such as work permit and residence title, should help to reduce mental distress and the need for psychiatric treatment., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Due to the divergence between the number of potential organ recipients and organ availability, transplant survival is of particular importance. In order to create the best possible conditions, it is not only important to address the risk factors for loss of organ functionality after transplantation, but also to focus on the time before transplantation. During this period, which lasts several years on average, the patient can create the conditions for risk reduction before and after transplantation with support. The optimization of physical health plays an important role here in order to maintain transplantability, on the one hand, and to counteract the general loss of physical performance due to dialysis, on the other. Therefore, the focus must be placed on "exercise" and "nutrition", which represent an increased risk of declining physical health in dialysis patients. After transplantation, the focus should again be on physical health. Through support, patients learn how to improve their cardiovascular risk profile and increase their physical performance. Psychosocial support is also important to combat psychological comorbidities and prevent risks such as nonadherence. In addition to improved physical and mental health, the focus here is also on the long-term survival of the patient and the transplant., (© 2024. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Health care of pregnant women and their newborns is facing major challenges due to the decline in birth rate and shortage of specialists. In the current discussion about future concepts, the centralization associated with minimum quantities and the necessary safeguarding of care in the area are often construed as conflicting goals. Instead, concepts are needed to guarantee that pregnant women and their children will continue to receive care close to home. The example of the saxony center for feto/neonatal health is used to show how partners in a region can jointly ensure care during pregnancy, birth and the neonatal period on a supra-local and cross-hospital basis. The close cooperation of maximum care providers with regional partners enables comprehensive health care. At the same time, this cooperation enables hospitals to remain attractive employers in structurally weak regions and to provide comprehensive care for young families in need of medical services related to pregnancy and birth through good family and social integration close to home and work. The overriding goals of the saxony center for feto/neonatal health are optimal, guideline-based, interdisciplinary and intersectoral care of pregnant women and premature or sick newborns in the region., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

In recent years, the cross-border exchange between European member states regarding the use of health data has become increasingly relevant. In order to jointly counteract the current heterogeneity and health-related challenges as well as to successively implement the vision of the European Health Data Space (EHDS) in compliance with high data protection standards, different projects with the participation of the Health Data Lab at the Federal Institute for Drugs and Medical Devices (BfArM) and the Health Data Hub have been initiated. This close German-French cooperation on the one hand creates synergies and examines challenges and possible solutions on a European level. On the other hand, the cooperation between both institutions promotes the cross-border exchange of knowledge and experience in order to jointly meet challenges and achieve goals at national and European levels., (© 2024. The Author(s).)

Early interventions of laypersons can improve the survival and neurological outcome in patients with out-of-hospital cardiac arrest. There are several organizations in Austria which train lay people in basic life support and raise awareness for sudden cardiac death. To obtain an overview of the various initiatives, a questionnaire was sent to 26 organizations, and 15 of the organizations (58%) replied. The geographical distribution of the organizations between rural and urban areas was illustrated in a map. Most of them are situated in a university city, resulting in accessibility disparities for individuals in urban and rural settings. Layperson resuscitation education in Austria is largely dependent on the individual commitments of volunteers. The time spent practicing chest compressions in resuscitation courses ranges from 25% to 90% of the total course time. Furthermore, reasons for a lack of scientific endeavours could be identified, and solutions are suggested. Through better networking between organizations and initiatives, more laypersons could be trained in the future, which would lead to improved survival chances for persons suffering from out-of-hospital cardiac arrest in Austria. Appropriate support by political bodies and public authorities is and will remain a key element., (© 2024. The Author(s).)

Until recently, human monkeypox (Mpox) were rarely observed outside of Africa, where the Mpox virus (MPXV) is endemic in some regions. In early May 2022, a global Mpox outbreak occurred. Crucial to this outbreak was human-to-human transmission during sexual activity. In particular, young men who have sex with men (MSM) became ill. In July 2022, this Mpox epidemic was declared a public health emergency of international concern by the World Health Organization. As of 26 September 2023, 90,618 confirmed cases of Mpox have been reported worldwide, with Germany accounting for around 3700 cases. The strongest increase in incidence occurred from May to mid-August 2022; since then, the number of cases has declined significantly as a result of intensive prevention efforts (education, vaccination). Currently, there are only sporadic, smaller outbreaks-in Germany (Berlin) most recently in August 2023. Despite the current calm epidemiological situation worldwide, isolated cases must therefore still be expected in Germany. The clinical picture of the "new" clade IIb-associated Mpox variant, which is mostly transmitted sexually from person to person, differs markedly from that of the "classical" Mpox (clades I and IIa), which, apart from rapidly breaking human infection chains, essentially occur as a zoonosis., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background: In the context of climate change and migration, both common and previously less common pathogens are gaining importance as cutaneous bacterial infections., Objective: To inform medical professionals about challenges to dermatology posed by climate change and migration., Materials and Methods: Review of the current literature on emerging antimicrobial resistance and emerging pathogens in general and on the epidemiological situation in Germany in particular., Results: Climate change has a direct impact on microbiological ecosystems in Germany's warming coastal waters leading to an increase of marine V. vulnificus counts and human infections. Secondary to global warming, transmitting vectors of, for example, Lyme disease, rickettsioses and tularemia are also increasing. In addition, infectious diseases like cutaneous diphtheria and mycobacteriosis have been diagnosed in migrants, mostly likely acquired before migration or on the migration route and first diagnosed in Germany. In this context, antimicrobial resistance (e.g. methicillin-resistant Staphylococcus aureus [MRSA] and multidrug-resistant gram-negative bacteria) is gaining importance., Conclusion: Due to progressive changes in global climate and ongoing migration, the aforementioned pathogens of infectious skin diseases and changes in antimicrobial resistance patterns have to be expected. Physicians should be aware of these developments in order to offer appropriate diagnostics and treatment. Epidemiological and biogeographic monitoring will be indispensable for managing emerging changes., (© 2023. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Objective: In dairy cattle, numerous factors determine the success of an insemination. The aim of the present study was to generate findings concerning the association between the preovulatory follicles, the corpora lutea with or without cavities and pregnancy in dairy cows under field conditions., Material and Methods: Data was obtained from 176 dairy cows scheduled for artificial insemination. The cows were gynecologically examined using sonography at the time of insemination, 24 hours later, on day 9, on day 34 and after day 42 after insemination. Additionally, blood samples were collected from the coccygeal vein at the time of insemination and on day 9 in order to determine blood progesterone level., Results: Depending on the result of the pregnancy test, no difference was detected between the dimensions of the follicles, corpora lutea as well as their cavities and progesterone levels 9 days after insemination in the dairy cows with spontaneous ovulations. In contrast to the corpus luteum without cavity, the surface area of the corpus luteum with cavity remained constant during the study period, while at the same time the cavity decreased in size to a significant degree. In addition, breed differences in corpus luteum sizes were detected on day 34., Conclusion: No cause was detected for the formation of cavities in corpora lutea and there was no link to the follicle from which the corpus luteum developed., Clinical Relevance: Both the changes in corpus luteum sizes over time and their breed-related differences could have an impact on insemination outcome., Competing Interests: Die Autoren bestätigen, dass kein Interessenkonflikt besteht.Herrn Prof. Dr. Dr. h.c. mult. H. Bostedt zum 85. Geburtstag gewidmet., (Thieme. All rights reserved.)

In its current state the German healthcare system will not be able to adequately care for a growing proportion of older patients with a decreasing healthcare work force. This is particularly so in the postacute care of severely ill patients. In a second of two parts we discuss the perspectives and options at hand. A major conclusion is that substantial gains could be obtained by regulatory adjustments that better align acute care and rehabilitative measures., (© 2023. The Author(s).)

In the next two decades the aging baby boomers in Germany will gradually be leaving the work force. They are being followed by the much less numerous, "baby bust" generation who now need to finance and staff healthcare for the growing number of old people in society. In order to care for more needy persons with a smaller working population, the healthcare system must be restructured; however, despite these worrisome prospects, the awareness of the problem is still low in many areas. Here we focus on the area in the healthcare system that is growing particularly rapidly and additionally has the greatest need of personnel per patient: the care of the critically ill and functionally impaired patients. The lack of coordination of hospitals, rehabilitation centers and nursing institution is historical in origin. It promotes the tendency to discharge functionally impaired patients to nursing facilities without giving them a chance for recovery of functional autonomy. As the demographic change progresses, this tendency threatens to increase. In a first of two parts, we attempt to describe the present situation., (© 2022. The Author(s).)