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Conservationists speculated on potential benefits to wildlife of lockdown restrictions because of the COVID-19 pandemic but voiced concern that restrictions impeded nature conservation. We assessed the effects of lockdown restrictions on biodiversity conservation in South Africa, a biodiverse country with economic inequality and reliance on wildlife resources. We solicited expert opinion using the IUCN’s Threats Classification Scheme to structure a questionnaire and illustrated responses with individual case studies from government parastatal and non-governmental conservation organisations. The most highly reported threats were biological resource use, residential/commercial developments, invasive species, and human intrusions. The trends reported by 90 survey respondents were supported by case studies using environmental compliance data from parastatal conservation organisations. Lack of tourism revenue and funding were cited as hindrances to conservation. Mechanisms to prevent environmental degradation in the face of global emergencies must be implemented and ‘ring-fenced’ to ensure conservation is not a casualty during future global crises.

Combining several additive manufactured (AM) parts to larger parts by welding may be required due the limited building volume of powder bed AM methods. Laser powder bed fusion (LPBF) has a great potential because it enables the production of nearly full-density components through AM processes; however, additional residual stresses and production defects are induced by LPBF. These residual stresses affect the residual stress state of welded AM parts. In combination with the production related defects, both alter the mechanical anddin particulardthe fatigue behavior of these welded joints. In this study, various tests are performed to characterize the butt joints of 316L AM steel plates made by gas metal arc welding. To this goal, joints are produced with weld seams parallel and vertical to the layer orientation of AM plates. The results are compared to joints of conventionally rolled steel plates produced with the same welding parameter. The residual stress states in initial (unloaded) condition and after cyclic loading were determined by X-ray diffraction techniques for AM and rolled plates. Complex residual stress states were determined at the welds made of AM steel plates compared to the welds made of rolled steel plates; however, the residual stress level in the heat affected zone of the butt-welded AM steel plates was similar to the welds made of hot-rolled steel plates. After cyclic loading with a high load level, high residual stress relaxations were observed in the parent materials. The fatigue design curve for butt joints from international standards is exceeded by all three test series, but the fatigue strength of the butt joints made by LBPF and hot rolling vary significantly. This is thought to be related to differences between the AM and coventional joints in microstructure, static strength, residual stress level, and small crack-like defects that partially interact with stress concentrations at the weld transition.

Peter Ehlers was to give a speech at the 2nd Session of the Assembly (2020) in Monaco, which was to mark the 100th anniversary of the International Hydrographic Organization (IHO). Sadly, the speech was cancelled due to the exceptional circumstances posed by the COVID-19 pandemic. His words were left unspoken. Nevertheless, as Peter Ehlers still had something of significance to say, we are now publishing the manuscript of his intended speech.greatest risk of climate change-related hazards.

SLC35F1 is a member of the sugar-like carrier (SLC) superfamily that is expressed in the mammalian brain. Malfunction of SLC35F1 in humans is associated with neurodevelopmental disorders. To get insight into the possible roles of Slc35f1 in the brain, we generated Slc35f1-deficient mice. The Slc35f1-deficient mice are viable and survive into adulthood, which allowed examining adult Slc35f1-deficient mice on the anatomical as well as behavioral level. In humans, mutation in the SLC35F1 gene can induce a Rett syndrome-like phenotype accompanied by intellectual disability (Fede et al. Am J Med Genet A 185:2238–2240, 2021). The Slc35f1-deficient mice, however, display only a very mild phenotype and no obvious deficits in learning and memory as, e.g., monitored with the novel object recognition test or the Morris water maze test. Moreover, neuroanatomical parameters of neuronal plasticity (as dendritic spines and adult hippocampal neurogenesis) are also unaltered. Thus, Slc35f1-deficient mice display no major alterations that resemble a neurodevelopmental phenotype.

Introduction: Services to support adults with acquired brain injury (ABI) and return to work goals are varied. In Queensland, Australia, return to work goals may be addressed through private or publicly funded rehabilitation services or through publicly funded employment programs. No set frameworks or processes are in place to guide clinicians in providing vocational rehabilitation to adults with ABI, and the extent to which services address clients’ vocational goals and/or provide vocational rehabilitation is unknown. Method: This qualitative study investigated the clinical practice and experiences of allied health rehabilitation clinicians (n = 34) to identify current practice in providing vocational rehabilitation to adults with ABI, including pathways and services; models, frameworks and tools; and recommendations for ideal services. Focus groups and online surveys were conducted, with data analysed via content analysis. Results: ABI vocational rehabilitation was inconsistently delivered within and across services in Queensland, with differences in access to services, aspects of vocational rehabilitation provided and timeframes for rehabilitation. Five key themes were identified regarding ABI vocational rehabilitation and service delivery in Queensland: Factors influencing ABI and return to work; Service provision; ABI vocational rehabilitation processes (including assessment tools and interventions); Service gaps; and Ideal ABI vocational rehabilitation services. Discussion: These findings can inform clinical practice and development, and current and future service delivery models for ABI vocational rehabilitation.

ZusammenfassungMaßnahmen des Klimaschutzes – insbesondere der Ausbau der Erneuerbare Energien – aber auch der Klimaanpassung stoßen auf einen immer breiter werdenden Grundkonsens in der Bevölkerung, führen aber auch zu gesellschaftlichen Konflikten. Mediation kann dabei mehr als ein reines Konfliktlösungsinstrument sein. Vielmehr kann Mediation längerfristige Effekte erzielen, indem sie die Beteiligten anregt, konstruktive statt destruktive Gedanken zu verfolgen, unter Beachtung der Fakten nach Lösungen statt Problemen zu suchen und damit zum einen die Möglichkeit der Selbstwirksamkeit der Beteiligten eröffnet und zu mehr Vertrauen zwischen Bürgern, Zivilgesellschaft, Politik und Verwaltung beitragen kann. Der Beitrag skizziert Möglichkeiten und Grenzen einer Intensivierung und Systematisierung von Mediation im Kontext von Konflikten, die bei der Planung und Durchführung von Klimaschutz- und Klimaanpassungsmaßnahmen auftreten.

We demonstrate in this work how we can take advantage of known unfocused SAR (UF-SAR) retracking methods (e.g. the physical SAMOSA model) for retracking of fully-focused SAR (FF-SAR) waveforms. Our insights are an important step towards consistent observations of sea surface height, significant wave height and backscatter coefficient (wind speed) with both UF-SAR and FF-SAR. This is of particular interest for SAR altimetry in the coastal zone, since coastal clutter may be filtered out more efficiently in the high-resolution FF-SAR waveform data, which has the potential to improve data quality. We implemented a multi-mission FF-SAR altimetry processor for Sentinel-3 (S3) and Sentinel-6 Michael Freilich (S6), using a back-projection algorithm, and analysed ocean waveform statistics compared to multilooked UF-SAR. We find for Sentinel-3 that the averaged power waveforms of UF-SAR and FF-SAR over ocean are virtually identical, while for Sentinel-6 the FF-SAR power waveforms better resemble the UF-SAR zero-Doppler beam. We can explain and model the similarities and differences in the data via theoretical considerations of the waveform integrals. These findings suggest to use the existing UF-SAR SAMOSA model for retracking S3 FF-SAR waveforms but the SAMOSA zero-Doppler beam model for S6 FF-SAR waveforms, instead. Testing the outlined approach over short track segments, we obtain range biases between UF-SAR and FF-SAR lower than 2 mm and significant wave height biases lower than 5 cm.

Component separation (CS) techniques have evolved in recent years. How surgeons apply the various CS techniques, anterior component separation (aCS) versus posterior component separation (pCS), by patient and hernia-specific factors remain unknown in the general population. Improving the quality of ventral hernia repair (VHR) on a large scale requires an understanding of current practice variations and how these variations ultimately affect patient care. In this study, we examine the application of CS techniques and the associated short-term outcomes while taking into consideration patient and hernia-specific factors.We retrospectively reviewed a clinically rich statewide hernia registry, the Michigan Surgical Quality Collaborative Hernia Registry, of persons older than 18 y who underwent VHR between January 2020 and July 2021. The exposure of interest was the use of CS. Our primary outcome was a composite end point of 30-d adverse events including any complication, emergency department visit, readmission, and reoperation. Our secondary outcome was surgical site infection (SSI). Multivariable logistic regression examined the association of CS use, 30-d adverse events, and SSI with patient-, hernia-, and operative-specific variables. We performed a sensitivity analysis evaluating for differences in application and outcomes of the posterior and aCS techniques.A total of 1319 patients underwent VHR, with a median age (interquartile range) of 55 y (22), 641 (49%) female patients, and a median body mass index of 32 (9) kg/mThis is the first population-level report of patients undergoing VHR with concurrent posterior or aCS. These data suggest wide variation in the application of CS in VHR and raises a concern for potential overutilization in smaller hernias. Continued analysis of CS application and the associated outcomes, specifically recurrence, is necessary and underway.

Multiple myeloma (MM) is an incurable disease, characterized by malignant plasma cells in the bone marrow. MM growth is largely dependent on the tumor microenvironment (TME), consisting of complex cellular networks that shape a tumor-permissive environment. Within the TME, tumor-associated cells (TAC) comprise heterogeneous cell populations that collectively support immunosuppression. Reshaping the TME toward an immunostimulatory environment may enhance effectiveness of immunotherapies. Here, we investigated interactions between donor-derived natural killer (NK) cells and TAC, like tumor-associated macrophages (TAM) and M1 macrophages, and assessed whether anti-tumor effector functions of NK cells could be enhanced by an ADCC-triggering antibody targeting macrophages. Monocytes were polarized in vitro toward either M1 or TAM before co-culture with high-dose IL-2-activated NK cells. NK cell responses were assessed by measuring degranulation (CD107a) and IFN-γ production. We found that NK cells degranulated and produced IFN-γ upon interaction with both macrophage types. NK cell responses against PD-L1+ M1 macrophages could be further enhanced by Avelumab, an anti-PD-L1- and ADCC-inducing antibody. Additionally, NK cell responses were influenced by HLA class I, shown by stronger degranulation in NK cell subsets for which the corresponding HLA ligand was absent on the macrophage target cells (KIR-ligand mismatch) compared to degranulation in the presence of the HLA ligand (KIR-ligand match). Our results suggest that NK cells could, next to killing tumor cells, get activated upon interaction with TAC, like M1 macrophages and TAMs, and that NK cells combined with PD-L1 blocking antibodies with ADCC potential could, through IFN-γ secretion, promote a more immune-favorable TME.

Background: This study tested the hypothesis that training reduces resting sympathetic activity and improves baroreflex control in both hypertensive and normotensive men but reduces blood pressure only in hypertensive men.Methods: Middle-aged/older un-medicated stage-1 hypertensive males (mean age 55±3 yrs; n=13) and normotensive controls (mean age 60±5 yrs; n=12) participated in 8 weeks of supervised high-intensity interval spinning training. Before and after training, muscle sympathetic nerve activity (MSNA) and blood pressure were measured at rest and during a sympatho-excitatory cold pressor test (CPT). Based on the measurements, baroreceptor sensitivity and baroreceptor threshold were calculated.Results: Resting MSNA and baroreceptor sensitivity were similar for the hypertensive and the normotensive groups. Training lowered MSNA (ppp>0.05) alter the MSNA or blood pressure response to CPT or increase baroreceptor sensitivity but reduced (pConclusion: The dissociation between the training induced changes in resting MSNA, lack of change in baroreflex sensitivity and the change in blood pressure, suggests that MSNA is not a main cause of the blood pressure reduction with exercise training in un-medicated middle-aged/older men.

Zusammenfassung Hintergrund Während Grenzverletzungen in Psychotherapien in den letzten Jahren zunehmend in den Fokus gerückt sind, waren die Besonderheiten der Grenzverletzungen in Lehrtherapien und Lehranalysen bislang kaum Gegenstand der wissenschaftlichen Untersuchungen. Ziel Die vorliegende Arbeit beschreibt spezifische Kontextmerkmale einer Ausbildungssituation, die mit dem Auftreten, dem Verlauf und den Folgen von Schweigepflichtverletzungen verbunden sind. Methode Es werden 18 anonymisierte Beratungsdokumentationen des Ethikvereins e. V., in denen Schweigepflichtverletzungen im Rahmen einer Psychotherapie-Ausbildung beobachtet werden, qualitativ im Sinne der „Grounded-theory“-Methodologie, angelehnt an Charmaz, ausgewertet. Dazu wird die Software „MAXQDA“ (von VERBI, Berlin) benutzt. Ergebnis Die untersuchten Lehrtherapien hatten schädigende Auswirkungen auf die betroffenen Aus- und Weiterbildungskandidaten und -kandidatinnen (AWT). Die Variablen „Eignungszweifel“, „multiple Rollen des Lehrtherapeuten“ und „institutionelle Verleugnung der Grenzverletzung“ waren bedeutsame ausbildungsspezifische Charakteristika der untersuchten Schweigepflichtverletzungen. Die Destruktivität der entgleisten dyadischen Beziehung wurde in den ungünstigen Verläufen durch eine Wiederholung der gestörten Beziehung zwischen AWT und dem Institut potenziert. Schlussfolgerungen Schweigepflichtverletzungen können schädigende Grenzverletzungen sein, die im Ausbildungskontext auf weitere Grenzverluste in der Dyade und in der Institution hinweisen können. Es werden verschiedene autonomiefördernde Maßnahmen vorgeschlagen, die Ausbildungsteilnehmende vor Grenzverletzungen besser schützen können.

Dibenzoacridines were prepared by alkyne–carbonyl-metathesis and the optical properties of the products were studied.

ispartof: JOURNAL OF CLINICAL IMMUNOLOGY vol:43 issue:3 ispartof: location:Netherlands status: Published online

Obesity-associated type 2 diabetes (DM) leads to adipose tissue dysfunction. Lumican is a proteoglycan implicated in obesity, insulin resistance (IR), and adipocyte dysfunction. Using human visceral adipose tissue (VAT) from subjects with and without DM, we studied lumican effects on adipocyte function. Lumican was increased in VAT and adipocytes in DM. Lumican knockdown in adipocytes decreased lipolysis and improved adipogenesis and insulin sensitivity in VAT adipocytes in DM, while treatment with human recombinant lumican increased lipolysis and impaired insulin-sensitivity in an ERK-dependent manner. We demonstrate that lumican impairs adipocyte metabolism, partially via ERK signalling, and is a potential target for developing adipose tissue-targeted therapeutics in DM.

Portomesenteric vein thrombosis (PVT) is a rare complication following bariatric surgery but can result in severe morbidity as well as death.Identification of risk factors for PVT to facilitate targeted management strategies to reduce incidence.Prospective, statewide bariatric-specific clinical registry.We identified all patients who underwent primary bariatric surgery between June 2006 and November 2021 (n = 102,869). Patient characteristics, procedure type, operative details, and 30-day postoperative complications were analyzed with multivariable logistic regression to evaluate for independent predictors of PVT.A total of 117 patients (.11%) developed a postoperative PVT, with 6 (5.1%) associated deaths. The majority of PVTs occurred in patients who underwent sleeve gastrectomy (109 patients; 93.2%), and the PVT occurred most commonly during the second (37%), third (31%), and fourth weeks (23%) after surgery. Independent risk factors for PVT included a prior history of venous thromboembolism (odds ratio [OR] = 3.1; 95% confidence interval [CI]: 1.64-5.98; P = .0005), liver disorder (OR = 2.3; 95% CI: 1.36-4.00; P = .0021), undergoing sleeve gastrectomy (OR = 12.4; 95% CI: 4.98-30.69; P.0001), and postoperative complications including obstruction (OR = 12.5; 95% CI: 4.65-33.77; P.0001), leak (OR = 7.9; 95% CI: 2.76-22.64; P = .0001), and hemorrhage (OR = 7.6; 95% CI: 3.57-16.06; P.0001).Independent predictors of PVT include a prior history of venous thromboembolism, liver disease, undergoing sleeve gastrectomy, and experiencing a serious postoperative complication. Given that the incidence of PVT is most common within the first month after surgery, extending postdischarge chemoprophylaxis during this time frame is advised for patients with increased risk.

To study the associations between perceived historical trauma, current traumatic events, diagnoses of post-traumatic stress disorder (PTSD), and suicidal behaviors in an American Indian community sample.Participants were American Indians recruited from reservations who were assessed with the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA), as well as the Historical Loss Scale, Historical Loss Associated Symptoms Scale, and Stressful Life Events Scale.In data from 447 American Indian adults (mean age = 33 years), twenty percent reported lifetime experiences of suicidal thoughts (ideation and/or plans) and 14% reported suicidal acts, (including either a suicide attempt history or verified death by suicide (n = 4)). Diagnosis of PTSD and experience of assaultive trauma were each significantly associated with suicidal thoughts and acts, although assaultive trauma did not remain significant in models adjusting for gender and PTSD. High endorsement of symptoms associated with historical trauma was significantly associated with suicidal acts, and this remained significant when adjusting for gender and PTSD.PTSD and historical trauma have an association with suicide and suicidal attempts in this American Indian community. Although further research is needed to evaluate the causal nature of these relations, these findings suggest treatment and prevention programs for American Indian suicide may benefit from addressing issues related to feelings of historical losses, PTSD, and their associated symptomatology.

Event-related oscillations (EROs) may represent sensitive biomarkers or endophenotypes for disorders that underlie risk behaviors such as suicidal thoughts and actions. In this study, young adults of American Indian (AI) (n = 821) and Mexican American (MA) (n = 721) ancestry (age 18-30 yrs) were clinically assessed for internalizing and externalizing disorders, and an internalizing scale was generated by extracting core diagnostic items from 6 lifetime DSM5-compatible diagnoses (social phobia, panic disorder, agoraphobia, obsessive compulsive disorder, post-traumatic stress disorder, major depressive episode) and symptoms of suicidality. EROs were generated to sad, happy and neutral faces, and energy and phase locking of delta ERO oscillations were assessed in frontal areas. An increase in delta ERO energy was found in the frontal lead (FZ) following presentation of the sad facial expressions in those with a history of 10 or more internalizing symptoms compared to those with no symptoms. Increases in delta ERO energy in FZ were also associated with a diagnosis of major depressive disorder (MDD), but not with anxiety disorders or antisocial personality disorder/conduct disorders (ASP). Major depression was also associated with increases in cross-cortical phase-locking (FZ-PZ). A decrease in the percentage of correctly identified neutral faces also was seen among those with 10 or more internalizing symptoms compared to those without internalizing symptoms, and in those with anxiety disorders, but not in those with ASP or MDD as compared to their controls. These findings suggest ERO measures may represent important potential biomarkers of depressive disorders as well as risk indicators for suicidal behaviors.

One feature of papillary thyroid cancer (PTC) is the frequently present somatic BRAFV600E mutation. PTCs are also characterized by a lymphocytic infiltration, which may correlate with an improved clinical outcome. The objective of the study was the characterization of BRAFV600E specific anti-immunity in PTC patients and correlation analyses with the clinical outcome. Fourteen HLA A2 positive PTC patients were included into the study of whom tumor tissue samples were also available. Of those, 8 PTC patients revealed a somatic BRAFV600E mutation. All PTC patients were also MHC class II typed. Tetramer analyses for detection of MHC class I and MHC class II-restricted, BRAFV600E epitope-specific T cells using unstimulated and peptide-stimulated T cells were performed; correlation analyses between MHC phenotypes, T cell immunity, and the clinical course were performed. In regard to unstimulated T cells, a significantly higher amount of BRAFV600E epitope specific T cells was detected compared to a control tetramer. Importantly, after overnight peptide stimulation a significantly higher number of BRAFV600E positive and BRAF WT epitope-specific T cells could be seen. In regard to the clinical course, however, no significant differences were seen, neither in the context of the initial tumor size, nor in the context of lymph node metastases or peripheral metastastic spread. In conclusion, we clearly demonstrated a BRAF-specific tumor immunity in PTC-patients which is, however, independent of a BRAFV600E status of the PTC patients.

We consider taxation of exchanges among a set of agents in which each agent owns one object. Agents may have different valuations for the objects, and they need to pay taxes for exchanges. We show that, if a rule satisfies individual rationality, strategy-proofness, constrained efficiency, weak anonymity, and weak consistency, then it is either the no-trade rule or a fixed-tax core rule. For the latter rules, whenever any agent exchanges an object, the agent pays the same fixed tax (a lump sum payment that is identical for all agents) independently of which object the agent consumes. Gale’s top trading cycles algorithm finds the final assignment using the agents’ valuations adjusted with the fixed tax if the induced preferences are strict.

Antibodies against Rho GDP-dissociation inhibitor 2 (RhoGDI2) are associated with inferior graft survival in transplant patients receiving a kidney from deceased donors. Although this suggests that these antibodies contribute to graft injury because of ischemia, it remains unknown whether they are also pathogenically involved in the process of graft loss. To study this, we firstly analyzed the IgG subclass profile of anti-RhoGDI2 antibodies in kidney transplant recipients, and whether antibody titers change over time or because of acute rejection. Next, we investigated the expression of RhoGDI2 on primary kidney and lung endothelial cells (ECs) upon hypoxia reperfusion. In addition, the complement-fixing properties of anti-RhoGDI2 antibodies were studied using imaging flow cytometry. Anti-RhoGDI2 antibodies in patients are mainly IgG1, and titers remained stable and seemed not be changed because of rejection. Antibodies against RhoGDI2, which surface expression seemed to increase upon hypoxia reperfusion, co-localized with C3 on ECs. Binding of human IgG1 monoclonal anti-RhoGDI2 antibodies as well as patient derived antibodies, resulted in complement activation, suggesting that these antibodies are complement fixing. This study suggested a potential pathogenic role of anti-RhoGDI2 antibodies in kidney graft loss. During ischemia reperfusion, the ability of these antibodies to fix complement could be one of the mechanisms resulting in tissue injury.

OBJECTIVE: To estimate the economic burden of non-communicable diseases (NCDs) in people living with HIV (PLWH) in Denmark.METHODS: We conducted a cohort study using population-based Danish medical registries including all adult residents of the Central Denmark Region registered with a first-time HIV-diagnosis during the period 2006-2017. For each PLWH, we matched 10 persons without HIV from the background population by birth year, sex and municipality of residence. Information on healthcare utilization and costs for the PLWH and non-HIV cohorts was retrieved from register data. For each cohort, we estimated the annual costs for major disease categories (HIV care, other somatic care, and psychiatric care) in the period from 3 years before to 9 years after diagnosis/matching date.RESULTS: We identified 407 PLWH and 4070 persons from the background population. The total healthcare costs during the study period were approximately three times higher for PLWH compared to the non-HIV cohort (€76 198 vs. €23 692). Average annual cost of hospital care, primary care and selected prescription medicine was estimated to be €6987 per year in the years after the diagnosis compared to €2083 per year in the non-HIV cohort. In PLWH, the cost of NCDs and psychiatric care was approximately two times higher than the cost of HIV care.CONCLUSION: PLWH have higher healthcare costs stemming from three areas: excess cost due to the HIV infection, the treatment of NCDs, and psychiatric care.

Die Europäische Union strebt mit den Maßnahmen des Fit-for-55-Pakets eine Verringerung der CO2-Emissionen bis 2030 um 55% an, verglichen mit dem Stand von 1990. Diese Reduktion soll durch verschiedene Maßnahmen erreicht werden, die auch die kommerzielle Luftfahrt betreffen. Dies sind unter anderem eine Verschärfung des Emissionshandels, bei der insbesondere die frei zugeteilten Zertifikate zügig abgebaut werden sollen, eine verpflichtende Beimischungsquote für nachhaltige Flugtreibstoffe an europäischen Flughäfen sowie eine europaweite Mindesthöhe für Steuern auf Treibstoffe. Dadurch verteuern sich die Flüge in verschiedenen Gebieten unterschiedlich. The European Union seeks to reduce carbon emissions 55 % compared to 1990 rates by 2030. The instruments that are intended to support this reduction are a tightened Emission Trading Scheme (EU-ETS), a mandatory blending of jet fuel with sustainable aviation fuel (SAF), and a minimum tax on energy carriers (Energy Taxation Directive, ETD). In this article, we analyse the impact of these instruments on airfares in different markets: within Germany, between Germany and other European countries, as well as international connections to Asia, Africa and North America. Furthermore, we compare the impact between different carrier types: network carriers, touristic carriers and low-cost carriers.

Generation Y consumers have become an important consumer group and, as a result, theirperceptions of media credibility has become an important issue for many organisations andmedia planners. This study explores the credibility of traditional media advertising versus newmedia advertising, the credibility of broadcast-media advertising versus print-media advertising,the credibility of cellphone advertising versus Internet advertising, and the relationship betweenthe credibility of Internet advertising and likelihood of Generation Y consumers shopping online.The target audience comprises students between the ages of 18 and 30 years at one of thelargest residential universities in South Africa. Convenience sampling was used and a total of1 345 questionnaires were completed. Some of the results indicate that Generation Y consumersrate the credibility of traditional media higher than new media and that print media has highercredibility ratings compared with broadcast media.

Adrian Gillissen,1 Tonja Kochanek,1 Michaela Zupanic,2 Jan P Ehlers1 1Institute for Didactics and Educational Research in Health Care, Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, Germany; 2Interprofessional and Collaborative Didactics in Medicine- and Health professions, Department of Medicine, Faculty of Health, Witten/Herdecke University, Witten, GermanyCorrespondence: Adrian Gillissen, Institute for Didactics and Educational Research in Health Care, Department of Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, Witten, 58455, Germany, Email adrian.gillissen@uni-wh.deBackground and Objectives: The aim of this study was to investigate in the millennium medical student generation the influence of the curriculum (problem-based curriculum [PBC] vs science-based curriculum [SBC]), gender and semester level on medical students’ motives to study medicine, their attitudes toward their career and in this regard their view about their study condition in university.Methods: Semi-structured qualitative interviews with 28 medical students were performed and analyzed using Mayring’s content analysis. Based on these results, a quantitative questionnaire for a nationwide survey was developed using a mixed-method-approach and send to most medical faculties in Germany. Data from n=1053 students entered statistical analysis.Results: Humanistic ideals prevailed in the choice to enter medical school and to become a physician. PBC students were found to be significantly (p< 0.001) more idealistic and patient oriented, and they regard their curriculum more competitive than SBC-students (p< 0.001). A balanced work and family life is essential for all students but particularly important for the PBC – group, male and undergraduate students. The majority of students wanted to work with patients and omitted patient-distant line of work. Undergraduate SBC-students saw their studies as old-fashioned citing lack of patient contact (p< 0.001 compared to PBC), which eased in the graduate study part.Conclusion: This study found major differences in student’s perceptions depending on curriculum type. PBC-students were more idealistic, and humanistic ideals prevailed in comparison to SBC. For both, close patient contact is essential in their training. Particularly for female students, lifestyle factors and a balanced work-life-integration outweigh career ambitiousness. This study offers an important insight to policy makers and educators to understand the motivation and perceptions of the millennial student generation regarding their studies and future career plans, which should be considered in educational policies.Keywords: medical students, career expectations, perceptions

_ The aim of this paper is to investigate the relationship between design and operational ship parameters with respect to radiated underwater noise and to develop a semiempirical noise prediction model that includes the dominant noise contributors present on merchant vessels. The model is based on Dietrich Wittekind’s prediction model and on underwater noise measurements with related Automatic Identification System (AIS) data. Additionally, the noise contribution of a two-stroke engine is investigated using structure-borne noise measurements and Finite Element Methods (FEM). The updated model can be used to assess the expected underwater noise emissions induced by ship traffic in a specific sea area based on AIS data and as a basis to produce noise maps. In conclusion, the prediction model will work as a useful tool to help understanding the noise contributors, their sensitivity on ships speed, and their impact in a defined environment. Introduction When discussing emissions in shipping, the focus is mainly reduced to greenhouse gases and pollutants. In the meantime, ships have been recognized as the most common source of anthropogenic noise emission in the oceans (Tournadre 2014). The dominant components of shipping noise are propeller cavitation, as well as the vibration of the hull caused by the power plant (Zou et al. 2003; Wittekind 2014). An increase in ship traffic and larger ship sizes are responsible for the steady rise in ambient noise, especially at low frequencies (Andrew et al. 2002). Several studies identified an increase of noise by 3 dB per decade. In other words, noise emissions double every 10 years as observed between the 1960s and 1990s (Andrew et al. 2002).

Declines in cervical intraepithelial neoplasia grades 2 to 3 and adenocarcinoma in situ (CIN2+) observed among young women suggest impact from human papillomavirus (HPV) vaccination. To further evaluate vaccine impact including cross-protection and type replacement, we described high-risk (HR)-HPV type-specific cervical precancer incidence rates among women aged 20 to 39 years, 2008 to 2016. We analyzed cross-sectional population-based data on 18 344 cases of CIN2+ from a 5-site surveillance system. Diagnostic specimens were tested for individual HPV types, including 14 HR-HPV types (HPV16/18/31/33/35/39/45/51/52/56/58/59/66/68). We estimated age-specific annual HR-HPV type-specific CIN2+ incidence per 100 000 screened women for individual types, vaccine HR-HPV types (HPV16/18) and nonvaccine HR-HPV types (non-HPV16/18). We evaluated trends using average annual percent changes (AAPC) and 95% confidence intervals (CI), and estimated total declines by comparing 2015-2016 to 2008-2009 using incidence rate ratios. Among 20-24-year-olds, HPV16/18-CIN2+ declined from 2008 through 2016 (AAPC: -21.3%, 95% CI: -28.1%, -13.8%), whereas no trend was observed for non-HPV16/18-CIN2+ (AAPC: -1.8%, 95% CI: -8.1%, 4.9%). After 2010, CIN2+ among 20-24-year-olds was more often caused by nonvaccine vs vaccine HR-HPV types. No significant declining trends were observed in older age groups. In 2015-2016 compared with 2008-2009, HPV16-CIN2+ declined 78%, HPV18-CIN2+ 72% and HPV31-CIN2+ 51% among 20-24-year-olds; no increases were observed in type-specific CIN2+ incidence. Among 25-29-year-olds, HPV16-CIN2+ declined 18%; CIN2+ attributed to seven nonvaccine types increased significantly. No significant declines were observed in older groups. Significant declines in HPV16/18-CIN2+ in 20-24-year-olds and HPV16-CIN2+ in 25-29-year-olds corroborate impact of HPV vaccination. A declining trend in HPV31-CIN2+ is consistent with cross-protection from vaccination.