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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]

Point-of-care sonography is a precondition in acute and emergency medicine for the diagnosis and initiation of therapy for critically ill and injured patients. While emergency sonography is a mandatory part of the training for clinical acute and emergency medicine, it is not everywhere required for prehospital emergency medicine. Although some medical societies in Germany have already established their own learning concepts for emergency ultrasound, a uniform national training concept for the use of emergency sonography in the out-of-hospital setting is still lacking. Experts of several professional medical societies have therefore joined forces and developed a structured training concept for emergency sonography in the prehospital setting. The consensus paper serves as quality assurance in prehospital emergency sonography. [ABSTRACT FROM AUTHOR]

The German school system employs centrally organized performance assessments (some of which are called "VERA") as a way of promoting lesson development. In recent years, several German federal states introduced a computer-based performance testing system which will replace the paper-pencil testing system in the future. Scores from computer-based testing are required to be equivalent to paper-pencil testing scores so that the new testing medium does not lead to disadvantages for students. Therefore, the current study aimed at investigating the size of the mode effect and the moderating impact of students' gender, academic achievement and mainly spoken language in everyday life. In addition, the variance of the mode effect across tasks was investigated. The study was conducted in four German federal states in 2019 using a field experimental design. The test scores of 5140 eighth-graders from 165 schools in the subject German were analysed. The results of multi-level modelling revealed that students' test scores in the computerized version of the VERA test were significantly lower than in the paper-pencil version. Students with a lower academic achievement were more disadvantaged by the VERA computerized test. The results were inconsistent regarding the interactions between testing mode and students' gender and mainly spoken language in everyday life. The variance of the mode effect across tasks was high. Research into different subjects and in other federal states and countries under different testing conditions might yield further evidence about the generalizability of these results. [ABSTRACT FROM AUTHOR]

Since the first statement of the German Society of Oto-Rhino-Laryngology, hypoglossal nerve stimulation (HNS) is meanwhile an established treatment option for obstructive sleep apnea (OSA). There are three HNS systems available in Germany which differ in their technical details of the underlying comparable basic principle. For the unilateral HNS with respiratory sensing, several comparative studies, high-volume register analysis and long-term reports exist. The continuous HNS without respiratory sensing does not require a sleep endoscopy for indication. For the bilateral continuous HNS as the single partially implantable device, a feasibility study exists. For indication, the assessment of positive airway pressure failure by sleep medicine is crucial, and the decision for HNS should be made in discussion of other treatment options for at least moderate OSA. The implantation center holds primarily responsibility among the interdisciplinary sleep team and is primary contact for the patient in problems. This depicts why structural processes are required to secure outcome quality and minimize the complications. The aftercare of HNS patients can be provided interdisciplinary and by different medical institutions, whereat, minimal reporting standards to document outcome and usage are recommended. [ABSTRACT FROM AUTHOR]

Bacteriocins are antimicrobial compounds with targeted activities that are produced by a variety of bacterial species. Different aspects of bacteriocins were intensively studied and highlighted in previous research publications. Developments in this field are best demonstrated through analysis of the most cited scientific literature concerning bacteriocins. The objective of this report was to identify and establish main characteristics of the 100 top-cited papers presenting research on bacteriocins. Publications regarding bacteriocins between 1970 and 12th May 2017 were retrieved from the Web of Knowledge database of the Institute of Scientific Information. From this list, the top-cited 100 papers in the field of bacteriocins were established. The top-cited papers in this field were published from 1991 to 2013 and, as of this date, they have received from 85 to 1097 citations. The average citation rate of the 100 top-cited papers was 166.23 times (SD 136.87). The most common fields of study were microbiology (45%), biochemistry and molecular biology (35%), and biotechnology and applied microbiology (26%). Among the top-cited papers, 24 and 17 papers originated from the United States and Germany, respectively. Among these top-cited papers close to 80% concerned mainly bacteriocins from Gram-positive bacteria, whereas, only nine of the top-cited papers described bacteriocins of Gram-negative bacteria. [ABSTRACT FROM AUTHOR]

Background: With reference to the United Nations Convention on the Rights of Persons with Disabilities (UN CRPD), a fundamental change in psychiatric care in Germany was proposed in 2019 by Zinkler and von Peter, supported by a legal perspective from Kammeier, which has since led to controversial debates. Essentially, the aim is not only to reduce coercion in psychiatry to a minimum, but also to fundamentally exclude it in a psychiatry that only provides care. The function as an agent of social control is to be returned from psychiatry to state institutions. Psychiatric hospitals will only admit patients with their consent; patients who refuse therapy will not be admitted regardless of their capacity for self-determination and will remain untreated or, if they have committed a criminal offence or threaten to commit a criminal offence, they will be taken into custody or imprisoned in accordance with the legal regulations applicable to all people. There they will receive psychiatric care if they so wish. Aim of the paper: The paper outlines the background of this concept, including international sources, traces the discussion in German specialist literature and takes a critical look at it. Results: The criticism is primarily directed against the fact that responsibility for a relevant proportion of psychiatric patients would be handed over to the police and judiciary and that, as a result, two realities of care would be established that would considerably differ in terms of quality. Conclusion: Arguments are put forward in favor of retaining the function of social control and considerations are suggested as to how caring coercion can be largely minimized. [ABSTRACT FROM AUTHOR]

The present paper is the second of a series of publications that aim at investigating relevant directions to turn the nuclear energy density functional (EDF) method as an effective field theory (EFT). The EDF approach has known numerous successes in nuclear theory over the past decades [1] and is currently the only microscopic technique that can be applied to all atomic nuclei. However, the phenomenological character of the EDF method also comes with important limitations, such as the lack of an explicit connection with quantum chromodynamics (QCD). As was argued in the first paper of this series [2], reformulating the EDF framework as an EFT would enable us to overcome these limitations. In particular, path-integral (PI) techniques are suited to achieve such a purpose as they allow us to design numerous non-perturbative approximations and can take Lagrangians possibly derived from EFTs of QCD as inputs. In our previous paper [2], we have illustrated such technical features for diagrammatic PI techniques in a study of the (0+0)-D O(N)-symmetric φ 4 -theory. In the present work, we consider another class of PI techniques, i.e. functional renormalization group (FRG) approaches, that we apply to the same toy model. Despite our explicit interest for the nuclear many-body problem, the presented study is also directed towards FRG practitioners from various fields: technical details are provided for FRG techniques based on 1-particle-irreducible (1PI), 2-particle-irreducible (2PI) and 2-particle-point-irreducible (2PPI) effective actions, coined respectively as 1PI-, 2PI- and 2PPI-FRGs, and the treatment of the O(N) symmetry is also addressed thoroughly. Connections between these various FRG methods are identified as well. [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]

Fire statistics mirror the outcome of fire prevention. Most fire statistics in Germany deal with the loss of life, value, and fire department actions (number of interventions, nozzles used, or alarm category like a false alarm). However, these results also represent the safety level the legislator has set through the prescriptive building regulations. The current statistics cannot evaluate the level of fire safety and the fulfillment or necessity of fire safety precautions. Today, expert judgment from firefighters is necessary to fill this gap. Here, we show the first evaluation of fire prevention and hazard protection measures by evaluating 900 potentially harming fires throughout Germany. In contrast to minor fires, these fires have advanced to the extent that they could potentially violate the protection objectives outlined in building regulations. The fire department association developed a questionnaire to evaluate the fire safety level and possibly reduce unnecessary fire safety regulations. One hundred twenty-three fire departments carried out the questionnaire, which are responsible for 25% of the German population. Fire prevention officers of the fire departments went to the scene after the fire was extinguished, and the fire safety concept of the building could be evaluated. We found a high rate of injuries, smoke spread, need for rescue by firefighters, and higher than expected firefighter response times after arrival at the scene. Surprisingly, smoke spread rates correlated with building height and not with building age. It was even possible to assess the risk of multiple casualties. Overall, the questionnaire results give insight into the current level of fire safety in existing buildings. Ways and rates for smoke and fire spread prove the importance of second escape routes and the influence of human misconduct. According to these results, current building code regulations are sufficient to prevent fire spread. On the other hand, smoke spreading is a severe threat to people's safety. For example, the data shown can be applied in Bayes nets or other risk calculations to optimize individual building designs or even governmental building codes concerning fire safety engineering. Based on our observations, science, and building codes, authorities could in the future establish a performance-based building code instead of the current prescriptive code. This paper presents the first approach in Germany to quantify the expert judgment of fire departments and use it as a source of knowledge for fire prevention. [ABSTRACT FROM AUTHOR]

Between 2016 and 2021, Germany's first total diet study was performed to assess the variety of substances humans are exposed to by dietary intake. On a global scale rather unique, the natural radionuclides lead-210, uranium-234, uranium-238, radium-226, and radium-228 should be investigated in over 200 different food samples within that study. This paper serves as a guide how to successfully determine these natural radionuclides in very low concentrations in a variety of samples. Two independent laboratories were involved for comparison to assure the quality of the presented sample pretreatment and analyzing techniques. [ABSTRACT FROM AUTHOR]

Background: According to the legal definition healthcare systems and their components (e.g., hospitals) are part of the critical infrastructure of modern industrial nations. During the last few years hospitals increasingly became targets of cyber attacks causing severe impairment of their operability for weeks or even months. According to the German federal strategy for protection of critical infrastructures (KRITIS strategy), hospitals are obligated to take precautions against potential cyber attacks or other IT incidents. Objective: This article describes the process of planning, execution and results of an advanced table-top exercise which took place in a university hospital in Germany and simulated the first 3 days after a cyber attack causing a total failure of highly critical IT systems. Material and methods: During a first stage lasting about 8 months IT-dependent processes within the clinical routine were identified and analyzed. Then paper-based and off-line back-up processes and workarounds were developed and department-specific emergency plans were defined. Finally, selected central facilities such as pharmacy, laboratory, radiology, IT and the hospitals crisis management team took part in the actual disaster exercise. Afterwards the participants were asked to evaluate the exercise and the hospitals cyber security using a questionnaire. On this basis the authors visualized the hospitalʼs resilience against cyber incidents and defined short-term, medium-term and long-term needs for action. Results: Of the participants 85% assessed the exercise as beneficial, 97% indicated that they received adequate support during the preparations and 75% had received sufficient information; however, only 34% had the opinion that the hospitalʼs and their own preparedness against critical IT failures were sufficient. Before the exercise took place, IT-specific emergency plans were present only in 1.7% of the hospital facilities but after the exercise in 86.7% of the clinical and technical departments. The highest resilience against cyber attacks was not surprisingly reported by facilities that still work routinely with paper-based or off-line processes, the IT department showed the lowest resilience as it would come to a complete shutdown in cases of a total IT failure. Conclusion: The authors concluded that the planning phase is the most important stage of developing the whole exercise, giving the best opportunity for working out fallback levels and workarounds and through this strengthen the hospitals resilience against cyber attacks and comparable incidents. A meticulous preparedness can minimize the severe effects a total IT failure can cause on patient care, staff and the hospital as a whole. [ABSTRACT FROM AUTHOR]

Purpose: Hospital information systems (HIS) play a critical role in modern healthcare by facilitating the management and delivery of patient care services. We aimed to evaluate the current landscape of HIS in the specialty of gynecology and obstetrics in Germany. Methods: An anonymous questionnaire was distributed via the German Society of Gynecology and Obstetrics newsletter in December 2022. The questionnaire covered the domains baseline demographic information, satisfaction with daily use, satisfaction with implementation, and degree of digitization. Results: Ninety-one participants completed the survey. Median age was 34 years; 67.4% (60 of 89) were female, and 32.6% (29 of 89) were male. Of the survey participants, 47.7% (42 of 88) were residents, 26.1% (23 of 91) senior physicians, and 9.1% (8 of 88) medical directors. The degree of digitization of clinical documentation is mainly mixed digital and paper-based (64.0%, 57 of 89) while 16.9% (15 of 89) operate mainly paper-based. The current HIS has been in use on average for 9 years. The median number of different software systems used in daily routine is 4. About 33.7% (30 of 89) would likely or very likely recommend their current HIS to a colleague. Conclusions: The current landscape of HIS in gynecology and obstetrics in Germany is characterized by a high heterogeneity of systems with low interoperability and long service life; thus, many healthcare professionals are not satisfied. There is both a need to enhance and an interest in modernizing the technological infrastructure to meet today's requirements for patient care. [ABSTRACT FROM AUTHOR]

This paper investigates the Maximum Acquisition Values (MAVs) of weeding robots and their determinants in both organic and conventional sugar beet farming in Germany. The MAV is defined in this paper as the price of the weeding robot that renders the same net profit as the current weeding methods. For our analysis, a Monte Carlo simulation approach is used, combined with empirical data and data collected from weeding robot companies. The results show that the MAVs of mechanical weeding robots for organic farming are substantially higher than that of spot spraying robots for conventional farming. Technology attributes are more influential than labour cost in determining the MAVs of weeding robots: in organic farming, technology attributes such as area capacity and weeding efficiency impact the MAVs of mechanical weeding robots the most; in conventional farming, supervision intensity and the robot's ability to save herbicides are the most influential factors. The wage rate of unskilled labour, relevant for manual weeding, plays a more important role in determining the MAVs than that of skilled labour, relevant for supervision of the robot. This implies that a shortage of seasonal workers and hence increases in the wage of low-skilled labour could be important drivers of the adoption of mechanical weeding robots. Plot characteristics such as plot size and mechanisation level only have limited impacts on the MAVs. [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]

Increasing residential mobility is said to challenge existing social support systems as mobility raises geographic distances between family members. Since family social support is essential for health and well-being, this study investigates whether residential mobility affects familial social support following changes in proximity to family and kin. By applying a stepwise linear regression on data from the German Socio-Economic Panel study, this paper is looking at variations between different residential mobility trajectories regarding social support provision and spatial proximity to family members in Germany over a 10-year period. Our findings show that people who are moving within Germany are receiving significantly more social support from their family and kin, while internationally mobile respondents receive less compared to non-mobile people. Mediation analyses show that proximity to family and kin are accounting for the negative effect of international mobility on social support but cannot explain the positive effect of internal migration. [ABSTRACT FROM AUTHOR]

Purpose: This paper reports on the first evaluation of infertility counselling in Germany. Methods: Sixty-nine infertility counsellors provided feedback via 524 survey sheets and 182 questionnaires were filled in by clients. Results: The results show a high level of satisfaction on behalf of the clients. They valued the emotional support, information, and exploration of family-building options with and without medical assistance and the counsellors' expertise. During counselling, coping with the emotional burden of infertility was an important issue, but in more than half of all counselling sessions, future parental issues were addressed. The group of clients seeking support can be described to be very heterogeneous, and counselling issues comprise a wide range of aspects. Conclusions: This piece of research suggests that the following issues need to be considered to improve infertility counselling. Better integration of counselling in infertility clinics, more awareness for infertility counselling for other medical and non-medical professions Better funding for counselling so that its uptake is not dependent upon the financial resources of clients Awareness for new groups of clients and counselling issues such as single and transgender individuals, co-parenting families There is a need for more research and the development of counselling concepts. [ABSTRACT FROM AUTHOR]

This paper addresses the challenges and solutions in developing a holistic prevention mobile health application (mHealth app) for Germany's healthcare sector. Despite Germany's lag in healthcare digitalization, the app aims to enhance primary prevention in physical activity, nutrition, and stress management. A significant focus is on user participation and usability to counter the prevalent issue of user attrition in mHealth applications, as described by Eysenbach's 'law of attrition'. The development process, conducted in a scientific and university context, faces constraints like limited budgets and external service providers. The study firstly presents the structure and functionality of the app for people with statutory health insurance in Germany and secondly the implementation of user participation through a usability study. User participation is executed via usability tests, particularly the think-aloud method, where users verbalize their thoughts while using the app. This approach has proven effective in identifying and resolving usability issues, although some user feedback could not be implemented due to cost-benefit considerations. The implementation of this study into the development process was able to show that user participation, facilitated by methods like think-aloud, is vital for developing mHealth apps. Especially in health prevention, where long-term engagement is a challenge. The findings highlight the importance of allocating time and resources for user participation in the development of mHealth applications. [ABSTRACT FROM AUTHOR]

This paper addresses the challenges and solutions in developing a holistic prevention mobile health application (mHealth app) for Germany's healthcare sector. Despite Germany's lag in healthcare digitalization, the app aims to enhance primary prevention in physical activity, nutrition, and stress management. A significant focus is on user participation and usability to counter the prevalent issue of user attrition in mHealth applications, as described by Eysenbach's 'law of attrition'. The development process, conducted in a scientific and university context, faces constraints like limited budgets and external service providers. The study firstly presents the structure and functionality of the app for people with statutory health insurance in Germany and secondly the implementation of user participation through a usability study. User participation is executed via usability tests, particularly the think-aloud method, where users verbalize their thoughts while using the app. This approach has proven effective in identifying and resolving usability issues, although some user feedback could not be implemented due to cost-benefit considerations. The implementation of this study into the development process was able to show that user participation, facilitated by methods like think-aloud, is vital for developing mHealth apps. Especially in health prevention, where long-term engagement is a challenge. The findings highlight the importance of allocating time and resources for user participation in the development of mHealth applications. [ABSTRACT FROM AUTHOR]

Since 2019, a global increase in patients presenting with functional Tourette-like behaviors (FTB) has been observed. This has been related to the exposure of tic-related content in social media, although other factors seem to further fuel this phenomenon. Recently, we, therefore, proposed the term mass social media-induced illness (MSMI) as, in our opinion, this phenomenon constitutes a new type of mass sociogenic illness (MSI) that is in contrast to all recent outbreaks spread solely via social media. In accordance with this hypothesis, we were able to identify the host of the German YouTube channel "Gewitter im Kopf" ("Thunderstorm in the brain") as the initial virtual index case. The purpose of this paper is to present clinical characteristics of a sample of 32 patients diagnosed with MSMI-FTB compared to a large sample of patients with Tourette syndrome (TS) and other chronic tic disorders (CTD) (n = 1032) from the same center in Germany indicating clinical factors helpful to distinguish between tics in TS/CTD and MSMI-FTB. Our main findings were: in patients with MSMI-FTB compared to those with TS/CTD we found (i) a significantly higher age at onset, (ii) a significantly higher rate of females, (iii) a significantly higher rate of obscene and socially inappropriate symptoms, (iv) a significantly lower rate of comorbid ADHD, and (v) a significantly lower rate of OCD/OCB. In contrast, rates of comorbid anxiety and depression as well as reported frequencies of premonitory urges/sensations and suppressibility of symptoms did not differ between groups. [ABSTRACT FROM AUTHOR]

This paper investigates the changes in time use, working conditions and subjective time wealth during the COVID-19 pandemic in Germany. Our analysis draws on panel data collected before and during the first lockdown among 786 employees. It employs a recently developed scale on time wealth which has been suggested as a comprehensive measure to capture the subjective experience of time. We provide separate analyses according to gender and essential occupation. First-difference regressions are applied to examine how changes in time use and changes in working conditions during the lockdown affected subjective time wealth. Our results show a general growth in time wealth during the lockdown which is, among other factors, driven by a decline in work hours and an increase in sleep duration. We also find positive effects on time wealth from decreased time pressure at work, more autonomy in organising one's working day, and an improved reconciliation of work and private life. This study contributes to existing research by identifying key aspects how to improve time wealth among employees. [ABSTRACT FROM AUTHOR]

Fire detection and fire alarm systems (FDAS) have the function of warning people swiftly of the hazards of a fire and thus permitting rapid rescue, protecting material assets (particularly where unattended), ensuring operational processes, and preventing fires from spreading, i.e. ensuring early and effective firefighting. In attaining these objectives, installed FDAS contribute substantially to fire protection. In this context, automatic fire detectors have the function of detecting fires early, swiftly and reliably. Fire detectors are sensor systems and form part of a wider safety system. They are exposed to numerous environmental conditions specific to their use and, like other socio-technical systems, undergo natural ageing processes which limit their service lifespan. Owing to the numerous risks that arise when a fire detector fails or its function is impaired, the continuous serviceability of a FDAS must be ensured. This requires controlled replacement of fire detectors. In some countries, this is ensured by standards. This paper explains the need for controlled replacement of fire detectors and the associated causes and effects, with reference to the example of Germany and the provisions of DIN 14675-1. The paper explains, in terms of practical relevance and with reference to examples, the basic concept of preventing possible failure of a technical safety system in order to assure its protective function in the event of a hazard occurring, together with the range of essential causes and effects. [ABSTRACT FROM AUTHOR]

The ongoing demographic change in most developed countries consists of two coinciding independent developments that differ in structure and persistence: A slow, monotonic and (presumably) permanent longevity effect caused by an increasing life expectancy; and a more rapidly changing, non-monotonic and less permanent cohort effect caused by fluctuations in the size of cohorts. This paper shows the longevity effect has a positive impact on the rates of return households generate within a pay-as-you-go (PAYG) pension system. The cohort effect, by contrast, results in winners and losers in PAYG systems. The paper additionally shows that the type of PAYG pension system alters the results significantly. Taking the remarkable demographic change in Germany as an example, a large-scale overlapping generation model quantifies rates of return within the PAYG pension system for every cohort. The results show that the two effects combined cause return differentials of almost 1.3 percentage points between generations. [ABSTRACT FROM AUTHOR]

Up-to-date management of medical emergencies implies primarily that definitive diagnoses and treatment are performed in a timely manner. These claims have been reconfirmed in 2007 by the leading German language medical associations in their 'White Paper on Emergency Treatment'. To actually realize the demands described in this paper a timely, transsectoral and close collaboration of all involved organizations is mandatory. To illustrate this race against cell death the phrase relay of survival is proposed and launched to replace the hitherto used but rigid concept of chain of survival. The tasks of each member of this relay of survival are critically scrutinized one after the other from a patient perspective. The paper presents tangible recommendations for improving the respective individual performance as well as, in particular, the cooperation and coordination between the team members which is comparable to handing over the baton in a relay race. [ABSTRACT FROM AUTHOR]

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

In this paper, I study the role of gender-typical parental occupation for young adults' gender-typical university major choice using data on a recent cohort of university students in Germany. Results show significant intergenerational associations between the gender typicality in parental occupation and young adults' majors. As to why these effects occur, findings suggest that the transfer of occupation-specific resources from parents to their children plays an important role and that a transmission of gender roles explains at least some of the father-son associations. The paper contributes to existing literature by introducing a novel measure that operationalises the extent to which majors and occupations are 'typically female' or 'typically male' and by studying different transmission channels. [ABSTRACT FROM AUTHOR]

The new psychotherapists' law in Germany requires that future studies in psychotherapy enable students to evaluate the evidence base of psychotherapeutic methods based on established criteria. This article summarizes and applies the most important national and international criteria for evaluating the evidence base of psychodynamic psychotherapy including the criteria detailed in the Methods Paper of the Scientific Advisory Board Psychotherapy in Germany, the internationally influential criteria by Chambless et al. (1998) as well as the most recent criteria by Tolin et al. (2015). Criticism of the criteria for evidence assessment (e.g., the disorder-specific approach), current controversies (e.g., concerning the evidence base of long-term psychodynamic therapy and analytic psychotherapy, integrative psychotherapy frameworks versus specific treatment approaches), and the relevance of the participation of practicing psychodynamic psychotherapists in research projects are addressed. For the adequate assessment of the efficacy/effectiveness of psychodynamic psychotherapy, especially long-term psychodynamic therapy and analytic psychotherapy, it is necessary to include longer follow-up periods and also to assess changes in accordance with psychodynamic assumptions about therapeutic change processes. [ABSTRACT FROM AUTHOR]

SEIR (Susceptible–Exposed–Infected–Recovered) approach is a classic modeling method that is frequently used to study infectious diseases. However, in the vast majority of such models transitions from one population group to another are described using the mass-action law. That causes inability to reproduce observable dynamics of an infection such as the incubation period or progression of the disease's symptoms. In this paper, we propose a new approach to simulate the epidemic dynamics based on a system of differential equations with time delays and instant transitions to approximate durations of transition processes more correctly and make model parameters more clear. The suggested approach can be applied not only to Covid-19 but also to the study of other infectious diseases. We utilized it in the development of the delay-based model of the COVID-19 pandemic in Germany and France. The model takes into account testing of different population groups, symptoms progression from mild to critical, vaccination, duration of protective immunity and new virus strains. The stringency index was used as a generalized characteristic of the non-pharmaceutical government interventions in corresponding countries to contain the virus spread. The parameter identifiability analysis demonstrated that the presented modeling approach enables to significantly reduce the number of parameters and make them more identifiable. Both models are publicly available. [ABSTRACT FROM AUTHOR]

In Germany, building codes relating to fire safety are mainly prescriptive nature. Therefore, fire safety engineering is based on a combination of expert judgment and reverse engineering of prescriptive rules. This necessitates to connect the given objectives with the detailed prescriptive rules—if not already described within the law or bylaw. This paper proposes a table relating the fire safety objectives of European building regulations and their German counterpart with the prescriptive model building code in Germany. In addition, a risk curve for prenormative work is also given. This represents the prescriptive regulations concerning in terms of fatalities of a level acceptable to society and emphasizes the lower degree of acceptance of multiple fatalities occurring in a single incident. This residual risk limit represents the opinion of German firefighting associations. Data taken from the London area supports the suggested slope rate, as the level of safety in Britain is similar to that in Germany. The table of prescriptive building regulations and their corresponding objectives aids everyday planning decisions in the context of determining adequate compensation without missing out any essential aspects, such as firefighting and firefighter safety. The proposed table forms the basis of the current discussion of a European model performance-based model building code (PBC) within the European Committee for Standardization CEN. Moreover, the risk curve is the first to be discussed in Germany that takes into consideration the societal aspect. It forms an appropriate basis for performing fire safety risk calculations based on fault tree analysis or Bayes nets. The CEN working group for fire safety engineering discusses both aspects of the current development of a European, performance-based fire safety code. It is presented here for the first time. [ABSTRACT FROM AUTHOR]

In 2017, patients aged 0-18 years accounted for about 10million medical consultations in German general practitioners' (GPs') practices compared to 26.7 million in pediatric practices. Despite this high demand in GP practices, few federal statemedical boards require a mandatory pediatric component in GP training. The aim of this paper is to outline the main reasons for children and adolescents consulting a GP, discuss the basic skills needed for physical examinations and the appropriate investigations which should be provided and to consider which symptoms should alert the GP as "red flags" requiring immediate action (e.g., dehydration, severe bacterial infections, failure to thrive). In Germany, GPs are indispensable for the primary care of children and adolescents. Thus, appropriate training in pediatricmedicine is essential to enable German GPs to be true "family doctors" caring for all ages. This article is seen as part of continuing medical education for general practitionerswho treat children and adolescents. [ABSTRACT FROM AUTHOR]

Women in academia are typically outnumbered by men, a phenomenon metaphorically known as "the leaky pipeline." This study contributes by showing a motherhood penalty in the career pipeline at the postdoctoral stage in Germany—that is, during habilitation. Based on CV information and an email survey, the paper examines which factors are associated with being awarded a habilitation and whether these factors differ between women and men as well as mothers and fathers. Using Cox regressions of retrospective career trajectories of almost all psychologists at German universities in 2019 (2527 scientists with 37,423 publications), the study shows that SSCI/SCIE articles and having a PhD from abroad increase the habilitation risk more strongly for women and mothers than for men and fathers. Net of career factors observed by CVs, however, mothers have a 42% significantly lower habilitation risk. [ABSTRACT FROM AUTHOR]

A cornerstone of well-being research is that the resource-rich are happier with their lives than the resource-poor and better positioned to cope with stressful life events. This paper addresses the role of various resources—human, economic, social, and psychological capital—in life satisfaction during the coronavirus pandemic, using panel data from Germany and the United Kingdom for 2020 and 2021. Cross-sectionally, we find life satisfaction to be clearly related to all these forms of capital, with psychological capital being the strongest predictor of life satisfaction. Longitudinally, the capital endowments in 2020 did not predict changes in life satisfaction within individuals from 2020 to 2021, except for psychological capital. Our results suggest two things: first, the unfolding pandemic did not heighten well-being inequalities; and second, weathering the pandemic required psychological resources in the first place. [ABSTRACT FROM AUTHOR]

Purpose: This paper presents the results of the first joint survey on the use of SPECT and PET myocardial perfusion imaging (MPI) and cardiac amyloidosis imaging in Austria, Germany, and Switzerland of the year 2021. Methods: A questionnaire was sent in 2022 to centres practicing nuclear medicine. Results: Data from 14 Austrian (10,710 SPECT), 218 German (133,047 SPECT), and 16 Swiss centres (11,601 MPI (6,879 SPECT, 4722 PET)) were analysed. In Austria and Germany, the PET MPI numbers were close to zero and not considered. Official MPS numbers from 2015 to 2021 from Austria and Germany revealed a decline in Austria by about 40% in the pandemic years 2020 to 2021, but an increase in Germany by 9%. Ambulatory care cardiologists represented the major referral group (56–71%). Mostly, stress tests were performed pharmacologically (58–92%). Contrary to Germany, a 1-day protocol was predominant (58–97%) in Austria and Switzerland. The leading camera systems were SPECT-CT in Austria and Switzerland (57–79%) and multi-head systems in Germany (58%). Switzerland had the highest proportion of SPECT MPI with attenuation correction (84%), followed by Austria (43%), and Germany (33%). Electrocardiogram-gated SPECT MPI showed an overall high penetration of 87–99%. Scoring was most frequently applied in Germany (72%), followed by Austria (64%), and Switzerland (60%). Related to the population, the number of cardiac amyloidosis imaging was highest in Austria, followed by Switzerland and Germany. Conclusions: This first joint survey of 2021 shows considerable differences among the countries. The Swiss situation is outstanding due to the wide use of PET MPI. In terms of camera equipment, Switzerland is also leading, followed by Austria and Germany. Despite the differences in procedural issues, the results reveal an overall high standard of MPI imaging. [ABSTRACT FROM AUTHOR]

The paper presents the findings of two recent books on the financial history of the Frankfurt School: Jeanette Erazo-Heufelder, Der argentinische Krösus: Kleine Wirtschaftsgeschichte der Frankfurter Schule, 2017, and Bertus Mulder, Sophie Louisa Kwaak und das Kapital der Unternehmerfamilie Weil. Ein Beitrag zur Wirtschaftsgeschichte der Frankfurter Schule, 2021 (Dutch original 2015). In contrast to the "court histories" of the school, the two authors tell the story of the money that brought the school to life and secured its existence throughout a turbulent period of history. At the center of the books are individuals who have been sidelined until now or even completely ignored by the literature on the Frankfurt School: on the one hand, Felix Weil, who founded and financed the Institute of Social Research and, on the other hand, Erich A. Nadel and Sophie L. Kwaak, two employees of the holding company who managed the accounts of the Weil family and the Institute's foundations and were responsible for protecting the assets from being seized by Nazis. The books' thick descriptions induced the author of the present paper to consider an alternative perspective on the Frankfurt School by contemplating Max Horkheimer and Friedrich Pollock as playing confidential games with Weil and others. [ABSTRACT FROM AUTHOR]

Mental health home treatment is a service where patients with severe mental illnesses are visited by a multiprofessional psychiatric care team at their homes. In Germany, inpatient-equivalent home treatment as a specialized form of home treatment has been offered by hospitals since 2018. In its early stage, the shift of care activities out of the hospital toward the patient's home opened up a new set of problems and blurred the existing boundaries. This ethnographic study follows two home treatment teams and provides an in-depth description of their work. The findings are presented by three themes from our data analysis: (i) closeness and familiarity; (ii) bridging the distance; and (iii) tensions of proximity and distance. We then discuss the findings with the guiding lens of Becoming a Guest, which refers to the ambiguity of proximity and distance. The contribution for computer-supported cooperative work (CSCW) is twofold; on the one hand, we provide a detailed account of mental health home treatment, and on the other hand, we outline a conceptual model that helps to describe and analyze similar cases. We conclude the paper with directions for further research. [ABSTRACT FROM AUTHOR]

Based on anthropological fieldwork among protesters against the Covid policy in Germany, this paper elaborates the symmetry of accusations made against each other by proponents and opponents of the state-imposed protection measures against the backdrop of an asymmetrical distribution of power. The social dynamics that emerged during the pandemic are often understood as the result of a knowledge controversy that most participants thus categorize as a media problem. A key finding of my research on protests against the German Covid policy is that, as in my research on the controversy over mediumism, the controversy is about the agency of human and nonhuman actors and carried out to a great extent based on the same values on both sides, which at the same time accuse each other of not conforming to these values. The protesters are part of a heterogeneous minority that in large parts embodies the values of the majority and, in a way, exceeds them, i.e., a minority that is hypercritical and has extreme expectations about the values of the majority society – in this case: of solidarity, science, transparency, rationality, and coherence. From its marginal position, the minority develops a canny eye for the unfulfilled promises of the majority: its contradictions and conscious or unconscious double standards are perceived as bigotry against the backdrop of the aspiration to absence of contradiction. Therefore, this minority suspects that the motivations and goals behind the measures taken are other than just the protection of health, while the majority in turn see the minority's commitment to society and democracy as (self-)deception and also suspect hidden motives and actors behind it. This mutual suspicion leads to a hysterical state of doubt and distrust, which is rooted in the nature of mediality. [ABSTRACT FROM AUTHOR]

SEIR (Susceptible–Exposed–Infected–Recovered) approach is a classic modeling method that is frequently used to study infectious diseases. However, in the vast majority of such models transitions from one population group to another are described using the mass-action law. That causes inability to reproduce observable dynamics of an infection such as the incubation period or progression of the disease's symptoms. In this paper, we propose a new approach to simulate the epidemic dynamics based on a system of differential equations with time delays and instant transitions to approximate durations of transition processes more correctly and make model parameters more clear. The suggested approach can be applied not only to Covid-19 but also to the study of other infectious diseases. We utilized it in the development of the delay-based model of the COVID-19 pandemic in Germany and France. The model takes into account testing of different population groups, symptoms progression from mild to critical, vaccination, duration of protective immunity and new virus strains. The stringency index was used as a generalized characteristic of the non-pharmaceutical government interventions in corresponding countries to contain the virus spread. The parameter identifiability analysis demonstrated that the presented modeling approach enables to significantly reduce the number of parameters and make them more identifiable. Both models are publicly available. [ABSTRACT FROM AUTHOR]

Purpose: The WHO 2016 re-classification of myeloproliferative neoplasms resulted in a separation of essential thrombocythemia (ET) from the pre-fibrotic and fibrotic (overt) phases of primary myelofibrosis (MF). This study reports on a chart review conducted to evaluate the real life approach regarding clinical characteristics, diagnostic assessment, risk stratification and treatment decisions for MPN patients classified as ET or MF after implementation of the WHO 2016 classification. Methods: In this retrospective chart review, 31 office-based hematologists/oncologists and primary care centers in Germany participated between April 2021 and May 2022. Physicians reported available data obtained from patient charts via paper–pencil based survey (secondary use of data). Patient features were evaluated using descriptive analysis, also including diagnostic assessment, therapeutic strategies and risk stratification. Results: Data of 960 MPN patients diagnosed with essential thrombocythemia (ET) (n = 495) or myelofibrosis (MF) (n = 465) after implementation of the revised 2016 WHO classification of myeloid neoplasms was collected from the patient charts. While they met at least one minor WHO-criteria for primary myelofibrosis, 39.8% of those diagnosed with ET did not have histological BM testing at diagnosis. 63.4% of patients who were classified as having MF, however, did not obtain an early prognostic risk assessment. More than 50% of MF patients showed characteristics consistent with the pre-fibrotic phase, which was emphasized by the frequent use of cytoreductive therapy. Hydroxyurea was the most frequently used cytoreductive medication in 84.7% of ET and 53.1% of MF patients. While both ET and MF cohorts showed cardiovascular risk factors in more than 2/3 of the cases, the use of platelet inhibitors or anticoagulants varied between 56.8% in ET and 38.1% in MF patients. Conclusions: Improved histopathologic diagnostics, dynamic risk stratification including genetic risk factors for cases of suspected ET and MF are recommended for precise risk assessment and therapeutic stratification according to WHO criteria. [ABSTRACT FROM AUTHOR]

Black people and People of Color are disproportionately affected by racism and show increased rates of psychosis. To examine whether racialized migrant groups are particularly exposed to racism and therefore have higher risks for psychosis, this paper (1) systematically assesses rates of psychosis among racialized migrant groups concerning the country of origin, and (2) analyzes interviews regarding the association of racism experiences with psychosis-related symptoms in racialized Black people and People of Color populations in Germany. We present an umbrella review of meta-analyses that report the incidence of positive symptoms (e.g., hallucinations and delusions) and negative symptoms (e.g., apathy and incoherent speech) of diagnosed schizophrenia, other non-affective psychotic disorders (e.g., schizoaffective disorder) or first-episode psychosis among migrants by country of origin. We also report 20 interviews with first- and second-generation migrants racialized as Black and of Color in Germany to capture and classify their experiences of racism as well as racism-associated mental health challenges. In the umbrella review, psychosis risk was greatest when migration occurred from developing countries. Effect size estimates were even larger among Caribbean and African migrants. In the qualitative study, the application of the constant comparative method yielded four subordinate themes that form a subclinical psychosis symptomatology profile related to experiences of racism: (1) a sense of differentness, (2) negative self-awareness, (3) paranoid ideation regarding general persecution, and (4) self-questioning and self-esteem instability. We here provide converging evidence from a quantitative and qualitative analysis that the risk of poor mental health and psychotic experiences is related to racism associated with minority status and migration. [ABSTRACT FROM AUTHOR]

Shallow-seismic full-waveform inversion (FWI) provides an effective way for the accurate reconstruction of near-surface models. The common 2D shallow-seismic FWI inverts either individual Rayleigh or Love waves, and the joint FWI of Rayleigh and Love waves can further improve the reliability of the result. Conventionally, FWI is formulated as a single-objective inverse problem and is solved with deterministic optimization algorithms. It suffers from a relatively high level of ill-posedness and high computational cost, which are two of the main problems that FWI faces. Recently, a random-objective waveform inversion (ROWI) method is proposed to mitigate these problems. ROWI reformulates waveform inversion as a multi-objective inverse problem and solves it with a stochastic optimization algorithm. The multi-objective framework and the stochastic nature provide ROWI relatively high freedom in searching for the optimal model and therefore improve its robustness against the poor initial model. In this paper, we perform a comprehensive comparison between the performance of shallow-seismic FWI and ROWI for the reconstruction of near-surface models. We compare their performance in the scenario of individual inversion of Rayleigh wave, individual inversion of Love wave, and joint inversion of both wave types. Besides, we also compare their effectiveness when using good and poor initial models. Synthetic examples of a highly heterogeneous model show that ROWI is more efficient and more robust than FWI in both individual and joint inversions. The individual ROWI of Love wave can reconstruct the model more efficiently than Rayleigh wave if a good initial model is available, and the other way around if a poor initial model is provided. The joint inversion, in both FWI and ROWI, outperforms the individual inversion of a single wave type. In both individual and joint inversions, ROWI is more efficient in reducing model error and more robust against the poor initial model than FWI. We also compare the performance of ROWI and FWI by using field data sets acquired in Rheinstetten, Germany. The results show that when a good initial model is available, both FWI and ROWI can nicely reconstruct the main structure of the subsurface model. The validity of the reconstructed model is proved by comparing it to a migrated ground-penetrating radar profile. ROWI can consistently reconstruct the model to a good level even when using a poor initial model, while the individual and joint FWIs fail to work when the initial model is poor. It confirms the relatively higher efficiency and robustness of ROWI than FWI in the reconstruction of near-surface models. [ABSTRACT FROM AUTHOR]

Purpose: To extend knowledge about measurement equivalence of depression measures assessed by tablet and paper-pencil administration, the present study evaluated the effect of mode of administration (MoA) on scale and item level for the Patient Health Questionnaire (PHQ-9) and the Aachen Depression Item Bank (ADIB) in elderly patients.Methods: Primary care patients (N = 193, ≥60 years) were assessed following a crossover design in Leipzig, Germany. All participants filled out the PHQ-9 and the ADIB in both MoAs under study. Effects of MoA were analyzed by intra-class correlation, mixed-effects regression, and differential item functioning (DIF). Additionally, detection rates between both MoAs were compared using receiver operating characteristics analysis compared to a diagnostic interview (SCID-I, N = 163).Results: No effect of MoA was found in the PHQ-9 on scale score or item level. Two ADIB items showed DIF according to MoA. In terms of discriminatory power, MoA did not influence detection rates of both instruments.Conclusions: In summary, our findings suggest that no severe effect of mode of administration on self-report assessments of depression should be expected. It can be concluded that tablets provide a valid way to electronically assess depressive symptoms in elderly patients. Yet changes in item presentation can influence the psychometric properties and require equivalence testing using sophisticated analyses on item level such as DIF. [ABSTRACT FROM AUTHOR]

Universities have increasingly been subjected to policy- and industry demands to produce multi- and interdisciplinary knowledge. This paper explores the extent to which different higher education policy instruments are used to promote interdisciplinarity in teaching and research at universities in the German higher education system comparing them across different federal states. Based on a manifest content analysis of higher education laws and performance agreements with universities in the 16 German states, we were able to distinguish between three types of states: Those a) with a general use of policy instruments aimed at all universities in a state, whereas considerable differences could be observed with regard to the degree of coercion (enabling versus prescriptive provisions) and scope (teaching or research), b) a directed use of policy instrument, targeting specific universities, and c) a hybrid use of policy instruments using both general and directed elements. This paper provides a novel mapping of the promotion of interdisciplinarity in German higher education policies through a variety of policy instruments and hereby contributes to the extant literature on interdisciplinarity in higher education. [ABSTRACT FROM AUTHOR]

The genus Taxus (yew) is a source of a number of high-value medicinal substances, particularly, paclitaxel (taxol)—a complex diterpenoid compound with a powerful antitumor action (trade name of Taxol®). Paclitaxel is one of the most efficient drugs in chemotherapy owing to its specific ability to suppress proliferation of tumor cells via stabilization of their microtubules. The world-wide demand for taxol is 800–1000 kg a year and these figures annually rise by 20%. The growing need for paclitaxel and its derivatives and the shortage of plant resources necessary for their production made compounds of the taxane group one of the most important objects for development of biotechnological methods of their production. Out of all the possible ways of taxol production (isolation from wild or plantation trees, total chemical synthesis or semisynthesis, use of yew cell cultures, techniques of metabolic engineering, and use of yew endophytic fungi), the most promising is industrial cultivation of Taxus spp. cell cultures. This review examines the papers dealing with investigation of secondary metabolism in dedifferentiated cells in vitro of various yew species and feasibility of industrial use of cell cultures for production of taxoids. We revealed a number of specificity of Taxus spp. cell cultures: (1) from a cytophysiological aspect—difficult initiation of cell cultures, their low growth characteristics, specific media and culturing conditions; (2) from a phytochemical aspect—distinction from intact plants in qualitative composition and content of secondary metabolites accounted for by specificity of cell culture as a biological system; predominant formation of С14-hydroxylated rather than of С13-hydroxylated taxoids; an opportunity for elevation of the content of taxoids—including commercially valuable ones (paclitaxel and baccatin III) with the aid of different tools (elicitation, stress exposures, two-phase cultivation and some others); (3) from a biotechnological aspect—possibility of industrial cultivation of yew cell cultures; existence of several successful industries (Germany and the Republic of Korea). [ABSTRACT FROM AUTHOR]

Criminological research on COVID-19 and its repercussions on crimes, criminals and law enforcement agencies is still in its infancy. This paper fills that void with regard to the influence of COVID-19 on organized crime and the work of law enforcement agencies' investigations of organized crime in Germany by presenting empirical findings from a nationwide qualitative interview study. Through the methodological combination of Grounded Theory and Situational Analysis, we find three central narratives (us vs. them, nationalization vs. internationalization, conservatism vs. innovation) that were provided by law enforcement personnel in terms of the way in which COVID-19 influenced both organized crime groups and their work in the investigation thereof. Following a reflexive approach, the implications of COVID-19 on the research process itself are also discussed. [ABSTRACT FROM AUTHOR]

This paper explores Twitter adoption and social media engagement of private German environmental foundations. The study follows Lovejoy and Saxton's (2012) approach to the hierarchy of social media engagement. It demonstrates the domination of an information provision role on Twitter and the almost equal relevance of action mobilizations and community building posts. At the same time, the study supplements the existing typology with the additional dimension of communication partners addressed in each type of tweet. Finally, using data from interviews, the study interprets and explains the role of social media tweets and patterns of engagement with different groups. In-depth analysis of tweets and interviews with the foundation representatives confirmed a limited use of social media as a means for dialogue and community development. Simultaneously, analysis shows that tweets posted by foundations predominantly address a professional community of other civil society actors, experts and politicians, creating an online expert bubble. Interviews confirmed that such online connections mirror offline cooperation networks that are perceived to be more important for successful communication and project development by the investigated organizations. [ABSTRACT FROM AUTHOR]

Purpose: This paper summarises the results of 4 national surveys on the numbers, utilisation and technique of myocardial perfusion SPECT (MPS) from 2012 to 2021. Methods: A one-page questionnaire for information on MPS in 2012, 2015, 2018 and 2021 was sent to German centres practising nuclear medicine. To check for representativeness, the numbers obtained were related to official annual data and furthermore to the numbers of invasive coronary angiography procedures (ICA). Results: MPS examinations increased by > 40% from 2012 to 2021 and showed a centralisation with increasing MPS per centre. In 2020, a mild impact of the COVID-19 pandemic could be observed in the form of only a slight MPS increase, which was compensated in the following year. Outpatient care cardiologists represent the most important referrer (70%). Mostly, 2-day protocols were used. One-day protocols and stress-only protocols showed insignificant changes. The use of exercise stress decreased steadily. In 2021, exercise stress was replaced by pharmacological stress as the most frequent stress modality. Camera systems showed a shift to more SPECT-CT systems. The use of gated SPECT increased to almost 90%. Quantitative scoring showed an increasing acceptance. The ratio of invasive coronary angiographies (ICA) to MPS was between 3.9 and 4.5. A significant proportion of ICA in the context of CCS (chronic coronary syndrome) was performed without prior testing for ischaemia. Conclusion: The 2012 to 2021 MPS surveys reveal a continuously growing number of examinations with only a mild temporary effect of the COVID-19 pandemic and a centralisation with increasing numbers per centre. Performance and technical data reveal a high-grade adherence of MPS practice to the current ESC guideline. A large potential of non-invasive diagnostics remains for the future. [ABSTRACT FROM AUTHOR]

Backgound: Headache disorders are not only among the most prevalent, they are also among the most disabling disorders worldwide. This paper investigates the association between headache impact on daily life and the socioeconomic status (SES) of headache sufferers. Methods: Data stem from a random general population sample in Germany. Respondents who reported having headache for at least a year and were aged ≥ 18 years were included in the study. A standardized questionnaire addressing headache and headache treatment was filled in during the face-to-face survey. The impact of headache on daily life was measured using the German version of the Headache Impact Test (HIT-6). Results: Higher headache impact was found in low and medium SES compared to high SES. After adjustment for sociodemographics, headache-related factors (analgesic use, headache duration, headache frequency, migraine diagnosis), depressive symptoms, physical inactivity and obesity, an increased odds ratio of having higher headache impact in low SES compared to high SES was found: OR = 1.83, 95% CI [1.43, 2.23], p =.014. When the interactions "SES*obesity", "SES*depressive symptoms", and "SES*physical inactivity" were added, the results showed a significant interaction effect of "SES*obesity". Obese persons with low SES were 3.64 times more likely to have higher headache impact than non-obese persons with low SES. No significant differences between obese and non-obese persons were found in the medium and high SES groups. Conclusions: SES is an important factor that should not be neglected in headache awareness campaigns and headache treatment. Longitudinal studies are needed in the future to investigate whether lifestyle interventions, such as weight reduction, can help to reduce headache impact in people in lower SES. [ABSTRACT FROM AUTHOR]

Since the 1990s, Albania has recognized human dignity as one of the main constitutional principles. However, the national medical jurisprudence regarding informed consent has not been developed as in other Western European Countries. Germany is one of the countries that has a long tradition of protecting human dignity in patient-physician relations.This contribution studies the German law on informed consent to medical treatment, Gesetz zur Verbesserung der Rechte von Patientinnen und Patienten of February 2013 through the application of a case-law study. This law, which codifies the national courts' decisions, highlights the ethical principle of autonomy. In other words, in the absence of a solid national medical jurisprudence, this paper investigates the possibility that Albanian judges could apply the legal arguments of their German colleagues since in the case of case-law study there is an absence of political interference, which can better demonstrate the ethical principle of autonomy and the right to self-determination. [ABSTRACT FROM AUTHOR]

Risk assessment in operative medicine is a key aspect for patient safety. The aim of this paper is to outline the degree of dissemination of a standardized procedure for risk analysis, process-oriented risk analysis, at German university hospitals. Process-oriented risk analysis represents a standardized procedure for the analysis of adverse events within the framework of clinical risk management. In this study, 262 full professors of German university hospitals were surveyed in November 2020 regarding the use of this instrument. The response rate was 17%. The analysis showed that 29% of the respondents already introduced the process-oriented risk analysis in their department. Further, 97% of the respondents were willing to standardize clinical processes with regard to patient safety. Moreover, 95% of the respondents said that a risk analysis and the resulting implementation of new procedural measures were important. It could be shown that the readiness for the procedural consideration of clinical processes with regard to patient safety is 92%. Currently, there is a lack of scientific evidence on the effectiveness and efficiency of the process-oriented risk analysis which is why further studies are needed to achieve a comprehensive understanding of this tool. [ABSTRACT FROM AUTHOR]

Anisotropic fast-marching algorithms are computationally efficient tools for generating realistic maps of karst conduit networks, constrained by both the spatial extent and the orientation of karstifiable geologic units. Existing models to generate conduit network maps are limited either by high computational requirements (for chemistry-based models) or by their inability to incorporate the effects of elevation and orientation gradients (for isotropic fast-marching models). The new anisotropic fast-marching approach described here provides a significant improvement, though it imitates rather than reproduces actual speleogenetic processes. It can rapidly generate a stochastic ensemble of plausible networks from basic geologic information, which can also be used as input to karst-appropriate flow models. This paper introduces an open-source, easy-to-use implementation through the Python package pyKasso, then describes its application to a well-mapped geologically complex long-term study site: the Gottesacker alpine karst system (Germany/Austria). Groundwater flow in this system is exceptionally well understood from speleological investigations and tracer tests. Conduit formation primarily occurs at the base of the karst aquifer, following plunging synclines. Although previous attempts to reproduce the conduit network at this site yielded implausible network maps, pyKasso quickly generated networks faithful to the known conduit system. However, the model was only able to generate these realistic networks when the inlet-outlet connections of the system were correctly assigned, highlighting the importance of pairing modeling efforts with field tracer tests. Therefore, a model ensemble method is also presented, to optimize field efforts by identifying the most informative tracer tests to perform. [ABSTRACT FROM AUTHOR]

Students from a lower socioeconomic background have a higher risk of dropping out of higher education. The underlying mechanisms of this association between socioeconomic background and higher education dropout are not well understood. Previous research in higher education has followed Tinto's model of academic and social integration to explain dropout but has largely neglected social inequality therein. In contrast, social stratification research draws on rational choice theory to explain social inequality in educational attainment but has rarely been applied to explain dropout from higher education. In our paper, we combine these two strands of research. Utilizing data from the National Educational Panel Study (NEPS), we draw on a largescale, representative sample of students in Germany to quantify the relative contribution of each theoretical approach for explaining social inequality in dropout from higher education. Binary logistic regression models reveal that both students' integration and costs-benefit considerations are associated with their dropout risk net of each other. While academic and social integration appears to better predict dropout, rational choice theory accounts for a larger proportion of social inequality therein. We conclude that combining Tinto's model and rational choice theory provides a more comprehensive perspective of dropouts from higher education and social inequality therein. [ABSTRACT FROM AUTHOR]