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Purpose: As the famous linguist and anthropologist C. Hockett noted about 30 years ago, "What one sees of language, as of anything, depends on the angle of view, and different explorers approach from different directions. Unfortunately, sometimes they become so enamored of their particular approach that they incline to scoff at any other, so that instead of everybody being the richer for the variety, everybody loses. ... It is obviously impossible to see all of anything from a single vantage point. So it is never inappropriate to seek new perspectives" (Hockett, 1987, p. 1). This supplement takes such a broad perspective and contains a selection of peer-reviewed papers seeing speech production through the window of complex interactions between physical, linguistic, social, and communicative factors. Papers were presented at the 10th International Seminar on Speech Production in Cologne. We hope to encourage the reader to continue working in this exciting direction.

Unlabelled: CONSTRUCT: In this study, we examine the differences in test performance between the paper-based and the computer-based version of the Berlin formative Progress Test. In this context it is the first study that allows controlling for students' prior performance., Background: Computer-based tests make possible a more efficient examination procedure for test administration and review. Although university staff will benefit largely from computer-based tests, the question arises if computer-based tests influence students' test performance., Approach: A total of 266 German students from the 9th and 10th semester of medicine (comparable with the 4th-year North American medical school schedule) participated in the study (paper = 132, computer = 134). The allocation of the test format was conducted as a randomized matched-pair design in which students were first sorted according to their prior test results. The organizational procedure, the examination conditions, the room, and seating arrangements, as well as the order of questions and answers, were identical in both groups., Results: The sociodemographic variables and pretest scores of both groups were comparable. The test results from the paper and computer versions did not differ. The groups remained within the allotted time, but students using the computer version (particularly the high performers) needed significantly less time to complete the test. In addition, we found significant differences in guessing behavior. Low performers using the computer version guess significantly more than low-performing students in the paper-pencil version., Conclusions: Participants in computer-based tests are not at a disadvantage in terms of their test results. The computer-based test required less processing time. The reason for the longer processing time when using the paper-pencil version might be due to the time needed to write the answer down, controlling for transferring the answer correctly. It is still not known why students using the computer version (particularly low-performing students) guess at a higher rate. Further studies are necessary to understand this finding.

Background: While substantial progress has been made in the development of disease-modifying medications for multiple sclerosis (MS), a high percentage of treated patients still show progression and persistent inflammatory activity. Autologous haematopoietic stem cell transplantation (AHSCT) aims at eliminating a pathogenic immune repertoire through intense short-term immunosuppression that enables subsequent regeneration of a new and healthy immune system to re-establish immune tolerance for a long period of time. A number of mostly open-label, uncontrolled studies conducted over the past 20 years collected about 4000 cases. They uniformly reported high efficacy of AHSCT in controlling MS inflammatory disease activity, more markedly beneficial in relapsing-remitting MS. Immunological studies provided evidence for qualitative immune resetting following AHSCT. These data and improved safety profiles of transplantation procedures spurred interest in using AHSCT as a treatment option for MS. Objective: To develop expert consensus recommendations on AHSCT in Germany and outline a registry study project. Methods: An open call among MS neurologists as well as among experts in stem cell transplantation in Germany started in December 2021 to join a series of virtual meetings. Results: We provide a consensus-based opinion paper authored by 25 experts on the up-to-date optimal use of AHSCT in managing MS based on the Swiss criteria. Current data indicate that patients who are most likely to benefit from AHSCT have relapsing-remitting MS and are young, ambulatory and have high disease activity. Treatment data with AHSCT will be collected within the German REgistry Cohort of autologous haematopoietic stem CeLl trAnsplantation In MS (RECLAIM). Conclusion: Further clinical trials, including registry-based analyses, are urgently needed to better define the patient characteristics, efficacy and safety profile of AHSCT compared with other high-efficacy therapies and to optimally position it as a treatment option in different MS disease stages. Plain language summary: Autologous haematopoietic stem cell transplantation for multiple sclerosis Substantial progress has been made in the development of disease-modifying medications for multiple sclerosis (MS) during the last 20 years. However, in a relevant percentage of patients, the disease cannot completely be contained. Autologous haematopoietic stem cell transplantation (AHSCT) enables rebuilding of a new and healthy immune system and to potentially stop the autoimmune disease process for a long time. A number of studies documenting 4000 cases cumulatively over the past 20 years reported high efficacy of AHSCT in controlling MS inflammatory disease activity. These data and improved safety profiles of the treatment procedures spurred interest in using AHSCT as a treatment option for MS. An open call among MS neurologists as well as among experts in stem cell transplantation in Germany started in December 2021 to join a series of video calls to develop recommendations and outline a registry study project. We provide a consensus-based opinion paper authored by 25 experts on the up-to-date optimal use of AHSCT in managing MS. Current data indicate that patients are most likely to benefit from AHSCT if they are young, ambulatory, with high disease activity, that is, relapses or new magnetic resonance imaging (MRI) lesions. Treatment data with AHSCT will be collected within the German REgistry Cohort of autoLogous haematopoietic stem cell transplantation MS (RECLAIM). Further clinical trials including registry-based analyses and systematic follow-up are urgently needed to better define the optimal patient characteristics as well as the efficacy and safety profile of AHSCT compared with other high-efficacy therapies. These will help to position AHSCT as a treatment option in different MS disease stages. [ABSTRACT FROM AUTHOR]

Due to an increasing demand, companies have started producing recycled products. However, little is known about the specific purchase behavior. Hence, this study analyses the factors influencing purchase intention for recycled products including differences related to different types of products and between Germany and South Africa. A quantitative study in Germany (n = 603) and South Africa (n = 692). shows that purchase intention is significantly higher in South Africa. The influencing factors (individual, product, and context related constructs) are the same in both countries, but they differ regarding their strength. Thus, the factor "attitude/environmental concern" has the strongest influence in South Africa, while it is "value/accessibility" in Germany. Furthermore, purchase intention for mobile phones is generally smaller than for t‐shirts and toilet paper. Purchase intention for recycled t‐shirts is significantly higher in South Africa than in Germany. [ABSTRACT FROM AUTHOR]

The Tibetan Plateau works as an important environmental and ecological barrier for the Asian continent. The researches on Tibetan environment and ecology are becoming extensive, but there is no systematic summary of research hotspots and trends in this field. Here, we analyzed 9180 publications retrieved from the WOS and CNKI during 2000 ~ 2020. The characteristics of publication, keywords with a 5-year interval and co-occurrence analysis were carried out so as to reveal the evolution and development trends of topics. The results show that articles increase dramatically since 2012. Except for common concerns like evolution, climate change, and precipitation, diversity was been studied more by Chinese scholars, while the USA, Germany, UK, and Australia researchers focused more on adaptability, basin western Tibet, lake, barley, and ore-related themes, respectively. Besides, China closely collaborated with the USA, Australia, and Germany in topics of evolution, climate change and degradation, precipitation, and diversity. The institutions located in Chinese different economic regions focused on different research keywords, such as vegetation, growth, trace elements, and geochemistry. The CAS contributed the most articles with 4254, showed advantages both in quantity and quality. Few articles were published by researchers affiliated to Free University of Berlin but with higher citations. It is the only one institute outside of China in the top 20. Main research hotspots include climate change, geology, and diversity. In future researches, ecological management and rehabilitation of mining area and tailings ponds, waste disposal, and changes of soil and water quality are worthy of attention and funding., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Seemingly mundane bureaucratic papers – such as birth and marriage certificates – are official proof of legal identities and relations to kin, usually issued by the state of origin. For Syrians who have sought asylum in Germany, these documents are necessary during the asylum procedure and beyond, for certain bureaucratic procedures and the recording of crucial life events. Retracing the crafting of these documents in Syria, and their encounter with German bureaucracy, captures the depth of the entanglement between the Syrian and German citizenship regimes, as well as their discrepancies in relation to paperwork and legality. Drawing on ethnographic research with Syrians in Lebanon and in Germany, this article argues that the legal production of legality in Germany can only be achieved through legally ambiguous, if not so-called illegal, practices in Syria. [ABSTRACT FROM AUTHOR]

Hemp is a primary substance for papermaking, having been used for 2,000 years in this capacity. In the 20th century wood pulp came to replace hemp and other long fibres, and this has been an environmental disaster. Recent efforts to re-introduce hemp fibres into paper pulp are under way, with a number of writing papers having been manufactured in Europe and North America. However, most of these were done in small batches. Most papermills in southeast Asia produce 500,000 tons or more annually, whilst mills in the West tend to be small, specialty paper mills. Hemp is used rather consistently for fine papers, including cigarette paper and cosmetic tissue paper, but writing paper may continue to be made from trees until we run out and are forced to use other material. One large papermill in Germany, Gmund (which is distributed in the UK by The Hemp Shop) is starting to catch up, with a number of different papers including writing paper now being made in increasingly larger batches. A number of other companies are also offering hemp papers, ranging from writing paper to wallpaper. Part of the issue is the fact that the hurd, which is lower in cellulose content that the bast, can be used for paper, as demonstrated by the US government in the early 20th century. doi:10.1300/J237v12n02_08 [ABSTRACT FROM PUBLISHER]

This article presents a reanalysis of the data of 862 second and fourth graders collected in two previous studies, focusing on the influence of method (psychometric vs. chronometric) and stimulus type on the gender difference in mental-rotation accuracy. The children had to solve mental-rotation tasks with animal pictures, letters, or cube figures, either in a chronometric condition (computerized) or in a psychometric condition (paper-and-pencil). Results show a slight male advantage in mental-rotation accuracy, which is neither influenced by method nor by stimulus type. However, mental-rotation accuracy differed between the stimulus types, with the highest accuracy in animal pictures and the lowest accuracy in cube figures, and between age groups, with better performance in fourth graders than in second graders in both conditions. Results show that psychometric and chronometric mental-rotation tests with all the stimulus types are more or less similarly usable with children of that age.

Ruscio, Seaman, D'Oriano, Stremlo, and Mahalchik (this issue) evaluate 22 bibliometric indicators, including conventional measures, like the number of publications, the "h" index, and many "h" index variants. To assess the quality of the indicators, their well-justified criteria encompass conceptual, empirical, and practical issues: ease of understanding, accuracy of calculation, effects on incentives, influence of extreme scores, and validity. Although they found that some indicators are more attractive for research evaluation purposes than others, the correlation between most of the indicators is (very) high. A generally high correlation between the indicators points out a redundant contribution each to each other. Calculating a comprehensive metaanalysis, Bornmann and colleagues (Bornmann, Mutz, Hug, & Daniel, 2011) came to a very similar result: Only a few "h" index variants make a nonredundant contribution to the "h" index; most of the variants correlate very highly with the "h" index. They presented the first metaanalysis of studies that computed correlations between the "h" index and variants of the "h" index that have been proposed and discussed in the literature. Thus, the study was not about the added value of the "h" index or "h" index variants to other bibliometric indices, e.g., total number of citations. They tested whether there is a generally high (or low) correlation between the "h" index and the variants. The metaanalysis included a total of 135 different bivariate correlation coefficients between the "h" index and an "h" index variant (such as the "g" index). In total, they analyzed 37 different "h" variants. Their results show, with an overall mean value between 0.8 and 0.9, there is a high correlation between the "h" index and the "h" index variants. According to Navon (2009), "high correlations indicate that despite the differences in how the metrics are calculated, there is too much redundancy in the information they yield." Even if the "actual" correlations might be higher than those claimed in the original papers introducing the new "h"-type indices due to systematic sampling selection effects, a mean correlation coefficient of between 0.8 and 0.9 is still high and might not justify the development of more and more "h" index variants. However, not all "h" index variants have a high correlation with the "h" index. Their results indicate that some "h" index variants have been developed that have a relatively low correlation with the "h" index, and it can be assumed that they can make a nonredundant contribution to the "h" index. These variants are mainly the MII (Sypsa & Hatzakis, 2009) and the "m" index (Bornmann, Mutz, & Daniel, 2008). For evaluative purposes, then, the "h" index could be combined with these "h" index variants to better depict research performance bibliometrically. (Contains 1 table.)

2,4,7,9-Tetramethyl-5-decyne-4,7-diol (TMDD) is a non-ionic surfactant which is preferentially used as defoamer in paints and printing ink and for the treatment of surfaces. Effluents of wastewater treatment plants (WWTPs) have been identified as the domination point sources for TMDD in rivers since the removal rate of the compound in the WWTPs is in general less than 70%. However, the dominating entry pathways of TMDD into the sewage were unknown so far. In this study effluents from both, municipal WWTPs with and without treatment of indirect industrial dischargers and from industrial WWTPs with direct discharge of wastewater into receiving rivers were analyzed for the first time to identify the proportions of TMDD coming from domestic wastewater and from various industrial sources. Moreover, rivers were samples before and after the influent of sewage water from WWTPs. The TMDD concentrations in the water samples were measured using solid phase extraction (SPE) followed by gas chromatography/mass spectrometry (GC/MS). High TMDD concentrations were found in rivers (up to 63.5 μg/L), and in effluents of WWTPs (up to 310 μg/L) affected by wastewater from paper recycling industry and factories producing paint and printing ink. Concentrations of TMDD revealed to be far higher in wastewater from factories processing recycled paper (up to 113 μg/L) compared to wastewater from factories not processing recycled paper (0.066 μg/L). The results indicate that the use of recycling paper in the paper production process is the dominating reason for increased TMDD concentrations in wastewaters and receiving rivers due to the wash out of TMDD from the paper impregnated with printing ink. Very high TMDD concentrations (up to 3300 μg/L) were also detected in wastewater from a printing ink factory and a paint factory., (© 2013 Elsevier B.V. All rights reserved.)

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

The aim of the study was to describe, categorise and analyse students' (aged 14-16) processes of scientific inquiry in biology and chemistry education. Therefore, a theoretical structure for scientific inquiry for both biology and chemistry, the VerE model, was developed. This model consists of nine epistemological acts, which combine processes of scientific thinking and inquiry methods. Based on the theoretical structure, a paper-and-pencil test was developed to investigate the students' abilities in the acts of scientific inquiry. Each of the nine acts was operationalised to generate multiple-choice items. For each act, ten items were constructed. In total, ninety items per subject were tested in a field study to evaluate their psychometric quality. The article focuses on the outcomes for testing in biology. In biology, 537 students were tested with a paper-and-pencil test, following a multi-matrix design in which each student solved twenty-seven items. Data from 260 students have been analysed so far. Seventy-five items showed satisfactory item characteristics. The distribution of the items' difficulties fits the students' abilities appropriately. We conclude that theory-driven epistemological acts can be operationalised in tasks that assess students' abilities in scientific inquiry.

Since the implementation of the Excellence Initiative and the Excellence Strategy, German higher education institutions have been restructuring university governance, especially those selected as Universities of Excellence. This study uses a holistic and mission-related integrated governance approach to conduct a qualitative analysis of the governance transformation of German Universities of Excellence, aiming to provoke discussion on transforming governance to optimize organizational effectiveness and sustainable development of German higher education institutions. Transforming governance of German Universities of Excellence involves mission statements, strategic goals, institutional strategies, research, teaching, the third mission, internationalization, global engagement, governance relationships and structures, institutional leadership, funding, autonomy, innovation, digital transformation, quality assurance, and sustainable development, aiming to enhance accountability, performativity, transparency, openness and organizational effectiveness with efficient administrative management in alignment with institutional missions, vision, core values, and strategic goals.

Objective: The aim of this study was to explore the geographic distribution and number of papers published in international and Science Citation Index (SCI)-indexed cytology journals based on their country of origin., Materials and Methods: A country-based geographic analysis of studies published over a 5.5-year period from January 2016 to June 2021 in 5 cytopathology journals indexed as SCI and SCI-E with an impact factor higher than 1 (Cancer Cytopathology, Cytopathology, Diagnostic Cytopathology, Acta Cytologica, and CytoJournal) and papers categorized as "original" and "other" was performed., Results: A total of 3,063 papers were found, with 1,466 (47.8%) categorized as "original" papers and 1,597 (52.1%) designated as "other" papers. These papers were submitted from 62 different countries. The five countries with the greatest number of papers were the USA (38.4%), India (16.8%), Japan (7.4%), Italy (5.5%), and Brazil (3.1%). A general subgroup analysis was also performed on the original studies without a country breakdown. Cytomorphological, cytomorphological-immunohistochemical, and molecular assessments compose 38.5%, 45.7%, and 15% of the subgroups, respectively., Conclusion: The number of academic papers originating from developing countries in the field of cytopathology has increased in recent years. Although most scientific papers are produced in developed countries, the rate in these countries is much lower than that in some developing countries as the rate of academic growth in developed countries has stabilized. Despite the widespread and sophisticated implementation of cytology in daily practice in Western European countries outside the UK, such as Germany and the Netherlands, and in Scandinavian countries and other developed countries, such as Australia and Canada, these countries rank in the middle to lower end of countries producing cytology papers. Meanwhile, there has been an increase in the number of cytology papers published by authors from Southern European countries, such as Italy (ranked 4th) and Spain (ranked 6th), and Turkey (ranked 8th). There is a remarkable increase in cytology papers originating from Asia, particularly India, Japan, and China., Summary: We aimed to present a basic survey of the geographic distribution of manuscript submissions to high-impact cytopathology journals and to point out emerging trends in cytology utilization and basic research. However, our results show that the landscape of cytology is changing and suggest geographic regions that are ripe for the production of novel "points of view" and new research findings., (© 2022 S. Karger AG, Basel.)

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Background: A large part of the population in Germany makes use of naturopathic, complementary and integrative medical treatments. There are now numerous scientific studies that provide evidence of efficacy for certain indications. At German medical faculties, selected procedures and their application are taught within the cross-sectoral unit called QB 12 and some elective courses, with a focus on specific aspects are offered. So far, however, there has been no structured curriculum that longitudinally anchors teaching across medical studies and enables all students to consider naturopathic and complementary medical options for patient care later on and to integrate them effectively into the diagnostic and treatment process., Objective: The aim of this position paper is to show the relevance of this topic for medical education, to clarify terminology and to present core competencies and possible implementation options for training., Method: The Integrative Medicine and Perspective Pluralism Committee of the German Association for Medical Education developed this position paper in a multi-stage consensual process, in cooperation with the Forum of University Work Groups on Naturopathic Treatment and Complementary Medicine., Results: First, different umbrella terms were discussed and an existing definition of integrative medicine and health was chosen for subsequent use. Building on this step, the status of education and its scientific foundation in Germany was considered in an international context. In the next step, a competency profile for medical training, consisting of seven areas of competency, was developed and described in detail with regard to naturopathic, complementary and integrative medicine. Implementation options were identified using possible starting points in the curriculum and using established examples of best practice., Conclusion: Despite different priorities at each faculty, it was possible to find an agreement on the development of competencies and anchoring them in medical education on the basis of a common definition of terms. Currently, the implementation in the mandatory and elective areas is very heterogeneous. As part of the current revision of the Medical Licensure Act, there are many possible starting points for the integration of naturopathic and complementary medical teaching content, especially in interprofessional and general practice courses. The implementation and accompanying research of targeted teaching settings should lay the foundations for a long-term and binding integration into medical education. Overall, it is clear that medical education in the field of naturopathy and complementary and integrative medicine has the potential to develop comprehensive core medical competencies., Competing Interests: The authors declare that they have no competing interests., (Copyright © 2022 Homberg et al.)

Background: Irrespective of the great impact stroke exerts on the society as a whole and far-reaching advances in acute treatment and rehabilitation of stroke, so far outpatient services for post-stroke care have not been established on a national level in Germany., Objective and Methods: Against the background of this contemporary lack of care, in May 2020 the German Stroke Society (DSG) established the stroke aftercare commission. This position paper discusses structural models of future services addressing outpatient post-stroke care., Results and Discussion: The specialized care by a neurologist should be central to a multidisciplinary, interprofessional and transsectoral treatment. Structural concepts of post-stroke care must take regional differences but also effective strategies for quality control into account. Certification processes and appropriate financing of follow-up registries at state and federal levels may pave the way for improvement over the medium term. Structured outpatient post-stroke care services should be open to all subgroups of stroke patients. Additionally, innovative technologies can make an important contribution to post-stroke care; however, the implementation of specialized services demands adequate funding as well as separate financial incentives for the providers. The solution must carefully balance the advantages and disadvantages of the specific care and financing models. Currently the discussion of new models of post-stroke care is gaining new momentum, which opens up perspectives for the advancement of the otherwise still insufficient contemporary care structures., (© 2021. The Author(s).)

The acute treatment of stroke patients in Germany is of a very high standard, guaranteed by its system of stroke units. Stroke as a disease has an acute phase followed by a chronic phase that requires a high level of qualified aftercare given by multidisciplinary and interdisciplinary teams. In 2020, the German Stroke Society (DSG) founded a commission for long-term stroke care. The aim is to evaluate the current situation of long-term aftercare and suggest improvements for its structure. In this paper the status quo of aftercare is presented and possible deficits are identified. Contributions of various stakeholders from the German healthcare system are analyzed and different projects for post-acute care are presented. Germany has no acknowledged structured aftercare concepts for patients after stroke. The general practitioner-based care is currently the focus of patient management but without a greater, more coordinated integration of neurologists, guideline-led and quality-controlled aftercare will be harder to implement in the future. The assignment of duties and the necessary training standards for the specialist groups in order to comply with the guidelines do not exist. Besides medical health, the needs of physical, social and emotional domains are too seldom considered by a multiprofessional care team. Further developments of a regional care management concept are discussed. The results and costs of any aftercare concepts must be evaluated before widespread implementation., (© 2021. The Author(s).)

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

The article discusses the Best Paper Prize awarded by the journal Computational Optimization and Applications. The winning paper, written by Alberto De Marchi, focuses on a numerical method for convex quadratic programs (QPs), which are optimization problems with quadratic objective functions and polyhedral constraints. De Marchi's method, called QPDO, combines the proximal point algorithm and a globalized Newton-type method to solve QPs efficiently and robustly. The paper's findings have influenced the development of methods for more general problem classes and have potential applications in various fields, including control systems and data science. Alberto De Marchi is a postdoctoral researcher at the University of the Bundeswehr Munich, Germany, with expertise in computational optimization. [Extracted from the article]

Citation rates can be used as an indicator of the influence and relevance of scientific papers. The present study analyzed the 100 most-cited articles related to erosive tooth wear (ETW). The top 100 most-cited papers focusing on ETW topics were collected from the Web of Science database on November 11, 2020. The following bibliometric data were extracted from papers: title, authorship, institutions, countries, number of citations, year of publication, journal title, study design, topic, and keywords. Scopus and Google Scholar were searched to compare the number of citations. The VOSviewer software was used to generate collaborative network maps for the authors and keywords. The number of citations of the 100 most-cited papers ranged from 71 to 330 (average: 97.44). The papers were published between 1949 and 2015. Caries Research (28%) and The Journal of Dentistry (16%) presented the majority of papers. Laboratorial (44%) and observational studies (33%) were the most common study designs. The most studied topics were epidemiology (31%) and the erosive potential of substances (drinks, foods, or medicines) (22%). The countries with the highest number of most-cited papers were England (32%), Germany (18%), and Switzerland (10%). The University of Bern was the institution with the most papers (10%). Lussi A was the author with the highest number of papers in the top 100 (14%). The most common keyword was "dental erosion" with 64 occurrences. The top 100 most-cited papers related to ETW were composed mainly of laboratorial and observational studies focusing on epidemiology and the erosive potential of substances., (© 2022 S. Karger AG, Basel.)

Introduction: Multiple-choice-examinations are still fundamental for assessment in medical degree programs. In addition to content related research, the optimization of the technical procedure is an important question. Medical examiners face three options: paper-based examinations with or without computer support or completely electronic examinations. Critical aspects are the effort for formatting, the logistic effort during the actual examination, quality, promptness and effort of the correction, the time for making the documents available for inspection by the students, and the statistical analysis of the examination results., Methods: Since three semesters a computer program for input and formatting of MC-questions in medical and other paper-based examinations is used and continuously improved at Wuerzburg University. In the winter semester (WS) 2009/10 eleven, in the summer semester (SS) 2010 twelve and in WS 2010/11 thirteen medical examinations were accomplished with the program and automatically evaluated. For the last two semesters the remaining manual workload was recorded., Results: The cost of the formatting and the subsequent analysis including adjustments of the analysis of an average examination with about 140 participants and about 35 questions was 5-7 hours for exams without complications in the winter semester 2009/2010, about 2 hours in SS 2010 and about 1.5 hours in the winter semester 2010/11. Including exams with complications, the average time was about 3 hours per exam in SS 2010 and 2.67 hours for the WS 10/11., Discussion: For conventional multiple-choice exams the computer-based formatting and evaluation of paper-based exams offers a significant time reduction for lecturers in comparison with the manual correction of paper-based exams and compared to purely electronically conducted exams it needs a much simpler technological infrastructure and fewer staff during the exam.

Background and objective: The number of people suffering from dementia is increasing worldwide and so is the need for reliable and economical diagnostic instruments. Therefore, the aim of this study was to compare the processing times of the neuropsychological tests Trail Making Tests A and B (TMT-A/B) and Color-Word Interference Test (CWIT), which were performed in both digital and paper versions. Methods: The pilot study was conducted among 50 healthy participants (age 65–83 years) using a randomized crossover design. The correlations and differences in the individual processing times of the two test versions were statistically analyzed. Further research questions concerned the influence of the individual usage of technology and the technology commitment of participants as well as the influence of the assessed usability on participants' performance. Results: Between the two versions (paper-based vs. digital) statistically significant correlations were found in all tests, e.g., TMT-A r(48) = 0.63, p < 0.01; TMT-B rs(48) = 0.77, p < 0.001). The mean value comparison showed statistically significant differences, e.g., interference table (CWIT) t(49) = 11.24, p < 0.01). Correlations with medium effect were found between the differences in processing times and the individual usage of computer (e.g., rs(48) = − 0.31) and smartphone (rs(48) = − 0.29) and between the processing times of the TMT-B and the usability (rs(48) = 0.29). Conclusions: The high correlations between the test procedures appear promising. However, the differences found in the processing times of the two test versions require validation and standardization of digitized test procedures before they can be used in practice. [ABSTRACT FROM AUTHOR]

A position paper on the topic of freedom of expression and the right to access political, ideological, and religious literature in libraries is presented.

Background, Aim and Scope: The applicability of the Whole Effluent Assessment concept for the proof of compliance with the "best available techniques" has been analysed with paper mill wastewater from Germany by considering its persistency (P), potentially bio-accumulative substances (B) and toxicity (T)., Materials and Methods: Twenty wastewater samples from 13 paper mills using different types of cellulose fibres as raw materials have been tested in DIN or ISO standardised bioassays: the algae, daphnia, luminescent bacteria, duckweed (Lemna), fish-egg and umu tests with lowest ineffective dilution (LID) as test result. The potentially bio-accumulative substances (PBS) were determined by solid-phase microextraction and referred to the reference compound 2,3-dimethylnaphthalene. Usually, a primary chemical-physical treatment of the wastewater was followed by a single or multi-stage biological treatment. One indirectly discharged wastewater sample was pre-treated biologically in the Zahn-Wellens test before determining its ecotoxicity., Results: No toxicity or genotoxicity at all was detected in the acute daphnia and fish egg as well as the umu assay. In the luminescent bacteria test, moderate toxicity (up to LIDlb=6) was observed. Wastewater of four paper mills demonstrated elevated or high algae toxicity (up to LIDA=128), which was in line with the results of the Lemna test, which mostly was less sensitive than the algae test (up to LIDDW=8). One indirectly discharged wastewater sample was biodegraded in the Zahn-Wellens test by 96% and was not toxic after this treatment. Low levels of PBS have been detected (median 3.27 mmol L(-1)). The colouration of the wastewater samples in the visible band did not correlate with algae toxicity and thus is not considered as its primary origin. Further analysis with a partial wastewater stream from thermomechanically produced groundwood pulp (TMP) revealed no algae or luminescent bacteria toxicity after pre-treatment of the sample in the Zahn-Wellens test (chemical oxygen demand elimination 85% in 7 days). Thus, the algae toxicity of the respective paper mill cannot be explained with the TMP partial stream; presumably other raw materials such as biocides might be the source of algae toxicity., Discussion: Comparative data from wastewater surveillance of authorities confirmed the range of ecotoxicity observed in the study. Wastewater from paper mills generally has no or a moderate ecotoxicity (median LID 1 and 2) while the maximum LID values, especially for the algae and daphnia tests, are considerably elevated (LIDA up to 128, LIDD up to 48)., Conclusions: Wastewater from paper mills generally is low to moderately ecotoxic to aquatic organisms in acute toxicity tests. Some samples show effects in the chronic algae growth inhibition test which cannot be explained exclusively with colouration of the samples. The origin of elevated algae ecotoxicity could not be determined. In the algae test, often flat dose-response relationships and growth promotion at higher dilution factors have been observed, indicating that several effects are overlapping., Recommendations and Perspectives: At least one bioassay should be included in routine wastewater control of paper mills because the paper manufacturing industry is among the most water consuming. Although the algae test was the most sensitive test, it might not be the most appropriate test because of the complex relationship of colouration and inhibition and the smooth dose-effect relationship or even promotion of algae growth often observed. The Lemna test would be a suitable method which also detects inhibitors of photosynthesis and is not disturbed by wastewater colouration.

The effects of mental diseases on the employment and working situation can be substantial. They are one of the main reasons for inability to work and reduced earning capacity. Against this background the question arises about suitable occupational reintegration measures for people with severe mental illnesses. In recent years, the principle of supported employment has been internationally shown to be increasingly more successful. In this context mentally ill people are primarily placed at a position of the first employment market and supported on-site by a job coach. This concept is inclusive, individual and evidence based. Despite proven effectiveness, it has so far been insufficiently implemented in German-speaking regions. In the future it will be a matter of considering the individual needs for assistance of mentally ill people more intensively than previously and to respond with functional and in a best-case scenario, multiprofessional and flexible offers., (© 2021. Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

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