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This paper discusses key themes of the 15th biennial conference of the Association for Language Awareness (2020), with a focus on increasing digital engagement in language education. The COVID-19 pandemic occasioned an abrupt transition to emergency remote language teaching and learning (ERLTL) worldwide. The ALA 2020 conference was also affected by this transition; originally planned as a located conference in Geelong, Australia, it was eventually held online, a first in ALA's conference history. The current paper engages with contemporary debates of language teaching and learning in two ways. Firstly, it traces recent discussions by presenting key findings from five papers given at the conference, and secondly, via a scoping review of literature focusing on critical lessons from the pandemic regarding language teaching and learning. The review captures recent research from the Australasian region. Key debates identified in the literature include the needs of teachers and learners during the transition to online learning, and how student engagement was affected. The literatures highlight that both educators and students have been developing new practices in teaching and learning resulting from the shift to online and blended modes, which may continue to shape language education and new pedagogies in the future.

From 2014 to 2022, the BMBF has funded five research networks in prevention research and health promotion that are also jointly coordinated (Research Network Primary Prevention and Health Promotion, www.fp2g.net). The researchers have produced a large number of relevant research outputs with insights gained into essential aspects of prevention research and health promotion. The networks research focused on basic principles, application-relevant findings, and implementation conditions of long-term prevention and health promotion for non-communicable diseases (NCDs). The constraints imposed by the pandemic from 2020 onwards were partly addressed by integrating Corona-related research and transfer activities. The importance of resilience for dealing with multiple health and social challenges got increased attention and was analyzed and discussed during the pandemic. For prevention research, research questions such as how to better implement prevention measures through digital tools are gaining additional importance. Together, the research networks have presented achievements and desiderata for future research. This perspective paper with its nine theses formulated in conclusion is intended as a stimulus for discussion among funders as well as the communty of researchers on the subject of successful prevention and health promotion. It is explicitly part of the continuity of the memoranda on prevention research developed in 2012., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

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.

The discussion paper "Institutionalization of Teacher Education" was developed within the framework of the QLB-Camp and aims to establish institutional standards for teacher education in central scientific institutions. There are no institutional standards for teacher education in Germany, and the diversity of teacher education leads to problems and challenges. The Quality Initiative for Teacher Education has brought about positive changes, but there is uncertainty about how the created structures can be sustained and legally secured. The text describes various key points for the institutionalization of teacher education, including anchoring it in state higher education laws and promoting scholars in subject didactics and educational sciences. Teacher education institutions should regularly evaluate their measures and the development of teacher education students. [Extracted from the article]

Abstract: Aims: In the scientific community no consensus exists regarding the question whether excessive smartphone use (ESU) should be considered as a behavioral addiction. This position paper summarizes relevant aspects of previous research on ESU with respect to content and methodology. From this, recommendations are derived as to which approaches should be given greater consideration in future research work. Conclusions: Our recommendations include the following points: 1. Development and consistent use of smartphone-based measuring instruments that allow the collection of real-time usage data and the submission of time-controlled questionnaire, 2. Validation of these instruments in large representative samples in Germany, 3. Using real-time smartphone user data to address the question whether ESU can become addictive in nature, 4. Clarification of the central question of the extent to which ESN is specific (i. e., use of specific smartphone functions such as social networks) or generalized (in terms of a behavioral pattern of general smartphone overuse). In the long term, further studies on the neurobiology and long-term stability of ESN should be carried out before the classification of ESN as a behavioral addiction can be recommended. [ABSTRACT FROM AUTHOR]

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  MRI is attractive for the guiding and monitoring of interventional procedures due to its high intrinsic soft tissue contrast and the possibility to measure physiologic parameters like flow and cardiac function. Method  The current status of interventional MRI for the clinical routine was analyzed. Results  The effort needed for the development of MR-safe monitoring systems and instruments initially resulted in the application of interventional MRI only for procedures that could not be performed by other means. Accordingly, biopsy of lesions in the breast, which are not detectable by other modalities, has been performed under MRI guidance for decades. Currently, biopsies of the prostate under MRI guidance are established in a similar fashion. At many sites blind biopsy has already been replaced by MR-guided biopsy or at least by the fusion of MR images with ultrasound. Cardiovascular interventions are performed at several centers for ablation as a treatment for atrial fibrillation. Conclusion  Interventional MRI has been established in the clinical routine for a variety of indications. Broader application can be expected in the clinical routine in the future owing to the multiple advantages compared to other techniques. Key points   · Due to the significant technical effort, MR-guided interventions are only recommended in the long term for regions in which MRI either facilitates or greatly improves the intervention.. · Breast biopsy of otherwise undetectable target lesions has long been established in the clinical routine. Prostate biopsy is currently being introduced in the clinical routine for similar reasons. Other methods such as MR-guided focused ultrasound for the treatment of uterine fibroids or tumor ablation of metastases represent alternative methods and are offered in many places.. · Endovascular MR-guided interventions offer advantages for a number of indications and have already been clinically established for the treatment of children with congenital heart defects and for atrial ablation at individual centers. Greater application can be expected in the future.. Citation format · Barkhausen J, Kahn T, Krombach GA et al. White Paper: Interventional MRI: Current Status and Potential for Development Considering Economic Perspectives, Part 1: General Application. Fortschr Röntgenstr 2017; 189: 611 - 623., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (© Georg Thieme Verlag KG Stuttgart · New York.)

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.

Competing Interests: Im Folgenden sind die Interessenerklärungen als tabellarische Zusammenfassung dargestellt. Siehe Tab. 2 im Anhang.

The development and application of digital interventions in health-related topics are gaining momentum in health service research. Digital interventions are often complex and need to be evaluated and implemented in complex settings. Due to their characteristics, this poses methodological challenges for health services research that have to be identified and addressed. Hence, the Working Group on Digital Health of the German Network for Health Services Research (DNVF) has prepared a discussion paper. This paper discusses methodological, practical and theoretical challenges associated with the development and evaluation of digital interventions from the perspective of health services research. Possible solutions are suggested and future research needs to address these methodological challenges are identified., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background and Objectives: In March 2020, the WHO declared the SARS-CoV-2 corona virus a pandemic which caused a great disruption to global society and had a pronounced effect on the worldwide supply of blood., Materials and Methods: In 2022 an on-line meeting was organised with experts from Austria, Canada, Germany, Greece, Netherlands and United States to explore the opportunities for increasing preparedness within blood systems for a potential future pandemic with similar, or more devastating, consequences. The main themes included the value of preparedness, current risks to the blood supply, supply chain vulnerabilities, and the role of innovation in increasing resiliency and safety., Results: Seven key recommendations were formulated and including required actions at different levels., Conclusion: Although SARS-CoV-2 might be seen as a unique event, global health risks are expected to increase and will affect blood transfusion medicine if no preparedness plans are developed., (© 2022 International Society of Blood Transfusion.)

The methodological challenges of evaluating digital interventions (DI) for health services research are omnipresent. The Digital Health Working Group of the German Network for Health Services Research (DNVF) presented and discussed these challenges in a two-part discussion paper. The first part addressed challenges in definition, development and evaluation of DI. In this paper, which represents the second part, the definition of outcomes, reporting of results, synthesis of evidence, and implementation are addressed as methodological challenges of DI. Potential solutions are presented and the need to address these challenges in future research are discussed., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

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.)

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]

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.

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.)

This paper presents a physical input-output table (PIOT) that shows the complete wood and paper flow through the economic system of Germany. The PIOT illustrates the wood and paper flow between different sectors and to different types of final use. It can be used both as a monitoring instrument and for scenario analysis. The hypothetical extraction method is applied in order to assess inter-industry linkages and single out key industries. Despite the wide variety of wood-based products and the versatile use of wood, it turns out that there is a surprisingly linear organization of the production system when it comes to the flow of wood and paper through Germany (“throughput economy”). [ABSTRACT FROM AUTHOR]

The inpatient care of children after ENT surgery is organized heterogeneously across Germany. In this statement, the working group on Pediatric ENT comments a national survey on the status quo of child care after ENT interventions in German hospitals. The statement should serve as a basis for further interdisciplinary discussion., (© 2022. The Author(s).)

Goals for health and health care are an indispensable basic requirement for a functioning health care system. The dilemma of the German health care system is that it has not been designed in a planned way, but that it has grown historically. In recent years, it has developed through the free play of forces into what it is today. The OECD characterizes the current state as follows: The costs of the German health system do not correspond to the often only average health outcomes for the population. To meet the legal requirements (especially SGB V §§ 12, 27 and 70), health care/the health system in Germany needs concrete goals. An orientation towards health care goals entails measures on all levels of health care: on the macro level (overall system/total population), on the meso level (subdivided according to regions, specific population groups, etc.) as well as on the micro level (patients and health care providers). Based on national and international experiences, this position paper of the DNVF e.V. (German Network for health services research) shows the potential of how operationalised health care targets can ensure effective, affordable and high-quality health care. The coalition agreement of the current government propagates a reorientation with patient-related health care goals. Now it is important to derive concrete and realisable goals from this declaration of intent and to involve all important groups in the process. In addition, values and ethical standards for implementation shall be agreed upon in this process. The Health Ministry (BMG) should facilitate and promote the process of societal will-building for the definition of national health care goals. This requires a clear political will. As a result, the National Health Care Goals are available at the end of the process, which are published and maintained together with evidence-based facts as well as valid and resilient data in a Manual "National Health Care Goals". The operational responsibility for implementation could lie with the newly to be founded Federal Institute of Public Health, as already announced in the agreement of the governing coalition. The DNVF is willing to actively participate in the development of health care targets., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)

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]

A corrigendum has been issued for an article titled "Observational study on the neonatal outcome during the COVID-19 pandemic in Germany" published in Acta Paediatrica. The corrigendum addresses typing errors in Table 1, specifically related to the numbers of live births, stillbirths, and perinatal complications. The errors have been rectified in the updated version of the table, and the calculations and scientific conclusions of the article remain unchanged. The authors have provided their contributions to the study, and a graph (Table S1) is included. [Extracted from the article]

Paper and board recycling is now a central issue in papermaking. Understanding of material flows, as a part of the total production chain, as well as, fibrous and non-fibrous component flows needs further clarification. These flows are studied at a European level, with special focus on Germany and Sweden. Non-fibrous components are discussed in terms of a material which hampers the processing of paper and board. Resource-efficiency improvements, in conjunction with economic benefits, are sought and recycling has been able to fulfil both of these. The main drivers to maximize the use of recovered paper in paper and board manufacturing, have been improved over the last decades. These drivers are cost, environmental image and good technical properties to be used as raw material. The increased recycling rate has reduced the quality of the collected paper, produced recycled paper, and replaced virgin pulp. Also, recycling as a process, like deinking, produces large amounts of waste material that has challenges to find proper utilization. These problem areas are addressed in this paper, too. One focus area in the analysis of statistical information is an estimation of the share of non-fibrous components and fibre volumes of paper in Europe (EU) for the year 2010. [ABSTRACT FROM AUTHOR]

(1) Background: The main basis for the public recognition of the merits of scientists has always been the system of scientific publications and citations. Our goal is to identify and analyze the most cited articles in the Public, Environmental & Occupational Health category. (2) Methods: We searched the Web of Science for all articles published in the "Public, Environmental & Occupational Health" category up to March 2022 and selected the 100 most cited articles. We recorded the number of citations, the journal, the year of publication, quartile, impact factor, institution, country, authors, topic, type of publication and collaborations. (3) Results: 926,665 documents were analyzed. The top 100 had 401,620 citations. The journal with the most articles was the Journal of Clinical Epidemiology and the one with the highest number of citations was Medical Care. The year with the highest number of articles in the top 100 was 1998. The country with the highest percentage of publications was the USA and the most productive institution was Harvard. The most frequent keywords were bias, quality, and extension. The largest collaboration node was between the USA, Canada, Germany, Spain, Australia, France, and Sweden. (4) Conclusions: This bibliometric study on Public, Environmental & Occupational Health provides valuable information not only to identify topics of interest in the analyzed category, but also to identify the differences in the topics they study.

This brief introduction summarizes and gives the biographical context of Roger Money-Kyrle's 1934 paper "A psychological analysis of the causes of war". It also contextualizes his interest in the interplay between the psychological mechanisms operating within the individual, the society and groups and his personal experience with Germany in between and after two catastrophic wars.

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]

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

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, 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.

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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.)