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Objective: Short-term RCTs have demonstrated that MPH-treatment significantly reduces ADHD-symptoms, but is also associated with adverse events, including sleep problems. However, data on long-term effects of MPH on sleep remain limited. Methods: We performed a 2-year naturalistic prospective pharmacovigilance multicentre study. Participants were recruited into three groups: ADHD patients intending to start MPH-treatment (MPH-group), those not intending to use ADHD-medication (no-MPH-group), and a non-ADHD control-group. Sleep problems were assessed with the Children's-Sleep-Habits-Questionnaire (CSHQ). Results: 1,410 participants were enrolled. Baseline mean CSHQ-total-sleep-scores could be considered clinically significant for the MPH-group and the no-MPH-group, but not for controls. The only group to show a significant increase in any aspect of sleep from baseline to 24-months was the control-group. Comparing the MPH- to the no-MPH-group no differences in total-sleep-score changes were found. Conclusion: Our findings support that sleep-problems are common in ADHD, but don't suggest significant negative long-term effects of MPH on sleep.

A general framework is developed using routine German diagnosis‐related group (G‐DRG) accounting data to estimate carbon footprints of hospital care pathways in the context of patients with acute decompensated heart failure (ADHF) admitted to the Red Cross Hospital Bremen in 2018. Financial activity data encompass G‐DRG material costs from hospital accounting data submitted to the Institute for the Hospital Remuneration System. A set of seven greenhouse gases (GHGs) is included. Environmentally extended input–output emission factors (EFs) compiled by Eurostat are employed. EFs of cost modules are calculated separately considering respective emissions' intensities. Total emissions reach 72,652 kg carbon dioxide equivalent (CO2e) (nonbiogenic: 85.5%; biogenic: 14.5%) for general inpatient care throughout ADHF patient care pathways in 2018. Emissions from normal wards account for the largest proportion (74.8%) of total emissions for ADHF patients. Compared to other matched industry categories, cost‐types covered by the industry category D "electricity, steam and air conditioning supply" cause the vast majority (approximately 87%) of total emissions. GHG emissions per unit of analysis, per bed day, and per euro are estimated at 263, 32, and 0.31 kg CO2e, respectively. Although this framework is currently limited to hospitals that participate in the G‐DRG calculation scheme or apply these accounting standards on a voluntary basis, it has particular advantages that render it amenable to other contexts. It enables the calculation of emissions separately for each cost module considering its specific emission intensity, which can improve the accuracy of estimates. [ABSTRACT FROM AUTHOR]

Background: Most studies on health-related quality of life (HRQoL) in chronic kidney disease (CKD) focus on patients with end-stage kidney disease although they represent a small proportion of patients with CKD. We aimed to analyze HRQoL according to glomerular filtration rate (GFR) categories in a population-based sample of adults living in Germany. Methods: Data from the German health interview and examination survey conducted from 2008 to 2011 were used. Participants with valid interview and examination data aged 40–79 years were included (n = 5,159). Serum creatinine levels were used to calculate estimated GFR via the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. We classified kidney function in GFR categories according to the Kidney Disease Improving Global Outcomes Initiative (KDIGO) guidelines on CKD: G1 (high): ≥90 mL/min/1.73 m2, G2 (normal): 60–89 mL/min/1.73 m2, G3a (mildly decreased): 45–59 mL/min/1.73 m2, G3b (moderately decreased): 30–44 mL/min/1.73 m2, G4/5 (severely decreased/end-stage kidney disease): <30 mL/min/1.73 m2. HRQoL was evaluated with the Short Form Health Survey (SF-36). Different multivariate linear and logistic regression models were used to analyze the association of HRQoL with GFR categories. Results: Overall, 5.9% had a GFR <60 mL/min/1.73 m2 (corresponding to categories G3a, G3b, and G4/5). Compared to category G2 linear regression showed a decline in physical HRQoL in categories G3a (−2.34, p = 0.004), G3b (−5.37, p = 0.009), and G4/5 (−4.82, p = 0.117). No decline in mental HRQoL was detected with increasing GFR categories. Categories G3a to G4/5 were significantly associated with a low perceived general state of health (G3a: odds ratio [OR] = 2.03, p = 0.001; G3b: OR = 3.01, p = 0.009; G4/5: OR = 8.70, p = 0.016) when compared to category G2. Conclusion: In a representative sample of adults living in Germany, both physical HRQoL and the perceived general state of health are already significantly reduced in category G3a. [ABSTRACT FROM AUTHOR]

Summary: Reduced adherence after heart transplantation increases the risk for acute rejection. Therefore, the aim of this study was to evaluate the patient's satisfaction with outpatient care and quality of life (QOL) after pediatric and adult heart transplantation. Observational study after pediatric (n = 22) and adult (n = 65) heart transplantation and the parents of the pediatric patients (n = 22) to evaluate the patients' satisfaction with outpatient care and QOL. Established standardized questionnaires were used for patient satisfaction (ZAP survey) and QOL (SF36); the latter was compared with the cohort of the BGS98 survey (BGS98 cohort). ZAP score: excellent results with almost all values >80. QOL: pediatric cohort showed significantly higher values in physical functioning (P = 0.041) and role physical (P = 0.003) but significantly lower values in the sub‐scale general health (P = 0.02) compared to adult cohort. In comparison with BGS98 cohort, children showed almost similar results, whereas adult cohort showed worse values in physical and emotional functioning, but higher values regarding general health. The QOL of patients after pediatric heart transplantation is comparable to a standardized reference population in Germany, whereas adult patients show reduced physical and emotional functioning, but better values regarding general health. The patients' satisfaction with the outpatient care is very high. [ABSTRACT FROM AUTHOR]

Questions: Mountain grasslands can be strongly affected by extreme droughts such as those related to climate change. What are the impacts of extreme droughts on community composition, diversity, Ellenberg indicator scores and species groups in oligotrophic montane Nardus grasslands, and what are the associated mechanisms of vegetation change? Location: Rhön Mountains, Germany. Methods: Over three consecutive years, we investigated the effects of yearly droughts (April–August) in an experimental setup with rainout shelters. Owing to the coincidence of ambient extreme dry conditions in those years and our artificial rainfall reduction, we evaluated the contribution to community change of ambient drought conditions and the treatments. We analysed changes in community composition by applying redundancy analysis to species differences in comparison with the pretreatment year, and used mixed‐effects models to test for changes in community‐weighted means of Ellenberg indicator scores, sociological and functional groups. Results: We found significant changes in species abundance and community structures in response to drought. Evenness increased, but species richness remained rather stable over time. Ellenberg indicator scores for temperature and nitrogen increased, whereas the score for moisture decreased. Simultaneously, dominant species declined and subdominants increased. Changes occurred with a time lag and were driven largely by the high ambient drought level and less by the artificial treatments. Conclusions: Our results show that drought‐related changes in community composition in Nardus grasslands occur across community structures, characteristic species, and species groups. The post‐drought recovery of the community is shaped by community filters, which in particular allow subdominants to take advantage of newly available niches in the matrix, even if they lack strong drought tolerance. Our findings indicate a certain resilience of the community to droughts related to climate change, which suggests that the observed changes should not lead to an accelerated short‐term decline in these grasslands, but that this cannot be excluded in the long term. [ABSTRACT FROM AUTHOR]

Agricultural intensification has led to dramatic losses of species and associated ecosystem services. In the European Union, agri‐environment schemes (AESs) have been developed to mitigate these challenges. There are two opposing AES strategies, targeting either production or non‐production areas. Organic farming focuses on production and conservation on the same land‐use area, whereas flower strips adjacent to crop fields are in favour of intensified conventional production combined with conservation strips outside the cultivated area.We investigated pest and natural enemy abundances of organic farming versus establishing flower strip in 10 agricultural landscapes in Central Germany along a gradient of mean field size (1.24–6.78 ha). We focused on three winter wheat fields per landscape: conventional field (control), conventional field with adjacent flower strip and organic field. We sampled crop pests such as cereal leaf beetles (CLBs) and cereal aphids as well as their natural enemies.Our results indicated that the abundance of CLB larvae was more than two times higher in conventional farming with and without flower strip than that in the organic farming. The abundance of natural enemies was supported by landscapes with small mean field size, that is their numbers increased c. threefold when field size decreased from 7 to 2 ha.Aphid abundance was lower in organic fields and conventional control fields than in conventional fields with flower strips suggesting a potential disservice of flower strips. Parasitoids and natural enemies benefited from flower strips, but they were obviously not able to control the aphids.Synthesis and applications. The major pests in cereals, aphids and CLBs infested organic farming less than flower strips along conventional fields. However, the abundance of natural enemies of pests benefited from flower strips and, in addition, from decreasing field size in agricultural landscapes. Hence, enhancing predator populations for more effective biological pest control may be best with decreasing field sizes combined with organic farming and flower strips. Altogether, organic farming might contribute much more to low pest damage than a conventional farming strategy with flower strips. [ABSTRACT FROM AUTHOR]

The German labour market policy regime constitutes a reliable supporting pillar of the highly productive German employment system. Due to the most recent reforms, its core principle of status protection – a basic norm of the German middle-class-related model of social protection for the population of working age – is losing its formative character. Our analysis focuses on three separate policy principles that form the guiding logic of status centredness, namely the equivalence in security provision, the mechanisms that protect the socio-economic status in the event of unemployment, and the tripartite mode of funding. We argue that the ‘Hartz Reforms’ have reinforced the logic of the legal modifications since the mid-1990s, cumulating now in a shift away from the middle-class-oriented status-centred approach of social security provision. [ABSTRACT FROM PUBLISHER]

We assessed the dynamics in the prevalence of children with congenital heart disease (CHD) and Down syndrome in Germany with regard to phenotype, severity, and gender. Data from patients with CHD and Down syndrome born between 1980 and 2014 were analyzed, who are registered with the German National Register for Congenital Heart Defects. One thousand six hundred eighteen CHD patients with Down syndrome were identified. The prevalence of children born with both Down syndrome and CHD was constant from 2005 to 2009 but increased from 2010 to 2014. Regarding CHD groups, complex and simple lesions have become more equal since 2005. The number of simple lesions with shunt has a peak prevalence in the period of 2010-2014. Atrioventricular septal defect was the most common CHD phenotype, but temporal changes were found within the group of CHD phenotypes over the observation period.Conclusion: Our findings suggest a growing number of CHD and Down syndrome, which may be the result of improved medical management and progress in educational, social, and financial support. This development is noteworthy as it adds new aspects to present discussions in the media and political settings. What is known: • Congenital heart disease is regarded to be the most important clinical phenomenon in children with Down syndrome, due to its significant impact on morbidity and mortality. • New developments in prenatal diagnostic and therapy management of congenital heart disease continue to influence the number of patients diagnosed with congenital heart disease and Down syndrome. What is New: • This study provides essential data giving the first overview of the dynamics in the prevalence of congenital heart disease and Down syndrome over an extended length of time up to 2015 in a large patient cohort, taking recent developments into account. • Our data suggest a growing prevalence of congenital heart disease and Down syndrome, which may be the result of improved medical management for Down syndrome patients and progress in educational, social, and financial support for their families; this development is noteworthy as it adds new aspects to the present discussion in the media and political settings. [ABSTRACT FROM AUTHOR]

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Purpose: Toxic reactions to local anesthetics are rare but potentially lethal. In fact, animal studies and case reports demonstrate that the administration of lipid emulsions after initializing cardiopulmonary resuscitation is a promising treatment option. The aim of this study was to determine how many hospitals in Germany are prepared to treat toxic reactions to local anesthetics with lipid infusion and to identify how often and what type of toxic reactions occur and if treatment was successful. Further, we aimed to elucidate if current guidelines lead to more immediate availability of lipid emulsions in direct proximity to the room where regional anesthesia is performed.Methods: A standardized survey was sent to 1,305 German hospitals. The main question was whether lipid emulsions are readily available and if published guidelines contributed to this availability. Additionally, we asked whether local anesthetic toxicity had already successfully been treated by lipid emulsions and what type of symptoms were treated.Results: We received replies from n = 509 (39%) hospitals. In 338 (66%) of the responding hospitals, lipid emulsions are readily available. Hospitals with standard operating procedures (SOPs) implemented according to published guidelines have lipids significantly more often immediately available than hospitals with just SOPs (chi-square test of independence, p-value < 0.01). Of all responding hospitals 287 (56%) have implemented a SOP for the treatment of toxic reactions to local anesthetics and 196 (39%) of the hospitals introduced the SOP because of the guidelines. In 28 (6%) of the hospitals, local anesthetic toxicity had already caused cardiac arrest with subsequent cardiopulmonary resuscitation in at least one patient. In 132 (26%) hospitals, local anesthetic toxicity had already been treated by infusing lipid emulsions. Of these hospitals 128 (96%) state this therapeutic approach was successful. Treatment with lipid emulsions was performed frequently after prodromal symptoms 83 (63%) were witnessed.Conclusions: The majority of surveyed German hospitals are prepared to treat toxic reactions to local anesthetics and published guidelines contributed to this preparedness. The infusion of lipid emulsions is a promising measure to deal with toxic reactions to local anesthetics. Since toxic reactions to local anesthetics are potentially lethal, it seems desirable that lipid emulsions are generally available in routine clinical practice. Currently, the treatment of toxic reactions to local anesthetics is mostly performed in situations (e.g. treatment of prodromal symptoms) that are not recommended by current guidelines. Further research is necessary to better define the future use of lipid emulsions in routine clinical practice. [ABSTRACT FROM AUTHOR]

Background: Polypharmacy has become an emerging public health issue in recent years, since use of multiple medications or polypharmacy is beneficial for many conditions, but may also have negative effects like adverse drug reactions. The risk further increases in patients with chronic renal failure, a comorbidity very frequent in nursing home residents. Since more than 50 % of all drugs were renally excreted, dose adjustments in patients with renal failure are required. Objective: To assess polypharmacy in German nursing homes, in particular in residents with renal failure. Methods: Multi-center cross-sectional study in 21 nursing homes in Bremen and Lower Saxony/Germany. Baseline data were analysed using descriptive statistics. Multivariable logistic regression model and 95 % confidence intervals were used to study the association of renal failure and polypharmacy. Results: Of all 852 residents, the analysis comprised those 685 with at least one serum creatinine value so that the estimated creatinine clearance could be calculated. Of those, 436 (63.6 %) had a severe or moderate renal failure, defined as estimated creatinine clearance <60 mL/min. Polypharmacy (5-9 drugs) was found in 365 (53.3 %) and excessive polypharmacy (≥10 drugs) in 112 (16.4 %) residents. Diuretics and psycholeptics were the most commonly used drug classes. Severe renal failure (estimated creatinine clearance <30 mL/min) was associated with polypharmacy (OR: 2.8, 95 % CI 1.4-5.7). Conclusion: Both, polypharmacy and renal failure are common in German nursing home residents and an association of both could be found. Further studies are needed to assess the appropriateness of polypharmacy in these patients. [ABSTRACT FROM AUTHOR]

The author discusses U.S. foreign policy regarding the Muslim Brotherhood political organization, describes the U.S. and German relations with Islamic groups throughout the 20th century, and argues that full disclosure of Germany's possible accommodation of Islamic extremism will not occur unless German government records are made available by the West German foreign intelligence service BND. Topics include the relationship between Muslim Brother Said Ramadan and the U.S. Central Intelligence Agency (CIA), the book "A Mosque in Munich: Nazis, the CIA, and the Rise of the Muslim Brotherhood in the West," by Ian Johnson, and the book "A Mosque in Germany: Nazis, Intelligence Services, and the Rise of Political Islam in the West" by Stefan Meining.

Direct job creation has long been a classic instrument of labour market policy, pursuing a number of potential goals. Recently in Germany, policies of this type have come under growing pressure. This is partly due to the increasingly scarce resources available for job creation measures. Taken together with the continual policy reforms of the past few years and the growing pressure on public employment agencies to promote measures of non-subsidized labour market inclusion, this means that the area of direct job creation has come under close scrutiny and forced to justify its approach. In this article, we present our arguments for a further development of local authority concepts with a programmatic segmentation under the headings of ‘structurally effective direct job creation’ and ‘socially inclusive direct job creation’. [ABSTRACT FROM PUBLISHER]

The article discusses the role of Germany regarding the European sovereign debt crisis as of June 2012 with a focus on the responsibility of the entire euro zone to restore financial balance. Topics include Germany's violations of the Stability and Growth Pact in 2002 by creating budget deficits; the political purpose of the European monetary union; and a comparison of the economic effects after the introduction of the euro in Germany to the effects of the euro in southern European countries including Portugal, Italy, Greece, and Spain.

The article looks at the political parties and tendencies typically labeled "right-wing" in Europe as of 2012. The author argues that the right-wing label is simplistic and inaccurate. He looks at parties including the French National Front (FN) headed by Marine Le Pen, the Dutch Party for Freedom (PVV) headed by Geert Wilders, and the Vlaams Belang in Belgium. He says these parties are often lumped together with neo-Nazi groups and points out that they are mostly pro-Israel and anti-Muslim. He says grouping them together obscures their varied economic views, which extend from right to left. Topics include views of Muslim immigrants, appeals to working-class voters, and "political correctness." Also discussed are the Austrian Freedom Party (FPÖ) and German politican Michael Sarrazin.

The euroSCORE is a widely applied scoring system to estimate perioperative risk in patients undergoing cardiac surgery. It acknowledges an increased risk in women but does not apply a gender-specific weighing of individual risk indicators. We separately investigated the performance of the euroSCORE for men and women. Cardiac surgical patients operated in 2002 and 2003 (n == 1930) served as training group. Patients operated in 2004 served as validation group (n == 870). Using binary regression analysis, we developed a gender-specific model on the basis of the original euroSCORE risk indicators. The individual risk indicators were assigned gender-specific correlation coefficients. Applying ROC analysis to the validation group, the original euroSCORE performed well, with an area under curve (AUC) of 0.758, for men but poor, with an AUC 0.676, for women. After gender-specific re-weighing, ROC analysis revealed considerably improved predictive values of the modified euroSCORE. AUC for women increased to 0.755, AUC for men further increased to 0.772. The original euroSCORE failed to accurately predict perioperative mortality in women. A binary regression model, assigning a gender-specific weight to each of the risk indicators of the original euroSCORE, considerably improved the predictive power of the modified euroSCORE. [ABSTRACT FROM AUTHOR]

This essay describes the theoretical and methodological approach behind the empirical case reconstructions that are discussed in the following articles. The essay also introduces a social constructivist and biographical theoretical concept of the creation and transformation of the constructions of collective belonging before going on to develop the methodological implications. On the basis of empirical findings, this essay will discuss the enormous impact that the interaction between family stories and life stories with the historical and cultural framework has on the construction and reinterpretation of collective belongings. [ABSTRACT FROM AUTHOR]

The article discusses the use of torture against inmates and prisoners in the U.S. and Germany. A description is given of a German case in which the threat of torture was used against kidnapping suspect Magnus Gäfgen in 2002. In June 2008, the European Court of Human Rights (ECHR) cleared Germany of charges of tolerating torture in the case of Gafgen, the author states. Other topics include charges of the use of torture on detainees at the U.S. Guantánamo Bay Prison Camp located in Cuba.

The Triassic-Jurassic (T-J) boundary was one of the largest but least understood mass extinction events in the Phanerozoic. We measured bulk organic nitrogen and carbon isotopes and trace metal concentrations from a core near Mingolsheim (Germany) to infer paleoenvironmental conditions associated with this event. Poorly fossiliferous claystones across the boundary have relatively low δ15N values and low concentrations of redox-sensitive elements, characteristic of an oxic environment with significant terrestrial input. The Early Jurassic features enrichment in δ15N coincident with high redox-sensitive element concentrations, indicating an increase in water column denitrification and decreased oxygen concentrations. These redox state variations are concordant with shifts in abundance and species composition in terrestrial and marine microflora. We propose that the mass extinction at the T-J boundary was caused by a series of events resulting in a long period of stratification, deep-water hypoxia, and denitrification in this region of the Tethys Ocean basin. [ABSTRACT FROM AUTHOR]

The quality of chronic kidney disease (CKD) care and the control of CKD progression factors and of comorbid conditions according to current recommendations in primary care were investigated in this retrospective cohort study of 127 consecutive CKD patients. CKD was advanced (glomerular filtration rate 21 ± 10 ml/min). Fifty-seven per cent of patients had been evaluated to clarify CKD aetiology. Blood pressure was substantially elevated (148 ± 20/83 ± 11 mmHg) and only 39% of patients achieved target blood pressure levels. At a mean HbA1c of 6.5 ± 1.1%, glycaemic control was good in 63% of diabetics. Mean haemoglobin was 10.8 ± 1.8 g/dl, and anaemia was adequately controlled in 49%. In 42% the management of bone disease and in 80% the nutritional status was sufficient. Angiotensin converting enzyme inhibitors or angiotensin-2-receptor blockers was used in 59% of patients with diabetic nephropathy or proteinuria above 1 g/day. High-total quality of care was only achieved in 35% which suggests that the management of advanced CKD in primary care is suboptimal. [ABSTRACT FROM AUTHOR]

Features the architectural works of Daniel Libeskind, an architect from Berlin, Germany who won a competition for the reconstruction of Ground Zero of the former World Trade Center in New York City. Controversy regarding the selection of Libeskind; Information on his work on the Jewish Museum in Berlin; Structure of the master plan of Libeskind for his Ground Zero building project.

In the offshore region of Germany, human activity is increasing in type and intensity. Larger portions of the sea are sectioned off, dedicated for specific, often exclusive uses that cause rising conflicts between interests groups. One solution calls for stakeholder integration and the multifunctional use of space. This article focuses on two examples, offshore wind farms and open ocean aquaculture. It analyses their potential synergies within a co-management approach. It can be shown, that an integrated co-management strategy for offshore regions requires very different sets of rights and duties, as well as holding different types of conflicts, constrains and alliances, some of which are illustrated for the presented case study. The article closes with the conclusion that an integrated regulative framework is the most important basic precondition for a multifunctional utilisation of offshore areas and its sustainable development. [Copyright &y& Elsevier]

The impact of how the past of grandparents and parents and their way of dealing with it affect the lives of their descendants is the general empirical question of this research. Two different family groupings, based on the first generation having been categorized as victims or perpetrators during the Nazi period, are compared. We examine how family histories that differ dramatically affect the process of transmitting the family past from one generation to the next. Similarities as well as structural differences between the family dialogue of survivors' and a perpetrator's families are examined. The impact on the second and third generation is also a concern. [ABSTRACT FROM AUTHOR]

Compares the Anglo-Saxon and Rhenish versions of capitalism in Germany. Institutional structure of Rhenish capitalism; Notion of rhenanophiles on social welfare provisions; Characterization of solidarity exhibited within the Rhenish model; Correlation of the withholding of citizenship with the suppression of social welfare.

SummaryAquaculture in Germany is a small industry, practiced only in a few specifically suited areas. Marine finfish farming is almost nonexistent but mussel farming is a steady activity with a notable level of production. However, this industry is presently very restricted with no hope for expansion as regulations are stringent and new licences in both fresh and marine waters are extremely difficult to obtain. In addition to State-specific conditions within the Federation, the complexity of the regulatory framework is exemplified by focusing on some key aspects for finfish farming and by specific aspects of mussel farming activities in the Schleswig-Holstein Wadden Sea where environmental protection measures dictate the level of control, mainly as a result of the recent establishment of the National Wadden Sea Park. [ABSTRACT FROM AUTHOR]

Botulinum neurotoxin type A (BoNT/A) injections have to be administered repeatedly to achieve a rather stable, high level of improvement. This study aimed to take a look at changes in the daily routine of a BoNT/A outpatient clinic due to the SARS-CoV-2 pandemic lockdown, analyze the impact of SARS-CoV-2-induced re-injection delay on outcomes in patients with cervical dystonia (CD) (n = 36) and four other disease entities (n = 58), and study the influence of covariables, including previous injections and doses. For the present observational study, the first 100 patients who were scheduled to have an appointment between April 20 and May 18 during the partial lockdown and also had been treated regularly before the lockdown were recruited. Clinical and demographical characteristics and treatment-related data from the previous visits were extracted from charts. Time delay, symptom severity assessment, and TSUI score (if applicable) were gathered at the first coronavirus pandemic lockdown emergency visit for each patient. Of the 94 patients who could come to the clinic, 48 reported a delay and 44 reported worsening during the delay. Delays ranged from 1 to 63 days, the mean delay was 23 days, and the mean worsening was 26% compared to the previous visit. A significant correlation was found between the duration of the delay and the patient's rating of worsening (PwP). In CD patients, the physician´s rating of CD worsening by the TSUI score (ATUSI-PTSUI) was significantly correlated with general worsening (DwP) and the TSUI at the last visit (PTSUI). A small delay of a few weeks led to a similar worsening of symptoms in CD and all other disease entities and to relapse on a higher level of severity. This relapse can only be compensated by continuous treatment up to at least 1 year until patients reach the same level of treatment efficacy as that before the SARS-CoV-2 pandemic. [ABSTRACT FROM AUTHOR]

The article discusses the highlights of the 4th International Symposium on Food and Bioprocesses in Foz do Iguaçu, Brazil and the 5th International Symposium on Food Processing, Monitoring Technology in Bioprocesses and Food Quality Management in Potsdam, Germany. The first conference tackled various topics such as food technology and food engineering. The other focused on issues such as food processing, quality and bioprocesses.

Introduces a series of articles representing collaborative work of scientists on the fish ecology of the Elbe Catchment Area in Germany. Ecomorphology and hydrodynamics of fish habitats; Species diversity, age, structure abundance, habitat quality, habitat use, larval drift, fish migrations, growth, health status, and population genetics of the fish fauna in the Elbe River.

Water and sediment quality conditions in and around a cage culture unit located in Wismar Bay (Western Baltic Sea, Germany) were investigated during summer 1994 using bacterial group indicators (Enterobacteriaceae, saprophytic bacteria and Vibrio, determined on selective media). Fish were fed once daily with extruded commercial pellets. Over a period of 8 days samples were taken before and after feeding at different sampling points close to or at the cages. The results showed that a drastic (up to 10 times) increase in different bacterial groups occurred inside the cages 10 min after feeding as well as occasionally in the surrounding water. Additional electron-microscopic observations of the bacterial biofilm on the cage nets revealed that a decrease (in comparison with the original number) in total bacteria on the net materials of 9.5 up to 42.8% occurred after feeding. It was concluded that water mixing caused by frenzied swimming just before and during feeding caused a release of bacteria which were growing vigorously on the surfaces of the cage system. Since the pathogenity and hydrophobicity of bacteria are closely related, this process of redistribution of bacteria into the water column could constitute an important stress factor for fish, which could probably also have a negative effect on fish production. [ABSTRACT FROM AUTHOR]