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This article examines whether German respondents in an interactive vignette experiment prefer immigrants who are ethno‐racially more proximate to the majority population versus whether immigrants find acceptance in German society as long as they follow the law and respect the rules and customs of society. The approach is both descriptive and experimental. The descriptive results indicate that despite liberalisation of immigration policies since 2000 there is a sizable reservoir of the German population who holds ethno‐racial attitudes. The interactive experimental approach distinguishes two treatments: race and reason for dismissal from a job of two fictitious immigrants who are applying for permanent residency in Germany. Results indicate that while German respondents react more harshly when the reason for dismissal is drug possession than race, the Black immigrant is treated with more hostility for the same infraction than the White immigrant, independently of whether the reason for dismissal from a job is being downsized or drug possession. [ABSTRACT FROM AUTHOR]

Millions of Ukrainians have been displaced by the Russian war on Ukraine, with over one million alone coming to Germany since the beginning of the war. Data from the second survey wave of the IAB-BiB/FReDA-BAMF-SOEP Survey of Ukrainian Refugees in Germany study show that as of the beginning of 2023, an increasing share of Ukrainian refugees plan on staying in Germany for the longer term. Around three quarters have found private accommodation and a similarly large share have already attended or are currently attending German language courses. Eighteen percent of the 18 to 64 year olds are employed; of the rest, over two thirds intend to start working immediately or within the next year. While almost all refugee children and adolescents of school age are attending a general or vocational school in Germany, only six out of ten children between three and six years old are attending daycare. To increase refugees' social participation and, in light of the high share of mothers among them, childcare options should be improved. This would facilitate participation in integration and language courses as well as the path to employment. In addition, it is crucial to quickly decide on the extension of Ukrainian refugees' right of residence, which is currently limited until March 2024, thus making their legal status more certain and planning possible. [ABSTRACT FROM AUTHOR]

Whereas "Dysbindin" is considered a schizophrenia vulnerability gene, there is no consistency of findings. Phenotype refinement approaches may help to increase the genetic homogeneity and thus reconcile conflicting results. Premorbid adjustment (PMA) has been suggested to aid the phenotypic dissection. Gornick et al. ("J Autism Dev Disord" 35:831-838, 2005) reported an association between "Dysbindin" and PMA in US-Caucasian individuals with childhood-onset psychosis. In a sample of 222 adult-onset schizophrenia inpatients from Germany, we could not detect an association between PMA and 36 SNPs in "Dysbindin." Our results suggest that genetic variation in "Dysbindin" may not contribute to the schizophrenia phenotype with an onset beyond childhood. Further studies including even larger samples and more SNPs may be warranted to clarify the relationship between "Dysbindin" and PMA.

The German and Australian "longitudinal" surveys analysed here are the first national representative surveys to show that (1) people who continuously own a pet are the healthiest group and (2) people who cease to have a pet or never had one are less healthy. Most previous studies which have claimed that pets confer health benefits were "cross-sectional." So they were open to the objection that owners may have been healthier in the first place, rather than becoming healthier due to owning a pet. In both countries the data show that pet owners make about 15% fewer annual doctor visits than non-owners. The relationship remains statistically significant after controlling for gender, age, marital status, income and other variables associated with health. The German data come from the German Socio-Economic Panel in which respondents have been interviewed every year since 1984 (N = 9723). Australian data come from the Australian National Social Science Survey 2001 (N = 1246).

The IAB's Sample of Integrated Labour Market Biographies (SIAB) and the Socio-Economic Panel (SOEP) are the two data sets most commonly used to analyze wage inequality in Germany. While the SIAB is based on administrative reports by employers to the social security system, the SOEP is a survey data set in which respondents self-report their wages. Both data sources have their specific advantages and disadvantages. The objective of this study is to describe and compare the evolution of wage inequality for these two types of data. For this purpose, different sample restrictions are applied. The comparison without any harmonization of the data shows different levels and trends. When the information is largely harmonized, comparable trends and similar levels emerge. [ABSTRACT FROM AUTHOR]

This study describes the first wave of the IAB-BiB/FReDA-BAMF-SOEP Survey on Ukrainian Refugees in Germany, a unique panel dataset based on over 11,000 interviews conducted between August and October 2022. The aim of the IAB-BiB/FReDA-BAMF-SOEP Survey is to provide a data-infrastructure for theorydriven and evidence-based research on various aspects of integration among Ukrainian refugees in Germany, the second most important destination country in the EU after Poland, hosting over a million people who arrived in Germany shortly after the Russian invasion of Ukraine. Based on the survey, this study also provides first insights into demographic, educational, linguistic, occupational, and social characteristics of this population. The analyses revealed that the refugee population comprised mostly young and educated individuals, with a significant proportion of females without partners and female-headed separated families. While German language skills were limited, about half of Ukrainian refugees had attended or were attending language courses. However, the integration process faced significant challenges, as the participation of children in day-care was relatively low, and the self-reported life satisfaction was markedly below the average of the German population. The study highlights the need for targeted policy measures to address such issues. Additionally, policies may aim at harnessing the high potential of the Ukrainian refugees for the German labor market. Given that a substantial proportion would like to stay in Germany permanently, policymakers should take note of these findings and aim to facilitate their long-term integration process to ensure that these refugees may thrive in Germany. [ABSTRACT FROM AUTHOR]

Pre-vaccine SARS-CoV-2 seroprevalence data from Germany are scarce outside hotspots, and socioeconomic disparities remained largely unexplored. The nationwide representative RKI-SOEP study (15,122 participants, 18–99 years, 54% women) investigated seroprevalence and testing in a supplementary wave of the Socio-Economic-Panel conducted predominantly in October–November 2020. Self-collected oral-nasal swabs were PCR-positive in 0.4% and Euroimmun anti-SARS-CoV-2-S1-IgG ELISA from dry-capillary-blood antibody-positive in 1.3% (95% CI 0.9–1.7%, population-weighted, corrected for sensitivity = 0.811, specificity = 0.997). Seroprevalence was 1.7% (95% CI 1.2–2.3%) when additionally correcting for antibody decay. Overall infection prevalence including self-reports was 2.1%. We estimate 45% (95% CI 21–60%) undetected cases and lower detection in socioeconomically deprived districts. Prior SARS-CoV-2 testing was reported by 18% from the lower educational group vs. 25% and 26% from the medium and high educational group (p < 0.001, global test over three categories). Symptom-triggered test frequency was similar across educational groups. Routine testing was more common in low-educated adults, whereas travel-related testing and testing after contact with infected persons was more common in highly educated groups. This countrywide very low pre-vaccine seroprevalence in Germany at the end of 2020 can serve to evaluate the containment strategy. Our findings on social disparities indicate improvement potential in pandemic planning for people in socially disadvantaged circumstances. [ABSTRACT FROM AUTHOR]

Food banks are returning to the spotlight as their use increases due to the coronavirus pandemic and the influx of Ukrainian refugees to Germany. The current discussion is focused on whether the food banks can handle the increasing number of users as well as the financial and organizational challenges that come with them. Until now, however, no robust, empirical data on food bank use has been available. Using Socio-Economic Panel (SOEP) data, this Weekly Report presents new findings and analyses on the number of food bank users and their socio-demographic distribution. According to the SOEP data, about 1.1 million people used food banks in the first half of 2020. A large share of users are women, people with a migration background, divorced or separated people, and the unemployed; additionally, one fourth of those who benefit from food banks are children. Food bank users also tend to be in poor health. As expected, they also have a below average net household income and accordingly, over two thirds of them are at risk of poverty. The structural causes of poverty must be addressed to ensure that food banks do not reach their limit. Increasing the standard rate for welfare benefits and providing targeted support measures for job seekers could lessen dependency on food banks. Food banks should also be professionalized, as is currently under discussion, and increasingly take on a pilot function for other support measures in the social security system. [ABSTRACT FROM AUTHOR]

The role of partisanship in the Bundesrat, Germany's second chamber designed to represent the territorial interest of the 16 Länder, has been at the centre of debates for decades. In this contribution, we revisit the topic from a novel perspective, focusing on the Bundesrat's Finance Committee, a central, but so far overlooked actor in the realm of fiscal and financial policies in the Federal Republic. Based on around 1,300 roll call votes, we are able to analyse the voting behaviour of the committee members, the 16 Länder finance ministers and senators, on a large empirical basis. We find, first, that unanimity is an important feature of decision-making, reflecting the existence of joint policy perspectives among the finance ministers and senators. Nevertheless, there is, second, no 'consensus by default' as around 40 percent of the roll call votes are contested. The W-Nominate ideal point estimation thereby provides strong evidence that partisanship instead of territorial interests accounts for the conflict. [ABSTRACT FROM AUTHOR]

Background: Acute pancreatitis (AP) is among the commonest non-malignant admission diagnoses in gastroenterology. Its incidence in Germany lies between 13 and 43 per 100 000 inhabitants and is increasing. In 2017, 24 per 100 000 inhabitants were hospitalized for chronic pancreatitis. Methods: From October 2018 to January 2019, we systematically searched the literature for original articles, meta-analyses, and evidence-based guidelines that were published in German or English between 1960 and 2018. Results: 30--50% of cases of acute pancreatitis are caused by gallstone disease, and another 30--50% are due to alcohol abuse. The diagnosis is made when at least two of the following three criteria are met: typical abdominal pain, elevation of serum lipase, and characteristic imaging findings. If those criteria are ambiguous, transabdominal sonography is indicated. The early initiation of food intake lowers the rate of infected pancreatic necrosis, organ failure, or death (odds ratio 0.44; 95% confidence interval [0.2; 0.96]). In AP, Ringer's lactate solution should be preferred for fluid resuscitation, at 200--250 mL/hr for 24 hours. Severe pain should be treated with opiates. Conclusion: The current German clinical practice guideline reflects the developments in the diagnosis and treatment of pancreatitis that have taken place over the past few years. The long-term care and monitoring of patients with complication-free pancreatitis is the responsibility of primary care physicians and gastroenterologists. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this article is to investigate the associations between submissive authoritarianism, multiculturalism, and perceived economic threat. More specifically, it explores whether the effects of multiculturalism on authoritarianism are moderated by perceived economic anxieties. Methods: An original data set was collected using the online platform Qualtrics, which consisted of a stratified sample of 1010 complete responses from a German non‐probability sample in January 2019. Results: In simple additive models, multiculturalist attitudes show a statistically significant depressing effect on authoritarianism, while economic threat significantly increases it. However, when multiculturalist attitudes are interacted with perceived economic threats, the depressing effect of multiculturalism on authoritarianism wanes. While low levels of economic threat demonstrate a statistically significant depressing effect of multiculturalism on authoritarianism, at higher levels of economic threat, this effect wanes and becomes statistically insignificant. Conclusion: This article shows that turning away from inclusionary policies may lead not only to a withering of multiculturalism but also to an increased tendency to succumb to authoritarian temptations, particularly in a climate of rising economic anxieties. [ABSTRACT FROM AUTHOR]

Families' economic wealth is a resource that can provide children with crucial advantages early in their lives. Prior research identified substantial variation of wealth levels between different family types with children from single-parent families being most disadvantaged. The causes of this disadvantage, how much the disadvantage varies between children and how the non-resident parents' wealth may potentially reduce the disadvantage remain unclear. To address these research gaps, we use data from the German Socio-Economic Panel (2002–17) to examine the level of and inequality in wealth for children from single-parent families using recentred influence function regression and decomposition analysis. We replicate earlier findings of a large wealth disadvantage for children in single-parent families. We find that the wealth disadvantage can be mainly explained with compositional differences in household income and employment characteristics. Beyond level differences, inequality between children from single-parent families is higher than for other family types and this inequality can only partly be explained by observed demographic and socio-economic characteristics. When considering the wealth of non-resident parents, the wealth disadvantage of children in single-parent families is reduced but remains substantial. JEL-codes: D31, D1, J1 [ABSTRACT FROM AUTHOR]

An International Consensus Conference (ICC) on PBM was held in 2018 to develop evidence‐based clinical and research recommendations for preoperative anaemia, red blood cell (RBC) transfusion thresholds for adults and implementation of PBM programmes. An international scientific committee (SC) defined 17 Population‐Intervention‐Comparison‐Outcome (PICO) questions for the three topics preoperative anaemia, red blood cell (RBC) transfusion thresholds for adults and PBM implementation. Based on these questions, an extensive literature search was conducted in four biomedical databases. The GRADE framework (= grading of recommendations, assessment, development and evaluation) was used to develop a systematic approach to the presentation of evidence summaries and for making clinical recommendations. Three expert panels (EP) consisting of clinicians, scientists, nurses, patient representatives and methodologists were established and used these methods to develop recommendations driven by published evidence. Out of more than 17 500 literature citations, data from 145 studies were incorporated. The expert panel for preoperative anaemia developed 4 clinical and 3 research recommendations. A strong recommendation advices early detection and management of preoperative anaemia before major elective surgery. For RBC transfusion thresholds, 4 clinical and 6 research recommendations have been formulated. Two strong clinical recommendations for RBC transfusion thresholds comprise a haemoglobin concentration of <7 g/dl for critically ill, but clinical stable adult intensive care patients independent of septic shock and <7·5 g/dl for adults undergoing cardiac surgery. For the implementation of PBM programmes, 2 clinical and 3 research recommendations were developed. Research recommendations were formulated as encouragement of new studies to answer open questions. Due to the relative paucity of strong evidence‐based answers in current publications to the 17 PICO questions, additional research, an international consensus for accepted definitions and Hb thresholds as well as clinically meaningful end‐points for clinical studies are necessary. The 2018 PBM ICC defined the current status of PBM evidence and established 10 clinical and 12 research recommendations for preoperative anaemia, RBC transfusion thresholds for adults and implementation of PBM programmes. [ABSTRACT FROM AUTHOR]

Background: Iron status has been linked with impaired glucose metabolism (IGM), type 2 diabetes mellitus (T2DM) and the metabolic syndrome (MetS), but the role of hepatic steatosis or iron overload on these associations remains uncertain. Methods: We analysed data from 2310 participants without known T2DM of the population‐based Study of Health in Pomerania (SHIP‐TREND, Germany) through logistic regression models. We tested additive and multiplicative interactions between ferritin and hepatic steatosis or iron overload. Results: Serum ferritin was positively associated with IGM (OR per 100 µg/L: 1.11 [1.01, 1.23]), T2DM (OR per 100 µg/L: 1.20 [1.06, 1.36]) and MetS (OR per 100 µg/L: 1.11 [1.02, 1.20]) in the total population as well as in participants without hepatic iron overload. However, the synergistic effect of higher ferritin concentrations and hepatic iron overload showed stronger associations with IGM and T2DM. Similarly, while ferritin was positively associated with T2DM and MetS even in the absence of hepatic steatosis, the synergistic effect of higher ferritin concentrations and hepatic steatosis showed stronger associations with IGM, T2DM and MetS. Transferrin was associated with isolated impaired glucose tolerance but not with T2DM and MetS. Conclusions: Our study suggests that ferritin may be associated with glucose metabolism disorders and MetS even in people without hepatic steatosis or iron overload. However, in individuals with higher ferritin concentrations, the presence of hepatic steatosis may indicate stronger risk for glucose metabolism disorders and MetS, while the presence of hepatic iron overload may indicate stronger risk only for glucose metabolism disorders. [ABSTRACT FROM AUTHOR]

Purpose: Due to conflicting scientific evidence for an increased risk of dementia by intake of proton pump inhibitors (PPIs), this study investigates associations between PPI use and brain volumes, estimated brain age, and cognitive function in the general population. Methods: Two surveys of the population-based Study of Health in Pomerania (SHIP) conducted in Northeast Germany were used. In total, 2653 participants underwent brain magnetic resonance imaging (MRI) and were included in the primary analysis. They were divided into two groups according to their PPI intake and compared with regard to their brain volumes (gray matter, white matter, total brain, and hippocampus) and estimated brain age. Multiple regression was used to adjust for confounding factors. Cognitive function was evaluated by the Verbal Learning and Memory Test (VLMT) and the Nuremberg Age Inventory (NAI) and put in relation to PPI use. Results: No association was found between PPI use and brain volumes or the estimated brain age. The VLMT score was 1.11 lower (95% confidence interval: − 2.06 to − 0.16) in immediate recall, and 0.72 lower (95% CI: − 1.22 to − 0.22) in delayed recall in PPI users than in non-users. PPI use was unrelated to the NAI score. Conclusions: The present study does not support a relationship between PPI use and brain aging. [ABSTRACT FROM AUTHOR]

Both wages and needs-adjusted household income increased by ten percent between 2013 and 2018, benefiting all income groups. Wage inequality has been declining for many years and has now again reached the level of the early 2000s. At the same time, the low-wage sector shrank by two percentage points. Household income inequality, in contrast, has hardly changed for many years and the low-income rate is stagnating. However, the share of people in Germany who are affected by severe material deprivation sank to a low level in a European comparison. Income inequality in Germany has declined slightly since the beginning of the coronavirus pandemic, but this is likely primarily due to incomes decreasing among the self-employed. However, the pandemic poses the risk that an increasing number of insolvencies and unemployed people will cause incomes to fall again across the board. Financial assistance for the self-employed and business owners should not be ended too early and its targeting should be readjusted. [ABSTRACT FROM AUTHOR]

We provide a concise introduction to a household-panel data infrastructure that provides the international research community with longitudinal data of private households in Germany since 1984: the German Socio-Economic Panel (SOEP). We demonstrate the comparative strength of the SOEP data in answering economically-relevant questions by highlighting its diverse and impactful applications throughout the field. [ABSTRACT FROM AUTHOR]

We examine the composition of augmented household wealth (i.e., the sum of net worth and pension wealth) in the United States and Germany. Pension wealth makes up a considerable portion of household wealth, of about 48 percent in the United States and 61 percent in Germany. When pension wealth is included in household wealth, the Gini coefficient falls from 0.889 to 0.700 in the United States, and from 0.755 to 0.508 in Germany. If the wealth shares in Germany were the same as in the United States, this would lead to a 12.6 percent increase in the Gini coefficient in the augmented wealth distribution in Germany. [ABSTRACT FROM AUTHOR]

Background: Arcobacter species, particularly A. butzleri, but also A. cryaerophilus constitute emerging pathogens causing gastroenteritis in humans. However, isolation of Arcobacter may often fail during routine diagnostic procedures due to the lack of standard protocols. Furthermore, defined breakpoints for the interpretation of antimicrobial susceptibilities of Arcobacter are missing. Hence, reliable epidemiological data of human Arcobacter infections are scarce and lacking for Germany. We therefore performed a 13-month prospective Arcobacter prevalence study in German patients. Results: A total of 4636 human stool samples was included and Arcobacter spp. were identified from 0.85% of specimens in 3884 outpatients and from 0.40% of specimens in 752 hospitalized patients. Overall, A. butzleri was the most prevalent species (n = 24; 67%), followed by A. cryaerophilus (n = 10; 28%) and A. lanthieri (n = 2; 6%). Whereas A. butzleri, A. cryaerophilus and A. lanthieri were identified in outpatients, only A. butzleri could be isolated from samples of hospitalized patients. Antimicrobial susceptibility testing of Arcobacter isolates revealed high susceptibilities to ciprofloxacin, whereas bimodal distributions of MICs were observed for azithromycin and ampicillin. Conclusions: In summary, Arcobacter including A. butzleri, A. cryaerophilus and A. lanthieri could be isolated in 0.85% of German outpatients and ciprofloxacin rather than other antibiotics might be appropriate for antibiotic treatment of infections. Further epidemiological studies are needed, however, to provide a sufficient risk assessment of Arcobacter infections in humans. [ABSTRACT FROM AUTHOR]

Background: Arcobacter constitute emerging food- and waterborne pathogens causing gastroenteritis in humans, but the underlying mechanisms are only incompletely understood. We therefore characterized Arcobacter isolates derived from human stool samples that had been collected during a prospective prevalence study in Germany in vitro. Thirty-six bacterial isolates belonging to the species A. butzleri (n = 24), A. cryaerophilus (n = 10) and A. lanthieri (n = 2) were genotyped by ERIC-PCR, the presence of 10 putative virulence genes was assessed and cytotoxic effects on the human intestinal cell line HT-29/B6 were analyzed applying the WST-assay. Results: Genotyping revealed high genetic diversity within the species A. butzleri, A. cryaerophilus and A. lanthieri. Both, A. butzleri and A. lanthieri encoded for a large number of putative virulence genes, while fewer genes were detectable in A. cryaerophilus isolates. Notably, the three cytolethal distending toxin (CDT) genes cdtA, cdtB and cdtC were abundant in both A. lanthieri isolates. Furthermore, all A. butzleri and A. lanthieri, but only one of the A. cryaerophilus isolates exerted cytotoxic effects. Conclusions: Our study provides evidence for the abundance of putative virulence genes in Arcobacter isolates and prominent cytotoxic effects of A. butzleri and A. lanthieri in vitro. The presence of cdtA, cdtB, cdtC in A. lanthieri points towards CDT secretion as potential mechanism underlying cytotoxicity as opposed to A. butzleri. However, the association of the Arcobacter virulence factors detected and human morbidity should be addressed in future studies. [ABSTRACT FROM AUTHOR]

The research on wealth inequality has generally focused on real and financial assets, while giving little attention to pension wealth: the present value of future pension entitlements from public and company pension schemes. This is surprising given the important role pension plans play in guaranteeing material security and well‐being for a majority of the population, and suggests that they should be accounted for in peoples' wealth portfolios. Using novel data from the Socio‐Economic Panel (SOEP), we study the incidence, relevance, and distribution of individual pension wealth, net worth, and augmented wealth (the sum of the two) in Germany. Further, we investigate age‐wealth profiles and differences between East and West Germany. [ABSTRACT FROM AUTHOR]

Background: Approximately 4550 persons were under treatment for hemophilia in Germany in 2017. The condition is currently treated with intravenous supplementation of the missing clotting factor, either prophylactically or as needed. Newer treatment options rely on novel mechanisms of action. Methods: This review is based on pertinent publications retrieved by a selective search in MEDLINE/PubMed, as well as on expert opinions and the recommendations of specialty societies. Results: Randomized controlled trials have shown that, in children aged 30 months to 6 years, prophylactic clotting-factor supplementation yields a markedly lower annual rate of hemorrhage than supplementation as needed: 3.27 (standard deviation [SD] 6.24) for the former vs. 17.69 (SD 9.25) for the latter. A similar large effect was seen in patients aged 12 to 50 years, with hemorrhage rates of 1.9 (SD 4.1) vs. 28.7 (SD 18.8). Clotting-factor preparations with longer half-lives make it possible to lessen the frequency of administration and to prevent subtherapeutic factor levels. A number of alternatives to clotting-factor supplementation have recently been approved or are currently being clinically tested. These new drugs are injected sub-cutaneously and have a longer half-life, possibly enabling better protection against bleeding than the current standard treatment. A further advantage of some of these drugs is that they can be given even in the presence of inhibitors to factor VIII. In addition, initial (phase I) clinical trials of gene therapy have been performed successfully for both hemophilia A and hemophilia B. Conclusion: Now that new alternatives to classic supplementation therapy are becoming available, pertinent treatment algorithms for patients with hemophilia will have to be developed. It is still unclear to what extent the new drugs might supplant clotting factor supplementation as the first line of treatment. [ABSTRACT FROM AUTHOR]

Chronic pancreatitis (CP) may be caused by oxidative stress. An important source of reactive oxygen species (ROS) is the methylglyoxal-derived formation of advanced glycation endproducts (AGE). Methylglyoxal is detoxified by Glyoxalase I (GLO1). A reduction in GLO1 activity results in increased ROS. Single nucleotide polymorphisms (SNPs) of GLO1 have been linked to various inflammatory diseases. Here, we analyzed whether common GLO1 variants are associated with alcoholic (ACP) and non-alcoholic CP (NACP). Using melting curve analysis, we genotyped a screening cohort of 223 ACP, 218 NACP patients, and 328 controls for 11 tagging SNPs defined by the SNPinfo LD TAG SNP Selection tool and the functionally relevant variant rs4746. For selected variants the cohorts were extended to up to 1,441 patient samples. In the ACP cohort, comparison of genotypes for rs1937780 between patients and controls displayed an ambiguous result in the screening cohort (p = 0.08). However, in the extended cohort of 1,441 patients no statistically significant association was found for the comparison of genotypes (p = 0.11), nor in logistic regression analysis (p = 0.214, OR 1.072, 95% CI 0.961–1.196). In the NACP screening cohort SNPs rs937662, rs1699012, and rs4746 displayed an ambiguous result when patients were compared to controls in the recessive or dominant model (p = 0.08, 0.08, and 0.07, respectively). Again, these associations were not confirmed in the extended cohorts (rs937662, dominant model: p = 0.07, logistic regression: p = 0.07, OR 1.207, 95% CI 0.985–1.480) or in the replication cohorts for rs4746 (Germany, p = 0.42, OR 1.080, 95% CI 0.673–1.124; France, p = 0.19, OR 0.90, 95% CI 0.76–1.06; China, p = 0.24, OR 1.18, 95% CI 0.90–1.54) and rs1699012 (Germany, Munich; p = 0.279, OR 0.903, 95% CI 0.750–1.087). Common GLO1 variants do not increase chronic pancreatitis risk. [ABSTRACT FROM AUTHOR]

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Importance: Blood transfusion is one of the most frequently used therapies worldwide and is associated with benefits, risks, and costs.Objective: To develop a set of evidence-based recommendations for patient blood management (PBM) and for research.Evidence Review: The scientific committee developed 17 Population/Intervention/Comparison/Outcome (PICO) questions for red blood cell (RBC) transfusion in adult patients in 3 areas: preoperative anemia (3 questions), RBC transfusion thresholds (11 questions), and implementation of PBM programs (3 questions). These questions guided the literature search in 4 biomedical databases (MEDLINE, EMBASE, Cochrane Library, Transfusion Evidence Library), searched from inception to January 2018. Meta-analyses were conducted with the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology and the Evidence-to-Decision framework by 3 panels including clinical and scientific experts, nurses, patient representatives, and methodologists, to develop clinical recommendations during a consensus conference in Frankfurt/Main, Germany, in April 2018.Findings: From 17 607 literature citations associated with the 17 PICO questions, 145 studies, including 63 randomized clinical trials with 23 143 patients and 82 observational studies with more than 4 million patients, were analyzed. For preoperative anemia, 4 clinical and 3 research recommendations were developed, including the strong recommendation to detect and manage anemia sufficiently early before major elective surgery. For RBC transfusion thresholds, 4 clinical and 6 research recommendations were developed, including 2 strong clinical recommendations for critically ill but clinically stable intensive care patients with or without septic shock (recommended threshold for RBC transfusion, hemoglobin concentration <7 g/dL) as well as for patients undergoing cardiac surgery (recommended threshold for RBC transfusion, hemoglobin concentration <7.5 g/dL). For implementation of PBM programs, 2 clinical and 3 research recommendations were developed, including recommendations to implement comprehensive PBM programs and to use electronic decision support systems (both conditional recommendations) to improve appropriate RBC utilization.Conclusions and Relevance: The 2018 PBM International Consensus Conference defined the current status of the PBM evidence base for practice and research purposes and established 10 clinical recommendations and 12 research recommendations for preoperative anemia, RBC transfusion thresholds for adults, and implementation of PBM programs. The relative paucity of strong evidence to answer many of the PICO questions supports the need for additional research and an international consensus for accepted definitions and hemoglobin thresholds, as well as clinically meaningful end points for multicenter trials. [ABSTRACT FROM AUTHOR]

Calculations based on data from the Socio-Economic Panel (SOEP) show that after the introduction of a statutory minimum wage in Germany in January 2015, the wage growth of eligible employees with low wages accelerated significantly. Before the reform, the nominal growth in contractual hourly wages in the lowest decile, the bottom tenth of the pay distribution, was less than two percent in the long-term two-year average, while from 2014 to 2016 it was around 15 percent. Nevertheless, in the first half of 2016, around 1.8 million employees who were eligible for the minimum wage of 8.50 euros gross per hour still earned contractual hourly wages below this level. In 2015, the count was approximately 2.1 million workers, and in the year before the introduction of the minimum wage, almost 2.8 million. The figures for 2015 and 2016 reported here are thus higher than corresponding figures from company surveys. Despite the disproportionate increase in wages in the lowest wage decile, many workers are still not earning the minimum wage. The objectives of the German Minimum Wage Act (Mindestlohngesetz) are often not being met, especially among the marginally employed. Instruments for better enforcement of the Minimum Wage Act include more frequent inspections, stricter sanctioning, more effective grievance procedures for workers, and stricter requirements for the documentation systems (especially timekeeping). [ABSTRACT FROM AUTHOR]

Demographic projections for Germany indicate a drop in the population of many regions by 2030. This is likely to have an impact on the real estate market. Our report presents the result of a model calculation of asking prices for residential real estate in Germany up to 2030 based on market data from empirica-systeme GmbH and a population projection from the Bertelsmann Foundation. Depending on the model specifications, it appears that real estate price polarization will increase by 2030. As with all model calculations, the results are subject to uncertainty. In the scenario presented here, we strictly focus on the demographic effect on real estate prices. According to our projections, in one-third of all rural districts (Landkreise) and urban districts (kreisfreie Städte), the market value of condominiums will fall by over 25 percent. This will also be the case for single- and two-family homes in one-quarter of all districts. Some regions in eastern Germany will be hit particularly hard by this development. In and around urban centers, however, the trend of rising prices is expected to continue. Our findings also show that the polarization of real estate prices might cause the inequality of wealth in Germany to rise slightly. [ABSTRACT FROM AUTHOR]

The real disposable income of private households in Germany, accounting for inflation, rose by 12 percent between 1991 and 2014. This is what the present study based on data from the Socio-Economic Panel (SOEP) has shown. However, the trends varied greatly depending on income group. While the middle income segment rose by more than eight percent, the highest income segment increased by up to 26 percent. The lower income segment, on the contrary, declined in real terms. Consequently, income inequality has increased overall, especially in the first half of the 1990s, in the period from 1999 to 2005, and after 2009. It stagnated or even decreased in the interim periods. The proportion of people at risk of poverty has recently become greater again. Gainful employment still provides the most effective protection against income poverty, but more and more employed persons are at risk of becoming poor. Containment of the low wage sector, by revoking the privileged status of mini-jobs, for example, could counteract this effect. And single parents should no longer be fiscally disadvantaged in comparison to childless coupled households - this could also reduce the number of children at risk of poverty. [ABSTRACT FROM AUTHOR]

Background Common variants in the gene GATA binding protein 4 ( GATA4) show association with alcohol dependence ( AD). The aim of this study was to identify rare variants in GATA4 in order to elucidate the role of this gene in AD susceptibility. Identification of rare variants may provide a more complete picture of the allelic architecture at this risk locus. Methods Sanger sequencing of all 6 coding exons of GATA4 was performed in 528 patients and 517 controls. Four in silico prediction tools were used to determine the effect of a DNA variant on the amino acid sequence and protein function. Five variants were included in the replication step. Of these, 4 were successfully genotyped in our replication cohort of 655 patients and 1,501 controls. All patients fulfilled DSM- IV criteria for AD, and all individuals were of German descent. Results In the discovery step, 19 different heterozygous variants were identified. Four patient-specific and potentially functionally relevant variants were followed up. Only the variant S379S (c.1137C>T) remained patient specific (1/1,166 patients vs. 0/1,997 controls). None of the variants showed a statistically significant association with AD. Conclusions The present study elucidated the role of GATA4 in AD susceptibility by identifying rare variants via Sanger sequencing and subsequent replication. Although novel patient-specific rare variants of GATA4 were identified, none received support in the independent replication step. However, given previous robust findings of association with common variants, GATA4 remains a promising candidate gene for AD. [ABSTRACT FROM AUTHOR]

According to calculations based on the Socio-Economic Panel (SOEP) study, the proportion of middle-income group in Germany fell by more than five percentage points from 1991 to 2013, taking it to 61 percent. Germany is not the only country to have experienced such a downturn, however. Analyses of the situation in the US indicate a similar decline. To the middle-income group belong individuals in households earning a total income, before tax and social security contributions, of 67 to 200 percent of the median. In the US, however, there has been a stronger increase in income polarization than in Germany: in the US, those who have left the middle-income group tend to be concentrated more on the periphery of the income distribution. The share of income of the middleincome group has also dropped substantially in both countries studied. This decline affected all age groups with the exception of individuals of people at retirement age. In the US, it was primarily immigrants from Latin America who tended to move down from the middle-income group, while in Germany, the most notable decline was seen in the share of foreigners in the middle-income bracket. However, when looking at the personal wealth of the middleincome group, patterns differ: while in the US, this group experienced a decline in real net worth of over one quarter, in Germany it experienced an increase of 15 percent in real terms. [ABSTRACT FROM AUTHOR]

Rationale: Sarcoidosis is a multisystem disease of unknown cause. Löfgren's syndrome (LS) is a characteristic subgroup of sarcoidosis that is associated with a good prognosis in sarcoidosis. However, little is known about its genetic architecture or its broader phenotype, non-LS sarcoidosis.Objectives: To address the genetic architecture of sarcoidosis phenotypes, LS and non-LS.Methods: An association study in a white Swedish cohort of 384 LS, 664 non-LS, and 2,086 control subjects, totaling 3,134 subjects using a fine-mapping genotyping platform was conducted. Replication was performed in four independent cohorts, three of white European descent (Germany, n = 4,975; the Netherlands, n = 613; and Czech Republic, n = 521), and one of black African descent (United States, n = 1,657), totaling 7,766 subjects.Measurements and Main Results: A total of 727 LS-associated variants expanding throughout the extended major histocompatibility complex (MHC) region and 68 non-LS-associated variants located in the MHC class II region were identified and confirmed. A shared overlap between LS and non-LS defined by 17 variants located in the MHC class II region was found. Outside the MHC region, two LS-associated loci, in ADCY3 and between CSMD1 and MCPH1, were observed and replicated.Conclusions: Comprehensive and integrative analyses of genetics, transcription, and pathway modeling on LS and non-LS indicates that these sarcoidosis phenotypes have different genetic susceptibility, genomic distributions, and cellular activities, suggesting distinct molecular mechanisms in pathways related to immune response with a common region. [ABSTRACT FROM AUTHOR]

By 2010, 27 to 40 percent of all households in euro countries had inherited or received gifts. This only includes transfers from outside their own household. The present value of these transfers averaged between 85,000 and 274,000 euros, depending on the relevant country. The sum of all inheritances and gifts in western Germany corresponds to one-third of the current net worth of households--and is the highest of all euro countries included in this study. Based on recipient households only, the share in western Germany is 52 percent. In Austria, Belgium, France, and western Germany, individuals from high-income households inherit more frequently and receive much higher amounts than those from low-income households. Since intergenerational income mobility is low, highincome households can build wealth, both from regular income and from substantial capital transfers. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to examine the recurrence rate of wound rupture in primary pilonidal sinus disease (PSD) after median closure.Subjects and Methods: A total of 583 patients from the German military cohort were interviewed. We compared the choice of surgical therapy, wound dehiscence (if present) and long-term recurrence-free survival for patients with primary open treatment, marsupialization and primary median treatment (closed vs. secondary open, respectively). Actuarial recurrence rate was determined using the Kaplan-Meier calculation with a follow-up of up to 20 years after primary PSD surgery.Results: Patients with excision followed by primary open wound treatment showed a significantly lower 5- than 10-year recurrence rate (8.3 vs. 11.2%) compared to the patients with primary midline closure (17.4 vs. 20.5%, p = 0.03). The 20-year recurrence rate was 28% in primary open wound treatment versus 44% in primary midline closure without wound rupture. In contrast to these findings, long-term recurrence rates following secondary open wound treatment (12.2% at 5 years vs. 17.1% at 10 years) tended to be higher (although not significantly, p = 0.57) compared to primary open treatment (8.3% at 5 years vs. 11.2% at 10 years). There was no statistical difference in long-term recurrence rates between secondary open and primary midline closure (p = 0.7). Hence, despite only a short wound closure time experienced before wound rupture, the patient does not fully benefit from an open wound treatment in terms of recurrence rate.Conclusion: The postoperative pilonidal sinus wound rupture of primary midline closures did not significantly increase the 5- and 10-year long-term recurrence rates compared to uneventfully healing primary midline closures. [ABSTRACT FROM AUTHOR]

Studies indicating the development of household wealth in Germany are typically based on nominal values and do not take account of price rises and thus the actual purchasing power of those assets. DIW Berlin took inflation into account in a recent evaluation and concluded that the average net worth of households in Germany decreased in real terms by almost 15 percent from 2003 to 2013. This figure, based on the German Income and Expenditure Survey (Einkommens- und Verbrauchsstichprobe, EVS) of the Federal Statistical Office, is confirmed by data from the German Socio-Economic Panel (SOEP) study and shows that real assets declined by more than 11 percent between 2002 and 2012. In particular, the weak performance of the estimated fair value of owner-occupied real estate is likely to have contributed to this decline. In contrast to DIW Berlin's findings, the national accounts system (Volkswirtschaftlichen Gesamtrechnungen, VGR) indicated an increase in real net worth of around 19 percent between 2003 and 2013. This discrepancy is likely due to the different valuation methods used. The development of wealth held by the most affluent individuals is not likely to be responsible for the decline in the overall volume of real assets: Although the EVS and SOEP samples do not provide any details concerning the development of wealth held by the most affluent individuals, because these are either not meaningful or did not appear in the surveys at all, an analysis of the fortunes asset-holders based on information provided by manager magazin suggests that between 2007 and 2012 their assets stagnated on average. The relevant factors for successful wealth accumulation are regular saving, capital gains, and, in particular, inheritances and gifts. In addition, net asset values held by private households rise considerably whenever debtors pay off their liabilities in accordance with contracts. [ABSTRACT FROM AUTHOR]

The analyses of wealth inequality based on survey data usually suffer from undercoverage of the upper percentiles of the very wealthy. Yet given this group's substantial share of total net worth, it is of particular relevance. As no tax data are available in Germany, the largest fortunes can only be simulated using "rich lists." For example, combining the Forbes list, with its approximately 50 Ger man US dollar billionaires, with survey data results in an increased aggregate total net worth for all households in Germany in 2012 of between one-third and 50 percent, depending on the scenario. Moreover, the share of the richest one percent of the population (about 400,000 households) rises from approximately one-fifth to one-third. After reassessment, the richest ten percent of the population's share of total net worth is estimated to be between 64 and 74 percent, depending on the scenario. These reassessments are characterized by a high degree of uncertainty which eventually can only be reduced by improving the base data. [ABSTRACT FROM AUTHOR]

Very nearly 25 years after the fall of the Berlin Wall, households in eastern Germany have an average net worth of 67,400 euros which is less than half that of their counterparts in western Germany with an average net worth of 153,200 euros. In both parts of the country, real estate ownership is quantitatively the most important asset type. Although the share of owner-occupiers has increased significantly in both regions since 1990, only one-third of all households in eastern Germany are owner occupied whereas the corresponding share in the west is almost half. Further, the market value of the real estate owned in eastern Germany is only half of that in the west. There has, however, been a significant convergence both in terms of average living space and property furnishings since the fall of the Wall. [ABSTRACT FROM AUTHOR]

According to current analyses based on the Socio-Economic Panel Study (SOEP), the total net assets of German households in 2012 amounted to 6.3 trillion euros. Almost 28 percent of the adult population had no or even negative net wealth. On average, individual net assets in 2012 totaled over 83,000 euros, slightly more than ten years previously. The degree of wealth inequality also remained virtually unchanged. With a Gini coefficient of 0.78, Germany has a high degree of wealth inequality compared to other countries, and there is still a wide gap between western and eastern Germany almost 25 years after unification. In 2012, the average net wealth of eastern Germans was less than half that of western Germans. [ABSTRACT FROM AUTHOR]

Inequality of disposable incomes in Germany has decreased slightly since its peak in 2005. However, this trend did not continue in 2011. The most important reasons for this were the inequality in market incomes, including capital incomes, which had increased again. Besides this finding, the updated analyses of personal income distribution based on the Socio-Economic Panel Study (SOEP) show that the risk of poverty did not rise further after a long period of upward movement. Income mobility over time is equally important in terms of social policy, i.e., the upward or downward movement of individual groups of people in the income hierarchy. Here, the most recent analyses confirm the trend of significantly decreasing income mobility since German reunification. For example, the odds of exiting the risk of poverty within a period of four years has dropped by ten percentage points to 46 percent in recent years. [ABSTRACT FROM AUTHOR]

Neurogranin (NRGN) is the main postsynaptic protein regulating the availability of calmodulin-Ca(2+) in neurons. NRGN is expressed exclusively in the brain, particularly in dendritic spines and has been implicated in spatial learning and hippocampal plasticity. Genetic variation in rs12807809 in the NRGN gene has recently been confirmed to be associated with schizophrenia in a meta-analysis of genome-wide association studies: the T-allele was found to be genome-wide significantly associated with schizophrenia. Cognitive tests and personality questionnaires were administered in a large sample of healthy subjects. Brain activation was measured with functional magnetic resonance imaging (fMRI) during an episodic memory encoding and retrieval task in a subsample. All subjects were genotyped for NRGN rs12807809. There was no effect of genotype on personality or cognitive measures in the large sample. Homozygote carriers of the T-allele showed better performance in the retrieval task during fMRI. After controlling for memory performance, differential brain activation was evident in the anterior cingulate cortex for the encoding and posterior cingulate regions during retrieval. We could demonstrate that rs12807809 of NRGN is associated with differential neural functioning in the anterior and posterior cingulate. These areas are involved in episodic memory processes and have been implicated in the pathophysiology of schizophrenia in structural and functional imaging as well as postmortem studies. [ABSTRACT FROM PUBLISHER]

The article reports on income inequality and poverty risk or relative income poverty in Germany between 2005 and 2010. Information is gathered from analyses of personal income distribution in Germany, based on data from the German Socio-Economic Panel. The increase in real market income in private households from 2005 and 2010 is revealed.

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OBJECTIVES:Patients with severe acute pancreatitis (AP) typically develop vascular leak syndrome, resulting in hemoconcentration, hypotension, pulmonary edema, and renal insufficiency. Angiopoietin-1 (Ang-1) and 2 (Ang-2) are autocrine peptides that reduce or increase endothelial permeability, respectively. The aim of this study was to determine whether Ang-1 and/or Ang-2 levels are predictive biomarkers of persistent organ failure (>48 h) and prolonged hospital course.METHODS:Banked serum from 28 patients enrolled in the Severity of Acute Pancreatitis Study at the University of Pittsburgh Medical Center (UPMC) and 58 controls was analyzed for Ang-1 and Ang-2 levels. Separately, serum from 123 patients and 103 controls at Greifswald University (GU), Germany was analyzed for Ang-2 levels. Angiopoietin levels were measured by enzyme-linked immunosorbent assay.RESULTS:In all, 6 out of 28 UPMC patients (21%) and 14 out of 123 GU patients (13%) developed persistent organ failure and were classified as severe AP. Ang-2 was significantly higher on admission in patients who developed persistent organ failure compared with those who did not in UPMC (3,698 pg/ml vs. 1,001 pg/ml; P=0.001) and GU (4,945 pg/ml vs. 2,631 pg/ml; P=0.0004) cohorts. After data scaling, admission Ang-2 levels showed a receiver-operator curve of 0.81, sensitivity 90%, and specificity 67% in predicting persistent organ failure. In addition, Ang-2 levels remained significantly higher in severe AP compared with mild AP patients until day 7 (days 2-4: P<0.005; day 7: P<0.02). Ang-1 levels were not significantly different between mild and severe AP patients on admission.CONCLUSIONS:Elevated serum Ang-2 levels on admission are associated with and may be a useful biomarker of predicting persistent organ failure and ongoing endothelial cell activation in AP. [ABSTRACT FROM AUTHOR]

In response to increasing health expenditures and a high number of physician visits, the German government introduced a copayment for ambulatory care in 2004 for individuals with statutory health insurance (SHI). Because persons with private insurance were exempt from the copayments, this health-care reform can be regarded as a natural experiment. We used a difference-in-difference approach to examine whether the new copayment effectively reduced the overall demand for physician visits and to explore whether it acted as a deterrent to vulnerable groups, such as those with low income or chronic conditions. We found that there was no significant reduction in the number of physician visits among SHI members compared to our control group. At the same time, we did not observe a deterrent effect among vulnerable individuals. Thus, the copayment has failed to reduce the demand for physician visits. It is likely that this result is due to the design of the copayment scheme, as the copayment is low and is paid only for the first physician visit per quarter. [ABSTRACT FROM AUTHOR]

The positive association between moderate alcohol consumption and wages is well documented in the economic literature. Positive health effects as well as networking mechanisms serve as explanations for the “alcohol–income puzzle.” Using individual-based microdata from the SOEP for 2006, we confirm that this relationship exists for Germany as well. More importantly, we shed light on the alcohol–income puzzle by analyzing, for the first time, the association between beverage-specific drinking behavior and wages. In our analysis, we disentangle the general wage effect of drinking into diverse effects for different types of drinkers. Mincerian estimates reveal significant and positive relationships between wine drinkers and wages as well as between multiple beverage drinkers and wages. When splitting the sample into age groups, the “drinking gain” disappears for employees under the age of 35 and increases in size and significance for higher age groups. We also find a “beer gain” for the oldest age group and male residents of rural areas as well as a “cocktail gain” for residents of urban areas. Several explanations for our empirical results are discussed in view of the likelihood that the alcohol–income puzzle is a multicausal phenomenon. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Gallstones are a common disease worldwide, with disparities in the prevalence of the disease in different settings. The aim of the present study was to assess if different distributions of risk factors could explain the disparities in the prevalence of gallstone disease between Denmark and northeast Germany. METHODS: Data of 5,559 subjects from the Danish MONICA survey and of 3,647 subjects of the German Study of Health in Pomerania were investigated. Gallstone disease was defined as a prior history of cholecystectomy or the presence of sonographically diagnosed gallstones. Logistic regression models were performed to assess the confounding effect of selected risk factors on regional disparities in gallstone disease. RESULTS: After adjustment for age and vocational training, German subjects (women: Odds ratio, OR, 2.46 (95% confi dence interval, CI: 2.07-2.91); men: OR, 1.89 (95% CI: 1.52-2.36)) had approximatively twice the odds of gallstones than Danes. Inclusion of lifestyle factors (smoking, alcohol intake, coffee use) did not affect this result, whereas adjustment for body mass index (BMI), lipids, diabetes, and use of oral contraceptives, menopausal hormone therapy (MHT) and parity (women only) changed the estimates considerable, but still Germans (women: OR, 1.65 (95% CI: 1.36-2.00); men: OR, 1.61 (95% CI: 1.27-2.04)) had higher odds than Danes. CONCLUSIONS: German individuals had a higher prevalence of gallstones than Danes. This difference was partly explained by a higher BMI, unfavorable lipid levels, higher prevalence of diabetes, and a more frequent use of OR and MHT in German subjects. Further research is needed to evaluate the impact of unmeasured predictors, including genetic components, on the population-related risk of gallstones. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The R122H mutation represents the most common point mutation of the cationic trypsinogen gene ( PRSS1) in patients with hereditary pancreatitis (HP; Online Mendelian inheritance in man [OMIM] 167800), a rare variety of chronic pancreatitis. We identified a large number of HP families carrying this mutation in a confined region of Northern Germany within a 100-km radius. This apparent clustering could be due to the inheritance from a common ancestor (founder effect). METHODS: To address this question, we genotyped SNPs in close vicinity of the PRSS1 locus and determined common haplotypes. RESULTS: In members from 10 unrelated HP families (all R122H-positive), we found 7 different haplotypes to segregate with the R122H mutation. CONCLUSIONS: This virtually excludes a founder effect and suggests the presence of a mutational hot spot in codon 122 of the PRSS1 gene. An ascertainment bias of a large-volume referral center may have contributed to the locally increased detection of HP cases. [ABSTRACT FROM AUTHOR]

Objective: G72 is among the most frequently replicated vulnerability genes for schizophrenia and bipolar disorder. The authors previously found identical haplotypes of markers M23 and M24 to be associated with schizophrenia, bipolar disorder, and panic disorder. Given both the well-recognized familial clustering across these disorders and recent linkage findings implicating the region harboring G72 in the etiology of major depression and panic disorder, we can hypothesize that G72 should also be involved in the etiology of major depression. Neuroticism, measuring trait anxiety, may be the endophenotypic link underlying genetic associations with G72 across diagnostic boundaries. The authors tested whether the previously observed risk haplotypes are also associated with major depression and neuroticism. Method: The authors performed a standard haplotype analysis in a group of 500 major depression patients and 1,030 population-based comparison subjects. The authors also performed an exploratory analysis on 10 additional G72 markers using a novel haplotype-sharing approach. They performed a quantitative trait haplotype analysis in an independent group of 907 individuals phenotyped for neuroticism. Results: The previously identified M23-M24 risk haplotype was significantly associated with major depression and high levels of neuroticism. The haplotype-sharing analysis also implicated the same region, whereas more proximal markers showed no association with major depression. Conclusions: This is the first study to the authors' knowledge to implicate the G72 locus in the etiology of major depression and neuroticism. The results strengthen the notion of a genetic overlap between diagnoses, commonly conceptualized as distinct entities. Neuroticism may constitute the common underlying endophenotypic link. [ABSTRACT FROM AUTHOR]

Background/Aims:Cholelithiasis is a common disorder in north-eastern Germany. Analyses of risk factors for gallstone formation in this population may have high explanatory power. Gender-specific risk factors for gallstone formation and their interactions were investigated by using data of the population-based Study of Health in Pomerania (SHIP). Methods:Data of 4,202 persons aged 20–79 years were available. Cholelithiasis was defined by either a prior history of cholecystectomy or the presence of gallstones on abdominal ultrasound. Multivariable analyses were performed to identify independent risk factors for gallstone formation. Results:There were 468 persons (11.1%) with previous cholecystectomy and 423 persons (10.1%) with sonographic evidence of gallstones. Women had a twofold higher risk for cholelithiasis compared to men. Age, body mass index and low serum HDL cholesterol levels were independently associated with cholelithiasis in both men and women. In the male population, low alcohol and high coffee consumption and in the female population, low physical activity, were further independently related to gallstone formation. Additionally, sex-specific interactions between risk factors were found. Conclusions: Female sex, age and being overweight are major risk factors for gallstone formation in this region where cholelithiasis is a frequent disorder. Additional factors and interactions contribute to a gender-specific gallstone risk. Copyright © 2005 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Examines a framework for analyzing modern statehood change in Germany in relation to regulations concerning the telecommunication, broadcasting and banking industries in the country. Overview of economic policy changes in Germany; Background on the nature of regulation; Discussion on the regulatory state in Germany.