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Deutschland und der Westen stehen vor der Herausforderung, auch ihre maritimen kritischen Infrastrukturen (KRITIS) gegen Angriffe zu schützen. Lösungsansätze für den Schutz maritimer KRITIS lassen sich identifizieren im Rahmen von notwendiger Resilienz, ausreichend Redundanzen und einer übergreifenden Zusammenarbeit verschiedener Stakeholder, etwa zur effektiven Überwachung und Präsenz. Um erfolgreich zu sein, sollten solche Kooperationen über Staaten und ihre Streitkräfte hinausgehen und privatwirtschaftliche Akteure einbeziehen. Aus strategischem Blickwinkel wird zusammenfassend deutlich, dass der Schutz maritimer kritischer Infrastrukturen als ein Teil effektiver Abschreckung anzusehen ist. Germany and the West face the challenge of protecting their maritime critical infrastructures against attacks. Possible solutions for the protection of maritime critical infrastructures can be identified within the framework of necessary resilience, sufficient redundancies, and an overarching cooperation of different stakeholders, for example for effective monitoring and presence. Of particular importance is that this cooperation must go beyond nation states and their armed forces, to also include the private sector in order to be successful. In summary, from a strategic perspective, it must be recognized that the protection of maritime critical infrastructure must also be seen as a part of effective deterrence. [ABSTRACT FROM AUTHOR]

Simple Summary: Rupture of the cranial cruciate ligament in dogs is a very common condition in veterinary medicine. Surgical treatment is well established and several procedures provide very good clinical results. However, surgical treatment is associated with a high financial burden for patients' owners. Veterinarians are bound to charging services according to a mandatory fee schedule, which gives a range in pricing. In this study, we examine the prices for two surgical interventions. We found that one technique is slightly more expensive; however, it also creates greater costs in the veterinary practice setting. Therefore, it is questionable whether the more expensive procedure provides a greater scope for profit. Pricing strategies are identified and may either be based on costs or a promise of quality in terms of a better clinical outcome. In surgical treatment of cranial cruciate ligament disease in dogs, Tibial Plateau Levelling Osteotomy (TPLO) and Tibial Tuberosity Advancement (TTA) are commonly established procedures and have proven effective in restoring limb function. Unlike clinical outcome, economic aspects have not been studied as extensively. However, the surgical intervention poses an enormous financial burden on patients' owners. In a veterinary practice setting, this study compares prices for TPLO and TTA and examines prices differences as well as potential cost drivers. Charges for veterinary treatments are based on the Gebührenordnung für Tierärztinnen und Tierärzte (GOT), which is mandatory for veterinarians in Germany but allows a certain range in billing. This study found that TPLO is charged at a higher price than TTA; however, this might not cover the additional costs of this procedure. The price is also associated with weight, heavier dogs being more expensive. The underlying strategies for pricing decisions may be based on costs, as efforts for TPLO and heavier dogs are higher in terms of a prolonged surgical time, the number of staff involved and in surgeons' training. Price setting may also be based on a quality promise, suggesting better clinical outcome in a more expensive procedure. Future investigations should involve economic considerations and consider cost-effectiveness analysis when evaluating surgical treatment options. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease with a multifactorial genesis including genetic predispositions and environmental risk and trigger factors. One of the latter possibly is smoking, indicated by an increased prevalence of AD in adults and children that are actively or passively exposed to cigarette smoke. Objectives: In this study, AD characteristics and its atopic comorbidities are compared in smoking and non‐smoking AD patients. Methods: TREATgermany is a non‐interventional clinical registry which includes patients with moderate to severe AD in Germany. Baseline data of patients included in TREATgermany from inception in June 2016 to April 2020 in 39 sites across Germany was analysed comparing AD disease characteristics and comorbidities in smokers vs. non‐smokers. Results: Of 921 patients, 908 (male: 58.7%) with a mean age of 41.9 ± 14.4 reported their smoking status. The objective Scoring of Atopic Dermatitis (oSCORAD) did not differ between smokers (n = 352; 38.8%) and non‐smokers, however, lesions' intensity of oozing/crusts and excoriations as well as patient global assessment scores (PGA) of AD severity were higher in smoking as opposed to non‐smoking patients. Smokers reported a lower number of weeks with well‐controlled AD and more severe pruritus than non‐smokers. Total IgE levels were more elevated in smokers and they displayed a younger age at the initial diagnosis of bronchial asthma. After adjustment for potential confounders, the increased intensity of oozing/crusts, the reduced number of weeks with well‐controlled AD and the greater pruritus remained different in smokers compared to non‐smokers. In addition, smoking patients with adult‐onset AD showed a 2.5 times higher chance of involvement of the feet. Conclusions: German registry data indicate that AD patients who smoke have a higher disease burden with a different distribution pattern of lesions in adult‐onset AD. Linked Commentary Valeria Aoki and Raquel Leão Orfali J Eur Acad Dermatol Venereol 2022; 36: 324–325. https://doi.org/10.1111/jdv.17901. [ABSTRACT FROM AUTHOR]

This essay summarizes the presentation delivered on January 22, 2020 at Nakasone Peace Institute in Tokyo, Japan. It discusses the reasons that reconciliation between Poland and Germany is necessary and the treaties in the early 1990s that created conditions for building trust between Poland and united Germany. The essay describes the challenges faced and the benefits gained from reconciliation and emphasizes that reconciliation is a long process that requires continuing efforts from both parties. [ABSTRACT FROM AUTHOR]