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Emission reference materials (ERMs) are sought after to further control and improve indoor air quality. The impregnation of porous materials with volatile organic compounds (VOCs) is a promising approach to produce ERMs. Different VOCs were used to impregnate various porous materials (mainly zeolites, activated carbons and a metal organic framework). The influence of different methodological parameters and material properties were studied to optimize the impregnation procedure and to find the best material/VOC combination. The impregnation procedure remains quite irreproducible, nevertheless, very good ERM candidates were identified. Two materials (zeolite 4 and AC 1 impregnated with n-hexadecane) showed a very stable emission over 14 days (<10 % change). Another material (AC 1 impregnated with toluene) showed a declining emission profile but with a very good in-batch reproducibility and a storage stability of up to 12 months., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: For the treatment of the symptoms of post-COVID-19 syndrome, no causal therapy is currently widely recommended according to evidence-based criteria. The overarching goal of the intervention study over a 3-year period (Q1-2021-Q4-2023) was to evaluate the changes in the key symptoms of fatigue and sensorimotor instability through individualized stress-controlled training therapy and through intensified cognitive behavioral therapy., Material and Methods: In the 3‑year period 407 vaccinated nucleocapsid positive patients were treated at the Post-COVID-19 Center Lausitz (Senftenberg). In 78 (around 19%) fatigue/immunometabolic depression and sensorimotor instability were identified as the leading syndromes. The evaluation of the individualized stress-controlled training therapy was based on the specific post-COVID-19 syndrome and motor fatigue parameters. The secondary psychosomatic syndrome was assessed using cognitive fatigue parameters and cognitive behavioral therapy instruments. The investigation of -parameters influencing behavior took place in Q2-2023-Q4-2023 with a guide-supported qualitative interview among the participants., Results: The post-COVID-19 key symptoms "fatigue," "sensorimotor instability," "neuropsychiatric symptoms," "cardiac/autonomic dysfunction," and "pain" improved significantly in the overall cohort and in the gender-specific analysis. A deterioration occurred in "secondary psychosomatic symptoms". A therapeutic effect was demonstrated for all motor fatigue parameters for the entire cohort using the Cohen's d value. An intensification of cognitive behavioral therapy achieved positive effects through an increasing development of the patients' own activity and their self-control using persuasion and gamification., (© 2024. The Author(s).)

This review provides a summary of the existing literature on a crucial raw material for the production of isotopically pure semiconductors, which are essential for the development of second-generation quantum systems. Silicon-28-tetrafluoride ( 28 SiF 4 ) is used as an educt for several isotope-engineered chemicals, such as silane-28 ( 28 SiH 4 ) and silicon-28-trichloride ( 28 SiHCl 3 ), which are needed in the pursuit of various quantum technologies. We are exploring the entire chain from the synthesis of 28 SiF 4 to quantum applications. This includes the chemical properties of SiF 4 , isotopic enrichment, conversion to silanes, conversion to bulk 28 Si and thin films, the physical properties of 28 Si (spin neutrality, thermal conductivity, optical properties), and the applications in quantum computing, photonics, and quantum sensing techniques.

Psychosocial stress and working conditions of nursing home staff in Covid-19 pandemic: A cross-sectional study Abstract: Background: With the onset of the Covid-19 pandemic in March 2020 there were numerous changes in the daily professional lives of healthcare professionals. Aim: Since the focus has been mainly on hospital staff so far, it is also important to watch the care situation in old people's and nursing homes. This study aimed to investigate the impact of the Covid-19 pandemic on the daily professional life, the psychosocial situation and the interpersonal relationships of nursing staff in old people's and nursing homes in Brandenburg. Methods: Cross-sectional survey of nursing staff from old people's and nursing homes in Brandenburg in the period from August to December 2020. The questionnaires were analysed using descriptive statistics and qualitative thematic analysis. Results: On the one hand, the increased workload with more difficult working conditions due to Covid-19 hygiene measures or increased working hours led to physical and psychosocial stress. In private life, increased social isolation was evident and changes in interpersonal relationships were stressful. On the other hand, the participants reported recognition and increased professional political interest. Conclusions: The Covid 19 pandemic highlighted pre-existing pressures on caregivers. In the future, it is important to improve the known workloads for nursing staff in old people's and nursing homes and to work out measures to counteract an increase of stress in situations like the pandemic.

Background: The holistic characterization of different microbiomes in anaerobic digestion (AD) systems can contribute to a better understanding of these systems and provide starting points for bioengineering. The present study investigates the microbiome of 80 European full-scale AD systems. Operational, chemical and taxonomic data were thoroughly collected, analysed and correlated to identify the main drivers of AD processes., Results: The present study describes chemical and operational parameters for a broad spectrum of different AD systems. With this data, Spearman correlation and differential abundance analyses were applied to narrow down the role of the individual microorganisms detected. The authors succeeded in further limiting the number of microorganisms in the core microbiome for a broad range of AD systems. Based on 16S rRNA gene amplicon sequencing, MBA03, Proteiniphilum, a member of the family Dethiobacteraceae, the genus Caldicoprobacter and the methanogen Methanosarcina were the most prevalent and abundant organisms identified in all digesters analysed. High ratios for Methanoculleus are often described for agricultural co-digesters. Therefore, it is remarkable that Methanosarcina was surprisingly high in several digesters reaching ratios up to 47.2%. The various statistical analyses revealed that the microorganisms grouped according to different patterns. A purely taxonomic correlation enabled a distinction between an acetoclastic cluster and a hydrogenotrophic one. However, in the multivariate analysis with chemical parameters, the main clusters corresponded to hydrolytic and acidogenic microorganisms, with SAOB bacteria being particularly important in the second group. Including operational parameters resulted in digester-type specific grouping of microbes. Those with separate acidification stood out among the many reactor types due to their unexpected behaviour. Despite maximizing the organic loading rate in the hydrolytic pretreatments, these stages turned into extremely robust methane production units., Conclusions: From 80 different AD systems, one of the most holistic data sets is provided. A very distinct formation of microbial clusters was discovered, depending on whether taxonomic, chemical or operational parameters were combined. The microorganisms in the individual clusters were strongly dependent on the respective reference parameters., (© 2024. The Author(s).)

Knee arthroplasty is one of the most frequently performed operations in Germany, with approximately 170000 procedures per year. It is therefore essential that physicians should adhere to an appropriate, and patient-centered indication process. The updated guideline indication criteria for knee arthroplasty (EKIT-Knee) contain recommendations, which are based on current evidence and agreed upon by a broad consensus panel. For practical use, the checklist has also been updated.For this guideline update, a systematic literature research was conducted in order to analyse (inter-)national guidelines and systematic reviews focusing on osteoarthritis of the knee and knee arthroplasty, to answer clinically relevant questions on diagnostic, predictors of outcome, risk factors and contraindications.Knee arthroplasty should solely be performed in patients with radiologically proven moderate or severe osteoarthritis of the knee (Kellgren-Lawrence grade 3 or 4), after previous non-surgical treatment for at least three months, in patients with high subjective burden with regard to knee-related complaints and after exclusion of possible contraindications (infection, comorbidities, BMI ≥ 40 kg/m 2 ). Modifiable risk factors (such as smoking, diabetes mellitus, anaemia) should be addressed and optimised in advance. After meeting current guideline indications, a shared decision-making process between patients and surgeons is recommended, in order to maintain high quality surgical management of patients with osteoarthritis of the knee.The update of the S2k-guideline was expanded to include unicondylar knee arthroplasty, the preoperative optimisation of modifiable risk factors was added and the main indication criteria were specified., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

We study epidemic spreading in complex networks by a multiple random walker approach. Each walker performs an independent simple Markovian random walk on a complex undirected (ergodic) random graph where we focus on the Barabási-Albert (BA), Erdös-Rényi (ER), and Watts-Strogatz (WS) types. Both walkers and nodes can be either susceptible (S) or infected and infectious (I), representing their state of health. Susceptible nodes may be infected by visits of infected walkers, and susceptible walkers may be infected by visiting infected nodes. No direct transmission of the disease among walkers (or among nodes) is possible. This model mimics a large class of diseases such as Dengue and Malaria with the transmission of the disease via vectors (mosquitoes). Infected walkers may die during the time span of their infection, introducing an additional compartment D of dead walkers. Contrary to the walkers, there is no mortality of infected nodes. Infected nodes always recover from their infection after a random finite time span. This assumption is based on the observation that infectious vectors (mosquitoes) are not ill and do not die from the infection. The infectious time spans of nodes and walkers, and the survival times of infected walkers, are represented by independent random variables. We derive stochastic evolution equations for the mean-field compartmental populations with the mortality of walkers and delayed transitions among the compartments. From linear stability analysis, we derive the basic reproduction numbers RM,R0 with and without mortality, respectively, and prove that RM1, the healthy state is unstable, whereas for zero mortality, a stable endemic equilibrium exists (independent of the initial conditions), which we obtained explicitly. We observed that the solutions of the random walk simulations in the considered networks agree well with the mean-field solutions for strongly connected graph topologies, whereas less well for weakly connected structures and for diseases with high mortality. Our model has applications beyond epidemic dynamics, for instance in the kinetics of chemical reactions, the propagation of contaminants, wood fires, and others.

Polychlorinated biphenyls (PCB) both continue to spread into the environment and to bioaccumulate from primary urban and industrial sources as well as from secondary sources such as soils and the oceans. Fractions of congeners in PCB mixtures, i.e. PCB profiles, can be used as fingerprints to trace contamination pathways from sources to sinks because PCB mixtures fractionate during transport due to congener specific phase changes and degradation. Using a statistical analysis of a total of 8584 PCB profiles with seven congeners (CB28, CB52, CB101, CB118, CB138, CB153, CB180) for contaminated fish from two international datasets as well as a modelling of profiles, two major fractionation processes related to distinct contamination pathways were identified: (1) A relative enrichment of lighter congeners (CB28, CB52, CB101) in seawater fish due to a predominantly atmospheric transport, whereas freshwater and some coastal fish had higher fractions of heavier congeners (CB138, CB153) because those were mainly contaminated by particle-sorbed PCB from surface runoff. (2) A temperature driven fractionation tended to affect congeners with a medium molecular weight (CB118) as well as the heaviest congeners (CB180), a fractionation process which was conceptually associated with transport of PCB from secondary sources. Specifically, medium chlorinated PCB is sufficiently volatile and persistent for a preferred transport into cooler waters. In warmer climates, only the highest chlorinated congeners are persistent enough to ultimately accumulate in fish. Our analysis and modelling provide a starting point for the development of systems to trace - better than before - sources of PCB contaminations observed in fish., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Benny Selle reports financial support was provided by Federal Environmental Agency. Alexander Blume reports financial support was provided by Federal Environmental Agency. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Optical metasurfaces enable the manipulation of the light-matter interaction in ultrathin layers. Compared with their metal or dielectric counterparts, hybrid metasurfaces resulting from the combination of dielectric and metallic nanostructures can offer increased possibilities for interactions between modes present in the system. Here, we investigate the interaction between lattice resonances in a hybrid metal-dielectric metasurface obtained from a single-step nanofabrication process. Finite-difference time domain simulations show the avoided crossing of the modes appearing in the wavelength-dependent absorptance inside the Ge upon variations in a selected geometry parameter as evidence for strong optical coupling. We find good agreement between the measured and simulated absorptance and reflectance spectra. Our metasurface design can be easily incorporated into a top-down optoelectronic device fabrication process with possible applications ranging from on-chip spectroscopy to sensing.

Introduction: Functional trait-based approaches are extensively applied to the study of mechanisms governing community assembly along environmental gradients. These approaches have been classically based on studying differences in mean values among species, but there is increasing recognition that alternative metrics of trait distributions should be considered to decipher the mechanisms determining community assembly and species coexistence. Under this framework, the main aim of this study is to unravel the effects of environmental conditions as drivers of plant community assembly in sub-Mediterranean ecotones., Methods: We set 60 plots in six plant communities of a sub-Mediterranean forest in Central Spain, and measured key above- and belowground functional traits in 411 individuals belonging to 19 species, along with abiotic variables. We calculated community-weighted mean (CWM), skewness (CWS) and kurtosis (CWK) of three plant dimensions, and used maximum likelihood techniques to analyze how variation in these functional community traits was driven by abiotic factors. Additionally, we estimated the relative contribution of intraspecific trait variability and species turnover to variation in CWM., Results and Discussion: The first three axes of variation of the principal component analyses were related to three main plant ecological dimensions: Leaf Economics Spectrum, Root Economics Spectrum and plant hydraulic architecture, respectively. Type of community was the most important factor determining differences in the functional structure among communities, as compared to the role of abiotic variables. We found strong differences among communities in their CWMs in line with their biogeographic origin (Eurosiberian vs Mediterranean), while differences in CWS and CWK indicate different trends in the functional structure among communities and the coexistence of different functional strategies, respectively. Moreover, changes in functional composition were primarily due to intraspecific variability., Conclusion: We observed a high number of strategies in the forest with the different communities spreading along the acquisitive-conservative axis of resource-use, partly matching their Eurosiberian-Mediterranean nature, respectively. Intraspecific trait variability, rather than species turnover, stood as the most relevant factor when analyzing functional changes and assembly patterns among communities. Altogether, our data support the notion that ecotones are ecosystems where relatively minor environmental shifts may result in changes in plant and functional composition., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 de Tomás Marín, Galán Díaz, Rodríguez-Calcerrada, Prieto and de la Riva.)

Aim of the Study: In a nationwide comparison, the state of Brandenburg has one of the highest morbidity and mortality rates of ischemic heart disease. Access to medical care infrastructure is considered to be one possible explanation for regional health inequalities. Accordingly, the study aims to calculate the distances to different types of cardiology care at the community level and to consider these in the context of local care needs., Methodology: Preventive sports facilities, general practitioners, outpatient specialist care, hospitals with cardiac catheterization laboratory and outpatient rehabilitation were chosen and mapped as essential facilities for cardiological care. Thereafter, the distances across the road network from the center of each Brandenburg community to the nearest location of each care facility was calculated and divided into quintiles. Medians and interquartile ranges of the German Index of Socioeconomic Deprivation and the proportion of the population over 65 were used as measures of the need for care. They were then related to the distance quintiles per type of care facility., Results: For 60% of Brandenburg's municipalities, general practitioners were found to be within 2.5 km, preventive sports facilities within 19.6 km, cardiology practices within 18.3 km, hospitals with cardiac catheterization laboratories within 22.7 km, and outpatient rehabilitation facilities within 14.7 km. The median of the German Index of Socioeconomic Deprivation rose with increasing distance for all types of care facilities. The median of the proportion of over 65-year-olds showed no significant variation between distance quintiles., Conclusions: The results show that a high proportion of the population lives far away from cardiology care services, while a high proportion seems to be able to reach a general practitioner. In Brandenburg, a regional and locally oriented cross-sectoral care seems to be necessary., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Direct-band-gap Germanium-Tin alloys (Ge 1- x Sn x ) with high carrier mobilities are promising materials for nano- and optoelectronics. The concentration of open volume defects in the alloy, such as Sn and Ge vacancies, influences the final device performance. In this article, we present an evaluation of the point defects in molecular-beam-epitaxy grown Ge 1- x Sn x films treated by post-growth nanosecond-range pulsed laser melting (PLM). Doppler broadening - variable energy positron annihilation spectroscopy and variable energy positron annihilation lifetime spectroscopy are used to investigate the defect nanostructure in the Ge 1- x Sn x films exposed to increasing laser energy density. The experimental results, supported with ATomic SUPerposition calculations, evidence that after PLM, the average size of the open volume defects increases, which represents a raise in concentration of vacancy agglomerations, but the overall defect density is reduced as a function of the PLM fluence. At the same time, the positron annihilation spectroscopy analysis provides information about dislocations and Ge vacancies decorated by Sn atoms. Moreover, it is shown that the PLM reduces the strain in the layer, while dislocations are responsible for trapping of Sn and formation of small Sn-rich-clusters., (Creative Commons Attribution license.)

Objective: Investigation of the association of concern about own infection or infection of friends, family and care recipients with Covid-19 and burnout symptoms of caregivers in Brandenburg full inpatient geriatric care facilities., Methods: Cross-sectional survey of nursing staff (n=195) in Brandenburg nursing homes between August and December 2020 regarding their psychosocial stress at work., Results: Concern about having infected oneself, family and/or friends, or care recipients with Covid-19 is associated with increased expression of burnout symptoms (b=0,200, t(155)=2,777, p=0,006)., Conclusion: Increased experience of burnout symptoms due to concerns of risk of infection with Covid-19 in the workplace indicates a need for comprehensive support measures as well as sustainable approaches to managing psychosocial stress for geriatric caregivers., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: Loneliness is an increasingly present topic in both public and scientific discourse. There is increasing research on the prevalence of loneliness and health-related correlates in adults. However, there are only a few findings on loneliness in childhood and adolescence in Germany. Therefore, this study aims to present findings on the prevalence of loneliness among 11- to 15-year-old German students and examines associations with socio-demographic characteristics., Methods: The Health Behaviour in School-aged Children (HBSC) study is a global research collaboration under the auspices of the World Health Organization (WHO). In the federal state of Brandenburg, Germany, the study collected data from 3819 children and adolescents in grades 5, 7, and 9 (M age  = 13.5, SD = 1.6) at schools for general education. Loneliness was assessed using the University of California, Los Angeles (UCLA) Loneliness Scale and a single item., Results: Of the respondents, 13.2% reported feeling lonely most of the time and 3.6% always. Loneliness was more prevalent among girls and non-binary students, as well as among older students and children and adolescents of lower socioeconomic status., Discussion: The findings indicate that loneliness is a widespread phenomenon among children and adolescents. The result that girls, older pupils and children, and adolescents with lower family wealth report feeling lonelier is consistent with findings from other countries and provides starting points for planning prevention measures. Further research is needed in Germany on possible health-related correlates of loneliness., (© 2023. The Author(s).)

We study an epidemic model for a constant population by taking into account four compartments of the individuals characterizing their states of health. Each individual is in one of the following compartments: susceptible S; incubated, i.e., infected yet not infectious, C; infected and infectious I; and recovered, i.e., immune, R. An infection is visible only when an individual is in state I. Upon infection, an individual performs the transition pathway S→C→I→R→S, remaining in compartments C, I, and R for a certain random waiting time t&#95;{C}, t&#95;{I}, and t&#95;{R}, respectively. The waiting times for each compartment are independent and drawn from specific probability density functions (PDFs) introducing memory into the model. The first part of the paper is devoted to the macroscopic S-C-I-R-S model. We derive memory evolution equations involving convolutions (time derivatives of general fractional type). We consider several cases. The memoryless case is represented by exponentially distributed waiting times. Cases of long waiting times with fat-tailed waiting-time distributions are considered as well where the S-C-I-R-S evolution equations take the form of time-fractional ordinary differential equations. We obtain formulas for the endemic equilibrium and a condition of its existence for cases when the waiting-time PDFs have existing means. We analyze the stability of healthy and endemic equilibria and derive conditions for which the endemic state becomes oscillatory (Hopf) unstable. In the second part, we implement a simple multiple-random-walker approach (microscopic model of Brownian motion of Z independent walkers) with random S-C-I-R-S waiting times in computer simulations. Infections occur with a certain probability by collisions of walkers in compartments I and S. We compare the endemic states predicted in the macroscopic model with the numerical results of the simulations and find accordance of high accuracy. We conclude that a simple random-walker approach offers an appropriate microscopic description for the macroscopic model. The S-C-I-R-S-type models open a wide field of applications allowing the identification of pertinent parameters governing the phenomenology of epidemic dynamics such as extinction, convergence to a stable endemic equilibrium, or persistent oscillatory behavior.

The positive effects of a healthy lifestyle on the holistic physical condition and quality of life of cancer survivors is scientifically proven. The National Comprehensive Cancer Network (NCCN) Guidelines for Survivorship specifically highlight the need for support in these areas. The lack of specialised offers for cancer patients in predominantly rural areas, however, represents a high level of assistance needed in terms of the development and implementation of a healthy lifestyle. Following a needs assessment, our aim was to conceptualise and design an easily accessible multi-media patient information system on the basis of a social-cognitive process model on health behaviour (Health Action Process Approach - HAPA). A higher level of health literacy represents, inter alia, the basis for informed choice and, as such, forms an important resource for the aftercare of cancer patients. Further studies are recommended on the acceptance, use and effects of patient information with regard to intended longer-term changes of health behaviour., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

La-doped SrTiO 3 thin films with high structural quality were homoepitaxially grown by the metal-organic vapor phase epitaxy (MOVPE) technique. Thermogravimetric characterization of the metal-organic precursors determines suitable flash evaporator temperatures for transferring the liquid source materials in the gas phase of the reactor chamber. An adjustment of the charge carrier concentration in the films, which is necessary for optimizing the thermoelectric power factor, was performed by introducing a defined amount of the metal-organic compound La(tmhd) 3 and tetraglyme to the liquid precursor solution. X-ray diffraction and atomic force microscopy verified the occurrence of the pure perovskite phase exhibiting a high structural quality for all La concentrations. The electrical conductivity of the films obtained from Hall-effect measurements increases linearly with the La concentration in the gas phase, which is attributed to the incorporation of La 3+ ions on the Sr 2+ perovskite sites by substitution inferred from photoemission spectroscopy. The resulting structural defects were discussed concerning the formation of occasional Ruddlesden-Popper-like defects. The thermoelectric properties determined by Seebeck measurements demonstrate the high potential of SrTiO 3 thin films grown by MOVPE for thermoelectric applications., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

Nonvascular photoautotrophs (NVP), including bryophytes, lichens, terrestrial algae, and cyanobacteria, are increasingly recognized as being essential to ecosystem functioning in many regions of the world. Current research suggests that climate change may pose a substantial threat to NVP, but the extent to which this will affect the associated ecosystem functions and services is highly uncertain. Here, we propose a research agenda to address this urgent question, focusing on physiological and ecological processes that link NVP to ecosystem functions while also taking into account the substantial taxonomic diversity across multiple ecosystem types. Accordingly, we developed a new categorization scheme, based on microclimatic gradients, which simplifies the high physiological and morphological diversity of NVP and world-wide distribution with respect to several broad habitat types. We found that habitat-specific ecosystem functions of NVP will likely be substantially affected by climate change, and more quantitative process understanding is required on: (1) potential for acclimation; (2) response to elevated CO 2 ; (3) role of the microbiome; and (4) feedback to (micro)climate. We suggest an integrative approach of innovative, multimethod laboratory and field experiments and ecophysiological modelling, for which sustained scientific collaboration on NVP research will be essential., (© 2022 The Authors New Phytologist © 2022 New Phytologist Foundation.)

Objective: Type D personality, a joint tendency toward negative affectivity and social inhibition, has been linked to adverse events in patients with heart disease, although with inconsistent findings. Here, we apply an individual patient-data meta-analysis to data from 19 prospective cohort studies ( N = 11,151) to investigate the prediction of adverse outcomes by type D personality in patients with acquired cardiovascular disease., Method: For each outcome (all-cause mortality, cardiac mortality, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, major adverse cardiac event, any adverse event), we estimated type D's prognostic influence and the moderation by age, sex, and disease type., Results: In patients with cardiovascular disease, evidence for a type D effect in terms of the Bayes factor (BF) was strong for major adverse cardiac event (BF = 42.5; odds ratio [OR] = 1.14) and any adverse event (BF = 129.4; OR = 1.15). Evidence for the null hypothesis was found for all-cause mortality (BF = 45.9; OR = 1.03), cardiac mortality (BF = 23.7; OR = 0.99), and myocardial infarction (BF = 16.9; OR = 1.12), suggesting that type D had no effect on these outcomes. This evidence was similar in the subset of patients with coronary artery disease (CAD), but inconclusive for patients with heart failure (HF). Positive effects were found for negative affectivity on cardiac and all-cause mortality, with the latter being more pronounced in male than female patients., Conclusion: Across 19 prospective cohort studies, type D predicts adverse events in patients with CAD, whereas evidence in patients with HF was inconclusive. In both patients with CAD and HF, we found evidence for a null effect of type D on cardiac and all-cause mortality., (Copyright © 2023 by the American Psychosomatic Society.)

The pseudomorphic growth of Ge 1- x Sn x on Ge causes in-plane compressive strain, which degrades the superior properties of the Ge 1- x Sn x alloys. Therefore, efficient strain engineering is required. In this article, we present strain and band-gap engineering in Ge 1- x Sn x alloys grown on Ge a virtual substrate using post-growth nanosecond pulsed laser melting (PLM). Micro-Raman and x-ray diffraction (XRD) show that the initial in-plane compressive strain is removed. Moreover, for PLM energy densities higher than 0.5 J cm -2 , the Ge 0.89 Sn 0.11 layer becomes tensile strained. Simultaneously, as revealed by Rutherford Backscattering spectrometry, cross-sectional transmission electron microscopy investigations and XRD the crystalline quality and Sn-distribution in PLM-treated Ge 0.89 Sn 0.11 layers are only slightly affected. Additionally, the change of the band structure after PLM is confirmed by low-temperature photoreflectance measurements. The presented results prove that post-growth ns-range PLM is an effective way for band-gap and strain engineering in highly-mismatched alloys., (Creative Commons Attribution license.)

Aim: This study examined the participation in health-promoting measures by teachers and the perceived fit between offers and subjective needs from the teachers' perspective., Methods: In the academic year 2017/18, questionnaire-based data were collected at schools in the German state of Brandenburg (n=830). The teachers answered questions about the use, offer and subjective need regarding health-promoting measures., Results: 81.3% of teachers had participated in one or more health-promoting measures in the past 24 months. We found no significant differences in age, gender, type and sponsorship of school. In most subjects of health promotion, teachers indicated a considerably higher need for such measures compared to the perceived offer. From the teachers' point of view, there was a particular need for measures to change individual behavior and the health-promoting design of the schools and classrooms., Conclusion: When implementing prevention measures, the fit between offers and subjective needs from the teachers' point of view should be given greater consideration., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany.)

The availability of large-scale medical equipment such as computed tomography (CT), magnet resonance imaging (MRI) and positron emission tomography (PET) scanners has increased rapidly worldwide over the last decades. Among OECD countries, Germany ranks high according to the number of imaging technologies and their applications per inhabitant. In contrast to other countries, there is no active governmental planning of large-scale medical equipment. We therefore investigated whether and how the adoption and distribution of CT, MRI and PET scanners in the German inpatient sector is subject to competition. Using a linear-probability model, we additionally examined the impact of regional, hospital- and population-based factors. In summary, our results indicate that the adoption rate by hospital sites decreases with the number of other sites being already equipped with the respective device and their proximity. However, the effect presumably depends on the technologies' stage within the diffusion process. No influence regarding the amount of state subsidies could be identified. Furthermore, hospital size and university status strongly affect the adoption., (© 2021. The Author(s).)

Aim: The aim of this study was to examine the supply structures of computer tomographs (CT) and positron emission tomographs (PET) 20 years after abolishing site planning of large-scale medical equipment in the German inpatient sector., Methodology: Cartographic analyses were used to visualize the inpatient supply with CT and PET between 2010 and 2017. Regional differences were investigated in relation to population and disease burden to identify potentially over- and under-served areas., Results: Almost German-wide coverage was observed for CT. Only 0.3 percent of the population did not have access to a device within 30 minutes of driving distance. In contrast, larger segments of the population in extensive regions did not have timely access to PET. In addition, there was a high degree of regional variation in supply, which could not be explained either by population density or the disease burden of the region., Conclusion: The supply structures of large-scale medical equipment over decades without concrete regulatory interventions reveal regional variation. This is to be viewed critically from both an economic and a medical perspective. The extent to which strengthening competitive elements or cross-sectoral site planning can lead to a demand-oriented and efficient supply of large-scale medical equipment still needs to be investigated in more detail., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: While there are increasing empirical findings on general health literacy (HL), there is a lack of evidence on digital HL in adolescence and its association with health behavior., Methods: A cross-sectional study of 490 students from grade eight and nine from the federal state of Hesse was conducted from October 2019 to February 2020. Digital HL was assessed using five subscales of the Digital Health Literacy Instrument (DHLI), while consumption of fruits, vegetables, and soft drinks as well as weekly physical activity were used as indicators of health behavior. In addition to gender and grade level, subjective social status (SSS) was used as a social characteristic. Univariate, bivariate, and multivariate analyses were performed, with binary-logistic regression adjusted for gender and SSS., Results: Across all items, 15.3 to 37.5% of adolescents reported difficulties in acquiring and dealing with digital health information. Stratified by social characteristics, gender and socioeconomic differences were found with girls and respondents reporting a lower SSS more often showed a limited digital HL. Adolescents with moderate and low digital HL reported higher levels of low physical activity and non-daily fruit and daily soft drink consumption., Discussion: The findings suggest a need for interventions to promote digital HL among adolescents, particularly for those of low SSS. In this context, the differential relationship patterns with health behaviors provide an avenue for the development of specific interventions. The school as a place of teaching and learning is a suitable setting because, among other things, of its fit with the mandatory strategy of media literacy education in schools., (© 2022. The Author(s).)

COVID-19 initially spread among prominent global cities and soon to the urban centers of countries across the globe. While cities are the hotbeds of activities, they also seem highly exposed to global risks including the pandemic. Using the case of COVID-19 and the World Risk Index framework, this paper examines if the leading cities from the global south are inherently vulnerable and exposed to global risks and can they exacerbate the overall risk of their respective nations. Compared against their respective national averages, most of the 20 cities from 10 countries analyzed in this paper, have higher exposure, lower adaptive capacity, higher coping capacity and varied susceptibility. As this relative understanding is based on respective national averages which are often lower than the global standards, even high performance on certain indicators may still result in elevated predisposition. This paper concludes that the leading urban centers from the global south are highly likely to be predisposed to global risks due to their inherent vulnerability and exposure, and many of the drivers of this predisposition are related to the process of urbanization itself. This predisposition can enhance the overall exposure and vulnerability of the nation in which they are located., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Elsevier Ltd. All rights reserved.)

Background: Stressors such as safety culture in organizations that increase the risk of burnout have been studied in nursing and inpatient care settings. However, investigations in the setting of preclinical emergency medical services (EMS) are still limited. The study aims at (1) investigating burnout in health care workers in preclinical EMS and their perceived safety culture, and (2) analyzing the association between the two., Methods: Using the Maslach Burnout Inventory (MBI) and the Emergency Medical Services - Safety Attitudes Questionnaire (EMS-SAQ), an online survey was conducted with non-medical health care workers in preclinical EMS. Descriptive analyses were performed using frequencies, mean values, percentages and the Pearson correlation coefficient. A logistic regression model was used to determine the relationship between safety culture and the risk of burnout., Results: A total of 1,101 questionnaires was considered for analysis. Most of the participants were male (86.2%) and younger than 40 years (73.2%). A high risk of burnout for participants was found for the dimensions of emotional exhaustion and depersonalization (EE 26.3% and DP 40.2%). In the context of measuring safety culture, especially management, working conditions, and safety climate were negatively perceived by the participants. Furthermore, high stress recognition (EE: OR=3.317, p<0.01; DP: OR=1.910, p<0.01), negative job satisfaction (EE: OR=0.297, p<0.01; DP: OR=0.576, p<0.01) and negatively perceived working conditions (EE: OR 0.598, p<0.05; DP: 0.937, p<0.05) were significantly associated with a high risk of burnout., Conclusion: This is the first large scale study investigating burnout among non-medical health care workers in preclinical EMS and their perceived safety culture in Germany as well as the association between the two. The results show the necessity to focus on perceived dimensions of safety culture in organizations, to develop measures reducing stress and improve job satisfaction and working conditions. In the context of increasing skills shortage, this is especially relevant with regard to the challenges of patient safety and quality of outcomes in care., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Background: The implementation of evidence-based practice (EBP) is a central goal in health care. As in other areas, the transfer of scientific knowledge into clinical practice is very delayed or incomplete in physiotherapy. The primary aim of the present study is to describe the adherence to EBP among physiotherapists working in Germany. The secondary goal is the exploratory analysis of selected factors influencing the implementation of EBP., Methods: The present exploratory analysis is based on the data of physiotherapists who participated in a cross-sectional study on the use of EBP by health care professionals (study registration no.: DRKS00013792). The participants in the online survey completed the "Evidence-based Practice Inventory", a questionnaire with five dimensions used to quantify the adherence to EBP. Univariable and multivariable regression analysis was used to examine the associations between various sociodemographic characteristics and EBP., Results: 318 physiotherapists participated in the survey (age: 37±12 years; 60 % female; professional experience: 14±11 years). Approximately 70-80 % of the participants, in principle, had a positive attitude towards EBP and perceived EBP as helpful and useful in clinical practice. About 60 % of the respondents felt able to apply the principles of the EBP (e. g., acquisition, appraisal and application of external evidence). However, the data also showed that the implementation of EBP in clinical physiotherapeutic care is insufficient. For example, only 20 % of the respondents reported that their facility paid great attention to applying the principles of the EBP in decision-making, and only about a third of the respondents said that they frequently searched for or used external evidence. The strongest facilitators of EBP include the participation in scientific publications and more than one hour per week to read scientific literature at work., Conclusion: In principle, physiotherapists in Germany have a positive attitude towards EBP, but currently do not adequately take into account the principles of EBP. These factors should be further analyzed and targeted through effective interventions., (Copyright © 2022. Published by Elsevier GmbH.)