University of Münster
Münstersches Informations und Archivsystem für Multimediale InhalteNot a member yet
10543 research outputs found
Sort by
Contemporary in-hospital and long-term prognosis of patients with acute ST-elevation myocardial infarction depending on renal function: a retrospective analysis
No full textBackground: Cardiovascular disease is often associated with chronic kidney disease (CKD), resulting in an increased risk for poor outcome. We sought to determine short-term mortality and overall survival in ST-elevation myocardial infarction (STEMI) patients with different stages of CKD. Methods: In our retrospective cohort study with health insurance claims data of the Allgemeine Ortskrankenkasse (AOK), anonymized data of all STEMI patients hospitalized between 2010 and 2017 were analyzed regarding presence and severity of concomitant CKD. Results: A total of 175,187 patients had an index-hospitalisation for STEMI (without CKD: 78.6% patients, CKD stage 1: 0.8%, CKD stage 2: 4.8%, CKD stage 3: 11.7%, CKD stage 4: 2.8%, CKD stage 5: 0.7%, CKD stage 5d: 0.6%). Patients with CKD were older and had more co-morbidities than patients without CKD. With increasing CKD severity, patients received less revascularization therapies (91.2%, 85.9%, 87.0%, 81.8%, 71.7%, 76.9% and 78.6% respectively, p < 0.001). After 1 year, guideline-recommended medications were prescribed less frequently in advanced CKD (83.4%, 79.3%, 81.5%, 74.7%, 65.0%, 59.4% and 53.7%, respectively, p < 0.001). CKD stages 4, 5 and 5d as well as chronic limb threatening ischemia (CLTI) were associated with decreased overall survival [CKD stage 4: hazard ratio (HR) 1.72; 95% CI 1.66–1.78; CKD stage 5: HR 2.55; 95% CI 2.37–2.73; CKD stage 5d: 5.64; 95% CI 5.42–5.86; CLTI: 2.06; 95% CI 1.98–2.13; all p < 0.001]. Conclusions: CKD is a frequent co-morbidity in patients with STEMI and is associated with a worse prognosis especially in advanced stages. Guideline-recommended therapies in patients with STEMI and CKD are still underused
Coriolano:Tragedia per Musica (1749), GraunWV B:I:20 (2025)
No full textCarl Heinrich Graun erhielt seine musikalische Ausbildung an die Kreuzschule in Dresden. 1725 wurde er an den Hof Herzog August Wilhelms von Braunschweig-Wolfenbüttel berufen, wo er bald zum Vizekapellmeister aufstieg. Der preußische Kronprinz Friedrich verpflichtete Graun 1735 für seine Hofkapelle in Ruppin und Rheinsberg, und im Jahr der Krönung Friedrichs zum preußischen König 1740 wurde Graun zum Hofkapellmeister ernannt. Grauns Kompositionsstil traf den Geschmack des Königs und der musikliebenden Gesellschaft so sehr, dass er bis zu seinem Tod unangefochten an der Spitze des Opernwesens Berlins stand. In der Musikbibliothek Rheda ist eine bedeutende Sammlung von Bearbeitungen und Auszügen aus insgesamt 20 Opern von Carl Heinrich Graun erhalten, darunter auch die Sinfonia sowie acht Arien aus der 1749 in Berlin uraufgeführten Oper "Coriolano". Um diese Abschriften in den Gesamtkontext der Oper einzuordnen, wurde dieses Werk anhand der in Berlin aufbewahrten Partitur vollständig ediert. - In der ersten Ausgabe von 2021 waren einige kleinere Fehler enthalten, die in dieser Ausgabe korrigiert wurden
Dissociation of value extraction: the financialisation of solidarity-based German ambulatory healthcare
No full textThis paper explores why the financialisation of physician practices by private equity (PE) and the resulting value extraction from Germany’s solidarity-based healthcare system go largely unexamined in healthcare studies and regulation, despite contestation by medical associations. It contributes to feminist political-economic critiques of finance’s impact on social reproduction, employing the perspectives of economisation and dissociation from heterodox economic geography. This framework reveals how a solidarity-based health economy has historically aligned with neoclassical logics and how value extraction falls from view in this framing. Drawing on analyses of corporate spatial structures of PE-led healthcare chains, as well as narrative patterns from expert interviews and a text corpus on the disputed financialised restructuring of ambulatory healthcare, the paper identifies two dissociations that obscure value extraction and hinder effective regulatory oversight. First, the discursive framing of the ambulatory health economy through a neoclassical (health) economics lens makes value extraction seem implausible or invisible. Second, the opaque spatial ownership structures of PE-led healthcare chains prevent independent, evidence-based monitoring of these financialised healthcare providers. Therefore, the paper advocates for incorporating heterodox perspectives in health policy advising to rethink and foster definancialised investment and ownership models for a sustainable and solidarity-based future health economy.Das Paper untersucht die unbeachtete Finanzialisierung von Arztpraxen durch Private Equity (PE) und die Wertextraktion aus dem deutschen Gesundheitssystem. Es verbindet feministische polit-ökonomische Kritiken der Finanzialisierung sozialer Reproduktion mit den heterodox wirtschaftsgeographischen Perspektiven von Economization und Dissoziation. Es zeigt, wie das traditionell solidarische Gesundheitssystem zunehmend durch neoklassische Logiken überformt wird, wodurch Wertextraktion unsichtbar wird. Qualitative Analysen räumlicher Eigentumsstrukturen von PE- Facharztketten sowie narrativer Muster in Experteninterviews und Textkorpus identifizieren zwei Dissoziationen: Die neoklassische Rahmung des ambulanten Sektors verschleiert Wertextraktion und komplexe Eigentümerstrukturen verhindern unabhängiges Monitoring. Das Paper empfiehlt heterodoxe Ansätze in der Gesundheitspolitik für eine Förderung nachhaltiger Finanzierungs- und Eigentumsmodelle von Gesundheitsversorgung
Estimates for Kähler metrics with prescribed scalar curvature
No full textDiese Arbeit untersucht zwei Aspekte des Verhaltens von Kählermannigfaltigkeiten mit kontrollierter skalaren Krümmung.
Der erste Teil befasst sich mit der Stabilität des Positiven Massentheorems für asymptotisch euklidische (AE) Kählermannigfaltigkeiten mit nichtnegativer skalaren Krümmung. Zunächst beweisen wir eine Integrationsungleichung für die ADM-Masse auf AE-Kählermannigfaltigkeiten beliebiger komplexer Dimension. Mithilfe dieses Ergebnisses beweisen wir einen Stabilitätssatz für jede Folge von AE-Kählermannigfaltigkeiten, deren ADM-Masse gegen null konvergiert.
Der zweite Teil untersucht das Grenzverhalten von Kählermetriken mit gleichmäßig beschränkter skalaren Krümmung am Apex einer konischen Kählermannigfaltigkeit. Zunächst beweisen wir einen Liouville-Satz für Kählermetriken mit konstanter skalaren Krümmung (cscK).
Anschließend entwickeln wir eine Hölder-artige Abschätzung für gleichmäßig beschränkte Kählermetriken auf einer Kugel um den Apex. Diese Abschätzung gilt für kleine positive Exponenten unter der Annahme gleichmäßig beschränkter skalaren Krümmung. Als Korollar dieses Ergebnisses zeigen wir, dass eine solche Kählermetrik asymptotisch zur Ricci-flachen Kegelmetrik mit polynomialer Abklingrate ist.This thesis studies two aspects of the behavior of Kähler manifolds with controlled scalar curvature.
The first part studies the stability of the Positive Mass Theorem for asymptotically Euclidean (AE) Kähler manifolds with nonnegative scalar curvature. We first prove an integral inequality for the ADM mass on AE Kähler manifolds of all complex dimensions. Using this, we prove a stability result for any sequence of AE Kähler manifolds with ADM mass converging to zero.
The second part studies the limiting behavior of Kähler metrics with uniformly bounded scalar curvature and at the apex of a conical Kähler manifold. We first establish a Liouville theorem for constant scalar curvature Kähler (cscK) metrics on.
Next, we develop a Hölder-type estimate for uniformly bounded Kähler metrics on a ball around the apex This estimate applies for small, positive exponents under the assumption of uniformly bounded scalar curvature. As a corollary of this result, we show that such a Kähler metric is asymptotic to the Ricci-flat cone metric with polynomial decay rate
Habitat use, survival, and migration of a little-known East Asian endemic, the yellow-throated bunting Emberiza elegans
No full textBasic information on the ecology of species is key for their conservation. Here we study the ecology of the little-known yellow-throated bunting Emberiza elegans based on a multi-year study on its breeding grounds in the Russian Far East. For the first time in this species, we quantified breeding habitat parameters, calculated sex-specific apparent survival, and determined individual nonbreeding locations using light-level geolocation. We found that the habitat around song posts of male yellow-throated buntings is characterized by tree and shrub layers on richly littered moist ground. Habitat use overlaps with co-occurring Tristram's Buntings Emberiza tristrami and Black-faced Buntings E. spodocephala, but territories differ especially in tree cover and litter cover. Based on 4 years of color-ringing data of 72 individuals, we calculated an apparent survival rate of 36%, with higher survival estimates for male than for female yellow-throated buntings. We found no effect of carrying a geolocator on survival. We retrieved six geolocators from males. All birds migrated south-westward during autumn and spent the nonbreeding season at locations in China 700–1700 km away from their breeding sites. At least two individuals spent the boreal winter outside of the known range in northern or central China. Birds left the breeding area between early October and early November and returned between mid-March and mid-April. Our data on habitat use, survival rate, and migratory connectivity will help to assess threats to the populations of this enigmatic species, which might include habitat loss due to forest fires on the breeding grounds, and unsustainable harvest for consumption during the nonbreeding season
High-bandwidth noise-reduced loss-corrected autobalanced detection
No full textA compact and easy-to-use high-bandwidth autobalanced detector for microscopy is presented, being able to remove up to 67 dB of correlated noise, thus, allowing for shot-noise limited image acquisition even in the presence of high laser excess noise. Detecting a 20 MHz modulation frequency at half the repetition rate of the driving pulsed laser, the autobalanced detector is able to exploit an extra +3 dB increase in signal-to-noise ratio due to the coherent addition of modulation sidebands in stimulated Raman scattering. Pixel-by-pixel noise canceling and correction of sample transmission losses are possible for pixel scan rates of more than 1.7 Mpx/s, enabling full autobalanced operation at imaging speeds of more than 6.5 frames per second for 512 x 512 px images. It is demonstrated that the autobalanced detector is able to separate an overlaying parasitic loss-induced image from a stimulated Raman scattering microscopy image, providing both the noise and transmission corrected stimulated Raman scattering image as well as an attenuation image simultaneously
Improving the Care of Severe, Open Fractures and Postoperative Infections of the Lower Extremities: Protocol for an Interdisciplinary Treatment Approach
No full textBackground: Patients with open fractures often experience complications during their injury. The treatments incur high costs. Interdisciplinary cooperation between different medical disciplines may improve treatment outcomes. Such cooperation has not yet been envisaged in the German health care system. Objective: The aim of the study is to improve the treatment of fractures with open soft tissue damage or postoperative complications in terms of duration and sustainability in a region in northwest Germany. Largely standardized diagnostics and therapy are intended to optimize processes in hospitals. In addition, a reduction in the duration of treatment and treatment costs is to be achieved.
Methods: Using a digital platform, physicians from 31 hospitals present patient cases to an interdisciplinary group of experts from the fields of plastic surgery, infectiology, hygiene, and others. The group of experts from the environment of the University Hospital Münster promptly makes a joint treatment recommendation for the individual case. The plan is to examine 3300 patients with open fractures or surgical complications. As consortium partners, there are also 3 statutory health insurance companies. The extent to which the therapy recommendations are effective and contribute to cost reduction in the health care system will be empirically investigated in a stepped-wedge cluster-randomized design. In addition, medical and nonmedical professional groups involved in the project will be asked about their work in the project (in total, 248 clinic employees). The primary outcome is the complication rate of open fractures or the occurrence of postoperative complications. As secondary outcomes, the number of antibiotics administered, limb function, and quality of life will be assessed. The health economic evaluation refers to the costs of health services and absenteeism. For the work-related evaluation, workload, work engagement, work-related resources, readiness for technology, and ergonomic aspects of the new telemedical technology will be collected. In addition, clinic employees will give their assessments of the success of the project in a structured telephone interview based on scaled and open-ended questions. Results: The project started in June 2022; data collection started in April 2023. As of mid-June 2024, data from 425 patients had been included. In total, 146 members of staff had taken part in the questionnaire survey and 15 had taken part in the interviews. Conclusions: Standardized treatment pathways in the standard care of patients with open fractures and postoperative infections will be established to reduce complications, improve chances of recovery, and reduce costs. Unnecessary and redundant treatment steps will be avoided through standardized diagnostics and therapy. The interdisciplinary treatment perspective allows for a more individualized therapy. In the medium term, outpatient or inpatient treatment centers specialized in the patient group could be set up where the new diagnostic and therapeutic pathways could be competently applied
Kafka’s Lasting Legacy: Why We Still Talk About Him 100 Years Later
No full textFranz Kafkas Schaffen resoniert selbst 100 Jahre nach seinem Tod in Literatur, Philophie und Populärkultur. Dieser Artikel erkundet Kafkas Erbe, indem es sein Werk mit modernen Medien wie "Seinfeld" und Breaking Bad" kontextualisiert, in denen Absurdität, Ausweglosigkeit und bürokratische Frustration seine Themen spiegeln. Der Artikel untersucht Kafkas Verbindungen zum jiddischen Theater, die Evolution jüdischen Humors und, wie Termini wie "kafkaesk" Sprache und Kultur durchdringen. Von Kafkas surrealen Welten bis hin zu Jerrys und Georges neurotischen Eskapaden, Kafkas Visionen bleiben Relevant, weil sie unser Verständnis der modernen Absurditäten geformt haben.Franz Kafka's influence resonates across literature, philosophy, and popular culture, even 100 years after his death. This blog explores Kafka's legacy, connecting his works to modern media like "Seinfeld" and "Breaking Bad", where absurdity, confinement, and bureaucratic frustration mirror his themes. It examines Kafka’s ties to Yiddish theater, the evolution of Jewish humor, and how terms like "Kafkaesque" have permeated language and culture. From Kafka’s surreal worlds to Jerry and George’s neurotic escapades, the enduring relevance of Kafka’s vision continues to shape how we interpret modern absurdities