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Consumer perspectives on the national electronic health record and barriers to its adoption in Germany: does health policy require a change in communication?
Get PDFBackground The national health record (ePA) was introduced January 1st, 2021 in Germany and is available to every person insured under statutory health insurance. This study investigated the acceptance and expectations of the national health record in Germany, focusing on consumer perspectives, expectations, barriers, information needs, and communication aspects. Methods An exploratory, observational, cross-sectional online survey was conducted one year after ePA introduction, followed by descriptive statistical analysis. Results The top three ePA use cases were medical document collection, simplified data exchange between medical institutions, and emergency medical information. Adoption barriers included lack of information and access, privacy concerns, and perceived lack of necessity. Participants that felt informed about the ePA, reported they received information primarily from health insurances, the media, and educational or professional sources, mainly through printed brochures, social media, or via emails. Most participants (86.5%) preferred being informed through conversations, particularly with health insurance providers (81.5%) and doctors (61.0%). Written information was highly desired (94.5%), preferably via email or information letters/flyers. However, more than half of the participants (55.6%) reported being uninformed about the ePA introduction. Conclusion The study revealed a communication gap between providers and consumers, leading to a low acceptance rate of digital health technologies. Comparisons with other countries showed low adoption rates for opt-in systems. The authors suggest changing communication strategies, given users prefer direct information from doctors or health insurance companies. Adopting an opt-out system with professional social media and marketing campaigns could increase nationwide ePA adoption
Untersuchungen abstimmbarer Mikrowellenfilter für Hochfrequenzanwendungen
No full textIn dieser Arbeit wird die Synthese und Realisierung von abstimmbaren Mikrowellenfilter untersucht. Rekonfigurierbare Mikrowellenfilter können in zukünftigen Hochfrequenzanwendungen wie Mobilfunk oder Satellitenkommunikation eingesetzt werden und gelten als Schlüsselkomponenten für eine effiziente Datenübertragung. Im Allgemeinen lässt sich durch eine variable Anpassung der Mittenfrequenz oder Bandbreite das Frequenzspektrum effizienter nutzen. In dieser Arbeit werden unterschiedliche abstimmbare Mikrowellenfilter präsentiert, die jeweiligen Abstimmelemente analysiert sowie die Übertragungscharakteristik thematisiert. Als Erstes werden drei Filter präsentiert, in denen Flüssigkristall als zentrales Abstimmelement zum Einsatz kommt. Hierfür wird die Anisotropie der Flüssigkristallmoleküle ausgenutzt, um die relative Permittivität zu verändern. Die Umorientierung der Moleküle wird durch externe elektrische und magnetische Felder erreicht. Die Mittenfrequenz der drei Flüssigkristall-Filter liegt bei 30 GHz. Anschließend werden drei verschiedene Hohlleiterfilter präsentiert. Es werden unterschiedliche Entwürfe im W-Band, X-Band und Ku-Band vorgestellt. Hierbei kommen Kurzschlussschieber und Abstimmschrauben zur Variation der Resonanzfrequenzen zum Einsatz. Weiterhin thematisiert dieses Kapitel die Verwendung der konventionellen Methoden zur Erzeugung von Übertragungsnullstellen. Daraufhin werden zwei abstimmbare Koaxialresonatorfilter analysiert, welche in der Höhe verstellbare Innenleiter aufweisen. Durch weitere Abstimmschrauben oder durch Rotation der Innenleiter werden Abstimmeffekte realisiert. Die Mittenfrequenz der beiden Filter liegt bei ca. 2 GHz. Zum Schluss erfolgt eine Beurteilung der präsentierten Arbeit sowie ein Ausblick auf mögliche Forschungsthemen im Bereich der abstimmbaren Mikrowellenfilter
The North American Repository for Archaeological Isotopes
Get PDFHere, we present the North American Repository for Archaeological Isotopes (NARIA), the largest open-access compilation of previously reported isotopic measurements (n = 28,374) from bioarchaeological samples in North America (i.e., Canada, Greenland, Mexico, and the United States of America) covering a time-frame of more than 12,000 years. This database consists of stable (δ13C, δ15N, δ18O) and radiogenic (87Sr/86Sr) isotope measurements from archaeological human, animal, and plant sources and their corresponding contextual information (e.g., location, chronology, cultural affiliation, etc.). This synthesis of isotopic measurements and other forms of data presents significant research potential for investigating past human lifeways, particularly in the realms of paleomobility, paleoenvironment, and paleodiet. Additionally, it serves to pinpoint spatial and temporal data gaps, offering valuable insights for future research directions
The microbial mechanism of maize residue decomposition under different temperature and moisture regimes in a Solonchak
Get PDFSoil salinization becomes serious under climate change and human activities. Although the residue decomposition contributes lots to soil carbon storage and fertility, the decomposition process and microbial mechanisms on saline-alkali soils are still vague facing climate change. We measured the mass loss of residue (0, 4, 8, 15, 30, 60 and 90 days), CO2 emission (every two days), and the microbial community structure (0, 4, 15 and 90 days) by using the litter bag method, gas chromatography and high-throughput sequencing technology during the residue decomposition (90 days) in a saline-alkali soil from the Tarim River Basin, China under various temperatures (15 °C, 25 °C, 35 °C) and soil moisture levels (20%, 40%, 60% water holding capacity). The decomposition stage consisted of fast (0-15 days) and slow periods (15-90 days). Using the double exponential equation, the decomposition rates of labile and recalcitrant components, the labile component and cumulative CO2 emissions increased faster with increased moisture than with temperature. The Q10 was greater at 15-25 °C than at 25-35 °C, which increased with the increased soil moisture in the leaf but with decreased soil moisture in the stem at 15-25 °C. Proteobacteria increased from 0 to 15 days on leaves (25-43%) and stems (25-29%) and showed no changes thereafter. [...] Firmicutes were the main bacterial groups at 0-15 days, but decreased at 15-90 days (leaf: 44 - 15%, stem: 49 - 13%). In conclusion, warming, especially 15-25 °C, contributes to the decomposition of stems and wetting, especially 20-40% WHC, contributes to that of leaves within the first 15 days, afterwards wetting played an important role. Our results could also provide the adopting strategies for residue return to increase the soil carbon content while decreasing CO2 emissions facing climate change
An Expert Guide to Planning Experimental Tasks For Evidence-Accumulation Modeling
Get PDFEvidence-accumulation models (EAMs) are powerful tools for making sense of human and animal decision-making behavior. EAMs have generated significant theoretical advances in psychology, behavioral economics, and cognitive neuroscience and are increasingly used as a measurement tool in clinical research and other applied settings. Obtaining valid and reliable inferences from EAMs depends on knowing how to establish a close match between model assumptions and features of the task/data to which the model is applied. However, this knowledge is rarely articulated in the EAM literature, leaving beginners to rely on the private advice of mentors and colleagues and inefficient trial-and-error learning. In this article, we provide practical guidance for designing tasks appropriate for EAMs, relating experimental manipulations to EAM parameters, planning appropriate sample sizes, and preparing data and conducting an EAM analysis. Our advice is based on prior methodological studies and the our substantial collective experience with EAMs. By encouraging good task-design practices and warning of potential pitfalls, we hope to improve the quality and trustworthiness of future EAM research and applications
Robert Shea Terrell, A Nation Fermented. Beer, Bavaria, and the Making of Modern Germany. Oxford, Oxford University Press 2023
Get PDFRobert Shea Terrell, A Nation Fermented. Beer, Bavaria, and the Making of Modern Germany. 2023 Oxford University Press Oxford, 9780198881834, £ 35,
A Wave of Unbelief? Conservative Muslims and the Challenge of Ilḥād in the Post-2013 Arab World
Get PDFThis article analyses the spread of unbelief among conservative Egyptian and Syrian Muslims in the post-Arab Spring period. In this period, social media gave an unprecedented visibility to transgressive expressions of fiducial doubt, creating the impression of a ‘wave of atheism’ within the conservative milieu. Based on original sources and interviews, the article argues that what the participants called ‘atheism’ (ilḥād) must not be read from the perspective of preconceived notions of atheism, but examined inductively as an emergent phenomenon of nonreligion in a specific social context, the conservative Muslim and Islamist milieu. Its appearance can be traced to a multifaceted overlay of different developments and factors, including cultural and media globalisation, the unsettling social effects of the Arab Spring, and the severe doubts and disappointments suffered by sympathisers of political Islam in the post-2013 period. It is conceivable that a significant number of people defected from conservative Islam to other shapes of religion and nonreligion, but their personal trajectories await further research. More manifestly, the crisis provided an opportunity for a new generation of conservative religious guides and thinkers who have been leading an updating of religious socialisation and propagation methods among conservative Muslims
Nose-to-Brain Delivery of Antiseizure Drugs: Rational Design of Lipid Nanoparticle Systems
No full textThe treatment of central nervous system (CNS) diseases remains challenging due to the restrictive nature of the blood–brain barrier (BBB). While only a limited number of drugs can cross the BBB, strategies such as invasive administration or nanocarrier-based delivery have been developed to bypass it. In epilepsy, a considerable number of patients are pharmaco-resistant, often due to efflux transporters at the BBB. Optimised drug delivery strategies could help improve therapeutic efficacy by enhancing brain penetration or prolonging drug retention. This thesis explored nose-to-brain (N2B) delivery as a non-invasive and patient-friendly approach, particularly for childhood absence epilepsy. Small lipid-based nanoparticles (LNPs)—solid lipid nanoparticles (SLNs), nanostructured lipid carriers (NLCs), and liposomes—were used to encapsulate the antiseizure drugs ethosuximide (ETX) and lamotrigine (LTG). For ETX, a hydrophobic ion pairing strategy was investigated but failed due to unexpected chemical reactions. This led to the synthesis of a novel aliphatic ETX derivative, now awaiting preclinical characterisation. A major challenge in ETX-LNP formulation was the determination of encapsulation efficiency (EE). A systematic literature review of over 100 studies revealed inconsistent EE methods. Consequently, a structured development approach was proposed, including a decision tree to guide method selection and optimisation. For LTG, an NLC formulation was developed and refined using a quality-by-design strategy. The system showed significant and sustained seizure suppression in GAERS rats, even at low doses. To enhance storage stability and dosing, spray and freeze drying were evaluated. Notably, atomisation-induced shear destabilisation in spray drying was surfactant-dependent and impaired particle integrity.Die Behandlung von Erkrankungen des zentralen Nervensystems bleibt eine Herausforderung, da die Blut-Hirn-Schranke (BHS) den Übertritt vieler Wirkstoffe verhindert. Nur wenige Arzneistoffe können sie passieren. Neben invasiven Ansätzen wurden nanopartikuläre Trägersysteme entwickelt, um die BHS zu umgehen. Bei Epilepsie zeigt ein relevanter Teil der Patient:innen eine Pharmakoresistenz, oft bedingt durch Effluxtransporter an der BHS. Eine optimierte Wirkstofffreisetzung kann helfen, die Wirkung zu verbessern. Diese Arbeit untersucht die nasale Applikation zur Hirnversorgung (nose-to-brain, N2B) als nicht-invasive, patient:innenfreundliche Alternative – speziell bei kindlicher Absencen-Epilepsie. Lipidbasierte Nanopartikel wie solid lipid nanoparticles, nanostructured lipid carriers (NLCs) und Liposomen wurden zur Verkapselung der Antiepileptika Ethosuximid (ETX) und Lamotrigin (LTG) eingesetzt. Für ETX wurde ein hydrophobes Ionenpaarungskonzept verfolgt, das jedoch aufgrund unerwünschter chemischer Reaktionen scheiterte. Infolge dessen wurde eine neuartige aliphatische ETX-Derivatstruktur synthetisiert, die nun präklinisch evaluiert wird. Eine zentrale Herausforderung bei der ETX-Formulierung war die Bestimmung der Einschlussrate. Eine systematische Literaturrecherche von über 100 Studien zeigte eine uneinheitliche Methodenauswahl. Darauf aufbauend wurde ein strukturierter Entwicklungsansatz inkl. Entscheidungsbaum zur Methodenauswahl erstellt. Für LTG wurde eine NLC-Formulierung mittels QbD-Ansatz entwickelt und optimiert. Diese zeigte in einem GAERS-Rattenmodell eine signifikante Anfallsunterdrückung – trotz niedriger Dosis. Zur Stabilitäts- und Dosissteigerung wurden Sprüh- und Gefriertrocknung eingesetzt. Dabei zeigte sich, dass Scherstress beim Zerstäuben die Partikel destabilisieren kann – abhängig vom eingesetzten Tensid
Lyrik, poésie et poésie lyrique | Lyrik, poésie und poésie lyrique | Lyric, poésie and poésie lyrique: En guise d’introduction | Zur Einleitung | An introduction
Get PDFDie Einführung in Heft 3 von POEMA diskutiert die Entwicklung und Definition der ›poésie lyrique‹ als eigenständige literarische Gattung. Ausgangspunkt ist Charles Batteux’ Theorie, die Lyrik als Ausdruck von Gefühlen und zugleich als fiktionale Nachahmung versteht. Die Debatte um das ›lyrische Ich‹ beleuchtet die enge Verknüpfung von Autor und Text, besonders in der französischen Tradition. Neuere Ansätze hinterfragen diese Verbindung, ohne sie völlig aufzugeben. Gezeigt wird, dass eine eindeutige Definition von Lyrik kaum möglich ist. Gleichwohl werden zentrale Merkmale wie Gefühl, Formdominanz und subjektive Perspektive heraus- und moderne Formen wie digitale, mehrsprachige und realitätsbezogene Lyrik vorgestellt.The introduction to issue 3 of POEMA discusses the development and definition of ›poésie lyrique‹ as an independent literary genre. It begins with Charles Batteux’s theory, which views lyric poetry as an expression of emotions and, at the same time, as fictional imitation. The debate on the ›lyrical I‹ highlights the close connection between author and text, especially in the French tradition. More recent approaches question this link without completely abandoning it. The text shows that a clear definition of lyric poetry is hardly possible. Nevertheless, key characteristics such as emotion, formal dominance, and subjective perspective are emphasized, and modern forms such as digital, multilingual, and reality-oriented poetry are presented.L’introduction du troisième numéro de POEMA aborde le développement et la définition de la « poésie lyrique » en tant que genre littéraire autonome. Elle prend pour point de départ la théorie de Charles Batteux, qui considère la poésie lyrique à la fois comme expression des sentiments et comme imitation fictionnelle. Le débat autour du « je lyrique » met en lumière le lien étroit entre l’auteur et le texte, notamment dans la tradition française. Des approches plus récentes remettent en question cette relation sans l’abandonner entièrement. Le texte montre qu’une définition claire de la poésie lyrique est difficilement possible. Néanmoins, des caractéristiques centrales comme l’émotion, la prédominance formelle et la perspective subjective sont mises en avant, ainsi que des formes modernes telles que la poésie numérique, multilingue et ancrée dans le réel
Corrosion inhibitors for bare and PEO-coated Mg alloys
Get PDFMagnesium (Mg) alloys offer excellent strength-to-weight ratio and biocompatibility, making them attractive for automotive, aerospace, and biomedical applications. However, their widespread use is limited by their high corrosion susceptibility. Plasma Electrolytic Oxidation (PEO) coatings have emerged as a promising solution, providing a protective barrier and enabling the incorporation of corrosion inhibitors for active protection. Despite this potential, little is known about which inhibitors are truly effective in PEO-coated Mg systems. This thesis systematically investigates a wide range of corrosion inhibitors to enhance the durability of PEO-coated AZ21 Mg alloy. Screening over twenty candidates revealed that inhibitors effective on bare Mg do not necessarily perform well in PEO systems. For instance, 2,5-pyridinedicarboxylate sodium salt (2,5PDC-Na) was found to degrade the coating rather than protect it. This unexpected behavior was studied in depth to understand the underlying mechanisms. In contrast, sodium salts of 8-hydroxyquinoline (8HQ) and decylphosphonic acid (DP) significantly improved the corrosion resistance of PEO-coated Mg. DP, in particular, extended the coating's lifetime by more than 50 days compared to a reference system without inhibitors. Its superior performance was linked to the formation of insoluble compounds with Mg²⁺ ions, effectively blocking corrosion pathways. Based on these findings, the thesis proposes a set of criteria for selecting inhibitors for PEO-coated Mg alloys, emphasizing the importance of forming stable, insoluble compounds. These guidelines were applied retrospectively to validate their broader applicability. The insights provided contribute to a better understanding of inhibitor-PEO interactions and support the development of more robust Mg-based materials for critical applications