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Autocratization of the state in Turkey:an analysis of decree-laws and presidential decrees between 2016-2023
No full textDas Ziel dieser Dissertation ist es, die Autokratisierung des Staates in der Türkei im Hinblick auf Machtverschiebungen und -konzentration unter der Herrschaft der Partei für Gerechtigkeit und Entwicklung (AKP) und Präsident Erdogan zu verstehen. Es wird argumentiert, dass der Putschversuch vom 15. Juli der Wendepunkt war, der die Autokratisierung beschleunigte und zu einem System- und Regimewechsel führte, und dass die zwischen 2016 und 2023 erlassenen Gesetzesdekrete und Präsidentendekrete die wichtigsten Instrumente waren, um dies zu erreichen. Daher werden diese offiziellen Dokumente im Hinblick auf Machtverschiebungen und -konzentration analysiert und die Autokratisierung des Staates aufgedeckt. Während Gesetzesdekrete Machtverschiebungen ermöglichen und Autokratisierung begünstigen, konzentrieren Präsidialdekrete die Exekutivgewalt in den Händen des Präsidenten. Darüber hinaus wird argumentiert, dass die Autokratisierung zu schwerwiegenden Problemen im Regierungsprozess führt, wodurch der Präsident scheinbar gestärkt wird, während er in Wirklichkeit in seiner Regierungsfähigkeit eingeschränkt und seine Macht unweigerlich geschwächt wird.The aim of this dissertation is to understand the autocratization of the state in Turkey in terms of power shifts and concentration under the rule of the Justice and Development Party (AKP) and President Erdogan. It is argued that the July 15 coup attempt was the turning point that accelerated the autocratization leading to system and regime change and that the decree-laws and presidential decrees issued between 2016 and 2023 were the main instruments used to achieve this. Therefore, these official documents will be analyzed in terms of power shifts and concentration and the autocratization of the state will be revealed. While decree-laws enable power shifts and facilitate autocratization, presidential decrees concentrate executive power in the hands of the President. Moreover, it will be argued that autocratization leads to serious problems in the governance process, thus ostensibly empowering the President while in fact limiting his ability to govern and inevitably weakening his power
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
Disentangling the impact of cerebrospinal fluid formation and neuronal activity on solute clearance from the brain
No full textBackground: Despite recent attention, pathways and mechanisms of fluid transposition in the brain are still a matter of intense discussion and driving forces underlying waste clearance in the brain remain elusive. Consensus exists that net solute transport is a prerequisite for efficient clearance. The individual impact of neuronal activity and cerebrospinal fluid (CSF) formation, which both vary with brain state and anesthesia, remain unclear. Methods: To separate conditions with high and low neuronal activity and high and low CSF formation, different anesthetic regimens in naive rat were established, using Isoflurane (ISO), Medetomidine (MED), acetazolamide or combinations thereof. With dynamic contrast-enhanced MRI, after application of low molecular weight contrast agent (CA) Gadobutrol to cisterna magna, tracer distribution was monitored as surrogate for solute clearance. Simultaneous fiber-based Ca2+-recordings informed about the state of neuronal activity under different anesthetic regimen. T2-weighted MRI and diffusion-weighted MRI (DWI) provided size of subarachnoidal space and aqueductal flow as surrogates for CSF formation. Finally, a pathway and mechanism-independent two-compartment model was introduced to provide a measure of efficiency for solute clearance from the brain. Results: Anatomical imaging, DWI and Ca2+-recordings confirmed that conditions with distinct levels of neuronal activity and CSF formation were achieved. A sleep-resembling condition, with reduced neuronal activity and enhanced CSF formation was achieved using ISO+MED and an awake-like condition with high neuronal activity using MED alone. CA distribution in the brain correlated with the rate of CSF formation. The cortical brain state had major influence on tracer diffusion. Under conditions with low neuronal activity, higher diffusivity suggested enlargement of extracellular space, facilitating a deeper permeation of solutes into brain parenchyma. Under conditions with high neuronal activity, diffusion of solutes into parenchyma was hindered and clearance along paravascular pathways facilitated. Exclusively based on the measured time signal curves, the two-compartment model provided net exchange ratios, which were significantly larger for the sleep-resembling condition than for the awake-like condition. Conclusions: Efficiency of solute clearance in brain changes with alterations in both state of neuronal activity and CSF formation. Our clearance pathway and mechanism agnostic kinetic model informs about net solute transport, solely based on the measured time signal curves. This rather simplifying approach largely accords with preclinical and clinical findings
Diskurse des Feudalismus und des gerechten Krieges im Don Quijote
No full textDas Dokument untersucht die Diskurse des Feudalismus und des gerechten Krieges im "Don Quijote". Es wird analysiert, wie Cervantes die feudalen Strukturen und die Rechtfertigungen für Kriege im Kontext der spanischen Literatur des Siglo de Oro darstellt und kritisiert. Der Text verbindet die Analyse dieser Themen mit der Philosophie Hegels, insbesondere dem Herr-Knecht-Verhältnis. Es wird gezeigt, wie Don Quijote die Feudalordnung parodiert und gleichzeitig die Legitimität von Kriegen hinterfragt, indem er die Begründungen für Gewalt und Herrschaft in einem neuen Licht präsentiert
Effect of Prior Transurethral Prostate Resection (TURP) or Laser Enucleation (ThuLEP) on Radiotherapy-Induced Toxicity and Quality of Life in Prostate Cancer Patients Undergoing Definitive Radiotherapy
No full textIn our study, the post-radiotherapy quality of life of prostate cancer patients who previously underwent transurethral resection of the prostate (TURP) is compared to those who had thulium laser enucleation of the prostate (ThuLEP) and those who had no prior surgery. It also aims to identify and assess risk factors affecting therapy tolerance in this patient group. We analyzed 132 patients with localized prostate cancer treated with definitive radiotherapy (RT), including 23 who had prior TURP and 19 who previously underwent ThuLEP. A total of 62% of patients underwent irradiation within 12 months after surgery. We included only patients treated with radiotherapy using the IMRT technique. Changes in patient-reported urinary toxicity were evaluated using the International Prostate Syndrome Score (IPSS) and the quality of life index of the World Health Organization (QoL/WHO-PSS) over a three-year post-radiotherapy period. Patients with prior TURP experienced significant deterioration in QoL and IPSS immediately after irradiation (p < 0.001), whereas those without previous surgery showed both less significant differences in IPSS and QoL scores. In conclusion, patients with previous TURP/ThuLEP differ from those without previous surgery in urinary quality of life and acute and chronic urinary symptom profiles after RT. The surgical technique (ThuLEP vs. TURP) and the time interval to irradiation are crucial factors affecting RT tolerance in acute and late settings. The previously operated patient group reported a significantly longer period of increased symptom burden
Effects of a short-term fasting period as a model for excitation manipulation on brain volume and cognitive performance
No full textDie für eine gesunde Gehirnfunktion notwendige Balance aus exzitatorischen und inhibitorischen Signalen und ihre Regulationsmechanismen bieten die Grundlage zur Erklärung multipler assoziierter Erkrankungen, sowie für Interventions- und Behandlungsmaßnahmen. Eine 72-stündige Fastenperiode, als möglicher Modulator neuronaler Exzitabilität in Form erhöhter synaptischer Lipidsignalisierung, bewirkte in unserer longitudinalen, klinisch experimentellen Studie mit 30 gesunden, männlichen Probanden zwischen 18 und 49 eine Abnahme der neurokognitiven Performanz im d2-Attention-Test, sowie eine Zunahme depressiver Symptome, negativer Emotionen, Ängstlichkeit und Nahrungsverlangen, sowie eine Zunahme des Gehirnvolumens im gefasteten Zustand in multiplen Clustern in einer ROI- und Whole-Brain-Analyse. Zusätzlich zeigte sich eine möglicherweise durch osmotische Neuronenschwellung bedingte, negative Korrelation zwischen kognitiver Leistung und fasteninduzierter Volumenzunahme
A magnetic resonance imaging based radiomics model to predict mitosis cycles in intracranial meningioma
No full textThe aim of this study was to develop a magnetic resonance imaging (MRI) based radiomics model to predict mitosis cycles in intracranial meningioma grading prior to surgery. Preoperative contrast-enhanced T1-weighted (T1CE) cerebral MRI data of 167 meningioma patients between 2015 and 2020 were obtained, preprocessed and segmented using the 3D Slicer software and the PyRadiomics plugin. In total 145 radiomics features of the T1CE MRI images were computed. The criterion on the basis of which the feature selection was made is whether the number of mitoses per 10 high power field (HPF) is greater than or equal to zero. Our analyses show that machine learning algorithms can be used to make accurate predictions about whether the number of mitoses per 10 HPF is greater than or equal to zero. We obtained our best model using Ridge regression for feature pre-selection, followed by stepwise logistic regression for final model construction. Using independent test data, this model resulted in an AUC (Area under the Curve) of 0.8523, an accuracy of 0.7941, a sensitivity of 0.8182, a specificity of 0.7500 and a Cohen’s Kappa of 0.5576. We analyzed the performance of this model as a function of the number of mitoses per 10 HPF. The model performs well for cases with zero mitoses as well as for cases with more than one mitosis per 10 HPF. The worst model performance (accuracy = 0.6250) is obtained for cases with one mitosis per 10 HPF. Our results show that MRI-based radiomics may be a promising approach to predict the mitosis cycles in intracranial meningioma prior to surgery. Specifically, our approach may offer a non-invasive means of detecting the early stages of a malignant process in meningiomas prior to the onset of clinical symptoms
Developments in Severance Payments for Executive Board Members from 2010 to 2019
No full textDieser Beitrag untersucht die Entwicklung der Akzeptanz der Empfehlung G.13 Satz 1 des Deutschen Corporate Governance Kodex (in der Fassung vom 16. Dezember 2019, vormals 4.2.3 Abs. 4 Satz 1), die für vorzeitige Vertragsbeendigungen von Vorstandsmitgliedern Abfindungsobergrenzen vorsieht. Die Abfindungshöhen der vorzeitig ausscheidenden Vorstandsmitglieder von DAX-Unternehmen im Verhältnis zu Jahresvergütung und Restvertragslaufzeit sind im Zeitraum 2015 bis 2019 signifikant niedriger als zwischen 2010 und 2014. Ein signifikanter Rückgang der Abfindungsfälle kann hingegen nicht nachgewiesen werden. In den Erklärungen nach § 161 AktG der DAX-Unternehmen ist die Abweichungsquote bezüglich der untersuchten Empfehlung rückläufig, jedoch wird eine Überschreitung der empfohlenen Obergrenze in keinem der Fälle in der folgenden Erklärung erwähnt. Schließlich gibt es zunehmend andere Formen großzügiger Zahlungen an ausscheidende Vorstandsmitglieder neben den nicht mehr so üppigen Abfindungen.This study investigates the development of the acceptance of Recommendation G.13 sentence 1 of the German Corporate Governance Code (dated December 16, 2019, formerly 4.2.3 paragraph 4 sentence 1), which provides ceilings for early termination of contracts of members of the executive board. The severance payment amounts of early retiring members of the executive board of DAX companies in relation to annual compensation and remaining contract term are significantly lower in the period 2015 to 2019 than between 2010 and 2014. However, there is no evidence of a significant decrease in severance cases. In the DAX companies’ declarations of conformity pursuant to § 161 AktG, the rate of deviation with respect to the recommendation under consideration is decreasing, but an exceeding of the recommended upper limit is not mentioned in any of the following declarations of conformity. Finally, there are increasingly other forms of generous payments to departing board members in addition to the less generous severance payments
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
Integrating I(I)/I(III) catalysis in reaction cascade design enables the synthesis of gem-difluorinated tetralins from cyclobutanols
No full textPartially saturated, fluorine-containing rings are ubiquitous across the drug discovery spectrum. This capitalises upon the biological significance of the native structure and the physicochemical advantages conferred by fluorination. Motivated by the significance of aryl tetralins in bioactive small molecules, a reaction cascade has been validated to generate novel gem-difluorinated isosteres from 1,3-diaryl cyclobutanols in a single operation. Under the Brønsted acidity of the catalysis conditions, an acid-catalysed unmasking/fluorination sequence generates a homoallylic fluoride in situ. This species serves as the substrate for an I(I)/I(III) cycle and is processed, via a phenonium ion rearrangement, to an (isolable) 1,3,3-trifluoride. A final C(sp3)-F bond activation event, enabled by HFIP, forges the difluorinated tetralin scaffold. The cascade is highly modular, enabling the intermediates to be intercepted: this provides an expansive platform for the generation of structural diversity