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Zwischen Kooperation und Konkurrenz: Vernetzung der Akteur*innen der Wasserstoffindustrie, -politik und -wissenschaft in Deutschland
No full textWelche Netzwerke der Wasserstoffindustrie, der Politik und der Wissenschaft bestehen in Deutschland und welche Bedeutung messen die Beteiligten ihnen bei? Diese Frage stand im Zentrum einer quantitativen Befragung von 170 Stakeholderinnen und Stakeholdern aus der Wasserstoffindustrie, der Politik und der Wissenschaft. Das Arbeitspapier stellt die Ergebnisse dieser Untersuchung vor. Sie zeigen, dass regionale Netzwerke die Landschaft der Wasserstoffbranche in Deutschland prägen. Vernetzung wird vor allem wegen der Möglichkeiten zur Kooperation, zum Wissensaustausch und zur Steigerung der Reputation geschätzt, während praktische Vorteile wie die Personalgewinnung eine nachrangige Rolle spielen. Besonders relevant erscheint die Vernetzung in den Bereichen Infrastruktur, Sicherheit und Regulierung. Die Ergebnisse verdeutlichen, dass Netzwerke zu den zentralen Treibern der Wasserstofftransformation in Deutschland zählen.This study examines how actors from Germany’s hydrogen industry, politics and science are connected through networks and how they perceive their value. Drawing on a quantitative survey of 170 stakeholders, the analysis shows that regional networks dominate the German hydrogen landscape, while strategic initiatives enjoy disproportionate visibility and influence. Overall, membership is perceived as highly beneficial, particularly for cooperation, knowledge exchange and reputation building, whereas more practical benefits such as recruitment or direct problem solving play a minor role. Stakeholders also highlight future networking needs that go beyond technical development, stressing infrastructure, safety, regulatory frameworks and cross-sector integration as crucial fields. The findings suggest that networks are a key driver of the hydrogen transition in Germany, providing platforms for coordination, trust-building and strategic orientation in an emerging market
A Comparative Analysis of Carlevale IOL Versus Artisan IOL Implantation Using a Scleral Tunnel Incision Technique
No full textBackground: The aim of this retrospective study was to compare the surgical and refractive outcomes using the Carlevale IOL (FIL SSF; SOLEKO) with those of the retropupillary-fixated Artisan IOL (Aphakia Model 205; OPHTEC), implanted through a 6 mm sclerocorneal tunnel incision in both groups. Methods: This study included 51 consecutive eyes (25 Carlevale and 26 Artisan IOLs). Due to complex preoperative conditions (e.g., dislocated polymethylmethacrylat IOL, luxated Cataracta rubra), all patients underwent lens explantation using a standardized 6 mm sclerocorneal tunnel incision and a 23 G or 25 G pars plana vitrectomy. Visual acuity (VA), spherical equivalent, refractive prediction error (PE), incision-suture time, and complication rates were recorded preoperatively and during the follow-up period. Results: The average follow-up period was 40.9 ± 5.7 days. VA improved by 0.28 ± 0.39 logMAR (p < 0.0001) in the Carlevale group and by 0.36 ± 0.47 logMAR (p < 0.0001) in the Artisan group. The improvement was comparable between both groups (p = 0.921). The deviation of the PE was −0.67 ± 0.56 in the Carlevale group and 0.34 ± 0.71 in the Artisan group (p < 0.0001). The mean incision-suture time was 42.5 ± 5.8 min in the Carlevale group and 28.2 ± 6.4 min in the Artisan group. Anterior chamber and vitreous hemorrhages were the most common complications, occurring in 12% in the Carlevale group and 17.2% in the Artisan group. Conclusions: The use of the Carlevale IOL, implanted using a sclerocorneal tunnel technique, presents a valid option for treating complex lens dislocations. The scleral fixation of the Carlevale IOL minimizes risks associated with iris fixation, such as chronic inflammation and pupil distortion, making it particularly suitable for patients with damaged irises
Assessment of the Ferroptosis Regulators: Glutathione Peroxidase 4, Acyl-Coenzyme A Synthetase Long-Chain Family Member 4, and Transferrin Receptor 1 in Patient-Derived Endometriosis Tissue
No full textFerroptosis, an iron-dependent form of non-apoptotic cell death, plays a pivotal role in various diseases and is gaining considerable attention in the realm of endometriosis. Considering the classical pathomechanism theories, we hypothesized that ferroptosis, potentially driven by increased iron content at ectopic sites, may contribute to the progression of endometriosis. This retrospective case–control study provides a comprehensive immunohistochemical assessment of the expression and tissue distribution of established ferroptosis markers: GPX4, ACSL4, and TfR1 in endometriosis patients. The case group consisted of 38 women with laparoscopically and histologically confirmed endometriosis and the control group consisted of 18 women with other gynecological conditions. Our study revealed a significant downregulation of GPX4 in stromal cells of endometriosis patients (M = 59.7% ± 42.4 versus 90.0% ± 17.5 in the control group, t (54) = −2.90, p = 0.005). This finding aligned with slightly, but not significantly, higher iron levels detected in the blood of endometriosis patients, using hemoglobin as an indirect predictor (Hb 12.8 (12.2–13.5) g/dL versus 12.5 (12.2–13.4) g/dL in the control group; t (54) = −0.897, p = 0.374). Interestingly, there was no concurrent upregulation of TfR1 (M = 0.7 ± 1.2 versus 0.2 ± 0.4 for EM, t (54) = 2.552, p = 0.014), responsible for iron uptake into cells. Our empirical findings provide support for the involvement of ferroptosis in the context of endometriosis. However, variances in expression patterns within stromal and epithelial cellular subsets call for further in-depth investigations
Association of hospitalization with structural brain alterations in patients with affective disorders over nine years
No full textRepeated hospitalizations are a characteristic of severe disease courses in patients with affective disorders (PAD). To elucidate how a hospitalization during a nine-year follow-up in PAD affects brain structure, a longitudinal case-control study (mean [SD] follow-up period 8.98 [2.20] years) was conducted using structural neuroimaging. We investigated PAD (N = 38) and healthy controls (N = 37) at two sites (University of Münster, Germany, Trinity College Dublin, Ireland). PAD were divided into two groups based on the experience of in-patient psychiatric treatment during follow-up. Since the Dublin-patients were outpatients at baseline, the re-hospitalization analysis was limited to the Münster site (N = 52). Voxel-based morphometry was employed to examine hippocampus, insula, dorsolateral prefrontal cortex and whole-brain gray matter in two models: (1) group (patients/controls)×time (baseline/follow-up) interaction; (2) group (hospitalized patients/not-hospitalized patients/controls)×time interaction. Patients lost significantly more whole-brain gray matter volume of superior temporal gyrus and temporal pole compared to HC (pFWE = 0.008). Patients hospitalized during follow-up lost significantly more insular volume than healthy controls (pFWE = 0.025) and more volume in their hippocampus compared to not-hospitalized patients (pFWE = 0.023), while patients without re-hospitalization did not differ from controls. These effects of hospitalization remained stable in a smaller sample excluding patients with bipolar disorder. PAD show gray matter volume decline in temporo-limbic regions over nine years. A hospitalization during follow-up comes with intensified gray matter volume decline in the insula and hippocampus. Since hospitalizations are a correlate of severity, this finding corroborates and extends the hypothesis that a severe course of disease has detrimental long-term effects on temporo-limbic brain structure in PAD
Blood-saving dissection with monopolar tungsten needle electrodes and Teflon-coated spatula electrodes in tumor orthopedics
No full textIntroduction: Resection of musculoskeletal tumors and reconstruction with tumor endoprostheses often results in blood loss requiring transfusion of blood products. We assessed the blood-saving potential of using monopolar tungsten needle electrodes and polytetrafluoroethylene (PTFE)-coated spatula electrodes (intervention) compared with conventional dissection with sharp instruments and coagulation with uncoated steel electrodes (control). Methods: We retrospectively analyzed data of 132 patients (79 interventions, 53 controls) undergoing surgery by one single experienced surgeon in our tertiary referral center between 2012 and 2021. Results: Intraoperative blood loss in the intervention group was reduced by 29% [median (IQR): 700 (400–1200) vs 500 (200–700) ml; p = 0.0043]. Postoperative wound drainage decreased by 41% [median (IQR): 1230 (668–2041) vs 730 (450–1354) ml; p = 0.0080]. Additionally, patients in need of PRBCs during surgery declined from 43% to 15% (23/53 vs 12/79; p = 0.0005), while the transfusion rate after surgery did not change notably. The number of patients in need of revision surgery due to wound healing disorders was low in both groups (control group: 4/53 vs intervention group: 4/79). Only one patient in the control group and two patients in the intervention group underwent revision surgery due to hemorrhage. Baseline characteristics were similar between groups (sex, Charlson Comorbidity score, tumor entity).
Conclusion: Dissection with tungsten needle electrodes and PTFE-coated spatula electrodes appears an effective surgical blood-saving measure without increased risk of wound healing disorders
Protektive Effekte konjugierter Linolsäure im Rahmen der ZNS-Autoimmunität
No full textIn dieser Arbeit wurde eine protektive Wirkung der konjugierten Linolsäure (CLA) im Rahmen der ZNS-Autoimmunität evaluiert. Im murinen Modell der spontanen opticospinalen Enzephalomyelitis (OSE) konnten Effekte einer diätetischen Supplementation der CLA auf die Erkrankung der Tiere gezeigt werden. Es fand sich eine deutlich geringere Zellinfiltration in das ZNS. Im Detail wurden T- und B-Zell-Antworten der Tiere untersucht. Weiterhin erfolgte der Nachweis einer verminderten T-Zell-Antwort unter CLA-Einfluss in vitro. Diese in vitro Ergebnisse konnten auch mit humanen Zellen reproduziert werden. Letztlich gelang durch eine ex vivo Restimulation von Zellen aus dem Liquor von RRMS-Patienten der Nachweis einer inhibitorischen Wirkung der CLA auf diese bereits im Autoimmunkontext aktivierten Lymphozyten. Weitere Studien zur Rolle der CLA als protektiver Substanz für die additive Behandlung der Multiplen Sklerose sind notwendig und wurden teils bereits in Nachfolgeprojekten durchgeführt
Smiths Münzen:Grundlegungen zur Hermeneutisch-Explorativen Gedankenexperimentation
No full textDie herkömmliche Gedankenexperimentation in der Philosophie läuft unreguliert ab und erfährt inner- und interdisziplinäre Kritik und Ablehnung. Dass dasselbe Gedankenexperiment Nutzer zu unterschiedlichen Ergebnissen führen kann, stellt dabei die Reproduzierbarkeit der Ergebnisse dieser Methode infrage. Die Untersuchung erwägt Möglichkeiten methodologischer Optimierung. Aus der Erfassung des Angebots zur Theorie des Gedankenexperiments (nach 1980) und aus einer Untersuchung der zeitgenössischen gedankenexperimentellen Praxis werden bestehende Probleme auf beiden Ebenen ermittelt. Es wird ein Anwendungsmodell für gedankenexperimentelle Szenarien entwickelt, das die identifizierten Probleme weitestgehend vermeiden kann. Aus der Feststellung, dass es sich bei den Methodenoptimierungen um Kommunikationsmaßnahmen handelt, wird eine Kommunikationstheorie der Gedankenexperimentation und eine Narrationstheorie des Gedankenexperiments entwickelt. Wer gedankenexperimentiert, kommuniziert. Hauptkommunikationsmittel sind kleine Narrationen: die Gedankenexperimente
The Up-or-out Rule
No full textDie Up-or-out-Regel besagt, dass Assistenten in Partnerschaften (oder auch Universitäten) nach einer gewissen Zeit zu Partnern aufsteigen oder die Partnerschaft verlassen müssen. Eine dauerhafte Assistententätigkeit ist nicht möglich. Dies wirft die Frage auf, warum nicht Assistent bleiben darf, wer auf dieser Position seine Kosten mehr als erwirtschaftet, auch wenn seine Produktivität zur Beförderung zum Partner nicht ausreicht. Es werden unterschiedliche ökonomische Erklärungsansätze zur Beantwortung dieser Frage untersucht. Nach Zurückweisung des weit verbreiteten, aber unplausiblen Ansatzes, dass die Partnerschaft zur Selbstbindung an ihr implizites Beförderungsversprechen Assistenten in deren eigenem Interesse entlassen muss, lautet die Antwort, dass in Partnerschaften die fragliche Situation gar nicht auftritt und die Anwendung der Up-or-out-Regel deshalb als effizient einzuschätzen ist.The up-or-out rule states that assistants in partnerships (or universities) must become partners after a certain period of time or have to leave the partnership. Permanent assistantship is not possible. This raises the question of why someone is not being allowed to remain an assistant if he generates more in this position than he costs, even if his productivity is insufficient to promote him to a partner. Different economic explanations to answer this question are examined. After rejecting the widespread but implausible approach that the partnership has to dismiss assistants in their own interest in order to bind themselves to their implicit promotion promise, the answer is that in partnerships the situation in question does not occur at all and the application of the up-or-down out rule is therefore to be assessed as efficient
Reporting of flow diagrams in randomised controlled trials published in periodontology and implantology: a survey
No full textBackground: Item 13 of the CONSORT guidelines recommends documentation of the participant flow in randomised clinical trials (RCTs) using a diagram. In the medical literature, the reporting of the flow of participants in RCTs has been assessed to be inadequate. The quality of reporting flow diagrams in periodontology and implantology remains unknown. The aim of this study was to assess the reporting of flow diagrams in RCTs published in periodontology and implantology journals. Materials and Methods:
RCTs published between 15th January 2018 and 15th January 2022 in twelve high-ranked periodontology and implantology journals were identified. Trial characteristics at the RCT level were extracted. The flow diagram included in each RCT was assessed for completeness of reporting in relation to published criteria and the CONSORT flow diagram template. Results: From the 544 eligible articles, 85% were single-centre, 82% of parallel-group design and 79% investigated surgical interventions. Three-hundred and fifteen (58%) articles were published in CONSORT endorsing journals. A flow diagram was reported in 317 (58%) trials and reporting was more common in periodontology (73.1%). Overall, 56% of publications with a flow diagram reported a complete CONSORT flow diagram, while in 44% of flow diagrams, at least one point from the CONSORT reporting template was missing. Reasons for loss to follow-up (69.7%) and exclusions from the RCT analysis (86.4%) were poorly reported. Conclusion: The reporting of flow diagrams in periodontology and implantology RCTs was sub-optimal. Greater awareness of the importance of fully completing the participant CONSORT flow diagram is required
„Haken halten, Klappe halten?“ – Eine retrospektive longitudinale Evaluationsstudie des Chirurgie-Tertials und des Wahltertials im Praktischen Jahr
No full textIntroduction: In the context of the shortage of physicians, the practical year is an important component in the acquisition of future medical talent. Previous studies suggest that PJ students rate several satisfaction parameters significantly lower in the surgical term than in other terms. Poor perceptions of surgical topics may lead to a health care problem. The aim of the current study was to analyse in detail the specific comparison between compulsory surgical and other elective surgical terms.
Methods: 7762 anonymous online PJ evaluations at the Medical Faculty of Münster from 2007-2020 (RR 60.6%) were retrospectively analysed. The elective subjects were divided into operative and conservative subjects. In particular, evaluations and subjective learning gains were compared. Results: On the one hand, this study confirmed that the mandatory subject surgery was rated significantly worse than the other tertials (Msurg=69,3, MInt=76,7, Melec=84,6; p<0,001). Among the elective subjects, the conservative subjects were also preferred and rated better than the operative subjects (30,7% vs. 69,3%; Mop=85,9, Mkons=81,8; p<0,001). A final comparison of the elective operative subjects and the compulsory surgical terms showed that the elective operative subjects were also rated sig. better than the compulsory surgical term (Msurg=69,3, Mop=85,9; p<0,001). Discussion: The compulsory surgical specialty was found to be deficient in student autonomy and supervision, which may explain the worsening recruitment problem. In order to improve the attractiveness of surgical training, a compulsory surgical elective could be introduced, where students could learn the core competencies in smaller units. This enhancement could increase the interest of future medical professionals in surgical training.Einleitung: Im Rahmen des Ärztemangels ist das Praktische Jahr (PJ) ein wichtiger Baustein der Nachwuchsgewinnung. Vorangegangene Studien deuten darauf hin, dass Studierende im PJ verschiedene Zufriedenheitsparameter im Chirurgie-Tertial deutlich schlechter bewerten als in anderen Tertialen. Eine schlechte Wahrnehmung der operativen Fächer kann zu einem wachsenden Versorgungsproblem führen. Ziel der aktuellen Studie war eine Detailanalyse des konkreten Vergleichs zwischen dem Chirurgie-Pflicht- und anderen operativen Wahltertialen. Methoden: Retrospektiv wurden 7762 anonyme online-PJ-Evaluationen an der Medizinischen Fakultät Münster von 2007-2020 (RQ 60,6%) ausgewertet. Die Wahlfächer wurden in operative sowie konservative Fächer unterteilt. Insbesondere wurden subjektive Gesamtbewertungen und Lernzuwachs verglichen. Ergebnisse: Diese Studie konnte zum einen bestätigen, dass das Pflichtfach Chirurgie sig. schlechter evaluiert wurde als die anderen Tertiale (MChir=69,3, MInn=76,7, MWahl=84,6, je p<0,001). Auch innerhalb der Wahlfächer wurden die konservativen Fächer gegenüber den operativen Fächern präferiert und besser evaluiert (30,7% vs. 69,3%; Mop=85,9, Mkons=81,8; p<0,001). Eine abschließende Gegenüberstellung der operativen Wahlfächer und des Pflichtteils Chirurgie zeigte, dass auch die operativen Wahlfächer retrospektiv sig. besser beurteilt wurden, als das Pflichttertial Chirurgie (MChir=69,3, Mop=85,9; p<0,001). Diskussion: Das Pflichtfach Chirurgie zeigte in den Analysen Defizite in Betreuung und Selbstständigkeit der Studierenden mit der sich das verschärfende Nachwuchsproblem erklären lässt. Um die Ausbildung in operativen Fächern aufzuwerten, könnte ein operativer Wahl-Pflichtbereich eingeführt werden, in dem Studierende in kleineren Einheiten die zentralen Kompetenzen erlenen können. Diese Aufwertung könnte das Interesse des ärztlichen Nachwuchses an einer operativen Weiterbildungen stärken