BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encoura...BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encouraging collaborative patient-provider relationships may foster better adherence and patient outcomes.AIM To quantify the association between patient participation in treatment decisionmaking and adherence to oral mesalamine in UC.METHODS We conducted a 12-month,prospective,non-interventional cohort study at 113 gastroenterology practices in Germany.Eligible patients were aged≥18 years,had a confirmed UC diagnosis,had no prior mesalamine treatment,and provided informed consent.At the first visit,we collected data on demographics,clinical characteristics,patient preference for mesalamine formulation(tablets or granules),and disease knowledge.Self-reported adherence and disease activity were assessed at all visits.Correlation analyses and logistic regression were used to examine associations between adherence and various factors.RESULTS Of the 605 consecutively screened patients,520 were included in the study.The median age was 41 years(range:18-91),with a male-to-female ratio of 1.1:1.0.Approximately 75%of patients reported good adherence at each study visit.In correlation analyses,patient participation in treatment decision-making was significantly associated with better adherence across all visits(P=0.04).In the regression analysis at 12 months,this association was evident among patients who both preferred and received prolonged-release mesalamine granules(odds ratio=2.73,P=0.001).Patients reporting good adherence also experienced significant improvements in disease activity over 12 months(P<0.001).CONCLUSION Facilitating patient participation in treatment decisions and accommodating medication preferences may improve adherence to mesalamine.This may require additional effort but has the potential to improve long-term management of UC.展开更多
1) Introduction: Ventilation disorders of the middle ear play a major role in everyday clinical ENT-practice and sometimes represent a major therapeutic challenge. In addition to the conventional therapy of tympanosto...1) Introduction: Ventilation disorders of the middle ear play a major role in everyday clinical ENT-practice and sometimes represent a major therapeutic challenge. In addition to the conventional therapy of tympanostomy tube insertion, tuboplasty (TP) offers a less invasive option for treating this problem. The study should examine whether TP can be performed in a rural setting. 2) Material and methods: This is a prospective, monocentric study of patients scheduled for TP because of tubal ventilation disorder (TVD) in a rural region of Germany. The diagnosis was established after a thorough clinical examination and by assessing the possibility of performing the Valsalva maneuver, the tympanogram type, recording the middle ear pressure and air-bone gap. The subjective impairment caused by the TVD was evaluated using the EDTQ-7 questionnaire pre- and approximately 3 months postoperatively. 3) Results: Sixty-two patients with 92 TP were included with a mean age of 44.1 years. The EDTQ-7 score decreased highly significantly from 3.6 to 1.7 (p < 0.0001) without correlating with parameters such as age, sex, BMI, allergies or smoking. Middle ear pressure fell in average by −87 daPa, resulting in an improvement of the tympanogram type. The preoperative air-bone gap of 10.2 dB also was reduced significantly in most patients to 8.0 dB after the procedure. No notable complications occurred beside a sore throat due to the use of a laryngeal mask for ventilation during anesthesia in two cases. 4) Conclusion: In our experience, TP represents a less invasive and, in many cases, successful alternative to the established tympanostomy tube insertion with the advantage of an intact eardrum. It can also be offered and successfully performed in a rural setting.展开更多
Norway spruce(Picea abies(L.)Karst.)in the Harz Mountains National Park(Germany)has experienced widespread mortality(>97%of trees in the study stands)due to infestation with the large spruce bark beetle(Ips typogra...Norway spruce(Picea abies(L.)Karst.)in the Harz Mountains National Park(Germany)has experienced widespread mortality(>97%of trees in the study stands)due to infestation with the large spruce bark beetle(Ips typographus L.).The dead trees(snags)remain standing in the forest for 2-5 years before harvesting.It is important to identify trees that can still produce quality timber,which may be achieved by examining their outer appearance using selected characteristics.The aim of this study was to identify possible correlations between the standing storage duration and defined external characteristics of the snags.The mean tree height at compartment level was calculated using a vegetation height model,based on light detection and ranging data from 2018,to derive the stem breakage proportion.The condition of the crown and the bark and presence of fungi,wood rot,stem cracks and bark stripping damage were also assessed.The majority of the snags were broken at least once.Windthrows were less likely compared to living spruce trees because of reduced resistance to the wind as a result of needle loss and breakage.The mean stem breakage proportion increased significantly with the duration of the standing storage;however,prolonged storage durations did not always lead to complete breakage.The occurrence of fungal fruiting bodies was significantly correlated with a higher proportion of stem breakage,and the longer the storage,the more snags had fungal fruiting bodies.The condition of the crown,assessed by the presence of branchlets,was a good indicator of the duration of the standing storage.If trees had few or no branchlets,they had been standing for at least 4 years.Overall,this initial description of the external appearance of spruce trees that have been stored standing for many years suggests that time significantly influences the tree condition and breakage intensity,which is reflected by certain tree characteristics.Future studies should examine these aspects in greater depth,particularly with regard to utilization options and safety during timber harvesting.展开更多
The energy retrofit of public buildings is an effective strategy to achieve carbon neutrality goals,with educational buildings representing a significant proportion of this sector.This paper presents an in-depth analy...The energy retrofit of public buildings is an effective strategy to achieve carbon neutrality goals,with educational buildings representing a significant proportion of this sector.This paper presents an in-depth analysis of energy retrofitting policies for educational buildings and examines the design case of the“Plus Energy School”demonstration project in Rostock,Germany.The study reveals innovative approaches in several key areas:overall layout optimization,creation of climate buffer zones,enhancement of building envelope performance,ventilation and heating system design,integration of diverse renewable energy sources,and formulation of energy balance schemes with corresponding calculations.The holistic theory and methodology of this energy strategy synergy offer valuable insights for the retrofitting of existing educational buildings in China.The project successfully transformed two aging school buildings into a single“plus energy”facility through coordinated architectural and technological interventions.Notable features include the compact redesign reducing the form factor from 0.38 to 0.21,the implementation of climate buffer zones maintaining 15℃without active heating,and the integration of photovoltaic panels and wind turbines.The combination of district heating with an Organic Rankine Cycle(ORC)system further optimized energy utilization.Post-retrofit calculations demonstrate a two-thirds reduction in annual unit energy consumption,with the building generating an energy surplus.This case study provides a comprehensive framework for achieving high energy performance in educational building retrofits,offering valuable lessons for similar initiatives in China and globally.The paper concludes by discussing the potential for widespread application of these strategies in China’s existing educational buildings,considering the country’s vast building stock and increasing energy efficiency requirements.展开更多
AIM To detect infection rate of GBV-C/HGV inhepatitis C patients,to determine the methodsof higher sensitivity and the primers of higherefficiency for GBV-C/HGV RNA detection and tostudy the dominant subtype and mutat...AIM To detect infection rate of GBV-C/HGV inhepatitis C patients,to determine the methodsof higher sensitivity and the primers of higherefficiency for GBV-C/HGV RNA detection and tostudy the dominant subtype and mutation ofGBV-C/HGV.METHODS Quantitative RT-PCR for detectionpf HCV RNA concentration in serum samples,RT-nested PCR with two sets of primers fordetection of GBV-C RNA,RT-PCR ELISA with twosets of primers for detection of HGV RNA,nucleotide sequence and putative amino acidsequence analysis.RESULTS The positive rates of GBV-C RNA atthe 5’-NCR and NS3 region in 211 serums amplesfrom the patients with HCV infection were 31.8%and 22.8% respectively.The positive rates ofHGV RNA at the 5’-NCR and NS5 region in thesame samples were 47.9% and 31.8%respectively.The total positive rate of GBV-C/HGV RNA was as high as 55.5%.HCV copynumbers in the patients without GBV-C/ HGVcoinfection were statistically higher than that inthe patients with GBV-C/ HGV coinfection(P【0.01).Frequent mutation of nucleotideresidue was present in the amplificationproducts.Frameshift mutation was found in twosamples with GBV-C NS3 region nucleotidesequences.All nucleotide sequences fromamplification products showed higher homologyto HGV genome than to GBV-C genome even though part of the sequences were amplifiedwith GBV-C primers.CONCLUSION A high frequency of GBV-C/ HGV coinfection existed in the hepatitis C patients. RT-PCR ELISA was more sensitive than RT-nested PCR for detection of GBV-C/ HGV RNA. The primers derived from the 5 -NCR was more efficient than those derived from the NS3 and NS5 regions. A reverse relationship was found to exist between HCV RNA concentration and GBV-C/ HGV infection frequency. HGV was the dominant subtype of the virus in the local area. The major mutations of GBV-C/ HGV genomes were random mutation of nucleotide residue.展开更多
Germany and China use different stable systems for fattening pigs. Widespread systems in Germany are closed stables with slatted or partly slatted floor, which produce liquid manure （a mixture of urine, faeces, and c...Germany and China use different stable systems for fattening pigs. Widespread systems in Germany are closed stables with slatted or partly slatted floor, which produce liquid manure （a mixture of urine, faeces, and cleaning water） whereas in China open stables with closed concrete floors are used with separate collection of faeces and urine. Based on data from literature and own analyses nutrient flows of both systems are calculated. The Chinese manure system or mechanized belt or V-shaped pit floor systems with faeces/urine separation are more effective to separate solids, nutrients, carbon, and heavy metal than mechanical separation from liquid manure. The separation rates can be up to 88% for the solids, 67% for nitrogen, 93% for phosphorus, 60% for potassium, 94% for magnesium, 97% for cupper, and 98% for zinc. The faeces can be used for composting to produce a market product.展开更多
The rehabilitation of coal mines is an up-to-date issue, heavily discussed not only by the industry but also by scientists and the adjacent communities since open cut coal mining has extensive impacts affecting all pa...The rehabilitation of coal mines is an up-to-date issue, heavily discussed not only by the industry but also by scientists and the adjacent communities since open cut coal mining has extensive impacts affecting all parties. Whereas, before and during the mining process not only nature but sometimes also the population of a whole region has to give way to a mine, the consequences of the operations remain long after mining closure. Typically a once intact and functioning ecosystem is replaced with a destroyed wideness evocative of a moon landscape. Fortunately, the awareness of the need to rehabilitate the destroyed nature is increasing steadily and all involved parties are making efforts to improve the situation, even if it is a major challenge to bring all parties to a consensus. Therefore, a legislative basis is required and the know-how of optimal rehabilitation solutions must be developed. In this article the rehabilitation of mined land in Australia and Germany are compared. More precisely the article will present an overview of the legislative regulations, certain applied methods of rehabilitation work and the problems that are likely to occur in respect to the influence of mining on nature.展开更多
The present study aimed to clarify the current status and awareness of psychological preparation for children undergoing medical procedures in pediatric nursing in Japan as compared with that in Germany. An original q...The present study aimed to clarify the current status and awareness of psychological preparation for children undergoing medical procedures in pediatric nursing in Japan as compared with that in Germany. An original questionnaire about the current status and awareness of psychological preparation for children in hospitals was distributed by mail to nurses’ working on Japanese pediatric wards in 2010. The same questionnaire, translated into German, was distributed to nurses working on German pediatric wards via the internet in 2010. A large majority of respondents strongly agreed that children have a right to informed consent. German nurses expressed a longer-term viewpoint on the effects of preparation than Japanese nurses. Japanese nurses recognized a greater need for improvement in their duties than German nurses. The results suggest that we should consider our own country’s nursing practices and need for improvement, but also learn from studies of other countries to address each culture and medical situation appropriately.展开更多
Human alveolar echinococcosis, caused by the larval stage of the small fox tapeworm, is a lethal zoonotic infection if left untreated. E. multilocularis is distributed in the Northern Hemisphere and lives in the small...Human alveolar echinococcosis, caused by the larval stage of the small fox tapeworm, is a lethal zoonotic infection if left untreated. E. multilocularis is distributed in the Northern Hemisphere and lives in the small intestines of carnivores, mainly canids. The main definitive host of E. multilocularis in European countries is the red fox Vulpes vulpes and in the last ten years new endemic areas for the parasite in Central Europe have been identified. In some areas, for instance in Germany, the raccoon dog Nyctereutes procyonoides - a spreading neozoon - must be regarded as an additional definitive host for E. multilocularis. In 2001 this parasite was found for the first time in raccoon dogs in the Federal State of Brandenburg, Germany. Between 2000 and 2008, 1,252 raccoon dogs from Brandenburg were examined by the Intestinal Scraping Technique. The majority of samples were obtained in five northern counties and all 60 animals that tested positive for E. multilocularis were located there. The estimated true prevalence calculated by a beta-binomial- model ranged from 6%-12% [Current Zoology 57 （5）： 655-661, 2011].展开更多
AIM: To evaluate 5-year effectiveness and cos between latanoprost or timolol monotherapy in a pilot trial.METHODS: A retrospective, multi-center trial performed at 6 sites in Germany of patients who had a diagnosis of...AIM: To evaluate 5-year effectiveness and cos between latanoprost or timolol monotherapy in a pilot trial.METHODS: A retrospective, multi-center trial performed at 6 sites in Germany of patients who had a diagnosis of primary open-angle or pigmentary glaucoma, in at least one eye, initiated on monotherapy with latanoprost or timolol maleate. Qualified consecutive charts were reviewed in which 5-year efficacy, safety and cost data was abstracted.RESULTS: Seventy-seven latanoprost and 49 timolo patients were included, at the final visit no difference existed between the two groups in disc parameters including: rim area, rim area/disc area ratio, cup volume or vertical cup/disc ratio (P 】0.05). There was no difference in intraocular pressure (IOP) between the initial latanoprost (17.4 ±2.6) and timolol (16.3 ±2.8mmHg) groups. There was less change in medicines over the follow-up period (0.1 vs 0.8) and fewer medications at the final visit (1.2 vs 1.8) with latanoprost compared to timolol. No patient treated with latanoprost discontinued therapy during follow-up, while 12% discontinued timolol mostly due to inadequate IOP control. Cost/year was less with initial timolol ($458±236) as compared to latanoprost ($552±202). CONCLUSION: Patients begun on latanoprost o timolol and followed over 5 years may have similar clinical outcomes. However, timolol patients may require more medicines and medicine changes to control IOP for long-term, but at a lower cost.展开更多
For drinking water security the German waterworks proceed on a comprehensive concept,i.e.,the protection of all the regions from the recharge area to the client.It includes the protection of the recharge area by a pre...For drinking water security the German waterworks proceed on a comprehensive concept,i.e.,the protection of all the regions from the recharge area to the client.It includes the protection of the recharge area by a precautionary management,a safe water treatment,a strict maintenance of the water distribution network,continuous control and an intensive training of staff.Groundwater protection zones together with effective regulations and control play a very important role.Three protection zones with different restrictions in land-use are distinguished.Water in reservoirs and lakes is also protected by Surface Water Protection Zones.Within the surrounding area the land-use is controlled,too.Special treatment is necessary if acidification happens caused by acid rain,or eutrophication caused by the inflow of sewage.Very important is the collaboration between waterworks and the farmers cultivating land in the recharge area in order to execute water-protecting ecological farming with the aim to reduce the application of fertilizers and plant protection agents.Probable financial losses have to be compensated by the waterworks.展开更多
Objective: To observe the effect of insomnia patients with deficiency of heart and spleen in Germany by the therapy of ear points pressing with bean. Methods: A total of 80 cases of insomnia with deficiency of heart a...Objective: To observe the effect of insomnia patients with deficiency of heart and spleen in Germany by the therapy of ear points pressing with bean. Methods: A total of 80 cases of insomnia with deficiency of heart and spleen in Germany were divided into the observation group and the control group, with 40 cases in each group. The patients in the control group were treated with oral modified Guipi Decoction(归脾汤), while the patients in the observation group were treated with oral traditional Chinese medicine(TCM) and the therapy of ear points pressing with bean. The efficacy, sleep quality, the TCM syndromes score and the incidence of adverse reactions were compared between the two groups. Results: The effective rate in the observation group was higher than that in the control group, and there was statistical difference between the two group(P<0.05). After treatment, the Pittsburgh sleep quality index scale(PSQI) score, insomnia severity index(ISI) score and the TCM syndromes score in the two groups were decreased sharply(P<0.01), and those scores in the observation group were lower than that in the control group(P<0.05). There was no adverse reaction between the two groups. Conclusion: The therapy of ear points pressing with bean is effective on insomnia in Germany, which is worth further study and promotion.展开更多
In the last decade the use of earth in construction has become increasingly widespread in many countries.Building with earth can contribute to sustainable development by reducing environmental impact compared with oth...In the last decade the use of earth in construction has become increasingly widespread in many countries.Building with earth can contribute to sustainable development by reducing environmental impact compared with other building materials or systems.This new consciousness has given rise to a growth in the number of earth building standards in recent years although,in absolute terms,the number is very small compared with other typical building materials and systems.Forty different earth building standards coming from 20 different countries were examined.The standards provide varying degrees of technical information.With regard to their scope of application,the documents can be classified into three types,each of them dealing with a particular aspect:soil classification,earth building materials,earth construction systems.In Germany,a revival of building with earth first came about in the 1980s as an awareness of ecological criteria grew.A product of this development was the elaboration of an earth building standard,the“Lehmbau Regeln”by the Dachverband Lehm e.V.,the German national earth building association.That part of the“Lehmbau Regeln”concerning earth blocks and earth mortars was adapted to the circumstances of national DIN/European building codes and published in August 2013 as DIN 18945–47.A new DIN 18948“Earth boards”will be issued in 2019.The four DINs were elaborated for industrially produced,chemically non-stabilized earth building materials.展开更多
Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent...Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent of psychosocial burdens in migrant populations the prevalence among the study population remains unclear. The aim of this study was to collect prevalence data for the largest migrant population in Germany-individuals with Turkish migration backgrounds—using a culturally and linguistically sensitive approach. Methods: The study employs a cross-sectional design. The multi-centre study (Hamburg, Berlin) is based on a sample of individuals with Turkish migration backgrounds living in the two cities stratified by age, gender, and education. The study programme consists of three phases: 1) a qualitative focus group to collect information on how to increase the participation rate of the target population as a minority group in Germany;2) a translation phase to create culture and linguistic sensitive versions of the assessment tools (e.g., the Composite International Diagnostic Interview (CIDI) for Turkish speaking individuals;and 3) a baseline community study to assess the lifetime, 12-month and four-week prevalence and comorbidity rates of mental disorder, health care utilization and help-seeking behaviour in individuals of Turkish migration backgrounds living in Germany. Discussion: The study provides important data on the lifetime prevalence of mental disorders and health care utilization of individuals with Turkish migration backgrounds. Furthermore, the study is an important step towards gaining a better understanding of potential barriers to participation, creating resources for difficult-to- reach minorities, and understanding the need for assessing mental disorders in migrant populations. These results can offer a starting point for the initiation of the necessary structural changes for mental health care services and policies for groups with migration backgrounds.展开更多
Six German scenario studies on urban passenger transport for Munich 2058, Wuppertal 2050, Eastern Ruhr Region 2030, Tuebingen 2030, Cologne 2020 and Hanover Region 2020 investigate the key question： With which strate...Six German scenario studies on urban passenger transport for Munich 2058, Wuppertal 2050, Eastern Ruhr Region 2030, Tuebingen 2030, Cologne 2020 and Hanover Region 2020 investigate the key question： With which strategies and on what kind of scale, is it possible to reduce the carbon dioxide emissions of urban passenger transport to accomplish the 2℃ climate protection goal with a consequently huge reduction of greenhouse gas emissions by 80% to 95% by 2050 in relation to the base year 1990？ The scenarios show that the major challenge of a ＂climate-friendly city transport＂ can be achieved by appropriate measures （regarding direction and scale）： in small and medium-sized cities, large cities, cities of over a million people, and metropolitan regions. The scenarios demonstrate the extent to which the considered measures contribute to the CO2 reduction, and which gap to the achievement of the goal remains if that which is currently regarded as realistic in practice is really implemented in future. Thus, they illustrate the conflict between that which is necessary for climate protection and that which is currently considered feasible in politics. The scenarios show that it is essential to act quickly and appropriately, and not hesitantly or without conviction.展开更多
Amazon Germany has formulated a series of marketing strategies based on the shopping habits of German consumers and it has achieved success.This article summarizes the current marketing strategies of Amazon in Germany...Amazon Germany has formulated a series of marketing strategies based on the shopping habits of German consumers and it has achieved success.This article summarizes the current marketing strategies of Amazon in Germany,and explores the key factors for the success of this marketing strategy.By comparing with other e-commerce platforms,this article critically analyzes the innovation and deficiency of Amazon in Germany.展开更多
The paper reports sunthetically the Cocene fauna of the Messel Pit Fossil site of Germany, in detail, including its rich taxanomic composttions, geological and paleogeographic backgroud, and the studying and applying ...The paper reports sunthetically the Cocene fauna of the Messel Pit Fossil site of Germany, in detail, including its rich taxanomic composttions, geological and paleogeographic backgroud, and the studying and applying history.展开更多
Breastfeeding is considered to be the key variable for infant health. Consequently, UNICEF and the World Health Organization promote the beginning of breastfeeding within the first hour after birth and recommend to ex...Breastfeeding is considered to be the key variable for infant health. Consequently, UNICEF and the World Health Organization promote the beginning of breastfeeding within the first hour after birth and recommend to exclusively breastfeed the infant during the first six months. The origins of these modern breastfeeding campaigns can be traced back to the beginning of the twentieth century. Whereas high infant mortality rates traditionally were considered to be a matter of fate and the declining birth rates towards the end of the nineteenth century raised fears about the nation’s future and led to the emergence of an increasing infant welfare movement in imperial Germany. As low breastfeeding rates were identified as a key factor behind the high infant mortality rates, the main objective of the infant care movement was to increase breastfeeding. The paper examines how the context of infant care and infant mortality was constructed and how breastfeeding campaigns in the context of infant mortality, breastfeeding rates and socio-political changes developed during the twentieth century. Thus the paper covers the period from the beginnings of social paediatrics at the beginning of the 20th century, the breastfeeding campaigns embedded into Nazi ideology during the Third Reich, until the declining breastfeeding ratios and the “feeding on demand”-movement in the 1970s as well as the ideological differences between West and East Germany during the Cold War.展开更多
This paper concentrates on the most important findings and the lessons learned from German experience in the field of wind energy integration. It reflects the work of the governmental experts who were auditing the 200...This paper concentrates on the most important findings and the lessons learned from German experience in the field of wind energy integration. It reflects the work of the governmental experts who were auditing the 2008-revision of the Renewable Energy Sources Act （EEG 2008） in the EEG-Report 2011 and the actual political debate in Germany in 2013. The EEG report 2011 makes it clear that a feed-in-tariff-mechanism lowers entry barriers and open the market for new competitors but, also, that incentives without a favorable legal framework fail to fulfill the purpose.展开更多
Objective:To investigate the distribution of TCM syndromes,the regularity of syndrome differentiation and the correlation between syndromes and body mass index(BMI)of simple obesity in Germany.Methods:From July 2020 t...Objective:To investigate the distribution of TCM syndromes,the regularity of syndrome differentiation and the correlation between syndromes and body mass index(BMI)of simple obesity in Germany.Methods:From July 2020 to May 2021,122 patients with simple obesity were collected from the Bad Koetzting hospital of Beijing University of Chinese Medicine.The basic information of age,gender,height,weight and TCM syndrome were collected.The distribution of syndrome and its correlation with BMI were analyzed by frequency analysis and single sample chi square test.Results:According to the frequency,the syndrome distribution of simple obesity was as follows:yin deficiency and internal heat type,liver stagnation and qi stagnation type,qi stagnation and blood stasis type,spleen and kidney deficiency type,spleen deficiency and dampness resistance type and stomach heat and dampness resistance type.The BMI of spleen kidney deficiency type was the highest,while that of stomach heat dampness stagnation type was the lowest.There was no significant difference in BMI between stomach heat and dampness stagnation type,liver qi stagnation type,qi stagnation and blood stasis type(P=0.110,P=0.111).There was no significant difference in BMI between yin deficiency and internal heat type and liver stagnation,qi stagnation and blood stasis type(P=0.175,P=0.437).However,there were significant differences in BMI among other TCM syndromes(P<0.01).Conclusion:The most common TCM syndrome type of simple obesity in Germany is yin deficiency and internal heat type,and the highest BMI value is spleen and kidney deficiency type,and there is a certain correlation between BMI value and different TCM syndrome types of simple obesity.展开更多
文摘BACKGROUND Mesalamine is the recommended first-line treatment for inducing and maintaining remission in mild-to-moderate ulcerative colitis(UC).However,adherence in real-world settings is frequently suboptimal.Encouraging collaborative patient-provider relationships may foster better adherence and patient outcomes.AIM To quantify the association between patient participation in treatment decisionmaking and adherence to oral mesalamine in UC.METHODS We conducted a 12-month,prospective,non-interventional cohort study at 113 gastroenterology practices in Germany.Eligible patients were aged≥18 years,had a confirmed UC diagnosis,had no prior mesalamine treatment,and provided informed consent.At the first visit,we collected data on demographics,clinical characteristics,patient preference for mesalamine formulation(tablets or granules),and disease knowledge.Self-reported adherence and disease activity were assessed at all visits.Correlation analyses and logistic regression were used to examine associations between adherence and various factors.RESULTS Of the 605 consecutively screened patients,520 were included in the study.The median age was 41 years(range:18-91),with a male-to-female ratio of 1.1:1.0.Approximately 75%of patients reported good adherence at each study visit.In correlation analyses,patient participation in treatment decision-making was significantly associated with better adherence across all visits(P=0.04).In the regression analysis at 12 months,this association was evident among patients who both preferred and received prolonged-release mesalamine granules(odds ratio=2.73,P=0.001).Patients reporting good adherence also experienced significant improvements in disease activity over 12 months(P<0.001).CONCLUSION Facilitating patient participation in treatment decisions and accommodating medication preferences may improve adherence to mesalamine.This may require additional effort but has the potential to improve long-term management of UC.
文摘1) Introduction: Ventilation disorders of the middle ear play a major role in everyday clinical ENT-practice and sometimes represent a major therapeutic challenge. In addition to the conventional therapy of tympanostomy tube insertion, tuboplasty (TP) offers a less invasive option for treating this problem. The study should examine whether TP can be performed in a rural setting. 2) Material and methods: This is a prospective, monocentric study of patients scheduled for TP because of tubal ventilation disorder (TVD) in a rural region of Germany. The diagnosis was established after a thorough clinical examination and by assessing the possibility of performing the Valsalva maneuver, the tympanogram type, recording the middle ear pressure and air-bone gap. The subjective impairment caused by the TVD was evaluated using the EDTQ-7 questionnaire pre- and approximately 3 months postoperatively. 3) Results: Sixty-two patients with 92 TP were included with a mean age of 44.1 years. The EDTQ-7 score decreased highly significantly from 3.6 to 1.7 (p < 0.0001) without correlating with parameters such as age, sex, BMI, allergies or smoking. Middle ear pressure fell in average by −87 daPa, resulting in an improvement of the tympanogram type. The preoperative air-bone gap of 10.2 dB also was reduced significantly in most patients to 8.0 dB after the procedure. No notable complications occurred beside a sore throat due to the use of a laryngeal mask for ventilation during anesthesia in two cases. 4) Conclusion: In our experience, TP represents a less invasive and, in many cases, successful alternative to the established tympanostomy tube insertion with the advantage of an intact eardrum. It can also be offered and successfully performed in a rural setting.
基金supported by the German Federal Ministry of Food and Agriculture(BMEL)and the German Federal Ministry for the Environment,Nature Conservation,Nuclear Safety and Consumer Protection(BMUV)via the Agency for Renewable Resources(FNR)(GRANT no.2220WK49E3)。
文摘Norway spruce(Picea abies(L.)Karst.)in the Harz Mountains National Park(Germany)has experienced widespread mortality(>97%of trees in the study stands)due to infestation with the large spruce bark beetle(Ips typographus L.).The dead trees(snags)remain standing in the forest for 2-5 years before harvesting.It is important to identify trees that can still produce quality timber,which may be achieved by examining their outer appearance using selected characteristics.The aim of this study was to identify possible correlations between the standing storage duration and defined external characteristics of the snags.The mean tree height at compartment level was calculated using a vegetation height model,based on light detection and ranging data from 2018,to derive the stem breakage proportion.The condition of the crown and the bark and presence of fungi,wood rot,stem cracks and bark stripping damage were also assessed.The majority of the snags were broken at least once.Windthrows were less likely compared to living spruce trees because of reduced resistance to the wind as a result of needle loss and breakage.The mean stem breakage proportion increased significantly with the duration of the standing storage;however,prolonged storage durations did not always lead to complete breakage.The occurrence of fungal fruiting bodies was significantly correlated with a higher proportion of stem breakage,and the longer the storage,the more snags had fungal fruiting bodies.The condition of the crown,assessed by the presence of branchlets,was a good indicator of the duration of the standing storage.If trees had few or no branchlets,they had been standing for at least 4 years.Overall,this initial description of the external appearance of spruce trees that have been stored standing for many years suggests that time significantly influences the tree condition and breakage intensity,which is reflected by certain tree characteristics.Future studies should examine these aspects in greater depth,particularly with regard to utilization options and safety during timber harvesting.
文摘The energy retrofit of public buildings is an effective strategy to achieve carbon neutrality goals,with educational buildings representing a significant proportion of this sector.This paper presents an in-depth analysis of energy retrofitting policies for educational buildings and examines the design case of the“Plus Energy School”demonstration project in Rostock,Germany.The study reveals innovative approaches in several key areas:overall layout optimization,creation of climate buffer zones,enhancement of building envelope performance,ventilation and heating system design,integration of diverse renewable energy sources,and formulation of energy balance schemes with corresponding calculations.The holistic theory and methodology of this energy strategy synergy offer valuable insights for the retrofitting of existing educational buildings in China.The project successfully transformed two aging school buildings into a single“plus energy”facility through coordinated architectural and technological interventions.Notable features include the compact redesign reducing the form factor from 0.38 to 0.21,the implementation of climate buffer zones maintaining 15℃without active heating,and the integration of photovoltaic panels and wind turbines.The combination of district heating with an Organic Rankine Cycle(ORC)system further optimized energy utilization.Post-retrofit calculations demonstrate a two-thirds reduction in annual unit energy consumption,with the building generating an energy surplus.This case study provides a comprehensive framework for achieving high energy performance in educational building retrofits,offering valuable lessons for similar initiatives in China and globally.The paper concludes by discussing the potential for widespread application of these strategies in China’s existing educational buildings,considering the country’s vast building stock and increasing energy efficiency requirements.
文摘AIM To detect infection rate of GBV-C/HGV inhepatitis C patients,to determine the methodsof higher sensitivity and the primers of higherefficiency for GBV-C/HGV RNA detection and tostudy the dominant subtype and mutation ofGBV-C/HGV.METHODS Quantitative RT-PCR for detectionpf HCV RNA concentration in serum samples,RT-nested PCR with two sets of primers fordetection of GBV-C RNA,RT-PCR ELISA with twosets of primers for detection of HGV RNA,nucleotide sequence and putative amino acidsequence analysis.RESULTS The positive rates of GBV-C RNA atthe 5’-NCR and NS3 region in 211 serums amplesfrom the patients with HCV infection were 31.8%and 22.8% respectively.The positive rates ofHGV RNA at the 5’-NCR and NS5 region in thesame samples were 47.9% and 31.8%respectively.The total positive rate of GBV-C/HGV RNA was as high as 55.5%.HCV copynumbers in the patients without GBV-C/ HGVcoinfection were statistically higher than that inthe patients with GBV-C/ HGV coinfection(P【0.01).Frequent mutation of nucleotideresidue was present in the amplificationproducts.Frameshift mutation was found in twosamples with GBV-C NS3 region nucleotidesequences.All nucleotide sequences fromamplification products showed higher homologyto HGV genome than to GBV-C genome even though part of the sequences were amplifiedwith GBV-C primers.CONCLUSION A high frequency of GBV-C/ HGV coinfection existed in the hepatitis C patients. RT-PCR ELISA was more sensitive than RT-nested PCR for detection of GBV-C/ HGV RNA. The primers derived from the 5 -NCR was more efficient than those derived from the NS3 and NS5 regions. A reverse relationship was found to exist between HCV RNA concentration and GBV-C/ HGV infection frequency. HGV was the dominant subtype of the virus in the local area. The major mutations of GBV-C/ HGV genomes were random mutation of nucleotide residue.
基金The authors would like to thank the German Ministry for Education and Research （BMBF） （project No. 0330847G）, the National Natural Science Foundation of China （project No. 40971177）, and the Ministry of Science and Technology of the People＇s Republic of China （MOST） for financing the project.
文摘Germany and China use different stable systems for fattening pigs. Widespread systems in Germany are closed stables with slatted or partly slatted floor, which produce liquid manure （a mixture of urine, faeces, and cleaning water） whereas in China open stables with closed concrete floors are used with separate collection of faeces and urine. Based on data from literature and own analyses nutrient flows of both systems are calculated. The Chinese manure system or mechanized belt or V-shaped pit floor systems with faeces/urine separation are more effective to separate solids, nutrients, carbon, and heavy metal than mechanical separation from liquid manure. The separation rates can be up to 88% for the solids, 67% for nitrogen, 93% for phosphorus, 60% for potassium, 94% for magnesium, 97% for cupper, and 98% for zinc. The faeces can be used for composting to produce a market product.
文摘The rehabilitation of coal mines is an up-to-date issue, heavily discussed not only by the industry but also by scientists and the adjacent communities since open cut coal mining has extensive impacts affecting all parties. Whereas, before and during the mining process not only nature but sometimes also the population of a whole region has to give way to a mine, the consequences of the operations remain long after mining closure. Typically a once intact and functioning ecosystem is replaced with a destroyed wideness evocative of a moon landscape. Fortunately, the awareness of the need to rehabilitate the destroyed nature is increasing steadily and all involved parties are making efforts to improve the situation, even if it is a major challenge to bring all parties to a consensus. Therefore, a legislative basis is required and the know-how of optimal rehabilitation solutions must be developed. In this article the rehabilitation of mined land in Australia and Germany are compared. More precisely the article will present an overview of the legislative regulations, certain applied methods of rehabilitation work and the problems that are likely to occur in respect to the influence of mining on nature.
文摘The present study aimed to clarify the current status and awareness of psychological preparation for children undergoing medical procedures in pediatric nursing in Japan as compared with that in Germany. An original questionnaire about the current status and awareness of psychological preparation for children in hospitals was distributed by mail to nurses’ working on Japanese pediatric wards in 2010. The same questionnaire, translated into German, was distributed to nurses working on German pediatric wards via the internet in 2010. A large majority of respondents strongly agreed that children have a right to informed consent. German nurses expressed a longer-term viewpoint on the effects of preparation than Japanese nurses. Japanese nurses recognized a greater need for improvement in their duties than German nurses. The results suggest that we should consider our own country’s nursing practices and need for improvement, but also learn from studies of other countries to address each culture and medical situation appropriately.
文摘Human alveolar echinococcosis, caused by the larval stage of the small fox tapeworm, is a lethal zoonotic infection if left untreated. E. multilocularis is distributed in the Northern Hemisphere and lives in the small intestines of carnivores, mainly canids. The main definitive host of E. multilocularis in European countries is the red fox Vulpes vulpes and in the last ten years new endemic areas for the parasite in Central Europe have been identified. In some areas, for instance in Germany, the raccoon dog Nyctereutes procyonoides - a spreading neozoon - must be regarded as an additional definitive host for E. multilocularis. In 2001 this parasite was found for the first time in raccoon dogs in the Federal State of Brandenburg, Germany. Between 2000 and 2008, 1,252 raccoon dogs from Brandenburg were examined by the Intestinal Scraping Technique. The majority of samples were obtained in five northern counties and all 60 animals that tested positive for E. multilocularis were located there. The estimated true prevalence calculated by a beta-binomial- model ranged from 6%-12% [Current Zoology 57 （5）： 655-661, 2011].
基金an unrestricted grant from Pfizer, Inc., New York, USA
文摘AIM: To evaluate 5-year effectiveness and cos between latanoprost or timolol monotherapy in a pilot trial.METHODS: A retrospective, multi-center trial performed at 6 sites in Germany of patients who had a diagnosis of primary open-angle or pigmentary glaucoma, in at least one eye, initiated on monotherapy with latanoprost or timolol maleate. Qualified consecutive charts were reviewed in which 5-year efficacy, safety and cost data was abstracted.RESULTS: Seventy-seven latanoprost and 49 timolo patients were included, at the final visit no difference existed between the two groups in disc parameters including: rim area, rim area/disc area ratio, cup volume or vertical cup/disc ratio (P 】0.05). There was no difference in intraocular pressure (IOP) between the initial latanoprost (17.4 ±2.6) and timolol (16.3 ±2.8mmHg) groups. There was less change in medicines over the follow-up period (0.1 vs 0.8) and fewer medications at the final visit (1.2 vs 1.8) with latanoprost compared to timolol. No patient treated with latanoprost discontinued therapy during follow-up, while 12% discontinued timolol mostly due to inadequate IOP control. Cost/year was less with initial timolol ($458±236) as compared to latanoprost ($552±202). CONCLUSION: Patients begun on latanoprost o timolol and followed over 5 years may have similar clinical outcomes. However, timolol patients may require more medicines and medicine changes to control IOP for long-term, but at a lower cost.
文摘For drinking water security the German waterworks proceed on a comprehensive concept,i.e.,the protection of all the regions from the recharge area to the client.It includes the protection of the recharge area by a precautionary management,a safe water treatment,a strict maintenance of the water distribution network,continuous control and an intensive training of staff.Groundwater protection zones together with effective regulations and control play a very important role.Three protection zones with different restrictions in land-use are distinguished.Water in reservoirs and lakes is also protected by Surface Water Protection Zones.Within the surrounding area the land-use is controlled,too.Special treatment is necessary if acidification happens caused by acid rain,or eutrophication caused by the inflow of sewage.Very important is the collaboration between waterworks and the farmers cultivating land in the recharge area in order to execute water-protecting ecological farming with the aim to reduce the application of fertilizers and plant protection agents.Probable financial losses have to be compensated by the waterworks.
文摘Objective: To observe the effect of insomnia patients with deficiency of heart and spleen in Germany by the therapy of ear points pressing with bean. Methods: A total of 80 cases of insomnia with deficiency of heart and spleen in Germany were divided into the observation group and the control group, with 40 cases in each group. The patients in the control group were treated with oral modified Guipi Decoction(归脾汤), while the patients in the observation group were treated with oral traditional Chinese medicine(TCM) and the therapy of ear points pressing with bean. The efficacy, sleep quality, the TCM syndromes score and the incidence of adverse reactions were compared between the two groups. Results: The effective rate in the observation group was higher than that in the control group, and there was statistical difference between the two group(P<0.05). After treatment, the Pittsburgh sleep quality index scale(PSQI) score, insomnia severity index(ISI) score and the TCM syndromes score in the two groups were decreased sharply(P<0.01), and those scores in the observation group were lower than that in the control group(P<0.05). There was no adverse reaction between the two groups. Conclusion: The therapy of ear points pressing with bean is effective on insomnia in Germany, which is worth further study and promotion.
文摘In the last decade the use of earth in construction has become increasingly widespread in many countries.Building with earth can contribute to sustainable development by reducing environmental impact compared with other building materials or systems.This new consciousness has given rise to a growth in the number of earth building standards in recent years although,in absolute terms,the number is very small compared with other typical building materials and systems.Forty different earth building standards coming from 20 different countries were examined.The standards provide varying degrees of technical information.With regard to their scope of application,the documents can be classified into three types,each of them dealing with a particular aspect:soil classification,earth building materials,earth construction systems.In Germany,a revival of building with earth first came about in the 1980s as an awareness of ecological criteria grew.A product of this development was the elaboration of an earth building standard,the“Lehmbau Regeln”by the Dachverband Lehm e.V.,the German national earth building association.That part of the“Lehmbau Regeln”concerning earth blocks and earth mortars was adapted to the circumstances of national DIN/European building codes and published in August 2013 as DIN 18945–47.A new DIN 18948“Earth boards”will be issued in 2019.The four DINs were elaborated for industrially produced,chemically non-stabilized earth building materials.
文摘Background: There is a lack of reliable epidemiological data on prevalence and comorbidity rates of mental disorders in the migrant population in Germany. Despite existing national and international data on the extent of psychosocial burdens in migrant populations the prevalence among the study population remains unclear. The aim of this study was to collect prevalence data for the largest migrant population in Germany-individuals with Turkish migration backgrounds—using a culturally and linguistically sensitive approach. Methods: The study employs a cross-sectional design. The multi-centre study (Hamburg, Berlin) is based on a sample of individuals with Turkish migration backgrounds living in the two cities stratified by age, gender, and education. The study programme consists of three phases: 1) a qualitative focus group to collect information on how to increase the participation rate of the target population as a minority group in Germany;2) a translation phase to create culture and linguistic sensitive versions of the assessment tools (e.g., the Composite International Diagnostic Interview (CIDI) for Turkish speaking individuals;and 3) a baseline community study to assess the lifetime, 12-month and four-week prevalence and comorbidity rates of mental disorder, health care utilization and help-seeking behaviour in individuals of Turkish migration backgrounds living in Germany. Discussion: The study provides important data on the lifetime prevalence of mental disorders and health care utilization of individuals with Turkish migration backgrounds. Furthermore, the study is an important step towards gaining a better understanding of potential barriers to participation, creating resources for difficult-to- reach minorities, and understanding the need for assessing mental disorders in migrant populations. These results can offer a starting point for the initiation of the necessary structural changes for mental health care services and policies for groups with migration backgrounds.
文摘Six German scenario studies on urban passenger transport for Munich 2058, Wuppertal 2050, Eastern Ruhr Region 2030, Tuebingen 2030, Cologne 2020 and Hanover Region 2020 investigate the key question： With which strategies and on what kind of scale, is it possible to reduce the carbon dioxide emissions of urban passenger transport to accomplish the 2℃ climate protection goal with a consequently huge reduction of greenhouse gas emissions by 80% to 95% by 2050 in relation to the base year 1990？ The scenarios show that the major challenge of a ＂climate-friendly city transport＂ can be achieved by appropriate measures （regarding direction and scale）： in small and medium-sized cities, large cities, cities of over a million people, and metropolitan regions. The scenarios demonstrate the extent to which the considered measures contribute to the CO2 reduction, and which gap to the achievement of the goal remains if that which is currently regarded as realistic in practice is really implemented in future. Thus, they illustrate the conflict between that which is necessary for climate protection and that which is currently considered feasible in politics. The scenarios show that it is essential to act quickly and appropriately, and not hesitantly or without conviction.
文摘Amazon Germany has formulated a series of marketing strategies based on the shopping habits of German consumers and it has achieved success.This article summarizes the current marketing strategies of Amazon in Germany,and explores the key factors for the success of this marketing strategy.By comparing with other e-commerce platforms,this article critically analyzes the innovation and deficiency of Amazon in Germany.
文摘The paper reports sunthetically the Cocene fauna of the Messel Pit Fossil site of Germany, in detail, including its rich taxanomic composttions, geological and paleogeographic backgroud, and the studying and applying history.
文摘Breastfeeding is considered to be the key variable for infant health. Consequently, UNICEF and the World Health Organization promote the beginning of breastfeeding within the first hour after birth and recommend to exclusively breastfeed the infant during the first six months. The origins of these modern breastfeeding campaigns can be traced back to the beginning of the twentieth century. Whereas high infant mortality rates traditionally were considered to be a matter of fate and the declining birth rates towards the end of the nineteenth century raised fears about the nation’s future and led to the emergence of an increasing infant welfare movement in imperial Germany. As low breastfeeding rates were identified as a key factor behind the high infant mortality rates, the main objective of the infant care movement was to increase breastfeeding. The paper examines how the context of infant care and infant mortality was constructed and how breastfeeding campaigns in the context of infant mortality, breastfeeding rates and socio-political changes developed during the twentieth century. Thus the paper covers the period from the beginnings of social paediatrics at the beginning of the 20th century, the breastfeeding campaigns embedded into Nazi ideology during the Third Reich, until the declining breastfeeding ratios and the “feeding on demand”-movement in the 1970s as well as the ideological differences between West and East Germany during the Cold War.
文摘This paper concentrates on the most important findings and the lessons learned from German experience in the field of wind energy integration. It reflects the work of the governmental experts who were auditing the 2008-revision of the Renewable Energy Sources Act （EEG 2008） in the EEG-Report 2011 and the actual political debate in Germany in 2013. The EEG report 2011 makes it clear that a feed-in-tariff-mechanism lowers entry barriers and open the market for new competitors but, also, that incentives without a favorable legal framework fail to fulfill the purpose.
文摘Objective:To investigate the distribution of TCM syndromes,the regularity of syndrome differentiation and the correlation between syndromes and body mass index(BMI)of simple obesity in Germany.Methods:From July 2020 to May 2021,122 patients with simple obesity were collected from the Bad Koetzting hospital of Beijing University of Chinese Medicine.The basic information of age,gender,height,weight and TCM syndrome were collected.The distribution of syndrome and its correlation with BMI were analyzed by frequency analysis and single sample chi square test.Results:According to the frequency,the syndrome distribution of simple obesity was as follows:yin deficiency and internal heat type,liver stagnation and qi stagnation type,qi stagnation and blood stasis type,spleen and kidney deficiency type,spleen deficiency and dampness resistance type and stomach heat and dampness resistance type.The BMI of spleen kidney deficiency type was the highest,while that of stomach heat dampness stagnation type was the lowest.There was no significant difference in BMI between stomach heat and dampness stagnation type,liver qi stagnation type,qi stagnation and blood stasis type(P=0.110,P=0.111).There was no significant difference in BMI between yin deficiency and internal heat type and liver stagnation,qi stagnation and blood stasis type(P=0.175,P=0.437).However,there were significant differences in BMI among other TCM syndromes(P<0.01).Conclusion:The most common TCM syndrome type of simple obesity in Germany is yin deficiency and internal heat type,and the highest BMI value is spleen and kidney deficiency type,and there is a certain correlation between BMI value and different TCM syndrome types of simple obesity.
