Asignificant Impact Research Articles

Tracking changes in the area, thickness, and volume of the Thwaites tabular iceberg “B30” using satellite altimetry and imagery

Abstract. Icebergs account for half of all ice loss from Antarctica and, once released, present a hazard to maritime operations. Their melting leads to a redistribution of cold fresh water around the Southern Ocean which, in turn, influences water circulation, promotes sea ice formation, and fosters primary production. In this study, we combine CryoSat-2 satellite altimetry with MODIS and Sentinel-1 satellite imagery and meteorological data to track changes in the area, freeboard, thickness, and volume of the B30 tabular iceberg between 2012 and 2018. We track the iceberg elevation when it was attached to Thwaites Glacier and on a further 106 occasions after it calved using Level 1b CryoSat data, which ensures that measurements recorded in different acquisition modes and within different geographical zones are consistently processed. From these data, we map the iceberg's freeboard and estimate its thickness taking snowfall and changes in snow and ice density into account. We compute changes in freeboard and thickness relative to the initial average for each overpass and compare these to estimates from precisely located tracks using the satellite imagery. This comparison shows good agreement (correlation coefficient 0.87) and suggests that colocation reduces the freeboard uncertainty by 1.6 m. We also demonstrate that the snow layer has a significant impact on iceberg thickness change. Changes in the iceberg area are measured by tracing its perimeter, and we show that alternative estimates based on arc lengths recorded in satellite altimetry profiles and on measurements of the semi-major and semi-minor axes also capture the trend, though with a 48 % overestimate and a 15 % underestimate, respectively. Since it calved, the area of B30 has decreased from 1500±60 to 426±27 km2, its mean freeboard has fallen from 49.0±4.6 to 38.8±2.2 m, and its mean thickness has reduced from 315±36 to 198±14 m. The combined loss amounts to an 80 %±16 % reduction in volume, two thirds (69 %±14 %) of which is due to fragmentation and the remainder (31 %±11 %) of which is due to basal melting.

Positron emission tomography with computed tomography/magnetic resonance imaging for primary staging of prostate cancer

Prostate cancer is the most common malignancy and the second leading cause of cancer-related death in men. Accurate imaging diagnosis and staging are crucial for patient management and treatment. The role of nuclear medicine in the diagnosis of prostate cancer has evolved rapidly in recent years due to the availability of hybrid imaging with radiopharmaceuticals targeting the prostate-specific membrane antigen (PSMA). Hybrid imaging provides higher diagnostic accuracy compared to conventional imaging and has a significant impact on clinical management. Numerous radiotracers have been used in clinical applications, with PSMA ligands being the most commonly used. Hybrid imaging provides higher diagnostic accuracy for lymph node and bone metastases compared to conventional imaging and has asignificant impact on clinical management. The high accuracy for primary staging in high-risk prostate cancer using PSMA ligands has led to the inclusion of PSMA positron emission tomography (PET)/computed tomography (CT) in the new German S3 guideline for primary staging of prostate cancer. The aim of this article is to provide an overview of the use of PET imaging in the primary diagnosis of prostate cancer, to present the most commonly used radiotracers, and to highlight the results of recent studies.

Diagnostics of benign and malignant tumors of the orbit

Orbital space-occupying lesions can have asignificant impact on the quality of life. Depending on the dignity and etiology of the mass, they can even represent a life-threatening process, which must be timely treated in an interdisciplinary cooperation. To achieve acomprehensive overview about the diagnostics and frequency of malignant and benign masses of the orbit. A literature search was carried out in PubMed and Google scholar. Clinically, orbital lesions can show symptoms, such as exophthalmos with an increase in the vertical lid fissure, visual impairment and motility dysfunction with diplopia. Depending on the extent, an exposure keratopathy can occur due to failure to close the eyelids. For the diagnostics several tests should be carried out. Following athorough anamnesis and clinical examination, these should include ablood sample to test for various parameters, an ultrasound examination with subsequent computed tomography (CT) in cases of bone involvement or thin slice magnetic resonance imaging (MRI) of the orbit for assessment of soft tissues. In adults an endocrine orbitopathy is the most frequent cause of an inflammatory orbital process, where lymphomas are the most frequent entity among malignant tumors and vascular space-occupying lesions are the most frequent benign tumors. In children the most frequent benign masses are dermoid cysts and rhabdomyosarcoma is the most frequent primary malignant orbital tumor. The multimodal interdisciplinary treatment can include surgical excision and adjuvant radiotherapy or chemotherapy, depending on the entity.

Geospatial Analysis of the Dynamics of Climate in Kolkata Metropolitan Area

The Kolkata Metropolitan Area region comprises urban towns that have witnessed major changes and have been exposed to urban agglomerations, population outbursts, and have faced difficulties in regional management. The growing cities comprising these areas thus faced various kinds of natural changes. One of the major significant changes included the change in climaticconditions. Climateis the weather experienced by any region for a long period, particularly extending to 30-35 years. Therefore, the climate is a long-term study of any region where any slight change shows a significant impact on the lives and balance of the region’s habitats. This paper tries to deal with the analysis of climate change in the KMA region. Metropolitan cities in India are currently considered prime concerns due to various climatic distortion and global warming effects. Thus, the paper tries to show the factors and effects of climate change. The study period has been taken for 35 years in the paper. The analysis is carried out using various GIS techniques using the ArcMap 10.1.1 software and statistical techniques to generate graphs. From 1989 to 2006 ranged high as the population showed a rising trend in Kolkata, Howrah, and Kalyani.However, this trend changed for some time during 2014 and 2015 as various plantation activities, programs, and projects were taken up by the government to safeguard climate change’s harmful effect. It shows a rise in the temperature and fall in the rainfall quantities from 2015 to 2019. It also shows the disturbed rainfall pattern as a characteristic feature in the KMA cities as sudden droughts or urban flooding rise as a common phenomenon. The area is highly exposed to constant modifications. The paper concludes in a nutshell how the changes have affected the region and are still having asignificant impact on influencing lives and living.

Economic impact of the COVID-19 pandemic in general and visceral surgery : Acomparison of performance and revenue data from two departments of hospitals with different levels of referral

HintergrundBereits während der ersten Welle der COVID-19-Pandemie wurden die deutschen Krankenhäuser dazu aufgefordert, ihre elektiven Operationskapazitäten einzuschränken, um eine Überlastung des Gesundheitswesens abzuwenden. Im März 2020 wurden mit dem COVID-19-Krankenhausentlastungsgesetz finanzielle Hilfen zum Ausgleich dieser Einschränkungen vereinbart. Die Auswirkungen dieser Maßnahmen wurden in dieser Studie regional untersucht.Material und MethodenEs wurden die Leistungsdaten und Erlöskennzahlen der Klinik für Allgemein- und Viszeralchirurgie des Universitätsklinikums Erlangen (UKER) und der Chirurgischen Abteilung des Kreiskrankenhauses St. Anna Höchstadt/Aisch (KKH) im Zeitraum 01.04. bis 30.06.2019 mit denen des Jahres 2020 verglichen.ErgebnisseEs zeigte sich eine deutliche Reduktion der Bettenauslastung und der Fallzahlen stationär behandelter Patienten. Letztere sanken um 20,06 % im UKER bzw. 60,76 % im KKH. Nichtonkologische elektive Operationen nahmen um 33,04 % (UKER) bzw. 60,87 % (KKH) ab. Die Anzahl der Notfalleingriffe blieb am UKER unverändert und verringerte sich am KKH um 51,58 %.Die Erlöse aus DRG („diagnosis-related groups“) sanken um 22,12 % (UKER) und 54 % (KKH). Nach Berücksichtigung der Ausgleichszahlungen und Einsparungen aus variablen Sachkosten verzeichnete das UKER einen Verlust von −3,87 %, das KKH erreichte hingegen einen positiven Erlöseffekt von 6,5 %.DiskussionDie nichtselektive Einschränkung des elektiven Operationsbetriebs beeinflusste die Patientenversorgung und die Erlöskennzahlen an beiden Standorten signifikant. In Bezug auf die Schaffung von Intensivkapazitäten erscheint diese ungezielte Maßnahme jedoch nicht effizient. Zudem führte die einheitliche Freihaltepauschale zu einer unausgeglichenen Verteilung der finanziellen Hilfen zwischen den untersuchten Kliniken.

Health-related quality of life of children and adolescents with primary nocturnal enuresis who are undergoing therapy

Primary nocturnal enuresis (PNE) affects arelevant proportion of children (10-15% at school entrance). While asignificant impact on psychological well-being and self-esteem of children has been reported, the consequences for Health-Related Quality of Life (HRQoL) have been less addressed. The aim of this investigation is the analysis of HRQoL of PNE under therapy with an established questionnaire. The KINDL‑R questionnaire for HRQoL with 24items in 6dimensions was sent to all patients of the enuresis outpatient clinic (ages 7-17years, minimum 3months of therapy, no achieved dryness). Actual number of wet nights and eventual comorbidities were extracted from the clinical data. Of 57 questionnaires sent by mail, 47 were returned from patients and parents (82.5%). The patient results did not show acorrelation between HRQoL and age, but there was anegative correlation of physical well-being and increasing age (r = -0.259, p < 0.05). Amarked negative correlation was seen between bed-wetting frequency and HRQoL (r = -0.372, p < 0.05), especially in the dimensions "self-worthiness" (r = -0.399, p < 0.005) and "chronic-generic" (r = -0.383, p < 0.05). During enuresis treatment without achieved dryness, the patients did not show systematic limitation in HRQoL compared to reference populations. This is in contrast to limitations in HRQoL and self-esteem before therapy, but may possibly be explained by the correlation of this dimension with bed-wetting frequency in this study and the reported improvement through treatment in other studies. Both factors support the need and importance of adequate PNE therapy.

Quality assurance in dMMR and MSI diagnostics

Deficient mismatch repair (dMMR) and microsatellite instability (MSI) have therapeutic relevance not only for colorectal carcinomas but also for carcinomas of other entities (endometrium, biliary tract, pancreas). In order to guarantee the knowledge and good technical quality necessary for adequate implementation of the corresponding analyses in pathology institutes, the Pathology Quality Assurance Initiative ("Die Qualitätssicherung-Initiative Pathologie") has been offering proficiency tests (PT) for years. It has been shown for the dMMR PT that various antibody clones from different manufacturers provide comparable results in immunohistological examinations, except for slight variations. The difficulty lies in the staining protocol (intensity of staining) and the interpretation of the staining results. The molecular pathological MSI PT has shown apositive trend at ahigh-quality level over the last three years. Success rates increased from 89 (2018) to 97% (2019/2020). The choice of assay, whether commercial or in-house tests with the designated cutoffs for this purpose, has not been shown to have asignificant impact on the PTs in the selected EQA samples.

The effects of government expenditure on sustainable economic growth in India: assessment of the circular economy

Government expenditure is linked to the economic growth and is the driving force of the every country. In the post liberalization era, India has been exposed to the dynamics of the world economy due to which India has witnessed a significant impact of Government spending on its economic growth. The objective of this paper is to investigate the effects of the Central Government spending on the growth of the Indian economy over a period, from 2006 to 2016. The online data disclosures of the various ministries have been the major source of secondary data. Co-integration analysis is adopted to evaluate the effect of individual sectorial spending on the economic growth and gross domestic product. The economic spending is classified into 5 sectors namely: General Services, Social Services, Economic Services, Grants in Aid &amp; Contribution and Public debt &amp; Loans for analysis, as disclosed by the sources. The analysis gives us an idea of the various sectors which have a positive impact and the sectors which have a negative impact. The results would play an instrumental role in exploring the sectors in which the government should invest more, thereby contributing to an enhancement in the country’s growth.

THE IMPACT OF THE AUDITOR’S PERSONAL CHARACTERISTICS THROUGH DYSFUNCTIONAL AUDIT BEHAVIOUR ACCEPTANCE TOWARDS THE AUDIT QUALITY

The research aims to discover the impact of personal auditor’s characteristics, includingemployee’s performance, auditor burnout, professional commitment, turnover intention, selfesteem,&#x0D; locus of control, towards dysfunctional audit behavior acceptance, and its impact on thequality of audit through dysfunctional audit behavior. The technique employed in this research waspurposive sampling with 121 auditors at BPKP Province of Papua representative office and PapuaInspectorate Office as the size of the sample. However, there were only 94 used. StructuralEquation Model (SEM) with Partial Least Square (PLS) WrapPLS 6.0 method was also used astechnical analysis to test the variable’s impact. The research found that employee performance and self-esteem have no impact on the dysfunctionalaudit behavior, however auditor burnout, professional commitment, and external locus of controlhave significant and positive impacts on the dysfunctional audit behavior. Auditor burnout,turnover intention, and external locus of control have no impact on the quality of the audit,however, the employee’s performance, professional commitment, and self-esteem do have asignificant and positive impact on the quality of audit. All auditor’s characteristics have no impacton the quality of audit through dysfunctional audit behavior acceptance, another word, thedysfunctional audit behavior acceptance is not necessarily the intervening variable betweenauditor’s personal characteristic towards the quality of audit.

Dividend Policy on IPOs Companies in Indonesia: A Life Cycle Theory Test

This study intends to assess the accuracy of life cycle theory prediction in explaining the dividendpayment policies when a company in Indonesia conducts the Initial Public Offerings. Technically, this studyaims to (1) examine the impacts of Retained Earnings to Total Equity (RE/TE), return on assets, firm age, firmsize, and growth opportunity toward propensity to pay dividends, and (2) examine the impacts of RE/TE, returnon assets, firm age, firm size, and growth opportunity toward dividend pay-out ratio. The population of thisstudy was all companies that conducted the Initial Public Offerings on the Indonesia Stock Exchange from2000 to 2017. The binary logistic regression model was used to analyze the data for reaching the first purposewhile the ordinary least square was applied to answer the second one. The results show that dividend paymentpolicies in the first year of companies conduct the Initial Public Offerings are in line with the life cycle theoryprediction. It is proved by the positive and significant impacts of RE/TE, return on assets, firm age, and firmsize toward propensity to pay dividends. Besides, it is also proved by the positive and significant impacts ofreturn on assets and firm size toward dividend pay-out ratio; as well as the negative and significant impact ofgrowth opportunity toward dividend pay-out ratio. The study does not acquire that growth opportunity gives asignificant impact on the propensity to pay dividends, and RE/TE and firm age significantly impact dividendpay-out ratio.

The role of urban defenseless spaces in women’s security: A case study of Jiroft, Kerman province, Iran

Growing trends in urban development combined with fundamental changes in the physical context of cities necessitate paying attention to the quality of urban spaces. The low quality of spaces, known as defenseless spaces, has a significant impact on the security of citizens, particularly vulnerable groups, including women. By emphasizing the role of defenseless spaces in Jiroft, the present study aims to evaluate their effect on women?s security. Data were collected using a questionnaire and analyzed using an independent t-test. Kendall correlation and regression were also applied in order to determine the quality of urban spaces and to evaluate their relationship with women?s safety. The results show that the physical spaces in Jiroft, more than 30% of which are worn out, are of low quality, and thus can be referred to as defenseless. The level of women?s satisfaction with the quality of the space is not high enough and this situation has increased women?s insecurity by 41%. Therefore, reconsidering urban design, especially in the peripheral and suburban areas is necessary, owing to women?s dissatisfaction with the quality of urban spaces and the positive correlation of these spaces with the level of security.

A Study on the Impact of Logistics Service Quality on the Satisfaction and Loyalty of E-Shoppers in Egypt

Customers nowadays are increasingly using online shopping due to its convenience in terms of time and cost, in addition to providing a vast variety of products and services and allowing customer to compare between different products. Several factors can affect the satisfaction levels of online customers including the quality of logistics services. This paper studies the relationship between logistics service quality (LSQ) dimensions and customer satisfaction and then studies the impact of customer satisfaction on customer loyalty. The study targeted online shoppers in Egypt and 292 responses were collected. The findings of the study revealed that information quality, product quality, product condition and reverse logistics are the most significant variable relating to customer satisfaction and that customer satisfaction has a significant impact on customer loyalty. This study can help online retailers in identifying areas of improvements to achieve higher levels of customer satisfaction.

Intergenerational Transmission, Self-Effort and Income Gap between Urban and Rural Youth in China

Based on the data of China Health and Nutrition Survey (CHNS) from 1991 to 2015, the effects of intergenerational income transmission and self-effort on the income gap between urban and rural youth under different quantiles were studied by using RIF’s unconditional quantile regression and distribution decomposition method. The results show that the parents’ income has a significant impact on the income of urban and rural youth in each quantile, and it is the main driving force to widen the income gap. By decomposing the intergenerational income elasticity, it is found that the intergenerational income of urban youth is mainly transmitted through education, while the rural youth is more reflected in the path of career transmission. Hard work has a strong impact on the income of urban and rural youth only in the middle and low quantiles, and the effect of rural youth is greater than that of urban youth. Hard work can reduce the income gap between urban and rural youth in the middle and low quantiles, but at the cost of “reverse discrimination” against rural youth.

Organizational Citizenship Behaviours - Antecedents, Outcomes &amp; Paradoxes: A Literature Review

Organizational Citizenship Behaviours(OCBs) have asignificant impact on how employees go over and beyondat the workplace and form a competitive edge for theirfirms. Grounded in industrial-organizational psychology,OCBs provide insights for leaders and managers to alignand engage staff to improve organizational effectiveness.While a lot of studies have focused on the benefits ofcitizenship behaviours, there are paradoxes which needmore attention. This paper reviews the literature onOCBs, the antecedents, outcomes and paradoxes whenexcessive OCBs can come in the way of organizationalsuccess.

Emission of fine particles (PM2.5) from residential biomass combustion in Croatia and how to reduce it

Wood burning in residential appliances is very represented in the Republic of Croatia. It is a main or an additional form of heating for many households in rural and urban areas and is therefore an important source of air pollution. The choice of energy and the combustion appliance used in home have a significant impact on PM2.5 emissions. The paper informs the reader about PM2.5 emissions, their main sources and impacts on human health, environment, climate, air quality, and the reason why PM2.5 emissions from residential wood burning are harmful. Paper also gives an overview of spatial PM2.5 emission distribution in Croatia, their five air quality zones and four agglomerations. The paper analyses the sources and their contribution to PM2.5 emissions with the relevance of PM2.5 emissions from residential plants, the use of fuels in residential plants and their contribution to PM2.5 emissions and PM2.5 emissions by fuel combustion technologies in residential sector. Appropriate strategies, policies, and actions to reduce the impact of residential biomass (wood) burning on the environment, air quality and human health are considered.

Agency work in intensive care : Impact of temporary contract work on patient care in intermediate care and intensive care units

HintergrundLeiharbeiter werden, meist im Sinne einer Arbeitnehmerüberlassung, zur pflegerischen Versorgung von Intensivpatienten eingesetzt. Ob bzw. wie sich Leiharbeit in der Pflege auf die Patientenversorgung auswirkt, wurde bislang kaum untersucht.ZielZweck dieser systematischen Übersichtsarbeit ist es, die verfügbaren Forschungsergebnisse über den Einsatz von Leiharbeitern in der pflegerischen Versorgung auf Intensiv- und Überwachungsstationen zu beschreiben und die potenziellen Auswirkungen auf das Patientenoutcome zusammenzufassen.MethodeEs wurde in sieben Datenbanken mit booleschen Operatoren systematisch nach englisch- und deutschsprachigen Studien recherchiert und in Anlehnung an das PRISMA-Schema ausgewertet. Referenzen der Studien wurden ebenfalls in die Suche inkludiert und die Qualität aller eingeschlossenen Studien nach Hawker-Kriterien bewertet.ErgebnisVon insgesamt N = 630 gesichteten Datensätzen konnten jeweils eine qualitative und zwei quantitative Studien identifiziert und in die Auswertung einbezogen werden. Die Ergebnisse der qualitativen Studien gaben nicht signifikant an, dass Leiharbeiter zu einem schlechteren Patientenoutcome beitragen können. Die Ergebnisse der quantitativen Studien zeigten, dass die Wahrscheinlichkeit für das Auftreten von katheterassoziierten Infektionen mit dem Einsatz von Leiharbeitern steigen kann, aber eher von der Stationsgröße anhängig ist: Je zusätzlichem Bett steigt die Wahrscheinlichkeit für eine VAP um 14,8 % (95 %-CI = 1,032–1,277, p = 0,011). Allerdings konnten Tendenzen für einen Rückgang der Sepsisrate, sobald weniger Leiharbeiter (Stunden/Patient) auf der Intensivstation eingesetzt wurden, nicht bestätigt werden.SchlussfolgerungIn den wenigen auswertbaren Studien wurden keine Hinweise dafür gefunden, dass der Einsatz von Leiharbeitern auf Intensiv- (ITS) und Überwachungsstationen (IMC) einen signifikanten Einfluss auf das Patientenoutcome hat. Es wurden allerdings Hinweise gefunden, dass individuelle Qualifikationen und die Arbeitsbedingungen einen Einfluss auf das Outcome haben. Weitere Studien sollten betrachten, welches Verhältnis von Festangestellten zu Leiharbeitern als unkritisch anzusehen ist, welche Qualifikationen temporäre Mitarbeiter vorweisen sollten und inwieweit diese überprüft werden können.Zusatzmaterial onlineDie Online-Version dieses Beitrags (10.1007/s00063-020-00753-5) enthält die vollständige Suchstrategie je Datenbank. Beitrag und Zusatzmaterial stehen Ihnen auf www.springermedizin.de zur Verfügung. Bitte geben Sie dort den Beitragstitel in die Suche ein, das Zusatzmaterial finden Sie beim Beitrag unter „Ergänzende Inhalte“.

Comparison of the U&amp;lt;sub&amp;gt;37&amp;lt;/sub&amp;gt;&amp;lt;sup&amp;gt;K&amp;lt;sup&amp;gt;′&amp;lt;/sup&amp;gt;&amp;lt;/sup&amp;gt;, LDI, TEX&amp;lt;sub&amp;gt;86&amp;lt;/sub&amp;gt;&amp;lt;sup&amp;gt;H&amp;lt;/sup&amp;gt;, and RI-OH temperature proxies in sediments from the northern shelf of the South China Sea

Abstract. The temperature proxies U37K′, LDI, TEX86H, and RI-OH are derived from lipid biomarkers, namely long-chain alkenones from coccolithophorids and long-chain diols ascribed tentatively to eustigmatophytes, as well as glycerol dialkyl glycerol tetraethers (GDGTs) and OH-GDGTs produced by Archaea. The applicability of these proxies in the South China Sea (SCS) has been investigated previously. However, in each study only one or two of the proxies were compared, and the recently updated calibrations or new calibrating methods such as BAYSPAR and BAYSPLINE were not applied. Here, we investigate four proxies in parallel in a set of surface sediment samples from the northern SCS shelf and relate them to local sea surface temperature (SST), which allows for us to compare and assess similarities and differences between them and also help improve regional multiproxy seawater temperature reconstructions. Our results indicate that U37K′ reflects annual mean SST with a slight bias toward the warm season. Terrestrial inputs appear to have a significant impact on LDI, TEX86H, and RI-OH proxies near the coast, leading to colder LDI- and TEX86H-derived temperatures but a warmer RI-OH temperature estimate. After excluding samples influenced by terrestrial materials, we find that LDI-derived temperature agrees well with annual SST, while TEX86H- and RI-OH-derived temperature estimates are close to SSTs in seasons dominated by the East Asian winter monsoon and summer monsoon, respectively. The different seasonal biases of these temperature proxies provide valuable tools to reconstruct regional SSTs under different monsoonal conditions.

Effects of the SARS-CoV-2 pandemic on surgery-anational cross-sectional study

Hintergrund und ZieleDas deutsche Gesundheitssystem wurde mit Beginn der SARS-CoV-2-Pandemie auf die Behandlung von COVID-19-Patienten ausgerichtet. Dies ging mit der Aussetzung des operativen Elektivprogramms einher. Ziel der Studie war es, den Einfluss der SARS-CoV-2-Pandemie auf die Allgemein- und Viszeralchirurgie der Universitätskliniken in Deutschland zu untersuchen.MethodenDie vorliegende Querschnittsstudie basiert auf einer anonymen Umfrage, die vom 03.04.2020 bis zum 17.04.2020 für die Teilnehmer des Konvents der Ordinarien für Allgemein- und Viszeralchirurgie in Deutschland online zugänglich war. 73 % (n = 29/40) der Befragten nahmen teil.ErgebnisseDie Zusammenarbeit mit den Behörden und der Krankenhausleitung wurde überwiegend als angemessen empfunden. Allerdings stimmten nur 3 % (1/29) bzw. 7 % (2/29) der Aussage voll zu, dass sich die Gesundheitsbehörden auf Bundes- bzw. Landesebene unterstützend gegenüber der Allgemein- und Viszeralchirurgie zeigten. Die Klinikdirektoren erwarten einen niedrigeren Umsatz von durchschnittlich 28 ± 16 %. Es kam zu einer durchschnittlichen Verringerung der Betten- bzw. Operationssaalkapazität um 38 % bzw. 45 %. Darüber hinaus wurden 11 % des ärztlichen Personals der Allgemein- und Viszeralchirurgie in andere Abteilungen umverteilt.DiskussionDie SARS-CoV-2-Pandemie hat deutliche Auswirkungen auf die universitäre Allgemein- und Viszeralchirurgie in Deutschland. Die Reduktion der Betten- sowie der Operationsaalkapazität kann zu erheblichen Verzögerungen dringlicher Operationseingriffe und finanziellen Belastungen im Jahr 2020 und den Folgejahren führen.Zusatzmaterial onlineZusätzliche Informationen sind in der Onlineversion dieses Artikels (10.1007/s00104-020-01256-x) enthalten.

Hormone replacement therapy in peri- and postmenopause

Peri- and postmenopausal disorders can have asignificant impact on quality of life. Hormone replacement therapy (HRT) might be necessary in order to decrease women's symptoms. The German S3 guideline "Peri- and Postmenopause-Diagnostics and Therapy" (2020) provides recommendations that include the most recent evidence as well as the Women's Health Initiative (WHI) study results from 2002 and 2004. These results led to reduced prescription patterns due to ahigh risk of cardiovascular diseases as well as an increased risk for breast cancer if HRT had been administered. Both ongoing analyses of subgroups and other studies extenuated the WHI data, since the increased risks were neither generalizable to the typical postmenopausal patient (regarding age and risk profile) nor to the medication being used today. This article summarizes all aspects of HRT in peri- and postmenopausal women (indications, contraindications, practical approaches, risks, prevention) and provides recommendations with respect to the most recent S3 guideline.

ON THE ISSUE OF IMPORTANCE OF SOCIAL AND DEMOGRAFIC DEVELOPMENT OF THE REGION

The authors approaches to the definition of the concepts of social development and demographic development are considered. The authors studied various points of view regarding a set of indicators for assessing the level of sociodemographic development of the region. The list of basic and special indicators of the sociodemographic development of the region has been clarified. Particular attention is paid to factors that have asignificant impact on the sociodemographic development of the regions. The construction of state policy in the field of socio-demographic development of regions should take into account the above factors. This will help to establish the stability of the sociodemographic situation of the region.