Current German Research Articles

Germany’s anti-antisemitic complex and the question of settler colonialism

ABSTRACT This discussion article argues that contestations about antisemitism in current German public discourse and an uncompromising and institutionally mandated support for Israel, even in the face of plausibly genocidal actions, are related to and enabled by an unreconstructed embrace of a settler colonialist ethos. In this context, an unwillingness to come to terms with a history of colonial violence is only one component among multiple determining factors. And yet the question of settler colonialism, while not immediately recognisable, should be recovered and foregrounded to explain the operation of what is here defined as an anti-antisemitic complex, where institutions, the media, and the law combine to enforce a ban on discussions of Israeli history and policies towards Palestinians.

Land competition and its impact on decarbonized energy systems: A case study for Germany

In densely populated countries, land competition is a key challenge in light of a growing population and the land-intensive decarbonization of energy supply. We apply an energy system model using linear optimization to Germany as an example for a densely populated and industrialized nation with a high energy demand to show how land competition affects the economics of land-intensive renewable energies. Bioenergy crops are currently cultivated on 6.5% of Germany’s land area. We find that allocating only 6% of the total land to the future energy system, which is even less than the current allocation to bioenergy crops, allows for a system that is close to the cost-minimum that we calculate when not restricting the land area. This 6% of the land area is divided into 4% for photovoltaics (PV), 2% for onshore wind and 0% for bioenergy crops. This would save 15billion€/a (15.1%) relative to the system that matches current political targets for utility-scale PV. For areas exceeding this 6%, we find that the most cost-efficient utilization comes from bioenergy crops, but they only add value to the energy system if there is plenty of land available. The value of land to the energy system is at least twice as high for 0% remaining emissions when compared to the case of 10% remaining green house gas emissions, although both scenarios are separated by less than five years according to current German law. Both our findings underline that considering the value of land as early as possible is necessary when developing state policies that shall lead to cost-efficient renewable energy systems.

Speed and lateral distance behavior on highly frequented bicycle facilities in Germany

Due to increasing bicycle traffic demands in Germany, more and more bicycle facilities are designed with widths beyond the standard values given in the existing design guidelines. To date, only few findings are available regarding the traffic flow at bicycle facilities with high volumes, especially when comparing different facility types and percentages of specific bicycle types. For this, the driving behavior of cyclists at high traffic volumes was analyzed, considering different bicycle types. Traffic flow was examined on segments of bicycle facilities with different geometric characteristics, including facility type, gradient, and width. The speed and lateral distance behavior of cyclists was analyzed by using radar and video measurements. It was found that the speed and lateral distance behavior in bicycle traffic is particularly influenced by the gradient and the composition of bicycle types. Furthermore, the results show that the number of bicyclists in the cross section, the width of the facility, the type of interaction (meeting, passing or riding next to each other at the same speed) as well as the type of the constructional boundary influence the lateral distance behavior. In general, it could be observed that bicyclists make use of the available width of the bicycle facility and choose larger distances in case of passing or meeting. Furthermore, it was observed that a minimum lateral wheel distance of 0.80 m is maintained during passing both in one- and two-directional traffic. This minimum lateral distance is already included in the current German design guidelines.

Surgical Treatment of Oropharyngeal Cancer - Recommendations of the Current German S3 Guideline, Part I

In general, a trend towards transoral resection (as opposed to classic open approaches) + neck dissection + adjuvant radio- (chemo-) therapy has been observed for oropharyngeal carcinoma over the last 20 years. Techniques of transoral surgery (TOS), including transoral laser microsurgery (TLM) and transoral robotic surgery (TORS) have been propagated in retrospective comparisons with conventional surgery or primary radiochemotherapy as gentle, minimally invasive procedures with good late functional results. Meta-analyses of mostly uncontrolled retrospective analyses suggest that TORS may have better disease-free survival (DFS) and a reduced risk of free flap reconstruction compared with open surgery. TORS (TOS) was associated with fewer tumor-positive resection margins (R1), a lower number of recurrences, fewer intraoperative tracheostomies, a shorter inpatient stay and a shorter duration of postoperative nasal tube feeding compared to open surgery. In principle, based on the best evidence currently available from registry studies, stage I-II oropharyngeal carcinomas can be treated either with primary surgery or radiochemotherapy with a comparable chance of survival. With comparable evidence for stage III and IVa, p16neg. oropharyngeal carcinomas, the majority of authors advocate primary surgery followed by adjuvant radiotherapy or radiochemotherapy as the treatment of first choice. For p16pos. patients the results of registry studies are inconsistent, although the largest registry study on 450 HPV-positive stage III patients shows a significant superiority of primary surgery + adjuvant radiochemotherapy. Since all registry studies did not adjust for smoking status, among other factors, the current data situation should be evaluated with the necessary caution.

Ready to Care for Pregnant Women with Breech Presentation? - Results from an Online Survey for Midwives and Midwifery Students in Germany, Austria, and Switzerland

The vaginal birth of breech presentation is an option for pregnant women supported by current German and international guidelines when favorable conditions and appropriately trained personnel are available. According to midwifery laws in the D-A-CH region, midwives should be able to provide care for a vaginal breech birth in emergencies. Therefore, imparting skills for breech delivery is enshrined in the curriculum for midwifery students. This study evaluated the knowledge and training needs of midwives and midwifery students in the German-speaking region. In May 2022, experiences, specific knowledge, and further training needs regarding vaginal breech birth were assessed through an online survey. Analysis of 467 questionnaires showed that only 30% of respondents currently attend vaginal breech births in their professional environment, but 50% would like to offer this service. 94% of respondents indicated that they would feel more confident if regular training opportunities, particularly simulations and virtual offerings, were provided for vaginal breech birth. However, currently only 10% of respondents receive regular training opportunities for vaginal breech births. The results suggest an increased provision of training opportunities for vaginal breech births to enhance midwives' safety in managing such births.

Spectrum of MRI findings in central nervous system affection in Lyme neuroborreliosis

Affections of the central nervous system (CNS) rarely occur in Lyme neuroborreliosis (LNB). CNS manifestations can have residual neurological symptoms despite antibiotic treatment. We explored the spectrum of CNS affections in patients with LNB in a tertiary care center in a region endemic for Lyme borreliosis. We retrospectively included patients treated at a tertiary care center from January 2020–December 2021 fulfilling the case criteria for LNB as stated in the current German guideline on LNB. Clinical data, cerebrospinal fluid (CSF) findings and MRI imaging were collected. We included 35 patients with LNB, 24 with early manifestations and 11 with CNS-LNB. CNS-LNB patients had encephalomyelitis (n = 6) or cerebral vasculitis (n = 5). Patients with early LNB and CNS-LNB differed regarding albumin CSF/serum quotient and total protein in CSF. Duration from onset of symptoms until diagnosis was statistically significantly longer in patients with encephalomyelitis. MRI findings were heterogeneous and showed longitudinal extensive myelitis, perimedullar leptomeningeal enhancement, pontomesencephalic lesions or cerebral vasculitis. CNS-LNB can present with a variety of clinical syndromes and MRI changes. No clear pattern of MRI findings in CNS-LNB could be identified. The role of MRI consists in ruling out other causes of neurological symptoms.

Industrial multi-energy communities as grid-connected microgrids: Understanding the role of asymmetric grid-charge regulation

The industrial sector is currently the leading emitter of greenhouse gases worldwide. Lowering emissions, the collaborative use of energy and storage technologies in Industrial Energy Communities (IEC) is a promising option, typically implemented as a grid-connected microgrid. To support successful implementations of IECs, it is essential to understand not only the interaction of different technical assets within an IEC but also the corresponding regulation that determines the IEC's economic and ecological performance. Similar to different technical capabilities of available assets, companies of an IEC are typically affected by regulation in different, asymmetric ways. To the best of our knowledge, we are the first to investigate the economic and ecologic effects stemming from asymmetric regulation, i.e., regulation that differs between different participating companies via a microgrid approach. By developing a novel linear model for German asymmetric grid charge regulation, we are able to optimize the economic operation of complex multi-energy microgrids under detailed regulatory conditions. In more detail, we formulate and implement a mixed-integer linear program to investigate the joint operation of a multi-energy IEC under asymmetric regulation. We conduct a real-world case study to evaluate the effects of German grid-charge regulation as a significant example of asymmetric regulation and compare the results of our IEC to a situation where every company of the IEC manages its assets individually. Our results indicate that IECs have the potential to significantly reduce the total operational energy costs under the current asymmetric German grid-charge regulation. While the shared assets see a higher utilization in the IEC, the impact on emissions is, however, limited.

Cutaneous adverse events to systemic anticancer therapies : Hand-foot syndrome and nail changes

Hand-foot syndrome (HFS) and nail changes are frequent adverse events of anticancer therapies. To provide areview of current evidence in HFS and nail disorders associated with medical tumor treatment. Basis is the current German S3guideline "Supportive therapy in oncologic patients" and literature on this topic published since the guideline was finalized. Two variants of HFS are distinguished: achemotherapy-associated and akinase-inhibitor-associated variant. In the first form, painful erythema, blisters and ulceration can occur, also in other areas with ahigh number of sweat glands such as axillary and inguinal regions. Thus, the secretion of toxic substances through sweat glands is aproposed pathogenetic mechanism. For the second form, which results in callus-like painful thickening of the horny layer on areas of mechanic pressure, avascular mechanism is proposed. For prophylaxis of HFS, avoidance of mechanical stress, regular cleaning of predisposed areas, and also urea- and diclofenac-containing ointments are recommended; in case of infusions (taxanes, doxorubicine), cooling of hands and feet during infusion is recommended. In case of manifest HFS, dose reduction or prolongation of intervals of the associated treatment are recommended. Nail changes often develop under therapy with chemotherapeutic agents but also under treatment with agents such as checkpoint inhibitors or under targeted therapy. Different components of the nail unit may be involved such as the nail matrix, nail bed, nail plate, hyponychium, lunula and proximal and lateral nail folds. This work gives insight into the pathophysiology of HFS and nail disorders that develop under systemic oncologic treatments and gives recommendations for prophylaxis and treatment.

Thematic coverage and readability of online patient information on cochlear implant care

IntroductionThe treatment of patients with a cochlear implant (CI) is usually an elective, complex and interdisciplinary process. As an important source of information, patients often access the internet prior to treatment. The quality of internet-based information regarding thematic coverage has not yet been analysed in detail. Therefore, the aim of this study was to analyse the information on CI care available on the internet regarding its thematic coverage and readability.Material methodsEight search phrases related to CI care were defined as part of the study. A checklist for completeness of thematic coverage was then created for each search phrase. The current German CI clinical practice guideline and the white paper on CI care in Germany were used as a basis. As a further parameter, readability was assessed using Flesch Reading Ease Scores. The search phrases were used for an internet search with Google. The first ten results were then analysed with regard to thematic coverage, readability and the provider of the website.ResultsA total of 80 websites were identified, which were set up by 54 different providers (16 providers were found in multiple entries) from eight different provider groups. The average completeness of thematic coverage was 41.6 ± 28.2%. Readability according to the Flesch Reading Ease Score was categorised as "hard to read" on average (34.7 ± 14.2 points, range: 0–72). There was a negative statistically significant correlation between the thematic coverage of content and readability (Spearman's rank correlation: r = − 0.413, p = 0.00014).SummaryThe completeness of thematic coverage of information on CI care available on the internet was highly heterogeneous and had a significant negative correlation with the readability. This result should be taken into account by both the providers of internet information and by patients when using internet-based information on CI care and help to further improve the quality of web-based information.

EUROPEAN CLIMATE PROTECTION STRATEGY UNDER CONSIDERATION OF BUILT HERITAGE PRESERVATION

Climate change affects all areas of life. The European Union strives for climate-neutrality of their members until 2050 with the project European Green Deal. By this, the emissions of greenhouse gases should be reduced to zero by 2050 with simultaneous economic development decoupled from resource use. 600 Billion Euros the European Union will spend to lower net greenhouse gas emissions until 2030 by at least 55%, compared to 1990 levels. Climate change affects historical structures, thus by variations in groundwater levels, hydrological cycle, or intense precipitation. However, also climate protection activities such as renewable energy installations may result in negative effects. Solar panels or wind turbines do not emit carbon dioxide and other greenhouse gases but, installed nearby historical buildings, affect the historical appearance of structures. That may result in conflicts between ecological and heritage conservation interests. The authors inform about the European Green Deal and analyze effects of the planned measures on built heritage with a focus on solar and wind energy installations. They also discuss requirements from heritage preservation regulations. The manuscript analyzes how renewable energy installations may affect built heritage in its historical appearance. For that, the authors use available information about the European Green Deal, discuss current research literature and relevant German court cases. It is concluded that renewable energy installations may negatively affect the appearance of built heritage. Interests of climate protection and built preservation need to be balanced to ensure that future generations even can experience and enjoy the cultural heritage.

EUROPEAN CLIMATE PROTECTION STRATEGY UNDER CONSIDERATION OF BUILT HERITAGE PRESERVATION

Climate change affects all areas of life. The European Union strives for climate-neutrality of their members until 2050 with the project European Green Deal. By this, the emissions of greenhouse gases should be reduced to zero by 2050 with simultaneous economic development decoupled from resource use. 600 Billion Euros the European Union will spend to lower net greenhouse gas emissions until 2030 by at least 55%, compared to 1990 levels. Climate change affects historical structures, thus by variations in groundwater levels, hydrological cycle, or intense precipitation. However, also climate protection activities such as renewable energy installations may result in negative effects. Solar panels or wind turbines do not emit carbon dioxide and other greenhouse gases but, installed nearby historical buildings, affect the historical appearance of structures. That may result in conflicts between ecological and heritage conservation interests. The authors inform about the European Green Deal and analyze effects of the planned measures on built heritage with a focus on solar and wind energy installations. They also discuss requirements from heritage preservation regulations. The manuscript analyzes how renewable energy installations may affect built heritage in its historical appearance. For that, the authors use available information about the European Green Deal, discuss current research literature and relevant German court cases. It is concluded that renewable energy installations may negatively affect the appearance of built heritage. Interests of climate protection and built preservation need to be balanced to ensure that future generations even can experience and enjoy the cultural heritage.

Biomonitoring of lead in blood of children living in a former mining area in Lower Saxony, Germany

Environmental exposure to lead substantially decreased over the past decades. However, soil of former mining areas still contains high lead levels. We therefore performed a biomonitoring study among children living in two former mining communities in Lower Saxony, Germany. In these communities, soil contains lead levels of 1000 to 30,000 mg/kg. Overall, 75 children (6–10 years of age) attending the two primary schools of the study area took part in the study. Parents completed a short questionnaire on sociodemographics, and children provided capillary whole blood samples. We analysed lead using inductively coupled plasma tandem mass spectrometer. We compared the results to current German (20 μg/l for boys, 15 μg/l for girls) and US (35 μg/l) reference values. Potential associations between questionnaire information and lead results were tested using lead as continuous outcome and using lead dichotomized at the reference values. Finally, we analysed spatial patterns of elevated biomonitoring results. Of all children, 48% exceeded the German reference values for lead (5% expected) and 8% the US reference value (2.5% expected). Children 6–8 years of age were more likely to exceed German reference values (63%) than 9–10 year old children were (32%; pFisher = 0.01). No other questionnaire information was statistically significantly associated with biomonitoring results. Additionally, we did not find any indication of spatial clustering. In conclusion, we observed elevated blood lead levels in primary school children living in a former mining area. In the next step, exposure pathways need to be identified to implement effective public health measures.

Towards true prices in food retailing: the value added tax as an instrument transforming agri-food systems

AbstractCurrent crises (i.e., climate crisis, COVID-19 pandemic, Russian invasion of Ukraine, and the resulting energy and food shortages) indicate the need for robust, and sustainable supply chains with regional food production and farmland to secure food supply in the European Union (EU). Recent research shows that organic food is more resilient to supply chain disruptions and price fluctuations. In this context, we examine an approach for the sustainable and resilient transformation of agri-food networks: can an adaptation of value added tax (VAT) levels work as a financial incentive to amplify resilient agricultural practices and sustainable dietary patterns? Within the setting of the amendment of the European framework directive on the use of VAT in 2022, we model the effects of adapting the current German VAT system by (1) reducing VAT on organic vegetarian food to 0% and (2) raising VAT on conventional meat and fish to 19%. Based on historical data on organic sales shares and price elasticities, we project sales shares differentiated by product group for each scenario. Then, we calculate expected tax revenues, changes in consumption patterns, and arising total external climate costs in Germany for both scenarios. Our results show that the overall consumption share of organic food would increase by 21.83% due to the modeled VAT reform compared to the status quo. Despite the VAT reduction to 0% on organic vegetarian products, the measure would yield €2.04 billion in extra tax revenues in Germany per year due to the increased taxation on conventional meat products. We find that annual environmental costs of €5.31 billion can be avoided as a result of lower external climate costs of organic and vegetarian food. Therefore, adjusting VAT rates in the food market can be a political instrument to drive organic food consumption and reduce animal livestock. This supports re-territorialization of agriculture and a more sustainable and resilient European food supply.

Autor und Subjekt im lyrischen Gedicht: Rezension und Neukonzeption einer Theorie der lyrischen Persona

Autor und Subjekt im lyrischen Gedicht: Rezension und Neukonzeption einer Theorie der lyrischen Persona

The gender representation of women and men in the occupational areas of STEM and care work in German textbooks

Science, technology, engineering, and mathematics (STEM) occupations and care work occupations are highly segregated by gender. School textbooks play an essential socializing role in determining which occupations are perceived as typically male or female. Existing research on the gender representation of STEM and care work occupations in textbooks is limited in scope. Therefore, we used quantitative text analyses in a large sample of 202 current German textbooks to examine the gender representation of STEM and care work occupations. We used collocation analysis to explore the nature of the occupational representations, focusing on agency and communion. Men were portrayed significantly more frequently than women in STEM and care work occupations. Adjectives of agency and communion occurred rarely in the collocations. Further research is required to test our findings in other cultures and to take a more differentiated look into the use of agency and communion in textbooks.

Value of contrast-enhanced sonography in the diagnosis of vesicoureteral reflux.

Contrast-enhanced ultrasound of the urinary tract and bladder (ceVUS) is an alternative examination method to micturition cysturethrography (MCU/VCUG) for suspected vesicoureteral reflux (VUR) that is increasing in practice. The purpose of this review is to present the current value of ceVUS in the diagnosis. A systematic literature search was performed using the keywords "vesicoureteral reflux", "ceVUS", "VCUG" of the databases MEDLINE and Cochrane Library as well as a review of current German, European, and American guidelines on this topic. In addition, recommendations for action in clinical practice were developed. ceVUS is a quick-to-learn examination method that is equivalent to VCUG for the diagnosis of vesicoureteral reflux and should be used as the diagnostic method of first choice when available given the absence of radiation exposure. · Like VCUG, ceVUS is the diagnostic method of first choice in suspected vesicoureteral reflux and should be used preferentially given the absence of radiation exposure.. · Especially in comparison to the alternative VCUG, ceVUS is a quick-to-learn examination method.. · ceVUS can also be used to diagnose other pathologies of the lower urinary tract.. · Conen P, Thiemann J, Stredele R et al. Value of contrast-enhanced sonography in the diagnosis of vesicoureteral reflux. Fortschr Röntgenstr 2024; 196: 1022 - 1028.

Current German Recommendations and International Research on the Use of COVID-19 Boosters among Health Care Providers in 2024: A Narrative Review.

While the World Health Organization (WHO) has de-escalated coronavirus disease 2019 (COVID-19) from a global health emergency, ongoing discussions persist as new viral variants. This article aimed to consolidate German recommendations and international research to offer health care providers (HCPs) a comprehensive guide on COVID-19 boosters in 2024. The review outlines key recommendations from the German Robert Koch Institute. HCPs should receive COVID-19 boosters at least 12 months after their last vaccination or COVID-19 infection, contingent on the prevalent viral variant(s) in the region. However, excessive doses and/or frequent boosters, especially with mRNA vaccines, may lead to immune imprinting, T-cell exhaustion, and immunoglobulin (Ig) switching. Notably, this review highlights the significance of Ig, particularly IgA and IgG subclasses, in influencing infection risk and disease progression. Furthermore, it explores the implications of mRNA vaccine technology and potential adverse effects related to excessive dosing. In conclusion, this article provides a comprehensive analysis of COVID-19 vaccine boosters for HCPs, synthesising current recommendations, scientific debates, and considerations for optimising protection against SARS-CoV-2 in the evolving landscape of the post-pandemic era.

Current practice of intracranial pressure monitoring in children with severe traumatic brain injury-a nationwide prospective surveillance study in Germany.

For management of severe traumatic brain injuries (sTBI) in children, the overall level of evidence to guide diagnostic and therapeutic procedures is low. Since 2016, international guidelines have subsequently suggested invasive intracranial pressure (ICP) monitoring in patients with initial Glasgow Coma Scale (GCS) ≤8. In Germany, ICP monitoring was an individual case decision from 2011 until the 2022 update of the German pediatric TBI guideline. The aim of this study was to evaluate current clinical practice of invasive ICP monitoring in Germany in children <10 years with respect to guideline recommendations. Anonymized clinical data on sTBI cases <10 years of age were collected in a nationwide prospective surveillance study via the German Pediatric Surveillance Unit ESPED from July 2019 until June 2022. Inclusion criteria for the surveillance study were sTBI (initial GCS ≤8) or neurosurgery following TBI. For this analysis, only cases with GCS ≤8 were subject to the present analysis. Descriptive analyses were performed to assess the proportion of ICP monitored patients and describe the cohort. Out of 217 reported cases, 102 cases met the inclusion criteria and thus qualified for ICP monitoring. Of these, 37 (36%) received ICP monitoring. Monitored patients were older, had lower median GCS values at presentation (4 vs. 5), higher mortality (32% vs. 22%), and were more frequently diagnosed with cerebral edema (68% vs. 37%). In children <10 years with sTBI, the present clinical management regarding ICP monitoring deviates from the current German national and international guidelines. The reasons remain unclear, with the low level of evidence in the field of ICP monitoring and the recency of changes in guideline recommendations as potential contributors. Prospective interventional studies should elucidate the benefit of ICP monitoring and ICP directed therapies to provide evidence-based recommendations on ICP monitoring.

Entrepreneurs of memory: Selling history in the GDR Museum shop in Berlin

The field of memory studies rarely deals with commercial enterprises, which, as we argue in this article, play just as prominent a role in shaping collective memories as state actors or nongovernmental organizations. The aim of our study is therefore to discuss the role of private entrepreneurs and their businesses in the context of GDR memory. We focus on the privately run GDR Museum in Berlin and its best-selling products. Through the lens of the museum store, we analyze the exhibition, an iconic eggcup, and a book on the history of the GDR that has enjoyed sustained sales over a lengthy period. By tracing the intertwined distribution chains of these memory goods, we emphasize the importance of private entrepreneurs and their networks in the current German memory culture. We argue that economic interests and developments are just as important as political decisions and public institutions regarding the memory of the communist past. Thus memory studies should also focus on enterprises of memory by analyzing business data. This poses an empirical challenge that is worth tackling, since it broadens our understanding of current memory culture.

Cumulative effects of offshore wind farms on common guillemots (Uria aalge) in the southern North Sea - climate versus biodiversity?

Governments are under increasing pressure to reduce greenhouse gas emissions, and large-scale wind farms are being developed in marine environments worldwide. However, top predators are strongly affected by environmental change and anthropogenic activities. Common guillemots (Uria aalge, hereafter guillemots), as one of the world’s most numerous seabird species, are prone to interference with offshore wind farms (OWFs). This study assessed the cumulative impacts of all operating OWFs on guillemots in the German North Sea. These estimates were applied to quantify the possible conflicts between guillemot occurrence and current German government plans to implement large-scale OWFs. If OWFs were implemented according to the current maritime spatial plan for the German Exclusive Economic zone, they would cover 13% of the German North Sea. Guillemot numbers peak during autumn, with German North Sea offshore waters hosting approximately 90,000 individuals. Guillemot density in autumn was significantly reduced within a radius of 19.5 km around operating OWFs. Applying this disturbance distance to current installation plans, about 70% of the German North Sea would be affected, and an estimated 68% of guillemots in the German North Sea would experience habitat loss. This highlights the possible threat to guillemots in the southern North Sea if the current German government plans are implemented. The current estimates are highly relevant to decisions regarding marine spatial planning and management recommendations. Such evaluations are essential for developing sustainable scenarios including reducing the human CO2 footprint, whilst also conserving biodiversity.