Distribution In Germany Research Articles

Integration of disamenity costs and equality considerations regarding onshore wind power expansion and distribution into energy system optimization models

BackgroundSocial acceptance of energy infrastructure projects affects public support for the energy transition and is essential for the transition’s sustainability and success. Despite extensive research focusing on the social acceptance of renewable energy, and on the acceptance of onshore wind power in particular, energy system models have largely prioritized techno-economic aspects. This focus has created a gap between model results and decision-makers’ needs. In this study, we offer recommendations for integrating disamenity costs and equality considerations—two critical social aspects related to onshore wind power—into energy system optimization. To achieve this, we use a spatially distributed model from a climate-neutral Germany and explore various implementations and trade-offs of these two social aspects.ResultsWe identified effective linear formulations for both disamenity costs and equality considerations as model extensions, notably outperforming quadratic alternatives, which exhibit longer solution times (+ 50–115%). Our findings reveal that the endogenous consideration of disamenity costs in the optimization approach can significantly reduce the human population’s exposure to wind turbines, decreasing the average disamenity per turbine by 53%. Drawing on notions of welfare economics, we employ two different approaches for integrating equality into the optimization process, permitting the modulation of the degree of equality within spatial distributions in energy system models. The trade-offs of the two social aspects compared to the cost-optimal reference are moderate, resulting in a 2–3% increase in system costs.ConclusionsDisamenity costs emerge as a predominant factor in the distribution of onshore wind power in energy system optimization models. However, existing plans for onshore wind power distribution in Germany underscore equality as the driving factor. The inclusion of social aspects in energy system models facilitates the identification of socially superior wind turbine locations. Neglecting disamenity costs and equality considerations leads to an overestimation of the practical solution space for decision-makers and, consequently, the resulting energy system designs.

Spatial Prediction of Organic Matter Quality in German Agricultural Topsoils

Soil organic matter (SOM) and the ratio of soil organic carbon to total nitrogen (C/N ratio) are fundamental to the ecosystem services provided by soils. Therefore, understanding the spatial distribution and relationships between the SOM components mineral-associated organic matter (MAOM), particulate organic matter (POM), and C/N ratio is crucial. Three ensemble machine learning models were trained to obtain spatial predictions of the C/N ratio, MAOM, and POM in German agricultural topsoil (0–10 cm). Parameter optimization and model evaluation were performed using nested cross-validation. Additionally, a modification to the regressor chain was applied to capture and interpret the interactions among the C/N ratio, MAOM, and POM. The ensemble models yielded mean absolute percent errors (MAPEs) of 8.2% for the C/N ratio, 14.8% for MAOM, and 28.6% for POM. Soil type, pedo-climatic region, hydrological unit, and soilscapes were found to explain 75% of the variance in MAOM and POM, and 50% in the C/N ratio. The modified regressor chain indicated a nonlinear relationship between the C/N ratio and SOM due to the different decomposition rates of SOM as a result of variety in its nutrient quality. These spatial predictions enhance the understanding of soil properties’ distribution in Germany.

International harm reduction indicators are still not reached: results from a repeated cross-sectional study on drug paraphernalia distribution in Germany, 2021

BackgroundTo prevent the transmission of blood-borne infections and reach the elimination of viral hepatitis by 2030, the World Health Organization (WHO) has set the goal to distribute 300 sterile needles and syringes each year per person who injects drugs (PWID). We aimed to assess drug paraphernalia distribution in Germany in 2021, including the WHO indicator, and to analyse changes to the distribution measured in 2018.MethodsWe conducted a repeated cross-sectional study of low-threshold drug services in Germany. We assessed type and quantity of distributed drug paraphernalia and the number of supplied PWID in 2021 using an online and paper-based questionnaire. We conducted a descriptive statistical analysis of data from 2021, assessed fulfillment of the WHO indicator and changes in services that participated 2021 and in the previous study 2018.ResultsFive hundred and eighty-nine of 1760 distributed questionnaires were returned in 2021. 204 drug services from 15 out of 16 federal states confirmed drug paraphernalia distribution, covering 20% of Germany’s rural and 51% of urban counties. 108 services had also participated in 2018. The most frequently distributed paraphernalia for injecting drug use in 2021 were syringes (97% of services), needles (96%) and vitamin C (90%). Pre-cut aluminium foil (79% of services) and pipes (28%) for inhaling, and sniff tubes (43%) for nasal use were distributed less frequently. We found a median reduction in distributed syringes by 18% and by 12% for needles compared to 2018. Of 15 states, two reached the 2030 WHO-target for needles and one for syringes.ConclusionsThe current national estimates and changes from 2018 to 2021 for drug paraphernalia distribution seem far from meeting the WHO target. Reasons could include a change in drug consumption behaviour towards less injecting use and more inhaling, and effects of the COVID-19 pandemic (supply difficulties, social distancing, lockdown, reduced opening hours of services). We observed pronounced regional differences in drug paraphernalia distribution. To close existing gaps, Germany should expand its drug paraphernalia distribution programmes and other harm reduction services, such as drug consumption rooms. Further investigation of determinants for adequate distribution is essential to reduce blood-borne infections in this key population.

Accessibility to specialist palliative care services in Germany: a geographical network analysis.

The need for palliative care will increase over the next years because of the rise in deaths from chronic illness and demographic changes. The provision of specialist palliative care (SPC) in Germany (palliative care units (PCU), specialist palliative home care(SPHC) teams and palliative care advisory(PCA) teams) has been expanded in recent years. Despite the increasing availability, there is still insufficient coverage with long travel times. The aim was to describe the spatial distribution of SPC services in Germany, to calculate the potential accessibility of facilities and to assess potential spatial under-provision. Retrospective cross-sectional study with regional analysis of SPC services in Germany. Addresses of SPC services registered online were geocoded, accessibility and network analyses were conducted, and proportion of the population living up to 60minutes driving time were calculated. A total of 673 facilities were included. Their distribution is heterogeneous with every fourth of the 401 districts (110/401; 27.4%) lacking a SPC service. In half of the area of Germany the existing PCU and SPHC teams are within reach of 30minutes, with nearly 90% of the population living there. Hospitals providing PCA teams can be reached within 30minutes in 17% of the total area with provision for 43% of the population. A high coverage of SPHC teams and PCU indicates a good spatial distribution in Germany but no complete adequate provision of SPC services, especially for PCA teams. There is a persistent need for further implementation of hospital PCA teams.

White-Toothed Shrews (Genus Crocidura): Potential Reservoirs for Zoonotic Leptospira spp. and Arthropod-Borne Pathogens?

Three species of white-toothed shrews of the order Eulipotyphla are present in central Europe: the bicolored (Crocidura leucodon), greater (Crocidura russula) and lesser (Crocidura suaveolens) white-toothed shrews. Their precise distribution in Germany is ill-defined and little is known about them as reservoirs for zoonotic pathogens (Leptospira spp., Coxiella burnetii, Brucella spp., Anaplasma phagocytophilum, Babesia spp., Neoehrlichia mikurensis and Bartonella spp.). We investigated 372 Crocidura spp. from Germany (n = 341), Austria (n = 18), Luxembourg (n = 2) and Slovakia (n = 11). West European hedgehogs (Erinaceus europaeus) were added to compare the presence of pathogens in co-occurring insectivores. Crocidura russula were distributed mainly in western and C. suaveolens mainly in north-eastern Germany. Crocidura leucodon occurred in overlapping ranges with the other shrews. Leptospira spp. DNA was detected in 28/227 C. russula and 2/78 C. leucodon samples. Further characterization revealed that Leptospira kirschneri had a sequence type (ST) 100. Neoehrlichia mikurensis DNA was detected in spleen tissue from 2/213 C. russula samples. Hedgehogs carried DNA from L. kirschneri (ST 100), L. interrogans (ST 24), A. phagocytophilum and two Bartonella species. This study improves the knowledge of the current distribution of Crocidura shrews and identifies C. russula as carrier of Leptospira kirschneri. However, shrews seem to play little-to-no role in the circulation of the arthropod-borne pathogens investigated.

Assessment of multiple model algorithms to predict earthworm geographic distribution range and biodiversity in Germany: implications for soil-monitoring and species-conservation needs

Identifying the potential distribution of soil-biodiversity with its density and richness relationships, including constituent species, is a pre-requisite for the assessment, conservation and protection of soil biodiversity and the soil functions it drives. Although the role of earthworms in improving soil quality has long been established, to quantitatively and spatially assess how this soil-animal group’s distribution changes along environmental gradients and geographic space and the identification of the drivers of such change has not been fully investigated. This comprehensive study aimed at modelling and mapping earthworm spatial distribution and diversity patterns to determine their conservation needs and provide baseline reference data for Germany. The study compared multiple modelling algorithms to map earthworm community parameters and 12 species-specific distribution probabilities, calculate their geographic range sizes and determine responses to environmental predictor variables. Three general patterns of spatial distribution ranges were identified by the model predictions (large-range, mid-range, and restricted-range species) with the corresponding environmental contributions to the predictions. Modelled species responses to environmental predictors confirm observed environmental drivers of earthworm distribution in Germany. The range classes based both on distributional level and geographic space provide the necessary information for identifying conservation and decision-making priorities, especially for restricted-distribution species as well as those with clearly defined habitat preferences.

Update and prognosis of Dermacentor distribution in Germany: Nationwide occurrence of Dermacentor reticulatus.

A considerable range expansion of Dermacentor reticulatus has been observed in several European countries, which is concerning in the light of its vector function for several pathogens, including Babesia canis and tick-borne encephalitis virus (TBEV). The present study provides an update on the distribution of Dermacentor ticks in Germany, using a citizen science approach. Ticks were collected by citizens from March 2020 to May 2021, and submitted along with information on the date and location of collection, potential hosts and details about the circumstances of discovery. In total, 3,292 Dermacentor specimens were received, of which 76.4% (2,515/3,292) were identified as D. reticulatus and 23.0% (758/3,292) as D. marginatus, while 0.6% (19/3,292) were too damaged for species-level identification. Dermacentor reticulatus was received from all federal states of Germany. Maxent species distribution models predicted suitable environmental conditions for D. reticulatus throughout Germany. Findings on the vegetation or on pastured animals without travel history confirmed the occurrence of this tick species as far north as the most northern German federal state Schleswig-Holstein. In contrast, the distribution of D. marginatus still appears to be limited to southwestern Germany, although the northward shift of the distribution limit observed in the preceding citizen science study, as compared with previous published distributions, was confirmed. This shift was also predicted by Maxent species distribution models, reflecting the broader distribution of the tick occurrence data contributed by citizens. Most D. reticulatus ticks were found on dogs (1,311/1,960, 66.9%), while D. marginatus was mainly discovered on hoofed animals (197/621, 31.7%) and humans (182/621, 29.3%). Human tick bites were reported in 0.7% (14/1,960) of host-assigned D. reticulatus and 3.4% (21/621) of host-assigned D. marginatus. Further studies to investigate an increasing endemisation of Babesia canis in Germany as well as the relevance of D. reticulatus for TBEV spread throughout the country, e.g., by traveling dogs, are urgently needed. In view of the activity of D. reticulatus during winter or the colder months, which complements that of Ixodes ricinus, a year-round tick protection of at least dogs is strongly recommended.

Understanding the public-private sector wage gap in Germany: New evidence from a Fixed Effects quantile Approach∗

The public-private sector wage gap is an important labor market indicator, reflecting sectoral differences in wage and recruitment policies. We provide new evidence on this sectoral gap throughout the wage distribution in Germany. Using data from the German Socio-Economic Panel (1984–2017), we decompose the wage gap and control for unobservable factors that endogenously determine the occupational sector choice. Our estimates confirm the result in the literature that women benefit from working in the public sector. For men, we find that they are unambiguously disadvantaged, with higher remuneration in the private sector across the entire wage distribution. This result contrasts with previous findings in the literature. Moreover, our findings show that taking endogenous selection into account substantially changes the decomposition of the gap, and it is crucial for assessing alternative policy measures. • We decompose the public-private sector wage gap in Germany over a long time span. • We adopt a novel approach that takes endogenous sector choice into account. • Women benefit from working in the public sector throughout the wage distribution. • Men are penalized for working in the public sector throughout the wage distribution. • Controlling for selection changes the assessment of alternative policy measures.

Burden of disease due to PM2.5 and NO2 emissions from coal-fired power plants in Germany

Background Coal combustion emits pollutants that affect human health. We aimed to quantify the environmental burden of disease (EBD) due to PM2.5 and NO2 emissions from coal-fired power-plants (CFPPs) in Germany. Methods Emissions from CFPPs and other sources were extracted from official German and European inventories. The contribution of CFPPs to AP in Germany was calculated with the chemical transport model REM-CALGRID on a grid of 2x2 km2 for 2015. Mean annual PM2.5 and NO2 exposure was assessed by intersecting the contribution of CFPPs to AP with the population distribution in Germany for 2015. Age- and sex-stratified mortality data and life-expectancy were extracted from the Federal Health Monitoring. The attributable EBD, expressed as Years of Life Lost (YLL), was calculated based on relative risk estimates for natural cause mortality from single- and multi-pollutant models for PM2.5 and NO2 from the ELAPSE (Effects of Low-Level Air Pollution: A Study in Europe) study. For disease-specific endpoints, we calculated YLL using relative risk estimates for PM2.5 from the Global Burden of Disease 2019 study and for NO2 from the ELAPSE study. Results The mean (min; max) calculated contributions of CFPPs to ambient PM2.5 and NO2 concentrations in Germany in 2015 were 0.25 µg/m3 (0.05 µg/m3; 3.11 µg/m3) and 0.48 µg/m3 (0.03 µg/m3; 14.95 µg/m3), respectively. The combined attributable EBD for natural cause mortality was 71,912 YLL (95% CI 52,818; 91,510). The sum of YLL for disease specific endpoints was 12,483 YLL for PM2.5 (coronary heart disease 49.7% of YLL, lung cancer 29.5%, COPD 8.9%, stroke 8.6% and diabetes mellitus type 2 3.3%) and 18,380 YLL for NO2 (cardiovascular mortality 96.8%, COPD mortality 3.2%). Conclusion In 2015, disease burden due to PM2.5 and NO2 emissions from CFPPs in Germany was substantial and dominated by coronary heart disease and cardiovascular mortality. Keywords Coal-fired power-plants; health

The gender pay gap revisited: Does machine learning offer new insights?

This paper analyses gender differences in pay at the mean as well as along the wage distribution in Germany. We estimate the adjusted gender pay gap applying a machine learning method (post-double-LASSO procedure). Comparing results from this method to conventional models in the literature, we find that the estimated gap differs substantially depending on the approach used. The main reason is that the machine learning approach selects numerous interactions and second-order polynomials as well as different covariates at various points of the distribution. This insight suggests that more flexible specifications are needed to estimate gender differences in pay more appropriately.

A large-scale citizen science approach to assess the distribution and ecology of the declining Garden Dormouse in Germany

The Garden Dormouse has shown an ongoing decline over the last decades across large parts of its range. As the reasons for the species’ shrinking range are poorly understood, effective conservation actions have been lacking so far. The Germany- wide project “In Search of the Garden Dormouse” aims to investigate the causes, and develop concepts and measures to mitigate the decline. The current distribution has been assessed using a large-scale citizen science approach. More than 6,000 dormouse observations were gathered via an online reporting tool, of which >4,000 reports could be verified by photos, videos, or call recordings. Our aim was to obtain important information about the ecology of the species in different habitat types. For this, volunteers systematically collected approximately 1,000 Garden Dormouse droppings for food analysis, installed footprint tunnels and camera traps, helped to obtain several hundred DNA samples, collected > 500 carcasses, and recorded Garden Dormouse calls from various sampling sites. Volunteers also used a novel device for automated Garden Dormouse monitoring in the field that was developed and successfully applied in support of the project. The gathered data displays the current Garden Dormouse distribution in Germany and provides insights into the biology and ecology of this endangered, understudied species. The multidisciplinary approach of the project combined several disciplines, from field ecology to population genomics, in a fruitful cooperation of scientists, citizen scientists, and a conservation NGO. It can serve as a template for future projects aiming to produce large-scale scientific data in animal research and conservation.

Wealth and its Distribution in Germany, 1895-2018

Wealth and its Distribution in Germany, 1895-2018

Assessing Long-Term Impacts of Automation on Freight Transport and Logistics Networks: Large-Scale LRP Integrated in Microscopic Transport Simulation

Up to now, bulk transports have been carried out via a hub-and-spoke network in the general cargo sector. However, it is expected that the use of autonomous vehicles will enable a more flexible delivery. Such developments may, economically, make sense for shippers. From an ecological point of view, also negative effects can be expected due to enhanced transport performance. In the framework of this research, we investigate the impacts of automation on general cargo transport at the logistics network level. For assessing the impacts of autonomous vehicles on logistics network structures and on freight transport routes ex-ante, an instrument for strategic transport and logistics network planning is needed. We develop an effective heuristic to find new facilities and adjust the network, while thereby considering the routing characteristics by tackling the large-scale location routing problem (LRP). By the linked approach, we can optimize the logistics network and also measure exact transport distances, driving transport lead times and number of necessary vehicles on the infrastructure network. We operationalize this approach in the framework of a case study focusing on the food retail distribution in Germany. In fact, this research reveals that the utilization of autonomous vehicles significantly enhances transportation ranges and the number of tours, while reducing the number of operating facilities.

The book industry in Germany

The article analyzes book publishing, book distribution in Germany. Some features and tendencies of development of the German book industry in the modern period are covered. The article analyzes the geography of large publishing centers, shows German publishing houses that have their own history, traditions, market segment, publish books in the relevant field of knowledge, and finally have their own philosophy.
 Export markets of German books, problems of distribution of editions abroad are considered.
 Book market segments are highlighted.
 The role and place of e-book publishing, audiobook sector, e-book are clarified in the general system of the book industry.
 The features of book distribution, sales volumes of the largest publishers of Germany, specifics of activity of book trade networks are shown.

Geogenic arsenic and uranium in Germany: Large-scale distribution control in sediments and groundwater

Arsenic (As) and uranium (U) are naturally occurring trace elements with potentially adverse effects on human health. This work revisits nine case studies on As/U accumulation and remobilization mechanisms in aquifers with different geological and stratigraphical backgrounds to develop a systematic overview of Germany's geogenic inventory of these trace elements. It uses geochemical proxies for a total of 270 solid samples to explain their spatio-temporal distribution: while Pleistocene geological development can explain their extensive absence in sediments and related groundwater in northern Germany, their abundance and distribution in the central and southern parts are widely controlled by sediment provenance geochemistry. Only highly felsic origin (Moldanubian Variscides) enables creation of elevated U in the systems while lower degrees of provenance felsicity (Rhenohercynian Variscides) appear to be sufficient for As presence. Postdepositional (hydro)geological and anthropogenically triggered intra-basinal processes of trace element accumulation, redistribution and eventually remobilization to groundwater contribute to the present-day situation. Therefore, the ultimate control of these incompatible trace elements is magmatic, even in old sedimentary systems, and still clearly traceable in nowadays large-scale geogenic As and U distribution in Germany and probably elsewhere.

Liquid Organic Hydrogen Carriers and alternatives for international transport of renewable hydrogen

Hydrogen can be transported over long distances when stored in Liquid Organic Hydrogen Carriers (LOHC). This transport is possible under the following conversion steps: first, hydrogen is stored inside a LOHC molecule (exothermic hydrogenation) at the starting point of the provision chain. Then, the loaded LOHC can be stored and transported. At the point of consumption, hydrogen is released (endothermic de-hydrogenation) and the unloaded LOHC returns to the point of hydrogen production. The optimal LOHC for transport should be liquid at ambient conditions and show similar properties to crude oil-based liquids (e.g., diesel, gasoline). This allows for a stepwise implementation using the existing crude oil-based infrastructure. However, there is a large variety of different LOHCs and other competing transport options; e.g., the transport of compressed hydrogen gas in pipelines or the transport of liquefied hydrogen in tanker ships. Against this background, this paper investigates the energy consumption and costs of these different hydrogen transport options. Therefore, the production of hydrogen is considered in areas with favorable renewable energy sources, followed by international transport logistics, and a local distribution in Germany. The assessment shows that the distance and the way heat is supplied to de-hydrogenate the LOHCs - especially for methanol - define the cost performance compared to a transport of compressed or liquid hydrogen. If the heat needed for dehydrogenation is covered by waste heat, dibenzyltoluene (DBT) or toluene can show benefits in terms of efficiency and costs. Furthermore, the different transport systems have different specific niches in which they are competitive; i.e., no specific transportation chain is superior to all systems under all circumstances. Nevertheless, the assessment shows that long-distance transport favors LOHC, while short-distance transport via pipelines can be used for lower costs.

Is ABO blood group a risk or prognostic factor for patients with endometrioid endometrial cancer? A retrospective analysis in Germany.

A relationship is known to exist between gastric and pancreatic cancers and ABO antigens, caused by various immune modulations related to the ABO blood group of the patient. A similar relationship with regard to gynaecological cancers remains controversial. Patients who underwent surgery for endometrioid endometrial cancer in International Federation of Gynaecology and Obstetrics (FIGO) stage I, II, III or IV from 2006 to 2018 were identified. The research explored the existence of a relationship between the patients' blood group or Rhesus factor and the incidence of endometrial cancer, grade (G1, G2, G3), FIGO stage, nodal status, recurrence, menopausal status, parity, and body mass index. Statistical methods such as the chi-square test, analysis of variance and the Scheffé post-hoc test were used. Two hundred and two patients with endometrioid endometrial cancer were included: 96 had blood group A, 19 blood group B, 75 blood group 0, and 12 had blood group AB. This distribution corresponds to the general blood group distribution in Germany. The vast majority of the dependent variables, such as grade, FIGO stage, nodal status or recurrence were not significantly associated with ABO blood group or Rhesus factor status. The relative frequencies of G1 and G3 endometrial cancers with respect to blood group were similar. Menopausal status, parity, and body mass index were not related to more advanced FIGO stages at initial diagnosis or to ABO blood group. Blood group screening would probably not be helpful in the diagnosis of endometrioid endometrial carcinomas in early stages compared to the current gold standard. Furthermore, a specific blood group does not increase either the risk of recurrence or the risk of a dedifferentiated type of endometrial carcinoma.

Historisierung des Diskurses und Potenzierung ästhetischer Erfahrungen in der Literatur der (Post-)Moderne

AbstractThe paper is based on the assumption that modern art centralises aesthetic experience in a specific way, why it as well be may regarded – in contrast to the rather forced interpretation of art already opposed by Susan Sontag (Sontag 2001, 10) – as an appropriate mode for encountering art. However, the theoretical discourse on aesthetic experience is characterised by opposite poles, which will be examined in the first part of this paper. On the one hand, there is the utopian conception around 1800, in which the reflection on aesthetic experience originally is rooted, in Friedrich Schiller’sOn the Aesthetic Education of Man(cf. Noetzel 2006, 198) or Friedrich Schlegel’s imaginations of a life in art inLucinde(cf. Dziudzia 2015, 38sqq.). On the other hand, the reflections in the German discourse at the beginning of the 20th century are marked in a conspicuously negative way, which can still be seen until the 1980s.In the theoretical first part of the essay, a few cursory positions on the ›problem of the aesthetic human being‹ will be considered initially, which reject aesthetic views in everyday life and evaluate such tendencies as forms of social decay. Concerned about morality on the surface, these positions indeed aim at criticising individual lifestyles in a modern world, which, in particular, are opposed to conservative and collectivist ideas of society and morality. These discourse positions, which are ultimately ideologically grounded, then lead to the deliberate reflections on aesthetic experience, as they unfold most notably from the 1970s onwards, where they form the implicit background.As will be shown, the explicitly negative evaluation expressed in the earlier positions then shapes the assessments of aesthetic experience of Hans-Robert Jauß (cf. Jauß 2007), Peter Bürger (cf. Bürger 1977) and Rüdiger Bubner (cf. Bubner 1989) as a fundamental, rather implicit scepticism. For the most part, their positions seem to make it impossible to think of the aesthetic experience as enrichment or to evaluate it positively, as is common in the US-American discourse, for instance.The latter stance, which is, in essence, initiated by John Dewey and his consciously non-strict separation between art and everyday life as well as his decidedly anti-elitist understanding of art and aesthetics, is more in keeping with the utopian concepts of around 1800. However, his writings only find late distribution in Germany (cf. Dewey 1980). In contrast to Dewey’s position – and Susan Sontag’s explicit rejection of the interpretation as a violent act and the omittance of the sensual experience of the artwork (Sontag 2001) – the critical condemnation of aesthetic experience, which ultimately remains unfounded in the German discourse (because of its implicit ideological origin), now appears challenged.In fact, attentive observation in an aesthetic stance becomes part of the aesthetic programme in modern art across the board (cf. Dziudzia 2015b). Bürger reflects on this and offers – especially in the examination of Marcel ProustIn Search of Lost Time – a productive proposal to grasp the ›aestheticizing perception‹ (as he calls it) as a literary technique. In his conception, Bürger refers to media as a specific ›projection area‹ of aesthetic experience, especially in literature around 1900. The ›imaginary fadings‹ (cf. Schmitz-Emans 2001) in modern literature are, following Bürger, to be further thought of as ›exponentiated‹ aesthetic experiences, which find their form not only around 1900 but also in more recent literature.Therefore, in the second part of the paper and the exemplary reading of a contemporary German novel, Martin MosebachsDer Mond und das Mädchen(The Moon and the Maiden), published in 2007, it is to be shown how aesthetic experience finds complex forms. In the specific shaping of imaginary fadings in the interplay of figure and narrator level, especially in recourse to the medium film to be observed therein, the ambivalence of the theoretical concept of aesthetic experience insinuates as will be argued.

A Head‐to‐Head Comparison of Augmented Wealth in Germany and the United States*

AbstractWe examine the composition of augmented household wealth (i.e., the sum of net worth and pension wealth) in the United States and Germany. Pension wealth makes up a considerable portion of household wealth, of about 48 percent in the United States and 61 percent in Germany. When pension wealth is included in household wealth, the Gini coefficient falls from 0.889 to 0.700 in the United States, and from 0.755 to 0.508 in Germany. If the wealth shares in Germany were the same as in the United States, this would lead to a 12.6 percent increase in the Gini coefficient in the augmented wealth distribution in Germany.

PNS252 DO MARKET WITHDRAWALS IMPACT PATIENT ACCESS TO TREATMENT IN GERMANY?

In Germany, the G-BA determines the additional benefit (AB) of new therapies relative to the appropriate comparator therapy (ACT). For products without a (proven) AB, annual therapy costs cannot exceed those of the ACT. Drug prices are negotiated with the GKV-Spitzenverband; where manufacturers do not accept the (expected) price, they may stop distribution in Germany to protect the price in other markets. Therefore, we wanted to understand the number and timing of withdrawals and their impact on supply to patients. We analyzed all G-BA assessments conducted before 13 May 2019 for products that were withdrawn. Publications and current sales status on Lauer Taxe were reviewed. We identified 28 products that are no longer marketed in Germany and 12 that were withdrawn but re-introduced. Across the 40 product withdrawals, 16 were withdrawn within 4 weeks of the AB determination (opt-out), the remaining after price negotiations; the G-BA assigned no AB to 29 products (73%). However, supply is continued through pre-approved or manufacturer-sponsored imports. Three products were withdrawn only from the ambulatory sector, and supply was continued for inpatients. In eight cases, a price was agreed after the withdrawal, and the product was re-introduced. For two products, the manufacturer initiated a re-assessment with new data. This study shows that several pathways exist for continuing supply to German patients; however, treatment disruptions due to delayed price agreements or re-introductions are still likely. Statutory health insurance funds argue that withdrawals from the market following no AB do not affect patients, since therapies with the same efficacy are available. However, 27% of products were withdrawn despite being assigned an AB. Additionally, no AB is often assigned for purely methodological reasons, such as lack of comparative studies with the ACT. Therefore, further research is warranted on the impact of withdrawals and treatment switching on patients.