Northeast Germany Research Articles

Lack of association between proton pump inhibitor use and brain aging: a cross-sectional study

PurposeDue to conflicting scientific evidence for an increased risk of dementia by intake of proton pump inhibitors (PPIs), this study investigates associations between PPI use and brain volumes, estimated brain age, and cognitive function in the general population.MethodsTwo surveys of the population-based Study of Health in Pomerania (SHIP) conducted in Northeast Germany were used. In total, 2653 participants underwent brain magnetic resonance imaging (MRI) and were included in the primary analysis. They were divided into two groups according to their PPI intake and compared with regard to their brain volumes (gray matter, white matter, total brain, and hippocampus) and estimated brain age. Multiple regression was used to adjust for confounding factors. Cognitive function was evaluated by the Verbal Learning and Memory Test (VLMT) and the Nuremberg Age Inventory (NAI) and put in relation to PPI use.ResultsNo association was found between PPI use and brain volumes or the estimated brain age. The VLMT score was 1.11 lower (95% confidence interval: − 2.06 to − 0.16) in immediate recall, and 0.72 lower (95% CI: − 1.22 to − 0.22) in delayed recall in PPI users than in non-users. PPI use was unrelated to the NAI score.ConclusionsThe present study does not support a relationship between PPI use and brain aging.

Drastic changes of the amphipod fauna in northern Germany and the displacement of Gammarus lacustris G.O. Sars, 1864 to relict habitats/status

The amphipod fauna of Central Europe has changed dramatically over the last century. This change has increased dramatically over the past 30 years. This dynamic is well documented in northeast Germany. This study places it in a landscape-ecological context. An example of a displacement is Gammarus lacustris G.O. Sars, 1864, a circumpolar species with a variety of habitats, but relegated to relic habitats. The species turns out to be a very weak competitor. Already with the immigration of Gammarus roeselii Gervais, 1835 (probably in the 1960s), it became a relic species in northeast Germany. Massive waves of introduction of Pontocaspian species of the genera Dikerogammarus, Pontogammarus and Echinogammarus a few decades later intensified this process for this and other species.

Correlations of Soil Fungi, Soil Structure and Tree Vigour on an Apple Orchard with Replant Soil

The soil-borne apple replant disease (ARD) is caused by biotic agents and affected by abiotic properties. There is evidence for the interrelation of the soil fungal population and soil aggregate structure. The aim of this study conducted between March and October 2020 on an orchard in north-east Germany was to detect the correlations of soil fungal density, soil structure and tree vigour under replant conditions in a series of time intervals. By using the replant system as the subject matter of investigation, we found that replanting had an impact on the increase of soil fungal DNA, which correlated with a mass decrease of large macro-aggregates and an increase of small macro- and large micro-aggregates in the late summer. Increased proportions of water-stable aggregates (WS) with binding forces ≤ 50 J mL−1, decreased proportions of WS > 100 J mL−1 and a decrease of the mean weight diameter of aggregates (MWD) emphasised a reduction of aggregate stability in replant soils. Correlation analyses highlighted interactions between replant-sensitive soil fungi (Alternaria-group), the loss of soil structure and suppressed tree vigour, which become obvious only at specific time intervals.

From Individual Farms to Agriholdings: Methodological Implications. An Explorative Regional Case Study in East Germany

Agricultural economics and policy planning make use of—and rely on—agricultural statistics. Individual agricultural firms, as they are represented in statistical systems, are usually treated as independent economic decision-makers. Our paper investigates the impacts of agriholding structures on statistical and economic parameters. Therefore, the paper will draw on the empirical evidence generated in a local case study in seven communities in northeast Germany. It is argued that cross-regional investors systematically “assemble” agriholdings based on their overall business strategy. If large holding structures exist, then the individual business perspective may create a flawed representation of farm structures.

Spatial accessibility of general inpatient care in Germany: an analysis of surgery, internal medicine and neurology

Improving spatial accessibility to hospitals is a major task for health care systems which can be facilitated using recent methodological improvements of spatial accessibility measures. We used the integrated floating catchment area (iFCA) method to analyze spatial accessibility of general inpatient care (internal medicine, surgery and neurology) on national level in Germany determining an accessibility index (AI) by integrating distances, hospital beds and morbidity data. The analysis of 358 million distances between hospitals and population locations revealed clusters of lower accessibility indices in areas in north east Germany. There was a correlation of urbanity and accessibility up to r = 0.31 (p < 0.001). Furthermore, 10% of the population lived in areas with significant clusters of low spatial accessibility for internal medicine and surgery (neurology: 20%). The analysis revealed the highest accessibility for heart failure (AI = 7.33) and the lowest accessibility for stroke (AI = 0.69). The method applied proofed to reveal important aspects of spatial accessibility i.e. geographic variations that need to be addressed. However, for the majority of the German population, accessibility of general inpatient care was either high or at least not significantly low, which suggests rather adequate allocation of hospital resources for most parts of Germany.

Ceramides are related to subclinical atherogenesis in the general population

Abstract Introduction Biomarkers for risk stratification of patients with cardiovascular disease are essential for disease prevention. Ceramides play an important role during atherogenesis. For the C24:0/C16:0 ratio an inverse association with incident coronary artery disease and heart failure has been shown. Hence, ceramides may be a new predictive biomarker for cardiovascular disease. Purpose We explored the relation of three specific ceramides (i.e. C16:0, C22:0 and C24:0) and their ratios with subclinical atherosclerosis, assessed by carotid intima media thickness (cIMT), carotid lumen diameter (LD), brachial artery flow mediated dilation (FMD), nitroglyceride mediated brachial artery dilation (NMD) as well as with the presence of atherosclerotic plaques in the common carotid artery, the carotid bifurcation, and the internal as well as external carotid artery. Methods We used data from the population-based Study of Health in Pomerania (SHIP-1) from North-East Germany (n=2,506, 47% male, 53 median age, 25th and 75th inter-quartile range 41–64 years). Ceramides were quantified by liquid chromatography/tandem mass spectrometry assay. Extracranial carotid arteries were measured with B-mode ultrasound and used to assess plaque presence, LD, NMD, FMD and cIMT with standard procedures. Subjects with missing data were excluded. The relationship between ceramides and log LD, log cIMT, NMD, FMD as well as plaque score were modelled using multivariable regression models adjusted for sex, age, body mass index, diabetes mellitus, dyslipidaemia, hypertension and smoking status. Results A 1 μg/ml higher C22:0 and C24:0 were associated with a 3% (95% confidence interval [CI] 1% - 5%, p&amp;lt;0.01) and 1% (95% CI 0% - 1%, p=0.01) smaller LD, respectively. Furthermore, an increased C22:0/C16:0 and C24:0/C16:0 ratio were related to a 1.2% (95% CI 0.6% - 1.8%) and 0.2% (95% CI 0.009% - 0.37%, p&amp;lt;0.01) narrower LD, respectively. A one point higher C22:0/C16:0 ratio was associated with a 0.04 mm (95% CI 0 – 0.08 mm, p=0.04) greater absolute FMD. Moreover, a 1 μg/ml higher C16:0 or C22:0 concentration increased the odds for the presence of plaque by 13.6% (95% CI 2.33–79.0, p&amp;lt;0.01) and 1.68% (95% CI 1.08–2.61, p=0.02). Neither C24:0 nor the C22:0/C16:0 or C24:0/C16:0 ratios were related to the presence of atherosclerotic plaques and did not find any significant associations between ceramides and cIMT or NDM. Conclusions We found significant associations of ceramides with various markers of subclinical atherosclerosis. Hence, our findings further support the investigation of ceramides as biomarkers of vascular disease. However, our results indicate that not all ceramides are equal with regards to atherosclerosis. For example, C22:0 is related with vasoprotective effects (high HDL-C, low triglycerides) and intriguingly, more atherosclerotic plaques. Future studies should explore the role of ceramides during the different stages of atherosclerosis. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): BMBF

Underscreening and undertreatment? Periodontal service provision in very old Germans

ObjectivesWe aimed to assess periodontal services utilization in very old Germans.MethodsA comprehensive sample of very old (≥ 75 years), insured at a large Northeastern statutory insurer was followed over 6 years (2012–2017). We assessed periodontal service provision, entailing (1) periodontal screening index (PSI), (2) periodontal status/treatment planning, (3) periodontal therapy (scaling and root planning with or without access surgery), (4) postoperative reevaluation, and (5) any of these four services groups. Association of utilization with (1) sex, (2) age, (3) region, (4) social hardship status, (5) ICD-10 diagnoses, and (6) diagnoses-related groups was explored.Results404.610 individuals were followed; 173,733 did not survive follow-up. The mean (SD) age was 81.9 (5.4) years. 29.4% (119,103 individuals) utilized any periodontal service, nearly all of them the PSI. Periodontal status/treatment planning, treatment provision, and reevaluation were provided to only a small fraction (1.54–1.57%, or 6224–6345) of individuals. The utilization of the PSI increased between 2012 and 2017; no such increase was observed for treatment-related services. Utilization decreased with age; those aged > 85 years received nearly no services at all. Decreases were more pronounced for treatment-related services. Utilization was lower in rural than urban areas, those with hardship status, and those severely ill (e.g., dementia, heart insufficiency). In multivariable analysis, a previous PSI measurement tripled the odds of receiving treatment-related services (OR: 3.2; 95% CI: 3.0-3.4).ConclusionsPeriodontal services utilization was low. Screening for periodontal disease significantly increased therapy provision. Social, demographic, regional, and general health aspects were associated with utilization.Clinical significanceThe utilization of periodontal services in the very old in Northeast Germany was low, and even screening was only performed in a minority of individuals. Policies to increase identification and management of periodontitis especially in the most vulnerable individuals are needed.

Dental service utilization in the very old: an insurance database analysis from northeast Germany

ObjectivesWe assessed dental service utilization in very old Germans.MethodsA comprehensive sample of 404,610 very old (≥ 75 years), insured at a large statutory insurer (Allgemeine Ortskrankenkasse Nordost, active in the federal states Berlin, Brandenburg, Mecklenburg-Western Pomerania), was followed over 6 years (2012–2017). Our outcome was the utilization of dental services, in total (any utilization) and in five subgroups: (1) examinations and associated assessment or advice, (2) restorations, (3) surgery, (4) prevention, (5) outreach care. Association of utilization with (1) sex, (2) age, (3) region, (4) social hardship status, (5) ICD-10 diagnoses, and (6) German modified diagnosis-related groups (GM-DRGs) was explored.ResultsThe mean (SD) age of the sample was 81.9 (5.4) years. The utilization of any dental service was 73%; utilization was highest for examinations (68%), followed by prevention (44%), surgery (33%), restorations (32%), and outreach care (13%). Utilization decreased with age for nearly all services except outreach care. Service utilization was significantly higher in Berlin and most cities compared with rural municipalities, and in individuals with common, less severe, and short-term conditions compared with life-threatening and long-term conditions. In multi-variable analysis, social hardship status (OR: 1.14; 95% CI: 1.12-1.16), federal state (Brandenburg 0.85; 0.84–0.87; Mecklenburg-Western Pomerania: 0.80; 0.78–0.82), and age significantly affected utilization (0.95; 0.95–0.95/year), together with a range of co-morbidities according to ICD-10 and DRG.ConclusionsSocial, demographic, regional, and general health aspects were associated with the utilization of dental services in very old Germans. Policies to maintain access to services up to high age are needed.Clinical significanceThe utilization of dental services in the very old in northeast Germany showed significant disparities within populations. Policies to allow service utilization for sick, economically disadvantaged, rural and very old populations are required. These may include incentives for outreach servicing, treatment-fee increases for specific populations, or referral schemes between general medical practitioners and dentists.

Factors associated with calf mortality and poor growth of dairy heifer calves in northeast Germany

A cross-sectional study was conducted on fifty German dairy farms to identify risk factors for high mortality and poor growth in calves. Between 2012 and 2014, farm visits took place and a questionnaire on farm management practices was completed by in-person interview. In addition, heart girth measurements of calves around weaning were performed to estimate average daily weight gain. Furthermore, blood and faecel samples of calves were collected and a score addressing calf welfare was determined. The epidemiological associations between risk factors and high mortality and poor growth were estimated using two regression models. The factors significantly associated with high calf mortality (> 5%) were a high rate of calves with failure of passive transfer (> 25%) and the metaphylactic use of halofuginone lactate. A small amount of concentrates consumed around weaning, relocating calves more than twice until weaning and a low incidence risk of milk fever (< 5%) were found to be significantly associated with poor growth (median: 675 grams). Although the fifty farms cannot be considered as a representative sample for North-East Germany, the results indicate that the farm management has a big impact on growth and survival of dairy calves and needs to be addressed more thoroughly when raising the future dairy cow.

Root biomass and root traits of Alnus glutinosa show size-dependent and opposite patterns in a drained and a rewetted forest peatland.

Background and AimsForest peatlands represent 25 % of global peatlands and store large amounts of carbon (C) as peat. Traditionally they have been drained in order to increase forestry yield, which may cause large losses of C from the peat. Rewetting aims to stop these losses and to restore the initial storage function of the peatlands. As roots represent major peat-forming elements in these systems, we sampled roots with diameter <5 mm in a drained and a rewetted forest peatland in north-east Germany to evaluate differences in tree biomass investments below ground, root functional characteristics and root age.MethodsWe cored soil next to Alnus glutinosa stems and sorted root biomass into <1, 1–2 and 2–5 mm diameter classes. We measured biomass distribution and specific root area (SRA) in 10-cm depth increments down to 50 cm, and estimated root age from annual growth rings.Key ResultsRoot biomass in the rewetted site was more than double that in the drained site. This difference was mostly driven by very fine roots <1 mm, which accounted for 51 % of the total root biomass and were mostly (75 %) located in the upper 20 cm. For roots <1 mm, SRA did not differ between the sites. However, SRA of the 1–2 mm and 2–5 mm diameter roots was higher in the drained than in the rewetted site. Root age did not differ between sites.ConclusionsThe size-dependent opposite patterns between root biomass and their functional characteristics under contrasting water regimes indicate differences between fine and coarse roots in their response to environmental changes. Root age distribution points to similar root turnover rates between the sites, while higher root biomass in the rewetted site clearly indicates larger tree C stocks below ground under rewetting, supporting the C sink function of the ecosystem.

Relationship between milk constituents from milk testing and health, feeding, and metabolic data of dairy cows

A new evaluation scheme to assess the nutritional status of dairy cows on the basis of milk constituents was derived from 7.37 million German records of milk testing. The aim of this work was to validate this new scheme. Two data sets with fertility and health information (data set A) and with measured energy and nutrient intake and metabolic characteristics (data set B) were analyzed. Data set A included 32 commercial dairy farms in northeast Germany, with 72,982 records of 43,863 German Holstein cows; data set B included 12 German experimental farms, with 49,275 records of 1,650 German Holstein, Simmental, and Brown Swiss cows. Milk traits were linked to health disorders and metabolic and feeding characteristics. Frequently used limits of milk constituents were compared with ranges of the new "Dummerstorf feeding evaluation." To distinguish an optimal from a deficient energy supply, a milk protein content ≥3.20% (previously used) and a milk fat:protein ratio (FPR) ≤1.4 (new scheme) were chosen and compared with feed energy intake in relation to demand. Energy status was more often correctly assigned by FPR than by milk protein content (80.7 and 68.7%, respectively). Over all data, the new optimum range of milk urea between 150 and 250 mg/L was better suited to dietary crude protein intake in relation to demand than the previously used range of 150 to 300 mg/L (42.4 and 38.0%, respectively). Ketosis or blood values associated with ketosis such as β-hydroxybutyrate >1.2 mmol/L or nonesterified fatty acids >1,000 µmol/L, as well as strong mobilization of body weight ≥1.5 kg/d, loss of back fat thickness ≥10 mm, and loss of body condition score ≥1 unit in first 60 days in milk were compared with different milk trait thresholds. For the updated scheme FPR >1.4 was used in combination with either milk protein content below the individual statistical lower limit of milk protein content, or milk fat content greater than the individual statistical upper limit of milk fat content; FPR >1.5 was taken as a frequently used threshold. For these ketosis indicators, the new scheme had higher sensitivities. Energy oversupply or the risk of overconditioning could not be identified by milk constituents alone. Urinary acid-base content was not related to milk content. Similarly, milk testing data did not allow a clear distinction to be made between the diagnoses of acidosis and, for example, ketosis. Essential requirements for good herd management are the continuous observation of milk testing data in combination with other established instruments of feeding and animal monitoring.

Acute neurological care in north-east Germany with telemedicine support (ANNOTeM): protocol of a multi-center, controlled, open-label, two-arm intervention study

BackgroundBoth diagnosis and treatment of neurological emergencies require neurological expertise and are time-sensitive. The lack of fast neurological expertise in regions with underserved infrastructure poses a major barrier for state-of-the-art care of patients with acute neurological diseases and leads to disparity in provision of health care. The main purpose of ANNOTeM (acute neurological care in North East Germany with telemedicine support) is to establish effective and sustainable support structures for evidence based treatments for stroke and other neurological emergencies and to improve outcome for acute neurological diseases in these rural regions.MethodsA “hub-and-spoke” network structure was implemented connecting three academic neurological centres (“hubs”) and rural hospitals (“spokes”) caring for neurological emergencies. The network structure includes (1) the establishment of a 24/7 telemedicine consultation service, (2) the implementation of standardized operating procedures (SOPs) in the network hospitals, (3) a multiprofessional training scheme, and (4) a quality management program. Data from three major health insurance companies as well as data from the quality management program are being collected and evaluated. Primary outcome is the composite of first time of receiving paid outpatient nursing care, first time of receiving care in a nursing home, or death within 90 days after hospital admission.DiscussionBeyond stroke only few studies have assessed the effects of telemedically supported networks on diagnosis and outcome of neurological emergencies. ANNOTeM will provide information whether this approach leads to improved outcome. In addition, a health economic analysis will be performed.Study registrationGerman Clinical Trials Register DRKS00013067, date of registration: November 16 th, 2017, URL: http://www.drks.de/DRKS00013068

First molecular detection of Pneumocystis spp. in red foxes (Vulpes vulpeslinnaeus, 1758) and raccoon dogs (Nyctereutes procyonoidesgray, 1834)

Fungal organisms of the genus Pneumocystis may cause Pneumocystis pneumonia (PCP) in humans, but also domestic and wild mammals. Almost every animal species hosts its own genetically distinct Pneumocystis species, however information is sparse. In this study, 62 red foxes (Vulpes vulpes) and 37 raccoon dogs (Nyctereutes procyonoides) were collected in North-East Germany. The lung tissues of the animals were analysed by a new designed specific pan-Pneumocystis mtLSU rRNA gene PCR and sequencing. With this PCR, detection and discrimination of all known Pneumocystis spp. in a single step should be possible. This first detection of Pneumocystis spp. in 29/62 (46.8%) red foxes and 29/37 (78.4%) raccoon dogs indicated, that they harbour two dissimilar strains, as seen by specific single nucleotide position changes (SNPs). Nevertheless, five samples with contrary SNPs showed a probable inter-species transmission.

Climate Change Mitigation through Land Use on Rewetted Peatlands \u2013 Cross-Sectoral Spatial Planning for Paludiculture in Northeast Germany

Drainage of peatlands causes severe environmental damage, including high greenhouse gas emissions. Peatland rewetting substantially lowers these emissions. After rewetting, paludiculture (i.e. agriculture and forestry on wet peatlands) is a promising land use option. In Northeast Germany (291,361 ha of peatland) a multi-stakeholder discussion process about the implementation of paludiculture took place in 2016/2017. Currently, 57% of the peatland area is used for agriculture (7% as arable land, 50% as permanent grassland), causing greenhouse gas emissions of 4.5 Mt CO2eq a−1. By rewetting and implementing paludiculture, up to 3 Mt CO2eq a−1 from peat soils could be avoided. To safeguard interests of both nature conservation and agriculture, the different types of paludiculture were grouped into ‘cropping paludiculture’ and ‘permanent grassland paludiculture’. Based on land legislation and plans, a paludiculture land classification was developed. On 52% (85,468 ha) of the agriculturally used peatlands any type of paludiculture may be implemented. On 30% (49,929 ha), both cropping and permanent grassland paludiculture types are possible depending on administrative check. On 17% (28,827 ha), nature conservation restrictions allow only permanent grassland paludiculture. We recommend using this planning approach in all regions with high greenhouse gas emissions from drained peatlands to avoid land use conflicts.

Screening of Mothers in a COVID-19 Low-Prevalence Region: Determination of SARS-CoV-2 Antibodies in 401 Mothers from Rostock by ELISA and Confirmation by Immunofluorescence

Zusammenfassung Hintergrund Bei Kindern verläuft die Infektion mit SARS-CoV-2, dem Erreger von COVID-19, in der Regel weniger schwer und häufiger symptomlos als bei Erwachsenen. Kinder können aber diese Infektion u. a. auf vulnerable Erwachsene übertragen. Daher sind zur Zeit Einrichtungen der Kinderbetreuung und Schulen teilweise geschlossen. Methoden Da sich der Infektionsstatus bei Kindern unter 13 Jahren und deren Müttern meist ähnlich darstellt, untersuchten wir bei 401 Rostocker Müttern von Kindern zwischen 1 und 10 Jahren Rachenabstriche auf SARS-CoV-2 und Serumproben auf Antikörper gegen diesen Erreger. Ergebnisse Wir fanden bei keiner der untersuchten Mütter RNA von SARS-CoV-2 im Rachenabstrich. Im ELISA waren IgG-Antikörper in einem Serum positiv, IgA-Antikörper waren in 11 Seren positiv und in 3 Seren grenzwertig. Alle 401 Seren waren im Fluoreszenz-Bestätigungstest (IIFT) mit FITC-markierten IgG-, IgA- und IgM-Antikörpern negativ. Schlussfolgerung Im Untersuchungszeitraum waren bei den getesteten Rostocker Müttern weder RNA von SARS-CoV-2 noch spezifische Antikörper nachweisbar.

Base Neutralizing Capacity of Agricultural Soils in a Quaternary Landscape of North-East Germany and Its Relationship to Best Management Practices in Lime Requirement Determination

Despite being a natural soil-forming process, soil acidification is a major agronomic challenge under humid climate conditions, as soil acidity influences several yield-relevant soil properties. It can be counterbalanced by the regular application of agricultural lime to maintain or re-establish soil fertility and to optimize plant growth and yield. To avoid underdose as well as overdose, lime rates need to be calculated carefully. The lime rate should be determined by the optimum soil pH (target pH) and the response of the soil to lime, which is described by the base neutralizing capacity (BNC). Several methods exist to determine the lime requirement (LR) to raise the soil pH to its optimum. They range from extremely time-consuming equilibration methods, which mimic the natural processes in the soil, to quick tests, which rely on some approximations and are designed to provide farmers with timely and cost-efficient data. Due to the higher analytical efforts, only limited information is available on the real BNC of particular soils. In the present paper, we report the BNC of 420 topsoil samples from Central Europe (north-east Germany), developed on sediments from the last ice age 10,000 years ago under Holocene conditions. These soils are predominantly sandy and low in humus, but they exhibit a huge spatial variability in soil properties on a small scale. The BNC was determined by adding various concentrations of Ca(OH)2 and fitting an exponential model to derive a titration curve for each sample. The coefficients of the BNC titration curve were well correlated with soil properties affecting soil acidity and pH buffer capacity, i.e., pH, soil texture and soil organic matter (SOM). From the BNC model, the LRs (LRBNC) were derived and compared with LRVDLUFA based on the standard protocol in Germany as established by the Association of German Agricultural Analytic and Research Institutes (VDLUFA). The LRBNC and LRVDLUFA correlated well but the LRVDLUFA were generally by approximately one order of magnitude higher. This is partly due to the VDLUFA concept to recommend a maintenance or conservation liming, even though the pH value is in the optimum range, to keep it there until the next lime application during the following rotation. Furthermore, the VDLUFA method was primarily developed from field experiments where natural soil acidification and management practices depressed the effect of lime treatment. The BNC method, on the other hand, is solely based on laboratory analysis with standardized soil samples. This indicates the demand for further research to develop a sound scientific algorithm that complements LRBNC with realistic values of annual Ca2+ removal and acidification by natural processes and N fertilization.

Rapid multi-scale analysis of near-surface geophysical anomaly maps: Application to an archaeo-geophysical data set

In near-surface geophysics, ground-based mapping surveys are routinely employed in a variety of applications including those from archaeology, civil engineering, hydrology, and soil science. The resulting geophysical anomaly maps of, for example, magnetic or electrical parameters are usually interpreted to laterally delineate subsurface structures such as those related to the remains of past human activities, subsurface utilities and other installations, hydrological properties, or different soil types. To ease the interpretation of such data sets, we propose a multi-scale processing, analysis, and visualization strategy. Our approach relies on a discrete redundant wavelet transform (RWT) implemented using cubic-spline filters and the à trous algorithm, which allows to efficiently compute a multi-scale decomposition of 2D data using a series of 1D convolutions. The basic idea of the approach is presented using a synthetic test image, while our archaeo-geophysical case study from North-East Germany demonstrates its potential to analyze and process rather typical geophysical anomaly maps including magnetic and topographic data. Our vertical-gradient magnetic data show amplitude variations over several orders of magnitude, complex anomaly patterns at various spatial scales, and typical noise patterns, while our topographic data show a distinct hill structure superimposed by a microtopographic stripe pattern and random noise. Our results demonstrate that the RWT approach is capable to successfully separate these components and that selected wavelet planes can be scaled and combined so that the reconstructed images allow for a detailed, multi-scale structural interpretation also using integrated visualizations of magnetic and topographic data. Because our analysis approach is straightforward to implement without laborious parameter testing and tuning, computationally efficient, and easily adaptable to other geophysical data sets, we believe that it can help to rapidly analyze and interpret different geophysical mapping data collected to address a variety of near-surface applications from engineering practice and research.

Studying boundary layer methane isotopy and vertical mixing processes at a rewetted peatland site using an unmanned aircraft system

Abstract. The combination of two well-established methods, of quadrocopter-borne air sampling and methane isotopic analyses, is applied to determine the source process of methane at different altitudes and to study mixing processes. A proof-of-concept study was performed to demonstrate the capabilities of quadrocopter air sampling for subsequently analysing the methane isotopic composition δ13C in the laboratory. The advantage of the system compared to classical sampling on the ground and at tall towers is the flexibility concerning sampling location, and in particular the flexible choice of sampling altitude, allowing the study of the layering and mixing of air masses with potentially different spatial origin of air masses and methane. Boundary layer mixing processes and the methane isotopic composition were studied at Polder Zarnekow in Mecklenburg–West Pomerania in the north-east of Germany, which has become a strong source of biogenically produced methane after rewetting the drained and degraded peatland. Methane fluxes are measured continuously at the site. They show high emissions from May to September, and a strong diurnal variability. For two case studies on 23 May and 5 September 2018, vertical profiles of temperature and humidity were recorded up to an altitude of 650 and 1000 m, respectively, during the morning transition. Air samples were taken at different altitudes and analysed in the laboratory for methane isotopic composition. The values showed a different isotopic composition in the vertical distribution during stable conditions in the morning (delta values of −51.5 ‰ below the temperature inversion at an altitude of 150 m on 23 May 2018 and at an altitude of 50 m on 5 September 2018, delta values of −50.1 ‰ above). After the onset of turbulent mixing, the isotopic composition was the same throughout the vertical column with a mean delta value of −49.9 ± 0.45 ‰. The systematically more negative delta values occurred only as long as the nocturnal temperature inversion was present. During the September study, water samples were analysed as well for methane concentration and isotopic composition in order to provide a link between surface and atmosphere. The water samples reveal high variability on horizontal scales of a few tens of metres for this particular case. The airborne sampling system and consecutive analysis chain were shown to provide reliable and reproducible results for two samples obtained simultaneously. The method presents a powerful tool for distinguishing the source process of methane at different altitudes. The isotopic composition showed clearly depleted delta values directly above a biological methane source when vertical mixing was hampered by a temperature inversion, and different delta values above, where the air masses originate from a different footprint area. The vertical distribution of methane isotopic composition can serve as tracer for mixing processes of methane within the atmospheric boundary layer.

Prosthetic treatment patterns in the very old: an insurance database analysis from Northeast Germany

ObjectivesWe assessed dental prosthetic services utilization in very old Germans.MethodsA comprehensive sample of 404,610 very old (≥ 75 years), insured at one large statutory insurer (Allgemeine Ortskrankenkasse Nordost, acting in the federal states Berlin, Brandenburg, Mecklenburg-Vorpommern), were followed over 6 years (2012–2017). Our outcome was the utilization of prosthetic services, in total and seven subgroups: (1) Crowns/partial crowns, (2) fixed dental prostheses (FDPs), (3) partial removable prostheses (RDPs), (4) full RDPs, (5) temporary services, (6) relining/rebasing/repairing/extending RDPs, (7) repairing FDPs. Association of utilization with (1) gender, (2) age, (3) region, (4) social hardship status, (5) ICD-10 diagnoses and (6) German diagnoses related groups (G-DRG) was explored.ResultsThe mean (SD) age of the sample was 81.9 (5.4) years; mean follow-up was 1689 (705) days. The mean utilization of any prosthetic service was 27.0%; the most often utilized service type were total RDPs (13.2% utilization), crowns (8.1%), and partial RDPs (7.1%). Utilization decreased with age for nearly all services (except relining/rebasing/repairing/extending RDPs). Utilization of prosthetic services was significantly higher in Berlin and most cities compared with rural municipalities and in individuals with common, less severe conditions according to ICD-10 and DRGs compared with life-threatening conditions or dementia. In multivariable analysis, gender (OR; 95% CI: 0.95; 0.93–0.98), social hardship status (1.19; 1.17–1.21), federal state (Brandenburg 0.57; 0.56–0.59; Mecklenburg-Vorpommern: 0.66; 0.64–0.67) and age significantly affected utilization (0.95; 0.95–0.95/year).ConclusionsPatient-related and healthcare factors determine the utilization of prosthetic services in very old Germans. Interventions to maintain sufficient prosthetic care up to high age are required.Clinical significanceThe utilization of prosthetic services in the very old in Northeast Germany showed significant disparities within populations and service types. There seems to be great need to better understand the drivers of utilization, and to develop and evaluate interventions to maintain sufficient prosthetic care up to high age.

Associations of iron markers with type 2 diabetes mellitus and metabolic syndrome: Results from the prospective SHIP study

AimsTo assess the role of serum ferritin and transferrin with prevalent and incident type 2 diabetes mellitus (T2DM) and metabolic syndrome (MetS) and whether these associations are independent of inflammatory markers and hepatic enzymes. MethodsWe analyzed data from 3,232 participants aged 20–81 years of the population-based Study of Health in Pomerania (SHIP) from Northeast Germany with a median follow-up time of 10.6 years. Logistic and Cox regression analyses were performed. ResultsSerum ferritin concentrations were associated with a higher prevalence of T2DM (total population OR: 1.16 [95% CI: 1.07, 1.26]; men OR: 1.18 [95% CI: 1.08, 1.30) and MetS (total population OR: 1.27 [95% CI: 1.16, 1.38]; men OR: 1.26 [95% CI: 1.15, 1.38]) in the total population and men independently of inflammatory markers and hepatic enzymes. In longitudinal analyses, baseline ferritin concentrations were associated with a higher risk of incident T2DM in women (HR: 1.38 [95% CI: 1.10, 1.71]), but not in men or in the total population and also with a higher risk of incident MetS (HR: 1.09 [95% CI: 1.01, 1.17]) in the total population. These longitudinal associations attenuated considerably after adjustment for hepatic enzymes but not inflammatory markers. Transferrin was not associated with any of the outcomes. ConclusionsOur results suggest a link between ferritin and T2DM and MetS, which might be partially explained by hepatic dysfunction.