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Efficacy of Bacteriophages Against Staphylococcus aureus Isolates from Bovine Mastitis (2020)

Titze, Isabel ; Lehnherr, Tatiana ; Lehnherr, Hansjörg ; Krömker, Volker

The lytic efficacy of bacteriophages against Staphylococcus aureus isolates from bovine milk was investigated in vitro, regarding possible applications in the therapy of udder inflammation caused by bacterial infections (mastitis). The host range of sequenced, lytic bacteriophages was determined against a collection of 92 Staphylococcus (S.) aureus isolates. The isolates originated from quarter foremilk samples of clinical and subclinical mastitis cases. A spot test and a subsequent plaque assay were used to determine the phage host range. According to their host range, propagation and storage properties, three phages, STA1.ST29, EB1.ST11, and EB1.ST27, were selected for preparing a bacteriophage mixture (1:1:1), which was examined for its lytic activity against S. aureus in pasteurized and raw milk. It was found that almost two thirds of the isolates could be lysed by at least one of the tested phages. The bacteriophage mixture was able to reduce the S. aureus germ density in pasteurized milk and its reduction ability was maintained in raw milk, with only a moderate decrease compared to the results in pasteurized milk. The significant reduction ability of the phage mixture in raw milk promotes further in vivo investigation.

Graphene Nanoplatelet (GNPs) Doped Carbon Nanofiber (CNF) System: Effect of GNPs on the Graphitic Structure of Creep Stress and Non-Creep Stress Stabilized Polyacrylonitrile (PAN) (2020)

Bin Ali, Annas ; Renz, Franz ; Koch, Julian ; Tegenkamp, Christoph ; Sindelar, Ralf

Improving the graphitic structure in carbon nanofibers (CNFs) is important for exploiting their potential in mechanical, electrical and electrochemical applications. Typically, the synthesis of carbon fibers with a highly graphitized structure demands a high temperature of almost 2500 °C. Furthermore, to achieve an improved graphitic structure, the stabilization of a precursor fiber has to be assisted by the presence of tension in order to enhance the molecular orientation. Keeping this in view, herein we report on the fabrication of graphene nanoplatelets (GNPs) doped carbon nanofibers using electrospinning followed by oxidative stabilization and carbonization. The effect of doping GNPs on the graphitic structure was investigated by carbonizing them at various temperatures (1000 °C, 1200 °C, 1500 °C and 1700 °C). Additionally, a stabilization was achieved with and without constant creep stress (only shrinkage stress) for both pristine and doped precursor nanofibers, which were eventually carbonized at 1700 °C. Our findings reveal that the GNPs doping results in improving the graphitic structure of polyacrylonitrile (PAN). Further, in addition to the templating effect during the nucleation and growth of graphitic crystals, the GNPs encapsulated in the PAN nanofiber matrix act in-situ as micro clamp units performing the anchoring function by preventing the loss of molecular orientation during the stabilization stage, when no external tension is applied to nanofiber mats. The templating effect of the entire graphitization process is reflected by an increased electrical conductivity along the fibers. Simultaneously, the electrical anisotropy is reduced, i.e., the GNPs provide effective pathways with improved conductivity acting like bridges between the nanofibers resulting in an improved conductivity across the fiber direction compared to the pristine PAN system.

Perception of university students about doctors and quality of health care provision at clinics: a multi-national study in India, Pakistan, Spain and United States of America (2020)

Limaye, Dnyanesh ; Fortwengel, Gerhard ; Shankar Pitani, Ravi ; Sathe, Sushama ; Chivate, Sanika ; Jagadale, Prabhas ; Saeed, Farah ; Alam, Syed Mahboob ; Rodilla, Vicent ; Mounib, Chaimae ; Santiesteban Jr., Edel

Background: Patient satisfaction is considered as an indicator of the healthcare quality. Information on patient satisfaction based on medical expertise of the physician, interpersonal skills, physician-patient interaction time, perception and needs of the patient allow policymakers to identify areas for improvement. Primary care services and healthcare structure differ between the countries. The present study was done to determine and analyze the determinants associated with patient satisfaction in India, Pakistan, Spain and USA. Methods: This descriptive study was performed in January to August 2019 among students from Mumbai University, India, Dow University of Health Sciences, Karachi, Pakistan, University CEU Cardenal Herrera, Valencia, Spain, Texas State University, Texas, USA. On the basis of the eligibility criterion (those who gave a written informed consent and were registered students of respective university) 890 (India: 369, Pakistan: 128, Spain: 195, USA: 99) students were selected for the present study. Results: India had almost similar male (49%) to female (51%) ratio of participants. For other 3 countries (PK, ES, US), female participant percentage was nearly 20% or even more as compared to male participants. Overall participant’s satisfaction score about medial expertise of the doctor were highest in India (71%) and were lowest in Spain (43%). Overall satisfaction score about time spent with doctor were highest for India (64%) and were lowest for Spain (41%). Overall satisfaction score about communication with doctor were highest for US (60%) and were lowest for PK (53%). Overall satisfaction score for medical care given by the doctor was lowest in PK (43%) and was highest in US (64%). Overall satisfaction about doctor, highest number of US (83%) and lowest number of PK (32%) participants were satisfied about medical interaction with doctors. Conclusions: These multi-country findings can provide information for health policy making in India, Pakistan, Spain and USA. Although the average satisfaction per country, except Pakistan is more than 60%, the results suggest that there is ample room for improvement.

Antimicrobial Activity of a Phage Mixture and a Lactic Acid Bacterium against Staphylococcus aureus from Bovine Mastitis (2020)

Titze, Isabel ; Krömker, Volker

The antimicrobial activity of a phagemixture and a lactic acid bacteriumagainst Staphylococcus aureus isolates from bovine origin was investigated in vitro with regard to possible applications in the therapy of udder inflammation (mastitis) caused by bacterial infections. The S. aureus isolates used for inoculation derived from quarter foremilk samples of mastitis cases. For the examination of the antimicrobial activity, the reduction of the S. aureus germ density was determined [log10 cfu/mL]. The phage mixture consisted of the three obligatory lytic and S. aureus-specific phages STA1.ST29, EB1.ST11 and EB1.ST27 (1:1:1). The selected Lactobacillus plantarum strain with proven antimicrobial properties and the phage mixture were tested against S. aureus in milk, both alone and in combination. The application of the lactic acid bacterium showed only a low reduction ability for a 24 h incubation period. The bacteriophage mixture as well as its combination with the lactic acid bacterium showed high antimicrobial activity against S. aureus for a 24 h incubation period at 37 C, with only the phage mixture showing significance.

Modified ‘Stable Schools’ as a Consulting Tool for Organic Dairy Herds (2020)

Hansmann, Verena ; Volling, Otto ; Krömker, Volker

The aim of this study was to examine the opinions of farmers on a consulting project, which was established for organic dairy farms in Northern Germany involving different animal health experts who participated in the meetings. Furthermore, the properties of measures that are of decisive importance for implementation on the farms were identified to improve consultancy services for dairy farming. Once a year, the farmers met on a host-farm in one of three groups consisting of five to nine farms, a facilitator and an expert. At each meeting, a host-farm was visited and the analysed data of all participating farms of the previous year were presented to the group members. Each farmer had the possibility to report on success stories and issues concerning his herd. During discussions, the farmers first proposed mutual farm-specific measures for improving herd health and animal welfare. Afterwards, the expert named possible interventions and commented on the given measures of the farmers. All measures were noted by the facilitator. At the end of each meeting, each farmer could choose which of the given measures he wanted to implement. Open group-interviews as well as anonymous questionnaires for the farmers were used at the meetings in winter 2016/2017 to evaluate their perception of this consulting project and to determine which properties of measures were important for implementation on the farms. Based on the results of this study, the participating farmers were very positive towards this kind of consulting project. They favoured the participation of an expert during the meetings and the analysis of farm-specific data. Farmers mostly chose measures for implementation proposed by farmers and approved by the expert, followed by those proposed by the expert only. Measures were chosen when they were practical in the implementation, effective, efficient and took a low additional workload for implementation.

Noise patterns in visceral surgical procedures: Analysis of second-bysecond dBA data of 599 procedures over the course of one year (2020)

Baltin, Christoph Tobias ; Wilhelm, Hendrik ; Wittland, Michael ; Hölscher, Arnulf H. ; Stippel, Dirk ; Astvatsatourov, Anatoli

The objective of this study is to analyze noise patterns during 599 visceral surgical procedures. Considering work-safety regulations, we will identify immanent noise patterns during major visceral surgeries. Increased levels of noise are known to have negative health impacts. Based on a very finegrained data collection over a year, this study will introduce a new procedure for visual representation of intra-surgery noise progression and pave new paths for future research on noise reduction in visceral surgery. Digital decibel sound-level meters were used to record the total noise in three operating theatres in one-second cycles over a year. These data were matched to archival data on surgery characteristics. Because surgeries inherently vary in length, we developed a new procedure to normalize surgery times to run cross-surgery comparisons. Based on this procedure, dBA values were adjusted to each normalized time point. Noise-level patterns are presented for surgeries contingent on important surgery characteristics: 16 different surgery types, operation method, day/night time point and operation complexity (complexity levels 1–3). This serves to cover a wide spectrum of day-to-day surgeries. The noise patterns reveal significant sound level differences of about 1 dBA, with the mostcommon noise level being spread between 55 and 60 dBA. This indicates a sound situation in many of the surgeries studied likely to cause stress in patients and staff. Absolute and relative risks of meeting or exceeding 60 dBA differ considerably across operation types. In conclusion, the study reveals that maximum noise levels of 55 dBA are frequently exceeded during visceral surgical procedures. Especially complex surgeries show, on average, a higher noise exposure. Our findings warrant active noise management for visceral surgery to reduce potential negative impacts of noise on surgical performance and outcome.

A systematic scorecard-based approach to site assessment in preparation for Lassa fever vaccine clinical trials in affected countries (2020)

Salami, Kolawole ; Imbault, Nathalie ; Erlebach, Aljoscha ; Urban, Johanna ; Zoglowek, Mike ; Tornieporth, Nadia G.

Background: We sought to develop and test an objective scorecard-based system for assessing and categorizing available research sites in Lassa fever-affected countries based on their preparedness and capability to host Lassa fever vaccine clinical trials. Methods: We mapped available clinical research sites through interrogation of online clinical trial registries and relevant disease-based consortia. A structured online questionnaire was used to assess the capability of clinical trial sites to conduct Lassa fever vaccine clinical trials. We developed a new scoring template by allocating scores to questionnaire parameters based on perceived importance to the conduct of clinical trials as described in the WHO/TDR Global Competency Framework for Clinical Research. Cutoff points of 75% and 50% were used to categorize sites into categories A, B, or C. Results: This study identified 44 clinical trial sites in 8 Lassa fever-affected countries. Out of these, 35 sites were characterized based on their capacity to hold Lassa fever vaccine clinical trials. A total of 14 sites in 4 countries were identified as ready to host Lassa fever vaccine trials immediately or with little support. Conclusion: It is feasible to hold Lassa fever vaccine trials in affected countries based on the outcome of the survey. However, the findings are to be validated through sites' visits. This experience with a standardized and objective method of the site assessment is encouraging, and the site selection method used can serve as an orientation to sponsors and researchers planning clinical trials in the region.

Prevention of Intramammary Infections by Prepartum External Application of a Teat Dip Containing Lactic Acid Bacteria with Antimicrobial Properties in Dairy Heifers (2020)

Paduch, Jan-Hendrik ; Lücking, Johanna ; Mansion-de Vries, Elisabeth ; Zinke, Claudia ; Wente, Nicole ; Krömker, Volker

The aim of the current study was to investigate the effects of the prepartum external treatment of teats with a combination of four lactic acid bacteria strains viz. Lactobacillus (Lb.) rhamnosus ATCC 7469, Lactococcus lactis subsp. lactis ATCC 11454, Lb. paracasei 78/37 (DSM 26911), and Lb. plantarum 118/37 (DSM 26912) on the postcalving udder health of dairy heifers. The study used a split-udder design. Two weeks before the expected calving date, one of two contralateral teats of a teat pair was dipped with an aqueous suspension of lactic acid bacteria (final bacterial counts 8.40–8.47 log10-transformed CFU/mL) once in a week until calving; the other teat of the pair was not treated. After calving, quarter foremilk samples were taken and investigated cyto-microbiologically. In total, 629 teat pairs of 319 heifers were included. There was an association between the treatment and intramammary infections caused by the major udder-pathogenic bacteria Staphylococcus aureus, Streptococcus dysgalactiae, and enterococci, as well as clinical mastitis in the first 100 days after calving. The present study indicates that intramammary infections with major pathogens and clinical mastitis may be prevented by regular prepartum external application of lactic acid bacteria in dairy heifers.

In Vitro Susceptibility of Mastitis Pathogens Isolated from Clinical Mastitis Cases on Northern German Dairy Farms (2020)

Bolte, Josef ; Zhang, Yanchao ; Wente, Nicole ; Krömker, Volker

The present research study investigated the susceptibility of common mastitis pathogens—obtained from clinical mastitis cases on 58 Northern German dairy farms—to routinely used antimicrobials. The broth microdilution method was used for detecting the Minimal Inhibitory Concentration (MIC) of Streptococcus agalactiae (n = 51), Streptococcus dysgalactiae (n = 54), Streptococcus uberis (n = 50), Staphylococcus aureus (n = 85), non-aureus staphylococci (n = 88), Escherichia coli (n = 54) and Klebsiella species (n = 52). Streptococci and staphylococci were tested against cefquinome, cefoperazone, cephapirin, penicillin, oxacillin, cloxacillin, amoxicillin/clavulanic acid and cefalexin/kanamycin. Besides cefquinome and amoxicillin/clavulanic acid, Gram-negative pathogens were examined for their susceptibility to marbofloxacin and sulfamethoxazole/trimethoprim. The examined S. dysgalactiae isolates exhibited the comparatively lowest MICs. S. uberis and S. agalactiae were inhibited at higher amoxicillin/clavulanic acid and cephapirin concentration levels, whereas S. uberis isolates additionally exhibited elevated cefquinome MICs. Most Gram-positive mastitis pathogens were inhibited at higher cloxacillin than oxacillin concentrations. The MICs of Gram-negative pathogens were higher than previously reported, whereby 7.4%, 5.6% and 11.1% of E. coli isolates had MICs above the highest concentrations tested for cefquinome, marbofloxacin and sulfamethoxazole/trimethoprim, respectively. Individual isolates showed MICs at comparatively higher concentrations, leading to the hypothesis that a certain amount of mastitis pathogens on German dairy farms might be resistant to frequently used antimicrobials.

Analysis of Marketing Tactics for Green Tourism (2019)

Boje, Kirsten

Sustainable tourism is a niche market that has been growing in recent years. At the same time, companies in the mass tourism market have increasingly marketed themselves with a “green” image, although this market is not sustainable. In order to successfully market sustainability, targeted marketing tactics are needed. The aim of this research is to establish appropriate marketing tactics for sustainable tourism in the niche market and in the mass market. The purpose is to uncover current marketing tactics for both the mass tourism market and the sustainable tourism niche market. It also intends to explore how consumers who are more interested in sustainability differ from consumers with less interest in sustainability in terms of their perception of sustainability in tourism. Furthermore, this research paper will assess the trustworthiness of sustainable travel offers and the trustworthiness of quality seals in sustainable tourism. For this purpose, an online survey was conducted, which was addressed at German-speaking consumers. The survey showed, that consumers with more general interest in sustainability also consider sustainability to be more relevant in tourism. Offers for sustainable travel and quality seals were perceived as not very trustworthy. Moreover, no link could be found between the interest in sustainability and the perception of trustworthiness. On the basis of the above, it is advisable to directly advertise sustainability in the niche market and to mention sustainability in the mass market only as an accompaniment or not at all. Further research could be undertaken to identify which factors influence the trustworthiness of offers, and trustworthiness of quality seals in sustainable tourism.

Transformational Ethics: The Concept of Obedience in Post-Conciliar Jesuit Thinking (2019)

Schnoor, Antje

The paper sheds light on the change in the concept of obedience within the Society of Jesus since the 1960s. In the aftermath of the Second Vatican Council, a so-called crisis of authority and obedience took place in the Catholic Church and the religious orders. As a consequence, the notions of responsibility and conscience came to the fore in the Jesuit definition of obedience. The religious concept of obedience, that is the obedience towards God, was reassessed as a service to humanity. The paper analyzes how the change in the concept of obedience gave rise to the promotion of social justice, which the Society of Jesus proclaimed at General Congregation 32 in 1974/75. By including the promotion of social justice into their central mission, Jesuits not only fundamentally transformed their self-conception, but also their ethical values. The paper argues that the pursuit of social justice became a form of religious obedience.

A Peek into the Swarm: Analysis of the Gravitational Search Algorithm and Recommendations for Parameter Selection (2019)

Knauf, Florian ; Bruns, Ralf

The Gravitational Search Algorithm is a swarm-based optimization metaheuristic that has been successfully applied to many problems. However, to date little analytical work has been done on this topic. This paper performs a mathematical analysis of the formulae underlying the Gravitational Search Algorithm. From this analysis, it derives key properties of the algorithm's expected behavior and recommendations for parameter selection. It then confirms through empirical examination that these recommendations are sound.

Resistance of Injection Molded Wood-Polypropylene Composites against Basidiomycetes According to EN 15534-1 : New Insights on the Test Procedure, Structural Alterations, and Impact of Wood Source (2019)

Krause, Kim Christian ; Brischke, Christian ; Koddenberg, Tim ; Buschalsky, Andreas ; Militz, Holger ; Krause, Andreas

In this study, we investigated injection molded wood-polypropylene composites based on various wood sources and their decay resistance against white rot (Trametes versicolor) and brown rot (Coniophora puteana) in a laboratory test according to EN 15534-1:2014. The manufactured composites consisted of poplar (Populus spp.), willow (Salix spp.), European beech (Fagus sylvatica L.), Norway spruce (Picea abies (L.) H. Karst.), and a commercial wood source (Arbocel® C100), respectively. All formulations were compounded on a co-rotating twin screw extruder and subsequently injection molded to wood–PP specimens with a wood content of 60% or 70% by weight. It was found that the test procedure had a significant eﬀect on the mechanical properties. Loss in mechanical properties was primarily caused by moisture and less by fungal decay. Moisture caused a loss in the modulus of rupture and modulus of elasticity of 34 to 45% and 29 to 73%, respectively. Mean mass and wood mass losses were up to a maximum of 3.7% and 5.3%, respectively. The high resistance against fungal decay was generally attributed to the encapsulation of wood by the polymer matrix caused by sample preparation, and enhanced by reduced moisture uptake during the preconditioning procedure. Notable diﬀerences with respect to the wood particle source and decay fungi were also observed. Structural characterization confirmed the decay pattern of the fungi such as void cavities close the surface and the deposition of calcium oxalates.

Accuracy of Magnetometer-Guided Sentinel Lymphadenectomy after Intraprostatic Injection of Superparamagnetic Iron Oxide Nanoparticles in Prostate Cancer: The SentiMag Pro II Study (2019)

Winter, Alexander ; Engels, Svenja ; Goos, Philipp ; Süykers, Marie-Christin ; Gudenkauf, Stefan ; Henke, Rolf-Peter ; Wawroschek, Friedhelm

Radioisotope-guided sentinel lymph node dissection (sLND) has shown high diagnostic reliability in prostate (PCa) and other cancers. To overcome the limitations of the radioactive tracers, magnetometer-guided sLND using superparamagnetic iron oxide nanoparticles (SPIONs) has been successfully used in PCa. This prospective study (SentiMag Pro II, DRKS00007671) determined the diagnostic accuracy of magnetometer-guided sLND in intermediate- and high-risk PCa. Fifty intermediate- or high-risk PCa patients (prostate-specific antigen (PSA) >= 10 ng/mL and/or Gleason score >= 7; median PSA 10.8 ng/mL, IQR 7.4–19.2 ng/mL) were enrolled. After the intraprostatic SPIONs injection a day earlier, patients underwent magnetometer-guided sLND and extended lymph node dissection (eLND, followed by radical prostatectomy. SLNs were detected in in vivo and in ex vivo samples. Diagnostic accuracy of sLND was assessed using eLND as the reference. SLNs were detected in all patients (detection rate 100%), with 447 sentinel lymph nodes SLNs (median 9, IQR 6–12) being identified and 966 LNs (median 18, IQR 15–23) being removed. Thirty-six percent (18/50) of patients had LN metastases (median 2, IQR 1–3). Magnetometer-guided sLND had 100% sensitivity, 97.0% specificity, 94.4% positive predictive value, 100% negative predictive value, 0.0% false negative rate, and 3.0% additional diagnostic value (LN metastases only in SLNs outside the eLND template). In vivo, one positive SLN/LN-positive patient was missed, resulting in a sensitivity of 94.4%. In conclusion, this new magnetic sentinel procedure has high accuracy for nodal staging in intermediate- and high-risk PCa. The reliability of intraoperative SLN detection using this magnetometer system requires verification in further multicentric studies.

Biopolymers - facts and statistics (2019)

One of the main concerns of this publication is to furnish a more rational basis for discussing bioplastics and use fact-based arguments in the public discourse. Furthermore, “Biopolymers – facts and statistics” aims to provide specific, qualified answers easily and quickly for decision-makers in particular from public administration and the industrial sector. Therefore, this publication is made up like a set of rules and standards and largely foregoes textual detail. It offers extensive market-relevant and technical facts presented in graphs and charts, which means that the information is much easier to grasp. The reader can expect comparative market figures for various materials, regions, applications, process routes, agricultural land use, water use or resource consumption, production capacities, geographic distribution, etc.

Politicians’ Self-Reported Social Media Activities (2019)

Kelm, Ole ; Dohle, Marco ; Bernhard, Uli

The growing importance of social media in the political arena seems to be in line with the mediatization of politics thesis, which states that mediated communication is becoming more important in politics and increasingly influences political processes. However, how politicians’ social media activities and politicians’ perceptions concerning social media have developed over time has rarely been examined. Moreover, it is unclear how the politicians’ activities and perceptions are related to each other. Referring to theoretical approaches, such as the influence of presumed influence approach, four surveys were conducted among German parliamentarians (MPs) between 2012 and 2016 (n = 194/149/170/118). The results indicate that the MPs’ self-reported social media activities and perceptions have remained remarkably constant since 2012. Regression analyses indicate that MPs’ self-reported social media activities and perceptions are hardly related to each other. This raises the question whether mediatization processes are indeed driven by politicians’ perceptions about media influences.

Case-control study on factors associated with a decreased milk yield and a depressed health status of dairy herds in northern Germany (2019)

Jensen, Katharina Charlotte ; Frömke, Cornelia ; Schneider, Bettina ; Do Duc, Phuong ; Gundling, Frieder ; Birnstiel, Katrin ; Schönherr, Franziska ; Scheu, Theresa ; Kaiser-Wichern, Anika ; Woudstra, Svenja ; Seyboldt, Christian ; Hoedemaker, Martina ; Campe, Amelie

Background In the past years, it became apparent that health status and performance differ considerably within dairy farms in Northern Germany. In order to obtain clues with respect to possible causes of these differences, a case-control study was performed. Case farms, which showed signs of health and performance problems, and control farms, which had none of these signs, were compared. Risk factors from different areas such as health management, housing, hygiene and nutrition were investigated as these are known to be highly influential. The aim of this study was to identify major factors within these areas that have the strongest association with health and performance problems of dairy herds in Northern Germany. Results In the final model, a lower energy density in the roughage fraction of the diet, more pens with dirty lying areas and a low ratio of cows per watering spaces were associated with a higher risk for herd health problems. Moreover, case farms were affected by infections with intestinal parasites, lungworms, liver flukes and Johne’s Disease numerically more often than control farms. Case farms more often had pens with raised cubicles compared to the deep bedded stalls or straw yards found in control farms. In general, the hygiene of the floors and beddings was worse in case farms. Concerning nutrition, the microbiological and sensory quality of the provided silages was often insufficient, even in control farms. Less roughage was provided to early lactating cows and the feed was pushed to the feeding fence less frequently in case farms than in control farms. Conclusions The results show that milk yield and health status were associated with various factors from different areas stressing the importance of all aspects of management for good animal health and performance. Moreover, this study confirmed well-known risk factors for health problems and performance losses. These should better be taken heed of in herd health management.

Knowledge, attitude and practices of antibiotic usage among university students from Karachi, Pakistan (2019)

Limaye, Dnyanesh ; Ziesenis, Patrick ; Limaye, Vaidehi ; Ahmad, Mansoor ; Saeed, Farah ; Rizvi, Ramla ; Kapadi, Atul ; Sathe, Sushama ; Fortwengel, Gerhard

Background: Antimicrobial resistance has become a serious global problem. A potential post-antibiotic era is threatening present and future medical advances. In Pakistan, the usage of antibiotic is unnecessarily high and due to over exposure to these drugs, bacteria are developing resistance against these drugs. It is necessary to improve public awareness about the rational use of antibiotics in order to bring a change in consumer’s behaviour. Therefore, present study was undertaken to assess the existing knowledge, attitude and practices related to antibiotic usage among university students. Methods: A cross-sectional study was carried out among university students from Karachi, Pakistan during May-June 2018. 200 students were approached to participate in the study of which 159 agreed to participate (males: 70, females: 89). Pretested questionnaire was distributed to the study subjects and the collected data was analyzed using IBM SPSS version 23. Results: Substantial number of (33% and 50%) participants were unaware about the differences in antibiotic: anti-inflammatory drugs and antibiotic: antipyretics respectively. 29% of the participants thought it is right to stop antibiotics only based on symptomatic improvement. Thirty nine percent and eighty three percent participants believed that antibiotics should always be prescribed to treat flu like symptoms and pneumonia respectively. Conclusions: Participants demonstrated average knowledge about antibiotics. Similarly, their attitude and practice toward antibiotic use was associated with misconceptions. An educational intervention is necessary to make them aware about rational use of antibiotics.

Using openEHR Archetypes for Automated Extraction of Numerical Information from Clinical Narratives (2019)

Zubke, Maximilian ; Bott, Oliver J. ; Marschollek, Michael

Up to 80% of medical information is documented by unstructured data such as clinical reports written in natural language. Such data is called unstructured because the information it contains cannot be retrieved automatically as straightforward as from structured data. However, we assume that the use of this flexible kind of documentation will remain a substantial part of a patient’s medical record, so that clinical information systems have to deal appropriately with this type of information description. On the other hand, there are efforts to achieve semantic interoperability between clinical application systems through information modelling concepts like HL7 FHIR or openEHR. Considering this, we propose an approach to transform unstructured documented information into openEHR archetypes. Furthermore, we aim to support the field of clinical text mining by recognizing and publishing the connections between openEHR archetypes and heterogeneous phrasings. We have evaluated our method by extracting the values to three openEHR archetypes from unstructured documents in English and German language.

A study to assess knowledge and attitude towards HIV among students from Mumbai university (2019)

Limaye, Dnyanesh ; Fortwengel, Gerhard ; Limaye, Vaidehi ; Bhasi, Aishwarya ; Dhule, Aditya ; Dugane, Rajesh ; Borkar, Asang ; Shankar Pitani, Ravi ; Sathe, Sushama ; Kapadi, Atul

Background: India has the third largest HIV epidemic in the world. The Indian epidemic is characterized by low levels in the general population and elevated concentrations among high-risk groups. The present study was planned to determine the awareness of HIV among students from Mumbai University. Methods: A cross-sectional study was carried out among students from Mumbai University, India during May–June 2017. Two hundred and fifty students were approached to participate in the study of which 199 agreed to participate (males: 132; females: 67). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: Study participants had high knowledge (86%) and attitude score (87%). There was no significant difference between males and female participants for attitude and knowledge, except for one question regarding knowledge about HIV transmission via breastfeeding to child. Conclusions: Present study showed that there are no misconceptions or negative attitudes regarding HIV among students. A longitudinal study with a larger sample size across India is recommended for further investigation.

Results of a Literature Review to Prepare Data Modelling in the Context of Kidney Transplant Rejection Diagnosis (2019)

Katzensteiner, Matthias ; Ludwig, Wolfram ; Marschollek, Michael ; Bott, Oliver J.

Due to demographic change the number of serious kidney diseases and thus required transplantations will increase. The increased demand for donor organs and a decreasing supply of these organs underline the necessity for effective early rejection diagnostic measures to improve the lifetime of transplants. Expert systems might improve rejection diagnostics but for the development of such systems data models are needed that encompass the relevant information to enable optimal data aggregation and evaluation. Results of a literature review concerning published data models and information systems concerned with kidney transplant rejection diagnostic lead to a set of data elements even if no papers could be identified that publish data models explicitly.

Impact of physical exercises on immune function, bone mineral density, and quality of life in people living with HIV/AIDS: a systematic review with meta-analysis (2019)

Ibeneme, Sam Chidi ; Irem, Franklin Onyedinma ; Iloanusi, Nneka Ifeyinwa ; Ezuma, Amarachi Destiny ; Ezenwankwo, Fortune Elochukwu ; Okere, Philip Chinedu ; Nnamani, Amaka Obiageli ; Ezeofor, Salome Nwaelom ; Dim, Ngozi Regina ; Fortwengel, Gerhard

Background: Compromised immune function, associated with human immune deficiency virus (HIV) infection, is improved by antiretroviral therapy (ART) which also decreases bone mineral density (BMD), and possibly the quality of life (QoL). However, physical (aerobic/resistance) exercises, were reported to induce reverse effects in uninfected individuals and were appraised in the literature for evidence of similar benefits in people living with HIV/AIDS(PLWHA). The main study objective was to evaluate the impact of physical (aerobic and resistance) exercises on CD4+ count, BMD and QoL in PLWHA. Methods: A systematic review was conducted using the Cochrane Collaboration protocol. Searching databases, up to June 2017, only randomized control trials investigating the effects of either aerobic, resistance or a combination of both exercise types with a control/other intervention(s) for a period of at least 4 weeks among adults living with HIV, were included. Two independent reviewers determined the eligibility of the studies. Data were extracted and risk of bias (ROB) was assessed with the Cochrane Collaboration ROB tool. Meta-analyses were conducted using random effect models using the Review Manager (RevMan) computer software. Results: Nineteen studies met inclusion criteria(n = 491 participants at study completion) comprising male and female with age range 22–66 years. Two meta-analyses across 13 sub-group comparisons were performed. However, there were no RCTs on the impact of physical exercises on BMD in PLWHA. The result showed no significant change in CD4+ count unlike a significant effect of 5.04 point (95%CI:-8.49,-3.74,p = 0.00001) for role activity limitation due to physical health (QoL sub-domain). Overall, the GRADE evidence for this review was of moderate quality. Conclusions: There was evidence that engaging in moderate intensity aerobic exercises (55–85% Maximum heart rate-MHR), for 30–60 min, two to five times/week for 6–24 weeks significantly improves role activity limitation due to physical health problems, otherwise physical(aerobic or/and resistance) exercises have no significant effects on CD4+ count and other domains of QoL. Also, there is lack of evidence on the impact of exercises on BMD in PLWHA due to the paucity of RCTs. The moderate grade evidence for this review suggests that further research may likely have an important impact on our confidence in the estimate of effects and may change the estimate.

Response of Gait Output and Handgrip Strength to Changes in Body Fat Mass in Pre- and Postmenopausal Women (2019)

Ibeneme, Sam ; Ezeigwe, Chinenye ; Ibeneme, Georgian C. ; Ezuma, Amarachi ; Okoye, Ifeoma ; Nwankwo, Joseph M.

Background: Available preliminary data on menopause does not relate changes in body fat mass (BFM) and handgrip strength (HGS) (an indicator of body/muscle strength) to gait parameters. Objective: To determine the relationship between BFM, HGS and gait parameters, namely, stride length (SL) (an indicator of walking balance/postural stability), stride frequency (SF), and velocity (V) (gait out- put), to guide gait training. Methods: Ninety consenting (45 postmenopausal and 45 premenopausal) female staffof the University of Nigeria Teaching Hospital, Enugu, were randomly selected and assessed for BFM and HGS with a hydration monitor and dynamometer, respectively, in an observational study. The mean of 2 trials of the number of steps and time taken to cover a 10-m distance at normal speed was used to calculate SF, SL, and V. Data were analyzed using an independent t test and a Pearson correlation coefficient at P < 0.05. Results: Premenopausal (BFM = 42.93% [12.61%], HGS = 27.89 [7.52] kg, stride ratio = 1.43, and velocity = 1.04 [0.01] m/sec) and postmenopausal (BFM = 41.55% [12.71%], HGS = 30.91 [7.07] kg, stride ratio = 1.44, and velocity = 1.06 [0.01] m/sec) women showed no significant differences in gait output/velocity ( t = 0.138; P = 0.89; d = 0.029). At postmenopause, BFM was significantly and negatively ( r = –0.369; r 2 = 0.1362; P = 0.013) correlated with SL, whereas HGS was positively and significantly ( r = 0.323; r 2 = 0.104; P = 0.030) correlated with gait output at premenopause. Conclusions: BFM may adversely influence walking balance at postmenopause, whereas HGS may enhance gait output at premenopause but not postmenopause. Therefore, muscle strengthening alone may not enhance gait output in postmenopausal women without balance training.

Detecting Paraphrases of Standard Clause Titles in Insurance Contracts (2019)

Josi, Frieda ; Wartena, Christian ; Heid, Ulrich

For the analysis of contract texts, validated model texts, such as model clauses, can be used to identify used contract clauses. This paper investigates how the similarity between titles of model clauses and headings extracted from contracts can be computed, and which similarity measure is most suitable for this. For the calculation of the similarities between title pairs we tested various variants of string similarity and token based similarity. We also compare two additional semantic similarity measures based on word embeddings using pre-trained embeddings and word embeddings trained on contract texts. The identification of the model clause title can be used as a starting point for the mapping of clauses found in contracts to verified clauses.

Association between teat skin colonization and intramammary infection with Staphylococcus aureus and Streptococcus agalactiae in herds with automatic milking systems (2019)

Svennesen, Line ; Nielsen, Søren S. ; Mahmmod, Yasser S. ; Krömker, Volker ; Pedersen, Karl ; Klaas, Ilka C.

The objective of this study was to investigate the association between teat skin colonization and intramammary infection (IMI) with Staphylococcus aureus or Streptococcus agalactiae at the quarter level in herds with automatic milking systems. Milk and teat skin samples from 1,142 quarters were collected from 300 cows with somatic cell count >200,000 cells/mL from 8 herds positive for Strep. agalactiae. All milk and teat skin samples were cultured on calf blood agar and selective media. A subset of samples from 287 quarters was further analyzed using a PCR assay (Mastit4 PCR; DNA Diagnostic A/S, Risskov, Denmark). Bacterial culture detected Staph. aureus in 93 (8.1%) of the milk samples and 75 (6.6%) of the teat skin samples. Of these, 15 (1.3%) quarters were positive in both the teat skin and milk samples. Streptococcus agalactiae was cultured in 84 (7.4%) of the milk samples and 4 (0.35%) of the teat skin samples. Of these, 3 (0.26%) quarters were positive in both the teat skin and milk samples. The PCR detected Staph. aureus in 29 (10%) of the milk samples and 45 (16%) of the teat skin samples. Of these, 2 (0.7%) quarters were positive in both the teat skin and milk samples. Streptococcus agalactiae was detected in 40 (14%) of the milk samples and 51 (18%) of the teat skin samples. Of these, 16 (5.6%) quarters were positive in both the teat skin and milk samples. Logistic regression was used to investigate the association between teat skin colonization and IMI at the quarter level. Based on bacterial culture results, teat skin colonization with Staph. aureus resulted in 7.8 (95% confidence interval: 2.9; 20.6) times higher odds of Staph. aureus IMI, whereas herd was observed as a major confounder. However, results from the PCR analyses did not support this association. Streptococcus agalactiae was isolated from the teat skin with both PCR and bacterial culture, but the number of positive teat skin samples detected by culture was too low to proceed with further analysis. Based on the PCR results, Strep. agalactiae on teat skin resulted in 3.8 (1.4; 10.1) times higher odds of Strep. agalactiae IMI. Our results suggest that Staph. aureus and Strep. agalactiae on teat skin may be a risk factor for IMI with the same pathogens. Focus on proper teat skin hygiene is therefore recommended also in AMS.

Professional Life of Information System Graduates : Impressions and Experiences (2019)

Disterer, Georg

Aim/Purpose: We explore impressions and experiences of Information Systems graduates during their first years of employment in the IT field. The results help to understand work satisfaction, career ambition, and motivation of junior employees. This way, the attractiveness of working in the field of IS can be increased and the shortage of junior employees reduced. Background: Currently IT professions are characterized by terms such as “shortage of professionals” and “shortage of junior employees”. To attract more people to work in IT detailed knowledge about experiences of junior employees is necessary. Methodology: Data from a large survey of 193 graduates of the degree program “Information Systems” at University of Applied Sciences and Arts Hannover (Germany) show characteristics of their professional life like work satisfaction, motivation, career ambition, satisfaction with opportunities, development and career advancement, satisfaction with work-life balance. It is also asked whether men and women gain the same experiences when entering the job market and have the same perceptions. Findings: The participants were highly satisfied with their work, but limitations or restrictions due to gender are noteworthy. Recommendations for Practitioners: The results provide information on how human resource policies can make IT professions more attractive and thus convince graduates to seek jobs in the field. For instance, improving the balance between work and various areas of private life seems promising. Also, restrictions with respect to the work climate and improving communication along several dimensions need to be considered. Future Research: More detailed research on ambition and achievement is necessary to understand gender differences.

Biofilm Challenge: Lactic Acid Bacteria Isolated from Bovine Udders versus Staphylococci (2019)

Wallis, Jonathan K. ; Krömker, Volker ; Paduch, Jan-Hendrik

Mastitis poses a considerable threat to productivity and to animal welfare on modern dairy farms. However, the common way of antibiotic treatment does not always lead to a cure. Unsuccessful cures can, among other reasons, occur due to biofilm formation of the causative agent. This has attracted interest from researchers to introduce promising alternative therapeutic approaches, such as the use of beneficial lactic acid bacteria (LAB). In fact, using LAB for treating mastitis probably requires the formation of a beneficial biofilm by the probiotic bacteria. The present study investigated the ability of five LAB strains, selected on the basis of results from previous studies, to remove and to replace pathogenic biofilms in vitro. For this purpose, Staphylococcus (S.) aureus ATCC 12,600 and two strains—S. xylosus (35/07) and S. epidermidis (575/08)—belonging to the group of coagulase negative staphylococci (CNS) were allowed to form biofilms in a 96-well plate. Subsequently, the LAB were added to the well. The biofilm challenge was evaluated by scraping off and suspending the biofilm cells, followed by a plate count of serial dilutions using selective media. All the LAB strains successfully removed the staphylococcal biofilms. However, only Lactobacillus (L.) rhamnosus ATCC 7469 and L. plantarum 2/37 formed biofilms of their own to replace the pathogenic ones.

A Probabilistic Morphology Model for German Lemmatization (2019)

Wartena, Christian

Lemmatization is a central task in many NLP applications. Despite this importance, the number of (freely) available and easy to use tools for German is very limited. To fill this gap, we developed a simple lemmatizer that can be trained on any lemmatized corpus. For a full form word the tagger tries to find the sequence of morphemes that is most likely to generate that word. From this sequence of tags we can easily derive the stem, the lemma and the part of speech (PoS) of the word. We show (i) that the quality of this approach is comparable to state of the art methods and (ii) that we can improve the results of Part-of-Speech (PoS) tagging when we include the morphological analysis of each word.

Predicting Word Concreteness and Imagery (2019)

Charbonnier, Jean ; Wartena, Christian

Concreteness of words has been studied extensively in psycholinguistic literature. A number of datasets have been created with average values for perceived concreteness of words. We show that we can train a regression model on these data, using word embeddings and morphological features, that can predict these concreteness values with high accuracy. We evaluate the model on 7 publicly available datasets. Only for a few small subsets of these datasets prediction of concreteness values are found in the literature. Our results clearly outperform the reported results for these datasets.

Moving Hadoop to the cloud for big data analytics (2019)

Astrova, Irina ; Koschel, Arne ; Heine, Felix ; Kalja, Ahto

Hadoop is a Java-based open source programming framework, which supports the processing and storage of large volumes of data sets in a distributed computing environment. On the other hand, an overwhelming majority of organizations are moving their big data processing and storing to the cloud to take advantage of cost reduction – the cloud eliminates the need for investing heavily in infrastructures, which may or may not be used by organizations. This paper shows how organizations can alleviate some of the obstacles faced when trying to make Hadoop run in the cloud.

Systematizing IT Risks (2019)

Disterer, Georg

IT risks — risks associated with the operation or use of information technology — have taken on great importance in business, and IT risk management is accordingly important in the science and practice of information management. Therefore, it is necessary to systematize IT risks in order to plan, manage and control for different risk-specific measures. In order to choose and implement suitable measures for managing IT risks, effect-based and causebased procedures are necessary. These procedures are explained in detail for IT security risks because of their special importance.

Structural Analysis of Contract Renewals (2019)

Josi, Frieda ; Wartena, Christian

In the present paper we sketch an automated procedure to compare different versions of a contract. The contract texts used for this purpose are structurally differently composed PDF files that are converted into structured XML files by identifying and classifying text boxes. A classifier trained on manually annotated contracts achieves an accuracy of 87% on this task. We align contract versions and classify aligned text fragments into different similarity classes that enhance the manual comparison of changes in document versions. The main challenges are to deal with OCR errors and different layout of identical or similar texts. We demonstrate the procedure using some freely available contracts from the City of Hamburg written in German. The methods, however, are language agnostic and can be applied to other contracts as well.

Evaluating the RESTfulness of “APIs from the Rough” (2019)

Koschel, Arne ; Astrova, Irina ; Blankschyn, Maximilian ; Schöner, Dominik ; Schulze, Kevin

Nowadays, REST is the most dominant architectural style of choice at least for newly created web services. So called RESTfulness is thus really a catchword for web application, which aim to expose parts of their functionality as RESTful web services. But are those web services RESTful indeed? This paper examines the RESTfulness of ten popular RESTful APIs (including Twitter and PayPal). For this examination, the paper defines REST, its characteristics as well as its pros and cons. Furthermore, Richardson's Maturity Model is shown and utilized to analyse those selected APIs regarding their RESTfulness. As an example, a simple, RESTful web service is provided as well.

Evaluating RuleCore as Event Processing Network Model (2019)

Astrova, Irina ; Koschel, Arne ; Kobert, Sebastian ; Naumann, Jan ; Ruhe, Tobias ; Starodubtsev, Oleg

Our work is motivated primarily by the lack of standardization in the area of Event Processing Network (EPN) models. We identify general requirements for such models. These requirements encompass the possibility to describe events in the real world, to establish temporal and causal relationships among the events, to aggregate the events, to organize the events into a hierarchy, to categorize the events into simple or complex, to create an EPN model in an easy and simple way and to use that model ad hoc. As the major contribution, this paper applies the identified requirements to the RuleCore model.

Is the Brief Child Abuse Potential Inventory (BCAPI) a valid measure of child abuse potential among mothers and fathers of young children in Germany? (2019)

Liel, Christoph ; Meinck, Franziska ; Steinert, Janina I. ; Kindler, Heinz ; Lang, Katrin ; Eickhorst, Andreas

Background: In order to prevent child abuse, instruments measuring child abuse potential (CAP) need to be appropriate, reliable and valid. Objective: This study aimed to confirm the 6-factor structure of the Brief Child Abuse Potential Inventory (BCAPI) in a German sample of mothers and fathers, and to examine longitudinal predictors of CAP. Participants and setting: Two waves of data were collected from 197 mothers and 191 fathers of children aged 10–21 months for the “Kinder in Deutschland–KiD 0–3” in-depth study. Families were stratified based on prior self-report data for screening purposes. Methods: 138 fathers and 147 mothers were included in the analysis (invalid: 25% mothers, 30% fathers). First, validity of reporting was examined. Second, confirmatory factor analysis (CFA) was employed to assess factor structure. Third, internal reliability and criterion validity were examined. Finally, multivariate poisson regressions investigated longitudinal predictors of CAP in mothers. Results: A previously established six-factor structure was confirmed for mothers but not fathers. CFA failed for fathers due to large numbers of variables with zero variance. For mothers, internal consistency and criterion validity were good. BCAPI score at follow-up was associated with baseline BCAPI score (β= 00.08), stress (β= 0.06), education (β=-0.19) and alcohol use(β= .58). Conclusions: Findings confirm the six-factor structure of the BCAPI among German mothers. The clinical use of the BCAPI in fathers is not recommended as it might produce data that are hard to interpret. Further research with fathers is needed to establish if this is due to limitations with this dataset or with the questionnaire.

Oral cancer awareness among university students from Karachi, Pakistan (2019)

Limaye, Dnyanesh ; Ziesenis, Patrick ; Limaye, Vaidehi ; Ahmad, Mansoor ; Saeed, Farah ; Alam, Mahboob ; Rizvi, Ramla ; Kapadi, Atul ; Sathe, Sushama ; Fortwengel, Gerhard

Background: Oral cancers (OC) are malignant lesions occurring in the oral cavity that include squamous cell carcinomas (SCC), salivary gland and odontogenic neoplasms. Even though it is the eighth most common malignancy globally but in Pakistan it is the second commonest type of cancer. Lack of awareness about ill-effects of preventable risk factors of oral cancer increases the burden of disease due to the associated high cost of treatment, permanent impairment and high mortality. Hence, awareness can be very helpful in prevention, control and early diagnosis of oral cancer. Methods: A cross-sectional study was carried out among university students from Karachi, Pakistan during April to May 2018. Three hundred students were approached to participate in the study of which 277 agreed to participate. Pretested questionnaire was distributed and collected data was analysed using IBM SPSS version 23. Results: There were 125 (45%) males and 152 (55%) females in the study and response rate was 94%. Sixty one percent (154/250) respondents correctly identified smoking, and tobacco chewing as possible causes of oral cancer. Almost one third (74%; 184/250) respondents correctly responded that oral cancer does not spread from person to person through touch or speaking. Sixty six percent (164/250) respondents believed that oral cancer is curable. Mean score of knowledge was higher in females (61%) than males (53%). Significantly higher number of females compared to male participants answered correctly to questions regarding cause of oral cancer, spread of disease and occurrence of oral cancer in AIDS patients. Conclusions: Participants showed poor knowledge about oral cancer. Female participants showed better knowledge compared to male counterparts. Details about oral cancer should be incorporated in the university curriculum and periodic awareness programs should be organized for students.

EMC-compliant installation of automation networks (2019)

Niemann, Karl-Heinz

The topic of electromagnetic compatibility (EMC) remains an important aspect during the planning, installation and operation of automation systems. Communication networks, such as PROFIBUS and PROFINET, are known to be robust and reliable transmission systems. Nevertheless, it is important that a number of fundamental principles needs to be observed to ensure fault-free operation over a long plant lifetime. This paper first describes a number of principles of EMC. On the basis of these principles, six recommendations for action are then developed which are to be observed during the planning of an automation system for use in the manufacturing industry. Finally, an overview is provided of future work for systems in the process industry.

Using Word Embeddings for Unsupervised Acronym Disambiguation (2018)

Charbonnier, Jean ; Wartena, Christian

Scientific papers from all disciplines contain many abbreviations and acronyms. In many cases these acronyms are ambiguous. We present a method to choose the contextual correct definition of an acronym that does not require training for each acronym and thus can be applied to a large number of different acronyms with only few instances. We constructed a set of 19,954 examples of 4,365 ambiguous acronyms from image captions in scientific papers along with their contextually correct definition from different domains. We learn word embeddings for all words in the corpus and compare the averaged context vector of the words in the expansion of an acronym with the weighted average vector of the words in the context of the acronym. We show that this method clearly outperforms (classical) cosine similarity. Furthermore, we show that word embeddings learned from a 1 billion word corpus of scientific exts outperform word embeddings learned from much larger general corpora.

NOA: A Search Engine for Reusable Scientific Images Beyond the Life Sciences (2018)

Charbonnier, Jean ; Sohmen, Lucia ; Rothman, John ; Rohden, Birte ; Wartena, Christian

NOA is a search engine for scientific images from open access publications based on full text indexing of all text referring to the images and filtering for disciplines and image type. Images will be annotated with Wikipedia categories for better discoverability and for uploading to WikiCommons. Currently we have indexed approximately 2,7 Million images from over 710 000 scientific papers from all fields of science.

Figures in Scientific Open Access Publications (2018)

Sohmen, Lucia ; Charbonnier, Jean ; Blümel, Ina ; Wartena, Christian ; Heller, Lambert

This paper summarizes the results of a comprehensive statistical analysis on a corpus of open access articles and contained figures. It gives an insight into quantitative relationships between illustrations or types of illustrations, caption lengths, subjects, publishers, author affiliations, article citations and others.

Noninferiority trial investigating the efficacy of a nonantibiotic intramammary therapy in the treatment of mild- to-moderate clinical mastitis in dairy cows with longer lasting udder diseases (2018)

Marco, Ziesch ; Nicole, Wente ; Zhang, Yanchao ; Zaremba, W. ; Engl, S. ; Krömker, Volker

A nonblinded, positively controlled, noninferiority trial was conducted to evaluate the efficacy of an alternative, nonantibiotic therapy with Masti Veyxym® to reduce ineffective antibiotic usage in the treatment of nonsevere clinical mastitis (CM) in cows with longer lasting udder diseases. The solely intramammary treatment with Masti Veyxym® (three applications, 12 hr apart) and the combined treatment with Masti Veyxym® and antibiotics as usual on the farm according to label of the respective product were compared with the reference treatment of solely antibiotic therapy. The matched field study was conducted on eight free-stall dairy farms located in Eastern Germany. Cases of mild-to-moderate CM in cows with longer lasting high somatic cell counts in preceding dairy herd improvement test days and with previous CM cases in current lactation were randomly allocated to one of the three treatment groups. A foremilk sample of the affected quarter was taken before treatment and again approximately 14 days and 21 days after the end of therapy for cyto-bacteriological examination. Primary outcomes were clinical cure (CC) and no CM recurrence within 60 days after the end of treatment (no R60). Bacteriological cure (BC) and quarter somatic cell count (QSCC) cure were chosen as secondary outcomes although low probabilities of BC and QSCC cure for selected cows were expected. The study resulted in the following findings: the pathogens mostly cultured from pretreatment samples were Streptococcus uberis, followed by Staphylococcus aureus and coagulase-negative staphylococci. There were no significant differences between the two test treatments in comparison with the reference treatment regarding all outcome variables. The sole therapy with Masti Veyxym® resulted in a numerically lower likelihood of BC without significant differences to the reference treatment. The combined therapy group showed a numerically higher nonrecurrence rate than the two other treatment groups and noninferiority compared to the reference treatment was proven. Having regard to the selection criteria of cows in this study, the findings indicated that sole treatment with Masti Veyxym® in nonsevere CM cases may constitute an alternative therapy to reduce antibiotics. However, noninferiority evaluations were mostly inconclusive. Further investigations with a larger sample size are required to confirm the results and to make a clear statement on noninferiority.

LCA and Eco-Design : Consequential and Attributional Approaches for Biobased Plastics (2018)

Venkatachalam, Venkateshwaran ; Spierling, Sebastian ; Horn, Rafael ; Endres, Hans-Josef

Against the background of climate change and finite fossil resources, bio-based plastics have been in the focus of research for the last decade and were identified as a promising alternative to fossil-based plastics. Now, with an evolving bio-based plastic market and application range, the environmental advantages of bio-based plastic have come to the fore and identified as crucial by different stakeholders. While the majority of assessments for bio-based plastics are carried out based on attributional life cycle assessment, there have been only few consequential studies done in this area. Also, the application of eco-design strategies has not been in the focus for the bio-based products due to the prevailing misconceptions of renewable materials (as feedstock for bio-based plastics) considered in itself as an ‘eco-design strategy’. In this paper, we discuss the life cycle assessment as well as eco-design strategies of a bio-based product taking attributional as well as consequential approaches into account.

Staphylococcus aureus Isolates from Bovine Mastitis in Eight Countries: Genotypes, Detection of Genes Encoding Different Toxins and Other Virulence Genes (2018)

Monistero, Valentina ; Graber, Hans Ulrich ; Pollera, Claudia ; Cremonesi, Paola ; Castiglioni, Bianca ; Bottini, Enriqueta ; Ceballos-Marquez, Alejandro ; Lasso-Rojas, Laura ; Krömker, Volker ; Wente, Nicole ; Petzer, Inge-Marie ; Santisteban, Carlos ; Runyan, Jeff ; Veiga dos Santos, Marcos ; Gomes Alves, Bruna ; Piccinini, Renata ; Bronzo, Valerio ; Abbassi, Mohamed Salah ; Ben Said, Meriam ; Moroni, Paolo

Staphylococcus aureus is recognized worldwide as one of the major agents of dairy cow intra-mammary infections. This microorganism can express a wide spectrum of pathogenic factors used to attach, colonize, invade and infect the host. The present study evaluated 120 isolates from eight different countries that were genotyped by RS-PCR and investigated for 26 different virulence factors to increase the knowledge on the circulating genetic lineages among the cow population with mastitis. New genotypes were observed for South African strains while for all the other countries new variants of existing genotypes were detected. For each country, a specific genotypic pattern was found. Among the virulence factors, fmtB, cna, clfA and leucocidins genes were the most frequent. The sea and sei genes were present in seven out of eight countries; seh showed high frequency in South American countries (Brazil, Colombia, Argentina), while sel was harboured especially in one Mediterranean country (Tunisia). The etb, seb and see genes were not detected in any of the isolates, while only two isolates were MRSA (Germany and Italy) confirming the low diffusion of methicillin resistance microorganism among bovine mastitis isolates. This work demonstrated the wide variety of S. aureus genotypes found in dairy cattle worldwide. This condition suggests that considering the region of interest might help to formulate strategies for reducing the infection spreading.

Interprofessional collaboration in nursing homes (interprof): development and piloting of measures to improve interprofessional collaboration and communication: a qualitative multicentre study (2018)

Müller, Christiane A. ; Fleischmann, Nina ; Cavazzini, Christoph ; Heim, Susanne ; Seide, Svenja ; Geister, Christina ; Tetzlaff, Britta ; Hoell, Andreas ; Werle, Jochen ; Weyerer, Siegfried ; Scherer, Martin ; Hummers, Eva

Background: Given both the increase of nursing home residents forecast and challenges of current interprofessional interactions, we developed and tested measures to improve collaboration and communication between nurses and general practitioners (GPs) in this setting. Our multicentre study has been funded by the German Federal Ministry of Education and Research (FK 01GY1124). Methods: The measures were developed iteratively in a continuous process, which is the focus of this article. In part 1 “exploration of the situation”, interviews were conducted with GPs, nurses, nursing home residents and their relatives focusing on interprofessional interactions and medical care. They were analysed qualitatively. Based on these results, in part 2 “development of measures to improve collaboration”, ideas for improvement were developed in nine focus groups with GPs and nurses. These ideas were revisited in a final expert workshop. We analysed the focus groups and expert workshop using mind mapping methods, and finally drew up the compilation of measures. In an exploratory pilot study "study part 3" four nursing homes chose the measures they wanted to adopt. These were tested for three months. Feasibility and acceptance of the measures were evaluated via guideline interviews with the stakeholders which were analysed by content analyses. Results: Six measures were generated: meetings to establish common goals, main contact person, standardised pro re nata medication, introduction of name badges, improved availability of nurse/GP and standardised scheduling/ procedure for nursing home visits. In the pilot study, the measures were implemented in four nursing homes. GPs and nurses reviewed five measures as feasible and acceptable, only the designation of a “main contact person” was not considered as an improvement. Conclusions: Six measures to improve collaboration and communication could be compiled in a multistep qualitative process respecting the perspectives of involved stakeholders. Five of the six measures were positively assessed in an exploratory pilot study. They could easily be transferred into the daily routine of other nursing homes, as no special models have to exist in advance. Impact of the measures on patient oriented outcomes should be examined in further research. Trial registration: Not applicable.

Text-based annotation of scientific images using Wikimedia categories (2018)

Josi, Frieda ; Wartena, Christian ; Charbonnier, Jean

The reuse of scientific raw data is a key demand of Open Science. In the project NOA we foster reuse of scientific images by collecting and uploading them to Wikimedia Commons. In this paper we present a text-based annotation method that proposes Wikipedia categories for open access images. The assigned categories can be used for image retrieval or to upload images to Wikimedia Commons. The annotation basically consists of two phases: extracting salient keywords and mapping these keywords to categories. The results are evaluated on a small record of open access images that were manually annotated.

Biopolymers - facts and statistics (2018)

One of the main concerns of this publication is to furnish a more rational basis for discussing bioplastics and use fact-based arguments in the public discourse. Furthermore, “Biopolymers – facts and statistics” aims to provide specific, qualified answers easily and quickly for decision-makers in particular from public administration and the industrial sector. Therefore, this publication is made up like a set of rules and standards and largely foregoes textual detail. It offers extensive market-relevant and technical facts presented in graphs and charts, which means that the information is much easier to grasp. The reader can expect comparative market figures for various materials, regions, applications, process routes, agricultural land use, water use or resource consumption, production capacities, geographic distribution, etc.

Systems librarian, IT librarian, data librarian – Demand for graduates in Germany, Austria and Switzerland: a quantitative job advertisement analysis (2018)

Zellmann, Cedrik ; Blümel, Ina

This paper deals with new job profiles in libraries, mainly systems librarians (German: Systembibliothekare), IT librarians (German: IT-Bibliothekare) and data librarians (German: Datenbibliothekare). It investigates the vacancies and requirements of these positions in the German-speaking countries by analyzing one hundred and fifty published job advertisements of OpenBiblioJobs between 2012-2016. In addition, the distribution of positions, institutional bearers, different job titles as well as time limits, scope of work and remuneration of the positions are evaluated. The analysis of the remuneration in the public sector in Germany also provides information on demands for a bachelor's or master's degree. The average annual increase in job vacancies between 2012 and 2016 is 14.19%, confirming the need and necessity of these professional library profiles. The higher remuneration of the positions in data management, in comparison to the systems librarian, proves the prerequisite of the master's degree and thus indicates a desideratum due to missing or few master's degree courses. Accordingly, the range of bachelor's degree courses (or IT-oriented major areas of study with optional compulsory modules in existing bachelor's degree courses) for systems and IT librarians must be further expanded. An alternative could also be modular education programs for librarians and information scientists with professional experience, as it is already the case for music librarians.

Walking balance is mediated by muscle strength and bone mineral density in postmenopausal women: an observational study (2018)

Ibeneme, Sam C. ; Ekanem, C. ; Ezuma, A. ; Iloanusi, N. ; Lasebikan, N.N. ; Lasebikan, O.A. ; Oboh, O.E.

Background: Depletion of ovarian hormone in postmenopausal women has been associated with changes in the locomotor apparatus that may compromise walking function including muscle atrophy/weakness, weight gain, and bone demineralization. Therefore, handgrip strength (HGS), bone mineral density (BMD) and body composition [percentage body fat mass (%BFM), fat mass (FM), Fat-free mass (FFM) and body mass index (BMI)], may significantly vary and predict WB in postmenopausal women. Consequently, the study sought to 1. Explore body composition, BMD and muscle strength differences between premenopausal and postmenopausal women and 2. Explore how these variables [I.e., body composition, BMD and muscle strength] relate to WB in postmenopausal women. Method: Fifty-one pre-menopausal (35.74 + 1.52) and 50 postmenopausal (53.32 + 2.28) women were selected by convenience sampling and studied. Six explanatory variables (HGS, BMD, %BFM, FFM, BMI and FM) were explored to predict WB in postmenopausal women: Data collected were analyzed using multiple linear regression, ANCOVA, independent t-test and Pearson correlation coefficient at p < 0.05. Result: Postmenopausal women had higher BMI(t = + 1.72; p = 0.04), %BFM(t = + 2.77; p = .003), FM(t = + 1.77; p = 0.04) and lower HGS(t = − 3.05; p = 0.001),compared to the premenopausal women. The predicted main effect of age on HGS was not significant, F(1, 197) = 0.03, p = 0.06, likewise the interaction between age and %BFM, F(1, 197) = 0.02, p = 0.89; unlike the predicted main effect of %BFM, F(1, 197) = 10.34, p = .002, on HGS. HGS was the highest predictor of WB (t = 2.203; β=0.3046) in postmenopausal women and combined with T-score right big toe (Tscorert) to produce R2 = 0.11;F (2, 47)=4.11;p = 0.02 as the best fit for the predictive model. The variance (R2) change was significant from HGS model (R2 = 0.09;p = 0.03) to HGS + Tscorert model (R2 = 0.11;p = 0.02). The regression model equation was therefore given as: WB =5.4805 + 0.1578(HGS) + (− 1.3532) Tscorert. Conclusion: There are differences in body composition suggesting re-compartmentalization of the body, which may adversely impact the (HGS) muscle strength in postmenopausal women. Muscle strength and BMD areassociated with WB, although, only contribute to a marginal amount of the variance for WB. Therefore, other factors in addition to musculoskeletal health are necessary to mitigate fall risk in postmenopausal women.

The benefits of agreeing on what matters most: Team cooperative norms mediate the effect of co-leaders' shared goals on safety climate in neonatal intensive care units (2018)

Kuntz, Ludwig ; Scholten, Nadine ; Wilhelm, Hendrik ; Wittland, Michael ; Hillen, Hendrik Ansgar

BACKGROUND: Safety climate research suggests that a corresponding climate in work units is crucial for patient safety. Intensive care units are usually co-led by a nurse and a physician, who are responsible for aligning an interprofessional workforce and warrant a high level of safety. Yet, little is known about whether and how these interprofessional co-leaders jointly affect their unit's safety climate. PURPOSE: This empirical study aims to explain differences in the units' safety climate as an outcome of the nurse and physician leaders' degree of shared goals. Specifically, we examine whether the degree to which co-leaders share goals in general fosters a safety climate by pronouncing norms of interprofessional cooperation as a behavioral standard for the team members' interactions. METHODOLOGY/APPROACH: A cross-sectional design was used to gather data from 70 neonatal intensive care units (NICUs) in Germany. Survey data for our variables were collected from the unit's leading nurse and the leading physician, as well as from the unit's nursing and physician team members. Hypotheses testing at unit level was conducted using multivariate linear regression. RESULTS: Our analyses show that the extent to which nurse-physician co-leaders share goals covaries with safety climate in NICUs. This relationship is partially mediated by norms of interprofessional cooperation among NICU team members. Our final model accounts for 54% of the variability in safety climate of NICUs. CONCLUSION: Increasing the extent to which co-leaders share goals is an effective lever to strengthen interprofessional cooperation and foster a safety climate among nursing and physician team members of hospital units.

Knowledge, attitude and practices of antibiotic usage among students from Mumbai University (2018)

Limaye, Dnyanesh ; Naware, Sanika ; Bare, Priyanka ; Dalvi, Shreya ; Dhurve, Ketaki ; Sydymanov, Arlan ; Limaye, Vaidehi ; Shankar Pitani, Ravi ; Kanso, Zeinab ; Fortwengel, Gerhard

Background: Discovery of antibiotics have helped to manage the devastating diseases. Presently, the antibiotic era is threatened by the emergence of high level of antibiotic resistance of important pathogens. Misuse of antibiotics poses a serious risk to infectious disease control. It is necessary to improve public awareness to bring a change in the behavior of consumers. Therefore, present study was undertaken to assess the existing knowledge, attitude and practices related to antibiotic usage among university students. Methods: A cross-sectional study was carried out among students from Mumbai University, India during May-June 2017. 300 students were approached to participate in the study of which 250 agreed to participate (males: 117; females: 133). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: Substantial number (33% and 40%) participants were unaware about the differences in antibiotic-anti-inflammatory drugs and antibiotic-antipyretics respectively. 28% of the participants thought it is right to stop antibiotics only based on symptoms improvement. Sixty eight percent and seventy nine percent participants believed that antibiotics should always be prescribed to treat flu like symptoms and pneumonia respectively. Conclusions: Participants demonstrated poor knowledge about antibiotics. Similarly, their attitude and practice toward antibiotic use was associated with misconceptions. An educational intervention can be introduced to make them aware about rational antibiotic practices.

Self-medication practices in urban and rural areas of western India: a cross sectional study (2018)

Limaye, Dnyanesh ; Limaye, Vaidehi ; Fortwengel, Gerhard ; Krause, Gerard

Background: Concerns about practice of self-medication (SM) world across are based on associated risks such as adverse reactions, disease masking, increased morbidity, wastage of resources and antibiotic resistance. SM is likely to differ between rural and urban areas of India. Systematically retrieved evidence on these differences are required in order to design targeted measures for improvement. Methods: We conducted a cross sectional study among the general population in urban (Matunga) and rural (Tala) areas of Maharashtra, India to explore SM practices and its associated factors. Face to face interviews were conducted using the validated study questionnaire. Data was analyzed by using descriptive and analytical statistical methods. Results: A total of 1523 inhabitants from 462 households were interviewed between [June/2015] and [August /2015], 778 (51%) of them in rural and 745 (49%) in urban areas. Overall self-medication prevalence was 29.1% (urban; 51.5%, rural; 7.7%, OR 12.7, CI 9.4-17.2) in the study participants. Participants having chronic disease (OR: 3.15, CI: 2.07-4.79) and from urban areas (OR:15.38, CI:8.49-27.85) were more likely to self-medicate. Self-medication practices were characterized by having old prescription (41.6%) as the main reason, fever (39.4%) as top indication and NSAIDs (Non-Steroidal Anti Inflammatory Agents) as the most self-medicated category of drugs (40.7%). Conclusions: The present study documented that the prevalence of self-medication is associated with place of residence, and health status of the study participants. Self-medication is still a major issue in western Maharashtra, India and is majorly an urban phenomenon. Status of implementation of existing regulations should be reconsidered.

Oral cancer awareness among students from Mumbai University (2018)

Limaye, Dnyanesh ; Bhatkhande, Gauri ; Sabu, Shweta ; Jain, Aashvi ; Taskar, Poorva ; Gupta, Utkarsh ; Sydymanov, Arlan ; Limaye, Vaidehi ; Pitani, Ravi Shankar ; Sathe, Sushama ; Fortwengel, Gerhard ; Kanso, Zeinab

Background: Oral cancer is among the top three types of cancers in India. Severe alcoholism, use of tobacco in the form of cigarettes, smokeless tobacco, and betel nut chewing are the most common risk factors for oral cancer. Often individuals with pre cancer even notice the alterations, such as reduced mouth opening in oral submucous fibrosis (OSMF), but they are not aware about the causes and consequences of these changes. Awareness about causes and features of oral cancers can be very helpful in prevention, control and early diagnosis of oral cancer. Methods: A cross-sectional study was carried out among students from Mumbai University, India during May-June 2017. Five hundred students were approached to participate in the study of which 400 agreed to participate. Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: There were 199 (49%) males and 201 (50%) females in the study and response rate was (80%). Respondents had good knowledge about oral cancer. Seventy four percent (268/362) respondents correctly identified smoking, and tobacco chewing as possible causes of oral cancer. Almost all (96%; 348/362) respondents correctly responded that oral cancer does not spread from person to person through touch or speaking. Seventy two percent (260/362) respondents believed that oral cancer is curable. Significantly higher number of male (98%) compared to female participants answered correctly to questions regarding spread of disease and occurrence of oral cancer in AIDS patients. Conclusions: Participants showed good knowledge about oral cancer. Female participants showed lesser knowledge compared to male counterparts. Details about oral cancer should be incorporated in the undergraduate curriculum and periodic awareness programs should be organized for students.

Knowledge and attitude towards voluntary blood donation among students from Mumbai University (2018)

Limaye, Dnyanesh ; Naik, Pooja ; Varekar, Tejal ; Salunkhe, Priyanka ; Shah, Chaitali ; Sydymanov, Arlan ; Limaye, Vaidehi ; Pitani, Ravi Shankar ; Sathe, Sushama ; Kapadi, Atul ; Fortwengel, Gerhard

Background: Blood is scarce; its demand far outweighs the supply. In addition to limited supply, the issue of safety especially with regard to the risk of transfusion transmissible infection is also an issue of utmost concern especially in the developing countries. Blood transfusion services in India have gained special significance in recent years and forms a vital part of national health care system. Voluntary Non-Remunerated Blood Donation (VNRBD) is the safest of all types of blood donations. One of the potential sources that can be tapped for blood donation is the young and physically fit students from educational institutions across India. Methods: A cross-sectional study was carried out among students from Mumbai University, India during May–June 2017. Two hundred and fifty students were approached to participate in the study of which 201 agreed to participate (males: 104; females: 97). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: High number of participants agreed about encouraging general public about voluntary blood donation (96%; 193/201), lack of awareness about VBD in general public (82%; 164/201). But not a single participant was able to respond to the knowledge part of the questionnaire with 100% accuracy. Almost all the participants had correct knowledge about blood groups (98%; 196/201) and blood matching need (195/201; 97%). Conclusions: Participants showed good attitude but demonstrated poor knowledge about voluntary blood donation. Details about blood donation should be incorporated in the undergraduate curriculum and periodic awareness programs should be organized for students.

Knowledge, and attitude towards human papilloma virus infection among pharmacy students in Mumbai, India (2018)

Limaye, Dnyanesh ; Mehta, Drashty ; Singh, Shakshi ; Pardeshi, Apurva ; Patil, Tanvi ; Sydymanov, Arlan ; Limaye, Vaidehi ; Pitani, Ravi Shankar ; Sathe, Sushama ; Kapadi, Atul ; Fortwengel, Gerhard

Background: Human papillomavirus (HPV) is a common sexually transmitted infection (STI) that may cause cervical cancer and other malignancies including those of the vulva, anus, vagina, penis, head and neck. In most Asian countries including India, cervical cancer is the second most common cancer in women. Awareness about HPV and cervical cancer, use of vaccines can be very helpful in prevention, control and early diagnosis of cervical cancer. Methods: A cross-sectional study was carried out among students from Mumbai University, India during May - June 2017. Two hundred students were approached to participate in the study of which 142 were selected to participate (males: 54; females: 88). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: Participants had fair knowledge (61% average) about HPV, whereas knowledge about symptoms, prevention and spread of HPV was very poor i.e. 18%. Knowledge about HPV vaccine was 50% and 78% participants had positive attitude for HPV vaccine. Conclusions: This study showed the lacunas in the pharmacy curriculum and urgent need to create awareness of HPV among bachelor of pharmacy students from Mumbai University.

Toward a service-based workflow for automated information extraction from herbarium specimens (2018)

Kirchhoff, Agnes ; Bügel, Ulrich ; Santamaria, Eduard ; Reimeier, Fabian ; Röpert, Dominik ; Tebbje, Alexander ; Güntsch, Anton ; Chaves, Fernando ; Steinke, Karl-Heinz ; Berendsohn, Walter

Over the past years, herbarium collections worldwide have started to digitize millions of specimens on an industrial scale. Although the imaging costs are steadily falling, capturing the accompanying label information is still predominantly done manually and develops into the principal cost factor. In order to streamline the process of capturing herbarium specimen metadata, we specified a formal extensible workflow integrating a wide range of automated specimen image analysis services. We implemented the workflow on the basis of OpenRefine together with a plugin for handling service calls and responses. The evolving system presently covers the generation of optical character recognition (OCR) from specimen images, the identification of regions of interest in images and the extraction of meaningful information items from OCR. These implementations were developed as part of the Deutsche Forschungsgemeinschaft funded a standardised and optimised process for data acquisition from digital images of herbarium specimens (StanDAP-Herb) Project.

A study to determine the knowledge of pharmacovigilance among pharmacy students from Mumbai university (2018)

Limaye, Dnyanesh ; Shah, Purav ; Shah, Akhil ; Pillay, Ragini ; Modak, Viraj ; Chaudhari, Ameya ; Sydymanov, Arlan ; Limaye, Vaidehi ; Pitani, Ravi Shankar ; Sathe, Sushama ; Fortwengel, Gerhard

Background: Pharmacovigilance (PV); also known as drug safety surveillance, is the science of enhancing patient care and patient safety regarding the use of medicines by collecting, monitoring, assessing, and evaluating information from healthcare providers and patients. Pharmacists are pivotal players in adverse drug event (ADE) monitoring and reporting. However, most pharmacists are unaware or not knowledgeable about the guidelines used by their respective countries’ drug regulatory bodies. It is the need of the hour to train pharmacy students on the concept of pharmacovigilance. Methods: A cross-sectional study was carried out among pharmacy students from Mumbai University, India during May-June 2017. On the basis of the eligibility criterion 352 students were selected for the present study. Four hundred students were approached to participate in the study of which 201 agreed to participate (males: 179; females: 173). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: Overall pharmacovigilance knowledge (44%) and perception (58%) was low among the participants of the present study. Seventy four percent of the participants felt that adverse drug reaction (ADR) reporting should be made compulsory for healthcare professionals. And only 21% agreed that the topic of Pharmacovigilance is well covered in pharmacy curriculum. Conclusions: Pharmacy council of India, pharmacy teacher’s association and respective pharmacy college should take necessary steps to increase the knowledge and create awareness regarding pharmacovigilance and adverse drug reaction reporting among pharmacy students.

Knowledge and attitude towards epilepsy among pharmacy students from Mumbai university (2018)

Limaye, Dnyanesh ; Deshpande, Omkar ; Gite, Pratik ; Chavan, Sushil ; Sydymanov, Arlan ; Limaye, Vaidehi ; Pitani, Ravi Shankar ; Sathe, Sushama ; Fortwengel, Gerhard

Background: Epilepsy is a chronic disorder of the brain that affects people worldwide. The overall prevalence (3.0-11.9 / 1,000) and incidence (0.2-0.6/1,000) of epilepsy in India are comparable to the rates of high-income countries. The high prevalence of negative attitudes towards epilepsy has been highlighted by several studies. Pharmacy students represent a better-educated section of society regarding drugs and have the potential to create awareness, and influence attitudes towards the disease. Thus, it is important that they have the appropriate and updated knowledge and appropriate attitude towards epilepsy and antiepileptic drugs. Objective of the present study was to determine the Mumbai University pharmacy student’s awareness about epilepsy, so as to know the kind of education and awareness strategies that would be applicable to them. Methods: A cross-sectional study was carried out among students from Mumbai University, India during May-June 2017. Two hundred and fifty students were approached to participate in the study of which 213 agreed to participate (males: 107; females: 106). Pretested questionnaire was distributed and collected data was analyzed using IBM SPSS version 23. Results: Response rate for this study was 85.2% (213/250). Ninety six percent (204/213) of the participants had heard or read about epilepsy. Overall knowledge was poor (40.2%) and attitude was fair (75.3%). None of the participants were aware about recent research regarding hereditary nature of epilepsy. Only 2 (0.98%) students were aware how to perform the first aid in epilepsy. Only 6.8% participants felt that epileptics should participate in sports. Conclusions: The findings of this study show that, even with extensive curriculum covering diseases, drugs and relevant laws of land, the knowledge and attitude scores were low. There is a need to have focused education and campaigns to increase the knowledge and attitude towards epilepsy.

Review of new medical devices approvals by USFDA during the period of 2010 to 2014 (2018)

Limaye, Rewati ; Fortwengel, Gerhard

Medical devices are health care products distinguished from drugs for regulatory purposes in most countries based on mechanism of action. Unlike drugs, medical devices operate via physical or mechanical means and are not dependent on metabolism to accomplish their primary intended effect. Developing new medical devices requires clinical investigations and approval process goes through similar process like drugs. Medical device approvals in the period of 2010 to 2014 were searched from USFDA website. Disease burden data in the similar period was searched from centers for disease control and prevention website. Collected data was analyzed to know number of approved devices, top therapy areas, and mechanism of action of these devices. Out of a total of 200 medical devices approvals in the time period of 2010 to 2014, maximum number of devices (51; 25.5%) were approved in the year 2011, cardiovascular (78; 39%) was the top therapy area. Highest number (180; 90%) of approved medical devices belonged to the category III and maximum number (73; 36.5%) of approved medical devices had ―mechanical‖ mechanism of action. The top 3 causes of deaths in USA during 2010 to 2014 were heart disease, cancer and followed by respiratory infection. There was a match between the top diseases and the medical device approvals for top 2 diseases in USA i.e. heart disease, and cancer. With respect to respiratory infections and ailments which was the 3rd leading cause of death only one device was approved out of 200 approvals in total.

Flow rate dependent continuous hydrolysis of protein isolates (2018)

Sewczyk, Tim ; Hoog Antink, Marieke ; Maas, Michael ; Kroll, Stephen ; Beutel, Sascha

Food protein hydrolysates are often produced in unspecific industrial batch processes. The hydrolysates composition underlies process-related fluctuations and therefore the obtained peptide fingerprint and bioactive properties may vary. To overcome this obstacle and enable the production of specific hydrolysates with selected peptides, a ceramic capillary system was developed and characterized for the continuous production of a consistent peptide composition. Therefore, the protease Alcalase was immobilized on the surface of aminosilane modified yttria stabilized zirconia capillaries with a pore size of 1.5 μm. The loading capacity was 0.3 μg enzyme per mg of capillary with a residual enzyme activity of 43%. The enzyme specific peptide fingerprint produced with this proteolytic capillary reactor system correlated with the degree of hydrolysis, which can be controlled over the residence time by adjusting the flow rate. Common food proteins like casein, sunflower and lupin protein isolates were tested for continuous hydrolysis in the developed reactor system. The peptide formation was investigated by high-performance liquid chromatography. Various trends were found for the occurrence of specific peptides. Some are just intermediately occurring, while others cumulate by time. Thus, the developed continuous reactor system enables the production of specific peptides with desired bioactive properties.

Formal Guide to Questioning Witnesses and the Accused, With Flash Cards for Questioning (2018)

Hermanutz, Max ; Schröder, Jochen

This formal guide serves as a tool for questioning adult witnesses and accused persons. The utilisation of this framework follows the standard procedure of questioning and is underpinned by a purpose-built set of flash cards. Starting with concrete sample phrasings for informing the person of their rights, tried-and-tested questions and queries follow and lead through the questioning like the central theme. In addition, you will find supplementary explanations for each flash card. This technique enables law-enforcement professionals to obtain comprehensive statements of high quality from individuals willing to testify, which in turn permits a subsequent evaluation of truthfulness of statements to be conducted. The entire technique of questioning is geared towards the most recent scientific consensus. We selected the flash card format in order to allow police officers, for instance, to be able to conduct a questioning at any time and in whichever context. The specified structure contributes to ensuring that the general legislative framework is upheld and that we achieve statements that are considered solid in court. The final section addresses FAQs about this questioning technique, as well as references to further reading for those wishing to delve deeper.

On the slow implementation of pilot projects: Suspected causes from the perspective of statutory health insurance funds (2018)

Wessels, Michael ; Geuen, Dorith

Background: The system of nursing care in Germany is currently changing. For years, a further development of cooperation in the health care sector has been discussed. And thus a change in the distribution of tasks between health care professions. In 2008, the legislature introduced the introduction of pilot projects for the transfer of medicinal tasks to nurses according to § 63 para. 3c Social Code V. The implementation is very sluggish. The aim of the study was to analyze the reasons for this sluggish implementation from the perspective of the statutory health insurance funds. Methods: Quantitative survey of all statutory health insurance funds (n=124) in Germany. Results: To ensure supply, 94 % of health insurance companies consider the transfer of medical tasks to non-medical care providers as a sensible approach. Also 96 % consider this to be very important in order to ensure care. Although 96 % of health insurance funds support the implementation of pilot projects, only 8 % are in fact involved in such contracts; 71 % do not plan own pilot projects for the future. In the view of the statutory health insurance funds, legal obstacles (90 %), resistance by medical representatives (84 %), unresolved financing (74 %) and liability issues (70 %) as well as non-applicable regulations in G-BA-directive (79 %) and the law (85 %). Less than half (46 %) of the health insurance companies suspect high costs causing the slow implementation. Discussion: The amendments adopted by the legislature in the current reform of the law on care professions can be described as appropriate; in particular the fact that statutory health insurance funds should implement and carry out appropriate pilot projects by 31 December 2020. Transfer

Electrospun Polyacrylonitrile Based Carbon Nanofibers: The Role of Creep Stress towards Cyclization and Graphitization (2018)

Bin Ali, Annas ; Dreyer, Bastian ; Renz, Franz ; Tegenkamp, Christoph ; Sindelar, Ralf

The properties of these carbon nanostructures are determined by the structure and orientation of the graphitic domains during pyrolysis of carbon precursors. In this work, we investigated systematically the impact of creep stress during the stabilization process on the cyclization and molecular orientation of polyacrylonitrile as well as the graphitized structure after high temperature carbonization. Therefore, polyacrylonitrile (PAN) is electrospun and then stabilized with and without application of creep stress at different temperatures. The effect of creep stress on cyclization was monitored via Fourier transform IR spectroscopy (FTIR) and it was found that the degree of cyclization varies with the application of creep stress during the initial stages of cyclization at low temperatures (190°C and 210°C) in contrast to cyclization done at higher temperature (230°C). Herman molecular orientation factor was evaluated by polarized FTIR for PAN nanofibers cyclized with and without creep stress at 230°C-10 h. Subsequently, carbonization was performed at 1000°C and 1200°C for nanofibers cyclized at 230°C-10 h. Our results from XRD and Raman spectroscopy shows that the degree of graphitization and ordering of graphitic domains was enhanced for PAN nanofibers that were creep stressed during the cyclization process, even though both PAN nanofibers cyclized with creep stress and without creep stress showed the same amount of cyclized material. This increased degree of graphitization can be tracked to application of creep stress during the stabilization process which obviously favors the formation of sp2-hybridized carbon planes in the carbonization process. This finding highlights the impact of mechanical stress linking the cyclization of PAN nanofibers to graphitization. Our results will pave the way for a deeper understanding of mechano-chemical processes to fabricate well-aligned graphitic domains which improves the mechanical and electrical properties of CNFs.

A Hybrid Approach to Assignment of Library of Congress Subject Headings (2018)

Wartena, Christian ; Franke-Maier, Michael

Library of Congress Subject Headings (LCSH) are popular for indexing library records. We studied the possibility of assigning LCSH automatically by training classifiers for terms used frequently in a large collection of abstracts of the literature on hand and by extracting headings from those abstracts. The resulting classifiers reach an acceptable level of precision, but fail in terms of recall partly because we could only train classifiers for a small number of LCSH. Extraction, i.e., the matching of headings in the text, produces better recall but extremely low precision. We found that combining both methods leads to a significant improvement of recall and a slight improvement of F1 score with only a small decrease in precision.

Classifying Medical Literature Using k-Nearest-Neighbours Algorithm (2017)

Lüschow, Andreas ; Wartena, Christian

The amount of papers published yearly increases since decades. Libraries need to make these resources accessible and available with classification being an important aspect and part of this process. This paper analyzes prerequisites and possibilities of automatic classification of medical literature. We explain the selection, preprocessing and analysis of data consisting of catalogue datasets from the library of the Hanover Medical School, Lower Saxony, Germany. In the present study, 19,348 documents, represented by notations of library classification systems such as e.g. the Dewey Decimal Classification (DDC), were classified into 514 different classes from the National Library of Medicine (NLM) classification system. The algorithm used was k-nearest-neighbours (kNN). A correct classification rate of 55.7% could be achieved. To the best of our knowledge, this is not only the first research conducted towards the use of the NLM classification in automatic classification but also the first approach that exclusively considers already assigned notations from other classification systems for this purpose.

Editorial for the 17th European Networked Knowledge Organization Systems Workshop (NKOS 2017) (2017)

Mayr, Philipp ; Tudhope, Douglas ; Golub, Koraljka ; Wartena, Christian ; De Luca, Ernesto William

Knowledge Organization Systems (KOS), in the form of classification systems, thesauri, lexical databases, ontologies, and taxonomies, play a crucial role in digital information management and applications generally. Carrying semantics in a well-controlled and documented way, Knowledge Organization Systems serve a variety of important functions: tools for representation and indexing of information and documents, knowledge-based support to information searchers, semantic road maps to domains and disciplines, communication tool by providing conceptual framework, and conceptual basis for knowledge based systems, e.g. automated classification systems. New networked KOS (NKOS) services and applications are emerging, and we have reached a stage where many KOS standards exist and the integration of linked services is no longer just a future scenario. This editorial describes the workshop outline and overview of presented papers at the 17th European Networked Knowledge Organization Systems Workshop (NKOS 2017) which was held during the TPDL 2017 Conference in Thessaloniki, Greece.

A study to assess the vaccination coverage of university students in Mumbai, India (2017)

Limaye, Dnyanesh ; Limaye, Vaidehi ; Fortwengel, Gerhard

Background: Immunization is the most cost-effective intervention for infectious diseases which are the major cause of morbidity and mortality worldwide. There is a scarcity of information on the vaccination status of young adults and the role of socioeconomic conditions in India. Objectives: Present study explored the adult vaccination status and influence of income and education of parents on adult vaccination status in university students from Mumbai, India. Methods: On the basis of the eligibility criterion 149 students were selected for the present study. A total of 8 vaccines namely Tdap/DTP, Varicella, MMR, Influenza, Pneumococcal, Hepatitis A, Hepatitis B and Meningococcal were included in this study for all the respondents. In addition to these vaccines, Human Papilloma Virus vaccine was also included for female respondents. Results: There were total of 149 (75 male and 74 females) respondents with the mean age of 21.5 years. The top 3 immunizations were Td/Tdap (97.3%), MMR (66.4%) and Hepatitis B (55%) among the respondents. Only 4 (5.5%) female respondents have been immunized against the HPV. Conclusions: Td/Tdap (97.3%) and MMR (66.4%) coverage was in line with the recommendations. For all the other vaccines the coverage was low varying from 5.5% to 35.4%. The vaccination coverage was better in respondents with higher educated and higher income parents. We suggest that patient education, planning by government for the implementation of policy for adult vaccination and involvement of physicians are must for better adult vaccination coverage.

Delphi Method Variants in Information Systems Research: Taxonomy Development and Application (2017)

Strasser, Artur

Delphi is a frequently used research method in the information systems (IS) field. The last fifteen years have seen many variants of the Delphi Method proposed and used in IS research. However, these variants do not seem to be properly derived; while all variants share certain characteristics, their reasoning for differentiation inconsistently varies. It seems that researchers tend to create “new” Delphi Method variants, although the underlying modification of the Delphi Method is, in fact, minor. This leads to a heterogeneity of Delphi Method variants and undermines scientific rigor when using Delphi. The study addresses this deficit and (1) identifies different variants of Delphi and determines their characteristics, (2) critically reflects to what extent a clear distinction between these variants exists, (3) shows the clearly distinguishable Delphi Method variants and their characteristics, (4) develops a proposed taxonomy of Delphi Method variants, and (5) evaluates and applies this taxonomy. The proposed taxonomy helps clearly differentiate Delphi Method variants and enhances methodological rigor when using the Delphi Method.

Which Benefits Are Mentioned Most Often in Drug Development Publications? (2017)

Strüver, Vanessa

Objectives: The aim was to identify theoretically expected as well as actually reported benefits from drug development and the importance of individual patient benefits compared to the collective benefits to society in general. Background: Ethical guidelines require that clinical research involving humans offer the potential for benefit. A number of characteristics can be applied to define research benefit. Often benefit is categorized as being either direct or indirect. Indirect benefits can involve collective benefits for society rather than any benefits to the trial patient or subject. The purpose of this review was to examine which potential individual and societal benefits were mentioned as being expected in publications from government experts and which were mentioned in publications describing completed drug development trial results. Methods: Literature on research benefit was first identified by searching the PubMed database using several combinations of the key words benefit and clinical research. The search was limited to articles published in English. A Google search with the same combinations of key words but without any language limitation was then performed. Additionally, the reference lists of promising articles were screened for further thematically related articles. Finally, a narrative review was performed of relevant English- and German-language articles published between 1996 and 2016 to identify which of several potential benefits were either theoretically expected or which were mentioned in publications on clinical drug development trial results. Results: The principal benefits from drug development discussed included 2 main types of benefit, namely individual benefits for the patients and collective benefits for society. Twenty-one of an overall total of 26 articles discussing theoretically expected benefits focused on individual patient benefits, whereas 17 out of 26 articles mentioned collective benefits to society. In these publications, the most commonly mentioned theoretically expected individual patient benefit was the chance to receive up-to-date care (38.1%). A general increase in knowledge about health care, treatments, or drugs (70.6%) was the most commonly mentioned theoretically expected benefit for society. In contrast, all 13 publications reporting actual benefits of clinical drug development trials focused on personal benefits and only 1 of these publications also mentioned a societal benefit. The most commonly mentioned individual benefit was an increased quality of life (53.9%), whereas the only mentioned collective benefit to society was a general gain of knowledge (100.0%). Conclusions: Both theoretically expected and actually reported benefits in the majority of the included publications emphasized the importance of individual patient benefits from drug development rather than the collective benefits to society in general. The authors of these publications emphasized the right of each individual patient or subject to look for and expect some personal benefit from participating in a clinical trial rather than considering societal benefit as a top priority. From an ethical point of view, the benefits each individual patient receives from his or her participation in a clinical trial might also be seen as a societal benefit, especially when the drug or device tested, if approved for marketing, would eventually be made available for other similar patients from the country in which the clinical trial was conducted.

Public release of hospital quality data for referral practices in Germany: results from a cluster-randomised controlled trial (2017)

Emmert, Martin ; Meszmer, Nina ; Jablonski, Lisa ; Zinth, Lena ; Schöffski, Oliver ; Taheri-Zadeh, Fatemeh

Objective: To evaluate the impact of different dissemination channels on the awareness and usage of hospital performance reports among referring physicians, as well as the usefulness of such reports from the referring physicians’ perspective. Data sources/Study setting: Primary data collected from a survey with 277 referring physicians (response rate = 26.2%) in Nuremberg, Germany (03–06/2016). Study design: Cluster-randomised controlled trial at the practice level. Physician practices were randomly assigned to one of two conditions: (1) physicians in the control arm could become aware of the performance reports via mass media channels (Mass Media, npr MM=132, nph MM=147); (2) physicians in the intervention arm also received a printed version of the report via mail (Mass and Special Media, npr MSM=117; nph MSM=130). Principal findings: Overall, 68% of respondents recalled hospital performance reports and 21% used them for referral decisions. Physicians from the Mass and Special Media group were more likely to be aware of the performance reports (OR 4.16; 95% CI 2.16–8.00, p < .001) but not more likely to be influenced when referring patients into hospitals (OR 1.73; 95% CI 0.72–4.12, p > .05). On a 1 (very good) to 6 (insufficient) scale, the usefulness of the performance reports was rated 3.67 (±1.40). Aggregated presentation formats were rated more helpful than detailed hospital quality information. Conclusions: Hospital quality reports have limited impact on referral practices. To increase the latter, concerns raised by referring physicians must be given more weight. Those principally refer to the underlying data, the design of the reports, and the lack of important information.

Do Physicians Respond to Web-Based Patient Ratings? An Analysis of Physicians’ Responses to More Than One Million Web-Based Ratings Over a Six-Year Period (2017)

Emmert, Martin ; Sauter, Lisa ; Sander, Uwe ; Taheri-Zadeh, Fatemeh

Background: Physician-rating websites (PRWs) may lead to quality improvements in case they enable and establish a peer-to-peer communication between patients and physicians. Yet, we know little about whether and how physicians respond on the Web to patient ratings. Objective: The objective of this study was to describe trends in physicians’ Web-based responses to patient ratings over time, to identify what physician characteristics influence Web-based responses, and to examine the topics physicians are likely to respond to. Methods: We analyzed physician responses to more than 1 million patient ratings displayed on the German PRW, jameda, from 2010 to 2015. Quantitative analysis contained chi-square analyses and the Mann-Whitney U test. Quantitative content techniques were applied to determine the topics physicians respond to based on a randomly selected sample of 600 Web-based ratings and corresponding physician responses. Results: Overall, physicians responded to 1.58% (16,640/1,052,347) of all Web-based ratings, with an increasing trend over time from 0.70% (157/22,355) in 2010 to 1.88% (6377/339,919) in 2015. Web-based ratings that were responded to had significantly worse rating results than ratings that were not responded to (2.15 vs 1.74, P<.001). Physicians who respond on the Web to patient ratings differ significantly from nonresponders regarding several characteristics such as gender and patient recommendation results (P<.001 each). Regarding scaled-survey rating elements, physicians were most likely to respond to the waiting time within the practice (19.4%, 99/509) and the time spent with the patient (18.3%, 110/600). Almost one-third of topics in narrative comments were answered by the physicians (30.66%, 382/1246). Conclusions: So far, only a minority of physicians have taken the chance to respond on the Web to patient ratings. This is likely because of (1) the low awareness of PRWs among physicians, (2) the fact that only a few PRWs enable physicians to respond on the Web to patient ratings, and (3) the lack of an active moderator to establish peer-to-peer communication. PRW providers should foster more frequent communication between the patient and the physician and encourage physicians to respond on the Web to patient ratings. Further research is needed to learn more about the motivation of physicians to respond or not respond to Web-based patient ratings.

Roads to Health in Developing Countries: Understanding the Intersection of Culture and Healing (2017)

Ibeneme, Sam C. ; Ezuma, A. ; Fortwengel, Gerhard

Background: The most important attribute to which all human beings aspire is good health because it enables us to undertake different forms of activities of daily living. The emergence of scientific knowledge in Western societies has enabled scientists to explore and define several parameters of health by drawing boundaries around factors that are known to influence the attainment of good health. For example, the World Health Organization defined health by taking physical and psychological factors into consideration. Their definition of health also included a caveat that says, “not merely the absence of sickness.” This definition has guided scientists and health care providers in the Western world in the development of health care programs in non-Western societies. Objective: However, ethnomedical beliefs about the cause(s) of illness have given rise to alternative theories of health, sickness, and treatment approaches in the developing world. Thus, there is another side to the story. Method: Much of the population in developing countries lives in rural settings where the knowledge of health, sickness, and care has evolved over centuries of practice and experience. The definition of health in these settings tends to orient toward cultural beliefs, traditional practices, and social relationships. Invariably, whereas biomedicine is the dominant medical system in Western societies, traditional medicine — or ethno-medicine — is often the first port of call for patients in developing countries. Results: The 2 medical systems represent, and are influenced by, the cultural environment in which they exist. On one hand, biomedicine is very effective in the treatment of objective, measurable disease conditions. On the other hand, ethnomedicine is effective in the management of illness conditions or the experience of disease states. Nevertheless, an attempt to supplant 1 system of care with another from a different cultural environment could pose enormous challenges in non-Western societies. Conclusion: In general, we, as human beings, are guided in our health care decisions by past experiences, family and friends, social networks, cultural beliefs, customs, tradition, professional knowledge, and intuition. No medical system has been shown to address all of these elements; hence, the need for collaboration, acceptance, and partnership between all systems of care in cultural communities. In developing countries, the roads to health are incomplete without an examination of the intersection of culture and healing. Perhaps mutual exclusiveness rather inclusiveness of these 2 dominant health systems is the greatest obstacle to health in developing countries.

Antibiotic resistances in livestock: a comparative approach to identify an appropriate regression model for count data (2017)

Hüls, Anke ; Frömke, Cornelia ; Ickstadt, Katja ; Hille, Katja ; Hering, Johanna ; von Münchhausen, Christiane ; Hartmann, Maria ; Kreienbrock, Lothar

Antimicrobial resistance in livestock is a matter of general concern. To develop hygiene measures and methods for resistance prevention and control, epidemiological studies on a population level are needed to detect factors associated with antimicrobial resistance in livestock holdings. In general, regression models are used to describe these relationships between environmental factors and resistance outcome. Besides the study design, the correlation structures of the different outcomes of antibiotic resistance and structural zero measurements on the resistance outcome as well as on the exposure side are challenges for the epidemiological model building process. The use of appropriate regression models that acknowledge these complexities is essential to assure valid epidemiological interpretations. The aims of this paper are (i) to explain the model building process comparing several competing models for count data (negative binomial model, quasi-Poisson model, zero-inflated model, and hurdle model) and (ii) to compare these models using data from a cross-sectional study on antibiotic resistance in animal husbandry. These goals are essential to evaluate which model is most suitable to identify potential prevention measures. The dataset used as an example in our analyses was generated initially to study the prevalence and associated factors for the appearance of cefotaxime-resistant Escherichia coli in 48 German fattening pig farms. For each farm, the outcome was the count of samples with resistant bacteria. There was almost no overdispersion and only moderate evidence of excess zeros in the data. Our analyses show that it is essential to evaluate regression models in studies analyzing the relationship between environmental factors and antibiotic resistances in livestock. After model comparison based on evaluation of model predictions, Akaike information criterion, and Pearson residuals, here the hurdle model was judged to be the most appropriate model.

First International Conference on Health Research, Hannover, Germany (2017)

Fortwengel, Gerhard

Editorial to the Special Edition on Clinical Trials, featuring scientific articles presented during 2016 at the First International Conference on Health Research held at the Hochschule Hannover, University of Applied Sciences and Arts, in Hannover, Germany.

A systematic review of the literature on survey questionnaires to assess self-medication practices (2017)

Limaye, Dnyanesh ; Limaye, Vaidehi ; Krause, Gerard ; Fortwengel, Gerhard

Self-medication is of great public health importance as it often bypasses regulatory mechanisms to assure quality of health care. Nevertheless there are no established standards on how to assess self-medication. We therefore intended to systematically retrieve questionnaires and survey tools used to capture self-medication, with the aim to identify the scope of information investigated in this context and commonalities between the tools. We conducted a systematic review of the literature on questionnaires used for self-medication assessment by searching PubMed and Web of Science databases using the combinations of following keywords; self-medication, self-prescription, non-prescription, questionnaire. Truncation was used to ensure retrieval of all possible variations of search terms. The search was limited to articles published between 1st January 2000 and 31st December 2015, human studies and English language. Duplicate and irrelevant studies were excluded from the final review. A total of 158 studies were included in the review. Studies were from diverse geographical locations, most of the studies were from Nigeria 16 (10.1%) followed by India 10 (6.3%) and Iran 8 (5%). Forty-three studies (27.2%) focused on antibiotic self-medication. Majority of the studies (106; 67%) were done with adult populations. The components addressed by the questionnaires covered: reasons for self-medications in 147 (93%) studies, purchasing source in 136 (86%) studies, medical conditions to be treated in 153 (96.8%) studies, adverse events in 67 (42.4%) studies, use of prescribing information in 24 (15.1%) studies and antibiotic resistance awareness in 20 (46.5%) antibiotic studies. For 74 (46.8%) studies, survey questionnaires were self-administered and most studies (57; 36%) were done at homes of respondents. Thirty-seven (23.4%) studies did not report any recall period for self-medication practices. Study response rates varied from 17.9% to 100%, and while validity of the study questionnaire was reported for 100 (63.3%) studies, 15 (9.5%) studies reported reliability test of the study questionnaire. There is a large variety of questionnaires being used for investigating self-medication practices making comparability and meta-analyses very difficult. It is desirable to have a basic set of standardized survey questions on this topic to make available for future research groups in this field.

A distributed architecture for real-time evacuation guidance in large smart buildings (2017)

Lujak, Marin ; Billhardt, Holger ; Dunkel, Jürgen ; Fernandez, Alberto ; Hermoso, Ramon ; Ossowski, Sascha

In this paper, we consider the route coordination problem in emergency evacuation of large smart buildings. The building evacuation time is crucial in saving lives in emergency situations caused by imminent natural or man-made threats and disasters. Conventional approaches to evacuation route coordination are static and predefined. They rely on evacuation plans present only at a limited number of building locations and possibly a trained evacuation personnel to resolve unexpected contingencies. Smart buildings today are equipped with sensory infrastructure that can be used for an autonomous situation-aware evacuation guidance optimized in real time. A system providing such a guidance can help in avoiding additional evacuation casualties due to the flaws of the conventional evacuation approaches. Such a system should be robust and scalable to dynamically adapt to the number of evacuees and the size and safety conditions of a building. In this respect, we propose a distributed route recommender architecture for situation-aware evacuation guidance in smart buildings and describe its key modules in detail. We give an example of its functioning dynamics on a use case.

Automatic Identification of Synonym Relations in the Dutch Parliament’s Thesaurus (2017)

Aga, Rosa Tsegaye ; Wartena, Christian ; Lange, Otto ; Aders, Nelleke

For indexing archived documents the Dutch Parliament uses a specialized thesaurus. For good results for full text retrieval and automatic classification it turns out to be important to add more synonyms to the existing thesaurus terms. In the present work we investigate the possibilities to find synonyms for terms of the parliaments thesaurus automatically. We propose to use distributional similarity (DS). In an experiment with pairs of synonyms and non-synonyms we train and test a classifier using distributional similarity and string similarity. Using ten-fold cross validation we were able to classify 75% of the pairs of a set of 6000 word pairs correctly.

Artificial Intelligence as a Commons – Opportunities and Challenges for Society (2017)

Salameh, Amelie

The development of Artificial Intelligence (AI) has profound implications for improving human and computational productivity in the future. However, it also is an existential risk to human life because it could exceed human capabilities. As such, information about the technology, the direction of the development and its purpose is important. This can be achieved through openness and transparency of processes. Indeed, companies hold property rights over AI and monopolies of software, data and experts. As a countermovement to leading AI companies, the “Open AI Movement” has evolved to push open-source AI research and products, to empower users, and to bridge the digital divide through participation and access. In this thesis, the implications of the declaration of AI as a commons have been analyzed through interviews with AI experts in the United States. The legal placement of AI is controversial but it could be seen as a basic human right. Other findings are that this field is very competitive and that the best approach is to collaboratively develop software that adds additional value on the edge of the commons.

Hand hygiene practices and microbial investigation of hand contact swab among physiotherapists in an Ebola endemic region: implications for public health (2017)

Ibeneme, Sam C. ; Maduako, Victor ; Ibeneme, Georgian C. ; Ezuma, Amarachi ; Ettu, Theresa ; Onyemelukwe, Ngozi ; Limaye, Dnyanesh ; Fortwengel, Gerhard

Background: Hand hygiene practices (HHP), as a critical component of infection prevention/control, were investigated among physiotherapists in an Ebola endemic region. Method: A standardized instrument was administered to 44 randomly selected physiotherapists (23 males and 21 females), from three tertiary hospitals in Enugu, Nigeria. Fifteen participants (aged 22–59 years) participated in focus group discussions (FGDs) and comprised 19 participants in a subsequent laboratory study. After treatment, the palms/fingers of physiotherapists were swabbed and cultured, then incubated aerobically overnight at 37°C, and examined for microbial growths. An antibiogram of the bacterial isolates was obtained. Results: The majority (34/77.3%) of physiotherapists were aware of the HHP protocol, yet only 15/44.1% rated self-compliance at 71–100%. FGDs identified forgetfulness/inadequate HHP materials/infrastructure as the major barriers to HHP. Staphylococcus aureus were the most prevalent organisms, prior to (8/53.33%) and after (4/26.67%) HPP, while Pseudomonas spp. were acquired thereafter. E. coli were the most antibiotic resistant microbes but were completely removed after HHP. Ciprofloxacin and streptomycin were the most effective antibiotics. Conclusion: Poor implementation of HPP was observed due to inadequate materials/infrastructure/poor behavioral orientation. Possibly, some HPP materials were contaminated; hence, new microbes were acquired. Since HPP removed the most antibiotic resistant microbes, it might be more effective in infection control than antibiotic medication.

Biopolymers - facts and statistics (2017)

One of the main concerns of this publication is to furnish a more rational basis for discussing bioplastics and use fact-based arguments in the public discourse. Furthermore, “Biopolymers – facts and statistics” aims to provide specific, qualified answers easily and quickly for decision-makers in particular from public administration and the industrial sector. Therefore, this publication is made up like a set of rules and standards and largely foregoes textual detail. It offers extensive market-relevant and technical facts presented in graphs and charts, which means that the information is much easier to grasp. The reader can expect comparative market figures for various materials, regions, applications, process routes, agricultural land use, water use or resource consumption, production capacities, geographic distribution, etc.

Expectancy, usage and acceptance by general practitioners and patients: exploratory results from a study in the German outpatient sector (2017)

Albrecht, Urs-Vito ; Afshar, Kambiz ; Illiger, Kristin ; Becker, Stefan ; Hartz, Tobias ; Breil, Bernhard ; Wichelhaus, Daniel ; von Jan, Ute

Objective: The study’s objective was to assess factors contributing to the use of smart devices by general practitioners (GPs) and patients in the health domain, while specifically addressing the situation in Germany, and to determine whether, and if so, how both groups differ in their perceptions of these technologies. Methods: GPs and patients of resident practices in the Hannover region, Germany, were surveyed between April and June 2014. A total of 412 GPs in this region were invited by email to participate via an electronic survey, with 50 GPs actually doing so (response rate 12.1%). For surveying the patients, eight regional resident practices were visited by study personnel (once each). Every second patient arriving there (inclusion criteria: of age, fluent in German) was asked to take part (paper-based questionnaire). One hundred and seventy patients participated; 15 patients who did not give consent were excluded. Results: The majority of the participating patients (68.2%, 116/170) and GPs (76%, 38/50) owned mobile devices. Of the patients, 49.9% (57/116) already made health-related use of mobile devices; 95% (36/38) of the participating GPs used them in a professional context. For patients, age (P<0.001) and education (P<0.001) were significant factors, but not gender (P>0.99). For doctors, neither age (P¼0.73), professional experience (P>0.99) nor gender (P¼0.19) influenced usage rates. For patients, the primary use case was obtaining health (service)-related information. For GPs, interprofessional communication and retrieving information were in the foreground. There was little app-related interaction between both groups. Conclusions: GPs and patients use smart mobile devices to serve their specific interests. However, the full potentials of mobile technologies for health purposes are not yet being taken advantage of. Doctors as well as other care providers and the patients should work together on exploring and realising the potential benefits of the technology.

On Teaching International Courses on Health Information Systems (2017)

Ammenwerth, Elske ; Knaup, Petra ; Winter, Alfred ; Bauer, Axel W. ; Bott, Oliver J. ; Gietzelt, Matthias ; Haarbrandt, Birger ; Hackl, Werner O. ; Hellrung, Nils ; Hübner-Bloder, Gudrun ; Jahn, Franziska ; Jaspers, Monique W. ; Kutscha, Ulrike ; Machan, Christoph ; Oppermann, Bianca ; Pilz, Jochen ; Schwartze, Jonas ; Seidel, Christoph ; Slot, Jan-Eric ; Smers, Stefan ; Spitalewsky, Katharina ; Steckel, Nathalie ; Strübing, Alexander ; van der Haak, Minne ; Haux, Reinhold ; ter Burg, Willem J.

Background: Health information systems (HIS) are one of the most important areas for biomedical and health informatics. In order to professionally deal with HIS well-educated informaticians are needed. Because of these reasons, in 2001 an international course has been established: The Frank – van Swieten Lectures on Strategic Information Management of Health Information Systems. Objectives: Reporting about the Frank – van Swieten Lectures and about our students‘ feedback on this course during the last 16 years. Summarizing our lessons learned and making recommendations for such international courses on HIS. Methods: The basic concept of the Frank – van Swieten lectures is to teach the theoretical background in local lectures, to organize practical exercises on modelling sub-information systems of the respective local HIS and finally to conduct Joint Three Days as an international meeting were the resulting models are introduced and compared. Results: During the last 16 years, the Universities of Amsterdam, Braunschweig, Heidelberg/Heilbronn, Leipzig as well as UMIT were involved in running this course. Overall, 517 students from these universities participated. Our students‘ feedback was clearly positive. The Joint Three Days of the Frank – van Swieten Lectures, where at the end of the course all students can meet, turned out to be an important component of this course. Based on the last 16 years, we recommend common teaching materials, agreement on equivalent clinical areas for the exercises, support of group building of international student groups, motivation of using a collaboration platform, ensuring quality management of the course, addressing different levels of knowledge of the students, and ensuring sufficient funding for joint activities. Conclusions: Although associated with considerable additional efforts, we can clearly recommend establishing such international courses on HIS, such as the Frank – van Swieten Lectures.

Self-medication practices among university students from Karachi, Pakistan (2017)

Limaye, Dnyanesh ; Saeed, Farah ; Ahmad, Mansoor ; Pitani, Ravi Shankar ; Fortwengel, Gerhard

Background: Self-medication, practiced globally is an important public health problem. Research studies have indicated inappropriate self‐medication results in adverse drug reactions, disease masking, antibiotic resistance and wastage of healthcare resources. The objectives of the study were to explore overall self-medication and antibiotic self-medication prevalence among students of university students in Karachi, Pakistan along with probable reasons, indications, and sources of advice for self-medication. Methods: A descriptive, cross-sectional, questionnaire-based study was carried out among students from university of Karachi, Pakistan during the time period of September to November 2016. Pretested questionnaire was distributed to 320 students, collected data was analyzed using IBM SPSS version 24. Results: From 320 students, 311 (83 male and 228 female) students participated in the study giving a response rate of 97%. Prevalence of self-medication was 66%. Belonging to higher monthly family income group was associated with likelihood of self-medication. Antibiotic self-medication prevalence was 39%. Lack of time (39%), and old prescription (35%) were the main reasons for self-medication. Pharmacy shop (75%) was the main source for self-medication. In case of antibiotics, 44% students changed the dosage of antibiotic and 50% students stopped antibiotics after the disappearance of the symptoms. Conclusions: Antibiotic self-medication (39%) and self-medication with other drugs among university students of Karachi is a worrisome problem. Our findings highlight the need for planning interventions to promote the judicious use of general medicines as well as that of antibiotics.

IT Security in Production Facilities (2017)

Niemann, Karl-Heinz

This document concerns IT security in production facilities. It is intended for small and medium-sized enterprises that are looking for a simple procedural model for ensuring IT security in production areas. In order to raise readers’ awareness of IT security in production facilities, security incidents are presented in section 2. It is clear that cyber attacks on production facilities in this day and age are not random, but are instead based on a targeted process. An overview of the most important standards and recommendations on the topic of “IT security in production” then follows in section 3. Section 4 develops a concept for setting up an IT security system for small and medium-sized enterprises (SMEs) on the basis of a ten-point plan. The focus is not only on technical measures, but also in particular on the most frequently neglected organizational measures. Section 5 then describes the outlook for future requirements and solutions in the context of Industry 4.0.

Expectancy, usage and acceptance by general practitioners and patients: exploratory results from a study in the German outpatient sector (2017)

Albrecht, Urs-Vito ; Afshar, Kambiz ; Illiger, Kristin ; Becker, Stefan ; Hartz, Tobias ; Breil, Bernhard ; Wichelhaus, Daniel ; von Jan, Ute

Objective The study’s objective was to assess factors contributing to the use of smart devices by general practitioners (GPs) and patients in the health domain, while specifically addressing the situation in Germany, and to determine whether, and if so, how both groups differ in their perceptions of these technologies. Methods GPs and patients of resident practices in the Hannover region, Germany, were surveyed between April and June 2014. A total of 412 GPs in this region were invited by email to participate via an electronic survey, with 50 GPs actually doing so (response rate 12.1%). For surveying the patients, eight regional resident practices were visited by study personnel (once each). Every second patient arriving there (inclusion criteria: of age, fluent in German) was asked to take part (paper-based questionnaire). One hundred and seventy patients participated; 15 patients who did not give consent were excluded. Results The majority of the participating patients (68.2%, 116/170) and GPs (76%, 38/50) owned mobile devices. Of the patients, 49.9% (57/116) already made health-related use of mobile devices; 95% (36/38) of the participating GPs used them in a professional context. For patients, age (P < 0.001) and education (P < 0.001) were significant factors, but not gender (P > 0.99). For doctors, neither age (P = 0.73), professional experience (P > 0.99) nor gender (P = 0.19) influenced usage rates. For patients, the primary use case was obtaining health (service)-related information. For GPs, interprofessional communication and retrieving information were in the foreground. There was little app-related interaction between both groups. Conclusions GPs and patients use smart mobile devices to serve their specific interests. However, the full potentials of mobile technologies for health purposes are not yet being taken advantage of. Doctors as well as other care providers and the patients should work together on exploring and realising the potential benefits of the technology.

Burden and factors associated with post-stroke depression in East central Nigeria (2017)

Ibeneme, Sam Chidi ; Nwosu, Akachukwu ; Anyachukwu, Canice Chukwudi ; Ibeneme, Georgian C. ; Bakare, Muideen O. ; Fortwengel, Gerhard ; Limaye, Dnyanesh

Objective: To determine the burden and factors associated with post-stroke depression in East central Nigeria. Method: We carried out this cross-sectional study of 50 stroke survivors (mean age=54.8 ± 8.8 years), at the physiotherapy Department of the University of Nigeria Teaching Hospital, Enugu. Data were collected using Becks Depression Inventory , it was analyzed using Z-scores, Chi-square test and univariate logistic regression. Results: PSD was more common in females (45.45%); middle-age(60%) adults(27-36/47-56 years respectively); living with spouse (45%); left cerebral lesions (40.74%). Self-employed and unemployed (66.67%), respectively. Age was significantly associated with depression (p=0.03), and was related to the risk ofOR3.7 (95% CI 1.1-12.0 ) Conclusion: Age could be a risk factor for PSD, which was more prevalent in the elderly than young/middle-age adults, female gender, left cerebral lesion, complications, cold case; those living with a spouse, self-employed and unemployed.

The challenge of extra-intra craniometry: a computer-assisted three-dimensional approach on the equine skull (2017)

Lang, A. ; Brucker, P. ; Ludwig, M. ; Wrede, Tibor ; Theunert, Joscha ; Gasse, H.

Background: The topographical correlations between certain extracranial and intracranial osseous points of interest (POIs), and their age-related changes, are indispensable to know for a diagnostical or surgical access to intracranial structures; however, they are difficult to assess with conventional devices. Materials and methods: In this pilot study, the 3-dimensional coordinates of extra-/intracranial POIs were determined, thus avoiding perspective distortions that used to be intrinsic problems in 2-dimensional morphometry. The data sets were then analysed by creating virtual triangles. The sizes, shapes, and positions of these triangles described the extent and the directions of the age-related shifts of the POIs. A selection of extracranial and intracranial POIs were marked on half skulls of four warmblood horses in two age groups (young: 6 weeks, n = 2; old: 14 and 17 years, n = 2). The x-, y-, and z-coordinates of these POIs were determined with a measurement arm (FaroArm Fusion, FARO Europe®). Direct distances between the POIs as well as their indirect distances on the x-, y-, and z-axis, and angles were calculated. Results: The analysed virtual triangles revealed that some parts of the skull grew in size, but did not change in shape/relative proportions (proportional type of growth, as displayed by POI A and POI B at the Arcus zygomaticus). The same POIs (A and B) remained in a very stable relationship to their closest intracranial POI at the Basis cranii on the longitudinal axis, however, shifted markedly in the dorso-lateral direction. In contrast, a disproportional growth of other parts of the cranium was, for example, related to POI C at the Crista nuchae, which shifted strongly in the caudal direction with age. A topographically stable reference point (so-called anchor point) at the Basis cranii was difficult to determine. Conclusions: Two candidates (one at the Synchondrosis intersphenoidalis, another one at the Synchondrosis sphenooccipitalis) were relatively stable in their positions. However, the epicentre of (neuro-)cranial growth could only be pinpointed to an area between them.

Low-cost, in-liquid measuring system using a novel compact oscillation circuit and quartz-crystal microbalances (QCMs) as a versatile biosensor platform (2017)

Beißner, Stefan ; Thies, Jan-Wilhelm ; Bechthold, Christopher ; Kuhn, Philipp ; Thürmann, Bettina ; Dübel, Stefan ; Dietzel, Andreas

Quartz-crystal microbalances (QCMs) are commercially available mass sensors which mainly consist of a quartz resonator that oscillates at a characteristic frequency, which shifts when mass changes due to surface binding of molecules. In addition to mass changes, the viscosity of gases or liquids in contact with the sensor also shifts the resonance but also influences the quality factor (Q-factor). Typical biosensor applications demand operation in liquid environments leading to viscous damping strongly lowering Q-factors. For obtaining reliable measurements in liquid environments, excellent resonator control and signal processing are essential but standard resonator circuits like the Pierce and Colpitts oscillator fail to establish stable resonances. Here we present a lowcost, compact and robust oscillator circuit comprising of state-of-the-art commercially available surface-mount technology components which stimulates the QCMs oscillation, while it also establishes a control loop regulating the applied voltage. Thereby an increased energy dissipation by strong viscous damping in liquid solutions can be compensated and oscillations are stabilized. The presented circuit is suitable to be used in compact biosensor systems using custom-made miniaturized QCMs in microfluidic environments. As a proof of concept we used this circuit in combination with a customized microfabricated QCM in a microfluidic environment to measure the concentration of C-reactive protein (CRP) in buffer (PBS) down to concentrations as low as 5 μgmL -1.

Cradle to Cradle – An analysis of the market potential in the German outdoor apparel industry (2016)

Weiner, Mareike

The purpose of this study is to investigate the market potential in the German outdoor apparel industry by focusing on sustainable production in terms of environmental and human health. A literature study of the Cradle to Cradle (C2C) design concept is provided, as it represents a solution for pollution, waste and environmental destruction caused by the current industrial design and waste management. The data for the subsequent market- and competitive analysis of the German outdoor apparel industry was collected through secondary research in order to identify several key market indicators for the assessment of the market potential. The outcome of this research is the identification of a positioning strategy for outdoor apparel according to the C2C design concept. The results show stagnant growth rates in recent years in the German outdoor apparel market and strong rivalry among the competitors. However, a significant market potential was calculated and beneficial trends for sustainable outdoor brands were recognised. These findings reveal the existence of a market potential for an outdoor apparel brand according to the C2C design concept. By following a positioning strategy of transparency and full commitment to a sustainable production, the company might be able to gain market shares from its competitors, as future predictions indicate slow growth rates in the market. The results of this analysis can be of great interest for entrepreneurs that plan to enter the German outdoor apparel industry.

Development of Medical Devices (2016)

Limaye, Dnyanesh

The medical devices sector helps save lives by providing innovative health care solutions regarding diagnosis, prevention, monitoring, treatment, and alleviation. Medical devices are classified into 1 of 3 categories in the order of increasing risk: Class I, Class II, and Class III.1 Medical devices are distinguished from drugs for regulatory purposes based on mechanism of action. Unlike drugs, medical devices operate via physical or mechanical means and are not dependent on metabolism to accomplish their primary intended effect.

Editorial for the 15th European Networked Knowledge Organization Systems Workshop (NKOS 2016) (2016)

Mayr, Philipp ; Tudhope, Douglas ; Golub, Koraljka ; Wartena, Christian ; De Luca, Ernesto William

Knowledge Organization Systems (KOS), in the form of classification systems, thesauri, lexical databases, ontologies, and taxonomies, play a crucial role in digital information management and applications generally. Carrying semantics in a well-controlled and documented way, Knowledge Organisation Systems serve a variety of important functions: tools for representation and indexing of information and documents, knowledge-based support to information searchers, semantic road maps to domains and disciplines, communication tool by providing conceptual framework, and conceptual basis for knowledge based systems, e.g. automated classification systems. New networked KOS (NKOS) services and applications are emerging, and we have reached a stage where many KOS standards exist and the integration of linked services is no longer just a future scenario. This editorial describes the workshop outline and overview of presented papers at the 15th European Networked Knowledge Organization Systems Workshop (NKOS 2016) in Hannover, Germany.

Learning thesaurus relations from distributional features (2016)

Aga, Rosa Tsegaye ; Wartena, Christian ; Drumond, Lucas ; Schmidt-Thieme, Lars

In distributional semantics words are represented by aggregated context features. The similarity of words can be computed by comparing their feature vectors. Thus, we can predict whether two words are synonymous or similar with respect to some other semantic relation. We will show on six different datasets of pairs of similar and non-similar words that a supervised learning algorithm on feature vectors representing pairs of words outperforms cosine similarity between vectors representing single words. We compared different methods to construct a feature vector representing a pair of words. We show that simple methods like pairwise addition or multiplication give better results than a recently proposed method that combines different types of features. The semantic relation we consider is relatedness of terms in thesauri for intellectual document classification. Thus our findings can directly be applied for the maintenance and extension of such thesauri. To the best of our knowledge this relation was not considered before in the field of distributional semantics.

An architecture for situation-aware evacuation guidance in smart buildings (2016)

Billhardt, Holger ; Dunkel, Jürgen ; Lujak, Marin ; Fernández, Alberto ; Hermoso, Ramón ; Ossowski, Sascha

Smart Cities require reliable means for managing installations that offer essential services to the citizens. In this paper we focus on the problem of evacuation of smart buildings in case of emergencies. In particular, we present an abstract architecture for situation-aware evacuation guidance systems in smart buildings, describe its key modules in detail, and provide some concrete examples of its structure and dynamics.

Reaching the elderly: understanding of health and preventive experiences for a tailored approach – results of a qualitative study (2016)

Patzelt, Christiane ; Heim, Susanne ; Deitermann, Bernhilde ; Theile, Gudrun ; Krauth, Christian ; Hummers-Pradier, Eva ; Walter, Ulla

Background: Often preventive measures are not accessed by the people who were intended to be reached. Programs for older adults may target men and women, older adults, advanced old age groups and/or chronically ill patients with specific indications. The defined target groups rarely participate in the conception of programs or in the design of information materials, although this would increase accessibility and participation. In the German “Reaching the Elderly” study (2008–2011), an approach to motivating older adults to participate in a preventive home visit (PHV) program was modified with the participatory involvement of the target groups. The study examines how older men and women would prefer to be addressed for health and prevention programs. Methods: Four focus groups (N = 42 participants) and 12 personal interviews were conducted (women and men in 2 age groups: 65–75 years and ≥ 76 years). Participants from two districts of a major German city were selected from a stratified random sample (N = 200) based on routine data from a local health insurance fund. The study focused on the participants’ knowledge about health and disease prevention and how they preferred to be approached and addressed. Videos of the focus groups were recorded and analysed using mind mapping techniques. Interviews were digitally recorded, transcribed verbatim and subjected to qualitative content analysis. Results: A gender-specific approach profile was observed. Men were more likely to favor competitive and exerciseoriented activities, and they associated healthy aging with mobility and physical activity. Women, on the other hand, displayed a broader understanding of healthy aging, which included physical activity as only one aspect as well as a healthy diet, relaxation/wellness, memory training and independent living; they preferred holistic and socially oriented services that were not performance-oriented. The “older seniors” (76+) were ambivalent towards certain wordings referring to aging. Conclusions: Our results suggest that gender-specific needs must be considered in order to motivate older adults to participate in preventive services. Age-specific characteristics seem to be less relevant. It is more important to pay attention to factors that vary according to the individual state of health and life situation of the potential participants.

Influence of Socioeconomic Factors on Nutrition During Childhood in Germany and India (2016)

Chas, Sarah Jane ; Kale, M. ; Konwert, Stefanie ; Meißler, Luise ; Limaye, Dnyanesh

Malnutrition, nutritional deficiency, or undernutrition is an imbalanced nutritional status resulting from insufficient intake of nutrients to meet normal physiologic requirements. Malnutrition in childhood has both short-term consequences and long-term consequences on mental and physical health as well as the overall health development of children. Of all regions in the world, the Asia and the Pacific region has achieved the fastest rate of economic growth. There is no evidence that this rapid economic growth translates into a decline in malnutrition of children in Asian countries such as India.

Prevalence of musculoskeletal disorders among dentists from Mumbai, India (2016)

Limaye, Vaidehi ; Limaye, Dnyanesh ; Desai, R. ; Seth, J. ; Prabhu, S. ; Fortwengel, Gerhard

The world health organization defines musculoskeletal disorder (MSD) as “a disorder of muscles, tendons, peripheral vascular system not directly resulting from an acute or instantaneous event.1 Work related MSDs are one of the most important occupational hazards.1 Among many other occupations, dentistry is a highly demanding profession that requires good visual acuity, hearing, depth perception, psychomotor skills, manual dexterity, and ability to maintain occupational postures over long periods.

Boosting the CD4 Count in HIV Infection: Comparative Effects of Highly Active Anti-retroviral therapy (HAART) and Different Modalities of Physical Exercise on Biomarkers of Immunity (2016)

Ibeneme, Sam C. ; Asogwa, E. ; Okoye, I. ; Fortwengel, Gerhard ; Asogwa, O. ; Ezuma, A.

A decline in the CD4 count is a common feature in HIV/AIDS, suggesting a compromise in immunity of patients. In response, highly active antiretroviral therapy (HAART) is prescribed to slow-down a diminution in the CD4 count and risk of AIDS-related malignancies. However, exercise may improve both the utility and population of innate immune cell components, and may be beneficial for patients with HIV infection. Comparing the effects of different exercises against HAART, on CD4 count, helps in understanding the role and evidence-based application of exercises to ameliorate immune deficiency.

Malnutrition Awareness Among University Students From Mumbai, India, and Hannover, Germany (2016)

Le, T. ; Pisarck, N. ; Salameh, A. ; Reckemeyer, S. ; Kale, M. ; Limaye, Dnyanesh

Malnutrition is the condition in which the body does not get the right amount of proteins, vitamins, or other nutrients.1 The global prevalence of malnutrition was reported as 13% in 2015.2 The subregion of South Asia is especially known as a critical area for severe wasted children aged <5 years.3 In India, 38.4% of children aged <3 years are stunted, and 46% are underweight.4 Malnutrition can lead to mortality as well as disabilities and long-term consequences such as cognitive disabilities, less economic productivity, or diseases.

Legal requirements on secondary use of medical data in the EU and USA – A case study (2016)

Kindler, Florentina ; Fortwengel, Gerhard ; Hewitt, B.

The use of secondary data in health care research has become a very important issue over the past few years. Data from the treatment context are being used for evaluation of medical data for external quality assurance, as well as to answer medical questions in the form of registers and research databases. Additionally, the establishment of electronic clinical systems like data warehouses provides new opportunities for the secondary use of clinical data. Because health data is among the most sensitive information about an individual, the data must be safeguarded from disclosure.

Clinical Research and Standard of Care — An Unresolved Question? (2016)

Tornieporth, Nadia ; Fneish, Firas ; Fortwengel, Gerhard

Ever since the 1996 revision of the Declaration of Helsinki, the World Medical Association has attempted to address ethical and scientific concerns of its diverse stakeholders for Articles 33 (use of placebo) and 34 (posttrial provisions), most recently in 2013. Both are inextricably linked to standard of care, an essential element of any comparative, interventional clinical trial. But has this now 20-year-long ethical debate truly been put to rest? The choice of standard of care in clinical trials remains a complex issue, particularly for comparative trials conducted in emerging countries.

Roads to Health in Nigeria – Understanding the Intersection of Culture and Healing (2016)

Ibeneme, Sam C. ; Eni, G. ; Ezuma, A.

The most important attribute for which we all aspire as human beings is good health because it enables us to undertake different forms of activities of daily living. The emergence of scientific knowledge in Western societies has enabled us to explore and define several parameters of “health” by drawing boundaries around factors that are known to impact the achievement of good health. For example, the World Health Organization defined health by taking physical and psychological factors into consideration.

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