Refine
Has Fulltext
- yes (32)
Year of publication
Document Type
- Journal article (32) (remove)
Keywords
- Germany (32) (remove)
Institute
- Institut für Geographie und Geologie (7)
- Institut für Klinische Epidemiologie und Biometrie (5)
- Institut für Hygiene und Mikrobiologie (4)
- Institut für Anatomie und Zellbiologie (3)
- Comprehensive Cancer Center Mainfranken (2)
- Institut für Sportwissenschaft (2)
- Kinderklinik und Poliklinik (2)
- Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I) (2)
- Klinik und Poliklinik für Anästhesiologie (ab 2004) (2)
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie (2)
Sonstige beteiligte Institutionen
EU-Project number / Contract (GA) number
- 223153 (1)
Background and objectives
Bullous pemphigoid (BP) is associated with neuropsychiatric disorders. Other comorbid diseases are discussed controversially. We evaluated the prevalence of comorbidity in BP patients in a representative area of Germany.
Patients and methods
Medical files of all BP patients treated at the Department of Dermatology, University Hospital Würzburg, Germany, between June 2002 and May 2013 were retrospectively reviewed. Bullous pemphigoid was diagnosed based on established criteria. For each patient, two controls were individually matched. Records were evaluated for age, sex, laboratory values, concomitant medication and comorbidity. Conditional logistic regression, multivariable regression analysis and complex regression models were performed to compare results.
Results
300 BP patients were identified and compared to 583 controls. Bullous pemphigoid was associated with neuropsychiatric disorders as well as laboratory abnormalities including leukocytosis and eosinophilia. Importantly, a highly significant association of BP with anemia (OR 2.127; 95 % CI 1.532–2.953) and renal impairment (OR 2.218; 95 % CI 1.643–2.993) was identified. No association was found with malignancy and arterial hypertension.
Conclusions
Our data revealed an increased frequency of anemia and renal impairment in BP patients. In accordance with previous studies the strong association for neuropsychiatric disorders was confirmed (p < 0.0005).
Coagulase-negative staphylococci (CoNS) are common opportunistic pathogens, but also ubiquitous human and animal commensals. Infection-associated CoNS from healthcare environments are typically characterized by pronounced antimicrobial resistance (AMR) including both methicillin- and multidrug-resistant isolates. Less is known about AMR patterns of CoNS colonizing the general population. Here we report on AMR in commensal CoNS recovered from 117 non-hospitalized volunteers in a region of Germany with a high livestock density. Among the 69 individuals colonized with CoNS, 29 had reported contacts to either companion or farm animals. CoNS were selectively cultivated from nasal swabs, followed by species definition by 16S rDNA sequencing and routine antibiotic susceptibility testing. Isolates displaying phenotypic AMR were further tested by PCR for presence of selected AMR genes. A total of 127 CoNS were isolated and Staphylococcus epidermidis (75%) was the most common CoNS species identified. Nine isolates (7%) were methicillin-resistant (MR) and carried the mecA gene, with seven individuals (10%) being colonized with at least one MR-CoNS isolate. While resistance against gentamicin, phenicols and spectinomycin was rare, high resistance rates were found against tetracycline (39%), erythromycin (33%) and fusidic acid (24%). In the majority of isolates, phenotypic resistance could be associated with corresponding AMR gene detection. Multidrug-resistance (MDR) was observed in 23% (29/127) of the isolates, with 33% (23/69) of the individuals being colonized with MDR-CoNS. The combined data suggest that MR- and MDR-CoNS are present in the community, with previous animal contact not significantly influencing the risk of becoming colonized with such isolates.
Investigating diversity gradients helps to understand biodiversity drivers and threats. However, one diversity gradient is rarely assessed, namely how plant species distribute along the depth gradient of lakes. Here, we provide the first comprehensive characterization of depth diversity gradient (DDG) of alpha, beta, and gamma species richness of submerged macrophytes across multiple lakes. We characterize the DDG for additive richness components (alpha, beta, gamma), assess environmental drivers, and address temporal change over recent years. We take advantage of yet the largest dataset of macrophyte occurrence along lake depth (274 depth transects across 28 deep lakes) as well as of physiochemical measurements (12 deep lakes from 2006 to 2017 across Bavaria), provided publicly online by the Bavarian State Office for the Environment. We found a high variability in DDG shapes across the study lakes. The DDGs for alpha and gamma richness are predominantly hump-shaped, while beta richness shows a decreasing DDG. Generalized additive mixed-effect models indicate that the depth of the maximum richness (Dmax) is influenced by light quality, light quantity, and layering depth, whereas the respective maximum alpha richness within the depth gradient (Rmax) is significantly influenced by lake area only. Most observed DDGs seem generally stable over recent years. However, for single lakes we found significant linear trends for Rmax and Dmax going into different directions. The observed hump-shaped DDGs agree with three competing hypotheses: the mid-domain effect, the mean–disturbance hypothesis, and the mean–productivity hypothesis. The DDG amplitude seems driven by lake area (thus following known species–area relationships), whereas skewness depends on physiochemical factors, mainly water transparency and layering depth. Our results provide insights for conservation strategies and for mechanistic frameworks to disentangle competing explanatory hypotheses for the DDG.
Introduction
Low-grade appendiceal mucinous neoplasms (LAMN) are semi-malignant tumors of the appendix which are incidentally found in up to 1% of appendectomy specimen. To this day, no valid descriptive analysis on LAMN is available for the German population.
Methods
Data of LAMN (ICD-10: D37.3) were collected from the population-based cancer registries in Germany, provided by the German Center for Cancer Registry Data (Zentrum für Krebsregisterdaten—ZfKD). Data was anonymized and included gender, age at diagnosis, tumor staging according to the TNM-classification, state of residence, information on the performed therapy, and survival data.
Results
A total of 612 cases were reported to the ZfKD between 2011 and 2018. A total of 63.07% were female and 36.93% were male. Great inhomogeneity in reporting cases was seen in the federal states of Germany including the fact that some federal states did not report any cases at all. Age distribution showed a mean age of 62.03 years (SD 16.15) at diagnosis. However, data on tumor stage was only available in 24.86% of cases (n = 152). A total of 49.34% of these patients presented with a T4-stage. Likewise, information regarding performed therapy was available in the minority of patients: 269 patients received surgery, 22 did not and for 312 cases no information was available. Twenty-four patients received chemotherapy, 188 did not, and for 400 cases, no information was available. Overall 5-year survival was estimated at 79.52%. Patients below the age of 55 years at time of diagnosis had a significantly higher 5-year survival rate compared to patients above the age of 55 years (85.77% vs. 73.27%).
Discussion
In this study, we observed an incidence of LAMN in 0.13% of all appendectomy specimen in 2018. It seems likely that not all cases were reported to the ZfKD; therefore, case numbers may be considered underestimated. Age and gender distribution goes in line with international studies with females being predominantly affected. Especially regarding tumor stage and therapy in depth information cannot be provided through the ZfKD-database. This data analysis emphasizes the need for further studies and the need for setting up a specialized registry for this unique tumor entity to develop guidelines for the appropriate treatment and follow-up.
Park−People Relationships: The Socioeconomic Monitoring of National Parks in Bavaria, Germany
(2021)
Questions about park–people relationships and the understanding and handling of the conflicts that may result from the creation and management of national parks in the surrounding area are prerequisites for both successful park management and sustainable rural tourism development. This paper analyzes the roles that research may play in relation to park–people relationships in the context of the two oldest German national parks located in Bavaria. The different fields of action of national parks are used to identify the potential for conflict, using detailed case studies from the Bavarian Forest and Berchtesgaden National Parks using quantitative population surveys carried out in 2018. The overall attitude towards both national parks is overwhelmingly positive, with trust towards park administrations and the perceived economic benefits from rural tourism being the attitudes most strongly correlated to the overall level of park–people relationships. Nevertheless, some points of contention still exist, like the ecological integrity approach towards strict nature conservation and related landscape changes (e.g., deadwood cover). A comparison over time shows in both cases that the spatial proximity to the protected area negatively influences people’s attitudes towards the parks, but less so than in the past. Recommendations for national park management include communicating proactively and with greater transparency with locals and decision-makers, to identify conflicts earlier and, where possible, to eliminate them. Furthermore, developing a standardized method to monitor park–people relationships in Germany is a must and would benefit integrated approaches in research and management based on conservation social science.
A fuzzy classification scheme that results in physically interpretable meteorological patterns associated with rainfall generation is applied to classify homogeneous regions of boreal summer rainfall anomalies in Germany. Four leading homogeneous regions are classified, representing the western, southeastern, eastern, and northern/northwestern parts of Germany with some overlap in the central parts of Germany. Variations of the sea level pressure gradient across Europe, e.g., between the continental and maritime regions, is the major phenomenon that triggers the time development of the rainfall regions by modulating wind patterns and moisture advection. Two regional climate models (REMO and CCLM4) were used to investigate the capability of climate models to reproduce the observed summer rainfall regions. Both regional climate models (RCMs) were once driven by the ERA-Interim reanalysis and once by the MPI-ESM general circulation model (GCM). Overall, the RCMs exhibit good performance in terms of the regionalization of summer rainfall in Germany; though the goodness-of-match with the rainfall regions/patterns from observational data is low in some cases and the REMO model driven by MPI-ESM fails to reproduce the western homogeneous rainfall region. Under future climate change, virtually the same leading modes of summer rainfall occur, suggesting that the basic synoptic processes associated with the regional patterns remain the same over Germany. We have also assessed the added value of bias-correcting the MPI-ESM driven RCMs using a simple linear scaling approach. The bias correction does not significantly alter the identification of homogeneous rainfall regions and, hence, does not improve their goodness-of-match compared to the observed patterns, except for the one case where the original RCM output completely fails to reproduce the observed pattern. While the linear scaling method improves the basic statistics of precipitation, it does not improve the simulated meteorological patterns represented by the precipitation regimes.
This study compares the performance of three bias correction (BC) techniques in adjusting simulated precipitation estimates over Germany. The BC techniques are the multivariate quantile delta mapping (MQDM) where the grids are used as variables to incorporate the spatial dependency structure of precipitation in the bias correction; empirical quantile mapping (EQM) and, the linear scaling (LS) approach. Several metrics that include first to fourth moments and extremes characterized by the frequency of heavy wet days and return periods during boreal summer were applied to score the performance of the BC techniques. Our results indicate a strong dependency of the relative performances of the BC techniques on the choice of the regional climate model (RCM), the region, the season, and the metrics of interest. Hence, each BC technique has relative strengths and weaknesses. The LS approach performs well in adjusting the first moment but tends to fall short for higher moments and extreme precipitation during boreal summer. Depending on the season, the region and the RCM considered, there is a trade-off between the relative performances of the EQM and the MQDM in adjusting the simulated precipitation biases. However, the MQDM performs well across all considered metrics. Overall, the MQDM outperforms the EQM in improving the higher moments and in capturing the observed return level of extreme summer precipitation, averaged over Germany.
The July 2021 heavy rainfall episode in parts of Western Europe caused devastating floods, specifically in Germany. This study examines circulation types (CTs) linked to extreme precipitation in Germany. It was investigated if the classified CTs can highlight the anomaly in synoptic patterns that contributed to the unusual July 2021 heavy rainfall in Germany. The North Atlantic Oscillation was found to be the major climatic mode related to the seasonal and inter-annual variations of most of the classified CTs. On average, wet (dry) conditions in large parts of Germany can be linked to westerly (northerly) moisture fluxes. During spring and summer seasons, the mid-latitude cyclone when located over the North Sea disrupts onshore moisture transport from the North Atlantic Ocean by westerlies driven by the North Atlantic subtropical anticyclone. The CT found to have the highest probability of being associated with above-average rainfall in large part of Germany features (i) enhancement and northward track of the cyclonic system over the Mediterranean; (ii) northward track of the North Atlantic anticyclone, further displacing poleward, the mid-latitude cyclone over the North Sea, enabling band of westerly moisture fluxes to penetrate Germany; (iii) cyclonic system over the Baltic Sea coupled with northeast fluxes of moisture to Germany; (iv) and unstable atmospheric conditions over Germany. In 2021, a spike was detected in the amplitude and frequency of occurrence of the aforementioned wet CT suggesting that in addition to the nearly stationary cut-off low over central Europe, during the July flood episode, anomalies in the CT contributed to the heavy rainfall event.
Forests in Germany cover around 11.4 million hectares and, thus, a share of 32% of Germany's surface area. Therefore, forests shape the character of the country's cultural landscape. Germany's forests fulfil a variety of functions for nature and society, and also play an important role in the context of climate levelling. Climate change, manifested via rising temperatures and current weather extremes, has a negative impact on the health and development of forests. Within the last five years, severe storms, extreme drought, and heat waves, and the subsequent mass reproduction of bark beetles have all seriously affected Germany’s forests. Facing the current dramatic extent of forest damage and the emerging long-term consequences, the effort to preserve forests in Germany, along with their diversity and productivity, is an indispensable task for the government. Several German ministries have and plan to initiate measures supporting forest health. Quantitative data is one means for sound decision-making to ensure the monitoring of the forest and to improve the monitoring of forest damage. In addition to existing forest monitoring systems, such as the federal forest inventory, the national crown condition survey, and the national forest soil inventory, systematic surveys of forest condition and vulnerability at the national scale can be expanded with the help of a satellite-based earth observation. In this review, we analysed and categorized all research studies published in the last 20 years that focus on the remote sensing of forests in Germany. For this study, 166 citation indexed research publications have been thoroughly analysed with respect to publication frequency, location of studies undertaken, spatial and temporal scale, coverage of the studies, satellite sensors employed, thematic foci of the studies, and overall outcomes, allowing us to identify major research and geoinformation product gaps.
Background: Proportions of patients dying from the coronavirus disease-19 (COVID-19) vary between different countries. We report the characteristics; clinical course and outcome of patients requiring intensive care due to COVID-19 induced acute respiratory distress syndrome (ARDS).
Methods: This is a retrospective, observational multicentre study in five German secondary or tertiary care hospitals. All patients consecutively admitted to the intensive care unit (ICU) in any of the participating hospitals between March 12 and May 4, 2020 with a COVID-19 induced ARDS were included.
Results: A total of 106 ICU patients were treated for COVID-19 induced ARDS, whereas severe ARDS was present in the majority of cases. Survival of ICU treatment was 65.0%. Median duration of ICU treatment was 11 days; median duration of mechanical ventilation was 9 days. The majority of ICU treated patients (75.5%) did not receive any antiviral or anti-inflammatory therapies. Venovenous (vv) ECMO was utilized in 16.3%. ICU triage with population-level decision making was not necessary at any time. Univariate analysis associated older age, diabetes mellitus or a higher SOFA score on admission with non-survival during ICU stay.
Conclusions: A high level of care adhering to standard ARDS treatments lead to a good outcome in critically ill COVID-19 patients.