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Background: The health status, health awareness and health behavior of persons with a migration background often differ from the autochthonous population. Little is known about the proportion of patients with a migration background (PMB) that participate in primary care studies on oral antithrombotic treatment (OAT) in Germany, and whether the quality of their antithrombotic care differs from patients without a migration background. The aim of this paper was to use the results of a cluster-randomized controlled trial (PICANT) to determine the proportion of PMB at different stages of recruitment, and to compare the results in terms of sociodemographic characteristics and antithrombotic treatment.
Methods: This study used screening and baseline data from the PICANT trial on oral anticoagulation management in GP practices. For this analysis, we determined the proportion of PMB during the recruitment period at stage 1 (screening of potentially eligible patients), stage 2 (eligible patients invited to participate in the trial), and stage 3 (assessment of baseline characteristics of patients participating in the PICANT trial). In addition, we compared patients in terms of sociodemographic characteristics and quality of anticoagulant treatment. Statistical analysis comprised descriptive and bivariate analyses.
Results: The proportion of PMB at each recruitment stage declined from 9.1% at stage 1 to 7.9% at stage 2 and 7.3% at stage 3). A lack of German language skills led to the exclusion of half the otherwise eligible PMB. At stages 1 and 3, PMB were younger (stage 1: 70.7 vs. 75.0 years, p<0.001; stage 3: 70.2 vs. 73.5 years, p = 0.013), but did not differ in terms of gender. The quality of their anticoagulant care was comparable (100.0% vs. 99.1% were receiving appropriate OAT, 94.4% vs. 95.7% took phenprocoumon, or warfarin, and the most recent INR measurement of 60.8% vs. 69.3% was within their individual INR range).
Conclusions: In the potentially eligible population and among participants at baseline, the quality of anticoagulant care was high in all groups of patients, which is reassuring. To enable the inclusion of more PMB, future primary care research on OAT in Germany should address how best to overcome language barriers. This will be challenging, particularly because the heterogeneity of PMB means the resulting sample sizes for each specific language group are small.
Trial registration: Current Controlled Trials ISRCTN41847489.
We provide a review of the enoplid suborder Trefusiina Siddiqi, 1983, based on morphological considerations and analyses of new and published 18S rDNA sequences. We also describe Halanonchus scintillatulus Leduc sp. nov. from the Hauraki Gulf, northern New Zealand, as well as females of Trefusialaimus idrisi Leduc, 2013 from the continental slope of New Zealand. We show for the first time that the structure of the female reproductive system of Trefusialaimus Riemann, 1974 consists of two opposed and outstretched ovaries, an unusual feature for the Enoplida. The Trefusiina did not form a monophyletic group in the 18S rDNA phylogeny due to the placement of Lauratonema Gerlach, 1953 and Trefusialaimus sequences well away from the main Trefusiina clade. However, due to generally weak Maximum Likelihood support values, we refrain from changing the classification of these taxa until more comprehensive analyses can be conducted. Our phylogenetic analysis supports the inclusion of the Trischistomatidae Andrássy, 2007 within the Trefusiina, meaning that all of the enoplid suborders now include at least some terrestrial/freshwater representatives. The Trefusiina currently comprises five families, 14 genera and 92 valid species.
Feasibility, design and sensitivity studies on innovative nuclear reactors that could address the issue of nuclear waste transmutation using fuels enriched in minor actinides, require high accuracy cross section data for a variety of neutron-induced reactions from thermal energies to several tens of MeV. The isotope 241Am (T1/2= 433 years) is present in high-level nuclear waste (HLW), representing about 1.8 % of the actinide mass in spent PWR UOx fuel. Its importance increases with cooling time due to additional production from the β-decay of 241Pu with a half-life of 14.3 years. The production rate of 241 Am in conventional reactors, including its further accumulation through the decay of 241Pu and its destruction through transmutation/incineration are very important parameters for the design of any recycling solution. In the present work, the 241 Am(n,f) reaction cross-section was measured using Micromegas detectors at the Experimental Area 2 of the n_TOF facility at CERN. For the measurement, the 235U(n,f) and 238U(n,f) reference reactions were used for the determination of the neutron flux. In the present work an overview of the experimental setup and the adopted data analysis techniques is given along with preliminary results.
Introduction: Reliable and cost-effective diagnostics for hepatitis E virus (HEV) infection are necessary. The aim of our study was to investigate which diagnostic test is most accurate to detect HEV infection in immunocompetent and immunosuppressed patients in a real world setting. Patients and Methods: We performed a retrospective analysis of 1165 patients tested for HEV antibodies and HEV PCR at the same time point. Clinical, laboratory and virological data were taken from patient charts. HEV IgA was measured in a subgroup of 185 patients. Results: HEV RNA was detectable in 61 patients (5.2%); most of them (n = 49, 80.3%/n = 43, 70.5%) were HEV IgM+ and IgG+; however, 12 patients (19.6%) were HEV RNA positive/HEV IgM negative and 17 patients (27.8%) were HEV RNA positive/HEV IgG negative. Ten HEV RNA positive patients (16.4%) had neither HEV IgG nor IgM antibodies. Importantly, all of them were immunosuppressed. HEV IgA testing was less sensitive than HEV IgM for HEV diagnosis. Conclusions: HEV infection can be overlooked in patients without HEV specific antibodies. Performing PCR is necessary to diagnose or exclude HEV infection in immunocompromised hosts. In immunocompetent patients, a screening based on HEV antibodies (IgG/IgM) is sufficient.
Human cytomegalovirus (CMV) is a significant cause of morbidity and mortality in patient groups at risk. We have previously shown that the anti-CMV IgG seroprevalence in an urban region of Germany has changed over the last decades. Overall, a decline from 63.7 to 57.25% had been observed between 1988–1997 and 1998–2008 (p < 0,001). Here, we continuously follow the trends to the most recent decade 2009 to 2018. In a retrospective analysis, we determined the seroprevalence of CMV IgG antibodies in our patient cohort, stratified by gender and selected groups at risk (e.g., patients with HIV infection; women of childbearing age). The overall prevalence of anti-CMV IgG non-significantly declined further from 57.25% in 1998–2008 to 56.48% in 2009–2018 (p = 0.881). Looking at gender differences, overall CMV seroprevalence in males declined to 52.82% (from 55.54% in 1998–2008; p = 0.0254), while it non-significantly increased in females to 59.80%. The high seroprevalence in patients with a known HIV infection further increased from 87.46% in 1998–2008 to 92.93% in the current period (p = 0.9999). In women of childbearing age, no significant changes over the last three decades could be observed. The CMV seroprevalence in oncological patients was determined to be 60.64%. Overall, the former significant decline of CMV seroprevalence between the decades 1988–1997 and 1998–2008 in this urban region of Germany slowed down to a non-significant decrease of 0.77% (1998–2008 vs. 2009–2018). This might be an indicator that CMV seroprevalence has reached a plateau.
We study the incidence and severity of lower-bound episodes and the efficacy of three types of state-dependent policies—forward guidance about the future path of interest rates, large-scale asset purchases and spending-based fiscal stimulus—in ameliorating the adverse consequences stemming from the effective lower bound on nominal interest rates. In particular, we focus on the euro area economy and examine, using the ECB’s New Area- Wide Model, the consequences of the lower bound both for the near-term economic outlook, characterised by persistently low nominal interest rates and inflation, and in a lasting low-real-interest-rate world. Our findings suggest that, if unaddressed, the lower bound can have very substantial costs in terms of worsened macroeconomic performance. Forward guidance, if fully credible, is most powerful and can largely undo the distortionary effects due to the lower bound. A combination of imperfectly credible forward guidance, asset purchases and fiscal stimulus is almost equally effective, in particular when asset purchases enhance the credibility of the forward guidance policy via a signalling effect.
Die vorliegende Arbeit zielt auch darauf ab, aus der Analyse des Konzepts der Mimesis eine Reihe von theoretischen Kanten zu gewinnen, die als normative oder transformierende Gesichtspunkte betrachtet werden können. Das heißt, Standpunkte, auf die die Theorien der Gegenwart noch zurückgreifen können, nicht nur um eine diagnostische Analyse des sozialen Ganzen vorzunehmen, sondern auch um Vorschläge zur Veränderung des sozialen Charakters zu unterbreiten. Diese Möglichkeit kann noch als normativer Ansatz in Adornos Werk bezeichnet werden. Solche theoretischen Perspektiven sind notwendige Folgen der Analyse des Begriffs der Mimesis.
Die Übersetzung, insbesondere die literarische, ist vor allem eine Art Kulturübertragung. Neben der Beherrschung der Sprachen setzt sie die Kenntnis des Allgemeinen und Besonderen des Landes wie Kultur, Tradition, Glauben, geschichtliche und gesellschaftliche Begebenheiten und auch soziale Strukturen voraus. Wenn die Sprachen und Kulturen tiefgreifend wahrgenommen werden, können die übersetzten Texte die Adressaten erreichen, d.h., dass die Ausgangssprache und -kultur für die Zielrezipienten verständlich sein können. So wird der Übersetzer als Kulturträger angenommen. Cornelius Bischoff ist beispielsweise ein wohlbekannter Name für den deutschen und türkischen Literaturkreis. Er ist vor allem bekannt als "der deutscheste Türke und der türkischste Deutsche" sowie als eine Brücke zwischen Deutschland und der Türkei. Das Ziel der vorliegenden Arbeit ist es, Cornelius Bischoff, einen Kulturträger zwischen der deutschen und türkischen Übersetzung, zu behandeln. Als ein "Haymatloser" fand er in der Türkei die Möglichkeit, die türkische Sprache und Kultur wesentlich kennenzulernen und viele türkische Werke ins Deutsche zu übersetzen. Als ein Übersetzer trug er zuallererst dazu bei, die türkische Literatur, die bedeutenden türkischen Schriftsteller, die türkische Kultur und Tradition sowie den türkischen Sprachgebrauch in Deutschland bekannt zu machen. In der vorliegenden Arbeit wird die Besonderheit Bischoffs in der Übersetzungswelt im Hinblick auf drei Aspekte diskutiert: zuerst im Hinblick auf den Zusammenhang seiner Wurzeln in der Türkei und im Türkischen - schon in seinen Wurzeln, besonders mütterlicherseits, wurde das Türkische verinnerlicht -, dann auf die in der Türkei verbrachten Jahre - die Jahre, in denen er "haymatlos" genannt wurde - und zuletzt auf die Wahrnehmung und Aneignung der türkischen Sprache, Kultur und Gesellschaft - was auf ihn lebenslang einwirkte. In diesem Kontext wird versucht, sein Leben, seine Werke und seine Wirkung im Rahmen der übersetzerischen Tätigkeit zu analysieren.