Palliative care in Germany from a public health perspective: qualitative expert interviews

<p>Abstract</p> <p>Background</p> <p>Improving palliative care is a public health priority. However, little is known about the views of public health experts regarding the state of palliative care in Germany and the challenges facing it. The main aim of this pilot study was to gather information on the views of internationally experienced public health experts with regard to selected palliative care issues, with the focus on Germany, and to compare their views with those of specialist palliative care experts. Qualitative guided interviews were performed with ten experts (five from palliative care, five from public health). The interviews were analysed using qualitative content analysis.</p> <p>Findings</p> <p>Older people and non-cancer patients were identified as target groups with a particular priority for palliative care. By contrast to the public health experts, the palliative care experts emphasized the need for rehabilitative measures for palliative patients and the possibilities of providing these. Significant barriers to the further establishment of palliative care were seen, amongst other things, in the powerful lobby groups and the federalism of the German health system.</p> <p>Conclusion</p> <p>The findings suggest that from the experts' point of view (1) palliative care should focus on the needs of older people particularly in view of the demographic changes; (2) more attention should be paid to rehabilitative measures in palliative care; (3) rivalries among different stakeholders regarding their responsibilities and the allocation of financial resources have to be overcome in Germany.</p

From Fibers and Yarns to Scaffolds and Skins

Architectures of Weaving bridges architecture and textile by exploring fiber architectures from the micro scale of biological systems to the macro scale of textile and built structures. Selected case studies, essays, and interviews reflect on cultural practices and materials research through the lens of textile thinking. In the quest for sustainable and resilient approaches that meet the challenges of our time, the book presents fascinating approaches heralding a paradigm shift by working with fibrous materiality: structures become flexible and adaptive, they interact with their environment. As a source of inspiration, the book assembles exceptional contributions from the fields of architecture, art, material science, cultural history, design, engineering, mathematics, microbiology, and textile technology.Peer Reviewe

Indentation-induced two-way shape-memory effect in aged Ti-50.9 at.% Ni

In this study, Vickers indentation was used to investigate the two-way shape-memory effect (TWSME) in an austenitic Ti-50.9 at.% Ni alloy, exposed to different heat treatments. Three aging treatments were used to manipulate the size of Ti3Ni4 precipitates. All samples were Vickers indented, and the indent depth was investigated as function of thermal cycling. The TWSME was found only in the material aged at 400 °C, which contained coherent precipitates. Thermal cycling shows stable TWSME, however, heating well above the austenite finish temperature lead to permanent austenitic protrusions. The results indicate that stabilized martensite plays a critical role in creating TWSME surfaces

Grüner Wasserstoff in der Industrie : kurzfristige Einsatzpotentiale und langfristige Bedarfe in Deutschland

Die Forschung der FVEE-Institute zum Einsatz von klimaneutral erzeugtem Wasserstoff in der Industrie deckt sowohl technische Aspekte für einzelne Prozesse ab als auch systemanalytische Betrachtungen, die die Einsatzmöglichkeiten von Wasserstoff am einzelnen Standort oder für bestimmte Branchen in Deutschland bzw. Europa untersuchen. Die Motivation zum Einsatz von Wasserstoff ergibt sich aus drei Gründen: 1. In der stofflichen Verwendung wird Wasserstoff als Molekül benötigt und kann deshalb auch nicht durch andere Energieträger substituiert werden. So wird Wasserstoff bereits heute in großen Mengen in der Ammoniaksynthese (Haber-Bosch-Verfahren) sowie in den Raffinerien benötigt. 2. Eine weitere Verwendungsart für Wasserstoff ergibt sich aus seiner Fähigkeit, Sauerstoff aus Eisenerz chemisch zu binden. Beim Einsatz in Direktreduktionsanlagen kann Wasserstoff als Reduktionsmittel eingesetzt werden, um Eisenerz zu Roheisen zu reduzieren. 3. Als dritte Option gerät die energetische Verwendung von Wasserstoff in der Industrie zunehmend in den Fokus der energiepolitischen Debatten. Hier steht Wasserstoff in einem klimaneutralen System direkt in Konkurrenz zu anderen Energieträgern wie Strom und Biomasse

Biochemical characterization of a multi-drug resistant HIV-1 subtype AG reverse transcriptase: antagonism of AZT discrimination and excision pathways and sensitivity to RNase H inhibitors

We analyzed a multi-drug resistant (MR) HIV-1 re- verse transcriptase (RT), subcloned from a patient- derived subtype CRF02 AG, harboring 45 amino acid exchanges, amongst them four thymidine analog mutations (TAMs) relevant for high-level AZT (azi- dothymidine) resistance by AZTMP excision (M41L, D67N, T215Y, K219E) as well as four substitutions of the AZTTP discrimination pathway (A62V, V75I, F116Y and Q151M). In addition, K65R, known to an- tagonize AZTMP excision in HIV-1 subtype B was present. Although MR-RT harbored the most signif- icant amino acid exchanges T215Y and Q151M of each pathway, it exclusively used AZTTP discrimi- nation, indicating that the two mechanisms are mu- tually exclusive and that the Q151M pathway is ob- viously preferred since it confers resistance to most nucleoside inhibitors. A derivative was created, ad- ditionally harboring the TAM K70R and the rever- sions M151Q as well as R65K since K65R antago- nizes excision. MR-R65K-K70R-M151Q was compe- tent of AZTMP excision, whereas other combinations thereof with only one or two exchanges still pro- moted discrimination. To tackle the multi-drug resis- tance problem, we tested if the MR-RTs could still be inhibited by RNase H inhibitors. All MR-RTs exhibited similar sensitivity toward RNase H inhibitors be- longing to different inhibitor classes, indicating the importance of developing RNase H inhibitors further as anti-HIV drugs

Grüner Wasserstoff in der Industrie – kurzfristige Einsatzpotenziale und langfristige Bedarfe in Deutschland

Der vorliegende Tagungsbeitrag widmet sich den Chancen und Herausforderungen der industriellen Nutzung von grünem Wasserstoff als effizientes Werkzeug zur Dekarbonisierung im Rahmen der Energiewende. Hierzu werden aktuelle Wasserstoffstrategien ausgewählter emissionsintensiver Industriezweige vorgestellt und deren Umsetzung im Hinblick auf die am Standort vorhandene Infratruktur und die poltischen Rahmenbedingungen beleuchtet. Darüber hinaus werden aktuelle Forschungsprojekte des Wuppertal Instituts und des DLR mit Themenbezug Wasserstoff vorgestellt

O Kaspertheater no Nacional-Socialismo - uma conversa com Gerd Bohlmeier sobre estratégias de propaganda nazistas

Entrevista com Gerd Bohlmeier realizada pelas pesquisadoras Adriana Schneider Alcure e Mareike Gaubitz e traduzida por Sofia Osthoff Bediaga

DEMON: a Proposal for a Satellite-Borne Experiment to study Dark Matter and Dark Energy

We outline a novel satellite mission concept, DEMON, aimed at advancing our comprehension of both dark matter and dark energy, taking full advantage of two complementary methods: weak lensing and the statistics of galaxy clusters. We intend to carry out a 5000 sqdeg combined IR, optical and X-ray survey with galaxies up to a redshift of z~2 in order to determine the shear correlation function. We will also find ~100000 galaxy clusters, making it the largest survey of this type to date. The DEMON spacecraft will comprise one IR/optical and eight X-ray telescopes, coupled to multiple cameras operating at different frequency bands. To a great extent, the technology employed has already been partially tested on ongoing missions, therefore ensuring improved reliability.Comment: 12 pages, 3 figures, accepted for publication in the SPIE conference proceeding

Nanolithography Based on the Formation and Manipulation of Nanometer-Size Organic Liquid Menisci

In this work we form and manipulate nanometer-size liquid bridges of nonpolar organic solvents such as octane and 1-octene with a dynamic force microscope. These menisci have been used to confine chemical reactions that gave rise to the fabrication of nanometer-size structures.Peer reviewe

A gradient-based approach to fast and accurate head motion compensation in cone-beam CT

Cone-beam computed tomography (CBCT) systems, with their portability, present a promising avenue for direct point-of-care medical imaging, particularly in critical scenarios such as acute stroke assessment. However, the integration of CBCT into clinical workflows faces challenges, primarily linked to long scan duration resulting in patient motion during scanning and leading to image quality degradation in the reconstructed volumes. This paper introduces a novel approach to CBCT motion estimation using a gradient-based optimization algorithm, which leverages generalized derivatives of the backprojection operator for cone-beam CT geometries. Building on that, a fully differentiable target function is formulated which grades the quality of the current motion estimate in reconstruction space. We drastically accelerate motion estimation yielding a 19-fold speed-up compared to existing methods. Additionally, we investigate the architecture of networks used for quality metric regression and propose predicting voxel-wise quality maps, favoring autoencoder-like architectures over contracting ones. This modification improves gradient flow, leading to more accurate motion estimation. The presented method is evaluated through realistic experiments on head anatomy. It achieves a reduction in reprojection error from an initial average of 3mm to 0.61mm after motion compensation and consistently demonstrates superior performance compared to existing approaches. The analytic Jacobian for the backprojection operation, which is at the core of the proposed method, is made publicly available. In summary, this paper contributes to the advancement of CBCT integration into clinical workflows by proposing a robust motion estimation approach that enhances efficiency and accuracy, addressing critical challenges in time-sensitive scenarios.Comment: This work has been submitted to the IEEE for possible publication. Copyright may be transferred without notice, after which this version may no longer be accessibl