The impact of regional socioeconomic deprivation on the timing of HIV diagnosis: a cross-sectional study in Germany

Background: HIV infections which are diagnosed at advanced stages are associated with significantly poorer health outcomes. In Germany, the proportion of persons living with HIV who are diagnosed at later stages has remained continuously high. This study examined the impact of regional socioeconomic deprivation on the timing of HIV diagnosis. Methods: We used data from the national statutory notification of newly diagnosed HIV infections between 2011 and 2018 with further information on the timing of diagnosis determined by the BED-Capture-ELISA test (BED-CEIA) and diagnosing physicians. Data on regional socioeconomic deprivation were derived from the German Index of Socioeconomic Deprivation (GISD). Outcome measures were a non-recent infection based on the BED-CEIA result or an infection at the stage of AIDS. The effect of socioeconomic deprivation on the timing of diagnosis was analysed using multivariable Poisson regression models with cluster-robust error variance. Results: Overall, 67.5% (n = 10,810) of the persons were diagnosed with a non-recent infection and 15.2% (n = 2746) with AIDS. The proportions were higher among persons with heterosexual contact compared to men who have sex with men (MSM) (76.8% non-recent and 14.9% AIDS vs. 61.7% non-recent and 11.4% AIDS). MSM living in highly deprived regions in the countryside (< 100 k residents) were more likely to have a non-recent infection (aPR: 1.16, 95% CI: 1.05–1.28) as well as AIDS (aPR: 1.41, 95% CI: 1.08–1.85) at the time of diagnosis compared to MSM in less deprived regions in the countryside. No differences were observed among MSM from towns (100 k ≤ 1 million residents) or major cities (≥ 1 million residents), and no differences overall in the heterosexual transmission group. Conclusions: An effect of socioeconomic deprivation on the timing of HIV diagnosis was found only in MSM from countryside regions. We suggest that efforts in promoting HIV awareness and regular HIV testing are increased for heterosexual persons irrespective of socioeconomic background, and for MSM with a focus on those living in deprived regions in the countryside.Peer Reviewe

Report and preliminary results of SONNE cruise SO175, Miami - Bremerhaven, 12.11 - 30.12.2003 : (GAP, Gibraltar Arc Processes)

Expedition SO175 using FS Sonne aimed for a multidisciplinerary geoscientific approach with an international group of researchers. Methods covered the entire span from geophysical data acquisition (seafloor mapping, echography, seismic reflection), sediment coring at sites of active fluid venting, in situ heat flow measurements across the entire length of the Gibraltar thrust wedge, the deformation front, landslide bodies, and mud volcanoes, and finally the deployment of a long-term pore pressure probe. Video-supported operations helped to identify fluid vent sites, regions with tectonic activity, and other attractive high priority targets. Qualitative and quantitative examinations took place on board and are continued on land with respect to pore pressure variation, geomicrobiology, sediment- and fluid mobilization, geochemical processes, faunal assemblages (e.g. cold water corals), and gas hydrates (flammable methane-ice-crystals). Main focus of the expedition has been a better understanding of interaction between dynamic processes in a seismically active region region with slow plate convergence. In the context of earthquake nucleation and subduction zone processes, the SO175 research programme had a variety of goals, such as: • To test the frictional behaviour of the abyssal plain sediments. • To explore the temperature field of the 1755 thrust earthquake event via heat flow measurements. • To assess the role of fluid venting and gas hydrate processes control slope stability and mud volcanic activity along the Iberian continental margin. • To measure isotope geochemistry of pore waters and carbonates of deep fluids. • To quantify microbial activity in Gibraltar wedge sediments. • To test whether microseismicity in the area corresponds to in situ pore pressure changes. • To find out if enhanced heat flow max be indicative of active subduction. Initial tentative results during the cruise suggest that there is a component of active thrusting at the base of the wedge, as attested by heat flow data. Based on mostly geochemical evidence, mud volcanism was found less active than previously assumed. Highlights from post-cruise research include the successful deployment of the long-term station and high frictional resistance of all incoming sediment on the three abyssal plains

Facilitation of Digital Change of Teaching in School by Professional Learning Communities: Use of Multiplicators to Establish Learning Communities

Zahlreiche Studien zeigen, dass die wirkungsvolle Implementierung von Innovationen davon profitiert und sich positive Effekte auf die Schüler:innen nachweisen lassen, wenn Lehrpersonen kooperieren. In vielen Fällen einer solchen Zusammenarbeit handelt es sich um professionelle Lerngemeinschaften, typischerweise bestehend aus Lehrpersonen, Schulleitung, Schulverwaltung und Wissenschaft. Unter einer Professionellen Lerngemeinschaft (PLG) wird eine «Gemeinschaft fortlaufender Forschung und Verbesserung» verstanden, in der alle Gruppenmitglieder sowohl miteinander als auch voneinander lernen. Eine offene Frage in der Forschung zu Professionellen Lerngemeinschaften ist, inwieweit anstelle einer intensiven Kooperation mit Vertreter:innen aus der Wissenschaft geschulte Multiplikator:innen die Inhalte aus der Wissenschaft einbringen und die Arbeit in den Lerngemeinschaften fördern können. Dieser Fragestellung wird im Rahmen dieser Pilotstudie nachgegangen. Zu diesem Zweck wurden an drei bayerischen Schulen (zwei Mittelschulen, eine Realschule) professionelle Lerngemeinschaften zur Digitalisierung des MINT-Unterrichts in der Schule im Schuljahr 2020/2021 gegründet. Die Befunde der durchgeführten Interviewstudie deuten darauf hin, dass die wissenschaftliche Unterstützung von Lerngemeinschaften zur Digitalisierung von Unterricht in der Schule mit Ausnahme der evidenzbasierten Arbeit an Unterrichtskonzepten erfolgreich mithilfe von Multiplikator:innen umgesetzt werden kann. Für die fachspezifische Unterstützung sollten jedoch zusätzliche Lehrpersonen (z. B. die Fachleitungen) geschult werden, um die fachbezogene Arbeit an den Unterrichtskonzepten zu unterstützen.Numerous studies provide evidence that successful implementation of innovation as well as learning of students benefit from teacher collaboration. Such collaboration often takes place as part of so-called Professional Learning Communities (PLC). PLCs are communities of learners that continuously do research with the goal of further improvement at three levels: individual, community, and institution. All members of PLC learn from and with each other through collaborative work to reach a joint goal. An open issue in research on PLC is, however, to what extent an intensive collaboration with Science can be compensated by facilitation through specifically trained multiplicators. To what extent can multiplicators place the scientific content and facilitate the collaboration within a PLC? To answer these research questions, PLCs on digitalization of teaching STEM in school were founded in 2020/2021 at three Bavarian secondary schools (two Mittelschulen, one Realschule). The results of the conducted interview study suggest, that multiplicators can successfully establish PLCs. However, not all functions of scientific PLC members can be equally compensated. To fulfill the needs of the PLC, additional multiplicators with focus on STEM didactics (e. g., heads of STEM subjects from the schools themselves) may be trained to support the subject-related work on material for teaching with digital media

Progressive skin fibrosis is associated with a decline in lung function and worse survival in patients with diffuse cutaneous systemic sclerosis in the European Scleroderma Trials and Research (EUSTAR) cohort.

Objectives To determine whether progressive skin fibrosis is associated with visceral organ progression and mortality during follow-up in patients with diffuse cutaneous systemic sclerosis (dcSSc). Methods We evaluated patients from the European Scleroderma Trials and Research database with dcSSc, baseline modified Rodnan skin score (mRSS) ≥7, valid mRSS at 12±3 months after baseline and ≥1 annual follow-up visit. Progressive skin fibrosis was defined as an increase in mRSS &gt;5 and ≥25% from baseline to 12±3 months. Outcomes were pulmonary, cardiovascular and renal progression, and all-cause death. Associations between skin progression and outcomes were evaluated by Kaplan-Meier survival analysis and multivariable Cox regression. Results Of 1021 included patients, 78 (7.6%) had progressive skin fibrosis (skin progressors). Median follow-up was 3.4 years. Survival analyses indicated that skin progressors had a significantly higher probability of FVC decline ≥10% (53.6% vs 34.4%; p&lt;0.001) and all-cause death (15.4% vs 7.3%; p=0.003) than non-progressors. These significant associations were also found in subgroup analyses of patients with either low baseline mRSS (≤22/51) or short disease duration (≤15 months). In multivariable analyses, skin progression within 1 year was independently associated with FVC decline ≥10% (HR 1.79, 95% CI 1.20 to 2.65) and all-cause death (HR 2.58, 95% CI 1.31 to 5.09). Conclusions Progressive skin fibrosis within 1 year is associated with decline in lung function and worse survival in dcSSc during follow-up. These results confirm mRSS as a surrogate marker in dcSSc, which will be helpful for cohort enrichment in future trials and risk stratification in clinical practice

Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study

Objectives. Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations.Methods. SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses.Results. The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P &lt; 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P &lt; 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P &lt; 0.001) diffuse skin involvement than had WP.AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P &lt; 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P &lt; 0.001; OR(BP) = 2.4, P &lt; 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P &lt; 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P &lt; 0.001].Conclusion. Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality

timeseriesdb: Manage and Archive Time Series Data in Establishment Statistics with R and PostgreSQL

timeseriesdb is an R package which suggests a PostgreSQL database structure to store time series alongside extensive multi-lingual meta information and provides an R database interface including a web based GUI. The timeseriesdb package was designed to handle time series in establishment statistics. Information such as the GDP or data stemming from the aggregation of economic surveys is typically published on a monthly, quarterly or yearly basis. Hence the package is optimized to handle a large amount of dierent time series as opposed to managing a smaller number of high frequency time series such as real time data obtained from measuring devices. The particular focus of timeseriesdb is to help the user nd and extract a particular set of information within a larger set of information. The timeseriesdb package intends to provide the infrastructure for a time series catalog as opposed to handling time series operations on database level. The underlying structure relies on PostgreSQL's hstore data type which allows to store an array of key-value pairs in a single cell. The hstore data type is not only used to reduce the number of records by storing an entire time series in a single record but also to store a record specic amount of multi-lingual meta information items exibly