Threshold Effects and Regional Economic Growth – Evidence from West Germany

We study an overlapping generations model of human capital accumulation with threshold effects using regional data for West Germany. Our basic goal is to shed light on what makes German regions grow. The paper finds that the relative income distribution appears to be stratifying into a trimodal distribution. Thus, application of the threshold model to a real world case, here West Germany, shows that the model might help to explain regional growth patterns.regional economic growth, human capital, Germany

Benchmarking and environmental performance classes in life cycle assessment—development of a procedure for non-leather shoes in the context of the Product Environmental Footprint

Purpose: In the process of developing Product Environmental Footprint Category Rules (PEFCR)—currently tested in various pilots in the Single Market for Green Products initiative of the European Commission—the definition of product category benchmarks and environmental performance classes is a crucial element of each PEFCR. Whilst life cycle assessment (LCA) methodology developed over the last 20 years can be used for many other topics to be tackled in the pilots, there is a clear lack of methodology for the determination of benchmarks and environmental performance classes. In this article, hence, we address this gap and develop a procedure for benchmarking and environmental performance classes in LCA. Methods: To do this, given requirements and definitions of the PEF guidelines on both subjects are taken as a basis and are refined by using common LCA techniques like hot spot and sensitivity analyses. The specific steps of the procedure are applied systematically in a case study using sports shoes as an example. Results and discussion: The resulting procedure involves the definition of a scenario vector, which is composed of relevant life cycle phases as well as the lifetime of the product (i.e. sports shoes) as variables. On the basis of the hot spot and sensitivity analyses, these variables are quantified, first, to generate the benchmark and, second, to determine the environmental performance classes around the benchmark for each considered impact category individually. In addition, the influence of data uncertainty on the class distribution is assessed with the help of the Monte Carlo simulation. Conclusions: The results of the application in the case study demonstrate the high impact of the product’s lifetime on the final environmental performance classes, and the importance of data quality. Limitations are identified regarding data availability and the harmonisation of the classes to potentially create a PEF label. A debate is induced on the validity of such a label when considering the fact that the characterisation methods and factors proposed in the PEF guidelines may not be complete or accurate enough

Risk-taking and self-harm behaviors as markers of adolescent borderline personality disorder.

Adolescence is a critical period for early identification and intervention of borderline personality disorder (BPD). Risk-taking and self-harm behaviors (RSB) have been identified as promising early markers of BPD and correlates of depression in school-based samples. The present study aimed, first, to examine the association between RSB and BPD in a clinical sample of adolescents and, second, to examine whether RSB are also linked to depression. N = 405 participants (82.7% female) were recruited from an outpatient clinic for adolescents with RSB. RSB assessed included truancy, excessive media use, alcohol, tobacco, and illicit drug use, sexual risk-taking, and self-harm behavior. Regression analyses and generalized linear models were performed to examine the associations between individual RSB or patterns of RSB (identified using latent class analysis, LCA) and a diagnosis and severity of BPD or depression. All RSB (except excessive media use) were positively associated with BPD diagnosis and severity. In contrast, only non-suicidal self-injury (NSSI) and suicide attempts were positively associated with depression diagnosis and severity, while illicit drug use was negatively associated with depression severity. The LCA yielded two classes differing in the occurrence of RSB. The high RSB class was more likely to have a BPD diagnosis and greater BPD severity than the low RSB class. Classes did not differ regarding depression diagnosis or severity. As NSSI and suicide attempts were associated with both BPD and depression, the presence of additional RSB, besides self-harm behavior, may represent a specific risk marker for BPD in adolescents

Einsatz von Instrumenten bei der klinischen Untersuchung in deutschen HNO-Abteilungen und Privatpraxen heutzutage

Background: The classical forehead reflector as traditionally used by ear, nose, and throat (ENT) physicians for the ENT examination is now iconic for doctors in general. It is unknown which instruments are currently used in Germany to clinically examine ENT patients. Therefore, this study aims to present results of a survey about commonly used instruments. Materials and methods: An evaluation of 321 questionnaires from ENT doctors working in general and university hospitals (172) and in private practices (149) was performed. Results: The ENT mirror examination is nowadays carried out with a self-illuminating headlamp with battery and/or light guide cable. Approximately 20% of respondents also use a forehead mirror. The microscope is used by 90% of doctors to examine the ears; a rigid endoscope was used in 53.3% to examine the larynx, epipharynx (41.1%), and the nose/sinuses (34.6%). Flexible endoscopes and otoscopes are used only rarely. Conclusion: The self-illuminating headlamp, which is more often wireless in eastern Germany, has largely replaced the classical forehead reflector, with which doctors younger than 40 years were no longer trained. At least some organs are also examined very regularly with the microscope or rigid endoscope. The flexible endoscope and otoscope are used much less frequently overall, mainly by younger physicians and ENT doctors working in hospitals. The diagnostic potential of flexible endoscopy may be compromised by the outpatient remuneration structures in Germany

Studienprotokoll: Register zur Prognose akut-symptomatischer Anfälle (PROSA-Register) – eine prospektive multizentrische Beobachtungsstudie

Background: Acute symptomatic epileptic seizures occur in close temporal relation to an acute disturbance of brain function. They are associated with a low risk of subsequent unprovoked seizures; thus, current guidelines recommend not to administer a long-term antiseizure medication; however, in clinical practice long-term secondary seizure prophylaxis is frequently initiated. The seizure prognosis after guideline-conform untreated or only briefly treated acute symptomatic seizures, is so far unknown. Hypothesis: Following an acute symptomatic first epileptic seizure of structural etiology, the 1-year risk of subsequent unprovoked seizures is not higher than 25%, even if antiseizure medication was not applied or for a short period only. Methods: The PROSE register is a single-arm, open, prospective, multicenter observational study. A total of 115 subjects aged 18 years or older with an acute symptomatic first epileptic seizure of structural etiology will be included if the seizure was not a status epilepticus. Intrahospital follow-up will be based on the hospital records. Telephone follow-up interviews will be conducted 3, 6, and 12 months after the acute symptomatic seizure. Discussion: The PROSE register will shed light on current treatment practice of acute symptomatic seizures and the actual seizure outcome within 1 year. The results are assumed to support the current evidence that giving antiseizure medication for a longer period of time exceeding the acute phase of the underlying condition is unnecessary

Improved multiplex ligation-dependent probe amplification analysis identifies a deleterious PMS2 allele generated by recombination with crossover between PMS2 and PMS2CL

Heterozygous PMS2 germline mutations are associated with Lynch syndrome. Up to one third of these mutations are genomic deletions. Their detection is complicated by a pseudogene (PMS2CL), which - owing to extensive interparalog sequence exchange - closely resembles PMS2 downstream of exon 12. A recently redesigned multiplex ligation-dependent probe amplification (MLPA) assay identifies PMS2 copy number alterations with improved reliability when used with reference DNAs containing equal numbers of PMS2- and PMS2CL-specific sequences. We selected eight such reference samples - all publicly available - and used them with this assay to study 13 patients with PMS2-defective colorectal tumors. Three presented deleterious alterations: an Alu-mediated exon deletion; a 125-kb deletion encompassing PMS2 and four additional genes (two with tumor-suppressing functions); and a novel deleterious hybrid PMS2 allele produced by recombination with crossover between PMS2 and PMS2CL, with the breakpoint in intron 10 (the most 5' breakpoint of its kind reported thus far). We discuss mechanisms that might generate this allele in different chromosomal configurations (and their diagnostic implications) and describe an allele-specific PCR assay that facilitates its detection. Our data indicate that the redesigned PMS2 MLPA assay is a valid first-line option. In our series, it identified roughly a quarter of all PMS2 mutations. © 2012 Wiley Periodicals, Inc

High prevalence of BRCA1 stop mutation c.4183C>T in the Tyrolean population: implications for genetic testing

Screening for founder mutations in BRCA1 and BRCA2 has been discussed as a cost-effective testing strategy in certain populations. In this study, comprehensive BRCA1 and BRCA2 testing was performed in a routine diagnostic setting. The prevalence of the BRCA1 stop mutation c.4183C>T, p.(Gln1395Ter), was determined in unselected breast and ovarian cancer patients from different regions in the Tyrol. Cancer registry data were used to evaluate the impact of this mutation on regional cancer incidence. The mutation c.4183C>T was detected in 30.4% of hereditary BRCA1-associated breast and ovarian cancer patients in our cohort. It was also identified in 4.1% of unselected (26% of unselected triple negative) Tyrolean breast cancer patients and 6.8% of unselected ovarian cancer patients from the Lower Inn Valley (LIV) region. Cancer incidences showed a region-specific increase in age-stratified breast and ovarian cancer risk with standardized incidence ratios of 1.23 and 2.13, respectively. We, thus, report a Tyrolean BRCA1 founder mutation that correlates to a local increase in the breast and ovarian cancer risks. On the basis of its high prevalence, we suggest that targeted genetic analysis should be offered to all women with breast or ovarian cancer and ancestry from the LIV region

Temporal variations of perfluoroalkyl substances and polybrominated diphenyl ethers in alpine snow

The occurrence and temporal variation of 18 perfluoroalkyl substances (PFASs) and 8 polybrominated diphenyl ethers (PBDEs) in the European Alps was investigated in a 10 m shallow firn core from Colle Gnifetti in the Monte RosaMassif (4455mabove sea level). The firn core encompasses the years 1997e2007. Firn core sections were analyzed by liquid chromatographyetandem mass spectrometry (PFASs) and gas chromatographyemass spectrometry (PBDEs). We detected 12 PFASs and 8 PBDEs in the firn samples. Perfluorobutanoic acid (PFBA; 0.3e1.8 ng L1) and perfluorooctanoic acid (PFOA; 0.2e0.6 ng L1) were the major PFASs while BDE 99 (<MQLe4.5 ng L1) and BDE 47 (n.d.e2.6 ng L1) were the major PBDEs. This study demonstrates the occurrence of PFASs and PBDEs in the European Alps and provides the first evidence that PFASs compositions may be changing to PFBA-dominated composition

Agglomeration, Spatial Interaction and Convergence in the EU

We investigate the convergence process among EU regions between 1980-2002 taking into account the effects of spatial heterogeneity and spatial spillover effects. The spatial regimes model allows for different steady-state growth paths. In contrast to previous analyses, the regimes in this paper refer to spatial categories, i.e. we assume that agglomerations, urbanised and rural regions are characterised by group-specific steadystates. Moreover, the regression analysis considers the effects of interaction among neighbouring regions, possibly leading to a spatial dependence of regional growth rates. We check whether spatial dependence is caused by spatial spillovers or based on country effects