Im Fokus: 20 Jahre Innovationspolitik: Vom „nackten Überleben“ zur Hightech-Förderung in Ostdeutschland

The article uses the occasion of “20 years German re-unification” in order to provide an overview of the range of innovation policy schemes in East Germany with the intention to identify changing patterns or paradigms in its philosophy and priorities over time. In general, innovation policy schemes aim at increasing research and development (R&D) activities of companies in order to strengthen their competitiveness as market incentives for R&D are usually too low (problem of market failure). However, in East Germany in the early 1990s the situation was different. At the very beginning, the transformation process in East Germany was accompanied by innovation policy schemes that aimed at the pure maintenance of industrial research and the stock of R&D personnel since the potential for innovation was at a risk to be eliminated completely. In the late 1990s the intention of innovation policies changed. Instead of financial support primarily for human resources, innovation policy schemes since then focused on the support of cooperation projects between different research entities (companies and scientific organizations) and, later on, also the setup of networks in order to close the economic differences between East and West Germany.

Environmental impacts, nutritional profiles, and retail prices of commonly sold retail food items in 181 countries: an observational study

Affordability is often seen as a barrier to consuming sustainable diets. This study provides the first worldwide test of how retail food prices relate to empirically estimated environmental impacts and nutritional profile scores between and within food groups. We use prices for 811 retail food items commonly sold in 181 countries during 2011 and 2017, matched to estimated carbon and water footprints and nutritional profiles, to test whether healthier and more environmentally sustainable foods are more expensive between and within food groups. We find that within almost all groups, less expensive items have significantly lower carbon and water footprints. Associations are strongest for animal source foods, where each 10% lower price is associated with 20 grams lower CO2-equivalent carbon and 5 liters lower water footprint per 100kcal. Gradients between price and nutritional profile vary by food group, price range, and nutritional attribute. In contrast, lower-priced items have lower nutritional value in only some groups over some price ranges, and that relationship is sometimes reversed. These findings reveal opportunities to reduce financial and environmental costs of diets, contributing to transitions towards healthier, more environmentally sustainable food systems

A first-in-human, randomized, controlled, subject- and reviewer-blinded multicenter study of Actamax™ Adhesion Barrier

Purpose: Post-surgical adhesions remain a significant concern following abdominopelvic surgery. This study was to assess safety, manageability and explore preliminary efficacy of applying a degradable hydrogel adhesion barrier to areas of surgical trauma following gynecologic laparoscopic abdominopelvic surgery. Methods: This first-in-human, prospective, randomized, multicenter, subject- and reviewer-blinded clinical study was conducted in 78 premenopausal women (18–46 years) wishing to maintain fertility and undergoing gynecologic laparoscopic abdominopelvic surgery with planned clinically indicated second-look laparoscopy (SLL) at 4–12 weeks. The first two patients of each surgeon received hydrogel, up to 30 mL sprayed over all sites of surgical trauma, and were assessed for safety and application only (n = 12). Subsequent subjects (n = 66) were randomized 1:1 to receive either hydrogel (Treatment, n = 35) or not (Control, n = 31); 63 completed the SLL. Results: No adverse event was assessed as serious, or possibly device related. None was severe or fatal. Adverse events were reported for 17 treated subjects (17/47, 36.2%) and 13 Controls (13/31, 41.9%). For 95.7% of treated subjects, surgeons found the device “easy” or “very easy” to use; in 54.5%, some residual material was evident at SLL. For 63 randomized subjects who completed the SLL, adjusted between-group difference in the change from baseline adhesion score demonstrated a 41.4% reduction for Treatment compared with Controls (p = 0.017), with a 49.5% reduction (p = 0.008) among myomectomy subjects (n = 34). Conclusion: Spray application of a degradable hydrogel adhesion barrier during gynecologic laparoscopic abdominopelvic surgery was performed easily and safely, without evidence of clinically significant adverse outcomes. Data suggest the hydrogel was effective in reducing postoperative adhesion development, particularly following myomectomy

Influence of isolation technique on the survival of resin-modified glass-ionomer restorations in primary molars : a 9-months randomized controlled trial

Objective: To compare the survival of occlusal and occlusal-proximal restorations performed with resinmodified glass-ionomer cement (RMGIC) in deciduous molars using rubber dam and cotton rolls isolation. Material and Methods: Ninety-two patients were included and 200 deciduous molars with cavitated occlusal or occlusoproximal dentin caries lesions were randomized into two groups: cotton rolls (n = 100) and rubber dam (n = 100) and RMGIC restorations were placed. At baseline and in the follow-up visit, presence, severity and activity of caries lesions were registered. Two independent, blinded examiners evaluated the treated teeth clinically using the USPHS criteria and radiographically after 9 months. Descriptive analysis, survival curve (log-rank test) and Cox regression were performed to assess risk factors related to failure. Results: Out of the 179 teeth (92 cotton rolls group and 87 rubber dam group) evaluated at 9-month follow-up period. No lesion progression was observed radiographically. The overall treatment success rate was 85.47% (83.47% for cotton rolls and 87.35 rubber dam group). No significant difference between isolation methods was observed in the log-rank test (p = 0.16). Cox regression showed no risk factors related to failure. Conclusion: No difference was found in the survival of occlusal and occlusalproximal restorations performed with RMGIC in deciduous molars using a rubber dam and cotton rolls isolation after a 9-month follow-up period

PReVENT - protective ventilation in patients without ARDS at start of ventilation: study protocol for a randomized controlled trial

Background It is uncertain whether lung-protective mechanical ventilation using low tidal volumes should be used in all critically ill patients, irrespective of the presence of the acute respiratory distress syndrome (ARDS). A low tidal volume strategy includes use of higher respiratory rates, which could be associated with increased sedation needs, a higher incidence of delirium, and an increased risk of patient-ventilator asynchrony and ICU-acquired weakness. Another alleged side-effect of low tidal volume ventilation is the risk of atelectasis. All of these could offset the beneficial effects of low tidal volume ventilation as found in patients with ARDS. Methods/Design PReVENT is a national multicenter randomized controlled trial in invasively ventilated ICU patients without ARDS with an anticipated duration of ventilation of longer than 24 hours in 5 ICUs in The Netherlands. Consecutive patients are randomly assigned to a low tidal volume strategy using tidal volumes from 4 to 6 ml/kg predicted body weight (PBW) or a high tidal volume ventilation strategy using tidal volumes from 8 to 10 ml/kg PBW. The primary endpoint is the number of ventilator-free days and alive at day 28. Secondary endpoints include ICU and hospital length of stay (LOS), ICU and hospital mortality, the incidence of pulmonary complications, including ARDS, pneumonia, atelectasis, and pneumothorax, the cumulative use and duration of sedatives and neuromuscular blocking agents, incidence of ICU delirium, and the need for decreasing of instrumental dead space. Discussion PReVENT is the first randomized controlled trial comparing a low tidal volume strategy with a high tidal volume strategy, in patients without ARDS at onset of ventilation, that recruits a sufficient number of patients to test the hypothesis that a low tidal volume strategy benefits patients without ARDS with regard to a clinically relevant endpoin