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Reasons and potential solution approaches for the shortage of nursing staff in German hospitals
(2021)
The aim of this scientific paper was to find out the reasons for the shortage of nursing staff in German hospitals and to provide potential solution approaches for this shortage. Over the last years, the shortage of nursing staff has become a more and more important topic in the news: Not only due to the increasing amount of missing nurses, but also due to the ageing population in Germany, which leads to an increasing amount of patients in German hospitals. To reach this aim two surveys were done, of which one was for nursing staff only and the other one was for people from all occupational groups with the intention of creating comparative values. The surveys were done from March to April 2019 and were analysed afterwards. After a detailed analysis of the survey results, it can be summarized that the reasons for the shortage of nursing staff in German hospitals are very diverse: Starting with a weak salary, improvable working conditions – for example the shift work and the high amount of physical and psychological stress -, a difficult compatibility of family and job as well as the unattractive image of the job as a nurse in the society. It can be concluded that the solution for the shortage of nursing staff is very difficult. The future will show whether the governmental support will help to make the job as a nurse more attractive – not only for the current nurses, but also for potential future nurses.
Bauprojekte sind in der Regel komplexe Vorhaben. Sie werden mit Hilfe des Projektmanagements und dessen Verfahren, Prozessen und Techniken bewältigt. Dennoch sind deutsche Bauprojekte nicht selten von Kosten- und Terminüberschreitungen betroffen. Ziel dieser Arbeit ist es, mögliche Optimierungsfelder im Planungs- und Steuerungsprozess eines Unternehmens für Industriebauprojekte zu identifizieren und darauf aufbauende Verbesserungsansätze zu erarbeiten. Um die Ziele verfolgen zu können, wurde eine qualitative Sozialforschung mittels Experteninterviews durchgeführt. Die Expertenaussagen verdeutlichen weiterhin Optimierungspotenzial, sowohl im Planungs- als auch im Steuerungsprozess. Ausgewählte Techniken (hauptsächlich aus dem klassischen Projektmanagement) dienen indessen dazu, die Effektivität und Effizienz des Planungsprozesses zu erhöhen. Innerhalb des Steuerungsprozesses zeigt sich, dass viele Optimierungsbereiche der Steuerung auf den Defiziten der Planung beruhen.
Im Oktober 2019 veröffentlichte die Amerikanische Psychologische Gesellschaft APA die siebte, überarbeitete Auflage ihres Publikationshandbuchs "Publication Manual of the American Psychological Association". In diesem Ratgeber werden Ihnen die Grundregeln des enthaltenen Zitierregelwerks vorgestellt, ergänzt um eine Einführung in das Zitieren. Einige wenige Regeln wurden der deutschen Grammatik angepasst (z. B. hinsichtlich Kommasetzung vor "&").
Inhalt:
1. Zitieren: Einleitung
2. Zitieren: Definitionen, Grundregeln und Plagiate
3. Zitiersysteme: Klassifikation
4. Zitiersysteme: APA – ein erster Eindruck
5. Text: Kurzbelege gestalten und platzieren
6. Text: sinngemäße Zitate
7. Text: direkte Zitate
8. Literaturverzeichnis: Inhalt und Sortierung (allgemein)
9. Literaturverzeichnis: Autor-Element (allgemein)
10. Literaturverzeichnis: Datum-Element (allgemein)
11. Literaturverzeichnis: Titel-Element (allgemein)
12. Literaturverzeichnis: Quellen-Informations-Element (allgemein)
13. Literaturverzeichnis: Quellen-DOI/URL-Element (allgemein)
14. Literaturverzeichnis: Schriftwerke
14.1 Periodika (Beiträge in Zeitschriften, Zeitungen etc.)
14.2 Bücher (Fach-, Lehrbücher, Sammel-, Nachschlagewerke u. Ä.)
14.3 Beiträge in Sammel- und Nachschlagewerken
14.4 Berichte und graue Literatur
14.5 Tagungs- und Konferenzbeiträge
14.6 Dissertationen und Abschlussarbeiten
14.7 Rezensionen und Besprechungen (in Periodika oder Blogs)
14.8 Unveröffentlichte und informell veröffentlichte Werke
14.9 Normblätter
14.10 Patentschriften
14.11 Spezial: Juristische Texte
15. Datensätze, Software und Tests
15.1 Datensätze
15.2 Software, mobile Apps, Apparaturen und Ausrüstung
16. Tests, Skalen und Messinstrumente
17. Audiovisuelle Medien
17.1 Audiovisuelle Werke (allgemein)
17.2 Ton-Bild-Werke (Filme etc.)
17.3 Tonwerke (Musikalben etc.)
17.4 Bildwerke (Karten etc.)
18. Online-Medien
18.1 Soziale Medien
18.2 Webseiten und Websites
19. Abbildungszitate gemäß APA
20. Zitiersysteme: APA-Handbuch und -Zitierhilfen
21. Zitiersysteme: Alternativen
22. Extra: Tipps für das Zusammenstellen einer Literaturgrundlage
Unintended nuclear war
(2021)
Cryotropic gelation is one of the most common approaches to design novel hydrogels with multifaceted technological and biological functionalities. In the present paper, we studied the ability of highly galactosyl-substituted galactomannans, i.e. fenugreek and alfalfa gum, to form physically crosslinked hydrogels via cryogenic processing. Cycling of the galactomannan solutions (0.25 to 4% wt) from 25 to −20 to 25 °C induced the physical crosslinking of the galactomannan chains leading to the formation of different cryogel structures, i.e. filamentous aggregates (c* < c < 1%), cellular-like gel networks (1 ≤ c < 4%) or a homogeneously swollen gel (c ≥ 4%), depending on the total biopolymer content. Alfalfa gum-based cryogels exhibited higher elasticity and stiffness, better uniformity of the structure and a lower macropore size than their fenugreek counterparts. The physical blending of alfalfa or fenugreek gum with locust bean gum (2% total biopolymer) led to the reinforcement of the mechanical properties of the cryogels without significantly altering their microstructural aspects.
The present work aimed at investigating an extraction protocol based on consecutive steps of isoelectric point (pH ~ 4.25) mediated gum swelling and deproteinisation as an alternative method to produce flaxseed gum extracts of enhanced techno-functional characteristics. The osidic and proximate composition, structure conformation, flow behaviour, dynamic rheological and thermal properties of gums isolated from brown and golden flaxseeds were assessed. Gum extraction under near-to-isoelectric point conditions did not impair the extraction yield, residual protein and ash content, whilst it resulted in minor changes in the sugar composition of the flaxseed gum extracts. The deconvolution of the GPC/SEC chromatographs revealed the presence of four major polysaccharidic populations corresponding to arabinoxylans, rhamnogalacturonan–I and two AX-RG-I composite fractions. The latter appeared to minimise the intra- and interchain polymer non-covalent interactions (hydrogen bonding) leading to a better solvation affinity in water and lyotropic solvents. Golden flaxseed gums exerted higher molecular weight (Mw = 1.34–1.15 × 106 Da) and intrinsic viscosities (6.63–5.13 dL g−1) as well as better thickening and viscoelastic performance than the brown flaxseed gum exemplars. Golden flaxseed gums exhibited a better thermal stability compared to the brown flaxseed counterparts and therefore, they are suitable for product applications involving severe heat treatments.
Optimal mental workload plays a key role in driving performance. Thus, driver-assisting systems that automatically adapt to a drivers current mental workload via brain–computer interfacing might greatly contribute to traffic safety. To design economic brain computer interfaces that do not compromise driver comfort, it is necessary to identify brain areas that are most sensitive to mental workload changes. In this study, we used functional near-infrared spectroscopy and subjective ratings to measure mental workload in two virtual driving environments with distinct demands. We found that demanding city environments induced both higher subjective workload ratings as well as higher bilateral middle frontal gyrus activation than less demanding country environments. A further analysis with higher spatial resolution revealed a center of activation in the right anterior dorsolateral prefrontal cortex. The area is highly involved in spatial working memory processing. Thus, a main component of drivers’ mental workload in complex surroundings might stem from the fact that large amounts of spatial information about the course of the road as well as other road users has to constantly be upheld, processed and updated. We propose that the right middle frontal gyrus might be a suitable region for the application of powerful small-area brain computer interfaces.
Intraspecific diet specialization, usually driven by resource availability, competition and predation, is common in natural populations. However, the role of parasites on diet specialization of their hosts has rarely been studied. Eye flukes can impair vision ability of their hosts and have been associated with alterations of fish feeding behavior. Here it was assessed whether European perch (Perca fluviatilis) alter their diet composition as a consequence of infection with eye flukes. Young-of-the-year (YOY) perch from temperate Lake Müggelsee (Berlin, Germany) were sampled in two years, eye flukes counted and fish diet was evaluated using both stomach content and stable isotope analyses. Perch diet was dominated by zooplankton and benthic macroinvertebrates. Both methods indicated that with increasing eye fluke infection intensity fish had a more selective diet, feeding mainly on the benthic macroinvertebrate Dikerogammarus villosus, while less intensively infected fish appeared to be generalist feeders showing no preference for any particular prey type. Our results show that infection with eye flukes can indirectly affect interaction of the host with lower trophic levels by altering the diet composition and highlight the underestimated role of parasites in food web studies.
The aim of this work was to develop and evaluate the reinforcement learning algorithm VentAI, which is able to suggest a dynamically optimized mechanical ventilation regime for critically-ill patients. We built, validated and tested its performance on 11,943 events of volume-controlled mechanical ventilation derived from 61,532 distinct ICU admissions and tested it on an independent, secondary dataset (200,859 ICU stays; 25,086 mechanical ventilation events). A patient “data fingerprint” of 44 features was extracted as multidimensional time series in 4-hour time steps. We used a Markov decision process, including a reward system and a Q-learning approach, to find the optimized settings for positive end-expiratory pressure (PEEP), fraction of inspired oxygen (FiO2) and ideal body weight-adjusted tidal volume (Vt). The observed outcome was in-hospital or 90-day mortality. VentAI reached a significantly increased estimated performance return of 83.3 (primary dataset) and 84.1 (secondary dataset) compared to physicians’ standard clinical care (51.1). The number of recommended action changes per mechanically ventilated patient constantly exceeded those of the clinicians. VentAI chose 202.9% more frequently ventilation regimes with lower Vt (5–7.5 mL/kg), but 50.8% less for regimes with higher Vt (7.5–10 mL/kg). VentAI recommended 29.3% more frequently PEEP levels of 5–7 cm H2O and 53.6% more frequently PEEP levels of 7–9 cmH2O. VentAI avoided high (>55%) FiO2 values (59.8% decrease), while preferring the range of 50–55% (140.3% increase). In conclusion, VentAI provides reproducible high performance by dynamically choosing an optimized, individualized ventilation strategy and thus might be of benefit for critically ill patients.
Introduction: The use of social marketing strategies to induce the promotion of cognitive health has received little attention in research. The objective of this scoping review is twofold: (i) to identify the social marketing strategies that have been used in recent years to initiate and maintain health-promoting behaviour; (ii) to advance research in this area to inform policy and practice on how to best make use of these strategies to promote cognitive health.
Methods and analysis: We will use the five-stage methodological framework of Arksey and O'Malley. Articles in English published since 2010 will be searched in electronic databases (the Cochrane Library, DoPHER, the International Bibliography of the Social Sciences, PsycInfo, PubMed, ScienceDirect, Scopus). Quantitative and qualitative study designs as well as reviews will be considered. We will include those articles that report the design, implementation, outcomes and evaluation of programmes and interventions concerning social marketing and/or health promotion and/or promotion of cognitive health. Grey literature will not be searched. Two independent reviewers will assess in detail the abstracts and full text of selected citations against the inclusion criteria. A Preferred Reporting Items for Systematic Reviews and Meta-Analyses flowchart for Scoping Reviews will be used to illustrate the process of article selection. We will use a data extraction form, present the results through narrative synthesis and discuss them in relation to the scoping review research questions.
Ethics and dissemination: Ethics approval is not required for conducting this scoping review. The results of the review will be the first step to advance a conceptual framework, which contributes to the development of interventions targeting the promotion of cognitive health. The results will be published in a peer-reviewed scientific journal. They will also be disseminated to key stakeholders in the field of the promotion of cognitive health.
Vibroarthrography measures joint sounds caused by sliding of the joint surfaces over each other. and can be affected by joint health, load and type of movement. Since both warm-up and muscle fatigue lead to local changes in the knee joint (e.g., temperature increase, lubrication of the joint, muscle activation), these may impact knee joint sounds. Therefore, this study investigates the effects of warm-up and muscle fatiguing exercise on knee joint sounds during an activity of daily living. Seventeen healthy, physically active volunteers (25.7 ± 2 years, 7 males) performed a control and an intervention session with a wash-out phase of one week. The control session consisted of sitting on a chair, while the intervention session contained a warm-up (walking on a treadmill) followed by a fatiguing exercise (modified sit-to-stand) protocol. Knee sounds were recorded by vibroarthrography (at the medial tibia plateau and at the patella) at three time points in each session during a sit-to-stand movement. The primary outcome was the mean signal amplitude (MSA, dB). Differences between sessions were determined by repeated measures ANOVA with intra-individual pre-post differences for the warm-up and for the muscle fatigue effect. We found a significant difference for MSA at the medial tibia plateau (intervention: mean 1.51 dB, standard deviation 2.51 dB; control: mean -1.28 dB, SD 2.61 dB; F = 9.5; p = .007; η2 = .37) during extension (from sit to stand) after the warm-up. There was no significant difference for any parameter after the muscle fatiguing exercise (p > .05). The increase in MSA may mostly be explained by an increase in internal knee load and joint friction. However, neuromuscular changes may also have played a role. It appears that the muscle fatiguing exercise has no impact on knee joint sounds in young, active, symptom-free participants during sit to stand.
Understanding and modulating CNS function in physiological as well as pathophysiological contexts remains a significant ambition in research and clinical applications. The investigation of the multifaceted CNS cell types including their interactions and contributions to neural function requires a combination of the state-of-the-art in vivo electrophysiology and imaging techniques. We developed a novel type of liquid crystal polymer (LCP) surface micro-electrode manufactured in three customized designs with up to 16 channels for recording and stimulation of brain activity. All designs include spare central spaces for simultaneous 2P-imaging. Nanoporous platinum-plated contact sites ensure a low impedance and high current transfer. The epidural implantation of the LCP micro-electrodes could be combined with standard cranial window surgery. The epidurally positioned electrodes did not only display long-term biocompatibility, but we also observed an additional stabilization of the underlying CNS tissue. We demonstrate the electrode’s versatility in combination with in vivo 2P-imaging by monitoring anesthesia-awake cycles of transgenic mice with GCaMP3 expression in neurons or astrocytes. Cortical stimulation and simultaneous 2P Ca2+ imaging in neurons or astrocytes highlighted the astrocytes’ integrative character in neuronal activity processing. Furthermore, we confirmed that spontaneous astroglial Ca2+ signals are dampened under anesthesia, while evoked signals in neurons and astrocytes showed stronger dependency on stimulation intensity rather than on various levels of anesthesia. Finally, we show that the electrodes provide recordings of the electrocorticogram (ECoG) with a high signal-to noise ratio and spatial signal differences which help to decipher brain activity states during experimental procedures. Summarizing, the novel LCP surface micro-electrode is a versatile, convenient, and reliable tool to investigate brain function in vivo.
As productive biofilms are increasingly gaining interest in research, the quantitative monitoring of biofilm formation on- or offline for the process remains a challenge. Optical coherence tomography (OCT) is a fast and often used method for scanning biofilms, but it has difficulty scanning through more dense optical materials. X-ray microtomography (μCT) can measure biofilms in most geometries but is very time-consuming. By combining both methods for the first time, the weaknesses of both methods could be compensated. The phototrophic cyanobacterium Tolypothrix distorta was cultured in a moving bed photobioreactor inside a biocarrier with a semi-enclosed geometry. An automated workflow was developed to process µCT scans of the biocarriers. This allowed quantification of biomass volume and biofilm-coverage on the biocarrier, both globally and spatially resolved. At the beginning of the cultivation, a growth limitation was detected in the outer region of the carrier, presumably due to shear stress. In the later phase, light limitations could be found inside the biocarrier. µCT data and biofilm thicknesses measured by OCT displayed good correlation. The latter could therefore be used to rapidly measure the biofilm formation in a process. The methods presented here can help gain a deeper understanding of biofilms inside a process and detect any limitations.
Thailand’s power system has been facing an energy transition due to the increasing amount of Renewable Energy (RE) integration, prosumers with self-consumption, and digitalization-based business models in a Local Energy Market (LEM). This paper introduces a decentralized business model and a possible trading platform for electricity trading in Thailand’s Micro-Grid to deal with the power system transformation. This approach is Hybrid P2P, a market structure in which sellers and buyers negotiate on energy exchanging by themselves called Fully P2P trading or through the algorithm on the market platform called Community-based trading. A combination of Auction Mechanism (AM), Bill Sharing (BS), and Traditional Mechanism (TM) is the decentralized price mechanism proposed for the Community-based trading. The approach is validated through a test case in which, during the daytime, the energy import and export of the community are significantly reduced when 75 consumers and 25 PV rooftop prosumers participate in this decentralized trading model. Furthermore, a comparison analysis confirms that the decentralized business model outperforms a centralized approach on community and individual levels.
The implementation of single-use technologies offers several major advantages, e.g. prevention of cross-contamination, especially when spore-forming microorganisms are present. This study investigated the application of a single-use bioreactor in batch fermentation of filamentous fungus Penicillium sp. (IBWF 040-09) from the Institute of Biotechnology and Drug Research (IBWF), which is capable of intracellular production of a protease inhibitor against parasitic proteases as a secondary metabolite. Several modifications to the SU bioreactor were suggested in this study to allow the fermentation in which the fungus forms pellets. Simultaneously, fermentations in conventional glass bioreactor were also conducted as reference. Although there are significant differences in the construction material and gassing system, the similarity of the two types of bioreactors in terms of fungal metabolic activity and the reproducibility of fermentations could be demonstrated using statistic methods. Under the selected cultivation conditions, growth rate, yield coefficient, substrate uptake rate, and formation of intracellular protease-inhibiting substance in the single-use bioreactor were similar to those in the glass bioreactor.
Purification of mRNA with oligo(dT)-functionalized magnetic particles involves a series of magnetic separations for buffer exchange and washing. Magnetic particles interact and agglomerate with each other when a magnetic field is applied, which can result in a decreased total surface area and thus a decreased yield of mRNA. In addition, agglomeration may also be caused by mRNA loading on the magnetic particles. Therefore, it is of interest how the individual steps of magnetic separation and subsequent redispersion in the buffers used affect the particle size distribution. The lysis/binding buffer is the most important buffer for the separation of mRNA from the multicomponent suspension of cell lysate. Therefore, monodisperse magnetic particles loaded with mRNA were dispersed in the lysis/binding buffer and in the reference system deionized water, and the particle size distributions were measured. A concentration-dependent agglomeration tendency was observed in deionized water. In contrast, no significant agglomeration was detected in the lysis/binding buffer. With regard to magnetic particle recycling, the influence of different storage and drying processes on particle size distribution was investigated. Agglomeration occurred in all process alternatives. For de-agglomeration, ultrasonic treatment was examined. It represents a suitable method for reproducible restoration of the original particle size distribution.
Laboratory protocols using magnetic beads have gained importance in the purification of mRNA for vaccines. Here, the produced mRNA hybridizes specifically to oligo(dT)-functionalized magnetic beads after cell lysis. The mRNA-loaded magnetic beads can be selectively separated using a magnet. Subsequently, impurities are removed by washing steps and the mRNA is eluted. Magnetic separation is utilized in each step, using different buffers such as the lysis/binding buffer. To reduce the time required for purification of larger amounts of mRNA vaccine for clinical trials, high-gradient magnetic separation (HGMS) is suitable. Thereby, magnetic beads are selectively retained in a flow-through separation chamber. To meet the requirements of biopharmaceutical production, a disposable HGMS separation chamber with a certified material (United States Pharmacopeia Class VI) was developed which can be manufactured using 3D printing. Due to the special design, the filter matrix itself is not in contact with the product. The separation chamber was tested with suspensions of oligo(dT)-functionalized Dynabeads MyOne loaded with synthetic mRNA. At a concentration of cB = 1.6–2.1 g·L–1 in lysis/binding buffer, these 1 μm magnetic particles are retained to more than 99.39% at volumetric flows of up to 150 mL·min–1 with the developed SU-HGMS separation chamber. When using the separation chamber with volumetric flow rates below 50 mL·min–1, the retained particle mass is even more than 99.99%.
Modeling and executing knowledge-intensive processes (KiPs) are challenging with state-of-the-art approaches, and the specific demands of KiPs are the subject of ongoing research. In this context, little attention has been paid to the ontology-driven combination of data-centric and semantic business process modeling, which finds additional motivation by enabling the division of labor between humans and artificial intelligence. Such approaches have characteristics that could allow support for KiPs based on the inferencing capabilities of reasoners. We confirm this as we show that reasoners can infer the executability of tasks based on a currently researched ontology- and data-driven business process model (ODD-BP model). Further support for KiPs by the proposed inference mechanism results from its ability to infer the relevance of tasks, depending on the extent to which their execution would contribute to process progress. Besides these contributions along with the execution perspective (start-to-end direction), we will also show how our approach can help to reach specific process goals by inferring the relevance of process elements regarding their support to achieve such goals (end-to-start direction). The elements with the most valuable process progress can be identified in the intersection of both, the execution and goal perspective. This paper will introduce this new approach and verifies its practicability with an evaluation of a KiP in the field of emergency call centers.
Carbon footprinting of universities worldwide: Part I — objective comparison by standardized metrics
(2021)
Background: Universities, as innovation drivers in science and technology worldwide, should be leading the Great Transformation towards a carbon–neutral society and many have indeed picked up the challenge. However, only a small number of universities worldwide are collecting and publishing their carbon footprints, and some of them have defined zero emission targets. Unfortunately, there is limited consistency between the reported carbon footprints (CFs) because of different analysis methods, different impact measures, and different target definitions by the respective universities.
Results: Comprehensive CF data of 20 universities from around the globe were collected and analysed. Essential factors contributing to the university CF were identified. For the first time, CF data from universities were not only compared. The CF data were also evaluated, partly corrected, and augmented by missing contributions, to improve the consistency and comparability. The CF performance of each university in the respective year is thus homogenized, and measured by means of two metrics: CO2e emissions per capita and per m2 of constructed area. Both metrics vary by one order of magnitude across the different universities in this study. However, we identified ten universities reaching a per capita carbon footprint of lower than or close to 1.0 Mt (metric tons) CO2e/person and year (normalized by the number of people associated with the university), independent from the university’s size. In addition to the aforementioned two metrics, we suggested a new metric expressing the economic efficiency in terms of the CF per $ expenditures and year. We next aggregated the results for all three impact measures, arriving at an overall carbon performance for the respective universities, which we found to be independent of geographical latitude. Instead the per capita measure correlates with the national per capita CFs, and it reaches on average 23% of the national impacts per capita. The three top performing universities are located in Switzerland, Chile, and Germany.
Conclusion: The usual reporting of CO2 emissions is categorized into Scopes 1–3 following the GHG Protocol Corporate Accounting Standard which makes comparison across universities challenging. In this study, we attempted to standardize the CF metrics, allowing us to objectively compare the CF at several universities. From this study, we observed that, almost 30 years after the Earth Summit in Rio de Janeiro (1992), the results are still limited. Only one zero emission university was identified, and hence, the transformation should speed up globally.
Radar signal processing is a promising tool for vital sign monitoring. For contactless observation of breathing and heart rate a precise measurement of the distance between radar antenna and the patient’s skin is required. This results in the need to detect small movements in the range of 0.5 mm and below. Such small changes in distance are hard to be measured with a limited radar bandwidth when relying on the frequency based range detection alone. In order to enhance the relative distance resolution a precise measurement of the observed signal’s phase is required. Due to radar reflections from surfaces in close proximity to the main area of interest the desired signal of the radar reflection can get superposed. For superposing signals with little separation in frequency domain the main lobes of their discrete Fourier transform (DFT) merge into a single lobe, so that their peaks cannot be differentiated. This paper evaluates a method for reconstructing the phase and amplitude of such superimposed signals.