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Ultrasound practice is a longstanding tradition for radiology departments, being part of the family of imaging techniques. Ultrasound is widely practiced by non-radiologists but becoming less popular within radiology. The position of ultrasound in radiology is reviewed, and a possible long-term solution to manage radiologist expectations is proposed. An international group of experts in the practice of ultrasound was invited to describe the current organisation of ultrasound within the radiology departments in their own countries and comment on the interaction with non-radiologists and training arrangements. Issues related to regulation, non-medical practitioners, and training principles are detailed. A consensus view was sought from the experts regarding the position of ultrasound within radiology, with the vision of the best scenario for the continuing dominance of radiologists practising ultrasound. Comments were collated from nine different countries. Variable levels of training, practice, and interaction with non-radiologist were reported, with some countries relying on non-physician input to manage the service. All experts recognised there was a diminished desire to practice ultrasound by radiologists. Models varied from practising solely ultrasound and no other imaging techniques to radiology departments being central to the practice of ultrasound by radiologists and non-radiologist, housed within radiology. The consensus view was that the model favoured in select hospitals in Germany would be the most likely setup for ultrasound radiologist to develop and maintain practice. The vision for 20 years hence is for a central ultrasound section within radiology, headed by a trained expert radiologist, with non-radiologist using the facilities. Critical relevance statement The future of ultrasound within the radiology department should encompass all ultrasound users, with radiologists expert in ultrasound, managing the ultrasound section within the radiology department. The current radiology trainees must learn of the importance of ultrasound as a component of the 'holistic' imaging of the patient. Key points: 1. Ultrasound imaging within radiology departments precedes the introduction of CT and MR imaging and was first used over 50 years ago. 2. Non-radiology practitioners deploy ultrasound examinations to either 'problem solve' or perform a comprehensive ultrasound examination; radiologists provide comprehensive examinations or use ultrasound to direct interventional procedures. 3. Radiology does not 'own' ultrasound, but radiologists are best placed to offer a comprehensive patient-focused imaging assessment. 4. A vision of the future of ultrasound within the radiology department is encompassing all ultrasound users under radiologists who are experts in ultrasound, positioned within the radiology department. 5. The current radiology trainee must be aware of the importance of ultrasound as a component of the 'holistic' imaging of the patient. [ABSTRACT FROM AUTHOR]

The global trend in manufacturing has shifted from a manufacturing-centric process toward a user-centric process. This has resulted in a shorter lifespan and a high product replacement rate of any consumer product. Germany has introduced the concept of Industry Revolution 4.0 (IR 4.0) to convert manufacturing processes and mechanisms into cyber-physical systems (CPS). Digital factory, being the first step into CPS and IR4.0, is being targeted as the most important evolution of the manufacturing industry. This paper defines digital factories and their differences between other similar domains such as smart factories, CPS, and virtual factories. The requirements and goals of a digital factory are explained in detail to facilitate future digital factory tool developments. Furthermore, the current challenges faced in the implementation of the digital factory are proposed to be approached by adapting an interoperable virtual reality technology. This paper emphasizes the usage of virtual reality (VR) in simulating a digital factory that aids in the decision-making and efficient operation of a manufacturing facility. Furthermore, recommendations gathered from previous studies for developing VR-based digital factory tools are also explained in detail in this paper. [ABSTRACT FROM AUTHOR]

SEIR (Susceptible–Exposed–Infected–Recovered) approach is a classic modeling method that is frequently used to study infectious diseases. However, in the vast majority of such models transitions from one population group to another are described using the mass-action law. That causes inability to reproduce observable dynamics of an infection such as the incubation period or progression of the disease's symptoms. In this paper, we propose a new approach to simulate the epidemic dynamics based on a system of differential equations with time delays and instant transitions to approximate durations of transition processes more correctly and make model parameters more clear. The suggested approach can be applied not only to Covid-19 but also to the study of other infectious diseases. We utilized it in the development of the delay-based model of the COVID-19 pandemic in Germany and France. The model takes into account testing of different population groups, symptoms progression from mild to critical, vaccination, duration of protective immunity and new virus strains. The stringency index was used as a generalized characteristic of the non-pharmaceutical government interventions in corresponding countries to contain the virus spread. The parameter identifiability analysis demonstrated that the presented modeling approach enables to significantly reduce the number of parameters and make them more identifiable. Both models are publicly available. [ABSTRACT FROM AUTHOR]

SEIR (Susceptible–Exposed–Infected–Recovered) approach is a classic modeling method that is frequently used to study infectious diseases. However, in the vast majority of such models transitions from one population group to another are described using the mass-action law. That causes inability to reproduce observable dynamics of an infection such as the incubation period or progression of the disease's symptoms. In this paper, we propose a new approach to simulate the epidemic dynamics based on a system of differential equations with time delays and instant transitions to approximate durations of transition processes more correctly and make model parameters more clear. The suggested approach can be applied not only to Covid-19 but also to the study of other infectious diseases. We utilized it in the development of the delay-based model of the COVID-19 pandemic in Germany and France. The model takes into account testing of different population groups, symptoms progression from mild to critical, vaccination, duration of protective immunity and new virus strains. The stringency index was used as a generalized characteristic of the non-pharmaceutical government interventions in corresponding countries to contain the virus spread. The parameter identifiability analysis demonstrated that the presented modeling approach enables to significantly reduce the number of parameters and make them more identifiable. Both models are publicly available. [ABSTRACT FROM AUTHOR]

Backgound: Headache disorders are not only among the most prevalent, they are also among the most disabling disorders worldwide. This paper investigates the association between headache impact on daily life and the socioeconomic status (SES) of headache sufferers. Methods: Data stem from a random general population sample in Germany. Respondents who reported having headache for at least a year and were aged ≥ 18 years were included in the study. A standardized questionnaire addressing headache and headache treatment was filled in during the face-to-face survey. The impact of headache on daily life was measured using the German version of the Headache Impact Test (HIT-6). Results: Higher headache impact was found in low and medium SES compared to high SES. After adjustment for sociodemographics, headache-related factors (analgesic use, headache duration, headache frequency, migraine diagnosis), depressive symptoms, physical inactivity and obesity, an increased odds ratio of having higher headache impact in low SES compared to high SES was found: OR = 1.83, 95% CI [1.43, 2.23], p =.014. When the interactions "SES*obesity", "SES*depressive symptoms", and "SES*physical inactivity" were added, the results showed a significant interaction effect of "SES*obesity". Obese persons with low SES were 3.64 times more likely to have higher headache impact than non-obese persons with low SES. No significant differences between obese and non-obese persons were found in the medium and high SES groups. Conclusions: SES is an important factor that should not be neglected in headache awareness campaigns and headache treatment. Longitudinal studies are needed in the future to investigate whether lifestyle interventions, such as weight reduction, can help to reduce headache impact in people in lower SES. [ABSTRACT FROM AUTHOR]

Background: The paper examines whether the widespread assumption holds that younger birth cohorts (referred to as Millennials or Generation Y) act as pioneers of changing everyday mobility. Methodology: Based on the time-series dataset "Mobility in Germany" (Mobilität in Deutschland), cohort-specific changes in everyday bicycle and car use that have occurred between 2002 and 2017 are analyzed. The empirical analyses are differentiated by age-group and settlement type. Additionally, socio-structural factors are taken into account. Results: The results show a decline in the predominant everyday use of cars in metropolitan cities, especially among Generation Y. However, the Millennials do not emerge as pioneers of the trend toward predominant bicycle use. The results challenge the assumption that changes in everyday mobility are essentially driven by generational change. [ABSTRACT FROM AUTHOR]

This paper investigates the selection of third-party logistics providers (3PLs) based on the best prices offered by them. The focus is on outbound logistics where 3PLs must have their own distribution centres for storage and picking activities. They must also have suitable trucks for distribution to different small-scale customers. The motivation for this paper is a case study from Germany in which a furniture company with hundreds of small customers in ten zones is seeking one or more 3PLs to do the distribution. A mathematical programming model was built based on integer programming where demand per order can be expressed using exponential distribution in each customer zone. The main contribution of this paper is that it finds the best 3PLs based on the different pricing methods of the various providers; this means including the location problem indirectly using the new integer programming model. The model takes into consideration three different methods of pricing based on the offers of five 3PLs. These different methods make it difficult for the decision makers to choose the best solution, especially if specific trends in demand are expected in the future for some customer zones. The results show that future increases in demand in terms of the number of orders or order size could affect the optimal solution. The best pricing method with the lowest variability in cost over time is selected. [ABSTRACT FROM AUTHOR]

An accurate estimator of the real-time fatality rate is warranted to monitor the progress of ongoing epidemics, hence facilitating the policy-making process. However, most of the existing estimators fail to capture the time-varying nature of the fatality rate and are often biased in practice. A simple real-time fatality rate estimator with adjustment for reporting delays is proposed in this paper using the fused lasso technique. This approach is easy to use and can be broadly applied to public health practice as only basic epidemiological data are required. A large-scale simulation study suggests that the proposed estimator is a reliable benchmark for formulating public health policies during an epidemic with high accuracy and sensitivity in capturing the changes in the fatality rate over time, while the other two commonly-used case fatality rate estimators may convey delayed or even misleading signals of the true situation. The application to the COVID-19 data in Germany between January 2020 and January 2022 demonstrates the importance of the social restrictions in the early phase of the pandemic when vaccines were not available, and the beneficial effects of vaccination in suppressing the fatality rate to a low level since August 2021 irrespective of the rebound in infections driven by the more infectious Delta and Omicron variants during the fourth wave. [ABSTRACT FROM AUTHOR]

In order to slow the spread of the CoViD-19 pandemic, governments around the world have enacted a wide set of policies limiting the transmission of the disease. Initially, these focused on non-pharmaceutical interventions; more recently, vaccinations and large-scale rapid testing have started to play a major role. The objective of this study is to explain the quantitative effects of these policies on determining the course of the pandemic, allowing for factors like seasonality or virus strains with different transmission profiles. To do so, the study develops an agent-based simulation model, which explicitly takes into account test demand and behavioral changes following positive tests. The model is estimated using data for the second and the third wave of the CoViD-19 pandemic in Germany. The paper finds that during a period where vaccination rates rose from 5 to 40%, seasonality and rapid testing had the largest effect on reducing infection numbers. Frequent large-scale rapid testing should remain part of strategies to contain CoViD-19; it can substitute for many non-pharmaceutical interventions that come at a much larger cost to individuals, society, and the economy. [ABSTRACT FROM AUTHOR]

In recent years, multistatic specular meteor radars (SMRs) have been introduced to study the Mesosphere and Lower Thermosphere (MLT) dynamics with increasing spatial and temporal resolution. SMRs, compared to other ground-based observations, have the advantage of continuously measuring the region between 80 and 100 km independent of weather, season, or time of day. In this paper, frequency spectra of MLT horizontal winds are explored through observations from a campaign using the SIMONe (Spread-spectrum Interferometric Multistatic meteor radar Observing Network) approach conducted in northern Germany in 2018 (hereafter SIMONe 2018). The 7-day SIMONe 2018 comprised of fourteen multistatic SMR links and allows us to build a substantial database of specular meteor trail events, collecting more than one hundred thousand detections per day within a geographic area of ∼ 500 km × 500 km. We have implemented two methods to obtain the frequency spectra of the horizontal wind components: (1) Mean Wind Estimation (MWE) and (2) Wind field Correlation Function Inversion (WCFI), which utilizes the mean and the covariances of the line of sight velocities, respectively. Monte Carlo simulations of a gravity wave spectral model were implemented to validate and compare both methods. The simulation analyses suggest that the WCFI helps us to capture the energy of smaller scale wind fluctuations than those capture with MWE. Characterization of the spectral slope of the horizontal wind at different MLT altitudes has been conducted on the SIMONe 2018, and it provides evidence that gravity waves with periods smaller than 7 h and greater than 2 h dominate with horizontal structures significantly larger than 500 km. In the future, these analyses can be extended to understand the significance of small-scale fluctuations in the MLT, which were not possible with conventional MWE methods. [ABSTRACT FROM AUTHOR]

Since 2011, the Industry 4.0 initiative is a key research and development direction towards flexible production systems in Germany. The objective of the initiative is to deal with the challenge of an increased production complexity caused by various factors such as increasing global competition between companies, product variety, and individualization to meet customer needs. For this, Industry 4.0 envisions an overarching connection of information technologies with the production process, enabling smart manufacturing. Bringing current production systems to this objective will be a long transformation process, which requires a coherent migration path. The aim of this paper is to represent an exemplary production development way towards Industry 4.0 using eminent formalization approaches and standardized automation technologies. [ABSTRACT FROM AUTHOR]

Background: Health care costs of migraine constitute a major issue in health economics. Several publications analyzed health care costs for adult migraine patients, based on questionnaires or secondary (health insurance) data. Although migraine often starts already in primary school age, data on migraine related costs in children is scarce. In this paper we aimed to assess the migraine-related health care costs in 6 to 11 year old children in Germany. Methods: Using claims data of a large German health insurer (BARMER), overall annual health care costs of 6 to 11 year old children with a diagnosis of migraine in 2017 (n = 2597) were compared to a control group of 6 to 11 year old children without a headache diagnosis between 2013 and 2017 (n = 306,926). The association of migraine and costs was modeled by generalized linear regression (Gamma regression) with adjustment for sex, age and comorbidities. Results: Children with migraine caused considerably higher annual per capita health care costs than children without a headache diagnosis (migraine group: € 1018, control group: € 618). Excess costs directly related to migraine amounted to € 115. The remaining excess costs were related to comorbidities, which were more frequent in the migraine group. Mental and behavioural disorders constituted the most expensive comorbidity, accounting for € 105 of the € 400 annual excess costs in the migraine group. Conclusion: 6 to 11 year old children with a migraine diagnosis cause significant direct and comorbidity related excess costs in the German health care system. [ABSTRACT FROM AUTHOR]

Nature-based solutions (NBS) find increasing attention as actions to address societal challenges through harnessing ecological processes, yet knowledge gaps exist regarding approaches to landscape planning with NBS. This paper aims to provide suggestions of how planning NBS can be conceptualized and applied in practice. We develop a framework for planning NBS by merging insights from literature and a case study in the Lahn river landscape, Germany. Our framework relates to three key criteria that define NBS, and consists of six steps of planning: Co-define setting, Understand challenges, Create visions and scenarios, Assess potential impacts, Develop solution strategies, and Realize and monitor. Its implementation is guided by five principles, namely Place-specificity, Evidence base, Integration, Equity, and Transdisciplinarity. Drawing on the empirical insights from the case study, we suggest suitable methods and a checklist of supportive procedures for applying the framework in practice. Taken together, our framework can facilitate planning NBS and provides further steps towards mainstreaming. [ABSTRACT FROM AUTHOR]

Nature-based solutions (NBS) for mitigating climate change are gaining popularity. The number of NBS is increasing, but research gaps still exist at the governance level. The objectives of this paper are (i) to give an overview of the implemented NBS for flood risk management and mitigation in Germany, (ii) to identify governance models that are applied, and (iii) to explore the differences between these models. The results of a hierarchical clustering procedure and a qualitative analysis show that while no one-size-fits-all governance model exists, polycentricism is an important commonality between the projects. The study concludes by highlighting the need for further research on traditional governance model reconversion and paradigm changes. We expect the findings to identify what has worked in the past, as well as what is important for the implementation of NBS for flood risk management in future projects. [ABSTRACT FROM AUTHOR]