How effective is drinking natural mineral water against heartburn from functional dyspepsia, gastroesophageal reflux disease or other causes? A systematic review of clinical intervention studies

Background For centuries, spring and other natural waters have been recommended as external or internal remedies for numerous diseases. For studies that examined the effects of drinking mineral waters against heartburn, gastroesophageal reflux disease (GERD), or functional dyspepsia a systematic review is lacking. Objectives The main aim of this systematic review was to examine the effects of drinking natural mineral waters on heartburn from various causes by identifying all published intervention studies and critically appraising their methods as well as summarizing their results. Methods We systematically searched the largest medical literature database MEDLINE, further relevant web sources and gray literature for randomized and non-randomized trials, with or without control groups, up to September 2021 and no language restrictions. Further inclusion criteria were adult patients with heartburn, drinking cure with natural mineral water as intervention, compared to no or other interventions (care-as-usual, waiting list). We defined the reduction of heartburn symptoms and duration of disease episodes as primary and quality of life as secondary outcomes. Two reviewers independently carried out the study quality assessments (risk of bias) using the National Institutes of Health-Study Quality Assessment Tools. Results Nine trials comprising 393 patients from Italy, Russia, Ukraine, and Germany fulfilled all inclusion criteria. We identified three randomized controlled trials (all with poor methodological quality), plus six before-after (pre/post) intervention studies without a control group. The intervention groups of the three comparative trials seemed to show a stronger reduction of self-reported heartburn symptoms, and duration of heartburn episodes than the respective control groups, however they all had a poor methodological quality. Conclusion Based on the best available evidence of clinical studies, we cannot recommend or advise against drinking natural mineral waters as a treatment for heartburn. The potential benefits of natural mineral waters that were reported in some studies with a lower evidence level (e.g., lacking a control group) should be verified by good quality randomized clinical trials with adequate comparison groups and longer follow-up periods. .

Die Dinosaurier und das Weltklima

Der Einschlag des im Durchmesser 14 km messenden Asteroiden vor 66 Millionen Jahren auf unserem Planeten kam urplötzlich – und hatte gravierende Folgen 1. Geologisch hinterließ er im Durchmesser den 180 km messenden Chicxulub-Krater auf der mexikanischen Halbinsel Yukatan, biologisch war er der Anfang vom Ende der Dinosaurier. Von diesen „schrecklichen Echsen“ (griechisch: „deinos sauros“) stammen die beindruckend großen Fossilien, welche heute in Naturkundemuseen weltweit zu bestaunen sind. Das mit diesem Ereignis verbundene Sterben von drei Vierteln aller Arten – nicht nur bei den Sauriern – als Folge eines globalen Winters und einer anschließenden anhaltenden Abkühlung erstreckte sich vermutlich über Tausende von Jahren. Es markierte den Übergang von der Kreidezeit in ein neues Erdzeitalter, welches insbesondere den Säugetieren neue ökologische Nischen zur weiteren erfolgreichen Entfaltung bot. Es war das fünfte massenhafte Artensterben innerhalb der letzten 500 Millionen Jahre gewesen. Deren Auslöser waren neben dem beschriebenen Asteroideneinschlag (Ereignis fünf) eine rasche alternierende Abfolge von Kalt- und Warmzeiten (Ereignis eins), eine globale Kaltzeit infolge der Besiedlung des Landes durch Pflanzen (Ereignis zwei), intensive vulkanische Aktivitäten mit Übersäuerung durch Kohlendioxid und Schwefelwasserstoffe zu Lande und zu Wasser (Ereignis drei) sowie tiefseeische Vulkanausbrüche mit globaler Erwärmung und chemischen Veränderungen in den Ozeanen (Ereignis vier) 2.

Klagelieder

Klagelieder sind wohl so alt wie die Menschheit – und das nicht ohne Grund: Not und Leid, von Menschen verschuldetes und unverschuldetes Unheil, das über Einzelne, Familien, Städte und auch ganze Bevölkerungsgruppen und Völker hereinbricht, bieten reichlich Anlass. Konkrete Ausformungen sind Krankheit und Tod, die Kluft zwischen arm und reich, soziale Zurückweisung und Ausgrenzung, Unterdrückung und Ungerechtigkeit, Seuchen, Unruhen, Kriege. Ausdruck findet die diesbezügliche Menschheitsklage in den Klage- und Trauerliedern, Lamentos und Nänien aller Zeiten, von den biblischen Jeremiaden bis zum Blues der Neuzeit.

Maria Theresia und ihre Kinder

Maria Theresia, Regentin von Österreich, Böhmen und Ungarn und ab 1745 auch Kaiserin des Heiligen Römischen Reichs, hatte kein leichtes Amt. Als sie 1780 im Alter von 63 Jahren starb, hatte sie ihren Herrschaftsraum – aus einer feudalen Staatsordnung kommend – im Sinne eines „aufgeklärten Absolutismus“ umgestaltet. Ihr Mann, Kaiser Franz, war bereits 1765 im Alter von 57 Jahren gestorben und ihr gemeinsamer Sohn Joseph II. war als Kaiser und Mitregent an dessen Stelle getreten – er starb 1790 mit 48 Jahren. Von ihren 16 Kindern erreichten nur zwei mit jeweils 65 Jahren ein höheres Lebensalter als sie selbst. Ein Kind war im ersten Lebensjahr gestorben, fünf weitere Kinder vor ihrem 18. Geburtstag 1. Für Aufsehen sorgte auch der frühe Tod ihrer 38jährigen Tochter Marie Antoinette 1793 durch eine Guillotine der Französischen Revolution: Diese hatte dem dortigen, unaufgeklärt gebliebenen Absolutismus ein Ende gesetzt. „Media vita in morte sumus – Mitten im Leben sind wir im Tod“, singt ein mittelalterlicher gregorianischer Choral.

Vibrational entropy of disordering in omphacite

The cations of an ordered omphacite from the Tauern window were gradually disordered in piston cylinder experiments at temperatures between 850 and 1150 °C. The samples were examined by X-ray powder diffraction and then investigated using low-temperature calorimetry and IR spectroscopy. The low-temperature heat capacity data were used to obtain the vibrational entropies, and the line broadening of the IR spectra served as a tool to investigate the disordering enthalpy. These data were then used to calculate the configurational entropy as a function of temperature. The vibrational entropy does not change during the cation ordering phase transition from space group C2/c to P2/n at 865 °C but increases with a further temperature increase due to the reduction of short-range order.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00269-023-01260-7.

Aufarbeitung von COVID-19: Der Elefant im Raum

Die Redewendung vom „Elefanten im Raum“ stammt ursprünglich aus einer russischen Fabel, welche vom Museumsbesuch eines Wissbegierigen erzählt, der vor lauter Begeisterung über kleine Insekten den im selben Raum ebenfalls ausgestellten großen Elefanten übersieht 1. Abstrahiert beschreibt Krylows Fabel einen Sachverhalt, welcher angesichts seiner Bedeutung das Gespräch dominieren und große Aufmerksamkeit bekommen müsste, aber überraschender Weise nicht thematisiert wird. Auch aus dem asiatischen Raum ist eine Lehrerzählung mit Bezug zu einem Elefanten überliefert. So wird im buddhistischen Palikanon die Geschichte von blind geborenen Männern erzählt, die von ihrem König an jeweils unterschiedliche Stellen eines Elefanten herangeführt werden – Kopf, Ohren, Stoßzähne, Rüssel, Beine, Schwanz usw. – und anschließend berichten sollen, was ein Elefant sei. Die Antworten fallen recht unterschiedlich aus: Der den Kopf des Elefanten betasten konnte, zieht den Vergleich mit einem großen Kessel, der das Ohr betastet hatte, berichtet von einer Ähnlichkeit mit einer Schaufel, der den Stoßzahn betastet hatte, zieht den Vergleich mit einer Pflugschar, andere berichten von einer Stange, einer Säule und einem Besen. „Und unter dem Geschrei: ,So ist ein Elefant, ein Elefant ist nicht so; nicht so ist ein Elefant, ein Elefant ist so’, wurden sie mit den Fäusten gegenseitig handgemein. […] Genau so, ihr Mönche, verhält es sich mit den Wanderasketen verschiedener Richtungen. Blind und augenlos erkennen sie nicht, worauf es ankommt und worauf es nicht ankommt; sie erkennen nicht die Wahrheit und was nicht die Wahrheit ist.“ 2.

Self-Assessment of Having COVID-19 With the Corona Check Mhealth App

At the beginning of the COVID-19 pandemic, with a lack of knowledge about the novel virus and a lack of widely available tests, getting first feedback about being infected was not easy. To support all citizens in this respect, we developed the mobile health app Corona Check. Based on a self-reported questionnaire about symptoms and contact history, users get first feedback about a possible corona infection and advice on what to do. We developed Corona Check based on our existing software framework and released the app on Google Play and the Apple App Store on April 4, 2020. Until October 30, 2021, we collected 51,323 assessments from 35,118 users with explicit agreement of the users that their anonymized data may be used for research purposes. For 70.6% of the assessments, the users additionally shared their coarse geolocation with us. To the best of our knowledge, we are the first to report about such a large-scale study in this context of COVID-19 mHealth systems. Although users from some countries reported more symptoms on average than users from other countries, we did not find any statistically significant differences between symptom distributions (regarding country, age, and sex). Overall, the Corona Check app provided easily accessible information on corona symptoms and showed the potential to help overburdened corona telephone hotlines, especially during the beginning of the pandemic. Corona Check thus was able to support fighting the spread of the novel coronavirus. mHealth apps further prove to be valuable tools for longitudinal health data collection.

Associations of Country-Specific and Sociodemographic Factors With Self-Reported COVID-19-Related Symptoms: Multivariable Analysis of Data From the CoronaCheck Mobile Health Platform

BACKGROUND

The COVID-19 symptom-monitoring apps provide direct feedback to users about the suspected risk of infection with SARS-CoV-2 and advice on how to proceed to prevent the spread of the virus. We have developed the CoronaCheck mobile health (mHealth) platform, the first free app that provides easy access to valid information about the risk of infection with SARS-CoV-2 in English and German. Previous studies have suggested that the clinical characteristics of individuals infected with SARS-CoV-2 vary by age, gender, and viral variant; however, potential differences between countries have not been adequately studied.

OBJECTIVE

The aim of this study is to describe the characteristics of the users of the CoronaCheck mHealth platform and to determine country-specific and sociodemographic associations of COVID-19-related symptoms and previous contacts with individuals infected with COVID-19.

METHODS

Between April 8, 2020, and February 3, 2022, data on sociodemographic characteristics, symptoms, and reports of previous close contacts with individuals infected with COVID-19 were collected from CoronaCheck users in different countries. Multivariable logistic regression analyses were performed to examine whether self-reports of COVID-19-related symptoms and recent contact with a person infected with COVID-19 differed between countries (Germany, India, South Africa), gender identities, age groups, education, and calendar year.

RESULTS

Most app users (N=23,179) were from Germany (n=8116, 35.0%), India (n=6622, 28.6%), and South Africa (n=3705, 16.0%). Most data were collected in 2020 (n=19,723, 85.1%). In addition, 64% (n=14,842) of the users were male, 52.1% (n=12,077) were ≥30 years old, and 38.6% (n=8953) had an education level of more than 11 years of schooling. Headache, muscle pain, fever, loss of smell, loss of taste, and previous contacts with individuals infected with COVID-19 were reported more frequently by users in India (adjusted odds ratios [aORs] 1.3-8.3, 95% CI 1.2-9.2) and South Africa (aORs 1.1-2.6, 95% CI 1.0-3.0) than those in Germany. Cough, general weakness, sore throat, and shortness of breath were more frequently reported in India (aORs 1.3-2.6, 95% CI 1.2-2.9) compared to Germany. Gender-diverse users reported symptoms and contacts with confirmed COVID-19 cases more often compared to male users.

CONCLUSIONS

Patterns of self-reported COVID-19-related symptoms and awareness of a previous contact with individuals infected with COVID-19 seemed to differ between India, South Africa, and Germany, as well as by gender identity in these countries. Viral symptom-collecting apps, such as the CoronaCheck mHealth platform, may be promising tools for pandemics to support appropriate assessments. Future mHealth research on country-specific differences during a pandemic should aim to recruit representative samples.

Analysis of seven SARS-CoV-2 rapid antigen tests in detecting omicron (B.1.1.529) versus delta (B.1.617.2) using cell culture supernatants and clinical specimens

PURPOSE

Omicron is rapidly spreading as a new SARS-CoV-2 variant of concern (VOC). The question whether this new variant has an impact on SARS-CoV-2 rapid antigen test (RAT) performance is of utmost importance. To obtain an initial estimate regarding differences of RATs in detecting omicron and delta, seven commonly used SARS-CoV-2 RATs from different manufacturers were analysed using cell culture supernatants and clinical specimens.

METHODS

For this purpose, cell culture-expanded omicron and delta preparations were serially diluted in Dulbecco's modified Eagle's Medium (DMEM) and the Limit of Detection (LoD) for both VOCs was determined. Additionally, clinical specimens stored in viral transport media or saline (n = 51) were investigated to complement in vitro results with cell culture supernatants. Ct values and RNA concentrations were determined via quantitative reverse transcription polymerase chain reaction (RT-qPCR).

RESULTS

The in vitro determination of the LoD showed no obvious differences in detection of omicron and delta for the RATs examined. The LoD in this study was at a dilution level of 1:1,000 (corresponding to 3.0-5.6 × 10⁶ RNA copies/mL) for tests I-V and at a dilution level of 1:100 (corresponding to 3.7-4.9 × 10⁷ RNA copies/mL) for tests VI and VII. Based on clinical specimens, no obvious differences were observed between RAT positivity rates when comparing omicron to delta in this study setting. Overall positivity rates varied between manufacturers with 30-81% for omicron and 42-71% for delta. Test VII was only conducted in vitro with cell culture supernatants for feasibility reasons. In the range of Ct < 23, positivity rates were 50-100% for omicron and 67-93% for delta.

CONCLUSION

In this study, RATs from various manufacturers were investigated, which displayed no obvious differences in terms of analytical LoD in vitro and RAT positivity rates based on clinical samples comparing the VOCs omicron and delta. However, differences between tests produced by various manufacturers were detected. In terms of clinical samples, a focus of this study was on specimens with high virus concentrations. Further systematic, clinical and laboratory studies utilizing large datasets are urgently needed to confirm reliable performance in terms of sensitivity and specificity for all individual RATs and SARS-CoV-2 variants.

Comparing the occurrence of chronic physical disorders in self-employed individuals with that of employees: A systematic review

BACKGROUND

A stringent systematic review of population-based observational studies focusing on the physical health of self-employed individuals as a basis for the development of targeted prevention strategies is lacking.

OBJECTIVE

We aimed to systematically evaluate all the studies of good quality that compared the occurrence of chronic physical disorders in self-employed individuals with that of employees.

METHODS

We searched three major medical databases (MEDLINE, Web of Science, Embase) following the Cochrane guidelines. The quality of the studies was rated based on the slightly modified validated assessment tool that was developed by Hoy et al.RESULTS:We included 16 population-based studies of good quality, with data from 15,369,964 participants in total. The two longitudinal evaluations of Swedish national registers with the longest follow-up periods showed increased cardiovascular mortality and incidence estimates of cardiovascular disease in self-employed individuals compared with those of white-collar (i.e., nonmanual) employees but decreased risk estimates compared with those of blue-collar (i.e., manual) workers. The results of the shorter cohort studies were heterogeneous. In cross-sectional studies, prevalence estimates for musculoskeletal, respiratory and malignant diseases were higher among self-employed individuals than among employees.

CONCLUSION

The long-term cardiovascular disease risk and mortality of self-employed individuals seemed to be higher than those of white-collar employees but lower than those of blue-collar employees. As a basis for targeted prevention strategies, further longitudinal studies in different settings are required to better understand the development of physical health disorders for specific self-employment categories such as sole proprietors, small entrepreneurs, family businesses and others.

Spectroscopic analysis of sequestered chloroplasts in Elphidium williamsoni (Foraminifera)

Foraminifera are unicellular, marine organisms that occur worldwide. A very common species in the German Wadden Sea is Elphidium williamsoni. Some foraminifera (such as elphidia) are able to use kleptoplastidy, which allows them to incorporate chloroplasts from their algal food source into their own cell body. The experiments reported here are based on the fact that chlorophyll (a and c) can be detected in the intact cells with spectroscopic methods in the visible spectral range, which allows an indirect investigation of the presence of sequestered chloroplasts. Starving experiments of E. williamsoni in the light (24 h continuous) showed that the greatest decrease in chlorophyll content was recorded within the first 20-30 days. From day 60 on, chlorophyll was hardly detectable. Through subsequent feeding on a renewed algal food source a significant increase in the chlorophyll content in foraminifera was noticed. The degradation of chlorophyll in the dark (24 h continuous darkness) during the starving period was much more complex. Chlorophyll was still detected in the cells after 113 days of starving time. Therefore, we hypotheses that the effect of photoinhibition applies to chloroplasts in foraminifera under continuous illumination.

COVID-19 – (noch) Krise oder (schon) Epikrise?

Das Jahresende als Übergangszeit und die weihnachtliche Besinnungszeit laden dazu ein, neben anderen Krisen auch über das 2022/2023 noch anhaltende Krisenthema COVID-19 nachzudenken. Die Bezeichnung Krise ist allgegenwärtig: Sie bezieht sich auf eine schwierige Situation, bisweilen auf den Höhe- oder auch Wendepunkt einer gefährlichen Entwicklung, der einer fortlaufenden Beurteilung bedarf. Der Begriff der Epikrise (griech. epi: nach, krisis: Beurteilung) ist zumindest den ärztlichen Leserinnen und Lesern ebenfalls vertraut: Er bezieht sich auf die Schlussbetrachtung eines Krankheitsverlaufs, mithin eine differenzierende Darstellung und Beurteilung nach Abschluss des konkreten Behandlungsfalls. Will man diese Schlussbetrachtung von der Individualmedizin auf die Bevölkerungsmedizin übertragen, stößt dieser Ansatz allerdings sehr schnell auch auf Widerstände. Zum einen wegen der grundsätzlichen Unterschiedlichkeiten eines Krankheitsverlaufs bei einzelnen Menschen gegenüber dem epidemischen Verlauf aus Bevölkerungsperspektive, zum anderen könnte man auf die vergleichsweise hoch entwickelten diagnostischen, therapeutischen und prognostischen Werkzeuge der Individualmedizin gegenüber den teilweise noch unterentwickelt scheinenden Instrumenten im Bereich von Öffentlicher Gesundheit/ Public Health verweisen und zum dritten stellt sich auch die Frage, ob bei COVID-19 als pandemischem Geschehen überhaupt schon eine Epikrise möglich ist.

Epidemiological and Serological Analysis of a SARS-CoV-2 Outbreak in a Nursing Home: Impact of SARS-CoV-2 Vaccination and Enhanced Neutralizing Immunity Following Breakthrough Infection

Background: Despite a vaccination rate of 82.0% (n = 123/150), a SARS-CoV-2 (Alpha) outbreak with 64.7% (n = 97/150) confirmed infections occurred in a nursing home in Bavaria, Germany. Objective: the aim of this retrospective cohort study was to examine the effects of the Corminaty vaccine in a real-life outbreak situation and to obtain insights into the antibody response to both vaccination and breakthrough infection. Methods: the antibody status of 106 fully vaccinated individuals (54/106 breakthrough infections) and epidemiological data on all 150 residents and facility staff were evaluated. Results: SARS-CoV-2 infections (positive RT-qPCR) were detected in 56.9% (n = 70/123) of fully vaccinated, compared to 100% (n = 27/27) of incompletely or non-vaccinated individuals. The proportion of hospitalized and deceased was 4.1% (n = 5/123) among fully vaccinated and therewith lower compared to 18.5% (n = 5/27) hospitalized and 11.1% (n = 3/27) deceased among incompletely or non-vaccinated. Ct values were significantly lower in incompletely or non-vaccinated (p = 0.02). Neutralizing antibodies were detected in 99.1% (n = 105/106) of serum samples with significantly higher values (p < 0.001) being measured post-breakthrough infection. α-N-antibodies were detected in 37.7% of PCR positive but not in PCR negative individuals. Conclusion: Altogether, our data indicate that SARS-CoV-2 vaccination does provide protection against infection, severe disease progression and death with regards to the Alpha variant. Nonetheless, it also shows that infection and transmission are possible despite full vaccination. It further indicates that breakthrough infections can significantly enhance α-S- and neutralizing antibody responses, indicating a possible benefit from booster vaccinations.

[Preparedness on Assaults with Highly Toxic Substances in Public Space]

The use of chemical substances in terrorist scenarios is to be feared everywhere, especially in the western world, after the events that have become known in recent years. In order to protect civilian populations in an emergency, it is essential that the poisoning pattern (toxidrome) is recognized as quickly and reliably as possible through further training of the relevant agents and the provision of necessary rescue equipment (antidotes) in prepared facilities. In the event of a chemical attack with terrorist motivation, doctors from the Public Health Service (PHS) will foreseeably play a key role in communicating with decision-makers and the public a spart of a competency network.

Wissenschaft im Dienst der Politik

Kong Fuzi (551 bis 479 v. Chr.), „Lehrmeister Kong“, von den Jesuiten als Konfuzius latinisiert, hat wohl wie kein anderer die chinesische Kultur beeinflusst. Das moderne China nennt seine weltweiten Kulturinstitute „Konfuzius-Institute“, vergleichbar den deutschen Goethe-Instituten. Nach Karl Jaspers bildet die Zeit von 800 bis 200 vor Christus in einer historisch-philosophischen Betrachtung eine Zeitenwende, die „Achsenzeit“, in welcher in den ostasiatischen, indischen, orientalischen und okzidentalen Kulturkreisen eine fundamentale Wendung des Denkens zu beobachten ist, mit Konfuzius und Laotse, Buddha, Heraklit, Sokrates, Plato, Aristoteles und den biblischen Propheten als bekannten Proponenten 2. Ein zentrales Werk mit Bezug zu Konfuzius ist das von seinen Schülern gesammelte Lun Yu, die Gespräche des Konfuzius. Im vierzehnten Kapitel findet sich als 23. Gespräch eine Aussage zum Fürstendienst: Dsï Lu fragte, wie man dem Fürsten diene. Der Meister sprach: „Ihn nicht betrügen und ihm widerstehen.“ 1 So kurz es ist, hat es dieses Zitat in sich – und bietet Konfliktstoff gerade auch in der Gegenwart dieses großen Kulturraums. Es enthält zum einen die Verpflichtung zur Aufrichtigkeit und Wahrheit, zum anderen auch die Aufforderung, für diese Wahrheit einzustehen und sich auch den Vorgesetzten und Mächtigen zu widersetzen, wenn es erforderlich sein sollte – als notwendige Form aufrichtigen Dienens: Staatsdienst statt Fürstendienst.

Results of the enhanced COVID-19 surveillance during UEFA EURO 2020 in Germany

In general, mass gatherings might pose a risk to the public health (PH). The UEFA EURO 2020 tournament (EURO 2020) was one of the first mass gathering events since the start of the coronavirus disease 2019 (COVID-19) pandemic in Germany. To allow early detection and response to any EURO 2020-associated impact on the COVID-19-related epidemiological situation, we initiated enhanced surveillance activities using the routine surveillance system in collaboration with the regional PH authority of Bavaria. Several preventive measures regarding the attendance of football matches and public viewing were implemented according to state regulations. We describe the results from the enhanced surveillance during the EURO 2020. In total, five cases who had attended a football match in the stadium of Munich, nine cases, who attended a football match in a stadium outside of Germany, and 123 cases in association with public viewing events were identified by enhanced surveillance. Concluding, the EURO 2020 seems to not have had a major impact on the COVID-19 pandemic development in Germany. Health measures for stadium visitors and the restriction of large public viewing events may have potentially contributed to the low case numbers detected, emphasising the need of appropriate PH surveillance and regulations to limit the potential risk to PH during mass gathering events.

Crystallography relevant to Mars and Galilean icy moons: crystal behavior of kieserite-type monohydrate sulfates at extraterrestrial conditions down to 15 K

Monohydrate sulfate kieserites (M ²⁺SO₄·H₂O) and their solid solutions are essential constituents on the surface of Mars and most likely also on Galilean icy moons in our solar system. Phase stabilities of end-member representatives (M ²⁺ = Mg, Fe, Co, Ni) have been examined crystallographically using single-crystal X-ray diffraction at 1 bar and temperatures down to 15 K, by means of applying open He cryojet techniques at in-house laboratory instrumentation. All four representative phases show a comparable, highly anisotropic thermal expansion behavior with a remarkable negative thermal expansion along the monoclinic b axis and a pronounced anisotropic expansion perpendicular to it. The lattice changes down to 15 K correspond to an 'inverse thermal pressure' of approximately 0.7 GPa, which is far below the critical pressures of transition under hydro-static compression (P_c ≥ 2.40 GPa). Consequently, no equivalent structural phase transition was observed for any compound, and neither dehydration nor rearrangements of the hydrogen bonding schemes have been observed. The M ²⁺SO₄·H₂O (M ²⁺ = Mg, Fe, Co, Ni) end-member phases preserve the kieserite-type C2/c symmetry; hydrogen bonds and other structural details were found to vary smoothly down to the lowest experimental temperature. These findings serve as an important basis for the assignment of sulfate-related signals in remote-sensing data obtained from orbiters at celestial bodies, as well as for thermodynamic considerations and modeling of properties of kieserite-type sulfate monohydrates relevant to extraterrestrial sulfate associations at very low temperatures.

COVID-19: Resilienz, nicht Resignation

Die Pandemie der COVID-19-Erkrankungen begann im Jahr 2019, was in ihre Namensgebung einging. Inzwischen erstreckt sie sich über die Jahre 2020 und 2021 hinaus in das dritte Pandemiejahr 2022. Ein wenig erinnert die Stimmung an die Beschreibungen von Albert Camus in seiner Erzählung „Die Pest“, 1947 erschienen 1.

Age, period, and cohort effects on trends in outpatient addiction care utilization in the general Berlin population from 2008 to 2016

Background

The aim of this study was to decompose independent effects of age, period, and cohort on trends in outpatient addiction care utilization resulting from alcohol (AUD) and illicit substances use disorders (ISUD). Decomposing trends in addiction care utilization into their independent effects by age, period, and cohort may lead to a better understanding of utilization patterns.

Methods

Individuals seeking help in Berlin outpatient addiction care facilities between 2008 and 2016 with an age range of 18–81 years for AUD (n = 46,706) and 18–70 years for ISUD (n = 51,113) were standardized to the general Berlin population using data from the German Federal Statistical Office. Classification of utilization as AUD- (F10) or ISUD-related (F11, F12, F14, F15, F16, F18, F19) help-seeking was based on primary diagnoses according to the International Statistical Classification of Diseases and Related Health Problems. Age was measured in years and period as year of data collection. Cohort was defined as the mathematical difference between period and age. Age, period, and cohort analyses were conducted using the intrinsic estimator model on AUD- and ISUD-related outpatient addiction care utilization.

Results

Age effects on AUD-related utilization were highest in 18- to 19-year-old and in 39- to 59-year-old individuals. ISUD-related utilization declined almost continuously with increasing age. Period effects on AUD- and ISUD-related utilization were small. AUD-related utilization was highest in cohorts born from 1951 to 1986. ISUD-related utilization increased in cohorts born between 1954 and 1973 where utilization peaked, followed by a decline of the same order.

Conclusions

Age and cohort effects were the strongest drivers of trends in AUD- and ISUD-related outpatient addiction care utilization. Onset of help-seeking in earlier phases of AUD development should be enhanced as well as help-seeking for AUD and ISUD in general. The highest cohort-related rates in the baby boomer and following cohorts for AUD and ISUD underline an increased demand for addiction care.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-12744-6.

COVID-19: Schicksal oder Verantwortung?

Ist unsere Zukunft vorherbestimmt? Eine Frage, die sich insbesondere zum wiederkehrenden astronomischen Ereignis einer Sonnenumrundung, mithin des Jahreswechsels und den damit verbundenen guten Wünschen und Vorsätzen stellt. Das aus dem Altniederländischen stammende Wort „Schicksal“ legt solches Denken nahe: Persönliche oder kollektive Geschichte als etwas von höheren Mächten „Geschicktes“ – gesetzte Fakten, welche damit im zeitlichen Verlauf als Zu-kunft unabänderlich auf uns zu-kommen. Eine Vorstellung, welche sich in vielen Kulturen bis in die Jetztzeit findet: Als Fatum, Präfation oder Kismet vorherbestimmtes Leben, welches durch Omen, Orakel, Kristallkugeln und Horoskope teilweise, allerdings nur undeutlich enthüllt werden kann.

Der Schlaf der Vernunft

Francisco de Goya hat uns mit seinen Aquatinta-Radierungen aus dem Jahr 1799, den Caprichos („Einfällen“), in Blatt 43 eine besonders eindringliche Mahnung hinterlassen. Das mit dem Titel „Der Schlaf der Vernunft gebiert Ungeheuer“ (span.: El sueño de la razón produce monstruos) versehene Blatt zeigt den schlafenden Maler, hinter welchem nächtliche Ungeheuer aufsteigen, nicht unähnlich einem Schwarm an Fledermäusen. Schützend beschirmen ihn gleichzeitig zwei Eulen, von denen die eine ihm eine Feder reicht, als wolle sie ihn zum wachen Tätigwerden drängen. Die Kunstkritik ordnet das Bild zunächst in den aufklärerischen Rahmen seiner Zeit ein, gleichsam als Programm gegen die monströsen Fantasien von Unvernunft und Laster, Ignoranz und Arroganz. 1810–1814 folgt eine zweite Sammlung an Aquatinta-Radierungen, betitelt „Die Schrecken des Krieges“, eine ungeschminkte Illustration der (un)menschlichen Gräuel im Kontext der politischen und sozialen Zustände seiner Zeit – gewissermaßen eine Kommentierung und Illustration der Folgen einer schlafenden Vernunft.

COVID-19: Das Endspiel

Nachdem die Fußball-Europameisterschaft im ersten Pandemie-Jahr 2020 abgesagt worden war, fand sie ein Jahr später, in den Sommermonaten des Jahres 2021 an elf Spielorten in Europa statt. Die Spiele in Städten, welche einen Einlass von Zuschauern in die dortigen Stadien nicht zusagen wollten, wurde an andere Orte vergeben. Die (Halb-)Finalspiele wurden alle im traditionsreichen Wembley-Stadion in London ausgetragen, einer Arena mit 65 000 genutzten Plätzen. Das Endspiel war dramatisch, letztlich unterlag die englische Mannschaft nach der Verlängerung gegen Italien im Elfmeterschießen.

In Vitro Rapid Antigen Test Performance with the SARS-CoV-2 Variants of Concern B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), and B.1.617.2 (Delta)

Rapid antigen tests (RATs) are an integral part of SARS-CoV-2 containment strategies. As emerging variants of concern (VOCs) displace the initially circulating strains, it is crucial that RATs do not fail to detect these new variants. In this study, four RATs for nasal swab testing were investigated using cultured strains of B.1.1 (non-VOC), B.1.1.7 (Alpha), B.1.351 (Beta), P.1 (Gamma), and B.1.617.2 (Delta). Based on dilution series in cell culture medium and pooled saliva, the limit of detection of these RATs was determined in a laboratory setting. Further investigations on cross-reactivity were conducted using recombinant N-protein from seasonal human coronaviruses (hCoVs). RATs evaluated showed an overall comparable performance with cultured strains of the non-VOC B.1.1 and the VOCs Alpha, Beta, Gamma, and Delta. No cross-reactivity was detected with recombinant N-protein of the hCoV strains HKU1, OC43, NL63, and 229E. A continuous evaluation of SARS-CoV-2 RAT performance is required, especially with regard to evolving mutations. Moreover, cross-reactivity and interference with pathogens and other substances on the test performance of RATs should be consistently investigated to ensure suitability in the context of SARS-CoV-2 containment.

CoSO4·H2O and its continuous transition compared to the compression properties of isostructural kieserite-type polymorphs

The kieserite-type compound cobalt(II) sulfate monohydrate, CoSO4·H2O, has been investigated under isothermal (T = 295 K) hydrostatic compression up to 10.1 GPa in a diamond anvil cell by means of single-crystal X-ray diffraction and Raman spectroscopy. The monoclinic α-phase (space group C2/c) undergoes a second-order ferroelastic phase transition at P c  = 2.40(3) GPa to a triclinic β-phase (space group P 1 ‾ $&#x203e;{1}$ ). Lattice elasticities derived from fitting third-order Birch-Murnaghan equations of state to the pressure dependent unit-cell volume data yield V 0 = 354.20(6) Å3, K 0 = 53.0(1.7) GPa, K′ = 5.7(1.8) for the α-phase and V 0 = 355.9(8) Å3, K 0 = 45.2(2.6) GPa, K′ = 6.6(6) for the β-phase. Crystal structure data of the high-pressure polymorph were determined at 2.98(6) and 4.88(6) GPa. The most obvious structural feature and thus a possible driving mechanism of the phase transition, is a partial rearrangement in the hydrogen bonding system. However, a comparative analysis of pressure-induced changes in the four kieserite-type compounds investigated to date suggests that the loss of the point symmetry 2 at the otherwise rather rigid SO4 tetrahedron, allowing symmetrically unrestricted tetrahedral rotations and edge tiltings in the β-phase, could be the actual driving mechanism of the phase transition.

Occurrence of Mental Illness and Mental Health Risks among the Self-Employed: A Systematic Review

We aimed to systematically identify and evaluate all studies of good quality that compared the occurrence of mental disorders in the self-employed versus employees. Adhering to the Cochrane guidelines, we conducted a systematic review and searched three major medical databases (MEDLINE, Web of Science, Embase), complemented by hand search. We included 26 (three longitudinal and 23 cross-sectional) population-based studies of good quality (using a validated quality assessment tool), with data from 3,128,877 participants in total. The longest of these studies, a Swedish national register evaluation with 25 years follow-up, showed a higher incidence of mental illness among the self-employed compared to white-collar workers, but a lower incidence compared to blue-collar workers. In the second longitudinal study from Sweden the self-employed had a lower incidence of mental illness compared to both blue- and white-collar workers over 15 years, whereas the third longitudinal study (South Korea) did not find a difference regarding the incidence of depressive symptoms over 6 years. Results from the cross-sectional studies showed associations between self-employment and poor general mental health and stress, but were inconsistent regarding other mental outcomes. Most studies from South Korea found a higher prevalence of mental disorders among the self-employed compared to employees, whereas the results of cross-sectional studies from outside Asia were less consistent. In conclusion, we found evidence from population-based studies for a link between self-employment and increased risk of mental illness. Further longitudinal studies are needed examining the potential risk for the development of mental disorders in specific subtypes of the self-employed.

Evaluation of Screening Tests in Bavarian Healthcare Facilities during the Second Wave of the SARS-CoV-2 Pandemic

Due to the lack of data on asymptomatic SARS-CoV-2-positive persons in healthcare institutions, they represent an inestimable risk. Therefore, the aim of the current study was to evaluate the first 1,000,000 reported screening tests of asymptomatic staff, patients, residents, and visitors in hospitals and long-term care (LTC) facilities in the State of Bavaria over a period of seven months. Data were used from the online database BayCoRei (Bavarian Corona Screening Tests), established in July 2020. Descriptive analyses were performed, describing the temporal pattern of persons that tested positive for SARS-CoV-2 by real-time polymerase chain reaction (RT-PCR) or antigen tests, stratified by facility. Until 15 March 2021, this database had collected 1,038,146 test results of asymptomatic subjects in healthcare facilities (382,240 by RT-PCR, and 655,906 by antigen tests). Of the RT-PCR tests, 2.2% (n = 8380) were positive: 3.0% in LTC facilities, 2.2% in hospitals, and 1.2% in rehabilitation institutions. Of the antigen tests, 0.4% (n = 2327) were positive: 0.5% in LTC facilities, and 0.3% in both hospitals and rehabilitation institutions, respectively. In LTC facilities and hospitals, infection surveillance using RT-PCR tests, or the less expensive but less sensitive, faster antigen tests, could facilitate the long-term management of the healthcare workforce, patients, and residents.

COVID-19 und die Ökonomik von Leben und Tod

Im Jahr 1993 veröffentlichte Amartya Sen seinen nicht nur in Fachkreisen beachteten Artikel „The Economics of Life and Deaths“ 1. In diesem Beitrag, ins Deutsche zu übersetzen als „Wirtschaftswissenschaftliche Überlegungen [Economics] zu Leben und Tod“, formuliert der Harvard-Professor und spätere Nobel-Preisträger wesentliche Gedanken seiner kritischen Wohlfahrtsökonomik auf dem Weg zu einer „Ökonomie für den Menschen“ 2. Er weist darauf hin, dass sich die Wirtschaftswissenschaften nicht nur mit Ressourcen wie Einkommen und Vermögen als solchen beschäftigen sollten, sondern auch mit deren Gebrauch zu bedeutsameren Zwecken, insbesondere für ein langes und lebenswertes Leben.

Detection of the new SARS-CoV-2 variants of concern B.1.1.7 and B.1.351 in five SARS-CoV-2 rapid antigen tests (RATs), Germany, March 2021

SARS-CoV-2 variants of concern (VOC) should not escape molecular surveillance. We investigated if SARS-CoV-2 rapid antigen tests (RATs) could detect B.1.1.7 and B.1.351 VOCs in certain laboratory conditions. Infectious cell culture supernatants containing B.1.1.7, B.1.351 or non-VOC SARS-CoV-2 were respectively diluted both in DMEM and saliva. Dilutions were analysed with Roche, Siemens, Abbott, nal von minden and RapiGEN RATs. While further studies with appropriate real-life clinical samples are warranted, all RATs detected B.1.1.7 and B.1.351, generally comparable to non-VOC strain.

COVID-19: Pandemie, Infodemie?

„Eine Infodemie ist ein Übermaß an angebotener Information, sowohl offline [in den klassischen Medien] als auch online“, stellen die internationalen Organisationen WHO, UN, UNICEF, UNDP, UNESCO, UNAIDS, ITU, UN Global Pulse und IFRC in einer seltenen gemeinsamen Erklärung fest 1. Sie kommen dann schnell auf den Punkt: Darin enthalten seien „gezielte Versuche, Falschinformationen zu verbreiten, um die öffentlichen Abwehr- und Hilfsmaßnahmen zu unterminieren und alternative Agenden zu befördern“. Solche Fehlinformationen könnten dann gesundheitliche Folgen haben, zu Stigmatisierungen und zur Ablehnung von sinnvollen Infektionsschutzmaßnahmen führen, einschließlich von Hygienemaßnahmen, Test- und Impfangeboten. Kurz: Falschinformationen können Menschenleben kosten, insbesondere in einer Pandemie und darüber hinaus durch Hetze und Misstrauen den sozialen Zusammenhalt einer Gemeinschaft nachhaltig schädigen. Damit wird die Pandemie in einem zweiten Schritt zum Vehikel einer nochmals die Gesundheit auf individueller und Bevölkerungsebene schädigenden „Infodemie“.

Disparities in accessibility to evidence-based breast cancer care facilities by rural and urban areas in Bavaria, Germany

BACKGROUND

Breast cancer (BC), which is most common in elderly women, requires a multidisciplinary and continuous approach to care. With demographic changes, the number of patients with chronic diseases such as BC will increase. This trend will especially hit rural areas, where the majority of the elderly live, in terms of comprehensive health care.

METHODS

Accessibility to several cancer facilities in Bavaria, Germany, was analyzed with a geographic information system. Facilities were identified from the national BC guideline and from 31 participants in a proof-of-concept study from the Breast Cancer Care for Patients With Metastatic Disease registry. The timeframe for accessibility was defined as 30 or 60 minutes for all population points. The collection of address information was performed with different sources (eg, a physician registry). Routine data from the German Census 2011 and the population-based Cancer Registry of Bavaria were linked at the district level.

RESULTS

Females from urban areas (n = 2,938,991 [ie, total of females living in urban areas]) had a higher chance for predefined accessibility to the majority of analyzed facilities in comparison with females from rural areas (n = 3,385,813 [ie, total number of females living in rural areas]) with an odds ratio (OR) of 9.0 for cancer information counselling, an OR of 17.2 for a university hospital, and an OR of 7.2 for a psycho-oncologist. For (inpatient) rehabilitation centers (OR, 0.2) and genetic counselling (OR, 0.3), women from urban areas had lower odds of accessibility within 30 or 60 minutes.

CONCLUSIONS

Disparities in accessibility between rural and urban areas exist in Bavaria. The identification of underserved areas can help to inform policymakers about disparities in comprehensive health care. Future strategies are needed to deliver high-quality health care to all inhabitants, regardless of residence.

COVID-19: Navigieren im Unbekannten

Die Geschichte der Menschheit ist voll von Entdeckungsreisen. Sie haben teilweise mythisch-erzählerischen Charakter und reichen von den sagenhaften Reisen der griechischen Argonauten, den Irrfahrten des Odysseus oder den Abenteuern Sindbad des Seefahrers aus 1001 Nacht bis hin zu Stanley Kubricks moderner filmischer Science-Fiction-Erzählung „2001: Odyssee im Weltall“ (1968) eintausend Jahre später, zu „E.T.“ und „Star Wars“. Neben diesen Geschichten gibt es auch die tatsächliche, historisch belegte Geschichte und ihre nicht minder packenden Inhalte: Die Fahrt des Griechen Pytheas schon im vierten vorchristlichen Jahrhundert bis zum Polarkreis, die Besiedlung Grönlands durch Erik den Roten und die daran anschließende erste europäische Besiedlung Amerikas um das Jahr 1000 (Leif Eriksson), im 15.

COVID-19 Impfung: Die menschliche Doppelnatur

Die Vorstellung einer Doppelnatur des Menschen findet sich schon in früher geschichtlicher und davor wohl auch vorgeschichtlicher Zeit. Teilweise wird sie philosophisch ausgedeutet als die Wesensverschiedenheit von Leib und Seele, Trieb und Vernunft, teilweise spiegelt sie sich in Erzählungen und Mythen. Bezogen auf den Mythos des Asklepios (lat. Äskulap), den altgriechischen Schutzgott der Heilkunst, findet sich diese Doppelnatur gleich zweifach.

Substance use disorder and the baby boom generation: Does Berlin outpatient addiction care face a sustained change?

Introduction

The ageing of baby boomers is expected to confront addiction care with new challenges. This cohort had greater exposure to psychoactive substances in youth than earlier cohorts. In this study, we aimed to investigate whether Berlin addiction care is confronted with a sustained change in its clientele initiated by the baby boomers.

Methods

Using data from Berlin outpatient addiction care facilities, we contrasted type of primary substance use disorder and number of comorbid substance use disorders in baby boomers with an earlier and a later cohort. To isolate cohort effects, two‐level random intercept regression models were applied in the overlapping age groups of the baby boomer cohort with each of the other cohorts.

Results

Compared with the earlier cohort, alcohol use disorder lost importance whereas illicit substance use disorder gained importance in the baby boomers. Baby boomers presented a higher number of comorbid substance use disorders than the earlier cohort. Comparing baby boomers with the later cohort, these relationships pointed in the opposite direction.

Discussion and Conclusions

Outpatient addiction care faces a sustained change to more illicit and comorbid substance use disorders. With increasing life expectancy and the ageing of baby boomers marked by higher substance use than previous cohorts, older clients, who had been under‐represented in outpatient addiction care, will gain relevance. Hence, addiction care has to adapt its offers to appropriately meet the changing needs of its clientele.

Epidemien und gesellschaftliches Leben

Eine gern zitierte Bestimmung des Aristoteles beschreibt den Menschen als „geselliges Lebewesen“, ja geradezu als „politisches Tier“ (zoon politikon) 1. In seiner Abhandlung über „Die politischen Dinge“ macht der altgriechische Philosoph das u. a. an der Fähigkeit des Menschen zur einsichtigen Rede fest, zur „Unterscheidung von Gut und Böse, Richtig und Falsch und zu anderen moralischen Qualitäten“. Diese gemeinsame Befähigung wiederum vereint die Menschen und befähigt sie so zu staatlicher Organisation – mehr noch: Damit ist gesellschaftliches Leben Teil der menschlichen Natur.

Advancing the WHO-INTEGRATE Framework as a Tool for Evidence-Informed, Deliberative Decision-Making Processes: Exploring the Views of Developers and Users of WHO Guidelines

Background: Decision-making on matters of public health and health policy is a deeply value-laden process. The World Health Organization (WHO)-INTEGRATE framework was proposed as a new evidence-to-decision (EtD) framework to support guideline development from a complexity perspective, notably in relation to public health and health system interventions, and with a foundation in WHO norms and values. This study was conducted as part of the development of the framework to assess its comprehensiveness and usefulness for public health and health policy decision-making.

Methods: We conducted a qualitative study comprising nine key informant interviews (KIIs) with experts involved in WHO guideline development and four focus group discussions (FGDs) with a total of forty health decision-makers from Brazil, Germany, Nepal and Uganda. Transcripts were analyzed using MAXQDA12 and qualitative content analysis.

Results: Most key informants and participants in the FGDs appreciated the framework for its relevance to real-world decision-making on four widely differing health topics. They praised its broad perspective and comprehensiveness with respect to new or expanded criteria, notably regarding societal implications, equity considerations, and acceptability. Some guideline developers questioned the value of the framework beyond current practice and were concerned with the complexity of applying such a broad range of criteria in guideline development processes. Participants made concrete suggestions for improving the wording and definitions of criteria as well as their grouping, for covering missing aspects, and for addressing overlap between criteria.

Conclusion: The framework was well-received by health decision-makers as well as the developers of WHO guidelines and appears to capture all relevant considerations discussed in four distinct real-world decision processes that took place on four different continents. Guidance is needed on how to apply the framework in guideline processes that are both transparent and participatory. A set of suggestions for improvement provides a valuable starting point for advancing the framework towards version 2.0.

Wenn die Begriffe nicht stimmen

Vom chinesischen Philosophen Konfuzius – Meister Kong – ist uns ein bemerkenswertes Gespräch überliefert: „Dsï Lu sprach: Der Fürst von We wartet auf den Meister, um die Regierung auszuüben. Was würde der Meister zuerst in Angriff nehmen? Der Meister sprach: Sicherlich die Richtigstellung der Begriffe. […] Wenn die Begriffe nicht richtig sind, so stimmen die Worte nicht; stimmen die Worte nicht, so kommen die Werke nicht zustande; kommen die Werke nicht zustande, so gedeiht Moral und Kunst nicht; gedeiht Moral und Kunst nicht, so treffen die Strafen nicht; treffen die Strafen nicht, so weiß das Volk nicht, wohin Hand und Fuß setzen. […] Der Edle duldet nicht, dass in seinen Worten irgend etwas in Unordnung ist. Das ist es, worauf alles ankommt“ 1.

The parisite-(Ce) enigma: challenges in the identification of fluorcarbonate minerals

A multi-methodological study was conducted in order to provide further insight into the structural and compositional complexity of rare earth element (REE) fluorcarbonates, with particular attention to their correct assignment to a mineral species. Polycrystals from La Pita Mine, Municipality de Maripí, Boyacá Department, Colombia, show syntaxic intergrowth of parisite-(Ce) with röntgenite-(Ce) and a phase which is assigned to B ₃ S ₄ (i.e., bastnäsite-3-synchisite-4; still unnamed) fluorcarbonate. Transmission electron microscope (TEM) images reveal well-ordered stacking patterns of two monoclinic polytypes of parisite-(Ce) as well as heavily disordered layer sequences with varying lattice fringe spacings. The crystal structure refinement from single crystal X-ray diffraction data - impeded by twinning, complex stacking patterns, sequential and compositional faults - indicates that the dominant parisite-(Ce) polytype M ₁ has space group Cc. Parisite-(Ce), the B ₃ S ₄ phase and röntgenite-(Ce) show different BSE intensities from high to low. Raman spectroscopic analyses of parisite-(Ce), the B ₃ S ₄ phase and röntgenite-(Ce) reveal different intensity ratios of the three symmetric CO₃ stretching bands at around 1100 cm^-1. We propose to non-destructively differentiate parisite-(Ce) and röntgenite-(Ce) by their 1092 cm^-1 / 1081 cm^-1 ν₁(CO₃) band height ratio.

Substance use disorder and the baby boomers: Does German outpatient addiction care face a change?

Background

The aging of baby boomers is expected to confront addiction care with new challenges. This study aims to investigate if German addiction care is confronted with a sustained change in its clientele that was initiated by the baby boomers.

Methods

Using data from Berlin outpatient addiction care facilities, we contrasted type of primary substance use disorder and number of comorbid substance use disorders in baby boomers with an older (n = 6524) as well as a younger cohort (n = 15677). To isolate cohort effects, two-level random-intercept regression models were applied in the overlapping age groups of the baby boomer cohort with each other cohort.

Results

Compared to the older cohort, alcohol use disorder lost importance while illicit substances use disorder gained importance in the baby boomers. Baby boomers presented a higher number of comorbid substance use disorders than the older cohort. Comparing baby boomers with the younger cohort, these relationships pointed in the opposite direction.

Conclusions

Outpatient addiction care faces a sustained change to more illicit and comorbid substance use disorders. The addiction care system ought to adapt its services to address the changing needs of its clientele.

Key messages

Baby boomers differed in comparison to the older cohort regarding type of substance use disorder and comorbid substance use disorders. The changes set off by the baby boomers continued in the younger cohort.

COVID-19: Eine Formel als Heuristik

Heureka – ich habe es gefunden! Dieser freudige Ausruf anlässlich einer geistigen Erkenntnis ist uns vom griechischen Mathematiker und Naturforscher Archimedes überliefert, der mit diesem Ausruf unbekleidet durch die Straßen von Syrakus gelaufen sein soll, nachdem er in der Badewanne das Prinzip des Auftriebs eines Körpers als proportional zum verdrängten Medium (hier: Wasser) entdeckt haben soll. Im Notizbuch des Mathematikers Gauß findet sich auch 2000 Jahre später noch ein „Heureka!“ neben der Erkenntnis, dass jede positive ganze Zahl als Summe von höchstens 3 Dreieckszahlen ausgedrückt werden kann. Anknüpfend an diese historischen Anekdoten ist eine Heuristik, welche den Wortstamm mit Heureka teilt, verallgemeinernd eine praktische Lösungsstrategie – die Kunst, mit unvollständiger Information und oft unter Zeitdruck ausreichend schnell zu einer praktikablen Lösung zu gelangen, auch wenn diese noch nicht die optimale Lösung darstellt.