Universität Augsburg
  • Augsburg, Bavaria, Germany
Recent publications
The benefit of tree canopy exists in reducing suicide attempts. • Area deprivation correlated with a higher attempted suicide rate. • The spatial disparity of suicide attempts was addressed. • Local variation in attempted suicides was found. • The interaction effect of area deprivation and tree canopy was observed on attempted suicide rates. A lack of knowledge about the benefits of urban trees on mental health is addressed by exploring the association between tree canopy coverage, suicide attempts and the levels of neighborhood deprivation. Although the positive association between tree canopy cover and mental health as well as a negative association between neighborhood socioeconomic status and suicide attempts are well-known, it remains largely unclear how both area deprivation and tree canopy cover can help predicting local suicide attempts. Using the local suicide records (n = 3442) between 2015 and 2019 in the city of Cincinnati, OH, we analyzed if the number of local suicide attempts was related to the tree canopy cover at the census block group level (n = 275). After adjusting for control variables, we found that as the deprivation level gets a one-percentage point higher, the number of attempted suicide rate significantly increases by 1.05 %, while a one-percentage point increase in tree canopy coverage significantly decreases the attempted suicide rate by 0.9 %. Additionally, the level of area deprivation showed a moderating effect on the association between overall tree canopy and attempted suicide. Our findings suggest that local tree canopy cover could be a useful tool to improve local mental health including suicide attempts. More importantly, the benefit of tree canopy cover was stronger in less disadvantaged areas than in highly disadvantaged areas, which provides a new insight that interventions to qualitatively improve green space may be important for improving mental health in left-behind areas as a form of environmental justice.
We consider the homogenisation of a coupled reaction–diffusion process in a porous medium with evolving microstructure. A concentration-dependent reaction rate at the interface of the pores with the solid matrix induces a concentration-dependent evolution of the domain. Hence, the evolution is fully coupled with the reaction–diffusion process. In order to pass to the homogenisation limit, we employ the two-scale-transformation method. Thus, we homogenise a highly non-linear problem in a periodic and in time cylindrical domain instead. The homogenisation result is a reaction–diffusion equation, which is coupled with an internal variable, representing the local evolution of the pore structure.
This study aimed to evaluate the levels and phenomenology of equivalent black carbon (eBC) at the city center of Augsburg, Germany (01/2018 to 12/2020). Furthermore, the potential health risk of eBC based on equivalent numbers of passively smoked cigarettes (PSC) was also evaluated, with special emphasis on the impact caused by the COVID19 lockdown restriction measures. As it could be expected, peak concentrations of eBC were commonly recorded in morning (06:00–8:00 LT) and night (19:00–22:00 LT) in all seasons, coinciding with traffic rush hours and atmospheric stagnation. The variability of eBC was highly influenced by diurnal variations in traffic and meteorology (air temperature (T), mixing-layer height (MLH), wind speed (WS)) across days and seasons. Furthermore, a marked “weekend effect” was evidenced, with an average eBC decrease of ∼35% due to lower traffic flow. During the COVID19 lockdown period, an average ∼60% reduction of the traffic flow resulted in ∼30% eBC decrease, as the health risks of eBC exposure was markedly reduced during this period. The implementation of a multilinear regression analysis allowed to explain for 53% of the variability in measured eBC, indicating that the several factors (e.g., traffic and meteorology) may contribute simultaneously to this proportion. Overall, this study will provide valuable input to the policy makers to mitigate eBC pollutant and its adverse effect on environment and human health.
Purpose Role expectations of physicians providing health care for hunger strikers have been discussed in the context of prisons and detention centres. Ethical guidance for physicians in these situations is codified in the Declaration of Malta. In the last years, new forms of collective, public hunger strikes of asylum seekers have occurred. We have aimed at reconstructing the experiences of health-care personnel involved in one of such cases. Methods Semi-structured interviews with nine participants (physicians and paramedics) that had been involved in a public collective hunger strike of asylum seekers in Germany were conducted. Results We identified three health-care provider groups: voluntary physicians, emergency service providers and medical consultants for the authorities. Role conflicts arising from multiple loyalty situations with obligations towards different stakeholders (e.g., strikers, employers, authorities) were perceived as the greatest challenge especially for voluntary doctor and emergency service provider participants. Such conflicts culminated in feeling instrumentalized for political goals. Conclusion The results illustrate that professional challenges in the health care during a public collective hunger strike differ in various aspects from those described in the literature on custodial settings. We recommend expanding and adapting the medico-ethical guidance.
Medical students have been shown to be vulnerable to mental stress. Strengthening individual protective characteristics can be one cornerstone for promoting medical students’ mental health and thereby preventing mental disorders. Online programs are an opportunity to provide appropriate options that have the advantage of being accessible from anywhere, at any time, and with a low entry threshold. This review provides a literature overview of current online programs for medical students. The findings can serve as a point of reference for designing effective online programs for mental health-promotion and mental disorder-prevention in medical curricula. We applied a systematic literature search in PubMed, ERIC, Cochrane, and Web of Science. Programs offered had to be web-based, and the addressed group had to be medical students. Protective individual characteristics for mental health and information on the programs’ effectiveness were included in the search. As outcomes, we included mental health, burnout, symptoms of depression, anxiety, and well-being. The search yielded 723 articles; of them, 11 met the inclusion criteria. Programs found were grouped according to their focus: mental health literacy, mindfulness, based on Cognitive Behavioral Therapy, or peer support. Two studies showed significant reductions in perceived stress; one study indicated reduced burnout levels. One program had significant immediate effects on mindfulness, empathy, and resilience; two studies indicated strengthening coping strategies. Two programs were qualitatively assessed as helpful; two studies are ongoing. Nine studies lacked control groups; two randomized controlled trials were ongoing. Only a few online programs with limited evidence of effectiveness were found. They addressed protective individual characteristics, highlighting their importance for mental health. Thus, more health-promoting and mental disorder-preventing programs with high-quality effectiveness studies are necessary. An integration of such programs into curricula would allow for greater utilization and could give greater emphasis to and prioritize mental health in medical education.
The COVID-19 pandemic forced a rapid shift to digital strategies including e-exams in medical schools. However, there are significant concerns, predominately from student perspectives, and further data is required to successfully establish e-assessment in the medical curricula. The objective of the study was to examine medical students’ perceptions, concerns, and needs regarding e-assessment to establish a comprehensive e-exam based on these and previous findings and to evaluate its effectiveness in terms of examinee perceptions and further needs. During the 2021 summer term, a cross-sectional study using qualitative and quantitative methods was conducted among all 1077 students at the School of Medicine, Technical University of Munich. They were asked to provide information regarding their characteristics, preferred exam format, e-assessment perception, concerns, and needs in an online questionnaire. Based on these findings, a pilot e-exam including an e-exam preparation for the students were established and subsequently evaluated among 125 pilot e-exam examinees under study consideration via an online-questionnaire. Of the 317 pre-exam participants (73.2% female), 70.3% preferred in-person exams and showed concerns about the technological framework, privacy, and examination requirements. Qualitative analysis showed that these concerns lead to additional exam stress and fear of failure. The 34 (79.4% female) participants who participated in the evaluation survey showed a significantly more positive e-exam perception. The fairness of the platform, the independence from an internet connection, the organization including the e-exam preparation, and the consideration of participant needs were discussed as particularly positive in the open-ended comments. In both surveys, participants requested uniform platforms and processes for all subjects. This study provides evidence for a positive, complementary role of student participation in a successful e-exam implementation. Furthermore, when establishing an e-exam format in the medical curricula, e-exam training, equal accessibility, availability offline, and all-round fairness should be considered.
Magnetoelectric phenomena are intimately linked to relativistic effects and also require the material to break spatial inversion symmetry and time-reversal invariance. Magnetoelectric coupling can substantially affect light–matter interaction and lead to non-reciprocal light propagation. Here, we confirm on a fully experimental basis, without invoking either symmetry-based or material-specific assumptions, that the optical magnetoelectric effect in materials with non-parallel magnetization ( M ) and electric polarization ( P ) generates a trilinear term in the refractive index, δ n ∝ k ⋅ ( P × M ), where k is the propagation vector of light. Its sharp magnetoelectric resonances in the terahertz regime, which are simultaneously electric and magnetic dipole active excitations, make Co 2 Mo 3 O 8 an ideal compound to demonstrate this fundamental relation via independent variation of M , P , and k . Remarkably, the material shows almost perfect one-way transparency in moderate magnetic fields for one of these magnetoelectric resonances.
Coexisting density-wave and superconducting states along with the large anomalous Hall effect in the absence of local magnetism remain intriguing and enigmatic features of the AV 3 Sb 5 kagome metals (A = K, Rb, Cs). Here, we demonstrate via optical spectroscopy and density-functional calculations that low-energy dynamics of KV 3 Sb 5 is characterized by unconventional localized carriers, which are strongly renormalized across the density-wave transition and indicative of electronic correlations. Strong phonon anomalies are prominent not only below the density-wave transition, but also at high temperatures, suggesting an intricate interplay of phonons with the underlying electronic structure. We further propose the star-of-David and tri-hexagon (inverse star-of-David) configurations for the density-wave order in KV 3 Sb 5 . These configurations are strongly reminiscent of p -wave states expected in the Hubbard model on the kagome lattice at the filling level of the van Hove singularity. The proximity to this regime should have intriguing and far-reaching implications for the physics of KV 3 Sb 5 and related materials.
Background In severe cases, SARS-CoV-2 infection leads to acute respiratory distress syndrome (ARDS), often treated by extracorporeal membrane oxygenation (ECMO). During ECMO therapy, anticoagulation is crucial to prevent device-associated thrombosis and device failure, however, it is associated with bleeding complications. In COVID-19, additional pathologies, such as endotheliitis, may further increase the risk of bleeding complications. To assess the frequency of bleeding events, we analyzed data from the German COVID-19 autopsy registry (DeRegCOVID). Methods The electronic registry uses a web-based electronic case report form. In November 2021, the registry included N = 1129 confirmed COVID-19 autopsy cases, with data on 63 ECMO autopsy cases and 1066 non-ECMO autopsy cases, contributed from 29 German sites. Findings The registry data showed that ECMO was used in younger male patients and bleeding events occurred much more frequently in ECMO cases compared to non-ECMO cases (56% and 9%, respectively). Similarly, intracranial bleeding (ICB) was documented in 21% of ECMO cases and 3% of non-ECMO cases and was classified as the immediate or underlying cause of death in 78% of ECMO cases and 37% of non-ECMO cases. In ECMO cases, the three most common immediate causes of death were multi-organ failure, ARDS and ICB, and in non-ECMO cases ARDS, multi-organ failure and pulmonary bacterial ± fungal superinfection, ordered by descending frequency. Interpretation Our study suggests the potential value of autopsies and a joint interdisciplinary multicenter (national) approach in addressing fatal complications in COVID-19.
Background Transcatheter mitral valve-in-valve (TMVIV) or valve-in-ring (TMVIR) replacement offer an alternative therapy for high risk patients. We aimed to highlight the operative and postoperative results of TMVIV and TMVIR procedures. Results We included all patients underwent TMVIV and TMVIR procedures between 2017 and 2020 at two heart centers in Germany. We included a total of 36 high risk patients in our study where 12 received TMVIV and 24 received TMVIR. All patients underwent TMVIV or TMVIR with Edwards Sapien XT or S3 transcatheter valves (Edwards Lifesciences). The mean age was 79 (75–83 years old). The median (IQR) preoperative STS score was 9 (7–13)% and EuroSCORE II was 14.5% (12–16). The majority of our patients were operated via transapical approach ( n = 26) and the minority via transseptal approach ( n = 10). Out of our records, none of our patients required reopening for bleeding or any other surgical complications. None of our patients required reintervention during the 6 months follow-up period. One mortality was recorded on fifth postoperative day due to low cardiac output syndrome (obviously because of LVOT obstruction by the anterior mitral leaflet). The average blood loss was 200 ml in the first 24 h in patients underwent transapical approach. Average operative time was 93 min and all patients were immediately extubated after the procedure in the operating room (even the patient with echocardiographically documented LVOT obstruction who died on the fifth postoperative day). Length of Intensive Care Unit stay was 2 ± 1.2 days and length of hospital stay was 4.1 ± 1.2 days. In the follow up period, echocardiograms showed normal prosthetic valve function with low transvalvular gradients, no LVOT obstruction in TMVIR cases and no evidence of valve migration or thrombosis (except in one patient). Concerning 6 months readmission, it was recorded in 2 patients due to right sided heart failure symptoms due to preexisting high degree of tricuspid valve regurge which did not disappear or even decrease after the operation and the other patient due to gastrointestinal bleeding. Conclusions TMVIV and TMVIR offer an efficient, safe and less invasive alternative in high surgical risk patients.
Emerging evidence from observational studies suggests an increased risk of Parkinson’s disease (PD) in patients with inflammatory bowel disease (IBD). However, to date it is not clear whether a causal relationship exists. To investigate whether IBD is causally related to PD, a two-sample Mendelian randomization study was carried out. Independent genetic instruments from the largest available genome-wide association study (GWAS) for IBD (7045 cases, 456,327 controls) including European participants were used to investigate the association with PD (56,306 cases; 1.4 million controls). The results were validated by using a second IBD sample (12,882 cases; 21,770 controls) including the main subtypes ulcerative colitis (UC; 6968 cases; 20,464 controls) and Crohn’s disease (CD; 5956 cases; 14,927 controls). The radial inverse-variance weighted (IVW) approach was used in the primary analysis, and the robustness of the findings were confirmed in a number of sensitivity analyses. Finally, the recently proposed CAUSE approach was performed. There was no evidence of an association between IBD and PD (OR IVW = 0.98; 95% CI: [0.93; 1.04]; P = 0.48). This finding could be validated using a second sample of IBD cases (OR IVW = 0.98; 95% CI: [0.95; 1.02]; P = 0.36). Furthermore, MR analyses did not support a causal effect of CD (OR IVW = 1.00; 95% CI: [0.98; 1.03]; P = 0.96) or UC (OR IVW = 1.02; 95% CI: [0.98; 1.06]; P = 0.45) on PD. The present study suggests that neither IBD nor its subtypes CD and UC causally affect Parkinson’s disease in the European population. Further research is necessary to investigate whether intestinal inflammation impacts the development of PD.
The family of room temperature atomic scale magnetometers is currently limited to nitrogen-vacancy centers in diamond. However, nitrogen-vacancy centers are insensitive to strong off-axis magnetic fields. In this work, we show that the well-known TR12 radiative defect in diamond, exhibits strong optically detected magnetic resonance (ODMR) signal under optical saturation. We also demonstrate that the spin system responsible for the magnetic resonance is an excited triplet state that can be coherently controlled at room temperature on a single defect level. The high optically detected magnetic resonance contrast, which is maintained even for strong off-axis magnetic fields, suggests that TR12 centers can be used for vector magnetometry even at high field.
In the last decade, research on artificial intelligence has seen rapid growth with deep learning models, especially in the field of medical image segmentation. Various studies demonstrated that these models have powerful prediction capabilities and achieved similar results as clinicians. However, recent studies revealed that the evaluation in image segmentation studies lacks reliable model performance assessment and showed statistical bias by incorrect metric implementation or usage. Thus, this work provides an overview and interpretation guide on the following metrics for medical image segmentation evaluation in binary as well as multi-class problems: Dice similarity coefficient, Jaccard, Sensitivity, Specificity, Rand index, ROC curves, Cohen’s Kappa, and Hausdorff distance. Furthermore, common issues like class imbalance and statistical as well as interpretation biases in evaluation are discussed. As a summary, we propose a guideline for standardized medical image segmentation evaluation to improve evaluation quality, reproducibility, and comparability in the research field.
Negative symptoms and cognitive deficits are common in individuals with schizophrenia, greatly affect their outcome, and have been associated with alterations in cerebral gray and white matter volume (GMV, WMV). In the last decade, aerobic endurance training has emerged as a promising intervention to alleviate these symptoms and improved aerobic fitness has been suggested as a key moderator variable. In the present study, we investigated, whether aerobic fitness is associated with fewer cognitive deficits and negative symptoms and with GMVs and WMVs in individuals with schizophrenia in a cross-sectional design. In the largest study to date on the implications of fitness in individuals with schizophrenia, 111 participants at two centers underwent assessments of negative symptoms, cognitive functioning, and aerobic fitness and 69 underwent additional structural magnetic resonance imaging. Multilevel Bayesian partial correlations were computed to quantify relationships between the variables of interest. The main finding was a positive association of aerobic fitness with right hippocampal GMV and WMVs in parahippocampal and several cerebellar regions. We found limited evidence for an association of aerobic fitness with cognitive functioning and negative symptoms. In summary, our results strengthen the notion that aerobic fitness and hippocampal plasticity are interrelated which holds implications for the design of exercise interventions in individuals with schizophrenia.
We study pointwise convergence properties of weakly* convergent sequences {ui}i∈N in BV(Rn). We show that, after passage to a suitable subsequence (not relabeled), we have pointwise convergence ui∗(x)→u∗(x) of the precise representatives for all x∈Rn∖E, where the exceptional set E⊂Rn has on the one hand Hausdorff dimension at most n−1, and is on the other hand also negligible with respect to the Cantor part of |Du|. Furthermore, we discuss the optimality of these results.
The aim of the research and investigation methodology was based on an expert survey, using questionnaires translated into German, English, French, Spanish and Portuguese languages. The experts, interviewed in this study as part of the international community, represent institutions or organizations, that are involved in educational policy or in university research and teaching contexts with the topics and content as well as the implementation of ESD. The answers of the experts provide a different and wide range of variations in assessments of the implementation of the UN Decade and its characteristics of democratic potential and support. This shows that the potential democratic influences can always be assessed much more positively through sustainable development than that of actual democratic changes, particularly in reference to good governance, to the basic and human rights, to the protection of minorities, to civil society participation and to the separation of powers and the rule of law.
Roughness is the key parameter for surface runoff simulations. This study aims to determine robust Manning resistance coefficients on the basis of consecutive artificial rainfall experiments on natural hillslopes available in literature, obtained at 22 different sites with different degrees of vegetation cover and type. The Manning resistance coefficient is particularly important in the context of two-dimensional (2D) hydraulic heavy rainfall simulations. Since there is a wide range of possible resistance values available leading to significantly different results regarding the accumulation of surface runoff, especially for shallow water depths. The planning of flood protection structures is directly affected by these uncertainties. This work also improves the knowledge between roughness and the shape of the hydrograph allowing a better calibration of infiltration models. As flow velocity, water depth, and infiltration rate were not observed during the rainfall experiments, only the outflow of the test field and rain intensity are known. For this purpose, a framework was developed to parameterize shallow water depth (< 1 cm) -dependent roughness coefficients. To test the robustness of the framework, three different formulations of depth-dependent roughness and a constant Manning coefficient are used by comparing the measured discharge under different rainfall intensities with simulations in a 2D-hydraulic model. We identified a strong dependency of Manning’s n on the degree of vegetation cover and -type as well as an influence of consecutive rainfall events. This finally leads to a more robust parameterization of near surface roughness for hydrodynamic modelling, which is particularly important for the simulation of heavy rainfall events.
Background Cognitive impairment is a serious comorbidity in heart failure patients, but effective therapies are lacking. We investigated the mechanisms that alter hippocampal neurons following myocardial infarction (MI). Methods MI was induced in male C57Bl/6 mice by left anterior descending coronary artery ligation. We utilised standard procedures to measure cystic fibrosis transmembrane regulator (CFTR) protein levels, inflammatory mediator expression, neuronal structure, and hippocampal memory. Using in vitro and in vivo approaches, we assessed the role of neuroinflammation in hippocampal neuron degradation and the therapeutic potential of CFTR correction as an intervention. Findings Hippocampal dendrite length and spine density are reduced after MI, effects that associate with decreased neuronal CFTR expression and concomitant microglia activation and inflammatory cytokine expression. Conditioned medium from lipopolysaccharide-stimulated microglia (LCM) reduces neuronal cell CFTR protein expression and the mRNA expression of the synaptic regulator post-synaptic density protein 95 (PSD-95) in vitro. Blocking CFTR activity also down-regulates PSD-95 in neurons, indicating a relationship between CFTR expression and neuronal health. Pharmacologically correcting CFTR expression in vitro rescues the LCM-mediated down-regulation of PSD-95. In vivo, pharmacologically increasing hippocampal neuron CFTR expression improves MI-associated alterations in neuronal arborisation, spine density, and memory function, with a wide therapeutic time window. Interpretation Our results indicate that CFTR therapeutics improve inflammation-induced alterations in hippocampal neuronal structure and attenuate memory dysfunction following MI. Funding Knut and Alice Wallenberg Foundation [F 2015/2112]; Swedish Research Council [VR; 2017-01243]; the German Research Foundation [DFG; ME 4667/2-1]; Hjärnfonden [FO2021-0112]; The Crafoord Foundation; Åke Wibergs Stiftelse [M19-0380], NMMP 2021 [V2021-2102]; the Albert Påhlsson Research Foundation; STINT [MG19-8469], Lund University; Canadian Institutes of Health Research [PJT-153269] and a Heart and Stroke Foundation of Ontario Mid-Career Investigator Award.
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5,305 members
Stefan Künzell
  • Faculty of Philosophy and Social Sciences
Markus Dresel
  • Psychology
Alexandra Manzei-Gorsky
  • Faculty of Philosophy and Social Sciences
Axel R Heller
  • Anesthesiology & Intensive Care Medicine
Mayukh Majumder
  • Institute of Physics
Universitätsstr. 2, 86159, Augsburg, Bavaria, Germany
Head of institution
Prof. Dr. Sabine Doering-Manteuffel
+49 821 598-0
+49 821 598-5116