Isolating COVID-19 cases and quarantining their close contacts can prevent COVID-19 transmissions but also inflict harm. We analysed isolation and quarantine orders by the local public health agency ...in Berlin-Reinickendorf (Germany) and their dependence on the recommendations by the Robert Koch Institute, the national public health institute. Between 3 March 2020 and 18 December 2021 the local public health agency ordered 24 603 isolations (9.2 per 100 inhabitants) and 45 014 quarantines (17 per 100 inhabitants) in a population of 266 123. The mean contacts per case was 1.9. More days of quarantine per 100 inhabitants were ordered for children than for adults: 4.1 for children aged 0-6, 5.2 for children aged 7-17, 0.9 for adults aged 18-64 and 0.3 for senior citizens aged 65-110. The mean duration for isolation orders was 10.2 and for quarantine orders 8.2 days. We calculated a delay of 4 days between contact and quarantine order. 3484 contact persons were in quarantine when they developed an infection. This represents 8% of all individuals in quarantine and 14% of those in isolation. Our study quantifies isolation and quarantine orders, shows that children had been ordered to quarantine more than adults and that there were fewer school days lost to isolation or quarantine as compared to school closures. Our results indicate that the recommendations of the Robert Koch Institute had an influence on isolation and quarantine duration as well as contact identification and that the local public health agency was not able to provide rigorous contact tracing, as the mean number of contacts was lower than the mean number of contacts per person known from literature. Additionally, a considerable portion of the population underwent isolation or quarantine, with a notable number of cases emerging during the quarantine period.
Today, boys generally underperform relative to girls in schools throughout the industrialized world. Building on theories about gender identity and reports from prior ethnographic classroom ...observations, we argue that school environment channels conceptions of masculinity in peer culture, fostering or inhibiting boys' development of anti-school attitudes and behavior. Girls' peer groups, by contrast, vary less strongly with the social environment in the extent to which school engagement is stigmatized as un-feminine. As a consequence, boys are more sensitive than girls to school resources that create a learning-oriented environment. To evaluate this argument, we use a quasi-experimental research design and estimate the gender difference in the causal effect of peer socioeconomic status (SES) as an important school resource on test scores. Our design is based on the assumption that assignment to 5th-grade classrooms within Berlin's schools is as good as random, and we evaluate this selection process with an examination of Berlin's school regulations, a simulation analysis, and qualitative interviews with school principals. Estimates of the effect of SES composition on male and female performance strongly support our central hypothesis, and other analyses support our proposed mechanism as the likely explanation for gender differences in the causal effect.
Abstract
Study Objectives
Research suggests that sleep disturbances are associated with elevated levels of inflammation. Some evidence indicates that women may be particularly vulnerable; increased ...levels of inflammatory biomarkers with sleep disturbances are primarily observed among women. Midlife, which encompasses the menopause transition, is typically reported as a time of poor sleep. We tested whether poorer objectively measured sleep characteristics were related to a poorer inflammatory profile in midlife women.
Methods
Two hundred ninety-five peri- and postmenopausal women aged 40–60 completed 3 days of wrist actigraphy, physiologic hot flash monitoring, questionnaires (e.g. Berlin sleep apnea risk questionnaire, and a blood draw for the assessment of inflammatory markers, including C-reactive protein (CRP), interleukin-6 (IL-6), and von Willebrand factor (VWF) antigen. Associations of objective (actigraphy) sleep with inflammatory markers were tested in regression models. Sleep efficiency was inverse log transformed. Covariates included age, race/ethnicity, education, body mass index, sleep apnea risk, homeostatic model assessment (a measure of insulin resistance), systolic blood pressure, low-density lipoprotein cholesterol, and physical activity.
Results
In separate models controlling for age, race/ethnicity, and education, lower sleep efficiency was associated with higher IL-6 b(SE) = .02 (.10), p = .003 and VWF b(SE) = .02 (.08), p = .002. More minutes awake after sleep onset was associated with higher VWF b(SE) = .12 (.06), p = .01. Findings persisted in multivariable models.
Conclusions
Lower sleep efficiency and more minutes awake after sleep onset were independently associated with higher circulating levels of VWF. Lower sleep efficiency was associated with higher circulating levels of IL-6. These findings suggest that sleep disturbances are associated with greater circulating inflammation in midlife women.
BackgroundWest Nile virus (WNV), found in Berlin in birds since 2018 and humans since 2019, is a mosquito-borne virus that can manifest in humans as West Nile fever (WNF) or neuroinvasive disease ...(WNND). However, human WNV infections and associated disease are likely underdiagnosed.AimWe aimed to identify and genetically characterise WNV infections in humans and mosquitoes in Berlin.MethodsWe investigated acute WNV infection cases reported to the State Office for Health and Social Affairs Berlin in 2021 and analysed cerebrospinal fluid (CSF) samples from patients with encephalitis of unknown aetiology (n = 489) for the presence of WNV. Mosquitoes were trapped at identified potential exposure sites of cases and examined for WNV infection.ResultsWest Nile virus was isolated and sequenced from a blood donor with WNF, a symptomatic patient with WNND and a WNND case retrospectively identified from testing CSF. All cases occurred in 2021 and had no history of travel 14 days prior to symptom onset (incubation period of the disease). We detected WNV in
mosquitoes sampled at the exposure site of one case in 2021, and in 2022. Genome analyses revealed a monophyletic Berlin-specific virus clade in which two enzootic mosquito-associated variants can be delineated based on tree topology and presence of single nucleotide variants. Both variants have highly identical counterparts in human cases indicating local acquisition of infection.ConclusionOur study provides evidence that autochthonous WNV lineage 2 infections occurred in Berlin and the virus has established an endemic maintenance cycle.
The Berlin polytrauma definition (BPD) was established to identify multiple injury patients with a high risk of mortality. The definition includes injuries with an Abbreviated Injury Scale score of ...≥3 in ≥2 body regions (2AIS ≥3) combined with the presence of ≥1 physiological risk factors (PRFs). The PRFs are based on age, Glasgow Coma Scale, hypotension, acidosis, and coagulopathy at specific cutoff values. This study evaluates and compares the BPD with two other multiple injury definitions used to identify patients with high resource utilization and mortality risk, using data from the Dutch National Trauma Register (DNTR).
The evaluation was performed based on 2015 to 2018 DNTR data. First, patient characteristics for 2AIS ≥3, Injury Severity Score (ISS) of ≥16, and BPD patients were compared. Second, the PRFs prevalence and odds ratios of mortality for 2AIS ≥3 patients were compared with those from the Deutsche Gesellschaft für Unfallchirurgie Trauma Register. Subsequently, the association between PRF and mortality was assessed for 2AIS ≥3-DNTR patients and compared with those with an ISS of ≥16.
The DNTR recorded 300,649 acute trauma admissions. A total of 15,711 patients sustained an ISS of ≥16, and 6,263 patients had suffered a 2AIS ≥3 injury. All individual PRFs were associated with a mortality of >30% in 2AIS ≥3-DNTR patients. The increase in PRFs was associated with a significant increase in mortality for both 2AIS ≥3 and ISS ≥16 patients. A total of 4,264 patients met the BPDs criteria. Overall mortality (27.2%), intensive care unit admission (71.2%), and length of stay were the highest for the BPD group.
This study confirms that the BPD identifies high-risk patients in a population-based registry. The addition of PRFs to the anatomical injury scores improves the identification of severely injured patients with a high risk of mortality. Compared with the ISS ≥16 and 2AIS ≥3 multiple injury definitions, the BPD showed to improve the accuracy of capturing patients with a high medical resource need and mortality rate.
Epidemiological study, level III.
The Berlin EXCOR ventricular assist device has become a standard treatment in pediatric bridge to transplantation. Despite its increased use in pediatric heart failure, the patient population ...supported with this technology continues to suffer from hematologic issues such as postoperative hemorrhage and neurologic dysfunction secondary to thrombotic events. Finding a balance between hemorrhagic and thrombotic risks in the acute postoperative period poses a significant challenge. In this report, we describe our approach using a temporary centrifugal pump connected to cannulas designed for the Berlin EXCOR ventricular assist device. We believe that the interim use of an extracorporeal centrifugal pump allows time for hemodynamic stability, limits the hemorrhagic risks, and provides relevant hemodynamic information before conversion to the Berlin EXCOR.
Walter Mehring (1896?1981), in der Weimarer Republik einer der herausragenden satirischen Schriftsteller und Kabarett-Autoren, hat - neben Gedichten und Chansons, Romanen und essayistisch-erzählenden ...Texten (Die verlorene Bibliothek , 1951) - auch Dramen geschrieben. Das wichtigste unter ihnen, Der Kaufmann von Berlin (1929), spielt zur Zeit der Inflation 1923 und liefert ein facettenreiches und in den Details geistvoll-treffsicher gezeichnetes Bild der Großstadt Berlin - von der Börse bis zum Scheunenviertel - und einen politisch-sozialen Querschnitt durch die deutsche Bevölkerung nach dem Ersten Weltkrieg. Das Drama, das bei der Aufführung durch Erwin Piscator (1929) den größten Theaterskandal der Weimarer Republik verursachte, veranschaulicht unter anderem auch das Leben von Juden im Berlin dieser Zeit und ist vielleicht nicht zuletzt deshalb mehrfach neu gedruckt worden. Die jetzige Ausgabe erfüllt, auf der Grundlage der Erstausgabe, die Ansprüche, die man an eine kritische Ausgabe stellen kann, und erschließt heutigen Lesern den Text durch einen Kommentar, der die Bezüge zum Inflationsgeschehen ebenso berücksichtigt wie die zum jüdischen Leben in Deutschland.
Through this history the State Museums in Berlin appear in a new light. Berlin's Museum Island was the focus of a discussion about national ownership from the late German Empire until the post-war ...period. Timo Saalmann discusses the social significance of the interactions between art and politics as well as the role of the Prussian Cultural Heritage Foundation in the Cold War.
Carsharing, currently growing strongly in Germany, is an important instrument for sustainable urban mobility. The present boom is mainly due to so-called “free-floating carsharing”. Whilst the ...environmental effects of station-based carsharing have been intensively studied in the German-speaking context, to date there have been hardly any empirical findings on the effect of free-floating carsharing.
Using the example of DriveNow and Flinkster in Berlin and Munich, this article examines to what extent free-floating carsharing leads to a reduction of car ownership compared to station-based carsharing. Based on online surveys (n=819/227) carried out within the “WiMobil” project (9/2012 – 10/2015), descriptive analyses and two binary logistic regressions were performed.
The findings show that station-based and free-floating carsharing leads to a reduction of private cars but to different degrees (DriveNow 7%; Flinkster 15%). The shedding of cars is influenced by the frequency of use of carsharing and the increasing membership of station-based carsharing providers. Furthermore, for many people of both systems carsharing is an important reason not to buy a car. But there is also a significant proportion of people planning a car purchase. This is true especially for car-savvy persons for whom car ownership is very important. Thus, carsharing can be an important factor for sustainable urban mobility. In order to maximize the positive effects of carsharing, it is of central importance to reach additional user groups such as women and elderly people with private car ownership.
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