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Kleine Geschichte Spaniens
(2004)
Background Uptake of self-testing and self-management of oral coagulation has remained inconsistent, despite good evidence of their effectiveness. To clarify the value of self-monitoring of oral anticoagulation, we did a meta-analysis of individual patient data addressing several important gaps in the evidence, including an estimate of the effect on time to death, first major haemorrhage, and thromboembolism.
Methods We searched Ovid versions of Embase (1980-2009) and Medline (1966-2009), limiting searches to randomised trials with a maximally sensitive strategy. We approached all authors of included trials and requested individual patient data: primary outcomes were time to death, first major haemorrhage, and first thromboembolic event. We did prespecified subgroup analyses according to age, type of control-group care (anticoagulation-clinic care vs primary care), self-testing alone versus self-management, and sex. We analysed patients with mechanical heart valves or atrial fibrillation separately. We used a random-effect model method to calculate pooled hazard ratios and did tests for interaction and heterogeneity, and calculated a time-specific number needed to treat.
Findings Of 1357 abstracts, we included 11 trials with data for 6417 participants and 12 800 person-years of follow-up. We reported a significant reduction in thromboembolic events in the self-monitoring group (hazard ratio 0.51; 95% CI 0.31-0.85) but not for major haemorrhagic events (0.88, 0.74-1.06) or death (0.82, 0.62-1.09). Participants younger than 55 years showed a striking reduction in thrombotic events (hazard ratio 0.33, 95% CI 0.17-0.66), as did participants with mechanical heart valve (0.52, 0.35-0.77). Analysis of major outcomes in the very elderly (age >= 85 years, n=99) showed no significant adverse effects of the intervention for all outcomes.
Interpretation Our analysis showed that self-monitoring and self-management of oral coagulation is a safe option for suitable patients of all ages. Patients should also be offered the option to self-manage their disease with suitable health-care support as back-up.
The synthesis, structure, and photocatalytic water splitting performance of two new titania (TiO2)/gold(Au)/Bombyx mori silk hybrid materials are reported. All materials are monoliths with diameters of up to ca. 4.5 cm. The materials are macroscopically homogeneous and porous with surface areas between 170 and 210 m(2)/g. The diameter of the TiO2 nanoparticles (NPs) - mainly anatase with a minor fraction of brookite - and the Au NPs are on the order of 5 and 7-18 nm, respectively. Addition of poly(ethylene oxide) to the reaction mixture enables pore size tuning, thus providing access to different materials with different photocatalytic activities. Water splitting experiments using a sunlight simulator and a Xe lamp show that the new hybrid materials are effective water splitting catalysts and produce up to 30 mmol of hydrogen per 24 h. Overall the article demonstrates that the combination of a renewable and robust scaffold such as B. mori silk with a photoactive material provides a promising approach to new monolithic photocatalysts that can easily be recycled and show great potential for application in lightweight devices for green fuel production.
The synthesis, structure, and photocatalytic water splitting performance of two new titania (TiO 2 )/gold(Au)/Bombyx mori silk hybrid materials are reported. All materials are monoliths with diameters of up to ca. 4.5 cm. The materials are macroscopically homogeneous and porous with surface areas between 170 and 210 m 2/g. The diameter of the TiO 2 nanoparticles (NPs) – mainly anatase with a minor fraction of brookite – and the Au NPs are on the order of 5 and 7–18 nm, respectively. Addition of poly(ethylene oxide) to the reaction mixture enables pore size tuning, thus providing access to different materials with different photocatalytic activities. Water splitting experiments using a sunlight simulator and a Xe lamp show that the new hybrid materials are effective water splitting catalysts and produce up to 30 mmol of hydrogen per 24 h. Overall the article demonstrates that the combination of a renewable and robust scaffold such as B. mori silk with a photoactive material provides a promising approach to new monolithic photocatalysts that can easily be recycled and show great potential for application in lightweight devices for green fuel production.
The most complex but potentially most severe impacts of climate change are caused by extreme weather events. In a globally connected economy, damages can cause remote perturbations and cascading consequences-a ripple effect along supply chains. Here we show an economic ripple resonance that amplifies losses when consecutive or overlapping weather extremes and their repercussions interact. This amounts to an average amplification of 21% for climate-induced heat stress, river floods, and tropical cyclones. Modeling the temporal evolution of 1.8 million trade relations between >7000 regional economic sectors, we find that the regional responses to future extremes are strongly heterogeneous also in their resonance behavior. The induced effect on welfare varies between gains due to increased demand in some regions and losses due to demand or supply shortages in others. Within the current global supply network, the ripple resonance effect of extreme weather is strongest in high-income economies-an important effect to consider when evaluating past and future economic climate impacts.
Many researchers and politicians believe that the COVID-19 crisis may have opened a "window of opportunity " to spur sustainability transformations. Still, evidence for such a dynamic is currently lacking. Here, we propose the linkage of "big data " and "thick data " methods for monitoring debates on transformation processes by following the COVID-19 discourse on ecological sustainability in Germany. We analysed variations in the topics discussed by applying text mining techniques to a corpus with 84,500 newspaper articles published during the first COVID-19 wave. This allowed us to attain a unique and previously inaccessible "bird's eye view " of how these topics evolved. To deepen our understanding of prominent frames, a qualitative content analysis was undertaken. Furthermore, we investigated public awareness by analysing online search behaviour. The findings show an underrepresentation of sustainability topics in the German news during the early stages of the crisis. Similarly, public awareness regarding climate change was found to be reduced. Nevertheless, by examining the newspaper data in detail, we found that the pandemic is often seen as a chance for sustainability transformations-but not without a set of challenges. Our mixed-methods approach enabled us to bridge knowledge gaps between qualitative and quantitative research by "thickening " and providing context to data-driven analyses. By monitoring whether or not the current crisis is seen as a chance for sustainability transformations, we provide insights for environmental policy in times of crisis.
Tropical cyclones range among the costliest disasters on Earth. Their economic repercussions along the supply and trade network also affect remote economies that are not directly affected. We here simulate possible global repercussions on consumption for the example case of Hurricane Sandy in the US (2012) using the shock-propagation model Acclimate. The modeled shock yields a global three-phase ripple: an initial production demand reduction and associated consumption price decrease, followed by a supply shortage with increasing prices, and finally a recovery phase. Regions with strong trade relations to the US experience strong magnitudes of the ripple. A dominating demand reduction or supply shortage leads to overall consumption gains or losses of a region, respectively. While finding these repercussions in historic data is challenging due to strong volatility of economic interactions, numerical models like ours can help to identify them by approaching the problem from an exploratory angle, isolating the effect of interest. For this, our model simulates the economic interactions of over 7000 regional economic sectors, interlinked through about 1.8 million trade relations. Under global warming, the wave-like structures of the economic response to major hurricanes like the one simulated here are likely to intensify and potentially overlap with other weather extremes.
Tropical cyclones range among the costliest of all meteorological events worldwide and planetary scale warming provides more energy and moisture to these storms. Modelling the national and global economic repercussions of 2017's Hurricane Harvey, we find a qualitative change in the global economic response in an increasingly warmer world.
While the United States were able to balance regional production failures by the original 2017 hurricane, this option becomes less viable under future warming.
In our simulations of over 7000 regional economic sectors with more than 1.8 million supply chain connections, the US are not able to offset the losses by use of national efforts with intensifying hurricanes under unabated warming.
At a certain warming level other countries have to step in to supply the necessary goods for production, which gives US economic sectors a competitive disadvantage. In the highly localized mining and quarrying sector-which here also comprises the oil and gas production industry-this disadvantage emerges already with the original Hurricane Harvey and intensifies under warming.
Eventually, also other regions reach their limit of what they can offset.
While we chose the example of a specific hurricane impacting a specific region, the mechanism is likely applicable to other climate-related events in other regions and other sectors.
It is thus likely that the regional economic sectors that are best adapted to climate change gain significant advantage over their competitors under future warming.
Cities can be severely affected by climate change. Hence, many of them have started to develop climate adaptation strategies or implement measures to help prepare for the challenges it will present. This study aims to provide an overview of climate adaptation in 104 German cities. While existing studies on adaptation tracking rely heavily on self-reported data or the mere existence of adaptation plans, we applied the broader concept of adaptation readiness, considering five factors and a total of twelve different indicators, when making our assessments. We clustered the cities depending on the contribution of these factors to the overall adaptation readiness index and grouped them according to their total score and cluster affiliations. This resulted in us identifying four groups of cities. First, a pioneering group comprises twelve (mainly big) cities with more than 500,000 inhabitants, which showed high scores for all five factors of adaptation readiness. Second, a set of 36 active cities, which follow different strategies on how to deal with climate adaptation. Third, a group of 28 cities showed considerably less activity toward climate adaptation, while a fourth set of 28 mostly small cities (with between 50,000 and 99,999 inhabitants) scored the lowest. We consider this final group to be pursuing a 'wait-and-see' approach. Since the city size correlates with the adaptation readiness index, we recommend policymakers introduce funding schemes that focus on supporting small cities, to help them prepare for the impact of a changing climate.