Background: In many European countries including Germany, migrants utilize preventive services less frequently than the majority population. This is also true for the utilization of dental checkups. Little is known about which demographic, social, behavioral, and health-related factors influence the decision of migrants to seek preventive dental health care and how these factors differ from those in non-migrants. The aim of the present study was to examine the role of these factors among migrants and non-migrants residing in Germany. Methods: Data from cross-sectional national health surveys are used, providing information on preventive dental health behavior from n = 41,220 individuals, of which 15.0% are migrants. Andersen’s Behavioral Model of Health Services Use is the conceptual framework of the investigation. Multiple logistic regression models were applied to examine the role of different predisposing and enabling factors. Interaction terms were included in order to examine whether determinants differ between migrants and non-migrants. Average marginal effects (AMEs) are reported in addition to odds ratios (ORs) as measures of effect size which are robust against bias arising from unobserved heterogeneity. Results: Migrants are at an about 36% lower chance of utilizing regular dental checkups than non-migrants [OR = 0.64 (95% confidence interval, 95% CI: 0.61, 0.68); AME = −0.081 (95% CI = −0.093, −0.069)]. Differences are partly explained by the influence of demographic, social, behavioral, and health-related factors [adjusted OR = 0.69 (95% CI: 0.64, 0.73); AME = −0.065 (95% CI = −0.076, −0.053)]. Younger age, being male, lower socioeconomic status, a non-statutory health insurance, not living in a relationship, living in the Western part of Germany and in an urban setting, and poor limited social support were associated with a lower chance of utilizing regular dental checkups. Interaction effects could be observed for age and for the type of health insurance. Discussion: The study identifies different enabling and predisposing factors that are relevant for the utilization of dental checkups among the population in Germany, some of which differ between migrants and non-migrants. Differences are particularly pronounced for younger ages. This differs from findings on other preventive services where older migrants tend to be more disadvantaged. Additional explanatory factors such as barriers that migrants experience in the dental health care system need to be considered in order to implement patient-oriented services and to reduce disparities in access to dental prevention.

In binocular rivalry, paradigms have been proposed for unobtrusive moment-by-moment readout of observers' perceptual experience (“no-report paradigms”). Here, we take a first step to extend this concept to auditory multistability. Observers continuously reported which of two concurrent tone sequences they perceived in the foreground: high-pitch (1008 Hz) or low-pitch (400 Hz) tones. Interstimulus intervals were either fixed per sequence (Experiments 1 and 2) or random with tones alternating (Experiment 3). A horizontally drifting grating was presented to each eye; to induce binocular rivalry, gratings had distinct colors and motion directions. To associate each grating with one tone sequence, a pattern on the grating jumped vertically whenever the respective tone occurred. We found that the direction of the optokinetic nystagmus (OKN)—induced by the visually dominant grating—could be used to decode the tone (high/low) that was perceived in the foreground well above chance. This OKN-based readout improved after observers had gained experience with the auditory task (Experiments 1 and 2) and for simpler auditory tasks (Experiment 3). We found no evidence that the visual stimulus affected auditory multistability. Although decoding performance is still far from perfect, our paradigm may eventually provide a continuous estimate of the currently dominant percept in auditory multistability.

Accelerometers and gyroscopes are used to detect foot strike (FS), i.e., the moment when the foot first touches the ground. However, it is unclear whether different conditions (footwear hardness or foot strike pattern) influence the accuracy and precision of different FS detection methods when using such micro-electromechanical sensors (MEMS). This study compared the accuracy of four published MEMS-based FS detection methods with each other and the gold standard (force plate) to establish the most accurate method with regard to different foot strike patterns and footwear conditions. Twenty-three recreational runners (12 rearfoot and 11 forefoot strikers) ran on a 15-m indoor track at their individual running speed in three footwear conditions (low to high hardness). MEMS and a force plate were sampled at a rate of 3750 Hz. Individual accuracy and precision of FS detection methods were found which were dependent on running styles and footwear conditions. Most of the methods were characterized by a delay which generally increased from rearfoot to forefoot strike pattern and from high to low midsole hardness. It can be concluded that only one of the four methods can accurately determine FS in a variety of conditions.

Objectives Rehabilitation following medical conditions is largely offered as in-patient service in Germany. Foreign-national residents use rehabilitative services less often than Germans and attain less favourable treatment outcomes. These differences are independent of demographic, socioeconomic and health characteristics. Satisfaction with different aspects of rehabilitative care presumably affects the effectiveness of rehabilitative services. We compared the degree of satisfaction with different domains of the rehabilitative care process between Germans and non-German nationals residing in Germany. Methods We used data from a cross-sectional rehabilitation patient survey annually conducted by the German Statutory Pension Insurance Scheme. The sample comprises 274 513 individuals undergoing medical rehabilitation in 642 hospitals during the years 2007–2011. Participants rated their satisfaction with different domains of rehabilitation on multi-item scales. We dichotomised each scale to low/moderate and high satisfaction. For each domain, a multilevel adjusted logistic regression analysis was conducted to examine differences in the levels of satisfaction between German and non-German nationals. Average marginal effects (AMEs) and 99.5% CI were computed as effect estimates. AMEs represent differences in the probability for the occurrence of the outcome. Results Turkish nationals had a higher probability for being less satisfied with most aspects of their rehabilitation, with AMEs ranging between 0.05 (99.5% CI 0.00 to 0.09) for ‘satisfaction with psychological care’ and 0.11 (99.5% CI 0.08 to 0.14) for ‘satisfaction with treatments during rehabilitation’. Patients from former Yugoslavia and from Portugal/Spain/Italy/Greece were as satisfied as Germans with most aspects of their rehabilitation. Conclusions Turkish nationals are less satisfied with their rehabilitative care than other population groups. This may be attributable to the diversity of the population in terms of its expectations towards rehabilitation. Rehabilitative care institutions need to provide services that are sensitive to the needs of all clients. Diversity management can contribute to this process.

The calculation of frequency-dependent cable parameters is essential for simulations of transient phenomena in electrical power systems. The simulation of transients is more complicated than the calculation of currents and voltages in the nominal frequency range. The model has to represent the frequency dependency and the wave propagation behavior of cable lines. The introduced model combines an improved subconductor method for the determination of the frequency-dependent parameters and a PI section wave propagation model. The subconductor method considers the skin and proximity effect in all conductors for frequency ranges up to few megahertz. The subconductor method method yields accurate results. The wave propagation part of the cable model is based on a cascaded PI section model. A modal transformation technique has been used for the calculation in the time domain. The frequency-dependent elements of the related modal transformation matrices have been fitted with rational functions. The frequency dependence of cable parameters has been reproduced using a vector fitting algorithm and has been implemented into an resistor-inductor-capacitor network (RLC network) for each PI section. The proposed full model has been validated with measured data.

In recent years, research on embodied cognition has inspired a number of studies on multimedia learning and instructional psychology. However, in contrast to traditional research on education and multimedia learning, studies on embodied learning (i.e., focusing on bodily action and perception in the context of education) in some cases pose new problems for the measurement of cognitive load. This review provides an overview over recent studies on embodied learning in which cognitive load was measured using surveys, behavioral data, or physiological measures. The different methods are assessed in terms of their success in finding differences of cognitive load in embodied learning scenarios. At the same time, we highlight the most important challenges for researchers aiming to include these measures into their study designs. The main issues we identified are: (1) Subjective measures must be appropriately phrased to be useful for embodied learning; (2) recent findings indicate potentials as well as problematic aspects of dual-task measures; (3) the use of physiological measures offers great potential, but may require mobile equipment in the context of embodied scenarios; (4) meta-cognitive measures can be useful extensions of cognitive load measurement for embodied learning.

Gyroscopes have been used in previous studies to measure the peak angular velocity of the shoe or foot in the frontal plane (evVel). However, it is not clear whether different test conditions (footwear hardness or locomotion speed) can influence the accuracy of evVel. The purpose of the present study was to compare the accuracy of gyroscopes and electrogoniometers when measuring evVel and the time until evVel (t_evVel) in 12 different conditions using a single axis gyroscope attached to the heel cap. Twenty-four recreational runners were instructed to walk and run on a 15-m indoor track at four locomotion speeds (1.5, 2.5, and 3.5 m/s, and individual running speed) and in three footwear conditions (low to high hardness). The gyroscope data and electrogoniometer data were sampled at a rate of 1000 Hz. Comparisons between both measurement devices showed small mean differences up to 49.8 ± 46.9 deg/s for evVel and up to 5.3 ± 3.5 ms for t_evVel. Furthermore, strong relationships between gyroscope and electrogoniometer data were found for evVel as well as for t_evVel for all conditions. It can be concluded that gyroscopes can be used to accurately determine evVel and t_evVel under a variety of conditions.

Impaired wound healing is a frequent and very severe problem in patients with diabetes mellitus, yet little is known about the underlying pathomechanisms. In this paper we review the biology of wound healing with particular attention to the pathophysiology of chronic wounds in diabetic patients. The standard treatment of diabetic ulcers includes measures to optimize glycemic control as well as extensive debridement, infection elimination by antibiotic therapy based on wound pathogen cultures, the use of moisture dressings, and offloading high pressure from the wound bed. In this paper we discuss novel adjuvant therapies with particular reference to the use of autologous skin transplants for the treatment of diabetic foot ulcers which do not respond to standard care.

Here we review viral and cellular requirements for entry and intracellular trafficking of foamy viruses (FVs) resulting in integration of viral sequences into the host cell genome. The virus encoded glycoprotein harbors all essential viral determinants, which are involved in absorption to the host membrane and triggering the uptake of virus particles. However, only recently light was shed on some details of FV’s interaction with its host cell receptor(s). Latest studies indicate glycosaminoglycans of cellular proteoglycans, particularly heparan sulfate, to be of utmost importance. In a species-specific manner FVs encounter endogenous machineries of the target cell, which are in some cases exploited for fusion and further egress into the cytosol. Mostly triggered by pH-dependent endocytosis, viral and cellular membranes fuse and release naked FV capsids into the cytoplasm. Intact FV capsids are then shuttled along microtubules and are found to accumulate nearby the centrosome where they can remain in a latent state for extended time periods. Depending on the host cell cycle status, FV capsids finally disassemble and, by still poorly characterized mechanisms, the preintegration complex gets access to the host cell chromatin. Host cell mitosis finally allows for viral genome integration, ultimately starting a new round of viral replication.

Karst aquifers are characterized by highly conductive conduit flow paths embedded in a less conductive fissured and fractured matrix resulting in strong permeability contrasts with structured heterogeneity and anisotropy. Groundwater storage occurs predominantly in the fissured matrix. Hence, most karst models assume quasi steady-state flow in conduits neglecting conduit associated drainable storage (CADS). The concept of CADS considers storage volumes, where karst water is not part of the active flow system but rather hydraulically connected to conduits (for example karstic voids and large fractures). The disregard of conduit storage can be inappropriate when direct water abstraction from karst conduits occurs, e.g. large scale pumping. In such cases, CADS may be relevant. Furthermore, the typical fixed head boundary condition at the karst outlet can be inadequate for water abstraction scenarios because unhampered water inflow is possible. The objective of this paper is to analyze the significance of CADS and flow-limited boundary conditions on the hydraulic behavior of karst aquifers in water abstraction scenarios. To this end, the numerical hybrid model MODFLOW-2005 Conduit Flow Process Mode 1 (CFPM1) is enhanced to account for CADS. Additionally, a fixed-head limited-flow (FHLQ) boundary condition is added that limits inflow from constant head boundaries to a user-defined threshold. The affect and proper functioning of these modifications is demonstrated by simplified model studies. Both enhancements, CAD storage and the FHLQ boundary, are shown to be useful for water abstraction scenarios within karst aquifers. An idealized representation of a large-scale pumping test in a karst conduit is used to demonstrate that the enhanced CFPM1 is potentially able to adequately represent water abstraction processes in both the conduits and the matrix of real karst systems.