Detecting high-risk neighborhoods and socioeconomic determinants for common oral diseases in Germany.

BACKGROUND: Ideally, health services and interventions to improve dental health should be tailored to local target populations. But this is not the standard. Little is known about risk clusters in dental health care and their evaluation based on small-scale, spatial data, particularly among under-represented groups in health surveys. Our study aims to investigate the incidence rates of major oral diseases among privately insured and self-paying individuals in Germany, explore the spatial clustering of these diseases, and evaluate the influence of social determinants on oral disease risk clusters using advanced data analysis techniques, i.e. machine learning. METHODS: A retrospective cohort study was performed to calculate the age- and sex-standardized incidence rate of oral diseases in a study population of privately insured and self-pay patients in Germany who received dental treatment between 2016 and 2021. This was based on anonymized claims data from BFS health finance, Bertelsmann, Dortmund, Germany. The disease history of individuals was recorded and aggregated at the ZIP code 5 level (n = 8871). RESULTS: Statistically significant, spatially compact clusters and relative risks (RR) of incidence rates were identified. By linking disease and socioeconomic databases on the ZIP-5 level, local risk models for each disease were estimated based on spatial-neighborhood variables using different machine learning models. We found that dental diseases were spatially clustered among privately insured and self-payer patients in Germany. Incidence rates within clusters were significantly elevated compared to incidence rates outside clusters. The relative risks (RR) for a new dental disease in primary risk clusters were min = 1.3 (irreversible pulpitis; 95%-CI = 1.3-1.3) and max = 2.7 (periodontitis; 95%-CI = 2.6-2.8), depending on the disease. Despite some similarity in the importance of variables from machine learning models across different clusters, each cluster is unique and must be treated as such when addressing oral public health threats. CONCLUSIONS: Our study analyzed the incidence of major oral diseases in Germany and employed spatial methods to identify and characterize high-risk clusters for targeted interventions. We found that private claims data, combined with a network-based, data-driven approach, can effectively pinpoint areas and factors relevant to oral healthcare, including socioeconomic determinants like income and occupational status. The methodology presented here enables the identification of disease clusters of greatest demand, which would allow implementing more targeted approaches and improve access to quality care where they can have the most impact.

Triarylamine Enriched Organostannoxane Drums: Synthesis, Optoelectrochemical Properties, Association Studies, and Gelation Behavior.

The straightforward synthesis of three organotin clusters endowed with six triarylamine-based moieties is reported herein. The optoelectronic properties of the molecules, as well as their ability to form gels, were investigated. The association ability of the compounds was studied as well by means of variable temperature nuclear magnetic resonance (NMR) and ultraviolet-visible (UV-vis) spectroscopy. The optimization of the geometry of the compounds has been performed and compared to the X-ray diffraction of the crystals. The results obtained through this comparison are useful for the explanation of their different gelation behaviors. In fact, organostannoxane drum 1 exhibits a strong ability to form organized supramolecular structures by means of a number of noncovalent short contacts that finally yield luminescent organogels in aromatic solvents.

Dendritic-Like Molecules Built on a Pillar[5]arene Core as Hole Transporting Materials for Perovskite Solar Cells.

Multi-branched molecules have recently demonstrated interesting behaviour as charge-transporting materials within the fields of perovskite solar cells (PSCs). For this reason, extended triarylamine dendrons have been grafted onto a pillar[5]arene core to generate dendrimer-like compounds, which have been used as hole-transporting materials (HTMs) for PSCs. The performances of the solar cells containing these novel compounds have been extensively investigated. Interestingly, a positive dendritic effect has been evidenced as the hole transporting properties are improved when going from the first to the second-generation compound. The stability of the devices based on the best performing pillar[5]arene material has been also evaluated in a high-throughput ageing setup for 500 h at high temperature. When compared to reference devices prepared from spiro-OMeTAD, the behaviour is similar. An analysis of the economic advantages arising from the use of the pillar[5]arene-based material revealed however that our pillar[5]arene-based material is cheaper than the reference.

Dendritic-Like Molecules Built on a Pillar[5]arene Core as Hole Transporting Materials for Perovskite Solar Cells.

Invited for the cover of this issue are the groups of S. Seki (Kyoto), G. Reginato (Sesto Fiorentino), J.-F. Nierengarten (Strasbourg), A. Abate (Berlin) and J. L. Delgado (San Sebastian). The image depicts an artistic view of a dendrimer-like hole transporting material at work in a perovskite solar cell. Read the full text of the article at 10.1002/chem.202101110.

[Geographic analyses as a foundation for evidence-based public health interventions: the example identification and typology of risk clusters for mumps, measles, and rubella]. / Geografische Analysen für evidenzbasierte Public-Health-Interventionen: Das Beispiel Identifikation und Typisierung von Risikoclustern für Masern, Mumps und Röteln.

BACKGROUND: Ideally, health services and interventions to improve immunization rates should be tailored to local target populations, such as spatial clusters. However, to date, little attention has been paid to spatial clusters of underimmunization and have instead been typified based on small-scale data. AIM: Using the example of vaccination against measles, mumps, and rubella (MMR) in children, the present study aims to (1) identify the spatial distribution of insufficient MMR vaccination in Westphalia-Lippe on a small scale, (2) identify specific, spatial risk clusters with insufficient vaccination protection, and (3) describe spatial-neighborhood influencing factors of the different risk clusters as starting points for public health interventions. MATERIAL AND METHODS: Account data from the Kassenärztliche Vereinigung Westfalen-Lippe (KVWL) were used as a basis. Birth cohorts 2013-2016 of children with statutory health insurance were formed and aggregated at postcode level (n = 410). Statistically significant, spatially compact clusters and relative risks (RRs) of underimmunization were identified. Local risk models were estimated in binary logistic regressions based on spatial-neighborhood variables. RESULTS AND DISCUSSION: Two significant clusters of underimmunization were identified for each of the vaccination rates "at least one MMR vaccination" and "both MMR vaccinations." Significant risk factors for low immunization rates included age structure, socioeconomic variables, population density, medical coverage, and value attitude. The proposed methodology is suitable for describing spatial variations in vaccination behavior based on identified typologies for targeted evidence-based interventions.

[Geographic Clusters of Underimmunization Against Influenza in the Elderly: Westphalia-Lippe as an Example]. / Geografische Cluster der Unterimmunisierung gegen Influenza bei über 60-Jährigen am Beispiel Westfalen-Lippe.

BACKGROUND: Underimmunization against influenza has been increasing in recent years. A spatial clustering of underimmunization is suspected. These clusters can pose risks to health care and make achieving immunization quality standards difficult. The objectives of this paper are to (a) identify and describe PLZ-level spatial clusters with high levels of underimmunization against influenza, (b) compare the clusters with other preventive services, and (c) model possible factors influencing underimmunization. MATERIAL AND METHODS: From the routine data of the Association of Statutory Health Insurance physicians Westphalia-Lippe, patients ≥ 60 years and vaccinations between 2012-2017 were extracted. As a methodology, the spatial scan statistics were chosen, which show high relative risks of underimmunization in clusters. RESULTS AND DISCUSSION: Four statistically significant clusters of underimmunization against influenza were identified, which proved to be stable even after adjustment with the temporal trend of local underimmunization rates. In the flu season 2016/2017, the underimmunization rate in the higher risk clusters (RR>1) was 71.9-74.7% and the rate outside these clusters was 67.0%. As influencing factors on underimmunization, socio-economic factors and vaccination behavior in the preseason were identified. Underimmunization rates are geographically clustered. The spatial scan statistics can be used for the identification of persistent clusters in order to carry out targeted spatial and addressee-specific measures to reduce underimmunization rates.

[Utilization of Outpatient Emergency Care in Westphalia-Lippe: A Health Geographic Analysis]. / Die Inanspruchnahme der ambulanten Notfallversorgung in Westfalen-Lippe: eine medizingeographische Studie.

Identification of geographical variations in the utilization of outpatient emergency care facilities is the most effective tool to locate regions with the greatest potential for increasing quality and efficiency in emergency care. The aim of the study was to estimate utilization of emergency care facilities in a regression model, taking into account local dependencies and agglomeration effects. The basis of this ecological study was formed by all outpatient emergency patient contacts in 2013 (n=1,927,471), which were aggregated according to the place of residence to the 231 municipalities of the supply area of the Association of Statutory Health Insurance Physicians Westphalia-Lippe. With the help of geostatistical procedures, the proportion of outpatient emergency patient contacts in hospital ambulances was modeled by socio-economic, patient-focused and geographic variables. The use of hospital ambulances (Ø=56.2%) in Westphalia-Lippe is heterogeneous (min=14.8%, max=83.9%). The patient autonomy and state of health, the spatial distance to emergency care facilities and the Ruhr region were identified as important influencing factors. In this study, the cross-border perspective plays an important role in the outpatient use of emergency care facilities and helps to identify potential intervention areas.

Fullerene-Based Materials as Hole-Transporting/Electron-Blocking Layers: Applications in Perovskite Solar Cells.

Here we report for the first time an efficient fullerene-based compound, FU7, able to act as hole-transporting material (HTM) and electron blocking contact. It has been applied on perovskite solar cells (PSCs), obtaining 0.81 times the efficiency of PSCs with the standard HTM, spiro-OMeTAD, with the additional advantage that this performance is reached without any additive introduced in the HTM layer. Moreover, as a proof of concept, we have described for the first time efficient PSCs in which both selective contacts are fullerene derivatives, to obtain unprecedented "fullerene sandwich" PSCs.

Energy Transfer Between Squaraine Polymer Sections: From Helix to Zigzag and All the Way Back.

We provide a joint experimental and theoretical study of squaraine polymers in solution. The absorption spectra show evidence that two different conformations are present in the polymer: a helix and a zigzag structure. This unique situation allows investigating ultrafast energy-transfer processes between different structural segments within a single polymer chain in solution. The understanding of the underlying dynamics is of fundamental importance for the development of novel materials for light-harvesting and optoelectronic applications. Here, we combine femtosecond transient absorption spectroscopy with time-resolved 2D electronic spectroscopy in order to demonstrate that ultrafast energy transfer within the squaraine polymer chains proceeds from initially excited helix segments to zigzag segments or vice versa, depending on the solvent as well as on the excitation wavenumber. These observations contrast other conjugated polymers such as MEH-PPV where much slower intrachain energy transfer was reported. The reason for the very fast energy transfer in squaraine polymers is most likely a close matching of the density of states between donor and acceptor polymer segments because of the very small reorganization energy in these cyanine-like chromophores.

Field testing hot water temperature reduction as an energy-saving measure--does the Legionella presence change in a clinic's plumbing system?

Legionella spp. represent a significant health risk for humans. To ensure hygienically safe drinking water, technical guidelines recommend a central potable water hot (PWH) supply temperature of at least 60°C at the calorifier. In a clinic building we monitored whether slightly lowered temperatures in the PWH system led to a systemic change in the growth of these pathogens. In four separate phases we tested different scenarios concerning PWH supply temperatures and disinfection with chlorine dioxide (ClO2). In each phase, we took 5 sets of samples at 17 representative sampling points in the building's drinking water plumbing system. In total we collected 476 samples from the PWH system. All samples were tested (culture-based) for Legionella spp. and serogroups. Additionally, quantitative parameters at each sampling point were collected, which could possibly be associated with the presence of Legionella spp. (Pseudomonas aeruginsoa, heterotrophic plate count at 20°C and 36°C, temperatures, time until constant temperatures were reached, and chlorine dioxide concentration). The presence of Legionella spp. showed no significant reactions after reducing the PWH supply temperature from 63°C to 60°C and 57°C, as long as disinfection with ClO2 was maintained. After omitting the disinfectant, the PWH system showed statistically significant growth rates at 57°C. PWH temperatures which are permanently lowered to less than recommended values should be carefully accompanied by frequent testing, a thorough evaluation of the building's drinking water plumbing system, and hygiene expertise.

Charge transfer dynamics in squaraine-naphthalene diimide copolymers.

The synthesis of an alternating squaraine-naphthalene diimide donor-acceptor low band gap polymer (1.14-1.40 eV) as well as its monomolecular analogue is presented. Spectroelectrochemistry experiments and transient absorption spectroscopy in the fs-time regime reveal an ultrafast population of a charge separated state for both polymer and monomer. Local excitation of the squaraine moiety is followed by population of intermediate states, presumably charge transfer states, followed by full charge separation, which occurs within a ca. 2 ps. Charge recombination takes place within 5.2 ps, probably because the system is close to the Marcus optimal region for barrierless ET. For the polymer, measurements of the transient absorption anisotropy show that neither charge nor does energy transfer take place within the lifetime of the charge separated state, indicating that this state is essentially confined within one donor-acceptor pair.

Squaraine dyes as efficient coupling bridges between triarylamine redox centres.

Various indolenine squarylium dyes with additional electron-donating amine redox centres have been synthesised and their redox chemistry has been studied. A combination of cyclic voltammetry, spectro-electrochemistry and DFT calculations has been used to characterise the electronic structure of the mono-, di- and, in one case, trications. All monocations still retain the cyanine-like, delocalised character due to the relatively low redox potential of the squaraine bridge and are therefore compounds of Robin-Day class III. Thus we extended previous studies on organic mixed-valence systems by using the indolenine squaraine moiety as very electron-rich bridge between two electron-donating amine redox centres to provoke a strong coupling between the additional redox centres. We synthesised TA3, which has an N-N distance of 26 bonds between the triarylamine redox centres and is to our knowledge the longest bis(triarylamine) radical cation that is completely delocalised. We furthermore show that altering the symmetry of a squaraine dye by substitution of a squaric ring oxygen atom by a dicyanomethylene group has a direct impact on the optical properties of the monocations. In case of the dications, it turned out that the energetically most stable state of dianisylamine-substituted squaraines is an anti-ferromagnetically coupled open-shell singlet state.

A Generic IT Infrastructure for Identity Management and Pseudonymization in Small Research Projects with Heterogeneous and Distributed Data Sources Under Consideration of the GDPR.

Each year, millions of rescue operations occur in Germany. Despite rising numbers, there is a shortfall of systematic quality management (QM). Focusing on finding the required quality parameters, this work aims at linking heterogeneous and distributed data sources on the patient-level. Presented here is necessary IT infrastructure for linking patients' data records properly and efficiently. The focus of the IT infrastructure is to provide a lightweight and easy applicable solution with an utmost generic approach.

Perovskite Solar Cells Based on Oligotriarylamine Hexaarylbenzene as Hole-Transporting Materials.

A cobalt-catalyzed cyclotrimerization of bis(aryl)alkyne is used as an innovative tool to obtain hole-transport materials (HTMs). The novel HTM containing six units of oligotriarylamine (HAB1), characterized by UV-vis, cyclic voltammetry, DFT, and thermogravimetric analysis, confirms its suitability as an efficient HTM in PSCs. A PCE of 17.5% was obtained in HAB1-containing PSCs, a performance comparable to that obtained with spiro-OMeTAD and with slightly better thermal stability.

Quantification of cysteine S-conjugate of 3-sulfanylhexan-1-ol in must and wine of petite arvine vine by stable isotope dilution analysis.

Making use of a convenient synthetic approach to prepare the deuterated S-3-(hexan-1-ol)-cysteine by a Michael addition reaction, an analytical method was developed to measure the presence of the cysteine S-conjugate, precursor of 3-sulfanylhexan-1-ol (3-mercaptohexan-1-ol), in must and wine from Petite Arvine vine. The method uses a stable isotope dilution assay with a suitable one-step sample preparation and HPLC-MS detection. The method has limits of detection and quantification of 3 and 10 microg/L, respectively. A correlation between the increase of the precursor concentration and the increase of the degree of rot has been established.

Poly(ethylene glycol)-[60]Fullerene-Based Materials for Perovskite Solar Cells with Improved Moisture Resistance and Reduced Hysteresis.

A series of [60]fullerenes covalently functionalized with the polymer poly(ethylene glycol) is presented. These new [60]fullerene-based materials have been incorporated as additives in CH3 NH3 PbI3 (MAPbI3 ), the most common organic-inorganic perovskite used in perovskite solar cells. The extensive photovoltaic study performed by using these materials shows several beneficial effects on the performance of these cells, including a reduction in hysteresis and an increased stability against moisture, whereby the solar cells retain up to 97 % of their initial power conversion efficiency in an ambient atmosphere.

Modelling characteristics to predict Legionella contamination risk - Surveillance of drinking water plumbing systems and identification of risk areas.

For the surveillance of drinking water plumbing systems (DWPS) and the identification of risk factors, there is a need for an early estimation of the risk of Legionella contamination within a building, using efficient and assessable parameters to estimate hazards and to prioritize risks. The precision, accuracy and effectiveness of ways of estimating the risk of higher Legionella numbers (temperature, stagnation, pipe materials, etc.) have only rarely been empirically assessed in practice, although there is a broad consensus about the impact of these risk factors. We collected n = 807 drinking water samples from 9 buildings which had had Legionella spp. occurrences of >100 CFU/100mL within the last 12 months, and tested for Legionella spp., L. pneumophila, HPC 20°C and 36°C (culture-based). Each building was sampled for 6 months under standard operating conditions in the DWPS. We discovered high variability (up to 4 log(10) steps) in the presence of Legionella spp. (CFU/100 mL) within all buildings over a half year period as well as over the course of a day. Occurrences were significantly correlated with temperature, pipe length measures, and stagnation. Logistic regression modelling revealed three parameters (temperature after flushing until no significant changes in temperatures can be obtained, stagnation (low withdrawal, qualitatively assessed), pipe length proportion) to be the best predictors of Legionella contamination (>100 CFU/100 mL) at single outlets (precision = 66.7%; accuracy = 72.1%; F(0.5) score = 0.59).

Efficient Regular Perovskite Solar Cells Based on Pristine [70]Fullerene as Electron-Selective Contact.

[70]Fullerene is presented as an efficient alternative electron-selective contact (ESC) for regular-architecture perovskite solar cells (PSCs). A smart and simple, well-described solution processing protocol for the preparation of [70]- and [60]fullerene-based solar cells, namely the fullerene saturation approach (FSA), allowed us to obtain similar power conversion efficiencies for both fullerene materials (i.e., 10.4 and 11.4 % for [70]- and [60]fullerene-based devices, respectively). Importantly, despite the low electron mobility and significant visible-light absorption of [70]fullerene, the presented protocol allows the employment of [70]fullerene as an efficient ESC. The [70]fullerene film thickness and its solubility in the perovskite processing solutions are crucial parameters, which can be controlled by the use of this simple solution processing protocol. The damage to the [70]fullerene film through dissolution during the perovskite deposition is avoided through the saturation of the perovskite processing solution with [70]fullerene. Additionally, this fullerene-saturation strategy improves the performance of the perovskite film significantly and enhances the power conversion efficiency of solar cells based on different ESCs (i.e., [60]fullerene, [70]fullerene, and TiO2 ). Therefore, this universal solution processing protocol widens the opportunities for the further development of PSCs.

Developing the urban blue: Comparative health responses to blue and green urban open spaces in Germany.

Recently, new perspectives upon healthy urban open spaces propose that open spaces can be regarded as urban green or blue spaces. However, there has so far been very little research into blue environments and their benefits for mental well-being. Our article focuses on the effects of water in cities, "urban blue" (as compared to "urban green"), on human health and well-being. To assess the mental well-being of visitors, we conducted qualitative semi-standardised interviews (n=113), asking which differences in well-being occur when visiting urban green and blue spaces in high-density areas of the inner city in Dusseldorf and Cologne, Germany. Although we found many similarities, some health-enhancing effects for users turned out to be prominent for urban blue in the four conceptual therapeutic landscape dimensions: experienced, symbolic, social and activity space. These effects include enhanced contemplation, emotional bonding, participation, and physical activity. The results suggest that urban blue as a health-promoting factor needs more detailed and accurate determination and examination of its general and local health-enhancing effects.