Direct Download Germany

Purpose: German hospital reimbursement modalities changed as a result of the introduction of Diagnosis Related Groups (DRG) in 2004. Therefore, no data on the direct costs of adverse drug reactions (ADRs) resulting in admissions to departments of internal medicine are available. The objective was to quantify the ADR-related economic burden (direct costs) of hospitalizations in internal medicine wards in Germany.

I can't buy directly from ps direct, because I have an Italian account and I can't add a German credit card to it... Any known retailer that started selling it? Or a way to bypass the geographic restrictions of ps direct?

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The German rules on foreign direct investment (FDI) are set out in the German Foreign Trade and Payments Act (Auenwirtschaftsgesetz; AWG) and the German Foreign Trade and Payments Ordinance (Auenwirtschaftsverordnung; AWV). The regulatory framework is broadly structured as follows:

Any other type of investment may only be scrutinized if the investor is based outside the EU/EFTA (a so-called "cross-sectoral review"). The BMWi takes a broad view and looks at all entities in the entire acquisition chain from the direct acquirer to the ultimate parent, and also at shareholders such as limited partners.

All transactions that require flings are subject to a "standstill obligation." In particular, it is prohibited to allow the acquirer to directly or indirectly exercise voting rights or grant the acquirer access to certain sensitive data before clearance has been or is deemed to be granted.

Public takeovers must be notified to MOE directly after the publication of the intention to launch a takeover offer, and the shares can then be acquired prior to clearance. However, the standstill obligations otherwise still apply, and the acquisition is subject to unwinding through a sale to the market or transfer to a trustee in case the transaction is not subsequently cleared.

But the overall number of approved transactions clearly shows that the investment climate in Germany remains liberal for the overall majority of transactions. The recent clearance of the CRRC/Vossloh transaction is a clear sign that Germany generally continues to welcome foreign direct investment.

The project DINA (Diversity of Insects in Nature protected Areas) investigates insect communities in 21 nature conservation areas belonging to the Natura2000 network in agricultural landscapes across Germany. Insects were collected in Malaise traps using ethanol as conservation fluid (for project details see33, SOM Table A1 and Fig. A1). The minimal distance to the cropping area bordering the nature conservation area was 25 m (see method section for details). Pesticide exposure of insects was directly measured by analysing pesticide residues present in the ethanol of the Malaise trap collecting bottles. This is a new methodological approach to provide qualitative data on pesticide contamination of insects that are alive.

Of the 92 target common CUPs, 47 were detected in the insect samples from 21 nature conservation areas from two sampling dates in May and August 2020: 13 herbicides, 28 fungicides and 6 insecticides. Additionally, metabolites of fipronil, an insecticide registered for biocidal use in the EU, were recorded at three locations. At the 21 sites, insects in the conservation areas were exposed to 16.7 pesticides on average, ranging from 7 to 27 substances. More fungicides than herbicides were recorded and, on average, insects were exposed to less than two insecticides (Table 1). This may in part reflect the application in arable crops where more fungicides than herbicides are applied and insecticides are used less frequently. On the other hand, as insecticides affect insects directly due to their high acute toxicity, exposure to insecticides results in mortality or sublethal effects that impair mobility, leading to an underestimation of insecticide residues in our samples.

In addition to pesticide applications, seasonality has a direct effect on insect communities that change in composition from spring to autumn38,39,40. Because of shifts in insect community composition and pesticide application schemes, the mixture of pesticide residues present in insect samples changes throughout the year. Thus, it is likely that a finer time resolution than the selected two sampling intervals could reveal additional pesticide residues for the exposure of insects in conservation areas in the agricultural landscape.

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This new summer service augments another direct link from Germany to Bordeaux which only started last December. That other service is a direct train from Freiburg-im-Breisgau to Bordeaux which runs weekly. There are departures from Freiburg on Saturdays and from Bordeaux on Sundays. Its timings will appeal to families, with departure from Freiburg at 12.22 on Saturdays. The Sunday journey back to Germany normally leaves Bordeaux at 08.54, but there are some Sundays in July where departure is slightly earlier to accommodate a diversion in the Paris area due to engineering work.

The direct train to Freiburg was the first international departure from Bordeaux since 2019, when Thalys offered a non-stop Brussels to Bordeaux service on summer Saturdays. Pre-pandemic there was talk of a direct Eurostar service from London to Bordeaux being launched in the mid-2020s. Hope for that possible international link have now faded as Eurostar, faced by considerable economic pressures, focuses on its core markets. So, for now at least, Germany is the only country with direct international trains from Bordeaux.

Detailed and up-to-date data on the epidemiology and healthcare costs of Influenza are fundamental for public health decision-making. We analyzed inpatient data on Influenza-associated hospitalizations (IAH), selected complications and risk factors, and their related direct costs for Germany during ten consecutive years.

We conducted a retrospective cost-of-illness study on patients with laboratory-confirmed IAH (ICD-10-GM code J09/J10 as primary diagnosis) by ICD-10-GM-based remote data query using the Hospital Statistics database of the German Federal Statistical Office. Clinical data and associated direct costs of hospital treatment are presented stratified by demographic and clinical variables.

Between January 2010 to December 2019, 156,097 persons were hospitalized due to laboratory-confirmed Influenza (J09/J10 primary diagnosis). The annual cumulative incidence was low in 2010, 2012 and 2014 (1.3 to 3.1 hospitalizations per 100,000 persons) and high in 2013 and 2015-2019 (12.6 to 60.3). Overall direct per patient hospitalization costs were mean (SD) 3521 EUR ( 8896) and median (IQR) 1805 EUR (1502; 2694), with the highest mean costs in 2010 (mean 8965 EUR 26,538) and the lowest costs in 2012 (mean 2588 EUR 6153). Mean costs were highest in 60-69 year olds, and in 50-59, 70-79 and 40-49 year olds; they were lowest in 10-19 year olds. Increased costs were associated with conditions such as diabetes (frequency 15.0%; 3.45-fold increase compared to those without diabetes), adiposity (3.3%; 2.09-fold increase) or immune disorders (5.6%; 1.88-fold increase) and with Influenza-associated complications such as Influenza pneumonia (24.3%; 1.95-fold), bacterial pneumonia (6.3%; 3.86-fold), ARDS (1.2%; 10.90-fold increase) or sepsis (2.3%; 8.30-fold). Estimated overall costs reported for the 10-year period were 549.6 Million euros (95% CI 542.7-556.4 million euros).

The healthcare costs of Influenza disease as well as cost, efficacy, and safety of yearly immunization campaigns are aspects worth considering in the ongoing discussion of broadening the vaccine recommendation to healthy working adults, children and adolescents [7,8,9]. Therefore, country-specific economic burden estimates of Influenza disease are required [10]. The German Influenza surveillance mechanisms include estimates of Influenza-associated excess medical visits, excess hospitalizations, Influenza-associated work days lost, need for care and death, but detailed data on direct medical costs stratified by age groups, underlying conditions and complications are not publicly available [11]. In the present analyses, we close this data gap by contributing inpatient data on Influenza-associated hospitalizations, selected complications and risk factors for severe disease, and related costs of the entire German population during ten consecutive years.

The cumulative annual hospitalization rate per 100,000 persons due to laboratory-confirmed Influenza in Germany is assessed. Clinical burden of diseases caused by or associated with Influenza virus are presented by indicator variables and stratified by age group. Direct medical costs per inpatient Influenza case are presented at the hospital perspective stratified by demographic data, relevant risk factors and selected Influenza-associated complications. Non-reimbursed direct medical costs (e.g. additional charges, out-of-pocket payments), direct non-medical costs (e.g. transportation, rehabilitation, and housekeeping assistance as a consequence of illness) and indirect costs (work or school absenteeism, burden to caregivers, short-term productivity loss, early retirement or death due to the illness) are not represented. Costs were presented in 2019 euros using the German Consumer Price index [16]. 006ab0faaa