Geospatial truck parking locations data for Europe.

This data article introduces a comprehensive dataset of real-world truck parking locations across Europe. The dataset comprises N = 19,713 designated parking sites classified according to public accessibility and suitability for heavy-duty trucks (HDTs). More specifically, core information comprises the truck stop category, latitude and longitude information, area size, and country assignment. Furthermore, additional information such as truck traffic flow volumes, proximity to the highway network, and land use information provide supplemental data on ambient conditions and thus enhance the contextual relevance of those locations. The dataset was systematically generated using OpenStreetMap (OSM) data, focusing on parking areas, rest areas, and fueling stations as predominant public truck parking sites. These locations were evaluated and filtered for truck accessibility and suitability and then complemented and validated using commercial truck routing / geocoding software. Further refinement was achieved by Mean-Shift clustering. The further integration of supplementary datasets increased the information level, and all clustered locations were labeled into four archetypal categories. Finally, filtering retained only confidently classified publicly accessible and truck-certified parking and service facilities. This dataset assists in finding real-world stop options for HDTs during national or international operations and identifying suitable and most attractive sites for deploying alternative charging or refueling infrastructures along the European transport network. Accordingly, it can serve as a valuable resource for research in traffic science, future energy systems, and alternative truck powertrains. Its added value extends to diverse stakeholders like Charge Point Operators (CPOs), truck manufacturers, logistics companies, and public authorities.

The outcomes of peripheral nerve surgeries in Africa: Narrative synthesis from existing literature.

BACKGROUND: In Africa, peripheral nerve pathologies are a major source of disability, and the results of surgical therapies differ greatly among countries. The goal of this narrative review is to compile the most recent data on peripheral nerve surgery results in Africa, pinpoint critical variables that affect surgical outcomes, and offer suggestions for enhancing patient care. METHODS: A comprehensive literature review was conducted, focusing on studies published over the past four decades. The sources included peer-reviewed journals, hospital records, and reports from healthcare organizations. The review examined outcomes related to functional recovery, quality of life, and postoperative complications. RESULTS: The outcomes of peripheral nerve surgeries in Africa are influenced by the availability of medical infrastructure, the level of surgeon expertise, and the timeliness of the intervention. Urban centers with better resources tend to report more favorable outcomes, whereas rural areas face significant challenges. Common barriers include limited access to advanced surgical tools, a shortage of specialized surgeons, and inadequate postoperative care and rehabilitation services. Despite these challenges, successful interventions have been reported, particularly in settings where targeted training programs and international collaborations are in place. CONCLUSION: Enhancing surgeon training programs, building comprehensive postoperative care and rehabilitation facilities, and investing in healthcare infrastructure are critical to improving peripheral nerve surgery results in Africa. International and regional collaborations can be extremely helpful in advancing these initiatives by enabling the sharing of knowledge and granting access to cutting-edge methods. Patients with peripheral nerve injuries across the continent may experience improved functional recovery and overall quality of life if these criteria are met.

Synthesis of aminopropyl triethoxysilane/melamine incorporated superhydrophilic membranes for simultaneous removal of oil, metals, and Salt ions from produced water.

Water treatment has turned out to be more important in most societies due to the expansion of most economies and to advancement of industrialization. Developing efficient materials and technologies for water treatment is of high interest. Thin film nanocomposite membranes are regarded as the most effective membranes available for salts, hydrocarbon, and environmental pollutants removal. These membranes improve productivity while using less energy than conventional asymmetric membranes. Here, the polyvinylidene fluoride (PVDF) membranes have been successfully modified via dip single-step coating by silica-aminopropyl triethoxysilane/trimesic acid/melamine nanocomposite (Si-APTES-TA-MM). The developed membranes were evaluated for separating the emulsified oil/water mixture, the surface wettability of the membrane materials is therefore essential. During the conditioning step, that is when the freshwater was introduced, the prepared membrane reached a flux of about 27.77 L m-2 h-1. However, when the contaminated water was introduced, the flux reached 18 L m-2 h-1, alongside an applied pressure of 400 kPa. Interestingly, during the first 8 h of the filtration test, the membrane showed 90 % rejection for ions including Mg2+, and SO42- and ≈100 % for organic pollutants including pentane, isooctane, toluene, and hexadecane. Also, the membrane showed 98 % rejection for heavy metals including strontium, lead, and cobalt ions. As per the results, the membrane could be recommended as a promising candidate to be used for a mixture of salt ions, hydrocarbons, and mixtures of heavy metals from wastewater.

Can transportation infrastructure improve resource misallocation? Evidence from China.

Transportation infrastructure plays a crucial role in the free movement and rational allocation of resources. Utilizing provincial panel data from China spanning from 2000 to 2017, we employ a dynamic spatial Durbin model (DSDM) and a panel threshold model to analyze the impact of transportation infrastructure on resource misallocation. The findings are as follows: (1) Overall, transportation infrastructure serves to correct misallocations of capital and labor, exhibiting spatial effects; (2) Under the influence of spatial spillover effects, transportation infrastructure improves capital misallocation in neighboring regions, yet exacerbates labor misallocation; (3) The impact of transportation infrastructure on capital and labor misallocations shows regional heterogeneity; (4) Transportation infrastructure indirectly ameliorates resource misallocation through three pathways: opening up to external markets, urbanization, and industrial upgrading; (5) There is a threshold effect of transportation infrastructure on labor misallocation - it only improves labor misallocation when it reaches a certain scale.

Proposal of a domain model for 3D representation of buildings in Ecuador.

The accelerated urban sprawl of cities around the world presents major challenges for urban planning and land resource management. In this context, it is crucial to have a detailed 3D representation of buildings enriched with accurate alphanumeric information. A distinctive aspect of this proposal is its specific focus on the spatial unit corresponding to buildings. In order to propose a domain model for the 3D representation of buildings, the national standard of Ecuador and the international standard (ISO 19152:2012 LADM) were considered. The proposal includes a detailed specification of attributes, both for the general subclass of buildings and for their infrastructure. The application of the domain model proposal was crucial in a study area located in the Riobamba canton, due to the characteristics of the buildings in that area. For this purpose, a geodatabase was created in pgAdmin4 with official information, taking into account the structure of the proposed model and linking it with geospatial data for an adequate management and 3D representation of the buildings in an open-source Geographic Information System. This application improves cadastral management in the study region and has wider implications. This model is intended to serve as a benchmark for other countries facing similar challenges in cadastral management and 3D representation of buildings, promote efficient urban development and contribute to global sustainable development.

Risk mapping for better governance in biobanking: the case of biobank.cy.

Introduction: Risk governance is central for the successful and ethical operation of biobanks and the continued social license for being custodians of samples and data. Risks in biobanking are often framed as risks for participants, whereas the biobank's risks are often considered as technical ones. Risk governance relies on identifying, assessing, mitigating and communicating all risks based on technical and standardized procedures. However, within such processes, biobank staff are often involved tangentially. In this study, the aim has been to conduct a risk mapping exercise bringing biobank staff as key actors into the process, making better sense of emerging structure of biobanks. Methods: Based on the qualitative research method of situational analysis as well as the card-based discussion and stakeholder engagement processes, risk mapping was conducted at the biobank setting as an interactive engagement exercise. The analyzed material comprises mainly of moderated group discussions. Results: The findings from the risk mapping activity are framed through an organismic metaphor: the biobank as a growing, living organism in a changing environment, where trust and sustainability are cross-cutting elements in making sense of the risks. Focusing on the situatedness of the dynamics within biobanking activity highlights the importance of prioritizing relations at the core of risk governance and promoting ethicality in the biobanking process by expanding the repertoire of considered risks. Conclusion: With the organismic metaphor, the research brings the diverse group of biobank staff to the central stage for risk governance, highlighting how accounting for such diversity and interdependencies at the biobank setting is a prerequisite for an adaptive risk governance.

Environmental policy stringency, ICT, and technological innovation for achieving sustainable development: Assessing the importance of governance and infrastructure.

Achieving sustainable development goals (SDGs) has garnered significant attention from academia and policymakers worldwide. In this study, we examine the impact of ICT, technological innovation (TI), and environmental policy stringency (EPS) on SDI, considering the moderating role of governance quality (GQI) and transport infrastructure (TIS). A comprehensive dataset of 17 advanced nations is utilized from 1996 to 2021. To capture the dynamic and extreme marginal impacts of these policy instruments on SDG attainment, we employ the advanced technique of Feasible Generalized Least Square (FGLS). The results demonstrate that ICT has a positive and significant effect on SDGs, particularly when combined with high levels of governance quality (GOV) and transport infrastructure (TIS). Likewise, TI has a positive impact on SDGs, especially in the presence of strong governance. Furthermore, EPS exhibits a positive association with SDGs. The findings also reveal that while governance hurts SDGs, this effect diminishes when combined with higher levels of ICT, TI, and EPS, and when TIS positively moderates the relationships. The robustness estimations using DOLS and PCSE methods validate the FGLS findings. These results underscore the importance of ICT, TI, and EPS in advancing sustainable development. Moreover, they highlight the significance of good governance and robust transport infrastructure in maximizing the positive effects of these factors. These findings hold implications for policymakers and stakeholders involved in promoting sustainable development.

Impacts of a herring gull colony on runoff water quality from an urban green roof.

Green infrastructure (GI) strategies, including green roofs, have become a common, decentralized, nature-based strategy for reducing urban runoff and restoring ecosystem services to the urban environment. In this study, we examined the water quality of incident rainfall and runoff from a green roof installed on top of the Jacob K. Javits Convention Center in New York City. Since the 2014 installation of this green roof, one of the largest in North America, a colony of nesting herring gulls grew to approximately 100 nesting pairs in 2018 and 150 nesting pairs in 2019. Water quality monitoring took place between September 2018 and October 2019. Except for phosphorus on some occasions, we found concentrations of nitrate, nitrite, chlorine, sulfate to be below federal drinking water standards. Levels of the fecal indicator bacteria (FIB), total coliform, E. coli, and Enterococcus, were consistently higher in runoff samples than rainwater, ranging from 150 to over 20,000 CFU/100 mL for E. coli and 100 to over 140,000 CFU/100 mL for total coliform. Quantitative polymerase chain reaction (qPCR) methods were used to search for potential opportunistic pathogens, including Legionella spp., Mycobacterium spp., Campylobacter spp., and Salmonella spp. Discovery of the presence of Catellicoccus marimammalium, a gull-associated marker in runoff water indicates that herring gulls are the likely source of contamination. Due to habitat loss, herring gulls, and other Larus gull species are increasingly nesting on urban roofs, both green (such as at the Javits Center) and conventional (such as on Rikers and Governors Islands). Habitat creation is one of the target ecosystem services desired from GI systems. Although the discharge from the green roof of the Javits Center is directed to the city's sewer system, this study demonstrates the need to treat runoff from green roofs with nesting gull populations if its intended use involves reuse or human contact.

Streamlining intersectoral provision of real-world health data: a service platform for improved clinical research and patient care.

Introduction: Obtaining real-world data from routine clinical care is of growing interest for scientific research and personalized medicine. Despite the abundance of medical data across various facilities - including hospitals, outpatient clinics, and physician practices - the intersectoral exchange of information remains largely hindered due to differences in data structure, content, and adherence to data protection regulations. In response to this challenge, the Medical Informatics Initiative (MII) was launched in Germany, focusing initially on university hospitals to foster the exchange and utilization of real-world data through the development of standardized methods and tools, including the creation of a common core dataset. Our aim, as part of the Medical Informatics Research Hub in Saxony (MiHUBx), is to extend the MII concepts to non-university healthcare providers in a more seamless manner to enable the exchange of real-world data among intersectoral medical sites. Methods: We investigated what services are needed to facilitate the provision of harmonized real-world data for cross-site research. On this basis, we designed a Service Platform Prototype that hosts services for data harmonization, adhering to the globally recognized Health Level 7 (HL7) Fast Healthcare Interoperability Resources (FHIR) international standard communication format and the Observational Medical Outcomes Partnership (OMOP) common data model (CDM). Leveraging these standards, we implemented additional services facilitating data utilization, exchange and analysis. Throughout the development phase, we collaborated with an interdisciplinary team of experts from the fields of system administration, software engineering and technology acceptance to ensure that the solution is sustainable and reusable in the long term. Results: We have developed the pre-built packages "ResearchData-to-FHIR," "FHIR-to-OMOP," and "Addons," which provide the services for data harmonization and provision of project-related real-world data in both the FHIR MII Core dataset format (CDS) and the OMOP CDM format as well as utilization and a Service Platform Prototype to streamline data management and use. Conclusion: Our development shows a possible approach to extend the MII concepts to non-university healthcare providers to enable cross-site research on real-world data. Our Service Platform Prototype can thus pave the way for intersectoral data sharing, federated analysis, and provision of SMART-on-FHIR applications to support clinical decision making.

In-built network-wide road safety assessment methodologies for rural roads.

OBJECTIVE: Road traffic crashes are mainly caused by three concurrent factors: infrastructure, vehicle, and human factors. Regarding infrastructure, in recent decades, a series of management tools and procedures called Road Infrastructure Safety Management (RISM) have been proposed. The aim of RISM procedures is to support road authorities in the prevention and mitigation of future road traffic crashes. One of these procedures is the In-built Road Safety Assessment (IRSA) methodology. The peculiarity of an IRSA methodology is the underpinning method used to assign a score to a road section with the aim of identifying those road sections in a network with safety-related infrastructure deficiencies. The objective of this paper is to provide an overall literature review of existing methodologies used worldwide for network-wide road safety assessment for rural road. METHODS: The review was conducted following the guidelines provided by Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) checklist 2020. The characteristics of these methodologies were compared with respect to the following research questions: What are the general characteristics of IRSA methodologies? What risk method/index is applied? Which data collection method/technique is used? What types of road parameters are considered for the assessment? What is the level of expertise needed to implement the methodology? Where and how are the results validated? RESULTS: As a result, 14 IRSA methodologies were identified. Also, the review showed that similar road parameters were used including: operating speed, road surface, low curve radius, poor sight distance (horizontal and vertical curves), lane width, undivided road (median type), shoulder width, sight obstructions (landscape, obstacles and vegetation), absence of traffic signs and road markings, traffic flow (AADT), intersection quality and density of intersections/lateral accesses. CONCLUSIONS: Despite these similarities, some differences were observed in risk formulation, safety quantities of parameters, level of expertise required, and validation of studies. Researchers may use these findings to develop future road safety assessment methodologies, while road practitioners can make use of this in identifying suitable network-wide assessment methods for safety assessments of road infrastructures. Finally, a series of recommendations for future research work on IRSA methodologies is suggested.

Improving Autonomous Vehicle Perception through Evaluating LiDAR Capabilities and Handheld Retroreflectivity Assessments.

Road safety is a serious concern worldwide, and traffic signs play a critical role in confirming road safety, particularly in the context of AVs. Therefore, there is a need for ongoing advancements in traffic sign evaluation methodologies. This paper comprehensively analyzes the relationship between traffic sign retroreflectivity and LiDAR intensity to enhance visibility and communication on road networks. Using Python 3.10 programming and statistical techniques, we thoroughly analyzed handheld retroreflectivity coefficients alongside LiDAR intensity data from two LiDAR configurations: 2LRLiDAR and 1CLiDAR systems. The study focused specifically on RA1 and RA2 traffic sign classes, exploring correlations between retroreflectivity and intensity and identifying factors that may impact their performance. Our findings reveal variations in retroreflectivity compliance rates among different sign categories and color compositions, emphasizing the necessity for targeted interventions in sign design and production processes. Additionally, we observed distinct patterns in LiDAR intensity distributions, indicating the potential of LiDAR technology for assessing sign visibility. However, the limited correlations between retroreflectivity and LiDAR intensity underscore the need for further investigation and standardization efforts. This study provides valuable insights into optimizing traffic sign effectiveness, ultimately contributing to improved road safety conditions.

It's getting hot in here: Effects of heat on temperature, disinfection, and opportunistic pathogens in drinking water distribution systems.

As global temperatures rise with climate change, the negative effects of heat on drinking water distribution systems (DWDS) are of increasing concern. High DWDS temperatures are associated with degradation of water quality through physical, chemical and microbial mechanisms. Perhaps the most pressing concern is proliferation of thermotolerant opportunistic pathogens (OPs) like Legionella pneumophila and Naegleria Fowleri. Many OPs can be controlled in DWDS by residual disinfectants such as chlorine or chloramine, but maintaining protective residuals can be challenging at high temperatures. This critical review evaluates the literature on DWDS temperature, residual disinfectant decay, and OP survival and growth with respect to high temperatures. The findings are synthesized to determine the state of knowledge and future research priorities regarding OP proliferation and control at high DWDS temperatures. Temperatures above 40 °C were reported from multiple DWDS, with a maximum of 52 °C. Substantial diurnal temperature swings from ∼30-50 °C occurred in one DWDS. Many OPs can survive or even replicate at these temperatures. However, most studies focused on just a few OP species, and substantial knowledge gaps remain regarding persistence, infectivity, and shifts in microbial community structure at high temperatures relative to lower water temperatures. Chlorine decay rates substantially increase with temperature in some waters but not in others, for reasons that are not well understood. Decay rates within real DWDS are difficult to accurately characterize, presenting practical limitations for application of temperature-dependent decay models at full scale. Chloramine decay is slower than chlorine except in the presence of nitrifiers, which are especially known to grow in DWDS in warmer seasons and climates, though the high temperature range for nitrification is unknown. Lack of knowledge about DWDS nitrifier communities may hinder development of solutions. Fundamental knowledge gaps remain which prevent understanding even the occurrence of high temperatures in DWDS, much less the overall effect on exposure risk. Potential solutions to minimize DWDS temperatures or mitigate the impacts of heat were identified, many which could be aided by proven models for predicting DWDS temperature. Industry leadership and collaboration is needed to generate practical knowledge for protecting DWDS water quality as temperatures rise.

Altered place engagement since COVID-19: A multi-method study of community participation and health among older americans.

Little is known about longer-term changes to community participation since the COVID-19 pandemic onset and potential implications for health and wellbeing in later life. This multi-method investigation analyzes national data from the COVID-19 Coping Study. Statistical analyses of survey data (n = 1,630; mean age 67.9 years; data collected April/May 2022) identified that adults residing in the US still tended to stay inside their homes more often since the pandemic onset. Overall, participants decreased their engagement with amenities such as eateries, gyms, and arts and cultural sites. Reflexive thematic analysis of semi-structured in-depth interviews (n = 57; mean age 70.7 years; data collected May-July 2021) identified altered community participation with perceived long-term impacts on physical, mental, and social health and wellbeing. The results provide novel insights about the critical nature of 'third places' to support later life, and policy implications to strengthen community environments. Investment in outdoor, well-ventilated, and distanced third places may support wellbeing.

Toward the European Health Data Space: The IMPaCT-Data secure infrastructure for EHR-based precision medicine research.

BACKGROUND: Art. 50 of the proposal for a Regulation on the European Health Data Space (EHDS) states that "health data access bodies shall provide access to electronic health data only through a secure processing environment, with technical and organizational measures and security and interoperability requirements". OBJECTIVE: To identify specific security measures that nodes participating in health data spaces shall implement based on the results of the IMPaCT-Data project, whose goal is to facilitate the exchange of electronic health records (EHR) between public entities based in Spain and the secondary use of this information for precision medicine research in compliance with the General Data Protection Regulation (GDPR). DATA AND METHODS: This article presents an analysis of 24 out of a list of 72 security measures identified in the Spanish National Security Scheme (ENS) and adopted by members of the federated data infrastructure developed during the IMPaCT-Data project. RESULTS: The IMPaCT-Data case helps clarify roles and responsibilities of entities willing to participate in the EHDS by reconciling technical system notions with the legal terminology. Most relevant security measures for Data Space Gatekeepers, Enablers and Prosumers are identified and explained. CONCLUSION: The EHDS can only be viable as long as the fiduciary duty of care of public health authorities is preserved; this implies that the secondary use of personal data shall contribute to the public interest and/or to protect the vital interests of the data subjects. This condition can only be met if all nodes participating in a health data space adopt the appropriate organizational and technical security measures necessary to fulfill their role.

Social Infrastructure Availability and Suicide Rates among Working-Age Adults in the United States.

Social infrastructure (SI) may buffer against suicide risk by improving social cohesion, social support, and information and resource sharing. This study uses an ecological approach to examine the relationship between county-level SI availability and suicide rates among working-age adults (ages 25-64) in the United States, a population for whom suicide rates are high, rising, and geographically unequal. Mortality data are from the National Vital Statistics System for 2016-2019. SI data are from the National Neighborhood Data Archive for 2013-2015 and capture the availability of typically free SI (e.g. libraries, community centers) and commercial SI (e.g. coffee shops, diners, entertainment venues). Results from negative binomial models show that suicide rates are significantly lower in counties with more SI availability, net of county demographic, socioeconomic, and health care factors. This relationship held for both typically free and commercial SI. Policymakers should consider strengthening existing and developing new social infrastructure, particularly in counties with less educated populations, as part of a broader strategy to reduce suicide rates in the United States.

The Structure of Clinical Ethical Decision-Making: A Hospital System Needs Assessment.

Bioethical dilemmas can emerge in research and clinical settings, from end-of-life decision-making to experimental therapies. The COVID-19 pandemic raised serious ethical challenges for healthcare organizations, highlighting the need to conduct needs assessments of the bioethics infrastructures of healthcare organizations. Clinical ethics committees (CECs) also create equitable policies, train staff on ethics issues, and play a consultative role in resolving the difficulty of complex individual cases. The main objective of this project was to conduct a needs assessment of the bioethics infrastructure within a comprehensive hospital system. A cross-sectional anonymous online survey, including quantitative and qualitative formatted questions. The survey was sent to five key leaders from the organization's hospitals. Survey questions focused on the composition, structure, function, and effectiveness of their facilities' bioethics infrastructure and ethics-related training and resources. Positive findings included that most facilities have active CECs with multidisciplinary membership; CECs address critical issues and encourage team members to express clinical ethics concerns. Areas of concern included uncertainty about how CECs function and the process for resolving clinical ethics dilemmas. Most reported no formal orientation process for CEC members, and many said there was no ongoing ethics education process. The authors conclude that if CECs are a critical institutional resource where the practice of medicine and mission intersect, having well-functioning ethics committees with trained and oriented members demonstrates an essential commitment to the mission. The survey revealed that more needs to be done to bolster the bioethics infrastructure of this institution.

Invisible and undervalued: A qualitative study of laboratory workers' experiences and perceptions of laboratory strengthening in Sierra Leone.

Background: The 2013-2016 West Africa Ebola outbreak highlighted the importance of laboratory capacity to outbreak response while also revealing its long-standing neglect. The outbreak prompted massive international investment into strengthening laboratory services across multiple healthcare settings. Objective: In this article, we explore hospital-based clinical laboratory workers' experiences and perceptions of their everyday working environment in Sierra Leone, and how recent investments in laboratory strengthening have shaped these. Methods: This qualitative study draws on in-depth interviews with eight laboratory workers and participant observation of laboratory practices at a tertiary referral hospital in Freetown between April 2019 and December 2019. Interview and observational data were coded and analysed using a reflexive thematic approach. Results: The Ebola outbreak prompted international investments in automated devices, biosafety training, and a new dedicated infectious diseases laboratory. However, little investment was made in the infrastructure and supply systems needed to sustain routine laboratory work or keep machines functioning. Laboratory workers perceived their work to be under-recognised and undervalued by the government, hospital managers and clinical staff, a perception compounded by under-use of the hospital's laboratory services by clinicians. Conclusion: Understanding laboratory technicians' views, experiences, and priorities is essential to any sustainable laboratory-strengthening effort. Investments in personnel should match investments in technologies and infrastructure for outbreak response. What this study adds: This study contributes to an understanding of how clinical laboratory personnel in Sierra Leone view and experience their work, and introduces the concept of social invisibility to explain these experiences.

Nancy S. Jecker, Zohar Lederman, and Anita Ho reply.

This letter replies to the letter "Colonial and Neocolonial Barriers to Companion Digital Humans in Africa," by Luís Cordeiro-Rodrigues, in the same, May-June 2024, issue of the Hastings Center Report.

Optimization of glass scrap recovery and reuse in road construction for promising physicochemical stabilization.

Waste glass is hugely present in Morocco, and can be recycled for many geotechnical purposes, including road construction. In contrast, earthworks often produce significant amounts of clay waste that lack the necessary technical criteria for use as barriers. The present work aimed to study the influence of the addition of glass waste on the evolution of the mechanical characteristics of clays stabilized with crushed glass (particles less than 63 µm). The work consists of carrying out CBR, Proctor, and shear tests on natural clay taken as a reference and mixtures (clay-crushed glass) at different percentages. Results showed that the addition of glass to clay decreases the swelling and compaction indices along with modifying the intrinsic characteristics of the clay.

[The Medical Informatics Initiative at a glance-establishing a health research data infrastructure in Germany]. / Die Medizininformatik-Initiative im Überblick ­ Aufbau einer Gesundheitsforschungsdateninfrastruktur in Deutschland.

The Medical Informatics Initiative (MII) funded by the Federal Ministry of Education and Research (BMBF) 2016-2027 is successfully laying the foundations for data-based medicine in Germany. As part of this funding, 51 new professorships, 21 junior research groups, and various new degree programs have been established to strengthen teaching, training, and continuing education in the field of medical informatics and to improve expertise in medical data sciences. A joint decentralized federated research data infrastructure encompassing the entire university medical center and its partners was created in the form of data integration centers (DIC) at all locations and the German Portal for Medical Research Data (FDPG) as a central access point. A modular core dataset (KDS) was defined and implemented for the secondary use of patient treatment data with consistent use of international standards (e.g., FHIR, SNOMED CT, and LOINC). An officially approved nationwide broad consent was introduced as the legal basis. The first data exports and data use projects have been carried out, embedded in an overarching usage policy and standardized contractual regulations. The further development of the MII health research data infrastructures within the cooperative framework of the Network of University Medicine (NUM) offers an excellent starting point for a German contribution to the upcoming European Health Data Space (EHDS), which opens opportunities for Germany as a medical research location.