Clinical trial research on COVID-19 in Germany – a systematic analysis

Background: In 2020, the COVID-19 pandemic led to an unprecedented volume of almost 3,000 clinical trials registered worldwide. We aimed to describe the COVID-19 clinical trial research agenda in Germany during the first year of the pandemic. Methods: We identified randomized clinical trials assessing interventions to treat or prevent COVID-19 that were registered in 2020 and recruited or planned to recruit participants in Germany. We requested recruitment information from trial investigators as of April 2021. Results: In 2020, 65 trials were completely (n=27) or partially (n=38) conducted in Germany. Most trials investigated interventions to treat COVID-19 (86.2%; 56/65), in hospitalized patients (67.7%; 44/65), with industry funding (53.8%; 35/65). Few trials were completed (21.5%; 14/65). Overall, 187,179 participants were planned to be recruited (20,696 in Germany), with a median number of 106 German participants per trial (IQR 40 to 345). From the planned German participants, 13.4% were recruited (median 15 per trial (IQR 0 to 44). Conclusions: The overall German contribution to the worldwide COVID-19 clinical trial research agenda was modest. Few trials delivered urgently needed evidence. Most trials did not meet recruitment goals. Evaluation and international comparison of the challenges for conducting clinical trials in Germany is needed.

Investigator initiated trials versus industry sponsored trials - translation of randomized controlled trials into clinical practice (IMPACT)

Background Healthcare decisions are ideally based on clinical trial results, published in study registries, as journal articles or summarized in secondary research articles. In this research project, we investigated the impact of academically and commercially sponsored clinical trials on medical practice by measuring the proportion of trials published and cited by systematic reviews and clinical guidelines. Methods We examined 691 multicenter, randomized controlled trials that started in 2005 or later and were completed by the end of 2016. To determine whether sponsorship/funding and place of conduct influence a trial’s impact, we created four sub-cohorts of investigator initiated trials (IITs) and industry sponsored trials (ISTs): 120 IITs and 171 ISTs with German contribution compared to 200 IITs and 200 ISTs without German contribution. We balanced the groups for study phase and place of conduct. German IITs were funded by the German Research Foundation (DFG), the Federal Ministry of Education and Research (BMBF), or by another non-commercial research organization. All other trials were drawn from the German Clinical Trials Register or ClinicalTrials.gov. We investigated, to what extent study characteristics were associated with publication and impact using multivariable logistic regressions. Results For 80% of the 691 trials, results were published as result articles in a medical journal and/or study registry, 52% were cited by a systematic review, and 26% reached impact in a clinical guideline. Drug trials and larger trials were associated with a higher probability to be published and to have an impact than non-drug trials and smaller trials. Results of IITs were more often published as a journal article while results of ISTs were more often published in study registries. International ISTs less often gained impact by inclusion in systematic reviews or guidelines than IITs. Conclusion An encouraging high proportion of the clinical trials were published, and a considerable proportion gained impact on clinical practice. However, there is still room for improvement. For publishing study results, study registries have become an alternative or complement to journal articles, especially for ISTs. IITs funded by governmental bodies in Germany reached an impact that is comparable to international IITs and ISTs.

Exploring Past, Present and Future of Orthotics and Prosthetics in Pakistan

This is a qualitative study to explore the perception of Orthotists and Prosthetists regarding past, present and future of their profession. The Qualitative research approach using individual interviews. Data was collected from professionals of some private and some government sector in Rawalpindi, Peshawar and Lahore during April 2019 to July 2019. The sample size was 12. A demographic questionnaire and standarized instrument from Nvivo was filled satisfying the inclusion criteria. A comprehensive audio-videography have been developed, recorded, transcripted and documented. Data was transcribed and thematic analysis along with characteristics was drawn manually. Data verification was done with the help of coders. After the extraction of data followings results are emerged. General category themes are trainings and seminars, opportunities, government setup, lack of coherence among professionals, uniform curriculum, and establishment of council, effects of earthquake, German contribution and techniques/technology. Barriers are identified at the level are lack of awareness/ acknowledgement, low job opportunities, no proper workshops, poor referral system, limited resources and old technologies. It is concluded that the field of orthotics and prosthetics in Pakistan need attention in the following categories i.e. trainings and seminars, job opportunities, uniform curriculum, unity among professionals, establishment of council, acknowledgment at government level and awareness among other health professionals.

The Origins of Neoliberalism and the Role of the German State

This chapter reviews the most prominent explanations of the global rise of neoliberalism provided within critical International Political Economy: (1) a state-centered argument, which holds that neoliberalism was imposed by the United States in a bid to reassert its global dominance; (2) a class-based argument, which sees neoliberalism as the project of globalizing elites who sought to restore their corporate profits and power; and (3) an ideational argument, which describes the rise of neoliberalism as a paradigmatic shift in economic ideas. The chapter argues that these accounts share a common bias: they pivot unduly on the Anglo-American world and are unable to capture the peculiar German contribution to the origins of neoliberalism. As a result, they misread the rise of Germany to the apex of a neoliberal Europe as a belated repetition of the same global movement spearheaded by the US and the UK.

German Contribution to Archeological Study of the Golden Horde Ukek: A Review of Ethnographic Sources

The article presents a chronological overview of the study of the Uvek settlement. Arguably one of the oldest cities and major political and economic centers of the Golden Horde, Ukek stood at the intersection of the Northern branch of the Great Silk Road and the Great Volga Trade Route, providing trade caravans and embassies a safe way across the Volga on their further journey to the Crimea or Scandinavia. It is noted that having been weakened by the decline of trade and the plague outbreak, Ukek was completely destroyed by Tamerlane and soon forgotten. It is safe to say that much of the credit for conducting research of that archaeological site belongs to researchers from countries other than Russia. The aim of the article is to reveal the role of German researchers in the study of Ukek. Methods of research. The author provides a timeline of the research of the Uvek archaeological site carried out by German archeologists. Having consulted various sources, primarily academic papers, the author has been able to collect information about the German researchers of Ukek and analyze their academic contribution. It is noted that the first scientific publication about Ukek was published in German as German researchers revealed the connection between Ukek and the Uvek settlement and started the first excavations there. As a result of the analysis, the article concludes that German archeologists, being at the origins of the research of the Uvek archaeological site, contributed to the formation of the traditions of the archeological schools of Volga region. The author emphasizes that the course of the study of the Ukek heritage is important for understanding the cultural and historical processes in the Volga region that facilitated academic links between this region and Europe.

Religious Beliefs as World-View Beliefs

In this paper, I defend a moderately cognitive account of religious beliefs. Religious beliefs are interpreted as “worldview beliefs”, which I explicate as being indispensable to our everyday and scientific practice; my reading is nonetheless distinct from non-cognitivist readings of “worldview belief” which occasionally appear in the literature. I start with a brief analysis of a recent German contribution to the debate which on the one hand (rightly) insists on the priority of epistemic reasons for or against religious beliefs, but on the other hand contends that religious beliefs are worldview beliefs (section 1). This leads me to explicate a special sense of worldview beliefs, as well as their cognitive role (2). After that, I shed some light on a special epistemological characteristic of worldview beliefs, namely the strong involvement of “free certitude” in their acceptance. I explore the implications for the possible role of arguments for worldview beliefs, especially for worldview beliefs concerning theism (3).