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Hierarchy of timescales in a disordered spin- 1 2 XX ladder
No full textUnderstanding the timescales associated with relaxation to equilibrium in closed quantum many-body systems is one of the central focuses in the study of their nonequilibrium dynamics. At late times, these relaxation processes exhibit universal behavior, emerging from the inherent randomness of chaotic Hamiltonians. In this work, we investigate a disordered spin- 1 / 2 XX ladder—an experimentally realizable model known for its diffusive dynamics—to explore the connection between transport properties and spectral measures derived solely from the energy levels of the system via these relaxation timescales. We begin by analyzing the spectral form factor, which yields the time when the system begins to follow the random matrix theory (RMT) statistics, known as the RMT time. We then determine the Thouless times—the average times for a local excitation to diffuse across the entire finite system—through the linear-response theory for both spin and energy transport. Our numerical results confirm that the RMT time scales quadratically with system size and upper bounds the Thouless times. Interestingly, we also find that, unlike other nonintegrable models, spin diffusion proceeds faster than energy diffusion.Deutsche Forschungsgemeinschaft http://dx.doi.org/10.13039/50110000165
Care-related questions for specialized outpatient palliative care teams when faced with requests for assisted suicide: A case series
No full textZusammenfassung Einleitung Seit der Aufhebung des § 217 StGB Anfang 2020 stellen sich auch in der spezialisierten ambulanten Palliativversorgung (SAPV) neue Herausforderungen im Umgang mit Wünschen nach Suizidassistenz, die bislang kaum systematisch untersucht wurden. Ziel der Arbeit ist es, Fälle mit einem Wunsch nach Suizidassistenz in der SAPV darzustellen und zu analysieren. Auf dieser Grundlage sollen zentrale Herausforderungen in der Versorgung identifiziert und Ansatzpunkte für Strategien zum Umgang mit diesen Wünschen entwickelt werden. Methoden Es wurde eine retrospektive Fallanalyse aller Patient:innen durchgeführt, die zwischen 02/2020 und 08/2025 durch das SAPV-Team der Uniklinik Köln betreut wurden und einen expliziten Wunsch nach Suizidassistenz geäußert haben. Die Daten wurden aus der elektronischen Dokumentation (PalliDoc®) extrahiert. Versorgungspraktische und -ethische Fragestellungen wurden im multiprofessionellen Team abgeleitet. Ergebnisse Insgesamt wurden sechs Patient:innen eingeschlossen. Fünf litten an amyotropher Lateralsklerose, eine Person an einer fortgeschrittenen onkologischen Erkrankung. Drei Patient:innen nahmen externe Suizidassistenz in Anspruch. Diskussion Zentrale Herausforderungen in der Versorgung betrafen die Rollenklärung der SAPV, die Kommunikation über Suizidassistenz, die Begleitung von Nahestehenden sowie den Versorgungsabschluss. Eine klare organisationsinterne Haltung sowie definierte Kommunikationswege im Team und gegenüber Patient:innen sowie deren Nahestehenden wirken unterstützend. Die Arbeit formuliert praxisrelevante Fragestellungen zur konzeptionellen Weiterentwicklung des Umgangs mit Wünschen nach Suizidassistenz.Abstract Introduction Following the repeal of § 217 of the German Criminal Code in early 2020, new related challenges have also emerged in specialized outpatient palliative care (SAPV) regarding how to address requests for assisted suicide that have so far received little systematic investigation. The aim of this study is to describe and analyze cases involving requests for assisted suicide within SAPV. On this basis, key challenges in care are identified and potential strategies for dealing with such requests are developed. Methods A retrospective case analysis was conducted of all patients who were cared for by the SAPV team at the University Hospital Cologne between February 2020 and August 2025 and explicitly expressed a wish for assisted suicide. Data were extracted from the electronic documentation system (PalliDoc®). Practical and ethical issues related to care were derived within the multiprofessional team. Results A total of six patients were included. Five patients suffered from amyotrophic lateral sclerosis and one patient had advanced oncological disease. Three patients made use of external assisted suicide services. Discussion Central challenges in care concerned clarification of the role of SAPV, communication about assisted suicide, support of relatives, and the conclusion of care. A clear internal organizational position, as well as defined communication pathways within the team towards patients and their relatives, proved to be supportive. This study formulates practice-relevant questions for the conceptual further development of approaches to requests for assisted suicides.Zusammenfassung Einleitung Seit der Aufhebung des § 217 StGB Anfang 2020 stellen sich auch in der spezialisierten ambulanten Palliativversorgung (SAPV) neue Herausforderungen im Umgang mit Wünschen nach Suizidassistenz, die bislang kaum systematisch untersucht wurden. Ziel der Arbeit ist es, Fälle mit einem Wunsch nach Suizidassistenz in der SAPV darzustellen und zu analysieren. Auf dieser Grundlage sollen zentrale Herausforderungen in der Versorgung identifiziert und Ansatzpunkte für Strategien zum Umgang mit diesen Wünschen entwickelt werden. Methoden Es wurde eine retrospektive Fallanalyse aller Patient:innen durchgeführt, die zwischen 02/2020 und 08/2025 durch das SAPV-Team der Uniklinik Köln betreut wurden und einen expliziten Wunsch nach Suizidassistenz geäußert haben. Die Daten wurden aus der elektronischen Dokumentation (PalliDoc®) extrahiert. Versorgungspraktische und -ethische Fragestellungen wurden im multiprofessionellen Team abgeleitet. Ergebnisse Insgesamt wurden sechs Patient:innen eingeschlossen. Fünf litten an amyotropher Lateralsklerose, eine Person an einer fortgeschrittenen onkologischen Erkrankung. Drei Patient:innen nahmen externe Suizidassistenz in Anspruch. Diskussion Zentrale Herausforderungen in der Versorgung betrafen die Rollenklärung der SAPV, die Kommunikation über Suizidassistenz, die Begleitung von Nahestehenden sowie den Versorgungsabschluss. Eine klare organisationsinterne Haltung sowie definierte Kommunikationswege im Team und gegenüber Patient:innen sowie deren Nahestehenden wirken unterstützend. Die Arbeit formuliert praxisrelevante Fragestellungen zur konzeptionellen Weiterentwicklung des Umgangs mit Wünschen nach Suizidassistenz.Abstract Introduction Following the repeal of § 217 of the German Criminal Code in early 2020, new related challenges have also emerged in specialized outpatient palliative care (SAPV) regarding how to address requests for assisted suicide that have so far received little systematic investigation. The aim of this study is to describe and analyze cases involving requests for assisted suicide within SAPV. On this basis, key challenges in care are identified and potential strategies for dealing with such requests are developed. Methods A retrospective case analysis was conducted of all patients who were cared for by the SAPV team at the University Hospital Cologne between February 2020 and August 2025 and explicitly expressed a wish for assisted suicide. Data were extracted from the electronic documentation system (PalliDoc®). Practical and ethical issues related to care were derived within the multiprofessional team. Results A total of six patients were included. Five patients suffered from amyotrophic lateral sclerosis and one patient had advanced oncological disease. Three patients made use of external assisted suicide services. Discussion Central challenges in care concerned clarification of the role of SAPV, communication about assisted suicide, support of relatives, and the conclusion of care. A clear internal organizational position, as well as defined communication pathways within the team towards patients and their relatives, proved to be supportive. This study formulates practice-relevant questions for the conceptual further development of approaches to requests for assisted suicides
Factors associated with medication self-management performance in the “Ability to Self-administer Medication in Non-demented In-hospital Patients” (ABLYMED) study
No full textAllogeneic stem cell transplantation for major T-cell lymphoma entities: an analysis of the EBMT-lymphoma working party
No full textAbstract Background Allogeneic hematopoietic stem cell transplantation (allo-SCT) is an established treatment for peripheral T-cell lymphoma (PTCL), particularly for patients with relapsed/refractory (r/r) disease. We aimed to retrieve novel information on the role of histology, disease status prior to transplantation, and donor choice for patients with PTCL not otherwise specified (NOS), angioimmunoblastic T-cell lymphoma (AITL), and anaplastic lymphoma kinase (ALK)-negative ALCL. We compared imaging by computed tomography (CT) or positron emission tomography (PET) for defining disease status prior to allo-SCT. Methods Eligible were adult patients with PTCL-NOS, AITL, and ALK-negative ALCL undergoing allo-SCT between 2010 and 2022 and reported to EBMT. Results 1958 patients underwent allo-SCT. Of patients with known number of prior lines of therapies (n = 1310), 301 (23%), 431 (32.9%) and 578 (44.1%) patients received allo-SCT after one (1L), two (2L) or three or more therapy lines (3L +), respective. Three-year GvHD-free, relapse-free survival (GRFS), progression-free survival (PFS) and overall survival (OS) were 35.8%, 50.9% and 56.8%, respectively. Three-year relapse incidence (RI) and non-relapse mortality were 25.1% and 24.1%, respectively. In multivariate analysis, histology other than AITL, no complete response (CR) at transplantation, having a haploidentical donor and higher age at allo-SCT resulted in significantly lower PFS and/or OS. Prior autologous SCT had no impact on the results of allo-SCT and major outcomes did not significantly change when the analyses were restricted to the patients with PET-based response at allo-SCT. Patients allografted in partial response (PR) or SD/PD still achieved long-term survival with a 3-year PFS/OS of 46%/53.7% and 39.6%/43.6%, respectively. Conclusion Allo-SCT is a valid treatment option in relapsed/refractory PTCL where targeted therapies still play a limited role. Patients with AITL survived significantly better than patients with PTCL NOS or ALK-negative ALCL following a significantly lower RI, also when comparing CR/complete metabolic response (CMR) and PR patients separately. Higher age and non-CR at allo-SCT are associated with worse outcomes
Letter to the editor regarding “Safety of tenecteplase versus alteplase for intravenous thrombolysis in acute ischemic stroke patients with direct oral anticoagulation: experience from a German stroke center” by Mers et al.
No full textRetrospective isotope monitoring reveals spatial and temporal effects of anthropogenic pressures on the trophic ecology of European wildcats (Felis silvestris) in Germany
No full textThe European wildcat ( Felis silvestris ) is increasingly exposed to anthropogenic pressures, including habitat fragmentation, agricultural intensification, road mortality and hybridisation with domestic cats ( Felis catus ). These factors may alter trophic behaviour, ecological roles, and long-term conservation prospects. In this study, we use stable isotope analysis of cat hair ( δ ¹³C, δ ¹⁵N, δ ³⁴S) to assess dietary patterns and niche dynamics in wildcats, domestic cats, and their hybrids across three German regions. We combine two complementary case studies: (1) a spatial comparison between a core population with low hybridisation rates (Taunus) and a heavily introgressed range edge population (Markgräflerland), and (2) a 26-year retrospective dataset from Thuringia (East Thuringia, Hainich, Harz Foreland, Thuringian Basin, Thuringian Forest) to analyse temporal dietary trends and responses to landscape change. Our results reveal trophic differences among the taxa. Wildcats showed the narrowest isotopic niches, particularly in the Taunus, indicating strong ecological specialization. In contrast, hybrids occupied the broadest niches and showed substantial isotopic overlap with wildcats, especially in the region with high hybridisation rates. Domestic cats exhibited minimal niche overlap with wildcats, suggesting limited trophic competition. Long-term trends in Thuringian wildcats revealed increasing δ ¹³C values over time, primarily in summer-grown hair, suggesting a growing reliance on prey associated with agricultural habitats. Correlations with land use and individual traits further highlighted how both factors shape isotopic signatures. Retrospective isotope monitoring using archived tissues provides a powerful, non-invasive tool to assess anthropogenic influences, hybridisation impacts, and long-term ecological change in elusive or protected carnivores such as the European wildcat.Deutsche Forschungsgemeinschaft http://dx.doi.org/10.13039/501100001659Paul-Ungerer-Stiftun
T-COL: Generating Counterfactual Explanations for General User Preferences on Variable Machine Learning Systems
No full textTo address the interpretability challenge in machine learning (ML) systems, counterfactual explanations (CEs) have emerged as a promising solution. CEs are unique as they provide workable suggestions to users, instead of explaining why a certain outcome was predicted. The application of CEs encounters two main challenges: general user preferences and variable ML systems. On one hand, user preferences for specific values can vary depending on the task and scenario. On the other hand, the ML systems for verification may change while the CEs are performed. Thus, user preferences tend to be general rather than specific, and CEs need to be adaptable to variable ML models while maintaining robustness even as these models change. Facing these challenges, we propose general user preferences based on insights from psychology and behavioral science, and add the challenge of non-static ML systems as one preference. Moreover, we introduce a novel method, Tree-based Conditions Optional Links (T-COL) for generating CEs adaptable to general user preferences. Moreover, we employ T-COL to enhance the robustness of CEs with specific conditions, making CEs robust even when the ML models are replaced. To assess subjectivity preferences, we define LLM-based autonomous agents to simulate users and align them with real users. Experiments show that T-COL outperforms all baselines in adapting to general user preferences
Reliability of Results from Randomized Studies and Systematic Reviews in Acupuncture: A Methodological Review for Acupuncture Against Symptoms of Breast Cancer Care
No full textPredicting longitudinal basal forebrain volume in the Alzheimer’s disease spectrum: the role of sex and ApoE epsilon 4 genotype
No full textIntroduction Imaging studies showed early atrophy of the cholinergic basal forebrain (BF) already at prodromal stages of sporadic Alzheimer’s disease (AD). Women and carriers of the ApoE epsilon 4 (ApoE ε4) allele are more likely to develop the disease; however, the underlying mechanisms are still unclear. Here we aimed at exploring the impact of sex and ApoE ε4 genotype in the AD spectrum on longitudinal measures of the basal forebrain and hippocampus, as a comparison region. Methods We leveraged the German multi-centered study DELCODE and analyzed 712 individuals (median age: 71.25 years, interquartile range [IQR] = 9.22) with follow-up MRI scans (median time: 2.8 years, [IQR] = 1.75). Diagnostic groups comprised cognitively normal ( N = 184), subjective cognitive decline ( N = 331), mild cognitive impairment ( N = 128) and AD ( N = 69). Regarding ApoE genotype, 5% of participants were ε4 homozygotes, while 27% were heterozygotes. Volume segmentation and linear mixed-effect models were used to calculate the effects of ApoE ε4 genotype, sex, diagnosis, age, time and their interactions in TIV-adjusted basal forebrain and hippocampal volumes. Results The hippocampus, but not the basal forebrain, showed significant atrophy over time (Hipp: β = −0.014, p < 0.001; BF: β = 0.040, p = 0.044). Post-TIV correction, female participants had significantly larger baseline basal forebrain ( β = 0.300, p < 0.001) and hippocampal volumes ( β = 0.273, p < 0.001). ApoE ε4 predicted smaller baseline volumes in both regions. After adjusting for multiple comparisons, faster longitudinal atrophy was observed only for ApoE ε4 homozygotes in the hippocampus ( β = −0.037, p < 0.001), with no corresponding effect in the basal forebrain ( β = 0.000, p = 0.841). Discussion Our findings did not show the anticipated longitudinal effects of sex and ApoE ε4 on longitudinal basal forebrain volume. Only hippocampal atrophy progressed significantly faster in ApoE ε4 homozygote carriers. This dissociation may reflect stage-dependent neurodegenerative processes, with early basal forebrain vulnerability followed by more rapid hippocampal decline, as well as methodological and sample-related constraints. If replicated, these findings suggest that hippocampal measures may be more sensitive longitudinal biomarkers in ApoE ε4 homozygotes, while sex- and ApoE ε4-related effects on the cholinergic system may be more prominent at earlier disease stages