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Owning, renting and environmental proactivity: the role of housing tenure in hypothetical housing decisions
No full textPast research indicates that for older individuals, transitioning to a home environment better suited to their needs reduces physical, psychological, and social risks, and may even impact the rate of institutionalization. Tenants, compared to homeowners, are subject to different conditions that influence their decisions to relocate, which can either encourage or inhibit them in their pursuit of environmental proactivity. This study investigates whether tenants make relocation decisions based on different factors than do owners. For this purpose, hypothetical relocation decisions are made under the influence of certain ownership constellations. The dataset consists of 264 participants. They were asked about home ownership and then presented with housing vignettes (factorial survey) to indicate how likely they would be to move to a new apartment. The data were analyzed using group comparisons and zero-inflated models. Tenants favor new apartments if their current dwelling is larger than the new one, and if they haven’t lived in their current home for a long time. In contrast, owners prefer the new apartment to have a central location. Both groups consider rent, proximity to kin, and a senior-friendly bathroom as important for the new apartment, with rent being more important to tenants than to those who are currently owners. In both groups, we identified predictors that can be interpreted as barriers to environmental proactivity. The results add to the large body of literature on social inequality in old age
Public Goods Games in Disease Evolution and Spread
No full textCooperation arises in nature at every scale, from within cells to entire ecosystems. Public goods games (PGGs) are used to represent scenarios characterised by the conflict/dilemma between choosing cooperation as a socially optimal strategy and defection as an individually optimal strategy. Evolutionary game theory is often used to analyse the dynamics of behaviour emergence in this context. Here, we focus on PGGs arising in the disease modelling of cancer evolution and the spread of infectious diseases. We use these two systems as case studies for the development of the theory and applications of PGGs, which we succinctly review. We also posit that applications of evolutionary game theory to decision-making in cancer, such as interactions between a clinician and a tumour, can learn from the PGGs studied in epidemiology, where cooperative behaviours such as quarantine and vaccination compliance have been more thoroughly investigated. Furthermore, instances of cellular-level cooperation observed in cancers point to a corresponding area of potential interest for modellers of other diseases, be they viral, bacterial or otherwise. We aim to demonstrate the breadth of applicability of PGGs in disease modelling while providing a starting point for those interested in quantifying cooperation arising in healthcare
Reading behavior as an indicator of comprehension monitoring when reading expository texts
No full textComprehension of expository texts is an important prerequisite for self-regulated learning. Processes of passive validation and metacognitive monitoring are thought to be involved in building a coherent situation model of a text. Inconsistency tasks are often used to measure these processes. Several studies have shown longer reading times for inconsistent sentences than for consistent sentences. However, it remains unclear whether the additional time arises from passive disruptions of the reading process when encountering an inconsistency or from metacognitive processes of reanalysis of previous text. To address this issue, we recorded the reading behavior of 96 university students with an eye-tracker while they read inconsistent and consistent expository texts. We analyzed first-pass reading (first-pass reading time, lookbacks) and reanalysis (rereading time, revisits) at the level of the (in)consistent target word, at the sentence-final word of the target sentence, and in the pre-target text. Our results did not strongly support the hypothesis that immediate changes in reading behavior when inconsistencies are first encountered influence the detection and processing of inconsistencies. Our results partially supported the hypothesis that processes of text reanalysis, specifically of the source of inconsistency, increase the probability of identifying an inconsistency. The findings indicate that a purposeful reanalysis of passages that appear inconsistent to readers improves situation model construction for (short) expository texts about conceptually difficult topics. Learning from texts thus requires metacognitive comprehension monitoring beyond passive validation processes.proves situation model construction for (short) expository texts about conceptually difficult topics. Learning from texts thus requires metacognitive comprehension monitoring beyond passive validation processes
Convergence of Nonmonotone Proximal Gradient Methods under the Kurdyka-Łojasiewicz Property without a Global Lipschitz Assumption
No full textWe consider the composite minimization problem with the objective function being the sum of a continuously differentiable and a merely lower semicontinuous and extended-valued function. The proximal gradient method is probably the most popular solver for this class of problems. Its convergence theory typically requires that either the gradient of the smooth part of the objective function is globally Lipschitz continuous or the (implicit or explicit) a priori assumption that the iterates generated by this method are bounded. Some recent results show that, without these assumptions, the proximal gradient method, combined with a monotone stepsize strategy, is still globally convergent with a suitable rate-of-convergence under the Kurdyka-Łojasiewicz property. For a nonmonotone stepsize strategy, there exist some attempts to verify similar convergence results, but, so far, they need stronger assumptions. This paper is the first which shows that nonmonotone proximal gradient methods for composite optimization problems share essentially the same nice global and rate-of-convergence properties as its monotone counterparts, still without assuming a global Lipschitz assumption and without an a priori knowledge of the boundedness of the iterates
Biomarkers in prostate cancer: current status and future directions in radiotherapy—statement from the Prostate Cancer Working Group of the German Society of Radiation Oncology (DEGRO)
No full textPurpose
Prostate cancer (PCa) is the most frequently diagnosed malignancy among men in Germany. Advances in diagnostics and treatment have transformed PCa into a chronic disease. Given the heterogeneity of PCa, there is a need for additional stratification tools. This review focuses on updating the evidence for genomic classifiers (GC; Decipher [Veracyte Inc. San Diego, CA, USA], Prolaris [Myriad Genetics, Inc., Salt Lake City, UT], and Oncotype DX [Exact Sciences, Madison, WI, USA] tests) and artificial intelligence (AI)-based digital histopathology biomarkers (ArteraAI Prostate Test) in the context of radiotherapy (RT) for PCa.
Methods
The members of the Prostate Cancer Working Group of the German Society of Radiation Oncology (DEGRO) conducted an updated literature search on GCs and histopathological biomarkers in PCa, covering original articles published between January 2022 and February 2024 in the PubMed database.
Results
In addition to previous reviews, 11 relevant studies were identified, of which nine studies analyzed biomarkers within prospective phase II or III trials. Eight trials focused on genomic biomarkers, of which three addressed GCs in primary localized PCa, three in recurrent PCa in the setting of salvage RT, and two in metastatic castration-sensitive PCa. In localized PCa, GCs could be validated in a retrospective analysis of randomized controlled trials. Additionally, three studies reported on AI-based histopathology biomarkers.
Conclusion
Genomic classifiers and AI-based digital histopathology models might have superior prognostic and predictive value compared to established clinical and pathological parameters in localized, recurrent, and metastatic PCa. Despite promising results, prospective validation of these biomarkers in randomized trials remains limited. This review underscores the need for further prospective trials to confirm the usefulness of these biomarkers in PCa
Tidal volume and mortality during extracorporeal membrane oxygenation for acute respiratory distress syndrome: a multicenter observational cohort study
No full textBackground
Approximately half of the patients with acute respiratory distress syndrome (ARDS) receiving extracorporeal membrane oxygenation (ECMO) remain ECMO-dependent beyond 14 days after ECMO initiation. The identification of factors associated with mortality during an ECMO run may update prognostic assessment and focus clinical interventions.
Methods
In this observational study, data from 1137 patients with COVID-19 ARDS receiving ECMO support in 29 German centers between January 1st 2020 and July 31st 2021 were analyzed. Multivariable stepwise logistic regression analyses were performed to build survival prediction models with day-by-day data during the first 14 days of an ECMO run. The primary endpoint was all-cause mortality in the intensive care unit.
Results
Mortality in this cohort was high (75%). Patients who remained ECMO-dependent on day 14 of their ECMO run showed comparable mortality to all patients receiving ECMO support on day 1. Yet, factors associated with mortality changed during the first 14 days of ECMO support. On day 1 of ECMO support, only patient age and lactate remained in the final mortality prediction model. On day 14 of an ECMO run, tidal volume was independently associated with mortality (adjusted Odds Ratio 0.693 (95%CI 0.564–0.851), p < 0.001 for 1 mL/kg increase in tidal volume per predicted body weight). The adjusted mortality for patients with a tidal volume below 2 mL/kg on day 14 of their ECMO run was above 80% (lower limit of the 95%CI interval). Higher tidal volume was mainly based on higher respiratory system compliance. Yet, the benefit of higher compliance was not observed in some patients who were still ventilated with very low driving pressures despite remaining ECMO-dependent on day 14 of ECMO support.
Conclusions
Mortality predictors change during the course of an ECMO run. In a cohort with high mortality, on day 14 of ECMO support for ARDS, tidal volume may be an independent predictor of mortality. Further analyses on ventilation strategies in patients who remain ECMO-dependent are needed
Detrended fluctuation analysis of heart rate variability during exercise: Time to reconsider the theoretical and methodological background. Comment on: Cassirame et al.`s (2025) Detrended fluctuation analysis to determine physiologic thresholds, investigation and evidence from incremental cycling test. Eur J Appl Physiol 125:523–533
No full textNo abstract available
Endovascular explantation of a PFO occluder device displaced in the suprarenal abdominal aorta
No full textNo abstract available
Digital empowerment on hold: DiGA adoption gaps−a German national cross-sectional patient survey study
No full textDigital health applications (DiGAs), prescribable and reimbursed in Germany since 2020, have the potential to enhance patient self-management. This study aimed to assess rheumatology patients’ awareness, willingness to use, suitability, and actual adoption of DiGAs. Between February 17 and April 8, 2025, adult patients attending seven German rheumatology outpatient clinics completed an electronic survey. A total of 246 patients participated (mean age 50.4 years; 71.1% female), with most treated at university hospitals (59.8%). The predominant diagnoses were rheumatoid arthritis (41.1%), psoriatic arthritis (18.3%), and axial spondyloarthritis (10.2%). While only 19.5% reported prior use of medical apps, 39.8% were aware of DiGAs, and 12.6% had used one. Notably, 84.6% reported at least one comorbidity matching an approved DiGA indication, most commonly back pain (54.8%), chronic pain (52.0%), and sleep disorders (35.8%). A majority expressed willingness to regularly use a DiGA (72.4%) and were open to recommendations from their rheumatologists or health insurers (72.8%). Additionally, 76.0% showed interest in a rheumatology-specific DiGA. Despite high interest and relevant comorbidities among patients, current DiGA use was limited. These findings underscore the need for targeted implementation strategies to increase uptake and realize the full potential of digital health applications in rheumatology care. The results also emphasize the need for rheumatologists to actively educate and guide their patients regarding the availability and potential benefits of DiGAs
Pedagogical content knowledge for simulations and mathematical modelling with digital tools: a quasi-experimental study with pre-service mathematics teachers
No full textThis study investigates the promotion of pedagogical content knowledge for simulations and mathematical modelling with digital tools among pre-service teachers. This knowledge can be described as modelling-specific TPaCK in the context of digital tools. In a quasi-experimental design, three groups of pre-service teachers (N = 230) were analysed and compared over four semesters. Experimental Group 1 attended a course on simulations and mathematical modelling with digital tools, Experimental Group 2 attended a course on mathematical modelling without the use of digital tools and the control group attended mathematics education courses without specific reference to modelling or digital tools. The results show that TPaCK was promoted significantly more in the group that worked with digital tools than in the other two groups in its four theoretically and empirically derived dimensions (theory knowledge, task knowledge, process knowledge and intervention knowledge). This study confirms that courses specifically designed for digital tools can effectively promote the modelling-specific TPaCK of pre-service mathematics teachers in all four dimensions. The results underscore the importance of integrating digital tools into teacher training and show that general pedagogical knowledge for modelling is not sufficient without a focus on digital tools to build pedagogical knowledge for simulations and mathematical modelling with digital tools