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Abstract Aims Cognitive impairment (CI) is a common, yet frequently unrecognized co‐morbidity in chronic heart failure (HF). We quantified trajectories of cognitive performance, brain volume, and related clinical outcome over a time course of 6 years. Methods and results The Cognition.Matters‐HF cohort study recruited patients with stable HF of any aetiology and severity. Beyond cardiological assessment, the workup included cognitive testing and brain magnetic resonance imaging (MRI). Of 148 recruited patients, 70% exhibited CI at baseline. During the median follow‐up time of 69 months (quartiles: 68, 70), indicators of HF severity remained essentially unaltered. CI was also stable, with the exception of intensity of attention, where age‐adjusted t‐scores decreased from 42 (38, 46) to 38 (34, 44; P

Introduction: Skin cancer is often fatal, which motivates new therapy avenues. Recent advances in cancer treatment are indicative of the importance of combination treatments in oncology. Previous studies have identified small molecule-based therapies and redox-based technologies, including photodynamic therapy or medical gas plasma, as promising candidates to target skin cancer. Objective: We aimed to identify effective combinations of experimental small molecules with cold gas plasma for therapy in dermato-oncology. Methods: Promising drug candidates were identified after screening an in-house 155-compound library using 3D skin cancer spheroids and high content imaging. Combination effects of selected drugs and cold gas plasma were investigated with respect to oxidative stress, invasion, and viability. Drugs that had combined well with cold gas plasma were further investigated in vascularized tumor organoids in ovo and a xenograft mouse melanoma model in vivo. Results: The two chromone derivatives Sm837 and IS112 enhanced cold gas plasma-induced oxidative stress, including histone 2A.X phosphorylation, and further reduced proliferation and skin cancer cell viability. Combination treatments of tumor organoids grown in ovo confirmed the principal anti-cancer effect of the selected drugs. While one of the two compounds exerted severe toxicity in vivo, the other (Sm837) resulted in a significant synergistic anti-tumor toxicity at good tolerability. Principal component analysis of protein phosphorylation profiles confirmed profound combination treatment effects in contrast to the monotherapies. Conclusion: We identified a novel compound that, combined with topical cold gas plasma-induced oxidative stress, represents a novel and promising treatment approach to target skin cancer.

Abstract Aims Mild cognitive impairment and dementia are common and serious co‐morbidities in people with chronic heart failure (HF) as they increase hospitalization rates, mortality and health care costs. Upon other factors, dysregulated cerebral perfusion might contribute to brain pathology. We aimed to evaluate the association of non‐invasively measured blood flow (BF) and pulsatility index (PI) of the internal carotid artery (ICA) with (i) chronic HF parameters, (ii) brain morphologic measures and (iii) cognitive impairment. Methods and results This post‐hoc analysis of the observational, prospective Cognition.Matters‐HF study included 107 chronic HF patients without atrial fibrillation or carotid artery stenosis (aged 63 ± 10 years; 19% women). Using extracranial sonography, we measured ICA‐BF and ICA‐PI 1.5 cm distal of the carotid bifurcation. Brain magnetic resonance imaging was performed on a 3‐Tesla scanner to quantify cerebral atrophy, hippocampal atrophy and white matter hyperintensities. Extensive neuropsychological testing tested the cognitive domains intensity of attention, visual/verbal memory and executive function (including its subdomains selectivity of attention, visual/verbal fluency and working memory) using a comprehensive test battery. (i) Neither ICA‐BF (median 630 (quartiles 570, 700) mL/min) nor ICA‐PI (1.05 (0.96. 1.23)) related to left ventricular ejection fraction, left atrial volume index or NT‐proBNP. (ii) Higher ICA‐PI (r = 0.25; P = 0.011), but not ICA‐BF (r = 0.08; P = 0.409), associated with increased volume of white matter hyperintensities beyond ageing, while neither ICA‐PI nor ICA‐BF related to cerebral or hippocampal atrophy indices. (iii) ICA‐BF, but not ICA‐PI, positively correlated with age‐adjusted T‐scores of executive function (r = 0.38; P

Abstract Aims Cellular communication network factor 1 (CCN1) is an independent predictor of MACE after ACS and elevated levels correlated with infarct size after STEMI. We compared the prognostic accuracy of baseline levels of CCN1, NT‐proBNP, hsTnT, and ST2 and changes in levels over time to predict the development of structural and functional alterations typical of LV remodelling. Methods Serial 3‐T cMRI scans were performed to determine LVEF, LVEDV, LVESV, infarct size, and relative infarct size, which were correlated with serial measurements of the four biomarkers. The prognostic significance of these biomarkers was assessed by multiple logistic regression analysis by examining their performance in predicting dichotomized cardiac MRI values 12 months after STEMI based on their median. For each biomarker three models were created using baseline (BL), the Δ value (BL to 6 months), and the two values together as predictors. All models were adjusted for age and renal function. Receiver operator curves were plotted with area under the curve (AUC) to discriminate the prognostic accuracy of individual biomarkers for MRI‐based structural or functional changes. Results A total of 44 predominantly male patients (88.6%) from the ETiCS (Etiology, Titre‐Course, and Survival) study were identified at a mean age of 55.5 ± 11.5 (SD) years treated by successful percutaneous coronary intervention (97.7%) at a rate of 95.5% stent implantation within a median pain‐to‐balloon time of 260 min (IQR 124–591). Biomarkers hsTnT and ST2 were identified as strong predictors (AUC > 0.7) of LVEDV and LVEF. BL measurement to predict LVEF [hsTnT: AUC 0.870 (95% CI: 0.756–0.983), ST2: AUC 0.763 (95% CI: 0.615–0.911)] and the Δ value BL‐6M [hsTnT: AUC 0.870 (95% CI: 0.756–0.983), ST2: AUC 0.809 (95% CI: 0.679–0.939)] showed a high prognostic value without a significant difference for the comparison of the BL model vs. the Δ‐value model (BL‐6M) for hsTnT (P = 1) and ST2 (P = 0.304). The combined model that included baseline and Δ value as predictors was not able to improve the ability to predict LVEF [hsTnT: AUC 0.891 (0.791–0.992), P = 0.444; ST2: AUC 0.778 (0.638–0.918), P = 0.799]. Baseline levels of CCN1 were closely associated with LVEDV at 12 months [AUC 0.708 (95% CI: 0.551–0.865)] and infarct size [AUC 0.703 (95% CI: 0.534–0.872)]. Conclusions Baseline biomarker levels of hsTnT and ST2 were the strongest predictors of LVEF and LVEDV at 12 months after STEMI. The association of CCN1 with LVEDV and infarct size warrants further study into the underlying pathophysiology of this novel biomarker.

Abstract Testing based on multiple choice questions (MCQ) is one of the most established forms of assessment, not only in the medical field. Extended matching questions (EMQ) represent a specific type of MCQ designed to require higher levels of cognition, such as problem-solving. The purpose of this evaluation was to assess the suitability and efficiency of EMQ as an assessment method. EMQ were incorporated into the end-of-semester examination in internal medicine, in which 154 students participated, and compared with three established MCQ types. Item and examination quality were investigated, as well as readability and processing time. EMQ were slightly more difficult to score; however, both item discrimination and discrimination index were higher when compared to other item types. EMQ were found to be significantly longer and required more processing time, but readability was improved. Students judged EMQ as clearly challenging, but attributed significantly higher clinical relevance when compared to established MCQ formats. Using the Spearman-Brown prediction, only ten EMQ items would be needed to reproduce the Cronbach’s alpha value of 0.75 attained for the overall examination. EMQ proved to be both efficient and suitable when assessing medical students, demonstrating powerful characteristics of reliability. Their expanded use in favor of common MCQ could save examination time without losing out on statistical quality.

Abstract Background Chronic heart failure (HF) is known to increase the risk of developing Alzheimer’s dementia significantly. Thus, detecting and preventing mild cognitive impairment, which is common in patients with HF, is of great importance. Serum biomarkers are increasingly used in neurological disorders for diagnostics, monitoring, and prognostication of disease course. It remains unclear if neuronal biomarkers may help detect cognitive impairment in this high-risk population. Also, the influence of chronic HF and concomitant renal dysfunction on these biomarkers is not well understood. Methods Within the monocentric Cognition.Matters-HF study, we quantified the serum levels of phosphorylated tau protein 181 (pTau) and neurofilament light chain (NfL) of 146 extensively phenotyped chronic heart failure patients (aged 32 to 85 years; 15.1% women) using ultrasensitive bead-based single-molecule immunoassays. The clinical work-up included advanced cognitive testing and cerebral magnetic resonance imaging (MRI). Results Serum concentrations of NfL ranged from 5.4 to 215.0 pg/ml (median 26.4 pg/ml) and of pTau from 0.51 to 9.22 pg/ml (median 1.57 pg/ml). We detected mild cognitive impairment (i.e., T-score < 40 in at least one cognitive domain) in 60% of heart failure patients. pTau (p = 0.014), but not NfL, was elevated in this group. Both NfL (ρ = − 0.21; p = 0.013) and pTau (ρ = − 0.25; p = 0.002) related to the cognitive domain visual/verbal memory, as well as white matter hyperintensity volume and cerebral and hippocampal atrophy. In multivariable analysis, both biomarkers were independently influenced by age (T = 4.6 for pTau; T = 5.9 for NfL) and glomerular filtration rate (T = − 2.4 for pTau; T = − 3.4 for NfL). Markers of chronic heart failure, left atrial volume index (T = 4.6) and NT-proBNP (T = 2.8), were further cardiological determinants of pTau and NfL, respectively. In addition, pTau was also strongly affected by serum creatine kinase levels (T = 6.5) and ferritin (T = − 3.1). Conclusions pTau and NfL serum levels are strongly influenced by age-dependent renal and cardiac dysfunction. These findings point towards the need for longitudinal examinations and consideration of frequent comorbidities when using neuronal serum biomarkers.

BackgroundThe COVID-19 pandemic has spurred large-scale, interinstitutional research efforts. To enable these efforts, researchers must agree on data set definitions that not only cover all elements relevant to the respective medical specialty but also are syntactically and semantically interoperable. Therefore, the German Corona Consensus (GECCO) data set was developed as a harmonized, interoperable collection of the most relevant data elements for COVID-19–related patient research. As the GECCO data set is a compact core data set comprising data across all medical fields, the focused research within particular medical domains demands the definition of extension modules that include data elements that are the most relevant to the research performed in those individual medical specialties. ObjectiveWe aimed to (1) specify a workflow for the development of interoperable data set definitions that involves close collaboration between medical experts and information scientists and (2) apply the workflow to develop data set definitions that include data elements that are the most relevant to COVID-19–related patient research regarding immunization, pediatrics, and cardiology. MethodsWe developed a workflow to create data set definitions that were (1) content-wise as relevant as possible to a specific field of study and (2) universally usable across computer systems, institutions, and countries (ie, interoperable). We then gathered medical experts from 3 specialties—infectious diseases (with a focus on immunization), pediatrics, and cardiology—to select data elements that were the most relevant to COVID-19–related patient research in the respective specialty. We mapped the data elements to international standardized vocabularies and created data exchange specifications, using Health Level Seven International (HL7) Fast Healthcare Interoperability Resources (FHIR). All steps were performed in close interdisciplinary collaboration with medical domain experts and medical information specialists. Profiles and vocabulary mappings were syntactically and semantically validated in a 2-stage process. ResultsWe created GECCO extension modules for the immunization, pediatrics, and cardiology domains according to pandemic-related requests. The data elements included in each module were selected, according to the developed consensus-based workflow, by medical experts from these specialties to ensure that the contents aligned with their research needs. We defined data set specifications for 48 immunization, 150 pediatrics, and 52 cardiology data elements that complement the GECCO core data set. We created and published implementation guides, example implementations, and data set annotations for each extension module. ConclusionsThe GECCO extension modules, which contain data elements that are the most relevant to COVID-19–related patient research on infectious diseases (with a focus on immunization), pediatrics, and cardiology, were defined in an interdisciplinary, iterative, consensus-based workflow that may serve as a blueprint for developing further data set definitions. The GECCO extension modules provide standardized and harmonized definitions of specialty-related data sets that can help enable interinstitutional and cross-country COVID-19 research in these specialties.

Factor XIII is a transglutaminase enzyme that plays a crucial role in hemostasis and wound healing. It crosslinks fibrin strands, stabilizing clots and promoting clot resistance to fibrinolysis. Additionally, Factor XIII has been found to have multiple other functions that extend beyond coagulation, including the regulation of inflammation and tissue repair processes. Emerging evidence suggests that Factor XIII may also have differential roles in acute myocardial infarction and ischemic stroke, two common cardiovascular events with significant morbidity and mortality. In acute myocardial infarction, Factor XIII has been implicated in promoting clot stability and reducing the risk of re-occlusion. In ischemic stroke, Factor XIII may also contribute to the pathogenesis of cerebral ischemia by promoting clot formation and exacerbating neuronal damage. Several studies have investigated the association between Factor XIII and these cardiovascular events, using various approaches such as genetic polymorphism analysis, animal models, and clinical data analysis. These studies have provided important insights into the role of Factor XIII in acute myocardial infarction and ischemic stroke, highlighting its potential as a therapeutic target for interventions aimed at improving outcomes in these conditions. In this review, we will summarize the current understanding of Factor XIII’s role in acute myocardial infarction and ischemic stroke.

Abstract Aims Cognitive dysfunction occurs frequently in patients with heart failure (HF), but early detection remains challenging. Serum glial fibrillary acidic protein (GFAP) is an emerging biomarker of cognitive decline in disorders of primary neurodegeneration such as Alzheimer's disease. We evaluated the utility of serum GFAP as a biomarker for cognitive dysfunction and structural brain damage in patients with stable chronic HF. Methods and results Using bead‐based single molecule immunoassays, we quantified serum levels of GFAP in patients with HF participating in the prospective Cognition.Matters‐HF study. Participants were extensively phenotyped, including cognitive testing of five separate domains and magnetic resonance imaging (MRI) of the brain. Univariable and multivariable models, also accounting for multiple testing, were run. One hundred and forty‐six chronic HF patients with a mean age of 63.8 ± 10.8 years were included (15.1% women). Serum GFAP levels (median 246 pg/mL, quartiles 165, 384 pg/mL; range 66 to 1512 pg/mL) did not differ between sexes. In the multivariable adjusted model, independent predictors of GFAP levels were age (T = 5.5; P

BackgroundCognitive impairment is a major comorbidity in patients with chronic heart failure (HF) with a wide range of phenotypes. In this study, we aimed to identify and compare different clusters of cognitive deficits.MethodsThe prospective cohort study “Cognition.Matters-HF” recruited 147 chronic HF patients (aged 64.5 ± 10.8 years; 16.2% female) of any etiology. All patients underwent extensive neuropsychological testing. We performed a hierarchical cluster analysis of the cognitive domains, such as intensity of attention, visual/verbal memory, and executive function. Generated clusters were compared exploratively with respect to the results of cardiological, neurological, and neuroradiological examinations without correction for multiple testing.ResultsDendrogram and the scree plot suggested three distinct cognitive profiles: In the first cluster, 42 patients (28.6%) performed without any deficits in all domains. Exclusively, the intensity of attention deficits was seen in the second cluster, including 55 patients (37.4%). A third cluster with 50 patients (34.0%) was characterized by deficits in all cognitive domains. Age (p = 0.163) and typical clinical markers of chronic HF, such as ejection fraction (p = 0.222), 6-min walking test distance (p = 0.138), NT-proBNP (p = 0.364), and New York Heart Association class (p = 0.868) did not differ between clusters. However, we observed that women (p = 0.012) and patients with previous cardiac valve surgery (p = 0.005) prevailed in the “global deficits” cluster and the “no deficits” group had a lower prevalence of underlying arterial hypertension (p = 0.029). Total brain volume (p = 0.017) was smaller in the global deficit cluster, and serum levels of glial fibrillary acidic protein were increased (p = 0.048).ConclusionApart from cognitively healthy and globally impaired HF patients, we identified a group with deficits only in the intensity of attention. Women and patients with previous cardiac valve surgery are at risk for global cognitive impairment when suffering HF and could benefit from special multimodal treatment addressing the psychosocial condition.

Abstract Aims Acute myocardial infarction (MI) is the major cause of chronic heart failure. The activity of blood coagulation factor XIII (FXIIIa) plays an important role in rodents as a healing factor after MI, whereas its role in healing and remodelling processes in humans remains unclear. We prospectively evaluated the relevance of FXIIIa after acute MI as a potential early prognostic marker for adequate healing. Methods and results This monocentric prospective cohort study investigated cardiac remodelling in patients with ST‐elevation MI and followed them up for 1 year. Serum FXIIIa was serially assessed during the first 9 days after MI and after 2, 6, and 12 months. Cardiac magnetic resonance imaging was performed within 4 days after MI (Scan 1), after 7 to 9 days (Scan 2), and after 12 months (Scan 3). The FXIII valine‐to‐leucine (V34L) single‐nucleotide polymorphism rs5985 was genotyped. One hundred forty‐six patients were investigated (mean age 58 ± 11 years, 13% women). Median FXIIIa was 118% (quartiles, 102–132%) and dropped to a trough on the second day after MI: 109% (98–109%; P

Ultrasonic sensors are one of the most common automatic monitoring methods in operational snow depth monitoring with reliable results. On the other hand, there is significant uncertainty when measuring small snow depths (

Acute and chronic cardiac disorders predispose to alterations in cognitive performance, ranging from mild cognitive impairment to overt dementia. Although this association is well-established, the factors inducing and accelerating cognitive decline beyond ageing and the intricate causal pathways and multilateral interdependencies involved remain poorly understood. Dysregulated and persistent inflammatory processes have been implicated as potentially causal mediators of the adverse consequences on brain function in patients with cardiac disease. Recent advances in positron emission tomography disclosed an enhanced level of neuroinflammation of cortical and subcortical brain regions as an important correlate of altered cognition in these patients. In preclinical and clinical investigations, the thereby involved domains and cell types of the brain are gradually better characterized. Microglia, resident myeloid cells of the central nervous system, appear to be of particular importance, as they are extremely sensitive to even subtle pathological alterations affecting their complex interplay with neighboring astrocytes, oligodendrocytes, infiltrating myeloid cells, and lymphocytes. Here, we review the current evidence linking cognitive impairment and chronic neuroinflammation in patients with various selected cardiac disorders including the aspect of chronic neuroinflammation as a potentially druggable target.

Considering the first ten years of Industrie 4.0 in Germany—the digital transformation of industry towards the goal of increased manufacturing productivity and mass customization—significant progress has been achieved. However, future efforts are required. This review first evaluates the status quo of implementation and research in Germany and finds that large-scale companies have proceeded faster than small- and middle-sized enterprises. Currently, regardless of their size, companies have in common a shortage of qualified specialists, coupled with a lack of adequate base technologies for Industrie 4.0 and an insufficient digital mindset. The creation of platform-based digital business models is particularly lagging behind, despite high research interest. This review subsequently identifies three research-driven fields of action that are particularly important for the future of Industrie 4.0: (1) resilience of value networks in the strategic area of sovereignty, (2) Open-Source as a driver for the strategic area of interoperability, and (3) the strategic combination of digitalization and sustainability as a basis for sustainable business models in the strategic area of sustainability.

Climate services are becoming the backbone to translate climate knowledge, data & information into climate-informed decision-making at all levels, from public administrations to business operators. It is essential to assess the technical and scientific quality of the provided climate data and information products, including their value to users, to establish the relation of trust between providers of climate data and information and various downstream users. The climate data and information products (i.e., from satellite, in-situ and reanalysis) shall be fully traceable, adequately documented and uncertainty quantified and can provide sufficient guidance for users to address their specific needs and feedbacks. This paper discusses details on how to apply the quality assurance framework to deliver timely assessments of the quality and usability of Essential Climate Variable (ECV) products. It identifies an overarching structure for the quality assessment of single product ECVs (i.e., consists of only one single variable), multi-product ECVs (i.e., more than one single parameter), thematic products (i.e., water, energy and carbon cycles), as well as the usability assessment. To support a traceable climate service, other than rigorously evaluating the technical and scientific quality of ECV products, which represent the upstream of climate services, how the uncertainty propagates into the resulting benefit (utility) for the users of the climate service needs to be detailed.

There is a compelling need to improve all physicians’ knowledge on lifestyle medicine (LM). This training needs to start early during medical education. This case report describes the feasibility and effects of integrating LM into an existing core curriculum of a Swedish undergraduate medical programme. A curriculum development project was organized using a six-step model: general needs assessment, targeted needs assessment, goals and objectives, educational strategies, implementation, and evaluation. New learning objectives regarding health, prevention and lifestyle medicine were formulated throughout the five-and-a-half-year programme. Learning activities and examinations were integrated in all courses with a structured progression and with focus on preventive activities in the workplace learning. The project was evaluated using student surveys of curricular quality, teacher survey of curricular content and integration in 2020, and an external review of adherence to the national qualitative target on preventive medicine. The project was executed during 2017–2018. Course evaluations and exit poll at graduation showed an overall high-quality student rating of education in prevention and in lifestyle counselling: on average, a score of 4.1/5 and 4.1/6, respectively. The teacher survey showed that over 70% of courses had a lasting increase in LM curricular content and that this content was to a large extent integrated into the existing course material. The external review concluded that the topic was well covered and integrated into the curriculum. LM could be successfully integrated into an existing medical programme curriculum with positive effects on student learning.

IntroductionDepression is a globally prevalent mental disorder; however, the stigmatization of individuals experiencing depression remains a significant challenge. The effectiveness of mental health promotion efforts and anti-stigma messages is contingent upon individuals' existing beliefs and the stigmatizing potential of their attitudes. Thus, understanding how individuals perceive mental disorders such as depression, as well as their communicative accessibility, is vital from a strategic health communication standpoint. This study explored the prevailing cognitive frames regarding depression in Germany, and the corresponding affective reactions toward individuals experiencing depression. Differences in communicative accessibility, individuals' social proximity to the topic, as well as socioeconomic characteristics were used to inform stigma-sensitive targeting strategies.MethodA representative survey of the German adult population (N = 1,530) was conducted, using a vignette describing a person with symptoms of major depression. Factor and cluster analyses identified four distinct cognitive frames of depression, characterized by varying stigmatizing attitudes and attributions of responsibility.ResultsThe study has revealed that stigmatizing cognitive frames demonstrate lower receptivity to mental health information. Individuals with stigmatizing perspectives represent a significant portion of the population, have reduced receptivity to mental health information, and are likely to exhibit defensive or even negative affective responses to anti-stigma efforts.DiscussionThe findings underscore the significance of considering cognitive frames as complex but suitable approaches for target group segmentation in mental health communication strategies. The development of tailored and creative low-threshold strategies fitting well within the cognitive frames of individuals with stigmatizing perspectives seems essential.

Abstract Background Seeking information on mental health issues – both for oneself and on behalf of others (so-called surrogate-seeking) – is a critical early step in dealing with mental illness and known to impede stigmatizing attitudes and foster help-seeking. Yet, knowledge about mental health tends to be insufficient worldwide. Therefore, it is necessary to better understand the search for mental health information and examine the factors that are positively associated with information-seeking. Method In a face-to-face survey in Germany (N = 1,522), we investigated the factors related to mental health information-seeking. The data was analyzed by means of a logistic regression model, in which we distinguished those searching information for themselves from so-called surrogate seekers, i.e., people who seek information on behalf of someone else. Results Twenty-six percent of German adults in our sample have already searched for information on mental health, with the majority already having searched for information for others (73% of all seekers). Our findings indicate that individuals’ proximity to people with mental health issues, including their own mental health treatment experience (Cramer’s V = .429, p

Abstract Individuals encounter varying environmental exposures throughout their lifetimes. Some exposures such as smoking are readily observed and have high personal recall; others are more indirect or sporadic and might only be inferred from long occupational histories or lifestyles. We evaluated the utility of using lifetime-long self-reported exposures for identifying differential methylation in an amyotrophic lateral sclerosis cases-control cohort of 855 individuals. Individuals submitted paper-based surveys on exposure and occupational histories as well as whole blood samples. Genome-wide DNA methylation levels were quantified using the Illumina Infinium Human Methylation450 array. We analyzed 15 environmental exposures using the OSCA software linear and MOA models, where we regressed exposures individually by methylation adjusted for batch effects and disease status as well as predicted scores for age, sex, cell count, and smoking status. We also regressed on the first principal components on clustered environmental exposures to detect DNA methylation changes associated with a more generalised definition of environmental exposure. Five DNA methylation probes across three environmental exposures (cadmium, mercury and metalwork) were significantly associated using the MOA models and seven through the linear models, with one additionally across a principal component representing chemical exposures. Methylome-wide significance for four of these markers was driven by extreme hyper/hypo-methylation in small numbers of individuals. The results indicate the potential for using self-reported exposure histories in detecting DNA methylation changes in response to the environment, but also highlight the confounded nature of environmental exposure in cohort studies.

Based on the uncertainty management theory considering different information-based coping strategies that are relevant during health crises, the purpose of the present study is to understand how individuals seek and avoid information during the COVID-19 pandemic. We focus on online information seeking and avoidance because of the high share of people searching for information about the pandemic online and the questionable quality of information about the virus available online. Data for this qualitative exploratory study were collected in semi-structured interviews with 21 participants. Our findings revealed four information-seeking patterns that can be located on a continuum between more active, targeted, and less purposeful acquisitions of information, and three avoidance patterns that are distinguished by different motives to avoid certain information. The findings on specific factors involved in individuals’ choices between seeking and avoiding information will help to design better information environments and to identify barriers to the adequate use of information during such crises.

In recent years scholars have attempted to reconsider the place of religion within Italian Futurism. A tendency to secularize the avant-garde has ensured that Futurism is often assumed to be in opposition to religion. This paper reassesses this notion by examining the religious dimension of the work of the Futurist artist Umberto Boccioni. In particular, it examines the mother images the artist produced during the early years of the Futurist movement. The paper argues that in Boccioni's 1912 work Matter (Materia) the maternal figures of the Virgin Mary and the Catholic Church coalesce through a process akin to what Sigmund Freud described as "condensation." During the years preceding the work's execution, Boccioni was recording the development of the Catholic Modernist Crisis in his diary. This crisis culminated in 1907 with the papal encyclical Pascendi Dominici Greg is. At this time, the Catholic Church was experiencing increasing pressure to adapt to new ways of thinking about ecclesiastical history. In this paper, Matter is reread as an investigation into the place of the Catholic Church in the modern world. In seeking to account for the religious significance of Boccioni's maternal imagery, this paper challenges the claim that the early Futurist movement was wholly anti-Christian in orientation. [ABSTRACT FROM AUTHOR]

Enrolling in a clinical trial or study requires informed consent. Furthermore, it is crucial to ensure proper consent when storing samples in biobanks for future research, as these samples may be used in studies beyond their initial purpose. For pediatric studies, consent must be obtained from both the child and their legal guardians, requiring the recording of multiple consents at once. Electronic consent has become more popular recently due to its ability to prevent errors and simplify the documentation of multiple consents. However, integrating consent capture into existing study software structures remains a challenge. This report evaluates the usability of the generic Informed Consent Service (gICS) of the University Medicine Greifswald (UMG) for obtaining electronic consent in pediatric studies. The setup was designed to integrate seamlessly with the current infrastructure and meet the specific needs of a multi-user, multi-study environment. The study was conducted in a pediatric research setting, where additional informed consent was obtained separately for the biobank. Over a period of 54 weeks, 1061 children and adolescents aged 3 to 17 years participated in the study. Out of these, 348 agreed also to participate in the biobank. The analysis included a total of 2066 consents and assents, with 945 paper-based and 1121 electronic consents. The study assessed the error susceptibility of electronic versus paper-based consents and found a significant reduction rate of errors of 94.7%. These findings provide valuable insights into the use of gICS in various studies and the practical implementation of electronic consent software in pediatric medicine.