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With the world population growth, energy consumption and the rapid development of industrial economy, a large amount of carbon emissions has brought destruction and threats to the earth's environment on which human beings depend. The development of low-carbon economy has become the consensus of governments all over the world and has been vigorously advocated & promoted. This paper focuses on the top five global GDP nations in 2022: The United States, China, Japan, Germany, and Britain. A comprehensive evaluation index system of urban low-carbon economic development level is constructed from four dimensions: economic development level, environmental quality, energy consumption emission intensity and social development speed by using literature review and field interview. The evaluation measures are determined using the TOPSIS evaluation method with entropy weight and the grey relational model, providing a comprehensive assessment of the low-carbon economy's development level in these five countries." Judging from the comprehensive evaluation score, the overall development of low-carbon economy in American cities is in good condition and has reached the development standard of low-carbon economy; Germany and Japan rank second and third, and they are low-carbon economies. Britain ranks fourth in comprehensive evaluation, although it belongs to a low-carbon economy country, but there is still a certain gap with Germany and Japan; There is still a big gap between China and the other four countries. Based on the measurement and evaluation outcomes, it presents recommendations and strategies to foster the growth of low-carbon economies, offering valuable insights for the advancement of such economies across different nations. The research results guide countries all over the world to reduce carbon emissions in the process of economic development, protect the earth environment on which human beings depend, and make a better tomorrow for sustainable development. [ABSTRACT FROM AUTHOR]

Background: Currently, more than 30,200,000 COVID-19 cases have been diagnosed in Germany alone. However, data regarding prevalence of COVID-19 in children, both in Germany and internationally, are sparse. We sought to evaluate the number of infected children by measuring IgG antibodies. Methods: Oropharyngeal swabs were collected between December 2020 and August 2021 to measure SARS-CoV-2, and capillary blood for the detection of SARS-CoV-2 antibodies (by rapid test NADAL® and filter paper test Euroimmun® ELISA); venous blood was taken for validation (Roche® ECLIA and recomLine Blot) in 365 German children aged 3–16 years from 30 schools and preschools. We used multiple serological tests because the filter paper test Euroimmun® ELISA performs better in terms of sensitivity and specificity than the rapid test NADAL®. The Roche® ECLIA test is used to detect SARS-CoV-2 spike protein, and the recomLine Blot test is used to rule out the possibility of infection by seasonal SARS-viruses and to test for specific SARS-CoV-2 proteins (NP, RBD and S1). In addition, one parent each (n = 336), and 4–5 teachers/caregivers (n = 90) per institution were tested for IgG antibodies from capillary blood samples. The total study duration was 4 months per child, including the first follow-up after 2 months and the second after 4 months. Results: Of 364 children tested at baseline, 3.6% (n = 13) were positive for SARS-CoV-2 IgG antibodies using Euroimmun® ELISA. Seven children reported previously testing positive for SARS-CoV-2; each of these was confirmed by the Roche® Anti-SARS-CoV-2-ECLIA (antibody to spike protein 1) test. SARS-CoV-2 IgG antibodies persisted over a 4-month period, but levels decreased significantly (p = 0.004) within this timeframe. The median IgG values were 192.0 BAU/ml [127.2; 288.2], 123.6 BAU/ml [76.6; 187.7] and 89.9 BAU/ml [57.4; 144.2] at baseline, 2 months and 4 months after baseline, respectively. During the study period, no child tested positive for SARS-CoV-2 by oropharyngeal swab. A total of 4.3% of all parents and 3.7% of teachers/caregivers tested positive for IgG antibodies by Euroimmun® ELISA at baseline. Conclusion: We noted a rather low seroprevalence in children despite an under-reporting of SARS-CoV-2 infections. Measurement of IgG antibodies derived from capillary blood appears to be a valid tool to detect asymptomatic infections in children. However, no asymptomatic active infection was detected during the study period of 4 months in the whole cohort. Further data on SARS-CoV-2 infections in children are needed, especially in the group of <5-year-olds, as there is currently no licensed vaccine for this age group in Germany. The Robert Koch Institute's Standing Commission on Vaccination (STIKO) recommended COVID-19 vaccination for 12–17 and 5–11 year olds in August 2021 and May 2022 respectively. [ABSTRACT FROM AUTHOR]

Status or relative concerns (as in the idiom 'keeping up with the Joneses') can lead to negative feelings such as stress and anxiety. One key question is whether these concerns relate to daily smoking behaviour. The conjecture is that status concerns and the accompanying stress and anxiety might be associated with a higher likelihood of smoking and a higher number of cigarettes smoked, generating a higher instant physical reward and reducing the stress and anxiety. The literature aiming to identify this relationship focuses mostly on a single cross section of individuals, ignoring potential differences in unobserved characteristics of smokers and non-smokers (e.g., genetic factors, personality differences, parental smoking during childhood). This paper investigates the role of unobserved individual characteristics on this relationship, which has not been done in previous studies. Using a long panel data of smoking information in Germany and a variety of panel data model specifications, we show that there is no statistically significant association between relative income concerns and the likelihood of smoking or the number of cigarettes smoked among the overall population. We find a positive and significant relationship only among people who smoked at least one cigarette in the past. A 10% appreciation in the income of comparable other individuals relates to about 3.5 more cigarettes per month among these people. Importantly, failing to allow for the unobserved influences of smoking leads to three times larger estimates than when using models with unobserved factors correlating to the income and smoking behaviour. The results are robust with respect to alternative assumptions and specifications where we use different functional forms of unobserved heterogeneity, definitions of relative concerns, incomes, and reference groups. [ABSTRACT FROM AUTHOR]

Real-time surveillance is a crucial element in the response to infectious disease outbreaks. However, the interpretation of incidence data is often hampered by delays occurring at various stages of data gathering and reporting. As a result, recent values are biased downward, which obscures current trends. Statistical nowcasting techniques can be employed to correct these biases, allowing for accurate characterization of recent developments and thus enhancing situational awareness. In this paper, we present a preregistered real-time assessment of eight nowcasting approaches, applied by independent research teams to German 7-day hospitalization incidences during the COVID-19 pandemic. This indicator played an important role in the management of the outbreak in Germany and was linked to levels of non-pharmaceutical interventions via certain thresholds. Due to its definition, in which hospitalization counts are aggregated by the date of case report rather than admission, German hospitalization incidences are particularly affected by delays and can take several weeks or months to fully stabilize. For this study, all methods were applied from 22 November 2021 to 29 April 2022, with probabilistic nowcasts produced each day for the current and 28 preceding days. Nowcasts at the national, state, and age-group levels were collected in the form of quantiles in a public repository and displayed in a dashboard. Moreover, a mean and a median ensemble nowcast were generated. We find that overall, the compared methods were able to remove a large part of the biases introduced by delays. Most participating teams underestimated the importance of very long delays, though, resulting in nowcasts with a slight downward bias. The accompanying prediction intervals were also too narrow for almost all methods. Averaged over all nowcast horizons, the best performance was achieved by a model using case incidences as a covariate and taking into account longer delays than the other approaches. For the most recent days, which are often considered the most relevant in practice, a mean ensemble of the submitted nowcasts performed best. We conclude by providing some lessons learned on the definition of nowcasting targets and practical challenges. Author summary: Current trends in epidemiological indicators are often obscured by the fact that recent values are still incomplete. This is due to reporting delays and other types of delays. Statistical nowcasting methods can be used to account for these biases and reveal yet unobserved trends, thereby improving situational awareness and supporting public health decision-making. While numerous methods exist for this purpose, little is known about their behavior in real-time settings and their relative performance. In this paper, we compared eight different nowcasting methods in an application to COVID-19 hospitalization incidences in Germany from November 2021 to April 2022. Additionally, we combined the predictions of these methods to create so-called ensemble nowcasts. Our findings indicate that while all methods yielded practically useful results, some systematic biases in nowcasts occurred and the remaining uncertainty was generally underestimated. Combined ensemble nowcasts showed promising performance relative to individual models and thus represent a promising avenue for future research. [ABSTRACT FROM AUTHOR]

In this paper we check whether social capital changes the association of subjective well-being with own income and social comparisons. We use panel data from Germany and publicly available data from three international surveys, for a total of nearly 500,000 respondents from industrial countries. Results show that the association of own income and social comparisons to subjective well-being weakens for individuals with high social capital. This finding holds in a variety of settings, and is robust to various measures of subjective well-being, of social capital, and of social comparisons. We also find evidence indicating that the role of social capital is, at least in part, causal. Finally, our findings support the macro-level implication that income differences are less related to subjective well-being differences in countries with high social capital. [ABSTRACT FROM AUTHOR]

Background: Incontinence and sexual dysfunction are long-lasting side effects after surgical treatment (radical prostatectomy, RP) of prostate cancer (PC). For an informed treatment decision, physicians and patients should discuss expected impairments. Therefore, this paper firstly aims to develop and validate prognostic models that predict incontinence and sexual function of PC patients one year after RP and secondly to provide an online decision making tool. Methods: Observational cohorts of PC patients treated between July 2016 and March 2021 in Germany were used. Models to predict functional outcomes one year after RP measured by the EPIC-26 questionnaire were developed using lasso regression, 80–20 splitting of the data set and 10-fold cross validation. To assess performance, R2, RMSE, analysis of residuals and calibration-in-the-large were applied. Final models were externally temporally validated. Additionally, percentages of functional impairment (pad use for incontinence and firmness of erection for sexual score) per score decile were calculated to be used together with the prediction models. Results: For model development and internal as well as external validation, samples of 11 355 and 8 809 patients were analysed. Results from the internal validation (incontinence: R2 = 0.12, RMSE = 25.40, sexual function: R2 = 0.23, RMSE = 21.44) were comparable with those of the external validation. Residual analysis and calibration-in-the-large showed good results. The prediction tool is freely accessible: https://nora-tabea.shinyapps.io/EPIC-26-Prediction/. Conclusion: The final models showed appropriate predictive properties and can be used together with the calculated risks for specific functional impairments. Main strengths are the large study sample (> 20 000) and the inclusion of an external validation. The models incorporate meaningful and clinically available predictors ensuring an easy implementation. All predictions are displayed together with risks of frequent impairments such as pad use or erectile dysfunction such that the developed online tool provides a detailed and informative overview for clinicians as well as patients. [ABSTRACT FROM AUTHOR]

Background: Retrospective hospital quality indicators can only be useful if they are trustworthy signals of current or future quality. Despite extensive longitudinal quality indicator data and many hospital quality public reporting initiatives, research on quality indicator stability over time is scarce and skepticism about their usefulness widespread. Objective: Based on aggregated, widely available hospital-level quality indicators, this paper sought to determine whether quality indicators are stable over time. Implications for health policy were drawn and the limited methodological foundation for stability assessments of hospital-level quality indicators enhanced. Methods: Two longitudinal datasets (self-reported and routine data), including all hospitals in Germany and covering the period from 2004 to 2017, were analysed. A logistic regression using Generalized Estimating Equations, a time-dependent, graphic quintile representation of risk-adjusted rates and Spearman's rank correlation coefficient were used. Results: For a total of eight German quality indicators significant stability over time was demonstrated. The probability of remaining in the best quality cluster in the future across all hospitals reached from 46.9% (CI: 42.4–51.6%) for hip replacement reoperations to 80.4% (CI: 76.4–83.8%) for decubitus. Furthermore, graphical descriptive analysis showed that the difference in adverse event rates for the 20% top performing compared to the 20% worst performing hospitals in the two following years is on average between 30% for stroke and AMI and 79% for decubitus. Stability over time has been shown to vary strongly between indicators and treatment areas. Conclusion: Quality indicators were found to have sufficient stability over time for public reporting. Potentially, increasing case volumes per hospital, centralisation of medical services and minimum-quantity regulations may lead to more stable and reliable quality of care indicators. Finally, more robust policy interventions such as outcome-based payment, should only be applied to outcome indicators with a higher level of stability over time. This should be subject to future research. [ABSTRACT FROM AUTHOR]

Over the year of 2015, about 800.000 refugees arrived in Germany, a number which equals around one percent of the total population. This migration process was labelled the refugee crisis and was accompanied by a contested debate. On the one hand, there was a widespread willingness to voluntarily help arriving refugees, on the other hand, the number of xenophobic attacks against refugees drastically increased. Our paper will focus on a specific form of xenophobic violence with a strong symbolic meaning: We analyze how arson attacks against collective accommodation facilities spread. Using a comprehensive web chronicle, we collected temporal and spatial data about arson attacks perpetrated on accommodations or facilities for refugees in Germany between 2015 and 2017. We counted 251 attacks, assigned each incident location to its county, merged county characteristics such as population size, proportion of foreigners, right-wing party support, and—going beyond previous research—added geographically coded media data from two digital archives. Besides newspaper contents of a popular nation-wide tabloid, we use a data base that covers local fake news on refugees. Based on these data, we constructed a balanced panel data set with the counties as geographical units and periods of 14 days as the time dimension. Results indicate that social contagion drives the diffusion process of arson attacks. Spatial proximity of previous attacks increased the propensity of attacks in the neighboring counties. Attacks were more likely to occur in counties with larger populations and fewer foreigners. While local newspaper coverage did not impact the diffusion of xenophobic attacks, fake news were relevant–but only in East Germany. We also considered two particularly salient threatening events that received nation-wide media attention, namely Merkel's "border opening" on the 5th of September 2015 and the sexual assaults occurring during New Year's 2015/16 in Cologne. Both were followed by temporary increases in violence. [ABSTRACT FROM AUTHOR]

Background: The international collaboration study PRICOV-19 –Primary Health Care in times of COVID-19 aims to assess the impact of the COVID-19 pandemic on the organisation of primary health care. The German part focuses on the subjective perceptions of general practitioners on primary health care and the impact of political measures during the second wave of the COVID-19 pandemic. Within this survey, the "open text field" of the questionnaire was utilised remarkably frequently and extensively by the respondents. It became clear that the content that was named needed to be analysed in an exploratory manner. Accordingly, this paper addresses the following question: What preoccupies general practitioners in Germany during COVID-19 that we have not yet asked them enough? Methods: The data collection took place throughout Germany from 01.02.2021 to 28.02.2021with a quantitative online questionnaire consisting of 53 items arranged across six topics as well as an "open text field" for further comments. The questionnaire's open text field was analysed following the premises of the qualitative content analysis. Results: The topics discussed by the respondents were: insufficient support from health policies, not being prioritised and involved in the vaccination strategy, feeling insufficient prepared, that infrastructural changes and financial concerns threatened the practice, and perceiving the own role as important, as well as that health policies affected the wellbeing of the respondents. One of the main points was the way general practitioners were not sufficiently acknowledged for their contribution to ensuring high-quality care during the pandemic. Discussion: German general practitioners perceived their work and role as highly relevant during the COVID-19 pandemic. In controversy with their perception, they described political conditions in which they were the ones who contributed significantly to the fight against the pandemic but were not given enough recognition. [ABSTRACT FROM AUTHOR]

Introduction: Artificial intelligence (AI) has the potential to transform clinical decision-making as we know it. Powered by sophisticated machine learning algorithms, clinical decision support systems (CDSS) can generate unprecedented amounts of predictive information about individuals' health. Yet, despite the potential of these systems to promote proactive decision-making and improve health outcomes, their utility and impact remain poorly understood due to their still rare application in clinical practice. Taking the example of AI-powered CDSS in stroke medicine as a case in point, this paper provides a nuanced account of stroke survivors', family members', and healthcare professionals' expectations and attitudes towards medical AI. Methods: We followed a qualitative research design informed by the sociology of expectations, which recognizes the generative role of individuals' expectations in shaping scientific and technological change. Semi-structured interviews were conducted with stroke survivors, family members, and healthcare professionals specialized in stroke based in Germany and Switzerland. Data was analyzed using a combination of inductive and deductive thematic analysis. Results: Based on the participants' deliberations, we identified four presumed roles that medical AI could play in stroke medicine, including an administrative, assistive, advisory, and autonomous role AI. While most participants held positive attitudes towards medical AI and its potential to increase accuracy, speed, and efficiency in medical decision making, they also cautioned that it is not a stand-alone solution and may even lead to new problems. Participants particularly emphasized the importance of relational aspects and raised questions regarding the impact of AI on roles and responsibilities and patients' rights to information and decision-making. These findings shed light on the potential impact of medical AI on professional identities, role perceptions, and the doctor-patient relationship. Conclusion: Our findings highlight the need for a more differentiated approach to identifying and tackling pertinent ethical and legal issues in the context of medical AI. We advocate for stakeholder and public involvement in the development of AI and AI governance to ensure that medical AI offers solutions to the most pressing challenges patients and clinicians face in clinical care. [ABSTRACT FROM AUTHOR]

In order to shed light on unmeasurable real-world phenomena, we investigate exemplarily the actual number of COVID-19 infections in Germany based on big data. The true occurrence of infections is not visible, since not every infected person is tested. This paper demonstrates that coronavirus-related search queries issued on Google can depict true infection levels appropriately. We find significant correlation between search volume and national as well as federal COVID-19 cases as reported by RKI. Additionally, we discover indications that the queries are indeed causal for infection levels. Finally, this approach can replicate varying dark figures throughout different periods of the pandemic and enables early insights into the true spread of future virus outbreaks. This is of high relevance for society in order to assess and understand the current situation during virus outbreaks and for decision-makers to take adequate and justifiable health measures. [ABSTRACT FROM AUTHOR]

In the Author Contributions, Lukas Broichhaus should be listed as the only author who wrote the paper under 'Writing–original draft.By Lukas Broichhaus; Julian Book; Sven Feddern; Barbara Grüne; Florian Neuhann; Johannes Nießen; Gerhard A. Wiesmüller; Annelene Kossow and Christine JoistenReported by Author; Author; Author; Author; Author; Author; Author; Author; Author [Extracted from the article]

The paper investigates potentials and challenges during the interpretation of prehistoric settlement dynamics based on large archaeological datasets. Exemplarily, this is carried out using a database of 1365 Neolithic sites in the Weiße Elster river catchment in Central Germany located between the southernmost part of the Northern German Plain and the Central Uplands. The recorded sites are systematically pre-processed with regard to their chronology, functional interpretation and spatial delineation. The quality of the dataset is reviewed by analyzing site distributions with respect to field surveys and modern land use. The Random Forests machine learning algorithm is used to examine the impact of terrain covariates on the depth of sites and pottery preservation. Neolithic settlement dynamics are studied using Site Exploitation Territories, and site frequencies per century are used to compare the intensity of land use with adjacent landscapes. The results show that the main trends of the Neolithic settlement dynamics can be derived from the dataset. However, Random Forests analyses indicate poor pottery preservation in the Central Uplands and a superimposition of Neolithic sites in the southernmost part of the Northern German Plain. Throughout the Neolithic the margins between soils on loess and the Weiße Elster floodplain were continuously settled, whereas only Early and Late Neolithic land use also extended into the Central Uplands. These settlement patterns are reflected in the results of the Site Exploitation Territories analyses and explained with environmental economic factors. Similar with adjacent landscapes the Middle Neolithic site frequency is lower compared to earlier and later periods. [ABSTRACT FROM AUTHOR]

Public perceptions of COVID-19 vaccines are critical in reaching protective levels of herd immunity. Vaccine skepticism has always been relatively high in Germany, and surveys suggest that over the course of the pandemic, enthusiasm for the COVID-19 vaccine has dropped. Looking at the period just prior to the approval of the Pfizer/BioNTech and Moderna vaccines in Germany in the latter half of 2020, this paper aims to assess the reasons for and against COVID-19 vaccine uptake among residents of Germany, and to provide in-depth qualitative data to better understand and address concerns surrounding the safety and efficacy of a COVID-19 vaccine. Our findings indicate that there is widespread trust in German institutions and health experts to provide a safe vaccine for those who need it most. However, interviewees also point to the need for more information and the centrality of support from trusted medical authorities in making individual vaccination decisions. We also present the complexity of individual positions on vaccination, and suggest that vaccine hesitancy in relation to COVID-19 needs to be understood as a nuanced, and socially malleable, territory. This indicates that the goal of a vaccination campaign is not only achieving 'herd immunity,' but also a social endorsement of the collaborative effort that is required for a vaccine to be successful. [ABSTRACT FROM AUTHOR]

The rise of digital media has increased the opportunities for individuals to self-select political content online. This development has stimulated empirical research on how people select political information, especially when political beliefs are at stake. In the present paper, we tested a series of theory-derived assumptions about antecedents and consequences of selective exposure to confirmative political information and opinions in the digital arena. We conducted an online survey with German Internet users (N = 897, April 2016) and assessed political attitudes, media use and general beliefs in the context of the so-called "migration crisis". 28% of the participants in our sample reported exposure to a confirmative information environment. They are more likely to hear or read about political opinions on migration and political asylum that are similar to their own compared to cross-cutting content. We found no evidence for the assumption that the technological affordances of the Internet foster this form of selective political exposure. Instead, our analyses indicate that conservatism is a positive predictor of selecting confirmative information environments when it comes to migration and political asylum. We also gathered evidence that this relation is mediated by perceived threat and that selective political exposure is linked to truly false consensus beliefs. Our findings inform supply- and demand-side explanations of selective political exposure online. We discuss the relevance for psychological theories about the motivational underpinnings of selective exposure. [ABSTRACT FROM AUTHOR]

Germany is among the largest countries in the world in terms of total GDP, owing largely to rapid industrialization and expansion of economic activities into several sectors. This paper contributes to the literature on German economic development by investigating the evolution of industry diversification in Germany; particularly focusing on the recent concepts of related (RV) and unrelated variety (UV) in West German regions. It also identifies the statistical and economic determinants of variation in variety over time. Among several industry structure measures; RV is the only measure that reveals a pronounced increasing trend. Since RV is composed of two parts: 1) entropy at five-digit within a two-digit classification, and 2) shares of two-digit sectors in total output, we examined which of the two components dominate. Our findings suggest that the entropy component within two-digit sectoral shares of the RV index is more dominant than the two-digit sectoral shares themselves. We further examined entries and exits of the firms among regions with top and bottom rankings in RV. Findings suggest that both the top and bottom regions experienced an increase in the total number of industries, however, exits were much less pronounced in the bottom regions. It suggests that an increase in variety among top regions is the result of the creative destruction type effect where new industries force inefficient old industries to leave the region. Finally, analysis shows support for the inverse u-shaped relationship between development and diversification. [ABSTRACT FROM AUTHOR]

Governments around the globe use non-pharmaceutical interventions (NPIs) to curb the spread of coronavirus disease 2019 (COVID-19) cases. Making decisions under uncertainty, they all face the same temporal paradox: estimating the impact of NPIs before they have been implemented. Due to the limited variance of empirical cases, researchers could so far not disentangle effects of individual NPIs or their impact on different demographic groups. In this paper, we utilize large-scale agent-based simulations in combination with Susceptible-Exposed-Infectious-Recovered (SEIR) models to investigate the spread of COVID-19 for some of the most affected federal states in Germany. In contrast to other studies, we sample agents from a representative survey. Including more realistic demographic attributes that influence agents' behavior yields accurate predictions of COVID-19 transmissions and allows us to investigate counterfactual what-if scenarios. Results show that quarantining infected people and exploiting industry-specific home office capacities are the most effective NPIs. Disentangling education-related NPIs reveals that each considered institution (kindergarten, school, university) has rather small effects on its own, yet, that combined openings would result in large increases in COVID-19 cases. Representative survey-characteristics of agents also allow us to estimate NPIs' effects on different age groups. For instance, re-opening schools would cause comparatively few infections among the risk-group of people older than 60 years. [ABSTRACT FROM AUTHOR]

Microplastics are a global challenge and a frequently studied environmental issue. Hence, the knowledge body about microplastics within the scientific community is growing fast and challenges an elaborated knowledge transfer from science to the general public. Just as well-informed people are the basis for reducing microplastics' impact on the environment, knowledge of the audience's conceptions is the basis for an accurate and successful dissemination of scientific findings. However, insights into the publics' perceptions of microplastics are still rare. The present study aimed to capture students' conceptions about microplastics based on their individual experiences following qualitative inductive, exploratory research. Therefore, 267 students of a state university in Germany responded to a paper-and-pencil questionnaire containing open and closed questions on microplastic-related conceptual understanding, risk perception, information behavior, sources, and sinks. The inductive classifying of all responses by a qualitative content analysis revealed six basic concepts: 1) Microplastics are mainly understood as small plastic particles. 2) Microplastics are closely associated with its negative consequences. 3) The most labeled source in households is plastic packaging. 4) Compared to other water bodies, microplastics are rarely suspected in groundwater. 5) A high threat awareness exists in classifying microplastics as very dangerous and dangerous. 6) Media such as TV or the Internet are the most crucial information sources while the school has less importance in acquiring information. It is precisely this pattern that indicates the need for profound science communication to establish a joint and scientifically sound knowledge base in society. Knowledge about conceptions of potential "customers" allows tailor-made scientific knowledge transfers to shape public awareness, initiate changes in thoughts and prepare the field for collaborative behavior. [ABSTRACT FROM AUTHOR]

Background: COVID-19 frequently necessitates in-patient treatment and in-patient mortality is high. Less is known about the long-term outcomes in terms of mortality and readmissions following in-patient treatment. Aim: The aim of this paper is to provide a detailed account of hospitalized COVID-19 patients up to 180 days after their initial hospital admission. Methods: An observational study with claims data from the German Local Health Care Funds of adult patients hospitalized in Germany between February 1 and April 30, 2020, with PCR-confirmed COVID-19 and a related principal diagnosis, for whom 6-month all-cause mortality and readmission rates for 180 days after admission or until death were available. A multivariable logistic regression model identified independent risk factors for 180-day all-cause mortality in this cohort. Results: Of the 8,679 patients with a median age of 72 years, 2,161 (24.9%) died during the index hospitalization. The 30-day all-cause mortality rate was 23.9% (2,073/8,679), the 90-day rate was 27.9% (2,425/8,679), and the 180-day rate, 29.6% (2,566/8,679). The latter was 52.3% (1,472/2,817) for patients aged ≥80 years 23.6% (1,621/6,865) if not ventilated during index hospitalization, but 53.0% in case of those ventilated invasively (853/1,608). Risk factors for the 180-day all-cause mortality included coagulopathy, BMI ≥ 40, and age, while the female sex was a protective factor beyond a fewer prevalence of comorbidities. Of the 6,235 patients discharged alive, 1,668 were readmitted a total of 2,551 times within 180 days, resulting in an overall readmission rate of 26.8%. Conclusions: The 180-day follow-up data of hospitalized COVID-19 patients in a nationwide cohort representing almost one-third of the German population show significant long-term, all-cause mortality and readmission rates, especially among patients with coagulopathy, whereas women have a profoundly better and long-lasting clinical outcome compared to men. [ABSTRACT FROM AUTHOR]

Strong public support is a prerequisite for ambitious and thus costly climate change mitigation policy, and strong public concern over climate change is a prerequisite for policy support. Why, then, do most public opinion surveys indicate rather high levels of concern and rather strong policy support, while de facto mitigation efforts in most countries remain far from ambitious? One possibility is that survey measures for public concern fail to fully reveal the true attitudes of citizens due to social desirability bias. In this paper, we implemented list-experiments in representative surveys in Germany and the United States (N = 3620 and 3640 respectively) to assess such potential bias. We find evidence that people systematically misreport, that is, understate their disbelief in human caused climate change. This misreporting is particularly strong amongst politically relevant subgroups. Individuals in the top 20% of the income distribution in the United States and supporters of conservative parties in Germany exhibit significantly higher climate change skepticism according to the list experiment, relative to conventional measures. While this does not definitively mean that climate skepticism is a widespread phenomenon in these countries, it does suggest that future research should reconsider how climate change concern is measured, and what subgroups of the population are more susceptible to misreporting and why. Our findings imply that public support for ambitious climate policy may be weaker than existing survey research suggests. [ABSTRACT FROM AUTHOR]