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The study compared two survey datasets from higher education students in Germany and Ghana regarding access to digital devices; perceived value of digital media, tools, and services used for learning; gap analysis of the actual and desired use of digital teaching and learning formats; and types of media usage profiles among students. The findings underscored commonalities between the two groups, revealing that students in both contexts are equipped with mobile devices, and are highly utilized for their learning. Similarly, both student groups exhibit a preference for utilizing external media, tools and services not owned nor administered by their respective universities. However, a stark contrast emerged in terms of the provision of, and expressed demand for digital teaching and learning formats, attributable to significant disparities in the underlying internet infrastructure and service provision between the two countries. The high intensity in the use of videos, social networks and messaging applications means majority of the students in both contexts were classified as entertainment users of media by means of a latent class analysis. While students in Germany showed differentiation between non-traditional and traditional students in terms of their media usage patterns, there was little differentiation among Ghanaian students. The study concludes by offering suggestions for enhancing support for non-traditional learning and improving digital education in Ghana and similar contexts.

An international comparative study of mathematics textbooks is essential in identifying trends in international mathematics education, developing textbooks and improving the quality of teaching and learning in mathematics. This study analyses and compares the contents of the probability and statistics curricula in the high school textbooks of Vietnam and Germany. It highlights the similarities and differences in the contents and the way they are presented, consolidated and deepened in textbooks of the two countries. The probability and statistics curricula in Vietnamese textbooks are much less than that of German textbooks. The Vietnamese textbooks focus on the mathematical content whereas the German textbooks focus on applications of the content in real life. Vietnamese textbooks tend to force students to accept probability and statistics knowledge while German textbooks encourage students to explore knowledge. Because of this, contexts relating to the contents in German textbooks are more detailed and more natural. German textbooks mainly use an inductive approach to present the contents whereas Vietnamese textbooks often use a deductive approach. In addition, German textbooks unlike those of Vietnam, always take advantage of realistic situations in exploring the contents, encourage co-operative learning and promote statistical reasoning by implementing several project works and provide an opportunity for practical experience and experiment by using the simulations of probability and statistics situations. The comparison shows the strengths of probability and statistics contents in German textbooks that Vietnamese textbooks can learn for the development of textbooks in future.

Teaching practical skills is of particular interest in the study of human medicine. With regard to medical statistics this means the use of statistical software, which may be effectively taught by a flipped classroom approach. As a pilot study, we designed and implemented an elective course on medical statistics that focused on hands-on data analysis in SAS Studio. Students independently prepared for class using materials such as pretaped asynchronous lectures, and worked on exercises during synchronous class sessions. On course evaluations completed by n 15 students out of 26, students rated their satisfaction with the course a mean of 1.3 (SD 0.6) on a scale where 1 best and 6 worst. Twelve (80%) indicated that they processed all materials provided, and 11 students (73%) rated the frequency of direct contact with the instructor as sufficient. Nearly all (14 out of 15) viewed the course as an adequate substitute for a full face-to-face course. Our results suggest that the proposed course design is well-accepted. The flipped classroom format offers high flexibility and can be implemented easily online. Our pilot data are encouraging regarding the aim of designing a prospective follow-up study which compares the flipped classroom approach to a teaching format based on attendance.

The Etherpad is an open source online editor providing the possibility for collaborative writing and discussions in real-time via a shared link. Previous research has shown that the use of technology in higher education can be effective and that online editors can facilitate collaborative learning. This article outlines the use of the Etherpad in a psychology Master's students' statistics class. During the lecture, students asked and answered questions in the Etherpad, followed the discussion of others, and/or gave general comments on the lecture and its topics. A tutor and the lecturer acted as moderators of the Etherpad. For evaluative purposes, students' participation in the Etherpad and their feedback in a mixed-methods survey were investigated. In all, 50 out of 90 students attending the course sessions participated in the evaluation. Students' commitment and feedback were very positive. We conclude by discussing implications of the Etherpad use for lecturers teaching statistics.

In the paper a software solution is presented for the generation of instances of exercises. The focus is on education in mathematics but the approach can be adopted in other fields such as computer science and natural science. The present solution uses the R environment for the generation process and LaTeX for the content presentation. In the established system, we realized the separation of computations and design which has the advantage that it is easier to find errors and shortcomings.

Current instruments for assessing university students' statistics anxiety prevailingly emphasize the affective construct component. In order to unfold the construct in a more exhaustive and differentiated manner, a scale for measuring university students' worry, avoidance, and emotionality cognitions was developed. In two samples of education science majors the present pilot study aimed at analyzing the scale's psychometric properties and at gaining preliminary validation results. Principal component analyses led to the formation of a unidimensional scale which appeared to be sufficiently reliable. Its relations to domain-specific self-belief and background variables turned out as theoretically expected -- thus, for the time being the scale should claim criterion validity.

Maturity and citizenship in a democracy require that laypersons are able to critically evaluate experts' use of mathematics. Learning to critically reflect on the use of mathematics, including the acquisition of the mathematical knowledge and skills required to that end, has been repeatedly postulated as an indispensable goal of compulsory education in mathematics. However, it remained unclear in how far such reflection is possible, even for the well-educated layperson in mathematics. We use different discussions in German mass media on the pandemic policy in the SARS-CoV-2 crisis in 2020 as examples with far-reaching individual and social consequences. The selected discussions build heavily on mathematical concepts such as mortality rates, casualty numbers, reproduction numbers, and exponential growth. We identify the concepts and discuss how far they can be understood by laypersons. On the one hand, we found that some mathematical models are inappropriate, which can also be determined by laypersons. On the other hand, we found uses of mathematics where ideal concepts are intermingled with complex statistical concepts. While only the ideal concepts can be understood by laypersons, only the statistical concepts lead to actual data. The identification of both types of concepts leads to a situation where the use of mathematics evades social control and opens spaces for misconceptions and manipulation. We conclude that the evaluation of experts' use of mathematics by laypersons is not possible in all relevant cases, and we discuss possible implications of this result.

Although statistical literacy has become a key competence in today's data-driven society, it is usually not a part of statistics education. To address this issue, we propose an innovative concept for a conference-like seminar on the topic of statistical literacy. This seminar draws attention to the relevance and importance of statistical literacy, and moreover, students are made aware of the process of science communication and are introduced to the peer review process for the assessment of scientific papers. In the summer term 2020, the seminar was conducted as a joint project by the University of Hamburg, the University of Muenster, and the Joachim Herz Foundation. In this article, we present the concept of the seminar and our experience with this concept in the summer term 2020.

A previous study found that task shifting and fluid intelligence, but not working memory capacity (WMC) and prior knowledge, influenced the worked example effect (Schwaighofer, Bühner, & Fischer, 2016). To increase confidence in these findings, we report a preregistered extended replication study of Schwaighofer et al.'s investigation. University students (N = 231, M[subscript age] = 22.40 [SD = 4.33], 87% women) solved statistical problems with textbook materials presented on a laptop in one of four conditions in a 2 × 2 factorial between-subjects design. We compared worked examples versus problem-solving (replication) and with versus without time pressure (extension). Time pressure was added to test whether learners in the original study were able to offload WMC demands, which would explain why the WMC moderation was not found. Results showed that the advantage of worked examples over problem-solving decreased with increasing prior knowledge, suggesting that problem-solving becomes eventually more effective than worked example study. Similarly, the benefit of worked examples over problem-solving decreased with increasing shifting ability of a learner. However, contingencies on WMC or fluid intelligence were not detected. Our extension analysis indicated that the worked example effect was also not contingent on WMC even when learners were under time pressure. These findings underline the important role that task shifting might play in scaffolded learning environments and suggest that trading in the focus on WMC for a broader perspective on cognitive architecture provides novel explanations for instructional effectiveness. Our study further highlights the importance of more customized instructional support.

Since many decisions in politics, economics, and social sciences are based on statistics, statistical literacy is a key component for an active citizen. Statistical skills and statistical reasoning can already be enhanced in primary school. Therefore, not only in Germany, statistics is an element of the primary-school curriculum, which usually includes issues of posing questions, collecting data, and of drawing displays such as pie charts or bar graphs. But to engage students and to start building future generations of statisticians at an early stage, more challenging incentives should engage students in meaningful statistical inquiries. In this paper, we describe activities that are part of a larger, long-term project that investigates how and if teaching units can be designed for primary schools and what their effect on students at that early age is. We focus on specific activities that have been tested for students at age 10. The empirical results show that -- beyond learning techniques and the use of software (TinkerPlots) -- the students acquired a way of statistical reasoning about the posed problems. Besides the cognitive development, we also documented the affective impact of our course on the young learners, which was very good. Our studies corroborate that it is possible to lead students to sophisticated statistical activities such as comparing groups with the help of suitable software. Furthermore, a positive attitude towards statistics could be observed as a result of the course, which may be the basis for further success in learning statistics. All in all, we can pave the way to the future generation of statisticians already at an early age in primary school.

Misconceptions impair not only learners' comprehension of a text but also the accuracy with which they judge their comprehension, that is, "metacomprehension accuracy." Refutation texts are beneficial to elicit conceptual-change processes and thus to overcome the detrimental impact of misconceptions on comprehension. However, it is unclear whether refutation texts and the conceptual-change processes induced by reading them benefit metacomprehension accuracy in addition to comprehension and how robust these effects are when reading further texts. We conducted an experiment in which we asked 80 student teachers with a varying number of statistical misconceptions to read either a standard or a refutation text on statistics and assessed their comprehension and metacomprehension. In a subsample, we examined the students' conceptual-change processes during reading with the think-aloud methodology. Subsequently, we asked the students to read a research report that required the application of the previously acquired statistical knowledge and assessed their comprehension and metacomprehension again. The results revealed that the refutation text compensated for the detrimental impact of misconceptions on comprehension and metacomprehension accuracy. The think-aloud data indicated that when reading the refutation text, students with more misconceptions engaged in conceptual-change processes more actively, which in turn supported their comprehension and metacomprehension accuracy. Compensatory effects of the refutation text were also found when the students read the research report. In sum, the findings show that refutation texts are beneficial for both comprehension and metacomprehension accuracy and that these benefits transfer to situations where the acquired knowledge has to be put into practice.

Elements of statistical modeling can be implemented already in primary school. A prerequisite for this approach is that teachers are well-educated in this domain. Content knowledge, pedagogical content knowledge and (pedagogical) content related technological knowledge are core components of teacher education. We designed a course for elementary preservice teachers with regard to developing statistical thinking including the mentioned knowledge facets. The course includes exploring data and modeling and simulating chance experiments with TinkerPlots. We use the 'data factory metaphor' in fictive contexts and in contexts stemming from civic statistics for supporting the idea of modeling. We interviewed four participants of the course to assess and analyze their reasoning. We analyze how they model a given civic statistics contextual problem using the TinkerPlots sampler and how they evaluate their model with regard to a civic statistics context (the situation of hospitals in Germany).

An experimental field study at a German university was conducted in order to test the effectiveness of an integrated learning environment to improve the acquisition of knowledge about empirical research methods. The integrated learning environment was based on the combination of instruction-oriented and problem-oriented design principles and consisted of twelve worked examples. An elaboration intervention was administered as instructional support. The effectiveness of the learning environment both with and without the elaboration intervention was assessed using knowledge application tasks (near and far transfer), which were applied after the training phase. In addition, student's self-reports on "mindfulness" (Salomon & Globerson, 1987) were collected. The training was implemented into the regular curriculum. The participants were advanced students in educational science. Both experimental groups (with elaboration intervention: n = 26; without elaboration intervention n = 27) clearly outperformed the control group (n = 17) in the knowledge application tasks. In order to (successfully) foster transferable applicable knowledge, instructional support provided via the elaboration intervention was in fact necessary. Furthermore, the self-reports of students in the experimental group with elaboration intervention showed higher mindfulness scores than those without it. Our results indicate that the integrated learning environment developed in this study can be implemented to improve the acquisition of knowledge about empirical research methods both effectively and efficiently.

As a component of the ongoing development of the mathematics curriculum in China, we compare the country's high school mathematics textbooks with those of several other countries. We base our analysis on the assumption that textbooks, as primary printed teaching resources, are key tools for interpreting educational policy. In this paper, we compare what content is selected and how that content is presented in series of high school textbooks from China, France, Germany, Japan, Russia, the United Kingdom, and the United States according to four core domains: algebra, geometry, statistics and probability, and calculus. We then discuss the implications of the analysis for the reform of the high school mathematics curriculum in China, particularly as it applies to the development of textbooks within that process of reform. The comparative results provide us with the opportunity to recognise the distinguishing features of the content and presentation of the Chinese mathematics curriculum and lead to some suggestions for future curriculum development.

Group comparisons offer students opportunities to reason about many fundamental statistical concepts like center, variation, or distribution. When doing such activities using large, real datasets, technology becomes an essential tool for exploring the data. With its large variety of features and its user-friendly handling, TinkerPlots™--as a software for learners and teachers--can facilitate the process of comparing distributions. In this article we focus on eight preservice teachers´ reasoning when comparing groups with TinkerPlots. We present ideas on the design of a course to develop statistical reasoning with TinkerPlots, present a framework to rate learners´ performance when comparing groups with TinkerPlots, and present results of a laboratory study about preservice teachers´ reasoning when comparing groups with TinkerPlots. Findings suggest that the TinkerPlots tool and design of the course supported these preservice teachers' reasoning and that more learning opportunities are needed to increase their group comparison elements' repertoire and interpretation in context.

Computer-assisted assessment (CAA) is widely used in modern university courses in many different fields. It can be used both in formative and summative assessments and with different emphasis on (self-)training, grading, and feedback generation. This article reports on experiences from using the CAA tool "JACK" to support a university lecture on mathematical statistics for exercises, tests, and exams. We show and discuss, among others, a positive relationship between usage intensity of JACK and final grades. Moreover, students generally report to invest more time into studying when offered a CAA, and to be satisfied with such a setup.

The present study investigates the processes of how German middle school students (age 14) interpret, contrast and evaluate different (informal) statistical measures in order to summarise and compare frequency distributions. To trace the developing insights into the properties of these measures, this paper uses the 'emergent modelling' perspective: measures are understood as models, which can either be used to make sense of a given situation or to reason about the statistical measures themselves, e.g. in terms of when they can be applied adequately. The emergent modelling approach is used (1) as a theoretical framework for describing students' conceptual development, and (2) as a design heuristic for developing a teaching-learning arrangement aiming at developing insights about (frequency) distributions and statistical measures. In the qualitative analysis of a design experiment, two students' emerging contextual and statistical knowledge is identified, revealing the intertwined nature of both types of knowledge. Overall, this paper illustrates the important role the emergent modelling perspective can play for designing as well as describing students' learning pathways in statistics education.

Connecting data and chance is fundamental in statistics curricula. The use of software like TinkerPlots can bridge both worlds because the TinkerPlots Sampler supports learners in expressive modeling. We conducted a study with elementary preservice teachers with a basic university education in statistics. They were asked to set up and evaluate their own models with TinkerPlots by using a real and open dataset they were given. In this article we present students' processes of setting up and evaluating their models and focus on their reasoning during this process.

Worked examples have proven to be effective for knowledge acquisition compared with problem solving, particularly when prior knowledge is low (e.g., Kalyuga, 2007). However, in addition to prior knowledge, executive functions and fluid intelligence might be potential moderators of the effectiveness of worked examples. The present study examines the roles of the executive functions of working memory capacity and shifting, as well as the role of fluid intelligence for knowledge acquisition in the presence or absence of worked examples. Seventy-six university students learned to solve statistical problems either with worked examples or through problem solving (the absence of worked examples). Results showed that shifting and fluid intelligence, but not prior knowledge and working memory capacity, moderated the effect of the presence of worked examples on knowledge acquisition. The higher the shifting ability and fluid intelligence were, the lower was the benefit of worked examples compared with problem solving. Learning environments did not differ with respect to cognitive load, and cognitive load was not correlated with working memory capacity, but it was correlated with fluid intelligence. These findings suggest that other important cognitive functions, such as shifting and fluid intelligence, might be more important than prior knowledge or working memory when worked examples are compared with problem solving. Future research can further examine whether the relative contribution of the different functions is likely to depend on the characteristics of the respective tasks--that is, whether a task puts a high or low demand on these cognitive functions.

Supporting motivational variables such as self-concept or interest is an important goal of schooling as they relate to learning and achievement. In this study, we investigated whether specific interest and self-concept related to the domains of statistics and mathematics can be fostered through a four-lesson intervention focusing on statistics. Data about these motivational variables and achievement related to statistics were gathered from 503 eighth graders. Our results indicate that students perceived mathematics and statistics differently with respect to their self-concept and interest. Moreover, statistics-related self-concept and interest could be fostered through the domain-specific intervention, whereby a greater increase was found among students with higher prior achievement in the domain of statistics.

Lecturers teaching statistics are faced with several challenges supporting students' learning in appropriate ways. A variety of methods and tools exist to facilitate students' learning on statistics courses. The online questionnaires presented in this report are a new, slightly different computer-based tool: the central aim was to support students to master the course content and to provide the lecturer with continuous feedback about the students' difficulties and deficits. The aims of online questionnaires supporting teaching and learning of statistics are compared to aims of other computer-based and non-computerized methods and tools. Additionally, data from a first evaluation of the questionnaires is presented. In a first year psychology student's statistics course (bachelor program), students were offered the possibility of filling in an online questionnaire every time a specific theme had been taught. Out of the 126 first year students there were 28 who answered the online questionnaires regularly and 12 answered them sometimes. Those who answered the online questionnaires assessed them as helpful for their understanding of the course's content. The lecturer judged the online questionnaires as particularly helpful for improving teaching and assessing performance deficits.

The ability to purposefully access, reflect, and use evidence from educational research (Educational Research Literacy) is expected of future professionals in educational practice. Based on the presented conceptual framework, a test instrument was developed to assess the different competency aspects: Information Literacy, Statistical Literacy, and Evidence-based Reasoning. This paper addresses the question of whether this test allows monitoring students' development during courses on research methods in educational science. In winter semester 2013/14, two courses in Early Education and Teacher Training degree programs were accompanied. Both cross-sectional (multidimensional latent regression models) and longitudinal (paired t tests of plausible values) comparisons are reported. The results indicate no significant differences in competencies between the degree programs at start of the semester. For the end of semester, only data of the Early Education course was available. These course participants showed higher proficiency in all aspects of educational research literacy. In conclusion, the results are discussed with regard to the goals of the assessment of competencies in higher education, particularly the use of test feedback for course development, and desiderata for future research (e.g., ability to transfer research into practice) are stated.

Background: It is often claimed that psychology students' attitudes towards research methods and statistics affect course enrolment, persistence, achievement, and course climate. However, the inter-institutional variability has been widely neglected in the research on students' attitudes towards research methods and statistics, but it is important for didactic purposes (heterogeneity of the student population). Aims: The paper presents a scale based on findings of the social psychology of attitudes (polar and emotion-based concept) in conjunction with a method for capturing beginning university students' attitudes towards research methods and statistics and identifying the proportion of students having positive attitudes at the institutional level. Sample: The study based on a re-analysis of a nationwide survey in Germany in August 2000 of all psychology students that enrolled in fall 1999/2000 ("N" = 1,490) and "N" = 44 universities. Methods: Using multilevel latent-class analysis (MLLCA), the aim was to group students in different student attitude types and at the same time to obtain university segments based on the incidences of the different student attitude types. Results: Four student latent clusters were found that can be ranked on a bipolar attitude dimension. Membership in a cluster was predicted by age, grade point average (GPA) on school-leaving exam, and personality traits. In addition, two university segments were found: universities with an average proportion of students with positive attitudes and universities with a high proportion of students with positive attitudes (excellent segment). Conclusions: As psychology students make up a very heterogeneous group, the use of multiple learning activities as opposed to the classical lecture course is required. (Contains 6 tables and 3 figures.)

This article is devoted to practical aspects of teaching and learning of probability at university. It presents the difficulties and attitudes of first-year university science and engineering students towards using paradoxes and counterexamples as a pedagogical strategy in teaching and learning of probability. It also presents a student's point of view on the effectiveness of this pedagogical strategy. (Contains 4 tables and 2 figures.)

Undergraduate students (N = 97) used an introductory text and a computer simulation to learn fundamental concepts about statistical analyses (e.g., analysis of variance, regression analysis and General Linear Model). Each learner was randomly assigned to one cell of a 2 (with or without instructional advice) x 2 (with or without time advice) x 2 (with or without learning questions) between subjects factorial design. Time spent with the simulation as well as retention and transfer tests were used as dependent measures. Neither the instructional advice to examine the different parameters in a simulation systematically presented immediately before the simulation nor the learning questions (without feedback) presented during the simulation improves learners' retention or transfer performances. Students who were asked to employ more time on the computer simulation immediately before they want to finish it spent considerably more time with the simulation and performed better on retention, but not on transfer than did students for whom this request was absent. The results were discussed on the basis of the extended "Scientific Discovery as Dual Search" model and in conjunction with adaptive computer simulations. (Contains 1 table and 1 figure.)

Starting from difficulties that students of education display when they interpret empirical findings and generate scientific arguments, a problem-based e-learning environment was developed. Based on first evaluation data, an elaboration tool was integrated into the learning environment. The tool consisted of a modelling and an explanation part. In order to investigate the effectiveness of this elaboration support, a quasi-experimental field study was carried out in two seminars on scientific methods for advanced students of education. Students in seminar 1 (n = 32) worked within the learning environment without the elaboration tool, students in seminar 2 (n = 20) worked with a version that contained the elaboration support. The seminars did not differ with respect to various student characteristics. The students' absolute performance on a posttest that included argumentation and statistics tasks was rather poor. However, the elaboration tool significantly enhanced performance and motivational aspects (acceptance of the learning environment and subjective learning outcomes). By cluster analytical methods three student profiles were identified that substantially differed concerning posttest performance. (Contains 1 note, 4 tables, and 1 figure.)

This article discusses using attributional retraining techniques with gifted girls to reduce gender differences in mathematics and science performance. Following an overview of the most important retraining techniques, two studies with extremely promising results are described, the first with 42 German high school students in mathematics, and the second with German female university students in statistics. (Author/DB)

Objectives: To evaluate the clinical effectiveness of regenerative treatment of intrabony defects in combination with consecutive orthodontic therapy with clear aligners in stage IV (type 2) periodontitis. Method and materials: Ten patients with a total of 103 intrabony defects were analyzed after regenerative surgery using collagen-deproteinized bovine bone mineral with or without collagen membrane or enamel matrix derivative followed by orthodontic therapy with clear aligners. Changes in radiographic bone level and probing pocket depths were evaluated after 1 year (T1) and at final splinting (T2) after orthodontic tooth movement. Results: Mean radiographic bone level gain was significant, with 2.13 ± 1.64 mm at T1 and 3.02 ± 2.00 mm at T2. Mean probing pocket depth was significantly reduced from 5.40 ± 1.80 mm at baseline to 3.78 ± 1.73 mm at T1, and remained stable with 3.73 ± 1.70 mm at T2. Pocket closure (≤ 4 mm probing pocket depth) was accomplished in 76% of all defects. Tooth loss amounted to 2.9%. Conclusion: Within the limitations of the retrospective study design, the findings suggest that the interdisciplinary treatment of periodontitis stage IV by regenerative periodontal surgery and consecutive orthodontic therapy with clear aligners can lead to favorable results. [ABSTRACT FROM AUTHOR]

Background: Child maltreatment (CM) can have devastating and potentially lifelong effects for those affected and is a major contributor to mental health problems. To tackle public health problems it is crucial to have reliable data on CM. The aim of this study is to assess the prevalence and predictors of CM in a nationwide sample of the German population of young adults. Methods: The study population (young adults aged 18 to 31 years) stems from the KiGGS Cohort study, the longitudinal branch of the German Health Interview and Examination Survey for children and adolescents. This sample meets the criteria of the United Nations Sustainable Development Goals (SDG) indicator 16.2.3. The data was collected between 2014 and 2017. CM were assessed with the Childhood Trauma Questionnaire (CTQ) in. In addition, socio-demographic variables and other known risk factors for CM were assessed. A total of 6433 (47.8% female) participants were included in the analyses. Binary logistic regression analyses were used to investigate predictors of maltreatment subtypes. Ordinal regression was used to examine their association with experience of multiple forms of CM. Results: Overall, 18.4% (f: 20.9%, m: 16.1%) of the participants reported having experienced at least one type of CM; 6.7% (f: 8.8%, m: 4.8%) reported experiences of emotional abuse, 3.7% (f: 3.9%, m: 3.5%) physical abuse, 3.5% (f: 5.3%, m: 1.7%) sexual abuse, 9.0% (f: 9.9%, m: 8.2%) emotional neglect and 8.6% (f: 8.5%, m: 8.7%) physical neglect. Gender, subjective social status, education and household dysfunction (e.g. living with an individual who is using substances) emerged as significant predictors for different types of CM. Additionally, all these factors were significant risk factors for experiencing cumulative CM. Conclusions: CM is common in the German population, with almost one in five people experiencing at least one type of CM. The results reveal important risk factors for the occurrence of CM. In particular, people with lower social status and those who grew up in dysfunctional households are at higher risk of CM. Greater support for this vulnerable population may reduce the prevalence of CM. [ABSTRACT FROM AUTHOR]

Sound symbolism is a non-arbitrary mapping between phonetic properties and meanings. The existence and nature of sound symbolism have long been the subject of empirical research. It is rarely recognized, however, that participants' intrinsic characteristics (e.g., age, gender, language knowledge), in addition to the commonly studied phonetic features, may also influence size ratings. Our study aims to empirically investigate the impact of participant-specific characteristics on size ratings: It also aims to examine whether these characteristics have a direct impact when considering the impact of phonetic features or they rather modify the effects of phonetic features. The current research reports a novel analysis of a previously published dataset with new research questions and previously unused (participant-specific) data. We show that (a) the participants' characteristics did not affect overall size ratings; however, (b) in some cases, they modify (intensify or weaken but do not reverse) the effect of phonetic features on size ratings. Our results emphasize a more comprehensive treatment of sound symbolism, one that considers not only phonetic but also non-phonetic factors in sound symbolism research. [ABSTRACT FROM AUTHOR]

Simple Summary: Seizures are one of the most common and severe symptoms of meningioma, leading to increased morbidity and mortality in the affected patients. Therefore, seizure prevention represents an important goal in the treatment of meningioma patients. For this purpose, our study aims to identify predictors for the occurrence of preoperative and postoperative seizures in meningioma. Neurosurgical tumor resection was demonstrated as an effective treatment of seizures in meningioma patients but is also associated with a moderate risk of new-onset seizures after surgery. The present study identified several independent predictors for seizures in meningioma that could contribute to improved seizure treatment and a deeper understanding of the occurrence of seizures in meningioma patients. Seizure is a common symptom of meningioma that has a major impact on patients' quality of life. The purpose of this study was to identify predictive factors for the occurrence of preoperative and postoperative seizures. The data of patients with resection of histologically confirmed meningioma at University Hospital Leipzig from 2009 to 2018 were retrospectively examined. Univariate and multivariate logistic regression analyses of different factors influencing seizure outcome were performed. The male gender was identified as an independent positive predictor for preoperative seizures (odds ratio [OR] 1.917 [95% confidence interval {CI} 1.044–3.521], p = 0.036), whereas headache (OR 0.230 [95% CI 0.091–0.582], p = 0.002) and neurological deficits (OR 0.223; [95% CI 0.121–0.410], p < 0.001) were demonstrated to be negative predictive factors. Sensorimotor deficit after surgery (OR 4.490 [95% CI 2.231–9.037], p < 0.001) was found to be a positive predictor for the occurrence of postoperative seizures. The identified predictors for the occurrence of seizures in meningioma can contribute to improving seizure treatment and patients' quality of life. [ABSTRACT FROM AUTHOR]

Background: Effects of the aging process on the flexural strength of Y-TZP and different Y-PSZ ceramics of different thicknesses were investigated. Methods: 300 disc-shaped samples (12 mm diameter, 0.8 and 1.5 mm thicknesses) were made from 5 different zirconia materials 3Y-TZP LA, 4Y-PSZ, 5Y-PSZ, 3 + 5Y-PSZ and 4 + 5Y-PSZ. Experimental groups were artificially aged in an autoclave at 134 °C, 2 bar pressure for 1 and 5 h; control groups were not subjected to any treatment. Microstructural analysis was conducted using Scanning Electron Microscopy, and X-Ray Diffraction analysis determined the crystalline phase content. The impact of aging on flexural strength was investigated with the use of the biaxial flexural strength test. Data were analyzed using three-way ANOVA tests with a significance level of p < 0.05, applying Bonferroni correction for multiple comparisons. Results: Statistically significant differences in flexural strength were observed among the materials and the material thicknesses (p < 0.05), while there were no significant differences among the aging times (p > 0.05). The highest mean flexural strength values were recorded in the case of the 3 Y-TZP-1.5 mm–5 h group (744.1 ± 61.2 MPa), which was attributed to phase-transformation toughening. The lowest values were observed in the case of the 5 Y-PSZ-1.5 mm–5 h (338.3 ± 34.8 MPa) group. Conclusions: Both material type and thickness significantly affect the flexural strength of zirconia ceramics, whereas aging time does not; thus, material selection and thickness are crucial considerations for clinicians. [ABSTRACT FROM AUTHOR]

Simple Summary: Inflammation-based prognostic markers have been recognized as useful in a range of oncologic conditions. Given the high mortality rate associated with pancreatic ductal adenocarcinoma (PDAC), the demand for accurate prognostic tools is significant. Nonetheless, the literature still shows conflicting results regarding the effectiveness of the various available scoring systems. Our data confirm that NLR and PNI are useful biomarkers regarding overall survival in PDAC. Especially in advanced disease stages, they seem to be of considerable benefit as easily accessible tools for prognosis prediction. Purpose: Prognostic inflammation-based parameters have been reported as useful tools in various oncologic diseases. Pancreatic ductal adenocarcinoma (PDAC) is characterized by a high mortality rate, making reliable prognostic markers highly desirable. However, there is still inconsistency in the literature regarding the efficacy of the different available scores. Methods: A total of 207 patients, who underwent primary resection of PDAC from January 2000 to December 2018 at the University Hospital of Erlangen, were included in this retrospective single-center study. Different biomarkers, including the preoperative neutrophil–lymphocyte ratio (NLR), the platelet–lymphocyte ratio (PLR), the c-reactive protein (CRP)–albumin ratio (CAR), the lymphocyte–CRP ratio (LCR), the prognostic nutritional index (PNI) and the modified Glasgow prognostic score (mGPS) were analyzed for their ability to predict overall survival (OS). Results: In our cohort, the median overall survival was 20.7 months. Among the investigated biomarkers, NLR and PNI were identified as independent prognostic markers (Hazard Ratio (HR) 1.6 (1.0–2.5), p = 0.048 and HR 0.6 (0.4–0.9), p = 0.018), whereas PLR, CAR, LCR and mGPS did not reach significance in the multivariate analysis. Subgroup analysis revealed that the prognostic value of NLR and PNI is particularly evident in locally advanced tumor stages (pT3/4 and pN+). Conclusions: The NLR and PNI could serve as valuable tools for estimating prognosis in patients with PDAC undergoing pancreatic resection in curative intention, especially in locally advanced tumor stages. However, conflicting results in the current literature highlight the need for further prospective studies to validate these findings. [ABSTRACT FROM AUTHOR]

Paramedics work under physically and cognitively demanding conditions to provide emergency care. As physical fitness could positively impact the quality of patient care, we investigated within a pilot study whether concurrent training (CT) affects work-related performance parameters in paramedics. At baseline (T1), 16 paramedics performed cardiopulmonary resuscitation whereby resuscitation performance (RP; total resuscitation quality, compressions with correct frequency, and correct ventilation), cognitive performance (CP; reaction time, divided attention, and working memory), and heart rate variability (HRV) were assessed (pre-exertion). Then, participants climbed seven floors carrying 20 kg of gear before completing the same assessments again (post-exertion). The baseline testing was followed by a CT intervention (12 weeks, three sessions/week). After the intervention (T2), the two-stage testing was repeated. We analyzed whether the pre-exertion and post-exertion values, as well as the difference between the pre-exertion and post-exertion values, changed from T1 to T2. Nine paramedics (male: N = 7; age = 26.3 (SD = 8.17) years) took part in the study. The comparison of the pre-exertion values showed significantly better reaction times (p = 0.001) and divided attention (p = 0.02) and a trend toward greater working memory and RP parameters at T2. Regarding the post-exertion values, significant improvements in working memory (p = 0.03) and a trend toward improved reaction time, divided attention, and RP occurred at T2. The difference between the pre- and post-exertion values did not change for any parameter from T1 to T2. HRV decreased significantly from pre- to post-exertion (T1: p = 0.01, T2: p = 0.01). These results indicate that CT is a promising training concept to improve RP and CP in paramedics and should therefore be investigated further to increase patient care quality. [ABSTRACT FROM AUTHOR]

Background: Long-lasting symptoms with a possible relation to psychosomatic comorbidity have been described following COVID-19. However, data is sparse in general practice. The trial's objective was to investigate the time-dependent frequency of disease symptoms and relation to psychosomatic comorbidity and daily life impairment (DLI). Methods: Comparative cohort study of patients reporting a previous SARS-CoV-2 infection and uninfected controls in general practice. Participants were recruited in 14 general practices in the greater Munich area. Data collection was questionnaire based with a 12 months follow-up. Descriptive statistics, multivariable regression and bivariate correlations were used for analysis. Results: A total of n = 204 cases infected up to 42 months ago (n = 141 Omicron, n = 63 earlier variants), and n = 119 controls were included. Disease symptoms were substantially more prevalent in cases (55–79% vs. 43% within one year of infection). This difference also appeared in the multivariable analysis adjusting for socio-demographics and psychosomatic comorbidity with odds ratios (OR) of 4.15 (p < 0.001) and 3.51 (p = 0.054) for the cohorts with Omicron or earlier variants infection (vs. controls), respectively. It was persistent with earlier variants (OR 1.00 per month, p = 0.903), while a decreasing trend was observed for Omicron (OR 0.89 per month, p < 0.001). DLI was especially correlated with fatigue (r = 0.628). Conclusion: DLI, psychosomatic comorbidity and independently increased disease symptoms require holistic treatment of the patient in general practice according to the bio-psycho-social model. A key role in restoring the daily life capability may be attributed to the symptom fatigue. [ABSTRACT FROM AUTHOR]

Background: Children of parents with a mental illness (COPMI) have multiple psychological and developmental risks, including an increased lifetime risk of developing a mental illness themselves. Emotion regulation (ER) has been identified as a potential underlying mechanism of the transgenerational transmission of mental disorders. This study compares ER strategies in parents with and without a mental illness and their children. Further, it aims to examine the relationship between parents and children's psychopathology with a focus on the role of parental and child ER. Methods: Participants were 96 COPMI (77% female) and 99 children of parents without mental illness (COPWMI, 83% female) aged 4–16 years and their parents. Psychopathology and ER strategies of parents and children were assessed with a series of questionnaires. Results: Both COPMI and their parents showed significantly more psychopathology and more maladaptive and adaptive ER strategies in comparison with COPWMI and their parents. Parent and child adaptive ER strategies mediated the relationship between the psychopathology of parents and children only when child maladaptive ER strategies were low. Conclusions : The findings further our understanding of the processes by which parental psychopathology affects child outcomes. Our findings highlight the importance of implementing preventive programs that specifically target the reduction of maladaptive ER in children to interrupt the transgenerational transmission of psychopathological symptoms. [ABSTRACT FROM AUTHOR]

Background: With the primary objective of addressing the disparity in global surgical care access, the College of Surgeons of East, Central, and Southern Africa (COSECSA) trains surgeons. While sufficient operative experience is crucial for surgical training, the extent of utilization of minimally invasive techniques during COSECSA training remains understudied. Methods: We conducted an extensive review of COSECSA general surgery trainees' operative case logs from January 1, 2015, to December 31, 2020, focusing on the utilization of minimally invasive surgical procedures. Our primary objective was to determine the prevalence of laparoscopic procedures and compare this to open procedures. We analyzed the distribution of laparoscopic cases across common indications such as cholecystectomy, appendicitis, and hernia operations. Additionally, we examined the impact of trainee autonomy, country development index, and hospital type on laparoscopy utilization. Results: Among 68,659 total cases, only 616 (0.9%) were laparoscopic procedures. Notably, 34 cases were conducted during trainee external rotations in countries like the United Kingdom, Germany, and India. Gallbladder and appendix pathologies were most frequent among the 582 recorded laparoscopic cases performed in Africa. Laparoscopic cholecystectomy accounted for 29% (276 of 975 cases), laparoscopic appendectomy for 3% (76 of 2548 cases), and laparoscopic hernia repairs for 0.5% (26 of 5620 cases). Trainees self-reported lower autonomy for laparoscopic (22.5%) than open cases (61.5%). Laparoscopy usage was more prevalent in upper-middle-income (2.7%) and lower-middle-income countries (0.8%) compared with lower-income countries (0.5%) (p < 0.001). Private (1.6%) and faith-based hospitals (1.5%) showed greater laparoscopy utilization than public hospitals (0.5%) (p < 0.001). Conclusions: The study highlights the relatively low utilization of minimally invasive techniques in surgical training within the ECSA region. Laparoscopic cases remain a minority, with variations observed based on specific diagnoses. The findings suggest a need to enhance exposure to minimally invasive procedures to ensure well-rounded training and proficiency in these techniques. [ABSTRACT FROM AUTHOR]

Simple Summary: Prostate specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) is a promising and recently approved treatment option for patients with metastatic castration-resistant prostate cancer (mCRPC). The aim of this study was to analyze which laboratory and PET imaging parameters are able to predict biochemical response and overall survival with this treatment. Two quantitative imaging biomarkers were identified that allow prediction of RLT outcome, further improving the pre-therapeutic characterization of mCRPC patients undergoing PSMA-RLT. The aim of this retrospective study was to identify pre-therapeutic predictive laboratory and molecular imaging biomarkers for response and overall survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT). Pre-therapeutic laboratory and [68Ga]Ga-PSMA-11 PET/CT data of n = 102 mCRPC patients receiving [177Lu]Lu-PSMA-617 RLT within a prospective registry (REALITY Study, NCT04833517) were analyzed including laboratory parameters such as alkaline phosphatase (ALP), prostate-specific antigen (PSA), gamma glutamyl transferase (GGT), glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), neuron specific enolase (NSE), hemoglobin (Hb), and imaging parameters such as maximum standardized uptake value of the tumor lesions (SUVmax), the mean standardized uptake value of all tumor lesions (SUVmean), the whole-body molecular tumor volume (MTV), and the whole-body total lesion PSMA (TLP). Mann–Whitney U test, univariate and multivariable Cox-regression were performed to test for association of the parameters with response and OS. The SUVmean of all lesions was significantly different between responders and non-responders (SUVmean responders 8.95 ± 2.83 vs. non-responders 7.88 ± 4.46, p = 0.003), whereas all other tested biochemical and imaging parameters did not reveal significant differences. Hb and the molecular imaging parameters MTV and TLP showed a significant association with OS (p = 0.013, p = 0.005; p = 0.009) in univariant Cox regression; however, only TLP remained significant in multivariable analysis (Hazard ratio 1.033, p = 0.009). This study demonstrates a statistically significant association between the quantitative PET/CT imaging parameter SUVmean and PSA response, as well as between the baseline TLP and OS of mCRPC patients undergoing RLT. [ABSTRACT FROM AUTHOR]

Purpose: Vocal fatigue-related symptoms, frequent in patients with voice disorders, are reliably quantifiable with the Vocal Fatigue Index (VFI) in several languages. The main aim of this work was to investigate the content and construct validity of the German Vocal Fatigue Index (VFI-D) by comparison with the German Voice Handicap Index 9 international (VHI9i) and the Vocal Tract Discomfort Scale (VTD). Moreover, the scale and retest reliability were investigated. Method: In a prospective cohort study at two tertiary care hospitals, 93 adults with all types of voice complaints filled out the VFI-D, the VHI-9i, and the VTD. Eighty-one adults (Mage = 53.5 years, SD = 15.7) completed them one time, and additional 12 patients (Mage = 53.8 years, SD = 15.6) did a test-retest, completed them twice at an interval of 1 week. The validity was assessed by Spearman's rho and Mokken scaling and the reliability by a factor analysis and a two-tailed t test. Results: Mokken scaling has proven the VFI-D as one-dimensional questionnaire (one cluster, r = .95). All VFI-D items could be assigned to one of three factors according to principal component and principal axis factor analysis. Although Factor 1 related best to the VHI9i (Φ rs = .76) and Factor 2 to the VTD (Φ rs = .74), Factor 3 correlated moderately with the VHI9i (rs = .34) and weakly with the VTD (rs = .25). Results from the first and second VFI-D completion agreed strongly (t = -1.78, p = .10). Conclusions: In this study, the content and construct validity of the VFI-D were confirmed. Also, both scale reliability with identical factors as those in the original study and retest reliability were verified. The VHI9i and VTD were highly indicative of VFI-D Factors 1 and 2, respectively. No correlation between Factor 3 and the other questionnaires was determined. Future research should evaluate which characteristics are specific to vocal fatigue versus general voice disorder-related symptoms. [ABSTRACT FROM AUTHOR]

Despite the well-documented link between child maltreatment (CM) and mental health, evidence suggests substantial variability in the post-traumatic sequelae of CM across cultures. The perceived acceptability of CM in one's community might moderate the association between CM and mental health, but little research has been conducted on it so far. This study examined how the perceived acceptability of CM may influence the relationship between CM experiences and post-traumatic symptoms in individuals from four different continents and if the pattern of associations is the same across countries. We recruited a sample of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122). We administered online questionnaires and performed multiple group moderation analyses for total CM, neglect, physical abuse, emotional maltreatment, sexual abuse, and exposure to domestic violence (DV). A significant positive main effect of CM on post-traumatic symptoms was found in the overall sample and in Cameroon; in Germany, only neglect and emotional maltreatment were positively associated to post-traumatic symptoms. Moderation effects were identified; the perceived acceptability of neglect in Cameroon and Germany and of exposure to DV in Cameroon had a dampening effect on the relationship between CM experiences and post-traumatic symptoms. Our findings confirm that CM experiences entail long-term post-traumatic sequelae that can vary across cultures and CM subtypes and further our understanding of this issue by showing that the perceived acceptability of CM may be an understudied moderator. [ABSTRACT FROM AUTHOR]

Aim: University students are sexually active, and the sexual risk behavior of this group is higher than that of the general population. The prevention of sexually transmitted infections (STIs) emphasizes the need for comprehensive knowledge about behaviors for STI protection and the actual realization of these behaviors. Subject and methods: First, an online questionnaire was developed to record the knowledge and realization of STI-protective behaviors among students at Hamburg University of Applied Sciences (HUAS) to conduct quantitative cross-sectional interviews. The sample included 1532 students. Specific aspects of the interview are based on lower response rates. The correlations were then tested by Spearman's rank correlation coefficient and Pearson's chi-squared test. Results: Significant positive correlations were identified between the self-efficacy (SE) and the use of condoms, STI vaccinations, STI tests, and HIV pre-exposure prophylaxis (PrEP). Significant negative correlations were suggested between substance use and the use of condoms and the use of PrEP and the intake of antiretroviral therapy (ART). Significant positive correlations were identified between the knowledge about STI-protective behaviors and the usage of STI-protective vaccinations, STI tests, and ART. Significant positive correlations were identified between the experiences in terms of STIs and the knowledge about STI-protective vaccinations, use of PrEP, and use of ART. Conclusion: Moreover, the results indicate that students with a divergent sexual identity have a higher level of knowledge about STI-protective behaviors. The sexual health of university students should be improved by preventive measures to improve the sexual health of individual students and their social environments. [ABSTRACT FROM AUTHOR]

Purpose: Considering the re-emergence of poliomyelitis (PM) in non-endemic regions, it becomes apparent that vaccine preventable diseases can rapidly develop epi- or even pandemic potential. Evaluation of the current vaccination status is required to inform patients, health care providers and policy makers about vaccination gaps. Methods: Between October 28 2022 and November 23 2022, 5,989 adults from the VACCELEREATE Volunteer Registry completed an electronic case report form on their previous PM vaccine doses including number, types/-valencies and the time of administration based on their vaccination records. A uni-/multivariable regression analysis was performed to assess associations in participant characteristics and immunization status. Results: Among German volunteers (n = 5,449), complete PM immunization schedule was found in 1,981 (36%) participants. Uncertain immunization, due to unknown previous PM vaccination (n = 313, 6%), number of doses (n = 497, 9%), types/-valencies (n = 1,233, 23%) or incoherent immunization schedule (n = 149, 3%) was found in 40% (n = 2,192). Out of 1,276 (23%) participants who reported an incomplete immunization schedule, 62 (1%) never received any PM vaccine. A total of 5,074 (93%) volunteers reported having been vaccinated at least once and 2,087 (38%) indicated that they received vaccination within the last ten years. Female sex, younger age, as well as availability of first vaccination record were characteristics significantly associated with complete immunization (p < 0.001). Conclusion: Full PM immunization schedule was low and status frequently classified as uncertain due to lack of details on administered doses. There is an obviousneed for improved recording to enable long-term access to detailed vaccination history in the absence of a centralized immunization register. [ABSTRACT FROM AUTHOR]