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An increasing worldwide concern about a decline in the quality of the motor ability of children was the motivation for this exploratory comparative study. It involves a comparison of the motor ability of children aged 8 and 9 years from Hamburg (n = 774), Melbourne (n = 141) and Cape Town (n = 81). Since each of these global cities represents a typically culturally diverse modern center of population, data were also tentatively analyzed according to ethno-cultural background, as a potential contributing variable to better understand the results of studies such as these. The children's motor abilities were tested by five items from the "Allgemeiner Sportmotorischer Test fur Kinder" or AST 6-11 (Bos, Opper, Woll, Liebisch, Breithecker, & Kremer, 2001). Results were analyzed in terms of city and sex by means of a two-way Analysis of Variance (ANOVA). A composite motor profile was also constructed using all five items. This was then used in a further comparison of major ethno-cultural groups within each of the three cities. Differences in motor ability were evident between the children of the three cities. The children from Hamburg demonstrated the highest levels of performance overall and those of Melbourne the lowest. Both sex and ethno-cultural background were significant mediating variables in all contexts. Boys scored higher than girls on the AST 6-11 at all locations. For children of a European background in both Hamburg and Melbourne, a higher performance was identified when compared with their same city peers of Asian origins. The best performing cultural group overall were the Black African (Xhosa) children of Cape Town. The limitations of the study were identified and some suggestions for future comparative studies of motor ability were made. (Contains 8 tables and 2 figures.)

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This article introduces the National Educational Panel Study (NEPS). This German longitudinal study produces a vast amount of data for the scientific community, and researchers all around Europe are invited to use the data to address various research questions empirically. Therefore, the authors provide information about the purpose as well as the design of this educational study that has just released data from several starting cohorts, ranging from newborns to adults. As the authors have coordinated the starting cohort of students in lower-secondary school, this target group will be introduced in more detail, with the implementation of NEPS's design being outlined, as well as the tests and survey contents. The analytical potentials are exemplified by the authors' stage-specific research on German-language instruction, the development of orthography competence, and engagement in reading and orthography in lower-secondary school. An overview of different modes of access to the available data completes this research report.

Introduction: The association between human papilloma virus (HPV) and the pathogenesis of prostate cancer (PCa) is still controversial. Existing studies often lack information about clinical risk factors, are limited by their retrospective design or only use a single detection method for HPV. Material and Methods: A total of 140 patients undergoing radical prostatectomy (RP) for PCa at the Department of Urology, Ludwig Maximilian University of Munich, Germany, were prospectively enrolled. Knowledge of HPV and sociodemographic parameters were assessed with questionnaires. The following methods were used for HPV detection: RP specimens were tested for HPV DNA by PCR. If HPV DNA was detected, an LCD-Array hybridization technique was used for HPV subtyping, and immunohistochemical staining for p16 was performed as a surrogate marker for HPV infection. Serological titers of HPV-16 L1 antibodies were measured using an HPV-16-specific immunoassay. Results: HPV DNA was detected in 9.3% (13/140) of RP specimens, with HPV-16 being the most predominantly detected subtype (5/13 = 39%). HPV-16 L1 antibody levels were below the limit of detection in 98% of patients (137/140). We found no significant difference between HPV PCR-positive (HPV+) and -negative (HPV-) patients in terms of HPV-16 antibody levels, history of HPV-associated diseases, level of education or marital status. Seventy-five percent of all PCa patients had never heard of HPV before. An acinar adenocarcinoma of the prostate was the most frequently detected histologic type in both HPV+ (100%) and HPV− (98%) patients (p = 0.86). HPV+ patients had fewer positive biopsy cores (3.5 vs. 5.8; p = 0.01) and a lower maximal tumor infiltration rate per core (37% vs. 57%; p = 0.03) compared to HPV- patients. However, when analyzing the whole prostate and the lymph nodes after RP, there were no significant differences in TNM stage, Gleason score or tumor volume between both groups. In a subgroup analysis of all high-risk HPV patients (n = 6), we found no significant differences in sociodemographic, clinical or histopathological parameters compared to HPV- or low-risk HPV+ patients. Conclusion: In our prospective study, we were not able to prove a clinically significant impact of HPV status on tumor characteristics in RP specimens. Most men with PCa had never heard of HPV, despite its proven causal association with other tumor entities. [ABSTRACT FROM AUTHOR]

Developmental Science aims to generate a new body of knowledge that encompasses and integrates findings from various well-defined academic disciplines concerned with developmental processes of human and non-human organisms. Although all development related research traditions surely have their own distinct history, certain theoretical ideas formulated by James Mark Baldwin, Jean Piaget, Lev Vygotsky, and Albert Bandura among others can be considered intellectual cornerstones in the history of Developmental Science. However, the claim for interdisciplinary developmental research put forth by theses theorists and more recently by scientists such as Clarence Luther Herrick and Zing-Yang Kuo did not receive much attention. It has only been in the past few decades that through the establishment of several interdisciplinary research centres and through the increasing number of publications--in the form of compendia, textbooks, and journals--the long standing endeavour to promote Developmental Science as independent research tradition slowly begin to take an effect.

Purpose: The transition process from paediatric/adolescent to adult medical care settings is of utmost importance for the future health of adolescents with chronic diseases and poses even more difficulties in the context of rare diseases (RDs). Paediatric care teams are challenged to deliver adolescent-appropriate information and structures. Here we present a structured transition pathway which is patient-focused and adoptable for different RDs. Methods: The transition pathway for adolescents 16 years and older was developed and implemented as part of a multi-centre study in 10 university hospitals in Germany. Key elements of the pathway included: assessment of patients' disease-related knowledge and needs, training/educational and counselling sessions, a structured epicrisis and a transfer appointment jointly with the paediatric and adult specialist. Specific care coordinators from the participating university hospitals were in charge of organization and coordination of the transition process. Results: Of a total of 292 patients, 286 completed the pathway. Deficits in disease-specific knowledge were present in more than 90% of participants. A need for genetic or socio-legal counselling was indicated by > 60%. A mean of 2.1 training sessions per patient were provided over a period of almost 1 year, followed by the transfer to adult care in 267 cases. Twelve patients remained in paediatric care as no adult health care specialist could be identified. Targeted training and counselling resulted in improved disease-specific knowledge and contributed to empowering of patients. Conclusion: The described transition pathway succeeds to improve health literacy in adolescents with RDs and can be implemented by paediatric care teams in any RD specialty. Patient empowerment was mainly achieved by individualized training and counselling. [ABSTRACT FROM AUTHOR]

Purpose: School closures have been used as part of lockdown strategies to contain the spread of SARS-CoV-2, adversely affecting children's health and education. To ensure the accessibility of educational institutions without exposing society to the risk of increased transmissions, it is essential to establish SARS-CoV-2 testing strategies that are child-friendly, scalable and implementable in a daily school routine. Self-sampling using non-invasive saliva swabs combined with pooled RT-qPCR testing (Lolli-Method) has been proven to be a sensitive method for the detection of SARS-CoV-2. Methods: We conducted a pilot project in Cologne, Germany, designed to determine the feasibility of a large-scale rollout of the Lolli-Method for testing without any additional on-site medical staff in schools. Over a period of three weeks, students from 22 schools were sampled using the Lolli-Method. At the end of the project, teachers were asked to evaluate the overall acceptance of the project. Results: We analyzed a total of 757 pooled RT-qPCRs obtained from 8,287 individual swabs and detected 7 SARS-CoV-2 infected individuals. The Lolli-Method was shown to be a feasible and accepted testing strategy whose application is only slightly disruptive to the daily school routine. Conclusion: Our observations suggest that the Lolli-Method in combination with pooled RT-qPCR can be implemented for SARS-CoV-2 surveillance in daily school routine, applicable on a large scale. [ABSTRACT FROM AUTHOR]

Systematic SARS-CoV-2 testing is a valuable tool for infection control and surveillance. However, broad application of high sensitive RT-qPCR testing in children is often hampered due to unpleasant sample collection, limited RT-qPCR capacities and high costs. Here, we developed a high-throughput approach ('Lolli-Method') for SARS-CoV-2 detection in children, combining non-invasive sample collection with an RT-qPCR-pool testing strategy. SARS-CoV-2 infections were diagnosed with sensitivities of 100% and 93.9% when viral loads were >106 copies/ml and >103 copies/ml in corresponding Naso-/Oropharyngeal-swabs, respectively. For effective application of the Lolli-Method in schools and daycare facilities, SEIR-modeling indicated a preferred frequency of two tests per week. The developed test strategy was implemented in 3,700 schools and 698 daycare facilities in Germany, screening over 800,000 individuals twice per week. In a period of 3 months, 6,364 pool-RT-qPCRs tested positive (0.64%), ranging from 0.05% to 2.61% per week. Notably, infections correlated with local SARS-CoV-2 incidences and with a school social deprivation index. Moreover, in comparison with the alpha variant, statistical modeling revealed a 36.8% increase for multiple (≥2 children) infections per class following infections with the delta variant. We conclude that the Lolli-Method is a powerful tool for SARS-CoV-2 surveillance and can support infection control in schools and daycare facilities. Dewald et al. combine a non-invasive sampling approach (Lolli-Test) with an RT qPCR-pool testing strategy to screen for SARS-CoV-2 infections in children and use the method for surveillance and infection control in > 4000 school and daycare settings. [ABSTRACT FROM AUTHOR]

This data brief introduces the Friendship and Identity in School (FIS) dataset. The FIS data are school-based longitudinal social network data, which have become increasingly important in recent years. Including information on 2,500 adolescents in nine secondary schools in the German federal state of North Rhine-Westphalia, the FIS data have four important key features that make them uniquely suited for studying the co-evolution of friendship networks and group identities or other time-varying individual characteristics. Specifically, the data include (i) fine-grained multidimensional measures of youth' ethnic, national, and religious identities, (ii) comparatively large social networks that span multiple classrooms, (iii) up to six waves over four and a half years, and (iv) an ethnoreligiously diverse sample. Besides friendship and identity, the data include other network dimensions such as romantic relations or dislike as well as repeated measurements of various individual attributes ranging from perceived discrimination over intergroup attitudes and religion to leisure time activities and students' perceptions of parents' identities and attitudes. In combination, the FIS data provide rich longitudinal information that allows researchers to study the development, change, and interplay of youth' group identities and friendship networks as well as broader questions concerning intergroup relations, network formation, and peer influence. [ABSTRACT FROM AUTHOR]

• Muslim youth' religious homophily does not depend on the share of Muslim classmates. • Non-Muslims' reluctance to be friends with Muslims peaks at medium shares of Muslims. • Non-Muslims are not reluctant to befriend Muslims at low or high shares of Muslims. • The share of Muslim classmates thus has different effects on Muslims and non-Muslims. While network studies have shown that preferences of both Muslim and non-Muslim adolescents contribute to religious friendship segregation, it is unclear whether these preferences are ubiquitous or dependent on local context. Examining large-scale longitudinal friendship network data of adolescents in Germany, we investigate how the proportion of Muslim classmates affects friendship preferences of Muslims and non-Muslims. We find that Muslim youth favor Muslims over non-Muslims to a similar degree at all proportions of Muslim classmates. Non-Muslims' reluctance to be friends with Muslims peaks in classrooms in which about half of the students are Muslims but is otherwise lower or absent. [ABSTRACT FROM AUTHOR]

Objective: The Care of Late-Stage Parkinsonism (CLaSP) study aimed to collect qualitative and standardized patient data in six European countries (France, Germany, Netherlands, Portugal, UK, Sweden) to enable a detailed evaluation of the underexplored late stages of the disease (Hoehn and Yahr stage > 3) using clinical, neuropsychological, behavioral, and health economic data. The aim of this substudy was to provide a health economic evaluation for the German healthcare system.Methods: In Germany, 228 patients were included in the study. Costs were calculated from a societal perspective for a 3-month period. Univariate analyses were performed to identify cost-driving predictors. Total and direct costs were analyzed using a generalized linear model with a γ-distributed dependent variable and log link function. Indirect costs were analyzed using a binomial generalized linear model with probit link function.Results: The mean costs for the 3-month period were approximately €20,000. Informal care costs and hospitalization are approximately €11,000 and €5000. Direct costs amounted to 89% of the total costs, and the share of indirect costs was 11%. Independent predictors of total costs were the duration of the disease and age. The duration of the disease was the main independent predictor of direct costs, whereas age was an independent predictor of indirect costs.Discussion: Costs in the late stage of the disease are considerably higher than those found in earlier stages. Compared to the latter, the mean number of days in hospital and the need for care is increasing. Informal caregivers provide most of the care.Clinical Trial Registration: The protocol was registered at ClinicalTrials.gov as NCT02333175 on 7 January, 2015. [ABSTRACT FROM AUTHOR]

The influence of friends in shaping students' educational expectations has received considerable theoretical and empirical attention in past research. However, few studies have directly tackled the methodological problems associated with estimating such influence effects. In particular, the separation of selection effects—with students selecting friends with similar educational expectations—from influence effects has remained elusive. In this study, we therefore investigate whether friend influence persists once we account for selection effects and other confounding network-related processes. In addition, we quantify the contribution of selection and influence to the similarity of educational expectations among friends. We rely on two-wave longitudinal data on 1,821 German secondary school students in 77 classrooms and multilevel random-coefficients stochastic actor-oriented models for the coevolution of networks and behaviour. Our results demonstrate that both selection and influence contribute to expectation-based similarity and that selection effects are substantial. This shows that without explicitly accounting for selection, estimates of friend influence effects are likely to be biased. [ABSTRACT FROM AUTHOR]

Purpose: Urinary stones can be successfully treated using a Holmium: Yttrium-Aluminum-Garnet (Ho: YAG) laser. Regarding success rates, laser pulse energy, frequency, and pulse width are well-known contributing factors. Whether the pulse shape might be a further factor influencing the laser efficiency is unclear. This study aimed to evaluate different modes of laser pulse shapes in a realworld setting. Materials and Methods: The Dornier Medilas® H Solvo (Weßling, Germany) was used in the treatment of ureter and kidney stones. Patients were randomized into standard pulse shape (SPS) and new pulse shape groups (NPS1; ureter) and (NPS2; kidney pelvis), depending on the stone localization. The primary endpoint was laser efficiency defined as mm³ stone destruction per overall operating time. Secondary endpoints encompassed number of stone recoveries and stone-free rate. Results: Altogether 145 patients (24 SPS vs. 32 NPS1; 51 SPS vs. 38 NPS2) were included. No differences in sex, age, body mass index, stone localization and stone composition were found, except for preoperative stone size (133±95 [SPS] vs. 197±139 [NPS1] mm³; p=0.023) and (348±298 [SPS] vs. 525±429 [NPS2] mm³; p=0.042). Regarding the primary endpoint, a significant increase in laser efficiency could be detected for the NPS1 and NPS2 groups compared to the SPS groups (39.9±44.9 vs. 28.8±30.2 and 51.7±61.3 vs. 22.4±24.2 mm³/min [mean±standard deviation]). No statistically significant differences were found for secondary endpoints and perioperative complication rates. Conclusions: Efficiency of the Ho: YAG laser can be positively influenced by different pulse shapes. This adds the variable of individualized intraoperative decision making. [ABSTRACT FROM AUTHOR]

Background: International guidelines recommend psychosocial care for children and adolescents with type 1 diabetes. Objective: To assess psychological care in children and adolescents with type 1 diabetes in a real‐world setting and to evaluate associations with metabolic outcome. Methods: Delivery of psychological care, HbA1c, and rates of severe hypoglycemia and diabetic ketoacidosis (DKA) in children and adolescents with type 1 diabetes from 199 diabetes care centers participating in the German diabetes survey (DPV) were analyzed. Results: Overall, 12 326 out of 31 861 children with type 1 diabetes were supported by short‐term or continued psychological care (CPC). Children with psychological care had higher HbA1c (8.0% vs 7.7%, P<.001) and higher rates of DKA (0.032 vs 0.021 per patient‐year, P<.001) compared with children without psychological care. In age‐, sex‐, diabetes duration‐, and migratory background‐matched children, HbA1c stayed stable in children supported by CPC during follow‐up (HbA1c 8.5% one year before psychological care started vs 8.4% after two years, P = 1.0), whereas HbA1c was lower but increased significantly by 0.3% in children without psychological care (HbA1c 7.5% vs 7.8% after two years, P <.001). Additional HbA1c‐matching showed that the change in HbA1c during follow‐up was not different between the groups, but the percentage of children with severe hypoglycemia decreased from 16.3% to 10.7% in children receiving CPC compared with children without psychological care (5.5% to 5.8%, P =.009). Conclusions: In this real‐world setting, psychological care was provided to children with higher HbA1c levels. CPC was associated with stable glycemic control and less frequent severe hypoglycemia during follow‐up. [ABSTRACT FROM AUTHOR]

We study how online video platforms affect the sales volume and sales distribution of recorded music. To do so, we study two events that removed and then partially restored access to online music videos for consumers in Germany. Because of a legal dispute, virtually all music videos were blocked from YouTube, which led to a decrease in record sales of about 5%–10%. When the dedicated platform Vevo entered a few years later, record sales increased again by a similar amount. This is effect can be attributed to user-generated content (fan videos and cover versions) as much as to official music videos. Record sales of newcomer artists and mainstream music benefit disproportionally. We discuss the implications for debates on the reform of compulsory licensing rules and copyright. We study the heterogeneous effects of online video platforms on the sales volume and sales distribution of recorded music. Identification comes from two natural experiments in Germany. In 2009, virtually all music videos were blocked from YouTube as a result of a legal dispute. In 2013, the dedicated platform Vevo entered the market, making videos of a large number of artists available overnight. Our estimates suggest that restricting (enabling) access to online videos decreases (increases) recorded music sales on average by about 5%–10%. We show that the effect operates independently of the nature of video content, suggesting that user-generated content is as effective as official content. Moreover, we highlight heterogeneity in this effect: online music videos disproportionally benefit sales of new artists and sales of mainstream music. [ABSTRACT FROM AUTHOR]

Purpose: The collimator monitoring fill factor (CM‐FF) introduced by Stelljes et al. (2017) and the FWHM fill factor (FWHM‐FF) introduced by Gago‐Arias et al. (2012) were determined using the measured photon fluence response functions of various 2D‐arrays. The error detection capabilities of 2D‐arrays were studied by comparing detector signal changes and local gamma index passing rates in different field setups with introduced collimation errors. Methods: The fill factor is defined as the ratio of the sensitive detector area and the cell area of a detector, defined by the detector arrangement on a 2D‐array. Gago‐Arias et al. calculated the FWHM‐FF, using the FWHM² of a detector's fluence response function KM(x) as the sensitive detector area. For the CM‐FF a sensitive detector width w(Δ mm, d%) is calculated. The sensitive detector width is the lateral extent of KM(x), lying inside the detector cell area, along which a collimator error of Δ mm yields a signal change exceeding a detection threshold of d%. The sensitive area for a single detector is calculated using w(Δ mm, d%)². The CM‐FF is then calculated as the ratio of the sensitive area of a detector within its cell area and the detector cell area. The fluence response functions of the central detector of the OCTAVIUS 729, 1500, and 1000 SRS array (all PTW‐Freiburg, Freiburg, Germany) and the MapCHECK 2 array (Sun Nuclear, Melbourne, US) were measured using a photon slit beam. The FWHM‐FF and the CM‐FF were calculated and compared for all 2D‐arrays under investigation. The error detection capabilities of 2D‐arrays in quadratic fields were studied by investigating the signal changes in the detectors adjacent to the collimator edge when changing the collimator position. The change in local gamma index passing rate with respect to the introduced collimator error was investigated for an ionization chamber and a diode array in quadratic and two intensity modulated fields. Results: Values for the CM‐FF and FWHM‐FF were 1.0 and 0.35, respectively for the area of the liquid‐filled 1000 SRS ionization chamber array with a detector to detector distance of 5 mm and 0.32 and 0.04, respectively, for the MapCHECK 2 diode array. For the vented ionization chamber array OCTAVIUS 729 fill factors were calculated as CM‐FF = 0.59 and FWHM‐FF = 0.53, while the OCTAVIUS 1500 array yielded fill factors of CM‐FF = 0.77 and FWHM‐FF = 0.72. Signal changes in vented ionization chambers for collimator errors of 1 mm surpassed those of diodes by a factor of 2 in quadratic fields. The gamma index passing rates in quadratic fields reflect those findings. In intensity modulated fields, the decline of the gamma index passing rate is bigger for the ionization chamber array compared to the diode array when introducing collimator errors. Conclusions: The calculated values of the CM‐FF correlate with the signal changes in quadratic field setups with introduced collimator position errors of 1 mm, while the FWHM‐FF underestimates the error detection capabilities of 2D‐arrays. An increased error detection capability of the ionization chamber array compared to diode array was observed in quadratic and intensity modulated fields. [ABSTRACT FROM AUTHOR]

To make sound educational decisions, students and their parents have to be informed about the way the educational system works. Such knowledge, however, tends to vary across social groups. This study investigates the differences in education‐related knowledge between native and migrant mothers in the German context. Empirical analyses based on a sample of native German mothers and mothers from Turkey or the former Soviet Union (N = 2076) indicate that migrant mothers know less about the German educational system than their native counterparts. An investigation of the potential sources of these knowledge gaps shows that migrants' weaker socio‐economic status explains a substantial part of their lower level of knowledge, particularly among families of Turkish origin. Furthermore, migrants' less profitable social network composition and lower levels of German language skills contribute to their information deficits. Based on these empirical results, the study considers opportunities for improving the knowledge base of migrant parents. [ABSTRACT FROM AUTHOR]

This study examines gender role attitudes of native and migrant adolescents in Germany and attempts to explain why adolescents of Turkish, former Yugoslavian, and Eastern European origin tend to have more traditional attitudes than their native peers. In order to do so, it combines a migrant-native comparative approach that highlights the impact of religiosity and host society integration with an intergenerational transmission perspective that emphasises the continuity of gender role attitudes across generations. The empirical analysis relies on dyadic parent-adolescent data (N = 2744) from the first wave of the Children of Immigrants Longitudinal Survey in Four European Countries. It demonstrates the importance of incorporating intergenerational transmission processes to fully understand attitude differences between natives and migrants: a substantial part of native-migrant gaps in gender role attitudes can be attributed to migrant parents’ more traditional attitudes and a strong transmission of attitudes across generations. Once intergenerational transmission and the influence of religiosity and integration have been accounted for, the remaining differences between gender role attitudes of native and migrant adolescents are small. [ABSTRACT FROM AUTHOR]

The aims of the present study were to investigate relations between moral reasoning, executive functioning and Theory of Mind in children with autism spectrum disorders (ASD) compared to typically developing children and to apply the dual aspect theory of , to moral reasoning in individuals with and without ASD. Overall, 21 children with ASD (age: M = 10·22, SD = 1·55) and 21 controls (age: M = 9·83, SD = 2·36) participated and completed the Moral Reasoning Test for children from , which tests affective and cognitive aspects of moral reasoning. In addition, participants completed two Theory of Mind tasks, a working memory and an inhibition test. Correlational analyses revealed significant relations between cognitive moral reasoning and inhibitory control as well as between Theory of Mind and inhibition for the ASD group. Thus, inhibitory control, but not working memory and Theory of Mind, might be one key mechanism underlying moral reasoning, and possibly ToM development in children with ASD. Analyses of variance revealed no significant differences in cognitive and affective aspects of moral reasoning between individuals with ASD and typically developing children. Both groups did also not differ in Theory of Mind and executive functioning. Findings are discussed in light of the heterogeneous literature. [ABSTRACT FROM AUTHOR]

This exploratory cross-cultural study investigates some relationships between the motor ability of selected primary school children aged 8 and 9 years in Hamburg, Melbourne and Cape Town and some socio-ecological factors believed to be relevant to children's motor performance. Data concerning selected variables of children's living conditions, play settings and media consumption were collected by questionnaire - and correlations between these environmental variables and the motor ability measures of the children were calculated. The variables describing the general living conditions of the children had a weaker relationship to their levels of motor achievement than those variables which were more specific to their motor behaviour, namely attendance at a sports club, possession of sports equipment and frequency of using challenging playing locations. No clear relationship with TV consumption was observed. These findings lead to the conclusion that children's motor ability can be more accurately predicted by their activities and motor related behaviour than their general living conditions. Although both gender and specific ethno-cultural group membership are implicated in the observations of weaker motor ability of the girls and the non-European children (with the exception of the Xhosa children from Cape Town) this also correlates with their lower involvement in less challenging motor behaviour. Consequently it is concluded that changes in lifestyle activities and motor related behaviour rather than factors related to general living environments remain a more powerful insight into understanding the implications of the changing childhood experience for children's physical and motor development in all contexts. [ABSTRACT FROM AUTHOR]

The article discusses the legal provisions on criminal involvement in terrorist associations in Germany as indicated in the classification and fundamental principles of the German Criminal Code Section 129a Strafgesetzbuch. It discusses Germany's criminal law prohibition on association, particularly, the definition of offence in the formation of criminal associations, formation of terrorist associations, and the extension to criminal and terrorist associations abroad.

Chronic venous leg ulcers are common and cause considerable burden of disease for affected patients with significant costs for health care systems worldwide. The complex pathophysiology of chronic venous leg ulcers is still not entirely understood. In addition, reliable pathogenic and/or prognostic parameters are not known. Published data suggest that patients with chronic venous leg ulcers reveal congenital or acquired thrombophilia. We examined the serum Lipoprotein (a) [Lp(a)] level, a proatherogenic and prothrombotic risk factor, in patients with chronic venous leg ulcers ( n=210, stratified into patients with postthrombotic syndrome or without) and in a healthy control group ( n=341). Forty-two percent of all patients, compared with 20% of healthy controls, revealed significantly increased Lp(a) serum concentrations above 0.3 g/L. Furthermore, 49% without postthrombotic syndrome but only 35% with postthrombotic syndrome showed increased Lp(a) levels. The increase of Lp(a) level was significantly different between all three groups ( p<0.001). There was no correlation of Lp(a) levels and CRP values in all groups. Based on these data, it is conceivable that Lp(a) plasma level is a novel pathogenic parameter for chronic venous leg ulcers. Elevated concentrations may contribute to the pathogenesis through induction of thrombogenic microcirculatory dysregulations, impaired extravascular fibrinolysis, or other mechanisms like proinflammatory effects. [ABSTRACT FROM AUTHOR]

Background: The hypothesis that distance matters but that in recent years geographical proximity has become less important for research collaboration was tested. We have chosen a sample-authors at German immunological institutes-that is relatively homogeneous with regard to research field, language and culture, which beside distance are other possible factors influencing the willingness to co-operate. We analyse yearly distributions of co-authorship links between institutes and compare them with the yearly distributions of distances of all institutes producing papers in journals indexed in the Science Citation Index, editions 1992 till 2002. We weight both types of distributions properly with paper numbers. Results: One interesting result is that place matters but if a researcher has to leave the home town to find a collaborator distance does not matter any longer. This result holds for all years considered, but is statistically most significant in 2002. The tendency to leave the own town for collaborators has slightly increased in the sample. In addition, yearly productivity distributions of institutes have been found to be lognormal. Conclusion: The Internet did not change much the collaboration patterns between German immunological institutes. [ABSTRACT FROM AUTHOR]

The present study addresses the question whether an extended ilioinguinal dissection as compared to an only superficial inguinal dissection improves survival and/or local tumour control after the appearance of palpable melanoma metastases to the groin. We retrospectively analysed the data of 104 patients with 69 ilioinguinal and 35 superficial inguinal dissections (median follow up 127 months). Prognostic factors of survival and groin recurrence were assessed using Kaplan-Meier estimation and Cox proportional hazards model. By multifactorial analysis, metastatic involvement of two lymph nodes or less was associated with a significantly better survival rate than involvement of >2 or pelvic nodes (p=0.0002). After radical ilioinguinal dissection, patients with extremity-located primaries had a better prognosis than patients with truncal primaries (p=0.03). Tumour infiltration of the ilio-obturator compartment was found to be an independent factor of poor prognosis (p=0.0009). The probability of recurrence in the dissected groin paralleled the number of positive nodes and significantly increased if intransits were observed (p=0.0002). The extent of surgery, Breslow thickness, epidermal ulceration, sex, age and adjuvant chemotherapy neither significantly influenced survival nor local control rates. In summary, when metastatic inguinal nodes become palpable, the presence of pelvic metastases indicates systemic disease. After therapeutic groin dissection, local recurrence and survival depend rather on regional tumour burden than on the extent of surgery. [ABSTRACT FROM AUTHOR]

The article discusses the historical and contemporary context of determining what occupations in Germany are classified as independent for the purposes of social security premium assessments and benefits. The categorizations of employees versus manual workers, agricultural occupations, and artists are examined from the constitutional legal perspective of job category setting and associated worker social security obligations.

Fungicide resistance frequencies of Botrytis cinerea populations in the German Wine Road region were determined for 4 years. Strains showing specific resistance against carbendazim, iprodione or fenhexamid were found to occur wide-spread, but at low frequencies. In contrast, cyprodinil resistance increased from 5.4% in 2006 to 21.9% in 2008 and 16% in 2009, and strains resistant to boscalid increased from 2% in 2006 to 26.7% in 2009. Strains with multidrug resistance (MDR) phenotypes were found at high frequencies. One of the three MDR phenotypes, MDR1, with reduced sensitivity to cyprodinil and fludioxonil, was dominating, representing 19% to 35% of the total population. Strains with a combination of cyprodinil resistance and MDR1 were found to be strongly increasing in 2008 and 2009. [ABSTRACT FROM AUTHOR]

Introduction: Urolithiasis is a common diagnosis in urology. New technologies offer a variety of diagnostic and therapy and consequently display a financial burden on healthcare systems. Hence, clinical practice guidelines (CPG) are essential to implement evidence-based medicine and assure a standard of care considering limited resources. To date, there is no evidence of the use and adherence to CPG on urolithiasis., Material and Methods: Therefore, we performed a cross-sectional study to analyze the use of CPG on urolithiasis. Data collection was carried out by a questionnaire given to 400 German urologists. The survey included use and adherence to guidelines, evaluation of the clinical situation, therapy spectrum, and workplace. In total, 150 (37%) questionnaires were received and included in our survey. Statistics were performed by SPSS using Chi-quadrat test/Fisher's exact test., Results: In our study, urologists were office based, hospital affiliated, non-academic, or academic centers in 53%, 32%, 16% and 5%, respectively. In 74% and 70%, urologists adhere to CPG in diagnostic and therapy. Interestingly, workplace and therapy spectrum determines the use of different CPG (p = 0.01; p = 0.022). Academic urologists were more likely to use international CPG of EAU (40%), while outpatient urologists significantly orientated on national CPG (46%). 86% of urologists with high volume of urolithiasis practice interventions in contrast to 53% in low volume (p = 0.001). More than 80% of urologists use short versions and app version of CPG., Conclusion: We firstly describe compliance and the use of CPG on urolithiasis. EAU and DGU present the most commonly used CPG. Short version and app version of CPG find frequent clinical utilization., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH, DE part of Springer Nature.)

Background: The aim of this work was to investigate the outcome of metastasis-directed radiotherapy (MDT) in prostate cancer patients with bone metastases following current ESTRO/EORTC subclassifications for oligometastatic disease., Methods: Clinical data of 80 consecutive oligometastatic patients with 115 bone lesions receiving MDT between 2011 and 2019 were retrospectively evaluated. Hormone-sensitive (77.5%) and castrate-resistant (22.5%) patients were included. MDT was delivered with conventional fractionated or stereotactic body radiotherapy (SBRT) techniques. Kaplan-Meier method, log rank test, as well as Cox regression were used to calculate local control (LC) and biochemical and clinical progression-free survival (bPFS/cPFS)., Results: At the time of MDT 31% of patients had de-novo synchronous oligometastatic disease, 46% had de-novo metachronous oligorecurrence after primary treatment and 23% had either de-novo oligoprogressive disease, repeat oligometastatic disease or induced oligometastatic disease. The median BED 3 was 93.3 Gy (range 75.8-95.3 Gy). Concomitant ADT was administered in 69% of patients. After a median follow-up of 23 months the median bPFS and cPFS were 16.5 and 21.5 months, respectively. The 2-year LC rate was 98.3%. In multivariate analysis, age ≤ 70 (HR = 2.60, 95% CI 1.20-5.62, p = 0.015) and concomitant ADT (HR = 0.26, 95% CI 0.12-0.58, p = 0.001) significantly correlated with cPFS. Category of oligometastatic disease and hormone-sensitivity were predictive for cPFS in univariate analysis. Of 45 patients with biochemical relapse, nineteen patients (42.2%) had repeat oligometastatic disease. Fourteen patients (31%) underwent a second course of MDT. No patients experienced grade ≥ 3 toxicities., Conclusions: MDT is safe and offers high local control rates in bone oligometastases of prostate cancer. At 2 years after treatment, more than 2 out of 5 patients are progression-free. Trial registration Retrospectively registered.

Background: The discovery of robust and trans-ethnically replicated DNA methylation markers of metabolic phenotypes, has hinted at a potential role of epigenetic mechanisms in lipid metabolism. However, DNA methylation and the lipid compositions and lipid concentrations of lipoprotein sizes have been scarcely studied. Here, we present an epigenome-wide association study (EWAS) (N = 5414 total) of mostly lipid-related metabolic measures, including a fine profiling of lipoproteins. As lipoproteins are the main players in the different stages of lipid metabolism, examination of epigenetic markers of detailed lipoprotein features might improve the diagnosis, prognosis, and treatment of metabolic disturbances., Results: We conducted an EWAS of leukocyte DNA methylation and 226 metabolic measurements determined by nuclear magnetic resonance spectroscopy in the population-based KORA F4 study (N = 1662) and replicated the results in the LOLIPOP, NFBC1966, and YFS cohorts (N = 3752). Follow-up analyses in the discovery cohort included investigations into gene transcripts, metabolic-measure ratios for pathway analysis, and disease endpoints. We identified 161 associations (p value < 4.7 × 10 -10 ), covering 16 CpG sites at 11 loci and 57 metabolic measures. Identified metabolic measures were primarily medium and small lipoproteins, and fatty acids. For apolipoprotein B-containing lipoproteins, the associations mainly involved triglyceride composition and concentrations of cholesterol esters, triglycerides, free cholesterol, and phospholipids. All associations for HDL lipoproteins involved triglyceride measures only. Associated metabolic measure ratios, proxies of enzymatic activity, highlight amino acid, glucose, and lipid pathways as being potentially epigenetically implicated. Five CpG sites in four genes were associated with differential expression of transcripts in blood or adipose tissue. CpG sites in ABCG1 and PHGDH showed associations with metabolic measures, gene transcription, and metabolic measure ratios and were additionally linked to obesity or previous myocardial infarction, extending previously reported observations., Conclusion: Our study provides evidence of a link between DNA methylation and the lipid compositions and lipid concentrations of different lipoprotein size subclasses, thus offering in-depth insights into well-known associations of DNA methylation with total serum lipids. The results support detailed profiling of lipid metabolism to improve the molecular understanding of dyslipidemia and related disease mechanisms.

Aim: To analyze the influence of implantation volume of artificial sphincters (AMS 800) on outcome in a large central European multicenter cohort study., Methods: As part of the DOMINO (Debates on Male Incontinence) project, the surgical procedures and outcomes were retrospectively analyzed in a total of 473 patients who received an artificial sphincter (AMS 800) between 2010 and 2012. Clinics that implanted at least 10 AMS 800 per year were defined as high-volume centers., Results: Sixteen centers had a mean rate of 9.54 AMS 800/y of which five clinics were identified as high-volume centers. They implanted significantly more double cuffs (55% vs 12.1%; P < .001), used the perineal approach significantly more often (78% vs 67.7%; P = .003) and chose larger mean cuff sizes (4.63 cm vs 4.42 cm; P = .002). With a mean follow-up of 18 months, the revision rate was significantly higher at low-volume centers (38.5% vs 26.7%; P = .037), urethral erosion being the main reason for revision. Social continence (0-1 pads/24 h) was achieved significantly more often in high-volume centers (45.5% vs 24.2%; P = .002)., Conclusions: Our study showed significantly better continence results and lower revision rates at high-volume centers, confirming earlier results that are still true in this decade. We, therefore, recommend surgery for male incontinence at qualified centers., (© 2020 Wiley Periodicals LLC.)

Objectives: To analyze the impact of surgeon's experience on surgical margin status, postoperative continence and operative time after radical prostatectomy (RP) in a surgeon who performed more than 2000 open RP., Patients and Methods: We retrospectively analyzed 2269 patients who underwent RP by one surgeon from April 2004 to June 2012. Multivariable logistic models were used to quantify the impact of surgeon's experience (measured by the number of prior performed RP) on surgical margin status, postoperative continence and operative time., Results: Negative surgical margin rate was 86 % for patients with pT2 stage, and continence rate at 3 years after RP was 94 %. Patients with negative surgical margin had lower preoperative PSA level (p = 0.02), lower pT stage (p < 0.001) and lower Gleason score (p < 0.001). The influence of the experience of the surgeon was nonlinear, positive and highly significant up to 750 performed surgeries (75-90 % negative surgical margin) (p < 0.01). The probability of continence rises significantly with surgeon's experience (from 88-96 %) (p < 0.05). A reduction in operative time (90-65 min) per RP was observed up to 1000 RP., Conclusions: In the present study, we showed evidence that surgeon's experience has a strong positive impact on pathologic and functional outcomes as well as on operative time. While significant learning effects concerning positive surgical margin rate and preserved long-term continence were detectable during the first 750 and 300 procedures, respectively, improvement in operative time was detectable up to a threshold of almost 1000 RP and hence is relevant even for very high-volume surgeons.

Despite the considerable consequences, school teachers treated in psychosomatic in-patient settings, have not yet been the subject of investigations. Whether, for whom and which kind of job related treatment can be helpful for teachers returning to work can only be discussed if the specific stress and the social situation of teachers as public officials ("Beamtenstatus") are taken into consideration. On this point of view a systematic evaluation of 63 psychosomatically ill teachers consecutively admitted in a psychosomatic hospital was performed. The average age was 50, suffering mostly from depression or/and tinnitus. Most teachers rated job related stress as influencing their symptomatologies. A program focusing on discrepancies between personal ideals versus real situations in school, problems in social interactions and time management, should be a valuable part of the teachers' psychosomatic inpatient treatment. This approach was affected by a strong desire for early retirement in about half of the teachers.