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Students' well-being, learning activities, and learning success are key student outcomes that can be affected by challenging times such as the COVID-19 pandemic. Thus, it is vital to investigate the role of important personal (resilience, self-efficacy) and social resources (support from family, friends, teachers, important other) for central student outcomes (life satisfaction as a vital aspect of well-being, learning activities, and learning success) alongside perception of the COVID-19 situation. While the pandemic affected all of society, adolescents as a group who face core developmental challenges were especially vulnerable towards being negatively affected by the pandemic. Thus, analyses are based on 220 adolescent students (60.9% female, 37.7% male, 1.4% diverse) in Germany who were 16.21 years old on average (SD = 0.88) at time of data collection in May 2021. Students filled out an online questionnaire on sociodemographics and variables of interest. Path models revealed that perceiving the COVID-19 pandemic as stressful was negatively related to life satisfaction ([beta] = -0.27). Furthermore, perceiving the COVID-19 pandemic as stressful was negatively related to students' self-efficacy ([beta] = -0.22) and positively to support from an important other ([beta] = 0.32). Moreover, several resources were mainly positively related to our central student outcomes ([beta] = 0.13-0.41), and perception of the COVID-19 situation mediated two of those relations. Results underscore the importance of students' self-efficacy, which was related to all student outcomes. Furthermore, the results and methodological issues can impact further research and practice.

Abstract Background The crude mortality rate and the lifetime mortality risk from prostate cancer in Germany are above international average. However age-standardised mortality and years of life lost per capita from prostate cancer are declining. This study analyses the mortality-related measures for the federal state of North Rhine-Westphalia (NRW) in Germany. Methods Based on the cause of death statistics and data from the NRW State Cancer Registry on 45,300 deaths in the years 2007–2021, mortality rates, the lifetime mortality risk from prostate cancer, median age at death and years of life lost are presented. Additionally, the 15 most frequent causes of death of 95,013 patients diagnosed with prostate cancer are reported. Results With a stable lifetime mortality risk from prostate cancer, age-standardised mortality and years of life lost per capita are decreasing while crude mortality and median age at death are increasing in NRW. Less than half of the patients die from their prostate cancer. Cancers of the urinary bladder and other urinary organs also occur more frequently as a cause of death than it would be expected based on the age-specific risk in the total population. Conclusions More people in North Rhine-Westphalia are dying of prostate cancer over time due to demographic ageing alone. At the same time, the age-specific mortality risk has not increased and when patients die of prostate cancer, it is at an increasingly older age. However, there is a statistical association with deaths from cancers of the lower urinary tract in patients diagnosed with prostate cancer, which demands further evaluation.

Abstract Introduction To better target stroke awareness efforts (pre and post first stroke) and thereby decrease the time window for help-seeking, this study aims to assess quantitatively whether stroke awareness is associated with appropriate help-seeking at symptom onset, and to investigate qualitatively why this may (not) be the case. Methods This study conducted in a German regional stroke network comprises a convergent quantitative-dominant, hypothesis-driven mixed methods design including 462 quantitative patient questionnaires combined with qualitative interviews with 28 patients and seven relatives. Quantitative associations were identified using Pearson’s correlation analysis. Open coding was performed on interview transcripts before the quantitative results were used to further focus qualitative analysis. Joint display analysis was conducted to mix data strands. Cooperation with the Patient Council of the Department of Neurology ensured patient involvement in the study. Results Our hypothesis that stroke awareness would be associated with appropriate help-seeking behaviour at stroke symptom onset was partially supported by the quantitative data, i.e. showing associations between some dimensions of stroke awareness and appropriate help-seeking, but not others. For example, knowing stroke symptoms is correlated with recognising one’s own symptoms as stroke (r = 0.101; p = 0.030*; N = 459) but not with no hesitation before calling help (r = 0.003; p = 0.941; N = 457). A previous stroke also makes it more likely to recognise one’s own symptoms as stroke (r = 0.114; p = 0.015*; N = 459), but not to be transported by emergency ambulance (r = 0.08; p = 0.872; N = 462) or to arrive at the hospital on time (r = 0.02; p = 0.677; N = 459). Qualitative results showed concordance, discordance or provided potential explanations for quantitative findings. For example, qualitative data showed processes of denial on the part of patients and the important role of relatives in initiating appropriate help-seeking behaviour on patients’ behalf. Conclusions Our study provides insights into the complexities of the decision-making process at stroke symptom onset. As our findings suggest processes of denial and inabilities to translate abstract disease knowledge into correct actions, we recommend to address relatives as potential saviours of loved ones, increased use of specific situational examples (e.g. lying on the bathroom floor) and the involvement of patient representatives in the preparation of informational resources and campaigns. Future research should include mixed methods research from one sample and more attention to potential reporting inconsistencies.

Abstract Background Cross-sectional and longitudinal studies have been conducted to investigate the association between migraine and any headache and white matter hyperintensities (WMH). However, studies are inconsistent regarding the strength of the association and its clinical significance. The aim of our study was to investigate the association between headache and its subtypes (migraine with aura (MigA+), migraine without aura (MigA-), non-migraine headache (nonMigHA)) and WMH and its course in the population-based 1000BRAINS study using state-of-the-art imaging techniques and migraine classification according to modified international classification of headache disorders. Methods Data from 1062 participants (45% women, 60.9 ± 13.0 years) with ever or never headache (neverHA) and complete quantitative (WMH volume) and qualitative (Fazekas classification) WMH data at first imaging and after 3.7 ± 0.7 years (393 participants) were analyzed. The sex-specific association between headache and its subtypes and WMH volume and its change was evaluated by linear regression, between headache and its subtypes and Fazekas score high vs. low (2–3 vs. 0–1) by log-binomial regression, adjusted for confounders. Results The lifetime prevalence of headache was 77.5% (10.5% MigA+, 26.9% MigA-, 40.1% nonMigHA). The median WMH volume was 4005 (IQR: 2454–6880) mm3 in women and 4812 (2842–8445) mm3 in men. Women with any headaches (all headache types combined) had a 1.23 [1.04; 1.45]-fold higher WMH volume than women who reported never having had a headache. There was no indication of higher Fazekas grading or more WMH progression in women with migraine or any headaches. Men with migraine or any headaches did not have more WMH or WMH progression compared to men without migraine or men who never had headache. Conclusions Our study demonstrated no increased occurrence or progression of WMH in participants with mgiraine. But, our results provide some evidence of greater WMH volume in women with headache of any type including migraine. The underlying pathomechanisms and the reasons why this was not shown in men are unclear and require further research.

Abstract Background Multiple Sclerosis (MS) represents the most common inflammatory neurological disease causing disability in early adulthood. Childhood and adolescence factors might be of relevance in the development of MS. We aimed to investigate the association between various factors (e.g., prematurity, breastfeeding, daycare attendance, weight history) and MS risk. Methods Data from the baseline assessment of the German National Cohort (NAKO) were used to calculate adjusted hazard ratios (HR) and 95% confidence intervals (CI) for the association between childhood and adolescence factors and risk of MS. Analyses stratified by sex were conducted. Results Among a total of 204,273 participants, 858 reported an MS diagnosis. Male sex was associated with a decreased MS risk (HR 0.48; 95% CI 0.41–0.56), while overweight (HR 2.03; 95% CI 1.41–2.94) and obesity (HR 1.89; 95% CI 1.02–3.48) at 18 years of age compared to normal weight were associated with increased MS risk. Having been breastfed for ≤ 4 months was associated with a decreased MS risk in men (HR 0.59; 95% CI 0.40–0.86) compared to no breastfeeding. No association with MS risk was observed for the remaining factors. Conclusions Apart from overweight and obesity at the age of 18 years, we did not observe considerable associations with MS risk. The proportion of cases that can be explained by childhood and adolescence factors examined in this study was low. Further investigations of the association between the onset of overweight and obesity in childhood and adolescence and its interaction with physical activity and MS risk seem worthwhile.

Abstract Supramolecular polymeric materials have exhibited attractive features such as self-healing, reversibility, and stimuli-responsiveness. However, on account of the weak bonding nature of most noncovalent interactions, it remains a great challenge to construct supramolecular polymeric materials with high robustness. Moreover, high usage of supramolecular units is usually necessary to promote the formation of robust supramolecular polymeric materials, which restrains their applications. Herein, we describe the construction of highly robust supramolecular polymer networks by using only a tiny amount of metallacycles as the supramolecular crosslinkers. A norbornene ring-opening metathesis copolymer with a 120° dipyridine ligand is prepared and self-assembled with a 60° or 120° Pt(II) acceptor to fabricate the metallacycle-crosslinked polymer networks. With only 0.28 mol% or less pendant dipyridine units to form the metallacycle crosslinkers, the mechanical properties of the polymers are significantly enhanced. The tensile strengths, Young’s moduli, and toughness of the reinforced polymers reach up to more than 20 MPa, 600 MPa, and 150 MJ/m3, respectively. Controllable destruction and reconstruction of the metallacycle-crosslinked polymer networks are further demonstrated by the sequential addition of tetrabutylammonium bromide and silver triflate, indicative of good stimuli-responsiveness of the networks. These remarkable performances are attributed to the thermodynamically stable, but dynamic metallacycle-based supramolecular coordination complexes that offer strong linkages with good adaptive characteristics.

Malignant pleural mesothelioma (MPM) is an aggressive cancer with limited therapeutic options. We evaluated the impact of CDK4/6 inhibition by palbociclib in 28 MPM cell lines including 19 patient‐derived ones, using various approaches including RNA‐sequencing. Palbociclib strongly and durably inhibited the proliferation of 23 cell lines, indicating a unique sensitivity of MPM to CDK4/6 inhibition. When observed, insensitivity to palbociclib was mostly explained by the lack of active T172‐phosphorylated CDK4. This was associated with high p16INK4A (CDKN2A) levels that accompany RB1 defects or inactivation, or (unexpectedly) CCNE1 overexpression in the presence of wild‐type RB1. Prolonged palbociclib treatment irreversibly inhibited proliferation despite re‐induction of cell cycle genes upon drug washout. A senescence‐associated secretory phenotype including various potentially immunogenic components was irreversibly induced. Phosphorylated CDK4 was detected in 80% of 47 MPMs indicating their sensitivity to CDK4/6 inhibitors. Its absence in some highly proliferative MPMs was linked to very high p16 (CDKN2A) expression, which was also observed in public datasets in tumours from short‐survival patients. Our study supports the evaluation of CDK4/6 inhibitors for MPM treatment, in monotherapy or combination therapy.

Background: The high rate of stunting is still a nutritional problem in children in Indonesia which has an impact on the quality of future generations. The study aims to determine the risk factors for stunting in children aged 6-23 months in Tanralili District, Maros Regency. Methodology: This study used a case control study design. The sampling technique uses the side exhaustive method with a ratio of 1: 1, as many as 260 samples consisting of 130 cases and 130 controls. Stata program version 17 is used for data analysis. Results: Risk factors associated with stunting were maternal age

Accurate traffic models are of decisive importance for well-founded traffic engineering and represent the basic framework for comprehensive simulation studies as modelling of traffic demand. Using traffic count and speed measurements of road segments is a common approach for the calibration of a realistic traffic simulation although the data acquisition process can be at very extensive costs. From an academical point of view, there have been many studies addressing the problem of calibration. In this respect, the microscopic simulation software SUMO offers the usage of the tools flowrouter and routesampler for generating network simulations on the base of traffic count measurements. In this paper, we propose a robust method for the calibration of microscopic traffic simulations by using vehicle count and speed measurements from collected GPS-data. The developed approach is a two-step optimization process: The application of integer linear programming (ILP) as a priori optimization is followed by adopting an evolutionary algorithm for minimizing the a posteriori deviation between real and simulated traffic data. As a proof of concept, the proposed method is tested in a subnet-work model of the inner city of Friedrichshafen and compared with the ready-to-use tools from SUMO. The suggested method indicates a promising correlation between simulated and real traffic data showing better calibration results in comparison to the aforementioned functions SUMO provides. Since the approach is network-independent, it also offers the possibility of large-scale traffic calibration.

Stereotype threat (ST) is a potential explanation for inequalities in language competencies observed between students from different language backgrounds. Language competencies are an important prerequisite for educational success, wherefore the significance for investigation arises. While ST effects on achievement are empirically well documented, little is known about whether ST also impairs learning. Thus, we investigated vocabulary learning in language minority elementary school students, also searching for potential moderators. In a pre-post design, 240 fourth-grade students in Germany who were on average 10 years old (M[subscript Age] = 9.92, SD = 0.64; 49.8% female) were randomly assigned to one of four experimental conditions: implicit ST, explicit ST without threat removal before posttest, explicit ST with threat removal before posttest, and a control group. Results showed that learning difficult vocabulary from reading two narrative texts was unaffected by ST. Neither students' identification with their culture of residence and culture of origin nor stereotyped domain of reading were moderators. The findings are discussed with regard to content and methodological aspects such that a motivation effect might have undermined a possible ST effect. Implications for future research include examining the question at what age children become susceptible to ST and whether students have internalized negative stereotypes about their own group, which could increase the likelihood of ST effects occurring.