German National Research Articles

NATIONAL EXAMINATION SURVEY ON BLOOD PRESSURE OF OLDER AND VERY OLD PEOPLE IN GERMANY 2022-2023: WHY SELF-REPORTS, MEASUREMENTS AND MEDICATION DATA ARE NEEDED

Objective: The National Study on Health of Older People in Germany “Gesundheit 65+” aimed to provide up-to-date information on the health of older adults in Germany including blood pressure (BP) measurements at home by a study nurse. Design and method: Nationally representative examination survey of the population aged 65 years and older residing in Germany and with sufficient German language skills, using two-stage population registry sampling from 128 sample points from June 2022 to April 2023. Participation of physically or cognitively impaired persons was possible via proxy interviews and consent from legal representatives. Recruitment and data collection used a mixed-mode design. Three standardized blood pressure measurements at two-minute intervals were taken after 5 minutes rest with an oscillometric device (Mobil-O-Graph) using one of five cuffs according to upper arm circumference. The mean of the second and third measurement was used for analysis. Hypertension was defined as mean systolic BP (SBP) at or above140 mm Hg, or mean diastolic BP (DBP) at or above 90 mm Hg, or the use of antihypertensives (ATC-codes C02 antihypertensives, C03 diuretics, C07 beta-blockers, C08 calcium-channel blockers or C09 ACEI and ARB) in participants with self-reported hypertension diagnosis. Provisional weights account for unequal sampling and participation probabilities. Results: The “Gesundheit 65+” examination survey included 1,493 participants and 1,475 (98.8%) had successful BP measurements (763 men and 712 women aged 65 to 100 years). External quality control showed very good standardization of BP measurements in the home environment. Central BP data were available from 1,356 participants. Based on self-reported diagnoses alone the prevalence of hypertension would be 58.3% [95% CI 53.2-63.3] in men and 59.5% [53.8-64.9] in women. However, overall hypertension prevalence was estimated at 70.4% [65.8-74.7] in men and 72.3% [66.9-77.1] in women based on the study definition which combines self-reported physician diagnoses, standardized BP measurements and medication. Conclusions: Our study shows very good feasibility, acceptability and data completeness of standardized BP measurements using home visits. The prevalence of hypertension would be greatly underestimated in the absence of examination survey data with standardized measurements and detailed recording of medication.

EMOTIONS THROUGH THE PRISM OF GERMAN PAREMIES

The article explores the concept of human emotions as a dynamic, systemic, socio-psychological phenomenon with distinct linguistic-cultural specificity and national characteristics. The choice of this research topic is driven by a perceived spiritual crisis affecting humanity in general, and the German ethnic group in particular, as well as by an anthropocentric approach to contemporary linguistic issues. The German language is seen as peripheral in many research contexts. The hypothesis underpinning this study suggests that a spiritual crisis is linked to a lack of inner harmony, arising from cognitive dissonance. From a theoretical perspective, cognitive dissonance should encourage individuals to engage in cognitive processes, enhancing their understanding of the world and their place within it. This process includes critical examination of received information and validation of its truth. Discomfort caused by mental dissonance can be resolved by changing behaviors or beliefs, controlling emotions, revising values or conflicting ideas, or increasing emotogenic knowledge.The article emphasizes that the definition of emotion remains open-ended, with its interpretation often tied to specific philosophical teachings, biological, somatic, psychological, cognitive, eclectic, or linguistic theories. The primary objective of the study is to establish a paradigm of the most typical emotions experienced by the German people over many centuries, as evidenced by paremias (proverbial expressions). Emotions that are codified in texts more than three times are identified as typical. Despite significant contributions from philosophers, psychologists, ethnographers, historians, sociologists, linguists, and philologists to the study of emotions, many aspects remain unresolved, particularly with respect to emotions in texts and paremias. Through this research, the concepts of "emotion," "emotion in text," and "emotion in paremia" are clarified. The study also provides a brief overview of the German way of life during the 8th to 18th centuries, offering examples of explicit and implicit emotions, as well as their variants. Additionally, emotional patterns and their variations are examined, distinguishing positive, neutral, negative, and undefined emotions based on semantic features. Ultimately, the article confirms the idea that there is a relationship between emotions and the cultural and spiritual experiences of an ethnic group.

Positive relationship between bird diversity and human mental health: an analysis of repeated cross-sectional data

An increasing body of research has examined the link between biodiversity of birds and human mental health, but most studies only use cross-sectional data. Few studies have used longitudinal or repeated cross-sectional data to investigate the mental health benefits of bird diversity. The aim of this study is to analyse the relationship between bird diversity and mental health at the national level using a unique repeated cross-sectional dataset. I used repeated cross-sectional health data from the German National Cohort health study, collected between March, 2014, and September, 2019, and annual bird citizen science data to investigate the effects of bird-diversity exposure on mental health. Mental health was measured using the summary score of the Patient Health Questionnaire depression module 9 (SumPHQ) and the Short Form Health Survey-12 Mental Health Component Scale. As a proxy for bird diversity, I created a unique indicator called reporting-rate richness and combined it with the health data. Reporting-rate richness measures the number of bird species within postcode areas across Germany in probabilities while accounting for variation in survey efforts. Alternative indicators of bird diversity, such as bird-species richness or abundance, were also calculated. Associations between bird diversity and mental health were estimated using linear regression with region and time fixed effects, adjusted for a range of sociodemographic and environmental confounders and spatial autocorrelation. Interaction terms between income levels and reporting-rate richness were also analysed to examine the moderating effect of socioeconomic status. I did the analyses for an unbalanced (n=176 362) and balanced (n=125 423) dataset, with the balanced dataset comprising only regions (postcode areas) in which health data were available for each year. The linear fixed-effects regression analysis indicated a significant negative association between reporting-rate richness and SumPHQ, as observed in both the unbalanced dataset (β -0·02, p=0·017) and the balanced dataset (β -0·03, p=0·0037). Similarly, regression results with both datasets showed a positive relationship between reporting-rate richness and Mental Health Component Scale (MCS; unbalanced β 0·02, p=0·0086; balanced β 0·03, p=0·0018). The moderator analyses revealed a significant influence of socioeconomic status on the relationship between reporting-rate richness and mental health. The robustness of these findings was confirmed through sensitivity analyses. The results suggest that a greater likelihood of having many different bird species in a person's area of residence might positively contribute to mental health, especially for people with lower socioeconomic status. These findings could have implications for biodiversity conservation and health policy decisions, as governments are facing challenges such as global biodiversity loss and growing public mental health problems. None.

The Image of the Ideal German Mother in Nazi Era Posters

The Image of the Ideal German Mother in Nazi Era Posters

Cancer detection rate of breast-MR in supplemental screening after negative mammography in women with dense breasts. Preliminary results of the MA-DETECT-Study after 200 participants

BACKGROUNDDue to increased cancer detection rates (CDR), breast MR (breast MRI) can reduce underdiagnosis of breast cancer compared to conventional imaging techniques, particularly in women with dense breasts. The purpose of this study is to report the additional breast cancer yield by breast MRI in women with dense breasts after receiving a negative screening mammogram. METHODSFor this study we invited consecutive participants of the national German breast cancer Screening program with breast density categories ACR C & D and a negative mammogram to undergo additional screening by breast MRI. Endpoints were CDR and recall rates. This study reports interim results in the first 200 patients. At a power of 80% and considering an alpha error of 5%, this preliminary population size is sufficient to demonstrate a 4/1000 improvement in CDR. RESULTSIn 200 screening participants, 8 women (40/1000, 17.4–77.3/1000) were recalled due to positive breast MRI findings. Image-guided biopsy revealed 5 cancers in 4 patients (one bilateral), comprising four invasive cancers and one case of DCIS. 3 patients revealed 4 invasive cancers presenting with ACR C breast density and one patient non-calcifying DCIS in a woman with ACR D breast density, resulting in a CDR of 20/1000 (95%-CI 5.5–50.4/1000) and a PPV of 50% (95%-CI 15.7–84.3%). CONCLUSIONOur initial results demonstrate that supplemental screening using breast MRI in women with heterogeneously dense and very dense breasts yields an additional cancer detection rate in line with a prior randomized trial on breast MRI screening of women with extremely dense breasts. These findings are highly important as the population investigated constitutes a much higher proportion of women and yielded cancers particularly in women with heterogeneously dense breasts.

“About false Jews”: Transgenerational posttraumatic identity confusions in Germany

In times of rising group-focused enmity and toxic polarizations between conflicted groups worldwide, a differentiated debate about the transgenerational complexities of German and Jewish posttraumatic entanglements of identity is needed. This article focuses on one specific and limited clinical phenomenon: the “adoption” by a few people in Germany of a Jewish identity that is not present in their own biography. An introduction to the phenomenon from clinical practice is followed by a brief historical and social contextualization, as well as theoretical models of explanation for the adoption of a potentially oppressed minority status. With reference to theories on social trauma and its transgenerational transmission to both victims and perpetrators, the psychoanalytic examination of a single case is used to develop the thesis that posttraumatic Jewish identity confusion and constructions are to be understood not only as an individual variant of “false-self,” but also as a form of transgenerational repercussion of the social trauma of the Shoah.

MULTIMEDIA FRAMING OF BRECHTIAN CHIMERISM

Brecht's epic theater in its artistic diversity includes works that, having received multimedia interpretation, not only do not lose their artistic and aesthetic significance but also enhance it. This refers to B. Brecht's use of photo-epigrams from "Kriegsfibel", which became emblems of war. "Kriegsfibel" is the title of the second part of the great oratorio "Deutsches Miserere", which emerged as a result of Bertolt Brecht's creative collaboration with the composer Paul Dessau. Twenty-nine photo-epigrams formed the basis of the concert, which Brecht called "Deutsches Miserere" – "the great repentance of the German people". In this article, we examine the basic principles of the construction of "Deutsches Miserere", focusing on the functional features of the alienation effect in the work through multimedia and intermedia means. The focus lies on the interconnection and combination of different types of art: fiction, photography, cinematography, and music aimed at creating an original author's language. The article claims that the unifying principle that connects them is chimerism, which contributes to the effect of alienation and serves to provocatively and paradoxically comprehend and embody a certain theme or idea. In the triad of "principle – technique – medium", the leading artistic principle is the effect of alienation, one of the techniques of artistic transformation of reality is chimerism, and the medium is multimedia. The introduction of multimedia amplifies the alienation effect, and this allows us to consider the interaction of chimerism with intermedial means of expression, namely, it makes intramediality the sphere of existence of chimerism.

Are We Always Right? Evaluation of the Performance and Knowledge of the Passive Leg Raise Test in Detecting Volume Responsiveness in Critical Care Patients: A National German Survey.

Background: In hemodynamically unstable patients, the passive leg raise (PLR) test is recommended for use as a self-fluid challenge for predicting preload responsiveness. However, to interpret the hemodynamic effects and reliability of the PLR, the method of performing it is of the utmost importance. Our aim was to determine the current practice of the correct application and interpretation of the PLR in intensive care patients. Methods: After ethical approval, we designed a cross-sectional online survey with a short user-friendly online questionnaire. Using a random sample of 1903 hospitals in Germany, 182 hospitals with different levels of care were invited via an email containing a link to the questionnaire. The online survey was conducted between December 2021 and January 2022. All critical care physicians from different medical disciplines were surveyed. We evaluated the correct points of concern for the PLR, including indication, contraindication, choice of initial position, how to interpret and apply the changes in cardiac output, and the limitations of the PLR. Results: A total of 292 respondents participated in the online survey, and 283/292 (97%) of the respondents completed the full survey. In addition, 132/283 (47%) were consultants and 119/283 (42%) worked at a university medical center. The question about the performance of the PLR was answered correctly by 72/283 (25%) of the participants. The limitations of the PLR, such as intra-abdominal hypertension, were correctly selected by 150/283 (53%) of the participants. The correct effect size (increase in stroke volume ≥ 10%) was correctly identified by 217/283 (77%) of the participants. Conclusions: Our results suggest a considerable disparity between the contemporary practice of the correct application and interpretation of the PLR and the practice recommendations from recently published data at German ICUs.

Maßnahmen zur Hitze- und Starkregenvorsorge in Kitas und Pflegeeinrichtungen: Eine Evaluation von Risikowahrnehmung, Kommunikation und Informationsmaterialien

ZusammenfassungHintergrund und ZielHitze und Starkregen können negative Auswirkungen auf die Gesundheit von Menschen auch in Deutschland haben. Insbesondere vulnerable Gruppen wie Kinder und Ältere sind einem erhöhten Risiko ausgesetzt und bedürfen der besonderen Vorsorge. Diese Arbeit untersucht, wie Gefahren durch Hitze und Starkregen in der kommunalen Verwaltung und bei Trägern von Kindertagesstätten und Pflegeeinrichtungen wahrgenommen werden und inwiefern hierzu ein Austausch zwischen kommunaler Ebene und Einrichtungen stattfindet. Eigens entwickelte Informationsmaterialien mit Handlungsempfehlungen zur Anpassung an Hitze und Starkregen, die sich an Einrichtungen richten, werden evaluiert.MethodenIm Sommer 2021 fand eine quantitative Befragung von insgesamt 333 Teilnehmenden aus Stadtverwaltungen, Trägern und Einrichtungen (Kindertagesstätten und Pflegeeinrichtungen) statt. Zur statistischen Auswertung wurden deskriptive Analysen und Varianzanalysen durchgeführt.ErgebnisseDie Risikowahrnehmung und auch das Handlungswissen bzgl. Hitze fielen höher als hinsichtlich Starkregen aus. Die Handlungsabsicht, Einrichtungen Unterstützung zur Anpassung aufzuzeigen, war bzgl. Hitze ebenfalls größer. Die Mehrheit der Befragten aus Stadtverwaltungen und von Trägern stand mit Einrichtungen über verschiedene Wege im Austausch und kommunizierte u. a. über die genannten Naturgefahren. Das Informationsmaterial wurde mehrheitlich positiv bewertet.DiskussionDie Einrichtungen werden in Hinblick auf Hitze als stark betroffen angesehen. Die Sensibilisierung hinsichtlich Starkregens bedarf stärkerer Förderung. Die Rückmeldungen zu dem Informationsmaterial machen einen hohen Bedarf in diesem Bereich deutlich.

Machine Learning-Based Perivascular Space Volumetry in Alzheimer Disease.

Impaired perivascular clearance has been suggested as a contributing factor to the pathogenesis of Alzheimer disease (AD). However, it remains unresolved when the anatomy of the perivascular space (PVS) is altered during AD progression. Therefore, this study investigates the association between PVS volume and AD progression in cognitively unimpaired (CU) individuals, both with and without subjective cognitive decline (SCD), and in those clinically diagnosed with mild cognitive impairment (MCI) or mild AD. A convolutional neural network was trained using manually corrected, filter-based segmentations (n = 1000) to automatically segment the PVS in the centrum semiovale from interpolated, coronal T2-weighted magnetic resonance imaging scans (n = 894). These scans were sourced from the national German Center for Neurodegenerative Diseases Longitudinal Cognitive Impairment and Dementia Study. Convolutional neural network-based segmentations and those performed by a human rater were compared in terms of segmentation volume, identified PVS clusters, as well as Dice score. The comparison revealed good segmentation quality (Pearson correlation coefficient r = 0.70 with P < 0.0001 for PVS volume, detection rate in cluster analysis = 84.3%, and Dice score = 59.0%). Subsequent multivariate linear regression analysis, adjusted for participants' age, was performed to correlate PVS volume with clinical diagnoses, disease progression, cerebrospinal fluid biomarkers, lifestyle factors, and cognitive function. Cognitive function was assessed using the Mini-Mental State Examination, the Comprehensive Neuropsychological Test Battery, and the Cognitive Subscale of the 13-Item Alzheimer's Disease Assessment Scale. Multivariate analysis, adjusted for age, revealed that participants with AD and MCI, but not those with SCD, had significantly higher PVS volumes compared with CU participants without SCD ( P = 0.001 for each group). Furthermore, CU participants who developed incident MCI within 4.5 years after the baseline assessment showed significantly higher PVS volumes at baseline compared with those who did not progress to MCI ( P = 0.03). Cognitive function was negatively correlated with PVS volume across all participant groups ( P ≤ 0.005 for each). No significant correlation was found between PVS volume and any of the following parameters: cerebrospinal fluid biomarkers, sleep quality, body mass index, nicotine consumption, or alcohol abuse. The very early changes of PVS volume may suggest that alterations in PVS function are involved in the pathophysiology of AD. Overall, the volumetric assessment of centrum semiovale PVS represents a very early imaging biomarker for AD.

Interactions and Interferences of Italian and German Nationalist Regimes in Asia during the Interwar Period (1928–1937)

This article presents a comprehensive narration and interpretation of the political relations between nationalist regimes in Asia and Europe during the interwar history from 1928 to 1937. Authoritarian regimes with political affinities and similar autarchic economic strategies created the ground for an unprecedented collaboration among governments situated on the opposite side of the world. China, Italy, Germany had a prolonged political, military and economic dialogue which lasted for almost a decade and involved the active mediation of political leaders, scholars and highly professional military officers. The interaction with Japan disrupted that partnership and finally changed the perspectives of the strategic alliance. Ultimately, affinities and disagreements among these governments were relevant in leading the world into the abyss of the Second World War. The preparation of this article is supported by primary sources consulted at diplomatic and historical archives and historical literature written in three languages (English, German, and Italian).

Objective assessment criteria reduce the influence of judgmental bias on grading

Past research has indicated that students with a migration background are graded worse than those without a migration background, despite them showing the same level of academic performance. Negative implicit associations of teachers associated with these student characteristics could explain these findings. Objective assessment criteria, such as error tables, provide user-independent rules for the interpretation of results and could therefore help to ensure that the influence of student characteristics on assessment is reduced. To test this hypothesis, 157 pre-service teachers assessed a dictation. Two aspects were varied: the presentation of an error table for assessment and the name of the student who had written the dictation (with vs. without a supposed Turkish migration background). An implicit association test measured implicit associations of the pre-service teachers toward the performance of Turkish and German people. When no error table was used and the pre-service teachers had negative implicit associations toward the performance of people with a Turkish migration background, they graded students with a migration background worse than students without a migration background. No grading disparities were found when the error table was used. To reduce judgmental bias, the use of objective assessment criteria can therefore be recommended.

Rise of Populism: Identity Threats as an Explanation in Relation With Deprivation and Cultural Fear

This article introduces the thesis of threatened social identities as a new explanatory approach to the emergence of populist attitudes and tests it explicitly for the first time using quantitative data. We examine whether SIT indicators explain populist attitudes directly and influence effects of indicators of two established approaches: the losers of modernization thesis (LOM) and the cultural backlash thesis (CBT). We use a sample representative for the German labor force. Furthermore, we developed items to quantify the recognition of social identities for the first time with respect to social class and occupational identities. All four of our SIT indicators—recognition of social class, recognition of an East or West German identity, political recognition of occupational groups, and identity insecurity—are significant predictors of populist attitudes. Based on SEMs, we also conclude that these variables are important antecedents of previously established indicators of LOM and CBT on populist attitudes. Overall, we conclude that SIT adds to the literature on the emergence of populism as another complementary explanatory approach. In addition to being effective as an explanation in its own right, this thesis can also fill theoretical and empirical gaps of the established LOM and CBT.

“A man who wants constant watching”: Karl Hens (1872-1948) and the politics of wartime internment in South Africa, 1914–1918

ABSTRACT The internment of ‘enemy subjects’ in many countries in response to the outbreak of war in Europe in August 1914 reflected global security concerns. South Africa, then a newly constituted Dominion of the British Empire, followed London’s lead and interned some 2,500 German and Austro-Hungarian nationals. Based on the examination of official and private records, this article analyses the story of a German, migrant couple: Karl and Marie Hens. It explores their life in South Africa hustling to make a living and then, after August 1914, first to escape and then survive war-time internment. It reveals the difficult relationships between them and their communities and between the internees themselves and the relief agencies; from the impact of severe personal restriction and growing impoverishment to the politics of release in 1919. Yet, as Marie no doubt realised, the wives and children – not interned, and left at the mercy of their ‘British’ neighbours – suffered the most.

Childhood and adolescence factors and multiple sclerosis: results from the German National Cohort (NAKO)

BackgroundMultiple 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.MethodsData 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.ResultsAmong 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.ConclusionsApart 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.

Цивілізаційний образ «Заходу» в історичних працях Михайла Максимовича.

The purpose of the article is to study the reception of the image of the West by Mykhailo Maksimovich in the context of his civilizational views and ideas. The methodological basis of the article is mental mapping as a strategy of cognitive reproduction of geographical objects in the imagination of scientists. The basic component of the used methodology is imagology as a method of studying one’s own/another person’s images. The scientific novelty of the article lies in the fact that it first clarified the attitude of this scientist to the West as an image of a civilized community; the role of this image in the civilizational self-identification of the historian is traced; an analysis of his ideas regarding the relationship between the historical images of Russia-Ukraine and the West in Maksymovich’s historical works is made. Conclusions. In Mykhailo Maksymovich’s civilizational identity the Slavic world was "his" civilizational community. The role of the main "foreign" and "enemy" civilizational community was performed by the West. The West was imagined by Maksymovich as a space populated by Germanic peoples, on which the Catholic faith prevails. The historian did not notice Romanic peoples or the Protestant faith in his historical texts. The Germanic West was interpreted by Maksymovich as an environment that has always carried out an aggressive expansion into the Slavic world with the aim of conquering and assimilating it. The scientist considered Catholicism, primarily the order of the Jesuits, to be the main characteristic of the West. For him, the ethnic representative of Western civilization was primarily the German people. Maksymovich interpreted the Germans as a people for whom the primordial, genetically determined "hostility" towards the Slavs is inherent. His historical image of Poland was also inscribed in Maksymovich’s reception of the West. This historian interpreted the Poles as the people who were the first to experience Western (German) expansion and were heavily influenced by it. As a result, the Poles were interpreted by scholars as bearers of "Western" traditions among the Slavs.

The relation between contact experiences and dual identity among German residents with a Turkish or Kurdish identity

AbstractWe present secondary analyses of data collected with German residents with Turkish and Kurdish ancestry (n = 414), who represent the largest migrant groups in Germany. The majority of our sample of mostly second‐generation migrants exhibited integrated identity profiles, with high levels of both ethnic (Turkish or Kurdish) and national (German) identification. National and ethnic identification were unrelated, and both were predicted by the frequency and quality of contact with members of the respective groups as well as the extent to which participants report daily discrimination experiences. We additionally adopted a regional bias approach (Calanchini et al., 2022), inserting regional‐level data as indicators of context variance of contact opportunity and local aggregates of racialized group attitudes into analyses. Results document that the varying level of contact opportunity did not predict individual contact experiences and social identity, whereas the local attitude aggregate predicted individual contact experiences and participants' reports of daily discrimination, which, in turn, related to both ethnic and national identifications. These results indicate the relevance of social and contextual variables on the formation and navigation of multiple identities, which has theoretical and practical implications for the current societal and political debates about migration and integration.

Definition of the Post-COVID syndrome using a symptom-based Post-COVID score in a prospective, multi-center, cross-sectoral cohort of the German National Pandemic Cohort Network (NAPKON)

PurposeThe objective examination of the Post-COVID syndrome (PCS) remains difficult due to heterogeneous definitions and clinical phenotypes. The aim of the study was to verify the functionality and correlates of a recently developed PCS score.MethodsThe PCS score was applied to the prospective, multi-center cross-sectoral cohort (in- and outpatients with SARS-CoV-2 infection) of the "National Pandemic Cohort Network (NAPKON, Germany)". Symptom assessment and patient-reported outcome measure questionnaires were analyzed at 3 and 12 months (3/12MFU) after diagnosis. Scores indicative of PCS severity were compared and correlated to demographic and clinical characteristics as well as quality of life (QoL, EQ-5D-5L).ResultsSix hundred three patients (mean 54.0 years, 60.6% male, 82.0% hospitalized) were included. Among those, 35.7% (215) had no and 64.3% (388) had mild, moderate, or severe PCS. PCS severity groups differed considering sex and pre-existing respiratory diseases. 3MFU PCS worsened with clinical severity of acute infection (p = .011), and number of comorbidities (p = .004). PCS severity was associated with poor QoL at the 3MFU and 12MFU (p < .001).ConclusionThe PCS score correlated with patients’ QoL and demonstrated to be instructive for clinical characterization and stratification across health care settings. Further studies should critically address the high prevalence, clinical relevance, and the role of comorbidities.Trail registration numberThe cohort is registered at www.clinicaltrials.gov under NCT04768998.

Differences in Anthropometric Measures Based on Sex, Age, and Health Status.

Obesity is a worldwide health problem. We conducted detailed analyses of anthropometric measures in a comprehensive, population-based, current cohort in Germany. In the German National Cohort (NAKO), we analyzed cross-sectional data on body mass index (BMI), waist and hip circumference, subcutaneous (SAT) and visceral adipose tissue (VAT) as measured by ultrasound, and body fat percentage. The data were stratified by sex, age, and self-reported physicians' diagnoses of cardiovascular diseases (CVD), metabolic diseases (MetD), cardiometabolic diseases (CMD), and cancer. Data were available from 204 751 participants (age, 49.9 ± 12.8 years; 50.5% women). Body size measures generally increased with age. Men had a higher BMI, larger waist circumference, and more VAT than women, while women had a larger hip circumference, more SAT, and a higher body fat percentage than men. For example, the mean BMI of participants over age 60 was 28.3 kg/m2 in men and 27.6 kg/m2 in women. CVD, MetD, and CMD were associated with higher anthropometric values, while cancer was not. For example, the mean BMI was 25.3 kg/m2 in healthy women, 29.4 kg/m2 in women with CMD, and 25.4 kg/m2 in women with cancer. Obesity is widespread in Germany, with notable differences between the sexes in anthro - pometric values. Obesity was more common in older participants and those with chronic diseases other than cancer. Elevated values were especially common in multimorbid individuals.

Large-scale assessment of physical activity in a population using high-resolution hip-worn accelerometry: the German National Cohort (NAKO)

Large population-based cohort studies utilizing device-based measures of physical activity are crucial to close important research gaps regarding the potential protective effects of physical activity on chronic diseases. The present study details the quality control processes and the derivation of physical activity metrics from 100 Hz accelerometer data collected in the German National Cohort (NAKO). During the 2014 to 2019 baseline assessment, a subsample of NAKO participants wore a triaxial ActiGraph accelerometer on their right hip for seven consecutive days. Auto-calibration, signal feature calculations including Euclidean Norm Minus One (ENMO) and Mean Amplitude Deviation (MAD), identification of non-wear time, and imputation, were conducted using the R package GGIR version 2.10-3. A total of 73,334 participants contributed data for accelerometry analysis, of whom 63,236 provided valid data. The average ENMO was 11.7 ± 3.7 mg (milli gravitational acceleration) and the average MAD was 19.9 ± 6.1 mg. Notably, acceleration summary metrics were higher in men than women and diminished with increasing age. Work generated in the present study will facilitate harmonized analysis, reproducibility, and utilization of NAKO accelerometry data. The NAKO accelerometry dataset represents a valuable asset for physical activity research and will be accessible through a specified application process.