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Left ventricular assist devices (LVADs) have become a valuable treatment for patients with advanced heart failure. Women appear to be disadvantaged in the usage of LVADs and concerning clinical outcomes such as death and adverse events after LVAD implant. Contrary to typical clinical characteristics (e.g., disease severity), device-related factors such as the intended device strategy, bridge to a heart transplantation or destination therapy, are often not considered in research on gender differences. In addition, the relevance of pre-implant psychosocial risk factors, such as substance abuse and limited social support, for LVAD outcomes is currently unclear. Thus, the aim of this dissertation is to explore the role of pre-implant psychosocial risk factors for gender differences in clinical outcomes, accounting for clinical and device-related risk factors.
In the first article, gender differences in pre-implant characteristics of patients registered in The European Registry for Patients with Mechanical Circulatory Support (EUROMACS) were investigated. It was found that women and men differed in multiple pre-implant characteristics depending on device strategy. In the second article, gender differences in major clinical outcomes (i.e., death, heart transplant, device explant due to cardiac recovery, device replacement due to complications) were evaluated for patients in the device strategy destination therapy in the Interagency Registry for Mechanically Assisted Circulation (INTERMACS). Additionally, the association of gender and psychosocial risk factors with the major outcomes were analyzed. Women had similar probabilities to die on LVAD support, and even higher probabilities to experience explant of the device due to cardiac recovery compared with men in the destination therapy subgroup. Pre-implant psychosocial risk factors were not associated with major outcomes. The third article focused on gender differences in 10 adverse events (e.g., device malfunction, bleeding) after LVAD implant in INTERMACS. The association of a psychosocial risk indicator with gender and adverse events after LVAD implantation was evaluated. Women were less likely to have psychosocial risk pre-implant but more likely to experience seven out of 10 adverse events compared with men. Pre-implant psychosocial risk was associated with adverse events, even suggesting a dose response-relationship. These associations appeared to be more pronounced in women.
In conclusion, women appear to have similar survival to men when accounting for device strategy. They have higher probabilities of recovery, but higher probabilities of device replacement and adverse events compared with men. Regarding these adverse events, women may be more susceptible to psychosocial risk factors than men. The results of this dissertation illustrate the importance of gender-sensitive research and suggest considering device strategy when studying gender differences in LVAD recipients. Further research is warranted to elucidate the role of specific psychosocial risk factors that lead to higher probabilities of adverse events, to intervene early and improve patient care in both, women and men
Anmerkung: Es handelt sich um die 2. überarbeitete Auflage der Dissertation.
1. Auflage siehe:
"https://ubt.opus.hbz-nrw.de/frontdoor/index/index/docId/2083".
Ausgangspunkt der politisch-ikonographischen Untersuchung, in deren
Zentrum zwei Staatsporträts König Maximilians II. von Bayern stehen, ist die Beobachtung, dass diese beiden Bildnisse grundsätzlich unterschiedliche Inszenierungsformen wählen. Das erste von Max Hailer gefertigte Werk zeigt Maximilian II. im vollen bayerischen Krönungsornat und greift eine tradierte Darstellungsweise im Staatsporträt auf. Es entstand zwei Jahre nach Maximilians II. Thronbesteigung und damit nach den revolutionären Unruhen der Jahre 1848/49 im Jahr 1850. Das zweite wurde von Joseph Bernhardt 1857 bis 1858 gemalt und im Jahr 1858 zum zehnjährigen Thronjubiläum des Monarchen erstmals präsentiert. Die Inszenierung ändert sich im zweiten Bildnis: Das bayerische Krönungsornat ist der Generalsuniform gewichen, ebenso weitere Details, die sich noch in der ersten Darstellung finden: Draperie und Wappen fehlen, der übliche bayerisch-königliche Thronsessel ist durch einen anderen ersetzt. In den Hintergrund gedrängt ist die Verfassung, immerhin seit 1818 staatliche Rechtsgrundlage des bayerischen Königreichs. Die beiden Staatsporträts Maximilians II. leiten offensichtlich von den Herrscherbildnissen im vollen bayerischen Krönungsornat seines Großvaters Maximilian I. und Vaters Ludwig I. über zu einer solchen in Uniform mit Krönungsmantel wie sie sich bei Napoleon III. und Friedrich Wilhelm IV. finden und wie sie sein Sohn Ludwig II. weiterführte. Es stellt sich somit die Frage, welche Faktoren zu diesem prägnanten Wandel in der Inszenierung Maximilians II. als König von Bayern führten. Die Arbeit geht der These nach, dass beide Darstellungen grundlegend auf eine reaktionäre, gegen die Revolution 1848/49 gerichtete Politik ausgelegt sind, wobei dieser reaktionäre Charakter in Maximilians II. Bildnis von 1858 noch eine Steigerung im Vergleich zu derjenigen von 1850 erfährt. Zudem wandelt sich die innenpolitisch-historische Ausrichtung des ersten Porträts bei der zweiten Darstellung des bayerischen Monarchen in eine außenpolitisch-progressive. Die Legitimation Maximilians II. begründet sich nicht mehr, wie bei ersterem, in der Geschichte und der Herrschaft der Wittelsbacher, sondern in seinen eigenen Errungenschaften und seiner eigenen Herrschaft. Dieser Wechsel der politischen Bildaussage fußt sowohl auf den politischen Veränderungen und Entwicklungen innerhalb und außerhalb Bayerns als auch auf der Entwicklung des Staatsporträts in der Mitte des 19. Jahrhunderts. Nach nur zehn Jahren wird so eine veränderte Botschaft über Maximilians II. Position und Machtanspruch ausgesendet.
Knowledge acquisition comprises various processes. Each of those has its dedicated research domain. Two examples are the relations between knowledge types and the influences of person-related variables. Furthermore, the transfer of knowledge is another crucial domain in educational research. I investigated these three processes through secondary analyses in this dissertation. Secondary analyses comply with the broadness of each field and yield the possibility of more general interpretations. The dissertation includes three meta-analyses: The first meta-analysis reports findings on the predictive relations between conceptual and procedural knowledge in mathematics in a cross-lagged panel model. The second meta-analysis focuses on the mediating effects of motivational constructs on the relationship between prior knowledge and knowledge after learning. The third meta-analysis deals with the effect of instructional methods in transfer interventions on knowledge transfer in school students. These three studies provide insights into the determinants and processes of knowledge acquisition and transfer. Knowledge types are interrelated; motivation mediates the relation between prior and later knowledge, and interventions influence knowledge transfer. The results are discussed by examining six key insights that build upon the three studies. Additionally, practical implications, as well as methodological and content-related ideas for further research, are provided.
There is no longer any doubt about the general effectiveness of psychotherapy. However, up to 40% of patients do not respond to treatment. Despite efforts to develop new treatments, overall effectiveness has not improved. Consequently, practice-oriented research has emerged to make research results more relevant to practitioners. Within this context, patient-focused research (PFR) focuses on the question of whether a particular treatment works for a specific patient. Finally, PFR gave rise to the precision mental health research movement that is trying to tailor treatments to individual patients by making data-driven and algorithm-based predictions. These predictions are intended to support therapists in their clinical decisions, such as the selection of treatment strategies and adaptation of treatment. The present work summarizes three studies that aim to generate different prediction models for treatment personalization that can be applied to practice. The goal of Study I was to develop a model for dropout prediction using data assessed prior to the first session (N = 2543). The usefulness of various machine learning (ML) algorithms and ensembles was assessed. The best model was an ensemble utilizing random forest and nearest neighbor modeling. It significantly outperformed generalized linear modeling, correctly identifying 63.4% of all cases and uncovering seven key predictors. The findings illustrated the potential of ML to enhance dropout predictions, but also highlighted that not all ML algorithms are equally suitable for this purpose. Study II utilized Study I’s findings to enhance the prediction of dropout rates. Data from the initial two sessions and observer ratings of therapist interventions and skills were employed to develop a model using an elastic net (EN) algorithm. The findings demonstrated that the model was significantly more effective at predicting dropout when using observer ratings with a Cohen’s d of up to .65 and more effective than the model in Study I, despite the smaller sample (N = 259). These results indicated that generating models could be improved by employing various data sources, which provide better foundations for model development. Finally, Study III generated a model to predict therapy outcome after a sudden gain (SG) in order to identify crucial predictors of the upward spiral. EN was used to generate the model using data from 794 cases that experienced a SG. A control group of the same size was also used to quantify and relativize the identified predictors by their general influence on therapy outcomes. The results indicated that there are seven key predictors that have varying effect sizes on therapy outcome, with Cohen's d ranging from 1.08 to 12.48. The findings suggested that a directive approach is more likely to lead to better outcomes after an SG, and that alliance ruptures can be effectively compensated for. However, these effects
were reversed in the control group. The results of the three studies are discussed regarding their usefulness to support clinical decision-making and their implications for the implementation of precision mental health.
The publication of statistical databases is subject to legal regulations, e.g. national statistical offices are only allowed to publish data if the data cannot be attributed to individuals. Achieving this privacy standard requires anonymizing the data prior to publication. However, data anonymization inevitably leads to a loss of information, which should be kept minimal. In this thesis, we analyze the anonymization method SAFE used in the German census in 2011 and we propose a novel integer programming-based anonymization method for nominal data.
In the first part of this thesis, we prove that a fundamental variant of the underlying SAFE optimization problem is NP-hard. This justifies the use of heuristic approaches for large data sets. In the second part, we propose a new anonymization method belonging to microaggregation methods, specifically designed for nominal data. This microaggregation method replaces rows in a microdata set with representative values to achieve k-anonymity, ensuring each data row is identical to at least k − 1 other rows. In addition to the overall dissimilarities of the data rows, the method accounts for errors in resulting frequency tables, which are of high interest for nominal data in practice. The method employs a typical two-step structure: initially partitioning the data set into clusters and subsequently replacing all cluster elements with representative values to achieve k-anonymity. For the partitioning step, we propose a column generation scheme followed by a heuristic to obtain an integer solution, which is based on the dual information. For the aggregation step, we present a mixed-integer problem formulation to find cluster representatives. To this end, we take errors in a subset of frequency tables into account. Furthermore, we show a reformulation of the problem to a minimum edge-weighted maximal clique problem in a multipartite graph, which allows for a different perspective on the problem. Moreover, we formulate a mixed-integer program, which combines the partitioning and the aggregation step and aims to minimize the sum of chi-squared errors in frequency tables.
Finally, an experimental study comparing the methods covered or developed in this work shows particularly strong results for the proposed method with respect to relative criteria, while SAFE shows its strength with respect to the maximum absolute error in frequency tables. We conclude that the inclusion of integer programming in the context of data anonymization is a promising direction to reduce the inevitable information loss inherent in anonymization, particularly for nominal data.
Building Fortress Europe Economic realism, China, and Europe’s investment screening mechanisms
(2023)
This thesis deals with the construction of investment screening mechanisms across the major economic powers in Europe and at the supranational level during the post-2015 period. The core puzzle at the heart of this research is how, in a traditional bastion of economic liberalism such as Europe, could a protectionist tool such as investment screening be erected in such a rapid manner. Within a few years, Europe went from a position of being highly welcoming towards foreign investment to increasingly implementing controls on it, with the focus on China. How are we to understand this shift in Europe? I posit that Europe’s increasingly protectionist shift on inward investment can be fruitfully understood using an economic realist approach, where the introduction of investment screening can be seen as part of a process of ‘balancing’ China’s economic rise and reasserting European competitiveness. China has moved from being the ‘workshop of the world’ to becoming an innovation-driven economy at the global technological frontier. As China has become more competitive, Europe, still a global economic leader, broadly situated at the technological frontier, has begun to sense a threat to its position, especially in the context of the fourth industrial revolution. A ‘balancing’ process has been set in motion, in which Europe seeks to halt and even reverse the narrowing competitiveness gap between it and China. The introduction of investment screening measures is part of this process.
In Luxemburg helfen externe Schulmediator*innen bei schulischen Konflikten. Die Anlaufstelle unterstützt bei drohenden Schulabbrüchen und Konflikten, die bei der Inklusion und Integration von Schüler*innen mit besonderem Förderbedarf oder mit Migrationshintergrund entstehen. Michèle Schilt sprach mit der Leiterin der Servicestelle, Lis De Pina, über die Arbeit der Schulmediation.
Emotionen gelten als Spiegelbild unserer persönlichen Bedürfnislage. Insbesondere in Konflikt- oder Mediationsgesprächen ist es demnach wichtig, nicht nur über den Moment zu sprechen, an dem ein Streit entstanden ist, sondern auch Bedürfnisse und Gefühle aufzudecken, die unser Handeln, Denken und Fühlen beeinflusst haben. Die folgenden Materialien zeigen, wie man als Lehrkraft Emotionen und Streit mit Grundschulkindern behandeln kann.
Sie haben eine spannende politische Diskussion in der Klasse. Das Gros Ihrer Schüler*innen ist wach, interessiert und engagiert. Alles läuft prima. Doch dann passiert's: Einer oder eine von ihnen stellt – absichtlich oder unreflektiert – eine extremistische oder verschwörungstheoretische Aussage in den Raum. Und nun?
Die Praxishefte Demokratische Schulkultur erscheinen halbjährlich und bieten Schulleitungen und Schulpersonal theoretische Grundlagen und praxisorientierte Anleitungen zur demokratiepädagogischen Schulentwicklung. Jedes Themenheft ist jeweils einer demokratiepädagogischen Bauform oder strategischen Frage der Schulentwicklung gewidmet. Die Praxishefte werden allen Luxemburger Schulen als Printausgabe zur Verfügung gestellt und online mit zusätzlichen Materialien und in französischer Fassung vorgehalten.
While humans find it easy to process visual information from the real world, machines struggle with this task due to the unstructured and complex nature of the information. Computer vision (CV) is the approach of artificial intelligence that attempts to automatically analyze, interpret, and extract such information. Recent CV approaches mainly use deep learning (DL) due to its very high accuracy. DL extracts useful features from unstructured images in a training dataset to use them for specific real-world tasks. However, DL requires a large number of parameters, computational power, and meaningful training data, which can be noisy, sparse, and incomplete for specific domains. Furthermore, DL tends to learn correlations from the training data that do not occur in reality, making DNNs poorly generalizable and error-prone.
Therefore, the field of visual transfer learning is seeking methods that are less dependent on training data and are thus more applicable in the constantly changing world. One idea is to enrich DL with prior knowledge. Knowledge graphs (KG) serve as a powerful tool for this purpose because they can formalize and organize prior knowledge based on an underlying ontological schema. They contain symbolic operations such as logic, rules, and reasoning, and can be created, adapted, and interpreted by domain experts. Due to the abstraction potential of symbols, KGs provide good prerequisites for generalizing their knowledge. To take advantage of the generalization properties of KG and the ability of DL to learn from large-scale unstructured data, attempts have long been made to combine explicit graph and implicit vector representations. However, with the recent development of knowledge graph embedding methods, where a graph is transferred into a vector space, new perspectives for a combination in vector space are opening up.
In this work, we attempt to combine prior knowledge from a KG with DL to improve visual transfer learning using the following steps: First, we explore the potential benefits of using prior knowledge encoded in a KG for DL-based visual transfer learning. Second, we investigate approaches that already combine KG and DL and create a categorization based on their general idea of knowledge integration. Third, we propose a novel method for the specific category of using the knowledge graph as a trainer, where a DNN is trained to adapt to a representation given by prior knowledge of a KG. Fourth, we extend the proposed method by extracting relevant context in the form of a subgraph of the KG to investigate the relationship between prior knowledge and performance on a specific CV task. In summary, this work provides deep insights into the combination of KG and DL, with the goal of making DL approaches more generalizable, more efficient, and more interpretable through prior knowledge.
Repeatedly encountering a stimulus biases the observer’s affective response and evaluation of the stimuli. Here we provide evidence for a causal link between mere exposure to fictitious news reports and subsequent voting behavior. In four pre-registered online experiments, participants browsed through newspaper webpages and were tacitly exposed to names of fictitious politicians. Exposure predicted voting behavior in a subsequent mock election, with a consistent preference for frequent over infrequent names, except when news items were decidedly negative. Follow-up analyses indicated that mere media presence fuels implicit personality theories regarding a candidate’s vigor in political contexts. News outlets should therefore be mindful to cover political candidates as evenly as possible.
The benefits of prosocial power motivation in leadership: Action orientation fosters a win-win
(2023)
Power motivation is considered a key component of successful leadership. Based on its dualistic nature, the need for power (nPower) can be expressed in a dominant or a prosocial manner. Whereas dominant motivation is associated with antisocial behaviors, prosocial motivation is characterized by more benevolent actions (e.g., helping, guiding). Prosocial enactment of the power motive has been linked to a wide range of beneficial outcomes, yet less has been investigated what determines a prosocial enactment of the power motive. According to Personality Systems Interactions (PSI) theory, action orientation (i.e., the ability to self-regulate affect) promotes prosocial enactment of the implicit power motive and initial findings within student samples verify this assumption. In the present study, we verified the role of action orientation as an antecedent for prosocial power enactment in a leadership sample (N = 383). Additionally, we found that leaders personally benefited from a prosocial enactment strategy. Results show that action orientation through prosocial power motivation leads to reduced power-related anxiety and, in turn, to greater leader well-being. The integration of motivation and self-regulation research reveals why leaders enact their power motive in a certain way and helps to understand how to establish a win-win situation for both followers and leaders.
We use a novel sea-ice lead climatology for the winters of 2002/03 to 2020/21 based on satellite observations with 1 km2 spatial resolution to identify predominant patterns in Arctic wintertime sea-ice leads. The causes for the observed spatial and temporal variabilities are investigated using ocean surface current velocities and eddy kinetic energies from an ocean model (Finite Element Sea Ice–Ice-Shelf–Ocean Model, FESOM) and winds from a regional climate model (CCLM) and ERA5 reanalysis, respectively. The presented investigation provides evidence for an influence of ocean bathymetry and associated currents on the mechanic weakening of sea ice and the accompanying occurrence of sea-ice leads with their characteristic spatial patterns. While the driving mechanisms for this observation are not yet understood in detail, the presented results can contribute to opening new hypotheses on ocean–sea-ice interactions. The individual contribution of ocean and atmosphere to regional lead dynamics is complex, and a deeper insight requires detailed mechanistic investigations in combination with considerations of coastal geometries. While the ocean influence on lead dynamics seems to act on a rather long-term scale (seasonal to interannual), the influence of wind appears to trigger sea-ice lead dynamics on shorter timescales of weeks to months and is largely controlled by individual events causing increased divergence. No significant pan-Arctic trends in wintertime leads can be observed.