Supporting users' influence in gamification settings and game live-streams

Playing games has long been important to mankind. One reason for this is the associated autonomy, as players can decide on many aspects on their own and can shape the experience. Game-related sub-fields have appeared in Human-Computer Interaction where this autonomy is questionable: in this thesis, we consider gamification and game live-streams and here, we support the users' influence at runtime. We hypothesize that this should affect the perception of autonomy and should lead to positive effects overall. Our contribution is three-fold: first, we investigate crowd-based, self-sustaining systems in which the user's influence directly impacts the outcome of the system's service. We show that users are willing to expend effort in such systems even without additional motivation, but that gamification is still beneficial here. Second, we introduce "bottom-up" gamification, i.e., the idea of self-tailored gamification. Here, users have full control over the gamification used in a system, i.e., they can set it up as they see fit at the system's runtime. Through user studies, we show that this has positive behavioral effects and thus adds to the ongoing efforts to move away from "one-size-fits-all" solutions. Third, we investigate how to make gaming live-streams more interactive, and how viewers perceive this. We also consider shared game control settings in live-streams, in which viewers have full control, and we contribute options to support viewers' self-administration here.Seit jeher nehmen Spiele im Leben der Menschen eine wichtige Rolle ein. Ein Grund hierfür ist die damit einhergehende Autonomie, mit der Spielende Aspekte des Spielerlebnisses gestalten können. Spiele-bezogene Teilbereiche werden innerhalb der Mensch-Maschine-Interaktion untersucht, bei denen dieser Aspekt jedoch diskutabel ist: In dieser Arbeit betrachten wir Gamification und Spiele Live-Streams und geben Anwendern mehr Einfluss. Wir stellen die Hypothese auf, dass sich dies auf die Autonomie auswirkt und zu positiven Effekten führt. Der Beitrag dieser Dissertation ist dreistufig: Wir untersuchen crowdbasierte, selbsterhaltende Systeme, bei denen die Einflussnahme des Einzelnen sich auf das Systemergebnis auswirkt. Wir zeigen, dass Nutzer aus eigenem Antrieb bereit sind, sich hier einzubringen, der Einfluss von Gamification sich aber förderlich auswirkt. Im zweiten Schritt führen wir "bottom-up" Gamification ein. Hier hat der Nutzer die volle Kontrolle über die Gamification und kann sie nach eigenem Ermessen zur Laufzeit einstellen. An Hand von Nutzerstudien belegen wir daraus resultierende positive Verhaltenseffekte, was die anhaltenden Bemühungen bestärkt, individuelle Gamification-Konzepte anzubieten. Im dritten Schritt untersuchen wir, wie typische Spiele Live-Streams für Zuschauer interaktiver gestaltet werden können. Zudem betrachten wir Fälle, in denen Zuschauer die gemeinsame Kontrolle über ein Spiel ausüben und wie dies technologisch unterstützt werden kann

Viewer types in game live streams: questionnaire development and validation

Producing and consuming live-streamed content is a growing trend attracting many people today. While the actual content that is streamed is diverse, one especially pop ular context is games. Streamers of gaming content broadcast how they play digital or analog games, attracting several thousand viewers at once. Previous scientific work has revealed that different motivations drive people to become viewers, which apparently impacts how they interact with the offered features and which streamers’ behaviors they appreciate. In this paper, we wanted to understand whether viewers’ motiva tions can be formulated as viewer types and systematically measured. We present an exploratory factor analysis (followed by a validation study) with which we developed a 25-item questionnaire assessing five different viewer types. In addition, we analyzed the predictive validity of the viewer types for existing and potential live stream fea tures. We were able to show that a relationship between the assessed viewer type and preferences for streamers’ behaviors and features in a stream exists, which can guide fellow researchers and streamers to understand viewers better and potentially provide more suitable experiences

Potential and effects of personalizing gameful fitness applications using behavior change intentions and Hexad user types

Personalizing gameful applications is essential to account for interpersonal differences in the perception of gameful design elements. Considering that an increasing number of people lead sedentary lifestyles, using personalized gameful applications to encourage physical activity is a particularly relevant domain. In this article, we investigate behavior change intentions and Hexad user types as factors to personalize gameful fitness applications. We first explored the potential of these two factors by analyzing differences in the perceived persuasiveness of gameful design elements using a storyboards-based online study (N=178). Our results show several significant effects regarding both factors and thus support the usefulness of them in explaining perceptual differences. Based on these findings, we implemented “Endless Universe,” a personalized gameful application encouraging physical activity on a treadmill. We used the system in a laboratory study (N=20) to study actual effects of personalization on the users’ performance, enjoyment and affective experiences. While we did not find effects on the immediate performance of users, positive effects on user experience-related measures were found. The results of this study support the relevance of behavior change intentions and Hexad user types for personalizing gameful fitness systems further

Locally advanced adrenocortical carcinoma in children and adolescents — enigmatic and challenging cases

Background: Locally advanced tumors account for approximately 50% of children and adolescents with adrenocortical carcinoma (ACC), and of these, up to 50% relapse. We explored the five-item microscopic score and the pS-GRAS score for guiding management. Methods: Data from children and adolescents with COG stage II and III ACC registered in the MET studies were included. The five-item and pS-GRAS score were retrospectively calculated. Results: By December 2021, 55 patients with stage II and III (stage II n = 18, stage III n = 37) had been reported. Median age was 4.3 years [0.1–17.8], median duration of follow-up 6.0 years [0–16.7]. 3-year event-free survival (EFS) rate was 76.5% and 49.8% (p = 0.088), respectively. In stage II tumors, neither the five-item score (p = 0.872) nor pS-GRAS grouping (p = 0.218) had any effect as prognostic factors. In stage III patients, EFS was impaired in tumors with unfavorable histology according to the five-item score (100% vs. 30.8%, p = 0.018). No difference was observed for pS-GRAS groups (p = 0.798). Conclusions: In patients with COG stage III, but not stage II, the five-item score affected EFS. Further studies are needed to identify patients at risk in COG stage II

Outcome for pediatric adreno-cortical tumors is best predicted by the COG stage and five-item microscopic score — report from the German MET studies

Background: Adrenocortical tumors (ACTs) encompassing the adrenocortical adenoma (ACA), carcinoma (ACC), and tumors of undetermined malignant potential (ACx) are rare endocrine neoplasms with a poor prognosis. We report on pediatric ACT patients registered with the Malignant Endocrine Tumor studies and explore the EXPeRT recommendations for management. Patients: Data from the ACT patients (<18 years) were analyzed. For the risk prediction, the patients were retrospectively assigned to the COG stages and the five-item score. Results: By December 2021, 161 patients with ACT (ACA n = 51, ACx n = 19, and ACC n = 91) had been reported (the median age at the diagnosis was 4.3 years with a range of 0.1–17.8), with lymph node and distant metastases in 10.7% and 18.9% of the patients with ACC/ACx. The mean follow-up was 4.5 years (with a range of 0–16.7). The three-year overall (OS) and event-free survival (EFS) rates were 65.5% and 50.6%. In the univariate analyses, the OS was impaired for patients aged ≥ 4 years (p = 0.001) with the initial biopsy (p = 0.016), tumor spillage (p = 0.028), incomplete tumor resection (p < 0.001), unfavorable histology (p = 0.047), and COG stages III/IV (p = 0.002). Multivariate analysis revealed COG stages III/IV and an unfavorable five-item score as independent negative prognostic factors for the EFS and OS. Conclusions: Age defines the clinical presentation and prognosis in pediatric ACTs. The outcome is best predicted by the COG stage and five-item score

Refractory and relapsed paediatric ACC in the MET studies – a challenging situation necessitating novel diagnostic and therapeutic concepts

Background Paediatric adrenocortical carcinomas (ACC) are highly aggressive malignancies with a dismal prognosis in advanced and metastatic disease. Little is known about outcome of patients with refractory and relapsed (r/r) disease. Procedure National retrospective multicentre study including r/r ACC diagnosed in patients aged <18 years registered in the MET studies between January 1997 and December 2021 Results A total of 16 patients (5 male; median age 12.9 years) with refractory disease were included. Median time to progression was 0.6 years [0.0-1.3]. Site of progression was locoregional (n=1), distant (n=3), and combined (n=12). 3-year overall (OS) and progression-free (PFS) survival were both 0%. Thirty patients with relapse (11 male; median age 7.3 years) were identified. Median time to relapse was 0.7 years [0.1-3.2]. Site of relapse was locoregional (n=8), distant (n=15), and combined (n=7). At last follow-up, 20 patients had died of disease or complications or were alive with disease, 10 patients were in second complete remission (median follow-up: 6.8 years [0-10.5]). 3-year OS and PFS following relapse were 39.1% and 31.9%. Survival was superior in patients with distant relapse (59.6%) compared to locoregional (28.6%) and combined (14.3%) (p=0.028) and in patients with complete surgical resection of all sites of recurrence (70.0%) compared to incomplete (21.4%) and no surgery (0%) (p=0.003). Conclusions For patients nonresponsive to first-line therapy or who experience relapse, prognosis is dismal and options are scarce. Site of relapse and resectability define prognosis. Novel therapeutic concepts are needed to improve the outcome of paediatric patients with r/r ACC

Trans-ancestry genome-wide association meta-analysis of prostate cancer identifies new susceptibility loci and informs genetic risk prediction.

Prostate cancer is a highly heritable disease with large disparities in incidence rates across ancestry populations. We conducted a multiancestry meta-analysis of prostate cancer genome-wide association studies (107,247 cases and 127,006 controls) and identified 86 new genetic risk variants independently associated with prostate cancer risk, bringing the total to 269 known risk variants. The top genetic risk score (GRS) decile was associated with odds ratios that ranged from 5.06 (95% confidence interval (CI), 4.84-5.29) for men of European ancestry to 3.74 (95% CI, 3.36-4.17) for men of African ancestry. Men of African ancestry were estimated to have a mean GRS that was 2.18-times higher (95% CI, 2.14-2.22), and men of East Asian ancestry 0.73-times lower (95% CI, 0.71-0.76), than men of European ancestry. These findings support the role of germline variation contributing to population differences in prostate cancer risk, with the GRS offering an approach for personalized risk prediction

Shared heritability and functional enrichment across six solid cancers

Correction: Nature Communications 10 (2019): art. 4386 DOI: 10.1038/s41467-019-12095-8Quantifying the genetic correlation between cancers can provide important insights into the mechanisms driving cancer etiology. Using genome-wide association study summary statistics across six cancer types based on a total of 296,215 cases and 301,319 controls of European ancestry, here we estimate the pair-wise genetic correlations between breast, colorectal, head/neck, lung, ovary and prostate cancer, and between cancers and 38 other diseases. We observed statistically significant genetic correlations between lung and head/neck cancer (r(g) = 0.57, p = 4.6 x 10(-8)), breast and ovarian cancer (r(g) = 0.24, p = 7 x 10(-5)), breast and lung cancer (r(g) = 0.18, p = 1.5 x 10(-6)) and breast and colorectal cancer (r(g) = 0.15, p = 1.1 x 10(-4)). We also found that multiple cancers are genetically correlated with non-cancer traits including smoking, psychiatric diseases and metabolic characteristics. Functional enrichment analysis revealed a significant excess contribution of conserved and regulatory regions to cancer heritability. Our comprehensive analysis of cross-cancer heritability suggests that solid tumors arising across tissues share in part a common germline genetic basis.Peer reviewe

Shared heritability and functional enrichment across six solid cancers

Quantifying the genetic correlation between cancers can provide important insights into the mechanisms driving cancer etiology. Using genome-wide association study summary statistics across six cancer types based on a total of 296,215 cases and 301,319 controls of European ancestry, here we estimate the pair-wise genetic correlations between breast, colorectal, head/neck, lung, ovary and prostate cancer, and between cancers and 38 other diseases. We observed statistically significant genetic correlations between lung and head/neck cancer (r(g) = 0.57, p = 4.6 x 10(-8)), breast and ovarian cancer (r(g) = 0.24, p = 7 x 10(-5)), breast and lung cancer (r(g) = 0.18, p = 1.5 x 10(-6)) and breast and colorectal cancer (r(g) = 0.15, p = 1.1 x 10(-4)). We also found that multiple cancers are genetically correlated with non-cancer traits including smoking, psychiatric diseases and metabolic characteristics. Functional enrichment analysis revealed a significant excess contribution of conserved and regulatory regions to cancer heritability. Our comprehensive analysis of cross-cancer heritability suggests that solid tumors arising across tissues share in part a common germline genetic basis