Primär- und Intervall-Tumor-Debulking des fortgeschrittenen Ovarialkarzinoms : Morbidität und Mortalität bei Patientinnen mit postoperativem Tumorrest

Mehr als die Hälfte der Ovarialkarzinome werden im fortgeschrittenen Stadium diagnostiziert, da es sehr spät zu Symptomen kommt. Im Stadium III/IV ist die Ausbreitung in den Bauchraum mit möglichem infiltrativen Wachstum in die Abdominalorgane sehr häufig. Das Hauptziel der Untersuchung war es herauszufinden, welche Auswirkungen Darmresektionen bei Patientinnen mit fortgeschrittenem Ovarialkarzinom, die postoperative Tumorreste aufwiesen ( Bei dieser retrospektiven, observatorischen Studie wurden 96 von 287 Patientinnen mit makroskopischem Tumorrest nach zytoreduktiver Operation identifiziert, die mit fortgeschrittenem Ovarialkarzinom im Zeitraum von 2002-2013 in der Universitätsfrauenklinik Bonn behandelt wurden. Die Analyse zeigt eine signifikant höhere Rate von leichten und schweren Komplikationen bei Patientinnen mit Darmresektion. Bei der Unterteilung in bestimmte Arten der Darmresektion konnten keine wesentlichen Unterschiede zwischen der Anzahl an leichten und schweren Komplikationsraten festgestellt werden. Hinsichtlich der chirurgischen und perioperativen Parameter zeigten sich bei den Patientinnen bei Durchführung einer Darmresektion längere Operationszeiten, erhöhte Blutverluste, vermehrte Gabe von PRCBs und FFPs und eine verlängerte Aufenthaltsdauer auf der IMC-Station. Entsprechend der erhöhten Komplikationsrate bei stattgehabter Darmresektion konnte eine erhöhte Rate an Anastomoseninsuffizienzen festgestellt werden, sowie eine erhöhte Mortalität bei Patientinnen mit mehr als 2 Anastomosen. Nicht signifikant, dennoch verkürzt war das mediane Überleben der Frauen mit Darmresektion. Aufgrund der Auswertung der vorliegenden Ergebnisse, wird die Einführung einer personalisierten Chirurgie für Patientinnen mit Ovarialkarzinom empfohlen. Die vorliegenden Daten belegen, dass eine Darmresektion nur dann vorgenommen werden sollte, wenn diese die Lebensqualität der Patientinnen postoperativ verbessern kann. Ein positiver Einfluss auf die Überlebenszeit der Patientinnen ist bei verbleibendem Tumorrest durch die Darmresektion nicht zu erreichen. Nach Entfernung der Haupttumormasse sollte eine ausführliche intraoperative Beurteilung der Durchführbarkeit einer kompletten Zytoreduktion vorgenommen werden. Wenn eine vollständige Zytoreduktion nicht möglich erscheint, sollte der Chirurg von einem radikalen Debulking-Verfahren absehen und sich auf Behandlungsmethoden beschränken, welche sich positiv auf die Lebensqualität und die individuelle Leistungsfähigkeit der Patientinnen auswirken

The influence of alcohol consumption on attractiveness ratings: The “Beer Goggles” effect

This research project investigates the so-called "Beer Goggles Effect", the phenomenon that individuals under the influence of alcohol perceive others as more attractive. The study aims to examine how different levels of alcohol consumption affect the attractiveness ratings of portrait images categorized as either attractive or unattractive. Specifically, we explore whether alcohol intoxication leads to higher attractiveness ratings, and whether this effect varies depending on the initial attractiveness of the faces and the level of intoxication. We will include 48 participants (24 male, 24 female) between the ages of 21 and 35 which will be randomly assigned to one of three experimental conditions: a placebo group (non-alcoholic beer), a low-dose group (4% alcohol), and a high-dose group (7% alcohol). After a 15-minute absorption period, participants were asked to rate 10 opposite-sex portrait photos (5 attractive, 5 unattractive) using a 10-point Likert scale. We expect the ratings of the attractive images to increase with alcohol consumption and the ratings of the unattractive images to decrease

Vision Restoration through transorbital electrical stimulation in Optic Neuropathy in patients with significant optic atrophy due to primary open-angle glaucoma—a randomised, controlled, double-blind, multicentre clinical trial: the VIRON study protocol

Introduction Glaucoma is one of the most common causes of blindness and affects more than 70 million people worldwide. The disease is characterised by the loss of retinal ganglion cells associated with a progressive optic neuropathy, resulting in an impairment of visual functions, for example, visual field loss. Nowadays, the only modifiable risk factor is the increase in intraocular pressure, and its treatment is to lower this pressure by medication, laser treatment or surgery to avoid disease progression. New methods for preventing and reversing vision loss are thus urgently needed. Several small and two multicentre studies have presented evidence that repetitive transorbital alternating current stimulation (rtACS) can lead to long-lasting visual field improvement. This could open a new and inexpensive therapeutic option for optic atrophy. However, the level of evidence for this method is still fairly rather poor, and further trials are needed. Therefore, this clinical trial aims to prove the effectiveness of rtACS compared with sham stimulation in patients with primary open-angle glaucoma (POAG). Methods and analysis VIRON (Vision Restoration in Optic Neuropathy) is a national, multicentre, prospective, randomised, placebo-controlled, double-blind trial with three arms. The primary objective is to assess the effectiveness of rtACS in patients with POAG compared with sham stimulation. The primary outcome is the change in mean defect (MD) in the visual field immediately after 10 sessions of rtACS (days 9, 16 and 23) compared with the values of initial perimetry (days −21 to –14 and 0) after applying electrical stimulation with a classical montage, compared with sham and electrical stimulation using individualised montage. Secondary outcome measures comprise a long-term effect with changes in MD at 24 weeks after stimulation, and data from the National Eye Institute Visual Function-25 and quality of life (Short Form 36) questionnaires. The target population are patients with glaucomatous optic atrophy and significant glaucomatous visual field defects (MD of 5–22 dB) due to POAG. After randomisation, patients received either classical rtACS (group 1), individual rtACS (group 2) or sham stimulation (group 3) in daily 25 min stimulation sessions in two series of five consecutive days separated by a weekend interval. In group 1, active stimulation will be via the routinely applied montage using two electrodes affixed on the right and left side of the head, next to the eyes, with straightforward fixation. In group 2, the current flow will be individually modelled (MRI-based) to target areas of partial visual field defects by optimising electrode positions in conjunction with an optimised visual fixation direction. Group 3 with sham stimulation will serve as control. The calculated sample size required to achieve a statistical power of 80% for a relevant effect size and allow for dropouts was 300 (100 per group). The trial has already begun with the first patient in July 2023. The planned recruitment period is 24 months with an estimated end of the study in November 2025 (last patient out). An adjusted extension of the study period is planned. Ethics and dissemination VIRON was approved by the Central Ethics Committee of the University Medical Center Göttingen (19 October 2022) and those of the individual participating centres (Bonn: 446/23-EP, Hamburg: 2023-200889-BO-bet, Cologne: 23-1487 and Mainz: 2023-17399-§23b). The study protocol complies with the Declaration of Helsinki, the national medicine device regulation (MDR) laws and the international standards of good clinical practice (GCP). The study protocol (V.5, 24 November 2023) was designed following the Standard Protocol Items: Recommendations for Interventional Trials guidelines and is registered on https://drks.de/search/de/trial/DRKS00029129 . As study initiatior the University Medical Center Göttingen (UMG) is responsible for data ownership and data management of the VIRON study. The study data will be published within 6 months of the study being completed. After the publication of the primary results, all data are anonymised and published in an open-access journal to ensure access to the data for third parties. Trial registration number https://drks.de/search/de/trial/DRKS00029129 .German Research Foundation 50110000165

Influence of the non-metal species on the oxidation kinetics of Hf, HfN, HfC, and HfB2 coatings

The influence of the non-metal species on the oxidation resistance of transition metal ceramic based thin films is still unclear. For this purpose, we thoroughly investigated the oxide scale formation of a metal (Hf), carbide (HfC0.96), nitride (HfN1.5), and boride (HfB2.3) coating grown by physical vapor deposition. The non-metal species decisively affect the onset temperature of oxidation, ranging between 550 °C for HfC0.96 to 840 °C for HfN1.5. HfB2.3 and HfN1.5 obtain the slowest oxide scale kinetic following a parabolic law with kp values of 4.97∙10-10 and 5.66∙10-11 kg2 m-4 s−1 at 840 °C, respectively. A characteristic feature for the oxide scale on Hf coatings, is a columnar morphology and a substantial oxygen inward diffusion. HfC0.96 reveals an ineffective oxycarbide based scale, whereas HfN1.5 features a scale with globular HfO2 grains. HfB2.3 exhibits a layered scale with a porous boron rich region on top, followed by a highly dense and crystalline HfO2 beneath. Furthermore, HfB2.3 presents a hardness of 47.7 ± 2.7 GPa next to an exceptional low inward diffusion of oxygen during oxidation. This study showcases the strong influence of the non-metallic bonding partner despite the same metallic basis, as well as the huge potential for HfB2 based coatings also for oxidative environments

Impact of Extended Primary Surgery on Suboptimally Operable Patients With Advanced Ovarian Cancer

ObjectivesExtensive surgical efforts to achieve an optimal debulking (no residual tumor) in primary surgery of ovarian cancer are today’s criterion standard in gyneco-oncologic surgery. However, it is controversial whether extensive surgery, including resections of metastases in the upper abdomen and bowel resections, is justifiable in patients with not completely operable lesions.MethodsAll patients who had undergone surgery for ovarian cancer in the years 2002 to 2013 at our institution were viewed (n = 472). We retrospectively identified 278 operations for primary ovarian cancer. Ninety-six (35%) of the 278 patients showed postoperative tumor residuals and were included in this study.ResultsFifty-five (57%) of 96 patients underwent bowel resection, showing significantly higher complication rates (64% vs 39% minor complications, P = 0.017; 31% vs 9.8% severe complications, P = 0.013) compared with patients without bowel resections as well as no improvement in progression-free or overall survival (median overall survival, 19.5 vs 32.9; P = 0.382). Multiple anastomoses (≥2) were associated with higher rates for anastomotic leakage (16.7% vs 2.6%, P = 0.02) and a higher mortality (16.7% vs 0%, P = 0.04) compared with patients with only 1 anastomosis. Extensive surgery of the upper abdomen was not associated with a significant increase in complication rates.ConclusionsBecause of the increased morbidity of bowel resections without any evidence for improvement of survival, we suggest to restrain from further resection of intestines if an optimal debulking seems not feasible after removal of the major tumor bulk.</jats:sec

Honest HARKing W24

Beware: This Project contains FAKE data. Not only, but mostly! It is just an educational projec

College Success SS25

Wir untersuchen, inwieweit einzelne Faktoren eine Prognose über den zukünftigen Studienerfolg ermöglichen. Dazu berücksichtigen wir die Highschool-Noten in Mathematik, Naturwissenschaften und Englisch sowie das Ergebnis des Aufnahmeverfahrens. Wir gehen davon aus, dass sowohl die schulischen Leistungen als auch das Aufnahmeergebnis einen Großteil des Studienerfolgs erklären können. Besonders die Mathematiknote sowie die Gesamtnoten aus der Highschool erscheinen uns hier als entscheidende Faktoren

Honest HARKing W24, Die Vermenschlichung von Künstlicher Intelligenz. Steigt die Akzeptanz gegenüber ihr?

Beware: This Project contains FAKE data. Not only, but mostly! It is just an educational projec

Armed society: the manorial mode of forming armed groups in the Brazilian Empire

This article deals with the problem of armed violence in the political life of the Brazilian Empire. Armed violence was used often in power struggles to win the general government, in the struggles of regional elites by provincial governments and local leaders for the cities. But the research also showed that armed violence was present in social life. The men had access to weapons and used them in their interpersonal conflicts in land disputes etc. The imperial society was an armed society, that is, a society that was able to obtain and use weapons regardless of control of government bodies. This article studies specifically forms of reproduction of armed society, means that it created to remain in possession of weapons and able to use them in conflict situations. How men learned to handle weapons and fight? To answer this question it is proposed the notion of "modo senhorial de atuação armada" (manorial mode of forming armed groups to employ them in conflicts).Este artigo aborda o emprego da violência armada nas relações políticas sob o Império brasileiro. De fato, chama atenção na vida política brasileira, e num extenso período que abrange de meados do século XVIII à primeira metade do século XX, a recorrência de conflitos armados. A violência física era recurso nas disputas por poder no governo geral do país, nas lutas entre setores das elites regionais pelos governos provinciais, depois estaduais, e no controle de municípios pelas lideranças locais. O estudo do uso de armas na vida política logo mostrou que a violência armada era largamente empregada, também, na vida social do país. Os homens tinham acesso a armas e as usavam nos seus conflitos interpessoais, nas disputas por terras, etc. Ao problema geral da formação do Estado brasileiro com as lutas nas instâncias de governo juntou-se o problema de uma sociedade armada, isto é, uma sociedade que tem capacidade de obter e empregar armas independentemente das instâncias governamentais. Este artigo estuda, especificamente, as formas de reprodução da sociedade armada, os meios que ela criou para se manter na posse de armas e a capacidade para empregá-las nas situações de conflito. Numa sociedade cujas pessoas dispunham facilmente de armas, que estavam nas mãos dos senhores e das famílias, os homens precisavam saber manejá-las e lutar. Como aprendiam isso? Para responder esta pergunta propõe-se a noção de "modo senhorial de atuação armada"