Validation of the German version of the Perceived Cohesion Scale.

OBJECTIVES: Team or group cohesion is a multifaceted construct with a variety of definitions and measurement instruments. However, most of these measures are context and group-specific and/or time-consuming. There is no adaptable and economic measure of group cohesion in Germany. Therefore, the aim of this study was to validate the German version of the 6-item Perceived Cohesion Scale (PCS) in a sample of adult nurses in a German University Hospital. MATERIAL AND METHODS: The German version of the PCS was generated according to existing guidelines. Confirmatory factor analysis was conducted to assess factor structure. Reliability was tested via internal consistency. To assess convergent and divergent validity, the authors applied the Copenhagen Psychosocial Questionnaire (COPSOQ), the Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Social Support Inventory (ESSI), the Effort-Reward Imbalance (ERI) scale and the Patient Health Questionnaire (PHQ-4). RESULTS: The confirmatory factor analysis confirmed a 2-factor structure. Psychometric properties of the German PCS prove satisfactory. Internal consistency was excellent for the whole scale (α = 0.95), as well as for both subscales: sense of belonging (SOB) (α = 0.94) and morale (MOR) (α = 0.93). Moderate to strong correlations with the subscales of COPSOQ (Kendall's Tau (τ) = 0.239 - 0.471) indicated very good convergent validity. Regarding divergent validity, the correlations of the PCS subscales and the PHQ-4 were low (τ = -0.109-[-0.143]), as were the correlations with ESSI (τ = 0.045-0.136). Correlations with ERI were low to moderate (τ = -0.181-0.283). CONCLUSIONS: The German version of the PCS showed good psychometric properties. Due to its economic and universal deployment, group cohesion can be measured in a variety of contexts and settings. Int J Occup Med Environ Health. 2024;37(4).

Evaluation of endocervical curettage (ECC) in colposcopy for detecting cervical intraepithelial lesions.

PURPOSE: Diagnostic challenges in colposcopy arise especially in women aged 50 or older, with postmenopausal status and transformation zone type 3 (TZ3). Endocervical curettage (ECC) is a valuable tool for diagnosing intracervical lesions. The aim of this retrospective analysis was to evaluate the use of ECC in colposcopy for detecting cervical intraepithelial lesions. METHODS: A retrospective study was carried out of colposcopies performed in the certified Dysplasia Unit at Erlangen University Hospital between July 2016 and June 2023. Pap and human papillomavirus (HPV) results were correlated with the histologic findings via ECC, obtained during examinations or surgery. The primary outcome was the rate of accuracy between the colposcopic and histologic findings with regard to cytology, age of patients, and type of transformation zone (TZ). RESULTS: A total of 429 colposcopies in 413 women with histologic samples obtained via ECC were included in the final analysis. In all, 355 women had TZ3. Among patients with TZ3, evidence of high-grade lesions and invasive carcinoma was also found in women with normal or low-grade abnormal cytology. For patients with normal colposcopic findings, cervical intraepithelial neoplasia (CIN) 2 and CIN 3/adenocarcinoma in situ (AIS) were found in 56 patients (16%), and invasive carcinoma was found in four patients (0.1%). CONCLUSION: This analysis suggests that ECC is a valuable tool in the diagnosis of cervical intraepithelial neoplasia, especially for patients who present with a normal colposcopy of the cervix and vagina but have either recurrent abnormal cytologic findings or high-grade abnormal cytology indicating CIN 2 + .

A longitudinal 5-year study for the prediction of HCC, death and liver decompensation by ARFI elastography.

AIM: Numerous studies have evaluated elastography for the staging of liver fibrosis. Fewer studies were performed investigating the prognostic relevance using transient elastography (TE), although with promising results. This study was designed to evaluate the prognostic relevance of ARFI elastography. MATERIAL AND METHOD: Patients receiving ARFI elastography in our ultrasound department between 2010 and 2012 were initially screened for an ARFI examination with a clinical follow-up of at least 5 years. The following events were recorded: liver related death, liver unrelated death, HCC, liver decompensation/ variceal bleeding. RESULTS: A total of 335 patients were included in the final analysis with an ARFI examination of the liver and a follow-up of 60 months. Within the observation interval the number of events with corresponding AUROCs (shown with 95% confidence interval) were: overall death (n=49, 0.76 [0.69 - 0.83]), liver related death (n=25, 0.85 [0.77 - 0.93]), liver unrelated death (n=24, 0.66 [0.55 - 0.77]), HCC (n=15, 0.80 [0.72 - 0.87]), liver related complications/variceal bleeding (n=34, 0.87 [0.82 - 0.93]). In the group of patients with ARFI values suggestive of cirrhosis (equal to or above 1.80 m/s; n=110) higher values (<2.5 m/s vs. >= 2.5 m/s) where associated with a significant decline in liver related survival (p=0.007). CONCLUSION: ARFI elastography seems to have a good diagnostic accuracy for the prediction of liver related death and decompensation. Further it seems to allow a risk stratification in patients with cirrhosis suspicious elastography values.

Impact of manual therapy on body posture-3-D analysis with rasterstereography - pilotstudy.

INTRODUCTION: The relationship between posture and temporomandibular disease (TMD) is unclear. The aim of our study was to determine the influence of manual therapy (MT) on posture in TMD patients compared with healthy subjects. MATERIAL/METHOD: After consideration of inclusion and exclusion criteria, 30 subjects were included. These were divided into two groups: group A comprised 15 healthy subjects and group B 15 patients with present proven TMD disease. Rasterstereographic images were taken at different times. Group A subjects were scanned twice within half a year and group B before initiation as well as after the first MT and after completion of the prescribed MT. The different posture variables were calculated using DIERS Formetric software. RESULTS: To illustrate the differences between the two groups, 10 different postural variables were examined. Significant differences between the two groups were observed in pelvic tilt, surface rotation, and kyphotic apex. Pelvic tilt: mean = 7.581, p-value = 0.029; surface rotation: mean = 3.098, p = 0.049; and mean kyphotic apex = 11.538 and 11.946, respectively, with p-values of 0.037 and 0.029, respectively. CONCLUSION: MT leads to a change in posture in TMD patients. This could influence the course of TMD treatment.

Investigation of Morphological Changes of the Soft Tissue in the Aesthetic Zone: A 3D Virtual Analysis after Conventional Tooth Extraction and Benex® Extraction.

BACKGROUND: Postoperative resorption of hard and soft tissues occurs as a consequence of tooth extraction. The Benex®-Control extractor allows minimally invasive extraction of the tooth without causing pronounced iatrogenic trauma. The aim of this study was to verify whether the resorption of the tissues after extraction can be reduced by using the Benex® system compared to the conventional extraction method. METHODS: Postoperative intraoral scans were superimposed after surgery (t0), after 7 days (t1), after 14 days (t2), after 30 days (t3), after 60 days (t4), and after 90 days (t5) within the two groups (study n = 14, control n = 16), and defined regions of interest (ROIs) (1-8) and volume changes were analyzed. In addition, the influence of gingival thickness and the thickness of the labial cortical plate was investigated. RESULTS: The greatest decrease in volume was observed in both groups in ROI3, although there was no significant difference observed between the groups. In the presence of an adjacent tooth, there was less volume loss in the affected ROIs (1, 2 and 7, 8). The thickness of the gingiva and the bony lamella did not significantly influence the change in volume. CONCLUSIONS: Due to the small cohort, the results are limited, and the hypothesis is rejected.

Three-Month Follow-Up of the Post-COVID Syndrome after Admission to a Specialised Post-COVID Centre-A Prospective Study Focusing on Mental Health with Patient Reported Outcome Measures (PROMs).

BACKGROUND AND OBJECTIVE: The impairments and duration of PASC (post-acute sequelae of COVID-19) symptoms in mental health have, to date, not been comprehensively examined. Our objective is to provide longitudinal data on the mental health of Post-COVID patients and to identify risk and protective factors associated with a severe or prolonged course. METHODS: The mental health of 265 Post-COVID patients of the outpatient Post-COVID centre of the University Hospital Erlangen was assessed 17.1 (T0) and 22.5 months after infection (T1). An online survey with validated questionnaires for Post-COVID symptoms (Post-COVID Syndrome Score), depression (Patient Health Questionnaire-9), somatic symptoms (Patient Health Questionnaire-15), anxiety (Generalized Anxiety Disorder-7), fatigue (Fatigue Severity Scale) and Post-Exertional Malaise (PEM) (DePaul Post-Exertional Malaise Screening) was conducted in the home environment. RESULTS: In total, 80% of patients experienced severe PASC at follow-up. Clinically relevant symptoms of depression, persistent somatic symptoms, anxiety and fatigue were reported by 55.8%, 72.5%, 18.9% and 89.4% of patients, respectively. Depressive, anxiety and somatic symptom severity decreased significantly over time; fatigue and PEM remained at an unchanged high level. The risk factor for higher depression scores was older age; prior psychiatric illness treated with psychotherapy was associated with more severe depressive, somatic, anxiety and PASC symptoms. PEM symptoms were significantly associated with longer duration between acute infection and initial presentation in the Post-COVID centre. CONCLUSIONS: Our findings align with previous research, claiming severe mental health symptoms in PASC syndrome, lasting for months after infection. In-depth assessment of risk and protective factors for the mental health implications of PASC is needed for the planning of health services and disease prevention.

The Influence of Climatic Factors on the Provocation of Epileptic Seizures.

Background/Objectives: Recent studies provide the first indications of the impact of climate factors on human health, especially with individuals already grappling with internal and neurological conditions being particularly vulnerable. In the face of escalating climate change, our research delves into the specific influence of a spectrum of climatic factors and seasonal variations on the hospital admissions of patients receiving treatment for epileptic seizures at our clinic in Kaiserslautern. Methods: Our study encompassed data from 9366 epilepsy patients who were admitted to hospital due to epileptic seizures. We considered seven climate parameters that Germany's National Meteorological Service made available. We employed the Kruskal-Wallis test to examine the correlation between the frequency of admittance to our hospital in the mentioned patient group and seasons. Furthermore, we used conditional Poisson regression and distributed lag linear models (DLMs) to scrutinize the coherence of the frequency of patient admittance and the investigated climate parameters. The mentioned parameters were also analyzed in a subgroup analysis regarding the gender and age of patients and the classification of seizures according to ILAE 2017. Results: Our results demonstrate that climatic factors, such as precipitation and air pressure, can increase the frequency of hospital admissions for seizures in patients with general-onset epilepsy. In contrast, patients with focal seizures are less prone to climatic changes. Consequently, admittance to the hospital for seizures is less affected by climatic factors in the latter patient group. Conclusions: The present study demonstrated that climatic factors are possible trigger factors for the provocation of seizures, particularly in patients with generalized seizures. This was determined indirectly by analyzing the frequency of seizure-related emergency admissions and their relation to prevailing climate factors. Our study is consistent with other studies showing that climate factors, such as cerebral infarcts or cerebral hemorrhages, influence patients' health.

The course of tumor-related epilepsy in glioblastoma patients: A retrospective analysis.

PURPOSE: Many patients with glioblastoma suffer from tumor-related seizures. However, there is limited data on the characteristics of tumor-related epilepsy achieving seizure freedom. The aim of this study was to characterize the course of epilepsy in patients with glioblastoma and the factors that influence it. METHODS: We retrospectively analyzed the medical records of glioblastoma patients treated at the University Hospital Erlangen between 01/2006 and 01/2020. RESULTS: In the final cohort of patients with glioblastoma (n = 520), 292 patients (56.2 %) suffered from tumor-related epilepsy (persons with epilepsy, PWE). Levetiracetam was the most commonly used first-line antiseizure medication (n = 245, 83.9 % of PWE). The onset of epilepsy was preoperative in 154/292 patients (52.7 %). 136 PWE (46.6 %) experienced only one single seizure while 27/292 PWE (9.2 %) developed drug-resistant epilepsy. Status epilepticus occurred in 48/292 patients (16.4 %). Early postoperative onset (within 30 days of surgery) of epilepsy and total gross resection (compared with debulking) were independently associated with a lower risk of further seizures. We did not detect dose-dependent pro- or antiseizure effects of radiochemotherapy. CONCLUSION: Tumor-related epilepsy occurred in more than 50% of our cohort, but drug-resistant epilepsy developed in less than 10% of cases. Epilepsy usually started before tumor surgery.

Effect of Luting Materials on the Accuracy of Fit of Zirconia Copings: A Non-Destructive Digital Analysis Method.

The marginal accuracy of fit between prosthetic restorations and abutment teeth represents an essential aspect with regard to long-term clinical success. Since the final gap is also influenced by the luting techniques and materials applied, this study analyzed the accuracy of the fit of single-tooth zirconia copings before and after cementation using different luting materials. Forty plaster dies with a corresponding zirconia coping were manufactured based on a single tooth chamfer preparation. The copings were luted on the plaster dies (n = 10 per luting material) with a zinc phosphate (A), glass-ionomer (B), self-adhesive resin (C), or resin-modified glass-ionomer cement (D). The accuracy of fit for each coping was assessed using a non-destructive digital method. Intragroup statistical analysis was conducted using Wilcoxon signed rank tests and intergroup analysis by Kruskal-Wallis and Mann-Whitney U tests (α = 0.05). Accuracy of fit was significantly different before/after cementation within A (0.033/0.110 µm) and B (0.035/0.118 µm; p = 0.002). A had a significantly increased marginal gap compared to C and D, and B compared to C and D (p ≤ 0.001). Significantly increased vertical discrepancies between A and B versus C and D (p < 0.001) were assessed. Of the materials under investigation, the zinc phosphate cement led to increased vertical marginal discrepancies, whereas the self-adhesive resin cement did not influence the restoration fit.

Intraday repeatability of macular layers measurements in glaucomatous and non-glaucomatous patients using spectral-domain optical coherence tomography.

PURPOSE: To assess the intraday repeatability of macular architecture measurements in glaucomatous and non-glaucomatous patients using spectral-domain optical coherence tomography (SD-OCT) and to evaluate the independence from intraindividual intraocular pressure (IOP) fluctuations. METHODS: In this single-center, time-point comparison study, 88 eyes with glaucoma, 53 eyes with ocular hypertension (OHT), and 253 healthy eyes underwent two standardized SD-OCT and intraocular pressure (IOP) measurements on the same day with a 5-h time gap. Bland-Altman plots, intraclass correlation coefficients (ICC), and random-effects model were used to analyze repeatability of entire retinal thickness, retinal nerve fiber layer, ganglion cell layer, inner plexiform layer, and inner nuclear layer measurements. RESULTS: Intraday measurements were highly reproducible in all 3 groups. ICC were greater than 0.90, respectively. The pairwise comparisons of morphometric parameters showed a statistically significant difference (P < 0.001, respectively) between groups (glaucoma vs. control, glaucoma vs. OHT) and a significant influence of time points. No correlation was found between IOP fluctuations and morphometric parameters (P > 0.05, respectively), except for a weak positive correlation with GCL (rho = 0.109, P = 0.031). CONCLUSIONS: The evaluation of macular morphometric parameters of SD-OCT showed a high intraday repeatability and an excellent degree of agreement in glaucoma, ocular hypertension, and healthy groups. The fixed effects of time points were statistically significant. Except for a weak positive correlation of ganglion cell layer, variability did not appear to be affected by intraday IOP changes. Additional research is required to fully understand the impact of IOP fluctuations on macular morphometric parameters, considering the small observed IOP changes.

Using Heart Rate Variability to Assess Nurses' Stress During the COVID-19 Pandemic.

OBJECTIVE: This study aimed to assess subjective and objective parameters of stress among nurses during the COVID-19 pandemic and to examine the recovery effect of a day off. METHODS: In this prospective observational trial, we measured heart rate variability (using a wearable device) and perceived stress levels on 3 working days and 1 day off. We obtained the following data using an online questionnaire: working conditions, COVID-19-related problems, depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), effort-reward imbalance, and work-family conflict in a sample of German nurses (N = 41). RESULTS: When comparing working days with a day off, we observed a significant difference for physical load (Cohen's d = 0.798, P < .001), mental load (Cohen's d = 0.660, P = .001), emotional exhaustion (Cohen's d = 0.945, P < .001), and overburdening (Cohen's d = 0.585, P = .002) with higher scores on working days. Regarding heart rate variability, we did not find a difference. Correlational analyses revealed a significant association between being afraid to get infected with COVID-19 and lower heart rate variability (r = -0.336, P = .045) and between being afraid to infect relatives and lower heart rate variability (r = -0.442, P = .007). Furthermore, a higher total sum score of work-family conflict was significantly associated with lower heart rate variability (r = -0.424, P = .01). CONCLUSION: As heart rate variability observations were different from those regarding subjectively perceived stress, further studies are needed to evaluate and differentiate the influence of work stress and other types of stress on heart rate variability.

Impact of Scanbody Geometry and CAD Software on Determining 3D Implant Position.

The implementation of CAD software in the digital production of implant prosthetics stands as a pivotal aspect of clinical dentistry, necessitating high precision in the alignment of implant scanbodies. This study investigates the influence of scanbody geometry and the method of superimposing in CAD software when determining 3D implant position. A standardized titanium model with three bone-level implants was digitized to create reference STL files, and 10 intraoral scans were performed on Medentika and NT-Trading scanbodies. To determine implant position, the generated STL files were imported into the Exocad CAD software and superimposed-automatically and manually-with the scanbody geometries stored within the software's shape library. Position accuracy was determined by a comparison of the 3D-defined scanbody points from the STL matching files with those from the reference STL files. The R statistical software was used for the evaluation of the data. In addition, mixed linear models and a significance level of 0.05 were applied to calculate the p-values. The manual overlay method was significantly more accurate than the automatic overlays for both scanbody types. The Medentika scanbodies showed slightly superior precision compared to the NT-Trading scanbodies. Both scanbody geometry and the type of alignment in the CAD software significantly affect digital workflow accuracy. Manual verification and adjustment of the automatic alignment process are essential for precise implant positioning.

Paradoxical effect of anti-inflammatory drugs on IL-6 mRNA expression in patients with PTSD during treatment.

The pathophysiology of posttraumatic stress disorder (PTSD) is associated with the activation of the innate immune system, including cytokines like interleukin 6 (IL-6). However, the role of IL-6 in the etiology and treatment of PTSD still remains elusive. We conducted a prospective controlled trial to investigate the development of IL-6 during psychosomatic treatment in individuals with PTSD in comparison with individuals without PTSD. We assessed IL-6 mRNA expression before and after 2 months of psychosomatic treatment in individuals with and without PTSD. Severities of PTSD and depressive symptoms were assessed in parallel. Linear mixed regression was applied for statistical analysis, including the factors diagnosis PTSD and pre-post treatment after subgrouping for intake of anti-inflammatory drugs. The development of IL-6 mRNA expression during treatment was affected by the use of anti-inflammatory drugs. In the subgroup without intake of anti-inflammatory drugs, no significant statistical treatment effect in individuals with and without PTSD emerged. In the subgroup of individuals taking anti-inflammatory drugs, a significant interaction effect of the factors pre-post treatment and diagnosis PTSD was observed. Whereas IL-6 mRNA expression in individuals without PTSD decreased according to amelioration of symptoms, IL-6 mRNA expression in individuals with PTSD increased significantly during treatment, in opposite direction to symptom severity. Anti-inflammatory drugs might affect IL-6 mRNA expression in individuals with PTSD in a paradoxical way. This study offers a further piece of evidence that IL-6 could be involved in the pathophysiology of PTSD and PTSD-specific immunologic molecular mechanisms.

A comparative study of cystoid macula edema following glaucoma drainage device surgery versus trabeculectomy.

PURPOSE: To assess and compare the risk for development of cystoid macula edema (CME) after glaucoma drainage device (GDD) implantation versus conventional trabeculectomy with mitomycin (trab) for glaucoma. METHODS: Retrospective review of consecutive patients receiving trab or GDD implantation between 2016 and 2018. Inclusion criteria were availability of pre- and postoperative spectral domain optical coherence tomography (SD-OCT) of the macula. SD-OCT images were evaluated for presence of CME qualitatively, central subfield thickness (CST) and macular volume (MV). RESULTS: 73 eyes could be included, 42 received trab and 31 GDD surgery. Eyes receiving trab on average had 0.8 ± 0.8 previous intraocular operations, while eyes with GDD implantation had 3.1 ± 1.9 (p < 0.001). Occurrence of postoperative CME was significantly more frequent after GDD implantation (6 out of 31 (19.4%)) than after trab (2 out of 42 eyes = 4.8%), (p = 0.049). Mean preoperative CST as well as MV was comparable in both groups (CST before trab: 282.7 ± 23.0 µm, CST before GDD 284.2 ± 27.3 µm, p = 0.287; MV before trab: 7.8 ± 1.1 mm3, MV before GDD: 8.0 ± 0.8mm3, p = 0.305). Mean postoperative CST and MV were significantly higher after GDD (CST 338.5 ± 129.3 µm, MV 8.8 ± 2.6 mm3) than after trabeculectomy (CST 290.6 ± 60.2 µm, p = 0.038; MV 7.8 ± 1.2mm3, p = 0.039). CONCLUSIONS: In real-life conditions, GDD surgery seems to be associated with a higher risk to develop CME when compared to conventional trabeculectomy. This information may be helpful for glaucoma surgeons to advise the patients on postoperative risks of surgery.

Depression and anxiety among nurses during the COVID-19 pandemic: Longitudinal results over 2 years from the multicentre VOICE-EgePan study.

AIMS: To examine symptoms of depression and generalised anxiety among nurses over 2 years during the pandemic and compare them to the general population. BACKGROUND: The COVID-19 pandemic has led to a significant increase in mental stress among the population worldwide. Nursing staff have been identified as being under remarkable strain. DESIGN: A multicentre prospective longitudinal study. METHODS: Symptoms of depression and generalised anxiety in 507 nurses were examined at four different time points (T1: April-July 2020, T2: November 2020-January 2021, T3: May-July 2021, T4: February-May 2022). Results were compared with values of the German general population, presence of gender-specific differences was analysed and frequencies of clinically relevant levels of depression and anxiety were determined. RESULTS: Throughout the study (T1-T4), a significant increase in depressive and anxiety symptoms was observed. At all four measurement time points, nurses showed significantly higher prevalence for depression and anxiety compared to the German general population. No significant gender differences were found. Frequencies for probable depression and generalised anxiety disorder among nurses were: 21.6% and 18.5% (T1), 31.4% and 29.2% (T2), 29.5% and 26.2% (T3), 33.7% and 26.4% (T4). CONCLUSION: During the pandemic, symptoms of depression and generalised anxiety among nurses increased significantly and remained elevated. Their symptom levels were permanently higher than in the general population. These findings strongly suggest that the circumstances of the pandemic severely affected nurses´ mental health. RELEVANCE TO CLINICAL PRACTICE: The COVID-19 pandemic caused a great mental strain on caregivers. This study was able to demonstrate the significant increase in depression and anxiety among nurses during the pandemic. It highlights the urgent need for prevention, screening and support systems in hospitals. IMPLICATIONS FOR THE PROFESSION: Supportive programmes and preventive services should be developed, not least to prevent the growing shortage of nurses in the health care systems. REPORTING METHOD: The study adhered to relevant EQUATOR guidelines. The STROBE checklist for cohort study was used as the reporting method. PATIENT CONTRIBUTION: Five hundred and seven nurses completed the questionnaire and provided data for analysis. TRIAL AND PROTOCOL REGISTRATION: The study was registered with the German Clinical Trials Register (https://drks.de/search/en) under the following ID: DRKS00021268.

Impact of the Corona Pandemic on Cervical Cancer Screening Assessment.

BACKGROUND/AIM: The global impact of the COVID-19 pandemic resulted in disruptions to healthcare systems throughout the world. The numbers of cytology examinations, human papillomavirus (HPV) tests, and women referred for colposcopy decreased in many countries. There have been no reports on cervical cancer screening in Germany. This study aimed to describe changes in the numbers of colposcopies, cytology examinations, HPV tests, and histological results during the pandemic compared to the pre-pandemic years in order to evaluate the impact of the COVID-19 pandemic on cervical cancer screening. PATIENTS AND METHODS: The numbers of colposcopies, cytology examinations, HPV tests, and histologic results were analyzed retrospectively for the period January 2018 to December 2022. The 2 years period before the pandemic (2018 and 2019) were compared with the 3 years period of the pandemic (2020-2022). RESULTS: In total, 6,518 colposcopies were performed in 5,579 women. The numbers of colposcopies, cytology examinations, and high-risk HPV (hrHPV) tests increased during the pandemic years. The number of biopsies per year taken was stable (range=450-554). The relative numbers of cervical intraepithelial neoplasia (CIN) III/HSIL findings were stable, while the numbers of cervical cancers identified increased slightly from 15 (6.6%) in 2018 to 22 (7.4%) in 2022. CONCLUSION: Increases in numbers of women examined and colposcopies were observed in the years 2021 and 2022 during the pandemic, in comparison to the preceding years. These also led to increases in the figures for cytology, hrHPV, histology, and operations. The onset of the pandemic occurred in the same year as a newly organized screening program started in Germany. The increases might therefore be due to the newly organized screening system.

Prognostic relevance of ARFI elastography in comparison to liver histology and the FIB-4 score.

PURPOSE: Liver histology has prognostic relevance and is used in surveillance and therapeutic strategies. This longitudinal study was designed to evaluate the prognostic relevance of ARFI elastography in comparison to liver histology and to the FIB-4 score in a 5-year observation interval. MATERIALS AND METHODS: Based on the hospital database, patients with an elastography examination of the liver between 2010-2012, a liver biopsy, and a follow-up of 5 years were included in the study. The AUROCs of the events liver-related death, HCC, and liver decompensation/variceal bleeding were calculated for ARFI elastography, liver histology, and FIB-4 and compared using the DeLong test. RESULTS: In the final analysis 113 patients were included with 30 (26.5 %) patients having high-grade fibrosis and 19 (16.8 %) having liver cirrhosis in histology. The AUROC for liver-related death in the 5-year interval (9.7 %, n=11) was 0.80 [0.68-0.92] for ARFI elastography, 0.79 [0.66-0.92] for liver histology, and 0.66 [0.53-0.79] for FIB-4 with a p-value of 0.83 comparing ARFI to histology and a p-value of 0.02 comparing ARFI to FIB-4. The AUROC for liver decompensation/variceal bleeding (13.3 %, n=15) was 0.86 [0.76-0.94] for ARFI, which is significantly higher than the AUROC of liver histology with 0.71 [0.56-0.86] (p=0.02) and FIB-4 with 0.67 [0.54-0.80] (p=0.003). There was no significant difference for the event HCC when comparing ARFI to histology (p=0.33) or FIB-4 (p=0.14). CONCLUSION: The prognostic value of ARFI elastography seems to not be inferior to liver histology regarding liver-related survival and might even outperform histology and the FIB-4 score for predicting some liver-related complications.

Prevalence of carotid artery calcification detected by different dental imaging techniques and their relationship with cardiovascular risk factors, age and gender.

BACKGROUND: Atherosclerosis and its secondary diseases display a major threat to patient's health. Sequelae, like carotid artery calcification (CAC), usually develop over decades and remain asymptomatic for a long time, making preventive measures to reduce mortality and morbidity extremely important. Through panoramic radiography (PR) and cone beam computed tomography (CBCT), dentists may have helpful tools in aiding the holistic care of patients. In this context, the correlation of atherosclerotic risk factors and CAC development have not yet been sufficiently investigated. Thus, the aim of this observational radiological study was to evaluate the diagnostic value of PR compared with CBCT for the detection of CAC in patients older than 60 years. The radiological findings were correlated with gender, age, and cardiac risk factors. METHODS: PRs and CBCTs of N = 607 patients were used for the qualitative analysis and compared. Basic patient information such as age, gender, body mass index (BMI), smoking history as well as patient's detailed medical history, including heart disease and cardiovascular risk factors such as hypercholesterolemia, arterial hypertension and diabetes mellitus type II were documented and their relation to CAC provided by radiological data was estimated in the form of odds ratios (OR), which were calculated using logistic regression models. Proportions of CAC in different risk groups were compared using Fisher's exact test, the significance level was set to α ≤ 0.05. The interrater reliability of two physicians was estimated using Cohen's kappa. RESULTS: With an accuracy of 90.6%, a sensitivity of 67.5% and a specificity of 99.5% compared to CBCT, PR was a reliable method for the diagnosis of CAC. The overall detection rate for CAC was 27.8% across all age groups. Age (OR: 1.351; p = 0.021), the male sex (OR: 1.645; p = 0.006), arterial hypertension (OR: 2.217; p = < 0.001), heart disease (OR: 1.675; p = 0.006), hypercholesterolemia (OR: 1.904; p = 0.003) and chronic obstructive pulmonary disease (OR: 2.016; p = 0.036) were statistically significant risk factors. When correlated, neither history of stroke nor nicotine abuse showed any statistical significance. CONCLUSIONS: Due to the capabilities of PR in the diagnosis of CAC, dentists can play a vital role in the early diagnosis of vascular disease. Awareness should therefore be raised among dentists regarding the detection of CAC in patients over 60 years of age, with a particular focus on those with arterial hypertension and hypercholesterolaemia.

Evaluation of finger cartilage composition in recreational climbers with 7 Tesla T2 mapping magnetic resonance imaging.

Purpose: Sport climbing may lead to tissue adaptation including finger cartilage before apparent surface damage is detectable. The main aim was to assess finger cartilage composition with T2 mapping in young, active climbers and to compare the results to a non-climbers' collective. A secondary aim was to compare whether differences in cartilage T2 times are observed between older vs. younger volunteers. Methods and materials: 7 Tesla MRI of the fingers Dig.2-4 was performed using a multi-echo spin echo sequence. Manual segmentation of 3 ROIs at the metacarpal heads, 1 ROI at the base phalanx and 1 ROI at the proximal interphalangeal joint was performed. Included were 13 volunteers without history of trauma who are regularly performing climbing activities as a recreational sport (>20 h/month). These were age-matched with 10 control subjects not performing climbing activities. Results: Mean age was 32.4 years for the climbing group and 25.8 years for the controls. Mean T2 values for the 5 different ROIs were 42.2 ± 7.8 msec for climbers and 41.4 ± 6.8 msec for non-climbers. No significant differences were observed for T2 values between both groups. However, higher age had a significant impact on T2 values for all assessed ROIs (higher age 44.2 ± 9.5, younger age 32.9 ± 5.7, p = 0.001). Discussion: This study evaluated the cartilage composition of young, engaged climbers with a T2 mapping MRI technique with the purpose to depict early onset joint changes. No negative impact on cartilage composition due to the sport activity was found, whereas age-related effects on the cartilage seemed to be more prominent.

Clinical Characteristics and Prognosis of HER2-0 and HER2-Low-Positive Breast Cancer Patients: Real-World Data from Patients Treated with Neoadjuvant Chemotherapy.

In our study, we observed the long-term survival outcomes investigated for HER2-0 and HER2-low-positive breast cancer patients who received neoadjuvant chemotherapy. Between 1998 and 2020, 10,333 patients with primary breast cancer were treated, including 1373 patients with HER2-0 or HER2-low-positive disease with neoadjuvant chemotherapy. Descriptive analyses were performed, and logistic regression models and survival analyses were calculated for disease-free survival (DFS) and overall survival (OS). Among the 1373 patients, 930 (67.73%) had HER2-low-positive and 443 (32.27%) had HER2-0 tumors. Patients with HER2-0 tumors had a significantly better pathological complete response, 29.25% vs. 20.09%, and pathological complete response/in situ, 31.97% vs. 24.08%, than patients with HER2-low-positive tumors (p < 0.001; p = 0.003), regardless of the hormone receptor (HR) status. No statistically significant differences were observed for the HR-positive (p = 0.315; p = 0.43) or HR-negative subgroups (p = 0.573; p = 0.931). DFS and OS were significantly longer for HR-positive, HER2-low-positive patients (log-rank p = 0.02; p = 0.012). OS was significantly longer for HR-negative, HER2-0 patients (log-rank p = 0.032). No significant DFS differences were found for the HR-negative cohort (log-rank p = 0.232). For the overall cohort, no significant differences were noted between HER2-low-positive and HER2-0 patients, either for DFS (log-rank p = 0.220) or OS (log-rank p = 0.403). These results show different survival outcomes for HER2-0 and HER2-low-positive tumors relative to HR status. These different cohorts can be identified using standardized immunohistochemistry, even retrospectively.