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Background: Young people and adults increasingly obtain information about contraception via social media., Research Aim: Against this background, the aim of this study is to investigate for the first time the content and quality of German-language contraceptive posts on YouTube, Instagram, and TikTok. Research questions on providers (F1), content (F2), and quality of contraceptive posts (F3) as well as audience reactions (F4) will be answered., Materials and Methods: A sample of N = 1000 contraceptive posts from YouTube (500), Instagram (250), and TikTok (250) was drawn. A maximum of 20 contraception-related audience comments per post were included in the comment sample (N = 12,454). Posts and comments were analyzed using reliability-tested codebooks. SPSS was used for data analysis. The study is preregistered and all data, materials, and analysis scripts are publicly available., Results: The majority of contraceptive posts were found to be from health laypersons (52%), followed by media professionals and health professionals (F1). In terms of content, contraceptive posts covered all available contraceptive methods, with the pill (69%) and condoms (40%) dominating (F2). According to common quality criteria, there were clear deficits, with YouTube videos scoring best in comparison (F3). TikTok videos, on the other hand, were top performers in terms of audience interaction, attracting the most views, likes, and comments. Comment columns were often used by the audience to share their own contraceptive experiences or ask follow-up questions (F4)., Discussion: Future research as well as practice interventions are needed to further assess the quality of contraceptive information in social media and improve it in a more targeted way., (© 2023. The Author(s).)

Background: Adolescents and adults today often obtain information about contraception from the Internet, especially from the online encyclopedia Wikipedia. This is because Google searches usually return Wikipedia entries as top hits., Research Aim: Against this background, the aim of the current study is to systematically analyze for the first time the content and quality of Wikipedia articles on contraceptive methods. Five central quality dimensions are examined: the degree of correctness (research question RQ1), completeness (RQ2), neutrality (RQ3), comprehensibility (RQ4), and currency (RQ5) of the contraceptive information - and on this basis the overall quality of the articles (RQ6)., Materials and Methods: A sample of all German-language Wikipedia articles on all contraceptive methods was formed (N = 25). These articles were analyzed by three independent, trained coders using a codebook that was developed based on the current state of the research and tested for reliability. Data analysis was performed using SPSS. The study is preregistered and all data, materials, and analysis scripts are publicly available., Results: The 25 Wikipedia articles on contraceptive methods were found to vary widely in content quality. While they showed good quality on average in terms of correctness (RQ1) and neutrality (RQ3), they scored mediocre in terms of completeness (RQ2), comprehensibility (RQ4), and currency (RQ5), resulting in moderate overall quality (RQ6)., Discussion: More research as well as practice measures are needed to further assess and improve the quality of contraceptive information on Wikipedia and in other social media in a more targeted way., (© 2022. The Author(s).)

Purpose: To evaluate feasibility of automatic software-based path proposals for CT-guided percutaneous biopsies., Methods: Thirty-three patients (60 [Formula: see text] 12 years) referred for CT-guided biopsy of focal liver lesions were consecutively included. Pre-interventional CT and dedicated software (FraunhoferMeVis Pathfinder) were used for (semi)automatic segmentation of relevant structures. The software subsequently generated three path proposals in downward quality for CT-guided biopsy. Proposed needle paths were compared with consensus proposal of two experts (comparable, less suitable, not feasible). In case of comparable results, equivalent approach to software-based path proposal was used. Quality of segmentation process was evaluated (Likert scale, 1 [Formula: see text] best, 6 [Formula: see text] worst), and time for processing was registered., Results: All biopsies were performed successfully without complications. In 91 % one of the three automatic path proposals was rated comparable to experts' proposal. None of the first proposals was rated not feasible, and 76 % were rated comparable to the experts' proposal. 7 % automatic path proposals were rated not feasible, all being second choice ([Formula: see text]) or third choice ([Formula: see text]). In 79 %, segmentation at least was good. Average total time for establishing automatic path proposal was 42 [Formula: see text] 9 s., Conclusion: Automatic software-based path proposal for CT-guided liver biopsies in the majority provides path proposals that are easy to establish and comparable to experts' insertion trajectories.

Purpose: Image-guided radiofrequency ablation (RFA) is a broadly used minimally invasive method for the thermal destruction of focal liver malignancies using needle-shaped instruments. The established planning workflow is based on examination of 2D slices and manual definition of the access path. During that process, multiple criteria for all possible trajectories have to be taken into account. Hence, it demands considerable experience and constitutes a significant mental task., Methods: An access path determination method based on image processing and numerical optimization is proposed. Fast GPU-based simulation approximation is utilized to incorporate the heat distribution including realistic cooling effects from nearby blood vessels. A user interface for intuitive exploration of the optimization results is introduced., Results: The proposed methods are integrated into a clinical software assistant. To evaluate the suitability of the interactive optimization approach for the identification of meaningful therapy strategies, a retrospective study has been carried out. The system is able to propose clinically relevant trajectories to the target by incorporating multiple criteria., Conclusions: A novel method for planning of image-guided radiofrequency ablation by means of interactive access path determination based on optimization is presented. A first retrospective study indicates that the method is suited to improve the classical planning of RFA.

Nocardia species are ubiquitous in the environment with an increasing number of species isolated from clinical sources. From 2005 to 2009, eight isolates (W9042, W9247, W9290, W9319, W9846, W9851T, W9865, and W9908) were obtained from eight patients from three states in the United States and Canada; all were from males ranging in age from 47 to 81 years old; and all were obtained from finger (n = 5) or leg (n = 3) wounds. Isolates were characterized by polyphasic analysis using molecular, phenotypic, morphologic and chemotaxonomic methods. Sequence analysis of 16S rRNA gene sequences showed the eight isolates are 100 % identical to each other and belong in the genus Nocardia. The nearest phylogenetically related neighbours were found to be the type strains for Nocardia altamirensis (99.33 % sequence similarity), Nocardia brasiliensis (99.37 %), Nocardia iowensis (98.95 %) and Nocardia tenerifensis (98.44 %). The G+C content of isolate W9851T was determined to be 68.4 mol %. The DNA-DNA relatedness between strain W9851T and the N. brasiliensis type strain was 72.8 % and 65.8 % when measured in the laboratory and in silico from genome sequences, respectively, and 95.6 % ANI. Whole-cell peptidoglycan was found to contain meso-diaminopimelic acid; MK-8-(H4)ω-cyc was identified as the major menaquinone; the major fatty acids were identified as C16:0, 10 Me C18:0, and C18:1 w9c, the predominant phospholipids were found to include diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylinositol and phosphatidylinositol mannosides; whole-cell sugars detected were arabinose and galactose; and mycolic acids ranging from 38 to 60 carbon atoms were found to be present. These chemotaxonomic analyses are consistent with assignment of the isolates to the genus Nocardia. Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectra of the clinical isolates showed genus and species level profiles that were different from other Nocardia species. All isolates were resistant to ciprofloxacin, clarithromycin and imipenem but were susceptible to amikacin, amoxicillin/clavulanate, linezolid and trimethoprim/sulfamethoxazole. The results of our polyphasic analysis suggest the new isolates obtained from wound infections represent a novel species within the genus Nocardia, for which the name Nocardia vulneris sp. nov. is proposed, with strain W9851T (= DSM 45737T = CCUG 62683T = NBRC 108936T) as the type strain.

Herein, we report the successful development of a novel nanosystem capable of an efficient delivery and temperature-triggered drug release specifically aimed at cancer. The water-soluble 130.1 ± 0.2 nm iron oxide nanoparticles (IONPs) were obtained via synthesis of a monodispersed iron oxide core stabilized with tetramethylammonium hydroxide pentahydrate (TMAOH), followed by coating with the thermoresponsive copolymer poly-(NIPAM-stat-AAm)-block-PEI (PNAP). The PNAP layer on the surface of the IONP undergoes reversible temperature-dependent structural changes from a swollen to a collapsed state resulting in the controlled release of anticancer drugs loaded in the delivery vehicle. We demonstrated that the phase transition temperature of the prepared copolymer can be precisely tuned to the desired value in the range of 36°C-44°C by changing the monomers ratio during the preparation of the nanoparticles. Evidence of modification of the IONPs with the thermoresponsive copolymer is proven by ATR-FTIR and a quantitative analysis of the polymeric and iron oxide content obtained by thermogravimetric analysis. When loaded with doxorubicin (DOX), the IONPs-PNAP revealed a triggered drug release at a temperature that is a few degrees higher than the phase transition temperature of a copolymer. Furthermore, an in vitro study demonstrated an efficient internalization of the nanoparticles into the cancer cells and showed that the drug-free IONPs-PNAP were nontoxic toward the cells. In contrast, sufficient therapeutic effect was observed for the DOX-loaded nanosystem as a function of temperature. Thus, the developed temperature-tunable IONPs-based delivery system showed high potential for remotely triggered drug delivery and the eradication of cancer cells.

Study Objective: This prospective, non-interventional study involving general practitioners and internists in Germany investigated the administration of tapentadol prolonged release (Palexia retard) for the treatment of severe chronic pain in routineclinical practice over a 3-month observation period., Methods: Collected data included tapentadol PR dosage, previous and concomitant analgesic treatment, pain intensity, sleep and quality of life parameters, and tolerability of tapentadol PR. Effectiveness was analyzed for 3134 patients; additionally, a subgroup analysis was performed in 1331 patients with WHO III pretreatment., Results: A total of 97.8% of all patients received analgesic long-term pretreatment, 42.5% of those strong opioids. Switching to tapentadol PR resulted in a mean pain reduction of 3.9 points from 7.0 +/- 1.5 at baseline to 3.1 +/- 1.8 at end of observation (NRS-11, 11-point pain scale; descriptive p value < or = 0.001); 72.1% of patients experienced a clinically relevant pain relief of > or = 50% at end of observation. A total of 89.4% of the patients attained either their intended pain reduction and/or an additional individual treatment goal at end of observation; both were established at start of tapentadol PR treatment. This was accompanied by a significant decrease in pain-related impairments of daily activities and an improvement in quality of life (descriptive p value < or = 0.001) with an overall good tolerability of tapentadol PR. In particular, good effectiveness of tapentadol PR treatment was reported for various pain indications in patients who had already previously been treated with strong opioids. A clinically relevant pain reduction > or = 50% was achieved in 67.2% of these patients., Conclusions: Tapentadol PR can be considered an alternative therapy to classical opioids for the treatment of severe chronic pain. Particularly for severe chronic pain requiring long-term medication, a reduction of common opioid side-effects with tapentadol PR therapy could contribute to better patient compliance.

Purpose: Percutaneous image-guided interventions, such as radiofrequency ablation or biopsy, are using needle-shaped instruments which have to be inserted into a target area without penetrating any vital structure. The established planning workflow is based on viewing 2D slices of a pre-interventional CT or MR scan. However, access paths not parallel to the axial plane are often necessary. For such complicated cases, the planning process is challenging and time consuming if solely based on 2D slices. To overcome these limitations while keeping the well-established workflow, we propose a visualization method that highlights less suited paths directly in the 2D visualizations with which the radiologist is familiar., Methods: Based on a user defined target point and segmentation masks of relevant risk structures, a risk structure map is computed using GPU accelerated volume rendering and projected onto the 2D slices. This visualization supports the user in defining safe linear access paths by selecting a second point directly in the 2D image slices., Results: In an evaluation for 20 liver radiofrequency ablation cases, 3 experienced radiologists stated for 55% of the cases that the visualization supported the access path choice. The visualization support was rated with an average mark of 2.2. For 2 of the 3 radiologists, a significant reduction of the planning duration by 54 and 50% was observed., Conclusions: The proposed visualization approach can both accelerate the access path planning for radiofrequency ablation in the liver and facilitate the differentiation between safer and less safe paths.

Objective: To assess the efficacy and safety of a novel long-acting im testosterone undecanoate (TU) formulation in comparison with testosterone enanthate (TE)., Subjects and Methods: An open-label, randomized, prospective clinical trial in 40 hypogonadal men (baseline serum testosterone levels <5 nmol/l), randomly assigned to 250 mg TE/3 weeks (no.=20) or 1000 mg TU im every 6 to 9 weeks for 30 weeks (no.=20). Subsequently, 32/40 men continued the study for another 114 weeks, now receiving TU 1000 mg/12 weeks., Results: TU and TE produced no statistically significant improvements in grip strength over the first 30 weeks, which only occurred after approximately 90 weeks when all subjects received TU. There were no changes in body mass index with TU and TE, neither in the follow-up period when all patients received TU. But ratios of waist to hip circumferences declined in the longer term. Total serum cholesterol, LDL cholesterol, and triglycerides declined over the first 30 weeks, while plasma HDL also declined. Plasma LDL decreased further under long-term TU therapy, while HDL then increased. Hemoglobin and hematocrit values significantly increased over the first 30 weeks in both treatment groups and then no further increase was observed. Levels did not exceed the upper limit of normal. In both treatment groups, serum prostate specific antigen levels rose slightly after 30 weeks, with no further increase over the first 12 months, remaining stable within the normal range. Plasma T before the following TU injection was above the lower limit of reference values. Four injections per year are adequate., Conclusions: Administration of TU every 12 weeks is at least as safe and efficacious for treatment of hypogonadal men as TE, with a substantially lower frequency of administration. Follow-up over 114 weeks, when all subjects received TU, showed an excellent profile of efficacy and safety.