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Aim: Sufficient liver function is crucial in extracellular matrix growth, hemostasis, and wound healing. Repeated abdominal surgery is a known risk factor for the development of wound complications. This study aimed to evaluate this high-risk constellation in patients undergoing associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) and repeated liver resections (RLR) in comparison to single liver resection (SLR). Method: Forty patients who underwent ALPPS between 2011 and 2020 were evenly matched with patients undergoing RLR or SLR (n = 40 per group) using propensity scores. Postoperative outcomes were compared and factors associated with wound complications were analyzed. Results: Postoperative wound complications were significantly more frequent in ALPPS group (p = 0.001). The reoperation rate was not significantly different between the three groups (p = 0.143). However, surgical reintervention due to wound complications occurred more frequently in the ALPPS group in relation to RLR and SLR (17.5% vs. 7.5% and 5% respectively). Length of stay was significantly longer in the ALPPS group (p = 0.033). ALPPS was an independent risk factor for postoperative wound complication (OR = 8.55, 95% CI:1.07–68.44, p = 0.043). Risk factor analysis identified age ≥ 60 years (OR = 27.64, 95% CI:3.09-246.75, p = 0.003), BMI ≥ 30 kg/m2 (OR = 30.21, 95% CI:3.35-271.83, p = 0.002), and low postoperative albumin levels (OR = 168.41, 95% CI:7.76-3651.18, p = 0.001) as independent predictors of postoperative wound complications after major liver resection. Conclusion: Patients undergoing ALPPS and RLR are faced with a high risk of developing wound complications. Older age, obesity, a history of previous abdominal surgery, and a decreased postoperative albumin level were independent risk factors for wound complications. [ABSTRACT FROM AUTHOR]

We developed and evaluated the Digital Platform for Exercise (DPEx): a decentralized, patient-centric approach designed to enhance all aspects of clinical investigation of exercise therapy. DPEx integrated provision of a treadmill with telemedicine and remote biospecimen collection permitting all study procedures to be conducted in patient's homes. Linked health biodevices enabled high-resolution monitoring of lifestyle and physiological response. Here we describe the rationale and development of DPEx as well as feasibility evaluation in three different cohorts of patients with cancer: a phase 0a development study among three women with post-treatment primary breast cancer; a phase 0b proof-of-concept trial of neoadjuvant exercise therapy in 13 patients with untreated solid tumors; and a phase 1a level-finding trial of neoadjuvant exercise therapy in 53 men with localized prostate cancer. Collectively, our study demonstrates the utility of a fully digital, decentralized approach to conduct clinical trials of exercise therapy in a clinical population. [ABSTRACT FROM AUTHOR]

Combining the frameworks of fundamental causes theory and diffusion of innovation, scholars had anticipated a delayed COVID-19 vaccination uptake for people in lower socioeconomic position depending on the socioeconomic context. We qualify these propositions and analyze educational differences in COVID-19 vaccination status over the first ten months of Germany's vaccination campaign in 2021. Data from the study "Corona Monitoring Nationwide" (RKI-SOEP-2), collected between November 2021 and February 2022, is linked with district-level data of the German Index of Socioeconomic Deprivation (GISD). We estimated the proportion of people with at least one vaccination dose stratified by educational groups and within different settings of regional socioeconomic deprivation at three time points. Logistic multilevel regression models were applied to adjust for multiple covariates and to test cross-level-interactions between educational levels and levels of area-level socioeconomic deprivation. Vaccination rates were lower among respondents with lower education. With increasing area-level socioeconomic deprivation, educational differences were larger due to particularly low vaccination rates in groups with low education levels. The analysis of vaccination timing reveals that educational gaps and gaps by area-level socioeconomic deprivation had appeared early in the vaccination campaign and did not close completely before the 4th wave of COVID-19 infections [ABSTRACT FROM AUTHOR]

Purpose: The significance of dental status and oral hygiene on a range of medical conditions is well-recognised. However, the correlation between periodontitis, oral bacterial dysbiosis and visceral surgical outcomes is less well established. To this end, we study sought to determine the influence of dental health and oral hygiene on the rates of postoperative complications following major visceral and transplant surgery in an exploratory, single-center, retrospective, non-interventional study. Methods: Our retrospective non-interventional study was conducted at the Department of General, Visceral, and Transplant Surgery, University Hospital Heidelberg, Germany. Patients operated on between January 2018 and December 2019 were retrospectively enrolled in the study based on inclusion (minimum age of 18 years, surgery at our Department, intensive care / IMC treatment after major surgery, availability of patient-specific preoperative dental status assessment, documentation of postoperative complications) and exclusion criteria (minor patients or legally incapacitated patients, lack of intensive care or intermediate care (IMC) monitoring, incomplete documentation of preoperative dental status, intestinal surgery with potential intraoperative contamination of the site by intestinal microbes, pre-existing preoperative infection, absence of data regarding the primary endpoints of the study). The primary study endpoint was the incidence of postoperative complications. Secondary study endpoints were: 30-day mortality, length of hospital stay, duration of intensive care stay, Incidence of infectious complications, the microbial spectrum of infectious complication. A bacteriology examination was added whenever possible (if and only if the examination was safe for the patient)for infectious complications. Results: The final patient cohort consisted of 417 patients. While dental status did not show an influence (p = 0.73) on postoperative complications, BMI (p = 0.035), age (p = 0.049) and quick (p = 0.033) were shown to be significant prognostic factors. There was significant association between oral health and the rate of infectious complications for all surgical procedures (p = 0.034), excluding transplant surgery. However, this did not result in increased 30-day mortality rates, prolonged intensive care unit treatment or an increase in the length of hospital stay (LOS) for the cohort as a whole. In contrast there was a significant correlation between the presence of oral pathogens and postoperative complications for a group as a whole (p < 0.001) and the visceral surgery subgroup (p < 0.001). Whilst this was not the case in the cohort who underwent transplant surgery, there was a correlation between oral health and LOS in this subgroup (p = 0.040). Bacterial swabs supports the link between poor oral health and infectious morbidity. Conclusions: Dental status was a significant predictor of postoperative infectious complications in this visceral surgery cohort. This study highlights the importance preoperative dental assessment and treatment prior to major surgery, particularly in the case of elective surgical procedures. Further research is required to determine the effect of oral health on surgical outcomes in order to inform future practice. Trial registration: Trial registered under the ethics-number S-082/2022 (Ethic Committee of the University Heidelberg). [ABSTRACT FROM AUTHOR]

Herein, we report polyphosphonate covalent organic frameworks (COFs) constructed via P-O-P linkages. The materials are synthesized via a single-step condensation reaction of the charge-assisted hydrogen-bonded organic framework, which is constructed from phenylphosphonic acid and 5,10,15,20‐tetrakis[p‐phenylphosphonic acid]porphyrin and is formed by simply heating its hydrogen-bonded precursor without using chemical reagents. Above 210 °C, it becomes an amorphous microporous polymeric structure due to the oligomerization of P-O-P bonds, which could be shown by constant-time solid-state double-quantum 31P nuclear magnetic resonance experiments. The polyphosphonate COF exhibits good water and water vapor stability during the gas sorption measurements, and electrochemical stability in 0.5 M Na2SO4 electrolyte in water. The reported family of COFs fills a significant gap in the literature by providing stable microporous COFs suitable for use in water and electrolytes. Additionally, we provide a sustainable synthesis route for the COF synthesis. The narrow pores of the COF effectively capture CO2. Covalent organic frameworks (COFs) can be synthesized through a wide range of reactions but phosphonate-COFs remained elusive. Here the authors report a polyphosphonate-COFs constructed via P-O-P linkages with good water and exceptional electrochemical stability. [ABSTRACT FROM AUTHOR]

Copyright of Chirurgie (2731-6971) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Two-dimensional free-surface flow past a submerged rectangular disturbance in an open channel is considered. The forced Korteweg–de Vries model of Binder et al. (Theor Comput Fluid Dyn 20:125–144, 2006) is modified to examine the effect of varying obstacle length and height on the response of the free-surface. For a given obstacle height and flow rate in the subcritical flow regime an analysis of the steady solutions in the phase plane of the problem determines a countably infinite set of discrete obstacle lengths for which there are no waves downstream of the obstacle. A rich structure of nonlinear behaviour is also found as the height of the obstacle approaches critical values in the steady problem. The stability of the steady solutions is investigated numerically in the time-dependent problem with a pseudospectral method. [ABSTRACT FROM AUTHOR]

The article develops an explanation of corporal punishment (CP) as an expression of family violence by developing a multi-level, conciliatory model of human behavior. The synthesis builds upon a review of the relevant analytic approaches and empirical evidence spanning multiple levels of human behavior to include five interrelated frameworks: (1) behavioral investment; (2) socialization; (3) cultural justification; (4) social location; and (5) societal context. The analytic levels highlight the various explanatory principles that address questions relevant mainly to investigators who study behavior in terms of different levels of informational complexity. The paper outlines the most important factors that shape the use and non-use of CP within family settings. The model identifies key ontogenetic and biophysiological factors linked to the fitness of parents' offspring, along with primary socialization processes and cultural justification mechanisms that increase the probability of the intergenerational transmission of violence. In addition, the model identifies the sociological dimensions of family relationships and the importance of social locational variables in shaping parental usage of CP, as well as the importance of communities and institutions as situated within sociocultural contexts. The main conclusion suggests that to understand and explain more fully why human beings use violence in the context of familial relationships—including corporal punishment practices—analysts must consider the different influences and possible impacts of factors across all five levels. [ABSTRACT FROM AUTHOR]

Modern Mars is bipolar, cold, and oxidizing, while early Mars was characterized by icy highlands, episodic warmth and reducing atmosphere. The timing and association of the climate and redox transitions remain inadequately understood. Here we examine the spatiotemporal distribution of the low surface iron abundance in the ancient Martian terrains, revealing that iron abundance decreases with elevation in the older Noachian terrains but with latitude in the younger Noachian terrains. These observations suggest: (a) low-temperature conditions contribute to surface iron depletion, likely facilitated by anoxic leaching through freeze-thaw cycles under a reducing atmosphere, and (b) temperature distribution mode shifted from elevation-dominant to latitude-dominant during the Noachian period. Additionally, we find iron leaching intensity decreases from the Early to Late Noachian epoch, suggesting a gradual atmospheric oxidation coupled with temperature mode transition during the Noachian period. We think atmospheric oxidation led to Mars becoming cold and bipolar in its early history. The study reveals anoxic leaching in ancient Martian terrains occurred during seasonal freeze-thaw cycles. Findings suggest that gradual atmospheric oxidation drove Mars to become cold and bipolar in its early history. [ABSTRACT FROM AUTHOR]

Background and Objecitves: The currently available kidney volume normative values in children are restricted to small populations from single-centre studies not assessing kidney function and including none or only a small number of adolescents. This study aimed to obtain ultrasound-based kidney volume normative values derived from a large European White/Caucasian paediatric population with normal kidney function. Methods: After recruitment of 1427 children aged 0–19 years, 1396 individuals with no history of kidney disease and normal estimated glomerular filtration rate were selected for the sonographic evaluation of kidney volume. Kidney volume was correlated with age, height, weight, body surface area and body mass index. Kidney volume curves and tables related to anthropometric parameters were generated using the LMS method. Kidney volume predictors were evaluated using multivariate regression analysis with collinearity checks. Results: No clinically significant differences in kidney volume in relation to height were found between males and females, between supine and prone position and between left and right kidneys. Males had, however, larger age-related kidney volumes than females in most age categories. For the prediction of kidney volume, the highest coefficient correlation was observed for body surface area (r = 0.94), followed by weight (r = 0.92), height (r = 0.91), age (r = 0.91), and body mass index (r = 0.67; p < 0.001 for all). Conclusions: This study presents LMS-percentile curves and tables for kidney volume which can be used as reference values for children aged 0–19 years. [ABSTRACT FROM AUTHOR]

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Let I be a line segment in the complex plane C . We describe a method of constructing a bi-Lipschitz sense-preserving mapping of C onto itself, which is harmonic in C \ I and coincides with a given sufficiently regular function f : I → C . As a result we show that a quasiconformal self-mapping of C which is harmonic in C \ I does not have to be harmonic in C . [ABSTRACT FROM AUTHOR]

We checked whether national cultural differences according to Hofstede dimensions (HD) contribute to differences in life expectancy (LE) irrespective of per capita gross domestic product (GDP) in the countries, such as the Russian Federation (RF), where LE is markedly below the general LE-vs.-GDP trend (Preston curve, PC). The sample of 102 countries included those from the lists available at World Bank, Human Mortality Database and Hofstede Insight websites that feature all required data on GDP, LE and HD. Partial Kendall correlations between LE, GDP and five HD scores were calculated for GDP ranges distinguished based on different patterns of LE-vs.-GDP relations. It was found that, among the countries where LE is higher at GDP lower than in RF (Group Q; 37 countries), RF stands at the tops of lists ranged by HD scores for power distance (PD) and uncertainty avoidance (UA). Generally, PD and UA are uncorrelated. In Group Q, the combination of high UA and PD scores is specific for former Soviet Union and Yugoslavia states. Correlations with LE are negative and significant for this combination and for separate UA but not PD scores. UA does not correlate with LE in all countries and in groups where GDP > 30 000 or < 30 000 US$. The main cultural correlates of LE there are long-term orientation (both groups) and individualism (at GDP < 30 000), which do not correlate with LE in Group Q. These observations may be useful for judging about prospects for increasing LE in Q countries by measures limited to economics, administration and public health. [ABSTRACT FROM AUTHOR]

Exocrine and endocrine pancreas are interconnected anatomically and functionally, with vasculature facilitating bidirectional communication. Our understanding of this network remains limited, largely due to two-dimensional histology and missing combination with three-dimensional imaging. In this study, a multiscale 3D-imaging process was used to analyze a porcine pancreas. Clinical computed tomography, digital volume tomography, micro-computed tomography and Synchrotron-based propagation-based imaging were applied consecutively. Fields of view correlated inversely with attainable resolution from a whole organism level down to capillary structures with a voxel edge length of 2.0 µm. Segmented vascular networks from 3D-imaging data were correlated with tissue sections stained by immunohistochemistry and revealed highly vascularized regions to be intra-islet capillaries of islets of Langerhans. Generated 3D-datasets allowed for three-dimensional qualitative and quantitative organ and vessel structure analysis. Beyond this study, the method shows potential for application across a wide range of patho-morphology analyses and might possibly provide microstructural blueprints for biotissue engineering. [ABSTRACT FROM AUTHOR]

Summary: The treatment elements used for pancreatic ductal adenocarcinoma (PDAC) include surgical resection, systemic cytotoxic agents, and targeted drugs. For second- and third-line therapies in PDAC, approximately 15% of patients have actionable mutations although only 2.5% receive matched targeted treatment but with a significant improvement in survival of around 16 months. For the majority of PDAC patients the current most effective strategy is surgical resection of the primary tumor and systemic combination chemotherapy. The chemotherapy regimens and the order of delivery relative to the resection reference point have been based to a large extent on randomized trials using a newly developed empirical staging (Em) system. Although the reductionist TNM based AJCC and UICC systems work well for pathology staging, they are less accurate and less manageable for treatment decision-making. This Em system defines locally resectable (EmR), borderline resectable (EmBR), and unresectable (EmUR) stages, plus the emerging entity of oligometastatic disease (EmOm). For EmR patients, 6 months of adjuvant chemotherapy achieves 5‑year survival rates of 30–50%. In EmBR short-course (2 months) neoadjuvant plus 6‑month adjuvant chemotherapy increases 12-month survival rates to around 77%, compared to 40% for upfront surgery, despite resection rates of 64–85% and 75%, respectively. Longer-course (4 months) neoadjuvant chemotherapy has also been shown to achieve an 18-month overall survival of 67%. In EmUR, induction therapy (3–6 months) may result in resections rates of 20–60% with significantly improved survival rates compared to no resection. For all stages including the polymetastatic (EmPm) setting, patients with good performance status receive combination chemotherapies based on either oxaliplatin (FOLFIRINOX or NALIRIFOX) or gemcitabine (GEM-CAP, or Gem-NabP). Molecular subtypes (Moffitt, Collisson, Bailey, and Cheng-Sen-Yue) are shown to be associated with treatment responses. Transcriptomic signatures have also been developed as classifiers for determining either oxaliplatin- or gemcitabine-based therapies (PurIST, Tiriac, GemPred+, and ESPAC) and are being evaluated in various studies. Most notably the ESPAC transcriptomic signature is being used as the treatment classifier in the experimental arms of the randomized ESPAC6 adjuvant trial in EmR patients and the ESPAC7 induction therapy trial in EmUR patients. Genomic and transcriptomic profiling at baseline and over time is an integral part of ESPAC6/7 to deepen our understanding of tumor plasticity during the course of therapy, identifying the intrinsic (persister cell) and acquired (genetic) tumor plasticity evolving over time and in reaction to different therapies in order to enable a scientific approach to overcoming clonal-resistance clades. [ABSTRACT FROM AUTHOR]

Copyright of Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Gastro-entero-pancreatic neuroendocrine carcinomas (GEP-NECs) are an aggressive subgroup of neuroendocrine neoplasms (NENs). In patients affected with NEN, there is a growing body of evidence that increased C-X-C motif chemokine receptor (CXCR4) expression is linked to decreasing overall survival (OS) in an ex-vivo setting. Thus, we aimed to determine whether the in-vivo-derived CXCR4-directed whole-body PET signal can also determine GEP-NEC patients with shorter OS. Methods: We retrospectively included 16 patients with histologically proven GEP-NEC, who underwent CXCR4-directed PET/CT for staging and therapy planning. We assessed maximum, peak, and mean standardized uptake values as well as whole-body tumor volume (TV) and total-lesion uptake (TLU = SUVmean × TV) using a semi-automatic segmentation tool with a 50% threshold. Association of PET-based biomarkers and OS or radiographic progression-free survival (rPFS; according to RECIST 1.1 criteria) was analyzed using univariable and multivariable cox regression. Results: Median OS and rPFS was 7.5 and 7 months, respectively. A significant correlation between TV and TLU was found for OS (TV: hazard ratio (HR) 1.007 95% confidence interval (CI) 1.000–1.014, p = 0.0309; TLU: HR 1.002 95% CI 1.000–1.003, p = 0.0350) and rPFS (TV: HR 1.010 95% CI 1.002–1.021; p = 0.0275; TLU: HR 1.002 95% CI 1.000–1.004, p = 0.0329), respectively. No significant correlation with OS or rPFS was found for non-volumetric parameters (p > 0.4). TV remained a significant predictive marker for OS and rPFS in multivariable analysis (OS: HR 1.012 95%, CI 1.003–1.022, p = 0.0084; rPFS: HR 1.009, 95% CI 0.9999–1.019, p = 0.0491), whereas TLU remained only prognostic for OS (HR 1.009, 95% CI 0.9999–1.019, p = 0.0194) but narrowly failed significance for rPFS (p = 0.0559). Conclusion: In-vivo assessment of CXCR4 PET-derived volumetric parameters is predictive for outcome of patients with GEP-NEC and could be used as a risk stratification tool, which detects patients prone to early progression. [ABSTRACT FROM AUTHOR]

Background: Bicondylar tibial plateau fractures pose many treatment challenges due to their complex fracture patterns and associated soft tissue compromise. We aim to evaluate outcomes of acute ORIF (aORIF) versus staged ORIF (sORIF) of high energy bicondylar tibial plateau fractures. Methods: We retrospectively reviewed 186 patients at two high-volume Level I trauma centers. One hundred one patients underwent aORIF and 85 underwent sORIF between 2011 and 2019. Clinical outcomes of interest included operative time, wound dehiscence, superficial and deep infection, nonunion, flap coverage, arthrodesis, and early conversion to arthroplasty. Results: Patients had a median follow up of 12 months (6–98 months). The sORIF group had a higher ISS (p = 0.02) and a higher rate of open fractures (24.7% vs 11.9%, p = 0.03). The groups were statistically similar in other demographics and co-morbidities. Operative time was significantly shorter in the aORIF group (157 vs 213 min., p < 0.001). There was no statistical difference in wound dehiscence, deep infection, flap coverage, nonunion, unplanned reoperation, or post-traumatic arthritis between groups. However, aORIF was associated with a significantly lower rate of superficial infection (p = 0.01), arthroplasty (p = 0.003) and unplanned reoperation (p = 0.005). Subgroup analysis of only the 41C3 fractures showed a lower rate of superficial infections in the aORIF group (p = 0.04). No difference in complications was found between the fracture subgroups. Conclusion: We found no increased risk of complications with aORIF compared to sORIF for bicondylar tibial plateau fractures. While not all injuries may be appropriate for aORIF, our results demonstrate the safety of aORIF when patients are properly selected by experienced fracture surgeons. Level of evidence: Level III. [ABSTRACT FROM AUTHOR]

There is increasing knowledge in the recognition of individuals at risk for progression to rheumatoid arthritis (RA) before the clinical manifestation of the disease. This prodromal phase preceding the manifestation of RA may represent a "window of opportunity" for preventive interventions that may transform the clinical approach to this disease. However, limited evidence exists in support of effective interventions to delay the onset or even halt the manifestation of RA. Given the multifactorial nature of RA development and disease progression, the latest guidelines for established RA stress the use of integrative interventions and multidisciplinary care strategies, combining pharmacologic treatment with non-pharmacological approaches. Accordingly, individuals at risk of RA could be offered an integrative, multifactorial intervention approach. Current data point toward pharmacological intervention reverting the subclinical inflammation and delay in the disease onset. In addition, targeting life style modifiable factors (smoking cessation, dental health, physical activity, and diet) may presumably improve RA prognosis in individuals at risk, mainly by changes in epigenetics, autoantibodies, cytokines profiles, and microbiome. Nonetheless, the benefits of multidisciplinary interventions to halt the manifestation of RA in at-risk individuals remain unknown. As there is a growing knowledge of possible pharmacological intervention in the preclinical phase, this narrative review aims to provide a comprehensive overview of non-pharmacological treatments in individuals at risk of RA. Considering the mechanisms preceding the clinical manifestation of RA we explored all aspects that would be worth modifying and that would represent an integrative non-pharmacological care for individuals at risk of RA. [ABSTRACT FROM AUTHOR]

The progressive miniaturization of electronic devices necessitates effective protection against electromagnetic interference and overheating. This study aims to explore the potential of polymer nanocomposites as multifunctional materials to address these challenges in applications related to airborne and space technology. Our investigation focuses on the hypothesis that the incorporation of graphene nanoplatelets (GNPs) into a fluoropolymer matrix (fluorinated ethylene propylene—FEP) will yield a composite material capable of simultaneously providing electromagnetic interference (EMI) shielding and enhanced thermal properties. This research presents initial studies as the foundational step toward designing multifunctional materials for specialized airborne and space technologies applications. The samples, comprising FEP and GNP, were fabricated using a simple powdered masterbatch hot pressing technique, ensuring optimal filler dispersion within the matrix. The dispersion quality was evaluated using Raman mapping and sheet/volume resistivity analyses. Subsequently, adding 25 wt% GNP results in outstanding EMI shielding effectiveness: SETOT ~ 50 dB at 5 GHz for only 1-mm-thick sample and almost 3000% enhancement of thermal conductivity (exceeding 4 Wm−1 K−1), similarly nearly 2000% enhancement of thermal diffusivity (2 mm2 s−1) and an electrical conductivity of over 7 S cm−1 were observed. These results stand out for their remarkable values, especially considering the use of straightforward production methods without further structural improvements or metallic additives. [ABSTRACT FROM AUTHOR]

This study was conducted in two groups of girls with PCOS (polycystic ovary syndrome) categorized as slim (group N) and overweight-to-obese (group Ov/Ob). The study's primary outcome was to assess the impact of a 12-week anti-inflammatory diet (AIDiet) intervention, without energy deficit, on daily diet quality improvement, evaluated according to the KIDMED index. The secondary outcome was improving inflammatory, redox, hormonal, and metabolic statuses. In the study, which was completed by 13 girls from the Ov/Ob group and 19 girls from the N group, a significant improvement in the mean KIDMED score was obtained. Moreover, the intervention significantly improves concentration of total antioxidant capacity (TAC), fasting insulin, and the homeostatic model assessment for insulin resistance (HOMA-IR) index, in the Ov/Ob group, while both groups experienced a reduction in the concentration of interleukin (IL)-1 and IL-6, tumour necrosis factor (TNF-α), and androstenedione. The AIDiet intervention effectively improved the quality of the subjects' diets, which was associated with the improvement of hormonal and immuno-metabolic markers. However, these changes in normal-weight patients were observed regardless of body weight reduction. ClinicalTrials.gov Identifier NCT04738409. [ABSTRACT FROM AUTHOR]

Background: Two randomized clinical trials demonstrated the efficacy of prostate-specific membrane antigen (PSMA) radioligand therapy (PSMA RLT) in metastatic castration-resistant prostate cancer (mCRPC). While the VISION trial used criteria within PSMA PET/CT for inclusion, the TheraP trial used dual tracer imaging including FDG PET/CT. Therefore, we investigated whether the application of the VISION criteria leads to a benefit in overall survival (OS) or progression-free survival (PFS) for men with mCRPC after PSMA RLT. Methods: Thirty-five men with mCRPC who had received PSMA RLT as a last-line option and who had undergone pretherapeutic imaging with FDG and [68Ga]Ga-PSMA I&T or [18F]PSMA-1007 were studied. Therapeutic eligibility was retrospectively evaluated using the VISION and TheraP study criteria. Results: 26 of 35 (74%) treated patients fulfilled the VISION criteria (= VISION+) and only 17 of 35 (49%) fulfilled the TheraP criteria (= TheraP+). Significantly reduced OS and PFS after PSMA RLT was observed in patients rated VISION− compared to VISION+ (OS: VISION−: 3 vs. VISION+: 12 months, hazard ratio (HR) 3.1, 95% confidence interval (CI) 1.0–9.1, p < 0.01; PFS: VISION−: 1 vs. VISION+: 5 months, HR 2.7, 95% CI 1.0–7.8, p < 0.01). For patients rated TheraP−, no significant difference in OS but in PFS was observed compared to TheraP+ patients (OS: TheraP−: 5.5 vs. TheraP+: 11 months, HR 1.6, 95% CI 0.8–3.3, p = 0.2; PFS: TheraP−: 1 vs. TheraP+: 6 months, HR 2.2, 95% CI 1.0–4.5, p < 0.01). Conclusion: Retrospective application of the inclusion criteria of the VISION study leads to a benefit in OS and PFS after PSMA RL, whereas TheraP criteria appear to be too strict in patients with end-stage prostate cancer. Thus, performing PSMA PET/CT including a contrast-enhanced CT as proposed in the VISION trial might be sufficient for treatment eligibility of end-stage prostate cancer patients. [ABSTRACT FROM AUTHOR]

Background: Aim of the current study was to present the results of the implementation phase of a robotic liver surgery program and to assess the validity of the IWATE difficulty score in predicting difficulty and postoperative complications in robotic liver surgery. Methods: Based on the prospective database of the Interdisciplinary Robotic Center of Ulm University Hospital, the first 100 robotic liver surgeries were identified and analyzed. Perioperative parameters (duration of surgery and blood loss) and postoperative parameters including morbidity, mortality, and length of hospital stay were assessed and the results were compared between different IWATE difficulty categories. Results: From November 2020 until January 2023, 100 robotic liver surgeries were performed (41 female, 59 male; median age 60.6 years, median BMI 25.9 kg/m2). Median duration of surgery was 180 min (IQR: 128.7), and median blood loss was 300 ml (IQR: 550). Ninety-day mortality was 2%, and overall morbidity was 21%, with major complications occurring in 13% of patients (≥ grade 3 according to Clavien/Dindo). A clinically relevant postoperative biliary leakage was observed in 3 patients. Posthepatectomy liver failure occurred in 7% (4 Grade A, 3 Grade B). Duration of surgery (p < 0.001), blood loss (p < 0.001), CCI (p = 0.004), overall morbidity (p = 0.004), and length of hospital stay (p < 0.001) were significantly increased in the IWATE 'expert' category compared to lower categories. Discussion: Robotic surgery offers a minimally invasive approach for liver surgery with favorable clinical outcomes, even in the implementation phase. In the current study the IWATE difficulty score had the ability to predict both difficulty of surgery as well as postoperative outcomes when assessing the complexity of robotic liver surgery. Therefore, the role of the IWATE score in predicting these outcomes highlights its importance as a tool in surgical planning and decision-making. [ABSTRACT FROM AUTHOR]

The research examines the influence of digital visual product package presentations on perceived purchase willingness. Subjects pairwise compared the graphical stimuli displayed on a computer monitor. Gathered purchase willingness preference weights were calculated by means of the Analytic Hierarchy Process technique. Two studies focused on the package edge roundedness effect applied along different axes are reported. The first one included the following factors: Roundedness axis defined on three levels (X, Y, Z) and Roundedness degree also specified on three levels (Small, Medium, Large). The second involved Roundedness type (two levels: All edges rounded, Only sides rounded – along one axis) and Roundedness degree (Tiny, Small, Medium, Large). Both package Roundedness axis and Roundedness degree influenced perception and purchase willingness. This research extends existing knowledge by presenting empirical evidence on how a variety of product digital forms influences visual perception and purchase willingness. The results deliver useful and detailed information for practitioners and the outcomes may be applied as guidelines for computer graphics designers preparing visual appearance for articles in electronic shops, websites, banners, or advertisements displayed in networked screens. [ABSTRACT FROM AUTHOR]

We analyze the state of software development practice for Lattice Boltzmann solvers by quantitatively and qualitatively measuring and comparing 24 software packages for 10 software qualities (installability, correctness/verifiability, reliability, robustness, usability, maintainability, reusability, understandability, visibility/transparency and reproducibility). Our reproducible analysis method employs a measurement template (containing 108 measures that are manually and automatically extracted from the project repository) and developer interviews (consisting of 20 questions). After measuring, we rank the software using the Analytic Hierarchy Process. Our ranking is roughly consistent with GitHub stars ranking, suggesting at least a partial correlation between the use of best practices and popularity. We find the state of the practice to be healthy with 67% of the measured packages ranking in the top two for at least two qualities, the majority of LBM generated artifacts corresponding to general recommendations from research software developers, common use of version control (67% of packages) and the adoption of a quasi-agile development process. Areas of best practice to potentially improve include adoption of continuous integration, API documentation and enforcement of programming style guides. We interviewed four developers to gain insight into their current pain points. Identified challenges include lack of development time, lack of funding, and difficulty with ensuring correctness. Developers are addressing these pain points by designing for change, circumventing the oracle problem and prioritizing documentation and usability. For future improvements we suggest the following: employing linters, conducting rigorous peer reviews, writing and submitting more papers on software, growing the number of contributors by following current recommendations for open source projects, and augmenting the theory manuals to include more requirements specification relevant information. [ABSTRACT FROM AUTHOR]

Recent advances in knowledge suggest that micro- and nanoplastics pose a threat to plant health, however, the responses of plants to this stressor are not well-known. Here we examined the response of plant cell defence mechanisms to nanoparticles of commonly used plastic, polystyrene. We used plant cell cultures of widely cultivated plants, the monocots wheat and barley (Triticum aestivum L., Hordeum vulgare L.) and the dicots carrot and tomato (Daucus carota L., Solanum lycopersicum L.). We measured the activities of enzymes involved in the scavenging of reactive oxygen species and nonenzymatic antioxidants and we estimated potential damages in plant cell structures and functioning via lipid peroxidation and DNA methylation levels. Our results demonstrate that the mode of action of polystyrene nanoparticles on plant cells involves oxidative stress. However, the changes in plant defence mechanisms are dependent on plant species, exposure time and nanoplastic concentrations. In general, both monocots showed similar responses to nanoplastics, but the carrot followed more the response of monocots than a second dicot, a tomato. Higher H2O2, lipid peroxidation and lower enzyme activities scavenging H2O2 suggest that tomato cells may be more susceptible to polystyrene-induced stress. In conclusion, polystyrene nanoplastics induce oxidative stress and the response of the plant defense mechanisms involving several chain reactions leading to oxidoreductive homeostasis. [ABSTRACT FROM AUTHOR]

Researchers have investigated the race-crime congruency effect for approximately 30 years; however, extant research makes it difficult to draw conclusions about this effect due to varied operationalization, methodology, and statistical reporting. We conducted a systematic review operationalizing race-crime congruency as a crossover effect such that defendants receive harsher punishment when a crime is deemed typical of their race and less punitive punishments when a crime is deemed atypical of their race. The objective of this systematic review is to summarize the current state of the literature and provide recommendations for future research. To identify relevant studies, we searched four databases, 18 conference programs, and reference lists in identified articles. We identified 14 published and unpublished papers that examine a crossover effect of the race-crime congruency effect found in experimental research. We recommend (a) using designs capable of testing a crossover interaction (b) including dichotomous guilt as a primary dependent variable (c) pilot testing race-typical and -atypical crimes (d) identifying crimes that associate equally with target groups (e) utilizing manipulation checks to ensure appropriate comparisons across studies and (f) reporting detailed statistical information to allow future researchers to conduct meta-analyses on this topic. Overall, race-crime congruency literature has important implications for marginalized groups within the United States' criminal justice system; therefore, researchers should work to appropriately ascertain the robustness of this effect. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) is a promising tool for training life skills in people with intellectual disabilities. However, there is a lack of evidence surrounding the implementation, suitability, and effectiveness of VR training in this population. The present study investigated the effectiveness of VR training for people with intellectual disabilities by assessing (1) their ability to complete basic tasks in VR, (2) real-world transfer and skill generalisation, and (3) the individual characteristics of participants able to benefit from VR training. Thirty-two participants with an intellectual disability of varying severity completed a waste management training intervention in VR that involved sorting 18 items into three bins. Real-world performance was measured at pre-test, post-test, and delayed time points. The number of VR training sessions varied as training ceased when participants met the learning target (≈ 90% correct). A survival analysis assessed training success probability as a function of the number of training sessions with participants split by their level of adaptive functioning (as measured on the Adaptive Behaviour Assessment System Third Edition). The learning target was met by 19 participants (59.4%) within ten sessions (Mdn = 8.5, IQR 4–10). Real-world performance significantly improved from pre- to post-test and pre- to delayed test. There was no significant difference from post- to delayed test. Further, there was a significant positive relationship between adaptive functioning and change in the real-world assessment from the pre-test to the post- and delayed tests. VR facilitated the learning of most participants, which led to demonstrations of real-world transfer and skill generalisation. The present study identified a relationship between adaptive functioning and success in VR training. The survival curve may assist in planning future studies and training programs. [ABSTRACT FROM AUTHOR]

Since June 2022, the Central Museum of Prisoners-of-War (Poland) has been carrying out a multidisciplinary research project entitled "Science for Society, Society for Science at the Site of National Remembrance in Łambinowice." The aim of this article is to discuss the preliminary results of selected non-invasive and invasive archaeological and ethnographic research realized during the first months of the field activities. Additionally, they show the value of so-called community archaeology in which the participation of local inhabitants in field research is an important element of applied methodology. [ABSTRACT FROM AUTHOR]

Background: To assess quality of life and unmet needs after stroke, patient-reported outcome measures (PROMs) have gained increasing attention. However, patients' perspectives on assessing PROMs remain unclear, potentially hindering implementation into clinical practice. Therefore, this study explored patients' preferences on assessing PROMs after ischemic stroke. Methods: A paper-based questionnaire was sent to stroke survivors treated at the Department of Neurology, University of Leipzig, Germany. Health-related quality of life (HRQoL, EQ-5D-5L) and preferences regarding different aspects of data collection to assess PROMs were investigated and linked to socio-demographic and medical characteristics. Results: 158 persons were contacted and 80 replies were subsequently analyzed. Mean age was 70.16 years and mean HRQoL was 68.79 (visual analogue scale with a theoretical maximum of 100). Participants showed positive attitudes towards PROMs as they saw potential to improve care of other patients (n = 66/79; 83.54%) or to improve their own situation (n = 53/74; 71.62%). Participants preferred an annual interview after stroke (n = 39/80; 48.75%) and would preferably spend 15–30 min (n = 41/79; 51.90%) to answer a written survey (n = 69/80; 86.25%). The initially treating clinic was preferred as initiator of such surveys (n = 43/79; 54.43%). Stratification revealed that participants with more than 1 h of daily digital media usage preferred email as way of communication. Conclusions: For the first time, this study showed individual preferences on assessing PROMs after ischemic stroke, focusing on the way, time interval, duration, and initiation site of surveys. These insights might help to successfully implement PROMs after stroke and subsequently detect unmet needs and deficits in stroke care. [ABSTRACT FROM AUTHOR]

Knowledge of the brain's structure and function is essential for understanding processes in health and disease. Histochemical and fluorescence-based techniques have proven beneficial in characterizing brain regions and cellular compositions in pre-clinical research. Atomic force microscopy (AFM) has been introduced for mechanical tissue characterization, which may also help investigate pathophysiological aspects in disease-related models such as stroke. While combining AFM and fluorescence-based techniques, this study explored the mechanical properties of naive and ischemic brain regions in mice. Ischemia-affected regions were identified by the green signal of fluorescein isothiocyanate-conjugated albumin. A semi-automated protocol based on a brain atlas allowed regional allocations to the neocortex, striatum, thalamus, hypothalamus, hippocampus, and fiber tracts. Although AFM led to varying measurements, intra-individual analyses indicated a gradually increased tissue stiffness in the neocortex compared to subcortical areas, i.e., the striatum and fiber tracts. Regions affected by ischemia predominantly exhibited an increased tissue stiffness compared to those of the contra-lateral hemisphere, which might be related to cellular swelling. This study indicated intra-individual differences in mechanical properties among naive and ischemia-affected brain regions. The combination of AFM, semi-automated regional allocations, and fluorescence-based techniques thus qualifies for mechanical characterizations of the healthy and disease-affected brain in pre-clinical research. [ABSTRACT FROM AUTHOR]

Cancer mortality has declined in recent decades, but—due to a lack of national individual-level data—it remains unclear whether this applies equally to all socioeconomic groups in Germany. Using an area-based approach, this study investigated socioeconomic inequalities in cancer mortality and their secular trends on a German nationwide scale for the first time. Official cause-of-death data from 2003 to 2019 were linked to the district-level German Index of Socioeconomic Deprivation. Age-standardised mortality rates for all cancers combined and the most common site-specific cancers were calculated according to the level of regional socioeconomic deprivation. To quantify the extent of area-based socioeconomic inequalities in cancer mortality, absolute (SII) and relative (RII) indices of inequality were estimated using multilevel Poisson models. On average, cancer mortality was 50% (women) and 80% (men) higher in Germany's most deprived than least deprived districts (absolute difference: 84 deaths per 100,000 in women and 185 deaths per 100,000 in men). As declines in cancer mortality were larger in less deprived districts, the socioeconomic gap in cancer mortality widened over time. This trend was observed for various common cancers. Exceptions were cancers of the lung in women and of the pancreas in both sexes, for which mortality rates increased over time, especially in highly deprived districts. Our study provides first evidence on increasing socioeconomic inequalities in cancer mortality on a nationwide scale for Germany. Area-based linkage allows to examine socioeconomic inequalities in cancer mortality across Germany and identify regions with high needs for cancer prevention and control. [ABSTRACT FROM AUTHOR]

Background: Quantification of [68 Ga]-labeled PSMA PET predicts response in patients with prostate cancer (PC) who undergo PSMA-targeted radioligand therapy (RLT). Given the increasing use [18F]-labeled radiotracers, we aimed to determine whether the uptake derived from [18F]PSMA-1007 PET can also identify responders and to assess its prognostic value relative to established clinical parameters. Methods: We retrospectively analyzed 103 patients with metastatic, castration-resistant PC who were treated with [177Lu]Lu-PSMA I&T. We calculated SUVmean, SUVmax, PSMA-avid tumor volume (TV), and total lesion PSMA (defined as PSMA-TV*SUVmean) on pre-therapeutic [18F]PSMA-1007 PET. Laboratory values for hemoglobin, C-reactive protein (CRP), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and alkaline phosphatase (AP) were also collected prior to RLT. We performed univariable Cox regression followed by multivariable and Kaplan–Meier analyses with overall survival (OS) serving as endpoint. Last, we also computed a risk factor (RF) model including all items reaching significance on multivariable analysis to determine whether an increasing number of RFs can improve risk stratification. Results: A total of 48 patients died and median OS was 16 months. On univariable Cox regression, SUVmean, CRP, LDH, hemoglobin, and the presence of liver metastases were significantly associated with OS. On multivariable Cox regression, the following significant prognostic factors for OS were identified: SUVmean (per unit, HR, 0.91; P = 0.04), the presence of liver metastases (HR, 2.37; P = 0.03), CRP (per mg/dl, HR, 1.13; P = 0.003), and hemoglobin (per g/dl, HR, 0.76; P < 0.01). Kaplan–Meier analysis showed significant separation between patients with a SUVmean below or above a median SUVmean of 9.4 (9 vs 19 months, HR 0.57; P = 0.03). Of note, patients with only one RF (median OS not reached) showed longest survival compared to patients with two (11 months; HR 2.43 95% CI 1.07–5.49, P = 0.02) or more than two RFs (7 months; HR 3.37 95% CI 1.62–7.03, P < 0.001). Conclusion: A lower SUVmean derived from [18F]PSMA-1007, higher CRP, lower hemoglobin, and the presence of liver metastases are associated with reduced OS in patients undergoing RLT. An early RF model also demonstrated that an increasing number of those factors is linked to worse outcome, thereby emphasizing the importance of clinical and imaging parameters for adequate risk stratification. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to prospectively evaluate the clinical and radiological results of double level osteotomy (distal femoral lateral closed wedge and proximal tibial medial open wedge) in medial osteoarthritis and varus malalignment due to bifocal deformity of femur and tibia. Methods: From 2017 to 2019 all cases of DLO in osteoarthritic varus malaligned knees with bifocal deformity (femoral and tibial deformity) were prospectively enrolled into this observational therapeutic study. Evaluation was performed preoperatively, at six, twelve, 18 and 24 months with regard to survival (not requiring arthroplasty), functional outcome [subjective International Knee Documentation Committee score (IKDC), Oxford Knee Score (OKS), Knee Injury and Osteoarthritis Outcome score (KOOS) and Tegner Activity Scale], pain level (numeric rating scale), subjective satisfaction (rating 1–5), radiographic parameters on a pre-and postoperative full leg x-rays (mechanical axis, mechanical proximal tibial and distal femoral angles) and complications. For statistical evaluation student's t test, Mann–Whitney U test and Wilcoxon-signed-rank test were used. Results: Fifty-two consecutive cases in 48 patients were enrolled in the study. Three cases were excluded, resulting in a follow-up rate of 94%. No arthroplasties were performed within follow-up. All functional outcome scores substantially and significantly increased as early as six months after the index procedure and further increased until final follow-up (p < 0.001). Pain level significantly decreased (p < 0.001). At final follow-up all patients stated that they would retrospectively undergo the operation again, and rated the result with 4.5 ± 0.6 out of 5 (3–5). Radiographic parameters were within physiological limits postoperatively. No severe complications occurred. Conclusions: Double level osteotomy has excellent short-term results while maintaining physiological radiographic parameters. Therefore, it should be an integral part and standard procedure in realignment surgery for monocompartimental osteoarthritis. Level of evidence: IV (prospective observational therapeutic study). [ABSTRACT FROM AUTHOR]

Introduction: In malignant cerebral infarction decompressive hemicraniectomy has demonstrated beneficial effects, but the optimum size of hemicraniectomy is still a matter of debate. Some surgeons prefer a large-sized hemicraniectomy with a diameter of more than 14 cm (HC > 14). We investigated whether this approach is associated with reduced mortality and an improved long-term functional outcome compared to a standard hemicraniectomy with a diameter of less than 14 cm (HC ≤ 14). Methods: Patients from the DESTINY (DEcompressive Surgery for the Treatment of malignant INfarction of the middle cerebral arterY) registry who received hemicraniectomy were dichotomized according to the hemicraniectomy diameter (HC ≤ 14 cm vs. HC > 14 cm). The primary outcome was modified Rankin scale (mRS) score ≤ 4 after 12 months. Secondary outcomes were in-hospital mortality, mRS ≤ 3 and mortality after 12 months, and the rate of hemicraniectomy-related complications. The diameter of the hemicraniectomy was examined as an independent predictor of functional outcome in multivariable analyses. Results: Among 130 patients (32.3% female, mean (SD) age 55 (11) years), the mean hemicraniectomy diameter was 13.6 cm. 42 patients (32.3%) had HC > 14. There were no significant differences in the primary outcome and mortality by size of hemicraniectomy. Rate of complications did not differ (HC ≤ 14 27.6% vs. HC > 14 36.6%, p = 0.302). Age and infarct volume but not hemicraniectomy diameter were associated with outcome in multivariable analyses. Conclusion: In this post-hoc analysis, large hemicraniectomy was not associated with an improved outcome or lower mortality in unselected patients with malignant middle cerebral artery infarction. Randomized trials should further examine whether individual patients could benefit from a large-sized hemicraniectomy. Clinical trial registration information: German Clinical Trials Register (URL: https://www.drks.de; Unique Identifier: DRKS00000624). [ABSTRACT FROM AUTHOR]

Purpose: We aimed to assess prevalence, distribution, and intensity of in-vivo arterial wall fibroblast activation protein (FAP) uptake, and its association with calcified plaque burden, cardiovascular risk factors (CVRFs), and FAP-avid tumor burden. Methods: We analyzed 69 oncologic patients who underwent [68 Ga]Ga-FAPI-04 PET/CT. Arterial wall FAP inhibitor (FAPI) uptake in major vessel segments was evaluated. We then investigated the associations of arterial wall uptake with calcified plaque burden (including number of plaques, plaque thickness, and calcification circumference), CVRFs, FAP-positive total tumor burden, and image noise (coefficient of variation, from normal liver parenchyma). Results: High focal arterial FAPI uptake (FAPI +) was recorded in 64/69 (92.8%) scans in 800 sites, of which 377 (47.1%) exhibited concordant vessel wall calcification. The number of FAPI + sites per patient and (FAPI +)-derived target-to-background ratio (TBR) correlated significantly with the number of calcified plaques (FAPI + number: r = 0.45, P < 0.01; TBR: r = − 0.26, P = 0.04), calcified plaque thickness (FAPI + number: r = 0.33, P < 0.01; TBR: r = − 0.29, P = 0.02), and calcification circumference (FAPI + number: r = 0.34, P < 0.01; TBR: r = − 0.26, P = 0.04). In univariate analysis, only body mass index was significantly associated with the number of FAPI + sites (OR 1.06; 95% CI, 1.02 − 1.12, P < 0.01). The numbers of FAPI + sites and FAPI + TBR, however, were not associated with other investigated CVRFs in univariate and multivariate regression analyses. Image noise, however, showed significant correlations with FAPI + TBR (r = 0.30) and the number of FAPI + sites (r = 0.28; P = 0.02, respectively). In addition, there was no significant interaction between FAP-positive tumor burden and arterial wall FAPI uptake (P ≥ 0.13). Conclusion: [68 Ga]Ga-FAPI-04 PET identifies arterial wall lesions and is linked to marked calcification and overall calcified plaque burden, but is not consistently associated with cardiovascular risk. Apparent wall uptake may be partially explained by image noise. [ABSTRACT FROM AUTHOR]

A σ -ideal I on a Polish group (X , +) has the Smital Property if for every dense set D and a Borel I -positive set B the algebraic sum D + B is a complement of a set from I . We consider several variants of this property and study their connections with the countable chain condition, maximality and how well they are preserved via Fubini products. In particular we show that there are c many maximal invariant σ -ideals with Borel bases on the Cantor space 2 ω . [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence of an "increased posterior tibial slope (PTS)" (PTS ≥ 12°) in a population with one, two or ≥ three anterior cruciate ligament (ACL) graft insufficiencies. Furthermore, to investigate whether the prevalence of an increased PTS and the absolute PTS increases with an increasing number of ACL graft insufficiencies, as well as to determine the survival time of the first ACL graft. Methods: Patients diagnosed with an ACL graft insufficiency between January 2021 and March 2022 were included. The PTS was measured using the proximal anatomical tibial axis on long lateral knee radiographs. Patients were divided into 3 groups depending on the number of ACL graft insufficiencies: group A (1 graft insufficiency), group B (2 graft insufficiencies) and group C (≥ 3 graft insufficiencies). The prevalence of increased PTS and absolute PTS between groups was compared alongside the survival of the first ACL graft between patients with or without increased PTS. Results: Two-hundred and six patients (147 males/59 females) met the inclusion criteria. 73 patients showed an increased PTS [prevalence 35% [95% confidence interval (CI) (29%; 42%)]. 155 patients were found in category A, 42 patients in B and 9 patients in C. The prevalence of increased PTS for group A, B and C was, 32% [95% CI (25%; 40%)], 38% [95% CI (23%; 53%)] and 78% [95% CI (51%; 100%)], respectively. The prevalence of increased PTS and mean PTS did not increase significantly between group A and B. However, both parameters increased significantly between group A and C, and group B and C (p < 0.05). The survival time of the first ACL graft in patients with or without an increased PTS was 3 (interquartile range (IQR) 5) and 6 years (IQR 9), respectively (p < 0.05). Conclusion: There is a 35% prevalence of increased PTS in the studied ACL graft insufficient patient cohort. The survival of the first ACL graft is shorter in patients with an increased PTS. Surgeons should be aware of the high prevalence of increased PTS when consulting patients for revision ACL reconstruction as it is an important risk factor for recurrent instability. Level of evidence: 3. [ABSTRACT FROM AUTHOR]

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