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Abstract Background The primary aims of this study were to compare in patients with esophageal or esophagogastric junction cancers the potential of 68Ga-NODAGA-RGD PET/CT with that of 18F-FDG PET/CT regarding tumoral uptake and distribution, as well as histopathologic examination. Methods Ten 68Ga-NODAGA-RGD and ten 18F-FDG PET/CT were performed in nine prospectively included participants (1 woman; aged 58 ± 8.4 y, range 40–69 y). Maximum SUV (SUVmax) and metabolic tumor volumes (MTV) were calculated. The Mann–Whitney U test and Spearman correlation analysis (ρ) were used. Results 68Ga-NODAGA-RGD PET/CT detected positive uptake in 10 primary sites (8 for primary tumors and 2 for local relapse suspicion), 6 lymph nodes and 3 skeletal sites. 18F-FDG PET/CT detected positive uptake in the same sites but also in 16 additional lymph nodes and 1 adrenal gland. On a lesion-based analysis, SUVmax of 18F-FDG was significantly higher than those of 68Ga-NODAGA-RGD (4.9 [3.7–11.3] vs. 3.2 [2.6–4.2] g/mL, p = 0.014). Only one participant showed a higher SUVmax in an osseous metastasis with 68Ga-NODAGA-RGD as compared to 18F-FDG (6.6 vs. 3.9 g/mL). Correlation analysis showed positive correlation between 18F-FDG and 68Ga-NODAGA-RGD PET parameters (ρ = 0.56, p = 0.012 for SUVmax, ρ = 0.78, p

Background: Well-established performance measures for organ donation programs do not fully address the complexity and multifactorial nature of organ donation programs such as the influence of relationships and organizational attributes. Objective: To synthesize the current evidence on key organizational attributes and processes of international organ donation programs associated with successful outcomes and to generate a framework to categorize those attributes. Design: Scoping Review using a mixed methods approach for data extraction. Setting: Databases included PubMed, CINAHL, Embase, LILACS, ABI Business ProQuest, Business Source Premier, and gray literature (organ donation association websites, Google Scholar—first 8 pages), and searches for gray literature were performed, and relevant websites were perused. Sample: Organ donation programs or processes. Methods: We systematically searched the literature to identify any research design, including text and opinion papers and unpublished material (research data, reports, institutional protocols, government documents, etc). Searches were completed on January 2018, updated it in May 2019, and lastly in March 2020. Title, abstracts, and full texts were screened independently by 2 reviewers with disagreements resolved by a third. Data extraction followed a mixed method approach in which we extracted specific details about study characteristics such as type of research, year of publication, origin/country of study, type of journal published, and key findings. Studies included considered definitions and descriptions of success in organ donation programs in any country by considering studies that described (1) attributes associated with success or effectiveness, (2) organ donation processes, (3) quality improvement initiatives, (4) definitions of organ donation program effectiveness, (5) evidence-based practices in organ donation, and (6) improvements or success in such programs. We tabulated the type and frequency of the presence or absence of reported improvement quality indicators and used a qualitative thematic analysis approach to synthesize results. Results: A total of 84 articles were included. Quantitative analysis identified that most of the included articles originated from the United States (n = 32, 38%), used quantitative approaches (n = 46, 55%), and were published in transplant journals (n = 34, 40.5%). Qualitative analysis revealed 16 categories that were described as positively influencing success/effectiveness of organ donation programs. Our thematic analysis identified 16 attributes across the 84 articles, which were grouped into 3 categories influencing organ donation programs’ success: context (n = 39, 46%), process (n = 48, 57%), and structural (n = 59, 70%). Limitations: Consistent with scoping review methodology, the methodological quality of included studies was not assessed. Conclusions: This scoping review identified a number of factors that led to successful outcomes. However, those factors were rarely studied in combination representing a gap in the literature. Therefore, we suggest the development and reporting of primary research investigating and measuring those attributes associated with the performance of organ donation programs holistically. Trial Registration: Not applicable.

Abstract Background The ever-expanding field of surgery requires novel tools to teach surgical pathologies and their management. Basic knowledge must already be acquired on a pre-graduate level at medical school. The SARS-CoV-19 pandemic has pushed students to explore digital online platforms to complement their medical education. This study aimed to assess the utility of short educational videos and the importance of digital learning methods to teach abdominal surgery. Methods A literature review was performed for a thorough understanding of educational videos. Short videos were then created covering different topics of abdominal surgery. To evaluate the utility of such videos, three consecutive cohorts of medical students were compared. The first cohort comprised students studying without the videos (V0), whereas the second and third cohorts had access to the videos (V1, V2). Between the three groups, the general demand for videos, subjective study habits, and objective examination scores were compared. In the V1 and V2 group, satisfaction and engagement regarding the videos were also assessed. Results This study included 746 medical students over a three-year period, with similar demographics. The demand for videos was high (90% in V0, 88% in V1 and V2 each) in all three groups. In total, 23 short videos were produced. Students recognized the benefits of videos in understanding the basics of surgical pathologies and their management. On average, 95.5% of the students found that videos were successful in summarizing the lectures’ key points. Moreover, 96.5% found that the videos helped them to better recall the lecture content. A median overall improvement of 12.5% between V0 and V1 examination results was observed. Conclusions This study emphasizes the importance of implementing innovative teaching methods in modern medical education. Students expressed a strong demand for short educational videos. In the future, this project could expand to other surgical and non-surgical specialties.

BackgroundThe transition from school to university is often accompanied by a change in students’ lifestyles. So far little is known whether convenience behavior is an essential factor affecting students’ health and social interaction. In a heterogeneous population regard to sociodemographic and anthropometric characteristics the Convenience Behavior Questionnaire (CBQ) showed a better relationship between convenience-related behavior with overweight and obesity than established questionnaires. Here we assessed convenience behavior in a large well characterized cohort of university students and its association with health-related (mainly sedentary behavior and physical activity), study-related and sociodemographic factors with the Convenience Behavior Questionnaire (CBQ).MethodsA total of 4,351 students participated in an online survey, of which 3,983 (23.6 ± 5.3 years old, 71.3% females) answered the questions concerning convenience behavior. A low value in the CBQ indicates more convenience behavior [Convenience Behavior Index (CBI) range: 3–15]. Differences with regard to sociodemographic (age, gender, body mass index), study-related (semester, degree, field of study) and health-related (physical activity, sedentary behavior) variables were examined with Mann–Whitney-U test or Kruskal–Wallis test and post-hoc tests (Bonferroni).ResultsThe CBI of men and women differed significantly (z = −6.847, p

Abstract University students worldwide are facing increasing mental health challenges. Traditional stress models, like the Job/Study Demand-Resources Model, link stressors directly to strain. Yet, recent studies suggest the influence of strain on stressors may be even stronger. Our research explored these reciprocal dynamics among university students, considering social support and mindfulness as potential moderators. We conducted a two-wave panel study with 264 university students. We ran separate cross-lagged panel structural equation analyses for three key health outcomes—emotional exhaustion, depression, and well-being—each paired with perceived study stressors, specifically workload and work complexity. Findings revealed significant stressor and strain effects, with social support notably moderating the impact of emotional exhaustion on workload. These insights challenge traditional stress theories and underscore the importance of mental health support and effective stress management strategies for students, emphasizing the need for proactive mental health initiatives in academic environments.

ObjectivesTo target health communication at less health-conscious groups, evidence on health behaviours’ effects on non-health-related outcomes – such as academic performance – is necessary. Recent research has highlighted the associations of various health behaviours on academic performance of university students. However, there is a lack of research investigating the most predominant health behaviours simultaneously and their association with academic performance, as well as the factors that potentially influence the direction or strength of these associations. Therefore, this study investigated (I) which of the predominant health behaviours (physical activity, healthy diet, sleep, sedentary behaviour, alcohol consumption, smoking, drug use) are most associated with academic performance and (II) whether the personal resource of trait mindfulness moderates these associations.MethodsAn online survey was conducted amongst university students during the 2021 summer semester. Group differences in academic performance regarding health behaviours were analysed using ANOVA (N = 1,049). A first linear regression model (N = 571), considering all selected health behaviours simultaneously, assessed their association with academic performance. A second model (N = 540) assessed interaction effects of health behaviours and trait mindfulness. Separate regressions assessed each interaction’s association with academic performance.ResultsSleep, fruit and vegetable consumption, and gender were significantly associated with academic performance. The second model showed no significant interaction effects.ConclusionTargeting sleep and fruit and vegetable consumption might be the most promising strategies for elevating students’ academic performance, thereby enabling health communication strategies to reach groups driven by performance improvements rather than health benefits.

Zu den wichtigsten Präventionsmaßnahmen für suizidales Verhalten zählt die Weltgesundheitsorganisation eine verantwortungsvolle Medienberichterstattung über Suizidalität. Hintergrund hierfür sind Erkenntnisse zu möglichen Medieneffekten, wonach die Medienberichterstattung über Suizidalität zur Entstehung bzw. Verhinderung von suizidalem Verhalten beitragen kann und auf Medienseite vor allem die Art und Weise der Berichterstattung über die Richtung der Effekte entscheidet. Mögliche Effekte medialer Darstellungen von Suizidalität beschränken sich allerdings nicht auf das soziale Lernen von positiven oder negativen Suizidmodellen, sondern können auch die Vorstellungen der Rezipient:innen von der sozialen Realität bei diesem Thema maßgeblich prägen. Zur Berichterstattung über Suizidalität abseits prominenter Einzelfälle in Deutschland ist jedoch bislang kaum etwas bekannt. Der Beitrag widmet sich mit Hilfe einer quantitativen Inhaltsanalyse der Berichterstattung von neun überregionalen Printmedien den Fragen, a) wie intensiv und prominent journalistische Medien in Deutschland über Suizidalität berichten, und b) welche Inhalte und Kontexte bei der Berichterstattung im Fokus stehen. Die Ergebnisse zeigen, dass die Medien in Deutschland kontinuierlich und intensiv, jedoch häufig auch beiläufig über Suizidalität berichten und die Medienrealität ein tendenziell verzerrtes Bild der sozialen Wirklichkeit zeichnet.

Abstract Background Perioperative decrease of albumin (ΔAlb) appeared as a promising predictor of complications after digestive surgery, but its role after liver surgery remains unclear. This study aimed to analyze whether and how ΔAlb can be used to predict complications after liver surgery. Methods A bicentric retrospective analysis of patients undergoing liver surgery (2010–2016) was performed, following TRIPOD guidelines. The preoperative and postoperative difference of albumin was calculated on POD 0 and defined as ΔAlb. Patients with any missing variable were excluded. The primary endpoint was overall complications according to the Clavien classification. A multiparametric algorithm based on ΔAlb was generated to optimize prediction performance. Results A total of 110 patients were analyzed. At least one complication occurred in 66 (60%) patients. Patients with and without complication showed a ΔAlb of 15.8 vs. 9.5 g/L (p

Abstract Vaccination hesitancy has been a major challenge for health authorities and societies during the COVID-19 pandemic. The general determinants of vaccination intentions and behavior include sociodemographic and health-related, psychological, and communication-related factors, with varying relevance for different types of vaccinations, countries, and target groups. The predictors of university students’ COVID-19 vaccination behavior have not been sufficiently studied. Using a German university as an example and based on an online survey of 1398 university students, we investigated factors related to (a) the likelihood of vaccination against COVID-19 and (b) vaccination intention among those who had not been vaccinated by summer of 2021. Psychological factors showed high relevance. Field of study, trust in, and use of certain media and information channels were found to be important determinants of students’ vaccination decision. Our findings can help better understand university students’ vaccination behavior to develop and implement tailored strategies and campaigns.

BackgroundStudents were at an increased risk for elevated mental symptoms during the first year of the COVID-19 pandemic compared to pre-pandemic levels. As universities remained closed much longer than anticipated, the mental burden was expected to persist through the second year of the pandemic. The current study aimed to investigate the prevalence of mental distress from 2019 through 2021 and identify risk factors for elevated mental burden, focusing on gender.MethodsWe analyzed three cross-sectional online surveys among students at the University of Mainz, conducted in 2019 (n = 4,351), 2020 (n = 3,066), and 2021 (n = 1,438). Changes in the prevalence of depressive symptoms, anxiety, suicidal ideation, and loneliness were calculated using Pearson's chi-square tests and analyses of variance. Multiple linear regressions yielded associated risk factors.ResultsThe proportion of students with clinically relevant depressive symptoms was significantly higher during the pandemic (38.9% in 2020, and 40.7% in 2021), compared to pre-pandemic (29.0% in 2019). Similarly, more students reported suicidal ideation and generalized anxiety during the pandemic with a peak in the second pandemic year (2021). The level of loneliness was significantly higher in 2020, compared to 2019, and remained at a high level in 2021 (p < 0.001, ηp2 = 0.142). Female and diverse/open gender, being single, living alone, and being a first-year student were identified as risk factors associated with mental burden during the pandemic.DiscussionMental burdens remained elevated among students through the second year of the pandemic and were associated with socio-demographic risk factors and pandemic-related concerns. Future research should monitor recovery and evaluate the need for psychosocial support.

BackgroundThe present study aimed to (1) assess and compare sedentary time (ST) of university students before and during the COVID-19 pandemic, (2) examine risk groups with regard to ST and the “extent of change” in ST (from before to during the pandemic) in association with sociodemographic (gender, age), study-related (degree aspired to, field of study, semester), and pre-pandemic physical health-related [pre-pandemic physical activity (PA) and ST levels, pre-pandemic BMI class] variables, and (3) investigate whether the change in ST was predicted by these variables.MethodsTwo online surveys were conducted among students at the University of Mainz, Germany—the first in 2019 (before the pandemic) and the second in 2020 (during the pandemic). Participants of both surveys were included in a longitudinal sample. With the longitudinal sample's data, paired t-tests, single factor, and mixed analyses of variances were used to examine group differences in ST and the “extent of change” in ST. A linear regression analysis was computed to investigate the influence of the abovementioned sociodemographic, study-related, and pre-pandemic physical health-related variables on the change in ST.ResultsOf the N = 4,351 (pre-pandemic) and N = 3,066 (in-pandemic) participants of the online surveys, N = 443 entered the longitudinal sample. ST increased by 1.4 h/day to critical levels (≥8 h/day) in all subgroups analyzed—even among students who were highly physically active before the pandemic. Students with a low pre-pandemic ST had the largest increase in ST. Pre-pandemic PA level negatively predicted the change in ST.ConclusionEven during a global pandemic lockdown, individuals who were previously more physically active and had less ST showed more health-promoting behavior in terms of ST. Therefore, it can be stated that efforts to promote PA and reduce ST are always valuable. Since ST increased and was worryingly high in all subgroups analyzed, all university students should be targeted by multidimensional approaches to tackle ST and promote their health.

Deutschland ist in den letzten Jahren mehrfach Ziel terroristischer Akte geworden. Gerade bei Gewaltereignissen mit vielen Opfern und Todesfällen, wie etwa dem Anschlag am Berliner Breitscheidplatz, ist das Medieninteresse hoch-worauf die Handlungen von Terroristen wiederum explizit abzielen. Die genauen Hintergründe und Einflussfaktoren der Medienberichterstattung über (terroristische) Gewaltereignisse sind in Deutschland bislang kaum beleuchtet. Dies gilt nicht zuletzt für die Frage, wann weshalb welche Begriffe für Gewaltereignisse verwendet werden. Der vorliegende Beitrag geht den Mechanismen der Berichterstattung über (terroristische) Gewaltereignisse a) mit Hilfe einer Analyse von Tweets journalistischer Medien und der Polizei zum Münchner Gewaltereignis 2016 sowie b) von neun leitfadengestützten Expert:inneninterviews mit Journalist:innen und Kommunikationsverantwortlichen von Polizeibehörden, die in den letzten Jahren beruflich mit (terroristischen) Gewaltereignissen in Berührung gekommen sind, auf den Grund. Die Ergebnisse zeigen, dass die Berichterstattung über diese Gewaltereignisse für Journalist:innen eine mitunter belastende Ausnahmesituation darstellt. Ihrem Berufsverständnis nach müssen sie berichten und aufklären-allerdings liegen ihnen in der konkreten Situation oftmals kaum belastbare Informationen vor. Die Quellenlage ist unsicher, auch die Aussagen der Polizei sind in diesen hochdynamischen Lagen von Momentaufnahmen des Einsatzgeschehens geprägt. Das konkrete Wording von Gewaltereignissen wird in den Redaktionen reflektiert und durchaus kontrovers diskutiert. Gleichzeitig führt die Attraktivität des Labels „Terror“ für die Berichterstattung auf Seiten journalistischer Medien mitunter zu ethisch fragwürdigen Auswüchsen.

Abstract Background Postoperative complications are frequent after gastrointestinal surgery and early prediction remains an unmet need. Serum albumin shows a rapid decrease after surgery, and this decline (ΔAlb) may reflect the intensity of the surgical stress response and thereby be a predictor of postoperative complications. This study aimed to comprehensively review the available data on ΔAlb in gastrointestinal surgery. Methods PRISMA guidelines were followed to conduct a systematic review of the literature in MEDLINE and Embase. Studies assessing the role of ΔAlb to predict complications after gastrointestinal surgery were included. Results A total of 1256 articles were screened, and 16 studies were included in the final analysis: 7 prospective and 9 retrospective trials. Sensitivity of ΔAlb to predict postoperative complications ranged from 63 to 84%, whereas specificity ranged from 61 to 86%. Nine out of the 16 included studies established a threshold of ΔAlb to predict morbidity (range: 5–11 g/l or 14–27%). Conclusion ΔAlb appeared as a valuable and promising biomarker to anticipate complications after gastrointestinal surgery. Future efforts are needed to determine whether and how ΔAlb may be integrated in clinical practice to guide clinicians in the perioperative management of patients.

Abstract Aiming to develop and implement intervention strategies targeting pharmacological neuroenhancement (PN) among university students more specifically, we (1) assessed the prevalence of PN among German university students, (2) identified potential sociodemographic and study-related risk groups, and (3) investigated sociodemographic, psychological, study-related psychosocial, general psychosocial and health behavior related factors predicting the 12-month prevalence of PN. Therefore, a cross-sectional online survey was administered to students of the University of Mainz, Germany. A binary logistic regression with stepwise inclusion of the five variable groups was performed to predict PN. A total number of 4351 students out of 31,213 registered students (13.9%) participated in the survey, of which N = 3984 answered the question concerning PN. Of these, 10.4% had used one substance for PN at least once in the past 12 months. The regression analysis revealed 13 variables that were significantly related to the 12-month prevalence of PN. Specifically, the group of health behavior related variables showed the strongest relationship with PN. Therefore, an approach to the prevention of PN should be multifactorial so that it addresses social conditions, as well as education on substance use and healthy behaviors in terms of non-pharmacological strategies as alternatives of PN.

Tristetraprolin (TTP) is a critical negative immune regulator. It binds AU-rich elements in the untranslated-regions of many mRNAs encoding pro-inflammatory mediators, thereby accelerating their decay. A key but poorly understood mechanism of TTP regulation is its timely proteolytic removal: TTP is degraded by the proteasome through yet unidentified phosphorylation-controlled drivers. In this study, we set out to identify factors controlling TTP stability. Cellular assays showed that TTP is strongly lysine-ubiquitinated, which is required for its turnover. A genetic screen identified the ubiquitin E3 ligase HUWE1 as a strong regulator of TTP proteasomal degradation, which we found to control TTP stability indirectly by regulating its phosphorylation. Pharmacological assessment of multiple kinases revealed that HUWE1-regulated TTP phosphorylation and stability was independent of the previously characterized effects of MAPK-mediated S52/S178 phosphorylation. HUWE1 function was dependent on phosphatase and E3 ligase binding sites identified in the TTP C-terminus. Our findings indicate that while phosphorylation of S52/S178 is critical for TTP stabilization at earlier times after pro-inflammatory stimulation, phosphorylation of the TTP C-terminus controls its stability at later stages.

Abstract The COVID-19 pandemic led to a shutdown of universities in Germany. In a longitudinal design, we compared mental health (depression, anxiety, somatic complaints) of university students in Germany before (June to August 2019) and in the course of the COVID-19 pandemic (June 2020) and determined the impact of pandemic-related stress and loneliness on students’ mental health in self-report online surveys. We investigated 443 participants (mean age 22.8 years), among them 77% female, and 10.4% medical students. A small increase of depression mean scores was observed (F(1,420) = 5.21; p = .023), anxiety and somatic complaints have not significantly changed. There was a medium increase in loneliness from pre-pandemic scores to the pandemic situation (F(1,423) = 30.56; p

Plasma cells (PCs) and their progenitors plasmablasts (PBs) are essential for the acute and long-term protection of the host against infections by providing vast levels of highly specific antibodies. Several transcription factors, like Blimp1 and Irf4, are already known to be essential for PC and PB differentiation and survival. We set out to identify additional genes, that are essential for PB development by CRISPR-Cas9 screening of 3,000 genes for the loss of PBs by employing the in vitro-inducible germinal center B cell (iGB) culture system and Rosa26Cas9/+ mice. Identified hits in the screen were Mau2 and Nipbl, which are known to contribute to the loop extrusion function of the cohesin complex. Other examples of promising hits were Taf6, Stat3, Ppp6c and Pgs1. We thus provide a new set of genes, which are important for PB development.

Abstract Background The reverse treatment of patients with synchronous colorectal liver metastases (CRLM) is a sequential approach with systemic chemotherapy first, followed by liver resection, and finally, primary tumor resection. The aim of this study was to assess the feasibility, the radiological and pathological tumor response to neoadjuvant therapy, recurrence rates and long-term survival after reverse treatment in a cohort study. Methods Data from patients with CRLM who underwent a reverse treatment from August 2008 to October 2016 were extracted from our prospective hepato-biliary database and retrospectively analyzed for response rates and survival outcomes. Radiological tumor response was assessed by RECIST (Response Evaluation Criteria In Solid Tumor) criteria and pathological response according to TRG (Tumor Regression Grade). Disease-free and overall survival were estimated with Kaplan-Meier survival curves. Results There were 44 patients with 19 rectal and 25 colonic tumors. The reverse treatment was fully completed until primary tumor resection in 41 patients (93%). Radiological assessment after chemotherapy showed 61% of complete/partial response. Pathological tumor response was major or partial in 52% of patients (TRG 1–3). Median disease-free survival after primary tumor resection was 10 months (95% CI 5–15 months). Disease-free survival at 3 and 5 years was 25% and 25%, respectively. Median overall survival was 50 months (95% CI 42–58 months). Overall survival at 3 and 5 years was 59% and 39%, respectively. Conclusion The reverse treatment approach was feasible with a high rate of patients with complete treatment sequence and offers promising long-term survival for selected patients with advanced simultaneous colorectal liver metastases.

BackgroundPhysical inactivity and sedentary behavior are modifiable risk factors for an unhealthy lifestyle in university students. The aim of this study was to identify subgroups among German university students with an increased risk for unhealthy behavior. For this purpose, differences in physical activity and sedentary behavior with respect to sociodemographic and study related factors were examined.MethodsA total of 4,351 students participated in an online survey. The amount of physical activity (metabolic equivalent of task-min/week) and the sitting time (h/day) were assessed using the German short form of the International Physical Activity Questionnaire. Differences in gender and age as well as field of study, targeted degree and study semester were analyzed using a single factorial ANOVA with Tukey correction or a Welch-ANOVA with Games-Howell correction.ResultsFor physical activity, significant differences were found for gender (F(2, 80.46) = 17.79, p < 0.001, ηp2 = 0.009), for field of study (F(5, 1738.09) = 7.41, p < 0.001, ηp2 = 0.01), and for study semester (F(1, 948.12) = 5.53, p < 0.05, ηp2 =0.001), but not for age and targeted degree (p > 0.05). For sedentary behavior, significant differences were found for field of study (F(5, 3816) = 5.69, p < 0.001, ηp2 = 0.01) and targeted degree (F(3, 3868) = 3.94, p < 0.01, ηp2 = 0.003), but not for gender, age and study semester (p > 0.05).ConclusionFemale students, students enrolled in “natural sciences, mathematics and informatics” and first year students appear to have an increased risk of an unhealthy lifestyle. Future research should identify barriers to and incentives of physical activity as well as reasons for high amounts of SB in sub-populations of university students. Suitable prevention and intervention programs are necessary.

Job crafting has been established as a bottom-up work design instrument for promoting health and well-being in the workplace. In recent years, the concepts of job crafting have been applied to the university student context, proving to be positively related to student well-being. Building on person-centered analyses from the employment context, we assessed approach study crafting strategy combinations and the relationships to students’ exhaustion, study engagement, and general well-being. Data from 2,882 German university students were examined, collected online during the summer term in 2020. Using latent profile analysis, we found five distinct crafting groups, which showed discriminate validity with regard to emotional exhaustion, engagement, and well-being. The results underscore the positive role of study crafting for students’ health and well-being. They further indicate a less important role of increasing social resources for emotional exhaustion when combined with a moderate increase in structural resources and a moderate increase in challenging demands. Our findings imply that interventions to promote study crafting should be considered to promote student health and well-being.

BackgroundMalnutrition has been shown to be a risk factor for postoperative complications after pancreatoduodenectomy (PD). In addition, patients needing a PD, such as patients with pancreatic cancer or chronic pancreatitis, often are malnourished. The best route of postoperative nutrition after PD remains unknown. The aim of this randomized controlled trial is to evaluate if early postoperative enteral nutrition can decrease complications after PD compared to oral nutrition.MethodsThis multicenter, open-label, randomized controlled trial will include 128 patients undergoing PD with a nutritional risk screening ≥3. Patients will be randomized 1:1 using variable block randomization stratified by center to receive either early enteral nutrition (intervention group) or oral nutrition (control group) after PD. Patients in the intervention group will receive enteral nutrition since the first night of the operation (250 ml/12 h), and enteral nutrition will be increased daily if tolerated until 1000 ml/12 h. The primary outcome will be the Comprehensive Complication Index (CCI) at 90 days after PD.DiscussionThis study with its multicentric and randomized design will permit to establish if early postoperative enteral nutrition after PD improves postoperative outcomes compared to oral nutrition in malnourished patients.Clinical trial registrationhttps://clinicaltrials.gov/(NCT05042882) Registration date: September 2021.

BackgroundAccording to the literature, the conditions of studying and living as well as the psychological, social and health behavior-related variables, which were strongly related to pharmacological neuroenhancement (PN) before the pandemic, significantly changed during the pandemic. For this reason, it is expected that the prevalence of PN among university students is higher during the pandemic compared to before the pandemic. Therefore, the present study aimed to investigate and compare the prevalence of PN among university students before and during the COVID-19-pandemic.MethodsThree online surveys assessing the 12-month prevalence of PN were conducted among university students at the University of Mainz, Germany. The first survey took place in summer term 2019 (before the pandemic), the second in summer term 2020 (during the first German lockdown), and the third in summer term 2021 (after the second German lockdown). Pearson's chi-square test was used to test whether the 12-month prevalence of PN differed significantly between the three surveys.ResultsThe 12-month prevalence of PN was 10.4% in 2019, 11.3% in 2020, and 8.0% in 2021. Chi-square tests revealed no statistical difference in the prevalence of PN between 2019 and 2020. Overall, the use of PN was lower in 2021 compared to 2019 (p < 0.0001) as well as in comparison to 2020 (p = 0.001). Only the use of cannabis slightly increased from 2019 to 2020 (7.1 vs. 8.3%) and decreased in 2021 (5.4%). At all three time points, cannabis was the most commonly used substance for the purpose of PN. Consequently, the results suggest that the prevalence of PN was highly intertwined with the prevalence of cannabis use for PN.DiscussionThe decrease in the prevalence of PN of around three percentage points in 2021 compared to the previous years was a surprising finding. It may be mainly due to the decrease in the prevalence of cannabis for the purpose of PN. However, the fairly high prevalence of PN of around 8% in 2021 is still an important finding that demonstrates that there is still an urgent need for prevention initiatives among university students to combat the use of PN.

Due to the rise of the Internet, the effects of different science communication formats in which experts appear cannot be neglected in communication research. Through their emotional and more comprehensible communication ‘sciencetubers’—who frequently differ from the stereotypical image of scientists as white, old men—may have a considerable effect on the public’s perceived trustworthiness of scientists as well as their trust in science. Thus, this study aims to extend trust and trustworthiness research to consider the role of emotion in science communication in the context of emerging online video content. Therefore, perceived trustworthiness was examined in an experimental online survey of 155 people aged 18–80. We considered different potential influencing variables for trustworthiness (expertise, integrity, benevolence) and used six different video stimuli about physics featuring scientific experts. The video stimuli varied according to format (TV interviews vs. YouTube videos), gender (male vs. female), and age of the experts depicted (old vs. young). The results suggest that: (1) Scientific experts appearing in TV interviews are perceived as more competent but not higher in integrity or benevolence than sciencetubers—while scientists interviewed on TV are regarded as typical scientists, sciencetubers stand out for their highly professional communication abilities (being entertaining and comprehensible); (2) these emotional assessments of scientists are important predictors of perceived trustworthiness; and (3) significantly mediate the effect of the stimulus (TV interview vs. YouTube video) on all dimensions of perceived trustworthiness of scientific experts.

Abstract Background Although 18F- FDG PET/CT is validated in baseline workup of esophageal cancer to detect distant metastases, it remains underused in assessing local staging and biology of the primary tumor. This study aimed to evaluate the association between 18F- FDG PET/CT-derived parameters of esophageal cancer, and its clinico-pathological features and prognosis. Methods All patients (n = 86) with esophageal adenocarcinoma or squamous cell cancer operated between 2005 and 2014 were analyzed. Linear regression was used to identify clinico-pathologic features of esophageal cancer associated with the tumor’s maximal Standardized Uptake Value (SUVmax), Total Lesion Glycolysis (TLG) and Metabolic Tumor Volume (MTV). ROC curve analysis was performed to precise the optimal cutoff of each variable associated with a locally advanced (cT3/4) status, long-term survival and recurrence. Kaplan Meier curves and Cox regression were used for survival analyses. Results High baseline SUVmax was associated with cT3/4 status and middle-third tumor location, TLG with a cT3/4 and cN+ status, whereas MTV only with active smoking. A cT3/4 status was significantly predicted by a SUVmax > 8.25 g/mL (p 41.7 (p 10.70 cm3 (p 12.7 g/mL was associated with an early tumor recurrence and a poor disease-free survival (median 13 versus 56 months, p = 0.030), particularly in squamous cell cancer. Conclusions Baseline 18F- FDG PET/CT has a high predictive value of preoperative cT stage, as its parameters SUVmax, TLG and MTV can predict a locally advanced tumor with high accuracy. A SUVmax > 12.7 g/mL may herald early tumor recurrence and poor disease-free survival.

Background: Universities represent an important setting of everyday life for health promotion. The Healthy Campus Mainz project aims to develop an evidence-based and comprehensive student health management program covering physical, mental, and social health promotion. Hence, an initial health survey was performed in order to identify the students' health concerns and resources. Up until now, it remains unclear which topics to choose in a health survey among university students and which strategies can be recommended to receive an acceptable response rate or representative student sample within a university setting. The present paper contributes to the call for the present research topic “Public Health Promotion in University Students” by describing methods for health assessment. Therefore, the current paper aims to give an empirical example on how to perform a health survey among university students, focusing on (1) choosing topics for the survey and (2) methodological considerations of how to reach the target population.Methods: An online questionnaire including around 270 items was developed covering a comprehensive set of health topics. Participants were recruited via the university email. Mixed channels for survey promotion, such as lecture visits and social media, were used, accompanied by different monetary and non-monetary incentives. Descriptive analyses were performed to describe the sample.Results: A total of 5,006 participants (out of 31,213 registered students) viewed the first page of the questionnaire; of whom, 4,714 continued further. After a manual data cleaning according to the predefined criteria, the final sample was 4,351, demonstrating a response rate of 13.9%. Students from different study disciplines participated. However, some study disciplines showed a low participation rate, hence, making the results not free from some bias.Discussion: This survey is exceptional as it integrates a great variety of health aspects. The incentive strategy demonstrated promising results. Future research should try to improve target-group-specific recruitment strategies for the traditionally underrepresented groups, such as males and specific study disciplines. This would not only include advancing marketing strategies, but also refining the incentive strategy.

Prolonging working hours and presenteeism have been conceptualized as self-endangering coping behaviors in employees, which are related to health impairment. Drawing upon the self-regulation of behavior model, the goal achievement process, and Warr's vitamin model, we examined the antecedents and moderation effects regarding quantitative demands, autonomy, emotion regulation, and self-motivation competence of university students' self-endangering coping behaviors (showing prolonging working hours and presenteeism). Results from a cross-sectional survey of 3,546 German university students indicate that quantitative demands are positively related and autonomy has a u-shape connection with self-endangering coping. Emotion regulation was shown to be a protective factor for prolonging working hours. Moreover, self-motivation moderated the relationship between quantitative demands and prolonging of working hours, but not in the assumed direction. Self-motivation showed a systematic positive relationship with prolonging of working hours, but no relationship with presenteeism. Autonomy moderated the relationship of quantitative demands with both self-endangering behaviors. We found no moderating effects for emotion regulation of quantitative demands or autonomy and self-endangering behaviors. Besides further practical implications, the results suggest that lecturers should design their courses accordingly with less time pressure and university students should be trained in the use of autonomy.

Structural joint configurations realized with serrated steel surfaces have started to be used in the construction fields to assemble the primary and the secondary structural members of civil engineering structures. The main advantages of these joint configurations rely on their flexibility to accommodate construction tolerances and their slip-resistant load-bearing mechanism against dynamic loading conditions. Therefore, it is important to reliably establish the characteristic value of the friction coefficient or in other words the slip factor between the serrated steel surfaces to design reliable slip-resistant connections. In this study, the characteristic slip factor between the CNC-cut serrated surfaces prepared from S355J2 grade steel plates is determined to investigate the impact of the CNC-cutting procedure on the slip-resistant load-bearing behaviour of steel-to-steel interfaces. Five experimental tests were performed according to EN1090-2, Annex G. The results are presented as the load-slip curves, variation of the bolt pre-tension load level, nominal and actual slip factors for the tested configuration of the CNC-cut serrated steel-to-steel interface.

Health information-seeking behavior is the process of gathering information about health and disease and can be influential for health-related perception and behavior. University students are an important target group for prevention and health promotion and largely belong to an age group that is considered to play a leading role in propagating the SARS-CoV-2 epidemic in Germany. The paper deals with students' health information-seeking behavior before and during the corona crisis, aiming to give insights into its determinants and implications. Using the example of a large German comprehensive university and based on two cross-sectional surveys in the summer of 2019 (n = 4,351) and 2020 (n = 3,066), we investigate which information channels students use for health information, how information seeking changes during the course of the pandemic, and to what extent information seeking is associated with risk perception and risk behavior. For a subsample of participants that participated in both surveys (n = 443), we also trace developments at the individual level through a longitudinal analysis. The results show that students' health information seeking takes place primarily online and changed markedly during the corona crisis. The comparatively high relevance of sources that are largely based on unchecked user-generated content raises the concern whether students' health information-seeking behavior guarantees the necessary quality and reliability of health information. Significant correlations between the intensity of corona-related information seeking, risk perception, and actual risk behavior were found.

Schiedsrichter gehören zu den zentralen Akteuren im Fußball, deren Entscheidungen über den Verlauf von Spielen (mit)entscheiden. Da diese Entscheidungen häufig in mehrdeutigen Spielsituationen getroffen werden, kommt externen Einflüssen große Bedeutung zu. Ausgehend von der Annahme, dass Schiedsrichter wie andere (Sport-)Akteure Massenmedien als einflussreich wahrnehmen und sich an der Medienlogik orientieren, sowie den bisherigen Erkenntnissen zu reziproken Effekten bei Sportlern, Richtern und Staatsanwälten, könnte auch die Medienberichterstattung über Schiedsrichter zu diesen Einflussfaktoren zählen. Der Beitrag geht mit einer quantitativen Online-Befragung aktiver Fußball-Schiedsrichter in Deutschland (n=1.290) den Fragen nach, a) welche Medienangebote Fußball-Schiedsrichter in Deutschland nutzen, b) wie sie die Berichterstattung über sich und ihre Kollegen wahrnehmen und c) welchen Einfluss dies auf sie hat. Die Ergebnisse zeigen, dass die Referees die Medien sowohl für Informationen über Schiedsrichter als auch über die eigenen Spiele heranziehen. Die Berichterstattung wird von den Unparteiischen als negativ und einflussreich wahrgenommen, wobei mit Blick auf die eigene Rolle eine Third-Person-Wahrnehmung zu beobachten ist. Hinweise gibt es darauf, dass die wahrgenommene Präsenz der Massenmedien bis auf den Platz reicht und die Referees diese bei ihren Entscheidungen reflektieren.

Background: Universities represent an important setting for health promotion. The unique collective of university students is of particular relevance since they are the leaders, decision-makers, and parents of tomorrow. In this context, modifiable health influencing factors as well as interventions to prevent these, play a crucial role. Therefore, the present umbrella review aims to (i) provide an overview of review articles addressing epidemiological issues (prevalence and determinants) of modifiable health influencing factors in university students and (ii) to provide an overview of review articles addressing the evidence of interventions to promote/enhance modifiable health influencing factors in university students.Methods: A systematic literature search was performed in the databases PubMed, Cochrane Reviews Library und Web of Science according to the PRISMA guidelines. Only systematic reviews and meta-analyses were included. The AMSTAR-2-Tool was used for the quality assessment.Result: The initial search resulted in 10,726 records of which 81 fulfilled the inclusion criteria, with a further distinction in articles with an epidemiological focus (n = 39) and in articles with interventional approaches (n = 42). Topics of the different review articles ranged from physical activity over mental health, substance use, sleep, diet and nutrition, and media consumption. Many review articles had a specific focus on medical and nursing students and originated from the U.S.A., U.K., or China.Discussion: This umbrella review provides an overview of review articles on the epidemiology of modifiable health influencing factors and on the evidence of interventions targeting these factors among university students. Thereby, experts as well as stakeholders in the field could gain insights into crucial target points for health promotion. It identifies research gaps in terms of study region and groups of students.

AIM To assess the impact of reorganising an 11-bed surgical intermediate care unit (IMCU) from an open to a semi-closed system in a Swiss University Hospital by adding a critical care specialist (CCS). METHODS This was a cohort study including adult IMCU patients enrolled in an Enhanced Recovery After Surgery protocol in the Department of Visceral Surgery, Lausanne University Hospital, from 1 February 2014 to 31 January 2016. Medical supervision by a CCS was implemented on 1 February 2015. RESULTS Introduction of a CCS in a surgical IMCU significantly reduced intensive care unit length of stay (p = 0.005) and potentially preventable operation (p = 0.04) for patients undergoing oesophageal surgery. A CCS in IMCU also proved to significantly reduce readmission in IMCU for hepatic surgery patients (p = 0.04). For other sub-specialties (colorectal, pancreatic and gastric bypass surgery) no significant difference could be found. CONCLUSIONS Reorganisation of a surgical IMCU from an open to a semi-closed system by implementing supervision by a CCS decreased length of stay and complications for the most fragile surgical patients (oesophageal and hepatic patients) after 12 months of implementation.

Fußball ist in Deutschland die mit Abstand beliebteste und medial meist berichtete Sportart. Neben Spielen und Ergebnissen rücken in der Fußballberichterstattung immer häufiger Aspekte abseits des sportlichen Spielgeschehens in den Fokus. Fußballtransfers scheinen für die Berichterstattung besonders interessant, weil sie ziemlich gut zur Handlungslogik der Massenmedien passen und einige Nachrichtenfaktoren aufweisen, die ihr Aufgreifen begünstigen. Zu Eigenschaften und Qualität der Transferberichterstattung in Deutschland ist bislang jedoch wenig bekannt. Der Beitrag untersucht mit Hilfe einer quantitativen Inhaltsanalyse (n=2.132) die Transferberichterstattung der überregionalen Tageszeitungen Bild, Süddeutsche Zeitung und Frankfurter Allgemeine Zeitung sowie der Fachmagazine Kicker und Sport Bild zu Spielertransfers der 1. Bundesliga während der Sommertransferperioden 2010 bis 2013. Durch eine Verknüpfung mit Extra-Media-Daten zu Spielertransfers der Bundesliga wird der Verlässlichkeit der Transferaussagen nachgegangen. Die Ergebnisse zeigen, dass die Transferberichterstattung sich stark am Status der beteiligten Spieler sowie am sportlichen Erfolg der beteiligten Vereine orientiert. Knapp ein Drittel der Transferaussagen stellt sich als falsch heraus.