@article{RiechelmannGamerBoeckleretal.2021, author = {Riechelmann, Eva and Gamer, Matthias and B{\"o}ckler, Anna and Huestegge, Lynn}, title = {How ubiquitous is the direct-gaze advantage? Evidence for an averted-gaze advantage in a gaze-discrimination task}, series = {Attention, Perception, \& Psychophysics}, volume = {83}, journal = {Attention, Perception, \& Psychophysics}, issn = {1943-3921}, doi = {10.3758/s13414-020-02147-3}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235268}, pages = {215-237}, year = {2021}, abstract = {Human eye gaze conveys an enormous amount of socially relevant information, and the rapid assessment of gaze direction is of particular relevance in order to adapt behavior accordingly. Specifically, previous research demonstrated evidence for an advantage of processing direct (vs. averted) gaze. The present study examined discrimination performance for gaze direction (direct vs. averted) under controlled presentation conditions: Using a backward-masking gaze-discrimination task, photographs of faces with direct and averted gaze were briefly presented, followed by a mask stimulus. Additionally, effects of facial context on gaze discrimination were assessed by either presenting gaze direction in isolation (i.e., by only showing the eye region) or in the context of an upright or inverted face. Across three experiments, we consistently observed a facial context effect with highest discrimination performance for faces presented in upright position, lower performance for inverted faces, and lowest performance for eyes presented in isolation. Additionally, averted gaze was generally responded to faster and with higher accuracy than direct gaze, indicating an averted-gaze advantage. Overall, the results suggest that direct gaze is not generally associated with processing advantages, thereby highlighting the important role of presentation conditions and task demands in gaze perception.}, language = {en} } @article{AngerDoeringvanDametal.2021, author = {Anger, Friedrich and D{\"o}ring, Anna and van Dam, Jacob and Lock, Johann Frisco and Klein, Ingo and Bittrich, Max and Germer, Christoph-Thomas and Wiegering, Armin and Kunzmann, Volker and van Eijck, Casper and L{\"o}b, Stefan}, title = {Impact of Borderline Resectability in Pancreatic Head Cancer on Patient Survival: Biology Matters According to the New International Consensus Criteria}, series = {Annals of Surgical Oncology}, volume = {28}, journal = {Annals of Surgical Oncology}, number = {4}, issn = {1068-9265}, doi = {10.1245/s10434-020-09100-6}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235251}, pages = {2325-2336}, year = {2021}, abstract = {Background International consensus criteria (ICC) have redefined borderline resectability for pancreatic ductal adenocarcinoma (PDAC) according to three dimensions: anatomical (BR-A), biological (BR-B), and conditional (BR-C). The present definition acknowledges that resectability is not just about the anatomic relationship between the tumour and vessels but that biological and conditional dimensions also are important. Methods Patients' tumours were retrospectively defined borderline resectable according to ICC. The study cohort was grouped into either BR-A or BR-B and compared with patients considered primarily resectable (R). Differences in postoperative complications, pathological reports, overall (OS), and disease-free survival were assessed. Results A total of 345 patients underwent resection for PDAC. By applying ICC in routine preoperative assessment, 30 patients were classified as stage BR-A and 62 patients as stage BR-B. In total, 253 patients were considered R. The cohort did not contain BR-C patients. No differences in postoperative complications were detected. Median OS was significantly shorter in BR-A (15 months) and BR-B (12 months) compared with R (20 months) patients (BR-A vs. R: p = 0.09 and BR-B vs. R: p < 0.001). CA19-9, as the determining factor of BR-B patients, turned out to be an independent prognostic risk factor for OS. Conclusions Preoperative staging defining surgical resectability in PDAC according to ICC is crucial for patient survival. Patients with PDAC BR-B should be considered for multimodal neoadjuvant therapy even if considered anatomically resectable.}, language = {en} } @article{GrunzPennigFieberetal.2021, author = {Grunz, Jan-Peter and Pennig, Lenhard and Fieber, Tabea and Gietzen, Carsten Herbert and Heidenreich, Julius Frederik and Huflage, Henner and Gruschwitz, Philipp and Kuhl, Philipp Josef and Petritsch, Bernhard and Kosmala, Aleksander and Bley, Thorsten Alexander and Gassenmaier, Tobias}, title = {Twin robotic x-ray system in small bone and joint trauma: Impact of cone-beam computed tomography on treatment decisions}, series = {European Radiology}, volume = {31}, journal = {European Radiology}, issn = {0938-7994}, doi = {10.1007/s00330-020-07563-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235233}, pages = {3600-3609}, year = {2021}, abstract = {Objectives Trauma evaluation of extremities can be challenging in conventional radiography. A multi-use x-ray system with cone-beam CT (CBCT) option facilitates ancillary 3-D imaging without repositioning. We assessed the clinical value of CBCT scans by analyzing the influence of additional findings on therapy. Methods Ninety-two patients underwent radiography and subsequent CBCT imaging with the twin robotic scanner (76 wrist/hand/finger and 16 ankle/foot/toe trauma scans). Reports by on-call radiologists before and after CBCT were compared regarding fracture detection, joint affliction, comminuted injuries, and diagnostic confidence. An orthopedic surgeon recommended therapy based on reported findings. Surgical reports (N = 52) and clinical follow-up (N = 85) were used as reference standard. Results CBCT detected more fractures (83/64 of 85), joint involvements (69/53 of 71), and multi-fragment situations (68/50 of 70) than radiography (all p < 0.001). Six fractures suspected in radiographs were ruled out by CBCT. Treatment changes based on additional information from CBCT were recommended in 29 patients (31.5\%). While agreement between advised therapy before CBCT and actual treatment was moderate (κ = 0.41 [95\% confidence interval 0.35-0.47]; p < 0.001), agreement after CBCT was almost perfect (κ = 0.88 [0.83-0.93]; p < 0.001). Diagnostic confidence increased considerably for CBCT studies (p < 0.001). Median effective dose for CBCT was 4.3 μSv [3.3-5.3 μSv] compared to 0.2 μSv [0.1-0.2 μSv] for radiography. Conclusions CBCT provides advantages for the evaluation of acute small bone and joint trauma by detecting and excluding extremity fractures and fracture-related findings more reliably than radiographs. Additional findings induced therapy change in one third of patients, suggesting substantial clinical impact.}, language = {en} } @article{StrzalkowskaStrzalkowskiAlYousefetal.2021, author = {Strzalkowska, A. and Strzalkowski, P. and Al Yousef, Y. and Grehn, F. and Hillenkamp, J. and Loewen, Nils A.}, title = {Exact matching of trabectome-mediated ab interno trabeculectomy to conventional trabeculectomy with mitomycin C followed for 2 years}, series = {Graefe's Archive for Clinical and Experimental Ophthalmology}, volume = {259}, journal = {Graefe's Archive for Clinical and Experimental Ophthalmology}, issn = {0721-832X}, doi = {10.1007/s00417-020-05031-w}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235224}, pages = {963-970}, year = {2021}, abstract = {Purpose We used exact matching for a highly balanced comparison of ab interno trabeculectomy (AIT) with the trabectome to trabeculectomy with mitomycin C (TRAB). Methods A total of 5485 patients who underwent AIT were exact-matched to 196 TRAB patients by baseline intraocular pressure (IOP), number of glaucoma medications, and glaucoma type. Nearest-neighbor-matching was applied to age. Success was defined as a final IOP of less than 21 mmHg, IOP reduction of at least 20\% reduction from baseline, and no secondary surgical interventions. Outcomes were measured at 1, 3, 6, 12, 18, and 24 months. Results A total of 165 AIT could be matched to 165 TRAB. The mean baseline IOP was 22.3 ± 5.6 mmHg, and the baseline number of glaucoma medications was 2.7 ± 1.1 in both groups. At 24 months, IOP was reduced to 15.8 ± 5.2 mmHg in AIT and 12.4 ± 4.7 mmHg in TRAB. IOP was lower than baseline at all visits (p < 0.01) and lower in TRAB than AIT (p < 0.01). Glaucoma medications were reduced to 2.1 ± 1.3 in AIT and 0.2 ± 0.8 in TRAB. Compared to baseline, patients used fewer drops postoperatively (p < 0.01) and more infrequently in TRAB than in AIT (p > 0.01). Secondary surgical interventions had the highest impact on success and became necessary in 15 AIT and 59 TRAB patients. Thirty-two challenging events occurred in TRAB and none in AIT. Conclusion Both AIT and TRAB reduced IOP and medications. This reduction was more significant in TRAB but at the expense of four times as many secondary interventions.}, language = {en} } @article{ZhouBaiMeckeletal.2021, author = {Zhou, Xiang and Bai, Tao and Meckel, Katharina and Song, Jun and Jin, Yu and Kort{\"u}m, Martin K. and Eisele, Hermann and Hou, Xiaohua and Rasche, Leo}, title = {COVID-19 infection in patients with multiple myeloma: a German-Chinese experience from W{\"u}rzburg and Wuhan}, series = {Annals of Hematology}, volume = {100}, journal = {Annals of Hematology}, issn = {0939-5555}, doi = {10.1007/s00277-020-04184-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235108}, pages = {843-846}, year = {2021}, abstract = {No abstract available.}, language = {en} } @article{HuHahnYangetal.2021, author = {Hu, Chen and Hahn, Lukas and Yang, Mengshi and Altmann, Alexander and Stahlhut, Philipp and Groll, J{\"u}rgen and Luxenhofer, Robert}, title = {Improving printability of a thermoresponsive hydrogel biomaterial ink by nanoclay addition}, series = {Journal of Materials Science}, volume = {56}, journal = {Journal of Materials Science}, issn = {0022-2461}, doi = {10.1007/s10853-020-05190-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-234894}, pages = {691-705}, year = {2021}, abstract = {As a promising biofabrication technology, extrusion-based bioprinting has gained significant attention in the last decade and major advances have been made in the development of bioinks. However, suitable synthetic and stimuli-responsive bioinks are underrepresented in this context. In this work, we described a hybrid system of nanoclay Laponite XLG and thermoresponsive block copolymer poly(2-methyl-2-oxazoline)-b-poly(2-n-propyl-2-oxazine) (PMeOx-b-PnPrOzi) as a novel biomaterial ink and discussed its critical properties relevant for extrusion-based bioprinting, including viscoelastic properties and printability. The hybrid hydrogel retains the thermogelling properties but is strengthened by the added clay (over 5 kPa of storage modulus and 240 Pa of yield stress). Importantly, the shear-thinning character is further enhanced, which, in combination with very rapid viscosity recovery (~ 1 s) and structure recovery (~ 10 s), is highly beneficial for extrusion-based 3D printing. Accordingly, various 3D patterns could be printed with markedly enhanced resolution and shape fidelity compared to the biomaterial ink without added clay.}, language = {en} } @article{BrandReimerReibetanzetal.2021, author = {Brand, Markus and Reimer, Stanislaus and Reibetanz, Joachim and Flemming, Sven and Kornmann, Marko and Meining, Alexander}, title = {Endoscopic full thickness resection vs. transanal endoscopic microsurgery for local treatment of rectal neuroendocrine tumors - a retrospective analysis}, series = {International Journal of Colorectal Disease}, volume = {36}, journal = {International Journal of Colorectal Disease}, issn = {0179-1958}, doi = {10.1007/s00384-020-03800-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-234833}, pages = {971-976}, year = {2021}, abstract = {Purpose Local treatment of small well-differentiated rectal neuroendocrine tumors (NETs) is recommended by current guidelines. However, although several endoscopic methods have been established, the highest R0 rate is achieved by transanal endoscopic microsurgery (TEM). Since a recently published study about endoscopic full thickness resection (eFTR) showed a R0 resection rate of 100\%, the aim of this study was to evaluate both methods (eFTR vs. TEM). Methods We retrospectively analyzed all patients with rectal NET treated either by TEM (1999-2018) or eFTR (2016-2019) in two tertiary centers (University Hospital Wuerzburg and Ulm). We analyzed clinical, procedural, and histopathological outcomes in both groups. Results Twenty-eight patients with rectal NET received local treatment (TEM: 13; eFTR: 15). Most tumors were at stage T1a and grade G1 or G2 (in the TEM group two G3 NETs were staged T2 after neoadjuvant chemotherapy). In both groups, similar outcomes for en bloc resection rate, R0 resection rate, tumor size, or specimen size were found. No procedural adverse events were noted. Mean procedure time in the TEM group was 48.9 min and 19.2 min in the eFTR group. Conclusion eFTR is a convincing method for local treatment of small rectal NETs combining high safety and efficacy with short interventional time.}, language = {en} } @article{GreefrathOldenburgSilleretal.2021, author = {Greefrath, Gilbert and Oldenburg, Reinhard and Siller, Hans-Stefan and Ulm, Volker and Weigand, Hans-Georg}, title = {Basic Mental Models of Integrals - Theoretical Conception, Development of a Test Instrument, and first Results}, series = {ZDM - Mathematics Education}, volume = {53}, journal = {ZDM - Mathematics Education}, issn = {1863-9690}, doi = {10.1007/s11858-020-01207-0}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232830}, pages = {649-661}, year = {2021}, abstract = {A basic mental model (BMM—in German 'Grundvorstellung') of a mathematical concept is a content-related interpretation that gives meaning to this concept. This paper defines normative and individual BMMs and concretizes them using the integral as an example. Four BMMs are developed about the concept of definite integral, sometimes used in specific teaching approaches: the BMMs of area, reconstruction, average, and accumulation. Based on theoretical work, in this paper we ask how these BMMs could be identified empirically. A test instrument was developed, piloted, validated and applied with 428 students in first-year mathematics courses. The test results show that the four normative BMMs of the integral can be detected and separated empirically. Moreover, the results allow a comparison of the existing individual BMMs and the requested normative BMMs. Consequences for future developments are discussed.}, language = {en} } @article{KunzHirthSchweitzeretal.2021, author = {Kunz, Felix and Hirth, Matthias and Schweitzer, Tilmann and Linz, Christian and Goetz, Bernhard and Stellzig-Eisenhauer, Angelika and Borchert, Kathrin and B{\"o}hm, Hartmut}, title = {Subjective perception of craniofacial growth asymmetries in patients with deformational plagiocephaly}, series = {Clinical Oral Investigations}, volume = {25}, journal = {Clinical Oral Investigations}, issn = {1432-6981}, doi = {10.1007/s00784-020-03417-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232803}, pages = {525-537}, year = {2021}, abstract = {Objectives The present investigation aimed to evaluate the subjective perception of deformational cranial asymmetries by different observer groups and to compare these subjective perceptions with objective parameters. Materials and methods The 3D datasets of ten infants with different severities of deformational plagiocephaly (DP) were presented to 203 observers, who had been subdivided into five different groups (specialists, pediatricians, medical doctors (not pediatricians), parents of infants with DP, and laypersons). The observers rated their subjective perception of the infants' cranial asymmetries using a 4-point Likert-type scale. The ratings from the observer groups were compared with one another using a multilevel modelling linear regression analysis and were correlated with four commonly used parameters to objectively quantify the cranial asymmetries. Results No significant differences were found between the ratings of the specialists and those of the parents of infants with DP, but both groups provided significantly more asymmetric ratings than did pediatricians, medical doctors, or laypersons. Moreover, the subjective perception of cranial asymmetries correlated significantly with commonly used parameters for objectively quantifying cranial asymmetries. Conclusions Our results demonstrate that different observer groups perceive the severity of cranial asymmetries differently. Pediatricians' more moderate perception of cranial asymmetries may reduce the likelihood of parents to seek therapeutic interventions for their infants. Moreover, we identified some objective symmetry-related parameters that correlated strongly with the observers' subjective perceptions. Clinical relevance Knowledge about these findings is important for clinicians when educating parents of infants with DP about the deformity.}, language = {en} } @article{FuchsEdenGilbertetal.2021, author = {Fuchs, Konrad F. and Eden, Lars and Gilbert, Fabian and Bernuth, Silvia and Wurmb, Thomas and Meffert, Rainer H. and Jordan, Martin C.}, title = {F{\"u}hrt eine COVID-19 bedingte Ausgangsbeschr{\"a}nkung zu einer Reduktion schwerverletzter Patienten an einem {\"u}berregionalen Traumazentrum?}, series = {Der Unfallchirurg}, volume = {124}, journal = {Der Unfallchirurg}, issn = {0177-5537}, doi = {10.1007/s00113-020-00924-1}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232547}, pages = {352-357}, year = {2021}, abstract = {Hintergrund Intensiv- und Beatmungskapazit{\"a}ten sind f{\"u}r die Behandlung COVID-19-erkrankter Patienten essenziell. Unabh{\"a}ngig davon beanspruchen auch schwer verletzte Patienten h{\"a}ufig Intensiv- und Beatmungskapazit{\"a}ten. Daraus ergibt sich folgende Fragestellung: F{\"u}hrt eine Ausgangsbeschr{\"a}nkung zu einer Reduktion schwer verletzter Patienten, und kann hierdurch mit frei werdenden Intensivkapazit{\"a}ten gerechnet werden? Material und Methoden Es erfolgte eine retrospektive Auswertung schwer verletzter Patienten mit einem Injury Severity Score (ISS) ≥16 zwischen dem 17.03.2020 und 30.04.2020 (landesweiter Shutdown) an einem {\"u}berregionalen Traumazentrum. Erfasst wurden der Unfallmechanismus, ISS, Versicherungstr{\"a}ger (BG vs. GKV/PKV), ob es sich um einen dokumentierten Suizidversuch handelte, und ob eine operative Intervention innerhalb der ersten 24 h erforderlich war. Als Kontrollgruppe wurden die Daten des gleichen Zeitraums der Jahre 2018 und 2019 ausgewertet. Ergebnisse Es konnte keine wesentliche Ver{\"a}nderung bez{\"u}glich der Anzahl an schwer verletzten Patienten festgestellt werden (2018 n = 30, 2019 n = 23, 2020 n = 27). Es zeigten sich insgesamt keine deutlichen Ver{\"a}nderungen der absoluten Zahlen bez{\"u}glich der Intensivpflichtigkeit in den ersten 24 h und der Beatmungspflichtigkeit beim Verlassen des Schockraums. Die Anzahl an Patienten, die eine Operation innerhalb der ersten 24 h nach Eintreffen im Schockraum ben{\"o}tigten, war 2020 sogar leicht erh{\"o}ht, jedoch nicht statistisch signifikant. Der durchschnittliche ISS blieb konstant. Bez{\"u}glich der Unfallursache zeigte sich 2020 kein Motorradfahrer, der einen nicht berufsgenossenschaftlich versicherten Unfall erlitt (2018 n = 5, 2019 n = 4, 2020 n = 0). Es wurde 2020 ein erh{\"o}hter Anteil an Arbeitsunf{\"a}llen mit einem ISS ≥16 festgestellt (2018: 10 \%, 2019: 26,1 \%, 2020: 44,4 \%). Diskussion Eine Ausgangsbeschr{\"a}nkung f{\"u}hrte zu keiner Reduktion verletzter- und intensivpflichtiger Patienten am untersuchten Zentrum. Auch unter einer landesweiten Ausgangsbeschr{\"a}nkung muss f{\"u}r dieses Patientenkollektiv eine ausreichende Menge an Intensiv- und OP-Kapazit{\"a}ten vorgehalten werden. Die Best{\"a}tigung dieser Ergebnisse durch Auswertung nationaler Register steht noch aus.}, language = {de} }