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Purpose: In Germany, colorectal robot-assisted surgery (RAS) has found its way and is currently used as primary technique in colorectal resections at our clinic. We investigated whether RAS can be extensively combined with enhanced recovery after surgery (ERAS®) in a large prospective patient group. Methods: Using the DaVinci Xi surgical robot, all colorectal RAS from 09/2020 to 01/2022 were incorporated into our ERAS® program. Perioperative data were prospectively recorded using a data documentation system. The extent of resection, duration of the operation, intraoperative blood loss, conversion rate, and postoperative short-term results were analyzed. We documented the postoperative duration of Intermediate Care Unit (IMC) stay and major and minor complications according to the Clavien–Dindo classification, anastomotic leak rate, reoperation rate, hospital-stay length, and ERAS® guideline adherence. Results: One hundred patients (65 colon and 35 rectal resections) were included (median age: 69 years). The median durations of surgery were 167 min (colon resection) and 246 min (rectal resection). Postoperatively, four patients were IMC-treated (median stay: 1 day). In 92.5% of the colon and 88.6% of the rectum resections, no or minor complications occurred postoperatively. The anastomotic leak rate was 3.1% in colon and 5.7% in rectal resection. The reoperation rate was 7.7% (colon resection) and 11.4% (rectal resection). The hospital stay length was 5 days (colon resection) and 6.5 days (rectal resection). The ERAS® guideline adherence rate was 88% (colon resection) and 82.6% (rectal resection). Conclusion: Patient perioperative therapy per the multimodal ERAS® concept is possible without any problems in colorectal RAS, leading to low morbidity and short hospital stays. [ABSTRACT FROM AUTHOR]

The goal of this analysis is to describe seasonal disaster patterns in Central Europe in order to raise awareness and improve hospital disaster planning and resilience, particularly during peak events. Hospitals are essential pillars of a country's critical infrastructure, vital for sustaining healthcare services and supporting public well-being-a key issue of national security. Disaster planning for hospitals is crucial to ensure their functionality under special circumstances. But the impact of climate change and seasonal variations in the utilization of hospital services are raising challenges. Therefore, the knowledge of perennial disaster patterns could help strengthen the resilience of hospitals. We conducted a cross-sectional analysis of the Emergency Events Database EM-DAT for disasters in Central Europe (Germany, France, Denmark, The Netherlands, Belgium, Luxembourg, Switzerland, Austria, Czech Republic, and Poland) between January 2000 and December 2023. Time distribution of disasters, patterns and longitudinal trends, were analyzed to discuss impact on disaster preparedness in hospitals. Out of 474 events, 83% were associated with a natural hazard and only 80 events (17%) were of technological cause. While technological disasters were spread equally over the whole year, the vast majority of disasters related to natural hazards (n = 394), i.e. storms (n = 178, 45%), floods (n = 101, 26%), and extreme temperatures (n = 93, 24%) peaked during summer and winter months. Fewer disasters were registered during autumn and especially spring seasons. More than 50% of the technological disasters were categorized in the transport accident subgroup. Technological disasters were spread equally over the whole year. Looking at the three most common disaster types, extreme temperatures, floods, and storms are clearly dominating and cause over 90% of the disasters due to natural hazards in central Europe. Overall, the number of events per year fluctuates without a clear trend, only the technological events appear to become less frequent with 70% (n = 56) of the registered disasters occurring in the first half of the study period (2000-2011). An overlap of hospital admissions due to seasonal effects and catastrophic events, mainly triggered by disasters of natural cause in vulnerable periods may lead to a partial collapse of the health care system. To close knowledge gaps, future comprehensive data collection is vital for informed decision-making. Awareness and preparedness are key: an "all-hazards" approach to manage diverse, potentially simultaneous seasonal threats is often the most versatile strategy for hospital emergency planning., Competing Interests: Declarations. Competing interest: Markus Ries: Is a guest Editor of the collection „Disaster and emergency preparedness “ of Scientific Reports. The remaining authors have no conflicts of interest to declare., (© 2024. The Author(s).)

In addition to the national pandemic plan to cope with the COVID-19 pandemic, it is stipulated that the Federal Centre for Health Education (BZgA) provides information on coronavirus SARS-CoV‑2 for the general population via a subpage of www.infektionsschutz.de . In particular, the informational material should contain answers to frequently asked questions (FAQ) as well as behavioural recommendations for prevention.This article describes how information content is created ad hoc in the form of FAQ and why these FAQ are significant for crisis communication. The evolution of the FAQ from a simple information instrument to an inter-institutional rapid reaction tool in the context of risk communication on COVID-19 becomes clear. Close cooperation between the authorities is required to ensure that information is provided in a congruent and up-to-date manner. The work and coordination processes as well as various update procedures are presented. Theoretical implications for crisis communication and crisis management can be derived from the work processes described and assessed.These processes can be taken up by other institutions as examples of good practice and, if necessary, further developed and/or transferred to other contexts., (© 2022. The Author(s).)

Background: Postoperative pancreatic fistula is a dangerous complication in pancreatic surgery. This study assessed the impact of microbiologic pathogens detected in postoperative pancreatic fistula on clinical outcomes after partial pancreatoduodenectomy and distal pancreatectomy., Methods: Microorganisms in postoperative pancreatic fistula were identified by microbiologic analyses from abdominal drains or intraoperative swabs during relaparotomy. Demographic, operative, and microbiologic data, as well as postoperative outcomes were examined., Results: Of 2,752 patients undergoing partial pancreatoduodenectomy and distal pancreatectomy, 256 patients with clinically relevant postoperative pancreatic fistula (International Study Group of Pancreatic Surgery [ISGPS] grades B and C) were identified (9.3%) and microbiologic cultures were positive in 210 patients (82.0%), with a higher rate after partial pancreatoduodenectomy (95.8%) than after distal pancreatectomy (64.3%; P < .001). Microbiologic spectra differed distinctively between partial pancreatoduodenectomy and distal pancreatectomy. Detection of microorganisms in postoperative pancreatic fistula resulted in a higher morbidity and mortality, including postpancreatectomy hemorrhage (42.4% vs 21.7%; P = .009), sepsis (38.1% vs 6.5%; P < .001), wound infection (30.0% vs 6.5%; P = .001), reoperation (48.1% vs 10.9%; P < .001), hospital stay (median 42 vs 26 days; P < .001), and overall 90-day mortality (19.5% vs 4.3%; P = .013) and was identified as an independent risk factor for sepsis, wound infection, and reoperation in the multivariate analysis., Conclusion: Detection of microorganisms in postoperative pancreatic fistula is frequent after pancreatic resection and indicates a turning point in the development of postoperative pancreatic fistula into a life-threatening condition. Whether early anti-infective therapy in combination with interventional measures or a surgical reintervention are warranted, has yet to be elucidated., (Copyright © 2018 Elsevier Inc. All rights reserved.)

Using an analogy between moths and men, in 1916, Richard Goldschmidt proposed that homosexuality was a case of genetic intersexuality. As he strove to create a unified theory of sex determination that would encompass animals ranging from moths to men, Goldschmidt's doubts grew concerning the association of homosexuality with intersexuality until, in 1931, he dropped homosexuality from his theory of intersexuality. Despite Goldschmidt's explicit rejection of his theory of homosexuality, Theo Lang, a researcher in the Genealogical-Demographic Department of the Institute for Psychiatric Research in Munich, revived it, maintained Goldschmidt's association with it, and argued on its behalf in publications from 1936 to 1960. Lang's appropriation of Goldschmidt's theory did not depend on his resolution of the difficulties Goldschmidt had found with his own theory. Lang and Goldschmidt, I argue, had fundamentally different scientific and social commitments that allowed one to reject this theory of homosexuality and the other to accept it.

Objective: This study compares teacher-reported prevalence rates for disruptive behavior disorders using DSM-IV, DSM-III-R, and DSM-III criteria within the same population of elementary school students and examines the relationships between DSM "subtypes" and academic performance, perceived behavior problems, and demographic variables., Method: Teacher rating scales were obtained on 1,077 students in five rural and five urban public schools in Regensburg, Germany. Rating scales included DSM-III-R items (attention-deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder), DSM-IV items (attention-deficit/hyperactivity disorders [AD/HDs], oppositional defiant disorder), and DSM-III items (attention deficit disorder, with and without hyperactivity). Factor analyses of significance were performed., Results: Overall prevalence for attention deficit disorders increased from 9.6% (DSM-III) to 17.8% (DSM-IV) primarily because of new cases identified as AD/HD-AD (inattentive type) and to a lesser degree, AD/HD-HI (hyperactive-impulsive type). Inattention in any subtype was associated with academic problems, and perceived behavior problems were associated with more than 80% of the cases that included hyperactivity-impulsivity. DSM-IV AD/HD subtypes showed significant behavioral, academic, and demographic differences., Conclusion: Application of DSM-IV criteria increased total AD/HD prevalence rates by 64% and identified the majority of children with academic and/or behavioral dysfunction. The data show significant heterogeneity between the subtypes and imply that many children screened into these subtypes require further evaluation to ensure appropriate management.