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Background: Due to the further decrease in the number of habilitations in medicine since 2010, the general requirements for habilitation could have increased during the same period. Objective: The requirements for a medical habilitation at German universities in a comparison of 23 years are re-evaluated. Material and methods: An analysis of habilitation regulations for 12 target parameters and evaluation of these by a scoring system (range 0–34 points). Results: Only the criterion of the requirement for a doctorate has remained the same in the 23-year comparison in the evaluation (1998–2021). All results of the other 11 criteria have changed compared to the previous study from 2010. The rating of habilitation achievements has increased from a total score in 1998 of 15.2 ± 5.1 points (95% confidence interval 13.6–16.9 points) to 25.1 ± 3.6 points in 2021 (95% confidence interval 23.9–26.2 points; p < 0.001). The range of assigned scoring values is again more broadly spread in the 11-year comparison with values from 12 to 31 points. A striking new criterion was that 98% of the assessed habilitation regulations now require a didactic continuing education in, however, significantly different requirements from the faculties. Conclusion: The requirements for a medical habilitation continued to significantly increase over the 23-year period with, however, a wider dispersion of scores. The more detailed description can be seen as a direct indication of an improvement in transparency. In contrast, the broader dispersion shows that a uniform assessment standard for Germany has again receded into the distance. [ABSTRACT FROM AUTHOR]

Objectives: Although the endovascular management of infrarenal abdominal aortic aneurysms (AAAs) is widely performed, many studies have shown better long-term results with open graft repairing, mostly focusing on the classical open repair with midline access. This study aims to evaluate long-term results comparing EVAR (endovascular aneurysm repair) and surgical open repair with retroperitoneal access associated with ERAS (Enhanced Recovery After Surgery) protocol., Methods: A retrospective analysis of 156 patients treated for AAA between 2015 and 2018 was conducted. Clinical and demographic characteristics of the two groups were homogeneous except for age, which was significantly higher in patients belonging to the EVAR one, and for previous laparotomies. A total of 100 patients (58.7%) underwent open retroperitoneal repair (ORR group), and 56 (42.3%) underwent EVAR. A mean of 51 ± 28 months of follow-up was conducted. This study aims to evaluate long-term survival by comparing EVAR (endovascular aneurysm repair) and surgical open repair with retroperitoneal access associated with ERAS (Enhanced Recovery After Surgery) protocol. Secondary aims evaluate differences between the two techniques regarding late complications, need for re-interventions, and perioperative results., Results: Freedom from all-cause mortality, calculated with Kaplan-Meier survival curves equalizing the two population with a Covariate Propensity Score, showed significant better survival rates at 1, 3, and 5 years in ORRs then in EVARs. Late complications (>30 days) and need for late re-intervention rates were greater in the EVAR group (6 late re-interventions needed vs 0 in the ORR group).Perioperative results show longer mean length of hospital stay in patients belonging to the ORR group (5 days vs 2) and significantly higher in-hospital-complication rate., Conclusions: The long-term comparison between EVAR and open retroperitoneal repair shows significantly better late outcomes in the ORR group. The perioperative course appears significantly better in EVARs but anyway good in ORRs when a perioperative protocol as ERAS is applied.In a selected population of young patients fit for surgery, the retroperitoneal surgical approach should be highly taken into account in the therapeutical choice., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: A process of “emptying” can be observed in Swiss cemeteries. Urn burials are increasingly preferred to traditional interments, requiring much less space. Consequently, cemeteries are gradually transforming into park-like areas, triggering debates about proactive ways to use them as public spaces, rather than mourning sites. Objectives and Method: The study presented here probes for changes in the public perception of Bern cemeteries during the last two decades. The long-term analysis is based on a secondary analysis of interviews with 383 cemetery visitors in 2002 and a representative survey among 519 inhabitants of the city of Bern. Results: Tolerance for alternative land use increased further: Motivations for cemetery visits have shifted with a decline from 80% who mentioned ‘grave visit’ to 63% in 2021; ‘leisurely walk’ increased from 63% to 83%. High satisfaction with what cemeteries have to offer is mirrored in high values for perceived restorativeness in 2021. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to report and analyze the long-term outcomes of the patients who underwent high tibial osteotomy (HTO) with three different techniques for the treatment of medial compartment arthrosis. Methods: A total of 187 patients (195 knees) who underwent HTO between 1990 and 2010 were retrospectively evaluated. Eighty-eight knees, opening-wedge osteotomy with Puddu plate (group A); 51 knees, transverse osteotomy below the tubercle with external fixator (group B); and 29 knees, closing-wedge osteotomy with staple fixation (group C) were included in the study. The patients (mean age 44.9 ± 10.6 years, mean follow-up of 12.4 ± 3.2 years) were called for final controls and survival rates of the knees, and functional evaluations of the patients were performed using Knee Society Score (KSS) and Hospital for Special Surgery (HSS) knee score assessments. Results: In the comparison of the three groups, there were no differences regarding the mean age, preoperative arthrosis levels, or preoperative deformity analyses (n.s.). The main finding of these comparisons showed that the closing-wedge osteotomy has the greatest lateralization effect on mechanical axis deviation (MAD) (p = 0.024), the greatest valgization effect on medial proximal tibial angles (MPTA) (p = 0.026), and the lowest posterior tibial slope (PTS) angles (p = 0.032) in comparison to the other groups. There were no functional differences between the three groups in the long-term assessment of patients with KSS and HSS knee scores. According to the Kaplan--Meier survival analysis, the probability of the survival of the native knee joint after HTO was 93.4% in 5 years and 71.2% in 10 years in our study group. During the follow-up of the 168 knees, revision surgery with total knee replacement was needed in 27 knees (16%). The mean time from HTO to total knee replacement was 8.9 years in these patients. Conclusions: HTO has acceptable long-term clinical and functional results that should not be underestimated by orthopedic surgeons under pressure to perform arthroplasty operations. [ABSTRACT FROM AUTHOR]

Monsampolo Organic VEgetable (MOVE) long-term field experiment produced a comparison between organic and a conventionally managed agroecosystem for vegetable production in Central Italy. The study was based on a four-year crop rotation involving six main crops: tomato, melon, fennel, lettuce, cauliflower, and bean. The experiment started in 2001. The agronomic performance and environmental sustainability of the two different management systems were assessed over a three-year period (2007–2010), comparing a) the yield and produce quality; b) cultivar adaptability to organic farming conditions; c) soil quality; and d) potential risk of soil nitrogen leaching. The organic and conventional four-years rotation systems yielded similarly and most of the crops showed no significant differences in produce quality. The study also indicates that comparisons among cultivars to be used in organic farming should be carried out on such experimental field sites where organic farming management had been in place for the long term. Our study demonstrated that soil organic C and total N increased, respectively, of 37% and 22% in the organically managed vegetable production system as compared to the conventional one. The risks of soil nitrate leaching were higher in autumn/winter conventionally managed crops as compared to the organic ones. [ABSTRACT FROM AUTHOR]