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Enhanced recovery after radical cystectomy for bladder cancer : a prospective observational case -control study
(2026) Habicher, Marit; Swoboda, Christina; Hauptmann, Arne; Koch, Christian; Diemer, Thorsten; Paul, Ann-Catrin; Markmann, Melanie; Schneck, Emmanuel; Wagenlehner, Florian; Wolff, Matthias; Sander, Michael
Introduction: The perioperative management of patients undergoing major surgical interventions is a dynamic field, continually striving for advancements in quality, reduction of complications, and cost-effectiveness. The implementation of Enhanced Recovery After Surgery (ERAS) pathways has demonstrated remarkable success in various surgical disciplines, particularly in colorectal procedures. This study investigates whether the implementation of an ERAS protocol for radical cystectomy for bladder cancer at our institution results in a reduced complication rate compared to traditional standards.DRKS00035673 (retrospective) on 13th December 2024. Methods: This prospective observational case-control pilot study was conducted at the University Hospital Giessen, Germany. Following ethics committee approval, 30 patients were enrolled: 15 patients received perioperative management based on prevailing standard operating procedures, and the subsequent 15 patients were managed according to the newly developed ERAS protocol. The multidisciplinary team included urologists, anaesthesiologists, nursing staff, ICU staff, pharmacists, physiotherapists, dietitians, and administrative staff. Key components of the ERAS protocol included optimized pain management, early nutrition, thrombosis prophylaxis, intraoperative goal directed therapy and early mobilization. The primary outcome was the complication rate until the 30th postoperative day, while secondary outcomes included ICU and hospital mortality, length of stay, and quality of life assessed by the EQ-5D-5L questionnaire. Results: Thirty patients were included in the final analysis. Patients in the control group underwent radical cystectomy between September 2018 and December 2019, and those in the ERAS group between July 2020 and March 2021. There were no significant differences in basic characteristics between the groups. The primary outcome showed numeric but no statistically significant difference in complication rates (86.7% in the control group vs. 60% in the ERAS group, p=0.21). However, the cumulative POMS score was significantly higher in the control group (7.87 vs. 2.87, p<0.01), and the Clavien-Dindo score was significantly lower in the ERAS group (p=0.02). Quality of life was significantly improved in the ERAS group on the 7th and 30th postoperative day. Conclusion: Our pilot study suggests feasibility of ERAS implementation in radical cystectomy. The primary endpoint (overall complication rate) did not differ significantly between groups; however, ERAS was associated with lower complication severity and improved early postoperative quality of life, which should be interpreted as exploratory given the small, non-randomised sequential design. Larger multicentre prospective implementation studies are warranted to confirm these findings and to evaluate the influence of protocol adherence and individual ERAS elements.
Mmp2 regulates basement membrane remodeling and dedifferentiation of the visceral musculature during Drosophila metamorphosis
(2026) Töpfer, Uwe; Dahlitz, Ina; Holz, Anne
The basement membrane (BM) is a specialized extracellular matrix that surrounds most tissues and organs. Remodeling of the BM is critical for morphogenesis and to control tissue homeostasis. During Drosophila metamorphosis, most tissues undergo apoptosis and become histolyzed to be replaced by progenitor cells to generate adult structures, but the visceral musculature trans-differentiates to give rise to new adult muscles. The molecular mechanisms of the BM remodeling during this extensive tissue reorganization are poorly understood. Here, we identified Matrix metalloprotease 2 (Mmp2) as a key regulator of BM remodeling in visceral musculature. We find that Mmp2 is localized when the BM is degraded and that Mmp2 is required for degradation of the major BM components. In addition, Mmp2 is important for survival and tissue metamorphosis. Our results suggests that Mmp2-mediated BM remodeling is a prerequisite for metamorphosis and visceral muscle dedifferentiation.
Constant traffic noise affects the behavior and physiology of naïve horses at pasture
(2026) Henke-von der Malsburg, Johanna; König von Borstel, Uta
Introduction: Horses are frequently kept on pastures near major roads, exposing them to high levels of traffic noise. In humans, prolonged traffic noise exposure is associated with physiological stress, sleep disruption, and adverse health effects. Despite horses’ high auditory sensitivity, comparable data on the behavioral and welfare implications of continuous traffic noise are scarce. This study investigated short-term behavioral and physiological responses of horses naïve to constant motorway noise in their home environment. Methods: Twenty horses housed in four stable groups across three facilities were exposed to recorded motorway noise for 1–2 weeks. Emitted noise levels ranged from 54 to 71 dB, corresponding to distances of approximately 500 to 10 m from a four-lane motorway, and were played during daytime for up to 11 h/day using portable outdoor loudspeakers. Control periods without motorway noise (average ambient noise level: 38 dB) before and between exposure days served as baseline, intermediate washout, and final control phases. Behavioral parameters were recorded throughout the day using focal and scan samplings. Heart rate was continuously monitored as a physiological indicator of stress. Results: During noise exposure, horses reduced foraging behavior from a median of 81% at baseline to 41% during the first exposure phase (p<0.001), while vigilance increased from nine to 54 instances per day (p<0.001). Horses also avoided the vicinity of the noise source (p<0.001). Behavioral effects were pronounced at higher noise levels, with clear avoidance responses suggesting aversion as an active coping strategy. Heart rate increased within the first exposure phase, rising from an average of 57.60 bpm to 66.76 bpm (p<0.001), suggesting an acute stress response. Discussion: Although some behavioral habituation was observed over time, spatial avoidance of the noise source persisted, and elevated heart rates indicated continued physiological arousal. Even noise levels of a 500 m distant motorway (≥54 dB) altered behavior and physiology. These findings demonstrate that traffic noise represents a relevant environmental stressor for horses and may compromise welfare when exposure is frequent or prolonged. The study highlights the need to consider noise in equine management and supports mitigation strategies such as providing large pastures with quiet retreat zones or installing noise barriers.
Genetic and non-genetic determinants of vitamin D status : a polygenic score analysis in elite athletes
(2026) Hacker, Sebastian; Reichert, Lukas; Lenz, Claudia; Henne, Sabrina; David, Friederike; Heilmann-Heimbach, Stefanie; Zentgraf, Karen; Krüger, Karsten
Introduction: Vitamin D plays a critical role in bone metabolism, immune regulation, and muscle performance. Serum 25-hydroxyvitamin D [25(OH)D] levels are shaped by both genetic and non-genetic determinants. To explore their combined role, we investigated the association between a polygenic score (PGS) for vitamin D metabolism and serum 25(OH)D concentrations in elite athletes. Methods: Serum vitamin D status was measured in 473 German national squad athletes. PRSice-2 was used for PGS development. Linear regression models compared the predictive utility of an overall model (PGS plus covariates) versus a null model (covariates only). Covariates included age, sex, competition environment, ambient UVB dose, and supplementation. Results: Serum 25(OH)D was significantly predicted by the standardized PGS (β = 4.04), age (β = 8.59), supplementation (β = 20.86), and cumulative weighted UVB dose (cw-D-UVB, β = 7.18; all p < 0.05). The full model explained 31.7% (12.1%) of variance (adjusted R2 = 0.235), with the PGS contributing an incremental 1% (1%). Model performance yielded a mean absolute error of 18.64 nmol/L (3.18 nmol/L) and root mean squared error of 25.27 nmol/L (4.24 nmol/L). No significant interactions were found for PGS × cw- D-UVB, PGS × supplementation status and PGS × competition environment. Discussion: The findings indicate that genetic determinants account for a small proportion of the total variance in vitamin D status. Stronger predictors are non-genetic determinants such as supplementation, UVB exposure, and age, highlighting the predominant role of environmental influences. Given the limited explanatory power of the PGS, individualized management strategies should primarily focus on modifiable factors such as sun exposure and supplementation.
Intrapartum risk factors for calf morbidity and mortality in dairy cattle : a systematic review (2000–2025)
(2026) Trzebiatowski, Lukas; Freick, Markus; Donat, Karsten; Wehrend, Axel
The aim of this study was to perform a systematic review of studies published in the last 25 years to determine the influence of calving management (type of calving pen, bedding, frequency of cleaning), birth monitoring, birth induction, and dystocia on calf morbidity and mortality. The following databases were used for research: PubMed, CAB Abstracts, and Web of Science. In total, four studies were included for birth induction, sixteen for calving management, eight for birth monitoring, and twenty for dystocia. All factors included had an influence on perinatal mortality. Calving management and dystocia influenced mortality up to weaning. Severe cases of dystocia raised the risk of mortality from 11.2 to 53.17 and even cases of moderate dystocia led to an increased risk of mortality from 2.04 to 11.6. Passive transfer of immunity was improved by more frequent birth monitoring. Dystocia increased the risk of failure of passive transfer. Good calving management and performing of birth monitoring reduced the risk of morbidity. Dystocia led to a higher risk of morbidity. Dystocia had the greatest influence on the parameters examined. This systematic review provides evidence that intrapartum factors have an influence on calf morbidity and mortality and shows possibilities to improve calf health outcomes.