Klinikum Südstadt Rostock

This study aims to contribute to investigating the potential impact of the SARS-CoV-2 pandemic and lockdown measures on perinatal care.A statistical analysis of diagnoses (ICD-10) of 21,393 newborns born between 2019 and 2021 from three Level 1 perinatal centers was conducted. During the study period, a statistical decrease in full-term births and very early preterm births (VLBW), coupled with an increase in infants born between 28 and 37.0 weeks of gestation, was observed in 2020 and 2021. Likewise, a significantly higher number of infants were born after 42.0 weeks of gestation. Neonatal morbidity, characterized by increased rates of asphyxiated newborns and umbilical artery pH values<7.1 as well as infant damage due to maternal pregnancy complications increased significantly. Furthermore, a statistically significant increase in the number of IUGR/SGA births was observed.While the reduction in the number of very premature infants observed in many places can be interpreted as a positive result of the lockdown measures, our data demonstrate an increase in pathological perinatal parameters. An increase in perinatally depressed newborns and a significantly increased postnatal morbidity of the children can possibly be indicators for an inadequate prenatal and/or intranatal care. Implications for similar, anticipated situations should be drawn.

• Ecological plausibility of species-distribution models is often neglected • Traditional optimal performance metrics often yield implausible models • Temperature response should comply with the ecological niche concept • Performance metrics based on decadal changes are better for climate studies • Temperature bell-shape responses provide better models for climate projections Species Distribution Models (SDMs) are widely used tools for studying potential climate-induced shifts in species distribution to support future marine spatial planning. However, the ecological plausibility of selected models is often neglected, particularly in marine ecosystems, resulting in potentially misleading outcomes, especially when climate effects are of concern. In this study we modeled the distribution of 11 commercial fish species in the North Sea using 57 years of observations and 60 SDMs with various degrees of freedom and aimed to improve the ecological plausibility of SDMs by evaluating common model selection techniques. Model performance was evaluated using deviances obtained with three cross-validation designs, Akaike Information Criterion, median absolute deviation and percentage of local mismatch. We identified top performing models based on consistent good scores of those metrics and assessed the ecological plausibility of all models. Specifically, we tested whether the modeled temperature response curve aligned with the ecological niche concept, i.e. having a bell shape within the plausible temperature range for each species, where the highest habitat suitability should relate to optimal conditions. The tested performance metrics often yielded conflicting outcomes and selected models with implausible temperature response curves that had poor extrapolation skills in temperature space and, thus, may result in unreliable predictions under climate change. Building on our findings, we provide recommendations for future SDM applications to improve their accuracy, ecological plausibility and predictive skills in climate-related studies.

Background: The shift in surgery is taking place in two directions. On the one hand, it is shifting from open surgery to minimally invasive surgery which will ultimately morph into robot-assisted surgery. On the other hand, the therapeutic possibilities of flexible endoscopy have developed enormously in recent years. Various procedures, such as the debridement of pancreatic necrosis, the resection of early neoplasms, the treatment of achalasia, or the resection of numerous submucosal tumors, have passed into the hands of the interventional endoscopist. Endoscopic procedures have also become established in the management of complications of major intestinal procedures. Despite the fact that endoscopic therapy requires time to heal, for example, in VAC therapy, it being less invasive reduces patient morbidity. Summary: The most common complications in modern pancreatic surgery are pancreatogenic fistulas and fluid collections, as well as insufficiencies of pancreatointestinal or biliodigestive anastomoses. Such complications can be treated endoscopically using methods such as stent placement in the pancreatic or bile duct, endosonographically guided drainage of fluid collections, and even VAC therapy. Key Messages: Endoscopic intervention is the first procedure of choice offered in the treatment of complications in pancreatic surgery. It primarily reduces morbidity in the recovery phase of patients.