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Background Partial sensory rhizotomy (PSR) is an “ultima ratio” procedure for patients with therapy-refractory trigeminal neuralgia (TN). The treatment can be offered to patients without a neurovascular conflict or to patients who did not benefit either from previous microvascular decompression (MVD) or from other interventional procedures. This study presents our experience with PSR. Methods Our prospectively maintained database was searched for patients who underwent PSR. We conducted a retrospective analysis of all patients with PSR. Clinical data, MR imaging, surgical videos, and OR notes were evaluated and a telephone interview for the last follow-up was done. Results Our search revealed 48 patients treated with PSR between 2004 and 2023. The average age was 59.4 years. Mean history of symptoms was 7.81 years (1–30 years). All types of previous treatments were included. Fifteen patients suffered from multiple sclerosis. A total pain relief was observed in 42 patients immediately after PSR, two patients had a partial pain improvement, and four patients observed no difference. An expected, variable hypesthesia occurred in 37 patients. The most common procedure was a PSR of the lower third. The mean follow-up was 38 months (3–183 months), five patients were lost to follow-up. 28 patients still had complete, 13 partial pain relief. Ten patients still needed medications but were satisfied with a lower dose and generally improved or were even pain-free. Thirteen patients who had benefited from the PSR initially, reported recurrent TN. Five of them received a second PSR after 5–55 months with complete pain relief. Conclusion Early after surgery patient satisfaction regarding pain relief/improvement was 92.7% (44 of 48 patients). During follow-up we observed complete or partial pain relief in 31 of 43 patients (72.1%) without pain medication, another 23.3% were satisfied with on-going medication. However, the degree of sensitive deficits is not predictable. Because of our convincing results, patients should be informed about PSR as a therapeutic option for therapy-refractory or recurrent TN. It may be considered either instead of, or as an alternative to, percutaneous procedures or radiosurgery.

Attracting and securing potential mating partners is of fundamental importance for reproduction. Therefore, signaling sexual attractiveness is expected to be tightly coordinated in communication systems synchronizing senders and receivers. Chemical signaling has permeated through all taxa of life as the earliest and most widespread form of communication and is particularly prevalent in insects. However, it has been notoriously difficult to decipher how exactly information related to sexual signaling is encoded in complex chemical profiles. Similarly, our knowledge of the genetic basis of sexual signaling is very limited and usually restricted to a few case studies with comparably simple pheromonal communication mechanisms. The present study jointly addresses these two knowledge gaps by characterizing two fatty acid synthase genes that most likely evolved by tandem gene duplication and that simultaneously impact sexual attractiveness and complex chemical surface profiles in parasitic wasps. Gene knockdown in female wasps dramatically reduces their sexual attractiveness coinciding with a drastic decrease in male courtship and copulation behavior. Concordantly, we found a striking shift of methyl-branching patterns in the female surface pheromonal compounds, which we subsequently demonstrate to be the main cause for the greatly reduced male mating response. Intriguingly, this suggests a potential coding mechanism for sexual attractiveness mediated by specific methyl-branching patterns in complex cuticular hydrocarbon (CHC) profiles. So far, the genetic underpinnings of methyl-branched CHCs are not well understood despite their high potential for encoding information. Our study sheds light on how biologically relevant information can be encoded in complex chemical profiles and on the genetic basis of sexual attractiveness. Attracting a mate is critical in all species that sexually reproduce. Most animals, particularly insects, do this using chemical compounds called pheromones which can be sensed by potential mates. But how these vast range of different compounds encode and convey the information needed to secure a partner is not fully understood, and the genes that drive this complex communication mechanism are largely unknown. To address this knowledge gap, Sun et al. studied the parasitic wasp Nasonia vitripennis. Like other insects, female N. vitripennis contain a wide range of chemical compounds on their cuticle, the outer waxy layer coating their surface. Sun et al. set out to find exactly which of these compounds, known as cuticular hydrocarbons, are involved in sexual communication. They did this by simultaneously inactivating two related genes that they hypothesized to be responsible for synthesizing and maintaining chemical compounds on the cuticle of insects. The genetic modification altered the pattern of chemicals on the surface of the female wasps by specifically up- and down-regulating compounds with similar branching structures. The mutant females were also much less sexually attractive to male wasps. These findings suggest that the chemical pattern identified by Sun et al. is responsible for communicating and maintaining sexual attractiveness in N. vitripennis female wasps. This is a significant stepping stone towards unravelling how sexual attractiveness can be encoded in complex mixtures of pheromones. The results also have important implications for agriculture, as this parasitic wasp species is routinely used to exterminate particular fly populations that cause agricultural damage. The work by Sun et al. provides new insights into how these wasps sexually communicate, which may help scientists improve their rearing conditions and sustain them over multiple generations. This could contribute to a wider application of this more sustainable, eco-friendly alternative to destructive agricultural pesticides.

Purpose Prognostic significance of lateral spreads response (LSR) disappearance in microvascular decompression (MVD) for hemifacial spasm (HFS) remains controversial. Still the timing of LSR disappearance and its association with overall outcomes has not been sufficiently investigated. We evaluate the prognostic significance of the timing of LSR disappearance during MVD in HFS. Methods Prospective documentation of the LSR-Status during the procedural steps was performed alongside routinely collected data. Surgical steps were categorized into three phases: Opening phase (skin incision till cisternal opening), arachnoid dissection, and actual Decompression phase. Outcome assessment was conducted after a follow-up period of at least 12 months, with favorable outcome defined as at least 90% resolution of the spasms. Results 214 patients were included with a mean age (SD) of 54.9 ± 11.6 years and a follow-up duration (SD) of 25.8 ± 15.7 months. The male-to-female ratio was 1:1.6. LSR was \"not detected\" in 32 patients (15.0%), with a 93.8% favorable outcome. LSR \"persisted\" in 22 patients (10.3%), showing only 77.3% favorable outcome. In 16 patients (7.4%), LSR disappeared during the opening phase, yielding a 100% favorable outcome. LSR disappearance occurred during arachnoid dissection in 40 patients (18.7%), with a 91.1% favorable outcome. Finally, LSR disappearance following nerve decompression was observed in 104 patients (48.6%), showing a 78.9% favorable outcome. Earlier disappearance of the LSR was associated with long-term cure (P-value < 0.05). Conclusion LSR may serve as a valuable intraoperative indicator during MVD for HFS. Early intraoperative disappearance of the LSR may predict favorable long-term outcomes. However, the disappearance of the LSR in general does not consistently correlate with surgical success.

Purpose To benchmark palliative care practices in neurooncology centers across Germany, evaluating the variability in palliative care integration, timing, and involvement in tumor board discussions. This study aims to identify gaps in care and contribute to the discourse on optimal palliative care strategies. Methods A survey targeting both German Cancer Society-certified and non-certified university neurooncology centers was conducted to explore palliative care frameworks and practices for neurooncological patients. The survey included questions on palliative care department availability, involvement in tumor boards, timing of palliative care integration, and use of standardized screening tools for assessing palliative burden and psycho-oncological distress. Results Of 57 centers contacted, 46 responded (81% response rate). Results indicate a dedicated palliative care department in 76.1% of centers, with palliative specialists participating in tumor board discussions at 34.8% of centers. Variability was noted in the initiation of palliative care, with early integration at the diagnosis stage in only 30.4% of centers. The survey highlighted a significant lack of standardized spiritual care assessments and minimal use of advanced care planning. Discrepancies were observed in the documentation and treatment of palliative care symptoms and social complaints, underscoring the need for comprehensive care approaches. Conclusion The study highlights a diverse landscape of palliative care provision within German neurooncology centers, underscoring the need for more standardized practices and early integration of palliative care. It suggests the necessity for standardized protocols and guidelines to enhance palliative care's quality and uniformity, ultimately improving patient-centered care in neurooncology.

Early exposure to negative environmental impact shapes individual behavior and potentially contributes to any mental disease. We reported previously that accumulated environmental risk markedly decreases age at schizophrenia onset. Follow-up of matched extreme group individuals (≤1 vs. ≥3 risks) unexpectedly revealed that high-risk subjects had >5 times greater probability of forensic hospitalization. In line with longstanding sociological theories, we hypothesized that risk accumulation before adulthood induces violent aggression and criminal conduct, independent of mental illness. We determined in 6 independent cohorts (4 schizophrenia and 2 general population samples) pre-adult risk exposure, comprising urbanicity, migration, physical and sexual abuse as primary, and cannabis or alcohol as secondary hits. All single hits by themselves were marginally associated with higher violent aggression. Most strikingly, however, their accumulation strongly predicted violent aggression (odds ratio 10.5). An epigenome-wide association scan to detect differential methylation of blood-derived DNA of selected extreme group individuals yielded overall negative results. Conversely, determination in peripheral blood mononuclear cells of histone-deacetylase1 mRNA as ‘umbrella mediator’ of epigenetic processes revealed an increase in the high-risk group, suggesting lasting epigenetic alterations. Together, we provide sound evidence of a disease-independent unfortunate relationship between well-defined pre-adult environmental hits and violent aggression, calling for more efficient prevention.

Numerous studies have been conducted regarding the interaction between human beings and the biophysical environment. They primarily sought to address the ever-increasing destructive behavior of human beings towards the biophysical environment. In Environmental Education, it is widely assumed that this destructive behavior is the result of a reductionist worldview, which separates human beings from nature. Environmental Education developed as a response towards this destructive interaction. Various Environmental Education models have been developed to understand and change the complex interaction between human beings and the biophysical environment. One such model was developed by Van Rooyen (2002). He identified, amongst others, two constituents that determine abovementioned interaction. The first is the individual self, and the second is the context within which the self functions. These two constituents are closely related. This study wants to contribute to this field by providing a deeper investigation of these two constituents. This is done through emphasis on the depth of experiencing, and through that the personal construction of meaning regarding the value of the biophysical environment.This deeper investigation will incorporate the personal worldview and psychological aspects of the individual. The psychotherapeutic centre, which is situated in a wilderness area, will provide the psychological milieu in which these psychological aspects are investigated. The investigation focuses on adult group work at the centre as a real life situation within which these constituents will be studied.In this study, activities for group work with adults are developed, where ecological principles are being used during therapeutic intervention to address the problems of patients who have been referred to the centre. The biophysical environment within which the centre is situated is used as an active component in the therapeutic process. These ecological principles which are being used are well known in the field of psychology to address personal problems. This study, though, wants to take it one step further, namely, to develop caring and respect for the biophysical environment. This is done through developing a better understanding of the interaction and relationship between human beings and the biophysical environment.This descriptive case study uses the individual responses of participants to monitor the experience and construction of meaning of the natural environment from a personal life context. A holistic open system approach to Environmental and Adult Education has been followed throughout the study, which assumes that each individual is part of a bigger system and that change of behavior towards the biophysical environment cannot be predicted or controlled. The assumption is also made that interaction with the biophysical environment is closely related and influenced by the personal context and problems of the individual. This study in Environmental Education uses the group work at a psychotherapeutic centre as the basis for Environmental Education for adults.

Attracting and securing potential mating partners is of fundamental importance for successfully initiating reproduction and thus assuring the passing of genes to the next generation. Therefore, signaling sexual attractiveness is expected to be tightly coordinated in communication systems synchronizing senders and receivers. Chemical signaling has permeated through all taxa of life as the earliest and most wide-spread form of communication and is particularly prevalent in insects. However, it has been notoriously difficult to decipher how exactly information related to sexual signaling is encoded in complex chemical profiles. Similarly, our knowledge of the genetic basis of sexual signaling is very limited and usually restricted to a few case studies with comparably simple pheromonal communication mechanisms. The present study jointly addresses these two knowledge gaps by characterizing a single gene simultaneously impacting sexual attractiveness and complex chemical surface profiles in parasitic wasps. Knocking down a fatty acid synthase gene in female wasps dramatically reduces their sexual attractiveness coinciding with a drastic decrease in male courtship and copulation behavior. Concordantly, we found a striking shift of methyl-branching patterns in the female surface pheromonal compounds, which we subsequently demonstrate to be the main cause for the greatly reduced male response. Intriguingly, this suggests a potential coding mechanism for sexual attractiveness mediated by specific methyl-branching patterns, whose genetic underpinnings are not well understood despite their high potential for encoding information. Our study sheds light on how biologically relevant information can be encoded in complex chemical profiles and on the genetic basis of sexual attractiveness.Competing Interest StatementThe authors have declared no competing interest.

Home-based remote work becomes increasingly popular. The facets of remote work, especially working from home, are multifaceted and can become stressors that affect a person’s health. At the same time, self-efficacy is an important personal resource to deal with health-related stressors. The objective of this study is therefore to explore the relationship between self-efficacy (SE), work-related stress (WRS), health outcomes (health and anxiety), contributing factors (autonomy and experience) and work-family conflict (WFC) in a remote work setting. Using a PLS-model (partial least square) with a sample of n = 5163 responses, we found that SE significantly reduces WRS (β = −0.164; p < 0.001). Moreover, WFC increases WRS and anxiety, while SE reduces WFC and mediates health outcomes (anxiety: β = −0.065; p < 0.001; health: β = −0.048; p < 0.001). At the same time, autonomy (β = 0.260; p < 0.001) and experience (β = 0.215; p < 0.001) increase SE. Our results have high practical implications for employers and employees, underlining the importance of self-efficacy as a personal resource to buffer WRS and WFC while promoting overall health at the same time.