Early-Start vs. Late-Start Icodextrin for Children Receiving Chronic Peritoneal Dialysis: Findings from the International Pediatric Peritoneal Dialysis Network.

Background: Experience with icodextrin use in children on long-term peritoneal dialysis is limited. We describe international icodextrin prescription practices and their impact on clinical outcomes: ultrafiltration, blood pressure control, residual kidney function (RKF), technique and patient survival.

Methods: We included patients under 21 years enrolled in the International Pediatric Peritoneal Dialysis Network (IPPN) between 2007 and 2024, on automated PD with a daytime dwell.

Testing the Efficacy of a Web-Based Intervention for Loss and Bereavement in Later Life (AgE-health Study): Results From a Randomized Controlled Trial.

Background: The loss of a loved one is a common yet stressful event in later life. Internet- and mobile-based interventions have been proposed as an effective treatment approach for individuals with prolonged grief.

Objective: The AgE-health study aimed to investigate the efficacy of an eHealth intervention, trauer@ktiv, in reducing prolonged grief symptoms in a sample of older adults.

Deep reinforcement learning control unlocks enhanced heat transfer in turbulent convection.

Turbulent convection governs heat transport in both natural and industrial settings, yet optimizing it under extreme conditions remains a significant challenge. Traditional control strategies, such as predefined temperature modulation, struggle to achieve substantial enhancement. Here, we introduce a deep reinforcement learning (DRL) framework that autonomously discovers optimal control policies to maximize heat transfer in turbulent Rayleigh-Bénard convection.

Excitatory glycine receptors control ventral hippocampus synaptic plasticity and anxiety-related behaviors.

Excitatory glycine receptors (eGlyRs), composed of the glycine-binding NMDA receptor subunits GluN1 and GluN3A, have recently emerged as a novel neuronal signaling modality that challenges the traditional view of glycine as an inhibitory neurotransmitter. Unlike conventional GluN1/GluN2 NMDARs, the distribution and role of eGlyRs remain poorly understood. Here, we show that eGlyRs are highly enriched in the ventral hippocampus (VH) and confer distinct properties on this brain region.

Synovial MS4A4A correlates with inflammation and counteracts response to corticosteroids in arthritis.

MS4A4A belongs to the MS4A tetraspan protein superfamily and is selectively expressed by the monocyte-macrophage lineage. In this study, we aimed to evaluate the role of MS4A4A+ macrophages in rheumatoid arthritis (RA) pathogenesis and response to treatment. RNA sequencing and immunohistochemistry of synovial samples from either early treatment-naïve or active chronic RA patients showed that MS4A4A expression positively correlated with synovial inflammation.

Lymphotoxin beta receptor mice display altered B- and T-cell subpopulations in the bone marrow and peritoneal cavity after infection.

Lymphotoxin β receptor (LTβR/TNFRSF3) signaling plays a crucial role in immune defense. Notably, LTβR-deficient (LTβR) mice exhibit severe defects in innate and adaptive immunity against various pathogens and succumb to infection. Here, we investigated the bone marrow (BM) and peritoneal cavity (PerC) compartments of LTβR mice during infection, demonstrating perturbed B-cell and T-cell subpopulations in the absence of LTβR signaling.

Digital Psychological Intervention for Inflammatory Rheumatic Diseases: A Pilot Randomized Clinical Trial.

Importance: Patients with inflammatory rheumatic diseases (IRDs) frequently experience psychological distress; however, access to psychological support remains limited.

Objective: To investigate the effectiveness of a digital psychological intervention for individuals with IRDs.

Design, Setting, And Participants: Participants aged 18 years or older were recruited across Germany between February 22 and June 4, 2024, if they had been diagnosed with rheumatoid arthritis, psoriatic arthritis, or systemic lupus erythematosus and reported psychological distress and reduced quality of life.

Essentials of the System of Radiological Protection.

The System of Radiological Protection (the "System") developed by the International Commission on Radiological Protection (ICRP) is built on nearly a century of efforts of numerous scientists and practitioners working together internationally. It rests on three enduring pillars: science, ethics, and experience. These pillars support the three fundamental principles that shape radiological protection strategies: justification, optimisation, and application of dose limits.

Fluorescence-Based Online Monitoring Enables Differentiation in Co-Cultures of Untagged Streptomyces Species and Trichoderma reesei.

Microbial co-cultures provide significant advantages over commonly used axenic cultures in biotechnological processes, including increased productivity and access to novel natural products. However, differentiated quantification of the microorganisms in co-cultures remains challenging using conventional measurement techniques. To address this, a fluorescence-based approach was developed to enable the differentiated online monitoring of microbial growth in co-cultures.

Visualization support for remote collaborative aneurysm treatment planning.

Purpose: Cerebral aneurysms are blood-filled bulges that form at weak points in blood vessel walls, and their rupture can lead to life-threatening consequences. Given the high risk associated with these aneurysms, thorough examination and analysis are essential for determining appropriate treatment. While existing tools such as ANEULYSIS and its web-based counterpart WEBANEULYSIS provide interactive means for analyzing simulated aneurysm data, they lack support for collaborative analysis, which is crucial for enhancing interpretation and improving treatment decisions in medical team meetings.

Targeting the Epigenetic Remodeler GCN5 Prevents Vascular Oxidative Stress and Endothelial Dysfunction in Obesity: Insights in Patients with Cardiometabolic Disease.

Introduction: Epigenetic changes are important modulators of gene expression. The histone acetyltransferase gene non-derepressible 5 (Gcn5) is emerging as a pivotal epigenetic player in metabolism and cancer, yet its role in obesity and cardiovascular disease remains elusive.

Aims: To investigate Gcn5 role in obesity-related endothelial dysfunction.

Machine learning for myocarditis diagnosis using cardiovascular magnetic resonance: a systematic review, diagnostic test accuracy meta-analysis, and comparison with human physicians.

Myocarditis is an inflammation of heart tissue. Cardiovascular magnetic resonance imaging (CMR) has emerged as an important non-invasive imaging tool for diagnosing myocarditis, however, interpretation remains a challenge for novice physicians. Advancements in machine learning (ML) models have further improved diagnostic accuracy, demonstrating good performance.

Role of patient frailty in resection of newly diagnosed motor eloquent glioblastomas guided by a navigated transcranial magnetic stimulation and tractography approach.

Purpose: Resection of glioblastomas infiltrating the motor cortex and corticospinal tract (CST) is often linked to increased perioperative morbidity. Navigated transcranial magnetic stimulation (nTMS) motor mapping has been advocated to increase patient safety in these cases. The additional impact of patient frailty on overall outcome after resection of cases with increased risk for postoperative motor deficits as identified with nTMS needs to be investigated.

Statins in Acute Ischemic Stroke: Mechanisms, Resistance, and Precision Strategies for Neurovascular and Cognitive Protection.

Acute ischemic stroke (AIS) remains a leading cause of mortality and long-term disability globally, with survivors at high risk of recurrent stroke, cardiovascular events, and post-stroke dementia. Statins, while widely used for their lipid-lowering effects, also possess pleiotropic properties, including anti-inflammatory, endothelial-stabilizing, and neuroprotective actions, which may offer added benefit in AIS management. This article synthesizes emerging evidence on statins' dual mechanisms of action and evaluates their role in reducing recurrence, improving survival, and mitigating cognitive decline.

Evaluating the quality, feasibility and patient satisfaction of medication history taking by telephone for patients with scheduled admissions: a pilot study.

Introduction: Medication history taking at hospital admission is still prone to errors. Despite numerous quality improvement initiatives, new strategies to improve medication history taking are still sought and evaluated. Unfortunately, the gold standard research methodology for evaluation is resource-intensive, as it requires each patient to complete two medication history interviews.

Target controlled infusion in the intensive care unit: a scoping review.

Target-controlled infusion (TCI) systems, originally developed for intravenous drug administration of anesthetic drugs, enable precise drug delivery based on pharmacokinetic-pharmacodynamic (PKPD) models. While widely used in the operating room, their application in the intensive care unit (ICU) remains limited despite the complexity of drug dosing in critically ill patients. This scoping review evaluates existing evidence on the use of TCI systems in ICU settings, focusing on sedation, analgesia, and antibiotic administration.

Individual and group reflection in lecture-based large groups lead to comparable learning success.

Objective: The study aims to elucidate a possible effect of individual reflection (IR) or group reflection (GR) on short-term and long-term memory retention in a large group lecture-based environment.

Methods: In this quasi-experimental study 656 medical students were enrolled to compare the impact of IR and GR directly after the lectures and 2 months later. Students were divided into two groups and given two different lectures using IR or GR in a cross-over fashion.

Moderate manipulation to somatosensory feedback does not affect Libet-style intentional action.

The existence of free will has been called into question by Benjamin Libet's seminal experiment, who argued that our conscious decision is preceded by an unconscious decision reflected in the readiness potential (RP). Alternatively, it has been argue that the RP rather reflects a decision process in which different signals accumulate until they reach the intention threshold, at which point an agent experience their intention simultaneously. This raises the question what type of signal is accumulated given that no external information is provided.

DigiNet: Optimizing personalized care for patients with stage IV non-small cell lung cancer (NSCLC) through a digitally connected provider network-analysis plan of a prospective multicenter cohort trial.

Purpose: The German sector-based healthcare system poses a major challenge to continuous patient monitoring and long-term follow-up, both essential for generating high-quality, longitudinal real-world data. The national Network for Genomic Medicine (nNGM) bridges the inpatient and outpatient care sectors to provide comprehensive molecular diagnostics and personalized treatment for non-small cell lung cancer (NSCLC) patients in Germany. Building on the established nNGM infrastructure, the DigiNet study aims to evaluate the impact of digitally integrated, personalized care on overall survival (OS) and the optimization of treatment pathways, compared to routine care.

The role of remote ischaemic preconditioning (RIPC) in colorectal surgery: a meta-analysis of randomized-controlled studies.

Introduction: Remote ischaemic preconditioning (RIPC) which consists of repeated brief episodes of non-lethal limb ischaemia is associated with organ protection and improved clinical outcomes through complex pathophysiological pathways. The aim of this meta-analysis was to evaluate the postoperative effects of RIPC in bowel recovery and surgical morbidity after colorectal surgery.

Methods: In strict adherence to the PRISMA guidelines, a systematic literature search was performed for studies comparing the postoperative effect RIPC in colorectal surgery.

Individual alpha frequency tACS modifies the detection of space-time optical illusion.

Postdiction is a perceptual phenomenon where the perception of an earlier stimulus is influenced by a later one. This effect is commonly studied using the 'rabbit illusion', in which temporally regular, but spatially irregular, stimuli are perceived as equidistant. While previous research has focused on short inter-stimulus intervals (100-200 ms), the role of longer intervals, which may engage late attentional processes, remains unexplored.

Transposing intensive care innovation from modern warfare to other resource-limited settings.

Background: Delivering intensive care in conflict zones and other resource-limited settings presents unique clinical, logistical, and ethical challenges. These contexts, characterized by disrupted infrastructure, limited personnel, and prolonged field care, require adapted strategies to ensure critical care delivery under resource-limited settings.

Objective: This scoping review aims to identify and characterize medical innovations developed or implemented in recent conflicts that may be relevant and transposable to intensive care units operating in other resource-limited settings.

Impact of sociodemographic and socioeconomic factors on functional and health-related quality of life outcomes 24 months after radical prostatectomy.

Introduction And Objectives: High socioeconomic status (SES) is associated with improved oncological outcomes across various cancer types, including prostate cancer. However, limited evidence exists regarding the impact of SES and lifestyle factors on patient-reported outcomes (PROs), including quality of life (QoL), health status (HS), and functional recovery following radical prostatectomy (RP).

Materials And Methods: We conducted a retrospective single-center analysis of 327 patients undergoing RP (177 open, 150 robotic-assisted) assessing pre- and postoperative functional outcomes (QoL, HS, erectile function, continence).