Pain, Agitation, Delirium, and Iatrogenic Withdrawal Syndrome Management in Children Who Are Critically Ill: Protocol for a European Clinical Practice Guideline Using the Grading of Recommendations Assessment, Development, and Evaluation Approach.

Background: In pediatric intensive care units, pain, sedation, delirium, and iatrogenic withdrawal syndrome (IWS) must be managed as interrelated conditions. Although clinical practice guidelines (CPGs) exist, new evidence needs to be incorporated, gaps in recommendations addressed, and recommendations adapted to the European context.

Objective: This protocol describes the development of the first patient- and family-informed European guideline for managing pain, sedation, delirium, and IWS by the European Society of Paediatric and Neonatal Intensive Care.

200 years of KIT/TH Karlsruhe, 125 Years of Polymer Science in Karlsruhe: The Place Where Staudinger's Polymer Research Started.

Within this special issue we would like to celebrate 200 years of the Karlsruhe Institute of Technology (KIT) and the former Technical University Karlsruhe/Germany. The Technical University Karlsruhe served, according to the first president of MIT, William Barton Rogers, as the role model for the planned MIT in Boston/USA after he visited Karlsruhe. All authors of this special issue of Macromolecular Rapid Communications have been or are still active in Karlsruhe.

Elinzanetant for the Treatment of Vasomotor Symptoms Associated With Menopause: A Phase 3 Randomized Clinical Trial.

Importance: There is an unmet need for long-term, safe, effective, and hormone-free treatments for menopausal symptoms, including vasomotor symptoms (VMS) and sleep disturbances.

Objective: To evaluate the 52-week efficacy and safety of elinzanetant, a dual neurokinin-targeted therapy, for treating moderate to severe VMS associated with menopause.

Design, Setting, And Participants: OASIS-3 was a double-blind, placebo-controlled, randomized phase 3 clinical trial that was conducted at 83 sites in North America and Europe from August 27, 2021, to February 12, 2024, and included postmenopausal women aged 40 to 65 years who were seeking treatment for moderate to severe VMS (no requirement for a minimum number of VMS events per week).

Rethinking the relationship between ambulatory activity and falls in long-term care: Risk versus reward.

Background: Ambulatory older residents in long-term care(LTC) have the highest risk of falling. However, the relationship between ambulatory activity (steps per day) and fall risk in LTC is unclear. This study examined whether baseline daily step count, functional capacity and cognitive function predicted falls in LTC residents, and whether functional capacity modified the relationship between step count and fall risk.

Micro- and nanoplastic effects on the reproduction of Daphnia spp. - A meta-analysis.

Several micro- and nanoplastic particle (MNP) traits, like polymer type, size, and shape, have been shown to influence MNP toxicity. However, the direction and strength of these moderating effects are often unclear, and generalizations from single studies are challenging to establish. Meta-analyses increase generalizability and derive more accurate and precise effect size estimates by combining measurements from published studies.

Relationship between Weight Bias Internalization, Diabetes Stigma, and Perceptions of Healthcare Interactions among People with Type 2 Diabetes.

Introduction: Weight and diabetes stigma among healthcare professionals (HCPs) may negatively impact treatment decisions, patient outcomes, and physician-patient interactions. We assessed the relationship between weight stigma, diabetes stigma, perceptions of healthcare quality, and avoidance of healthcare among adults with type 2 diabetes (T2D).

Methods: This observational, online survey-based study included 857 US adults with T2D.

Isolated spinal aneurysms with spontaneous regression.

Purpose: To share our clinical experience with conservative management of isolated spinal arterial aneurysms (ISAs) and to identify clinical scenarios where conservative management may be appropriate, in the context of a literature review.

Methods: We performed a retrospective review of spinal angiograms from two German neuroradiology centers and conducted a systematic literature review of reported ISA cases. We analyzed demographics, clinical presentation, imaging findings, treatments, and outcomes.

Prescription of lipid-lowering drugs and their association with hospitalization for ST-elevation myocardial infarction (STEMI) in Germany in 2010-2022.

Objectives: We investigated changes in lipid-lowering drug prescriptions in Germany as a whole and in the 16 federal states over the last 13 years and their association with hospitalization rates for acute myocardial infarction.

Design: Ecological study.

Setting: Nationwide German hospitalization, Diagnosis-Related Groups Statistic.

Exploitation of Biodiversity in Bioeconomy: Examples, Opportunities, and Challenges.

While bioprocesses using Escherichia coli, Corynebacterium glutamicum, various species of Bacillus, lactic acid bacteria, Clostridia, the yeasts Saccharomyces cerevisiae and Pichia pastoris, fungi such as Aspergillus niger, and Chinese hamster ovary cells are well established, the high level of microbial diversity has not yet been exploited industrially. However, the use of alternative organisms has the potential to significantly expand the process window of bioprocesses. These extensions include the use of alternative substrates (e.

Comparative evaluation of the CGuard dual-layer stent and Carotid Wallstent for elective carotid artery stenting: a retrospective multicenter study.

Purpose: This study aims to evaluate the safety and efficacy of the CGuard dual-layer stent with its mesh embolic protection system (EPS) in elective cases for treatment of internal carotid artery stenosis and compares it to the Carotid Wallstent as benchmark.

Methods: In this retrospective, multicenter study, we analyzed data from consecutive patients who underwent carotid artery stenting with CGuard at two high-volume neurointerventional centers and compared them with prior consecutive patients treated with Carotid Wallstent (CWS), with and without a balloon guiding catheter (BGC) as protection, at the same institutions. Patient demographics, procedural details, clinical complications, early in-stent thrombosis and occlusion rates, and late follow-up restenosis rates were assessed.

[Tinnitus-current developments : Overview and summary of current state of knowledge in 2024].

Chronic tinnitus is a common symptom of the auditory system. Its pathophysiology remains incompletely understood, primarily due to its multifactorial etiology, which resembles that of other chronic conditions. As a result, effective clinical management requires interdisciplinary diagnostics and personalized therapeutic strategies.

Photon-counting detector CT angiography to evaluate carotid and subclavian artery stents and compared to ultrasound and angiography - an in-vivo study with spectral reconstructions.

PurposeTo evaluate the potential of Photon-Counting Detector CT Angiography (PCD-CTA) for the assessment of carotid and subclavian artery stents compared to digital subtraction angiography (DSA) and Duplex ultrasound (DUS).MethodsThis study is a single-center, retrospective analysis of consecutive patients treated with a stent for high grade stenosis of the extra-cranial carotid and the subclavian artery between April 2023 and May 2024. Polyenergetic images (PE), iodine and virtual monoenergetic images were performed at different keV levels (40 and 80) and with two body vascular reconstruction kernels (Bv56 and 72) with and without iterative metal artifact reduction.

Angiography-like neurovascular training without radiation utilizing optical cameras and virtual roadmap imaging.

BackgroundAt present, nonvirtual neurovascular training can be performed using either an angiographic suite under fluoroscopic guidance (entailing radiation exposure) or direct optical visualization with a camera-based system. The angiographic approach offers high-fidelity visualization and catheter control but is constrained by the limited availability of such specialized facilities, whereas the camera-based approach can be implemented virtually anywhere yet lacks comparable realism in key procedural aspects. The objective of this work is to develop and evaluate a novel camera-based angiography training system (CBATS) that generates artificial angiograms and roadmaps, thereby combining the advantages of both imaging techniques while eliminating radiation exposure.

Effect of material, prosthesis height, and aging on the fracture strength of additively and subtractively manufactured implant-supported cantilevered prostheses.

Purpose: This study aimed to evaluate the inherent and after cyclic loading fracture strength of implant-supported cantilevered fixed prostheses fabricated from recently introduced additively manufactured (AM) and subtractively manufactured (SM) materials, considering variations in prosthesis height.

Materials And Methods: Three cylinder-shaped master files (20 mm long and 11 mm wide) with varying heights (7, 11, and 15 mm) and a titanium-base (Ti-base) abutment space were designed. These designs were used to fabricate a total of 144 specimens with two AM resins indicated for definitive use (Crowntec; AM-CT and Flexcera Smile Ultra+; AM-FS), one high-impact polymer composite (breCAM.

Are bio-based resins suitable alternatives for additively manufactured removable dies? An in vitro study on dimensional and positional trueness and stability.

Purpose: This study aimed to compare the dimensional and positional deviations of additively manufactured removable dies fabricated using two bio-based resins and one conventional dental cast resin, while also evaluating these outcomes over a 4-week period.

Materials And Methods: A right mandibular first molar preparation on a typodont was scanned to digitally design removable dies and hollow partial arch casts. Based on a priori power analysis, a total of 30 dies (n = 10) and three hollow casts (n = 1) were fabricated using additive manufacturing (AM) from three different dental cast resins: DentaMODEL (DM), FotoDent bio-based model (CB), and soy-based resin (SB).

A causal inference framework to compare the effectiveness of life-sustaining ICU therapies-using the example of cancer patients with sepsis.

The rise in cancer patients could lead to an increase in intensive care units (ICUs) admissions. We explored differences in treatment practices and outcomes of invasive therapies between patients with sepsis with and without cancer. Adults from 2008 to 2019 admitted to the ICU for sepsis were extracted from the databases MIMIC-IV and eICU-CRD.

Severe Neonatal Respiratory Failure and Transfer for Higher Level Intensive Care: Early Factors Associated With Mortality and Other Outcomes in a Retrospective Cohort, 2018-2020.

Objectives: To identify factors associated with death, requirement for extracorporeal membrane oxygenation (ECMO), or cardiac intervention in neonates referred for higher level neonatal ICU (NICU) due to respiratory failure.

Design: Retrospective cohort study, 2018-2020.

Setting: Referrals for transport to tertiary-level NICUs using the London Neonatal Transfer Service in the United Kingdom.

Perception of frequency-dependent processing delays motivated by hearing devices.

Processing delays can negatively affect listening experience, especially in cases where the (processed) delayed sound interferes with an un-delayed (or direct) sound component, as it is the case for (open-fit) hearing devices. In this study, psychometric functions for delay perception in individual frequency bands were measured. Also, it was assessed how noticeability adds up across frequency bands for frequency-dependent processing delays.

Mixed-Length Multivariate Covalent Organic Framework for Combined Near-Infrared Photodynamic Therapy and Drug Delivery.

Covalent organic frameworks (COFs) have been emerging as versatile reticular materials due to their tunable structures and functionalities, enabled by precise molecular engineering at the atomic level. While the integration of multiple components into COFs has substantially expanded their structural complexity, the strategic engineering of diverse functionalities within a single framework the random distribution of linkers with varying lengths remains largely unexplored. Here, we report a series of highly crystalline mixed-length multivariate COFs synthesized using azobenzene and bipyridine as linkers, where tuning the ratio of linkers and incorporating palladium effectively modulates the balance between near-infrared (NIR) light absorption and catalytic sites for NIR-generation of hydrogen peroxide (HO).

spp.-taxonomy, clinical significance, and antibiotic resistance of a highly versatile pathogen.

SUMMARY spp. are members of the order and are widely found in humans, animals, and the environment. Some species, particularly are highly pathogenic and are among the most frequent causes of urinary tract and bloodstream infections.

Dynamics of polymer rings: The Rouse ring chain with attractive harmonic potential of spherical symmetry.

The static and dynamic properties of a cyclic Rouse chain modified by the introduction of an effective, spherically symmetric, attracting potential of entropic nature are studied. It is shown that a relatively weak potential can lead to a strong contraction of the polymer chain: the radius of gyration becomes much smaller compared to the size of the free cyclic chain. The pronounced decrease in the terminal relaxation time of cyclic macromolecules in the presence of a harmonic potential compared to the Rouse relaxation time leads to a lengthening of the time interval for the transition to the normal, i.

Cationic, anionic, and global dynamics in 1-hexyl-3-methylimidazolium halide supercooled ionic liquids studied by 1H and 35Cl magnetic resonance and oscillatory shear rheology.

The dynamics of the different constituents of the ionic liquid 1-hexyl-3-methylimidazolium chloride (HmimCl) is investigated using nuclear magnetic resonance including chlorine relaxometry, line shape analysis, and proton-detected diffusometry, as well as frequency-dependent shear mechanical measurements. This combination of techniques is useful to probe the individual motions of the anions and the cations, and the sample's overall flow response. The 35Cl- dynamics appears to be close to the structural (or α-) relaxation as seen by rheology.

Reproducibility of fixed-node diffusion Monte Carlo across diverse community codes: The case of water-methane dimer.

Fixed-node diffusion quantum Monte Carlo (FN-DMC) is a widely trusted many-body method for solving the Schrödinger equation, known for its reliable predictions of material and molecular properties. Furthermore, its excellent scalability with system complexity and near-perfect utilization of computational power make FN-DMC ideally positioned to leverage new advances in computing to address increasingly complex scientific problems. Even though the method is widely used as a computational gold standard, reproducibility across the numerous FN-DMC code implementations has yet to be demonstrated.

Rethinking the Kohn-Sham inverse problem.

Density functional theory (DFT) is a cornerstone of modern electronic structure theory. In the Kohn-Sham scheme, the many-electron Schrödinger equation is replaced by a set of effective single-particle equations. Thus, the full complexity of the quantum mechanical many-particle effects is mapped to the exchange-correlation potential vxc(r).