Not everything is delirium at the end of life: a case report.

Background: Delirium is a common condition at the end of life and causes significant distress in patients and their loved ones. A precipitant factor can be found in less than half of the patients and the management interventions are limited.

Case Description: A patient in his late sixties with low English proficiency with a metastatic neuroendocrine tumor was transferred to a palliative care unit on non-invasive bilevel ventilation.

Is every pancreatic cancer patient a palliative care patient?

ancreatic cancer is an aggressive disease and often presents at an advanced stage with no curative options. The disease is often characterized by rapid progression, limited or short-lived responsiveness to standard therapies, and a profound impact on patients' quality of life. Despite advances in targeted therapies and immunotherapy, curative outcomes remain elusive for the majority of patients with advanced or high-grade disease with a 5-year survival rate of less than 10%.

A clinical practice review: management strategies and emerging approaches for anastomotic leakage following radical surgery for esophageal cancer.

Radical esophagectomy remains the cornerstone of curative treatment for esophageal cancer, but is frequently complicated by postoperative events, most notably anastomotic leakage. Anastomotic leakage, occurring in up to 30% of cases, is multifactorial in origin and significantly increases morbidity and mortality. This review aims to summarize current management strategies, highlight emerging therapies, and identify persistent clinical challenges related to this complication.

Colonization with antiseptic tolerant in children with cancer: a longitudinal study.

Objective: In the and genes have been associated with elevated MICs to antiseptics with such organisms often termed antiseptic tolerant (ATSA). The impact of repeated healthcare or antiseptic exposure on colonization with ATSA is uncertain.

Design: Prospective longitudinal cohort study.

Exploring Neural Markers of Reward and Loss Processing and Problematic Parenting Styles A Mothers With and Without Histories of Depression.

Depressed mothers often experience parenting difficulties, which can persist after their symptoms have remitted. However, not all depressed mothers show parenting struggles, suggesting that there could be unidentified characteristics that increase risk. Specifically, neurobiological models emphasize that reward system deficits contribute to maladaptive parenting and depression, but no studies have evaluated how they could conjointly lead to parenting challenges.

Bridging Dental Education Gaps in Uganda through Blended Learning: A Qualitative Study.

Purpose: Uganda faces significant oral health workforce shortages, limiting access to dental care. The Uganda Christian University School of Dentistry (UCUSoD) implemented a blended learning approach to enhance dental education by integrating online training. This qualitative study assesses the feasibility and effectiveness of hybrid learning in improving students' knowledge and preparedness for clinical practice.

Unraveling Origins of N-Acetylcysteine (NAC): A Critical Review.

The controversial status of -acetylcysteine (NAC) as a dietary supplement ingredient has renewed interest in its origin. This opinion article critically examines the scientific literature to investigate whether NAC is a naturally occurring compound, with a particular focus on its potential presence in plants. The primary objective of this opinion is to determine the natural occurrence of NAC, specifically within herbal matter.

Sample size reduction in preclinical experiments: A Bayesian sequential decision-making framework.

When animals are used in a preclinical experiment, ethical concerns may arise regarding animal welfare. The 3Rs principles were developed to guide more humane animal research practices. This article specifically addresses the reduction aspect of the 3Rs.

Democratizing Organ-On-Chip Technologies With a Modular, Reusable, and Perfusion-Ready Microphysiological System.

Organ-on-chip (OOC) technologies, also called microphysiological systems (MPS), offer dynamic microenvironments that improve upon static culture systems, yet widespread adoption has been hindered by fabrication complexity, reliance on polydimethylsiloxane (PDMS), and limited modularity. Here, a modular MPS platform is presented, designed for ease of use, reproducibility, and broad applicability. The system comprises layered elastomeric inserts for dual monolayer cell culture, which is clamped within a reusable acrylic cassette for perfusion studies.

Validity of MRI and Ultrasound Volume Measurements of Foot Muscles and Plantar Fascia Cross-Sectional Area Within Older Adults With and Without Chronic Plantar Fasciitis.

Introduction: Intrinsic foot muscles and the plantar fascia are crucial for foot health, which diminishes with age and conditions such as chronic plantar fasciitis (PF). Ultrasound (US) is an accessible and cost-effective method for evaluating these structures. This study aims to assess the repeatability, reliability, and validity of plantar fascia thickness and flexor digitorum brevis (FDB) muscle measurements using US compared with MRI in individuals with and without PF.

An annotated chromosome-level genome for the red-fronted brown lemur (Eulemur rufifrons) sheds light on brown lemur evolution.

The red-fronted brown lemur (Eulemur rufifrons) is an important species to the function of Madagascar's ecosystems, contributing to critical ecological processes such as seed dispersal. Given its ecological, as well as cultural, importance, genomic resources for E. rufifrons are valuable for understanding evolutionary history and informing conservation strategies.

Repeatability of diffusion-weighted arterial spin labeling MRI for mapping blood-brain barrier water exchange rate at different postlabel delays.

Purpose: This study sought to determine the intrasession repeatability of the diffusion-weighted (DW) arterial spin labeling (ASL) sequence at different postlabel delays (PLDs).

Methods: We first performed numerical simulations to study the accuracy of the two-compartment water exchange rate (Kw) fitting model with added Gaussian noise for DW PLDs at 1500, 1800, and 2100 ms. Ten young, healthy participants then underwent a structural T scan and two intrasession in vivo DW ASL scans at each PLD on a 3T MRI.

Volumetric thermometry in moving tissues using stack-of-radial MRI and an image-navigated multi-baseline proton resonance frequency shift method.

Purpose: To develop and evaluate a volumetric proton resonance frequency shift (PRF)-based thermometry method for monitoring thermal ablation in moving tissues.

Methods: A golden-angle-ordered 3D stack-of-radial MRI sequence was combined with an image-navigated multi-baseline (iNAV-MB) PRF method to reconstruct motion-compensated 3D temperature maps with high spatiotemporal resolution and volumetric coverage. Two radial MRI reconstruction techniques, k-space weighted image contrast filter (KWIC) and golden-angle radial sparse parallel (GRASP) MRI, were implemented and compared within a sliding window reconstruction framework.

Many Will Enter, Few Will Win: Cost and Sensitivity of Exploratory Dynamics.

A variety of biomolecular systems rely on exploratory dynamics to reach target locations or states within a cell. Without a mechanism to remotely sense and move directly towards a target, the system must sample over many paths, often including resetting transitions back to the origin. We investigate how exploratory dynamics can confer an important functional benefit: the ability to respond to small changes in parameters with large shifts in the steady-state behavior.

PATJ deficiency leads to cystic kidney disease and related ciliopathies.

Cystic kidney disease and related ciliopathies are caused by pathogenic variants in genes that commonly result in ciliary dysfunction. For a substantial number of individuals affected by those cilia-related diseases, the causative gene still remains unknown. Using massively parallel sequencing, we here identified a pathogenic bi-allelic variant in the gene encoding PALS1-Associated Tight Junction Protein (PATJ; also known as Inactivation-No-Afterpotential D-Like, INADL) in an individual with ciliopathy.

Redefining agroecological zones in China to mitigate climate change impacts on maize production.

This study introduces Multi-Dimensional Environment (MDE) zoning to enhance maize resilience and improve stagnant yields in China amidst climate change. Utilizing comprehensive environmental and yield data, MDE zoning accurately identifies areas for targeted, climate-adaptive breeding. The tool provides a flexible framework for updates using annual variety testing and daily environmental data, optimizing production and resource allocation.

Complement C4b as a Key Mediator of Synaptic Loss and Cognitive Decline in Brain Aging.

Brain aging is a major risk factor for cognitive decline and neurodegenerative diseases, driven by synaptic loss, reduced synaptic function, and inflammation. However, the molecular mechanisms underlying these dysfunctions remain unclear. Here, we conducted comparative transcriptomic analyses of brain regions (cortex and hippocampus) and kidney tissues, a peripheral organ with documented age-related dysfunction.

Nature-inspired IL-1 targeted therapy to treat chronic inflammatory diseases.

The interleukin (IL)-1 pathway is a key mediator of inflammation and innate immune responses. Its dysregulation contributes to rheumatoid arthritis (RA) and autoinflammatory diseases (AIDs). In this study, we develop a recombinant adeno-associated virus (rAAV)-based gene therapy to deliver an inflammation-inducible, secreted human IL-1 receptor antagonist (sIL-1Ra) as a complementary approach to existing IL-1 blockers.

A New Wave of Ultrasound Phantoms Using Real Fixed Organs: Birth of the Danny Phantom.

Ultrasonography in veterinary medicine serves a vital role in the diagnosis and management of various medical conditions by allowing noninvasive visualization of internal structures. Veterinary students face many challenges in gaining hands-on experience with ultrasound equipment and developing competencies in ultrasonography. This is largely due to the limited access and ethical dilemmas of live animal models and the high cost of commercial phantoms.

ISBP 2025 Kidney Health Congress Abstract.

The 39th International Society of Blood Purification (ISBP) Congress, Honolulu, Hawaii, USA August 20-22, 2025 www.ISBP-online.org Accepted Abstracts for publication in Blood Purification Release date to Karger's Blood Purification: 2025-07-27 Abstract Reviewers: Connie M Rhee, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, CA.

Entropy, Assessed by Homeostatic Dysregulation on Electrocardiograms Predicts Fracture and Mortality.

Entropy, characterized by increased disorder throughout biological systems, can be quantified by homeostatic dysregulation (HD). One potential measure of HD is the dispersion of points from a normal value, approximated at the individual level by Mahalanobis distance (D). We hypothesized that greater HD in electrocardiogram (ECG) would also reflect greater HD in the musculoskeletal system which, in turn, would be associated with age and manifest as an increased risk of fracture independently of age, bone mineral density (BMD), and history of fracture.

Cyclic combing of untreated and bleached human hair: Analysis of the time-dependent breakage of hair through recording the formation of fibre fragments.

Objectives: Machine-based cyclic combing of hair tresses under dry conditions is a proven method for evaluating hair strength and the impact of treatments. Recent advancements in image analysis allow for a detailed review of hair fragment lengths and quantities produced after specific combing cycles. Our aim is to provide an in-depth analysis of the kinetics of hair fragment formation.

Sucrose-Induced Transcription Factor IjSUSIBA2 Fine-Tunes Growth Transition Through the IjSVL2-IjFLCL1 Module in Evergreen Irises.

Sugar metabolism is commonly implicated as crucial in the transition between growth and cessation during winter; however, its exact role remains elusive. The evergreen iris (Iris japonica) ceases growth in winter without entering endodormancy, yet it continues to sustain sugar metabolism and transport throughout the season. Here, we elucidate the mechanisms underlying the sugar-mediated growth transition-the shift between growth and cessation-in I.