Balancing palliative care needs and medication appropriateness: Initiation and reinitiation of medications at the end of life.

Background: Medications deemed inappropriate and discontinued in the earlier stages of life-limiting disease may become relevant in palliative care context at the end of life. This study aims to determine the incidence of and factors associated with initiation and reinitiation of medications deemed inappropriate according to the STOPPFrail guideline.

Methods: A retrospective cohort study using linked healthcare reimbursement data.

TAB2 controls a TAK1-independent cell death checkpoint at the level of TNFR1 complex II in the TNF pathway.

Tumor necrosis factor (TNF) signaling determines the cell's fate by promoting either survival or cell death via apoptosis, necroptosis or pyroptosis. Excessive or chronic cell death by TNF was shown to drive inflammatory pathologies, highlighting the importance of the mechanisms that normally block TNF cytotoxicity. This study investigates the role of TAB2, an adaptor protein traditionally linked to TAK1 activation in the TNF pathway.

A case for absolute gene expression estimates in microbiome studies using metatranscriptomics.

Metatranscriptomics is widely used to study the functional dynamics of microbial communities in their natural environment [1-6]. Changes in gene expression in microbial communities can be subdivided in two main categories: per capita changes at the cellular or organismal scale in response to developmental cues and environmental signals, and changes mediated by population dynamics and taxonomic shifts. In this perspective, we argue that understanding the effects of population dynamics on gene expression patterns benefits from the estimation of absolute transcript abundances, augmenting the relative expression measures that are commonly used.

A European Association for Palliative Care White Paper defining an integrative palliative, geriatric, and rehabilitative approach to care and support for older people living with frailty and their family carers: a 28-country Delphi study and recommendations.

Background: A fast-growing number of older people living with frailty experience complex needs throughout their illness trajectory. However, currently, there is no international consensus on optimal care and support to older people living with frailty and their family carers. The European Association for Palliative Care (EAPC) Reference Group on Aging and Palliative Care aimed to develop a White Paper defining an optimal integrative palliative, geriatric, and rehabilitative approach to care and support for this population.

[Medicine's collective memory: a contribution to the debate on gendersensitive medicine].

In this article, we explore how the genderhealth gap has developed from a cultural-historical perspective, through the lens of a general practitioner, health scientist and medical historian. We describe the application of the concept of 'the collective memory' to medicine as a discipline, and show how it shapes medicine's identity. Awareness of the collective memory reveals underlying biases and could result in a sustainable and systematic change in medicine that ultimately improves the health of both women and men.

The emergence of egg intermediaries in the European fertility landscape: the creation of value in reproductive bioeconomies.

With recent growth in both domestic and global private health care markets and increased medical travel by patients, there has been an increase in the existence of medical mediation services. Whilst there is a developing scholarship that considers the brokerage of this travel, less attention has been paid to other forms of medical facilitation. Taking the example of fertility treatment - specifically egg donation - this paper examines how intermediaries develop, how they operate and specifically how they create multiple forms of value within systems of healthcare traditionally based around non-commercial logics.

Shared and distinct alterations in brain structure of youth with internalizing or externalizing disorders: Findings from the ENIGMA Antisocial Behavior, ADHD, MDD, and Anxiety Working Groups.

Background: Externalizing and internalizing disorders are common in youth but are often studied separately, preventing researchers from identifying shared (i.e., transdiagnostic) alterations in brain structure.

Real-world outcomes in patients with Philadelphia chromosome-positive acute lymphoblastic leukemia or chronic myeloid leukemia treated with ponatinib - final 6-year results from a Belgian registry.

Background: Ponatinib is a third-generation tyrosine kinase inhibitor (TKI) for treatment of chronic myeloid leukemia (CML) and Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) in patients who fail or are intolerant to a second generation TKI or who carry the mutation.

Method: This is the final analysis of the Belgian ponatinib registry evaluating use of ponatinib in clinical practice, with data available for up to 6 years after reimbursement.

Result: Forty-eight percent of 54 CML and 28% of 29 Ph+ ALL patients had received ≥3 previous TKIs.

Trunk Laterality Judgement in Chronic Low Back Pain: Influence of Low Back Pain History, Task Complexity, and Clinical Correlates.

: Left/right discrimination (LRD) training is increasingly being used in the treatment of chronic low back pain (CLBP). However, it is unclear whether trunk LRD-performance is impaired in CLBP patients and whether clinical parameters are related to LRD-performance. Therefore, this cross-sectional study aimed to examine (1) whether LRD-performance differs between CLBP patients and pain-free individuals; (2) whether these differences depend on the low back pain (LBP) history in pain-free individuals; (3) if clinical factors are related to LRD-performance; (4) whether LRD-task difficulty influences these results.

Deferred revascularization of left main stenosis based on instantaneous wave-free ratio: Long-term clinical outcomes from the PHYNAL registry.

Background: An accurate assessment of intermediate left main (LM) stenoses is crucial for revascularization decision-making. However, data on LM revascularization strategy according to instantaneous wave-free ratio (iFR) are limited. This study aimed to evaluate the safety of deferring LM revascularization according to iFR.

Soft locality restrictions in negative concord: Evidence from the French future polarity effect.

This paper provides new evidence that syntactic principles that are proposed to explain the (un)grammaticality of a sentence can also hold in sociolinguistic variation. In particular, we argue that two puzzling frequency patterns involving negation in French-the on negative concord and the on future temporal reference-are deeply related and are both derived from the sensitivity of syntactic agreement to "soft" locality constraints. Recent quantitative studies of future temporal reference reveal that, although all negative items are subject to the polarity effect in Laurentian French, does not give rise to the polarity effect in Parisian French.

Search for Extremely-High-Energy Neutrinos and First Constraints on the Ultrahigh-Energy Cosmic-Ray Proton Fraction with IceCube.

We present a search for the diffuse extremely-high-energy neutrino flux using 12.6 years of IceCube data. The nonobservation of neutrinos with energies well above 10 PeV constrains the all-flavor neutrino flux at 10^{18}  eV to a level of E^{2}Φ_{ν_{e}+ν_{μ}+ν_{τ}}≃10^{-8}  GeV cm^{-2} s^{-1} sr^{-1}, the most stringent limit to date.

Master narratives as imperatives: A qualitative study of adolescent identity experiences.

In this study, we explore the influence of culture on adolescent identity formation, using the recently postulated master narrative framework. Most identity research using the framework thus far has departed from specific, a priori defined master narratives and domains. However, considering the rapidly changing and globalized sociocultural landscape, it is vital to consider contemporary developments and investigate what master narratives guide and constrain today's adolescents' identities.

Long-term performance of low-cost free chlorine sensors to monitor on-site water reuse.

Water scarcity increasingly challenges the supply of sufficient quantities of safe water for human consumption. On-site water reuse systems can contribute to mitigating the effects of water scarcity by closing water cycles locally. However, broader adoption of on-site water reuse is constrained by the high cost of water quality monitoring.

Relationship between brain atrophy and disability in a multi-site multiple sclerosis registry.

Background: In a retrospective multicentre cohort study, we explored the association between brain atrophy and multiple sclerosis (MS) disability using different MRI scanners and protocols at multiple sites.

Methods: Relapse-onset MS patients were included if they had two clinical MRIs 12 months apart and ≥2 Expanded Disability Status Scale (EDSS) scores. Percentage brain volume change (PBVC), percentage grey matter change (PGMC), fluid-attenuated inversion recovery (FLAIR) lesion volume change, whole brain volume (BV), grey matter volume (GMV), FLAIR lesion volume and T1 hypointense lesion volume were assessed by icobrain.

What determines quality in palliative sedation? A scoping review identifying elements contributing to palliative sedation quality.

Background: Palliative sedation involves using sedatives to reduce consciousness until death. Though common in end-of-life care, it remains complex and controversial, with unclear quality parameters and limited guidance for improvement. A comprehensive overview of elements that reflect quality in palliative sedation is currently missing.

Key Stakeholders' Perspectives on Acute Malnutrition Management Programs for Children Under Five in Bangladesh: Qualitative Insights.

Acute malnutrition (AM) in children under five is a significant global health concern. Community-based management of AM (CMAM) with provision of specially formulated foods (SFFs) is recommended for treating moderate (MAM) and uncomplicated severe (SAM) cases in outpatient settings. Integrating nutrition counseling and cooking demonstrations (NC&CD) into CMAM programs can improve caregiver knowledge and practices.

Ripk1 is critical for preserving effector regulatory T cells and the suppressive transcriptional program in regulatory T cells.

Ripk1 plays an important role as a regulator of programmed cell death processes such as apoptosis and necroptosis and is involved in initiating pro-inflammatory NF-κB signaling. Immune tolerance depends on the proper function and homeostasis of regulatory T (Treg) cells. Here, we show that specific ablation of Ripk1 in Treg cells leads to systemically reduced Treg cell numbers resulting in spontaneous whole-body pathology.

Sperm and egg donors' views on identity release, donor offspring information and genetic testing.

Purpose: The study intended to find out whether sperm and egg donors hold different views on identifiability, information about donor offspring, genetic testing, and extended carrier screening.

Methods: An online questionnaire was sent to accepted sperm (n = 70) and egg donors (n = 39) from the same gamete bank in the United States 3 years apart (2020 and 2023). Only questions that were identical for both groups were included in the analysis.

The subordinate role of pseudogenization to recombinative deletion following polyploidization in angiosperms.

Extensive gene loss is a hallmark of rediploidization following polyploidization, but its molecular basis remains unclear: whether it occurs primarily through pseudogenization or DNA deletion. Here, we examine pseudogenization in collinear segments from ancient whole-genome multiplications (WGMs) across 12 angiosperms. Although total pseudogenes are abundant, we find far fewer WGM-derived pseudogenes than expected if pseudogenization and DNA deletion contribute equally to gene loss.