ctDNA detects residual disease after neoadjuvant chemoradiotherapy and guides adjuvant therapy in esophageal squamous cell carcinoma.

The diagnostic accuracy of circulating tumor DNA (ctDNA) for detecting molecular residual disease (MRD) after multimodal treatment remains unclear. In a prospective cohort of 132 patients with locally advanced esophageal squamous cell carcinoma (ESCC) undergoing neoadjuvant chemoradiotherapy (nCRT) followed by clinical response evaluation and surgery, tumor-informed personalized-panel and fixed-panel ctDNA assays are applied to serial blood samples. Personalized ctDNA assay demonstrates a superior baseline detection rate (99.

Performance of non-invasive prenatal testing in vanishing-twin and multiple pregnancies: results of TRIDENT-2 study.

Objective: To evaluate the performance of non-invasive prenatal testing (NIPT) in vanishing-twin and multiple pregnancies.

Methods: This study was conducted as part of the TRIDENT-2 study, in which NIPT was offered as a first-tier screening test to women with a multiple pregnancy or vanishing-twin pregnancy between 1 June 2020 and 31 March 2023 in The Netherlands. Abnormal NIPT results were investigated by follow-up invasive prenatal testing and/or postnatal genetic testing.

A single-cell, long-read, isoform-resolved case-control study of FTD reveals cell-type-specific and broad splicing dysregulation in human brain.

Progranulin-deficient frontotemporal dementia (GRN-FTD) is a major cause of familial FTD with TAR DNA-binding protein 43 (TDP-43) pathology, which is linked to exon dysregulation. However, little is known about this dysregulation in glial and neuronal cells. Here, using splice-junction-covering enrichment probes, we introduce single-nuclei long-read RNA sequencing 2 (SnISOr-Seq2), targeting 3,630 high-interest genes without loss of precision, and complete the first single-cell, long-read-resolved case-control study for neurodegeneration.

Microvascular Occlusion and Postrecanalization Hyperperfusion in a Swine Model of Acute Ischemic Stroke.

Background: Despite successful recanalization after endovascular thrombectomy, more than half of patients with acute ischemic stroke with large-vessel occlusions experience an unsatisfactory outcome. Incomplete microvascular reperfusion may contribute to it, but its occurrence remains debated, partly due to clinical observations of hyperperfusion after recanalization. This study investigates the relationship between ischemia duration, infarct development, microclot presence, and cerebral perfusion in a swine model of focal cerebral ischemia and reperfusion.

National survey on the presence of multidisciplinary meetings for interstitial lung diseases (ILD-MDM) in hospitals in Germany.

Background: Interstitial lung diseases (ILD) represent an interdisciplinary clinical challenge and are not uncommonly associated with rheumatological diseases. Interstitial lung disease multidisciplinary meetings (ILD-MDM) provide a structured platform for interdisciplinary case discussions and decision making. Despite their great importance in patient care, data on the prevalence, structure and function of ILD-MDM in Germany are lacking.

ERS/EULAR clinical practice guidelines for connective tissue diseases associated interstitial lung disease.

Background: Interstitial lung disease (ILD) is a frequent manifestation of connective tissue diseases (CTDs) and is associated with high morbidity and mortality. Clinical practice guidelines to standardise screening, diagnosis, treatment and follow-up for CTD-ILD are of high importance for optimised patient care.

Methods: A European Respiratory Society and European Alliance of Associations for Rheumatology task force committee, composed of pulmonologists, rheumatologists, pathologists, radiologists, methodologists and patient representatives, developed recommendations based on PICO (Patients, Intervention, Comparison, Outcomes) questions with grading of the evidence according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology and complementary narrative questions agreed on by both societies.

A head-to-head comparison of soluble dietary fibers on microbiota composition and short-chain fatty acid production using the in vitro TIM-2 system.

Soluble dietary fibers (SDFs) are recognized for their health benefits through their fermentation and gut microbiota modulation. Previous studies focused on individual SDFs without sufficient structural information and a comparative analysis using different SDFs on microbiota composition and function is lacking. The present study aimed to determine key structural features of different SDFs, including soluble resistant starch (SRS), inulin (INU), four structurally diverse pectins (PS1 to PS4), one pectic derivative (PS5) and larch arabinogalactan (AG).

Identification of robust associations between admission microbiome profiles and complications of acute pancreatitis.

Objective: Patients with acute pancreatitis show reduced gut microbiome diversity and high abundance of pathogenic bacteria compared with healthy subjects. Admission microbiome profiles are increasingly linked to severity, but methodology and study quality hamper interpretation. Our aim was to investigate whether admission microbiome analysis provides robust and reproducible associations with severity and complications of acute pancreatitis.

Total tumor volume predicts overall survival and response to induction chemotherapy in patients with colorectal cancer liver metastases: An ancillary study of the phase 3 CAIRO5 trial.

Introduction: This study aimed to assess whether total tumor volume (TTV) outperforms RECIST1.1 for treatment response assessment in patients with colorectal liver metastases (CRLM), and to investigate TTV as a predictive biomarker for the optimal systemic treatment regimen for individual patients with initially unresectable CRLM.

Methods: Patients with initially unresectable liver-only CRLM from the phase 3 CAIRO5 trial (NCT02162563) were included.

The Role of Selection for Function in Aging and Chronic Diseases: A Novel Evolutionary Perspective.

Aging, and by extension age-related diseases, has traditionally been understood through classical evolutionary genetic models, such as the mutation accumulation and antagonistic pleiotropy theories. However, these frameworks primarily focus on the declining efficacy of organismal-level selection against mutations with deleterious effects in late life. Here, we propose a novel hypothesis: many chronic diseases associated with aging may emerge, at least in part, as a result of selection acting at lower organizational levels, including non-replicative biological entities, enabled by the relaxation of selective pressures that constrained within-organism evolutionary processes in early life.

Network Meta-Analysis of Quality of Life in Heart Failure With Reduced Ejection Fraction.

Background: Although the effects of various combinations of treatments on mortality and morbidity outcomes in heart failure with reduced ejection fraction (HFrEF) have been evaluated, the impact on quality of life is unknown. This study evaluated and compared the composite impact of pharmacological therapies on quality of life in HFrEF using a frequentist network meta-analysis and systematic review methodology.

Methods: We searched MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials for randomized controlled trials published between January 1, 2021 and August 10, 2024.

Impact of bleeding and thrombosis on outcome of 945 COVID-19 VV-ECMO cases from a German registry.

Unlabelled: Bleeding and thromboembolic events (BTE) increase the mortality of COVID-19 acute respiratory distress syndrome (ARDS) treated with extracorporeal membrane oxygenation (ECMO). The current analysis aimed to assess frequency and determinants of BTE according to their location and severity in a retrospective analysis of the German ECMO COVID-19 registry. Logistic regression was applied to identify factors influencing ICU survival as well as variables associated with risks of BTE.

Improving Healthcare through the Skills Mix of the Workforce.

The latest definition of skill mix refers to changes in tasks, skills, competencies or roles within and between healthcare professionals and healthcare workers in three areas: Task shifting, role expansion and multi-professional collaboration. There is evidence of the effectiveness of many changes in the skill mix - particularly in the areas of health promotion and disease prevention, chronic disease management and care of vulnerable populations. The implementation of skill-mix approaches begins with interprofessional education, which emphasises collaborative practice aimed at fostering working relationships between two or more health professions.

Quality and efficiency of integrating customised large language model-generated summaries versus physician-written summaries: a validation study.

Objectives: To compare the quality and time efficiency of physician-written summaries with customised large language model (LLM)-generated medical summaries integrated into the electronic health record (EHR) in a non-English clinical environment.

Design: Cross-sectional non-inferiority validation study.

Setting: Tertiary academic hospital.

ERS/EULAR clinical practice guidelines for connective tissue disease-associated interstitial lung diseaseDeveloped by the task force for connective tissue disease-associated interstitial lung disease of the European Respiratory Society (ERS) and the European Alliance of Associations for Rheumatology (EULAR)Endorsed by the European Reference Network on rare respiratory diseases (ERN-LUNG).

Background: Interstitial lung disease (ILD) is a frequent manifestation of connective tissue diseases (CTDs) and is associated with high morbidity and mortality. Clinical practice guidelines to standardise screening, diagnosis, treatment and follow-up for CTD-ILD are of high importance for optimised patient care.

Methods: A European Respiratory Society and European Alliance of Associations for Rheumatology task force committee, composed of pulmonologists, rheumatologists, pathologists, radiologists, methodologists and patient representatives, developed recommendations based on PICO (Patients, Intervention, Comparison, Outcomes) questions with grading of the evidence according to the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) methodology and complementary narrative questions agreed on by both societies.

Target volume delineation of the neck for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas.

The Chinese Society for Therapeutic Radiology Oncology, the Chinese Anti-Cancer Association, the Chinese Society of Clinical Oncology, the Head and Neck Cancer International Group, the European Society for Radiotherapy and Oncology, and the American Society for Radiation Oncology collaboratively developed evidence-based guidelines and a comprehensive contouring atlas for neck target volume delineation in nasopharyngeal carcinoma. These guidelines address five key challenges in modern radiotherapy practice: margin design of clinical target volume; nodal target volume delineation after induction chemotherapy; delineation of equivocal nodes evident on imaging; low-risk clinical target volume delineation based on regional stepwise extension patterns; and modifications for anatomical boundaries of lymphatic areas. Developed through a rigorous systematic review and expert appraisal process by a panel of 50 international, multidisciplinary members from 17 countries and regions, these guidelines incorporate the latest advances in nasopharyngeal carcinoma diagnosis and treatment.

Primary target volume delineation for radiotherapy in nasopharyngeal carcinoma: CSTRO, CACA, CSCO, HNCIG, ESTRO, and ASTRO guidelines and contouring atlas.

The Chinese Society for Therapeutic Radiology Oncology, the Chinese Anti-Cancer Association, the Chinese Society of Clinical Oncology, Head and Neck Cancer International Group, the European Society for Radiotherapy and Oncology, and the American Society for Radiation Oncology jointly developed evidence-based guidelines and a contouring atlas for primary target volume delineation for radiotherapy in nasopharyngeal carcinoma. The guidelines systematically address three crucial challenges: margin design of clinical target volumes; target volume delineation after induction chemotherapy; and low-risk clinical target volume delineation based on local stepwise extension patterns. Based on a comprehensive systematic review and critical appraisal by an international multidisciplinary panel of 50 nasopharyngeal carcinoma specialists from 17 countries and regions, these guidelines are in keeping with advances in nasopharyngeal carcinoma diagnosis and treatment, embodying contemporary treatment concepts, and elaborating on the differences in practice.

Screen first, vaccinate later: Enhancing tuberculosis vaccination safety through newborn immunodeficiency screening.

Tuberculosis (TB) remains a global health challenge, with around 10 million new cases reported annually and multidrug-resistant strains complicating control efforts. Although incidence has declined in many high-income regions, neonatal populations remain vulnerable, underscoring the continued role of Bacillus Calmette-Guérin (BCG) vaccination. BCG vaccination provides strong protection against severe forms of TB in infancy, though its efficacy against pulmonary disease in adolescents and adults is modest.

Epithelial tension controls intestinal cell extrusion.

Cell extrusion is essential for homeostatic self-renewal of the intestinal epithelium. Extrusion is thought to be triggered by crowding-induced compression of cells at the intestinal villus tip. In this study, we found instead that a local "tug-of-war" competition between contractile cells regulated extrusion in the intestinal epithelium.

Kinome analysis of Madurella mycetomatis identified kinases in the cell wall integrity pathway as novel potential therapeutic drug targets in eumycetoma caused by Madurella mycetomatis.

Eumycetoma is a neglected tropical subcutaneous disease most commonly caused by the fungus Madurella mycetomatis. Currently, eumycetoma is treated by a combination of antifungal therapy and surgery, with limited success rates. To identify novel drug targets we used an in silico approach to determine the kinases present in M.

Radiotherapy for Growing Vestibular Schwannomas.

Importance: In the literature, there is a lack of data reporting tumor control rates after radiotherapy in actively growing vestibular schwannomas (VS). Data for this rarely studied population are needed.

Objective: To estimate tumor control rates in radiologically growing VS treated with first-line radiotherapy.

Applying the "positive predictive value-recall diagram" to monitor performance and provide recommendations for screening radiologists.

Objectives: To evaluate the suitability of "positive predictive value-recall" (PPV-recall) diagrams for monitoring performance and providing recommendations for groups of radiologists (RUs or reading units) in breast cancer screening.

Materials And Methods: This retrospective study used datasets from triennial quality assurance audits within the Dutch screening programme. The recall rate (RR), cancer detection rate (CDR), and PPV between 2010 and 2019 were plotted in PPV-recall diagrams separately for initial and subsequent screening.