Primary care in rural areas: a qualitative study on medical students' images and experiences of working in rural areas in southern Germany.

Background: Rural areas are increasingly moving back into the focus of social research, especially in the context of health care. As the shortage of general practitioners (GP) in rural areas is a significant challenge in Germany, there are several programs to counteract underuse effectively, acutely, and sustainably. One of those programs is 'Beste Landpartie Allgemeinmedizin' (BeLA), which was developed to strengthen primary care in rural areas and to sustainably promote young doctors to work as general practitioners in rural regions through didactical and financial support.

Seeing the primary tumor because of all the trees: Cancer type prediction on low-dimensional data.

The Cancer of Unknown Primary (CUP) syndrome is characterized by identifiable metastases while the primary tumor remains hidden. In recent years, various data-driven approaches have been suggested to predict the location of the primary tumor (LOP) in CUP patients promising improved diagnosis and outcome. These LOP prediction approaches use high-dimensional input data like images or genetic data.

Early Multimodal Data Integration for Data-Driven Medical Research - A Scoping Review.

Introduction: Data-driven medical research (DDMR) needs multimodal data (MMD) to sufficiently capture the complexity of clinical cases. Methods for early multimodal data integration (MMDI), i.e.

How does the role of complementary and alternative medicine in general practice differ between countries? Interviews with doctors who have worked both in Germany and elsewhere in Europe.

Background: Available data suggest that general practitioners (GPs) in Germany use complementary and alternative medicine (CAM) modalities more frequently than GPs in many other countries. We investigated the country differences perceived by general practitioners who have worked in Germany and in one of four other European countries with regard to the role of complementary and alternative treatments in primary care.

Methods: In this qualitative study we conducted semi-structured interviews with 12 GPs who had worked both in Germany and Italy, the Netherlands, Norway or the United Kingdom (UK; n = 3 for each of the four countries).

Data Quality in Medical Real-World Data - An Oncological Use Case.

Data quality deficiencies significantly limit the applicability of real-world data in data-driven medical research. In this study, using an oncological use case, we report and discuss common quality deficiencies in real-world medical datasets, such as missing data, class imbalances, and timeliness issues. We compiled a multi-departmental real-world dataset comprising 13861 cancer cases diagnosed at University Hospital Cologne and examined data quality throughout the data integration process.

Evaluating a rehabilitative intervention for substance-dependent patients with and without their accompanying children in Germany (KontextSucht): study protocol for a non-randomised trial.

Introduction: People suffering from substance use disorders often live in social contexts with children or are parents themselves. Addicted parents show specific substance-related problems while raising their children, which often leads to various lifelong consequences for the children. The German rehabilitative treatment system allows bringing children to inpatient treatment centres.

Development, piloting and evaluation of an app-supported psychosocial prevention intervention to strengthen participation in working life: a study protocol of a mixed-methods approach.

Introduction: Rates of incapacity to work due to mental disorders have increased in many European countries. The consequences of persistent stress can impact individuals' physical and psychological well-being and gradually develop into chronic stress. Mental disorders or symptoms of burn-out syndrome can have severe consequences.

[Participation in primary care research - From the idea to the constitution of a citizens advisory board].

Introduction: Public participation in research processes is becoming increasingly important and is justified with positive effects for research. The first successful initiatives can also be found in general practice and health services research. The transparent presentation of these projects is essential to the discussion about participation.

EphrinA5 regulates cell motility by modulating Snhg15/DNA triplex-dependent targeting of DNMT1 to the Ncam1 promoter.

Cell-cell communication is mediated by membrane receptors and their ligands, such as the Eph/ephrin system, orchestrating cell migration during development and in diverse cancer types. Epigenetic mechanisms are key for integrating external "signals", e.g.

What prevents us from reusing medical real-world data in research.

Medical real-world data stored in clinical systems represents a valuable knowledge source for medical research, but its usage is still challenged by various technical and cultural aspects. Analyzing these challenges and suggesting measures for future improvement are crucial to improve the situation. This comment paper represents such an analysis from the perspective of research.

Integrating Cross-Departmental Data.

Developing smart clinical decision support systems requires integrating data from several medical departments. This short paper outlines the challenges we faced in cross-departmental data integration for an oncological use case. Most severely, they have led to a significant reduction in case numbers.

RGT: a toolbox for the integrative analysis of high throughput regulatory genomics data.

Background: Massive amounts of data are produced by combining next-generation sequencing with complex biochemistry techniques to characterize regulatory genomics profiles, such as protein-DNA interaction and chromatin accessibility. Interpretation of such high-throughput data typically requires different computation methods. However, existing tools are usually developed for a specific task, which makes it challenging to analyze the data in an integrative manner.

"It's pretty much flying blind in the home care setting": A qualitative study on the influence of home care specific circumstances on sedation in specialist palliative home care.

Background: Existing data on sedation at the end of life indicate challenges in the home care setting, leading to deviations from guidelines or non-provision of sedation.

Aim: As part of the "SedPall" study, we aimed to explore circumstances in specialist palliative home care, which influence the practice of sedation.

Design: Semi-structured qualitative interviews ( = 59) and two focus groups ( = 4,  = 5).

The Expression of the Cancer-Associated lncRNA Is Modulated by EphrinA5-Induced Signaling.

The Eph receptor tyrosine kinases and their respective ephrin-ligands are an important family of membrane receptors, being involved in developmental processes such as proliferation, migration, and in the formation of brain cancer such as glioma. Intracellular signaling pathways, which are activated by Eph receptor signaling, are well characterized. In contrast, it is unknown so far whether ephrins modulate the expression of lncRNAs, which would enable the transduction of environmental stimuli into our genome through a great gene regulatory spectrum.

SARS-CoV-2 infects and replicates in cells of the human endocrine and exocrine pancreas.

Infection-related diabetes can arise as a result of virus-associated β-cell destruction. Clinical data suggest that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing the coronavirus disease 2019 (COVID-19), impairs glucose homoeostasis, but experimental evidence that SARS-CoV-2 can infect pancreatic tissue has been lacking. In the present study, we show that SARS-CoV-2 infects cells of the human exocrine and endocrine pancreas ex vivo and in vivo.

DNA Methylation-Mediated Modulation of Endocytosis as Potential Mechanism for Synaptic Function Regulation in Murine Inhibitory Cortical Interneurons.

The balance of excitation and inhibition is essential for cortical information processing, relying on the tight orchestration of the underlying subcellular processes. Dynamic transcriptional control by DNA methylation, catalyzed by DNA methyltransferases (DNMTs), and DNA demethylation, achieved by ten-eleven translocation (TET)-dependent mechanisms, is proposed to regulate synaptic function in the adult brain with implications for learning and memory. However, focus so far is laid on excitatory neurons.

In Situ Monitoring of Membrane Protein Insertion into Block Copolymer Vesicle Membranes and Their Spreading via Potential-Assisted Approach.

Synthosomes are polymer vesicles with transmembrane proteins incorporated into block copolymer membranes. They have been used for selective transport in or out of the vesicles as well as catalysis inside the compartments. However, both the insertion process of the membrane protein, forming nanopores, and the spreading of the vesicles on planar substrates to form solid-supported biomimetic membranes have been rarely studied yet.

Chiral separation of d/l-arginine with whole cells through an engineered FhuA nanochannel.

Downstream processing to obtain enantiopure compounds from a racemic mixture relies mainly on crystallization. Natural transporters can specifically translocate enantiomers through membranes. Here a β-barrel transmembrane protein FhuA is re-engineered into a chiral channel protein (FhuAF4) to resolve racemic mixtures of d-/l-arginine.

Serum Level Measurements Optimize Aripriprazole Treatment in Adolescent Patients.

21 minors suffering from first-episode psychosis or related disorders were treated with the second-generation antipsychotic aripriprazole with serum levels being monitored over time. A significant variation of serum levels was observed in about half of the patients. Patients from Africa showed high levels of aripriprazole.

Author Correction: Environment and host as large-scale controls of ectomycorrhizal fungi.

Change history: In the HTML version of this Article, author 'Filipa Cox' had no affiliation in the author list, although she was correctly associated with affiliation 3 in the PDF. In addition, the blue circles for 'oak' were missing from Extended Data Fig. 1.

[Narcolepsy in childhood and adolescence: symptoms, diagnosis, and therapy. A case report].

Narcolepsy is a rare, multifactorial disease of the hypothalamus characterized by its leading symptoms of excessive daytime sleepiness and cataplexy. Sleep-EEG and a HLA-DR-genotype serve to secure the diagnosis. We report here on a 14-year-old girl suffering from anxieties, depression, school refusal, social withdrawal as well as very frequent attacks of sleep during the day and cataplexy.

Influences of luminance and accommodation stimuli on pupil size and pupil center location.

Purpose: We investigated effects of luminance and accommodation stimuli on pupil size and pupil center location, and their implications for progressive addition lens wear.

Methods: Participants were young and older adult groups (n = 20; 22 ± 2 years; age range, 18-25 years; and n = 19; 49 ± 4 years; age range, 45-58 years). A wave aberrometer included a relay system to allow a 12.

[Pediatric ADHD: what does the otolaryngologist need to know?].

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria, attention deficit hyperactivity disorder (ADHD) affects around 5% of all children and adolescents worldwide. The causes of ADHD are multifactorial, with a large genetic influence but also involvement of exogenic and psychosocial factors. Its core symptoms consist of attention deficits, hyperactivity and disruption of impulse control.