Broadscale dampening of uncertainty adjustment in the aging brain.

The ability to prioritize among input features according to relevance enables adaptive behaviors across the human lifespan. However, relevance often remains ambiguous, and such uncertainty increases demands for dynamic control. While both cognitive stability and flexibility decline during healthy ageing, it is unknown whether aging alters how uncertainty impacts perception and decision-making, and if so, via which neural mechanisms.

[Infections and liver cirrhosis].

End-stage liver disease is a life-threatening clinical syndrome combined with a state of immune dysfunction. In this constellation patients are prone to bacterial, fungal and viral infections associated with markedly increased morbidity and mortality rates. Bacterial infections are the most prevalent kind of infection in patients with end-stage liver disease accounting for nearly 30%.

Herpes Simplex Virus Bronchopneumonitis in Critically Ill Patients with Acute on Chronic Liver Failure: A Retrospective Analysis.

(1) Background: Critically ill patients are frequently diagnosed with pulmonary Herpes simplex virus-1 (HSV) reactivation, which then can lead to HSV bronchopneumonitis and is associated with higher mortality and longer mechanical ventilation. For the particular subgroup of critically ill patients with acute on chronic liver failure (ACLF), however, the impact of HSV reactivation is unknown. We investigated the impact of HSV reactivation in these patients.

Comparison of endoscopic ultrasound-guided fine-needle aspiration and fine-needle biopsy to generate pancreatic cancer organoids: Randomized trial.

The prognosis for pancreatic cancer remains poor. Molecular diagnostics and customized therapies are becoming increasingly important in clinical routine. Patient-derived, predictive model systems such as organoids have the potential to substantially increase the depth of information from biopsy material by functional and molecular characterization.

Increases in prosociality across adulthood: The pure-altruism hypothesis.

A growing body of research suggests that prosocial behavior increases across adulthood. Yet, whether these age differences reflect "pure altruistic" or selfish motives, or the developmental mechanisms that underlie them, are largely unknown. Within a value-based decision framework, pure altruistic tendencies can be measured and distinguished from impure altruistic motives through neural-level information.

Systematic Evaluation of Clinical, Nutritional, and Fecal Microbial Factors for Their Association With Colorectal Polyps.

Introduction: The identification of risk factors for precursor lesions of colorectal cancer (CRC) holds great promise in the context of prevention. With this study, we aimed to identify patient characteristics associated with colorectal polyps (CPs) and polyp features of potential malignant progression. Furthermore, a potential association with gut microbiota in this context was investigated.

The effect of abstract inter-chunk relationships on serial-order control.

Hierarchical control is often thought to dissect a complex task space into isolated subspaces in order to eliminate interference. Yet, there is also evidence from serial-order control tasks that our cognitive system can make use of abstract relationships between different parts (chunks) of a sequence. Past evidence in this regard was limited to situations with ordered stimuli (e.

What's so hard about hierarchical control? Pinpointing processing constraints within cue-based and serial-order control structures.

Most task spaces require a hierarchical structure, where decisions on one level are contingent on previous decisions made on one or more higher levels. While it is a truism that increasing the number of hierarchical levels makes it harder to solve a given task, the exact nature of this "number-of-levels" effect is not clear. On the one hand, processing costs might be strictly "local," incurred only when higher-level settings need to be updated, while otherwise lower-level decisions are insulated from the presence of higher-level settings (local updating costs with ballistic control).

Efficacy and Safety of Cold Snare Polypectomy of Colorectal Polyps 10-15 mm with a Hybrid Snare: A Prospective Observational Pilot Study.

Introduction: Cold snare polypectomy (CSP) is a safe and effective procedure for small colorectal polyps ≤9 mm. There are only limited data regarding CSP of larger neoplastic lesions. This study evaluated the efficacy and safety of CSP for polyps between 10 and 15 mm in size.

Transjugular intrahepatic portosystemic shunt creation (TIPS) in the angio-CT-a hybrid intervention with image fusion.

Objective: For transjugular intrahepatic portosystemic shunt (TIPS) creation, ultrasound guidance for portal vein puncture is strongly recommended. However, outside regular hours of service, a skilled sonographer might be lacking. Hybrid intervention suites combine CT imaging with conventional angiography allowing to project 3D information into the conventional 2D imaging and further CT-fluoroscopic puncture of the portal vein.

EASIX Is an Accurate and Easily Available Prognostic Score in Critically Ill Patients with Advanced Liver Disease.

Acute-on-chronic liver failure (ACLF) is associated with high mortality. Objective prognostic scores are important for treatment decisions. EASIX (Endothelial Activation and Stress Index) is a simple biomarker consisting of LDH, platelets, and creatinine, reflecting endothelial dysfunction after allogeneic stem cell transplantation.

Differentiation of Spontaneous Bacterial Peritonitis from Secondary Peritonitis in Patients with Liver Cirrhosis: Retrospective Multicentre Study.

Ascitic fluid infection is a serious complication of liver cirrhosis. The distinction between the more common spontaneous bacterial peritonitis (SBP) and the less common secondary peritonitis in patients with liver cirrhosis is crucial due to the varying treatment approaches. This retrospective multicentre study was conducted in three German hospitals and analysed 532 SBP episodes and 37 secondary peritonitis episodes.

Adjunctive Hydrocortisone Improves Hemodynamics in Critically Ill Patients with Septic Shock: An Observational Study Using Transpulmonary Thermodilution.

Septic shock is associated with high mortality and hemodynamic impairment. The use of corticoids is a common therapeutic tool in critically ill patients. However, data on the mechanisms and prognostic ability of hemodynamic improvement by adjunctive steroids are rare.

A Novel Machine Learning-Based Point-Score Model as a Non-Invasive Decision-Making Tool for Identifying Infected Ascites in Patients with Hydropic Decompensated Liver Cirrhosis: A Retrospective Multicentre Study.

This study is aimed at assessing the distinctive features of patients with infected ascites and liver cirrhosis and developing a scoring system to allow for the accurate identification of patients not requiring abdominocentesis to rule out infected ascites. A total of 700 episodes of patients with decompensated liver cirrhosis undergoing abdominocentesis between 2006 and 2020 were included. Overall, 34 clinical, drug, and laboratory features were evaluated using machine learning to identify key differentiation criteria and integrate them into a point-score model.

Accurate prediction of histological grading of intraductal papillary mucinous neoplasia using deep learning.

Background: Risk stratification and recommendation for surgery for intraductal papillary mucinous neoplasm (IPMN) are currently based on consensus guidelines. Risk stratification from presurgery histology is only potentially decisive owing to the low sensitivity of fine-needle aspiration. In this study, we developed and validated a deep learning-based method to distinguish between IPMN with low grade dysplasia and IPMN with high grade dysplasia/invasive carcinoma using endoscopic ultrasound (EUS) images.

The role of conjunctive representations in prioritizing and selecting planned actions.

For flexible goal-directed behavior, prioritizing and selecting a specific action among multiple candidates are often important. Working memory has long been assumed to play a role in prioritization and planning, while bridging cross-temporal contingencies during action selection. However, studies of working memory have mostly focused on memory for single components of an action plan, such as a rule or a stimulus, rather than management of all of these elements during planning.

Age differences in the recovery from interruptions.

We tested the hypothesis that there is an age-related deficit in the recovery from interruptions. This hypothesis is based on the idea that it is more difficult for old than for young adults to establish a focused state after working memory has been "opened up" through an interruption. Old ( = 95) and young adults ( = 94) performed competing nondominant and dominant primary tasks (selecting either exogenously or endogenously cued targets) in alternating, single-task blocks that were occasionally interrupted through trials with unrelated math tasks.

The causal effect of testosterone on men's competitive behavior is moderated by basal cortisol and cues to an opponent's status: Evidence for a context-dependent dual-hormone hypothesis.

Testosterone has been theorized to direct status-seeking behaviors, including competitive behavior. However, most human studies to date have adopted correlational designs, and findings across studies are inconsistent. This experiment ( = 115) pharmacologically manipulated men's testosterone levels prior to a mixed-gender math competition and examined basal cortisol (a hormone implicated in stress and social avoidance) and context cues related to an opponent's perceived status (an opponent's gender or a win/loss in a prior competition) as factors that may moderate testosterone's impact on competitive behavior.

Identification of treatment-induced vulnerabilities in pancreatic cancer patients using functional model systems.

Despite the advance and success of precision oncology in gastrointestinal cancers, the frequency of molecular-informed therapy decisions in pancreatic ductal adenocarcinoma (PDAC) is currently neglectable. We present a longitudinal precision oncology platform based on functional model systems, including patient-derived organoids, to identify chemotherapy-induced vulnerabilities. We demonstrate that treatment-induced tumor cell plasticity in vivo distinctly changes responsiveness to targeted therapies, without the presence of a selectable genetic marker, indicating that tumor cell plasticity can be functionalized.

The Role of Conjunctive Representations in Stopping Actions.

Action selection appears to rely on conjunctive representations that nonlinearly integrate task-relevant features. Here, we tested a corollary of this hypothesis: that such representations are also intricately involved during attempts to stop an action-a key aspect of action regulation. We tracked both conjunctive representations and those of constituent rule, stimulus, or response features through trial-by-trial representational similarity analysis of the electroencephalogram signal in a combined rule-selection and stop-signal paradigm.

Extracellular Matrix in Heart Failure: Role of ADAMTS5 in Proteoglycan Remodeling.

Background: Remodeling of the extracellular matrix (ECM) is a hallmark of heart failure (HF). Our previous analysis of the secretome of murine cardiac fibroblasts returned ADAMTS5 (a disintegrin and metalloproteinase with thrombospondin motifs 5) as one of the most abundant proteases. ADAMTS5 cleaves chondroitin sulfate proteoglycans such as versican.

Isavuconazole and Liposomal Amphotericin B as Successful Combination Therapy of Refractory Invasive Candidiasis in a Liver Transplant Recipient: A Case Report and Literature Review.

Invasive fungal infections in liver transplant recipients are associated with elevated morbidity and mortality and pose a challenge to the treating physicians. Despite of lacking clinical data, the use of antifungal combination therapy is often considered to improve response rates in an immunocompromised patient population. We herein report a case of refractory invasive candidiasis in a liver transplant recipient treated successfully with a combination of isavuconazole und high-dose liposomal amphotericin B.