[Unmet health care needs of younger and older people with intellectual, mental and multiple disabilities: A pilot study in a facility in the Ruhr area].

Introduction: Unmet health care needs are seen as a key indicator of equity in access to health care. With younger people, they can lead to poorer health outcomes in adulthood, and in older people they can be associated with an increased risk of mortality. The presence of a disability is considered a risk factor for unmet needs.

Gestational Diabetes, the Human Milk Metabolome, and Infant Growth and Adiposity.

Importance: Gestational diabetes (GD) is linked to health risks for the birthing parent and infant. The outcomes of GD on human milk composition are mostly unknown.

Objective: To determine associations between GD, the human milk metabolome, and infant growth and body composition.

A trust based framework for the envelopment of medical AI.

The importance of a trust-based relationship between patients and medical professionals has been recognized as one of the most important predictors of treatment success and patients' satisfaction. We have developed a novel legal, social and regulatory envelopment of medical AI that is explicitly based on the preservation of trust between patients and medical professionals. We require that the envelopment fosters reliance on the medical AI by both patients and medical professionals.

Comparison of diagnostic algorithms in clinically suspected viral myocarditis: Agreement between cardiovascular magnetic resonance, endomyocardial biopsy, and troponin T.

Aims: Myocardial inflammation is increasingly detected noninvasively by tissue mapping with cardiovascular magnetic resonance (CMR). Intraindividual agreement with endomyocardial biopsy (EMB) or markers of myocardial injury, high-sensitive cardiac troponin (hs-cTnT) in patients with clinically suspected viral myocarditis is incompletely understood.

Methods: Prospective multicenter study of consecutive patients with clinically suspected myocarditis who underwent blood testing for hs-cTnT, CMR, and EMB as a part of diagnostic workup.

Artificial intelligence in cardiovascular imaging and intervention.

Recent progress in artificial intelligence (AI) includes generative models, multimodal foundation models, and federated learning, which enable a wide spectrum of novel exciting applications and scenarios for cardiac image analysis and cardiovascular interventions. The disruptive nature of these novel technologies enables concurrent text and image analysis by so-called vision-language transformer models. They not only allow for automatic derivation of image reports, synthesis of novel images conditioned on certain textual properties, and visual questioning and answering in an oral or written dialogue style, but also for the retrieval of medical images from a large database based on a description of the pathology or specifics of the dataset of interest.

Associations between sleep duration trajectories and risk of cardio-metabolic disease among middle-aged and older Chinese adults.

Background: The association of a single time-point measure of sleep duration with cardio-metabolic disease has been extensively studied, but few studies have focused on the impact of sleep duration trajectory. This study aims to model the sleep duration trajectory as predictors for the subsequent development of cardio-metabolic disease.

Methods: This study recruited a notably large population (n = 9883) of subjects aged at least 45 years from the China Health and Retirement Longitudinal Study (CHARLS), who participated in sequential surveys conducted in 2011, 2013, 2015, and 2018.

Synthesis and crystal structure of 2,9-di-amino-5,6,11,12-tetra-hydro-dibenzo[,]cyclo-octene.

The - form of di-amino-dibenzo-cyclo-octane (DADBCO, CHN) is of inter-est as a negative coefficient of thermal expansion (CTE) material. The crystal structure was determined through single-crystal X-ray diffraction at 100 K and is presented herein.

Insulin-like growth factor-1 and insulin-like growth factor binding protein-3 as early predictors of growth, body composition, and neurodevelopment in preterm infants.

Objective: To investigate the relationship between insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3) and long-term growth, body composition, and neurodevelopment in preterm infants.

Study Design: Prospective data were collected from ≤32 weeks gestational age infant cohort (N = 50). IGF-1 and IGFBP-3 concentrations were measured at 1 week (early) and 35 weeks (late) post-menstrual age (PMA).

Model-Based Economic Evaluations of Interventions for Dementia: An Updated Systematic Review and Quality Assessment.

Background: There has been an increase in model-based economic evaluations of interventions for dementia. The most recent systematic review of economic evaluations for dementia highlighted weaknesses in studies, including lack of justification for model assumptions and data inputs.

Objective: This study aimed to update the last published systematic review of model-based economic evaluations of interventions for dementia, including Alzheimer's disease, with a focus on any methodological improvements and quality assessment of the studies.

Coronary Artery Disease Assessment via On-Site CT Fractional Flow Reserve in Patients Undergoing Transcatheter Aortic Valve Replacement.

Purpose To examine the clinical feasibility of workstation-based CT fractional flow reserve (CT-FFR) for coronary artery disease (CAD) evaluation during preprocedural planning in patients undergoing transcatheter aortic valve replacement (TAVR). Materials and Methods In this retrospective single-center study, 434 patients scheduled for TAVR between 2018 and 2020 were screened for study inclusion; a relevant proportion of patients (35.0% [152 of 434]) was not suitable for evaluation due to insufficient imaging properties.

[Redirection of patients from the emergency department to ambulatory care: a feasibility study].

Background: § 120 para. 3b SGB V mandates the Federal Joint Committee to define guidelines for the initial assessment of self-referred walk-in patients as well as for the redirection of patients who can be treated by office-based physicians. A corresponding streaming and redirection process was tested in a feasibility study at the RoMed Clinic Rosenheim.

Body composition after implementation of an enhanced parenteral nutrition protocol in the neonatal intensive care unit: a randomised pilot trial.

Background: Very low birthweight (VLBW) infants are at risk for growth failure and poor neurodevelopment. Optimised parenteral nutrition may help promote optimal growth and development, but concerns that provision of enhanced nutrition may contribute to increased early adiposity and later metabolic disease remain.

Aim: To determine associations between provision of an early enhanced parenteral nutrition protocol or standard parenteral nutrition protocol and growth and body composition for VLBW preterm infants in the neonatal intensive care unit.

DNMT3A clonal hematopoiesis-driver mutations induce cardiac fibrosis by paracrine activation of fibroblasts.

Hematopoietic mutations in epigenetic regulators like DNA methyltransferase 3 alpha (DNMT3A), play a pivotal role in driving clonal hematopoiesis of indeterminate potential (CHIP), and are associated with unfavorable outcomes in patients suffering from heart failure (HF). However, the precise interactions between CHIP-mutated cells and other cardiac cell types remain unknown. Here, we identify fibroblasts as potential partners in interactions with CHIP-mutated monocytes.

An exploratory study of clinical factors associated with IGF-1 and IGFBP-3 in preterm infants.

Background: Despite advances in parenteral nutrition, postnatal growth failure in very low birthweight (VLBW) preterm infants is common and associated with chronic health problems. Insulin-like growth factor 1 (IGF-1) is positively associated with improved infant growth, but factors which promote IGF-1 levels in this population have not been clearly identified. The objective of this study was to explore early factors that influence IGF-1 in VLBW preterm infants.

How to further develop quality competition in the German healthcare system? Results of a Delphi expert study.

Introduction: Many international healthcare systems use quality competition to improve the quality of care. The corresponding instruments include quality measurement, public reporting, selective contracting, and pay for performance. The German healthcare system clearly shows that the possibilities are often limited in the status quo.