Full bladder, empty rectum? Revisiting a paradigm in the era of adaptive radiotherapy.

Background And Purpose: Many patients find it challenging to comply with instructions regarding rectum and bladder filling during pelvic radiotherapy. With the implementation of online adaptive radiotherapy, the reproducibility of organ volumes is no longer a prerequisite. This study aims to analyze the sparing of the bladder and the posterior rectum wall (PRW) in conditions of full versus empty bladder and rectum.

Surgical outcome of the borderline hypoplastic left ventricle: impact of the left ventricle rehabilitation strategy.

Objective: This study aims to assess the surgical outcome of borderline hypoplastic left ventricle before and after the induction of the left ventricle rehabilitation strategy.

Methods: A retrospective review investigated patients with borderline hypoplastic left ventricle who underwent surgical intervention between 2012 and 2022. The patient cohort was stratified into two groups based on the initiation of left ventricle rehabilitation: an early-era group (E group, 2012-2017) and a late-era group (L group, 2018-2022).

Nutrition and Periodontitis: A Cross-Sectional Study from a Practice-Based Research Network.

Background: Despite clinical interventional studies on the influence of diet on periodontal inflammatory parameters, there has been no practice-based cross-sectional study from a German population to date that has conducted both a comprehensive dental and periodontal examination and a thorough validated assessment of dietary behavior. Therefore, the aim of this pilot study was to evaluate, in a proof of concept, whether there is a correlation between the overall periodontal inflammatory surface area (PISA), periodontal clinical parameters (pocket probing depths (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), furcation involvement (FI), tooth mobility (TM)), and the dietary behavior of patients with periodontal disease when utilizing a practice-based research network. The primary outcome was the correlation between the periodontal inflammatory surface (PISA) and the dietary assessment data.

Outcomes after bidirectional cavopulmonary shunt with antegrade pulmonary blood flow in high-risk patients.

Objective: We have left antegrade pulmonary blood flow (APBF) at bidirectional cavopulmonary shunt (BCPS) only for high-risk patients. This study evaluates the indication and the outcomes of patients with APBF, compared to those without APBF.

Methods: Patients with APBF after BCPS were identified among patients who underwent BCPS between 1997 and 2022.

Effect of different optimization parameters in single isocenter multiple brain metastases radiosurgery.

Purpose: Automated treatment planning for multiple brain metastases differs from traditional planning approaches. It is therefore helpful to understand which parameters for optimization are available and how they affect the plan quality. This study aims to provide a reference for designing multi-metastases treatment plans and to define quality endpoints for benchmarking the technique from a scientific perspective.

Quantification of ventricular stress in univentricular hearts during early childhood using age-independent zlog-NT-proBNP.

Background: Children with univentricular hearts (UVH) undergo up to three palliative surgical procedures to achieve complete circulatory separation (Fontan circulation). As a marker of cardiac wall stress, NT-proBNP is a promising tool to assess systemic ventricular load in these patients. However, different reference intervals (RI) apply to each stage, as NT-proBNP is highly age-dependent.

Removing barriers to accessing medical cannabis for paediatric patients.

Medical cannabis (MC) may offer therapeutic benefits for children with complex neurological conditions and chronic diseases. In Canada, parents, and caregivers frequently report encountering barriers when accessing MC for their children. These include negative preconceived notions about risks and benefits, challenges connecting with a knowledgeable healthcare provider (HCP), the high cost of MC products, and navigating MC product shortages.

The impact of cineole treatment timing on common cold duration and symptoms: Non-randomized exploratory clinical trial.

Introduction: Common cold (CC) symptoms arise from an inflammatory response treatable with cineole and generally peak within two days, which complicates research implementation. We therefore explored the benefits of early cineole administration with enrolment of participants prior to CC onset.

Methods: Out of 522 adults enrolled in our phase IV, open-label, non-randomized, exploratory clinical trial (EudraCT No.

Bioactive adrenomedullin (bio-ADM) is associated with endothelial dysfunction in infants and children with complex congenital heart disease undergoing open-heart surgery on cardiopulmonary bypass.

Objectives: Children with congenital heart disease (CHD) undergoing cardiac surgery on cardiopulmonary bypass (CPB) are at risk for systemic inflammation leading to endothelial dysfunction associated with increased morbidity. Bioactive adrenomedullin (bio-ADM) is a peptide regulating vascular tone and endothelial permeability. The aim of this study was to evaluate the dynamics of plasma bio-ADM in this patient cohort and its role in capillary leak.

Pitfalls in Analyzing FHIR Data from Different University Hospitals.

The German Medical Informatics Initiative has agreed on a HL7 FHIR-based core data set as the common data model that all 37 university hospitals use for their patient's data. These data are stored locally at the site but are centrally queryable for researchers and accessible upon request. This infrastructure is currently under construction, and its functionality is being tested by so-called Projectathons.

Radiation-Induced Brain Injury: Age Dependency of Neurocognitive Dysfunction Following Radiotherapy.

Cranial radiotherapy is a known risk factor for neurocognitive impairment in cancer survivors. Although radiation-induced cognitive dysfunction is observed in patients of all ages, children seem to be more vulnerable than adults to suffering age-related deficits in neurocognitive skills. So far, the underlying mechanisms by which IR negatively influences brain functions as well as the reasons for the profound age dependency are still insufficiently known.

Exploring energy citizenship in the urban heating system with the 'Walking with Energy' methodology.

Background: Energy citizenship has emerged as a concept which attempts to capture the new role envisaged for urban citizens as engaged and active in the energy transition. However, exactly how to successfully engage energy citizens requires more research and this article aims to contribute to this knowledge gap. The article presents a new methodology, 'Walking with Energy', which seeks to (re)connect citizens with where their energy is coming from.

Disruptions in Standard Care in Patients After Arthroscopic Rotator Cuff Repair During the COVID-19 Pandemic.

Background: The coronavirus disease-2019 (COVID-19) pandemic led to disruptions in care for orthopaedic patients who underwent surgery just before the outbreak, rendering some unable to participate in standard postoperative care. Many of these patients underwent clinical follow-up and physical therapy via telehealth.

Purpose: To evaluate the methods of postoperative care in patients who underwent arthroscopic rotator cuff repair (RCR) and had follow-ups during the height of the pandemic versus those who received prior standard of care.

Work-Focused Versus Generic Internet-Based Interventions for Employees With Stress-Related Disorders: Randomized Controlled Trial.

Background: In recent decades, stress-related disorders have received more attention, with an increasing prevalence, especially within the working population. The internet provides new options for broad dissemination, and a growing body of evidence suggests that web-based interventions for stress might be effective. However, few studies have examined the efficacy of interventions in clinical samples and work-related outcomes.

Imaging doses for different CBCT protocols on the Halcyon 3.0 linear accelerator - TLD measurements in an anthropomorphic phantom.

Introduction: Image guided radiotherapy allows for particularly conformal tumour irradiation through precise patient positioning. Becoming the standard for radiotherapy, this increases imaging doses to the patient. The Halcyon 3.

Exploring total economic values in an emerging urban circular wastewater system.

Circular water management has the potential to close resource and material loops within and across value chains. In the water industry, circular municipal wastewater management through industrial urban symbiosis (IUS) is recognized as a solution to overcome water scarcity in urban environments. IUS involves collaboration between actors with different organizational backgrounds, which can lead to inherent risks of conflicting goals.

"fhircrackr": An R Package Unlocking Fast Healthcare Interoperability Resources for Statistical Analysis.

Background: The growing interest in the secondary use of electronic health record (EHR) data has increased the number of new data integration and data sharing infrastructures. The present work has been developed in the context of the German Medical Informatics Initiative, where 29 university hospitals agreed to the usage of the Health Level Seven Fast Healthcare Interoperability Resources (FHIR) standard for their newly established data integration centers. This standard is optimized to describe and exchange medical data but less suitable for standard statistical analysis which mostly requires tabular data formats.

Haptoglobin in Juvenile Idiopathic Arthritis.

Background: Haptoglobin (Hp), a liver derived acute phase inflammatory protein (APP), has scarcely been studied in juvenile idiopathic arthritis (JIA). Hp can occur in blood as two isoforms (Hp1 and Hp2) in precursor and mature forms. Routine clinical chemistry immunoturbidimetry does not discern these forms.

Intrinsic lipolysis rate for systematic design of lipid-based formulations.

Lipid-based formulations (LBFs) are used by the pharmaceutical industry in oral delivery systems for both poorly water-soluble drugs and biologics. Digestibility is key for the performance of LBFs and in vitro lipolysis is commonly used to compare the digestibility of LBFs. Results from in vitro lipolysis experiments depend highly on the experimental conditions and formulation characteristics, such as droplet size (which defines the surface area available for digestion) and interfacial structure.

The shoulder function "tipping-point" for elective rotator cuff repair: demographic and longitudinal trends.

Background: A patient's decision to undergo an elective orthopedic procedure is largely based on their symptoms and functional limitations. This point where patients choose to undergo surgery is known as the "tipping point." The primary aim of this study is to determine the relationship between demographic parameters and the tipping point for elective rotator cuff repair.