Digital Representation of Patients as Medical Digital Twins: Data-Centric Viewpoint.

Precision medicine involves a paradigm shift toward personalized data-driven clinical decisions. The concept of a medical "digital twin" has recently become popular to designate digital representations of patients as a support for a wide range of data science applications. However, the concept is ambiguous when it comes to practical implementations.

Posterior instrumented correction and fusion of Scheuermann´s results in physiological reconstruction of sagittal alignment and excellent overall clinical outcome- clinical trail of 73 patients.

Purpose: The aim was to assess the clinical outcomes after posterior spinal fusion (PSF) in patients with Scheuermann's disease (SD).

Methods: SD undergoing PSF were retrospectively analyzed. Clinical outcome was determined using SRS-22- and Eq.

Factors influencing role preferences in decision-making of healthy women with BRCA1/2 pathogenic variants: subanalysis from a randomised controlled decision coaching trial.

Background: Patients who actively engage in their medical decision-making processes can experience better health outcomes. This exploratory study aimed to identify predictors of preferred and actual roles in decision-making in healthy women with BRCA1/2 pathogenic variants (PVs).

Methods: Women with BRCA1/2 PVs without a history of breast and/or ovarian cancer were recruited in six centres across Germany.

A Digital Tool (Technology-Assisted Problem Management Plus) for Lay Health Workers to Address Common Mental Health Disorders: Co-production and Usability Study in Pakistan.

Background: Mental health remains among the top 10 leading causes of disease burden globally, and there is a significant treatment gap due to limited resources, stigma, limited accessibility, and low perceived need for treatment. Problem Management Plus, a World Health Organization-endorsed brief psychological intervention for mental health disorders, has been shown to be effective and cost-effective in various countries globally but faces implementation challenges, such as quality control in training, supervision, and delivery. While digital technologies to foster mental health care have the potential to close treatment gaps and address the issues of quality control, their development requires context-specific, interdisciplinary, and participatory approaches to enhance impact and acceptance.

MR imaging of proton beam-induced oxygen depletion.

Background: Previous studies have shown that in-beam magnetic resonance imaging (MRI) can be used to visualize a proton beam during the irradiation of liquid-filled phantoms. The beam energy- and current-dependent local image contrast observed in water was identified to be predominantly caused by beam-induced buoyant convection and associated flow effects. Besides this flow dependency, the MR signal change was found to be characterized by a change in the relaxation time of water, hinting at a radiochemical contribution, which was hypothesized to lie in oxygen depletion-evoked relaxation time lengthening.

Can surgeons trust AI? Perspectives on machine learning in surgery and the importance of eXplainable Artificial Intelligence (XAI).

Purpose: This brief report aims to summarize and discuss the methodologies of eXplainable Artificial Intelligence (XAI) and their potential applications in surgery.

Methods: We briefly introduce explainability methods, including global and individual explanatory features, methods for imaging data and time series, as well as similarity classification, and unraveled rules and laws.

Results: Given the increasing interest in artificial intelligence within the surgical field, we emphasize the critical importance of transparency and interpretability in the outputs of applied models.

Evaluation of mobile clinics by MSF in pastoralist community in Doolo Zone, Somali region, Ethiopia.

Background: The Somali region in Ethiopia has poor health infrastructure, coupled with the adversity experienced by the largely pastoralist population through frequent droughts, disease outbreaks and conflict. From January 2019, MSF strategically focused on improving access to primary healthcare in the Doolo zone of the Somali region by providing 15-20 mobile clinics covering a wide geographical area. We aimed to evaluate the extent to which mobile clinics were an appropriate and effective modality to deliver healthcare for populations living in the region.

Validity of one-time phantomless patient-specific quality assurance in proton therapy with regard to the reproducibility of beam delivery.

Background: Patient-specific quality assurance (PSQA) is a crucial yet resource-intensive task in proton therapy, requiring special equipment, expertise and additional beam time. Machine delivery log files contain information about energy, position and monitor units (MU) of all delivered spots, allowing a reconstruction of the applied dose. This raises the prospect of phantomless, log file-based QA (LFQA) as an automated replacement of current phantom-based solutions, provided that such an approach guarantees a comparable level of safety.

A Short Cognitive and Neuropsychiatric Assessment Scale for Progressive Supranuclear Palsy.

Background: Patients with Progressive Supranuclear Palsy (PSP) suffer from several neuropsychological impairments. These mainly affect the frontal lobe and subcortical brain structures. However, a scale for the assessment of cognitive and neuropsychiatric disability in PSP is still missing.

SwarmMAP: Swarm Learning for Decentralized Cell Type Annotation in Single Cell Sequencing Data.

Rapid technological advancements have made it possible to generate single-cell data at a large scale. Several laboratories around the world can now generate single-cell transcriptomic data from different tissues. Unsupervised clustering, followed by annotation of the cell type of the identified clusters, is a crucial step in single-cell analyses.

Overview of basic design recommendations for user-centered explanation interfaces for AI-based clinical decision support systems: A scoping review.

Objective: The application of artificial intelligence (AI)-based clinical decision support systems (CDSS) in the healthcare domain is still limited. End-users' difficulty understanding how the outputs of opaque black AI models are generated contributes to this. It is still unknown which explanations are best presented to end users and how to design the interfaces they are presented in (explanation user interface, XUI).

Extracellular vesicles from pancreatic cancer and its tumour microenvironment promote increased Schwann cell migration.

Background: Pancreatic ductal adenocarcinoma (PDAC) exhibits a high frequency of neural invasion (NI). Schwann cells (SCs) have been shown to be reprogrammed to facilitate cancer cell migration and invasion into nerves. Since extracellular vesicles (EVs) affect the tumour microenvironment and promote metastasis, the present study analysed the involvement of EVs from pancreatic cancer cells and their microenvironment in altering SC phenotype as part of the early events in the process of NI.

Comparison of ZnS(Ag) Scintillator and Proportional Counter Tube for Alpha Detection in Thin-Layer Chromatography.

(1) : Targeted alpha therapy is an emerging field in nuclear medicine driven by two advantages: overcoming resistance in cancer-suffering patients to beta therapies and the practical application of lower activities of Pb- and Ac-labelled peptides to achieve the same doses compared to beta therapy due to the highly cytotoxic nature of alpha particles. However, quality control of the Pb/Ac-radiopharmaceuticals remains a challenge due to the low activity levels used for therapy (100 kBq/kg) and the formation of several free daughter nuclides immediately after the formulation of patient doses; (2) : The routine alpha detection on thin-layer chromatograms (TLC) of Pb- and Ac-labelled peptides using a MiniScanPRO+ scanner combined with an alpha detector head was compared with detection using an AR-2000 scanner equipped with an open proportional counter tube. Measurement time, resolution and validity were compared for both scanners; (3) : For Ac, the quality control values of the radiochemical purity (RCP) were within the acceptance criteria 2 h after TLC development, regardless of when the TLC probe was taken.

Comparison of Radio- and Phototoxicity in Association with an Enhancing Effect of the Photosensitizers Psoralen, Trioxsalen and Ortho-Iodo-Hoechst33258 on FaDu, PC-3, 4T1 and B16-F10 Cells.

Energy delivered at different wavelengths causes different types of damage to DNA. PC-3, FaDu, 4T1 and B16-F10 cells were irradiated with different wavelengths of ultraviolet light (UVA/UVC) and ionizing radiation (X-ray). Furthermore, different photosensitizers (ortho-iodo-Hoechst33258/psoralen/trioxsalen) were tested for their amplifying effect.

Bosworth fracture: Pathoanatomy, Complications, and Medium-term Results of Treatment.

Background: Bosworth fractures (BFs) with entrapment of a fibular fragment behind the posterior malleolus (PM) are rare but potentially serious injuries to the ankle. Despite an increased awareness through a more regular use of computed tomography (CT) scanning, there is still a scarcity of clinical outcome studies.

Methods: Over a course of 25 years, data on 23 patients treated for BF at our institutions (mean age 44 years) were collected prospectively.

An interactive course program on nutrition for medical students: interdisciplinary development and mixed-methods evaluation.

Nutrition plays a crucial role in human and planetary health, as prevailing nutritional patterns significantly contribute to the global non-communicable disease pandemic. Moreover, the global food system is inextricably linked to planetary health deterioration. The relevance of nutrition for individual and planetary health is insufficiently addressed in German medical schools.

Genomics yields biological and phenotypic insights into bipolar disorder.

Bipolar disorder is a leading contributor to the global burden of disease. Despite high heritability (60-80%), the majority of the underlying genetic determinants remain unknown. We analysed data from participants of European, East Asian, African American and Latino ancestries (n = 158,036 cases with bipolar disorder, 2.

Perioperative Chemotherapy or Preoperative Chemoradiotherapy in Esophageal Cancer.

Background: The best multimodal approach for resectable locally advanced esophageal adenocarcinoma is unclear. An important question is whether perioperative chemotherapy is preferable to preoperative chemoradiotherapy.

Methods: In this phase 3, multicenter, randomized trial, we assigned in a 1:1 ratio patients with resectable esophageal adenocarcinoma to receive perioperative chemotherapy with FLOT (fluorouracil, leucovorin, oxaliplatin, and docetaxel) plus surgery or preoperative chemoradiotherapy (radiotherapy at a dose of 41.

Cell-free tumor DNA analysis in advanced or metastatic breast cancer patients: mutation frequencies, testing intention, and clinical impact.

Background: Circulating cell-free tumor DNA (ctDNA) provides a non-invasive approach for assessing somatic alterations. The German PRAEGNANT registry study aims to explore molecular biomarkers and investigate their integration into clinical practice. In this context, ctDNA testing was included to understand the motivations of clinicians to initiate testing, to identify somatic alterations, and to assess the clinical impact of the results obtained.

Current applications and challenges in large language models for patient care: a systematic review.

Background: The introduction of large language models (LLMs) into clinical practice promises to improve patient education and empowerment, thereby personalizing medical care and broadening access to medical knowledge. Despite the popularity of LLMs, there is a significant gap in systematized information on their use in patient care. Therefore, this systematic review aims to synthesize current applications and limitations of LLMs in patient care.

The Co-IMPACT Consortium: Integrating Prostate-specific Membrane Antigen Positron Emission Tomography and Radiotherapy in Prostate Cancer Care.

The Co-IMPACT consortium addresses knowledge gaps in prostate-specific membrane antigen positron emission tomography-guided radiotherapy for prostate cancer by establishing a global database (46 centres from 16 countries) to standardise and analyse data across four distinguished clinical scenarios. A collaborative model with the Advanced Prostate Cancer Consensus Conference aligns urgent clinical needs with actionable research insights.

Deep Learning for Biomarker Discovery in Cancer Genomes.

Background: Genomic data is essential for clinical decision-making in precision oncology. Bioinformatic algorithms are widely used to analyze next-generation sequencing (NGS) data, but they face two major challenges. First, these pipelines are highly complex, involving multiple steps and the integration of various tools.

Local erythropoiesis directs oxygen availability in bone fracture repair.

Bone fracture ruptures blood vessels and disrupts the bone marrow, the site of new red blood cell production (erythropoiesis). Current dogma holds that bone fracture causes severe hypoxia at the fracture site, due to vascular rupture, and that this hypoxia must be overcome for regeneration. Here, we show that the early fracture site is not hypoxic, but instead exhibits high oxygen tension (> 55 mmHg, or 8%), similar to the red blood cell reservoir, the spleen.

Deep learning helps discriminate between autoimmune hepatitis and primary biliary cholangitis.

Background & Aims: Biliary abnormalities in autoimmune hepatitis (AIH) and interface hepatitis in primary biliary cholangitis (PBC) occur frequently, and misinterpretation may lead to therapeutic mistakes with a negative impact on patients. This study investigates the use of a deep learning (DL)-based pipeline for the diagnosis of AIH and PBC to aid differential diagnosis.

Methods: We conducted a multicenter study across six European referral centers, and built a library of digitized liver biopsy slides dating from 1997 to 2023.