Different keratoconus definitions can lead to substantial prevalence disparities in population-based studies.

This report explores the prevalence of keratoconus in a population-based cohort of adults aged 40 or older according to ten different definitions. All Rotterdam Study participants with reliable Pentacam scans and no prior corneal refractive surgery were cross-sectionally analysed (n = 2660). First, we applied a novel evidence-based definition.

Comparative analysis of salivary cytokine profiles in newly diagnosed pediatric patients with cancer and healthy children.

Salivary cytokines have the potential to serve as biomarkers for evaluating cancer progression and treatment response in specific cancer types. This study explored salivary cytokine profiles in pediatric cancer patients and healthy controls, examining changes during chemotherapy. We conducted a prospective study involving newly diagnosed cancer patients and healthy controls under 19 years old.

A large synthetic dataset for machine learning applications in power transmission grids.

With the ongoing energy transition, power grids are evolving fast. They operate more and more often close to their technical limit, under more and more volatile conditions. Fast, essentially real-time computational approaches to evaluate their operational safety, stability and reliability are therefore highly desirable.

Exploring when to exploit: the cognitive underpinnings of foraging-type decisions in relation to psychopathy.

Impairments in reinforcement learning (RL) might underlie the tendency of individuals with elevated psychopathic traits to behave exploitatively, as they fail to learn from their mistakes. Most studies on the topic have focused on binary choices, while everyday functioning requires us to learn the value of multiple options. In this study, we evaluated the cognitive correlates of naturalistic foraging-type decision-making and their electrophysiological signatures in a community sample (n = 108) with varying degrees of psychopathic traits.

High prevalence of veterinary drugs in bird's nests.

The environmental impact of insecticides used as ectoparasitic treatments for companion animals is not well understood, since they are not subject to detailed environmental risk assessment. Many of these treatments include active ingredients such as fipronil and imidacloprid that are banned from agricultural use in the EU. These treatments are applied topically and can remain on the animal's fur for an extended period of time.

Oncogenic competence: balancing mutations, cellular state, and microenvironment.

Cancer development is driven by mutations, yet tumor-causing mutations only lead to tumor formation within specific cellular contexts. The reasons why certain mutations trigger malignant transformation in some contexts but not others remain often unclear. Both intrinsic and extrinsic factors play a key role in driving carcinogenesis by leading the cells toward a state of 'oncogenic competence'.

'I wish I had been better prepared': a mixed-methods study of psychological reactions, perceptions and opinions of cardiovascular preparticipation screening among young competitive athletes.

Objective: To evaluate the psychological reactions, perceptions and opinions of cardiovascular preparticipation screening (PPS) among young competitive athletes.

Methods: This convergent parallel mixed-methods study recruited 222 athletes (mean age: 18.7 years) who underwent PPS at a Canadian university.

Parsimonious versus extensive bleeding score: can we simplify risk stratification after percutaneous coronary intervention and reduce bleeding events by de-escalation of the antiplatelet strategy?

Background And Aims: Due to the multitude of risk factors outlined in the guidelines, personalised dual antiplatelet therapy (DAPT) guidance after percutaneous coronary intervention (PCI) is complex. A simplified method was created to facilitate the use of risk stratification. We aimed to compare the predictive and prognostic value of the 'Zuidoost Nederland Hart Registratie' (ZON-HR) classification for bleeding risk with the PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent DAPT (PRECISE-DAPT) score and to determine the effect of ticagrelor monotherapy versus DAPT in patients with or without high bleeding risk (HBR).

The Impact of Changing Physicians on Compliance with Management of Myopia Progression.

Background: The global incidence of high myopia is increasing, with projections indicating a rise from 3 to 10% of the global population by 2050. Effective treatment options exist to reduce myopia progression, but their success is contingent on patient adherence. This study assesses the impact of changes in treating physicians on adherence to therapy to control myopia progression.

Formulation screening of lyophilized mRNA-lipid nanoparticles.

Lipid nanoparticles (LNPs) have demonstrated their therapeutic potential as safe and effective drug delivery systems for nucleic acids during the COVID-19 pandemic. However, one of the main challenges during technical CMC (Chemistry, Manufacturing, and Controls) development is their long-term stability at temperatures of 2-8 °C or higher, which may be improved by the removal of water by lyophilization. In this study, we identified lyo-/cryo-protectants for freeze-dried mRNA-LNP formulations beyond conventional excipients such as sucrose and trehalose as T-modifiers using polyA as a surrogate.

Abiraterone acetate fixed-dosed combinations with ibuprofen-based therapeutic eutectic and deep eutectic solvents.

In recent years, deep eutectic solvents (DESs) with their outstanding solubilization properties have emerged as strong candidates for oral enabling formulations of poorly soluble drugs. This study explores the use of drug-based therapeutic DESs (THEDESs) to solubilize a poorly soluble compound with the aim of providing a fixed-dose combination of two complementary therapeutic agents. Specifically, potential anticancer effects of ibuprofen (IBU) are harnessed in a novel type of THEDES to dissolve higher amounts of abiraterone acetate (AbAc), an antitumor agent.

Acute effect of aerobic exercise on inhibitory control and task-related heart rate variability in preadolescent children.

Objectives: To investigate whether a single session of aerobic exercise improves inhibitory control in preadolescent children and whether this effect is mediated by changes in parasympathetic activity.

Design: In this experimental study, an intervention and control group were pair-matched by age, sex and moderate-to-vigorous physical activity.

Method: 114 participants either completed a 20-min moderately-intense exercise bout on a cycling ergometer or watched a 20-min video.

Promising LOX proteins for cartilage- targeting osteoarthritis therapy.

Osteoarthritis (OA) is the most affected joint disease worldwide, touching millions of people every year. It is caused by a progressive degeneration of articular cartilage, causing pain and limited mobility. Among the pathways involved in cartilage homeostasis, "LOX" proteins (referring to three distinct protein families, very often confused in the literature) play a prominent role.

Clinical outcomes and management following progressive disease with anti-PD-(L)1 therapy in patients with advanced Merkel Cell Carcinoma.

Aim: Merkel Cell Carcinoma (MCC) is a rare skin cancer with a rising incidence worldwide. Anti-programmed death-1/ligand-1 (anti-PD-(L)1) therapies are effective for the treatment of advanced MCC. This study examines patterns of response / progression of advanced MCC to anti-PD-(L)1 therapies and describes subsequent management.

Has the documentation of chest injuries and the development of systemic complications in patients with long bone fractures changed over time?-A systematic literature review and meta-analysis by the IMPACT expert group.

Introduction: Blunt chest trauma represents a major risk factor for complications in polytrauma patients. Various scoring systems have emerged, but their impact is not fully appreciated. This review evaluates changes in chest trauma scoring over time and potential shifts in complication rates linked to modified surgical approaches in long bone fractures.

Towards contrast-agnostic soft segmentation of the spinal cord.

Spinal cord segmentation is clinically relevant and is notably used to compute spinal cord cross-sectional area (CSA) for the diagnosis and monitoring of cord compression or neurodegenerative diseases such as multiple sclerosis. While several semi and automatic methods exist, one key limitation remains: the segmentation depends on the MRI contrast, resulting in different CSA across contrasts. This is partly due to the varying appearance of the boundary between the spinal cord and the cerebrospinal fluid that depends on the sequence and acquisition parameters.

The Clinicians' Guide to Large Language Models: A General Perspective With a Focus on Hallucinations.

Large language models (LLMs) are artificial intelligence tools that have the prospect of profoundly changing how we practice all aspects of medicine. Considering the incredible potential of LLMs in medicine and the interest of many health care stakeholders for implementation into routine practice, it is therefore essential that clinicians be aware of the basic risks associated with the use of these models. Namely, a significant risk associated with the use of LLMs is their potential to create hallucinations.

Value Propositions for Digital Shared Medication Plans to Boost Patient-Health Care Professional Partnerships: Co-Design Study.

Background: Health authorities worldwide have invested in digital technologies to establish robust information exchange systems for improving the safety and efficiency of medication management. Nevertheless, inaccurate medication lists and information gaps are common, particularly during care transitions, leading to avoidable harm, inefficiencies, and increased costs. Besides fragmented health care processes, the inconsistent incorporation of patient-driven changes contributes to these problems.

The Use of Acellular Dermal Matrix May Not Increase 30-Day Complications in Direct-to-Implant Breast Reconstruction: A Multi-institutional Analysis of 10,177 Cases.

Background: Direct-to-implant (DTI) breast reconstruction offers immediate aesthetic and psychological benefits, but the role of acellular dermal matrix (ADM) remains debated. Using a multi-institutional database, this study evaluates and compares outcomes between ADM-assisted and non-ADM DTI procedures.

Methods: The American College of Surgeons National Surgical Quality Improvement Program database from 2008 to 2022 was queried to identify female patients who underwent DTI breast reconstruction for oncological purposes.

Comparative assessment of exposure tools to estimate pesticide concentrations in rice paddies: a discussion of the Brazilian context.

Estimating pesticide concentrations in paddy rice systems is challenging due to unique cultivation methods and water management practices. Various models, ranging from simple exposure calculators to complex scenario-dependent tools, have been developed globally to address this issue (PADDY, MED-Rice, RICEWQ, PFAM). In Brazil, pesticides are used in paddy rice production, and there is a potential risk of these compounds reaching waterbodies.

The European Registry for Patients with Mechanical Circulatory Support (EUROMACS) of the European Association for Cardio-Thoracic Surgery Fourth report: Focus on standardized outcome ratios.

Objectives: This fourth report aimed to provide insights into patient characteristics, outcomes, and standardized outcome ratios of patients implanted with durable Mechanical Circulatory Support across participating centers in the European Registry for Patients with Mechanical Circulatory Support (EUROMACS) registry.

Methods: All registered patients receiving durable mechanical circulatory support up to August 2024 were included. Expected number of events were predicted using penalized logistic regression.

Highly deformable flapping membrane wings suppress the leading edge vortex in hover to perform better.

Airborne insects generate a leading edge vortex when they flap their wings. This coherent vortex is a low-pressure region that enhances the lift of flapping wings compared to fixed wings. Insect wings are thin membranes strengthened by a system of veins that does not allow large wing deformations.

EULAR recommendations for the treatment of systemic sclerosis: 2023 update.

Objectives: To update the 2017 European Alliance of Associations for Rheumatology (EULAR) recommendations for treatment of systemic sclerosis (SSc), incorporating new evidence and therapies.

Methods: An international task force was convened in line with EULAR standard operating procedures. A nominal group technique exercise was performed in two rounds to define questions underpinning a subsequent systematic literature review.