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Collection of the digital data from the neurological examination
Get PDFThis review presents the status quo of how far the digitalization of elements of the neurological examination has progressed. Our focus was on studies that assessed the examination conducted in person, rather than through telemedicine platforms. Five hundred and twenty studies were included in this systematic review. The digital tools covered ten elements of the neurological examination: gait (173, 33%), motor system (149, 29%), eyes (85, 16%), cognitive functions (53, 10%), sensory system (47, 9%), balance (35, 7%), other movements (24, 5%), other cranial nerves (24, 5%), coordination (10, 2%), and autonomic nervous system (9, 2%). Most of the tools were portable (442, 85%), and in 215 studies (41%) the devices were wearable. The cost of the digital tools used was described and discussed in 167 (32%) studies. Most devices (61%) had a low complexity, and half required high additional analytic effort
Both Alcoholic and Non-Alcoholic Liver Cirrhosis Are Associated with an Increased Risk of HF—A Cohort Study Including 75,558 Patients
Get PDFThe objective of the present study was to evaluate the association between liver cirrhosis (LC) and subsequent Heart failure (HF). This retrospective cohort study utilized data from the Disease Analyzer database (IQVIA) and included adults with a first-time diagnosis of LC in 1293 general practices in Germany between January 2005 and December 2023. A comparison cohort without liver diseases was matched to the cirrhosis group using 5:1 propensity score matching. Univariable Cox proportional hazards models were used to assess the association between alcoholic vs. non-alcoholic LC and HF. The final study cohort included 5530 patients with alcoholic LC and 27,650 matched patients without liver disease, as well as 7063 patients with non-alcoholic LC and 35,315 matched patients without liver disease. After up to 10 years of follow-up, HF was diagnosed in 20.9% of patients with alcoholic LC compared to 10.3% of matched cohort, and in 23.0% of patients with non-alcoholic LC, compared to 14.2% in matched cohort. Alcoholic LC (Hazard Ratio (HR): 2.07 (95% CI: 1.85–2.31) and non-alcoholic LC (HR: 1.70; 95% CI: 1.56–1.82) were associated with an increased risk of HF. The association was also stronger in men than in women. LC, both alcoholic and non-alcoholic, is significantly associated with an increased long-term risk of HF. The association is particularly pronounced in patients with alcoholic cirrhosis and in men. To the best of the authors’ knowledge, this is the first real-world evidence for the positive association between LC and subsequent HF from Europe
Are there alterations in the metabolome of urine or serum following febrile seizures and other epileptic seizures?
Get PDFMetabolomic analysis using mass spectrometry and proteomics enables the identification of potential biomarkers of epileptic seizures. This study aimed to detect biochemical markers in urine and plasma to support non-invasive diagnostics and monitoring, while also assessing the influence of nutrition and fluid intake on the metabolome. One to three urine samples at different time points and postictal plasma samples were collected from pediatric participants with diagnosed epilepsy. Proteomic analysis was performed using bottom-up MS-based proteomics. As a control, the same children were re-sampled 24 hours postictally. Structured questionnaires on daily routine, nutrition, and hydration were also included. Several metabolites were found to be altered immediately after seizures and may represent modifiable variables influencing seizure occurrence. Notably, an increase of glutamine, lactate, urate, and ornithine was observed, accompanied by a reduction of L-histidine, creatine, L-carnitine, and the branched-chain amino acids valine, leucine, and isoleucine, suggesting an acute disturbance of central metabolic pathways. These metabolites may serve as a basis for novel diagnostic tests or as biomarkers for monitoring disease progression and treatment adaptation. The results further provide insights that may contribute to the development of therapeutic approaches by improving understanding of the pathophysiology of childhood epilepsy. This study highlights the importance of biomarker research in refining diagnosis and therapy of epileptic seizures. Future work should validate the identified markers and assess their clinical applicability
Der ›Blinkerwall‹ in der Mecklenburger Bucht: Von der Entdeckung während einer Ausbildungsfahrt zum Leibniz-Projekt
Get PDFIm Rahmen einer studentischen Ausbildungsfahrt des Studiengangs ›Physik des Erdsystems‹ wurde 2022 in der Mecklenburger Bucht eine bis dahin unbekannte, über 900 Meter lange Steinstruktur entdeckt, die als ›Blinkerwall‹ bekannt wurde. Hochauflösende hydroakustische Vermessungen, Sedimentanalysen und Tauchgänge bestätigten, dass es sich nicht um eine geologische, sondern um eine anthropogene Konstruktion handelt. Datierungen legen nahe, dass der Wall vor rund 9.000 Jahren an einem damaligen Seeufer errichtet wurde, bevor er durch den postglazialen Meeresspiegelanstieg überflutet wurde. Wahrscheinlich diente er als steinzeitliche Jagdarchitektur zur Lenkung von Rentieren. Damit zählt er zu den ältesten dokumentierten Jagdanlagen weltweit und stellt ein bedeutendes Zeugnis früher Jäger-Sammler-Gesellschaften dar. Die Entdeckung führte zur Einrichtung des Leibniz-Projekts SEASCAPE, das weitere Großstrukturen in der westlichen Ostsee erforscht. Zugleich verdeutlicht der Fund die enge Verknüpfung von Spitzenforschung und praxisnaher Lehre an der Christian-Albrechts-Universität zu Kiel.During a student training cruise of the ›Physics of the Earth System‹ program in 2022, a previously unknown stone structure over 900 meters long was discovered in the Mecklenburg Bight, later named the ›Blinkerwall.‹ High-resolution hydroacoustic surveys, sediment analyses, and diver inspections confirmed that this was not a natural formation but an anthropogenic construction. Dating indicates that the wall was built about 9,000 years ago along the shore of a lake before being submerged by the postglacial sea-level rise. It was most likely used as Stone Age hunting architecture for directing reindeer, making it one of the oldest documented hunting structures worldwide and a key testimony of early hunter-gatherer societies. The discovery led to the establishment of the Leibniz project SEASCAPE, dedicated to exploring further large-scale Stone Age structures in the western Baltic Sea. At the same time, it highlights the close integration of cutting-edge research and hands-on teaching at Kiel University
EndoCompass Project: Research Roadmap for Reproductive and Developmental Endocrinology
Get PDFEndocrine science remains underrepresented in European Union research programs despite the fundamental role of hormone health in human well-being. Analysis of the CORDIS database reveals a persistent gap between the societal impact of endocrine disorders and their research prioritization. At national funding level, endocrine societies report limited or little attention of national research funding towards endocrinology. The EndoCompass project - a joint initiative between the European Society of Endocrinology and the European Society of Paediatric Endocrinology, aimed to identify and promote strategic research priorities in endocrine science to address critical hormone-related health challenges. Research priorities were established through comprehensive analysis of the EU CORDIS database covering the Horizon 2020 framework period (2014-2020). Expert consultation was conducted to identify key research priorities, followed by broader stakeholder engagement including society members and patient advocacy groups. Research priorities encompass variations in sex development, hypothalamic-pituitary-gonadal regulation, and female and male reproductive disorders. [...] analysis, optimizing hormonal treatments, developing fertility preservation strategies. Special emphasis is placed on establishing pan-European registries, developing novel reproductive technologies, and exploring environmental impacts on reproductive health. This component of the EndoCompass project provides an evidence-based roadmap for strategic research investment. This framework identifies crucial investigation areas into reproductive and developmental endocrinology pathophysiology, prevention, and treatment strategies, ultimately aimed at reducing the burden of these disorders on individuals and society. The findings support the broader EndoCompass objective of aligning research funding with areas of the highest potential impact in endocrine health
Revisiting the Effectiveness of Nitrification Inhibitors Under Different Soil Moisture Conditions and Mineral Nitrogen Extraction Methods: Further Experimental Work Considering the Pasda et al. (2023) Opinion Paper
Get PDFBackground In a recent opinion article, Pasda et al. indicated that the findings from our previous study (Guo et al.) were misleading due to the inappropriateness of the experimental work. The mentioned study focused on the effectiveness of four nitrification inhibitors (NIs) in reducing nitrous oxide (N2O) emissions as affected by temperature and moisture. Aims We assessed to what extent the issues raised by Pasda et al. impact the findings presented by Guo et al. The points considered were (i) the lack of distinction between pure NIs, commercial formulations, and NI-treated fertilizers, (ii) unsuitable application rates of nitrogen (N) and NIs, and (iii) inappropriate soil NH4+-N extraction method. [....] Results The control treatments at the both 60% and 80% WHC exhibited highest N2O-N emissions; however, emissions were higher at 80% WHC compared to 60%. NIs effectively reduced N2O emissions although the efficiency was slightly lower 80% WHC. Furthermore, NI treatments also retained higher NH4+-N levels and suppressed NO3−-N accumulation. KCl extractions consistently yielded higher amount of NH4+-N as compared to CaCl2. Conclusions The study proves that the dilution of ENTEC significantly affected Guo et al.’s results. In the current study, ENTEC effectively reduced N2O emissions, performing similar to DMPP, DCD, and PIADIN. The high efficiency of these inhibitors remains consistent and in line with the earlier findings. Although the KCl extraction is more precise for NH4+-N measurement, CaCl2 can still detect NI effects and may be suitable depending on the specific context of study
Crosstalk of TGF-β and somatostatin signaling in adenocarcinoma and neuroendocrine tumors of the pancreas: a brief review
Get PDFAlthough the vast majority of cancers affecting the human pancreas are pancreatic ductal adenocarcinomas (PDAC), there are several other cancer types originating from non-exocrine cells of this organ, i.e., pancreatic neuroendocrine tumors (panNET). Genomic analyses of PDAC and panNET revealed that certain signaling pathways such as those triggered by transforming growth factor-β (TGF-β) are frequently altered, highlighting their crucial role in pancreatic tumor development. In PDAC, TGF-β plays a dual role acting as a tumor suppressor in healthy tissue and early stages of tumor development but as a promoter of tumor progression in later stages. This peptide growth factor acts as a potent inducer of epithelial-to-mesenchymal transition (EMT), a developmental program that transforms otherwise stationary epithelial cells to invasive mesenchymal cells with enhanced metastatic potential. TGF-β signals through both the canonical Smad pathway involving the receptor-regulated Smad proteins, SMAD2 and SMAD3, and the common-mediator Smad, SMAD4, as well as Smad-independent pathways, i.e., ERK1/2, PI3K/AKT, and somatostatin (SST). Accumulating evidence indicates an intimate crosstalk between TGF-β and SST signaling, not only in PDAC but, more recently, also in panNET. In this work, we review the available evidence on signaling interactions between both pathways, which we believe are of potential but as yet insufficiently appreciated importance for pancreatic cancer development and/or progression as well as novel therapeutic approaches
Cold atmospheric plasmas for material synthesis: particle-free thin film deposition initiated by VUV photochemistry
No full textDeposition of high-quality, homogeneous thin films with controllable chemical structure and properties under ambient conditions is a topic of current research due to the possibility to integrate such processes in production lines without the challenge of transferring substrates into vacuum. Atmospheric plasmas are promising tools for this application. The high collision frequency at this pressure increases reaction rates but also leads to low kinetic energy of depositing species, source degradation by internal deposition, fast gas phase polymerization and ultimately to film defects like nanoparticle incorporation. This work addresses these issues by utilizing vacuum ultraviolet (VUV) radiation from a pure noble gas plasma for initiating (ionic) gas phase chemistry with deposition from different precursors. A deposition source providing windowless separation of plasma, photons and precursor was built. Influence of photon energy could be studied as photons from helium plasma have higher energies compared to photons from argon plasma. Gas phase polymerization mainly proceeded via reactions of precursor fragment ions with neutral precursor molecules. The photons interacting with the growing film were found to influence film structure and properties. Film oxidation due to omnipresent water impurities was advantageous in case of silicon oxide deposition, where the energetic photons removed the organic fraction from the film by photodesorption, enhanced cross-linking and reduced porosity. To demonstrate the capabilities of the developed source, deposition from acetylene and silane was carried out, which very effectively form nanoparticles from negative ions in plasma. Homogeneous, particle-free films could be deposited by irradiating these precursors with photons from the atmospheric helium plasma
Challenging the Paradigm: Long-Term Outcomes in Dialysis-Dependent Patients Undergoing CABG
Get PDFDialysis-dependent (DD) patients undergoing coronary artery bypass grafting (CABG) remain a particularly high-risk population with impaired outcomes despite advances in surgical techniques. In this single-center, retrospective cohort study, 97 DD patients (2010-2015) were compared with 488 non-dialysis-dependent (NDD) controls. The primary endpoint was all-cause mortality; the secondary endpoint was major adverse cardiac and cerebrovascular events (MACCE). Median follow-up was 5.4 ± 2.1 years. DD patients had significantly higher perioperative mortality (10.3% vs. 3.1%, p = 0.002) and markedly reduced overall survival (OS) (40.8% vs. 82.1% at 5 years). Dialysis dependence conferred an 8.4-fold increase in mortality risk and a 2.6-fold increase in MACCE risk. Increasing age, diabetes, and critical preoperative state were independent predictors of an adverse long-term outcome. While arterial grafting improved survival in NDD patients, no comparable benefit was observed in DD patients, possibly due to vascular calcification, limited conduit availability, and reduced graft patency. EuroSCORE II adequately predicted perioperative mortality (AUC = 0.78 in DD patients) but demonstrated poor discriminatory power for long-term survival (AUC = 0.67 at 5 years). These findings highlight the urgent need for dialysis-specific risk models. Despite poor long-term prognosis, DD patients with low-risk EuroSCORE II profiles experienced the most relative benefit from CABG
Damage Control Surgery in Obstetrics and Gynecology: Abdomino-Pelvic Packing in Multimodal Hemorrhage Management
Get PDFDamage control surgery (DCS) is a staged surgical strategy for rapid control of life-threatening bleeding, followed by physiological stabilization and delayed definitive repair. Abdomino-pelvic packing (APP)-placing compressive material within the pelvis and/or abdomen to tamponade bleeding-is a cornerstone of DCS as a temporizing measure to achieve hemostasis and stabilization in critically unstable patients. This narrative review synthesizes current evidence on DCS with a focus on APP-a technique historically developed in trauma and orthopedic surgery for exsanguinating pelvic bleeding but adaptable to gynecologic and obstetric emergencies. We outline the historical evolution, physiological basis, and stepwise protocol of DCS, adapted to specialty-specific conditions such as postpartum hemorrhage, placenta accreta spectrum, uterine rupture, and hepatic rupture in HELLP syndrome, as well as oncologic surgeries (debulking, exenteration, lymphadenectomy) and benign procedures (trocar-entry injuries in laparoscopy, presacral bleeding in sacrocolpopexy, and retroperitoneal hemorrhage in deep-infiltrating endometriosis). Modern adjuncts-including early tranexamic acid, topical hemostatic agents, and multidisciplinary coordination-have transformed packing from a last-resort maneuver into an integrated component of staged hemorrhage control. In OB/GYN, APP allows for successful hemostasis in 75-90% of cases, with significantly lower mortality rates than trauma surgery. In conclusion, APP as a potentially life-saving maneuver within DCS requires integration into standardized, institution-wide hemorrhage protocols in OB/GYN. Training, simulation, and guideline adoption are critical, particularly in resource-limited settings where advanced interventions for catastrophic bleeding are inaccessible