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Background Early recognition of emerging heart failure prior to diagnosis could offer an opportunity for prevention-focused care, but it remains unclear whether healthcare seeking patterns before diagnosis indicate an earlier window for intervention. The objective was to determine if changes in utilization appeared during the 12-week pre-diagnosis period preceding a first diagnosis of heart failur
Life stories are widely promoted in person-centred dementia care as tools to preserve the identity of the ‘person behind the dementia’. However, as cognitive decline progresses, staff often face dilemmas when current expressions of preference appear to contradict a person's documented past, for example, a devout Muslim requesting pork or a lifelong teetotaller showing interest in alcohol. The aim
The Parameter Efficient Fine-Tuning (PEFT) method freezes the original pre-trained model parameters and introduces a small number of trainable parameters from Adapter or LoRA to adapt models to downstream tasks. Current PEFT methods mainly enhance LLMs’ cross-task generalization through rigid pruning and global pruning strategies. However, these approaches suffer from coarse-grained adaptation and
Branched polycations such as poly(amidoamine) (PAMAM) dendrimers have been extensively investigated for applications including drug delivery and gene transfection, where phosphate-buffered solutions are commonly employed to maintain pH. Experimental and simulation studies have reported phosphate accumulation around PAMAM and attributed it, at least in part, to phosphate-specific interactions. Here
Maritime decarbonization is not only a technical task; it is also a governance challenge. This chapter argues that decarbonization measures are more likely to be durable when those most affected can meaningfully influence how the transition is shaped. It first outlines the legal framework for regulating shipping emissions under UNCLOS, the international climate regime, and the IMO’s work through M
Maritime decarbonisation is often framed as a techno-economic challenge, with most efforts toward a green future focusing on reducing the sector’s carbon output. There is no shortage of innovation in this regard, and the drive to make the transition happen is strong: the process demands the development of cleaner fuel alternatives and the advancement of propulsion system engineering, complemented
This study critically depicts the position on culpa in contrahendo in European private international law. The critical description is based on a conceptual analysis of culpa in contrahendo: first, the conceptual elements and the legal character of culpa in contrahendo are determined in consideration of the differences between the national legal systems and, more broadly, between the two main legal
IMPORTANCE: No-touch saphenous vein harvesting preserves perivascular tissue and may improve graft patency after coronary artery bypass grafting (CABG), but whether it reduces long-term clinical events remains uncertain.OBJECTIVE: To compare 7-year clinical outcomes after no-touch vs conventional saphenous vein harvesting in patients undergoing CABG.DESIGN, SETTING, AND PARTICIPANTS: This is a pre
Background: Establishment of an organized, risk-adapted prostate cancer screening program in Germany could serve as a key entry point for preventive men’s health. Objectives: How can the introduction of an organized, risk-adapted prostate cancer screening program in Germany shape preventive urology of the future? Materials and methods: This narrative review article is based on guidelines and exper
Background: The EU4Health project PCM4EU aimed to improve survival rates and quality of life of patients with cancer based on precision cancer medicine. To achieve this, enhanced expertise and quality of molecular cancer diagnostics are key. Clinical decision support systems (CDSS) have become increasingly important after the introduction of comprehensive genomic diagnostic profiling. While extern
There has been an increased interest in utilizing gas turbine facilities with batteries due to continued increase in intermittent energy source production. Gas turbine-battery combination is able to cover the different categories of frequency containment reserve. One issue with operating gas turbines in the frequency reserve is their low efficiency, amounting to ∼30% for small engines. Thus, 70% o
Cyclic peptides are promising modalities for targeting intracellular sites; however, cell-membrane permeability remains a key bottleneck, exacerbated by limited public data and the need for well-calibrated uncertainty. Instead of relying on data-eager complex deep learning architecture, we propose a monomer-aware decoupled global alignment kernel (MD-GAK), which couples chemically meaningful resid
Background: Child study satisfaction has rarely been assessed in longitudinal pediatric research. This study examined child and maternal study satisfaction among 10–15-year-old participants in The Environmental Determinants of Diabetes in the Young (TEDDY) study, an observational multinational (US, Finland, Germany, and Sweden) study of children at increased genetic risk for type 1 diabetes enroll
OBJECTIVES: This is a protocol for a Cochrane review (intervention). The objectives are as follows: The primary objective of this review is to evaluate the benefits and harms of a subanaesthetic dosage of ketamine/esketamine as an adjunct to perioperative analgesia versus standard analgesia or placebo for reducing postoperative pain in participants undergoing gynaecological surgical procedures. A
The specific circumstances under which autism spectrum disorder could meet the legal standards severe mental disorder (SMD; the core Swedish legal concept underpinning sentencing to forensic psychiatric care) in criminal court cases are unclear. Aim To explore which neurocognitive and contextual factors that have been emphasized in the assessment of SMD in cases of autism spectrum disorder. Method
The aetiology of type 1 diabetes is not understood. Our new hypothesis suggests that the aetiology is related to a low beta cell mass at birth. Beta cells may be stressed by increased insulin demands related to accelerated growth, puberty, pregnancy, infections and other conditions. Resulting beta-cell necrosis induced by the metabolic stress is the pathogenesis. This will be detrimental to indivi
Sensitive detection of biomolecules in complex, non-transparent biological media is highly desirable for diagnostics and food safety. Semiconductor nanowires (NW) strongly amplify fluorescence signals, however their application has been largely limited to transparent media due to the scattering and absorption arising in turbid sample matrices. We present a detection platform based on polymer-suppo
Artificial light at night (ALAN) alters nocturnal ecosystems through both intensity and spectrum, yet routine mapping of ecologically relevant light fields at scales appropriate for management decision making remains elusive. We present LumiMaSAM, a probabilistic indicator that translates aerial night-time Red, Green, and Blue (RGB) imagery and Light Detection and Ranging (LiDAR) derived structure
