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Background Nutritional deficiency is common in critically ill hospitalized patients. This condition may be aggravated by increased dietary requirements and deficiencies in nutrient absorption. This study aimed to evaluate the associations between the modified Nutritional Risk in Critically ill (mNUTRIC) score and mortality and morbidity in patients with sepsis. Methods In this prospective observational study, 78 patients with sepsis were enrolled in the general intensive care unit over a 3-month period. Demographic and clinical data and laboratory results were recorded and followed up. The nutrition of each patient was started by the nutrition team, and a modified score (mNUTRIC) was calculated. This score was used to assess the patients’ nutritional status and mortality risk. Results The mean age of the patients was 77.2 ± 9.9 years, and the majority were men. The median mNUTRIC score was 6. The cohort was divided into two groups: 31 patients (39.7%) with low scores and 47 patients (60.3%) with high mNUTRIC scores. A high mNUTRIC score was associated with an increased need for vasoactive drugs ( p  < 0.001) and mechanical ventilation ( p  < 0.001), as well as increased acute kidney injury ( p  = 0.014) and prolonged hospital stay ( p  < 0.001) during ICU follow-up. The mNUTRIC score showed high accuracy in predicting mortality ( p  < 0.001). Conclusions In this study, to predict the prognosis of patients with sepsis in the ICU, the mNUTRIC score was associated with mortality. The inclusion of nutritional assessment scoring tools in the routine clinical evaluation of ICU patients is important.

Current imitation learning approaches, predominantly based on deep neural networks (DNNs), offer efficient mechanisms for learning driving policies from real-world datasets. However, they suffer from inherent limitations in interpretability and generalizability—issues of critical importance in safety-critical domains such as autonomous driving. In this paper, we introduce Symbolic Imitation Learning (SIL), a novel framework that leverages Inductive Logic Programming (ILP) to derive explainable and generalizable driving policies from synthetic datasets. We evaluate SIL on real-world HighD and NGSim datasets, comparing its performance with state-of-the-art neural imitation learning methods using metrics such as collision rate, lane change efficiency, and average speed. The results indicate that SIL significantly enhances policy transparency while maintaining strong performance across varied driving conditions. These findings highlight the potential of integrating ILP into imitation learning to promote safer and more reliable autonomous systems.

Wheatgrass (Triticum aestivum L.) is a functional food rich in phenolic compounds with demonstrated antioxidant and potential anticancer properties. Its phenolic compounds, vitamins, minerals, and enzymes are the main contributors to its positive health effects. In this study, the phenolic profile of wheatgrass juice powder was determined by HPLC-DAD, its antioxidant capacity was measured by DPPH and total phenolic content assays, and its cytotoxic effect on the MCF-7 breast cancer cell line was assessed using the MTT protocol. For in silico studies, the 3D structures of identified compounds (catechin, caffeic acid, coumarin, esculetin, quercetin, ellagic acid, and apigenin) were optimized using the DFT/B3LYP/6-311 + + G(d, p) method. Their interactions with selected cancer-related targets (estrogen receptor, epidermal growth factor receptor, IkB kinase beta, C-X-C chemokine receptor type 4) and antioxidant-associated targets (superoxide dismutase, catalase, Kelch-like ECH-associated protein 1) were investigated via molecular docking simulations. The pharmacokinetic and toxicological profiles of all the compounds were estimated via ADMET analysis. This integrative study demonstrated that wheatgrass juice powder possesses antioxidant and antitumor properties, mediated at least in part via the inhibition of factors with roles in cancer and oxidative stress.

Background Trochanteric-entry intramedullary nailing (IMN) is widely used for the treatment of femoral shaft fractures. However, concerns remain regarding potential iatrogenic injury to the gluteus medius (GMed), a key hip abductor muscle essential for gait stability. Limited clinical studies have simultaneously investigated postoperative muscle morphology and gait biomechanics in this context. This retrospective study aimed to quantitatively evaluate gait and gluteus medius muscle alterations following trochanteric-entry intramedullary nailing in patients with healed femoral fractures. Methods This retrospective observational study included 50 adult patients who underwent trochanteric-entry IMN between January 2020 and January 2024. At the 12th postoperative month, bilateral evaluations of GMed muscle thickness (ultrasonography), plantar pressure distribution, and spatiotemporal gait parameters (step length and cadence) were performed using the WIN-TRACK gait analysis system (Medicapteurs, France). Comparisons between operated and contralateral limbs were conducted with paired tests. Correlation, regression, and receiver operating characteristic (ROC) analyses were performed to examine associations between morphological and functional measures. Results The operated limbs demonstrated significantly reduced step length (0.553 ± 0.051 m vs. 0.584 ± 0.045 m), cadence (104.6 ± 11.2 vs. 109.9 ± 10.8 steps/min), and GMed thickness (2.09 ± 0.28 cm vs. 2.27 ± 0.29 cm), all with p  < 0.001. Plantar pressure variables, including maximum pressure, pressure-time integral, and contact area, were also significantly decreased on the operated side ( p  < 0.001). Effect size analyses revealed medium differences (Cohen’s d: 0.48–0.63). Although step length showed weak positive correlations with GMed thickness and plantar loading parameters, regression (R² = 0.035, p  = 0.643) and ROC analyses (AUC 0.46–0.53) indicated limited predictive accuracy. Conclusion One year after trochanteric-entry IMN, patients exhibited persistent structural and functional asymmetries, including reduced step length, cadence, GMed thickness, and plantar pressure. Despite bone union and fracture healing, compensatory deficits remained evident. These findings highlight the need for postoperative rehabilitation protocols focusing on hip abductor strengthening, and gait re-education, as well as long-term monitoring of gluteus medius integrity.

Guidelines of the European Society of Cardiology recommend a clinical risk assessment for patients with atrial fibrillation (AF). However, scores such as the CHA2DS2-VASc score show only a modest performance for prediction of adverse endpoints. This retrospective single-center all-comer study uses data from the Heidelberg Registry of Atrial Fibrillation of 9,995 patients with non-valvular AF presenting to the emergency department (ED) of the University Hospital of Heidelberg from June 2009 until March 2020. Per CHA2DS2-VASc, risk was classified as low (0 point in men, ≤ 1 point in females), intermediate, or high (≥2 points in men and ≥3 points in females). The predictive performance of the CHA2DS2-VASc score, with and without highly sensitive cardiac troponin T (hs-cTnT), was evaluated for a composite endpoint comprising stroke, myocardial infarction (MI) or all-cause mortality. Performance of the CHA2DS2-VASc score for the prediction of the composite endpoint was poor Area under the curve (AUC): 0.648 (95%CI: 0.638-0.657) particularly in patients at intermediate-risk AUC: 0.542 (95%CI: 0.508-0.575). Adding hs-cTnT improved discrimination substantially in intermediate-risk patients (AUC: 0.778, 95% CI: 0.748-0.805). Notably, no events occurred in intermediate-risk patients with undetectable hs-cTnT (<5 ng/L). In patients with AF at intermediate thromboembolic risk, the addition of hs-cTnT to the CHA₂DS₂-VASc score enhances prediction of adverse cardiovascular outcomes. Hs-cTnT may help identify patients who could benefit from anticoagulation, while also identifying a low-risk subgroup unlikely to experience events.

In this study, we explored the biocultural mechanisms underlying ancient craft behaviours. Archaeological methods were integrated with neuroscience techniques to explore the impact on neuroplasticity resulting from the introduction of early pottery techniques. The advent of ceramic marked a profound change in the economy and socio-cultural dynamics of past societies. It may have also played a central role in developing new craft skills that influenced the neural plasticity of the potters. Coiling, one of the most widespread neolithic techniques, requires precise hand movements and the ability to regulate finger pressure to shape the clay without deformation. In a pilot study involving intensive training in neolithic pottery, we used TMS-EEG co-registration to monitor a group of participants and we examined the shape of the artefacts they made before and after training. Our findings suggest changes in the functional properties of the primary motor cortex (M1) responsible for the control and execution of actions. We also observed an improvement in symmetry and consistency of the artefacts and a significant reduction in errors. This multidisciplinary approach sheds light on the mechanisms of material culture’s variation in the archaeological field and provides promising insights into the co-evolution of technology and human skill.

Background Sepsis is an organ dysfunction that impairs response to infection. Inflammatory biomarkers have been used to diagnose and monitor sepsis. The aim of the present study was to determine the role of immature granulocytes (IGs) in monitoring sepsis treatment. Methods This two-center, prospective, observational study included patients diagnosed with sepsis according to the Sepsis-3 criteria, who were followed-up in the adult intensive care units of the Bolu Izzet Baysal State Hospital and Bolu Izzet Baysal Training and Research Hospital (Bolu Merkez/Bolu, Türkiye). Laboratory investigation results, demographic information, treatment responses, and mortality were recorded. Patients were divided into 2 groups according to treatment: appropriate (group 1); and inappropriate (group 2). Differences in the number of IGs and IG% were compared. Differences with P  < 0.05 were considered to be statistically significant for all analyses. Results The study included 87 patients from 2 centers. The most common comorbidities were hypertension (54%) and 28-day mortality (37.9%). Empirical antibiotic therapy (43.7%) was appropriate for 38 patients (group 1) and 49 patients when the treatment was incorrect or inadequate (group 2). There were no significant differences between the groups in terms of laboratory investigation results on the day of treatment initiation. IG count and IG% on day 3 of treatment were significantly higher in group 2. Mortality was higher in patients with a high IG count (IG %) and in group 2. Conclusion IG% was a simple, inexpensive, and useful test for monitoring sepsis treatment and, in addition, IG count was also effective in predicting mortality.

Acute stress impairs executive functions, and these higher-order cognitive processes are often positively associated with intelligence. Even though intelligence is generally stable over time, performance in an intelligence test can be influenced by a variety of factors, including psychological processes like motivation or attention. For instance, test anxiety has been shown to correlate with individual differences in intelligence test performance, and theoretical accounts exist for causality in both directions. However, the potential impact of acute stress before or during an intelligence test remains elusive. Here, in a research context, we investigated the effects of test anxiety and acute stress as well as their interaction on performance in the short version of the Intelligence Structure Test 2000 in its German version (I-S-T 2000 R). Forty male participants completed two sessions scheduled 28 days apart, with the order counterbalanced across participants. In both sessions, participants underwent either the socially evaluated cold-pressor test (SECPT) or a non-stressful control procedure, followed by administration of I-S-T 2000 R (parallelized versions on both days). The SECPT is a widely used laboratory paradigm that elicits a stress response through the combination of psychosocial and physical components. Trait test anxiety scores were obtained via the German Test Anxiety Inventory (TAI-G). Stress induction was successful as indicated by physiological and subjective markers, including salivary cortisol concentrations. We applied linear mixed models to investigate the effects of acute stress (elicited by our stress manipulation) and test anxiety on the intelligence quotient (IQ). The analysis revealed that neither factor had a significant effect, nor was there a significant interaction between them. Consistent with these findings, Bayesian analyses provided evidence supporting the absence of these effects. Notably, IQ scores increased significantly from the first to the second testing day. These results suggest that neither test anxiety nor stress is significantly impacting intelligence test performance. However, improvements due to repeated testing call for caution, both in scientific and clinical settings.

(1) Background: Prompt acute coronary syndrome (ACS) recognition remains challenging. This study evaluated the diagnostic and prognostic performance of novel biomarkers for non-ST-elevation myocardial infarction (NSTEMI). (2) Methods: Patients with suspected ACS presenting to Heidelberg University Hospital’s Emergency Department between August 2014 and February 2023 were analyzed. The biomarker panel included high-sensitivity cardiac troponin T (hs-cTnT), cardiac myosin-binding protein C (cMyBP-C), pro-B-type natriuretic peptide (proBNP), total N-terminal pro-B-type natriuretic peptide (t-NtproBNP), Angiotensin II (Ang2), Bone morphogenetic protein 10 (BMP10), Endothelial cell-specific molecule 1 (ESM1), fatty acid-binding protein 3 (FABP3), Fibroblast growth factor 23 (FGF23), Growth differentiation factor 15 (GDF15), and Copeptin. Negative predictive values (NPVs), sensitivities, and area under the curve (AUC) values were calculated for NSTEMI discrimination. Effectiveness and prognostic performance were assessed based on cardiovascular events at 30 days and 1 year. (3) Results: Of 1765 patients, 212 (12%) were diagnosed with NSTEMI. The European Society of Cardiology (ESC) 0/1 h and 0/3 h algorithms achieved sensitivities of 100% and 96.8%, NPVs of 100% and 99.3%, and effectiveness values of 54.8% and 66.0%. Hs-cTnT (AUC: 0.922) and cMyBP-C (AUC: 0.917) exhibited the highest diagnostic accuracy, followed by FABP3 (AUC: 0.759) and Copeptin (AUC: 0.624). Other biomarkers had lower performance (AUC: 0.516–0.617). At 1 year, event rates ranged from 0.0% to 3.4%, with the ESC algorithms demonstrating superior prognostic performance (0.8%, 2.4%). (4) Conclusions: The ESC 0/1 h and 0/3 h algorithms remain the most effective NSTEMI diagnostic strategies, balancing high sensitivity, prognostic reliability, and effectiveness. Among novel biomarkers, only cMyBP-C demonstrated comparable accuracy to hs-cTnT, supporting its potential as an adjunct to troponin assays.