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In recent years, there has been an increase in studies reporting on effective child language interventions for people with or at risk for (Developmental) Language Disorder ((D)LD). However, the translation of this evidence into practice has been impeded by under-specified intervention reporting, specifically on what the active ingredients of therapy are and how they are defined. This systematic review forms part of a larger research programme conducted by the Intervention Consensus for Language Disorder group. To identify, summarise, and synthesize how the active ingredients of oral language interventions for children with or at risk for (D)LD have been labelled, defined, described, and classified in empirical and clinical literature. This registered review (PROSPERO ID CRD42024541407) adhered to PRISMA guidelines. Search terms were included in seven electronic databases. Included literature comprised peer-reviewed oral language intervention studies (published in English, German, Portuguese, Croatian, Italian, or Finnish; between January 2019 and May 2024; and reporting on participants who were ≤ 18 years, with/at risk for (D)LD); intervention-focused taxonomies; intervention manuals (published in the last 10 years); and textbooks used to teach child language interventions in pre-registration Speech and Language Therapy/Pathology courses (identified through the Whatworks database and a social media survey, respectively). Data extraction was guided by the TIDieR checklist with additional items deemed relevant for this review. 9576 articles were identified and screened; 619 were included for full text screening; and 243 articles were included in the review. Significant reporting inconsistencies were evident, including identical labels masking different mechanisms, as well as similar mechanisms operating under different labels; conflation of discrete techniques and procedures; the application of common labels in multiple ways; the use of unfamiliar terminology to refer to familiar techniques; and the use of broad terms masking multiple active ingredients. These inconsistencies do not align with what is considered well-specified active ingredients and consequently, significantly impede intervention replication and cross study comparisons. This review highlights the need to develop consensus on (1) how active ingredients of intervention are labelled and defined so that they are consistent, precise and non-overlapping and (2) a comprehensive integrative taxonomy for ease of understanding and use, when reporting on oral language interventions for children with or at risk for (D)LD. What is already known on this subject Oral language interventions contain numerous proposed 'active ingredients', but these are reported with substantial inconsistency across studies, textbooks, and intervention manuals. In addition, different taxonomies classify similar elements in divergent ways. What this paper adds to the existing knowledge We have provided the first comprehensive analysis demonstrating the extent of inconsistency, ambiguity, and conceptual overlap in how active ingredients are labelled and described in the oral language intervention literature. There is misalignment across current taxonomies and we lack an internationally agreed framework that integrates discrete active ingredients along with dosage and contextual active support ingredients. What are the potential or actual clinical implications of this work? Without clear, shared definitions of active ingredients, clinicians cannot reliably interpret research, replicate interventions, or implement evidence-based practices with fidelity. A unified internationally agreed lexicon and taxonomy would enable clinicians to understand precisely what constitutes a given technique, how it should be delivered, and what child behaviours it is intended to influence, strengthening the quality and consistency of intervention delivery.

Alcohol health warning labels are an important part of a comprehensive alcohol policy, but there is a lack of recent implementation data across Europe. This study examined the presence, content and format of health warnings across 13 European countries. Store audits were conducted across 32 stores in 23 cities. The sampled products were assessed for the presence, topic and format of health warnings. Among the 1636 investigated products, 69.7% displayed health warnings. The most common topics were pregnancy (68.0%), drink-driving (21.4%) and age restrictions (16.6%), followed by responsible drinking messages (6.9%) and health harms due to alcohol use (0.3%). About one in four (26.7%) products contained a multi-topic warning. The majority of products featured only a pictogram (62.3%), while 6.7% included both pictogram and text, and 0.7% contained text only. Lithuania, France and the Netherlands had the highest proportions of products displaying at least one warning (above 90%). Proportions were lowest in Croatia, Poland, Slovenia and Greece (under 50% of products with health warnings). Existing warnings predominantly focus on messages relevant to at-risk population groups rather than on alcohol harms affecting the general population. The current implementation largely reflects the alcohol producers' voluntary commitments, although the highest implementation is found in countries with existing legislation. There is underutilised potential to inform Europeans about the health harms of alcohol through warning labels. Stronger regulatory approaches at the EU or Member State level could improve the quality of information provided directly to consumers.

Increases in colorectal cancer (CRC) incidence among young adults were reported in 27 countries/territories worldwide, yet information on mortality trends is limited. Using the WHO Mortality database (1990 to 2023), we found CRC mortality rates among younger adults (25 to 49 years) increased in 18 of 49 countries (0.7-4.3%/year) during the most recent decade, decreased in 15, and were otherwise stable. Trends ranged from decreases of > 2%/year in Singapore, Belgium, and Denmark to increases of > 3%/year in Paraguay, Uruguay, Chile, and the UK. In half of the countries with increasing trends, rates in older adults (50 to 79 years) were stable (Colombia, Philippines, Croatia [women only]) or decreasing (Uruguay, the U.K., Australia, Canada, the U.S., Argentina). In the remainders-primarily in Latin America/the Caribbean-mortality rose in both groups. Increasing CRC mortality among younger adults may signal a growing future burden, reinforcing the need for etiologic investigation and heightened awareness to avert deaths through earlier detection.

The present guideline updates the initial ESCD patch testing guideline, summarizing all aspects of patch testing for the diagnosis of contact allergy in patients suspected of suffering, or having been suffering, from allergic contact dermatitis or other delayed-type hypersensitivity skin and mucosal conditions. Sections with brief descriptions and discussions of different pertinent topics are followed by highlighted short practical recommendations, which have been consensualized in a Delphi process. Topics comprise, after an introduction with important definitions, materials, technique, modifications of epicutaneous testing, individual factors influencing the patch test outcome or necessitating special considerations, children, patients with occupational contact dermatitis and drug eruptions as special groups, patch testing of materials brought in by the patient, adverse effects of patch testing and the final evaluation and patient counselling based on this judgement. Finally, short reference is made to aspects of (continuing) medical education and to electronic collection of data for epidemiological surveillance.

The increasing demand for gluten-free products has necessitated improved formulations, particularly under frozen storage conditions. Although freezing and thawing often lead to quality deterioration, limited research has explored the role of additives in enhancing gluten-free frozen batter. This study investigates the effects of pumpkin seed protein concentrate (PSPC) and xanthan gum on the properties of gluten-free frozen batter and the resulting cake. Batter samples were formulated with varying mass fractions of PSPC (0, 10 and 20 %) and xanthan gum (0, 0.1 and 0.2 %), then frozen at -18 &#xb0;C for 30 and 60 days. After thawing, the physicochemical properties, including viscosity and density, of the batters were analysed. Ash, moisture, protein content, porosity, volume, crust colour, and sensory properties of the baked cakes were evaluated. Increasing the PSPC mass fraction significantly improved the viscosity and density of the batter, as well as the porosity and volume of the cakes (p<0.05). Higher PSPC mass fractions also led to a significant decrease in crust lightness and redness (p<0.05). Xanthan gum positively affected most quality attributes, although it significantly increased cake hardness (p<0.05). Sensory analysis showed that the formulation containing 10 % PSPC and 0.2 % xanthan gum, after 30 days of freezing, achieved the highest overall quality and consumer acceptance (p<0.05). The positive effect of PSPC and xanthan gum on the properties of gluten-free frozen batter and the resulting cakes was confirmed in the study. These findings contribute to the optimisation of gluten-free formulations that could be used to develop high-quality gluten-free frozen bakery products.

Polynuclear and mononuclear molybdenum(VI) complexes coordinated with water or methanol were synthesized using Schiff base ligands derived from the condensation of 2-furoic hydrazide with 2-hydroxybenzaldehyde (H2L1) or 2-hydroxy-5-nitrobenzaldehyde (H2L2), emphasising a mechanochemical synthetic pathway. The complexes were characterized using comprehensive spectroscopic techniques, while single-crystal X-ray diffraction provided definitive structural elucidation for [MoO2(L1)(MeOH)] (1) and [MoO2(L1)(H2O)] (3). Thermogravimetric analysis revealed insights into the thermal stability and decomposition pathways of the complexes. DFT calculations showed that solvent donor ability controls Mo(VI) coordination and aggregation, rendering &#x3bc;-oxo dimer formation thermodynamically unfavourable. The catalytic performance of six Mo(VI) complexes was investigated for the oxidation of benzyl alcohol using tert-butyl hydroperoxide (TBHP) in aqueous medium, with systematic optimization of the oxidant-to-substrate ratio. To explore greener alternatives, H2O2 was also evaluated as an oxidant, and the influence of acetonitrile as a co-solvent and reaction temperature on catalytic efficiency was thoroughly studied. These results highlight the importance of ligand structure and solvent coordination in modulating catalytic activity. Overall, this study demonstrates that these Mo(VI) complexes serve as highly efficient and tunable catalysts for selective alcohol oxidation under mild and environmentally benign conditions. This work provides new insights into the design of molybdenum-based oxidation catalysts and emphasizes the potential of fine-tuning reaction parameters to achieve optimal catalytic performance.

SSc is associated with increased malignancy risk, a growing cause of mortality in SSc. However, standardised incidence ratios (SIR) vary widely across studies and different malignancy subtypes. This meta-analysis aimed to determine the SIR of different malignancy subtypes and the temporal relationship with SSc diagnosis. A systematic review and meta-analysis were conducted by searching Embase, MEDLINE and Cochrane Library databases from inception to 7 December 2024. Cohort studies reporting SIRs of malignancies in SSc patients were included. Studies where SIR was not reported were excluded. Random-effects models were used to calculate pooled estimates, while study quality was assessed using the Newcastle-Ottawa Scale. This review is registered on PROSPERO (CRD42023445876). Thirty-one cohort studies comprising at least 32,134 SSc patients were included. Overall malignancy risk was significantly increased (SIR 1.66; 95% CI 1.32 - 2.08). Highest risks were observed for esophageal, liver, cervical, lung, and haematological malignancies (SIR 3.35 - 13.95), while breast malignancy showed modest increased risk (SIR 1.34, 95% CI 1.00 - 1.80) that was not statistically significant. High-quality studies confirmed these associations except for esophageal malignancy, with only one high quality study for liver malignancy. There was a mean interval of 7.4 years (95% CI 5.3 - 9.5) between SSc and malignancy diagnosis. Our findings confirm an increased malignancy risk, particularly lung, haematological and cervical malignancies, and an approximate 7-year interval between SSc diagnosis and malignancy development. Further studies are needed to clarify the risk factors for different malignancy subtypes to develop cancer screening strategies. NIL.

Open and reproducible research in materials science relies on the availability of data, code, and established metadata standards. Journal research data policies (RDPs) are a primary mechanism by which these community norms are enforced. We survey RDPs for 171 materials science journals spanning 17 publishers, using an expanded coding framework that captures both data-and-code sharing behavior as well as refereeing standards. We find clear signs of progress in comparison to earlier research on RDPs: nearly all journals provide an RDP, and most mention data availability statements. However, enforceable requirements remain uncommon, public deposition of underlying data is rarely mandatory, and FAIR publication is typically encouraged rather than required. Expectations for research software are substantially less developed than those for data, with limited attention to versioning and persistent identifiers, dependency disclosure, reproducible execution environments, or software quality practices. Aggregating the findings on policy features into an open research data score reveals pronounced heterogeneity across journals. Neither impact factor nor access model reliably predicts policy strength. Double-coding further shows that more complex policies and stricter policies can be more challenging to interpret consistently, and we highlight challenges in consistent RDP encoding across studies. Lastly, we conclude with recommended best practice directions for the future.

National income level influences the prevalence and outcomes of cardiovascular disease (CVD), with lower-income countries contributing disproportionately to the global CVD burden. Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) requires specialised equipment, increasing procedural costs. However, whether national income level contributes to disparities in managing patients with CTO remains unclear. To compare the clinical profiles, procedural settings and outcomes of patients undergoing CTO-PCI in middle-income countries (MICs) and high-income countries (HICs). This cross-sectional study included 15,329 patients who underwent CTO-PCI between 2021 and 2023. Data were obtained from the European Registry of Chronic Total Occlusions (ERCTO). Of the 24 enrolling countries, 7 were classified as MICs and 14 as HICs. Patients in HICs were older (67&#x202f;&#xb1;&#x202f;10 vs 61&#x202f;&#xb1;&#x202f;10&#x202f;years; p&#x202f;<&#x202f;0.001) and presented with greater CTO complexity (J-CTO score: 2.31&#x202f;&#xb1;&#x202f;1.25 vs 1.99&#x202f;&#xb1;&#x202f;1.17; p&#x202f;<&#x202f;0.001). Conversely, patients in MICs were more likely to have diabetes (35% vs 29%; p&#x202f;<&#x202f;0.001) and to be active smokers (59% vs 49%; p&#x202f;<&#x202f;0.001). Patients in MICs had lower use of mechanical cardiac support (0.1% vs 0.8%; p&#x202f;<&#x202f;0.001), advanced calcific plaque modification devices (1% vs 6.1%; p&#x202f;<&#x202f;0.001), and intravascular ultrasound (14% vs 25%; p&#x202f;<&#x202f;0.001). MICs achieved higher procedural success (89.5% vs 90.5%; p&#x202f;=&#x202f;0.07) but higher mortality compared to HICs (0.6% vs 0.2%; p&#x202f;<&#x202f;0.001). Among a selected population of patients undergoing CTO-PCI, notable clinical, anatomical, and procedural differences exist between MICs and HICs. These findings highlight the importance of tailoring public health strategies to optimise cardiovascular care across diverse economic settings.

Thai community product quality standards have been established for nam pla-ra, which require at least 4 % protein and 12 % sodium chloride. Determining the protein and NaCl contents requires chemicals and is time-consuming. In addition to reporting protein and salt content, other quality controls must also be carried out. Thus, the objective of this research is to develop predictive models for the determination of physicochemical properties of nam pla-ra using near-infrared spectroscopy (NIRS) for fast and simultaneous multi-parameter prediction. The physicochemical values of commercially available fermented fish sauce ('nam pla-ra' in Thai) were evaluated to develop predictive models for determining physicochemical values and developing models to categorize samples. The model was developed and tested based on the seven parameters: total soluble solids (TSS), pH, L*, a*, b*, NaCl and protein content. The predictive models for pH and colour (L*, a*, b*) could be used for screening, based on their coefficients of determination (R2=0.73-0.81; SEP=0.15-0.94). The model for determining protein content (R2=0.86; SEP=0.44) is suitable for screening, routine quality control, and research applications. In contrast, the TSS and NaCl models (R2=0.97-0.98; SEP=0.41-0.61) demonstrate high predictive performance and can be reliably applied to all analytical tasks, including screening, routine quality control, and research purposes. The physicochemical properties of nam pla-ra could be predicted accurately using TSS, colour (L*, a*, b*), NaCl, and protein content. There was no significant (p>0.05) difference between the quality values obtained from the predictive model and the reference method, except for the pH value. NIRS showed potential in predicting the physicochemical properties of nam pla-ra using TSS and colour (L*, a*, b*) in the range 1000-2500 nm, and NaCl and protein contents in the selected ranges 1000-1889 and 2031-2408 nm, respectively. Furthermore, these findings demonstrate the potential of NIRS as a rapid, non-destructive, environmentally friendly and reliable analytical tool for determining the properties of nam pla-ra. NIRS can contribute to ensuring product consistency and facilitating standardisation in the fermented fish sauce industry. Such applications enhance food safety and consumer confidence.

We explore how minimal neural networks can invert the renormalization group (RG) coarse-graining procedure in the two-dimensional Ising model, effectively dreaming up microscopic configurations from coarse-grained states. This task, formally impossible at the level of configurations, can be approached probabilistically, allowing machine-learning models to reconstruct scale-invariant distributions without relying on microscopic input. We demonstrate that even neural networks with as few as three trainable parameters can learn to generate critical configurations, reproducing the scaling behavior of observables such as magnetic susceptibility, heat capacity, and Binder ratios. A real-space renormalization group analysis of the generated configurations confirms that the models capture not only scale invariance but also reproduce nontrivial eigenvalues of the RG transformation. While the inversion is necessarily imperfect, these minimal models robustly reproduce the RG-relevant structure of the critical distribution. Surprisingly, we find that increasing network complexity by introducing multiple layers offers no significant benefit. These findings suggest that simple local rules, akin to those generating fractal structures, are sufficient to encode the universality of critical phenomena, creating an opportunity for efficient generative models of statistical ensembles in physics.

Fermented soymilk has emerged as a potential functional food due to its nutritional and health-promoting properties. Enhancing its functionality by enriching it with gamma-aminobutyric acid (GABA), a neurotransmitter with various health benefits, is an area of active research. This study aims to develop a novel GABA-enriched fermented soymilk using a newly isolated Lactiplantibacillus plantarum strain with both probiotic and GABA-producing capabilities. Five L. plantarum strains isolated from Vietnamese soybean whey were screened for GABA production and probiotic characteristics. Strain W12, which exhibited superior performance, was selected for optimisation. Response surface methodology with a central composite design was used to optimise monosodium glutamate (MSG) and sucrose amounts for maximal GABA yield. A time-course study was then conducted to monitor bacterial growth, pH changes, organic acid production, and GABA accumulation during fermentation under the optimised conditions. L. plantarum W12 demonstrated exceptional probiotic traits: 97.1 % survival at pH=2.5, 96.5 % survival in bile salts/pancreatin, 97.3 % pepsin tolerance, 96.7 % auto-aggregation and 85.4 % hydrophobicity in chloroform. Initial GABA production reached (9.1&#xb1;0.4) mM. Response surface optimisation predicted a maximum GABA concentration of 34.2 mM at 1.564 mg/mL MSG and 10.93 % sucrose, which was experimentally validated at (34.5&#xb1;1.0) mM (15 h, 45 &#xb0;C). Lactic acid was the predominant organic acid produced ((182.4&#xb1;8.0) mg/g at 18 h), with viable cell counts exceeding 7.9 log CFU/mL, meeting probiotic thresholds. This study presents the first comprehensive characterisation of L. plantarum W12, a strain combining exceptional GABA biosynthesis with robust probiotic properties. The systematic response surface methodology (RSM) optimisation framework and detailed metabolic profiling provide reproducible protocols for developing multifunctional fermented soy beverages with applications in neurological and gastrointestinal health promotion.

This paper examines how Water-Energy-Food (WEF) Nexus projects, as perceived by a European expert sample drawn primarily from academia, can help bridge the gap between academia and practice to achieve greater long-term impact. Drawing on an expert survey, particularly involving members of the EU-based NexusNet COST Action, the study aims to assess the current status of WEF+ Nexus projects (NPs), identify perceived impact dimensions, and evaluate the effectiveness of existing approaches to their design, governance, and implementation. Survey findings reveal perceived key challenges and barriers to achieving lasting project impact, including limited understanding of the Nexus approach. Predominantly academic respondents point to a perceived disconnect between research and practice, which they associate with insufficient systematic impact assessment and weak policy implementation, alongside siloed institutional structures, and resistance to change. In response, the authors propose a set of practical impact indicators and tailored recommendations for improving WEF+ NP design and implementation. These recommendations emphasize mainstreaming Nexus thinking in education and capacity building, enhancing stakeholder engagement, strengthening cross-sectoral collaboration, ensuring policy coherence, and securing sustainable financing for WEF+ initiatives. By addressing these factors, the study supports the development of more integrated and transdisciplinary solutions and calls for further refinement of impact measurement tools to better capture the real-world contributions of WEF+ NPs to sustainable development.

The aortic valve-sparing procedure has been performed for more than 2 decades and has proven durable results in several aortic and root phenotypes. Few studies have analyzed the impact of aortic valve regurgitation on the need for leaflet repair and outcomes after trileaflet aortic valve-sparing surgery. The aim of this study is to analyze in a large cohort the clinical and echocardiographic outcomes of trileaflet aortic valve-sparing surgery in patients with aortic root dilatation, focusing on the impact of preoperative aortic regurgitation and cusp repair. We extracted the data from the Heart Valve Society Aortic Registry (previously also known as AVIATOR). We selected patients with trileaflet aortic valves undergoing operations for aortic root dilatation (root/ascending aorta &#x2265;45 mm) by the valve-sparing procedure. The primary outcome was the incidence of moderate or more aortic insufficiency and progression level of aortic insufficiency of at least 1 grade at follow-up. A cusp repair score was created as the cumulative sum of all leaflet repair techniques used per patients. A total of 1116 patients were included in the analysis. Mean age of patients was 53 &#xb1; 15 years, and 84% were male. The observed incidence of moderate/severe aortic insufficiency at 1, 5, and 10 years was 0.7%, 3%, and 6.8%, respectively. Both moderate or more aortic insufficiency and progression of aortic insufficiency by 1&#xb0; increase significantly with time. Preoperative aortic insufficiency and the need for additional clamping sessions were independent predictors of aortic insufficiency progression, whereas the cusp repair score increases the risk of aortic insufficiency of moderate or more. In patients with trileaflet aortic valves undergoing sparing surgery, preoperative aortic insufficiency and the need of a more extensive cusp repair increase the long-term risk of aortic insufficiency. Time also impacts the recurrence of aortic insufficiency or its increase.

This study reports the design, synthesis, and biological evaluation of novel resveratrol-inspired thieno-benzimidazole and thieno-oxazole derivatives as potential therapeutics for Alzheimer's disease. The research is grounded in the cholinergic hypothesis, which links cognitive decline to reduced acetylcholine levels due to enzymatic degradation by acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). Given the increasing relevance of BChE in later disease stages, the focus was placed on developing selective BChE inhibitors. A series of 14 compounds was synthesized using multi-step organic reactions, including Wittig reactions, Vilsmeier formylation, and cyclization strategies. Structural confirmation was achieved through NMR and mass spectrometry. The studied acetylated derivatives exhibit photochemical instability due to efficient trans-cis isomerization and subsequent secondary processes under UV irradiation, necessitating strict light protection during handling, storage, and application. Biological evaluation revealed that all compounds selectively inhibited BChE, with no significant AChE inhibition observed. Among them, carbamate-oxazole derivative 14 exhibited the highest potency (IC50&#xa0;=&#xa0;0.248&#xa0;&#x3bc;M), outperforming the reference drug rivastigmine. Several other derivatives showed moderate to strong activity, with oxazole-based compounds generally outperforming benzimidazole analogs. In addition to enzyme inhibition, antioxidant activity was assessed using the DPPH and CUPRAC assays. Compound 8 exhibited the strongest radical-scavenging activity, comparable to that of Trolox. Molecular docking and dynamics simulations provided insight into binding interactions, highlighting key &#x3c0;-&#x3c0; stacking and hydrogen bonding within the BChE active site. Furthermore, in silico genotoxicity analysis indicated that the most active compounds lack mutagenic potential. Overall, the study identifies promising multifunctional candidates combining selective BChE inhibition, antioxidant properties, and favorable safety profiles, supporting their potential as lead compounds for Alzheimer's disease therapy.

This systematic review assesses current evidence on the management of non-plaque (dental biofilm)-induced gingival diseases and conditions (NPIGDs), including (i) inflammatory and immune conditions, (ii) neoplasms and (iii) gingival pigmentations. To address the question 'How should NPIGDs affecting the gingiva be managed?' specific searches were conducted in four electronic databases to identify clinical studies evaluating the effectiveness of any intervention for NPIGDs in patients of all ages. All descriptive and analytical study designs were eligible, provided they described conditions presenting at the gingival level. Over a total of 6111 articles initially identified, 461 met inclusion criteria. Reports ranged from case reports to randomised controlled trials. Overall evidence quality was moderate to very low, reflecting highly heterogeneous literature published over the past 50&#x2009;years. Treatment approaches varied substantially depending on whether the condition was primarily gingival (e.g., leukoplakia, pigmentations) or a gingival manifestation of a systemic disease (e.g., leukaemic infiltration). Potentially malignant and malignant gingival lesions required careful evaluation and biopsy for diagnosis, followed by surgical management, typically involving radical excision. Gingival pigmentations were most often managed by dentists and, generally, only when patients expressed aesthetic concerns. NPIGD management is challenging due to the heterogeneity of these conditions and often requires multidisciplinary care. Dental professionals must conduct thorough clinical assessments, identify prognostic factors, perform appropriate screening and diagnosis and select the most suitable treatment strategy-which frequently includes referral to medical or oral medicine specialists, especially for potentially malignant or malignant gingival lesions.

Coronary angiography induces oxidative stress through contrast media exposure and ionizing radiation, potentially contributing to vascular and renal injury. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) exert antioxidant and anti-inflammatory effects beyond glycemic control. We investigated whether a single pre-procedural dose of empagliflozin modulates oxidative stress and inflammatory glycosylation patterns in non-diabetic patients undergoing elective coronary angiography. In this prospective, randomized, double-blind study, 60 patients undergoing elective coronary angiography were assigned to standard care or empagliflozin 10&#xa0;mg administered 2&#xa0;h before the procedure. Blood samples were collected at baseline, 4&#xa0;h, and 24&#xa0;h post-procedure. Total antioxidant capacity (TAC), oxidative DNA damage (alkaline comet assay), and N-glycosylation profiles of immunoglobulin G (IgG) and total plasma proteins were analyzed. Longitudinal changes were assessed using mixed-effects models with correction for multiple testing. Baseline characteristics and procedural variables were comparable between groups. Empagliflozin administration was associated with attenuation of oxidative DNA damage 24&#xa0;h after angiography and stabilization of antioxidant capacity compared with standard care. Directional shifts in IgG N-glycosylation toward a less pro-inflammatory profile were observed in the intervention group, including reduced agalactosylated and core-fucosylated glycans and relative preservation of galactosylated structures. Similar modulatory trends were detected in total plasma protein glycosylation patterns. Although several glycomic changes did not reach statistical significance after correction for multiple testing, the overall biological signal consistently favored reduced oxidative and inflammatory activation in the empagliflozin group. A single pre-procedural dose of empagliflozin was associated with attenuation of oxidative stress-related DNA damage and modulation of inflammatory glycosylation patterns following coronary angiography. These findings suggest a potential peri-procedural cytoprotective role of SGLT2 inhibition that warrants confirmation in larger studies. ISRCTN11022820. Registered 13 October 2025. Retrospectively registered.

Older patients are increasingly presenting to Emergency Departments (EDs) and therefore, outcome prediction tools are important to provide adequate care. The study aimed to explore the value of the 6-item brief geriatric assessment (BGA) as a rapid screening tool for identifying the potential risk of adverse outcomes in older patients. This was an observational prospective cohort study, conducted in 36 European EDs and included patients aged 65 years and older with any complaint for seven consecutive days. The 6-item BGA was performed at admission and classified the population into three levels of risk (low (LR), moderate (MR) or high (HR)). Generalised linear mixed models were used to assess the association of end points (admission, length of stay (LOS) and death) and BGA risk groups. Among 4657 patients, 48% were men and the median age was 77 years. The association of ward admission was similar in BGA LR and MR groups but higher in the HR group (risk ratio RR&#x2009;=&#x2009;1.22 [95%-confidence interval (CI) 1.13-1.31]). Compared to the LR group, the hospital LOS was similar in MR but higher in the HR group with a LOS ratio at 1.31 [95%-CI 1.20-1.42]. Mortality was higher in the MR and HR groups with RR&#x2009;=&#x2009;2.02 [95%-CI 1.20-2.83] and 3.12 [95%-CI 2.47-3.77] respectively. The study showed that higher BGA risk levels were associated with adverse outcomes in older ED patients. The 6-item BGA may help support rapid risk stratification and complement existing ED triage systems for identifying frailer patients. Further prospective studies are needed before routine implementation. The study was registered with the U.S. National Library of Medicine Clinical Trials (trial number NCT04680299; registration date: 2020-12-22).

Klippel-Feil syndrome (KFS) is a rare congenital condition defined by the fusion of one or more cervical vertebrae, often associated with a range of skeletal and extra-skeletal abnormalities. The presence of cervical vertebral fusion and spinal deformities can make both airway management and neuraxial anaesthesia technically challenging in this population. This report describes a primigravida with KFS who underwent an elective caesarean section under spinal anaesthesia. The preparation included consideration of a potentially difficult airway, even though general anaesthesia had not initially been planned. We reviewed relevant literature on anaesthetic management in similar cases. There is no consensus on the optimal anaesthetic technique for the management of parturients with KFS undergoing caesarean section. Each case should be evaluated individually. It is essential to prepare for potential conversion to general anaesthesia and always prioritize patient safety.