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The article discusses the shift in American medicine towards precision medicine, focusing on predicting health risks rather than curing illnesses. Topics discussed include the expansion of technologies like continuous glucose monitors, the growing emphasis on genetic risk prediction, and the evolution of genetics research from curing diseases to assessing health risks.

Driving behaviour is a critical factor in accidents today. Physiological factors have a significant impact on driving behaviour. A potential solution lies in vehicle services that benefit from sensing environmental conditions to improve road safety, such as collision avoidance routines in driver assistance systems. Stress, assessed subjectively or physiologically, influences decision making and behaviour, with implications for individuals and the economy. In this paper we present a novel approach to formulate a risk index by combining data from subjective self-reports and objective physiological measures (in particular heart rate). The model identifies stress tendencies in driving behaviour by monitoring behavioural and physiological markers. We present our evaluation results and explore potential ways to implement the model in vehicle systems and its implications for improving road safety. We discuss potential enhancements to improve driving safety and enable timely responses in situations with an increased risk of accidents due to stress or drowsiness. [ABSTRACT FROM AUTHOR]

The heart of the project is the early and cost-effective diagnosis of impulse control disorders in children and adolescents. The methodology is based on the automatic analysis of speech and sleep patterns, which is being carried out in cooperation with Colombian and German partners. The group has set itself three project goals. In the first step, the synchronization of ongoing project work will be carried out so that, on the one hand, available results can be incorporated into this project and, on the other hand, cooperation results can be taken into account in ongoing work. Parallel to this, the second project objective is to set up competence groups that, as specialist groups, are familiar with the regional characteristics and help to record the current situation. The first two objectives are supported in particular by workshops and the exchange of researchers. In this way, the partners' methodology is made accessible to both groups, which significantly promotes the analysis of research topics and the approach. Finally, in the third project objective, practice-oriented and target group-oriented results based on validated case studies will be provided so that the jointly developed methodology can be created. This contribution provides an overview of the activities. [ABSTRACT FROM AUTHOR]

We describe a large new species of leaf-tailed gecko endemic to northern Madagascar. Uroplatus garamaso sp. n. is the sister species of U. henkeli but differs by a genetic divergence > 8% in the mitochondrial 16S rRNA gene, by the absence of haplotype sharing in four nuclear-encoded genes analyzed, a smaller body size, slightly narrower tail, a more pronounced yellowish/reddish iris colour in most individuals, and lack of black pigmentation on the tip of the tongue. The new species also appears to consistently differ from U. henkeli in genital morphology, with the apex of the hemipenis ending in two terminal elements consisting of 4-5 rotulae and longitudinal rows of calyces (versus an apex with irregularly distributed calyces and ending in two symmetrical structures consisting of two broader serrated fleshy elements in U. henkeli). We genetically confirm the occurrence of U. henkeli over a rather wide area, ranging from Tsingy de Bemaraha in the West to Nosy Be in the Sambirano region of northern Madagascar. Both, U. henkeli and the new species contain several deep mitochondrial lineages that are considered as conspecific due to extensive haplotype sharing and lack of obvious morphological differences among them. [ABSTRACT FROM AUTHOR]

Based on sequences of three mitochondrial and two nuclear-encoded genes, we examine genetic variation in the leaf tailed geckos Uroplatus sameiti and U. sikorae, and morphological and chromatic characteristics of the genetic clusters identified. The mitochondrial phylogeny reveals a puzzling diversity of 16 deep lineages (4 in U. sameiti and 12 in U. sikorae) differing by 2.9–9.9% uncorrected pairwise distance in a fragment of the 16S rRNA gene. Populations from Analalava in the North and Zahamena in the Northern Central East form two mitochondrial lineages clustering with U. sameiti but being deeply divergent (>8% 16S distance); however, no information on their morphology is available. In U. sikorae, the mitochondrial lineages identified form several major geographic clades, two of which (from the northernmost and southernmost populations, respectively) received substantial support in the phylogenetic analysis. No instance of sympatry of two or more mitochondrial lineages was observed, precluding an unambiguous assessment of species status under the biological species criterion without experimental approaches or detailed hybrid zone analyses. In the fragment of the nuclear encoded gene SACS we observed haplotype sharing between species and mitochondrial lineages, while in the fragment of KIAA1239 no haplotype sharing was detected although neither species nor mitochondrial lineages formed coherent phylogroups in the respective network. A screening of colour patterns from live photos, partly of the genotyped individuals, confirmed a large variation within species and populations, with a possible sexual dichromatism where a longitudinally striped phenotype is restricted to males. All individuals from populations of the U. sikorae clade from the Southern Central East and South East had an unpigmented oral mucosa just like U. sameiti, while all other U. sikorae populations are characterized by a black oral mucosa pigmentation. The extremely strong phylogeographic structure in the U. sikorae complex without obvious species-level divergences is unprecedented for large-sized squamates in Madagascar and calls for further taxonomic scrutiny using phylogenomic approaches; and it exemplifies how the loss of any major block of the remaining rainforests in Madagascar will inevitably lead to a substantial loss of genetic diversity – even if often intraspecific – in rainforest-specialized species. [ABSTRACT FROM AUTHOR]

The principal objective of this study is to investigate the impact of perceived stress on traffic and road safety. Therefore, we designed a study that allows the generation and collection of stress-relevant data. Drivers often experience stress due to their perception of lack of control during the driving process. This can lead to an increased likelihood of traffic accidents, driver errors, and traffic violations. To explore this phenomenon, we used the Stress Perceived Questionnaire (PSQ) to evaluate perceived stress levels during driving simulations and the EPQR questionnaire to determine the personality of the driver. With the presented study, participants can categorised based on their emotional stability and personality traits. Wearable devices were utilised to monitor each participant's instantaneous heart rate (HR) due to their non-intrusive and portable nature. The findings of this study deliver an overview of the link between stress and traffic and road safety. These findings can be utilised for future research and implementing strategies to reduce road accidents and promote traffic safety. [ABSTRACT FROM AUTHOR]

Purpose: Vascular-targeted photodynamic therapy with the intravascular photosensitizing agent padeliporfin (WST-11/TOOKAD-Soluble) has demonstrated therapeutic efficacy as an ablative treatment for localized cancer with potential adaptation for endoscopic management of upper tract urothelial carcinoma. This Phase I trial (NCT03617003) evaluated the safety of vascular-targeted photodynamic therapy with WST-11 in upper tract urothelial carcinoma. Materials and Methods: Nineteen patients underwent up to 2 endoscopic vascular-targeted photodynamic therapy treatments, with follow-up for up to 6 months. Patients who had residual or recurrent upper tract urothelial carcinoma (any grade/ size) failing prior endoscopic treatment or unable or unwilling to undergo surgical resection were eligible for inclusion. The primary endpoint was to identify the maximally tolerated dose of laser light fluence. A dose escalation model was employed, with increasing light fluence (100-200 mW/cm) using a modified continual reassessment method. The secondary endpoint was treatment efficacy, defined by absence of visible tumor and negative urine cytology 30 days posttreatment. Results: Fourteen (74%) patients received the maximally tolerated dose of 200 mW/cm, 2 (11%) of whom experienced a dose-limiting toxicity. The initial 30-day treatment response rate was 94% (50% complete, 44% partial). Eight patients underwent a second treatment, with a final observed 68% complete response rate. Leading toxicities were flank pain (79%) and hematuria (84%), which were transient. No ureteral strictures associated with treatment were identified during follow-up. Conclusions: Vascular-targeted photodynamic therapy with WST-11 has an acceptable safety profile with strong potential as an effective, kidney-sparing endoscopic management option for upper tract urothelial carcinoma. The recently initiated multicenter Phase 3 ENLIGHTED trial (NCT04620239) is expected to provide further evidence on this therapy. [ABSTRACT FROM AUTHOR]

The article presents the highlights of the "Justice for Survivors of Intimate Partner Violence: Transforming an Inequitable Family Law System" in New York on October 13-14, 2022. Panel discussion topics include intimate partner violence, custody law, and protection of children. Panelists include lawyer Kara Bellew, Professor Joan Meier, and lawyer Michael Scherz.

Home health applications have evolved over the last few decades. Assistive systems such as a data platform in connection with health devices can allow for health-related data to be automatically transmitted to a database. However, there remain significant challenges concerning intermodular communication. Central among them is the challenge of achieving interoperability, the ability of devices to communicate and share data with each other. A major goal of this project was to extend an existing data platform (COMES®) and establish working interoperability by connecting assistive devices with differing approaches. We describe this process for a sleep monitoring and a physical exercise device. Furthermore, we aimed to test this setup and the implementation with a data platform in both a laboratory and an in-home setting with 11 elderly participants. The platform modification was realized, and the relevant changes were made so that the incoming data could be processed by the data platform, as well as visually displayed in real-time. Data was recorded by the respective device and transmitted into the data server with minor disruptions. Our observations affirmed that difficulties and data loss are far more likely to occur with increasing technical complexity, in the event of instable internet connection, or when the device setup requires (elderly) subjects to take specific steps for proper functioning. We emphasize the importance for tests and evaluations of home health technologies in real-life circumstances. [ABSTRACT FROM AUTHOR]

Nowadays, the importance of early active patient mobilization in the recovery and rehabilitation phase has increased significantly. One way to involve patients in the treatment is a gamification-like approach, which is one of the methods of motivation in various life processes. This article shows a system prototype for patients who require physical activity because of active early mobilization after medical interventions or during illness. Bedridden patients and people with a sedentary lifestyle (predominantly lying in bed) are also potential users. The main idea for the concept was non-contact system implementation for the patients making them feel effortless during its usage. The system consists of three related parts: hardware, software, and game application. To test the relevance and coherence of the system, it was used by 35 people. The participants were asked to play a video game requiring them to make body movements while lying down. Then they were asked to take part in a small survey to evaluate the system's usability. As a result, we offer a prototype consisting of hardware and software parts that can increase and diversify physical activity during active early mobilization of patients and prevent the occurrence of possible health problems due to predominantly low activity. The proposed design can be possibly implemented in hospitals, rehabilitation centers, and even at home. [ABSTRACT FROM AUTHOR]

The interlinked character of the 2030 Agenda poses both a challenge and an opportunity in terms of coherent policy making. Accordingly, different methods have been used in approaching the interactions between SDG entities (goals, targets, indicators, policies, external entities) in several recent publications. In this paper, we provide a review and assessment of methods used for analysing SDG entity interactions. Specifically, we assess the suitability of these methods for addressing policy coherence at different levels and from different perspectives. A total of 30 methods are categorised into argumentative, literature, linguistic, simulation, statistical, and other quantitative methods and are examined with expert elicitation applying a range of criteria on the basis of the following factors: the ability to give detailed information about effects between SDG entities, practicability, sensitivity to interdisciplinarity, and collaboration and systems thinking. No single method, category, or research tradition (i.e. quantitative or qualitative) can be regarded as the most suitable for analysing SDG entity interactions. Quantitative methods (i.e. statistical, simulation, and other quantitative) are most frequently applied in the scientific context, although assessment results suggest that argumentative methods are particularly useful for obtaining information about effects while enabling interdisciplinarity and collaboration. In contrast, literature, linguistic, and quantitative methods can not be used to process different kinds of information. However, regarding the effort required, quantitative methods (except simulation methods) seem to require fewer resources. Although argumentative methods are evaluated best overall in our assessment, different implementation contexts and the importance assigned to the criteria may justify the application of most other methods as well. [Display omitted] • A literature review and assessment was performed to explore SDG entity interactions. • Argumentative, literature and simulation methods are best in analysing interactions. • Statistical methods have lower time requirements. • Argumentative methods encourage interdisciplinarity and collaboration. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases are directly or indirectly responsible for up to 38.5% of all deaths in Germany and thus represent the most frequent cause of death. At present, heart diseases are mainly discovered by chance during routine visits to the doctor or when acute symptoms occur. However, there is no practical method to proactively detect diseases or abnormalities of the heart in the daily environment and to take preventive measures for the person concerned. Long-term ECG devices, as currently used by physicians, are simply too expensive, impractical, and not widely available for everyday use. This work aims to develop an ECG device suitable for everyday use that can be worn directly on the body. For this purpose, an already existing hardware platform will be analyzed, and the corresponding potential for improvement will be identified. A precise picture of the existing data quality is obtained by metrological examination, and corresponding requirements are defined. Based on these identified optimization potentials, a new ECG device is developed. The revised ECG device is characterized by a high integration density and combines all components directly on one board except the battery and the ECG electrodes. The compact design allows the device to be attached directly to the chest. An integrated microcontroller allows digital signal processing without the need for an additional computer. Central features of the evaluation are a peak detection for detecting R-peaks and a calculation of the current heart rate based on the RR interval. To ensure the validity of the detected R-peaks, a model of the anatomical conditions is used. Thus, unrealistic RR-intervals can be excluded. The wireless interface allows continuous transmission of the calculated heart rate. Following the development of hardware and software, the results are verified, and appropriate conclusions about the data quality are drawn. As a result, a very compact and wearable ECG device with different wireless technologies, data storage, and evaluation of RR intervals was developed. Some tests yelled runtimes up to 24 hours with wireless Lan activated and streaming. [ABSTRACT FROM AUTHOR]

In previous studies, we used a method for detecting stress that was based exclusively on heart rate and ECG for differentiation between such situations as mental stress, physical activity, relaxation, and rest. As a response of the heart to these situations, we observed different behavior in the Root Mean Square of the Successive differences heartbeats (RMSSD). This study aims to analyze Virtual Reality via a virtual reality headset as an effective stressor for future works. The value of the Root Mean Square of the Successive Differences is an important marker for the parasympathetic effector on the heart and can provide information about stress. For these measurements, the RR interval was collected using a breast belt. In these studies, we can observe the Root Mean Square of the successive differences heartbeats. Additional sensors for the analysis were not used. We conducted experiments with ten subjects that had to drive a simulator for 25 minutes using monitors and 25 minutes using virtual reality headset. Before starting and after finishing each simulation, the subjects had to complete a survey in which they had to describe their mental state. The experiment results show that driving using virtual reality headset has some influence on the heart rate and RMSSD, but it does not significantly increase the stress of driving. [ABSTRACT FROM AUTHOR]