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The proposed mechanisms of sleep-dependent memory consolidation involve the overnight regulation of neural activity at both synaptic and whole-network levels. Now, there is a lack of in vivo data in humans elucidating if, and how, sleep and its varied stages balance neural activity, and if such recalibration benefits memory. We combined electrophysiology with in vivo two-photon calcium imaging in rodents as well as intracranial and scalp electroencephalography (EEG) in humans to reveal a key role for non-oscillatory brain activity during rapid eye movement (REM) sleep to mediate sleep-dependent recalibration of neural population dynamics. The extent of this REM sleep recalibration predicted the success of overnight memory consolidation, expressly the modulation of hippocampal-neocortical activity, favoring remembering rather than forgetting. The findings describe a non-oscillatory mechanism how human REM sleep modulates neural population activity to enhance long-term memory.

Background/Objectives: Outcomes for hip fracture patients have improved over the years, yet the population of older patients (≥80 years) continues to grow. By 2100, the global centenarian population is projected to exceed 25 million, but data on hip fracture outcomes in this group are rare and often derived from small samples. This study aimed to analyze outcomes for centenarian hip fracture patients in specialized geriatric trauma centers and compare them with those of patients under 80. Methods: We conducted a retrospective analysis of the AltersTraumaRegister DGU® from 2016 to 2022, including all proximal femur fracture data. Patients were categorized into two groups: under 80 years and centenarians. The primary outcome was in-hospital mortality, with secondary outcomes including quality of life, walking ability on postoperative day seven, length of hospital stay, readmission rates, and changes in living situations. Results: Among 14,521 patients, 316 were over 99 years old. In-house mortality was significantly higher in centenarians (15.44% vs. 3.58%; p < 0.001), with more discharged to nursing homes. After matching by the Geriatrics at Risk (GeRi) score, mortality differences diminished. Conclusions: While age is a risk factor for mortality, centenarian hip fracture patients' outcomes do not significantly differ from those aged ≤80 when considering other risk factors. [ABSTRACT FROM AUTHOR]

Background: Orthogeriatric treatment, which involves a collaborative approach between orthopedic surgeons and geriatricians, is generally considered to be superior to standard care following hip fractures. The aim of this study was to investigate additional effects of a geriatrician-led multidisciplinary rehabilitation program. Methods: In this matched paired observational cohort study, patients aged 70 years and older with a proximal femur fracture requiring surgery were included. Between 1 January 2016 and 31 December 2022 data were recorded from hospital admission to 120-day follow-up in the Registry for Geriatric Trauma (ATR-DGU), a registry of older adults with hip fractures. Out of 60,254 patients, 9580 patients met the inclusion criteria, 4669 patients received early multiprofessional rehabilitation (EMR) and 4911 patients were treated by standard orthogeriatric co-management (OGC). Results: Compared to standard orthogeriatric treatment, multiprofessional therapy significantly lowered the 7-day mortality rate (2.89% vs. 5.11%) and had a significant impact on walking ability seven days after surgery (86.44% vs. 77.78%). Conclusions: In summary, a geriatrician-led multiprofessional rehabilitation program resulted in lower mortality and improved walking ability than standard orthogeriatric care. [ABSTRACT FROM AUTHOR]

Background: In Germany, around 2.250 children and adolescents are diagnosed with cancer each year. Despite generally positive long-term survival rates, many patients must cope with late effects of the disease and its treatment. This highlights the need for a well-structured, long-term approach addressing both physical and mental health issues. Currently, the German healthcare system lacks such comprehensive structures. Our study aims to evaluate the effectiveness of a structured, multidisciplinary long-term approach compared to conventional "treatment as usual" (TAU). Methods: A prospective, multicenter study with ten pediatric university clinics in Germany will be conducted. The cluster-randomization takes place at the clinic level. Children and adolescents who completed their cancer treatment at least five years ago and their parents will be eligible to participate. While the control group (CG) receives TAU, the intervention group (IG) participates in a structured program. This program includes risk-based medical treatment and psychosocial interventions tailored to each patient's individual needs within a two-month timeframe. The primary outcome is the improvement of self-efficacy. Secondary outcomes are satisfaction with health care, improvement of health-related quality of life (HRQoL), reduction of mental health problems, and improvement of transition readiness. Discussion: This approach has the potential to optimize the health care for individuals who survived cancer during childhood or adolescence. It addresses the challenges of overuse, underuse, and misuse of health care resources. By considering both medical and psychosocial factors and promoting increased self-efficacy, independent from parental involvement, it may facilitate a smoother transition to adult medicine and enhance adherence to lifelong aftercare. If proven successful, this approach will contribute to the integration of multidisciplinary strategies into standard healthcare practice. Trial registration: German Clinical Trials Register DRKS00029269. Registered on December 23, 2022. [ABSTRACT FROM AUTHOR]

Background: Today, the use of digital media is already present at an early stage in the lives of children. Even preschool children can already develop increased digital media use (IDMU). Empirical findings indicate associations of IDMU with several problems in psychosocial development. Therefore, it seems important to identify IDMU early, but there are very few specific approaches for preschool children. The aim of the present survey was to evaluate a newly developed brief screening instrument (based on DSM-5 criteria) named the IDMUQ (an abbreviation for "Increased Digital Media Use Questionnaire"). Methods: We investigated two samples, consisting of 341 parents and of 809 parents, with the IDMUQ, the Short CIUS, and the Parenting Stress Index. Data on screen time and sociodemographic aspects were also collected. We conducted an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) as well as reliability and correlation analyses. Results: The findings of both the EFA and the CFA support a one-dimensional structure for the IDMUQ. The reliability coefficients (Cronbach's alpha values) were 0.74 and 0.86. We observed first indications of criterion validity for the IDMUQ as well as correlations between parenting stress and IDMU. Conclusions: The results indicate that the IDMUQ, with its four items, is a promising screening tool to measure IDMU in preschool children. [ABSTRACT FROM AUTHOR]