European Cancer Prevention

This study assessed the effectiveness of large language models (LLMs) in generating lay summaries for patient education on the management of precancerous lesions and early neoplasia in the stomach. In this pilot study, we used a two-period, crossover, blinded design to compare a ChatGPT-4o summary versus a Digestive Cancers Europe (DiCE) summary. Two panels rated the materials: expert physicians and DiCE Patient Advisory Committee members. Experts scored accuracy, completeness, comprehensibility, and satisfaction (across five sections); patients rated overall completeness, comprehensibility, and satisfaction. Paired comparisons used mixed-effects estimates. Readability was assessed with Flesch-Kincaid grade level (FKGL) and SMOG index. Median expert ratings were similar between materials across metrics. For the overall summary, median (range; IQR) scores were: accuracy 5 (4-6; 1) for ChatGPT-4o vs. 5 (3-6; 1) for DiCE (P = 0.10); completeness 4 (3-5; 1) vs. 4 (2-5; 1; P = 0.27); comprehensibility 4 (3-5; 1) vs. 4 (2-5; 1; P = 0.33); and satisfaction 4 (2-5; 1) vs. 3 (1-5; 2; P = 0.53). Patient ratings mirrored experts, with very similar results. Readability failed to meet guideline recommendations for both summaries on both FKGL and SMOG scores. ChatGPT-4o produced patient materials comparable to DiCE, but both require readability optimization; a human-in-the-loop workflow and future tests across prompts and models are warranted.

Keywords Atrial fibrillation • Multimorbidity • Software • Care pathways This Rapid Communication is linked to the Original Article 'Development of three-step holistic care pathways to detect and manage comorbidities in patients with atrial fibril-lation: the Horizon 2020 EHRA-PATHS consortium' by R Önder et al., https://doi.org/10.1093/ehjopen/oeaf120 and the Editorial 'The complexity of tackling multimorbidity in Atrial Fibrillation How European projects are reshaping our approach to comorbidities' by G Lip et al., https://doi. org/10.

Introdução: A incidência de ceratopatia é de 3% a 60% em pacientes crí­ticos, com tempo médio de aparecimento da lesão de 8 a 9 dias. Portanto, é imprescindí­vel traçar estratégias preventivas a fim de garantir cuidados oculares em paciente crí­ticos. Objetivo: Analisar através da literatura, as principais ações preventivas de enfermagem utilizadas para diminuir o surgimento da ceratopatia, por exposição em pacientes internados em unidade de terapia intensiva. Métodos: Revisão integrativa baseada em artigos publicados nas bases de dados Scielo, Lilacs, BDEnf e Pubmed entre 2014 e 2018. Resultados: Quatro diferentes métodos foram identificados e comparados, visando evidenciar a melhor proposta para prevenir a ceratopatia por exposição. O filme de polietileno foi a opção, estatisticamente, mais viável, seguida da pomada liposica que apresentou bons resultados clí­nicos. A utilização de solução salina como método preventivo é desaconselhável, pois essa intervenção aumentou a gravidade e prevalência de ceratopatia. Conclusão: A carência de estudos torna imprescindí­vel o despertar cientí­fico acerca do assunto, principalmente no Brasil, a fim de diminuir as altas taxas de incidência de ceratopatia em terapia intensiva.Palavras-chave: cuidados crí­ticos, protocolos clí­nicos, cuidados de enfermagem, doenças da córnea, prevenção e controle.

Three important recent models have shaped our current knowledge about breast cancer prevention: the accumulating evidence that the disease originates early in life, the impact of (epi-)genomic imprinting, and the recognition that breast cancer is a family of related but distinct diseases. The breast, the target organ, starting a unique intense growth after the first decade of life and involuting already during the third decade, is tremendously vulnerable to several endogenous and exogenous hormone disrupting molecules and other chemical and physical genotoxic factors. Lifestyle and toxins seem to generate long lasting (epi-)genomic marks especially in rapidly growing tissues such as the breast that can be reset for example by an early first full term pregnancy.

Cardiovascular (CV) risk prediction has a central role in primary CV prevention. Several risk charts have been developed in the attempt to identify subjects at risk who might benefit from more aggressive interventions. However, risk charts show main limitations and they remain underutilized in general practice. The addition of novel risk markers has substantially failed to improve risk charts discrimination power. Imaging has recently gained relevance in CV risk stratification for its ability to detect subclinical atherosclerosis. Although extending non-invasive imaging to all asymptomatic middle-aged people is currently not recommended, its progressive spread may provide information on preclinical atherosclerosis and detection of de facto initial disease might overcome some limitations of conventional risk stratification charts.

Herz-Kreislauf-Erkrankungen sind noch immer die haufigste Todesursache in Deutschland, bei ca. der Halfte der Todes - falle handelt es sich um einen plotzlichen Herztod. Um diese Zahl zu reduzieren, ist eine gezielte Fruherkennung und -behandlung notwendig. Die heute verfugbaren kardiovaskularen Risiko-Scores (PROCAM, ESC SCORE, Framingham) entstammen populationsbasierten Kohorten und haben Limitationen in der pradiktiven Aussage im individuellen Setting. Die Untersuchungstechniken sind im Rahmen der Screening Untersuchungen andere als die der ublichen kardiologischen Praxis, in der eine viel hohere Pratestwahrscheinlichkeit besteht. Eine flache, aber bereits mit Risiko verbundene Plaque z. B. ist nicht mit einem konventionellen Belastungs-EKG nachweisbar. Deshalb sind neue, insbesondere bildgebende Methoden, die unmittelbar das atherosklerotische Korrelat detektieren und quantifizieren, erforderlich. Es werden im Folgenden entsprechend der vorliegenden Evidenzen Empfehlungen gegeben zur Messung der Intima-Media-Dicke (IMT) und der unmittelbaren Plaque der Arteria carotis mittels Ultraschall, der Erfassung der Plaque-Komposition mittels Magnetresonanztomographie (MRT), der Vermessung des koronaren Calcium-Scores (CCAC) in der kardialen Mehrschicht-Computertomographie (MSCT), der bekannten Messung der Knochel-Arm-Indices (ABI; ankle brachial index) zur Erfassung einer (haufig noch asymptomatischen) arteriellen Verschlusskrankheit, der Untersuchungen zur Vasoreaktivitat der a. brachialis (FMD; flow mediated dilatation), der Pulswellenanalyse (PWA) und der Vermessung der Durchmesser der kleinen Gefase des Augenhintergrunds.

A Ni-5.7%Cr-25.2%W (wt%) alloy was deformed by cold rolling in different reduction conditions (50%, 70%, and 90%) and then annealed under hydrogen atmosphere. Microstructure and texture evolutions were analyzed using Electron BackScattered Diffraction (EBSD). Orientation Distribution Functions (ODFs) and stored energy were calculated from neutron diffraction measurements. A strengthening of the α-fiber texture was observed after 90% cold rolling and a homogenous microstructure was obtained after annealing at 900°C.