Graz University Hospital

596 Background: Testicular cancer is rare. Many cases presented to the German online second-opinion platform (eKonsil) involve non- or minimally metastatic stages. Expert reviews aim to optimize care quality. Large language models (LLMs) such as ChatGPT version 5 may support this process if their recommendations are shown to be non-inferior to expert consensus. Methods: Eleven eKonsil cases with primary non- or minimally metastatic disease were evaluated. Consensus treatment recommendations were generated by three testicular cancer experts (AH, JH, HS) based on the EAU guidelines. The same cases were entered into GPT5 with reference to the EAU guidelines on different days, in different countries, and by different individuals in September 2025. Recommendations by GPT5 and expert consensus were assessed independently by three urologists using a four-point Likert scale based on 21 validated evaluation criteria. Results: We obtained 99 evaluations of adherence to expert opinion. Expert recommendations for direct treatment were available for 81 evaluations. Primary therapy suggested by GPT5 was acceptable (no or insignificant deviations from experts) in 70% (57/81). GPT5’s adherence to expert opinion was similar for localized and metastasized cases (3.14 vs. 3.38; p Wilcoxon = 0.38). Adherence differed significantly depending on suggested therapeutic alternatives (p Chi2 < .01) with chemotherapeutic compounds being suggested correctly in 85% (74/87), radiation in 78% (47/60), active surveillance in 76% (50/66) and surgery in 59% (30/51). GPT5 acceptably identified missing information ahead of therapeutic suggestions in 82% (22/27) of relevant cases. In case of deficits, an acceptable path of diagnostics was suggested in 74% (20/27). Performance in identifying informational deficits did not vary by metastatic status (p Chi2 = 0.19) and performance in suggesting diagnostics was no better than in suggesting primary therapy (3.30 vs. 3.14; p Wilcoxon = 0.48). With GPT5 failing to reach clinically acceptable ratings in over 95% for any metric, it did not meet criteria of non-inferiority to experts. Conclusions: GPT5-generated second-opinion recommendations for patients with non- or minimally metastatic testicular cancer cannot be assumed to be non-inferior to expert consensus. Caution is needed when using GPT5 as an assistant to screen cases for missing information or to generate therapeutical suggestions, particularly with surgical paths being involved. This study shows that LLMs, even when provided with guidelines, require more training and expert validation currently remains essential.

ABSTRACT The media we consume may shape our cognition, emotion, and behavior. While violent media effects on aggression have been studied extensively, one popular media genre has escaped scrutiny until now: true crime, featuring real stories of assault, murder, or serial killings. We investigated the idea that the manifold examples of real human violence in true crime may be linked to people's capacity for malevolent creativity—generating creative ideas for harming others. Yet, in two cross‐sectional studies, we found only weak to contradictory evidence for this idea. Using multiple regression models, in Study 1 ( n = 160), true crime consumption was only linked to higher fluency on a malevolent creativity test (MCT) in individuals high in trait aggression. In Study 2 ( n = 307), links of true crime consumption with malevolent creativity were eclipsed by links to fictional horror, other media preference, and depressive affect. Moreover, both studies found that high true crime consumption seemed to mitigate the link between general creativity and malevolent originality. Although further experimental and longitudinal research is needed, true crime may potentially inhibit consumers from applying their creative potential to uniquely harming others, which may suggest prosocial and empathic motives in true crime consumption.

Purpose: Physical activity has consistently shown positive effects on psychological functioning and brain structure – particularly within the hippocampus, a region implicated in both exercise and mood regulation. Clinical findings suggest reduced hippocampal volume in individuals with depression compared to healthy controls. However, longitudinal intervention studies on young, healthy populations remain scarce. This preregistered study aimed to investigate the biological and social mechanisms driving structural brain, affective, and fitness-related changes during a running intervention, with a novel comparison between individual and group-based running formats. Methods: A four-week longitudinal intervention included 129 participants aged 18–35 who engaged in less than the WHO-recommended 150 minutes/week of aerobic activity. Participants were randomly assigned to one of three groups: (1) individual running, (2) small group running, or (3) waiting control. The running route, frequency, and duration were identical across intervention groups. Assessments were conducted at three timepoints and included magnetic resonance imaging (MRI), psychometric evaluations, electrocardiography (ECG), and estimated V̇O₂max via the UKK Walking Test. Preliminary Results: Previous intervention studies conducted in our laboratory have demonstrated significant volumetric changes in subfields of the hippocampus, which were associated with a reduction in depressive symptoms. In this study, we will follow up on these results by not only examining intervention-related volumetric changes in the hippocampus subfields but also by taking into account a broad range of psychometric measures and cardiac responses to gain insights into various facets of wellbeing induced by physical activity. It is anticipated that the study presented here, with a larger sample and a more rigorous methodological design, will more specifically bolster the results from previous research. Conclusion: Taken together, the findings of our laboratory suggest that regular running induces beneficial changes in brain and mood in previously rather inactive young adults. This work highlights the holistic benefits of running and supports its promotion as a tool for maintaining mental and brain health. Support/Funding Source: This research was funded by the Austrian Science Fund (FWF).

The International Dysphagia Diet Standardisation Initiative (IDDSI) framework establishes a global standard, with standardized terms, descriptors and measurement criteria, to enhance dysphagia care. This paper presents one of the first documented successful implementations of IDDSI in a large acute care hospital. The implementation at the University Hospital Graz, a 1554-bed acute care facility, took place between 2021 and 2024. The project aimed to standardize practices in five patient-focused areas to improve knowledge, and facilitate multiprofessional communication. Based on the IDDSI Monitor, Aware, Prepare, Adopt (MAPA) model and IDDSI implementation guide, a project plan was developed. An interdisciplinary working group consisting of dietitians, Speech-Language Pathologists (SLPs) and chefs conducted comprehensive audits of all existing recipes and aligned clinical swallowing assessments and dietetic recommendations with IDDSI standards. Training programs ensured the consistent application of terminology across the therapeutic, nursing, and kitchen teams. Two staff surveys were conducted - one before and one after implementation. The working group successfully integrated IDDSI into clinical workflows, menu planning, charting and electronic health record systems. Staff surveys showed a significant increase in IDDSI awareness, rising from 42.1% to 76.7%, along with greater use of the IDDSI standardized terminology by the staff during the project's duration. Key implementation challenges included adapting recipes to meet IDDSI texture levels and integrating the framework into the utilized Cook and Chill food preparation system. Dual project lead with one Speech-Language Pathologist (SLP) and one dietitian, targeted training, and the active engagement of kitchen staff were crucial to the project's success. This study demonstrates that implementing IDDSI in acute care settings is both feasible and beneficial, leading to multiprofessional knowledge of the framework and fostering collaboration.