Klinikum Ingolstadt

Stroma areactive invasion front area (SARIFA) was recently defined and introduced as ahistomorphological, prognostic biomarker for various carcinomas. Current state of research and prospects for future developments. Report on the results of the consensus meeting. Evaluation of the available literature and the results of the consensus meeting. SARIFA has been successfully established as astrong prognostic biomarker. Its advantages include rapid, almost cost-neutral determination and excellent low interobserver variability. SARIFA correlates with increased expression ofproteinases and lipid metabolism proteins and genes. The immune response, by contrast, is downregulated in SARIFA-positive tumours. The consensus experts confirm the prognostic relevance in gastric and colorectal carcinomas and advocate routine reporting. The role of the biological background should be investigated in further studies and the name should be reconsidered and, if necessary, adapted. SARIFA is aprognostically relevant and robust biomarker. The evidence is particularly strong for gastric and colorectal carcinomas.

In 2023 atotal of 57,776 people were imprisoned in German correctional facilities (JVA). According to international studies 50-75% of prison inmates suffer from mental disorders; however, so far there are no well-founded data on the psychiatric psychotherapeutic care situation in German prisons. The survey of the German Society of Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) is intended to provide an initial insight into the specific service provision. The online survey was designed as aunique cross-sectional survey. Atask force (TF) of the DGPPN developed aquestionnaire with 12topics and 85items. To reflect the situation in the institutions, the questionnaire was sent to the Criminological Service in advance. Targeted suggestions for improvement were implemented. The survey was conducted with the support of the Prison Committee, acommittee of the federal states that, among other things, monitors conditions in prisons, in the period from 1March-30April 2024. The questionnaire was sent online and as aprintout to the prisons in the federal states via the Prison Committee. The feedback was sent to the DGPPN. Participation in the survey was voluntary and anonymous. The data were evaluated descriptively. According to the information provided by the 137 (77.8%) institutions participating in the study, 41,173 persons were imprisoned as of 1 March 2024, including prisoners in pretrial detention, sentenced prisoners and preventive detention. Of the participating institutions 86.7% reported problems caring for prisoners with mental disorders. The capacities of full and partial inpatient psychiatric treatment were assessed by most of the institutions as not covering the actual needs. Athird of the specialist positions were not filled. In the last 12months 128 institutions recorded 5812 placements in specially secured detention rooms (15.9% of prisoners). The study confirmed the assumption of experts working in the field of psychiatric-psychotherapeutic care: the resources for the care of prisoners with mental disorders in German prisons are perceived as insufficient. Above all, there is alack of specialist staff and psychiatric treatment capacities. Sufficient funding to improve the service provision is indispensable. Treatment standards that conform to guidelines should be developed and introduced.

Non-exhaust traffic emissions have recently attracted attention due to their increasing contribution to ambient particulate matter (PM). Brake wear particles (BWP) are of particular concern among different non-exhaust emissions owing to their high content of heavy metals. Despite ongoing research and emerging regulatory frameworks, detailed insights into the physicochemical properties of BWP at the single-particle level remain limited. A single-particle mass spectrometer (SPMS) was used in combination with a brake dynamometer to characterize pure BWP and confirmed using scanning electron microscopy energy dispersive X-ray spectroscopy (SEM-EDX). Three main particle types were identified: Ba-containing particles, K-rich particles containing organic matter, and carbonaceous particles. The distinct mass spectral signatures reflect the formation pathways including mechanical frictional wear and thermal degradation processes. Ba-containing particle group was confirmed as a suitable chemical tracer, allowing extension of the laboratory findings to ambient environments through measurements at a highway tunnel entrance and an urban background station in Munich, Germany. Approximately 6% of detected PM was attributed to brake wear emissions. The presence of BWP at the background monitoring station demonstrated their chemical resilience and transport potential over a distance of ∼1km. Notably, both laboratory and field measurements revealed minor signals of traditional toxic brake pad constituents such as Cu and Sb, suggesting a shift toward alternative materials in modern brake pad formulations. Our results emphasize the need to integrate BWP into air quality monitoring and regulatory frameworks, particularly using chemically specific tracers to better understand their environmental and health impacts.

Counselling regarding a planned provision of medical aids is currently neither reimbursed nor regulated in Germany. It is offered by a range of providers with employees with varying levels of qualification and may be provided in a personal conversation, by phone, or remotely. In many cases, counselling is omitted entirely between the prescription and trial use or delivery of the product. The quality of medical aids counselling, which plays a key role in temporary, supportive or palliative care for urinary incontinence, is therefore considered problematic.In 2019, the working group "Geriatric Urology" of the German Society for Urology published the first guideline on the counselling process related to the provision of medical aids. An updated version is currently available and has been listed by the Association of the Scientific Medical Societies. The underlying idea was to define quality standard in Germany for the individual components of the counselling process - from identifying the type of incontinence and its severity to product trial use, the counselling setting, the counselling itself, the qualification of the counselling personnel, and the communication between prescribing physicians, service providers, and patients.This article presents the published guideline sections regarding the content of the medical aids prescription, the characteristics of the counselling setting, and the quality of counselling and product trial use.As medical aids counselling is expected to be financed from the low reimbursement rates provided by statutory health insurers for what is defined as an "appropriate and sufficient" supply - typically amounting to less than EUR 15 a month - more and more providers are withdrawing entirely from the sector of medical aids provision. Others continue to supply medical aids but offer no counselling at all or only to a very limited extent. The guideline "Medical Aids Counselling for Urinary Incontinence" developed by the working group "Geriatric Urology" of the German Society for Urology is meant to define quality standards, also with a view to a political discussion on reimbursement rates.

Abstract Microsatellite instability (MSI) is a key biomarker in colorectal cancer (CRC). Accurate distinction between MSI and microsatellite stable (MSS) tumors is critical for diagnosis, prognosis, and therapeutic decision-making. We developed an uncertainty-aware deep learning model for MSI prediction directly from H&E-stained whole-slide images. The approach is based on attention-based multiple instance learning, which can learn from slide-level labels. We extended the approach and included ensembling for more robust prediction. For training, we used 1,492 slides from three public archives and for evaluation 1,094 slides from five independent external cohorts. The approach provides predictions with confidence intervals and rejects uncertain cases. It achieved sensitivity over 97% on 59-78% of the cases, depending on the cohort. These results show that MSS cases can be identified with high confidence while uncertain cases can be rejected to avoid unreliable predictions, enabling clinically reliable MSS triage in colorectal cancer with AI.

This paper presents a comprehensive analysis of conductor design strategies to reduce joule losses in hairpin windings of high-speed permanent magnet synchronous machines (PMSMs). With the increasing demand for high torque density, efficiency, and high-speed operation in electric vehicles and aircraft, minimizing these losses is crucial. Starting with a reference winding layout, various loss mechanisms due to radial and tangential flux components are investigated using finite element analysis (FEA) under both no-load and short-circuit conditions. Design variants including adjustments to conductor geometry, slot opening shapes, layer-specific conductor height tuning and segmented conductor designs with overhang twisting are explored. The findings are relevant for improving the performance and manufacturability of electric machines, with additive manufacturing offering new design opportunities for enhanced efficiency and lower losses.

While the approximation properties of real-valued neural networks have been a subject of intense mathematical research since the 1990s, the approximation properties of complex-valued neural networks have only gained increased attention in recent years. In this paper, we provide an overview of the known results and specifically discuss the similarities and differences between the complex-valued and real-valued case.