Determinations of medical futility in the intensive care unit (ICU) are high-stakes, ethically charged, and clinically variable. Contemporary literature increasingly frames such situations as potentially inappropriate treatment (PIT), particularly when physiologically feasible interventions are judged unlikely to provide meaningful benefit. This study aimed to construct a transparent decision-analytical framework for identifying the clinical factors ICU physicians prioritise when assessing futility and PIT, using a hybrid multi-criteria decision-making (MCDM) approach. A decision-analytical modelling study was conducted in Türkiye with a national expert panel of 20 ICU physicians with 1-18 years of post-speciality experience. A two-round Delphi pre-process with five intensivists, using an a priori 80% consensus threshold, identified 15 clinical factors and 8 evaluation criteria. Criterion weights were derived using Shannon Entropy, and six MCDM techniques were applied in parallel. Bootstrap resampling, ±20% sensitivity analysis, and Spearman rank correlation were used to assess stability and agreement. Terminal malignancy (F4) and irreversible neurological injury (F5) ranked first and second across all six methods (mean ranks 1.000 and 2.000, σ = 0.00, 100% bootstrap stability). Inter-method agreement was very strong (Spearman ρ = 0.964-1.000, p < 0.001), while inter-group agreement across experience strata was moderate to strong (ρ = 0.643-0.807, p < 0.01). Documented treatment limitation preference (F15) ranked last across every method and experience group. Early-career clinicians ranked clinical frailty (F2) first, whereas advanced clinicians elevated refractory shock (F6) to fourth. Advanced age (F1) showed the widest experience-related variation, ranking 5th, 14th, and 11th across early-career, mid-career, and advanced groups, respectively. The Top-5 factors remained stable under ± 20% weight perturbation. In this expert-panel MCDM framework, ICU physicians appeared to prioritise biological non-recoverability when assessing futility and PIT, while treating treatment limitation preference as a separate ethical domain. The framework captures clinicians' cognitive prioritisation rather than outcome-validated prognostic accuracy and should be read as a decision-support scaffold, not a bedside prediction tool. Prospective outcome validation and recalibration across different legal and cultural settings are required before clinical implementation.

Due to the convincing evidence showing sustained reduction in mortality due to interdisciplinary multidimensional management of geriatric hip fracture patients, the "Guidelines for the care of proximal femoral fractures" of the German Federal Joint Committee came into force stepwise from 2021 onwards. The interdisciplinary concept enables a holistic view and multidimensional treatment approaches for geriatric trauma patients. The team approach and joint responsibility enables addressing the special needs of this vulnerable patient group  effectively during the inpatient stay. The aim is the avoidance of complications by adequate management of perioperative pain, early mobilization, management of delirium and nutrition, a critical review of the list of medications and a clarification of modifiable factors for the risk of falling beyond the acute inpatient stay and the management of osteoporosis, to reduce the risk of sustaining further fractures. Early patient-centered discharge management helps to ensure adequate care after the acute hospitalization phase according to the patient's abilities and needs.

Many OECD countries have implemented retirement policies aimed at increasing the minimum retirement age, with the dual objectives of improving older workers' employment rates and ensuring the financial sustainability of pension systems. However, the long-term effects of retirement on health - and particularly on the onset of frailty - remain underexplored. In this paper, we examine the impact of retirement duration on the probability of being frail using an instrumental variable approach and assess heterogeneity by gender and occupation. Our analysis draws on longitudinal data from seven waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), spanning 2004-2019, and restricted to individuals aged 50-75. We instrument retirement duration using both the number of years since the early retirement age and the number of years since the statutory retirement age. The results reveal a non-linear relationship between retirement duration and frailty: in the short and medium term, retirement reduces the likelihood of being frail, whereas in the long term, it increases this likelihood. The marginal effect of retirement duration becomes positive after approximately 4.4 years of retirement, indicating that beyond this point, each additional year of retirement is associated with a higher probability of being frail. These findings suggest that while retirement may initially benefit health, prolonged retirement can impact health negatively, highlighting the need for preventive programs targeting individuals exiting the labor market early.

Considerable progress in oncology has substantially reduced cancer-related mortality, as reflected by the growing number of cancer survivors. In this context, the management of adverse events associated with cancer treatments has become even more important. Small-molecule VEGFR inhibitors are associated with clinically relevant cardiovascular and hepatic adverse events, including arrhythmias, heart failure, liver enzyme elevations, and hepatic failure. This review integrates the clinical profiles, organ-specific mechanisms, and shared biological pathways underlying VEGFR inhibitor-associated cardiotoxicity and hepatotoxicity. Clinical evidence primarily supports parallel cardiovascular and hepatic toxicities, whereas experimental studies identify convergent mechanisms involving endothelial injury, oxidative stress, mitochondrial dysfunction, inflammation, autophagy dysregulation, apoptosis, and metabolic disturbance. Direct evidence of cross-organ propagation was not identified in the reviewed literature, and the proposed cardio-hepatic relationship should therefore be considered a testable framework rather than an established mechanism. Particular attention is given to ageing-related susceptibility, including reduced cardiovascular and hepatic reserve, frailty, multimorbidity, and polypharmacy, which may modify treatment tolerance and monitoring needs. We also critically evaluate candidate preventive and therapeutic strategies and identify the evidence required for their clinical translation. By separating established clinical observations from mechanistic hypotheses, this review provides an evidence-graded framework for interpreting VEGFR inhibitor-associated toxicity, refining risk-adapted surveillance, directing future studies of cardio-hepatic interactions and guiding the development and validation of targeted mitigation strategies aimed at safer cancer treatment.