bluuebunny/crossref_metadata_2025 huggingface dataset:
Wrap‐Around String‐Like ToF and Self‐Capacitance Combined Sensor for Robots
Authors: Tsuji Satoshi
Published: November 2024

Collaborative robots are becoming popular because they can operate without safety fences and can work in close proximity to humans. Proximity and tactile sensors on the robot's surface are important safety measures for existing robots. In this paper, we propose a string‐like ToF and self‐capacitance combined sensor that can be easily wrapped around various types of existing robots. The sensor can be freely connected to other sensors, and the length of the connected sensors attached can be adjusted depending on the shape of the robot. Prototype sensors were fabricated, and four connected sensors were wrapped around the robotic arm. Sensors on the robot's surface can detect objects within the proximity range and determine contact. In addition, a robotic arm with sensors can be controlled in real‐time using measured data from the sensors. It was confirmed that the proposed sensor can be used for proximity and tactile sensing on existing robots. © 2024 Institute of Electrical Engineers of Japan and Wiley Periodicals LLC.
Application of the horse grimace scale in horses with dental disease: Preliminary findings
Authors: Sidwell Amelia E. , Duz Marco , Hill Bradley , Freeman Sarah , Hole Sam L.
Published: November 2024

Background

Dental disease is a common but often under‐recognised condition in horses, possibly due to an inability to recognise clinical signs of oral discomfort. Some dental disorders are reportedly more painful than others, but there is no current metric by which dental pain can be objectively assessed. This study aimed to determine whether a facial expression‐based pain scale offered an objective and reliable method for assessing dental pain in horses. It was hypothesised that dental disorders affecting the periodontium would produce high pain scores.

Methods

Twelve horses with dental disease were evaluated for pain using a numerical rating scale (NRS) and a horse grimace scale (HGS) by blinded observers using still, lateral photographs.

Results

Interobserver reliability was poor across all observers when both the NRS (intraclass correlation coefficient [ICC] = 0.36) and the HGS (ICC = 0.27) were used in horses with dental disease. The highest mean scores were given for horses with equine odontoclastic tooth resorption and hypercementosis (EOTRH) and periodontal disease (PD).

Limitations

This study has a small sample size of both horses and questionnaire respondents, and the respondent demographics are not representative of the wider veterinary population Furthermore, no positive or negative controls were used for the pain scoring.

Conclusions

The results of this study indicate the unreliability of tools designed for identifying acute pain for assessing chronic pain, such as dental pain. A more dental‐specific ethogram is required to accurately identify dental pain in horses. Both the NRS and HGS produced the highest mean scores for EOTRH and PD, supporting existing literature that these conditions are associated with more obvious signs of pain.
Evaluation of Radiological and Anatomical Features of Cervical Vertebrae in Adult Persian Cat
Authors: Derakhshi Peghah , Alizadeh Siamak , Hosseinchi Mohammadreza
Published: November 2024

Background

Radiographic studies of Persian cat's cervical vertebrae can provide us with valuable information used in identifying its anatomical features, investigating various species of Persian cats and evaluating their cervical pathologies.

Objectives

The present study aimed to investigate the anatomical and radiological features of cervical vertebrae in Persian cats to create a comprehensive and accurate reference for the normal range of cervical bones and joints that can be used for clinical decision‐making and interpretation of radiographic findings in these cats.

Methods

The present descriptive‐cross‐sectional study included 10 adult Persian cats, including 5 males and 5 females. All cats underwent radiography in the dorsoventral, ventrodorsal, left lateral and right lateral recumbency. Then, anatomical investigations were performed.

Results

According to our findings, Persian cats were different from other cat species in some cervical vertebral characteristics, which can be suggested as comparative anatomy in these species. The most important differences were as follows: the C3 and C7 had the lowest and highest spinous process height (SPH), respectively. The atlas had the highest transverse process width (TPW), which was significantly different with other cervical vertebrae (p ≤ 0.05). Moreover, the cervical vertebrae were not significantly different in vertical diameter of cranial vertebral foramen (VDCrVF) and transverse diameter of cranial vertebral foramen (TDCrVF) (p ≤ 0.05). The caudal surface of the atlantic vertebral arch had two dorsal and ventral tubercles. Also, the ventral crest of the axis was quite indistinct in the cranial part while becoming prominent in the caudal part. The C3 spinous process was a wide, small tubercle, while the C7 spinous process was extended vertically. Finally, the C6 transverse processes had a large ventrocranial tubercle forming a sagittal plate with cranial and caudal parts separated by a notch.

Conclusion

The accurate and comprehensive standard ranges obtained from the present study can be used for the interpretation of imaging results, clinical decision‐making, and finding the normal and abnormal sizes of the cervical vertebrae and their processes in Persian cats.
Undesired effects of low‐level photobiomodulation analgesic therapy in three cats with osteoarthritis
Authors: Barale Loris , Adami Chiara
Published: November 2024

Three cats with osteoarthritis undergoing low‐level laser therapy showed undesired effects, namely, discomfort and behavioural changes, after their first laser session. Although visible burns could not be detected and rectal temperature was only slightly elevated compared to pre‐procedural values, it is hypothesised that the behavioural changes showed by all three cats, namely, restlessness, tail wiggling, flinching away from touch and frequent position changes, were caused by skin overheating, as it has been reported in human patients.

It is advisable to intensify post‐procedural monitoring in cats undergoing photobiomodulation as part of the analgesic treatment of osteoarthritis for early detection of complications. Measurement of skin surface temperature of the treated areas and behavioural observation may be recommended in cats following photobiomodulation, possibly until 3‒4 h after the end of the laser treatment.
An evaluation of the Hawthorne effect in a clinical trial of trauma care in Ghana
Authors: Gyedu Adam , Amponsah‐Manu Forster , Mensah Samuel , Donkor Peter , Mock Charles
Published: November 2024

Introduction

Hawthorne effect refers to changes in clinician behavior in response to being observed. It has been minimally evaluated in trauma and surgical research, especially in low‐ and middle‐income countries (LMICs).

Methods

We used data from the first (control) phase of a randomized clinical trial in Ghana (2020‐21). Trained observers were stationed in emergency units in eight non‐tertiary hospitals to observe the achievement of key performance indicators (KPI) (KPIs) of trauma care. We hypothesized that the observers' presence would create a Hawthorne effect, resulting in clinicians (doctors, nurses) performing above their usual level, with performance highest immediately after the observers were introduced, and with performance then declining over time toward the usual baseline.

Results

We enrolled 2067 injured patients. Achievement of 13 out of 16 KPIs declined significantly over the 14 months after the introduction of observers. For example, airway assessment declined from 77% initially to 60% at the end of the phase (p < 0.001). Chest examination declined from 66% to 31% (p < 0.001). Distal pulses checked declined from 45% to 7% (p < 0.001). The slope of decline in KPI achievement ranged from 0.8%/month (mobility assessed) to 15.9%/month (distal pulses checked).

Conclusions

The decline in KPI achievement over time is consistent with the hypothesis that clinicians performed above their usual level just after the observers were introduced, with performance then declining toward the usual baseline. This study is among the first to provide quantitative data on the Hawthorne effect for trauma research in LMICs. These data are useful for the design of future observational studies and clinical trials.
Introduction
Authors: Carrera Nunez Sergio , Karageorgiou Eleni , Ovacik Gamze , Tan Nikolas Feith
Published: November 2024

The United Nations Global Compact for Refugees (GCR) is the most significant attempt at global responsibility sharing reform since the failed 1977 Conference on Territorial Asylum. Although there are no substantive obligations on states to share responsibilities in relation to refugees in the text of the 1951 Convention relating to the Status of Refugees (Refugee Convention), cooperation, solidarity, and responsibility sharing are core principles of the refugee regime (Karageorgiou, 2019). The preamble to the Refugee Convention stipulates that, given the pressures refugee movements put on certain countries, displacement cannot be resolved without international cooperation. The concept of responsibility sharing is understood to entail a type of cooperation and joint action, the main goal of which is to alleviate pressure on states that are hosting large numbers of refugees, through measures such as resettlement and relocation, financial assistance, and capacity building with the view to ensuring effective protection to refugees (Dowd & McAdam, 2017).
The Outsourcing of European Migration and Asylum Policy in Niger
Authors: Tinni Bachirou Ayouba , Hamadou Abdoulaye
Published: November 2024

Situated at the crossroads of sub-Saharan Africa and the Maghreb, Niger has been a departure and transit zone for the past few decades. Following the fall of Gaddafi, the country became a strategic partner to the European Union and its Member States in the search for solutions to the so-called migration crisis. This position was consolidated by its participation in the Valletta Summit in Malta in 2015, during which an emergency trust fund for Africa was set up to stem migration flows from Africa to Europe. Niger is the main beneficiary of the financial mechanism that was put in place, ranging from direct budgetary aid to project funding from United Nations agencies, cooperation and development agencies and non-governmental organisations as well as police cooperation. In return, the country stands out as a reliable partner in the fight against irregular migration and the promotion of the right to asylum. Thus, in addition to the application of Law 2015–36 on Migrant Smuggling, the country innovated with an unprecedented mechanism (the ETM) for the transfer of asylum-seekers and refugees from Libya to Niger, where they are supposed to be resettled in Europe and Canada. In the same year, the UNHCR opened an office in Agadez to facilitate asylum applications in a situation of mixed movements. These actions aim to confine migrants and keep them away from Europe’s borders, against a backdrop of outsourcing of migration and asylum policies. Based on a legal and ethnographic approach, this chapter analyses the organisational changes that have arisen as a result of the EU’s engagement with Niger and the UNHCR in the field of asylum since 2015. The approach is mainly based on two mechanisms introduced after the Valletta Summit: the ETM and the provision of asylum in Agadez in the context of mixed migration. The analysis focuses on the issues of accountability, transparency and compatibility.
The Global Compact on Refugees in Serbia and Tunisia: Exploring the Roles of EU and Domestic Policy Actors in Asylum Governance
Authors: Dimitriadi Angeliki , Lehmann Julian
Published: November 2024

We explore in this chapter the actors in (and their preferences) implementing selected policies relevant for the Global Compact on Refugees in Serbia and Tunisia. Serbia and Tunisia are priority countries for the EU as regards the foreign policy of migration and asylum. Serbia has become the central theatre on the “Balkan route” since 2015 and is on a EU membership path that requires significant reforms, including on the governance of migration and asylum. Tunisia is a key country of origin and transit for irregular migrants and asylum seekers travelling through the Central Mediterranean route, making it a priority for both Italy as a key member state, and for the EU as a whole. Both Serbia and Tunisia have endorsed the Global Compact on Refugees, which provides policy guidance on a range of issues on asylum, from reception to integration. Yet, the two countries have pursued different approaches towards the Compact’s core elements. Utilizing a lens of “political responsibility”, we examine how in Serbia and Tunisia domestic and international actors share asylum policies.
Attributing Legal Responsibility in the Context of Mobility Containment
Authors: Noll Gregor , Ovacik Gamze , Karageorgiou Eleni
Published: November 2024

Today, the attribution in multi-actor settings can no longer be exclusively considered under the 2001 ARSIWA and the 2011 ARIO. In this chapter, we consider how human rights and refugee law violations in the framework of migration cooperation might entail responsibility attribution to the involved actors under an emerging framework of rules. This novel framework takes the systemic completeness of international law as a baseline. It consists of the 2020 Guiding Principles on Shared Responsibility in International Law, the critiques of attribution by scholars and arguments from justice. ‘Systemic responsibility attribution’ is the label we use for it, and EU migration arrangements with Türkiye, Tunisia, Serbia and Niger provide the context for showcasing the application of this framework. We analyse the containment of refugee movements in cases related to all four countries. While systemic responsibility attribution is grounded on ILC articles in the case of Türkiye and Tunisia, Principle 7 GPRSIL offered a pathway towards attribution for Niger, in parallel to an attribution argument drawing on arguments from justice. In the case of Serbia, the sole avenue for an attribution argument were arguments from justice. Neither ILC articles nor the GPSRIL offered stepping stones for responsibility attribution for cooperation with Serbia.
Actors and Their Networks: Scope for Adaptation to and Contestation of Global Norms for Refugee Protection
Authors: Brumat Leiza , Geddes Andrew , Pettrachin Andrea
Published: November 2024

This chapter analyses the extent of differential incorporation at domestic level of global norms and standards for asylum-seekers and refugees in Bangladesh, Brazil, Canada, Jordan, South Africa and Türkiye. The chapter identifies sources of variation and their effects on domestic level responses to global norms and standards associated with refugee protection. The Chapter identifies four potential domestic-level responses to global norms and standards: adoption, adaptation, resistance and rejection. It then provides empirical evidence combining network analysis supplemented by interviews with 99 elite actors in the six case countries with interviewees defined by their leadership role in relation to asylum and refugee governance. The Chapter identifies sources of variation in asylum/refugee governance and identifies: (i) variation in the meaning of protection; (ii) the important role played by IOs in mediating the relationship between the domestic and the international levels; (iii) scope for contestation of global norms; (iv) how contestation can lead both to watering-down of global norms and standards; and (v), in the case of Brazil, how protection standards can be upgraded at national level through use of regional norms and standards that are seen as more progressive than global norms and standards
Inventory and Typology of EU Arrangements with Third Countries: Instruments and Actors
Authors: Tan Nikolas Feith
Published: November 2024

This Chapter maps and analyses EU arrangements with selected third countries, with a focus on the role of instruments and actors in the implementation of such arrangements. The Chapter hones in on EU cooperation with Türkiye, Serbia, Niger and Tunisia, with particular attention afforded to arrangements since the European migrant and refugee ‘crisis’ of 2015. In mapping such arrangements, which encompass international relationships between the EU and third countries, the Chapter provides a country-by-country overview and inventory of relevant political, legal and financial instruments. The Chapter also takes particular note of the role of both EU and third country actors in implementing these instruments. The Chapter analyses the role of EU cooperation in providing for access to international protection, either within the transit country or on the basis of mobility via third country solutions, conceived of in the Global Compact on Refugees (GCR) as ‘resettlement and complementary pathways to admission’. The Chapter finally discusses how these arrangements form part of the EU’s containment approach, by preventing onward movement from Türkiye, Serbia, Niger and Tunisia towards EU borders.
Informational Privacy for Service Design
Authors: Parrilli Davide M.
Published: November 2024

This chapter delves into informational privacy within the context of service design, set against the backdrop of the surveillance era driven by digitalization and servitization. It critiques “surveillance capitalism”, highlighting its biases and conceptual flaws, while adopting the perspective of a surveillance society where citizens actively engage in surveillance culture. The chapter redefines privacy for the digital age, focusing on informational privacy, which aligns with EU data protection laws and Alan Westin's influential 1967 definition. By contrasting privacy utopia and dystopia through the lens of Panopticon and Foucault’s panopticism, the authors introduce privacy scenarios and potential threats in service design. The chapter concludes by proposing a nuanced definition of privacy tailored for service design, emphasizing its practical implications.
Freudenthal duality in conformal field theory
Authors: Chattopadhyay Arghya , Mandal Taniya , Marrani Alessio
Published: November 2024

Abstract

Rotational Freudenthal duality (RFD) relates two extremal Kerr-Newman (KN) black holes (BHs) with different angular momenta and electric-magnetic charges, but with the same Bekenstein-Hawking entropy. Through the Kerr/CFT correspondence (and its KN extension), a four-dimensional, asymptotically flat extremal KN BH is endowed with a dual thermal, two-dimensional conformal field theory (CFT) such that the Cardy entropy of the CFT is the same as the Bekenstein-Hawking entropy of the KN BH itself. Using this connection, we study the effect of the RFD on the thermal CFT dual to the KN extremal (or doubly-extremal) BH. We find that the RFD maps two different thermal, two-dimensional CFTs with different temperatures and central charges, but with the same asymptotic density of states, thereby matching the Cardy entropy. We also discuss the action of the RFD on doubly-extremal rotating BHs, finding a spurious branch in the non-rotating limit, and determining that for this class of BH solutions the image of the RFD necessarily over-rotates.
The lemur tail kinase family in neuronal function and disfunction in neurodegenerative diseases
Authors: Larose Angelique , Miller Christopher C. J. , Mórotz Gábor M.
Published: November 2024

The complex neuronal architecture and the long distance of synapses from the cell body require precisely orchestrated axonal and dendritic transport processes to support key neuronal functions including synaptic signalling, learning and memory formation. Protein phosphorylation is a major regulator of both intracellular transport and synaptic functions. Some kinases and phosphatases such as cyclin dependent kinase-5 (cdk5)/p35, glycogen synthase kinase-3β (GSK3β) and protein phosphatase-1 (PP1) are strongly involved in these processes. A primary pathological hallmark of neurodegenerative diseases, including Alzheimer’s disease, Parkinson’s disease and amyotrophic lateral sclerosis/frontotemporal dementia, is synaptic degeneration together with disrupted intracellular transport. One attractive possibility is that alterations to key kinases and phosphatases may underlie both synaptic and axonal transport damages. The brain enriched lemur tail kinases (LMTKs, formerly known as lemur tyrosine kinases) are involved in intracellular transport and synaptic functions, and are also centrally placed in cdk5/p35, GSK3β and PP1 signalling pathways. Loss of LMTKs is documented in major neurodegenerative diseases and thus can contribute to pathological defects in these disorders. However, whilst function of their signalling partners became clearer in modulating both synaptic signalling and axonal transport progress has only recently been made around LMTKs. In this review, we describe this progress with a special focus on intracellular transport, synaptic functions and neurodegenerative diseases.
Microbial Life in Playa-Lake Sediments: Adapted Structure, Plastic Function to Extreme Water Activity Variations
Authors: Boadella Judit , Butturini Andrea , Doménech-Pascual Anna , Freixinos Zeus , Perujo Núria , Urmeneta Jordi , Vidal Ariadna , Romaní Anna M.
Published: November 2024

Saline shallow lakes in arid and semi-arid regions frequently undergo drying episodes, leading to significant variations in salinity and water availability. Research on the impacts of salinity and drought on the structure and function of biofilms in hypersaline shallow lakes is limited. This study aimed to understand the potential changes of biofilms in playa-lake sediments during the drying process. Sediments were sampled at different depths (surface, subsurface) and hydrological periods (wet, retraction, and dry), which included a decrease in water activity (aw, the availability of water for microbial use) from 0.99 to 0.72. aw reduction caused a greater effect on functional variables compared to structural variables, indicating the high resistance of the studied biofilms to changes in salinity and water availability. Respiration and hydrolytic extracellular enzyme activities exhibited higher values under high aw, while phenol oxidase activity and prokaryote biomass increased at lower aw. This shift occurred at both depths but was more pronounced at the surface, possibly due to the more extreme conditions (up to 0.7 aw). The increased levels of extracellular polymeric substances and carotenoids developed at low aw may help protect microorganisms in high salinity and drought environments. However, these harsh conditions may interfere with the activity of hydrolytic enzymes and their producers, while promoting the growth of resistant prokaryotes and their capacity to obtain C and N sources from recalcitrant compounds. The resilience of biofilms in hypersaline lakes under extreme conditions is given by their resistant biochemichal structure and the adaptability of their microbial functioning.
Subclinical corneal inflammation and subbasal nerve alterations in keratoconus detected by in vivo confocal microscopy: a cross-sectional study
Authors: Chirapapaisan Chareenun , Sawarot Methawee , Kengpunpanich Sathiya
Published: November 2024

Purpose

To investigate the intracorneal inflammation and subbasal nerve alterations in keratoconus.

Methods

This prospective cross-sectional study recruited patients with keratoconus, who were diagnosed and graded the severity based on clinical examination and Schiempflug tomography. Laser in vivo confocal microscopy (IVCM) was performed on the corneal subbasal layer centrally to explore the inflammatory cells (ICs), subbasal nerve density (SND), and nerve tortuosity. Keratoconus severity and related factors including ocular allergy, systemic atopy, eye rubbing, floppy eyelids, and contact lens use were recorded. Association between the factors, IC density, SND and keratoconus severity were analyzed.

Results

Thirty-four keratoconus eyes were enrolled, and their IVCM findings were compared with those of 20 age-matched normal eyes. Keratoconus showed a significant increase in ICs (44.25 ± 7.01 vs. 13.06 ± 7.51 cells/mm2, p < 0.001) and a significant decrease in SND (16.54 ± 0.79 vs. 20.62 ± 0.72 mm/mm2, p < 0.001) when compared to controls. The alterations were pronounced in severe keratoconus as the IC density was significantly higher (p < 0.001), whereas SND was lower (p = 0.001) in high-graded keratoconus than in low-graded keratoconus. However, there was no significant correlation between the number of IC and SND in keratoconus eyes (p = 0.835). Corneal sensitivity and nerve tortuosity were not different between keratoconus and the controls. No keratoconus-related factors were associated with IC density except the severity of keratoconus (p < 0.001, 95% CI [0.70, 0.95]).

Conclusion

Keratoconus, a clinically noninflammatory corneal disease, demonstrates subclinical corneal inflammation and subbasal nerve decline as shown by IVCM. These alterations correlate considerably with the severity of keratoconus.

Key messages

What is known

Traditionally, Keratoconus is a clinically noninflammatory corneal disease.

What is new

Our study suspected keratoconus may be subclinical corneal inflammatory disease.

In our research, A Keratoconus patient was discovered to have corneal inflammation and a reduction in sub-basal nerve density through the use of In Vivo Confocal Microscopy.

Increase in corneal inflammation is considerably correlated with the severity of keratoconus.
Overall survival of patients with KIT-mutant metastatic GIST in the era of multiple kinase inhibitor availability
Authors: Haller Valerie , Reiff Carina , Hamacher Rainer , Kostbade Karina , Kaths Moritz , Treckmann Juergen , Bertram Stefanie , Zaun Yasmin , Bauer Sebastian , Falkenhorst Johanna
Published: November 2024

Purpose

The prognosis of patients with metastatic GIST and imatinib-sensitive primary mutations has significantly improved. However, limited data are available to inform patients about outcomes across different lines of treatment. This retrospective analysis aims to evaluate patient outcomes at a large German GIST referral center over the past 15 years.

Patients and methods

Overall survival (OS) and progression-free survival (PFS) were analyzed in patients with metastatic GIST, with diagnosis of metastases between 2008 and 2021, when at least three lines of treatment were available in Germany (n = 174).

Results

The median overall survival far exceeds historical data for patients with primary exon 11 and exon 9 mutations (median OS in palliative treatment with imatinib: 7.1 years; median OS in second-line palliative treatment with sunitinib: 2.9 years; median OS in third-line palliative treatment with regorafenib: 1.9 years). Among those patients who received palliative imatinib treatment, no significant difference in median OS survival was observed between those who had received perioperative imatinib for localized disease and those who did not. Furthermore, the location of metastases significantly impacted survival, whereas the time between the initial diagnosis and the diagnosis of metastases had no significant effect on survival.

Conclusion

In conclusion, this study provides a novel, real-world reference for survival outcomes in patients with metastatic GIST.
Impact of the COVID-19 pandemic on cancer diagnoses, oncological care and cancer patients in Germany: a report from the “COVID & Cancer” workshop 2023 of the German Society for Epidemiology (DGEpi)
Authors: Erdmann Friederike , Wellbrock Maike , De Santis Karina Karolina , Hübner Joachim , Voigtländer Sven , Arndt Volker
Published: November 2024

Purpose

The COVID-19 pandemic was associated with severe disruptions in healthcare worldwide. Cancer patients are at particular risk of adverse consequences from delays in diagnosis and treatment. To evaluate the available data on the impact of the pandemic on cancer diagnoses, oncological care and patient well-being in Germany, the German Society for Epidemiology (DGEpi) in collaboration with the Epidemiological Cancer Registry of Lower Saxony invited to a workshop on “COVID & Cancer” (held on 26–27 October 2023 in Hanover, Germany). This report provides a summary of the scientific presentations, highlights methodological challenges, and recognises essential evidence gaps.

Methods

Twelve studies addressing various aspects in relation to cancer diagnoses, oncological care and patient well-being during the COVID-19 pandemic in Germany and two talks sharing experiences from the UK and the Netherlands were presented at the workshop.

Results and conclusions

Results from German cancer registries consistently showed lower number of incident cancer diagnoses among adults during the first months of the pandemic compared to the respective months of the years before the pandemic. Data from the cancer registries of Baden-Württemberg and Lower Saxony found especially for breast cancer a notable drop (by approximately one third) in the numbers of diagnoses during the first restriction period (April-May 2020), during which the nationwide mammography screening programme in Germany was temporarily suspended. Overall, the extent and ways, in which the pandemic had adversely affected cancer diagnoses, oncological care and created service backlogs, is still not adequately understood. The long-term consequences are yet to be determined.
eTWST: An Extension to the Timed Water Swallow Test for Increased Dysphagia Screening Accuracy
Authors: Brage Louise , Nylén Fredrik , Hägglund Patricia , Holmlund Thorbjörn
Published: November 2024

We aimed to fine-tuning the Timed Water Swallow Test (TWST) screening procedure to provide the most reliable prediction of the Flexible Endoscopic Evaluation of Swallowing (FEES) assessment outcomes, with age, sex, and the presence of clinical signs of dysphagia being considered in the assessment. Participants were healthy people and patients with suspected dysphagia. TWST performance and participants’ reported dysphagia symptoms were assessed in terms of their utility in predicting the outcome of a FEES assessment the same day. The FEES assessors were blinded to the nature of the TWST performance. The water swallowing capacity levels and clinical observations during a screening performance that were indicative of dysphagia/no symptoms in FEES were determined. Convergent validity was assessed as the agreement with the Functional Oral Intake Scale (FOIS) in the FEES assessment. TWST predicted FEES findings (aspiration and dysphagia) with a sensitivity of 72 and 45% and a specificity of 75% and 80%, respectively. Extended analysis of the TWST procedure (eTWST) identified aspiration (sensitivity = 92%, specificity = 62%) and dysphagia (sensitivity = 70%, and specificity = 72%) more accurately and showed a high correlation with FOIS (ɸ = 0.37). Excellent inter-rater reliability was further observed (Kw = 0.83). The extended evaluation of TWST performance has superior criterion validity to that of TWST. eTWST displayed high convergent validity and excellent interrater reliability. We therefore believe that eTWST can be highly relevant for clinical dysphagia screening.
A qualitative study of the mental health outcomes in people being treated for obesity and type 2 diabetes with glucagon-like peptide-1 receptor agonists
Authors: Pierret Aureliane C. S. , Benton Madeleine , Sen Gupta Piya , Ismail Khalida
Published: November 2024

Objective

Obesity and type 2 diabetes (T2D) are associated with increased rates of mental disorders, particularly depression, anxiety and binge-eating disorder. GLP-1 receptor agonists are a novel class of pharmacological agents for obesity and T2D. We aimed to describe participants’ experiences of GLP-1 receptor agonists on their mental health.

Methods

Qualitative, individual, semi-structured interviews were conducted in nine participants who were prescribed GLP-1 receptor agonists for the treatment of obesity and/or T2D. Mental health status was measured at time of GLP-1 receptor agonist initiation and assessed again at 12–16 weeks when the semi-structured interview took place. Data were analysed using reflexive thematic analysis.

Results

Three main themes were generated from the analysis: (1) acceptance of negative side effects for long term physical health benefits; (2) reflections on the diverse impact on mental health; (3) reduced appetite and increased control of eating behaviours.

Discussion

Overall, participants with obesity and/or T2D described a positive impact of GLP-1 receptor agonists on their mental health, especially perception of improved control of eating behaviours. This suggests GLP-1 receptor agonists should be further studied for their potential effectiveness for treatment of binge-eating disorder.
Comparative analysis of 333 proGAV® and proGAV 2.0® adjustable valves in pediatric hydrocephalus treatment: survival and complication rate assessment
Authors: Issa Mohammed , Paggetti Filippo , Dannehl Clara , Ueding Nieke , Krieg Sandro M. , El Damaty Ahmed
Published: November 2024

Objective

ProGAV and ProGAV2.0 adjustable valves are extensively used for treating hydrocephalus in pediatric patients. This study aims to conduct a comprehensive comparison between these two valves concerning their survival and complication rates.

Methods

This retrospective study included all pediatric patients who underwent ProGAV or ProGAV2.0 valve implantation at our neurosurgical clinic from August 2008 to August 2020. A comparative analysis was performed considering age, gender, follow-up duration, complication and survival rates, adjustments, spontaneous adjustments, and adjustment difficulty rates. All valves were followed up for a maximum of 3 years.

Results

Inclusion involved 333 cases (mean age of 5.4 ± 5.1 years; 54.1% males), comprising 173 cases (52.0%) with ProGAV valve implantation and 160 cases (48.0%) with ProGAV 2.0. Early complications within the first month post-implantation were observed in 51 cases (15.3%). No significant differences were noted in valve implantation indications, age distribution, or survival duration (27.1 vs. 27.8 months, p = 0.629) between the two groups. Predominant indications for implantation were post-hemorrhagic hydrocephalus and aqueduct stenosis for both valve types. Notably, both valves showed non-significantly different explantation rates during the first three years after implantation (34.7% vs. 29.7%, p < 0.289). However, there was a significantly higher early post-implantation complication rate (22% vs. 9.4%,
p

 = 0.002), and a significantly increased association with difficulties in valve adjustments and spontaneous adjustments (
p

 = 0.041 and 0.011, respectively). ProGAV2.0 cases displayed notably enhanced clinical and radiological improvement within the initial 6 months after implantation (
p

 = 0.001 and p = 0.038). Younger children (< 2 years of age) also experienced significantly more valve adjustment difficulties (p = 0.049) and had higher rates of valve explantation (
p

 < 0.001).

Conclusion

The findings of this study highlight the superior performance of the ProGAV2.0 valve in terms of complication rate and maladjustment rate when employed in the treatment of pediatric hydrocephalus. Both valves demonstrated an acceptable survival rate with 65.3% for ProGAV and 71.3% for ProGAV2.0 within three years of implantation.
Dynamic or Static Goal Regulation: Implications of Weak and Strong Bonds Between Autonomous/Controlled Reasons and Aims for Achievement Goal Striving
Authors: Janke Stefan
Published: November 2024

Achievement goals have been key concepts for describing what motivates individuals in educational contexts. While achievement goals have often merely been conceptualized in terms of aspired end-states (aims of goal striving), contemporary research has proposed a more holistic perspective synthesizing these aims alongside autonomous versus controlled reasons derived from Self-Determination Theory into so-called achievement goal complexes. How these aims and reasons align is a matter of further discussion. An overview of empirical studies on goal complexes as well as associations between achievement goals and overarching goal systems reveals that aims differ in whether they show strong communality (static goal regulation) or rather high situational fluctuation regarding underlying reasons (dynamic goal regulation). Particularly, mastery aims show primarily strong bounds with autonomous reasons, whereas performance aims are more ambiguously aligned with underlying reasons. This has implications for the development of an overarching theory as well as for educational practice aiming to foster certain goals and goal complexes. Potential avenues for future research such as further investigations into goal valence, a broader set of aims, the impact of culture, and goal development are discussed.
Evaluation of decision support to wean patients from mechanical ventilation in intensive care: a prospective study reporting clinical and physiological outcomes
Authors: Vizcaychipi Marcela P. , Karbing Dan S. , Martins Laura , Gupta Amandeep , Moreno-Cuesta Jeronimo , Naik Manu , Welters Ingeborg , Singh Suveer , Randell Georgina , Osman Leyla , Rees Stephen E.
Published: November 2024

This study investigated the clinical and physiological response to use of the BEACON Caresystem, a bedside open-loop decision support system providing advice to guide clinicians when weaning patients from invasive mechanical ventilation. Multicenter prospective study conducted in five adult intensive care units in the UK. Following screening and assent, intubated patients mechanically ventilated for > 24 h were randomized to intervention or usual care. Intervention consisted of application of the BEACON Caresystem’s advice on tidal volume/inspiratory pressure, inspired oxygen, respiratory rate and PEEP. Usual care was defined as local clinical practice. The primary outcome was duration of mechanical ventilation. Secondary outcomes quantified prolonged intubation and survival; adverse events; ventilator settings and physiological state; time spent in ventilator modes; links to other therapy; the frequency of advice utilization and time spent outside normal physiological limits. The study was terminated early with a total of 112 patients included. Fifty-four were randomised to the intervention arm and fifty-eight to usual care. The study was underpowered and no significant differences were seen in duration of mechanical ventilation (p = 0.773), prolonged intubation or survival. Intervention arm patients had lower rates of adverse events (p = 0.016), including fewer hypoxaemic events (p = 0.008) and lower values of PEEP (p = 0.030) and tidal volume (p = 0.042). Values of peak inspiratory pressure and pressure support were reduced but at the boarder of statistical significance (p = 0.104, p = 0.093, respectively). No differences were seen for time in ventilator mode or other therapy. Advice presented by the decision support system was applied at the beside an average of 88% of occasions, with a significantly increased number of changes only in inspired oxygen fraction. No significant differences were seen in time spent outside physiological limits. This study investigated the use of the BEACON Caresystem, an open loop clinical decision support system providing advice on ventilator settings. It was terminated early, with no significant difference shown in duration of mechanical ventilation, the primary outcome. Application of advice indicated potential for fewer adverse events and improved physiological status. (Trial registration ClinicalTrials.gov under NCT03249623. Registered 22nd June 2017)
PASE: Pro-active Service Embedding in The Mobile Edge
Authors: Kolosov Oleg , Yadgar Gala , Breitgand David , Lorenz Dean H.
Published: November 2024

Mobile edge computing offers ultra-low latency, high bandwidth, and high reliability. Thus, it can support a plethora of emerging services that can be placed in close proximity to the user. One of the fundamental problems in this context is maximizing the benefit from the placement of networked services, while meeting bandwidth and latency constraints. In this study, we propose an adaptive and predictive resource allocation strategy for virtual-network function placement comprising services at the mobile edge. Our study focuses on maximizing the service provider’s benefit under user mobility, i.e., uncertainty. This problem is NP-hard. Therefore, we propose a heuristic solution: we exploit local knowledge about the likely movements of users to speculatively allocate service functions. We allow the service functions to be allocated at different edge nodes, as long as latency and bandwidth constraints are met. We evaluate our proposal against a theoretically optimal algorithm as well as against recent previous work, using widely used simulation tools. Through an extensive simulation study, we demonstrate that under realistic scenarios, an adaptive and proactive strategy coupled with flexible placement can achieve close-to-optimal benefit.
Design, synthesis, and anti-breast cancer activity evaluation of novel 3-cyanopyridine derivatives as PIM-1 inhibitors
Authors: Hussein Bahgat R. M. , Mohammed Hayam H. , Ahmed Eman A. , Alshazly Omar , Mohamed Mamdouh F. A. , Omran Omran A.
Published: November 2024

A novel series of cyanopyridines 7a-j were synthesized via a one-pot multicomponent reaction of arylidene 4 with ammonium acetate 5 and respective methylaryl/heterylketones 6a-j in ethanol using vanillin as a natural starting material. Moreover, the regioselective alkylation reaction was studied by the treatment of cyanopyridines 7a-f and 7j with CH3I in the presence of K2CO3 in DMF to afford O-methylcyanopyridines 8a-g (major) and N-methylcyanopyridines 9a-g (minor), whereas bipyridine 7h gave bipyridinium iodide salt 10. All of the designed cyanopyridines were evaluated as anti-breast cancer (MCF-7) cell lines via PIM Kinase inhibitory activity, and the results displayed that some of them showed high activities, especially compounds 7h and 8f, which showed excellent activities against MCF-7 with IC50 values of 1.89 and 1.69 μM, respectively, more potent than the reference drug doxorubicin. Mechanistically, compounds 7h and 8f exhibited strong in vitro PIM-1 kinase inhibitory activity with an IC50 of 0.281 and 0.58 μM, respectively, compared to the reference staurosporine. Moreover, compound 7h arrested the tumor cells at the S phase and caused cell death mainly by inducing early and late apoptosis. Molecular docking studies against PIM-1 revealed good binding modes of the synthesized compound and showed agreement with the biological results.

Graphical abstract
Beyond Preferences in AI Alignment
Authors: Zhi-Xuan Tan , Carroll Micah , Franklin Matija , Ashton Hal
Published: November 2024

The dominant practice of AI alignment assumes (1) that preferences are an adequate representation of human values, (2) that human rationality can be understood in terms of maximizing the satisfaction of preferences, and (3) that AI systems should be aligned with the preferences of one or more humans to ensure that they behave safely and in accordance with our values. Whether implicitly followed or explicitly endorsed, these commitments constitute what we term apreferentistapproach to AI alignment. In this paper, we characterize and challenge the preferentist approach, describing conceptual and technical alternatives that are ripe for further research. We first survey the limits of rational choice theory as a descriptive model, explaining how preferences fail to capture the thick semantic content of human values, and how utility representations neglect the possible incommensurability of those values. We then critique the normativity of expected utility theory (EUT) for humans and AI, drawing upon arguments showing how rational agents need not comply with EUT, while highlighting how EUT is silent on which preferences are normatively acceptable. Finally, we argue that these limitations motivate a reframing of the targets of AI alignment: Instead of alignment with the preferences of a human user, developer, or humanity-writ-large, AI systems should be aligned with normative standards appropriate to their social roles, such as the role of a general-purpose assistant. Furthermore, these standards should be negotiated and agreed upon by all relevant stakeholders. On this alternative conception of alignment, a multiplicity of AI systems will be able to serve diverse ends, aligned with normative standards that promote mutual benefit and limit harm despite our plural and divergent values.
Development of a prediction model for clinically-relevant fatigue: a multi-cancer approach
Authors: Adiprakoso Dhirendra , Katsimpokis Dimitris , Oerlemans Simone , Ezendam Nicole P. M. , van Maaren Marissa C. , van Til Janine A. , van der Heijden Thijs G. W. , Mols Floortje , Aben Katja K. H. , Vink Geraldine R. , Koopman Miriam , van de Poll-Franse Lonneke V. , de Rooij Belle H.
Published: November 2024

Purpose

Fatigue is the most prevalent symptom across cancer types. To support clinicians in providing fatigue-related supportive care, this study aims to develop and compare models predicting clinically relevant fatigue (CRF) occurring between two and three years after diagnosis, and to assess the validity of the best-performing model across diverse cancer populations.

Methods

Patients with non-metastatic bladder, colorectal, endometrial, ovarian, or prostate cancer who completed a questionnaire within three months after diagnosis and a subsequent questionnaire between two and three years thereafter, were included. Predictor variables included clinical, socio-demographic, and patient-reported variables. The outcome was CRF (EORTC QLQC30 fatigue ≥ 39). Logistic regression using LASSO selection was compared to more advanced Machine Learning (ML) based models, including Extreme gradient boosting (XGBoost), support vector machines (SVM), and artificial neural networks (ANN). Internal–external cross-validation was conducted on the best-performing model.

Results

3160 patients were included. The logistic regression model had the highest C-statistic (0.77) and balanced accuracy (0.65), both indicating good discrimination between patients with and without CRF. However, sensitivity was low across all models (0.22–0.37). Following internal–external validation, performance across cancer types was consistent (C-statistics 0.73–0.82).

Conclusion

Although the models’ discrimination was good, the low balanced accuracy and poor calibration in the presence of CRF indicates a relatively high likelihood of underdiagnosis of future CRF. Yet, the clinical applicability of the model remains uncertain. The logistic regression performed better than the ML-based models and was robust across cohorts, suggesting an advantage of simpler models to predict CRF.
Centenarians of the Basque Country are resilient to cancer
Authors: Cruces-Salguero Sara , Larrañaga Igor , Mar Javier , Matheu Ander
Published: November 2024

Cancer is one of the leading causes of death and its prevalence increases with age. While centenarians exhibit extreme longevity and potential to avoid or delay aging-related diseases, their response to cancer is still barely explored. Our study took advantage of the Electronic Health Records to retrospectively compare the severity of cancer in centenarians (n = 649) and non-centenarians (n = 62,753) in the Basque Country (province of Gipuzkoa), Spain, through analyzing all the recorded diagnoses throughout their lifetime. Descriptive statistics were applied to discern differences between the two population groups in terms of prevalence of tumor types, number of diagnoses, and treatments. Survival analysis was performed through Kaplan–Meier estimator. We found that centenarians had fewer cancer diagnoses (17.1%, n = 111) than non-centenarians (40.5%, n = 25,405), and notably avoided the most aggressive cancer types and did not develop metastasis. Furthermore, they barely had records of treatments or drugs and had extended survival both since the first and last diagnosis of cancer. These results suggest resilience of the centenarians against malignant cancers explaining, in part, their extended longevity.