bluuebunny/crossref_metadata_2025 huggingface dataset:
Die Verschwiegenheitspflicht im psychotherapeutischen Setting unter besonderer Berücksichtigung von virtuellen Angeboten
Authors: Friehs Barbara
Published: November 2023

Die Verschwiegenheitsverpflichtung – ein grundlegendes Gebot in der Psychotherapie – stellt sicher, dass Informationen vertraulich bleiben, um das Vertrauensverhältnis zwischen Klient:innen und Therapeut:innen zu wahren. Mit dem zunehmenden Einsatz von Online-Psychotherapie steigen die Herausforderungen zur Wahrung der Verschwiegenheitsverpflichtung. Ein Vergleich der gesetzlichen Grundlagen für Therapieangebote im virtuellen Raum zwischen Österreich und Deutschland zeigt, dass in Deutschland 30 % aller Behandlungen per Video erlaubt sind. In Österreich ist dieses Format seit den Bestimmungen im Kontext der COVID-19-Pandemie rechtlich ebenfalls zulässig und soll auch nach den Bestimmungen des neuen Psychotherapiegesetzes möglich sein. Zuvor waren dort lediglich psychotherapeutische Beratungsleistungen im Online-Setting erlaubt, nicht jedoch Therapien. Wissenschaftliche Studien weisen zwar auf Problembereiche von virtuellen Settings hin, erbringen aber auch viele Nachweise für einen erfolgreichen Einsatz von psychotherapeutischen Online-Anboten. Da die elektronische Kommunikation potenziell anfällig für Sicherheitsverletzungen ist, müssen Therapeut:innen jedoch angemessene Maßnahmen ergreifen, um das Gebot der Vertraulichkeit und Verschwiegenheit zu gewährleisten. Standardisierte Richtlinien auf internationaler Ebene wären für Online-Therapien wünschenswert, um erhöhte Rechtssicherheit zu schaffen.
Is physiotherapy in migraines known to sufferers? A cross-sectional study
Authors: Tedeschi Roberto , Pillastrini Paolo , Pierangeli Giulia , Favoni Valentina , Cortelli Pietro , Cevoli Sabina
Published: November 2023

Background

Migraine, a prevalent neurological condition, often impairs daily functioning and quality of life. While medications are the primary treatment, the potential of physiotherapy as an integrative approach remains underexplored. The aim of the study was to explore the awareness and experience of migraine patients regarding physiotherapy as a complementary treatment.

Methods

A comprehensive survey was conducted on 200 migraine patients. Data collected included demographics, diagnosis, Migraine Disability Assessment Score Questionnaire (MIDAS) scores, and perceptions and experiences related to physiotherapy.

Results

The average age of participants was 47.7 ± 13.2 years, with a predominance of females, 149 out of 200 (74.5%). The mean MIDAS score was 36.7 ± 45.3, indicating a significant impact on daily life. While 39 out of 200 (19.5%) had undergone physiotherapy for their headache, 161 out of 200 (80.5%) had not. Of those who had, 22 out of 39 (56.4%) reported benefits, including reduced attack intensity and frequency. Interestingly, 145 out of 161 (90.1%) expressed interest in physiotherapy, with many expecting it to reduce attack intensity, 57 out of 200 (28.5%) and frequency, 77 out of 200 (38.5%).

Conclusions

The study highlights the substantial burden of migraines and the potential of physiotherapy as an adjunctive treatment. Increasing awareness and accessibility to physiotherapy could offer migraine patients a more holistic treatment approach; however, randomized controlled trials are mandatory in order to confirm its efficacy.
Mixture of experts distributional regression: implementation using robust estimation with adaptive first-order methods
Authors: Rügamer David , Pfisterer Florian , Bischl Bernd , Grün Bettina
Published: November 2023

In this work, we propose an efficient implementation of mixtures of experts distributional regression models which exploits robust estimation by using stochastic first-order optimization techniques with adaptive learning rate schedulers. We take advantage of the flexibility and scalability of neural network software and implement the proposed framework in mixdistreg, an software package that allows for the definition of mixtures of many different families, estimation in high-dimensional and large sample size settings and robust optimization based on TensorFlow. Numerical experiments with simulated and real-world data applications show that optimization is as reliable as estimation via classical approaches in many different settings and that results may be obtained for complicated scenarios where classical approaches consistently fail.
Das Saarländische Klimaschutzgesetz
Authors: Guckelberger Annette
Published: November 2023

Das Saarland hat sich mit dem Erlass eines Klimaschutzgesetzes lange Zeit gelassen. Der Beitrag ordnet
dieses in die nationale Klimaschutzgesetzgebung ein.
Effects of dietary commercial phytobiotic “Sanacore® GM” on Pacific white shrimp (Litopenaeus vannamei) growth, immune response, redux status, intestinal health, and disease resistance against Fusarium solani
Authors: Eissa El-Sayed Hemdan , Elbahnaswy Samia , El-Baz Amira Hussein , El-Haroun Ehab , Ashour Mohamed , Mansour Abdallah Tageldein , Saadony Saadea , El-Saeed Adel F. , Kabary Hoda , Jastaniah Samyah D. , Alaidaroos Bothaina A. , Shafi Manal E. , Abd El-Hack Mohamed E. , Eissa Moaheda E. H. , Eldessouki Elsayed A.
Published: November 2023

The use of phytobiotic as functional feed additives is a promising inducer for growth performance and immune response in the Pacific whiteleg shrimp (Litopenaeus vannamei). It can be also commercially applied in combination with chemotherapeutic agents and vaccines. This study was carried out to evaluate the use of a commercial phytobiotic feed additive, Sanacore® GM, containing vegetable fatty acids and inactivated Saccharomyces cerevisiae with herbal extracts, on growth, body composition, non-specific immune response, antioxidant index, intestinal microflora count, and fungal resistance to Fusarium solani challenge in Pacific white shrimp, Litopenaeus vannamei. Shrimp juveniles (5.00 ± 0.1 g) were randomly distributed into 12 hapas (1 m3) in triplicates at a stocking density of 20 shrimp per hapa and fed increasing levels of Sanacore® (0, 0.1, 0.2, and 0.3%) for 63 days. At the end of the feeding trial, the experimental shrimp were infected with F. solani, and mortality was recorded for 15 days. Results revealed that growth performance, feed utilization, and whole-body protein deposition were improved with increasing dietary sanacore levels. A significant improvement was reported in cellular (hemocyte counts, phagocytosis, phagocytic index, respiratory burst activity) and humoral (lysozyme and phenoloxidase) immune responses with higher dietary sanacore levels. Superoxide dismutase, catalase, and glutathione peroxidase were notably improved in shrimp-fed sanacore-supplemented diets. Meanwhile, malondialdehyde level was significantly decreased in all sanacore-supplemented shrimp. Furthermore, the dietary sanacore consistently increased probiotic bacterial counts and decreased enteric and Clostridium sp. counts in the intestine. Juveniles fed with Sanacore exhibited significantly lower mortality rates when challenged with F. solani. In conclusion, dietary sanacore could exhibit a profitable effect on the growth performance, antioxidant capacity, immunity, intestinal microbial, and the health condition of L. vannamei. Thus, sanacore can be used as an attractive feed supplement in the L. vannamei diet (0.2–0.3%), providing more insights into its application in aquaculture as a functional immunostimulant feed additive.
Integrating the Maker pedagogical approach in teacher training: the acceptance level and motivational attitudes
Authors: Quintana-Ordorika Amaia , Camino-Esturo Edorta , Portillo-Berasaluce Javier , Garay-Ruiz Urtza
Published: November 2023

In recent years, Maker Education has gained popularity in formal education, but the perceptions of pre-service teachers after participating in a maker training program at a university-based makerspace remain to be explored. The purpose of this study is to analyze the acceptance level and the degree of motivation of pre-service teachers towards the maker educational approach. The research assesses attention, relevance, confidence and satisfaction according to Keller's motivational model, as well as the acceptance of the maker approach using the Technology Acceptance Model (TAM). The study focuses on Early Childhood Education pre-service teachers from UPV/EHU (University of the Basque Country) who have been involved in designing teaching and learning plans based on Maker Education. The results show a strong motivation among the pre-service teachers in terms of attention, relevance, confidence and satisfaction towards the maker approach. The study also highlights a high level of technology acceptance. These findings underline the positive impact of maker-based learning methods and suggest that greater motivation correlates with the positive attitudes towards integrating this pedagogy in the future. In light of these findings, integrating innovative maker pedagogy into teacher training appears to be beneficial, as the high levels of acceptance and motivation indicate its potential to equip students with essential twenty-first century skills.
The Right to Break the Law? Perfect Enforcement of the Law Using Technology Impedes the Development of Legal Systems
Authors: Custers Bart
Published: November 2023

Technological developments increasingly enable monitoring and steering the behavior of individuals. Enforcement of the law by means of technology can be much more effective and pervasive than enforcement by humans, such as law enforcement officers. However, it can also bypass legislators and courts and minimize any room for civil disobedience. This significantly reduces the options to challenge legal rules. This, in turn, can impede the development of legal systems. In this paper, an analogy is made with evolutionary biology to illustrate that the possibility to deviate from legal rules and existing norms is sometimes necessary for the further development of legal systems. Some room to break the law, for instance, through civil disobedience or imperfect enforcement of the law, will ensure sufficient variation. This allows for properly evolving legal systems that can continue to provide fair solutions, even when society and concepts of fairness further develop.
Beautiful, Magic, Lethal: a Social Perspective of Cinnabar Use and Mercury Exposure at the Valencina Copper Age Mega-site (Spain)
Authors: García Sanjuán Leonardo , Montero Artús Raquel , Emslie Steven D. , Lozano Rodríguez José Antonio , Luciañez-Triviño Miriam
Published: November 2023

Today, mercury is a matter of concern for health and environmental authorities across western countries, and legislation has been passed and programs have been implemented for its total elimination from human activity. But this was not always the case: mercury and its compounds have been highly appreciated and used since remote times all over the world with very diverse purposes ranging from decorative, medicinal, metallurgical and symbolic. In particular, cinnabar (HgS, mercury sulfide), a mineral of an intense red color, has been considered in many cultures as an exotic raw material, highly valued and associated with the elites and sacred practice. In this paper, we examine one such case, set almost 5000 years ago, in Copper Age Iberia, by investigating mercury exposure through human bone. The study presented here includes a total of 170 samples from 70 different human individuals and 22 animals (plus one soil sample) from the Copper Age mega-site of Valencina, south-western Spain. It is the largest ever single-site study of exposure to mercury based on human bone in combination with cinnabar use. Abnormally high values are recorded in some individuals dating between 2900 and 2650 BC, especially in those buried in remarkable tombs belonging to the social elite of this period, but high levels of mercury are also recorded in the rest of the population. Three lines of interpretation are used to explain these results, including the manipulation of cinnabar (grinding it into powder, mixing it with other substances, using it for the decoration of objects, buildings and the human body), its direct consumption through ingestion or inhalation by a ‘special’ social group and the contribution of environmental factors. Based on the currently available evidence, which is carefully reviewed, Valencina represents the most intense and prolonged case of exposure to mercury recorded in human history, which makes it an important site to assess the long and complex history of use of this substance.
Refining the mechanistic understanding of microstructural decay during rolling contact fatigue in 52100 bearing steel tempered at high temperature
Authors: Loaiza Tania , Babu R. Prasath , Ooi Steve , Hedström Peter
Published: November 2023

Subsurface rolling contact fatigue (RCF) failure occurs beneath heavily loaded hard contacts like gears, bearings, and cams. This study investigates microstructural decay beneath a RCF-tested surface in AISI/SAE 52100 bearing steel tempered at 240 ℃. RCF tests were conducted at 100 ℃ with a maximum Hertzian contact pressure of 4 GPa for four stress cycles. Microstructural characterization utilized scanning electron microscopy, electron backscatter diffraction, transmission Kikuchi diffraction, and transmission electron microscopy. Due to high tempering temperature, white etching bands (WEBs) were observed without preceding dark etching regions. The microstructural decay sequence involved: (1) formation of elongated ferrite and ferrite microbands, (2) complete dissolution of tempered carbides and partial dissolution of residual cementite, (3) formation of WEBs composed of nano-sized ferrite grains (100–300 nm) transformed from ferrite microbands, and (4) appearance of lenticular carbides. Within the WEBs, most nano-sized grains had high-angle grain boundaries, while the fraction of low-angle grain boundaries increased in later stages of RCF. Lenticular carbides formed alongside elongated ferrite and coalesced nano-sized ferritic grains.
Efficient determination of the accessible conformation space of multi-domain complexes based on EPR PELDOR data
Authors: Kazemi Sina , Lopata Anna , Kniss Andreas , Pluska Lukas , Güntert Peter , Sommer Thomas , Prisner Thomas F. , Collauto Alberto , Dötsch Volker
Published: November 2023

Many proteins can adopt multiple conformations which are important for their function. This is also true for proteins and domains that are covalently linked to each other. One important example is ubiquitin, which can form chains of different conformations depending on which of its lysine side chains is used to form an isopeptide bond with the C-terminus of another ubiquitin molecule. Similarly, ubiquitin gets covalently attached to active-site residues of E2 ubiquitin-conjugating enzymes. Due to weak interactions between ubiquitin and its interaction partners, these covalent complexes adopt multiple conformations. Understanding the function of these complexes requires the characterization of the entire accessible conformation space and its modulation by interaction partners. Long-range (1.8–10 nm) distance restraints obtained by EPR spectroscopy in the form of probability distributions are ideally suited for this task as not only the mean distance but also information about the conformation dynamics is encoded in the experimental data. Here we describe a computational method that we have developed based on well-established structure determination software using NMR restraints to calculate the accessible conformation space using PELDOR/DEER data.
The effect of consanguineous marriage on reading disability based on deep neural networks
Authors: Talaat Fatma M.
Published: November 2023

For knowledge acquisition and social engagement, reading comprehension is essential. However, 20% or so of younger students have trouble with it. In order to predict the effects of consanguineous marriage on reading handicap and customize adaptive learning experiences, the study proposes an Intelligent Adaptive Learning and Prediction Framework (IALPF). This framework is proposed as a transformative solution that smoothly combines cutting-edge AI approaches. IALPF provides precise predictions and individualized learning pathways by utilizing extensive cognitive profiling, data gathering, and hybrid neural network design. It includes early warning systems, flexible content distribution, and ongoing development based on active learning and feedback loops. The IALPF represents a significant change in education that has wide-ranging effects. We evaluated reading skills among 770 students in a study that included two experimental groups, a control group, and 22 pupils from first-cousin marriages and 21 children of unrelated parents, respectively. Tests were given for word identification and reading comprehension, among other things. The findings showed that children of first cousin parents had a higher chance of reading difficulties than those of parents from other families. The outstanding performance of IALPF, which outperformed conventional techniques like Back Propagation (BP) and General Regression Neural Network (GRNN), was further supported by empirical evaluation. This demonstrates IALPF's success in reinventing personalized learning and predictive analysis, strengthening its potential to improve education in a variety of scenarios. The seamless integration of cutting-edge AI methods into IALPF, which forecasts the effect of consanguineous marriage on reading handicap, is a significant innovation. To set it apart from conventional approaches, this special framework integrates cognitive profile, information gathering, and hybrid neural networks for accurate predictions. The empirical analysis demonstrates the revolutionary potential of IALPF by demonstrating its improved predictive accuracy when compared to Back Propagation (BP) and General Regression Neural Network (GRNN).
Assessing Religious Leadership: A Scoping Review of Leadership Effectiveness Criteria and Current Trends in the Academic Literature
Authors: Foppen Annemarie , van Saane Joke W.
Published: November 2023

A clear understanding of what constitutes effective religious leadership in the context of faith communities is essential for religious practitioners, religious communities, and educational institutes. Twenty-five years after the latest review study by Nauss, an updated overview is needed to account for new insights, especially regarding the latest developments in leadership research and the changing religious landscape. A scoping review was conducted in four databases from 1997 to 2022 to examine the academic literature. The search identified 64 unique references that researched effective religious leadership using 27 different effectiveness criteria. These criteria were categorized based on their target of evaluation: (1) the religious leader, (2) followers/members, and (3) the congregation. Although most references assessed leadership effectiveness by evaluating the religious leader, the most used effectiveness criterion was ‘attendance or numerical growth.’ Over the last 25 years, the criteria for religious leadership effectiveness have become more diverse, and a growing number of references combine criteria from multiple targets to evaluate effectiveness. However, the focus on Christian leadership remains prevalent in the academic literature. The present overview is intended as a starting point for future research as it identifies the current trends and existing knowledge gaps. The study’s findings also invite religious practitioners and congregations to reflect on their methods of assessing leadership effectiveness.
Seasonal variation in urban pollen resource use by north temperate European honeybees
Authors: Davey Marie L. , Blaalid Rakel , Dahle Sondre , Stange Erik E. , Barton David N. , Rusch Graciela M.
Published: November 2023

Urban green infrastructure can provide important habitats for pollinators and support urban ecosystem services. Therefore, these areas must be managed to maximize biodiversity and density of pollinating insects. We used DNA metabarcoding to study honeybee pollen resource use over time and space in the city of Oslo, Norway, and to assess the role of green infrastructure as a resource for pollinators and the services they generate. Urban honeybees used diverse pollen resources throughout their active season. There was considerable seasonal turnover in pollen resource use that reflected flowering phenology. Non-native plants (including invasive species) were an important resource early in the season but were replaced by native plants later in the season. Hive location was not strongly correlated with resource use, likely indicating effective long-distance foraging in the fragmented urban landscape. However, flower visitation rates and floral resource density in public urban green spaces were coupled to pollen use. Honeybees collected pollen from a small number of preferred species but also visited other species, likely for nectar. To preserve pollinator services, urban planning should consider flower resource management, with particular focus on planting native species that can act as early season resources for bees. Public campaigns and other incentive mechanisms to promote the cultivation of native plants that are resources for pollinators and the protection of urban semi-natural habitats have the potential to enhance the value of green infrastructure to support urban pollinators and pollination services.
Safety of cinacalcet in children and adolescents with chronic kidney disease-mineral bone disorder: systematic review and proportional meta-analysis of case series
Authors: Zamoner Soraya Mayumi Sasaoka , Takase Henrique Mochida , Riyuzo Marcia Camegaçava , Caramori Jacqueline Costa Teixeira , de Andrade Luis Gustavo Modelli
Published: November 2023

Background

Mineral and bone disease in children with chronic kidney disease can cause abnormalities in calcium, phosphorus, parathyroid hormone, and vitamin D and when left untreated can result in impaired growth, bone deformities, fractures, and vascular calcification. Cinacalcet is a calcimimetic widely used as a therapy to reduce parathyroid hormone levels in the adult population, with hypocalcemia among its side effects. The analysis of safety in the pediatric population is questioned due to the scarcity of randomized clinical trials in this group.

Objective

To assess the onset of symptomatic hypocalcemia or other adverse events (serious or non-serious) with the use of cinacalcet in children and adolescents with mineral and bone disorder in chronic kidney disease.

Data sources and study eligibility criteria

The bibliographic search identified 2699 references from 1927 to August/2023 (57 LILACS, 44 Web of Science, 686 PubMed, 131 Cochrane, 1246 Scopus, 535 Embase). Four references were added from the bibliography of articles found and 12 references from the gray literature (Clinical Trials). Of the 77 studies analyzed in full, 68 were excluded because they did not meet the following criteria: population, types of studies, medication, publication types and 1 article that did not present results (gray literature).

Participants and interventions

There were 149 patients aged 0–18 years old with Chronic Kidney Disease and mineral bone disorder who received cinacalcet.

Study appraisal and synthesis methods

Nine eligible studies were examined for study type, size, intervention, and reported outcomes.

Results

There was an incidence of 0.2% of fatal adverse events and 16% of serious adverse events (p < 0.01 and I2 = 69%), in addition to 10.7% of hypocalcemia, totaling 45.7% of total adverse events.

Limitations

There was a bias in demographic information and clinical characteristics of patients in about 50% of the studies and the majority of the studies were case series.

Conclusions and implications of key findings

If used in the pediatric population, the calcimimetic cinacalcet should be carefully monitored for serum calcium levels and attention to possible adverse events, especially in children under 50 months.

Systematic review registration number (PROSPERO register)

CRD42019132809.
Spillover of an endemic avian Influenza H6N2 chicken lineage to ostriches and reassortment with clade 2.3.4.4b H5N1 high pathogenicity viruses in chickens
Authors: Abolnik Celia
Published: November 2023

Prior to 2017, chicken production in South Africa had only ever been affected by an endemic strain of H6N2 low pathogenic avian influenza (LPAI), but since 2017, an outbreak of Goose/Guangdong clade 2.3.4.4b H5N8 high pathogenicity avian influenza (HPAI) introduced by wild birds, followed by clade 2.3.4.4b H5N1 HPAI (2021-present), affected the country. In the present study, the viruses from seven cases of H6N2 LPAI from commercial poultry between October 2019 and August 2020 were genome-sequenced along with an H5N2 HPAI virus, and phylogenetic analysis was performed. The H5N2 HPAI virus caused localized outbreaks in a small-scale chicken farm and a large commercial layer farm in the KwaZulu-Natal province between late October and early December 2022. The phylogenetic results confirmed the first incidence of the chicken-adapted H6N2 lineage in commercial ostriches in the Western Cape province, with a likely epidemiological origin in chickens from the KwaZulu Natal province. The results also showed that the H5N2 HPAI virus was a novel reassortant of PB2, PB1, PA, NP and NA genome segments derived from a parental H6N2 virus that circulated in region, whereas the HA, M and NS genome segments were derived from sub-genotype SA10 H5N1 HPAI parental virus that had circulated in the local wild bird reservoir since July 2021.
Food waste in Indian households: status and potential solutions
Authors: Priya Samant Shant , Dixit Sushil Kumar , Kabiraj Sajal , Priya Meenu Shant
Published: November 2023

According to a report by the Food and Agriculture Organization (FAO), India had the highest number of undernourished people in the world in 2020. The COVID-19 pandemic further exacerbated the problem of world hunger (WHO 2021). According to the Food Waste Index Report, 2021, by United Nations Environment Programme (UNEP) and The Waste and Resources Action Programme (WRAP), 931 million tonnes of food waste was produced in 2019, with households accounting for 61%, food services for 26%, and retail for 13%. The report estimates that Indian households generate 50 kg of food waste per capita per year, resulting in total of 68,760,163 tonnes annually. This study aimed to investigate the reasons for food waste in Indian households and potential solutions to minimize or control food waste using interpretive phenomenological analysis. Reasons for food waste include miscalculations in meal preparation, a lack of appreciation for food, and a weakening of traditional Indian value systems. The study identified two potential solutions for controlling or eliminating food waste: exploring alternative methods of food consumption and enhancing the family culture surrounding food. The study results could potentially guide policymakers and planners in designing policies to address the problem of food waste in Indian households.
Zum Gebrauch von Kennzahlen als Controllinginstrument in Kommunalverwaltungen: eine soziologische Perspektive
Authors: Lindner Diana
Published: November 2023

Der Artikel verfolgt das Ziel, Quantifizierungspraktiken in Kommunalverwaltungen am Beispiel des Kennzahlengebrauchs der Controllingabteilungen zu untersuchen. Auf Basis von Interviews, Dokumenten und Beobachtungen wird der Aufbau neuen Steuerungswissens als kognitive, soziale und technische Kalkulationspraxis rekonstruiert. Unter Nachvollzug des Einsatzes unterschiedlicher Methoden der Kennzahlrechnung und Prognosearbeit wird gezeigt, wie sich Steuerungshoffnungen von der „internen Leistungsvermessung“ zur „externen Umweltbeobachtung“ verschoben haben.
Martin–Löf reducibility and cost functions
Authors: Greenberg Noam , Miller Joseph S. , Nies André , Turetsky Dan
Published: November 2023

Martin-Löf (ML)-reducibility compares the complexity of K-trivial sets of natural numbers by examining the Martin-Löf random sequences that compute them. One says that a K-trivial set A is ML-reducible to a K-trivial set B if every ML-random computing B also computes A. We show that every K-trivial set is computable from a c.e. set of the same ML-degree. We investigate the interplay between ML-reducibility and cost functions, which are used to both measure the number of changes in a computable approximation, and the type of null sets intended to capture ML-random sequences. We show that for every cost function there is a c.e. set that is ML-complete among the sets obeying it. We characterise the K-trivial sets computable from a fragment of the left-c.e. random real Ω given by a computable set of bit positions. This leads to a new characterisation of strong jump-traceability.
Fatigue and quality of life during neoadjuvant chemotherapy of early breast cancer: a prospective multicenter cohort study
Authors: Pelzer Florian , Tröger Wilfried , Reif Marcus , Schönberg Susanne , Martin David D. , Müller Cornelia , Utz-Billing Isabell , Kühn Thorsten , Baumgartner Stephan , Kiechle Marion , Paepke Daniela
Published: November 2023

Background

Few measurements of fatigue and quality of life have been performed during neoadjuvant chemotherapy of early breast cancer. This study evaluates fatigue and quality of life experienced by early breast cancer patients during neoadjuvant chemotherapy and their association with different clinical parameters.

Methods

Fifty-four stage I–III patients’ responses to the Multidimensional Fatigue Inventory (MFI) and to the Functional Assessment of Cancer Therapy-Breast (FACT-B) were analyzed by a linear covariance pattern model. Chemotherapy regimen, age, baseline fatigue level, body-mass-index and cancer stage were added to the model to estimate their impact on both outcomes.

Results

All fatigue dimensions worsened in clinically relevant levels. Physical fatigue worsened the most, mental fatigue the least. For quality of life, physical and functional well-being worsened the most. Only emotional well-being improved during chemotherapy. Physical well-being worsened more during standard than during dose-dense chemotherapy, and more during anthracycline than during taxane cycles. Age, body-mass-index and cancer stage had no impact. The higher the fatigue levels at baseline, the less they worsened during chemotherapy.

Conclusions

Further actions to reduce fatigue and improve quality of life during neoadjuvant chemotherapy of early breast cancer are needed. Focus should be laid on the physical dimension. Future research should also investigate the impact of different chemotherapy sequences and densities on fatigue and quality of life.

Study registration

The study was registered in the German Clinical Trials Register in May 2019 (DRKS00016761).
Concurrent activation and surface modification (CAM) process to produce surface-modified palm kernel shell-derived activated carbon (PKSdAC)
Authors: Lai Jia Yen , Chew Jiuan Jing , Ngu Lock Hei
Published: November 2023

Activated carbon production via chemical activation followed by surface functionalization with metal groups aims to achieve surface functionalization for CO2, aromatic/metallic organic compounds, and dye adsorption. The prepared activated carbon possesses a porous structure containing metal functional groups with adsorptive properties. This work proposed integrating two synthesis steps to simplify the process and reduce resources and impact. The preparation of palm kernel shell (PKS) derived AC (PKSdAC) through a concurrent activation and surface modification (CAM) process combines sulphuric acid (H2SO4) activation (5–10% mass loading) with barium chloride (BaCl2) modification (10 wt.%) at an activation temperature of 400–700 °C. The barium (Ba) is produced through the reduction process. Incorporating Ba into PKSdAC is vital to initiate chemical CO2 and other related component adsorption. The optimization study identified that 7.5% H2SO4, 10 wt.% BaCl2, and 700 °C was optimal in obtaining a high 1.50 wt.% Ba impregnated in PKSdAC. CAM-PKSdAC synthesized at optimal conditions exhibited a sponge-like cubic meso-microporous carbon structure containing BaSO4 crystals with a surface area of 420 and 423 m2 g−1 for its micropore and mesopore structure. A total pore volume of 0.19 cm3 g−1 and an average pore diameter of 1.78 nm were achieved. Conventional surface modified-activated PKSdAC prepared at optimal conditions has a cubic porous structure and a crack surface containing little BaSO4 crystals with a higher surface area of 565 m2 g−1 and total pore volume of 0.18 cm3 g−1 and an average pore diameter of 1.27 nm.
Biosynthesis of selenium nanoparticles by potential endophytic fungi Penicillium citrinum and Rhizopus arrhizus: characterization and maximization
Authors: Gharieb Mohamed M. , Soliman Azza. M. , Omara Mohamed S.
Published: November 2023

Fungal-mediated biosynthesis of selenium nanoparticles (SeNPs) is one of the promising biological-based nanomanufacturing process. On the other hand, the use of endophytic fungi in this respect has emerged as a new approach for green and cost-effective production of several nanoparticles. In the present study, two endophytic fungal isolates, identified as Penicillium citrinum and Rhizopus arrhizus morphologically and genetically using the ITS rRNA- gene. These fungal strains exhibited tolerance up to 40 mM NaSeO3 accompanied with red coloration of the medium that suggested selenite reduction and formation of selenium nanoparticles (SeNPs). The reduced selenite was quantified using inductively coupled plasma mass spectrometry (ICP-MS), and the results revealed that these fungi under the optimum growth conditions are able to transform > 99.0% of 3.0 mM selenite into elemental selenium. The crystalline structure, particle-sized distribution, and morphology of the purified selenium particles were extracted and characterized by different techniques including UV–Vis, X-ray diffraction and high-resolution transmission electron microscopy. The results indicated the production of regular spherical shapes of SeNPs with a majority of average size between 50 and 80 nm. Fourier transform infrared spectroscopy (FT-IR) of the produced particles revealed the presence of different functional groups that would be implicated in the synthesis process as bioreducers and capping agents. The results of optimum growth conditions revealed that the higher fungal growth resulted in the higher selenite reduction activity. Sabouraud’s and yeast extract-peptone-glucose (YPG) broth media are the best media for maximum growth of P. citrinum and R. arrhizus, respectively, and synthesis of SeNPs. The best carbon sources are sucrose and starch while NH4NO3 and NH4Cl are the best nitrogen sources for growth and synthesis of SeNPs by the fungal strains. Selenite reduction and biosynthesis of SeNPs by the fungi seemed to increase with increasing pH and maximized at alkaline pH value (9.0) being 97.94 and 97.13% for P. citrinum and R. arrhizus respectively. Initial selenite concentration markedly influenced SeNP production and the maximum rates were 96.94 and 98.47% recorded at 3.0 mM selenite for both fungi. In conclusion, the results were discussed in relation to the potentiality of these endophytic fungi for biosynthesis of SeNPs, and the favorable nutritional conditions for maximum production.
An investigation of the effects of ironing parameters on the surface and compression properties of material extrusion components utilizing a hybrid-modeling experimental approach
Authors: Kechagias John D. , Zaoutsos Stephanos P.
Published: November 2023

Thermoplastic filament Material Extrusion (ME) is one of the most expansive 3D printing processes. Owed to the ME process’s simplicity, low cost of materials, popularity, and flexibility, considerable attention has been devoted to manufacturing specific parts in industries manipulating the polylactic acid (PLA) polymer, such as automotive and biomedical. This work aims to experimentally investigate the material flow and temperature for different layer heights on the surface texture parameters and compression strength of a tailored PLA hexagonal prismatic part. An experimental approach based on L9 Taguchi’s array and residual analysis (ANOVA) was employed to clarify the parameters’ effects and trends regarding the response variables. The analysis of means showed that the material flow and layer height are critical variables in defining ME parts’ roughness and compression. Based on ANOVA and mean absolute percentage errors (MAPE) results, additive models (ADMO) were used to predict all combinatorial response values. Then, the experimental and the ADMO values feed as trained data for developing a feed-forward back-propagation neural network (FFBP-NN). Three independent experiments confirmed the validity of the proposed methodology resulting in reasonable accuracy of all the performance metrics, making the proposed hybrid-modeling approach adequate for process multi-parameter multi-objective optimization 3D printing cases.
Resilience Misunderstood? Commenting on Germany’s National Security Strategy
Authors: Scharte Benjamin
Published: November 2023

Resilience features prominently in the new German National Security Strategy. But the strategy does not give an explicit definition of the term. In this commentary, I analyze the use of resilience in the strategy and show the links to prominent findings from resilience research. I use a disaster resilience point of view and show that the unspecific usage of resilience in the strategy could lead to undesirable consequences when implementing the strategy. Thus, in the implementation process the German government and the relevant public administration bodies should follow three recommendations resulting from resilience research. First, they should understand resilience as adaptive capacity and not as resistance. Second, they need to address conflicting goals, like efficiency versus resilience, explicitly. Third, they should give greater attention to social aspects of resilience, because empowering people but also taking their vulnerabilities seriously is decisive for making a society more resilient.
Attrition in Psychological mHealth Interventions for Young People: A Meta-Analysis
Authors: Prior Elise , Dorstyn Diana , Taylor Amanda , Rose Alice
Published: November 2023

Psychological interventions provided via mobile, wireless technological communication devices (mHealth) are a promising method of healthcare delivery for young people. However, high attrition is increasingly recognised as a challenge to accurately interpreting and implementing the findings of mHealth trials. The present meta-analysis consolidates this research and investigates potential methodological, sociodemographic, and intervention moderators of attrition. A systematic search of MEDLINE, PsycInfo, and Embase was conducted. Study reporting quality was evaluated (QualSyst tool), and attrition rates (proportions) were calculated and pooled, using both random- and mixed-effects models. The pooled attrition rate, sourced from 15 independent samples (Nparticipants = 1766), was 17% (CI [9.14, 30.13]). This increased to 26% (CI [15.20, 41.03]) when adjusting for publication bias. Attrition was significantly higher among application-based interventions (26%, CI [14.56, 41.86]) compared to those delivered via text or multimedia message (6%, CI [1.88, 16.98]). These data were, however, characterised by significant between-study variance. Attrition in mHealth trials with young people is common but may be mitigated by using message-based interventions. Taken together, the results can provide guidance in accounting for attrition across future mHealth research, clinical practice, public policy, and intervention design. However, sustained research focus on the effectiveness of different engagement strategies is needed to realise mHealth’s promise of equitable and efficient healthcare access for young people globally.
Trustworthy Healthcare Cloud Storage Auditing Scheme (TCSHAS) with blockchain-based incentive mechanism
Authors: Bose Rajesh , Sutradhar Shrabani , Bhattacharyya Debnath , Roy Sandip
Published: November 2023

The Trustworthy Healthcare Cloud Storage Auditing Scheme (TCSHAS) represents a progressive solution for resolving trust-related issues linked to third-party auditors (TPAs) within traditional healthcare cloud storage audit systems. As the healthcare industry increasingly relies on cloud storage, concerns surrounding security and privacy have grown, motivating the development of a unique incentive mechanism. This mechanism leverages the non-tamperable and traceable features of blockchain technology to encourage TPAs to uphold honesty and reliability. By organizing TPAs as a group of nodes on the blockchain, a system of mutual surveillance is established, enabling diligent monitoring and penalization of any malicious actions. TCSHAS encompasses a comprehensive system model that incorporates smart contracts to manage transaction-related matters, including dispute resolution. Performance evaluations have confirmed its efficiency and suitability for real-world healthcare applications. Our experiments demonstrate that TCSHAS performs well in terms of gas consumption and exhibits scalability as the number of participant’s increases. Compared with other common smart contracts, TCSHAS maintains a balanced level of complexity, incorporates strong security measures, offers comprehensive auditing capabilities, and remains flexible. To further enhance our research, we can explore ways to optimize TCSHAS scalability and performance, such as through shading, as the volume of healthcare data continues to grow. In addition, we can investigate the integration of advanced privacy technologies or AI-based auditing. These advancements will reinforce the role of TCSHAS in establishing trust and security in healthcare cloud storage audits, making it highly relevant in real-world healthcare settings. Ultimately, TCSHAS contributes to improving trust and security in healthcare cloud storage auditing, ensuring responsible management of sensitive healthcare data.
Inference for Type-I and Type-II Hybrid Censored Minimal Repair and Record Data
Authors: Berzborn Moritz , Cramer Erhard
Published: November 2023

In this paper, hybrid censoring mechanisms are applied to minimal repair and record data. Based on the derivation of the joint distribution of such data under hybrid censoring, likelihood inference is discussed. For illustration, Type-I and Type-II hybrid censoring schemes are considered for exponential distributions. In particular, the exact (conditional) distribution of the maximum likelihood estimator is obtained for an exponential distribution. This result is used to construct exact (conditional) confidence intervals using the method of pivoting the cumulative distribution function. Finally, the results are illustrated using two data sets taken from the literature on minimal repair models. Although the discussion of the results is in terms of minimal repair models, the results can be applied directly to record value data. By utilizing a connection of minimal repair times to occurrence times of non-homogeneous Poisson processes, a nonparametric estimate for the intensity rate of the process and the underlying lifetime distribution under hybrid censoring is also proposed. The paper is supplemented by simulational results.
3D anatomical modelling and analysis of the spine
Authors: Paccini Martina , Patané Giuseppe , Spagnuolo Michela
Published: November 2023

Purpose

This work proposes 3D modelling and patient-specific analysis of the spine by integrating information on the tissues with geometric information on the spine morphology.

Methods

The paper addresses the extraction of 3D patient-specific models of each vertebra and the intervertebral space from 3D CT images, the segmentation of each vertebra in its three functional regions, and the analysis of the tissue condition in the functional regions based on geometrical parameters.

Results

Main results are the localisation, visualisation, quantitative, and qualitative analysis of possible damages for surgery planning and early diagnosis or follow-up studies.

Conclusions

The framework properties are discussed in terms of the spine’s morphology and pathologies on the spine district’s benchmarks.
Managing unwarranted variation in hospital care – findings from a regional audit in Norway
Authors: Eide H. P. , Barach P. , Søreide E. , Thoresen C. , Tjomsland O.
Published: November 2023

Background/Aim

There has been increasing focus and research over the past decades on defining, identifying, visualizing and reducing unwarranted clinical variation in clinical practice. Both clinician-driven initiatives such as the US based “Choosing Wisely” campaign and the top-down driven “Evidence-based intervention programme (EBI)” launched by NHS UK to improve quality of care by reducing unnecessary interventions have shown marginal results. We present the findings from a mixed-methods audit performed to evaluate the compliance by senior hospital leaders of a new regional strategy to reduce unwarranted variation in outcomes and utilization rates.

Methods

Seventy-five mid- to senior-division and department leaders from eight hospital trusts in South-Eastern Norway Regional Trust (HSO) were invited to participate in evaluating the response and compliance of the regional leadership strategy for reducing unwarranted variation in patient outcomes and service utilization rates.

Results

The audit revealed that the aim of reducing unwanted variation was not clearly communicated by senior HSO management. There was varying use of data from the national quality registers and health atlases for quality improvement. One third of the clinical leaders reported a lack of scrutiny of their work and were insufficiently aware of the HSO’s top-management and the hospital’s Boards strategic expectations about the importance of reducing unwarranted variation in their hospital utilization.

Conclusions

We found that the strategic aim of reducing unwanted clinical variation was not clearly communicated by senior HSO management to hospital boards and senior management.

The hospitals could benefit from a better understanding of causes of variation by strengthening their efforts to reduce unwarranted variation in utilization rates as a key element in improving health care quality and patient safety. The findings of the audit are relevant for other healthcare organizations trying to improve their quality and reduce unnecessary variation.
Attractor Inspired Deep Learning for Modelling Chaotic Systems
Authors: Dutta Anurag , Harshith John , Ramamoorthy A. , Lakshmanan K.
Published: November 2023

Predicting and understanding the behavior of dynamic systems have driven advancements in various approaches, including physics-based models and data-driven techniques like deep neural networks. Chaotic systems, with their stochastic nature and unpredictable behavior, pose challenges for accurate modeling and forecasting, especially during extreme events. In this paper, we propose a novel deep learning framework called Attractor-Inspired Deep Learning (AiDL), which seamlessly integrates actual statistics and mathematical models of system kinetics. AiDL combines the strengths of physics-informed machine learning and data-driven methods, offering a promising solution for modeling nonlinear systems. By leveraging the intricate dynamics of attractors, AiDL bridges the gap between physics-based models and deep neural networks. We demonstrate the effectiveness of AiDL using real-world data from various domains, including catastrophic weather mechanics, El Niño cycles, and disease transmission. Our empirical results showcase AiDL’s ability to substantially enhance the modeling of extreme events. The proposed AiDL paradigm holds promise for advancing research in Time Series Prediction of Extreme Events and has applications in real-world chaotic system transformations.