bluuebunny/crossref_metadata_2025 huggingface dataset:
Retrograde intramedullary nail fixation with oblique fixed angle screws versus locking plates in periprosthetic supracondylar fractures after total knee arthroplasty
Authors: Rudolph Franziska , Brand Alexander G. , Osterhoff Georg , Kleber Christian , Roth Andreas , Fakler Johannes K. M.
Published: May 2024

Purpose

Common surgical procedures in the treatment of periprosthetic distal femur fractures (PPFF) include osteosynthesis with fixed angle locking plates (LP) and retrograde intramedullary nails (RIN). This study aimed to compare LPs to RINs with oblique fixed angle screws in terms of complications, radiographic results and functional outcome.

Methods

63 PPFF in 59 patients who underwent treatment in between 2009 and 2020 were included and retrospectively reviewed. The anatomic lateral and posterior distal femoral angle (aLDFA and aPDFA) were measured on post-surgery radiographs. The Fracture Mobility Score (FMS) pre- and post-surgery, information about perceived instability in the operated leg and the level of pain were obtained via a questionnaire and previous follow-up (FU) examinations in 30 patients (32 fractures).

Results

The collective (median age: 78 years) included 22 fractures treated with a RIN and 41 fractures fixed with a LP. There was no difference in the occurrence of complications (median FU: 21.5 months) however the rate of implant failures requiring an implant replacement was higher in fractures treated with a LP (p = 0.043). The aPDFA was greater in fractures treated with a RIN (p = 0.04). The functional outcome was comparable between both groups (median FU: 24.5 months) with a lower outcome in the post-surgery FMS (p =  < 0.001).

Conclusion

Fractures treated with RIN resulted in an increased recurvation of the femur however the rate of complications and the functional outcome were comparable between the groups. The need for implant replacements following complications was higher in the LP group.
Controversy on health-based guidance values for bisphenol A—the need of criteria for studies that serve as a basis for risk assessment
Authors: Leist Marcel , Buettner Andrea , Diel Patrick , Eisenbrand Gerhard , Epe Bernd , Först Petra , Grune Tilman , Haller Dirk , Heinz Volker , Hellwig Michael , Humpf Hans-Ulrich , Jäger Henry , Kulling Sabine E. , Mally Angela , Marko Doris , Nöthlings Ute , Röhrdanz Elke , Spranger Joachim , Vieths Stefan , Wätjen Wim , Hengstler Jan G.
Published: May 2024

Since 2006, the responsible regulatory bodies have proposed five health-based guidance values (HBGV) for bisphenol A (BPA) that differ by a factor of 250,000. This range of HBGVs covers a considerable part of the range from highly toxic to relatively non-toxic substances. As such heterogeneity of regulatory opinions is a challenge not only for scientific risk assessment but also for all stakeholders, the Senate Commission on Food Safety (SKLM) of the German Research Foundation (DFG) analyzed the reasons for the current discrepancy and used this example to suggest improvements for the process of HBGV recommendations. A key aspect for deriving a HBGV is the selection of appropriate studies that allow the identification of a point of departure (PoD) for risk assessment. In the case of BPA, the HBGV derived in the 2023 EFSA assessment was based on a study that reported an increase of Th17 cells in mice with a benchmark dose lower bound (BMDL40) of 0.53 µg/kg bw/day. However, this study does not comply with several criteria that are important for scientific risk assessment: (1) the selected end-point, Th17 cell frequency in the spleen of mice, is insufficiently understood with respect to health outcomes. (2) It is unclear, by which mechanism BPA may cause an increase in Th17 cell frequency. (3) It is unknown, if an increase of Th17 cell frequency in rodents is comparably observed in humans. (4) Toxicokinetics were not addressed. (5) Neither the raw data nor the experimental protocols are available. A further particularly important criterion (6) is independent data confirmation which is not available in the present case. Previous studies using other readouts did not observe immune-related adverse effects such as inflammation, even at doses orders of magnitude higher than in the Th17 cell-based study. The SKLM not only provides here key criteria for the use of such studies, but also suggests that the use of such a “checklist” requires a careful and comprehensive scientific judgement of each item. It is concluded that the Th17 cell-based study data do not represent an adequate basis for risk assessment of BPA.
Comparison of data processing strategies using commercial vs. open-source software in GC-Orbitrap-HRMS untargeted metabolomics analysis for food authentication: thyme geographical differentiation and marker identification as a case study
Authors: Rivera-Pérez Araceli , Garrido Frenich Antonia
Published: May 2024

Untargeted analysis of gas chromatography–high-resolution mass spectrometry (GC-HRMS) data is a key and time-consuming challenge for identifying metabolite markers in food authentication applications. Few studies have been performed to evaluate the capability of untargeted data processing tools for feature extraction, metabolite annotation, and marker selection from untargeted GC-HRMS data since most of them are focused on liquid chromatography (LC) analysis. In this framework, this study provides a comprehensive evaluation of data analysis tools for GC-Orbitrap-HRMS plant metabolomics data, including the open-source MS-DIAL software and commercial Compound Discoverer™ software (designed for Orbitrap data processing), applied for the geographical discrimination and search for thyme markers (Spanish vs. Polish differentiation) as the case study. Both approaches showed that the feature detection process is highly affected by unknown metabolites (Levels 4–5 of identification confidence), background signals, and duplicate features that must be carefully assessed before further multivariate data analysis for reliable putative identification of markers. As a result, Compound Discoverer™ and MS-DIAL putatively annotated 52 and 115 compounds at Level 2, respectively. Further multivariate data analysis allowed the identification of differential compounds, showing that the putative identification of markers, especially in challenging untargeted analysis, heavily depends on the data processing parameters, including available databases used during compound annotation. Overall, this method comparison pointed out both approaches as good options for untargeted analysis of GC-Orbitrap-HRMS data, and it is presented as a useful guide for users to implement these data processing approaches in food authenticity applications depending on their availability.

Graphical Abstract
Quantum No-signalling Correlations and Non-local Games
Authors: Todorov Ivan G. , Turowska Lyudmila
Published: May 2024

We introduce and examine three subclasses of the family of quantum no-signalling (QNS) correlations introduced by Duan and Winter: quantum commuting, quantum and local. We formalise the notion of a universal TRO of a block operator isometry, define an operator system, universal for stochastic operator matrices, and realise it as a quotient of a matrix algebra. We describe the classes of QNS correlations in terms of states on the tensor products of two copies of the universal operator system and specialise the correlation classes and their representations to classical-to-quantum correlations. We study various quantum versions of synchronous no-signalling correlations and show that they possess invariance properties for suitable sets of states. We introduce quantum non-local games as a generalisation of non-local games. We define the operation of quantum game composition and show that the perfect strategies belonging to a certain class are closed under channel composition. We specialise to the case of graph colourings, where we exhibit quantum versions of the orthogonal rank of a graph as the optimal output dimension for which perfect classical-to-quantum strategies of the graph colouring game exist, as well as to non-commutative graph homomorphisms, where we identify quantum versions of non-commutative graph homomorphisms introduced by Stahlke.
Intracranial arterial calcification in patients with unruptured and ruptured intracranial aneurysms
Authors: Kamphuis Maarten J. , van der Kamp Laura T. , Lette Edwin , Rinkel Gabriel J. E. , Vergouwen Mervyn D. I. , van der Schaaf Irene C. , de Jong Pim A. , Ruigrok Ynte M.
Published: May 2024

Objectives

Arterial calcification is thought to protect against rupture of intracranial aneurysms, but studies in a representative population of intracranial aneurysm patients have not yet been performed. The aim was to compare the prevalence of aneurysm wall calcification and intracranial carotid artery calcification (ICAC) between patients with an unruptured intracranial aneurysm (UIA) and a ruptured intracranial aneurysm (RIA).

Materials and methods

We matched 150 consecutive UIA patients to 150 RIA patients on age and sex. Aneurysm wall calcification and ICAC were quantified on non-contrast enhanced computed tomography images with the modified Agatston score. We compared the prevalence of aneurysm wall calcification, ICAC, and severe ICAC (defined as a modified Agatston score in the fourth quartile) between UIA and RIA patients using univariate and multivariate conditional logistic regression models adjusted for aneurysm characteristics and cardiovascular risk factors.

Results

Aneurysm wall calcification was more prevalent in UIA compared to RIA patients (OR 5.2, 95% CI: 2.0–13.8), which persisted after adjustment (OR 5.9, 95% CI: 1.7–20.2). ICAC prevalence did not differ between the two groups (crude OR 0.9, 95% CI: 0.5–1.8). Severe ICAC was more prevalent in UIA patients (OR 2.0, 95% CI: 1.1–3.6), but not after adjustment (OR 1.0, 95% CI: 0.5–2.3).

Conclusions

Aneurysm wall calcification but not ICAC was more prevalent in UIAs than in RIAs, which corresponds to the hypothesis that calcification may protect against aneurysmal rupture. Aneurysm wall calcification should be further assessed as a predictor of aneurysm stability in prospective cohort studies.

Clinical relevance statement

Calcification of the intracranial aneurysm wall was more prevalent in unruptured than ruptured intracranial aneurysms after adjustment for cardiovascular risk factors. Calcification may therefore protect the aneurysm against rupture, and aneurysm wall calcification is a candidate predictor of aneurysm stability.

Key Points

Aneurysm wall calcification was more prevalent in patients with unruptured than ruptured aneurysms, while internal carotid artery calcification was similar.

Aneurysm wall calcification but not internal carotid artery calcification is a candidate predictor of aneurysm stability.

Cohort studies are needed to assess the predictive value of aneurysm wall calcification for aneurysm stability.

Graphical Abstract
Neodymium (III)-containing poly(lactide-co-glycolide)-coated robocast bioactive glass scaffolds for photothermal therapy and bone regeneration
Authors: Deliormanlı Aylin M.
Published: May 2024

In this study, trivalent neodymium-doped silicate-based 13–93 bioactive glass scaffolds were prepared by the robocasting method using sol-gel-derived bioactive glass powders for tissue engineering applications. Sintered scaffolds were coated by borate-based 13-93B3 bioactive glass-containing polylactide-co-glycolide solution. The produced composite scaffolds’ mechanical, morphological, and structural characteristics were thoroughly examined, as their in vitro bioactivity in cell culture media and simulated body fluid. Furthermore, the scaffolds’ amoxicillin adsorption and release behavior was examined over time. The outcomes demonstrated that it was feasible to effectively create periodic, mesh-like-patterned robocast glass scaffolds utilizing Nd3+-doped sol-gel-derived bioactive glass powders. The scaffolds’ compressive strengths ranged from 10.02 MPa to 18.6 MPa, with the PLGA-coated scaffolds exhibiting the highest strength values. All of the scaffolds that were submerged in simulated body fluid for 28 days showed hydroxyapatite formation. The presence of borate glass on the surface of the silicate-based glass scaffolds improved the hydroxyapatite formation ability. The quantity of drug adsorption for all types of scaffolds was measured to be between 4 and 9% whereas the cumulative drug release was in the range of 58 to 96%. Borate glass particle-containing PLGA coating enhanced the drug delivery behavior.
Vaskulitis der Retina
Authors: zur Bonsen Lynn , Rübsam Anne , Knecht Vitus , Pleyer Uwe
Published: May 2024

Entzündliche Veränderungen der Netzhautgefäße können auf ein breites Spektrum von Ursachen zurückgeführt werden. Dazu zählen Infektionen, intraokulare und systemische Autoimmunprozesse, Allgemeinerkrankungen sowie iatrogene Faktoren. Da das Endothel der Retinakapillaren die innere Blut-Retina-Schranke bildet, ist eine Störung dieser Struktur unmittelbar mit Konsequenzen für den Flüssigkeitselektrolythaushalt der Netzhaut verbunden. Als klinische Folgen können sich Leckagen der Netzhautgefäße und Makulaödem einstellen, die oft funktionell bedrohlich sind und die Lebensqualität der Patienten bedeutend einschränken. Da das Auge als „Indexorgan“ betroffen sein kann, kommt der Abklärung des Patienten durch den Ophthalmologen eine wichtige Bedeutung zu. Im Zeitalter der „Präzisionsmedizin“ bestehen Anstrengungen, neue Erkenntnisse über die pathogenetischen Mechanismen der Vaskulitis durch „‑Omics“ zu erlangen, um innovative Behandlungskonzepte zu entwickeln.
Arc Connectivity and Submodular Flows in Digraphs
Authors: Abdi Ahmad , Cornuéjols Gérard , Zambelli Giacomo
Published: May 2024

Let $$D=(V,A)$$

D
=
(
V
,
A
)

be a digraph. For an integer $$k\ge 1$$

k
≥
1

, a k-arc-connected flip is an arc subset of D such that after reversing the arcs in it the digraph becomes (strongly) k-arc-connected. The first main result of this paper introduces a sufficient condition for the existence of a k-arc-connected flip that is also a submodular flow for a crossing submodular function. More specifically, given some integer $$\tau \ge 1$$

τ
≥
1

, suppose $$d_A^+(U)+(\frac{\tau }{k}-1)d_A^-(U)\ge \tau $$

d
A
+

(
U
)

+

(

τ
k

-
1
)

d
A
-

(
U
)

≥
τ

for all $$U\subsetneq V, U\ne \emptyset $$

U
⊊
V
,
U
≠
∅

, where $$d_A^+(U)$$

d
A
+

(
U
)

and $$d_A^-(U)$$

d
A
-

(
U
)

denote the number of arcs in A leaving and entering U, respectively. Let $${\mathcal {C}}$$
C
be a crossing family over ground set V, and let $$f:{\mathcal {C}}\rightarrow {\mathbb {Z}}$$

f
:
C
→
Z

be a crossing submodular function such that $$f(U)\ge \frac{k}{\tau }(d_A^+(U)-d_A^-(U))$$

f

(
U
)

≥

k
τ

(

d
A
+

(
U
)

-

d
A
-

(
U
)

)

for all $$U\in {\mathcal {C}}$$

U
∈
C

. Then D has a k-arc-connected flip J such that $$f(U)\ge d_J^+(U)-d_J^-(U)$$

f

(
U
)

≥

d
J
+

(
U
)

-

d
J
-

(
U
)

for all $$U\in {\mathcal {C}}$$

U
∈
C

. The result has several applications to Graph Orientations and Combinatorial Optimization. In particular, it strengthens Nash-Williams’ so-called weak orientation theorem, and proves a weaker variant of Woodall’s conjecture on digraphs whose underlying undirected graph is $$\tau $$
τ
-edge-connected. The second main result of this paper is even more general. It introduces a sufficient condition for the existence of capacitated integral solutions to the intersection of two submodular flow systems. This sufficient condition implies the classic result of Edmonds and Giles on the box-total dual integrality of a submodular flow system. It also has the consequence that in a weakly connected digraph, the intersection of two submodular flow systems is totally dual integral.
Imaging of cerebrovascular complications from blunt skull base trauma
Authors: Bai James , Ismail Rahim , Kessler Alex , Kawakyu-O’Connor Daniel
Published: May 2024

Cerebrovascular complications from blunt trauma to the skull base, though rare, can lead to potentially devastating outcomes, emphasizing the importance of timely diagnosis and management. Due to the insidious clinical presentation, subtle nature of imaging findings, and complex anatomy of the skull base, diagnosing cerebrovascular injuries and their complications poses considerable challenges. This article offers a comprehensive review of skull base anatomy and pathophysiology pertinent to recognizing cerebrovascular injuries and their complications, up-to-date screening criteria and imaging techniques for assessing these injuries, and a case-based review of the spectrum of cerebrovascular complications arising from skull base trauma. This review will enhance understanding of cerebrovascular injuries and their complications from blunt skull base trauma to facilitate diagnosis and timely treatment.
University teachers’ perspectives on student attendance: a challenge to the identity of university teachers before, during and after Covid-19
Authors: Detoni Mateus , Allan Arlene , Connelly Sean , Summerfield Tina , Townsend Sheena , Shephard Kerry
Published: May 2024

This article addresses university teachers’ perspectives, gathered via interviews, on issues involved in their students’ decreasing attendance in formal taught-events, before and during the pandemic, and the implications of this for university teaching in the future. The research was part of a broad enquiry into learning and teaching during the Covid-19 pandemic, conducted in one research-led university in New Zealand by a research team of 19 university academics from multiple departments in this institution. We undertook 11 semi-structured interviews with eight professors, one lecturer and two teaching fellows, anonymous to all but the interviewer. A sub-group (authors of this article) used a general inductive approach to seek an underlying structure of experiences evident in participants’ interviews, in the form of emergent and reoccurring themes in the data. Self-determination theory was used as a theoretical framework for analysis. Themes suggest that university teachers may be stressed about attendance, increasingly uncertain about the links between how they teach and what and how students learn, and feel personally rather than collectively responsible as they address matters that they perceive to be only partially under their control. Researchers concluded that interviewed teachers may be collectively experiencing some form of crisis of confidence relating to their roles, responsibilities and identity as university teachers. Although perceptions of limited autonomy, relatedness and competence all suggest solutions at the institutional level, their combination and link to generic academic identity suggests that Covid-19 may have exposed broader limitations in university teaching as a collegiate, rather than professional, activity.
We Might Have a Sports Gambling Problem and It Is Not What You Think: A Commentary
Authors: Whelan James P. , Pfund Rory A. , Ginley Meredith K.
Published: May 2024

The 2018 Supreme Court decision on Murphy v. National Collegiate Athletic Association brought not only a change in the United States commercial gambling landscape, but also considerable speculation across public forums about whether expanded sports gambling causes new, distinct, and greater harm than existing legal forms of gambling. This commentary brings into the focus that the definition of this form of gambling has recently begun to shift without a theoretical basis or empirical evidence. To bring evidence to bear, there is a need for a precise operational definition of sport gambling and greatly clarity to the questions that can drive knowledge generation.
Investigation of Gambling Behavior, Self-Confidence and Psychological Resilience Levels of University Students
Authors: Duran Songul , Demirci Özlem , Akgenç Filiz
Published: May 2024

The aim of this study is to examine the relationship between gambling behavior, self-confidence, and psychological resilience levels among university students. Additionally, the study aims to investigate the relationship between gambling behavior and socio-demographic variables. This descriptive and cross-sectional study was conducted between April and June 2023. The research employed a questionnaire, the Brief Psychological Resilience Scale, the South Oaks Gambling Screen (SOGS), and the Self-Confidence Scale. The study was carried out online, reaching 229 students through Google Forms. According to the SOGS scores, 4.8% of the students are at risk of gambling addiction. Male students have statistically significantly higher SOGS scores than female students. The SOGS score is significantly higher in working students, smokers, and alcohol drinkers (p < 0.05). No statistically significant relationship was found between the students’ SOGS scores and the self- confidence scale (p = 0.637) and the brief resilience scale (p = 0.675). It is thought that training should be given to risky groups in order to prevent gambling behavior. In addition, it is thought that supporting university students to be active in different arts and sports fields may have a positive effect on preventing and reducing addictions.
New criteria for sustainable land use planning of metropolitan green infrastructures in the tropical Andes
Authors: LaRota-Aguilera María José , Zapata-Caldas Emmanuel , Buitrago-Bermúdez Oscar , Marull Joan
Published: May 2024

Context

Urbanization is rapidly increasing worldwide, with about 60% of the global population currently residing in cities and expected to reach 68% by 2050. In Latin America's tropical Andes region, managing these changes poses challenges, including biodiversity loss and vulnerability to climate change.

Objectives

This study assesses urban growth and agricultural intensification impacts on the ecological functionality of metropolitan green infrastructures and their capacity to provide ecosystem services using a landscape sustainability and sociometabolic approach. Specifically, it aims to identify landscape configurations promoting socio-ecological sustainability amidst rapid urbanization.

Methods

A landscape-metabolic model (IDC) was applied to evaluate the interactions between land use changes and ecosystem functions in the metropolitan region of Cali.

Results

Agricultural intensification and industrialization, coupled with uncontrolled urban growth, have significantly transformed the landscape, posing threats to its sustainability. The prevailing biocultural landscapes hold a substantial potential to provide essential ecosystem services to the metropolis. The IDC offers an approach that utilizes a land cover map and agricultural production/metabolism data to calculate an indicator closely related to ecosystem services and multifunctionality.

Conclusions

The IDC model stands out for efficiently capturing landscape dynamics, providing insights into landscape configuration and social metabolism without extensive resource requirements. This research highlights the importance of adopting a landscape-metabolic and green infrastructure framework to guide territorial policies in the tropical Andes and similar regions. It stresses the need for informed land use planning to address challenges and leverage opportunities presented by biocultural landscapes for regional sustainability amidst rapid urbanization and agricultural expansion.
Temporal variability of sinkhole hazard illustrated in the western shore of the Dead Sea
Authors: Sevil Jorge , Gutiérrez Francisco
Published: May 2024

The growing economic and societal damage caused by sinkhole activity worldwide requires the development of scientifically sound sinkhole hazard assessment approaches. Currently, there is a striking paucity of quantitative sinkhole hazard studies largely related to the incompleteness of sinkhole inventories and the lack of chronological data. Moreover, the probability of occurrence of sinkholes (i.e., sinkhole hazard) is commonly considered as a steady variable, a concept that may lead to significant hazard over- or under-estimates. The extraordinarily high frequency of sinkhole occurrence of the studied sector of the western shore of the Dead Sea has allowed us to explore for the first time the potential temporal variability of sinkhole hazard parameters. Here, we produced six multi-temporal sinkhole inventories with morphometric data between 2005 and 2021 using remote-sensed imagery. The frequency-size relationships generated for successive time intervals with a total of 667 new sinkholes reveal substantial temporal changes in the sinkhole hazard components (i.e., frequency and size). Moreover, the work illustrates that spatial redundancy (sinkholes nested within or intersecting pre-existing ones) can lead to significant hazard overestimates if not considered, especially in areas with high sinkhole density and clustering. This work discusses the limitations of some widely used methods and concepts for sinkhole hazard assessment and illustrates the advantages of detailed multi-temporal mapping for assessing frequency-size relationships and their temporal trends.
Efficient estimation of true fixed-effects stochastic frontier models
Authors: Bellio Ruggero , Grassetti Luca
Published: May 2024

Fixed-effects modeling has become the method of choice in several panel data settings, including models for stochastic frontier analysis. A notable instance of stochastic frontier panel data models is the true fixed-effects model, which allows disentangling unit heterogeneity from efficiency evaluations. While such a model is theoretically appealing, its estimation is hampered by incidental parameters. This note proposes a simple and rather general estimation approach where the unit-specific intercepts are integrated out of the likelihood function. We apply the theory of composite group families to the model of interest and demonstrate that the resulting integrated likelihood is a marginal likelihood with desirable inferential properties. The derivation of the result is provided in full, along with some connections with the existing literature and computational details. The method is illustrated for three notable models, given by the normal-half normal model, the heteroscedastic exponential model, and the normal-gamma model. The results of simulation experiments highlight the properties of the methodology.
Running-in Period During Sliding Wear of Austenitic Steels
Authors: Zambrano O. A. , Iglesias-Guerrero B. , Rodríguez S. A. , Coronado J. J.
Published: May 2024

The running-in period during dry sliding wear might determine the evolution to steady-state wear behaviour. To this end, the running-in period during sliding wear of austenitic stainless steel, AISI 316L stainless steel, and Hadfield steel were studied through the testing pin (flat-ended)-on-disk configuration. The effects of the normal load, sliding speed, and alloy type were assessed, and the specific wear rate and strain hardening characteristics were determined. The wear rate was correlated with wear mechanism, friction coefficient, hardening, and roughness to characterize the changes occurring during the running-in period. These changes could influence the responses of these materials to wear during the steady-state period. The stabilization of the specific wear rate and hardness was noted to align with the end of the running-in period.

Graphical Abstract
Influence of Lubricated Rolling/Sliding Tribotesting on Hydrogen Trapping in 100Cr6 Bearing Steel
Authors: Weniger Lisa-Marie , Sefer Birhan , Pelcastre Leonardo , Åkerfeldt Pia , Hardell Jens
Published: May 2024

As hydrogen reduces the fatigue life of 100Cr6 bearing steel significantly, extensive research on the interaction of hydrogen with 100Cr6 is necessary. This study investigated the influence of rolling/sliding tribotesting performed on a micro-pitting-rig on the hydrogen absorption and trapping behaviour of 100Cr6 bearing steel. Thermal desorption mass spectrometry was used to compare the hydrogen desorption spectra of 100Cr6 samples after tribological tests and static heated oil-immersion tests to untested reference samples. The approach was chosen to further understand the influence of both microstructural deformation as well as steel-oil contact on the hydrogen absorption and trapping behaviour of 100Cr6. The tribological test showed a stable friction behaviour and mild wear which was dominated by local plastic deformation of surface asperities. Despite the mild wear, a change in de-trapping temperatures was found for tribotested samples compared to oil-immersed and untested reference samples. This finding indicates that even mild tribotesting conditions alter the hydrogen trapping behaviour of 100Cr6 bearing steel.
Rationality, inequality, and the output gap: evidence from a disaggregated Keynesian cross diagram
Authors: Teglio Andrea
Published: May 2024

This paper examines the conditions under which a representative agent (RA) model can accurately approximate the output of a multi-agent model that assumes many interacting agents. The study compares the widely used Keynesian cross diagram, which employs a representative agent, to an extended model that explicitly considers multiple interacting households and firms. The extended model reduces to the original RA model when there is one agent of each type. The findings suggest that the RA Keynesian cross diagram model does not accurately approximate the extended multi-agent model when: (1) the network structure of the economy is asymmetric (e.g., firms have different sizes), or (2) the rationality of agents is too low. Additionally, when income inequality is considered by introducing capitalists, the RA model is no longer a good approximation, even if agents are rational. However, fiscal policies that redistribute income can improve the accuracy of the RA model’s predictions. In general, features that increase the overall rationality of the economy and decrease heterogeneity tend to improve the performance of the RA approximation.
Prevalence of Mental Health and Substance use Problems and Awareness of Need for Services in Lesotho: Results from a Population-Based Survey
Authors: Fernández Lucia González , Yoon Grace H. , Firima Emmanuel , Gupta Ravi , Sematle Mamoronts’ane Pauline , Khomolishoele Makhebe , Molulela Manthabiseng , Bane Matumaole , Tlahani Mosa , Lee Tristan T. , Chammartin Frédérique , Gerber Felix , Lejone Thabo , Ayakaka Irene , Labhardt Niklaus Daniel , Amstutz Alain , Belus Jennifer M.
Published: May 2024

We conducted a household survey among 6061 adults in Lesotho to (1) assess the prevalence of moderate/severe mental health (MH) and substance use (SU) problems (2) describe the MH and SU service cascades, and (3) assess predictors of MH and SU problem awareness (i.e., awareness of having a MH/SU problem that requires treatment). Moderate/severe MH or SU problems was reported between 0.7% for anxiety in the past 2 weeks to 36.4% for alcohol use in the past 3 months. The awareness and treatment gaps were high for both MH (62% awareness gap; 82% treatment gap) and SU (89% awareness gap; 95% treatment gap). Individuals with higher than the median household wealth had lower MH and SU problem awareness and those living in urban settings had greater SU problem awareness. Research should investigate how to increase population awareness of MH/SU problems to reduce the burden of these conditions in this setting.
Disease-Management-Programme: Haben sie die Prävention in der Primärversorgung vorangebracht?
Authors: Wangler Julian , Jansky Michael
Published: May 2024

Hintergrund

Im Jahr 2003 wurden in Deutschland die Disease-Management-Programme (DMP) im ambulanten Bereich zur Verbesserung der Versorgung chronischer Erkrankungen eingerichtet. Bislang liegen nur wenige Untersuchungen hinsichtlich der Akzeptanz, Einstellungen und Erfahrungen von Hausärzt*innen in Bezug auf DMP vor.

Ziel der Arbeit

Die Studie beleuchtet anhand eines aktuellen Meinungsbildes, welche Standpunkte Hausärzt*innen in Bezug auf DMP vertreten, welche Erfahrungen sie in der praktischen Versorgung gemacht haben, wie sie den konkreten Nutzen von DMP beurteilen und welche Verbesserungen sie sich für die Zukunft wünschen.

Material und Methoden

Zwischen März und September 2023 wurden 44 halbstandardisierte Interviews mit Hausärzt*innen in Baden-Württemberg, Hessen, Nordrhein-Westfalen, Rheinland-Pfalz, Saarland und Thüringen geführt.

Ergebnisse

Die Interviewten setzen DMP verbreitet ein. Es besteht ein hohes Maß an Zufriedenheit mit den Programmen, die nach Ansicht der Befragten zu verbesserter Versorgung beitragen. Die Kombination aus kontinuierlicher Patient*innenbetreuung und Evidenzorientierung wird als großer Vorzug erachtet; der Nutzen für eine gesteigerte Awareness und Compliance wird hoch eingeschätzt. Ebenfalls wird konstatiert, dass die diagnostischen und therapeutischen Kenntnisse durch die DMP-Teilnahme erweitert werden konnten. Viele Interviewte richten sich inzwischen nach den DMP-Empfehlungen. Demgegenüber werden Handlungsvorgaben von DMP oft als zu starr erlebt. Weitreichende Dokumentationspflichten und eine nicht immer gegebene Hausarztkonformität führen mitunter zu Zeit- und Ressourcenproblemen. Die Kooperation mit fachärztlichen Kolleg*innen im DMP-Kontext wird als verbesserungsbedürftig erlebt.

Schlussfolgerung

Die DMP sind inzwischen fester und breit akzeptierter Bestandteil in der hausärztlichen Versorgung chronischer Erkrankungen. Zugleich sollte weiter an der Optimierung der Programme gearbeitet werden, sodass diese noch unkomplizierter in der Primärversorgung Einsatz finden können. So wäre es günstig, Hausärzt*innen größere Handlungsspielräume zu eröffnen und den Dokumentations- und Verwaltungsaufwand zu reduzieren. Ein größeres, differenzierteres Angebot an Pflichtschulungen könnte helfen, die Delegationskomponente innerhalb von DMP zu stärken. Auch eine stärkere Einbeziehung von Hausärzt*innen im Prozess der DMP-Weiterentwicklung sollte ins Auge gefasst werden.
Universitäre Lehre partizipativ gestalten. Reflecting Teams zum Thema Inklusion in Arbeit
Authors: Fasching Helga , Hauer Nikolaus , Aigner Alexandra , Lindtner Katharina
Published: May 2024

Hintergrund

Der Beitrag befasst sich mit der Darstellung und Reflexion einer partizipativ durchgeführten Lehrveranstaltung am Institut für Bildungswissenschaft der Universität Wien im Wintersemester 2022/23. Gemeinsam mit Expert*innen mit Behinderungserfahrungen wurde eine partizipative Lehrveranstaltung geplant, durchgeführt und reflektiert.

Ziel

Entlang grundlegender theoretischer Überlegungen zur Relevanz von partizipativer Forschung im Kontext von Inklusion führt der Beitrag in unsere konkreten Planungen partizipativer Lehre im Rahmen inklusiver Bildung und Forschung ein. Ziel ist es, das Potenzial partizipativer Lehre im universitären Rahmen hervorzuheben und zu diskutieren.

Methode

Im Beitrag wird der partizipativ-kooperative Planungsprozess der Lehrveranstaltung vorgestellt, wie auch die Durchführung in Orientierung an der systemischen Gruppenmethode des Reflecting Team (RT) nach Tom Andersen [1]. Die Gruppendiskussionen innerhalb von zwei Lehrveranstaltungseinheiten mit der Dauer von jeweils 4 h wurden schriftlich dokumentiert und ausgewertet.

Schlussfolgerung

Die dargestellten Ergebnisse geben zum einen Einblick in die Erzählungen der Expert*innen zu unterschiedlichen Aspekten von Inklusion im beruflichen Kontext. Zum anderen reflektiert der Beitrag die Durchführung von partizipativ gestaltetet Lehre im universitären Rahmen. Das Fazit ergibt sich aus den Reflexionen der Expert*innen zur partizipativ durchgeführten Lehre. Implikationen für die Praxis runden den Beitrag ab.
Phase Relations of the Sm–Ni–Al Ternary System at 800 °C in the 30–100 at.% Al Region
Authors: Delsante S. , Parodi N. , Novakovic R. , Borzone G.
Published: May 2024

The Sm–Ni–Al phase relationships at 800 °C have been investigated by using several well–focused experimental techniques such as X–Ray Powder Diffraction (XRPD), Light Optical Microscopy (LOM) and Scanning Electron Microscopy (SEM) coupled with Energy Dispersive Microprobe Analysis (EPMA). The isothermal section of the Sm–Ni–Al system at 800 °C was constructed according to the present experimental results. More than 50 alloys have been synthesized and characterized in the 30–100 at.% Al region. At 800 °C, 9 intermetallic phases have been confirmed, characterized and their relationships have been established. In the Al-rich corner, the presence of two ternary invariant reactions have been postulated whilst along the 16.67 at.% Sm isopleth, the presence of two structurally related extended solid solutions have been observed. The determined phase equilibria at 800 °C are discussed and compared with the isothermal section at 500 °C already reported in literature.
A Low-Rank Matrix Approach to Compute Polynomial Approximations of Smooth Two-Dimensional Functions
Authors: Lima Nilson J. , Matos José A. O. , Vasconcelos Paulo B.
Published: May 2024

Polynomial approximation of smooth functions is becoming increasingly important in fields like numerical analysis and scientific computing. These approximations are vital in models that rely on spectral methods. To reduce the memory costs for large dimensional problems, various methods to provide data-sparse representations have been proposed, including methods based on singular value decomposition, adaptive cross approximation, and matrices with hierarchical low-rank structures, to mention a few. This work presents implementation details on the polynomial approximation of univariate smooth functions through the class, and of bivariate smooth functions by low-rank matrix representation via the class. These approaches are explained within , a mathematical software library for solving integro-differential problems by the spectral Tau method.
The impact of expanded access programs for systemic anticancer therapy in an Irish cancer centre
Authors: Cronin Timothy K. , Ronayne Cian , O’Donovan Niamh , McGuinness Eimear , Cooke Katie , Dennehy Maeve , Dennehy Colum , Power Derek G. , Cahill Mary R. , Collins Dearbhaile C. , Connolly Roisin M. , Bambury Richard M. , Mykytiv Vitaliy , Higgins Michaela J. , Noonan Sinéad A. , O’Reilly Seamus
Published: May 2024

Background

Expanded access programs (EAPs) allow cancer patients with unmet clinical need to obtain access to pre-authorisation treatments. There is no standardised process for implementing these programs nationally, and real-world data on their impact is lacking.

Aims

This study aimed to evaluate the prevalence of such EAPs and their impact in a cancer centre.

Methods

Data relating to adult cancer patients treated via EAPs from 2011 to 2021 in three Cork university hospitals was collated. Descriptive statistics were employed to get an overview of the impact these programs currently have on cancer care provision.

Results

We identified 193 patients who accessed EAPs during the study period, availing of 33 separate drugs for a total of 50 different cancer indications. The prevalence of EAP usage was shown to have been trending upwards in recent years with a total of 189 programs being accessed throughout the period. Drugs provided were from a number of different anti-cancer drug classes, particularly targeted therapies (n = 18) and immune checkpoint inhibitors (n = 17). Cancers from a wide range of both solid and liquid tumour types were treated with EAP drugs, and patients treated were from across a broad spectrum of ages (26–82, SD 11.99).

Conclusions

EAPs have an increasing role in accessing novel cancer therapies in our community and by extension nationally. Equity of EAP access would be facilitated by a national registry of available agents which we have established. Assessment of their benefits and toxicities would be enhanced by the requirement for a real-world database as a condition of EAP approval.
HPV overtakes smoking as the leading cause of oropharyngeal cancer in Ireland: experience of a head and neck surgery tertiary referral centre
Authors: Cleere Eoin F. , Murphy Josh , Crotty Thomas J. , Hintze Justin M. , Timon Conrad V. I. , Kinsella John , Fitzgerald Conall W. R. , Lennon Paul
Published: May 2024

Background

Worldwide, the incidence of oropharyngeal squamous cell carcinoma (OPSCC) caused by human papillomavirus (HPV), a sexually transmitted virus, is increasing. This increase has yet to be demonstrated in an Irish cohort.

Aims

To evaluate the number of OPSCC presentations locally, to stratify cases by HPV status and to estimate if any changes in the patient population had occurred over a 10-year period.

Methods

A STROBE-compliant, retrospective evaluation of patients with OPSCC at St James’s Hospital between 2012 and 2022 was performed. Patients with non-SCC histology, undocumented HPV status and residual or recurrent tumours were excluded.

Results

We included 294 patients with a mean age of 60.4 years (95% CI 59.2–61.5 years) and 175 (59.5%) patients had HPV+ OPSCC. The number of new OPSCC diagnoses increased from 115 patients (39.1%) between 2012 and 2016 to 179 patients (60.9%) between 2017 and 2021. This was associated with an increased proportion of HPV-linked OPSCC (50.4% 2012–2016 vs. 65.4% 2017–2021, p = 0.011). Over time, more patients had a functionally limiting comorbidity (p = 0.011). The mean age of HPV+ OPSCC cases increased by 3.6 years (p = 0.019). Patients with HPV+ OPSCC had greater 2-year OS (83.9% vs. 54.9%; p < 0.001) and 2-year DFS (73.5% vs. 45.6%; p < 0.001). The 2-year OS and DFS did not change over time for HPV+ or HPV− patients.

Conclusions

In our institution, the number of patients with OPSCC is increasing due to an escalation in cases associated with HPV. Population-level interventions such as vaccination programs may alter the current increase in the incidence of these tumours.
Machine Learning Algorithms Versus Classical Regression Models in Pre-Eclampsia Prediction: A Systematic Review
Authors: Tiruneh Sofonyas Abebaw , Vu Tra Thuan Thanh , Rolnik Daniel Lorber , Teede Helena J. , Enticott Joanne
Published: May 2024

Purpose of Review

Machine learning (ML) approaches are an emerging alternative for healthcare risk prediction. We aimed to synthesise the literature on ML and classical regression studies exploring potential prognostic factors and to compare prediction performance for pre-eclampsia.

Recent Findings

From 9382 studies retrieved, 82 were included. Sixty-six publications exclusively reported eighty-four classical regression models to predict variable timing of onset of pre-eclampsia. Another six publications reported purely ML algorithms, whilst another 10 publications reported ML algorithms and classical regression models in the same sample with 8 of 10 findings that ML algorithms outperformed classical regression models. The most frequent prognostic factors were age, pre-pregnancy body mass index, chronic medical conditions, parity, prior history of pre-eclampsia, mean arterial pressure, uterine artery pulsatility index, placental growth factor, and pregnancy-associated plasma protein A. Top performing ML algorithms were random forest (area under the curve (AUC) = 0.94, 95% confidence interval (CI) 0.91–0.96) and extreme gradient boosting (AUC = 0.92, 95% CI 0.90–0.94). The competing risk model had similar performance (AUC = 0.92, 95% CI 0.91–0.92) compared with a neural network. Calibration performance was not reported in the majority of publications.

ML algorithms had better performance compared to classical regression models in pre-eclampsia prediction. Random forest and boosting-type algorithms had the best prediction performance. Further research should focus on comparing ML algorithms to classical regression models using the same samples and evaluation metrics to gain insight into their performance. External validation of ML algorithms is warranted to gain insights into their generalisability.
Asbestos exposure determined 357 days after death through autopsy: a report of a multidisciplinary approach
Authors: Albano Giuseppe Davide , Rodolico Vito , Di Franco Simone , Re Giuseppe Lo , Midiri Mauro , Malta Ginevra , Cannizzaro Emanuele , Argo Antonina , Zerbo Stefania
Published: May 2024

Asbestosis is an interstitial lung disease caused by the inhalation of asbestos fibers and poses a significant risk to individuals working in construction, shipping, mining, and related industries. In a forensic context, postmortem investigations are crucial for accurate diagnosis, for which the gold standard is the histopathological examination. This case report describes the autopsy and related investigations conducted on an 84-year-old man, nearly one year (357 days) after his death. After a post-mortem CT scan, an autoptic investigation was performed, followed by histopathological, immunohistochemical, and scanning electron microscopy examinations. The integration of the evidence from these examinations with previously available personal and clinical information conclusively confirmed the diagnosis of asbestosis. We demonstrated the efficacy and reliability of our diagnostic protocol in detecting asbestosis and asbestos fibers and excluding mesothelioma even in decomposed tissues. According to our findings autopsy remains the diagnostic gold standard in cases of suspected asbestosis within a forensic context, even 1 year after death, therefore it is always highly recommended, even in cases where the body has decomposed.
Gastric ischemia as an under-reported cause of death in older people
Authors: Bonasoni Maria Paola , Pirani Filippo , Grimaldi Federica , Fais Paolo , Giorgetti Arianna , Pelotti Susi
Published: May 2024

Acute gastric ischemia is a rare condition due to the rich vascular supply of the stomach. Here we present a case of fatal gastric ischemia associated with bowel ischemia, only diagnosed at autopsy, which was requested for the suspicion of medical liability. A complete post-mortem examination was conducted, along with a macroscopic analysis of the superior mesenteric artery and detailed histological analyses. Past clinical data was also reviewed. The macroscopic blackish discoloration of the stomach and the bowel, coupled with the presence of neutrophils in the mucosa and submucosal non-occlusive thrombi, were consistent with gastric and bowel ischemia, despite the presence of confounding putrefactive changes. The unique aspect of this case resides in the ante-mortem peculiar vascularization of the stomach, supplied by small collateral vessels. No mechanical occlusion was identified, and the cause of the ischemia was deemed as non-occlusive, likely due to systemic hypoperfusion. The analysis of clinical data and documentation of associated comorbidities are strongly recommended, especially when a rare cause of death is suspected. With the aging population, especially among women, and the prevalence of risk factors, the forensic pathologist could increasingly encounter rare cases of gastric ischemia.
Bewältigung des Fachkräftemangels durch technologische Innovation?
Authors: Pottharst Bill , Neumann Alexander , Ostrau Christoph , Seelmeyer Udo
Published: May 2024

Der Beitrag untersucht, wie technologische Innovationen die Soziale Arbeit beeinflussen und welche Auswirkungen neue Technologien auf den Bedarf an Fachkräften haben könnten. Dafür identifizieren wir sechs bereichsübergreifende Kerntätigkeiten der Sozialen Arbeit und setzen diese in Bezug zu potenziell disruptiven Technologien. Wir diskutieren, dass sich die Effekte neuer Ansätze der Datenverarbeitung, -vernetzung und -vermittlung nicht auf Rationalisierung und Arbeitsverdichtung beschränken lassen. Trotz der Substitutionspotenziale insbesondere neuer KI-Technologien kann komplexes, sozialarbeiterisches Handeln auch perspektivisch an vielen Stellen zwar unterstützt, aber nicht gleichwertig durch automatisierte Prozesse ersetzt werden. Aufgrund der steigenden Bedeutung technologischer Komponenten im Arbeitsprozess werden Einrichtungen der Sozialen Arbeit vermehrt Fachkräfte mit hoher Digital- und Datenkompetenz benötigen. Gleichzeitig können Sozialarbeiter_innen von neuen Freiräumen und Handlungsmöglichkeiten profitieren, die zu einem attraktiven und zukunftsorientierten Berufsbild beitragen, welches ggf. auch neue Zielgruppen für den Beruf anspricht.