bluuebunny/crossref_metadata_2025 huggingface dataset:
Pseudo-Fubini Real-Entire Functions on the Plane
Authors: Bernal-González Luis , Calderón-Moreno María del Carmen , Jung Andreas
Published: September 2022

In this note, it is proved the existence of a $$\mathfrak {c}$$
c
-dimensional vector space of real-entire functions all of whose nonzero members are non-integrable in the sense of Lebesgue but yet their two iterated integrals exist as real numbers and coincide. Moreover, it is shown that this vector space can be chosen to be dense in the space of all real $$C^\infty $$

C
∞

-functions on the plane endowed with the topology of uniform convergence on compacta for all derivatives of all orders. If the condition of being entire is dropped, then a closed infinite dimensional subspace satisfying the same properties can be obtained.
Ist das Telenotarzt-System eine sinnvolle Ergänzung im ländlichen Raum? – Eine Analyse aus medizinischer und ökonomischer Perspektive
Authors: Brinkrolf Peter , Kuntosch Julia , Metelmann Bibiana , Metelmann Camilla , Hahnenkamp Klaus , Süss Rebekka , Hasebrook Joachim Paul , Fleßa Steffen
Published: September 2022

Hintergrund und Ziel

Um die präklinische Notfallversorgung zu optimieren und aktuelle Herausforderungen zu bewältigen, wurde im Landkreis Vorpommern-Greifswald im Jahr 2017 ein Telenotarzt-System eingeführt. Es sollte aus medizinischer und ökonomischer Sicht geprüft werden, ob dies, insbesondere im ländlichen Raum, eine effiziente Ergänzung der präklinischen Notfallversorgung darstellt.

Methodik

Es wurden ca. 250.000 Einsatzdaten, vor und nach Einführung des Systems, über die Jahre 2015 bis 2020 ausgewertet und ein Prä-Post-Vergleich über die Einsatzstruktur erstellt. Die 3611 Einsätze der Telenotärztinnen und -ärzte (TNA) wurden nach medizinischen Indikationen und zeitlichen Faktoren analysiert sowie mit Einsätzen ohne TNA verglichen. Zusätzlich erfolgten eine Analyse der Gesamtkosten des neuen Versorgungskonzeptes sowie eine Kostenanalyse der prä- und innerklinischen Behandlungskosten ausgewählter Erkrankungen.

Ergebnisse

Das Einsatzspektrum des TNA umfasste alle Altersstufen mit verschiedenen Meldebildern, die zu 48,2 % eine mittlere Erkrankungsschwere (stationäre Behandlung erforderlich) hatten. Von Patient*innen und Mitarbeitenden wurde das System gut angenommen. Die Einsatzdaten zeigten einen signifikanten Rückgang der Notarztbeteiligung bei telenotarztfähigen Einsatzfahrzeugen um 20 %. Die jährlichen Kosten des Systems belaufen sich auf ca. 1,7 Mio. €.

Schlussfolgerung

Die Ergebnisse belegen die Vorteilhaftigkeit des TNA-Systems, sodass es über die Projektdauer hinaus implementiert wurde. Das System ist medizinisch sinnvoll, funktionsfähig sowie effizient und steht als Innovation für die Umsetzung in ganz Deutschland bereit.
Psychische und körperliche Belastung im Rettungsdienst: Zusammenhang des arbeitsbezogenen Verhaltens und der Beanspruchungsfolgen
Authors: Böckelmann Irina , Thielmann Beatrice , Schumann Heiko
Published: September 2022

Hintergrund

Einsatzkräfte im Rettungsdienst (RD) unterliegen zahlreichen arbeitsbezogenen Belastungsfaktoren. Diesen stehen verschiedene Ressourcen gegenüber, die der Belastung entgegenwirken können. Ziel der Arbeit war es, physische und psychische Belastungen im RD zu erheben sowie die Zusammenhänge zwischen dem arbeitsbezogenen Verhalten und den Folgen von (Fehl‑)Beanspruchung zu analysieren.

Material und Methoden

An der Befragung im Jahr 2015 nahmen 276 Einsatzkräfte (39,3 ± 8,04 Jahre alt) teil. Sie beinhaltete berufsbezogene Fragen sowie den Fragebogen zur subjektiven Einschätzung der Belastungen am Arbeitsplatz nach Slesina, den Fragebogen zum arbeitsbezogenen Verhaltens- und Erlebensmuster (AVEM), den Erholungs-Belastungs-Fragebogen (EBF) und den Fragebogen für körperliche, psychische und soziale Symptome (KOEPS).

Ergebnisse

Die von dem größten Teil der Befragten angegebenen Belastungen waren: ungünstige Körperhaltung, Heben/Tragen schwerer Lasten, körperliche Arbeit und Schichtarbeit. Am häufigsten fühlten sie sich durch Schichtarbeit belastet (76,9 % „oft“). Circa ein Drittel der Befragten zeigte in seinem arbeitsbezogenen Verhalten ein Risikomuster. In EBF und KOEPS traten keine Abweichungen vom Referenzbereich auf. Merkmale der emotionalen Einstellung gegenüber der Arbeit korrelierten positiv mit der Qualität der Erholung sowie negativ mit der Beanspruchung und gesundheitlichen Beschwerden. Das Perfektionsstreben, die offensive Problembewältigung und der berufliche Ehrgeiz waren nicht bzw. kaum mit den Beanspruchungsfolgen assoziiert.

Diskussion

Die Gefährdungsbeurteilung und die Erfassung des arbeitsbezogenen Verhaltens von Einsatzkräften geben Ansatzpunkte für Präventionsmaßnahmen. Auf Grundlage von AVEM-Mustern können diese individuell angepasst werden.
Individual computer-assisted 3D planning for placement of auricular prosthesis anchors in combination with an implantable transcutaneous bone conduction hearing device in patients with aural atresia
Authors: Seiwerth Ingmar , Plößl Sebastian , Herzog Michael , Schilde Sebastian , Radetzki Florian , Krämer Steffen , Rahne Torsten , Plontke Stefan K.
Published: September 2022

Background

The simultaneous implantation of the Bonebridge (MED-EL, Innsbruck, Austria), a semi-implantable active transcutaneous bone conduction hearing device and anchors for auricular prostheses can be challenging as both implants contain magnets and compete for the narrow space in the designated implantation area.

Material and methods

A preoperative planning tool (virtual surgery) was used with individual 3D computer models of the skull and implants for finding optimal implant positions for both the floating mass transducer (FMT) and the anchors for the auricular prosthesis. The interaction between the magnetic prosthesis anchors and the FMT was measured by means of static magnetic forces. A retrospective data analysis was conducted to evaluate the surgical and audiological outcome.

Results

Between 2014 and 2021, a 3D planning of a simultaneous implantation of the Bonebridge with auricular prosthesis anchors was conducted on 6 ears of 5 patients (3 males, 2 females; age range 17–56 years). The individual preoperative planning was considered very useful for the optimal placement of bone anchors in combination with the Bonebridge. Audiological data showed a clear benefit for hearing 3 months and > 11 months after implantation. No adverse interactions between the magnetic prosthesis anchors and the FMT were observed. In two patients, revision surgery was carried out due to skin inflammation or wound healing problems. No long-term complications were observed 3–5 years after surgery.

Conclusion

Preoperative 3D planning represents a clear benefit for the simultaneous audiological and esthetic rehabilitation using the Bonebridge and anchors for auricular prostheses.
Stellungnahme zur Hospitalisierung von Kindern anlässlich von HNO-Eingriffen in Deutschland
Authors: Windfuhr Jochen P. , Sittel Christian , Deitmer Thomas , Jungehülsing Markus , Grundmann Thomas , Hagen Rudolf , Baumann Ingo , Hackenberg Stephan ,   Arbeitsgemeinschaft Pädiatrische HNO-Heilkunde (AG PädHNO) der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.
Published: September 2022

Die stationäre Betreuung von Kindern nach Operationen im HNO-Bereich ist deutschlandweit heterogen organisiert. In dieser Stellungnahme kommentiert die Arbeitsgemeinschaft Pädiatrische HNO-Heilkunde eine nationale Umfrage zum Status quo der Kinderversorgung nach HNO-Eingriffen in deutschen Kliniken. Diese dient als Grundlage für die weitere interdisziplinäre Diskussion.
Generationenübergreifende Betreuung von Patienten mit tachykarden Rhythmusstörungen
Authors: Marx Manfred , Gass Matthias , Michel-Behnke Ina
Published: September 2022

Die Versorgung von Patienten mit Rhythmusstörungen hat sich in den letzten Jahrzehnten von einer rein konservativ medikamentösen Therapie zu einer echten kurativen Therapie mit Beseitigung des arryhthmogenen Substrats durch technisch immer ausgereiftere Möglichkeiten im Sinn der elektrophysiologische Untersuchung (EPU) und Ablation entwickelt. Parallel dazu haben sich in pädiatrisch-kardiologischen Zentren rhythmologische Spezialambulanzen zur Betreuung von Patienten mit Ionenkanalerkrankungen etabliert. Deren Aufgabe besteht in der generationenübergreifenden Betreuung von ganzen Familien, mit dem Ziel, präventiv, durch entsprechende Beratung und Führung, maligne Rhythmusstörungen primär zu verhindern.
Infections in the first year of life and development of beta cell autoimmunity and clinical type 1 diabetes in high-risk individuals: the TRIGR cohort
Authors: Kordonouri Olga , Cuthbertson David , Belteky Malin , Aschemeier-Fuchs Bärbel , White Neil H. , Cummings Elisabeth , Knip Mikael , Ludvigsson Johnny
Published: September 2022

Aims/hypothesis

Accumulated data suggest that infections in early life contribute to the development of type 1 diabetes. Using data from the Trial to Reduce IDDM in the Genetically at Risk (TRIGR), we set out to assess whether children who later developed diabetes-related autoantibodies and/or clinical type 1 diabetes had different exposure to infections early in life compared with those who did not.

Methods

A cohort of 2159 children with an affected first-degree relative and HLA-conferred susceptibility to type 1 diabetes were recruited between 2002 and 2007 and followed until 2017. Infections were registered prospectively. The relationship between infections in the first year of life and the development of autoantibodies or clinical type 1 diabetes was analysed using univariable and multivariable Cox regression models. As this study was exploratory, no adjustment was made for multiple comparisons.

Results

Adjusting for HLA, sex, breastfeeding duration and birth order, those who had seven or more infections during their first year of life were more likely to develop at least one positive type 1 diabetes-related autoantibody (p=0.028, HR 9.166 [95% CI 1.277, 65.81]) compared with those who had no infections. Those who had their first viral infection aged between 6 and 12 months were less likely to develop at least one positive type 1 diabetes-related antibody (p=0.043, HR 0.828 [95% CI 0.690, 0.994]) or multiple antibodies (p=0.0351, HR 0.664 [95% CI 0.453, 0.972]). Those who had ever had an unspecified bacterial infection were more likely to develop at least one positive type 1 diabetes-related autoantibody (p=0.013, HR 1.412 [95% CI 1.075, 1.854]), to develop multiple antibodies (p=0.037, HR 1.652 [95% CI 1.030, 2.649]) and to develop clinical type 1 diabetes (p=0.011, HR 2.066 [95% CI 1.182, 3.613]).

Conclusions/interpretation

We found weak support for the assumption that viral infections early in life may initiate the autoimmune process or later development of type 1 diabetes. In contrast, certain bacterial infections appeared to increase the risk of both multiple autoantibodies and clinical type 1 diabetes.

Graphical abstract
Assessing the consistency of the fixed-effects estimator: a regression-based Wald test
Authors: Spierdijk Laura
Published: September 2022

Under large-n and fixed-T panel data asymptotics, we develop a method to test a sufficient condition for the FE estimator’s consistency using a stacked regression framework. The resulting test exploits a previously unnoted relation between the fixed-effects estimator and the short- and long-differences estimators. It takes the familiar form of a panel-robust Wald test, but is also shown to be asymptotically equivalent to a GMM test. We provide a theoretical comparison between our test and two existing ones from the literature, which are shown to focus on generic strict exogeneity conditions instead of being specifically related to the FE estimator’s moment conditions. We investigate our test’s finite-sample properties in a simulation study, where we continue the comparison with the other tests. We show that our test has good finite-sample properties, especially if the estimator of the covariance matrix is based on a panel bootstrap. The practical use of our test is illustrated in two applications to existing data from the literature.
Lateral extension and attachment of mesh to the lateral vagina during laparoscopic sacrocolpopexy: a modified technique aimed at lowering recurrences in the anterior vaginal compartment. A surgical video
Authors: Bousouni E. , Sarlos D.
Published: September 2022

Purpose/objective

Laparoscopic sacrocolpopexy has been demonstrated to be the gold standard of prolapse surgery in cases with apical defect. Most recurrences seem to occur in the anterior compartment, especially if a paravaginal defect is present. To reduce the incidence of anterior recurrence after laparoscopic sacrocolpopexy we modified our previous published technique by placing the anterior mesh not only deep under the bladder but also laterally and fixing it to the lateral edge of the vagina. With this video article, we would like to show and explain our modified technique and demonstrate how lateral mesh placement can be easily and safely performed using laparoscopy.

Methods

The video demonstrates our modified technique with lateral extension and fixation of the anterior mesh to the lateral vagina during laparoscopic sacrocolpopexy in a patient with severe uterine prolapse (grade III) and a large cystocele (grade III). Special emphasis is given to the topographical anatomy of the paravaginal space and the surgical technique of lateral fixation.

Results

This modified new technique shows excellent perioperative results in more than 100 cases without any occurrences of lesions of the ureters. Our initial experience also shows very good anatomical results in all three compartments.

Conclusions

Paravaginal dissection and exposure of the ureters to extend the mesh placement and fixation to the lateral border of the vagina in the anterior compartment during laparoscopic sacrocolpopexy seem to be feasible and safe, helping to significantly reduce the risk of anterior recurrences. Prospective data are needed to evaluate this interesting technique.
„Black esophagus“ – zwei Obduktionsfälle mit infektiöser Beteiligung
Authors: Stock Benjamin , Möckel Sigrid , Zander Christine , Heinsen Helmut , Bohnert Simone , Bohnert Michael
Published: September 2022

„Black esophagus“ oder „akute Ösophagusnekrose“ (AÖN) ist eine seltene Erkrankung, die sich makroskopisch durch eine zirkumferente Schwarzverfärbung der Ösophagusmukosa mit abruptem Ende am gastroösophagealen Übergang auszeichnet. Die genaue Pathogenese ist unbekannt; es werden multifaktorielle Einflüsse wie z. B. Säurereflux, Ischämie und verringerte Schutzmechanismen der Mukosa als mögliche Ursachen diskutiert.

Vorgestellt werden 2 Obduktionsfälle, die typische Befunde einer AÖN aufwiesen. Zusätzlich hatten Fall 1 eine Candida-Infektion und Fall 2 eine Appendizitis, sodass eine infektiöse Genese in beiden Fällen eine Rolle gespielt haben könnte.
Complex Dirac Structures: Invariants and Local Structure
Authors: Aguero Dan , Rubio Roberto
Published: September 2022

We study complex Dirac structures, that is, Dirac structures in the complexified generalized tangent bundle. These include presymplectic foliations, transverse holomorphic structures, CR-related geometries and generalized complex structures. We introduce two invariants, the order and the (normalized) type. We show that, together with the real index, they allow us to obtain a pointwise classification of complex Dirac structures. For constant order, we prove the existence of an underlying real Dirac structure, which generalizes the Poisson structure associated to a generalized complex structure. For constant real index and order, we prove a splitting theorem, which gives a local description in terms of a presymplectic leaf and a small transversal.
Interrelationship among spatial cohesion, aggression rate, counter-aggression and female dominance in three lemur species
Authors: Seex Lauren , Fichtel Claudia , Kappeler Peter M. , Hemelrijk Charlotte K.
Published: September 2022

How social and ecological factors are associated with variation in dominance style across species of animals has been studied frequently, but the underlying processes are often not addressed. Theoretical research indicates that stronger spatial cohesion among individuals in a group causes a higher frequency of fighting and, thus, through the self-reinforcing effects of winning and losing fights, a stronger differentiation of the dominance hierarchy and dominance of females over more males. Our aim in the present paper is to study whether the same interrelationship among processes may underlie differences in dominance style among three species of lemur that differ in their degree of despotism:Lemur catta,Propithecus verreauxiandEulemur rufifrons. We investigated their agonistic interactions and spatial cohesion based on 2752 h of observational data of 20 wild groups of these three species. We determined dominance style using the proportion of counter-aggression, with a lower proportion indicating a more despotic dominance style. We found that stronger spatial cohesion among individuals is associated with a higher rate of aggression, stronger despotism and dominance of females over more males. The results of our study emphasise the general importance of spatial cohesion in determining dominance style.

Significance statement

Theoretical studies have shown that the spatial configuration of individuals in a group influences the dominance style. In an agent-based model, DomWorld, individuals are guided by simple rules of grouping and fighting and emergent patterns of behaviour switch between resembling those of despotic or egalitarian primates depending on the degree of cohesion in groups. Yet this link has seldom been studied empirically. We, therefore, examine the relevance of spatial cohesion on patterns of behaviour of individuals in groups of three species of lemur. We confirm the predictions from the model and show that stronger spatial cohesion results in more frequent aggression, a more despotic dominance style and stronger female dominance over males. In light of this, we urge future research of animal dominance to include measures of cohesion.
Investigating the flow field dynamics of transonic shock buffet using particle image velocimetry
Authors: Kokmanian Katherine , Scharnowski Sven , Schäfer Clara , Accorinti Alessandro , Baur Tim , Kähler Christian J.
Published: September 2022

An experimental investigation was performed in order to better understand the transonic shock buffet phenomenon and determine the dominant flow interactions at specific flow conditions. A rigid wing in the shape of an OAT15A airfoil was placed in the Trisonic Wind Tunnel Munich, where both the Mach number and the angle of attack were varied between $$0.65< M_\infty < 0.77$$

0.65
<

M
∞

<
0.77

and $$3.8< \alpha < 6.3^\circ$$

3.8
<
α
<
6
.

3
∘

respectively. With the use of high-speed imaging, high-quality optics and state-of-the-art laser equipment, highly resolved velocity field measurements were obtained via particle image velocimetry, where the streamwise and vertical velocity components were computed over the suction side of the wing center plane. It was shown that sustained buffet first occurs at $$M_\infty \ge 0.74$$

M
∞

≥
0.74

when maintaining the angle of attack constant at $$\alpha =5.8^\circ$$

α
=
5
.

8
∘

. Similarly, an increase in $$\alpha$$
α
for a fixed $$M_\infty =0.74$$

M
∞

=
0.74

also led to the development of shock buffet. Instantaneous snapshots confirmed the presence of a recirculation region downstream of the moving shock, where an increase in the wake size was confirmed when the shock was located most upstream. Streamwise correlations were also computed near the airfoil’s upper surface in order to extract the characteristic convective velocity of flow structures. The convective velocity appeared to increase with streamwise distance, ranging on average between 50 and 150 m/s. Overall, these time-resolved velocity field measurements allow for the investigation of the flow dynamics during shock buffet and highlight the independent effect of Mach number and angle of attack on this complex phenomenon.
First review on the selenium status in Germany covering the last 50 years and on the selenium content of selected food items
Authors: Liaskos Marina , Fark Nicole , Ferrario Paola , Engelbert Ann Katrin , Merz Benedikt , Hartmann Bernd , Watzl Bernhard
Published: September 2022

Introduction

Selenium is important for human health. However, the selenium status and selenium intake of the German population has not been recorded in a representative study so far.

Material and Methods

Thus, literature from the last 50 years was screened in a systematic way and the results of various studies were pulled together to shed light on the selenium status of the German population. Moreover, the selenium content of selected food items that were either found on the German market or grown in Germany was researched and evaluated.

Results

Of 3542 articles identified, 37 studies met the inclusion criteria. These 37 studies comprised a total of 8,010 healthy adults living in Germany with a weighted arithmetic mean of 82 μg/l selenium in plasma or serum. The results will form a basis for interpreting upcoming results from national food consumption surveys. Furthermore, 363 selenium values for 199 food items were identified out of 20 data sources—published or analysed between 2002 and 2019. An estimation of the selenium intake of the German population will be possible with this data in future nutrition surveys.
Nonregional small fibre neuropathy in cases of autoimmune autonomic neuropathy
Authors: Maier Andrea , Kapfenberger Romina , Katona Istvan , Weis Joachim , Schulz Jörg B. , Rolke Roman
Published: September 2022

Objective

Autonomic small fibre neuropathy is described in patients with autoimmune autonomic neuropathy (AAN). Few data are available on somatosensory function and skin biopsies in AAN.

Methods

Retrospective analysis of 17 patients (51.2 ± 6.8 years, n = 7 males) with AAN, including autoantibodies, quantitative sensory testing (QST, n = 13) and intraepithelial nerve fibre density (IENFD) in skin biopsy (n = 16). QST was performed according to the DFNS protocol over hands and feet dorsum. QST data were compared to healthy controls. Comparison of antibody-positive and antibody-negative cases.

Results

70.6% of patients were antibody positive. 82.4% described at least one episode with sensory symptoms. Skin biopsies revealed reduced IENFD in 58.8% of patients, whereas neuropathic pain was only present in 41.2%. QST showed a nonregional increase for nonpainful thermal and mechanical detection rather than for mechanical pain thresholds. Compared to healthy controls, sensory loss for cold and warm detection thresholds and for the thermal sensory limen—the temperature difference between alternating warm and cold stimuli—was found on hands and feet (all p < 0.05). For nonpainful mechanical stimuli, the vibration detection threshold on the hand was increased (p < 0.05). Of all pain thresholds, only the mechanical pain threshold was elevated for pinprick stimuli to the feet (p < 0.05).

Interpretation

Findings are consistent with a sensory small fibre more than large fibre neuropathy in AAN. Sensory loss was comparably distributed across hands and feet, indicating that nerve fibre dysfunction was rather generalized. Serostatus was not a significant predictor of the small fibre deficit present in AAN.
Exercise regulates shelterin genes and microRNAs implicated in ageing in Thoroughbred horses
Authors: Mandal Shama , Denham Michele M. , Spencer Sarah J. , Denham Joshua
Published: September 2022

Ageing causes a gradual deterioration of bodily functions and telomere degradation. Excessive telomere shortening leads to cellular senescence and decreases tissue vitality. Six proteins, called shelterin, protect telomere integrity and control telomere length through telomerase-dependent mechanisms. Exercise training appears to maintain telomeres in certain somatic cells, although the underlying molecular mechanisms are incompletely understood. Here, we examined the influence of a single bout of vigorous exercise training on leukocyte telomerase reverse transcriptase (TERT) and shelterin gene expression, and the abundance of three microRNAs (miRNAs) implicated in biological ageing (miRNA-143, -223 and -486-5p) in an elite athlete and large animal model, Thoroughbred horses. Gene and miRNA expression were analysed using primer-based and TaqMan Assay qPCR. Leukocyte TRF1, TRF2 and POT1 expression were all significantly increased whilst miR-223 and miR-486-5p were decreased immediately after vigorous exercise (all p < 0.05), and tended to return to baseline levels 24 h after training. Relative to the young horses (~ 3.9 years old), middle-aged horses (~ 14.8 years old) exhibited reduced leukocyte TERT gene expression, and increased POT1 and miR-223 abundance (all p < 0.05). These data demonstrate that genes transcribing key components of the shelterin-telomere complex are influenced by ageing and dynamically regulated by a single bout of vigorous exercise in a large, athletic mammal — Thoroughbred horses. Our findings also implicate TERT and shelterin gene transcripts as potential targets of miR-223 and miR-486-5p, which are modulated by exercise and may have a role in the telomere maintenance and genomic stability associated with long-term aerobic training.
What does the best interests principle of the convention on the rights of the child mean for paediatric healthcare?
Authors: März Julian W.
Published: September 2022

The present review analyses the implications of the best interests of the child principle, which is one of the most widely discussed principles of medical ethics and human rights, for paediatric healthcare. As a starting point, it presents the interpretation of the best interests principle by the United Nations Committee on the Rights of the Child. On this basis, it points out possible fields of application of the best interests principle with regard to paediatric healthcare and discusses the potential difficulties in the application of the best interests principle. Based on this, it illustrates the implications of the best interests principle for paediatric healthcare through four case studies, which look at ethical dilemmas in paediatric gynaecology, end-of-life care, HIV care and genetic testing.

   Conclusion: The best interests principle requires action, inter alia, by health policymakers, professional associations, hospital managers and medical teams to ensure children receive the best possible healthcare. Whilst the best interests principle does not provide a conclusive solution to all ethical dilemmas in paediatric healthcare (as illustrated by the case studies), it provides children, medical teams, parents and families, and clinical ethicists with an indispensable framework for health care centred on the rights of the child.

What is Known:• The best interests principle is one of the most widely discussed principles of medical ethics and human rights and one of the four general principles of the Convention on the Rights of the Child.

What is New:• The present review discusses possible fields of application and potential difficulties of the best interests principle with regard to paediatric healthcare.• Based on this, it illustrates the implications of the best interests principle for paediatric healthcare through four case studies, which look at ethical dilemmas in paediatric gynaecology, end-of-life care, HIV care and genetic testing.
Prolonged grief as a disease?
Authors: Lutz Ronja , Eibauer Cornelia , Frewer Andreas
Published: September 2022

Definition of the problem

The eleventh version of the International Classification of Diseases (ICD-11), which became effective in 2022, has raised a number of issues associated with medical ethics.

Arguments

In this context the paper explores the normative view of grief as a disease. ICD-11 contains the new diagnosis of “prolonged grief disorder” with a definition that fails to aid its clear distinction from the normal course of grief. The article discusses the philosophical and ethical implications of this diagnosis and explores the risks of medicalizing and pathologizing grief which may lead to an undermining of its value.

Conclusions and further perspectives

The paper’s specific focus is the particular case of parental grief. We show that pediatric palliative care counteracts many risk factors for difficult grief reactions and may therefore serve as a valuable instrument for their prevention. We propose in this context the concept of “advance bereavement planning” as a potentially beneficial extension of advance care planning and palliative care in general.
Sport improved medium-term results in a prospective cohort of 785 adolescents with idiopathic scoliosis braced full time. SOSORT 2018 award winner
Authors: Negrini Alessandra , Poggio Martina , Donzelli Sabrina , Vanossi Massimiliano , Cordani Claudio , Romano Michele , Negrini Stefano
Published: September 2022

Purpose

The association between idiopathic scoliosis (IS) and sports activities remains vague. We aimed to analyse their effect on full-time braced adolescents with IS.

Methods

We retrospectively recruited all the consecutive patients of a tertiary referral Institute of age ≥ 10 (adolescents), with a juvenile (JIS) or adolescent (AIS) IS diagnosis, Risser 0–2, TLSO brace prescription and self-reported adherence ≥ 20 h per day, and follow-up out-of-brace X-rays 18 months after brace prescription. We divided participants into two groups: SPORT (sport twice or more per week) and CONTROL (sport once per week or less). We calculated odds ratio (OR) to compare the outcome of subjects performing to those not performing sport. We ran a logistic regression with covariate adjustment to assess if sports frequency affected the outcomes.

Results

Out of 33,311 participants assessed for eligibility, 785 satisfied the inclusion criteria (693 females, age 12.7 ± 1.3 and 40 ± 11° Cobb). The SPORT group consisted of 290 participants and the CONTROL group of 495. The SPORT group showed higher odds of improvement (OR = 1.59, 95%CI = 1.17–2.16, p = 0.0018). The odds of improving increased with the frequency of sports activity (OR = 1.20, 95%CI 1.08–1.34).

Conclusion

This study shows that sports activities increase the odds of improvement at 18-month follow-up in adolescents with IS treated with a full-time brace. The odds of improvement increase with sports week frequency.
The relationship between thyroid dysfunction, cardiovascular morbidity and mortality in type 2 diabetes: The Fremantle Diabetes Study Phase II
Authors: Chubb S. A. Paul , Peters Kirsten E. , Bruce David G. , Davis Wendy A. , Davis Timothy M. E.
Published: September 2022

Aims

It is uncertain whether subclinical thyroid dysfunction is associated with cardiovascular disease (CVD) events and mortality in people with type 2 diabetes. The aim of this study was to determine whether undetected thyroid disease increases the risk of incident CVD and death in type 2 diabetes.

Methods

One thousand two hundred fifty participants with type 2 diabetes (mean age 65.3 years, 56.5% males, median diabetes duration 8.0 years) without known thyroid disease and not taking medications known to affect thyroid function were categorised, based on baseline serum free thyroxine (FT4) and thyrotropin (TSH) concentrations, as euthyroid, overt hypothyroid (increased TSH, low FT4), subclinical hypothyroid (increased TSH, normal FT4), overt thyrotoxic (decreased TSH, raised FT4) or subclinical thyrotoxic (decreased TSH, normal FT4). Incident myocardial infarction, incident stroke, all-cause and cardiovascular mortality were ascertained during a mean 6.2–6.7 years of follow-up.

Results

Most participants with newly-detected thyroid dysfunction had subclinical hypothyroidism (77.2%) while overt/subclinical thyrotoxicosis was infrequent. Compared to participants with TSH 0.34–2.9 mU/L, those with TSH > 5.1 mU/L were not at increased risk of incident myocardial infarction (adjusted hazard ratio (95% confidence limits) 1.77 (0.71, 2.87)), incident stroke (1.66 (0.58, 4.78)), all-cause mortality (0.78 (0.44, 1.37)) or cardiovascular mortality (1.16 (0.38, 3.58)). Independent baseline associates of subclinical hypothyroidism included estimated glomerular filtration rate and systolic blood pressure.

Conclusions

Subclinical hypothyroidism was not independently associated with CVD events or mortality in community-dwelling people with type 2 diabetes despite its associations with CVD risk factors, questioning strategies to identify and/or treat mild thyroid dysfunction outside usual care.
The electrochemical behaviour of butyltrimethylammonium bis(trifluoromethylsulfonyl)imide at negatively polarised aluminium electrode studied by in situ soft X-ray photoelectron spectroscopy, electrochemical impedance spectroscopy and cyclic voltammetry techniques
Authors: Kruusma Jaanus , Käämbre Tanel , Tõnisoo Arvo , Kisand Vambola , Lust Karmen , Lust Enn
Published: September 2022

The in situ X-ray photoelectron spectroscopy data indicate that butyltrimethylammonium bis(trifluoromethylsulfonyl)imide (N4111(TFSI)) adsorbs strongly within the potential range −3.25 V < E < −2.25 V and specifically at E < −3.25 V (vs. Ag-QRE) at the Al electrode. Strong adsorption of the intermediates of N4111(TFSI) electrochemical decomposition was observed in electrochemical impedance spectroscopy and cyclic voltammetry measurements. At E < −4.25 V (vs. Ag-QRE), very intensive electrochemical reduction of N4111(TFSI) took place at the Al electrode giving gaseous products. In the potential range from − 2.25 to 0.00 V (vs. Ag-QRE), non-specific adsorption of N4111(TFSI) exists et al. surface.
Step on it: asymmetric gain functions improve starting and stopping in virtual reality walking
Authors: van Gemert Thomas , Hornbæk Kasper , Bergström Joanna
Published: September 2022

Transfer functions with a high translational gain can increase the range of walking in virtual reality. These functions determine how much virtual movements are amplified compared to the corresponding physical movements. However, it is unclear how the design of these functions influences the user’s gait and experience when walking with high gain values. In a mixed-methods study with 20 users, we find that their best transfer functions are nonlinear and asymmetrical for starting and stopping. We use an optimization approach to determine individually optimized functions that are significantly better than a common approach of using a constant gain. Based on interviews, we also discuss what qualities of walking matter to users and how these vary across different functions. Our work shows that it is possible to create high-gain walking techniques that offer dramatically increased range of motion and speed but still feel like normal walking.
The Yellow-breasted Barbet (Trachyphonus margaritatus) introduces vocal duets and choruses with a specific multimodal signal, during territorial advertisement
Authors: Mahamoud Issa Mathieu , Sikora Bożena , Rusiecki Stanisław , Osiejuk Tomasz S.
Published: September 2022

Cooperative behaviour is a prominent feature among many group-living species and continues to pose challenges to our understanding about the evolution of social relationships and task coordination between members of the same social group. Individuals who are willing to cooperate to achieve a joined action need to communicate their intentions and somehow make a common agreement. We investigated how a coordinated chorus song is initiated in a cooperative-breeding bird species, The Yellow-Breasted Barbet (Trachyphonus margaritatus). A chorus can be defined as an interactive vocal display involving several individuals who are synchronizing their behaviour to sing in a time coordinated manner. Synchronizing behaviour to sing in chorus might become quite challenging when several individuals are involved. Thus, group members could use a specific signal to induce such collective action. Yet, few studies have investigated the mechanisms of communal display initiation in chorusing bird species. We conducted playback experiments to induce and record territorial defensive reactions from birds with a video camera. We recorded 26 different groups from distinct wild populations in Djibouti which belonged to 17 sites. We found that barbets use a specific vocalization namedchewpnote to introduce their duet and chorus. Moreover, we found that the individual that initiates such communal displays may broadcast a multimodal signal by combiningchewpnote series with a typical body posture with the tail raised and fanned. We suggest that the multimodal signal could serve to attract attention and elicit a response from other group members or could enhance the song coordination.
Factors influencing the initiation of adjuvant endocrine therapy in patients with estrogen receptor-positive ductal carcinoma in situ: a single institution experience
Authors: Levy Julia , Farag Fady , Cole John
Published: September 2022

Purpose

This study evaluates whether race, socioeconomic status, insurance type, oncological provider type, and prior cancer treatment are associated with the suggestion and acceptance of hormonal therapy in patients with estrogen receptor (ER)-positive Ductal carcinoma in situ (DCIS). This study also assesses whether disparities exist pertaining to prescription of such medications.

Methods

This single-center retrospective study included 111 patients diagnosed with DCIS between 2020 and 2021. Data collected included race, type of insurance, prescribing providers, and socioeconomic status. We used zip codes to identify the poverty levels in these areas as published in the United States Census Bureau and stratified the patients into quartiles accordingly. Chi-Square statistics were used to calculate significance levels.

Results

There was no significant correlation between the intake of hormonal therapy and race (p = 0.60), insurance (p = 0.50), socioeconomic (p = 0.58), or providers (p = 0.99). 79.3% of women were offered endocrine therapy. Of those who were offered endocrine therapy, 70.8% accepted. Of patients not on hormonal therapy, 45.8% were not recommended the medications by their provider, and 54.2% declined treatment when offered.

Conclusion

In this study, patients’ demographics and providers were not associated with adjuvant hormonal therapy initiation in DCIS. Our results show that abstaining from endocrine therapy in DCIS patients is both due to lack of provider recommendation and patient rejection of these medications. The wide variation in hormonal therapy treatment among ER-positive DCIS patients suggests a need for improved provider-patient communication regarding the risks and benefits of endocrine therapy in order to ensure a shared decision-making process.
The Effect of Ethical Commitment Reminder and Reciprocity in the Workplace on Misreporting
Authors: Ferdiansah Muhammad Irdam , Chong Vincent K. , Wang Isabel Z. , Woodliff David R.
Published: September 2022

Despite the pervasive use of ethics training by companies, research in management accounting has not considered the effectiveness of such training in curtailing managers’ misreporting. This study examines the effect of ethics training on misreporting as a reminder to raise the awareness of employees’ ethical commitment. Furthermore, this study investigates the extent to which reciprocity in the workplace affects managers’ misreporting. The results from an experiment involving 124 managers show that in the absence of an ethical commitment reminder, managers are more likely to engage in misreporting than when an ethical commitment reminder is present. The results suggest that ethical commitment reminder interacts with reciprocity in the workplace, affecting managers’ misreporting. Specifically, the results reveal that managers are more likely to engage in misreporting under the reciprocity in the workplace condition when the ethical commitment reminder is absent. The theoretical and practical implications of these findings are discussed.
Attitudes to Interpersonal Touch in the Workplace in Autistic and non-Autistic Groups
Authors: Penton Tegan , Bowling Natalie , Vafeiadou Aikaterini , Hammond Claudia , Bird Geoffrey , Banissy Michael J
Published: September 2022

Unemployment and underemployment have consistently been shown to be higher in autistic adults relative to non-autistic adults. This may be due, in part, to a lack of workplace accommodations being made for autistic people. One factor that may contribute to employment inequalities in autistic people is differences in attitudes towards interpersonal touch. This study acts as a preliminary investigation into whether employed autistic and non-autistic participants differ in their attitudes towards touch in the workplace, and in their loneliness and wellbeing. The current dataset was drawn from a larger online survey (the Touch Test) designed to explore attitudes and experiences towards touch. We found that employed autistic participants had more negative attitudes to general, social and workplace touch relative to non-autistic participants. Autistic participants also experienced greater loneliness and reduced wellbeing. Attachment-related anxiety was the only significant predictor of wellbeing in employed autistic adults. However, attachment-related anxiety, general attitudes to touch and the role of touch in the workplace predicted wellbeing in employed non-autistic adults. With regards to loneliness, general attitudes to touch and the role of touch in the workplace predicted loneliness in autistic participants. We also replicated the finding that a greater proportion of autistic participants were unemployed relative to non-autistic participants. Collectively, this research highlights the importance of considering touch in research investigating employment, and its impact on loneliness and wellbeing, in autistic participants.
Experimental measurement of particle crushing around model piles jacked in a calibration chamber
Authors: Tovar-Valencia Ruben D. , Galvis-Castro Ayda , Salgado Rodrigo , Prezzi Monica , Fridman Daniel
Published: September 2022

During installation of driven or jacked piles in sand, particle crushing occurs in a region below the base of these piles. Quantification of the degree and extent of particle crushing during driving or jacking in sand is necessary to improve current design methods. To study the effects of particle crushing on the capacity of piles jacked in uniform silica sand samples, a model pile was jacked and tested in a half-cylindrical calibration chamber with transparent observation windows in its front wall. Annular samples of crushed sand 3 mm in thickness were recovered after testing from several locations along the shaft and the base of the model piles and used to assess particle gradation changes and to calculate breakage parameters. Relationships between the load mobilized at the base of the model piles and three breakage parameters are proposed. Furthermore, the number of jacking strokes (ranging from 1 to 32 in this research) has a negligible effect on the degree of crushing produced during installation and on the measured stresses at the base of the model pile. Analyses of the digital images captured during pile jacking indicate that the silica sand particles in the path of the model pile crush mainly along irregularities and sharp edges. Different zones are identified below the model pile according to the degree of particle crushing. Digital images taken during static loading of the model pile allowed tracking of the displacement paths of individual sand particles during loading.
Einfluss der Berufserfahrung von Multiplikatorinnen und Multiplikatoren auf die Wirksamkeit von Fortbildungsmaßnahmen zur frühen mathematischen Bildung
Authors: Hagena Maike , Bruns Julia , Gasteiger Hedwig
Published: September 2022

Nach Meinung von Lehrkräften und frühpädagogischen Fachkräften sollten Multiplikatorinnen und Multiplikatoren insbesondere über eigene Berufserfahrung als Lehrkraft bzw. frühpädagogische Fachkraft verfügen, um wirksame Fortbildungsmaßnahmen durchführen zu können. Im Projekt EmMaM wird der Frage nachgegangen, inwieweit die Berufserfahrung von Multiplikatorinnen bei an Fortbildungsmaßnahmen teilnehmenden frühpädagogischen Fachkräften (n = 83) die Entwicklung mathematikdidaktischen Wissens begünstigt und die Freude an Mathematik stärkt. Es zeigt sich, dass die Berufserfahrung der teilnehmenden Multiplikatorinnen keinen Einfluss auf die Entwicklung des mathematikdidaktischen Wissens der frühpädagogischen Fachkräfte hat, sie begünstigt jedoch die Entwicklung der Freude der frühpädagogischen Fachkräfte an Mathematik. Unter Kontrolle dieser gesteigerten Freude zeigt sich ein Einfluss der Berufserfahrung auf die Entwicklung des mathematikdidaktischen Wissens, allerdings zugunsten der teilnehmenden Multiplikatorinnen, die keine Berufserfahrung in Kindertageseinrichtungen vorweisen konnten, aber stattdessen ein Studium absolviert hatten.
Towards narrowing the reality gap in electromechanical systems: error modeling in virtual commissioning
Authors: Kuhn Alexander Michael , May Marvin Carl , Liu Yuhui , Kuhnle Andreas , Tekouo William , Lanza Gisela
Published: September 2022

Digital factories and smart manufacturing systems have been increasingly researched and multiple concepts were developed to cope with prevailing ever-shortening life-cycles. The ubiquitous digital twin, despite many definitions, is often praised for accurate virtual models. One key idea to improve manufacturing through such virtual models is virtual commissioning (VC), aiming at early machine code validation. VC and its virtual models are still lacking behind their real counterparts. This gap between reality and its virtual model, commonly termed reality gap, increases the complexity of creating cyber-physical systems. An especially stark contrast is visible between the idealized virtual model and a real machine encountering errors. While error simulations exist in other fields of research, a thorough investigation in VC is missing. Thus, this paper addresses the task of narrowing the reality gap in VC based on two steps. First, a comprehensive body of research of possible errors encountered in virtual commissioning is analyzed. Secondly, the feasibility of error implementation is discussed. This paper lays the foundation for narrowing the reality gap and enabling test automation and digital twin-based control.
Does corporate social performance improve bank efficiency? Evidence from European banks
Authors: López-Penabad Maria Celia , Iglesias-Casal Ana , Neto José Fernando Silva , Maside-Sanfiz José Manuel
Published: September 2022

This paper analyses the impact of corporate social performance (CSP) on bank efficiency in a sample of 108 European listed banks across 21 countries over the period 2011–2019. Simar and Wilson’s two-stage approach (Simar and Wilson in J Econom 136:31–64, 2007) has been applied, specifically using data envelopment analysis (DEA) at the first stage to estimate efficiency scores and then truncated regression estimation with double-bootstrap to test the significance of the relationship between bank efficiency and CSP as well as its different dimensions. Our results suggest evidence of a U-shaped relationship between CSP and efficiency, indicating that banks with either high or low corporate social performance levels are the most efficient. Considering the isolated effect of environmental, social, and governance dimensions, the same conclusion can be drawn for the latter two, while the former does not appear to have any effect on a bank’s efficiency. Our work contributes to the existing literature by providing a holistic procedure for assessing CSP in terms of efficiency, allowing us to study the separate effect of each component on bank efficiency. Our results have strong implications for regulators, policymakers, bank managers and investors supporting the changes in the EU Regulatory Taxonomy that lead banks to align their activities and strategies with the Sustainable Development Goals.