Mads Emil Jacobsen, MD, Kristoffer Borbjerg Hare, MD, PhD, Nanna Sillesen, MD, PhD
et al.
Background:. Competency-based medical education relies on assessment to evaluate performance and guide learning. This study compared the validity evidence and psychometric performance of the Objective Structured Assessment of Technical Skills (OSATS), adapted for distal radius fracture fixation, with a procedure-specific instrument—the Distal Radius Fracture Assessment of Technical Expertise (DRF-RATE)—for assessing technical performance during volar locking plate (VLP) fixation of distal radius fractures (DRFs).
Methods:. First-year orthopaedic residents (n = 12) and practicing trauma or hand surgeons (n = 13) performed standardized VLP fixation on a cadaveric DRF model. Anonymous video recordings were independently assessed by 2 orthopaedic trauma surgeons and 2 hand surgeons using either OSATS or DRF-RATE. Validity evidence was gathered in accordance with the Messick contemporary validity framework.
Results:. Internal consistency reliability was good-to-excellent for OSATS (α = 0.82-0.98) and DRF-RATE (α = 0.95). Interrater reliability was weaker for OSATS (r = 0.59-0.69) than for DRF-RATE (r = 0.78), though both demonstrated systematic rater bias. OSATS discriminated between novices and experienced surgeons (p = 0.02), whereas DRF-RATE demonstrated even stronger discrimination (p < 0.001). Contrasting-groups analysis revealed higher misclassification rates with OSATS (21%-40%) than DRF-RATE (11%-13%), indicating superior accuracy for the latter.
Conclusions:. The DRF-RATE demonstrated stronger and more comprehensive validity evidence than the modified OSATS, with better reliability, higher discrimination and classification accuracy, and overall superior psychometric performance compared with OSATS. Its procedural granularity and structured design address key limitations of OSATS and support detailed, high-quality formative feedback for distal radius fracture fixation.
Miranda Olff, Irma Hein, Ananda B. Amstadter
et al.
To mark 15 years of the European Journal of Psychotraumatology, editors reviewed the past 15-year years of research on trauma exposure and its consequences, as well as developments in (early) psychological, pharmacological and complementary interventions. In all sections of this paper, we provide perspectives on sex/gender aspects, life course trends, and cross-cultural/global and systemic societal contexts. Globally, the majority of people experience stressful events that may be characterized as traumatic. However, definitions of what is traumatic are not necessarily straightforward or universal. Traumatic events may have a wide range of transdiagnostic mental and physical health consequences, not limited to posttraumatic stress disorder (PTSD). Research on genetic, molecular, and neurobiological influences show promise for further understanding underlying risk and resilience for trauma-related consequences. Symptom presentation, prevalence, and course, in response to traumatic experiences, differ depending on individuals’ age and developmental phase, sex/gender, sociocultural and environmental contexts, and systemic socio-political forces. Early interventions have the potential to prevent acute posttraumatic stress reactions from escalating to a PTSD diagnosis whether delivered in the golden hours or weeks after trauma. However, research on prevention is still scarce compared to treatment research where several evidence-based psychological, pharmacological and complementary/ integrative interventions exist, and novel forms of delivery have become available. Here, we focus on how best to address the range of negative health outcomes following trauma, how to serve individuals across the age spectrum, including the very young and old, and include considerations of sex/gender, ethnicity, and culture in diverse contexts, beyond Western, Educated, Industrialized, Rich, and Democratic (WEIRD) countries. We conclude with providing directions for future research aimed at improving the well-being of all people impacted by trauma around the world. The 15 years EJPT webinar provides a 90-minute summary of this paper and can be downloaded here [http://bit.ly/4jdtx6k].
Ramez Abdalla, Nermine Agban, Christian Lüddeke
et al.
Waterflooding optimization is a critical process for enhancing oil recovery in mature oil fields, where conventional approaches often rely on fixed injection rates over an extended period. However, this may not be the most efficient strategy due to reservoir heterogeneity and complexity. In this study, we propose a multi-agent physics informed reinforcement learning (MAPIRL) framework to optimize the waterflooding process. The MAPIRL approach utilizes a Markov decision process to formulate the optimization problem, where multiple RL agents are trained to interact with a reservoir simulation model and receive rewards for each action. The proposed approach uses an actor–critic RL architecture to train the agents to find the optimal strategy. The agents interact with the environment during several episodes until convergence is achieved. We evaluated the effectiveness of the MAPIRL approach based on the improvement in net present value (NPV), which reflects the economic benefits of the optimized waterflooding strategy. Then, we compared the MAPIRL approach with the multi-objective particle swarm optimization (MOPSO) algorithm. The comparison revealed that the MAPIRL approach outperformed the MOPSO algorithm in terms of net present value. In conclusion, the MAPIRL approach is a scientifically accurate method for optimizing waterflooding in mature oil fields, providing a more efficient and robust waterflooding strategy that reduces water consumption and associated costs while maximizing the economic benefits. The ability of the MAPIRL approach to optimize the waterflooding process with a high degree of complexity makes it a promising tool for the energy industry, and further research is needed to explore its potential for addressing other complex problems in this domain.
Abstract INTRODUCTION Alzheimer's disease (AD) prevalence is increasing, with no current cure. Natural language processing (NLP) offers the potential for non‐invasive diagnostics, social burden assessment, and research advancements in AD. METHOD A systematic review using Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines explored NLP applications in AD, focusing on dataset types, sources, research foci, methods, and effectiveness. Searches were conducted across six databases (ACM, Embase, IEEE, PubMed, Scopus, and Web of Science) from January 2020 to July 2024. RESULTSOf 1740 records, 79 studies were selected. Frequently used datasets included speech and electronic health records (EHR), along with social media and scientific publications. Machine learning and neural networks were primarily applied to speech, EHR, and social media data, while rule‐based methods were used to analyze literature datasets. DISCUSSIONNLP has proven effective in various aspects of AD research, including diagnosis, monitoring, social burden assessment, biomarker analysis, and research. However, there are opportunities for improvement in dataset diversity, model interpretability, multilingual capabilities, and addressing ethical concerns. Highlights This review systematically analyzed 79 studies from six major databases, focusing on the advancements and applications of natural language processing (NLP) in Alzheimer's disease (AD) research. The study highlights the need for models focusing on remote monitoring of AD patients using speech analysis, offering a cost‐effective alternative to traditional methods such as brain imaging and aiding clinicians in both prediagnosis and post‐diagnosis periods. The use of pretrained multilingual models is recommended to improve AD detection across different languages by leveraging diverse speech features and utilizing publicly available datasets.
Neurology. Diseases of the nervous system, Geriatrics
Differentiating between an irrational versus a rational fear of hypoglycemia has treatment implications and presents significant challenge for clinicians facing patients with type 1 diabetes, illustrated in this case. A 39-year-old woman with autoimmune-positive insulin-dependent diabetes sought help to alleviate severe diabetes distress, and symptoms of depression and anxiety, associated with unpredictable drastic blood glucose drops. After exhausting conventional methods, she adopted a ketogenic diet (KD). Her glucose values decreased from around 20 mmol/L to 12 mmol/L (360 mg/dL to 216 mg/dL) in the first days. Then, by combining a KD with an insulin pump, her time in optimal glucose range increased from 8 to 51% after 2 months, reducing her HbA1c with 25 mmol/mol (2.2%). This reduced biological and psychological stress, immediately improving her mental health and renewing her hope for the future. The main concerns regarding KD in patients with comorbid type 1 diabetes is the assumed increased risk of ketoacidosis, theoretical depletion of glycogen stores, and a potential adverse effect of saturated fat on cardiovascular risk factors. These concerns are evaluated against existing empirical evidence, suggesting instead that a KD may protect against acidosis, hypoglycemia, and cardiovascular risk. The present case, together with available data, indicate that patients with type 1 diabetes experiencing high levels of biological and psychological stress should be informed of the expected benefits and possible risks associated with a KD, to ensure their right to take informed decisions regarding their diabetes management.
Ivana Generalić Mekinić, Vida Šimat, Nikheel Bhojraj Rathod
et al.
Recently, the isolation and identification of various biologically active secondary metabolites from algae have been of scientific interest, with particular attention paid to carotenoids, widely distributed in various photosynthetic organisms, including algal species. Carotenoids are among the most important natural pigments, with many health-promoting effects. Since the number of scientific studies on the presence and profile of carotenoids in algae has increased exponentially along with the interest in their potential commercial applications, this review aimed to provide an overview of the current knowledge (from 2015) on carotenoids detected in different algal species (12 microalgae, 21 green algae, 26 brown algae, and 43 red algae) to facilitate the comparison of the results of different studies. In addition to the presence, content, and identification of total and individual carotenoids in various algae, the method of their extraction and the main extraction parameters were also highlighted.
Formålet med studien er å undersøke og problematisere praksisveilederes fokus i veiledning av sosionomstudenter. Problemstillingen er todelt og omhandler hva praksisveiledere retter oppmerksomheten mot i veiledningssamtalene, og hvilke implikasjoner denne oppmerksomheten kan få for studenters profesjonskvalifisering. Artikkelen bygger på intervjuer med åtte praksisveiledere, og den metodologiske tilnærmingen er inspirert av en dialogisk analysemetode. Studien viser at trygghetsskapende arbeid dominerer fremfor kontekstuell fagkunnskap i veiledningsarbeidet. Det forekommer to ulike metodisk orienterte diskurser i det trygghetsskapende arbeidet. Den ene er personlighetsorientert, og den andre er oppgaveorientert. I artikkelen stilles kritiske spørsmål til trygghetens dominerende posisjon i veiledningssamtalen. Det hevdes at et dominerende og noe ensidig trygghetstrykk kan føre til underkommunisering av sosionomers faglighet og deres profesjonelle kunnskapsgrunnlag.
Nowadays, rapid freezing is sought to favor the formation of small ice crystals. Several studies have shown that the application of ultrasounds (US) accelerates the processes of energy and mass transfer when they are applied through immersion systems. However, there are hardly any studies on its application in direct systems without the use of a liquid medium for its transmission. Therefore, the objective of this work was to evaluate the potential of the application of US for improving the freezing process of chicken breast samples. First, the application of intermittent US treatments at different net sonication times of 7, 17, 37, 50 and 67% during the freezing of distilled water samples in a conventional freezer was evaluated. It was observed that net sonication times of 37, 50 and 67% reduced the phase change period by 30.0, 21.4, 27.0%, respectively. The effective freezing time was also reduced by 12.4 and 12.8% by applying net sonication times of 37 and 50%. Considering these results, an intermittent US treatment with a net sonication time of 37% was chosen for chicken breast freezing in an air-forced cooling tunnel at ambient temperatures from −13 to −22 °C. The length of all the freezing phases was reduced upon application of US, leading to an overall process time reduction of approx. 11%. On the other hand, no significant differences were found either in the Water Holding Capacity (WHC) or Cooking Loss (CL) values between control and US assisted frozen chicken breast samples. Furthermore, in vitro experiments showed that US-assisted freezing did not influence protein digestibility of chicken meat samples.This study demonstrates the potential of the application of US by direct contact to favor energy transfer processes during freezing of water and chicken breasts samples. However, its effect on the quality of the frozen products should be further studied.
Sammendrag
I artiklen undersøges elevers erfaringer med identitetsdannelse og relationer i skolen. Det empiriske materiale udgøres af deltagerobservationer og uformelle samtaler med ni 12-13 åriges skoledrenge med læringsudfordringer og konflikter med voksne og andre elever. Drengene er fulgt gennem et sundhedsfremmeprojekt, Cykelholdet, med fokus på at skabe sammenhæng mellem fysisk aktivitet, inklusion samt læringsmæssige og pædagogiske mål. Teoretisk er tilgangen inspireret af Davies og Harré (2014). Via begreberne ”subjectification”, ”being”, ”becoming”, og ”positioning” undersøger artiklen deltagernes diskursive og sociale praksisser. Herved illustrerer analysen, at eleverne individuelt og sammen ”gør” Cykelholdet, som sted/tid og ad deres egne individuelle og fælles veje etablerer og genforhandler problemorienterede subjektpositioner, hvorved sundhedsfremme kan navigeres, på andre måder end som "kropumulige" drenge. Artiklen bidrager med empirisk viden, dels om sundhedsfremme i skolen med fokus på tiltag mod ulighed i sundhed blandt børn og unge, dels med viden om hvordan sundhedsfremme ”gøres” af elever med læringsudfordringer og konflikter. Artiklen præsenterer viden, der kan danne afsæt for at udvikle mere varierede tiltag til sundhedsfremme i skolen og lokalt tilpassede løsninger, som kobler læring til trivsel og bevægelse på måder, der har relevans for denne gruppe af elever.
Social pathology. Social and public welfare. Criminology
Artiklen undersøger den forestilling om historisk og kulturel forankring, man finder i det danske rockband Nephews projekt Ring-i-Ring. I 2018 udsendte gruppen fire EP-plader, en for hver årstid, der til sidst blev samlet på et album. Derved blev projektets fokus på de sider af tilværelsen, der forløber i cyklusser, understreget: dagene, årene, årstiderne, generationerne osv. I artiklen vises det, idet der perspektiveres idéhistorisk, hvordan bandet med sine sange tematiserer konservative værdier som cyklisk tidsopfattelse, tradition, nation og kristendom. Dette sker bl.a. via selve måden, hvorpå traditionelle sange og sangtekster blandes med ny lyd, i forsøget på at skrive nye sange i forlængelse af Højskolesangbogen og Salmebogen samt ved de performative forhold ved fremførelsen af sangene i koncertsituationen.
Farshid Aram, Ebrahim Solgi, Sepideh Baghaee
et al.
The combined effects of global warming and increasing urban heat islands (UHIs) on air temperature and heat stress in cities are notable physical and mental health implications for citizens. With research having shown the effective role of urban green spaces in decreasing urban heat, this study investigated the cooling effect of a large urban park on thermal comfort outside the park area, from psychological and physiological perspectives. The studied park is located in the center of Madrid and adjacent to UHI. The study was performed by conducting field measurements and a survey with questionnaires. The measurements made on six summer days (with two-week intervals) showed that the park’s cooling effect could decrease the air temperature by 2.4–2.8 °C right up to the edge of the heat island (600 m), and decrease the physiological equivalent temperature (PET) by about 3.9 °C. By decreasing air temperature and PET, this park was also shown to increase the perceived thermal comfort (PTC) of the citizens from the psychological perspective in the defined area of effect. This perceived thermal comfort was found to have a significant inverse relationship with PET (P-value <0.05). The examination of cognitive maps drawn by citizens showed that out of the 145 respondents, 68.3% marked the park as the area that they perceive as having the greatest thermal comfort, and prefer as the place to spend time enjoying thermal comfort, irrespective of its distance from their location.
Richard Wootton, Laurent Bonnardot, Laurent Bonnardot
The Collegium system was first made available in 2012 to support organizations conducting humanitarian or non-commercial telemedicine work in low resource settings. It provides the technical infrastructure necessary to establish a store-and-forward telemedicine service. During the subsequent 6 years a total of 46 networks were established, based on the Collegium infrastructure. The majority of the networks were set up to provide a clinical service (33), with six designed for education and training, and the remainder for test or administrative purposes. Of the potentially operational networks which were set up (i.e., those established for clinical or educational purposes), 15 networks (38%) were stillborn and did not handle a single case after being established. In contrast, the two most active networks had handled almost 12,000 cases. The average case rate of the five most active clinical networks operating in low-resource settings (i.e., the total number of cases divided by the length of time for which the network had been established) ranged from 0.5 to 29.4 cases/week. Across the networks there was little evidence of sigmoidal growth in activity, which is consistent with reports of other telemedicine activity in North America. A brief survey was sent to 49 network coordinators, from 31 networks. Responses were received from 9 coordinators (18% of those invited to participate). The median satisfaction with the system was 8 (on a scale from 1 = not at all satisfied to 10 = very satisfied). The free text comments were mainly technical suggestions regarding image transfer, the mobile application, or other modes of communication. The results of operating the Collegium system demonstrate that supporting telemedicine work in low resource settings can be successful, since the networks handled a very wide range of clinical cases, and at activity levels up to several cases per day. However, approximately one-third of the networks that were established did not handle a single clinical case. Nonetheless, this might represent a form of success in the sense that it prevented the waste of resource involved in an organization purchasing a telemedicine infrastructure only to find that it was not used.
Lucie Šedová, Michal Pravenec, Drahomíra Křenová
et al.
Metabolic syndrome is a highly prevalent human disease with substantial genomic and environmental components. Previous studies indicate the presence of significant genetic determinants of several features of metabolic syndrome on rat chromosome 16 (RNO16) and the syntenic regions of human genome. We derived the SHR.BN16 congenic strain by introgression of a limited RNO16 region from the Brown Norway congenic strain (BN-Lx) into the genomic background of the spontaneously hypertensive rat (SHR) strain. We compared the morphometric, metabolic, and hemodynamic profiles of adult male SHR and SHR.BN16 rats. We also compared in silico the DNA sequences for the differential segment in the BN-Lx and SHR parental strains. SHR.BN16 congenic rats had significantly lower weight, decreased concentrations of total triglycerides and cholesterol, and improved glucose tolerance compared with SHR rats. The concentrations of insulin, free fatty acids, and adiponectin were comparable between the two strains. SHR.BN16 rats had significantly lower systolic (18-28 mmHg difference) and diastolic (10-15 mmHg difference) blood pressure throughout the experiment (repeated-measures ANOVA, P < 0.001). The differential segment spans approximately 22 Mb of the telomeric part of the short arm of RNO16. The in silico analyses revealed over 1200 DNA variants between the BN-Lx and SHR genomes in the SHR.BN16 differential segment, 44 of which lead to missense mutations, and only eight of which (in Asb14, Il17rd, Itih1, Syt15, Ercc6, RGD1564958, Tmem161a, and Gatad2a genes) are predicted to be damaging to the protein product. Furthermore, a number of genes within the RNO16 differential segment associated with metabolic syndrome components in human studies showed polymorphisms between SHR and BN-Lx (including Lpl, Nrg3, Pbx4, Cilp2, and Stab1). Our novel congenic rat model demonstrates that a limited genomic region on RNO16 in the SHR significantly affects many of the features of metabolic syndrome.
Denne artikkelen tar utgangspunkt i mine år med erfaringer med styrearbeid og hvordan valgkomiteer arbeider. Et viktig overordnet råd for godt komitearbeid er å jobbe gjennom hele året, ikke bare like før valgtidspunktet. Det er sentralt at medlemmene i valgkomiteen har godt innsyn i selskapet og den bransjen man opererer i, og valgkomiteens nettverk er viktig for å finne de riktige kandidatene. Det er avgjørende at valgkomiteen er godt kjent med styrets arbeid. For å kunne få godt innsyn i dette bør komiteen ha dialog (både) med alle styrets medlemmer og administrasjonen i selskapet, og de bør også ha en åpen og balansert dialog med selskapets aksjonærer. Jevnlige evalueringer av styret, som bør skje både internt og av eksterne ressurser, er et godt verktøy for å danne seg et riktig bilde av hvilke oppgaver styret har, hvordan de løser dem, og hvilke kompetanser som eventuelt mangler. Informasjonen som fremkommer i evalueringene, er også viktig for at komiteen overfor potensielle kandidater skal kunne presentere et faktabasert og realistisk bilde av hvor stort omfanget av styrearbeidet må forventes å være, og hva som ellers forventes av nye styremedlemmer. Valgkomiteen bør også ha en oppfatning av hva som er relevant og riktig nivå på styrehonorar.
From early on, Henrik Ibsen has played an important part on the Georgian stage, as well as in Georgian literary thought. Since the publication of Ibsen’s biography in the newspaper Kvali in 1897, the dramatist has been continuously discussed, translated, written about and performed in Georgia. Ibsen has been received under different circumstances and by different generations: to pursue the reception of Ibsen in Georgia is, in a way, to pursue the development of Georgian intellectual and cultural history in the period.
In Georgia, various celebrations of Ibsen’s birth and death were marked, in a number of articles, and even a little book on Ibsen by Akaki Gelovani were published.
Well-known Georgian authors have also been interested in Ibsen. In our context, one should mention that both Mikhail Javakhishvili and Konstantin Gamsakhurdia, the classic authors of modern Georgian prose, wrote famous essays on Ibsen.
Ibsen was and is constantly referred to in Georgian literary studies, not least in connection with Georgian writers. In post-Soviet Georgia, Ibsen is very much on the agenda, and his plays are produced and discussed as they always have been.