An interdisciplinary integrated specialized one-stop outpatient clinic for idiopathic intracranial hypertension - a comprehensive assessment of patient satisfaction.

BACKGROUND: Management of idiopathic intracranial hypertension (IIH) is complex requiring contributions from multiple specialized disciplines. In practice, this creates considerable organizational and communicational challenges. To meet those challenges, we established an interdisciplinary integrated outpatient clinic for IIH with a central coordination and a one-stop concept. Here, we aimed to evaluate effects of this one-stop concept on subjective patient satisfaction and economic outcome in patients with IIH. METHODS: In a retrospective cohort study, we compared the one-stop era with integrated care (IC, 1-JUL-2021 to 31-DEC-2022) to a reference group receiving standard care (SC, 1-JUL-2018 to 31-DEC-2019) regarding subjective patient satisfaction (assessed by the Vienna Patient Inventory). Multivariable binary linear regression models were used to adjust for confounders. RESULTS: Baseline characteristics of the IC group (n = 85) and SC group (n = 81) were comparable (female: 90.6% vs. 90.1%; mean age: 33.6 vs. 32.8 years, educational level: ≥9 years of education 60.0% vs. 59.3%; located in Vienna 75.3% vs. 76.5%). Compared to SC, management within IC concept was associated with statistically significantly higher subjective patient satisfaction (beta = 0.93; p < 0.001) with the strongest effects observed in satisfaction with treatment accessibility and availability (beta = 2.05; p < 0.001). Subgroup analyses of patients with migration background and language barrier consistently indicated stronger effects of IC in these groups. CONCLUSIONS: Interdisciplinary integrated management of IIH statistically significantly and clinically meaningfully improves patient satisfaction - particularly in socioeconomically underprivileged patient groups. Providing structured central coordination to facilitate and improve access to interdisciplinary management provides means to further improve outcome.

An intuitionistic fuzzy graph's variation coefficient measure with application to selecting a reliable alliance partner.

Group decision-making (GDM) is crucial in various components of graph theory, management science, and operations research. In particular, in an intuitionistic fuzzy group decision-making problem, the experts communicate their preferences using intuitionistic fuzzy preference relations (IFPRs). This approach is a way that decision-makers rank or select the most desirable alternatives by gathering criteria-based information to estimate the best alternatives using a wider range of knowledge and experience. This article proposes a new statistical measure in a fuzzy environment when the data is ambiguous or unreliable to solve a decision-making problem. This study uses the variation coefficient measure combined with intuitionistic fuzzy graphs (IFG) and Laplacian energy (LE) to solve a GDM problem that utilizes intuitionistic fuzzy preference relations (IFPRs) to select a reliable alliance partner. Initially, the Laplacian energy determines the weight of individual standards, and the obtained weight average further estimates the overall criterion weight vector. We establish the authority criteria weights using the variation coefficient measure and then ultimately rank the alternatives for each criterion using the same measure. We examine four distinct companies Alpha, Beta, Delta, and Zeta to conduct a realistic GDM to choose which alliance partner would be ideal. We successfully implemented the suggested technique, determining that Alpha satisfies company standards and is ranked first among other companies. Moreover, this technique is useful for all kinds of Intuitionistic fuzzy group decision-making problems to select optimal ones.

Research on entity relation extraction for Chinese medical text.

Currently, the primary challenges in entity relation extraction are the existence of overlapping relations and cascading errors. In addressing these issues, both CasRel and TPLinker have demonstrated their competitiveness. This study aims to explore the application of these two models in the context of entity relation extraction from Chinese medical text. We evaluate the performance of these models using the publicly available dataset CMeIE and further enhance their capabilities through the incorporation of pre-trained models that are tailored to the specific characteristics of the text. The experimental findings demonstrate that the TPLinker model exhibits a heightened and consistent boosting effect compared to CasRel, while also attaining superior performance through the utilization of advanced pre-trained models. Notably, the MacBERT + TPLinker combination emerges as the optimal choice, surpassing the benchmark model by 12.45% and outperforming the leading model ERNIE-Health 3.0 in the CBLUE challenge by 2.31%.

Wave propagation in tailored metastructures consisting of elastic beams and rigid bodies.

This paper presents a study of wave propagation through an infinite periodic structure that consists of elastic Timoshenko beams interconnected with rigid bodies. This is a generalized approach in which the beams are not coaxial and the centre of mass of each rigid body is placed away from the intersection of their neutral axes. An analytical approach is used by applying the transfer matrix method (TMM), along with the Floquet-Bloch theorem for elastic wave propagation. Subsequent parametric analysis is performed with visualization of resulting band diagrams of a representative structure. These results are verified through comparison with solutions obtained using the finite-element method (FEM). In this manner, a comprehensive dynamical analysis of tailored metastructures is provided.This article is part of the theme issue 'Current developments in elastic and acoustic metamaterials science (Part 2)'.

Hybrid-resolution facial and dental scanning: a cost-effective approach to utilizing 3D facial data in anterior dental implant restoration.

As digital technology becomes more prevalent in the practice of dental medicine, methods to fully replace 2-dimensional photography and analog devices such as the facebow are still in their infancy. As more practices adopt 3-dimensional (3D) intraoral scanners, effective digital communication of the relationships between the teeth and the face becomes essential. With the high cost of intraoral scanners, the additional expense of a face scanner is not a feasible investment for many practices. This article explores a technique for meshing (lower resolution) facial data obtained from a smartphone-based scanner with high-resolution intraoral scan data. In this approach, the data from a free 3D scanning application on a smartphone and a traditional intraoral scanner are meshed so that high-resolution data are available for intraoral features and lower resolution data are used to capture the gross contours of the face. In this way, a hybrid-resolution composite scan that incorporates all of the data needed to simulate the face and accurately reproduce the teeth is generated without the cost of additional scanning equipment. This article defines a new term, the facial registration scan, for use alongside the familiar digital bite registration obtained with an intraoral scanner. To illustrate the clinical use of the hybrid-resolution scan concept, this article presents a case in which this method was used for the restoration of maxillary anterior implants.

Selection of appropriate location based on signed distance based ranking approach with interval type-2 trapezoidal fuzzy preference relations.

In real life situation, it is often difficult to judge the relative importance of different parameters being considered for evaluating some alternatives. In the context of fuzzy sets, it is a situation where it is difficult to define precise membership grades for attribute values. Here we require more generalized type of fuzzy sets which have a greater representational power than ordinary fuzzy sets. For this purpose we use "interval type-2 trapezoidal fuzzy preference relations (IT2TrFPRs)" in this article as a generalization of fuzzy preference relations and consider the environment discussed above, where there is no information on priority weights. A collective decision matrix will be constructed on the basis of hybrid averages using weighted averaging and signed distance based OWA operation. Then a least deviation model will be employed in order to determine the priority weight vectors. Finally, the alternatives will be ranked on the basis of weighted normalized signed distance of each alternative from the ideal solution. Moreover, a real life example of location selection is illustrated to elaborate the effectiveness of the proposed scheme.

A digital workflow for full-mouth rehabilitation using CAD-CAM tooth reduction template.

A digital workflow is presented for multiple transfers of targeted jaw relation and restorative spaces from interim to definitive restorations in patients with severe tooth wear. Following analysis of the targeted restorative space, segmented arch stereolithographic templates were digitally created and fabricated for precise control of reduction depth. Then, the jaw relation was transferred from the initially determined stabilization splint to the temporary fixed restoration and definitive restoration by using a digital articulator. This digital approach yielded a stabilized jaw relationship and restorative spaces transferring effect throughout successive stages of occlusal reconstruction resulting in satisfactory prosthetic outcomes.

A cost-sensitive decision model for efficient pooled testing in mass surveillance of infectious diseases like COVID-19.

The COVID-19 pandemic has imposed significant challenges on global health, emphasizing the persistent threat of large-scale infectious diseases in the future. This study addresses the need to enhance pooled testing efficiency for large populations. The common approach in pooled testing involves consolidating multiple test samples into a single tube to efficiently detect positivity at a lower cost. However, what is the optimal number of samples to be grouped together in order to minimize costs? i.e. allocating ten individuals per group may not be the most cost-effective strategy. In response, this paper introduces the hierarchical quotient space, an extension of fuzzy equivalence relations, as a method to optimize group allocations. In this study, we propose a cost-sensitive multi-granularity intelligent decision model to further minimize testing costs. This model considers both testing and collection costs, aiming to achieve the lowest total cost through optimal grouping at a single layer. Building upon this foundation, two multi-granularity models are proposed, exploring hierarchical group optimization. The experimental simulations were conducted using MATLAB R2022a on a desktop with Intel i5-10500 CPU and 8G RAM, considering scenarios with a fixed number of individuals and fixed positive probability. The main findings from our simulations demonstrate that the proposed models significantly enhance the efficiency and reduce the overall costs associated with pooled testing. For example, testing costs were reduced by nearly half when the optimal grouping strategy was applied, compared to the traditional method of grouping ten individuals. Additionally, the multi-granularity approach further optimized the hierarchical groupings, leading to substantial cost savings and improved testing efficiency.

Emotion Regulation, Relationship and Therapeutic Change in Analytical Psychology and Contemporary Psychodynamic Approaches.

All contemporary psychotherapies agree that (failing) emotion regulation is central to psychological disorders and that psychotherapy is about improving emotion regulation. In his research on the "emotion-laden" complex Jung put an emphasis on the role of failing emotion regulation in contributing to psychological disorders as well as to change in the process of psychotherapy, but he left this field of research and took a very different direction in favour of his archetype concept. Psychodynamic approaches generally argue that changes in emotion regulation are accomplished through corrective emotional experiences in the therapeutic relationship. Insights from affective neurosciences and attachment research have had a major influence on how the therapeutic relationship is constructed in contemporary psychodynamic approaches. There is a lack of similar developments in analytical psychology, which leads to substantial differences between the models of Jungian psychotherapy in contrast to other contemporary psychodynamic approaches. The implications of these differences for the practice of psychotherapy and especially the role of the therapeutic relationship are pointed out.

Toutes les psychothérapies actuelles s'accordent sur le fait que la régulation (défaillante) de l'émotion est au centre des désordres psychologiques et que la psychothérapie vise à améliorer la régulation de l'émotion. Dans sa recherche sur le « complexe à haute charge émotionnelle ¼, Jung a mis l'accent sur le rôle de la régulation défaillante de l'émotion comme participant aux désordres psychologiques ainsi qu'au changement dans le processus de psychothérapie. Mais il a abandonné ce champ de recherche et pris une direction très différente, y préférant son concept de l'archétype. Les approches psychodynamiques plaident généralement en faveur de l'idée que les changements dans la régulation de l'émotion sont atteints par les expériences émotionnelles corrective dans la relation thérapeutique. Des apports venant des neurosciences affectives et des recherches sur l'attachement ont eu une influence majeure sur comment la relation thérapeutique est construite dans les approches psychodynamiques actuelles. De tels développements font défaut dans la psychologie analytique, ce qui conduit à des différences considérables entre les modèles de psychothérapie jungienne en contraste avec les autres approches psychodynamiques actuelles. L'article souligne les conséquences de ces différences dans la pratique de la psychothérapie, tout particulièrement en ce qui concerne le rôle de la relation thérapeutique.

Todas las psicoterapias contemporáneas coinciden en que la regulación (fallida) de las emociones es central a los trastornos psicológicos y que la psicoterapia consiste en mejorar la regulación de las emociones. En su investigación sobre el complejo "de tonalidad afectiva", Jung hizo hincapié en el rol de una fallida regulación emocional en el desarrollo de los trastornos psicológicos, así como al cambio en el proceso de psicoterapia, pero abandonó este campo de investigación y tomó una dirección muy diferente en favor de su concepto de arquetipo. En general, los enfoques Psicodinámicos sostienen que los cambios en la regulación de las emociones se logran a través de experiencias emocionales correctivas en la relación terapéutica. Los conocimientos de las neurociencias afectivas y la investigación sobre el apego han tenido una gran influencia en cómo comprender la conformación de la relación terapéutica en los abordajes psicodinámicos contemporáneos. Faltan desarrollos similares en la psicología analítica, lo que conduce a diferencias sustanciales entre los modelos de la psicoterapia Junguiana en contraste con otros enfoques psicodinámicos contemporáneos. Se señalan las implicaciones de estas diferencias para la práctica de la psicoterapia y se destaca especialmente el rol de la relación terapéutica.

Discovery of novel amide derivatives against VEGFR-2/tubulin with potent antitumor and antiangiogenic activity.

Dual-target agents have more advantages than drug combinations for cancer treatment. Here, we designed and synthesized a series of novel VEGFR-2/tubulin dual-target inhibitors through a molecular hybridization strategy, and the activities of all the synthesized compounds were tested against tubulin and VEGFR-2. Among which, compound 19 exhibited strong potency against tubulin and VEGFR-2, with IC50 values of 0.76 ± 0.11 µM and 15.33 ± 2.12 nM, respectively. Additionally, compound 19 not only had significant antiproliferative effects on a series of human cancer cell lines, especially MGC-803 cells (IC50 = 0.005 ± 0.001 µM) but also overcame drug resistance in Taxol-resistant MGC-803 cells, with an RI of 1.8. Further studies showed that compound 19 could induce tumor cell apoptosis by reducing the mitochondrial membrane potential, increasing the level of ROS, facilitating the induction of G2/M phase arrest, and inhibiting the migration and invasion of tumor cells in a dose-dependent manner. In addition, compound 19 also exhibits potent antiangiogenic effects by blocking the VEGFR-2/PI3K/AKT pathway and inhibiting the tubule formation, invasion, and migration of HUVECs. More importantly, compound 19 demonstrated favorable pharmacokinetic profiles, robust in vivo antitumor efficacy, and satisfactory safety profiles. Overall, compound 19 can be used as a lead compound for the development of tubulin/VEGFR-2 dual-target inhibitors.

Elevating Restorative Dentistry: Use of the Art of Stamp Techniques in Mandibular Posterior Regions.

In modern dentistry, restorations that are more aesthetically pleasing have now replaced the amalgam restorations. The "stamp technique" is one of the more recently developed techniques for combining aesthetics and functionality. When caries are visible on radiographs or clinical examinations of teeth with complete marginal ridges and an ideal tooth structure, this method can be used. This novel stamp technique involves creating an index beforehand, which is essentially a miniature impression or negative copy of the occlusal topography. The advantage of the stamp technique is that it replicates the actual occlusion and its anatomy, reducing the need for additional corrections. The amount of time required for the restoration's polishing and finishing is also decreased. In comparison to manual methods, for the posterior teeth, the occlusal stamp is approachable as it is a biomimetic direct composite restoration that helps to restore hidden caries with the impaired occlusal surface. It produces better outcomes as it takes less post-restoration filling adjustments.

Dynamic development of changes in multi-scale structure during grain filling affect gelatinization properties of rice starch.

Rice was collected over the entire grain filling period (about 40 days) to explore the multi-structure evolution and gelatinization behavior changes of starch. During the early stage (DAA 6-14), the significant reduction in lamellar repeat distance (10.04 to 9.68 nm) and relative crystallinity (26.6 % to 22.7 %) was due to initial rapid accumulation of amylose (from 9.38 % to 14.05 %) and short amylopectin chains. Meanwhile, the decreased proportion of aggregation structure resulted in a decrease in the gelatinization temperature and a narrowed range of gelatinization temperature also indicated an increase in homogeneity as starch matured. Gelatinization enthalpy was mainly controlled by aggregation structure, which was negatively and positively related to the amylose content and the degree of order respectively. Peak viscosity of starch pasting increased and reached a maximum (924 cP) at DAA-21 due to larger granule size. Amylose and short amylopectin chains with degree of polymerization 6-12 showed positive and negative correlation with short-term retrogradation ability (setback value) respectively. The dynamics of different scale structure during grain filling had varying degrees of impact on gelatinization properties.

Responses to the needs of families with children with disabilities in Spain: The voices of families and professionals.

Children with disabilities and their families have the right to access Early Childhood Intervention (ECI). Family members should act as active agents of the intervention. In this sense, service professionals should offer support and intervention to improve family well-being and child development. We analyzed the experiences of parents of children with disabilities users of ECI services and the professional coordinators in the Balearic Islands (Spain) from a phenomenological-hermeneutic approach. Data collection was through semi-structured interviews and focus groups. A total of 5 coordinators and 30 family members participated in the study. The results indicate five categories: making ECI visible, reception phase, family well-being, intervention, and current barriers. The findings project the need to make ECI visible in policies and administrations, as well as plans to raise social awareness of child disability. Protocols must be found to facilitate access to services for children and families. Implications for the improvement of ECI are proposed.

Uncovering Nursing Communication Strategies and Relational Styles to Foster Patient Engagement in Oncology: A Scoping Review.

Nurses play an active role in fostering engagement of oncological patients, and, therefore, adopting effective communication and interpersonal skills is crucial. However, the nurse-patient relationship and communication strategies are frequently undervalued. This scoping review aims to address this gap with a twofold objective: (1) to explore the existing literature to identify communication strategies and relational styles employed by nurses to promote patient engagement in non-pediatric oncology patients; (2) to assess current knowledge on this topic to determine the need for future research. The search was conducted on different scientific databases and grey literature. The review was conducted following the methodology outlined in the Joanna Briggs Institute guidance for scoping reviews and the updated version of the PRISMA-ScR Checklist. Thirteen articles were included in the study. The studies in total enrolled 863 participants. Four clusters of nursing interventions were identified, encompassing communication strategies and relational styles of varying complexity, along with ten categories of general outcomes emerging from their implementation. This study summarizes the current knowledge regarding nursing communication strategies and relational styles used to promote patient engagement in oncological patients. Further research is needed, to evaluate and integrate the researched techniques, tools, and interventions for future clinical nursing practice.

Tackling Few-Shot Challenges in Automatic Modulation Recognition: A Multi-Level Comparative Relation Network Combining Class Reconstruction Strategy.

Automatic Modulation Recognition (AMR) is a key technology in the field of cognitive communication, playing a core role in many applications, especially in wireless security issues. Currently, deep learning (DL)-based AMR technology has achieved many research results, greatly promoting the development of AMR technology. However, the few-shot dilemma faced by DL-based AMR methods greatly limits their application in practical scenarios. Therefore, this paper endeavored to address the challenge of AMR with limited data and proposed a novel meta-learning method, the Multi-Level Comparison Relation Network with Class Reconstruction (MCRN-CR). Firstly, the method designs a structure of a multi-level comparison relation network, which involves embedding functions to output their feature maps hierarchically, comprehensively calculating the relation scores between query samples and support samples to determine the modulation category. Secondly, the embedding function integrates a reconstruction module, leveraging an autoencoder for support sample reconstruction, wherein the encoder serves dual purposes as the embedding mechanism. The training regimen incorporates a meta-learning paradigm, harmoniously combining classification and reconstruction losses to refine the model's performance. The experimental results on the RadioML2018 dataset show that our designed method can greatly alleviate the small sample problem in AMR and is superior to existing methods.

Compact stars with non-uniform relativistic polytrope.

This paper presents new relativistic composite polytropic models for compact stars by simultaneously solving Einstein field equations with the polytropic state equation to simulate the spherically symmetric, static matter distribution. Using a non-uniform polytropic index, we get the Tolman-Oppenheimer-Volkoff equation for the relativistic composite polytrope (CTOV). To analyze the star's structure, we numerically solve the CTOV equation and compute the Emden and mass functions for various relativistic parameters and polytropic indices appropriate for neutron stars. The calculation results show that, as the relativistic parameter approaches zero, we recover the well-known Lane-Emden equation from the Newtonian theory of polytropic stars; thus, testing the computational code by comparing composite Newtonian models to those in the literature yields good agreement. We compute composite relativistic models for the neutron star candidates Cen X-3, SAXJ1808.4-3658, and PSR J1614-22304. We compare the findings with various existing models in the literature. Based on the accepted models for PSR J1614-22304 and Cen X-3, the star's core radius is predicted to be between 50 and 60% percent of its total radius, while we found that the radius of the core of star SAXJ1808.4-3658 is around 30% of the total radius. Our findings show that the neutron star structure may be approximated by a composite relativistic polytrope, resulting in masses and radii that are quite consistent with observation.

HepG2 cells undergo regulatory volume decrease by mechanically induced efflux of water and solutes.

This study challenges the conventional belief that animal cell membranes lack a significant hydrostatic gradient, particularly under anisotonic conditions, as demonstrated in the human hepatoma cell line HepG2. The Boyle van't Hoff (BvH) relation describes volumetric equilibration to anisotonic conditions for many cells. However, the BvH relation is simple and does not include many cellular components such as the cytoskeleton and actin cortex, mechanosensitive channels, and ion pumps. Here we present alternative models that account for mechanical resistance to volumetric expansion, solute leakage, and active ion pumping. We found the BvH relation works well to describe hypertonic volume equilibration but not hypotonic volume equilibration. After anisotonic exposure and return isotonic conditions cell volumes were smaller than their initial isotonic volume, indicating solutes had leaked out of the cell during swelling. Finally, we observed HepG2 cells undergo regulatory volume decrease at both 20 °C and 4 °C, indicating regulatory volume decrease to be a relatively passive phenomenon and not driven by ion pumps. We determined the turgor-leak model, which accounts for mechanical resistance and solute leakage, best fits the observations found in the suite of experiments performed, while other models were rejected.

Individual and joint associations of air pollutants exposure with semen quality: A retrospective longitudinal study in Wenzhou, China.

PURPOSE: The impact of air pollution on semen quality has been confirmed, yet the joint effect remains unclear. We evaluate the individual and joint associations of particulate (PM2.5 and PM10) and gaseous pollutants (NO2, SO2, O3 and CO) with semen quality. METHODS: We included 5,114 men in this study from 2014 to 2022. The individual and joint associations were measured by multiple linear regression models. RESULTS: Sperm motility and semen volume were inversely associated with pollutant concentrations during every stage of sperm development, especially at lag days 0-9 and 10-14 (all P < 0.05). Stratified analyses showed that the study pollutants (except CO) had a positive effect on semen concentration during the stage of sperm development, especially in spring and autumn, while a decreased total sperm number was associated with CO (all P < 0.05). However, joint associations of particulate and gaseous pollutants with semen quality parameters were not statistically significant (all P > 0.05). CONCLUSIONS: During all stages of sperm development, particulate and gaseous pollutants had individual negative impacts on sperm motility and semen volume, and these impacts were less pronounced in spring and autumn. Our findings highlight the importance and necessity of reducing the exposure to pollutants especially in the critical stage of sperm development to improve semen quality.

Analysis of Survival Modification by Furosemide Use in a Cohort of Hospitalized COVID-19 Patients with Severe or Critical Disease in Mexico: Due to Its Chemical Structure, Furosemide Is More than Just a Diuretic.

In the ongoing fight against Coronavirus Disease 2019 (COVID-19), researchers are exploring potential treatments to improve outcomes, especially in severe cases. This includes investigating the repurposing of existing medications, such as furosemide, which is widely available. This study aimed to evaluate the impact of furosemide on mortality rates among COVID-19 patients with severe or critical illness. We assessed a cohort of 515 hospitalized adults who experienced a high mortality rate of 43.9%. Using a multivariate analysis with adjusted risk ratios (AdRRs), factors like smoking (AdRR 2.48, 95% CI 1.53-4.01, p < 0.001), a high Pneumonia Severity Index (PSI) score (AdRR 7.89, 95% CI 5.82-10.70, p < 0.001), mechanical ventilation (AdRR 23.12, 95% CI 17.28-30.92, p < 0.001), neutrophilia (AdRR 2.12, 95% CI 1.52-2.95, p < 0.001), and an elevated neutrophil-to-lymphocyte ratio (NLR) (AdRR 2.39, 95% CI 1.72-3.32, p < 0.001) were found to increase mortality risk. In contrast, vaccination and furosemide use were associated with reduced mortality risk (AdRR 0.58, p = 0.001 and 0.60, p = 0.008; respectively). Furosemide showed a pronounced survival benefit in patients with less severe disease (PSI < 120) and those not on hemodialysis, with mortality rates significantly lower in furosemide users (3.7% vs. 25.7%). A Kaplan-Meier analysis confirmed longer survival and better oxygenation levels in patients treated with furosemide. Furthermore, a Structure-Activity Relationship analysis revealed that furosemide's sulfonamide groups may interact with cytokine sites such as tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6), potentially explaining its beneficial effects in COVID-19 management. These findings suggest that furosemide could be a beneficial treatment option in certain COVID-19 patient groups, enhancing survival and improving oxygenation.