Purpose
To propose a paradigm change for the validation procedures of medication adherence questionnaires.
Methods
A total of 121 validation procedures of unique questionnaires for medication adherence were analyzed.
Results
“Construct validity” and “internal consistency” were most often assessed, and test results varied largely. A more in-depth analysis indicated that the assessment of medication non-adherence included distinct but related constructs, such as the extent to which doses are missed, and the attempt to identify different facets of medication-taking behavior. Consequently, each construct requires a different measurement approach with different psychometric tests for establishing its validity and reliability.
Conclusion
Results show that assessing the validity and reliability of adherence questionnaires with standard procedures including statistical tests is inconclusive. Refinement of the constructs of non-adherence is needed in pharmacy and medical practice. We suggest a distinction between the (i) extent of missed doses over the past 2 weeks, (ii) modifiable reasons for non-adherence behavior, and (iii) unmodifiable factors of non-adherence. Validation procedures and corresponding statistical methods should be selected according to the specific single constructs.
Weniger anzeigenWe established confrontations between two different fungi, i.e., the maize anthracnose and stalk rot pathogen Colletotrichum graminicola, and the ubiquitous fungus Aspergillus nidulans, and different biocontrol species, i.e., Bacillus subtilis, Bacillus velezensis, and Bacillus amyloliquefaciens. In all fungus–bacterium confrontations tested, growth arrest and, thus, distance inhibition was observed on solid substrata. LC–MS/MS analyses of culture filtrates suggested formation of several metabolites only synthesized in confrontations. Interestingly, microscopy of fungal hyphae grown in liquid medium showed protrusions and color changes occurred only in media harboring fungus-bacterium confrontations. These observations indicate metabolic re-programming and suggest formation of putative secondary metabolites in interactions involving microbial biocontrol agents.
Weniger anzeigenLaser-induced forward transfer (LIFT) of polymers is a versatile printing method for parallel in situ synthesis of peptides on microarrays. Chemical building blocks embedded in a polymer matrix are transferred and coupled in a desired pattern to a surface, generating peptides on microarrays by repetitive in situ solid-phase synthesis steps. To date, the approach is limited to simple, heat induced chemical reactions. The VaporLIFT method, disclosed here, combines LIFT with chemical vapor glycosylation to rapidly generate glycans on microarray surfaces while maintaining inert, low temperature conditions required for glycosylations. Process design and parameter optimization enables the synthesis of a collection of glycans at defined positions on a glass surface. The synthetic structures are detected by mass spectrometry, fluorescently labeled glycan-binding proteins, and covalent staining with fluorescent dyes. VaporLIFT is ideal for parallel screening of other chemical reactions, that require inert and well-defined reaction conditions.
Weniger anzeigenThe monazite-cheralite solid solutions LnPO4-Ca0.5Th0.5PO4 with Ln = La, Gd were prepared via a co-precipitation route, showcasing an optimised, scalable synthesis procedure for a possible waste form accommodating high level liquid waste streams. A distortion of the cheralite structure with respect to the monazite structure was observed throughout both solid solutions as evidenced by a deviation of the lattice parameters from the linear behaviour known from other monazite solid solutions. Using a high temperature flux method, cheralite single crystals were grown for the first time for in-depth structural investigations. Both thorium and calcium were found to deviate from the central position of the LnO9 polyhedron, supporting previous neutron diffraction investigations of identical cheralite samples.
Weniger anzeigenZirconia-based ceramics are promising host matrices for the immobilization of radionuclides in high-level waste streams due to their high radiation resistance and chemical stability. This study explores coprecipitation and different solid-state synthesis techniques to produce phase-pure zirconia-based ceramics with varying cerium and neodymium co-doping. Varying the dopant concentration enabled the synthesis of zirconates with monoclinic, cubic defect fluorite, and cubic pyrochlore structures. Powder X-ray diffraction was used for phase identification. In the case of coprecipitation, all synthesized compositions were predominantly phase-pure. Solid-state synthesis techniques included manual mixing of metal oxide powders with mortar and pestle, mechanical mixing in a ball mill, and magnetic mixing in a slurry. All solid-state mixing methods produced heterogeneous ceramics, featuring multiple phases, with manual mixing yielding the most phase-pure product. Extending the grinding time, re-sintering of the solid phases, and an increased Nd content were found to enhance the phase purity.
Weniger anzeigenThis article undertakes a crucial examination of Kant’s depiction of the interconnectedness between human reason and the divine. The argument posits that Kant conceptualizes reason as inherently founded on a divine basis. The primary objective of this article is not to delve into whether Kant endorses or dismisses specific Christian doctrines, or if his portrayal of reason aligns with a particular strand of Christian thought. Instead, the aim is to chart an interpretive middle path – one that embraces the profound philosophical underpinnings embedded in Kant’s rationalist legacy while recognizing the inherent limitations he imposes on human reason. The conclusion drawn is that Kant’s account of reason tends towards the divine, though the precise nature of this interconnectedness remains shrouded in mystery.
Weniger anzeigenThe self-identification of Sweden and Canada as exceptionally caring and ethical states committed to the goal of global gender justice has been reinforced through their adoption of feminist foreign policies (FFPs). However, despite the enthusiasm surrounding the potential of feminism as an ethical approach to foreign policy making, critics have drawn attention to the many failings of FFPs that hamper their ability to bring about transformative change. This article posits that the shortcomings of Swedish and Canadian FFPs are rooted in an unacknowledged legacy of colonial power relations. It is from within this history of violence that Swedish and Canadian practices of feminism both “at home” and “abroad” can be seen as a re-articulation of colonialism. Through two illustrative narrative readings of reconciliation efforts, the article examines state provisions of hierarchically imposed, paternalistic expressions of care that silence Indigenous “articulations of self-care.” As such, it addresses a significant gap in the literature on FFPs by highlighting the risk of self-proclaimed “caring” feminist states reproducing colonial power relations within and beyond borders.
Weniger anzeigenThis study investigates the determinants and dynamics of the linguistic features of key audit matters (KAMs) in European countries. Using natural language processing algorithms, including FINBERT, I quantify stylistic and content-based text characteristics at the KAM level and find that KAM length, readability, sentiment, quantitative density, specificity, the degree of forward-looking statements, and the extent of boilerplate language are associated with the type of KAM topics, client attributes, and audit firm characteristics. In additional analyses, I also find early empirical evidence of a time trend in these linguistic features. Since their introduction in 2016, KAMs are becoming longer, more quantitative, more specific, but also include more boilerplate phrases. Collectively, the results of the study contribute to a more nuanced understanding of the determinants and dynamics of KAM disclosures.
Weniger anzeigenTo contribute to a better understanding of the determinants of climate-friendly organizational behavior, we study the potential of behavioral policy interventions and social norms to foster individual contributions to organizational decarbonization initiatives. We investigate the effects of different types of behavioral policy interventions (default nudges vs. short-term boosts) in isolation and when they are combined with normative appeals to adopt climate-friendly behaviors in an organizational context. In a 2 × 2 between-subjects experiment, we find that default nudges generally induced higher individual contributions to organizational carbon compensation programs than short-term boosts. Moreover, injunctive social norm information decreased the effectiveness of both types of behavioral interventions but affected the effectiveness of short-term boosts to a stronger extent than the effectiveness of default nudges. Contributing to the nascent literature on motivating climate change mitigating behaviors in organizational contexts, we additionally explore whether factors such as personality traits, pro-social and pro-environmental beliefs, attitudes, and behaviors, and the degree of organizational identification exert an influence on the effectiveness of the interventions and provide qualitative insights into participants’ reasoning for their decisions.
Weniger anzeigenBackground: Although transparency is crucial for building public trust, public health communication during the COVID-19 pandemic was often nontransparent.
Methods: In a cross-sectional online study with COVID-19 vaccine-hesitant German residents (N = 763), we explored the impact of COVID-19 public health communication on the attitudes of vaccine-hesitant individuals toward vaccines as well as their perceptions of incomprehensible and incomplete information. We also investigated whether specific formats of public health messaging were perceived as more trustworthy.
Results: Of the 763 participants, 90 (11.8%) said they had become more open-minded toward vaccines in general, 408 (53.5%) reported no change, and 265 (34.7%) said they had become more skeptical as a result of public health communication on COVID-19 vaccines. These subgroups differed in how incomprehensible they found public health communication and whether they thought information had been missing. Participants' ranking of trustworthy public health messaging did not provide clear-cut results: the fully transparent message, which reported the benefit and harms in terms of absolute risk, and the nontransparent message, which reported only the benefit in terms of relative risk were both considered equally trustworthy (p = 0.848).
Discussion: Increased skepticism about vaccines during the COVID-19 pandemic may have partly been fueled by subpar public health communication. Given the importance of public trust for coping with future health crises, public health communicators should ensure that their messaging is clear and transparent.
Weniger anzeigenBackground: Myasthenia gravis (MG) is a rare autoimmune disease and chronic condition that necessitates specialized care. Patients experience a significant burden of disease affecting various aspects of their lives. The aim of this study was to investigate the impact of MG on family planning, challenges associated with pregnancy, childcare responsibilities and the extent to which MG patients perceive and utilize social support.
Methods: This analysis used data from our main data of a large cross-sectional study built on a questionnaire-based survey encompassing 1,660 MG patients and members of the German Myasthenia Association (Deutsche Myasthenie Gesellschaft), and focused on sociodemographic, clinical and family planning relevant data points.
Results: Decisions regarding family planning were significantly impacted for individuals with MG when MG symptoms started either before or during their family planning (men: n = 19 and 29.7%; women: n = 156 and 58.4%). In this subgroup a substantial proportion opted against parenthood due to MG (men: n = 8 and 50.0%; women: n = 54 and 38.0% and/or another n = 12 and 8.4% of female participants encountered partner-related refusals). In the subgroup of female SP with MG starting before or during family planning who have reported ever been pregnant the self-reported miscarriage rate was 29.0% (n = 51). MG patients with medium incomes or moderate disease severity reported lower levels of perceived social support. 42.7% (n = 606) of participants needed assistance in negotiations with health insurers and 28.0% (n = 459) needed support for transportation to medical appointments.
Conclusion: This study shows a significant impact of MG on family planning decisions, affecting both women and men, and often resulting in life-altering decisions such as voluntary childlessness due to MG. The significance of social support becomes evident as a vital factor, especially when navigating through the healthcare system. Tailored healthcare approaches, organized guidance and comprehensive support is needed to enable informed decision-making and offer assistance for MG patients.
Clinical trial registration: https://clinicaltrials.gov/study/NCT03979521, Registered 7 June 2019 (retrospectively registered).
Weniger anzeigenIntroduction: Work stress is a frequent factor in the development of depression. However, not only workplace environment, but also personal attitudes may affect stress experience. The aim of this study was to investigate the change sensitivity of occupational attitudes in psychosomatic inpatients and assess the relationship of changes to depressive symptom reduction.
Methods: The data set encompassed N = 1708 inpatients from two German psychosomatic rehabilitation clinics at admission and discharge. Responsivity of AVEM measures was evaluated by Bonferroni-corrected t-tests and Cohen's dz effect sizes for paired samples. The relation of occupational behavior and experience patterns and depressive symptoms as assessed by the BDI-II questionnaire was calculated by Pearson correlation analysis of pre-post differential values.
Results: Changes in work attitudes were found on eight out of eleven AVEM subscales (Padj <= 0.001, Cohen's dz = -0.45 to 0.43) and all AVEM coping styles. Most patients (57.4%) were classified to have a Burnout occupational coping style at admission. Changes following rehabilitation were most frequently observed from Burnout to Sparing coping styles (8.3%). Small to moderate associations between changes in occupational attitudes and depressive symptom reduction were found for all subscales (r = -0.39 to 0.25) except work ambition, and for occupational coping styles Burnout (r = 0.19), Sparing (r = -0.18) and Healthy (r = -0.10), but not Ambitious.
Discussion: The data support responsivity of occupational behavior and experience patterns within a psychosomatic rehabilitation setting. Correlations with depressive symptom reduction suggest that occupational attitudes are related but separate treatment targets.
Weniger anzeigenMucus is a complex biological hydrogel that acts as a barrier for almost everything entering or exiting the body. It is therefore of emerging interest for biomedical and pharmaceutical applications. Besides water, the most abundant components are the large and densely glycosylated mucins, glycoproteins of up to 20 MDa and carbohydrate content of up to 80 wt%. Here, we designed and explored a library of glycosylated peptides to deconstruct the complexity of mucus. Using the well-characterized hFF03 coiled-coil system as a hydrogel-forming peptide scaffold, we systematically probed the contribution of single glycans to the secondary structure as well as the formation and viscoelastic properties of the resulting hydrogels. We show that glycan-decoration does not affect α-helix and coiled-coil formation while it alters gel stiffness. By using oscillatory macrorheology, dynamic light scattering microrheology, and fluorescence lifetime-based nanorheology, we characterized the glycopeptide materials over several length scales. Molecular simulations revealed that the glycosylated linker may extend into the solvent, but more frequently interacts with the peptide, thereby likely modifying the stability of the self-assembled fibers. This systematic study highlights the interplay between glycan structure and hydrogel properties and may guide the development of synthetic mucus mimetics.
Weniger anzeigenFreshwater megafauna, such as sturgeons, giant catfishes, river dolphins, hippopotami, crocodylians, large turtles, and giant salamanders, have experienced severe population declines and range contractions worldwide. Although there is an increasing number of studies investigating the causes of megafauna losses in fresh waters, little attention has been paid to synthesising the impacts of megafauna on the abiotic environment and other organisms in freshwater ecosystems, and hence the consequences of losing these species. This limited understanding may impede the development of policies and actions for their conservation and restoration. In this review, we synthesise how megafauna shape ecological processes in freshwater ecosystems and discuss their potential for enhancing ecosystem restoration. Through activities such as movement, burrowing, and dam and nest building, megafauna have a profound influence on the extent of water bodies, flow dynamics, and the physical structure of shorelines and substrata, increasing habitat heterogeneity. They enhance nutrient cycling within fresh waters, and cross-ecosystem flows of material, through foraging and reproduction activities. Freshwater megafauna are highly connected to other freshwater organisms via direct consumption of species at different trophic levels, indirect trophic cascades, and through their influence on habitat structure. The literature documenting the ecological impacts of freshwater megafauna is not evenly distributed among species, regions, and types of ecological impacts, with a lack of quantitative evidence for large fish, crocodylians, and turtles in the Global South and their impacts on nutrient flows and food-web structure. In addition, population decline, range contraction, and the loss of large individuals have reduced the extent and magnitude of megafaunal impacts in freshwater ecosystems, rendering a posteriori evaluation more difficult. We propose that reinstating freshwater megafauna populations holds the potential for restoring key ecological processes such as disturbances, trophic cascades, and species dispersal, which will, in turn, promote overall biodiversity and enhance nature's contributions to people. Challenges for restoration actions include the shifting baseline syndrome, potential human–megafauna competition for habitats and resources, damage to property, and risk to human life. The current lack of historical baselines for natural distributions and population sizes of freshwater megafauna, their life history, trophic interactions with other freshwater species, and interactions with humans necessitates further investigation. Addressing these knowledge gaps will improve our understanding of the ecological roles of freshwater megafauna and support their full potential for facilitating the development of effective conservation and restoration strategies to achieve the coexistence of humans and megafauna.
Weniger anzeigenDas #AndYourSchool? Prompt-Workbook erklärt die Idee und den theoretischen Hintergrund zum 'politischen Weiterdenken anregen' und stellt im Prompt-Workbook-Teil konkrete Prompts zur Verfügung, mit denen politisches Weiterdenken in Bildungskontexten von Lehrenden mit ihren Bildungsteilnehmenden mit textgenerativer KI sofort umgesetzt werde kann.
(1) Background: We aimed to identify factors associated with the presence of apical lesions (AL) in panoramic radiographs and to evaluate the predictive value of the identified factors. (2) Methodology: Panoramic radiographs from 1071 patients (age: 11–93 a, mean: 50.6 a ± 19.7 a) with 27,532 teeth were included. Each radiograph was independently assessed by five experienced dentists for AL. A range of shallow machine learning algorithms (logistic regression, k-nearest neighbor, decision tree, random forest, support vector machine, adaptive and gradient boosting) were employed to identify factors at both the patient and tooth level associated with AL and to predict AL. (3) Results: AL were detected in 522 patients (48.7%) and 1133 teeth (4.1%), whereas males showed a significantly higher prevalence than females (52.5%/44.8%; p < 0.05). Logistic regression found that an existing root canal treatment was the most important risk factor (adjusted Odds Ratio 16.89; 95% CI: 13.98–20.41), followed by the tooth type ‘molar’ (2.54; 2.1–3.08) and the restoration with a crown (2.1; 1.67–2.63). Associations between factors and AL were stronger and accuracy higher when using fewer complex models like decision tree (F1 score: 0.9 (0.89–0.9)). (4) Conclusions: The presence of AL was higher in root-canal treated teeth, those with crowns and molars. More complex machine learning models did not outperform less-complex ones.
Weniger anzeigenHidradenitis suppurativa (HS) is a chronic inflammatory disease characterized by the appearance of painful inflamed nodules, abscesses, and pus-draining sinus tracts in the intertriginous skin of the groins, buttocks, and perianal and axillary regions. Despite its high prevalence of similar to 0.4-1%, therapeutic options for HS are still limited. Over the past 10 years, it has become clear that HS is a systemic disease, associated with various comorbidities, including metabolic syndrome (MetS) and its sequelae. Accordingly, the life expectancy of HS patients is significantly reduced. MetS, in particular, obesity, can support sustained inflammation and thereby exacerbate skin manifestations and the chronification of HS. However, MetS actually lacks necessary attention in HS therapy, underlining the high medical need for novel therapeutic options. This review directs attention towards the relevance of MetS in HS and evaluates the potential of phytomedical drug candidates to alleviate its components. It starts by describing key facts about HS, the specifics of metabolic alterations in HS patients, and mechanisms by which obesity may exacerbate HS skin alterations. Then, the results from the preclinical studies with phytochemicals on MetS parameters are evaluated and the outcomes of respective randomized controlled clinical trials in healthy people and patients without HS are presented.
Weniger anzeigenHuman genetic studies have associated Neuronatin gene variants with anorexia nervosa (AN) and obesity. Studies on the expression of the Neuronatin gene product, a proteolipid, are lacking. We investigated the relationship between circulating Neuronatin, body mass index (BMI), body composition (BC), physical activity (PA), and psychometric outcomes in patients with AN, normal weight, and obesity. Plasma Neuronatin was measured by ELISA in (1) 79 subjects of five BMI categories (AN/BMI < 17.5 kg/m2; normal weight/BMI 18.5–25 kg/m2; obesity/BMI 30–40 kg/m2; obesity/BMI 40–50 kg/m2; obesity/BMI > 50 kg/m2) with assessment of BC (bioimpedance analysis; BIA); (2) 49 women with AN (BMI 14.5 ± 1.8 kg/m2) with measurements of BC (BIA) and PA (accelerometry); (3) 79 women with obesity (BMI 48.8 ± 7.8 kg/m2) with measurements of anxiety (GAD-7), stress (PSQ-20), depression (PHQ-9) and eating behavior (EDI-2). Overall, a positive correlation was found between Neuronatin and BMI (p = 0.006) as well as total fat mass (FM; p = 0.036). In AN, Neuronatin did not correlate with BMI, FM, or PA (p > 0.05); no correlations were found between Neuronatin and psychometric outcomes in obesity (p > 0.05). The findings suggest an FM-dependent peripheral Neuronatin expression. The decreased Neuronatin expression in AN provides evidence that Neuronatin is implicated in the pathogenesis of eating disorders.
Weniger anzeigenSince more than a century ago, there has been awareness of the connection between viral infections and the onset and exacerbation of urticaria. Our knowledge about the role of viral infection and vaccination in acute and chronic urticaria improved as a result of the COVID-19 pandemic but it has also highlighted knowledge gaps. Viral infections, especially respiratory tract infections like COVID-19, can trigger the onset of acute urticaria (AU) and the exacerbation of chronic urticaria (CU). Less frequently, vaccination against viruses including SARS-CoV-2 can also lead to new onset urticaria as well as worsening of CU in minority. Here, with a particular focus on COVID-19, we review what is known about the role of viral infections and vaccinations as triggers and causes of acute and chronic urticaria. We also discuss possible mechanistic pathways and outline the unmet needs in our knowledge. Although the underlying mechanisms are not clearly understood, it is believed that viral signals, medications, and stress can activate skin mast cells (MCs). Further studies are needed to fully understand the relevance of viral infections and vaccinations in acute and chronic urticaria and to better clarify causal pathways.
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