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A life span perspective on competencies for a healthy, physically active lifestyle: Findings of a data pooling initiative with over 7000 individuals.
Get PDFIndividuals are recommended to lead active lifestyles throughout the life course. The model of physical activity-related health competence (PAHCO) adopts a competence approach by integrating physical, cognitive, and motivational determinants for health-enhancing PA (movement competence, control competence, self-regulation competence). Drawing on a comprehensive dataset pooling, the goal of the present study was to model the idiosyncratic courses of 10 PAHCO indicators over the life span. We identified studies that empirically operationalized PAHCO, combining data of 7134 individuals (age range: 15-97 years; 61% female) from 18 different populations (prevention and rehabilitation sectors). We applied a stepwise multilevel analysis approach with disjunct sub-samples (n = 48) to examine linear and quadratic associations between age and PAHCO. Indicators of movement competence (i.e., manageability of endurance, strength, and balance demands; task-specific self-efficacy) congruently showed negative associations with age (0.054 ≤ ≤ 0.211). However, parameters of control competence remained stable across the life span (-0.066 ≤ β ≤ 0.028). The three indicators of self-regulation competence revealed an inconsistent relationship with age, though uncovering positive associations for self-control (β = 0.106) and emotional attitude toward PA (β = 0.088). The associations of some indicators varied significantly across sub-samples. The results suggest differential analyses for associations between PAHCO and age. While the physically determined PAHCO indicators (movement competence) probably decline across the life span, the ability to ensure regularity of PA (self-regulation competence) or align PAs with an individual's health (control competence) appear to remain constant or improve with increasing age. The findings reinforce a de-stigmatizing approach for PA promotion practices with considerable space for aligning activities with health also in the elderly
Title and abstract screening for literature reviews using large language models: an exploratory study in the biomedical domain.
Get PDFBACKGROUND
Systematically screening published literature to determine the relevant publications to synthesize in a review is a time-consuming and difficult task. Large language models (LLMs) are an emerging technology with promising capabilities for the automation of language-related tasks that may be useful for such a purpose.
METHODS
LLMs were used as part of an automated system to evaluate the relevance of publications to a certain topic based on defined criteria and based on the title and abstract of each publication. A Python script was created to generate structured prompts consisting of text strings for instruction, title, abstract, and relevant criteria to be provided to an LLM. The relevance of a publication was evaluated by the LLM on a Likert scale (low relevance to high relevance). By specifying a threshold, different classifiers for inclusion/exclusion of publications could then be defined. The approach was used with four different openly available LLMs on ten published data sets of biomedical literature reviews and on a newly human-created data set for a hypothetical new systematic literature review.
RESULTS
The performance of the classifiers varied depending on the LLM being used and on the data set analyzed. Regarding sensitivity/specificity, the classifiers yielded 94.48%/31.78% for the FlanT5 model, 97.58%/19.12% for the OpenHermes-NeuralChat model, 81.93%/75.19% for the Mixtral model and 97.58%/38.34% for the Platypus 2 model on the ten published data sets. The same classifiers yielded 100% sensitivity at a specificity of 12.58%, 4.54%, 62.47%, and 24.74% on the newly created data set. Changing the standard settings of the approach (minor adaption of instruction prompt and/or changing the range of the Likert scale from 1-5 to 1-10) had a considerable impact on the performance.
CONCLUSIONS
LLMs can be used to evaluate the relevance of scientific publications to a certain review topic and classifiers based on such an approach show some promising results. To date, little is known about how well such systems would perform if used prospectively when conducting systematic literature reviews and what further implications this might have. However, it is likely that in the future researchers will increasingly use LLMs for evaluating and classifying scientific publications
Trajectory correction enables free-running chemical shift encoded imaging for accurate cardiac proton-density fat fraction quantification at 3T.
No full textBACKGROUND
Metabolic diseases can negatively alter epicardial fat accumulation and composition, which can be probed using quantitative cardiac chemical shift encoded(CSE) MRI by mapping proton-density fat fraction (PDFF). To obtain motion-resolved high-resolution PDFF maps, we proposed a free-running cardiac CSE-MRI framework at 3T. To employ faster bipolar readout gradients, a correction for gradients imperfections was added using the gradient impulse response function (GIRF) and evaluated on intermediate images and PDFF quantification.
METHODS
Ten minutes free-running cardiac 3D radial CSE-MRI acquisitions were compared in vitro and in vivo at 3T. Monopolar and bipolar readout gradients schemes provided 8 echoes (TE1/ΔTE = 1.16/1.96ms) and 13 echoes (TE1/ΔTE = 1.12/1.07ms), respectively. Bipolar-gradients free-running cardiac fat and water images and PDFF maps were reconstructed with or without GIRF-correction. PDFF values were evaluated in silico, in vitro on a fat/water phantom, and in vivo in 10 healthy volunteers and three diabetic patients.
RESULTS
In monopolar mode, fat-water swaps were demonstrated in silico and confirmed in vitro. Using bipolar readout gradients, PDFF quantification was reliable and accurate with GIRF correction with a mean bias of 0.03% in silico and 0.36% in vitro while it suffered from artifacts without correction, leading to a PDFF bias of 4.9% in vitro and swaps in vivo. Using bipolar readout gradients, in vivo PDFF of epicardial adipose tissue was significantly lower than in subcutaneous fat (80.4±7.1% vs 92.5±4.3%, P<0.0001).
CONCLUSION
Aiming for an accurate PDFF quantification, high-resolution free-running cardiac CSE-MRI imaging proved to benefit from bipolar echoes with k-space trajectory correction at 3T. This free-breathing acquisition framework enables to investigate epicardial adipose tissue PDFF in metabolic diseases
Mud in the Malay Archipelago: Rethinking Water and Colonial Agency in Almayer's Folly and Max Havelaar
No full textBreast cancer in women by HIV status: A report from the South African National Cancer Registry.
Get PDFBACKGROUND
Breast cancer (BC) is the leading cause of cancer-related morbidity and mortality in women living in South Africa, a country with a high HIV burden. However, characteristics of the double burden of HIV and BC in South Africa have not been properly investigated. We described characteristics of BC cases by HIV status in South Africa.
METHODS
In this nationwide South African study, we obtained BC records for women aged ≥15 years diagnosed in the public health sector between January 2004 and December 2014. We included records from the National Cancer Registry that had been linked to HIV-related laboratory records from the National Health Laboratory Service. We assessed the odds of being HIV positive versus HIV negative in relation to patient-, cancer-, and municipality-related characteristics.
RESULTS
From 2004-2014, 40 520 BC cases were diagnosed in women aged ≥15 years. Of these, 73.5% had unknown HIV status, 18.7% were HIV negative, and 7.7% were HIV positive. The median age at BC diagnosis was 43 years (interquartile range [IQR]: 37-52) in HIV positive and 57 years (IQR: 46-68) in HIV negative women, respectively. The odds of being HIV positive was higher for women who were aged 30-34 years compared to women aged 35-39 years at cancer diagnosis (odds ratio [OR] 1.38, 95% confidence interval [CI] 1.10-1.71), Black versus non-Black (OR 6.41, 95% CI 5.68-7.23), diagnosed with cancer in rural versus urban areas (OR 1.59, 95% CI 1.40-1.82) and diagnosed in municipalities with low and middle (OR 3.46, 95% CI 2.48-4.82) versus high socioeconomic position (OR 2.69, 95% CI 2.11-3.42).
CONCLUSION
HIV status was unknown for the majority of BC patients. Among those with known HIV status, being HIV positive was associated with a younger age at cancer diagnosis, being Black and receiving care in municipalities of poor socioeconomic position. Future studies should examine opportunities to integrate HIV and BC control programs
SP’s role-portrayal in Swiss high-stakes clinical exams is of high quality and improves over time as measured with the FAIR-OSCE
No full textIntroduction/Overview/Purpose
In high-stakes clinical exams, the quality of SPs' role-portrayal is of utmost importance for exam fairness and validity. The role of SP trainers is vital in ensuring the authenticity and standardization of SP role-portrayal. This study focuses on the clinical skills part of the Swiss federal licensing exam (CS-FLE) and aims to assess the quality of SP role-portrayal over time.
Methodology & Methods
A cohort study was conducted, involving five Swiss SP programs responsible for delivering the CS-FLE. Data on SP role-portrayal were collected from 2016 to 2021 by different local and one central SP trainers as observers using the FAIR-OSCE instrument developed in a literature-based consensus building process together with an interfaculty board of SP trainers in Switzerland. It assesses 4 dimensions of SP role-portrayal: introduction (3 items), delivery of information (7 items), portrayal (7 items), and others (3 items). Scores were defined as follows: Quality criterium fulfilled “completely agree = 2”, "agree = 1", "do not agree = -1". Items rated as not applicable were not included into the calculation. An ANOVA was calculated over the 5 exams.
Results/Outcome/Discussion
Results: The analysis of the altogether 1804 FAIR-OSCE ratings revealed a high general quality of SP role-portrayal and a statistically significant (2016-2021 p= < 0.001) continuous improvement in role-portrayal quality over the study period. Specifically, the results indicated that the overall mean scores representing the quality of role-portrayal increased continuously, from 1.75 in 2016 to 1.84 in 2021. None of the items received "do not agree" ratings exceeding 5%.
Discussion: This study demonstrates that SP role-portrayal in Swiss high-stakes clinical exams is consistently of high quality and meaningfully improves over time. The findings suggest that the FAIR-OSCE instrument effectively provides an efficient means to monitor and evaluate the quality of SP role-portrayal in high-stakes clinical exams.
Conclusion
SPs' role-portrayal in Swiss high-stakes exams is consistently of high quality and demonstrates continuous improvement over time. The FAIR-OSCE instrument has proven effective and valid in monitoring and enhancing SP role-portrayal quality
Prolonged Response to Afatinib and Crizotinib in a Rare Case of EGFR-, HER2-, MET- and ROS1-Alterated Lung Adenocarcinoma.
Get PDFWe present the case of a 70-year-old never-smoking female patient with epidermal growth factor receptor (EGFR) p.L858R-mutated metastatic non-small cell lung cancer (NSCLC). After three months of first-line treatment with erlotinib, progression occurred and platinum/pemetrexed was initiated, followed by a response for more than two years. After the progression, the molecular testing of a vertebral metastasis revealed a ROS proto-oncogene 1 (ROS1) translocation and a human epidermal growth factor receptor 2 (HER2) p.S310F mutation, in addition to the known EGFR p.L858R mutation. Crizotinib then led to a durable response of 17 months. The molecular retesting of the tumour cells obtained from the recurrent pleural effusion revealed the absence of the ROS1 translocation, whereas the EGFR and HER2 mutations were still present. Afatinib was added to the crizotinib, and the combination treatment resulted in another durable response of more than two years. The patient died more than 7 years after the initial diagnosis of metastatic NSCLC. This case demonstrates that the repeated molecular testing of metastatic NSCLC may identify new druggable genomic alterations that can impact the patient management and improve the patient outcome
In vitro functional assays to assess the reciprocal interplay between tumor cells and macrophages.
Get PDFTumor-associated macrophages (TAMs) are integral components of the tumor microenvironment. They are involved in various aspects of tumor cell biology, driving pathological processes such as tumor cell proliferation, metastasis, immunosuppression, and resistance to therapy. TAMs exert their tumorigenic effects by secreting growth factors, cytokines/chemokines, metabolites, and other soluble bioactive molecules. These mediators directly promote tumor cell proliferation and modulate interactions with immune and stromal cells, facilitating further tumor growth. As research into therapies targeting TAMs intensifies, there is a growing need for reliable methods to comprehend the impact of TAMs on cancer progression and to validate novel therapeutics directed at TAMs. The traditional "M1-M2" macrophage classification based on transcriptional profiles of TAMs is not only too simplistic to describe their physiological roles, it also does not explain differences observed between mouse and human macrophages. In this context, methods that assess how TAMs influence tumor or immune cells, either through direct contact or the release of soluble factors, offer a more promising approach. We describe here comprehensive protocols for in vitro functional assays to study TAMs, specifically regarding their impact on the growth of lung cancer cells. We have applied these methods to both mouse and human macrophages, achieving similar outcomes in promoting the proliferation of cancer cells. This methodology can serve as a standardized approach for testing novel therapeutic approaches, targeting TAMs with novel immunotherapeutic compounds, or utilizing gene-editing techniques. Taken together, the described methodology may contribute to our understanding of complex macrophage-tumor interactions and support the development of innovative therapeutic strategies
Mann-männliches Begehren, sexuelles Handeln und Homosexualität im islamischen Recht. Muslimische Diskurse und Perspektiven von der Vergangenheit bis in die Gegenwart
Get PDFMuslimische Gelehrte haben sich von der Vormoderne bis zur Gegenwart
detailliert zu homosexuellen Handlungen geäußert, genauer gesagt zu
liwāṭ (Analverkehr, vor allem zwischen Männern) und zu siḥāq (sexuelles
Handeln zwischen Frauen). Dieser Diskurs kann jedoch mit modernen
westlichen Kategorien nicht adäquat erfasst werden und bedarf daher ei-
ner eingehenden Analyse. In dem Kapitel gebe ich daher eine als Über-
blick gedachte Zusammenfassung meiner in mehreren Artikeln auf Eng-
lisch und Italienisch veröffentlichten Forschungsergebnisse. Der Beitrag ist wie folgt strukturiert: Einer theoretischen Einführung in das Thema folgt eine Zusammenfassung dessen, was die zwei grund- legenden Quellen des islamischen Rechts (Koran und Sunna) über Handlungen und Beziehungen sagen, die im westlichen Diskurs heute als ‚Homosexualität‘ oder ‚Homoerotik‘ verhandelt werden. Daran anschließend wird erörtert, wie muslimische Gelehrte (vor allem sunnitische Juristen) diese Quellen interpretierten, und schließlich aufgezeigt, welchen Einfluss diese juristischen Diskurse auf das Rechtssystem in islamisch geprägten Ländern, und vor allem im Nahen Osten, bis heute haben
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