Search Results (280)

Collaborative Research Centres (CRCs) are research institutions in which researchers from several German universities work together within a multidisciplinary research programme. A large number of projects led by one or several researchers from the participating research institutions characterize them. Integrated Research Training Programmes (IRTGs) can be part of the CRC’s supporting structures. They offer a structured training programme with the aim not only of supporting the doctoral researchers in their research activities but also making an engagement in the CRC attractive to young researchers. Key aims are to promote the doctoral researchers’ academic independence and to enable them to gain further qualifications. The integrated research training group of the CRC SFB-TRR 364 SynTrac-Synergies of Highly Integrated Transport Aircraft is inspired by the principles of New Work. This required an adjusted definition of New Work to fit the vision of the CRC SynTrac and the requirements of today’s highly talented doctoral researchers. On this basis, we designed the physical, inter-personal and virtual work-space and the methods which allow the doctoral researchers to perform the activities they “really, really” want to do. We report on two years of experience with this design of the IRTG. Full article

Patient-matched implants (PMIs) enable precise anatomical reconstruction but often introduce unforeseen intraoperative challenges that can provoke stress, reduce frustration tolerance, and influence surgical decision-making. Despite the growing clinical use of PMIs, the behavioural and psychological dimensions underpinning these challenging surgeries remain underexplored. This study examined the relationship between surgeon temperament, specifically frustration tolerance threshold, patience, and adherence to planned surgical workflows during PMI procedures. A qualitative thematic study was conducted over 22 months across two academic centres and 86 private surgical practices in South Africa. Data were collected through semi-structured interviews with consultant surgeons, assistant surgeons, surgical technologists, and biomedical engineers, supplemented by direct observation and detailed field notes. Inductive content analysis, thematic coding, and descriptive quantitative trends derived from Likert-style questionnaires were used to identify behavioural patterns associated with intraoperative stress and workflow deviation. Participant reports indicated that low frustration tolerance, often expressed as impatience, was perceived to be linked to increased deviations from surgical plans, including implant modification (reported in 4.6% of the 86 practices), even when design and fit were optimal. In 2.3% of the 86 practices surveyed, surgical team members reported incidents where impatience was perceived to have compromised patient safety. Stress inoculation theory and emotional intelligence frameworks offered explanatory models for the observed behaviours. Within the limits of this exploratory qualitative study, surgeon temperament—particularly mental preparedness and frustration tolerance—emerged as a recurring theme associated with intraoperative PMI workflow adherence. Whether these factors are determinants of workflow adherence whilst using high-fidelity PMIs, or merely correlated with other unmeasured variables, remains to be tested in future quantitative research. Full article

Background: Procalcitonin (PCT) is widely used as a biomarker of bacterial infection, but it may also increase in non-infectious inflammatory states. This study investigated the association of PCT with muscle injury severity and renal dysfunction in patients with non-traumatic rhabdomyolysis. Methods: We prospectively enrolled 39 adults with non-traumatic rhabdomyolysis (n = 39). Admission and longitudinal laboratory data included creatine kinase (CK), myoglobin, PCT, C-reactive protein (CRP), creatinine, and urea. Associations were assessed using Spearman correlation analysis with false-discovery-rate correction for multiple comparisons. Independent predictors of admission PCT were evaluated using linear regression with PCT (log10) as the dependent variable. Longitudinal dynamics were analyzed using linear mixed-effects models and a generalized mixed-effects sensitivity model. Results: At admission, after false-discovery-rate correction, PCT remained positively correlated with creatinine, CK, urea, and CRP; the weaker correlation with myoglobin did not remain significant after correction. In the primary admission model, both creatinine (log10) and CK (log10) were independently associated with PCT (log10), whereas infection status was not. In the broader sensitivity model, only creatinine (log10) remained significant. Longitudinal analyses showed that CK (log10) remained independently associated with PCT over time, including in the gamma mixed-effects sensitivity model; in that model, infection status was not independently associated with PCT. Conclusions: In this exploratory single-centre cohort of patients with predominantly intoxication- or immobilization-related “found-down” non-traumatic rhabdomyolysis, PCT elevation was associated with markers of muscle injury and renal dysfunction. Infection status was not independently associated with PCT in the fitted models; however, the modest sample size means that smaller infection-related effects cannot be excluded. These findings should therefore be interpreted cautiously and require confirmation in larger, more etiologically diverse rhabdomyolysis cohorts. Full article

Background/Objectives: Photobiomodulation (PBM) is a biologically plausible adjunct for modulating orthodontic tissue response, but its role in conventional clear aligner therapy remains uncertain. This narrative review summarises the mechanistic rationale and clinical evidence on PBM used with clear aligners, focusing on treatment efficiency, predictability, patient-centred outcomes, and biological safety. Methods: Scopus was searched using PBM/low-level laser terms combined with orthodontics and clear aligners. Titles and abstracts were screened for human studies evaluating PBM as an adjunct to conventional staged clear aligner therapy and reporting treatment duration or alignment efficiency, tracking/predictability (for example, additional aligners, refinements, or fit-related outcomes), pain, or biological safety. Eight aligner-based clinical studies formed the core set. Results: The included studies comprised case reports, retrospective cohorts, pilot investigations, and one historical prospective nonrandomized comparison. Most evaluated short daily sessions of home-use near-infrared LED PBM, while some used external laser-based or combined adjunct protocols. Some studies reported shorter treatment duration, faster alignment, or fewer finishing aligners in PBM users, but these findings were difficult to attribute to PBM alone because altered tray-change intervals and close monitoring were common co-interventions. Aligner-specific pain outcomes were inconsistently reported. Limited safety data, based mainly on one retrospective pilot cohort assessing anterior teeth, found no statistically significant difference in root-volume change between PBM users and controls. Conclusions: PBM has been investigated as a potential adjunct in clear aligner orthodontics, but the available evidence remains preliminary, heterogeneous, and largely non-randomised. No high-quality randomized clinical evidence currently supports the clinical effectiveness or routine use of PBM in clear aligner orthodontics. At present, PBM should be regarded as an investigational adjunct rather than an established clinical recommendation, pending larger and better-designed trials with standardised device-specific protocols, objective adherence measures, movement-specific analyses, and longer follow-up for safety and patient benefit. Full article

Background/Objectives: Endoscopic retrograde cholangiopancreatography (ERCP) requires deep sedation, which is increasingly provided by anaesthetists using propofol-based regimens. However, real-world data on the incidence and predictors of anaesthesia-related adverse events (AEs) in this setting remain limited. The objective of this study was to assess the frequency, predictors, and clinical significance of adverse events during anaesthetist-delivered sedation for ERCP, based on a propofol regimen. Methods: We conducted a retrospective single-centre cohort study including 388 consecutive adult patients who underwent ERCP with propofol-based sedation administered by an anaesthetist. Adverse events were classified into three tiers: Tier 1 (any adverse physiological events, including haemodynamic and respiratory threshold crossings), Tier 2 (clinically significant events requiring pharmacological intervention—the primary regression outcome), and Tier 3 (high-severity outcomes, reported descriptively). Independent predictors of Tier 2 events were identified using multivariable logistic regression. Results: Adverse physiological events occurred in 220 patients (56.7%), the majority of which were minor and self-limiting. Clinically significant events requiring active pharmacological intervention occurred in 108 patients (27.8%), with vasopressor-treated hypotension as the predominant component (88 patients, 22.7%). All bradycardia episodes required atropine administration (34 patients, 8.8%), while desaturation was largely self-limiting, with advanced airway management required in only three patients (0.8%). High-severity outcomes were rare (9 patients, 2.3%). In multivariable logistic regression predicting clinically significant adverse events, propofol dose (OR 1.20 per 10 mg, 95% CI 1.14–1.25, p < 0.001), ASA physical status (OR 1.63, 95% CI 1.07–2.49, p = 0.024), age (OR 1.04 per year, 95% CI 1.01–1.07, p = 0.007), and ketamine use, confounded by indication (OR 2.18, 95% CI 1.14–4.14, p = 0.018) were independent predictors. Model fit was good (Nagelkerke R² = 0.43). Conclusions: Adverse events are frequent when defined using inclusive criteria, but are predominantly minor in severity. Propofol dose is the principal modifiable risk factor, demonstrating a consistent dose–response relationship across multiple adverse outcomes. ASA physical status and age further identify patients at increased risk of clinically significant events requiring intervention. Ketamine use was associated with increased odds of adverse events; however, this association is likely confounded by indication and should not be interpreted as a direct causal effect. These findings support stepwise propofol titration guided by clinical sedation assessment, with avoidance of anticipatory dosing particularly in older patients and those with higher ASA scores, and highlight the safety of anaesthetist-led sedation in this setting. Full article

Artificial intelligence (AI) is increasingly embedded in how cities are governed, shaping decisions on mobility, land use, public services, and environmental management. Yet urban AI is predominantly governed through fragmented frameworks designed at national or corporate scales, offering limited guidance for municipal decision-making and overlooking place-specific social and ecological consequences. As the level of government closest to everyday urban life, cities are uniquely positioned to steer AI toward public value, but face persistent tensions between efficiency, equity, accountability, and sustainability. This paper argues that responsible urban AI cannot be governed through top-down or one-size-fits-all approaches. To address this, the study aims to conceptualise and advance a ground-up model of responsible urban AI governance that places cities and local governments at the centre of decision-making. It addresses the following research question: How can municipal authorities translate high-level ethical principles into practical, context-sensitive governance arrangements that respond to local capacities, risks, and public values? Drawing on global governance principles and illustrative city experiences, we propose a locally grounded, stage-based framework for municipal AI governance. The framework addresses institutional capacity gaps, fragmented responsibilities, and algorithmic externalities, advancing a participatory, place-sensitive, and adaptive model that aligns urban AI innovation with democratic legitimacy, social justice, and sustainable urban futures. Full article

Background/Objectives: Dyspnoea in heart failure with reduced or mildly reduced ejection fraction (HFrEF/HFmrEF) is multidimensional, yet conventional unidimensional scales do not capture its sensory and affective components. The Multidimensional Dyspnea Profile (MDP) addresses this gap; however, its psychometric properties have not been established in a dedicated HFrEF/HFmrEF cohort. We assessed structural validity, internal consistency, test–retest reliability, and construct validity of the MDP using COSMIN methodology. Methods: In this prospective, single-centre psychometric validation study, 101 clinically stable adults with HFrEF or HFmrEF were enrolled at a tertiary outpatient cardiac clinic in Riyadh, Saudi Arabia. Participants completed the MDP alongside Dyspnea-12, modified Medical Research Council scale, Kansas City Cardiomyopathy Questionnaire-12, Fatigue Severity Scale, and 6 min walk test. Test–retest data were obtained at 12 days in patients confirmed stable by the Global Rating of Change (n = 87). Psychometric evaluation included Cronbach’s α, intraclass correlation (ICC₂,₁), standard error of measurement, minimum detectable change (MDC₉₅), confirmatory factor analysis (comparative fit index [CFI], root mean square error of approximation [RMSEA], standardised root mean square residual [SRMR]), and 12 a priori construct hypotheses. A preliminary minimal clinically important difference (MCID) was estimated using anchor- and distribution-based methods. Results: The mean age was 55 ± 11 years and 80% were male. CFA supported the two-factor model (CFI = 0.96; RMSEA = 0.061; SRMR = 0.058). Cronbach α was 0.92 for the full scale, 0.88 for immediate perception, and 0.91 for emotional response. ICC_2,1 was 0.94 (95% CI: 0.91–0.96), and MDC₉₅ was 4.2 points. All 12 hypotheses were confirmed. The preliminary MCID was 8 points. Conclusions: The MDP is a reliable, valid, and clinically interpretable multidimensional dyspnoea measure in HFrEF/HFmrEF. The 8-point MCID is preliminary and requires confirmation in larger longitudinal intervention studies. Full article

Autistic people experience social stigma, which involves facing negative or false social stereotypes. A prevalent stereotype of autism in society is that it is a male condition, which has led to most traditional representations of autism across different types of media (e.g., characters in films and TV) being predominantly male-focused. In this study, a group of autistic women and/or non-binary people were recruited to speak about how they perceived media representations of autism, as their gender identities did not fit this traditional gendered stereotype. Participants shared their experiences through group discussions and a zine-making activity, where they created different forms of artwork that were then compiled into an independent community booklet and displayed in an exhibition in Central Scotland. Participants’ group discussions and descriptions of their artwork were analysed using IPA techniques, yielding two experiential themes. Participants discussed negative experiences with dehumanising media accounts of autism, which displayed autistic people as a stereotypical ‘other’, as well as positive experiences with humanised media accounts, which prioritised autistic lived experience in a more authentic and relatable way. Our findings highlight that the media can positively impact autistic people’s lives when representations centre on autistic lived experience, which fosters connectedness, autonomy, and self-understanding. Alternatively, this impact can be harmful when media accounts are stigmatising and dehumanising, which generates significant material and subjective challenges. Full article

Background: Family caregivers remain closely involved in communication, care planning, and shared decision-making in long-term care (LTC) facilities. In this context, the quality of the relationship between family caregivers and professional staff may influence trust, collaboration, and satisfaction with care. However, few instruments have been specifically adapted to assess caregiver–staff relationship quality in Taiwanese LTC settings. Objectives: This study aimed to culturally adapt and preliminarily validate the Family Caregiver Relationship Quality (FCRQ) Scale for use in Taiwanese LTC facilities. Methods: A cross-sectional psychometric validation study was conducted with 205 primary family caregivers recruited from 20 LTC facilities in Taiwan. The original Relationship Quality Scale was adapted to the LTC context through contextual revision, expert review, bilingual verification, and pilot testing. Psychometric evaluation included confirmatory factor analysis, internal consistency assessment, convergent validity, and structural equation modelling with Bollen–Stine bootstrap correction to address potential non-normality. Results: The initial 16-item model required refinement, and three items with low standardized factor loadings were removed. The revised 13-item model met the prespecified fit criteria and showed acceptable internal consistency and convergent validity. The retained items reflected three conceptually related domains of relationship quality: trust, commitment, and satisfaction. Overall, the findings provided preliminary psychometric support for the adapted scale in Taiwanese LTC settings. Conclusions: The adapted FCRQ Scale may be a useful tool for assessing caregiver–staff relationship quality in Taiwanese long-term care facilities, particularly in the context of shared decision-making and family-centred care. Nevertheless, the findings should be interpreted as preliminary, and further validation in larger and more diverse samples is needed before broader clinical or research application. Full article

Environmental and financial datasets often display complex distributional characteristics, including heavy tails, high skewness and the presence of extreme observations. Traditional probability models such as the exponential, gamma or log-normal distributions may not adequately capture these behaviours particularly when modelling extreme events such as rainfall, pollution levels, stock returns or loss severities. By integrating the characteristics of Pareto and exponential distributions into an exponentiated framework that can describe datasets arising from environmental and finance fields, this study presents a novel three-parameter exponentiated Pareto exponential distributions using the exponentiated Pareto family of distributions with classical exponential distribution as the baseline model. This novel model extends the classical exponential distribution with the addition of extra shape parameters which simultaneously regulate the centre and tail behaviours of the new model. The statistical and mathematical characteristics of the proposed distribution are determined and studied. The maximum likelihood estimate approach is used in a conducted simulation exercise, and the estimator’s efficiency is evaluated as seen from the results. The practical applicability of the model is illustrated with four real-life datasets utilising model adequacy and goodness-of-fit measurements such as log–likelihood, Akaike information criteria and Bayesian information criteria. The data reveal that the proposed model gives a better fit than the models chosen as comparators, making the EPE distribution useful and robust in environmental and financial fields of study. Full article

Portugal’s demographic ageing calls for effective strategies to address mild cognitive impairment (MCI) and Alzheimer’s Disease (AD). However, fragmented evidence on digital tools limits their clinical application. This review aimed to map the landscape of validated digital cognitive rehabilitation platforms in Portugal for older adults with MCI and AD and to analyze their effectiveness, usability, and implementation barriers. Following PRISMA 2020 guidelines, seven studies published between 2015 and 2025 were identified from PubMed, Scopus, and ScienceDirect, complemented by manual searches and platform website analysis. Methodological quality, assessed using the Joanna Briggs Institute (JBI) tools, ranged from 69% to 100%. The included studies evaluated platforms such as the Systemic Lisbon Battery (SLB), Digi&Mind, NeuroVRehab.PT, and the Fit4Alz project. Findings indicate improvements in global cognition, executive functioning, and attention. Multimodal interventions combining digital cognitive training and physical exercise produced more consistent cognitive benefits than isolated approaches. Despite initially low digital literacy among older adults, high adherence and motivation were reported, supported by gamification, user-centred design, and cultural adaptation. Although Portuguese digital platforms show strong potential for cognitive rehabilitation, the evidence base is constrained by methodological heterogeneity, small sample sizes, and short intervention durations. Future research should prioritize long-term follow-up and remote monitoring through telerehabilitation. Full article

Background: This study examined spherical and aspherical orthokeratology (Ortho-K) lens designs for myopia control and corneal optical stability over the course of a year. Methods: This retrospective analysis used data from a previously conducted two-centre, single-blind, randomised contralateral-eye clinical study, in which 48 children aged 8 to 15 years wore a spherical Ortho-K lens in one eye and an aspherical lens in the other. Measurements included axial length (AL), best-corrected visual acuity (BCVA), lens decentration, corneal power, and higher-order aberrations over 12 months. Corneal topography was analysed using customised MATLAB code, Zernike fitting and paired inter-eye differences were evaluated with the Wilcoxon signed-rank test. Results: Both lenses exhibited typical Ortho-K reshaping patterns, with central flattening and mid-peripheral steepening. The aspherical lens resulted in slower AL elongation than the spherical lens (p < 0.01). It also produced smaller, more stable treatment zones and less variability in higher-order aberrations. Significant differences between the designs were found for vertical coma (p = 0.006), spherical aberration (p = 0.002), and vertical tilt (p = 0.02). Lens decentration also differed significantly (p < 0.01). Conclusions: Over 12 months, the aspherical Ortho-K lens demonstrated superior myopia control and more stable corneal optics than the spherical lens. Full article

Wire explosion (WE) inherently generates particle ensembles spanning the nano- to microscale, posing challenges for conventional characterization methods in terms of capturing the full particle population. To address this issue, spectrophotometric analysis combined with algorithmic spectrum reconstruction based on Mie theory and constrained distribution models were employed to characterize copper WE products formed in aqueous surroundings within the 4–12 kV discharge voltage range. Three independent fitting strategies, specifically a semimanual fitting, an evolutionary algorithm, and a grid search, were applied to retrieve the size distributions and relative shares of copper and copper oxide particles as a function of discharge voltage. Based on experimental and theoretical findings, lognormal and normal distributions across the 10–300 nm diameter range were assumed as constraints for oxide and metallic fractions, respectively. The reconstructed metallic copper population exhibited mean diameters ranging from 123 to 181 nm, while oxidized fractions followed lognormal distributions centred near 10 nm mode diameters. Voltage-dependent trends revealed an optimal discharge regime between 6 kV and 8 kV, where the exploded fraction reached approximately 63% and the metallic mass share exceeded 80%. These results confirmed that spectrophotometry represents an essential tool for the quantitative characterization of such complex, wide-range systems. Full article

Nishijin weaving in Kyoto developed as a luxury textile for kimono, yet sustaining the district requires expansion toward contemporary apparel and markets. Within a silk-centred culture and quality regime, polyester has been adopted as a versatile option, and its use has increased, especially for kimono-related products, partly because its filament form can substitute for silk and fit existing processes. From this trajectory, we explore a craft–code–craft pathway by integrating a biodegradable polyester grade into Nishijin’s code-based Jacquard production (CGS). Through practice-based research, we trace how design intent is encoded (Houdini → CGS → Jacquard) and how shop-floor constraints reconfigure design (Jacquard → CGS → Houdini), revealing institutional constraints that shape which materials become usable. We report three case studies: (A) 3D woven structures informed by pleat parameterisation, (B) a zero-waste garment using a 25 cm repeat logic, and (C) a fashion show that makes translation processes legible to the public in an exhibition context. While biodegradable polyester can fit existing infrastructure, apparel-grade warp use remains under development due to warping and warp-joining requirements; yarn specifications and design parameters are being revised. By foregrounding translation across tools, roles, and standards, the study proposes pathways for material transition and circularity within a craft system. Full article

The present study examines the well-being of workers in an Italian manufacturing plant, focusing on work engagement, emotional exhaustion and work ability. These dimensions have received relatively little attention in manufacturing contexts. Utilising a person-centred approach, the objective is to identify distinct subjective well-being profiles among Italian manufacturing workers and to examine how work-related psychosocial characteristics differentiate these profiles. The research, which collected data from 340 workers (predominantly male at 62.1%) between July and September 2023, focused on work engagement, emotional exhaustion, and work ability—factors that have been previously understudied in manufacturing environments. Through cluster analysis, researchers were able to identify three worker profiles. The largest group, designated “Motivated & Healthy” (45.3%), exhibited the most favourable characteristics: strong work engagement, minimal emotional exhaustion, and adequate work ability. These workers reported experiencing reduced physical demands, greater autonomy in decision-making, and superior rewards compared to their colleagues. The second-largest group, “Motivated & Stressed” (32.5%), demonstrated a mixed profile. While maintaining average work engagement, these workers experienced high levels of emotional exhaustion and diminished work ability. The smallest group, termed “Disillusioned” (22.2%), consisted entirely of blue-collar workers and exhibited the most concerning pattern: low engagement, high exhaustion, and mediocre work ability. This group also reported the most challenging working conditions, including the highest physical and cognitive demands, least decision-making authority, and lowest rewards. The study corroborates earlier research findings by identifying significant relationships between work engagement and work ability (positive correlation) and emotional exhaustion (negative correlation). These results suggest that manufacturing facilities might benefit from tailoring their support strategies to address the specific needs of each worker profile, rather than applying one-size-fits-all solutions. Full article