Implementing Individually Tailored Prescription of Physical Activity in Routine Clinical Care:A Process Evaluation of the Physicians Implement Exercise = Medicine Project

BACKGROUND: Although the prescription of physical activity in clinical care has been advocated worldwide, in the Netherlands, "Exercise is Medicine" (E = M) is not yet routinely implemented in clinical care.METHODS: A set of implementation strategies was pilot implemented to test its feasibility for use in routine care by clinicians in 2 departments of a university medical center. An extensive learning process evaluation was performed, using structured mixed methods methodology, in accordance with the Reach, Effect, Adoption, Implementation, and Maintenance framework.RESULTS: From 5 implementation strategies employed (education, E = M tool embedded in the electronic medical records, lifestyle coach situated within the department, overviews of referral options, and project support), the presence of adequate project support was a strong facilitator of the implementation of E = M. Also, the presence of the lifestyle coach within the department seemed essential for referral rate. Although clinicians appreciated the E = M tool, barriers hampered its use in practice.CONCLUSIONS: Specific implementation strategies, tailored to the setting, are effective in facilitating the implementation of E = M with specific regard to education for clinicians on E = M, deployment of a lifestyle coach within a department, and project coordination. Care providers do see a future for lifestyle coaches who are structurally embedded in the hospital, to whom they can easily refer.</p

Comorbidity and sex differences in functional disorders and internalizing disorders

OBJECTIVE: In the current exploratory study we estimate comorbidity rates between FDs [fibromyalgia (FM), myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), and irritable bowel syndrome (IBS)]-and IDs-[major depressive disorder (MDD) and generalized anxiety disorder (GAD)] by using self-reported diagnostic criteria.METHOD: We analyzed data from 107,849 participants (mean age = 49.3 (SD = 13.0), 58.6% women) of the Lifelines Cohort Study. Lifelines is a prospective population-based cohort study in the northeast of the Netherlands. Current IDs were assessed using the Mini-International Neuropsychiatric Interview. Current FM, ME/CFS, and IBS were assessed according to the 2010 American College of Rheumatology criteria, the 1994 Centers for Disease Control and Prevention criteria and the ROME IV criteria, respectively. We estimated tetrachoric correlations between diagnoses and tested for sex differences. Additionally, we estimated the ratio of observed-to-expected frequency for combinations of diagnoses.RESULTS: FDs and IDs are highly comorbid (odds ratios: 3.2-12.6) with associations stronger among men. Participants with at least three disorders/diagnoses were more prevalent than expected by chance.CONCLUSION: Studies that aim to explain sex differences and the comorbidity of specific combinations of IDs and FDs will be an important contribution to understanding the etiology of these conditions.</p

Artificial intelligence, automation and the language industry

Widespread disruption to the language industry from artificial intelligence (AI) such as machine translation (MT) has been predicted for many years, but now that these technologies are being deployed, the effects are varied and, at times, unexpected. Neural MT, in particular, can produce output of greater quality compared to previous MT paradigms, but not without errors, and the best way to interact with MT to produce quality translation is not entirely clear. The use of MT and other forms of AI in the language industry necessitates consideration of risk, of value and of environmental and social sustainability. In this chapter, we introduce definitions of AI and automation, follow developments in AI within the language industry, and then consider the direction in which these developments need to go and how we might get there.</p

High Affinity Inhibitors of the Macrophage Infectivity Potentiator Protein from Trypanosoma cruzi, Burkholderia pseudomallei, and Legionella pneumophila:A Comparison

Since Chagas disease, melioidosis, and Legionnaires’ disease are all potentially life-threatening infections, there is an urgent need for new treatment strategies. All causative agents, Trypanosoma cruzi, Burkholderia pseudomallei, and Legionella pneumophila, express a virulence factor, the macrophage infectivity potentiator (MIP) protein, emerging as a promising new therapeutic target. Inhibition of MIP proteins having a peptidyl-prolyl isomerase activity leads to reduced viability, proliferation, and cell invasion. The affinity of a series of pipecolic acid-type MIP inhibitors was evaluated against all MIPs using a fluorescence polarization assay. The analysis of structure–activity relationships led to highly active inhibitors of MIPs of all pathogens, characterized by a one-digit nanomolar affinity for the MIPs and a very effective inhibition of their peptidyl-prolyl isomerase activity. Docking studies, molecular dynamics simulations, and quantum mechanical calculations suggest an extended σ-hole of the meta-halogenated phenyl sulfonamide to be responsible for the high affinit

Endoxa, regimes of truth and hatred rhetoric:Examining Golden Dawn’s online media discourses

Drawing upon the notion of hate speech—and soft hate speech, more specifically—this chapter aims to bring to light the discursive strategies that constituted Golden Dawn (GD)’s cultures of violence in their public appearances and justified hatred against the perceived “Other” (such as the migrant worker and leftist/communist trade unionist “Other”). To do that, this chapter presents an analysis of GD’s online media and records of their interventions during multiple crises in Greece. In particular, it maps how GD’s leadership built on assumptions of distinction from their political, cultural, and/or class “Others” to subtly justify discriminatory hatred against them. To that end, it follows the premises of the Discourse-Historical Approach (DHA) to Critical Discourse Studies (CDS), Foucault’s concept of regime of truth and the Aristotelian concepts of topos and endoxon

Intrathecal administration of clozapine to reduce side effects:A hypothesis

Clozapine, despite its superior efficacy in treating therapy-resistant schizophrenia, is often underutilized due to its challenging side effect profile. This paper proposes a novel approach to address this issue by exploring the hypothesis of intrathecal administration of clozapine, delivering the drug directly into the cerebrospinal fluid. The article reviews the existing routes of administration, pharmacokinetics, side effects, dosages, and challenges associated with intrathecal clozapine administration. The hypothesis suggests potential advantages, such as reduced systemic side effects due to the reduced dose and lower plasma levels of intrathecal clozapine. Intrathecal administration, delivered through a programmable implantable pump, offers a continuous and stable drug concentration in the central nervous system and improved treatment adherence. While theoretical benefits are outlined, challenges and risks, including infection and pump malfunctions, are discussed. Ethical considerations and the need for further research, including clinical trials, to evaluate safety, efficacy, and feasibility are emphasized. Intrathecal clozapine administration presents a promising way to enhance the therapeutic benefits of clozapine while minimizing its side effects. Still, extensive research is warranted to validate its practical application in schizophrenia treatment.</p

Researching Cultural Policy from the Perspective of Economics and Sociology of Conventions

This chapter discusses how the perspective of economics and sociology of conventions (EC/SC) is applied and helpful in analyzing public cultural policies. First, the concept of public cultural policies and the four types of decisions relevant in cultural policies are introduced: (1) decisions on the goals of cultural policies, (2) decisions on the infrastructure for cultural policies, (3) decisions on subsidy allocations, and (4) decisions on the content of cultural programs. The chapter analyzes how EC/SC has been used in research for cultural policy, mostly on the working realities in the creative industries and in research on cultural policies themselves: research focusing on policy legitimizations, on alternative sources of funding, and on subsidy allocation decisions. Overall, the research points out that cultural policies are based on a compromise between the inspired and civic conventions. There is a great variety in the ways this compromise is constituted by artists, managers, and bureaucrats who are involved in the process of developing cultural policies

Electronic Waste Management Using Smart Contracts on the Blockchain Platform

Nowadays, electronic waste is no longer considered ordinary waste; instead, it is recognized as valuable and hazardous waste containing significant amounts of precious metals. Therefore, it should not be disposed of illegally in any location. Traditional processes for managing electronic waste may not be suitable for the industry's future needs due to environmental pollution, high costs, and low efficiency. Consequently, the management of electronic waste has become a necessity in today's world. This research focuses on utilizing smart contracts to establish stable and regular waste management processes and activities. The proposed method encompasses all steps involved in waste management, including collection, separation, routing, transportation, destruction, and recycling. These steps are managed within a blockchain platform and under a smart contract. To simulate and evaluate the effectiveness of the proposed method, colored petri nets (CPNs) have been employed. The results demonstrate that the presented approach establishes a balanced situation in terms of reliability, response time, and availability parameters when providing services to customers within the context of a smart city. These results are achieved through various steps such as registration, authentication, interaction, routing, and checking the capacity of smart bins. The utilization of blockchain technology and smart contracts ensures transparency, efficiency, and accountability throughout the waste management process. The use of CPNs for simulation and evaluation further validates the effectiveness of the proposed method in achieving reliable and timely waste management services in a smart city environment.</p

Graph Neural Network-Based Real-Time 3D Tracking for Micro-Agent Control

Micro-surgical robotic systems are gaining prominence in minimally invasive surgery within the medical field.However, accurately tracking the position of the moving agents at the micro-scale remains a significant challenge, particularly for multi-agent systems operating in cluttered and unknown environments.Traditional image analysis methods can falter when confronted with issues such as mutual and obstacle occlusion, especially in dynamic and unstructured scenarios.In order to address this issue, this study introduces a graph-based multi-agent 3D tracking algorithm for a micro-agent control system.This algorithm integrates image information with the control inputs used to navigate the micro agents.We combine the power of Convolutional Neural Networks and Graph Neural Networks to effectively extract features from image sources, and combine them with historical data and control inputs.The primary novelty of this algorithm is its ability to make predictions when the target is occluded in the 2D detection results.The proposed system achieved a tracking error of 0.15 mm, outperforming standard model-based tracking techniques.</p