Control of Cyber-Physical Production Systems: A Concept to Increase the Trustworthiness within Multi-Agent Systems with Distributed Ledger Technology

In the course of increasing the flexibility in the area of production, industrial enterprises have been presented with cyber-physical production systems (CPPS). Through the use of autonomously acting CPPS and CPPS components – which often receive multi-agent systems as their corresponding cyber parts – new challenges arise from the need for flexibility and interoperability on the one hand and consistency, trustworthiness as well as reliability of the systems and their components on the other. In order to meet these challenges, this research paper is dedicated to the creation of a technical concept for implementing distributed ledger technology production systems. The paper follows a design-science approach, which consist of analysis, design, and evaluation. The technical concept is based on the GAIA method, which aims to design multi-agent systems and specifically addresses the security and trustworthiness of CPPS-environments. The subsequent evaluation of the concept based on discussions with experts documents its relevance and potential

Ocena dawek ryzyka popromiennej przetoki pochwowo-odbytniczej u chorych na raka szyjki macicy

PurposeTo evaluate the incidence and risk factors, both clinical and physical, of the development of a postradiation recto-vaginal fistula in cervical cancer patients.Materials and methodsA retrospective analysis of 222 consecutive patients receiving radical treatment for invasive cervical cancer at the Regional Oncology Centre in Bydgoszcz between 1993 and 1995 has been performed, on 140 patients treated with radiotherapy alone and 82 patients who received radiotherapy combined with surgical treatment. The doses and dose rates of brachytherapy were specified at point A, the mean dose being 49 and 46 Gy for radiotherapy alone and combined treatment, respectively. External beam irradiation was applied in fractions of 1.8–2 Gy, up to a total dose of 44.6 Gy (36–50 Gy). The dose and dose rate in the rectum (point R1) were determined according to the protocol 38th ICRU, the biological extrapolated dose (BED), using a LQ model, was calculated as a sum of a dose from external beam irradiation and brachytherapy.ResultsA total of 17 (7.6%) recto-vaginal cases of fistulae were found; 13 (9,2%) in patients treated with radiotherapy alone, 4 (4,8%) in patients treated with combined treatment. The median latency time was 11.8 months (range 7 to 24). There is a strong association between the risk of developing a fistula and the biological extrapolated dose (BED) at point R1. Addition of surgical treatment results in a higher risk of complications. Age, clinical stage, hemoglobin level, performance status and the overall treatment time, type and size of applicators were not found to have a significant effect on the risk of developing recto-vaginal fistula.ConclusionsThe biological extrapolated dose (BED) at point R1 is an important predictive factor relevant for postradiotherapeutic rectovaginal fistula incidence risk. Surgery is an important factor modifying the postradiotherapeutic rectovaginal fistula incidence risk. No significant influence on the fistula incidence risk of such parameters as age, FIGO stage, physical activity, haemoglobin level, overall treatment time, type and size of applicators has been demonstrated.CelIdentyfikacja klinicznych i fizycznych czynników ryzyka popromiennej przetoki pochwowo-odbytniczej u chorych na raka szyjki macicy.Materiał i metodykaMateriał obejmował grupę 222 kolejnych chorych na inwazyjnego raka szyjki macicy poddaną radykalnej radioterapii w latach 1993–1995. Pacjentki podzielono na 2 grupy w zależności od sposobu leczenia, samodzielną radioterapię zastosowano u 140 chorych, u 82 radioterapię w skojarzeniu z leczeniem chirurgicznym. Dla każdej chorej wyznaczono biologiczna dawkę równoważną (BED) w punkcie R1 (wg 38 raportu ICRU) wykorzystując model liniowo kwadratowy. Zastosowano metodę regresji logitowej jedno i wielokrotnej. Wyznaczono dawki i krzywe ryzyka popromiennej przetoki pochwowo-odbytniczej oraz iloraz szans dla analizowanych czynników ryzyka.WynikiWystąpiło 17 popromiennych przetok pochwowo odbytniczych (7,7%), 4 po leczeniu skojarzonym (4,9%) i 13 (9,3%) po samodzielnej radioterapii. Czynnikami ryzyka popromiennej przetoki pochwowo-odbytniczej były: biologiczna dawka równoważna w punkcie R1 oraz zastosowanie leczenia chirurgicznego. Nie wykazano istotnego wpływu takich cech jak wiek, stopień zawansowania klinicznego, stopień sprawności klinicznej, całkowity czas leczenia, rodzaj i wielkość aplikatorów.WnioskiBiologiczna dawka równoważna (BED) w punkcie R1 jest istotnym czynnikiem predykcyjnym ryzyka wystąpienia popromiennej przetoki pochwowo – odbytniczej a skojarzenie z leczeniem chirurgicznym istotnie modyfikuje tę zależność

Structure of Human Thymidylate Synthase under Low-Salt Conditions

Human thymidylate synthase, a target in cancer chemotherapy, was crystallized from PEG 3350 with 30 mM ammonium sulfate (AS) in the crystallization medium. The crystals are isomorphous with the high-salt crystals (~2.0 M AS) and the structure has been solved and refined (R = 22.6%, Rfree = 24.3%) at 1.8 Å resolution. The high- and low-AS-concentration structures are quite similar, with loop 181-197 is in the inactive conformation. Also, residues 95-106 and 129-135 (eukaryotic inserts region) show high mobility as assessed by poor electron density and high values of crystallographic temperature factors (residues 1-25 and 108-129 are disordered in both structures). The high mobility of this region may reflect the situation at physiological ionic strength. Of the four sulfate ions observed bound at 2.0 M AS, only two are present at 30 mM AS. The inactive conformation appears to be stabilized by the side chain of Val3 or a leucine residue from the disordered regions. The low-salt conditions of these crystals should be much more suitable for the study of thymidylate synthase inhibitors, especially those that utilize sulfate-binding sites to stabilize the inactive conformation of loop 181-197

Oral complaints in patients with acute myeloid leukemia treated with allogeneic hematopoietic stem cell transplantation

Acute myeloid leukemia belongs to proliferative diseases of the hematopoietic system. It is currently the leading indication for allogeneic hematopoietic stem cell transplantation. This study was designed to determine the most common subjective oral mucosa complaints in patients with acute myeloid leukemia after allogeneic hematopoietic cell transplantation, in relation to the type of conditioning used. Eighty patients diagnosed with acute myeloid leukemia were assigned to two groups depending on the intensity of the conditioning regimen before transplantation: myeloablative and reduced-intensity chemotherapy. The oral symptoms were evaluated based on an authorial questionnaire designed for this analysis. The following oral mucosa subjective complaints were included: pain, paraesthesia, burning mouth sensation, taste disorders, excessive salivation, halitosis, and dryness of the oral mucosa. The most commonly reported subjective oral complaint in the examined patients was xerostomia, which was found in 92% of patients during the second visit, followed by spontaneous pain in the mouth (55%), burning (36%), and dysgeusia (20%). It occurred significantly more frequently in patients who underwent myeloablative conditioning. Moreover, it was observed that the frequency of complaints increased considerably after the transplantation, reaching a peak intensity during the second week following the procedure. Oral complaints significantly decrease the patients' quality of life during the transplantation and may lead to premature termination of the treatment. As the number of transplantations in patients with acute myeloid leukemia increases, further investigations of oral complaints and symptoms induced by the disease itself and by the therapeutic approaches are required

Eating disorders in children and adolescents - the current state of knowledge

Introduction. Eating disorders (ED) are a group of severe mental health disorders with high prevalence, mortality and associated morbidity. The most common eating disorders are anorexia nervosa, bulimia nervosa and binge-eating disorder.  Objective. The aim of the study was to evaluate prevalence, risk factors, clinical manifestation as well as complications for proper diagnostic and treatment of eating disorders.   Materials and method. The literature review included articles from Google Scholar databases and PubMed. Articles published in 2013 or later were mainly considered.  Brief description of the state of knowledge. The prevalence of eating disorders vary according to gender. There are a variety of risk factors that can be divided into family history, individual and possible triggers. The most common risk factors include family history of mental disorders. Studies have shown that premorbid overweight is more frequent in male. In the diagnosis of eating disorders, the ICD-10 and DSM-5 classification is used. Complications of this disease can manifest itself from various systems of the body. Proper cooperation between the pediatrician and the patient is very important. Treatment of eating disorders focuses on psychotherapy, especially family-based treatment. Worse results are obtained due to underdiagnosis and late initiation of treatment.  Summary. Pediatricians are the first healthcare professionals which have contact with young patients, so education about the first symptoms and consequences of not receiving appropriate treatment is essential. 

Relevance of indirect comparisons in the German early benefit assessment and in comparison to HTA processes in England, France and Scotland

Early benefit assessment in Germany under the legislative framework of AMNOG (Arzneimittelmarktneuordnungsgesetz) requires direct comparisons of the new drug with appropriate comparators determined by the Federal Joint Committee (G-BA). In case no head-to-head studies are available for direct comparisons, the submission of indirect comparisons is permitted to assess the additional benefit of the new drug. However, the Institute for Quality and Efficiency in Health Care (IQWiG) states a clear preference for head-to-head trials and defines strict requirements for indirect comparisons to be considered in the benefit assessment. Similar requirements also exist in other countries with mandatory health technology assessments (HTA), like France, England and Scotland. Our evaluation shows that a comparison of the different HTA regarding indirect comparisons is difficult. Overall, external preconditions and methodological requirements are demanding and hardly to fulfill by pharmaceutical companies for implementation of indirect comparisons in early benefit assessment. The determination of the appropriate comparators, outcomes, patient subgroups and study choice are the main target within indirect comparisons for the future. To compare and assess submitted indirect comparisons it would be desirable that a transparent process was established, including the mandatory publication of HTA-reports within Europe and international guidelines, accepted by a large number of HTA-agencies

Structure of the thioredoxin-like domain of yeast glutaredoxin 3

Yeast Grx3 is involved in iron-responsive transcription regulation. The single active site thiol of the thioredoxin-like domain is in a flexible surface loop as suggested by its partial disorder

Cardiac remodeling and right ventricular function in patients with end-stage renal disease one year since maintenance hemodialysis initiation

Wstęp. Wobec rosnącej liczby chorych wymagających leczenia nerkozastępczego oraz dwukierunkowych interakcji między nerkami a sercem, znanych jako zespół nerkowo-sercowy, ocena wpływu dializoterapii na funkcję serca stała się kluczowa. Materiał i metody. Grupę badaną stanowiło 22 dorosłych pacjentów ze schyłkową niewydolnością nerek zakwalifikowanych do hemodializoterapii w Centrum Dializ między styczniem a grudniem 2019 roku. Wyniki. Mediana wieku pacjentów wyniosła 59,5 roku (51–64). Kobiety stanowiły 55% badanej grupy. Najczęstszymi chorobami współistniejącymi były: nadciśnienie tętnicze (86%) oraz cukrzyca (36%). W obserwacji rocznej odnotowano istotny spadek wymiarów proksymalnego i dystalnego RVOT (odpowiednio: p = 0,04; p = 0,007) oraz istotny spadek wartości IVAc (p = 0,01). W konsekwencji wydłużenia IVRTc (p < 0,001) i IVCTc (p < 0,001) zaobserwowano istotny wzrost wartości MPI (p < 0,001). Wnioski. U pacjentów ze schyłkową niewydolnością nerek długotrwała dializoterapia wpływa negatywnie na funkcję prawej komory. IVA oraz MPI, mierzone metodą tkankowego Dopplera pulsacyjnego, są czułymi wskaźnikami zmian w prawej komorze.Introduction. Due to the increasing number of patients requiring renal replacement therapy and bidirectional interactions between kidneys and heart, known as reno-cardiac syndrome, the assessment of dialysis influence on heart performance has become paramount. Material and methods. This was a prospective study analyzing data of 22 adult patients with end-stage renal disease, referred for maintenance hemodialysis (HD) at our Dialysis Centre between January 2019 and December 2019. Results. The median age of the patients was 59.5 (51–64) years, and 55% of the study group were females. The most common comorbidities were hypertension (86%) and diabetes (36%). At one-year follow-up, there was a significant decrease in proximal and distal right ventricular outflow tract (RVOT) dimensions (p = 0.04; p = 0.007 respectively) and in isovolumic acceleration time corrected (p = 0.01). As the result of the prolongation of isovolumic relaxation time corrected (p &lt; 0.001) and isovolumic contraction time corrected (p &lt; 0.001) a significant increase in myocardial performance index (MPI) (p &lt; 0.001) was observed. Conclusions. In patients with end-stage renal disease long-term HD negatively impacts RV function. Isovolumic acceleration and MPI measured with pulsed tissue Doppler are sensitive indicators of changes in RV function

An Exploratory Investigation Of College Students Attitudes Toward Californias New Menu-Labeling Law

In March of 2009, business students at a large public university in the Los Angeles area were polled about their attitudes towards a new menu-labeling law that was about to be implemented in California. It was hypothesized that the students would be in favor of the law and that those in favor of it would be inclined to select healthier items on the menu.  Moreover, it was hypothesized that the law would be favored more by females than males, and more by persons who perceive themselves as overweight than those who perceive themselves as average weight. Support was found for all of the hypotheses except for the one concerning a person’s perceived weight status. A student’s perceived weight status appears to have no effect on his or her reaction to the new menu-labeling law. The survey results indicate that menu-labeling will be effective in promoting better eating habits among college students who dine out