New multimodal intervention to reduce irritable bowel syndrome (IBS) severity symptoms—Pilot study with a 12 month follow-up

Introduction Irritable bowel syndrome (IBS) is characterized by patients' high level of suffering. Up to 60% of patients with IBS have symptoms of anxiety or depression and only little attention has been paid to their specific requirements. Anthroposophical multimodal therapy (AMT) has been shown to significantly improve health-related quality of life of patients with high symptomatic burden. Objective The aim of this pilot study was to find out whether AMT meets the needs of IBS patients and the interactions of AMT with IBS, depression and anxiety Methods Patients with diagnosed IBS were included in a feasibility study and received 12 sessions of AMT over 8 weeks (drks.de, DRKS00016890). The primary endpoint was the change of the IBS severity score (IBS-SSS) and changes were calculated by linear mixed effects analyses. The secondary endpoints were changes of self-reported PHQ-9 and GAD-7 for mental comorbidity as well as self-valued effectiveness and satisfaction of AMT. Results Thirty-six patients, 89% female, were included in the study. AMT was successfully applied to IBS patients (-45 points in the IBS-SSS, p < .05). AMT had a large positive effect (-84 points in IBS-SSS, p < .003) on patients without anxiety or depression. Over time, patients with higher anxiety scores worsened with regard to their IBS compared to patients with depression and without mental comorbidity. The AMT effect was maintained at a 12 month follow up and both mentally affected and unaffected patients, had even lower IBS severity than shortly after AMT. AMT modules were rated by IBS patients as very effective. Conclusion Our findings suggest that an 8-week program of AMT improves the severity of IBS with an ongoing effect at a 12 month follow-up. Especially for patients without psychological comorbidities, AMT is very successful. Future IBS therapies should incorporate a modified multimodal concept with stronger psychological therapy modules in parallel for patients with depression and anxiety

School Teachers’ Self-Reported Fear and Risk Perception during the COVID-19 Pandemic—A Nationwide Survey in Germany

With the coronavirus disease 2019 (COVID-19) cases peaking and health systems reaching their limits in winter 2020/21, schools remained closed in many countries. To better understand teachers' risk perception, we conducted a survey in Germany. Participants were recruited through various associations and invited to take part in a cross-sectional COVID-19-specific online survey. Descriptive statistical analysis was performed. Factors associated with teachers' fears of contracting the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) were evaluated with an adjusted multivariable regression analysis. The median age of the 6753 participating teachers was 43 years, and 77% were female. Most teachers worked in high schools (29%) and elementary schools (26%). The majority of participants (73%) feared contracting SARS-CoV-2 at school, while 77% intended to receive their COVID-19 vaccination. Ninety-eight percent considered students to pose the greatest risk. Female and younger teachers were significantly more anxious to get infected and teachers who opposed the re-opening of schools had significantly higher odds of being more anxious (p < 0.001). To the authors' knowledge, this is the first study to describe teachers' risk perception of COVID-19 and their attitudes towards vaccinations in a nationwide survey. The anxiety correlates with the COVID-19 protection measures demanded and appears to be a driving factor rather than rational logic

PROCESS MODELING AND SCENARIO SIMULATION IN CONSTRUCTION USING ENTERPRISE DYNAMICS SIMULATION SOFTWARE

Modeling and simulation of organizational processes are established methodologies and tools in most industries. In civil engineering, however, this is not the case. One of the reasons for this is the lack of special tools, specifically computer programs used primarily for modeling and simulating characteristic processes of construction. In this paper the authors look for analogies between processes typical for construction and those in other industries in which Enterprise Dynamics software has been successfully applied. In order to perform a valid software analysis, the authors tested this software in a case study that represents universal problems at construction sites: queuing and sequencing. In this study, authors modeled and simulated the production, transport, and laying of a hot asphalt mixture. Results show that this software is suitable for modeling and scenario simulation in this case and that the software shows promise for other uses in the construction industry

Artificial Intelligence for Hospital Health Care:Application Cases and Answers to Challenges in European Hospitals

The development and implementation of artificial intelligence (AI) applications in health care contexts is a concurrent research and management question. Especially for hospitals, the expectations regarding improved efficiency and effectiveness by the introduction of novel AI applications are huge. However, experiences with real-life AI use cases are still scarce. As a first step towards structuring and comparing such experiences, this paper is presenting a comparative approach from nine European hospitals and eleven different use cases with possible application areas and benefits of hospital AI technologies. This is structured as a current review and opinion article from a diverse range of researchers and health care professionals. This contributes to important improvement options also for pandemic crises challenges, e.g., the current COVID-19 situation. The expected advantages as well as challenges regarding data protection, privacy, or human acceptance are reported. Altogether, the diversity of application cases is a core characteristic of AI applications in hospitals, and this requires a specific approach for successful implementation in the health care sector. This can include specialized solutions for hospitals regarding human-computer interaction, data management, and communication in AI implementation projects

An Approach for Classication of Integrated Circuits by a Knowledge Conserving Library Concept

Abstract A simulation based analysis of analog and mixed analog/digital circuits on printed circuit board level requires a lot of information about the involved c omponents. Entering solely the data sheet information into a component library normally disregards structural knowledge which is well{known by the circuit designer. Therefore, the expert knowledge necessary for an optimum use of analysis tools is no more available. This paper presents an approach to overcome this problem. A concept to represent eciently expert knowledge and classication information is introduced and a classication of circuits which conserves the structural information is presented

Safety of Combined Targeted and Helixor&reg;&nbsp;Viscum album L. Therapy in Breast and Gynecological Cancer Patients, a Real-World Data Study

Background: Newer personalized medicines including targeted therapies such as PARP inhibitors and CDK 4/6 inhibitors have been shown to improve the survival of breast and gynaecological cancer patients. However, efficacy outcomes may be ham5pered by treatment discontinuation due to targeted therapy-related adverse drug reactions or resistance. Studies have suggested that add-on mistletoe (Viscum album L., VA) improves the quality of life and ameliorates the cytotoxic side effects of standard oncological therapy in cancer patients. The primary objective of this real-world data study was to determine the safety profile of targeted therapy in combination with add-on Helixor&reg; VA therapy compared to targeted therapy alone in breast and gynecological cancer patients. Methods: The present study is a real-world data observational cohort study utilizing demographic and treatment data from the accredited national Network Oncology (NO) registry. The study has received ethics approval. The safety profile of targeted therapies with or without Helixor&reg; VA therapy and safety&mdash;associated variables were evaluated by univariate and adjusted multivariable regression analyses. Results: All stages of breast and gynecological cancer patients (n = 242) were on average 54.5 &plusmn; 14.2 years old. One hundred and sixty patients (66.1%) were in the control (CTRL, targeted therapy) and 82 patients (33.9%) were in the combinational (COMB, targeted plus Helixor&reg; VA therapy) group. The addition of Helixor&reg; VA did not hamper the safety profile (&chi;2 = 0.107, p-value = 0.99) of targeted therapy. Furthermore, no adverse events and a trend towards an improved targeted therapy adherence were observed in the COMB group. Conclusions: The present study is the first of its kind showing the applicability of Helixor&reg; VA in combination with targeted therapies. The results indicate that add-on Helixor&reg; VA does not negatively alter the safety profile of targeted therapies in breast and gynaecological cancer patients