Investigation of Patient Satisfaction with Education in a Biosimilar Multiswitch Scenario - A Comparison Between Rheumatologists and Nurse Specialists

The aim of this project was to understand patients’ knowledge and opinion about biosimilars and to evaluate patient satisfaction with care after education on multiswitching of biosimilars (bsDMARDs) by rheumatologists in comparison to nurse specialists. Adult patients with rheumatoid arthritis, axial spondyloarthritis or psoriatic arthritis who underwent a non-medical switch to the adalimumab biosimilar MSB 11022 were randomized into a group in which information about multiswitching of bsDMARDs was provided by a nurse specialist or a rheumatologist. Validated outcome tools and standardized parameters for assessment of disease activity and function were used at baseline and 12 weeks after switching. Patients’ satisfaction with care was assessed by the Leeds Satisfaction Questionnaire. A structured questionnaire was used to assess patient’s knowledge. A total of 102 patients was randomized, 40 were seen by the rheumatologist (39.2%) and 62 by the nurse (60.8%). Fifty patients (49%) had already undergone one and 52 multiple switches (51%). Less than one third of patients was able to correctly answer questions on manufacturing, effectiveness, clinical trial evidence and cost of bsDMARDs. Patients were generally satisfied with care irrespective of whether the information had been given by the nurse or the rheumatologist. No difference in outcomes was seen.Patient satisfaction and outcomes after education about bsDMARDs and switching by nurses and rheumatologists were similarly good. The number of switches did not have a negative impact on patient satisfaction.

Standardizing Spatial Reconstruction Parameters for the Atom Probe Analysis of Common Minerals

Well-defined reconstruction parameters are essential to quantify the size, shape, and distribution of nanoscale features in atom probe tomography (APT) datasets. However, the reconstruction parameters of many minerals are difficult to estimate because intrinsic spatial markers, such as crystallographic planes, are not usually present within the datasets themselves. Using transmission and/or scanning electron microscopy imaging of needle-shaped specimens before and after atom probe analysis, we test various approaches to provide best-fit reconstruction parameters for voltage-based APT reconstructions. The results demonstrate that the length measurement of evaporated material, constrained by overlaying pre- and post-analysis images, yields more consistent reconstruction parameters than the measurement of final tip radius. Using this approach, we provide standardized parameters that may be used in APT reconstructions of 11 minerals. The adoption of standardized reconstruction parameters by the geoscience APT community will alleviate potential problems in the measurement of nanoscale features (e.g., clusters and interfaces) caused by the use of inappropriate parameters.

Stringent Base Specific and Optimization-Free Multiplex Mediator Probe ddPCR for the Quantification of Point Mutations in Circulating Tumor DNA

There is an increasing demand for optimization-free multiplex assays to rapidly establish comprehensive target panels for cancer monitoring by liquid biopsy. We present the mediator probe (MP) PCR for the quantification of the seven most frequent point mutations and corresponding wild types (KRAS and BRAF) in colorectal carcinoma. Standardized parameters for the digital assay were derived using design of experiments. Without further optimization, the limit of detection (LoD) was determined through spiking experiments with synthetic mutant DNA in human genomic DNA. The limit of blank (LoB) was measured in cfDNA plasma eluates from healthy volunteers. The 2-plex and 4-plex MP ddPCR assays showed a LoB of 0 copies/mL except for 4-plex KRAS G13D (9.82 copies/mL) and 4-plex BRAF V600E (16.29 copies/mL) and allele frequencies of 0.004% ≤ LoD ≤ 0.38% with R2 ≥ 0.98. The quantification of point mutations in patient plasma eluates (18 patients) during follow-up using the 4-plex MP ddPCR showed a comparable performance to the reference assays. The presented multiplex assays need no laborious optimization, as they use the same concentrations and cycling conditions for all targets. This facilitates assay certification, allows a fast and flexible design process, and is thus easily adaptable for individual patient monitoring.

Human and Cobot Cooperation Ethics: The Process Management Concept of the Production Workplace

The competitiveness of modern companies depends today on the ability to implement digitised technologies into production processes in human-friendly ways. The aim of this paper is to analyse ethical aspects of human-cobot cooperation in industrial production and to design a process standard aimed at ensuring an ethically stable cooperative workplace. The scientific contribution of this study lies in the identification and definition of standardized parameters of the ethics of the production process in the workplace. Based on the analysis of cooperative workplaces in 250 industrial companies, a code of ethics has been defined, i.e. a process standard that determines the navigation of the design by selected optimization criteria necessary for setting up a hybrid workplace defined as human and cobot (collaborative robot) with the support of digitised technologies. In the presented results and the final discussion attention is devoted to the need to radically change the philosophy of workplace standardization in the sense of equal access to workload settings by humans and robots. In the process of standardization, it is necessary to consider the difference in the standardization of human jobs and cobot jobs: the thinking process. In modern industrial companies the need has arisen to create working standards that take into account the adaptive ability of cobots and adapt the cobots’ workflow to human needs concerning performance and productivity. The presented results include recommendations for industrial companies to develop an ethical and stable production workplace based on an adequately defined form of cooperation.

Effect of Bamboo Nodes on the Mechanical Properties of P. edulis (Phyllostachys Edulis) Bamboo

In the context of global sustainable development, the use of natural and renewable bamboo as a building material is of great significance for building engineering. As an important part of bamboo, there is still a lack of systematic research on the effect of bamboo nodes on the mechanical properties of bamboo. In this paper, compression parallel to the grain of the bamboo, bending, tensile parallel to the grain, shear parallel to the grain, compression perpendicular to the grain and tensile perpendicular to the grain tests of an entire bamboo culm of P. edulis bamboo were carried out, and the effects of bamboo nodes on moisture content, bearing capacity and mechanical properties were analyzed. The relationship between the mechanical properties and standardized parameters of the node and internode specimens was established. A conversion method of mechanical properties of the same test type was proposed, and a conversion method among different mechanical properties was proposed. The bamboo was graded by tensile strength parallel to the grain. The results show that bamboo nodes have an obvious effect on the moisture content. Bamboo nodes have different effects on the bearing capacity and mechanical properties of different types of specimens. The mechanical properties of P. edulis bamboo can be predicted by the relationship between the mechanical properties and the standardized parameters and the mechanical property conversion method. The strength classification of P. edulis bamboo can be predicted by standardized parameters.

Subthreshold Micropulse Laser Modulates Retinal Neuroinflammatory Biomarkers in Diabetic Macular Edema

Subthreshold micropulse laser treatment has become a recognized option in the therapeutic approach to diabetic macular edema. However, some yet undefined elements pertaining to its mechanism of action and most effective treatment method still limit its clinical diffusion. We reviewed the current literature on subthreshold micropulse laser treatment, particularly focusing on its effects on the modulation of retinal neuroinflammation. Subthreshold micropulse laser treatment seems to determine a long-term normalization of specific retinal neuroinflammatory metabolic pathways, contributing to the restoration of retinal homeostasis and the curtailing of local inflammatory processes. Optimized and standardized parameters ensure effective and safe treatment.

Pulsed Electromagnetic Fields in Bone Healing: Molecular Pathways and Clinical Applications

In this article, we provide an extensive review of the recent literature of the signaling pathways modulated by Pulsed Electromagnetic Fields (PEMFs) and PEMFs clinical application. A review of the literature was performed on two medical electronic databases (PubMed and Embase) from 3 to 5 March 2021. Three authors performed the evaluation of the studies and the data extraction. All studies for this review were selected following these inclusion criteria: studies written in English, studies available in full text and studies published in peer-reviewed journal. Molecular biology, identifying cell membrane receptors and pathways involved in bone healing, and studying PEMFs target of action are giving a solid basis for clinical applications of PEMFs. However, further biology studies and clinical trials with clear and standardized parameters (intensity, frequency, dose, duration, type of coil) are required to clarify the precise dose–response relationship and to understand the real applications in clinical practice of PEMFs.

Role of Intestinal Ultrasound in the Management of Patients with Inflammatory Bowel Disease

Intestinal ultrasound (IUS) has gained popularity as a first line technique for the diagnosis and monitoring of patients with inflammatory bowel diseases (IBD) due to its many advantages. It is a non-invasive imaging technique with non-ionizing radiation exposure. It can be easily performed not only by radiologists but also by trained gastroenterologists at outpatient clinics. In addition, the cost of IUS equipment is low when compared with other imaging techniques. IUS is an accurate technique to detect inflammatory lesions and complications in the bowel in patients with suspected or already known Crohn’s disease (CD). Recent evidence indicates that IUS is a convenient and accurate technique to assess extension and activity in the colon in patients with ulcerative colitis (UC), and can be a non-invasive alternative to endoscopy. In patients with IBD, several non-specific pathological ultrasonographic signs can be identified: bowel wall thickening, alteration of the bowel wall echo-pattern, loss of bowel stratification, increased vascularization, decreased bowel peristalsis, fibro-fatty proliferation, enlarged lymph nodes, and/or abdominal free fluid. Considering the transmural CD inflammation, CD complications such as presence of strictures, fistulae, or abscesses can be detected. In patients with UC, where inflammation is limited to mucosa, luminal inflammatory ultrasonographic changes are similar to those of CD. As the technique is related to the operator’s experience, adequate IUS training, performance in daily practice, and a generalized use of standardized parameters will help to increase its reproducibility.

Design of Concrete Made with Recycled Brick Waste and Its Environmental Performance

In addition to the known uses of natural clays, less publication attention has been paid to clays returned to the production process. Industrially recovered natural clays such as bricks, tiles, sanitary ceramics, ceramic roofing tiles, etc., are applicable in building materials based on concrete as an artificial recycled aggregate or as a pozzolanic type II addition. In this way, the building products with higher added value are obtained from the originally landfilled waste. This paper details the research process of introducing concrete with recycled brick waste (RBW) up to the application output. The emphasis is placed on using a RBW brash as a partial replacement for natural aggregates and evaluating an RBW powder as a type II addition for use in concrete. A set of the results for an RBW is reported by the following: (a) an artificial RBW fine aggregate meets the required standardized parameters for use in industrially made concrete, (b) a RBW powder is suitable for use in concrete as industrially made type II addition TERRAMENT showing the same pozzolanic reactivity as a well-known and broadly used pozzolan-fly ash, and (c) such an RBW as aggregate and as powder are, therefore, suitable for the production of industrially made TRITECH Eco-designed ready-mixed concrete.

Limited cutaneous systemic sclerosis: Total rehabilitation with fixed prosthesis on dental implants

Introduction: Limited cutaneous systemic sclerosis with special manifestations (calcinosis cutis, Raynaud’s phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia) is part of the group of connective tissue diseases, these rare autoimmune systemic pathologies cause thickening and hardening of tissues in different parts of the body and can lead to complex disorders. Oral manifestations of systemic sclerosis may include limited ability to open the mouth, xerostomia, periodontal disease, enlarged periodontal ligament, and bone resorption of the jaw. Case Description: A 54-year-old Caucasian patient presented with oral pain, swallowing, phonation and chewing difficulties associated with dental instability, hygiene/handling difficulties and her main problem with microstomia, which prevented her from removing the skeletal prosthesis for 4 years, depriving her of social life. Gradual treatment with dental implants was diagnosed and planned to support a fixed total denture adapted to the ridge with self-cleaning characteristics. After implant insertion, panoramic radiographs with standardized parameters were taken to compare crestal bone levels at the time of prosthesis placement and with 10 years of follow-up. Conclusion: The average crestal bone loss of the 12 implants after the 10 years of follow-up was 1.26 mm for the maxilla and 1.17 mm for the mandible. The survival of the 12 support implants of two total fixed prostheses in a clinical/radiographic follow-up of 10 years was 100%. After 10 years of follow-up, the 12 implants inserted had a bone loss similar to that of healthy patients and no pathologies were registered, recovering function, aesthetics, and self-esteem. This therapy must be implemented before the interincisal distance decreases to 30 mm to allow intraoral surgical/prosthetic access. Implant-supported total fixed rehabilitation is a viable, predictable, and recommended therapy in patients with limited cutaneous systemic sclerosis.