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Article ; Online: Learning spatio-temporal patterns with Neural Cellular Automata.

Richardson, Alex D / Antal, Tibor / Blythe, Richard A / Schumacher, Linus J

2024 Volume 20, Issue 4, Page(s) e1011589

Abstract: Neural Cellular Automata (NCA) are a powerful combination of machine learning and mechanistic modelling. We train NCA to learn complex dynamics from time series of images and PDE trajectories. Our method is designed to identify underlying local rules ... ...

Abstract	Neural Cellular Automata (NCA) are a powerful combination of machine learning and mechanistic modelling. We train NCA to learn complex dynamics from time series of images and PDE trajectories. Our method is designed to identify underlying local rules that govern large scale dynamic emergent behaviours. Previous work on NCA focuses on learning rules that give stationary emergent structures. We extend NCA to capture both transient and stable structures within the same system, as well as learning rules that capture the dynamics of Turing pattern formation in nonlinear Partial Differential Equations (PDEs). We demonstrate that NCA can generalise very well beyond their PDE training data, we show how to constrain NCA to respect given symmetries, and we explore the effects of associated hyperparameters on model performance and stability. Being able to learn arbitrary dynamics gives NCA great potential as a data driven modelling framework, especially for modelling biological pattern formation.
Language	English
Publishing date	2024-04-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	2193340-6
ISSN	1553-7358 ; 1553-734X
ISSN (online)	1553-7358
ISSN	1553-734X
DOI	10.1371/journal.pcbi.1011589
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Patient reported outcome and quality of life measured by a simple questionnaire in patients with symptomatic benign prostate hyperplasia treated by holmium laser enucleation of the prostate (HoLEP).

Schumacher, Stephanie / Marghawal, David / Brunken, Claus / Herzberg, Jonas

Frontiers in surgery

2024 Volume 11, Page(s) 1358701

Abstract: Introduction: Holmium Laser Enucleation of the Prostate (HoLEP) is established as an effective transurethral treatment option for LUTS due to BPH with improved postoperative outcome. The aim of this study was to evaluate the medium-term results by ... ...

Abstract	Introduction: Holmium Laser Enucleation of the Prostate (HoLEP) is established as an effective transurethral treatment option for LUTS due to BPH with improved postoperative outcome. The aim of this study was to evaluate the medium-term results by patient reported outcome measurement and to detect potential risk factors for postoperative complications or impaired outcome. Methods: We performed a retrospective single-center cohort study including all patients undergoing HoLEP in the study center between April 2019 and December 2021. Therefore, perioperative parameters and postoperative outcome was documented and all patients were asked for their outcome (PROM), complications, IPSS, QoL and changes in sexual and continence function by a questionnaire at a single time point. Results: In the study period, a total of 541 patients with a mean age of 72.5 ± 8.4 years were treated by HoLEP in the study center. 71.7% of the questionnaires were returned after a mean observation period of 14.9 ± 6.3 month. 91% of the patients reported to the single-timepoint questionnaire reporting a good satisfaction with the procedure and a low postoperative complication rate. The international prostate symptom score could be reduced significantly to 6.2 ± 5.7 (preoperative 19.0 ± 7.2; Conclusion: The overall satisfaction with the procedure and its results are high. We could not identify any independent risk factors for postoperative complications after HoLEP. The used questionnaire is a simple tool for postoperative patient reported outcome measurement with a good correlation to clinical parameters.
Language	English
Publishing date	2024-02-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2024.1358701
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Article: Depression among refugee youth in an outpatient healthcare center-prevalence and associated factors.

Schumacher, Lea / Echterhoff, Jette / Zindler, Areej / Barthel, Dana

Frontiers in psychiatry

2024 Volume 15, Page(s) 1367799

Abstract: Background: Due to armed conflict and other crises, many children worldwide have to flee their home country and are, consequently, at a high risk for mental health problems.: Objective: As the majority of previous research on refugee minors focused ... ...

Abstract	Background: Due to armed conflict and other crises, many children worldwide have to flee their home country and are, consequently, at a high risk for mental health problems. Objective: As the majority of previous research on refugee minors focused on post-traumatic stress disorder (PTSD), we aimed to assess the prevalence and risk factors for depression in a clinical sample of refugee youth. Methods: Data were collected during the standard diagnostic process in an outpatient refugee clinic in Germany. We assessed the prevalence of depression based on a diagnostic interview and investigated the association between age, gender, duration of flight, accompanying status, number of interpersonal traumatic experiences, residence status, and PTSD diagnosis with a depression diagnosis. More specifically, we conducted a Bayesian logistic regression with these associated factors as predictors and the presence of depression as the outcome. Additionally, we conducted a Bayesian network analysis including all these variables. Results: The majority of the 575 included refugee children were male ( Conclusion: The high prevalence of depression and its strong associations with PTSD suggest that refugee minors are likely to experience depressive symptoms which might develop from PTSD symptoms. This implies a need for monitoring depressive symptoms in refugee minors, especially when these have a PTSD diagnosis.
Language	English
Publishing date	2024-04-19
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2024.1367799
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Article ; Online: Healthy rural hearts: The feasibility of a telehealth nutrition randomised controlled trial for rural people at risk of cardiovascular disease.

Herbert, Jaimee / Schumacher, Tracy / Brown, Leanne J / Clarke, Erin D / Collins, Clare E

Journal of telemedicine and telecare

2024 , Page(s) 1357633X241247245

Abstract: Introduction: Improving dietary patterns using medical nutrition therapy delivered via telehealth could make an effective contribution to reducing cardiovascular disease burden in rural Australia. However, it is important that medical nutrition therapy ... ...

Abstract	Introduction: Improving dietary patterns using medical nutrition therapy delivered via telehealth could make an effective contribution to reducing cardiovascular disease burden in rural Australia. However, it is important that medical nutrition therapy programmes are developed in collaboration with rural stakeholders, to increase feasibility for the rural context and the likelihood of successful implementation. The aim of this study was to evaluate the preliminary feasibility outcomes of integration (implementation), practicality, acceptability, demand, and preliminary effectiveness at the 3-month timepoint of the Healthy Rural Hearts randomised control trial. Methods: Feasibility measures were collected from participants in the Healthy Rural Hearts medical nutrition therapy trial. Study participants were patients from eligible primary care practices who had been assessed by their general practitioner as being at moderate to high risk of developing cardiovascular disease in the next five years. The sample in this analysis includes those who had completed the first 3-months of the study. Feasibility outcomes were measured over the first 3-months of the trial intervention. A process evaluation survey was used to collect measures relating to intervention implementation, practicality, acceptability, and demand. Completion rates of the Australian Eating Survey Heart version, Personalised Nutrition Questionnaire, pathology tests and telehealth medical nutrition therapy consultations delivered by Accredited Practising Dietitians were also used to measure intervention practicality. Preliminary effectiveness was evaluated by comparing the intervention group's dietary change, measured using Australian Eating Survey Heart with data from the control group. Results: A total of 105 participants (75 intervention, 30 control participants) were eligible for inclusion in analysis. Attendance rates at the first 3-months of dietitian consultations ranged from 94.7% to 89.3% between the first and 3-month consultations, and most participants were able to complete the Australian Eating Survey Heart and Personalised Nutrition Questionnaire prior to their initial consultation [Australian Eating Survey Heart ( Discussion: The positive findings related to acceptability and implementation outcomes suggest that the Healthy Rural Hearts intervention was acceptable, practical, and able to be implemented within this population living in rural NSW. This, combined with the small to medium effect size in the proportion of total energy derived from nutrient-dense core foods compared to the control group indicates that long-term intervention effectiveness on other cardiovascular disease outcomes is important to evaluate in the future.
Language	English
Publishing date	2024-04-22
Publishing country	England
Document type	Journal Article
ZDB-ID	1340281-x
ISSN	1758-1109 ; 1357-633X
ISSN (online)	1758-1109
ISSN	1357-633X
DOI	10.1177/1357633X241247245
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Article ; Online: Relevance, quick hits, and vibe: Features of meaningful teaching and learning during trainee consult interactions.

Rutsky, Jessica / Schumacher, Daniel / Mallon, Daniel

Journal of hospital medicine

2023 Volume 19, Issue 1, Page(s) 24–30

Abstract: Background: Consults are increasingly frequent in inpatient pediatric services. Consult interactions between trainees provide a rich opportunity for teaching and learning. What constitutes meaningful teaching interactions with trainees has not been ... ...

Abstract	Background: Consults are increasingly frequent in inpatient pediatric services. Consult interactions between trainees provide a rich opportunity for teaching and learning. What constitutes meaningful teaching interactions with trainees has not been described. Objective: Explore how consulting fellows and residents define "meaningful teaching interactions" associated with inpatient consult interactions. Methods: Four focus groups were conducted with 21 pediatric trainees (11 subspecialty fellows and 10 residents) at one institution. Transcriptions were analyzed using thematic analysis to inductively create categories and themes. Results: Five factors define meaningful teaching interactions: (1) Relevance; (2) Quick Hits; (3) Vibe; (4) Face-to-face Interactions; and (5) Timing and Busyness. Meaningful content was described as relevant to current or future patient care. Residents valued content that would enable them to explain the reasoning behind recommendations and think through the next steps. Trainees highlighted brief clinical pearls as superior to longer teaching sessions. The "vibe" between resident and fellow was described as a prerequisite to meaningful teaching and included aspects of interest, receptivity, tone, and attitude. Face-to-face interactions were preferred by many trainees, from initial consults to seeing patients or co-rounding. Timing and workload reflected discordant schedules, including time of day and week, but setting a planned time for teaching was beneficial. Conclusion: Relevant, bite-sized educational content combined with a good vibe and optimal timing creates a context in which consult fellows can foster meaningful teaching opportunities for residents.
MeSH term(s)	Humans ; Child ; Internship and Residency ; Education, Medical, Graduate ; Learning ; Focus Groups ; Referral and Consultation ; Teaching
Language	English
Publishing date	2023-12-10
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2233783-0
ISSN	1553-5606 ; 1553-5592
ISSN (online)	1553-5606
ISSN	1553-5592
DOI	10.1002/jhm.13256
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Zs.A 6276: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.MO 542: Show issues

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Article: Respiratory protection and refractive error: Comment on 'Staff perceptions of military chemical-biological-radiological-nuclear (CBRN) air-purifying masks during a simulated clinical task in the context of SARS-CoV-2'.

Schumacher, Jan / H Laidlaw, D Alistair

Anaesthesia and intensive care

2023 Volume 51, Issue 3, Page(s) 214–215

MeSH term(s)	Humans ; SARS-CoV-2 ; Masks ; Military Personnel ; COVID-19 ; Refractive Errors
Language	English
Publishing date	2023-04-21
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	187524-3
ISSN	1448-0271 ; 0310-057X
ISSN (online)	1448-0271
ISSN	0310-057X
DOI	10.1177/0310057X211039225
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Article ; Online: Building a Solid House of Scholarship: The Importance of Foundational Worldviews.

Kinnear, Benjamin / Beck, Jimmy / Schumacher, Daniel J / Zhou, Christine / Balmer, Dorene

Hospital pediatrics

2024 Volume 14, Issue 3, Page(s) e189–e193

Language	English
Publishing date	2024-02-22
Publishing country	United States
Document type	Journal Article
ISSN	2154-1671
ISSN (online)	2154-1671
DOI	10.1542/hpeds.2023-007515
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Article ; Online: Delivery of telehealth nutrition and physical activity interventions to adults living in rural areas: a scoping review.

Herbert, Jaimee / Schumacher, Tracy / Brown, Leanne J / Clarke, Erin D / Collins, Clare E

The international journal of behavioral nutrition and physical activity

2023 Volume 20, Issue 1, Page(s) 110

Abstract: Background: Lifestyle behaviours related to smoking, alcohol, nutrition, and physical activity are leading risk factors for the development of chronic disease. For people in rural areas, access to individualised lifestyle services targeting behaviour ... ...

Abstract	Background: Lifestyle behaviours related to smoking, alcohol, nutrition, and physical activity are leading risk factors for the development of chronic disease. For people in rural areas, access to individualised lifestyle services targeting behaviour change may be improved by using telehealth. However, the scope of literature investigating telehealth lifestyle behaviour change interventions for rural populations is unknown, making it difficult to ascertain whether telehealth interventions require adaptation for rural context via a systematic review. This scoping review aimed to address this gap, by mapping existing literature describing telehealth lifestyle interventions delivered to rural populations to determine if there is scope for systematic review of intervention effectiveness in this research topic. Methods: The PRISMA extension for scoping review checklist guided the processes of this scoping review. A search of eight electronic databases reported in English language until June 2023 was conducted. Eligible studies included adults (18 years and over), who lived in rural areas of high-income countries and undertook at least one synchronous (video or phone consultation) telehealth intervention that addressed either addictive (smoking or alcohol), or non-addictive lifestyle behaviours (nutrition or physical activity). Studies targeting addictive and non-addictive behaviours were separated after full text screening to account for the involvement of addictive substances in smoking and alcohol studies that may impact behaviour change interventions described. Studies targeting nutrition and/or physical activity interventions are presented here. Results: The search strategy identified 17179 citations across eight databases, with 7440 unique citations once duplicates were removed. Full texts for 492 citations were retrieved and screened for inclusion with 85 publications reporting on 73 studies eligible for data extraction and analysis. Of this, addictive behaviours were comprised of 15 publications from 13 studies. Non-addictive behaviours included 70 publications from 58 studies and are reported here. Most interventions were delivered within the United States of America (n = 43, 74.1%). The most common study design reported was Randomised Control Trial (n = 27, 46.6%). Included studies involved synchronous telehealth interventions targeting nutrition (11, 18.9%), physical activity (5, 8.6%) or nutrition and physical activity (41, 70.7%) and were delivered predominately via videoconference (n = 17, 29.3%). Conclusions: Despite differences in intervention characteristics, the number of randomised control trials published suggests sufficient scope for future systematic reviews to determine intervention effectiveness related to nutrition and physical activity telehealth interventions for rural populations. Trial registration: The scoping review protocol was not pre-registered.
MeSH term(s)	Humans ; Adult ; Adolescent ; Smoking ; Ethanol ; Telemedicine ; Life Style ; Exercise
Chemical Substances	Ethanol (3K9958V90M)
Language	English
Publishing date	2023-09-15
Publishing country	England
Document type	Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2134691-4
ISSN	1479-5868 ; 1479-5868
ISSN (online)	1479-5868
ISSN	1479-5868
DOI	10.1186/s12966-023-01505-2
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Article: How Augmenting Reality Changes the Reality of Simulation: Ethnographic Analysis.

Loeb, Daniel / Shoemaker, Jamie / Parsons, Allison / Schumacher, Daniel / Zackoff, Matthew

JMIR medical education

2023 Volume 9, Page(s) e45538

Abstract: Background: Simulation-based medical education (SBME) provides key medical training for providers to safely and ethically practice high-risk events. Augmented reality (AR)-enhanced simulation projects digital images of realistic examination findings ... ...

Abstract	Background: Simulation-based medical education (SBME) provides key medical training for providers to safely and ethically practice high-risk events. Augmented reality (AR)-enhanced simulation projects digital images of realistic examination findings into a participant's field of view, which allows nuanced physical examination findings such as respiratory distress and skin perfusion to be prominently displayed. It is unknown how AR compares to traditional mannequin (TM)-based simulation with regard to influencing participant attention and behavior. Objective: The purpose of this study is to use video-based focused ethnography-a problem-focused, context-specific descriptive form of research whereby the research group collectively analyzes and interprets a subject of interest-to compare and categorize provider attention and behavior during TM and AR and provide suggestions for educators looking to delineate these 2 modalities. Methods: Twenty recorded interprofessional simulations (10 TM, 10 AR) featuring a decompensating child were evaluated through video-based focused ethnography. A generative question was posed: "How do the attention and behavior of participants vary based on the simulation modality?" Iterative data collection, analysis, and pattern explanation were performed by a review team spanning critical care, simulation, and qualitative expertise. Results: The attention and behavior of providers during TM and AR simulation clustered into three core themes: (1) focus and attention, (2) suspension of disbelief, and (3) communication. Participants focused on the mannequin during AR, especially when presented with changing physical examination findings, whereas in TM, participants focused disproportionately on the cardiorespiratory monitor. When participants could not trust what they were seeing or feeling in either modality, the illusion of realism was lost. In AR, this manifested as being unable to physically touch a digital mannequin, and in TM, participants were often unsure if they could trust their physical examination findings. Finally, communication differed, with calmer and clearer communication during TM, while AR communication was more chaotic. Conclusions: The primary differences clustered around focus and attention, suspension of disbelief, and communication. Our findings provide an alternative methodology to categorize simulation, shifting focus from simulation modality and fidelity to participant behavior and experience. This alternative categorization suggests that TM simulation may be superior for practical skill acquisition and the introduction of communication strategies for novice learners. Meanwhile, AR simulation offers the opportunity for advanced training in clinical assessment. Further, AR could be a more appropriate platform for assessing communication and leadership by more experienced clinicians due to the generated environment being more representative of decompensation events. Further research will explore the attention and behavior of providers in virtual reality-based simulations and real-life resuscitations. Ultimately, these profiles will inform the development of an evidence-based guide for educators looking to optimize simulation-based medical education by pairing learning objectives with the ideal simulation modality.
Language	English
Publishing date	2023-06-30
Publishing country	Canada
Document type	Journal Article
ISSN	2369-3762
ISSN	2369-3762
DOI	10.2196/45538
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Article ; Online: The mitochondrial protease PARL is required for spermatogenesis.

Schumacher, Sarah / Klose, Laura / Lambertz, Jessica / Lütjohann, Dieter / Biemann, Ronald / Kuerten, Stefanie / Fester, Lars

Communications biology

2024 Volume 7, Issue 1, Page(s) 44

Abstract: Mitochondrial function plays an important role in the maintenance of male fertility. However, the mechanisms underlying mitochondrial defect-related infertility remain mostly unclear. Here we show that a deficiency of PARL ( ... ...

Abstract	Mitochondrial function plays an important role in the maintenance of male fertility. However, the mechanisms underlying mitochondrial defect-related infertility remain mostly unclear. Here we show that a deficiency of PARL (Parl
MeSH term(s)	Humans ; Male ; Endopeptidases ; Mitochondria/genetics ; Peptide Hydrolases ; Spermatogenesis/genetics ; Testosterone ; Mitochondrial Proteins/genetics ; Mitochondrial Proteins/metabolism ; Metalloproteases/genetics ; Metalloproteases/metabolism
Chemical Substances	Endopeptidases (EC 3.4.-) ; Peptide Hydrolases (EC 3.4.-) ; Testosterone (3XMK78S47O) ; PARL protein, mouse (EC 3.4.21.105) ; Mitochondrial Proteins ; Metalloproteases (EC 3.4.-)
Language	English
Publishing date	2024-01-05
Publishing country	England
Document type	Journal Article
ISSN	2399-3642
ISSN (online)	2399-3642
DOI	10.1038/s42003-023-05703-3
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