Paradigm Change Research Articles

The paradigm change from reactive medical services to 3PM in ischemic stroke: a holistic approach utilising tear fluid multi-omics, mitochondria as a vital biosensor and AI-based multi-professional data interpretation

Worldwide stroke is the second leading cause of death and the third leading cause of death and disability combined. The estimated global economic burden by stroke is over US$891 billion per year. Within three decades (1990–2019), the incidence increased by 70%, deaths by 43%, prevalence by 102%, and DALYs by 143%. Of over 100 million people affected by stroke, about 76% are ischemic stroke (IS) patients recorded worldwide. Contextually, ischemic stroke moves into particular focus of multi-professional groups including researchers, healthcare industry, economists, and policy-makers. Risk factors of ischemic stroke demonstrate sufficient space for cost-effective prevention interventions in primary (suboptimal health) and secondary (clinically manifested collateral disorders contributing to stroke risks) care. These risks are interrelated. For example, sedentary lifestyle and toxic environment both cause mitochondrial stress, systemic low-grade inflammation and accelerated ageing; inflammageing is a low-grade inflammation associated with accelerated ageing and poor stroke outcomes. Stress overload, decreased mitochondrial bioenergetics and hypomagnesaemia are associated with systemic vasospasm and ischemic lesions in heart and brain of all age groups including teenagers. Imbalanced dietary patterns poor in folate but rich in red and processed meat, refined grains, and sugary beverages are associated with hyperhomocysteinaemia, systemic inflammation, small vessel disease, and increased IS risks. Ongoing 3PM research towards vulnerable groups in the population promoted by the European Association for Predictive, Preventive and Personalised Medicine (EPMA) demonstrates promising results for the holistic patient-friendly non-invasive approach utilising tear fluid-based health risk assessment, mitochondria as a vital biosensor and AI-based multi-professional data interpretation as reported here by the EPMA expert group. Collected data demonstrate that IS-relevant risks and corresponding molecular pathways are interrelated. For examples, there is an evident overlap between molecular patterns involved in IS and diabetic retinopathy as an early indicator of IS risk in diabetic patients. Just to exemplify some of them such as the 5-aminolevulinic acid/pathway, which are also characteristic for an altered mitophagy patterns, insomnia, stress regulation and modulation of microbiota-gut-brain crosstalk. Further, ceramides are considered mediators of oxidative stress and inflammation in cardiometabolic disease, negatively affecting mitochondrial respiratory chain function and fission/fusion activity, altered sleep–wake behaviour, vascular stiffness and remodelling. Xanthine/pathway regulation is involved in mitochondrial homeostasis and stress-driven anxiety-like behaviour as well as molecular mechanisms of arterial stiffness. In order to assess individual health risks, an application of machine learning (AI tool) is essential for an accurate data interpretation performed by the multiparametric analysis. Aspects presented in the paper include the needs of young populations and elderly, personalised risk assessment in primary and secondary care, cost-efficacy, application of innovative technologies and screening programmes, advanced education measures for professionals and general population—all are essential pillars for the paradigm change from reactive medical services to 3PM in the overall IS management promoted by the EPMA.

Multicenter randomized trial of deferred cytoreductive nephrectomy in synchronous metastatic renal cell carcinoma receiving checkpoint inhibitors: the NORDIC-SUN-Trial

BackgroundPrimary tumor removal by cytoreductive nephrectomy in synchronous metastatic renal cell carcinoma patients has been investigated in the context of various treatment regimens. Two randomized controlled trials investigated the role and timing of cytoreductive nephrectomy in the era of targeted therapy and demonstrated that upfront nephrectomy should no longer be performed when patients require systemic therapy. Superiority of checkpoint immunotherapy agents has led to a paradigm change from targeted therapies to immunotherapy-based first-line treatment in patients with primary metastatic disease; thus, deferred cytoreductive nephrectomy needs to be verified in the immunotherapy setting. Furthermore, a need exists for personalizing treatment choices for the individual patient to avoid unnecessary overtreatment.Methods/designTo explore the impact of cytoreductive nephrectomy in this patient group receiving checkpoint immunotherapy, we initiated a randomized, controlled trial comparing deferred cytoreductive nephrectomy with no surgery. The trial integrates a comprehensive translational research program with specimen sampling for biomarker analysis.DiscussionThe trial aims to show that deferred cytoreductive nephrectomy improves overall survival in patients with synchronous metastatic renal cell carcinoma, and furthermore, to identify relevant biomarkers for personalized renal cancer management.Trial registrationClinicalTrials.gov NCT03977571 June 6, 2019.

A study on awareness of breast cancer and breast self-examination practices among women above 35 years of age in rural areas of Wardha District, Maharashtra: a protocol

Background Breast cancer is a major cause of morbidity and mortality in women and a global health issue. Breast self-examination (BSE) is a recommended breast cancer screening technique that a woman can use on her own, in the privacy of her home. Hence, awareness regarding it and knowledge to identify any changes will be a boon to the early identification and promotion of treatment. This study aimed to increase awareness and educate women about breast self-examination (BSE) to facilitate the early detection of breast cancer in rural areas of Wardha District. Methods A community-based cross-sectional study was conducted on rural women in Wardha district. Women older than 35 years of age will be included in the study and assessed using a ‘pre-designed’ and ‘pre-structured’ questionnaire inquiring about their socio-demographic profile, awareness of breast cancer, and breast self-examination. Research implications Most studies show how to self-examine breasts, but awareness and knowledge regarding the subject are not well demonstrated and applied in many studies. Although we now understand that women do not always need to use a specific BSE technique, they should still be taught and encouraged to recognize breast changes. BSE for early detection of breast cancer has undergone a paradigm change or development into breast awareness. The progression towards breast awareness is a concept where a woman is familiar with her breasts so that she detects any change that might emerge and brings this to the attention of her healthcare practitioner right away, whereas BSE is monthly palpation of the breasts in a specific manner in which women are professionally taught. Early detection of breast cancer relies heavily on breast awareness, which is why it should be covered in general breast health education.

From smuggled migrants to ‘alleged smugglers’: Empirical evidence and policy perspectives on the criminalization of people on the move in Italy

AbstractSince 2014, numerous people on the move have been accused of migrant smuggling in Italian courts for steering makeshift vessels or for assisting in navigation across the Mediterranean Sea. This is the case regardless of the fact that such behaviour was the result of coercion or threats. In this contribution, drawing upon extensive empirical research and following a socio‐legal paradigm, I first explore the criminalization of people on the move in relation to migrant smuggling charges in the years following the so‐called 2014–2015 refugee crisis and discuss the impact on their rights. Second, I tackle the issue from a policy perspective, considering three potential EU/national policy reforms and the ways in which they could successfully address an existing policy problem. Such reforms vary in scope, from a damage limitation logic to a fully fledged change of paradigm, and the three can be described as follows: alignment of EU and national frameworks with the United Nations Protocol against migrant smuggling; a more significant differentiation between migrant smuggling and the facilitation of undocumented migration; and an explicit exoneration from criminal liability for people on the move accused of migrant smuggling. This article presents innovative insights, providing on the one hand an up‐to‐date empirical understanding of this form of criminalization of people on the move and, on the other, extensive reflections on the way in which policy reforms could prevent it.

Design Resistance. Material Solutions for local remoteness

Material design and indigenous knowledge are more often intertwined in the contemporary practice of design. Sustainable design is evolving towards discourses that stress the relevance of local interventions and the diverse contribution native cultures can give in shaping post-developed societies. This paper addresses the topic of endemic material design in decentralised areas through Material Driven Design experience by analysing the project called Viral Nature, a material research and design of a composite material able to host vegetal life and attract biodiversity. Originally formulated as a potential design intervention against soil degradation and desertification, nonetheless, the exposure of Viral Nature artefacts to the public showed its potential to be employed as a communicative medium to foster human feelings of environmental empathy. A case study to display a design trend leading toward resistant practices of biointegrated design, to investigate and hypothesise how endemic DIY-Material Design strategies enhance the functionality of the material experience and encourage a change of paradigm towards alternative solutions for the pluriverse.

Nature and Treatment Received for Psoriasis and Co-morbidities in Patients with Psoriatic Arthritis. A Multi-centre Observational Study from Western India

Background: Many recent studies have suggested a changing paradigm of management of psoriatic disease. One of the main concerns is the lost opportunity of controlling ‘psoriatic disease’ during the early phase, especially when the disease is limited to the skin. Objective: The study’s main aim was to determine psoriasis (PsO) treatment before the patient’s presentation to the rheumatologist. We also studied the associated comorbidities in these patients. Methods: This was a cross-sectional study done at eight centres. Data was collected from 375 patients with psoriatic arthritis (PsA) about their demography, details of psoriatic lesions, treatment taken for them, additional co-morbidities and pattern of PsA. Results: Only 22.4% of patients had received oral methotrexate for PsO: the majority for less than a year. Plaque and scalp PsO were the most common, and 75% of patients had body surface area involvement greater than 5%. There was a significantly higher prevalence of type II diabetes mellitus (T2DM) (24% vs. 9.1%) and obesity as compared to the general population. Conclusion: Few patients received sustained systemic treatment for PsO prior to the development of arthritis. There was a significant association of co-morbidities such as T2DM and obesity with PsA.

Industry 4.0 Readiness Trends: A Bibliometric and Visualization Analysis

The Industrial Revolution 4.0 signifies a pivotal change in industrial paradigms, integrating advanced technologies like the Internet of Things (IoT), artificial intelligence (AI), robotics, and big data into production processes. This research aims to analyze the growth and readiness in industry for these changes through a detailed bibliometric analysis. It quantitatively tracks the expansion of Industry 4.0 readiness research, including publication counts, citation trends, and thematic shifts, reflecting heightened academic and industrial interests. A clear definition of Industry 4.0 readiness is provided, focusing on metrics and criteria used for assessment. The paper identifies key contributions and novel insights of the research, emphasizing its practical implications for industry and academia. It examines elements influencing Industry 4.0 readiness, such as infrastructure, policy, and workforce preparedness, offering a comprehensive overview of challenges. The practical implications of our findings are presented, suggesting actionable strategies for stakeholders. This research also highlights the gaps in the current literature, which offers a thorough and multidimensional understanding of Industry 4.0 readiness, its influences, and its impact on the global industrial system.

Synthetic data protection: Towards a paradigm change in data regulation?

Synthetic data generated through machine learning algorithms from original real-world data is gaining prominence across sectors due to their potential to provide privacy-preserving alternatives to traditional data sources. However, recent studies have raised concerns about the re-identification risks of synthetic data. This article examines the legal challenges surrounding synthetic data protection, with a focus on the European Union's General Data Protection Regulation (GDPR). After briefly explaining the methods of synthetic data generation and discussing their potential for privacy preservation, the article analyses the shortcomings of the personal/non-personal dualist approach under the GDPR. It then assesses the possibility of a paradigm change in data protection legislation, moving beyond this binary categorisation. The article argues in favour of establishing clear guidelines for the generation and processing of synthetic data, prioritising the principles of transparency, accountability and fairness.

Evaluating 3D printed mesh geometries in ceramic LiB electrodes

Additive manufacturing techniques have the potential to promote a paradigmatic change in the electrode fabrication processes for lithium-ion batteries (LiBs) as they may offer alternative component designs to boost their performance or to customise the application. The present research work explores the use of low-cost fused filament fabrication (FFF) 3D printing to fabricate Li4Ti5O12 (LTO) mesh electrodes in the search for enlarged electrochemically active areas. Using different nozzle diameters (ND), we have 3D printed several mesh electrodes that after sintering allow an increase in the surface to volume ratio by up to ≈290% compared to conventional flat cylindrical geometries. As the conventional route to produce 3D printed meshes, i.e. stacking of consecutive layers with a 90° rotation, leads to problems of vertical misalignment that may affect the electrical contact, we have developed a new compact design that maximises the contact between layers. All the 3D printed mesh electrodes with thicknesses of 400 and 800 μm, exhibit electrochemical performance very close to those of thin (70 μm) electrodes, e.g. 175 mAh g−1 at C/2 in the case of ND = 100 μm, which is the theoretical capacity value for LTO. At higher C-rates, 800 μm-thick mesh electrodes with larger ND exhibit a marked drop in the reversible capacity (28 mAh g−1 at 8 C), although the values obtained improve notably those of the equivalent thick solid electrode (almost null at 8 C). The compact design demonstrated superior performance at high C-rates, improving by ≈70% the results of the best conventional mesh electrode at 8 C for 800 μm electrodes. These results highlight the potential of FFF-3D printing to generate novel high aspect ratio geometries and the impact of design and printing parameters on the performance of LiB electrode materials. Exploring alternative efficient geometries may facilitate the integration of thick electrodes in high energy density LiBs.

Culturo-Behavioral Contributions to a Sustainable Market: The Interplay of Producers’ and Consumers’ Practices

Sustainability is a relevant and pressing theme in which concepts and tools of cultural systems analysis should be applied to a greater extent. The misalignment of the incentive system for producers and consumers raises the issue of sustainable production and consumption of goods and services. A change of paradigm may be needed for shifting defective practices into better informed choices that are consistent with environmental targets and avoid the overexploitation of our planet’s resources. Previous efforts include the 2010 special issue of The Behavior Analyst and the Matrix Project, which advocated a greater involvement of behavior analysts and scientists in sustainability issues. In this conceptual analysis, we continue this effort by analyzing and discussing some of the contingencies underlying: i. manufacturers’ drive for offering environmentally friendly goods; ii. consumers’ bounded choices; and iii. their interaction in the market for achieving sustainable goals. We provide examples of virtuous and defective practices and relate to the Green Shift in Norway. The potential impact of this work consists of informing and influencing policymakers and advocacy organizations as agents of change. Their work is key to shape producers’ and consumers’ preferences for implementing sustainable practices and achieving common environmental goals.

Corporate social responsibility in the new normal era: review

A business theory known as "corporate social responsibility" (CSR) places an emphasis on an organization's social and ethical responsibilities in addition to maximizing profits. It entails incorporating social responsibility, moral decision-making, and sustainable practices into the foundation of corporate operations. CSR essentially seeks to strike a balance between financial performance and a favorable influence on the environment and society, demonstrating a dedication to ethical business practices and stakeholder well-being. Businesses are realizing the value of corporate social responsibility (CSR) in the face of changing global issues in the "new normal" period. Corporate Social Responsibility (CSR) becomes more important in the new normal era as companies deal with previously unheard-of difficulties. Global events have brought about a paradigm change that requires robust and socially responsible corporate strategies. CSR provides businesses with a strategic framework to meet demands in society, gain the trust of stakeholders, and adjust to shifting expectations. It fosters long-term sustainability in a constantly changing global landscape by positioning firms as responsible contributors to community and environmental well-being, in addition to aligning them with ethical imperatives. A critical analysis of corporate social responsibility (CSR) in the new normal age reveals a dynamic business environment where companies adjust their approaches to meet changing needs. Important discoveries highlight how crucial CSR is to boosting long-term sustainability, stakeholder trust, and resilience. The literature emphasizes the value of moral behavior, environmental stewardship, and social contributions while highlighting successful CSR implementations during global upheavals. All things considered, the assessment shows how important corporate social responsibility (CSR) is in helping companies become not just financially sustainable but also socially and environmentally conscious in the face of enormous shifts.

The Impact of Information Communication Technology Developments in The Indigenous Law Community

The development of information and communication technology (ICT) always has an impact on changes in human paradigms, both positive and negative. This change in the human paradigm will conflict or not conflict with Indigenous law which is the guideline for the Indigenous law community. The question is, to what extent are the boundaries that guide Indigenous law community that this paradigm change is or is not in conflict with Indigenous law that applies to Indigenous law community, thereby resulting in restrictions on the use of ICT by Indigenous law community? In this research, there are two case studies, namely the development of ICT, which is considered contrary to Indigenous law and the acceptance of ICT development in the Indigenous law community of Baduy Dalam, Baduy Luar, and Kasepuhan Ciptagelar Sukabumi. This research aims to examine the impact of ICT developments on the paradigm of the Indigenous law community of Baduy Dalam, Baduy Luar, and Kasepuhan Ciptagelar so that the results of this research can be used as a reference for the government to determine appropriate regulations for implementing digital transformation programs for Indigenous law community.

Competence-based approach as a new strategy for preparing future Physics teachers to form a scientific worldview of students

Relevance. In the context of reforming the socio-economic, political and cultural life of the country, the modernisation of secondary and higher schools, the change of the educational paradigm and teaching technologies, the problems of training teachers of a new development are of particular relevance. A special place in the training of qualified specialists is given to integration education. Purpose. The purpose of this scientific article is to consider the problems of professional training of future physics teachers, concerning the development of the scientific worldview of students in the conditions of reforming the socio-economic, political and cultural life of the Republic of Kazakhstan. Methodology. The basic method of the scientific article is a systematic analysis of the existing process of modernisation of secondary and higher schools, the change of educational paradigm and learning technologies in the Republic of Kazakhstan, with reference to the conditions of reforming socio-economic, political and cultural life, in which the forecasting method is integrated to determine the general trends in the development of the education system for a specific period of time. Results. In the form of activities related to the profession, there is an increasing need for specialists of a wide profile who are able to mobilise the knowledge gained from various fields of science. The strategy of improving the professional training of future physics teachers assumes a conscious systematic organisation of the management of the educational process. The article succinctly describes the elements of this system organisation. Conclusions. The results of this scientific article are of particular importance for modern science and production, which are developing simultaneously in the direction of specialisation and integration, in activities that are associated with industrial professions, where the need for broad-profile specialists is increasing, who are able to mobilise the knowledge gained from various fields of science.

Rural development with agroecological emphasis for highly marginalized areas in Mexico; the bet for the paradigm change

For four years the Production for Well-being Program has been developed, which consists of three axes of operation: direct support to producers, marketing and technical support in 11 production chains in 27 states of the Mexican Republic, with more or less than 600 municipalities of high marginalization, the accompaniment is implemented by the National Institute of Forestry, Agriculture and Livestock Research, (INIFAP), the central objective of the program is: food self-sufficiency through the agroecological transition, the results indicate that at least in the In the first three years, agroecological work practices, plant nutrition and soil bioremediation have been adopted through the production of local bio-inputs by the producers, in addition to the rescue and conservation of native resources, mainly corn, as well as a holistic vision of management of the Rural Production Unit (UPF). The program places special emphasis not only on the promotion of agroecological practices but also on inclusion and gender equity, as evidenced by the 34% participation of women.

Effect analysis on waste recycling by introducing a new policy, "Environmental Assessment of Recycling," for establishment of the ESG management system in the Republic of Korea.

To move away from linear system mining-manufacture-production-disposal, most countries have been trying to establish a circular economy, by reusing waste as resources. Responding to this paradigm change, the Ministry of Environment of Korea amended the Wastes Control Act in the 2010s. To increase the recycling rate in Korea, the environmental assessment of recycling (EAR) has been introduced to improve the Wastes Control Act. The whole process of new recycling technologies can be assessed in terms of environmental or technical aspects by assessment institutes of the EAR. Finally, the governmental research institute can approve of an application case, which proves environmental friendliness, even if the technology is not defined in the current act. Recently, 17 companies have been coassessed and approved to recycle steel codes in waste tires as resources for iron smelting via assessments of the whole process, such as environmental analysis and quality assessment. The EAR has been enforcing recycling materials for six years, and the total profit of the companies that were approved was estimated to be approximately 55 million USD. However, many amendments to the EAR continue to be requested by stakeholders. In this study, the effect of the EAR was evaluated, and additional tasks were found to enhance the EAR. Integr Environ Assess Manag 2024;20:1473-1485. © 2024 SETAC.

Environmental clearance and sustainable development: changing paradigm of environmental constitutionalism in Indian

Environmental Clearance (EC) to operate in any industry or establishment is firmly accepted across the globe. It is issued after complying with four stages of Environmental Impact Assessment (EIA) namely screening, scoping, public hearing and appraisal. It stipulates the precautionary conditions to operate (CTO) an industry without causing environmental hazards deploying all necessary environmental protection measures. The MoEF&CC issues EC in India, directly or through its regional authorities. In recent decisions, the Supreme Court of India has allowed post-EC to some of the MSMEs that were operating without EC on account of ignorance of the law on the part of the owner as well as the State Pollution Control Board (SPCB). The post-EC has been permitted to remove procedural irregularity by applying the ‘proportionality principle’ on account of MSME’s contribution to the national economy and livelihood to a significant size of the populace. This research paper finds post-EC anathema to the sustainable development principles.

The Coproduction of Health Framework: Seeking Instructive Management Models and Theories.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

A paradigm change in sudden cardiac death risk prediction: 'static' goes out, 'dynamic' comes in.

A paradigm change in sudden cardiac death risk prediction: 'static' goes out, 'dynamic' comes in.

Libraries in the Age of Intelligent Information: AI-Driven Solutions

This study explores the paradigm change that artificial intelligence (AI) has brought about in the context of libraries in the age of intelligent information. A quantitative survey was carried out, and a methodical description of the study's procedure is provided. The research sampling strategy, data gathering, data collection tool, and statistical analysis are all included in this quantitative approach. Additionally, a random sampling procedure was used to choose the study sample. Similar to this, questionnaires were employed as response instruments to collect data in both physical and digital formats. Findings from the investigation showed that 45% of institutions are private nature and 50% institutions shows the status public. 1-10 years’ experience were 62% respondents, 11-20 years’ experience were 31% and only 8% of respondents were 21 years above experience. The study emphasizes how important it is to create a welcoming and open library ecosystem where artificial intelligence (AI) enhances operational effectiveness while protecting user privacy and pleasure. All things considered, this thorough analysis highlights the many ways that artificial intelligence (AI) might transform libraries and meet the many demands of their patrons. Looking forward, the article discusses the promising future of AI in libraries, envisioning AI-powered chatbots, predictive analytics, and virtual helpers as integral components of an AI-driven library landscape.

GSSC Now: ESA Thematic exploitation platform for navigation digital transformation. Enhancing GNSS scientific research

As Global Navigation Satellite Systems (GNSS) infrastructure expands and more satellites are launched, the number of signals and measurements available to users increases, resulting in a corresponding rise in data generation rates. GNSS receivers with the ability to process triple frequency measurements and multi-constellation reception, have been complemented with the massive deployment of connected, GNSS-enabled devices such as smartphones, wearables, and IoT sensors, triggering the growth of a highly dispersed cloud of GNSS data. This trend observed in other domains presents both challenges and opportunities for applications of GNSS technology.The scientific exploitation of GNSS data involves developing new concepts through the analysis of the aforementioned sources of information. Traditionally, the extraction of insights from GNSS data has relied on searching and downloading datasets from multiple repositories. These datasets provided by numerous organisations are scattered worldwide, containing gems of information difficult to track and discover. This approach hinders research productivity, as scientists are forced to shift their focus from data exploration, analysis, modelling, visualization, and realisation of conclusions to a long list of repetitive and manual tasks of little added value.The GNSS Science Support Centre (GSSC) hosts ESA’s innovative Digital Platform for GNSS, GSSC Now, which integrates a large GNSS repository with cutting-edge features for data exploration and analysis. The paper presents key functionalities of GSSC Now and highlights its value through case studies of real-world GNSS applications. This platform expands established computational limits, placing the data source side-by-side with cloud computing capabilities. The change of paradigm provides scientists with seamless execution of Machine Learning models, interactive algorithms and visualisation tools on a vast repository of GNSS data, removing barriers that hinder research productivity.