Competence Network Research Articles

Latest developments in cybersecurity management in Romania. Financing a condition for market evolution

Abstract Cybersecurity has become one of the foundations for the development and protection of the economy and of its digital component. It has evolved gradually from a new science into a cross branch inside the modern society, maintaining a niche characteristic and raising the need for allocation of numerous resources at industry, country and international level. Romania, similar to other states has witnessed the development of the ICT industry and of all the other services associated with it, with a particular focus on the cybersecurity. This was accompanied by some actions put in place by the public authorities and private players to guarantee the strategic importance of the sector: legislative update, launch of several initiatives and projects, introduction and enlargement of curricula in universities, collaboration with other specialized institutions, education of the population, creation of institutional framework, public-private partnership. Such a growing demand of this market has to be accompanied by a proper financing in order to achieve planned objectives. This editorial will present some of the actions implemented to highlight the constructive approach in the overall transformation undertaken by Romanian organizations and some of the tools available to them to finance future projects. Among the various platforms accessible for financing, European Cybersecurity Competence Centre and Network and Horizon Europe could function as sources for market evolution.

On a Sparse Shortcut Topology of Artificial Neural Networks

In established network architectures, shortcut connections are often used to take the outputs of earlier layers as additional inputs to later layers. Despite the extraordinary effectiveness of shortcuts, there remain open questions on the mechanism and characteristics. For example, why are shortcuts powerful? Why do shortcuts generalize well? In this article, we investigate the expressivity and generalizability of a novel sparse shortcut topology. First, we demonstrate that this topology can empower a one-neuron-wide deep network to approximate any univariate continuous function. Then, we present a novel width-bounded universal approximator in contrast to depth-bounded universal approximators and extend the approximation result to a family of equally competent networks. Furthermore, with generalization bound theory, we show that the proposed shortcut topology enjoys excellent generalizability. Finally, we corroborate our theoretical analyses by comparing the proposed topology with popular architectures, including ResNet and DenseNet, on well-known benchmarks and perform a saliency map analysis to interpret the proposed topology. Our work helps understand the role of shortcuts and suggests further opportunities to innovate neural architectures.

지역사회 통합돌봄 수행 구청조직과 사회복지조직 간 네트워크 패턴에 대한 탐색적 연구

This study attempted to provide data and implications for establishing a competent care network system through implementing community-based integrated care policies by examining the network between the district office, the SOS care center, and social welfare institutions within the local community. The target area was S District in Seoul, and in all twenty-six general social welfare centers, institutions and organizations for the elderly and the disabled were analyzed for social networking among private institutions. The structure and characteristics of the network between the district office and social welfare organization were examined through sociogram and centrality. The network between organizations carrying out integrated care in S District of the Seoul, was led by the local government, and the district office had a great influence. In addition, by confirming the role of the SOS care center as a central institution in the network in discovery and request of subjects, the basis for promoting an integrated care policy centered on local governments was presented. This study confirmed the importance of a public-private network in establishing a community-based advanced care service delivery system by revealing the characteristics of private central institutions participating in the network. Finally, this study proposed practical implications for the expansion and development of community-based integrated care.

Education Competencies for Integrative Oncology in Germany: Results of a Stakeholder Engagement Survey Study

Background: Integrative Medicine (IM) training programs in oncology lacked standardized education core competencies to ensure the practical relevance of its learning content and objectives. In a previous international and interprofessional consensus procedure, core competencies were developed for health professionals working in Integrative Oncology (IO). However, the transferability of the developed core competencies to IO physicians working in Germany has not yet been verified. The overall aim of this survey study as part of the KOKON Project (Kompetenznetzwerk Komplementärmedizin in der Onkologie; Competence Network Complementary Medicine in Oncology) was to investigate if the international core competencies developed for IO for a broader group of health professionals are suitable for physicians in Germany. Material and Methods: Paper-pencil and digital questionnaires were distributed amongst various stakeholder groups (cancer patients and representatives; IO physicians; members of IM organization and IM researchers; multipliers of cancer support groups). The stakeholders were asked to rate the 37 core competencies developed according to their importance for the respective stakeholder group (not important, moderately, very important). Analyses were conducted using a 60% agreement threshold for medium to highly important competencies and 50% agreement threshold for highly important competencies. Results: We contacted different persons from various stakeholder groups (n > 370) with a survey response rate of 55.5–68.4% (n = 271) depending on the respective stakeholder group. Using the 50% agreement threshold, all competencies were accepted by the stakeholder groups. 27 competencies were considered very important by 60% of the survey participants. In particular, cancer patients and cancer support groups showed similar results. Conclusion: The list of developed international core competencies for IM health professionals seems to be suitable for physicians providing IO in Germany according to different stakeholder groups. The implementation of competencies can support the development of evidence-based, patient-centered training programs for physicians.

Preparedness on Assaults with Highly Toxic Substances in Public Space

The use of chemical substances in terrorist scenarios is to be feared everywhere, especially in the western world, after the events that have become known in recent years. In order to protect civilian populations in an emergency, it is essential that the poisoning pattern (toxidrome) is recognized as quickly and reliably as possible through further training of the relevant agents and the provision of necessary rescue equipment (antidotes) in prepared facilities. In the event of a chemical attack with terrorist motivation, doctors from the Public Health Service (PHS) will foreseeably play a key role in communicating with decision-makers and the public a spart of a competency network.

Proposed European Competence Network on Mastocytosis—American Initiative in Mast Cell Diseases (ECNM-AIM) Response Criteria in Advanced Systemic Mastocytosis

Advanced systemic mastocytosis (AdvSM) is characterized by the presence of KIT D816V and other somatic mutations (eg, in SRSF2, ASXL1, and RUNX1) in 95% and 60% to 70% of patients, respectively. The biological and clinical consequences of AdvSM include multilineage involvement (eg, associated hematologic neoplasm) in 60% to 80% of patients, variable infiltration and damage (C-findings) of predominantly bone marrow and visceral organs through affected mast cell (MC) and non-MC lineages, and elevated levels of serum tryptase. Recently, the treatment landscape has substantially changed with the introduction of the multikinase/KIT inhibitor midostaurin and the selective KIT D816V inhibitor avapritinib. In this review, we discuss the evolution of AdvSM response criteria that have been developed to better capture clinical benefit (eg, improved responses and progression-free and overall survival). We propose refined response criteria from European Competence Network on Mastocytosis and American Initiative in Mast Cell Diseases investigators that use a tiered approach to segregate the effects of histopathologic (eg, bone marrow MC burden, tryptase), molecular (eg, KIT D816V variant allele frequency), clinical (eg, C-findings), and symptom response on long-term outcomes. These response criteria require evaluation in future prospective clinical trials of selective KIT inhibitors and other novel agents.

Sustainability-Oriented Open Innovation: A Small and Medium-Sized Enterprises Perspective

This study aims to develop a model of sustainability-oriented open innovation from the perspective of SMEs. Sustainability performance improvement is a problem for small and medium-sized enterprises (SMEs) due to limited resources. By implementing open innovation, SMEs can take advantage of external resources to innovate in their operations, thereby increasing sustainability performance. The model developed in this study consists of eighteen constructs: sustainability performance, innovativeness, inbound open innovation, six constructs representing organizational relationship factors, and nine constructs representing knowledge factors. The research model is evaluated using Partial Least Square Structural Equation Modeling. The respondents of this study are 199 SMEs that produce Batik Tulis, a traditional Indonesian fabric. The result shows that innovativeness positively relates to sustainability performance and inbound open innovation has a positive relationship with innovativeness. Competence mapping and network position are the organizational factors that positively affect inbound open innovation. The knowledge factors that positively affect inbound open innovation are the appropriation of knowledge output, connective capacity, inventive capacity, and innovative capacity. Identifying these six supporting factors for sustainability-oriented open innovation in SMEs based on empirical evidence is the main theoretical contribution of this study. As a practical implication, SMEs can gradually improve these six supporting factors by being active members and contributing to industrial associations.

Prevalence and prognostic impact of chronic kidney disease and anaemia across ACC/AHA precursor and symptomatic heart failure stages

BackgroundThe importance of chronic kidney disease (CKD) and anaemia has not been comprehensively studied in asymptomatic patients at risk for heart failure (HF) versus those with symptomatic HF. We analysed the prevalence, characteristics and prognostic impact of both conditions across American College of Cardiology/American Heart Association (ACC/AHA) precursor and HF stages A–D.Methods and results2496 participants from three non-pharmacological German Competence Network HF studies were categorized by ACC/AHA stage; stage C patients were subdivided into C1 and C2 (corresponding to NYHA classes I/II and III, respectively). Overall, patient distribution was 8.1%/35.3%/32.9% and 23.7% in ACC/AHA stages A/B/C1 and C2/D, respectively. These subgroups were stratified by the absence ( – ) or presence ( +) of CKD (estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73m2) and anaemia (haemoglobin in women/men < 12/ < 13 g/dL). The primary outcome was all-cause mortality at 5-year follow-up. Prevalence increased across stages A/B/C1 and C2/D (CKD: 22.3%/23.6%/31.6%/54.7%; anaemia: 3.0%/7.9%/21.7%/33.2%, respectively), with concordant decreases in median eGFR and haemoglobin (all p < 0.001). Across all stages, hazard ratios [95% confidence intervals] for all-cause mortality were 2.1 [1.8–2.6] for CKD + , 1.7 [1.4–2.0] for anaemia, and 3.6 [2.9–4.6] for CKD + /anaemia + (all p < 0.001). Population attributable fractions (PAFs) for 5-year mortality related to CKD and/or anaemia were similar across stages A/B, C1 and C2/D (up to 33.4%, 30.8% and 34.7%, respectively).ConclusionsPrevalence and severity of CKD and anaemia increased across ACC/AHA stages. Both conditions were individually and additively associated with increased 5-year mortality risk, with similar PAFs in asymptomatic patients and those with symptomatic HF.Graphical abstract

The ADEBAR project: European and international provision of analytical data from structure elucidation and analytical characterization of NPS.

Novel substances for which none or limited analytical data are available constitute a challenge for police and customs forensic laboratories. The time-consuming process of structural elucidation and acquisition of analytical data has been centralized in the ADEBAR project in Germany, co-funded since 2017 by the EU's Internal Security Fund. The project aims to comprehensively characterize substances relevant for forensic-toxicological casework within the analytical competence network. The analytical datasets are distributed digitally through European and (inter)national channels. Additionally, pharmacological evaluation allows for estimating in vivo potency and potential harm required as scientific evidence for legislative amendments. The ADEBAR project contributes to the availability of analytical data on new substances relevant to the daily work of police and customs laboratories. Since the inception of the ADEBAR project, 549 samples have been registered, and 302 substance reports notified to the EMCDDA, including numerous spectrometric and spectroscopic data. In addition, 3,619 mass spectra have been accumulated in ADEBAR mass spectra databases. A central institution for the structure elucidation and acquisition of valid, high-quality analytical data for police and customs forensic laboratories and forensic medicine institutes is important in the future because there does not seem to be an end to the dynamic of novel NPS appearing on the drug market.

Tyrosine kinase inhibitors for the treatment of indolent systemic mastocytosis: Are we there yet?

Indolent systemic mastocytosis (ISM) is the most prevalent form of systemic mastocytosis. Many patients with ISM suffer from mast cell (MC) mediator-related symptoms. In a small number of patients, hematologic progression is seen in the follow-up. In some patients with ISM, symptoms arising from MC-derived mediators including gastrointestinal symptoms, anaphylaxis, and neuropsychiatric symptoms are kept under control with conventional mediator-targeting drugs or MC-stabilizing agents. However, in a substantial number of patients, the symptoms are refractory to such conventional therapy. For these patients, novel drugs and targeted approaches are considered. One reasonable approach may be to apply tyrosine kinase inhibitors directed against KIT and other key kinase targets expressed in neoplastic MCs in ISM. Because MCs in more than 90% of all patients with typical ISM display the KIT D816V mutant receptor, clinically effective KIT-targeting drugs have to be active against this mutant form of KIT. The 2 such most effective and well-studied agents currently available are midostaurin and avapritinib. Other KIT-targeting drugs, such as imatinib or masitinib, are less effective or even noneffective against KIT D816V and are thus recommended for use only in patients with other KIT mutant forms (noncodon 816 mutations) or with wild-type KIT. In the present article, we review the current state in the treatment of ISM with tyrosine kinase inhibitors, with special emphasis on treatment responses and potential adverse effects. In fact, all of these agents also have unique and common adverse effects, and their use to treat patients with ISM should be balanced against their toxicity and short- and long-term safety.

Development and evaluation of evidence-based patient information handbooks about multiple sclerosis immunotherapies

BackgroundMultiple sclerosis treatment options are increasing. Evidence-based patient information (EBPI) are therefore crucial to enable patient involvement in decision making. Based on earlier work on decision support, patient information handbooks on 8 MS immunotherapies were developed, piloted and evaluated with support from the German Clinical Competence Network MS and the German MS Society. MethodsHandbooks were structured according to EBPI concepts. Drafts were commented by patient representatives and neurologists with an MS expertise. Executive boards of the German MS Society and the Competence Network as well as pharmaceutical companies’ feedback was included. Handbooks were distributed among MS neurologists by the German MS Society. Evaluation followed applying a mixed methods approach with interviews, focus groups and surveys. One survey addressed persons with MS (pwMS) based on a questionnaire included in each handbook. Neurologists who received printed patient handbooks were invited to give feedback in a second survey. ResultsEight handbooks were developed providing absolute and relative risk information in numbers and figures as well as monitoring needs and drug fact boxes. Despite the high amount of information and the display of low absolute risk reduction rates of treatments, handbooks were overall appreciated by pwMS (n=107) and mostly also by physicians (n=24). For more than 70% of the pwMS the information was new, understandable and supportive for decision making. But patients felt uncomfortable with relative risk information. However, response rates in the evaluation were low, exposing the challenges when implementing EBPI into clinical care. Therefore, conclusions must be considered preliminary. ConclusionEBPI on immunotherapies for MS seem feasible and are appreciated by patients and treating neurologists but more implementation research is needed.

&lt;인공지능 수학&gt; 교과를 위한 새로운 수학적 역량 개념 제안: 디지털 역량을 중심으로

This study proposes a mathematical competence network for the subject “Artificial Intelligence Mathematics.” The proposed competence network is a new concept of competence as an organic and hierarchical aggregate of mathematical competencies. To define this, the research used systematic literature analysis and review as a main research method and reviewed the relationship and properties among the elements constituting mathematical competence. Next, the research reviewed the meaning of digital competence and specified digital competence as the goal competence to be developed with Artificial Intelligence Mathematics. Finally, the research explored the digital competence framework which was the core idea of the study. The mathematical competence network for Artificial Intelligence Mathematics was then created by making a mathematical competence network and structuring the six mathematical competencies of the 2015 amended curriculum around the network. The new framework is expected to serve as a key standard for implementing competence-based education for Artificial Intelligence Mathematics.

COVID-19 vaccination in the setting of mastocytosis—Pfizer-BioNTech mRNA vaccine is safe and well tolerated

COVID-19 vaccination in the setting of mastocytosis—Pfizer-BioNTech mRNA vaccine is safe and well tolerated

Safety of COVID-19 vaccination in patients with clonal mast cell disorders

Safety of COVID-19 vaccination in patients with clonal mast cell disorders

Don’t forget about tau: the effects of ApoE4 genotype on Alzheimer’s disease cerebrospinal fluid biomarkers in subjects with mild cognitive impairment—data from the Dementia Competence Network

ApoE4, the strongest genetic risk factor for Alzheimer’s disease (AD), has been shown to be associated with both beta-amyloid (Aβ) and tau pathology, with the strongest evidence for effects on Aβ, while the association between ApoE4 and tau pathology remains inconsistent. This study aimed to investigate the associations between ApoE4 with CSF Aβ42, total tau (t-tau), phospho-tau181 (p-tau), and with the progression of decline in a large cohort of MCI subjects, both progressors to AD and other dementias, as well as non-progressors. We analyzed associations of CSF Aβ42, p-tau and t-tau with ApoE4 allele frequency cross-sectionally and longitudinally over 3 years of follow-up in 195 individuals with a diagnosis of MCI-stable, MCI-AD converters and MCI progressing to other dementias from the German Dementia Competence Network. In the total sample, ApoE4 carriers had lower concentrations of CSF Aβ42, and increased concentrations of t-tau and p-tau compared to non-carriers in a gene dose-dependent manner. Comparisons of these associations stratified by MCI-progression groups showed a significant influence of ApoE4 carriership and diagnostic group on all CSF biomarker levels. The effect of ApoE4 was present in MCI-stable individuals but not in the other groups, with ApoE4 + carriers having decreased CSF Aβ 42 levels, and increased concentration of t-tau and p-tau. Longitudinally, individuals with abnormal t-tau and Aβ42 had a more rapid progression of cognitive and clinical decline, independently of ApoE4 genotype. Overall, our results contribute to an emerging framework in which ApoE4 involves mechanisms associated with both CSF amyloid-β burden and tau aggregation at specific time points in AD pathogenesis.

Disseminated tense bullae on newborn

Disseminated tense bullae on newborn

E-Leadership theory – A more than ever virtually connected world needs a virtually theorized leadership in a globally cross-cultural network space

Existing research shows that there has not been adequate theorization of the relationship between organizational networks and cross-cultural leadership. What makes this integration important is need to make sense of the recent transition to the remote workspaces during Covid-19 and the limits of traditional understandings of leadership to catch up with changing organizational norms. The empirical research that this research draws upon is based on 18 international markets of an MNE that recently received ERP upgrades. Twenty-five respondents were selected from each market. Participants were selected if they had 40% or more of their work done virtually or if they worked physically and the leader was located elsewhere. Project managers were interviewed to understand the dynamics of each market and the technologies used in virtual teams (prior and post to the ERP); these interviews were qualitatively analyzed and triangulated with surveys to assess e-leadership, innovation, cross-cultural competence and organizational networks. The parent company's attempt to standardize the system in the foreign subsidiaries and the subsidiaries, made it harder to overcome the growing cultural difference caused by the unique demands of each market. The study focuses on business model innovation to gauge factors that enable or impede innovation and Actor-Network Theory to understand how the introduction of new technologies created new obstacles in the context of cross-cultural communication networks by expanding the trait theory and using e-Leadership as a moderator to explore the determinants of successful leadership in a highly virtual global workspace.

FRACTIONAL MEYER NEURAL NETWORK PROCEDURES OPTIMIZED BY THE GENETIC ALGORITHM TO SOLVE THE BAGLEY-TORVIK MODEL

<abstract> The current investigations are related to indicate a competent numerical fractional Meyer neural network (FMNN) procedure using the optimization of genetic algorithm and interior-point algorithm (GAIPA), i.e., FMNN-GAIPA for solving the Bagley--Torvik model (BTM). A merit function based on the differential BTM form, and its corresponding initial conditions is constructed and then optimized with the FMNN-GAIPA. Three different BTM cases will be solved through the FMNN-GAIPA and the correctness of the proposed FMNN-GAIPA is observed by using the comparison for each case of the BTM with the exact solutions. The statistical investigations based on the appropriate large independent trials recognized the constancy of the FMNN-GAIPA in terms of robustness, convergence, and stability trials. In addition, the annotations over the statistical measures validate the values of FMNN-GAIPA. </abstract>

Oscillation dynamic mechanism driven by time delays in the competent gene regulatory circuit of B. subtilis

Bacillus subtilis with competent states absorbs DNA and may improve the growth of bacteria by integrating new genetic material. Therefore, it is important to clarify how the genes interact in the circuit so that cells enter into a competent state or return to a vegetative state. The gene regulatory circuit consists of two positive feedback loops and one negative feedback loop. In this paper, a mathematical model is developed by considering transcription time delays to further study dynamic behavior of the B. subtilis competent gene regulatory network. Combined with theoretical calculation and numerical simulation, it is verified that the time delay in indirect transcription inhibition indeed has the effect of inducing the periodic oscillation of the B. subtilis competent system. In addition, some important chemical reaction rates can also regulate system dynamic behavior. However, under the control of time delay, the effects of the important chemical reaction rates have changed significantly. In particular, the time delay can advance critical value of the important chemical reaction rates where vibration occurs and can also weaken or even eliminate the effect of the important chemical reaction rates. These results will help us to analyze the competent state of B. subtilis.

Linking supply network flexibility with mass customization capability

PurposeThe importance of supply network flexibility (SNF) in the development of mass customization capability (MCC) has been implied in the literature but seldom subjected to empirical investigation. To fill the gap and contribute to MC literature, this paper aims to examine the role of SNF in facilitating the development of MCC of organizations. Furthermore, it has been investigated whether the use of information and communication technologies (ICTs) strengthens the above relationship.Design/methodology/approachDrawing on the supply chain literature and dynamic capability theory, the study proposes a research framework depicting the interconnectedness among the variables of interest. The proposed framework has been tested using structural equation modelling based on partial least squares by using the data collected from a questionnaire-based survey of a sample of Indian manufacturing organizations.FindingsThe findings indicate that the dimensions of SNF, namely, sourcing flexibility and supplier flexibility, positively affect the MCC of the organizations and the strength of these relationships is further amplified by the implementation of ICTs.Practical implicationsThe study shows the managerial opportunities for the development of a flexible and competent supply network to facilitate the development or enhancement of MCC.Originality/valueThis study contributes to scant literature by providing empirical evidence for the relationship between SNF and MCC. Further, this study enriches the understanding of the crucial role of ICT by exploring its moderating effect on the relationship between the variables of interest.