TY - JOUR A1 - Kempt, Hendrik A1 - Freyer, Nils A1 - Nagel, Saskia K. T1 - Justice and the normative standards of explainability in healthcare JF - Philosophy & Technology N2 - Providing healthcare services frequently involves cognitively demanding tasks, including diagnoses and analyses as well as complex decisions about treatments and therapy. From a global perspective, ethically significant inequalities exist between regions where the expert knowledge required for these tasks is scarce or abundant. One possible strategy to diminish such inequalities and increase healthcare opportunities in expert-scarce settings is to provide healthcare solutions involving digital technologies that do not necessarily require the presence of a human expert, e.g., in the form of artificial intelligent decision-support systems (AI-DSS). Such algorithmic decision-making, however, is mostly developed in resource- and expert-abundant settings to support healthcare experts in their work. As a practical consequence, the normative standards and requirements for such algorithmic decision-making in healthcare require the technology to be at least as explainable as the decisions made by the experts themselves. The goal of providing healthcare in settings where resources and expertise are scarce might come with a normative pull to lower the normative standards of using digital technologies in order to provide at least some healthcare in the first place. We scrutinize this tendency to lower standards in particular settings from a normative perspective, distinguish between different types of absolute and relative, local and global standards of explainability, and conclude by defending an ambitious and practicable standard of local relative explainability. KW - Clinical decision support systems KW - Justice KW - Medical AI KW - Explainability KW - Normative standards Y1 - 2022 U6 - https://doi.org/10.1007/s13347-022-00598-0 VL - 35 IS - Article number: 100 SP - 1 EP - 19 PB - Springer Nature CY - Berlin ER - TY - JOUR A1 - Stäudle, Benjamin A1 - Seynnes, Olivier A1 - Laps, Guido A1 - Brüggemann, Gert-Peter A1 - Albracht, Kirsten T1 - Altered gastrocnemius contractile behavior in former achilles tendon rupture patients during walking JF - Frontiers in Physiology N2 - Achilles tendon rupture (ATR) remains associated with functional limitations years after injury. Architectural remodeling of the gastrocnemius medialis (GM) muscle is typically observed in the affected leg and may compensate force deficits caused by a longer tendon. Yet patients seem to retain functional limitations during—low-force—walking gait. To explore the potential limits imposed by the remodeled GM muscle-tendon unit (MTU) on walking gait, we examined the contractile behavior of muscle fascicles during the stance phase. In a cross-sectional design, we studied nine former patients (males; age: 45 ± 9 years; height: 180 ± 7 cm; weight: 83 ± 6 kg) with a history of complete unilateral ATR, approximately 4 years post-surgery. Using ultrasonography, GM tendon morphology, muscle architecture at rest, and fascicular behavior were assessed during walking at 1.5 m⋅s–1 on a treadmill. Walking patterns were recorded with a motion capture system. The unaffected leg served as control. Lower limbs kinematics were largely similar between legs during walking. Typical features of ATR-related MTU remodeling were observed during the stance sub-phases corresponding to series elastic element (SEE) lengthening (energy storage) and SEE shortening (energy release), with shorter GM fascicles (36 and 36%, respectively) and greater pennation angles (8° and 12°, respectively). However, relative to the optimal fascicle length for force production, fascicles operated at comparable length in both legs. Similarly, when expressed relative to optimal fascicle length, fascicle contraction velocity was not different between sides, except at the time-point of peak series elastic element (SEE) length, where it was 39 ± 49% lower in the affected leg. Concomitantly, fascicles rotation during contraction was greater in the affected leg during the whole stance-phase, and architectural gear ratios (AGR) was larger during SEE lengthening. Under the present testing conditions, former ATR patients had recovered a relatively symmetrical walking gait pattern. Differences in seen AGR seem to accommodate the profound changes in MTU architecture, limiting the required fascicle shortening velocity. Overall, the contractile behavior of the GM fascicles does not restrict length- or velocity-dependent force potentials during this locomotor task. KW - tendon rupture KW - muscle fascicle behavior KW - walking gait KW - force generation KW - ultrasound imaging Y1 - 2022 U6 - https://doi.org/10.3389/fphys.2022.792576 SN - 1664-042X VL - 13 PB - Frontiers Research Foundation CY - Lausanne ER - TY - JOUR A1 - Quittmann, Oliver J. A1 - Abel, Thomas A1 - Albracht, Kirsten A1 - Strüder, Heiko K. T1 - Biomechanics of all-out handcycling exercise: kinetics, kinematics and muscular activity of a 15-s sprint test in able-bodied participants JF - Sports Biomechanics N2 - This study aims to quantify the kinematics, kinetics and muscular activity of all-out handcycling exercise and examine their alterations during the course of a 15-s sprint test. Twelve able-bodied competitive triathletes performed a 15-s all-out sprint test in a recumbent racing handcycle that was attached to an ergometer. During the sprint test, tangential crank kinetics, 3D joint kinematics and muscular activity of 10 muscles of the upper extremity and trunk were examined using a power metre, motion capturing and surface electromyography (sEMG), respectively. Parameters were compared between revolution one (R1), revolution two (R2), the average of revolution 3 to 13 (R3) and the average of the remaining revolutions (R4). Shoulder abduction and internal-rotation increased, whereas maximal shoulder retroversion decreased during the sprint. Except for the wrist angles, angular velocity increased for every joint of the upper extremity. Several muscles demonstrated an increase in muscular activation, an earlier onset of muscular activation in crank cycle and an increased range of activation. During the course of a 15-s all-out sprint test in handcycling, the shoulder muscles and the muscles associated to the push phase demonstrate indications for short-duration fatigue. These findings are helpful to prevent injuries and improve performance in all-out handcycling. KW - Handbike KW - sEMG KW - Paralympic sport KW - performance testing KW - high-intensity exercise Y1 - 2022 U6 - https://doi.org/10.1080/14763141.2020.1745266 SN - 1752-6116 (Onlineausgabe) SN - 1476-3141 (Druckausgabe) VL - 21 IS - 10 SP - 1200 EP - 1223 PB - Taylor & Francis CY - London ER - TY - JOUR A1 - Angermann, Susanne A1 - Günthner, Roman A1 - Hanssen, Henner A1 - Lorenz, Georg A1 - Braunisch, Matthias C. A1 - Steubl, Dominik A1 - Matschkal, Julia A1 - Kemmner, Stephan A1 - Hausinger, Renate A1 - Block, Zenonas A1 - Haller, Bernhard A1 - Heemann, Uwe A1 - Kotliar, Konstantin A1 - Grimmer, Timo A1 - Schmaderer, Christoph T1 - Cognitive impairment and microvascular function in end-stage renal disease JF - International Journal of Methods in Psychiatric Research (MPR) N2 - Objective Hemodialysis patients show an approximately threefold higher prevalence of cognitive impairment compared to the age-matched general population. Impaired microcirculatory function is one of the assumed causes. Dynamic retinal vessel analysis is a quantitative method for measuring neurovascular coupling and microvascular endothelial function. We hypothesize that cognitive impairment is associated with altered microcirculation of retinal vessels. Methods 152 chronic hemodialysis patients underwent cognitive testing using the Montreal Cognitive Assessment. Retinal microcirculation was assessed by Dynamic Retinal Vessel Analysis, which carries out an examination recording retinal vessels' reaction to a flicker light stimulus under standardized conditions. Results In unadjusted as well as in adjusted linear regression analyses a significant association between the visuospatial executive function domain score of the Montreal Cognitive Assessment and the maximum arteriolar dilation as response of retinal arterioles to the flicker light stimulation was obtained. Conclusion This is the first study determining retinal microvascular function as surrogate for cerebral microvascular function and cognition in hemodialysis patients. The relationship between impairment in executive function and reduced arteriolar reaction to flicker light stimulation supports the involvement of cerebral small vessel disease as contributing factor for the development of cognitive impairment in this patient population and might be a target for noninvasive disease monitoring and therapeutic intervention. KW - cerebral small vessel disease KW - cognitive impairment KW - dialysis KW - retinal vessels Y1 - 2022 U6 - https://doi.org/10.1002/mpr.1909 SN - 1049-8931 (Print) SN - 1557-0657 (Online) VL - 31 IS - 2 SP - 1 EP - 10 PB - Wiley ER - TY - JOUR A1 - Kotliar, Konstantin A1 - Ortner, Marion A1 - Conradi, Anna A1 - Hacker, Patricia A1 - Hauser, Christine A1 - Günthner, Roman A1 - Moser, Michaela A1 - Muggenthaler, Claudia A1 - Diehl-Schmid, Janine A1 - Priller, Josef A1 - Schmaderer, Christoph A1 - Grimmer, Timo T1 - Altered retinal cerebral vessel oscillation frequencies in Alzheimer's disease compatible with impaired amyloid clearance JF - Neurobiology of Aging N2 - Retinal vessels are similar to cerebral vessels in their structure and function. Moderately low oscillation frequencies of around 0.1 Hz have been reported as the driving force for paravascular drainage in gray matter in mice and are known as the frequencies of lymphatic vessels in humans. We aimed to elucidate whether retinal vessel oscillations are altered in Alzheimer's disease (AD) at the stage of dementia or mild cognitive impairment (MCI). Seventeen patients with mild-to-moderate dementia due to AD (ADD); 23 patients with MCI due to AD, and 18 cognitively healthy controls (HC) were examined using Dynamic Retinal Vessel Analyzer. Oscillatory temporal changes of retinal vessel diameters were evaluated using mathematical signal analysis. Especially at moderately low frequencies around 0.1 Hz, arterial oscillations in ADD and MCI significantly prevailed over HC oscillations and correlated with disease severity. The pronounced retinal arterial vasomotion at moderately low frequencies in the ADD and MCI groups would be compatible with the view of a compensatory upregulation of paravascular drainage in AD and strengthen the amyloid clearance hypothesis. KW - Alzheimer's disease KW - Retinal vessel analysis KW - Vasomotions KW - Pulsations KW - Mild cognitive impairment Y1 - 2022 U6 - https://doi.org/10.1016/j.neurobiolaging.2022.08.012 SN - 0197-4580 VL - 120 SP - 117 EP - 127 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Werfel, Stanislas A1 - Günthner, Roman A1 - Hapfelmeier, Alexander A1 - Hanssen, Henner A1 - Kotliar, Konstantin A1 - Heemann, Uwe A1 - Schmaderer, Christoph ED - Guzik, Tomasz J. T1 - Identification of cardiovascular high-risk groups from dynamic retinal vessel signals using untargeted machine learning JF - Cardiovascular Research N2 - Dynamic retinal vessel analysis (DVA) provides a non-invasive way to assess microvascular function in patients and potentially to improve predictions of individual cardiovascular (CV) risk. The aim of our study was to use untargeted machine learning on DVA in order to improve CV mortality prediction and identify corresponding response alterations. KW - Machine learning KW - Retinal vessels KW - Microcirculation KW - Haemodialysis KW - Myocardial infarction and cardiac death Y1 - 2022 U6 - https://doi.org/10.1093/cvr/cvab040 SN - 0008-6363 VL - 118 IS - 2 SP - 612 EP - 621 PB - Oxford University Press CY - Oxford ER - TY - THES A1 - Biewendt, Marcel T1 - Socio-Economic challenges in sustainability and resource management N2 - This dissertation uses in first stage a macroeconomic investigation to examine the dependence, influence and corruption of socio-economic development through effects of sustainability and resource management. The conducted research found that the state's dependence on its citizens decreases when the state's sources of revenue are largely detached and independent of the citizens' financial resources. In this case, financial resources are taxes and duties provided by the citizens. One possible consequence is the restriction of state investment in its citizens. Both the qualitative literature review and the quantitative data analysis revealed a negative correlation between socio-economic development and the resource economy's share of GDP for the period under study. The microeconomic investigation was primarily conducted through an intensive literature review. It was shown that the rebound effect as such is already very well researched. However, it also became clear that avoidance strategies for the rebound effect and links to sustainability initiatives are scarce or non-existent. The need for a redesign of the impact analysis with regard to technological innovations and their influence on resource consumption and resource management has become clear on the basis of the present study. Further, emerging and developing countries in particular, which will be confronted in the foreseeable future not only with the fundamental problems of resource abundance in the overall economic context, but also with the issues of their sustainable use, should be confronted with these problems as early as possible in order to find solutions in a timely manner. KW - Efficiency side-effects KW - Resource-optimization KW - Rebound effect KW - Socio-economics Y1 - 2022 PB - Hungarian University of Agriculture and Life Sciences ER - TY - JOUR A1 - Uysal, Karya A1 - Creutz, Till A1 - Firat, Ipek Seda A1 - Artmann, Gerhard A1 - Teusch, Nicole A1 - Temiz Artmann, Aysegül T1 - Bio-functionalized ultra-thin, large-area and waterproof silicone membranes for biomechanical cellular loading and compliance experiments JF - Polymers N2 - Biocompatibility, flexibility and durability make polydimethylsiloxane (PDMS) membranes top candidates in biomedical applications. CellDrum technology uses large area, <10 µm thin membranes as mechanical stress sensors of thin cell layers. For this to be successful, the properties (thickness, temperature, dust, wrinkles, etc.) must be precisely controlled. The following parameters of membrane fabrication by means of the Floating-on-Water (FoW) method were investigated: (1) PDMS volume, (2) ambient temperature, (3) membrane deflection and (4) membrane mechanical compliance. Significant differences were found between all PDMS volumes and thicknesses tested (p < 0.01). They also differed from the calculated values. At room temperatures between 22 and 26 °C, significant differences in average thickness values were found, as well as a continuous decrease in thicknesses within a 4 °C temperature elevation. No correlation was found between the membrane thickness groups (between 3–4 µm) in terms of deflection and compliance. We successfully present a fabrication method for thin bio-functionalized membranes in conjunction with a four-step quality management system. The results highlight the importance of tight regulation of production parameters through quality control. The use of membranes described here could also become the basis for material testing on thin, viscous layers such as polymers, dyes and adhesives, which goes far beyond biological applications. Y1 - 2022 SN - 2073-4360 VL - 14 IS - 11 SP - 2213 PB - MDPI CY - Basel ER - TY - JOUR A1 - Bergmann, Ole A1 - Götten, Falk A1 - Braun, Carsten A1 - Janser, Frank T1 - Comparison and evaluation of blade element methods against RANS simulations and test data JF - CEAS Aeronautical Journal N2 - This paper compares several blade element theory (BET) method-based propeller simulation tools, including an evaluation against static propeller ground tests and high-fidelity Reynolds-Average Navier Stokes (RANS) simulations. Two proprietary propeller geometries for paraglider applications are analysed in static and flight conditions. The RANS simulations are validated with the static test data and used as a reference for comparing the BET in flight conditions. The comparison includes the analysis of varying 2D aerodynamic airfoil parameters and different induced velocity calculation methods. The evaluation of the BET propeller simulation tools shows the strength of the BET tools compared to RANS simulations. The RANS simulations underpredict static experimental data within 10% relative error, while appropriate BET tools overpredict the RANS results by 15–20% relative error. A variation in 2D aerodynamic data depicts the need for highly accurate 2D data for accurate BET results. The nonlinear BET coupled with XFOIL for the 2D aerodynamic data matches best with RANS in static operation and flight conditions. The novel BET tool PropCODE combines both approaches and offers further correction models for highly accurate static and flight condition results. KW - BET KW - CFD propeller simulation KW - Propeller aerodynamics KW - Actuator disk modelling KW - Propeller performance Y1 - 2022 U6 - https://doi.org/10.1007/s13272-022-00579-1 SN - 1869-5590 (Online) SN - 1869-5582 (Print) N1 - Corresponding author: Ole Bergmann VL - 13 SP - 535 EP - 557 PB - Springer CY - Wien ER - TY - CHAP A1 - Engelmann, Ulrich M. A1 - Baumann, Martin ED - Herbig, Nicola ED - Poppelreuter, Stefan T1 - Moderationsexpertise für QMBs – das Mindset T2 - Qualitätsmanagement im Gesundheitswesen N2 - Teamsitzungen, Arbeitsgruppentreffen, Kickoffs und Meetings – sie alle werden mit dem Ziel durchgeführt, innerhalb einer vorgegebenen Zeitspanne ein gemeinsames Arbeitsziel zu erreichen. Damit die Zielerreichung auch bei komplexeren Arbeitsaufträgen nicht vom Zufall abhängt, empfiehlt es sich, die Leitung des Ablaufs einem Moderator zu übertragen. In diesem Beitrag einer mehrteiligen Serie wird beschrieben, über welches Mindset der Moderator verfügen sollte, welche grundsätzlichen Methoden hilfreich sind und was bei der Onlinemoderation im Besonderen zu beachten ist. Y1 - 2022 SN - 978-3-8249-0714-4 SP - Kapitel 10814 PB - TÜV-Verlag CY - Köln ET - 59. Update ER -