TY - JOUR A1 - Alnemer, Momin Sami Mohammad A1 - Kotliar, Konstantin A1 - Neuhaus, Valentin A1 - Pape, Hans-Christoph A1 - Ciritsis, Bernhard D. T1 - Cost-effectiveness analysis of surgical proximal femur fracture prevention in elderly: a Markov cohort simulation model JF - Cost Effectiveness and Resource Allocation N2 - Background Hip fractures are a common and costly health problem, resulting in significant morbidity and mortality, as well as high costs for healthcare systems, especially for the elderly. Implementing surgical preventive strategies has the potential to improve the quality of life and reduce the burden on healthcare resources, particularly in the long term. However, there are currently limited guidelines for standardizing hip fracture prophylaxis practices. Methods This study used a cost-effectiveness analysis with a finite-state Markov model and cohort simulation to evaluate the primary and secondary surgical prevention of hip fractures in the elderly. Patients aged 60 to 90 years were simulated in two different models (A and B) to assess prevention at different levels. Model A assumed prophylaxis was performed during the fracture operation on the contralateral side, while Model B included individuals with high fracture risk factors. Costs were obtained from the Centers for Medicare & Medicaid Services, and transition probabilities and health state utilities were derived from available literature. The baseline assumption was a 10% reduction in fracture risk after prophylaxis. A sensitivity analysis was also conducted to assess the reliability and variability of the results. Results With a 10% fracture risk reduction, model A costs between $8,850 and $46,940 per quality-adjusted life-year ($/QALY). Additionally, it proved most cost-effective in the age range between 61 and 81 years. The sensitivity analysis established that a reduction of ≥ 2.8% is needed for prophylaxis to be definitely cost-effective. The cost-effectiveness at the secondary prevention level was most sensitive to the cost of the contralateral side’s prophylaxis, the patient’s age, and fracture treatment cost. For high-risk patients with no fracture history, the cost-effectiveness of a preventive strategy depends on their risk profile. In the baseline analysis, the incremental cost-effectiveness ratio at the primary prevention level varied between $11,000/QALY and $74,000/QALY, which is below the defined willingness to pay threshold. Conclusion Due to the high cost of hip fracture treatment and its increased morbidity, surgical prophylaxis strategies have demonstrated that they can significantly relieve the healthcare system. Various key assumptions facilitated the modeling, allowing for adequate room for uncertainty. Further research is needed to evaluate health-state-associated risks. KW - Hip fractures KW - Prevention KW - Geriatric KW - Cost-effectiveness KW - Prophylaxis Y1 - 2023 U6 - https://doi.org/10.1186/s12962-023-00482-4 SN - 1478-7547 N1 - Corresponding author: Momin S. Alnemer IS - 21, Article number: 77 PB - Springer Nature ER - TY - JOUR A1 - Kuchler, Timon A1 - Günthner, Roman A1 - Ribeiro, Andrea A1 - Hausinger, Renate A1 - Streese, Lukas A1 - Wöhnl, Anna A1 - Kesseler, Veronika A1 - Negele, Johanna A1 - Assali, Tarek A1 - Carbajo-Lozoya, Javier A1 - Lech, Maciej A1 - Adorjan, Kristina A1 - Stubbe, Hans Christian A1 - Hanssen, Henner A1 - Kotliar, Konstantin A1 - Haller, Berhard A1 - Heemann, Uwe A1 - Schmaderer, Christoph T1 - Persistent endothelial dysfunction in post-COVID-19 syndrome and its associations with symptom severity and chronic inflammation N2 - Background Post-COVID-19 syndrome (PCS) is a lingering disease with ongoing symptoms such as fatigue and cognitive impairment resulting in a high impact on the daily life of patients. Understanding the pathophysiology of PCS is a public health priority, as it still poses a diagnostic and treatment challenge for physicians. Methods In this prospective observational cohort study, we analyzed the retinal microcirculation using Retinal Vessel Analysis (RVA) in a cohort of patients with PCS and compared it to an age- and gender-matched healthy cohort (n = 41, matched out of n = 204). Measurements and main results PCS patients exhibit persistent endothelial dysfunction (ED), as indicated by significantly lower venular flicker-induced dilation (vFID; 3.42% ± 1.77% vs. 4.64% ± 2.59%; p = 0.02), narrower central retinal artery equivalent (CRAE; 178.1 [167.5–190.2] vs. 189.1 [179.4–197.2], p = 0.01) and lower arteriolar-venular ratio (AVR; (0.84 [0.8–0.9] vs. 0.88 [0.8–0.9], p = 0.007). When combining AVR and vFID, predicted scores reached good ability to discriminate groups (area under the curve: 0.75). Higher PCS severity scores correlated with lower AVR (R = − 0.37 p = 0.017). The association of microvascular changes with PCS severity were amplified in PCS patients exhibiting higher levels of inflammatory parameters. Conclusion Our results demonstrate that prolonged endothelial dysfunction is a hallmark of PCS, and impairments of the microcirculation seem to explain ongoing symptoms in patients. As potential therapies for PCS emerge, RVA parameters may become relevant as clinical biomarkers for diagnosis and therapy management. KW - Endothelial dysfunction KW - Long COVID KW - Post-COVID-19 syndrome KW - retinal microvasculature Y1 - 2023 U6 - https://doi.org/10.1007/s10456-023-09885-6 N1 - Corresponding author: Christoph Schmaderer VL - 26 SP - 547 EP - 563 PB - Springer Nature CY - Dordrecht ER - TY - JOUR A1 - Fissabre, Anke A1 - Rottke, Evelin ED - Bergdoll, Barry ED - Schwarting, Andreas ED - Tragbar, Klaus T1 - Das Quelle-Fertighaus : Einklang von Maß, Konstruktion und Entwurf JF - architectura N2 - The steel prefabricated family house ›Quelle-Fertighaus‹ designed and constructed by the German company Quelle, is an innovative modular system commercialised in 1962. All aspects of the Quelle-Fertighaus are planned on the principle of minimal effort for maximal flexibility. The clever design of the ground plan based on a 4 m × 7 m module offers the flexibility for either one to three additional modules. The steel construction is innovative and unique, consisting of load-bearing portal frames acting as braces. The house design is furthermore characterised by a simple metrical grid layout and the practical placement of the foundation and basement, which allowed the very cost-effective production and the lowest price for a prefabricated family house in Germany during the postwar era. Nowadays its portal-frame-construction offers an interesting approach for its renovation and transformation according to present building demands. KW - Quelle-Fertighaus KW - Stahlkonstruktion KW - Portalrahmen KW - Modulbau KW - 60er Jahre Y1 - 2023 U6 - https://doi.org/10.1515/atc-2021-1005 SN - 2569-1554 VL - 51 IS - 1 SP - 57 EP - 78 PB - Deutscher Kunstverlag (DKV) CY - Berlin ER - TY - JOUR A1 - Laarmann, Lukas A1 - Thoma, Andreas A1 - Misch, Philipp A1 - Röth, Thilo A1 - Braun, Carsten A1 - Watkins, Simon A1 - Fard, Mohammad T1 - Automotive safety approach for future eVTOL vehicles JF - CEAS Aeronautical Journal N2 - The eVTOL industry is a rapidly growing mass market expected to start in 2024. eVTOL compete, caused by their predicted missions, with ground-based transportation modes, including mainly passenger cars. Therefore, the automotive and classical aircraft design process is reviewed and compared to highlight advantages for eVTOL development. A special focus is on ergonomic comfort and safety. The need for further investigation of eVTOL’s crashworthiness is outlined by, first, specifying the relevance of passive safety via accident statistics and customer perception analysis; second, comparing the current state of regulation and certification; and third, discussing the advantages of integral safety and applying the automotive safety approach for eVTOL development. Integral safety links active and passive safety, while the automotive safety approach means implementing standardized mandatory full-vehicle crash tests for future eVTOL. Subsequently, possible crash impact conditions are analyzed, and three full-vehicle crash load cases are presented. KW - eVTOL development KW - eVTOL safety KW - Crashworthiness KW - Automotive safety approach KW - Full-vehicle crash test Y1 - 2023 U6 - https://doi.org/10.1007/s13272-023-00655-0 SN - 1869-5590 (Online) SN - 1869-5582 (Print) N1 - Corresponding author: Lukas Laarmann PB - Springer Nature ER - TY - JOUR A1 - Böhnisch, Nils A1 - Braun, Carsten A1 - Muscarello, Vincenzo A1 - Marzocca, Pier T1 - A sensitivity study on aeroelastic instabilities of slender wings with a large propeller JF - AIAA SCITECH 2023 Forum N2 - Next-generation aircraft designs often incorporate multiple large propellers attached along the wingspan. These highly flexible dynamic systems can exhibit uncommon aeroelastic instabilities, which should be carefully investigated to ensure safe operation. The interaction between the propeller and the wing is of particular importance. It is known that whirl flutter is stabilized by wing motion and wing aerodynamics. This paper investigates the effect of a propeller onto wing flutter as a function of span position and mounting stiffness between the propeller and wing. The analysis of a comparison between a tractor and pusher configuration has shown that the coupled system is more stable than the standalone wing for propeller positions near the wing tip for both configurations. The wing fluttermechanism is mostly affected by the mass of the propeller and the resulting change in eigenfrequencies of the wing. For very weak mounting stiffnesses, whirl flutter occurs, which was shown to be stabilized compared to a standalone propeller due to wing motion. On the other hand, the pusher configuration is, as to be expected, the more critical configuration due to the attached mass behind the elastic axis. Y1 - 2023 U6 - https://doi.org/10.2514/6.2023-1893 N1 - AIAA SCITECH 2023 Forum, 23-27 January 2023, National Harbor, MD & Online SP - 1 EP - 14 PB - AIAA CY - Reston, Va. ER - TY - JOUR A1 - Ulmer, Jessica A1 - Braun, Sebastian A1 - Cheng, Chi-Tsun A1 - Dowey, Steve A1 - Wollert, Jörg T1 - A human factors-aware assistance system in manufacturing based on gamification and hardware modularisation JF - International Journal of Production Research N2 - Assistance systems have been widely adopted in the manufacturing sector to facilitate various processes and tasks in production environments. However, existing systems are mostly equipped with rigid functional logic and do not provide individual user experiences or adapt to their capabilities. This work integrates human factors in assistance systems by adjusting the hardware and instruction presented to the workers’ cognitive and physical demands. A modular system architecture is designed accordingly, which allows a flexible component exchange according to the user and the work task. Gamification, the use of game elements in non-gaming contexts, has been further adopted in this work to provide level-based instructions and personalised feedback. The developed framework is validated by applying it to a manual workstation for industrial assembly routines. KW - Human factors KW - assistance system KW - gamification KW - adaptive systems KW - manufacturing Y1 - 2023 U6 - https://doi.org/10.1080/00207543.2023.2166140 SN - 0020-7543 (Print) SN - 1366-588X (Online) PB - Taylor & Francis ER - TY - JOUR A1 - Kowalewski, Paul A1 - Bragard, Michael A1 - Hüning, Felix A1 - De Doncker, Rik W. T1 - An inexpensive Wiegand-sensor-based rotary encoder without rotating magnets for use in electrical drives JF - IEEE Transactions on Instrumentation and Measurement N2 - This paper introduces an inexpensive Wiegand-sensor-based rotary encoder that avoids rotating magnets and is suitable for electrical-drive applications. So far, Wiegand-sensor-based encoders usually include a magnetic pole wheel with rotating permanent magnets. These encoders combine the disadvantages of an increased magnet demand and a limited maximal speed due to the centripetal force acting on the rotating magnets. The proposed approach reduces the total demand of permanent magnets drastically. Moreover, the rotating part is manufacturable from a single piece of steel, which makes it very robust and cheap. This work presents the theoretical operating principle of the proposed approach and validates its benefits on a hardware prototype. The presented proof-of-concept prototype achieves a mechanical resolution of 4.5 ° by using only 4 permanent magnets, 2Wiegand sensors and a rotating steel gear wheel with 20 teeth. KW - Rotary encoder KW - Wiegand sensor Y1 - 2023 U6 - https://doi.org/10.1109/TIM.2023.3326166 SN - 0018-9456 (Print) SN - 1557-9662 (Online) VL - 72 SP - 10 Seiten PB - IEEE CY - New York ER - TY - JOUR A1 - Gaigall, Daniel ED - AitSahlia, Farid T1 - Allocating and forecasting changes in risk JF - Journal of risk N2 - We consider time-dependent portfolios and discuss the allocation of changes in the risk of a portfolio to changes in the portfolio’s components. For this purpose we adopt established allocation principles. We also use our approach to obtain forecasts for changes in the risk of the portfolio’s components. To put the approach into practice we present an implementation based on the output of a simulation. Allocation is illustrated with an example portfolio in the context of Solvency II. The quality of the forecasts is investigated with an empirical study. KW - portfolio risk KW - allocation KW - forecast KW - covariance principle KW - conditional expectation principle Y1 - 2023 U6 - https://doi.org/10.21314/JOR.2022.048 SN - 1755-2842 SN - 1465-1211 VL - 25 IS - 3 SP - 1 EP - 24 PB - Infopro Digital Risk CY - London ER - TY - JOUR A1 - Gaigall, Daniel T1 - On the applicability of several tests to models with not identically distributed random effects JF - Statistics : A Journal of Theoretical and Applied Statistics N2 - We consider Kolmogorov–Smirnov and Cramér–von-Mises type tests for testing central symmetry, exchangeability, and independence. In the standard case, the tests are intended for the application to independent and identically distributed data with unknown distribution. The tests are available for multivariate data and bootstrap procedures are suitable to obtain critical values. We discuss the applicability of the tests to random effects models, where the random effects are independent but not necessarily identically distributed and with possibly unknown distributions. Theoretical results show the adequacy of the tests in this situation. The quality of the tests in models with random effects is investigated by simulations. Empirical results obtained confirm the theoretical findings. A real data example illustrates the application. KW - central symmetry test KW - exchangeability test KW - independence test KW - random effects KW - not identically distributed Y1 - 2023 SN - 0323-3944 U6 - https://doi.org/10.1080/02331888.2023.2193748 SN - 1029-4910 VL - 57 PB - Taylor & Francis CY - London ER - TY - JOUR A1 - Gaigall, Daniel A1 - Gerstenberg, Julian T1 - Cramér-von-Mises tests for the distribution of the excess over a confidence level JF - Journal of Nonparametric Statistics N2 - The Cramér-von-Mises distance is applied to the distribution of the excess over a confidence level. Asymptotics of related statistics are investigated, and it is seen that the obtained limit distributions differ from the classical ones. For that reason, quantiles of the new limit distributions are given and new bootstrap techniques for approximation purposes are introduced and justified. The results motivate new one-sample goodness-of-fit tests for the distribution of the excess over a confidence level and a new confidence interval for the related fitting error. Simulation studies investigate size and power of the tests as well as coverage probabilities of the confidence interval in the finite sample case. A practice-oriented application of the Cramér-von-Mises tests is the determination of an appropriate confidence level for the fitting approach. The adoption of the idea to the well-known problem of threshold detection in the context of peaks over threshold modelling is sketched and illustrated by data examples. KW - Cramér-von-Mises test KW - conditional excess distribution KW - confidence interval KW - goodness-of-fit test Y1 - 2023 U6 - https://doi.org/10.1080/10485252.2023.2173958 SN - 1048-5252 (Print) SN - 1029-0311 (Online) PB - Taylor & Francis ER -