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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.
Companies often build their businesses based on product information and therefore try to automate the process of information extraction (IE). Since the information source is usually heterogeneous and non-standardized, classic extract, transform, load techniques reach their limits. Hence, companies must implement the newest findings from research to tackle the challenges of process automation. They require a flexible and robust system that is extendable and ensures the optimal processing of the different document types. This paper provides a distributed microservice architecture pattern that enables the automated generation of IE pipelines. Since their optimal design is individual for each input document, the system ensures the ad-hoc generation of pipelines depending on specific document characteristics at runtime. Furthermore, it introduces the automated quality determination of each available pipeline and controls the integration of new microservices based on their impact on the business value. The introduced system enables fast prototyping of the newest approaches from research and supports companies in automating their IE processes. Based on the automated quality determination, it ensures that the generated pipelines always meet defined business requirements when they come into productive use.
Obstacle avoidance is critical for unmanned aerial vehicles (UAVs) operating autonomously. Obstacle avoidance algorithms either rely on global environment data or local sensor data. Local path planners react to unforeseen objects and plan purely on local sensor information. Similarly, animals need to find feasible paths based on local information about their surroundings. Therefore, their behavior is a valuable source of inspiration for path planning. Bumblebees tend to fly vertically over far-away obstacles and horizontally around close ones, implying two zones for different flight strategies depending on the distance to obstacles. This work enhances the local path planner 3DVFH* with this bio-inspired strategy. The algorithm alters the goal-driven function of the 3DVFH* to climb-preferring if obstacles are far away. Prior experiments with bumblebees led to two definitions of flight zone limits depending on the distance to obstacles, leading to two algorithm variants. Both variants reduce the probability of not reaching the goal of a 3DVFH* implementation in Matlab/Simulink. The best variant, 3DVFH*b-b, reduces this probability from 70.7 to 18.6% in city-like worlds using a strong vertical evasion strategy. Energy consumption is higher, and flight paths are longer compared to the algorithm version with pronounced horizontal evasion tendency. A parameter study analyzes the effect of different weighting factors in the cost function. The best parameter combination shows a failure probability of 6.9% in city-like worlds and reduces energy consumption by 28%. Our findings demonstrate the potential of bio-inspired approaches for improving the performance of local path planning algorithms for UAV.
In this work, the effects of carbon sources and culture media on the production and structural properties of bacterial cellulose (BC) synthesized by Medusomyces gisevii have been studied. The culture medium was composed of different initial concentrations of glucose or sucrose dissolved in 0.4% extract of plain green tea. Parameters of the culture media (titratable acidity, substrate conversion degree etc.) were monitored daily for 20 days of cultivation. The BC pellicles produced on different carbon sources were characterized in terms of biomass yield, crystallinity and morphology by field emission scanning electron microscopy (FE-SEM), atomic force microscopy and X-ray diffraction. Our results showed that Medusomyces gisevii had higher BC yields in media with sugar concentrations close to 10 g L−1 after a 18–20 days incubation period. Glucose in general lead to a higher BC yield (173 g L−1) compared to sucrose (163.5 g L−1). The BC crystallinity degree and surface roughness were higher in the samples synthetized from sucrose. Obtained FE-SEM micrographs show that the BC pellicles synthesized in the sucrose media contained densely packed tangles of cellulose fibrils whereas the BC produced in the glucose media displayed rather linear geometry of the BC fibrils without noticeable aggregates.
Antibias training is increasingly demanded and practiced in academia and industry to increase employees’ sensitivity to discrimination, racism, and diversity. Under the heading of “Diversity Management,” antibias trainings are mainly offered as one-off workshops intending to raise awareness of unconscious biases, create a diversity-affirming corporate culture, promote awareness of the potential of
diversity, and ultimately enable the reflection of diversity in development processes. However, coming from childhood education, research and scientific articles on the sustainable effectiveness of antibias in adulthood, especially in academia, are very scarce. In order to fill this research gap, the article aims to explore how sustainable the effects of individual antibias trainings on participants’ behavior are. In order to investigate this, participant observation in a qualitative pre–post setting was conducted, analyzing antibias training in an academic context. Two observers actively participated in the training sessions and documented the activities and reflection processes of the participants. Overall, the results question the effectiveness of single antibias trainings and show that a target-group adaptive approach is mandatory owing to the background of the approach in early childhood education. Therefore, antibias work needs to be adapted to the target group’s needs and realities of life. Furthermore, the study reveals that single antibias trainings must be embedded in a holistic diversity management approach to stimulate sustainable reflection processes among the target group. This article is one of the first to scientifically evaluate antibias training effectiveness, especially in engineering sciences and the university context.
Throughout the last decade, and particularly in 2022, water scarcity has become a critical concern in Morocco and other Mediterranean countries. The lack of rainfall during spring was worsened by a succession of heat waves during the summer. To address this drought, innovative solutions, including the use of new technologies such as hydrogels, will be essential to transform agriculture. This paper presents the findings of a study that evaluated the impact of hydrogel application on onion (Allium cepa) cultivation in Meknes, Morocco. The treatments investigated in this study comprised two different types of hydrogel-based soil additives (Arbovit® polyacrylate and Huminsorb® polyacrylate), applied at two rates (30 and 20 kg/ha), and irrigated at two levels of water supply (100% and 50% of daily crop evapotranspiration; ETc). Two control treatments were included, without hydrogel application and with both water amounts. The experiment was conducted in an open field using a completely randomized design. The results indicated a significant impact of both hydrogel-type dose and water dose on onion plant growth, as evidenced by various vegetation parameters. Among the hydrogels tested, Huminsorb® Polyacrylate produced the most favorable outcomes, with treatment T9 (100%, HP, 30 kg/ha) yielding 70.55 t/ha; this represented an increase of 11 t/ha as compared to the 100% ETc treatment without hydrogel application. Moreover, the combination of hydrogel application with 50% ETc water stress showed promising results, with treatment T4 (HP, 30 kg, 50%) producing almost the same yield as the 100% ETc treatment without hydrogel while saving 208 mm of water.
In times of short product life cycles, additive manufacturing and rapid tooling are important methods to make tool development and manufacturing more efficient. High-performance polymers are the key to mold production for prototypes and small series. However, the high temperatures during vulcanization injection molding cause thermal aging and can impair service life. The extent to which the thermal stress over the entire process chain stresses the material and whether it leads to irreversible material aging is evaluated. To this end, a mold made of PEEK is fabricated using fused filament fabrication and examined for its potential application. The mold is heated to 200 ◦C, filled with rubber, and cured. A differential scanning calorimetry analysis of each process step illustrates the crystallization behavior and first indicates the material resistance. It shows distinct cold crystallization regions at a build chamber temperature of 90 ◦C. At an ambient temperature above Tg, crystallization of 30% is achieved, and cold crystallization no longer occurs. Additional tensile tests show a decrease in tensile strength after ten days of thermal aging. The steady decrease in recrystallization temperature indicates degradation of the additives. However, the tensile tests reveal steady embrittlement of the material due to increasing crosslinking.
Cell spraying has become a feasible application method for cell therapy and tissue engineering approaches. Different devices have been used with varying success. Often, twin-fluid atomizers are used, which require a high gas velocity for optimal aerosolization characteristics. To decrease the amount and velocity of required air, a custom-made atomizer was designed based on the effervescent principle. Different designs were evaluated regarding spray characteristics and their influence on human adipose-derived mesenchymal stromal cells. The arithmetic mean diameters of the droplets were 15.4–33.5 µm with decreasing diameters for increasing gas-to-liquid ratios. The survival rate was >90% of the control for the lowest gas-to-liquid ratio. For higher ratios, cell survival decreased to approximately 50%. Further experiments were performed with the design, which had shown the highest survival rates. After seven days, no significant differences in metabolic activity were observed. The apoptosis rates were not influenced by aerosolization, while high gas-to-liquid ratios caused increased necrosis levels. Tri-lineage differentiation potential into adipocytes, chondrocytes, and osteoblasts was not negatively influenced by aerosolization. Thus, the effervescent aerosolization principle was proven suitable for cell applications requiring reduced amounts of supplied air. This is the first time an effervescent atomizer was used for cell processing.
Melting probes are a proven tool for the exploration of thick ice layers and clean sampling of subglacial water on Earth. Their compact size and ease of operation also make them a key technology for the future exploration of icy moons in our Solar System, most prominently Europa and Enceladus. For both mission planning and hardware engineering, metrics such as efficiency and expected performance in terms of achievable speed, power requirements, and necessary heating power have to be known.
Theoretical studies aim at describing thermal losses on the one hand, while laboratory experiments and field tests allow an empirical investigation of the true performance on the other hand. To investigate the practical value of a performance model for the operational performance in extraterrestrial environments, we first contrast measured data from terrestrial field tests on temperate and polythermal glaciers with results from basic heat loss models and a melt trajectory model. For this purpose, we propose conventions for the determination of two different efficiencies that can be applied to both measured data and models. One definition of efficiency is related to the melting head only, while the other definition considers the melting probe as a whole. We also present methods to combine several sources of heat loss for probes with a circular cross-section, and to translate the geometry of probes with a non-circular cross-section to analyse them in the same way. The models were selected in a way that minimizes the need to make assumptions about unknown parameters of the probe or the ice environment.
The results indicate that currently used models do not yet reliably reproduce the performance of a probe under realistic conditions. Melting velocities and efficiencies are constantly overestimated by 15 to 50 % in the models, but qualitatively agree with the field test data. Hence, losses are observed, that are not yet covered and quantified by the available loss models. We find that the deviation increases with decreasing ice temperature. We suspect that this mismatch is mainly due to the too restrictive idealization of the probe model and the fact that the probe was not operated in an efficiency-optimized manner during the field tests. With respect to space mission engineering, we find that performance and efficiency models must be used with caution in unknown ice environments, as various ice parameters have a significant effect on the melting process. Some of these are difficult to estimate from afar.
Manufacturing companies across multiple industries face an increasingly dynamic and unpredictable environment. This development can be seen on both the market and supply side. To respond to these challenges, manufacturing companies must implement smart manufacturing systems and become more flexible and agile. The flexibility in operational planning regarding the scheduling and sequencing of customer orders needs to be increased and new structures must be implemented in manufacturing systems’ fundamental design as they constitute much of the operational flexibility available. To this end, smart and more flexible solutions for production planning and control (PPC) are developed. However, scheduling or sequencing is often only considered isolated in a predefined stable environment. Moreover, their orientation on the fundamental logic of the existing IT solutions and their applicability in a dynamic environment is limited. This paper presents a conceptual model for a task-based description logic that can be applied to factory planning, technology planning, and operational control. By using service-oriented architectures, the goal is to generate smart manufacturing systems. The logic is designed to allow for easy and automated maintenance. It is compatible with the existing resource and process allocation logic across operational and strategic factory and production planning.