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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.
Die Verfasser stellen in ihrem Beitrag die künftig in Kraft tretenden oder schon in Kraft getretenen Gesetzesvorhaben der europäischen Union vor. Vorab werde auf die abgelaufene Frist zur Anpassung von Standardvertragsklausel hingewiesen. Die Anpassung könne ggf. durch den Data Privacy Act der Kommission bewirkt werden, da dieser eine Angemessenheit suggeriere. Neben dem Digital Markets Act, der die Wahrung der Diskriminierungsfreiheit den Gatekeeper-Plattformen bezüglich der Bewerbung von Waren Dritter vorschreibt, sind ebenfalls der Digital Service Act und der Data Governance Act in Kraft getreten und werden künftig wirksam. Letzteres bezweckt den Datenaustausch von nicht-personenbezogenen Daten öffentlich-rechtlicher Datensätze, wobei anders als bei DSA, der die Verbraucherrechte durchsetzen möchte, mangels Verpflichtung die praktische Umsetzung ausbleiben werde. In der Entwurfsphase stecken der Artificial Intelligence Act, der Data Act, sowie der Cyber Resilience Act. Allen drei sei wegen dem weiten Anwendungsspielraum, der Bußgeldandrohung oder der Cyber-Bedrohungslage besondere praktische Relevanz beizumessen. Die Kommission weite durch diese Gesetzesvorhaben ihre Regelungsabsicht auch auf nicht-personenbezogene Daten und dem Datentransfer aus. Im Ergebnis werden die Unternehmen mit mehr Verpflichtungen konfrontiert, zu dessen Umsetzung ein funktionierendes Compliance-Management-System unabdingbar sei.
Datenschutz & Datenrecht – ein Ausblick auf 2023: Nationale Entwicklungen, EuGH-Vorlagen & Aufsicht
(2023)
Die Verfasser vermitteln einen Überblick über die nationalen Gesetzgebungsverfahren und wesentliche EuGH-Vorlagefragen betreffend den Datenschutz und das Datenrecht für das Jahr 2023. Zunächst folgen u.a. Hinweise in Bezug auf den Hinweisgeberschutz, die Verabschiedung der Einwilligungsverwaltungs-Verordnung zur Konkretisierung des § 26 TTDSG und das Mobilitätsdatengesetz. Anschließend werden Vorlagefragen deutscher Gerichte, die dem EuGH vorgelegt und bereits am 12.01.2023 beantwortet wurden, wie etwa C-154/21 und C-132/21 und die EuGH-Entscheidung vom 9.2.2023 (C-453/21), thematisiert. Überdies führen die Autoren wesentliche Entscheidungen des EuGH an, die im Jahr 2023 aus dem Bereich Datenrecht und Datenschutz zu erwarten seien. Auch Aktivitäten der Datenschutzaufsicht auf nationaler und europäischer Ebene finden Erwähnung. Die Verfasser machen abschließend auf besonders interessante Entscheidungen, die 2023 erwartet werden, wie etwa das EuGH-Urteil zum Auskunftsanspruch, sowie auf das Verhältnis des der Whistleblowing-RL umzusetzende Hinweisgeberschutzgesetz einerseits und Vorgaben des Datenschutzes andererseits, aufmerksam. Sie empfehlen, die künftige Rechtsprechung des EuGH im Blick zu behalten.
Umsatzbasierte Bußgelder – wie sonst nur aus dem Kartellrecht bekannt – waren einer der Gründe, warum die Datenschutz-Grundverordnung (DSGVO) vor ihrem Inkrafttreten für erhebliches Aufsehen sorgte. Die vielfach relevanteren Schadensersatzansprüche, die, wie bei „Dieselgate“, aufgrund der Vielzahl von betroffenen Personen und der aus Sicht von Rechtsdienstleistern bestehenden Skalierbarkeit mit weitaus höheren Einbußen für Unternehmen einhergehen können, blieben zunächst unbeachtet. Inzwischen ist der Schadensersatzanspruch gem. Art. 82 DSGVO die Vorschrift, die die meisten Vorlagen zum Europäischen Gerichtshof (EuGH) der letzten Jahre hervorgerufen hat. Am 4.5.2023 hat nun der EuGH (Urteil v. 4.5.2023 - Rs. C-300/21, NWB GAAAJ-41389) in einem Grundsatzurteil über zentrale Fragen rund um den Ersatz immaterieller Schäden als Folge von Datenschutzverstößen entschieden.
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.
To fulfil the CO2 emission reduction targets of the European Union (EU), heavy-duty (HD) trucks need to operate 15% more efficiently by 2025 and 30% by 2030. Their electrification is necessary as conventional HD trucks are already optimized for the long-haul application. The resulting hybrid electric vehicle (HEV) truck gains most of the fuel saving potential by the recuperation of potential energy and its consecutive utilization. The key to utilizing the full potential of HEV-HD trucks is to maximize the amount of recuperated energy and ensure its intelligent usage while keeping the operating point of the internal combustion engine as efficient as possible. To achieve this goal, an intelligent energy management strategy (EMS) based on ECMS is developed for a parallel HEV-HD truck which uses predictive discharge of the battery and adaptive operating strategy regarding the height profile and the vehicle mass. The presented EMS can reproduce the global optimal operating strategy over long phases and lead to a fuel saving potential of up to 2% compared with a heuristic strategy. Furthermore, the fuel saving potential is correlated with the investigated boundary conditions to deepen the understanding of the impact of intelligent EMS for HEV-HD trucks.
Using scenarios is vital in identifying and specifying measures for successfully transforming the energy system. Such transformations can be particularly challenging and require the support of a broader set of stakeholders. Otherwise, there will be opposition in the form of reluctance to adopt the necessary technologies. Usually, processes for considering stakeholders' perspectives are very time-consuming and costly. In particular, there are uncertainties about how to deal with modifications in the scenarios. In principle, new consulting processes will be required. In our study, we show how multi-criteria decision analysis can be used to analyze stakeholders' attitudes toward transition paths. Since stakeholders differ regarding their preferences and time horizons, we employ a multi-criteria decision analysis approach to identify which stakeholders will support or oppose a transition path. We provide a flexible template for analyzing stakeholder preferences toward transition paths. This flexibility comes from the fact that our multi-criteria decision aid-based approach does not involve intensive empirical work with stakeholders. Instead, it involves subjecting assumptions to robustness analysis, which can help identify options to influence stakeholders' attitudes toward transitions.
This study evaluates neuromechanical control and muscle-tendon interaction during energy storage and dissipation tasks in hypergravity. During parabolic flights, while 17 subjects performed drop jumps (DJs) and drop landings (DLs), electromyography (EMG) of the lower limb muscles was combined with in vivo fascicle dynamics of the gastrocnemius medialis, two-dimensional (2D) kinematics, and kinetics to measure and analyze changes in energy management. Comparisons were made between movement modalities executed in hypergravity (1.8 G) and gravity on ground (1 G). In 1.8 G, ankle dorsiflexion, knee joint flexion, and vertical center of mass (COM) displacement are lower in DJs than in DLs; within each movement modality, joint flexion amplitudes and COM displacement demonstrate higher values in 1.8 G than in 1 G. Concomitantly, negative peak ankle joint power, vertical ground reaction forces, and leg stiffness are similar between both movement modalities (1.8 G). In DJs, EMG activity in 1.8 G is lower during the COM deceleration phase than in 1 G, thus impairing quasi-isometric fascicle behavior. In DLs, EMG activity before and during the COM deceleration phase is higher, and fascicles are stretched less in 1.8 G than in 1 G. Compared with the situation in 1 G, highly task-specific neuromuscular activity is diminished in 1.8 G, resulting in fascicle lengthening in both movement modalities. Specifically, in DJs, a high magnitude of neuromuscular activity is impaired, resulting in altered energy storage. In contrast, in DLs, linear stiffening of the system due to higher neuromuscular activity combined with lower fascicle stretch enhances the buffering function of the tendon, and thus the capacity to safely dissipate energy.
Magnetic detection structure for Lab-on-Chip applications based on the frequency mixing technique
(2018)
A magnetic frequency mixing technique with a set of miniaturized planar coils was investigated for use with a completely integrated Lab-on-Chip (LoC) pathogen sensing system. The system allows the detection and quantification of superparamagnetic beads. Additionally, in terms of magnetic nanoparticle characterization ability, the system can be used for immunoassays using the beads as markers. Analytical calculations and simulations for both excitation and pick-up coils are presented; the goal was to investigate the miniaturization of simple and cost-effective planar spiral coils. Following these calculations, a Printed Circuit Board (PCB) prototype was designed, manufactured, and tested for limit of detection, linear response, and validation of theoretical concepts. Using the magnetic frequency mixing technique, a limit of detection of 15 µg/mL of 20 nm core-sized nanoparticles was achieved without any shielding.
The movement of magnetic beads due to a magnetic field gradient is of great interest in different application fields. In this report we present a technique based on a magnetic tweezers setup to measure the velocity factor of magnetically actuated individual superparamagnetic beads in a fluidic environment. Several beads can be tracked simultaneously in order to gain and improve statistics. Furthermore we show our results for different beads with hydrodynamic diameters between 200 and 1000 nm from diverse manufacturers. These measurement data can, for example, be used to determine design parameters for a magnetic separation system, like maximum flow rate and minimum separation time, or to select suitable beads for fixed experimental requirements.