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- ECSM European Center for Sustainable Mobility (21)
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- Solar-Institut Jülich (3)
- FH Aachen (2)
- Fachbereich Architektur (2)
- Institut fuer Angewandte Polymerchemie (2)
- Arbeitsstelle fuer Hochschuldidaktik und Studienberatung (1)
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.
Coupé Nr. 13
(2023)
Coupé Nr. 13 ist eine kurze Animation über ein Zugcoupé mit 6 individuellen Passagieren und den 5 Stufen der Kommunikationsentwicklung zwischen ihnen. Die Passagiere des "Coupé Nummer 13" werden zu ihrem wahren Ich, wenn sie sich gegenseitig die Kofferklappen öffnen. Doch dieses Offen-Sein ist gar nicht so einfach. Es fühlt sich anfangs verletzlich an, psychologisch nackt und meist ängstlich. Aber diese Verletzlichkeit ist aus psychologischer Sicht der Schlüssel zu engen Beziehungen. Wahre Verbundenheit entsteht nur, wenn man den Weg zur Schattenseite des anderen findet – indem man sie so sieht und annimmt, wie sie wirklich sind. In der Tat bewundern und respektieren wir meistens die Verletzlichkeit anderer Menschen. Wir sehen sie in der Regel als ein Zeichen von Stärke und Mut – nicht von Schwäche.
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.
Ambitious climate targets affect the competitiveness of industries in the international market. To prevent such industries from moving to other countries in the wake of increased climate protection efforts, cost adjustments may become necessary. Their design requires knowledge of country-specific production costs. Here, we present country-specific cost figures for different production routes of steel, paying particular attention to transportation costs. The data can be used in floor price models aiming to assess the competitiveness of different steel production routes in different countries (Rübbelke, 2022).
Ein neues tragendes, lagenweise aufgebautes Holzbau-Wandsystem und seine ökonomische und statische Entwicklung werden vorgestellt. Randbedingungen wie Nachhaltigkeit, Ressourceneffizienz und eine beanspruchungsadaptive Konstruktionsweise sind für diese innovative Bauteilentwicklung von zentraler Bedeutung. Eine wesentliche Herausforderung ist die Herstellung der Verbindung der Lagen untereinander zu einem bauphysikalisch und statisch leistungsfähigen Wandsystem. Die Tragfähigkeit und Steifigkeit verschiedener Verbindungsvarianten wurden ebenso wie die Eigenschaften der Wandelemente analytisch, numerisch und experimentell untersucht.
It has been shown that muscle fascicle curvature increases with increasing contraction level and decreasing muscle–tendon complex length. The analyses were done with limited examination windows concerning contraction level, muscle–tendon complex length, and/or intramuscular position of ultrasound imaging. With this study we aimed to investigate the correlation between fascicle arching and contraction, muscle–tendon complex length and their associated architectural parameters in gastrocnemius muscles to develop hypotheses concerning the fundamental mechanism of fascicle curving. Twelve participants were tested in five different positions (90°/105°*, 90°/90°*, 135°/90°*, 170°/90°*, and 170°/75°*; *knee/ankle angle). They performed isometric contractions at four different contraction levels (5%, 25%, 50%, and 75% of maximum voluntary contraction) in each position. Panoramic ultrasound images of gastrocnemius muscles were collected at rest and during constant contraction. Aponeuroses and fascicles were tracked in all ultrasound images and the parameters fascicle curvature, muscle–tendon complex strain, contraction level, pennation angle, fascicle length, fascicle strain, intramuscular position, sex and age group were analyzed by linear mixed effect models. Mean fascicle curvature of the medial gastrocnemius increased with contraction level (+5 m−1 from 0% to 100%; p = 0.006). Muscle–tendon complex length had no significant impact on mean fascicle curvature. Mean pennation angle (2.2 m−1 per 10°; p < 0.001), inverse mean fascicle length (20 m−1 per cm−1; p = 0.003), and mean fascicle strain (−0.07 m−1 per +10%; p = 0.004) correlated with mean fascicle curvature. Evidence has also been found for intermuscular, intramuscular, and sex-specific intramuscular differences of fascicle curving. Pennation angle and the inverse fascicle length show the highest predictive capacities for fascicle curving. Due to the strong correlations between pennation angle and fascicle curvature and the intramuscular pattern of curving we suggest for future studies to examine correlations between fascicle curvature and intramuscular fluid pressure.
Im Zentrum von Wien befindet sich in einem ehemaligen Flakturm aus dem 2. Weltkrieg, das Haus des Meeres. Auf ca 5000m2 beherbergen sie ca. 10.000 Tiere. Der Fokus liegt dabei auf die Unterwasserwelt und bietet einen ausgiebigen Einblick in die Welt der Meere. Das neue Erscheinungsbild positioniert die private und gemeinnützige Einrichtung sowohl als Ort des Zusammenkommens als auch der Wissensvermittlung. Dabei soll das Designkonzept vor dem Betreten des Zoos seine besondere Baukonstruktion aufzeigen und von Anfang an die Tiefe sowie Tiefenzonen der Meere einbeziehen. Damit distanzieren sie sich entscheidend von ähnlichen Institutionen. Inspiriert von der Teilung zwischen der Oberfläche und dem Meer, entstand eine feine abstrakte Skala. Diese visualisiert den Meeresspiegel mit seiner Tiefe und dient medienübergreifend als Orientierungshilfe.
Das KERAMION beherbergt ein breites Sortiment an historischen Keramikstücken wie auch modernen künstlerischen Keramikarbeiten. Bei der neuen Konzeptionierung des Museums wurde eine Verbindung der historischen Sammlung und der modernen Kunst geschaffen, als Visualisierung dafür steht die eigens für das Museum erstellte Schrift. In dieser Schrift wird eine historische, schwungvolle Kurrentschrift aus dem 16. Jahrhundert mit einer modernen kantigen Serifenschrift verbunden. Daraus entsteht eine Schrift, die die Breite der Keramik widerspiegelt und von Steingut bis Porzellan alle Facetten aufgreift. Gepaart wird die einzigartige Schrift mit einem auf das Zentrum ausgerichteten Layoutprinzip, bei dem 3D Scans der Exponate in den Fokus rücken. Somit können die Besucher*innen auch von zu Hause einen Vorgeschmack auf die einzigartigen Materialien und Keramiktechniken bekommen.
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.
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.