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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.
Persistent infection with the high-risk Human Papillomavirus type 16 (HPV 16) is the causative event for the development of cervical cancer and other malignant tumors of the anogenital tract and of the head and neck. Despite many attempts to develop therapeutic vaccines no candidate has entered late clinical trials. An interesting approach is a DNA based vaccine encompassing the nucleotide sequence of the E6 and E7 viral oncoproteins. Because both proteins are consistently expressed in HPV infected cells they represent excellent targets for immune therapy. Here we report the development of 8 DNA vaccine candidates consisting of differently rearranged HPV-16 E6 and E7 sequences within one molecule providing all naturally occurring epitopes but supposedly lacking transforming activity. The HPV sequences were fused to the J-domain and the SV40 enhancer in order to increase immune responses. We demonstrate that one out of the 8 vaccine candidates induces very strong cellular E6- and E7- specific cellular immune responses in mice and, as shown in regression experiments, efficiently controls growth of HPV 16 positive syngeneic tumors. This data demonstrates the potential of this vaccine candidate to control persistent HPV 16 infection that may lead to malignant disease. It also suggests that different sequence rearrangements influence the immunogenecity by an as yet unknown mechanism.
Detecting synchronization clusters in multivariate time series via coarse-graining of Markov chains
(2007)
In this paper research activities developed within the FutureCom project are presented. The project, funded by the European Metrology Programme for Innovation and Research (EMPIR), aims at evaluating and characterizing: (i) active devices, (ii) signal- and power integrity of field programmable gate array (FPGA) circuits, (iii) operational performance of electronic circuits in real-world and harsh environments (e.g. below and above ambient temperatures and at different levels of humidity), (iv) passive inter-modulation (PIM) in communication systems considering different values of temperature and humidity corresponding to the typical operating conditions that we can experience in real-world scenarios. An overview of the FutureCom project is provided here, then the research activities are described.
In this work, we present a compact, bifunctional chip-based sensor setup that measures the temperature and electrical conductivity of water samples, including specimens from rivers and channels, aquaculture, and the Atlantic Ocean. For conductivity measurements, we utilize the impedance amplitude recorded via interdigitated electrode structures at a single triggering frequency. The results are well in line with data obtained using a calibrated reference instrument. The new setup holds for conductivity values spanning almost two orders of magnitude (river versus ocean water) without the need for equivalent circuit modelling. Temperature measurements were performed in four-point geometry with an on-chip platinum RTD (resistance temperature detector) in the temperature range between 2 °C and 40 °C, showing no hysteresis effects between warming and cooling cycles. Although the meander was not shielded against the liquid, the temperature calibration provided equivalent results to low conductive Milli-Q and highly conductive ocean water. The sensor is therefore suitable for inline and online monitoring purposes in recirculating aquaculture systems.
RGB-D sensors such as the Microsoft Kinect or the Asus Xtion are inexpensive 3D sensors. A depth image is computed by calculating the distortion of a known infrared light (IR) pattern which is projected into the scene. While these sensors are great devices they have some limitations. The distance they can measure is limited and they suffer from reflection problems on transparent, shiny, or very matte and absorbing objects. If more than one RGB-D camera is used the IR patterns interfere with each other. This results in a massive loss of depth information. In this paper, we present a simple and powerful method to overcome these problems. We propose a stereo RGB-D camera system which uses the pros of RGB-D cameras and combine them with the pros of stereo camera systems. The idea is to utilize the IR images of each two sensors as a stereo pair to generate a depth map. The IR patterns emitted by IR projectors are exploited here to enhance the dense stereo matching even if the observed objects or surfaces are texture-less or transparent. The resulting disparity map is then fused with the depth map offered by the RGB-D sensor to fill the regions and the holes that appear because of interference, or due to transparent or reflective objects. Our results show that the density of depth information is increased especially for transparent, shiny or matte objects.
Clinical assessment of newly developed sensors is important for ensuring their validity. Comparing recordings of emerging electrocardiography (ECG) systems to a reference ECG system requires accurate synchronization of data from both devices. Current methods can be inefficient and prone to errors. To address this issue, three algorithms are presented to synchronize two ECG time series from different recording systems: Binned R-peak Correlation, R-R Interval Correlation, and Average R-peak Distance. These algorithms reduce ECG data to their cyclic features, mitigating inefficiencies and minimizing discrepancies between different recording systems. We evaluate the performance of these algorithms using high-quality data and then assess their robustness after manipulating the R-peaks. Our results show that R-R Interval Correlation was the most efficient, whereas the Average R-peak Distance and Binned R-peak Correlation were more robust against noisy data.
Microbial diversity studies regarding the aquatic communities that experienced or are experiencing environmental problems are essential for the comprehension of the remediation dynamics. In this pilot study, we present data on the phylogenetic and ecological structure of microorganisms from epipelagic water samples collected in the Small Aral Sea (SAS). The raw data were generated by massive parallel sequencing using the shotgun approach. As expected, most of the identified DNA sequences belonged to Terrabacteria and Actinobacteria (40% and 37% of the total reads, respectively). The occurrence of Deinococcus-Thermus, Armatimonadetes, Chloroflexi in the epipelagic SAS waters was less anticipated. Surprising was also the detection of sequences, which are characteristic for strict anaerobes—Ignavibacteria, hydrogen-oxidizing bacteria, and archaeal methanogenic species. We suppose that the observed very broad range of phylogenetic and ecological features displayed by the SAS reads demonstrates a more intensive mixing of water masses originating from diverse ecological niches of the Aral-Syr Darya River basin than presumed before.
Simulation model for the transient process behaviour of solar aluminium recycling in a rotary kiln
(2015)
Two of the main environmental problems of today’s society are the continuously increasing production of organic wastes as well as the increase of carbon dioxide in the atmosphere and the related green house effect. A way to solve these problems is the production of biogas. Biogas is a combustible gas consisting of methane, carbon dioxide and small amounts of other gases and trace elements. Production of biogas through anaerobic digestion of animal manure and slurries as well as of a wide range of digestible organic wastes and agricultural residues, converts these substrates into electricity and heat and offers a natural fertiliser for agriculture. The microbiological process of decomposition of organic matter, in the absence of oxygen takes place in reactors, called digesters. Biogas can be used as a fuel in a gas turbine or burner and can be used in a hybrid solar tower system offering a solution for waste treatment of agricultural and animal residues. A solar tower system consists of a heliostat field, which concentrates direct solar irradiation on an open volumetric central receiver. The receiver heats up ambient air to temperatures of around 700°C. The hot air’s heat energy is transferred to a steam Rankine cycle in a heat recovery steam generator (HRSG). The steam drives a steam turbine, which in turn drives a generator for producing electricity. In order to increase the operational hours of a solar tower power plant, a heat storage system and/ or hybridization may be considered. The advantage of solar-fossil hybrid power plants, compared to solar-only systems, lies in low additional investment costs due to an adaptable solar share and reduced technical and economical risks. On sunny days the hybrid system operates in a solar-only mode with the central receiver and on cloudy days and at night with the gas turbine only. As an alternative to methane gas, environmentally neutral biogas can be used for operating the gas turbine. Hence, the hybrid system is operated to 100% from renewable energy sources
Kinder sind bei der Suche nach Antworten auf ihre Fragen in unserer medialen Gesellschaft stark mit dem digitalen Raum konfrontiert. Diese Medien können bei einer nicht kindergerechten Benutzung wichtige Entwicklungsprozesse hindern. Im Gegensatz dazu geben diese aber auch die Möglichkeit, Kindern wichtige Denkgewohnheiten beizubringen und sie besser auf die Zukunft vorzubereiten. Ziel der Arbeit ist es, eine Verbindung zwischen der analogen und digitalen Welt herzustellen und ein vielfältiges Lernen zu ermöglichen. Die App „miela“ schafft eine neue Ebene der Wissensvermittlung durch die Kombination von digitaler und analoger Welt. Das Userinterface ist altersentsprechend gestaltet und bietet unterschiedliche Themenfelder an, wobei die Wissensvermittlung und die Kreativität im Fokus stehen. Eine Zusammenarbeit mit der Toniebox als digitale Erweiterung kann weitere Themenfelder anbieten.
Heat production in the windings of the stators of electric machines under stationary condition
(2014)
In electric machines due to high currents and resistive losses (joule heating) heat is produced. To avoid damages by overheating the design of effective cooling systems is required. Therefore the knowledge of heat sources and heat transfer processes is necessary. The purpose of this paper is to illustrate a good and effective calculation method for the temperature analysis based on homogenization techniques. These methods have been applied for the stator windings in a slot of an electric machine consisting of copper wires and resin. The key quantity here is an effective thermal conductivity, which characterizes the heterogeneous wire resin-arrangement inside the stator slot. To illustrate the applicability of the method, the analysis of a simplified, homogenized model is compared with the detailed analysis of temperature behavior inside a slot of an electric machine according to the heat generation. We considered here only the stationary situation. The achieved numerical results are accurate and show that the applied homogenization technique works in practice. Finally the results of simulations for the two cases, the original model of the slot and the homogenized model chosen for the slot (unit cell), are compared to experimental results.