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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.
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.
Environmental emissions, global warming, and energy-related concerns have accelerated the advancements in conventional vehicles that primarily use internal combustion engines. Among the existing technologies, hydrogen fuel cell electric vehicles and fuel cell hybrid electric vehicles may have minimal contributions to greenhouse gas emissions and thus are the prime choices for environmental concerns. However, energy management in fuel cell electric vehicles and fuel cell hybrid electric vehicles is a major challenge. Appropriate control strategies should be used for effective energy management in these vehicles. On the other hand, there has been significant progress in artificial intelligence, machine learning, and designing data-driven intelligent controllers. These techniques have found much attention within the community, and state-of-the-art energy management technologies have been developed based on them. This manuscript reviews the application of machine learning and intelligent controllers for prediction, control, energy management, and vehicle to everything (V2X) in hydrogen fuel cell vehicles. The effectiveness of data-driven control and optimization systems are investigated to evolve, classify, and compare, and future trends and directions for sustainability are discussed.
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.
There is a growing demand for more flexibility in manufacturing to counter the volatility and unpredictability of the markets and provide more individualization for customers. However, the design and implementation of flexibility within manufacturing systems are costly and only economically viable if applicable to actual demand fluctuations. To this end, companies are considering additive manufacturing (AM) to make production more flexible. This paper develops a conceptual model for the impact quantification of AM on volume and mix flexibility within production systems in the early stages of the factory-planning process. Together with the model, an application guideline is presented to help planners with the flexibility quantification and the factory design process. Following the development of the model and guideline, a case study is presented to indicate the potential impact additive technologies can have on manufacturing flexibility Within the case study, various scenarios with different production system configurations and production programs are analyzed, and the impact of the additive technologies on volume and mix flexibility is calculated. This work will allow factory planners to determine the potential impacts of AM on manufacturing flexibility in an early planning stage and design their production systems accordingly.
Traditional vulcanization mold manufacturing is complex, costly, and under pressure due to shorter product lifecycles and diverse variations. Additive manufacturing using Fused Filament Fabrication and high-performance polymers like PEEK offer a promising future in this industry. This study assesses the compressive strength of various infill structures (honeycomb, grid, triangle, cubic, and gyroid) when considering two distinct build directions (Z, XY) to enhance PEEK’s economic and resource efficiency in rapid tooling. A comparison with PETG samples shows the behavior of the infill strategies. Additionally, a proof of concept illustrates the application of a PEEK mold in vulcanization. A peak compressive strength of 135.6 MPa was attained in specimens that were 100% solid and subjected to thermal post-treatment. This corresponds to a 20% strength improvement in the Z direction. In terms of time and mechanical properties, the anisotropic grid and isotropic cubic infill have emerged for use in rapid tooling. Furthermore, the study highlights that reducing the layer thickness from 0.15 mm to 0.1 mm can result in a 15% strength increase. The study unveils the successful utilization of a room-temperature FFF-printed PEEK mold in vulcanization injection molding. The parameters and infill strategies identified in this research enable the resource-efficient FFF printing of PEEK without compromising its strength properties. Using PEEK in rapid tooling allows a cost reduction of up to 70% in tool production.
Seegras wird als „Rohstoff der Zukunft“ betitelt, da es helfen könnte, eine Reihe von globalen Problemen zu bekämpfen. Viele der erhofften Innovationen sind heute aber noch hypothetisch. Außerdem ist das Thema in der westlichen Welt trotz der Neigung zum Klimaschutz kaum bekannt. Die Idee von „Land Rover Symbiosis“ ist ein nachhaltiges Tourismuskonzept, das Forschung und Erlebnisreisen miteinander verknüpft. Auf einer 70m Katamaran Superyacht ist Platz für Forschungszwecke auf der einen und Raum für Expeditionsurlaub auf der anderen Seite. So entsteht ein Verhältnis an Bord, bei dem beide Parteien voneinander profitieren: Wissenschaftler:innen erhalten finanzielle Unterstützung und Kund:innen haben ein klimaneutrales Urlaubserlebnis, bei dem sie hautnah die Vorzüge und Potenziale von Seegras kennenlernen.
KALLE ist ein mitwachsender Kindertisch, dessen Besonderheit, neben der Höhenverstellung, in der Vergrößerung der Tischplatte liegt. Hierdurch kann KALLE optimal an das Wachstum der Kinder und die sich ändernden Anforderungen angepasst werden.
Es ist ein Möbelstück, das die Entwicklung der Kinder begleitet und fördert.
Im Gebrauch bezieht sich die Förderung besonders auf die kognitive Entwicklung, die Kreativität und das Sozialverhalten. Darüber hinaus sollen die Kinder mit KALLE aber auch den Umgang mit langlebigen Produkten erlernen, damit sie ein Verständnis für Nachhaltigkeit und ein umweltbewusstes Konsumverhalten entwickeln.
Wer A sagt, muss zumindest im Kaufrecht nicht immer B sagen: Es kommt nicht selten vor, dass sich in einem Kaufvertrag einerseits ein wirksamer Ausschluss der Gewährleistung des Verkäufers für Sachmängel findet, die Parteien aber andererseits gleichwohl eine Beschaffenheitsvereinbarung für bestimmte Eigenschaften vertraglich festlegen. In diesem Problemfeld führt eine aktuelle Entscheidung des BGH zu weiteren Klärungen für die Praxis (BGH, Urt. v. 10.4.2024 – VIII ZR 161/23, MDR 2024, 706). Der folgende Beitrag setzt sich mit den vielfältigen Aspekten der Entscheidung auseinander und erläutert, aus welchen Gründen der BGH dem Käufer einige goldene Brücken für einen Schadensersatzanspruch gebaut hat.
Incontrare, was übersetzt Begegnung bedeutet, ist ein Konferenztischkonzept, der durch seinen modularen
Aufbau heraus sticht. Dem Kunden ist es möglich das Produkt mit einem einzigen Werkzeug - fünfer Imbusschlüssel - aufzubauen. Der modulare Aufbau bietet die Möglichkeit kundenorientiert ein Produkt zusammensetzen zu können. Incontrare bietet hierdurch eine Vielzahl an Variationen, die nicht nur die gestalterischen Aspekte anspricht, sondern auch verschiedene Preisklassen abdeckt. Incontrare ist ein Tischkonzept, das sowohl im niederpreisigen , sowie auch im HighEnd Bereich funktioniert.
As one class of molecular imprinted polymers (MIPs), surface imprinted polymer (SIP)-based biosensors show great potential in direct whole-bacteria detection. Micro-contact imprinting, that involves stamping the template bacteria immobilized on a substrate into a pre-polymerized polymer matrix, is the most straightforward and prominent method to obtain SIP-based biosensors. However, the major drawbacks of the method arise from the requirement for fresh template bacteria and often non-reproducible bacteria distribution on the stamp substrate. Herein, we developed a positive master stamp containing photolithographic mimics of the template bacteria (E. coli) enabling reproducible fabrication of biomimetic SIP-based biosensors without the need for the “real” bacteria cells. By using atomic force and scanning electron microscopy imaging techniques, respectively, the E. coli-capturing ability of the SIP samples was tested, and compared with non-imprinted polymer (NIP)-based samples and control SIP samples, in which the cavity geometry does not match with E. coli cells. It was revealed that the presence of the biomimetic E. coli imprints with a specifically designed geometry increases the sensor E. coli-capturing ability by an “imprinting factor” of about 3. These findings show the importance of geometry-guided physical recognition in bacterial detection using SIP-based biosensors. In addition, this imprinting strategy was employed to interdigitated electrodes and QCM (quartz crystal microbalance) chips. E. coli detection performance of the sensors was demonstrated with electrochemical impedance spectroscopy (EIS) and QCM measurements with dissipation monitoring technique (QCM-D).
ARCHER : become the Arrow
(2024)
„Archer“ ist ein Redesign des Freischwingers. Ein klassischer Freischwinger ist ein aus Rohr gebogener Stuhl ohne Hinterbeine. Das Konzept des Freischwingers macht sich die Elastizität des Stahlrohrs zunutze, um einen schwingenden Sitz zu produzieren. An dieses Konzept knüpft „Archer“ herstellungstechnisch an, ergänzt jedoch ein paar Features. Der erste „USP“ ist die Rückenlehne, welche aus Nylonschnur gewoben ist. Die Lehne rahmt mehrdimensional eine Sattelfläche ein, die sich überraschend ergonomisch dem Rücken anpasst. Sie wächst aus den Armlehnen von vorne hinter dem Rücken zusammen. Eine weitere Neuheit sind die Hinterbeine des Stuhls. Der Schwung soll nicht weg, sondern hin zu dem, was was vor den Nutzenden liegt. In Kombination mit der Lehne, die aus den Armlehnen wächst und hinter dem Rücken schließt, ist das Gewicht über den Beinen gut ausbalanciert. In seinem Aufbau vereint Er ein reduziertes klares Stahlgestell mit dramatisch gewobener Schnur. Die zwei sichtbaren Materialien im Spiel miteinander werden optisch nur noch ergänzt von einem aus Kupfer, Messing oder Edelstahl gedrehten Stopfen mit konischem InLay. Der völlig eigene Aufbau mit Hinterbeinen und Armlehnen erlaubt federleichtes Schwingen, einfaches Aufstehen, neutralisiert Nervosität und fängt den Nutzer / die Nutzerin sanft auf. Die ineinander verwobenen Schnüre teilen das Gewicht gleichmäßig unter sich auf. Industrielle Herstellungsmethoden in Kombination mit Handarbeit machen diesen Stuhl zu etwas besonderem und da dem Konzept farblich kein Ende gesetzt ist, hat jeder Stuhl das Potenzial, zu einem unverkennbaren Einzelstück zu werden.
Generating synthetic LiDAR point cloud data for object detection using the Unreal Game Engine
(2024)
Object detection based on artificial intelligence is ubiquitous in today’s computer vision research and application. The training of the neural networks for object detection requires large and high-quality datasets. Besides datasets based on image data, datasets derived from point clouds offer several advantages. However, training datasets are sparse and their generation requires a lot of effort, especially in industrial domains. A solution to this issue offers the generation of synthetic point cloud data. Based on the design science research method, the work at hand proposes an approach and its instantiation for generating synthetic point cloud data based on the Unreal Engine. The point cloud quality is evaluated by comparing the synthetic cloud to a real-world point cloud. Within a practical example the applicability of the Unreal Game engine for synthetic point cloud generation could be successfully demonstrated.
Aircraft configurations with propellers have been drawing more attention in recent times, partly due to new propulsion concepts based on hydrogen fuel cells and electric motors. These configurations are prone to whirl flutter, which is an aeroelastic instability affecting airframes with elastically supported propellers. It commonly needs to be mitigated already during the design phase of such configurations, requiring, among other things, unsteady aerodynamic transfer functions for the propeller. However, no comprehensive assessment of unsteady propeller aerodynamics for aeroelastic analysis is available in the literature. This paper provides a detailed comparison of nine different low- to mid-fidelity aerodynamic methods, demonstrating their impact on linear, unsteady aerodynamics, as well as whirl flutter stability prediction. Quasi-steady and unsteady methods for blade lift with or without coupling to blade element momentum theory are evaluated and compared to mid-fidelity potential flow solvers (UPM and DUST) and classical, derivative-based methods. Time-domain identification of frequency-domain transfer functions for the unsteady propeller hub loads is used to compare the different methods. Predictions of the minimum required pylon stiffness for stability show good agreement among the mid-fidelity methods. The differences in the stability predictions for the low-fidelity methods are higher. Most methods studied yield a more unstable system than classical, derivative-based whirl flutter analysis, indicating that the use of more sophisticated aerodynamic modeling techniques might be required for accurate whirl flutter prediction.
Magnetic nanoparticles (MNP) are investigated with great interest for biomedical applications in diagnostics (e.g. imaging: magnetic particle imaging (MPI)), therapeutics (e.g. hyperthermia: magnetic fluid hyperthermia (MFH)) and multi-purpose biosensing (e.g. magnetic immunoassays (MIA)). What all of these applications have in common is that they are based on the unique magnetic relaxation mechanisms of MNP in an alternating magnetic field (AMF). While MFH and MPI are currently the most prominent examples of biomedical applications, here we present results on the relatively new biosensing application of frequency mixing magnetic detection (FMMD) from a simulation perspective. In general, we ask how the key parameters of MNP (core size and magnetic anisotropy) affect the FMMD signal: by varying the core size, we investigate the effect of the magnetic volume per MNP; and by changing the effective magnetic anisotropy, we study the MNPs’ flexibility to leave its preferred magnetization direction. From this, we predict the most effective combination of MNP core size and magnetic anisotropy for maximum signal generation.
Pulmonary arterial cannulation is a common and effective method for percutaneous mechanical circulatory support for concurrent right heart and respiratory failure [1]. However, limited data exists to what effect the positioning of the cannula has on the oxygen perfusion throughout the pulmonary artery (PA). This study aims to evaluate, using computational fluid dynamics (CFD), the effect of different cannula positions in the PA with respect to the oxygenation of the different branching vessels in order for an optimal cannula position to be determined. The four chosen different positions (see Fig. 1) of the cannulas are, in the lower part of the main pulmonary artery (MPA), in the MPA at the junction between the right pulmonary artery (RPA) and the left pulmonary artery (LPA), in the RPA at the first branch of the RPA and in the LPA at the first branch of the LPA.
Humic substances possess distinctive chemical features enabling their use in many advanced applications, including biomedical fields. No chemicals in nature have the same combination of specific chemical and biological properties as humic substances. Traditional medicine and modern research have demonstrated that humic substances from different sources possess immunomodulatory and anti-inflammatory properties, which makes them suitable for the prevention and treatment of chronic dermatoses, allergic rhinitis, atopic dermatitis, and other conditions characterized by inflammatory and allergic responses [1-4]. The use of humic compounds as agentswith antifungal and antiviral properties shows great potential [5-7].
This study presents the concept of AstroBioLab, an autonomous astrobiological field laboratory tailored for the exploration of (sub)glacial habitats. AstroBioLab is an integral component of the TRIPLE (Technologies for Rapid Ice Penetration and subglacial Lake Exploration) DLR-funded project, aimed at advancing astrobiology research through the development and deployment of innovative technologies. AstroBioLab integrates diverse measurement techniques such as fluorescence microscopy, DNA sequencing and fluorescence spectrometry, while leveraging microfluidics for efficient sample delivery and preparation.
This easy-to-understand introduction to SAP S/4HANA guides you through the central processes in sales, purchasing and procurement, finance, production, and warehouse management using the model company Global Bike. Familiarize yourself with the basics of business administration, the relevant organizational data, master data, and transactional data, as well as a selection of core business processes in SAP. Using practical examples and tutorials, you will soon become an SAP S/4HANA professional!
Tutorials and exercises for beginners, advanced users, and experts make it easy for you to practice your new knowledge. The prerequisite for this book is access to an SAP S/4HANA client with Global Bike version 4.1.
- Business fundamentals and processes in the SAP system
- Sales, purchasing and procurement, production, finance, and warehouse management
- Tutorials at different qualification levels, exercises, and recap of case studies
- Includes extensive download material for students, lecturers, and professors