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Für Fachangestellte für Medien- und Informationsdienste (FaMIs) ist berufsbegleitendes Studieren eine erfolgreiche Maßnahme zur Höherqualifizierung. Bibliotheken können ihrerseits im Rahmen der Personalentwicklung mit der Unterstützung von studierenden Mitarbeitenden dem Fachkräftemangel entgegenwirken. Der Beitrag stellt die Personalentwicklungsmaßnahme am Beispiel des Bachelor-Studiengangs „Informationsmanagement – berufsbegleitend“ der Hochschule Hannover vor. Es werden Informationen aus der Beratungspraxis dargelegt und die mögliche Unterstützung durch die entsendenden Bibliotheken aufgezeigt.
This paper proposes an extended Petri net formalism as a suitable language for composing optimal scheduling problems of industrial production processes with real and binary decision variables. The proposed approach is modular and scalable, as the overall process dynamics and constraints can be collected by parsing of all atomic elements of the net graph. To conclude, we demonstrate the use of this framework for modeling the moulding sand preparation process of a real foundry plant.
A semiparametric approach for meta-analysis of diagnostic accuracy studies with multiple cut-offs
(2022)
The accuracy of a diagnostic test is often expressed using a pair of measures: sensitivity (proportion of test positives among all individuals with target condition) and specificity (proportion of test negatives among all individuals without targetcondition). If the outcome of a diagnostic test is binary, results from different studies can easily be summarized in a meta-analysis. However, if the diagnostic test is based on a discrete or continuous measure (e.g., a biomarker), several cut-offs within one study as well as among different studies are published. Instead of taking all information of the cut-offs into account in the meta-analysis, a single cut-off per study is often selected arbitrarily for the analysis, even though there are statistical methods for the incorporation of several cut-offs. For these methods, distributional assumptions have to be met and/or the models may not converge when specific data structures occur. We propose a semiparametric approach to overcome both problems. Our simulation study shows that the diagnostic accuracy is underestimated, although this underestimation in sensitivity and specificity is relatively small. The comparative approach of Steinhauser et al. is better in terms of coverage probability, but may lead to convergence problems. In addition to the simulation results, we illustrate the application of the semiparametric approach using a published meta-analysis for a diagnostic test differentiating between bacterial and viral meningitis in children.
Dramatic increases in the number of cyber security attacks and breaches toward businesses and organizations have been experienced in recent years. The negative impacts of these breaches not only cause the stealing and compromising of sensitive information, malfunctioning of network devices, disruption of everyday operations, financial damage to the attacked business or organization itself, but also may navigate to peer businesses/organizations in the same industry. Therefore, prevention and early detection of these attacks play a significant role in the continuity of operations in IT-dependent organizations. At the same time detection of various types of attacks has become extremely difficult as attacks get more sophisticated, distributed and enabled by Artificial Intelligence (AI). Detection and handling of these attacks require sophisticated intrusion detection systems which run on powerful hardware and are administered by highly experienced security staff. Yet, these resources are costly to employ, especially for small and medium-sized enterprises (SMEs). To address these issues, we developed an architecture -within the GLACIER project- that can be realized as an in-house operated Security Information Event Management (SIEM) system for SMEs. It is affordable for SMEs as it is solely based on free and open-source components and thus does not require any licensing fees. Moreover, it is a Self-Contained System (SCS) and does not require too much management effort. It requires short configuration and learning phases after which it can be self-contained as long as the monitored infrastructure is stable (apart from a reaction to the generated alerts which may be outsourced to a service provider in SMEs, if necessary). Another main benefit of this system is to supply data to advanced detection algorithms, such as multidimensional analysis algorithms, in addition to traditional SIEMspecific tasks like data collection, normalization, enrichment, and storage. It supports the application of novel methods to detect security-related anomalies. The most distinct feature of this system that differentiates it from similar solutions in the market is its user feedback capability. Detected anomalies are displayed in a Graphical User Interface (GUI) to the security staff who are allowed to give feedback for anomalies. Subsequently, this feedback is utilized to fine-tune the anomaly detection algorithm. In addition, this GUI also provides access to network actors for quick incident responses. The system in general is suitable for both Information Technology (IT) and Operational Technology (OT) environments, while the detection algorithm must be specifically trained for each of these environments individually.
Rich literature abounds concerning the clinical effectiveness of programs aiming to produce weight gain/obesity prevention outcomes. However, there is very little evidence on how these outcomes are produced, and what interplay of factors made those programs effective (or not) in the environment that produced those effects. This study aims to describe the application of realistic evaluation in the field of obesity prevention, as an approach to unravel those components that influence the capacity of a program to produce its effects and to examine its significance in an effort to understand those components. The concepts of critical realism have informed the development of an interview topic guide, while three European programs were selected as case studies after a rigorous selection process. In total, 26 in-depth semi-structured interviews were taken, paired with personal observation and secondary data research. Several grounded context-mechanisms-outcomes (CMO) configurations were described within the respective context of each location, with the mechanisms introduced from each project resulting in distinctive outcomes. This study highlights the potential of realistic evaluation as a comprehensive framework to explain in which contextual circumstances of each program’s effects are produced, how certain underlying mechanisms produce those effects, and how to explicitly connect the context and the acting mechanisms into distinct outcome patterns, which will ultimately form unique configuration sets for each of the analyzed projects.
Complex Event Processing (CEP) is a modern software technology for the dynamic analysis of continuous data streams. CEP is able of searching extremely large data streams in real time for the presence of event patterns. So far, specifying event patterns of CEP rules is still a manual task based on the expertise of domain experts. This paper presents a novel batinspired swarm algorithm for automatically mining CEP rule patterns that express the relevant causal and temporal relations hidden in data streams. The basic suitability and performance of the approach is proven by extensive evaluation with both synthetically generated data and real data from the traffic domain.
Catholic Ownership, Physician Leadership and Operational Strategies: Evidence from German Hospitals
(2022)
Previous research has revealed that Catholic hospitals are more likely follow a strategy of horizontal diversification and maximization of the number of patients treated, whereas Protestant hospitals follow a strategy of horizontal specialization and focus on vertical differentiation. However, there is no empirical evidence pertaining to this mechanism. We conduct an empirical study in a German setting and argue that physician leadership mediates the relationship between ownership and operational strategies. The study includes the construction of a model combining data from a survey and publicly available information derived from the annual quality reports of German hospitals. Our results show that Catholic hospitals opt for leadership structures that ensure operational strategies in line with their general values, i.e., operational strategies of maximizing volume throughout the overall hospital. They prefer part-time positions for chief medical officers, as chief medical officers are identified to foster strategies of maximizing the overall number of patients treated. Hospital owners should be aware that the implementation of part-time and full-time leadership roles can help to support their strategies. Thus, our results provide insights into the relationship between leadership structures at the top of an organization, on the one hand, and strategic choices, on the other.
Background and Objectives:
Drawing causal conclusions from real-world data (RWD) poses methodological challenges and risk of bias. We aimed to systematically assess the type and impact of potential biases that may occur when analyzing RWD using the case of progressive ovarian cancer.
Methods:
We retrospectively compared overall survival with and without second-line chemotherapy (LOT2) using electronic medical records. Potential biases were determined using directed acyclic graphs. We followed a stepwise analytic approach ranging from crude analysis and multivariable-adjusted Cox model up to a full causal analysis using a marginal structural Cox model with replicates emulating a reference randomized controlled trial (RCT). To assess biases, we compared effect estimates (hazard ratios [HRs]) of each approach to the
HR of the reference trial.
Results:
The reference trial showed an HR for second line vs. delayed therapy of 1.01 (95% confidence interval [95% CI]: 0.82e1.25). The corresponding HRs from the RWD analysis ranged from 0.51 for simple baseline adjustments to 1.41 (95% CI: 1.22e1.64) accounting for immortal time bias with time-varying covariates. Causal trial emulation yielded an HR of 1.12 (95% CI: 0.96e1.28).
Conclusion:
Our study, using ovarian cancer as an example, shows the importance of a thorough causal design and analysis if one is expecting RWD to emulate clinical trial results.
To optimise udder health at the herd level, identifying incurable mastitis cases as well as providing an adequate therapy and culling strategy are necessary. Cows with clinical mastitis should be administered antibiotic medication if it is most likely to improve mammary cure. The somatic cell count (SCC) in milk of the monthly implemented Dairy Herd Improvement (DHI) test represents the most important tool to decide whether a cow has a promising mammary cure rate. Differential cell count (DCC) facilitates the specification of the immunological ability of defence, for example by characterising leukocyte subpopulations or cell viability. The aim of this study was to assess the DCC and cell viability in DHI milk samples regarding the cytological (CC) and bacteriological cure (BC) of the udder within a longitudinal study, thereby gaining a predictive evaluation of whether a clinical mastitis benefits from an antibiotic treatment or not. The cows enrolled in this study had an SCC above 200,000 cells/mL in the previous DHI test. Study 1 assessed the CC by reference to the SCC of two consecutive DHI tests and included 1010 milk samples: 28.4% of the mammary glands were classified as cytologically cured and 71.6% as uncured. The final mixed logistic regression model identified the total number of non-vital cells as a significant factor associated with CC. An increasing amount of non-vital cells was related to a lower individual ability for CC. Cows which were in the first or second lactation possessed a higher probability of CC than cows having a lactation number above two. If animals developed a clinical mastitis after flow cytometric investigation, the BC was examined in study 2 by analysing quarter foremilk samples microbiologically. Taking 48 milk samples, 81.3% of the mammary glands were classified as bacteriologically cured and 18.7% as uncured. The percentage of total non-vital cells tended to be lower for cows which were cured, but no significance could be observed. This study revealed that the investigation of the proportion of non-vital cells in DHI milk samples can enhance the prognosis of whether an antibiotic treatment of clinical mastitis might be promising or not. Prospectively, this tool may be integrated in the DHI tests to facilitate the decision between therapy or culling.
Aim:
The most suitable method for assessment of response to peptide receptor radionuclide therapy (PRRT) of neuroendocrine tumors (NET) is still under debate. In this study we aimed to compare size (RECIST 1.1), density (Choi), Standardized Uptake Value (SUV) and a newly defined ZP combined parameter derived from Somatostatin Receptor (SSR) PET/CT for prediction of both response to PRRT and overall survival (OS).
Material and Methods:
Thirty-four NET patients with progressive disease (F:M 23:11; mean age 61.2 y; SD ± 12) treated with PRRT using either Lu-177 DOTATOC or Lu-177 DOTATATE and imaged with Ga-68 SSR PET/CT approximately 10–12 weeks prior to and after each treatment cycle were retrospectively analyzed. Median duration of follow-up after the first cycle was 63.9 months (range 6.2–86.2). A total of 77 lesions (2–8 per patient) were analyzed. Response assessment was performed according to RECIST 1.1, Choi and modified EORTC (MORE) criteria. In addition, a new parameter named ZP, the product of Hounsfield unit (HU) and SUVmean (Standard Uptake Value) of a tumor lesion, was tested. Further, SUV values (max and mean) of the tumor were normalized to SUV of normal liver parenchyma. Tumor response was defined as CR, PR, or SD. Gold standard for comparison of baseline parameters for prediction of response of individual target lesions to PRRT was change in size of lesions according to RECIST 1.1. For prediction of overall survival, the response after the first and second PRRT were tested.
Results:
Based on RECIST 1.1, Choi, MORE, and ZP, 85.3%, 64.7%, 61.8%, and 70.6% achieved a response whereas 14.7%, 35.3%, 38.2%, and 29.4% demonstrated PD (progressive disease), respectively. Baseline ZP and ZPnormalized were found to be the only parameters predictive of lesion progression after three PRRT cycles (AUC ZP 0.753; 95% CI 0.6–0.9, p 0.037; AUC ZPnormalized 0.766; 95% CI 0.6–0.9; p 0.029). Based on a cut-off-value of 1201, ZP achieved a sensitivity of 86% and a specificity of 67%, while ZPnormalized reached a sensitivity of 86% and a specificity of 76% at a cut-off-value of 198. Median OS in the total cohort was not reached. In univariate analysis amongst all parameters, only patients having progressive disease according to MORE after the second cycle of PRRT were found to have significantly shorter overall survival (median OS in objective responders not reached, in PD 29.2 months; p 0.015). Patients progressive after two cycles of PRRT according to ZP had shorter OS compared to those responding (median OS for responders not reached, for PD 47.2 months, p 0.066).
Conclusions:
In this explorative study, we showed that Choi, RECIST 1.1, and SUVmax-based response evaluation varied significantly from each other. Only patients showing progressive disease after two PRRT cycles according to MORE criteria had a worse prognosis while baseline ZP and
ZPnormalized performed best in predicting lesion progression after three cycles of PRRT.
Continuous Fiber-Reinforced Material Extrusion with Hybrid Composites of Carbon and Aramid Fibers
(2022)
An existing challenge in the use of continuous fiber reinforcements in additively manufactured parts is the limited availability of suitable fiber materials. This leads to a reduced adaptability of the mechanical properties to the load case. The increased design freedom of additive manufacturing allows the flexible deposition of fiber strands at defined positions, so that even different fiber materials can be easily combined in a printed part. In this work, therefore, an approach is taken to combine carbon and aramid fibers in printed composite parts to investigate their effects on mechanical properties. For this purpose, tensile, flexural and impact tests were performed on printed composite parts made of carbon and aramid fibers in a nylon matrix with five different mixing ratios. The tests showed that the use of hybrid composites for additive manufacturing is a reasonable approach to adapt the mechanical properties to the loading case at hand. The experiments showed that increasing the aramid fiber content resulted in an increase in impact strength, but a decrease in tensile and flexural strength and a decrease in stiffness. Microstructural investigations of the fracture surfaces showed that debonding and delamination were the main failure mechanisms. Finally, Rule of Hybrid Mixture equations were applied to predict the mechanical properties at different mixture ratios. This resulted in predicted values that differed from the experimentally determined values by an average of 5.6%.
Durch die Covid-19-Pandemie und die damit einhergehenden Effekte auf die Arbeitswelt ist die Belastung der Mitarbeitenden in einen stärkeren Fokus gerückt worden. Dieser Umstand trifft unter anderem durch den umfassenden Wechsel in die Remote Work auch auf agile Software-Entwicklungsteams in vielen Unternehmen zu. Eine zu hohe Arbeitsbelastung kann zu diversen negativen Effekten, wie einem erhöhten Krankenstand, mangelndem Wohlbefinden der Mitarbeitenden oder reduzierter Produktivität führen. Es ist zudem bekannt, dass sich die Arbeitsbelastung in der Wissensarbeit auf die Qualität der Arbeitsergebnisse auswirkt. Dieser Forschungsbeitrag identifiziert potenzielle Faktoren der Arbeitsbelastung der Mitglieder eines agilen Software-Entwicklungsteams bei der Otto GmbH & Co KG. Auf der Grundlage der Faktoren präsentieren wir Maßnahmen zur Reduzierung von Arbeitsbelastung und erläutern unsere Erkenntnisse, die wir im Rahmen eines Experiments validiert haben. Unsere Ergebnisse zeigen, dass bereits kleinteilige Maßnahmen, wie das Einführen von Ruhearbeitsphasen während des Arbeitstages, zu positiven Effekten bspw. hinsichtlich einer gesteigerten Konzentrationsfähigkeit führen und wie sich diese auf die Qualität der Arbeitsergebnisse auswirken.
As part of the European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT), a webinar on the topic “Mastitis Treatment in Lactation” was held, in which eight mastitis experts from different European countries (Spain, The Netherlands, Estonia, Ireland, Poland, Finland, Germany, and Italy) presented their treatment approaches for clinical mastitis in lactation. The aim of this study was to compare the therapeutic approaches to identify commonalities and differences. In all eight participating countries, the decision to start treatment is usually made by the veterinarians, while the farm personnel are responsible for treatment administration. Antibiotic treatment is then typically administered intramammarily. The treatment duration often depends on the label instructions and is frequently extended if Staphylococcus aureus or Streptococcus uberis is involved. Administering supportive therapy, especially non-steroidal anti-inflammatory drugs (NSAIDs) is an established practice in all countries. Penicillin is the first-choice drug for the treatment of mastitis in an increasing number of countries. The use of critically important antimicrobials (CIAs) such as quinolones and third- and fourth-generation cephalosporins is at a low level in Finland and The Netherlands. In Estonia, Germany, Italy, and Spain, the use of CIAs is declining and is only allowed if milk samples are analyzed in advance following the legal framework. Systems for monitoring antibiotic use are being introduced in more and more countries. This exchange of different views will help the European countries to move towards a common high standard of antimicrobial stewardship in veterinary medicine.
Coaxial Laser wire Direct Energy Deposition (L-DED) promises a direction-independent buildup due to a centric supply of the welding material. To fabricate Functionally Graded Materials (FGMs), a processing head was designed that is capable of supplying two wire materials into the processing zone. This study investigates the direction dependency of welding seams produced by two 1.4718 metal wires with a diameter of 0.8 mm in a coaxial laser setup using three separately controllable single laser beams with a maximum combined laser power of 660 W. The welding wires are supplied simultaneously to the laser spot under an incidence angle of 3.5° to the middle axis of the processing head. The seam geometry is investigated using a confocal laserscanning-microscope. A comparison of the height, width and macroscopic seam geometry reveals the influence of the welding direction on the seam geometry and quality in Laser Double wire Direct Energy Deposition (LD-DED).
Objective
Cyberknife robotic radiosurgery (RRS) provides single-session high-dose radiotherapy of brain tumors with a steep dose gradient and precise real-time image-guided motion correction. Although RRS appears to cause more radiation necrosis (RN), the radiometabolic changes after RRS have not been fully clarified. 18F-FET-PET/CT is used to differentiate recurrent tumor (RT) from RN after radiosurgery when MRI findings are indecisive. We explored the usefulness of dynamic parameters derived from 18F-FET PET in differentiating RT from RN after Cyberknife treatment in a single-center study population.
Methods
We retrospectively identified brain tumor patients with static and dynamic 18F-FET-PET/CT for suspected RN after Cyberknife. Static (tumor-to-background ratio) and dynamic PET parameters (time-activity curve, time-to-peak) were quantified. Analyses were performed for all lesions taken together (TOTAL) and for brain metastases only (METS). Diagnostic accuracy of PET parameters (using mean tumor-to-background ratio >1.95 and time-to-peak of 20 min for RT as cut-offs) and their respective improvement of diagnostic probability were analyzed.
Results
Fourteen patients with 28 brain tumors were included in quantitative analysis. Time-activity curves alone provided the highest sensitivities (TOTAL: 95%, METS: 100%) at the cost of specificity (TOTAL: 50%, METS: 57%). Combined mean tumor-to-background ratio and time-activity curve had the highest specificities (TOTAL: 63%, METS: 71%) and led to the highest increase in diagnosis probability of up to 16% p. – versus 5% p. when only static parameters were used.
Conclusions
This preliminary study shows that combined dynamic and static 18F-FET PET/CT parameters can be used in differentiating RT from RN after RRS.
The optimization of lubricated sealing systems with respect to the stick-slip effect requires a friction model that describes the complex friction behavior in the lubricated contact area. This paper presents an efficient dynamic friction model based on the Stribeck curve, which allows to investigate the influencing parameters through finite element (FE) simulations. The simulation of a tribometer test using this friction model proofs that the model correlates well with the tribometer test results. It is shown that the system stiffness has a significant influence on the stick-slip tendency of the system.
Growing up in high-risk environments is detrimental to children’s development of attachment security. Parenting behavior is hypothesized to be the mechanism through which risks exert their influence. However, risk influences can vary between individuals by gender. Aim of this study was to explore specific pathways of family risk on early attachment security and additionally examine the transmission via parenting behavior. The sample consisted of 197 children and their primary caregivers. Children’s age ranged between 10 and 21 months (M = 15.25, SD = 3.59). Data assessment included 21 distal and proximal family risk factors, children’s attachment security, and parental responsivity and supportive presence. Whereas distal risk factors had an adverse effect only on girls’ attachment security, proximal risks negatively affected only boys’ attachment security. Additionally, patterns of risk factors occurring in our sample were analyzed using an exploratory principal component analysis. Regardless of the child’s gender, a low socio-economic status was negatively related to attachment security of all children. Migration and crowding and a high emotional load of the primary caregiver both negatively predicted girls’ but not boys’ attachment security. However, the attachment security of boys was affected by a negative family climate. Most of the adverse risk effects on attachment security were mediated by parental responsivity and supportive presence so that the transmission of risk occurs through parenting behavior. Results revealed a different susceptibility of family risks for girls and boys. The consideration of a gender-sensitive approach in developmental psychopathology and interventions of developmental child welfare services is recommended.
Aim
Musculoskeletal disorders are a major public health problem in most developed countries. As a main cause of chronic pain, they have resulted in an increasing prescription of opioids worldwide. With regard to the situation in Germany, this study aimed at estimating the prevalence of musculoskeletal diseases such as chronic low back pain (CLBP) and hip/knee osteoarthritis (OA) and at depicting the applied treatment patterns.
Subject and methods
German claims data from the InGef Research Database were analyzed over a 6-year period (2011–2016). The dataset contains over 4 million people, enrolled in German statutory health insurances. Inpatient and outpatient diagnoses were considered for case identification of hip/knee OA and CLBP. The World Health Organization (WHO) analgesic ladder was applied to categorize patients according to their pain management interventions. Information on demographics, comorbidities, and adjuvant medication was collected.
Results
In 2016, n = 2,693,481 individuals (50.5% female, 49.5% male) were assigned to the study population; 62.5% of them were aged 18–60 years. In 2016, n = 146,443 patients (5.4%) with CLBP and n = 307,256 patients (11.4%) with hip/knee OA were identified. Of those with pre-specified pain management interventions (CLBP: 66.3%; hip/knee OA: 65.1%), most patients received WHO I class drugs (CLBP: 73.6%; hip/knee OA: 68.7%) as the highest level.
Conclusion
This study provides indications that CLBP and hip/knee OA are common chronic pain conditions in Germany, which are often subjected to pharmacological pain management. Compared to non-opioid analgesic prescriptions of the WHO I class, the dispensation of WHO class II and III opioids was markedly lower, though present to a considerable extent.
Der Heilberuf Pflege mit seinem am Zentralwert Gesundheit ausgerichteten gesellschaftlichen Mandat ist mit definierten Vorbehaltsaufgaben betraut und gesetzlich legitimiert. Pflegefachpersonen als Vertreter*innen der Berufsgruppe obliegt eine spezifische professionelle Verantwortung. Um ihrem gesetzlich definierten Auftrag in beruflicher Autonomie und Eigenverantwortung verlässlich zu entsprechen, verpflichten sich Pflegefachpersonen einem gemeinsam konsentierten und verbindlichen Berufsethos, das über Landesgrenzen hinaus weltweit akzeptiert ist: Der ICN-Ethikkodex ist international für 20 Mio. Pflegefachpersonen gültig und von den nationalen Kammern oder berufsständischen Vertretungen in 130 Ländern ratifiziert. Gesellschaftliche Entwicklungen und daran gebundene Innovations- und Transformationsbedarfe in der Pflege machen auch in Deutschland die dauerhafte Etablierung von Pflegekammern unausweichlich. Das Fehlen einer berufsständischen Vertretung der Pflege im Bereich der sozialrechtlichen Selbstverwaltung des Gesundheitswesens stellt ein Risiko für die Versorgungssicherheit und Versorgungsqualität der Bevölkerung dar. Die Aufgaben von Pflegekammern werden hinsichtlich ihrer gesellschaftlichen Relevanz und ihres professionsethischen Auftrags in Anlehnung an den Ethikkodex des International Council of Nurses (ICN) erläutert.
Background
Systematic reviews demonstrated that gait variables are the most reliable predictors of future falls, yet are rarely included in fall screening tools. Thus, most tools have higher specificity than sensitivity, hence may be misleading/detrimental to care. Therefore, this study aimed to determine the validity, and reliability of the velocity field diagram (VFD -a gait analytical tool), and the Timed-up-and-go test (TUG)-commonly used in Nigeria as fall screening tools, compared to a gold standard (known fallers) among community-dwelling older adults.
Method
This is a cross-sectional observational study of 500 older adults (280 fallers and 220 non-fallers), recruited by convenience sampling technique at community health fora on fall prevention. Participants completed a 7-m distance with the number of steps and time it took determined and used to compute the stride length, stride frequency, and velocity, which regression lines formed the VFD. TUG test was simultaneously conducted to discriminate fallers from non-fallers. The cut-off points for falls were: TUG times ≥ 13.5 s; VFD’s intersection point of the stride frequency, and velocity regression lines (E1) ≥ 3.5velots. The receiver operating characteristic (ROC) area under the curves (AUC) was used to explore the ability of the E1 ≥ 3.5velots to discriminate between fallers and non-fallers. The VFD’s and TUG’s sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. Alpha was set at p < 0.05.
Results
The VFD versus TUG sensitivity, specificity, PPV and NPV were 71%, 27%, 55%, and 42%, versus 39%, 59%, 55%, and 43%, respectively. The ROC’s AUC were 0.74(95%CI:0.597,0.882, p = 0.001) for the VFD. The optimal categorizations for discrimination between fallers/non-fallers were ≥ 3.78 versus ≤ 3.78 for VFD (fallers versus non-fallers prevalence is 60.71% versus 95.45%, respectively), with a classification accuracy or prediction rate of 0.76 unlike TUG with AUC = 0.53 (95% CI:0.353,0.700, p = 0.762), and a classification accuracy of 0.68, and optimal characterization of ≥ 12.81 s versus ≤ 12.81 (fallers and non-fallers prevalence = 92.86% versus 36.36%, respectively).
Conclusion
The VFD demonstrated a fair discriminatory power and greater reliability in identifying fallers than the TUG, and therefore, could replace the TUG as a primary tool in screening those at risk of falls.
Background: Upsurge in cardiopulmonary dysfunctions in Enugu, Nigeria, involved mainly cement workers, automobile spray painters, woodworkers, and Cleaners and was worsened in the dry season, suggesting the need for an occupation-specific characterization of the disease features and seasonal evaluation of air quality for prevention and management.
Methods: We conducted a randomized cross-sectional study of eighty consenting participants (in Achara Layout, Enugu), comprising 20 cement workers (39.50 ± 14.95 years), 20 automobile spray painters (40.75 ± 9.85 years), 20 woodworkers (52.20 ± 9.77 years), and 20 cleaners (42.30 ± 9.06 years). The air quality, some haematological (fibrinogen-Fc, and C-reactive protein-CRP), and cardiopulmonary parameters were measured and analyzed using ANCOVA, at p < 0.05.
Results: The dry season particulate matter (PM) in ambient air exceeded the WHO standards in the New layout [PM10 = 541.17 ± 258.72 µg/m3; PM2.5 = 72.92 ± 25.81 µg/m3] and the University campus [PM10 = 244 ± 74.79 µg/m3; PM2.5 = 30.33 ± 16.10 µg/m3], but the former was twice higher. The PM differed significantly (p < 0.05) across the sites. Forced expiratory volume at the first second (FEV1) (F = 6.128; p = 0.001), and Peak expiratory flow rate (PEFR) (F = 5.523; p = 0.002), differed significantly across the groups. FEV1/FVC% was < 70% in cement workers (55.33%) and woodworkers (61.79%), unlike, automobile spray painters (72.22%) and cleaners (70.66%). FEV1 and work duration were significantly and negatively related in cement workers (r = -0.46; r2 = 0.2116; p = 0.041 one-tailed). CRP (normal range ≤ 3.0 mg/L) and Fc (normal range—1.5–3.0 g/L) varied in cement workers (3.32 ± 0.93 mg/L versus 3.01 ± 0.85 g/L), automobile spray painters (2.90 ± 1.19 mg/L versus 2.54 ± 0.99 mg/L), woodworkers (2.79 ± 1.10 mg/L versus 2.37 ± 0.92 g/L) and cleaners (3.06 ± 0.82 mg/L versus 2.54 ± 0.70 g/L).
Conclusion(s): Poor air quality was evident at the study sites, especially in the dry season. Cement workers and automobile spray painters showed significant risks of obstructive pulmonary diseases while woodworkers had restrictive lung diseases. Cement workers and cleaners recorded the highest risk of coronary heart disease (CRP ≥ 3.0 mg/L). The similarity in Fc and CRP trends suggests a role for the inflammation-sensitive proteins in the determination of cardiovascular risk in cement workers and cleaners. Therefore, there are occupation-specific disease endpoints of public health concern that likewise warrant specific preventive and management approaches among the workers.
Severe mastitis can lead to considerable disturbances in the cows’ general condition and even to septicemia and death. The aim of this cross-sectional study was to identify factors associated with the severity of the clinical expression of mastitis. Streptococcus (Str.) uberis (29.9%) was the most frequently isolated pathogen, followed by coliform bacteria (22.3%). The majority of all mastitis cases (n = 854) in this study were either mild or moderate, but 21.1% were severe. It can be deduced that the combination of coliform pathogens and increasing pathogen shedding of these showed associations with severe mastitis. Furthermore, animal-related factors associated with severe disease progression were stages of lactation, and previous diseases in the period prior to the mastitis episode. Cows in early lactation had more severe mastitis. Ketosis and uterine diseases in temporal relation to the mastitis were associated with more severe mastitis in the diseased cows. Hypocalcemia was significantly associated with milder mastitis. As another factor, treatment with corticosteroids within two weeks before mastitis was associated with higher severity of mastitis. Knowledge of these risk factors may provide the basis for randomized controlled trials of the exact influence of these on the severity of mastitis.
Family risks are known to be detrimental to children’s attachment development. This study investigated whether parental sensitivity plays different roles in early attachment development in the context of risk: Sensitivity was hypothesized to mediate risk effects on attachment, as well as a moderator that shapes the relation between risk and attachment. Multiple family risks, parental sensitivity (defined as responsivity and supportive presence), and children’s attachment security of 197 infants and toddlers (Mage = 15.25 months) and their caregivers were assessed in a prospective study with a cohort-sequential-design in Germany. Caregivers’ sensitivity served as a mediator of risk effects on attachment as well as a moderator that buffers adverse consequences of risk. Early sensitivity might be relevant in setting the stage for attachment development supporting resilience.
Milk concentrates are used in the manufacturing of dairy products such as yogurt and cheese or are processed into milk powder. Processes for the nonthermal separation of water and valuable milk ingredients are becoming increasingly widespread at farm level. The technical barriers to using farm-manufactured milk concentrate in dairies are minimal, hence the suspicion that the practice of on-farm raw milk concentration is still fairly uncommon for economic reasons. This study, therefore, set out to investigate farmers’ potential willingness to adopt a raw milk concentration plant. The empirical analysis was based on discrete choice experiments with 75 German dairy farmers to identify preferences and the possible adoption of on-farm raw milk concentration. The results showed that, in particular, farmers who deemed the current milk price to be insufficient viewed on-farm concentration using membrane technology as an option for diversifying their milk sales. We found no indication that adoption would be impeded by a lack of trustworthy information on milk processing technologies or capital.
Die technische Betreuung von Produktionsanlagen durch den Anlagenhersteller oder einen Dienstleister ist in der Industrie häufig anzutreffen. Die Durchführung solcher Wartungsarbeiten erfolgt zum Großteil vor Ort an der jeweiligen Anlage. Mit der Fernwartung gibt es jedoch die Möglichkeit, die jeweiligen Arbeiten aus der Ferne durchzuführen. Unternehmen stellen sich bei der Einrichtung einer Fernwartungslösung die Frage, wie ein solches System zu planen ist. Der vorliegende Artikel beleuchtet daher, welche Anforderungen an Fernwartungssysteme zu stellen sind, welche Fernwartungskonzepte es gibt, was allgemein bei dem Einsatz eines Fernwartungssystems insbesondere aus Sicht der OT-Security zu beachten ist und wie die NOA Verification of Request bei der Fernwartung einzusetzen ist.
FID Civil Engineering, Architecture and Urbanism digital - A platform for science (BAUdigital)
(2022)
University Library Braunschweig (UB Braunschweig), University and State Library Darmstadt (ULB Darmstadt), TIB – Leibniz Information Centre for Technology and Natural Sciences and the Fraunhofer Information Centre for Planning and Building (Fraunhofer IRB) are jointly establishing a specialised information service (FID, "Fachinformationsdienst") for the disciplines of civil engineering, architecture and urbanism. The FID BAUdigital, which is funded by the German Research Foundation (DFG, "Deutsche Forschungsgemeinschaft"), will provide researchers working on digital design, planning and production methods in construction engineering with a joint information, networking and data exchange platform and support them with innovative services for documentation, archiving and publication in their data-based research.
Der Beitrag stellt Ergebnisse der Fachgruppe Informationskompetenz der KIBA vor, in der alle Lehrenden im Bereich der Vermittlung von Medien- und Informationskompetenz an bibliotheks- und informationswissenschaftlichen Studiengängen in Deutschland zusammenarbeiten. Ausgangspunkt ist das „Framework Informationskompetenz“, ein Anforderungsrahmen, der gemeinsame Standards in der Qualifikation von Studierenden der Bibliotheks- und Informationswissenschaft für das Aufgabenfeld der Förderung von Informationskompetenz sichern soll. Es wird aufgezeigt, wie die in diesem Rahmenmodell formulierten Qualifikationsstandards in den verschiedenen Studiengängen umgesetzt werden und wo es bedarfsbezogene Ausprägung und Gewichtung in den Qualifikationszielen gibt.
Die Sozialarbeiterin Yildiz Sahinde Demirer hat mit anderen Frauen das Projekt „Erzählcafés für geflüchtete Frauen“ in Trägerschaft der Landeshauptstadt Hannover (2018 bis 2021) konzipiert und umgesetzt. In fünf Stadtteilen konnten sich die Frauen regelmäßig treffen und austauschen, sich beteiligen und kamen zu Wort. Ihre Arbeit bezeichnet Demirer als Gemeinwesenarbeit mit politischen und feministischen Schwerpunkten. Die wissenschaftliche Begleitung durch Rebecca Hassan und Joachim Romppel von der Hochschule Hannover führte zur Dokumentation und Auswertung des Modellprojekts. Das Bundesamt für Migration und Flüchtlinge (BAMF) förderte das Projekt. Bemerkenswert sind die Erfolge dieser nonformalen Bildungsarbeit.
Junge Menschen of Color sind von Kriminalisierung betroffen. Dieser Artikel widmet sich der Frage, wie die Soziale Arbeit im Kontext institutioneller Fremdunterbringung durch die Ubiquität von nationalen Grenzen und durch Polizeipraktiken gerahmt wird. Es wird empirisch nachgezeichnet, dass Racial Profiling sich über ritualhafte Wiederholungen manifestiert. Es zeigt sich, dass der formale Charakter der sog. gefährlichen, als kriminogen klassifizierten Orte über informelle Polizeipraktiken auf Organisationen der Jugendhilfe übertragen wird.
Background
Symptoms of depression are prevalent in people living with human immune deficiency virus/acquired immune deficiency syndrome (PLWHA), and worsened by lack of physical activity/exercises, leading to restriction in social participation/functioning. This raises the question: what is the extent to which physical exercise training affected, symptoms of depression, physical activity level (PAL) and social participation in PLWHA compared to other forms of intervention, usual care, or no treatment controls?
Method
Eight databases were searched up to July 2020, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) protocol. Only randomised controlled trials involving adults who were either on HAART/HAART-naïve and reported in the English language, were included. Two independent reviewers determined the eligibility of the studies, extracted data, assessed their quality, and risk of bias using the Physiotherapy Evidence Database (PEDro) tool. Standardised mean difference (SMD) was used as summary statistics for the mean primary outcome (symptoms of depression) and secondary outcomes (PAL and social participation) since different measuring tools/units were used across the included studies. Summary estimates of effects were determined using a random-effects model (I2).
Results
Thirteen studies met the inclusion criteria with 779 participants (n = 596 participants at study completion) randomised into the study groups, comprising 378 males, 310 females and 91 participants with undisclosed gender, and with an age range of 18–86 years. Across the studies, aerobic or aerobic plus resistance exercises were performed 2–3 times/week, at 40–60 min/session, and for between 6-24 weeks, and the risk of bias vary from high to low. Comparing the intervention to control groups showed significant difference in the symptoms of depression (SMD = − 0.74, 95% confidence interval (CI) − 1.01, − 0.48, p ≤ 0.0002; I2 = 47%; 5 studies; 205 participants) unlike PAL (SMD = 0.98, 95% CI − 0.25, 2.17, p = 0.11; I2 = 82%; 2 studies; 62 participants) and social participation (SMD = 0.04, 95% CI − 0.65, 0.73, p = 0.91; I2 = 90%; 6 studies; 373 participants).
Conclusion
Physical exercise training could have an antidepressant-like effect in PLWHA but did not affect PAL and social participation. However, the high heterogeneity in the included studies, implies that adequately powered randomised controlled trials with clinical/methodological similarity are required in future studies.
Acute stroke care is a time-critical process. Improving communication
and documentation process may support a positive effect on medical outcome. To achieve this goal, a new system using a mobile application has been integrated into existing infrastructure at Hannover Medical School (MHH). Within a pilot project, this system has been brought into clinical daily routine in February 2022. Insights generated may support further applications in clinical use-cases.
Background: To improve interprofessional collaboration between registered nurses (RNs) and general practitioners (GPs) for nursing home residents (NHRs), the interprof ACT intervention package was developed. This complex intervention includes six components (e.g., shared goal setting, standardized procedures for GPs’ nursing home visits) that can be locally adapted. The cluster‑randomized interprof ACT trial evaluates the effects of this intervention on the cumulative incidence of hospital admissions (primary outcome) and secondary outcomes (e.g., length of hospital stays, utilization of emergency care services, and quality of life) within 12 months. It also includes a process evaluation which is subject of this protocol. The objectives of this evaluation are to assess the implementation of the interprof ACT intervention package and downstream effects on nurse–physician collaboration as well as preconditions and prospects for successive implementation into routine care.
Methods: This study uses a mixed methods triangulation design involving all 34 participating nursing homes (clusters). The quantitative part comprises paper‑based surveys among RNs, GPs, NHRs, and nursing home directors at baseline and 12 months. In the intervention group (17 clusters), data on the implementation of preplanned implementation strategies (training and supervision of nominated IPAVs, interprofessional kick‑off meetings) and local implementation activities will be recorded. Major outcome domains are the dose, reach and fidelity of the implementation of the intervention package, changes in interprofessional collaboration, and contextual factors. The qualitative part will be conducted in a subsample of 8 nursing homes (4 per study group) and includes repeated non‑participating observations and semistructured interviews on the interaction between involved health professionals and their work processes. Quantitative and qualitative data will be descriptively analyzed and then triangulated by means of joint displays and mixed methods informed regression models.
Discussion: By integrating a variety of qualitative and quantitative data sources, this process evaluation will allow comprehensive assessment of the implementation of the interprof ACT intervention package, the changes induced in interprofessional collaboration, and the influence of contextual factors. These data will reveal expected and unexpected changes in the procedures of interprofessional care delivery and thus facilitate accurate conclusions for the further design of routine care services for NHRs.
High-performance firms typically have two features in common: (i) they produce in more than one country and (ii) they produce more than one product. In this paper, we analyze the internationalization strategies of multi-product firms. Guided by several new stylized facts, we develop a theoretical model to determine optimal modes of market access at the firm–product level. We find that the most productive firmssell core varieties via foreign direct investment and export products with intermediate productivity. Shocks to trade costs and technology affect the endogenous decision to export or produce abroad at the product-level and, in turn, the relative productivity between parents and affiliates.
Corynebacterium spp. are frequently detected in bovine quarter milk samples, yet their impact on udder health has not been determined completely. In this longitudinal study, we collected quarter milk samples from a dairy herd of approximately 200 cows, ten times at 14 d intervals. Bacteriologically, Catalase-positive and Gram-positive rods were detected in 22.7% of the samples. For further species diagnosis, colonies were analyzed by MALDITOF MS. Corynebacterium bovis, C. amycolatum, C. xerosis and 10 other Corynebacterium spp. were detected. The three aforementioned species accounted for 88.4%, 8.65% and 0.94% of all cultured Corynebacterium spp., respectively. For further evaluation of infection dynamics, the following three infection definitions were applied: A (2/3 consecutive samples positive for the same species), B (≥1000 cfu/mL in one sample), C (isolated from a clinical mastitis case). Infections according to definition B occurred most frequently and clinical mastitis with Corynebacterium spp. occurred once during sampling. Life tables were used to determine the duration of infection. According to infection definition A, infection durations of 111 d and 98 d were obtained for C. bovis and C. amycolatum, respectively. Exemplarily, longer lasting infections were examined for their strain diversity by RAPD PCR. A low strain diversity was found in the individual quarters that indicates a longer colonization of the udder parenchyma by C. bovis and C. amycolatum.
Mein Beitrag versucht, die philosophischen und geschichtlichen Hintergründe eines zentralen Begriffs bei Saul D. Alinsky neu auszuleuchten, dem Begriff des Ressentiments. Alinsky, der Begründer des Community Organizing, hat bei der Organisation von Bürgergruppen versucht, vorhandene Ressentiments aufzulösen, indem er die zugrundeliegende Diskriminierungen artikulierbar macht, sie in politische Forderungen verwandelt, die schließlich in Verhandlungen umgesetzt werden. Er sah darin auch ein Verfahren, die Menschen vor falschen Agitatoren zu schützen.
Gutes Arbeiten für Mitarbeiter ist je nach Arbeitskontext unterschiedlich zu bewerten, hängt jedoch von der Gestaltung bestimmter Kontextfaktoren ab. Die Kontextfaktoren guter Arbeit sind der zentrale Forschungsgegenstand dieser Arbeit. Dabei steht ein E‑Commerce-Team (EC-Team) von Otto im Fokus der Untersuchungen.
Das Ziel unseres Artikels ist es, die Kontextfaktoren zu analysieren, die dazu führen, dass gute Arbeit ermöglicht wird. Dabei ist eine auf Dauer funktionierende Arbeitsweise gesucht, welche eine hohe Arbeitsqualität und -quantität ermöglicht. Dazu sind die beiden primären Ziele zu definieren, was gutes Arbeiten ausmacht und zum anderen die Kontextfaktoren für gutes Arbeiten innerhalb des EC-Teams bei Otto zu identifizieren.
Unsere Forschungsfrage lautet: Welche Kontextfaktoren sind für gutes Arbeiten bei Otto im EC-Team in der derzeitigen Remote-Arbeit besonders relevant und entsprechend gestaltbar?
Um die Forschungsfrage beantworten zu können, wird zunächst eine Literaturrecherche zur Definition von guter Arbeit vorgenommen. Anschließend wird untersucht, welche Faktoren laut Literatur zu einer guten Arbeit beitragen, um aus den resultierenden Faktoren Cluster zu bilden.
Die Cluster werden dem Otto EC-Team zur Abstimmung mit der Mehrpunktabfrage über das virtuelle Kollaborations-Tool MiroFootnote 2 zur Verfügung gestellt. Aufbauend auf dem Ergebnis der Abstimmung, werden ein Gamification Board, Erinnerungsmails und ein Stimmungsbarometer erstellt, um die Auswirkungen des Clusters im Rahmen eines Experiments zu analysieren.
Diese Maßnahmen werden innerhalb von zwei Wochen durchgeführt. Um die Erfahrungen der Probanden zu sammeln, werden anschließend Interviews durchgeführt und ausgewertet. Die Ergebnisse der Interviews fließen in die anschließende Handlungsempfehlung ein.
In a cross-sectional study, impact of management in dairy farms on calf mortality rates and prevalence of rotavirus and Cryptosporidium parvum in feces of calves was investigated. Sixty-two commercial dairy herds in Mecklenburg-Western Pomerania, Germany, were stratified selected in 2019. We performed in-person interviews and fecal specimens in samples of all-female calves of age 7 up to 21 days. Management data were documented on farm level. A Multiscreen Ag-ELISA was performed to determine rotavirus and Cryptosporidium parvum. Associations between two calf mortality rates, detection of C. parvum and rotavirus, and predictors were examined with GLM models. In farms with routine vaccination against respiratory diseases, 31-days mortality rate was 4.2% +/-1.26 compared to 7.6% +/-0.97 (p = 0.040) on non-vaccinating farms. Six-months mortality was lower in farms that continued feeding milk to calves during periods of diarrhea compared to farms that did not (6.9% +/-0.8 vs. 12.4% +/-2.3). In case of a routine shifting of calves from the calving box into calf boxes less C. parvum was detected compared to an individual moving of calves (33.3% +/-2.6 vs. 19.6% +/-5.3; p = 0.024). Our model confirms a positive association between occurrence of aqueous feces and frequency of detection of C. parvum (45.4% +/-23.6 vs. 21.4% +/-18.7; p < 0.001). Frequency of detection of rotavirus was lower in farms that reported a defined amount of applicated colostrum per calf than in farms that presented a range of colostrum instead of a defined amount. This study indicates the potential for mitigation of risk factors for mortality in calves.
We present a methodology based on mixed-integer nonlinear model predictive control for a real-time building energy management system in application to a single-family house with a combined heat and power (CHP) unit. The developed strategy successfully deals with the switching behavior of the system components as well as minimum admissible operating time constraints by use of a special switch-cost-aware rounding procedure. The quality of the presented solution is evaluated in comparison to the globally optimal dynamic programming method and conventional rule-based control strategy. Based on a real-world scenario, we show that our approach is more than real-time capable while maintaining high correspondence with the globally optimal solution. We achieve an average optimality gap of 2.5% compared to 20% for a conventional control approach, and are faster and more scalable than a dynamic programming approach.
We performed classical molecular dynamics simulations to model the scattering process of nitric oxide, NO, off graphene supported on gold. This is motivated by our desire to probe the energy transfer in collisions with graphene. Since many of these collision systems comprising of graphene and small molecules have been shown to scatter non-reactively, classical molecular dynamics appear to describe such systems sufficiently. We directed thousands of trajectories of NO molecules onto graphene along the surface normal, while varying impact position, but also speed, orientation, and rotational excitation of the nitric oxide, and compare the results with experimental data. While experiment and theory do not match quantitatively, we observe agreement that the relative amount of kineti cenergy lost during the collision increases with increasing initial kinetic energy of the NO. Furthermore, while at higher collision energies, all NO molecules lose some energy, and the vast majority of NO is scattered back, in contrast at low impact energies, the fraction of those nitric oxide molecules that are trapped at the surface increases, and some NO molecules even gain some kinetic energy during the collision process. The collision energy seems to preferentially go into the collective motion of the carbon atoms in the graphene sheet.
Die gesetzlich vorgesehene Bereitstellung von Digitalisierungsangeboten stellt öffentliche Verwaltungen vor steigende Herausforderungen. Aufgrund der Heterogenität der Nutzerinnen und Nutzer ist es für öffentliche Verwaltungen häufig problematisch, klare Anforderungen zu erheben und zu erfüllen. Hinzukommen strukturelle und organisatorische Gegebenheiten wie beispielsweise ausgeprägte Entscheidungshierarchien, die eine nutzerzentrierte Vorgehensweise erschweren können. Darüber hinaus sieht sich die öffentliche Verwaltung zunehmend mit komplexer werdenden Problemen konfrontiert. Es stellt sich daher die Frage, wie in der öffentlichen Verwaltung ein moderner Ansatz zur Nutzerzentrierung und Problemlösung eingesetzt werden kann. Dieser Artikel präsentiert die Ergebnisse einer Einzelfallstudie bei der Niedersächsischen Landesbehörde für Straßenbau und Verkehr (NLStBV). Wir haben mit einer Fokusgruppe einen Design-Thinking-Workshop durchgeführt, um Potenziale und Anwendungsmöglichkeiten des Ansatzes in der öffentlichen Verwaltung zu identifizieren. Auf Basis einer SWOT-Analyse haben wir die Ergebnisse untersucht und geben vier konkrete Handlungsempfehlungen für die Einführung sowie Nutzung von Design Thinking.
Network convergence is an increasing trend in the automation domain. More and more plant owners strive for a unification of networks in their plants. This yields a seamless network structure, simplified supervision, and reduced training effort for the personnel, as only one unified network technology needs to be handled. Ethernet-APL is one piece of the puzzle for such a converged network, supporting various real time protocols like PROFINET, EtherNet, HART-IP as well as the middleware protocol OPC UA. This paper gives an overview on the impact of Ethernet-APL field devices to OT security and proposes how to ensure OT security for them.
Die Konvergenz von Netzwerken ist ein zunehmender Trend im Bereich der Automatisierung. Immer mehr Anlagenbetreiber streben eine Vereinheitlichung der Netzwerke in ihren Anlagen an. Dies führt zu einer nahtlosen Netzwerkstruktur, einer vereinfachten Überwachung und einem geringeren Schulungsaufwand für das Personal, da nur eine einheitliche Netzwerktechnologie gehandhabt werden muss. Ethernet-APL ist ein Teil des Puzzles für ein solches konvergentes Netzwerk und unterstützt verschiedene Echtzeitprotokolle wie PROFINET, EtherNet, HART-IP sowie das Middleware-Protokoll OPC UA. Dieses Papier gibt einen Überblick über die Auswirkungen von Ethernet-APL-Feldgeräten auf die OT-Sicherheit und schlägt vor, wie die OT-Sicherheit für diese Geräte gewährleistet werden kann.
Background: The globalization of clinical research should also benefit the population in developing markets. In this context, the approval of tested medicines and the associated expansion of medical care beyond clinical studies would be desirable as a possible long-term benefit.
Objectives: This study was designed to compare the development of the number of clinical trials with the number of marketing authorizations of medicines on the African continent. To contrast these 2 parameters, the data were analyzed using the model of an ecological study.
Methods: To reflect the broad spectrum of African developing countries with diverse levels of development, the data collection was based on 2 geographically selected sample countries each from Central, North, East, West, and Southern Africa. Based on the ClinicalTrials.gov registry, the first step was to collect trends data on the development of the clinical trials in the 10 selected countries of the country list of the African Region published by the World Health Organization for the period 2015 to 2018. Subsequently, data on the current number of marketing authorizations of medicines in the selected sample countries were identified using the online registries of the national authorities. The data were utilized in comparative analyses.
Results: Eight out of 10 model countries showed an increase in the number of clinical trials, with the exceptions of Cameroon and Libya, which showed an overall decline in research activity over the entire time. In direct comparison with drug registrations, the numbers indicate a similar development. The only exception here is Nigeria, a country with a solid performance in clinical research and yet a decrease in medicine registrations since 2015.
Conclusions: The expected increase in the development of clinical research as result of the globalization trend can basically be observed in most of the model countries. However, this increase does not guarantee an improvement in the number of medicine registrations. Although this is evident in some of the selected model countries, it cannot be projected to the entire African region. This may be linked to the diverse development of the individual countries due to the different political situations and the varying degrees of clinical research infrastructure.
Zu den Phänomenen digitalisierter Kommunikation ist inzwischen auch die Chatberatung zu zählen. Vor diesem Hintergrund zeigt sich die Notwendigkeit, Kommunikation via Chat phänomenologisch zu durchdringen, sozialtheoretisch einzuordnen und beratungsethisch kritisch zu reflektieren. Dies geschieht am Beispiel der Chatseelsorge, die zugleich von Beratung unterschieden wird.
Electrospinning with consequent thermal treatment consists in a carbon fiber production method that spins a polymer solution to create fibers with diameters around a few hundred nanometers. The thermal treatments are used for the cyclization and then carbonization of the material at 1700 °C for one hour. The unique structure of micro- and nano-carbon fibers makes them a promising material for various applications ranging from future battery designs to filtration. This work investigated the possibility of using milled gasification biochar, derived from a 20 kW fixed-bed gasifier fueled with vine pruning pellets, as an addictive in the preparation of electrospinning solutions. This study outlined that solvent cleaning and the consequent wet-milling and 32 µm sifting are fundamental passages for biochar preparation. Four different polyacrylonitrile-biochar shares were tested ranging from pure polymer to 50–50% solutions. The resulting fibers were analyzed via scanning electron microscopy, and energy-dispersive X-ray and infrared spectroscopy. Results from the morphological analysis showed that biochar grains dispersed themselves well among the fiber mat in all the proposed shares. All the tested solutions, once carbonized, exceeded 97%wt. of carbon content. At higher carbonization temperatures, the inorganic compounds naturally showing in biochar such as potassium and calcium disappeared, resulting in an almost carbon-pure fiber matrix with biochar grains in between.
Entwicklung und Implementierung von Schutzkonzepten haben mit dem Kinder- und Jugendstärkungsgesetz (KJSG) im Juni 2021 in vielen Handlungsfeldern der Kinder- und Jugendhilfe eine rechtliche Grundlage bekommen. Sexualisierte Gewalt ist dabei eine spezifische Herausforderung, die entsprechende Kompetenzen, Qualifikationen und Strukturen erfordert. Dem Jugendamt kommt hierbei eine Schlüsselfunktion zu. Hochproblematische Fallverläufe haben zuletzt verdeutlicht, dass diese Schlüsselfunktion einer kritischen Überprüfung und systematischen Stärkung bedarf. Es gilt insbesondere, die Themen Qualifizierung, Hilfeplanung und Schutzkonzepte zu fokussieren. Erforderlich sind praxisnahe und bedarfsgerechte Wissensbestände, eine Stärkung der professionellen Handlungskompetenz, die Weiterentwicklung organisationaler Strukturen sowie die Etablierung eigenständiger Qualitätsstandards. Das Verbundvorhaben „Fokus Jugendamt – Partizipativer Wissenstransfer zu Kooperation, Hilfeplanung und Schutzkonzepten im Kontext sexualisierte Gewalt (FokusJA)“ greift diese Desiderate mit einem Forschungs- und Transferansatz auf.
Nowadays, problems related with solid waste management become a challenge for most countries due to the rising generation of waste, related environmental issues, and associated costs of produced wastes. Effective waste management systems at different geographic levels require accurate forecasting of future waste generation. In this work, we investigate how open-access data, such as provided from the Organisation for Economic Co-operation and Development (OECD), can be used for the analysis of waste data. The main idea of this study is finding the links between socioeconomic and demographic variables that determine the amounts of types of solid wastes produced by countries. This would make it possible to accurately predict at the country level the waste production and determine the requirements for the development of effective waste management strategies. In particular, we use several machine learning data regression (Support Vector, Gradient Boosting, and Random Forest) and clustering models (k-means) to respectively predict waste production for OECD countries along years and also to perform clustering among these countries according to similar characteristics. The main contributions of our work are: (1) waste analysis at the OECD country-level to compare and cluster countries according to similar waste features predicted; (2) the detection of most relevant features for prediction models; and (3) the comparison between several regression models with respect to accuracy in predictions. Coefficient of determination (R2), Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and Mean Absolute Percentage Error (MAPE), respectively, are used as indices of the efficiency of the developed models. Our experiments have shown that some data pre-processings on the OECD data are an essential stage required in the analysis; that Random Forest Regressor (RFR) produced the best prediction results over the dataset; and that these results are highly influenced by the quality of available socio-economic data. In particular, the RFR model exhibited the highest accuracy in predictions for most waste types. For example, for “municipal” waste, it produced, respectively, R2 = 1 and MAPE = 4.31 global error values for the test set; and for “household” waste, it, respectively, produced R2 = 1 and MAPE = 3.03. Our results indicate that the considered models (and specially RFR) all are effective in predicting the amount of produced wastes derived from input data for the considered countries.
A proven method to enhance the mechanical properties of additively manufactured plastic parts is the embedding of continuous fibers. Due to its great flexibility, continuous fiber-reinforced material extrusion allows fiber strands to be deposited along optimized paths. Nevertheless, the fibers have so far been embedded in the parts contour-based or on the basis of regular patterns. The outstanding strength and stiffness properties of the fibers in the longitudinal direction cannot be optimally utilized. Therefore, a method is proposed which allows to embed fibers along the principal stresses into the parts in a load-oriented manner. A G-code is generated from the calculated principal stress trajectories and the part geometry, which also takes into account the specific restrictions of the manufacturing technology used. A distinction is made between fiber paths and the matrix so that the average fiber volume content can be set in a defined way. To determine the mechanical properties, tensile and flexural tests are carried out on specimens consisting of carbon fiber-reinforced polyamide. In order to increase the influence of the principal stress-based fiber orientation, open-hole plates are used for the tensile tests, as this leads to variable stresses across the cross section. In addition, a digital image correlation system is used to determine the deformations during the mechanical tests. It was found that the peak load of the optimized open-hole plates was greater by a factor of 3 and the optimized flexural specimens by a factor of 1.9 than the comparison specimens with unidirectional fiber alignment.
The aim of the podcast Digitization of Medicine is to interest a broader audience and, in particular, young women, in research and work in the field of medical informatics. This article presents the usage figures and discusses their significance for further research on the success of science communication. By 24/02/2022, a total of 24,351 downloads had been made. There were slightly more female than male listeners, and they tended to be younger. Despite the importance podcast are gaining for science communication, little is known about the respective user group and further research is needed. In this context, this paper aims to help make the effectiveness of podcasts comparable.
In the context of the ongoing digitization of interdisciplinary subjects, the need for digital literacy is increasing in all areas of everyday life. Furthermore, communication between science and society is facing new challenges, not least since the COVID-19 pandemic. In order to deal with these challenges and to provide target-oriented online teaching, new educational concepts for the transfer of knowledge to society are necessary. In the transfer project “Zukunftslabor Gesundheit” (ZLG), a didactic concept for the creation of E-Learning classes was developed. A key factor for the didactic concept is addressing heterogeneous target groups to reach the broadest possible spectrum of participants. The concept has already been used for the creation of the first ZLG E-Learning courses. This article outlines the central elements of the developed didactic concept and addresses the creation of the ZLG courses. The courses created so far appeal to different target groups and convey diverse types of knowledge at different levels of difficulty.
Background: One of the major challenges in pediatric intensive care is the detection of life-threatening health conditions under acute time constraints and performance pressure. This includes the assessment of pediatric organ dysfunction (OD) that demands extraordinary clinical expertise and the clinician’s ability to derive a decision based on multiple information and data sources. Clinical decision support systems (CDSS) offer a solution to support medical staff in stressful routine work. Simultaneously, detection of OD by using computerized decision support approaches has been scarcely investigated, especially not in pediatrics.
Objectives: The aim of the study is to enhance an existing, interoperable, and rulebased CDSS prototype for tracing the progression of sepsis in critically ill children by augmenting it with the capability to detect SIRS/sepsis-associated hematologic OD, and to determine its diagnostic accuracy.
Methods: We reproduced an interoperable CDSS approach previously introduced by our working group: (1) a knowledge model was designed by following the commonKADS methodology, (2) routine care data was semantically standardized and harmonized using openEHR as clinical information standard, (3) rules were formulated and implemented in a business rule management system. Data from a prospective diagnostic study, including 168 patients, was used to estimate the diagnostic accuracy of the rule-based CDSS using the clinicians’ diagnoses as reference
Introduction
Atopic dermatitis (AD) is a common inflammatory skin disease. Many patients are initiating a systemic therapy, if the disease is not adequately controlled with topical treatment only. Currently, there is little real-world evidence on the AD-related medical care situation in Germany. This study analyzed patient characteristics, treatment patterns, healthcare resource utilization and costs associated with systemically treated AD for the German healthcare system.
Methods
In this descriptive, retrospective cohort study, aggregated anonymized German health claims data from the InGef research database were used. Within a representative sample of four million insured individuals, patients with AD and systemic drug therapy initiation (SDTI) in the index year 2017 were identified and included into the study cohort. Systemic drug therapy included dupilumab, systemic corticosteroids (SCS) and systemic immunosuppressants (SIS). Patients were observed for one year starting from the date of SDTI in 2017.
Results
9975 patients were included (57.8% female, mean age 39.6 years [SD 25.5]). In the one-year observation period, the most common systemic drug therapy was SCS (> 99.0%). Administrations of dupilumab (0.3%) or dispensations of SIS were rare (cyclosporine: 0.5%, azathioprine: 0.6%, methotrexate: 0.1%). Median treatment duration of SCS, cyclosporine and azathioprine was 27 days, 102 days, and 109 days, respectively. 2.8% of the patients received phototherapy; 41.6% used topical corticosteroids and/or topical calcineurin inhibitor. Average annual costs for medications amounted to € 1237 per patient. Outpatient services were used by 99.6% with associated mean annual costs of € 943; 25.4% had at least one hospitalization (mean annual costs: € 5836). 5.3% of adult patients received sickness benefits with associated mean annual costs of € 5026.
Conclusions
Despite unfavorable risk–benefit profile, this study demonstrated a common treatment with SCS, whereas other systemic drug therapy options were rarely used. Furthermore, the results suggest a substantial economic burden for patients with AD and SDTI.
Der Aufsatz erläutert anschaulich, wie der Transport der elektrischen Energie vom Erzeuger zum Verbraucher im Detail erfolgt. Die Rechnung mit Hilfe grundlegender Beziehungen aus den Grundlagen der Elektrotechnik und dem Poynting-Vektor ermöglicht es, den physikalisch realen Transport der Energie räumlich quantitativ nachzuvollziehen und zu verstehen. An vereinfachten Beispielen wird gezeigt, wie die Energie über zwei Sammelschienen zu den Verbrauchern und insbesondere in die Verbraucher hinein gelangt. Bei den Verbrauchern handelt es sich exemplarisch um einen Widerstand, einen Kondensator, eine Spule und schließlich einen bewegten Leiter im magnetischen Feld als einfachste Form eines Gleichstrommotors. Es wird dargestellt, dass die Energie keinesfalls in den Zuleitungen transportiert wird, sondern durch den umgebenden Raum.
Der Beitrag beschreibt die aktuellen Überlegungen zur Weiterentwicklung der informationswissenschaftlichen Studiengänge der Hochschule Hannover vor dem Hintergrund des laufenden Prozesses der Reakkreditierung. Zentrale Aspekte bilden hierbei die inhaltliche und strukturelle Weiterentwicklung des Curriculums vor dem Hintergrund der sich verändernden Bedürfnisse der Bibliotheken. Ebenfalls berücksichtigt werden verschiedene Formen der Kooperation mit der Bibliothekspraxis, hochschuldidaktische Überlegungen sowie die Einbindung der Studiengänge in die informationswissenschaftliche Forschungslandschaft.
Der Bericht über die Mitgliederversammlung gliedert sich in vier Teile: Einen kurzen Bericht über die formalen Anteile der Versammlung (1), die kurze Vorstellung der mit dem Cora-Baltussen-Förderpreis ausgezeichneten Abschlussarbeiten (2), eine Paraphrase des Vortrags von Armin Nassehi (3) sowie eine kritisch-kommentierende Diskussion des Fishbowls über Führungskräfte in der klinischen Pflege (4).