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Harmonisation of German Health Care Data Using the OMOP Common Data Model – A Practice Report
(2023)
Data harmonization is an important step in large-scale data analysis and for generating evidence on real world data in healthcare. With the OMOP common data model, a relevant instrument for data harmonization is available that is being promoted by different networks and communities. At the Hannover Medical School (MHH) in Germany, an Enterprise Clinical Research Data Warehouse (ECRDW) is established and harmonization of that data source is the focus of this work. We present MHH’s first implementation of the OMOP common data model on top of the ECRDW data source and demonstrate the challenges concerning the mapping of German healthcare terminologies to a standardized format.
Autonomous and integrated passenger and freight transport (APFIT) is a promising approach to tackle both, traffic and last-mile-related issues such as environmental emissions, social and spatial conflicts or operational inefficiencies. By conducting an agent-based simulation, we shed light on this widely unexplored research topic and provide first indications regarding influential target figures of such a system in the rural area of Sarstedt, Germany. Our results show that larger fleets entail inefficiencies due to suboptimal utilization of monetary and material resources and increase traffic volume while higher amounts of unused vehicles may exacerbate spatial conflicts. Nevertheless, to fit the given demand within our study area, a comparatively large fleet of about 25 vehicles is necessary to provide reliable service, assuming maximum passenger waiting times of six minutes to the expense of higher standby times, rebalancing effort, and higher costs for vehicle acquisition and maintenance.
The NOA project collects and stores images from open access publications and makes them findable and reusable. During the project a focus group workshop was held to determine whether the development is addressing researchers’ needs. This took place before the second half of the project so that the results could be considered for further development since addressing users’ needs is a big part of the project. The focus was to find out what content and functionality they expect from image repositories.
In a first step, participants were asked to fill out a survey about their images use. Secondly, they tested different use cases on the live system. The first finding is that users have a need for finding scholarly images but it is not a routine task and they often do not know any image repositories. This is another reason for repositories to become more open and reach users by integrating with other content providers. The second finding is that users paid attention to image licenses but struggled to find and interpret them while also being unsure how to cite images. In general, there is a high demand for reusing scholarly images but the existing infrastructure has room to improve.
Building a well-founded understanding of the concepts, tasks and limitations of IT in all areas of society is an essential prerequisite for future developments in business and research. This applies in particular to the healthcare sector and medical research, which are affected by the noticeable advances in digitization. In the transfer project “Zukunftslabor Gesundheit” (ZLG), a teaching framework was developed to support the development of further education online courses in order to teach heterogeneous groups of learners independent of location and prior knowledge. The study at hand describes the development and components of the framework.
Powder bed-based additive manufacturing processes offer an extended freedom in design and enable the processing of metals, ceramics, and polymers with a high level of relative density. The latter is a prevalent measure of process and component quality, which depends on various input variables. A key point in this context is the condition of powder beds. To enhance comprehension of their particle-level formation and facilitate process optimization, simulations based on the Discrete Element Method are increasingly employed in research. To generate qualitatively as well as quantitatively reliable simulation results, an adaptation of the contact model parameterization is necessary. However, current adaptation methods often require the implementation of models that significantly increase computational effort, therefore limiting their applicability. To counteract this obstacle, a sophisticated formula-based adaptation and evaluation method is presented in this research. Additionally, the developed method enables accelerated parameter determination with limited experimental effort. Thus, it represents an integrative component, which supports further research efforts based on the Discrete Element Method by significantly reducing the parameterization effort. The universal nature of deducting this method also allows its adaptation to similar parameterization problems and its implementation in other fields of research.
Pathologists need to identify abnormal changes in tissue. With the developing digitalization, the used tissue slides are stored digitally. This enables pathologists to annotate the region of interest with the support of software tools. PathoLearn is a web-based learning platform explicitly developed for the teacher-student scenario, where the goal is that students learn to identify potential abnormal changes. Artificial intelligence (AI) and machine learning (ML) have become very important in medicine. Many health sectors already utilize AI and ML. This will only increase in the future, also in the field of pathology. Therefore, it is important to teach students the fundamentals and concepts of AI and ML early in their studies. Additionally, creating and training AI generally requires knowledge of programming and technical details. This thesis evaluates how this boundary can be overcome by comparing existing end-to-end AI platforms and teaching tools for AI. It was shown that a visual programming editor offers a fitting abstraction for creating neural networks without programming. This was extended with real-time collaboration to enable students to work in groups. Additionally, an automatic training feature was implemented, removing the necessity to know technical details about training neural networks.
After kidney transplantation graft rejection must be prevented. Therefore, a multitude of parameters of the patient is observed pre- and postoperatively. To support this process, the Screen Reject research project is developing a data warehouse optimized for kidney rejection diagnostics. In the course of this project it was discovered that important information are only available in form of free texts instead of structured data and can therefore not be processed by standard ETL tools, which is necessary to establish a digital expert system for rejection diagnostics. Due to this reason, data integration has been improved by a combination of methods from natural language processing and methods from image processing. Based on state-of-the-art data warehousing technologies (Microsoft SSIS), a generic data integration tool has been developed. The tool was evaluated by extracting Banff-classification from 218 pathology reports and extracting HLA mismatches from about 1700 PDF files, both written in german language.
In this poster we present the ongoing development of an integrated free and open source toolchain for semantic annotation of digitised cultural heritage. The toolchain development involves the specification of a common data model that aims to increase interoperability across diverse datasets and to enable new collaborative research approaches.
This paper aims to provide a structured overview of four open, participatory formats that are particularly applicable in inquiry-based teaching and learning contexts: hackathons, book sprints, barcamps, and learning circles. Using examples, mostly from the work and experience context of the Open Science Lab at TIB Hannover, we address concrete processes, working methods, possible outcomes and challenges.
The compilation offers an introduction to the topic and is intended to provide tools for testing in practice.
Techno-economic analysis that allocate costs to the energy flows of energy systems are helpful to understand the formation of costs within processes and to increase the cost efficiency. For the economic evaluation, the usefulness or quality of the energy is of great importance. In exergy-based methods, this is considered by allocating costs to the exergy instead of energy. As exergy represents the ability of performing work, it is often named the useful part of energy. In contrast, the anergy, the part of energy, which cannot perform work, is often assumed to be not useful.
However, heat flows as used e.g. in domestic heating are always a mixture of a relative small portion of exergy and a big portion of anergy. Although of lower quality, the anergy is obviously useful for these applications. The question is, whether it makes sense to differentiate between exergy and anergy and take both properties into account for the economic evaluation.
To answer this question, a new methodical concept based on the definition of an anergy-exergy cost ratio is compared to the commonly applied approaches of considering either energy or exergy as the basis for economic evaluation. These three different approaches for the economic analysis of thermal energy systems are applied to an exemplary heating system with thermal storages. It is shown that the results of the techno-economic analysis can be improved by giving anergy an economic value and that the proposed anergy-cost ratio allows a flexible adaptation of the evaluation depending on the economic constraints of a system.
Parametric study of piezoresistive structures in continuous fiber reinforced additive manufacturing
(2024)
Recent advancements in fiber reinforced additive manufacturing leverage the piezoresistivity of continuous carbon fibers. This effect enables the fabrication of structural components with inherent piezoresistive properties suitable for load measurement or structural monitoring. These are achieved without necessitating additional manufacturing or assembly procedures. However, there remain unexplored variables within the domain of continuous fiber-reinforced additive manufacturing. Crucially, the roles of fiber curvature radii and sensing fiber bundle counts have yet to be comprehensively addressed. Additionally, the compression-sensitive nature of printed carbon fiber-reinforced specimens remains a largely unexplored research area. To address these gaps, this study presents experimental analyses on tensile and three-point flexural specimens incorporating sensing carbon fiber strands. All specimens were fabricated with three distinct curvature radii. For the tensile specimens, the number of layers was also varied. Sensing fiber bundles were embedded on both tensile and compression sides of the flexural specimens. Mechanical testing revealed a linear-elastic behavior in the specimens. It was observed that carbon fibers supported the majority of the load, leading to brittle fractures. The resistance measurements showed a dependence on both the number of sensing layers and the radius of curvature, and exhibited a slight decreasing trend in the cyclic tests. Compared with the sensors subjected to tensile stress, the sensors embedded on the compression side showed a lower gauge factor.
This research focuses on the fundamental ideas and underlying principles of E-Learning technology, as well as theoretical considerations for an optimal learning environment. This theoretical exploration was then used as a basis for the design and construction of a new, interactive Web-Based ESH-Training. The quality and effectiveness of this new course was then compared with that of the existing analog PDF-Training via a test with a diverse sample of employee learners. Learners were later surveyed to ascertain their views on both trainings in terms of the quality of the content, facilitator, resources, and length. Results clearly showed that regardless of demographic factors, most employee learners preferred the new, Web-Based ESH-Training to the analog PDF-Training.
Compounds that exhibit the spin crossover effect are known to show a change of spin states through external stimuli. This reversible switching of spin states is accompanied by a change of the properties of the compound. Complexes, like iron (II)-triazole complexes, that exhibit this behavior at ambient temperature are often discussed for potential applications. In previous studies we synthesized iron (II)-triazole complexes and implemented them into electrospun nanofibers. We used Mössbauer spectroscopy in first studies to prove a successful implementation with maintaining spin crossover properties. Further studies from us showed that it is possible to use different electrospinning methods to either do a implementation or a deposition of the synthesized solid SCO material into or onto the polymer nanofibers. We now used a solvent in which both, the used iron (II)-triazole complex [Fe(atrz)3](2 ns)2 and three different polymers (Polyacrylonitrile, Polymethylmethacrylate and Polyvinylpyrrolidone), are soluble. This shall lead to a higher homogeneous distribution of the complex along the nanofibers. Mössbauer spectroscopy and other measurements are therefore in use to show a successful implementation without any significant changes to the complex.
Complexes like iron (II)-triazoles exhibit spin crossover behavior at ambient temperature and are often considered for possible application. In previous studies, we implemented complexes of this type into polymer nanofibers and first polymer-based optical waveguide sensor systems. In our current study, we synthesized complexes of this type, implemented them into polymers and obtained composites through drop casting and doctor blading. We present that a certain combination of polymer and complex can lead to composites with high potential for optical devices. For this purpose, we used two different complexes [Fe(atrz)3](2 ns)2 and [Fe(atrz)3]Cl1.5(BF4)0.5 with different polymers for each composite. We show through transmission measurements and UV/VIS spectroscopy that the optical properties of these composite materials can reversibly change due to the spin crossover effect.
The increasing variety of combinations of different building technology components offers a high potential for energy and cost savings in today's buildings. However, in most cases, this potential is not yet fully exploited due to the lack of intelligent supervisory control systems that are required to manage the complexity of the resulting overall systems. In this article, we present the implementation of a mixed-integer nonlinear model predictive control approach as a smart realtime building energy management system. The presented methodology is based on a forward-looking optimization of the overall energy costs. It takes into account energy demand forecasts and varying electricity market prices. We achieve real-time capability of the controller by applying a decomposition approach, which approximates the optimal solution of the underlying mixed-integer optimal control problem by convexification and rounding of the relaxed solution. The quality of the suboptimal solution is evaluated by comparison with the globally optimal solution obtained by the dynamic programming method. Based on a real-world scenario, we demonstrate that utilization of the real-time capable mixedinteger nonlinear model predictive control approach in a building control system leads to savings of 16% in the total operating costs and 13% in primary energy compared to the state-of-the-art control strategy without any loss of comfort for the residents.
On November 30th, 2022, OpenAI released the large language model ChatGPT, an extension of GPT-3. The AI chatbot provides real-time communication in response to users’ requests. The quality of ChatGPT’s natural speaking answers marks a major shift in how we will use AI-generated information in our day-to-day lives. For a software engineering student, the use cases for ChatGPT are manifold: assessment preparation, translation, and creation of specified source code, to name a few. It can even handle more complex aspects of scientific writing, such as summarizing literature and paraphrasing text. Hence, this position paper addresses the need for discussion of potential approaches for integrating ChatGPT into higher education. Therefore, we focus on articles that address the effects of ChatGPT on higher education in the areas of software engineering and scientific writing. As ChatGPT was only recently released, there have been no peer-reviewed articles on the subject. Thus, we performed a structured grey literature review using Google Scholar to identify preprints of primary studies. In total, five out of 55 preprints are used for our analysis. Furthermore, we held informal discussions and talks with other lecturers and researchers and took into account the authors’ test results from using ChatGPT. We present five challenges and three opportunities for the higher education context that emerge from the release of ChatGPT. The main contribution of this paper is a proposal for how to integrate ChatGPT into higher education in four main areas.
The PROFINET protocol has been extended in the current version to include security functions. This allows flexible network architectures with the consideration of OT security requirements to be designed for PROFINET, which were not possible due to the network segmentation previously required. In addition to the manufacturers of the protocol stacks, component manufacturers are also required to provide a secure implementation in their devices. The necessary measures go beyond the use of a secure protocol stack. Using the example of an Ethernet-APL transmitter with PROFINET communication, this article shows which technical and organizational conditions will have to be considered by PROFINET device manufacturers in the future.
Purpose: The calculation of aggregated composite measures is a widely used strategy to reduce the amount of data on hospital report cards. Therefore, this study aims to elicit and compare preferences of both patients as well as referring physicians regarding publicly available hospital quality information.
Methods: Based on systematic literature reviews as well as qualitative analysis, two discrete choice experiments (DCEs) were applied to elicit patients’ and referring physicians’ preferences. The DCEs were conducted using a fractional factorial design. Statistical data analysis was performed using multinomial logit models.
Results: Apart from five identical attributes, one specific attribute was identified for each study group, respectively. Overall, 322 patients (mean age 68.99) and 187 referring physicians (mean age 53.60) were included. Our models displayed significant coefficients for all attributes (p < 0.001 each). Among patients, “Postoperative complication rate” (20.6%; level range of 1.164) was rated highest, followed by “Mobility at hospital discharge” (19.9%; level range of 1.127), and ‘‘The number of cases treated” (18.5%; level range of 1.045). In contrast, referring physicians valued most the ‘‘One-year revision surgery rate’’ (30.4%; level range of 1.989), followed by “The number of cases treated” (21.0%; level range of 1.372), and “Postoperative complication rate” (17.2%; level range of 1.123).
Conclusion: We determined considerable differences between both study groups when calculating the relative value of publicly available hospital quality information. This may have an impact when calculating aggregated composite measures based on consumer-based weighting.
Chronic kidney disease is one of the main causes of mortality worldwide. It affects more than 800 million patients globally, accounting for approximately 10% of the general population. The significant burden of the disease prompts healthcare systems to implement adequate preventive and therapeutic measures. This systematic review and meta-analysis aimed to provide a concise summary of the findings published in the existing body of research about the influence that mobile health technology has on the outcomes of patients with the disease. A comprehensive systematic literature review was conducted from inception until March 1st, 2023. This systematic review and meta-analysis included all clinical trials that compared the efficacy of mobile app-based educational programs to that of more conventional educational treatment for the patients. Eleven papers were included in the current analysis, representing 759 CKD patients. 381 patients were randomly assigned to use the mobile apps, while 378 individuals were assigned to the control group. The mean systolic blood pressure was considerably lower in the mobile app group (MD -4.86; 95%-9.60, -0.13; p=0.04). Meanwhile, the mean level of satisfaction among patients who used the mobile app was considerably greater (MD 0.75; 95% CI 0.03, 1.46; p=0.04). Additionally, the mean self-management scores in the mobile app groups were significantly higher (SMD 0.534; 95% CI 0.201, 0.867; p=0.002). Mobile health applications are potentially valuable interventions for patients. This technology improved the self-management of the disease, reducing the mean levels of systolic blood pressure with a high degree of patient satisfaction.
Background: In Germany, hospice and palliative care is well covered through inpatient, outpatient, and home-based care services. It is unknown if, and to what extent, there is a need for additional day care services to meet the specific needs of patients and caregivers.
Methods: Two day hospices and two palliative day care clinics were selected. In the first step, two managers from each facility (n = 8) were interviewed by telephone, using a semi-structured interview guide. In the second step, four focus groups were conducted, each with three to seven representatives of hospice and palliative care from the facilities’ hospice and palliative care networks. Interviews and focus groups were audio recorded, transcribed verbatim and analyzed using qualitative content analysis.
Results: The interviewed experts perceived day care services as providing additional patient and caregiver benefits. Specifically, the services were perceived to meet patient needs for social interaction and bundled treatments, especially for patients who did not fit into inpatient settings (due to, e.g., their young age or a lack of desire for inpatient admission). The services were also perceived to meet caregiver needs for support, providing short-term relief for the home care situation.
Conclusions: The results suggest that inpatient, outpatient, and home-based hospice and palliative care services do not meet the palliative care needs of all patients. Although the population that is most likely to benefit from day care services is assumed to be relatively small, such services may meet the needs of certain patient groups more effectively than other forms of care.