bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic intelligence index and trade flow analysis
Authors: Starostina Alla , Kochkina Natalia , Adami Carlo
Published: September 2022

The aim of the research is to explore the natural predisposition of the world’s nations to implement an effective and efficient Economic Intelligence strategy, through the calculation of an index that measures the country’s position in the network of international relations. Economic Intelligence is a new discipline introduced by scholars in order to support the national governments through new information bases designed to succeed in the complex economic environment following the development of globalization. Given that a central role in the international economic relations’ network provides a privileged position for acquiring information useful for supporting the logical aspects of strategic planning, a country with such a role has a natural predisposition to develop a successful Economic Intelligence strategy. Thus, the subject of the research focuses on analysing that predisposition by measuring the significance of the position occupied by a country in the global trade network. For that purpose, the methodology of the Social Network Analysis is used. The assumption is that by calculating the Economic Intelligence Index, that is a weighted average of the main centrality indexes related to each country within the global trade network, it is possible to measure a national entity’s inclination to developing a sound Economic Intelligence strategy. The basic conclusion of the article highlights that, notwithstanding the fact that a prominent role in the global trade network is occupied by the major countries in terms of commercial importing value, other countries characterized by a significant Economic Intelligence Index could be in a position to develop a successful Economic Intelligence strategy.
The effect of brand credibility on search and credence goods: A cross-country analysis of Korea, China & France
Authors: Park Joonyong , Chenghui Xuan , Kim Renee B.
Published: September 2022

The purpose of this research is to investigate how brands as signals affect brand attributes/benefits and brand choices for search and credence goods. The empirical model approximates the relationship between brand credibility (BR) and consumers’ purchase intention (BCP), which is mediated by four selected constructs: perceived quality (PQ), information cost saved (ICS), lower perceived risk (LPR) and relative price (RP). This study examines the importance of brand credibility as a latent construct for brand attributes and benefits which influence consumers’ brand choices and purchase intentions. Consumers’ brand choice making process is assessed for three major consumer markets – Korea, China and France – for the month of October 2020. Different outcomes of the relative path importance in two product categories of three consumer markets evidently show that brand may need to ‘signal’ appropriate features (i.e., brand attributes/benefits) and context (i.e., elements of marketing mix) for various product/market conditions and consumer characteristics.
Financial engineering and its impact on audit efficiency in the opinion of experts
Authors: Tamimi Oday , Orbán Ildikó
Published: September 2022

The present study aimed to examine the impact of financial engineering on audit efficiency by analyzing the results of a research sample that included banks, auditors, financial analysts, and academics in Europe, as previous studies did not examine the relationship between these variables. Three major findings are outlined in this study. First, there is a statistically significant relationship between financial engineering and audit efficiency based on the results of the tests of the hypotheses. Second, there is a statistically significant relationship between financial engineering and the quality of financial reports, as the use of financial engineering innovations leads to a decrease in the credibility and relevance of financial reports for users. Finally, there is a statistically significant relationship between financial engineering and the expectations gap in the audit process, due to the increased need for more details about the financial instruments in the auditor's report. The findings of this study are important for auditors, financial engineers, bank executives, and bodies that set standards for accounting and auditing.
The relationship between crude oil prices, energy consumption, trade openness and economic growth: An empirical study on Vietnam
Authors: Nguyen Anh Tru
Published: September 2022

In the study, the VECM was employed to evaluate the nexus between crude oil prices, energy use, trade openness, and economic growth of Vietnam between 1991 and 2020. It has been empirically found that economic growth of Vietnam was significantly and negatively influenced by crude oil prices and energy consumption in the short run. Results state that the development of trade openness may accelerate economic growth of this country. Further, the increase of crude oil prices can reduce energy consumption and trade openness of Vietnam. Trade openness can be promoted by energy consumption in the short run. In the long run, results suggest that the increase of crude oil prices may harm economic growth, while the rise of energy consumption may facilitate economic growth of Vietnam. The Johansen test demonstrates that there is a long-term relationship between crude oil prices, energy consumption, trade openness, and economic growth in Vietnam. Lastly, policies are recommended to ensure energy security, accelerate economic growth and achieve sustainable development for Vietnam.
Hand Mouth Foot Disease Outbreaks in Johor:

The Influence of Health Education and Advocacy
Authors: vallasamy suriya kumareswaran , murali sundram bala , umairah muhadi siti
Published: September 2022

Introduction

Hand Foot-and-mouth disease (HFMD) continues to be the most prevalent among young children of all febrile illnesses and rash syndromes. Although this viral infection is highly contagious, it is benign and self-limiting. All Malaysian states have recently reported an increase in HFMD cases, with Johor, the most populous and most diverse state, being the hardest hit. Basic educational expertise and skills, are essential components of health. In addition, health enforcement plays a crucial role in assisting the implementation and enforcement of relevant laws and regulations to combat this disease. The objective of the study to describe the prevalence and enforcement activity of HMFD cases in Johor.

Methods

HFMD is a notifiable disease in Malaysia. A cross sectional investigation was carried out using secondary data gathered from Disease Infectious Control unit and Inspectorate and Enforcement Unit. Data analyses was performed using Microsoft Excel and SPSS.

Results

A total of 461 cases and 106 outbreaks was reported from January to July 2022. The highest outbreak contribution originated form childcare centre 45 (42.5%), personal home 22 (20.8%), kindergarten 13 (12.3%) and others 26 (24%). Bivariate correlation test was conducted to determine three continuous variables. The results show a significant relationship between enforcement activity, health promotion, and cases notified in Johor (P value <0.01, correlation coefficient 1.00).

Conclusion

National strategies on health education and health enforcement of individual and public health behaviours, jointly by ministries of Health, Education and Home affairs in collaboration with relevant professional bodies, such as infection control societies, can provide framework that is appropriate to tackle the increasing in cases and muster for future outbreaks. Education campaigns directed at reducing the spread of disease, particularly in high-risk age groups, include disseminating information on good personal hygiene habits should be continuously conducted even though if the case has reduced.
Assessment of the Effect of Dimethyl Disulfide Concentration Dosing on Coke Formation and Furnace Run Length Predictions: Experimental and Modeling Study
Authors: Darvishi Ali , Davand Razieh , Mohebi Somayyeh , Bolhasani Akbar , Karamian Soroush , Hosseini Shahin , Rashedi Reza , Dehghani Ourmazd , Parvin Aghil
Published: September 2022

The olefins are produced by steam cracking furnaces in the petrochemical industry. The olefins production is strongly affected by the furnace run length. The coke deposition inside the cracking coil determines the furnace run length. Dimethyl disulfide (DMDS) is mainly utilized in steam crackers as coke and CO inhibitors. A cracking setup is utilized for studying the influence of various concentrations of DMDS on cracking performance. The simulation model utilized to evaluate furnace run length showed excellent performance in the prediction of the furnace run length (average absolute error = 0.83%). The ethane conversion, ethylene selectivity, carbon monoxide (CO) formation, coking rate, coke morphology, and metal migration to coke are vital parameters in olefin performance and furnace run length. Accordingly, different concentrations of DMDS including the industrial dosage are selected, evaluated, and optimized by the experimental method. The results show that the minimum coke formation is achieved when the DMDS concentration is 20 ppmw, in which the coking rate for steam cracking is 52% less than that of industrial dosage (111 ppmw). Moreover, a 50% decrease in CO formation is observed when DMDS concentration changed from 111 to 20 ppmw. Based on the simulation model, the optimum DMDS dosage results in an increase in the run length from 60.21 to 95.12 days.
(Un)Blurred Concept of Sovereign Rights at Sea : Implementation Context
Authors: Afriansyah Arie , Paruna Dila , Andiani Rania
Published: September 2022

The term “sovereign rights” has been used on many occasions in referring to coastal states’ actions in exploring and exploiting the ocean’s natural resources beyond their sovereign territory. Not to mention the lack of comprehension between “sovereignty” and “sovereign rights” of the general public, it appears that the last term is also lacking clear definition available for a legal basis. This clarity is crucial to give the legal certainty for states’ entitlement to conduct actions within their jurisdictions. This paper tries to clarify the legal definition of “sovereign rights” under international dan national practice. It concludes that no single universally accepted definition of sovereign rights. The explanation of rights and duties of such a definition is mostly practiced both internationally and nationally. The finding is based on the survey of the implementation of international rules, international judgments, and Indonesian court decisions.
The Implementation of Establishing Marine Protected Area: Lessons Learned From Raja Ampat to Achieve Sustainable Fishery
Authors: Wartini Sri
Published: September 2022

Raja Ampat has one of the world’s richest coral reef, because it is located in the heart of the coral triangle. However, due to human activities, such as overfishing, shipping as well as climate change has caused serious impacts to the existence of the coral reef and its habitats.  As the member of the United Nations Law of the Sea Convention and the Biodiversity Convention, Indonesia has obligation to establish Marine Protected Areas (MPAs). The research aims  to analyze comprehensively the implementation of  establishing  the MPA in Indonesia   based on international and national law perspective and to examine whether the existence of the MPA in Raja Ampat  can be used as a model to develop MPA in other area to achieve sustainable fishery. This study  is a normative juridical research by applying conceptual and  statutory approaches. The result of the research finds that the establishing of MPA in Raja Ampat has   been successfully achieved sustainable Fishery as part of sustainable development. However, there are some challenges that have to be addressed,  such as lack of monitoring in the MPAs due to the limitation of the budget  as well as the illegal unreported and unregulated fishing conducted by the people outside indigenous community Thus, it is necessary to conduct monitoring cooperation among the MPAs.
Explainable AI: introducing trust and comprehensibility to AI engineering
Authors: Burkart Nadia , Brajovic Danilo , Huber Marco F.
Published: September 2022

Machine learning (ML) rapidly gains increasing interest due to the continuous improvements in performance. ML is used in many different applications to support human users. The representational power of ML models allows solving difficult tasks, while making them impossible to be understood by humans. This provides room for possible errors and limits the full potential of ML, as it cannot be applied in critical environments. In this paper, we propose employing Explainable AI (xAI) for both model and data set refinement, in order to introduce trust and comprehensibility. Model refinement utilizes xAI for providing insights to inner workings of an ML model, for identifying limitations and for deriving potential improvements. Similarly, xAI is used in data set refinement to detect and resolve problems of the training data.
Evaluation of methods for 3D imaging and analysis of vascularisation in biopreparations
Authors: Zöller Nora , Franke Lisa , Claussen Joelle , Gerth Stefan , Rauh Cornelia , Radlanski Ralf J. , Hiller Karl-Heinz , Hildenbrand Markus F. , Wittenberg Thomas , Hufnagel Eva
Published: September 2022

Motivation: Within the field of bio-implants one topic deals with the in-vitro production of 3D tissues from cell cultures. A major challenge in the cultivation of biopreparations is the imitation of the vascular system with its surrounding tissue. Additiv manufacturing of such vascularisation could be supported with an adequate template from high-resolution 3D radiographs. Goals: Evaluation of highresolution 3D-imaging methods and 3D-analysis approaches to extract the vascularisation from tissue samples. Methods: To provide such template, vascular structure of small tissues samples (partially treated with contrast medium) were recorded and compared using high-resolution CT and MRI imaging modalities. Optimal measurement parameters were selected for the acquisition of very small vessels. Interactive and semi-automated segmentation of the vessel system were investigated and compared. Results: MRI scans yield a higher contrast than CT scans, but are much slower. Duration of interactive segmentation ranges between 1 to 12 hours. Runtime of the (semi) automatic method was between 5 and 20 minutes, not counting manual adjustment of the parameters. Correlation between manual and automatic segmentation yield Hausdorff distances of 0.024 (CT) and 0.74 (MRI) and Dice coefficients of 0.7 (CT) and 0.39 (MRI). Conclusion: Both imaging methods are appropriate for high-resolution vessel detection and segmentation, nevertheless, MRI with no contrast agent seems preferable if the imaging time can be reduced.
“Are you breathing?” – Design, build and testing of a low-cost, portable respiratory rate monitor
Authors: Dawood Junaid , Muller Matthew , Carlson Craig S.
Published: September 2022

A patient’s respiratory rate is one of the critical vital signs that is a determinant of patient well-being. However, it is all too often neglected or misreported by health care professionals. This study presents the design, build and testing of a low-cost, portable monitor to facilitate accurate reporting of respiratory rate. The monitor comprised a thermistor-based transducer to capture the breath cycle of patients based on the temperature differential created across the thermistor. The signal was conditioned and processed such that the signal could be analysed to identify the peaks and ultimately determine the respiratory rate. For a total cost at the time of development of less than C40, the integrated system demonstrated a modest average error of 5.6% across a range of different ambient temperatures, rate and depth of breathing, and orifice of breathing. This is comparable with other commercial and custom devices. The presented monitor may be of interest for use in an emergency room or clinical setting, especially in severely resource-constrained countries.
Improving Equine Intramedullary Nail Osteosynthesis via Fracture Adjacent Polymer Reinforcement
Authors: Lang Jan J. , Baylacher Veronika , Micheler Carina M. , Wilhelm Nikolas J. , Hinterwimmer Florian , Schwaiger Benedikt , Barnewitz Dirk , Eisenhart-Rothe Rüdiger von , Grosse Christian U. , Burgkart Rainer
Published: September 2022

Introduction: Osteosynthesis of the equine femur is still a challenge for veterinary medicine. Even though intramedullary fracture fixation is possible nowadays, the varying geometry of the medullary cavity along the bone axis is a critical factor. Limited contact area between implant and bone can cause insufficient primary stability. In this study, it was investigated whether the osteosynthesis stability can be improved with a form-adaptive reinforcement for the diaphyseal part of the proximal fragment. Material and Methods: Eight equine femora were fitted with intramedullary nail osteosynthesis and analyzed by 4-point bending. Virtual position planning of the ex-vivo implantation using CT-data increased comparability. For five femora the proximal fragment was reinforced with a flexible polymer mixture. Longterm stability was tested via cyclic loading. Bending stiffness and its development due to cyclic loading was evaluated before and after reinforcement procedure. Finally, load-to-failure was tested in the same setup. Results and Discussion: The application of the polymer reinforcement increased the maximum torque in the load-tofailure measurement by 26%. Bending stiffness was not affected in the measured loading range by the reinforcement. Cyclic loading increased bending stiffness for a conditioned state but showed to be reversible for the most part. Conclusion: The fracture adjacent reinforcement showed to be beneficial to the osteosynthesis stability, but further investigation is necessary for surgical application.
Refining the Eikonal Model to Reproduce the Influence of Atrial Tissue Geometry on Conduction Velocity
Authors: Skupien Nils , Barrios Espinosa Cristian , Dössel Olaf , Loewe Axel
Published: September 2022

Atrial fibrillation is responsible for a significant and steadily rising burden. Simultaneously, the treatment options for atrial fibrillation are far from optimal. Personalized simulations of cardiac electrophysiology could assist clinicians in the risk stratification and therapy planning for atrial fibrillation. However, the use of personalized simulations in clinics is currently not possible due to either too high computational costs or non-sufficient accuracy. Eikonal simulations come with low computational costs but cannot replicate the influence of cardiac tissue geometry on the conduction velocity of the wave propagation. Consequently, they currently lack the required accuracy to be applied in clinics. Biophysically detailed simulations on the other hand are accurate but associated with too high computational costs. To tackle this issue, a regression model is created based on biophysically detailed bidomain simulation data. This regression formula calculates the conduction velocity dependent on the thickness and curvature of the heart wall. Afterwards the formula was implemented into the eikonal model with the goal to increase the accuracy of the eikonal model without losing its advantage of computational efficiency. The results of the modified eikonal simulations demonstrate that (i) the local activation times become significantly closer to those of the biophysically detailed bidomain simulations, (ii) the advantage of the eikonal model of a low sensitivity to the resolution of the mesh was reduced further, and (iii) the unrealistic occurrence of endo-epicardial dissociation in simulations was remedied. The results suggest that the accuracy of the eikonal model was significantly increased. At the same time, the additional computational costs caused by the implementation of the regression formula are neglectable. In conclusion, a successful step towards a more accurate and fast computational model of cardiac electrophysiology was achieved.
A Six Degree of Freedom Extrusion Bioprinter
Authors: Budde Leon , Ihler Sontje , Spindeldreier Svenja , Lücking Tobias , Meyer Tim , Bodenschatz Eberhard , Zimmermann Wolfram-Hubertus
Published: September 2022

Motivated by a high demand, the research interest in personalized artificial tissues is steadily increasing. Combining knowledge of additive manufacturing and tissue engineering, the research field of 3D bioprinting emerged. This work presents a six-degree-of-freedom mechanically actuated extrusion bioprinter within a sterile working environment. The system is based on an off-the-shelf robot arm and a custom modular printhead end-effector. Advanced dexterity is achieved by the six degrees of freedom, enabling printing on non-planar surfaces. The printhead is designed for co-axial extrusion of three fluids but can easily be adapted for different number of fluids or different extrusion flows. The custom controller of the system is implemented within the Robot Operating System (ROS) framework and plans the trajectory based on a path given in a custom GCode dialect. Since the robot is clean-room-certified, can be sterilized using hydrogen peroxide steam, and is placed within a sterile hood, the setup enables working under sterile conditions.
A participatory approach to redesign a tube connecting system for home parental nutrition
Authors: Volz Diana , Benderoth Gunther , Erol Serkan
Published: September 2022

Patients receiving parenteral nutrition at home suffer from a lower quality of life as they receive continuous therapy for up to 16 hours a day. It is not possible to interrupt nutriton therapy for everyday activities, as any interruption poses a health risk to the patient. Therefore, a ambulatory care services comes twice a day to connect and disconnect. The aim of this project is to develop a system that makes it manageable for patients to interrupt their feeding therapy in a self-determined way. In order to achieve this, enginners and social scientists collaborated to conduct an ergonomics study using the Design of Experiments(DoE) method to compare three commonly used connection systems. Analysis of variance(ANOVA) was used to secure the tests. In parallel, the probands were asked about their subiective feelings during the closure process. The results provided indications for the redesign of a home parenteral nutrition system. As safety is a crucial issue, the opening and closing process of the system was virtually simulated with the min. and max. finger force of the test persons in order to ensure a safe connection and disconnection with the system at all times. Overall, this participatory approach enable the design of the closure system to take account patients'fears wishes.
Cost-utility Analysis of Home Mechanical Ventilation Compared to Hospital Settings in Patients with Amyotrophic Lateral Sclerosis
Authors: Gajdoš Ondřej , Rožánek Martin , Donin Gleb , Kamenský Vojtěch
Published: September 2022

Amyotrophic lateral sclerosis is a progressive neuromuscular disease. Mechanical ventilation delays death and use at home can reduce costs and increase quality of life. The aim of the study is comparison of home mechanical ventilation with mechanical ventilation in a healthcare facility for adult patients with amyotrophic lateral sclerosis from the societal perspective in the Czech Republic. The Markov model from a previous Czech study was used and updated with data revelant to the societal perspective, which was obtained from the literature and opinions of experts from companies dealing with home mechanical ventilation. The cost-utility analysis was carried out over a time horizont of 10 years and results were presented in incremental cost-utility ratio. Accuracy and validity were verified by probabilistic sensitivity analysis and scenario analysis. The cumulative costs of home mechanical ventilation are CZK 6,116,394 and the cumulative utilities of home mechanical ventilation are CZK 8,195,848. The cumulative utilities of home mechanical ventilation are 3.55 QALY and the cumulative utilities of mechanical ventilation are 3.78 QALY. The incremental cost-utility ratio is CZK 9,094,042. Probabilistic sensitivity analysis and scenario analysis do not show significant changes. Home mechanical ventilation may be considered cost-effective for patients with amyotrophic lateral sclerosis from the societal perspective.
The Design of an Avatar in a Multiplayer Serious Game
Authors: Jakob Rebekka , Schmücker Vanessa , Joan Eiler Tanja , Grensing Florian , Brück Rainer
Published: September 2022

Avatars are often used to represent people in the virtual world. In the process, they can also have numerous psychological influences on the users. Therefore, this paper discusses a multiplayer application in virtual reality and how a appealing avatar could be designed in it. In a small study with six persons the application was tested competitively in teams of two, the users filled out a questionnaire and answered some additional questions. While an increase in motivation was observed in all participants, the choice of the preferred avatar was not uniform. Thus, this showed that an appealing avatar for everyone could not simply be determined, but personal preferences and experience must be taken into account.
Topology-optimized patient-specific osteosynthesis plates
Authors: Maintz Michaela , Seiler Daniel , Thieringer Florian M. , Wild Michael de
Published: September 2022

Patient-specific osteosynthesis plates can be used to reduce complications related to bone fracture treatment, such as infection, malocclusion and fatigue fractures of plates and screws. However, the implant design process is tedious. We propose a semi-automatic workflow to computationally design patient-specific titanium osteosynthesis plates for mandibular angle fractures. In this process, the plate stiffness is maximized while the mass is reduced. Two plate designs with different numbers of screw holes (implant #1 with four holes, implant #2 with eight holes) were generated with identical topology optimization settings and compared in a finite element model simulating various biomechanical masticatory loads. Differences in von Mises stresses in the implants and screws were observed. The load case of clenching the jaw on the opposite side of the fracture showed the highest stress distribution in implant #1 and higher peak stresses in implant #2. Stress concentrations were observed in sharp corners of the implant and could be reduced using local stress-based topology optimization. We conclude that the design process is an effective method to generate patientspecific implants.
Preliminary validation system for cuffless blood pressure measurement
Authors: Gonçalves Seabra Ana Carolina , Ferreira da Silva Alexandre , Stieglitz Thomas , Belen Amado-Rey Ana
Published: September 2022

The development of a non-invasive, cuffless, continuous, wearable device for the measurement of blood pressure is a complex endeavour due to the high specificity at each measuring site and the need for high accuracy. Proof-ofconcept and validation of a prototype should be performed at an early stage for functionality assessment. Additionally, the emergence of biological computer models allows for in-silico research, which results should be verified in a practical experiment. To grant an optimal preliminary assessment of a prototype, this work aimed to develop and validate accurate in-vitro and ex-vivo arterial models, with simple construction and easily available components. The comparison between a silicone tube and a porcine artery as a mimicked human radial artery was based on the stiffness parameter. Flow pressure is controlled by a centrifugal heart-like pump. Pressure values are extracted with ultrasound and a commercial piezoresistive pressure sensor is used for pressure validation. The porcine artery showed much more realistic stiffness values (·=15.360) than the silicon tube (·=543.420), which was very stiff in comparison to the typical in-vivo radial artery stiffness (·=9.5). The decrease in stiffness of 97.173 % (from the silicone tube to the porcine artery) led to an acute decrease in the derived pressure error. This work serves as guidelines for the development of a low-budget arm phantom, as the simple setup allowed for a primary validation of a proof-of-concept ultrasound-based sensor for the measurement of pressure.
Cross-spectral analysis quantifies the segmental coordination in unstable sitting
Authors: Roberts Brad , Vette Albert
Published: September 2022

Introduction: Low back pain(LBP) affects many individuals and is known to be associated with impaired trunk control. While LBP can be associated by treating underlying trunk impairments, a better understandinf of the mechanistic origin of the disorder is required. Trunk control has been commonly studied via an unstable sitting paradigm. Knowledge on how the base of support and body segments work together to complete the unstable sitting task, and how this is modified in individuals with LBP, could be utilized when designing interventions for this population. Our obiective was to characterize the segmental coordination in non-impaired unstable sitting as elicited via a wobble board(WB) paradigm. Methods: WB, pelvis, and trunk motion were recorded in fifteen non-disabled participants sitting on a wobble board. We used cross-spectral analysis to quantify the coordination of the anterior-posterior angular kinematics of the wobble board, pelvis, and trunk. Results: During unstable sitting, the motion of the pelvis was followed by that of the trunk(one-eighth-cycle delay) and wobble board(half-cyclw delay) at frequenties between 1 and 2 Hz. Conclusion: Future work should utilize the knowledge gained in this study when creating rehabilitation interventions for individuals with LBP.
Clinical utility of gait stability measures: Selection and preliminary evaluation of the margin of stability
Authors: Hall Jeremy C. , Roberts Brad W.R. , Bahari Hosein , Forero Juan , Rouhani Hossein , Hebert Jacqueline S. , Vette Albert H.
Published: September 2022

Introduction: gait-related falls account for most falls in the elderly. The identification of individuals at risk of falling due to unstable gait requires clinically feasible measures that can detect impairments in gait. Our obiective was to : (1) assess the feasibility for clinical implementation of existing gait stability measures and selected measures to detect gait impairments. Methods: Nine measures were assessed for clinical feasibility, with only the margin of stability(MOS) being selected for evaluation. Ground reactions and motion of the lower body were recorded in fifteen non-disabled and three disabled participants during treadmil walking. Media-lateral MOS was calculated and compared between the non-disabled and disabled participants to evaluate its ability to detect gait impairments. Results: MOS values at heel strike(HS) and at the point between HS and contralateral toe-off with minimum MOS deviated between participants with lower limb impaiments and non-disabled participants. Conclusion: MOS at HS demonstrated the greatest potential to assess fall risk. Additional work is required before MOS can be recommanded for clinical use.
Development of a Venous Collapse Prevention Device for Blood Draw
Authors: Liu Jan , Heumann Maximilian , Stewart Kent W. , Pott Peter P.
Published: September 2022

Blood sampling typically involves puncturing a superficial vein with a needle and then creating a vacuum (e. g., with a syringe) to transfer the blood from the venous system to the collection container. In some cases, the venous walls collapse due to excessive vacuum generated. In this work, a device is presented that prevents venous collapse and can be combined with any blood collection system available on the market. The mechanism of preventing venous collapse is based on a tubular segment interconnected between the needle and the syringe, which collapses at a lower vacuum pressure than the vein. The prototype was tested and evaluated using a test rig that simulates venous blood draw. The experiments proved the functionality of the device on a vein phantom.
Development of a compact sterilization and shredding machine for infectious or toxic wastes (MACS 800)
Authors: Taraschuk Igor , Reuter Thomas , Luft Conrad , Modaleck Toni
Published: September 2022

The amount of the toxic waste generated in the hospitals and medical facilities is steadily increasing. Although, the centralized disposal or waste management service solutions for the removal of toxic waste are available in highly developed industrialized countries; this does not, however, apply to the developing and emerging countries. For this reason, a compact sterilization and shredding machine was developed. The steam sterilization used (temperatures of 134 °C + 4 K and pressures of 480 to 3500 mbar) complies with the recognized procedure of the Robert Koch Institute (without chemical substances). Thus, it was possible to transform the infectious or toxic waste into non-hazardous household waste. The microbiological and physical test results show that the machine meets the requirements for sterilization of class C solid and liquid clinical wastes. The capacity of the machine is maximum 400 liters of waste per cycle, with an average cycle time of about 1 hour. It is possible to process contaminated materials both loose and in sealed disposal containers (C-boxes).
Improved Global Navigation Satellite System filtering methods for the mobile six-minute walk test
Authors: Ogris Maximilian , Edegger Kurt , Rzepka Angelika , Ziegl Andreas , Schreier Günter
Published: September 2022

Heart failure (HF) is a chronic disease with high hospitalizations rates and increased mortality. The six-minute walk test (6MWT) is a standardized method to assess the functional health of HF patients by measuring the distance walked in six minutes [1]. The improved 6MWT with new filter algorithms, based on the development of smartphone application [9], can be used everywhere with a good global navigation satellite system (GNSS) signal. This paper tests multiple filtering approaches to reduce the measured distance error in the application.We were able to decrease the average relative error of the application from 4.5% to 2.0%. Additionally, the number of experiments with relative error over our chosen clinically significant difference of 5% is reduced by 90%. Keeping these results in mind, the system can be considered clinically acceptable.
A concept and technical requirements for the Temi platform supporting care and nursing
Authors: Weigand Christian , Flemming Daniel , Zweyer Georg , Borutta Paul , Hofmann Fabian , Wieland Georg , Hayir Erdem , Seuß Dominik , Wittenberg Thomas
Published: September 2022

With a growing number of people in need of care and the shortage of skilled workers, caregivers express the desire for improved support to reduce physical strain and psychological stress. One task for burden relieve is documentation of nursing actions and treatment processes, as this can be done in parallel with the action. Hence tools capturing information in real time could improve information sharing. Also, contactless assessment of patients’ vital signs and emotions is desirable. Thus, the idea is to enhance an existing mobile platform, which can follow the nurse, includes a voice-controlled assistant, and be able for wireless (e.g., via Bluetooth) assessment of vital data from patients in its direct vicinity. Using the Temi telepresence robot as an open technical platform, we provide and discus requirements for this platform to potentially aid and relief to medical staff within caring and elderly homes, with respect to voice-control, Bluetooth-based vital data collection, interfaces to a digital patient manager and automated emotion recognition. The presented concept and the rating of the associated technologies leads to the conclusion that - if adequately implemented and installed - the caregivers could potentially receive noticeable relief from them. Nevertheless, as next steps, the examined technologies and ideas must be completely implemented, thoroughly fused with each other, and evaluated to provide a real support system for clinical care and assisted documentation.
Investigation of everyday influencing factors on the variability of exhaled breath profiles in healthy subjects
Authors: Fachet Melanie , Lowitzki Simon , Reckzeh Marie-Louise , Walles Thorsten , Hoeschen Christoph
Published: September 2022

Introduction: The human breath is an accurate but complex read-out of many physiological processes in the organism that can be monitored via volatile organic compounds (VOCs) in the exhaled air. However, there are many confounding variables that limit the transfer and application of breath analysis to become a clinical procedure. Method: This work aims to establish a systematic procedure for sampling and characterization of various everyday influences of healthy subjects using proton transfer reaction-mass spectrometry (PTR-MS). In order to limit the influencing factors on the breath profile, a standard analysis procedure for sampling and evaluation of the exhaled breath samples was developed. The correlations between the selected experimental conditions and the resulting VOC profiles were investigated using a non-parametric Wilcoxon rank sum test. Results: In addition to the relevant influence of methodological experimental parameters, interesting insights into the effect of everyday factors on the exhalat gas were obtained and discussed. Furthermore, subject and condition-specific differences were found in the exhaled air of male and female subjects. Conclusion: With a more robust, standardized and reproducible breath sampling protocol, breath analysis is a promising non-invasive tool towards a system-wide understanding and personalized diagnosis and treatment of a wide range of diseases.
Susceptibility artifacts evaluation for non-metallic biopsy needles in a biological-engineered 3D tumor model
Authors: Al-Maatoq Marwah , Fachet Melanie , Walles Heike , Hoeschen Christoph
Published: September 2022

Nowadays, needle artifacts are an essential restriction for MRI-guided interventions, as they influence the visually perceived needle size and needle destination. Standard MRI needles made of Nickel-Titanium (NiTi) alloys still produce massive artifacts in MRI due to materials’ interactions with the magnetic environment. The use of non-metallic materials can reduce these artifacts. Therefore, we propose a nonmetallic concept of a coaxial needle design concept with a fiber-enforced inner core and an outer polymeric hollow sheet. This work aims to evaluate the artifact performance of the proposed needles in a custom-made three-dimensional (3D) tumor model with a relevant size and thickness for medical interventions under MRI guidance using a 3T field strength with a T1-weighted gradient-echo sequence. Three coaxial MRcompatible needles were inserted in the custom-made 3D tissue phantom, one standard needle from NiTi, and two proposed non-metallic needles. Artifact’s width and length were measured for each needle. Overall, the non-metallic needles showed significantly lower artifacts than the standard NiTi needle inside the 3D tumor model.
Work space analysis of a new instrument for Natural Orifice Transluminal Endoscopic Surgery (NOTES)
Authors: Bachmann Ada L. , Giacoppo Giuliano A. , Pott Peter P.
Published: September 2022

Minimally invasive procedures such as Natural Orifice Transluminal Endoscopic Surgery (NOTES) require powerful, small, and flexible instruments. A cable-driven instrument was developed, which is able to retract tissue to create sufficient space for an actual operation (e.g. cholecystectomy). In this paper, the work space of a developed instrument is presented. The work space is calculated using direct kinematics equations and verified by measurement using an electromagnetic (EM) tracking system. The angular orientation of the instrument can be up to 85° with a length of the active section of 60 mm. However, a longitudinal rotation up to 17° becomes apparent. This is due to the characteristics of the steel cable used for actuation. Nevertheless, the instrument reaches the intended work space. Further measurements are necessary to evaluate the instrument’s behavior under payload and whether this affects the work space.
Evaluation of spatio-temporal electrocutaneous warning signals
Authors: Dölker Eva-Maria , Bernhard Maria Anne , Daniswara Indra , Haueisen Jens
Published: September 2022

Acoustic or visual warning signals for workers in hazardous situations might fail under loud and/or lowvisibility work situations. A warning system that uses electrocutaneous stimulation can overcome this problem. The aim of this pilot study was to find spatio-temporal stimulation patterns for appropriate electrical warning. Eight electrode pairs were attached to the upper right arm of 16 participants. The stimulation was conducted with bi-phasic rectangular pulses of 150 μs and an amplitude of up to 25 mA. Pulse intervals that generate a single pulse, pulsating, vibrating, and continuous perception as well as varying spatial patterns (e.g. alternating between electrode pairs or circumferentially around the arm) were investigated and evaluated with regard to alertness, discomfort, and urgency. The pilot study revealed that a stimulation signal that generates a vibrating perception and is applied as a circumferential signal around the arm showed the highest values of alertness and is therefore considered a potential warning pattern for future studies with larger study groups.
Differentiation of COVID-19 Conditions using Mediastinum Shape in Chest X-ray Images
Authors: Kumar Tulo Sukanta , Govindarajan Satyavratan , Ramu Palaniappan , Swaminathan Ramakrishnan
Published: September 2022

In this work, an attempt has been made to analyze the shape variations in mediastinum for differentiation of Coronavirus Disease-2019 (COVID-19) and normal conditions in chest X-ray images. For this, the images are obtained from a publicly available dataset. Segmentation of mediastinum from the raw images is performed using Reaction Diffusion Level Set (RDLS) method. Shape-based features are extracted from the delineated mediastinum masks and are statistically analyzed. Further, the features are fed to two classifiers, namely, multi-layer perceptron and support vector machine for differentiation of normal and COVID-19 images. From the results, it is observed that the employed RDLS method is able to delineate mediastinum from the raw chest Xray images. Eight shape features are observed to be statistically significant. The mean values of these features are found to be distinctly higher for COVID-19 images as compared to normal images. Area under the curve of greater than 76.9% is achieved for both the classifiers. It appears that mediastinum could be used as a region of interest for computerized detection and mass screening of the disease.
IEEE 11073 SDC for Pandemics like COVID-19: Example Implementation of an Isolation Room
Authors: Kasparick Martin , Schackmann Dennis , Klotz Tobias , Ritz Fabian , Golatowski Frank , Rethfeldt Michael , Neumuth Thomas , Timmermann Dirk , Rockstroh Max
Published: September 2022

Treating patients in an intensive care unit (ICU) isolation room is full of challenges for the caregivers and the patients. While this is known for years, the COVID-19 pandemic has highlighted these challenges as if under a burning glass - intensified by a high number of patients at the same time. The risk of infection for the caregivers is very high inside the isolation room and the time spent for putting on and taking off personal protective equipment (PPE) is enormous. Thus, every treatment that can be performed from the anteroom of the isolation room at the same quality level as if being inside the isolation room is a potential building block for solving the challenges. However, data like vital signs have to be provided to the anteroom, alarms have to be transferred to the right caregiver at the right place, and controlling medical device parameters from the anteroom are prerequisites. The new IEEE 11073 Service-oriented Device Connectivity (SDC) series of standards is a key technology to realize this. Therefore, this paper presents an example implementation of IEEE 11073 SDC-based ICU isolation rooms by means of a demonstrator. Such systems can significantly reduce the amount of time the caregivers have to spend in the isolation room and reduce the number of clothing (PPE) changes while providing care at a level of a non-isolation room. As a midterm goal these are steps for the vision of a “silent/quiet ICU”.
Thermal annealing of injection molded VHMW PLLA
Authors: Oschatz Stefan , Arbeiter Daniela , Schultz Selina , Fiedler Nicklas , Grabow Niels
Published: September 2022

In this study, DSC experiments were used to elaborate an annealing protocol for injection molded very high molecular weight (VHMW) PLLA with two molecular masses, 320,000 g/mol and 700,000 g/mol. The initial material obtained from the injection molding process was found to be highly amorphous and not in thermodynamic equilibrium state, as distinct cold crystallization and enthalpy relaxation were observed in DSC data. Thermal annealing to 85 °C for 60 - 90 min under controlled conditions using a DSC device showed to be sufficient to stabilize the polymer and increase the crystallinity to up to 50 %. Annealing did not result in any signs of thermal decomposition. The elaborated thermal treatment has been transferred to manual annealing of large specimen geometries for subsequent DMA analysis.
Design study of dynamic mechanical test bench specimen grips
Authors: Fiedler Nicklas , Arbeiter Daniela , Kleine Thomas , Grabow Niels
Published: September 2022

The characterization of mechanical properties of materials used in biomedical applications is essential for performance evaluation. In addition to quasi-static tests, dynamic tests extend the range of methods and allow predictions of failure, as well as information on durability. Appropriate specimen grips according to the test sample geometry are crucial for a reliable examination of mechanical testing and therefore valid experimental data. In particular, the investigation of polymers is challenging, as properties show major differences depending on temperature and applied loading rate. This could result in slipping or tearing of samples in the specimen grip area. Numerical simulations of reference grips, as well as alternative custom designs, were performed evaluating damage due to the clamping process and to provide appropriate specimen grips for future dynamic-mechanical investigations of materials with variable properties. Both the results of the numerical simulation and preliminary tests with 3D-printed prototypes show a distinct improvement in specimen clamping. Plastic deformation and local stress peaks were reduced while maintaining the same tightening torque.
PLLA crystallization kinetics in dependence of molecular weight
Authors: Arbeiter Daniela , Grabow Niels , Oschatz Stefan
Published: September 2022

The effect of molecular weight Mwon the polymorphous crystallization and melting behavior of poly(Llactide) PLLA (L206, L210 and L214) were systemically studied by differential scanning calorimetry (DSC). Melting and reorganization of conformationally disordered crystals (α′-phase) of PLLA are analyzed with respect to the cooling rate qcin a range between about 4 and 50 K/min and the heating rate qhin a range between about 5 and 200 K/min. It was shown that the α′- to α-crystalline phase transition prior to the dominant melting depends on cooling rate qcand Mw. Unlike very high-MwPLLA L214, for low-MwPLLA L206 crystallized at high qc, the α′-form crystals only partially transformed into the α-modification, and certain amounts of α′-form crystals melted directly without α′- to α-transition during the heating process. With increasing qc, the melting of PLLA L210 changed from phase-transition- and -melting mechanism to the common melt-recrystallization mechanism. It was also found that the polymorphism of PLLA significantly affected the crystallization kinetics. Consequently, the reorganization of α′-crystals into stable α- crystals could be inhibited by fast heating (qh> 150 K/min).