bluuebunny/crossref_metadata_2025 huggingface dataset:
Statistical analysis of double stress accelerated life testing under adaptive type-Ⅱ progressive censoring
Authors: YANG Tianle , LI Huacong , FU Jiangfeng
Published: October 2024

Aiming at the traditional accelerated life test only considering the single stress and single failure cause, the inference method of double stress accelerated competing risks data is studied under the adaptive type-Ⅱ progressively censored and the life of test units follow Weibull distribution. The maximum likelihood estimations and the asymptotic confidence intervals of unknown parameters are obtained by using the Newton-Raphson iteration and asymptotic likelihood theory. A Gibbs sampling combining with Metropolis-Hasting algorithm method is developed to obtain Bayes estimations, and the Monte Carlo method is employed to construct the HPD credible intervals. The simulated results show that the present method has good statistical inference performance, meanwhile the failure sample size and the expected experimentation time have significant effect on the estimations.
Register transfer level hardware design information flow modeling and security verification method
Authors: QIN Maoyuan , HOU Jiaying , LI Jiale , TANG Shibo , TAI Yu
Published: October 2024

Information flow analysis can effectively model the security behavior and security properties of hardware design. However, the existing gate level information flow analysis methods cannot deal with large-scale designs due to computing power and verification effectiveness, and the register transfer level (RTL) information flow analysis methods require formal languages to rewrite hardware designs. This paper proposes a RTL hardware design information flow modeling and security verification method. Based on the RTL functional model, this method develops an information flow tracking logical model to model security behavior and security properties of RTL hardware designs from the perspective of information flow. This method can be integrated into EDA flows and uses EDA testing and verification tools to capture security property violations and detect security vulnerabilities based on non-interference security policy. The results on experiments with Trust-Hub hardware Trojan benchmarks show that the proposed method can effectively detect hardware Trojans.
Study on multi-state of meshing-impacting dynamic characteristics of spur gear systems considering friction under localized tooth breakage
Authors: QI Pengfei , SHI Jianfei , JIN Wuyin , CHEN Guolong
Published: October 2024

Localized tooth breakage is one of the common failures of spur gears, which affects the smooth and safe operation of spur gear transmission systems. The tooth collision cannot be neglected, and it is especially important to reveal the meshing-impacting dynamic characteristics of the gear system under localized tooth breakage to improve the safe and stable operation of the gear system. Based on the gear meshing principle and the dissipative collision contact force model, the drive-side tooth meshing model and back-side tooth impacting model are established with considering the transient nature of tooth back-side contact. The tooth surface meshing model and tooth back collision model under partial breakage are established. According to the contact state and force environment of the gear pair, the multi-state meshing-impacting behaviour under local breakage is classified, and the discrete meshing-impact dynamics model of an involute spur gear system under local breakage is established to explore the influence of local breakage on the meshing stiffness and load distribution. The mechanism of contact force under partial tooth breakage is revealed, and the influence of load coefficient and meshing frequency on the nonlinear dynamics is studied by defining two Poincaré maps. It is found that local tooth breakage affects the contact force of single-and double-tooth meshes and reduces gear load carrying capacity. Larger loads inhibit back-side impact, and smaller loads induce the coexistence behaviour and back-side impact. Larger or smaller meshing frequency induce back-side impact behaviour. The coexistence of chaotic and periodic motions induces back-side impact behaviour, and localized tooth breakage affects the coexistence phenomenon and aggravates the complexity of the dynamic behaviour. The dynamic model of gear system considering energy dissipation and nonlinear vibration under the presence of local tooth breakage of the pinion is explored, and the conditions of back-side impact are studied. This research provides new methods and ideas for nonlinear dynamic modelling and analysis of faulty gear systems.
Studies on meshing clearance of thread pairs of planetary roller screw mechanism in different directions
Authors: CAI Wei , FU Xiaojun , MA Shangjun , LI Xin , LIU Geng
Published: October 2024

The helix surface model of planetary roller screw mechanism (PRSM) is established by utilizing the parametric equations of space surface according to the structural features of screw, roller and nut. The helix surface model of PRSM is improved in consideration of the PRSM assembly relationship. The normal vector equations of helix surfaces are obtained based on the helix surface model. The meshing clearance models of PRSM in axial, radial and circumferential directions are built considering the movement direction of parts utilizing surface meshing conditions. The influence of structural parameters on the meshing clearance of PRSM is also analyzed. The results show that the meshing points between the roller and the screw in three directions are not in the middle diameter. The meshing points in the three directions of the roller and the nut are in the middle diameter of the roller. The pitch, tooth angle and tooth thickness of the thread all have an influence on the meshing clearance of PRSM. Only by increasing the tooth thickness of the thread can the meshing clearance in the three directions be reduced at the same time. The pitch and tooth angle should be selected properly to meet the practical requirements.
Dynamic characteristics of compound rotor system of mechanically rectified permanent magnet generator
Authors: LIU Xin , XUE Zhiwei , ZHANG Yuting , NIU Leilei
Published: October 2024

The compound rotor system of a mechanically rectified permanent magnet generator is the key structure to realize the rectification function. The dynamics of the compound rotor system under bidirectional input conditions are studied to analyze the vibration deformation degree of each component of the rotor system and to ensure the uniform distribution of the shunt load of each planetary gear. In this paper, based on the theory of concentrated mass parameters, a dynamic model of the compound rotor system under the condition of bidirectional input is established. The model is solved with the Runge-Kutta numerical integration method. The dynamics of each component under the condition of bidirectional input are obtained. The results show that the oscillations of torsional displacement of each component of the compound rotor system are all about 25 μm, and the standard deviations of the meshing forces of each planetary shunt are all about 200 N during the two-way input, indicating that the vibration degree of the compound rotor system is similar; The load sharing coefficient of meshing forces decreases obviously with the increase of input torque and tends to be gentle when the torque reaches 500 N·m. Therefore, increasing the input torque can improve the dynamic meshing force and load sharing performance, so that the compound rotor system can obtain better dynamic performance under the bidirectional input condition. The research results are of great significance for the vibration and noise reduction and reliable operation of the permanent magnet generator.
Firsttrimester Diagnosis and Therapy @ 11–13+6 Weeks of Gestation – Part 2
Authors: von Kaisenberg Constantin , Kozlowski Peter , Kagan Karl-Oliver , Hoopmann Markus , Heling Kai-Sven , Chaoui Rabih , Klaritsch Philipp , Pertl Barbara , Burkhardt Tilo , Tercanli Sevgi , Frenzel Jochen , Mundlos Christine
Published: October 2024

This extensive AWMF 085-002 S2e-guideline “First Trimester Diagnosis and Therapy @ 11–13+6 Weeks of Gestation” has systematically analyzed high-quality studies and publications and the existing evidence (evidence tables) and produced recommendations (level of recommendation, level of evidence, strength of consensus).

This guideline deals with the following topics in the context of the 11–13+6 weeks scan: the legal basis, screening for anatomical malformations, screening for chromosomal defects, quality assessment and audit, screening for preeclampsia and FGR, screening for preterm birth, screening for abnormally invasive placenta (AIP) and placenta accreta spectrum (PAS), screening for velamentous cord insertion and vasa praevia, screening for diabetes mellitus and LGA.

Screening for complications of pregnancy can best be carried out @ 11–13+6 weeks of gestation. The issues of how to identify malformations, chromosomal abnormalities and certain disorders of placentation (high blood pressure and proteinuria, intrauterine growth retardation) have been solved. The problem of how to identify placenta percreta and vasa previa has been partially solved. What is still unsolved is how to identify disorders of glucose metabolism and preterm birth.

In the first trimester, solutions to some of these problems are available: parents can be given extensive counselling and the risk that a pregnancy complication will manifest at a later stage can be delayed and reduced. This means that screening is critically important as it helps in decision-making about the best way to manage pregnancy complications (prevention and intervals between follow-up examinations).

If no treatment is available and if a termination of pregnancy is considered, the intervention can be carried out with far lower complications compared to the second trimester of pregnancy. In most cases, further examinations are not required and the parents can be reassured. A repeat examination at around week 20 of gestation to complete the screening for malformations is recommended.

Note The guideline will be published simultaneously in the official journals of both professional societies (i.e. Ultraschall in der Medizin/European Journal of Ultrasound for the DEGUM and Geburtshilfe und Frauenheilkunde for the DGGG).
Firsttrimester Diagnosis and Therapy @ 11 – 13+6 Weeks of Gestation – Part 2
Authors: von Kaisenberg Constantin , Kozlowski Peter , Kagan Karl-Oliver , Hoopmann Markus , Heling Kai-Sven , Chaoui Rabih , Klaritsch Philipp , Pertl Barbara , Burkhardt Tilo , Tercanli Sevgi , Frenzel Jochen , Mundlos Christine
Published: October 2024

This extensive AWMF 085-002 S2e-guideline “First Trimester Diagnosis and Therapy @ 11 – 13+6 Weeks of Gestation” has systematically analyzed high-quality studies and publications and the existing evidence (evidence tables) and produced recommendations (level of recommendation, level of evidence, strength of consensus).

This guideline deals with the following topics in the context of the 11 – 13+6 weeks scan: the legal basis, screening for anatomical malformations, screening for chromosomal defects, quality assessment and audit, screening for preeclampsia and FGR, screening for preterm birth, screening for abnormally invasive placenta (AIP) and placenta accreta spectrum (PAS), screening for velamentous cord insertion and vasa praevia, screening for diabetes mellitus and LGA.

Screening for complications of pregnancy can best be carried out @ 11 – 13+6 weeks of gestation. The issues of how to identify malformations, chromosomal abnormalities and certain disorders of placentation (high blood pressure and proteinuria, intrauterine growth retardation) have been solved. The problem of how to identify placenta percreta and vasa previa has been partially solved. What is still unsolved is how to identify disorders of glucose metabolism and preterm birth.

In the first trimester, solutions to some of these problems are available: parents can be given extensive counselling and the risk that a pregnancy complication will manifest at a later stage can be delayed and reduced. This means that screening is critically important as it helps in decision-making about the best way to manage pregnancy complications (prevention and intervals between follow-up examinations).

If no treatment is available and if a termination of pregnancy is considered, the intervention can be carried out with far lower complications compared to the second trimester of pregnancy. In most cases, further examinations are not required and the parents can be reassured. A repeat examination at around week 20 of gestation to complete the screening for malformations is recommended.

Note: The guideline will be published simultaneously in the official journals of both professional societies (i.e. Ultraschall in der Medizin/European Journal of Ultrasound for the DEGUM and Geburtshilfe und Frauenheilkunde for the DGGG).
Effects of Progesterone on Vasomotor Symptoms in Postmenopausal Women (PROGEST) – a Prospective Multi-Center Randomized Double-Blind Placebo-Controlled Trial (RDPCT)
Authors: Beinert Sissi Valentina , Kleinsorge Frauke , Worm Julia , Tropschuh Katharina Victoria , Seifert-Klauss Vanadin
Published: October 2024

Introduction Monotherapy with progesterone for treatment of vasomotor symptoms (VMS) was more effective than placebo treatment of postmenopausal healthy women in a Canadian trial. The PROGEST-trial was initiated to fulfill FDA-approval criteria for the indication of treatment of postmenopausal VMS.

Methods This prospective randomized, double-blind placebo-controlled clinical trial studied three doses of oral micronized progesterone (200 mg, 300 mg, 400 mg) and placebo for 12 weeks. Postmenopausal women with moderate to severe VMS (> 50 per week) were screened for one week for VMS frequency, then randomized to 200, 300 or 400 mg progesterone daily or placebo for a double-blinded trial of 12 weeks duration.

Results 74 women were recruited in 12 study centers. 44 terminated the study as per protocol (PP). Moderate to severe hot flushes decreased by 7.4/d in the placebo arm, 7.7 VMS/d with 200 mg/d progesterone (P4), 8.3 VMS/d on 300 mg/d and 9.0 VMS/d on 400 mg/d P4, respectively by week 12. 32 treatment emergent adverse events were documented in 18 participants, mostly minor AEs. The only SAE was a syncope requiring hospitalization on the day after treatment initiation, leading to discontinuation of the drug.

Discussion Baseline VMS frequency was much higher in the German than in the Canadian study and the course of the placebo group had a markedly stronger decrease in VMS-frequency during the PROGEST study (−7.4/d) than in the Canadian trial (−1.4/d). Trial populations differed by age, BMI, the number of women with natural menopause, and comorbidities, mainly hypertension.

Conclusion Premature discontinuation of the trial due to insufficient subject accrual rate led to only 55 randomized participants for analysis, therefore the study results lack statistical power. Still, a slight dose-dependent improvement in VMS was seen for all doses, while AE frequency did not increase with progesterone dose.
STRIDE-Regime zeigt auch bei nicht-viraler Ätiologie hohe Wirksamkeit
Authors: Schöllmann Claudia
Published: October 2024

Das STRIDE-Regime, bestehend aus einer Initialdosis des CTLA-4 Inhibitors Tremelimumab (Imjudo®) plus kontinuierlicher 4-wöchentlicher Applikation des PD-L1-Inhibitors Durvalumab (Imfinzi®), ist als duale immunonkologische Erstlinientherapie beim uHCC zugelassen. Eine explorative Analyse der Zulassungsstudie HIMALAYA zeigt, dass STRIDE auch bei nicht viraler Ätiologie ähnlich gut wirkt wie in der Gesamt-Studienpopulation 1.
Zweite positive Phase-III-Studie mit 177Lu-PSMA-617
Authors: Arnheim Katharina
Published: October 2024

Durch die Radioliganden-Therapie mit 177Lu-PSMA-617 wurde in der Phase-III-Studie PSMAfore an Männern mit metastasiertem kastrationsresistentem Prostatakrebs (CRPC) eine Verlängerung des radiologischen progressionsfreien Überlebens (rPFS) bei gleichzeitiger Verbesserung der Lebensqualität erreicht.
Spielt die Anzahl der Vortherapien eine Rolle?
Authors: Willen Christine
Published: October 2024

Inhibitoren der Bruton-Tyrosinkinase (BTKI) sind etablierte Therapieoptionen bei Menschen mit chronisch lymphatischer Leukämie (CLL). Inwiefern die Anzahl der Vortherapien das Outcome unter einer Therapie mit Acalabrutinib beeinflusst, wurde anlässlich des EHA 2024 in Madrid (Spanien) erläutert.
Technical and clinical success analysis of transarterial embolization therapy in type II endoleaks following endovascular aortic repair
Authors: Krompaß Kristina , Grunz Jan-Peter , Augustin Anne Marie , Peter Dominik , Schönleben Frank , Bley Thorsten , Kickuth Ralph
Published: October 2024

This single-center study investigated the safety and efficacy of transarterial embolization of type II endoleaks for expanding aneurysm sacs following endovascular aortic repair (EVAR).

36 patients (33 men, 75.9±6.6 years) underwent a total of 50 endovascular procedures for type II endoleak embolization between 2008 and 2023. Analyses included the assessment of patient risk profiles, aneurysm morphology, and endoleak characteristics. Outcome parameters comprised the technical success (i.e., complete lack of blood flow in the previously perfused aneurysm sac) and complication rates, while clinical success was defined as the absence of endoleak persistence or recurrence and freedom from aneurysm enlargement > 0.5 cm over the follow-up period.

Transarterial embolization was technically successful in 84% of procedures with a complication rate of 2%. Most interventions were coil-based (72%), while a small number relied solely on liquid embolic agents (14%). Absence of a persisting endoleak in the earliest follow-up could be demonstrated in 75.6% of cases, whereas the absence rate for endoleak recurrence was substantially lower (46.3%). No aneurysm enlargement > 0.5 cm during follow-up was ascertained after 73.2% of interventions.

Transarterial embolization represents a safe treatment for type II endoleaks after EVAR. While embolization was moderately effective in preventing further expansion of aneurysms due to endoleak recurrence, most procedures were successful in permanently eliminating the targeted feeder vessels.
Soll ich bleiben oder soll ich gehen? Resilienz, Kündigungsabsicht
und Arbeitszufriedenheit von Krankenpflegefachkräften auf
Intensivstationen
Authors: Füreder Nina , Herber Gabriele , Stadlmayr Elke
Published: October 2024

Ziel Die Bewältigung des weltweiten Mangels an Pflegekräften trägt zu den
nationalen und internationalen Bemühungen bei, die Gesundheit und das
Wohlbefinden der Weltbevölkerung zu sichern. Das Ziel dieses Beitrages besteht
darin, auf die Bedeutung der Resilienz und dessen Einfluss auf die
Kündigungsabsichten und die Arbeitszufriedenheit unter den aktuellen
Herausforderungen von Krankenpflegefachkräften hinzuweisen.

Methodik Es handelt sich um ein Mixed-Methods-Design mit diplomierten
Krankenpflegefachkräften auf Intensivstationen eines Universitätskrankenhauses
in Österreich. In der ersten Phase der Datenerhebung wurden mittels qualitativen
Fokusgruppeninterviews Daten zu den aktuellen Herausforderungen und Belastungen
der Fachkräfte erhoben. Unter Bezugnahme auf relevante Literatur wurde im
darauffolgenden Schritt eine quantitative Erhebung mit den Skalen Resilienz,
Kündigungsabsicht und Arbeitszufriedenheit, unter allen Pflegefachkräften
durchgeführt, um die Zusammenhänge der ausgewählten Variablen zu untersuchen.
Darüber hinaus konnte mithilfe der konfirmatorischen Faktorenanalyse eine
Datenstrukturierung der Resilienz Skala erzielt werden. Im Anschluss wurden die
Zusammenhänge der Resilienz-Subfaktoren mit den anderen Variablen mittels einer
weiterführenden Korrelations-, Regressions- und Mediationsanalyse
untersucht.

Ergebnisse Die Ergebnisse zeigen negative Zusammenhänge hinsichtlich
Resilienz und Kündigungsabsicht sowie in Bezug auf Arbeitszufriedenheit und
Kündigungsabsicht. Demgegenüber korrelieren Arbeitszufriedenheit und Resilienz
stark positiv miteinander. Der negative Zusammenhang zwischen Resilienz und
Kündigungsabsicht differenzierter betrachtet insbesondere für die Faktoren
„Zielfokussierung“ und „Stolz und Bindung“. Betrachtet man die beiden Faktoren
und die dazugehörigen Items genauer, lässt sich eine Verbindung zur
Berufsidentität bzw. zur organisationalen Identität erkennen.

Schlussfolgerungen Die Studie liefert wertvolle Erkenntnisse für
Führungskräfte in der allgemeinen Gesundheitspraxis und für
Entscheidungsträger*innen im Gesundheitswesen, um das Pflegepersonal in der
medizinischen Grundversorgung effektiv zu führen, zu entwickeln und dadurch zu
halten. Die Autorinnen argumentieren, dass die Förderung der Resilienz und die
Stärkung der organisationalen Identität wesentliche Einflussfaktoren für eine
höhere Arbeitszufriedenheit und eine Verringerung der Kündigungsabsicht des
Pflegpersonals sind.
Tumorinfiltrierende Lymphozyten sagen unabhängig die Prognose triple-negativer Mammakarzinome voraus
Authors: Krome Susanne
Published: October 2024

Patientinnen mit triple-negativen Mammakarzinomen haben auch in frühen Stadien ein hohes Rezidiv- und Metastasierungsrisiko. Adjuvante und neoadjuvante Chemotherapien reduzieren die Wahrscheinlichkeit. Ein hoher Anteil tumorinfiltrierender Lymphozyten (TIL) bestätigte sich als günstiger Biomarker bei chemotherapeutisch behandelten Frauen. Die retrospektive Metaanalyse belegt nun einen unabhängigen prognostischen Wert der TIL bei Patientinnen, die ausschließlich lokoregionär behandelt wurden.
Spontaneous Umbilical Cord Vascular Rupture during Labor: A Retrospective Analysis of 12 Cases
Authors: Chen Ruiyun , Lin Lin
Published: October 2024

Objective Umbilical cord vascular rupture is a rare and severe condition that can occur during labor, leading to adverse outcomes for the fetus before as well as after delivery. Prompt diagnosis and intervention are crucial for improving the chances of a successful outcome. We aimed to analyze cases of umbilical cord vascular rupture during labor to provide insights into this challenging condition.

Study Design This retrospective study evaluated the medical records of patients diagnosed with umbilical cord vessel rupture or umbilical cord hematoma at Fujian Maternity and Child Health Hospital from January 1, 2015, to May 31, 2023. The inclusion criteria included gestational age of ≥28 weeks, occurrence during labor, and availability of complete delivery data. Data on fetal heart rate (FHR) changes, delivery intervals, intraoperative findings, placental pathology, and neonatal outcomes were collected and analyzed.

Results A total of 12 cases were analyzed. The incidence of umbilical cord vascular rupture during childbirth was 0.08%. The FHR patterns in umbilical cord rupture during delivery included baseline tachycardia, minimal or absent variability, variable or late deceleration, prolonged deceleration, and undetectable heart rate. The bradycardia-to-delivery interval (BDI) ranged from 6 to 26 minutes. Among the 12 neonates, 9 were discharged well, 2 were stillbirths, and there was 1 neonatal death. Hemorrhagic shock was common in live births.

Conclusion Our study highlights the significance of continuous FHR monitoring during labor and the urgent need for medical teams to respond quickly in cases of umbilical cord vascular rupture. Despite advancements in neonatal resuscitation techniques, managing cases with undetectable fetal heart activity remains clinically challenging, and even with immediate pregnancy termination, poor neonatal outcomes may still occur.

Key Points
The Retrosynthesis Mindset: A Problem-Solving Tool
Authors: Milić Jovana V. , Fung Fun Man , Choo Yvonne S. L. , Kolanowski Jacek L.
Published: October 2024

Retrosynthesis refers to the process of deconstructing a target molecule step by step until simpler and commercially available synthetic precursors are identified to develop a valid synthetic pathway. As a powerful problem-solving tool, it has gradually been expanded to other fields of chemistry. The application of a ‘retrosynthesis mindset’ can be relevant beyond chemistry, such as in education, research management, and science advice. In this Letter, we discuss the concept of the retrosynthesis mindset and its implications within and beyond chemistry in the hope of highlighting a broader potential and encouraging the adoption of such a mindset to enhance problem solving and strategic planning across disciplines.

1 Introduction

2 Retrosynthesis Education

3 Retrosynthesis Within and Beyond the Lab

4 Conclusion
Comparison of Frequently Used Fever Measurement Methods: Which One is the Best?
Authors: Aydın Cansu , Bayhan Gülsüm İclal
Published: October 2024

Objective Peripheral measurement sites and methods used to determine core body temperature were investigated, as there is still debate about which noninvasive core body temperature measurement method is the most valuable and accurate for each age group.

Methods Children aged 1 to 36 months were included in the study. The temperature was measured from the forehead (noncontact cutaneous), temporal artery (TA), axilla, and rectum. The rectal measurement was accepted as the reference measurement. A rectal temperature of ≥38.3°C was defined as fever.

Results The noncontact cutaneous, axillary, and TA measurements were 1.2, 1.1, and 0.7°C lower than rectal measurements, respectively (p < 0.001, <0.001, <0.001). The TA and noncontact cutaneous measurements demonstrated a moderate positive correlation with rectal measurements, whereas a strong positive correlation was seen between the axillary and rectal measurements. A cutaneous temperature of 37.8°C was found to have a positive predictive value (PPV) of 100%, negative predictive value (NPV) of 81%, sensitivity of 34%, and specificity of 100% for detecting fever. The respective values were 80, 79.4, 23.5, and 98% for an axillary temperature of 37.5°C, and 90, 86.2, 52.9, and 98% for a TA temperature of 38°C.

Conclusion The commonly used fever measurement methods have high PPV and NPV and specificity but low sensitivity.
Preventable Hospital Admission-associated VTE: Thoughts on Thromboprophylaxis as Asians
Authors: D. Maran Esan Saciin , Er Chaozer , Gohar Sandeep , Adamjee Thofique
Published: October 2024

Previous studies surveying senior and junior doctors have shown that thromboprophylaxis was not commonly practiced in hospitalized medical patients in three public hospitals in Singapore. We, therefore, conducted an audit of our hospital's venous thromboembolism (VTE) clinic cases to study the proportion of preventable hospital admission-associated VTE (HAAVTE). All newly diagnosed VTE cases referred to our VTE clinic from March 2023 to December 2023 were reviewed, to identify those potentially associated with recent hospital admissions. We then reviewed the medical records of those cases to see if thromboprophylaxis was prescribed if indicated. HAAVTEs that had high VTE risk and did not receive appropriate thromboprophylaxis (pharmacological or mechanical) were considered preventable HAAVTE. Thirteen cases of HAAVTEs were identified, out of which only one was given the appropriate thromboprophylaxis. The proportion of preventable HAAVTE was 92.3%. Thromboprophylaxis is not widely practiced in our hospital. More effort is required to improve local thromboprophylaxis practice for hospitalized patients to reduce the burden of preventable HAAVTE.
Vorhaltevergütung: Ein Rückschritt
Authors: Bornemeier Olaf
Published: October 2024

Das Tal der Tränen muss durchschritten werden, die dann übrig gebliebenen Krankenhäuser werden die heutige Gesamtbudgetsumme erhalten und dadurch ökonomisch gesunden.
Insolvenzverfahren: Ein Investor für alles in Bad Bramstedt
Authors: Kohrs Jens
Published: October 2024

Wenn nicht doch noch wieder etwas schiefgeht, übernimmt die IGP medical GmbH das insolvente Klinikum Bad Bramstedt. Hinter den Beteiligten liegt eine nervenzerrende Achterbahnfahrt – an der sich zum Schluss sogar zwei berühmte Musiker-Brüder beteiligten.
Sternbach-Klinik Schleiz: Anzeige wegen Insolvenzverschleppung
Authors: Kohrs Jens
Published: October 2024

Ende August hat die insolvente Sternbach-Klinik im thüringischen Schleiz geschlossen – doch der Fall dürfte noch länger Wellen schlagen.
RKH Gesundheit: Landkreise müssen zahlen
Authors: Schmidt Hartmut
Published: October 2024

Börsenexperte Hartmut Schmidt analysiert für kma die Jahresabschlüsse ausgewählter Kliniken kma Online Ausführliche Berichte lesen Sie jeden Monat auf kma Online unter www.kma-online.de/kassensturz
Rechtskolumne: Mehr oder weniger Transparenz durch den Bundes-Klinik-Atlas?
Authors: Rybak Christian
Published: October 2024

Der Bundes-Klinik-Atlas soll transparent insbesondere über Umfang und Qualität der Versorgung in Krankenhäusern informieren. In einer Zeit, in der Transparenz zu einem der zentralen Werte unserer Gesellschaft erhoben wurde, verspricht das Krankenhaustransparenzgesetz damit eine Revolution im Gesundheitswesen. Doch hält das Gesetz wirklich, was es verspricht, oder bringt es am Ende mehr Verwirrung als Klarheit?
Ambulante Versorgung: Mehr als eine Nebensache
Authors: Heeser Alexandra
Published: October 2024

Die Ambulantisierung gehört zu den zentralen Zielen von Gesundheitsminister Prof. Dr. Karl Lauterbach (SPD). Dennoch tritt sie im derzeitigen Gesetzentwurf zur Krankenhausreform eher als Nebeneffekt auf. Um die ambulante Versorgung zu stärken, muss sie zum Brennpunkt werden.
Strategie: Stationär und ambulant aus einer Hand
Authors: Heeser Alexandra
Published: October 2024

Schon vor 20 Jahren wurde gefordert, dass sich die Kliniken für die ambulante Behandlung öffnen müssen. Damals glaubte Karl Lauterbach als Berater von Ulla Schmidt, das DRG-System werde es schon richten. Heute ist klar: Es werden immer noch zu viele Patienten stationär behandelt, die Anreize waren falsch.
Diskussion: Vorhaltefinanzierung – ein Für und Wider
Authors: Heeser Alexandra
Published: October 2024

Wenn die Anreize der Vorhaltefinanzierung wie geplant wirken, werden künftig bis zu 20 Prozent weniger Fälle in den Krankenhäusern behandelt. Ob diese Leistungsverlagerung gelingen kann, ist schwer umstritten. kma hat dazu mit einem Befürworter und einem Kritiker der Vorhaltepauschalen gesprochen.
Führen und Verwalten: Lohnt sich ein MVZ-Geschäftsführer?
Authors: Frielingsdorf Oliver
Published: October 2024

Bundesweit gibt es mehr als 2 000 medizinische Versorgungszentren in Klinik-Trägerschaft. Rund 10 Prozent davon sind Mitglied im Statis e. V., der jedes Jahr einen umfassenden „Betriebsvergleich Klinik-MVZ“ durchführt. Aus den dabei gewonnenen Zahlen lassen sich Rückschlüsse über Tätigkeitsfelder, Kosten und Nutzen einer eigenen MVZ-Geschäftsleitung gewinnen.
Klinikfusion gestoppt: UK Mannheim setzt auf Ministererlaubnis
Authors: Rößing Sabine
Published: October 2024

Die Auseinandersetzung um die angepeilte Übernahme des defizitären Mannheimer Universitätsklinikums durch das Uniklinikum in Heidelberg ist noch nicht entschieden. Der wirtschaftliche Druck steigt und Ideen für spürbare Kostensenkungen sind rar. Umso ehrgeiziger sind die Vorstellungen für neue Investitionen.
Verpflegung: Hier kocht ein Roboter
Authors: Kucera Martin
Published: October 2024

Seit Ende Mai setzt Tübingen als weltweit erstes Universitätsklinikum eine Roboterküche ein. Das Zusatzangebot richtet sich vor allem an Schichtarbeitende, bietet aber auch ambulanten Patienten und Gästen außerhalb der Öffnungszeiten von Betriebsrestaurants und Cafeterien warme Mahlzeiten.
Functional inorganic compounds hold promise for revolutionizing myriad aspects of cancer care
Authors: Liebendorfer Adam
Published: October 2024

From boosting detecting in imaging studies to homing in specifically on cancer cells, modified nanoparticles have demonstrated several exciting avenues for treatment.
Development of a compact bolometer camera concept for investigation of radiation asymmetries at Wendelstein 7-X
Authors: Partesotti G. , Reimold F. , Ruhnau J. , Tsikouras A. , Kubeneck D. , Zhang D. , Geißler P. ,   W7-X Team
Published: October 2024

Power exhaust is one of the central challenges in magnetically confined fusion plasmas. Radiative detachment can be employed to reduce particle and heat fluxes to the divertor target, mitigating divertor damage and erosion. However, accomplishing this for a non-axisymmetric machine such as Wendelstein 7-X is a non-trivial task because of the complex role of transport and plasma-wall interaction in a three-dimensional magnetic field topology. We introduce a new bolometer camera design that can be easily installed in multiple toroidal locations and adapted to the required geometry, providing additional spatial coverage. This can be used to locally enhance tomographic capabilities or to resolve spatial variations of the plasma emissivity. By including these non-uniformities in the total radiated power estimate, global power balance measurements can be improved. We model each bolometer camera using ray tracing. We then analyze the forward-modeled detector response to several physically motivated synthetic emission phantoms with respect to its capability to quantify the local average emissivity. The results prove this concept as a promising asset for the investigation of poloidal and toroidal radiated power asymmetries in Wendelstein 7-X. The first CBC prototypes have undergone development and installation for the next experimental campaign.
Optimization of W-band interaction structure developed using three different micro-fabrication techniques
Authors: Jain Sahil , Vishant  , Kaur Maninder , Kumar Niraj
Published: October 2024

In this paper, an experimental investigation has been performed for the three different micro-fabrication techniques for optimization in the development process of the W-band planar beam–wave interaction structure. The W-band planar beam–wave interaction structure has been developed using three different micro-fabrication methods, namely micro-EDM (electric discharge milling), wire-EDM, and micro-milling. The effect of each fabrication method on the developed structure is analyzed using scanning electron microscopy and ZETA 3D optical microscopy for their optimization. The experimental analysis has been performed for the developed W-band planar beam–wave interaction structure with an optimized process to achieve a dimensional deviation of less than 10 μm and surface roughness of less than 50 nm.
Investigating the ions emitted by multiply charged ionic liquids from a porous electrospray ion source
Authors: Dworski Szymon , Ryan Charles N.
Published: October 2024

A porous electrospray ion source was tested with three ionic liquids in order to investigate the effects of ionic liquid properties on the sizes of ion clusters emitted by purely ionic electrospray sources. Two of the ionic liquids, bis(1-ethyl-3-methylimidazolium) tetrathiocyanatocobaltate and 1,6-bis(3-methylimidazolium-1-yl)hexane bis(trifluoromethylsulfonyl)amide, were selected due to them having a dication or dianion, which were termed multiply charged ionic liquids due to them containing anions or cations with more than one charge within them. These were selected in order to investigate ionic clustering within electrospray ion emission and were compared against one of the most common ionic liquids, EMI-BF4. The current–voltage data showed that EMI-BF4 emitted similar levels of current to bis(1-ethyl-3-methylimidazolium) tetrathiocyanatocobaltate, even though the latter liquid had significantly lower conductivity and higher viscosity, suggesting an improvement in current speculated to be due to the extra charges contained by the ions. Time-of-flight and retarding potential analysis data are provided, showing all three liquids emitting ions comprising of monomers, dimers, trimers, and quadramers, with some of the 1,6-bis(3-methylimidazolium-1-yl)hexane bis(trifluoromethylsulfonyl)amide data showing heavier species emission. The data also suggested that the multiply charged ionic liquids produced ions that have two anions or cations attached, termed “double ions,” with these ions not been previously reported using porous electrospray sources. Furthermore, it was found that the dimers emitted by both of the multiply charged ionic liquids seemed to be more stable than EMI-BF4 dimers, providing insight into ion cluster formation.
Modulating outcomes of oil drops bursting at a water–air interface
Authors: Kulkarni Varun , Tamvada Suhas , Lolla Yashasvi Venkata , Anand Sushant
Published: October 2024

Recent studies have shown that capillary waves generated by the bursting of an oil drop at the water–air interface produces a daughter droplet inside the bath, while a part of it floats above it. Successive bursting events produce next generations of daughter droplets, gradually diminishing in size until the entire volume of oil rests atop the water–air interface. In this work, we demonstrate two different ways to modulate this process by modifying the constitution of the drop. First, we introduce hydrophilic clay particles inside the parent oil drop and show that it arrests the cascade of daughter droplet generation preventing it from floating over the water–air interface. Second, we show that bursting behavior can be modified by a compound water–oil–air interface made of a film of oil with finite thickness and design a regime map, which displays each of these outcomes. We underpin both of these demonstrations by theoretical arguments providing criteria to predict outcomes resulting therein. Finally, all our scenarios have a direct relation to control of oil–water separation and stability of emulsified solutions in a wide variety of applications, which include drug delivery, enhanced oil recovery, oil spills, and food processing, where a dispersed oil phase tries to separate from a continuous phase.
Current potential patches
Authors: Elder Todd , Boozer Allen H.
Published: October 2024

A novel form of the current potential, a mathematical tool for the design of stellarators and stellarator coils, is developed. Specifically, these are current potentials with a finite-element basis, called current potential patches. Current potential patches leverage the relationship between distributions of magnetic dipoles and current potentials to explore limits of the access properties of stellarator coil sets. An example calculation is shown using the Helically Symmetric Experiment (HSX) equilibrium, demonstrating the method's use in coil design and understanding the limits of the access properties of coil sets. Current potential patches have additional desirable properties such as of promoting sparse current sheet solutions and identifying crucial locations of shaping current placement. A result is found for the HSX equilibrium that shaping currents covering only 22% of the winding surface are sufficient to produce the equilibrium to a good accuracy, provided a toroidal field is generated by an exterior coil set.
Development of a thermal diagnostic system for the SPARC tokamak
Authors: Hanson M. O. , Kuang A. Q. , Kulchy R. , Lagieski M. , Looby T. , Myers C. E. , Brettingen J. , Chan K. H. C. , Fox-Widdows E. , Fritsch A. , Henderson T. , Lafleur C. , Li R. , McKanas S. , Pentecost J. , Quinn M. , Reinke M. L. , van Overbeeke-Costello A. , Witham J.
Published: October 2024

The SPARC tokamak will have scrape-off layer parallel heat fluxes on the order of GW/m2. Managing power exhaust of this magnitude will be mandatory for a reactor-scale device. To enable this mission, a thermal diagnostic suite will be deployed to measure the in-vessel structural temperatures to ensure they do not exceed their design limits and to determine the spatial distribution and magnitude of energy deposited onto the first wall. Thermocouples and fiber Bragg gratings have been selected for their environmental compatibility and proven useful on other fusion devices. High-density thermocouple arrays in the divertor will have two spring-loaded thermocouples per divertor target tile, which are being used as calorimeters, and will look to resolve the temperature distribution within the tile due to a swept or static strike point. All systems will need to survive the vacuum vessel bake, set at a minimum plasma facing surface temperature of 350 °C, which presents a particularly challenging environment for the fiber-based subsystem. Along with this temperature design requirement, all the materials in the primary vacuum need to be ultra-high vacuum compatible, able to handle the expected neutron and gamma radiation, as well as tritium exposure, all of which restrict material options. Finally, due to the expected activated environment in SPARC, there will be little chance to replace defective sensors, so system resilience is ensured through toroidal redundancy, probe material selection, and mitigating the impact of common-mode failures. Initial testing of sensors show that intershot structural measurements are sufficiently captured with the raw output, but intrashot measurements of the plasma facing material requires model-based interpretive tools.
Inferring ion cluster lifetimes from energy-resolved mass spectra of an EMI-BF4 electrospray plume
Authors: Lyne Christopher T. , Rovey Joshua L.
Published: October 2024

The fragmentation of ion clusters within the accelerating fields of ionic liquid ion sources (ILISs) is well documented and degrades ILIS performance and lifetime. Some of the most popular ILIS liquids, such as EMI-BF4 (1-Ethyl-3-methylimidazolium tetrafluoroborate) and EMI-Im (1-Ethyl-3-methylimidazolium bis(trifluoromethylsulfonyl)imide), emit clusters with lifetimes as low as ∼1 ns. Studies of fragmentation within the accelerating field typically rely on measuring the plume energy distribution averaged over all plume species and comparing those measurements with numerical simulations to estimate ion cluster lifetimes. Here, for the first time, we estimate EMI-BF4 cluster lifetimes by analyzing the energy distributions of individual plume species. We use this novel analysis method to estimate mean lifetimes of positive EMI-BF4 ion clusters from previously published experimental data. We find that the mean lifetime ranges from τ=3.7ns to τ=124ns for [EMI+][EMI-BF4] dimers and ranges from τ=1.5ns to τ=23ns for [EMI+][EMI-BF4]2 trimers. Fitting those data to an analytical fragmentation model, we estimate the binding energy and temperature as ΔGS0=0.49eV and T=394K for dimers and ΔGS0=0.40eV and T=365K for trimers. Comparing our results with previous studies supports the conclusion that clusters are emitted with a wide distribution of internal energies, contrary to the common assumption of single internal energy for each species.
Modeling of output characteristics of giant magnetostrictive transducer considering temperature and eddy currents
Authors: Huang Bohao , Gao Bing , Hu Sijia , Ning Qian , Zhao Nengtong , Peng Chaoyi
Published: October 2024

Due to the high conductivity and low permeability of giant magnetostrictive materials (GMMs), eddy currents and temperature rise caused by these materials are unavoidable. These factors will significantly impact the output efficiency and reliability of giant magnetostrictive transducers (GMTs). It is essential to conduct precise evaluations of the output characteristics in various temperature settings to effectively design and optimize the transducer. However, to reduce the eddy current loss of GMMs, a radial slit is introduced. The intricate geometry also contributes to the complexity of analysis. According to the practical engineering requirements, this paper initially established a testing system for GMM characteristic and analyzed the mechanism between material temperature and output characteristics. Second, improvements have been made to the equivalent circuit method. Research has been conducted on the influence of temperature and eddy currents on the electrical and mechanical equivalent circuits, leading to the creation of a comprehensive equivalent circuit model for GMTs. Finally, a testing platform has been set up to assess the temperature-output characteristics of the transducer. The impedance and displacement characteristics of a GMT were examined to validate the proposed model. The test results demonstrated that within the 20 – 100 °C range, the discrepancy between the model and the measured impedance is under 1%, and the displacement amplitude error is less than 5%, thus confirming the precision of the proposed model.
Uncertainty quantification based on active subspace dimensionality-reduction method for high-dimensional geometric deviations of compressors
Authors: Song Zhaoyun , Wu Yang , Liu Xiaoquan , Li Jianfeng
Published: October 2024

Compressors are inevitably exposed to diverse geometric deviations from manufacturing errors and in-service degradation. Consequently, the evaluation of performance uncertainties becomes of utmost importance for compressors in engineering application. However, the presence of high-dimensional and strongly nonlinear geometric deviations poses significant challenges in efficiently and accurately assessing the performance uncertainties of compressors. This study proposes an active subspace-based dimensionality-reduction method for high-dimensional uncertainty quantification (UQ) of compressors. Based on the active subspace (AS) method, a dimensionality-reduction high-precision artificial neural network is raised to solve the dimension disaster problem for high-dimensional UQ. Additionally, a data-driven approach is used to calculate the gradient of the quantity of interest, addressing the issue of high computational cost during the AS dimensionality reduction process. Furthermore, the Shapley method is applied to explore the influence mechanism of geometric uncertainties on performance deviations of compressors. The UQ of one transonic compressor stage at design point and near stall point is conducted by the proposed method. The findings show that the original 24-dimensional uncertainties are reduced to three-dimensional uncertainties by using this method. Consequently, the required sample size is reduced by 75% while maintaining almost unchanged model accuracy. The findings reveal that the sweep and stagger deviation of the rotor are key uncertainties on the performance of the compressor. The dispersion in efficiency is attributed to variations in shock wave position and intensity, while the dispersion in total pressure ratio is primarily affected by changes in rotor work capacity. Moreover, the dispersion at near stall is 50% higher than that at design point. Therefore, when studying UQ, it is important to pay closer attention to the performance dispersion at near stall conditions.