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For a drive unit for axes of robots and robot-like systems (RLS) usually a motor-gearbox arrangement is chosen due to its high-power density. The combination of a high-ratio gearbox and a high-speed electric motor ensures a very compact and efficient design of the drive train. The transmission properties primarily determine the properties of the axes and the whole robot system. Robots and RLS use various types of high-ratio precision gearboxes based on different operating principles. Due to the different operating principles, it is difficult to describe comparable properties across all different types. In addition, there are many influences on the properties which significantly determine their shapes and values. These influencing parameters are insufficiently documented and are often poorly accessible for profound comparability and further consideration. In this paper, an overview of the properties of robot gearboxes is given. Based on these properties, different robot gearboxes can be systematically evaluated and compared to one another. The properties are influenced by various design, operating or manufacturing factors such as the gearbox size, the operating torque and speed or the manufacturing process. In a further step, these influences on the most relevant properties, efficiency and stiffness, are determined and systematically evaluated. This evaluation is based on the specification data of various robot gearbox manufacturers. The properties efficiency and stiffness show a dependency on the gearbox size, the operating torque, speed as well as the ambient temperature and on the transmission ratio. The shown procedure can also be adapted to other properties.

Background The aim of this study was to investigate whether bioactive adrenomedullin (bio-ADM) and interleukin-6 (IL-6) are related to acute kidney injury (AKI) and severe illness in COVID-19 patients. Methods 153 patients with COVID-19 admitted to the emergency department (ED) were included. Blood samples were collected from each patient at admission. Bio-ADM and IL-6, as well as DPP3 and routinely measured markers were evaluated regarding the endpoints AKI (22/128 hospitalized patients) and a composite endpoint of admission to intensive care unit and/or in-hospital death (n = 26/153 patients). Results Bio-ADM and IL-6 were significantly elevated in COVID-19 patients with AKI compared to COVID-19 patients without AKI (each p

Design education prepares novice designers to solve complex and challenging problems requiring diverse skill sets and an interdisciplinary approach. Hackathons, for example, offer a hands-on, collaborative learning approach in a limited time frame to gain practical experience and develop problem-solving skills quickly. They enable collaboration, prototyping and testing among interdisciplinary teams. Typically, hackathons strongly focus on the solution, assuming that this will support learning. However, building the best product and achieving a strong learning effect may not be related. This paper presents the results of an empirical study that examines the relationship between product quality, learning effect and effort spent in an academic 2-week hackathon. Thirty teams identified user problems in this course and developed hardware and mechatronic products. This study collected the following data: (1) effort spent during the hackathon through task tracking, (2) learning effect through self-assessment by the participants and (3) product quality after the hackathon by an external jury. The study found that the team effort spent has a statistically significant but moderate correlation with product quality. The correlation between product quality and learning effect is statistically insignificant, suggesting that for this setting, there is no relevant association.

Introduction: The ongoing COVID-19 pandemic is placing an extraordinary burden on our health care system with its limited resources. Accurate triage of patients is necessary to ensure medical care for those most severely affected. In this regard, biomarkers could contribute to risk evaluation. The aim of this prospective observational clinical study was to assess the relationship between urinary N-terminal pro-brain natriuretic peptide (NT-proBNP) and acute kidney injury (AKI) as well as severe disease in patients with COVID-19. Methods: 125 patients treated with an acute respiratory infection in the emergency department of the University Hospital Regensburg were analyzed. These patients were divided into a COVID-19 cohort (n = 91) and a cohort with infections not caused by severe acute respiratory syndrome-coronavirus-2 (n = 34). NT-proBNP was determined from serum and fresh urine samples collected in the emergency department. Clinical endpoints were the development of AKI and a composite one consisting of AKI, intensive care unit admission, and in-hospital death. Results: 11 (12.1%) COVID-19 patients developed AKI during hospitalization, whereas 15 (16.5%) reached the composite endpoint. Urinary NT-proBNP was significantly elevated in COVID-19 patients who suffered AKI or reached the composite endpoint (each p < 0.005). In a multivariate regression analysis adjusted for age, chronic kidney disease, chronic heart failure, and arterial hypertension, urinary NT-proBNP was identified as independent predictor of AKI (p = 0.017, OR = 3.91 [CI: 1.28–11.97] per standard deviation [SD]), as well as of the composite endpoint (p = 0.026, OR 2.66 [CI: 1.13–6.28] per SD). Conclusion: Urinary NT-proBNP might help identify patients at risk for AKI and severe disease progression in COVID-19.

Increased attention has been given to MRI in radiation-free screening for malignant nodules in recent years. Our objective was to compare the performance of human readers and radiomic feature analysis based on stand-alone and complementary CT and MRI imaging in classifying pulmonary nodules. This single-center study comprises patients with CT findings of pulmonary nodules who underwent additional lung MRI and whose nodules were classified as benign/malignant by resection. For radiomic features analysis, 2D segmentation was performed for each lung nodule on axial CT, T2-weighted (T2w), and diffusion (DWI) images. The 105 extracted features were reduced by iterative backward selection. The performance of radiomics and human readers was compared by calculating accuracy with Clopper–Pearson confidence intervals. Fifty patients (mean age 63 +/− 10 years) with 66 pulmonary nodules (40 malignant) were evaluated. ACC values for radiomic features analysis vs. radiologists based on CT alone (0.68; 95%CI: 0.56, 0.79 vs. 0.59; 95%CI: 0.46, 0.71), T2w alone (0.65; 95%CI: 0.52, 0.77 vs. 0.68; 95%CI: 0.54, 0.78), DWI alone (0.61; 95%CI:0.48, 0.72 vs. 0.73; 95%CI: 0.60, 0.83), combined T2w/DWI (0.73; 95%CI: 0.60, 0.83 vs. 0.70; 95%CI: 0.57, 0.80), and combined CT/T2w/DWI (0.83; 95%CI: 0.72, 0.91 vs. 0.64; 95%CI: 0.51, 0.75) were calculated. This study is the first to show that by combining quantitative image information from CT, T2w, and DWI datasets, pulmonary nodule assessment through radiomics analysis is superior to using one modality alone, even exceeding human readers’ performance.

Background and study aims Only a few studies are available regarding endoscopic vacuum-assisted closure (E-VAC) therapy for the post-surgery leakage of the lower gastrointestinal tract. Patients and methods In this multicenter German study, we retrospectively analyzed patients treated with E-VAC therapy due to post-surgery leakage of the lower gastrointestinal tract from 2000–2020 at Hannover Medical School, University Medical Center Schleswig-Holstein, Campus Luebeck, and Robert Koch Hospital Gehrden. Results Overall, 147 patients were included in this study. Most patients had undergone tumor resections of the lower gastrointestinal tract (n = 88; 59.9 %). Median time to diagnosis of leakage was 10 days (interquartile range [IQR] 6–19). Median duration of E-VAC therapy was 14 days (IQR 8–27). Increase of C-reactive protein (CRP) levels significantly correlated with first diagnosis of leakage (P 100 mg/L (78.4 % vs. 52.7 %; P = 0.012). Odds ratio for failure of stoma reversal was 3.36 in cases with CRP values > 100 mg/L (P = 0.017). In total, leakage- and/ or E-VAC therapy-associated complications occurred in 26 patients (17.7 %). Minor complications included recurrent E-VAC dislocations and subsequent stenosis. Overall, 14 leakage- or E-VAC-associated deaths were observed most often due to sepsis. Conclusions E-VAC therapy due to post-surgery leakage of the lower gastrointestinal tract is safe and effective. High levels of CRP are a negative predictor of E-VAC therapy success.

The continuous integration and verification of components is essential in distributed design processes. Identifying the optimal integration and verification frequency, however, can be challenging due to the complexity of product development. Especially the effect of human decision-making in partially isolated development scenarios is difficult to consider. Thus, we performed an experimental study based on the following three steps: first, an extension of the existing parameter design framework, which is used to conduct experiments under laboratory conditions, in which human subjects solve quantitative surrogate design tasks. Second, a series of experiments in which 32 subjects divided into groups of two solved 229 parameter design tasks with a varying integration and verification frequency. And, third, a statistical analysis of the results with respect to development time, coupling strength and process costs. According to our results, development time can be reduced by up to 71%, if the integration and verification frequency is doubled. If process costs are also considered, the optimal frequency can be subject to a conflict of goals between reducing development time and minimising process cost.

Unmasking the decision making process of machine learning models is essential for implementing diagnostic support systems in clinical practice. Here, the authors demonstrate that adversarially trained models can significantly enhance the usability of pathology detection as compared to their standard counterparts.

With the increased demand for customisation, developing task-specific robots for industrial and personal applications has become essential. Collaborative robots are often preferred over conventional industrial robots in human-centred production environments. However, fixed architecture robots lack the ability to adapt to changing user demands, while modular, reconfigurable robots provide a quick and affordable alternative. Standardised robot modules often derive their characteristics from conventional industrial robots, making them expensive and bulky and potentially limiting their wider adoption. To address this issue, the current work proposes a top-down multidisciplinary computational design strategy emphasising the low cost and lightweight attributes of modular robots within two consecutive optimisation problems. The first step employs an informed search strategy to explore the design space of robot modules to identify a low-cost robot architecture and controller. The second step employs dynamics-informed structural optimisation to reduce the robot’s net weight. The proposed methodology is demonstrated on a set of example requirements, illustrating that (1) the robot modules allow exploring non-intuitive robot architectures, (2) the structural mass of the resulting robot is 16 % lower compared to a robot designed using conventional aluminium tubes, and (3) the designed modules ensure the physical feasibility of the robots produced.

Due to complex component interactions and multidisciplinary and possibly conflicting requirements, it is challenging to identify appropriate design goals for individual components to keep the vibration of a mechanical system below a specified level. Existing development methods are limited in that they only provide precise component targets without tolerance. Tolerance is required, however, for reconciling conflicting requirements and to provide freedom for component design. This paper presents a systematic design method for vibrating systems based on so-called solution spaces. It consists of (1) system modeling, (2) solution space computation, (3) component modeling and (4) detailed design. Solution spaces are admissible value ranges and serve as component requirements that guide independent component design. Meeting these component requirements guarantees that the overall system design goal with respect to vibration and possibly other disciplines is achieved. The proposed method is applied to an industry use case, where the rubber mount and geometrical layout of a vibratory rammer are modified to improve its dynamic and static performance. Both the system model and component model are validated by experiments. The vibration of a reference design is reduced by 48%.

Abstract Aims The objective of this study was to investigate the prognostic value of urinary N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) compared with plasma NT‐proBNP in patients presenting with acute chest pain in the emergency department. Methods and results We measured simultaneously plasma and urinary NT‐proBNP at admission in 301 patients with acute chest pain. In our cohort, 174 patients suffered from acute coronary syndrome (ACS). A follow‐up (median of 55 months) was performed regarding the endpoints all‐cause mortality and major adverse cardiac events (mortality, congestive heart failure, ACS with the necessity of a coronary intervention, and stroke). Fifty‐four patients died during follow‐up; 98 suffered from the combined endpoint. A significant and positive correlation of urinary and plasma NT‐proBNP was found (r = 0.87, P

The measurement of quantitative, tissue-specific MR properties, e.g., water content, longitudinal relaxation time (T1) and effective transverse relaxation time (T2⁎), using quantitative MRI at a clinical field strength (1.5 T to 3T) is a well-explored topic. However, none of the commonly used standard brain atlases, such as MNI or JHU, provide quantitative information. Within the framework of quantitative MRI of the brain, this work reports on the development of the first quantitative brain atlas for tissue water content at 3T. A methodology to create this quantitative atlas of in vivo brain water content based on healthy volunteers is presented, and preliminary, practical examples of its potential applications are also shown.Established methods for the fast and reliable measurement of the absolute water content were used to achieve high precision and accuracy. Water content and T2⁎ were mapped based on two different methods: an intermediate-TR, two-point method and a long-TR, single-scan method. Twenty healthy subjects (age 25.3 ± 2.5 years) were examined with these quantitative imaging protocols. The images were normalised to MNI stereotactic coordinates, and water content atlases of healthy volunteers were created for each method and compared. Regions-of-interest were generated with the help of a standard MNI template, and water content values averaged across the ROIs were compared to water content values from the literature.Finally, in order to demonstrate the strength of quantitative MRI, water content maps from patients with pathological changes in the brain due to stroke, tumour (glioblastoma) and multiple sclerosis were voxel-wise compared to the healthy brain.The water content atlases were largely independent of the method used to acquire the individual water maps. Global grey matter and white matter water content values between the methods agreed with each other to within 0.5 %. The feasibility of detecting abnormal water content in the brains of patients based on comparison to a healthy brain water content atlas was demonstrated.In summary, the first quantitative water content brain atlas in vivo has been developed, and a voxel-wise assessment of pathology-related changes in the brain water content has been performed. These results suggest that qMRI, in combination with a water content atlas, allows for a quantitative interpretation of changes due to disease and could be used for disease monitoring.

When do we follow requests and recommendations and which ones do we choose not to comply with? This publication combines definitions of compliance and reactance as behaviours and as affective processes in one model for application to human-robot interaction. The framework comprises three steps: human perception, comprehension, and selection of an action following a cue given by a robot. The paper outlines the application of the model in different study settings such as controlled experiments that allow for the assessment of cognition as well as observational field studies that lack this possibility. Guidance for defining and measuring compliance and reactance is outlined and strategies for improving robot behaviour are derived for each step in the process model. Design recommendations for each step are condensed into three principles on information economy, adequacy, and transparency. In summary, we suggest that in order to maximise the probability of compliance with a cue and to avoid reactance, interaction designers should aim for a high probability of perception, a high probability of comprehension and prevent negative affect. Finally, an example application is presented that uses existing data from a laboratory experiment in combination with data collected in an online survey to outline how the model can be applied to evaluate a new technology or interaction strategy using the concepts of compliance and reactance as behaviours and affective constructs.

Abstract Aims We aimed to assess whether expression of whole‐blood RNA of sodium proton exchanger 1 (NHE1) and glucose transporter 1 (GLUT1) is associated with COVID‐19 infection and outcome in patients presenting to the emergency department with respiratory infections. Furthermore, we investigated NHE1 and GLUT1 expression in the myocardium of deceased COVID‐19 patients. Methods and results Whole‐blood quantitative assessment of NHE1 and GLUT1 RNA was performed using quantitative PCR in patients with respiratory infection upon first contact in the emergency department and subsequently stratified by SARS‐CoV‐2 infection status. Assessment of NHE1 and GLUT1 RNA using PCR was also performed in left ventricular myocardium of deceased COVID‐19 patients. NHE1 expression is up‐regulated in whole blood of patients with COVID‐19 compared with other respiratory infections at first medical contact in the emergency department (control: 0.0021 ± 0.0002, COVID‐19: 0.0031 ± 0.0003, P = 0.01). The ratio of GLUT1 to NHE1 is significantly decreased in the blood of COVID‐19 patients who are subsequently intubated and/or die (severe disease) compared with patients with moderate disease (moderate disease: 0.497 ± 0.083 vs. severe disease: 0.294 ± 0.0336, P = 0.036). This ratio is even further decreased in the myocardium of patients who deceased from COVID‐19 in comparison with the myocardium of non‐infected donors. Conclusions NHE1 and GLUT1 may be critically involved in the disease progression of SARS‐CoV‐2 infection. We show here that SARS‐CoV‐2 infection critically disturbs ion channel expression in the heart. A decreased ratio of GLUT1/NHE1 could potentially serve as a biomarker for disease severity in patients with COVID‐19.

Complexity in product design increases with little understanding of cause and effect. As a consequence, the impact of design decisions (or changes) on the product is difficult to predict and control. This article presents a model of cause and effect for design decisions that avoid circular dependencies: the so-called attribute dependency graph (ADG) models complex system behaviour and properties, and increases transparency by carefully distinguishing between what is realised and what is required. An ADG is a polyhierarchy, with design variables (directly controllable) at the bottom, quantities of interest (not directly controllable) on the top, and intermediate attributes. The dependencies represent causality in a simple sense: assigning values to design variables, representing the cause, will determine the values of the dependent attributes, representing the effect. ADGs do not account for what is required, but for what effects emerge by design activity. A set of rules makes them independent of designers’ views. They provide the structure for so-called INUS conditions, that is, insufficient but necessary parts of unnecessary but sufficient conditions that can be used for requirement development. The modelling approach is applied to one simple synthetic and then to two real-world design problems, the design of a water hose box and a passenger vehicle.

Introduction Influenza is a major concern in hospitals, including the emergency department (ED), mainly because of a high risk for ED personnel to acquire and transmit the disease. Although influenza vaccination is recommended for health care workers, vaccination coverage is low. Methods This survey was conducted in the 2016/2017 and 2020/2021 influenza seasons. Questionnaires were sent to ED personnel in 12 hospitals in Bavaria, South-Eastern Germany. The response rates were 62% and 38% in 2016/2017 and 2020/2021, respectively. Data were compared between the two seasons as well as between vaccinated and not vaccinated respondents in 2020/2021. Results Significantly more ED personnel reported having been vaccinated in the 2020/2021 season. Factors associated with vaccination coverage (or the intention to get vaccinated) were profession (physician / medical student), having been vaccinated at least twice, the availability of an influenza vaccination on site (in the ED) as well as the COVID-19 pandemic. Additionally, significant differences in the assessment and evaluation of influenza, its vaccination side effects and ethical aspects were found between vaccinated and not vaccinated ED personnel in 2020/2021. Unvaccinated respondents estimated higher frequencies of almost all potential vaccination side effects, were less likely to accept lay-offs if employees would not come to work during an influenza pandemic and more likely to agree that work attendance should be an employee´s decision. Vaccinated participants instead, rather agreed that vaccination should be mandatory and were less likely to consider job changes in case of a mandatory vaccination policy. Conclusion The COVID-19 pandemic might have contributed to a higher influenza vaccination rate among ED workers. Vaccination on site and interventions targeting the perception of influenza vaccination and its side effects may be most promising to increase the vaccination coverage among ED personnel.

Water concentration is tightly regulated in the healthy human brain and changes only slightly with age and gender in healthy subjects. Consequently, changes in water content are important for the characterization of disease. MRI can be used to measure changes in brain water content, but as these changes are usually in the low percentage range, highly accurate and precise methods are required for detection. The method proposed here is based on a long-TR (10 s) multiple-echo gradient-echo measurement with an acquisition time of 7:21 min. Using such a long TR ensures that there is no T1 weighting, meaning that the image intensity at zero echo time is only proportional to the water content, the transmit field, and to the receive field. The receive and transmit corrections, which are increasingly large at higher field strengths and for highly segmented coil arrays, are multiplicative and can be approached heuristically using a bias field correction. The method was tested on 21 healthy volunteers at 3T field strength. Calibration using cerebral-spinal fluid values (~100% water content) resulted in mean values and standard deviations of the water content distribution in white matter and gray matter of 69.1% (1.7%) and 83.7% (1.2%), respectively. Measured distributions were coil-independent, as seen by using either a 12-channel receiver coil or a 32-channel receiver coil. In a test-retest investigation using 12 scans on one volunteer, the variation in the mean value of water content for different tissue types was ~0.3% and the mean voxel variability was ~1%. Robustness against reduced SNR was assessed by comparing results for 5 additional volunteers at 1.5T and 3T. Furthermore, water content distribution in gray matter is investigated and regional contrast reported for the first time. Clinical applicability is illustrated with data from one stroke patient and one brain tumor patient. It is anticipated that this fast, stable, easy-to-use, high-quality mapping method will facilitate routine quantitative MR imaging of water content.

Purpose: Size and density measurements of the ablation zones on contrast-enhanced computed tomography (CT) after radiofrequency ablation (RFA) of hepatic metastases of primary breast or colorectal cancer were acquired over time. Materials and Methods: Twenty-five liver metastases [colorectal cancer (CRC): n = 16; mean size: 19.6 ± 8.5 mm; breast cancer (BC): n = 9; 27.9 ± 13.6 mm] in 15 patients (CRC: n = 11; age: 65.4 ± 6.5 years; BC: n = 4; 62.0 ± 13.8 years) treated by RFA were included in this retrospective study. All patients had undergone postinterventional serial follow-up using multidetector CT (MDCT) (1 day/1/4/7/10/14/18/23/>24 months) without evidence of local tumor recurrence during the follow-up. The ablation zones were evaluated using a commercial software tool (Syngo CT Oncology) in order to determine volumetric, RECIST-, WHO- and density changes over the course of time. Results were compared by applying repeated measures analysis of variance and displayed graphically. Results: The RF ablation zones demonstrated significant shrinkage (P ≤ 0.05) over the first 7 months (volume, RECIST, WHO) of the follow-up. Follow-up after 7 months did not show any significant changes in size (P > 0.05) (mean volume (ml): 55.2/34.7/26.3/16.5/12.7/10.0/8.9/8.1/7.5; RECIST (mm): 58.7/49.3/43.7/37.8/34.2/31.3/29.1/27.3/24.8; WHO (mm2): 2458.3/1769.3/1341.8/1027.1/870.1/720.2/649.0/570.4/511.3). Mean density values decreased significantly between 1 day (58.9 HU) and 1 month (47.5 HU) after the procedure. Conclusion: Typical changes in size and density values of RF-induced, recurrence-free ablation zones after RFA of hepatic metastases of colorectal and breast cancer were acquired, showing a significant decrease in density of the ablation zone within the first month and significant shrinkage within the first 7 months after RFA.

Topology optimization is a powerful digital engineering tool for the development of lightweight products. Nevertheless, the transition of obtained design proposals into manufacturable parts is still a challenging task. In this article, the development of a freeware framework is shown, which uses a hybrid topology optimization algorithm for stiffness and strength combined with manufacturing constraints based on finite spheres and a two-step smoothing algorithm to design manufacturable prototypes with “one click”. The presented workflow is shown in detail on a rocker, which is “one-click”-optimized and manufactured. These parts were experimentally tested using a universal testing machine. The objective of this article was to investigate the performance of “one-click”-optimized parts in comparison with manually redesigned optimized parts and the initial design space. The test results show that the design proposals created while applying the finite-spheres and two-step smoothing are equal to the manual redesigned parts based on the optimization results, proposing that the “one-click”-development can be used for the fast and direct development and fabrication of prototypes.

The aim of this study was to identify prognostic factors affecting intrahepatic progression-free survival (ihPFS) and overall survival (OS) in patients with colorectal cancer liver metastases (CRCLM) undergoing portal vein embolization (PVE) and subsequent (extended) right hemihepatectomy. A total of 59 patients (mean age: 60.8 ± 9.3 years) with CRCLM who underwent PVE in preparation for right hemihepatectomy were included. IhPFS and OS after PVE were calculated using the Kaplan–Meier method. Cox regression analyses were conducted to investigate the association between the following factors and survival: patient age, laterality of the colorectal cancer (right- versus left-sided), tumor location (colon versus rectal cancer), time of occurrence of hepatic metastases (synchronous versus metachronous), baseline number and size of hepatic metastases, presence or absence of metastases in the future liver remnant (FLR) before PVE, preoperative carcinoembryogenic antigen (CEA) levels, time between PVE and surgery, history of neoadjuvant or adjuvant chemotherapy, and the presence or absence of extrahepatic disease before PVE. Median follow up was 18 months. The median ihPFS was 8.2 months (95% confidence interval: 6.2–10.2 months), and median OS was 34.1 months (95% confidence interval: 27.3–40.9 months). Laterality of the primary colorectal cancer was the only statistically significant predictor of ihPFS after PVE (hazard ratio (HR) = 2.242; 95% confidence interval: 1.125, 4.465; p = 0.022), with patients with right-sided colorectal cancer having significantly shorter median ihPFS than patients with left-sided cancer (4.0 ± 1.9 months versus 10.2 ± 1.5 months; log rank test: p = 0.018). Other factors, in particular also the presence or absence of additional metastases in the FLR, were not associated with intrahepatic progression-free survival. The presence of extrahepatic disease was associated with worse OS (HR = 3.050, 95% confidence interval: 1.247, 7.459; p = 0.015).

Background and Methods: Tumors infiltrating the inferior caval vein (ICV) have been considered irresectable in the past due to high perioperative risks. Consequently, the only treatment option for these patients was best supportive care, which resulted in reduced survival. Advancements in surgical techniques have since evolved, such that combined resections of the ICV and the hepatic malignancy are being performed. The aim of this study was the evaluation of the long-term outcomes (e.g., survival) and short-term risks of this procedure. In this single-center, retrospective cohort study (n = 24), we evaluated surgical and oncological outcome for patients undergoing hepatic surgery for oncological indications in combination with resections of the ICV. In addition, we investigated which factors are associated with survival. Results: First, we showed that perioperative mortality is as low as 4.1%. Second, we showed that perioperative co-morbidities are acceptable for this type of advanced hepatobiliary surgery. Third, the reconstruction of the ICV by means of a patch was superior in terms of survival compared to other types of reconstructions. This finding was independent of the type or the aggressiveness of tumor or the resections status. Discussion: In our cohort, many patients had undergone (multiple) preceding visceral surgical interventions or underwent multi-visceral surgery. Despite the medical complexity, survival was encouraging in this cohort, offering novel treatment modalities with a low risk of severe morbidities.

During the development of aerospace structures, typically many fatigue tests are conducted. During these tests, much effort is put into inspections in order to detect the onset of failure before complete failure. Strain sensor data may be used to reduce inspection effort. For this, a sufficient number of sensors need to be positioned appropriately to collect the relevant data. In order to minimize cost and effort associated with sensor positioning, the method proposed here aims at minimizing the number of necessary strain sensors while positioning them such that fatigue-induced damage can still be detected before complete failure. A suitable detection criterion is established as the relative change of strain amplitudes under cyclic loading. Then, the space of all possible crack lengths is explored. The regions where the detection criterion is satisfied before complete failure occurs are assembled into so-called detection zones. One sensor in this zone is sufficient to detect criticality. The applicability of the approach is demonstrated on a representative airplane structure that resembles a lower wing section. The method shows that four fatigue critical spots can be monitored using only one strain sensor in a non-intuitive position. Furthermore, we discuss two different strain measures for crack detection. The results of this paper can be used for reliable structural health monitoring using a minimum number of sensors.

Quantitative imaging of the human brain is of great interest in clinical research as it enables the identification of a range of MR biomarkers useful in diagnosis, treatment and prognosis of a wide spectrum of diseases. Here, a 3D two-point method for water content and relaxation time mapping is presented and compared to established gold standard methods. The method determines free water content, H2O, and the longitudinal relaxation time, T1, quantitatively from a two-point fit to the signal equation including corrections of the transmit and receive fields. In addition, the effective transverse relaxation time, T2*, is obtained from an exponential fit to the multi-echo signal train and its influence on H2O values is corrected. The phantom results obtained with the proposed method show good agreement for H2O and T1 values with known and spectroscopically measured values, respectively. The method is compared in vivo to already established gold standard quantitative methods. For H2O and T2* mapping, the 3D two-point results were compared to a measurement conducted with a multiple-echo GRE with long TR and T1 is compared to results from a Look-Locker method, TAPIR. In vivo results show good overall agreement between the methods, but some systematic deviations are present. Besides an expected dependence of T2* on voxel size, T1 values are systematically larger in the 3D approach than those obtained with the gold standard method. This behaviour might be due to imperfect spoiling, influencing each method differently. Results for H2O differ due to differences in the saturation of cerebrospinal fluid and partial volume effects. In addition, ground truth values of in vivo studies are unknown, even when comparing to in vivo gold standard methods. A detailed region-of-interest analysis for H2O and T1 matches well published literature values.

In recent decades, a number of global frameworks have been developed for disaster risk reduction (DRR). The Hyogo Framework for Action 2005–2015 and its successor document, the Sendai Framework for Disaster Risk Reduction, adopted in Japan in March 2015, provide general guidance for reducing risks from natural hazards. This is particularly important for mountainous areas, but DRR for mountain areas and sustainable mountain development received little attention in the recent policy debate. The question remains whether the Hyogo and Sendai frameworks can provide guidance for sustainable mountain development. This article evaluates the 2 frameworks in light of the special challenges of DRR in mountain areas and argues that, while the frameworks offer valuable guidance, they need to be further adapted for local contexts—particularly for mountain areas, which require special attention because of changing risk patterns like the effects of climate change and high land-use pressure.