Family involvement in the context of chronic diseases: The role of social support in treatment decision-making for surgical procedures

If medical decision-making about complex treatment options (such as surgical procedures) is challenging for patients, family members can provide them with advice and health information. Previous research about family involvement in health communication has largely focused on cancer patients. Thus, it lacks an examination of family involvement in surgery decision-making in the context of non-life-threatening chronic diseases like arthrosis. In particular, we focus on the role of social support for family involvement in these situations. Against this background, we conducted semi-structured qualitative interviews with arthrosis patients and their family members (n = 32 patients; n = 8 relatives). To better understand family involvement in surgery decision-making, three research questions were analyzed: (1) What are the perceived characteristics of the arthroplasty decisional process? (2) Which patterns of family involvement exist with regard to social support? (3) What general circumstances are relevant for family involvement? Our results demonstrate that social support plays an important role in the patterns of family decision-making. Instrumental, emotional, and informational support can indirectly enhance family involvement in decision-making. In addition, relatives are also directly involved in decision-making processes and may instigate the decision. The type of family involvement is influenced by characteristics of the decision-making situation. In addition to personal factors and the relationship with the physician, which is perceived as less supportive, the need for familial decisional support intensifies.Besonders wenn medizinische Entscheidungen zu komplexen Behandlungsmöglichkeiten (wie operativen Eingriffen) von den Patienten als Herausforderung wahrgenommen werden, können Familienmitglieder sie mit Rat und Gesundheitsinformationen unterstützen. Die bisherige Forschung hat sich größtenteils auf die Beteiligung von Familienmitgliedern in der Gesundheitskommunikation bei Krebserkrankungen fokussiert. Daher mangelt es an Untersuchungen, die die Familienbeteiligung bei nicht-lebensbedrohlichen chronischen Krankheiten wie Arthrose betrachten. Wir fokussieren im Besonderen die Rolle der sozialen Unterstützung für die Beteiligung von Familienangehörigen in solchen Situationen. Vor diesem Hintergrund, haben wir qualitative Leitfadeninterviews mit Arthrose-Patienten und ihren Familienmitgliedern durchgeführt (n = 32 Patienten; n = 8 Angehörige). Um die Beteiligung von Angehörigen bei medizinischen Entscheidungen besser zu verstehen, wurden drei Fragestellungen analysiert: (1) Was sind die wahrgenommenen Eigenschaften der Entscheidungssituation für die Implantation einer Endoprothese? (2) Welche Muster der der familiären Beteiligung existieren hinsichtlich der sozialen Unterstützungsfunktionen? (3) Welche generellen Rahmenbedingungen sind relevant für die Beteiligung der Familienmitglieder? Unsere Ergebnisse zeigen, dass die soziale Unterstützung eine wichtige Rolle für die Beteiligung der Familienmitglieder an medizinischen Entscheidungen spielt. Instrumentelle, emotionale und informationelle Unterstützung können die Beteiligung indirekt erhöhen. Außerdem sind die Familienmitglieder auch direkt am Entscheidungsprozess beteiligt und initiieren die Entscheidungsfindung. Die Art der Beteiligung wird durch Merkmale der Entscheidungssituation beeinflusst. Neben Eigenschaften der Personen, spielt hierbei die Beziehung zum Arzt eine wichtige Rolle. Diese wird teilweise als wenig unterstützend wahrgenommen, was den Bedarf der Patienten an Unterstützung durch die Familienangehörigen erhöht

Trends in Automotive Battery Cell Design: A Statistical Analysis of Empirical Data

Lithium-ion (Li-ion) batteries have become the preferred power source for electric vehicles (EVs) due to their high energy density, low self-discharge rate, and long cycle life. Over the past decade, technological enhancements accompanied by massive cost reductions have enabled the growing market diffusion of EVs. This diffusion has resulted in customized and cost-effective Li-ion battery cell designs tailored to automotive requirements. This study describes design trends in Li-ion batteries from the pack to the electrode level based on empirical data, including pack energy, cell capacity, outer cell dimensions and formats, energy density, specific energy, and electrode properties, such as active material selection, porosities, and component thicknesses. Market share-weighted findings imply several trends, such as (1) increasing cell dimensions, with the longest cells reaching 500 mm (pouch) and almost 1000 mm (prismatic) in 2021, (2) increasing differentiation between either high-energy or low-cost cathode and anode materials, and (3) increasing cell energy, equivalent to gaining about 100% (energy density) and 70% (specific energy) compared to the 2010 and 2021 averages. Despite these improvements, this study finds that the widespread market diffusion of the latest cell technologies proceeds slower than industry announcements suggest and that several well-known, literature-proofed potentials are not yet fully exploited

An Innovative Integration Methodology of Independent Data Sources to Improve the Quality of Freight Transport Surveys

AbstractPast experiences show that data of the official Austrian freight transport statistics are often underestimated. Therefore, a methodology was developed, merging existing independent road freight transport data to a consistent and valid road freight matrix. The methodology comprises four steps, using data of the Austrian and European freight transport statistics, data of roadside interviews of truck drivers, and data of counting stations and toll gantries. The methodology was applied to data from the year 2009. Results show the reliability and plausibility of the methodology, indicated by a high correlation with high quality roadside traffic counts

A surface acoustic wave-driven micropump for particle uptake investigation under physiological flow conditions in very small volumes

Static conditions represent an important shortcoming of many in vitro experiments on the cellular uptake of nanoparticles. Here, we present a versatile microfluidic device based on acoustic streaming induced by surface acoustic waves (SAWs). The device offers a convenient method for introducing fluid motion in standard cell culture chambers and for mimicking capillary blood flow. We show that shear rates over the whole physiological range in sample volumes as small as 200 mu L can be achieved. A precise characterization method for the induced flow profile is presented and the influence of flow on the uptake of Pt-decorated CeO2 particles by endothelial cells (HMEC-1) is demonstrated. Under physiological flow conditions the particle uptake rates for this system are significantly lower than at low shear conditions. This underlines the vital importance of the fluidic environment for cellular uptake mechanisms

Conditional human VEGF‐mediated vascularization in chicken embryos using a novel temperature‐inducible gene regulation (TIGR) system

Advanced heterologous transcription control systems for adjusting desired transgene expression are essential for gene function assignments, drug discovery, manufacturing of difficult to produce protein pharmaceuticals and precise dosing of gene‐based therapeutic interventions. Conversion of the Streptomyces albus heat shock response regulator (RheA) into an artificial eukaryotic transcription factor resulted in a vertebrate thermosensor (CTA; cold‐inducible transactivator), which is able to adjust transcription initiation from chimeric target promoters (PCTA) in a low‐temperature‐ inducible manner. Evaluation of the temperature‐dependent CTA-PCTA interaction using a tailored ELISA‐like cell‐free assay correlated increased affinity of CTA for PCTA with temperature downshift. The temperature‐inducible gene regulation (TIGR) system enabled tight repression in the chicken bursal B‐cell line DT40 at 41°C as well as precise titration of model product proteins up to maximum expression at or below 37°C. Implantation of microencapsulated DT40 cells engineered for TIGR‐controlled expression of the human vascular endothelial growth factor A (hVEGF121) provided low‐temperature‐induced VEGF‐mediated vascularization in chicken embryo

Accuracy and Longevity of an Implantable Continuous Glucose Sensor in the PRECISE Study: A 180-Day, Prospective, Multicenter, Pivotal Trial

It is known that continuous glucose monitoring (CGM) systems can lower mean glucose compared with episodic self-monitoring of blood glucose. Implantable CGM systems may provide additional benefits. We studied the Eversense (Senseonics Inc.) implantable CGM sensor in 71 participants aged 18 years and older with type 1 and type 2 diabetes in a 180-day multinational, multicenter pivotal trial. Participants used the CGM system at home and in the clinic. CGM accuracy was assessed during eight in-clinic visits with the mean absolute relative difference (MARD) for venous reference glucose values >4.2 mmol/L as the primary end point. Secondary end points included Clarke Error Grid Analysis and alarm performance. The primary safety outcome was device-related serious adverse events. This trial is registered with ClinicalTrials.gov, number NCT02154126. The MARD value against reference glucose values >4.2 mmol/L was 11.1% (95% CI 10.5, 11.7). Clarke Error Grid Analysis showed 99.2% of samples in the clinically acceptable error zones A and B. Eighty-one percent of hypoglycemic events were detected by the CGM system within 30 min. No device-related serious adverse events occurred during the study. Our results indicate the safety and accuracy of this new type of implantable CGM system and support it as an alternative for transcutaneous CG

Graphene ribbon growth on structured silicon carbide

Structured Silicon Carbide was proposed to be an ideal template for the production of arrays of edge specific graphene nanoribbons (GNRs), which could be used as a base material for graphene transistors. We prepared periodic arrays of nanoscaled stripe-mesas on SiC surfaces using electron beam lithography and reactive ion etching. Subsequent epitaxial graphene growth by annealing is differentiated between the basal-plane mesas and the faceting stripe walls as monitored by means of atomic force microscopy (AFM). Microscopic low energy electron diffraction (μ-LEED) revealed that the graphene ribbons on the facetted mesa side walls grow in epitaxial relation to the basal-plane graphene with an armchair orientation at the facet edges. The ¼- band system of the ribbons exhibits linear bands with a Dirac like shape corresponding to monolayer graphene as identified by angle-resolved photoemission spectroscopy (ARPES)