The impact of the AO foundation on fracture care : an evaluation of 60 years AO foundation

Objectives Sixty years ago, the Association of Osteosynthesis (AO) was founded with the aim to improve fracture treatment and has since grown into one of the largest medical associations worldwide. Aim of this study was to evaluate AO's impact on science, education, patient care and the MedTech business. Design/methods Impact evaluations were conducted as appropriate for the individual domains: Impact on science was measured by analyzing citation frequencies of publications promoted by AO. Impact on education was evaluated by analyzing the evolution of number and location of AO courses. Impact on patient care was evaluated with a health economic model analyzing cost changes and years of life gained through the introduction of osteosynthesis in 17 high-income countries (HICs). Impact on MedTech business was evaluated by analyzing sales data of AO-associated products. Results Thirty-five AO papers and 2 major AO textbooks are cited at remarkable frequencies in high ranking journals with up to 2000 citations/year. The number of AO courses steadily increased with a total of 645'000 participants, 20‘000 teaching days and 2‘500 volunteer faculty members so far. The introduction of osteosynthesis saved at least 925 billion Swiss Francs [CHF] in the 17 HICs analyzed and had an impact on avoiding premature deaths comparable to the use of antihypertensive drugs. AO-associated products generated sales of 55 billion CHF. Conclusion AO's impact on science, education, patient care, and the MedTech business was significant because AO addressed hitherto unmet needs by combining activities that mutually enriched and reinforced each other

“Autonomous control of gap distance and angel of attack in slot-die coating”

Despite the rapid scale-up of battery production which could be observed the last years, various challenges remain in electrode production. In particular, the high scrap rates of up to 40 % during the coating process of the electrodes offer enormous potential in terms of economic and ecological aspects. To counter these problems, a system concept was developed that can react autonomously to process conditions and thus reduce scrap. For this purpose, with the gap distance and the angle of attack deliberately two parameters are varied during slot-die coating, which react quickly and furthermore do not affect the productivity of the system. By adapting the position of the slot-die, it is possible to achieve an optimum operating point in the coating window and thus improve the quality of the results without regulating the volume flow or the web speed. The aim is both to shorten the start-up process by a fast and precise correction of the slot-die position on the basis of the coating result and to increase the quality in the adjusted operation. With the help of the corresponding measuring technology and the control based on the coating result, the processing of slurries with fluctuating fluid properties or the processing of new recipes is simplified and possible without manual intervention. The concept is possible for existing plants as well as for new plants

Lessons learnt from the user journey of well-known digital games for the development of educational software

In addition to the actual core content of games, the user journey or user experience in digital games is becoming more and more important. The menu structure should be as intuitive as possible. Features that are important should be displayed to the player at the moment when the game engine assumes that access is necessary. The player should then reach the content with one tap or click. This persuasive design concept is called ‘nudging’ and is rooted in behavioural psychology. Therefore, in the design of the game environment, the viewpoint of goal orientation plays a major role. Two perspectives exist here. First, from the player's point of view: What is necessary to ensure a well-rounded game experience? The second perspective is from the producer's point of view and revolves around what do they want the player to accomplish next. Some of the top games have now also developed so-called "main menu games", which are challenges around the actual game to keep the players content and give them additional tasks that are as stimulating as possible. In this paper, the authors would like to demonstrate the above-mentioned mechanics by analysing four smash hits, namely “FIFA”, “Clash of Clans”, “Pokemon Go” and “League of Legends”, with the aim of gaining learnings for the development of digital educational software. This new form of learning software should be user-centred and offer an outstanding learning experience through optimal design and mechanics.peer-reviewe

Irradiation-dependent topology optimization of metallization grid patterns and variation of contact layer thickness used for latitude-based yield gain of thin-film solar modules

We show that the concept of topology optimization for metallization grid patterns of thin-film solar devices can be applied to monolithically integrated solar cells. Different irradiation intensities favor different topological grid designs as well as a different thickness of the transparent conductive oxide (TCO) layer. For standard laboratory efficiency determination, an irradiation power of 1000W/m$^{2}$ is generally applied. However, this power rarely occurs for real-world solar modules operating at mid-latitude locations. Therefore, contact layer thicknesses and also lateral grid patterns should be optimized for lower irradiation intensities. This results in material production savings for the grid and TCO layer of up to 50 % and simultaneously a significant gain in yield of over 1% for regions with a low annual mean irradiation

Teaching financial literacy around the topic of games : a case study

In the last decade, various pricing models have been developed around computer games. The classic model is games that are bought at a fixed price and no further spending is necessary. However, for some of these games, there are frequent content expansions, such as new stories, available to purchase. Other games have an initial price and a subscription model. A further concept, which can be seen in well-known esports games, such as “League of Legends”, but also in mobile games, such as “Clash of Clans”, is the free2play model. Here, the game can basically be played for free, but there are in-game purchases or so-called season passes, where rewards can be earned more quickly. In all models with in-game purchases, it is always the same procedure: for real money, a further type of ingame token (for instance, jewels in Clash of Clans and “FIFA points” in FIFA) can be bought in addition to the in-game currency that can be earned by playing the game. However, it is only possible to invest money in the game, but not to convert the in-game currency into real money (although there are workarounds like using eBay or other platforms and sell the game accounts or meet in game to transfer in-game currency which has been purchased with a peer2peer FIAT transaction before). In some cases, that secondary currency, which is intended to be purchased for real money, can also be earned, but usually only very slowly and with a lot of effort while playing, which might have legal reasons, so the games cannot be blamed to fall under the gambling jurisdiction. This paper takes the esports School League Floridsdorf+ in Vienna as an example to examine how the topic of digital games and their respective around the game and in-game economy can be used to introduce students to the topic of financial literacy. This can also be facilitated to explain classic financial topics such as interest rates, inflation, deflation, savings accounts or new technologies such as blockchain in an applied and sustainable way.peer-reviewe

The use of blockchain technologies to issue and verify micro-credentials for customised educational journeys : presentation of a demonstrator

In recent years, a clear trend towards personalised learning experiences has emerged. Individual preferences are in the foreground and should be made possible, for example, through selectable choices. If these courses take place in the same educational institution, the handling of credit and the clear allocation to learning outcomes is usually possible. However, it becomes difficult when the options also extend to courses outside the main educational institution. It is even more difficult when the study opportunities occur, for example, at educational institutions abroad or at businesses with a strong focus on practice. Here, accreditation is often very difficult, dependent on the case and a painstaking process, unless it is regulated by law, for example through the Bologna Process in the case of universities. New ways in adult education go a whole step further, especially via the so-called second-chance education, when the trainee has a choice of often hundreds of possible courses at various educational and vocational institutions. However, the diploma or work permit is ultimately awarded by the authorities and not a specific university or college. This is an ideal example for the concept of micro-credentials or the possibility of partial achievements being made through various channels, whereby each of these microcredentials clearly defines the educational goal that is required and the extent to which this has been achieved by the learner. The most important factor regarding micro-credentials is a standardised form of storage, presentation, verification and approval processes. By discussing a demonstrator, this paper shows how blockchain technologies in combination with digital identities represent a feasible approach to mapping and comparing micro-credentials.peer-reviewe

Efficacy and safety of ruxolitinib in the treatment of chronic graft-versus-host disease: a retrospective analysis

Steroid-refractory chronic graft-versus-host disease (cGvHD) is associated with significant morbidity and mortality, with ruxolitinib being the first drug approved for its treatment. We retrospectively analyzed the safety and efficacy of ruxolitinib for treatment of cGvHD at our center between 07/2015 and 12/2022 and identified 48 patients receiving ruxolitinib as second (18/48) or advanced (30/48) treatment line. Ruxolitinib was started on median day 340 (range 119–595) after cGvHD onset; median duration of administration was 176 (range, 79–294) days with 16/48 patients continuing treatment at last follow-up. National Institutes of Health organ grading and the intensity of immunosuppression were assessed at the start of ruxolitinib treatment and repeated after 1, 3, 6, and 12 months. Response assessment was terminated at the start of any additional new immunosuppressant treatment. The median time of follow-up was 582 (range, 104–1161) days. At the primary analysis after six months on ruxolitinib treatment, the overall response rate was 33%, and failure-free survival was 58%. Infectious adverse events ≥ CTCAE grade III were observed in 10/48 patients. The response rate was not associated with the severity of cGvHD, number of previous treatment lines, or number of additional agents combined with ruxolitinib applying a univariate regression model. At the time of the 12-month follow-up, four patients experienced recurrence of the underlying malignancy and two patients had experienced non-relapse-related mortality. Overall, ruxolitinib was relatively well-tolerated and showed outcomes comparable to the REACH3 trial in a heavily pretreated patient population

Adaptive learning and assessment : from the teachers' perspective

Digital technologies have changed and continue to shape the way students interact with learning material, both in traditional and informal education. Adaptive learning methodologies offer an interesting avenue for personalized learning, whereas every individual student is presented with tailormade content, specifically based on the distinct strengths, weaknesses, goals and engagement patterns of the learner. This is intended to consolidate knowledge and ensure that learning progresses at the right time and pace. Underpinning such computer-mediated interventions, one might find simple logic, allowing the content to be adapted after short intermediate tests, up to more complex Artificial Intelligence (AI) methods, which for example, in the realm of serious games, take on the role of the teacher whom facilitates the appropriate learning experience. Such an approach is an interesting and well-meaning methodology that requires additional research and consequently should be developed further, both in terms of the supporting technology and pedagogy. For instance, with regard to the latter, the role of the teachers (and educators in general), in self-directed learning of students whilst utilizing adaptive educational applications is to be investigated. This will allow teachers to take on the role of learning companions and subsequently better estimate the student's progress and facilitate the overall learning experience. In this paper, the authors critically analyse the role of adaptive learning methodologies from the teacher’s perspective and extend this notion not only to support the learning experience itself, but also to assess it, particularly in formative and embedded ways. Furthermore, the authors take a glimpse at the future, where in a few years' time, the assessment of a teacher (through standardized testing or otherwise), will no longer be the decisive factor affecting and/or shaping the career path of a child or young adult. As such, this paper takes an explorative approach to identify the current state of play amongst educators, their expectations and fears regarding adaptive learning and assessment, through a mixed methods approach involving an online survey, followed by a focus group discussion with experts in the field.peer-reviewe

Create digital games for education : dame design as a teaching methodology

Besides the pure application of serious games as tools for knowledge transfer, a further trend has been observed in the last few years: The creation of games as an opportunity to gain practical experience and thereby also build up valuable knowledge. In this context several approaches are possible, such as using paper prototyping, game maker tools like Scratch, RPG-Maker, Construct 3 or Game Maker Studio 2, and the application of actual game engines like Unity. This contribution aims to discuss the possibility of creating games in a very specific, predefined genre using game maker tools that have been especially developed for use in an educational context and therefore offer didactic guidance. The Game Creator Tool which was developed as part of the Erasmus+ project Create Digital Games for Education (CDG4E) is presented in more depth. Using this tool, one can create decision card games inspired by the mobile game bestseller "Reigns". Within the project, the consortium created educational games in different areas such as fake news prevention and STEM education. In addition to these ready-made games, another focus was placed on using the tool itself as a teaching technique, for example to create games on a specific topic with school classes or within youth work, but also as an instrument for setting up dedicated "game jams". This contribution reports on the advantages and drawbacks of creating the tool itself by analysing qualitative and quantitative data gathered during the iterative design process of the Game Creator.peer-reviewe

Unusually swift response of relapsed Burkitt leukemia to R‐DHAP

Burkitt leukemia (BL) represents a highly aggressive lymphoma characterized by proliferation rates of around 100%, and a frequent spread into the central nervous system. If standard frontline chemotherapy fails, the prognosis is usually dismal, and reports on successful effective salvage therapy strategies for patients with relapsed/refractory BL are scant. Here, we report on a 40-year-old female patient who suffered an early relapse of BL three months after the completion of frontline chemoimmunotherapy. Strikingly, after only one cycle of R-DHAP chemotherapy, the patient showed CR of BL enabling swift transition to a consolidating allogeneic stem cell transplantation. A 40-year-old previously healthy woman presented to the hospital with fatigue and incessant epistaxis, and a diagnosis of BL was made upon histological examination of a bone marrow biopsy. Treatment was initiated according to the GMALL 2002 B-NHL/ALL protocol, which could induce complete molecular remission. Nevertheless, three months after chemotherapy, the patient exhibited BL relapse in the bone marrow, and on Fluorodeoxyglucose (FDG)–PET-imaging. The relapse therapy was started with R-DHAP, and after only one cycle, the patient once again entered complete remission (CR) paving the way for allogeneic stem cell transplantation. Unfortunately, the patient again relapsed five months after transplantation prompting salvage therapy with R-DHAC and the execution of the second stem cell transplantation. However, one month after the second transplantation the patient presented with chemorefractory meningeosis leukemia resulting in the initiation of palliative care treatment. In summary, we report on rapid CR of relapsed BL after a single cycle of rituximab-DHAP. Given a paucity of clinical trials on the treatment of patients with r/r BL, we intend to highlight the potential efficacy of rituximab-DHAP as salvage therapy in those patients