Accuracy of elevation recording using sport watches while walking and running on hilly and flat terrain

Elevation gain (EG) is a significant contributor to the total workload in many endurance sports. Hence, the aim of this study was to evaluate the accuracy of elevation recording as assessed by popular sport watches. Eighteen participants walked and ran at different speeds in various weather conditions in two terrain types: on a hilly 2490 m course with a total EG of 90 m and on a flat 1200 m outdoor track with 0 m EG. In total, 180 recordings from each sport watch were analyzed and compared according to two processing types: filtered and unfiltered EG data. Compared to the reference values, regarding default settings, on hilly terrain, EG was underestimated by −3.3 to −9.8 %, and on flat terrain, EG was overestimated by 0.0– 4.8 m per 1200 m. These errors could be reduced to −3.3 to +0.4 %, when filtering conditions were adjusted according to the terrain. Gait speed (ranging from 1.47 to 4.89 m s−1) or fluctuations in weather conditions between- or within-trials did not influence EG accuracy. A straightforward comparison between manufacturers is hampered as the filter conditions set by default differ. In conclusion, all devices measure EG adequately; however, the displayed default feedback on EG data is not always the most accurate measurement. Consequently, accuracy in elevation recordings could be increased if users appropriately post-process EG data

Rapid progression of aortic and mitral stenosis in a patient with AA amyloidosis: a case report

Background: Aortic stenosis is a common finding in cardiac amyloidosis (CA). Younger patients often remain asymptomatic. If unrecognized, this can lead to serious complications such as heart failure. Progression of aortic stenosis can be accelerated in patients with chronic kidney disease and need for dialysis. Perioperative risk in these patients is often high due to the underlying systemic disease. Case summary: A 40-year-old Caucasian man with known AA amyloidosis, highly active Ankylosing Spondylitis and need for chronic dialysis due to end-stage chronic renal failure presented for echocardiographic routine exam without reporting any cardiac symptoms. At the last visit 4 years ago, a normal heart valve function was noted and no echocardiographic follow-up was performed in the following. Now, rapid progression with severe aortic valve and mitral valve stenosis was stated and the patient underwent combined aortic and mitral surgical valve replacement following discussion in the multidisciplinary cardiology meeting. Macroscopic examination of the valves revealed significant calcification and histological examination showed the high presence of amyloid by Congo-red staining and immunohistological staining for AA-Amyloid. Both valve prosthetic devices showed normal function as well as a normal left ventricular ejection fraction in initial post-operative transoesophageal echocardiography. After prolonged and complicated post-operative course in the intensive care unit the patient died 3 months after surgery due to intractable multiorgan failure in combined severe abdominal septic and cardiogenic shock. Discussion: Concomitant CA and chronic dialysis can accelerate the onset of severe aortic valve stenosis. Young patients, as in this case, often stay asymptomatic, perioperative risk increases with duration of chronic dialysis and severity of valve stenosis. This increases the need for regular short-term echocardiographic examinations even in clinical stable patients

Does climate change transform military medicine and defense medical support?

BackgroundClimate change has effects on multiple aspects of human life, such as access to food and water, expansion of endemic diseases as well as an increase of natural disasters and related diseases. The objective of this review is to summarize the current knowledge on climate change effects on military occupational health, military healthcare in a deployed setting, and defense medical logistics.MethodsOnline databases and registers were searched on August 22nd, 2022 and 348 papers retrieved, published between 2000 and 2022, from which we selected 8 publications that described climate effects on military health. Papers were clustered according to a modified theoretical framework for climate change effects on health, and relevant items from each paper were summarized.ResultsDuring the last decades a growing body of climate change related publications was identified, which report that climate change has a significant impact on human physiology, mental health, water- and vector borne infectious diseases, as well as air pollution. However, regarding the specific climate effects on military health the level of evidence is low. The effects on defense medical logistics include vulnerabilities in the cold supply chain, in medical devices functioning, in need for air conditioning, and in fresh water supply.ConclusionsClimate change may transform both the theoretical framework and practical implementations in military medicine and military healthcare systems. There are significant knowledge gaps on climate change effects on the health of military personnel in operations of both combat and non-combat nature, alerting the need for prevention and mitigation of climate-related health issues. Further research within the fields of disaster and military medicine is needed to explore this novel field. As climate effects on humans and the medical supply chain may degrade military capability, significant investments in military medical research and development are needed

Electrification of waste collection vehicles: Techno-economic analysis based on an energy demand simulation using real-life operational data

Waste transport plays an important role in the decarbonization of the transport sector. In this paper diesel-powered (dWCV) and electric waste collections vehicles (eWCV) and their operation are analysed regarding energy demand and total cost of ownership (TCO) integrating Well-to-Wheel emission costs. Further, an open-source simulation tool with a route synthetization approach is presented using extensive real-life operational data of five different route types. Determined WCV energy demand varies greatly between vehicle topologies and analysed route types. eWCV show a mean distance-specific energy demand of 1.85 kWh·km-1, while values for dWCV increase to 5.43 kWh·km-1 respectively. The factors route distance and number of waste containers collected show the highest influence on results. Therefore, battery capacity should be sized according to specific route types. eWCV show higher TCO than dWCV under current economic constraints but fuel price level and annual vehicle mileage show a high influence on economic feasibility. Taking the planned emissions price mechanism of the German Government into account, economic scenarios could be identified, which make eWCV advantageous yet in 2021. In technical terms, there is nothing to stop for the electrification of WCV, and with suitable political instruments eWCV could become profitable in the short-term

Economic benefits through system integration of electric waste collection vehicles: Case study of grid-beneficial charging and discharging strategies

Electrification of a waste collection fleet as part of vehicle-to-grid can be used in a grid- beneficial way, which in turn can increase the economy of these vehicles. In this study the system and grid integration of fully battery-electric waste collection vehicles (eWCV) is examined. The possibility to shave power peaks of a lightweight packaging plant and to provide balancing power by eWCV are analyzed. For this, performance and market models are developed using an ex-post analysis, considering also levies and charges. Building on this, various scenarios for the grid-beneficial integration of eWCV are designed. These are assessed based on the resulting energy consumption of the eWCV, charging costs and feasibility for real-life implementation. It is shown that using electricity generated by thermal waste management plants for charging can reduce the operation costs of eWCV. Also, peak shaving is viable from an economic point of view. Network charges and well as the complexity of the system prevent an economical provision of balancing power by eWCV

Impact of BRCA Mutation Status on Tumor Dissemination Pattern, Surgical Outcome and Patient Survival in Primary and Recurrent High-Grade Serous Ovarian Cancer:A Multicenter Retrospective Study by the Ovarian Cancer Therapy-Innovative Models Prolong Survival (OCTIPS) Consortium

Background: This study seeks to evaluate the impact of breast cancer (BRCA) gene status on tumor dissemination pattern, surgical outcome and survival in a multicenter cohort of paired primary ovarian cancer (pOC) and recurrent ovarian cancer (rOC). Patients and Methods: Medical records and follow-up data from 190 patients were gathered retrospectively. All patients had surgery at pOC and at least one further rOC surgery at four European high-volume centers. Patients were divided into one cohort with confirmed mutation for BRCA1 and/or BRCA2 (BRCAmut) and a second cohort with BRCA wild type or unknown (BRCAwt). Patterns of tumor presentation, surgical outcome and survival data were analyzed between the two groups. Results: Patients with BRCAmut disease were on average 4 years younger and had significantly more tumor involvement upon diagnosis. Patients with BRCAmut disease showed higher debulking rates at all stages. Multivariate analysis showed that only patient age had significant predictive value for complete tumor resection in pOC. At rOC, however, only BRCAmut status significantly correlated with optimal debulking. Patients with BRCAmut disease showed significantly prolonged overall survival (OS) by 24.3 months. Progression-free survival (PFS) was prolonged in the BRCAmut group at all stages as well, reaching statistical significance during recurrence. Conclusions: Patients with BRCAmut disease showed a more aggressive course of disease with earlier onset and more extensive tumor dissemination at pOC. However, surgical outcome and OS were significantly better in patients with BRCAmut disease compared with patients with BRCAwt disease. We therefore propose to consider BRCAmut status in regard to patient selection for cytoreductive surgery, especially in rOC

Characterisation of tumor microvessel density during progression of high-grade serous ovarian cancer: clinico-pathological impact. An OCTIPS Consortium study.

Background: High-grade serous ovarian cancer (HGSOC) intratumoural vasculature evolution remains unknown. The study investigated changes in tumour microvessel density (MVD) in a large cohort of paired primary and recurrent HGSOC tissue samples and its impact on patients’ clinico-pathological outcome. Methods: A total of 222 primary (pOC) and recurrent (rOC) intra-patient paired HGSOC were assessed for immunohistochemical expression of angiogenesis-associated biomarkers (CD31, to evaluate MVD, and VEGF-A). Expression profiles were compared between pOCs and rOCs and correlated with patients' data. Results: High intratumoural MVD and VEGF-A expression were observed in 75.7% (84/111) and 20.7% (23/111) pOCs, respectively. MVDhighand VEGF(+)samples were detected in 51.4% (57/111) and 20.7% (23/111) rOCs, respectively. MVDhigh/VEGF(+)co-expression was found in 19.8% (22/111) and 8.1% (9/111) of pOCs and rOCs, respectively (p = 0.02). Pairwise analysis showed no significant change in MVD (p = 0.935) and VEGF-A (p = 0.121) levels from pOCs to rOCs. MVDhighpOCs were associated with higher CD3(+)(p = 0.029) and CD8(+)(p = 0.013) intratumoural effector TILs, while VEGF(+)samples were most frequently encountered among BRCA-mutated tumours (p = 0.019). Multivariate analysis showed VEGF and MVD were not independent prognostic factors for OS. Conclusions: HGSOC intratumoural vasculature did not undergo significant changes during disease progression. High concentration of CD31(+)vessels seems to promote recruitment of effector TILs. The study also provides preliminary evidence of the correlation between VEGF-positivity and BRCA status

Characterization of Aqueous Peroxomolybdates with Catalytic Applicability

Abstract This thesis is a summary of five papers, containing equilibrium and structure studies of aqueous molybdate and peroxomolybdate species. Some of the peroxomolybdate species have also been studied in terms of their dynamic and catalytic properties. The primary objective was to characterize species with potential catalytic activity, with emphasis on thebleach process of kraft pulp. For this, potentiometry, EXAFS and 17O, 31P, 1H and 95 Mo NMR have been used. The molybdate speciation in 0.300 M Na2(SO4) medium was found to differ from that in 0.600 M Na(Cl) medium, in that the uncharged monomeric molybdate species H2MoO4 was stronger in the sulphate medium, while highly charged species, such as Mo7O24 6-, became somewhat less pronounced. Diperoxomolybdate species, (MoX2)n (X = peroxo ligand, n = 1-2), dominated the peroxomolybdate systems when sufficient peroxide was available. Both sulphate and chloride coordinated to molybdenum in the presence of hydrogen peroxide and these species were more inert than diperoxomolybdate species without coordinated medium anions. Chemical exchange rates increased upon protonation. A dimeric triperoxomolydate species was the only species found that contained more than two peroxo groups per molybdenum atom. At low concentrations of hydrogen peroxide, monoperoxoheptamolybdate species, Mo7X, were found. Phosphate was found to coordinate relatively weakly to molybdate in the presence of peroxide. Species with four different nuclearities, i.e. (MoX2)nP (n = 1-4), were found. At excess of peroxide, no molybdophosphates were present. Chemical exchange rates were found to be substantially lower than in the peroxomolybdate system. The aqueous monomeric diperoxomolybdate species retain the pentagonal bipyramidal seven-coordination found in the solid state, although with increased bond lengths. Sulphate seems to coordinate to molybdenum in a monodentate fashion by replacing an oxygen atom. Chloride probably coordinates by replacing an oxygen atom as well. For the dimeric diperoxomolybdate species, a single oxygen-bridge was proposed. Conjugated carbon double bonds in the side chains of lignin model compounds were found to be hydroxylated or epoxidised by peroxomolybdate species. The addition of phosphate did not affect the type or yield of oxidation products noticeably. It was also shown that hydrogen peroxide, in the absence of molybdate, did not react to any noticeable extent with the lignin model compounds under these conditions

Accuracy of elevation recording using sport watches while walking and running on hilly and flat terrain

Elevation gain (EG) is a significant contributor to the total workload in many endurance sports. Hence, the aim of this study was to evaluate the accuracy of elevation recording as assessed by popular sport watches. Eighteen participants walked and ran at different speeds in various weather conditions in two terrain types: on a hilly 2490 m course with a total EG of 90 m and on a flat 1200 m outdoor track with 0 m EG. In total, 180 recordings from each sport watch were analyzed and compared according to two processing types: filtered and unfiltered EG data. Compared to the reference values, regarding default settings, on hilly terrain, EG was underestimated by -3.3 to ?9.8 %, and on flat terrain, EG was overestimated by 0.0–4.8 m per 1200 m. These errors could be reduced to -3.3 to +0.4 %, when filtering conditions were adjusted according to the terrain. Gait speed (ranging from 1.47 to 4.89 m s?1) or fluctuations in weather conditions between- or within-trials did not influence EG accuracy. A straightforward comparison between manufacturers is hampered as the filter conditions set by default differ. In conclusion, all devices measure EG adequately; however, the displayed default feedback on EG data is not always the most accurate measurement. Consequently, accuracy in elevation recordings could be increased if users appropriately post-process EG data

Deviations of inorganic and organic carbon content in hypomineralised enamel

Objectives: The purpose of this study was to discriminate hypomineralised enamel of permanent first molars from normal enamel by means of spectroscopic methods. Methods: The present study was conducted using Multi spot Raman Fourier Transform Spectroscopy, Diffuse Reflectance Infrared Fourier Transform Spectroscopy (FTIR) and X-ray diffraction (XRD). Results: Raman-spectroscopy indicated significantly more B-type carbonate and hydrocarbons in hypomineralised enamel diagnosed as MIH (Molar Incisor Hypomineralisation). From XRD analysis, no changes in crystallinity of the enamel apatite could be found. Conclusions: Using multi spot Raman-spectroscopy, a significant molecular discrimination between normal and hypomineralised enamel could be made