Orthopedic trauma patient satisfaction with telemedicine during the Covid-19 lockdown: an interview study among 25 patients

BACKGROUND: Telemedicine can take many forms, from telephone-only consultations to video consultations via smartphone or personal computer, depending on the goals of the treatment. One of the advantages of videoconferencing is the direct visual contact between patients and therapists even over long distances. While some telemedicine models require specially designed add-on devices, others get by with off-the-shelf equipment and software and achieve similarly successful results. This depends, among other things, on the nature of the injury, the desired outcome of therapy, and the medical consultation. In the last decade, the science and practice of telemedicine have grown exponentially and even more so during the Covid-19 pandemic. Depending on the traumatic lesion, post-traumatic and post-operative treatment and care of trauma patients may require medical or physical therapy consultation in a clinic or office. However, due to the Covid-19 lockdown, direct physical follow-up was more difficult and telemedicine solutions were sought and implemented. OBJECTIVE: The aim of this study was to assess orthopedic trauma patients` satisfaction with telemedical aftercare. METHODS: Between March and July 2020, a standardized interview using a standardized questionnaire (Freiburg Index of Patient Satisfaction; FIPS) amongst orthopedic trauma patients who received telemedical post-surgical or physiotherapeutic care was conducted. The FIPS is composed of five questions regarding treatment and one question on the overall treatment satisfaction. Furthermore, we assessed patients` demographics and their telemedical use. Sub-group analysis was performed for age groups (< 65 years vs. ≥ 65 years), the used device and gender. RESULTS: In total, we assessed 25 patients with a mean age of 43 years (14 female). The majority of patients used their smartphone for the consultations (76%). The assessed mean overall FIPS score was 2.14. The mean FIPS score of younger patients was 2.23 (versus 1.91 for elderly patients). The vast majority of the surveyed patients (80%) were absolutely confident with their smartphone or tablet use. CONCLUSIONS: The majority of patients surveyed stated a high satisfaction with the telemedical follow-up. Older patients showed a higher satisfaction rate than their counterparts. It seems that telemedical post-surgical or physiotherapeutic care is a viable option, especially in times of reduced contact, like the current Covid-19 pandemic. Thus, telemedicine offers the opportunity to ensure access to effective patient care even over long distances while maintaining patient satisfaction

Culture-based prescribing to improve mental health: a scoping review protocol

Objective: The objective of this review is to investigate what is known about culture-based prescribing to improve mental health and well-being. Introduction: Culture-based prescribing, where a person is referred by a clinical professional to an arts or cultural activity aimed at improving mental health and well-being, is increasingly used as a community-based source of support. Although culture-based prescribing seems promising, the field is heterogeneous with respect to definition, underlying hypotheses, and cultural activity, and this hampers its further development and implementation. Inclusion criteria: We will consider publications that report on or explore culture-based prescribing to improve mental health and well-being for adults suffering from symptoms related to mental health conditions who are seeking care from any clinical professional. Methods: We will search 8 electronic literature databases for published or unpublished reports on culture-based prescribing, without time limits. We will also search for gray literature and screen reference lists of relevant reviews. No language restrictions will be applied during the screening process, but for data extraction, we will only extract studies in languages our team has proficiency in. The screening and data extraction will be performed by 2 reviewers, independently. Data analysis will be descriptive, with results tabulated separately for each subquestion. The results will be complemented with a narrative summary

O ICMS Ecológico como ferramenta de conservação: estudo de caso no município de Marmeleiro (PR)

Este estudo teve como objetivo avaliar os impactos socioambientais da implantação do Programa ICMS Ecológico em propriedades ribeirinhas de uma comunidade no município de Marmeleiro (PR), por meio da aplicação de um questionário quantitativo com perguntas abertas e fechadas. Identificaram-se impactos socioambientais, expressos na adequação do projeto à realidade das propriedades e na opinião dos proprietários em relação às cercas implantadas pelo ICMS Ecológico para proteção de matas ciliares. O programa propiciou o isolamento de matas ciliares (mediante a construção de cercas) e a readequação de estradas rurais. O diferencial na implantação das ações nessa comunidade foi o capital social desta, que possibilitou redes sociais fortalecidas. A maior preocupação ambiental da comunidade foi a relação de importância entre as matas ciliares e a qualidade e quantidade de água disponível. Detectou-se uma carência de publicação de artigos específicos sobre resultados de programas de ICMS Ecológico. Para a implantação destes, é importante identificar as motivações dos proprietários ribeirinhos e integrar ações de educação ambiental. Recomenda-se fortalecer as redes sociais atuantes e estabelecer um maior monitoramento ambiental por órgãos governamentais para o sucesso de tais programas

Improved Configuration Management for Greener Approaches – Evaluation of a Novel Pilot Support Concept

Speed and configuration management is the key to carrying out an approach that is not only safe, but as environmentally friendly as possible, minimising fuel / noise. A new operational concept and FMS functionality is developed and evaluated in piloted simulator trials to support the flight crew in this task under fluctuating wind and weather conditions while following individual ATC instructions

Improved energy management during arrival for lower noise emissions

Analysis of operational flight data has shown that energy management during approach is a challenging task for pilots. This is detrimental for both fuel consumption and noise emission. The difficulty is increased when shortcuts result in an over-energy scenario. To alleviate the situation, a novel functionality was developed which improves aircraft energy management during descent and approach. It includes cues shown in the Primary Flight Display and the Navigation Display of an exemplary single-aisle aircraft. Noise benefits of the functionality were evaluated during piloted real-time simulation trials. Using the functionality, noise emissions during descent and approach can be decreased in the area within 10 NM from the threshold

Spectroscopy of a single-carrier bilayer graphene quantum dot from time-resolved charge detection

We measured the spectrum of a single-carrier bilayer graphene quantum dot as a function of both parallel and perpendicular magnetic fields, using a time-resolved charge detection technique that gives access to individual tunnel events. Thanks to our unprecedented energy resolution of 4$\mu~$eV, we could distinguish all four levels of the dot's first orbital, in particular in the range of magnetic fields where the first and second excited states cross ($B_\perp\lesssim 100~$mT). We thereby experimentally establish, the hitherto extrapolated, single-charge carrier spectrum picture and provide a new upper bound for the inter-valley mixing, equal to our energy resolution

Ultra-long relaxation of a Kramers qubit formed in a bilayer graphene quantum dot

The intrinsic valley degree of freedom makes bilayer graphene a unique platform for emerging types of semiconducting qubits. The single-carrier quantum dot ground state exhibits a two-fold degeneracy where the two states have opposite spin and valley quantum numbers. By breaking the time-reversal symmetry of this ground state with an out-of-plane magnetic field, a novel type of qubit (Kramers qubit), encoded in the two-dimensional spin-valley subspace, becomes accessible. The Kramers qubit is robust against known spin- and valley-mixing mechanisms, as it requires a simultaneous change of both quantum numbers, potentially resulting in long relaxation and coherence times. We measure the relaxation time of a single carrier in the excited states of a bilayer graphene quantum dot at small ($\sim \mathrm{mT}$) and zero magnetic fields. We demonstrate ultra-long spin-valley relaxation times of the Kramers qubit exceeding $30~\mathrm{s}$, which is about two orders of magnitude longer than the spin relaxation time of $400~\mathrm{ms}$. The demonstrated high-fidelity single-shot readout and long relaxation times are the foundation for novel, long-lived semiconductor qubits

Large Process Models: Business Process Management in the Age of Generative AI

The continued success of Large Language Models (LLMs) and other generative artificial intelligence approaches highlights the advantages that large information corpora can have over rigidly defined symbolic models, but also serves as a proof-point of the challenges that purely statistics-based approaches have in terms of safety and trustworthiness. As a framework for contextualizing the potential, as well as the limitations of LLMs and other foundation model-based technologies, we propose the concept of a Large Process Model (LPM) that combines the correlation power of LLMs with the analytical precision and reliability of knowledge-based systems and automated reasoning approaches. LPMs are envisioned to directly utilize the wealth of process management experience that experts have accumulated, as well as process performance data of organizations with diverse characteristics, e.g., regarding size, region, or industry. In this vision, the proposed LPM would allow organizations to receive context-specific (tailored) process and other business models, analytical deep-dives, and improvement recommendations. As such, they would allow to substantially decrease the time and effort required for business transformation, while also allowing for deeper, more impactful, and more actionable insights than previously possible. We argue that implementing an LPM is feasible, but also highlight limitations and research challenges that need to be solved to implement particular aspects of the LPM vision

In vitro neurotoxicity of particles from diesel and biodiesel fueled engines following direct and simulated inhalation exposure

Combustion-derived particulate matter (PM) is a major source of air pollution. Efforts to reduce diesel engine emission include the application of biodiesel. However, while urban PM exposure has been linked to adverse brain effects, little is known about the direct effects of PM from regular fossil diesel (PMDEP) and biodiesel (PMBIO) on neuronal function. Furthermore, it is unknown to what extent the PM-induced effects in the lung (e.g., inflammation) affect the brain. This in vitro study investigates direct and indirect toxicity of PMDEP and PMBIO on the lung and brain and compared it with effects of clean carbon particles (CP). PM were generated using a common rail diesel engine. CP was sampled from a spark generator. First, effects of 48 h exposure to PM and CP (1.2–3.9 µg/cm2) were assessed in an in vitro lung model (air–liquid interface co-culture of Calu-3 and THP1 cells) by measuring cell viability, cytotoxicity, barrier function, inflammation, and oxidative and cell stress. None of the exposures caused clear adverse effects and only minor changes in gene expression were observed. Next, the basal medium was collected for subsequent simulated inhalation exposure of rat primary cortical cells. Neuronal activity, recorded using microelectrode arrays (MEA), was increased after acute (0.5 h) simulated inhalation exposure. In contrast, direct exposure to PMDEP and PMBIO (1–100 µg/mL; 1.2–119 µg/cm2) reduced neuronal activity after 24 h with lowest observed effect levels of respectively 10 µg/mL and 30 µg/mL, indicating higher neurotoxic potency of PMDEP, whereas neuronal activity remained unaffected following CP exposure. These findings indicate that combustion-derived PM potently inhibit neuronal function following direct exposure, while the lung serves as a protective barrier. Furthermore, PMDEP exhibit a higher direct neurotoxic potency than PMBIO, and the data suggest that the neurotoxic effects is caused by adsorbed chemicals rather than the pure carbon core

Drug Screening Boosted by Hyperpolarized Long-Lived States in NMR

Transverse and longitudinal relaxation times (T1ρ and T1) have been widely exploited in NMR to probe the binding of ligands and putative drugs to target proteins. We have shown recently that long-lived states (LLS) can be more sensitive to ligand binding. LLS can be excited if the ligand comprises at least two coupled spins. Herein we broaden the scope of ligand screening by LLS to arbitrary ligands by covalent attachment of a functional group, which comprises a pair of coupled protons that are isolated from neighboring magnetic nuclei. The resulting functionalized ligands have longitudinal relaxation times T1(1H) that are sufficiently long to allow the powerful combination of LLS with dissolution dynamic nuclear polarization (D-DNP). Hyperpolarized weak “spy ligands” can be displaced by high-affinity competitors. Hyperpolarized LLS allow one to decrease both protein and ligand concentrations to micromolar levels and to significantly increase sample throughput