Model-based (Mechanical) Product Design

Lien vers la version éditeur: http://link.springer.com/chapter/10.1007/978-3-642-24485-8_40Mechanical product engineering is a research and industrial activity which studies the design of complex mechanical systems. The process, which involves the collaboration of various experts using domain-specific software, raises syntactic and semantic interoperability issues which are not addressed by existing software solutions or their underlying concepts. This article proposes a flexible model-based software architecture that allows for a federation of experts to define and collaborate in innovative design processes. The presented generic approach is backed and validated by its implementation on an academic usecase

High prevalence and undertreatment of osteoporosis in elderly patients undergoing total hip arthroplasty

We detected a high prevalence of low bone mineral density assessed by DXA in 268 elderly patients with end-stage osteoarthritis scheduled for total hip arthroplasty (18% osteoporosis, 41% osteopenia). Therefore, and due to the identified concomitant undertreatment, routine DXA measurements should be considered in elderly patients prior to surgery.!##!Introduction!#!Bone quality represents a decisive factor for osseointegration, durability, and complications of an implanted prosthesis. Although the risk of osteoporosis increases with age and the assessment of bone mineral density (BMD) prior to total hip arthroplasty (THA) is recommended in elderly patients, a systematic, unbiased analysis of such patients is not available in the literature.!##!Methods!#!In this retrospective study, we examined 268 elderly patients (age ≥70 years) who underwent dual-energy X-ray absorptiometry (DXA) within 3 months prior to primary THA. Demographics, medical history, radiographic OA grade, and stem fixation method (i.e., cemented or cementless) were obtained.!##!Results!#!In total, 153 (57%) cemented and 115 (43%) cementless stem fixations during THA were performed. Forty-nine patients (18%) were diagnosed with osteoporosis (T-score ≤-2.5), 110 patients (41%) with osteopenia (T-score ≤-1.0), and 109 patients (41%) with normal BMD (T-score >-1.0). Importantly, 36/49 patients (73%) with osteoporosis were not diagnosed before, resulting in a relevant undertreatment. Female sex and low body mass index (BMI) were the main factors negatively influencing the bone mineral density (BMD).!##!Conclusions!#!Due to a high incidence of undiagnosed and untreated osteoporosis in elderly patients with potential effects on the success of osseointegration as well as other clinical outcomes, DXA measurements should be included in the clinical routine for these patients prior to THA

A joint cross-border investigation of a cluster of multidrug-resistant tuberculosis in Austria, Romania and Germany in 2014 using classic, genotyping and whole genome sequencing methods: lessons learnt

Molecular surveillance of multidrug-resistant tuberculosis (MDR-TB) using 24-loci MIRU-VNTR in the European Union suggests the occurrence of international transmission. In early 2014, Austria detected a molecular MDR-TB cluster of five isolates. Links to Romania and Germany prompted the three countries to investigate possible cross-border MDR-TB transmission jointly. We searched genotyping databases, genotyped additional isolates from Romania, used whole genome sequencing (WGS) to infer putative transmission links, and investigated pairwise epidemiological links and patient mobility. Ten isolates from 10 patients shared the same 24-loci MIRU-VNTR pattern. Within this cluster, WGS defined two subgroups of four patients each. The first comprised an MDR-TB patient from Romania who had sought medical care in Austria and two patients from Austria. The second comprised patients, two of them epidemiologically linked, who lived in three different countries but had the same city of provenance in Romania. Our findings strongly suggested that the two cases in Austrian citizens resulted from a newly introduced MDR-TB strain, followed by domestic transmission. For the other cases, transmission probably occurred in the same city of provenance. To prevent further MDR-TB transmission, we need to ensure universal access to early and adequate therapy and collaborate closely in tuberculosis care beyond administrative borders

Working Towards Fuhrer: A Chaotic View

Leadership is a concept that has been discussed since the beginning of history. Even though there have been many theories in the field accepting leadership's role in bringing order, chaotic aspects of leadership are generally neglected. This chapter aims to examine the leadership beyond an orderly interpretation of universe. For this purpose, Third Reich period and leadership during this period will be examined. Ian Kershaw's "Working Towards Fuhrer" concept provides a unique understanding of leadership concept. It goes beyond the dualist depiction of Third Reich, it does not state Adolf Hitler as an all powerful dictator, or a weak one. Rather, he expresses that due to the conditions in the Third Reich, Adolf Hitler was both of this. This complex situation can be understood deeper when it is examined through the lens of chaos theory. This study contributes to the field by being the first in using chaos theory for examining "Working Towards Fuhrer" concept and its development. Seemingly orderly nature of synchronization process and its vortex will be shown. Adolf Hitler's storm spot position in the chaotic system and its dynamics are explained. War's entropic power and its effect on the downfall of the system is crucial in understanding this unique chaotic system. The chaotic pattern of "Working Towards Fuhrer" offers an opportunity to analyze the complexities of the leadership concept