Komplexitätssteigerung medizinischer Entscheidungssituationen - Herausforderungen der Digitalisierung erkennen und gestalten

The opportunities and limits of digitalisation for medical decision-making situations have been discussed heavily so far regarding to the potentials of single technologies and digital tools. Following sociological perspectives, which understand medical decision-making as socially embedded and hybrid, we show central structural challenges of digitalisation in clinical decision-making situations and develop recommendations for action for practice. If the structural challenges of digitalisation can be overcome positively, sustainable opportunities for improving medical decision-making situations through digitalisation will open up. With this integrative perspective, it is possible to avoid narrowing down to individual technologies and idealising decision-making situations, to anticipate unintended consequences and to open up perspectives for medium- and long-term quality improvements. © 2022 Georg Thieme Verlag. All rights reserved.Die Chancen und Grenzen der Digitalisierung für medizinische Entscheidungssituationen werden bislang stark in Bezug auf die Potenziale einzelner Technologien und digitaler Tools diskutiert. Im Anschluss an soziologische Perspektiven, die medizinisches Entscheiden als sozial eingebettet und hybrid verstehen, zeigen wir zentrale strukturelle Herausforderungen der Digitalisierung in klinischen Entscheidungssituationen auf und entwickeln Handlungsempfehlungen für die Praxis. Gelingt es, strukturelle Herausforderung der Digitalisierung positiv zu bewältigen, eröffnen sich nachhaltige Möglichkeiten zur Verbesserung medizinischer Entscheidungssituationen durch Digitalisierung. Mit dieser integrativen Perspektive gelingt es, Engführungen auf einzelne Technologien und Idealisierungen von Entscheidungssituationen zu vermeiden, nichtintendierte Folgen zu antizipieren und Perspektiven für mittel- und langfristige Qualitätssteigerungen zu eröffnen

Synthesis and Physical Properties of Iridium-Based Sulfide Ca1−xIr4S6(S2) [x = 0.23–0.33]

We present the synthesis and characterization of the iridium-based sulfide Ca1−xIr4S6(S2). Quality and phase analysis were conducted by means of energy-dispersive X-ray spectroscopy (EDXS) and powder X-ray diffraction (XRD) techniques. Structure analysis reveals a monoclinic symmetry with the space group C 1 2/m 1 (No. 12), with the lattice constants a = 15.030 (3) Å, b = 3.5747 (5) Å and c = 10.4572 (18) Å. Both X-ray diffraction and EDXS suggest an off-stoichiometry of calcium, leading to the empirical composition Ca1−xIr4.0S6(S2) [x = 0.23–0.33]. Transport measurements show metallic behavior of the compound in the whole range of measured temperatures. Magnetic measurements down to 1.8 K show no long range order, and Curie–Weiss analysis yields θCW = −31.4 K, suggesting that the compound undergoes a magnetic state with short range magnetic correlations. We supplement our study with calculations of the band structure in the framework of the density functional theory

Suppression of the magnetic order in CeFeAsO: non-equivalence of hydrostatic and chemical pressure

We present a detailed investigation of the electronic properties of CeFeAsO under chemical (As by P substitution) and hydrostatic pressure by means of in-house and synchrotron M\"ossbauer spectroscopy. The Fe magnetism is suppressed due to both pressures and no magnetic order was observed above a P-substitution level of 40% or 5.2 GPa hydrostatic pressure. We compared both pressures and found that the isovalent As by P substitution change the crystallographic and electronic properties differently than hydrostatic pressure.Comment: supplement is included in the pdf fil

Curcumin and Graphene Oxide Incorporated into Alginate Hydrogels as Versatile Devices for the Local Treatment of Squamous Cell Carcinoma

With the aim of preparing hybrid hydrogels suitable for use as patches for the local treatment of squamous cell carcinoma (SCC)-affected areas, curcumin (CUR) was loaded onto graphene oxide (GO) nanosheets, which were then blended into an alginate hydrogel that was crosslinked by means of calcium ions. The homogeneous incorporation of GO within the polymer network, which was confirmed through morphological investigations, improved the stability of the hybrid system compared to blank hydrogels. The weight loss in the 100–170 °C temperature range was reduced from 30% to 20%, and the degradation of alginate chains shifted to higher temperatures. Moreover, GO enhanced the stability in water media by counteracting the de-crosslinking process of the polymer network. Cell viability assays showed that the loading of CUR (2.5% and 5% by weight) was able to reduce the intrinsic toxicity of GO towards healthy cells, while higher amounts were ineffective due to the antioxidant/prooxidant paradox. Interestingly, the CUR-loaded systems were found to possess a strong cytotoxic effect in SCC cancer cells, and the sustained CUR release (~50% after 96 h) allowed long-term anticancer efficiency to be hypothesized

On the Wake Structure in Streaming Complex Plasmas

The theoretical description of complex (dusty) plasmas requires multiscale concepts that adequately incorporate the correlated interplay of streaming electrons and ions, neutrals, and dust grains. Knowing the effective dust-dust interaction, the multiscale problem can be effectively reduced to a one-component plasma model of the dust subsystem. The goal of the present publication is a systematic evaluation of the electrostatic potential distribution around a dust grain in the presence of a streaming plasma environment by means of two complementary approaches: (i) a high precision computation of the dynamically screened Coulomb potential from the dynamic dielectric function, and (ii) full 3D particle-in-cell simulations, which self-consistently include dynamical grain charging and non-linear effects. The applicability of these two approaches is addressed

Linear colossal magnetoresistance driven by magnetic textures in LaTiO3 thin films on SrTiO3

Linear magnetoresistance (LMR) is of particular interest for memory, electronics, and sensing applications, especially when it does not saturate over a wide range of magnetic fields. One of its principal origins is local mobility or density inhomogeneities, often structural, which in the Parish-Littlewood theory leads to an unsaturating LMR proportional to mobility. Structural disorder, however, also tends to limit the mobility and hence the overall LMR amplitude. An alternative route to achieve large LMR is via non-structural inhomogeneities which do not affect the zero field mobility, like magnetic domains. Here, linear positive magnetoresistance caused by magnetic texture is reported in \ch{LaTiO3}/\ch{SrTiO3} heterostructures. The LMR amplitude reaches up to 6500\% at 9T. This colossal value is understood by the unusual combination of a very high thin film mobility, up to 40 000 cm$^2$/V.s, and a very large coverage of low-mobility regions. These regions correlate with a striped magnetic structure, compatible with a spiral magnetic texture in the \ch{LaTiO3} film, revealed by low temperature Lorentz transmission electron microscopy. These results provide a novel route for the engineering of large-LMR devices

Sequentially Processed P3HT/CN6-CP•−NBu4+ Films: Interfacial or Bulk Doping?

Derivatives of the hexacyano-[3]-radialene anion radical (CN6-CP•−) emerge as a promising new family of p-dopants having a doping strength comparable to that of archetypical dopant 2,3,5,6-tetrafluoro-7,7,8,8-tetracyano-quinodimethane (F4TCNQ). Here, mixed solution (MxS) and sequential processing (SqP) doping methods are compared by using a model semiconductor poly(3-hexylthiophene) (P3HT) and the dopant CN6-CP•−NBu4 + (NBu4 + = tetrabutylammonium). MxS films show a moderate yet thickness-independent conductivity of ≈0.1 S cm−1. For the SqP case, the highest conductivity value of ≈6 S cm−1 is achieved for the thinnest (1.5–3 nm) films whereas conductivity drops two orders of magnitudes for 100 times thicker films. These results are explained in terms of an interfacial doping mechanism realized in the SqP films, where only layers close to the P3HT/dopant interface are doped efficiently, whereas internal P3HT layers remain essentially undoped. This structure is in agreement with transmission electron microscopy, atomic force microscopy, and Kelvin probe force microscopy results. The temperature-dependent conductivity measurements reveal a lower activation energy for charge carriers in SqP samples than in MxS films (79 meV vs 110 meV), which could be a reason for their superior conductivity. © 2020 The Authors. Published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinhei

Characteristics of the plasma distribution in Mercury's equatorial magnetosphere derived from MESSENGER Magnetometer observations

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/96228/1/jgra22273.pd