Outcome and patients' satisfaction after functional treatment of acute lateral ankle injuries at emergency departments versus family doctor offices

<p>Abstract</p> <p>Background</p> <p>In some Western countries, more and more patients seek initial treatment even for minor injuries at emergency units of hospitals. The initial evaluation and treatment as well as aftercare of these patients require large amounts of personnel and logistical resources, which are limited and costly, especially if compared to treatment by a general practitioner. In this study, we investigated whether outsourcing from our level 1 trauma center to a general practitioner has an influence on patient satisfaction and compliance.</p> <p>Methods</p> <p>This prospective, randomized study, included n = 100 patients who suffered from a lateral ankle ligament injury grade I-II (16, 17). After radiological exclusion of osseous lesions, the patients received early functional treatment and were shown physical therapy exercises to be done at home, without immobilization or the use of stabilizing ortheses. The patients were randomly assigned into two groups of 50 patients each: Group A (ER): Follow-up and final examination in the hospital's emergency unit. Group B (GP): Follow-up by general practitioner, final examination at hospital's emergency unit. The patients were surveyed regarding their satisfaction with the treatment and outcome of the treatment.</p> <p>Results</p> <p>Female and male patients were equally represented in both groups. The age of the patients ranged from 16 – 64 years, with a mean age of 34 years (ER) and 35 years (GP). 98% (n = 98) of all patients were satisfied with their treatment, and 93% (n = 93) were satisfied with the outcome. For these parameters no significant difference between the two groups could be noted (p = 0.7406 and 0.7631 respectively). 39% of all patients acquired stabilizing ortheses like ankle braces (Aircast, Malleoloc etc.) on their own initiative. There was a not significant tendency for more self-acquired ortheses in the group treated by general practicioners (p = 0,2669).</p> <p>Conclusion</p> <p>Patients who first present at the ER with a lateral ankle ligament injury grade I-II can be referred to a general practitioner for follow-up treatment without affecting patient satisfaction regarding treatment and treatment outcome.</p

Analysis of the Levelized Cost of Renewable Hydrogen in Austria

Austria is committed to the net-zero climate goal along with the European Union. This requires all sectors to be decarbonized. Hereby, hydrogen plays a vital role as stated in the national hydrogen strategy. A report commissioned by the Austrian government predicts a minimum hydrogen demand of 16 TWh per year in Austria in 2040. Besides hydrogen imports, domestic production can ensure supply. Hence, this study analyses the levelized cost of hydrogen for an off-grid production plant including a proton exchange membrane electrolyzer, wind power and solar photovoltaics in Austria. In the first step, the capacity factors of the renewable electricity sources are determined by conducting a geographic information system analysis. Secondly, the levelized cost of electricity for wind power and solarphotovoltaics plants in Austria is calculated. Thirdly, the most cost-efficient portfolio of wind power and solar photovoltaics plants is determined using electricity generation profiles with a 10-min granularity. The modelled system variants differ among location, capacity factors of the renewable electricity sources and the full load hours of the electrolyzer. Finally, selected variables are tested for their sensitivities. With the applied model, the hydrogen production cost for decentralized production plants can be calculated for any specific location. The levelized cost of hydrogen estimates range from 3.08 EUR/kg to 13.12 EUR/kg of hydrogen, whereas it was found that the costs are most sensitive to the capacity factors of the renewable electricity sources and the full load hours of the electrolyzer. The novelty of the paper stems from the model applied that calculates the levelized cost of renewable hydrogen in an off-grid hydrogen production system. The model finds a cost-efficient portfolio of directly coupled wind power and solar photovoltaics systems for 80 different variants in an Austria-specific context