The Reconnection of Nature and Health

Healthcare is an ever-changing field and often a field of uncertainty of what will be around the next corner. As of recent we have faced new challenges such as the Covid-19 pandemic where the medical field had to shift of this virus that was completely unknown to the world. We, as a society, are increasingly aging and urbanizing. Even among staff there are shortages, efficiency problems among departments, and the need for better work environments. Thus, becoming the premise for this thesis project which dives into how circulation can improve movement and efficiency with patients and professionals. Which leads to the question of ?How does implementing biophilia in architecture improve the well-being and way-finding of those who are using the facilities?? The focus of this thesis is to bring these natural forces back into built environments so we can live healthier as a society

Computational Design, Simulation of Meshing, and Stress Analysis of Strain Wave Gear Drives

Strain wave gear (SWG) drives were patented in 1959 by C. Walton Musser as a coaxial, compact, and lightweight gear drive providing remarkably large gear ratios without backlash. This outstanding performance requires the use of a flexible gear, as well as a meshing process with two regions of tooth contact as opposed to traditional gear drives, which only mesh in a single region. The latter drives have been studied for centuries under the principles of solid mechanics whereas SWG drives lack strong bodies of literature, principles, and computational tools for their design. SWG drives include three parts: wave generator, flexible spline, and ring gear. Typically, the wave generator is an elliptical cam surrounded by a flexible race ball bearing which, inserted inside the flexible spline, provides the input motion to the drive. The flexible spline is a cup-shaped spring with external teeth on the open-end which, deflected by the wave generator, mesh with the internal teeth of the ring gear in two regions along the major axis of the drive. This thesis dissertation focuses on understanding the influence of the geometries of the wave generator and tooth profiles of the flexible spline and the ring gear over stresses throughout the operation of SWG drives. In doing so, computational tools have been developed and design recommendations have been formulated. The wave generator geometries simplified, elliptical, and four roller have been implemented based on previous geometries, while an additional geometry called parabolic is newly proposed. For the tooth profiles, the involute, as a generated profile, and the double and quadruple circular arc geometries, as directly-defined profiles, have been implemented. Two- and three-dimensional finite element models have been developed in a custom-made software to generate fully parameterized models based on the design and manufacturing processes of SWG drives. The models are analyzed and the resulting stresses for each design are compared to determine which geometries and micro-geometry modifications are the most influential over the mechanical performance of this type of gear drive. Significant improvement has been achieved by modifying the geometries of the wave generator and the tooth flanks of the flexible spline and the ring gear. Simplified and parabolic wave generator geometries proved similarly advantageous and the elliptical geometry resulted in the lowest compressive stresses, while the four roller geometry was discarded due to large stresses. The involute tooth profile was proven unsuitable while the directly-defined tooth profiles showed similarly beneficial outcomes when the root geometry was reinforced. The three-dimensional model evidenced the complex state of deflection of the flexible spline due to the cup-shaped spring and the need for micro-geometry modifications to further improve the behavior of SWG drives. Crowning and slope micro-geometry modifications on the wave generator and crowning on the tooth flanks of the flexible spline have been implemented. When combined, these modifications eliminated the areas of stress concentration due to the deflection of the flexible spline and allowed the contact pattern to move closer to the center of the teeth. These improvements resulted in remarkably lower stresses which serve to increase the overall mechanical performance of SWG drives

Apokalypse. Studien zu Franz Schmidt XIII. Symposion 1999, hg. von Carmen Ottner, Ludwig Doblinger KG: Wien / München 2001, ISBN 3-900695-54-7, 383 S. [Rezension]

Rezension des Konferenzberichts zum 13. Franz-Schmidt-Symposiu

Primož Kuret, Mahler in Ljubljana [Mahler und Ljubljana] (1881-1882), Ljubljana 1997, 139 S. In slowenischer Sprache, Zusammenfassung in deutscher Sprache auf 33 Seiten; Vladimir Karbusicky, Mahler in Hamburg. Chronik einer Freundschaft, Hamburg 1996, 179 S. [Rezension]

Beide Veröffentlichungen haben das Wirken des jungen Gustav Mahler zum Gegenstand ihrer Arbeiten gemacht

Diabetes and hyperglycemia: relation with clinical outcome in the community acquired pneumonia

Background: Community acquired pneumonia (CAP) is a common condition and a major cause of morbidity. Diabetes mellitus (DM) increases the risk and complications of infectious diseases. However, the role of DM and glycemia at the time of presentation as prognostic factors in patients with CAP remains to be clarified. Aims: To evaluate the relationship between DM/glycemia at the time of presentation and complications, length of stay and mortality in patients with CAP, and the relationship between glycemic control and complications in patients with diabetes.Methods: Observational, analytical and retrospective study of adults admitted to our hospital between October/2011 and March/2012, with CAP. Electronic clinical data were analyzed and telephone calls were done to assess mortality at 30 and 90 days. The chi-square test, Mann-Whitney and Kruskal-Wallis tests, and logistic regression were used. Results: Of the 440 included patients, 51.1% were women, 83.1% elderly and 29.3% had diagnosis of DM. Of these, 48.8% had HbA1c measured (median 6.8%, IQR: 6.3-7.8%). The median glucose was 134 mg/dL (IQR: 111-176 mg/dL). Patients with DM were older (p = 0.002), had higher severity of pneumonia (p = 0.025), more complications (p = 0.001) and longer hospital stay (p = 0.001). DM proved to be a predictor of complications (p = 0.008). No association between DM and mortality was found, nor between HbA1c levels and complications, length of stay and mortality. Higher glucose levels at admission were associated with longer hospital stay (p = 0.016) and patients with hyperglycemia on admission had more complications (no statistically significant). However, no association between glucose levels on admission and mortality was found. Conclusion: DM and hyperglycemia on admission are associated with adverse outcome in CAP. Both are associated with longer hospital stay and DM predicts complications from CAP

Influenza Vaccine Effectiveness in the Elderly Based on Administrative Databases: Change in Immunization Habit as a Marker for Bias

Administrative databases provide efficient methods to estimate influenza vaccine effectiveness (IVE) against severe outcomes in the elderly but are prone to intractable bias. This study returns to one of the linked population databases by which IVE against hospitalization and death in the elderly was first assessed. We explore IVE across six more recent influenza seasons, including periods before, during, and after peak activity to identify potential markers for bias.Acute respiratory hospitalization and all-cause mortality were compared between immunized/non-immunized community-dwelling seniors ≥65 years through administrative databases in Manitoba, Canada between 2000-01 and 2005-06. IVE was compared during pre-season/influenza/post-season periods through logistic regression with multivariable adjustment (age/sex/income/residence/prior influenza or pneumococcal immunization/medical visits/comorbidity), stratification based on prior influenza immunization history, and propensity scores. Analysis during pre-season periods assessed baseline differences between immunized and unimmunized groups. The study population included ∼140,000 seniors, of whom 50-60% were immunized annually. Adjustment for key covariates and use of propensity scores consistently increased IVE. Estimates were paradoxically higher pre-season and for all-cause mortality vs. acute respiratory hospitalization. Stratified analysis showed that those twice consecutively and currently immunized were always at significantly lower hospitalization/mortality risk with odds ratios (OR) of 0.60 [95%CI0.48-0.75] and 0.58 [0.53-0.64] pre-season and 0.77 [0.69-0.86] and 0.71 [0.66-0.77] during influenza circulation, relative to the consistently unimmunized. Conversely, those forgoing immunization when twice previously immunized were always at significantly higher hospitalization/mortality risk with OR of 1.41 [1.14-1.73] and 2.45 [2.21-2.72] pre-season and 1.21 [1.03-1.43] and 1.78 [1.61-1.96] during influenza circulation.The most pronounced IVE estimates were paradoxically observed pre-season, indicating bias tending to over-estimate vaccine protection. Change in immunization habit from that of the prior two years may be a marker for this bias in administrative data sets; however, no analytic technique explored could adjust for its influence. Improved methods to achieve valid interpretation of protection in the elderly are needed

Waiting on Congress: How State Legislators Proposed and Enacted 50 Different Solutions To the Problem of Illegal Immigration

The U.S. Congress has not passed a significant piece of immigration reform since IIRIRA in 1996. Over the past 20 years, legislators at the state, county, and municipal level have taken the lead on crafting policy that addresses illegal immigration or the presence of unauthorized immigrants. This thesis critically examines the arguments that have been used at the state level to promote new legislation in recent years, focusing on laws found in politically competitive states. Through two lines of research, I investigate the question of 1) what types of arguments have state legislators used the most frequently to enact legislation that deals with illegal immigration over the past two decades, and 2) what types of arguments are actually the most persuasive and generate the greatest support among members of the general public. A synthesis of my findings reveals that legislators are not, in fact, addressing the most important concerns of the American people on the issue of illegal immigration. Recommendations can be made for policy-makers at all levels of government, including members of Congress