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The utilization of lasers in dentistry expands greatly in recent years. For instance, fs-lasers are effective for both drilling and caries prevention, while cw-lasers are useful for adhesive hardening. A cutting-edge application of lasers in dentistry is the debonding of veneers. While there are pre-existing tools for this purpose, there is still potential for improvement. Initial efforts to investigate laser assisted debonding mechanisms with measurements of the optical and mechanical properties of teeth and prosthetic ceramics are presented. Preliminary tests conducted with a laser system used for debonding that is commercially available showed differences in the output power set at the systems console to that at specified distances from the handpiece. Furthermore, the optical properties of the samples (human teeth and ceramics) were characterised. The optical properties of the ceramics should closely resemble those of teeth in terms of look and feel, but they also influence the laser assisted debonding technique and thus must be taken into account. In addition first attempts were performed to investigate the mechanical properties of the samples by means of pump-probe-elastography under a microscope. By analyzing the sample surface up to 20 ns after a fs-laser pulse impact, pressure and shock waves could be detected, which can be utilized to determine the elastic constants of specific materials. Together such investigations are needed to shape the basis for a purely optical approach of debonding of veneers utilizing acoustic waves.
Zu Beginn wurde im eigenen beruflichen Umfeld beobachtet, dass Informationen und Wissen, die heutzutage im Arbeitsalltag in Fülle ausgetauscht werden, häufig nicht die gewünschte Aufmerksamkeit und Offenheit erhalten. Diese Masterarbeit untersucht, wie bei dieser Art von Beobachtungen, deren komplexe Natur die Identifizierung von Lösungsansätzen erschwert, das eigentliche Problem erkannt werden kann. Frederic Vester zufolge ermöglicht ein vernetztes Denken dabei, Erkenntnisse vor allem aus den miteinander verknüpften Faktoren zu gewinnen. Diese Denkweise lässt sich in einer systemischen wie auch einer transdisziplinären Betrachtungsweise finden, wobei diese der Herausforderung gegenüberstehen vielfältige Perspektiven auf das Problem miteinander in Einklang zu bringen. Dies wirft die Frage auf, inwiefern eine gestalterische Zwischeninstanz dazu beitragen kann, einen gemeinsamen Denkraum zu eröffnen. Das Ziel dieser Arbeit ist, einen Entwurfsvorschlag für die Gestaltung eines Erkenntnisprozesses zu erarbeiten. Der Forschungsansatz dieser Arbeit – (FÜR+ÜBER)DURCH – leitet sich aus Christopher Fraylings Kategorien zur Designforschung ab. Die ‚Recherche FÜR‘ führt dazu, ein Problem als ein System zu betrachten, für das Wolfgang Jonas ein Problem-Design vorschlägt. In der ‚Recherche ÜBER‘ zeigt sich, dass es explizites wie auch implizites Wissen für eine umfassende Problembetrachtung braucht. Dafür wurde die Spuren-sicherung der Kunst auf das Design übertragen, um vorhandenes Wissen visuell zu dokumentieren. Mit Charles S. Peirce visuelles Entwurfs- und Erkenntnisverfahren lässt sich zudem ein anschauliches Denken durch diagrammatisches Schlussfolgern fördern. Die theoretischen Erkenntnisse münden in der ‚Transformation DURCH‘ in einen Vorschlag für ein diagrammatisches Problem-Design. Diesen gilt es in Bezug zu dem praxisbasierten Gestaltungsentwurf aus dem Masterprojekt zu reflektieren. In einer Werkshalle wurden Prototypische Beobachtungen zum ‚Zusammenspiel von Aufmerksamkeit und Offenheit‘ physisch in Beziehung gesetzt und anschließend mit zwei Testgruppen daraufhin untersucht, ob sich daraus neue Erkenntnisse ergeben. Es zeigte sich, das Design auf diese Weise einen gemeinsamen Austausch fördern kann. Gleichzeitig wurde deutlich, dass der Gestaltungsprozess die Vernetztheit eines Problems darstellen kann, jedoch ein vernetztes Denken aktiv initiiert werden muss, wofür im Entwurfsvorschlag dieser Arbeit ein visuelles Verfahren vorgestellt wird.
Power plant operators increasingly rely on predictive models to diagnose and monitor their systems. Data-driven prediction models are generally simple and can have high precision, making them superior to physics-based or knowledge-based models, especially for complex systems like thermal power plants. However, the accuracy of data-driven predictions depends on (1) the quality of the dataset, (2) a suitable selection of sensor signals, and (3) an appropriate selection of the training period. In some instances, redundancies and irrelevant sensors may even reduce the prediction quality.
We investigate ideal configurations for predicting the live steam production of a solid fuel-burning thermal power plant in the pulp and paper industry for different modes of operation. To this end, we benchmark four machine learning algorithms on two feature sets and two training sets to predict steam production. Our results indicate that with the best possible configuration, a coefficient of determination of R^2 = 0.95 and a mean absolute error of MAE=1.2 t/h with an average steam production of 35.1 t/h is reached. On average, using a dynamic dataset for training lowers MAE by 32% compared to a static dataset for training. A feature set based on expert knowledge lowers MAE by an additional 32 %, compared to a simple feature set representing the fuel inputs. We can conclude that based on the static training set and the basic feature set, machine learning algorithms can identify long-term changes. When using a dynamic dataset the performance parameters of thermal power plants are predicted with high accuracy and allow for detecting short-term problems.
Highly-sensitive single-step sensing of levodopa by swellable microneedle-mounted nanogap sensors
(2023)
Microneedle (MN) sensing of biomarkers in interstitial fluid (ISF) can overcome the challenges of self-diagnosis of diseases by a patient, such as blood sampling, handling, and measurement analysis. However, the MN sensing technologies still suffer from poor measurement accuracy due to the small amount of target molecules present in ISF, and require multiple steps of ISF extraction, ISF isolation from MN, and measurement with additional equipment. Here, we present a swellable MN-mounted nanogap sensor that can be inserted into the skin tissue, absorb ISF rapidly, and measure biomarkers in situ by amplifying the measurement signals by redox cycling in nanogap electrodes. We demonstrate that the MN-nanogap sensor measures levodopa (LDA), medication for Parkinson disease, down to 100 nM in an aqueous solution, and 1 μM in both the skin-mimicked gelatin phantom and porcine skin.
Organic acidurias (OAs), urea-cycle disorders (UCDs), and maple syrup urine disease (MSUD) belong to the category of intoxication-type inborn errors of metabolism (IT-IEM). Liver transplantation (LTx) is increasingly utilized in IT-IEM. However, its impact has been mainly focused on clinical outcome measures and rarely on health-related quality of life (HRQoL). Aim of the study was to investigate the impact of LTx on HrQoL in IT-IEMs. This single center prospective study involved 32 patients (15 OA, 11 UCD, 6 MSUD; median age at LTx 3.0 years, range 0.8–26.0). HRQoL was assessed pre/post transplantation by PedsQL-General Module 4.0 and by MetabQoL 1.0, a specifically designed tool for IT-IEM. PedsQL highlighted significant post-LTx improvements in total and physical functioning in both patients' and parents' scores. According to age at transplantation (≤3 vs. >3 years), younger patients showed higher post-LTx scores on Physical (p = 0.03), Social (p < 0.001), and Total (p =0.007) functioning. MetabQoL confirmed significant post-LTx changes in Total and Physical functioning in both patients and parents scores (p ≤ 0.009). Differently from PedsQL, MetabQoL Mental (patients p = 0.013, parents p = 0.03) and Social scores (patients p = 0.02, parents p = 0.012) were significantly higher post-LTx. Significant improvements (p = 0.001–0.04) were also detected both in self- and proxy-reports for almost all MetabQoL subscales. This study shows the importance of assessing the impact of transplantation on HrQoL, a meaningful outcome reflecting patients' wellbeing. LTx is associated with significant improvements of HrQol in both self- and parentreports. The comparison between PedsQL-GM and MetabQoL highlighted that MetabQoL demonstrated higher sensitivity in the assessment of diseasespecific domains than the generic PedsQL tool.
Long-Term outcome of infantile onset pompe disease patients treated with enzyme replacement therapy
(2024)
Background: Enzyme replacement therapy (ERT) with recombinant human alglucosidase alfa (rhGAA) was approved in Europe in 2006. Nevertheless, data on the long-term outcome of infantile onset Pompe disease (IOPD) patients at school age is still limited.
Objective: We analyzed in detail cardiac, respiratory, motor, and cognitive function of 15 German-speaking patients aged 7 and older who started ERT at a median age of 5 months.
Results: Starting dose was 20 mg/kg biweekly in 12 patients, 20 mg/kg weekly in 2, and 40 mg/kg weekly in one patient. CRIM-status was positive in 13 patients (86.7%) and negative or unknown in one patient each (6.7%). Three patients (20%) received immunomodulation. Median age at last assessment was 9.1 (7.0–19.5) years. At last follow-up 1 patient (6.7%) had mild cardiac hypertrophy, 6 (42.9%) had cardiac arrhythmias, and 7 (46.7%) required assisted ventilation. Seven patients (46.7%) achieved the ability to walk independently and 5 (33.3%) were still ambulatory at last follow-up. Six patients (40%) were able to sit without support, while the remaining 4 (26.7%) were tetraplegic. Eleven patients underwent cognitive testing (Culture Fair Intelligence Test), while 4 were unable to meet the requirements for cognitive testing. Intelligence quotients (IQs) ranged from normal (IQ 117, 102, 96, 94) in 4 patients (36.4%) to mild developmental delay (IQ 81) in one patient (9.1%) to intellectual disability (IQ 69, 63, 61, 3x < 55) in 6 patients (54.5%). White matter abnormalities were present in 10 out of 12 cerebral MRIs from 7 patients.
Measuring what matters
(2023)
Patient reported outcomes (PROs) are generally defined as ‘any report of the status of a patient's health condition that comes directly from the patient, without interpretation of the patient's response by a clinician or anyone else’. A broader definition of PRO also includes ‘any information on the outcomes of health care obtained directly from patients without modification by clinicians or other health care professionals’. Following this approach, PROs encompass subjective perceptions of patients on how they function or feel not only in relation to a health condition but also to its treatment as well as concepts such as health-related quality of life (HrQoL), information on the functional status of a patient, signs and symptoms and symptom burden. PRO measurement instruments (PROMs) are mostly questionnaires and inform about what patients can do and how they feel. PROs and PROMs have not yet found unconditional acceptance and wide use in the field of inborn errors of metabolism. This review summarises the importance and usefulness of PROs in research, drug legislation and clinical care and informs about quality standards, development, and potential methodological shortfalls of PROMs. Inclusion of PROs measured with high-quality, well-selected PROMs into clinical care, drug legislation, and research helps to identify unmet needs, improve quality of care, and define outcomes that are meaningful to patients. The field of IEM should open to new methodological approaches such as the definition of core sets of variables including PROs to be systematically assessed in specific metabolic conditions and new collaborations with PRO experts, such as psychologists to facilitate the systematic collection of meaningful data.