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Das Ziel der Bundesregierung von jährlich 400.000 neuen Wohnungen (davon 100.000 mit Sozialbindung) ist gefährdet. Deutschland steht nämlich möglicherweise eine längere Stagflationsphase bevor, die nicht zuletzt durch den Abriss von Lieferketten und den Anstieg der Energiepreise bedingt ist. Investoren von Wohnungen geraten dabei wirtschaftlich in die Zange: Einerseits sind die Möglichkeiten, weitere Mieterhöhungen durchzusetzen, aufgrund sinkender Realeinkommen beschränkt. Auf der anderen Seite explodiert aufgrund steigender Baukosten und Zinsen die Kostenseite. Dies alles dürfte sich auf die Investitionsbereitschaft sehr negativ auswirken, zumal derzeit noch keine Erleichterung in Gestalt eines deutlichen Absinkens der Bodenpreise zu erkennen ist. Letzteres ist allerdings ein Argument für den verstärkten Einsatz von öffentlich ausgegebenen Erbbaurechten, über die auch Sozialbindungen für die gesamte Vertragslaufzeit auferlegt werden können.
Allerdings können u. U. in der sich abzeichnenden wirtschaftlichen Situation durchaus auch Erbbaurechtnehmer mit Bestandsverträgen in Probleme geraten. Die Ursache hierfür sind Anpassungen der Erbbauzinsen, deren Entwicklung an die Inflationsrate gekoppelt ist. Zwar existiert eine gesetzliche Billigkeitsprüfung. Diese setzt in ihrer gegenwärtigen Ausgestaltung aber möglicherweise zu geringe Hürden bei inflationsbedingt starken Erhöhungen der Erbbauzinsen. Diese Hürden könnte einerseits aber erhöht werden, indem neben den Bruttoverdiensten der Arbeitnehmer auf die Kerninflationsrate anstatt der Verbraucherpreissteigerungen Bezug genommen wird. Eine Alternative besteht in der Bezugnahme der Kappungsgrenze auf den Wohnungsmietindex, was allerdings einen Bruch mit der bisherigen wirtschaftlichen Logik der Kappungsgrenze bedeutet.
Bei von der öffentlichen Hand ausgegebenen Erbbaurechten würde sich ebenfalls eine freiwillige Bezugnahme der Anpassung der Erbbauzinsen im Rahmen von Gleitklauseln an der Kerninflationsrate empfehlen.
Die erstmalige Ausgabe von Erbbaurechten durch die öffentliche Hand sollte orientiert an langfristigen Baufinanzierungszinsen erfolgen. Dabei wäre jedoch ein Abschlag mit Blick auf die erwartete (Kern-) Inflation vorzunehmen, die bei Erbbaurechtsverträgen wegen der hier möglichen Wertsicherungsklauseln deutlich weniger auf die Rendite als bei Baufinanzierungen durchschlägt. Die Länder sind hier v. a. dahingehend gefordert, in den Gemeindeordnungen klarzustellen, dass ein derartiges Vorgehen nicht gegen das Gebot der Abgabe von Vermögenswerten zum „vollen Wert“ verstößt.
Ebenfalls vornehmlich den Aufgabenbereich der Länder (aber auch der Gemeinden) betrifft die Notwendigkeit, eine eigenständige Förderkulisse für bezahlbaren Wohnraum über Erbbaurechte aufzustellen, die perspektivisch die gesamte Vertragslaufzeit umfasst. Eine weitere Absenkung der Erbbauzinsen über das oben diskutierte Niveau (Orientierung an inflationsadjustierten langfristigen Baufinanzierungszinsen) stellt i.d.R. nur eine zweitbeste Lösung dar.
Background: As electric kick scooters, three-wheelers, and passenger cars enter the streets, efficiency trade-offs across vehicle types gain practical relevance for consumers and policy makers. Here, we compile a comprehensive dataset of 428 electric vehicles, including seven vehicle types and information on certified and real-world energy consumption. Regression analysis is applied to quantify trade-offs between energy consumption and other vehicle attributes.
Results: Certified and real-world energy consumption of electric vehicles increase by 60% and 40%, respectively, with each doubling of vehicle mass, but only by 5% with each doubling of rated motor power. These findings hold roughly also for passenger cars whose energy consumption tends to increase 0.6 ± 0.1 kWh/100 km with each 100 kg of vehicle mass. Battery capacity and vehicle mass are closely related. A 10 kWh increase in battery capacity increases the mass of electric cars by 15 kg, their drive range by 40–50 km, and their energy consumption by 0.7–1.0 kWh/100 km. Mass-produced state-of-the-art electric passenger cars are 2.1 ± 0.8 kWh/100 km more efficient than first-generation vehicles, produced at small scale.
Conclusion: Efficiency trade-offs in electric vehicles differ from those in conventional cars—the latter showing a strong dependency of fuel consumption on rated engine power. Mass-related efficiency trade-offs in electric vehicles are large and could be tapped by stimulating mode shift from passenger cars to light electric road vehicles. Electric passenger cars still offer potentials for further efficiency improvements. These could be exploited through a dedicated energy label with battery capacity as utility parameter.
Integrated analysis on socio-economic metabolism could provide a basis for understanding and optimizing regional sustainability. The paper conducted socio-economic metabolism analysis by means of the emergy accounting method coupled with data envelopment analysis and decomposition analysis techniques to assess the sustainability of Qingyang city and its eight sub-region system, as well as to identify the major driving factors of performance change during 2000–2007, to serve as the basis for future policy scenarios. The results indicate that Qingyang greatly depended on non-renewable emergy flows and feedback (purchased) emergy flows, except the two sub-regions, named Huanxian and Huachi, which highly depended on renewable emergy flow. Zhenyuan, Huanxian and Qingcheng were identified as being relatively emergy efficient, and the other five sub-regions have potential to reduce natural resource inputs and waste output to achieve the goal of efficiency. The results of decomposition analysis show that the economic growth, as well as the increased emergy yield ratio and population not accompanied by a sufficient increase of resource utilization efficiency are the main drivers of the unsustainable economic model in Qingyang and call for polices to promote the efficiency of resource utilization and to optimize natural resource use.
Background: Electric vehicles have been identified as being a key technology in reducing future emissions and energy consumption in the mobility sector. The focus of this article is to review and assess the energy efficiency and the environmental impact of battery electric cars (BEV), which is the only technical alternative on the market available today to vehicles with internal combustion engine (ICEV). Electricity onboard a car can be provided either by a battery or a fuel cell (FCV). The technical structure of BEV is described, clarifying that it is relatively simple compared to ICEV. Following that, ICEV can be ‘e-converted’ by experienced personnel. Such an e-conversion project generated reality-close data reported here.
Results: Practicability of today's BEV is discussed, revealing that particularly small-size BEVs are useful. This article reports on an e-conversion of a used Smart. Measurements on this car, prior and after conversion, confirmed a fourfold energy efficiency advantage of BEV over ICEV, as supposed in literature. Preliminary energy efficiency data of FCV are reviewed being only slightly lower compared to BEV. However, well-to-wheel efficiency suffers from 47% to 63% energy loss during hydrogen production. With respect to energy efficiency, BEVs are found to represent the only alternative to ICEV. This, however, is only true if the electricity is provided by very efficient power plants or better by renewable energy production. Literature data on energy consumption and greenhouse gas (GHG) emission by ICEV compared to BEV suffer from a 25% underestimation of ICEV-standardized driving cycle numbers in relation to street conditions so far. Literature data available for BEV, on the other hand, were mostly modeled and based on relatively heavy BEV as well as driving conditions, which do not represent the most useful field of BEV operation. Literature data have been compared with measurements based on the converted Smart, revealing a distinct GHG emissions advantage due to the German electricity net conditions, which can be considerably extended by charging electricity from renewable sources. Life cycle carbon footprint of BEV is reviewed based on literature data with emphasis on lithium-ion batteries. Battery life cycle assessment (LCA) data available in literature, so far, vary significantly by a factor of up to 5.6 depending on LCA methodology approach, but also with respect to the battery chemistry. Carbon footprint over 100,000 km calculated for the converted 10-year-old Smart exhibits a possible reduction of over 80% in comparison to the Smart with internal combustion engine.
Conclusion: Findings of the article confirm that the electric car can serve as a suitable instrument towards a much more sustainable future in mobility. This is particularly true for small-size BEV, which is underrepresented in LCA literature data so far. While CO2-LCA of BEV seems to be relatively well known apart from the battery, life cycle impact of BEV in categories other than the global warming potential reveals a complex and still incomplete picture. Since technology of the electric car is of limited complexity with the exception of the battery, used cars can also be converted from combustion to electric. This way, it seems possible to reduce CO2-equivalent emissions by 80% (factor 5 efficiency improvement).
Zur Optimierung von Zulaufsatzkultur-Fermentationen von methylotrophen Organismen wird eine Online-Messmethode vorgestellt, mit der die Methanol-Konzentration im Medium während einer Fermentation durch ein Spülgaspervaporations-Prinzip bestimmt werden kann. Im Gegensatz zu anderen Analysemethoden bietet die Messmethode die Möglichkeit, die Substratkonzentration bei Prozessen mit Methanol als zentralem Substrat über eine Regelung auf einem definierten Wert zu halten. Es werden Schwierigkeiten, aber auch deren Überwindung bei der Adaption der Messmethode auf Fermentationsprozesse dargestellt.
Background: Tobacco smoking prevalence continues to be high, particularly among adolescents and young adults with lower educational levels, and is therefore a serious public health problem. Tobacco smoking and problem drinking often co-occur and relapses after successful smoking cessation are often associated with alcohol use. This study aims at testing the efficacy of an integrated smoking cessation and alcohol intervention by comparing it to a smoking cessation only intervention for young people, delivered via the Internet and mobile phone.
Methods/Design: A two-arm cluster-randomised controlled trial with one follow-up assessment after 6 months will be conducted. Participants in the integrated intervention group will: (1) receive individually tailored web-based feedback on their drinking behaviour based on age and gender norms, (2) receive individually tailored mobile phone text messages to promote drinking within low-risk limits over a 3-month period, (3) receive individually tailored mobile phone text messages to support smoking cessation for 3 months, and (4) be offered the option of registering for a more intensive program that provides strategies for smoking cessation centred around a self-defined quit date. Participants in the smoking cessation only intervention group will only receive components (3) and (4). Study participants will be 1350 students who smoke tobacco daily/occasionally, from vocational schools in Switzerland. Main outcome criteria are 7-day point prevalence smoking abstinence and cigarette consumption assessed at the 6-month follow up.
Discussion: This is the first study testing a fully automated intervention for smoking cessation that simultaneously addresses alcohol use and interrelations between tobacco and alcohol use. The integrated intervention can be easily implemented in various settings and could be used with large groups of young people in a cost-effective way.
Background: Problem drinking, particularly risky single-occasion drinking is widespread among adolescents and young adults in most Western countries. Mobile phone text messaging allows a proactive and cost-effective delivery of short messages at any time and place and allows the delivery of individualised information at times when young people typically drink alcohol. The main objective of the planned study is to test the efficacy of a combined web- and text messaging-based intervention to reduce problem drinking in young people with heterogeneous educational level.
Methods/Design: A two-arm cluster-randomised controlled trial with one follow-up assessment after 6 months will be conducted to test the efficacy of the intervention in comparison to assessment only. The fully-automated intervention program will provide an online feedback based on the social norms approach as well as individually tailored mobile phone text messages to stimulate (1) positive outcome expectations to drink within low-risk limits, (2) self-efficacy to resist alcohol and (3) planning processes to translate intentions to resist alcohol into action. Program participants will receive up to two weekly text messages over a time period of 3 months. Study participants will be 934 students from approximately 93 upper secondary and vocational schools in Switzerland. Main outcome criterion will be risky single-occasion drinking in the past 30 days preceding the follow-up assessment.
Discussion: This is the first study testing the efficacy of a combined web- and text messaging-based intervention to reduce problem drinking in young people. Given that this intervention approach proves to be effective, it could be easily implemented in various settings, and it could reach large numbers of young people in a cost-effective way.
Vibroarthrography measures joint sounds caused by sliding of the joint surfaces over each other. and can be affected by joint health, load and type of movement. Since both warm-up and muscle fatigue lead to local changes in the knee joint (e.g., temperature increase, lubrication of the joint, muscle activation), these may impact knee joint sounds. Therefore, this study investigates the effects of warm-up and muscle fatiguing exercise on knee joint sounds during an activity of daily living. Seventeen healthy, physically active volunteers (25.7 ± 2 years, 7 males) performed a control and an intervention session with a wash-out phase of one week. The control session consisted of sitting on a chair, while the intervention session contained a warm-up (walking on a treadmill) followed by a fatiguing exercise (modified sit-to-stand) protocol. Knee sounds were recorded by vibroarthrography (at the medial tibia plateau and at the patella) at three time points in each session during a sit-to-stand movement. The primary outcome was the mean signal amplitude (MSA, dB). Differences between sessions were determined by repeated measures ANOVA with intra-individual pre-post differences for the warm-up and for the muscle fatigue effect. We found a significant difference for MSA at the medial tibia plateau (intervention: mean 1.51 dB, standard deviation 2.51 dB; control: mean -1.28 dB, SD 2.61 dB; F = 9.5; p = .007; η2 = .37) during extension (from sit to stand) after the warm-up. There was no significant difference for any parameter after the muscle fatiguing exercise (p > .05). The increase in MSA may mostly be explained by an increase in internal knee load and joint friction. However, neuromuscular changes may also have played a role. It appears that the muscle fatiguing exercise has no impact on knee joint sounds in young, active, symptom-free participants during sit to stand.
Intervention in the form of core-specific stability exercises is evident to improve trunk stability. The purpose was to assess the effect of an additional 6 weeks sensorimotor or resistance training on maximum isokinetic trunk strength and response to sudden dynamic trunk loading (STL) in highly trained adolescent athletes. The study was conducted as a single-blind, 3-armed randomized controlled trial. Twenty-four adolescent athletes (14f/10 m, 16 ± 1 yrs.;178 ± 10 cm; 67 ± 11 kg; training sessions/week 15±5; training h/week 22±8) were randomized into resistance training (RT; n=7), sensorimotor training (SMT; n = 10), and control group (CG; n = 7). Athletes were instructed to perform standardized, center-based training for 6 weeks, two times per week, with a duration of 1 h each session. SMT consisted of four different core-specific sensorimotor exercises using instable surfaces. RT consisted of four trunk strength exercises using strength training machines, as well as an isokinetic dynamometer. All participants in the CG received an unspecific heart frequency controlled, ergometer-based endurance training (50 min at max. heart frequency of 130HF). For each athlete, each training session was documented in an individual training diary (e.g., level of SMT exercise; 1RM for strength exercise, pain). At baseline (M1) and after 6 weeks of intervention (M2), participants’ maximum strength in trunk rotation (ROM:63°) and flexion/extension (ROM:55°) was tested on an isokinetic dynamometer (concentric/eccentric 30°/s). STL was assessed in eccentric (30°/s) mode with additional dynamometer-induced perturbation as a marker of core stability. Peak torque [Nm] was calculated as the main outcome. The primary outcome measurements (trunk rotation/extension peak torque: con, ecc, STL) were statistically analyzed by means of the two-factor repeated measures analysis of variance (α = 0.05). Out of 12 possible sessions, athletes participated between 8 and 9 sessions (SMT: 9 ± 3; RT: 8 ± 3; CG: 8 ± 4). Regarding main outcomes of trunk performance, experimental groups showed no significant pre–post difference for maximum trunk strength testing as well as for perturbation compensation (p > 0.05). It is concluded, that future interventions should exceed 6 weeks duration with at least 2 sessions per week to induce enhanced trunk strength or compensatory response to sudden, high-intensity trunk loading in already highly trained adolescent athletes, regardless of training regime.
E-commerce live streaming - An emerging industry in China and a potential future trend in the world
(2021)
With the widespread use of the Internet, many industries have developed rapidly. The economy based on the Internet poses a significant threat to the traditional economy. Live streaming plus e-commerce, which is acknowledged as the current global economic status, is the result of combing live streaming and various industries through the Internet. E-commerce live streaming is one of the most essential types of online live streaming. In this article, it is defined as the live streaming of the e-commerce platform used by Key Opinion Leaders or product sellers through the built-in live streaming function of the platform to propagate goods, brands, events, etc. to achieve goals of brand exposure and product sales. Compared with the traditional economic model, the combined model of e-commerce and live streaming has its advantages and characteristics. This kind of marketing tool is now prevalent. However, there are many deficiencies in e-commerce live streaming that need to be improved since the development of e-commerce is immature and supervision of Internet use is ongoing.
Stabilization exercise (SE) is evident for the management of chronic non-specific low back pain (LBP). The optimal dose-response-relationship for the utmost treatment success is, thus, still unknown. The purpose is to systematically review the dose-response-relationship of stabilisation exercises on pain and disability in patients with chronic non-specific LBP. A systematic review with meta-regression was conducted (Pubmed, Web of Knowledge, Cochrane). Eligibility criteria were RCTs on patients with chronic non-specific LBP, written in English/German and adopting a longitudinal core-specific/stabilising/motor control exercise intervention with at least one outcome for pain intensity and/or disability. Meta-regressions (dependent variable = effect sizes (Cohens d) of the interventions (for pain and for disability), independent variable = training characteristics (duration, frequency, time per session)), and controlled for (low) study quality (PEDro) and (low) sample sizes (n) were conducted to reveal the optimal dose required for therapy success. From the 3,415 studies initially selected, 50 studies (n = 2,786 LBP patients) were included. N = 1,239 patients received SE. Training duration was 7.0 ± 3.3 weeks, training frequency was 3.1 ± 1.8 sessions per week with a mean training time of 44.6 ± 18.0 min per session. The meta-regressions’ mean effect size was d = 1.80 (pain) and d = 1.70 (disability). Total R2 was 0.445 and 0.17. Moderate quality evidence (R2 = 0.231) revealed that a training duration of 20 to 30 min elicited the largest effect (both in pain and disability, logarithmic association). Low quality evidence (R2 = 0.125) revealed that training 3 to 5 times per week led to the largest effect of SE in patients with chronic non-specific LBP (inverted U-shaped association). In patients with non-specific chronic LBP, stabilization exercise with a training frequency of 3 to 5 times per week (Grade C) and a training time of 20 to 30 min per session (Grade A) elicited the largest effect on pain and disability.
Background: Core-specific sensorimotor exercises are proven to enhance neuromuscular activity of the trunk, improve athletic performance and prevent back pain. However, the dose-response relationship and, therefore, the dose required to improve trunk function is still under debate. The purpose of the present trial will be to compare four different intervention strategies of sensorimotor exercises that will result in improved trunk function.
Methods/design: A single-blind, four-armed, randomized controlled trial with a 3-week (home-based) intervention phase and two measurement days pre and post intervention (M1/M2) is designed. Experimental procedures on both measurement days will include evaluation of maximum isokinetic and isometric trunk strength (extension/flexion, rotation) including perturbations, as well as neuromuscular trunk activity while performing strength testing. The primary outcome is trunk strength (peak torque). Neuromuscular activity (amplitude, latencies as a response to perturbation) serves as secondary outcome.
The control group will perform a standardized exercise program of four sensorimotor exercises (three sets of 10 repetitions) in each of six training sessions (30 min duration) over 3 weeks. The intervention groups’ programs differ in the number of exercises, sets per exercise and, therefore, overall training amount (group I: six sessions, three exercises, two sets; group II: six sessions, two exercises, two sets; group III: six sessions, one exercise, three sets). The intervention programs of groups I, II and III include additional perturbations for all exercises to increase both the difficulty and the efficacy of the exercises performed. Statistical analysis will be performed after examining the underlying assumptions for parametric and non-parametric testing.
Discussion: The results of the study will be clinically relevant, not only for researchers but also for (sports) therapists, physicians, coaches, athletes and the general population who have the aim of improving trunk function.
Disconnection in a left-hemispheric temporo-parietal network impairs multiplication fact retrieval
(2023)
Arithmetic fact retrieval has been suggested to recruit a left-lateralized network comprising perisylvian language areas, parietal areas such as the angular gyrus (AG), and non-neocortical structures such as the hippocampus. However, the underlying white matter connectivity of these areas has not been evaluated systematically so far. Using simple multiplication problems, we evaluated how disconnections in parietal brain areas affected arithmetic fact retrieval following stroke. We derived disconnectivity measures by jointly considering data from n = 73 patients with acute unilateral lesions in either hemisphere and a white-matter tractography atlas (HCP-842) using the Lesion Quantification Toolbox (LQT). Whole-brain voxel-based analysis indicated a left-hemispheric cluster of white matter fibers connecting the AG and superior temporal areas to be associated with a fact retrieval deficit. Subsequent analyses of direct gray-to-gray matter disconnections revealed that disconnections of additional left-hemispheric areas (e.g., between the superior temporal gyrus and parietal areas) were significantly associated with the observed fact retrieval deficit. Results imply that disconnections of parietal areas (i.e., the AG) with language-related areas (i.e., superior and middle temporal gyri) seem specifically detrimental to arithmetic fact retrieval. This suggests that arithmetic fact retrieval recruits a widespread left-hemispheric network and emphasizes the relevance of white matter connectivity for number processing.
Sowohl der stationäre Handel als auch die Online Pure Player befinden sich durch die zunehmende Digitalisierung und die Beeinflussung durch die dynamisch veränderten Trends in einem Wandel. Insbesondere wird von der Möbelbranche ein adaptives Verhalten an die vorliegenden Entwicklungen verlangt. Durch die Intensivierung der Markt- und Wettbewerbslandschaften und die Veränderungen des Verbraucherverhaltens bezüglich der verlangten Verschmelzung der Einkaufskanäle wird ein Umdenken gefordert und notwendig. Zusätzlich wird diese Notwendigkeit durch aktuelle Gegebenheiten, wie die Covid-19-Pandemie dringlicher. Die Omnichannel-Strategie und deren Etablierung birgt für die Möbelbranche insbesondere hinsichtlich der logistischen Herausforderungen Gelegenheiten und Bedrohungen. Diese sind zu erkennen, zu nutzen und zu beheben.
Die vorliegende Ausarbeitung beschäftigt sich mit der Frage, ob weibliche Führungskräfte aufgrund spezieller Führungskompetenzen auf den langfristigen Unternehmenserfolg einzahlen. Besondere Beachtung findet hierbei der Faktor der Emotionalen Intelligenz. Nach wie vor ist der Anteil weiblicher Führungskräfte auf deutschen Managementebenen auffallend gering. Um ein Verständnis für die Hintergründe dieser Thematik zu entwickeln, werden zunächst die Ursachen geschlechtsbedingter Differenzierungen erläutert. Die wesentlichen Erkenntnisse entstammen dem Bereich der Geschlechterforschung. Im Anschluss werden diese im Kontext der Führung beleuchtet. Ein besonderes Augenmerk liegt auf der Frage, ob und inwiefern sich ein potentieller weiblicher Führungsstil von der als männlich geltenden Führung unterscheidet. Im weiteren Verlauf des Artikels wird das Phänomen der Emotionalen Intelligenz im Detail betrachtet. Dieses gilt im Kontext der Führung seit geraumer Zeit als Erfolgsfaktor. Ob und inwiefern diese Annahme tatsächlich Bestand hat, soll daher zunächst herausgestellt werden. Abschließend wird geprüft, ob es sich bei der Emotionalen Intelligenz um eine vorwiegend weibliche Kompetenz handelt
In 2019 at IBM, it was found that there is a strong dependence on a few large banks in bank sales, and the growth targets of the sales division cannot be achieved due to the existing business with these same customers. To counteract this dependency, an NCA-specific sales team for the banking industry was established to support small and medium-sized banks with personal commitment and expertise and to develop them into long-term business partners of IBM. This research focuses on the development of a performance measurement system for NCA-Sales teams. It postulates the hypothesis that more effective and better-suited performance measurement systems can be developed for NCA-Sales of information technology towards financial institutions. Authors use the methodology of expert interviews and Mayrings qualitative content analysis to gain insights into the relevant factors that need to be considered when evaluating the performance of such sales teams. The paper identifies stakeholders, challenges, and goals that should be integrated into a performance measurement system as well as KPIs to measure them. The results are being consolidated into a conceptual sketch for an NCA-sales optimized PMS. The paper distinguishes itself from other research through an approach that gives detailed guidance for the practical implementation of its findings. The research was conducted with professionals in the IT sector; however, all of them were working for the same company, and the data was collected in the short span of one week as it was part of a research. The outcome can be used for further studies on how to effectively measure performance in NCA-Sales teams.
Laboratory protocols using magnetic beads have gained importance in the purification of mRNA for vaccines. Here, the produced mRNA hybridizes specifically to oligo(dT)-functionalized magnetic beads after cell lysis. The mRNA-loaded magnetic beads can be selectively separated using a magnet. Subsequently, impurities are removed by washing steps and the mRNA is eluted. Magnetic separation is utilized in each step, using different buffers such as the lysis/binding buffer. To reduce the time required for purification of larger amounts of mRNA vaccine for clinical trials, high-gradient magnetic separation (HGMS) is suitable. Thereby, magnetic beads are selectively retained in a flow-through separation chamber. To meet the requirements of biopharmaceutical production, a disposable HGMS separation chamber with a certified material (United States Pharmacopeia Class VI) was developed which can be manufactured using 3D printing. Due to the special design, the filter matrix itself is not in contact with the product. The separation chamber was tested with suspensions of oligo(dT)-functionalized Dynabeads MyOne loaded with synthetic mRNA. At a concentration of cB = 1.6–2.1 g·L–1 in lysis/binding buffer, these 1 μm magnetic particles are retained to more than 99.39% at volumetric flows of up to 150 mL·min–1 with the developed SU-HGMS separation chamber. When using the separation chamber with volumetric flow rates below 50 mL·min–1, the retained particle mass is even more than 99.99%.
The aim of this work was to develop and evaluate the reinforcement learning algorithm VentAI, which is able to suggest a dynamically optimized mechanical ventilation regime for critically-ill patients. We built, validated and tested its performance on 11,943 events of volume-controlled mechanical ventilation derived from 61,532 distinct ICU admissions and tested it on an independent, secondary dataset (200,859 ICU stays; 25,086 mechanical ventilation events). A patient “data fingerprint” of 44 features was extracted as multidimensional time series in 4-hour time steps. We used a Markov decision process, including a reward system and a Q-learning approach, to find the optimized settings for positive end-expiratory pressure (PEEP), fraction of inspired oxygen (FiO2) and ideal body weight-adjusted tidal volume (Vt). The observed outcome was in-hospital or 90-day mortality. VentAI reached a significantly increased estimated performance return of 83.3 (primary dataset) and 84.1 (secondary dataset) compared to physicians’ standard clinical care (51.1). The number of recommended action changes per mechanically ventilated patient constantly exceeded those of the clinicians. VentAI chose 202.9% more frequently ventilation regimes with lower Vt (5–7.5 mL/kg), but 50.8% less for regimes with higher Vt (7.5–10 mL/kg). VentAI recommended 29.3% more frequently PEEP levels of 5–7 cm H2O and 53.6% more frequently PEEP levels of 7–9 cmH2O. VentAI avoided high (>55%) FiO2 values (59.8% decrease), while preferring the range of 50–55% (140.3% increase). In conclusion, VentAI provides reproducible high performance by dynamically choosing an optimized, individualized ventilation strategy and thus might be of benefit for critically ill patients.
Many SMEs still face a problematic fact that their corporate structures and processes are not designed for efficient development and market positioning and there is a lack of appropriate methods and tools. SMEs are often inefficiently targeted to the internal or external demands for services. The goal of the research regarding contents and methodology was to investigate the practice of strategic planning and the implementation and application of service engineering in young SMEs on the one hand, and on the other hand specifically for young SMEs, whose performance and the probability of success can be increased by its application. These two goals have been achieved.
Background: Stratified care approach involving use of the STarT-Back tool to optimise care for patients with low back pain is gaining widespread attention in western countries. However, adoption and implementation of this approach in low-and-middle-income countries will be restricted by context-specific factors that need to be addressed. This study aimed to develop with physiotherapists, tailored intervention strategies for the implementation of stratified care for patients with low back pain.
Methods: A two-round web-based Delphi survey was conducted among purposively sampled physiotherapists with a minimum of three years of clinical experience, with post-graduation certification or specialists. Thirty statements on barriers and enablers for implementation were extracted from the qualitative phase. Statements were rated by a Delphi panel with additional open-ended feedback. After each Delphi round, participants received feedback which informed their subsequent responses. Additional qualitative feedback were analysed using qualitative content analysis. The criteria for consensus and stability were pre-determined using percentage agreement (≥ 75%), median value (≥ 4), Inter-quartile range (≤ 1), and Wilcoxon matched-pairs test respectively.
Results: Participants in the first round were 139 and 125 of them completed the study, yielding a response rate of 90%. Participants were aged 35.2 (SD6.6) years, and 55 (39.6%) were female. Consensus was achieved in 25/30 statements. Wilcoxon’s test showed stability in responses after the 5 statements failed to reach consensus: ‘translate the STarT-Back Tool to pidgin language’ 71% (p = 0.76), ‘begin implementation with government hospitals’ 63% (p = 0.11), ‘share knowledge with traditional bone setters’ 35% (p = 0.67), ‘get second opinion on clinician’s advice’ 63% (p = 0.24) and ‘carry out online consultations’ 65% (p = 0.41). Four statements strengthened by additional qualitative data achieved the highest consensus: ‘patient education’ (96%), ‘quality improvement appraisals’ (96%), ‘undergraduate training on psychosocial care’ (96%) and ‘patient-clinician communication’ (95%).
Conclusion: There was concordance of opinion that patients should be educated to correct misplaced expectations and proper time for communication is vital to implementation. This communication should be learned at undergraduate level, and for already qualified clinicians, quality improvement appraisals are key to sustained and effective care. These recommendations provide a framework for future research on monitored implementation of stratified care in middle-income countries.