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  • 1
    Online Resource
    Online Resource
    Proposal of a New Rating Concept for Digital Health Applications in Orthopedics and Traumatology
    MDPI AG ; 2022
    In:  International Journal of Environmental Research and Public Health Vol. 19, No. 22 ( 2022-11-13), p. 14952-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 19, No. 22 ( 2022-11-13), p. 14952-
    Abstract: Background: Health-related mobile applications (apps) are rapidly increasing in number. There is an urgent need for assessment tools and algorithms that allow the usability and content criteria of these applications to be objectively assessed. The aim of this work was to establish and validate a concept for orthopedic societies to rate health apps to set a quality standard for their safe use. Methods: An objective rating concept was created, consisting of nine quality criteria. A self-declaration sheet for app manufacturers was designed. Manufacturers completed the self-declaration, and the app was examined by independent internal reviewers. The pilot validation and analysis were performed on two independent health applications. An algorithm for orthopedic societies was created based on the experiences in this study flow. Results: “Sprunggelenks-App“ was approved by the reviewers with 45 (98%) fulfilled criteria and one (2%) unfulfilled criterion. “Therapie-App” was approved, with 28 (61%) met criteria, 6 (13%) unfulfilled criteria and 12 (26%) criteria that could not be assessed. The self-declaration completed by the app manufacturer is recommended, followed by a legal and technical rating performed by an external institution. When rated positive, the societies’ internal review using independent raters can be performed. In case of a positive rating, a visual certification can be granted to the manufacturer for a certain time frame. Conclusion: An objective rating algorithm is proposed for the assessment of digital health applications. This can help societies to improve the quality assessment, quality assurance and patient safety of those apps. The proposed concept must be further validated for inter-rater consistency and reliability.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph192214952
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2175195-X
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  • 2
    Online Resource
    Online Resource
    Mosquito-Textile Physics: A Mathematical Roadmap to Insecticide-Free, Bite-Proof Clothing for Everyday Life
    MDPI AG ; 2021
    In:  Insects Vol. 12, No. 7 ( 2021-07-13), p. 636-
    Details
    In: Insects, MDPI AG, Vol. 12, No. 7 ( 2021-07-13), p. 636-
    Abstract: Garments treated with chemical insecticides are commonly used to prevent mosquito bites. Resistance to insecticides, however, is threatening the efficacy of this technology, and people are increasingly concerned about the potential health impacts of wearing insecticide-treated clothing. Here, we report a mathematical model for fabric barriers that resist bites from Aedes aegypti mosquitoes based on textile physical structure and no insecticides. The model was derived from mosquito morphometrics and analysis of mosquito biting behavior. Woven filter fabrics, precision polypropylene plates, and knitted fabrics were used for model validation. Then, based on the model predictions, prototype knitted textiles and garments were developed that prevented mosquito biting, and comfort testing showed the garments to possess superior thermophysiological properties. Our fabrics provided a three-times greater bite resistance than the insecticide-treated cloth. Our predictive model can be used to develop additional textiles in the future for garments that are highly bite resistant to mosquitoes.
    Type of Medium: Online Resource
    ISSN: 2075-4450
    URL: Article
    DOI: 10.3390/insects12070636
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662247-6
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  • 3
    Online Resource
    Online Resource
    Compensation or Displacement of Physical Activity in Children and Adolescents: A Systematic Review of Empirical Studies
    MDPI AG ; 2022
    In:  Children Vol. 9, No. 3 ( 2022-03-03), p. 351-
    Details
    In: Children, MDPI AG, Vol. 9, No. 3 ( 2022-03-03), p. 351-
    Abstract: Regular physical activity during childhood and adolescence is associated with health benefits. Consequently, numerous health promotion programs for children and adolescents emphasize the enhancement of physical activity. However, the ActivityStat hypothesis states that increases in physical activity in one domain are compensated for by decreasing physical activity in another domain. Currently, little is known about how physical activity varies in children and adolescents within intervals of one day or multiple days. This systematic review provides an overview of studies that analyzed changes in (overall) physical activity, which were assessed with objective measurements, or compensatory mechanisms caused by increases or decreases in physical activity in a specific domain in children and adolescents. A systematic search of electronic databases (PubMed, Scopus, Web of Science, SportDiscus) was performed with a priori defined inclusion criteria. Two independent researchers screened the literature and identified and rated the methodological quality of the studies. A total of 77 peer-reviewed articles were included that analyzed changes in overall physical activity with multiple methodological approaches resulting in compensation or displacement. Of 40,829 participants, 16,265 indicated compensation associated with physical activity. Subgroup analyses separated by study design, participants, measurement instrument, physical activity context, and intervention duration also showed mixed results toward an indication of compensation. Quality assessment of the included studies revealed that they were of high quality (mean = 0.866). This review provides inconclusive results about compensation in relation to physical activity. A trend toward increased compensation in interventional studies and in interventions of longer duration have been observed.
    Type of Medium: Online Resource
    ISSN: 2227-9067
    URL: Article
    DOI: 10.3390/children9030351
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2732685-8
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  • 4
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    Online Resource
    Real-World Evidence: How Long Do Our Patients Fast?—Results from a Prospective JAGO-NOGGO-Multicenter Analysis on Perioperative Fasting in 924 Patients with Malignant and Benign Gynecological Diseases
    MDPI AG ; 2023
    In:  Cancers Vol. 15, No. 4 ( 2023-02-18), p. 1311-
    Details
    In: Cancers, MDPI AG, Vol. 15, No. 4 ( 2023-02-18), p. 1311-
    Abstract: Background: Despite the key role of optimized fasting in modern perioperative patient management, little current data exist on perioperative fasting intervals in routine clinical practice. Methods: In this multicenter prospective study, the length of pre- and postoperative fasting intervals was assessed with the use of a specifically developed questionnaire. Between 15 January 2021 and 31 May 2022, 924 gynecology patients were included, from 13 German gynecology departments. Results: On average, patients remained fasting for about three times as long as recommended for solid foods (17:02 ± 06:54 h) and about five times as long as recommended for clear fluids (9:21 ± 5:48 h). The average perioperative fasting interval exceeded one day (28:23 ± 14:02 h). Longer fasting intervals were observed before and after oncological or extensive procedures, while shorter preoperative fasting intervals were reported in the participating university hospitals. Smoking, treatment in a non-university hospital, an increased Charlson Comorbidity Index and extensive surgery were significant predictors of longer preoperative fasting from solid foods. In general, prolonged preoperative fasting was tolerated well and quality of patient information was perceived as good. Conclusion: Perioperative fasting intervals were drastically prolonged in this cohort of 924 gynecology patients. Our data indicate the need for better patient education about perioperative fasting.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    URL: Article
    DOI: 10.3390/cancers15041311
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2527080-1
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  • 5
    Online Resource
    Online Resource
    Comparison of Virtual Intersection and Occlusal Contacts between Intraoral and Laboratory Scans: An In-Vivo Study
    MDPI AG ; 2023
    In:  Journal of Clinical Medicine Vol. 12, No. 3 ( 2023-01-28), p. 996-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 12, No. 3 ( 2023-01-28), p. 996-
    Abstract: Background. The inaccurate maxillomandibular relationship of virtual casts following alignment by the vestibular scan may result in intersection (intermesh penetration) between opposing dental arch surfaces. Intersection occurs at short interocclusal distances in the occlusal contact area (OCA) and may result in infra-occluded definitive restorations. The purpose of this clinical study was to compare initial (by the proprietary scanner software) and new alignments (by a standalone 3D software) of virtual casts regarding OCA and intersection failure. New alignments aimed to rectify intersections by refinement of occlusal contacts. Material and Methods. The virtual casts of 30 patients following digital and conventional impression-taking were analyzed, which were acquired for single implant restoration in the posterior site. Digital impressions were performed by both IOS 1 (3M True Definition) and IOS 2 (TRIOS 3), either as complete- or partial-arch scans, respectively. Mounted gypsum casts were digitized as complete-arch by a laboratory scanner (LS) in enabled and disabled mode to avoid intersection [LS (+)/LS (−)]. All virtual casts were newly aligned by a 3D software. The difference of the OCA and the area of intersection were calculated for initial and new alignments, using interocclusal distance ranges of 0–100 μm, 0–10 μm or 〈 0 μm (=intersection). The difference of the OCA was compared using a linear mixed model. The distribution of occlusal contact points per modality and alignment was assessed independently by three observers and estimated by inter- and intraclass correlation (ICC) coefficients. Results. Virtual casts following initial alignment demonstrated intersections irrespective of the modality. The mean area of the intersection was most for IOS 2 (79.23 mm2), followed by IOS 1 (48.28 mm2), LS (−) (2.77 mm2), and LS (+) (2.01 mm2) in partial-arch scans. Complete-arch scans demonstrated an area of intersection of 70.63 mm2 for IOS 1 followed by 65.52 mm2 (IOS 2), 6.13 mm2 [LS (−)] and 2.76 mm2 [LS (+)] . Newly aligned scans showed no intersections. The overall distribution of occlusal contact points demonstrated moderate reliability (ICC 0.63). Good reliability could be observed (ICC 0.9) for LS (−) scans. Conclusions. Intersections in the area of occlusal contact points are a phenomenon restricted to virtual casts, which should be considered in CAD/CAM. Initial alignments of LS are less affected by this virtual phenomenon, and contact points may be more distinct according to their anatomic region compared to IOS. Furthermore, intersections can be rectified in a 3D software by adjustment of the maxillomandibular relationship.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm12030996
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662592-1
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  • 6
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    Online Resource
    Retrospective Evaluation of Implants Placed in Iliac Crest Autografts and Pristine Bone
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 5 ( 2022-03-02), p. 1367-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 5 ( 2022-03-02), p. 1367-
    Abstract: Objective: Iliac crest autografts can compensate for severe mandibular atrophy before implant placement. However, the implant success in the augmented bone is not entirely predictable. Here we performed a retrospective cohort study to determine the success and related parameters of implants placed in augmented bone and pristine bone for up to 11 years. Material and Methods: We analyzed 18 patients where 72 implants were placed six months after iliac crest transplantation and 19 patients where 76 implants were placed in pristine bone. The primary endpoint was implant loss. Secondary endpoints were the implant success, peri-implant bone loss, and the clinical parameters related to peri-implantitis. Moreover, we evaluated the oral-health-related quality of life (OHIP). Results: Within a mean follow-up of 5.8 ± 2.2 and 7.6 ± 2.8 years, six but no implants were lost when placed in augmented and pristine bone, respectively. Among those implants remaining in situ, 58% and 68% were rated as implant success (p = 0.09). A total of 11% and 16% of the implants placed in the augmented and the pristine bone were identified as peri-implantitis (p = 0.08). Bone loss was similar in both groups, with a mean of 2.95 ± 1.72 mm and 2.44 ± 0.76 mm. The mean OHIP scores were 16.36 ± 13.76 and 8.78 ± 7.21 in the augmentation and the control group, respectively (p = 0.35). Conclusions: Implants placed in iliac crest autografts have a higher risk for implant loss and lower implant success rates compared to those placed in the pristine bone.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11051367
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 7
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    Online Resource
    Bone Graft Packing and Its Association with Bone Regeneration in Maxillary Sinus Floor Augmentations: Histomorphometric Analysis of Human Biopsies
    MDPI AG ; 2022
    In:  Biology Vol. 11, No. 10 ( 2022-09-30), p. 1431-
    Details
    In: Biology, MDPI AG, Vol. 11, No. 10 ( 2022-09-30), p. 1431-
    Abstract: Research in maxillary sinus floor augmentation (MSFA) focussed on the optimisation of microstructural parameters such as microporosity and particle size of bone substitute particles (BS). However, little is known about the impact of BS packing and the corresponding (void) interparticular space on bone regeneration. The aim of this study was to characterise the spatial distribution of BS and its association with BS integration 6 ± 1 months after MSFA. Histological thin-ground sections of 70 human sinus biopsies were histomorphometrically analysed: In serial zones of 100 µm proceeding from the sinus floor (SF) up to the apical end of the biopsy, we measured the distribution of BS particles within these zones in terms of volume (BSV/TV), number and size of BS particles, interparticle spacing (BS.Sp) and bone-to-BS contact. BS particles were not homogeneously distributed over the length of biopsies: The first 200 µm directly adjacent to the SF represented a zone poor in BS particles but with high osteogenic potential. Graft packing density increased from the SF towards the apical part of the AA. Integration of BS particles was inversely associated with the distance to the SF and the graft packing density. A high packing density through excessive compaction of BS particles should be avoided to optimise the macrostructural environment for bone regeneration.
    Type of Medium: Online Resource
    ISSN: 2079-7737
    URL: Article
    DOI: 10.3390/biology11101431
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2661517-4
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  • 8
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    Online Resource
    Differences and Similarities in the Pattern of Early Metabolic and Morphologic Response after Induction Chemo-Immunotherapy versus Induction Chemotherapy Alone in Locally Advanced Squamous Cell Head and Neck Cancer
    MDPI AG ; 2022
    In:  Cancers Vol. 14, No. 19 ( 2022-09-30), p. 4811-
    Details
    In: Cancers, MDPI AG, Vol. 14, No. 19 ( 2022-09-30), p. 4811-
    Abstract: Background: In head and neck cancer patients, parameters of metabolic and morphologic response of the tumor to single-cycle induction chemotherapy (IC) with docetaxel, cis- or carboplatin are used to decide the further course of treatment. This study investigated the effect of adding a double immune checkpoint blockade (DICB) of tremelimumab and durvalumab to IC on imaging parameters and their significance with regard to tumor cell remission. Methods: Response variables of 53 patients treated with IC+DICB (ICIT) were compared with those of 104 who received IC alone. Three weeks after one cycle, pathologic and, in some cases, clinical and endoscopic primary tumor responses were evaluated and correlated with a change in 18F-FDG PET and CT/MRI-based maximum-standardized uptake values (SUVmax) before (SUVmaxpre), after treatment (SUVmaxpost) and residually (resSUVmax in % of SUVmaxpre), and in maximum tumor diameter (Dmax) before (Dmaxpre) and after treatment (Dmaxpost) and residually (resD). Results: Reduction of SUVmax and Dmax occurred in both groups; values were SUVmaxpre: 14.4, SUVmaxpost: 6.6, Dmaxpre: 30 mm and Dmaxpost: 23 mm for ICIT versus SUVmaxpre: 16.5, SUVmaxpost: 6.4, Dmaxpre: 21 mm, and Dmaxpost: 16 mm for IC alone (all p 〈 0.05). ResSUVmax was the best predictor of complete response (IC: AUC: 0.77; ICIT: AUC: 0.76). Metabolic responders with resSUVmax ≤ 40% tended to have a higher rate of CR to ICIT (88%; n = 15/17) than to IC (65%; n = 30/46; p = 0.11). Of the metabolic nonresponders (resSUVmax 〉 80%), 33% (n = 5/15) achieved a clinical CR to ICIT versus 6% (n = 1/15) to IC (p = 0.01). Conclusions: ICIT and IC quickly induce a response and 18F-FDG PET is the more accurate modality for identifying complete remission. The rate of discrepant response, i.e., pCR with metabolic nonresponse after ICIT was 〉 30%.
    Type of Medium: Online Resource
    ISSN: 2072-6694
    URL: Article
    DOI: 10.3390/cancers14194811
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2527080-1
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  • 9
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    Online Resource
    Single Femtosecond Laser-Pulse-Induced Superficial Amorphization and Re-Crystallization of Silicon
    MDPI AG ; 2021
    In:  Materials Vol. 14, No. 7 ( 2021-03-27), p. 1651-
    Details
    In: Materials, MDPI AG, Vol. 14, No. 7 ( 2021-03-27), p. 1651-
    Abstract: Superficial amorphization and re-crystallization of silicon in 〈 111 〉 and 〈 100 〉 orientation after irradiation by femtosecond laser pulses (790 nm, 30 fs) are studied using optical imaging and transmission electron microscopy. Spectroscopic imaging ellipsometry (SIE) allows fast data acquisition at multiple wavelengths and provides experimental data for calculating nanometric amorphous layer thickness profiles with micrometric lateral resolution based on a thin-film layer model. For a radially Gaussian laser beam and at moderate peak fluences above the melting and below the ablation thresholds, laterally parabolic amorphous layer profiles with maximum thicknesses of several tens of nanometers were quantitatively attained. The accuracy of the calculations is verified experimentally by high-resolution transmission electron microscopy (HRTEM) and energy dispersive X-ray spectroscopy (STEM-EDX). Along with topographic information obtained by atomic force microscopy (AFM), a comprehensive picture of the superficial re-solidification of silicon after local melting by femtosecond laser pulses is drawn.
    Type of Medium: Online Resource
    ISSN: 1996-1944
    URL: Article
    DOI: 10.3390/ma14071651
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2487261-1
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  • 10
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    Online Resource
    Investigating the Influence of Process Parameters on the Mechanical Properties of Extruded Aluminum Tubes by Cyclic Indentation Tests
    MDPI AG ; 2021
    In:  Metals Vol. 11, No. 5 ( 2021-04-30), p. 744-
    Details
    In: Metals, MDPI AG, Vol. 11, No. 5 ( 2021-04-30), p. 744-
    Abstract: Given the complex process condition, extruded aluminum (Al) alloy tubes show locally pronounced differences in microstructure and mechanical properties, which can be influenced by subsequent heat treatment. In the present study, cyclic indentation tests (CITs) were conducted on extruded Al alloy EN AW-6082 to locally determine hardness and cyclic hardening potential, which was complemented with light optical microscopy. To analyze the influence of extrusion process and subsequent heat treatment, the EN AW-6082 tubes investigated were manufactured with extrusion ratios Ψ of 13:1 and 22:1, both in as-extruded and T6 heat-treated conditions. The results obtained for the as-extruded state showed significant differences of the local mechanical properties and demonstrated that an increased Ψ leads to higher hardness, caused by more pronounced plastic deformation during the manufacturing process. Moreover, an increase of hardness and cyclic hardening potential was observed after a T6 heat treatment, which also reduced the difference in hardness between the different extrusion ratios. Additionally, the pronounced local differences in hardness and cyclic hardening potential correlated with the local microstructure. The results demonstrated that CITs enable the analysis of local mechanical properties of extruded EN AW-6082 profiles, resulting from different extrusions ratios as well as subsequent heat treatment.
    Type of Medium: Online Resource
    ISSN: 2075-4701
    URL: Article
    DOI: 10.3390/met11050744
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2662252-X
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