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Institute
Hintergrund
Die Anämie hat eine hohe Prävalenz bei Patienten vor Hüftgelenkrevisionsoperation und ist mit einer erhöhten Komplikationsrate assoziiert. Die vorliegende Arbeit untersucht erstmals den Zusammenhang von Kosten, realen DRG-Erlösen und Falldeckung der präoperativen Anämie bei elektiven Hüftgelenkrevisionsoperationen.
Methoden
Für alle Patienten, die sich von 2010 bis 2017 an 2 Campi der Charité – Universitätsmedizin Berlin einer Hüftgelenkrevisionsoperation unterzogen, wurden Daten zu Patienten sowie Transfusionen, Kosten und Erlösen gesammelt. Subgruppen- und lineare Regressionsanalysen untersuchten die Falldeckung anämischer und nichtanämischer Patienten.
Ergebnisse
Von 1187 eingeschlossenen Patienten waren 354 (29,8 %) präoperativ anämisch. Insgesamt wurden 565 (47,6 %) Patienten, mit einem deutlichen Überwiegen anämischer Patienten (72,6 % vs. 37,0 %, p < 0,001), transfundiert. Kosten (12.318 € [9027;20.044 €] vs. 8948 € [7501;11.339 €], p < 0,001) und Erlöse (11.788 € [8992;16.298 €] vs. 9611 € [8332;10.719 €], p < 0,001) waren für anämische Patienten höher, die Fallkostendeckung defizitär (−1170 € [−4467;1238 €] vs. 591 € [−1441;2103 €] €, p < 0,001). Bei anämischen Patienten nahm die Falldeckung mit zunehmender Transfusionsrate ab (p ≤ 0,001). Komorbiditäten hatten keinen signifikanten ökonomischen Einfluss.
Schlussfolgerung
Die präoperative Anämie und perioperative Transfusionen bei Hüftgelenkrevisionsoperationen sind mit erhöhten Behandlungskosten und einer finanziellen Unterdeckung für Kostenträger im Gesundheitswesen verbunden. Konzepte zur Behandlung der präoperativen Anämie (z. B. Patient Blood Management) könnten mittelfristig Behandlungskosten senken.
The influence of moderate electric fields (MEF) on thermally induced gelation and network structures of patatin enriched potato protein (PPI) was investigated. PPI solutions with 9 wt% protein (pH 7) and 25 mM NaCl were heated from 25 to 65 °C via OH (3–24 V/cm) or conventional heating (COV) at various come-up (240 s and 1200 s) and holding times (30 s and 600 s). Self-standing gels were produced but less proteins denatured when heated via OH. Further, SDS-PAGE and GPC measurements revealed more native patatin remaining after OH treatment. Scanning electron microscopy showed OH gels to have more gap-like structures and frayed areas than COV treated gels which resulted in lower water holding capacity. On molecular scale, less hydrophobic interactions were measured within the protein network and FTIR trials showed the MEF to affect beta-sheet structures. OH gels further showed lower rigidity and higher flexibility, thus, gelling functionality was affected via OH.
The kiwifruit processing industry is focused on product yield maximization and keeping energy costs and waste effluents to a minimum while maintaining high product quality. In our study, pulsed electric field (PEF) pretreatment enhanced kiwifruit processing to facilitate peelability and specific peeling process and enhanced valorization of kiwifruit waste. PEF optimization was applied to obtain the best treatment parameters. A 32 factorial design of response surface methodology was applied to find the effect of time elapsed after PEF treatment and the PEF-specific energy input on specific peeling force and kiwifruit firmness as response criteria. Under the optimized condition, the specific peeling force decreased by 100, and peelability increased by 2 times. The phenolic content and antioxidant capacity of PEF-treated kiwifruit bagasse were 5.1% and 260% richer than the control sample. Overall, the optimized PEF pretreatments incorporated into kiwifruit processing led to decreased energy demand and increased productivity.
In Deutschland werden jährlich ca. 11 Mio. Tonnen Lebensmittel entlang der Wertschöpfungskette entsorgt.
Die Tafeln verteilen ca. 265 000 Tonnen dieser Lebensmittel
und spielen eine bedeutende Rolle in der Reduzierung von
vermeidbaren Lebensmittelabfällen. Ein Teilziel des Projekts LeMiFair ist es, Einblicke in die Arbeit und die Herausforderungen der Tafeln in Niedersachsen zu gewinnen.
Novel foods by process are a special case in the catalogue of the ten novel food categories according to Article 3 (2) point (a) of the Novel Food Regulation (EU) 2015/2283, since the other nine categories derive their assessment as possible novel foods from their purely substantial properties. In the case of novel foods by process, the problem of dealing with the reference date of 15 May 1997, which is in the end a random reference date, is particularly significant. It would make more sense to have a dynamic reference date that ‘moves along the timeline’ or at least is reset from time to time and is more up-to-date. The characteristic that a process causes ‘significant changes in the composition or structure of the food, affecting its nutritional value, metabolism or level of undesirable substances’ must be understood in such a way that it is only a question of the generation of undesirable substances through the application of the process, but not their reduction, e.g. the reduction of undesirable microorganisms. Finally, the question also arises as to how the assessment of the process technology relates to the assessment of a food in the context of a novel food by composition category. This concerns the exemption for foods that have a history of use as safe foods, which, according to the view taken here, must also be interpreted into the category of novel foods by process.
Plant-based proteins are rapidly emerging, while novel technologies are explored to offer more efficient extraction processes. The current study aimed to evaluate the effects of pulsed electric fields (PEFs) and temperature on the extraction of soluble proteins from nettle leaves (Urtica dioica L.) and identify an optimal operational range for the highest yield of soluble proteins. Extractions and kinetic modeling were conducted with whole and ground dried leaves at different temperatures (30–70 °C) and specific energy of PEF (0–30 kJ kg−1) with extraction times of up to 60 min. The influence of temperature and specific energy on the soluble protein extraction yields was investigated and modeled using composite central design and response surface methodology. The experimental results were fitted to Peleg's kinetic model, which satisfactorily described the extraction process (R2 > 0.902), and PEF treated samples resulted in a higher soluble protein yield and shortened processing time. Response surface methodology showed that the linear effect of temperature and quadratic effect of PEF (p < 0.01) were highly significant for protein yield. In the optimized PEF-extraction region (specific energy between 10 and 24 kJ kg−1, and 70–78 °C), soluble protein yield was higher than 60% after 5 minutes of extraction. The achieved results are relevant for developing processes for PEF assisted extraction of soluble proteins from leaves. Understanding the effects of PEFs and process parameters is crucial to obtain high protein yields, while requiring low energy and short processing time.
Ohmic heating (OH) is an alternative sustainable heating technology that has demonstrated its potential to modify protein structures and aggregates. Furthermore, certain protein aggregates, namely amyloid fibrils (AF), are associated with an enhanced protein functionality, such as gelation. This study evaluates how Ohmic heating (OH) influences the formation of AF structures from ovalbumin source under two electric field strength levels, 8.5 to 10.5 and 24.0–31.0 V/cm, respectively. Hence, AF aggregate formation was assessed over holding times ranging from 30 to 1200 sunder various environmental conditions (3.45 and 67.95 mM NaCl, 80, 85 and 90 °C, pH = 7). AF were formed under all conditions. SDS-PAGE revealed that OH had a higher tendency to preserve native ovalbumin molecules. Furthermore, Congo Red and Thioflavin T stainings indicated that OH reduces the amount of AF structures. This finding was supported by FTIR measurements, which showed OH samples to contain lower amounts of beta-sheets. Field flow fractioning revealed smaller-sized aggregates or aggregate clusters occurred after OH treatment. In contrast, prolonged holding time or higher treatment temperatures increased ThT fluorescence, beta-sheet structures and aggregate as well as cluster sizes. Ionic strength was found to dominate the effects of electric field strength under different environmental conditions.
Olive oil holds significant importance in the European diet and is renowned globally for its sensory attributes and health benefits. The effectiveness of producing olive oil is greatly influenced by factors like the maturity and type of olives used, as well as the milling techniques employed. Generally, mechanical methods can extract approximately 80% of the oil contained in the olives. The rest 20% of the oil remains in the olive waste generated at the end of the process. Additionally, significant amounts of bioactive compounds like polyphenols are also lost in the olive pomace. Traditionally, heat treatment, enzymes, and other chemicals are used for the enhancement of oil extraction; however, this approach may impact the quality of olive oil. Therefore, new technology, such as pulsed electric field (PEF), is of great benefit for nonthermal yield and quality improvements.
Easy and inexpensive methods for measuring ammonia emissions in multi-plot field trials allow the comparison of several treatments with liquid manure application. One approach that might be suitable under these conditions is the dynamic tube method (DTM). Applying the DTM, a mobile chamber system is placed on the soil surface, and the air volume within is exchanged at a constant rate for approx. 90 s. with an automated pump. This procedure is assumed to achieve an equilibrium ammonia concentration within the system. Subsequently, a measurement is performed using an ammonia-sensitive detector tube. Ammonia fluxes are calculated based on an empirical model that also takes into account the background ammonia concentration measured on unfertilized control plots. Between measurements on different plots, the chamber system is flushed with ambient air and cleaned with paper towels to minimize contamination with ammonia. The aim of this study was to determine important prerequisites and boundary conditions for the application of the DTM.
We conducted a laboratory experiment to test if the ammonia concentration remains stable while performing a measurement. Furthermore, we investigated the cleaning procedure and the effect of potential ammonia carryover on cumulated emissions under field conditions following liquid manure application. The laboratory experiment indicated that the premeasurement phase to ensure a constant ammonia concentration is not sufficient. The concentration only stabilized after performing more than 100 pump strokes, with 20 pump strokes (lasting approximately 90 s) being the recommendation.
However, the duration of performing a measurement can vary substantially, and linear conversion accounts for those differences, so a stable concentration is mandatory. Further experiments showed that the cleaning procedure is not sufficient under field conditions. Thirty minutes after performing measurements on high emitting plots, which resulted in an ammonia concentration of approx.
10 ppm in the chamber, we detected a residual concentration of 2 ppm. This contamination may affect measurements on plots with liquid manure application as well as on untreated control plots. In a field experiment with trailing hose application of liquid manure, we subsequently demonstrated that the calculation of cumulative ammonia emissions can vary by a factor of three, depending on the degree of chamber system contamination when measuring control plots. When the ammoni background values were determined by an uncontaminated chamber system that was used to measure only control plots, cumulative ammonia emissions were approximately 9 kg NH3-N ha1.
However, when ammonia background values were determined using the contaminated chamber system that was also used to measure on plots with liquid manure application, the calculation of cumulative ammonia losses indicated approximately 3 kg NH3-N ha1. Based on these results, it can be concluded that a new empirical DTM calibration is needed for multi-plot field experiments with high-emitting treatments.
Hintergrund
Die Anämie hat eine hohe Prävalenz bei Patienten vor Hüftgelenkrevisionsoperation und ist mit einer erhöhten Komplikationsrate assoziiert. Die vorliegende Arbeit untersucht erstmals den Zusammenhang von Kosten, realen DRG-Erlösen und Falldeckung der präoperativen Anämie bei elektiven Hüftgelenkrevisionsoperationen.
Methoden
Für alle Patienten, die sich von 2010 bis 2017 an 2 Campi der Charité – Universitätsmedizin Berlin einer Hüftgelenkrevisionsoperation unterzogen, wurden Daten zu Patienten sowie Transfusionen, Kosten und Erlösen gesammelt. Subgruppen- und lineare Regressionsanalysen untersuchten die Falldeckung anämischer und nichtanämischer Patienten.
Ergebnisse
Von 1187 eingeschlossenen Patienten waren 354 (29,8 %) präoperativ anämisch. Insgesamt wurden 565 (47,6 %) Patienten, mit einem deutlichen Überwiegen anämischer Patienten (72,6 % vs. 37,0 %, p < 0,001), transfundiert. Kosten (12.318 € [9027;20.044 €] vs. 8948 € [7501;11.339 €], p < 0,001) und Erlöse (11.788 € [8992;16.298 €] vs. 9611 € [8332;10.719 €], p < 0,001) waren für anämische Patienten höher, die Fallkostendeckung defizitär (−1170 € [−4467;1238 €] vs. 591 € [−1441;2103 €] €, p < 0,001). Bei anämischen Patienten nahm die Falldeckung mit zunehmender Transfusionsrate ab (p ≤ 0,001). Komorbiditäten hatten keinen signifikanten ökonomischen Einfluss.
Schlussfolgerung
Die präoperative Anämie und perioperative Transfusionen bei Hüftgelenkrevisionsoperationen sind mit erhöhten Behandlungskosten und einer finanziellen Unterdeckung für Kostenträger im Gesundheitswesen verbunden. Konzepte zur Behandlung der präoperativen Anämie (z. B. Patient Blood Management) könnten mittelfristig Behandlungskosten senken.
Introduction Postoperative delirium (POD) is seen in approximately 15% of elderly patients and is related to poorer outcomes. In 2017, the Federal Joint Committee (Gemeinsamer Bundesausschuss) introduced a ‘quality contract’ (QC) as a new instrument to improve healthcare in Germany. One of the four areas for improvement of in-patient care is the ‘Prevention of POD in the care of elderly patients’ (QC-POD), as a means to reduce the risk of developing POD and its complications.
The Institute for Quality Assurance and Transparency in Health Care identified gaps in the in-patient care of elderly patients related to the prevention, screening and treatment of POD, as required by consensus-based and evidence-based delirium guidelines. This paper introduces the QC-POD protocol, which aims to implement these guidelines into the clinical routine. There is an urgent need for well-structured, standardised and interdisciplinary pathways that enable the reliable screening and treatment of POD. Along with effective preventive measures, these concepts have a considerable potential to improve the care of elderly patients.
Methods and analysis The QC-POD study is a non-randomised, pre–post, monocentric, prospective trial with an interventional concept following a baseline control period. The QC-POD trial was initiated on 1 April 2020 between Charité-Universitätsmedizin Berlin and the German health insurance company BARMER and will end on 30 June 2023. Inclusion criteria: patients 70 years of age or older that are scheduled for a surgical procedure requiring anaesthesia and insurance with the QC partner (BARMER). Exclusion criteria included patients with a language barrier, moribund patients and those unwilling or unable to provide informed consent. The QC-POD protocol provides perioperative intervention at least two times per day, with delirium screening and non-pharmacological preventive measures.
Ethics and dissemination This protocol was approved by the ethics committee of the Charité-Universitätsmedizin, Berlin, Germany (EA1/054/20). The results will be published in a peer-reviewed scientific journal and presented at national and international conferences.
A brief questionnaire for measuring alarm fatigue in nurses and physicians in intensive care units
(2023)
When exposed to hundreds of medical device alarms per day, intensive care unit (ICU) staff can develop “alarm fatigue” (i.e., desensitisation to alarms). However, no standardised way of quantifying alarm fatigue exists. We aimed to develop a brief questionnaire for measuring alarm fatigue in nurses and physicians. After developing a list of initial items based on a literature review, we conducted 15 cognitive interviews with the target group (13 nurses and two physicians) to ensure that the items are face valid and comprehensible. We then asked 32 experts on alarm fatigue to judge whether the items are suited for measuring alarm fatigue. The resulting 27 items were sent to nurses and physicians from 15 ICUs of a large German hospital. We used exploratory factor analysis to further reduce the number of items and to identify scales. A total of 585 submissions from 707 participants could be analysed (of which 14% were physicians and 64% were nurses). The simple structure of a two-factor model was achieved within three rounds. The final questionnaire (called Charité Alarm Fatigue Questionnaire; CAFQa) consists of nine items along two scales (i.e., the “alarm stress scale” and the “alarm coping scale”). The CAFQa is a brief questionnaire that allows clinical alarm researchers to quantify the alarm fatigue of nurses and physicians. It should not take more than five minutes to administer.
Die Digitalisierung des Bodenbeprobungsverfahrens mit einer automatisierten Generierung einer Düngeempfehlung auf Grundlage der analysierten Bodennährstoffgehalte – direkt nach Beendigung der Bodenbeprobung auf dem Acker – ist ein übergeordnetes Ziel bei der Nutzung des mobilen Feldlabors „soil2data“. Neben den Bodennährstoffanalyse-Ergebnissen sind für die Umsetzung einer automatisierten generierten Düngeempfehlung weitere Informationen notwendig.
Die Quellen dieser Informationen haben einen unterschiedlichen Ursprung. Es sind Daten aus verschiedenen Quellen vom Bewirtschafter, von Dienstleistern und vom mobilen Feldlabor, welche miteinander verknüpft und synchronisiert werden müssen. Für einen automatisierten Prozessablauf zur Generierung einer Düngeempfehlung ist die Datenorganisation eine essenzielle Voraussetzung. Die Grundlage der Empfehlung sind die Tabellenwerke der offiziellen Düngeempfehlung, die bei den für die Düngung zuständigen Behörden der Bundesländer vorliegen. In dieser Publikation werden die notwendigen Daten und der Prozessdatenfluss für die Bodenbeprobung und Düngeempfehlung-Generierung beschrieben und grafisch dargestellt.
Die funktionale Wiedervernetzung von Ökosystemen ist ein notwendiger und entscheidender Beitrag zur nachhaltigen Sicherung der Artenvielfalt. In der nationalen Strategie zur Biologischen Vielfalt 2007 ist formuliert, dass von Verkehrswegen bis 2020 in der Regel keine erheblichen Beeinträchtigungen des Biotopverbundsystems ausgehen (sollen). In der EU-Biodiversitätsstrategie 2030 ist formuliert, dass es für ein wirklich kohärentes und resilientes transeuropäisches Naturschutznetz wichtig sein wird, ökologische Korridore zu schaffen, um eine genetische Isolierung zu verhindern, die Migration von Arten zu ermöglichen und gesunde Ökosysteme zu erhalten und zu verbessern.
Knowledge of the maximum friction coefficient µmax between tire and road is necessary for implementing autonomous driving. As this coefficient cannot be measured via existing serial vehicle sensors, µmax estimation is a challenging field in modern automotive research. In particular, model-based approaches are applied, which are limited in the estimation accuracy by the physical vehicle model. Therefore, this paper presents a data-based µmax estimation using serial vehicle sensors. For this purpose, recurrent artificial neural networks are trained, validated, and tested based on driving maneuvers carried out with a test vehicle showing improved results compared to the model-based algorithm from previous works.
Dissertation zur Erlangung des Doktorgrades (Dr. rer. nat.)
Universität Osnabrück
Fachbereich Kultur- und Sozialwissenschaften
Institut für Geographie
in Kooperation mit der Hochschule Osnabrück
Fakultät Agrarwissenschaften und Landschaftsarchitektur
This textbook provides a comprehensive foundation of food physics by addressing the physical properties of food, food ingredients, and their measurements. Physical properties of food play a key role in all fields where modern technological processes are applied for the generation of food raw materials and the production of food. The determination of the physical properties of food and related products is a pre-requisite for product and process development, production engineering and automation in today’s food, pharmaceutical and cosmetics industries, as well as related quality control activities.
Following the success of its first edition published in 2007, the book has been updated to reflect recent industrial applications of novel physical food processing technologies. Each chapter begins with basic principles and progresses to a comprehensive coverage of the topic. The authors enriched this second edition with several didactic elements, including definition boxes, examples, and chapter-end summaries.
This textbook helps readers to build up their knowledge of the important aspects surrounding the physical properties of foods and food ingredients. It is also an essential resource for students of food science and technology to complement textbooks in food chemistry and food microbiology, as well as for food and chemical engineers, technologists, and technicians in the food industry.
Die planungsrechtliche Zulässigkeit von Betrieben der Urbanen Produktion unterscheidet sich je nach ihrem Störgrad deutlich zwischen den Baugebietstypen der Baunutzungsverordnung (BauNVO). Während Betriebe, die das Wohnen nicht wesentlichen stören, auch in gemischten Baugebieten zulässig sind, kommen für Betriebe mit höheren Störgraden nur Gewerbe- und ggf. auch Industriegebiete infrage. Über die Ausweisung von Gewerbegebieten kann jedoch innerhalb eines Quartiers eine grobkörnige Nutzungsmischung erreicht werden. Betriebe, die das Wohnen nicht wesentlich stören, können über die Ausweisung gemischter Baugebiete wie dem Urbanen Gebiet zusätzlich in einer feinkörnigen Nutzungsmischung realisiert werden. Dabei kann die Verdrängung von Betrieben der Urbanen Produktion durch zahlungskräftigere Nutzungen mithilfe des Planungsrechts nur begrenzt beeinflusst werden. Insbesondere in Urbanen Gebieten besteht die Gefahr, dass sie von anderen Nutzungen wie dem Wohnen verdrängt werden.
Computer-image processing becomes more and more important in the analysis of data in biological and agricultural research and practice. However, robust image processing is highly de pendent on the histogram analysis algorithms used and the quality of the data being processed. The algorithm presented here aims to improve the accuracy of the classification of image data generated under complex boundary situations and inconsistent lighting conditions. Using the example of the determination of nitrogen content of tomato leaves and the qualitative determination of starch con tent of apples on the basis of color image processing, we showed that the developed algorithm is able to perform a robust classification and represents an improvement to simple histogram analysis.
Within the consortium “Experimentation Field Agro-Nordwest”, a practical concept for knowledge and technology transfer of digital competence in agriculture was created. For this purpose, the web-based e-learning system “SensX” was set up, consisting of videos, presentations and instructions. In addition, the classical e-learning concept was extended by data sets, student experiments and sensor data of plants acquired by a remote phenotyping robot. This resulted in a massive open online course (MOOC), which was tested with agricultural and biotechnology students in higher education at the University of Applied Sciences Osnabrück over two years. The evaluation process of “SensX” included an empirical survey, qualitative interviews of the participating students by an external institution and an evaluation of the concept by the lecturers.
In a protein reduction feeding trial (Study 1) on a commercial broiler farm in northern Germany, it was attempted to be shown that research results from station tests on protein reduction can be transferred to agricultural practice. In a second study, the limits of the N reduction were tested in a research facility. In Study 1, commercial standard feeds were fed to the control group (variant 1:210,000 animals; n = 5 barns). In the test group (variant 2:210,000 animals; n = 5 barns), the weighted mean crude protein (CP) content was moderately reduced by 0.3%. The nitrogen reduction in the feed did not affect performance (feed intake (FA), daily gain (DG), feed conversion (FCR)), but nitrogen conversion rate increased from approx. 61% to approx. 63%. The solid litter weight was reduced by 12% and nitrogen excretion by 9% (p < 0.05). Significantly healthier footpads were due to lower water intake (−4%; p < 0.05) and a numerically drier bedding. In Study 2, responses of treatments (1250 broiler per variant; n = 5) showed that sharper N-lowering (−1.5% CP; weighted average) did not impair performance either, but N-conversion improved and N-excretions decreased significantly. Converted to a protein reduction of one percentage point, the N excretions were able to be reduced by 22% in Study 1 and 18% in Study 2. Feeding trials in the commercial sector, such as the present Study 1, should convince feed mills and farmers to allow the latest scientific results to be used directly and comprehensively in commercial ration design.
Auf der dritten Strategietagung Nachhaltigkeit wurde deutlich, dass Nachhaltigkeit breit angelegte Veränderungen in Staat, Gesellschaft und Unternehmen erfordert. Diakonische Unternehmen sind hochmotiviert und bestens geeignet, diese Änderungen zu vollziehen. Sie haben sich längst auf den Weg gemacht, neben der ökologischen auch die soziale Nachhaltigkeit zu befördern. Es hat für Frustration gesorgt, dass Themen besprochen werden mussten, die bereits bei der ersten Tagung als dringend identifiziert worden waren. Dem gegenüber standen aber die Beispiele aus den Unternehmen, die zeigten, dass bereits im bestehenden Rahmen viele entscheidende Verbesserungen möglich sind. Immer mehr diakonische Unternehmen entwickeln Nachhaltigkeitsstrategien und installieren ein Nachhaltigkeitsmanagement. Die Berichterstattung, z.B. in Form von CO2-Bilanzen oder Nachhaltigkeitsberichten nach anerkannten Standards wie EMAS-plus, DNK oder GWÖ, wird zügig ausgebaut. Soweit Daten vorhanden sind, konnten die CO2-Emissionen bereits signifikant reduziert werden. Zudem, das wurde an vielen Punkten der Tagung klar, stellten die Beteiligten eine stark gewachsene Bereitschaft in der Politik fest, die Nachhaltigkeits- und Klimaziele zu konkretisieren und Maßnahmen gegen den Klimawandel ressortübergreifend und engagiert auf den Weg zu bringen.