OPUS THD (Technischen Hochschule Deggendorf)
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Periacetabular osteotomy versus hip arthroscopy in patients with borderline developmental dysplasia of the hip: A systematic review and multi‐level meta‐analysis
No full textPurpose
A comprehensive meta‐analysis is required to address the lack of quantitative evidence on treatment outcomes in borderline developmental dysplasia of the hip (BDDH). This study compares periacetabular osteotomy (PAO) and hip arthroscopy (HAS) through a multi‐level meta‐analysis, providing quantitative insights into their efficacy and safety.
Methods
A systematic literature search was conducted in PubMed, Epistemonikos, and Embase up to February 28, 2025. A frequentist meta‐analysis was performed using the Hartung‐Knapp‐Sidik‐Jonkman heterogeneity estimator. Continuous variables were analyzed using mean values with 95% confidence intervals (CIs), and binary outcomes as proportions with 95% CIs. Sensitivity analysis compared studies defining BDDH as 20–25° versus all included studies. Statistical heterogeneity was assessed using Higgins' I². A random‐effects model was applied in cases of significant heterogeneity.
Results
The literature search identified 39 primary studies with a total of 2075 patients (2121 hips). The test for subgroup differences showed no statistically significant difference between the PAO group and the HAS group in post‐operative mHHS (χ2= 0.55; df = 1; p= 0.46), in post‐operative iHOT‐12 (χ2 = 0.00; df = 1; p = 0.98), in the change in mHHS (χ2 = 0.37; df = 1; p = 0.54), in the change in iHOT‐12 (χ2 = 1.05; df = 1; p = 0.30), in MCID of post‐operative functional outcome scores (χ2 = 0.43; df = 1; p = 0.51), in reoperation (χ2 = 0.17; df = 1; p = 0.68), and in complications (χ2 = 3.35; df = 1; p = 0.07). The absolute mean values for nearly all parameters favour PAO, which may indicate a potential advantage.
Conclusion
PAO and HAS yield comparable short‐ to mid‐term outcomes in BDDH. Long‐term studies are needed to determine whether HAS is a definitive treatment or delays structural correction. Future research should standardize BDDH definitions (LCEA 20–25°) to enhance comparability and treatment consistency.
Level of Evidence
A meta‐analysis of retrospective and prospective primary studies
RoboCT: The State and Current Challenges of Industrial Twin Robotic CT Systems
No full textTwin robotic X-ray computed tomography (CT) refers to CT systems in which two robotic arms are used to independently move the X-ray source and the X-ray detector around the object. This setup enables flexible CT scans by using robots to move the X-ray source and the X-ray detector around an object’s region of interest. This allows scans of large objects, image quality optimization and scan time reduction. Despite these advantages, robotic CT systems still face challenges that limit their widespread adoption. This paper discusses the state of twin robotic CT and its current main challenges. These challenges include the optimization of scanning trajectories, precise geometric calibration and advanced 3D reconstruction techniques
Evaluation and Mitigation of Domain Shift Impact between Volumetric Submicro-Scale and Micro-Scale Computed Tomography Systems in the Context of Automated Binary Wood Classification
No full textRapid and reliable automated identification of wood species can be a boon for applications across wood scientific context including forestry and biodiversity conservation, as well as in an industrial context via requirements for timber trade regulations. However, robust machine learning classifiers must be properly analyzed and immunized against domain shift effects. These can degrade the automated system performance for input data variations occurring in many real-world scenarios. This work methodologically analyses the domain shift generated by using two differing sub-micro-scale and micro-scale computed tomography setups in the focused context of deep learning based binary wood classification from volumetric image data. To counteract this, we examine several mitigation strategies and propose primary data-level and narrow model-level strategies to effectively and successfully minimize the performance domain gap. Core elements of the data-wise strategy include the combined usage of phase-correction methods, low-pass pyramid representation of the data and adjustments of model normalization and regularization. Vanishing domain performance differences led to the conclusion that the combined strategy ultimately prompted the model to learn robust features. These features are discriminative for the utilized wood species data from both sub-micro-system and micro-system domains, despite the substantial differences in data acquisition setup that propagate into fundamental image quality metrics like resolution, contrast and signal-to-noise ratio
Expert Experiences in Anonymizing Personal Data and Its Use as Open Data: Qualitative Insights
No full textIntroduction : The effective and meaningful use of anonymized personal data, including open data, is globally significant across various sectors. Enhancing data utilization aims to generate substantial societal benefits and added value through innovations, products, and services. However, several legal, ethical, and technical challenges currently hinder the development and broader adoption of open data. Furthermore, the availability of technical support tools with high usability is especially desirable to facilitate the anonymization process effectively. Methods : As part of the EAsyAnon research project, preliminary insights were gathered through a scoping review that identified factors promoting or impeding the anonymization and use of personal data. Based on these findings, a structured interview guide was developed. Following a pretest, 19 interviews were conducted with diverse stakeholders from healthcare institutions, research organizations, public authorities, and private companies. The collected data were analyzed using Kuckartz’s structural content analysis methodology, supported by qualitative analysis software. Results : The content analysis yielded five overarching categories and 21 subcategories. These encompassed stakeholder experiences related to anonymization and open data processes, the various types and formats of personal data, identified barriers and enabling factors, support services, and the ethical and legal considerations associated with anonymization. Discussion : The findings highlight significant uncertainty among stakeholders regarding the anonymization of personal data. Although the importance and potential applications of open data for innovation and continuous improvement are widely acknowledged and supported, numerous challenges persist at both the macro and micro levels. The results emphasize a clear need for targeted support measures to address these challenges effectively
Measuring Optical Scattering in Relation to Coatings on Crystalline X-Ray Scintillator Screens
No full textScattered light makes up a significant amount of recorded intensities during tomographic imaging, thereby leading to severe misinterpretation and artifacts in the reconstructed volume images. Correcting artificial intensities that stem from scattered light, therefore, is of primary interest and demands quantitative measurements. While numerous methods have been developed to reduce X-ray scattering artifacts, fewer methods deal with optical scattering. In this study, a measurement method for determining optical scattering in scintillators is presented with the aim of further developing correction algorithms. A theoretical model based on internal multiple reflections was developed for this purpose. This model assumes an additive exponential kernel with a certain scattering length to the system’s point spread function. This assumption was confirmed, and the scatter length was estimated from three new different kinds of experiments (hgap, rect, and LSF) on the BM18 beamline of the European synchrotron. The experiments further revealed significant differences in scattering proportion and length when different coatings are applied to the front and back faces of crystalline LuAG scintillators. Anti-reflective coatings on the backside show an effect of reducing the scattering magnitude while reflective coatings on the front side increase the proportion of the unscattered signal and, thus, show proportionally less scattering than black coating or no front coating. In particular, roughened black coating is found to worsen optical scattering. In summary, our results indicate that a combination of reflective (front) and anti-reflective (back) coatings yields the least optical scattering and, hence, the best image quality
High-throughput differentiation of human blood vessel organoids reveals overlapping and distinct functions of the cerebral cavernous malformation proteins
No full textAbstract
Cerebral cavernous malformations (CCMs) are clusters of thin-walled enlarged blood vessels in the central nervous system that are prone to recurrent hemorrhage and can occur in both sporadic and familial forms. The familial form results from loss-of-function variants in the CCM1 , CCM2 , or CCM3 gene. Despite a better understanding of CCM pathogenesis in recent years, it is still unclear why CCM3 mutations often lead to a more aggressive phenotype than CCM1 or CCM2 variants. By combining high-throughput differentiation of blood vessel organoids from human induced pluripotent stem cells (hiPSCs) with a CCM1 , CCM2 , or CCM3 knockout, single-cell RNA sequencing, and high-content imaging, we uncovered both shared and distinct functions of the CCM proteins. While there was a significant overlap of differentially expressed genes in fibroblasts across all three knockout conditions, inactivation of CCM1 , CCM2 , or CCM3 also led to specific gene expression patterns in neuronal, mesenchymal, and endothelial cell populations, respectively. Taking advantage of the different fluorescent labels of the hiPSCs, we could also visualize the abnormal expansion of CCM1 and CCM3 knockout cells when differentiated together with wild-type cells into mosaic blood vessel organoids. In contrast, CCM2 knockout cells showed even reduced proliferation. These observations may help to explain the less severe clinical course in individuals with a pathogenic variant in CCM2 and to decode the molecular and cellular heterogeneity in CCM disease. Finally, the excellent scalability of blood vessel organoid differentiation in a 96-well format further supports their use in high-throughput drug discovery and other biomedical research studies
A Call for Bio-Inspired Technologies: Promises and Challenges for Ecosystem Service Replacement
No full textEcosystem services are crucial for animals, plants, the planet, and human well-being. Decreasing biodiversity and environmental destruction of ecosystems will have severe consequences. Designing technologies that could support, enhance, or even replace ecosystem services is a complex task that the Manufactured Ecosystems Project team considers to be only achievable with transdisciplinarity, as it unlocks new directions for designing research and development systems. One of these directions in the project is bio-inspiration, learning from natural systems as the foundation for manufacturing ecosystem services. Using soil formation as a case study, text-mining of existing scientific literature reveals a critical gap: fewer than 1% of studies in biomimetics address soil formation technological replacement, despite the rapid global decline in natural soil formation processes. The team sketches scenarios of ecosystem collapse, identifying how bio-inspired solutions for equitable and sustainable innovation can contribute to climate adaptation. The short communication opens the discussion for collaboration and aims to initiate future research
An Ontology‐Augmented Digital Twin for Fiber‐Reinforced Polymer Structures at the Example of Wind Turbine Rotor Blades
No full textA methodology for establishing a structural digital twin is proposed to facilitate the lifetime prediction of fiber‐reinforced polymer (FRP) structures, in this case, a wind turbine rotor blade. The digital twin incorporates production peculiarities and imperfections occurring during the manufacturing process of the FRP component. The methodology involves the computation of process‐defined effective elastic properties and residual stresses through numerical simulation of the resin cure cycle. The results are then transferred to a structural finite‐element model. By applying local wind conditions to this model, a comprehensive state of stress is obtained. This serves as a basis for a practical evaluation of material fatigue within the composite, leading to the prediction of the component's lifetime. The entire workflow is implemented in a Jupyter‐based application that uses an ontology with an appertaining knowledge graph to facilitate the transfer of intermediate results between the observation scales and process steps of the digital twin. In line with the principles of open science, the methodology utilizes open‐source software
Parents’ experience of child loss during pregnancy or birth: protocol for an explorative, sequential and participative mixed-methods study
No full textBackground
Internationally, the rate of child loss during pregnancy or birth remains high. This has not only physical but also psychological implications for the parents. While much is known today about the medium- and long-term impact of such a loss, very little research is available on the experience and needs before and during intrauterine or perinatal loss. In addition, healthcare professionals feel insecure and unprepared when dealing with this specific group, which also has a lasting impact on those affected.
Aim
To develop recommendations for healthcare professionals on how to deal with families before and during the intrauterine or perinatal loss of their child.
Methods
An explorative, sequential and participatory mixed-methods study will be conducted. Along its design, an affected mother is involved throughout the entire study. In detail, workshops, focus groups and narrative interviews with parents are planned. We will include parents who have lost their child during pregnancy or birth within the last 12 months and live in Germany, Austria or Switzerland. The results of the research are then translated into recommendations, which are reviewed and confirmed together with affected parents in a Delphi survey. Finally, a guideline for healthcare professionals will be developed.
Discussion
The co-creative design of this study enables the experience-based development of recommendations for healthcare professionals.
Clinical trial registration
The study was registered in the National Library of Medicine on January 13th, 2025 with the unique ClinicalTrials.gov identifier NCT06771661 (https://clinicaltrials.gov/study/NCT06771661)
Overcoming Barriers in the Introduction of Early Warning Scores for Prevention of In-Hospital Cardiac Arrests in Austrian Medical Centers †
No full textIntroduction:
In-hospital cardiac arrest (IHCA) is still associated with high mortality. Introduction of multi-parameter early warning systems (EWS) could reduce the incidence of IHCA. However, data regarding prevention of IHCA remains conflicting. Moreover, an aging population and a shortage of healthcare workers strain Austrian acute care hospitals. Sicker patients and fewer staff could hinder the implementation of multi-parameter EWS in Austria. Therefore, we sought to identify such barriers by assessing local and national data. Furthermore, we investigated the incidence of in-hospital cardiac arrests at Medical University Innsbruck.
Methods:
In this perspective study, we retrospectively analyzed all patients experiencing an in-hospital cardiac arrest between 2017 and 2024. In the qualitative part, ten experts in in-hospital emergency medicine were interviewed using guided interviews. The main results from the interviews were identified using a structured content analysis according to Mayring. Quantitative and qualitative data were integrated through narrative. Using the Consolidated Framework for Implementation Research, we stratified our data into five domains. Finally, we applied the “eight steps for leading change” to develop a practice guideline.
Results:
In six years, 1356 patients were treated by an emergency medical team; 1317 emergencies were included, with 365 of them being resuscitated. Overall, 114 survived for 24 h. The incidence rate of in-hospital cardiac arrests was 0.86 cases/1000 admissions per year. The guided interviews demonstrated a nearly complete absence of EWS using multiple parameters in Austria. Strained human resources after the pandemic, the fear of an increased workload and the lack of robust data regarding the benefit of survival were mentioned as main reasons. The best practice tutorial considers the challenges identified and provides guidance for structured implementation in hospitals.
Conclusions:
Implementing NEWS2 can facilitate detection of critically ill patients despite decreased staffing. Identifying common barriers and facilitators in five domains described and applying this to the “eight steps for leading change” enabled us to provide a tutorial for implementation of an EWS. This could help master future challenges in in-hospital emergency medicine