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Betriebswirtschaftliche Aufgaben erfordern betriebswirtschaftliche Methodenkompetenz. Unter Fokussierung der Leistungsprozesse insbesondere produzierender Unternehmen werden in dem vorliegenden Werk meist
aus der Welt der Konzerne bekannte und dort auch erfolgreich angewendete Methoden vorgestellt. Im „Handbuch Lean-Konzepte für den Mittelstand“ wird Wert darauf gelegt, die Besonderheiten kleiner und mittlerer Betriebe zu berücksichtigen. Insgesamt erhält der Leser eine Navigationshilfe durch die Methodik modernen Produktionsmanagements.
The aim was to evaluate the effects of additional exercises during inpatient stays on bone mass in pediatric bone tumor patients. 21 patients were non-randomly allocated either to the exercise group (n=10) or the control group (n=11). DXA of the lumbar spine, the non-affected femur and both calcanei was performed after completion of neoadjuvant chemotherapy (baseline), as well as 6 and 12 months after baseline. Bone mineral content (BMC), bone mineral density (BMD) and height-corrected lumbar spine Z-scores were determined. Group changes after 6 and 12 months were compared by covariance analyses. Additionally, daily physical activities (PA) were assessed by means of accelerometry. After adjusting for initial age, height and weight, mean reductions in lumbar spine and femoral BMC were lower in the exercise group (not significant). Effect sizes during the observational period for lumbar spine and femur BMC were generally small (partial η²=0.03). The exercise group demonstrated substantially higher PA levels in terms of gait cycles per day, per hour and moderate PA (activities above 40 gait cycles per minute). Additional exercises for bone tumor patients are feasible during hospitalization. Though the intervention did not influence BMC, it appeared beneficial regarding PA promotion with respect to volume and intensity.
Objectives
Complex midfoot injuries could lead to severe functional impairment of mobility and quality of daily living. Aim of this study was to compare the clinical and functional outcomes of Chopart, Lisfranc fractures and multiple metatarsal shaft fractures.
Design
Retrospective case series.
Setting
Level one trauma center.
Intervention
Open or closed reduction and internal fixation with screws, K-wires, plates, external fixation or combination of different technics.
Main outcome measurements
The American Orthopaedic Foot and Ankle Society (AOFAS) Midfoot Score and the Maryland Foot Score were used to assess pain and functional outcome. 3D gait analysis, pedobarographic analysis and radiologic examinations were performed. The activity level was measured by a step counting accelerometer. All results were compared to an age-matched healthy control group.
Results
24 patients with a median age of 44 years (16–72) were included: 12 patients with multiple metatarsal shaft fractures, 6 patients with Chopart and 6 patients with Lisfranc fractures. The median follow-up was 2.6 years. The pedobarographic analysis reports reduced contact time of the total foot (p = 0.08), the forefoot (p = 0.008) and the hallux (p = 0.015) for the injured foot. A median score of 64 for the SF-36, 64 for the AOFAS Midfoot Score and 73 for the Maryland Foot Score indicated a poor restoration of foot function. Multiple metatarsal shaft fractures presented a significantly lower walking speed (p = 0.03) and cadence (p = 0.04).
Conclusion
The worst results were reported for multiple metatarsal shaft fractures on outcome scores, pedobarography, gait analysis and activity. Metatarsal serial fractures should not be underestimated as well as Chopart and Lisfranc fractures.
Novel Orange Emitting Phosphor (Tb1-xSmx)2Mo3O12 with Highly Efficient Tb3+ to Sm3+ Energy Transfer
(2014)
Photochemische Reaktionen
(2014)
Sediment bypass tunnels are an effective countermeasure against reservoir sedimenta-tion. They are operated at supercritical sediment-laden open channel flow conditions. The major drawback of these tunnels, besides high construction costs, is the severe invert abrasion caused by these flows provoking high annual maintenance costs. The project goal was to analyze the fundamental physical processes and to develop design criteria to decrease these negative effects. A laboratory study was performed in a scaled hydraulic model flume. The project was divided in three main test phases giving new insights into the dynamics of turbulence structures and particle motions, resulting bed abrasion and their interactions in a supercritical open channel flow, respectively. In phase A the mean and turbulent flow characteristics were investigated. In phase B single sediment particle motion was analyzed. In phase C the invert abrasion development in time and space was examined.
Phase A revealed that secondary current cells affect the turbulent flow pattern leading to high bed shear stress at the wall vicinity. In phase B it was found, that particles were dominantly transported in saltation. Relationships between the saltation probability, and particle hop lengths and heights to the flow Shields parameter were found. The specific impact energy was determined by the impact velocity, number of impacts and the amount of particles transported in time. In phase C the results show that bed abrasion progresses with time both in the lateral and vertical direction. Two lateral incision chan-nels developed along the flume side walls at narrow flow conditions occurring at low flume-width to flow-depth aspect ratios b/h < 4-5, whereas randomly distributed pot-holes were found at wide channels where b/h > 4-5. The observed abrasion patterns match well with the spanwise bed shear stress distributions found in phase A. Further-more it was found that the abraded mass linearly increases with the transported sedi-ment mass allowing for a linear fit. Further results showed that abrasion increased with flow intensity and sediment transport rate, with highest values for the mean particle diameter category, whereas abrasion decreased with increasing material strength.
Finally, a new formulation was developed based on Sklar’s saltation abrasion model. A new abrasion coefficient CA is introduced correlating the impact energy and material properties with the gravimetric abrasion rate.