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Little study has been done on the adoption of End-of-Life (EoL) strategies on the medical devices industry, despite the reasons why it is an important area of study for the implementation of circularity. The rates of waste in the medical field are alarming and tend to grow. Though presenting a wide potential for EoL strategies implementation, the medical field is also inherently challenging, considering the rigid regulations and product's risk to patients life. This paper analyses 17 Product-Service System case studies identified in the literature. Eleven of them are from various fields of industry, whereas the other six are applied to the medical devices industry. The adoption of EoL strategies - namely repair, reconditioning, remanufacture and recycling - is analysed in each case and compared for the two categories of cases. This adoption is related to the sources of value creation in Circular Economy, to the PSS typology and, at last, special EoL treatment for medical devices is discussed.
‘Today, my dear wife, née Nissen, successfully delivered a healthy boy. 7th May 1833. J. J. Brahms.’ Thus, on 8 May 1833 Johann Jakob Brahms announced the birth of his first son Johannes in the local paper, the Privileged Weekly General News of and for Hamburg (Privilegirte wöchentliche gemeinnützige Nachrichten von und für Hamburg). At a time when such announcements were the exception, this was a clear sign of pride. Johann Jakob Brahms or Brahmst, as he also spelled it, was born on 1 June 1806 in Heide in Holstein, the second son of the innkeeper and trader Johann Brahms, who had moved to Heide from Brunsbüttel via Meldorf. His ancestors were from Lower Saxony. Johann Jakob completed a five-year apprenticeship as a city wait in Heide and Wesselburen, during which he learned the flugelhorn, flute, violin, viola and cello, then standard instruments. In early 1826, the young journeyman began his travels with his certificate of apprenticeship, received in December 1825.
Structure–property relationships are the foundation of materials science and are essential for predicting material response to driving forces, managing in-service material degradation, and engineering materials for optimal performance. Elastic, thermal, and acoustic properties provide a convenient gateway to directly or indirectly probe materials structure across multiple length scales. This article will review how using the laser-induced transient grating spectroscopy (TGS) technique, which uses a transient diffraction grating to generate surface acoustic waves and temperature gratings on a material surface, nondestructively reveals the material’s elasticity, thermal diffusivity, and energy dissipation on the sub-microsecond time scale, within a tunable subsurface depth. This technique has already been applied to many challenging problems in materials characterization, from analysis of radiation damage, to colloidal crystals, to phonon-mediated thermal transport in nanostructured systems, to crystal orientation and lattice parameter determination. Examples of these applications, as well as inferring aspects of microstructural evolution, illustrate the wide potential reach of TGS to solve old materials challenges and to uncover new science. We conclude by looking ahead at the tremendous potential of TGS for materials discovery and optimization when applied in situ to dynamically evolving systems.
Social and cultural aspects are rarely assessed in health technology assessments (HTA), despite being part of most HTA definitions. One hypothesis for the reason why they are hardly considered in HTA is that we lack relevant assessment methods. Accordingly, this review aims at providing an overview of methodological approaches to address social and cultural aspects related to health technologies in HTA.
We conducted a comprehensive literature search by searching fourteen databases and a hand-search of two pertinent journals. Additionally, we sent a query to all member agencies of the International Network of Agencies for Health Technology Assessment (INAHTA) asking them for methods they use to assess social and cultural aspects.
A total of 125 publications met our inclusion criteria. We grouped the methodological approaches into checklists for experts, literature reviews, stakeholder participatory approaches, primary data collection methods, and combinations of methodological approaches.
There is a wide variety of methods available for assessing social and cultural aspects of health technologies, some of which have been applied in HTA. The presented overview of the different approaches and their merits can facilitate the assessment of these aspects, and improve the knowledge regarding (potential) success and failure of the implementation of a health technology.
X-ray excited Photoelectron Spectroscopy (XPS) has become an indispensable tool for the study of metals and semiconductors. Due to the small mean free path of the photoelectrons In solids of the order of a few nanometers for energies in the keV range, it is a surface analysis technique. Its capability of quantitative analysis of all elements except hydrogen and helium and their chemical bonding states has recently been combined with small area and imaging analysis to typical spatial resolutions of about 10 μm. After a brief survey of the basic capabilities and limitations of XPS, some illustrative examples in typical metals and semiconductor research areas are presented, such as surface contamination and failure analysis in microelectronics, oxidation and corrosion, segregation at surfaces and interfaces, oxide/metal and oxide/semiconductor interfaces, and thin film analysis using angle resolved XPS and sputter depth profiling. Recent developments emphasize improved data evaluation and quantification schemes as well as instrumental capabilities with respect to both high spatial and energy resolution, and high power excitation sources such as synchrotron radiation.
Little is known about health-related quality of life in young children undergoing staged palliation for single-ventricle CHD. The aim of this study was to assess the impact of CHD on daily life in pre-schoolers with single-ventricle CHD and to identify determinants of health-related quality of life.
Prospective two-centre cohort study assessing health-related quality of life using the Preschool Paediatric Cardiac Quality of Life Inventory in 46 children at a mean age of 38 months and 3 weeks. Children with genetic anomalies were excluded. Scores were compared with reference data of children with biventricular CHD. Multiple linear regression analysis was used to identify determinants of health-related quality of life.
Health-related quality of life in pre-schoolers with single-ventricle CHD was comparable to children with biventricular CHD. Preterm birth and perioperative variables were significant predictors of low health-related quality of life. Notably, pre-Fontan brain MRI findings and neurodevelopmental status were not associated with health-related quality of life. Overall, perioperative variables explained 24% of the variability of the total health-related quality of life score.
Despite substantial health-related burden, pre-schoolers with single-ventricle CHD showed good health-related quality of life. Less-modifiable treatment-related risk factors and preterm birth had the highest impact on health-related quality of life. Long-term follow-up assessment of self-reported health-related quality of life is needed to identify patients with poorer health-related quality of life and to initiate supportive care.
A staple theme in clinical psychology, emotion regulation, or the ability to manage one's emotions, is directly linked with personal wellbeing and the ability to effectively navigate the social world. Until recently, this concept has been limited to a focus on intrapersonal processes, such as suppression. Less emphasis has been placed on developmental, social, and cultural aspects of emotion regulation. We argue here that as social beings, our engagement in emotion regulation may often occur interpersonally, with trusted others helping us to regulate our emotions. This review will highlight recent research on interpersonal emotion regulation processes.
Attractive colloidal dispersions, suspensions of fine particles which aggregate and frequently form a space-spanning elastic gel are ubiquitous materials in society with a wide range of applications. The colloidal networks in these materials can exist in a mode of free settling when the network weight exceeds its compressive yield stress. An equivalent state occurs when the network is held fixed in place and used as a filter through which the suspending fluid is pumped. In either scenario, hydrodynamic instabilities leading to loss of network integrity occur. Experimental observations have shown that the loss of integrity is associated with the formation of eroded channels, so-called streamers, through which the fluid flows rapidly. However, the dynamics of growth and subsequent mechanism of collapse remain poorly understood. Here, a phenomenological model is presented that describes dynamically the radial growth of a streamer due to erosion of the network by rapid fluid back flow. The model exhibits a finite-time blowup – the onset of catastrophic failure in the gel – due to activated breaking of the inter-colloid bonds. Brownian dynamics simulations of hydrodynamically interacting and settling colloids in dilute gels are employed to examine the initiation and propagation of this instability, which are in good agreement with the theory. The model dynamics is also shown to accurately replicate measurements of streamer growth in two different experimental systems. The predictive capabilities and future improvements of the model are discussed and a stability-state diagram is presented providing insight into engineering strategies for avoiding settling instabilities in networks meant to have long shelf lives.
Equivalence and non-inferiority trials are becoming more and more popular. Typically, they compare the effects of a treatment of interest with the current gold-standard treatment as the comparator. However, for this approach, the definition of equivalence or non-inferiority margins (NIM) is crucial, and no clear rules for their definition exist. We criticized the practice of these trials of being over-inflationary in favor of (erroneous) equivalence, and we outlined our critique with some study examples comparing psychodynamic treatments with current first-line treatments for mental disorders. Here we answer to a commentary of Leichsenring et al. to our paper. Although focusing on our commentary, these authors are less arguing against our conclusions, but they address issues of study conduct, and lack of appreciation of our examples. However, the crucial question is: What is the risk of erroneous equivalence conclusions that we want to accept as responsible clinicians and scientists? We conclude that the scientific community has to define better and clearer criteria for NIMs. We do not believe that it is ethically justifiable to recommend a treatment that is 10 or 20% less effective than the current gold standard interventions.
Motivated by the need to reason about hybrid systems, we study limits in categories of coalgebras whose underlying functor is a Vietoris polynomial one – intuitively, the topological analogue of a Kripke polynomial functor. Among other results, we prove that every Vietoris polynomial functor admits a final coalgebra if it respects certain conditions concerning separation axioms and compactness. When the functor is restricted to some of the categories induced by these conditions, the resulting categories of coalgebras are even complete.
As a practical application, we use these developments in the specification and analysis of non-deterministic hybrid systems, in particular to obtain suitable notions of stability and behaviour.