ABSTRACT
As today's society ages, age-related diseases become more frequent. One very common but yet preventable disease is the development of pressure ulcers (PUs). PUs can occur if tissue is exposed to a long-lasting pressure load, e.g., lying on tissue without turning. The cure of PUs requires intensive care, especially for the elderly or people with preexisting conditions whose tissue needs longer healing times. The consequences are heavy suffering for the patient and extreme costs for the health care system. To avoid these consequences, our objective is to develop a pressure ulcer prophylaxis device. For that, we built a new sensor system able to monitor the pressure load and tissue vital signs in immediate local proximity at patient's predilection sites. In the clinical study, we found several indicators showing correlations between tissue perfusion and the risk of PU development, including strongly reduced SpO2 levels in body tissue prior to a diagnosed PU. Finally, we propose a prophylaxis system that allows for the prediction of PU developments in early stages before they become visible. This work is the first step in generating an effective system to warn patients or caregivers about developing PUs and taking appropriate preventative measures. Widespread application could reduce patient suffering and lead to substantial cost savings.
ABSTRACT
The global energy system changes towards renewables-dominated and liberalized markets. This requires making novel trade-offs between the profitable development of hydropower and its environmental effects on the natural flow regime. Here, we used a pristine river as a model for how these future changes will affect the natural flow regime and identify future changes on previously overlooked levels. We found that damming and discharging based on market prices leads to first- and second-level deviation from natural flows. Beyond these effects, we identified a third level of distance from natural flow. This third level is created by the transition towards a renewables-dominated energy system. The volatile energy input from renewables incentivizes hydropower plant operators to discharge based on more flexible trading behavior. We conclude that novel economic models be combined with tailored implementations of environmental flows. This will allow to find novel solutions for the trade-off between market liberalization and sustainable hydropower development.
