[Virtual staff teamwork during the pandemic - development of digital training formats for community emergency response during the coronavirus pandemic]. / Virtuelle Stabsarbeit in Zeiten der Pandemie ­ Entwicklung digitaler Übungsformate in der zivilen Gefahrenabwehr während der Coronapandemie: Erfahrungen am Beispiel des Projekts ARMIHN.

Background: In the event of emergency response to large-scale incidents, such as a mass casualty incident (MCI) or a mass casualty incident-infectious disease (MCI-ID), regular training is essential in order to have experienced emergency personnel available in the event of an incident. Due to the pandemic drills often had to be cancelled or were only possible with small groups of people. It was often not possible to simulate a large-scale emergency with actors, so that the trainees could not be offered realistic scenarios of a mass casualty or disease incident. As part of two research projects, a digital platform for conducting training was used to avoid the risk of infection between participants during the exercises, so that on-site personnel deployment could be reduced to a minimum. The goal of this work was to evaluate end-user acceptance of the digital solution approaches. Methods: Within the framework of the project "Adaptive Resilience Management in Ports" (ARMIHN), a digital exercise platform was applied and evaluated with the help of participant surveys according to the focal points "implementation", "alternative possibilities", "learning effect" and "usability". The participants used the digital platform to exchange information and to communicate. For this purpose, various collaboration tools were embedded in the platform, which enabled simultaneous exchange of information in real time. Constant video communication with in-house and external authorities/teams was also established. Results: The potential of the digital platform as an alternative to on-site exercises was confirmed by the participating end users in the ARMIHN project with 90% agreement. The increase in subjective skills and knowledge gained during a MCI-ID was also predominantly rated approvingly (up to 70%). Participants who rated the implementation of the online format as well performed were significantly more likely to state that subjectively their ability to handle a MCI-ID had improved (p = 0.016). In contrast, virtual staff teamwork in real crisis situations was viewed critically by about half of respondents. Conclusion: Overall, the evaluation results point to the high end-user acceptance of the developed concept. Even though the aim is to evaluate the system over a longer period with a larger number of participants, the studies already conducted confirm the positive experiences in the respective projects.

Improved accuracy of glenoid positioning in total shoulder arthroplasty with intraoperative navigation: a prospective-randomized clinical study.

HYPOTHESIS: The correct implantation of the glenoid component is of paramount importance in total shoulder arthroplasty (TSA). We hypothesized that the accuracy of the glenoid positioning in the transverse plane can be improved using intraoperative navigation. MATERIALS AND METHODS: This prospective, randomized clinical study comprised 2 groups of 10 patients each with osteoarthritis of the shoulder TSA, with or without intraoperative navigation. Glenoid version was measured on axial computed tomography scans preoperatively and 6 weeks postoperatively. RESULTS: The operating time was significantly longer in the navigation group (169.5 +/- 15.2 vs 138 +/- 18.4 min). We found an average change of retroversion from 15.4 degrees +/- 5.8 degrees (range, 3.0 degrees -24.0 degrees) preoperatively to 3.7 degrees +/- 6.3 degrees (range, -8.0 degrees to 15.0 degrees) postoperatively in the navigation group compared with 14.4 degrees +/- 6.1 degrees (range, 2.0 degrees -24.0 degrees) preoperatively to 10.9 degrees +/- 6.8 degrees (range, 0.0 degrees -19.0 degrees) postoperatively in the group without navigation (P = .021). CONCLUSION: We found an improved accuracy in glenoid positioning in the transverse plane using intraoperative navigation. The validity of the study is limited by the small number, which advocates continuation with more patients and longer follow-up. LEVEL OF EVIDENCE: Level 2; Therapeutic study.

Three-dimensional measurements of the pressure distribution in artificial joints with a capacitive sensor array.

A spherically folded capacitive pressure sensor array is introduced and characterized. By placing the sensor array between the ball and the cavity of artificial joints, the pressure distribution within the joint was recorded with spatial resolution for different size matching between the ball and the cavity, for different directions of loading and for joints with incomplete cavities. The performance of the sensor array is analyzed, possible fields of application as well as its limitations are discussed.

Characterization of FGFRL1, a novel fibroblast growth factor (FGF) receptor preferentially expressed in skeletal tissues.

Clones for a novel transmembrane receptor termed FGFRL1 were isolated from a subtracted, cartilage-specific cDNA library prepared from chicken sterna. Homologous sequences were identified in other vertebrates, including man, mouse, rat and fish, but not in invertebrates such as Caenorhabditis elegans and Drosophila. FGFRL1 was expressed preferentially in skeletal tissues as demonstrated by Northern blotting and in situ hybridization. Small amounts of the FGFRL1 mRNA were also detected in other tissues such as skeletal muscle and heart. The novel protein contained three extracellular Ig-like domains that were related to the members of the fibroblast growth factor (FGF) receptor family. However, it lacked the intracellular protein tyrosine kinase domain required for signal transduction by transphosphorylation. When expressed in cultured cells as a fusion protein with green fluorescent protein, FGFRL1 was specifically localized to the plasma membrane where it might interact with FGF ligands. Recombinant FGFRL1 protein was produced in a baculovirus system with intact disulfide bonds. Similar to FGF receptors, the expressed protein interacted specifically with heparin and with FGF2. When overexpressed in MG-63 osteosarcoma cells, the novel receptor had a negative effect on cell proliferation. Taken together our data are consistent with the view that FGFRL1 acts as a decoy receptor for FGF ligands.