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ABSTRACT Objectives: to describe the validity process of the TBApp mobile application for self-care management for people with tuberculosis linked to Primary Health Care. Methods: methodological research developed with ten expert judges, carried out virtually. The application was assessed in relation to content and technology quality in seven domains (objectivity; structure and appearance; relevance; functionality; reliability; usability; and efficiency), using an instrument with a Likert scale. Results: TBApp was considered valid, relevant, functional, reliable and effective by expert judges. The objectives, structure and presentation and relevance domains presented an overall Content Validity Index of 0.93, and the functionality, reliability, usability and efficiency domains presented characteristics and sub-characteristics values greater than 0.80. Conclusions: TBApp is a creative and innovative tool that can be used by people with TB and disseminated in the scientific community.

Abstract We derive price limits as decision aids for identifying favorable and unfavorable contracts from the perspective of a selling firm in face of uncertain outcomes. The analysis is based on the concept of almost stochastic dominance to incorporate incomplete information about the decision-maker’s preferences. The main challenges to use this concept in practice are to define and limit the required preference information and to demonstrate the performance of the resulting price limits. We propose price limits that are suitable for a wide range of applications, in particular services. While their information requirements vary, all price limits refer to the same type of aggregate information about marginal utilities and risk aversion. In the scenario with the lowest requirements, the preference information shrinks to a single number which is easy to approximate and to communicate. A comprehensive numerical study featuring fixed-price contracts shows that the incomplete preference information may lead to substantial improvements of the price limits over the situation of no preference information. We also discuss determinants and caveats of these improvements. For instance, the improvements increase with decreases of the decision-maker’s risk sensitivity and may differ substantially in magnitude between the lower and the upper price limit.

Abstract Background Sclerosing angiomatoid nodular transformation is a benign disorder of splenic tissue and is often mistaken as a potentially malignant entity in the diagnostic process. To the best of our knowledge, this is the first report of sclerosing angiomatoid nodular transformation mimicking metastasis of melanoma in the literature. Case presentation A 43-year-old white man presented with a newly found splenic mass 4 years ago to our Department of Gastroenterology. He was diagnosed as having a superficial spreading malignant melanoma localized at his left instep 7 years ago and was successfully treated with radical local resection. Several diagnostic procedures were conducted. Ultrasound showed a hypoechoic lesion in the inferior pole of his spleen with a diameter of 2 cm, blurred boundaries, and inhomogeneous interior pattern. Contrast-enhanced ultrasound was inconclusive and showed only discrete contrast enhancement of the lesion with accentuated nodule-like enrichment of the boundaries in the arterial phase. Computed tomography and magnetic resonance imaging scans showed two splenic lesions which were highly suspicious of metastasis. Magnetic resonance imaging of his head was inconspicuous. Bone scintigraphy showed no abnormal results. Fine-needle aspiration indicated metastasis of the above-mentioned malignant melanoma. We conducted a laparoscopic splenectomy. His intraoperative and postoperative course were uneventful. In contrast to the result of the fine-needle aspiration, the presence of metastasis of melanoma could not be confirmed. Histological analysis revealed nodule-like arrangement of fibroblasts with low cell density and a predominance of dilated capillaries, indicating sclerosing angiomatoid nodular transformation of the spleen. Conclusions There are no preoperative diagnostic imaging procedures which can definitely differentiate sclerosing angiomatoid nodular transformation from malignancies in cases of morphological and immunophenotypic variations of the specimen. Morphological and immunophenotypic variations of the specimen represent a diagnostic challenge and can mimic malignoma. As reported in our case, the specimen obtained by ultrasound-guided fine-needle aspiration led to the diagnosis of metastasis of melanoma. Splenectomy is often conducted due to a splenic mass suspicious of malignoma as described in our case or with unknown valency in different diagnostic imaging procedures.

Road traffic is one of the main causes of poor air quality in European cities. The air pollution burden due to road traffic in a street canyon consists of shares from local traffic and contributions of vehicles driving elsewhere in the city as well as elsewhere on a larger scale. Are electric vehicles a solution for air quality problems in cities? Do they reduce noise levels in street canyons significantly? The aim of this sensitivity study is to investigate the regional and local effects of electric vehicles on noise and air quality taking possible effects of additional electricity production into account. Focus of the present study lies for air quality on the regional scale in North Rhine-Westphalia and the overall effect in some selected street canyons, to be more precise the annual average PM10 and NO2 concentrations. A sensitivity study using the chemistry transport model EURAD and a screening model for street canyons was carried out. The influence on noise levels was analysed based on measurements of vehicles at different speeds. It turns out that road traffic has a significant impact on the regional air pollution levels. Furthermore it is shown that the reduction potential is bigger for NO2 than for PM10. With regard to EC limit value compliance a major share of electric vehicles could be a solution for the NO2 problems in moderately polluted street canyons. One of our findings is that if the additional electricity need causes additional emissions these counteract the possible reduction, especially for PM10. The noise reduction potential of electric vehicles is only significant for vehicles moving at low speeds.

Two commonly used models to assess air pollution concentration for investigating health effects of air pollution in epidemiological studies are Land Use Regression (LUR) models and Dispersion and Chemistry Transport Models (DCTM). Both modeling approaches have been applied in the Ruhr area, Germany, a location where multiple cohort studies are being conducted. Application of these different modelling approaches leads to differences in exposure estimation and interpretation due to the specific characteristics of each model. We aimed to compare both model approaches by means of their respective aims, modeling characteristics, validation, temporal and spatial resolution, and agreement of residential exposure estimation, referring to the air pollutants PM2.5, PM10, and NO2. Residential exposure referred to air pollution exposure at residences of participants of the Heinz Nixdorf Recall Study, located in the Ruhr area. The point-specific ESCAPE (European Study of Cohorts on Air Pollution Effects)-LUR aims to temporally estimate stable long-term exposure to local, mostly traffic-related air pollution with respect to very small-scale spatial variations (≤100 m). In contrast, the EURAD (European Air Pollution Dispersion)-CTM aims to estimate a time-varying average air pollutant concentration in a small area (i.e., 1 km2), taking into account a range of major sources, e.g., traffic, industry, meteorological conditions, and transport. Overall agreement between EURAD-CTM and ESCAPE-LUR was weak to moderate on a residential basis. Restricting EURAD-CTM to sources of local traffic only, respective agreement was good. The possibility of combining the strengths of both applications will be the next step to enhance exposure assessment.