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Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of synovial joints, often resulting in irreversible structural damage. The activity of the disease is evaluated by clinical examinations, laboratory tests, and patient self-assessment. The long-term course of the disease is assessed with radiographs of hands and feet. The evaluation of the X-ray images performed by trained medical staff requires several minutes per patient. We demonstrate that deep convolutional neural networks can be leveraged for a fully automated, fast, and reproducible scoring of X-ray images of patients with rheumatoid arthritis. A comparison of the predictions of different human experts and our deep learning system shows that there is no significant difference in the performance of human experts and our deep learning model.
When a country grants preferential tariffs to another, either reciprocally in a free trade agreement (FTA) or unilaterally, rules of origin (RoOs) are defined to determine whether a product is eligible for preferential treatment. RoOs exist to avoid that exports from third countries enter through the member with the lowest tariff (trade deflection). However, RoOs distort exporters' sourcing decisions and burden them with red tape. Using a global data set, we show that, for 86% of all bilateral product-level comparisons within FTAs, trade deflection is not profitable because external tariffs are rather similar and transportation costs are non-negligible; in the case of unilateral trade preferences extended by rich countries to poor ones that ratio is a striking 98%. The pervasive and unconditional use of RoOs is, therefore, hard to rationalize.
The aim of this paper is to portray the risks of climate change for low mountain range tourism and to develop sustainable business models as adaption strategy. A mixed-method-approach is applied combining secondary analysis, a quantitative survey, and qualitative in-depth-interviews in a transdisciplinary setting. Results show, that until now, climate change impacts on the snow situation in the Black Forest – at least above 1,000 m – have been mild and compensated by artificial snowmaking, and up to now have not had measurable effects on tourism demand. In general, the Black Forest appears to be an attractive destination for more reasons than just snow. The climate issue seems to be regarded as a rather incidental occurrence with little importance to current business decisions. However, the authors present adaption strategies as alternatives for snow tourism, e. g. the implementation of hiking hostels, since climate change will make winter tourism in the Black Forest impossible in the long run.
This paper presents a framework to assess the cultural sustainability of Aboriginal tourism in British Columbia, which meets must take into account the protection of human rights, good self-governance, identity, control of land, the tourism product’s authenticity, and a market-ready tourism product. These criteria are specified by two indicators each. The cultural sustainability framework was generated by triangulating qualitative research methods like experts’ interviews, secondary research, and participant and non-participant observations. This paper is thus conceptual in nature and inductive in its approach. It partly leverages a collaborative approach, as it includes interviewees in an iterative research loop. Furthermore, the paper shows why cultural sustainability is a determinant of the success of Aboriginal tourism.
Border issues continue to be of interest in tourism literature, most significantly that which focusses on cross-border shopping (e.g., currency values, taxation,
security). Borders as destinations are recognized in this area but the notion of shopping as a destination is perhaps less acknowledged. Following a review of the relevant literature, including the presentation of a table summarizing key areas of cross-border tourism research around the world, this paper presents a unique example of a border region with two-way traffic for cross-border shopping tourism: the border between Germany and Switzerland.
The particular case is where two cities meet at the border: Konstanz, Germany and Kreuzlingen, Switzerland. An intercept survey and key informant interviews were conducted in both communities in the spring of 2015. The results indicate high levels of traffic for various products and services. And while residents are generally satisfied with cross-border shopping in their communities, there are emerging issues related to volume and, in particular, too many in Konstanz and not enough in Kreuzlingen.
The paper concludes with a discussion that includes the development of a model cross-border shopping tourism that recognizes the multiple layers in space and destination.
The paper concludes with a proposal to further investigate the particular issues related to the volume on both sides of borders where cross-border shopping is the destination.
Purpose – The purpose of this paper is to examine visitor management in the German-Swiss border area of the Lake Constance region. Taking a customer perspective, it determines the requirements for an application with the ability to optimize personal mobility.
Design/methodology/approach – A quantitative study and a survey of focus groups were conducted to identify movement patterns of different types of visitors and their requirements concerning the development of a visitor management application.
Findings – Visitors want an application that provides real-time forecasts of issues such as traffic, parking and queues and, at the same time, enables them to create a personal activity schedule based on this information.
Research limitations/implications – Not every subsample reached a sufficient number of cases to yield representative results.
Practical implications – The results may lead to an optimization and management separation of mobility flows in the research area and be helpful to municipal planners, destination marketing organizations and visitors.
Originality/value – The German border cities of Konstanz, Radolfzell and Singen in the Lake Constance region need improved visitor management, mainly because of a high level of shopping tourism by Swiss visitors to Germany. In the Summer months, Lake Constance is also a popular destination for leisure tourists, which causes overtourism. For the first time, the results of this research presented here offer possible solutions, in particular by showing how a mobile application for visitors could defuse the situation.
The project aims for the development of a new material system from high tensile stainless steel wires as net material with environmentally compatible antifouling properties for off-shore fish farm cages. Therefore, current net materials from textiles (polyamide) shall be partially replaced by high strength stainless steel in order to have a more environmentally compatible system which meets the more severe mechanical loads (waves, storms, predators (sharks)). With a new antifouling strategy current issues like reduced ecological damage (e.g. due to copper disposal), lower maintenance costs (e.g. cleaning) and reduced durability shall be resolved.
Thermal shape memory alloys show extraordinary material properties and can be used as actuators, dampers and sensors. Since their discovery in the middle of the last century they have been investigated and further developed. The majority of the industrial applications with the highest material sales can still be found in the medical industry, where they are used due to their superelastic and thermal shape memory effect, e.g. as stents or as guidewires and tools in the minimal invasive surgery. Particularly in recent years, more and more applications have been developed for other industrial fields, e.g. for the household goods, civil engineering and automotive sector. In this context it is worth mentioning that for the latter sector, million seller series applications have found their way into some European automobile manufacturers. The German VDI guideline for shape memory alloys introduced in 2017 will give the material a further boost in application. Last but not least the new production technologies of additive manufacturing with metal laser sintering plants open up additional applications for these multifunctional materials. This paper gives an overview of the extraordinary material properties of shape memory components, shows examples of different applications and discusses European trends against the background of the most recent standard and new production technologies.
Thermochemical surface hardening is used to overcome the weak mechanical performance of austenitic and duplex stainless steels. Both low-temperature carburizing and nitrocarburizing can improve the hardness, wear, galling, and cavitation resistance, while maintaining their good corrosion resistance. Therefore, it is crucial to not form chromium-rich precipitates during hardening as these can deteriorate the passivity of the alloy. The hardening parameters, the chemical composition of the steel, and the manufacturing route of a component determine whether precipitates are formed. This article gives an overview of suitable alloys for low-temperature surface hardening and the performance under corrosive loading.