B. Bornschein

Karlsruhe Institute of Technology, Carlsruhe, Baden-Württemberg, Germany

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Publications (67)153.76 Total impact

  • Fusion Science and Technology 03/2015; 67:117. DOI:10.13182/FST14-T29 · 0.59 Impact Factor
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    ABSTRACT: Purpose The international multicentre FAME Study (n = 1,005) demonstrated significant health benefits for patients undergoing multivessel percutaneous coronary intervention (PCI) guided by fractional flow reserve (FFR) measurement compared with angiography guidance alone (ANGIO). We determined the cost-effectiveness and the public health/budget impact for Australia. Methods We performed a prospective economic evaluation comparing FFR vs. ANGIO in patients with multivessel disease based on original patient-level FAME data. We used Australian utilities (EQ-5D) and costs to calculate quality-adjusted life years (QALYs) and incremental cost-effectiveness adopting the societal perspective. The public health and budget impact from the payer's perspective was based on Australian PCI registries. Uncertainty was explored using deterministic sensitivity analyses and the Bootstrap method (n = 5,000 samples) Results The cost-effectiveness analysis showed that FFR was cost-saving and reduces costs by 1,776 AUD per patient during one year. Over a two-year time horizon, the public health impact ranged from 7.8 to 73.9 QALYs gained and the budget impact from 1.8 to 14.5 million AUD total cost savings. Sensitivity analyses demonstrated that FFR was cost-saving over a wide range of assumptions. Conclusions FFR-guided PCI in patients with multivessel coronary disease substantially reduces cardiac events, improves QALYs and is cost-saving in the Australian health care system.
    Heart, Lung and Circulation 06/2014; 23(6). DOI:10.1016/j.hlc.2013.12.009 · 1.17 Impact Factor
  • Das Gesundheitswesen 09/2013; 75(08/09). DOI:10.1055/s-0033-1354216 · 0.62 Impact Factor
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    ABSTRACT: The Raman depolarization ratios for individual Q1(J”) branch lines of all diatomic hydrogen isotopologues – H2, HD, D2, HT, DT, and T2 – were measured, for all rotational levels with population larger than 1/100 relative to the Boltzmann maximum at room temperature. For these measurements, the experimental setup normally used for the monitoring of the tritiated hydrogen molecules at KArlsruhe TRItium Neutrino experiment was adapted to optimally control the excitation laser power and polarization, and to precisely define the Raman light collection geometry. The measured Raman depolarization values were compared to theoretical values, which are linked to polarizability tensor quantities. For this, the ‘raw data’ were corrected taking into account distinct aspects affecting Raman depolarization data, including (1) excitation polarization impurities; (2) extended Raman excitation volumes; and (3) Raman light collection over finite solid angles. Our corrected depolarization ratios of the hydrogen isotopologues agree with the theoretical values (based on ab initio quantum calculations by R.J. LeRoy, University of Waterloo, Canada) to better than 5% for nearly all of the measured Q1(J”) lines, with 1σ confidence level. The results demonstrate that reliable, accurate Raman depolarization ratios can be extracted from experimental measurements, which may be substantially distorted by excitation polarization impurities and by geometrical effects. Copyright © 2013 John Wiley & Sons, Ltd.
    Journal of Raman Spectroscopy 06/2013; 44(6):n/a-n/a. DOI:10.1002/jrs.4283 · 2.52 Impact Factor
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    ABSTRACT: In addition to medical treatment, deep brain stimulation has become an alternative therapeutic option in advanced Parkinson's disease. High initial costs of surgery have to be weighted against long-term gains in health-related quality of life. The objective of this study was to assess the cost-effectiveness of deep brain stimulation compared with long-term medical treatment. We performed a cost-utility analysis using a lifetime Markov model for Parkinson's disease. Health utilities were evaluated using the EQ-5D generic health status measure. Data on effectiveness and adverse events were obtained from clinical studies, published reports, or meta-analyses. Costs were assessed from the German health care provider perspective. Both were discounted at 3% per year. Key assumptions affecting costs and health status were investigated using one-way and two-way sensitivity analyses. The lifetime incremental cost-utility ratio for deep brain stimulation was €6700 per quality-adjusted life year (QALY) and €9800 and €2500 per United Parkinson's Disease Rating Scale part II (motor experiences of daily living) and part III (motor examination) score point gained, respectively. Deep brain stimulation costs were mainly driven by the cost of surgery and of battery exchange. Health status was improved and motor complications were reduced by DBS. Sensitivity analysis revealed that battery life time was the most influential parameter, with the incremental cost-utility ratio ranging from €20,000 per QALY to deep brain stimulation dominating medical treatment. Deep brain stimulation can be considered cost-effective, offering a value-for-money profile comparable to other well accepted health care technologies. Our data support adopting and reimbursing deep brain stimulation within the German health care system. © 2013 Movement Disorder Society.
    Movement Disorders 06/2013; 28(6). DOI:10.1002/mds.25407 · 5.63 Impact Factor
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    ABSTRACT: BACKGROUND: Clinical studies employ the Unified Parkinson's Disease Rating Scale (UPDRS) to measure the severity of Parkinson's disease. Evaluations often fail to consider the health-related quality of life (HrQoL) or apply disease-specific instruments. Health-economic studies normally use estimates of utilities to calculate quality-adjusted life years. We aimed to develop an estimation algorithm for EuroQol- 5 dimensions (EQ-5D)-based utilities from clinical (UPDRS) or disease-specific HrQoL data in the absence of original utilities estimates. METHODS: Linear and fractional polynomial regression analyses were performed with data from a study of Parkinson's disease patients (n=138) to predict the EQ-5D index values from UPDRS and Parkinson's disease questionnaire eight dimensions (PDQ-8) data. German and European weights were used to calculate the EQ-5D index. The models were compared by R2, the root mean square error (RMS), the Bayesian information criterion, and Pregibon's link test. Three independent data sets validated the models. RESULTS: The regression analyses resulted in a single best prediction model (R2: 0.713 and 0.684, RMS: 0.139 and 13.78 for indices with German and European weights, respectively) consisting of UPDRS subscores II, III, IVa-c as predictors. When the PDQ-8 items were utilised as independent variables, the model resulted in an R2 of 0.60 and 0.67. The independent data confirmed the prediction models. CONCLUSION: The best results were obtained from a model consisting of UPDRS subscores II/III/IV a-c. Although a good model fit was observed, primary EQ-5D data are always preferable. Further validation of the prediction algorithm within large, independent studies is necessary prior to its generalised use.
    Health and Quality of Life Outcomes 03/2013; 11(1):35. DOI:10.1186/1477-7525-11-35 · 2.10 Impact Factor
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    ABSTRACT: In this article, we address the notoriously difficult problem to quantitatively link measured Raman depolarization values to theoretical polarizability tensor quantities, since quantum calculations do not incorporate experimental parameters. For this, we introduce a numerical model to calculate, for realistic experimental configurations, effective Raman line strength functions, Φ, which find their way into depolarization ratios, ρ. The model is based on interlinked integrations over the angles in the light collection path and a finite Raman source volume along the excitation laser beam. The model deals also with the conditional aperture parameters, associated with more than one optical component in the light collection path. Finally, we also can take into account polarization aberrations introduced by the sample cell windows. The procedure was fully tested for Raman depolarization spectra of selected hydrogen isotopologues. Distinct aspects affecting Raman depolarization data were validated, namely: (1) excitation polarization impurities; (2) extended Raman excitation volumes; (3) Raman light collection over finite solid angles; and (4) polarization aberrations introduced by optics in the light collection path. The correction of the experimental measurement data for the aforementioned effects resulted in depolarization ratios for the Q1(J " ) Raman lines of H2 and T2, which mostly differed by less than 5% from those obtained by quantum-calculations.
    Journal of Raman Spectroscopy 03/2013; 44(3). DOI:10.1002/jrs.4201 · 2.52 Impact Factor
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    ABSTRACT: The KArlsruhe TRItium Neutrino (KATRIN) experiment will measure the absolute mass scale of neutrinos with a sensitivity of m ν = 200 meV/ c 2 by high-precision spectroscopy close to the tritium β -decay endpoint at 18.6 keV. Its Windowless Gaseous Tritium Source (WGTS) is a β -decay source of high intensity (10 11 s −1 ) and stability, where high-purity molecular tritium at 30 K is circulated in a closed loop with a yearly throughput of 10 kg. To limit systematic effects the column density of the source has to be stabilized at the 10 −3 level. This requires extensive sensor instrumentation and dedicated control and monitoring systems for parameters such as the beam tube temperature, injection pressure, gas composition and so on. In this paper, we give an overview of these systems including a dedicated laser-Raman system as well as several β -decay activity monitors. We also report on the results of the WGTS demonstrator and other large-scale test experiments giving proof-of-principle that all parameters relevant to the systematics can be controlled and monitored on the 10 −3 level or better. As a result of these works, the WGTS systematics can be controlled within stringent margins, enabling the KATRIN experiment to explore the neutrino mass scale with the design sensitivity
    New Journal of Physics 10/2012; 14(10):103046. DOI:10.1088/1367-2630/14/10/103046 · 3.67 Impact Factor
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    ABSTRACT: The aim of the Karlsruhe Tritium Neutrino experiment - KATRIN - is the direct (model-independent) measurement of the mass of the electron anti-neutrino [T. Thümmler, Introduction to direct neutrino mass measurements and KATRIN, Neutrino 2010 (Athens, Greece).]. For that purpose a windowless gaseous tritium source WGTS is used, with a tritium throughput of 40 g/day. In order to reach the design sensitivity of 0.2 eV/c2 (90% C.L.) the key parameters of the tritium source, i.e. the gas inlet rate and the gas composition, have to be stabilized and monitored at the 0.1 % level (1σ). Any small change of the tritium gas composition will manifest itself in non-negligible effects on the KATRIN measurements; therefore, precise methods to specifically monitor the gas composition have to be implemented. Laser Raman Spectroscopy is the method of choice for the monitoring of the gas composition because it is a non-invasive and fast in-line measurement technique. An overview of the current Raman activities at Tritium Laboratory Karlsruhe (TLK) is given.
    Nuclear Physics B - Proceedings Supplements 08/2012; 229–232:492 -. DOI:10.1016/j.nuclphysbps.2012.09.129 · 0.88 Impact Factor
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    ABSTRACT: Safe, reliable, and efficient tritium management in the breeder blanket will have to face unprecedented technological challenges. Beside the efficiency for tritium recovery from the breeder blanket (Tritium Extraction (TES) and Coolant Purification Systems (CPS)), the accuracy for tritium tracking between the inner and the outer fuel cycle must also be demonstrated. This paper focuses on the recent R&D carried out at the Tritium Laboratory Karlsruhe to tackle these issues. For ITER, the recently consolidated TES and CPS designs comprise adsorption columns and getter beds operated in semi-continuous mode. Different approaches for the tritium accountancy stage (TAS) have been evaluated. Balancing static (batch-wise gas collection at the TBM outlets and the tritium plant) or dynamic (in/on-line) approaches with respect to the expected analytical performances and integration issues, the first conceptual design of the TAS for EU TBMs is presented. For DEMO, the overall strategy for tritium recovery and tracking has been revisited. The necessity for on-line real-time tritium accountancy and improved process efficiency suggest the use of continuous processes such as permeator and catalytic membrane reactor. The main benefits combining the PERMCAT process with advanced membranes is discussed with respect to process improvements and facilitated accountancy using spectroscopic methods.
    Fusion Engineering and Design 03/2012; 87(7–8):1206-1213. DOI:10.1016/j.fusengdes.2012.02.105 · 1.15 Impact Factor
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    ABSTRACT: For monitoring and control of gaseous tritium sources in fuel circulation systems of fusion reactors beta induced X-ray spectrometry (BIXS) seems to be an applicable method. The characteristics of a BIXS monitoring setup built at TLK were examined. A low-noise silicon drift detector (SDD) was used together with two thin beryllium windows evaporated with gold films of 100 nm for efficient X-ray production. The measured X-ray intensity was proportional to the tritium partial pressure and the average detection efficiency was evaluated as 32.6 x 10(-8) cps/Bq. A tritium memory effect was revealed. From the results it was concluded that such a monitoring system would be a useful complement for tritium analytics devices if well designed in terms of memory effect suppression.
    Fusion Engineering and Design 01/2012; DOI:10.1016/j.fusengdes.2012.11.001 · 1.15 Impact Factor
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    ABSTRACT: The objective of this review was to assess models of cost effectiveness for Parkinson's disease (PD) published after July 2002 and to derive recommendations for future modelling. A systematic literature search was performed in the databases PubMed, Current Contents, EMBASE, EconLit, the Cochrane Database of Systematic Reviews, and DARE (Database of Abstracts of Reviews of Effectiveness), NHS EED (Economic Evaluation Database) and HTA (Health Technology Assessment) of the UK NHS Centre for Review and Dissemination (July 2002 to March 2010). Only fully published studies using decision trees, Markov models, individual simulation models or sets of mathematical equations were included. Most of the 11 studies identified used Markov models (n = 9) and two employed were based on decision trees. Based on the Hoehn & Yahr (HY) scale, authors evaluated the cost effectiveness of drug treatments (n = 6), surgical approaches such as deep brain stimulation (n = 1) or striatal cell grafting (n = 1), and diagnostic procedures such as single photon emission computed tomography (SPECT) testing (n = 3) over a time horizon of 1 year to lifetime. Costs were adapted to address a societal and/or healthcare provider/third-party payer perspective. All but one of the interventions investigated were considered cost effective or cost saving. Cost-effectiveness modelling in PD between 2003 and 2010 showed only minor improvement when compared with our earlier review of models published from 1998 up to 2003. Cost-effectiveness modelling recommendations were complied with to only a limited extent, leaving room for quality improvement. More advanced modelling approaches may, so far, be under-represented, but may be used in the future, driven by the research question. Adverse events of treatment, co-morbidities or disease complications are not yet sufficiently included in the models to adequately represent clinical reality.
    PharmacoEconomics 12/2011; 29(12):1025-49. DOI:10.2165/11587110-000000000-00000 · 3.34 Impact Factor
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    ABSTRACT: In modern particle and accelerator physics as well as in nuclear fusion experiments turbo-molecular pumps (TMP) are used in close proximity to super-conducting magnets. This can cause considerable heating of the fast moving rotor by eddy currents, which can ultimately lead to the destruction of the pump. Motivated by the KATRIN neutrino experiment, where TMPs are operated close to super-conducting magnets, a measurement programme has been elaborated to investigate the effect of magnetic fields on TMPs. An infra-red pyrometer has been used to measure the temperature of the revolving rotor. In addition the effect of different gas loads on the temperature was investigated. With these data a simplified model has been developed to predict the evolution of the rotor temperature over time, using easy to measure parameters. Here we introduce the new model and present first measurements and their application in predicting the rotor temperature in the pulsed field of a nuclear fusion experiment.
    Vacuum 11/2011; 86(4). DOI:10.1016/j.vacuum.2011.07.063 · 1.43 Impact Factor
  • Value in Health 11/2011; 14(7). DOI:10.1016/j.jval.2011.08.112 · 2.89 Impact Factor
  • Value in Health 11/2011; 14(7). DOI:10.1016/j.jval.2011.08.083 · 2.89 Impact Factor
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    ABSTRACT: The gas circulation loop LOOPINO has been set up and commissioned at Tritium Laboratory Karlsruhe (TLK) to perform Raman measurements of circulating tritium mixtures under conditions similar to the inner loop system of the neutrino-mass experiment KATRIN, which is currently under construction. A custom-made interface is used to connect the tritium containing measurement cell, located inside a glove box, with the Raman setup standing on the outside. A tritium sample (purity > 95%, 20 kPa total pressure) was circulated in LOOPINO for more than three weeks with a total throughput of 770 g of tritium. Compositional changes in the sample and the formation of tritiated and deuterated methanes CT4-nX n (X=H,D; n=0,1) were observed. Both effects are caused by hydrogen isotope exchange reactions and gas-wall interactions, due to tritium ß decay. A precision of 0.1% was achieved for the monitoring of the T2 Q1-branch, which fulfils the requirements for the KATRIN experiment and demonstrates the feasibility of high-precision Raman measurements with tritium inside a glove box. Compositional changes; Deuterated methanes; ; Gas-wall interactions; Gloveboxes; High-precision; Hydrogen isotope exchange reaction; Inner loops; Laser Raman spectroscopy; Measurement cell; Raman measurements; Total pressure; Tritium Laboratory Karlsruhe
    Fusion Science and Technology 10/2011; 60(3):925-930. · 0.59 Impact Factor
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    ABSTRACT: In this paper we discuss the implementation of Raman spectroscopy for compositional analysis, and monitoring and control of tritium-carrying gas flows. Specifically, we discuss how the criteria for the detection and handling of tritium impact on the conceptual design and actual system suitability and performance in applications such as the KATRIN experiment or the ITER fuel cycle, which require real-time, in-line monitoring and control.
    Fusion Science and Technology 10/2011; 60(3):976-981. · 0.59 Impact Factor
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    ABSTRACT: The gas-flow reduction factor of the second forward Differential Pumping Section (DPS2-F) for the KATRIN experiment was determined using a dedicated vacuum-measurement setup and by detailed molecular-flow simulation of the DPS2-F beam tube and of the measurement apparatus. In the measurement, non-radioactive test gases deuterium, helium, neon, argon and krypton were used, the input gas flow was provided by a commercial mass-flow controller, and the output flow was measured using a residual gas analyzer, in order to distinguish it from the outgassing background. The measured reduction factor with the empty beam tube at room temperature for gases with mass 4 is 1.8(4)E4, which is in excellent agreement with the simulated value of 1.6E4. The simulated reduction factor for tritium, based on the interpolated value for the capture factor at the turbo-molecular pump inlet flange is 2.5E4. The difference with respect to the design value of 1E5 is due to the modifications in the beam tube geometry since the initial design, and can be partly recovered by reduction of the effective beam tube diameter.
    Vacuum 07/2011; 86(8). DOI:10.1016/j.vacuum.2011.10.017 · 1.43 Impact Factor
  • 03/2011; 1(1):13. DOI:10.1016/j.baga.2011.01.004
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    ABSTRACT: An electron-impact ion source based on photoelectron emission was developed for ionization of gases at pressures below 10(-4) mbar in an axial magnetic field in the order of 5 T. The ion source applies only dc fields, which makes it suitable for use in the presence of equipment sensitive to radio-frequency (RF) fields. The ion source was successfully tested under varying conditions regarding pressure, magnetic field, and magnetic-field gradient, and the results were studied with the help of simulations. The processes in the ion source are well understood, and possibilities for further optimization of generated ion currents are clarified.
    The Review of scientific instruments 01/2011; 82(1):013303. DOI:10.1063/1.3504372 · 1.58 Impact Factor

Publication Stats

1k Citations
153.76 Total Impact Points

Institutions

  • 2009–2013
    • Karlsruhe Institute of Technology
      • Institute of Technical Physics
      Carlsruhe, Baden-Württemberg, Germany
  • 2011
    • Hospital Universitario de Canarias
      San Cristóbal de La Laguna, Canary Islands, Spain
  • 2004–2011
    • Philipps University of Marburg
      • Klinik für Neurologie (Marburg)
      Marburg, Hesse, Germany
    • Ludwig-Maximilian-University of Munich
      • Department of Medical Informatics
      München, Bavaria, Germany
  • 2010
    • Fachhochschule für Gesundheit Gera
      Gera, Thuringia, Germany
  • 2007–2008
    • Private Universität für Gesundheitswissenschaften, Medizinische Informatik und Technik
      • Institute of Health Informatics
      Solbad Hall in Tirol, Tyrol, Austria
  • 2006
    • Technische Universität München
      München, Bavaria, Germany
  • 2004–2005
    • University of Bonn
      • Department of Neurobiology
      Bonn, North Rhine-Westphalia, Germany
  • 2000–2005
    • Johannes Gutenberg-Universität Mainz
      • Institute of Physics
      Mayence, Rheinland-Pfalz, Germany
  • 2003–2004
    • Harvard University
      Cambridge, Massachusetts, United States