99 research outputs found
Silicon micro venturi nozzles for cost-efficient spray coating of thin organic P3HT/PCBM layers
Improvements on spray coating are of particular interest to different fields of technology as it is a scalable deposition method and processing from solutions offer various application possibilities outside of typical facilities. When it comes to the deposition of expensive and film-forming media such as organic semiconductors, consumption and nozzle cleaning issues are of particular importance. We demonstrate the simple steps to design and fabricate micro venturi nozzles for economical spray coating with a consumption as low as 30-50 ”l centerdot min. For spray coating an active area of 25âcm a 2.45-4.01 fold coating efficiency is observed compared to a conventional airbrush nozzle set. The electrical characterization of first diodes sprayed with an active layer thickness of ~750ânm using a single micronozzle at a coating speed of 1.7âcm2 centerdot minâ1 reveals a good external quantum efficiency of 72.9% at 532ânm and a dark current of ~7.4 centerdot 10 mA centerdot cm, both measured atâââ2 V. Furthermore, the high resistance of the micronozzles against solvents and most acids is provided through realization in a silicon wafer with silicon dioxide encapsulation, therefore allowing easy and effective cleaning
Megatrends in Healthcare: Review for the Swiss National Science Foundationâs National Research Programme 74 (NRP74) âSmarter Health Careâ.
Objectives: In this paper, we present a review of some relevant megatrends in healthcare conducted as part of the Swiss National Science Foundationâs National Research Programme 74 (NRP74) âSmarter Health Care.â Our aim is to stimulate discussions about long-term tendencies underlying the current and future development of the healthcare system.
Methods: Our teamâa multidisciplinary panel of researchers involved in the NRP74âwent through an iterative process of internal consultations followed by a rapid literature review with the goal of reaching group consensus concerning the most relevant megatrends in healthcare.
Results: Five megatrends were identified, namely: 1) Socio-demographic shifts. 2) Broadening meaning of âhealth.â 3) Empowered patients and service users. 4) Digitalization in healthcare. 5) Emergence of new models of care. The main features of each megatrend are presented, drawing often on the situation in Switzerland as a paradigmatic example and adding reflections on the potential influence of the COVID19 pandemic on them.
Conclusion: Considering the long-term megatrends affecting the evolution of healthcare is importantâamongst other thingsâto understand and contextualise the relevance and implications of innovative health services research results
Intersection Complexity and Its Influence on Human Drivers
As mixed traffic between automated vehicles and human drivers in inner city becomes more prevalent in the near future understanding and predicting driversâ behavior is important. Additionally, there is a wide variety of inner city intersections. They can differ greatly in traffic density, visibility, number of objects and many more aspects. This difference in complexity has an influence on the behavior of human drivers at intersections. To further understand the effect of complexity we conducted a naturalistic driving field study in inner city traffic with 34 participants. We focused on unsignalized intersections because there is a greater range of possibly ambiguous situations at such intersections than compared to e.g. an intersection regulated by traffic lights. Features describing the behavior (commit distance, drop in velocity and the minimal velocity) are extracted from the driven trajectories. Additionally, we define intersection complexity by several features describing an intersection. These features include both the static (street, visible and driveable width, the visibility of the other streets and the number of trees) and the dynamic environment (entry location and turning direction, numbers of vehicles, vehicles with interaction, vehicles with priority, vehicles having to yield and pedestrians). Based on those we show that the entry location and the turning direction have a significant effect on the behavior features. Additionally, we show that the typical behavior of human drivers can be predicted by the features describing an intersectionâs complexity. Finally, the feature set is reduced in dimensionality for a more condensed intersection description. For that we test reduced feature sets as well as feature sets from an autoencoder and show that prediction is feasible with them as well
PMMA-Cement-PLIF Is Safe and Effective as a Single-Stage Posterior Procedure in Treating Pyogenic Erosive Lumbar Spondylodiscitis-A Single-Center Retrospective Study of 73 Cases.
BACKGROUND
Surgical treatment for erosive pyogenic spondylodiscitis of the lumbar spine is challenging as, following debridement of the intervertebral and bony abscess, a large and irregular defect is created. Sufficient defect reconstruction with conventional implants using a posterior approach is often impossible. Therefore, we developed the "Cement-PLIF", a single-stage posterior lumbar procedure, combining posterior lumbar interbody fusion (PLIF) with defect-filling using antibiotic-loaded polymethylmethacrylate (PMMA). This study first describes and evaluates the procedure's efficacy, safety, and infection eradication rate. Radiological implant stability, bone-regeneration, sagittal profile reconstruction, procedure-related complications, and pre-existing comorbidities were further analyzed.
METHODS
A retrospective cohort study analyzing 73 consecutive patients with a minimum of a one-year follow-up from 2000-2017. Patient-reported pain levels and improvement in infectious serological parameters evaluated the clinical outcome. Sagittal profile reconstruction, anterior bone-regeneration, and posterior fusion were analyzed in a.p. and lateral radiographs. A Kaplan-Meier analysis was used to determine the impact of pre-existing comorbidities on mortality. Pre-existing comorbidities were quantified using the Charlson-Comorbidity Index (CCI).
RESULTS
Mean follow-up was 3.3 (range: 1-16; ±3.2) years. There was no evidence of infection persistence in all patients at the one-year follow-up. One patient underwent revision surgery for early local infection recurrence (1.4%). Five (6.9%) patients required an early secondary intervention at the same level due to minor complications. Radiological follow-up revealed implant stability in 70/73 (95.9%) cases. Successful sagittal reconstruction was demonstrated in all patients (p < 0.001). There was a significant correlation between Kaplan-Meier survival and the number of pre-existing comorbidities (24-months-survival: CCI †3: 100%; CCI ℠3: 84.6%; p = 0.005).
CONCLUSIONS
The Cement-PLIF procedure for pyogenic erosive spondylodiscitis is an effective and safe treatment as evaluated by infection elimination, clinical outcome, restoration, and maintenance of stability and sagittal alignment
Feasibility of postoperative spine stereotactic body radiation therapy in proximity of carbon and titanium hybrid implants using a robotic radiotherapy device.
BACKGROUND AND PURPOSE
To assess the feasibility of postoperative stereotactic body radiation therapy (SBRT) for patients with hybrid implants consisting of carbon fiber reinforced polyetheretherketone and titanium (CFP-T) using CyberKnife.
MATERIALS AND METHODS
All essential steps within a radiation therapy (RT) workflow were evaluated. First, the contouring process of target volumes and organs at risk (OAR) was done for patients with CFP-T implants. Second, after RT-planning, the accuracy of the calculated dose distributions was tested in a slab phantom and an anthropomorphic phantom using film dosimetry. As a third step, the accuracy of the mandatory image guided radiation therapy (IGRT) including automatic matching was assessed using the anthropomorphic phantom. For this goal, a standard quality assurance (QA) test was modified to carry out its IGRT part in presence of CFP-T implants.
RESULTS
Using CFP-T implants, target volumes could precisely delineated. There was no need for compromising the contours to overcome artifact obstacles. Differences between measured and calculated dose values were below 11% for the slab phantom, and at least 95% of the voxels were within 5% dose difference. The comparisons for the anthropomorphic phantom showed a gamma-passing rate (5%, 1Â mm) of at least 97%. Additionally the test results with and without CFP-T implants were comparable. No issues concerning the IGRT were detected. The modified machine QA test resulted in a targeting error of 0.71Â mm, which corresponds to the results of the unmodified standard tests.
CONCLUSION
Dose calculation and delivery of postoperative spine SBRT is feasible in proximity of CFP-T implants using a CyberKnife system
Wie Risikogruppen und Hausrzte das erste Pandemiejahr erlebten.
Als die COVID-19-Pandemie Anfang 2020 unseren Alltag auf den Kopf stellte und es zum ersten Shutdown kam, gab es insbesondere fĂŒr Betroffene aus sogenannten Risikogruppen und deren HausĂ€rzte und HausĂ€rztinnen neue Herausforderungen. Ein Forschungsprojekt zeigt nun auf, welche Auswirkungen die Pandemie auf die KontinuitĂ€t der Grundversorgung hatte
eHealth supported multi-months dispensing of antiretroviral therapy: a mixed-methods preference assessment in rural Lesotho
Background
Multi-month dispensing (MMD) of antiretroviral therapy (ART) represents one approach of differentiated service delivery (DSD) aiming to improve quality and cost-effectiveness for HIV services in resource-limited settings. However, reduction in clinic visits for people living with HIV (PLWH) should go along with out-of-clinic care tailored to PLWH`s preferences and comorbidities to maintain quality of care. eHealth supported MMD offers a potential solution.
Methods
Between October 2019 and January 2020 we assessed preferences on an eHealth supported MMD package among adult PLWH attending routine ART care at a rural clinic in Lesotho using a mixed-methods approach. Participants reported their preferences among different refill and eHealth options. They were invited to test automated text messages (SMS) informing about their viral load results, an automated tuberculosis symptoms screening call and telemedical support by an expert nurse. Telemedical service comprised a call-back option if participants required any additional support and adherence counselling for closer follow-up of participants with unsuppressed viral loads. After 6 weeks, participants were followed-up to assess perception of the chosen eHealth support using a qualitative approach.
Results
Among 112 participants (median age = 43 years; 74% female), 83/112 (75%) preferred MMD for 6â12 months (median = 9 months, IQR = [5, 12]). Neither sex, age, employment, costs and time for travel to clinic, nor the duration of taking ART correlated with the MMD preference. All 17 participants attending routine viral load measurement wished to receive the result via SMS. Fifteen (19.2%) participants requested a telemedical nurse call-back during the study period. All participants with recent unsuppressed viral load (N = 13) requested telemedical adherence counselling for closer follow-up. Among 78 participants followed-up, 76 (97%) would appreciate having the call-back option in future. Seventy-five participants (67%) received and evaluated the automated symptomatic tuberculosis screening call, overall 71 (95%) appreciated it.
Conclusions
The great majority of PLWH in this study preferred 6â12 months MMD and appreciated the additional eHealth support, including viral load results via SMS, telemedical nurse consultations and automated tuberculosis symptom screening calls. eHealth supported MMD packages appear to be a promising approach for DSD models and should be assessed for clinical endpoints and cost-effectiveness in larger studies
Determinants of vaccine hesitancy in Switzerland: study protocol of a mixed-methods national research programme
Vaccine hesitancy is a complex public health issue referring to concerns about the safety, efficacy or need for vaccination. Relatively little is known about vaccine hesitancy in Switzerland. This ongoing study (2017-2021) focuses on biomedical and complementary and alternative medicine (CAM) providers and their patients since healthcare professionals play important roles in vaccination decision-making. This national research programme seeks to assess the sociocultural determinants of vaccine hesitancy regarding childhood and human papillomavirus vaccines in Switzerland. We aim to provide a detailed characterisation of vaccine hesitancy, including CAM and biomedical perspectives, patient-provider interactions, and sociocultural factors, to establish the mediating effects of vaccine hesitancy on underimmunisation, and to design an intervention to improve vaccination communication and counselling among physicians, parents and adolescents.; Our transdisciplinary team employs a sequential exploratory mixed-methods study design. We have established a network of more than 150 medical providers across Switzerland, including more than 40 CAM practitioners. For the qualitative component, we conduct interviews with parents, youth, and biomedical and CAM providers and observations of vaccination consultations and school vaccination information sessions. For the quantitative component, a sample of 1350 parents of young children and 722 young adults (15-26 years) and their medical providers respond to questionnaires. We measure vaccine hesitancy with the Parent Attitudes about Childhood Vaccines 15-item survey and review vaccination certificates to assess vaccination status. We administer additional questions based on findings from qualitative research, addressing communication with medical providers, vaccine information sources and perceptions of risk control vis-Ă -vis vaccine-preventable diseases. The questionnaires capture sociodemographics, political views, religion and spirituality, and moral foundations.; The study was approved by the local ethics committee. The results will be published in peer-reviewed journals and disseminated to healthcare professionals, researchers and the public via conferences and public presentations
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Novel phase diagram behavior and materials design in heterostructural semiconductor alloys
Structure and composition control the behavior of materials. Isostructural alloying is historically an extremely successful approach for tuning materials properties, but it is often limited by binodal and spinodal decomposition, which correspond to the thermodynamic solubility limit and the stability against composition fluctuations, respectively. We show that heterostructural alloys can exhibit a markedly increased range of metastable alloy compositions between the binodal and spinodal lines, thereby opening up a vast phase space for novel homogeneous single-phase alloys. We distinguish two types of heterostructural alloys, that is, those between commensurate and incommensurate phases. Because of the structural transition around the critical composition, the properties change in a highly nonlinear or even discontinuous fashion, providing a mechanism for materials design that does not exist in conventional isostructural alloys. The novel phase diagram behavior follows from standard alloy models using mixing enthalpies from first-principles calculations. Thin-film deposition demonstrates the viability of the synthesis of these metastable single-phase domains and validates the computationally predicted phase separation mechanism above the upper temperature bound of the nonequilibrium single-phase region
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