An Analysis of the Wash and Flotation Deinking Processes

The purpose of this paper is to obtain data, so that we may compare the ability of Floatation vs. Wash deinking to produce a paper of equal standards as the original unprinted base-stock. It was determined that both flotation and wash deinked stock with the addition of 40% fresh pulp can produce a paper of equal physical and optical properties as the unprinted stock from which it was made. Floatation deinked stock was found have a higher materials cost, however, it displayed better strength and opacity properties than wash deinked stock. The difference is thought to result from a large fines loss in the wash deinking process

Micellization in the presence of polyelectrolyte

We present a simple model to study micellization of amphiphiles condensed on a rodlike polyion. Although the mean field theory leads to a first order micellization transition for sufficiently strong hydrophobic interactions, the simulations show that no such thermodynamic phase transition exists. Instead, the correlations between the condensed amphiphiles can result in a structure formation very similar to micelles.Comment: 8 pages, 7 figure

Complexation of DNA with Cationic Surfactant

Transfection of an anionic polynucleotide through a negatively charged membrane is an important problem in genetic engineering. The direct association of cationic surfactant to DNA decreases the effective negative charge of the nucleic acid, allowing the DNA-surfactant complex to approach a negatively charged membrane. The paper develops a theory for solutions composed of polyelectrolyte, salt, and ionic surfactant. The theoretical predictions are compared with the experimental measurements.Comment: 9 pages, 3 figure

Charge inversion in DNA-amphiphile complexes: Possible application to gene therapy

We study a complex formation between the DNA and cationic amphiphilic molecules. As the amphiphile is added to the solution containing DNA, a cooperative binding of surfactants to the DNA molecules is found. This binding transition occurs at specific density of amphiphile, which is strongly dependent on the concentration of the salt and on the hydrophobicity of the surfactant molecules. We find that for amphiphiles which are sufficiently hydrophobic, a charge neutralization, or even charge inversion of the complex is possible. This is of particular importance in applications to gene therapy, for which the functional delivery of specific base sequence into living cells remains an outstanding problem. The charge inversion could, in principle, allow the DNA-surfactant complexes to approach negatively charged cell membranes permitting the transfection to take place.Comment: Latex, 5 figure

On properties of (weakly) small groups

A group is small if it has countably many complete $n$-types over the empty set for each natural number n. More generally, a group $G$ is weakly small if it has countably many complete 1-types over every finite subset of G. We show here that in a weakly small group, subgroups which are definable with parameters lying in a finitely generated algebraic closure satisfy the descending chain conditions for their traces in any finitely generated algebraic closure. An infinite weakly small group has an infinite abelian subgroup, which may not be definable. A small nilpotent group is the central product of a definable divisible group with a definable one of bounded exponent. In a group with simple theory, any set of pairwise commuting elements is contained in a definable finite-by-abelian subgroup. First corollary : a weakly small group with simple theory has an infinite definable finite-by-abelian subgoup. Secondly, in a group with simple theory, a normal solvable group A of derived length n is contained in an A-definable almost solvable group of class n

Physician decision making on new technologies and the role of coverage with evidence development

Published under a different title: Felgner, S., Ex, P., & Henschke, C. (2018). Physicians’ Decision Making on Adoption of New Technologies and Role of Coverage with Evidence Development: A Qualitative Study. Value in Health, 21(9), 1069–1076. https://doi.org/10.1016/j.jval.2018.03.006OBJECTIVES: To foster value-based pricing and coverage with evidence development in Germany, certain new diagnostic and treatment methods have been subject to a benefit assessment since 2016 to determine their reimbursement. Although this is a paradigm shift, the German approach is limited to some few specific technologies for which reimbursement is requested. As physicians encounter this regulatory instrument, the aim of the study was to understand physicians' decision making regarding the adoption of new medical technologies and to identify their perspectives on the evidence base and financing with additional reimbursement systems. METHODS: From April to August 2017, semistructured interviews with chief and senior physicians of vascular surgery and cardiology in inpatient care in Germany were conducted (N = 23). The interviews were carried out by one researcher in one-to-one appointments or via telephone. Data were analyzed inductively to identify factors and generate thematic categories using qualitative content analysis. RESULTS: We identified 52 factors in eight categories influencing physicians' adoption of new technologies. The evidence base for new technologies was criticized (e.g., lack of available studies). Physicians' knowledge of the regulation of market approval and innovation payments varied. They recommended the utilization of new technologies in certain specialist centers and the facilitation of observational studies. CONCLUSIONS: Physicians saw the need for the new approach and supported its aim. However, its design and implementation appeared to be questionable from their medical perspective. The provision of summarized information on the benefit of technologies might be a possibility to assist physicians' decision making.BMBF, 01EH1604A, Berliner Zentrum der Gesundheitsökonomischen Forschun

Jurisdictions on the reimbursement of new medical technologies by public health insurance: A systematic review

Hintergrund: Die Erstattung neuer Gesundheitstechnologien wird nicht selten über Sozialgerichte eingeklagt. Dabei liegt es nahe, dass gerichtliche Entscheidungen auch Einzelfallentscheidungen der Krankenkassen und damit den Patientenzugang insgesamt beeinflussen. Ziel der Studie: Ziel ist anhand von Rechtsprechungen zu identifizieren, welche Technologien wiederholt eingeklagt wurden und ob diese zu einer Kostenerstattung führten. Dabei liegt der Fokus auf Unterschieden zwischen Sektoren, Technologiegruppen sowie Indikationen. Auf dieser Grundlage soll exemplarisch anhand von vier Technologien analysiert werden, ob die Ergebnisse der gerichtlichen Entscheidungen zur Kostenerstattung gleicher Gesundheitstechnologien über die Jahre variieren. Methodik: Mittels einer systematischen Datenbankrecherche wurden Rechtsprechungen von deutschen Sozialgerichten zu neuen Gesundheitstechnologien der Jahre 2011 bis 2016 gesucht. Ausgewertet wurden solche Rechtsprechungen, bei denen Sozialgerichte über die Kostenerstattung von Technologien zur Behandlung einzelner Personen entschieden hatten. Ergebnisse: Die Recherche brachte 284 relevante Rechtsprechungen hervor. Bei einem Drittel der Klagen wurden die Krankenkassen zur Kostenerstattung verpflichtet, im stationären Sektor häufiger als im ambulanten. Technologien zu Erkrankungen der Augen und Ohren wurden am häufigsten bewilligt. Dabei kamen Sozialgerichte auch zu unterschiedlichen Kostenerstattungsentscheidungen bei inhaltlich und zeitlich ähnlichen Fällen. Die Rechtsprechungen stehen in Teilen im Widerspruch zu nachfolgenden Entscheidungen der Methodenbewertung durch den Gemeinsamen Bundesausschuss (G-BA). Schlussfolgerung: Die Uneinheitlichkeit der Erstattungsentscheidungen kann zu Unsicherheit darüber führen, welche Technologien den ‚allgemein anerkannten Stand der medizinischen Erkenntnisse‘ erfüllen. Dabei erweist es sich für Patienten und Ärzte als problematisch, dass Klagen zu Behandlungsmethoden über Jahre hinweg eingereicht werden, ohne dass Nutzen und Erstattungsfähigkeit systematisch bewertet sind.Background: In Germany reimbursement for new medical technologies is often enforced before a social court. It is likely that these judicial decisions also affect the sickness funds’ decisions on requests for reimbursement and thus patient access to new technologies in general. Objectives: The aim of this study was to identify the technologies that have repeatedly generated court actions and whether these actions have been successful. The focus was on differences between sectors, technology groups and indications. Based on this, we analysed in a case study whether judicial decisions on the reimbursement of the same technologies vary across the years. Material and methods: Based on a systematic review, we identified judicial decisions of German social courts on new technologies for the years 2011 to 2016. The analysis included social court decisions on reimbursements for technologies used in the treatment of individual patients. Results: 284 judicial decisions on new technologies were considered in the analysis. In one third of the cases, the sickness funds were required to reimburse the costs, with a higher percentage in inpatient than in outpatient care. Technologies used in treatment of diseases of the eyes and the ears were granted most frequently. In cases involving similar circumstances the social courts sometimes came to conflicting decisions; these decisions are, in part, contradictory to subsequent assessments by the Joint Federal Committee (G-BA). Conclusions: Decisions as to whether reimbursement for new technologies is granted or not do not appear to follow a systematic approach. In the context of the seemingly innovation-friendly policy in inpatient care, there is uncertainty with regard to the “generally accepted state of medical knowledge.” It is problematic for both patients and their treating physicians that over a number of years legal proceedings are being initiated for technologies that have not been subjected to a systematic assessment of their benefit

Introducing Explicit Causality in Object-oriented Hybrid System Modeling

International audienceAlong with the rapid development of embedded devices and network technology, the area of CyberPhysical Systems (CPS), has arisen. In terms of modeling and simulation, CPS—like many technical systems—have ahybrid nature, i.e., discrete-event behavior and continuous-time dynamics have to be integrated with each other.Basically, this integration is supported by modern object-oriented modeling paradigms such as Modelica®. Theequation-based concept resolves the causality between interconnected components, which qualifies this modelingscheme for complex multi-domain systems. However, in hybrid systems, explicit causality is required to correctlymanage iterative events. This paper highlights these issues, including algorithmic loops and instantaneous multipleupdates, which essentially arise from incompatibilities between the object-oriented concept and specific discrete-eventphenomena. We discuss several possible solutions and introduce the concept of re-allocating the objects’ behavioralintelligence

Polyelectrolyte Solutions with Multivalent Salts

We investigate the thermodynamic properties of a polyelectrolyte solution in a presence of {\it multivalent} salts. The polyions are modeled as rigid cylinders with the charge distributed uniformly along the major axis. The solution, besides the polyions, contain monovalent and divalent counterions as well as monovalent coions. The strong electrostatic attraction existing between the polyions and the counterions results in formation of clusters consisting of one polyion and a number of associated monovalent and divalent counterions. The theory presented in the paper allows us to explicitly construct the Helmholtz free energy of a polyelectrolyte solution. The characteristic cluster size, as well as any other thermodynamic property can then be determined by an appropriate operation on the free energy