Pressure-dependent hydrometra dimensions in hysteroscopy

Aim: To investigate the relation between intrauterine pressures and volumes for virtual-reality-based surgical training in hysteroscopy. Material and methods: Ten fresh extirpated uteri were insufflated by commercial hysteroscopy pump and imaged by computer tomography (CT) under intrauterine air pressure in distension-collapse cycles between 0, 20 (150mmHg), and 0kPa, performing a CT scan at every step at about 2.7kPa (20mmHg). Results: An initial threshold pressure to distend the cavity was avoided by introducing the insufflation tube up to the fundus. The filling and release phases of seven uteri that were completely distended showed the typical characteristics of a hysteresis curve which is expected from a viscoelastic, nonlinear, anisotropic soft tissue organ like the uterus. In three cases tightening the extirpated uterus especially at the lateral resection lines caused significant problems that inhibited registration of a complete distension-collapse cycle. Interpolated volumes for complete distended cavities and extrapolated for incomplete data sets, derived from the digitally reconstructed three-dimensional (3D) geometries, ranged from 0.6 to 11.4mL at 20kPa. These values highly correlate with the uterine volume (not insufflated) considering different biometric data of the uteri and patient data. Linear (R 2=0.66) and quadratic least-squares fits (R 2=0.74) were used to derive the formulas y=0.069x and y=0.00037x 2+0.036x, where x is the uterine volume in mL (not insufflated) and y is the cavity volume in mL at 20kPa intrauterine pressure. Conclusions: Our experimental hysteroscopical setup enabled us to reconstruct the changes in volumes of insufflated uteri under highly realistic conditions in 3D. The relation between intrauterine pressure and cavity volume in distension-collapse cycles describes a typical hysteresis curv

IMPROVE ::enhancing demand-side energy reduction through informative billing strategies

In Switzerland, most of the information available on the energy bills corresponds to the minimum legal requirements imposed by national regulations. Such a scarcely understandable information does not motivate consumers to reflect on their level of energy consumption. A more user-friendly information presentation on the energy bill may induce increased awareness, laying the grounds for behaviour changes required to achieve the goals of the Energy Strategy 2050 of the Swiss Federal Council. The aim of the IMPROVE project was to explore how both consumers and energy utilities evaluate and perceive the importance of introducing enriched information on the energy bill to encourage households to reconsider their energy consumption levels

Outcomes in Newly Diagnosed Atrial Fibrillation and History of Acute Coronary Syndromes: Insights from GARFIELD-AF

BACKGROUND: Many patients with atrial fibrillation have concomitant coronary artery disease with or without acute coronary syndromes and are in need of additional antithrombotic therapy. There are few data on the long-term clinical outcome of atrial fibrillation patients with a history of acute coronary syndrome. This is a 2-year study of atrial fibrillation patients with or without a history of acute coronary syndromes