Laboratory and intra-oral tests of the degradation of elastic chains

Two brands of elastic chain, Alastic (Unitek Co.) and Power Chain II (Ormco Co.), were tested for force development in laboratory and intra-oral experiments. During the laboratory test, the chains were extended to 180 and 215 per cent of their original passive length and the force exerted at this length was measured at the start and after 15 minutes, 2, 8 and 24 hours, 3 days and 1, 2, 3 and 4 weeks of continuous extension. The two brands behaved similarly. After 4 weeks, they had lost 25-30 per cent of their initial force. The decrease of the force value was greatest in the beginning of the test period, with a decline of 6-11 per cent during the first 15 minutes and 10-16 per cent during the first 2 hours. The intra-oral tests were performed in 10-25 subjects, who wore the elastic chains continuously for up to 4 weeks. The chains were extended up to 200 per cent of their original passive length. In one test, the force development was measured at the start and after 8 and 24 hours, 5 days and 1, 2, 3 and 4 weeks. In two other tests the force was measured after 1 day and 4 weeks, respectively. The two brands behaved similarly. The decline of the force value during intra-oral use was greater than in the laboratory tests. After 4 weeks, the force was only 43-52 per cent of the original value. The decline was greatest in the initial phase after insertion; after 8 hours the force had declined by 28-34 per cent. Thus, an initial force of 300g was reduced to 200g after 8 hours and to less than 150g after 4 weeks: in no specimen was the force after 4 weeks less than 100

NewOX - extending the online exXam system to provide automated formative evaluation of student text-based assignments

A cheat-resistant and foolproof distributed electronic application for summativeassessment of student learning outcomes has been developed and field tested "OnlineeXam" (OX). Good usability experience and feedback features for the students as wellas the lecturers were design goals of the implementation. The field tests showed therobustness of the system in a heterogenic PC pool environment, the ease of use and agood student learning outcome assessment ability (summative assessment) but a lackof a formative impact on the student learning efforts. The incorporation and adoption(for European needs) of a short essay assessment algorithm with a rich user interfaceis proposed

Dynamic plate osteosynthesis for fracture stabilization: how to do it

Plate osteosynthesis is one treatment option for the stabilization of long bones. It is widely accepted to achieve bone healing with a dynamic and biological fixation where the perfusion of the bone is left intact and micromotion at the fracture gap is allowed. The indications for a dynamic plate osteosynthesis include distal tibial and femoral fractures, some midshaft fractures, and adolescent tibial and femoral fractures with not fully closed growth plates. Although many lower limb shaft fractures are managed successfully with intramedullary nails, there are some important advantages of open-reduction-and-plate fixation: the risk of malalignment, anterior knee pain, or nonunion seems to be lower. The surgeon performing a plate osteosynthesis has the possibility to influence fixation strength and micromotion at the fracture gap. Long plates and oblique screws at the plate ends increase fixation strength. However, the number of screws does influence stiffness and stability. Lag screws and screws close to the fracture site reduce micromotion dramatically

Initial management of and outcome in patients with pneumococcal bacteremia: a retrospective study at a Swiss university hospital, 2003-2009

Purpose: The aim of this quality control study was to assess the time to initial diagnostic procedures and the time to the first dose of antibiotics in patients with pneumococcal bacteremia, and to investigate whether the timeliness of these interventions influenced outcome. Methods: We retrospectively studied patient characteristics, chronological sequence of diagnostic and therapeutic steps, and the course of disease of all patients with pneumococcal bacteremia at a Swiss university hospital between 2003 and 2009, and we analyzed associations between these factors and the length of hospital stay (LOS) and mortality. Results: A total of 102 episodes of pneumococcal bacteremia in 98 patients were analyzed, of whom 15.7% died during hospitalization. The median time (interquartile range [IQR]) to the first antibiotic dose was 4.0 (2.0-5.9)h, and the median times (IQR]) to blood cultures, chest radiograph, lumbar puncture, and brain computed tomography (CT) scan or magnetic resonance imaging (MRI) were 1.4 (0.5-3.3), 2.5 (1.2-4.2), 4.2 (2.7-7.2), and 2.3 (0.6-6.2)h, respectively. The time to diagnostic procedures and therapy were not associated with LOS or death. Risk factors for death in the univariable analysis were: Charlson comorbidity index [odds ratio [OR] (95% confidence interval) per unit increase, 1.3 (1.1-1.6)], neutropenia [OR 10.1 (2.0-51.0)], human immunodeficiency virus (HIV) infection [OR 3.9 (1.1-13.8)], chronic respiratory disease [OR 4.4 (1.2-16.0)], chronic liver disease [OR 3.2 (1.0-9.7)], smoking [OR 3.8 (1.1-13.5)], injection drug use [OR 9.7 (1.5-63.7)], and antibiotic therapy within 6months before admission [OR 4.0 (1.3-12.5)]. The multivariable analysis revealed age >60years (P=0.048) and alcoholism (P=0.009) as risks for prolonged LOS. Conclusions: The outcome of pneumococcal bacteremia may be more influenced by patient characteristics than by minor differences in the timeliness of initial diagnostic and therapeutic measures within the first several hours after hospital admissio

Statistical evaluation of the flux cross-calibration of the XMM-Newton EPIC cameras

The second XMM-Newton serendipitous source catalogue, 2XMM, provides the ideal data base for performing a statistical evaluation of the flux cross-calibration of the XMM-Newton European Photon Imaging Cameras (EPIC). We aim to evaluate the status of the relative flux calibration of the EPIC cameras on board XMM-Newton (MOS1, MOS2, and pn) and investigate the dependence of the calibration on energy, position in the field of view of the X-ray detectors, and lifetime of the mission. We compiled the distribution of flux percentage differences for large samples of 'good quality' objects detected with at least two of the EPIC cameras. The mean offset of the fluxes and dispersion of the distributions was then found by Gaussian fitting. Count rate to flux conversion was performed with a fixed spectral model. The impact on the results of varying this model was investigated. Excellent agreement was found between the two EPIC MOS cameras to better than 4% from 0.2 keV to 12.0 keV. MOS cameras register 7-9% higher flux than pn below 4.5 keV and 10-13% flux excess above 4.5 keV. No evolution of the flux ratios is seen with time, except at energies below 0.5 keV, where we found a strong decrease in the MOS to pn flux ratio with time. This effect is known to be due to a gradually degrading MOS redistribution function. The flux ratios show some dependence on distance from the optical axis in the sense that the MOS to pn flux excess increases with off-axis angle. Furthermore, in the 4.5-12.0 keV band there is a strong dependence of the MOS to pn excess flux on the azimuthal-angle. These results strongly suggest that the calibration of the Reflection Grating Array (RGA) blocking factors is incorrect at high energies. Finally, we recommend ways to improve the calculation of fluxes in future versions of XMM-Newton source catalogues.Comment: 11 pages, 10 figures, 3 tables. Abridged Abstract. Accepted for publication in Astronomy and Astrophysic

Factors associated with positive blood cultures in outpatients with suspected bacteremia

Blood cultures are routinely taken in outpatients with fever and suspected bacterial infections. However, in the majority of cases, they are not informative and of limited value for clinical decision making. The aim of this study was therefore to investigate factors associated with positive blood cultures in outpatients presenting to an outpatient clinic and emergency room. This was a case-control study of all outpatients with positive blood cultures from January 1, 2006 to October 31, 2007 and matched control patients with negative blood cultures in the same time period. Microbiology results and medical charts were reviewed to determine factors associated with positive blood cultures. The presence of a systemic inflammation response syndrome (SIRS) (OR 2.7, 95% Cl 1.0-7.2) and increased C-reactive protein (CRP) (OR 1.1 per 10mg/l, 95% Cl 1.0-1.2) were the most powerful predictive values for the development of positive blood cultures. In positive cases serum albumin was lower (35mg/l versus 39mg/l) than in controls. SIRS, increasing CRP and low albumin were associated with positive blood cultures in outpatients. With simple clinical assessment and few laboratory tests indicative of infection, it is possible to define a group at higher risk for bacteremia in outpatient

The cost of surgical training: analysis of operative time for laparoscopic cholecystectomy

Background: Duration of surgery is a main cost factor of surgical training. The purpose of this analysis of operative times for laparoscopic cholecystectomies (LC) was to quantify the extra time and related costs in regards to the surgeons' experience in the operating room (OR). Methods: All LC performed between January 01, 2005 and December 31, 2008 in 46 hospitals reporting to the database of the Swiss Association for Quality Management in Surgery (AQC) were analyzed (n=10,010). Four levels of seniority were specified: resident (R), junior consultant (JC), senior consultant (SC), and attending surgeon (AS). The differences in operative time according to seniority were investigated in a multivariable log-linear and median regression analysis controlling for possible confounders. The OR costs were calculated by using a full cost rate in a teaching hospital. Results: A total of 9,208 LC were available for analysis; 802 had to be excluded due to missing data (n=212) or secondary major operations (n=590). Twenty-eight percent of the LC were performed by R as teaching operations (n=2,591). Compared with R, the multivariable analysis of operative time showed a median difference of −2.5min (−9.0; 4.8) for JC and −18min (−25; −11) for SC and −28min (−35; −10) for AS, respectively. The OR minute costs were €17.57, resulting in incremental costs of €492 (159; 615) per operation in case of tutorial assistance. Conclusions: The proportion of LC performed as tutorial assistance for R remains low. Surgical training in the OR causes relevant case-related extra time and therefore cost

Probing the outer edge of an accretion disk : a Her X-1 turn-on observed with RXTE

We present the analysis of Rossi X-ray Timing Explorer (RXTE) observations of the turn-on phase of a 35 day cycle of the X-ray binary Her X-1. During the early phases of the turn-on, the energy spectrum is composed of X-rays scattered into the line of sight plus heavily absorbed X-rays. The energy spectra in the 3–17 keV range can be described by a partial covering model, where one of the components is influenced by photoelectric absorption and Thomson scattering in cold material plus an iron emission line at 6.5 keV. In this paper we show the evolution of spectral parameters as well as the evolution of the pulse profile during the turn-on. We describe this evolution using Monte Carlo simulations which self-consistently describe the evolution of the X-ray pulse profile and of the energy spectrum

Field Performance Of Domestic Heat Pumps For Heating And Hot Water In Switzerland Part I: Technology, Methods And State Of The Art Of The Field Studies

carried out by the Heat Pump Test Center (WPZ) in Buchs SG, Switzerland. In the current study, heat pumps for hydronic heating systems in single family houses within Switzerland have been investigated since 2016. So far, over 20 air-source and geothermal heat pumps have been added to this governmental quality assurance program (Swiss Federal authority EnergieSchweiz). For each heat pump system, more than 40 measured variables are recorded at a time interval of 10 s with calibrated sensors with very low measurement uncertainty. The aim of this field study is to record the real heat pump system efficiency in operation and to draw comparisons with characteristic values from laboratory measurements and manufacturer data. The study presented, is divided into two parts. The first part that is entitled “Technology, Methods and State of the Art of the field studies” focuses on the procedure, system boundaries and measuring technology of past and current field studies at WPZ Buchs and provides an insight to the state of the art of field performance measurements of domestic heat pumps carried out in Switzerland. The second part is entitled “Results, Analysis and Optimization of current field studies” and concentrates on various measured figures and the improvement potential of the investigated heat pump systems. Compared to the former studies made in the 1990s and early 2000s, the measurement methodology and data acquisition have changed considerably to date. Nowadays, thanks to digitalization, much more data is available. Short sampling intervals are used to describe temporal processes in heat pump systems in detail, enabling an easier detection of defects such as heat losses and unwanted circulation. Thanks to carefully defined system boundaries like JAZ, WNG and SNG heat pump systems can be compared and optimized effectively. Great importance is attached to the measurement of temperature because of its major influence on the overall uncertainty. Therefore, temperature is measured with an uncertainty of ±0.1 K/±0.02 K (absolute/relative) using directly immersed PT-100 sensors and four wire technology. Together with the prior calibration of the whole measuring equipment in the laboratory, an overall uncertainty of the target values (COP, JAZ) of 10% was achieved