Prüfzeiten des Einheitlichen Bewertungsmaßstabes

Für die im Einheitlichen Bewertungsmaßstab, dem Abrechungskatalog im ambulanten und belegärztlichen Bereich der Gesetzlichen Krankenversicherung, aufgeführten Leistungsziffern werden auch sogenannte Prüfzeiten angegeben. Diese werden von den Kassenärztlichen Vereinigungen verwendet im Rahmen der Plausibilitätsprüfung der ärztlichen Quartalsabrechnung. Wird dabei eine bestimmte Zeitsumme überschritten, ist die Abrechnung auffällig und wird weiterer Prüfung unterzogen. Da dieses Verfahren weitreichende Konsequenzen habe kann bis hin zu Regreßverfahren und Anklage wegen Betruges, soll im Rahmen dieser Studie untersucht werden, ob diese Prüfzeiten eine wissenschaftliche Basis haben und am Beispiel der Koloskopie durch Analyse von Studien und eigenen Untersuchungsdaten die Validität der Koloskopie-Prüfzeit geprüft werden. Es konnte dabei festgestellt werden, daß die Prüfzeiten einer wissenschaftlichen Basis entbehren und rein normativ festgelegt wurden. Die ermittelten Studien mit Angaben zur Untersuchungszeit der Koloskopie konnten nahezu ausnahmslos Zeiten dokumentieren, die unter der Koloskopie-Prüfzeit des EBM liegen. Auch die Zeitanalysen der 1262 Koloskopien der eigenen Patientengruppe ergab bei 74 % eine Untersuchungsdauer unter der vorgegebenen Prüfzeit, 24 % der Prozeduren oberhalb. Es wird deshalb empfohlen, bis zur Validierung der Prüfzeiten des EBM durch wissenschaftliche Studien, diese im Rahmen der Plausibilitätsprüfung nicht mehr zu verwenden.The billing list (EBM) of the medical account system in Germany includes a register of so called test-times (Prüfzeiten) for nearly every medicine-performance. They are used for plausibility checks by the association of panel doctors. If a doctor overspend a definated summary of time, his account is conspicuous und will be underneath more intensive. This test could result in recourse and accusal of deception. Because of that we examinate if the test-times are based on studies and using the example of colonoscopy if the test-time is valid. Therefore we analyzed results of studies and data of own examinations. Results: 1. The test-times are not based on scientific studies, they are determinated on normative statements. 2. The examination-time of colonoscopy published in international studies are mainly shorter than test-times. 3. In the group of 1262 colonoscopies of own patients 74 % of examinations were done in a time shorter than the corresponding test-time, 26 % took a longer time. We therefore recommanded not using the test-times any longer in plausibility checks until a verification with scientific studies are available

Limb radiance inversion radiometer

Engineering and scientific objectives of the LRIR experiment are described along with system requirements, subassemblies, and experiment operation. The mechanical, electrical, and thermal interfaces between the LRIR experiment and the Nimbus F spacecraft are defined. The protoflight model qualification and acceptance test program is summarized. Test data is presented in tables to give an overall view of each test parameter and possible trends of the performance of the LRIR experiment. Conclusions and recommendations are included

The Co-Ni distribution in decagonal Al69.7(4)Co10.0(4)Ni20.3(4)

The Co—Ni distribution in d-Al69.7(4)Co10.0(4)Ni20.3(4) was investigated based on X-ray and neutron diffraction data. The structure was modelled in higher dimensional space using the ‘charge-flipping' and ‘low-density elimination' methods and it was quantitatively refined in three-dimensional space employing a pseudo-approximant approach. In higher-dimensional description, the Co atoms are found at the centre of one of the two symmetry independent occupation domains, enclosed by regions mainly occupied by Ni. The other occupation domain is mostly occupied by Al. In physical space Co atoms are located in the centres of small Al pentagons and form pentagonal units, which are arranged in decagonal rings. On these sites Co is partly substituted by Ni, while all other transition metal sites are occupied by Ni and to a minor degree by Al. The fraction of Co found on transition metal sites decreases with decreasing Co-Co distances, whereby Co is replaced by N

Growth of Bi thin films on quasicrystal surfaces

We present a comprehensive study of Bi thin-film growth on quasicrystal surfaces. The substrates used for the growth are the fivefold surface of icosahedral (i)-Al-Cu-Fe and i-Al-Pd-Mn and the tenfold surface of decagonal (d)-Al-Ni-Co quasicrystals. The growth is investigated at 300 and 525 K substrate temperatures and at different coverage (θ) ranging from submonolayer to ten monolayers. The film is characterized by scanning tunneling microscopy, reflection high-energy electron diffraction, and x-ray photoelectron spectroscopy. At 300 K, the deposited Bi yields a quasicrystalline film for θ≤1. For 1\u3cθ\u3c5, it forms nanocrystallites with (100) surface orientation. The islands have magic heights, which correspond to the stacking of four atomic layers (predominantly). The selection of magic heights is interpreted in terms of quantum size effects arising from the electron confinement within the film thickness. The islands establish rotational epitaxial relationship with the substrate. For higher coverage, the film grows with monatomic height, not with magic heights, and reflects the symmetry of the bulk Bi. When deposition is performed at 525 K, terrace diffusion is more effective, resulting in the aggregation of Bi adatoms developing into a smooth monolayer with quasiperiodic order. At this temperature, multilayers do not adsorb

Cathodoluminescence Instrumentation for Analysis of Martian Sediments

International audienceThe morphologic study of the surface of Mars reveals that liquid water existed during the first few hundred millions of years of the planet's history (e.g. Smith et al. 1999). The flow of water produced extensive erosion in some place, but also large sedimentary basins. With a long enough duration of the presence of liquid water and the oxidation of basalts, the emergence of biological activity may have eventually occurred, as on Earth. The detection of biomarkers at the surface of Mars is one of the main challenges of current and planned planetary exploration missions (e.g. Westall et al. 2000). Looking for a fossil or present biological activity may be approached by the search for cells, but also by the study of the results of their activity and their interface with the sedimentary environment. Such bio-sedimentations are known among the oldest terrestrial fossils and testify to the earliest terrestrial bioactivity. A discovery of such bio-sedimentations on the Martian surface would be of prime interest for addressing some of the key goals in exobiology. Cathodoluminescence (CL) is a method relevant to the search for life, as it is in line with these analytical goals of detecting bio-sedimentations (Barbin et al. 1999), and it fits well with robotic facilities usable in modern space missions (Blanc et al. 1999, Thomas et al. 2002. 2005). An established technique, cathodoluminescence is a newcomer to Martian exploration, whereit is expected to contribute to the mineralogical characterisation of sedimentary rocks, to the search for biomarkers revealing past biological activity, and to identify past geochemical conditions (Melezhik et al. 1999; Denson et al. 2007). CL is one of the best methods when the growth dynamics, microstructure, and origin of minerals need to be determined, such as with Martian sediments. CL has become an important standard technique for studying geological materials, offering a wide spectrum of applications (Marshall 1988; Barker and Kopp 1991; Barbin and Schvoerer 1997; Pagel et al. 2000). However, it is in the field of sedimentology and petrography that CL has proved to be especially valuable

Information content of ozone retrieval algorithms

The algorithms are characterized that were used for production processing by the major suppliers of ozone data to show quantitatively: how the retrieved profile is related to the actual profile (This characterizes the altitude range and vertical resolution of the data); the nature of systematic errors in the retrieved profiles, including their vertical structure and relation to uncertain instrumental parameters; how trends in the real ozone are reflected in trends in the retrieved ozone profile; and how trends in other quantities (both instrumental and atmospheric) might appear as trends in the ozone profile. No serious deficiencies were found in the algorithms used in generating the major available ozone data sets. As the measurements are all indirect in someway, and the retrieved profiles have different characteristics, data from different instruments are not directly comparable

Pressurized extraction of unsaturated fatty acids and carotenoids from wet Chlorella vulgaris and Phaeodactylum tricornutum biomass using subcritical liquids

The objective of this study was to investigate the extraction of lipids, for example, mono‐ and polyunsaturated fatty acids (PUFA) as well as carotenoids, from wet microalgae biomass using pressurized subcritical extraction solvents, which meet the requirements of food and feed applications. To demonstrate the effect of the solvent and temperature on the lipid yield, we chose two microalgae species, viz. Chlorella vulgaris and Phaeodactylum tricornutum , differing in their biochemical composition fundamentally. In case of P. tricornutum, ethanol showed the highest fatty acid yield of 85.9% w/w. In addition to eicosapentaenoic acid (EPA), the ethanolic extracts contained exceptional amounts of fucoxanthin (up to 26.1 mg/g d. w.), which can be beneficial to protect unsaturated fatty acids from oxidation processes and in terms of human nutrition. For C. vulgaris , a fatty acid yield of 76.5% w/w was achieved from wet biomass using ethyl acetate at 150°C. In general, an increase in the extraction temperature up to 150°C was found to be important in terms of fatty acid yield when extracting wet microalgae biomass. The results suggest that it is possible to efficiently extract both fatty acids and carotenoids from wet microalgae by selecting suitable solvents and thus circumvent energy‐intensive drying of the biomass

Coproduction of EPA and Fucoxanthin with – A Promising Approach for Up‐ and Downstream Processing

Eicosapentaenoic acid (EPA) and fucoxanthin, a carotenoid, provide a broad variety of health benefits in human nutrition. In this study, an up- and downstream process for the coproduction of EPA and fucoxanthin using the diatom Phaeodactylum tricornutum in flat-panel airlift photobioreactors is proposed. The approach represents a promising alternative to conventional sources for both compounds, viz. marine fish and macroalgae. The productivity as well as the biomass-specific product content were optimized during cultivation. Subsequently, both compounds were extracted, separated and purified using pressurized liquids

The SPARC Data Initiative: comparisons of CFC-11, CFC-12, HF and SF6 climatologies from international satellite limb sounders

A quality assessment of the CFC-11 (CCl3F), CFC-12 (CCl2F2), HF, and SF6 products from limb-viewing satellite instruments is provided by means of a detailed intercomparison. The climatologies in the form of monthly zonal mean time series are obtained from HALOE, MIPAS, ACE-FTS, and HIRDLS within the time period 1991–2010. The intercomparisons focus on the mean biases of the monthly and annual zonal mean fields and aim to identify their vertical, latitudinal and temporal structure. The CFC evaluations (based on MIPAS, ACE-FTS and HIRDLS) reveal that the uncertainty in our knowledge of the atmospheric CFC-11 and CFC-12 mean state, as given by satellite data sets, is smallest in the tropics and mid-latitudes at altitudes below 50 and 20 hPa, respectively, with a 1σ multi-instrument spread of up to ±5 %. For HF, the situation is reversed. The two available data sets (HALOE and ACE-FTS) agree well above 100 hPa, with a spread in this region of ±5 to ±10 %, while at altitudes below 100 hPa the HF annual mean state is less well known, with a spread ±30 % and larger. The atmospheric SF6 annual mean states derived from two satellite data sets (MIPAS and ACE-FTS) show only very small differences with a spread of less than ±5 % and often below ±2.5 %. While the overall agreement among the climatological data sets is very good for large parts of the upper troposphere and lower stratosphere (CFCs, SF6) or middle stratosphere (HF), individual discrepancies have been identified. Pronounced deviations between the instrument climatologies exist for particular atmospheric regions which differ from gas to gas. Notable features are differently shaped isopleths in the subtropics, deviations in the vertical gradients in the lower stratosphere and in the meridional gradients in the upper troposphere, and inconsistencies in the seasonal cycle. Additionally, long-term drifts between the instruments have been identified for the CFC-11 and CFC-12 time series. The evaluations as a whole provide guidance on what data sets are the most reliable for applications such as studies of atmospheric transport and variability, model–measurement comparisons and detection of long-term trends. The data sets will be publicly available from the SPARC Data Centre and through PANGAEA (doi:10.1594/PANGAEA.849223)