Head-to-head comparison of length of stay, patients' outcome and satisfaction in Switzerland before and after SwissDRG-Implementation in 2012 in 2012: an observational study in two tertiary university centers.

On 1 January 2012 Swiss Diagnosis Related Groups (DRG), a new uniform payment system for in-patients was introduced in Switzerland with the intention to replace a "cost-based" with a "case-based" reimbursement system to increase efficiency. With the introduction of the new payment system we aim to answer questions raised regarding length of stay as well as patients' outcome and satisfaction. This is a prospective, two-centre observational cohort study with data from University Hospital Basel and the Cantonal Hospital Aarau, Switzerland, from January to June 2011 and 2012, respectively. Consecutive in-patients with the main diagnosis of either community-acquired pneumonia, exacerbation of COPD, acute heart failure or hip fracture were included. A questionnaire survey was sent out after discharge investigating changes before and after SwissDRG implementation. Our primary endpoint was LOS. Of 1,983 eligible patients 841 returned the questionnaire and were included into the analysis (429 in 2011, 412 in 2012). The median age was 76.7 years (50.8% male). Patients in the two years were well balanced in regard to main diagnoses and co-morbidities. Mean LOS in the overall patient population was 10.0 days and comparable between the 2011 cohort and the 2012 cohort (9.7 vs 10.3; p = 0.43). Overall satisfaction with care changed only slightly after introduction of SwissDRG and remained high (89.0% vs 87.8%; p = 0.429). Investigating the influence of the implementation of SwissDRG in 2012 regarding LOS patients' outcome and satisfaction, we found no significant changes. However, we observed some noteworthy trends, which should be monitored closely

Wavepacket reconstruction via local dynamics in a parabolic lattice

We study the dynamics of a wavepacket in a potential formed by the sum of a periodic lattice and of a parabolic potential. The dynamics of the wavepacket is essentially a superposition of ``local Bloch oscillations'', whose frequency is proportional to the local slope of the parabolic potential. We show that the amplitude and the phase of the Fourier transform of a signal characterizing this dynamics contains information about the amplitude and the phase of the wavepacket at a given lattice site. Hence, {\em complete} reconstruction of the the wavepacket in the real space can be performed from the study of the dynamics of the system.Comment: 4 pages, 3 figures, RevTex

The nonlinear Schroedinger equation for the delta-comb potential: quasi-classical chaos and bifurcations of periodic stationary solutions

The nonlinear Schroedinger equation is studied for a periodic sequence of delta-potentials (a delta-comb) or narrow Gaussian potentials. For the delta-comb the time-independent nonlinear Schroedinger equation can be solved analytically in terms of Jacobi elliptic functions and thus provides useful insight into the features of nonlinear stationary states of periodic potentials. Phenomena well-known from classical chaos are found, such as a bifurcation of periodic stationary states and a transition to spatial chaos. The relation of new features of nonlinear Bloch bands, such as looped and period doubled bands, are analyzed in detail. An analytic expression for the critical nonlinearity for the emergence of looped bands is derived. The results for the delta-comb are generalized to a more realistic potential consisting of a periodic sequence of narrow Gaussian peaks and the dynamical stability of periodic solutions in a Gaussian comb is discussed.Comment: Enhanced and revised version, to appear in J. Nonlin. Math. Phy

Outer membrane protein folding from an energy landscape perspective

The cell envelope is essential for the survival of Gram-negative bacteria. This specialised membrane is densely packed with outer membrane proteins (OMPs), which perform a variety of functions. How OMPs fold into this crowded environment remains an open question. Here, we review current knowledge about OFMP folding mechanisms in vitro and discuss how the need to fold to a stable native state has shaped their folding energy landscapes. We also highlight the role of chaperones and the β-barrel assembly machinery (BAM) in assisting OMP folding in vivo and discuss proposed mechanisms by which this fascinating machinery may catalyse OMP folding

Mammalian cell sensitivity to hyperthermia in various cell lines: a new universal and predictive description

Introduction The Cumulative Equivalent Minute at 43 °C (CEM43) thermal dose model has been empirically derived more than 30 years ago and still serves as a benchmark for hyperthermia protocols despite the advent of regulatory network models. However, CEM43 suffers from several limitations regarding its inability to predict the effect of complex time varying profiles (thermotolerance, step-down heating), to predict synergistic effects with drug treatments or to explain the specificity of a cell line in thermal resistance. Objective Define a new generic predictive tool for thermal injury based on regulatory network models. Identify the biological parameters that account for the thermal resistance. Materials Comparative study of cell survival upon hyperthermia collected from literature (17 sets in 11 publications that cover 14 different cell lines from 8 different tissues). Results A dynamical model describes accurately cell survival according to the amplitude and duration of exposure but also molecular chaperone expression level. In the case of square shape hyperthermia, approximated analytical expression of the cell survival is derived from the dynamical model and compared to CEM43 description. The molecular chaperone expression level defines the thermal resistance of a given cell line and can be estimated from a single experimental result through an easy-to-use graphical tool. Conclusion The tools offered here can be useful for designing treatments combining hyperthermia and chemotherapy targeting molecular chaperones, but also for designing personalized hyperthermic treatment by prior biochemical screening of molecular chaperones. These tools could advantageously replace the description of CEM43