Nosokomiale Harnwegsinfektionen des Erwachsenen

Zusammenfassung: Die Harnwegsinfektion ist die häufigste Infektion des Erwachsenen im Spital. Sie ist meistens mit dem Tragen von Harnwegskathetern assoziiert. Entscheidend sind daher die richtige Indikationsstellung für die Kathetereinlage, die frühzeitige Wiederentfernung des Katheters sowie die korrekte Diagnosestellung zur Vermeidung unnötiger antibiotischer Behandlungen. Die therapeutischen Überlegungen sollten die Komorbiditäten und potenzielle Behinderungen des Urinabflusses mit einschließen. In der Behandlung stehen Chinolone, Breitspektrumpenizilline und Cephalosporine der 3.Generation im Vordergrund. Bei den ökonomischen Überlegungen sollte v.a. der höhere Preis von i.v.-Antibiotika im Vergleich zu per os mit einfließe

Fabrication and electroosmotic flow measurements in micro- and nanofluidic channels

An easy method for fabricating micro- and nanofluidic channels, entirely made of a thermally grown silicon dioxide is presented. The nanochannels are up to 1-mm long and have widths and heights down to 200nm, whereas the microfluidic channels are 20-μm wide and 4.8-μm high. The nanochannels are created at the interface of two silicon wafers. Their fabrication is based on the expansion of growing silicon dioxide and the corresponding reduction in channel cross-section. The embedded silicon dioxide channels were released and are partially freestanding. The transparent and hydrophilic silicon dioxide channel system could be spontaneously filled with aqueous, fluorescent solution. The electrical resistances of the micro- and nanofluidic channel segments were calculated and the found values were confirmed by current measurements. Electrical field strengths up to 600V/cm were reached within the nanochannels when applying a potential of only 10V. Electroosmotic flow (EOF) measurements through micro- and nanofluidic channel systems resulted in electroosmotic mobilities in the same order of those encountered in regular, fused silica capillarie

Virtual Induction Machine Strategy for Converters in Power Systems with Low Rotational Inertia

This paper presents a novel comprehensive control strategy for grid-connected Voltage Source Converters (VSCs) in power systems with low rotational inertia. The proposed model is based on emulating the physical properties of an Induction Machine (IM) and taking advantage of its inherent grid-friendly properties, i.e. self-synchronization, virtual inertia, power and frequency oscillation damping. For that purpose, a detailed mathematical model of the IMs working principles is derived, which includes the possibility of obtaining the unknown grid frequency without a dedicated synchronization unit, but rather via processing the voltage and current magnitude measurements at the converter output. This eliminates the need for an inherently nonlinear phase-locked loop, characteristic for virtual synchronous machines, while simultaneously preserving the synchronization and damping properties of a conventional electrical machine. Several case studies are presented that validate the mathematical principles of the proposed model and conclusions on VSC performance are drawn

Stability Performance of Power Electronic Deviceswith Time Delays

This paper deals with the impact of time delays on small-signal stability of power systems with an all converter-interfaced generation. For this purpose, a delay differential algebraic equation model of the voltage source converter and its control scheme is developed. The regulation is based on replicating the dynamical properties of a synchronous machine through appropriate controller configuration. Therefore, a virtual inertia emulation is included in the active power control loop. A transcedental nature of the characteristic equation is resolved by implementing the Chebyshev's discretization method and observing a finite number of critical, low-frequency eigenvalues. Based on the proposed approach, a critical measurement delay is evaluated. Furthermore, a bifurcation analysis of the droop gains and inertia constant is conducted. Stability regions and optimal parametrization of the voltage source converter controls are evaluated and discussed

Fast Frequency Control Scheme through Adaptive Virtual Inertia Emulation

This paper presents a novel virtual inertia controller for converters in power systems with high share of renewable resources. By combining the analytical study of system dynamics and a Linear-Quadratic Regulator (LQR)-based optimization technique, the optimal state feedback gain is determined, adapting the emulated inertia constant according to the frequency disturbance in the system. The optimality is achieved through trade-off between the critical frequency limits and the required control effort, i.e. utilization of the internal energy storage. The proposed controller is integrated into a state-of-the-art converter control scheme and verified through EMT simulations. The results show a significant improvement in the frequency response compared to an open-loop system, while also preserving drastically more DC-side energy than a non-adaptive controller

Stability Analysis of Converter Control Modes in Low-Inertia Power Systems

This paper deals with the small-signal stability analysis of converter control modes in low-inertia power systems. For this purpose, a detailed differential-algebraic equation model of the voltage source converter and its control scheme is developed. Both grid-forming and grid-feeding concepts have been considered, as well as different active power controllers based on traditional droop and virtual inertia emulation. An eigenvalue analysis of the linearized state-space system is conducted and the performance of different control configurations is compared. Furthermore, various bifurcation studies have been completed and conclusions on stability margins have been drawn with respect to control sensitivity and robustness

Droop vs. virtual inertia: Comparison from the perspective of converter operation mode

Virtual Inertia Emulation (VIE) and traditional Active Power Droop Control (APDC) are among the most common approaches for regulating the active power output of inverter-based generators. Furthermore, it has been shown that, under certain conditions, these two methods can be equivalent. However, neither those studies, nor the analyses comparing the two control schemes with respect to their dynamical properties, have investigated the impact of the converter operation mode. This paper explores the subject by investigating the two control approaches under such conditions, and determining when this assumption does not hold. Using time-domain simulations with a detailed Voltage Source Converter model, we compare VIE and APDC qualitatively and reformulate the respective conditions for equivalence

SPECT/CT in der Handgelenkdiagnostik

Zusammenfassung: Klinisches/methodisches Problem: Handgelenkschmerzen sind eine diagnostische Herausforderung für Handchirurgen und Radiologen. Insbesondere chronische Handgelenkschmerzen sind oft nur schwer einer genauen Lokalisation zuzuordnen, eine Schnittbildgebung ist deshalb oft unerlässlich. Radiologische Standardverfahren: Der etablierte Standard zur nichtinvasiven Diagnostik chronischer Handgelenkschmerzen ist die Magnetresonanztomographie. Methodische Innovationen: In den letzten Jahren ist mit der "single photon emission computed tomography"/CT (SPECT/CT) eine neue Modalität zum diagnostischen Spektrum muskuloskelettaler Veränderungen hinzugetreten, welche neben morphologischen Daten auch metabolische Informationen liefert. Leistungsfähigkeit: Die SPECT/CT ermöglicht eine genaue Detektion und präzise anatomische Zuordnung unterschiedlicher Handgelenkpathologien. Dies ist oftmals entscheidend für eine korrekte Therapie. Bewertung: Die SPECT/CT ist bei Patienten mit chronischen Handgelenkschmerzen spezifischer als die MRT. Sie bietet außerdem Vorteile bei Patienten mit posttraumatischen Veränderungen oder Metallimplantaten und kann als problemlösende Methode bei unklaren Fällen eingesetzt werden. Empfehlung für die Praxis: Eine Anwendung der SPECT/CT erscheint aus unserer Sicht immer dann sinnvoll, wenn eine Abklärung mittels MRT unergiebig war bzw. das MRT mehrere Pathologien zeigt, bei denen nicht klar ist, welche die klinisch führende ist. Auch ein primärer Einsatz bei bestimmten ossären Pathologien, bei Patienten mit Metallimplantaten oder bei unklaren Handgelenkschmerzen erscheint gerechtfertig

Atypisches Erythema induratum Bazin bei tuberkulöser Osteomyelitis

Zusammenfassung: Hauttuberkulosen können sich mit sehr unterschiedlichen klinischen Bildern manifestieren und damit die Diagnosestellung erschweren. Wir stellen den Fall einer 79-jährigen Patientin vor, mit einer atypischen Präsentation eines Erythema induratum Bazin (EIB) am Oberkörper und einer tuberkulösen Osteomyelitis des Olekranon links. Aus den Biopsien der EIB-Knoten konnte M.tuberculosis kulturell nachgewiesen werden. Das widerspricht der klassischen Vorstellung, dass das EIB als Folge einer Hypersensitivitätsreaktion auf Mykobakterien entsteht, und unterstützt die Hypothese, dass das EIB auch durch eine hämatogene oder lymphogene Streuung von lebenden M.tuberculosis entstehen kan

Thermal preference of adult mosquitoes (Culicidae) and biting midges (Ceratopogonidae) at different altitudes in Switzerland

Mosquitoes (Diptera: Culicidae) and biting midges (Diptera: Ceratopogonidae) are among the most important vectors of human and veterinary pathogens. For modelling the distribution of these pathogens, entomological aspects are essential, which in turn are highly dependent on environmental factors, such as temperature. In this study, mosquitoes and biting midges were sampled in multiple microclimates at two low (360, 480 meters above sea level, m.a.s.l.) and two high (1250, 1530 m.a.s.l.) altitude locations in Switzerland. Sets of various traps (CO2 -baited CDC, LED-UV, resting boxes, oviposition cups) equipped with dataloggers were placed in transects at five sites with similar vegetation at each location. Only the CDC and the LED-UV traps collected enough insects for analyses. Taxonomic diversity was greater for mosquitoes but lower for biting midges at lower altitudes. Both mosquitoes and biting midges had a thermal preference. Culicoides preferred the traps with warmer microclimate, especially at lower altitudes, whereas mosquito preferences depended on the species, but not on altitude. Relative humidity had a significant positive impact on catches of biting midges but not mosquitoes. To obtain better data on thermal preferences of resting and ovipositing vectors in addition to host seeking individuals, new and improved collecting methods are needed