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Impactor identification with spallogenic Cr isotopes: The Wabar impact craters (Saudi Arabia)
Get PDFStrain assessment in patients with aortic regurgitation undergoing transcatheter aortic valve implantation: case series.
Get PDFBACKGROUND
Limited data exist on strain changes after transcatheter aortic valve implantation (TAVI) in patients with aortic regurgitation (AR).
CASE SUMMARY
Three patients with AR undergoing TAVI showed an initial reduction in global longitudinal strain (GLS), followed by sustained GLS improvement within the first year.
DISCUSSION
Findings align with those of surgically treated patients with AR. There is a possible superiority of GLS to left ventricular end-diastolic diameter ratio in assessing patients with severe volume overload
Clinical Assessment of the Nystagmus Fixation Suppression Test: An Experimental Study.
No full textBACKGROUND
Assessment of nystagmus fixation suppression can be used as an additional diagnostic tool for patients with an acute vestibular syndrome to distinguish between a central or peripheral cause. We investigated the ability of physicians to detect fixation suppression using a nystagmus simulation model.
METHODS
We used a nystagmus simulator to measure the accuracy of the nystagmus fixation suppression test. Fixation suppression was assessed randomly in 6170 trials by 20 otorhinolaryngologists and neurologists, segregated into 2 groups based on their neurootological experience, a beginner and an experienced group. The simulator presented random nystagmus slow velocity (SPV) reductions and presented 3 conditions with either changed nystagmus frequency, amplitude, or both.
RESULTS
The cutoff for the discernment of fixation suppression ranged from 1.2 to 14°/s nystagmus velocity difference. The more intense the baseline nystagmus was, the more difficult was the detection of fixation suppression. There was not significant difference (P >.05) in the cutoff values in the experts group compared to the novices for all 3 different conditions. Both, novices and experts, detected frequency changes easier than differences of the nystagmus amplitude. Test sensitivity was very low (19%-65%) for discernment of small nystagmus velocity differences of <2°/s by experts.
CONCLUSION
In our study, there was no difference between experts and novices in detection of nystagmus suppression by visual fixation. The examiners could only detect large suppression effects at low-intensity baseline nystagmus. Overall, the sensitivity and accuracy of a clinical fixation suppression test is low and the assistance with a video-oculography device is highly recommended
Editorial: Geographische Fachzeitschriften aus dem deutschsprachigen Raum - Ein Aufruf zur Debatte und Unterstützung
No full textPrecision and accuracy of craniofacial growth and orthodontic treatment evaluation by digital image correlation: a prospective cohort study.
Get PDFINTRODUCTION
A precise and accurate method for structural superimposition is essential for analyzing dentofacial growth and orthodontic or surgical treatment in longitudinal studies. The errors associated with different superimposition methods have not yet been assessed in high-quality studies.
OBJECTIVES
This study aimed to assess the precision and accuracy of digital image correlation (DIC) for structural superimposition.
METHODS
Two cephalometric images from 30 consecutive patients were superimposed using three DIC methods, each measured twice by two examiners. Areas including the contours of the sella, the whole cranial base (CB), and Walker's point and lamina cribrosa (WPLC) were compared using a random coefficient model. Inter-rater and intra-rater errors were assessed for each method.
RESULTS
WPLC provided the best precision for image rotation and cephalometric landmarks. Systematic bias was observed between the WPLC and CB methods for image rotation and most landmarks. The intra-rater error in image rotation during DIC was strongly correlated with the intra-rater error in the landmarks of the anterior nasal spine, articulare, and pogonion.
CONCLUSION
Structural superimposition using DIC with WPLC is a precise method for analyzing dentofacial growth and orthodontic or surgical treatment. Moreover, the best method is the measurement of longitudinal dental and craniofacial changes on structurally superimposed cephalometric radiographs with WPLC and a reference grid including the true vertical and horizontal lines from Walker's point
Optical coherence tomography quantifies gradient refractive index and mechanical stiffness gradient across the human lens.
Get PDFBACKGROUND
As a key element of ocular accommodation, the inherent mechanical stiffness gradient and the gradient refractive index (GRIN) of the crystalline lens determine its deformability and optical functionality. Quantifying the GRIN profile and deformation characteristics in the lens has the potential to improve the diagnosis and follow-up of lenticular disorders and guide refractive interventions in the future.
METHODS
Here, we present a type of optical coherence elastography able to examine the mechanical characteristics of the human crystalline lens and the GRIN distribution in vivo. The concept is demonstrated in a case series of 12 persons through lens displacement and strain measurements in an age-mixed group of human subjects in response to an external (ambient pressure modulation) and an intrinsic (micro-fluctuations of accommodation) mechanical deformation stimulus.
RESULTS
Here we show an excellent agreement between the high-resolution strain map retrieved during steady-state micro-fluctuations and earlier reports on lens stiffness in the cortex and nucleus suggesting a 2.0 to 2.3 times stiffer cortex than the nucleus in young lenses and a 1.0 to 7.0 times stiffer nucleus than the cortex in the old lenses.
CONCLUSIONS
Optical coherence tomography is suitable to quantify the internal stiffness and refractive index distribution of the crystalline lens in vivo and thus might contribute to reveal its inner working mechanism. Our methodology provides new routes for ophthalmic pre-surgical examinations and basic research
Current and future workforce of general internal medicine in Switzerland: a cross-sectional study.
Get PDFAIM OF THIS STUDY
General internal medicine is a crucial element in healthcare systems. Understanding how many people are and will be working in this field is important to maintain and improve quality for patients in healthcare systems. This can provide a basis for political decisions.
METHODS
We conducted a cross-sectional study to analyse the current and future workforce of generalists (general practitioners and internists in hospitals) in Switzerland. The Swiss Society of General Internal Medicine (SSGIM) distributed a survey to all members. Respondents were asked about their current average workload in 2023 and planned workload in 2033. The responses were used to calculate full-time equivalent (FTE) for the current and future workforce of generalists and to extrapolate FTE for all active SSGIM members. To model the demand by 2033, we derived different scenarios.
RESULTS
Of all 6,232 active SSGIM members, 2,030 (33%) participated: 46% female, 25% (largest age group) 56-65 years old, 19% still in postgraduate training. The average workload in 2023 was 78% for female and 87% for male generalists; the FTE extrapolated to all active SSGIM members in 2023 was 5,246. By 2033, 1,935 FTEs (36%) will retire, 502 FTEs (10%) will reduce their workload, 116 FTEs (2%) will increase their workload and 2,800 FTEs (53%) will remain in the workforce with the same workload as in 2023. To maintain the same workforce as in 2023, 2,321 new FTEs (44%) will be needed by 2033. To fill this gap of 232 FTE new generalists per year, we modelled different scenarios with assumptions of interest, workload, migration and dropouts.
CONCLUSIONS
Within only one decade, 44% of the current workforce of generalists will disappear, mainly due to retirement and decreased workload. To fill this gap, various scenarios need to be incorporated. Politicians are called upon to create the political framework to create attractive training and working conditions for generalists to address the future demand for healthcare services
Extremwinter, nasse Sommer und Jahrhundertstürme: Einblicke in das Klima und die Witterung der Barockzeit
Get PDFProviding ramps during lay has larger impacts on laying hens than ramps at rearing.
Get PDFCommercial laying hen housing is shifting from traditional cages to non-cage housing systems, such as the aviary, which has gained popularity due to potential for more species-typical behavior. However, birds housed in aviaries may have difficulties moving through the vertical tiers of the system leading to health problems such as keel bone fracture (KBF). One possible way to improve movement is to add ramps into an aviary system, allowing hens to walk between tiers rather than jump or fly. The objective of this study was to evaluate the impact of adding ramps to rearing and laying aviaries on bird health, production, and movement across vertical tiers of the aviary. Lohmann Selected Leghorn pullets were raised in 2 treatments: 4 pens (600 birds/pen) were raised with wire mesh ramps to aid movement between aviary tiers (RR) and 4 pens (600 birds/pen) were raised without ramps (RO). At 17 wk of age (WOA), birds were moved to the laying facility, in which 16 aviary pens with 225 birds/pen were populated. Half the pens (n = 8) were supplemented with wire mesh ramps (LR) and the other half were not (LO). Within each laying treatment group, 4 pens were populated with RR hens and 4 pens were populated with RO hens, creating 4 treatment combinations (RRLR, RRLO, ROLR, ROLO). From each pen, 15 focal hens were selected for radiographic imaging of their keel bones taken at 21, 36, 45, and 60 WOA and the images were subsequently scored for KBF severity. Focal hens were also scored for feather condition and footpad quality at 36 and 60 WOA using a standardized welfare assessment protocol. The number of downward transitions among aviary areas and falls were recorded at 19 to 20 and 30 to 31 WOA. Data were analyzed using (generalized) linear mixed models in R software. When ramps were available, they were used in most of the observed downward transitions (79% in ROLR and 86% in RRLR). Hens who received ramps in lay (i.e., RRLR and ROLR) showed more transitions immediately after lights on compared to midday or dusk phases (p < 0.001), performed more transitions from the first aviary tier compared to nest or top tier (p = 0.013) and had lower KBF severity than those who did not receive ramps in the laying aviaries (ROLO, RRLO; p < 0.001). At 60 WOA, hens in the RRLR treatment had greater feather coverage than those in ROLR and RRLO treatments (p < 0.001). Birds in the RRLR treatment had better foot health overall than those in treatments without ramps in lay (p = 0.018). Providing ramps to hens in aviaries appeared to be the preferred means of transitioning between aviary tiers though had positive effects on welfare parameters such as food health, feather coverage, and KBF severity, without negative impacts on production. Benefits were seen primarily when ramps were provided in lay, though their installation in rearing provided evidence of easier adaptation to the laying barn. Our study supports providing ramps throughout the lifetime of the bird to accommodate hens' preferred means of moving vertically in aviaries and deliver consequent benefits to health and welfare
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