Image and imaging an emergency department: expense and benefit of different quality assessment methods

Introduction. In this era of high-tech medicine, it is becoming increasingly important to assess patient satisfaction. There are several methods to do so, but these differ greatly in terms of cost, time, and labour and external validity. The aim of this study is to describe and compare the structure and implementation of different methods to assess the satisfaction of patients in an emergency department. Methods. The structure and implementation of the different methods to assess patient satisfaction were evaluated on the basis of a 90-minute standardised interview. Results. We identified a total of six different methods in six different hospitals. The average number of patients assessed was 5012, with a range from 230 (M5) to 20 000 patients (M2). In four methods (M1, M3, M5, and M6), the questionnaire was composed by a specialised external institute. In two methods, the questionnaire was created by the hospital itself (M2, M4).The median response rate was 58.4% (range 9-97.8%). With a reminder, the response rate increased by 60% (M3). Conclusion. The ideal method to assess patient satisfaction in the emergency department setting is to use a patient-based, in-emergency department-based assessment of patient satisfaction, planned and guided by expert personnel.

Oberflächenveränderung verschiedener zahnmedizinischer Werk-stoffe nach in-vitro Alterung

Susceptibility of different restorative materials to toothbrush abrasion and coffee staining Objective: The aim of this study was to evaluate the susceptibility of different restorative materials to surface alterations after an aging simulation. Methods: Specimens (n=15 per material) of five different restorative materials (CER: ceramic/Vita Mark II; EMP: composite/Empress Direct; LAV: CAD/CAM composite/Lava Ultimate; COM: prefabricated composite/Componeer; VEN: prefabricated composite/Venear) were produced. Whereas CER was glazed, EMP and LAV were polished with silicon polishers, and COM and VEN were left untreated. Mean roughness (Ra and Rz) and colorimetric parameters (L*a*b*), expressed as colour change (E), were measured. The specimens underwent an artificial aging procedure. After baseline measurements (M1), the specimens were successively immersed for 24 hours in coffee (M2), abraded in a toothbrushing simulator (M3), immersed in coffee (M4), abraded (M5) and repeatedly abraded (M6). After each aging procedure (M2-M6), surface roughness and colorimetric parameters were recorded. Differences between the materials regarding Ra/Rz and E were analysed with a nonparametric ANOVA analysis. The level of significance was set at α=0.05. Results: The lowest roughness values were obtained for CER. A significant increase in Ra was detected for EMP, COM and VEN compared to CER. The Ra/Rz values were found to be highly significantly different for the materials and measuring times (M) (p<0.0001). Regarding E most alterations were found for EMP and COM, whereas CER and LAV remained mostly stable. The E values were significantly different for the materials and M (p<0.0001). Conclusion: The ceramic and the CAD/CAM composite were the most stable materials with regard to roughness and colour change and the only materials that resulted in Ra values below 0.2 μm (the clinically relevant threshold). Venears and Componeers were more inert than the direct composite material and thus might be an alternative for extensive restorations in the aesthetic zone.

Black probes of Schrödinger spacetimes

We consider black probes of Anti-de Sitter and Schrödinger spacetimes embedded in string theory and M-theory and construct perturbatively new black hole geometries. We begin by reviewing black string configurations in Anti-de Sitter dual to finite temperature Wilson loops in the deconfined phase of the gauge theory and generalise the construction to the confined phase. We then consider black strings in thermal Schrödinger, obtained via a null Melvin twist of the extremal D3-brane, and construct three distinct types of black string configurations with spacelike as well as lightlike separated boundary endpoints. One of these configurations interpolates between the Wilson loop operators, with bulk duals defined in Anti-de Sitter and another class of Wilson loop operators, with bulk duals defined in Schrödinger. The case of black membranes with boundary endpoints on the M5-brane dual to Wilson surfaces in the gauge theory is analysed in detail. Four types of black membranes, ending on the null Melvin twist of the extremal M5-brane exhibiting the Schrödinger symmetry group, are then constructed. We highlight the differences between Anti-de Sitter and Schrödinger backgrounds and make some comments on the properties of the corresponding dual gauge theories.

Physical activity interventions in schools for improving lifestyle in European countries

Background: In the last decades, children’s and adolescents’ obesity and overweight have increased in European Countries. Unhealthy eating habits and sedentary lifestyle have been recognized to determine such an epidemic. Schools represent an ideal setting to modify harmful behaviors, and physical activity could be regarded as a potential way to avoid the metabolic risks related to obesity. Methods: A systematic review of the literature was carried out to summarize the evidence of school-based interventions aimed to promote, enhance and implement physical activity in European schools. Only randomized controlled trials were included, carried out in Europe from January 2000 to April 2014, universally delivered and targeting pupils aged between 3 and 18 years old. Results: Forty-seven studies were retrieved based either on multicomponent interventions or solely physical activity programs. Most aimed to prevent obesity and cardiovascular risks among youths. While few studies showed a decrease in BMI, positive results were achieved on other outcomes, such as metabolic parameters and physical fitness. Conclusion: Physical activity in schools should be regarded as a simple, non-expensive and enjoyable way to reach all the children and adolescents with adequate doses of moderate to vigorous physical activity.

The M-theory origin of global properties of gauge theories

We show that global properties of gauge groups can be understood as geometric properties in M-theory. Different wrappings of a system of N M5-branes on a torus reduce to four-dimensional theories with AN−1 gauge algebra and different unitary groups. The classical properties of the wrappings determine the global properties of the gauge theories without the need to impose any quantum conditions. We count the inequivalent wrappings as they fall into orbits of the modular group of the torus, which correspond to the S-duality orbits of the gauge theories.

Miscellany of Hebrew Literature. Vol. 1

[ed. by Israel Davis]

Jacobi Rhenferdii ... dissertationes philologicae de Decem Otiosis Synagogae : in quibus viri clariss. Johannis Lightfooti, aliorum que sententiae de Otiosis examinatur, varia de Synagogis, earumque jure, praefectis, ministris ... adsperguntur

Univ., Diss., 1686

Martin Buber : sein Gang in die Wirklichkeit

von Wilhelm Michel

Mikraʾe ḳodesh oder Fest-Reden und Fest-Vorbereitungsreden für Israeliten, auf alle Feste des Jahres

gehalten und hrsg. von Salomon Plessner

Miḳraʾe ḳodesh oder Fest-Reden für Israeliten auf alle Feste des Jahres

von Salomon Plessner. Hrsg. von Elias Plessner

Paleoclimate reconstructions from sediment core MD01-2378

On the basis of the radiocarbon (14C) plateau-tuning method a new age model for Timor Sea Core MD01-2378 was established. It revealed a precise centennial-scale phasing of climate events in the ocean, cryo-, and atmosphere during the last deglacial and provides important new insights into causal linkages controlling events of global climate change. At Site MD01-2378 reservoir ages of surface waters dropped from 1600 yr prior to 20 cal ka to 250-500 yr after 18.8 cal ka. This evidence was crucial for generating a high-resolution age model for deglacial events in the Indo-Pacific Warm Pool. Sea-surface temperatures (SST) started to change near 18.8 cal ka, that is ~500 yr after the start of, presumably northern hemispheric, deglacial melt and sea level rise as shown by the benthic foraminiferal oxygen isotope ratio (d18O). However, the SST rise occurred 500-1000 yr prior to the onset of deglacial Antarctic warming and the first major rise in atmospheric carbon dioxide at about 18 ka. The increase in SST may partly reflect reduced seasonal upwelling of cold subsurface waters along the eastern margin of the Indian Ocean, which is reflected by a doubling of the thermal gradient between the sea surface and the thermocline, a halving of chlorin productivity from 19 to 18.5 cal ka, and in particular, by the strong decrease in surface water reservoir ages. Two significant increases in deglacial Timor Sea surface salinities from 19-18.5 and 15.5-14.5 cal ka, may partly reflect the deglacial increase in the distance of local river mouths, partly an inter-hemispheric millennial-scale see-saw in tropical monsoon intensity, possibly linked to a deglacial increase in the dominance of Pacific El Niño regimes over Heinrich stadial 1.

Near-bottom zooplankton aggregations in Kongsfjorden with link to images from the optical zooplankton sensor MOKI

Near-bottom zooplankton communities have rarely been studied despite numerous reports of high zooplankton concentrations, probably due to methodological constraints. In Kongsfjorden, Svalbard, the near-bottom layer was studied for the first time by combining daytime deployments of a remotely operated vehicle (ROV), the optical zooplankton sensor moored on-sight key species investigation (MOKI), and Tucker trawl sampling. ROV data from the fjord entrance and the inner fjord showed high near-bottom abundances of euphausiids with a mean concentration of 17.3 ± 3.5 n/100 m**3. With the MOKI system, we observed varying numbers of euphausiids, amphipods, chaetognaths, and copepods on the seafloor at six stations. Light-induced zooplankton swarms reached densities in the order of 90,000 (euphausiids), 120,000 (amphipods), and 470,000 ind/m**3 (chaetognaths), whereas older copepodids of Calanus hyperboreus and C. glacialis did not respond to light. They were abundant at the seafloor and 5 m above and showed maximum abundance of 65,000 ind/m**3. Tucker trawl data provided an overview of the seasonal vertical distribution of euphausiids. The most abundant species Thysanoessa inermis reached near-bottom concentrations of 270 ind/m**3. Regional distribution was neither related to depth nor to location in the fjord. The taxa observed were all part of the pelagic community. Our observations suggest the presence of near-bottom macrozooplankton also in other regions and challenge the current view of bentho-pelagic coupling. Neglecting this community may cause severe underestimates of the stock of elagic zooplankton, especially predatory species, which link secondary production with higher trophic levels.

Slope stability analyses based on sediment cores of the Ligurian Margin, Southern France

Submarine slope failures of various types and sizes are common along the tectonic and seismically active Ligurian margin, northwestern Mediterranean Sea, primarily because of seismicity up to ~M6, rapid sediment deposition in the Var fluvial system, and steepness of the continental slope (average 11°). We present geophysical, sedimentological and geotechnical results of two distinct slides in water depth >1,500 m: one located on the flank of the Upper Var Valley called Western Slide (WS), another located at the base of continental slope called Eastern Slide (ES). WS is a superficial slide characterized by a slope angle of ~4.6° and shallow scar (~30 m) whereas ES is a deep-seated slide with a lower slope angle (~3°) and deep scar (~100 m). Both areas mainly comprise clayey silt with intermediate plasticity, low water content (30-75 %) and underconsolidation to strong overconsolidation. Upslope undeformed sediments have low undrained shear strength (0-20 kPa) increasing gradually with depth, whereas an abrupt increase in strength up to 200 kPa occurs at a depth of ~3.6 m in the headwall of WS and ~1.0 m in the headwall of ES. These boundaries are interpreted as earlier failure planes that have been covered by hemipelagite or talus from upslope after landslide emplacement. Infinite slope stability analyses indicate both sites are stable under static conditions; however, slope failure may occur in undrained earthquake condition. Peak earthquake acceleration from 0.09 g on WS and 0.12 g on ES, i.e. M5-5.3 earthquakes on the spot, would be required to induce slope instability. Different failure styles include rapid sedimentation on steep canyon flanks with undercutting causing superficial slides in the west and an earthquake on the adjacent Marcel fault to trigger a deep-seated slide in the east.

Characteristic magnetizations of paleomagnetic samples from ODP Leg 103

Lower Cretaceous and Tithonian sediments were sampled for magnetostratigraphy at six holes (Holes 638B, 638C, 639A, 639D, 640A, and 641C). Magnetic polarity chrons were assigned to polarity zones using biostratigraphic constraints. In Holes 638B and 638C, polarity Chrons M3 and perhaps Ml are present in the upper part, M4 and M5 are apparently absent, M6 through M9 are poorly represented, M10 and M10N are apparently absent, and Ml 1 and M12 are tentatively assigned to the lower part. Strata in Holes 638B and 638C dip toward the south. In Hole 639A, polarity Chron M13 is well documented and M12A may be present. In Hole 639D, polarity Chrons M19 through M21 may be present, but the data is poor. Hole 640A had inadequate recovery to identify polarity chrons. In Hole 641C, polarity Chron MO is well documented and occurs significantly above the nannofossil marker of the Barremian/Aptian boundary; comparison to Italian magnetostratigraphy implies that this nannofossil datum is timetransgressive.