Le fixateur externe dans les lésions traumatiques graves du bassin: résultats à propos de 20 cas consécutifs [External fixator in severe traumatic injuries of the pelvis: results apropos of 20 consecutive cases]

From August 91 to December 94, 20 external fixators were used for severely injured patients (avg. ISS 25.2). The fractures were essentially open book with or without lateral compression and vertical lesions. The indication for fixation was treatment of shock and stabilization in 8 cases, stabilization alone in 9 cases, and in 3 cases as complementary fixation after internal fixation of posterior lesions. The fixation of the pelvis was effective on the amount of blood loss. One acetabulum fracture required surgery, two patients had internal fixation for loss of reduction and two others for late pubic and posterior pain. The clinical results are good; they are more related to the severity of the initial lesion than to the mode of fixation or the quality of the reduction. No superficial sepsis or osteitis was observed in relation to the pins.

Validity of the acoustic approximation in full-waveform seismic crosshole tomography

Acoustic waveform inversions are an increasingly popular tool for extracting subsurface information from seismic data. They are computationally much more efficient than elastic inversions. Naturally, an inherent disadvantage is that any elastic effects present in the recorded data are ignored in acoustic inversions. We investigate the extent to which elastic effects influence seismic crosshole data. Our numerical modeling studies reveal that in the presence of high contrast interfaces, at which P-to-S conversions occur, elastic effects can dominate the seismic sections, even for experiments involving pressure sources and pressure receivers. Comparisons of waveform inversion results using a purely acoustic algorithm on synthetic data that is either acoustic or elastic, show that subsurface models comprising small low-to-medium contrast (?30%) structures can be successfully resolved in the acoustic approximation. However, in the presence of extended high-contrast anomalous bodies, P-to-S-conversions may substantially degrade the quality of the tomographic images. In particular, extended low-velocity zones are difficult to image. Likewise, relatively small low-velocity features are unresolved, even when advanced a priori information is included. One option for mitigating elastic effects is data windowing, which suppresses later arriving seismic arrivals, such as shear waves. Our tests of this approach found it to be inappropriate because elastic effects are also included in earlier arriving wavetrains. Furthermore, data windowing removes later arriving P-wave phases that may provide critical constraints on the tomograms. Finally, we investigated the extent to which acoustic inversions of elastic data are useful for time-lapse analyses of high contrast engineered structures, for which accurate reconstruction of the subsurface structure is not as critical as imaging differential changes between sequential experiments. Based on a realistic scenario for monitoring a radioactive waste repository, we demonstrated that acoustic inversions of elastic data yield substantial distortions of the tomograms and also unreliable information on trends in the velocity changes.

Glioblastoma in elderly patients: health-related quality of life (hrqol) in a randomized trial comparing 6-weeks of tadiotherapy (rt) vs hypofractionated rt over 2 weeks vs temozolomide chemotherapy (tmz)

BACKGROUND: Despite advances in treatment, survival of patients with GBM over 60 years is still often less than 1 year. In the perspective of a short expected survival, the quality of the remaining life and the effects of therapy on health-related quality of life (HRQoL) should be given special emphasis when recommending treatment for the individual patients. Several studies have focused on survival of the elderly, but few data are available on HRQoL for different treatments. In a randomized trial, we compared survival and HRQoL for 3 treatment options, 6 weeks of RT, vs hypofractionated RT, or chemotherapy with TMZ. MATERIALS AND METHODS: Newly diagnosed GBM patients, age ≥60 years with PS 0-2, were randomized to either standard RT (60 Gy in 2-Gy fractions over 6 weeks), hypofractionated RT (34 Gy in 3.4-Gy fractions over 2 weeks), or 6 cycles of chemotherapy with TMZ (200 mg/m2 day 1-5 every 28 days). QoL was determined by the EORTC QLQ 30 questionnaire and the Brain Cancer Module at inclusion, before start of therapy, at 6 weeks, 3 months, and 6 months after start of treatment. Patients were followed until death. The primary study endpoint was overall survival (OS) and secondary objectives were HRQoL, neurologic symptom control, and safety. RESULTS: A total of 342 patients were included and 292 patients were randomized between the 3 treatment options and 50 patients between hypofractionated RT and TMZ. Median age was 70 years (range 60-92) with 58% being male. Performance status was 0-1 for 75% of patients and 73% had undergone surgical resection. CONCLUSION: The results from the HRQoL analysis of this trial will be presented together with survival data at the upcoming EANO meeting.

Quality of Learners' Time and Learning Performance Beyond Quantitative Time-on-Task

Peer-reviewed

Benchmarking project of the Department of Electrical Engineering of Lappeenranta University of Technology

Lappeenrannan teknillisen korkeakoulun sähkötekniikan osasto muutti 1.8.2005 sähkötekniikan tutkinnon kaksiportaiseksi ja vastaamaan näin Bologna-prosessia ja Suomen yliopistolainsäädäntöä. Tutkinnonuudistuksen myötä osasto haluaa varmistaa sähkötekniikan tutkintojen laadun ja vertailtavuuden sekä parantaa opiskelijoidensekä henkilökunnan liikkuvuutta. Tutkintojen laatu ja vertailtavuus osoitetaan sähkötekniikan osaston benchmark-projektilla, jossa kerätään tietoja maisteri- ja tohtorintutkintoa tarjoavista eurooppalaisista yliopistoista. Diplomityö käsittää BM-projektin kolmannen vaiheen suunnittelun ja toteutuksen sisältäen teoriaa benchmark-projekteille tyypillisistä toimintatavoista. Hyväksi havaitut menetelmiä, kuten kyselyt ja matriisit, on tässä työssä otettu soveltuvin osin sähkötekniikan osaston BM-projektin työkaluiksi. Diplomityössä analysoidaan työkalujen avulla BM-kumppaneilta kerättyjä tietoja sekä esitetään ratkaisuja, miten sähkötekniikan osastolla voidaan jatkaa parhaiden toimintatapojen löytämistä.

Limestone particle sizes and lighting regimens on egg and bone quality of laying hens

Abstract:The objective of this work was to evaluate the effect of limestone particle sizes in the diet and of lighting regimes on the egg and bone quality and on the performance of commercial laying hens. Three hundred Hissex White layers, at 18 weeks of age, were distributed in a completely randomized design, in a 5×2 factorial arrangement (coarse limestone in the diet at 0, 25, 50, 75, and 100%; with or without artificial light), with five replicates of six birds. No significant interaction was observed between particle sizes and lighting regime for the evaluated parameters. There was no significant effect of coarse limestone level in the diet on the performance and egg quality of hens; however, bone deformity (3.23 to 4.01 mm), strength (5.19 to 6.70 kgf cm-2), and mineral matter (51.09 to 59.61%) improved as the proportion of coarse limestone increased. For lighting regime, the treatment with artificial light yielded higher Haugh unit values (87.17 vs. 85.54) than that with natural light only. Greater limestone particles improve bone quality of laying hens, and the use of artificial light can benefit the albumen quality of the eggs.

Forage potential and silage quality of four varieties of saccharine sorghum

Abstract: The objective of this work was to evaluate four cultivars of saccharine sorghum (Sorghum bicolor) regarding productivity, chemical composition of plant parts, and quality of the ensiling process. The tested varieties of saccharine sorghum were BRS 506, BRS 508, BRS 509, and BRS 511. The experiment was divided into two trials, which assessed: production, morphological composition, and nutritional quality of the saccharine varieties; and fermentation quality and nutritional value of the silage produced from the saccharine varieties. Of the tested varieties, BRS 509 and BRS 511 showed the highest total dry matter (DM) production. The BRS 508 variety presented the highest in vitro digestibility of the whole plant (70.65% DM). During ensiling, the BRS 509 variety showed the lowest DM loss (8.87%). The highest effluent production was observed for BRS 506 and BRS 508, with yields of 521.87 and 393.16 kg Mg-1 ensiled DM, respectively. The BRS 511 variety is the most recommended because of the best results for plant production and nutritional quality. Regarding the ensiling process, BRS 509 presents the lowest fermentation losses and the highest nutritional value of silage.

Quality of web-based information on bipolar disorder

OBJECTIVE: To evaluate web-based information on bipolar disorder and to assess particular content quality indicators. METHODS: Two keywords, "bipolar disorder" and "manic depressive illness" were entered into popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality. "Health on the Net" (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. RESULTS: Of the 80 websites identified, 34 were included. Based on outcome measures, the content quality of the sites turned-out to be good. Content quality of web sites dealing with bipolar disorder is significantly explained by readability, accountability and interactivity as well as a global score. CONCLUSIONS: The overall content quality of the studied bipolar disorder websites is good.

Sensitivity analysis, dominant factors, and robustness of the ECETOC TRA v3, Stoffenmanager 4.5, and ART 1.5 occupational exposure models

Occupational exposure modeling is widely used in the context of the E.U. regulation on the registration, evaluation, authorization, and restriction of chemicals (REACH). First tier tools, such as European Centre for Ecotoxicology and TOxicology of Chemicals (ECETOC) targeted risk assessment (TRA) or Stoffenmanager, are used to screen a wide range of substances. Those of concern are investigated further using second tier tools, e.g., Advanced REACH Tool (ART). Local sensitivity analysis (SA) methods are used here to determine dominant factors for three models commonly used within the REACH framework: ECETOC TRA v3, Stoffenmanager 4.5, and ART 1.5. Based on the results of the SA, the robustness of the models is assessed. For ECETOC, the process category (PROC) is the most important factor. A failure to identify the correct PROC has severe consequences for the exposure estimate. Stoffenmanager is the most balanced model and decision making uncertainties in one modifying factor are less severe in Stoffenmanager. ART requires a careful evaluation of the decisions in the source compartment since it constitutes ∼75% of the total exposure range, which corresponds to an exposure estimate of 20-22 orders of magnitude. Our results indicate that there is a trade off between accuracy and precision of the models. Previous studies suggested that ART may lead to more accurate results in well-documented exposure situations. However, the choice of the adequate model should ultimately be determined by the quality of the available exposure data: if the practitioner is uncertain concerning two or more decisions in the entry parameters, Stoffenmanager may be more robust than ART.

"Voyage through death/to life upon these shores": the living dead of the Middle Passage

While historical studies of the Atlantic slave trade have amply demonstrated the magnitude of slave mortality during the Middle Passage, only recently have they started to examine how the captives might have endured and coped with this traumatic experience. Although it constitutes a major topos in African diasporic culture, the Middle Passage has only occasionally been represented directly and in details in novels and in films. This article examines three recent narratives of the Middle Passage, Fred D'Aguiar's novel Feeding the Ghosts (1998), Guy Deslauriers's film Passage du milieu (2000), and Stephanie Smallwood's historical study Saltwater Slavery: A Middle Passage from Africa to American Diaspora (2007). Beyond their individual poetic, aesthetic, and scholarly qualities, what is most striking about these three texts is that they all use the figure of the living dead in order to explore the captives' experience of the transatlantic journey. If the ghastly quality of the living dead powerfully captures the life-threatening material and physical conditions the captives endured on the voyage, its dual, liminal character also allows D'Aguiar, Deslauriers, and Smallwood to represent the metaphysical, psychological, social, and cultural journey they were forced to undertake. Through their use of the trope of the living dead, these three texts show that if death is indeed a central aspect of the experience of the Middle Passage, it impacts the captives in ways that go well beyond the issue of mortality.

Fruit quality of 'Tahiti' lime (Citrus latifolia Tanak) grafted on twelve different rootstocks

In the present work, the effect of twelve rootstocks on fruit quality of the nucellar clone IAC-5 of 'Tahiti' lime, (Citrus latifolia Tanaka) and the influence of fruit position on tree in fruit quality was evaluated in the Citrus Experimental Station of Bebedouro (EECB), located in the Bebedouro county, state of São Paulo, Brazil. A 8.0 x 5.0m planting frame was utilized. The evaluated rootstocks were: 'Carrizo' citrange (C. sinensis (L.) Osbeck x Poncirus trifoliata (L.) Raf.); the hybrids 'Rangpur' lime x 'Swingle' citrumello (C. limonia Osbeck x P. trifoliata Raf) and 'Changsha' x 'English Small'(C. sunki Hort. ex Tan. x P. trifoliata Raf.); the mandarins 'Sun Chu Sha Kat' (C. reticulata Blanco) and 'Sunki' (C. sunki Hort. ex Tanaka); the 'Rangpur' limes 'Cravo Limeira' and ' Cravo FCAV' (C. limonia Osbeck); the 'Swingle' citrumello (P. trifoliata Raf. x C. paradisi Macf.); the 'Orlando' tangelo (C. reticulata Blanco x C. paradisi Macf.) and the trifoliates cvs. 'Rubidoux', 'FCAV' and 'Flying Dragon' (P. trifoliata Raf.). The experiment was arranged in a randomized block design, with twelve treatments, six replicates and one plant per plot. The rootstocks induced differences in fruit quality; however, all the evaluated quality characteristics were within the values considered as normal and acceptable for the variety, constituting good alternative rootstocks for the 'Rangpur' lime. Additionally, the fruit position in the plant (northeastern or southwestern) had a significant influence on the external fruit color regardless of the rootstock.

The new final Clinical Skills examination in human medicine in Switzerland: Essential steps of exam development, implementation and evaluation, and central insights from the perspective of the national Working Group.

OBJECTIVE: Since 2011, the new national final examination in human medicine has been implemented in Switzerland, with a structured clinical-practical part in the OSCE format. From the perspective of the national Working Group, the current article describes the essential steps in the development, implementation and evaluation of the Federal Licensing Examination Clinical Skills (FLE CS) as well as the applied quality assurance measures. Finally, central insights gained from the last years are presented. METHODS: Based on the principles of action research, the FLE CS is in a constant state of further development. On the foundation of systematically documented experiences from previous years, in the Working Group, unresolved questions are discussed and resulting solution approaches are substantiated (planning), implemented in the examination (implementation) and subsequently evaluated (reflection). The presented results are the product of this iterative procedure. RESULTS: The FLE CS is created by experts from all faculties and subject areas in a multistage process. The examination is administered in German and French on a decentralised basis and consists of twelve interdisciplinary stations per candidate. As important quality assurance measures, the national Review Board (content validation) and the meetings of the standardised patient trainers (standardisation) have proven worthwhile. The statistical analyses show good measurement reliability and support the construct validity of the examination. Among the central insights of the past years, it has been established that the consistent implementation of the principles of action research contributes to the successful further development of the examination. CONCLUSION: The centrally coordinated, collaborative-iterative process, incorporating experts from all faculties, makes a fundamental contribution to the quality of the FLE CS. The processes and insights presented here can be useful for others planning a similar undertaking.

Service Quality of ASPs (Application Service Providers): Case of an E-accounting Service

Service quality has been a hot topic in services marketing research since the ‘80s. Although it has been widely researched in the B2C context, as well as there is some research in the B2B side, it has received very little attention specifically in the context of the ASP (Application Service Provider) business model. The thesis uses streams of service quality literature in B2C and B2B as well as research of the ASP model to form a comprehensive understanding of service quality in the context of the ASPs. The empirical part consists of a case study of Netvisor, a fast-growing Finnish ASP providing e-accounting services. The key findings are that some traditional service quality dimensions seem to apply also in the ASP context and the relative importance of some dimensions differs with regard to different customer levels. Suggestions are made to improve the service quality of the case company.

The Progress and Challenges of the e-Government Initiatives and Implementation in the Kurdistan Region of Iraq

The Electronic Government (e-Government) means delivering the services and information to the citizens and businesses through the use of Information and Communication Technology (ICT) in order to enable them to interact more effectively with the government, and to increase the quality of the services. As many other governments in the developed and developing countries, the Kurdistan Regional Government (KRG) has embarked on the e-Government initiatives. This study revealed that there are various challenges which affect the e-Government in the Kurdistan Region of Iraq (KRI), but also a lot of e-Government progress has happened. In addition, based on the United Nations’ e-Government maturity level benchmarking, the e-Government in the KRI is at the interactive stage. In this study the services that the citizens want from the government in order to implement an appropriate e-Government were also identified.

The influence of the season of the year and of dilution on the development of swine manure and wood shaves co-composting

The objective of this research was to study the influence of factors related to the proper management of pig manure (lower dilution) and the season of the year in the progress of the co-composting of pig manure with wood shavings and in the final quality of the compost resulting from the treatments. In the first experiment, two types of swine manure were used: a diluted one (2% Dry Matter - DM), typical from the management usually used in Brazil, and a more concentrated one (6% DM). The manures were incorporated into the wood shavings (6L:1kg) over the course of four weeks. The development of composting was accompanied by monitoring of temperatures inside the piles and the emission of CO2 and CH4 gases during 65 days, including the period of incorporation. The results showed that the diluted manure does not provide the minimum conditions for starting the process. After the incorporation period, any biomass heating was observed and neither the aerobic or anaerobic respiration of the microorganisms, resulting in a compost with low quality. In the second experiment, which evaluated composting in winter and summer during 85 days, it was found that the heat exchange with the environment influences the temperature generated within the piles. The lower temperatures significantly reduced the methanogenesis on the biomass.