Ab initio quantum mechanical investigation of structural and chemical-physical properties of selected minerals for minero-petrological, structural ceramic and biomaterial applications

The purpose of this thesis is the atomic-scale simulation of the crystal-chemical and physical (phonon, energetic) properties of some strategically important minerals for structural ceramics, biomedical and petrological applications. These properties affect the thermodynamic stability and rule the mineral-environment interface phenomena, with important economical, (bio)technological, petrological and environmental implications. The minerals of interest belong to the family of phyllosilicates (talc, pyrophyllite and muscovite) and apatite (OHAp), chosen for their importance in industrial and biomedical applications (structural ceramics) and petrophysics. In this thesis work we have applicated quantum mechanics methods, formulas and knowledge to the resolution of mineralogical problems ("Quantum Mineralogy”). The chosen theoretical approach is the Density Functional Theory (DFT), along with periodic boundary conditions to limit the portion of the mineral in analysis to the crystallographic cell and the hybrid functional B3LYP. The crystalline orbitals were simulated by linear combination of Gaussian functions (GTO). The dispersive forces, which are important for the structural determination of phyllosilicates and not properly con-sidered in pure DFT method, have been included by means of a semi-empirical correction. The phonon and the mechanical properties were also calculated. The equation of state, both in athermal conditions and in a wide temperature range, has been obtained by means of variations in the volume of the cell and quasi-harmonic approximation. Some thermo-chemical properties of the minerals (isochoric and isobaric thermal capacity) were calculated, because of their considerable applicative importance. For the first time three-dimensional charts related to these properties at different pressures and temperatures were provided. The hydroxylapatite has been studied from the standpoint of structural and phonon properties for its biotechnological role. In fact, biological apatite represents the inorganic phase of vertebrate hard tissues. Numerous carbonated (hydroxyl)apatite structures were modelled by QM to cover the broadest spectrum of possible biological structural variations to fulfil bioceramics applications.

Evaluation of slope stability under water and seismic load through the Minimum Lithostatic Deviation method

The main objective of this thesis is to obtain a better understanding of the methods to assess the stability of a slope. We have illustrated the principal variants of the Limit Equilibrium (LE) method found in literature, focalizing our attention on the Minimum Lithostatic Deviation (MLD) method, developed by Prof. Tinti and his collaborators (e.g. Tinti and Manucci, 2006, 2008). We had two main goals: the first was to test the MLD method on some real cases. We have selected the case of the Vajont landslide with the objective to reconstruct the conditions that caused the destabilization of Mount Toc, and two sites in the Norwegian margin, where failures has not occurred recently, with the aim to evaluate the present stability state and to assess under which conditions they might be mobilized. The second goal was to study the stability charts by Taylor and by Michalowski, and to use the MLD method to investigate the correctness and adequacy of this engineering tool.

Estimation of Quasi-Rational DSGE Models

Small-scale dynamic stochastic general equilibrium have been treated as the benchmark of much of the monetary policy literature, given their ability to explain the impact of monetary policy on output, inflation and financial markets. One cause of the empirical failure of New Keynesian models is partially due to the Rational Expectations (RE) paradigm, which entails a tight structure on the dynamics of the system. Under this hypothesis, the agents are assumed to know the data genereting process. In this paper, we propose the econometric analysis of New Keynesian DSGE models under an alternative expectations generating paradigm, which can be regarded as an intermediate position between rational expectations and learning, nameley an adapted version of the "Quasi-Rational" Expectatations (QRE) hypothesis. Given the agents' statistical model, we build a pseudo-structural form from the baseline system of Euler equations, imposing that the length of the reduced form is the same as in the `best' statistical model.

Contribution of Non-Covalent Interactions and Electronic Effects on the Conformational Landscape and Tautomeric Equilibria of Molecules and Molecular Complexes: Structural and Dynamical Data from Rotational Spectroscopy

This thesis concerns the study of complex conformational surfaces and tautomeric equilibria of molecules and molecular complexes by quantum chemical methods and rotational spectroscopy techniques. In particular, the focus of this research is on the effects of substitution and noncovalent interactions in determining the energies and geometries of different conformers, tautomers or molecular complexes. The Free-Jet Absorption Millimeter Wave spectroscopy and the Pulsed-Jet Fourier Transform Microwave spectroscopy have been applied to perform these studies and the obtained results showcase the suitability of these techniques for the study of conformational surfaces and intermolecular interactions. The series of investigations of selected medium-size molecules and complexes have shown how different instrumental setups can be used to obtain a variety of results on molecular properties. The systems studied, include molecules of biological interest such as anethole and molecules of astrophysical interest such as N-methylaminoethanol. Moreover halogenation effects have been investigated on halogen substituted tautomeric systems (5-chlorohydroxypyridine and 6-chlorohydroxypyridine), where it has shown that the position of the inserted halogen atom affects the prototropic equilibrium. As for fluorination effects, interesting results have been achieved investigating some small complexes where a molecule of water is used as a probe to reveal the changes on the electrostatic potential of different fluorinated compounds: 2-fluoropyridine, 3-fluoropyridine and penta-fluoropyridine. While in the case of the molecular complex between water and 2-fluoropyridine and 3-fluoropyridine the geometry of the complex with one water molecule is analogous to that of pyridine with the water molecule linked to the pyridine nitrogen, the case of pentafluoropyridine reveals the effect of perfluorination and the water oxygen points towards the positive center of the pyridine ring. Additional molecular adducts with a molecule of water have been analyzed (benzylamine-water and acrylic acid-water) in order to reveal the stabilizing driving forces that characterize these complexes.

Detection of individual spin transitions of a single proton confined in a cryogenic Penning trap

Das in dieser Arbeit vorgestellte Experiment zur Messung des magnetischen Moments des Protons basiert auf der Messung des Verhältnisses von Zyklotronfrequenz und Larmorfrequenz eines einzelnen, in einer kryogenen Doppel-Penning Falle gespeicherten Protons. In dieser Arbeit konnten erstmalig zwei der drei Bewegungsfrequenzen des Protons gleichzeitig im thermischen Gleichgewicht mit entsprechenden hochsensitiven Nachweissystemen nicht-destruktiv detektiert werden, wodurch die Messzeit zur Bestimmung der Zyklotronfrequenz halbiert werden konnte. Ferner wurden im Rahmen dieser Arbeit erstmalig einzelne Spin-Übergänge eines einzelnen Protons detektiert, wodurch die Bestimmung der Larmorfrequenz ermöglicht wird. Mithilfe des kontinuierlichen Stern-Gerlach Effekts wird durch eine sogenannte magnetische Flasche das magnetische Moment an die axiale Bewegungsmode des Protons gekoppelt. Eine Änderung des Spinzustands verursacht folglich einen Frequenzsprung der axialen Bewegungsfrequenz, welche nicht-destruktiv gemessen werden kann. Erschwert wird die Detektion des Spinzustands dadurch, dass die axiale Frequenz nicht nur vom Spinmoment, sondern auch vom Bahnmoment abhängt. Die große experimentelle Herausforderung besteht also in der Verhinderung von Energieschwankungen in den radialen Bewegungsmoden, um die Detektierbarkeit von Spin-Übergängen zu gewährleisten. Durch systematische Studien zur Stabilität der axialen Frequenz sowie einer kompletten Überarbeitung des experimentellen Aufbaus, konnte dieses Ziel erreicht werden. Erstmalig kann der Spinzustand eines einzelnen Protons mit hoher Zuverlässigkeit bestimmt werden. Somit stellt diese Arbeit einen entscheidenden Schritt auf dem Weg zu einer hochpräzisen Messung des magnetischen Moments des Protons dar.

Plasmonic nanoparticles as sensors : a novel approach to quantify adsorption and diffusion kinetics

Biosensors find wide application in clinical diagnostics, bioprocess control and environmental monitoring. They should not only show high specificity and reproducibility but also a high sensitivity and stability of the signal. Therefore, I introduce a novel sensor technology based on plasmonic nanoparticles which overcomes both of these limitations. Plasmonic nanoparticles exhibit strong absorption and scattering in the visible and near-infrared spectral range. The plasmon resonance, the collective coherent oscillation mode of the conduction band electrons against the positively charged ionic lattice, is sensitive to the local environment of the particle. I monitor these changes in the resonance wavelength by a new dark-field spectroscopy technique. Due to a strong light source and a highly sensitive detector a temporal resolution in the microsecond regime is possible in combination with a high spectral stability. This opens a window to investigate dynamics on the molecular level and to gain knowledge about fundamental biological processes.rnFirst, I investigate adsorption at the non-equilibrium as well as at the equilibrium state. I show the temporal evolution of single adsorption events of fibrinogen on the surface of the sensor on a millisecond timescale. Fibrinogen is a blood plasma protein with a unique shape that plays a central role in blood coagulation and is always involved in cell-biomaterial interactions. Further, I monitor equilibrium coverage fluctuations of sodium dodecyl sulfate and demonstrate a new approach to quantify the characteristic rate constants which is independent of mass transfer interference and long term drifts of the measured signal. This method has been investigated theoretically by Monte-Carlo simulations but so far there has been no sensor technology with a sufficient signal-to-noise ratio.rnSecond, I apply plasmonic nanoparticles as sensors for the determination of diffusion coefficients. Thereby, the sensing volume of a single, immobilized nanorod is used as detection volume. When a diffusing particle enters the detection volume a shift in the resonance wavelength is introduced. As no labeling of the analyte is necessary the hydrodynamic radius and thus the diffusion properties are not altered and can be studied in their natural form. In comparison to the conventional Fluorescence Correlation Spectroscopy technique a volume reduction by a factor of 5000-10000 is reached.

IMEX finite volume methods for the shallow water equations

Die Flachwassergleichungen (SWE) sind ein hyperbolisches System von Bilanzgleichungen, die adäquate Approximationen an groß-skalige Strömungen der Ozeane, Flüsse und der Atmosphäre liefern. Dabei werden Masse und Impuls erhalten. Wir unterscheiden zwei charakteristische Geschwindigkeiten: die Advektionsgeschwindigkeit, d.h. die Geschwindigkeit des Massentransports, und die Geschwindigkeit von Schwerewellen, d.h. die Geschwindigkeit der Oberflächenwellen, die Energie und Impuls tragen. Die Froude-Zahl ist eine Kennzahl und ist durch das Verhältnis der Referenzadvektionsgeschwindigkeit zu der Referenzgeschwindigkeit der Schwerewellen gegeben. Für die oben genannten Anwendungen ist sie typischerweise sehr klein, z.B. 0.01. Zeit-explizite Finite-Volume-Verfahren werden am öftersten zur numerischen Berechnung hyperbolischer Bilanzgleichungen benutzt. Daher muss die CFL-Stabilitätsbedingung eingehalten werden und das Zeitinkrement ist ungefähr proportional zu der Froude-Zahl. Deswegen entsteht bei kleinen Froude-Zahlen, etwa kleiner als 0.2, ein hoher Rechenaufwand. Ferner sind die numerischen Lösungen dissipativ. Es ist allgemein bekannt, dass die Lösungen der SWE gegen die Lösungen der Seegleichungen/ Froude-Zahl Null SWE für Froude-Zahl gegen Null konvergieren, falls adäquate Bedingungen erfüllt sind. In diesem Grenzwertprozess ändern die Gleichungen ihren Typ von hyperbolisch zu hyperbolisch.-elliptisch. Ferner kann bei kleinen Froude-Zahlen die Konvergenzordnung sinken oder das numerische Verfahren zusammenbrechen. Insbesondere wurde bei zeit-expliziten Verfahren falsches asymptotisches Verhalten (bzgl. der Froude-Zahl) beobachtet, das diese Effekte verursachen könnte.Ozeanographische und atmosphärische Strömungen sind typischerweise kleine Störungen eines unterliegenden Equilibriumzustandes. Wir möchten, dass numerische Verfahren für Bilanzgleichungen gewisse Equilibriumzustände exakt erhalten, sonst können künstliche Strömungen vom Verfahren erzeugt werden. Daher ist die Quelltermapproximation essentiell. Numerische Verfahren die Equilibriumzustände erhalten heißen ausbalanciert.rnrnIn der vorliegenden Arbeit spalten wir die SWE in einen steifen, linearen und einen nicht-steifen Teil, um die starke Einschränkung der Zeitschritte durch die CFL-Bedingung zu umgehen. Der steife Teil wird implizit und der nicht-steife explizit approximiert. Dazu verwenden wir IMEX (implicit-explicit) Runge-Kutta und IMEX Mehrschritt-Zeitdiskretisierungen. Die Raumdiskretisierung erfolgt mittels der Finite-Volumen-Methode. Der steife Teil wird mit Hilfe von finiter Differenzen oder au eine acht mehrdimensional Art und Weise approximniert. Zur mehrdimensionalen Approximation verwenden wir approximative Evolutionsoperatoren, die alle unendlich viele Informationsausbreitungsrichtungen berücksichtigen. Die expliziten Terme werden mit gewöhnlichen numerischen Flüssen approximiert. Daher erhalten wir eine Stabilitätsbedingung analog zu einer rein advektiven Strömung, d.h. das Zeitinkrement vergrößert um den Faktor Kehrwert der Froude-Zahl. Die in dieser Arbeit hergeleiteten Verfahren sind asymptotisch erhaltend und ausbalanciert. Die asymptotischer Erhaltung stellt sicher, dass numerische Lösung das "korrekte" asymptotische Verhalten bezüglich kleiner Froude-Zahlen besitzt. Wir präsentieren Verfahren erster und zweiter Ordnung. Numerische Resultate bestätigen die Konvergenzordnung, so wie Stabilität, Ausbalanciertheit und die asymptotische Erhaltung. Insbesondere beobachten wir bei machen Verfahren, dass die Konvergenzordnung fast unabhängig von der Froude-Zahl ist.

Non-aqueous dispersions of particles and their applications

In the current work, three studies about non-aqueous dispersions of particles were carried out by using an amphiphilic block copolymer poly(isoprene)-block-poly(methyl methacrylate) (PI-b-PMMA) as stabilizer:rn1. Dispersions of polyurethane and polyurea porous particles for polymer compositesrn2. Dispersions of PMMA and PU particles with PDI dye for study of Single Molecule Spectroscopy Detectionrn3. Dispersions of graphene nanosheets for polymer compositesrnrnIn the first study, highly porous polyurethane and polyurea particles were prepared in a non-aqueous emulsion. The preparation of porous particles consisted of two parts: At first, a system was developed where the emulsion had high stability for the polymerization among diisocyanate, diol and water. In the second part, porous particles were prepared by using two methods fission/fusion and combination by which highly porous particles were obtained. In this study, the applications of porous particles were also investigated where polyurethane particles were tested as filling material for polymer composites and as catalyst carrier for polyethylene polymerization. rnrnIn the second study, PMMA and PU particles from one non-aqueous emulsion were investigated via single molecule fluorescence detection. At first the particles were loaded with PDI dye, which were detected by fluorescence microscopy. The distribution and orientation of the PDI molecules in the particles were successfully observed by Single Molecule Fluorescence Detection. The molecules were homogenously distributed inside of the particles. In addition they had random orientation, meaning that no aggregations of dye molecules were formed. With the results, it could be supposed that the polymer chains were also homogenously distributed in the particles, and that the conformation was relatively flexible. rnrnIn the third part of the study, graphene nanosheets with high surface area were dispersed in an organic solvent with low boiling point and low toxicity, THF, stabilized with a block copolymer PI-b-PMMA. The dispersion was used to prepare polymer composites. It was shown that the modified graphene nanosheets had good compatibility with the PS and PMMA matrices. rn

Social housing e sostenibilita. Progetto di un intervento di 24 alloggi ad energia quasi zero a Rovigo

L’oggetto di questa tesi di laurea è un intervento di recupero e riprogettazione di un edificio non completato, destinato a 24 alloggi di edilizia residenziale pubblica, situato a Rovigo. Questo è stato oggetto di una lunga ed articolata vicenda caratterizzata da continue interruzioni del cantiere, principalmente causate da una cattiva esecuzione dei lavori da parte dell’impresa costruttrice. Allo stato attuale è presente la sola struttura metallica assemblata sulle fondazioni in calcestruzzo armato; tutto il fabbricato risulta abbandonato e congelato da diversi anni dopo i primi collaudi che hanno stabilito la non idoneità del telaio in acciaio. L’obiettivo del progetto è dunque quello di recuperare le fondazioni esistenti e di riprogettare l’edificio in una chiave più attuale e sostenibile. E’ stato effettuato un sopralluogo per comprendere più da vicino le problematiche relative all’area di progetto, oltre ad un’attenta analisi delle documentazioni riguardanti il progetto originario in modo da correggere eventuali punti deboli. Le strategie non hanno tenuto conto dunque solamente di un’ottima efficienza energetica o di un’offerta di alloggi adeguata alla domanda della situazione abitativa attuale, ma anche di tutte le problematiche che sono derivate dalla cattiva gestione del progetto originario. Le scelte progettuali, infatti, sono state il risultato anche delle necessità di limitare tempi e costi di un intervento per il quale sono state sprecate fin troppe risorse, soprattutto economiche. La fase progettuale è stata affiancata dalla realizzazione di simulazioni effettuate tramite software di calcolo (Termolog EpiX 6 e DIALux evo) che hanno permesso di ottenere ottimi risultati per quanto riguarda prestazione energetica e comfort luminoso indoor.

Stability of the tunnel face reinforced by bolts under seepage flow conditions

Il presente lavoro tratta la stabilità del fronte di scavo, rinforzato con barre di consolidamento ed interessato da drenaggi in avanzamento, di gallerie sotto falda in rocce tenere o terreni. Tale studio è stato sviluppato dal progetto di Tesi attraverso l’analisi all’equilibrio limite che approssima il fronte di scavo con un rettangolo e considera un meccanismo di rottura composto da un cuneo, a tergo del fronte, caricato da un prisma. Il metodo descritto consente di tenere conto dell’effetto stabilizzante delle barre, mediante una distribuzione della pressione di supporto non uniforme. Nel caso di gallerie sotto falda, lo stesso metodo permette inoltre di considerare l’effetto destabilizzante dei gradienti idraulici. Sono state ricavate soluzioni analitiche per la valutazione della stabilità, ed implementate successivamente nel software di analisi numerica MATLAB. Dalle analisi condotte è emerso che il numero minimo di barre per garantire la stabilità del fronte di scavo è in molti casi elevato e risulta impossibile da porre in opera in terreni scarsamente coesivi o in gallerie sotto elevati battenti d’acqua. Per risolvere questa situazione si può prevedere l’inserimento di drenaggi in avanzamento, con lo scopo di diminuire i gradienti idraulici nei pressi del fronte della galleria. Il modello che descrive il nuovo andamento dei carichi idraulici, considerando la presenza di dreni, è stato realizzato con il software commerciale agli elementi finiti COMSOL. Una volta determinati gli andamenti dei carichi idraulici, sono stati condotti studi parametrici sull’effetto dei dreni combinato con gli elementi di rinforzo. Dopo tali analisi sono stati ricavati nomogrammi adimensionali che tengano conto della presenza contemporanea delle barre e dei dreni. Tali diagrammi costituiscono uno strumento utile e valido per la progettazione del rinforzo del fronte di scavo. Infine sono stati realizzati confronti fra casi di studio reali e risultati ottenuti dal modello.

Strumenti di monitoraggio di dati web non strutturati

Negli ultimi anni i documenti web hanno attratto molta attenzione, poiché vengono visti come un nuovo mezzo che porta quello che sono le esperienze ed opinioni di un individuo da una parte all'altra del mondo, raggiungendo quindi persone che mai si incontreranno. Ed è proprio con la proliferazione del Web 2.0 che l’attenzione è stata incentrata sul contenuto generato dagli utenti della rete, i quali hanno a disposizione diverse piattaforme sulle quali condividere i loro pensieri, opinioni o andare a cercarne di altrui, magari per valutare l’acquisto di uno smartphone piuttosto che un altro o se valutare l’opzione di cambiare operatore telefonico, ponderando quali potrebbero essere gli svantaggi o i vantaggi che otterrebbe modificando la sia situazione attuale. Questa grande disponibilità di informazioni è molto preziosa per i singoli individui e le organizzazioni, che devono però scontrarsi con la grande difficoltà di trovare le fonti di tali opinioni, estrapolarle ed esprimerle in un formato standard. Queste operazioni risulterebbero quasi impossibili da eseguire a mano, per questo è nato il bisogno di automatizzare tali procedimenti, e la Sentiment Analysis è la risposta a questi bisogni. Sentiment analysis (o Opinion Mining, come è chiamata a volte) è uno dei tanti campi di studio computazionali che affronta il tema dell’elaborazione del linguaggio naturale orientato all'estrapolazione delle opinioni. Negli ultimi anni si è rilevato essere uno dei nuovi campi di tendenza nel settore dei social media, con una serie di applicazioni nel campo economico, politico e sociale. Questa tesi ha come obiettivo quello di fornire uno sguardo su quello che è lo stato di questo campo di studio, con presentazione di metodi e tecniche e di applicazioni di esse in alcuni studi eseguiti in questi anni.

Investigation of spectral stability of X-ray tubes by simulations and experimental spectrum measurements

L'obiettivo di questo lavoro è quello di analizzare la stabilità di uno spettro raggi X emesso da un tubo usurato per analisi cardiovascolari, in modo da verificare il suo comportamento. Successivamente questo tipo di analisi sarà effettuata su tubi CT. Per raggiungere questo scopo è stato assemblato un particolare set-up con un rivelatore al germanio criogenico in modo da avere la miglior risoluzione energetica possibile ed alcuni particolari collimatori così da ridurre il flusso fotonico per evitare effetti di pile-up. Il set-up è stato costruito in modo da avere il miglior allineamento possibile nel modo più veloce possibile, e con l'obiettivo di rendere l'intero sistema portabile. Il tubo usato è un SRM Philips tube per analisi cardiovascolari; questa scelta è stata fatta in modo da ridurre al minimo i fattori esterni (ottica elettromagnetica, emettitori) e concentrare l'attenzione solo sugli effetti, causati dalle varie esposizioni, sull'anodo (roughness e bending) e sul comportamento di essi durante il surriscaldamento e successivo raffreddamento del tubo. I risultati mostrano come durante un'esposizione alcuni fattori di usura del tubo possono influire in maniera sostanziale sullo spettro ottenuto e quindi alterare il risultato. Successivamente, nell'elaborato, mediante il software Philips di ricostruzione e simulazione dello spettro si è cercato di riprodurre, variando alcuni parametri, la differenza riscontrata sperimentalmente in modo da poter simulare l'instabilità e correggere i fattori che la causano. I risultati sono interessanti non solo per questo esperimento ma anche in ottica futura, per lo sviluppo di applicazioni come la spectral CT. Il passo successivo sarà quello di spostare l'attenzione su un CT tube e verificare se l'instabilità riscontrata in questo lavoro è persiste anche in una analisi più complessa come quella CT.

Surgical treatment of upper, middle and lower cervical injuries and non-unions by anterior procedures

The goals of any treatment of cervical spine injuries are: return to maximum functional ability, minimum of residual pain, decrease of any neurological deficit, minimum of residual deformity and prevention of further disability. The advantages of surgical treatment are the ability to reach optimal reduction, immediate stability, direct decompression of the cord and the exiting roots, the need for only minimum external fixation, the possibility for early mobilisation and clearly decreased nursing problems. There are some reasons why those goals can be reached better by anterior surgery. Usually the bony compression of the cord and roots comes from the front therefore anterior decompression is usually the procedure of choice. Also, the anterior stabilisation with a plate is usually simpler than a posterior instrumentation. It needs to be stressed that closed reduction by traction can align the fractured spine and indirectly decompress the neural structures in about 70%. The necessary weight is 2.5 kg per level of injury. In the upper cervical spine, the odontoid fracture type 2 is an indication for anterior surgery by direct screw fixation. Joint C1/C2 dislocations or fractures or certain odontoid fractures can be treated with a fusion of the C1/C2 joint by anterior transarticular screw fixation. In the lower and middle cervical spine, anterior plating combined with iliac crest or fibular strut graft is the procedure of choice, however, a solid graft can also be replaced by filled solid or expandable vertebral cages. The complication of this surgery is low, when properly executed and anterior surgery may only be contra-indicated in case of a significant lesion or locked joints.

Early non-invasive cardiac output monitoring in hemodynamically unstable intensive care patients: A multi-center randomized controlled trial

Introduction Acute hemodynamic instability increases morbidity and mortality. We investigated whether early non-invasive cardiac output monitoring enhances hemodynamic stabilization and improves outcome. Methods A multicenter, randomized controlled trial was conducted in three European university hospital intensive care units in 2006 and 2007. A total of 388 hemodynamically unstable patients identified during their first six hours in the intensive care unit (ICU) were randomized to receive either non-invasive cardiac output monitoring for 24 hrs (minimally invasive cardiac output/MICO group; n = 201) or usual care (control group; n = 187). The main outcome measure was the proportion of patients achieving hemodynamic stability within six hours of starting the study. Results The number of hemodynamic instability criteria at baseline (MICO group mean 2.0 (SD 1.0), control group 1.8 (1.0); P = .06) and severity of illness (SAPS II score; MICO group 48 (18), control group 48 (15); P = .86)) were similar. At 6 hrs, 45 patients (22%) in the MICO group and 52 patients (28%) in the control group were hemodynamically stable (mean difference 5%; 95% confidence interval of the difference -3 to 14%; P = .24). Hemodynamic support with fluids and vasoactive drugs, and pulmonary artery catheter use (MICO group: 19%, control group: 26%; P = .11) were similar in the two groups. The median length of ICU stay was 2.0 (interquartile range 1.2 to 4.6) days in the MICO group and 2.5 (1.1 to 5.0) days in the control group (P = .38). The hospital mortality was 26% in the MICO group and 21% in the control group (P = .34). Conclusions Minimally-invasive cardiac output monitoring added to usual care does not facilitate early hemodynamic stabilization in the ICU, nor does it alter the hemodynamic support or outcome. Our results emphasize the need to evaluate technologies used to measure stroke volume and cardiac output--especially their impact on the process of care--before any large-scale outcome studies are attempted.

Long-term stability of surgical bone regenerative procedures of peri-implantitis lesions in a prospective case-control study over 3 years

Objectives: To evaluate the extent of bone fill over 3 years following the surgical treatment of peri-implantitis with bone grafting with or without a membrane. Material and Methods: In a non-submerged wound-healing mode, 15 subjects with 27 implants were treated with a bone substitute (Algipore®) alone and 17 subjects with 29 implants were treated with the bone substitute and a resorbable membrane (Osseoquest®). Implants with radiographic bone loss ≥1.8 mm following the first year in function and with bleeding and/or pus on probing were included. Following surgery, subjects were given systemic antibiotics (10 days) and rinsed with chlorhexidine. After initial healing, the subjects were enrolled in a strict maintenance programme. Results: Statistical analysis failed to demonstrate changes in bone fill between 1 and 3 years both between and within procedure groups. The mean defect fill at 3 years was 1.3 ± (SD) 1.3 mm if treated with the bone substitute alone and 1.6 ± (SD) 1.2 mm if treated with an adjunct resorbable membrane, (p=0.40). The plaque index decreased from approximately 40–10%, remaining stable during the following 2 years. Conclusion: Defect fill using a bone substitute with or without a membrane technique in the treatment of peri-implantitis can be maintained over 3 years.