The Centre for Development and Environment (CDE), University of Bern

The Centre for Development and Environment (CDE) is the University of Bern's center for sustainable development research. Founded in 1988 as a part of the Institute of Geography, CDE became an interdisciplinary university center in 2009. Its current overall aim is to foster sustainable development-oriented research across various institutes and departments of the University of Bern. In view of this new mandate, CDE devised a new strategy focusing on 6 strategic themes. These are explored and advanced by groups of researchers organized in thematic clusters. Three of the 6 clusters address sustainable development from a comprehensive perspective: global change impacts, innovations for sustainable development, and education for sustainable development. These clusters are complemented by 3 clusters that investigate sustainable development with a specialized perspective: natural resources and ecosystem services, multidimensional disparities, and governance of land and natural resources.

The use of intramedullary helix wire for the treatment of proximal humerus fractures

OBJECTIVE: To present the functional and radiographic outcome 1 and 6 years after application of a new intramedullary fixation device for proximal humerus fractures. DESIGN: Retrospective case series. SETTING: Level II orthopaedic surgery hospital. PATIENTS: Twenty-six consecutive patients (average age 68.9 years) with 2-, 3- and 4-part fractures of the proximal humerus were operated at a single institution. Follow-up was performed after 1 year (26 patients) and 6 years (16 patients). INTERVENTION: All patients were treated with closed reduction and intramedullary helix wires. MAIN OUTCOME MEASUREMENTS: The Constant-Murley score and the University of California Los Angeles (UCLA) score. Clinical complications and radiological posttraumatic arthritis were recorded. RESULTS: The average Constant-Murley score was 70.3 (points) and 70.7 after 1 and 6 years, respectively; the average UCLA score was 27.2 and 31.5 after 1 and 6 years, respectively. Major complications were 4 revisions for 3 secondary fragment displacements and 1 nonunion with partial avascular osteonecrosis in the first postoperative year. Complications were found predominantly in 4-part fractures (3/5, 60%). There were no further complications or progressive posttraumatic arthritis up to 6 years following surgery. CONCLUSION: The helix wire is well suited for displaced or unstable 2- and 3-part proximal humerus fractures. Adequate functional outcome, a low number of implant displacements, a low number of application morbidity, and infrequent implant removals were recorded. The use of this device is not recommended for 4-part fractures.

University of Wisconsin versus St. Thomas' Hospital solution for human donor heart preservation

Prolongation of the safe period of ischemia of the heart is an efficient way to overcome donor organ shortage, as demonstrated in renal and hepatic transplantation. We present the results of a prospective, randomized study comparing preservation with University of Wisconsin solution (UWS) versus St. Thomas' Hospital solution (STS) in clinical heart transplantation. A total of 39 patients were enrolled in the study (n = 20 for UWS and n = 19 for STS). Hemodynamic, electron microscopic, and biochemical evaluation did not reveal any significant differences in postoperative myocardial performance. Only the number of intraoperative defibrillations (0.82 for UWS versus 1.7 for STS) and the rhythm stability after reperfusion (13/20 UWS hearts versus 6/19 STS hearts in sinus rhythm) were significantly different. Heart preservation with UWS and STS appears to be of comparable efficacy at mean ischemic times of less than 4 hours.