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This paper aims to identify the processes that lead to the establishment of public-private partnerships (PPPs) with a focus on the financial and policy incentives of the actors involved. To this end, it applies the Multiple Streams Framework to a qualitative case study to answer the following research question: are actors of PPPs for innovation motivated due to financial incentives or can they be policy driven? Although the fiscal context plays an important role in our case, the study shows that policy goals, such as providing infrastructure or public services and promoting innovation can be the main drivers for establishing a PPP. These findings offer a theoretical and practical contribution to analyze PPPs as a phenomenon. First, we establish a theoretical framework of possible incentives for actors in PPPs and, secondly, provide new insights into the PPP discussion in the public administration literature.

Postoperative pain relief remains a key problem after surgery. Multimodal pain therapy has proven beneficial in alleviating pain to a certain extent. However, when combining non-opioids, the focus has been on NSAIDs and paracetamol, but effects of combined use are only moderate. Metamizole could be a potent adjunct, due to its preclusion in several countries, data on its combined use are sparse, despite its common use in many countries. The aim of this study was to examine whether the combination of metamizole and ibuprofen is superior in relieving postoperative pain to either drug alone.For this randomized, placebo-controlled, cross-over study, 35 patients undergoing bilateral lower third molar extraction were randomized. Each patient received three applications of 1000 mg metamizole + 400 mg ibuprofen for surgery on one side and either 1000 mg metamizole + placebo or 400 mg ibuprofen + placebo on the other side. Pain ratings, rescue-medication (tramadol), and sleep were assessed for 18 hours.The combined treatment of metamizole and ibuprofen showed lower mean pain scores over 12 hours than ibuprofen (2.4±1.3 vs 3.8±1.6; P=0.005). Further, combined treatment showed lower mean pain scores over 6 hours than ibuprofen (2.0±1.2 vs. 3.1±1.6; P=0.022) or metamizole alone (2.0±1.2 vs. 3.3±1.7; P=0.015). Consumption of rescue medication was lowest in the combination-group (25% vs. 46%-metamizole; 50%-ibuprofen). The trial was stopped prematurely as the COVID-pandemic halted elective surgeries.Combined use enables superior pain control compared to ibuprofen after molar extraction and tends to be superior to metamizole alone. The premature study-termination may overestimate this effect.

Hybrid organizations face the fundamental challenge of building legitimacy. To deal with this challenge in administrative theory and practice, we apply an analytical framework following an organizational logic of legitimacy building to an exemplary case of hybridity—the Swiss Institute for Translational and Entrepreneurial Medicine. Our framework application illustrates that pragmatic legitimacy (i.e., establishing instrumental value) must be built before moral legitimacy (i.e., fostering normative evaluation) and cognitive legitimacy (i.e., creating comprehensibility), followed by an iterative process of mutual influence between the legitimacy forms. Originating in the management literature, the framework promises new insights for public administration research on hybrids.

Fragestellung/Zielsetzung: Die Qualität medizinischer Curricula, bezüglich wissenschaftlicher Kompetenzen, wurde von verschiedenen Gutachten und Stellungnahmen angezweifelt und neue Konzepte wurden gefordert [ref:1]. Auch der Entwurf zur neuen ÄApprO [ref:2] schlägt[zum vollständigen Text gelangen Sie über die oben angegebene URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)

Einleitung: In zahlreichen Stellungnahmen werden die Qualität der humanmedizinischen Ausbildung in Bezug auf wissenschaftliche Kompetenzen in Frage gestellt und neue Konzepte gefordert [ref:1], [ref:2]. Eine interdisziplinäre Arbeitsgruppe erarbeitete das Längsschnittcurriculum[zum vollständigen Text gelangen Sie über die oben angegebene URL], Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA), des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ) und der Chirurgischen Arbeitsgemeinschaft Lehre (CAL)

Zielsetzung: Die Qualität des Medizinstudiums bzgl. wissenschaftlicher Kompetenzen wird von einer Reihe von Gutachten und Stellungnahmen in Frage gestellt. Daher besteht Handlungsbedarf, die Lehre zur Vermittlung dieser Kompetenzen zu intensivieren und weiterzuentwickeln. Hier sind insbesondere[zum vollständigen Text gelangen Sie über die oben angegebene URL], Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA), des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ) und der Chirurgischen Arbeitsgemeinschaft Lehre (CAL)

Schulungstermin, Kolloquium Wissensinfrastruktur, Wintersemester 2016/2017

Pre-clinical animal models are commonly used to evaluate the osteogenic potential of bone grafting materials in-vivo. Based on the histology analysis, the currently commercially available bone grafting materials show comparable results with respect to biocompatibility, incorporation and remodeling. In the present pilot study we introduce a methodology to compare calcium phosphate-based bone grafting materials from world-leading companies in clinical trials and analyze them by means of established histology and synchrotron radiation-based micro computed tomography (SRμCT). The results indicate that the morphology of the bony structures depends on the selected bone grafting material and that an arbitrarily selected histological slice can lead to misleading conclusions. Complementary μCT data can become the basis for the identification of a representative slice. The registration of the selected histological slice with its counterpart in the three-dimensional μCT dataset was performed both visually and automatically with well comparable results. This registration allows for the compilation of a joint histogram to identify anatomical features, which can neither be extracted from histology nor from μCT data on their own. Accordingly, μCT will become an integral part of studies on the efficacy of bone augmentation materials and beyond.

Zapfenzahne kommen im Bereich der oberen seitlichen Inzisiven relativ haufig vor und beschaftigen den Zahnarzt entsprechend oft in der taglichen Praxis. Das Hauptanliegen der betroffenen Patienten ist in erster Linie eine Verbesserung des asthetischen Erscheinungsbilds ihrer Frontzahne. Allerdings konnen hypoplastische Frontzahne auch funktionelle, parodontale oder endodontische Probleme verursachen. Im vorliegenden Beitrag werden die Probleme beleuchtet, die Diagnostik aufgezeigt und verschiedene Therapieoptionen erortert. Vor- und Nachteile von Kompositaufbauten im Vergleich zu Keramikrestaurationen werden diskutiert und anhand eines klinischen Falls dargestellt.

Objectives: This study investigated the influence of proximal box elevation (PBE) with composite resin when applied to deep proximal defects in root-filled molars with mesio-occluso-distal (MOD) cavities, which were subsequently restored with computer-aided designed/computer-aided manufacturing (CAD/CAM) ceramic or composite restorations. Materials and method: Root canal treatment was performed on 48 human mandibular molars. Standardized MOD cavities were prepared with the distal box located 2mm below the cemento-enamel junction (CEJ). The teeth were randomly assigned to one of four experimental groups (n = 12). In groups G1 and G2, the distal proximal box was elevated up to the level of the CEJ with composite resin (PBE). No elevation was performed in the remaining two groups (G3, G4). CAD/CAM restorations were fabricated with feldspathic ceramic (Vita Mark II, CER) in groups G1 (PBE-CER) and G3 (CER) or with resin nano-ceramic blocks (Lava Ultimate, LAV) in groups G2 (PBE-LAV) and G4 (LAV). Replicas were taken before and after thermomechanical loading (TML; 1.2 Mio cycles; 49N; 3,000 thermocycles between 50°C and 5°C). Following TML, load was applied until failure. Fracture analysis was performed under a stereomicroscope (×16). Marginal quality before and after TML (tooth restoration, composite restoration) was evaluated using scanning electron microscopy (×200). Results: After TML, lower percentages of continuous margins were observed in groups G1-G3 compared with pre-TML assessments; however, the differences were not statistically significant. For group G4-LAV, the marginal quality after TML was significantly better than in any other group. The highest mean fracture value was recorded for group G4. No significant difference was found for this value between the groups with PBE compared with the groups without PBE, regardless of the material used. The specimens restored with ceramic onlays exhibited fractures that were mainly restricted to the restoration while, in teeth restored with composite onlays, the percentage of catastrophic failures (fractures beyond bone level) was increased. Conclusion: PBE had no impact on either the marginal integrity or the fracture behavior of root canal-treated mandibular molars restored with feldspathic ceramic onlays. CAD/CAM-fabricated composite onlays were more favorable than ceramic onlays in terms of both marginal quality and fracture resistance, particularly in specimens without PBE. Clinical relevance: Composite onlays with or without PBE may be a viable approach for the restoration of root-filled molars with subgingival MOD cavities.

Micro computed tomography (mCT) is well established in virtually all fields of biomedical research, allowing for the non-destructive volumetric visualization of tissue morphology. A variety of specimens can be investigated, ranging from soft to hard tissue to engineered structures like scaffolds. Similarly, the size of the objects of interest ranges from a fraction of a millimeter to several tens of centimeters. While synchrotron radiation-based μCT still offers unrivaled data quality, the ever-improving technology of cathodic tube-based machines offers a valuable and more accessible alternative. The Biomaterials Science Center of the University of Basel operates a nanotomOR m (phoenix|x-ray, GE Sensing and Inspection Technologies GmbH, Wunstorf, Germany), with a 180 kV source and a minimal spot size of about 0.9 μm. Through the adjustable focus-specimen and focus-detector distances, the effective pixel size can be adjusted from below 500 nm to about 80 μm. On the high-resolution side, it is for example possible to visualize the tubular network in sub-millimeter thin dentin specimens. It is then possible to locally extract parameters such as tubule diameter, density, or alignment, giving information on cell movements during tooth formation. On the other side, with a horizontal shift of the 3,072 pixels x 2,400 pixels detector, specimens up to 35 cm in diameter can be scanned. It is possible, for example, to scan an entire human knee, albeit with inferior resolution. Lab source μCT machines are thus a powerful and flexible tool for the advancement of biomedical research, and a valuable and more accessible alternative to synchrotron radiation facilities.

The simultaneous post mortem visualization of soft and hard tissues using absorption-based CT remains a challenge. If the photon energy is optimized for the visualization of hard tissue, the surrounding soft tissue components are almost X-ray transparent. Therefore, the combination with other modalities such as phase-contrast CT, magnetic resonance microscopy, and histology is essential to detect the anatomical features. The combination of the 2D and 3D data sets using sophisticated segmentation and registration tools allows for conclusions about otherwise inaccessible anatomical features essential for improved patient treatments.

In diesem Beitrag werden wir zunächst ausgehend von den Erfahrungen in der Lehrerbildung an der Otto-von-Gericke-Universität Magdeburg unser Verständnis einer "neuen Lernkultur" aufzeigen. Wir sehen diese wesentlich in der Zunahme der Heterogenität der Studierenden begründet. Um diesen heterogenen Lernkulturen in der Lehre verantwortungsbewusst zu begegnen, entwickelten wir ein Lehrkonzept, welches Phasen der Selbstreflexion von Praxiserfahrungen in Portfolios artikuliert.

The introduction of microinstruments for root-end cavity preparation has clearly improved the surgical technique in periradicular surgery with apicectomy. The new generation of sonic and ultrasonic root-end preparation devices, usually termed 'retrotips', has simplified the preparation of a sufficiently deep cavity that follows the original path of the root canal. The present paper describes the use of a new set of diamond-surfaced retrotips driven by a sonic handpiece. For clinical evaluation a prospective study was carried out, with assessment of pre-, intra- and postoperative data in 50 teeth (43 patients). This paper analyses: (i) the applicability of the new retrotips; (ii) the quality of the root-end filling assessed radiographically; (iii) the immediate postoperative course. Access with the retrotips to the resected root-end was found to be excellent in 80% of the treated teeth. The postoperative radiographs showed a root-end filling of at least 3 mm in 70% of the resected teeth. Healing was uneventful in all cases and most patients presented without any symptoms after 5 days and 10 days. The long-term treatment outcome will be reported in a future paper.

Bone augmentation is a vital part of surgical interventions of the oral and maxillofacial area including dental implantology. Prior to implant placement, sufficient bone volume is needed to reduce the risk of peri-implantitis. While augmentation using harvested autologous bone is still considered as gold standard, many surgeons prefer bone substitutes to reduce operation time and to avoid donor site morbidity. To assess the osteogenic efficacy of commercially available augmentation materials we analyzed drill cores extracted before implant insertion. In younger patients, distraction osteogenesis is successfully applied to correct craniofacial deformities through targeted bone formation. To study the influence of mesenchymal stem cells on bone regeneration during distraction osteogenesis, human mesenchymal stem cells were injected into the distraction gap of nude rat mandibles immediately after osteotomy. The distraction was performed over eleven days to reach a distraction gap of 6 mm. Both the rat mandibles and the drill cores were scanned using synchrotron radiation-based micro computed tomography. The three-dimensional data were manually registered and compared with corresponding two-dimensional histological sections to assess bone regeneration and its morphology. The analysis of the rat mandibles indicates that bone formation is enhanced by mesenchymal stem cells injected before distraction. The bone substitutes yielded a wide range of bone volume and degree of resorption. The volume fraction of the newly formed bone was determined to 34.4% in the computed tomography dataset for the augmentation material Geistlich Bio-Oss®. The combination of computed tomography and histology allowed a complementary assessment for both bone augmentation and distraction osteogenesis.

Solid electrolytes are used for electrochemical devices like batteries, fuel cells and sensors. NASICON, a ceramic Na + conductor, has been used as a sensitive membrane for an Na + -sensitive electrode for several years. In this contribution we report on the stability of NASICON in aqueous solutions and on the characteristic of an Na + -sensitive electrode with NASICON as membrane. Such a membrane can be prepared by conventional ceramic techniques but also by the screen printing technique. An all thick film electrode with NASICON as sensitive membrane and sodium tungsten bronze as internal reference electrode is less sensitive to Na + than an electrode with a membrane in pellet form.

Human teeth are anisotropic composites. Dentin as the core material of the tooth consists of nanometer-sized calcium phosphate crystallites embedded in collagen fiber networks. It shows its anisotropy on the micrometer scale by its well-oriented microtubules. The detailed three-dimensional nanostructure of the hard tissues namely dentin and enamel, however, is not understood, although numerous studies on the anisotropic mechanical properties have been performed and evaluated to explain the tooth function including the enamel-dentin junction acting as effective crack barrier. Small angle X-ray scattering (SAXS) with a spatial resolution in the 10 μm range allows determining the size and orientation of the constituents on the nanometer scale with reasonable precision. So far, only some dental materials, i.e. the fiber reinforced posts exhibit anisotropic properties related to the micrometer-size glass fibers. Dental fillings, composed of nanostructures oriented similar to the natural hard tissues of teeth, however, do not exist at all. The current X-ray-based investigations of extracted human teeth provide evidence for oriented micro- and nanostructures in dentin and enamel. These fundamental quantitative findings result in profound knowledge to develop biologically inspired dental fillings with superior resistance to thermal and mechanical shocks.

Chemical gas sensors with solid electrolytes have been prepared by the thick-film screen-printing technique. Nasicon or zirconia (YSZ) solid ion conductors are used, which have been deposited on α-alumina substrates. An all-thick-film potentiometric H 2 sensor based on Nasicon containing a Na x WO 3 reference electrode and a porous Pt working electrode and an all-thick-film potentiometric O 2 sensor based on zirconia with a Pd/PdO reference electrode and a porous Pt working electrode have been produced. Development of a CO 2 sensor based on Nasicon or β-alumina with an Na 2 CO 3 working electrode is the object of the current research work. Also a thick-film oxygen sensor based on the limiting current behaviour of a zirconia pumping cell has been investigated.

A retrograde radicular preparation in the axis of the root canal as well as an excess-free obturation of the canal is surgically very demanding due to the complex anatomical structures and to the limited intraoral operative field. As from the early 1990s, advisable methods for the retrograde root canal obturation under minimal place requirements have been implemented thanks to ultrasonic- and sonic-driven microinstruments. This publication presents a new microsurgical instrument, the "Surgical-Retro" Micro Apical Placement System (MAPS), which facilitates in a large extent the retrograde obturation with a plas tic root canal filling material. The device provides an unrestricted access to the retrograde cavity, allowing thus an accurate obturating technique whilst avoiding the dispersion of the root canal filling material in the surrounding bone. Thanks to the "Surgical-Retro" Micro Apical Placement System, a further gap in the improvement of the quality and, thus, of the success of the treatment by apical resection has been filled.

This paper describes the application of a new material, Biocem, for retrograde root canal filling. A total of 234 roots in 222 teeth were treated during the period 1987-1992. Biocem consists of two components and once mixed, the autopolymerisation results in a three-dimensional structure. The biomechanical and histologic properties and a clinical longterm follow-up confirm the optimal qualities of this material. It fulfills the requirements in regard to biocompatibility, watertight sealing and application. The material proved superior in comparison to conventional materials and ceramics. The evaluation of the results are most encouraging.

Chemical sensors with solid ion-conductors have been prepared by thick film screen printing method. Solid ion conductors Nasicon (Na1+xZr2SixP3−xO12) and YSZ (yttria stabilized zirconia) have been deposited onto α-alumina substrate. An all-thick film hydrogen sensor based on Nasicon electrolyte with sodium tungsten bronze (NaxWO3) reference electrode and porous platinum working electrode and an oxygen sensor based on zirconia electrolyte with Pd/PdO-reference electrode have been developed. Development of carbon dioxide sensor based on Nasicon or β-alumina with sodium carbonate working electrode will be the objective of the current research work.