547,351 research outputs found
The influence of clearance on friction, lubrication and squeaking in large diameter metal-on-metal hip replacements
Large diameter metal-on-metal bearings (MOM) are becoming increasingly popular, addressing the needs of young and more active patients. Clinical data has shown excellent short-to-mid-term results, though incidences of transient squeaking have been noted between implantation and up to 2 years post-operative. Geometric design features, such as clearance, have been significant in influencing the performance of the bearings. Sets of MOM bearings with different clearances were investigated in this study using a hip friction simulator to examine the influence of clearance on friction, lubrication and squeaking. The friction factor was found to be highest in the largest clearance bearings under all test conditions. The incidence of squeaking was also highest in the large clearance bearings, with all bearings in this group squeaking throughout the study. A very low incidence of squeaking was observed in the other two clearance groups. The measured lubricating film was found to be lowest in the large clearance bearings. This study suggests that increasing the bearing clearance results in reduced lubricant film thickness, increased friction and an increased incidence of squeaking
A Principal Components Analysis Approach to Quantifying Foot Clearance and Foot Clearance Variability
Low foot clearance and high variability may be related to falls risk. Foot clearance is often defined as the local minimum in toe height during swing; however, not all strides have this local minimum. The primary purpose of this study was to identify a nondiscrete measure of foot clearance during all strides, and compare discrete and nondiscrete measures in ability to rank individuals on foot clearance and variability. Thirty-five participants (young adults [n = 10], older fallers [n = 10], older nonfallers [n = 10], and stroke survivors [n = 5]) walked overground while lower extremity 3D kinematics were recorded. Principal components analysis (PCA) of the toe height waveform yielded representation of toe height when it was closest to the ground. Spearman\u27s rank order correlation assessed the association of foot clearance and variability between PCA and discrete variables, including the local minimum. PCA had significant (P \u3c.05) moderate or strong associations with discrete measures of foot clearance and variability. An approximation of the discrete local minimum had a weak association with PCA and other discrete measures of foot clearance. A PCA approach to quantifying foot clearance can be used to identify the behavioral components of toe height when it is closest to the ground, even for strides without a local minimum
Modelling mucociliary clearance
Mathematical modelling of the fluid mechanics of mucociliary clearance (MCC) is reviewed and future challenges for researchers are discussed. The morphology of the bronchial and tracheal airway surface liquid (ASL) and ciliated epithelium are briefly introduced. The cilia beat cycle, beat frequency and metachronal coordination are described, along with the rheology of the mucous layer. Theoretical modelling of MCC from the late 1960s onwards is reviewed, and distinctions between ‘phenomenological’, ‘slender body theory’ and recent ‘fluid–structure interaction’ models are explained.\ud
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The ASL consists of two layers, an overlying mucous layer and underlying watery periciliary layer (PCL) which bathes the cilia. Previous models have predicted very little transport of fluid in the PCL compared with the mucous layer. Fluorescent tracer transport experiments on human airway cultures conducted by Matsui et al. [Matsui, H., Randell, S.H., Peretti, S.W., Davis, C.W., Boucher, R.C., 1998. Coordinated clearance of periciliary liquid and mucus from airway surfaces. J. Clin. Invest. 102 (6), 1125–1131] apparently showed equal transport in both the PCL and mucous layer. Recent attempts to resolve this discrepancy by the present authors are reviewed, along with associated modelling findings. These findings have suggested new insights into the interaction of cilia with mucus due to pressure gradients associated with the flat PCL/mucus interface. This phenomenon complements previously known mechanisms for ciliary propulsion. Modelling results are related to clinical findings, in particular the increased MCC observed in patients with pseudohypoaldosteronism. Recent important advances by several groups in modelling the fluid–structure interaction by which the cilia movement and fluid transport emerge from specification of internal mechanics, viscous and elastic forces are reviewed. Finally, we discuss the limitations of existing work, and the challenges for the next generation of models, which may provide further insight into this complex and vital system
Impaired clearance of ceftizoxime and cefotaxime after orthotopic liver transplantation.
The pharmacokinetics of ceftizoxime (CZX) and of cefotaxime (CTX) were studied in five children and five adults after orthotopic liver transplantation (OLT). Delayed clearance of CZX (clearance of 0.21 to 1.26 ml/min per kg [body weight]) and CTX (clearance of 0.40 to 1.49 ml/min per kg) occurred in 7 of the 10 OLT patients. We conclude that abnormal CZX and CTX clearance is common after OLT and may be associated with minimal change in serum creatinine
Urban renewal plan for the Kosciusko urban renewal area
Kosciusko Urban Renewal Plan, Project Mo. R-2. From the text: A. URBAN RENEWAL PLAN- SCOPE The Urban Renewal Plan for the Kosciusko Urban Renewal Project Area encompasses both slum clearance and redevelopment , and rehabilitation , and consists of, and only of, text items A through N and exhibits I through XII as herein set forth. 27 pages, includes maps.https://openscholarship.wustl.edu/books/1021/thumbnail.jp
Inert gas clearance from tissue by co-currently and counter-currently arranged microvessels
To elucidate the clearance of dissolved inert gas from tissues, we have developed numerical models of gas transport in a cylindrical block of tissue supplied by one or two capillaries. With two capillaries, attention is given to the effects of co-current and counter-current flow on tissue gas clearance. Clearance by counter-current flow is compared with clearance by a single capillary or by two co-currently arranged capillaries. Effects of the blood velocity, solubility, and diffusivity of the gas in the tissue are investigated using parameters with physiological values. It is found that under the conditions investigated, almost identical clearances are achieved by a single capillary as by a co-current pair when the total flow per tissue volume in each unit is the same (i.e., flow velocity in the single capillary is twice that in each co-current vessel). For both co-current and counter-current arrangements, approximate linear relations exist between the tissue gas clearance rate and tissue blood perfusion rate. However, the counter-current arrangement of capillaries results in less-efficient clearance of the inert gas from tissues. Furthermore, this difference in efficiency increases at higher blood flow rates. At a given blood flow, the simple conduction-capacitance model, which has been used to estimate tissue blood perfusion rate from inert gas clearance, underestimates gas clearance rates predicted by the numerical models for single vessel or for two vessels with co-current flow. This difference is accounted for in discussion, which also considers the choice of parameters and possible effects of microvascular architecture on the interpretation of tissue inert gas clearance
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Sociodemographic and clinical characteristics of persons who experienced spontaneous hepatitis C viral clearance.
BackgroundIn the United States Hepatitis C virus (HCV) viral clearance is estimated to range between 20 and 30%. The objective of this study was to estimate the frequency of HCV clearance and identify correlates of viral clearance among patients newly identified as HCV antibody positive in a large urban health system in Los Angeles, California.MethodsWe identified patients between November 2015 and September 2017 as part of a newly implemented HCV screening and linkage-to-care program at University of California Los Angeles (UCLA) Health System. All patients were eligible for screening, though there were additional efforts to screen patients born between 1945 and 1965. We reviewed Medical records to categorize anti-HCV antibody positive patients as having spontaneously cleared HCV infection (HCV RNA not detected) or not (HCV RNA detected). We excluded those with a prior history of anti-HCV positivity or history of HCV treatment. We compared differences between those with and without detectable HCV RNA using chi-square test, Fisher's exact test, and t-test as appropriate. We assessed factors associated with HCV clearance using logistic regression analysis.ResultsAmong the 320 patients included in this study, 56% were male. Baby boomers (52-72 years of age) comprised the single largest age group (62%). We found spontaneous HCV clearance in 58% (n = 185). HCV viral clearance was slightly higher among women as compared to men (63% vs. 53%; p value = 0.07) and varied by race/ethnicity: clearance among Blacks/African Americans was 37% vs. 58% among whites (p value = 0.02). After adjusting for age, race/ethnicity, and sex we found that those diagnosed with chronic kidney disease had a tendency of decreased HCV viral clearance (adjusted OR = 0.34; 95% CI 0.14-1.03).ConclusionOf those patients newly identified as anti-HCV positive, 58% had cleared HCV virus, while the rest showed evidence of active infection. In addition, we found that clearance varied by race/ethnicity and clinical characteristics
Blood lactate clearance during active recovery after an intense running bout depends on the intensity of the active recovery
High-intensity exercise training contributes to the production and accumulation of blood lactate, which is cleared by active recovery. However, there is no commonly agreed intensity or mode for clearing accumulated blood lactate. We studied clearance of accumulated blood lactate during recovery at various exercise intensities at or below the lactate threshold after high-intensity interval runs that prompted lactate accumulation. Ten males repeated 5-min running bouts at 90% of maximal oxygen uptake ([Vdot]O2max), which increased blood lactate concentration from 1.0 ± 0.1 to 3.9 ± 0.3 mmol · l-1. This was followed by recovery exercises ranging from 0 to 100% of lactate threshold. Repeated blood lactate measurements showed faster clearance of lactate during active versus passive recovery, and that the decrease in lactate was more rapid during higher (60-100% of lactate threshold) than lower (0-40% of lactate threshold) (P < 0.05) intensities. The more detailed curve and rate analyses showed that active recovery at 80-100% of lactate threshold had shorter time constants for 67% lactate clearance and higher peak clearance rates than 40% of lactate threshold or passive recovery (P < 0.05). Finally, examination of self-regulated intensities showed enhanced lactate clearance during higher versus lower intensities, further validating the intensity dependence of clearance of accumulated blood lactate. Therefore, active recovery after strenuous exercise clears accumulated blood lactate faster than passive recovery in an intensity-dependent manner. Maximum clearance occurred at active recovery close to the lactate threshold
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