Decision-making regarding total knee replacement surgery: a qualitative meta-synthesis

Knee osteoarthritis is a highly prevalent condition that can result in disability and reduced quality of life. The evidence suggests that total knee replacement surgery (TKR) is an effective intervention for patients with severe knee problems, but there is also an unmet need for this treatment in the UK. To help understand the reason for this unmet need, the aim of this study was to explore the factors that influence the decision-making process of TKR surgery by synthesising the available evidence from qualitative research on this topic

CFD simulation of flow past MAV wings

Turbulent flow past low aspect ratio (AR) thin wing used for two different MAV (Micro Air Vehicles) configurations viz. Black Kite and Golden Hawk has been carried out in order to analyze their aerodynamic characteristics. The Reynolds (Re) number for these two wings based on the root chord are 2.4´105 and 1.72´ 105 respectively. These simulations have been carried out using the in-house flow solution code to solve the Unsteady Reynolds Averaged Navier Stokes (URANS) equations coupled to different turbulence models. The standard k-e model has been used to simulate the turbulence for the Black Kite wing. The influence of three different turbulence models (standard k-e, SA and SST) in predicting the aerodynamic coefficient has been studied for the Golden Hawk configuration. In the present study the aerodynamic characteristics computed for the two wing configurations are compared with the CSIR-NAL experiments. The cross flow patterns and the tip vortex for the Golden Hawk wing are presented and discussed

CFD simulation using FLUENT and RANS3D - A validation exercise

The present work involves two-dimensional numerical simulation of three benchmark problems like (i) Laminar flow in a lid driven cavity (ii) Turbulent flow past a backward facing step and (iii) turbulent flow past NACA0012 aerofoil, using in-house flow solution code RANS3D and the commercially available FLUENT code. The results obtained using these codes are compared with the available measurement data and/or other computations

Multi-user Internet environment for gear design optimization

A Web based multi-user system has been developed to remotely execute a large size software package via the Internet. The software implements genetic algorithm to optimize the design of spur and helical gears. To accomplish this, a combination of HTML, JavaServlets, JavaApplets, JavaScript and HTTP protocol has been employed

A Comparative Study of Plasma Trace Elements (Copper, Iron and Zinc) Status in Anaemic and Non-anaemic Pregnant Women in Abakaliki, Nigeria

For a comparative study of plasma copper, iron and zinc between anaemic and non-anaemic pregnant women, data for anaemic (n = 223) and non-anaemic (n = 126) pregnant women drawn from a cohort of 351 pregnant Nigerians recruited at gestational age of ≤ 25 weeks for the study of impacts of trace element status on pregnancy outcomes were analysed. With the exception of plasma copper which was significantly (p < 0.05) higher in anaemic women in comparison to the non-anaemic women (10.11 ± 10.15 vs. 8.68 ± 7.92 µmol/l), plasma iron and zinc were lower (p > 0.05) in the former. While plasma copper, iron and zinc concentration were not correlated with maternal haemoglobin concentration, plasma zinc significantly correlated negatively (r = -0.141, p < 0.05) with plasma copper. It is thus concluded that anaemia in pregnant women in this population may partly be due to a combination of trace element deficiencies and their interactions with each other. While interventions should go beyond improving intakes, more research is desired to clearly define these interactions

Arctic Soil Governs Whether Climate Change Drives Global Losses or Gains in Soil Carbon

Key uncertainties in terrestrial carbon cycle projections revolve around the timing, direction, and magnitude of the carbon cycle feedback to climate change. This is especially true in carbon-rich Arctic ecosystems, where permafrost soils contain roughly one third of the world's soil carbon stocks, which are likely vulnerable to loss. Using an ensemble of soil biogeochemical models that reflect recent changes in the conceptual understanding of factors responsible for soil carbon persistence, we quantify potential soil carbon responses under two representative climate change scenarios. Our results illustrate that models disagree on the sign and magnitude of global soil changes through 2100, with disagreements primarily driven by divergent responses of Arctic systems. These results largely reflect different assumptions about the nature of soil carbon persistence and vulnerabilities, underscoring the challenges associated with setting allowable greenhouse gas emission targets that will limit global warming to 1.5°C

A comparative study of frequency of postnatal depression among subjects with normal and caesarean deliveries

Background: Prevalence of postnatal depression (PND) is 12-15%. Recent studies are equivocal about the earlier inference that PND is higher among caesarian than normal delivery. Objective: The aim of this study is to investigate the frequency of PND among the Indian women and the association between the mode of delivery and PND. Material and method: Fifty subjects each; having delivered normally and by caesarian section was chosen. All the women were within 3 months post delivery and could understand Kannada language. Those who consented were asked to complete the Edinburgh Postnatal Depression Scale (EPDS). Those found to have scores suggestive of depression on EPDS were assessed for depression according to ICD-10. The data was analyzed using paired t test and chi square test. Result and conclusion: Among Post caesarean subjects, depression was diagnosed in 20% (n=10) as compared to 16% (n=8) in subjects that delivered normally. However there was no significant difference in the frequency of depression among the two groups. Due to the small sample size the results cannot be generalized

Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck.

OBJECTIVE:The recommended treatment for cutaneous squamous cell cancer (CuSCC) of the head and neck is Mohs surgical excision or wide local excision. Excision is recommended to a gross surgical margin of 4-6 mm however this is based on limited evidence and specify a goal histologic margin. The objective of this study was therefore to examine the reported histological margin distance following WLE of advanced CuSCC and its association with recurrence and survival. STUDY DESIGN:Retrospective database review. SETTING:All patients included received treatment at UC Davis Department of Otolaryngology-Head and Neck Surgery and/or Radiation Oncology in Sacramento, California. SUBJECTS AND METHODS:The patients included were treated for advanced CuSCC with primary surgery with or without adjuvant therapy. Kaplan Meier survival curves with log rank analysis were then performed to compare 5-year recurrence free survival, and disease-specific survival for patients with different margin distances. RESULTS:Total number of subjects was 92. The overall 5-year DSS and RFS was 68.8 and 51.0% respectively. When the pathological margin distance was ≥5 mm, 5-year disease specific survival was improved when compared to margin distance less than 5 mm (94.7 vs 60.7 p = 0.034). CONCLUSION:The findings of this study suggest that a histologic margin of at least 5 mm may increase survival in advanced head and neck CuSCC patients

Effects of an ethanolic extract of Garcinia kola on glucose and lipid levels in streptozotocin induced diabetic rats

The effect of Garcinia kola on glucose and lipid levels in streptozotocin-induced diabetic rats was investigated. Ethanolic extract of G. kola was prepared and used for animal treatments. Diabetes was induced by a single intraperitoneal injection of streptozotocin (40 mg/kg body weight). Acute effects of G. kola on glucose were investigated by giving a single dose of distilled water or 300 mg/kg G. kola extract or metformin 300 mg/kg. Glucose levels were measured 2, 4 and 6 h after treatment. To investigate the long term effects, animals were treated daily for four weeks with either distilled water (controls) or 300 mg/kg G. kola extract. At termination, serum glucose, low density lipoprotein (LDL) and high density lipoprotein (HDL) levels were measured. There was no significant difference (P&gt;0.05) in single dose glucose levels, long term HDL levels and body weights compared to the controls. However, in the four week treated rats, glucose (mmol/L) was significantly lower (16.2±2.9; P&lt;0.05) than in the controls (21.6±3.6) and the LDL levels were significantly decreased by 66% in the treated group compared to controls (P&lt;0.01; 86.8±18.2 versus 29.8±10.9). This confirms the hypoglycaemic and especially the hypolipidemic effects of G. kola in a diabetic rat model.Keywords: G. kola, ethanolic extract, hyperglycemia, low density lipoprotein (LDL), high density lipoprotein (HDL), streptozotoci