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

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

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

STUDI MODEL FISIK PEMECAH GELOMBANG TIDAK TENGGELAM TIPE LURUS BERPORI TERHADAP POLA DIFRAKSI GELOMBANG

Ketenangan daerah kolam pelabuhan adalah hal sangat yang penting diperhatikan pada sebuah pelabuhan. Aksi arus gelombang yang terbentuk akibat pola difraksi di sekitar breakwater akan mengganggu kenyamanan kapal saat memasuki kolam pelabuhan. Penelitian ini mengkaji pola difraksi tersebut dengan menggunakan model bangunan pemecah gelombang tidak tenggelam (emerged beakwater) yang terbuat dari susunan blok-blok kubus kayu berpori. Blok-blok ini dirangkai membentuk model breakwater tipe lurus dengan panjang 1,5 m dengan tinggi 40 cm untuk setiap B1 = 10 cm, B2 = 20 cm, dan B3 = 30 cm. Penelitian dilakukan di Laboratorium Teknik Sungai dan Pantai Fakultas Teknik Universitas Syiah Kuala dengan menggunakan kolam gelombang yang terbuat dari beton bertulang berukuran panjang 15 m, lebar 5 m, dan tinggi 0,65 m, dengan kedalaman air adalah 30 cm, dilengkapi mesin regular wave generator pada ujung kolam dan dibuat wave absorber pada ujung lainnya. Gelombang dibangkitkan dengan 3 kondisi untuk masing-masing ukuran lebar breakwater yaitu H1T1 (H = 8.7 cm, T = 1,45 detik, L=2,25 m), H2T2 (H = 10 cm, T = 1,43 detik, L=2,21 m) dan H3T3 (H = 12 cm, T = 1,18 detik, L=1,73 m). Alat yang digunakan adalah alat pengukur tinggi gelombang otomatis capacitative wave gauge. Hasil yang diperoleh adalah bahwa pemecah gelombang dengan ukuran lebar 30 cm lebih mampu meredam gelombang yaitu sebesar 53,8-61% daripada model dengan lebar 20 cm yaitu 52,6-57,5% dan lebar 10 cm yaitu 49,4%. Nilai koefisien difraksi (Kd) yang didapat akan semakin kecil untuk lebar ukuran breakwater (B/L) yang semakin besar. Hubungan kecuraman gelombang H/L (wave stepness) dengan Kd adalah berbanding terbalik sedangkan hubungan periode gelombang (T) dengan Kd adalah berbanding lurus. Nilai Kd meningkat dengan berkurangnya angka kecuraman gelombang dan sebaliknya, namun Nilai Kd justru menurun pada periode gelombang yang semakin kecil, dan sebaliknya. Kata kunci: Pola difraksi gelombang, emerged breakwater, pemecah gelombang berpor

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

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

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