Wear Tests of a Potential Biolubricant for Orthopedic Biopolymers

Most wear testing of orthopedic implant materials is undertaken with dilute bovine serum used as the lubricant. However, dilute bovine serum is different to the synovial fluid in which natural and artificial joints must operate. As part of a search for a lubricant which more closely resembles synovial fluid, a lubricant based on a mixture of sodium alginate and gellan gum, and which aimed to match the rheology of synovial fluid, was produced. It was employed in a wear test of ultra high molecular weight polyethylene pins rubbing against a metallic counterface. The test rig applied multidirectional motion to the test pins and had previously been shown to reproduce clinically relevant wear factors for ultra high molecular weight polyethylene. After 2.4 million cycles (125 km) of sliding in the presence of the new lubricant, a mean wear factor of 0.099 × 10−6 mm3/Nm was measured for the ultra high molecular weight polyethylene pins. This was over an order of magnitude less than when bovine serum was used as a lubricant. In addition, there was evidence of a transfer film on the test plates. Such transfer films are not seen clinically. The search for a lubricant more closely matching synovial fluid continues

Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System

Our understanding of pressure injury etiology and development has grown in recent years through research, clinical expertise, and global interdisciplinary expert collaboration. Therefore, the National Pressure Ulcer Advisory Panel (NPUAP) has revised the definition and stages of pressure injury. The revision was undertaken to incorporate the current understanding of the etiology of pressure injuries, as well as to clarify the anatomical features present or absent in each stage of injury. An NPUAP-appointed Task Force reviewed the literature and created drafts of definitions, which were then reviewed by stakeholders and the public, including clinicians, educators, and researchers around the world. Using a consensus-building methodology, these revised definitions were the focus of a multidisciplinary consensus conference held in April 2016. As a result of stakeholder and public input, along with the consensus conference, important changes were made and incorporated into the new staging definitions. The revised staging system uses the term injury instead of ulcer and denotes stages using Arabic numerals rather than Roman numerals. The revised definition of a pressure injury now describes the injuries as usually occurring over a bony prominence or under a medical or other device. The revised definition of a Stage 2 pressure injury seeks to clarify the difference between moisture-associated skin damage and injury caused by pressure and/or shear. The term suspected has been removed from the Deep Tissue Pressure Injury diagnostic label. Each definition now describes the extent of tissue loss present and the anatomical features that may or may not be present in the stage of injury. These important revisions reflect the methodical and collaborative approach used to examine the available evidence and incorporate current interdisciplinary clinical expertise into better defining the important phenomenon of pressure injury etiology and development

The repeatability and reproducibility of four techniques for measuring horizontal heterophoria: Implications for clinical practice

PURPOSE: Convergence insufficiency, the most common binocular vision anomaly, is characterised by a receded near point of convergence and an exophoria which is at least 4 prism dioptres (Δ) larger at near than at distance. However, the repeatability of standard heterophoria measures are poorly understood. This study assessed the ability of four common heterophoria tests to detect differences of 4Δ by evaluating the inter- and intra-examiner variability of the selected techniques. METHODS: Distance and near horizontal heterophorias of 20 visually-normal adults were measured with the alternating prism cover test, von Graefe prism dissociation, Howell Card and Maddox Rod by two examiners at two separate visits using standardised instructions and techniques. We investigated inter- and intra-examiner variability using repeatability and reproducibility indices, as well as Bland-Altman analysis with acceptable limits of agreement defined as ±2Δ. RESULTS: The Howell card test had the lowest intra-examiner variability at both distance and near, as well as the best 95% limits of agreement (±1.6Δ for distance and ±3.7Δ for near). Inter-examiner reproducibility results were similar, although at near the alternating prism cover test had better repeatability (1.1Δ, 95% confidence intervals −1.1Δ to 4.0Δ) than the Howell card (1.4Δ, 95% confidence intervals −1.9Δ to 5.9Δ). CONCLUSION: The low repeatability of many standard clinical heterophoria tests limits the ability to reliably detect a 4Δ difference. The Howell Card provided the most repeatable and reproducible results indicating that this technique should be used to detect small changes in heterophoria magnitude and direction

Enhancing pressure ulcer prevention using wound dressings: what are the modes of action?

Recent clinical research has generated interest in the use of sacral wound dressings as preventive devices for patients at risk of ulceration. This study was conducted to identify the modes of action through which dressings can add to pressure ulcer prevention, for example, shear and friction force redistribution and pressure distribution. Bench testing was performed using nine commercially available dressings. The use of dressings can reduce the amplitude of shear stress and friction reaching the skin of patients at risk. They can also effectively redirect these forces to wider areas which minimises the mechanical loads upon skeletal prominences. Dressings can redistribute pressure based upon their effective Poisson ratio and larger deflection areas, providing greater load redistribution.info:eu-repo/semantics/publishedVersio

Learning to Teach Argumentation: Research and development in the science classroom

The research reported in this study focuses on an investigation into the teaching of argumentation in secondary science classrooms. Over a one-year period, a group of 12 teachers from schools in the greater London area attended a series of workshops to develop materials and strategies to support the teaching of argumentation in scientific contexts. Data were collected at the beginning and end of the year by audio and video recording lessons where the teachers attempted to implement argumentation. To assess the quality of argumentation, analytical tools derived from Toulmin's argument pattern (TAP) were developed and applied to classroom transcripts. Analysis shows there was development in teachers' use of argumentation across the year. Results indicate that the pattern of use of argumentation is teacher-specific, as is the nature of change. To inform future professional development programmes, transcripts of five teachers, three showing a significant change and two no change, were analysed in more detail to identify features of teachers' oral contributions that facilitated and supported argumentation. The analysis showed that all teachers attempted to encourage a variety of processes involved in argumentation and that the teachers whose lessons included the highest quality of argumentation (TAP analysis) also encouraged higher order processes in their teaching. The analysis of teachers' facilitation of argumentation has helped to guide the development of in-service materials and to identify the barriers to learning in the professional development of less experienced teachers

Conserving socio-ecological landscapes: An analysis of traditional and responsive management practices for floodplain meadows in England

Contemporary practice in the conservation of socio-ecological landscapes draws on both a model of responsive management, and also on ideas about historic management. This study considered what evidence might exist for the exercise of these approaches to management in the conservation of floodplain meadows in England, in order to inform understanding and knowledge of conservation management and assessment practice. Evidence for a model of responsive management was limited, with managing stakeholders often alternating between this model and an alternative approach, called here the ‘traditional management approach’, based on ideas, narratives and prescriptions of long-established land management practices. Limited monitoring and assessment appeared to undermine the former model, whilst uncertainty over past long-standing management practices undermined the latter. As a result of the relative power of conservation actors over farmers delivering site management, and their framings of meadows as ‘natural’ spaces, management tended to oscillate between aspects of these two approaches in a sometimes inconsistent manner. Conservation managers should consider the past motivating drivers and management practices that created the landscapes they wish to conserve, and bear in mind that these are necessarily implicated in aspects of the contemporary landscape value that they wish to maintain. They should ensure that assessment activity captures a broad range of indicators of site value and condition, not only biological composition, and also record data on site management operations in order to ensure management effectiveness

Wound infection in clinical practice : principles of best practice

The International Wound Infection Institute (IWII) is an organisation of volunteer interdisciplinary health professionals dedicated to advancing and improving practice relating to prevention and control of wound infection. This includes acute wounds (surgical, traumatic and burns) and chronic wounds of all types, although principally chronic wounds of venous, arterial, diabetic and pressure aetiologies. Wound infection is a common complication of wounds. It leads to delays in wound healing and increases the risk of loss of limb and life. Implementation of effective strategies to prevent, diagnose and manage, is important in reducing mortality and morbidity rates associated with wound infection. This second edition of Wound Infection in Clinical Practice is an update of the first edition published in 2008 by the World Union of Wound Healing Societies (WUWHS). The original document was authored by leading experts in wound management and endorsed by the WUWHS. The intent of this edition is to provide a practical, updated resource that is easy-to-use and understand. For this edition, the IWII collaborative team has undertaken a comprehensive review of contemporary literature, including systematic reviews and meta-analyses when available. In addition, the team conducted a formal Delphi process to reach consensus on wound infection issues for which scientific research is minimal or lacking. This rigorous process provides an update on the science and expert opinion regarding prevention, diagnosis and control of wound infection. This edition outlines new definitions relevant to wound infection, presents new paradigms and advancements in the management and diagnosis of a wound infection, and highlights controversial areas of discussion

JAK Kinase Inhibition Abrogates STAT3 Activation and Head and Neck Squamous Cell Carcinoma Tumor Growth

AbstractAberrant activation of the Janus kinase (JAK)/signal transducer and activator of transcription (STAT) 3 has been implicated in cell proliferation and survival of many cancers including head and neck squamous cell carcinoma (HNSCC). AZD1480, an orally active pharmacologic inhibitor of JAK1/JAK2, has been tested in several cancer models. In the present study, the in vitro and in vivo effects of AZD1480 were evaluated in HNSCC preclinical models to test the potential use of JAK kinase inhibition for HNSCC therapy. AZD1480 treatment decreased HNSCC proliferation in HNSCC cell lines with half maximal effective concentration (EC50) values ranging from 0.9 to 4 μM in conjunction with reduction of pSTAT3Tyr705 expression. In vivo antitumor efficacy of AZD1480 was demonstrated in patient-derived xenograft (PDX) models derived from two independent HNSCC tumors. Oral administration of AZD1480 reduced tumor growth in conjunction with decreased pSTAT3Tyr705 expression that was observed in both PDX models. These findings suggest that the JAK1/2 inhibitors abrogate STAT3 signaling and may be effective in HNSCC treatment approaches

Extension of the TAMSAT satellite-based rainfall monitoring over Africa and from 1983 to present

Tropical Applications of Meteorology Using Satellite Data and Ground-Based Observations (TAMSAT) rainfall monitoring products have been extended to provide spatially contiguous rainfall estimates across Africa. This has been achieved through a new, climatology-based calibration, which varies in both space and time. As a result, cumulative estimates of rainfall are now issued at the end of each 10-day period (dekad) at 4-km spatial resolution with pan-African coverage. The utility of the products for decision making is improved by the routine provision of validation reports, for which the 10-day (dekadal) TAMSAT rainfall estimates are compared with independent gauge observations. This paper describes the methodology by which the TAMSAT method has been applied to generate the pan-African rainfall monitoring products. It is demonstrated through comparison with gauge measurements that the method provides skillful estimates, although with a systematic dry bias. This study illustrates TAMSAT’s value as a complementary method of estimating rainfall through examples of successful operational application