The influence of the strength of bone on the deformation of acetabular shells : a laboratory experiment in cadavers

Date of Acceptance: 24/08/2014 ©2015 The British Editorial Society of Bone & Joint Surgery. The authors would like to thank N. Taylor (3D Measurement Company) for his work with regard to data acquisition and processing of experimental data. We would also like to thank Dr A. Blain of Newcastle University for performing the statistical analysis The research was supported by the NIHR Newcastle Biomedical Research Centre. The authors P. Dold, M. Flohr and R. Preuss are employed by Ceramtec GmbH. Martin Bone received a salary from the joint fund. The author or one or more of the authors have received or will receive benefits for personal or professional use from a commercial party related directly or indirectly to the subject of this article. This article was primary edited by G. Scott and first proof edited by J. Scott.Peer reviewedPostprin

Planar charged-particle trajectories in multipole magnetic fields

International audienceThis paper provides a complete generalization of the classic result that the radius of curvature (?) of a charged-particle trajectory confined to the equatorial plane of a magnetic dipole is directly proportional to the cube of the particle's equatorial distance (?) from the dipole (i.e. ? ? ?3). Comparable results are derived for the radii of curvature of all possible planar charged-particle trajectories in an individual static magnetic multipole of arbitrary order m and degree n. Such trajectories arise wherever there exists a plane (or planes) such that the multipole magnetic field is locally perpendicular to this plane (or planes), everywhere apart from possibly at a set of magnetic neutral lines. Therefore planar trajectories exist in the equatorial plane of an axisymmetric (m = 0), or zonal, magnetic multipole, provided n is odd: the radius of curvature varies directly as ?n+2. This result reduces to the classic one in the case of a zonal magnetic dipole (n =1). Planar trajectories exist in 2m meridional planes in the case of the general tesseral (0 m n) magnetic multipole. These meridional planes are defined by the 2m roots of the equation cos[m(? ? ?nm)] = 0, where ?nm = (1/m) arctan (hnm/gnm); gnm and hnm denote the spherical harmonic coefficients. Equatorial planar trajectories also exist if (n ? m) is odd. The polar axis (? = 0,?) of a tesseral magnetic multipole is a magnetic neutral line if m > 1. A further 2m(n ? m) neutral lines exist at the intersections of the 2m meridional planes with the (n ? m) cones defined by the (n ? m) roots of the equation Pnm(cos ?) = 0 in the range 0 ? ?, where Pnm(cos ?) denotes the associated Legendre function. If (n ? m) is odd, one of these cones coincides with the equator and the magnetic field is then perpendicular to the equator everywhere apart from the 2m equatorial neutral lines. The radius of curvature of an equatorial trajectory is directly proportional to ?n+2 and inversely proportional to cos[m(? ? ?nm)]. Since this last expression vanishes at the 2m equatorial neutral lines, the radius of curvature becomes infinitely large as the particle approaches any one of these neutral lines. The radius of curvature of a meridional trajectory is directly proportional to rn+2, where r denotes radial distance from the multipole, and inversely proportional to Pnm(cos ?)/sin θ. Hence the radius of curvature becomes infinitely large if the particle approaches the polar magnetic neutral line (m > 1) or any one of the 2m(n ? m) neutral lines located at the intersections of the 2m meridional planes with the (n ? m) cones. Illustrative particle trajectories, derived by stepwise numerical integration of the exact equations of particle motion, are presented for low-degree (n ? 3) magnetic multipoles. These computed particle trajectories clearly demonstrate the "non-adiabatic'' scattering of charged particles at magnetic neutral lines. Brief comments are made on the different regions of phase space defined by regular and irregular trajectories

Maintained physical activity and physiotherapy in the management of distal upper limb pain – a protocol for a randomised controlled trial (the arm pain trial)

<b>Background</b><p></p> Distal upper limb pain (pain affecting the elbow, forearm, wrist, or hand) can be non-specific, or can arise from specific musculoskeletal disorders. It is clinically important and costly, the best approach to clinical management is unclear. Physiotherapy is the standard treatment and, while awaiting treatment, advice is often given to rest and avoid strenuous activities, but there is no evidence base to support these strategies. This paper describes the protocol of a randomised controlled trial to determine, among patients awaiting physiotherapy for distal arm pain, (a) whether advice to remain active and maintain usual activities results in a long-term reduction in arm pain and disability, compared with advice to rest; and (b) whether immediate physiotherapy results in a long-term reduction in arm pain and disability, compared with physiotherapy delivered after a seven week waiting list period.<p></p> <b>Methods/Design</b><p></p> Between January 2012 and January 2014, new referrals to 14 out-patient physiotherapy departments were screened for potential eligibility. Eligible and consenting patients were randomly allocated to one of the following three groups in equal numbers: 1) advice to remain active, 2) advice to rest, 3) immediate physiotherapy. Patients were and followed up at 6, 13, and 26 weeks post-randomisation by self-complete postal questionnaire and, at six weeks, patients who had not received physiotherapy were offered it at this time. The primary outcome is the proportion of patients free of disability at 26 weeks, as determined by the modified DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire.<p></p> We hypothesise (a) that advice to maintain usual activities while awaiting physiotherapy will be superior than advice to rest the arm; and (b) that fast-track physiotherapy will be superior to normal (waiting list) physiotherapy. These hypotheses will be examined using an intention-to-treat analysis.<p></p> <b>Discussion</b><p></p> Results from this trial will contribute to the evidence base underpinning the clinical management of patients with distal upper limb pain, and in particular, will provide guidance on whether they should be advised to rest the arm or remain active within the limits imposed by their symptoms

Factors associated with unvaccinated caregivers who plan to vaccinate their children

Vaccine hesitancy is complex and a threat to global public health during the ongoing COVID-19 pandemic. Our objective was to determine factors associated with caregivers' willingness to vaccinate children despite not being immunized themselves against COVID-19. The International COVID-19 Parental Attitude Study (COVIPAS), a multinational cohort study, recruited caregivers of children 0-18 years old in 21 Emergency Departments (EDs) in USA, Canada, Israel, and Switzerland during November-December 2021. Of a total of 4536 caregivers who completed the survey, 882 (19.4%) were unvaccinated, and 62 (7.0%) of the unvaccinated planned to vaccinate their children. Unvaccinated caregivers with children that had their childhood vaccines up-to-date (OR 3.03 (1.36, 8.09), p = 0.01), and those very worried their child has COVID-19 in the ED (OR 3.11 (1.44, 6.34), p < 0.01) were much more likely to plan to immunize their children. Primary care providers and public health agencies should not assume that unvaccinated parents will not vaccinate their children. Determining child's vaccination status and parental level of concern about COVID-19 may help identify caregivers who are open to give their children the vaccine. Keywords: COVID-19; Sars-cov-2; Unvaccinated; Vaccination; Vaccine hesitancy

A life less lonely: the state of the art in interventions to reduce loneliness in people with mental health problems

PURPOSE: There is growing evidence of significant harmful effects of loneliness. Relatively little work has focused on how best to reduce loneliness in people with mental health problems. We aim to present an overview of the current state of the art in loneliness interventions in people with mental health problems, identify relevant challenges, and highlight priorities for future research and implementation. METHODS: A scoping review of the published and grey literature was conducted, as well as discussions with relevant experts, to propose a broad classification system for types of interventions targeting loneliness. RESULTS: We categorised interventions as ‘direct’, targeting loneliness and related concepts in social relationships, and ‘indirect’ broader approaches to well-being that may impact on loneliness. We describe four broad groups of direct interventions: changing cognitions; social skills training and psychoeducation; supported socialisation or having a ‘socially-focused supporter’; and ‘wider community approaches’. The most promising emerging evidence appears to be in ‘changing cognitions’, but, as yet, no approaches have a robust evidence base. Challenges include who is best placed to offer the intervention, how to test such complex interventions, and the stigma surrounding loneliness. CONCLUSIONS: Development of clearly defined loneliness interventions, high-quality trials of effectiveness, and identifying which approaches work best for whom is required. Promising future approaches may include wider community initiatives and social prescribing. It is important to place loneliness and social relationships high on the wider public mental health and research agenda

Sharks of the order Carcharhiniformes from the British Coniacian, Santonian and Campanian (Upper Cretaceous).

Bulk sampling of phosphate-rich horizons within the British Coniacian to Campanian (Upper Cretaceous) yielded very large samples of shark and ray teeth. All of these samples yielded teeth of diverse members of the Carcharhiniformes, which commonly dominate the fauna. The following species are recorded and described: Pseudoscyliorhinus reussi (Herman, 1977) comb. nov., Crassescyliorhinus germanicus (Herman, 1982) gen. nov., Scyliorhinus elongatus (Davis, 1887), Scyliorhinus brumarivulensis sp. nov., ? Palaeoscyllium sp., Prohaploblepharus riegrafi (Müller, 1989) gen. nov., ? Cretascyliorhinus sp., Scyliorhinidae inc. sedis 1, Scyliorhinidae inc. sedis 2, Pteroscyllium hermani sp. nov., Protoscyliorhinus sp., Leptocharias cretaceus sp. nov., Palaeogaleus havreensis Herman, 1977, Paratriakis subserratus sp. nov., Paratriakis tenuis sp. nov., Paratriakis sp. indet. and ? Loxodon sp. Taxa belonging to the families ?Proscylliidae, Leptochariidae, and Carcharhinidae are described from the Cretaceous for the first time. The evolutionary and palaeoecological implications of these newly recognised faunas are discussed

Social setting, intuition, and experience in lab experiments interact to shape cooperative decision-making

Recent studies suggest that cooperative decision-making in one-shot interactions is a history-dependent dynamic process: promoting intuition versus deliberation has typically a positive effect on cooperation (dynamism) among people living in a coop- erative setting and with no previous experience in economic games on cooperation (history-dependence). Here we report on a lab experiment exploring how these findings transfer to a non-cooperative setting. We find two major results: (i) promoting intuition versus deliberation has no effect on cooperative behavior among inexperienced subjects living in a non-cooperative setting; (ii) experienced subjects cooperate more than inexperienced subjects, but only under time pressure. These results suggest that cooperation is a learning process, rather than an instinctive impulse or a self-controlled choice, and that experience operates primarily via the channel of intuition. In doing so, our findings shed further light on the cognitive basis of human cooperative decision-making and provide further support for the recently proposed Social Heuristics Hypothesis

Human rights, Public health and Medicinal cannabis use

This paper explores the interplay between the human rights and drug control frameworks and critiques case law on medicinal cannabis use to demonstrate that a bona fide human rights perspective allows for a broader conception of ‘health’. This broad conception, encompassing both medicalised and social constructionist definitions, can inform public health policies relating to medici-nal cannabis use. The paper also demonstrates how a human rights lens can alleviate a core tension between the State and the individual within the drug policy field. The leading medicinal cannabis case in the UK highlights the judiciary’s failure to engage with an individual’s human right to health as they adopt an arbitrary, externalist view, focussing on the legality of cannabis to the exclusion of other concerns. Drawing on some international comparisons, the paper considers how a human rights perspective can lead to an approach to medicinal cannabis use which facilitates a holistic understanding of public health