Patient-reported outcome measures (PROMs) after elective hip, knee and shoulder arthroplasty: Protocol for a prospective cohort study

Background The number of hip, knee and shoulder arthroplasties continues to rise worldwide. The Organization for Economic Cooperation and Development has launched an initiative (called PaRIS Initiative) for the systematic collection of Patient Reported Outcome Measures (PROMs) in patients undergoing elective hip and knee arthroplasty. The Rizzoli Orthopedic Institute (IOR) was selected as a pilot center for the launch of the Initiative in Italy given that IOR hosts the Registry of Orthopedic Prosthetic Implants (RIPO), a region-wide registry which collects joint implant data from all the hospitals in the Emilia-Romagna Region. In this specific geographic area information related to PROMs after joint replacement is unknown. This paper describes the protocol of a study (PaRIS-IOR) that aims to implement the collection of a set of PROMs within an existing implant registry in Italy. The study will also investigate the temporal trend of PROMs in relation to the type of prosthesis and the type of surgical intervention. Methods The PaRIS-IOR study is a prospective, single site, cohort study that consists of the administration of PROMs questionnaires to patients on the list for elective arthroplasty. The questionnaires will be administered to the study population within 30 days before surgery, and then at 6 and 12 months following surgery. The study population will consist of consecutive adult patients undergoing either hip, knee or shoulder arthroplasty. The collected data will be linked with those routinely collected by the RIPO in order to assess the temporal trend of PROMs in relation to the type of prosthesis and the type of surgical intervention. Discussion The PaRIS-IOR study could have important implications in targeting the factors influencing functional outcomes and quality of life reported by patients after hip, knee and shoulder arthroplasty, and will also represent the first systematic collection of PROMs related to arthroplasty in Italy

Microscopic origin of random telegraph noise fluctuations in aggressively scaled RRAM and its impact on read disturb variability

Random telegraph noise (RTN) is an important intrinsic phenomenon of any logic or memory device that is indicative of the reliability and stochastic variability in its performance. In the context of the resistive random access memory (RRAM), RTN becomes a key criterion that determines the read disturb immunity and memory window between the low (LRS) and high resistance states (HRS). With the drive towards ultra-low power memory (low reset current) and aggressive scaling to 10 × 10 nm2 area, contribution of RTN is significantly enhanced by every trap (vacancy) in the dielectric. The underlying mechanisms governing RTN in RRAM are yet to be fully understood. In this study, we aim to decode the role of conductance fluctuations caused by oxygen vacancy transport and inelastic electron trapping and detrapping processes. The influence of resistance state (LRS, shallow and deep HRS), reset depth and reset stop voltage (VRESET-STOP) on the conductance variability is also investigated. © 2013 IEEE

Long-term evaluation of infliximab in the treatment of persistently active juvenile idiopathic arthritis refractory to conventional therapy

Objectives: To evaluate, in long-term open label prospective study, infliximab as therapeutic choice for Juvenile Idiopathic Arthritis (JIA) non responsive to conventional therapy. Methods: We enrolled to treat with infliximab 78 JIA patients (66 females, 12 males): the mean age was 20.7±7.1 years (median 20.9, range 5.4-34.9); mean JIA duration was 13.6±7.6 years (median 13.5, range 0.4-31.4). Infliximab, at dose of 3-10 mg/kg/infusion added to weekly subcutaneous Methotrexate or other previous DMARDs, was administered by intravenous infusions at weeks 0, 2, 6 and every 8 weeks thereafter. Chest X-ray, Mantoux's test, electrocardiogram were performed at baseline; laboratory tests and clinical evaluation were performed at each infusion. Response was evaluated according to ACR improvement criteria. Results: Mean treatment period was 21.6 months±18.8 (median 14.7, range 1.4-72.4). Just after first infusion most of patients reported significant improvement in pain, fatigue, morning stiffness. Infliximab is still successfully administered to 23 patients (29.5%); 55 (70.5%) patients suspended because of: inefficacy (7), infusion reactions (17), adverse events (9), disease flare-up after a period of effectiveness on synovitis, pain, and morning stiffness (19), remission (2), lack of compliance to treatment (1). Infusion reactions, like dyspnea, flushing, chills, headache, hypotension, anxiety, throat oedema, were observed in 29 patients (34.5%). Anti-DNA antibodies were present in 7 patients (none developed Systemic Lupus Eritematous). Conclusions: Infliximab showed impressive effectiveness treating refractory JIA, although most of patients had to discontinue treatment because of disease flare-up or adverse events. Infliximab may represent a good therapeutic choice in patients non-responders to Methotrexate

Eta photoproduction off the neutron at GRAAL: Evidence for a resonant structure at W=1.67 GeV

New (preliminary) data on eta photoproduction off the neutron are presented. These data reveal a resonant structure at W=1.67 GeV.Comment: 8 pages, 4 figures. Published in Proceedings of Workshop on the Physics of Excited Nucleons NSTAR2004, Grenoble, France, March 24 - 27, pg.19