No drain, autologous transfusion drain or suction drain? A randomised prospective study in total hip replacement surgery of 168 patients

We performed a prospective, randomised controlled trial to assess the differences in the use of a conventional suction drain, an Autologous Blood Transfusion (ABT) drain and no drain, in 168 patients. There was no significant difference between the drainage from ABT drains ( mean : 345 ml) and the suction drain (314 ml). Forty percent of patients receiving a suction drain had a haemoglobin level less than 10 g/dL at 24 hours, compared to 35% with no drain and 28% with an ABT drain. Patients that had no drains had wounds that were dry significantly sooner, mean 3.0 days compared to a mean of 3.9 days with an ABT drain and a mean of 4 days with a suction drain. Patients that did not have a drain inserted stayed in hospital a significantly shorter period of time, compared with drains. We feel the benefits of quicker drying wounds, shorter hospital stays and the economic savings justify the conclusion that no drain is required after hip replacement

Optimizing egalitarian performance in the side-effects model of colocation for data center resource management

In data centers, up to dozens of tasks are colocated on a single physical machine. Machines are used more efficiently, but tasks' performance deteriorates, as colocated tasks compete for shared resources. As tasks are heterogeneous, the resulting performance dependencies are complex. In our previous work [18] we proposed a new combinatorial optimization model that uses two parameters of a task - its size and its type - to characterize how a task influences the performance of other tasks allocated to the same machine. In this paper, we study the egalitarian optimization goal: maximizing the worst-off performance. This problem generalizes the classic makespan minimization on multiple processors (P||Cmax). We prove that polynomially-solvable variants of multiprocessor scheduling are NP-hard and hard to approximate when the number of types is not constant. For a constant number of types, we propose a PTAS, a fast approximation algorithm, and a series of heuristics. We simulate the algorithms on instances derived from a trace of one of Google clusters. Algorithms aware of jobs' types lead to better performance compared with algorithms solving P||Cmax. The notion of type enables us to model degeneration of performance caused by using standard combinatorial optimization methods. Types add a layer of additional complexity. However, our results - approximation algorithms and good average-case performance - show that types can be handled efficiently.Comment: Author's version of a paper published in Euro-Par 2017 Proceedings, extends the published paper with addtional results and proof

Limits of minimal models and continuous orbifolds

The lambda=0 't Hooft limit of the 2d W_N minimal models is shown to be equivalent to the singlet sector of a free boson theory, thus paralleling exactly the structure of the free theory in the Klebanov-Polyakov proposal. In 2d, the singlet sector does not describe a consistent theory by itself since the corresponding partition function is not modular invariant. However, it can be interpreted as the untwisted sector of a continuous orbifold, and this point of view suggests that it can be made consistent by adding in the appropriate twisted sectors. We show that these twisted sectors account for the `light states' that were not included in the original 't Hooft limit. We also show that, for the Virasoro minimal models (N=2), the twisted sector of our orbifold agrees precisely with the limit theory of Runkel & Watts. In particular, this implies that our construction satisfies crossing symmetry.Comment: 33 pages; v2: minor improvements and references added, published versio

A scheduling theory framework for GPU tasks efficient execution

Concurrent execution of tasks in GPUs can reduce the computation time of a workload by overlapping data transfer and execution commands. However it is difficult to implement an efficient run- time scheduler that minimizes the workload makespan as many execution orderings should be evaluated. In this paper, we employ scheduling theory to build a model that takes into account the device capabili- ties, workload characteristics, constraints and objec- tive functions. In our model, GPU tasks schedul- ing is reformulated as a flow shop scheduling prob- lem, which allow us to apply and compare well known methods already developed in the operations research field. In addition we develop a new heuristic, specif- ically focused on executing GPU commands, that achieves better scheduling results than previous tech- niques. Finally, a comprehensive evaluation, showing the suitability and robustness of this new approach, is conducted in three different NVIDIA architectures (Kepler, Maxwell and Pascal).Proyecto TIN2016- 0920R, Universidad de Málaga (Campus de Excelencia Internacional Andalucía Tech) y programa de donación de NVIDIA Corporation

The impact of consent on observational research: a comparison of outcomes from consenters and non consenters to an observational study

Background Public health benefits from research often rely on the use of data from personal medical records. When neither patient consent nor anonymisation is possible, the case for accessing such records for research purposes depends on an assessment of the probabilities of public benefit and individual harm. Methods In the late 1990s, we carried out an observational study which compared the care given to affluent and deprived women with breast cancer. Patient consent was not required at that time for review of medical records, but was obtained later in the process prior to participation in the questionnaire study. We have re-analysed our original results to compare the whole sample with those who later provided consent. Results Two important findings emerged from the re-analysis of our data which if presented initially would have resulted in insufficient and inaccurate reporting. Firstly, the reduced dataset contains no information about women presenting with locally advanced or metastatic cancer and we would have been unable to demonstrate one of our initial key findings: namely a larger number of such women in the deprived group. Secondly, our re-analysis of the consented women shows that significantly more women from deprived areas (51 v 31%, p = 0.018) received radiotherapy compared to women from more affluent areas. Previously published data from the entire sample demonstrated no difference in radiotherapy treatment between the affluent and deprived groups. Conclusion The risk benefit assessment made regarding the use of medical records without consent should include the benefits of obtaining research evidence based on 100% of the population and the possibility of inappropriate or insufficient findings if research is confined to consented populations

Effects of whole body cryotherapy and cold water immersion on immune and inflammatory markers following exercise induced muscle damage

Introduction: Cold therapies are used regularly in medicine for their analgesic and anti-inflammatory effects. Whole-body cryotherapy (WBC) involves exposure to air maintained between -110 and -160oC, and is hypothesised to reduce pain, local and systemic inflammation. WBC has recently become popular in an exercise and sporting context as a recovery method after skeletal muscle damage. However, research examining the efficacy of WBC in an athletic context is minimal, in particular, studies comparing WBC to currently accepted recovery methods are lacking. Cold water immersion (CWI) is a widely researched and applied method of skeletal muscle recovery in sport science. As yet, no study has compared the proposed new method of WBC and the currently practiced method of CWI. We have designed a randomised control trial to examine the efficacy of WBC, as compared with CWI on recovery from a bout of eccentric muscle damage. Methods: Sixty healthy male subjects will perform skeletal muscle function tests and an eccentric muscle damage protocol of their left quadriceps femoris, using an isokinetic dynamometer. They will then be randomly assigned to one of 3 groups, WBC, CWI or a passive recovery control (PAS). The WBC will expose subjects to -160°C for 3min, using cold air. The CWI condition involves whole body exposure for 3min, in water maintained at 12°C. The PAS will have subjects seated comfortably at room temperature following the exercise protocol. Blood samples, muscle functional measurements and pain reports will be taken before muscle damage, immediately following damage, prior to therapy administration and post therapy. Further follow up measures to be taken 6 h post, 24 h and 7 days post. Blood samples will be analysed for changes in interleukins 6, 8 and 10, creatine kinase and leukocyte population kinetics. Results: Testing is being conducted. Results to be presented at the international society of exercise immunology (ISEI) symposium in September 2013

VPS18 recruits VPS41 to the human HOPS complex via a RING-RING interaction

Eukaryotic cells use conserved multisubunit membrane tethering complexes, including CORVET (class C core vacuole/endosome tethering) and HOPS (homotypic fusion and vacuole protein sorting), to control the fusion of endomembranes. These complexes have been extensively studied in yeast, but to date there have been far fewer studies of metazoan CORVET and HOPS. Both of these complexes comprise six subunits: a common four-subunit core and two unique subunits. Once assembled, these complexes function to recognise specific endosomal membrane markers and facilitate SNARE-mediated membrane fusion. CORVET promotes the homotypic fusion of early endosomes, while HOPS promotes the fusion of lysosomes to late endosomes and autophagosomes. Many of the subunits of both CORVET and HOPS contain putative C-terminal zinc-finger domains. Here, the contribution of these domains to the assembly of the human CORVET and HOPS complexes has been examined. Using biochemical techniques, we demonstrate that the zinc-containing RING (really interesting new gene) domains of human VPS18 and VPS41 interact directly to form a stable heterodimer. In cells, these RING domains are able to integrate into endogenous HOPS, showing that the VPS18 RING domain is required to recruit VPS41 to the core complex subunits. Importantly, this mechanism is not conserved throughout eukaryotes, as yeast Vps41 does not contain a C-terminal zinc-finger motif. The subunit analogous to VPS41 in human CORVET is VPS8, in which the RING domain has an additional C-terminal segment that is predicted to be disordered. Both the RING and disordered C-terminal domains are required for integration of VPS8 into endogenous CORVET complexes, suggesting that HOPS and CORVET recruit VPS41 and VPS8 via distinct molecular interactions.This work was supported by a Sir Henry Dale Fellowship, jointly funded by the Royal Society and the Wellcome Trust, to S.C.G. [098406/Z/12/Z], an Isaac Newton Trust/Wellcome Trust ISSF/University of Cambridge Joint Research Grant to S.C.G., and a Wellcome Trust Senior Research Fellowship [WT097997MA] to Ian Goodfellow (University of Cambridge)

TAM receptor tyrosine kinase function and the immunopathology of liver disease.

Tyro3, Axl, MERTK (TAM) receptor tyrosine kinases are implicated in the regulation of the innate immune response through clearance of apoptotic cellular debris and control of cytokine signaling cascades. As a result they are pivotal in regulating the inflammatory response to tissue injury. Within the liver, immune regulatory signaling is employed to prevent the overactivation of innate immunity in response to continual antigenic challenge from the gastrointestinal tract. In this review we appraise current understanding of the role of TAM receptor function in the regulation of both innate and adaptive immunity, with a focus on its impact upon hepatic inflammatory pathology