Effects of the Balanced Gap Technique on Femoral Component Rotation in TKA

Femoral component rotation from a total knee prosthesis can be determined by either a measured resection technique or a balanced gap technique. With the balanced gap implantation technique, femoral component rotation can vary freely within the restrictions produced by soft tissue structures. Because internal rotation might cause patella problems, the effect of ligament releases on femoral component rotation in a prospective clinical study was studied. Femoral component rotation was measured intraoperatively with a tensor applied in flexion at 150 N in 87 knees. Great interpatient variability was found; femoral component rotation, reference from the posterior condyles, ranged from −4° to 13°. There was no difference in femoral component rotation of knees with or without ligament releases in extension. However, knees with major medial release had less external femoral component rotation than knees with minor lateral releases. Preoperative alignment had no influence on femoral component rotation. The use of the balanced gap implantation technique theoretically will result in a balanced flexion gap, but the amount of femoral component rotation will be variable owing to patient variability and variation in ligament releases

The Normal College News, September 22, 1916

Introduction and Aim: Knowledge on patterns of beliefs about the illness (illness cognitions) can provide insight into individual differences in adjustment to haemophilia. The current study aimed to identify (a) which sociodemographic and disease characteristics were associated with illness cognitions and (b) which illness cognitions were associated with health-related quality of life (HRQOL) in young adult men with haemophilia, besides sociodemographic and disease characteristics. Methods: Young adult men (18-30 years) with haemophilia in the Netherlands participated in an online multicentre cross-sectional study. Participants completed the Pediatric Quality of Life Inventory Young Adult version (PedsQL_YA). Potential sociodemographic determinants were assessed with the Course of Life Questionnaire (CoLQ) and illness cognitions with the Illness Cognition Questionnaire (ICQ). Multiple linear regression analyses were performed to assess potential determinants of illness cognitions and HRQOL. Results: Seventy young adult men with haemophilia (mean age 24.7 years, SD 3.5) participated. Born outside the Netherlands (β −0.24) and >1 bleed past 6 months (β −0.32) were associated with less acceptance of the disease. More acceptance was associated with better HRQOL in all domains: β 0.23-0.39. More helplessness was associated with worse total (β −0.30) and physical (β −0.42) HRQOL. Disease benefits, sociodemographic and disease characteristics were not associated with HRQOL. Conclusion: Illness cognitions are associated with HRQOL in young adult men with haemophilia. Early recognition and identification of illness cognitions are important to facilitate support and psychosocial treatment to optimize young adults’ well-being. Extra attention is needed for young adult men with frequent bleeds because they are at risk of lowered levels of acceptance of the disease

The circulation of Anaplasma phagocytophilum ecotypes is associated with community composition of vertebrate hosts

Anaplasma phagocytophilum is a tick-borne pathogen that has been detected in many tick and vertebrate species. It is among the most widespread tick-borne pathogens in animals in Europe. The bacterium can be genetically divided into four ecotypes, which are linked to distinct but overlapping host species. However, knowledge about the transmission dynamics of the enzootic cycles of the different ecotypes is limited. Here, we quantified the link between the ecotypes of A. phagocytophilum, the different life stages of the tick Ixodes ricinus, and vertebrate host groups through a meta-analysis. We extracted data on the mean I. ricinus burden and the A. phagocytophilum infection prevalence in both hosts and feeding I. ricinus from 197 papers on 77 wildlife species. With this information, we modeled the relative importance of different host taxonomic groups for the circulation of the different ecotypes of A. phagocytophilum in a theoretical assemblage of hosts with varying presence of red deer (Cervus elaphus) and densities of small mammals. We showed that the composition of the vertebrate community affects the relative abundance of different ecotypes of A. phagocytophilum in the different life stages of I. ricinus. The presence of red deer is likely to increase the infection prevalence of Ecotype 1 in ticks, while small mammal densities drive the prevalence in ticks of mainly Ecotype 3, and to a lesser extent Ecotype 1. In Europe, vertebrate communities are changing, with an increase in red deer abundance and changes in the population dynamics of small mammals. Our results suggest that these changes could imply an increase in the circulation of A. phagocytophilum and thus an increase in the risk for public and veterinary health

Extinction times in the subcritical stochastic SIS logistic epidemic

Many real epidemics of an infectious disease are not straightforwardly super- or sub-critical, and the understanding of epidemic models that exhibit such complexity has been identified as a priority for theoretical work. We provide insights into the near-critical regime by considering the stochastic SIS logistic epidemic, a well-known birth-and-death chain used to model the spread of an epidemic within a population of a given size $N$. We study the behaviour of the process as the population size $N$ tends to infinity. Our results cover the entire subcritical regime, including the "barely subcritical" regime, where the recovery rate exceeds the infection rate by an amount that tends to 0 as $N \to \infty$ but more slowly than $N^{-1/2}$. We derive precise asymptotics for the distribution of the extinction time and the total number of cases throughout the subcritical regime, give a detailed description of the course of the epidemic, and compare to numerical results for a range of parameter values. We hypothesise that features of the course of the epidemic will be seen in a wide class of other epidemic models, and we use real data to provide some tentative and preliminary support for this theory.Comment: Revised; 34 pages; 6 figure

Modelling the dynamic relationship between spread of infection and observed crowd movement patterns at large scale events.

Understanding how contact patterns arise from crowd movement is crucial for assessing the spread of infection at mass gathering events. Here we study contact patterns from Wi-Fi mobility data of large sports and entertainment events in the Johan Cruijff ArenA stadium in Amsterdam. We show that crowd movement behaviour at mass gathering events is not homogeneous in time, but naturally consists of alternating periods of movement and rest. As a result, contact duration distributions are heavy-tailed, an observation which is not explained by models assuming that pedestrian contacts are analogous to collisions in the kinetic gas model. We investigate the effect of heavy-tailed contact duration patterns on the spread of infection using various random walk models. We show how different types of intermittent movement behaviour interact with a time-dependent infection probability. Our results point to the existence of a crossover point where increased contact duration presents a higher level of transmission risk than increasing the number of contacts. In addition, we show that different types of intermittent movement behaviour give rise to different mass-action kinetics, but also show that neither one of two mass-action mechanisms uniquely describes events

Роль православної церкви у формуванні та функціонуванні політичної системи України в 90-і роки ХХ ст.

У статті зроблено спробу аналізу місця та ролі православної церкви у процесах формування та функціонування політичної системи України у 90-і роки ХХ ст. Доведено, що українські православні церкви відігравали значну роль у політичному житті країни, не тільки агітуючи віруючих за певну політичну силу, а й балотуючи своїх представників до місцевих органів влади. Українські політики використовували церкву заради досягнення власних цілей, що ще більше загострювало міжконфесійні взаємини і посилювало політизацію церковного життя.В статье сделана попытка анализа места и роли православной церкви в процессе формирования и функционирования политической системы Украины в 90-е годы ХХ ст. Доказано, что украинские православные церкви играли значительную роль в политической жизни страны, не только агитируя верующих за определенную политическую силу, но и баллотируя своих представителей в местные органы власти. Украинские политики использовали церковь ради достижения собственных целей, что еще больше обостряло межконфессиональные отношения и усиливало политизацию церковной жизни.In the article the attempt of analysis of place and role of orthodox church in the process of forming and functioning of the political system of Ukraine in the 90 th ys of the XX ct is done. It is proved, that the Ukrainian orthodox churches acted considerable part in the political life of country, not only agitating believers for definite political force, but also voting the representatives in local authorities. The Ukrainian politicians used a church for achievement of own purposes, that yet more intensified the interconfession relations reinforced the political impact on the church life

Spatiotemporal mortality and demographic trends in a small cetacean: Strandings to inform conservation management

With global increases in anthropogenic pressures on wildlife populations comes a responsibility to manage them effectively. The assessment of marine ecosystem health is challenging and often relies on monitoring indicator species, such as cetaceans. Most cetaceans are however highly mobile and spend the majority of their time hidden from direct view, resulting in uncertainty on even the most basic population metrics. Here, we discuss the value of long-term and internationally combined stranding records as a valuable source of information on the demographic and mortality trends of the harbour porpoise (Phocoena phocoena) in the North Sea. We analysed stranding records (n = 16,181) from 1990 to 2017 and demonstrate a strong heterogeneous seasonal pattern of strandings throughout the North Sea, indicative of season-specific distribution or habitat use, and season-specific mortality. The annual incidence of strandings has increased since 1990, with a notable steeper rise particularly in the southern North Sea since 2005. A high density of neonatal strandings occurred specifically in the eastern North Sea, indicative of areas important for calving, and large numbers of juvenile males stranded in the southern parts, indicative of a population sink or reflecting higher male dispersion. These findings highlight the power of stranding records to detect potentially vulnerable population groups in time and space. This knowledge is vital for managers and can guide, for example, conservation measures such as the establishment of time-area-specific limits to potentially harmful human activities, aiming to reduce the number and intensity of human-wildlife conflicts