Functional Outcomes of the Knee after Retrograde and Antegrade Intramedullary Nailing for Femoral Shaft Fractures

Background: Antegrade intramedullary nailing is currently considered the gold standard for treatment of femur shaft fractures although retrograde technique is gaining acceptance. Although introducing the nail through the knee has potential to damage the intra articular structures, several reports have indicated acceptable functional outcome. The results are not known in our centre that so far lacks an established patient selection and knee rehabilitative protocols inspite of the widespread use of the retrograde technique.Objective: To compare the functional outcome of the knee joint after retrograde and antegrade intramedullary nailing of femoral shaft fractures.Methods: A comparative cross sectional study carried out on patients who were treated with retrograde and antegrade intramedullary nailing for femoral shaft fractures between January 2007 and December 2009. Functional outcome was determined using modified HSS score.Results: A total of 124 patients participated in the study. According to the modified H.S.S knee rating system, overall, functional results were rated as excellent in 71.8%, good in 23.4% and poor in 3.2%.The retrograde group had poorer results than Antegrade group (p<0.001). There was a negative correlation between age and the functional outcome in the retrograde group (p < .001).The incidence of knee pain was higher in the retrograde group (37.5%) as compared to 10% in the Antegrade group, while the rate of knee stiffness was higher in the retrograde group (40.6%) compared to the Antegrade group (3%).Conclusion: Retrograde nailing is associated with poorer knee scores in our patient population. Increasing age is a factor associated with poorer scores especially after retrograde nailing

Exposure of benthic invertebrates to sediment vibration: From laboratory experiments to outdoor simulated pile-driving

This is the final version of the article. Available from Acoustical Society of America via the DOI in this record.Fourth International Conference on the Effects of Noise on Aquatic Life, Dublin, Ireland, 10-16 July 2016Activities directly interacting with the seabed, such as pile-driving, can produce vibrations that have the potential to impact benthic invertebrates within their vicinity. This stimuli may interfere with crucial behaviors such as foraging and predator avoidance, and the sensitivity to vibration is largely unknown. Here, the responsiveness of benthic invertebrates to sediment vibration is discussed in relation to laboratory and semi-field trials with two marine species: the mussel (Mytilus edulis) and hermit crab (Pagurus bernhardus). Sensory threshold curves were produced for both species in controlled laboratory conditions, followed by small-scale pile-driving exposures in the field. The merits of behavioral indicators are discussed, in addition to using physiological measures, as a method of determining reception and measuring responses. The measurement and sensors required for sediment vibration quantification are also discussed. Response and threshold data were related to measurements taken in the vicinity of anthropogenic sources, allowing a link between responsiveness and actual operations. The impact of pile-driving on sediment-dwelling invertebrates has received relatively little research, yet the data here suggest that such activities are likely to impact key coastal species which play important roles within the marine environment.LR would like to thank the organizers and sponsors of the 2016 conference for supporting her attendance for which she is extremely grateful. This study was partially funded by a research award from the Malacological Society of London to LR. The authors would also like to acknowledge Defra and NERC who funded the laboratory and field work aspects respectively, and the staff at the OREC field site, Blyth

Developing a decomposable measure of profit efficiency using DEA

In for-profit organizations efficiency measurement with reference to the potential for profit augmentation is particularly important as is its decomposition into technical, and allocative components. Different profit efficiency approaches can be found in the literature to measure and decompose overall profit efficiency. In this paper, we highlight some problems within existing approaches and propose a new measure of profit efficiency based on a geometric mean of input/output adjustments needed for maximizing profits. Overall profit efficiency is calculated through this efficiency measure and is decomposed into its technical and allocative components. Technical efficiency is calculated based on a non-oriented geometric distance function (GDF) that is able to incorporate all the sources of inefficiency, while allocative efficiency is retrieved residually. We also define a measure of profitability efficiency which complements profit efficiency in that it makes it possible to retrieve the scale efficiency of a unit as a component of its profitability efficiency. In addition, the measure of profitability efficiency allows for a dual profitability interpretation of the GDF measure of technical efficiency. The concepts introduced in the paper are illustrated using a numerical example

Driving massive molecular gas flows in central cluster galaxies with AGN feedback

We present an analysis of new and archival ALMA observations of molecular gas in 12 central cluster galaxies. We examine emerging trends in molecular filament morphology and gas velocities to understand their origins. Molecular gas masses in these systems span 109−−1011M⊙⁠, far more than most gas-rich galaxies. ALMA images reveal a distribution of morphologies from filamentary to disc-dominated structures. Circumnuclear discs on kiloparsec scales appear rare. In most systems, half to nearly all of the molecular gas lies in filamentary structures with masses of a few ×108--10M⊙ that extend radially several to several tens of kpc. In nearly all cases the molecular gas velocities lie far below stellar velocity dispersions, indicating youth, transience, or both. Filament bulk velocities lie far below the galaxy’s escape and free-fall speeds indicating they are bound and being decelerated. Most extended molecular filaments surround or lie beneath radio bubbles inflated by the central active galactic nuclei (AGNs). Smooth velocity gradients found along the filaments are consistent with gas flowing along streamlines surrounding these bubbles. Evidence suggests most of the molecular clouds formed from low entropy X-ray gas that became thermally unstable and cooled when lifted by the buoyant bubbles. Uplifted gas will stall and fall back to the galaxy in a circulating flow. The distribution in morphologies from filament to disc-dominated sources therefore implies slowly evolving molecular structures driven by the episodic activity of the AGNs

Concealed concern: Fathers' experience of having a child with Juvenile Idiopathic Arthritis

Despite increased research into families of chronically ill children, more needs to be known about the father’s experience. We address this issue through asking: ‘What is it like to be the father of a child with juvenile idiopathic arthritis?’ (JIA). Four members of eight families with an adolescent diagnosed with JIA, including seven fathers, were interviewed and transcripts analyzed using grounded theory. This study suggests that fathers of children with JIA experience several severe losses which are exacerbated through comparisons they make between their own situation and that of fathers of healthy children. In addition, the fathers faced several constraints which reduced their opportunities to communicate with their ill child through shared activities. Fathers appeared to conceal their distress by adopting strategies of denial and distraction however their adjustment was facilitated, to some extent, by social support. They could also develop greater acceptance of their situation over time as the care of their ill child became assimilated into family life and constraints upon their life gradually reduced through the increased maturity of their son or daughter with JIA. These findings have implications for healthcare professionals and voluntary organizations

Holographic aspects of three dimensional QCD from string theory

We study two aspects of 3D QCD with massless fermions in a holographic set-up from string theory, based on D3/D7 branes; parity anomaly and baryons as baby Skyrmions. We first give a novel account of parity anomaly of 3D QCD with odd number of flavors from the IR holographic viewpoint by observing a subtle point in D7 brane embeddings with a given fixed UV theory. We also discuss its UV origin in terms of weakly coupled D-brane pictures. We then focus on the parity-symmetric case of even number of N_F flavors, and study baryons in the holographic model. We identify the monopoles of U(N_F) gauge theory dynamically broken down to U(N_F/2)x U(N_F/2) in the holographic 4 dimensional bulk as a holographic counter-part of 3D baby-Skyrmions for baryons in large N limit, and work out some details how the mapping goes. In particular, we show that the correct baryon charges emerge from the Witten effect with a space-varying theta angle.Comment: 33 pages, 10 figures; v2: references added with comments, typos corrected; v3: more references added; v4: holographic baryon profile and the analysis of its baryon charge is significantly revised, correcting errors in the previous discussio

Removal of visual disruption caused by rain using cycle-consistent generative adversarial networks

This paper addresses the problem of removing rain disruption from images without blurring scene content, thereby retaining the visual quality of the image. This is particularly important in maintaining the performance of outdoor vision systems, which deteriorates with increasing rain disruption or degradation on the visual quality of the image. In this paper, the Cycle-Consistent Generative Adversarial Network (CycleGAN) is proposed as a more promising rain removal algorithm, as compared to the state-of-the-art Image De-raining Conditional Generative Adversarial Network (ID-CGAN). One of the main advantages of the CycleGAN is its ability to learn the underlying relationship between the rain and rain-free domain without the need of paired domain examples, which is essential for rain removal as it is not possible to obtain the rain-free image under dynamic outdoor conditions. Based on the physical properties and the various types of rain phenomena [10], five broad categories of real rain distortions are proposed, which can be applied to the majority of outdoor rain conditions. For a fair comparison, both the ID-CGAN and CycleGAN were trained on the same set of 700 synthesized rain-and-ground-truth image-pairs. Subsequently, both networks were tested on real rain images, which fall broadly under these five categories. A comparison of the performance between the CycleGAN and the ID-CGAN demonstrated that the CycleGAN is superior in removing real rain distortions

Building robust prediction models for defective sensor data using Artificial Neural Networks

Predicting the health of components in complex dynamic systems such as an automobile poses numerous challenges. The primary aim of such predictive systems is to use the high-dimensional data acquired from different sensors and predict the state-of-health of a particular component, e.g., brake pad. The classical approach involves selecting a smaller set of relevant sensor signals using feature selection and using them to train a machine learning algorithm. However, this fails to address two prominent problems: (1) sensors are susceptible to failure when exposed to extreme conditions over a long periods of time; (2) sensors are electrical devices that can be affected by noise or electrical interference. Using the failed and noisy sensor signals as inputs largely reduce the prediction accuracy. To tackle this problem, it is advantageous to use the information from all sensor signals, so that the failure of one sensor can be compensated by another. In this work, we propose an Artificial Neural Network (ANN) based framework to exploit the information from a large number of signals. Secondly, our framework introduces a data augmentation approach to perform accurate predictions in spite of noisy signals. The plausibility of our framework is validated on real life industrial application from Robert Bosch GmbH.Comment: 16 pages, 7 figures. Currently under review. This research has obtained funding from the Electronic Components and Systems for European Leadership (ECSEL) Joint Undertaking, the framework programme for research and innovation Horizon 2020 (2014-2020) under grant agreement number 662189-MANTIS-2014-

The incidence of liver injury in Uyghur patients treated for TB in Xinjiang Uyghur autonomous region, China, and its association with hepatic enzyme polymorphisms nat2, cyp2e1, gstm1 and gstt1.

BACKGROUND AND OBJECTIVE: Of three first-line anti-tuberculosis (anti-TB) drugs, isoniazid is most commonly associated with hepatotoxicity. Differences in INH-induced toxicity have been attributed to genetic variability at several loci, NAT2, CYP2E1, GSTM1and GSTT1, that code for drug-metabolizing enzymes. This study evaluated whether the polymorphisms in these enzymes were associated with an increased risk of anti-TB drug-induced hepatitis in patients and could potentially be used to identify patients at risk of liver injury. METHODS AND DESIGN: In a cross-sectional study, 2244 tuberculosis patients were assessed two months after the start of treatment. Anti-TB drug-induced liver injury (ATLI) was defined as an ALT, AST or bilirubin value more than twice the upper limit of normal. NAT2, CYP2E1, GSTM1 and GSTT1 genotypes were determined using the PCR/ligase detection reaction assays. RESULTS: 2244 patients were evaluated, there were 89 cases of ATLI, a prevalence of 4% 9 patients (0.4%) had ALT levels more than 5 times the upper limit of normal. The prevalence of ATLI was greater among men than women, and there was a weak association with NAT2*5 genotypes, with ATLI more common among patients with the NAT2*5*CT genotype. The sensitivity of the CT genotype for identifying patients with ATLI was 42% and the positive predictive value 5.9%. CT ATLI was more common among slow acetylators (prevalence ratio 2.0 (95% CI 0.95,4.20) )compared to rapid acetylators. There was no evidence that ATLI was associated with CYP2E1 RsaIc1/c1genotype, CYP2E1 RsaIc1/c2 or c2/c2 genotypes, or GSTM1/GSTT1 null genotypes. CONCLUSIONS: In Xinjiang Uyghur TB patients, liver injury was associated with the genetic variant NAT2*5, however the genetic markers studied are unlikely to be useful for screening patients due to the low sensitivity and low positive predictive values for identifying persons at risk of liver injury