Computational Modelling of Patella Femoral Kinematics During Gait Cycle and Experimental Validation

The effect of loading and boundary conditions on patellar mechanics is significant due to the complications arising in patella femoral joints during total knee replacements. To understand the patellar mechanics with respect to loading and motion, a computational model representing the patella femoral joint was developed and validated against experimental results. The computational model was created in IDEAS NX and simulated in MSC ADAMS/VIEW software. The results obtained in the form of internal external rotations and anterior posterior displacements for a new and experimentally simulated specimen for patella femoral joint under standard gait condition were compared with experimental measurements performed on the Leeds ProSim knee simulator. A good overall agreement between the computational prediction and the experimental data was obtained for patella femoral kinematics. Good agreement between the model and the past studies was observed when the ligament load was removed and the medial lateral displacement was constrained. The model is sensitive to ±5 % change in kinematics, frictional, force and stiffness coefficients and insensitive to time step

Equine Protozoal Myeloencephalitis: An Updated Consensus Statement with a Focus on Parasite Biology, Diagnosis, Treatment, and Prevention

Equine protozoal myeloencephalitis (EPM) remains an important neurologic disease of horses. There are no pathognomonic clinical signs for the disease. Affected horses can have focal or multifocal central nervous system (CNS) disease. EPM can be difficult to diagnose antemortem. It is caused by either of 2 parasites, Sarcocystis neurona and Neospora hughesi, with much less known about N. hughesi. Although risk factors such as transport stress and breed and age correlations have been identified, biologic factors such as genetic predispositions of individual animals, and parasite-specific factors such as strain differences in virulence, remain largely undetermined. This consensus statement update presents current published knowledge of the parasite biology, host immune response, disease pathogenesis, epidemiology, and risk factors. Importantly, the statement provides recommendations for EPM diagnosis, treatment, and prevention

Improving automobile insurance ratemaking using telematics: incorporating mileage and driver behaviour data

We show how data collected from a GPS device can be incorporated in motor insurance ratemaking . The calculation of premium rates based upon driver behaviour represents an opportunity for the insurance sector . Our approach is based on count data regression models for frequency, where exposure is driven by the distance travelled and additional paramete rs that capture characteristics of automobile usage and which may affect claiming behaviour . We propose implement ing a classical frequency model that is updated with telemetrics information. We illustrate the method using real data from usage - based insurance policies. Results show that not only the distance travelled by the driver, but also driver habits, significantly influence the expected number of accidents and, hence, the cost of insurance coverage . This paper provides a methodology including a transition pricing transferring knowledge and experience that the company already had before the telematics data arrived to the new world including telematics information incorporated in motor insurance ratemaking . The calculation of premium rates based upon driver behaviour represents an opportunity for the insurance sector. Our approach is based on count data regression models for frequency, where exposure is driven by the distance travelled and additional parameters that capture characteristics of automobile usage and which may affect claiming behaviour. We propose implementing a classical frequency model that is updated with telemetrics information. We illustrate the method using real data from usage - based insurance policies. Results show that not only the distance travelled by the driver, but also driver habits, significantly influence the expected number of accidents and, hence, the cost of insurance coverage . This paper provides a methodology including a transition pricing transferring knowledge and experience that the company already had before the telematics data arrived to the new world including telematics information

Does preoperative weight loss in a specialist medical weight management centre influence postoperative weight loss after bariatric surgery?

Summary: Weight loss of 5%–10% is advised in medical weight management (MWM) programmes prior to bariatric surgery but it remains to be established whether it influences postoperative weight loss outcomes. We studied postoperative percent total weight loss (%TWL) in 168 patients categorized by preoperative referral weight loss <5% or ≥5% in a UK NHS bariatric centre. Eighty‐six (51.2%) patients achieved sustained referral weight loss <5% (Group A) and 82 (48.8%) ≥5% (Group B). Overall postoperative %TWL in Group A compared with Group B was 30.0% versus 28.3% (p = .30) at 12 months and 32.5% versus 29.6% (p = .20) at 24 months. There were no significant differences in postoperative %TWL at 12 and 24 months when categorized by procedure (gastric bypass, n = 106; or sleeve gastrectomy, n = 62), age or sex. Preoperative weight loss during intensive specialist MWM did not influence postoperative weight loss up to 24 months with gastric bypass or sleeve gastrectomy

Development and validation of a questionnaire to identify severe maternal morbidity in epidemiological surveys

<p>Abstract</p> <p>Objective</p> <p>to develop and validate a questionnaire on severe maternal morbidity and to evaluate the maternal recall of complications related to pregnancy and childbirth. <it>Design: </it>validity of a questionnaire as diagnostic instrument. <it>Setting: </it>a third level referral maternity in Campinas, Brazil. <it>Population: </it>386 survivors of severe maternal complications and 123 women that delivered without major complications between 2002 and 2007.</p> <p>Methods</p> <p>eligible women were traced and interviewed by telephone on the occurrence of obstetric complications and events related to their treatment. Their answers were compared with their medical records as gold standard. Sensitivity, specificity and likelihood ratios plus their correspondent 95% confidence intervals were used as main estimators of accuracy. <it>Main outcomes: </it>diagnosis of severe maternal morbidity associated with past pregnancies, including hemorrhage, eclampsia, infections, jaundice and related procedures (hysterectomy, admission to ICU, blood transfusion, laparotomy, inter-hospital transfer, mechanical ventilation and post partum stay above seven days).</p> <p>Results</p> <p>Women did not recall accurately the occurrence of obstetric complications, especially hemorrhage and infection. The likelihood ratios were < 5 for hemorrhage and infection, while for eclampsia it almost reached 10. The information recalled by women regarding hysterectomy, intensive care unit admission and blood transfusion were found to be highly correlated with finding evidence of the event in the medical records (likelihood ratios ranging from 12.7-240). The higher length of time between delivery and interview was associated with poor recall.</p> <p>Conclusion</p> <p>Process indicators are better recalled by women than obstetric complication and should be considered when applying a questionnaire on severe maternal morbidity.</p

The Collaborative Image of The City: Mapping the Inequality of Urban Perception

A traveler visiting Rio, Manila or Caracas does not need a report to learn that these cities are unequal; she can see it directly from the taxicab window. This is because in most cities inequality is conspicuous, but also, because cities express different forms of inequality that are evident to casual observers. Cities are highly heterogeneous and often unequal with respect to the income of their residents, but also with respect to the cleanliness of their neighborhoods, the beauty of their architecture, and the liveliness of their streets, among many other evaluative dimensions. Until now, however, our ability to understand the effect of a city's built environment on social and economic outcomes has been limited by the lack of quantitative data on urban perception. Here, we build on the intuition that inequality is partly conspicuous to create quantitative measure of a city's contrasts. Using thousands of geo-tagged images, we measure the perception of safety, class and uniqueness; in the cities of Boston and New York in the United States, and Linz and Salzburg in Austria, finding that the range of perceptions elicited by the images of New York and Boston is larger than the range of perceptions elicited by images from Linz and Salzburg. We interpret this as evidence that the cityscapes of Boston and New York are more contrasting, or unequal, than those of Linz and Salzburg. Finally, we validate our measures by exploring the connection between them and homicides, finding a significant correlation between the perceptions of safety and class and the number of homicides in a NYC zip code, after controlling for the effects of income, population, area and age. Our results show that online images can be used to create reproducible quantitative measures of urban perception and characterize the inequality of different cities.MIT Media Lab Consortiu

The association between family and community social capital and health risk behaviours in young people: an integrative review

Background: Health risk behaviours known to result in poorer outcomes in adulthood are generally established in late childhood and adolescence. These ‘risky’ behaviours include smoking, alcohol and illicit drug use and sexual risk taking. While the role of social capital in the establishment of health risk behaviours in young people has been explored, to date, no attempt has been made to consolidate the evidence in the form of a review. Thus, this integrative review was undertaken to identify and synthesise research findings on the role and impact of family and community social capital on health risk behaviours in young people and provide a consolidated evidence base to inform multi-sectorial policy and practice.&lt;p&gt;&lt;/p&gt; Methods: Key electronic databases were searched (i.e. ASSIA, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, Embase, Medline, PsycINFO, Sociological Abstracts) for relevant studies and this was complemented by hand searching. Inclusion/exclusion criteria were applied and data was extracted from the included studies. Heterogeneity in study design and the outcomes assessed precluded meta-analysis/meta-synthesis; the results are therefore presented in narrative form.&lt;p&gt;&lt;/p&gt; Results: Thirty-four papers satisfied the review inclusion criteria; most were cross-sectional surveys. The majority of the studies were conducted in North America (n=25), with three being conducted in the UK. Sample sizes ranged from 61 to 98,340. The synthesised evidence demonstrates that social capital is an important construct for understanding the establishment of health risk behaviours in young people. The different elements of family and community social capital varied in terms of their saliency within each behavioural domain, with positive parent–child relations, parental monitoring, religiosity and school quality being particularly important in reducing risk.&lt;p&gt;&lt;/p&gt; Conclusions: This review is the first to systematically synthesise research findings about the association between social capital and health risk behaviours in young people. While providing evidence that may inform the development of interventions framed around social capital, the review also highlights key areas where further research is required to provide a fuller account of the nature and role of social capital in influencing the uptake of health risk behaviours.&lt;p&gt;&lt;/p&gt

The contribution of the environment (especially diet) to breast cancer risk

Environmental factors play an important role in breast carcinogenesis. Opportunities for prevention are limited, however, because most of the known or suspected risk factors are not targets for modification. Dietary factors have generally not emerged as crucial contributors to mammary tumor causation. We still appear to be missing a critical piece of the breast cancer puzzle because we can only explain a moderate proportion of international and national variation in breast cancer rates. Research needs to pursue new avenues, focusing on exposure windows that have not yet been sufficiently explored, such as events between conception and adolescence, and on modifiable risk factors that show large variation within or between populations

Radio emission from Supernova Remnants

The explosion of a supernova releases almost instantaneously about 10^51 ergs of mechanic energy, changing irreversibly the physical and chemical properties of large regions in the galaxies. The stellar ejecta, the nebula resulting from the powerful shock waves, and sometimes a compact stellar remnant, constitute a supernova remnant (SNR). They can radiate their energy across the whole electromagnetic spectrum, but the great majority are radio sources. Almost 70 years after the first detection of radio emission coming from a SNR, great progress has been achieved in the comprehension of their physical characteristics and evolution. We review the present knowledge of different aspects of radio remnants, focusing on sources of the Milky Way and the Magellanic Clouds, where the SNRs can be spatially resolved. We present a brief overview of theoretical background, analyze morphology and polarization properties, and review and critical discuss different methods applied to determine the radio spectrum and distances. The consequences of the interaction between the SNR shocks and the surrounding medium are examined, including the question of whether SNRs can trigger the formation of new stars. Cases of multispectral comparison are presented. A section is devoted to reviewing recent results of radio SNRs in the Magellanic Clouds, with particular emphasis on the radio properties of SN 1987A, an ideal laboratory to investigate dynamical evolution of an SNR in near real time. The review concludes with a summary of issues on radio SNRs that deserve further study, and analyzing the prospects for future research with the latest generation radio telescopes.Comment: Revised version. 48 pages, 15 figure