Total hip arthroplasty surgical approach does not alter postoperative gait mechanics one year after surgery

Objective: To investigate the differences in gait biomechanics on the basis of surgical approach 1 year after surgery. Design: This was a descriptive laboratory study to investigate the side-to-side differences in walking mechanics at a self-selected walking speed as well as a functional assessment 1year after total hip arthroplasty (THA). Temporospatial, kinetic, and kinematic data as well as functional outcomes were collected. Two-way analysis of variance was used to assess for between-group differences and limb-to-limb asymmetries. Setting: A controlled laboratory study. Participants: This study examined 35 patients with primary, unilateral THA. The THA surgical approaches that were used in these patients included 12 direct lateral, 18 posterior, and 11 anterolateral. All the patients were assessed 1 year after THA. Patients were excluded from the study if they had contralateral hip pain or pathology, or any prior lower extremity total joint replacements. Main Outcome Measurements: Three-dimensional lower extremity kinematics and kinetics as well as spatiotemporal variables were collected. In addition, a series of physical performance measures were collected. Results: No main effects for the physical performance measures or biomechanical variables were observed among the approach groups. Significant limb-to-limb asymmetries were observed among all the patients, with decreased sagittal plane range of motion, peak extension, and peak vertical ground reaction forces on the operative side. Conclusion: The results of this study indicated that no significant differences existed among the different surgical approach groups for any study variable. However, 1 year after THA, the patients demonstrated asymmetric gait patterns regardless of surgical approach, which indicated the potential need for continued intervention through physical therapy to regain normal side-to-side symmetry after THA. © 2014 American Academy of Physical Medicine and Rehabilitation

Post impact evaluation of an E-learning cross-infection control CD-ROM provided to all general dental practitioners in England

Aim To carry out a post-impact evaluation of a cross-infection control CD-ROM, developed for NHS dental teams as a continuing professional development e-learning tool. The program was commissioned by the Department of Health and developed by a project team through the UK Committee of Postgraduate Dental Deans. The Dental Practice Boardhad originally sent one copy of the CD-ROM to each dental practice in England in 2004. Method A quantitative statistical analysis of the results of 326 online respondents to the learning package and a survey of 118 dental practitioners drawn from the Dental Practice Board database. Results Practitioners felt the CD-ROM in this instance was well designed and appropriate for their needs. It is inclusive and accessible to a wide range of dental professionals including nurses and hygienists. Conclusions This form of continuing professional development is popular with dental practitioners, although it should not be the only form of continuing professional development available. However, whilst the project was generally regarded as successful, there were problems with the distribution of the CD-ROM. This suggests that anonline resource should be made available in the future

Laboratory observations of double-diffusive convection using high-frequency broadband acoustics

Author Posting. © The Author(s), 2008. This is the author's version of the work. It is posted here by permission of Springer for personal use, not for redistribution. The definitive version was published in Experiments in Fluids 46 (2009): 355-364, doi:10.1007/s00348-008-0570-9.High-frequency broadband (200-300 kHz) acoustic scattering techniques have been used to observe the diffusive regime of double-diffusive convection in the laboratory. Pulse compression signal processing techniques allow 1) centimetre-scale interface thickness to be rapidly, remotely, and continuously measured, 2) the evolution, and ultimate merging, of multiple interfaces to be observed at high-resolution, and 3) convection cells within the surrounding mixed layers to be observed. The acoustically measured interface thickness, combined with knowledge of the slowly-varying temperatures within the surrounding layers, in turn allows the direct estimation of double-diffusive heat and buoyancy fluxes. The acoustically derived interface thickness, interfacial fluxes and migration rates are shown to support established theory. Acoustic techniques complement traditional laboratory sampling methods and provide enhanced capabilities for observing the diffusive regime of double-diffusion in the ocean.Funding for this project was provided by the Ocean Acoustics program at the Office of Naval Research, and by the WHOI Cecil and Ida Greene Technology Award

Augmenting the 6-3-5 method with design information

This paper describes a comparative study between the 6-3-5 Method and the ICR Grid. The ICR Grid is an evolved variant of 6-3-5 intended to better integrate information into the concept generation process. Unlike a conventional 6-3-5 process where participants continually sketch concepts, using the ICR Grid (the name derived from its Inform, Create, Reflect activities and structured, grid-like output) participants are additionally required to undertake information search tasks, use specific information items for concept development, and reflect on the merit of concepts as the session progresses. The results indicate that although the quantity of concepts was lower, the use of information had a positive effect in a number of areas, principally the quality and variety of output. Although grounded in the area of product development, this research is applicable to any organisation undertaking idea generation and problem solving. As well as providing insights on the transference of information to concepts, it holds additional interest for studies on the composition and use of digital libraries

Effects of Supersymmetric Threshold Corrections on High-Scale Flavor Textures

Integration of superpartners out of the spectrum induces potentially large contributions to Yukawa couplings. These corrections, the supersymmetric threshold corrections, therefore influence the CKM matrix prediction in a non-trivial way. We study effects of threshold corrections on high-scale flavor structures specified at the gauge coupling unification scale in supersymmetry. In our analysis, we first consider high-scale Yukawa textures which qualify phenomenologically viable at tree level, and find that they get completely disqualified after incorporating the threshold corrections. Next, we consider Yukawa couplings, such as those with five texture zeroes, which are incapable of explaining flavor-changing proceses. Incorporation of threshold corrections, however, makes them phenomenologically viable textures. Therefore, supersymmetric threshold corrections are found to leave observable impact on Yukawa couplings of quarks, and any confrontation of high-scale textures with experiments at the weak scale must take into account such corrections.Comment: 25 pages, submitted to JHE

The astrophysics of nanohertz gravitational waves

Pulsar timing array (PTA) collaborations in North America, Australia, and Europe, have been exploiting the exquisite timing precision of millisecond pulsars over decades of observations to search for correlated timing deviations induced by gravitational waves (GWs). PTAs are sensitive to the frequency band ranging just below 1 nanohertz to a few tens of microhertz. The discovery space of this band is potentially rich with populations of inspiraling supermassive black hole binaries, decaying cosmic string networks, relic post-inflation GWs, and even non-GW imprints of axionic dark matter. This article aims to provide an understanding of the exciting open science questions in cosmology, galaxy evolution, and fundamental physics that will be addressed by the detection and study of GWs through PTAs. The focus of the article is on providing an understanding of the mechanisms by which PTAs can address specific questions in these fields, and to outline some of the subtleties and difficulties in each case. The material included is weighted most heavily toward the questions which we expect will be answered in the near-term with PTAs; however, we have made efforts to include most currently anticipated applications of nanohertz GWs

KCC2 is required for the survival of mature neurons but not for their development

The K+/Cl- co-transporter KCC2 (SLC12A5) allows mature neurons in the CNS to maintain low intracellular Cl- levels that are critical in mediating fast hyperpolarizing synaptic inhibition via type A γ-aminobutyric acid receptors (GABAARs). In accordance with this, compromised KCC2 activity results in seizures, but whether such deficits directly contribute to the subsequent changes in neuronal structure and viability that lead to epileptogenesis, remains to be assessed. Canonical hyperpolarizing GABAAR currents develop postnatally which reflect a progressive increase in KCC2 expression levels and activity. To investigate the role that KCC2 plays in regulating neuronal viability and architecture we have conditionally ablated KCC2 expression in developing and mature neurons. Decreasing KCC2 expression in mature neurons resulted in the rapid activation of the extrinsic apoptotic pathway. Intriguingly, direct pharmacological inhibition of KCC2 in mature neurons was sufficient to rapidly induce apoptosis, an effect that was not abrogated via blockade of neuronal depolarization using Tetrodotoxin (TTX). In contrast, ablating KCC2 expression in immature neurons had no discernable effects on their subsequent development, arborization or dendritic structure. However, removing KCC2 in immature neurons was sufficient to ablate the subsequent postnatal development of hyperpolarizing GABAAR currents. Collectively, our results demonstrate that KCC2 plays a critical role in neuronal survival by limiting apoptosis, and mature neurons are highly sensitive to the loss of KCC2 function. In contrast, KCC2 appears to play a minimal role in mediating neuronal development or architecture

Limited Effect of Dietary Saturated Fat on Plasma Saturated Fat in the Context of a Low Carbohydrate Diet

We recently showed that a hypocaloric carbohydrate restricted diet (CRD) had two striking effects: (1) a reduction in plasma saturated fatty acids (SFA) despite higher intake than a low fat diet, and (2) a decrease in inflammation despite a significant increase in arachidonic acid (ARA). Here we extend these findings in 8 weight stable men who were fed two 6-week CRD (12%en carbohydrate) varying in quality of fat. One CRD emphasized SFA (CRD-SFA, 86 g/d SFA) and the other, unsaturated fat (CRD-UFA, 47 g SFA/d). All foods were provided to subjects. Both CRD decreased serum triacylglycerol (TAG) and insulin, and increased LDL-C particle size. The CRD-UFA significantly decreased plasma TAG SFA (27.48 ± 2.89 mol%) compared to baseline (31.06 ± 4.26 mol%). Plasma TAG SFA, however, remained unchanged in the CRD-SFA (33.14 ± 3.49 mol%) despite a doubling in SFA intake. Both CRD significantly reduced plasma palmitoleic acid (16:1n-7) indicating decreased de novo lipogenesis. CRD-SFA significantly increased plasma phospholipid ARA content, while CRD-UFA significantly increased EPA and DHA. Urine 8-iso PGF2α, a free radical-catalyzed product of ARA, was significantly lower than baseline following CRD-UFA (−32%). There was a significant inverse correlation between changes in urine 8-iso PGF2α and PL ARA on both CRD (r = −0.82 CRD-SFA; r = −0.62 CRD-UFA). These findings are consistent with the concept that dietary saturated fat is efficiently metabolized in the presence of low carbohydrate, and that a CRD results in better preservation of plasma ARA

Neural Correlates of Visual Aesthetics – Beauty as the Coalescence of Stimulus and Internal State

How do external stimuli and our internal state coalesce to create the distinctive aesthetic pleasures that give vibrance to human experience? Neuroaesthetics has so far focused on the neural correlates of observing beautiful stimuli compared to neutral or ugly stimuli, or on neural correlates of judging for beauty as opposed to other judgments. Our group questioned whether this approach is sufficient. In our view, a brain region that assesses beauty should show beauty-level-dependent activation during the beauty judgment task, but not during other, unrelated tasks. We therefore performed an fMRI experiment in which subjects judged visual textures for beauty, naturalness and roughness. Our focus was on finding brain activation related to the rated beauty level of the stimuli, which would take place exclusively during the beauty judgment. An initial whole-brain analysis did not reveal such interactions, yet a number of the regions showing main effects of the judgment task or the beauty level of stimuli were selectively sensitive to beauty level during the beauty task. Of the regions that were more active during beauty judgments than roughness judgments, the frontomedian cortex and the amygdala demonstrated the hypothesized interaction effect, while the posterior cingulate cortex did not. The latter region, which only showed a task effect, may play a supporting role in beauty assessments, such as attending to one's internal state rather than the external world. Most of the regions showing interaction effects of judgment and beauty level correspond to regions that have previously been implicated in aesthetics using different stimulus classes, but based on either task or beauty effects alone. The fact that we have now shown that task-stimulus interactions are also present during the aesthetic judgment of visual textures implies that these areas form a network that is specifically devoted to aesthetic assessment, irrespective of the stimulus type

Primary Language and Receipt of Recommended Health Care Among Hispanics in the United States

BackgroundDisparities in health care services between Hispanics and whites in the United States are well documented.ObjectiveThe objective of the study was to determine whether language spoken at home identifies Hispanics at risk for not receiving recommended health care services.DesignThe design of the study was cross-sectional, nationally representative survey of households.PatientsThe patients were non-Hispanic white and Hispanic adults participating in the 2003 Medical Expenditure Panel Survey.MeasurementsWe compared receipt of ten recommended health care services by ethnicity and primary language adjusting for demographic and socioeconomic characteristics, health status, and access to care.ResultsThe sample included 12,706 whites and 5,500 Hispanics. In bivariate comparisons, 57.0% of whites received all eligible health care services compared to 53.6% for Hispanics who spoke English at home, 44.9% for Hispanics who did not speak English at home but who were comfortable speaking English, and 35.0% for Hispanics who did not speak English at home and were uncomfortable speaking English (p < .001). In multivariate logistic models, compared to non-Hispanic whites, Hispanics who did not speak English at home were less likely to receive all eligible health care services, whether they were comfortable speaking English (risk ratio [RR] 0.88, 95% confidence interval [CI] 0.74-0.97) or not (RR 0.84, 95% CI 0.68-0.95).ConclusionsSpeaking a language other than English at home identified Hispanics at risk for not receiving recommended health care services, whether they were comfortable in speaking English or not. Identifying the mechanism for disparities by language usage may lead to interventions to reduce ethnic disparities