The societal costs of femoral neck fracture patients treated with internal fixation

__Abstract__ The study rationale was to provide a detailed overview of the costs for femoral neck fracture treatment with internal fixation in the Netherlands. Mean total costs per patient at 2-years follow-up were €19,425. Costs were higher for older, less healthy patients. Results are comparable to internationally published costs. Introduction The aim of this study was to provide a detailed overview of the cost and healthcare consumptio

The Debye-Waller Factor in solid 3He and 4He

The Debye-Waller factor and the mean-squared displacement from lattice sites for solid 3He and 4He were calculated with Path Integral Monte Carlo at temperatures between 5 K and 35 K, and densities between 38 nm^(-3) and 67 nm^(-3). It was found that the mean-squared displacement exhibits finite-size scaling consistent with a crossover between the quantum and classical limits of N^(-2/3) and N^(-1/3), respectively. The temperature dependence appears to be T^3, different than expected from harmonic theory. An anisotropic k^4 term was also observed in the Debye-Waller factor, indicating the presence of non-Gaussian corrections to the density distribution around lattice sites. Our results, extrapolated to the thermodynamic limit, agree well with recent values from scattering experiments.Comment: 5 figure

Geometric Phase, Curvature, and Extrapotentials in Constrained Quantum Systems

We derive an effective Hamiltonian for a quantum system constrained to a submanifold (the constraint manifold) of configuration space (the ambient space) by an infinite restoring force. We pay special attention to how this Hamiltonian depends on quantities which are external to the constraint manifold, such as the external curvature of the constraint manifold, the (Riemannian) curvature of the ambient space, and the constraining potential. In particular, we find the remarkable fact that the twisting of the constraining potential appears as a gauge potential in the constrained Hamiltonian. This gauge potential is an example of geometric phase, closely related to that originally discussed by Berry. The constrained Hamiltonian also contains an effective potential depending on the external curvature of the constraint manifold, the curvature of the ambient space, and the twisting of the constraining potential. The general nature of our analysis allows applications to a wide variety of problems, such as rigid molecules, the evolution of molecular systems along reaction paths, and quantum strip waveguides.Comment: 27 pages with 1 figure, submitted to Phys. Rev.

Ferrets as a novel animal model for studying human respiratory syncytial virus infections in immunocompetent and immunocompromised hosts

Human respiratory syncytial virus (HRSV) is an important cause of severe respiratory tract disease in immunocompromised patients. Animal models are indispensable for evaluating novel intervention strategies in this complex patient population. To complement existing models in rodents and non-human primates, we have evaluated the potential benefits of an HRSV infection model in ferrets (Mustela putorius furo). Nine- to 12-month-old HRSV-seronegative immunocompetent or immunocompromised ferrets were infected with a low-passage wild-type strain of HRSV subgroup A (105 TCID50) administered by intra-tracheal or intra-nasal inoculation. Immune suppression was achieved by bi-daily oral administration of tacrolimus, mycophenolate mofetil, and prednisolone. Throat and nose swabs were collected daily and animals were euthanized four, seven, or 21 days post-infection (DPI). Virus loads were determined by quantitative virus culture and qPCR. We observed efficient HRSV replication in both the upper and lower respiratory tract. In immunocompromised ferrets, virus loads reached higher levels and showed delayed clearance as compared to those in immunocompetent animals. Histopathological evaluation of animals euthanized 4 DPI demonstrated that the virus replicated in the respiratory epithelial cells of the trachea, bronchi, and bronchioles. These animal models can contribute to an assessment of the efficacy and safety of novel HRSV intervention strategies

Foundations of Dissipative Particle Dynamics

We derive a mesoscopic modeling and simulation technique that is very close to the technique known as dissipative particle dynamics. The model is derived from molecular dynamics by means of a systematic coarse-graining procedure. Thus the rules governing our new form of dissipative particle dynamics reflect the underlying molecular dynamics; in particular all the underlying conservation laws carry over from the microscopic to the mesoscopic descriptions. Whereas previously the dissipative particles were spheres of fixed size and mass, now they are defined as cells on a Voronoi lattice with variable masses and sizes. This Voronoi lattice arises naturally from the coarse-graining procedure which may be applied iteratively and thus represents a form of renormalisation-group mapping. It enables us to select any desired local scale for the mesoscopic description of a given problem. Indeed, the method may be used to deal with situations in which several different length scales are simultaneously present. Simulations carried out with the present scheme show good agreement with theoretical predictions for the equilibrium behavior.Comment: 18 pages, 7 figure

A jump-growth model for predator-prey dynamics: derivation and application to marine ecosystems

This paper investigates the dynamics of biomass in a marine ecosystem. A stochastic process is defined in which organisms undergo jumps in body size as they catch and eat smaller organisms. Using a systematic expansion of the master equation, we derive a deterministic equation for the macroscopic dynamics, which we call the deterministic jump-growth equation, and a linear Fokker-Planck equation for the stochastic fluctuations. The McKendrick--von Foerster equation, used in previous studies, is shown to be a first-order approximation, appropriate in equilibrium systems where predators are much larger than their prey. The model has a power-law steady state consistent with the approximate constancy of mass density in logarithmic intervals of body mass often observed in marine ecosystems. The behaviours of the stochastic process, the deterministic jump-growth equation and the McKendrick--von Foerster equation are compared using numerical methods. The numerical analysis shows two classes of attractors: steady states and travelling waves.Comment: 27 pages, 4 figures. Final version as published. Only minor change

Clinical characteristics of women captured by extending the definition of severe postpartum haemorrhage with 'refractoriness to treatment': a cohort study

Background: The absence of a uniform and clinically relevant definition of severe postpartum haemorrhage hampers comparative studies and optimization of clinical management. The concept of persistent postpartum haemorrhage, based on refractoriness to initial first-line treatment, was proposed as an alternative to common definitions that are either based on estimations of blood loss or transfused units of packed red blood cells (RBC). We compared characteristics and outcomes of women with severe postpartum haemorrhage captured by these three types of definitions. Methods: In this large retrospective cohort study in 61 hospitals in the Netherlands we included 1391 consecutive women with postpartum haemorrhage who received either ≥4 units of RBC or a multicomponent transfusion. Clinical characteristics and outcomes of women with severe postpartum haemorrhage defined as persistent postpartum haemorrhage were compared to definitions based on estimated blood loss or transfused units of RBC within 24 h following birth. Adverse maternal outcome was a composite of maternal mortality, hysterectomy, arterial embolisation and intensive care unit admission. Results: One thousand two hundred sixty out of 1391 women (90.6%) with postpartum haemorrhage fulfilled the definition of persistent postpartum haemorrhage. The majority, 820/1260 (65.1%), fulfilled this definition within 1 h following birth, compared to 819/1391 (58.7%) applying the definition of ≥1 L blood loss and 37/845 (4.4%) applying the definition of ≥4 units of RBC. The definition persistent postpartum haemorrhage captured 430/471 adverse maternal outcomes (91.3%), compared to 471/471 (100%) for ≥1 L blood loss and 383/471 (81.3%) for ≥4 units of RBC. Persistent postpartum haemorrhage did not capture all adverse outcomes because of missing data on timing of initial, first-line treatment. Conclusion: The definition persistent postpartum haemo

Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

Energy distribution functions for ions from pulsed EUV-induced plasmas in low pressure N2-diluted H2 gas

The operation of Extreme Ultraviolet (EUV) lithography scanners inherently goes hand-in-hand with the creation of highly transient pulsed plasmas in the optical path of these tools. These so-called EUV-induced plasmas are created upon photoionization events when a pulsed beam of EUV photons travels through the low pressure background gas. It is fully recognized by the lithography industry that EUV-induced plasmas may significantly impact the quality and life-time of expensive and delicate optical elements in the scanner. Research efforts into EUV-induced plasmas impacting plasma-facing surfaces have so far been limited to pure hydrogen (H2) plasmas. However, this hydrogen background gas may occasionally be diluted with a small fraction of another molecular gas such as nitrogen (N2). The impact on the relevant plasma parameters of such molecular contaminants has remained unknown until now. In this letter, we put forward measurements of energy-resolved fluxes of (positive) hydrogen ions, nitrogen ions, and hydrogen-nitrogen ions created in a pulsed N2-diluted EUV-induced plasma in H2 at approximately 5 Pa (typical EUV lithography scanner conditions). The data have been obtained using an electrostatic quadrupole plasma analyzer and show that although the N2-dilution fraction is small (∼2 × 10−3) compared to the H2 partial pressure, implications for the ion flux out of the plasma and the composition thereof are significant. Since the mass of nitrogen-containing ions is much higher in comparison to that of their hydrogen counterparts, and because of their potential chemical activity, this effect has to be taken into account while studying the surface impact of EUV-induced plasmas