Stryker Osteonics: Prosthetic Knee Joint

We examine, within a simple bearing model of a knee joint that only consideres pure sliding, the effect of the presence of a small vertical hole in the load area on the fluid film properties. The calculations indicate that fluid is entrapped in such a hole, which, for constant load, causes a smaller minimal film separation of the two surfaces. This will lower the horizontal friction, but may also bring about surface contact in high load situations

Neutrophil lymphocyte ratio in outcome prediction after emergency abdominal surgery in the elderly

AbstractIntroductionAccurate prediction of outcome after emergency surgery in elderly patients may assist decision-making. Many scoring systems require post-operative data (e.g. P-POSSUM) whilst others have failed to gain widespread use. Recent reports suggest that C-reactive protein (CRP) and the neutrophil lymphocyte (N/L ratio) ratio may predict surgical outcome.MethodsA retrospective review of all patients aged 80 years or over undergoing emergency abdominal surgery over a 22 month period was conducted. Outcome and clinical data were collected. Univariate, multivariate and recursive analyses were performed for outcome at 30 days, 6 months and 12 months. Findings were validated in a second independent dataset.Results88 patients were included in the test dataset, median age 84 years. 30-day mortality was 31%, 6-month mortality 43% and 12-month mortality 50%. Univariate analysis identified N/L ratio, CRP, midline laparotomy, and surgical risk score to predict outcome at each time point. Recursive analysis showed, N/L ratio ≥22 best predicted 30-day outcome (p=0.0018). Multivariate analysis identified N/L ratio to be an independent predictor of 30-day outcome (p=0.004) yet CRP did not predict outcome at any time point. An independent dataset (n=84) confirmed N/L ratio to be a prognostic factor at 30 days (p=0.001), 6 months (p<0.001) and 12 months (p=0.001).ConclusionN/L ratio is an easily calculable pre-operative measure that may have utility in the prediction of outcome after emergency abdominal surgery in the elderly. Further work to validate this measure in a larger, prospective setting and determine the underlying mechanisms that mediate outcome are necessary

Effect of aerosolized uridine-5'-triphosphate on airway clearance with cough in patients with primary ciliary dyskinesia

Primary ciliary dyskinesia (PCD) is a genetic disease characterized by abnormal ciliary structure and function and impaired mucociliary clearance. Because patients with PCD use cough clearance as an airway defense mechanism, we tested the hypothesis that aerosolized uridine-5'-triphosphate (UTP) would improve clearance during cough by its actions to stimulate CI secretion and mucin release by goblet cells. We measured clearance during cough in 12 patients with PCD (ages 14 to 71 yr, FEV1 43% to 89% predicted) in a double blind, randomized, crossover study after aerosolization of a single dose of UTP (5 mg/ml, 3.5 ml) or vehicle (0.12% saline, 3.5 ml). Clearance during cough (whole lung) was quantified during and after a series of controlled coughs by measuring the clearance of [99mTc]Fe2O3 particles via gamma camera scanning over 120 min. Safety parameters were recorded during and after drug delivery. Aerosolized UTP improved whole-lung clearance during cough as compared with vehicle (from 0 to 60 min: 0.40 ± 0.07%/min [UTP] versus 0.26 ± 0.04%/min [vehicle] [mean ± SEMI, p = 0.01), and from 0 to 120 min: 0.38 ± 0.05%/min [UTP] versus 0.25 ± 0.04%/min [vehicle], p = 0.02), Aerosolized UTP is safe, with no serious adverse effects. Whole-lung clearance during cough in patients with defective ciliary function is enhanced after inhalation of UTP

Time capsules of biodiversity: Future research directions for groundwater-dependent ecosystems of the Great Artesian Basin

The Great Artesian Basin of Australia represents one of the largest and deepest basins of freshwater on Earth. Thousands of springs fed by the Basin are scattered across Australia’s arid zone, often representing the sole sources of freshwater for thousands of kilometers. As “islands” in the desert, the springs support endemic fauna and flora that have undergone millions of years of evolution in almost total isolation. Here, we review the current body of knowledge surrounding Great Artesian Basin springs and their significance from ecological, evolutionary, and cultural perspectives using South Australian spring wetlands as a case study. We begin by identifying the status of these springs as critical sources of groundwater, the unique biodiversity they support, and their cultural significance to the Arabana people as Traditional Custodians of the land. We then summarize known threats to the springs and their biota, both exogenous and endogenous, and the potential impacts of such processes. Finally, considering the status of these at-risk habitats as time capsules of biodiversity, we discuss lessons that can be learnt from current conservation and management practices in South Australia. We propose key recommendations for improved biodiversity assessment and monitoring of Great Artesian Basin springs nationwide, including 1) enhanced legal protections for spring biota; 2) increased taxonomic funding and capacity; 3) improved biodiversity monitoring methods, and 4) opportunities for reciprocal knowledge-sharing with Aboriginal peoples when conducting biodiversity research.P. G. Beasley-Hall, N. P. Murphy, R. A. King, N. E. White, B. A. Hedges, S. J. B. Cooper, A. D. Austin, and M. T. Guzi

An overview of jets and outflows in stellar mass black holes

In this book chapter, we will briefly review the current empirical understanding of the relation between accretion state and and outflows in accreting stellar mass black holes. The focus will be on the empirical connections between X-ray states and relativistic (`radio') jets, although we are now also able to draw accretion disc winds into the picture in a systematic way. We will furthermore consider the latest attempts to measure/order jet power, and to compare it to other (potentially) measurable quantities, most importantly black hole spin.Comment: Accepted for publication in Space Science Reviews. Also to appear in the Space Sciences Series of ISSI - The Physics of Accretion on to Black Holes (Springer Publisher

The Potential for Neutrino Physics at Muon Colliders and Dedicated High Current Muon Storage Rings

Conceptual design studies are underway for muon colliders and other high-current muon storage rings that have the potential to become the first true ``neutrino factories''. Muon decays in long straight sections of the storage rings would produce precisely characterized beams of electron and muon type neutrinos of unprecedented intensity. This article reviews the prospects for these facilities to greatly extend our capabilities for neutrino experiments, largely emphasizing the physics of neutrino interactions.Comment: 107 pages, 16 figures, to be published in Physics Report

Floor and ceiling effects in the EORTC QLQ-C30 Physical Functioning Subscale among patients with advanced or metastatic breast cancer

Background: The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire Core 30 Physical Functioning subscale is a widely used patient-reported outcome measure that quantifies cancer patients' physical functioning. Strong floor/ceiling effects can affect a scale's sensitivity to change. The aim of this study was to characterize floor/ceiling effects of the physical functioning domain in patients with advanced/metastatic breast cancer enrolled in commercial clinical trials and a community-based trial. Methods: The clinical trial cohort comprised patients from 5 registrational trials submitted to the Food and Drug Administration for review (2010-2017). The community cohort comprised a subgroup of patients from the Alliance Patient Reported Outcomes to Enhance Cancer Treatment (PRO-TECT) trial. The distribution of patient responses to Physical Functioning items and the summed score were assessed at the baseline and 3-month follow-up for both cohorts. Descriptive statistics were used to determine floor/ceiling effects at the item and scale levels. Results: The clinical trial cohort and the community cohort consisted of 2407 and 178 patients, respectively. Twenty-four percent or more of the respondents reported “not at all” for having trouble/needing help with each Physical Functioning item across both cohorts and measurement time points. Fourteen to twenty percent of the patients scored perfectly (100 of 100) on the Physical Functioning subscale summary measure (where higher scores indicated better physical functioning) across both cohorts and time points. Conclusions: Minor floor effects and notable ceiling effects were found at the item and scale levels of the Physical Functioning subscale, regardless of cohort, and this creates some uncertainty about its ability to detect changes in physical functioning among high-functioning patients. Investigators may consider adding additional high-functioning items from the EORTC's item library to more accurately describe the impact of anticancer treatment on patients' physical functioning

Dynamic nuclear polarization and spin-diffusion in non-conducting solids

There has been much renewed interest in dynamic nuclear polarization (DNP), particularly in the context of solid state biomolecular NMR and more recently dissolution DNP techniques for liquids. This paper reviews the role of spin diffusion in polarizing nuclear spins and discusses the role of the spin diffusion barrier, before going on to discuss some recent results.Comment: submitted to Applied Magnetic Resonance. The article should appear in a special issue that is being published in connection with the DNP Symposium help in Nottingham in August 200

Charged pion form factor between Q^2=0.60 and 2.45 GeV^2. II. Determination of, and results for, the pion form factor

The charged pion form factor, Fpi(Q^2), is an important quantity which can be used to advance our knowledge of hadronic structure. However, the extraction of Fpi from data requires a model of the 1H(e,e'pi+)n reaction, and thus is inherently model dependent. Therefore, a detailed description of the extraction of the charged pion form factor from electroproduction data obtained recently at Jefferson Lab is presented, with particular focus given to the dominant uncertainties in this procedure. Results for Fpi are presented for Q^2=0.60-2.45 GeV^2. Above Q^2=1.5 GeV^2, the Fpi values are systematically below the monopole parameterization that describes the low Q^2 data used to determine the pion charge radius. The pion form factor can be calculated in a wide variety of theoretical approaches, and the experimental results are compared to a number of calculations. This comparison is helpful in understanding the role of soft versus hard contributions to hadronic structure in the intermediate Q^2 regime.Comment: 18 pages, 11 figure