617 research outputs found
Angular dependence of domain wall resistivity in SrRuO films
is a 4d itinerant ferromagnet (T 150 K) with
stripe domain structure. Using high-quality thin films of SrRuO we study
the resistivity induced by its very narrow ( nm) Bloch domain walls,
(DWR), at temperatures between 2 K and T as a function of the
angle, , between the electric current and the ferromagnetic domains
walls. We find that which provides the first experimental
indication that the angular dependence of spin accumulation contribution to DWR
is . We expect magnetic multilayers to exhibit a similar
behavior.Comment: 5 pages, 5 figure
Total knee arthroplasty using computer-assisted navigation in patients with deformities of the femur and tibia: A report of 5 cases
Anatomic aberrations of the femur and tibia secondary to trauma, congenital defects, and prior surgery present challenges for the reconstructive knee surgeon because of an altered mechanical axis and distorted anatomic landmarks. Five patients with arthritis of the knee and extra-articular femoral and/or tibial deformity, retained hardware, or intramedullary (IM) implants underwent total knee arthroplasty using a computer navigation system. The navigation system obviated the need for an IM guide, and the normal mechanical axis of the patients was restored. Extensive dissection for hardware removal or osteotomy was not necessary in these patients. In these 5 cases, a navigation system proved to be an effective tool for restoration of limb alignment in the presence of significant extra-articular deformities and/or IM hardware. Thus, it provides an alternative approach to the traditional IM instrumentation for treating these patients in an effective manner
The Use of Computerized Tomography Scans in Elective Knee and Hip Arthroplasty-What Do They Tell Us and at What Risk?
The average background radiation exposure in the United States has nearly doubled over the previous quarter century, with almost all the increase derived from medical imaging. Nearly 2% of all cancers in the United States may be attributable to radiation from computerized tomography (CT) scans. Given the nondiagnostic nature of CT scans that are used in elective knee and hip arthroplasty today, special consideration should be given to the inherent risk of radiation exposure with routine use of this technology. Methods to decrease radiation exposure including modulating the settings of the CT machine and using alternative non-CT-based systems can decrease patient exposure to radiation from CT scans. The rapid evolution of CT technology in arthroplasty has allowed for expanded clinical applications, the benefits of which remain controversial
Real-time analysis and display of quantitative measures to track and improve clinical workflow
PURPOSE: Radiotherapy treatment planning is a complex process with multiple, dependent steps involving an interdisciplinary patient care team. Effective communication and real-time tracking of resources and care path activities are key for clinical efficiency and patient safety.
MATERIALS AND METHODS: We designed and implemented a secure, interactive web-based dashboard for patient care path, clinical workflow, and resource utilization management. The dashboard enables visualization of resource utilization and tracks progress in a patient\u27s care path from the time of acquisition of the planning CT to the time of treatment in real-time. It integrates with the departmental electronic medical records (EMR) system without the creation and maintenance of a separate database or duplication of work by clinical staff. Performance measures of workflow were calculated.
RESULTS: The dashboard implements a standardized clinical workflow and dynamically consolidates real-time information queried from multiple tables in the EMR database over the following views: (1) CT Sims summarizes patient appointment information on the CT simulator and patient load; (2) Linac Sims summarizes patient appointment times, setup history, and notes, and patient load; (3) Task Status lists the clinical tasks associated with a treatment plan, their due date, status and ownership, and patient appointment details; (4) Documents provides the status of all documents in the patients\u27 charts; and (5) Diagnoses and Interventions summarizes prescription information, imaging instructions and whether the plan was approved for treatment. Real-time assessment and quantification of progress and delays in a patient\u27s treatment start were achieved.
CONCLUSIONS: This study indicates it is feasible to develop and implement a dashboard, tailored to the needs of an interdisciplinary team, which derives and integrates information from the EMR database for real-time analysis and display of resource utilization and clinical workflow in radiation oncology. The framework developed facilitates informed, data-driven decisions on clinical workflow management as we seek to optimize clinical efficiency and patient safety
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JOHNSON-MATTHEY DIFFUSER CHARACTERIZATION TESTING
A diffuser/permeator commercially fabricated by Johnson-Matthey was purchased for characterization testing at the Savannah River National Laboratory (SRNL). A test system was fabricated to not only feed and bleed flows and pressures, but also permeate pressure for flows up to 20 SLPM
Radio spectra and polarisation properties of radio-loud Broad Absorption Line Quasars
We present multi-frequency observations of a sample of 15 radio-emitting
Broad Absorption Line Quasars (BAL QSOs), covering a spectral range between 74
MHz and 43 GHz. They display mostly convex radio spectra which typically peak
at about 1-5 GHz (in the observer's rest-frame), flatten at MHz frequencies,
probably due to synchrotron self-absorption, and become steeper at high
frequencies, i.e., >~ 20 GHz. VLA 22-GHz maps (HPBW ~ 80 mas) show unresolved
or very compact sources, with linear projected sizes of <= 1 kpc. About 2/3 of
the sample look unpolarised or weakly polarised at 8.4 GHz, frequency in which
reasonable upper limits could be obtained for polarised intensity. Statistical
comparisons have been made between the spectral index distributions of samples
of BAL and non-BAL QSOs, both in the observed and the rest-frame, finding
steeper spectra among non-BAL QSOs. However constraining this comparison to
compact sources results in no significant differences between both
distributions. This comparison is consistent with BAL QSOs not being oriented
along a particular line of sight. In addition, our analysis of the spectral
shape, variability and polarisation properties shows that radio BAL QSOs share
several properties common to young radio sources like Compact Steep Spectrum
(CSS) or Gigahertz-Peaked Spectrum (GPS) sources.Comment: 18 pages, 11 Postscript figures, 12 Tables. Accepted for publication
in MNRA
Intravascular Lithotripsy for Treatment of Calcified Coronary Lesions: Patient-Level Pooled Analysis of the Disrupt CAD Studies.
Abstract Objectives The aim of this pooled analysis was to assess the cumulative safety and effectiveness of coronary intravascular lithotripsy (IVL). Background The clinical outcomes of IVL to opt..
Association of A1C and Fasting Plasma Glucose Levels With Diabetic Retinopathy Prevalence in the U.S. Population: Implications for diabetes diagnostic thresholds
Abstract OBJECTIVE To examine the association of A1C levels and fasting plasma glucose (FPG) with diabetic retinopathy in the U.S. population and to compare the ability of the two glycemic measures to discriminate between people with and without retinopathy. RESEARCH DESIGN AND METHODS This study included 1,066 individuals aged ā„40 years from the 2005ā2006 National Health and Nutrition Examination Survey. A1C, FPG, and 45Ā° color digital retinal images were assessed. Retinopathy was defined as a level ā„14 on the Early Treatment Diabetic Retinopathy Study severity scale. We used joinpoint regression to identify linear inflections of prevalence of retinopathy in the association between A1C and FPG. RESULTS The overall prevalence of retinopathy was 11%, which is appreciably lower than the prevalence in people with diagnosed diabetes (36%). There was a sharp increase in retinopathy prevalence in those with A1C ā„5.5% or FPG ā„5.8 mmol/l. After excluding 144 people using hypoglycemic medication, the change points for the greatest increase in retinopathy prevalence were A1C 5.5% and FPG 7.0 mmol/l. The coefficients of variation were 15.6 for A1C and 28.8 for FPG. Based on the areas under the receiver operating characteristic curves, A1C was a stronger discriminator of retinopathy (0.71 [95% CI 0.66ā0.76]) than FPG (0.65 [0.60 ā 0.70], P for difference = 0.009). CONCLUSIONS The steepest increase in retinopathy prevalence occurs among individuals with A1C ā„5.5% and FPG ā„5.8 mmol/l. A1C discriminates prevalence of retinopathy better than FPG. Tests of glycemia and their thresholds for diabetes diagnosis is an area of long-standing debate. The presence of diabetic retinopathy is arguably the best criterion from which to compare glycemic measures because it is a specific and early clinical complication usually related to diabetes, and it represents a specific and relevant clinical end point for judging an alternative test (1). For these reasons, diabetic retinopathy has served as the basis for diagnostic criteria of type 2 diabetes (2ā4) and provides the rationale for the American Diabetes Association's recommendation of a threshold of a fasting plasma glucose (FPG) of 7.0 mmol/l to define the presence of diabetes (4,5). However, an analysis of three recent population-based cross-sectional studies suggested that there may be considerable variation across populations and that the association of FPG with retinopathy prevalence may be more of a continuous relationship than previously thought (5). A1C levels are being considered as an alternative diagnostic tool for diabetes diagnosis (6). Unlike FPG, A1C does not require an overnight fast, is not affected by short-term lifestyle changes, and has less variability within individuals than FPG (7ā9). Nevertheless, few studies have examined the prevalence of retinopathy across the spectrum of A1C levels, which could assist in the designation of ideal A1C diagnostic cut points (2,3). The newly released National Health and Nutrition Examination Survey (NHANES) 2005ā2006 incorporated a multiple-field retinal photograph examination, presenting an opportunity to reassess the selection of glucose and A1C cut points for diabetes diagnosis. Our objectives were to examine the relation between levels of A1C and FPG and prevalence of retinopathy in the U.S. population and to compare the ability of both measures to differentiate people with and without retinopathy
Do ceramic femoral heads reduce taper fretting corrosion in hip arthroplasty? A retrieval study.
BACKGROUND: Previous studies regarding modular head-neck taper corrosion were largely based on cobalt chrome (CoCr) alloy femoral heads. Less is known about head-neck taper corrosion with ceramic femoral heads.
QUESTIONS/PURPOSES: We asked (1) whether ceramic heads resulted in less taper corrosion than CoCr heads; (2) what device and patient factors influence taper fretting corrosion; and (3) whether the mechanism of taper fretting corrosion in ceramic heads differs from that in CoCr heads.
METHODS: One hundred femoral head-stem pairs were analyzed for evidence of fretting and corrosion using a visual scoring technique based on the severity and extent of fretting and corrosion damage observed at the taper. A matched cohort design was used in which 50 ceramic head-stem pairs were matched with 50 CoCr head-stem pairs based on implantation time, lateral offset, stem design, and flexural rigidity.
RESULTS: Fretting and corrosion scores were lower for the stems in the ceramic head cohort (p=0.03). Stem alloy (p=0.004) and lower stem flexural rigidity (Spearman\u27s rho=-0.32, p=0.02) predicted stem fretting and corrosion damage in the ceramic head cohort but not in the metal head cohort. The mechanism of mechanically assisted crevice corrosion was similar in both cohorts although in the case of ceramic femoral heads, only one of the two surfaces (the male metal taper) engaged in the oxide abrasion and repassivation process.
CONCLUSIONS: The results suggest that by using a ceramic femoral head, CoCr fretting and corrosion from the modular head-neck taper may be mitigated but not eliminated.
CLINICAL RELEVANCE: The findings of this study support further study of the role of ceramic heads in potentially reducing femoral taper corrosion
Easier done than undone ... by some of the people, some of the time:The role of elaboration in explicit and implicit group preferences
Evidence suggests that while explicit evaluations of others are easily formed and equally easily changed, implicit evaluations are more intransigent. The present research investigated the role of individual and situational differences in determining whether explicit and implicit evaluations are changed in light of new information. In three studies, participants formed implicit and explicit evaluations of two groups before learning new information that objectively contradicted those evaluations. In Experiment 1, individuals characterised by a greater Personal Need for Structure (PNS) formed more extreme explicit evaluations but were also more likely to reverse them later. In contrast, while higher PNS individuals also formed more extreme implicit preferences, they were less likely to change them in response to new information. In Experiments 2a and 2b, the opportunity to re-assess the same evidence on which initial impressions were formed was essential to revising implicit evaluations, but was less important for changing explicit evaluations. These results confirm that differences in motivation and opportunity to engage in elaborative processing moderate the revision of implicit, but not explicit, group preferences. (C) 2015 Elsevier Inc All rights reserved
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