No drain, autologous transfusion drain or suction drain? A randomised prospective study in total hip replacement surgery of 168 patients

We performed a prospective, randomised controlled trial to assess the differences in the use of a conventional suction drain, an Autologous Blood Transfusion (ABT) drain and no drain, in 168 patients. There was no significant difference between the drainage from ABT drains ( mean : 345 ml) and the suction drain (314 ml). Forty percent of patients receiving a suction drain had a haemoglobin level less than 10 g/dL at 24 hours, compared to 35% with no drain and 28% with an ABT drain. Patients that had no drains had wounds that were dry significantly sooner, mean 3.0 days compared to a mean of 3.9 days with an ABT drain and a mean of 4 days with a suction drain. Patients that did not have a drain inserted stayed in hospital a significantly shorter period of time, compared with drains. We feel the benefits of quicker drying wounds, shorter hospital stays and the economic savings justify the conclusion that no drain is required after hip replacement

Discussion on environmental planning and sustainable development

Urban Ecological environment is the basic condition for people to survive , is the symbol and standard for the development of urban social civilization . in urban planning , targeted Effective governance and resolution of urban pollution is a prerequisite for ensuring sustainable urban development . People-oriented construction of green Ecological city is the highest state and goal of urban construction .

An Examination Into The Determinants Of Positive And Negative Electronic Word-Of-Mouth Communication

The Internet has empowered consumers. More and more marketers attempt to harness the power of word-of-mouth communication in the online environment. In this paper, we attempt to explore the underlying motives for consumers engaging in both positive and negative eWOM communication. The findings reported here indicate that consumers engage in positive eWOM mostly for altruistic, self-enhancement, reciprocity, and sense of belonging. In contrast, consumers engage in negative eWOM for altruistic and venting negative feeling. The results of this exploratory study showed that though eWOM behaviour is the same, the underlying motives are very different. Thus, we recommend future research should clearly specify whether they are investigating PeWOM or NeWOM, and researchers should continue to identify corresponding theories to explain the two different eWOM phenomena

THE URGE TO CHECK SOCIAL NETWORKING SITES: ANTECEDENTS AND CONSEQUENCES

Social networking sites (SNSs), combined with the rapid growth trajectory of mobile devices, and widespread deployment of mobile data services, have evolved as a primary platform for daily social interaction. While the majority of users enjoy frequent interactions with their friends and family members, some users suffer from incessant urges to check up on the lives of others on their social networks. In the last decade, the use of SNSs has received much attention in the IS literature. Not until recently, researchers have begun to examine the dark side of using SNSs. In this study, we attempt to advance existing literature by exploring the role of urges in the context of SNSs. Particularly, we propose a research model that examines the antecedents and consequences of the urge to check SNSs. We will test the model with SNS users using structural equation modeling. We believe that current work will enrich the existing literature on the dark side of SNS use, and raise the awareness in the community regarding this emerging phenomenon

Experimental study on the coefficient of restitution of grain against block interfaces for natural and engineered materials

The coefficient of restitution (COR) is an important input parameter in the numerical simulation of granular flows, as it governs the travel distance, the lateral spreading and the design of barriers. In this study, a new custom-built micro-mechanical impact loading apparatus is presented along with impact experiments on engineered and natural materials. The COR and energy loss of various grains and base block combinations are studied, including fairly regular shaped Leighton Buzzard sand (LBS) grains as a natural soil and granite/rubber as base blocks, apart from the use of engineered materials for the grains (chrome steel balls, glass balls) and blocks (stainless steel, brass). The repeatability of the new micro-mechanical impact loading apparatus was checked by impacting chrome steel balls on stainless steel block. In all the test combinations, the higher and lower values of the COR are found for granite block (ranging between 0.75-0.95) and rubber block (ranging between 0.37-0.44) combinations, respectively. For the tested grain-block combinations, lower values of COR were observed for impacts between materials of low values of composite Young’s modulus. However, within the narrow range of composite surface roughness of the tested grain-block interfaces no particular trend was observed in the COR values. Compared to glass balls and chrome steel balls, greater scatter in the COR values is observed for natural sand grains. This is due to the variation of the elastic and morphological characteristics among individual LBS grains

Reproducibility of aortic intima-media thickness in infants using edge-detection software and manual caliper measurements

Background: Aortic intima-media thickness measured by transabdominal ultrasound (aIMT) is an intermediate phenotype of cardiovascular risk. We aimed to (1) investigate the reproducibility of aIMT in a population-derived cohort of infants; (2) establish the distribution of aIMT in early infancy; (3) compare measurement by edge-detection software to that by manual sonographic calipers; and (4) assess the effect of individual and environmental variables on image quality. Methods. Participants were term infants recruited to a population-derived birth cohort study. Transabdominal ultrasound was performed at six weeks of age by one of two trained operators. Thirty participants had ultrasounds performed by both operators on the same day. Data were collected on environmental (infant sleeping, presence of a sibling, use of sucrose, timing during study visit) and individual (post-conception age, weight, gender) variables. Two readers assessed image quality and measured aIMT by edge-detection software and a subset by manual sonographic calipers. Measurements were repeated by the same reader and between readers to obtain intra-observer and inter-observer reliability. Results: Aortic IMT was measured successfully using edge-detection in 814 infants, and 290 of these infants also had aIMT measured using manual sonographic calipers. The intra-reader intra-class correlation (ICC) (n = 20) was 0.90 (95% CI 0.76, 0.96), mean difference 1.5 μm (95% LOA -39, 59). The between reader ICC using edge-detection (n = 20) was 0.92 (95% CI 0.82, 0.97) mean difference 2 μm (95% LOA -45.0, 49.0) and with manual caliper measurement (n = 290) the ICC was 0.84 (95% CI 0.80, 0.87) mean difference 5 μm (95% LOA -51.8, 61.8). Edge-detection measurements were greater than those from manual sonographic calipers (mean aIMT 618 μm (50) versus mean aIMT 563 μm (49) respectively; p < 0.001, mean difference 44 μm, 95% LOA -54, 142). With the exception of infant crying (p = 0.001), no associations were observed between individual and environmental variables and image quality. Conclusion: In a population-derived cohort of term infants, aIMT measurement has a high level of intra and inter-reader reproducibility. Measurement of aIMT using edge-detection software gives higher inter-reader ICC than manual sonographic calipers. Image quality is not substantially affected by individual and environmental factors. © 2014 McCloskey et al.; licensee BioMed Central Ltd

On RR couplings on D-branes at order O(α′2)O(\alpha'^2)

Recently, it has been found that there are couplings of the RR field strength $F^{(p)}$ and the B-field strength $H$ on the world volume of D$_p$-branes at order ${\cal O}(\alpha'^2)$. These couplings which have both world-volume and transverse indices, are invariant under the linear T-duality transformations. Consistency with the nonlinear T-duality indicates that the RR field strength $F^{(p)}$ in these couplings should be replaced by ${\cal F}^{(p)}=d{\cal C}^{(p-1)}$ where ${\cal C}=e^{B}C$. This replacement, however, reproduces some non-gauge invariant terms. On the other hand, the nonlinear terms are invariant under the linear T-duality transformations at the level of two B-fields. This allows one to remove some of the nonlinear terms in ${\cal F}^{(p)}$. We fix this by comparing the nonlinear couplings with the S-matrix element of one RR and two NSNS vertex operators. Our results indicate that in the expansion of ${\cal F}^{(p)}$ one should keep only the B-field gauge invariant terms, e.g. $B\wedge dC^{(p-3)}$ where both indices of B-field lie along the brane. Moreover, in this case one should replace $B$ with $B+2\pi\alpha'f$ to have the $B$-field gauge invariance.Comment: 23 pages, Latex file, 1 figure; v2:typos corrected, to appear in JHE

Predicting the Impact of Climate Change on Threatened Species in UK Waters

Global climate change is affecting the distribution of marine species and is thought to represent a threat to biodiversity. Previous studies project expansion of species range for some species and local extinction elsewhere under climate change. Such range shifts raise concern for species whose long-term persistence is already threatened by other human disturbances such as fishing. However, few studies have attempted to assess the effects of future climate change on threatened vertebrate marine species using a multi-model approach. There has also been a recent surge of interest in climate change impacts on protected areas. This study applies three species distribution models and two sets of climate model projections to explore the potential impacts of climate change on marine species by 2050. A set of species in the North Sea, including seven threatened and ten major commercial species were used as a case study. Changes in habitat suitability in selected candidate protected areas around the UK under future climatic scenarios were assessed for these species. Moreover, change in the degree of overlap between commercial and threatened species ranges was calculated as a proxy of the potential threat posed by overfishing through bycatch. The ensemble projections suggest northward shifts in species at an average rate of 27 km per decade, resulting in small average changes in range overlap between threatened and commercially exploited species. Furthermore, the adverse consequences of climate change on the habitat suitability of protected areas were projected to be small. Although the models show large variation in the predicted consequences of climate change, the multi-model approach helps identify the potential risk of increased exposure to human stressors of critically endangered species such as common skate (Dipturus batis) and angelshark (Squatina squatina)

"Resurrection of clinical efficacy" after resistance to endocrine therapy in metastatic breast cancer

BACKGROUND: In a significant proportion of metastatic breast cancer (MBC) patients whose tumour has progressed within 6 months of endocrine therapy (de novo resistance), it is generally believed that the chance of achieving clinical benefit (CB) with further endocrine therapy is minimal. METHODS: Data was retrieved from a prospectively updated database of metastatic breast cancer. Relevant data was exported to SPSS™ software for statistical analysis. RESULTS: In oestrogen receptor (ER) positive MBC patients with assessable disease, CB was achieved in 159 (71.3%) (1(st )line) patients. When these patients were put on further endocrine therapy, the CB rates were 63.2% (on 2(nd )line), 46.1% (on 3(rd )line) and 20% (on 4(th )line) with a median duration of response (DOR) in those with CB of 22, 12, 11 and 15 months respectively. The remaining 64(28.7%) patients had de novo resistance on 1(st )line endocrine therapy. Seventeen of these patients were treated with further endocrine therapy. The CB rates were 29.4% (on 2(nd )line) and 22.2% (on 3(rd )line) with a median DOR in those with CB of 22.7 months and 14 months respectively. CONCLUSION: The chance of further endocrine response continues to decrease with each line of therapy, yet CB is still seen with reasonable duration even with a 4(th )line agent. In addition, further endocrine response, with long duration, can be seen in a significant proportion of patients who have developed de novo resistance to 1(st )line endocrine therapy. The use of further endocrine therapy should not be excluded under these circumstances

Seiberg duality for Chern-Simons quivers and D-brane mutations

Chern-Simons quivers for M2-branes at Calabi-Yau singularities are best understood as the low energy theory of D2-branes on a dual type IIA background. We show how the D2-brane point of view naturally leads to three dimensional Seiberg dualities for Chern-Simons quivers with chiral matter content: They arise from a change of brane basis (or mutation), in complete analogy with the better known Seiberg dualities for D3-brane quivers. This perspective reproduces the known rules for Seiberg dualities in Chern-Simons-Yang-Mills theories with unitary gauge groups. We provide explicit examples of dual theories for the quiver dual to the Y^{p,q}(CP^2) geometries. We also comment on the string theory derivation of CS quivers dual to massive type IIA geometries.Comment: 32 pages+appendix; v2: added a referenc