Assessing the Efficacy of Physical Prehabilitation on a Total Knee Arthroplasty

Prehabilitation is a rather new method of approach to the physical therapy setting in which patients attend therapy sessions to prepare for their upcoming surgery. Researchers hypothesize that if patients enter a procedure with higher levels of strength and function, they will be able to recover from their surgery quicker and more successfully. This literature review assesses different approaches that numerous studies have taken with regards to prehabilitation for patients about to undergo a Total Knee Arthroplasty. Majority of the studies conclude that there needs to be further research done to yield consistent results. Based on what has been done, prehabilitation does not yield enough statistically significant results to justify the implementation of such a program for all individuals. The current discourse analyzes the impact of prehabilitation on objective measurements of the knee however, should shift towards analyzing the impact prehabilitation has on future health-care spending for patients

A case for hornblende dominated fractionation of arc magmas: the Chelan Complex (Washington Cascades)

Amphibole fractionation in the deep roots of subduction-related magmatic arcs is a fundamental process for the generation of the continental crust. Field relations and geochemical data of exposed lower crustal igneous rocks can be used to better constrain these processes. The Chelan Complex in the western U. S. forms the lowest level of a 40-km thick exposed crustal section of the North Cascades and is composed of olivine websterite, pyroxenite, hornblendite, and dominantly by hornblende gabbro and tonalite. Magmatic breccias, comb layers and intrusive contacts suggest that the Chelan Complex was build by igneous processes. Phase equilibria, textural observations and mineral chemistry yield emplacement pressures of similar to 1.0 GPa followed by isobaric cooling to 700 degrees C. The widespread occurrence of idiomorphic hornblende and interstitial plagioclase together with the lack of Eu anomalies in bulk rock compositions indicate that the differentiation is largely dominated by amphibole. Major and trace element modeling constrained by field observations and bulk chemistry demonstrate that peraluminous tonalite could be derived by removing successively 3% of olivine websterite, 12% of pyroxene hornblendite, 33% of pyroxene hornblendite, 19% of gabbros, 15% of diorite and 2% tonalite. Peraluminous tonalite with high Sr/Y that are worldwide associated with active margin settings can be derived from a parental basaltic melt by crystal fractionation at high pressure provided that amphibole dominates the fractionation process. Crustal assimilation during fractionation is thus not required to generate peraluminous tonalite