Robotic-arm assisted lateral unicompartmental knee arthroplasty: 5-Year outcomes & survivorship

INTRODUCTION: Robotic-arm assisted unicompartmental knee arthroplasty (RA-UKA) has demonstrated accurate component positioning and excellent outcomes for medial components. However, there is a paucity of literature on lateral compartment RA-UKA. The purpose of our study was to assess the midterm clinical outcomes and survivorship of lateral RA-UKA. METHODS: This study was a retrospective review of a single-center prospectively maintained cohort of 33 patients (36 knees) indicated for lateral UKA. Perioperative, and postoperative two- and five-year Knee injury Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Score (WOMAC), and Forgotten Joint Score (FJS) patient reported outcome measures were collected. Five-year follow-up was recorded in 29 patients (32 knees). RESULTS: Mean follow up was 5.1 ± 0.1 years. Mean age and BMI was 70.9 ± 7.2 years and 29.0 ± 4.2 kg/m2, respectively. At discharge, mean distance walked was 273.4 ± 70.4 feet, and mean pain score was 2.0 ± 2.5. At 2-year follow up, mean KOOS, WOMAC, and FJS were 75.1 ± 13.5, 15.0 ± 7.2, and 81.0 ± 23.3, respectively. At 5-year follow up, mean KOOS, WOMAC, and FJS were 75.3 ± 14.6, 14.9 ± 5.0, and 75.8 ± 27.4, respectively. Mean change in KOOS and WOMAC were 35.6 ± 27.1 and 11.7 ± 13.4 (p\u3c .001 and p\u3c .001). 94% of patients were very satisfied/satisfied, 3% neutral, and 3% dissatisfied. 91% met activity expectations, and 59% were more active than before. Survivorship was 100% at 5 years. DISCUSSION: In this study, lateral RA-UKA demonstrated significantly improved clinical outcomes, high patient satisfaction, met expectations, and excellent functional recovery at midterm follow up. Comparative studies are needed to determine differences between robotic-assisted and conventional lateral UKA, as well as TKA

5-Year Survivorship and Outcomes of Robotic-Arm-Assisted Medial Unicompartmental Knee Arthroplasty

Purpose: While unicompartmental knee arthroplasty (UKA) has demonstrated benefits over total knee arthroplasty (TKA) in selected populations, component placement continues to be challenging with conventional surgical instruments, resulting in higher early failure rates. Robotic-arm-assisted UKA (RA-UKA) has shown to be successful in component positioning through preop planning and intraop adjustability. The purpose of this study is to assess the 5-year clinical outcomes of medial RA-UKA. Methods: This study was a retrospective review of a single-center prospectively maintained cohort of 133 patients (146 knees) indicated for medial UKA from 2009 to 2013. Perioperative data and 2- and 5-year Knee injury Osteoarthritis Outcome Score (KOOS), Western Ontario and McMaster Universities Osteoarthritis Score (WOMAC), and Forgotten Joint Score (FJS) outcome measures were collected. Five-year follow-up was recorded in 119 patients (131 knees). Results: Mean follow-up was 5.1 ± 0.2 years. Mean age and BMI were 68.0 ± 8.1 years and 29.3 ± 4.7 kg/m(2), respectively. At 2-year follow-up, mean KOOS, WOMAC, and FJS were 71.5 ± 15.3, 14.3 ± 7.9, and 79.1 ± 25.8, respectively. At 5-year follow-up, mean KOOS, WOMAC, and FJS were 71.6 ± 15.2, 14.2 ± 7.9, and 80.9 ± 25.1, respectively. Mean change in KOOS and WOMAC was 34.6 ± 21.4 and 11.0 ± 13.6, respectively (p \u3c 0.001 and p \u3c 0.001). For patient satisfaction at last follow-up, 89% of patients were very satisfied/satisfied and 5% were dissatisfied. For patient activity expectations at last follow-up, 85% met activity expectations, 52% were more active than before, 25% have the same level of activity, 23% were less active than before, and 89% were walking without support. All patients returned to driving after surgery at a mean 15.2 ± 9.4 days. Survivorship was 95% (95% CI 0.91-0.98) at 5 years. One knee (1%) had a patellofemoral revision, two knees (1.3%) were revised to different partial knee replacements, and five knees (3.4%) were converted to TKA. Conclusion: Overall, medial RA-UKA demonstrated improved patient-recorded outcomes, high patient satisfaction, met expectations, and excellent functional recovery. Midterm survivorship was excellent. Longitudinal follow-up is needed to evaluate long-term outcomes of robotic-arm-assisted UKA procedures

Geometric Phases and Mielnik's Evolution Loops

The cyclic evolutions and associated geometric phases induced by time-independent Hamiltonians are studied for the case when the evolution operator becomes the identity (those processes are called {\it evolution loops}). We make a detailed treatment of systems having equally-spaced energy levels. Special emphasis is made on the potentials which have the same spectrum as the harmonic oscillator potential (the generalized oscillator potentials) and on their recently found coherent states.Comment: 11 pages, harvmac, 2 figures available upon request; CINVESTAV-FIS GFMR 11/9

Spatially modelling the association between access to recreational facilities and exercise: the ‘Multi-ethnic study of atherosclerosis’

Numerous studies have investigated the relationship between the built environment and physical activity. However these studies assume that these relationships are invariant over space. In this study, we introduce a novel method to analyze the association between access to recreational facilities and exercise allowing for spatial heterogeneity. In addition, this association is studied before and after controlling for crime, a variable that could explain spatial heterogeneity of associations. We use data from the Chicago site of the Multi-Ethnic Study of Atherosclerosis of 781 adults aged 46 years and over. A spatially varying coefficient Tobit regression model is implemented in the Bayesian setting to allow for the association of interest to vary over space. The relationship is shown to vary over Chicago, being positive in the south but negative or null in the north. Controlling for crime weakens the association in the south with little change observed in northern Chicago. The results of this study indicate that spatial heterogeneity in associations of environmental factors with health may vary over space and deserve further exploration

Phase-Resolved Rydberg Atom Field Sensing using Quantum Interferometry

Although Rydberg atom-based electric field sensing provides key advantages over traditional antenna-based detection, it remains limited by the need for a local oscillator (LO) for low-field and phase resolved detection. In this work, we demonstrate that closed-loop quantum interferometric schemes can be used to generate a system-internal reference that can directly replace an external LO for Rydberg field sensing. We reveal that this quantum-interferometrically defined internal reference phase and frequency can be used analogously to a traditional LO for atom-based down-mixing to an intermediate frequency for lock-in phase detection. We demonstrate that this LO-equivalent functionality provides analogous benefits to an LO, including full 360$^\circ$ phase resolution as well as improved sensitivity. The general applicability of this approach is confirmed by demodulating a four phase-state signal broadcast on the atoms. Our approach opens up new sensing schemes and provides a clear path towards all-optical Rydberg atom sensing implementations

Projected Demand and Potential Impacts to the National Airspace System of Autonomous, Electric, On-Demand Small Aircraft

Electric propulsion and autonomy are technology frontiers that offer tremendous potential to achieve low operating costs for small-aircraft. Such technologies enable simple and safe to operate vehicles that could dramatically improve regional transportation accessibility and speed through point-to-point operations. This analysis develops an understanding of the potential traffic volume and National Airspace System (NAS) capacity for small on-demand aircraft operations. Future demand projections use the Transportation Systems Analysis Model (TSAM), a tool suite developed by NASA and the Transportation Laboratory of Virginia Polytechnic Institute. Demand projections from TSAM contain the mode of travel, number of trips and geographic distribution of trips. For this study, the mode of travel can be commercial aircraft, automobile and on-demand aircraft. NASA's Airspace Concept Evaluation System (ACES) is used to assess NAS impact. This simulation takes a schedule that includes all flights: commercial passenger and cargo; conventional General Aviation and on-demand small aircraft, and operates them in the simulated NAS. The results of this analysis projects very large trip numbers for an on-demand air transportation system competitive with automobiles in cost per passenger mile. The significance is this type of air transportation can enhance mobility for communities that currently lack access to commercial air transportation. Another significant finding is that the large numbers of operations can have an impact on the current NAS infrastructure used by commercial airlines and cargo operators, even if on-demand traffic does not use the 28 airports in the Continental U.S. designated as large hubs by the FAA. Some smaller airports will experience greater demand than their current capacity allows and will require upgrading. In addition, in future years as demand grows and vehicle performance improves other non-conventional facilities such as short runways incorporated into shopping mall or transportation hub parking areas could provide additional capacity and convenience

Independent Rydberg Atom Sensing using a Dual-Ladder Scheme

Rydberg atom-based electric field sensing can provide all-optical readout of radio frequency fields in a dielectric environment. However, because a single set of optical fields is typically used to prepare the Rydberg state and read out its response to RF fields, it is challenging to perform simultaneous and independent measurements of the RF field(s). Here we show that using two independent schemes to prepare and read out the same Rydberg state can be used to perform independent measurements in general, which we demonstrate specifically by resolving the the RF polarization. We expect this work will be useful for fiber-coupled sensor heads where spatial multiplexing is challenging, as well as for complex multi-level sensing schemes

Solving Witten's string field theory using the butterfly state

We solve the equation of motion of Witten's cubic open string field theory in a series expansion using the regulated butterfly state. The expansion parameter is given by the regularization parameter of the butterfly state, which can be taken to be arbitrarily small. Unlike the case of level truncation, the equation of motion can be solved for an arbitrary component of the Fock space up to a positive power of the expansion parameter. The energy density of the solution is well-defined and remains finite even in the singular butterfly limit, and it gives approximately 68% of the D25-brane tension for the solution at the leading order. Moreover, it simultaneously solves the equation of motion of vacuum string field theory, providing support for the conjecture at this order. We further improve our ansatz by taking into account next-to-leading terms, and find two numerical solutions which give approximately 88% and 109%, respectively, of the D25-brane tension for the energy density. These values are interestingly close to those by level truncation at level 2 without gauge fixing studied by Rastelli and Zwiebach and by Ellwood and Taylor.Comment: 38 pages, no figures, LaTeX2e; v2: the footnote on hep-th/0302151 changed and moved to the introduction; v3: minor typos corrected, published versio

The Standard Model with gravity couplings

In this paper, we examine the coupling of matter fields to gravity within the framework of the Standard Model of particle physics. The coupling is described in terms of Weyl fermions of a definite chirality, and employs only (anti)self-dual or left-handed spin connection fields. It is known from the work of Ashtekar and others that such fields can furnish a complete description of gravity without matter. We show that conditions ensuring the cancellation of perturbative chiral gauge anomalies are not disturbed. We also explore a global anomaly associated with the theory, and argue that its removal requires that the number of fundamental fermions in the theory must be multiples of 16. In addition, we investigate the behavior of the theory under discrete transformations P, C and T; and discuss possible violations of these discrete symmetries, including CPT, in the presence of instantons and the Adler-Bell-Jackiw anomaly.Comment: Extended, and replaced with LaTex file. 25 Page