644 research outputs found
Transition from single-file to two-dimensional diffusion of interacting particles in a quasi-one-dimensional channel
Diffusive properties of a monodisperse system of interacting particles
confined to a \textit{quasi}-one-dimensional (Q1D) channel are studied using
molecular dynamics (MD) simulations. We calculate numerically the mean-squared
displacement (MSD) and investigate the influence of the width of the channel
(or the strength of the confinement potential) on diffusion in finite-size
channels of different shapes (i.e., straight and circular). The transition from
single-file diffusion (SFD) to the two-dimensional diffusion regime is
investigated. This transition (regarding the calculation of the scaling
exponent () of the MSD ) as a
function of the width of the channel, is shown to change depending on the
channel's confinement profile. In particular the transition can be either
smooth (i.e., for a parabolic confinement potential) or rather sharp/stepwise
(i.e., for a hard-wall potential), as distinct from infinite channels where
this transition is abrupt. This result can be explained by qualitatively
different distributions of the particle density for the different confinement
potentials.Comment: 13 pages, 11 figure
Environmental consciousness in the Netherlands
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When Punishment is Emotion-Driven: Children’s, Adolescents’, and Adults’ Costly Punishment of Unfair Allocations
When do children, adolescents, and adults decide to punish fairness violations? Two studies with 9-year-old children, 13-year-old adolescents, and adults investigated whether the link between unfairness and punishment was mediated by negative emotional reactions (measured through galvanic skin responses and emotion ratings). Study 1 (N = 117) examined this question in the context of second-party punishment, where the punisher is a direct victim of the violation. Study 2 (N = 119) assessed third-party punishment, where the punisher is an observer, unaffected by the violation. In each study, participants were presented with seven distributions of points between a proposer and receiver which differed in how fairly the points were allocated between proposer and receiver. Participants had to decide whether to punish these distributions. While the unfairness of the distribution strongly influenced second- and third-party punishment in all age groups, the mediating role of emotional appraisals (i.e., galvanic skin responses vs. emotion ratings) depended on whether or not the punisher was personally affected by the violation (i.e., second- vs. third-party punishment) and age. These findings suggest that negative emotions primarily motivate costly punishment when the punisher is affected by the violation or when an unaffected third-party punisher takes the perspective of the victim of a violation, an ability that develops between childhood and adolescence
Modular component exchange and outcome of DAIR for hip and knee periprosthetic joint infection A SYSTEMATIC REVIEW AND META-REGRESSION ANALYSIS
AimsThe aim of this meta-analysis is to assess the association between exchange of modular parts in debridement, antibiotics, and implant retention (DAIR) procedure and outcomes for hip and knee periprosthetic joint infection (PJI).MethodsWe conducted a systematic search on PubMed, Embase, Web of Science, and Cochrane library from inception until May 2021. Random effects meta-analyses and meta-regression was used to estimate, on a study level, the success rate of DAIR related to component exchange. Risk of bias was appraised using the (AQUILA) checklist.ResultsWe included 65 studies comprising 6,630 patients. The pooled overall success after DAIR for PJI was 67% (95% confidence interval (CI) 63% to 70%). This was 70% (95% CI 65% to 75%) for DAIR for hip PJI and 63% (95% CI 58% to 69%) for knee PJI. In studies before 2004 (n = 27), our meta-regression analysis showed a 3.5% increase in success rates for each 10% increase in component exchange in DAIR for hip PJI and a 3.1% increase for each 10% increase in component exchange for knee PJI. When restricted to studies after 2004 (n = 37), this association changed: for DAIR for hip PJI a decrease in successful outcome by 0.5% for each 10% increase in component exchange and for DAIR for knee PJI this was a 0.01% increase in successful outcome for each 10% increase in component exchange.ConclusionThis systematic review and meta-regression found no benefit of modular component exchange on reduction of PJI failure. This limited effect should be weighed against the risks for the patient and cost on a case-by-case basis. The association between exchange of modular components and outcome changed before and after 2004. This suggests the effect seen after 2004 may reflect a more rigorous, evidence-based, approach to the infected implant compared to the years before.Immunogenetics and cellular immunology of bacterial infectious disease
Performing a knee arthroscopy among patients with degenerative knee disease:one-third is potentially low value care
PURPOSE: The purpose of this study was to assess in which proportion of patients with degenerative knee disease aged 50+ in whom a knee arthroscopy is performed, no valid surgical indication is reported in medical records, and to explore possible explanatory factors. METHODS: A retrospective study was conducted using administrative data from January to December 2016 in 13 orthopedic centers in the Netherlands. Medical records were selected from a random sample of 538 patients aged 50+ with degenerative knee disease in whom arthroscopy was performed, and reviewed on reported indications for the performed knee arthroscopy. Valid surgical indications were predefined based on clinical national guidelines and expert opinion (e.g., truly locked knee). A knee arthroscopy without a reported valid indication was considered potentially low value care. Multivariate logistic regression analysis was performed to assess whether age, diagnosis ("Arthrosis" versus "Meniscal lesion"), and type of care trajectory (initial or follow-up) were associated with performing a potentially low value knee arthroscopy. RESULTS: Of 26,991 patients with degenerative knee disease, 2556 (9.5%) underwent an arthroscopy in one of the participating orthopedic centers. Of 538 patients in whom an arthroscopy was performed, 65.1% had a valid indication reported in the medical record and 34.9% without a reported valid indication. From the patients without a valid indication, a joint patient-provider decision or patient request was reported as the main reason. Neither age [OR 1.013 (95% CI 0.984-1.043)], diagnosis [OR 0.998 (95% CI 0.886-1.124)] or type of care trajectory [OR 0.989 (95% CI 0.948-1.032)] were significantly associated with performing a potentially low value knee arthroscopy. CONCLUSIONS: In a random sample of knee arthroscopies performed in 13 orthopedic centers in 2016, 65% had valid indications reported in the medical records but 35% were performed without a reported valid indication and, therefore, potentially low value care. Patient and/or surgeons preference may play a large role in the decision to perform an arthroscopy without a valid indication. Therefore, interventions should be developed to increase adherence to clinical guidelines by surgeons that target invalid indications for a knee arthroscopy to improve care. LEVEL OF EVIDENCE: IV
Genetic variation in the myeloperoxidase gene and cognitive impairment in Multiple Sclerosis
There is evidence that multiple sclerosis (MS) may associated with cognitive impairment in 25 to 40% of cases. The gene encoding myeloperoxidase (MPO) is involved in molecular pathways leading to β-amyloid deposition. We investigated a functional biallelic (G/A) polymorphism in the promoter region (-463) of the MPO gene in 465 patients affected by MS, divided into 204 cognitively normal and 261 impaired. We did not find significant differences in allele or genotype distributions between impaired and preserved MS patients. Our findings suggest that MPO polymorphism is not a risk factor for cognitive impairment in MS
Why I tense up when you watch me: inferior parietal cortex mediates an audience’s influence on motor performance
The presence of an evaluative audience can alter skilled motor performance through changes in force output. To investigate how this is mediated within the brain, we emulated real-time social monitoring of participants’ performance of a fine grip task during functional magnetic resonance neuroimaging. We observed an increase in force output during social evaluation that was accompanied by focal reductions in activity within bilateral inferior parietal cortex. Moreover, deactivation of the left inferior parietal cortex predicted both inter- and intra-individual differences in socially-induced change in grip force. Social evaluation also enhanced activation within the posterior superior temporal sulcus, which conveys visual information about others’ actions to the inferior parietal cortex. Interestingly, functional connectivity between these two regions was attenuated by social evaluation. Our data suggest that social evaluation can vary force output through the altered engagement of inferior parietal cortex; a region implicated in sensorimotor integration necessary for object manipulation, and a component of the action-observation network which integrates and facilitates performance of observed actions. Social-evaluative situations may induce high-level representational incoherence between one’s own intentioned action and the perceived intention of others which, by uncoupling the dynamics of sensorimotor facilitation, could ultimately perturbe motor output
Preferences and beliefs of Dutch orthopaedic surgeons and patients reduce the implementation of "Choosing Wisely" recommendations in degenerative knee disease
Purpose: The purpose of this study was to assess which factors were associated with the implementation of “Choosing Wisely” recommendations to refrain from routine MRI and arthroscopy use in degenerative knee disease. Methods: Cross-sectional surveys were sent to 123 patients (response rate 95%) and 413 orthopaedic surgeons (response rate 62%) fulfilling the inclusion criteria. Univariate and multivariate logistic regression analyses were used to identify factors associated with implementation of “Choosing Wisely” recommendations. Results: Factors reducing implementation of the MRI recommendation among patients included explanation of added value by an orthopaedic surgeon [OR 0.18 (95% CI 0.07–0.47)] and patient preference for MRI [OR 0.27 (95% CI 0.08–0.92)]. Factors reducing implementation among orthopaedic surgeons were higher valuation of own MRI experience than existing evidence [OR 0.41 (95% CI 0.19–0.88)] and higher estimated patients’ knowledge to participate in shared decision-making [OR 0.38 (95% CI 0.17–0.88)]. Factors reducing implementation of the arthroscopy recommendation among patients were orthopaedic surgeons’ preferences for an arthroscopy [OR 0.03 (95% CI 0.00–0.22)] and positive experiences with arthroscopy of friends/family [OR 0.03 (95% CI 0.00–0.39)]. Factors reducing implementation among orthopaedic surgeons were higher valuation of own arthroscopy experience than existing evidence [OR 0.17 (95% CI 0.07–0.46)] and belief in the added value [OR 0.28 (95% CI 0.10–0.81)]. Conclusions: Implementation of “Choosing Wisely” recommendations in degenerative knee disease can be improved by strategies to change clinician beliefs about the added value of MRIs and arthroscopies, and by patient-directed strategies addressing patient preferences and underlying beliefs for added value of MRI and arthroscopies resulting from experiences of people in their environment. Level of evidence: IV
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