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Hip arthroscopy versus total hip arthroplasty-A study on patients with obesity above 40 years of age

Patients older than 40 years with a body-mass-index (BMI) >30 kg/m$^{2}$ , a femoroacetabular-impingement (FAI) and little cartilage damage are a challenge for hip surgeons. Hip-arthroscopy (HAS) or conservative therapy until a total hip arthroplasty (THA) is needed are possible treatments. Our research purpose was to compare the clinical results and complication/reoperation rate after HAS and THA in patients with obesity over 40 years. This retrospective study includes a consecutive series of patients with obesity (BMI >30 kg/m$^{2}$ ) who underwent HAS (19 hips) and THA (37 hips) over 40 years of age between 2007 and 2013 at our institution with a minimum of 12-months follow-up. Outcome measures were WOMAC (Western Ontario und McMaster Universities Arthritis Index), subjective-hip-value (SHV), residual complaints and the reoperation rate. Patient data and scores were collected pre-operative, 12 months post-operatively and at the last follow-up. Both groups showed a comparable age (mean 48 years). Regarding SHV-Scores the THA-group shows continuous significant improvements. Reaching 87% (range 50%-100%), the HAS-group showed in case of the SHV no significant change after 1 year and an improvement from preoperative to the last follow-up reaching 72% (range 30%-100%) at the last follow-up. Residual groin pain was significant higher in the HAS-group. Two deep infections (5.4%) requiring reoperations were reported in the THA-group. The conversion rate to THA after a mean time of 60 months was 26% (5 of 19). Patients with obesity over 40 years demonstrated inferior SHV, more often residual pain and revision surgery after HAS, when compared to THA at short-term, with conversions rate of one fourth. However, THA in this patient group showed high infection rate of 5%. This information is relevant for counselling above-mentioned patients

'To live and die [for] Dixie': Irish civilians and the Confederate States of America

Around 20,000 Irishmen served in the Confederate army in the Civil War. As a result, they left behind, in various Southern towns and cities, large numbers of friends, family, and community leaders. As with native-born Confederates, Irish civilian support was crucial to Irish participation in the Confederate military effort. Also, Irish civilians served in various supporting roles: in factories and hospitals, on railroads and diplomatic missions, and as boosters for the cause. They also, however, suffered in bombardments, sieges, and the blockade. Usually poorer than their native neighbours, they could not afford to become 'refugees' and move away from the centres of conflict. This essay, based on research from manuscript collections, contemporary newspapers, British Consular records, and Federal military records, will examine the role of Irish civilians in the Confederacy, and assess the role this activity had on their integration into Southern communities. It will also look at Irish civilians in the defeat of the Confederacy, particularly when they came under Union occupation. Initial research shows that Irish civilians were not as upset as other whites in the South about Union victory. They welcomed a return to normalcy, and often 'collaborated' with Union authorities. Also, Irish desertion rates in the Confederate army were particularly high, and I will attempt to gauge whether Irish civilians played a role in this. All of the research in this paper will thus be put in the context of the Drew Gilpin Faust/Gary Gallagher debate on the influence of the Confederate homefront on military performance. By studying the Irish civilian experience one can assess how strong the Confederate national experiment was. Was it a nation without a nationalism

NATO Conference on Work, Organizations, and Technological Change

This volume is the proceedings of the Symposium entitled, "Work, Organizations and Technological Change" which was held in Garmisch-Partenkirchen, West Germany, 14-19 June 1981. The meeting was sponsored by the Special Panel on Systems Sciences of the NATO Scientific Affairs Division. In proposing this meeting the Symposium Directors built upon several preceding NATO conferences in the general area of personnel systems, manpower modelling, and organization. The most recent NATO Conference, entitled "Manpower Planning and Organization Design," was held in Stresa, Italy in 1977. That meeting was organized to foster research on the interrelationships between programmatic approaches to personnel planning within organizations and behavioral science approachs to organization design. From that context of corporate planning the total internal organizational perspective was the MACRO view, and the selection, assignment, care and feeding of the people was the MICRO view. Conceptually, this meant that an integrated approach was needed if all the dimensions of such problems within private and public organizations were to corne out correctly

NATO Conference on Manpower Planning and Organization Design

This volume is the proceedings of the conference entitled "Manpower Planning and Organization Design" which was held in Stresa, Italy, 20-24 June 1977. The Conference was sponsored by the NATO Scientific Affairs Division and organized jointly through the Special Programs Panels on Human Factors and on Systems Science. Two Conference Directors were appointed with overall responsibilities for the programme and for policy, and they were assisted in their tasks by a small advisory panel consisting of Professor A. Charnes (University of Texas), Professor W.W. Cooper (Carnegie Mellon University, now at Harvard University) and Dr. F.A. Heller (TavistQck Institute of Human Relations). Professor R. Florio of Bergamo kindly agreed to become Administrative Director and, as such, was responsible for all the local arrangements. The Conference Directors were further assisted by "national points of contact" appointed from each of the member countries of NATO. These national representatives played a substantial part in the search for participants and in the collection and trans­ mission of the various conference communications. Although full details of the national points of contact are included in the Appendices, special tribute must be paid to the UK point of contact, Brian Smith of the Civil Service Department. He very capably shouldered the additional burdens of maintaining conti­ nuity and resolving problems during the absence in Canada of Don Bryant in the particularly demanding two months preceding the Conference

Modern ICT Network Simulator for Co-Simulations in Smart Grid Applications

The current transformation of power grids towards smart grids and the associated increase in the use of ICT technologies lead to an increased attack surface via the communication network. Holistic, multi-domain co-simulations can be used to evaluate the possibilities for, and impacts of, ICT-based attacks on these grids. This paper presents an ICT network simulator that can be used in co-simulation environments. It outlines requirements for this kind of simulation tool and provides insight into how these requirements can be met. In addition, co-simulation use cases for the simulator arising from different research projects are laid out. Finally, the simulator’s functionalities in co-simulation environments are verified with a practical application example. This application shows that our simulator (rettij) is able to exchange data with other simulators through a co-simulation interface. It also demonstrates our simulators capabilities to perform real-world ICT attacks on realistic network topologies.22723

Hip arthroscopy versus total hip arthroplasty in patients above 40 differences: outcome and residual complain

This study aimed to compare patient outcomes and residual complains after hip arthroscopy (HAS) and total hip arthroplasty (THA) to improve patient counseling. It includes 140 hips/129 HAS-patients and 77 hips/62 THA-patients aged 40 to 55 years with a BMI under 30. All patients underwent primary HAS or primary THA in our hospital from 2007 until 2014. Exclusion criteria were a history of prior hip surgery or suffering sequels of childhood's hip disease, systemic inflammatory disease or avascular hip osteonecrosis. Outcome measures were WOMAC, subjective hip value, residual complains, the need of infiltrations and the complication and conversion rate. Patient data and scores were collected pre-operative, after one year and at the last follow-up. Scores indicated significant patient benefits in both groups (p < 0.0001). Variability of outcome was significantly higher and less predictable in the HAS group (HAS: 1.9 vs. THA: 0.9). While THA showed significant improvement mainly after one year, HAS showed significant improvements after one year and the latest follow-up. Residual complains were more frequent after HAS (p = 0.026). Groin pain was the main complain after HAS, limping and disturbing leg length discrepancy after THA. THA more predictably improves patient's outcome with shorter recovery time. Limping and leg length discrepancy are predominant after THA