Diagnostic Validity of Patient-Reported History for Shoulder Pathology

Objective The purpose of this article is to determine whether patient-reported history items are predictive of shoulder pathology and have the potential for use in triaging patients with shoulder pathology to orthopaedic outpatient clinics. Setting It is set at two tertiary orthopaedic clinics. Patients All new patients reporting pain and/or disability of the shoulder joint were prospectively recruited. A total of 193 patients were enrolled, 15 of whom withdrew, leaving 178 patients composing the study sample. Design Patients completed a questionnaire on the history of their pathology, then the surgeon took a thorough history indicating the most likely diagnosis. The clinician then performed appropriate physical examination. Arthroscopy was the reference standard for those undergoing surgery and magnetic resonance imaging (MRI) with arthrogram for all others. We calculated the sensitivity, specificity, and likelihood ratios (LRs) of history items alone and in combination. We used the LRs to generate a clinical decision algorithm. Main Outcome Measures Diagnosis was determined through arthroscopy or MRI arthrogram. Reporting was standardized to ensure review of all structures. Results The physical examination and history agreed in 75% of cases. Of those that did not agree, the physical examination misdirected the diagnosis in 47% of our cases. In particular, history items were strong predictors of anterior and posterior instability and subscapularis tears and were combined in a tool to be utilized for screening patients. Conclusion The patient-reported history items were effective for diagnosing shoulder pathology and should be considered for use in a triaging instrument

Molecular dynamics simulations of vibrated granular gases

We present molecular dynamics simulations of mono- or bidisperse inelastic granular gases driven by vibrating walls, in two dimensions (without gravity). Because of the energy injection at the boundaries, a situation often met experimentally, density and temperature fields display heterogeneous profiles in the direction perpendicular to the walls. A general equation of state for an arbitrary mixture of fluidized inelastic hard spheres is derived and successfully tested against numerical data. Single-particle velocity distribution functions with non-Gaussian features are also obtained, and the influence of various parameters (inelasticity coefficients, density...) analyzed. The validity of a recently proposed Random Restitution Coefficient model is assessed through the study of projected collisions onto the direction perpendicular to that of energy injection. For the binary mixture, the non-equipartition of translational kinetic energy is studied and compared both to experimental data and to the case of homogeneous energy injection (``stochastic thermostat''). The rescaled velocity distribution functions are found to be very similar for both species

Tracer diffusion in granular shear flows

Tracer diffusion in a granular gas in simple shear flow is analyzed. The analysis is made from a perturbation solution of the Boltzmann kinetic equation through first order in the gradient of the mole fraction of tracer particles. The reference state (zeroth-order approximation) corresponds to a Sonine solution of the Boltzmann equation, which holds for arbitrary values of the restitution coefficients. Due to the anisotropy induced in the system by the shear flow, the mass flux defines a diffusion tensor $D_{ij}$ instead of a scalar diffusion coefficient. The elements of this tensor are given in terms of the restitution coefficients and mass and size ratios. The dependence of the diffusion tensor on the parameters of the problem is illustrated in the three-dimensional case. The results show that the influence of dissipation on the elements $D_{ij}$ is in general quite important, even for moderate values of the restitution coefficients. In the case of self-diffusion (mechanically equivalent particles), the trends observed in recent molecular dynamics simulations are similar to those obtained here from the Boltzmann kinetic theory.Comment: 5 figure

Diffusion of impurities in a granular gas

Diffusion of impurities in a granular gas undergoing homogeneous cooling state is studied. The results are obtained by solving the Boltzmann--Lorentz equation by means of the Chapman--Enskog method. In the first order in the density gradient of impurities, the diffusion coefficient $D$ is determined as the solution of a linear integral equation which is approximately solved by making an expansion in Sonine polynomials. In this paper, we evaluate $D$ up to the second order in the Sonine expansion and get explicit expressions for $D$ in terms of the restitution coefficients for the impurity--gas and gas--gas collisions as well as the ratios of mass and particle sizes. To check the reliability of the Sonine polynomial solution, analytical results are compared with those obtained from numerical solutions of the Boltzmann equation by means of the direct simulation Monte Carlo (DSMC) method. In the simulations, the diffusion coefficient is measured via the mean square displacement of impurities. The comparison between theory and simulation shows in general an excellent agreement, except for the cases in which the gas particles are much heavier and/or much larger than impurities. In theses cases, the second Sonine approximation to $D$ improves significantly the qualitative predictions made from the first Sonine approximation. A discussion on the convergence of the Sonine polynomial expansion is also carried out.Comment: 9 figures. to appear in Phys. Rev.

Navier-Stokes transport coefficients of dd-dimensional granular binary mixtures at low density

The Navier-Stokes transport coefficients for binary mixtures of smooth inelastic hard disks or spheres under gravity are determined from the Boltzmann kinetic theory by application of the Chapman-Enskog method for states near the local homogeneous cooling state. It is shown that the Navier-Stokes transport coefficients are not affected by the presence of gravity. As in the elastic case, the transport coefficients of the mixture verify a set of coupled linear integral equations that are approximately solved by using the leading terms in a Sonine polynomial expansion. The results reported here extend previous calculations [V. Garz\'o and J. W. Dufty, Phys. Fluids {\bf 14}, 1476 (2002)] to an arbitrary number of dimensions. To check the accuracy of the Chapman-Enskog results, the inelastic Boltzmann equation is also numerically solved by means of the direct simulation Monte Carlo method to evaluate the diffusion and shear viscosity coefficients for hard disks. The comparison shows a good agreement over a wide range of values of the coefficients of restitution and the parameters of the mixture (masses and sizes).Comment: 6 figures, to be published in J. Stat. Phy

Mechanisms of Size Control and Polymorphism in Viral Capsid Assembly

We simulate the assembly dynamics of icosahedral capsids from subunits that interconvert between different conformations (or quasi-equivalent states). The simulations identify mechanisms by which subunits form empty capsids with only one morphology but adaptively assemble into different icosahedral morphologies around nanoparticle cargoes with varying sizes, as seen in recent experiments with brome mosaic virus (BMV) capsid proteins. Adaptive cargo encapsidation requires moderate cargo-subunit interaction strengths; stronger interactions frustrate assembly by stabilizing intermediates with incommensurate curvature. We compare simulation results to experiments with cowpea chlorotic mottle virus empty capsids and BMV capsids assembled on functionalized nanoparticles and suggest new cargo encapsidation experiments. Finally, we find that both empty and templated capsids maintain the precise spatial ordering of subunit conformations seen in the crystal structure even if interactions that preserve this arrangement are favored by as little as the thermal energy, consistent with experimental observations that different subunit conformations are highly similar

Invaders in hot water: a simple decontamination method to prevent the accidental spread of aquatic invasive non-native species.

Watersports equipment can act as a vector for the introduction and spread of invasive non native species (INNS) in freshwater environments. To support advice given to recreational water users under the UK Government’s Check Clean Dry biosecurity campaign and ensure its effectiveness at killing a range of aquatic INNS, we conducted a survival experiment on seven INNS which pose a high risk to UK freshwaters. The efficacy of exposure to hot water (45 °C, 15 min) was tested as a method by which waters users could ‘clean’ their equipment and was compared to drying and a control group (no treatment). Hot water had caused 99 % mortality across all species 1 h after treatment and was more effective than drying at all time points (1 h: χ2 = 117.24, p < 0.001; 1 day χ2 = 95.68, p < 0.001; 8 days χ2 = 12.16, p < 0.001 and 16 days χ2 = 7.58, p < 0.001). Drying caused significantly higher mortality than the control (no action) from day 4 (χ2 = 8.49, p < 0.01) onwards. In the absence of hot water or drying, 6/7 of these species survived for 16 days, highlighting the importance of good biosecurity practice to reduce the risk of accidental spread. In an additional experiment the minimum lethal temperature and exposure time in hot water to cause 100 % mortality in American signal crayfish (Pacifastacus leniusculus), was determined to be 5 min at 40 °C. Hot water provides a simple, rapid and effective method to clean equipment. We recommend that it is advocated in future biosecurity awareness campaigns