The comprehensive cohort model in a pilot trial in orthopaedic trauma

Background: The primary aim of this study was to provide an estimate of effect size for the functional outcome of operative versus non-operative treatment for patients with an acute rupture of the Achilles tendon using accelerated rehabilitation for both groups of patients. The secondary aim was to assess the use of a comprehensive cohort research design (i.e. a parallel patient-preference group alongside a randomised group) in improving the accuracy of this estimate within an orthopaedic trauma setting. Methods: Pragmatic randomised controlled trial and comprehensive cohort study within a level 1 trauma centre. Twenty randomised participants (10 operative and 10 non-operative) and 29 preference participants (3 operative and 26 non-operative). The ge range was 22-72 years and 37 of the 52 patients were men. All participants had an acute rupture of their Achilles tendon and no other injuries. All of the patients in the operative group had a simple end-to-end repair of the tendon with no augmentation. Both groups then followed the same eight-week immediate weight-bearing rehabilitation programme using an off-the-shelf orthotic. The disability rating index (DRI; primary outcome), EQ-5D, Achilles Total Rupture Score and complications were assessed ed at two weeks, six weeks, three months, six months and nine months after initial injury. Results: At nine months, there was no significant difference in DRI between patients randomised to operative or non-operative management. There was no difference in DRI between the randomised group and the parallel patient preference group. The use of a comprehensive cohort of patients did not provide useful additional information as to the treatment effect size because the majority of patients chose non-operative management. Conclusions: Recruitment to clinical trials that compare operative and non-operative interventions is notoriously difficult; especially within the trauma setting. Including a parallel patient preference group to create a comprehensive cohort of patients has been suggested as a way of increasing the power of such trials. In our study, the comprehensive cohort model doubled the number of patients involved in the study. However, a strong preference for non-operative treatment meant that the increased number of patients did not significantly increase the ability of the trial to detect a difference between the two interventions

GLOBAL REFINEMENT OF TERRESTRIAL LASER SCANNER DATA REGISTRATION USING WEIGHTED SENSOR POSES

Terrestrial laser scanner (TLS) sensor captures highly dense and accurate point clouds quite useful for indoor and outdoor mapping, navigation, 3D reconstruction, surveillance, industrial projects, infrastructure management, and others. In this paper, we present a global registration method that weights the sensor poses for refinement of TLS data registration. Our global refinement method assumes that the variance-covariance matrix that describes the uncertainty of sensor poses is available to refine the registration errors. The effectiveness of the proposed method is demonstrated with TLS dataset obtained into outdoor environment. Our results show that the weighting the sensor poses obtained in registration task improves the positional accuracy of TLS sensor

Processing Bi-Pb-Sr-Ca-Cu-O superconductors from amorphous state

The bismuth based high T sub c superconductors can be processed via an amorphous Bi-Pb-Sr-Ca-Cu oxide. The amorphous oxides were prepared by melting the constituent powders in an alumina crucible at 1200 C in air followed by pouring the liquid onto an aluminum plate, and rapidly pressing with a second plate. In the amorphous state, no crystalline phase was identified in the powder x ray diffraction pattern of the quenched materials. After heat treatment at high temperature the amorphous materials crystallized into a glass ceramic containing a large fraction of the Bi2Sr2Ca2Cu3O(x) phase T sub c = 110 K. The processing method, crystallization, and results of dc electrical resistivity and ac magnetic susceptibility measurements are discussed

Immigration Enforcement and Fairness to Would-Be Immigrants

This chapter argues that governments have a duty to take reasonably effective and humane steps to minimize the occurrence of unauthorized migration and stay. While the effects of unauthorized migration on a country’s citizens and institutions have been vigorously debated, the literature has largely ignored duties of fairness to would-be immigrants. It is argued here that failing to take reasonable steps to prevent unauthorized migration and stay is deeply unfair to would-be immigrants who are not in a position to bypass visa regulations. Importantly, the argument here is orthogonal to the debate as to how much and what kinds of immigration ought to be allowed

On orientational relief of inter-molecular potential and the structure of domain walls in fullerite C60

A simple planar model for an orientational ordering of threefold molecules on a triangular lattice modelling a close-packed (111) plane of fullerite is considered. The system has 3-sublattice ordered ground state which includes 3 different molecular orientations. There exist 6 kinds of orientational domains, which are related with a permutation or a mirror symmetry. Interdomain walls are found to be rather narrow. The model molecules have two-well orientational potential profiles, which are slightly effected by a presence of a straight domain wall. The reason is a stronger correlation between neighbour molecules in triangular lattice versus previously considered square lattice A considerable reduction (up to one order) of orientational interwell potential barrier is found in the core regions of essentially two-dimentional potential defects, such as a three-domain boundary or a kink in the domain wall. For ultimately uncorrelated nearest neighbours the height of the interwell barrier can be reduced even by a factor of 100.Comment: 11 pages, 13 figures, LaTeX, to appear in Low Temperature Physic

Inhibition of DUSP6 sensitizes ovarian cancer cells to chemotherapeutic agents via regulation of ERK signaling response genes

Dual specificity phosphatase 6 (DUSP6) is a protein phosphatase that deactivates extracellular-signal-regulated kinase (ERK). Since the ovarian cancer biomarker human epididymis protein 4 (HE4) interacts with the ERK pathway, we sought to determine the relationship between DUSP6 and HE4 and elucidate DUSP6’s role in epithelial ovarian cancer (EOC). Viability assays revealed a significant decrease in cell viability with pharmacological inhibition of DUSP6 using (E/Z)-BCI hydrochloride in ovarian cancer cells treated with carboplatin or paclitaxel, compared to treatment with either agent alone. Quantitative PCR was used to evaluate levels of ERK pathway response genes to BCI in combination with recombinant HE4 (rHE4), carboplatin, and paclitaxel. Expression of EGR1, a promoter of apoptosis, was higher in cells co-treated with BCI and paclitaxel or carboplatin than in cells treated with chemotherapeutic agents alone, while expression of the proto-oncogene c-JUN was decreased with co-treatment. The effect of BCI on the expression of these two genes opposed that of rHE4. Pathway focused quantitative PCR also revealed suppression of ERBB3 in cells co-treated with BCI plus carboplatin or paclitaxel. Finally, expression levels of DUSP6 in EOC tissue were evaluated by immunohistochemistry, revealing significantly increased levels of DUSP6 in serous EOC tissue compared to adjacent normal tissue. A positive correlation between HE4 and DUSP6 levels was determined by Spearman Rank correlation. In conclusion, DUSP6 inhibition sensitizes ovarian cancer cells to chemotherapeutic agents and alters gene expression of ERK response genes, suggesting that DUSP6 could plausibly function as a novel therapeutic target to reduce chemoresistance in EOC

Mathematical talent in Braille code pattern finding and invention

The recognition of patterns and creativity are two characteristics associated with mathematical talent. In this study, we analyzed these characteristics in a group of 37 mathematically talented students. The students were asked to find the pattern the Braille code had been built upon and reinvent it with the aim of making its mathematical language become more functional. Initially, the students were unable to identify the formation pattern of Braille, but after experiencing the difficulties that blind people face when reading it, they recognized the generating element and the regularity. The results were in contrast with those of a control group, and it is noted that the students with mathematical talent were more effective in using visualization to identify the regularity of the pattern and their invention proposals were more sophisticated and used less conventional mathematical content.This research is part of the R+D+I project EDU2015- 69,731-R (Spanish Government/MinEco and ERDF)

Associations of homelessness and residential mobility with length of stay after acute psychiatric admission

Background: A small number of patient-level variables have replicated associations with the length of stay (LOS) of psychiatric inpatients. Although need for housing has often been identified as a cause of delayed discharge, there has been little research into the associations between LOS and homelessness and residential mobility (moving to a new home), or the magnitude of these associations compared to other exposures. Methods: Cross-sectional study of 4885 acute psychiatric admissions to a mental health NHS Trust serving four South London boroughs. Data were taken from a comprehensive repository of anonymised electronic patient records. Analysis was performed using log-linear regression. Results: Residential mobility was associated with a 99% increase in LOS and homelessness with a 45% increase. Schizophrenia, other psychosis, the longest recent admission, residential mobility, and some items on the Health of the Nation Outcome Scales (HoNOS), especially ADL impairment, were also associated with increased LOS. Informal admission, drug and alcohol or other non-psychotic diagnosis and a high HoNOS self-harm score reduced LOS. Including residential mobility in the regression model produced the same increase in the variance explained as including diagnosis; only legal status was a stronger predictor. Conclusions: Homelessness and, especially, residential mobility account for a significant part of variation in LOS despite affecting a minority of psychiatric inpatients; for these people, the effect on LOS is marked. Appropriate policy responses may include attempts to avert the loss of housing in association with admission, efforts to increase housing supply and the speed at which it is made available, and reforms of payment systems to encourage this

Heterogeneity in Health Insurance Coverage Among US Latino Adults

We sought to determine the differences in observed and unobserved factors affecting rates of health insurance coverage between US Latino adults and US Latino adults of Mexican ancestry. Our hypothesis was that Latinos of Mexican ancestry have worse health insurance coverage than their non-Mexican Latino counterparts. The National Health Interview Survey (NHIS) database from 1999–2007 consists of 33,847 Latinos. We compared Latinos of Mexican ancestry to non-Mexican Latinos in the initial descriptive analysis of health insurance coverage. Disparities in health insurance coverage across Latino categories were later analyzed in a multivariable logistic regression framework, which adjusts for confounding variables. The Blinder-Oaxaca technique was applied to parse out differences in health insurance coverage into observed and unobserved components. US Latinos of Mexican ancestry consistently had lower rates of health insurance coverage than did US non-Mexican Latinos. Approximately 65% of these disparities can be attributed to differences in observed characteristics of the Mexican ancestry population in the US (e.g., age, sex, income, employment status, education, citizenship, language and health condition). The remaining disparities may be attributed to unobserved heterogeneity that may include unobserved employment-related information (e.g., type of employment and firm size) and behavioral and idiosyncratic factors (e.g., risk aversion and cultural differences). This study confirmed that Latinos of Mexican ancestry were less likely to have health insurance than were non-Mexican Latinos. Moreover, while differences in observed socioeconomic and demographic factors accounted for most of these disparities, the share of unobserved heterogeneity accounted for 35% of these differences