Intra-Operative Experience using Magnetic Resonance Imaging (MRI) Based Patient Specific Cutting Guides during Total Knee Arthroplasty

Background. The incidence of malalignment in total knee arthroplasty(TKA) using conventional instrument has beenreported as high as 25%. A relatively new TKA system involvesthe use of a preoperative magnetic resonance image(MRI) to obtain accurate implant placement more consistently.For broad acceptance of this new technique, it iscrucial to analyze the initial intra-operative experience. Thespecific aim of this study was to evaluate the initial intra-operativeexperience of a single surgeon using this new technique. Methods. A total of 15 knees (12 patients: 6 female and 6male) were reviewed from TKA procedures using the selectedmanufacturer’s patient specific cutting guides between January2011 and April 2013 at a single institution. Patient demographicand specific parameters and intra-operative alterationsof component positioning were recorded and evaluated.Results. The preoperative plan was able to predict correctly thesize of the implanted femoral component in 87% (n = 13) andtibial component in 80% (n = 12) of the cases. However, 60% (n= 9) of cases required additional intra-operative corrections onfemoral resection, and 73% (n = 11) required an additional 2 - 4mm correction on the tibial proximal resection. Twenty percent(n = 3) required additional tibial varus/valgus correction, butthere were no tibial slope corrections for any of the 15 cases. Conclusions. The initial intra-operative experience of a singlesurgeon using current patient specific cutting guides for a selectedmanufacturer to align femoral and tibial components duringTKA has raised some concerns. We agreed with previous studiesthat caution should be taken when using patient specific cuttingguides without supportive data. The findings of this study providedadditional evidence to contest the accuracy of patient specificcutting guides with respect to the initial experience of an orthopaedicsurgeon who is trained in total joint replacement. Theresults provided more evidence to assist orthopaedic surgeonsin the decision of whether to use these patient specific systemsversus conventional TKA methods. KS J Med 2016;9(2):22-26

Prepartum Nutritional Strategies to Manage Postpartum Hypocalcemia

This information was presented at the 2015 Cornell Nutrition Conference for Feed Manufacturers, organized by the Department of Animal Science In the College of Agriculture and Life Sciences at Cornell University. Softcover copies of the entire conference proceedings may be purchased at http://ansci.cals.cornell.edu/extension-outreach/adult-extension/dairy-management/order-proceedings-resources

Reliability of Hallux Rigidus Radiographic Grading System

Introduction. The purpose of this study was to determine the inter- and intra-observer reliability of a clinical radiographic scale for hallux rigidus. Methods. A total of 80 patients were retrospectively selected from the patient population of two foot and ankle orthopaedic surgeons. Each corresponding series of radiographic images (weight-bearing anteroposterior, weight-bearing lateral, and oblique of the foot) was randomized and evaluated. Re-randomization was performed and the corresponding radiograph images re-numbered. Four orthopaedic foot and ankle surgeons graded each patient, and each rater reclassified the re-randomized radiographic images three weeks later. Results. Sixty-one out of 80 patients (76%) were included in this study. For intra-observer reliability, most of the raters showed “excellent” agreement except one rater had a “substantial” agreement. For inter-observer reliability, only 14 out of 61 cases (23%) showed total agreement between the eight readings from the four surgeons, and 11 out of the 14 cases (79%) were grade 3 hallux rigidus. One of the raters had a tendency to grade at a higher grade resulting in poorer agreement. If this rater was excluded, the results demonstrated a “substantial” agreement by using this classification. Conclusion. The hallux rigidus radiographic grading system should be used with caution. Although there is an “excellent” level of intra-observer agreement, there is only “moderate” to “substantial” level of inter-observer reliability

Research Update: Energy Strategies for Dry Cows

This information was presented at the 2014 Cornell Nutrition Conference for Feed Manufacturers, organized by the Department of Animal Science In the College of Agriculture and Life Sciences at Cornell University. Softcover copies of the entire conference proceedings may be purchased at http://ansci.cals.cornell.edu/extension-outreach/adult-extension/dairy-management/order-proceedings-resources or by calling (607)255-4285

Measuring black-hole parameters and testing general relativity using gravitational-wave data from space-based interferometers

Among the expected sources of gravitational waves for the Laser Interferometer Space Antenna (LISA) is the capture of solar-mass compact stars by massive black holes residing in galactic centers. We construct a simple model for such a capture, in which the compact star moves freely on a circular orbit in the equatorial plane of the massive black hole. We consider the gravitational waves emitted during the late stages of orbital evolution, shortly before the orbiting mass reaches the innermost stable circular orbit. We construct a simple model for the gravitational-wave signal, in which the phasing of the waves plays the dominant role. The signal's behavior depends on a number of parameters, including $\mu$, the mass of the orbiting star, $M$, the mass of the central black hole, and $J$, the black hole's angular momentum. We calculate, using our simplified model, and in the limit of large signal-to-noise ratio, the accuracy with which these quantities can be estimated during a gravitational-wave measurement. Our simplified model also suggests a method for experimentally testing the strong-field predictions of general relativity.Comment: ReVTeX, 16 pages, 5 postscript figure

Prediction of multiple infections after severe burn trauma: a prospective cohort study.

OBJECTIVE: To develop predictive models for early triage of burn patients based on hypersusceptibility to repeated infections. BACKGROUND: Infection remains a major cause of mortality and morbidity after severe trauma, demanding new strategies to combat infections. Models for infection prediction are lacking. METHODS: Secondary analysis of 459 burn patients (≥16 years old) with 20% or more total body surface area burns recruited from 6 US burn centers. We compared blood transcriptomes with a 180-hour cutoff on the injury-to-transcriptome interval of 47 patients (≤1 infection episode) to those of 66 hypersusceptible patients [multiple (≥2) infection episodes (MIE)]. We used LASSO regression to select biomarkers and multivariate logistic regression to built models, accuracy of which were assessed by area under receiver operating characteristic curve (AUROC) and cross-validation. RESULTS: Three predictive models were developed using covariates of (1) clinical characteristics; (2) expression profiles of 14 genomic probes; (3) combining (1) and (2). The genomic and clinical models were highly predictive of MIE status [AUROCGenomic = 0.946 (95% CI: 0.906-0.986); AUROCClinical = 0.864 (CI: 0.794-0.933); AUROCGenomic/AUROCClinical P = 0.044]. Combined model has an increased AUROCCombined of 0.967 (CI: 0.940-0.993) compared with the individual models (AUROCCombined/AUROCClinical P = 0.0069). Hypersusceptible patients show early alterations in immune-related signaling pathways, epigenetic modulation, and chromatin remodeling. CONCLUSIONS: Early triage of burn patients more susceptible to infections can be made using clinical characteristics and/or genomic signatures. Genomic signature suggests new insights into the pathophysiology of hypersusceptibility to infection may lead to novel potential therapeutic or prophylactic targets

Uncertainty in below-ground carbon biomass for major land covers in Southeast Asia

10.1016/j.foreco.2013.09.042Forest Ecology and Management310915-926FECM

Quantum walk on distinguishable non-interacting many-particles and indistinguishable two-particle

We present an investigation of many-particle quantum walks in systems of non-interacting distinguishable particles. Along with a redistribution of the many-particle density profile we show that the collective evolution of the many-particle system resembles the single-particle quantum walk evolution when the number of steps is greater than the number of particles in the system. For non-uniform initial states we show that the quantum walks can be effectively used to separate the basis states of the particle in position space and grouping like state together. We also discuss a two-particle quantum walk on a two- dimensional lattice and demonstrate an evolution leading to the localization of both particles at the center of the lattice. Finally we discuss the outcome of a quantum walk of two indistinguishable particles interacting at some point during the evolution.Comment: 8 pages, 7 figures, To appear in special issue: "quantum walks" to be published in Quantum Information Processin