1,356 research outputs found

    The Resolution of the Labor Scarcity Paradox

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    This paper reconciles the apparently contradictory evidence about American and British technology in the first half of the nineteenth century. Past studies have focused on the writings of a number of distinguished British engineers, who toured the United States during the 1850s and commented extensively on the highly mechanized state of the manufacturing sector. Other studies, however, have marshalled evidence that the interest rate was higher, and the aggregate manufacturing capital stock was lower, in the United States relative to Britain. We resolve this paradox by noting that British engineers were most impressed by only a few industries which relied on skilled workers. Using the 1849 Census of Manufactures, we estimate separate production functions for the skilled sector and for the remaining, less skilled manufacturing sector. We find strong relative complementarity between capital and natural resources in the skilled sector, and relative substitutability between skilled labor and capital. Using these parameters in a computable general equilibrium model of the U.S. and British economies indicates greater capital intensity (or labor scarcity) in the skilled manufacturing sector, but overall capital scarcity and higher interest rates, in the U.S. relative to Britain.

    Local Volume Effects in the Generalized Pseudopotential Theory

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    The generalized pseudopotential theory (GPT) is a powerful method for deriving real-space transferable interatomic potentials. Using a coarse-grained electronic structure, one can explicitly calculate the pair ion-ion and multi-ion interactions in simple and transition metals. Whilst successful in determining bulk properties, in central force metals the GPT fails to describe crystal defects for which there is a significant local volume change. A previous paper [PhysRevLett.66.3036 (1991)] found that by allowing the GPT total energy to depend upon some spatially-averaged local electron density, the energetics of vacancies and surfaces could be calculated within experimental ranges. In this paper, we develop the formalism further by explicitly calculating the forces and stress tensor associated with this total energy. We call this scheme the adaptive GPT (aGPT) and it is capable of both molecular dynamics and molecular statics. We apply the aGPT to vacancy formation and divacancy binding in hcp Mg and also calculate the local electron density corrections to the bulk elastic constants and phonon dispersion for which there is refinement over the baseline GPT treatment.Comment: 11 pages, 6 figure

    Broadening Responsibilities: Consideration Of The Potential To Broaden The Role Of Uniformed Fire Service Employees

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    What is this report about? This report, commissioned by the National Joint Council for Local Authority Fire and Rescue Services (NJC), aims to identify what impact, if any, firefighters can have on the delivery of emergency medical response and wider community health interventions in the UK. What are the overall conclusions? Appropriately trained and equipped firefighters co-responding1 to targeted, specific time critical medical events, such as cardiac arrest, can improve patient survival rates. The data also indicate that there is support from fire service staff – and a potential need from members of the public, particularly the elderly, isolated or vulnerable – to expand ‘wider work’. This includes winter warmth assessments, Safe and Well checks, community defibrillator training and client referrals when staff believe someone may have dementia, are vulnerable or even, for example, have substance dependencies such as an alcohol addiction. However, there is currently insufficient data to estimate the net benefit of this work

    Revision of failed hip resurfacing to total hip arthroplasty rapidly relieves pain and improves function in the early post operative period

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    We reviewed the results of 25 consecutive patients who underwent revision of a hip resurfacing prosthesis to a total hip replacement. Revisions were performed for recurrent pain and effusion, infection and proximal femoral fractures. Both components were revised in 20 cases

    Material Loss at the Head Taper Junction of the Metal-on-Metal Pinnacle Total Hip Replacement

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    Introduction The ASR XL (DePuy) total hip replacement (THR) is a notable example of a modern metal-on-metal (MOM) implant design that has demonstrated unacceptable survival rates, leading to its recall by the manufacturer; national joint registries have reported revision rates at 7 years of 40% when paired with the Corail stem [1]. The ASR XL THR has a considerably greater risk of revision than the ASR resurfacing hip, which used the same bearing design. This suggests that material loss at the head-stem junction may be responsible for the greater percentage of THR failures observed in this design. The Pinnacle MOM-THR (DePuy) however used the same Corail stem as the ASR XL THR but demonstrated better clinical results, with revision rates of less than 10% at 7 years [1]. The ASR XL and MOM Pinnacle are two designs that have been widely used in hip replacement surgery. The reasons for the differences in the failure rates of the two designs are not fully understood. Comparing the mechanisms of failure of both hips will help surgeons understand whether patients with MOM Pinnacle hips will experience the same types of problems as with those seen with the ASR XL. The aims of this retrieval study were to investigate the significance of differences between the ASR XL and MOM Pinnacle in relation to: (1) pre-revision whole blood Co/Cr ratios, (2) visual evidence of taper corrosion, (3) volumetric material loss at the bearing surfaces and (4) volumetric material loss at the taper surfaces. Methods This study involved a series of failed MOM hips consisting of the ASR XL (n=30) and Pinnacle (n=30), all that had been used with a Corail stem. The bearing material in each design was cobalt-chromium and the Corail stem is of a cementless titanium 12/14 design. The ASR XL and Pinnacle had a median head diameter of 47mm (39-55) and 36mm (36-40) respectively, and a median time to revision of 38.5 months (12-74) and 55 months (14-86) respectively. Pre-revision whole blood metal ion levels were collected for each Table 1 summarises patient and implant data for the hips in this study. The female taper surfaces of all 60 heads were examined macroscopically and microscopically to assess the severity of corrosion. Each surface was graded with a score of between 1 (no corrosion) and 4 (severe corrosion) using a well-published scoring system, which has been shown to be statistically reliable. A Zeiss Prismo (Carl Zeiss Ltd, Rugby, UK) coordinate measuring machine (CMM) was used to determine the volume of material loss at the cup and head bearing surfaces. Up to 300,000 data points were collected using a 2mm ruby stylus that was translated along 400 polar scan lines on the surface. The raw data was used to map regions of material loss by comparing with the unworn geometry of the bearing. A Talyrond 365 (Hobson, Leicester, UK) roundness measuring machine was used to measure the volumetric material loss at each of the head taper surfaces. Published protocols were used to take a series of 180 vertical traces along the taper surface using a 5μm diamond stylus; worn and unworn regions were mapped and used to calculate material loss. Neither the volumetric measurement data nor corrosion scores were normally distributed. Therefore non-parametric tests were performed to assess the statistical significance of differences between the two designs in relation to the parameters under investigation in this study. Results Both the whole blood Co ion levels and the Co/Cr ratios, Figure 1, of the ASR XL hips were significantly greater than the Pinnacles (p<0.05). There was no significant difference between the whole blood Cr ion levels between the two designs (p=0.0542). 18 of the ASR XL hips presented evidence of edge wearing of the cup, compared with 14 Pinnacle hips; this difference was not significant (p=0.438). The length of the stem trunnion contact engagement length with the taper was approximated as being 10.5mm for both designs. The median time to revision of the ASR XL hips was significantly less than the Pinnacle hips (p<0.01). There was visual evidence of corrosion in 93% (n=28) and 90% (n=27) of head tapers for the ASR XLs and Pinnacles respectively. Moderate to severe corrosion was observed in 67% (n=20) of ASR XLs compared to 60% (n=18) of Pinnacles. There was however no statistically significant difference between the scores of the two groups (p=0.927). Figure 2 presents the distribution of material loss rates for the bearing and taper surfaces of the two designs in this study. The median total bearing surface (combined cup and head) rate of material loss for the ASR XL and Pinnacle hips was 4.45mm3/year (0.32-22.85) and 4.03mm3/year (0.87-62.12) respectively. There was no significant difference between the two groups (p=0.928). The median material loss rate at the taper surfaces of the ASR XL and Pinnacle hips was 0.62mm3/year (0-4.20) and 0.30mm3/year (0-3.12); this difference was not significant (p=0.198). Discussion The work of this study presents comparisons of retrieval findings between the ASR XL and Pinnacle MOM-THRs; these hip designs were two of the most commonly implanted in patients worldwide. The significantly greater whole blood Co/Cr ratios found in the ASR XL group compared to the Pinnacle group are of interest. It is speculated that a Co/Cr ratio of greater than 1 may be an indicator of corrosion of an implant whereby more Cr ions are retained on the surface, whilst comparatively more Co ions are released into the blood. In the current study we found wear rates at the bearing surfaces of both designs to be comparable, suggesting that the significantly greater Co/Cr ratios in the ASR XL hips must be due to greater corrosion at the taper junction than the Pinnacles. Although the ASR XL hips had been implanted for a significantly shorter period of time, our visual assessment of the corrosion of the taper junctions found that corrosion scores were comparable between the two designs; indeed, a marginally greater number of ASR XL tapers had evidence of moderate to severe corrosion. This finding, coupled with the elevated Co/Cr ratios suggests that the ASR XL design is more susceptible to corrosion at the taper junction than the Pinnacle hip. We found that the median rate of material loss at the ASR XL taper was over twice that of the Pinnacle taper. Whilst not statistically significant, this difference may be due to a greater risk of corrosion at this interface in the ASR XL design. The differences in material loss and corrosion that were observed at the taper junctions may be explained by considering the larger head sizes of the ASR XL hips in comparison to the Pinnacles. It has previously been shown that increasing head size is correlated with greater visual evidence of corrosion and that increased frictional torque along the taper junction due a larger head diameter can increase the risk of fretting-corrosion. It is suggested therefore that the combination of the larger head sizes of the ASR XLs coupled with the comparatively short, rough surface of the Corail trunnion results in a cumulative effect leading to greater corrosion at the taper junction. Significance The results of the study suggest that the combination of (1) increased frictional torque in the larger ASR XLs and (2) the rough Corail trunnion surface, results in greater corrosion at the taper junction in comparison to the Pinnacle hips; this helps to explain the higher risk of revision in this hip design

    Identifying The Pattern of Material Loss at the Head-Neck Junction Wear Helps Determine the Mechanism of Failure of Metal on Metal Total Hip Replacements

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    Material loss at the Head-Neck junction accounts for a third of the total volume material loss in contemporary metal-on-metal total hip replacements. It is speculated that the material loss is the result of corrosion and mechanical wear (fretting). High volumes of material loss have been reported, especially from the head taper. There is only one report on characterizing the pattern of material loss and this was in a very small number of cases (n=5). Our aim was to identify the different material loss patterns at the head taper and their corresponding mechanisms We retrospectively analysed a series of retrieved Large Head Metal on Metal Total Hip Replacements (155 cups, 155 femoral heads and 4 stems). We measured material loss on the bearing surfaces and the head-neck junction using well-published metrology methods. Furthermore we collected patient (age, gender and time of primary/revision operations), pre-revision (cobalt and chromium blood metal ion, oxford hip score, cup orientation and implant position) implant (cup and head size, manufacturer and corrosion severity) data. Finally we used surface analysis techniques (microscopy and spectroscopy) to identify fretting, imprinting and the material composition of debris. We devised a novel four-group classification and two blinded engineers classified the material loss patterns using wear maps derived from the metrology analysis We observed four distinct patterns of taper surface material loss at our retrieval centre and we set out to characterize these types and relate them to patient, implant and clinical variables. The four groups of material loss patterns were defined as: (1) Low wear (n= 63), (2) Open-end band (n=32), (3) Stripped material loss (n=54) and (4) Coup-Countercoup (n=6) (Figure). The Interobserver Reliability Kappa score was 0.78 (p<0.001) indicating substantial agreement between the two examiners. Analysis of variables between the groups identified significantly different head sizes (highest: Group 2, p=0.000), corrosion severity (highest: Group 2, p=0.004) and time to revision (highest: Group 3, p=0.040). We identified four different material loss patterns each with its own mechanism. Corrosion was identified as the principal mechanism in Groups 1 and 3. Group 1 head-neck junctions are thought to have a better seal with less fluid ingress in the junction. Group 3 head-neck junctions are attacked by corrosion either circumferentially, or unilaterally, along the whole engagement length. Mechanically assisted corrosion was the principal mechanism in Group 2. The higher friction torque opens up the open-end part of the junction and the ingressing fluid accelerates the corrosion. Extensive fretting was also observed under the scanning electron microscope. Intra-operative surgical damage was identified as the principal mechanism in Group 4, with only 6 components. The patterns and the mechanisms of material loss at the head-neck junction contribute to the understanding of large head metal-on-metal hip replacements. As a result, better implants can be designed in the future. Clinically, these findings suggest that head size and head taper-trunnion fit are the main factors that determine the longevity of the head-neck junction. On the other hand, patients selection does not influence the integrity of the junction
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