Secondary resurfacing of the patella in total knee arthroplasty

Anterior knee pain following primary total knee arthroplasty is common and can be difficult to treat satisfactorily. We reviewed 28 consecutive patients (29 knees) who underwent secondary resurfacing of the patella for persistent anterior knee pain and report on the results. Mean follow-up was 28 months (range12-61) with no cases lost to follow-up. Oxford knee scores, range of motion, the patient's assessment of outcome and overall satisfaction were recorded. Seventeen out of 19 (59%) felt their knee was better following patellar resurfacing, 10 out of 29 (34%) felt it was the same and two out of 29 (7%) felt it was worse. There was a significant improvement in Oxford knee scores (p < 0.001) and significant increase in patient satisfaction (p < 0.001) following secondary resurfacing. While secondary resurfacing of the patella does not provide the solution for every case of anterior knee pain following total knee joint replacement, in greater than 50% of cases it can be effective at relieving symptoms and in this series carries a low risk of worsening symptoms or complications

Spaces for smoking in a psychiatric hospital: social capital, resistance to control, and significance for 'therapeutic landscapes'

This paper reports on research framed by theories of therapeutic landscapes and the ways that the social, physical and symbolic dimensions of landscapes relate to wellbeing and healing. We focus especially on the question of how attributes of therapeutic landscapes are constructed in different ways according to the variable perspectives of individuals and groups. Through an ethnographic case study in a psychiatric hospital in the North of England we explore the perceived significance for wellbeing of ‘smoking spaces’ (where tobacco smoking is practiced in ways that may, or may not be officially sanctioned). We interpret our findings in light of literature on how smoking spaces are linked to the socio-geographical power relations that determine how smoking is organised within the hospital and how this is understood by different groups using the hospital building. We draw on qualitative research findings from discussion groups, observations, and interviews with patients, carers and staff. These focused on their views about the building design and setting of the new psychiatric hospital in relation to their wellbeing, and issues relating to smoking spaces emerged as important for many participants. Creating and managing smoking spaces as a public health measure in psychiatric hospitals is shown to be a controversial issue involving conflicting aims for health and wellbeing of patients and staff. Our findings indicate that although from a physical health perspective, smoking is detrimental, the spaces in which patients and staff smoke have social and psychological significance, providing a forum for the creation of social capital and resistance to institutional control. While the findings relate to one case study setting, the paper illustrates issues of wider relevance and contributes to an international literature concerning the tensions between perceived psychological and psychosocial benefits of smoking vs. physical harm that smoking is likely to cause. We consider the implications for hospital design and the model of care

'Therapeutic landscapes' and the importance of nostalgia, solastalgia, salvage and abandonment for psychiatric hospital design

We examine emotional reactions to changes to medical spaces of care, linked with past experiences. In this paper we draw on findings from a qualitative study of the transfer of psychiatric inpatient care from an old to a newly built facility. We show how the meanings attributed to ‘therapeutic landscapes’ from one׳s past can evoke emotions and memories, manifesting in ideas about nostalgia, solastalgia, salvage and abandonment, which can impinge on one׳s present therapeutic experience. We reflect on how consideration of these ideas might contribute to better future design of psychiatric inpatient facilities and the wellbeing of those using them

A "Littlest Higgs" Model with Custodial SU(2) Symmetry

In this note, a ``littlest higgs'' model is presented which has an approximate custodial SU(2) symmetry. The model is based on the coset space $SO(9)/(SO(5)\times SO(4))$. The light pseudo-goldstone bosons of the theory include a {\it single} higgs doublet below a TeV and a set of three $SU(2)_W$ triplets and an electroweak singlet in the TeV range. All of these scalars obtain approximately custodial SU(2) preserving vacuum expectation values. This model addresses a defect in the earlier $SO(5)\times SU(2)\times U(1)$ moose model, with the only extra complication being an extended top sector. Some of the precision electroweak observables are computed and do not deviate appreciably from Standard Model predictions. In an S-T oblique analysis, the dominant non-Standard Model contributions are the extended top sector and higgs doublet contributions. In conclusion, a wide range of higgs masses is allowed in a large region of parameter space consistent with naturalness, where large higgs masses requires some mild custodial SU(2) violation from the extended top sector.Comment: 22 pages + 8 figures; JHEP style, added references and extra discussion on size of T contributions, as well as some other minor clarifications. Version to appear in JHE

Continuous twin screw rheo-extrusion of an AZ91D magnesium alloy

© The Minerals, Metals & Materials Society and ASM International 2012The twin screw rheo-extrusion (TSRE) is designed to take advantage of the nondendritc microstructure and thixotropic characterization of semisolid-metal slurries and produce simple metal profiles directly from melts. The extrusion equipment consists of a rotor-stator high shear slurry maker, a twin screw extruder, and a die assembly. The process is continuous and has a potential for significantly saving energy, manufacturing cost, and enhancing efficiency. The present investigation was carried out to study the process performance for processing rods of an AZ91D magnesium alloy and the microstructure evolution during processing. The semisolid slurry prepared by the process was characterized by uniformly distributed nondendritic granular primary phase particles. AZ91D rods with uniform and fine microstructures and moderate mechanical properties were produced. For the given slurry making parameters, decreasing extrusion temperature was found to improve microstructures and properties. The mechanisms of particle granulation and refinement and the effect of processing parameters on process performance and thermal management are discussed. © 2012 The Minerals, Metals & Materials Society and ASM International.EPSRC (UK) and Rautomead Lt

The Green, Green Grass of Home: an archaeo-ecological approach to pastoralist settlement in central Kenya

© 2016 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This paper considers the ecological residues of pastoralist occupation at the site of Maili Sita in Laikipia, central Kenya, drawing links with the archaeological record so as to contribute a fresh approach to the ephemeral settlement sites of mobile herding communities, a methodological aspect of African archaeology that remains problematic. Variations in the geochemical and micromorphological composition of soils along transects across the site are compared with vegetation distributions and satellite imagery to propose an occupation pattern not dissimilar to contemporary Cushitic-speaking groups further north. We argue that Maili Sita exemplifies the broad migratory and cultural exchange networks in place during the mid- to late second millennium AD, with pastoralist occupants who were both physically and culturally mobile.British Academy (2002-5 Funding) European Union - Marie Curie Initiatives (EXT grant 2007-11

Chip-Firing and Rotor-Routing on Directed Graphs

We give a rigorous and self-contained survey of the abelian sandpile model and rotor-router model on finite directed graphs, highlighting the connections between them. We present several intriguing open problems.Comment: 34 pages, 11 figures. v2 has additional references, v3 corrects figure 9, v4 corrects several typo

Study of the B^0 Semileptonic Decay Spectrum at the Upsilon(4S) Resonance

We have made a first measurement of the lepton momentum spectrum in a sample of events enriched in neutral B's through a partial reconstruction of B0 --> D*- l+ nu. This spectrum, measured with 2.38 fb**-1 of data collected at the Upsilon(4S) resonance by the CLEO II detector, is compared directly to the inclusive lepton spectrum from all Upsilon(4S) events in the same data set. These two spectra are consistent with having the same shape above 1.5 GeV/c. From the two spectra and two other CLEO measurements, we obtain the B0 and B+ semileptonic branching fractions, b0 and b+, their ratio, and the production ratio f+-/f00 of B+ and B0 pairs at the Upsilon(4S). We report b+/b0=0.950 (+0.117-0.080) +- 0.091, b0 = (10.78 +- 0.60 +- 0.69)%, and b+ = (10.25 +- 0.57 +- 0.65)%. b+/b0 is equivalent to the ratio of charged to neutral B lifetimes, tau+/tau0.Comment: 14 page, postscript file also available at http://w4.lns.cornell.edu/public/CLN