Recovery after total hip or knee arthroplasty: physical and mental functioning

Musculoskeletal complaints are extremely common and have important consequences for the individual and society. The most prevalent chronic musculoskeletal disease is osteoarthritis (OA). OA is a disease of the articular joint and can lead to severe disability. In Western adult populations it is one of the most frequent causes of pain and stiffness, loss of function and disability. With regard to the major joints, OA is most prevalent in the knee and hip joint. In the Netherlands, in 2007 about 312,000 persons had knee OA and 238,000 persons had hip OA. Based on demographic development it is expected that the absolute number of persons with OA will increase by about 52% between 2007 and 2040. If the expected increase of patients with obesity is also taken into account, the prevalence of OA will become even greater. The initial treatment of OA consists of pain medication, physical therapy, and lifestyle recommendations. These treatments aim to suppress the symptoms and to improve or maintain functioning. When conservative treatment fails to alleviate pain and dysfunction caused by knee or hip OA, total knee arthroplasty (TKA) and total hip arthroplasty (THA) are cost-effective surgical options that can provide significant pain relief and improvement in physical functioning. The number of TKA and THA procedures performed in the Netherlands has increased substantially in the last decades. Between 1996 and 2008 the annual number of TKAs placed in the Netherlands in patients with a primary diagnosis of OA increased from 4,046 to 11,881, an increase of almost 300%. During this same period, the number of THAs placed in the Netherlands increased from 16,803 to 17,401 procedures. Because of the aging of the Western population, together with the increasing number of people with overweight and the improvements in surgical techniques, these numbers are expected to increase even further

Natural Choline from Egg Yolk Phospholipids Is More Efficiently Absorbed Compared with Choline Bitartrate; Outcomes of A Randomized Trial in Healthy Adults

Choline is a vitamin-like essential nutrient, important throughout one’s lifespan. Therefore, choline salts are added to infant formula, supplements and functional foods. However, if choline is present in a natural form, e.g. bound to phospholipids, it may be more efficiently absorbed. The study’s aim was to evaluate if choline uptake is improved after consumption of an egg yolk phospholipid drink, containing 3 g of phospholipid bound choline, compared to a control drink with 3 g of choline bitartrate. We performed a randomized, double blind, cross-over trial with 18 participants. Plasma choline, betaine and dimethylglycine concentrations were determined before and up to six hours after consumption of the drinks. The plasma choline response, as determined by the incremental area under the curve, was four times higher after consumption of the egg yolk phospholipid drink compared with the control drink (p < 0.01). Similar outcomes were also observed for choline’s main metabolites, betaine (p < 0.01) and dimethylglycine (p = 0.01). Consumption of natural choline from egg yolk phospholipids improved choline absorption compared to consumption of chemically produced choline bitartrate. This information is of relevance for the food industry, instead of adding choline-salts, adding choline from egg yolk phospholipids can improve choline uptake and positively impact health

Functional capacity and actual daily activity do not contribute to patient satisfaction after total knee arthroplasty

Abstract Background: After total knee arthroplasty (TKA) only 75-89% of patients are satisfied. Because patient satisfaction is a prime goal of all orthopaedic procedures, optimization of patient satisfaction is of major importance. Factors related to patient satisfaction after TKA have been explored, but no studies have included two potentially relevant factors, i.e. the functional capacity of daily activities and actual daily activity. This present prospective study examines whether functional capacity and actual daily activity (in addition to an extensive set of potential factors) contribute to patient satisfaction six months after TKA. Methods: A total of 44 patients were extensively examined preoperatively and six months post surgery. Functional capacity was measured with three capacity tests, focusing on walking, stair climbing, and chair rising. Actual daily activity was measured in the patient's home situation by means of a 48-hour measurement with an Activity Monitor. To establish which factors were related to patient satisfaction six months post surgery, logistic regression analyses were used to calculate odds ratios. Results: Preoperative and postoperative functional capacity and actual daily activity had no relation with patient satisfaction. Preoperatively, only self-reported mental functioning was positively related to patient satisfaction. Postoperatively, based on multivariate analysis, only fulfilled expectations regarding pain and experienced pain six months post surgery were related to patient satisfaction. Conclusions: Functional capacity and actual daily activity do not contribute to patient satisfaction after TKA. Patients with a better preoperative self-reported mental functioning, and patients who experienced less pain and had fulfilled expectations regarding pain postoperatively, were more often satisfied

Dielectric loss of boron-based dielectrics on niobium resonators

Advanced solid-state quantum bits (qubits) are likely to require a variety of dielectrics for wiring crossovers, substrates, and Josephson junctions. Microwave superconducting resonators are an excellent tool for measuring the internal dielectric loss of materials. We report the dielectric loss of boron-based dielectric films using a microwave coplanar waveguide (CPW) resonator with heterostructure geometry. Power-dependent internal quality factors of magnetron-sputtered boron carbide ( B4C ) and boron nitride (BN) were measured and are compared to silicon oxide ( SiO2 ), a common material used in wiring crossovers. The internal dielectric loss due to two-level systems for B4C , and BN is less than silicon dioxide ( SiO2 ), which demonstrates the existence of low-loss sputtered materials. We also found that niobium (Nb) CPW resonators suffer a decrease in internal quality factor after deposition of B4C at temperatures above 150 ∘C . This result is consistent with the idea that the oxidation of the surface of the superconducting metal can contribute to loss in a device

Reference models for advanced e-services

Reference models (RMs) capitalize on the experience that key functions and relationships determine a system’s main design structure which has to be established before other design details can be settled. As such RMs can play an important role in designing complex (distributed) systems, in allocating design tasks to cooperating design teams and in facilitating their communication. These roles are also eminent in standardization. This paper discusses the need for precisely defined basic architectural concepts to construct RMs, building on experience with designing the OSI-RM. We apply these concepts in the design of a number of RMs for networked applications that provide advanced eservices

Uitgebreide paronychia bij gebruik van de epidermale groeifactorreceptor-inhibitor cetuximab.

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