Functional performance of mobile versus fixed bearing total knee prostheses: a randomised controlled trial

PURPOSE: The primary goal of this study was to assess the difference in active flexion between patients with a mobile versus a fixed bearing, cruciate retaining, and total knee arthroplasty. The study was designed as a randomised controlled multi-centre trial. METHODS: Participants were assigned to interventions by using block-stratified, random allocation. Outcome parameters were active flexion, passive flexion, and Knee Society Score (KSS). Outcome parameters were assessed preoperatively and at 3, 6, and 12 months postoperatively by an independent nurse. RESULTS: Ninety-two patients from one centre were included, 46 in each group. Active flexion was comparable for the two groups, 99.9° for the mobile bearing group and 101° for the fixed bearing group with a baseline controlled difference of 1.0 (95% CI −3.9 to 5.8, n.s.). The Clinical KSS was comparable between the two bearing groups (Mobile 90.0 vs. fixed 92.4, n.s.). The functional KSS showed a difference that was attributable to the stair climbing subscore, which showed a difference in favour of the fixed bearing design between preoperative and 3 months (7.3 point difference; 95% CI 2.3–12.5; P = 0.005) as well as 12 months (4.8 point difference; 95% CI 0.1–9.6; P = 0.045). CONCLUSIONS: There were no short-term differences in active flexion between fixed bearing and mobile bearing total knee arthroplasty. LEVEL OF EVIDENCE: I

Rijkswaterstaat:Guardian of the Dutch Delta

Founded in 1798, Rijkswaterstaat, the Dutch government’s agency for infrastructural works, brought flood security, navigable waterways and highways to the Netherlands. It is an iconic institution within Dutch society, best known for its ‘battle against the water’. The Zuiderzee Works (1920–1968) and the Delta Works (1954–1997) brought worldwide acclaim. This chapter tells the story of a humble semi-military organization that developed into a formidable institution of civil engineers with a strong technocratic mission mystique. It also recounts the institutional crisis the agency experienced in the 1970s–1990s when it was too slow to adapt to major sociocultural and political changes. To ride the waves of change, it eventually developed several proactive adaptation strategies and reinvented its mission mystique in managerial terms. Adaptation to climate change now presents another key challenge, for which Rijkswaterstaat will have to develop a new ‘social license to operate’

Galactose inhibition of the constitutive transport of hexoses in Saccharomyces cerevisiae

The relationship between the pathways of glucose and galactose utilization in Saccharomyces cerevisiae has been studied. Galactose (which is transported and phosphorylated by inducible systems) is a strong inhibitor of the utilization of glucose, fructose and mannose (which have the same constitutive transport and phosphorylation systems). Conversely, all these three hexoses inhibit the utilization of galactose, though with poor efficiency. These cross-inhibitions only occur in yeast adapted to galactose or in galactose-constitutive mutants. The efficiency of galactose as inhibitor is even greater than the efficiencies of each of the other three hexoses to inhibit the utilization of each other. Phosphorylation is not involved in the inhibition and transport of sugars is the affected step. The cross-inhibitions between galactose and either glucose, fructose or mannose do not implicate utilization of one hexose at the expense of the other, as it occurs in the mutual interactions between the latter three sugars. it seems that, by growing the yeast in galactose, a protein component is synthesized, or alternatively modified, that once bound to either galactose or any one of the other three hexoses (glucose, fructose or mannose), cross-interacts respectively with the constitutive or the inducible transport systems, impairing their function.This work was supported by a grant (PB87-0206) from the DGICYT, Promoción General del Conocimiento.Peer Reviewe

Wet-Chemical Synthesis of 3D Stacked Thin Film Metal-Oxides for All-Solid-State Li-Ion Batteries.

By ultrasonic spray deposition of precursors, conformal deposition on 3D surfaces of tungsten oxide (WO₃) negative electrode and amorphous lithium lanthanum titanium oxide (LLT) solid-electrolyte has been achieved as well as an all-solid-state half-cell. Electrochemical activity was achieved of the WO₃ layers, annealed at temperatures of 500 °C. Galvanostatic measurements show a volumetric capacity (415 mAh·cm-3) of the deposited electrode material. In addition, electrochemical activity was shown for half-cells, created by coating WO₃ with LLT as the solid-state electrolyte. The electron blocking properties of the LLT solid-electrolyte was shown by ferrocene reduction. 3D depositions were done on various micro-sized Si template structures, showing fully covering coatings of both WO₃ and LLT. Finally, the thermal budget required for WO₃ layer deposition was minimized, which enabled attaining active WO₃ on 3D TiN/Si micro-cylinders. A 2.6-fold capacity increase for the 3D-structured WO₃ was shown, with the same current density per coated area

Giant deer (Megaloceros giganteus) diet from Mid-Weichselian deposits under the present North Sea inferred from molar-embedded botanical remains

The molar of a giant deer, Megaloceros giganteus (Blumenbach, 1799), was discovered in sandy deposits of the North Sea, about 10 km west of the present shoreline of the Netherlands. Compacted masticated plant remains were preserved in the molar's deep folds. A palaeoecological analysis of these plant remains shows the complete dominance of pollen from Artemisia (sage) and other Asteraceae Tubuliflorae (Compositae), indicating that the animal foraged in a steppe environment, and may have preferred to eat Artemisia, which contain a high level of nutrients such as calcium and phosphorous components, which are important for antler building. Radiocarbon dating indicates that the plant remains are of mid‐Weichselian age [38 570 (+300, −290) 14C a BP, Greenland Interstadial‐11]. This is the first study of the food choice of M. giganteus based on palaeoecological evidence. We hypothesize about links between the extirpation of M. giganteus at the onset of the Holocene in North‐West Europe and the transition from a landscape with highly dynamic geomorphological processes and consequently prevalence of immature and nutrient‐rich soils, to a less dynamic landscape with stable, leached and acidifying soils, and the decline of Artemisia and other calciphilous plants

Halfvortices in flat nanomagnets

We discuss a new type of topological defect in XY systems where the O(2) symmetry is broken in the presence of a boundary. Of particular interest is the appearance of such defects in nanomagnets with a planar geometry. They are manifested as kinks of magnetization along the edge and can be viewed as halfvortices with winding numbers \pm 1/2. We argue that halfvortices play a role equally important to that of ordinary vortices in the statics and dynamics of flat nanomagnets. Domain walls found in experiments and numerical simulations are composite objects containing two or more of these elementary defects. We also discuss a closely related system: the two-dimensional smectic liquid crystal films with planar boundary condition.Comment: 7 pages, 8 figures, To appear as a chapter in Les Houches summer school on Quantum Magnetis

A wider Europe? The view from Russia, Belarus and Ukraine

On the evidence of national surveys conducted between 2000 and 2006, there is a declining sense of European self-identity in the three Slavic post-Soviet republics of Russia, Belarus and Ukraine. Attitudes towards the European Union and the possibility of membership are broadly supportive, but with a substantial proportion who find it difficult to express a view, and substantial proportions are poorly informed in comparison with the general public in EU member or prospective member countries. Those who are better informed are more likely to favour EU membership and vice versa. Generally, socioeconomic characteristics (except for age and region) are relatively poor predictors of support for EU membership as compared with attitudinal variables. But ‘Europeanness’ should not be seen as a given, and much will depend on whether EU member countries emphasize what is common to east and west or establish ‘new dividing lines’ in place of those of the cold war

In vitro-Induced Human IL-10+ B Cells Do Not Show a Subset-Defining Marker Signature and Plastically Co-express IL-10 With Pro-Inflammatory Cytokines

Regulatory B cells (Breg) have been described as a specific immunological subsets in several mouse models. Identification of a human counterpart has remained troublesome, because unique plasma membrane markers or a defining transcription factor have not been identified. Consequently, human Bregs are still primarily defined by production of IL-10. In this study, we sought to elucidate if in vitro-induced human IL-10 producing B cells are a dedicated immunological subset. Using deep immune profiling by multicolor flow cytometry and t-SNE analysis, we show that the majority of cells induced to produce IL-10 co-express pro-inflammatory cytokines IL-6 and/or TNFα. No combination of markers can be identified to define human IL-10+TNFα−IL-6− B cells and rather point to a general activated B cell phenotype. Strikingly, upon culture and restimulation, a large proportion of formerly IL-10 producing B cells lose IL-10 expression, showing that induced IL-10 production is not a stable trait. The combined features of an activated B cell phenotype, transient IL-10 expression and lack of subset-defining markers suggests that in vitro-induced IL-10 producing B cells are not a dedicated subset of regulatory B cells

Patient-reported daily functioning after SARS-CoV-2 vaccinations in autoimmune neuromuscular diseases

Background and purpose: There are concerns for safety regarding SARS-CoV-2 vaccines for patients with autoimmune neuromuscular disease. We compared daily functioning using disease-specific patient-reported outcome measures (PROMs) before and after SARS-CoV-2 vaccinations. Methods: In this substudy of a prospective observational cohort study (Target-to-B!), patients with myasthenia gravis (MG), chronic inflammatory demyelinating polyneuropathy (CIDP), multifocal motor neuropathy (MMN), and idiopathic inflammatory myopathy (IIM) vaccinated against SARS-CoV-2 were included. Surveys of daily functioning (Myasthenia Gravis Activities of Daily Living, Inflammatory Rasch-Built Overall Disability Scale, Multifocal Motor Neuropathy Rasch-Built Overall Disability Scale, and Health Assessment Questionnaire-Disability Index) were sent before first vaccination and every 60 days thereafter for up to 12 months. Regression models were constructed to assess differences in PROM scores related to vaccination, compared to scores unrelated to vaccination. We also assessed the proportion of patients with deterioration of at least the minimal clinically important difference (MCID) between before first vaccination and 60 days thereafter. Results: We included 325 patients (median age = 59 years, interquartile range = 47-67, 156 [48%] female sex), of whom 137 (42%) had MG, 79 (24%) had CIDP, 43 (13%) had MMN, and 66 (20%) had IIM. PROM scores related to vaccination did not differ from scores unrelated to vaccination. In paired PROMs, MCID for deterioration was observed in three of 49 (6%) MG patients, of whom none reported a treatment change. In CIDP, MCID for deterioration was observed in eight of 29 patients (28%), of whom two of eight (25%) reported a treatment change. Conclusions: SARS-CoV-2 vaccination had no effect on daily functioning in patients with autoimmune neuromuscular diseases, confirming its safety in these patients