Modified margin convergence: over-under lacing suture technique

The principle of margin convergence can be applied to rotator cuff repair to enhance the security of fixation by decreasing the mechanical strain at the margins of the tear. We describe a suture technique, over-under lacing, that reproduces the same margin convergence, with equal tissue tension across the entire surface area of the cuff. A consecutive series of patients affected by massive U-shaped rotator cuff tears were treated by this repair technique. Preoperative diagnosis, tear assessment, and grading of fatty infiltration of the cuff muscles were based on arthro-computed tomography evaluation. The technique passes 2 sutures from the medial to lateral margin of the tear, with a knotless suture anchor for tendon-to-bone fixation. The proposed technique seems to reduce tensile strain on the repaired tendon, can reconstruct the rotator cuff cable, and can attain the balanced pull of the tendon in a medial-to-lateral fashion. The over-under lacing suture technique is both simple and reproducible. This technique may achieve the goals of margin convergence with satisfactory preliminary clinical results for patients with massive rotator cuff tears

Prevalence and awareness of lower urinary tract symptoms among males in the Outpatient Clinics of Universiti Kebangsaan Malaysia Medical Centre.

This study aims to determine the prevalence of lower urinary tract symptoms (LUTS) and level of awareness among male outpatients in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). A questionnaire consisting of demographic data, questions related to knowledge, attitude and practice on BPH and the International Prostate Symptom Score (IPSS) was used for this study. Uroflowmetry and bladder scan were used to evaluate the function of the urinary tract and severity of BPH. Urine dipstick was done for glycosuria, proteinuria and haematuria. A total of 220 respondents were surveyed. The prevalence of moderately and severely symptomatic LUTS was 42.7%. The most commonly reported LUTS were nocturia (78.2%), frequency (58.2%) and incomplete emptying (44.6%). The prevalence of glycosuria, proteinuria and haematuria were 23.6%, 11.4% and 1.8% respectively. There was a significant association between increasing age with the severity of LUTS (p=0.005). Out of 102 respondents with voided urine volume greater than 150 mL, there was a significant decrease in maximum (Qmax) (p=0.039) and average (Qave) urine flow rates with every 10 years increase of age (p=0.001). The majority of respondents (59.5%) have heard of BPH before. Over 78.2% of the respondents would seek medical attention if they have LUTS with 15.9% saying they would seek traditional treatment. In conclusion, the prevalence of LUTS was high and the level of awareness was satisfactory

Narratives of therapeutic art-making in the context of marital breakdown: Older women reflect on a significant mid-life experience

This paper explores the narratives of three women aged 65-72 years. They reflected on an episode of therapeutic art-making in midlife, which addressed depression associated with marital crisis and breakdown. The narrative analysis focused upon on the ways in which participants narrated the events leading up to their participation in therapeutic art-making; the aspects of therapeutic art-making that continued to be given significance; the characters given primacy in the stories they told about their journey through therapy and marital breakdown; meanings, symbolic and otherwise, that participants ascribed to their artwork made during this turning point in their lives; and aspects of the narratives that conveyed present-day identities and artistic endeavors. The narratives revealed the complexity of the journey through marital breakdown and depression into health, and showed that therapeutic art-making could best be understood, not as a stand-alone experience, but as given meaning within the context of wider personal and social resources. Participants looked back on therapeutic art-making that occurred two decades earlier and still described this as a significant turning point in their personal development. Art as an adjunct to counselling/therapy was not only symbolically self-expressive but provided opportunity for decision-making, agency and a reformulated self-image

Collaborative research and development (R&D) for climate technology transfer and uptake in developing countries: Towards a needs driven approach

While international cooperation to facilitate the transfer and uptake of climate technologies in developing countries is an ongoing part of climate policy conversations, international collaborative R&D has received comparatively little attention. Collaborative R&D, however, could be a potentially important contributor to facilitating the transfer and uptake of climate technologies in developing countries. But the complexities of international collaborative R&D options and their distributional consequences have been given little attention to date. This paper develops a systematic approach to informing future empirical research and policy analysis on this topic. Building on insights from relevant literature and analysis of empirical data based on a sample of existing international climate technology R&D initiatives, three contributions are made. First, the paper analyses the coverage of existing collaborative R&D efforts in relation to climate technologies, highlighting some important concerns, such as a lack of coverage of lower-income countries or adaptation technologies. Second, it provides a starting point for further systematic research and policy thinking via the development of a taxonomic approach for analysing collaborative designs. Finally, it matches characteristics of R&D collaborations against developing countries’ climate technology needs to provide policymakers with guidance on how to Configure R&D collaborations to meet these needs

Clinical relevance and therapeutic potential of angiopoietin-like protein 4 in hepatocellular carcinoma

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Simulating quantum statistics with entangled photons: a continuous transition from bosons to fermions

In contrast to classical physics, quantum mechanics divides particles into two classes-bosons and fermions-whose exchange statistics dictate the dynamics of systems at a fundamental level. In two dimensions quasi-particles known as 'anyons' exhibit fractional exchange statistics intermediate between these two classes. The ability to simulate and observe behaviour associated to fundamentally different quantum particles is important for simulating complex quantum systems. Here we use the symmetry and quantum correlations of entangled photons subjected to multiple copies of a quantum process to directly simulate quantum interference of fermions, bosons and a continuum of fractional behaviour exhibited by anyons. We observe an average similarity of 93.6\pm0.2% between an ideal model and experimental observation. The approach generalises to an arbitrary number of particles and is independent of the statistics of the particles used, indicating application with other quantum systems and large scale application.Comment: 10 pages, 5 figure

Data-Driven Understanding of Smart Service Systems Through Text Mining

Smart service systems are everywhere, in homes and in the transportation, energy, and healthcare sectors. However, such systems have yet to be fully understood in the literature. Given the widespread applications of and research on smart service systems, we used text mining to develop a unified understanding of such systems in a data-driven way. Specifically, we used a combination of metrics and machine learning algorithms to preprocess and analyze text data related to smart service systems, including text from the scientific literature and news articles. By analyzing 5,378 scientific articles and 1,234 news articles, we identify important keywords, 16 research topics, 4 technology factors, and 13 application areas. We define ???smart service system??? based on the analytics results. Furthermore, we discuss the theoretical and methodological implications of our work, such as the 5Cs (connection, collection, computation, and communications for co-creation) of smart service systems and the text mining approach to understand service research topics. We believe this work, which aims to establish common ground for understanding these systems across multiple disciplinary perspectives, will encourage further research and development of modern service systems

Quantum Interference of Photon Pairs from Two Trapped Atomic Ions

We collect the fluorescence from two trapped atomic ions, and measure quantum interference between photons emitted from the ions. The interference of two photons is a crucial component of schemes to entangle atomic qubits based on a photonic coupling. The ability to preserve the generated entanglement and to repeat the experiment with the same ions is necessary to implement entangling quantum gates between atomic qubits, and allows the implementation of protocols to efficiently scale to larger numbers of atomic qubits.Comment: 4 pages, 4 figure

Persistent fluctuations in stride intervals under fractal auditory stimulation

Copyright @ 2014 Marmelat et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Stride sequences of healthy gait are characterized by persistent long-range correlations, which become anti-persistent in the presence of an isochronous metronome. The latter phenomenon is of particular interest because auditory cueing is generally considered to reduce stride variability and may hence be beneficial for stabilizing gait. Complex systems tend to match their correlation structure when synchronizing. In gait training, can one capitalize on this tendency by using a fractal metronome rather than an isochronous one? We examined whether auditory cues with fractal variations in inter-beat intervals yield similar fractal inter-stride interval variability as isochronous auditory cueing in two complementary experiments. In Experiment 1, participants walked on a treadmill while being paced by either an isochronous or a fractal metronome with different variation strengths between beats in order to test whether participants managed to synchronize with a fractal metronome and to determine the necessary amount of variability for participants to switch from anti-persistent to persistent inter-stride intervals. Participants did synchronize with the metronome despite its fractal randomness. The corresponding coefficient of variation of inter-beat intervals was fixed in Experiment 2, in which participants walked on a treadmill while being paced by non-isochronous metronomes with different scaling exponents. As expected, inter-stride intervals showed persistent correlations similar to self-paced walking only when cueing contained persistent correlations. Our results open up a new window to optimize rhythmic auditory cueing for gait stabilization by integrating fractal fluctuations in the inter-beat intervals.Commission of the European Community and the Netherlands Organisation for Scientific Research