Wear debris pseudotumor following total knee arthroplasty: a case report

<p>Abstract</p> <p>Introduction</p> <p>In patients who have undergone a total joint replacement, any mass occurring in or adjacent to the joint needs thorough investigation and a wear debris-induced cyst should be suspected.</p> <p>Case presentation</p> <p>An 81-year-old man presented with a painful and enlarging mass at the popliteal fossa and calf of his right knee. He had had a total right knee replacement seven years previously. Plain radiographs showed narrowing of the medial compartment. Magnetic resonance imaging showed a cystic lesion at the postero-medial aspect of the knee joint mimicking popliteal cyst or soft tissue sarcoma. Fine needle aspiration was non-diagnostic. A core-needle biopsy showed metallosis. Intraoperative findings revealed massive metallosis related to extensive polyethylene wear, delamination and deformation. Revision knee and patella arthroplasty was carried out after a thorough debridement of the knee joint.</p> <p>Conclusion</p> <p>Long-term follow-up is critical for patients with total joint replacement for early detection of occult polyethylene wear and prosthesis loosening. In these cases, revision arthroplasty may provide a satisfactory knee function.</p

A BDI agent architecture for the GAMA modeling and simulation platform

International audienceWith the increase of computing power and the development of user-friendly multi-agent simulation frameworks, social simulations have become increasingly realistic. However, most agent architectures in these simulations use simple reactive models. Indeed, cognitive agent architectures face two main obstacles: their complexity for the field-expert modeler, and their computational cost. In this paper, we propose a new cognitive agent architecture based on the BDI (Belief-Desire-Intention) paradigm integrated into the GAMA modeling platform and its GAML modeling language. This architecture was designed to be simple-to-use for modelers, flexible enough to manage complex behaviors, and with low computational cost. An experiment carried out with different profiles of end-users shows that the architecture is actually usable even by modelers who have little knowledge in programming and in Artificial Intelligence

SAJaS: enabling JADE-based simulations

Multi-agent systems (MAS) are widely acknowledged as an appropriate modelling paradigm for distributed and decentralized systems, where a (potentially large) number of agents interact in non-trivial ways. Such interactions are often modelled defining high-level interaction protocols. Open MAS typically benefit from a number of infrastructural components that enable agents to discover their peers at run-time. On the other hand, multi-agent-based simulations (MABS) focus on applying MAS to model complex social systems, typically involving a large agent population. Several MAS development frameworks exist, but they are often not appropriate for MABS; and several MABS frameworks exist, albeit sharing little with the former. While open agent-based applications benefit from adopting development and interaction standards, such as those proposed by FIPA, MABS frameworks typically do not support them. In this paper, a proposal to bridge the gap between MAS simulation and development is presented, including two components. The Simple API for JADE-based Simulations (SAJaS) enhances MABS frameworks with JADE-based features. While empowering MABS modellers with modelling concepts offered by JADE, SAJaS also promotes a quicker development of simulation models for JADE programmers. In fact, the same implementation can, with minor changes, be used as a large scale simulation or as a distributed JADE system. In its current version, SAJaS is used in tandem with the Repast simulation framework. The second component of our proposal consists of a MAS Simulation to Development (MASSim2Dev) tool, which allows the automatic conversion of a SAJaS-based simulation into a JADE MAS, and vice-versa. SAJaS provides, for certain kinds of applications, increased simulation performance. Validation tests demonstrate significant performance gains in using SAJaS with Repast when compared with JADE, and show that the usage of MASSim2Dev preserves the original functionality of the system. © Springer-Verlag Berlin Heidelberg 2015

Arthroplasty versus internal fixation for femoral neck fractures in the elderly

We studied 140 patients with femoral neck fractures treated from January 1999 to December 2006. There were 68 men and 72 women with a mean age of 72 years (range 60–80 years). Seventy patients were treated with closed reduction and internal fixation (group A), and 70 patients with hip arthroplasty (group B). The duration of surgery, length of hospitalization, complications, postoperative Harris hip score, and need for reoperation were recorded. Group B had significantly higher blood loss, increased surgical time and length of hospitalization compared to group A patients. The Harris hip score was significantly higher in group B at the 3, 6, and 12-month follow-up evaluations; however, the differences were no longer significant at the 24-month evaluation. The overall complications rate was 18.6% (13 patients) in group A compared to 25.7% (18 patients) in group B; this was not statistically significant (P = 0.309). A statistically significant difference was found regarding reoperation rate in group A (11.4%, eight patients) compared to group B (1.4%, one patient) (P = 0.016). Arthroplasty compared to internal fixation for displaced femoral neck fractures is associated with a significantly higher functional score and lower risk of reoperation at the cost of greater infection rates, blood loss, and operative time

A Marketplace-based Approach to Cloud Network Slice Composition Across Multiple Domains

Cloud network slicing can be defined as the process that enables isolated end-to-end and on-demand networking abstractions, which: (a) contain both cloud and network resources, and (b) are independently controlled, managed and orchestrated. This paper contributes to the vision of the NECOS project and relevant platform, that aim to address the limitations of current cloud computing infrastructures to accomplish the challenging requirements of the slicing approach. The NECOS platform implements the Slice-as-a-Service model, enabling the dynamic creation of end-to-end (E2E) slices from a set of constituent slice parts contributed from multiple domains. A challenging issue is to define the facility that implements dynamic slice resource discovery, aligned to the requirements of the slice owner or tenant, over different infrastructure providers. Here, we propose a Marketplace-based approach implementing relevant federated interactions for the resource discovery and we detail its architecture, workflows, and information model. We also present its initial implementation details and provide both quantitative and qualitative experimental results validating its main operation

GEOMORPHOLOGY, SEDIMENTOLOGY AND GEOCHEMISTRY IN THE MARINE AREA BETWEEN SIFNOS AND KIMOLOS ISLANDS, GREECE

Στην ελάχιστα μελετημένη θαλάσσια περιοχή μεταξύ των νησιών Σίφνου και Κιμώλου πραγματοποιήθηκε μια εκτεταμένη ωκεανογραφική μελέτη, με σκοπό την καταγραφή της υποθαλάσσιας μορφολογίας και των χαρακτηριστικών των επιφανειακών ιζημάτων, καθώς και της πηγής προέλευσης αυτών. Έγιναν καταγραφές με πολυδεσμικό βυθόμετρο και δειγματοληψίες επιφανειακών ιζημάτων με box corer με το Ω/Κ Αιγαίο και ακολούθησαν αναλύσεις μεγέθους κόκκων, ορυκτολογίας και γεωχημείας. Ένα μεγάλο βαθυμετρικό βύθισμα εντοπίστηκε βόρεια της Κιμώλου, με μέγιστο βάθος 743 μ., που συγκεντρώνει λεπτόκοκκα ιζήματα. Η κατανομή των ιζημάτων ως προς το μέγεθος κόκκων χαρακτηρίζεται από σταδιακή μείωση του μεγέθους από νότο προς βορρά. Η ορυκτολογική σύσταση περιλαμβάνει ασβεστίτη, Mg-ασβεστίτη, αραγωνίτη, δολομίτη, χαλαζία, Κ-άστριους, πλαγιόκλαστα, αμφίβολους και αργιλικά ορυκτά. Οι κύριες ιζηματολογικές επαρχίες που αναγνωρίστηκαν είναι 1) η ρηχή περιοχή πλησίον της Κιμώλου, με υψηλό περιεχόμενο σε Si, Al, K, Rb και Ba, 2) η βαθιά περιοχή δυτικά της Σίφνου, όπου εμφανίζεται και το μεγάλο βύθισμα, που χαρακτηρίζεται από υψηλό περιεχόμενο σε Fe, Ti, Na, Mg, S, Cr, Cu, Ni, V, Zn και 3) το στενό μεταξύ Σίφνου και Κιμώλου, με υψηλότερο περιεχόμενο σε Ca, S και Sr. Στο βύθισμα αυτό, παρατηρήθηκε σημαντικός εμπλουτισμός των ιζημάτων σε μαγγάνιο, ενώ τα οξείδια του Mn φαίνεται να προσροφούν διάφορα μέταλλα.An extensive oceanographic survey was conducted in the marine area between Kimolos and Sifnos Islands, a rather poorly-studied sector of the Aegean Sea, in order to gain better understanding of submarine geomorphological features and associated sediment provenance. Multi-beam bathymetry and surface sediment sampling with a box corer were carried out on board R/V Aegaeo, followed by grain-size analysis, XRD and XRF measurements. A large circular depression was identified north of Kimolos reaching a water depth of 743 m, filled with fine grained sediments. Surface sediment distribution is characterized by gradual decrease in grain-size from silty sand to silt in a S-N direction. The mineralogical composition comprises calcite, Mgcalcite, aragonite, dolomite, quartz, K feldspars, plagioclase, amphiboles and clay minerals. Major sediment provinces identified were: (i) the shallow sector proximal to Kimolos, characterized by higher contents in Si, Al, K, Rb and Ba; (ii) the deep area west of Sifnos, including the large depression, characterized by higher contents in Fe, Ti, Na, Mg, S, Cr, Cu, Ni, V, Zn; and (iii) the south passage between Kimolos and Sifnos, which exhibits higher Ca, S, and Sr contents. Manganese enrichment was observed in and around the bathymetric depression, where Mn oxides act efficiently as scavengers of a suite of metals

Transition phase towards psoriatic arthritis: Clinical and ultrasonographic characterisation of psoriatic arthralgia

Objective Non-specific musculoskeletal pain is common in subjects destined to develop psoriatic arthritis (PsA). We evaluated psoriatic patients with arthralgia (PsOAr) compared with psoriasis alone (PsO) and healthy controls (HCs) using ultrasonography (US) to investigate the anatomical basis for joint symptoms in PsOAr and the link between these imaging findings and subsequent PsA transition. Methods A cross-sectional prevalence analysis of clinical and US abnormalities (including inflammatory and structural lesions) in PsOAr (n=61), PsO (n=57) and HCs (n=57) was performed, with subsequent prospective follow-up for PsA development. Results Tenosynovitis was the only significant sonographic feature that differed between PsOAr and PsO (29.5% vs 5.3%, p<0.001), although synovitis and enthesitis were numerically more frequent in PsOAr. Five patients in PsOAr and one in PsO group developed PsA, with an incidence rate of 109.2/1000 person-years in PsOAr vs 13.4/1000 person-years in PsO (p=0.03). Visual Analogue Scale pain, Health Assessment Questionnaire, joint tenderness and US active enthesitis were baseline variables associated with PsA development. Conclusion Tenosynovitis was associated with arthralgia in subjects with psoriasis. Baseline US evidence of enthesitis was associated with clinical PsA development in the longitudinal analysis. These findings are relevant for enriching for subjects at risk of imminent PsA development

Association of the 894G>T polymorphism in the endothelial nitric oxide synthase gene with risk of acute myocardial infarction

Background: This study was designed to investigate the association of the 894G>T polymorphism in the eNOS gene with risk of acute myocardial infarction (AMI), extent of coronary artery disease (CAD) on coronary angiography, and in-hospital mortality after AMI. Methods: We studied 1602 consecutive patients who were enrolled in the GEMIG study. The control group was comprised by 727 individuals, who were randomly selected from the general adult population. Results: The prevalence of the Asp298 variant of eNOS was not found to be significantly and independently associated with risk of AMI (RR = 1.08, 95%CI = 0.77–1.51, P = 0.663), extent of CAD on angiography (OR = 1.18, 95%CI = 0.63–2.23, P = 0.605) and in-hospital mortality (RR = 1.08, 95%CI = 0.29–4.04, P = 0.908). Conclusion: In contrast to previous reports, homozygosity for the Asp298 variant of the 894G>T polymorphism in the eNOS gene was not found to be associated with risk of AMI, extent of CAD and in-hospital mortality after AM