Implementation and Validation of the 2013 Caprini Score for Risk Stratification of Arthroplasty Patients in the Prevention of Venous Thrombosis

© The Author(s) 2019. Appropriate chemoprophylaxis choice following arthroplasty requires accurate patient risk assessment. We compared the results of our prospective department protocol to the Caprini risk assessment model (RAM) retrospectively in this study group. Our goal was to determine whether the department protocol or the Caprini score would identify venous thromboembolism (VTE) events after total joint replacement. A secondary purpose was to validate the 2013 Caprini RAM in joint arthroplasty and determine whether patients with VTE would be accurately identified using the Caprini score. A total of 1078 patients met inclusion criteria. A Caprini score of 10 or greater is considered high risk and a score of 9 or less is considered low risk. The 2013 version of the Caprini RAM retrospectively stratified 7 of the 8 VTE events correctly, while only 1 VTE was identified with the prospective department protocol. This tool provided a consistent, accurate, and efficacious method for risk stratification and selection of chemoprophylaxis

Clan structure analysis and new physics signals in pp collisions at LHC

The study of possible new physics signals in global event properties in pp collisions in full phase space and in rapidity intervals accessible at LHC is presented. The main characteristic is the presence of an elbow structure in final charged particle MD's in addition to the shoulder observed at lower c.m. energies.Comment: 9 pages, talk given at Focus on Multiplicity (Bari, Italy, June 2004

Minimizing Induced Drag with Weight Distribution, Lift Distribution, Wingspan, and Wing-Structure Weight

Because the wing-structure weight required to support the critical wing section bending moments is a function of wingspan, net weight, weight distribution, and lift distribution, there exists an optimum wingspan and wing-structure weight are presented for rectangular wings with four different sets of design constraints. These design constraints are fixed lift distribution and net weight combined with 1) fixed maximum stress and wing loading, 2) fixed maximum deflection and wing loading, 3) fixed maximum stress and stall speed and 4) fixed maximum deflection and stall speed. For each of these analytic solutions, the optimum wing-structure weight is found to depend only on the net weight, independent of the arbitrary fixed lift distribution. Analytic solutions for optimum weight and lift distributions are also presented for the same four sets of design constraints. Depending on the design constraints, the optimum lift distribution can differ significantly from the elliptic lift distribution. Solutions for two example wing designs are presented, which demonstrate how the induced drag varies with lift distribution, wingspan, and wing-structure weight in the design space near the optimum solution. Although the analytic solutions presented here are restricted to rectangular wings, these solutions provide excellent test cases for verifying numerical algorithms used for more general multidisciplinary analysis and optimization

Does the Constitution Provide More Ballot Access Protection for Presidential Elections Than for U.S. House Elections?

Both the U.S. Constitution and The Federalist Papers suggest that voters ought to have more freedom to vote for the candidate of their choice for the U.S. House of Representatives than they do for the President or the U.S. Senate. Yet, strangely, for the last thirty-three years, the U.S. Supreme Court and lower courts have ruled that the Constitution gives voters more freedom to vote for the candidate of their choice in presidential elections than in congressional elections. Also, state legislatures, which have been writing ballot access laws since 1888, have passed laws that make it easier for minor-party and independent candidates to get on the ballot for President than for the U.S. House. As a result, voters in virtually every state invariably have far more choices on their general election ballots for the President than they do for the House. This Article argues that the right of a voter to vote for someone other than a Democrat or a Republican for the House is just as important as a voter’s right to do so for President, and that courts should grant more ballot access protection to minor-party and independent candidates for the House

Immunofluorescent spectral analysis reveals the intrathecal cannabinoid agonist, AM1241, produces spinal anti-inflammatory cytokine responses in neuropathic rats exhibiting relief from allodynia

During pathological pain, the actions of the endocannabinoid system, including the cannabinoid 2 receptor (CB2R), leads to effective anti-allodynia and modifies a variety of spinal microglial and astrocyte responses. Here, following spinal administration of the CB2R compound, AM1241, we examined immunoreactive alterations in markers for activated p38 mitogen-activated protein kinase, interleukin-1β (IL-1β), the anti-inflammatory cytokine, interleukin-10 (IL-10) as well as degradative endocannabinoid enzymes, and markers for altered glial responses in neuropathic rats. In these studies, the dorsal horn of the spinal cord and dorsal root ganglia were examined. AM1241 produced profound anti-allodynia with corresponding immunoreactive levels of p38 mitogen-activated kinase, IL-1β, IL-10, the endocannabinoid enzyme monoacylglycerol lipase, and astrocyte activation markers that were similar to nonneuropathic controls. In contrast, spinal AM1241 did not suppress the increased microglial responses observed in neuropathic rats. The differences in fluorescent markers were determined within discrete anatomical regions by applying spectral analysis methods, which virtually eliminated nonspecific signal during the quantification of specific immunofluorescent intensity. These data reveal expression profiles that support the actions of intrathecal AM1241 control pathological pain through anti-inflammatory mechanisms by modulating critical glial factors, and additionally decrease expression levels of endocannabinoid degradative enzymes

Interferon β-1a in relapsing multiple sclerosis: four-year extension of the European IFNβ-1a Dose-C omparison Study

Background: Multiple sclerosis (MS) is a chronic disease requiring long-term monitoring of treatment. Objective: To assess the four-year clinical efficacy of intramuscular (IM) IFNb-1a in patients with relapsing MS from the European IFNb-1a Dose-C omparison Study. Methods: Patients who completed 36 months of treatment (Part 1) of the European IFNb-1a Dose-C omparison Study were given the option to continue double-blind treatment with IFNb-1a 30 mcg or 60 mcg IM once weekly (Part 2). Analyses of 48-month data were performed on sustained disability progression, relapses, and neutralizing antibody (NA b) formation. Results: O f 608/802 subjects who completed 36 months of treatment, 493 subjects continued treatment and 446 completed 48 months of treatment and follow-up. IFNb-1a 30 mcg and 60 mcg IM once weekly were equally effective for up to 48 months. There were no significant differences between doses over 48 months on any of the clinical endpoints, including rate of disability progression, cumulative percentage of patients who progressed (48 and 43, respectively), and annual relapse rates; relapses tended to decrease over 48 months. The incidence of patients who were positive for NAbs at any time during the study was low in both treatment groups. Conclusion: C ompared with 60-mcg IM IFNb-1a once weekly, a dose of 30 mcg IM IFNb-1a once weekly maintains the same clinical efficacy over four years

The zonal currents and transports at 35°W in the tropical Atlantic

The total of 13 existing cross-equatorial shipboard current profiling sections taken during the WOCE period between 1990 and 2002 along 35°W are used to determine the mean meridional structure of the zonal top-to-bottom circulation between the Brazilian coast, near 5°S, and 5°N and to estimate mean transports of the individual identified shallow, intermediate and deep current branches. One of the results is that, on the equator, a mean westward Equatorial Intermediate Current below the Equatorial Undercurrent exists