What is required to measure the wear of explanted metal on metal hips?

Abstract INTRODUCTION There is increasing worldwide interest in the assessment of wear in explanted hip components. This is due is part to high profile failures of orthopaedic components in the US, whilst in the UK hip resurfacings have been experiencing a higher than expected failure rate. The reasons for these failures are not well understood, with data from the NJR suggesting the 43% of MoM resurfacing failures are unexplained. Wear analysis is a vital tool in determining failure mechanisms and ultimately improving the longevity of joint replacements through improved design and manufacturing control. There are currently no relevant measurement standards for the evaluation of retrieved orthopaedic components. This paper will assess two of the most commonly used techniques namely roundness measurement and co-ordinate measurement. The advantages and disadvantages of both techniques are considered in this paper. ROUNDNESS MACHINE The Talyrond 365 is a stylus based roundness machine. The component is located on a rotating table and the stylus measures the deviation from a perfect circle as the component is slowly rotated. The Talyrond measures a single profile to an accuracy of 30 nm and up to 72,000 data points per revolution. The air spindle has a radial accuracy of <0.02 μm and the Talymin gauge a minimum resolution of 12 nm. Individual roundness profiles can be stitched together to build up 3D cylinder maps, allowing 3D pictures of sections of explanted hip components to be generated. COORDINATE MEASURING MACHINE Co-ordinate measuring machines (CMMs) have been widely used in manufacturing quality and research departments for a number of years and the CMM is recognised as a powerful and important tool capable of ascertaining geometric data from a component. The CMM used in this study was a Zeiss Prismo CMM (Carl Zeiss Ltd., Rugby, UK) with a probing error of 0.7 μm. Components are securely held in a chuck fixture arrangement and the dimensions of the component in the portion of the bearing that is unworn is ascertained through measurement. The initial measurements are used to produce a reverse engineered 3D CAD surface which represents the component ‘pre-wear’ surface. The surface of the component is then scanned and the deviation from this pre-wear surface is mapped. The maximum linear wear and wear volume are then calculated directly. DISCUSSION The main advantage of CMM and Talyrond is that they are available in most metrology and measurement rooms. The CMM is a particularly versatile machine and can be used to measure any orthopaedic components. There is a need to develop a suitable Standard for both machines detailing a protocol to measure explanted hip and quantify the wear. A study is underway to measure a set of explanted hip components to allow a detailed comparison between of measurements between the Talyrond and CMM. The result of this study will be included in the paper. CONCLUSIONS The CMM and Talyrond are both instruments suited to measuring wear of explanted hips. A full evaluation of the systems and the development of robust measurement protocol and standard would be advantageous to the orthopaedic industry

The South African estuarine specialist Codium tenue (Bryopsidales, Chlorophyta) discovered in a south-western Australian estuary

Codium tenue, previously known reliably only from estuarine habitats in South Africa, is recorded from a similar habitat in the Walpole and Nornalup Inlet system, on the south coast of Western Australia. The Australian C. tenue has a repeatedly divaricately dichotomously branched thallus to 11.5 cm in height, with markedly compressed axes up to 1 cm in width at branch dichotomies, but distally attenuating to terete branch apices. Structurally, thalli have cortices with distinctive cuneate utricles up to 1310 μm long and 650 μm in diameter. Both the habit and structural morphology essentially agree with C. tenue as known in South Africa. Sequences generated from the Australian specimens are also wholly comparable with those of South African specimens newly generated in this study. While similarly disjunct South African/Western Australian distributions are known for other algae, that of C. tenue is particularly remarkable in that the species is apparently an estuarine specialist

The pathological physiology of Gaigeria pachyscelis infestation

In two experiments, sheep under controlled conditions were artificially infested with the hookworm Gaigeria pachyscelis Railliet & Henry, 1910. The effects of the helminth infestation on the host's metabolism were monitored by a series of blood, chemical and enzyme analyses. Significant changes recorded were the development of a macrocytic normochromic anaemia, hypoproteinaemia, hypocalcaemia, hyperglycaemia and eosinophilia. The disease and death of some of the sheep were due primarily to loss of blood.The journals have been scanned in colour with a HP 5590 scanner; 600 dpi. Adobe Acrobat v.11 was used to OCR the text and also for the merging and conversion to the final presentation PDF-format

Neuropeptide Y polymorphism significantly magnifies diabetes and cardiovascular disease risk in obesity: the Hoorn Study

0.001) in the obese but not in the nonobese subjects. The results indicate that obesity may be a pivotal factor in multiplying the disease risk associated with the Leu7Pro polymorphism in preproNP

A cross-sectional study in healthy elderly subjects aimed at development of an algorithm to increase identification of Alzheimer pathology for the purpose of clinical trial participation

In the current study, we aimed to develop an algorithm based on biomarkers obtained through nonor minimally invasive procedures to identify healthy elderly subjects who have an increased risk of abnormal cerebrospinal fluid (CSF) amyloid beta42 (Aβ) levels consistent with the presence of Alzheimer’s disease (AD) pathology. The use of the algorithm may help to identify subjects with preclinical AD who are eligible for potential participation in trials with disease modifying compounds being developed for AD. Due to this pre-selection, fewer lumbar punctures will be needed, decreasing overall burden for study subjects and costs.Perioperative Medicine: Efficacy, Safety and Outcome (Anesthesiology/Intensive Care

Analysis of human performance as a measure of mental fatigue

In our day to day, we often experience a sense of being tired due to mental or physical workload. Along with that, there is also a feeling of degrading performance, even after the completion of simple tasks. These mental states however, are often not felt consciously or are ignored. This is an attitude that may result in human error, failure, and may lead to potential health problems together with a decrease in quality of life. States of acute mental fatigue may be detected with the close monitoring of certain indicators, such as productivity, performance and health indicators. In this paper, a model and prototype are proposed to detect and monitor acute acute fatigue, based on non-invasive Humancomputer Interaction (HCI). This approach will enable the development of better working environments, with an impact on the quality of life and the work produced.This work was developed in the context of the project CAMCoF - Contextaware Multimodal Communication Framework funded by ERDF - European Regional Development Fund through the COMPETE Programme (operational programme for competitiveness) and by National Funds through the FCT - Funda ção para a Ciência e a Tecnologia (Portuguese Foundation for Science and Technology) within project FCOMP-01-0124-FEDER-028980

Topological susceptibility with the improved Asqtad action

As a test of the chiral properties of the improved Asqtad (staggered fermion) action, we have been measuring the topological susceptibility as a function of quark masses for 2 + 1 dynamical flavors. We report preliminary results, which show reasonable agreement with leading order chiral perturbation theory for lattice spacing less than 0.1 fm. The total topological charge, however, shows strong persistence over Monte Carlo time.Comment: Lattice2002(algor

Comparison of the cardiometabolic profiles of adolescents conceived through ART with those of a non-ART cohort

STUDY QUESTION Is the cardiometabolic health of adolescents conceived through ART worse than that of their counterparts conceived without ART? SUMMARY ANSWER The majority of cardiometabolic and vascular health parameters of adolescents conceived through ART are similar or more favourable, than those of their counterparts of similar age and conceived without ART. WHAT IS KNOWN ALREADY It has been proposed that the cardiometabolic health of offspring conceived with ART may be unfavourable compared to that of their counterparts conceived without ART. The literature pertaining to cardiometabolic health of offspring conceived after ART is contradictory, but generally suggests unfavourable cardiometabolic health parameters, such as an increase in blood pressure (BP), vascular dysfunction and adiposity, as well as unfavourable glucose and lipid profiles. With over 8 million children and adults born through ART worldwide, it is important to investigate whether these early signs of adverse cardiometabolic differences persist into adolescence and beyond. STUDY DESIGN, SIZE, DURATION The Growing Up Healthy Study (GUHS) is a prospective cohort study that recruited 303 adolescents and young adults conceived after ART (aged 13–21 years) and born between 1991 and 2001 in Western Australia. Their health parameters, including cardiometabolic factors, were assessed and compared with counterparts from the Raine Study Generation 2 (Gen2). The 2868 Gen2 participants were born 1989–1992 and are representative of the Western Australian adolescent population. At ∼17 years of age (2013–2017), 163 GUHS participants replicated assessments previously completed by Gen2 at a similar age. PARTICIPANTS/MATERIALS, SETTING, METHODS Cardiometabolic parameters were compared between a total of 163 GUHS and 1457 Gen2 adolescents. Separate male (GUHS n = 81, Gen2 n = 735) and female (GUHS n = 82, Gen2 n = 722) analyses were conducted. Assessments consisted of a detailed questionnaire including health, lifestyle and demographic parameters, anthropometric assessments (height, weight, BMI, waist circumference and skinfold thickness), fasting serum biochemistry, arterial stiffness and BP (assessed using applanation tonometry). Abdominal ultrasonography was used to assess the presence and severity of hepatic steatosis, and thickness of abdominal fat compartments. Non-alcoholic fatty liver disease (NAFLD) was diagnosed if there was sonographic fatty liver in the absence of significant alcohol consumption. Chi2, Fisher’s exact and Mann–Whitney U tests, performed in SPSS V25, examined cohort differences and generalized estimating equations adjusted for the following covariates: singleton vs non-singleton pregnancy, birthweight (z-score), gestational age, BMI, smoking, alcohol consumption in the past 6 months and parent cardiovascular status. Arterial stiffness measures and waist circumference were additionally adjusted for height, and female analyses were additionally adjusted for use of oral contraceptives in the preceding 6 months. MAIN RESULTS AND THE ROLE OF CHANCE In adjusted analyses, GUHS females had a lower BMI (22.1 vs 23.3 kg/m2, P = 0.014), and thinner skinfolds (triceps, subscapular, mid-abdominal; 16.9 vs 18.7 mm, P = 0.021, 13.4 vs 15.0 mm, P = 0.027, 19.7 vs 23.2 mm, P < 0.001, respectively), whereas males were not significantly different. Waist circumference was lower in GUHS adolescents (males: 78.1 vs 81.3 cm, P = 0.008, females: 76.7 vs 83.3 cm, P = 0.007). There were no significant differences between the two groups in glucose, insulin, homeostatic model assessment for insulin resistance, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C), total cholesterol (TC), alanine aminotransferase and high-sensitivity C-reactive protein in both sexes. In females, serum triglycerides were lower in GUHS adolescents (1.0 vs 1.2 mmol/l, P = 0.029). GUHS males had higher serum HDL-C (1.1 vs 1.0 mmol/l, P = 0.004) and a lower TC/HDL-C ratio (3.2 vs 3.6, P = 0.036). There were no significant differences in the prevalence of NAFLD or steatosis severity scores between the cohorts in males and females. GUHS females had less subcutaneous adipose tissue (9.4 vs 17.9 mm, P < 0.001), whereas GUHS males had greater visceral adipose thickness (44.7 vs 36.3 mm, P < 0.001). There was no significant difference in pre-peritoneal adipose thickness. Pulse wave velocity was lower in GUHS males (5.8 vs 6.3 m/s, P < 0.001) and heart rate corrected augmentation index was lower in GUHS females (−8.4 vs −2.7%, P = 0.048). There were no significant differences in BP or heart rate in males or females between the two groups. LIMITATIONS, REASONS FOR CAUTION Despite the substantial study size and the unique study design of the ART cohort, we were unable to differentiate between different types of ART, due to the low number of ICSI cycles (e.g. IVF vs ICSI), draw definite conclusions, or relate the outcomes to the cause of infertility. Considering the differences in time points when both cohorts were studied, external factors could have changed, which could not be accounted for. Given the observational nature of this study, causation cannot be proven. WIDER IMPLICATIONS OF THE FINDINGS Contrary to our hypothesis and previous findings focussing mainly on childhood, this study reports mostly similar or favourable cardiometabolic markers in adolescents conceived with ART compared to those conceived without ART. The greater visceral adipose thickness, particularly present in males, requires further investigation. While these findings are generally reassuring, future well-designed and appropriately powered studies are required to definitively address the issue of cardiometabolic health in ART adults. STUDY FUNDING/COMPETING INTEREST(S) This project was supported by NHMRC project grant number 1042269 and R.J.H. received education grant funding support from Ferring Pharmaceuticals. R.J.H. is the Medical Director of Fertility Specialists of Western Australia and a shareholder in Western IVF. He has received educational sponsorship from MSD, Merck-Serono and Ferring Pharmaceuticals. P.B. is the Scientific Director of Concept Fertility Centre, Subiaco, Western Australia. J.L.Y. is the Medical Director of PIVET Medical Centre, Perth, Western Australia

Updated adolescent diagnostic criteria for polycystic ovary syndrome: impact on prevalence and longitudinal body mass index trajectories from birth to adulthood

Background: Polycystic ovary syndrome (PCOS) is challenging to diagnose. While the 2003 Rotterdam criteria are widely used for adults, the 2018 international PCOS guideline recommended updated Rotterdam criteria with both hyperandrogenism and oligo-anovulation for adolescents based on evidence-informed expert consensus. This study compared the prevalence of PCOS using updated and original Rotterdam criteria in community-based adolescents and explored long-term body mass index (BMI) trajectories across different diagnostic phenotypes. Methods: Overall, 227 postmenarchal adolescent females from the prospective cohort Raine Study undertook comprehensive PCOS assessment at age 14–16 years. Detailed anthropometric measurements were collected from birth until age 22 years. Cross-sectional and longitudinal BMI were analyzed using t tests and generalized estimating equations. Results: PCOS was diagnosed in 66 (29.1%) participants using original criteria versus 37 (16.3%) participants using updated Rotterdam criteria. Using updated criteria, participants with PCOS had higher BMI than participants without PCOS from prepubertal. Only the phenotype meeting the updated criteria was significantly associated with higher long-term BMI gain whereas other PCOS phenotypes had similar BMI trajectories to participants without PCOS (p < 0.001). Conclusions: The use of the 2018 updated Rotterdam criteria reduces over-diagnosis of PCOS in adolescents and identifies those at the greatest risk of long-term weight gain, a key contributor to disease severity and long-term health implications. The BMI trajectories of females with PCOS on updated criteria diverge prepubertally compared to those without PCOS. This work supports targeting adolescents diagnosed with PCOS on the 2018 updated criteria for early lifestyle interventions to prevent long-term health complications.Chau Thien Tay, Roger J. Hart, Martha Hickey, Lisa J. Moran, Arul Earnest, Dorota A. Doherty, Helena J. Teede and Anju E. Joha

Genetic factors and insulin secretion: gene variants in the IGF genes

IGFs are important regulators of pancreatic beta-cell development, growth, and maintenance. Mutations in the IGF genes have been found to be associated with type 2 diabetes, myocardial infarction, birth weight, and obesity. These associations could result from changes in insulin secretion. We have analyzed glucose-stimulated insulin secretion using hyperglycemic clamps in carriers of a CA repeat in the IGF-I promoter and an ApaI polymorphism in the IGF-II gene. Normal and impaired glucose-tolerant subjects (n = 237) were independently recruited from three different populations in the Netherlands and Germany to allow independent replication of associations. Both first- and second-phase insulin secretion were not significantly different between the various IGF-I or IGF-II genotypes. Remarkably, noncarriers of the IGF-I CA repeat allele had both a reduced insulin sensitivity index (ISI) and disposition index (DI), suggesting an altered balance between insulin secretion and insulin action. Other diabetes-related parameters were not significantly different for both the IGF-I and IGF-II gene variant. We conclude that gene variants in the IGF-I and IGF-II genes are not associated with detectable variations in glucose-stimulated insulin secretion in these three independent populations. Further studies are needed to examine the exact contributions of the IGF-I CA repeat alleles to variations in ISI and DI