Small Stem Total Hip Arthroplasty in Hypoplasia of the Femur

Total hip arthroplasty in hypoplastic femurs is technically difficult and the incidence of complications and aseptic loosening is relatively high. Cemented, uncemented, off-the-shelf, and custom-made stems all have been advocated in these cases. From 1978 to 1997, we performed 86 total hip arthroplasties in 77 patients with a hypoplastic femur using a cemented, off-the-shelf, small, curved, cobalt-chromium stem. We hypothesized results equaled those of the identical but larger-sized stems in normal-sized femora which were used as comparisons. Clinical and radiographic evaluations were performed. Minimum followup was 4.2 years (mean, 12 years; range, 4.2–20.3 years); mean Harris hip score was 88, and mean hip flexion was 104°. Six stems were revised: four because of aseptic loosening, one after a femoral fracture, and one because of malpositioning. Complications included one perforation and one fracture of the femur, one fracture, one nonunion of the greater trochanter, and one deep infection. Implant survivorship for all hips at 15 years with aseptic revision of the stem as the end point was 90% (confidence interval, 82–99) which equaled results of the larger stems. The small off-the-shelf cemented Weber stem has a high long-term survival and a low complication rate. Survival compares favorably with other small-sized total hip systems

Metal on metal hip resurfacing versus uncemented custom total hip replacement - early results

<p>Abstract</p> <p>Introduction</p> <p>There is no current consensus on the most appropriate prosthesis for treating symptomatic osteoarthritis (OA) of the hip in young, active patients. Modern metal on metal hip resurfacing arthroplasty (HR) has gained popularity as it is theoretically more stable, bone conserving and easier to revise than total hip arthroplasty. Early results of metal on metal resurfacing have been encouraging. We have compared two well matched cohorts of patients with regard to function, pain relief and patient satisfaction.</p> <p>Methods</p> <p>This prospective study compares 2 cohorts of young, active patients treated with hip resurfacing (137 patients, 141 hips) and custom uncemented (CADCAM) stems (134 patients, 141 hips). All procedures were performed by a single surgeon. Outcome measures included Oxford, WOMAC and Harris hip scores as well as an activity score. Statistical analysis was performed using the unpaired student's t-test.</p> <p>Results</p> <p>One hundred and thirty four and 137 patients were included in the hip replacement and resurfacing groups respectively. The mean age of these patients was 54.6 years. The mean duration of follow up for the hip resurfacing group was 19.2 months compared to 13.4 months for the total hip replacement group.</p> <p>Pre operative oxford, Harris and WOMAC scores in the THA group were 41.1, 46.4 and 50.9 respectively while the post operative scores were 14.8, 95.8 and 5.0. In the HR group, pre- operative scores were 37.0, 54.1 and 45.9 respectively compared to 15.0, 96.8 and 6.1 post operatively. The degree of improvement was similar in both groups.</p> <p>Conclusion</p> <p>There was no significant clinical difference between the patients treated with hip resurfacing and total hip arthroplasty in the short term.</p

Life Cycle Assessment of a Demonstration Project: Vehicle Use of Hydrogen-Blended Natural Gas

Hydrogen is often considered as the way out of the environmental and economical problems associated with the use of fossil fuels. However, one of the main implementation barriers is the missing infrastructure. The introduction of hydrogen-blended compressed natural gas (HCNG) as a fuel for natural gas vehicles could serve as a bridging technology by using the existing natural gas infrastructure for the distribution of hydrogen. The unique conditions on site the large petrochemical complex in Stenungsund, Sweden—a hydrogen surplus and the connection to the natural gas grid—initiated a discussion about demonstrating the vehicle use of HCNG by using an already projected natural gas filling station near the industrial area. The hydrogen surplus used in this context will be replaced by natural gas. The intended aim of this demonstration project is learning in dealing with hydrogen as a fuel for vehicles. The purpose of this thesis is to assess and compare the environmental aspects of using natural gas, HCNG with 15% and 30% hydrogen by volume, and hydrogen as vehicle fuels within the scope of the proposed demonstration project. Life Cycle Assessment is used to analyse and quantify the potential environmental impacts from the use of the considered fuels in two different types of light-duty vehicles with internal combustion engines. The results show that the environmental benefits of performing the demonstration project are limited since there are no overall benefits connected to the use of HCNG and hydrogen compared to the use of natural gas. In general, the results reveal that the potential environmental impact from the fuel supply chain considerably increases towards a hydrogen share of 100% in the fuel. Besides these environmental considerations, however, it has to be taken into account that potential environmental impacts as direct project results cannot be consulted alone, when assessing the demonstration project and deciding whether it should be performed or not. Learning should be maximised and, therefore, the assessment of the demonstration project has to be extended by focusing on the dynamics of technological change, which can be given as a suggestion for further studies

Creating Effective Online (Virtual) Learning Environments

Online learning has become ubiquitous in education. At the secondary level, online charter schools are gaining ground on traditional brick and mortar institutions. A similar evolution is occurring in higher education where online programs reduce the geographic constraint of attending degree programs. The online format has a clear financial advantage as the institution can reduce its need of physical facilities while attracting students and faculty outside of a specific geographic region. Simply posting content online does not differentiate an educational institution from a service such as Lynda.com; therefore, competition on quality of courses is expected. In order to be successful when teaching an online course, instructors need to change from traditional teaching methods to online teaching methods. Appana (2008) recognizes that limitations to online learning may be tied to the limited experiences and skills of instructors. Support mechanisms need to be in place to assist instructors in creating and teaching an online course. This may help to improve the online learning experience of students because of a resulting higher quality course. Further, Appana explains that online training with technology is vital. This includes not only how to use the technology, but to also solve technological problems. Administrative support, available technical personnel, and mentoring are also vital aspects to course success. Instructors are often thrust into online delivery formats with little to no training. Professors are seldom trained in teaching methodology let alone teaching online (Alley, 1996). Further, instructors who do not have adequate computer literacy skills will struggle with online teaching (Thurmond, 2003). One study conducted by Kosak, Manning, Dobson, Rogerson, Cotnam, Colaric, and McFadden (2004) found that the majority of faculty believed the online course training they received and participated in was adequate in terms of pedagogical and technical training. At the same time, faculty may remain reluctant to teach online courses. This research proposal seeks to measure instructor’s attitudes of preparedness to teach an online class based on training received and administrative support

Mining the Bureau of Labor and Statistics for Job Skills

The United States Bureau of Labor Statistics (www.bls.gov) provides information about occupations including growth rates, median salaries, and job descriptions. Determining which skills will be most in demand in the next decade can assist higher education in designing relevant curriculum. Determining common skills among hundreds of occupation descriptions is a tedious task which lends itself well to a technology-based solution. This applied research applies data mining and topic analysis techniques to job descriptions and duties from BLS.gov in order to extract the most relevant job skills. Job descriptions for the top growing jobs, as defined by number of new positions projected, were extracted from BLS.gov. The descriptions were then mined for the highest frequency terms to determine the skills most relevant in the next decade. Preliminary results indicate terms such as analyze, software, develop, systems, computer, technology, data, systems, and information are in the top 50 terms thereby indicating the importance of technology in the future job market

Internet of Things: Entrepreneurial Concepts

Currently, the one hottest technology trends occurring is the Internet of Things (IoT). Specifically, the IoT can be defines as a connection of sensors and machines. As such, the real value that the IoT creates is at the crosssroads of collecting data and leveraging the data to make valuable information. The data collected by sensors isn’t of value until it can be analyzed to produce valuable information. For example, icy roads are very hazardous and often times can cause injury and possible death to drivers. Providing wireless sensors in the road to detect the freezing ice and wirelessly communicate to an automobile’s sensor to slow the car down to a safe speed. The Internet of things provides a world of opportunity and innovation to occur. This presentation will define the IoT and explore underlying opportunities for innovation that can occur at the crossroads of collecting data and leveraging the data to make valuable information. Hence, establishing new entrepreneurial concepts and creating new products and services

Online Education: Status and Change

Research has shown that online education has grown leaps and bounds with the last decade, alter the way students learn, and provided opportunities for students and schools to further education beyond the boundaries of the physical school. However, with every technology change a large budgetary item also comes. Providing online education courses within public school districts is not cheap. Currently, many public school districts have been experiencing heavy budgetary problems. Has Pennsylvania’s state budget problems affected public schools’ efforts to go online? The purpose of this study was to examine the status of fully online and blended learning environments in Northeastern Pennsylvania K-12 public schools, as well as provide indicators of change

Using Simple Data Mining Techniques with a Course Management System

Research has shown that discussion forums add value to traditional and online classroom experiences. However, while many instructors embrace discussion forums to add interactivity in online courses as well as encourage class-room activity outside of class, individually reading and manually grading student discussion posts can be a daunting and time consuming process for the instructor. The purpose of this pilot research study was to utilize data mining techniques to assess asynchronous discussion forums and examine its effectiveness between those individualized manually graded

Curriculum-based measurement of oral reading (R-CBM): A diagnostic test accuracy meta-analysis of evidence supporting use in universal screening

A great deal of research over the past decade has examined the appropriateness of curriculum-based measurement of oral reading (R-CBM) in universal screening. Multiple researchers have meta-analyzed available correlational evidence, yielding support for the interpretation of R-CBM as an indicator of general reading proficiency. In contrast, researchers have yet to synthesize diagnostic accuracy evidence, which pertains to the defensibility of the use of R-CBM for screening purposes. The overall purpose of this research was to therefore conduct the first meta-analysis of R-CBM diagnostic accuracy research. A systematic search of the literature resulted in the identification of 34 studies, including 20 peer-reviewed articles, 7 dissertations, and 7 technical reports. Bivariate hierarchical linear models yielded generalized estimates of diagnostic accuracy statistics, which predominantly exceeded standards for acceptable universal screener performance. For instance, when predicting criterion outcomes within a school year (≤ 9 months), R-CBM sensitivity ranged between .80 and .83 and specificity ranged between .71 and .73. Multiple moderators of R-CBM diagnostic accuracy were identified, including the (a) R-CBM cut score used to define risk, (b) lag in time between R-CBM and criterion test administration, and (c) percentile rank corresponding to the criterion test cut score through which students were identified as either truly at risk or not at risk. Follow-up analyses revealed substantial variability of extracted cut scores within grade and time of year (i.e., fall, winter, and spring). This result called into question the inflexible application of a single cut score across contexts and suggested the potential necessity of local cut scores. Implications for practices, directions for future research, and limitations are discussed