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  1. Conversion total hip arthroplasty: Primary or revision total hip arthroplasty

    Science.gov (United States)

    Schwarzkopf, Ran; Baghoolizadeh, Mahta

    2015-01-01

    Total hip arthroplasty (THA) is an increasingly common procedure among elderly individuals. Although conversion THA is currently bundled in a diagnosis related group (DRG) with primary THA, there is a lack of literature supporting this classification and it has yet to be identified whether conversion THA better resembles primary or revision THA. This editorial analyzed the intraoperative and postoperative factors and functional outcomes following conversion THA, primary THA, and revision THA to understand whether the characteristics of conversion THA resemble one procedure or the other, or are possibly somewhere in between. The analysis revealed that conversion THA requires more resources both intraoperatively and postoperatively than primary THA. Furthermore, patients undergoing conversion THA present with poorer functional outcomes in the long run. Patients undergoing conversion THA better resemble revision THA patients than primary THA patients. As such, patients undergoing conversion THA should not be likened to patients undergoing primary THA when determining risk stratification and reimbursement rates. Conversion THA procedures should be planned accordingly with proper anticipation of the greater needs both in the operating room, and for in-patient and follow-up care. We suggest that conversion THA be reclassified in the same DRG with revision THA as opposed to primary THA as a step towards better allocation of healthcare resources for conversion hip arthroplasties. PMID:26601055

  2. Total elbow arthroplasty for primary osteoarthritis.

    Science.gov (United States)

    Schoch, Bradley S; Werthel, Jean-David; Sánchez-Sotelo, Joaquín; Morrey, Bernard F; Morrey, Mark

    2017-08-01

    Primary osteoarthritis of the elbow is a less common indication for total elbow arthroplasty (TEA). Higher complication rates in younger, active patients may offset short-term improvements in pain and function. The purpose of this study was to determine pain relief, functional outcomes, complications, and survival of TEA in this population. Between 1984 and 2011, 20 consecutive TEAs were performed for primary elbow osteoarthritis. Two patients died before the 2-year follow-up. Mean age at surgery was 68 years (range, 51-85 years). Outcome measures included pain, motion, Mayo Elbow Performance Score, satisfaction, complications, and reoperations. Mean follow-up was 8.9 years (range, 2-20 years). Three elbows sustained mechanical failures. Complications included intraoperative fracture (n = 2), wound irrigation and débridement (n = 1), bony ankylosis (n = 1), humeral loosening (n = 1), humeral component fracture (n = 1), and mechanical failure of a radial head component (n = 1). Fifteen elbows without mechanical failure were examined clinically. Pain improved from 3.6 to 1.5 (P  .05), with preoperative flexion contractures not improving. Mayo Elbow Performance Scores were available for 13 elbows without mechanical failure, averaging 81.5 points (range, 60-100 points); these were graded as excellent (n = 5), good (n = 2), and fair (n = 6). Subjectively, all patients without mechanical failure were satisfied. TEA represents a reliable surgical option for pain relief in patients with primary osteoarthritis. However, restoration of extension is not always obtained, indicating that more aggressive soft tissue releases or bony resection should be considered. Complications occurred in a large number of elbows, but mechanical failure was low considering the nature of this population and the length of follow-up. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  3. Interim results: fines recycle testing using the 4-inch diameter primary graphite burner

    International Nuclear Information System (INIS)

    Palmer, W.B.

    1975-05-01

    The results of twenty-two HTGR primary burner runs in which graphite fines were recycled pneumatically to the 4-inch diameter pilot-plant primary fluidized-bed burner are described. The result of the tests showed that zero fines accumulation can easily be achieved while operating at plant equivalent burn rates. (U.S.)

  4. Diagnostic Air Quality Model Evaluation of Source-Specific Primary and Secondary Fine Particulate Carbon

    Science.gov (United States)

    Ambient measurements of 78 source-specific tracers of primary and secondary carbonaceous fine particulate matter collected at four midwestern United States locations over a full year (March 2004–February 2005) provided an unprecedented opportunity to diagnostically evaluate...

  5. Application of Total Quality Management System in Thai Primary Schools

    Science.gov (United States)

    Prueangphitchayathon, Setthiya; Tesaputa, Kowat; Somprach, Kanokorn

    2015-01-01

    The present study seeks to develop a total quality management (TQM) system that can be applied to primary schools. The approach focuses on customer orientation, total involvement of all constituencies and continuous improvement. TQM principles were studied and synthesized according to case studies of the best practices in 3 primary schools (small,…

  6. The Benefits of Fine Art Integration into Mathematics in Primary School

    Science.gov (United States)

    Brezovnik, Anja

    2015-01-01

    The main purpose of the article is to research the effects of the integration of fine art content into mathematics on students at the primary school level. The theoretical part consists of the definition of arts integration into education, a discussion of the developmental process of creative mathematical thinking, an explanation of the position…

  7. False Negative Fine Needle Aspiration Biopsy Results in Primary Thyroid Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Kim, In Joong; Kim, Eun Kyung; Koh, Myoung Ju; Kwak, Jin Young; Moon, Hee Jung [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2012-06-15

    Ultrasonography-guided fine needle aspiration biopsy (US-FNA) is one of the methods used to diagnose thyroid lymphoma, but it has a relatively high false-negative rate. The authors report a case of a primary thyroid lymphoma associated with underlying lymphocytic thyroiditis that was initially misdiagnosed as lymphocytic thyroiditis based on US-FNA findings

  8. Trabecular metal acetabular components in primary total hip arthroplasty

    DEFF Research Database (Denmark)

    Laaksonen, Inari; Lorimer, Michelle; Gromov, Kirill

    2018-01-01

    Background and purpose - Trabecular metal (TM) cups have demonstrated favorable results in acetabular revision and their use in primary total hip arthroplasty (THA) is increasing. Some evidence show that TM cups might decrease periprosthetic infection (PPI) incidence. We compared the survivorship...... of TM cups with that of other uncemented cups in primary THA, and evaluated whether the use of TM cups is associated with a lower risk of PPI. Patients and methods - 10,113 primary THAs with TM cup and 85,596 THAs with other uncemented cups from 2 high-quality national arthroplasty registries were...

  9. Primary extra-cranial meningioma following total hip replacement

    Energy Technology Data Exchange (ETDEWEB)

    Campbell, T.J.; Beggs, I. [Royal Infirmary, Department of Radiology, Edinburgh (United Kingdom); Patton, J.T.; Porter, D. [Royal Infirmary, Department of Orthopaedics, Edinburgh (United Kingdom); Salter, D.M.; Al-Nafussi, A. [Royal Infirmary, Department of Pathology, Edinburgh (United Kingdom)

    2009-01-15

    A 61-year-old man presented with pain at the left hip and decreased mobility 10 years after total hip replacement. Imaging demonstrated a large destructive expansile mass adjacent to the prosthesis. Histological analysis confirmed the presence of an extra-cranial meningioma. Primary tumours after total hip replacement are rare and include soft tissue sarcomas, bone sarcomas and lymphomas. To our knowledge, no previous cases of primary extracranial meningioma have been identified. The imaging features, histology, pathogenesis and differential diagnosis are discussed. (orig.)

  10. Primary vs Conversion Total Hip Arthroplasty: A Cost Analysis

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    Chin, Garwin; Wright, David J.; Snir, Nimrod; Schwarzkopf, Ran

    2018-01-01

    Introduction Increasing hip fracture incidence in the United States is leading to higher occurrences of conversion total hip arthroplasty (THA) for failed surgical treatment of the hip. In spite of studies showing higher complication rates in conversion THA, the Centers for Medicare and Medicaid services currently bundles conversion and primary THA under the same diagnosis-related group. We examined the cost of treatment of conversion THA compared with primary THA. Our hypothesis is that conversion THA will have higher cost and resource use than primary THA. Methods Fifty-one consecutive conversion THA patients (Current Procedure Terminology code 27132) and 105 matched primary THA patients (Current Procedure Terminology code 27130) were included in this study. The natural log-transformed costs for conversion and primary THA were compared using regression analysis. Age, gender, body mass index, American Society of Anesthesiologist, Charlson comorbidity score, and smoker status were controlled in the analysis. Conversion THA subgroups formed based on etiology were compared using analysis of variance analysis. Results Conversion and primary THAs were determined to be significantly different (P conversion THA has significantly greater cost and resource use than primary THA. In order to prevent disincentives for treating these complex surgical patients, reclassification of conversion THA is needed, as they do not fit together with primary THA. PMID:26387923

  11. On a fine structure of a primary impulse of a magnetic storm sudden commencement

    International Nuclear Information System (INIS)

    Parkhomov, V.A.

    1985-01-01

    A fine structure of a primary reverse impulse of a sudden commencement (SSC*) of a magnetic storm is analyzed. 200 cases of SSC* recorded in 1965-79 have been chosen for the investigation. It is shown that the preliminary impulse of the sudden copmencement of magnetic storms has a fine structure in the form of the train of damped oscillations in Pc2-3 range of < or approximately 2 min durations. The excitation of oscillations is related with the propagation of the fast magnetoacoustic wave which is generated during interaction of the interplanetary shock wave with the earth magnetosphere

  12. International survey of primary and revision total knee replacement

    NARCIS (Netherlands)

    Kurtz, Steven M.; Ong, Kevin L.; Lau, Edmund; Widmer, Marcel; Maravic, Milka; Gomez-Barrena, Enrique; de Pina, Maria de Fatima; Manno, Valerio; Torre, Marina; Walter, William L.; de Steiger, Richard; Geesink, Rudolph G. T.; Peltola, Mikko; Roeder, Christoph

    2011-01-01

    Total knee arthroplasty (TKA) is currently the international standard of care for treating degenerative and rheumatologic knee joint disease, as well as certain knee joint fractures. We sought to answer the following three research questions: (1) What is the international variance in primary and

  13. Incidence of Early Post Operative Infection after Primary Total Knee ...

    African Journals Online (AJOL)

    Incidence of Early Post Operative Infection after. Primary Total Knee Arthroplasty at an East African. Centre. Kigera JWM1, Kimpiatu P2. 1. School of Medicine, University of Nairobi. 2. PCEA Kikuyu Hospital. Correspondence to: Dr James Kigera, P.O Box 30197 – 00100 Nairobi. Email: jameskigera@yahoo.co.uk. Abstract.

  14. Total Quality Management Practices in Turkish Primary Schools

    Science.gov (United States)

    Toremen, Fatih; Karakus, Mehmet; Yasan, Tezcan

    2009-01-01

    Purpose: The purpose of this paper is to determine the extent of total quality management (TQM) practices in primary schools based on teachers' perceptions, and how their perceptions are related to different variables. Design/methodology/approach: In this study, a survey based descriptive scanning model was used. This study was carried out in…

  15. Midflexion instability in primary total knee replacement: a review

    Directory of Open Access Journals (Sweden)

    Ramappa Manjunath

    2015-01-01

    Full Text Available Introduction: Midflexion instability in primary total knee replacement (TKR is an evolving concept. Successful treatment of instability requires an understanding of the different types of instability. Methods: A literature review was performed to identify information pertinent to midflexion instability in primary total knee replacement, utilising PRISMA guidelines. Databases searched included Embase, Medline, All of the Cochrane Library, PubMed and cross references. Results: Three factors, i.e., elevated joint line, multiradii femoral component and medial collateral ligament (MCL laxity, were identified to influence midflexion instability. Literature suggested mediolateral instability at 30–60° of flexion as diagnostic of midflexion instability. Literature search also revealed paucity in clinical studies analysing midflexion instability. Most of the evidence was obtained from cadaveric studies for elevated joint line and MCL laxity. Clinical studies on multiradii femoral component were limited by their small study size and early followup period. Conclusion: Elevated joint line, multiradii femoral component and MCL laxity have been suggested to cause midflexion laxity in primary TKR. Due to limitations in available evidence, this review was unable to raise the strength of overall evidence. Future well-designed clinical studies are essential to make definitive conclusions. This review serves as a baseline for future researchers and creates awareness for routine assessment of midflexion instability in primary total knee replacement.

  16. Total thyroidectomy as primary elective procedure in multinodular thyroid disease

    International Nuclear Information System (INIS)

    Sheikh, I.A.; Haider, I.Z.; Haroon, A.; Ashfaq, M.

    2009-01-01

    Multinodular goitre is one of the commonest thyroid diseases encountered in the practice of surgery. The most common surgery being performed for multinodular goitre is subtotal thyroidectomy. Total thyroidectomy is designed to remove all of the thyroid tissue. The objective of this study was to evaluate total thyroidectomy as a primary elective procedure for treatment of multinodular thyroid disease. This descriptive study was carried out at Combined Military Hospital Rawalpindi from June 2003 to September 2006. 88 patients of multinodular thyroid disease were included. Patients having evidence of recurrent laryngeal nerve damage, recurrent goitre, evidence of altered parathyroid functions or evidence of malignancy were excluded. All patients underwent total thyroidectomy by the same team of surgeons and the patients were closely followed up for postoperative complications especially in terms of recurrent laryngeal nerve damage and hypocalcaemic tetany. No major postoperative complication was noted. Only 1 patient (1.14%) developed unilateral recurrent laryngeal nerve damage and 2 patients (2.27%) developed transient hypocalcaemia that recovered quickly. Total thyroidectomy as a primary elective procedure in multinodular thyroid disease is a safe option and it removes the disease process completely, lowers local recurrence rates and avoids the substantial risks of re operative surgery. (author)

  17. The Benefits of Fine Art Integration into Mathematics in Primary School

    Directory of Open Access Journals (Sweden)

    Anja Brezovnik

    2015-09-01

    Full Text Available The main purpose of the article is to research the effects of the integration of fine art content into mathematics on students at the primary school level. The theoretical part consists of the definition of arts integration into education, a discussion of the developmental process of creative mathematical thinking, an explanation of the position of art and mathematics in education today, and a summary of the benefits of arts integration and its positive effects on students. The empirical part reports on the findings of a pedagogical experiment involving two different ways of teaching fifth-grade students: the control group was taught mathematics in a traditional way, while the experimental group was taught with the integration of fine art content into the mathematics lessons. At the end of the teaching periods, four mathematics tests were administered in order to determine the difference in knowledge between the control group and the experimental group. The results of our study confirmed the hypotheses, as we found positive effects of fine art integration into mathematics, with the experimental group achieving higher marks in the mathematics tests than the control group. Our results are consistent with the findings of previous research and studies, which have demonstrated and confirmed that long-term participation in fine art activities offers advantages related to mathematical reasoning, such as intrinsic motivation, visual imagination and reflection on how to generate creative ideas.

  18. The role of hinges in primary total knee replacement.

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    Gehrke, T; Kendoff, D; Haasper, C

    2014-11-01

    The use of hinged implants in primary total knee replacement (TKR) should be restricted to selected indications and mainly for elderly patients. Potential indications for a rotating hinge or pure hinge implant in primary TKR include: collateral ligament insufficiency, severe varus or valgus deformity (>20°) with necessary relevant soft-tissue release, relevant bone loss including insertions of collateral ligaments, gross flexion-extension gap imbalance, ankylosis, or hyperlaxity. Although data reported in the literature are inconsistent, clinical results depend on implant design, proper technical use, and adequate indications. We present our experience with a specific implant type that we have used for over 30 years and which has given our elderly patients good mid-term results. Because revision of implants with long cemented stems can be very challenging, an effort should be made in the future to use shorter stems in modular versions of hinged implants. ©2014 The British Editorial Society of Bone & Joint Surgery.

  19. Mathematical modeling of atmospheric fine particle-associated primary organic compound concentrations

    Science.gov (United States)

    Rogge, Wolfgang F.; Hildemann, Lynn M.; Mazurek, Monica A.; Cass, Glen R.; Simoneit, Bernd R. T.

    1996-08-01

    An atmospheric transport model has been used to explore the relationship between source emissions and ambient air quality for individual particle phase organic compounds present in primary aerosol source emissions. An inventory of fine particulate organic compound emissions was assembled for the Los Angeles area in the year 1982. Sources characterized included noncatalyst- and catalyst-equipped autos, diesel trucks, paved road dust, tire wear, brake lining dust, meat cooking operations, industrial oil-fired boilers, roofing tar pots, natural gas combustion in residential homes, cigarette smoke, fireplaces burning oak and pine wood, and plant leaf abrasion products. These primary fine particle source emissions were supplied to a computer-based model that simulates atmospheric transport, dispersion, and dry deposition based on the time series of hourly wind observations and mixing depths. Monthly average fine particle organic compound concentrations that would prevail if the primary organic aerosol were transported without chemical reaction were computed for more than 100 organic compounds within an 80 km × 80 km modeling area centered over Los Angeles. The monthly average compound concentrations predicted by the transport model were compared to atmospheric measurements made at monitoring sites within the study area during 1982. The predicted seasonal variation and absolute values of the concentrations of the more stable compounds are found to be in reasonable agreement with the ambient observations. While model predictions for the higher molecular weight polycyclic aromatic hydrocarbons (PAH) are in agreement with ambient observations, lower molecular weight PAH show much higher predicted than measured atmospheric concentrations in the particle phase, indicating atmospheric decay by chemical reactions or evaporation from the particle phase. The atmospheric concentrations of dicarboxylic acids and aromatic polycarboxylic acids greatly exceed the contributions that

  20. Primary total hip replacement versus hip resurfacing - hospital considerations.

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    Ward, William G; Carter, Christina J; Barone, Marisa; Jinnah, Riyaz

    2011-01-01

    Multiple factors regarding surgical procedures and patient selection affect hospital staffing needs as well as hospital revenues. In order to better understand the potential impact on hospitals that hip arthroplasty device selection (standard total hip arthroplasty vs. resurfacing) creates, a review of all primary hip arthroplasties performed at one institution was designed to identify factors that impacted hospital staffing needs and revenue generation. All primary hip arthroplasties undertaken over three fiscal years (2008 to 2010) were reviewed, utilizing only hospital business office data and medical records data that had been previously extracted prior for billing purposes. Analysis confirmed differing demographics for two hip arthroplasty populations, with the resurfacing patients (compared to the conventional total hip arthroplasty population) consisting of younger patients (mean age, 50 vs. 61 years), who were more often male (75% vs. 45%), were more likely to have osteoarthritis as their primary diagnosis (83 vs. 67%) and were more often covered by managed care or commercial insurance (83 vs. 34%). They also had shorter hospital stays (mean length of stay, 2.3 vs. 4.1 days) and consequently provided a more favorable financial revenue stream to the hospital on a per patient basis. Several trends appeared during the study periods. There was a steady increase in all procedures in all groups except for the resurfacings, which decreased 26% in males and 53% in females between 2009 and 2010. Differences were observed in the demographics of patients presenting for resurfacing, compared to those presenting for conventional total hip arthroplasty. In addition to the revenue stream considerations, institutions undertaking a resurfacing program must commit the resources and planning in order to rehabilitate these patients more expeditiously than is usually required with conventional hip arthroplasty patients.

  1. Primary cemented total hip arthroplasty: 10 years follow-up

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    Nath Rajendra

    2010-01-01

    Full Text Available Background: Primary cemented total hip arthroplasty is a procedure for non-traumatic and traumatic affections of the hip. Long term follow-up is required to assess the longevity of the implant and establish the procedure. Indo-Asian literature on long term result of total hip arthroplasty is sparse. We present a 10-year follow-up of our patients of primary cemented total hip arthroplasty. Materials and Methods: We operated 31 hips in 30 patients with primary cemented total hip arthroplasty. We followed the cases for a minimum period of 10 years with a mean follow-up period of 12.7 years. The mean age of the patients was 60.7 years (range 37-82 yrs male to female ratio was 2:1. The clinical diagnoses included - avascular necrosis of femoral head (n=15, sero positive rheumatoid arthritis (n=5, seronegative spondylo-arthropathy (n=4, neglected femoral neck fractures (n=3, healed tubercular arthritis (n=2 and post traumatic osteoarthritis of hip (n=2. The prostheses used were cemented Charnley′s total hip (n=12 and cemented modular prosthesis (n=19. The results were assessed according to Harris hip score and radiographs taken at yearly intervals. Results: The mean follow-up is 12.7 yrs (range 11-16 yrs Results in all operated patients showed marked improvement in Harris hip score from preoperative mean 29.2 to 79.9 at 10 years or more followup. However, the non-inflammatory group showed more sustained long term improvement as compared to the inflammatory group, as revealed by the Harris hip score. Mean blood loss was 450ml (±3.7 ml, mean transfusion rate was 1.2 units (±.3. The complications were hypotension (n=7, shortening> 1.5 cm (n=9, superficial infection (n=2 and malposition of prosthesis (n=1. Conclusion: The needs of Indian Asian patients, vary from what is discussed in literature. The pain tolerance is greater than western population and financial constraints are high. Thus revision surgery among Indian-Asian patients is less compared

  2. Molecular characterization of primary humic-like substances in fine smoke particles by thermochemolysis-gas chromatography-mass spectrometry

    Science.gov (United States)

    Fan, Xingjun; Wei, Siye; Zhu, Mengbo; Song, Jianzhong; Peng, Ping'an

    2018-05-01

    In this study, the molecular structures of primary humic-like substances (HULIS) in fine smoke particles emitted from the combustion of biomass materials (including rice straw, corn straw, and pine branches) and coal, and atmospheric HULIS were determined by off-line tetramethylammonium hydroxide thermochemolysis coupled with gas chromatography and mass spectrometry (TMAH-GC/MS). A total of 89 pyrolysates were identified by the thermochemolysis of primary and atmospheric HULIS. The main groups were polysaccharide derivatives, N-containing compounds, lignin derivatives, aromatic acid methyl ester, aliphatic acid methyl ester, and diterpenoid derivatives. Both the type and distribution of pyrolysates among primary HULIS were comparable to those in atmospheric HULIS. This indicates that primary HULIS from combustion processes are important contributors to atmospheric HULIS. Some distinct differences were also observed. The aromatic compounds, including lignin derivatives and aromatic acid methyl ester, were the major pyrolysates (53.0%-84.9%) in all HULIS fractions, suggesting that primary HULIS significantly contributed aromatic structures to atmospheric HULIS. In addition, primary HULIS from biomass burning (BB) contained a relatively high abundance of lignin and polysaccharide derivatives, which is consistent with the large amounts of lignin and cellulose structures contained in biomass materials. Aliphatic acid methyl ester and benzyl methyl ether were prominent pyrolysates in atmospheric HULIS. Moreover, some molecular markers of specific sources were obtained from the thermochemolysis of primary and atmospheric HULIS. For example, polysaccharide derivatives, pyridine and pyrrole derivatives, and lignin derivatives can be used as tracers of fresh HULIS emitted from BB. Diterpenoid derivatives are important markers of HULIS from pine wood combustion sources. Finally, the differences in pyrolysate types and the distributions between primary and atmospheric HULIS

  3. Primary Total Knee Replacement: Is Suction a Portal of Infection?

    Science.gov (United States)

    Budnar, Vijaya M; Amirfeyz, Rouin; Ng, Michael; Bannister, Gordon C; Blom, Ashley W

    2009-01-01

    INTRODUCTION Pulsed lavage during a total knee replacement usually leaves a pool of fluid on the surgical drapes. It is common practice to suck away this fluid using the same suction device used intra-operatively. This could be a cause of direct wound contamination. We hypothesised that bacteria contaminate fluid that collects around the foot in total knee replacement surgery and that suction equipment could be a portal of contamination. We also hypothesised that bacterial count in the fluid is lower if chlorhexidine, rather than saline, is used in the pulsed lavage. PATIENTS AND METHODS Forty patients undergoing primary total knee replacement were divided into two groups. The first group had pulsed lavage with normal saline and the second with 0.05% chlorhexidine. RESULTS At the end of the operation, 20 ml of fluid, pooled on the surgical drapes was aspirated and cultured for bacterial growth. None of the fluid samples showed bacterial growth. CONCLUSIONS Suction device used peri-operatively during knee replacement is unlikely to be a cause of wound contamination. Pulsed lavage with normal saline is as effective as lavage with chlorhexidine. PMID:19335972

  4. Fine Motor Skills Predict Maths Ability Better than They Predict Reading Ability in the Early Primary School Years

    Science.gov (United States)

    Pitchford, Nicola J.; Papini, Chiara; Outhwaite, Laura A.; Gulliford, Anthea

    2016-01-01

    Fine motor skills have long been recognized as an important foundation for development in other domains. However, more precise insights into the role of fine motor skills, and their relationships to other skills in mediating early educational achievements, are needed to support the development of optimal educational interventions. We explored concurrent relationships between two components of fine motor skills, Fine Motor Precision and Fine Motor Integration, and early reading and maths development in two studies with primary school children of low-to-mid socio-economic status in the UK. Two key findings were revealed. First, despite being in the first 2 years of primary school education, significantly better performance was found in reading compared to maths across both studies. This may reflect the protective effects of recent national-level interventions to promote early literacy skills in young children in the UK that have not been similarly promoted for maths. Second, fine motor skills were a better predictor of early maths ability than they were of early reading ability. Hierarchical multiple regression revealed that fine motor skills did not significantly predict reading ability when verbal short-term memory was taken into account. In contrast, Fine Motor Integration remained a significant predictor of maths ability, even after the influence of non-verbal IQ had been accounted for. These results suggest that fine motor skills should have a pivotal role in educational interventions designed to support the development of early mathematical skills. PMID:27303342

  5. Fine motor skills predict maths ability better than they predict reading ability in the early primary school years

    Directory of Open Access Journals (Sweden)

    Nicola J. Pitchford

    2016-05-01

    Full Text Available Fine motor skills have long been recognised as an important foundation for development in other domains. However, more precise insights into the role of fine motor skills, and their relationships to other skills in mediating early educational achievements, are needed to support the development of optimal educational interventions. We explored concurrent relationships between two components of fine motor skills, Fine Motor Precision and Fine Motor Integration, and early reading and maths development in two studies with primary school children of low-to-mid socio-economic status in the U.K. Two key findings were revealed. First, despite being in the first two years of primary school education, significantly better performance was found in reading compared to maths across both studies. This may reflect the protective effects of recent national-level interventions to promote early literacy skills in young children in the U.K. that have not been similarly promoted for maths. Second, fine motor skills were a better predictor of early maths ability than they were of early reading ability. Hierarchical multiple regression revealed that fine motor skills did not significantly predict reading ability when verbal short-term memory was taken into account. In contrast, Fine Motor Integration remained a significant predictor of maths ability, even after the influence of non-verbal IQ had been accounted for. These results suggest that fine motor skills should have a pivotal role in educational interventions designed to support the development of early mathematical skills.

  6. Fine Motor Skills Predict Maths Ability Better than They Predict Reading Ability in the Early Primary School Years.

    Science.gov (United States)

    Pitchford, Nicola J; Papini, Chiara; Outhwaite, Laura A; Gulliford, Anthea

    2016-01-01

    Fine motor skills have long been recognized as an important foundation for development in other domains. However, more precise insights into the role of fine motor skills, and their relationships to other skills in mediating early educational achievements, are needed to support the development of optimal educational interventions. We explored concurrent relationships between two components of fine motor skills, Fine Motor Precision and Fine Motor Integration, and early reading and maths development in two studies with primary school children of low-to-mid socio-economic status in the UK. Two key findings were revealed. First, despite being in the first 2 years of primary school education, significantly better performance was found in reading compared to maths across both studies. This may reflect the protective effects of recent national-level interventions to promote early literacy skills in young children in the UK that have not been similarly promoted for maths. Second, fine motor skills were a better predictor of early maths ability than they were of early reading ability. Hierarchical multiple regression revealed that fine motor skills did not significantly predict reading ability when verbal short-term memory was taken into account. In contrast, Fine Motor Integration remained a significant predictor of maths ability, even after the influence of non-verbal IQ had been accounted for. These results suggest that fine motor skills should have a pivotal role in educational interventions designed to support the development of early mathematical skills.

  7. Total elbow arthroplasty in primary osteoarthritis of the elbow.

    Science.gov (United States)

    Kozak, T K; Adams, R A; Morrey, B F

    1998-10-01

    Primary osteoarthritis of the elbow is an infrequent condition typically managed by some form of debridement. There is no comment in the literature regarding prosthetic replacement for this condition. We report 5 patients (mean age, 68), with a minimum assessment of 3 years (range, 37-125 years) after total elbow arthroplasty. Complications in 4 patients included subluxation, fracture of a humeral component with particulate synovitis, heterotopic ossification, recurrent osteophyte formation, and transient ulnar neuropathy. Although revision was required in 2 of the 5, currently all experience had satisfactory outcomes. While replacement has proven ultimately to be a successful option for this high-demand patient group because of the high complication rate, we do not recommend replacement unless alternate operative options are deemed unacceptable.

  8. Clinical outcome after treatment of infected primary total knee arthroplasty

    DEFF Research Database (Denmark)

    Husted, Henrik; Jensen, Tim Toftgaard

    2002-01-01

    Twenty-six consecutive cases of infected primary total knee arthroplasties were treated at our institution from 1989 through 2000. Eleven patients had debridement and irrigation performed within 2 months of index arthroplasty or hematogenous spread; only one infection was eradicated. Twenty......-five patients had their prostheses removed; 17 had two-stage revision arthroplasty, following which infection was eradicated in 15; one had a permanent spacer, 7 had arthrodesis (following failed revision arthroplasty in one) and 2 had a femur amputation (following failed revision arthroplasty in one) at follow......-up of mean 24 months. Infections were cured equally well with revision arthroplasty and arthrodesis. Among the 15 patients who ended up with revision arthroplasty, 11 had a better range of motion compared to the index arthroplasty, but 8 had daily pain. We present our treatment protocol, which eradicated 15...

  9. Cytology of primary vaginal melanoma: An unusual report on fine needle aspiration.

    Science.gov (United States)

    Agarwal, Poojan; Kaushal, Manju

    2017-03-01

    Primary malignant melanoma of the vagina is an extremely uncommon malignancy comprising of less than 10% malignancies of the female genital tract and 0.3% of all melanomas. Melanoblasts are neural crest derivatives and are notorious for causing primary cutaneous neoplasms. However, they involve virtually every organ of the body including eye, intestines and ocular mucosa, probably due to aberrancies in cell migration. Vagina is a rare site and primary melanoma of the vagina occurs in postmenopausal women with vaginal discharge, bleeding, or mass as common presenting complaints. Only a handful of case reports are available describing this entity on biopsy and PAP smear samples; however, fine needle aspiration has seldom been discussed. In the present report we discuss a case of an elderly female who complained of mass protruding through the vaginal opening, FNAC was done from the mass as well as from the right inguinal lymph node. An extensive clinicoradiological workup, and immunohistochemical confirmation is essential to rule out metastatic lesions and confirm primary. Diagn. Cytopathol. 2017;45:252-256. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. Patient dissatisfaction with rehabilitation following primary total knee arthroplasty.

    Science.gov (United States)

    Johnson, Aaron J; Issa, Kimona; Naziri, Qais; Harwin, Steven F; Bonutti, Petter M; Mont, Michael A

    2013-12-01

    Most patients who receive a total knee arthroplasty (TKA) undergo rehabilitation in the postoperative period. However, these therapies are often not under the direct supervision of the treating physicians, have variable protocols, and have unclear long-term efficacies. The purposes of this study were to assess patient satisfaction with their rehabilitation following TKA and to evaluate whether various factors were different between satisfied and unsatisfied patients. A total of 100 consecutive patients who underwent 107 primary TKA were prospectively surveyed to evaluate their rehabilitation experiences. There were 28 men and 72 women who had a mean age of 61 years (range, 37 to 91 years) at the time of surgery. Patients answered questions regarding the number and duration of therapies, amount of hands-on time with the therapists, number of different therapists, amount of co-pay, and their overall level of satisfaction with their rehabilitation experience. Over one-third of the patients reported not being satisfied with their rehabilitation experiences. The patients who were dissatisfied reported a shorter mean duration of each therapy session spent directly with the therapist, a higher mean number of therapists seen over the duration of their treatment, and an increased number of co-participants during their therapy sessions. The authors believe that to minimize patient dissatisfaction with rehabilitation, surgeons should refer patients to therapists who are willing to spend adequate hands-on time during one-on-one or smaller group therapy sessions with their patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. The basis of orientation decoding in human primary visual cortex: fine- or coarse-scale biases?

    Science.gov (United States)

    Maloney, Ryan T

    2015-01-01

    Orientation signals in human primary visual cortex (V1) can be reliably decoded from the multivariate pattern of activity as measured with functional magnetic resonance imaging (fMRI). The precise underlying source of these decoded signals (whether by orientation biases at a fine or coarse scale in cortex) remains a matter of some controversy, however. Freeman and colleagues (J Neurosci 33: 19695-19703, 2013) recently showed that the accuracy of decoding of spiral patterns in V1 can be predicted by a voxel's preferred spatial position (the population receptive field) and its coarse orientation preference, suggesting that coarse-scale biases are sufficient for orientation decoding. Whether they are also necessary for decoding remains an open question, and one with implications for the broader interpretation of multivariate decoding results in fMRI studies. Copyright © 2015 the American Physiological Society.

  12. Source Apportionment of Primary and Secondary Fine Particulate Matter in China

    Science.gov (United States)

    Hu, J.; Zhang, H.; Ying, Q.

    2015-12-01

    In the past few decades, China have been facing extreme particulate matter (PM) pollution problems due to the combination of fast increase of population, industrialization, urbanization and associated energy consumption and lagging of sufficient emission control measures. Studies have identified the major components of fine PM (PM2.5) in China include primary PM (which is directly emitted into the atmosphere), sulfate and nitrate (which are mainly secondary PM, i.e., formed from gaseous precursors), and organic aerosols (which can be primary or secondary). Contributions of different source sectors to the different PM components are substantially different; therefore source apportionment of these components can provide critical information needed for policy makers to design effective emission control strategies. In the current study, a source-oriented version of the Community Multiscale Air Quality (CMAQ) model that directly tracks the contributions from multiple emission sources to primary and secondary PM2.5 is developed, and then applied to determine the regional contributions of power, industry, transportation and residential sectors to primary PM, nitrate and sulfate concentrations in China. Four months in 2012-2013 are simulated to predict the seasonal variations of source contributions. Model predictions are evaluated with ambient measured concentrations. The source-oriented CMAQ model is capable of reproducing most of the available PM10 and PM2.5 mass, and PM2.5 EC, POC, nitrate and sulfate observations. Predicted source contributions for EC also generally agree with to the source contributions estimated by receptor models reported in previous studies. Model predictions suggest residential is a major contributor to primary PM (30-70%) in the spring and winter, and industrial contributes 40-60% of primary PM in the summer and fall; Transportation is an important source for EC (20-30%); Power sector is the dominating source of nitrate and sulfate in both

  13. Original Article Blood Loss and Influencing Factors in Primary Total ...

    African Journals Online (AJOL)

    KIGZ

    aid the surgeon in the African region estimate the expected blood loss after total hip replacement. We conducted a study to quantify the blood loss following total hip arthroplasty and to determine the factors .... Hemoglobin European Overview (OSTHEO) study: blood management in elective knee and hip arthroplasty in ...

  14. Endoscopic Ultrasound Fine-Needle Aspiration Characteristics of Primary Adenocarcinoma versus Other Malignant Neoplasms of The Pancreas

    Directory of Open Access Journals (Sweden)

    Veronika Gagovic

    2012-01-01

    Full Text Available BACKGROUND: Endoscopic ultrasound (EUS with fine-needle aspiration (FNA is often used to assist in the evaluation of pancreatic lesions and may help to diagnose benign versus malignant neoplasms. However, there is a paucity of literature regarding comparative EUS characteristics of various malignant pancreatic neoplasms (primary and metastatic.

  15. Cost-effective reduction of fine primary particulate matter emissions in Finland

    International Nuclear Information System (INIS)

    Karvosenoja, Niko; Klimont, Zbigniew; Tohka, Antti; Johansson, Matti

    2007-01-01

    Policies to reduce adverse health impacts of fine particulate matter (PM 2.5 ) require information on costs of abatement and associated costs. This paper explores the potential for cost-efficient control of anthropogenic primary PM 2.5 emissions in Finland. Based on a Kyoto-compliant energy projection, two emission control scenarios for 2020 were developed. 'Baseline' assumes implementation of PM controls in compliance with existing legislation. 'Reduction' assumes ambitious further reductions. Emissions for 2020 were estimated at 26 and 18.6 Gg a -1 for 'Baseline' and 'Reduction', respectively. The largest abatement potential, 3.0 Gg a -1 , was calculated for power plants and industrial combustion. The largest potential with marginal costs below 5000 Euro MG(PM 2.5 ) -1 was for domestic wood combustion, 1.7 Gg a -1 . For traffic the potential was estimated at 1.0 Gg a -1 , but was associated with high costs. The results from this paper are used in the policy-driven national integrated assessment modeling that explores cost-efficient reductions of the health impacts of PM

  16. Total fine root mass and nutrient content in forest ecosystems (Pinus patula Schltdl and Cham Cupressus lusitanica Mill and Quercus humboldtii bonpl.) from Piedras Blancas, Antioquia - Colombia

    International Nuclear Information System (INIS)

    Barreto Sanchez, Luis Hernan; Leon Pelaez, Juan Diego

    2005-01-01

    In the Piedras Blancas region, Antioquia - Colombia, a sampling of fine roots K > Mg > Fe > P this study sought to highlight the importance of fine roots and their concentrations of nutrients in natural forests and plantations and their relationship with nutrient cycling. For this purpose, the methodological approach comprised total root mass, both dead and alive

  17. Fine-Root Production in an Amazon Rain Forest: Deep Roots are an Important Component of Net Primary Productivity

    Science.gov (United States)

    Norby, R.; Cordeiro, A. L.; Oblitas, E.; Valverde-Barrantes, O.; Quesada, C. A.

    2017-12-01

    Fine-root production is a significant component of net primary production (NPP), but it is the most difficult of the major components to measure. Data on fine-root production are especially sparse from tropical forests, and therefore the estimates of tropical forest NPP may not be accurate. Many estimates of fine-root production are based on observations in the top 15 or 30 cm of soil, with the implicit assumption that this approach will capture most of the root distribution. We measured fine-root production in a 30-m tall, old-growth, terra firme rain forest near Manaus, Brazil, which is the site for a free-air CO2 enrichment (FACE) experiment. Ten minirhizotrons were installed at a 45 degree angle to a depth of 1.1 meters; the tubes were installed 2 years before any measurements were made to allow the root systems to recover from disturbance. Images were collected biweekly, and measurements of root length per area of minirhizotron window were scaled up to grams of root per unit land area. Scaling up minirhizotron measurments is problematic, but our estimate of fine-root standing crop in the top 15 cm of soil (281 ± 37 g dry matter m-2) compares well with a direct measurement of fine roots in two nearby 15-cm soil cores (290 ± 37 g m-2). Although the largest fraction of the fine-root standing crop was in the upper soil horizons, 44% of the fine-root mass was deeper than 30 cm, and 17% was deeper than 60 cm. Annual fine-root production was 934 ± 234 g dry matter m-2 (453 ± 113 g C m-2), which was 35% of estimated NPP of the forest stand (1281 g C m-2). A previous estimate of NPP of the forest at this site was smaller (1010 g m-2), but that estimate relied on fine-root production measured elsewhere and only in the top 10 or 30 cm of soil; fine roots accounted for 21% of NPP in that analysis. Extending root observations deeper into the soil will improve estimates of the contribution of fine-root production to NPP, which will in turn improve estimates of ecosystem

  18. Pain following primary total knee replacement: Causes, diagnosis and treatment

    NARCIS (Netherlands)

    van Geene, A.R.; Saris, Daniël B.F.; Custers, R.J.H.

    2015-01-01

    De plaatsing van een totale knieprothese (TKP) is een succesvolle ingreep bij patiënten met invaliderende gonartrose. Ondanks de goede resultaten is er een grote groep patiënten die niet tevreden is na de ingreep. Mannen, jonge patiënten en patiënten met chronische pijn zijn vaker tevreden na een

  19. Primary break with total loss of high pressure safety injection

    International Nuclear Information System (INIS)

    Cordelle, F.; Champ, M.; Pochard, R.

    1988-10-01

    The probabilitic safety assessment of a 900 MW plant has displayed the potential importance, with regard to the risk, of intermediate primary breaks with failure of the high pressure safety injection system. The probability of such sequence is about 10 -6 /plant X year. Therefore, it is necessary to establish: - if this sequence can lead to core melt down, - if clad ruptures can occur. This event must be taken into account to determine the repair time of contaminated systems. For these studies, a three inch equivalent diameter break is considerd, as this is the most sensitive in its category with regard to these phenomena. In addition to the above objectives, the purpose of these studies is to evaluate the sensitivity of the results to the following parameters: - the time limit at which the operator starts cooling down the plant via the steam generators. Two calculations have been made with the RELAP code (1 and 2) and two with the CATHARE code (3 and 4) - the pump trip time. Four calculations have been made with the CATHARE code (5, 6, 7 and 8). In the case of failure of only one high pressure safety injection file, 6 calculations have been made with the CATHARE code, concerning the influence of pump trip time (9, 10, 11, 12, 13 and 14)

  20. Primary total knee arthroplasty assisted by computer (orthopilot)

    International Nuclear Information System (INIS)

    Naquira, Luis Felipe; Restrepo Tello, Fabio; Pineda Acero, Gustavo; Clavijo, Edgar; Buitrago, Mario

    2004-01-01

    Between December 2001 and December 2003, 21 patients suffering from osteoarthrosis of the knee were treated using computer assisted complete primary arthroplasty of the knee (Orthopilot) at the Department of Orthopedics and Traumatology in the Hospital Militar Central. Results were followed up for an average of 18 months. The criteria evaluated were function and mechanical axis, using ortho-radiography, and length of surgery. The average value obtained was 4.3 degrades with a mechanical axis passing through the centre of the knee joint in 95% of cases, confirmed by a mechanical femoral-tibial angle of -2.5 degrades. Length of surgery was increased by an average of 1 hour compared to the conventional technique. Complications were as follows: One patient experienced an infection which required the withdrawal of the prosthesis and in four of the operations technical problems with the navigator made it necessary to proceed using conventional techniques and these patients were excluded from the study. Radiological results ranged from Excellent to Good in 100% of cases

  1. Use of PROMIS for Patients Undergoing Primary Total Shoulder Arthroplasty.

    Science.gov (United States)

    Dowdle, S Blake; Glass, Natalie; Anthony, Chris A; Hettrich, Carolyn M

    2017-09-01

    The Patient-Reported Outcomes Measurement Information System (PROMIS) consists of question banks for health domains through computer adaptive testing (CAT). For patients with glenohumeral arthritis, (1) there would be high correlation between traditional patient-reported outcome (PRO) measures and the PROMIS upper extremity item bank (PROMIS UE) and PROMIS physical function CAT (PROMIS PF CAT), and (2) PROMIS PF CAT would not demonstrate ceiling effects. Cohort study (diagnosis); Level of evidence, 3. Sixty-one patients with glenohumeral osteoarthritis were included. Each patient completed the American Shoulder and Elbow Surgeons (ASES) assessment form, Marx Shoulder Activity Scale, Short Form-36 physical function scale (SF-36 PF), EuroQol 5 Dimensions (EQ-5D) questionnaire, Western Ontario Osteoarthritis Shoulder (WOOS) index, PROMIS PF CAT, and the PROMIS UE. Correlation was defined as high (>0.7), moderate (0.4-0.6), or weak (0.2-0.3). Significant floor and ceiling effects were present if more than 15% of individuals scored the lowest or highest possible total score on any PRO. The PROMIS PF demonstrated excellent correlation with the SF-36 PF ( r = 0.81, P ceiling or floor effects observed. The mean number of items administered by the PROMIS PRO was 4. These data suggest that for a patient population with operative shoulder osteoarthritis, PROMIS UE and PROMIS PF CAT may be valid alternative PROs. Additionally, PROMIS PF CAT offers a decreased question burden with no ceiling effects.

  2. Use of PROMIS for Patients Undergoing Primary Total Shoulder Arthroplasty

    Science.gov (United States)

    Dowdle, S. Blake; Glass, Natalie; Anthony, Chris A.; Hettrich, Carolyn M.

    2017-01-01

    Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) consists of question banks for health domains through computer adaptive testing (CAT). Hypothesis: For patients with glenohumeral arthritis, (1) there would be high correlation between traditional patient-reported outcome (PRO) measures and the PROMIS upper extremity item bank (PROMIS UE) and PROMIS physical function CAT (PROMIS PF CAT), and (2) PROMIS PF CAT would not demonstrate ceiling effects. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Sixty-one patients with glenohumeral osteoarthritis were included. Each patient completed the American Shoulder and Elbow Surgeons (ASES) assessment form, Marx Shoulder Activity Scale, Short Form–36 physical function scale (SF-36 PF), EuroQol 5 Dimensions (EQ-5D) questionnaire, Western Ontario Osteoarthritis Shoulder (WOOS) index, PROMIS PF CAT, and the PROMIS UE. Correlation was defined as high (>0.7), moderate (0.4-0.6), or weak (0.2-0.3). Significant floor and ceiling effects were present if more than 15% of individuals scored the lowest or highest possible total score on any PRO. Results: The PROMIS PF demonstrated excellent correlation with the SF-36 PF (r = 0.81, P ceiling or floor effects observed. The mean number of items administered by the PROMIS PRO was 4. Conclusion: These data suggest that for a patient population with operative shoulder osteoarthritis, PROMIS UE and PROMIS PF CAT may be valid alternative PROs. Additionally, PROMIS PF CAT offers a decreased question burden with no ceiling effects. PMID:28944248

  3. 78 FR 10269 - National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule

    Science.gov (United States)

    2013-02-13

    ... Illness CWS--Community Water System DBP--Disinfection Byproduct DWC--Drinking Water Committee EA--Economic... 141 and 142 National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule; Final...-9684-8] RIN 2040-AD94 National Primary Drinking Water Regulations: Revisions to the Total Coliform Rule...

  4. Poorer survival after a primary implant during revision total knee arthroplasty

    NARCIS (Netherlands)

    Meijer, Marrigje F.; Reininga, Inge H. F.; Boerboom, Alexander L.; Stevens, Martin; Bulstra, Sjoerd K.

    Revision total knee arthroplasty (rTKA) is a complex procedure. Depending on the degree of ligament and bone damage, either primary or revision implants are used. The purpose of this study was to compare survival rates of primary implants with revision implants when used during rTKA. A retrospective

  5. Primary splenic angiosarcoma with liver metastasis: A rare neoplasm diagnosed on fine-needle aspiration cytology and cell block immunocytochemistry

    Directory of Open Access Journals (Sweden)

    Saniya Sharma

    2018-01-01

    Full Text Available Primary splenic angiosarcoma is a rare malignant vascular neoplasm of mesenchymal origin. The tumor is highly aggressive and has a high metastatic potential. It is usually diagnosed on histopathological examination of splenectomy specimen. Only few cases of angiosarcoma diagnosed by fine-needle aspiration (FNA cytology alone have been reported in the literature. The cytologic features of angiosarcoma are heterogeneous, however, diagnosis can be suggested by FNA when vasoformative features are present. A 55-year-old female presented with abdominal pain and hepatosplenomegaly. Computed tomography scan revealed a heterogeneous splenic lesion with liver metastases. FNA from the splenic and liver lesions showed moderately pleomorphic tumor cells closely associated with anastomosing vascular channels. Cell block immunocytochemistry (ICC showed tumor cells positive for CD31, CD34, CD68 as well as for CD99. FNA supplemented by cell block ICC can render a definite diagnosis of primary splenic angiosarcoma with liver metastasis.

  6. ORGANIZING PROSPECTIVE PRIMARY SCHOOL TEACHERS’ INDEPENDENT WORK IN THE COURSE OF “FINE ARTS WITH METHODOLOGY”

    Directory of Open Access Journals (Sweden)

    Oleksandr Plakhotskyi

    2016-04-01

    Full Text Available This article is devoted to the actual problem of modern art education - organization of independent artwork of seekers of higher education in the prospective primary school teachers’ professional training. The authors note that the independent work is one of the most important components of the educational process, which involves the integration of different types of individual and collective educational activities conducted as in the classroom, extracurricular classes, without a teacher, and under his direct leadership. The authors point out that mastering the skills of independent work intensifies future specialist’s cognitive activity, facilitates searching scientific and methodological information, makes mastering of educational material more conscious, encourages self-development and self-study. Analysing the scientific exploration of modern educators and psychologists on the organization of independent work, the author determines the optimal forms and methods of students’ independent activity in the course "Fine Arts with Teaching Methodology." Particular attention is paid to methodological support of students' independent work with thematic module "Decorative painting", which contains forms and instructional techniques of teaching Petrykivska painting. The authors emphasize that one of the important conditions for successful primary school teachers’ fine arts training, developing their artistic abilities during the tasks of independent work is the individual approach, the choice of methods, techniques, learning pace, depending on students’ individual characteristics and interests.

  7. Strength and fine dexterity recovery profiles after a primary motor cortex insult and effect of a neuronal cell graft.

    Science.gov (United States)

    Vaysse, Laurence; Conchou, Fabrice; Demain, Boris; Davoust, Carole; Plas, Benjamin; Ruggieri, Cyrielle; Benkaddour, Mehdi; Simonetta-Moreau, Marion; Loubinoux, Isabelle

    2015-08-01

    The aim of this study was to set up (a) a large primary motor cortex (M1) lesion in rodent and (b) the conditions for evaluating a long-lasting motor deficit in order to propose a valid model to test neuronal replacement therapies aimed at improving motor deficit recovery. A mitochondrial toxin, malonate, was injected to induce extensive destruction of the forelimb M1 cortex. Three key motor functions that are usually evaluated following cerebral lesion in the clinic-strength, target reaching, and fine dexterity-were assessed in rats by 2 tests, a forelimb grip strength test and a skilled reaching task (staircase) for reaching and dexterity. The potential enhancement of postlesion recovery induced by a neuronal cell transplantation was then explored and confirmed by histological analyses. Both tests showed a severe functional impairment 2 days post lesion, however, reaching remained intact. Deficits in forelimb strength were long lasting (up to 3 months) but spontaneously recovered despite the extensive lesion size. This natural grip strength recovery could be enhanced by cell therapy. Histological analyses confirmed the presence of grafted cells 3 months postgraft and showed partial tissue reconstruction with some living neuronal cells in the graft. In contrast, fine dexterity never recovered in the staircase test even after grafting. These results suggest that cell replacement was only partially effective and that the forelimb M1 area may be a node of the sensorimotor network, where compensation from secondary pathways could account for strength recovery but recovery of forelimb fine dexterity requires extensive tissue reconstruction. (c) 2015 APA, all rights reserved).

  8. Fine Motor Skills Predict Maths Ability Better than They Predict Reading Ability in the Early Primary School Years

    OpenAIRE

    Pitchford, Nicola J.; Papini, Chiara; Outhwaite, Laura A.; Gulliford, Anthea

    2016-01-01

    Fine motor skills have long been recognised as an important foundation for development in other domains. However, more precise insights into the role of fine motor skills, and their relationships to other skills in mediating early educational achievements, are needed to support the development of optimal educational interventions. We explored concurrent relationships between two components of fine motor skills, Fine Motor Precision and Fine Motor Integration, and early reading and maths devel...

  9. Should All Patients Be Included in Alternative Payment Models for Primary Total Hip Arthroplasty and Total Knee Arthroplasty?

    Science.gov (United States)

    Rozell, Joshua C; Courtney, Paul M; Dattilo, Jonathan R; Wu, Chia H; Lee, Gwo-Chin

    2016-09-01

    Alternative payment models in total joint replacement incentivize cost effective health care delivery and reward reductions in length of stay (LOS), complications, and readmissions. If not adjusted for patient comorbidities, they may encourage restrictive access to health care. We prospectively evaluated 802 consecutive primary total hip arthroplasty and total knee arthroplasty patients evaluating comorbidities associated with increased LOS and readmissions. During this 9-month period, 115 patients (14.3%) required hospitalization >3 days and 16 (1.99%) were readmitted within 90 days. Univariate analysis demonstrated that preoperative narcotic use, heart failure, stroke, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), and liver disease were more likely to require hospitalization >3 days. In multivariate analysis, CKD and COPD were independent risk factors for LOS >3 days. A Charlson comorbidity index >5 points was associated with increased LOS and readmissions. Patients with CKD, COPD, and Charlson comorbidity index >5 points should not be included in alternative payment model for THA and TKA. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Estimating concentrations of fine-grained and total suspended sediment from close-range remote sensing imagery

    Science.gov (United States)

    Mosbrucker, Adam; Spicer, Kurt R.; Christianson, Tami; Uhrich, Mark A.

    2015-01-01

    data range among sensors. Of greatest interest to many programs is a hysteresis in the relationship between turbidity and SSC, attributed to temporal variation of particle size distribution (Landers and Sturm, 2013; Uhrich et al., 2014). This phenomenon causes increased uncertainty in regression-estimated values of SSC, due to changes in nephelometric reflectance off the varying grain sizes in suspension (Uhrich et al., 2014). Here, we assess the feasibility and application of close-range remote sensing to quantify SSC and particle size distribution of a disturbed, and highly-turbid, river system. We use a consumer-grade digital camera to acquire imagery of the river surface and a depth-integrating sampler to collect concurrent suspended-sediment samples. We then develop two empirical linear regression models to relate image spectral information to concentrations of fine sediment (clay to silt) and total suspended sediment. Before presenting our regression model development, we briefly summarize each data-acquisition method.

  11. Comparison of complications in transtrochanteric and anterolateral approaches in primary total hip arthroplasty.

    LENUS (Irish Health Repository)

    Cashman, James P

    2008-11-01

    Three surgical approaches to primary total hip arthroplasty (THA) have been in use since Charnley popularized the transtrochanteric approach. This study was designed to examine the difference in morbidity between the transtrochanteric approach and the anterolateral approach in primary THA. Information on 891 patients who underwent primary THA performed by a single surgeon was collected prospectively between 1998 and 2003 using a modified SF-36 form, preoperatively, intraoperatively, and at 3 months postoperatively. The transtrochanteric group had higher morbidity and more patients who were dissatisfied with their THA. There was a greater range of motion in the anterolateral group.

  12. Helium generated cold plasma finely regulates activation of human fibroblast-like primary cells.

    Directory of Open Access Journals (Sweden)

    Paola Brun

    Full Text Available Non-thermal atmospheric pressure plasmas are being developed for a wide range of health care applications, including wound healing. However in order to exploit the potential of plasma for clinical applications, the understanding of the mechanisms involved in plasma-induced activation of fibroblasts, the cells active in the healing process, is mandatory. In this study, the role of helium generated plasma in the tissue repairing process was investigated in cultured human fibroblast-like primary cells, and specifically in hepatic stellate cells and intestinal subepithelial myofibroblasts. Five minutes after treatment, plasma induced formation of reactive oxygen species (ROS in cultured cells, as assessed by flow cytometric analysis of fluorescence-activated 2',7'-dichlorofluorescein diacetate probe. Plasma-induced intracellular ROS were characterized by lower concentrations and shorter half-lives with respect to hydrogen peroxide-induced ROS. Moreover ROS generated by plasma treatment increased the expression of peroxisome proliferator activated receptor (PPAR-γ, nuclear receptor that modulates the inflammatory responses. Plasma exposure promoted wound healing in an in vitro model and induced fibroblast migration and proliferation, as demonstrated, respectively, by trans-well assay and partitioning between daughter cells of carboxyfluorescein diacetate succinimidyl ester fluorescent dye. Plasma-induced fibroblast migration and proliferation were found to be ROS-dependent as cellular incubation with antioxidant agents (e.g. N-acetyl L-cysteine cancelled the biological effects. This study provides evidence that helium generated plasma promotes proliferation and migration in liver and intestinal fibroblast-like primary cells mainly by increasing intracellular ROS levels. Since plasma-evoked ROS are time-restricted and elicit the PPAR-γ anti-inflammatory molecular pathway, this strategy ensures precise regulation of human fibroblast activation and

  13. Matched cohort study of topical tranexamic acid in cementless primary total hip replacement.

    Science.gov (United States)

    Sanz-Reig, Javier; Mas Martinez, Jesus; Verdu Román, Carmen; Morales Santias, Manuel; Martínez Gimenez, Enrique; Bustamante Suarez de Puga, David

    2018-03-29

    Tranexamic acid has been shown to be effective in reducing blood loss after total hip replacement. The purpose of this study was to prospectively assess the effectiveness of topical TXA use to reduce blood loss after primary total hip replacement and to compare these outcomes with those of a matched control group from a similar cohort that did not have received tranexamic acid. This is a prospective matched control study to assess the effect of a 2 g topical tranexamic acid in 50 mL physiological saline solution in total hip replacement. Primary outcomes were hemoglobin and hematocrit drop, and total blood loss. Secondary outcomes were transfusion rates, length of hospital stay, deep vein thrombosis, and pulmonary embolism events. We could match 100 patients to a control group. There were no statistical significantly differences between the two groups. The hemoglobin and hematocrit postoperative values were significantly higher in topical tranexamic acid group than in control group (P tranexamic acid group and 1163 in control group with significant differences (P = 0.001), which meant 34% reduction in total blood loss. Length of stay was lower in topical tranexamic acid group. The risk of deep vein thrombosis and pulmonary events did not increase. A single dose of 2 g tranexamic acid in 50 mL physiological saline solution topical administration was effective and safe in reducing bleeding in patients undergoing unilateral primary non-cemented total hip replacement compared to a matched control group.

  14. Danish survey of acetabular component positioning practice during primary total hip arthroplasty

    DEFF Research Database (Denmark)

    Cotong, Dana; Troelsen, Anders; Husted, Henrik

    2017-01-01

    questions on optimal component positioning, surgical practice patterns in primary THA, indications and surgical techniques used in revision THA. RESULTS: A total of 42 questionnaires were collected, two were excluded, leaving 40 for analyses. 97% of the surgeons reported an optimum cup anteversion within...

  15. Early Removal of Drainage Tube after Fast-Track Primary Total Knee Arthroplasty.

    Science.gov (United States)

    Zhang, Shaoyun; Xu, Bin; Huang, Qiang; Yao, Huan; Xie, Jinwei; Pei, Fuxing

    2017-07-01

    There is no consensus as to whether drainage tube should be used and how long it should remain in use after primary total knee arthroplasty (TKA). As fast-track (FT) program has been implemented in TKA, whether drainage tube could be removed early, and the ideal timing for removal after FT primary TKA has been a new topic. The purpose of this prospective cohort study was to evaluate the safety and feasibility of early removal of drainage tube when FT program was implemented in primary TKA. A total of 101 patients undergoing FT primary TKA were prospectively allocated into three groups. Patients in group A (31 patients) indwelled wound drainage tube for 6 hours after surgery while group B (34 patients) for 12 hours and group C (36 patients) for 18 hours. The knee circumference, resting and moving visual analogue score (VAS), hemoglobin (Hb), hematocrit, white blood count (WBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), interleukin-6 (IL-6), the volume of blood loss and drainage, and postoperative length of stay (LOS) among three groups were recorded and compared. There was no statistically significant difference in the volume of total and hidden blood loss among three groups ( p  > 0.05), but as the time of drainage prolonged, total volume of drainage and dominant blood loss increased gradually ( p   0.05), the decrease of Hb in the perioperative period and postoperative LOS as well. Early removal of wound drainage tube could drain the hematocele and reduce the risk of infection, and it doesn't increase the sense of pain, inflammatory reaction, limb swelling, and total blood loss. It's safe and feasible to remove the drainage tube within 6 to 12 hours after FT primary TKA. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  16. Age and Early Revision After Primary Total Hip Arthroplasty for Osteoarthritis.

    Science.gov (United States)

    Meyer, Zachary; Baca, Geneva; Rames, Richard; Barrack, Robert; Clohisy, John; Nam, Denis

    2017-11-01

    Prior reports have noted an increased risk of early revision among younger patients undergoing total hip arthroplasty (THA) but have been confounded by the inclusion of various diagnoses. The purpose of this study was to assess the revision rate and the time to revision for patients undergoing THA for osteoarthritis based on age. Patients with a diagnosis of osteoarthritis who underwent both primary and revision THA at the same institution were identified. The time between primary and revision surgery and the indication for revision were collected. Patients were stratified into 2 groups based on age at the time of primary THA: 64 years or younger (group 1) or 65 years or older (group 2). Between 1996 and 2016, a total of 4662 patients (5543 hips) underwent primary THA for a diagnosis of osteoarthritis. Of these, 100 patients (104 hips) received a revision THA (62 in group 1 and 42 in group 2). Mean age was 52.7±8.4 years in group 1 vs 73.4±6.3 years in group 2 (Pprimary to revision surgery was 3.0±3.2 years for group 1 and 1.1±2.1 years for group 2 (P=.001). Among patients undergoing primary THA for a diagnosis of osteoarthritis, younger age is not associated with an increased rate of early failure or revision. [Orthopedics. 2017; 40(6):e1069-e1073.]. Copyright 2017, SLACK Incorporated.

  17. Primary Total Hip Replacement for a Femoral Neck Fracture in a Below-Knee Amputee

    OpenAIRE

    Masmoudi, Karim; Rbai, H?di; Fradj, Ayman Ben; Sa?dena, Jecem; Boughattas, Anouar

    2016-01-01

    Introduction: Femoral neck fracture on amputated limb is an uncommon lesion and challenging to manage. Case Report: We report a case of a displaced neck fracture of the left femur in a 57-year-old female. She underwent at the age of the three a below-knee amputation of the ipsilateral limb for post traumatic ischemia. The fracture was managed by a total hip arthroplasty (THA), as a primary procedure. In this article we describe our experience of this unusual entity. Conclusion: Total hip arth...

  18. HYBRID LAYER THICKNESS IN PRIMARY AND PERMANENT TEETH – A COMPARISON BETWEEN TOTAL ETCH ADHESIVES

    Directory of Open Access Journals (Sweden)

    Natalia Gateva

    2012-05-01

    Full Text Available Purpose: The aim this study is to compare the hybrid layer thickness and its micromorphological characteristics in samples from primary and permanent teeth following application of total etch adhesives.Materials and methods: On intact specimens of 20 primary and 10 permanent teeth was created flat dentin surfaces. The patterns were divided in 6 groups. Two different total etch adhesive systems were used – one tree steps (OptiBond, Kerr and one two steps (Exite, VivaDent. In groups 3, 4, 5 and 6 recommended etching time was used - 15 s, in groups 1 and 2 the etching time was reduced to 7 s. After applying the adhesive, resin composite build-ups were constructed. Thus restored samples are stored in saline solution for 24 hours at temperature 37 C. Then they are subjected to thermal stress in temperature between 5 C to 55 C for 1,500 cycles and to masticatory stress – 150,000 cycles with force 100 N in intervals of 0.4 s. After that the teeth are cut through the middle in medio-distal direction with a diamond disc. SEM observation was done to investigate the thickness of the hybrid layer and the presence of microgaps. Statistical analysis was performed with ANOVA and Tukey׳s tests.Results: SEM observation showed significant differences of the hybrid layer thickness between primary and permanent teeth under equal conditions and after different etching time. Group 6 presented the highest average thickness 8.85 μ and group 1 the lowest average in hybrid layer 3.74 μ.Conclusion: In primary teeth the hybrid layer thickness increases with the increased etching time. The hybrid layer thickness in primary teeth is greater than that of the hybrid layer in permanent teeth under equal conditions. For primary teeth it is more appropriate to reduce the etching time to 7s to obtain a hybrid layer with better quality

  19. Lifetime risk of primary total hip replacement surgery for osteoarthritis from 2003-2013

    DEFF Research Database (Denmark)

    Ackerman, Ilana N; Bohensky, Megan A; de Steiger, Richard

    2017-01-01

    OBJECTIVE: To compare the lifetime risk of total hip replacement surgery (THR) for osteoarthritis (OA) between countries, and over time. METHODS: Data on primary THR procedures performed for OA in 2003 and 2013 were extracted from national arthroplasty registries in Australia, Denmark, Finland, N....... These multi-national risk estimates can inform resource planning for OA service delivery. This article is protected by copyright. All rights reserved....

  20. Blood Loss and Transfusion After Topical Tranexamic Acid Administration in Primary Total Knee Arthroplasty.

    Science.gov (United States)

    Wang, Hao; Shen, Bin; Zeng, Yi

    2015-11-01

    There has been much debate and controversy about the safety and efficacy of the topical use of tranexamic acid in primary total knee arthroplasty (TKA). The purpose of this study was to perform a meta-analysis to evaluate whether there is less blood loss and lower rates of transfusion after topical tranexamic acid administration in primary TKA. A systematic review of the electronic databases PubMed, CENTRAL, Web of Science, and Embase was undertaken. All randomized, controlled trials and prospective cohort studies evaluating the effectiveness of topical tranexamic acid during primary TKA were included. The focus of the analysis was on the outcomes of blood loss results, transfusion rate, and thromboembolic complications. Subgroup analysis was performed when possible. Of 387 studies identified, 16 comprising 1421 patients (1481 knees) were eligible for data extraction and meta-analysis. This study indicated that when compared with the control group, topical application of tranexamic acid significantly reduced total drain output (mean difference, -227.20; 95% confidence interval, -347.11 to -107.30; Ptranexamic acid in primary TKA. Furthermore, the currently available evidence does not support an increased risk of deep venous thrombosis or pulmonary embolism due to tranexamic acid administration. Topical tranexamic acid was effective for reducing postoperative blood loss and transfusion requirements without increasing the prevalence of thromboembolic complications. Copyright 2015, SLACK Incorporated.

  1. Quantifying Blood Loss and Transfusion Risk After Primary vs Conversion Total Hip Arthroplasty.

    Science.gov (United States)

    Newman, Jared M; Webb, Matthew R; Klika, Alison K; Murray, Trevor G; Barsoum, Wael K; Higuera, Carlos A

    2017-06-01

    Primary total hip arthroplasty (THA) and conversion THA may result in substantial blood loss, sometimes necessitating transfusion. Despite the complexities of the latter, both are grouped in the same category for quality assessment and reimbursement. This study's purpose was to compare both blood loss and transfusion risk in primary and conversion THA and identify their associated predictors. A total of 1616 patients who underwent primary and conversion THA at a single hospital from 2009-2013 were reviewed (primary THA = 1575; conversion THA = 41). Demographics, comorbidities, and perioperative data were collected from electronic records. Blood loss was calculated using a validated method. Transfusion triggers were based on standardized criteria. Separate multivariable regression models for blood loss and transfusion were performed. Conversion THA patients were younger (P = .002), had lower age-adjusted Charlson scores (P = .006), longer surgeries (P quantified in the present study and showed consistent results between the 2 metrics. The differences between these procedures should be addressed during quality assurance because conversion THA is associated with higher resource utilization, which is important in the allocation of resources and tiered reimbursement strategies. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Lawsuits After Primary and Revision Total Hip Arthroplasties: A Malpractice Claims Analysis.

    Science.gov (United States)

    Patterson, Diana C; Grelsamer, Ronald P; Bronson, Michael J; Moucha, Calin S

    2017-10-01

    As the prevalence of total hip arthroplasty (THA) expands, so too will complications and patient dissatisfaction. The goal of this study was to identify the common etiologies of malpractice suits and costs of claims after primary and revision THAs. Analysis of 115 malpractice claims filed for alleged neglectful primary and revision THA surgeries by orthopedic surgeons insured by a large New York state malpractice carrier between 1983 and 2011. The incidence of malpractice claims filed for negligent THA procedures is only 0.15% per year in our population. In primary cases, nerve injury ("foot drop") was the most frequent allegation with 27 claims. Negligent surgery causing dislocation was alleged in 18 and leg length discrepancy in 14. Medical complications were also reported, including 3 thromboembolic events and 6 deaths. In revision cases, dislocation and infection were the most common source of suits. The average indemnity payment was $386,153 and the largest single settlement was $4.1 million for an arterial injury resulting in amputation after a primary hip replacement. The average litigation cost to the insurer was $61,833. Nerve injury, dislocation, and leg length discrepancy are the most common reason for malpractice after primary THA. Orthopedic surgeons should continue to focus on minimizing the occurrence of these complications while adequately incorporating details about the risks and limitations of surgery into their preoperative education. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Preoperative predictors of returning to work following primary total knee arthroplasty.

    Science.gov (United States)

    Styron, Joseph F; Barsoum, Wael K; Smyth, Kathleen A; Singer, Mendel E

    2011-01-05

    There is little in the literature to guide clinicians in advising patients regarding their return to work following a primary total knee arthroplasty. In this study, we aimed to identify which factors are important in estimating a patient's time to return to work following primary total knee arthroplasty, how long patients can anticipate being off from work, and the types of jobs to which patients are able to return following primary total knee arthroplasty. A prospective cohort study was performed in which patients scheduled for a primary total knee arthroplasty completed a validated questionnaire preoperatively and at four to six weeks, three months, and six months postoperatively. The questionnaire assessed the patient's occupational physical demands, ability to perform job responsibilities, physical status, and motivation to return to work as well as factors that may impact his or her recovery and other workplace characteristics. Two survival analysis models were constructed to evaluate the time to return to work either at least part-time or full-time. Acceleration factors were calculated to indicate the relative percentage of time until the patient returned to work. The median time to return to work was 8.9 weeks. Patients who reported a sense of urgency about returning to work were found to return in half the time taken by other employees (acceleration factor = 0.468; p mental health scores (acceleration factor = 0.891), higher physical function scores (acceleration factor = 0.809), higher Functional Comorbidity Index scores (acceleration factor = 0.914), and a handicap accessible workplace (acceleration factor = 0.736). A slower return to work was associated with having less pain preoperatively (acceleration factor = 1.132), having a more physically demanding job (acceleration factor = 1.116), and receiving Workers' Compensation (acceleration factor = 4.360). Although the physical demands of a patient's job have a moderate influence on the patient's ability

  4. Autograft reconstructions for bone defects in primary total knee replacement in severe varus knees

    Directory of Open Access Journals (Sweden)

    Yatinder Kharbanda

    2014-01-01

    Full Text Available Background: Large posteromedial defects encountered in severe varus knees during primary total knee arthroplasty can be treated by cementoplasty, structural bone grafts or metallic wedges. The option is selected depending upon the size of the defect. We studied the outcome of autograft (structural and impaction bone grafting reconstruction of medial tibial bone defects encountered during primary total knee replacement in severe varus knees. Materials and Methods: Out of 675 primary varus knees operated, bone defects in proximal tibia were encountered in 54 knees. Posteromedial defects involving 25-40% of the tibial condyle cut surface and measuring more than 5 mm in depth were grafted using a structural graft obtained from cut distal femur or proximal tibia in 48 knees. For larger, peripheral uncontained vertical defects in six cases, measuring >25 mm in depth and involving >40% cut surface of proximal tibial condyle, impaction bone grafting with a mesh support was used. Results: Bone grafts incorporated in 54 knees in 6 months. There was no graft collapse or stress fractures, loosening or nonunion. The average followup period was 7.8 years (range 5-10 years. We observed an average postoperative increase in the Knee Society Score from 40 to 90 points. There was improvement in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC scores in terms of pain, stiffness and physical function during activities of daily living. Conclusion: Bone grafting for defects in primary total knee is justified as it is biological, available then and is cost effective besides preserving bone stock for future revisions. Structural grafts should be used in defects >5 mm deep and involving 25-40% of the cut proximal tibial condyle surface. For larger peripheral vertical defects, impaction bone grafting contained in a mesh should be done.

  5. Rate and Risk Factors for Periprosthetic Joint Infection Among 36,494 Primary Total Hip Arthroplasties.

    Science.gov (United States)

    Triantafyllopoulos, Georgios K; Soranoglou, Vasileios G; Memtsoudis, Stavros G; Sculco, Thomas P; Poultsides, Lazaros A

    2018-04-01

    As periprosthetic joint infections (PJIs) can have tremendous health and socioeconomic implications, recognizing patients at risk before surgery is of great importance. Therefore, we sought to determine the rate of and risk factors for deep PJI in patients undergoing primary total hip arthroplasty (THA). Clinical characteristics of patients treated with primary THA between January 1999 and December 2013 were retrospectively reviewed. These included patient demographics, comorbidities (including the Charlson/Deyo comorbidity index), length of stay, primary diagnosis, total/allogeneic transfusion rate, and in-hospital complications, which were grouped into local and systemic (minor and major). We determined the overall deep PJI rate, as well as the rates for early-onset (occurring within 2 years after index surgery) and late-onset PJI (occurring more than 2 years after surgery). A Cox proportional hazards regression model was constructed to identify risk factors for developing deep PJI. Significance level was set at 0.05. A deep PJI developed in 154 of 36,494 primary THAs (0.4%) during the study period. Early onset PJI was found in 122 patients (0.3%), whereas late PJI occurred in 32 patients (0.1%). Obesity, coronary artery disease, and pulmonary hypertension were identified as independent risk factors for deep PJI after primary THA. The rate of deep PJIs of the hip is relatively low, with the majority occurring within 2 years after THA. If the optimization of modifiable risk factors before THA can reduce the rate of this complication remains unknown, but should be attempted as part of good practice. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Small phytoplankton contribution to the standing stocks and the total primary production in the Amundsen Sea

    Directory of Open Access Journals (Sweden)

    S. H. Lee

    2017-08-01

    Full Text Available Small phytoplankton are anticipated to be more important in a recently warming and freshening ocean condition. However, little information on the contribution of small phytoplankton to overall phytoplankton production is currently available in the Amundsen Sea. To determine the contributions of small phytoplankton to total biomass and primary production, carbon and nitrogen uptake rates of total and small phytoplankton were obtained from 12 productivity stations in the Amundsen Sea. The daily carbon uptake rates of total phytoplankton averaged in this study were 0.42 g C m−2 d−1 (SD  =  ± 0.30 g C m−2 d−1 and 0.84 g C m−2 d−1 (SD  =  ± 0.18 g C m−2 d−1 for non-polynya and polynya regions, respectively, whereas the daily total nitrogen (nitrate and ammonium uptake rates were 0.12 g N m−2 d−1 (SD  =  ± 0.09 g N m−2 d−1 and 0.21 g N m−2 d−1 (SD  =  ± 0.11 g N m−2 d−1, respectively, for non-polynya and polynya regions, all of which were within the ranges reported previously. Small phytoplankton contributed 26.9 and 27.7 % to the total carbon and nitrogen uptake rates of phytoplankton in this study, respectively, which were relatively higher than the chlorophyll a contribution (19.4 % of small phytoplankton. For a comparison of different regions, the contributions for chlorophyll a concentration and primary production of small phytoplankton averaged from all the non-polynya stations were 42.4 and 50.8 %, which were significantly higher than those (7.9 and 14.9 %, respectively in the polynya region. A strong negative correlation (r2 = 0. 790, p<0. 05 was found between the contributions of small phytoplankton and the total daily primary production of phytoplankton in this study. This finding implies that daily primary production decreases as small phytoplankton contribution increases, which is

  7. Prospective Assessment of Sleep Quality Before and After Primary Total Joint Replacement.

    Science.gov (United States)

    Manning, Blaine T; Kearns, Sean M; Bohl, Daniel D; Edmiston, Tori; Sporer, Scott M; Levine, Brett R

    2017-07-01

    Sleep disruption is a common, yet rarely addressed, complaint among patients who have undergone total joint arthroplasty (TJA). This study assessed sleep quality before and after primary TJA. A total of 105 patients who underwent primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) prospectively completed questionnaires during the preoperative, early postoperative, and late postoperative periods. The survey included the Epworth Sleepiness Scale, current sleeping habits, and patient perspectives of sleep quality and duration. In the early postoperative period (4.7±2.0 weeks), patients reported significant increases in sleep disturbance as denoted by increased length of time to fall asleep (P=.006) and mean nightly awakenings (P=.002) compared with the preoperative baseline. At late postoperative follow-up (40.8±19.5 weeks), patients' sleep quality subsequently improved above the preoperative baseline. Approximately 40% of patients tried a new sleeping method postoperatively, the most common being new pillow placement. No significant differences in pre- or postoperative sleeping trends were noted between THA and TKA patients. These findings suggest transient sleep disturbance is common in the early postoperative period, with subsequent improvement by 10-month follow-up after a primary TJA. Given the growing importance of patient satisfaction in health care systems, orthopedic surgeons must manage patients' expectations while working with them to optimize sleep quality after TJA. A multimodal approach with preoperative counseling, early postoperative sleep modifications, and possibly preemptive use of medications may improve transient sleep disturbance among TJA patients. [Orthopedics. 2017; 40(4):e636-e640.]. Copyright 2017, SLACK Incorporated.

  8. Probability and heritability estimates on primary osteoarthritis of the hip leading to total hip arthroplasty

    DEFF Research Database (Denmark)

    Skousgaard, Søren Glud; Hjelmborg, Jacob; Skytthe, Axel

    2015-01-01

    INTRODUCTION: Primary hip osteoarthritis, radiographic as well as symptomatic, is highly associated with increasing age in both genders. However, little is known about the mechanisms behind this, in particular if this increase is caused by genetic factors. This study examined the risk and heritab......INTRODUCTION: Primary hip osteoarthritis, radiographic as well as symptomatic, is highly associated with increasing age in both genders. However, little is known about the mechanisms behind this, in particular if this increase is caused by genetic factors. This study examined the risk...... and heritability of primary osteoarthritis of the hip leading to a total hip arthroplasty, and if this heritability increased with increasing age. METHODS: In a nationwide population-based follow-up study 118,788 twins from the Danish Twin Register and 90,007 individuals from the Danish Hip Arthroplasty Register...... not have had a total hip arthroplasty at the time of follow-up. RESULTS: There were 94,063 twins eligible for analyses, comprising 835 cases of 36 concordant and 763 discordant twin pairs. The probability increased particularly from 50 years of age. After sex and age adjustment a significant additive...

  9. Risk factors for revision of primary total hip arthroplasty: a systematic review

    Directory of Open Access Journals (Sweden)

    Prokopetz Julian JZ

    2012-12-01

    Full Text Available Abstract Background Numerous papers have been published examining risk factors for revision of primary total hip arthroplasty (THA, but there have been no comprehensive systematic literature reviews that summarize the most recent findings across a broad range of potential predictors. Methods We performed a PubMed search for papers published between January, 2000 and November, 2010 that provided data on risk factors for revision of primary THA. We collected data on revision for any reason, as well as on revision for aseptic loosening, infection, or dislocation. For each risk factor that was examined in at least three papers, we summarize the number and direction of statistically significant associations reported. Results Eighty-six papers were included in our review. Factors found to be associated with revision included younger age, greater comorbidity, a diagnosis of avascular necrosis (AVN as compared to osteoarthritis (OA, low surgeon volume, and larger femoral head size. Male sex was associated with revision due to aseptic loosening and infection. Longer operating time was associated with revision due to infection. Smaller femoral head size was associated with revision due to dislocation. Conclusions This systematic review of literature published between 2000 and 2010 identified a range of demographic, clinical, surgical, implant, and provider variables associated with the risk of revision following primary THA. These findings can inform discussions between surgeons and patients relating to the risks and benefits of undergoing total hip arthroplasty.

  10. Bipolar sealer not superior to standard electrocautery in primary total hip arthroplasty: a meta-analysis.

    Science.gov (United States)

    Yang, Yang; Zhang, Li-Chao; Xu, Fei; Li, Jia; Lv, Yong-Ming

    2014-10-10

    To assess whether bipolar sealer has advantages over standard electrocautery in primary total hip arthroplasty (THA). All studies published through November 2013 were systematically searched in PubMed, Embase, ScienceDirect, The Cochrane Library, and other databases. Relevant journals or conference proceedings were searched manually. Only randomized controlled trials were included. Two independent reviewers identified and assessed the literature. Mean difference in blood loss and risk ratios of transfusion rates and of complication rates in the bipolar sealer group versus the standard electrocautery group were calculated. The meta-analysis was conducted using RevMan 5.1 software. Five studies were included, with a total sample size of 559 patients. The use of bipolar sealer did not significantly reduce intraoperative blood loss, hemoglobin drop, hospital stay, and operative time. There were no significant differences in need for transfusion and the incidence of infection between the study groups. The available evidence suggests that the use of bipolar sealer was not superior to standard electrocautery in patients undergoing primary THA. The use of bipolar sealer is not recommended in primary THA.

  11. Preoperative physiotherapy and short-term functional outcomes of primary total knee arthroplasty.

    Science.gov (United States)

    Mat Eil Ismail, Mohd Shukry; Sharifudin, Mohd Ariff; Shokri, Amran Ahmed; Ab Rahman, Shaifuzain

    2016-03-01

    Physiotherapy is an important part of rehabilitation following arthroplasty, but the impact of preoperative physiotherapy on functional outcomes is still being studied. This randomised controlled trial evaluated the effect of preoperative physiotherapy on the short-term functional outcomes of primary total knee arthroplasty (TKA). 50 patients with primary knee osteoarthritis who underwent unilateral primary TKA were randomised into two groups: the physiotherapy group (n = 24), whose patients performed physical exercises for six weeks immediately prior to surgery, and the nonphysiotherapy group (n = 26). All patients went through a similar physiotherapy regime in the postoperative rehabilitation period. Functional outcome assessment using the algofunctional Knee Injury and Osteoarthritis Outcome Score (KOOS) scale and range of motion (ROM) evaluation was performed preoperatively, and postoperatively at six weeks and three months. Both groups showed a significant difference in all algofunctional KOOS subscales (p 0.05). Significant differences were observed in the time-versus-treatment analysis between groups for the symptoms (p = 0.003) and activities of daily living (p = 0.025) subscales. No significant difference in ROM was found when comparing preoperative measurements and those at three months following surgery, as well as in time-versus-treatment analysis (p = 0.928). Six-week preoperative physiotherapy showed no significant impact on short-term functional outcomes (KOOS subscales) and ROM of the knee following primary TKA. Copyright: © Singapore Medical Association.

  12. Dislocation of primary total hip arthroplasty and the risk of redislocation.

    LENUS (Irish Health Repository)

    Brennan, Stephen A

    2012-09-01

    6554 primary total hip arthroplasties were reviewed. Risk factors for dislocation were analysed to assess which were important in terms of predicting recurrent instability. The patients risk of having a second dislocation was independently associated with the surgical approach adopted (p = 0.03) and the time to first dislocation from the primary hip replacement (p = 0.002). Early dislocators whose surgery was performed through an anterolateral approach had less recurrence than late dislocators through a posterior or transtrochanteric approach. None of the other risk factors including head size (p = 0.59), modularity (p = 0.54), mechanism of dislocation (p = 0.23), leg length discrepancy (p = 0.69) and acetabular inclination (p = 0.31) were influential. The use of an abduction brace was not useful in preventing a further dislocation with 69.2% of those braced re-dislocating compared to 68.5% who were not braced (p = 0.96).

  13. Unconstrained tripolar implants for primary total hip arthroplasty in patients at risk for dislocation.

    Science.gov (United States)

    Guyen, Olivier; Pibarot, Vincent; Vaz, Gualter; Chevillotte, Christophe; Carret, Jean-Paul; Bejui-Hugues, Jacques

    2007-09-01

    We performed a retrospective study on 167 primary total hip arthroplasty (THA) procedures in 163 patients at high risk for instability to assess the reliability of unconstrained tripolar implants (press-fit outer metal shell articulating a bipolar polyethylene component) in preventing dislocations. Eighty-four percent of the patients had at least 2 risk factors for dislocation. The mean follow-up length was 40.2 months. No dislocation was observed. Harris hip scores improved significantly. Six hips were revised, and no aseptic loosening of the cup was observed. The tripolar implant was extremely successful in achieving stability. However, because of the current lack of data documenting polyethylene wear at additional bearing, the routine use of tripolar implants in primary THA is discouraged and should be considered at the present time only for selected patients at high risk for dislocation and with limited activities.

  14. Comparison of total polyphenols content and antioxidant potential of wines from ‘Welschriesling’ and ‘Sauvignon Blanc’ varieties during ageing on fine lees

    Directory of Open Access Journals (Sweden)

    Jasna Lužar

    2016-10-01

    Full Text Available Phenolic compounds are key components of wine, since they contribute to wine characteristics such as colour, astringency and bitterness. They also act like antioxidants, with mechanisms involving free-radical scavenging that could prevent cardiovascular diseases and cancer. The aim of the present work was to compare the obtained results of total polyphenols content and antioxidant potential (AOP of several white wines (welschriesling and sauvignon blanc during ageing on fine lees. The total polyphenols content decreased in average for 16.1 % in welschriesling wines and for 18.7 % in sauvignon blanc wines in the period of three months of wine ageing on lees. In the same period AOP of wines decreased in average for 16.0 % in welschriesling wines and for 8.0 % in sauvignon blanc wines. Expectedly, the samples with added oak chips in grape must had higher antioxidant potential than others.

  15. Use of tranexamic acid in primary total knee replacement: effects on perioperative blood loss.

    Science.gov (United States)

    Volquind, Daniel; Zardo, Remi Antônio; Winkler, Bruno Costamilan; Londero, Bruno Bertagnolli; Zanelatto, Natália; Leichtweis, Gisele Perondi

    2016-01-01

    The use of tranexamic acid in primary total knee replacement surgeries has been the subject of constant study. The strategies to reduce bleeding are aimed at reducing the need for blood transfusion due to the risks involved. In this study we evaluated the use of tranexamic acid in reducing bleeding, need for blood transfusion, and prevalence of postoperative deep vein thrombosis in primary total knee replacement. 62 patients undergoing primary total knee replacement were enrolled in the study, from June 2012 to May 2013, and randomized to receive a single dose of 2.5g of intravenous tranexamic acid (Group TA) or saline (Group GP), 5min before opening the pneumatic tourniquet, respectively. Hemoglobin, hematocrit, and blood loss were recorded 24h after surgery. Deep vein thrombosis was investigated during patient's hospitalization and 15 and 30 days after surgery in review visits. There was no demographic difference between groups. Group TA had 13.89% decreased hematocrit (p=0.925) compared to placebo. Group TA had a decrease of 12.28% (p=0.898) in hemoglobin compared to Group GP. Group TA had a mean decrease of 187.35mL in blood loss (25.32%) compared to group GP (p=0.027). The number of blood transfusions was higher in Group GP (p=0.078). Thromboembolic events were not seen in this study. Tranexamic acid reduced postoperative bleeding without promoting thromboembolic events. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  16. Danish survey of acetabular component positioning practice during primary total hip arthroplasty

    DEFF Research Database (Denmark)

    Cotong, Dana; Troelsen, Anders; Husted, Henrik

    2017-01-01

    questions on optimal component positioning, surgical practice patterns in primary THA, indications and surgical techniques used in revision THA. RESULTS: A total of 42 questionnaires were collected, two were excluded, leaving 40 for analyses. 97% of the surgeons reported an optimum cup anteversion within...... the Lewinnek and Callanan "safe zones", whereas 97% and 83% reported optimum cup inclination within the Lewinnek and Callanan "safe zones", respectively. The reported range for optimal cup positioning varied from 30-55 degrees of inclination and 15-30 degrees of anteversion. The minimum and max-imum accepted...

  17. Management of Medial Collateral Ligament Injury During Primary Total Knee Arthroplasty: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Paul Della Torre, MD

    2014-07-01

    Full Text Available Medial collateral ligament injury during primary total knee arthroplasty is a recognised complication potentially resulting in valgus instability, suboptimal patient outcomes and a higher rate of revision or reoperation. Options for management include primary repair with or without augmentation, reconstruction or immediate conversion to prosthesis with greater constraint, in conjunction with various postoperative rehabilitation protocols. Inconsistent recommendations throughout the orthopaedic literature have made the approach to managing this complication problematic. The objective of this study was to review the available literature to date comparing intraoperative and postoperative management options for primary total knee arthroplasty complicated by recognised injury to the medial collateral ligament. This systematic literature review was prospectively registered with PROSPERO (#CRD42014008866 and performed in accordance with PRISMA guidelines including a PRISMA flow diagram. Five articles satisfied the inclusion criteria. Each was a retrospective, observational cohort or case series with small numbers reported, inconsistent methodology and incompletely reported outcomes. Four of the five studies managing medial collateral ligament injury during total knee arthroplasty (47/84 patients with direct repair with or without autograft augmentation reported good outcomes with no revision or reoperation required for symptomatic instability over a follow-up period of 16 months to almost 8 years. The fifth study with a follow-up to 10 years and a high rate of conversion to unlinked semi constrained total knee arthroplasty implant (30/37 patients reported a greater incidence of revision due to instability, in patients in whom the medial collateral ligament injury was directly repaired without added constraint. Overall balance of evidence is in favour of satisfactory outcomes without symptomatic instability following direct repair with or without

  18. An updated h-index measures both the primary and total scientific output of a researcher.

    Science.gov (United States)

    Bucur, Octavian; Almasan, Alex; Zubarev, Roman; Friedman, Mark; Nicolson, Garth L; Sumazin, Pavel; Leabu, Mircea; Nikolajczyk, Barbara S; Avram, Dorina; Kunej, Tanja; Calin, George A; Godwin, Andrew K; Adami, Hans-Olov; Zaphiropoulos, Peter G; Richardson, Des R; Schmitt-Ulms, Gerold; Westerblad, Håkan; Keniry, Megan; Grau, Georges E R; Carbonetto, Salvatore; Stan, Radu V; Popa-Wagner, Aurel; Takhar, Kasumov; Baron, Beverly W; Galardy, Paul J; Yang, Feng; Data, Dipak; Fadare, Oluwole; Yeo, Kt Jerry; Gabreanu, Georgiana R; Andrei, Stefan; Soare, Georgiana R; Nelson, Mark A; Liehn, Elisa A

    2015-01-01

    The growing interest in scientometry stems from ethical concerns related to the proper evaluation of scientific contributions of an author working in a hard science. In the absence of a consensus, institutions may use arbitrary methods for evaluating scientists for employment and promotion. There are several indices in use that attempt to establish the most appropriate and suggestive position of any scientist in the field he/she works in. A scientist's Hirsch-index (h-index) quantifies their total effective published output, but h-index summarizes the total value of their published work without regard to their contribution to each publication. Consequently, articles where the author was a primary contributor carry the same weight as articles where the author played a minor role. Thus, we propose an updated h-index named Hirsch(p,t)-index that informs about both total scientific output and output where the author played a primary role. Our measure, h(p,t) = h(p),h(t), is composed of the h-index h(t) and the h-index calculated for articles where the author was a key contributor; i.e. first/shared first or senior or corresponding author. Thus, a h(p,t) = 5,10 would mean that the author has 5 articles as first, shared first, senior or corresponding author with at least 5 citations each, and 10 total articles with at least 10 citations each. This index can be applied in biomedical disciplines and in all areas where the first and last position on an article are the most important. Although other indexes, such as r- and w-indexes, were proposed for measuring the authors output based on the position of researchers within the published articles, our simpler strategy uses the already established algorithms for h-index calculation and may be more practical to implement.

  19. Multi-ligament instability after early dislocation of a primary total knee replacement - case report.

    Science.gov (United States)

    Sisak, Krisztian; Lloyd, John; Fiddian, Nick

    2011-01-01

    Peripheral nerve blocks have found increased popularity in providing prolonged post-operative analgesia following total knee replacement surgery. They generally provide effective analgesia with fewer complications than epidurals. This report describes an acute low-energy knee dislocation after a well balanced, fixed bearing, cruciate-retaining primary total knee replacement performed under a spinal anaesthetic with combined complimentary femoral and sciatic nerve blocks. The dislocation was not accompanied by neurovascular compromise. Due to the subsequent instability and injury to both collaterals, the posterior cruciate ligament and posterolateral corner structures, the knee was treated with a rotating-hinge revision total knee replacement. The dislocation occurred whilst the peripheral nerve blocks (PNB) were still working. We review our incidence of PNB related complications and conclude that PNB remain a safe and effective analgesia for total knee replacements. However, we advocate that ward staff and patients should be sufficiently educated to ensure that unaided post-operative mobilisation is prevented until such a time that patients have regained complete voluntary muscle control. Copyright © 2009 Elsevier B.V. All rights reserved.

  20. Primary total hip replacement for displaced subcapital fractures of the femur.

    Science.gov (United States)

    Taine, W H; Armour, P C

    1985-03-01

    The management of displaced subcapital fracture of the hip is still controversial because of the high incidence of complications after internal fixation or hemiarthroplasty. To avoid some of these complications we have used primary total hip replacement for independently mobile patients over 65 years of age. A total of 163 cases, operated on over four years, have been reviewed. There were relatively more dislocations after operation for fracture than after total replacement for arthritis, and these were associated with a posterior approach to the hip. Only seven revision operations have been required. Of 57 patients who were interviewed an average of 42 months after replacement, 62% had excellent or good results as assessed by the Harris hip score. All the others had major systemic disease which affected their assessment. This inadequacy of current systems of hip assessment is discussed. It is concluded that total hip replacement is the best management for a selected group of patients with this injury, and that further prospective studies are indicated.

  1. The Impact of Discharge Disposition on Episode-of-Care Reimbursement After Primary Total Hip Arthroplasty.

    Science.gov (United States)

    Sabeh, Karim G; Rosas, Samuel; Buller, Leonard T; Roche, Martin W; Hernandez, Victor H

    2017-10-01

    Total joint arthroplasty (TJA) accounts for more Medicare expenditure than any other inpatient procedure. The Comprehensive Care for Joint Replacement model was introduced to decrease cost and improve quality in TJA. The largest portion of episode-of-care costs occurs after discharge. This study sought to quantify the cost variation of primary total hip arthroplasty (THA) according to discharge disposition. The Medicare and Humana claims databases were used to extract charges and reimbursements to compare day-of-surgery and 91-day postoperative costs simulating episode-of-care reimbursements. Of the patients who underwent primary THA, 257,120 were identified (204,912 from Medicare and 52,208 from Humana). Patients were stratified by discharge disposition: home with home health, skilled nursing facility, or inpatient rehabilitation facility. There is a significant difference in the episode-of-care costs according to discharge disposition, with discharge to an inpatient rehabilitation facility the most costly and discharge to home the least costly. Postdischarge costs represent a sizeable portion of the overall expense in THA, and optimizing patients to allow safe discharge to home may help reduce the cost of THA. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. SAETTA: fine-scale observation of the total lightning activity in the framework of the CORSiCA atmospheric observatory

    Science.gov (United States)

    Coquillat, Sylvain; Defer, Eric; Lambert, Dominique; Martin, Jean-Michel; Pinty, Jean-Pierre; Pont, Véronique; Prieur, Serge

    2015-04-01

    Located in the West Mediterranean basin, Corsica is strategically positioned for atmospheric studies referred by MISTRALS/HyMeX and MISTRALS/CHARMEX programs. The implementation of the project of atmospheric observatory CORSiCA (supported by the Collectivité Territoriale de Corse via CPER/FEDER funds) was an opportunity to strengthen the potential observation of convective events causing heavy rainfall and flash floods, by acquiring a total lightning activity detection system adapted to storm tracking at a regional scale. This detection system called SAETTA (Suivi de l'Activité Electrique Tridimensionnelle Totale de l'Atmosphère) is a network of 12 LMA stations (Lightning Mapping Array). Developed by New Mexico Tech (USA), the instrument allows observing lightning flashes in 3D and real time, at high temporal and spatial resolutions. It detects the radiations emitted by cloud discharges in the 60-66 MHz band, in a radius of about 300 km from the centre of the network, in passive mode and standalone (solar panel and battery). Each LMA station samples the signal at high rate (80 microseconds), records data on internal hard disk, and transmits a decimated signal in real-time via the 3G phone network. The decimated data are received on a server that calculates the position of the detected sources by the time-of-arrival method and manages a quasi real-time display on a website. The non decimated data intended for research applications are recovered later on the field. Deployed in May and June 2014, SAETTA operated nominally from July 13 to October 20, 2014. It is to be definitively re-installed in spring 2015 after a hardware updating. The operation of SAETTA is contractually scheduled until the end of 2019, but it is planned to continue well beyond to obtain longer-term observations for addressing issues related to climatic trends. SAETTA has great scientific potential in a broad range of topics: physics of discharge; monitoring and simulation of storm systems

  3. Is There an Association Between Smoking Status and Prosthetic Joint Infection After Primary Total Joint Arthroplasty?

    Science.gov (United States)

    Gonzalez, Amanda I; Luime, Jolanda J; Uçkay, Ilker; Hannouche, Didier; Hoffmeyer, Pierre; Lübbeke, Anne

    2018-02-23

    Recent reports highlighted the association between smoking and higher risk of postsurgical infections. The aim was to compare the incidence of prosthetic joint infection after primary total joint arthroplasty (TJA) according to smoking status. A prospective hospital registry-based cohort study was performed including all primary knee and hip TJAs performed between March 1996 and December 2013. Smoking status preoperatively was classified into never, former, and current smoker. Incidence rates and hazard ratios (HRs) for prosthetic joint infection according to smoking status were assessed within the first year and beyond. We included 8559 primary TJAs (mean age 69.5 years), and median follow-up was 67 months. There were 5722 never, 1315 former, and 1522 current smokers. Incidence rates of infection within the first year for never, former, and current smokers were, respectively, 4.7, 10.1, and 10.9 cases/1000 person-years, comparing ever vs never smokers, crude and adjusted HRs were 2.35 (95% confidence interval [CI] 1.39-3.98) and 1.8 (95% CI 1.04-3.2). Beyond the first year, crude and adjusted HRs were 1.37 (95% CI 0.78-2.39) and 1.12 (95% CI 0.61-2.04). Smoking increased the infection risk about 1.8 times after primary hip or knee TJA in both current and former smokers. Beyond the first year, the infection risk was similar to never smokers. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. The Impact of Medical Comorbidities on Primary Total Knee Arthroplasty Reimbursements.

    Science.gov (United States)

    Sabeh, Karim G; Rosas, Samuel; Buller, Leonard T; Freiberg, Andrew A; Emory, Cynthia L; Roche, Martin W

    2018-05-23

    Medical comorbidities have been shown to cause an increase in peri-and postoperative complications following total knee arthroplasty (TKA). However, the increase in cost associated with these complications has yet to be determined. Factors that influence cost have been of great interest particularly after the initiation of bundled payment initiatives. In this study, we present and quantify the influence of common medical comorbidities on the cost of care in patients undergoing primary TKA. A retrospective level of evidence III study was performed using the PearlDiver supercomputer to identify patients who underwent primary TKA between 2007 and 2015. Patients were stratified by medical comorbidities and compared using analysis of variance for reimbursements for the day of surgery and over 90 days postoperatively. A cohort of 137,073 US patients was identified as having undergone primary TKA between 2007 and 2015. The mean entire episode-of-care reimbursement was $23,701 (range: $21,294-26,299; standard deviation [SD] $2,611). The highest reimbursements were seen in patients with chronic obstructive pulmonary disease (mean $26,299; SD $3,030), hepatitis C (mean $25,662; SD $2,766), morbid obesity (mean $25,450; SD $2,154), chronic kidney disease (mean $25,131, $3,361), and cirrhosis (mean $24,890; SD $2,547). Medical comorbidities significantly impact reimbursements, and therefore cost, after primary TKA. Comprehensive preoperative optimization for patients with medical comorbidities undergoing TKA is highly recommended and may reduce perioperative complications, improve patient outcome, and ultimately reduce cost. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. What are the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty?

    Science.gov (United States)

    Harato, Kengo; Maeno, Shinichi; Tanikawa, Hidenori; Kaneda, Kazuya; Morishige, Yutaro; Nomoto, So; Niki, Yasuo

    2016-08-01

    It was hypothesized that surgical time of beginners would be much longer than that of experts. Our purpose was to investigate and clarify the important manoeuvres for beginners to minimize surgical time in primary total knee arthroplasty (TKA) as a multicentre study. A total of 300 knees in 248 patients (averaged 74.6 years) were enrolled. All TKAs were done using the same instruments and the same measured resection technique at 14 facilities by 25 orthopaedic surgeons. Surgeons were divided into three surgeon groups (four experts, nine medium-volume surgeons and 12 beginners). The surgical technique was divided into five phases. Detailed surgical time and ratio of the time in each phase to overall surgical time were recorded and compared among the groups in each phase. A total of 62, 119, and 119 TKAs were done by beginners, medium-volume surgeons, and experts, respectively. Significant differences in surgical time among the groups were seen in each phase. Concerning the ratio of the time, experts and medium-volume surgeons seemed cautious in fixation of the permanent component compared to other phases. Interestingly, even in ratio, beginners and medium-volume surgeons took more time in exposure of soft tissue compared to experts. (0.14 in beginners, 0.13 in medium-volume surgeons, 0.11 in experts, P time in exposure and closure of soft tissue compared to experts. Improvement in basic technique is essential to minimize surgical time among beginners. First of all, surgical instructors should teach basic techniques in primary TKA for beginners. Therapeutic studies, Level IV.

  6. Postoperative Pain Management After Primary Total Knee Arthroplasty: The Value of Liposomal Bupivacaine.

    Science.gov (United States)

    Sporer, Scott M; Rogers, Thea

    2016-11-01

    Multimodal pain protocols have been proposed to achieve improved long-acting postoperative analgesia. Controlling postoperative pain after joint arthroplasty is especially important as it relates to patient satisfaction and outcomes. The purpose of this study was to compare the postoperative pain, time to ambulation, and overall narcotic usage between patients who received either a femoral nerve block with a periarticular bupivacaine injection or a periarticular bupivacaine and extended-release liposomal bupivacaine injection after primary total knee arthroplasty. A total of 597 consecutive primary total knee arthroplasties performed between September 1, 2012 and August 31, 2014 received preoperative celecoxib, oxycodone, and transdermal scopolamine. Intraoperatively, patients either received a single-dose bupivacaine femoral nerve block along with 30-mL 0.25% bupivacaine periarticular injection (group A) or a 60-mL periarticular injection alone (20-mL liposomal bupivacaine, 30-mL 0.25% bupivacaine, and 10-mL saline; group B). The postoperative pain scores, narcotic usage, and time to ambulation were retrospectively collected from the electronic medical record. These outcomes were compared between treatment groups. There were 325 patients in group A compared with 272 in group B during the time frame. There was no difference among age, gender, race, and body mass index between the groups. Group B demonstrated a decreased need for breakthrough pain medication (16.9% vs 36.3% P bupivacaine resulted in a decrease need for breakthrough pain medication, improved pain scores at 12 hours, and an earlier time to ambulation compared to a combined femoral nerve block and periarticular bupivacaine injection. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Portable ultrahigh-vacuum sample storage system for polarization-dependent total-reflection fluorescence x-ray absorption fine structure spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Watanabe, Yoshihide, E-mail: e0827@mosk.tytlabs.co.jp; Nishimura, Yusaku F.; Suzuki, Ryo; Beniya, Atsushi; Isomura, Noritake [Toyota Central R& D Labs., Inc., Yokomichi 41-1, Nagakute, Aichi 480-1192 (Japan); Uehara, Hiromitsu; Asakura, Kiyotaka; Takakusagi, Satoru [Catalysis Research Center, Hokkaido University, Kita 21-10, Sapporo, Hokkaido 001-0021 (Japan); Nimura, Tomoyuki [AVC Co., Ltd., Inada 1450-6, Hitachinaka, Ibaraki 312-0061 (Japan)

    2016-03-15

    A portable ultrahigh-vacuum sample storage system was designed and built to investigate the detailed geometric structures of mass-selected metal clusters on oxide substrates by polarization-dependent total-reflection fluorescence x-ray absorption fine structure spectroscopy (PTRF-XAFS). This ultrahigh-vacuum (UHV) sample storage system provides the handover of samples between two different sample manipulating systems. The sample storage system is adaptable for public transportation, facilitating experiments using air-sensitive samples in synchrotron radiation or other quantum beam facilities. The samples were transferred by the developed portable UHV transfer system via a public transportation at a distance over 400 km. The performance of the transfer system was demonstrated by a successful PTRF-XAFS study of Pt{sub 4} clusters deposited on a TiO{sub 2}(110) surface.

  8. Elevated levels of numerous cytokines in drainage fluid after primary total hip arthroplasty.

    Science.gov (United States)

    van der Heide, Huub J L; van der Kraan, Peter M; Rijnberg, Willard J; Buma, Pieter; Schreurs, B Willem

    2010-12-01

    As cytokines are involved in wound healing and other inflammatory processes, it could be valuable to measure their levels at the operative site. This study was conducted to investigate whether different cytokines are measurable in drainage fluid and, when measurable, whether we can find a difference in cytokine levels between one and six hours postoperatively. Samples from the drainage system in 30 consecutive patients undergoing primary total hip replacement were collected at one and six hours after closure of the wound. Levels of several cytokines were measured in the drainage fluids. A significant elevation of almost all cytokines was observed between the sample after one hour and six hours postoperatively. We found a strong correlation between the different pro-inflammatory cytokines. The IL-6 to IL-10 ratio were also raised, showing a pro-inflammatory predominance. Levels were much higher than those previously shown in serum.

  9. Acetabular cup position and risk of dislocation in primary total hip arthroplasty

    DEFF Research Database (Denmark)

    Seagrave, Kurt G; Troelsen, Anders; Malchau, Henrik

    2017-01-01

    Background and purpose - Hip dislocation is one of the most common complications following total hip arthroplasty (THA). Several factors that affect dislocation have been identified, including acetabular cup positioning. Optimal values for cup inclination and anteversion are debatable. We performed...... a systematic review to describe the different methods for measuring cup placement, target zones for cup positioning, and the association between cup positioning and dislocation following primary THA. Methods - A systematic search of literature in the PubMed database was performed (January and February 2016......) to identify articles that compared acetabular cup positioning and the risk of dislocation. Surgical approach and methods for measurement of cup angles were also considered. Results - 28 articles were determined to be relevant to our research question. Some articles demonstrated that cup positioning influenced...

  10. Satisfactory Results of the Exeter Revision Femoral Stem Used for Primary Total Hip Arthroplasty.

    Science.gov (United States)

    Desy, Nicholas M; Johnson, Joshua D; Sierra, Rafael J

    2017-02-01

    The Exeter cemented femoral stem has demonstrated excellent clinical and radiographic outcomes as well as long-term survivorship free from aseptic loosening. A shorter revision stem (125 mm) with a 44 offset became available for the purpose of cement-in-cement revision situations. In certain cases, this shorter revision stem may be used for various primary total hip arthroplasties (THAs) where the standard length stem would require distally reaming the femoral canal. We sought to report on the early to midterm results of this specific stem when used for primary THA regarding (1) clinical and radiographic outcomes, (2) complications, and (3) survivorship. Twenty-nine patients (33 hips) underwent a hybrid THA using the smaller revision Exeter cemented femoral stem. Twenty-five patients (28 hips) had at least 2 years of follow-up and were assessed for clinical and radiographic outcomes. All 33 hips were included in the analysis of complications and survivorship. The Kaplan-Meier survivorship was performed using revision for all causes and for aseptic loosening as the end points. The average clinical follow-up was 4 years (range, 2-7). Harris Hip Scores improved from a mean preoperative value of 56 (range, 23-96) to 90 (range, 51-100) at the latest follow-up. All patients demonstrated superior cement mantles with no signs of loosening. One patient suffered a B2 periprosthetic fracture and 1 patient experienced 2 episodes of instability. The 5-year Kaplan-Meier survivorship was 96.7% for all causes of revision and was 100% using aseptic loosening as the end point. The shorter Exeter revision cemented femoral stem has favorable early to midterm clinical and radiographic outcomes when used for primary THA with a low complication rate and is a viable option in patients with narrow femoral canals where uncemented stem fixation is not desired. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. [Single intravenous tranexamic acid dose to reduce blood loss in primary total knee replacement].

    Science.gov (United States)

    Sanz-Reig, J; Parra Ruiz, B; Ferrández Martínez, J; Martínez López, J F

    2016-01-01

    To evaluate the effectiveness and safety of a single intravenous dose of tranexamic acid in order to reduce blood loss in total knee replacement. Prospective observational study of the administration of tranexamic acid in patients undergoing primary total knee arthroplasty from November 2013 to February 2015, in which an autologous blood recovery system was used. The study included 98 patients, distributed into two groups of 49 patients according to whether or not they received intravenous tranexamic acid. The primary endpoint was the number of patients requiring autologous transfusion from the recovery system autologous blood recovery system. No drop-outs were recorded during follow-up. There were no significant differences between groups as regards the preoperative and hospital variables. The mean preoperative haemoglobin and haematocrit at 24 and 48 hours postoperatively were similar in both groups. The average volume of bleeding in the autologous blood recovery system and estimated average blood loss was lower in patients who had been administered tranexamic acid, with significant differences. No patients in the group that was administered tranexamic acid required blood autotransfusion. The transfusion rate was zero in the two groups. No adverse events related to the administration of tranexamic acid were recorded. Intravenous administration of tranexamic acid, according to the described protocol, has presented a non-autotransfusion or allo-transfusion rate of 100%, with no increased incidence of thrombotic events. Thus, its use in this group of patients is recommended. The indication should be individualized, its use justified in the patient medical records, and informed consent is mandatory. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.

  12. Do large heads enhance stability and restore native anatomy in primary total hip arthroplasty?

    Science.gov (United States)

    Lombardi, Adolph V; Skeels, Michael D; Berend, Keith R; Adams, Joanne B; Franchi, Orlando J

    2011-06-01

    Dislocation remains a serious complication in hip arthroplasty. Resurfacing proponents tout anatomic femoral head restoration as an advantage over total hip arthroplasty. However, advances in bearings have expanded prosthetic head options from traditional sizes of 22, 26, 28, and 32 mm to diameters as large as 60 mm. Large heads reportedly enhance stability owing to increased range of motion before impingement and increased jump distance to subluxation. Available larger diameter material combinations include metal- or ceramic-on-highly crosslinked polyethylene and metal-on-metal, each with distinct advantages and disadvantages. We sought to determine (1) if using larger diameter heads has lowered our dislocation rate; and (2) how closely an anatomic metal-on-metal bearing with diameters to 60 mm replicates native femoral head size. We retrospectively reviewed 2020 primary arthroplasties performed with large heads (≥ 36 mm) in 1748 patients and noted dislocation incidence. In a prospective subset of 89 cases using anatomic heads, native femoral head diameter was measured intraoperatively with calipers by an independent observer and later compared with implanted size. One dislocation has occurred in 2020 hips for an incidence of 0.05%. The prosthetic head averaged 0.7 mm larger than the native head with 68 of 89 (76%) reconstructed to within ± 2 mm of native size. Larger diameter heads have contributed to lower dislocation rates and large-diameter metal-on-metal articulation can provide close anatomic restoration in primary THA.

  13. Improvement in quality of lifesix months after primary total hip arthroplasty in a Pakistani population.

    Science.gov (United States)

    Zubairi, Akbar Jaleel; Bin Mahmood, Syed Usman; Ali, Moiz; Noordin, Shahryar

    2016-10-01

    This prospective, cohort study was carried out to assess the improvement in quality of life of patients undergoing elective primary total hip arthroplasty (THA). It was conducted at the orthopaedic department of the Aga Khan University Hospital, Karachi, from June 2014 to May 2015, and comprised patients who had undergone THA. A total of 89 patients having a mean age of 41.5±12.0 years with a baseline core outcomes measure index (COMI)-hip score of > 3.5 were included. A decrease in COMI-hip score by >3 points six months post-operatively was considered improvement in quality of life. Patient satisfaction with restriction to squatting was assessed separately. The mean reduction in COMI-hip was 4.9±1.3 with 83(93%) patients experiencing significant improvement in quality of life. Age >50 years and American Society of Anaesthesiologists (ASA) level >III was significantly associated with no improvement in quality of life. Most patients were satisfied with their disability to squat irrespective of COMI-hip score. THA was found to be associated with significant improvement in quality of life and COMI-hip score was applicable in our population despite its inability to assess disability with restriction in squatting.

  14. Effect of tranexamic acid administration on bleeding in primary total hip arthroplasty.

    Science.gov (United States)

    Fernández-Cortiñas, A B; Quintáns-Vázquez, J M; Gómez-Suárez, F; Murillo, O Simón; Sánchez-López, B R; Pena-Gracía, J M

    To study the efficacy of tranexamic acid to decrease perioperative bleeding in patients who have undergone a total hip arthroplasty operation and to evaluate drug safety. Observational, prospective, controlled and randomized study on the efficacy of tranexamic acid as a method to reduce bleeding in primary hip replacement surgery. We included 134 patients operated during 2014 in our centre, who were divided into 2 groups according to whether or not they had received tranexamic acid. The main study variables were haemoglobin and haematocrit levels, the amount of blood collected from the post-operative drain in the first 12, 24 and 48hours and transfusion requirements. Post-operative haemoglobin and haematocrit levels were statistically higher (Ptranexamic acid. Statistically significant differences (P=.001) were found as to the need for transfusion according to group, more transfusions were performed in the cohort that had not received tranexamic acid: 25.37% compared to 4.48% for the group with tranexamic acid. No adverse events related to administration of tranexamic acid were recorded. Administration of tranexamic acid has proved to be an effective and safe method to reduce peri-operative bleeding in patients who underwent total hip arthroplasty and avoids allogenic blood transfusion. Therefore, tranexamic acid treatment could entail a financial saving for the healthcare system and expose the patient to less risk. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Primary Care Physician and Patient Perceptions of Reimbursement for Total Knee and Hip Replacement.

    Science.gov (United States)

    Wiznia, Daniel H; Kim, Chang-Yeon; Wang, Yuexin; Swami, Nishwant; Pelker, Richard R

    2016-07-01

    The opinions of nonspecialists and patients will be important to determining reimbursements for specialists such as orthopedic surgeons. In addition, primary care physician (PCP) perceptions of reimbursements may affect utilization of orthopedic services. We distributed a web-based survey to PCPs, asking how much they believed orthopedic surgeons were reimbursed for total hip arthroplasty (THA) and total knee arthroplasty (TKA). We also proctored a paper-based survey to postoperative patients, asking how much orthopedic surgeons should be reimbursed. There was a significant difference between perceived and actual reimbursement values for THA and TKA. Hospital-affiliated PCPs estimated higher reimbursements for both THA ($1657 vs $838, P < .0001 for Medicaid and $2246 vs $1515, P = .018 for Medicare) and TKA ($1260 vs $903, P = .052 for Medicaid and $2022 vs $1514, P = .049 for Medicare). Similarly, larger practices estimated higher reimbursements for both THA ($1861 vs $838, P < .0001 for Medicaid and $2635 vs $1515, P = .004 for Medicare) and TKA ($1583 vs $903, P = .005 for Medicaid and $2380 vs $1514, P = .011 for Medicare). Compared to PCPs, patients estimated that orthopedic surgeons should be paid 4 times higher for both THA ($9787 vs $2235, P < .0001) and TKA ($9088 vs $2134, P < .0001). PCPs believe that reimbursements for orthopedic procedures are higher than actual values. The effect that these perceptions will have on efforts at cost reform and utilization of orthopedic services requires further study. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Inpatient Consults and Complications During Primary Total Joint Arthroplasty in a Bundled Care Model.

    Science.gov (United States)

    Baumgartner, Billy T; Karas, Vasili; Kildow, Beau J; Cunningham, Daniel J; Klement, Mitchell R; Green, Cindy L; Attarian, David E; Seyler, Thorsten M

    2018-04-01

    The Centers for Medicare and Medicaid Services (CMS) are implementing changes in hospital reimbursement models for total joint arthroplasty (TJA), moving to value-based bundled payments from the fee-for-service model. The purpose of this study is to identify consults and complications during the perioperative period that increase financial burden. We combined CMS payment data for inpatient, professional, and postoperative with retrospective review of patients undergoing primary TJA and developed profiles of patients included in the Comprehensive Care for Joint Replacement bundle undergoing TJA. Statistical comparison of episode inpatient events and payments was conducted. Multiple regression analysis was adjusted for length of stay, disposition, and Charlson-Deyo comorbidity profile. Median total payment was $21,577.36, which exceeded the median bundle target payment of $20,625.00. Adjusted analyses showed that psychiatry consults (increase of $73,123.32; P care unit admission ($14,078.37; P care unit admission, and medical/psychiatric consultation exceeded the CMS target. Although study results showed typical complication rates, acute inpatient consultation significantly increased utilization beyond the CMS target even when adjusted for length of stay, patient comorbidities, and discharge. Needed medical care should continue to be a priority for inpatients, and allowance for individual outliers should be considered in policy discussions. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Variation in the cost of care for primary total knee arthroplasties.

    Science.gov (United States)

    Haas, Derek A; Kaplan, Robert S

    2017-03-01

    The study examined the cost variation across 29 high-volume US hospitals and their affiliated orthopaedic surgeons for delivering a primary total knee arthroplasty without major complicating conditions. The hospitals had similar patient demographics, and more than 80% of them had statistically-similar Medicare risk-adjusted readmission and complication rates. Hospital and physician personnel costs were calculated using time-driven activity-based costing. Consumable supply costs, such as the prosthetic implant, were calculated using purchase prices, and postacute care costs were measured using either internal costs or external claims as reported by each hospital. Despite having similar patient demographics and readmission and complication rates, the average cost of care for total knee arthroplasty across the hospitals varied by a factor of about 2 to 1. Even after adjusting for differences in internal labor cost rates, the hospital at the 90th percentile of cost spent about twice as much as the one at the 10th percentile of cost. The large variation in costs among sites suggests major and multiple opportunities to transfer knowledge about process and productivity improvements that lower costs while simultaneously maintaining or improving outcomes.

  18. Climate, soil texture, and soil types affect the contributions of fine-fraction-stabilized carbon to total soil organic carbon in different land uses across China.

    Science.gov (United States)

    Cai, Andong; Feng, Wenting; Zhang, Wenju; Xu, Minggang

    2016-05-01

    Mineral-associated organic carbon (MOC), that is stabilized by fine soil particles (i.e., silt plus clay, organic carbon (SOC) persistence and sequestration, due to its large contribution to total SOC (TSOC) and long turnover time. Our objectives were to investigate how climate, soil type, soil texture, and agricultural managements affect MOC contributions to TSOC in China. We created a dataset from 103 published papers, including 1106 data points pairing MOC and TSOC across three major land use types: cropland, grassland, and forest. Overall, the MOC/TSOC ratio ranged from 0.27 to 0.80 and varied significantly among soil groups in cropland, grassland, and forest. Croplands and forest exhibited significantly higher median MOC/TSOC ratios than in grassland. Moreover, forest and grassland soils in temperate regions had higher MOC/TSOC ratios than in subtropical regions. Furthermore, the MOC/TSOC ratio was much higher in ultisol, compared with the other soil types. Both the MOC content and MOC/TSOC ratio were positively correlated with the amount of fine fraction (silt plus clay) in soil, highlighting the importance of soil texture in stabilizing organic carbon across various climate zones. In cropland, different fertilization practices and land uses (e.g., upland, paddy, and upland-paddy rotation) significantly altered MOC/TSOC ratios, but not in cropping systems (e.g., mono- and double-cropping) characterized by climatic differences. This study demonstrates that the MOC/TSOC ratio is mainly driven by soil texture, soil types, and related climate and land uses, and thus the variations in MOC/TSOC ratios should be taken into account when quantitatively estimating soil C sequestration potential of silt plus clay particles on a large scale. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Intravenous versus topical tranexamic acid administration in primary total knee arthroplasty: a meta-analysis.

    Science.gov (United States)

    Shin, Young-Soo; Yoon, Jung-Ro; Lee, Hoon-Nyun; Park, Se-Hwan; Lee, Dae-Hee

    2017-11-01

    This meta-analysis was designed to compare the effectiveness and safety of intravenous (IV) versus topical administration of tranexamic acid (TXA) in patients undergoing primary total knee arthroplasty (TKA) by evaluating the need for allogenic blood transfusion, incidence of postoperative complications, volume of postoperative blood loss, and change in haemoglobin levels. Studies were included in this meta-analysis to check whether they assessed the allogenic blood transfusion rate, postoperative complications including pulmonary thromboembolism (PTE) or deep vein thrombosis (DVT), volume of postoperative blood loss via drainage, estimated blood loss, total blood loss, and change in haemoglobin levels before and after surgery in primary TKA with TXA administered through both the IV and topical routes. Ten studies were included in this meta-analysis. The proportion of patients requiring allogenic blood transfusion (OR 1.34, 95 % CI 0.63-2.81; n.s.) and the proportion of patients who developed postoperative complications including PTE or DVT (OR 0.85, 95 % CI 0.41 to 1.77; n.s.) did not significantly differ between the two groups. There was 52.3 mL less blood loss via drainage (95 % CI -50.74 to 185.66 mL; n.s.), 52.1 mL greater estimated blood loss (95 % CI -155.27 to 51.03 mL; n.s.), and 51.4 mL greater total blood loss (95 % CI -208.16 to 105.31 mL; n.s.) in the topical TXA group as compared to the IV TXA group. The two groups were also similar in terms of the change in haemoglobin levels (0.02 g/dL, 95 % CI -0.36 to 0.39 g/dL; n.s.). In primary TKA, there are no significant differences in the transfusion requirement, postoperative complications, blood loss, and change in haemoglobin levels between the IV and topical administration of TXA. In addition, results from subgroup analysis evaluating the effect of the times of TXA administration through the IV route suggested that double IV dose of TXA is more effective than single dose in terms of the

  20. Long-term Outcome of Unconstrained Primary Total Hip Arthroplasty in Ipsilateral Residual Poliomyelitis.

    Science.gov (United States)

    Buttaro, Martín A; Slullitel, Pablo A; García Mansilla, Agustín M; Carlucci, Sofía; Comba, Fernando M; Zanotti, Gerardo; Piccaluga, Francisco

    2017-03-01

    Incapacitating articular sequelae in the hip joint have been described for patients with late effects of poliomyelitis. In these patients, total hip arthroplasty (THA) has been associated with a substantial rate of dislocation. This study was conducted to evaluate the long-term clinical and radiologic outcomes of unconstrained THA in this specific group of patients. The study included 6 patients with ipsilateral polio who underwent primary THA between 1985 and 2006. Patients with polio who underwent THA on the nonparalytic limb were excluded. Mean follow-up was 119.5 months (minimum, 84 months). Clinical outcomes were evaluated with the modified Harris Hip Score (mHHS) and the visual analog scale (VAS) pain score. Radiographs were examined to identify the cause of complications and determine the need for revision surgery. All patients showed significantly better functional results when preoperative and postoperative mHHS (67.58 vs 87.33, respectively; P=.002) and VAS pain score (7.66 vs 2, respectively; P=.0003) were compared. Although 2 cases of instability were diagnosed, only 1 patient needed acetabular revision as a result of component malpositioning. None of the patients had component loosening, osteolysis, or infection. Unconstrained THA in the affected limb of patients with poliomyelitis showed favorable long-term clinical results, with improved function and pain relief. Nevertheless, instability may be a more frequent complication in this group of patients compared with the general population. [Orthopedics. 2017; 40(2):e255-e261.]. Copyright 2016, SLACK Incorporated.

  1. Improving value in primary total joint arthroplasty care pathways: changes in inpatient physical therapy staffing.

    Science.gov (United States)

    Pelt, Christopher E; Anderson, Mike B; Pendleton, Robert; Foulks, Matthew; Peters, Christopher L; Gililland, Jeremy M

    2017-03-01

    An early physical therapy (PT) care pathway was implemented to provide same-day ambulation after total joint arthroplasty by changing PT staffing hours. After receiving an exemption from our institutional review board, we performed a secondary data analysis on a cohort of patients that underwent primary TJA of the hip or knee 6 months before and 12 months after implementation of the change. Data on same-day ambulation rates, length of stay (LOS), and in-hospital costs were reviewed. Early evaluation and mobilization of patients by PT improved on postoperative day (POD) 0 from 64% to 85% after the change ( P ≤ .001). The median LOS before the change was 3.27 days compared to 3.23 days after the change ( P  = .014). Patients with higher American Society of Anesthesiologists scores were less likely to ambulate on POD 0 ( P  = .038) and had longer hospital stays ( P < .001). Early mobilization in the entire cohort was associated with a greater cost savings ( P < .001). A relatively simple change to staffing hours, using resources currently available to us, and little additional financial or institutional investment resulted in a significant improvement in the number of patients ambulating on POD 0, with a modest reduction in both LOS and inpatient costs.

  2. Body mass and weight thresholds for increased prosthetic joint infection rates after primary total joint arthroplasty.

    Science.gov (United States)

    Lübbeke, Anne; Zingg, Matthieu; Vu, Diemlan; Miozzari, Hermes H; Christofilopoulos, Panayiotis; Uçkay, Ilker; Harbarth, Stephan; Hoffmeyer, Pierre

    2016-01-01

    Obesity increases the risk of deep infection after total joint arthroplasty (TJA). Our objective was to determine whether there may be body mass index (BMI) and weight thresholds indicating a higher prosthetic joint infection rate. We included all 9,061 primary hip and knee arthroplasties (mean age 70 years, 61% women) performed between March 1996 and December 2013 where the patient had received intravenous cefuroxime (1.5 g) perioperatively. The main exposures of interest were BMI (5 categories: prosthetic joint infection. The mean follow-up time was 6.5 years (0.5-18 years). 111 prosthetic joint infections were observed: 68 postoperative, 16 hematogenous, and 27 of undetermined cause. Incidence rates were similar in the first 3 BMI categories (infection from the early postoperative period onward (adjusted HR = 2.1, 95% CI: 1.3-3.6). BMI ≥ 35 or weight ≥ 100 kg may serve as a cutoff for higher perioperative dosage of antibiotics.

  3. Total body retention of orally administered 47Ca in primary hyperparathyroidism

    International Nuclear Information System (INIS)

    Mallette, L.E.; Sode, J.E.; Marx, S.J.; Georges, L.P.; Aurbach, G.D.

    1975-01-01

    Using a whole-body radiation detector, the total-body retention of 47 Ca 7 days after oral administration of the isotope to patients with various disorders of calcium metabolism was measured. The percent retention of 47 Ca given with 90 mg of unlabeled (carrier) calcium varied with the calcium metabolic status as follows: normals (n = 14), 33--43 percent (mean 38); primary hyperparathyroidism (n = 28), 32--74 percent (mean 52); idiopathic hypercalciuria (n = 9), 34--49 percent (mean 42); and hypercalcemia of other etiology (n = 3), 23--26 percent (mean 25). Almost half (13/28) of those with hyperparathyroidism showed a retention above 55 percent, distinguishing them from subjects with idiopathic hypercalciuria. Retention of 47 Ca correlated poorly with clinical measures of severity of hyperparathyroidism. When isotope was diluted with a smaller amount of carrier calcium (20 mg), retention was increased in normals (n = 5) to 46--54 percent (mean 50) and in hyperparathyroidism (n = 5) to 64--87 percent (mean 73). After surgical cure of hyperparathyroidism retention of isotope returned toward normal in 5 of 7 subjects. Whole-body retention of orally administered 47 Ca may prove useful in detecting hyperparathyroidism in subjects with mild hypercalcemia or hypercalciuria. (U.S.)

  4. Obesity is Not Associated with Increased Short-term Complications After Primary Total Shoulder Arthroplasty.

    Science.gov (United States)

    Jiang, Jimmy J; Somogyi, Jason R; Patel, Pranay B; Koh, Jason L; Dirschl, Douglas R; Shi, Lewis L

    2016-03-01

    Few studies have analyzed the association between elevated BMI and complications after total shoulder arthroplasty (TSA). Previous studies have not consistently arrived at the same conclusion regarding whether obesity is associated with a greater number of postoperative complications. We used a national surgical database to compare the 30-day complication profile and hospitalization outcomes after primary TSA among patients in different BMI categories. We asked: (1) Is obesity associated with an increased risk of complications within 30 days of primary TSA? (2) Is obesity associated with increased operative time? The American College of Surgeons National Surgical Quality Improvement Program(®) database for 2006 to 2012 was queried to identify all patients who underwent a primary TSA for osteoarthritis of the shoulder. The ACS-NSQIP(®) database was selected for this study as it is a nationally representative database that provides prospectively collected perioperative data and a comprehensive patient medical profile. Exclusion criteria included revision TSA, infection, tumor, or fracture. We analyzed 4796 patients who underwent a primary TSA for osteoarthritis of the shoulder. Patients who underwent a TSA were divided in four BMI categories: normal (18.5-25 kg/m(2)), overweight (25-30 kg/m(2)), obesity Class 1 (30-35 kg/m(2)), and obesity Class 2 or greater (> 35 kg/m(2)). Perioperative hospitalization data and 30-day postoperative complications were compared among different BMI classes. Differences in patient demographics, preoperative laboratory values, and preexisting patient comorbidities also were analyzed among different BMI groups, and multivariate analysis was used to adjust for any potential confounding variables. There was no association between BMI and 30-day complications after surgery (normal as reference, overweight group relative risk: 0.57 [95% CI, 0.30-1.06], p = 0.076; obesity Class 1 relative risk: 0.52 [95% CI, 0.26-1.03], p = 0.061; obesity

  5. [PERSONALIZED DISTAL FEMORAL VALGUS RESECTION ANGLE IN PRIMARY TOTAL KNEE ARTHROPLASTY].

    Science.gov (United States)

    Wang, Xilong; Shang, Xifu; Ll, Guoyuan; He, Rui; Zheng, Jie

    2015-01-01

    To investigate the feasibility and effectiveness of a personalized distal femoral valgus resection angle for improving postoperative coronal alignment of lower limb in total knee arthroplasty (TKA). A retrospective analysis was made on the clinical data of 50 patients who received primary TKA between January 2013 and February 2013. There were 11 male and 39 female patients with degenerative knee osteoarthritis. The patients were divided into 2 groups. In test group (n=25), the resection angle was adjusted to the femoral mechanical anatomical angle (FMA); in control group (n=25), a fixed distal valgus resection angle of 5° was used. There was no significant difference in gender, age, body mass index, disease duration, sides, grade, preoperative FMA, mechanical femorotibial angle (MFT), and preoperative Knee Society Score (KSS) between 2 groups (P > 0.05). Whole long X-ray film was taken to measure FMA and MFT at 3 days after operation, postoperative KSS was used to evaluate the knee function after 6 and 15 months. MFT was (-0.20 ± 1.87)° in test group and was (1.71 ± 3.67)° in control group, showing significant difference between 2 groups (t = 2.32, P = 0.02). The ideal MFT angle (0 ± 3)° was achieved in 22 patients (88%) of test group and in 16 patients (64%) of control group, showing significant difference between 2 groups (χ2 = 2.32, P = 0.02). Primary healing of incision was obtained in all patients of 2 groups. No deep venous thrombosis occurred. The patients of 2 groups were followed up 15 months after operation. There was significant difference in KSS between test and control groups at 6 months (88.23 ± 2.57 vs. 82.92 ± 2.59) (t = 7.26, P = 0.00) and at 15 months (90.76 ± 2.77 vs. 88.65 ± 1.77) (t = 3.20, P = 0.02). No sign of prosthesis loosening was observed by X-ray examination. Compared with using of a fixed distal femoral resection angle, an individual FMA can significantly improve the postoperative MFT and promote early recovery of the knee

  6. Total Skin Electron Beam for Primary Cutaneous T-cell Lymphoma

    Energy Technology Data Exchange (ETDEWEB)

    Elsayad, Khaled; Kriz, Jan; Moustakis, Christos; Scobioala, Sergiu; Reinartz, Gabriele; Haverkamp, Uwe; Willich, Normann [Department of Radiation Oncology, University Hospital of Muenster, Muenster (Germany); Weishaupt, Carsten [Department of Dermatology, University Hospital of Muenster, Muenster (Germany); Stadler, Rudolf [Department of Dermatology, Johannes-Wesling-Klinikum Minden, Minden (Germany); Sunderkötter, Cord [Department of Dermatology, University Hospital of Muenster, Muenster (Germany); Eich, Hans Theodor, E-mail: Hans.Eich@ukmuenster.de [Department of Radiation Oncology, University Hospital of Muenster, Muenster (Germany)

    2015-12-01

    Purpose: Recent trials with low-dose total skin electron beam (TSEB) therapy demonstrated encouraging results for treating primary cutaneous T-cell lymphoma (PCTCL). In this study, we assessed the feasibility of different radiation doses and estimated survival rates of different pathologic entities and stages. Methods and Materials: We retrospectively identified 45 patients with PCTCL undergoing TSEB therapy between 2000 and 2015. Clinical characteristics, treatment outcomes, and toxicity were assessed. Results: A total of 49 courses of TSEB therapy were administered to the 45 patients. There were 26 pathologically confirmed cases of mycosis fungoides (MF) lymphoma, 10 cases of Sézary syndrome (SS), and 9 non-MF/SS PCTCL patients. In the MF patients, the overall response rate (ORR) was 92% (50% complete remission [CR]), 70% ORR in SS patients (50% CR), and 89% ORR in non-MF/SS patients (78% CR). The ORR for MF/SS patients treated with conventional dose (30-36 Gy) regimens was 92% (63% CR) and 75% (25% CR) for low-dose (<30-Gy) regimens (P=.09). In MF patients, the overall survival (OS) was 77 months with conventional dose regimens versus 14 months with low-dose regimens (P=.553). In SS patients, the median OS was 48 versus 16 months (P=.219), respectively. Median event-free survival (EFS) for MF in conventional dose patients versus low-dose patients was 15 versus 8 months, respectively (P=.264) and 19 versus 3 months for SS patients (P=.457). Low-dose regimens had shorter treatment time (P=.009) and lower grade 2 adverse events (P=.043). A second TSEB course was administered in 4 MF patients with 100% ORR. There is a possible prognostic impact of supplemental/boost radiation (P<.001); adjuvant treatment (P<.001) and radiation tolerability (P=.021) were detected. Conclusions: TSEB therapy is an efficacious treatment modality in the treatment of several forms of cutaneous T-cell lymphoma. There is a nonsignificant trend to higher and longer clinical benefit

  7. Increasing comorbidity is associated with worsening physical function and pain after primary total knee arthroplasty.

    Science.gov (United States)

    Hilton, Maren E; Gioe, Terence; Noorbaloochi, Siamak; Singh, Jasvinder A

    2016-10-07

    Previous studies suggested that pre-operative comorbidity was a risk factor for worse outcomes after TKA. To our knowledge, studies have not examined whether postoperative changes in comorbidity impact pain and function outcomes longitudinally. Our objective was to examine if increasing comorbidity postoperatively is associated with worsening physical function and pain after primary total knee arthroplasty (TKA). We performed a retrospective chart review of veterans who had completed Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form-36 (SF36) surveys at regular intervals after primary TKA. Comorbidity was assessed using a variety of scales: validated Charlson comorbidity index score, and a novel Arthroplasty Comorbidity Severity Index score (Including medical index, local musculoskeletal index [including lower extremity and spine] and TKA-related index subscales; higher scores are worse ), at multiple time-points post-TKA. We used mixed model linear regression to examine the association of worsening comorbidity post-TKA with change in WOMAC and SF-36 scores in the subsequent follow-up periods, controlling for age, length of follow-up, and repeated observations. The study cohort consisted of 124 patients with a mean age of 71.7 years (range 58.6-89.2, standard deviation (SD) 6.9) followed for a mean of 4.9 years post-operatively (range 1.3-11.4; SD 2.8). We found that post-operative worsening of the Charlson Index score was significantly associated with worsening SF-36 Physical Function (PF) (beta coefficient (ß) = -0.07; p < 0.0001), SF-36 Bodily Pain (BP) (ß = -0.06; p = 0.002), and WOMAC PF subscale (ß = 0.08; p < 0.001; higher scores are worse) scores, in the subsequent periods. Worsening novel medical index subscale scores were significantly associated with worsening SF-36 PF scores (ß = -0.03; p = 0.002), SF-36 BP (ß = -0.04; p < 0.001) and showed a non-significant trend

  8. Primary visual cortex volume and total neuron number are reduced in schizophrenia

    DEFF Research Database (Denmark)

    Dorph-Petersen, Karl-Anton; Pierri, Joseph H.; Wu, Qiang

    2007-01-01

    A number of studies that assessed the visual system in subjects with schizophrenia found impairments in early visual processing. Furthermore, functional imaging studies suggested changes in primary visual cortex activity in subjects with schizophrenia. Interestingly, postmortem studies of subject...

  9. Medium term results of total knee arthroplasty as a primary treatment for knee fractures

    Directory of Open Access Journals (Sweden)

    Ebied Ayman

    2018-01-01

    Conclusion: Knee arthroplasty achieves highly successful outcome when performed as a primary treatment for comminuted intra and periarticular knee fractures in elderly patients. Survival of implants and functional range of movement at midterm are excellent.

  10. Treatment of primary hip osteoarthritis for the primary care physician and the indications for total hip arthroplasty.

    Science.gov (United States)

    Levine, Mathew E; Nace, James; Kapadia, Bhaveen H; Issa, Kimona; Banerjee, Samik; Cherian, Jeffery J; Mont, Michael A

    2013-01-01

    Osteoarthritis is a degenerative condition that commonly affects knees and hips with an annual incidence of 88 in 100,000 people in the United States. The purpose of this study was to review the clinical presentation of osteoarthritis of the hip as well as the available management options. We reviewed the recent literature in regard to epidemiology, presentation, and treatment options available to patients. Nonoperative treatments include weight loss and low-impact, aerobic exercises. Along with weight loss and exercise, nonsteroidal anti-inflammatory drugs (NSAIDS), narcotics, and intra-articular steroid injections have been used to improve patient's symptoms. Surgical intervention is a viable option; however, indications such as severe pain that is refractory to nonsurgical management, osteophytes, or joint space narrowing on radiographic films, or impairment of function should be present. The most common surgical option, total hip arthroplasty, has been shown to improve a patient's physical and psychological well-being. However, inherent risks are present with surgery and these should be addressed with the patient so a sound decision can be made. Osteoarthritis of the hip can be bothersome to patients, but physicians can begin management with lifestyle changes or pharmaceuticals. In the event nonoperative measures fail to markedly improve quality of life, total hip arthroplasty remains a viable option.

  11. Comparison of mode of failure between primary and revision total knee arthroplasties.

    Science.gov (United States)

    Liang, H; Bae, J K; Park, C H; Kim, K I; Bae, D K; Song, S J

    2018-04-01

    Cognizance of common reasons for failure in primary and revision TKA, together with their time course, facilitates prevention. However, there have been few reports specifically comparing modes of failure for primary vs. revision TKA using a single prosthesis. The goal of the study was to compare the survival rates, modes of failure, and time periods associated with each mode of failure, of primary vs. revision TKA. The survival rates, modes of failure, time period for each mode of failure, and risk factors would differ between primary and revision TKA. Data from a consecutive cohort comprising 1606 knees (1174 patients) of primary TKA patients, and 258 knees (224 patients) of revision TKA patients, in all of whom surgery involved a P.F.C ® prosthesis (Depuy, Johnson & Johnson, Warsaw, IN), was retrospectively reviewed. The mean follow-up periods of primary and revision TKAs were 9.2 and 9.8 years, respectively. The average 10- and 15-year survival rates for primary TKA were 96.7% (CI 95%,±0.7%) and 85.4% (CI 95%,±2.0%), and for revision TKA 91.4% (CI 95%,±2.5%) and 80.5% (CI 95%,±4.5%). Common modes of failure included polyethylene wear, loosening, and infection. The most common mode of failure was polyethylene wear in primary TKA, and infection in revision TKA. The mean periods (i.e., latencies) of polyethylene wear and loosening did not differ between primary and revision TKAs, but the mean period of infection was significantly longer for revision TKA (1.2 vs. 4.8 years, P=0.003). Survival rates decreased with time, particularly more than 10 years post-surgery, for both primary and revision TKAs. Continuous efforts are required to prevent and detect the various modes of failure during long-term follow-up. Greater attention is necessary to detect late infection-induced failure following revision TKA. Case-control study, Level III. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  12. Calculation of total and ionization cross sections for electron scattering by primary benzene compounds

    Science.gov (United States)

    Singh, Suvam; Naghma, Rahla; Kaur, Jaspreet; Antony, Bobby

    2016-07-01

    The total and ionization cross sections for electron scattering by benzene, halobenzenes, toluene, aniline, and phenol are reported over a wide energy domain. The multi-scattering centre spherical complex optical potential method has been employed to find the total elastic and inelastic cross sections. The total ionization cross section is estimated from total inelastic cross section using the complex scattering potential-ionization contribution method. In the present article, the first theoretical calculations for electron impact total and ionization cross section have been performed for most of the targets having numerous practical applications. A reasonable agreement is obtained compared to existing experimental observations for all the targets reported here, especially for the total cross section.

  13. Calculation of total and ionization cross sections for electron scattering by primary benzene compounds

    Energy Technology Data Exchange (ETDEWEB)

    Singh, Suvam; Naghma, Rahla; Kaur, Jaspreet; Antony, Bobby, E-mail: bka.ism@gmail.com [Atomic and Molecular Physics Lab, Department of Applied Physics, Indian School of Mines, Dhanbad (India)

    2016-07-21

    The total and ionization cross sections for electron scattering by benzene, halobenzenes, toluene, aniline, and phenol are reported over a wide energy domain. The multi-scattering centre spherical complex optical potential method has been employed to find the total elastic and inelastic cross sections. The total ionization cross section is estimated from total inelastic cross section using the complex scattering potential-ionization contribution method. In the present article, the first theoretical calculations for electron impact total and ionization cross section have been performed for most of the targets having numerous practical applications. A reasonable agreement is obtained compared to existing experimental observations for all the targets reported here, especially for the total cross section.

  14. A primary assessment of a daybreak 2200 OSL reader using fine grain quartz and CaSO4:Tm TLD

    International Nuclear Information System (INIS)

    Zhang Keqi; Chen Jie; Lu Yanchou; Wang Changsheng; Yang Chuancheng

    2007-01-01

    Daybreak 2200 OSL readers are widely used for luminescence dating applications. As the sample irradiation and illumination may affect discs in adjacent positions, it is critical to confirm that these factors do not introduce significant systematic errors. Effects of cross-irradiation and cross-bleaching were examined and quantified using fine-grain quartz and highly sensitive CaSO 4 :Tm dosimeters, and the irradiation offset time was measured. The cross-bleaching effect on adjacent aliquots is non-linear with no more than 15% OSL signal reduction following 10ks illumination with the power of blue LED being at 95% maximum. But at positions other than the nearest neighboring sample, almost no effect of cross-bleaching was found. The cross-talk dose, even to the nearest samples, was about 0.02% of the applied dose, and it decreased with increasing distance from the source. Offset time of the built-in Beta source shutter is 0.22 s, which can be neglected in regular dating, and leak dose of the source can be ignored as well. Finally, measurement consistency at Position 0.5, 10, ..... and 55 of the sample tray is better than 3% in relative standard deviation. (authors)

  15. Primary fit of the Lord cementless total hip : a geometric study in cadavers

    NARCIS (Netherlands)

    Schimmel, J.W.; Huiskes, H.W.J.

    1988-01-01

    Two Lord prostheses, bilaterally implanted in cadavers, were sectioned. The contact areas between bone and prosthesis were studied and measured using a specially developed reproducible method. Primary fixation of the femoral components appeared to be based principally on wedging of the prosthetic

  16. Seasonal variation of total particulate matter and children respiratory diseases at Lisbon primary schools using passive methods

    NARCIS (Netherlands)

    Canha, N.; Almeida, M.; Do Carmo Freitas, M.; Almeida, S.M.; Wolterbeek, H.T.

    2011-01-01

    In this work, 14 primary schools of Lisbon city, Portugal, followed a questionnaire of the ISAAC - International Study of Asthma and Allergies in Childhood Program, in 2009/2010. The questionnaire contained questions to identify children with respiratory diseases (wheeze, asthma and rhinitis). Total

  17. Is etoricoxib effective in preventing heterotopic ossification after primary total hip arthroplasty?

    NARCIS (Netherlands)

    Brunnekreef, J.J.; Hoogervorst, P.; Ploegmakers, M.J.M.; Rijnen, W.H.C.; Schreurs, B.W.

    2013-01-01

    PURPOSE: Heterotopic ossification is a common complication after total hip arthroplasty. Non-steroidal anti-inflammatory drugs (NSAIDs) are known to prevent heterotopic ossifications effectively, however gastrointestinal complaints are reported frequently. In this study, we investigated whether

  18. Effectiveness of autologous transfusion system in primary total hip and knee arthroplasty.

    LENUS (Irish Health Repository)

    Schneider, Marco M

    2014-01-01

    Autologous transfusion has become a cost-efficient and useful option in the treatment of patients with high blood loss following major orthopaedic surgery. However, the effectiveness of autologous transfusion in total joint replacement remains controversial.

  19. The active and passive kinematic difference between primary reverse and total shoulder prostheses

    NARCIS (Netherlands)

    Alta, T.D.; de Toledo, J.S.; Veeger, H.E.J.; Janssen, T.W.J.; Willems, W.J.

    2014-01-01

    Background: Reverse shoulder arthroplasty (RSA) and total shoulder arthroplasty (TSA) effectively decrease pain and improve clinical outcome. However, indications and biomechanical properties vary greatly. Our aim was to analyze both active and passive shoulder motion (thoracohumeral [TH],

  20. [Simultaneous determination of 33 primary aromatic amines of free state in fine pigments by ultra-performance liquid chromatography coupled with triple quadrupole mass spectrometry].

    Science.gov (United States)

    Man, Zhengyin; Wang, Quanlin; Li, Hesheng; Zhang, Aizhi

    2014-12-01

    A comprehensive analytical method based on ultra-performance liquid chromatography coupled with triple quadrupole mass spectrometry (UPLC-MS/MS) has been developed for the simultaneous determination of 33 primary aromatic amines (PAAs) in fine pigments such as gouache paint, oil painting pigment and acrylic paint. The primary aromatic amines in samples were extracted with acetonitrile. Then the extract was concentrated by centrifugation and nitrogen blow, finally diluted to 2 mL with methanol-water (1:9, v/v) and filtered through 0. 22 im membrane before UPLC-MS/MS analysis. The analytes were separated on a BEH Phenyl column (100 mm x 2. 1 mm, 1. 7 1µm) with 0. 07% (v/v) formic acid in methanol-water as mobile phases in gradient elution. The PAAs were detected by UPLC-MS/MS under multiple reaction monitoring (MRM) mode and quantified by the internal standard method. The separation conditions, fragment voltages and collision energies were optimized. The impacts of extraction times, extraction solvents and concentration methods on recoveries were studied. The limits of detection and limits of quantitation for the 33 primary aromatic amines were 5-50 µg/kg and 15-150 µg/kg respectively. The mean recoveries of three different dye products at three spiked levels were 70. 1% - 115. 8%. The relative standard deviations were 2. 1% - 15%. The expenmental results indicated that the method is simple, rapid, sensitive, accurate and can meet the requirements for the determination.

  1. Avascular Necrosis Is Associated With Increased Transfusions and Readmission Following Primary Total Hip Arthroplasty.

    Science.gov (United States)

    Lovecchio, Francis C; Manalo, John Paul; Demzik, Alysen; Sahota, Shawn; Beal, Matthew; Manning, David

    2017-05-01

    Avascular necrosis (AVN) may confer an increased risk of complications and readmission following total hip arthroplasty (THA). However, current risk-adjustment models do not account for AVN. A total of 1706 patients who underwent THA for AVN from 2011 to 2013 were selected from the American College of Surgeon's National Surgical Quality Improvement Program database and matched 1:1 to controls using a predetermined propensity score algorithm. Rates of 30-day medical and surgical complications, readmissions, and reoperations were compared between cohorts. Propensity-score logistic regression was used to determine independent associations between AVN and outcomes of interest. Patients with AVN had a higher rate of medical complications than those without AVN (20.3% vs 15.3%, respectively; PAvascular necrosis of the femoral head is an independent risk factor for transfusion up to 72 hours postoperatively and readmission up to 30 days following total hip replacement. [Orthopedics. 2017; 40(3):171-176.]. Copyright 2017, SLACK Incorporated.

  2. CONTEMPORARY VIEW ON COMPUTER NAVIGATION USING AT PRIMARY KNEE TOTAL REPLACEMENT (REVIEW

    Directory of Open Access Journals (Sweden)

    A. I. Petukhov

    2010-01-01

    Full Text Available The topical questions of optical computer navigation at knee total arthroplasty are widely covered. The indications, contraindication to use, using features and possible complications of this technique are listed. The analysis of literature data makes it clear that computer navigation assists in the accuracy of endoprosthesis implantation that may to decrease the rate of revision surgeries in future.

  3. Safety aspects of preoperative high-dose glucocorticoid in primary total knee replacement

    DEFF Research Database (Denmark)

    Jørgensen, C C; Pitter, F T; Kehlet, H

    2017-01-01

    Background: Preoperative single high-dose glucocorticoid may have early outcome benefits in total hip arthroplasty (THA) and knee arthroplasty (TKA), but long-term safety aspects have not been evaluated. Methods: From October 2013, the departments reporting to the prospective Lundbeck Foundation....... Conclusions: In this detailed prospective cohort study, preoperative high-dose glucocorticoid administration was not associated with LOS >4 days, readmissions or infectious complications in TKA patients without contraindications....

  4. [Long-term result of total versus partial fundoplication following esophagomyotomy for primary esophageal motor disorders].

    Science.gov (United States)

    Zhu, Zi-jiang; Chen, Long-qi; Duranceau, Andre

    2008-02-15

    To compare the long-term results of total and partial fundoplication on esophagus myotomy. From January 1978 to October 1998, 64 patients with achalasia or diffuse esophageal spasm underwent esophagomyotomy and antireflux operation via left thoracotomy. Twenty-one patients underwent Nissen total fundoplication (Nissen group) and 43 patients underwent Belsey Marker IV partial fundoplication (Belsey group). Clinical, radiologic, radionuclide transit, manometric, 24-hour pH monitoring and endoscopic assessments were performed before and after the operation. There was no operative death and major complications for either group. At over 6 years follow-up and compared to Belsey group, patients in Nissen group revealed a higher frequency of dysphagia (P = 0.025) and more radionuclide material retention (P = 0.044). Both operative procedures reduced the lower esophageal sphincter pressure gradient. However, in Nissen group, the esophageal diameter observed on radiology was significantly increased from 3.9 cm preoperatively to 5.5 cm postoperatively (P = 0.012), while it kept the same for Belsey group (from 5.4 to 5.3 cm, P = 0.695). Reoperation in order to relieve the recurrent dysphagia and esophageal obstruction was performed on 8 patients in Nissen group and 1 in Belsey group (P < 0.01). When treating achalasia or diffuse esophageal spasm by esophageal myotomy and an antireflux operation, a total fundoplication is not appropriate, whereas a partial fundoplication provides proper antireflux effect without significant esophageal emptying difficulty.

  5. Duplex Ultrasonography Has Limited Utility in Detection of Postoperative DVT After Primary Total Joint Arthroplasty.

    Science.gov (United States)

    Vira, Shaleen; Ramme, Austin J; Alaia, Michael J; Steiger, David; Vigdorchik, Jonathan M; Jaffe, Frederick

    2016-07-01

    Duplex ultrasound is routinely used to evaluate suspected deep venous thrombosis after total joint arthroplasty. When there is a clinical suspicion for a pulmonary embolism, a chest angiogram (chest CTA) is concomitantly obtained. Two questions were addressed: First, for the population of patients who receive duplex ultrasound after total joint arthroplasty, what is the rate of positive results? Second, for these patients, how many of these also undergo chest CTA for clinical suspicion of pulmonary embolus and how many of these tests are positive? Furthermore, what is the correlation between duplex ultrasound results and chest CTA results? A retrospective chart review was conducted of total joint replacement patients in 2011 at a single institution. Inclusion criteria were adult patients who underwent a postoperative duplex ultrasonography for clinical suspicion of deep venous thrombosis (DVT). Demographic data, result of duplex scan, clinical indications for obtaining the duplex scan, and DVT prophylaxis used were recorded. Additionally, if a chest CTA was obtained for clinical suspicion for pulmonary embolus, results and clinical indication for obtaining the test were recorded. The rate of positive results for duplex ultrasonography and chest CTA was computed and correlated based on clinical indications. Two hundred ninety-five patients underwent duplex ultrasonography of which only 0.7% were positive for a DVT. One hundred three patients underwent a chest CTA for clinical suspicion of a pulmonary embolism (PE) of which 26 revealed a pulmonary embolus, none of which had a positive duplex ultrasound. Postoperative duplex scans have a low rate of positive results. A substantial number of patients with negative duplex results subsequently underwent chest CTA for clinical suspicion for which a pulmonary embolus was found, presumably resulting from a DVT despite negative duplex ultrasound result. A negative duplex ultrasonography should not rule out the presence of a

  6. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Bjerregaard, Lars S; Jorgensen, Christoffer C; Kehlet, Henrik

    2016-01-01

    of stay > 4 days or 30-day readmissions after fast-track THA and TKA, we conducted a detailed observational study based upon prospectively collected pre-operative data and a complete 30-day follow-up on complications and re-admissions in a unselected cohort of 8,804 consecutive fast-track THAs and TKAs......BACKGROUND: Overall medical complications have been reduced after fast-track total hip (THA) and knee arthroplasty (TKA), but data on specific renal and urological (RU) complications are limited. METHODS: To describe the incidence and consequences of serious RU complications resulting in length...

  7. Total Artificial Heart as Rescue Therapy for Primary Graft Failure in an Infant.

    Science.gov (United States)

    Ziegler, Luke A; Sainathan, Sandeep; Morell, Victor O; Sharma, Mahesh S

    2018-04-01

    An infant unable to be weaned from cardiopulmonary bypass after orthotopic heart transplantation was cannulated for extracorporeal membrane oxygenation. During the next 3 days, allograft failure and intracardiac thrombosis necessitated cardiectomy. To provide acute mechanical circulatory support, artificial atrial chambers were constructed with Gore-Tex conduits and PediMag centrifugal pumps were connected to each by Berlin Heart EXCOR cannulae. The PediMag pumps were subsequently exchanged for 10-mL Berlin Heart EXCOR pumps. After 60 days of support by total artificial heart, the patient was bridged successfully to a second heart transplant. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  8. Determining the primary cosmic ray energy from the total flux of Cherenkov light measured at the Yakutsk EAS array

    International Nuclear Information System (INIS)

    Ivanov, A. A.; Knurenko, S. P.; Sleptsov, I. E.

    2007-01-01

    We present a method for determining the energy of the primary particle that generates an extensive air shower (EAS) of comic rays based on measuring the total flux of Cherenkov light from the shower. Applying this method to Cherenkov light measurements at the Yakutsk EAS array has allowed us to construct the cosmic ray energy spectrum in the range 10 15 - 3 x 10 19 eV

  9. Can an Arthroplasty Registry Help Decrease Transfusions in Primary Total Joint Replacement? A Quality Initiative.

    Science.gov (United States)

    Markel, David C; Allen, Mark W; Zappa, Nicole M

    2016-01-01

    Standardized care plans are effective at controlling cost and quality. Registries provide insights into quality and outcomes for use of implants, but most registries do not combine implant and care quality data. In 2012, several Michigan area hospitals and a major insurance provider formed a voluntary statewide total joint database/registry, the Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI), to collect procedural, hospital, discharge, and readmission data. Noting substantial variation in transfusion practices after total joint arthroplasty (TJA) in our institutions, we used these prospectively collected data to examine whether awareness and education of the American Association of Blood Banks' (AABB) transfusion guidelines would result in decreased transfusions. (1) Can an established arthroplasty registry help implement a quality initiative (QI) designed to decrease the proportion of transfused postoperative patients undergoing TJA? (2) Do data-driven transfusion protocols decrease length of stay without increasing ischemic complications (myocardial infarctions and cerebrovascular accidents)? (3) Are decreased transfusion proportions associated with decreased readmissions, nonischemic morbidity (including deep vein thrombosis and deep prosthetic infection), and mortality in postoperative patients who had undergone TJA? After reviewing data from the recently established MARCQI registry, the orthopaedic department noticed many discrepancies and practice variances regarding blood transfusions among their providers. In October 2013, a QI was implemented to raise awareness of the discrepancies and education about the AABB guidelines was presented at the monthly orthopaedic service line meeting. A total of 1872 TJA cases were reviewed; 50 were excluded for incomplete data and two for intraoperative transfusions for the period before education (May 2012 to June 2013, n = 1240) and after education (November 2013 to April 2014, n = 580). Data

  10. Does pre-operative psychological distress affect patient satisfaction after primary total hip arthroplasty?

    Directory of Open Access Journals (Sweden)

    Nolan John

    2011-06-01

    Full Text Available Abstract Background There are concerns that pre-operative psychological distress might be associated with reduced patient satisfaction after total hip replacement (THR. Methods We investigated this in a multi-centre prospective study between January 1999 and January 2002. We dichotomised the patients into the mentally distressed (MHS ≤ 56 and the not mentally distressed (MHS > 56 groups based on their pre-operative Mental Health Score (MHS of SF36. Results 448 patients (340 not distressed and 108 distressed completed the patient satisfaction survey. Patient satisfaction rate at five year was 96.66% (415/448. There was no difference in patient satisfaction or willingness to have the surgery between the two groups. None of pre-operative variables predicted five year patient satisfaction in logistic regression. Conclusions Patient satisfaction after surgery may not be adversely affected by pre-operative psychological distress.

  11. Variation in Use of Blood Transfusion in Primary Total Hip and Knee Arthroplasties.

    Science.gov (United States)

    Menendez, Mariano E; Lu, Na; Huybrechts, Krista F; Ring, David; Barnes, C Lowry; Ladha, Karim; Bateman, Brian T

    2016-12-01

    There is growing clinical and policy emphasis on minimizing transfusion use in elective joint arthroplasty, but little is known about the degree to which transfusion rates vary across US hospitals. This study aimed to assess hospital-level variation in use of allogeneic blood transfusion in patients undergoing elective joint arthroplasty and to characterize the extent to which variability is attributable to differences in patient and hospital characteristics. The study population included 228,316 patients undergoing total knee arthroplasty (TKA) at 922 hospitals and 88,081 patients undergoing total hip arthroplasty (THA) at 606 hospitals from January 1, 2009 to December 31, 2011 in the Nationwide Inpatient Sample database, a 20% stratified sample of US community hospitals. The median hospital transfusion rates were 11.0% (interquartile range, 3.5%-18.5%) in TKA and 15.9% (interquartile range, 5.4%-26.2%) in THA. After fully adjusting for patient- and hospital-related factors using mixed-effects logistic regression models, the average predicted probability of blood transfusion use in TKA was 6.3%, with 95% of the hospitals having a predicted probability between 0.37% and 55%. For THA, the average predicted probability of blood transfusion use was 9.5%, with 95% of the hospitals having a predicted probability between 0.57% and 66%. Hospital transfusion rates were inversely associated with hospital procedure volume and directly associated with length of stay. The use of blood transfusion in elective joint arthroplasty varied widely across US hospitals, largely independent of patient case-mix and hospital characteristics. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Primary Report of Totally Tubeless Percutaneous Nephrolithotomy Despite Pelvi-calyceal Perforations.

    Science.gov (United States)

    Aghamir, Seyed Mohammad Kazem; Salavati, Alborz; Hamidi, Morteza; FallahNejad, Asghar

    2017-07-02

    Nephrostomy tube insertion and/or a ureteral stent placement is advised when pelvi-calyceal perforations are encountered during percutaneous nephrolithotomy (PNL) nevertheless totally tubeless PNL is a possible exit strategy in percutaneous renal surgery therefore case series on the short term clinical outcomes of noninvasive management of iatrogenic pelvicalyceal perforations encountered during PNL is presented. During retrospective analysis of 1271 PNL procedures, 25 incidents of accidental ureteral catheter/ jj stent dislodgement during first 24 post-operative hours were identified in patient who had pelvi calyceal perforations and had no nephrostomy tube (tubeless). Thirteen patients could not be re-stented nor a nephrostomytube could have been placed for them mainly due to patient refusal or comorbid conditions. The main outcome was rate of successful noninvasive management. Eighteen Patients bearing mucosal tears (grade I trauma) or visible peri-pelvic fat (grade II) successfully recovered without need for ureteral stenting or nephrostomy (72.0%). In seven (28.0%) cases of extension of the perforation into the peri-pelvic fat (grade III), either nephrostomy insertion or JJ stenting was needed for resolution of fever and urinoma. The major limitation was the necessity to exclude patients and manage them in the standard fashion according to clinical guidelines. Iatrogenic perforations of the collecting system are quite diverse in terms of severity that result in different natural histories and not all might need urinary diversion via nephrostomy or ureteral stenting.Low grade perforations may be successfully managed in totally tubeless fashion nevertheless further prospective investigations seem warranted.

  13. Combined application versus topical and intravenous application of tranexamic acid following primary total hip arthroplasty: a meta-analysis.

    Science.gov (United States)

    Zhang, Pei; Liang, Yuan; Chen, Pengtao; Fang, Yongchao; He, Jinshan; Wang, Jingcheng

    2017-02-21

    The use of intravenous (IV) or topical tranexamic acid (TXA) in total hip arthroplasty has been proven to be effective and safe in total hip arthroplasty. However, which of these two administration routes is better has not been determined. The combined administration of TXA has been used in total knee arthroplasty with satisfactory results. We hypothesized that combined application of TXA may be the most effective way without increased rate of thrombotic events such as deep vein thrombosis (DVT) and pulmonary embolisms (PE) in patients subjected to primary total hip replacement (THA). A meta-analysis was conducted to compare the efficacy and safety of the combined use of tranexamic acid (TXA) relative to topical or intravenous (IV) use alone for treatment of primary THA. The outcomes included total blood loss, postoperative hemoglobin decline, transfusion rates, and the incidence rates of deep vein thrombosis (DVT) and pulmonary embolisms (PE). We searched electronic databases including PubMed, EMBASE, the Cochrane Library, Web of Science, the Chinese Biomedical Literature database, the CNKI database, and Wanfang Data until September 2016. The references of the included articles were also checked for additional potentially relevant studies. There were no language restrictions for the search. The data of the included studies were analyzed using RevMan 5.3 software. Seven studies met the inclusion criteria, encompassing a total of 1762 patients. Our meta-analysis demonstrated that total blood loss, postoperative hemoglobin decline, and transfusion rates were significantly lower for patients that received the combined treatment compared to patients that received either topical or intravenous administration of TXA. No statistical differences were found in the incidence of deep venous thrombosis (DVT) or pulmonary embolism (PE). The group that received the combined treatment had lower total blood loss, postoperative hemoglobin decline, and transfusion rates without an

  14. Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty.

    Science.gov (United States)

    Leitner, Lukas; Musser, Ewald; Kastner, Norbert; Friesenbichler, Jörg; Hirzberger, Daniela; Radl, Roman; Leithner, Andreas; Sadoghi, Patrick

    2016-08-04

    Red blood cell concentrates (RCC) substitution after total knee arthroplasty (TKA) is correlated with multifold of complications and an independent predictor for higher postoperative mortality. TKA is mainly performed in elderly patients with pre-existing polymorbidity, often requiring permanent preoperative antithrombotic therapy (PAT). The aim of this retrospective analysis was to investigate the impact of demand for PAT on inpatient blood management in patients undergoing TKA. In this study 200 patients were retrospectively evaluated after TKA for differences between PAT and non-PAT regarding demographic parameters, preoperative ASA score > 2, duration of operation, pre-, and intraoperative hemoglobin level, and postoperative parameters including amount of wound drainage, RCC requirement, and inpatient time. In a multivariate logistic regression analysis the independent influences of PAT, demographic parameters, ASA score > 2, and duration of the operation on RCC demand following TKA were analyzed. Patients with PAT were significantly older, more often had an ASA > 2 at surgery, needed a higher number of RCCs units and more frequently and had lower perioperative hemoglobin levels. Multivariate logistic regression revealed PAT was an independent predictor for RCC requirement. PAT patients are more likely to require RCC following TKA and should be accurately monitored with respect to postoperative blood loss.

  15. Does cruciate retention primary total knee arthroplasty affect proprioception, strength and clinical outcome?

    Science.gov (United States)

    Vandekerckhove, Pieter-Jan T K; Parys, Roel; Tampere, Thomas; Linden, Patrick; Van den Daelen, Luc; Verdonk, Peter C

    2015-06-01

    It remains unclear what the contribution of the PCL is in total knee arthroplasty (TKA). The goal of this study was to investigate the influence of the PCL in TKA in relationship to clinical outcome, strength and proprioception. Two arthroplasty designs were compared: a posterior cruciate-substituting (PS) and a posterior cruciate-retaining (CR) TKA. A retrospective analysis was performed of 27 CR and 18 PS implants with a minimum of 1 year in vivo. Both groups were compared in terms of clinical outcome (range of motion, visual analogue scale for pain, Hospital for Special Surgery Knee Scoring system, Lysholm score and Knee Injury and Osteoarthritis Outcome Score), strength (Biodex System 3 Dynamometer(®)) and proprioception (balance and postural control using the Balance Master system(®)). Each design was also compared to the non-operated contralateral side in terms of strength and proprioception. There were no significant differences between both designs in terms of clinical outcome and strength. In terms of proprioception, only the rhythmic weight test at slow and moderate speed shifting from left to right was significant in favour of the CR design. None of the unilateral stance tests showed any significant difference between both designs. There was no difference in terms of strength and proprioception between the operated side and the non-operated side. Retaining the PCL in TKA does not result in an improved performance in terms of clinical outcome and proprioception and does not show any difference in muscle strength. III.

  16. Full phosphorescent white-light organic light-emitting diodes with improved color stability and efficiency by fine tuning primary emission contributions

    Directory of Open Access Journals (Sweden)

    Wang Hua

    2014-02-01

    Full Text Available In this paper, a novel type of white-light organic light emitting diode (OLED with high color stability was reported, in which the yellow-light emission layer of (4,4′-N,N′-dicarbazolebiphenyl (CBP : tris(2-phenylquinoline-C2,N′iridium(III (Ir(2-phq3 was sandwiched by double blue-light emission layers of 1,1-bis-[(di-4-tolylaminopheny1]cyclohexane (TAPC : bis[4,6-(di-fluorophenyl-pyridinato-N,C2′]picolinate (FIrpic and tris[3-(3-pyridylmesityl]borane (3TPYMB:FIrpic. And, it exhibited the maximum current efficiency of 33.1 cd/A, the turn-on voltage at about 3 V and the maximum luminance in excess of 20000 cd/m2. More important, it realized very stable white-light emission, and its CIE(x, y coordinates only shift from (0.34, 0.37 to (0.33, 0.37 as applied voltage increased from 5 V to 12 V. It is believed that the new scheme in emission layer of white-light OLED can fine tune the contribution of primary emission with applied voltage changed, resulting in high quality white-light OLED.

  17. Incidental primary mediastinal choriocarcinoma diagnosed by endobronchial ultrasound-guided fine needle aspiration in a patient presenting with transient ischemic attack and stroke.

    Science.gov (United States)

    Francischetti, Ivo M B; Cajigas, Antonio; Suhrland, Mark; Farinhas, Joaquim M; Khader, Samer

    2017-08-01

    We describe a case of a 41-year old male patient with no significant prior medical history who presents with symptoms of Transient Ischemic Attack and stroke. Magnetic Resonance Imaging (MRI) of the brain identified areas of ischemia in the left side, and angiography showed occlusion of the left Medial Cerebral Artery (MCA). Cardiac Transthoracic Echocardiogram (TTE) for stroke evaluation incidentally noted a mediastinal abnormality leading to cancer work-up. Computer Tomography (CT) and 18 F-fluorodeoxyglucose (FDG) PET-CT scan of the chest incidentally revealed an avid 6 cm paraesophagial/subcarinal mass. Further diagnostic work-up with endoscopic and endobronchial ultra sound (EBUS)-guided fine needle aspiration (FNA) of the mass yielded a cytology diagnosis of Germ Cell Tumor (GCT), with choriocarcinoma component. Additionally, high plasma levels of β-human chorionic gonadotrophin (β-HCG) were detected with no evidence of testicular tumor. This exceedingly rare presentation for a primary mediastinal choriocarcinoma underscores the importance of complete investigation of young patients presenting with neurological symptoms compatible with ischemic events. Diagn. Cytopathol. 2017;45:738-743. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  18. Full phosphorescent white-light organic light-emitting diodes with improved color stability and efficiency by fine tuning primary emission contributions

    Energy Technology Data Exchange (ETDEWEB)

    Hua, Wang, E-mail: wmsu2008@sinano.ac.cn, E-mail: wanghua001@tyut.edu.cn; Du, Xiaogang [Key Laboratory of Interface Science and Engineering in Advanced Materials, Taiyuan University of Technology, Ministry of Education, Taiyuan 030024 (China); Research Center of Advanced Materials Science and Technology, Taiyuan University of Technology, Taiyuan 030024 (China); Su, Wenming, E-mail: wmsu2008@sinano.ac.cn, E-mail: wanghua001@tyut.edu.cn; Zhang, Dongyu [Printable Electronics Research Centre, Suzhou Institute of Nano-Tech and Nano-Bionics, CAS, suzhou 215123 (China); Lin, Wenjing [Key Laboratory of Interface Science and Engineering in Advanced Materials, Taiyuan University of Technology, Ministry of Education, Taiyuan 030024 (China); Research Center of Advanced Materials Science and Technology, Taiyuan University of Technology, Taiyuan 030024 (China); Printable Electronics Research Centre, Suzhou Institute of Nano-Tech and Nano-Bionics, CAS, suzhou 215123 (China)

    2014-02-15

    In this paper, a novel type of white-light organic light emitting diode (OLED) with high color stability was reported, in which the yellow-light emission layer of (4,4{sup ′}-N,N{sup ′}-dicarbazole)biphenyl (CBP) : tris(2-phenylquinoline-C2,N{sup ′})iridium(III) (Ir(2-phq){sub 3}) was sandwiched by double blue-light emission layers of 1,1-bis-[(di-4-tolylamino)pheny1]cyclohexane (TAPC) : bis[4,6-(di-fluorophenyl)-pyridinato-N,C2{sup ′}]picolinate (FIrpic) and tris[3-(3-pyridyl)mesityl]borane (3TPYMB):FIrpic. And, it exhibited the maximum current efficiency of 33.1 cd/A, the turn-on voltage at about 3 V and the maximum luminance in excess of 20000 cd/m{sup 2}. More important, it realized very stable white-light emission, and its CIE(x, y) coordinates only shift from (0.34, 0.37) to (0.33, 0.37) as applied voltage increased from 5 V to 12 V. It is believed that the new scheme in emission layer of white-light OLED can fine tune the contribution of primary emission with applied voltage changed, resulting in high quality white-light OLED.

  19. Full phosphorescent white-light organic light-emitting diodes with improved color stability and efficiency by fine tuning primary emission contributions

    Science.gov (United States)

    Hua, Wang; Du, Xiaogang; Su, Wenming; Lin, Wenjing; Zhang, Dongyu

    2014-02-01

    In this paper, a novel type of white-light organic light emitting diode (OLED) with high color stability was reported, in which the yellow-light emission layer of (4,4'-N,N'-dicarbazole)biphenyl (CBP) : tris(2-phenylquinoline-C2,N')iridium(III) (Ir(2-phq)3) was sandwiched by double blue-light emission layers of 1,1-bis-[(di-4-tolylamino)pheny1]cyclohexane (TAPC) : bis[4,6-(di-fluorophenyl)-pyridinato-N,C2']picolinate (FIrpic) and tris[3-(3-pyridyl)mesityl]borane (3TPYMB):FIrpic. And, it exhibited the maximum current efficiency of 33.1 cd/A, the turn-on voltage at about 3 V and the maximum luminance in excess of 20000 cd/m2. More important, it realized very stable white-light emission, and its CIE(x, y) coordinates only shift from (0.34, 0.37) to (0.33, 0.37) as applied voltage increased from 5 V to 12 V. It is believed that the new scheme in emission layer of white-light OLED can fine tune the contribution of primary emission with applied voltage changed, resulting in high quality white-light OLED.

  20. TOTAL EYELID RECONSTRUCTION IN A PRIMARY IMMUN O DEFICIENT WI TH G I A NT PYOGENIC GRANULOMA

    Directory of Open Access Journals (Sweden)

    Vijay Kumar

    2015-06-01

    Full Text Available Total upper and lower eyelid defect is usually secondary to the excision of malignant or benign tumours, trauma and burns. Reconstruction of this type of defect is important not only for the cosmetic result, but also for coverage of the cornea an d prevent injury to eyeball. Pyogenic granuloma is usually preceded by the history of trauma to the eyelid. But reports of giant pyogenic granuloma of both upper and lower eyelid are rare. We present here a ten year old boy diagnosed primary immune deficient with a large fungating mass over both upper and lower eyelid, which was excised and total upper and lower eyelid defect was reconstructed with paramedian forehead flap. Histopathology revealed pyogenic granuloma. Post operatively c hild had good lid movements.

  1. Fracture of Fully-coated Femoral Stem after Primary Total Hip Arthroplasty for Nonunion of Intertrochanteric Fracture: A Case Report.

    Science.gov (United States)

    Chun, Young Soo; Juh, Hyung Suk; Cho, Yoon Je; Rhyu, Kee Hyung

    2015-09-01

    Femoral stem fracture is an uncommon reason for the failure of total hip arthroplasty, with only 16 cases of fully coated stem fractures reported to date. Here we report a case in which a fully coated primary femoral stem fracture occurred after conversion to total hip arthroplasty for the non-union of an intertrochanteric fracture of the femur. Metallurgic evaluation of the etiology and mechanism revealed that the fracture was initiated by fatigue-related failure and completed by ductile failure on the posterior side of the fracture. Considering the recent trend of treating an intertrochanteric fracture with hip arthroplasty, possible stem failure should be considered, since most patients will have at least one of the known risk factors for stem fracture.

  2. Evaluation of the Quality of Life and Psychiatric Symptoms of Patients with Primary Coxarthrosis after Total Hip Arthroplasty.

    Science.gov (United States)

    Balik, M S; Hocaoğlu, Ç; Erkut, A; Güvercin, Y; Keskin, D

    2017-01-01

    PURPOSE OF THE STUDY In this study, it was aimed to examine the preoperative and postoperative quality of life and psychiatric symptoms of the patients with primary coxarthrosis after total hip arthroplasty. MATERIAL AND METHODS 150 patients undergone total hip arthroplasty were involved in this study. The socio-demographical data form prepared by the researchers was utilized before and after the operation in order to demonstrate disease-related socio-demographical characteristics of the patient. The Quality of Life Scale Short Form (SF-36), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Harris Hip Score (HHS) and Visual Analog Scale (VSA) were implemented in the preoperative period and at 6th and 12th week after the operation. RESULTS Of the patients involved in study, 28.7% were male and 71.3% were female. Their mean age was 58.34±11.92 year. While statistically significant differences were found between the preoperative and postoperative periods in terms of physical function, physical role limitation, emotional role limitation, energy, social function, pain, and general health subscales of SF-36, no significant differences were found relating mental health subscale. In BAI, BDI, VAS, and HHS comparison, statistically significant differences were found between the preoperative and postoperative periods, except for BAI. CONCLUSIONS In this study, it was determined that primary coxarthrosis affects significantly the quality of the patients' lives in a negative way and can be accompanied by mental symptoms. After total hip arthroplasty, significant improvement was observed in quality of life, depression and pain scores. Key words: total hip prosthesis, quality of life, mental symptoms.

  3. Investigating the primary stability of the transversal support tibial plateau concept to retain both cruciate ligaments during total knee arthroplasty.

    Science.gov (United States)

    Nowakowski, Andrej M; Stangel, Melanie; Grupp, Thomas M; Valderrabano, Victor

    2012-09-27

    The important roles of the anterior cruciate ligament regarding knee stability, physiologic kinematics, and proprioception are unquestioned. Thus, various efforts have been made to retain the ACL during total knee arthroplasty (TKA). Neither of the existing solutions to this problem, i.e. bicruciate retaining prostheses and implantation of two unicondylar prostheses, has been successful because of concept-specific problems as well as general difficulties with implant fixation. The new transversal support tibial plateau concept is a prosthesis of two individual joint surfaces reinforced beneath the articular line by joint surface supports and buttressed by a single transversal support. This configuration, which enables retention of both cruciate ligaments, should provide good bone fixation and ensure long-term alignment of the individual joint surfaces. In the current study, four prototypes based on this novel concept were developed and the resulting primary stability was analyzed using adapted load testing. The test set-up, with the model-loading of specially prepared Sawbones® and a sinusoidal oscillating load transmission with 25 000 cycles over 10 increasing load levels, achieved subsidence, which enabled comparison of the four different model variants regarding primary stability in view of bone anchoring. The model variant (TSmobile) that allowed transverse glide of the joint surface supports along the transversal support revealed the largest subsidence. A rigid attachment of the joint surface supports of the transversal support tibial plateau thus appears to offer increased primary stability regarding bone anchoring.

  4. Has Health Care Reform Legislation Reduced the Economic Burden of Hospital Readmissions Following Primary Total Joint Arthroplasty?

    Science.gov (United States)

    Kurtz, Steven M; Lau, Edmund C; Ong, Kevin L; Adler, Edward M; Kolisek, Frank R; Manley, Michael T

    2017-11-01

    The purpose of this study was to determine whether the cost of readmissions after primary total hip and knee arthroplasty (THA and TKA) has decreased since the introduction of health care reform legislation and what patient, clinical, and hospital factors drive such costs. The 100% Medicare inpatient dataset was used to identify 1,654,602 primary THA and TKA procedures between 2010 and 2014. The per-patient cost of readmissions was evaluated in general linear models in which the year of surgery and patient, clinical, and hospital factors were treated as covariates in separate models for THA and TKA. The year-to-year risk of 90-day readmission was reduced by 2% and 4% (P total joint arthroplasty volume. The top 5 factors associated with the cost of 90-day TKA readmissions were (in rank order) the length of stay, hospital's teaching status, discharge disposition, patient's gender, and age. Although readmission rates declined slightly, the results of this study do not support the hypothesis that readmission costs have decreased since the introduction of health care reform legislation. Instead, we found that clinical and hospital factors were among the most important cost drivers. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Circumferential electrocautery of the patella in primary total knee replacement without patellar replacement: a meta-analysis and systematic review

    Science.gov (United States)

    Fan, Lihong; Ge, Zhaogang; Zhang, Chen; Li, Jia; Yu, Zefeng; Dang, Xiaoqian; Wang, Kunzheng

    2015-03-01

    The purpose of this meta-analysis and systematic review was to identify and assess whether circumferential electrocautery is useful for improving outcomes after primary total knee replacement(TKR). We searched MEDLINE, EMBASE, PubMed, SpringerLink, Web of Knowledge, OVID CINAHL, OVID EBM and Google Scholar and included articles published through January 2014. A total of 6 articles met the inclusion criteria. Of the 776 cases included in the analysis, 388 cases involved patellar denervation, and 388 cases were designated as the control group. The meta-analysis revealed no significant difference in the incidence of anterior knee pain (AKP, p = 0.18) or in the visual analogue scale score (VAS, p = 0.23) between the two groups. In addition, AKSS Function Score indicated no significant difference between the two groups (p = 0.28). However, the OKS (p = 0.02), patellar score (p = 0.01), AKSS-Knee Score (p = 0.004), range of motion (ROM, p electrocautery. The results indicate that circumferential electrocautery of the patella does not significantly improve AKP compared with non-electrocautery techniques but that circumferential electrocautery significantly improves patients' knee function after surgery. Therefore, we believe that circumferential electrocautery is beneficial to the outcome of primary TKR surgery without patellar replacement.

  6. [Quality of Outcome after Primary Total Hip Replacement at a Maximum Care Hospital in Relation to Preoperative Influencing Factors].

    Science.gov (United States)

    Osmanski-Zenk, K; Steinig, N S; Glass, Ä; Mittelmeier, W; Bader, R

    2015-12-01

    As the need for joint replacements will continue to rise, the outcome of primary total hip replacement (THR) must be improved and stabilised at a high level. In this study, we investigated whether pre-operative risk factors, such as gender, age and body weight at the time of the surgery or a restricted physical status (ASA-Status > 2 or Kellgren and Lawrence grade > 2) have a negative influence on the post-operative results or on patient satisfaction. Retrospective data collection and a prospective interview were performed with 486 patients who underwent primary total hip replacement between January 2007 and December 2010 in our hospital. The patients' satisfaction and quality of life were surveyed with the WOMAC-Score, SF-36 and EuroQol-5. Differences between more than two independent spot tests were tested with the non-parametric Kruskal-Wallis test. Differences between two independent spot tests were tested with the non-parametric Mann-Whitney U test. The frequencies were reported and odds ratios calculated. The confidence interval was set at 95 %. The level of significance was p total score of the SF-36 was 66.9 points. The patients declared an average EuroQol Index of 0.81. Our data show that the patients' gender did not influence the duration of surgery or the scores. However, female patients tended to exhibit more postoperative complications. However, increased patient age at the time of surgery was associated with an increased OR for duration of surgery, length of stay and risk of complications. Patients who had a normal body weight at time of the surgery showed better peri- and post-operative results. We showed that the preoperative estimated Kellgren and Lawrence grade had a significant influence on the duration of surgery. The ASA classification influenced the duration of surgery as well the length of stay and the rate of complications. The quality of results after primary THR depends on preoperative factors. Existing comorbidities have a

  7. Early results of Latitude primary total elbow replacement with a minimum follow-up of 2 years.

    Science.gov (United States)

    Mehta, Saurabh S; Watts, Adam C; Talwalkar, Sumedh C; Birch, Ann; Nuttall, David; Trail, Ian A

    2017-10-01

    The aim of this study was to present outcomes of primary Latitude total elbow replacement (TER) with a minimum follow-up of 2 years. A retrospective cohort study was undertaken with prospective outcome data collection for the latest outcome. Included were 63 consecutive primary Latitude TERs in 58 patients performed during a period of 5 years at a specialist orthopedic hospital. The mean age of the patients was 62 years (33-85 years). Five primary TERs (4 patients) were lost to follow-up. The primary diagnosis was rheumatoid arthritis in 49, osteoarthritis in 8, and trauma in 6 elbows. The mean flexion-extension arc was 75° preoperatively and 97° postoperatively. Mean postoperative Elbex pain score was 19/100, and function score was 37/100. Mean postoperative scores were 42/100 for the Quick Disabilities of the Arm, Shoulder, and Hand and 38/50 for the elbow-specific American Shoulder and Elbow Surgeons assessment. Four patients died of unrelated causes, and 8 of 63 underwent further surgical intervention, including explantation and conversion from unlinked to linked implant. On radiographic review of 41 surviving TERs, aseptic radiologic loosening was observed of the humeral component in 4 elbows and of the ulnar component in 9. Seven elbows had no radial component, and of the remaining 34 elbows, 16 (47%) had signs of loosening of the radial implant. Complications included 1 heterotopic ossification, 1 olecranon fracture, and 3 further procedures for ulnar nerve entrapment. The results indicate that the early outcome of Latitude TER is comparable to that of other prostheses. There is concern about early radiologic loosening of the radial component. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  8. Patient-Reported Esthetic and Functional Outcomes of Primary Total Laparoscopic Intestinal Vaginoplasty in Transgender Women With Penoscrotal Hypoplasia.

    Science.gov (United States)

    Bouman, Mark-Bram; van der Sluis, Wouter B; van Woudenberg Hamstra, Leonora E; Buncamper, Marlon E; Kreukels, Baudewijntje P C; Meijerink, Wilhelmus J H J; Mullender, Margriet G

    2016-09-01

    Puberty-suppressing hormonal treatment may result in penoscrotal hypoplasia in transgender women, making standard penile inversion vaginoplasty not feasible. For these patients, intestinal vaginoplasty is a surgical alternative, but knowledge on patient-reported postoperative outcomes and quality of life is lacking. To assess patient-reported functional and esthetic outcomes, quality of life, satisfaction, and sexual well-being after primary total laparoscopic intestinal vaginoplasty in transgender women. A survey study was performed on transgender women who underwent primary total laparoscopic intestinal vaginoplasty with at least 1 year of clinical follow-up. Thirty-one transgender women completed the questionnaires (median age at time of surgery = 19.1 years, range = 18.3-45.0) after a median clinical follow-up of 2.2 years (range = 0.8-7.5). Consenting women were asked to complete a combined questionnaire of the Subjective Happiness Scale, the Satisfaction With Life Scale, Cantril's Ladder of Life Scale, the Female Sexual Function Index, the Female Genital Self-Imaging Scale, the Amsterdam Hyperactive Pelvic Floor Scale-Women, and a questionnaire addressing postoperative satisfaction. Patient-reported functional and esthetic outcomes and postoperative quality of life. Patients graded their life satisfaction a median of 8.0 (range = 4.0-10.0) on Cantril's Ladder of Life Scale. Patients scored a mean total score of 27.7 ± 5.8 on the Satisfaction With Life Scale, which indicated high satisfaction with life, and a mean total score of 5.6 ± 1.4 on the Subjective Happiness Scale. Functionality was graded a median score of 8.0 of 10 (range = 1.0-10.0) and esthetics a score of 8.0 out of 10 (range = 3.0-10.0). The mean Female Sexual Function Index total score of sexually active transgender women was 26.0 ± 6.8. This group of relatively young transgender women reported satisfactory functional and esthetic results of the neovagina and a good quality of life

  9. Benefits and limitations of fine needle aspiration cytology in the diagnosis and classification of leprosy in primary and secondary healthcare settings.

    Science.gov (United States)

    Ray, R; Mondal, R K; Pathak, S

    2015-08-01

    The goal of the World Health Organization (WHO) is to eliminate leprosy as a public health problem. This will only be possible when all patients are detected and cured using multidrug therapy, which requires accurate diagnosis prior to treatment. The objective of this study was to evaluate the possibility of the diagnosis of leprosy lesions by fine needle aspiration cytology according to a modification of the Ridley-Jopling scale, as it can be used in primary and secondary healthcare centres, especially in low-resource settings in which leprosy is prevalent. A prospective study comprising 54 cases with cardinal features of leprosy was performed. Among the 54 cases, 27 patients consented to a histopathological biopsy procedure. The slides were stained with Giemsa, modified Ziehl-Neelsen, Papanicolaou and haematoxylin and eosin methods. Among the 54 cases, 34 were reported as tuberculoid leprosy, five as mid-borderline (BB), three as borderline lepromatous (BL) and eight as lepromatous leprosy (LL); four were unsatisfactory. Histopathological study was performed in 27 cases, which showed cyto-histological correlation in 21 cases (78%). Agreement between histological and cytological diagnosis was achieved in 12 of the 15 tuberculoid cases, one of the three BB cases, one of the two BL cases and all seven LL cases. With the implementation of the WHO classification based on patch counting, there is the possibility of the over-treatment of paucibacillary cases and under-treatment of multibacillary cases. Cytology in terms of cellular type morphology and bacteriological study can complement the WHO classification. © 2014 John Wiley & Sons Ltd.

  10. [Intra-Articular Application of Tranexamic Acid Significantly Reduces Blood Loss and Transfusion Requirement in Primary Total Knee Arthroplasty].

    Science.gov (United States)

    Lošťák, J; Gallo, J; Špička, J; Langová, K

    2016-01-01

    PURPOSE OF THE STUDY The aim of this prospective study was to investigate the effect of topical application of tranexamic acid (TXA, Exacyl) on the amount of post-operative blood loss, and blood transfusion requirement in patients undergoing primary total knee arthroplasty (TKA). Attention was paid to early complications potentially associated with TXA administration, such as haematoma, wound exudate, or knee swelling. In addition, the economic benefit of TXA treatment was also taken into account. MATERIAL AND METHODS The study included 238 patients (85 men and 153 women) who underwent primary total knee arthroplasty (TKA) at our department between January 2013 and November 2015. A group of 119 patients (41 men and 78 women) received intraarticular TXA injections according to the treatment protocol (TXA group). A control group matched in basic characteristics to the TXA group also consisted of 119 patients. The average age in the TXA group was 69.8 years, and the most frequent indication for TKA surgery was primary knee osteoarthritis (81.5%). In each patient, post-operative volume of blood lost from drains and total blood loss including hidden blood loss were recorded, as well as post-operative haemoglobin and haematocrit levels. On discharge of each patient from hospital, the size and site of a haematoma; wound exudate, if present after post-operative day 4; joint swelling; range of motion and early revision surgery, if performed, were evaluated. Requirements of analgesic drugs after surgery were also recorded. RESULTS In the TXA group, blood losses from drains were significantly lower than in the control group (456.7 ± 270.8 vs 640.5 ±448.2; p = 0.004). The median value for blood losses from drains was lower by 22% and the average value for total blood loss, including hidden losses, was also lower than in the control group (762.4 ± 345.2 ml vs 995.5 ± 457.3 ml). The difference in the total amount of blood loss between the two groups was significant (p = 0

  11. A Retrospective Analysis of Hemostatic Techniques in Primary Total Knee Arthroplasty: Traditional Electrocautery, Bipolar Sealer, and Argon Beam Coagulation.

    Science.gov (United States)

    Rosenthal, Brett D; Haughom, Bryan D; Levine, Brett R

    2016-01-01

    In this retrospective cohort study of 280 primary total knee arthroplasties, clinical outcomes relevant to hemostasis were compared by electrocautery type: traditional electrocautery (TE), bipolar sealer (BS), and argon beam coagulation (ABC). Age, sex, and preoperative diagnosis were not significantly different among the TE, BS, and ABC cohorts. The 3 hemostasis systems were statistically equivalent with respect to estimated blood loss. Wound drainage during the first 48 hours after surgery was equivalent between the BS and ABC cohorts but less for the TE cohort. Transfusion requirements were not significantly different among the cohorts. The 3 hemostasis systems were statistically equivalent with respect to mean change in hemoglobin level during the early postoperative period (levels were measured on postoperative day 1 and on discharge). As BS and ABC are clinically equivalent to TE, their increased cost may not be justified.

  12. The “true” incidence of surgically treated deep prosthetic joint infection after 32,896 primary total hip arthroplasties

    Science.gov (United States)

    Gundtoft, Per Hviid; Overgaard, Søren; Schønheyder, Henrik Carl; Møller, Jens Kjølseth; Kjærsgaard-Andersen, Per; Pedersen, Alma Becic

    2015-01-01

    Background and purpose It has been suggested that the risk of prosthetic joint infection (PJI) in patients with total hip arthroplasty (THA) may be underestimated if based only on arthroplasty registry data. We therefore wanted to estimate the “true” incidence of PJI in THA using several data sources. Patients and methods We searched the Danish Hip Arthroplasty Register (DHR) for primary THAs performed between 2005 and 2011. Using the DHR and the Danish National Register of Patients (NRP), we identified first revisions for any reason and those that were due to PJI. PJIs were also identified using an algorithm incorporating data from microbiological, prescription, and clinical biochemistry databases and clinical findings from the medical records. We calculated cumulative incidence with 95% confidence interval. Results 32,896 primary THAs were identified. Of these, 1,546 had first-time revisions reported to the DHR and/or the NRP. For the DHR only, the 1- and 5-year cumulative incidences of PJI were 0.51% (0.44–0.59) and 0.64% (0.51–0.79). For the NRP only, the 1- and 5-year cumulative incidences of PJI were 0.48% (0.41–0.56) and 0.57% (0.45–0.71). The corresponding 1- and 5-year cumulative incidences estimated with the algorithm were 0.86% (0.77–0.97) and 1.03% (0.87–1.22). The incidences of PJI based on the DHR and the NRP were consistently 40% lower than those estimated using the algorithm covering several data sources. Interpretation Using several available data sources, the “true” incidence of PJI following primary THA was estimated to be approximately 40% higher than previously reported by national registries alone. PMID:25637247

  13. Tranexamic acid administration to older patients undergoing primary total hip arthroplasty conserves hemoglobin and reduces blood loss.

    Science.gov (United States)

    El Beheiry, Hossam; Lubberdink, Ashley; Clements, Nigel; Dihllon, Kiran; Sharma, Vicky

    2018-06-01

    Tranexamic acid effects in older people are difficult to predict. This study investigated the following research questions: 1) Is tranexamic acid effective in older patients undergoing primary total hip arthroplasty (THA)? and 2) Is there a difference in the effect of tranexamic acid between younger and older patients? This was a 2-phase retrospective matched-pair study of patients who underwent THA in 2007-2013. All procedures were performed by surgeons with at least 10 years' experience as senior consultant. In the first phase, 58 patients aged 65 years or more who received tranexamic acid were matched 1:1 with patients who did not receive tranexamic acid for age, sex, American Society of Anesthesiologists (ASA) classification and body mass index. In the second phase, 58 patients aged 65 years or more who received tranexamic acid were matched 1:1 with patients less than 65 years of age who received tranexamic acid for sex, ASA classification and body mass index. The primary outcome measures were percent maximum decrease in hemoglobin level and estimated blood loss after surgery. In the first phase, patients who received tranexamic acid conserved postoperative hemoglobin by a mean of 10.26 g/L (standard deviation [SD] 9.89 g/L) compared to the control group ( p Tranexamic acid reduced the postoperative decrease in hemoglobin level and blood loss in older patients. Moreover, the significant hemoglobin-sparing effect of tranexamic acid in older patients was similar to that observed in younger patients.

  14. Post-Discharge Care Duration, Charges, and Outcomes Among Medicare Patients After Primary Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Ponnusamy, Karthikeyan E; Naseer, Zan; El Dafrawy, Mostafa H; Okafor, Louis; Alexander, Clayton; Sterling, Robert S; Khanuja, Harpal S; Skolasky, Richard L

    2017-06-07

    In April 2016, the U.S. Centers for Medicare & Medicaid Services initiated mandatory 90-day bundled payments for total hip and knee arthroplasty for much of the country. Our goal was to determine duration of care, 90-day charges, and readmission rates by discharge disposition and U.S. region after hip or knee arthroplasty. Using the 2008 Medicare Provider Analysis and Review database 100% sample, we identified patients who had undergone elective primary total hip or knee arthroplasty. We collected data on patient age, sex, comorbidities, U.S. Census region, discharge disposition, duration of care, 90-day charges, and readmission. Multivariate regression was used to assess factors associated with readmission (logistic) and charges (linear). Significance was set at p total hip arthroplasties were discharged to home (18%), home health care (34%), extended-care facilities (35%), and inpatient rehabilitation (13%); patients undergoing 329,233 total knee arthroplasties were discharged to home (21%), home health care (38%), extended-care facilities (31%), and inpatient rehabilitation (10%). Patients in the Northeast were more likely to be discharged to extended-care facilities or inpatient rehabilitation than patients in other regions. Patients in the West had the highest 90-day charges. Approximately 70% of patients were discharged home from extended-care facilities, whereas after inpatient rehabilitation, >50% of patients received home health care. Among those discharged to home, 90-day readmission rates were highest in the South (9.6%) for patients undergoing total hip arthroplasty and in the Midwest (8.7%) and the South (8.5%) for patients undergoing total knee arthroplasty. Having ≥4 comorbidities, followed by discharge to inpatient rehabilitation or an extended-care facility, had the strongest associations with readmission, whereas the region of the West and the discharge disposition to inpatient rehabilitation had the strongest association with higher charges

  15. Anne Fine

    Directory of Open Access Journals (Sweden)

    Philip Gaydon

    2015-04-01

    Full Text Available An interview with Anne Fine with an introduction and aside on the role of children’s literature in our lives and development, and our adult perceptions of the suitability of childhood reading material. Since graduating from Warwick in 1968 with a BA in Politics and History, Anne Fine has written over fifty books for children and eight for adults, won the Carnegie Medal twice (for Goggle-Eyes in 1989 and Flour Babies in 1992, been a highly commended runner-up three times (for Bill’s New Frock in 1989, The Tulip Touch in 1996, and Up on Cloud Nine in 2002, been shortlisted for the Hans Christian Andersen Award (the highest recognition available to a writer or illustrator of children’s books, 1998, undertaken the positon of Children’s Laureate (2001-2003, and been awarded an OBE for her services to literature (2003. Warwick presented Fine with an Honorary Doctorate in 2005. Philip Gaydon’s interview with Anne Fine was recorded as part of the ‘Voices of the University’ oral history project, co-ordinated by Warwick’s Institute of Advanced Study.

  16. The efficacy of intravenous aminocaproic acid in primary total hip and knee arthroplasty: a meta-analysis.

    Science.gov (United States)

    Li, Yong-Jiang; Xu, Bi-Sheng; Bai, Sun-Peng; Guo, Xiao-Jun; Yan, Xiang-Yuan

    2018-04-17

    We conducted a meta-analysis from randomized controlled trials (RCTs) and non-RCTs to assess the efficacy of aminocaproic acid in cases of primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). Potentially relevant academic articles were identified from the Cochrane Library, MEDLINE (1966-2017 October 31), PubMed (1966-2017 October 31), EMBASE (1980-2017 October 31), and ScienceDirect (1985-2017 October 31). Secondary sources were identified from the references of the included literature. The pooled data were analyzed using RevMan 5.1. Three RCTs and four non-RCTs met the inclusion criteria. There were significant differences in total blood loss (mean difference (MD) = - 495.80, 95% CI - 837.29 to - 154.32, P = 0.004), drainage volume (MD = - 249.43, 95% CI - 286.78 to - 212.08, P < 0.00001), postoperative hemoglobin level (MD = 0.90, 95% CI 0.78 to 1.02, P < 0.00001), hemoglobin reduction (MD = - 0.75, 95% CI - 0.93 to - 0.57, P < 0.00001), transfusion rates (risk difference (RD) = - 0.17, 95% CI - 0.25 to - 0.09, P < 0.0001), average transfusion units (MD = - 0.28, 95% CI - 0.48 to - 0.09, P = 0.004), and length of hospital stay (MD = - 0.33, 95% CI - 0.43 to - 0.24, P < 0.00001) between the two groups. No significant differences were found regarding deep vein thrombosis (DVT) (RD = - 0.00, 95% CI - 0.01 to 0.00, P = 0.36) between the two groups. The present meta-analysis indicated that the application of aminocaproic acid in THA or TKA decreases the total blood loss, drainage volume, transfusion rate, transfusion units per patient, and length of hospital stay and does not increase the risk of DVT.

  17. Effect of joint mobilization techniques for primary total knee arthroplasty: Study protocol for a randomized controlled trial.

    Science.gov (United States)

    Xu, Jiao; Zhang, Juan; Wang, Xue-Qiang; Wang, Xuan-Lin; Wu, Ya; Chen, Chan-Cheng; Zhang, Han-Yu; Zhang, Zhi-Wan; Fan, Kai-Yi; Zhu, Qiang; Deng, Zhi-Wei

    2017-12-01

    Total knee arthroplasty (TKA) has become the most preferred procedure by patients for the relief of pain caused by knee osteoarthritis. TKA patients aim a speedy recovery after the surgery. Joint mobilization techniques for rehabilitation have been widely used to relieve pain and improve joint mobility. However, relevant randomized controlled trials showing the curative effect of these techniques remain lacking to date. Accordingly, this study aims to investigate whether joint mobilization techniques are valid for primary TKA. We will manage a single-blind, prospective, randomized, controlled trial of 120 patients with unilateral TKA. Patients will be randomized into an intervention group, a physical modality therapy group, and a usual care group. The intervention group will undergo joint mobilization manipulation treatment once a day and regular training twice a day for a month. The physical modality therapy group will undergo physical therapy once a day and regular training twice a day for a month. The usual care group will perform regular training twice a day for a month. Primary outcome measures will be based on the visual analog scale, the knee joint Hospital for Special Surgery score, range of motion, surrounded degree, and adverse effect. Secondary indicators will include manual muscle testing, 36-Item Short Form Health Survey, Berg Balance Scale function evaluation, Pittsburgh Sleep Quality Index, proprioception, and muscle morphology. We will direct intention-to-treat analysis if a subject withdraws from the trial. The important features of this trial for joint mobilization techniques in primary TKA are randomization procedures, single-blind, large sample size, and standardized protocol. This study aims to investigate whether joint mobilization techniques are effective for early TKA patients. The result of this study may serve as a guide for TKA patients, medical personnel, and healthcare decision makers. It has been registered at http

  18. Comparison of the Effect of Continuous Femoral Nerve Block and Adductor Canal Block after Primary Total Knee Arthroplasty.

    Science.gov (United States)

    Seo, Seung Suk; Kim, Ok Gul; Seo, Jin Hyeok; Kim, Do Hoon; Kim, Youn Gu; Park, Beyoung Yun

    2017-09-01

    This study aimed to compare the effects of femoral nerve block and adductor canal block on postoperative pain, quadriceps strength, and walking ability after primary total knee arthroplasty. Between November 2014 and February 2015, 60 patients underwent primary total knee arthroplasty. Thirty patients received femoral nerve block and the other 30 received adductor canal block for postoperative pain control. Before spinal anesthesia, the patients received nerve block via a catheter (20 mL 0.75% ropivacaine was administered initially, followed by intermittent bolus injection of 10 mL 0.2% ropivacaine every 6 hours for 3 days). The catheters were maintained in the exact location of nerve block in 24 patients in the femoral nerve block group and in 19 patients in the adductor canal block group. Data collection was carried out from these 43 patients. To evaluate postoperative pain control, the numerical rating scale scores at rest and 45° flexion of the knee were recorded. To evaluate quadriceps strength, manual muscle testing was performed. Walking ability was assessed using the Timed Up and Go test. We also evaluated analgesic consumption and complications of peripheral nerve block. No significant intergroup difference was observed in the numerical rating scale scores at rest and 45° flexion of the knee on postoperative days 1, 2, 3, and 7. The adductor canal block group had significantly greater quadriceps strength than did the femoral nerve block group, as assessed by manual muscle testing on postoperative days 1, 2, and 3. The 2 groups showed no difference in walking ability on postoperative day 1, but on postoperative days 2, 3, walking ability was significantly better in the adductor canal block group than in the femoral nerve block group. No significant intergroup difference was observed in analgesic consumption. The groups showed no difference in postoperative pain control. Adductor canal block was superior to femoral nerve block in preserving quadriceps

  19. Risk factors for periprosthetic joint infection following primary total hip or knee arthroplasty: a meta-analysis.

    Science.gov (United States)

    Kong, Lingde; Cao, Junming; Zhang, Yingze; Ding, Wenyuan; Shen, Yong

    2017-06-01

    To identify risk factors for periprosthetic joint infection following primary total joint arthroplasty, a systematic search was performed in Pubmed, Embase and Cochrane library databases. Pooled odds ratios (ORs) or standardised mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Patient characteristics, surgical-related factors and comorbidities, as potential risk factors, were investigated. The main factors associated with infection after total joint arthroplasty (TJA) were male gender (OR, 1·48; 95% CI, 1.19-1.85), age (SMD, -0·10; 95% CI, -0.17--0.03), obesity (OR, 1·54; 95% CI, 1·25-1·90), alcohol abuse (OR, 1·88; 95% CI, 1·32-2·68), American Society of Anesthesiologists (ASA) scale > 2 (OR, 2·06; 95% CI, 1·77-2·39), operative time (SMD, 0·49; 95% CI, 0·19-0·78), drain usage (OR, 0·36; 95% CI, 0·18-0·74), diabetes mellitus (OR, 1·58; 95% CI, 1·37-1·81), urinary tract infection (OR, 1·53; 95% CI, 1.09-2.16) and rheumatoid arthritis (OR, 1·57; 95% CI, 1·30-1·88). Among these risk factors, ASA score > 2 was a high risk factor, and drain usage was a protective factor. There was positive evidence for some factors that could be used to prevent the onset of infection after TJA. © 2016 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  20. Inactivation and injury of total coliform bacteria after primary disinfection of drinking water by TiO2 photocatalysis

    International Nuclear Information System (INIS)

    Rizzo, Luigi

    2009-01-01

    In this study the potential application of TiO 2 photocatalysis as primary disinfection system of drinking water was investigated in terms of coliform bacteria inactivation and injury. As model water the effluent of biological denitrification unit for nitrate removal from groundwater, which is characterized by high organic matter and bacteria release, was used. The injury of photocatalysis on coliform bacteria was characterized by means of selective (mEndo) and less selective (mT7) culture media. Different catalyst loadings as well as photolysis and adsorption effects were investigated. Photocatalysis was effective in coliform bacteria inactivation (91-99% after 60 min irradiation time, depending on both catalyst loading and initial density of coliform bacteria detected by mEndo), although no total removal was observed after 60 min irradiation time. The contribution of adsorption mechanism was significant (60-98% after 60 min, depending on catalyst loading) compared to previous investigations probably due to the nature of source water rich in particulate organic matter and biofilm. Photocatalysis process did not result in any irreversible injury (98.8% being the higher injury) under investigated conditions, thus a bacteria regrowth may take place under optimum environment conditions if any final disinfection process (e.g., chlorine or chlorine dioxide) is not used.

  1. Inactivation and injury of total coliform bacteria after primary disinfection of drinking water by TiO{sub 2} photocatalysis

    Energy Technology Data Exchange (ETDEWEB)

    Rizzo, Luigi, E-mail: l.rizzo@unisa.it [Department of Civil Engineering, University of Salerno, 84084 Fisciano (Italy)

    2009-06-15

    In this study the potential application of TiO{sub 2} photocatalysis as primary disinfection system of drinking water was investigated in terms of coliform bacteria inactivation and injury. As model water the effluent of biological denitrification unit for nitrate removal from groundwater, which is characterized by high organic matter and bacteria release, was used. The injury of photocatalysis on coliform bacteria was characterized by means of selective (mEndo) and less selective (mT7) culture media. Different catalyst loadings as well as photolysis and adsorption effects were investigated. Photocatalysis was effective in coliform bacteria inactivation (91-99% after 60 min irradiation time, depending on both catalyst loading and initial density of coliform bacteria detected by mEndo), although no total removal was observed after 60 min irradiation time. The contribution of adsorption mechanism was significant (60-98% after 60 min, depending on catalyst loading) compared to previous investigations probably due to the nature of source water rich in particulate organic matter and biofilm. Photocatalysis process did not result in any irreversible injury (98.8% being the higher injury) under investigated conditions, thus a bacteria regrowth may take place under optimum environment conditions if any final disinfection process (e.g., chlorine or chlorine dioxide) is not used.

  2. Intravenous versus topical tranexamic acid in primary total hip replacement: A systemic review and meta-analysis.

    Science.gov (United States)

    Sun, Xiang; Dong, Qiang; Zhang, Yin-Guang

    2016-08-01

    Total hip arthroplasty (THA) is associated with substantial blood loss. Tranexamic acid (TXA) could reduce perioperative blood loss. The optimal administration routine of TXA remains controversial. The objective of the present systemic review and meta-analysis was to compare the effectiveness and safety of various application methods of tranexamic acid in primary THA. Potential relevant literature was identified from electronic databases including Medline, PubMed, Embase, ScienceDirect, web of science and Cochrane Library. Grey academic studies were also identified from the references of the included literature. There was no language restriction. The pooling of data was carried out by using RevMan 5.1. Three randomized controlled trials (RCTs) and two non-RCTs involving 1614 patients met the inclusion criteria. Current meta-analysis indicated that there were no significant differences in terms of total blood loss (MD = -30.04, 95% CI: -114.67 to 54.59, P = 0.49), postoperative hemoglobin level (MD = -0.29, 95% CI: -0.68 to 0.10, P = 0.14), transfusion rate (RD = -0.02, 95% CI: -0.5 to -0.00, P = 0.09), length of stay ((MD = -0.14, 95% CI: -0.30 to 0.01, P = 0.07) or operation time ((MD = 1.00, 95% CI: -0.31 to 2.31, P = 0.14) between treatment groups. No significant differences were found regarding the incidence of adverse effects such as wound infection (RD = -0.01, 95% CI: -0.06 to 0.04, P = 0.66), myocardial infarction (MI) (RD = -0.01, 95% CI: -0.04 to 0.02, P = 0.61), deep venous thrombosis (DVT) (RD = 0.00, 95% CI: -0.01 to 0.01, P = 0.51) or pulmonary embolism (PE) (RD = RD = 0.00, 95% CI: -0.01 to 0.01, P = 0.63) between groups. The topical administration of TXA in THA carried similar hemostasis effects compared with intravenous use without an increased risk of thrombotic complications. No other adverse effect was identified. Topical TXA application was a simple, safe, effective and cost-effective adjunct for

  3. Patterns of bone tracer uptake on SPECT-CT in symptomatic and asymptomatic patients with primary total hip arthroplasty

    Energy Technology Data Exchange (ETDEWEB)

    Schweizer, Thierry; Hirschmann, Michael T. [Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Department of Orthopaedic Surgery and Traumatology, Bruderholz (Switzerland); University of Basel, Basel (Switzerland); Schiapparelli, Filippo-Franco; Rotigliano, Niccolo [Kantonsspital Baselland (Bruderholz, Liestal, Laufen), Department of Orthopaedic Surgery and Traumatology, Bruderholz (Switzerland); Rasch, Helmut [Kantonsspital Baselland, Institute of Radiology and Nuclear Medicine, Bruderholz (Switzerland); Amsler, Felix [Amsler Consulting, Basel (Switzerland)

    2018-02-15

    The primary purpose of this study was to compare bone tracer uptake (BTU) on SPECT/CT in symptomatic and asymptomatic total hip arthroplasty (THA) and identify a possible relationship between BTU patterns and patient's symptoms. The secondary purpose was to investigate if the fixation methods (cemented versus uncemented) lead to different BTU patterns. A total of 58 THAs, 31 symptomatic (group S) and 27 asymptomatic (group AS), were prospectively collected and retrospectively analyzed. All symptomatic patients underwent standardized detailed history, clinical examination, radiographs and 99mTc-HDP SPECT/CT. BTU in SPECT/CT was quantified in three dimensions and anatomically localized in a scheme of quadrants and levels using a customized previously validated software. T tests were used on both quadrants and levels inside and between groups. A Pearson correlation was performed for BTU within the quadrants. An area under receiver operating characteristic curves was drawn in order to find a BTU value that could differentiate the two groups. Within the groups, patients with cemented and uncemented stems were compared for influences on BTU intensity. The causes of pain were identified in 61% of the patients. The most common problem was aseptic loosening (n = 12). In group AS, levels 1, 2 and 5 had similar BTUs. BTUs in these levels were significantly higher than in level 3, 4 and 6. In group S, no significant differences were seen in terms of BTU in level 1-5. However, BTU here was significantly higher than at level 6 (p < 0.001). In both groups, level 1, the superior, had a significantly higher BTU than level 2 (group AS p < 0.01, group S p < 0.05). Comparing the BTU of the two groups among levels, significant differences were found for level 4, level 5 and the entire stem areas (p < 0.05). The ROC curve calculated on the whole stem allowed identification of a BTU ratio of 3.1 that separated the 92.6% patients of group AS with BTU < 3.1 from the 54.8% of patients

  4. Impact of operative time on early joint infection and deep vein thrombosis in primary total hip arthroplasty.

    Science.gov (United States)

    Wills, B W; Sheppard, E D; Smith, W R; Staggers, J R; Li, P; Shah, A; Lee, S R; Naranje, S M

    2018-03-22

    Infections and deep vein thrombosis (DVT) after total hip arthroplasty (THA) are challenging problems for both the patient and surgeon. Previous studies have identified numerous risk factors for infections and DVT after THA but have often been limited by sample size. We aimed to evaluate the effect of operative time on early postoperative infection as well as DVT rates following THA. We hypothesized that an increase in operative time would result in increased odds of acquiring an infection as well as a DVT. We conducted a retrospective analysis of prospectively collected data using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2006 to 2015 for all patients undergoing primary THA. Associations between operative time and infection or DVT were evaluated with multivariable logistic regressions controlling for demographics and several known risks factors for infection. Three different types of infections were evaluated: (1) superficial surgical site infection (SSI), an infection involving the skin or subcutaneous tissue, (2) deep SSI, an infection involving the muscle or fascial layers beneath the subcutaneous tissue, and (3) organ/space infection, an infection involving any part of the anatomy manipulated during surgery other than the incisional components. In total, 103,044 patients who underwent THA were included in our study. Our results suggested a significant association between superficial SSIs and operative time. Specifically, the adjusted odds of suffering a superficial SSI increased by 6% (CI=1.04-1.08, ptime. When using dichotomized operative time (90minutes), the adjusted odds of suffering a superficial SSI was 56% higher for patients with prolonged operative time (CI=1.05-2.32, p=0.0277). The adjusted odds of suffering a deep SSI increased by 7% for every 10-minute increase in operative time (CI=1.01-1.14, p=0.0335). No significant associations were detected between organ/space infection, wound

  5. Determinants of patient satisfaction and their willingness to return after primary total hip replacement: a cross-sectional study.

    Science.gov (United States)

    Schaal, Tom; Schoenfelder, Tonio; Klewer, Joerg; Kugler, Joachim

    2016-08-08

    Surveys of patient satisfaction and their willingness to return can be used for the optimization of processes, improving their quality, and increasing the satisfaction and loyalty in customers. This study looked at the factors significantly associated with patient satisfaction after primary total hip replacement (THR), and which affect the patients' willingness to return to the same hospital for future treatment, even when unrelated to their THR. Data for the study was collected by written survey from 810 patients of 43 hospitals following their THR. Satisfaction and willingness to return were measured using a validated, multidimensional questionnaire, primarily based on six-point scales, which were then evaluated together with routine hospital data, according to bivariate and multivariate analyses. The bivariate analysis showed a strong correlation between satisfaction or willingness to return and the health condition before hospitalization as well as the perceived length of stay. In contrast, the patient's gender and the number of inpatient cases in a hospital with THR had no influence. The binary logistic regression analyses identified three predictors associated with overall satisfaction and seven predictors associated with willingness to return. The strongest factor for both dependent variables was the perceived length of stay, and the weakest factor for satisfaction was the treatment outcome. Overall, with all of the medical and service-related issues considered, high levels of satisfaction were reached. Despite the high satisfaction scores, probable causes for declining the willingness to return were identified. The results provide incentives for hospitals and medical professionals to attain a high satisfaction levels in their THR patients.

  6. Cost-utility analysis comparing radioactive iodine, anti-thyroid drugs and total thyroidectomy for primary treatment of Graves' disease.

    Science.gov (United States)

    Donovan, Peter J; McLeod, Donald S A; Little, Richard; Gordon, Louisa

    2016-12-01

    Little data is in existence about the most cost-effective primary treatment for Graves' disease. We performed a cost-utility analysis comparing radioactive iodine (RAI), anti-thyroid drugs (ATD) and total thyroidectomy (TT) as first-line therapy for Graves' disease in England and Australia. We used a Markov model to compare lifetime costs and benefits (quality-adjusted life-years (QALYs)). The model included efficacy, rates of relapse and major complications associated with each treatment, and alternative second-line therapies. Model parameters were obtained from published literature. One-way sensitivity analyses were conducted. Costs were presented in 2015£ or Australian Dollars (AUD). RAI was the least expensive therapy in both England (£5425; QALYs 34.73) and Australia (AUD5601; 30.97 QALYs). In base case results, in both countries, ATD was a cost-effective alternative to RAI (£16 866; 35.17 QALYs; incremental cost-effectiveness ratio (ICER) £26 279 per QALY gained England; AUD8924; 31.37 QALYs; ICER AUD9687 per QALY gained Australia), while RAI dominated TT (£7115; QALYs 33.93 England; AUD15 668; 30.25 QALYs Australia). In sensitivity analysis, base case results were stable to changes in most cost, transition probabilities and health-relative quality-of-life (HRQoL) weights; however, in England, the results were sensitive to changes in the HRQoL weights of hypothyroidism and euthyroidism on ATD. In this analysis, RAI is the least expensive choice for first-line treatment strategy for Graves' disease. In England and Australia, ATD is likely to be a cost-effective alternative, while TT is unlikely to be cost-effective. Further research into HRQoL in Graves' disease could improve the quality of future studies. © 2016 European Society of Endocrinology.

  7. Clinical Efficacy and Safety of Total Glucosides of Paeony for Primary Sjögren’s Syndrome: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Liang Jin

    2017-01-01

    Full Text Available Objective. To evaluate the clinical efficacy and safety of total glucosides of paeony (TGP for primary Sjögren’s syndrome (pSS. Methods. Eight electronic databases were searched from their inception to July 2016. Clinical randomized controlled trials (RCTs were included. The study quality was evaluated according to the standard suggested in the Cochrane Handbook. RevMan 5.1 was used for statistical analysis. Results. Seven RCTs involving 443 patients were included. The results showed that TGP combined with an immunosuppressant (IS showed greater efficacy for improving the saliva flow test of pSS compared to immunosuppressant alone (WMD −6.88, 95% CI −9.02 to −4.74, and P<0.00001. And the same trend favouring TGP-IS dual combination was found in Schirmer test (WMD 1.63, 95% CI 0.26 to 3.01, and P=0.02, ESR (WMD 7.33, 95% CI −10.08 to −4.59, and P<0.00001, CRP (WMD −6.00, 95% CI −7.17 to −4.83, and P<0.00001, IgM (WMD = −0.42, 95% CI −0.70 to 0.13, and P=0.004, and IgG (WMD −3.22, 95% CI −4.32 to −2.12, and P<0.00001 analysis. However, TGP did not affect IgA (WMD 0.53, 95% CI −1.34 to −0.29, and P=0.20. The adverse events manifested no significant differences between the two groups. Conclusions. The TGP-IS combination is superior to IS alone in the treatment of pSS. However, due to the low quality of included studies, high-quality RCTs are needed to confirm the beneficial effects of TGP.

  8. Functional and oncologic outcomes after excision of the total femur in primary bone tumors: Results with a low cost total femur prosthesis

    Directory of Open Access Journals (Sweden)

    Ajay Puri

    2012-01-01

    Full Text Available Background: The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP. We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival. Materials and Methods: Eight patients (four males and four females with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5, Ewing′s sarcoma (1, and chondrosarcoma (2. Mean followup was 33 months (9-72 months for all and 40 months (24-72 months in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival. Results: There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%. The implant survival was 88% at 5 years with only one TFP needing removal because of infection. Conclusions: A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.

  9. Fine chemistry

    International Nuclear Information System (INIS)

    Laszlo, P.

    1988-01-01

    The 1988 progress report of the Fine Chemistry laboratory (Polytechnic School, France) is presented. The research programs are centered on the renewal of the organic chemistry most important reactions and on the invention of new, highly efficient and highly selective reactions, by applying low cost reagents and solvents. An important research domain concerns the study and fabrication of new catalysts. They are obtained by means of the reactive sputtering of the metals and metal oxydes thin films. The Monte Carlo simulations of the long-range electrostatic interaction in a clay and the obtention of acrylamides from anhydrous or acrylic ester are summarized. Moreover, the results obtained in the field of catalysis are also given. The published papers and the congress communications are included [fr

  10. Evaluation of the effects of primary myotomy in total laryngectomy on the neoglottis with the use of quantitative videofluoroscopy.

    NARCIS (Netherlands)

    Coul, B.M.R. op de; Hoogen, F.J.A. van den; As, C.J. van; Marres, H.A.M.; Joosten, F.B.M.; Manni, J.J.; Hilgers, F.J.M.

    2003-01-01

    OBJECTIVE: To evaluate the influence of primary myotomy on characteristics of the neoglottis in patients after laryngectomy. DESIGN: Patient survey. SETTING: University Medical Center St Radboud, Nijmegen, the Netherlands. PATIENTS: Nineteen consecutive patients who underwent laryngectomy (12 with

  11. Effect of hydroxyapatite coating on risk of revision after primary total hip arthroplasty in younger patients: findings from the Danish Hip Arthroplasty Registry

    DEFF Research Database (Denmark)

    Paulsen, Aksel; Pedersen, Alma B; Johnsen, Søren P

    2007-01-01

    BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip Arthropla......BACKGROUND: The effect of hydroxyapatite (HA) on implant survival in the medium and long term is uncertain. We studied the effect of HA coating of uncemented implants on the risk of cup and stem revision in primary total hip arthroplasty (THA). PATIENTS AND METHODS: Using the Danish Hip...

  12. Absorption-based algorithm of primary production for total and size-fractionated phytoplankton in coastal waters

    NARCIS (Netherlands)

    Barnes, M.K.; Tilstone, G.H.; Smyth, T.J.; Suggett, D.J.; Astoreca, R.; Lancelot, C.; Kromkamp, J.C.

    2014-01-01

    Most satellite models of production have been designed and calibrated for use in the open ocean. Coastal waters are optically more complex, and the use of chlorophyll a (chl a) as a first-order predictor of primary production may lead to substantial errors due to significant quantities

  13. The "true" incidence of surgically treated deep prosthetic joint infection after 32,896 primary total hip arthroplasties

    DEFF Research Database (Denmark)

    Gundtoft, Per Hviid; Overgaard, Søren; Schønheyder, Henrik Carl

    2015-01-01

    using an algorithm incorporating data from microbiological, prescription, and clinical biochemistry databases and clinical findings from the medical records. We calculated cumulative incidence with 95% confidence interval. RESULTS: 32,896 primary THAs were identified. Of these, 1,546 had first-time...

  14. Comparison of topical versus intravenous tranexamic acid in primary total knee arthroplasty: a meta-analysis of randomized controlled and prospective cohort trials.

    Science.gov (United States)

    Wang, Hao; Shen, Bin; Zeng, Yi

    2014-12-01

    There has been much debate and controversy about the optimal regimen of tranexamic acid in primary total knee arthroplasty. The purpose of this study was to undertake a meta-analysis to compare the efficacy of topical and intravenous regimen of tranexamic acid in primary total knee arthroplasty. A systematic review of the electronic databases PubMed, CENTRAL, Web of Science, and Embase was undertaken. All randomized controlled trials and prospective cohort studies evaluating the effectiveness of topical and intravenous tranexamic acid during primary total knee arthroplasty were included. The focus of the analysis was on the outcomes of blood loss, transfusion rate, and thromboembolic complications. Subgroup analysis was performed when possible. Of 328 papers identified, six trials were eligible for data extraction and meta-analysis comprising 679 patients (739 knees). We found no statistically significant difference between topical and intravenous administration of tranexamic acid in terms of blood loss, transfusion requirements and thromboembolic complications. Topical tranexamic acid has a similar efficacy to intravenous tranexamic acid in reducing both blood loss and transfusion rate without sacrificing safety in primary total knee arthroplasty. II. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Predictors of fecal incontinence and related quality of life after a total mesorectal excision with primary anastomosis for patients with rectal cancer

    NARCIS (Netherlands)

    Walma, Marieke S; Kornmann, Verena N N; Boerma, Djamila; de Roos, Marnix A J; van Westreenen, Henderik L

    PURPOSE: After total mesorectal excision (TME) with primary anastomosis for patients with rectal cancer, the quality of life (QoL) may be decreased due to fecal incontinence. This study aimed to identify predictors of fecal incontinence and related QoL. METHODS: Patients who underwent TME with

  16. Physical Activity Behavior of Patients 1 Year After Primary Total Hip Arthroplasty : A Prospective Multicenter Cohort Study

    NARCIS (Netherlands)

    Wagenmakers, Robert; Stevens, Martin; Groothoff, Johan W.; Zijlstra, Wiebren; Bulstra, Sjoerd K.; van Beveren, Jan; van Raaij, Jos J. A. M.; van den Akker-Scheek, Inge

    Background. Besides the important beneficial effects of regular physical activity on general health, some of the musculoskeletal effects of physical activity are of particular interest for older adults after total hip arthroplasty (THA). However, research on physical activity behavior of patients

  17. Total primary production and the balance between benthic and pelagic plants in different nutrient regimes in a shallow estuary

    DEFF Research Database (Denmark)

    Markager, Svend Stiig; Krause-Jensen, Dorte; Dalsgaard, Tage

    on a large monitoring data set in combination with historical information we have quantified and compared the benthic and the pelagic primary production along nutrient gradients in space and time for the shallow estuary Limfjorden, Denmark. As expected, increases in nutrient load stimulated the pelagic...... was again reduced, and the ecosystem entered a phase of oligotrophication, pelagic GPP declined gradually while benthic GPP did not increase correspondingly leading to an decline in overall GPP. Instead the ecosystem showed a resistance or time lag against return to a clear water state with benthic...

  18. Does hydroxyapatite coating have no advantage over porous coating in primary total hip arthroplasty? A meta-analysis.

    Science.gov (United States)

    Chen, Yun-Lin; Lin, Tiao; Liu, An; Shi, Ming-Min; Hu, Bin; Shi, Zhong-Li; Yan, Shi-Gui

    2015-01-28

    There are some arguments between the use of hydroxyapatite and porous coating. Some studies have shown that there is no difference between these two coatings in total hip arthroplasty (THA), while several other studies have shown that hydroxyapatite has advantages over the porous one. We have collected the studies in Pubmed, MEDLINE, EMBASE, and the Cochrane library from the earliest possible years to present, with the search strategy of "(HA OR hydroxyapatite) AND ((total hip arthroplasty) OR (total hip replacement)) AND (RCT* OR randomiz* OR control* OR compar* OR trial*)". The randomized controlled trials and comparative observation trials that evaluated the clinical and radiographic effects between hydroxyapatite coating and porous coating were included. Our main outcome measurements were Harris hip score (HHS) and survival, while the secondary outcome measurements were osteolysis, radiolucent lines, and polyethylene wear. Twelve RCTs and 9 comparative observation trials were included. Hydroxyapatite coating could improve the HHS (p hydroxyapatite coating had no advantages on survival (p = 0.32), polyethylene wear (p = 0.08), and radiolucent lines (p = 0.78). Hydroxyapatite coating has shown to have an advantage over porous coating. The HHS and survival was duration-dependent-if given the sufficient duration of follow-up, hydroxyapatite coating would be better than porous coating for the survival. The properties of hydroxyapatite and the implant design had influence on thigh pain incidence, femoral osteolysis, and polyethylene wear. Thickness of 50 to 80 μm and purity larger than 90% increased the thigh pain incidence. Anatomic design had less polyethylene wear.

  19. Serious renal and urological complications in fast-track primary total hip and knee arthroplasty; a detailed observational cohort study

    DEFF Research Database (Denmark)

    Bjerregaard, Lars S; Jorgensen, Christoffer C; Kehlet, Henrik

    2016-01-01

    of stay > 4 days or 30-day readmissions after fast-track THA and TKA, we conducted a detailed observational study based upon prospectively collected pre-operative data and a complete 30-day follow-up on complications and re-admissions in a unselected cohort of 8,804 consecutive fast-track THAs and TKAs......BACKGROUND: Overall medical complications have been reduced after fast-track total hip (THA) and knee arthroplasty (TKA), but data on specific renal and urological (RU) complications are limited. METHODS: To describe the incidence and consequences of serious RU complications resulting in length...

  20. Fibrin sealants or cell saver eliminate the need for autologous blood donation in anemic patients undergoing primary total knee arthroplasty.

    Science.gov (United States)

    Bou Monsef, Jad; Buckup, Johannes; Waldstein, Wenzel; Cornell, Charles; Boettner, Friedrich

    2014-01-01

    Reducing allogeneic blood transfusions remains a challenge in total knee arthroplasty. Patients with preoperative anemia have a particularly high risk for perioperative blood transfusions. 176 anemic patients (Hb < 13.5 g/dl) undergoing total knee replacement were prospectively evaluated to compare the effect of a perioperative cell saver (26 patients), intraoperative fibrin sealants (5 ml Evicel, Johnson & Johnson Wound Management, Ethicon, Somerville, NJ) (45 patients), preoperative autologous blood donation (PABD) (21 patients), the combination of fibrin sealants and preoperative autologous blood donation (44) and no intervention (40 patients) on perioperative blood loss and transfusion requirements. All protocols resulted in significant reduction of allogeneic blood transfusions. Transfusion rates were similar with the use of PABD (19%), Evicel (18%), and cell saver (19%), all significantly lower than the control group (38 %, p < 0.05). Combining Evicel with PABD resulted in significantly higher wastage of autologous units (p < 0.05) with no significant reduction in allogeneic transfusion rate (14%). The use of fibrin sealant resulted in a significant reduction of blood loss compared to the PABD group (603 vs. 810 ml, p < 0.005) as well as the control group (603 vs. 822 ml, p < 0.005). While PABD proved to be the most cost-effective treatment option in anemic patients, fibrin sealants and cell saver show similar reduction in allogeneic transfusion rates compared to controls. The combination of fibrin sealants and PABD is not cost-effective and increases the number of wasted units.

  1. Blood transfusion in primary total shoulder arthroplasty: incidence, trends, and risk factors in the United States from 2000 to 2009.

    Science.gov (United States)

    Ryan, Devon J; Yoshihara, Hiroyuki; Yoneoka, Daisuke; Zuckerman, Joseph D

    2015-05-01

    Total shoulder arthroplasty (TSA) may be associated with substantial blood loss, and some patients require perioperative blood transfusion. Possible blood transfusion methods include predonated autologous blood transfusion, perioperative autologous blood transfusion, and allogeneic blood transfusion (ALBT). The purposes of the present study were to assess the incidence and recent trends over time of blood transfusion in TSA and analyze patient and hospital characteristics that affect the risk of ALBT. This study used national hospital discharge data from the National Inpatient Sample between 2000 and 2009. The data were used to generate the overall blood transfusion rate, and linear regression was used to assess trends in transfusion patterns over time. Logistic regression analysis was performed to analyze which patient and hospital characteristics independently influence the likelihood that a given patient undergoes ALBT. The overall blood transfusion rate (ie, the proportion of patients who received at least 1 transfusion of any kind) was 6.7%. This rate increased over time, from 4.9% in 2000 to 7.1% in 2009 (P blood transfusion rate in TSA found in the present study may be related to factors specific to TSA, such as the introduction of reverse total shoulder arthroplasty during the study period. A variety of patient and hospital characteristics contribute to the risk of undergoing ALBT. Copyright © 2015 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  2. Total Energy Expenditure in Obese Kuwaiti Primary School Children Assessed by the Doubly-Labeled Water Technique

    Directory of Open Access Journals (Sweden)

    Lena Davidsson

    2016-10-01

    Full Text Available The aim of this pilot study was to assess body composition and total energy expenditure (TEE in 35 obese 7–9 years old Kuwaiti children (18 girls and 17 boys. Total body water (TBW and TEE were assessed by doubly-labeled water technique. TBW was derived from the intercept of the elimination rate of deuterium and TEE from the difference in elimination rates of 18O and deuterium. TBW was used to estimate fat-free mass (FFM, using hydration factors for different ages and gender. Fat mass (FM was calculated as the difference between body weight and FFM. Body weight was not statistically different but TBW was significantly higher (p = 0.018 in boys (44.9% ± 3.3% than girls (42.4% ± 3.0%, while girls had significantly higher estimated FM (45.2 ± 3.9 weight % versus 41.6% ± 4.3%; p = 0.014. TEE was significantly higher in boys (2395 ± 349 kcal/day compared with girls (1978 ± 169 kcal/day; p = 0.001. Estimated physical activity level (PAL was significantly higher in boys; 1.61 ± 0.167 versus 1.51 ± 0.870; p = 0.034. Our results provide the first dataset of TEE in 7–9 years old obese Kuwaiti children and highlight important gender differences to be considered during the development of school based interventions targeted to combat childhood obesity.

  3. Comparison of 3 Types of Readmission Rates for Measuring Hospital and Surgeon Performance After Primary Total Hip and Knee Arthroplasty.

    Science.gov (United States)

    Bottle, Alex; Loeffler, Mark D; Aylin, Paul; Ali, Adam M

    2018-02-26

    All-cause 30-day hospital readmission is in widespread use for monitoring and incentivizing hospital performance for patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, little is known on the extent to which all-cause readmission is influenced by hospital or surgeon performance and whether alternative measures may be more valid. This is an observational study using multilevel modeling on English administrative data to determine the interhospital and intersurgeon variation for 3 readmission metrics: all-cause, surgical, and return-to-theater. Power calculations estimated the likelihood of identifying whether the readmission rate for a surgeon or hospital differed from the national average by a factor of 1.25, 1.5, 2, or 3 times, for both average and high-volume providers. 259,980 THAs and 311,033 TKAs were analyzed. Variations by both surgeons and hospitals were smaller for the all-cause measure than for the surgical or return-to-theater metrics, although statistical power to detect differences was higher. Statistical power to detect surgeon-level rates of 1.25 or 1.5 times the average was consistently low. However, at the hospital level, the surgical readmission measure showed more variation by hospital while maintaining excellent power to detect differences in rates between hospitals performing the average number of THA or TKA cases per year in England. In practice, more outliers than expected from purely random variation were found for all-cause and surgical readmissions, especially at hospital level. The 30-day surgical readmission rate should be considered as an adjunctive measure to 30-day all-cause readmission rate when assessing hospital performance. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Large scale comparative codon-pair context analysis unveils general rules that fine-tune evolution of mRNA primary structure.

    Directory of Open Access Journals (Sweden)

    Gabriela Moura

    Full Text Available BACKGROUND: Codon usage and codon-pair context are important gene primary structure features that influence mRNA decoding fidelity. In order to identify general rules that shape codon-pair context and minimize mRNA decoding error, we have carried out a large scale comparative codon-pair context analysis of 119 fully sequenced genomes. METHODOLOGIES/PRINCIPAL FINDINGS: We have developed mathematical and software tools for large scale comparative codon-pair context analysis. These methodologies unveiled general and species specific codon-pair context rules that govern evolution of mRNAs in the 3 domains of life. We show that evolution of bacterial and archeal mRNA primary structure is mainly dependent on constraints imposed by the translational machinery, while in eukaryotes DNA methylation and tri-nucleotide repeats impose strong biases on codon-pair context. CONCLUSIONS: The data highlight fundamental differences between prokaryotic and eukaryotic mRNA decoding rules, which are partially independent of codon usage.

  5. The Cost-Effectiveness of Dual Mobility Implants for Primary Total Hip Arthroplasty: A Computer-Based Cost-Utility Model.

    Science.gov (United States)

    Barlow, Brian T; McLawhorn, Alexander S; Westrich, Geoffrey H

    2017-05-03

    Dislocation remains a clinically important problem following primary total hip arthroplasty, and it is a common reason for revision total hip arthroplasty. Dual mobility (DM) implants decrease the risk of dislocation but can be more expensive than conventional implants and have idiosyncratic failure mechanisms. The purpose of this study was to investigate the cost-effectiveness of DM implants compared with conventional bearings for primary total hip arthroplasty. Markov model analysis was conducted from the societal perspective with use of direct and indirect costs. Costs, expressed in 2013 U.S. dollars, were derived from the literature, the National Inpatient Sample, and the Centers for Medicare & Medicaid Services. Effectiveness was expressed in quality-adjusted life years (QALYs). The model was populated with health state utilities and state transition probabilities derived from previously published literature. The analysis was performed for a patient's lifetime, and costs and effectiveness were discounted at 3% annually. The principal outcome was the incremental cost-effectiveness ratio (ICER), with a willingness-to-pay threshold of $100,000/QALY. Sensitivity analyses were performed to explore relevant uncertainty. In the base case, DM total hip arthroplasty showed absolute dominance over conventional total hip arthroplasty, with lower accrued costs ($39,008 versus $40,031 U.S. dollars) and higher accrued utility (13.18 versus 13.13 QALYs) indicating cost-savings. DM total hip arthroplasty ceased being cost-saving when its implant costs exceeded those of conventional total hip arthroplasty by $1,023, and the cost-effectiveness threshold for DM implants was $5,287 greater than that for conventional implants. DM was not cost-effective when the annualized incremental probability of revision from any unforeseen failure mechanism or mechanisms exceeded 0.29%. The probability of intraprosthetic dislocation exerted the most influence on model results. This model

  6. Fine structure of primary afferent axon terminals projecting from rapidly adapting mechanoreceptors of the toe and foot pads of the cat.

    Science.gov (United States)

    Maxwell, D J; Bannatyne, B A; Fyffe, R E; Brown, A G

    1984-04-01

    Two Pacinian corpuscle afferents and two rapidly adapting afferents from Krause corpuscles were intra-axonally labelled with horseradish peroxidase in the lumbosacral enlargement of the cat's spinal cord. Tissue was prepared for combined light and electron microscopical analysis. Boutons from both classes of afferent had similar ultrastructural appearances. They both formed from one to three synaptic junctions with dendritic shafts and spines and received axo-axonic synapses. In addition, both categories of bouton were seen to be presynaptic to structures interpreted as vesicle-containing dendrites. It is concluded that both types of afferent fibre are subject to presynaptic control and that they synapse with dorsal horn neurones which are possibly interneurones involved in primary afferent depolarization and post-synaptic dorsal column neurones.

  7. Quadriceps Tendon Rupture and Contralateral Patella Tendon Avulsion Post Primary Bilateral Total Knee Arthroplasty: A Case Report

    Directory of Open Access Journals (Sweden)

    Gaurav Sharma

    2016-07-01

    Full Text Available Background: Extensor mechanism failure secondary to knee replacement could be due to tibial tubercle avulsion, Patellar tendon rupture, patellar fracture or quadriceps tendon rupture. An incidence of Patella tendon rupture of 0.17% and Quadriceps tendon rupture of around 0.1% has been reported after Total knee arthroplasty. These are considered a devastating complication that substantially affects the clinical results and are challenging situations to treat with surgery being the mainstay of the treatment. Case Description: We report here an interesting case of a patellar tendon rupture of one knee and Quadriceps tendon rupture of the contralateral knee following simultaneous bilateral knee replacement in a case of inflammatory arthritis patient. End to end repair for Quadriceps tear and augmentation with Autologous Hamstring tendon graft was done for Patella tendon rupture. OUTCOME: Patient was followed up for a period of 1 year and there was no Extension lag with a flexion of 100 degrees in both the knees. DISCUSSION: The key learning points and important aspects of diagnosing these injuries early and the management techniques are described in this unique case of bilateral extensor mechanism disruption following knee replacements.

  8. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006–7: Australian Orthopaedic Association National Joint Replacement Registry

    Directory of Open Access Journals (Sweden)

    Brennan Sharon L

    2012-04-01

    Full Text Available Abstract Background The utilization of total hip replacement (THR surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD of Victoria, Australia. Methods Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006–7, primary THR with a diagnosis of osteoarthritis (OA among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Results Females accounted for 46.9% of the 642 primary THR performed during 2006–7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70–79 years (males 6.1, and females 5.4 per 1,000 person years. Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Conclusions Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

  9. Cross-sectional analysis of association between socioeconomic status and utilization of primary total hip joint replacements 2006-7: Australian Orthopaedic Association National Joint Replacement Registry.

    Science.gov (United States)

    Brennan, Sharon L; Stanford, Tyman; Wluka, Anita E; Henry, Margaret J; Page, Richard S; Graves, Stephen E; Kotowicz, Mark A; Nicholson, Geoffrey C; Pasco, Julie A

    2012-04-30

    The utilization of total hip replacement (THR) surgery is rapidly increasing, however few data examine whether these procedures are associated with socioeconomic status (SES) within Australia. This study examined primary THR across SES for both genders for the Barwon Statistical Division (BSD) of Victoria, Australia. Using the Australian Orthopaedic Association National Joint Replacement Registry data for 2006-7, primary THR with a diagnosis of osteoarthritis (OA) among residents of the BSD was ascertained. The Index of Relative Socioeconomic Disadvantage was used to measure SES; determined by matching residential addresses with Australian Bureau of Statistics census data. The data were categorised into quintiles; quintile 1 indicating the most disadvantaged. Age- and sex-specific rates of primary THR per 1,000 person years were reported for 10-year age bands using the total population at risk. Females accounted for 46.9% of the 642 primary THR performed during 2006-7. THR utilization per 1,000 person years was 1.9 for males and 1.5 for females. The highest utilization of primary THR was observed in those aged 70-79 years (males 6.1, and females 5.4 per 1,000 person years). Overall, the U-shaped pattern of THR across SES gave the appearance of bimodality for both males and females, whereby rates were greater for both the most disadvantaged and least disadvantaged groups. Further work on a larger scale is required to determine whether relationships between SES and THR utilization for the diagnosis of OA is attributable to lifestyle factors related to SES, or alternatively reflects geographic and health system biases. Identifying contributing factors associated with SES may enhance resource planning and enable more effective and focussed preventive strategies for hip OA.

  10. Source contributions to atmospheric fine carbon particle concentrations

    Science.gov (United States)

    Andrew Gray, H.; Cass, Glen R.

    A Lagrangian particle-in-cell air quality model has been developed that facilitates the study of source contributions to atmospheric fine elemental carbon and fine primary total carbon particle concentrations. Model performance was tested using spatially and temporally resolved emissions and air quality data gathered for this purpose in the Los Angeles area for the year 1982. It was shown that black elemental carbon (EC) particle concentrations in that city were dominated by emissions from diesel engines including both on-highway and off-highway applications. Fine primary total carbon particle concentrations (TC=EC+organic carbon) resulted from the accumulation of small increments from a great variety of emission source types including both gasoline and diesel powered highway vehicles, stationary source fuel oil and gas combustion, industrial processes, paved road dust, fireplaces, cigarettes and food cooking (e.g. charbroilers). Strategies for black elemental carbon particle concentration control will of necessity need to focus on diesel engines, while controls directed at total carbon particle concentrations will have to be diversified over a great many source types.

  11. A study of human DPOAE fine structure

    DEFF Research Database (Denmark)

    Reuter, Karen; Hammershøi, Dorte

    height and ripple prevalence. Temporary changes of the DPOAE fine structure are analyzed by measuring DPOAE both before and after exposing some of the subjects to an intense sound. The characteristic patterns of fine structure can be found in the DPOAE of all subjects, though they are individual and vary...... fine structures are obtained from 74 normalhearing humans using primary levels of L1/L2=65/45 dB. The subjects belong to groups with different age and exposure history. A classification algorithm is developed, which quantifies the fine structure by the parameters ripple place, ripple width, ripple...

  12. Primary total hip arthroplasty: a comparison of the lateral Hardinge approach to an anterior mini-invasive approach

    Directory of Open Access Journals (Sweden)

    Nathan Wayne

    2009-11-01

    Full Text Available The anterior mini-invasive (MI approach to performing total hip arthroplasty (THA is associated with less soft tissue damage and shorter postoperative recovery than other methods. Our hospital recently abandoned the traditional lateral Hardinge (LH approach in favour of this new method. We compared the first 100 patients operated after the changeover to the new method (MI group to the last 100 patients operated using the traditional method (LH group. Clinical and radiological parameters and complications were recorded pre- and postoperatively and the collected data of the two groups were statistically compared. There were no statistically significant differences between either group with regard to patient demographics or procedural data, placement of the femur component, postoperative leg discrepancy, prosthesis dislocation, blood transfusion, or postoperative dislocation of the components. The MI group had a significantly longer operating time, more bleeding, higher rate of nerve damage, and a higher percentage of acetabular component malposition whilst having a significantly shorter hospital stay and significantly fewer infections of the operative site in comparison to the LH group. Additionally, and perhaps most worrying was the clinically significant increase in intraoperative femur fractures in the MI group. The changeover to the anterior mini-invasive approach, which was the surgeons' initial experience with the MI technique, resulted in a drastic increase in the number of overall complications accompanied by less soft tissue damage and a shorter period of rehabilitation. Our results suggest that further analysis of this surgical MI technique will be needed before it can be recommended for widespread adoption.

  13. Does vitamin E-blended polyethylene reduce wear in primary total hip arthroplasty: a blinded randomised clinical trial.

    Science.gov (United States)

    Scemama, Caroline; Anract, Philippe; Dumaine, Valérie; Babinet, Antoine; Courpied, Jean Pierre; Hamadouche, Moussa

    2017-06-01

    Some data indicate that first-generation highly cross-linked polyethylene (HXLPE) can oxidise in vivo and is associated with reduced mechanical properties. To overcome these limitations, a natural anti-oxidant vitamin E has been added to HXLPE to preserve the mechanical properties and decrease oxidative degradation whilst conserving high wear resistance. We hypothesised that after a minimal three years of follow-up the use of vitamin E-blended HXLPE would result in lower radiographic wear when compared with ultra-high molecular weight polyethylene (UHMWPE). One hundred patients were randomised to receive hybrid total hip arthroplasty (THA) using a monoblock cementless acetabular component made either of UHMWPE or vitamin E-blended HXLPE. All other parameters were identical in both groups. Complete follow-up was available for 74 of these patients. Femoral head penetration was measured using a validated computer-assisted method. The median creep measured 0.111 mm (range, -0.576 - +0.444 mm) in the vitamin E-blended group versus 0.170 mm (range, -0.861 - +0.884 mm) in the UHMWPE group (difference of medians, 0.059; p = 0.046). The median steady state penetration rate was -0.008 mm/year (range, -0.88 - +0.64 mm/year) in the vitamin E-blended group versus 0.133 mm/year (range, -0.84 - +0.85 mm/year) in the UHMWPE group (difference of medians 0.141, p = 0.043). This study demonstrated that femoral head penetration was lower when using vitamin E-blended HXLPE when compared with UHMWPE, with a steady-state penetration rate far below the osteolysis threshold. Longer-term follow-up is needed to warrant whether wear reduction will generate less occurrence of osteolysis and aseptic loosening.

  14. The diagnostic utility of Merkel cell polyomavirus immunohistochemistry in a fine needle aspirate of metastatic Merkel cell carcinoma of unknown primary to the pancreas.

    Science.gov (United States)

    Li, Long; Molberg, Kyle; Cheedella, Naga; Thibodeaux, Joel; Hinson, Stacy; Lucas, Elena

    2018-01-01

    Merkel cell carcinoma (MCC) is an aggressive skin tumor with a high tendency for metastases. We report a case of MCC initially presenting as axillary and pancreatic metastases. A 33-year-old HIV-positive Hispanic male presented with a history of a rapidly growing axillary mass. A needle core biopsy demonstrated an epithelioid neoplasm composed of small to medium-sized cells with high nuclear-cytoplasmic ratio, nuclear molding, and frequent mitotic figures. A subsequent PET scan revealed a 1.5 cm FDG avid mass in the pancreas. Endoscopic ultrasound-guided FNA of the pancreatic mass showed neoplastic cells with similar morphology to those of the axillary mass. The tumor cells were positive with pancytokeratin AE1/AE3, CK20, CD56, synatophysin, chromogranin, and Merkel cell polyomavirus (MCPyV). This case of MCC most likely originated from a resolved primary skin lesion drained by the involved axillary lymph node with subsequent metastases to the pancreas and distant lymph nodes. © 2017 Wiley Periodicals, Inc.

  15. Long-Term Primary Patency Rate After Nitinol Self-Expandable Stents Implantation in Long, Totally Occluded Femoropopliteal (TASC II C & D) Lesions.

    Science.gov (United States)

    Elmahdy, Mahmoud Farouk; Buonamici, Piergiovanni; Trapani, Maurizio; Valenti, Renato; Migliorini, Angela; Parodi, Guido; Antoniucci, David

    2017-06-01

    Endovascular therapy for long femoropopliteal lesions using percutaneous transluminal balloon angioplasty or first-generation of peripheral stents has been associated with unacceptable one-year restenosis rates. However, with recent advances in equipment and techniques, a better primary patency rate is expected. This study was conducted to detect the long-term primary patency rate of nitinol self-expandable stents implanted in long, totally occluded femoropopliteal lesions TransAtlantic Inter-Society Census (TASC II type C & D), and determine the predictors of reocclusion or restenosis in the stented segments. The demographics, clinical, anatomical, and procedural data of 213 patients with 240 de novo totally occluded femoropopliteal (TASC II type C & D) lesions treated with nitinol self-expandable stents were retrospectively analysed. Of these limbs, 159 (66.2%) presented with intermittent claudication, while 81 (33.8%) presented with critical limb ischaemia. The mean-time of follow-up was 36±22.6 months, (range: 6.3-106.2 months). Outcomes evaluated were, primary patency rate and predictors of reocclusion or restenosis in the stented segments. The mean age of the patients was 70.9±9.3 years, with male gender 66.2%. Mean pre-procedural ABI was 0.45±0.53. One-hundred-and-seventy-five (73%) lesions were TASC II type C, while 65 (27%) were type D lesions. The mean length of the lesions was 17.9±11.3mm. Procedure related complications occurred in 10 (4.1%) limbs. There was no periprocedural mortality. Reocclusion and restenosis were detected during follow-up in 45 and 30 limbs respectively, and all were re-treated by endovascular approach. None of the patients required major amputation. Primary patency rates were 81.4±1.1%, 77.7±1.9% and 74.4±2.8% at 12, 24, and 36 months respectively. Male gender, severe calcification, and TASC II D lesion were independent predictors for reocclusion, while predictors of restenosis were DM, smoking and TASC II D lesions

  16. Risk factors for post-operative periprosthetic fractures following primary total hip arthroplasty with a proximally coated double-tapered cementless femoral component

    DEFF Research Database (Denmark)

    Gromov, K; Bersang, A; Nielsen, C S

    2017-01-01

    ratio were recorded post-operatively. Periprosthetic fractures were identified and classified according to the Vancouver classification. Regression analysis was performed to identify risk factors for early periprosthetic fracture. RESULTS: The mean follow-up was 713 days (1 to 2058). A total of 48......AIMS: The aim of this study was to identify patient- and surgery-related risk factors for sustaining an early periprosthetic fracture following primary total hip arthroplasty (THA) performed using a double-tapered cementless femoral component (Bi-Metric femoral stem; Biomet Inc., Warsaw, Indiana...... periprosthetic fractures (3.0%) were identified during the follow-up and median time until fracture was 16 days, (interquartile range 10 to 31.5). Patients with femoral Dorr type C had a 5.2 times increased risk of post-operative periprosthetic fracture compared with type B, while female patients had a near...

  17. Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis. A follow-up study of 32,019 total knee replacements in the Finnish Arthroplasty Register.

    Science.gov (United States)

    Julin, Jaakko; Jämsen, Esa; Puolakka, Timo; Konttinen, Yrjö T; Moilanen, Teemu

    2010-08-01

    Total knee replacements (TKRs) are being increasingly performed in patients aged age of the patient and prosthesis survival following primary TKR using nationwide data collected from the Finnish Arthroplasty Register. From Jan 1, 1997 through Dec 31, 2003, 32,019 TKRs for primary or secondary osteoarthritis were reported to the Finnish Arthroplasty Register. The TKRs were followed until the end of 2004. During the follow-up, 909 TKRs were revised, 205 (23%) due to infection and 704 for other reasons. Crude overall implant survival improved with increasing age between the ages of 40 and 80. The 5-year survival rates were 92% and 95% in patients aged 65 years of age (p age groups 65 years remained after adjustment for these factors (p age impairs the prognosis of TKR and is associated with increased revision rates for non-infectious reasons. Diagnosis, sex, type of TKR, use of patellar component, and fixation method partly explain the differences, but the effects of physical activity, patient demands, and obesity on implant survival in younger patients warrant further research.

  18. Dialysis Dependence Predicts Complications, Intensive Care Unit Care, Length of Stay, and Skilled Nursing Needs in Elective Primary Total Knee and Hip Arthroplasty.

    Science.gov (United States)

    Patterson, Joseph T; Tillinghast, Kyle; Ward, Derek

    2018-07-01

    Limited data describe risks and perioperative resource needs of total joint arthroplasty (TJA) in dialysis-dependent patients. Retrospective multiple cohort analysis of dialysis-dependent American College of Surgeons National Surgical Quality Improvement Program patients undergoing primary elective total hip and knee arthroplasty compared to non-dialysis-dependent controls from 2005 to 2015. Relative risks (RRs) of 30-day adverse events were determined by multivariate regression adjusting for baseline differences. Six hundred forty-five (0.2%) dialysis-dependent patients of 342,730 TJA patients were dialysis-dependent and more likely to be dependent, under weight, anemic, hypoalbuminemic, and have cardiopulmonary disease. In total hip arthroplasty patients, dialysis was associated with greater risk of any adverse event (RR = 1.1, P care unit (ICU) care (RR = 9.8, P total knee arthroplasty patients, dialysis conferred greater risk of any adverse event (RR = 1.1, P care (RR = 6.0, P care, longer admission, and rehabilitation needs in TJA patients. Thirty days is not sufficient to detect infectious complications among these patients. These findings inform shared decision-making, perioperative resource planning, and risk adjustment under alternative reimbursement models. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. Utilization and Short-Term Outcomes of Primary Total Hip and Knee Arthroplasty in the United States and Canada: An Analysis of New York and Ontario Administrative Data.

    Science.gov (United States)

    Cram, Peter; Landon, Bruce E; Matelski, John; Ling, Vicki; Stukel, Therese A; Paterson, J Michael; Gandhi, Rajiv; Hawker, Gillian A; Ravi, Bheeshma

    2018-04-01

    Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are common and effective surgical procedures. This study sought to compare utilization and short-term outcomes of primary TKA and THA in adjacent regions of Canada and the United States. The study was designed as a retrospective cohort study of patients who underwent primary TKA or THA, comparing administrative data from New York and Ontario in 2012-2013. Demographic features of the TKA and THA patients, per capita utilization rates, and short-term outcomes were compared between the jurisdictions. A higher percentage of New York hospitals performed TKA compared to Ontario hospitals (75.7% versus 42.1%; P New York hospitals (mean 179 versus 327 in Ontario hospitals; P New York compared to Ontario, both for TKA (16.1 TKAs versus 21.4 TKAs per 10,000 population per year; P New York hospitals; P New York patients were discharged directly home (46.2% versus 90.9% of Ontario patients; P New York compared to Ontario (30-day rates, 4.6% versus 3.9% [P New York but has a smaller percentage of hospitals performing these procedures. Patients are more likely to be discharged home and less likely to be readmitted in Ontario. Our results suggest areas where each jurisdiction could improve. © 2017, American College of Rheumatology.

  20. Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) in primary care using total diet replacement products: a protocol for a randomised controlled trial.

    Science.gov (United States)

    Jebb, Susan A; Astbury, Nerys M; Tearne, Sarah; Nickless, Alecia; Aveyard, Paul

    2017-08-04

    The global prevalence of obesity has risen significantly in recent decades. There is a pressing need to identify effective interventions to treat established obesity that can be delivered at scale. The aim of the Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) study is to determine the clinical effectiveness, feasibility and acceptability of referral to a low-energy total diet replacement programme compared with usual weight management interventions in primary care. The DROPLET trial is a randomised controlled trial comparing a low-energy total diet replacement programme with usual weight management interventions delivered in primary care. Eligible patients will be recruited through primary care registers and randomised to receive a behavioural support programme delivered by their practice nurse or a referral to a commercial provider offering an initial 810 kcal/d low-energy total diet replacement programme for 8 weeks, followed by gradual food reintroduction, along with weekly behavioural support for 24 weeks. The primary outcome is weight change at 12 months. The secondary outcomes are weight change at 3 and 6 months, the proportion of participants achieving 5% and 10% weight loss at 12 months, and change in fat mass, haemoglobin A1c, low-density lipoprotein cholesterol and systolic and diastolic blood pressure at 12 months. Data will be analysed on the basis of intention to treat. Qualitative interviews on a subsample of patients and healthcare providers will assess their experiences of the weight loss programmes and identify factors affecting acceptability and adherence. This study has been reviewed and approved by the National Health ServiceHealth Research Authority (HRA)Research Ethics Committee (Ref: SC/15/0337). The trial findings will be disseminated to academic and health professionals through presentations at meetings and peer-reviewed journals and to the public through the media. If the intervention is effective, the results

  1. Trends in primary total hip arthroplasty in Spain from 2001 to 2008: Evaluating changes in demographics, comorbidity, incidence rates, length of stay, costs and mortality

    Directory of Open Access Journals (Sweden)

    Jimenez-Trujillo Isabel

    2011-02-01

    Full Text Available Abstract Background Hip arthroplasties is one of the most frequent surgical procedures in Spain and are conducted mainly in elderly subjects. We aim to analyze changes in incidence, co-morbidity profile, length of hospital stay (LOHS, costs and in-hospital mortality (IHM of patients undergoing primary total hip arthroplasty (THA over an 8-year study period in Spain. Methods We selected all surgical admissions in individuals aged ≥40 years who had received a primary THA (ICD-9-CM procedure code 81.51 between 2001 and 2008 from the National Hospital Discharge Database. Age- and sex-specific incidence rates, LOHS, costs and IHM were estimated for each year. Co-morbidity was assessed using the Charlson comorbidity index. Multivariate analysis of time trends was conducted using Poisson regression. Logistic regression models were conducted to analyze IHM. Results We identified a total of 161,791 discharges of patients having undergone THA from 2001 to 2008. Overall crude incidence had increased from 99 to 105 THA per 100.000 inhabitants from 2001 to 2008 (p 2 and in 2008, the prevalence of 1-2 or >2 had increased to 20.4% and 1.1% respectively (p Conclusions The current study provides clear and valid data indicating increased incidence of primary THA in Spain from 2001 to 2008 with concomitant reductions in LOHS, slight reduction IHM, but a significant increase in cost per patient. The health profile of the patient undergoing a THA seems to be worsening in Spain.

  2. Oral tranexamic acid is equivalent to topical tranexamic acid without drainage in primary total hip arthroplasty: A double-blind randomized clinical trial.

    Science.gov (United States)

    Luo, Ze-Yu; Wang, Duan; Meng, Wei-Kun; Wang, Hao-Yang; Pan, Hui; Pei, Fu-Xing; Zhou, Zong-Ke

    2018-05-01

    To compare the efficacy of multiple doses of oral tranexamic acid (TXA) with topical TXA administration in reducing blood loss following total hip arthroplasty (THA). In this double-blinded trial, 117 patients undergoing primary THA were randomized to receive 2 g TXA orally 2 h preoperatively, and two doses of 1 g TXA postoperatively (oral group) or 3 g of TXA topical administration in the operating room (topical group). The primary outcome was a reduction in hemoglobin concentration. Other outcomes-such as blood loss, TXA-related cost (¥), length of hospital stay (days), complications such as pulmonary thromboembolism (PE), deep vein thrombosis (DVT), and infection, blood coagulation and fibrinolysis, and hip function-were recorded. The mean reduction in hemoglobin level was similar between the oral and topical groups (3.07 g/dL compared with 3.12 g/dL; p = 0.85). Similarly, there was no significant difference in the mean total blood loss between oral and topical administration (863 mL compared with 902 mL; p = 0.62). Three patients received an allogeneic blood transfusion, including one patient in the oral group and two patients in the topical group (p = 0.55). The oral group had a significantly lower TXA-related cost than the topical group: ¥944 and ¥4359, respectively (p = 0.01). No PE, DVT, cardiac infarction or renal failure occurred during the 90-day follow-up. The coagulation and fibrinolysis parameters were similar between the two groups. Oral TXA is equivalent to topical TXA administration in the reduction of blood loss in the setting of primary THA without drainage. Copyright © 2018. Published by Elsevier Ltd.

  3. Continued Inpatient Care After Primary Total Knee Arthroplasty Increases 30-Day Post-Discharge Complications: A Propensity Score-Adjusted Analysis.

    Science.gov (United States)

    McLawhorn, Alexander S; Fu, Michael C; Schairer, William W; Sculco, Peter K; MacLean, Catherine H; Padgett, Douglas E

    2017-09-01

    Discharge destination, either home or skilled care facility, after total knee arthroplasty (TKA) may be associated with significant variation in postacute care outcomes. The purpose of this study was to characterize the 30-day postdischarge outcomes after primary TKA relative to discharge destination. All primary unilateral TKAs performed for osteoarthritis from 2011-2014 were identified in the National Surgical Quality Improvement Program database. Propensity scores based on predischarge characteristics were used to adjust for selection bias in discharge destination. Propensity-adjusted multivariable logistic regressions were used to examine associations between discharge destination and postdischarge complications. Among 101,256 primary TKAs identified, 70,628 were discharged home and 30,628 to skilled care facilities. Patients discharged to facilities were more frequently were female, older, higher body mass index class, higher Charlson comorbidity index and American Society of Anesthesiologists scores, had predischarge complications, received general anesthesia, and classified as nonindependent preoperatively. Propensity adjustment accounted for this selection bias. Patients discharged to skilled care facilities after TKA had higher odds of any major complication (odds ratio = 1.25; 95% confidence interval, 1.13-1.37) and readmission (odds ratio = 1.81; 95% confidence interval, 1.50-2.18). Skilled care was associated with increased odds for respiratory, septic, thromboembolic, and urinary complications. Associations with death, cardiac, and wound complications were not significant. After controlling for predischarge characteristics, discharge to skilled care facilities vs home after primary TKA is associated with higher odds of numerous complications and unplanned readmission. These results support coordination of care pathways to facilitate home discharge after hospitalization for TKA whenever possible. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. A feasibility randomised controlled trial of pre-operative occupational therapy to optimise recovery for patients undergoing primary total hip replacement for osteoarthritis (PROOF-THR).

    Science.gov (United States)

    Jepson, Paul; Sands, Gina; Beswick, Andrew D; Davis, Edward T; Blom, Ashley W; Sackley, Catherine M

    2016-02-01

    To assess the feasibility of a pre-operative occupational therapy intervention for patients undergoing primary total hip replacement. Single blinded feasibility randomised controlled trial, with data collection prior to the intervention, and at 4, 12, and 26 weeks following surgery. Recruitment from two NHS orthopaedic outpatient centres in the West Midlands, UK. Patients awaiting primary total hip replacement due to osteoarthritis were recruited. Following pre-operative assessment, patients were individually randomised to intervention or control by a computer-generated block randomisation algorithm stratified by age and centre. The intervention group received a pre-surgery home visit by an occupational therapist who discussed expectations, assessed home safety, and provided appropriate adaptive equipment. The control group received treatment as usual. The study assessed the feasibility of recruitment procedures, delivery of the intervention, appropriateness of outcome measures and data collection methods. Health related quality of life and resource use were recorded at 4, 12 and 26 weeks. Forty-four participants were recruited, 21 were randomised to the occupational therapy intervention and 23 to usual care. Analysis of 26 week data included 18 participants in the intervention group and 21 in the control. The intervention was delivered successfully with no withdrawals or crossovers; 5/44 were lost to follow-up with further missing data for participation and resource use. The feasibility study provided the information required to conduct a definitive trial. Burden of assessment would need to be addressed. A total of 219 patients would be required in an efficacy trial. © The Author(s) 2015.

  5. The impact of food and nutrient-based standards on primary school children's lunch and total dietary intake: a natural experimental evaluation of government policy in England.

    Science.gov (United States)

    Spence, Suzanne; Delve, Jennifer; Stamp, Elaine; Matthews, John N S; White, Martin; Adamson, Ashley J

    2013-01-01

    In 2005, the nutritional content of children's school lunches in England was widely criticised, leading to a major policy change in 2006. Food and nutrient-based standards were reintroduced requiring primary schools to comply by September 2008. We aimed to determine the effect of the policy on the nutritional content at lunchtime and in children's total diet. We undertook a natural experimental evaluation, analysing data from cross-sectional surveys in 12 primary schools in North East England, pre and post policy. Dietary data were collected on four consecutive days from children aged 4-7 years (n = 385 in 2003-4; n = 632 in 2008-9). We used linear mixed effect models to analyse the effects of gender, year, and lunch type on children's mean total daily intake. Both pre- and post-implementation, children who ate a school lunch consumed less sodium (mean change -128 mg, 95% CI: -183 to -73 mg) in their total diet than children eating home-packed lunches. Post-implementation, children eating school lunches consumed a lower % energy from fat (-1.8%, -2.8 to -0.9) and saturated fat (-1.0%; -1.6 to -0.5) than children eating packed lunches. Children eating school lunches post implementation consumed significantly more carbohydrate (16.4 g, 5.3 to 27.6), protein (3.6 g, 1.1 to 6.0), non-starch polysaccharides (1.5 g, 0.5 to 1.9), vitamin C (0.7 mg, 0.6 to 0.8), and folate (12.3 µg, 9.7 to 20.4) in their total diet than children eating packed lunches. Implementation of school food policy standards was associated with significant improvements in the nutritional content of school lunches; this was reflected in children's total diet. School food- and nutrient-based standards can play an important role in promoting dietary health and may contribute to tackling childhood obesity. Similar policy measures should be considered for other environments influencing children's diet.

  6. The impact of food and nutrient-based standards on primary school children's lunch and total dietary intake: a natural experimental evaluation of government policy in England.

    Directory of Open Access Journals (Sweden)

    Suzanne Spence

    Full Text Available In 2005, the nutritional content of children's school lunches in England was widely criticised, leading to a major policy change in 2006. Food and nutrient-based standards were reintroduced requiring primary schools to comply by September 2008. We aimed to determine the effect of the policy on the nutritional content at lunchtime and in children's total diet. We undertook a natural experimental evaluation, analysing data from cross-sectional surveys in 12 primary schools in North East England, pre and post policy. Dietary data were collected on four consecutive days from children aged 4-7 years (n = 385 in 2003-4; n = 632 in 2008-9. We used linear mixed effect models to analyse the effects of gender, year, and lunch type on children's mean total daily intake. Both pre- and post-implementation, children who ate a school lunch consumed less sodium (mean change -128 mg, 95% CI: -183 to -73 mg in their total diet than children eating home-packed lunches. Post-implementation, children eating school lunches consumed a lower % energy from fat (-1.8%, -2.8 to -0.9 and saturated fat (-1.0%; -1.6 to -0.5 than children eating packed lunches. Children eating school lunches post implementation consumed significantly more carbohydrate (16.4 g, 5.3 to 27.6, protein (3.6 g, 1.1 to 6.0, non-starch polysaccharides (1.5 g, 0.5 to 1.9, vitamin C (0.7 mg, 0.6 to 0.8, and folate (12.3 µg, 9.7 to 20.4 in their total diet than children eating packed lunches. Implementation of school food policy standards was associated with significant improvements in the nutritional content of school lunches; this was reflected in children's total diet. School food- and nutrient-based standards can play an important role in promoting dietary health and may contribute to tackling childhood obesity. Similar policy measures should be considered for other environments influencing children's diet.

  7. Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Blønd, Lars; Sonne-Holm, Stig

    2003-01-01

    INTRODUCTION: We performed a prospective, randomized, double-blind study on 40 patients scheduled for primary total hip arthroplasty due to arthrosis or osteonecrosis to determine the effect of tranexamic acid on per- and postoperative blood losses and on the number of blood transfusions needed...... blood losses at removal of the drain 24 hours after the operation and the number of blood transfusions. RESULTS: Patients receiving tranexamic acid had a mean peroperative blood loss of 480 mL versus 622 mL in patients receiving placebo (p = 0.3), a postoperative blood loss of 334 mL versus 609 mL (p...... = 0.001), a total blood loss of 814 mL versus 1231 mL (p = 0.001) and a total need for 4 blood transfusions versus 25 (p = 0.04). No patient in either group had symptoms of deep venous thrombosis, pulmonary embolism or prolonged wound drainage. INTERPRETATION: Transemic acid is effective in reducing...

  8. Associations between preoperative Oxford hip and knee scores and costs and quality of life of patients undergoing primary total joint replacement in the NHS England: an observational study.

    Science.gov (United States)

    Eibich, Peter; Dakin, Helen A; Price, Andrew James; Beard, David; Arden, Nigel K; Gray, Alastair M

    2018-04-10

    To assess how costs and quality of life (measured by EuroQoL-5 Dimensions (EQ-5D)) before and after total hip replacement (THR) and total knee replacement (TKR) vary with age, gender and preoperative Oxford hip score (OHS) and Oxford knee score (OKS). Regression analyses using prospectively collected data from clinical trials, cohort studies and administrative data bases. UK secondary care. Men and women undergoing primary THR or TKR. The Hospital Episode Statistics data linked to patient-reported outcome measures included 602 176 patients undergoing hip or knee replacement who were followed up for up to 6 years. The Knee Arthroplasty Trial included 2217 patients undergoing TKR who were followed up for 12 years. The Clinical Outcomes in Arthroplasty Study cohort included 806 patients undergoing THR and 484 patients undergoing TKR who were observed for 1 year. EQ-5D-3L quality of life before and after surgery, costs of primary arthroplasty, costs of revision arthroplasty and the costs of hospital readmissions and ambulatory costs in the year before and up to 12 years after joint replacement. Average postoperative utility for patients at the 5th percentile of the OHS/OKS distribution was 0.61/0.5 for THR/TKR and 0.89/0.85 for patients at the 95th percentile. The difference between postoperative and preoperative EQ-5D utility was highest for patients with preoperative OHS/OKS lower than 10. However, postoperative EQ-5D utility was higher than preoperative utility for all patients with OHS≤46 and those with OKS≤44. In contrast, costs were generally higher for patients with low preoperative OHS/OKS than those with high OHS/OKS. For example, costs of hospital readmissions within 12 months after primary THR/TKR were £740/£888 for patients at the 5th percentile compared with £314/£404 at the 95th percentile of the OHS/OKS distribution. Our findings suggest that costs and quality of life associated with total joint replacement vary systematically with

  9. The efficiency and safety of fibrin sealant for reducing blood loss in primary total hip arthroplasty: A systematic review and meta-analysis.

    Science.gov (United States)

    Wang, Zhiyuan; Xiao, Lin; Guo, Hao; Zhao, Guanghui; Ma, Jianbing

    2017-01-01

    Total hip arthroplasty (THA) is associated with substantial blood loss. The objective of present systematic review and meta-analysis is to provide evidence from randomized controlled trials (RCTs) on the efficiency and safety of administration of fibrin sealant (FS) for reducing blood loss in patients undergoing primary THA. Potential relevant studies were identified from electronic databases including Medline, PubMed, Embase, ScienceDirect, web of science and Cochrane Library. Gray academic studies were also identified from the reference list of included studies. There was no language restriction. Pooling of data was carried out by using RevMan 5.1. Six randomized controlled trials (RCTs) met the inclusion criteria. Current meta-analysis indicated that there were significant differences in terms of total blood loss (MD = -153.77, 95% CI: -287.21 to -20.34, P = 0.02), postoperative hemoglobin level (MD = -0.25, 95% CI: -0.46 to -0.05, P = 0.02) and transfusion rate (RD = -0.12, 95% CI: -0.22 to -0.03, P = 0.01) between groups. No significant differences were found regarding the incidence of deep venous thrombosis (DVT) (RD = 0.00, 95% CI: -0.01to 0.01, P = 0.51) or other side effects. Administration of fibrin sealant in total hip arthroplasty may reduce total blood loss, postoperative hemoglobin decline and transfusion requirements. Moreover, no adverse effect was related to FS. Due to the limited quality of the evidence currently available, higher quality RCTs are required. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  10. Tranexamic acid reduces blood loss and blood transfusions in primary total hip arthroplasty: a prospective randomized double-blind study in 40 patients

    DEFF Research Database (Denmark)

    Husted, Henrik; Blønd, Lars; Sonne-Holm, Stig

    2003-01-01

    INTRODUCTION: We performed a prospective, randomized, double-blind study on 40 patients scheduled for primary total hip arthroplasty due to arthrosis or osteonecrosis to determine the effect of tranexamic acid on per- and postoperative blood losses and on the number of blood transfusions needed....... PATIENTS AND METHODS: 40 patients were randomized to tranexamic acid (10 mg/kg given as a bolus intravenous injection, followed by a continuous infusion of 1 mg/kg/hour for 10 hours) or placebo (20 mL saline given intravenously) 15 minutes before the incision. We recorded the peroperative and postoperative...... blood losses at removal of the drain 24 hours after the operation and the number of blood transfusions. RESULTS: Patients receiving tranexamic acid had a mean peroperative blood loss of 480 mL versus 622 mL in patients receiving placebo (p = 0.3), a postoperative blood loss of 334 mL versus 609 mL (p...

  11. Body Mass Index Class Is Independently Associated With Health-Related Quality of Life After Primary Total Hip Arthroplasty: An Institutional Registry-Based Study.

    Science.gov (United States)

    McLawhorn, Alexander S; Steinhaus, Michael E; Southren, Daniel L; Lee, Yuo-Yu; Dodwell, Emily R; Figgie, Mark P

    2017-01-01

    The purpose of this study was to compare the health-related quality of life (HRQoL) of patients across World Health Organization (WHO) body mass index (BMI) classes before and after total hip arthroplasty (THA). Patients with end-stage hip osteoarthritis who received elective primary unilateral THA were identified through an institutional registry and categorized based on the World Health Organization BMI classification. Age, sex, laterality, year of surgery, and Charlson-Deyo comorbidity index were recorded. The primary outcome was the EQ-5D-3L index and visual analog scale (EQ-VAS) scores at 2 years postoperatively. Inferential statistics and regression analyses were performed to determine associations between BMI classes and HRQoL. EQ-5D-3L scores at baseline and at 2 years were statistically different across BMI classes, with higher EQ-VAS and index scores in patients with lower BMI. There was no difference observed for the 2-year change in EQ-VAS scores, but there was a statistically greater increase in index scores for more obese patients. In the regression analyses, there were statistically significant negative effect estimates for EQ-VAS and index scores associated with increasing BMI class. BMI class is independently associated with lower HRQoL scores 2 years after primary THA. While absolute scores in obese patients were lower than in nonobese patients, obese patients enjoyed more positive changes in EQ-5D index scores after THA. These results may provide the most detailed information on how BMI influences HRQoL before and after THA, and they are relevant to future economic decision analyses on the topic. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Total Lignans of Schisandra chinensis Ameliorates Aβ1-42-Induced Neurodegeneration with Cognitive Impairment in Mice and Primary Mouse Neuronal Cells.

    Directory of Open Access Journals (Sweden)

    Xu Zhao

    Full Text Available Lignan compounds extracted from Schisandra chinensis (Turcz. Baill. have been reported to possess various biological activities, and have potential in the treatment of Alzheimer's disease. This study was designed to investigate the effects of total lignans of Schisandra chinensis (TLS on cognitive function and neurodegeneration in the model of AD induced by Aβ1-42 in vivo and in vitro. It was found that intragastric infusion with TLS (50 and 200 mg/kg to Aβ1-42-induced mice significantly increased the number of avoidances in the shuttle-box test and swimming time in the target quadrant in the Morris water maze test. TLS at dose of 200 mg/kg significantly restored the activities of total antioxidant capacity (T-AOC, as well as the level of malondialdehyde (MDA both in the hippocampus and cerebral cortex in mice. Results of histopathological examination indicated that TLS noticeably ameliorated the neurodegeneration in the hippocampus in mice. On the other hand, TLS (100 μM could protect the Aβ1-42-induced primary mouse neuronal cells by blocking the decrease of mitochondrial membrane potential (MMP, change the expressions of Bcl-2 (important regulator in the mitochondria apoptosis pathway. Moreover, TLS also decreased the activity of β-secretase 1 (BACE1, crucial protease contributes to the hydrolysis of amyloid precursor protein (APP, and inhibited the expression of JKN/p38, which involved in the MAPKs signaling pathways in both mice and primary mouse neuronal cells. In summary, TLS might protect against cognitive deficits and neurodegeneration by releasing the damage of oxidative stress, inhibiting the expression of BACE1 and the MAPKs inflammatory signaling pathways.

  13. Effect of lavage and brush preparation on cement penetration and primary stability in tibial unicompartmental total knee arthroplasty: An experimental cadaver study.

    Science.gov (United States)

    Scheele, Christian; Pietschmann, Matthias F; Schröder, Christian; Grupp, Thomas; Holderied, Melanie; Jansson, Volmar; Müller, Peter E

    2017-03-01

    Unicompartmental total knee arthroplasty (UKA) is a well-established treatment option for unicondylar osteoarthritis, and generally leads to better functional results than tricompartimental total knee arthroplasty (TKA). However, revision rates of UKAs are reported as being higher; a major reason for this is aseptic loosening of the tibial component due to implant-cement-bone interface fatigue. The objective of this study was to determine the effects of trabecular bone preparation, prior to implantation of tibial UKAs, on morphological and biomechanical outcomes in a cadaver study. Cemented UKAs were performed in 18 human cadaver knees after the bone bed was cleaned using pulsed lavage (Group A), conventional brush (Group B) or no cleaning at all (Group C, control). Morphologic cement penetration and primary stability were measured. The area proportion under the tibial component without visible cement penetration was significantly higher in Group C (21.9%, SD 11.9) than in both Group A (7.1%, SD 5.8), and Group B (6.5%, SD 4.2) (P=0.007). The overall cement penetration depth did not differ between groups. However, in the posterior part, cement penetration depth was significantly higher in Group B (1.9mm, SD 0.3) than in both Group A (1.3mm, SD 0.3) and Group C (1.4mm, SD 0.3) (P=0.015). The mode of preparation did not show a substantial effect on primary stability tested under dynamic compression-shear test conditions (P=0.910). Bone preparation significantly enhances cement interdigitation. The application of a brush shows similar results compared with the application of pulsed lavage. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. Effect of day of the week of primary total hip arthroplasty on length of stay at a university-based teaching medical center.

    Science.gov (United States)

    Rathi, Pranav; Coleman, Sheldon; Durbin-Johnson, Blythe; Giordani, Mauro; Pereira, Gavin; Di Cesare, Paul E

    2014-12-01

    Length of hospital stay (LHS) after primary total hip arthroplasty (THA) constitutes a critical outcome measure, as prolonged LHS implies increased resource expenditure. Investigations have highlighted factors that affect LHS after THA. These factors include advanced age, medical comorbidities, obesity, intraoperative time, anesthesia technique, surgical site infection, and incision length. We retrospectively analyzed the effect of day of the week of primary THA on LHS. We reviewed the surgery and patient factors of 273 consecutive patients who underwent THA at our institution, a tertiary-care teaching hospital. There was a 15% increase in LHS for patients who underwent THA on Thursday versus Monday when controlling for other covariates that can affect LHS. Other statistically significant variables associated with increased LHS included American Society of Anesthesiologists grade, transfusion requirements, and postoperative complications. The day of the week of THA may be an independent variable affecting LHS. Institutions with reduced weekend resources may want to perform THA earlier in the week to try to reduce LHS.

  15. Factor analysis of the contextual fine motor questionnaire in children.

    Science.gov (United States)

    Lin, Chin-Kai; Meng, Ling-Fu; Yu, Ya-Wen; Chen, Che-Kuo; Li, Kuan-Hua

    2014-02-01

    Most studies treat fine motor as one subscale in a developmental test, hence, further factor analysis of fine motor has not been conducted. In fact, fine motor has been treated as a multi-dimensional domain from both clinical and theoretical perspectives, and therefore to know its factors would be valuable. The aim of this study is to analyze the internal consistency and factor validity of the Contextual Fine Motor Questionnaire (CFMQ). Based on the ecological observation and literature, the Contextual Fine Motor Questionnaire (CFMQ) was developed and includes 5 subscales: Pen Control, Tool Use During Handicraft Activities, the Use of Dining Utensils, Connecting and Separating during Dressing and Undressing, and Opening Containers. The main purpose of this study is to establish the factorial validity of the CFMQ through conducting this factor analysis study. Among 1208 questionnaires, 904 were successfully completed. Data from the children's CFMQ submitted by primary care providers was analyzed, including 485 females (53.6%) and 419 males (46.4%) from grades 1 to 5, ranging in age from 82 to 167 months (M=113.9, SD=16.3). Cronbach's alpha was used to measure internal consistency and explorative factor analysis was applied to test the five factor structures within the CFMQ. Results showed that Cronbach's alpha coefficient of the CFMQ for 5 subscales ranged from .77 to .92 and all item-total correlations with corresponding subscales were larger than .4 except one item. The factor loading of almost all items classified to their factor was larger than .5 except 3 items. There were five factors, explaining a total of 62.59% variance for the CFMQ. In conclusion, the remaining 24 items in the 5 subscales of the CFMQ had appropriate internal consistency, test-retest reliability and construct validity. Copyright © 2013 Elsevier Ltd. All rights reserved.

  16. Expect the best, prepare for the worst: surgeon and patient expectation of the outcome of primary total hip and knee replacement.

    Science.gov (United States)

    Moran, M.; Khan, A.; Sochart, D. H.; Andrew, G.

    2003-01-01

    A cross-sectional study of 100 surgeons and 370 patients awaiting primary total hip or knee replacement was carried out. Oxford hip or knee score questionnaires were sent to the surgeons and patients. They were asked to predict the level of symptoms expected 6 months following surgery. The Oxford scores derive a value of 12-60, with a greater score indicating worsening symptoms. The mean pre-operative score was 45.12 for the hip patients and 42.96 for the knee patients, and the patients expected this to drop to 23.70 and 25.66, respectively, 6 months' postoperatively. This was a significant difference for both groups. The surgeons expected the patients to have a mean postoperative score of 20.91 for the hip group and 22.19 for the knee group. The surgeons' scores were significantly lower than those from the patients. There was a significant difference between the patients' and surgeons' expectations of the results of total knee and hip replacement surgery. The surgeons expected better results than the patients. We believe that this is the first study that directly compares surgeon and patient expectations of lower limb arthroplasty. PMID:12831497

  17. Association between preoperative anaemia with length of hospital stay among patients undergoing primary total knee arthroplasty in Singapore: a single-centre retrospective study.

    Science.gov (United States)

    Abdullah, Hairil Rizal; Sim, Yilin Eileen; Hao, Ying; Lin, Geng Yu; Liew, Geoffrey Haw Chieh; Lamoureux, Ecosse L; Tan, Mann Hong

    2017-06-08

    Studies in western healthcare settings suggest that preoperative anaemia is associated with poor outcomes after elective orthopaedic surgery. We investigated the prevalence of preoperative anaemia among patients with primary unilateral total knee arthroplasty (TKA) in Singapore and its association with length of hospital stay (LOS), perioperative blood transfusion and hospital readmission rates. Retrospective cohort study performed in a tertiary academic medical centre in Singapore, involving patients who underwent primary unilateral TKA between January 2013 and June 2014. Demographics, comorbidities, preoperative haemoglobin (Hb) level, LOS and 30-day readmission data were collected. Anaemia was classified according to WHO definition. Prolonged LOS was defined as more than 6 days, which corresponds to >75th centile LOS of the data. We analysed 2394 patients. The prevalence of anaemia was 23.7%. 403 patients (16.8%) had mild anaemia and 164 patients (6.8%) had moderate to severe anaemia. Overall mean LOS was 5.4±4.8 days. Based on multivariate logistic regression, preoperative anaemia significantly increased LOS (mild anaemia, adjusted OR (aOR) 1.71, p70 years were associated with prolonged LOS. Our 30-day related readmission rate was 1.7% (42) cases. Anaemia is common among patients undergoing elective TKA in Singapore and is independently associated with prolonged LOS and increased perioperative blood transfusion. We suggest measures to correct anaemia prior to surgery, including the use of non-gender-based Hb cut-off for establishing diagnosis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Utilisation of primary total knee joint replacements across socioeconomic status in the Barwon Statistical Division, Australia, 2006-2007: a cross-sectional study.

    Science.gov (United States)

    Brennan, Sharon Lee; Stanford, Tyman; Wluka, Anita E; Page, Richard S; Graves, Stephen E; Kotowicz, Mark A; Nicholson, Geoffrey C; Pasco, Julie A

    2012-01-01

    There are few Australian data that examine the association between total knee joint replacement (TKR) utilisation and socioeconomic status (SES). This study examined TKR surgeries with a diagnosis of osteoarthritis (OA) performed for residents of Barwon Statistical Division (BSD) for 2006-2007. Cross-sectional. BSD, South-eastern Victoria, Australia All patients who underwent a TKR for OA, 2006-2007, and whose residential postcode was identified as within the BSD of Australia, and for whom SES data were available, were eligible for inclusion. Primary TKR data ascertained from the Australian Orthopaedic Association National Joint Replacement Registry. Residential addresses were matched with the Australian Bureau of Statistics census data, and the Index of Relative Socioeconomic Disadvantage was used to determine SES, categorised into quintiles whereby quintile 1 indicated the most disadvantaged and quintile 5 the least disadvantaged. Age-specific and sex-specific rates of TKR utilisation per 1000 person-years were reported for 10-year age bands. Females accounted for 62.7% of the 691 primary TKR surgeries performed during 2006-2007. The greatest utilisation rates of TKR in males was 7.6 observed in those aged >79 years, and in 10.2 in females observed in those aged 70-79 years. An increase in TKR was observed for males in SES quintile four compared to quintile 1 in which the lowest utilisation which was observed (p=0.04). No differences were observed in females across SES quintiles. Further investigation is warranted on a larger scale to examine the role that SES may play in TKR utilisation, and to determine whether any social disparities in TKR utilisation reflect health system biases or geographic differences.

  19. Metabolic syndrome as a risk factor for total hip or knee replacement due to primary osteoarthritis: a prospective cohort study (the HUNT study and the Norwegian Arthroplasty Register).

    Science.gov (United States)

    Hellevik, Alf Inge; Johnsen, Marianne Bakke; Langhammer, Arnulf; Baste, Valborg; Furnes, Ove; Storheim, Kjersti; Zwart, John Anker; Flugsrud, Gunnar Birkeland; Nordsletten, Lars

    2018-01-01

    Biochemical changes associated with obesity may accelerate osteoarthritis beyond the effect of mechanical factors. This study investigated whether metabolic syndrome and its components (visceral obesity, hypertension, dyslipidemia and insulin resistance) were risk factors for subsequent total hip replacement (THR) or total knee replacement (TKR) due to primary osteoarthritis. In this prospective cohort study, data from the second survey of the Nord-Trøndelag Health Study 2 (HUNT2) were linked to the Norwegian Arthroplasty Register for identification of the outcome of THR or TKR. The analyses were stratified by age (<50, 50-69.9 and ≥70 years) and adjusted for gender, body mass index, smoking, physical activity and education. Of the 62,661 participants, 12,593 (20.1%) were identified as having metabolic syndrome, and we recorded 1,840 (2.9%) THRs and 1,111 (1.8%) TKRs during a mean follow-up time of 15.4 years. Cox regression analyses did not show any association between full metabolic syndrome and THR or TKR, except in persons <50 years with metabolic syndrome who had a decreased risk of THR (hazard ratio [HR] 0.58, 95% CI 0.40-0.83). However, when including only participants whose exposure status did not change during follow-up, this protective association was no longer significant. Increased waist circumference was associated with increased risk of TKR in participants <50 years (HR 1.62, 95% CI 1.10-2.39) and 50-69.9 years (HR 1.43, 95% CI 1.14-1.80). Hypertension significantly increased the risk of TKR in participants <50 years (HR 1.38, 95% CI 1.05-1.81), and this risk was greater for men. This study found an increased risk of TKR in men <50 years with hypertension and persons <70 years with increased waist circumference. Apart from this, neither metabolic syndrome nor its components were associated with increased risk of THR or TKR due to primary osteoarthritis.

  20. The Fine Structure Constant

    Indian Academy of Sciences (India)

    IAS Admin

    The article discusses the importance of the fine structure constant in quantum mechanics, along with the brief history of how it emerged. Al- though Sommerfelds idea of elliptical orbits has been replaced by wave mechanics, the fine struc- ture constant he introduced has remained as an important parameter in the field of ...

  1. Metabolic syndrome as a risk factor for total hip or knee replacement due to primary osteoarthritis: a prospective cohort study (the HUNT study and the Norwegian Arthroplasty Register

    Directory of Open Access Journals (Sweden)

    Hellevik AI

    2018-01-01

    Full Text Available Alf Inge Hellevik,1,2 Marianne Bakke Johnsen,3,4 Arnulf Langhammer,1 Valborg Baste,5 Ove Furnes,6,7 Kjersti Storheim,3,4 John Anker Zwart,3,4 Gunnar Birkeland Flugsrud,2 Lars Nordsletten2,4 1The HUNT Research Centre, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Levanger, 2Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, 3Research and Communication Unit for Musculoskeletal Health, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, 4Faculty of Medicine, University of Oslo, Oslo, 5Uni Research Health, Bergen, 6The Norwegian Arthroplasty Register, Department of Orthopedic Surgery, Haukeland University Hospital, Bergen, 7Department of Clinical Medicine, Institute of Medicine and Dentistry, University of Bergen, Bergen, Norway Objective: Biochemical changes associated with obesity may accelerate osteoarthritis beyond the effect of mechanical factors. This study investigated whether metabolic syndrome and its components (visceral obesity, hypertension, dyslipidemia and insulin resistance were risk factors for subsequent total hip replacement (THR or total knee replacement (TKR due to primary osteoarthritis.Design: In this prospective cohort study, data from the second survey of the Nord-Trøndelag Health Study 2 (HUNT2 were linked to the Norwegian Arthroplasty Register for identification of the outcome of THR or TKR. The analyses were stratified by age (<50, 50–69.9 and ≥70 years and adjusted for gender, body mass index, smoking, physical activity and education.Results: Of the 62,661 participants, 12,593 (20.1% were identified as having metabolic syndrome, and we recorded 1,840 (2.9% THRs and 1,111 (1.8% TKRs during a mean follow-up time of 15.4 years. Cox regression analyses did not show any association between full metabolic syndrome and THR or TKR, except in persons <50 years with metabolic syndrome who had a decreased risk

  2. Topical versus intravenous administration of tranexamic acid in primary total hip arthroplasty: a systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Sammy A. Hanna

    2016-09-01

    Full Text Available Tranexamic acid (TA is widely used by orthopedic surgeons to decrease blood loss and the need for transfusion following total hip arthroplasty (THA. Although both intravenous and topical applications are described in the literature, there remains no consensus regarding the optimal regimen, dosage and method of delivery of TA during THA. In addition, concerns still exist regarding the risk of thromboembolic events with intravenous administration. The purpose of this meta-analysis was to compare the efficacy and safety of topical versus intravenous administration of TA in THA. A systemic review of the electronic databases PubMed, CENTRAL, EMBASE and Google Scholar was undertaken to identify all randomized controlled trials (RCTs comparing the topical and intravenous administration of TA during THA, in terms of total blood loss, rate of blood transfusion and incidence of deep venous thrombosis (DVT and pulmonary embolism (PE post-operatively. A meta-analysis was performed to evaluate and compare the efficacy and safety of both methods of administration. Of 248 potentially relevant papers, three RCTs comprising (482 were eligible for data extraction and metaanalysis. The results showed a slightly higher amount of blood loss [Mean Difference (MD – 46.37, P=0.12, 95% confidence interval (CI – 12.54 to 105.29] and rate of transfusion (Risk Ratio 1.30, P=0.39, 95%CI 0.71 to 2.37 postoperatively in the topical TA group, but both did not reach statistical significance. There were 3 cases (1.2% of DVT/PE in the intravenous group and one case (0.4% in the topical group. Topical TA is an effective and safe method to reduce blood loss and the rate of transfusion following primary THA. It has comparative effectiveness to IV administration with slightly less post-operative thromboembolic complications. Larger and better-designed RCTs are required to establish the optimum dosage and regimen for topical use.

  3. The Effect of a Physical Activity Program on the Total Number of Primary Care Visits in Inactive Patients: A 15-Month Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Maria Giné-Garriga

    Full Text Available Effective promotion of exercise could result in substantial savings in healthcare cost expenses in terms of direct medical costs, such as the number of medical appointments. However, this is hampered by our limited knowledge of how to achieve sustained increases in physical activity.To assess the effectiveness of a Primary Health Care (PHC based physical activity program in reducing the total number of visits to the healthcare center among inactive patients, over a 15-month period.Randomized controlled trial.Three hundred and sixty-two (n = 362 inactive patients suffering from at least one chronic condition were included. One hundred and eighty-three patients (n = 183; mean (SD; 68.3 (8.8 years; 118 women were randomly allocated to the physical activity program (IG. One hundred and seventy-nine patients (n = 179; 67.2 (9.1 years; 106 women were allocated to the control group (CG. The IG went through a three-month standardized physical activity program led by physical activity specialists and linked to community resources.The total number of medical appointments to the PHC, during twelve months before and after the program, was registered. Self-reported health status (SF-12 version 2 was assessed at baseline (month 0, at the end of the intervention (month 3, and at 12 months follow-up after the end of the intervention (month 15.The IG had a significantly reduced number of visits during the 12 months after the intervention: 14.8 (8.5. The CG remained about the same: 18.2 (11.1 (P = .002.Our findings indicate that a 3-month physical activity program linked to community resources is a short-duration, effective and sustainable intervention in inactive patients to decrease rates of PHC visits.ClinicalTrials.gov NCT00714831.

  4. Effects of perceptions of care, medical advice, and hospital quality on patient satisfaction after primary total knee replacement: A cross-sectional study.

    Directory of Open Access Journals (Sweden)

    Tom Schaal

    Full Text Available The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction.A multicenter cross-sectional study was conducted with 856 patients having their primary total knee replacements at 41 hospitals. Patient satisfaction was queried via a validated, multidimensional questionnaire mainly using a six-point scale. In addition to bivariate calculations, patient satisfaction was the dependent variable in a binary logistic regression model.The bivariate analysis showed a strong association between satisfaction and sex (male or female, the patients' health before admission, and the length of stay. The number of cases treated at each hospital did not reveal any impact on satisfaction. The multivariate analysis identified three predictors associated with overall satisfaction. The strongest factor was the treatment outcome and the weakest was the quality of food. It became apparent that the statutory procedure minimums were not being met.The relevant factors influencing patient satisfaction were partially the same as previous study results and allowed more detailed conclusions. The results provide suggestions across hospitals that could help health care providers better meet needs of patients after knee arthroplasties.

  5. Associations between socioeconomic status and primary total knee joint replacements performed for osteoarthritis across Australia 2003-10: data from the Australian Orthopaedic Association National Joint Replacement Registry.

    Science.gov (United States)

    Brennan, Sharon L; Lane, Stephen E; Lorimer, Michelle; Buchbinder, Rachelle; Wluka, Anita E; Page, Richard S; Osborne, Richard H; Pasco, Julie A; Sanders, Kerrie M; Cashman, Kara; Ebeling, Peter R; Graves, Stephen E

    2014-10-28

    Relatively little is known about the social distribution of total knee joint replacement (TKR) uptake in Australia. We examine associations between socioeconomic status (SES) and TKR performed for diagnosed osteoarthritis 2003-10 for all Australian males and females aged ≥ 30 yr. Data of primary TKR (n=213,018, 57.4% female) were ascertained from a comprehensive national joint replacement registry. Residential addresses were matched to Australian Census data to identify area-level social disadvantage, and categorised into deciles. Estimated TKR rates were calculated. Poisson regression was used to model the relative risk (RR) of age-adjusted TKR per 1,000py, stratified by sex and SES. A negative relationship was observed between TKR rates and SES deciles. Females had a greater rate of TKR than males. Surgery utilisation was greatest for all adults aged 70-79 yr. In that age group differences in estimated TKR per 1,000py between deciles were greater for 2010 than 2003 (females: 2010 RR 4.32 and 2003 RR 3.67; males: 2010 RR 2.04 and 2003 RR 1.78). Identifying factors associated with TKR utilisation and SES may enhance resource planning and promote surgery utilisation for end-stage osteoarthritis.

  6. Effects of perceptions of care, medical advice, and hospital quality on patient satisfaction after primary total knee replacement: A cross-sectional study.

    Science.gov (United States)

    Schaal, Tom; Schoenfelder, Tonio; Klewer, Joerg; Kugler, Joachim

    2017-01-01

    The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction. A multicenter cross-sectional study was conducted with 856 patients having their primary total knee replacements at 41 hospitals. Patient satisfaction was queried via a validated, multidimensional questionnaire mainly using a six-point scale. In addition to bivariate calculations, patient satisfaction was the dependent variable in a binary logistic regression model. The bivariate analysis showed a strong association between satisfaction and sex (male or female), the patients' health before admission, and the length of stay. The number of cases treated at each hospital did not reveal any impact on satisfaction. The multivariate analysis identified three predictors associated with overall satisfaction. The strongest factor was the treatment outcome and the weakest was the quality of food. It became apparent that the statutory procedure minimums were not being met. The relevant factors influencing patient satisfaction were partially the same as previous study results and allowed more detailed conclusions. The results provide suggestions across hospitals that could help health care providers better meet needs of patients after knee arthroplasties.

  7. Fine structure studies of terbium atoms

    International Nuclear Information System (INIS)

    Abhay Kumar; Bandyopadhyay, Krishnanath; Niraj Kumar

    2012-01-01

    Terbium (Z = 65) is a typical rare-earth element. Fine structure of spectural lines of terbium (Tb) are presented using the laser optogalvanic spectroscopic technique. Altogether eighty transitions in the 5686-6367 A range have been observed in the fine structure spectrum of 159 Tb. Wavelengths of all the observed transitions have been determined. Out of 80 transitions of Tb, a total of 59 transitions are being reported for the first time. Classifications of 39 new transitions have been provided using the known energy levels, Doppler-limited optogalvanic spectroscopic technique is employed to study the fine structure (fs) 159 Tb. (author)

  8. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  9. What are the risk factors for dislocation in primary total hip arthroplasty? A multicenter case-control study of 128 unstable and 438 stable hips.

    Science.gov (United States)

    Fessy, M H; Putman, S; Viste, A; Isida, R; Ramdane, N; Ferreira, A; Leglise, A; Rubens-Duval, B; Bonin, N; Bonnomet, F; Combes, A; Boisgard, S; Mainard, D; Leclercq, S; Migaud, H

    2017-09-01

    Dislocation after total hip arthroplasty (THA) is a leading reason for surgical revision. The risk factors for dislocation are controversial, particularly those related to the patient and to the surgical procedure itself. The differences in opinion on the impact of these factors stem from the fact they are often evaluated using retrospective studies or in limited patient populations. This led us to carry out a prospective case-control study on a large population to determine: 1) the risk factors for dislocation after THA, 2) the features of these dislocations, and 3) the contribution of patient-related factors and surgery-related factors. Risk factors for dislocation related to the patient and procedure can be identified using a large case-control study. A multicenter, prospective case-control study was performed between January 1 and December 31, 2013. Four patients with stable THAs were matched to each patient with a dislocated THA. This led to 566 primary THA cases being included: 128 unstable, 438 stable. The primary matching factors were sex, age, initial diagnosis, surgical approach, implantation date and type of implants (bearing size, standard or dual-mobility cup). The patients with unstable THAs were 67±12 [37-73]years old on average; there were 61 women (48%) and 67 men (52%). Hip osteoarthritis (OA) was the main reason for the THA procedure in 71% (91/128) of the unstable group. The dislocation was posterior in 84 cases and anterior in 44 cases. The dislocation occurred within 3 months of the primary surgery in 48 cases (38%), 3 to 12 months after in 23 cases (18%), 1 to 5years after in 20 cases (16%), 5 to 10years after in 17 cases (13%) and more than 10years later in 20 cases. The dislocation recurred within 6 months of the initial dislocation in 23 of the 128 cases (18%). The risk factors for instability were a high ASA score with an odds ratio (OR) of 1.93 (95% CI: 1.4-2.6), neurological disability (cognitive, motor or psychiatric disorders) with

  10. Fine Arts Database (FAD)

    Data.gov (United States)

    General Services Administration — The Fine Arts Database records information on federally owned art in the control of the GSA; this includes the location, current condition and information on artists.

  11. Fine motor control

    Science.gov (United States)

    ... gross (large, general) motor control. An example of gross motor control is waving an arm in greeting. Problems ... out the child's developmental age. Children develop fine motor skills over time, by practicing and being taught. To ...

  12. Primary care physicians' perceptions about and confidence in deciding which patients to refer for total joint arthroplasty of the hip and knee.

    Science.gov (United States)

    Waugh, E J; Badley, E M; Borkhoff, C M; Croxford, R; Davis, A M; Dunn, S; Gignac, M A; Jaglal, S B; Sale, J; Hawker, G A

    2016-03-01

    The purpose of this study is to examine the perceptions of primary care physicians (PCPs) regarding indications, contraindications, risks and benefits of total joint arthroplasty (TJA) and their confidence in selecting patients for referral for TJA. PCPs recruited from among those providing care to participants in an established community cohort with hip or knee osteoarthritis (OA). Self-completed questionnaires were used to collect demographic and practice characteristics and perceptions about TJA. Confidence in referring appropriate patients for TJA was measured on a scale from 1 to 10; respondents scoring in the lowest tertile were considered to have 'low confidence'. Descriptive analyses were conducted and multiple logistic regression was used to determine key predictors of low confidence. 212 PCPs participated (58% response rate) (65% aged 50+ years, 45% female, 77% >15 years of practice). Perceptions about TJA were highly variable but on average, PCPs perceived that a typical surgical candidate would have moderate pain and disability, identified few absolute contraindications to TJA, and overestimated both the effectiveness and risks of TJA. On average, PCPs indicated moderate confidence in deciding who to refer. Independent predictors of low confidence were female physicians (OR = 2.18, 95% confidence interval (CI): 1.06-4.46) and reporting a 'lack of clarity about surgical indications' (OR = 3.54, 95% CI: 1.87-6.66). Variability in perceptions and lack of clarity about surgical indications underscore the need for decision support tools to inform PCP - patient decision making regarding referral for TJA. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  13. Analyses of fine paste ceramics

    International Nuclear Information System (INIS)

    Sabloff, J.A.

    1980-01-01

    Four chapters are included: history of Brookhaven fine paste ceramics project, chemical and mathematical procedures employed in Mayan fine paste ceramics project, and compositional and archaeological perspectives on the Mayan fine paste ceramics

  14. Analyses of fine paste ceramics

    Energy Technology Data Exchange (ETDEWEB)

    Sabloff, J A [ed.

    1980-01-01

    Four chapters are included: history of Brookhaven fine paste ceramics project, chemical and mathematical procedures employed in Mayan fine paste ceramics project, and compositional and archaeological perspectives on the Mayan fine paste ceramics. (DLC)

  15. Radioactivity in fine papers

    International Nuclear Information System (INIS)

    Taylor, H.W.; Singh, B.

    1993-01-01

    The radioactivity of fine papers has been studied through γ-ray spectroscopy with an intrinsic Ge detector. Samples of paper from European and North American sources were found to contain very different amounts of 226 Ra and 232 Th. The processes which introduce radionuclides into paper are discussed. The radioactivity from fine papers makes only a small contribution to an individual's annual radiation dose; nevertheless it is easily detectable and perhaps, avoidable. (Author)

  16. Transport of reservoir fines

    DEFF Research Database (Denmark)

    Yuan, Hao; Shapiro, Alexander; Stenby, Erling Halfdan

    Modeling transport of reservoir fines is of great importance for evaluating the damage of production wells and infectivity decline. The conventional methodology accounts for neither the formation heterogeneity around the wells nor the reservoir fines’ heterogeneity. We have developed an integral...... dispersion equation in modeling the transport and the deposition of reservoir fines. It successfully predicts the unsymmetrical concentration profiles and the hyperexponential deposition in experiments....

  17. Comparison of Fine Needle Aspiration and Fine Needle Nonaspiration Cytology of Thyroid Nodules: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Hongming Song

    2015-01-01

    Full Text Available Background. Fine needle aspiration cytology (FNAC and fine needle nonaspiration cytology (FNNAC are useful cost-effective techniques for preoperatively assessing thyroid lesions. Both techniques have advantages and disadvantages, and there is controversy over which method is superior. This meta-analysis was performed to evaluate the differences between FNAC and FNNAC for diagnosis of thyroid nodules. Methods. Primary publications were independently collected by two reviewers from PubMed, Web of Science, Google Scholar, EBSCO, OALib, and the Cochrane Library databases. The following search terms were used: fine needle, aspiration, capillary, nonaspiration, sampling without aspiration, thyroid, and cytology. The last search was performed on February 1, 2015. Results. Sixteen studies comprising 1,842 patients and 2,221 samples were included in this study. No statistically significant difference was observed between FNAC and FNNAC groups with respect to diagnostically inadequate smears, diagnostically superior smears, diagnostic performance (accuracy, sensitivity, specificity, negative predictive value, and positive predictive value, area under the summary receiver operating characteristic curve, average score of each parameter (background blood or clot, amount of cellular material, degree of cellular degeneration, degree of cellular trauma, and retention of appropriate architecture, and total score of five parameters. Conclusion. FNAC and FNNAC are equally useful in assessing thyroid nodules.

  18. Carbonaceous Aerosols in Fine Particulate Matter of Santiago Metropolitan Area, Chile

    Science.gov (United States)

    Toro Araya, Richard; Flocchini, Robert; Morales Segura, Rául G. E.; Leiva Guzmán, Manuel A.

    2014-01-01

    Measurements of carbonaceous aerosols in South American cities are limited, and most existing data are of short term and limited to only a few locations. For 6 years (2002–2007), concentrations of fine particulate matter and organic and elemental carbon were measured continuously in the capital of Chile. The contribution of carbonaceous aerosols to the primary and secondary fractions was estimated at three different sampling sites and in the warm and cool seasons. The results demonstrate that there are significant differences in the levels in both the cold (March to August) and warm (September to February) seasons at all sites studied. The percent contribution of total carbonaceous aerosol fine particulate matter was greater in the cool season (53 ± 41%) than in the warm season (44 ± 18%). On average, the secondary organic carbon in the city corresponded to 29% of the total organic carbon. In cold periods, this proportion may reach an average of 38%. A comparison of the results with the air quality standards for fine particulate matter indicates that the total carbonaceous fraction alone exceeds the World Health Organization standard (10 µg/m3) and the United States Environmental Protection Agency standard (15 µg/m3) for fine particulate matter. PMID:24587753

  19. Carbonaceous Aerosols in Fine Particulate Matter of Santiago Metropolitan Area, Chile

    Directory of Open Access Journals (Sweden)

    Richard Toro Araya

    2014-01-01

    Full Text Available Measurements of carbonaceous aerosols in South American cities are limited, and most existing data are of short term and limited to only a few locations. For 6 years (2002–2007, concentrations of fine particulate matter and organic and elemental carbon were measured continuously in the capital of Chile. The contribution of carbonaceous aerosols to the primary and secondary fractions was estimated at three different sampling sites and in the warm and cool seasons. The results demonstrate that there are significant differences in the levels in both the cold (March to August and warm (September to February seasons at all sites studied. The percent contribution of total carbonaceous aerosol fine particulate matter was greater in the cool season (53 ± 41% than in the warm season (44 ± 18%. On average, the secondary organic carbon in the city corresponded to 29% of the total organic carbon. In cold periods, this proportion may reach an average of 38%. A comparison of the results with the air quality standards for fine particulate matter indicates that the total carbonaceous fraction alone exceeds the World Health Organization standard (10 µg/m3 and the United States Environmental Protection Agency standard (15 µg/m3 for fine particulate matter.

  20. Carbonaceous aerosols in fine particulate matter of Santiago Metropolitan Area, Chile.

    Science.gov (United States)

    Toro Araya, Richard; Flocchini, Robert; Morales Segura, Rául G E; Leiva Guzmán, Manuel A

    2014-01-01

    Measurements of carbonaceous aerosols in South American cities are limited, and most existing data are of short term and limited to only a few locations. For 6 years (2002-2007), concentrations of fine particulate matter and organic and elemental carbon were measured continuously in the capital of Chile. The contribution of carbonaceous aerosols to the primary and secondary fractions was estimated at three different sampling sites and in the warm and cool seasons. The results demonstrate that there are significant differences in the levels in both the cold (March to August) and warm (September to February) seasons at all sites studied. The percent contribution of total carbonaceous aerosol fine particulate matter was greater in the cool season (53 ± 41%) than in the warm season (44 ± 18%). On average, the secondary organic carbon in the city corresponded to 29% of the total organic carbon. In cold periods, this proportion may reach an average of 38%. A comparison of the results with the air quality standards for fine particulate matter indicates that the total carbonaceous fraction alone exceeds the World Health Organization standard (10 µg/m(3)) and the United States Environmental Protection Agency standard (15 µg/m(3)) for fine particulate matter.

  1. Emissions of fine particulate nitrated phenols from the burning of five common types of biomass.

    Science.gov (United States)

    Wang, Xinfeng; Gu, Rongrong; Wang, Liwei; Xu, Wenxue; Zhang, Yating; Chen, Bing; Li, Weijun; Xue, Likun; Chen, Jianmin; Wang, Wenxing

    2017-11-01

    Nitrated phenols are among the major constituents of brown carbon and affect both climates and ecosystems. However, emissions from biomass burning, which comprise one of the most important primary sources of atmospheric nitrated phenols, are not well understood. In this study, the concentrations and proportions of 10 nitrated phenols, including nitrophenols, nitrocatechols, nitrosalicylic acids, and dinitrophenol, in fine particles from biomass smoke were determined under three different burning conditions (flaming, weakly flaming, and smoldering) with five common types of biomass (leaves, branches, corncob, corn stalk, and wheat straw). The total abundances of fine nitrated phenols produced by biomass burning ranged from 2.0 to 99.5 μg m -3 . The compositions of nitrated phenols varied with biomass types and burning conditions. 4-nitrocatechol and methyl nitrocatechols were generally most abundant, accounting for up to 88-95% of total nitrated phenols in flaming burning condition. The emission ratios of nitrated phenols to PM 2.5 increased with the completeness of combustion and ranged from 7 to 45 ppmm and from 239 to 1081 ppmm for smoldering and flaming burning, respectively. The ratios of fine nitrated phenols to organic matter in biomass burning aerosols were comparable to or lower than those in ambient aerosols affected by biomass burning, indicating that secondary formation contributed to ambient levels of fine nitrated phenols. The emission factors of fine nitrated phenols from flaming biomass burning were estimated based on the measured mass fractions and the PM 2.5 emission factors from literature and were approximately 0.75-11.1 mg kg -1 . According to calculations based on corn and wheat production in 31 Chinese provinces in 2013, the total estimated emission of fine nitrated phenols from the burning of corncobs, corn stalks, and wheat straw was 670 t. This work highlights the apparent emission of methyl nitrocatechols from biomass burning and

  2. Modelling the dynamics of total precipitation and aboveground net primary production of fescue-feather grass steppe at Askania Nova according to global climate change scenariosModelling the dynamics of total precipitation and aboveground net primary production of fescue-feather grass steppe at Askania Nova according to global climate change scenarios

    Directory of Open Access Journals (Sweden)

    S. O. Belyakov

    2017-01-01

    Full Text Available This article discusses modelling of Aboveground Net Primary Production (ANPP of steppe (arid grassland ecosystems plant species in relation to changes in total precipitation over the previous year at the “Stara” study site, Biosphere Reserve “Askania-Nova”, Khersonregion (Ukraine. To investigate linkages between precipitation and Aboveground Net Primary Production, correlation analysis was chosen and a time series regression analysis was based on the data set for the period 1988–2012. The NPP dependence on quantity of precipitation was found to be more significant for the previous autumn-winter-spring period (AWSP than for the previous 12 month period. A regression model of ANPP’s dependence on AWSP is proposed. This model was further validated by the authors’ samples of ANPP, collected at the “Stara” study site in 2013–2016. The regression model showed a non-linear (quadratic dependence of net primary production of zonal and intrazonal plant coenoses and total precipitation for the autumn-winter-spring period for arid grasslands with a coefficient of determination equal to 0.54 and significance level less than 0.05. The non-linear equation for these relations, visualized by a parabola curve, was calculated using the Nonlinear Least-Squares Regression Method. The data set, based on calculated predicted values, using the calculated equation, had a similar dynamic to the historical data on ANPP, but the model could not predict critical values. For this reason, additional studies are required for critical precipitation events. Non-linear response, investigated according to regression analysis, reveals optimal zones of plant growth, depending on the total precipitation level before the vegetation peak. For research areas where the dominant species are the turf grasses Stipa ucrainica P. Smirn., S. capillata L., S. lessingiana Trin. & Rupr., Festuca valesiaca Gaudin, Koeleria cristata (L. Pers. the optimal precipitation rates

  3. Improving Fine Motor Skills in Young Children: An Intervention Study

    Science.gov (United States)

    Brown, Carol G.

    2010-01-01

    The aim of this study was to evaluate the effect of the Primary Movement programme on the fine motor skills of children in an early years setting in an area of high social disadvantage. Primary Movement is a programme which can be used as an early intervention technique to help children inhibit persistent primary reflexes that have been shown to…

  4. A fine art

    Energy Technology Data Exchange (ETDEWEB)

    Schnabel, G.; Raaff, T. [Andritz AG (Austria)

    2006-07-15

    The paper describes a new dewatering system for coal fines which challenges established processes by using screenbowl centrifuge and hyperbaric filter combinations. Company acquisitions over the past three to four years enabled Andritz AG to develop a new system combining two technologies. The article describes the benefits of the combination process and explains the basic operation of these machines. 4 figs.

  5. Fine 5 lavastab Venemaal

    Index Scriptorium Estoniae

    2013-01-01

    Tantsuteatru Fine 5 koreograafid Tiina Ollesk ja Rene Nõmmik toovad Jekaterinburgis välja lavastuse "... and Red", esitajaks Venemaa nimekas nüüdistantsutrupp Provintsialnõje Tantsõ. Lavastuses kõlab Taavo Remmeli kontrabassiimprovisatsioon "12.12.2006"

  6. Imeilus Fine 5

    Index Scriptorium Estoniae

    2017-01-01

    Vaba Lava teatrikeskuse laval esineb Fine 5 oma lavastusega "Imeilus". Tiina Ollesk ja Renee Nõmmik, tantsulavastuse autorid on koreograafid, õppejõud, lavastajad ja kogemustega tantsijad. 29. jaanuaril korraldavad Tiina Ollesk ja Renee Nõmmik Tallinna Ülikoolis kaasaegse liikumismõtlemise töötoa, mis on pühendatud lavastusele "Imeilus"

  7. Method and equipment to determine fine dust concentrations

    International Nuclear Information System (INIS)

    Breuer, H.; Gebhardt, J.; Robock, K.

    1979-01-01

    The measured values for the fine dust concentration are obtained by optical means which where possible agree with the probable deposited quantity of fine dust in the pulmonary alveoli. This is done by receiving the strong radiation produced in dependence of the particle size at an angle of 70 0 to the angle of incidence of the primary beam. The wavelength of the primary radiation is in the region of 1000 to 2000 nm. (RW) [de

  8. Thirty-day Postoperative Complications following Primary Total Knee Arthroplasty: A Retrospective Study of Incidence and Risk Factors at a Single Center in China

    Directory of Open Access Journals (Sweden)

    Bin Feng

    2017-01-01

    Conclusions: This study highlighted complications with cardiac and respiratory origins as the most common complications within 30 postoperative days following primary TKA. The BMI of ≥30.0 kg/m2 and age ≥80 years were significant risk factors for 30-day postoperative complications.

  9. A prospective randomized trial of total synovectomy versus limited synovectomy in primary total knee arthroplasty: evaluation of bleeding, postoperative pain, and quality of life with SF-12 v2.

    Science.gov (United States)

    Bernal-Fortich, Luis Dario; Aguilar, Carlos Alberto; Rivera-Villa, Adrián H; Galindo-Avalos, Joel; Aguilera-Martínez, Pedro; Torres-González, Rubén; Colin-Vázquez, Avelino

    2018-05-01

    During total knee arthroplasty (TKA), total synovectomy (TS) as a part of the surgical technique has been proposed to reduce the inflammatory tissue after the procedure, but there is a controversy about it because of the risk of major postsurgical bleeding. The aim of this study was to compare postoperative bleeding, pain, and health-related quality of life (HRQOL) after a TKA when a TS is performed and when it is not. The difference in pre and postoperative hemoglobin was measured, as well as postoperative pain using visual analogue scale (VAS) scores at 24 and 48 h post-surgical, HRQOL was measured prior to surgery and at one year using the SF-12V2 questionnaire. We assessed a total of 148 patients (73 for TS and 75 for limited synovectomy). We have found a difference of 0.9 mg/dl of pre- and postoperative hemoglobin between both groups, with a higher bleeding amount for the TS group (P = 0.0000647); VAS scores were slightly lower for the TS group at 24 and 48 h after surgery, but not relevant. The TS group required transfusion in 13.3% and the limited synovectomy group in 6.8%. No significant differences in HRQOL were found in both groups at 1 year follow-up. Performing a TS in TKA in patients with osteoarthrosis does not result in a relevant lower postoperative pain, or in an improvement in HRQOL, and it does increase the amount of bleeding after the procedure.

  10. The Kjeldahl method as a primary reference procedure for total protein in certified reference materials used in clinical chemistry. II. Selection of direct Kjeldahl analysis and its preliminary performance parameters.

    Science.gov (United States)

    Vinklárková, Bára; Chromý, Vratislav; Šprongl, Luděk; Bittová, Miroslava; Rikanová, Milena; Ohnútková, Ivana; Žaludová, Lenka

    2015-01-01

    To select a Kjeldahl procedure suitable for the determination of total protein in reference materials used in laboratory medicine, we reviewed in our previous article Kjeldahl methods adopted by clinical chemistry and found an indirect two-step analysis by total Kjeldahl nitrogen corrected for its nonprotein nitrogen and a direct analysis made on isolated protein precipitates. In this article, we compare both procedures on various reference materials. An indirect Kjeldahl method gave falsely lower results than a direct analysis. Preliminary performance parameters qualify the direct Kjeldahl analysis as a suitable primary reference procedure for the certification of total protein in reference laboratories.

  11. Testing with fine fragrances in eczema patients

    DEFF Research Database (Denmark)

    Johansen, J D; Frosch, Peter J; Rastogi, Suresh Chandra

    2001-01-01

    The frequencies of contact allergic reactions to 2 fine fragrances were studied by patch testing. Further, a comparison was made of test results before and after evaporation of the solvent. A total of 480 consecutive eczema patients were included, 100 in the Dortmund clinic and 380 in the Gentoft...

  12. The Use of a Modular Titanium Baseplate with a Press-Fit Keel Implanted with a Surface Cementing Technique for Primary Total Knee Arthroplasty

    Directory of Open Access Journals (Sweden)

    Christopher E. Pelt

    2014-01-01

    Full Text Available Little data exists regarding outcomes following TKA performed with surface-cementation for the fixation of modular tibial baseplates with press-fit keels. Thus, we retrospectively reviewed the clinical and radiographic outcomes of 439 consecutive primary TKAs performed with surface cemented tibial components. There were 290 female patients and 149 male patients with average age of 62 years (range 30–84. Two tibial components were revised for aseptic loosening (0.5% and four tibial components (0.9% were removed to improve instability (n=2 or malalignment (n=2. Complications included 13 deep infections treated with 2-stage revision (12 and fusion (1. These results support the surface cement technique with a modular grit-blasted titanium surface and cruciform stem during primary TKA.

  13. Fine Channel Networks

    Science.gov (United States)

    1997-01-01

    A color image of fine channel networks on Mars; north toward top. The scene shows heavily cratered highlands dissected by dendritic open channel networks that dissect steep slopes of impact crater walls. This image is a composite of Viking high-resolution images in black and white and low-resolution images in color. The image extends from latitude 9 degrees S. to 5 degrees S. and from longitude 312 degrees to 320 degrees; Mercator projection. The dendritic pattern of the fine channels and their location on steep slopes leads to the interpretation that these are runoff channels. The restriction of these types of channels to ancient highland rocks suggests that these channels are old and date from a time on Mars when conditions existed for precipitation to actively erode rocks. After the channels reach a low plain, they appear to end. Termination may have resulted from burial by younger deposits or perhaps the flows percolated into the surface materials and continued underground.

  14. Acute side effects and complications after short-term preoperative radiotherapy combined with total mesorectal excision in primary rectal cancer: report of a multicenter randomized trial.

    NARCIS (Netherlands)

    Marijnen, C.A.; Kapiteijn, E.; Veld, C.J.H. van de; Martijn, H.; Steup, W.H.; Wiggers, T.; Meershoek-Klein Kranenbarg, E.; Leer, J.W.H.

    2002-01-01

    PURPOSE: Total mesorectal excision (TME) surgery in the treatment of rectal cancer has been shown to result in a reduction in the number of local recurrences in retrospective studies. Reports on improved local control after preoperative, hypofractionated radiotherapy (RT) have led to the

  15. Acute side effects and complications after short-term preoperative radiotherapy combined with total mesorectal excision in primary rectal cancer : Report of a multicenter randomized trial

    NARCIS (Netherlands)

    Marijnen, CAM; Kapiteijn, E; van de Velde, CJH; Martijn, H; Steup, WH; Wiggers, T; Kranenbarg, EK; Leer, JWH

    2002-01-01

    Purpose: Total mesorectal excision (TME) surgery in the treatment of rectal cancer has been shown to result in a reduction in the number of local recurrences in retrospective studies. Reports on improved local control after preoperative, hypofractionated radiotherapy (RT) have led to the

  16. Performance of concrete with partial replacement of fine aggregates ...

    African Journals Online (AJOL)

    The study investigated the level of replacement of fine aggregate with waste glass that will result in optimal compressive strength. A total of 36 cubes were cast. 6 cubes without waste glass (control) and 30 cubes containing waste glass as partial replacement for fine aggregates at 15%, 25%, 35%, 45%, and 50%.

  17. The efficacy of modified direct lateral versus posterior approach on gait function and hip muscle strength after primary total hip arthroplasty at 12months follow-up

    DEFF Research Database (Denmark)

    Rosenlund, Signe; Broeng, Leif; Overgaard, Søren

    2016-01-01

    -spatial parameters and range of motion. Isometric maximal hip muscle strength in abduction, flexion and extension was also tested. FINDINGS: Post-operatively, no between-group difference in gait function was observed. However, both hip abductor and flexor muscle strength improved more in the posterior approach group......BACKGROUND: The lateral and the posterior approach are the most commonly used procedures for total hip arthroplasty. Due to the detachment of the hip abductors, lateral approach is claimed to cause reduced hip muscle strength and altered gait pattern. However, this has not been investigated...... in a randomised controlled trial. The aim was to compare the efficacy of total hip arthroplasty performed by lateral or posterior approach on gait function and hip muscle strength up to 12months post-operatively. We hypothesised that posterior approach would be superior to lateral approach. METHODS: Forty...

  18. The Kjeldahl method as a primary reference procedure for total protein in certified reference materials used in clinical chemistry. I. A review of Kjeldahl methods adopted by laboratory medicine.

    Science.gov (United States)

    Chromý, Vratislav; Vinklárková, Bára; Šprongl, Luděk; Bittová, Miroslava

    2015-01-01

    We found previously that albumin-calibrated total protein in certified reference materials causes unacceptable positive bias in analysis of human sera. The simplest way to cure this defect is the use of human-based serum/plasma standards calibrated by the Kjeldahl method. Such standards, commutative with serum samples, will compensate for bias caused by lipids and bilirubin in most human sera. To find a suitable primary reference procedure for total protein in reference materials, we reviewed Kjeldahl methods adopted by laboratory medicine. We found two methods recommended for total protein in human samples: an indirect analysis based on total Kjeldahl nitrogen corrected for its nonprotein nitrogen and a direct analysis made on isolated protein precipitates. The methods found will be assessed in a subsequent article.

  19. Fine target of deuterium

    International Nuclear Information System (INIS)

    Diaz Diaz, J.; Granados Gonzalez, C. E.; Gutierrez Bernal, R.

    1959-01-01

    A fine target of deuterium on a tantalum plate by the absorption method is obtained. In order to obtain the de gasification temperature an induction generator of high frequency is used and the deuterium pass is regulated by means of a palladium valve. Two vacuum measures are available, one to measure the high vacuum in the de gasification process of the tantalum plate and the other, for low vacuum, to measure the deuterium inlet in the installation and the deuterium pressure change in the installation after the absorption in the tantalum plate. A target of 48 μ gr/cm 2 thick is obtained. (Author) 1 refs

  20. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  1. The responses of net primary production (NPP) and total carbon storage for the continental United States to changes in atmospheric CO{sub 2}, climate, and vegetation

    Energy Technology Data Exchange (ETDEWEB)

    McGuire, D.A. [Marine Biological Lab., Woods Hole, MA (United States)

    1995-06-01

    We extrapolated 3 biogeochemistry models (BIOME-BGC, CENTURY, and TEM) across the continental US with the vegetation distributions of 3 biogeography models (BIOME2, DOLY, and MAPSS) for contemporary climate at 355 ppmv CO{sub 2} and each of 3 GCM climate scenarios at 710 ppmv. For contemporary conditions, continental NPP ranges from 3132 to 3854 TgC/yr and total carbon storage ranges from 109 to 125 PgC. The responses of NPP range from no response (BIOME-BGC with DOLY or MAPSS vegetations for UKMO climate) to increases of 53% and 56% (TEM with BIOME2 vegetations for GFDL and OSU climates). The responses of total carbon storage vary from a decrease of 39% (BIOME-BGC with MAPSS vegetation for UKMO climate) to increases of 52% and 56% (TEM with BIOME2 vegetations for OSU and GFDL climates). The UKMO responses of BIOME-BGC with MAPSS vegetation are caused by both decreased forest area (from 44% to 38%) and photosynthetic water stress. The OSU and GFDL responses of TEM with BIOME2 vegetations are caused by forest expansion (from 46% to 67% for OSU and to 75% for GFDL) and increased nitrogen cycling.

  2. Variance in predicted cup size by 2-dimensional vs 3-dimensional computerized tomography-based templating in primary total hip arthroplasty.

    Science.gov (United States)

    Osmani, Feroz A; Thakkar, Savyasachi; Ramme, Austin; Elbuluk, Ameer; Wojack, Paul; Vigdorchik, Jonathan M

    2017-12-01

    Preoperative total hip arthroplasty templating can be performed with radiographs using acetate prints, digital viewing software, or with computed tomography (CT) images. Our hypothesis is that 3D templating is more precise and accurate with cup size prediction as compared to 2D templating with acetate prints and digital templating software. Data collected from 45 patients undergoing robotic-assisted total hip arthroplasty compared cup sizes templated on acetate prints and OrthoView software to MAKOplasty software that uses CT scan. Kappa analysis determined strength of agreement between each templating modality and the final size used. t tests compared mean cup-size variance from the final size for each templating technique. Interclass correlation coefficient (ICC) determined reliability of digital and acetate planning by comparing predictions of the operating surgeon and a blinded adult reconstructive fellow. The Kappa values for CT-guided, digital, and acetate templating with the final size was 0.974, 0.233, and 0.262, respectively. Both digital and acetate templating significantly overpredicted cup size, compared to CT-guided methods ( P cup size when compared to the significant overpredictions of digital and acetate templating. CT-guided templating may also lead to better outcomes due to bone stock preservation from a smaller and more accurate cup size predicted than that of digital and acetate predictions.

  3. NGST fine guidance sensor

    Science.gov (United States)

    Rowlands, Neil; Hutchings, John; Murowinski, Richard G.; Alexander, Russ

    2003-03-01

    Instrumentation for the Next Generation Space Telescope (NGST) is currently in the Phase A definition stage. We have developed a concept for the NGST Fine Guidance Sensor or FGS. The FGS is a detector array based imager which resides in the NGST focal plane. We report here on tradeoff studies aimed at defining an overall configuration of the FGS which will meet the performance and interface requirements. A key performance requirement is a noise equivalent angle of 3 milli-arcseconds to be achieved with 95% probability for any pointing of the observatory in the celestial sphere. A key interface requirement is compatibility with the architecture of the Integrated Science Instrument Module (ISIM). The concept developed consists of two independent and redundant FGS modules, each with a 4' x 2' field of view covered by two 2048 x 2048 infrared detector arrays, providing 60 milli-arcsecond sampling. Performance modeling supporting the choice of this architecture and the trade space considered is presented. Each module has a set of readout electronics which perform star detection, pixel-by-pixel correction, and in fine guiding mode, centroid calculation. These readout electronics communicate with the ISIM Command &Data Handling Units where the FGS control software is based. Rationale for this choice of architecture is also presented.

  4. Fine Particle Matter (PM2.5) Design Value

    Data.gov (United States)

    U.S. Environmental Protection Agency — Fine particulate matter or PM2.5 (total mass of particles below 2.5 micron is diameter) is known to cause adverse health effects in humans.See the following websites...

  5. performance of concrete with partial replacement of fine aggregates

    African Journals Online (AJOL)

    user

    aggregate with waste glass that will result in optimal compressive strength. A total of 36 cubes were ... to achieve the required strength and durability. The fine aggregate is ..... Ceramic Foundation Annual Technical Report, pp. 143-147. 2000.

  6. Sahara Coal: the fine art of collecting fines for profit

    Energy Technology Data Exchange (ETDEWEB)

    Schreckengost, D.; Arnold, D.

    1984-09-01

    A considerable increase in the volume of fines in rom coal caused Sahara Coal in Illinois to redesign the fine coal system in their Harrisburg preparation plant. Details of the new design, and particularly the fine refuse system which dewaters and dries 28 mesh x O clean coal, are given. Results have exceeded expectations in reducing product losses, operating costs and slurry pond cleaning costs.

  7. Emissions of fine particulate nitrated phenols from the burning of five common types of biomass

    International Nuclear Information System (INIS)

    Wang, Xinfeng; Gu, Rongrong; Wang, Liwei; Xu, Wenxue; Zhang, Yating; Chen, Bing; Li, Weijun; Xue, Likun; Chen, Jianmin; Wang, Wenxing

    2017-01-01

    Nitrated phenols are among the major constituents of brown carbon and affect both climates and ecosystems. However, emissions from biomass burning, which comprise one of the most important primary sources of atmospheric nitrated phenols, are not well understood. In this study, the concentrations and proportions of 10 nitrated phenols, including nitrophenols, nitrocatechols, nitrosalicylic acids, and dinitrophenol, in fine particles from biomass smoke were determined under three different burning conditions (flaming, weakly flaming, and smoldering) with five common types of biomass (leaves, branches, corncob, corn stalk, and wheat straw). The total abundances of fine nitrated phenols produced by biomass burning ranged from 2.0 to 99.5 μg m −3 . The compositions of nitrated phenols varied with biomass types and burning conditions. 4-nitrocatechol and methyl nitrocatechols were generally most abundant, accounting for up to 88–95% of total nitrated phenols in flaming burning condition. The emission ratios of nitrated phenols to PM 2.5 increased with the completeness of combustion and ranged from 7 to 45 ppmm and from 239 to 1081 ppmm for smoldering and flaming burning, respectively. The ratios of fine nitrated phenols to organic matter in biomass burning aerosols were comparable to or lower than those in ambient aerosols affected by biomass burning, indicating that secondary formation contributed to ambient levels of fine nitrated phenols. The emission factors of fine nitrated phenols from flaming biomass burning were estimated based on the measured mass fractions and the PM 2.5 emission factors from literature and were approximately 0.75–11.1 mg kg −1 . According to calculations based on corn and wheat production in 31 Chinese provinces in 2013, the total estimated emission of fine nitrated phenols from the burning of corncobs, corn stalks, and wheat straw was 670 t. This work highlights the apparent emission of methyl nitrocatechols from biomass burning

  8. Primary pulmonary non-small cell carcinomas: the College of American Pathologists Interlaboratory Comparison Program confirms a significant trend toward subcategorization based upon fine-needle aspiration cytomorphology alone.

    Science.gov (United States)

    Yildiz-Aktas, Isil Z; Sturgis, Charles D; Barkan, Guliz A; Souers, Rhona J; Fraig, Mostafa M; Laucirica, Rodolfo; Khalbuss, Walid E; Moriarty, Ann T

    2014-01-01

    Context.-Subtyping of non-small cell lung carcinomas (NSCLCs) is necessary for optimal patient management with specific diagnoses triggering specific molecular tests and affecting therapy. Objective.-To assess the accuracy of the participants of the College of American Pathologists Interlaboratory Comparison Program in diagnosing and subtyping NSCLC fine-needle aspiration (FNA) slides, based on morphology alone, considering preparation and participant type and trends over time. Design.-The performance of program participants was reviewed for the 5-year period spanning 2007-2011. Lung FNA challenges with reference diagnoses of adenocarcinoma and squamous cell carcinoma (SCC) were evaluated for diagnostic concordance by using a nonlinear mixed model analysis. Results.-There were 10 493 pathologist and 6378 cytotechnologist responses with concordance rates of 97.4% and 97.9% for malignancy, respectively. Overall concordance rates for subcategorization were 54.6% for adenocarcinoma and 74.9% for SCC. For the exact reference diagnoses, pathologists performed better for adenocarcinoma and cytotechnologists performed better for SCC. Accurate subcategorization of adenocarcinomas significantly increased over time with 31.5% of adenocarcinomas classified as NSCLC in 2007 and 25.5% of adenocarcinomas classified as NSCLC in 2011 (P alone. During the study period, a statistically significant trend was confirmed toward greater accuracy of subcategorization of adenocarcinomas, suggesting that participants are cognizant of the impact that more specific cytomorphologic interpretations have in directing molecular triage and therapy.

  9. Radiology and fine art.

    Science.gov (United States)

    Marinković, Slobodan; Stošić-Opinćal, Tatjana; Tomić, Oliver

    2012-07-01

    The radiologic aesthetics of some body parts and internal organs have inspired certain artists to create specific works of art. Our aim was to describe the link between radiology and fine art. We explored 13,625 artworks in the literature produced by 2049 artists and found several thousand photographs in an online image search. The examination revealed 271 radiologic artworks (1.99%) created by 59 artists (2.88%) who mainly applied radiography, sonography, CT, and MRI. Some authors produced radiologic artistic photographs, and others used radiologic images to create artful compositions, specific sculptures, or digital works. Many radiologic artworks have symbolic, metaphoric, or conceptual connotations. Radiology is clearly becoming an original and important field of modern art.

  10. Patient-reported outcome measures versus inertial performance-based outcome measures: A prospective study in patients undergoing primary total knee arthroplasty.

    Science.gov (United States)

    Bolink, S A A N; Grimm, B; Heyligers, I C

    2015-12-01

    Outcome assessment of total knee arthroplasty (TKA) by subjective patient reported outcome measures (PROMs) may not fully capture the functional (dis-)abilities of relevance. Objective performance-based outcome measures could provide distinct information. An ambulant inertial measurement unit (IMU) allows kinematic assessment of physical performance and could potentially be used for routine follow-up. To investigate the responsiveness of IMU measures in patients following TKA and compare outcomes with conventional PROMs. Patients with end stage knee OA (n=20, m/f=7/13; age=67.4 standard deviation 7.7 years) were measured preoperatively and one year postoperatively. IMU measures were derived during gait, sit-stand transfers and block step-up transfers. PROMs were assessed by using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Knee Society Score (KSS). Responsiveness was calculated by the effect size, correlations were calculated with Spearman's rho correlation coefficient. One year after TKA, patients performed significantly better at gait, sit-to-stand transfers and block step-up transfers. Measures of time and kinematic IMU measures demonstrated significant improvements postoperatively for each performance-based test. The largest improvement was found in block step-up transfers (effect size=0.56-1.20). WOMAC function score and KSS function score demonstrated moderate correlations (Spearman's rho=0.45-0.74) with some of the physical performance-based measures pre- and postoperatively. To characterize the changes in physical function after TKA, PROMs could be supplemented by performance-based measures, assessing function during different activities and allowing kinematic characterization with an ambulant IMU. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Handheld Navigation Device and Patient-Specific Cutting Guides Result in Similar Coronal Alignment for Primary Total Knee Arthroplasty: a Retrospective Matched Cohort Study.

    Science.gov (United States)

    Steinhaus, Michael E; McLawhorn, Alexander S; Richardson, Shawn S; Maher, Patrick; Mayman, David J

    2016-10-01

    Proper alignment of total knee arthroplasty (TKA) is essential for TKA function and may reduce the risk of aseptic failure. Technologies that prevent malalignment may reduce the risk of revision surgery. The purpose of this study was to compare two competing TKA systems that purport improved alignment: patient-specific instrumentation (PSI), and a handheld portable navigation device (NAV). After IRB approval, 49 consecutive PSI TKAs (40 patients) were matched based on preoperative characteristics to 49 NAV TKAs (40 patients) performed by a single surgeon. A blinded observer measured alignment on digital radiographs. Operating room records were reviewed for procedure times. Two-tailed paired sample t tests and McNemar's test were used as appropriate. Alpha level was 0.05 for all tests. Preoperative cohort characteristics were not different. Mean postoperative long-leg mechanical alignment was within ±1° of neutral for both groups, although statistically different ( p  = 0.026). There were no other significant differences in coronal alignment. PSI exhibited significantly greater posterior tibial slope (4.4°) compared to NAV (2.7°) ( p  = 0.004); PSI resulted in significantly more outliers (>6°; p  = 0.004). Procedure time for unilateral TKAs was lower for PSI (74.4 min) compared to that for NAV (80.6 min; p  = 0.023). NAV and PSI technologies provided excellent coronal plane alignment. NAV was better for sagittal tibial slope, while PSI procedure times were shorter for unilateral TKA. The impact of these technologies on patient-reported outcomes and TKA survivorship is controversial and should be the focus of future research.

  12. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of

  13. Fine root dynamics in moso bamboo and Japanese cedar forest by scanner method in central Taiwan

    Science.gov (United States)

    Chen, Zhi-Wei; Lin, Po-Hsuan; Kume, Tomonori

    2017-04-01

    Phyllostachys pubescens is one of the most important economic plant in the world. Phyllostachys pubescens originates from China and it had been introduced to neighbor countries about three hundred ago due to its economic value. But substantial bamboo forests were abandoned due to declines in demand. These unmanaged bamboo forests have been expanding to adjacent original forests in northern Taiwan. This vegetation alternation may not only decrease the local biodiversity but also affect the carbon cycle. Fine roots are responsible for water and nutrients acquisition and forming the most active part of the whole root system. The characteristics of fine roots are non-woody, small diameter and short lifespan. When roots keep producing new roots and replacing old roots, carbon and nutrients was transported into soil. Consequently, fine root production is one of the important component to understand the below-ground carbon cycle. However, there is few studies about fine root production in moso bamboo forests. We still lack effective method to obtain quantitative and objective data in Taiwan. It severely limits us to understand the below-ground carbon dynamics there. Minirhizotrons method has been used to investigate fine root dynamics by inserting transparent tubes into soil and by comparing changes in root length in images taken by micro-camera. But this method has some shortcomings; i.e. Most of image analysis are conducted manually and time-consuming. And it is difficult to estimate the stand level fine root production from small observation view. A new method "scanner method", which collect A4-size image (bigger than minirhizotrons) can overcome some parts of the shortcoming of minirhizotrons. The transparent acrylic box with A4-box view is inserted into soil and the interface between soil and box is scanned by commercial scanner. We can monitor the total projected root area, growth and decomposition separately by series of images. The primary objective of this study

  14. Process of briquetting fine shale

    Energy Technology Data Exchange (ETDEWEB)

    Kraemer, J

    1943-05-05

    A process is described for the preparation of briquetts of fine bituminous shale, so-called Mansfield copper shale, without addition of binding material, characterized in that the fine shale is warmed to about 100/sup 0/C and concurrently briquetted in a high-pressure rolling press or piece press under a pressure of 300 to 800 kg/cm/sup 2/.

  15. Fine structure of 25 extragalactic radio sources

    International Nuclear Information System (INIS)

    Wittels, J.J.; Knight, C.A.; Shapiro, I.I.; Hinteregger, H.F.; Rogers, A.E.E.; Whitney, A.R.; Clark, T.A.; Hutton, L.K.; Marandino, G.E.; Neill, A.E.; Ronnang, B.G.; Rydbeck, O.E.H.; Klemperer, W.K.; Warnock, W.W.

    1975-01-01

    Between 1972 April and 1973 May, 25 extragalactic radio sources were observed interferometrically at 7.8 GHz(lambdaapprox. =3.8 cm) with five pairings of antennas. These sources exhibit a broad variety of fine structures from very simple to complex. Although the structure and the total power of some of these sources have remained unchanged within the sensitivity of our measurements during the year of observations, both the total flux and the correlated flux of others have undergone large changes in a few weeks

  16. The fine particle emissions of energy production in Finland

    International Nuclear Information System (INIS)

    Ohlstroem, M.

    1998-01-01

    The main purpose of this master's thesis was to define the fine particle (PM2.5, diameter under 2,5 μm) emissions of the energy production and to compare the calculated emission factors between different energy production concepts. The purpose was also to define what is known about fine particle emissions and what should still be studied/measured. The purpose was also to compare briefly the fine particle emissions of energy production and vehicle traffic, and their correlations to the fine particle concentrations of urban air. In the theory part of this work a literature survey was made about fine particles in energy production, especially how they form and how they are separated from the flue gas. In addition, the health effects caused by fine particles, and different measuring instruments were presented briefly. In the experimental part of this work, the aim was to find out the fine particle emissions of different energy production processes by calculating specific emission factors (mg/MJ fuel ) from powerplants' annual total particulate matter emissions (t/a), which were obtained from VAHTI-database system maintained by the Finnish Environmental Institute, and by evaluating the share of fine particles from total emissions with the help of existing measurement results. Only those energy production processes which produce significantly direct emissions of solid particles have been treated (pulverised combustion and oil burners from burner combustion, fluidized bed combustion processes, grate boilers, recovery boilers and diesel engines). The processes have been classified according to boiler type, size category, main fuel and also according to dust separation devices. To be able to compare different energy production processes, shared specific emission factor have been calculated for the similar subprocesses. The fine particle emissions depend strongest on the boiler size category and dust separation devices used. Spent fuel or combustion technique does not have

  17. Chemical composition of Martian fines

    Science.gov (United States)

    Clark, B. C.; Baird, A. K.; Weldon, R. J.; Tsusaki, D. M.; Schnabel, L.; Candelaria, M. P.

    1982-01-01

    Of the 21 samples acquired for the Viking X-ray fluorescence spectrometer, 17 were analyzed to high precision. Compared to typical terrestrial continental soils and lunar mare fines, the Martian fines are lower in Al, higher in Fe, and much higher in S and Cl concentrations. Protected fines at the two lander sites are almost indistinguishable, but concentration of the element S is somewhat higher at Utopia. Duricrust fragments, successfully acquired only at the Chryse site, invariably contained about 50% higher S than fines. No elements correlate positively with S, except Cl and possibly Mg. A sympathetic variation is found among the triad Si, Al, Ca; positive correlation occurs between Ti and Fe. Sample variabilities are as great within a few meters as between lander locations (4500 km apart), implying the existence of a universal Martian regolith component of constant average composition. The nature of the source materials for the regolith fines must be mafic to ultramafic.

  18. Totally James

    Science.gov (United States)

    Owens, Tom

    2006-01-01

    This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

  19. Advanced Fine Particulate Characterization Methods

    Energy Technology Data Exchange (ETDEWEB)

    Steven Benson; Lingbu Kong; Alexander Azenkeng; Jason Laumb; Robert Jensen; Edwin Olson; Jill MacKenzie; A.M. Rokanuzzaman

    2007-01-31

    The characterization and control of emissions from combustion sources are of significant importance in improving local and regional air quality. Such emissions include fine particulate matter, organic carbon compounds, and NO{sub x} and SO{sub 2} gases, along with mercury and other toxic metals. This project involved four activities including Further Development of Analytical Techniques for PM{sub 10} and PM{sub 2.5} Characterization and Source Apportionment and Management, Organic Carbonaceous Particulate and Metal Speciation for Source Apportionment Studies, Quantum Modeling, and High-Potassium Carbon Production with Biomass-Coal Blending. The key accomplishments included the development of improved automated methods to characterize the inorganic and organic components particulate matter. The methods involved the use of scanning electron microscopy and x-ray microanalysis for the inorganic fraction and a combination of extractive methods combined with near-edge x-ray absorption fine structure to characterize the organic fraction. These methods have direction application for source apportionment studies of PM because they provide detailed inorganic analysis along with total organic and elemental carbon (OC/EC) quantification. Quantum modeling using density functional theory (DFT) calculations was used to further elucidate a recently developed mechanistic model for mercury speciation in coal combustion systems and interactions on activated carbon. Reaction energies, enthalpies, free energies and binding energies of Hg species to the prototype molecules were derived from the data obtained in these calculations. Bimolecular rate constants for the various elementary steps in the mechanism have been estimated using the hard-sphere collision theory approximation, and the results seem to indicate that extremely fast kinetics could be involved in these surface reactions. Activated carbon was produced from a blend of lignite coal from the Center Mine in North Dakota and

  20. Very fine pumps

    CERN Multimedia

    2004-01-01

    In Building 181, half the total number of vacuum chambers required for the LHC Long Straight Sections (LSS) have now been coated with getter material by sputtering. This innovative technique, invented at CERN, will be used on all the LHC 's "warm" vacuum chambers.

  1. Nitramine Drying & Fine Grinding Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Nitramine Drying and Fine Grinding Facility provides TACOM-ARDEC with a state-of-the-art facility capable of drying and grinding high explosives (e.g., RDX and...

  2. Fine 5 kolib Kumu lavale

    Index Scriptorium Estoniae

    2006-01-01

    Kumu kunstimuuseumi auditooriumis toimub 21. veebruaril Fine 5 kaasaegse tantsu etendus "Panus". Esinevad Tiina Ollesk, Irina Pähn, žonglöör Dimitri Kruus, disainer Rain Saukas ja muusik Mattias Siitan

  3. Finely divided, irradiated tetrafluorethylene polymers

    International Nuclear Information System (INIS)

    Brown, M.T.; Rodway, W.G.

    1977-01-01

    Dry non-sticky fine lubricant powders are made by γ-irradiation of unsintered coagulated dispersion grade tetrafluoroethylene polymers. These powders may also be dispersed in an organic medium for lubricating purposes

  4. Computer games and fine motor skills.

    Science.gov (United States)

    Borecki, Lukasz; Tolstych, Katarzyna; Pokorski, Mieczyslaw

    2013-01-01

    The study seeks to determine the influence of computer games on fine motor skills in young adults, an area of incomplete understanding and verification. We hypothesized that computer gaming could have a positive influence on basic motor skills, such as precision, aiming, speed, dexterity, or tremor. We examined 30 habitual game users (F/M - 3/27; age range 20-25 years) of the highly interactive game Counter Strike, in which players impersonate soldiers on a battlefield, and 30 age- and gender-matched subjects who declared never to play games. Selected tests from the Vienna Test System were used to assess fine motor skills and tremor. The results demonstrate that the game users scored appreciably better than the control subjects in all tests employed. In particular, the players did significantly better in the precision of arm-hand movements, as expressed by a lower time of errors, 1.6 ± 0.6 vs. 2.8 ± 0.6 s, a lower error rate, 13.6 ± 0.3 vs. 20.4 ± 2.2, and a shorter total time of performing a task, 14.6 ± 2.9 vs. 32.1 ± 4.5 s in non-players, respectively; p computer games on psychomotor functioning. We submit that playing computer games may be a useful training tool to increase fine motor skills and movement coordination.

  5. Primary non-Hodgkin's lymphoma of breast – A rare cause of breast lump

    Directory of Open Access Journals (Sweden)

    Veena Gupta

    2017-03-01

    Full Text Available We, here, report a case of primary breast lymphoma in a 59 years old female. The diagnosis was suspected on fine needle aspiration cytology and confirmed on excision biopsy of the tumor. Histology and immunophenotyping were in accordance with non-Hodgkin's diffuse large B-cell lymphoma. The patient has been planned for adjuvant chemoradiation. The management and outcome of primary breast lymphoma and carcinoma are totally different. Early and prompt diagnosis of primary breast lymphoma is of utmost importance to avoid unnecessary mastectomies. Fine needle aspiration cytology supplemented by immuno-cytochemistry can be applied as a reliable and cost-effective tool in the early diagnosis of primary breast lymphomas, while histopathology and immunohistochemistry are conclusive.

  6. Geographic region, socioeconomic position and the utilisation of primary total joint replacement for hip or knee osteoarthritis across western Victoria: a cross-sectional multilevel study of the Australian Orthopaedic Association National Joint Replacement Registry.

    Science.gov (United States)

    Brennan-Olsen, Sharon; Vogrin, Sara; Holloway, Kara L; Page, Richard S; Sajjad, Muhammad A; Kotowicz, Mark A; Livingston, Patricia M; Khasraw, Mustafa; Hakkennes, Sharon; Dunning, Trish L; Brumby, Susan; Pedler, Daryl; Sutherland, Alasdair; Venkatesh, Svetha; Williams, Lana J; Duque, Gustavo; Pasco, Julie A

    2017-11-06

    Compared to urban residents, those in rural/regional areas often experience inequitable healthcare from specialist service providers. Independent of small between-area differences in utilisation, socially advantaged groups had the greatest uptake of joint replacement. These data suggest low correlation between 'need' vs. 'uptake' of surgery in rural/regional areas. Compared to urban residents, those in rural and regional areas often experience inequitable healthcare from specialist service providers, often due to geographical issues. We investigated associations between socioeconomic position (SEP), region of residence and utilisation of primary total knee replacement (TKR) and/or total hip replacement (THR) for osteoarthritis. As part of the Ageing, Chronic Disease and Injury study, we extracted data from the Australian Orthopaedic Association National Joint Replacement Registry (2011-2013) for adults that utilised primary TKR (n = 4179; 56% female) and/or THR (n = 3120; 54% female). Residential addresses were matched with the Australian Bureau of Statistics (ABS) 2011 census data: region of residence was defined according to local government areas (LGAs), and area-level SEP (quintiles) defined using an ABS-derived composite index. The ABS-determined control population (n = 591,265; 51% female) excluded individuals identified as cases. We performed multilevel logistic regression modelling using a stratified two-stage cluster design. TKR was higher for those aged 70-79 years (AOR 1.4 95%CI 1.3-1.5; referent = 60-69 years) and in the most advantaged SEP quintile (AOR 2.1, 95%CI 1.8-2.3; referent = SEP quintile 3); results were similar for THR (70-79 years = AOR 1.7, 95%CI 1.5-1.8; SEP quintile 5 = AOR 2.5, 95%CI 2.2-2.8). Total variances contributed by the variance in LGAs were 2% (SD random effects ± 0.28) and 3% (SD ± 0.32), respectively. Independent of small between-LGA differences in utilisation, and in contrast to the expected greater

  7. Sahara Coal: the fine art of collecting fines for profit

    Energy Technology Data Exchange (ETDEWEB)

    Schreckengost, D.; Arnold, D.

    1984-09-01

    Because of a change in underground mining methods that caused a considerable increase in the amount of fine sizes in the raw coal, Sahara Coal Co. designed and constructed a unique and simple fine coal system at their Harrisburg, IL prep plant. Before the new system was built, the overload of the fine coal circuit created a cost crunch due to loss of salable coal to slurry ponds, slurry pond cleaning costs, and operating and maintenance costs--each and every one excessive. Motivated by these problems, Sahara designed a prototype system to dewater the minus 28 mesh refuse. The success of the idea permitted fine refuse to be loaded onto the coarse refuse belt. Sahara also realized a large reduction in pond cleaning costs. After a period of testing, an expanded version of the refuse system was installed to dewater and dry the 28 mesh X 0 clean coal. Clean coal output increased about 30 tph. Cost savings justified the expenditures for the refuse and clean coal systems. These benefits, combined with increased coal sales revenue, paid back the project costs in less than a year.

  8. The ozonolysis of primary aliphatic amines in fine particles

    Science.gov (United States)

    Zahardis, J.; Geddes, S.; Petrucci, G. A.

    2008-02-01

    The oxidative processing by ozone of the particulate amines octadecylamine (ODA) and hexadecylamine (HDA) is reported. Ozonolysis of these amines resulted in strong NO2- and NO3- ion signals that increased with ozone exposure as monitored by photoelectron resonance capture ionization aerosol mass spectrometry. These products suggest a mechanism of progressive oxidation of the particulate amines to nitroalkanes. Additionally, a strong ion signal at 125 m/z is assigned to the ion NO3- (HNO3). For ozonized mixed particles containing ODA or HDA + oleic acid (OL), with pO3≥3×10-7 atm, imine, secondary amide, and tertiary amide products were measured. These products most likely arise from reactions of amines with aldehydes (for imines) and stabilized Criegee intermediates (SCI) or secondary ozonides (for amides) from the fatty acid. The routes to amides via SCI and/or secondary ozonides were shown to be more important than comparable amide forming reactions between amines and organic acids, using azelaic acid as a test compound. Finally, direct evidence is provided for the formation of a surface barrier in the ODA + OL reaction system that resulted in the retention of OL at high ozone exposures (up to 10-3 atm for 17 s). This effect was not observed in HDA + OL or single component OL particles, suggesting that it may be a species-specific surfactant effect from an in situ generated amide or imine. Implications to tropospheric chemistry, including particle bound amines as sources of oxidized gas phase nitrogen species (e.g.~NO2, NO3), formation of nitrogen enriched HULIS via ozonolysis of amines and source apportionment are discussed.

  9. The ozonolysis of primary aliphatic amines in fine particles

    Directory of Open Access Journals (Sweden)

    J. Zahardis

    2008-02-01

    Full Text Available The oxidative processing by ozone of the particulate amines octadecylamine (ODA and hexadecylamine (HDA is reported. Ozonolysis of these amines resulted in strong NO2 and NO3 ion signals that increased with ozone exposure as monitored by photoelectron resonance capture ionization aerosol mass spectrometry. These products suggest a mechanism of progressive oxidation of the particulate amines to nitroalkanes. Additionally, a strong ion signal at 125 m/z is assigned to the ion NO3 (HNO3. For ozonized mixed particles containing ODA or HDA + oleic acid (OL, with pO3≥3×10–7 atm, imine, secondary amide, and tertiary amide products were measured. These products most likely arise from reactions of amines with aldehydes (for imines and stabilized Criegee intermediates (SCI or secondary ozonides (for amides from the fatty acid. The routes to amides via SCI and/or secondary ozonides were shown to be more important than comparable amide forming reactions between amines and organic acids, using azelaic acid as a test compound. Finally, direct evidence is provided for the formation of a surface barrier in the ODA + OL reaction system that resulted in the retention of OL at high ozone exposures (up to 10−3 atm for 17 s. This effect was not observed in HDA + OL or single component OL particles, suggesting that it may be a species-specific surfactant effect from an in situ generated amide or imine. Implications to tropospheric chemistry, including particle bound amines as sources of oxidized gas phase nitrogen species (e.g.~NO2, NO3, formation of nitrogen enriched HULIS via ozonolysis of amines and source apportionment are discussed.

  10. Fine structure transitions in Fe XIV

    Science.gov (United States)

    Nahar, Sultana N.

    2013-07-01

    Results are reported for Fe XIV energy levels and transitions obtained from the ab initio relativistic Breit-Pauli R-matrix (BPRM) method. BPRM method developed under the Iron Project is capable of calculating very large number of fine structure energy levels and corresponding transitions. However, unlike in the atomic structure calculations, where levels are identified spectroscopically based on the leading percentage contributions of configurations, BPRM is incapable of such identification of the levels and hence the transitions. The main reason for it is that the percentage contributions can not be determined exactly from the large number of channels in the R-matrix space. The present report describes an identification method that uses considerations of quantum defects of channels, contributions of channel from outer regions, Hund's rule, and angular momenta algebra for addition and completeness of fine structure components. The present calculations are carried out using a close coupling wave function expansion that included 26 core excitations from configurations 2s22p63s2, 2s22p63s3p,2s22p63p2,2s22p63s3d, and 2s22p63p3d. A total of 1002 fine structure levels with n ⩽ 10, l⩽9, and 0.5 ⩽J⩽ 9.5 with even and odd parities and the corresponding 130,520 electric dipole allowed (E1) fine structure transitions, a most complete set for astrophysical modelings of spectral analysis and opacities, is presented. Large number of new energy levels are found and identified. The energies agree very well, mostly in less than 1% with the highest being 1.9%, with the 68 observed fine structure levels. While the high lying levels may have some uncertainty, an overall accuracy of energy levels should be within 10%. BPRM transitions have been benchmarked with the existing most accurate calculated transition probabilities with very good agreement for most cases. Based on the accuracy of the method and comparisons, most of the transitions can be rated with A (⩽10%) to C (

  11. Hydrogen Reduction of Hematite Ore Fines to Magnetite Ore Fines at Low Temperatures

    Directory of Open Access Journals (Sweden)

    Wenguang Du

    2017-01-01

    Full Text Available Surplus coke oven gases (COGs and low grade hematite ores are abundant in Shanxi, China. Our group proposes a new process that could simultaneously enrich CH4 from COG and produce separated magnetite from low grade hematite. In this work, low-temperature hydrogen reduction of hematite ore fines was performed in a fixed-bed reactor with a stirring apparatus, and a laboratory Davis magnetic tube was used for the magnetic separation of the resulting magnetite ore fines. The properties of the raw hematite ore, reduced products, and magnetic concentrate were analyzed and characterized by a chemical analysis method, X-ray diffraction, optical microscopy, and scanning electron microscopy. The experimental results indicated that, at temperatures lower than 400°C, the rate of reduction of the hematite ore fines was controlled by the interfacial reaction on the core surface. However, at temperatures higher than 450°C, the reaction was controlled by product layer diffusion. With increasing reduction temperature, the average utilization of hydrogen initially increased and tended to a constant value thereafter. The conversion of Fe2O3 in the hematite ore played an important role in the total iron recovery and grade of the concentrate. The grade of the concentrate decreased, whereas the total iron recovery increased with the increasing Fe2O3 conversion.

  12. Distortion product otoacoustic emission fine structure as an early hearing loss predictor

    DEFF Research Database (Denmark)

    Reuter, Karen; Hammershøi, Dorte

    2006-01-01

    height, and ripple prevalence. Temporary changes of the DPOAE fine structure are analyzed by measuring DPOAE both before and after exposing some of the subjects to an intense sound. The characteristic patterns of fine structure can be found in the DPOAE of all subjects, though they are individual...... fine structures are obtained from 74 normal-hearing humans using primary levels of L1/L2=65/45 dB. The subjects belong to groups with different ages and exposure histories. A classification algorithm is developed, which quantifies the fine structure by the parameter's ripple place, ripple width, ripple...

  13. Total hip arthroplasty survival in femoral head avascular necrosis versus primary hip osteoarthritis: Case-control study with a mean 10-year follow-up after anatomical cementless metal-on-metal 28-mm replacement.

    Science.gov (United States)

    Ancelin, D; Reina, N; Cavaignac, E; Delclaux, S; Chiron, P

    2016-12-01

    Total hip arthroplasty is the most widely used procedure to treat avascular necrosis (AVN) of the femoral head. Few studies have compared the outcomes of THA in femoral head AVN and primary hip osteoarthritis. Therefore we performed a case-control study to compare THA for femoral head AVN vs. primary hip osteoarthritis in terms of: (1) prosthesis survival, (2) complication rates, (3) functional outcomes and radiographic outcomes, (4) and to determine whether specific risk factors for THA failure exist in femoral head AVN. THA survival is similar in femoral head AVN and primary hip osteoarthritis. We compared two prospective cohorts of patients who underwent THA before 65 years of age, one composed of cases with femoral head AVN and the other of controls with primary hip osteoarthritis. In both cohorts, a cementless metal-on-metal prosthesis with a 28-mm cup and an anatomical stem was used. Exclusion criteria were THA with other types of prosthesis, posttraumatic AVN, and secondary osteoarthritis. With α set at 5%, to obtain 80% power, 246 patients were required in all. Prosthesis survival was assessed based on time to major revision (defined as replacement of at least one implant fixed to bone) and time to aseptic loosening. The other evaluation criteria were complications, Postel-Merle d'Aubigné (PMA) score, and the Engh and Agora Radiographic Assessment (ARA) scores for implant osseointegration. The study included 282 patients, 149 with AVN and 133 with osteoarthritis. Mean age was 47.8±10.2 years (range, 18.5-65) and mean follow-up was 11.4±2.8 years (range, 4.5-18.3 years). The 10-year survival rates were similar in the two groups: for major revision, AVN group, 92.5% (95% confidence interval [95% CI], 90.2-94.8) and osteoarthritis group, 95.3% (95% CI, 92.9-97.7); for aseptic loosening, AVN group, 98.6% (95% CI, 97.6-98.6) and osteoarthritis, 99.2% (95% CI, 98.4-100). The AVN group had higher numbers of revision for any reason (19 vs. 6, P=0.018) and

  14. Dispersibility of lactose fines as compared to API in dry powders for inhalation.

    Science.gov (United States)

    Thalberg, Kyrre; Åslund, Simon; Skogevall, Marcus; Andersson, Patrik

    2016-05-17

    This work investigates the dispersion performance of fine lactose particles as function of processing time, and compares it to the API, using Beclomethasone Dipropionate (BDP) as model API. The total load of fine particles is kept constant in the formulations while the proportions of API and lactose fines are varied. Fine particle assessment demonstrates that the lactose fines have higher dispersibility than the API. For standard formulations, processing time has a limited effect on the Fine Particle Fraction (FPF). For formulations containing magnesium stearate (MgSt), FPF of BDP is heavily influenced by processing time, with an initial increase, followed by a decrease at longer mixing times. An equation modeling the observed behavior is presented. Surprisingly, the dispersibility of the lactose fines present in the same formulation remains unaffected by mixing time. Magnesium analysis demonstrates that MgSt is transferred to the fine particles during the mixing process, thus lubrication both BDP and lactose fines, which leads to an increased FPF. Dry particle sizing of the formulations reveals a loss of fine particles at longer mixing times. Incorporation of fine particles into the carrier surfaces is believed to be behind this, and is hence a mechanism of importance as regards the dispersion performance of dry powders for inhalation. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Application of the total etching technique or self-etching primers on primary teeth after air abrasion Aplicação da técnica de condicionamento total ou de "primers" autocondicionantes em dentes decíduos após abrasão a ar

    Directory of Open Access Journals (Sweden)

    Fábio Renato Manzolli Leite

    2005-09-01

    Full Text Available Since the use of air abrasion has grown in pediatric dentistry, the aim of this study was to evaluate, by means of shear bond strength testing, the need to use the total etching technique or self-etching primers on dentin of primary teeth after air abrasion. Twenty-five exfoliated primary molars had their occlusal dentin exposed by trimming and polishing. Specimens were treated by: Air abrasion + Scotchbond MultiPurpose adhesive (G1; 37% phosphoric acid + Scotchbond MP adhesive (G2; Clearfil SE (G3; Air abrasion + 37% phosphoric acid + Scotchbond MP adhesive (G4; Air abrasion + Clearfil SE (G5. On the treated surface, a cylinder of 2 mm by 6 mm was made using a composite resin (Z100. Duncan's test showed that: (G2 = G3 = G5 > (G1 = G4. The use of a self-etching primer on air abraded dentin is recommended to obtain higher bond strengths.Como o uso da abrasão a ar tem aumentado em odontopediatria, o objetivo deste trabalho foi avaliar a resistência ao cisalhamento da resina composta Z100 sobre a superfície dentinária de dentes decíduos após abrasionamento a ar associado ou não a técnica de condicionamento total (ácido fosfórico + Scotchbond Multi Purpose ou "primer" autocondicionante (Clearfil SE Bond. A superfície oclusal de 25 molares decíduos foi removida para exposição completa da superfície dentinária. Após polimento com lixas abrasivas, foram divididos em 5 grupos (5 espécimes em cada tratados por abrasão + adesivo Scotchbond (G1; condicionamento ácido + adesivo Scotchbond (G2; adesivo Clearfil (G3; abrasão a ar + condicionamento ácido + adesivo Scotchbond (G4; abrasão a ar + adesivo Clearfil (G5. Uma matriz bipartida foi adaptada à superfície dentinária e preenchida com resina composta. Após polimerização, corpos-de-prova de 2 mm x 6 mm foram obtidos. O teste de Duncan mostrou a desigualdade (G1 = G4 < (G2 = G3 = G5. Desse modo, conclui-se que, após o abrasionamento dentinário, deve ser utilizado o sistema de

  16. IQ discrepancy differentiates levels of fine motor skills and their relationship in children with autism spectrum disorders.

    Science.gov (United States)

    Yu, Tzu-Ying; Chou, Willy; Chow, Julie Chi; Lin, Chien-Ho; Tung, Li-Chen; Chen, Kuan-Lin

    2018-01-01

    We investigated 1) the impact of differences in intelligence quotient discrepancy (IQD) on motor skills of preschool-aged children with autism spectrum disorders (ASD); 2) the relationships between IQD and motor skills in preschool-aged children with ASD. A total of 127 ASD preschool-aged children were divided into three groups according to the size of the IQD: IQD within 1 standard deviation (1SD; EVENIQ; n=81), discrepantly higher verbal intelligence quotient (VIQ; n=22; VIQ>performance intelligence quotient [PIQ] above 1SD [≥15 points]), and discrepantly higher PIQ (n=24; PIQ>VIQ above 1SD [≥15 points]). Children's IQD and motor skills were determined with the Wechsler Preschool and Primary Scale of Intelligence™ - Fourth Edition and the motor subtests of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT), respectively. One-way analysis of variance revealed significant group differences for the fine motor domain of the CDIIT and the visual-motor coordination subtest ( F =3.37-4.38, p motor skills than were children with even IQD and those with discrepantly higher VIQ, and vice versa. IQD (PIQ - VIQ) had significant positive correlations with the fine motor domain and fine motor subtests of the CDIIT ( r =0.18-0.29, p motor skills in preschool-aged children with ASD. This study suggests important implications for clinicians, therapists, and researchers: discrepantly higher PIQ could be related to better visual-motor coordination, and discrepantly higher VIQ could be related to poor visual-motor coordination. Furthermore, the results support that when therapists are working with preschool-aged children with ASD who are developing fine motor skills or undertaking fine motor tasks related to visual-motor coordination, they may need to pay attention to the children's IQD.

  17. Fine root dynamics for forests on contrasting soils in the Colombian Amazon

    Directory of Open Access Journals (Sweden)

    E. M. Jiménez

    2009-12-01

    between forest types. Thus, a trade-off between above- and below-ground growth seems to exist with our results also suggesting that there are no differences in total net primary productivity between these two forests, but with higher below-ground production and lower above-ground production for the forest on the nutrient poor soil.

  18. Berry's Phase and Fine Structure

    CERN Document Server

    Binder, B

    2002-01-01

    Irrational numbers can be assigned to physical entities based on iterative processes of geometric objects. It is likely that iterative round trips of vector signals include a geometric phase component. If so, this component will couple back to the round trip frequency or path length generating an non-linear feedback loop (i.e. induced by precession). In this paper such a quantum feedback mechanism is defined including generalized fine structure constants in accordance with the fundamental gravitomagnetic relation of spin-orbit coupling. Supported by measurements, the general relativistic and topological background allows to propose, that the deviation of the fine structure constant from 1/137 could be assigned to Berry's phase. The interpretation is straightforward: spacetime curvature effects can be greatly amplified by non-linear phase-locked feedback-loops adjusted to single-valued phase relationships in the quantum regime.

  19. Compressive behavior of fine sand.

    Energy Technology Data Exchange (ETDEWEB)

    Martin, Bradley E. (Air Force Research Laboratory, Eglin, FL); Kabir, Md. E. (Purdue University, West Lafayette, IN); Song, Bo; Chen, Wayne (Purdue University, West Lafayette, IN)

    2010-04-01

    The compressive mechanical response of fine sand is experimentally investigated. The strain rate, initial density, stress state, and moisture level are systematically varied. A Kolsky bar was modified to obtain uniaxial and triaxial compressive response at high strain rates. A controlled loading pulse allows the specimen to acquire stress equilibrium and constant strain-rates. The results show that the compressive response of the fine sand is not sensitive to strain rate under the loading conditions in this study, but significantly dependent on the moisture content, initial density and lateral confinement. Partially saturated sand is more compliant than dry sand. Similar trends were reported in the quasi-static regime for experiments conducted at comparable specimen conditions. The sand becomes stiffer as initial density and/or confinement pressure increases. The sand particle size become smaller after hydrostatic pressure and further smaller after dynamic axial loading.

  20. Fine needle aspiration cytology of parapharyngeal tumors

    Directory of Open Access Journals (Sweden)

    Mondal Palash

    2009-01-01

    Full Text Available Background: Parapharyngeal tumors are rare and often pose diagnostic difficulties due to their location and plethora of presentations. Objectives: The study was undertaken to study the occurrence in the population and to evaluate the exact nature by fine needle aspiration cytology (FNAC. Materials and Methods: A total of five hundred and six cases of lateral neck lesions were studied over three and half years. Of these 56 suspected parapharyngeal masses were selected by clinical and radiological methods. Cytopathology evaluation was done by fine needle aspiration cytology with computed tomography and ultrasonography guidance wherever necessary. Histopathology confirmation was available in all the cases. Results: On FNAC diagnosis could be established in 54 cases while in two cases the material was insufficient to establish a diagnosis. The tumors encountered were, pleomorphic adenoma (33, schwannoma (3, neurofibroma (11, paraganglioma (5, angiofibroma (1 and adenoid cystic carcinoma (1. Four false positives and two false negative cases were encountered. Overall sensitivity was 96%, with specificity of 99% and accuracy being 98.8%. Conclusions: With proper clinical and radiological assessment, FNAC can be extremely useful in diagnosing most of these lesions except a few which need histopathological and even immunohistochemical confirmation.

  1. A randomized multicenter comparison of hybrid sirolimus-eluting stents with bioresorbable polymer versus everolimus-eluting stents with durable polymer in total coronary occlusion: rationale and design of the Primary Stenting of Occluded Native Coronary Arteries IV study

    Directory of Open Access Journals (Sweden)

    Teeuwen Koen

    2012-12-01

    Full Text Available Abstract Background Percutaneous recanalization of total coronary occlusion (TCO was historically hampered by high rates of restenosis and reocclusions. The PRISON II trial demonstrated a significant restenosis reduction in patients treated with sirolimus-eluting stents compared with bare metal stents for TCO. Similar reductions in restenosis were observed with the second-generation zotarolimus-eluting stent and everolimus-eluting stent. Despite favorable anti-restenotic efficacy, safety concerns evolved after identifying an increased rate of very late stent thrombosis (VLST with drug-eluting stents (DES for the treatment of TCO. Late malapposition caused by hypersensitivity reactions and chronic inflammation was suggested as a probable cause of these VLST. New DES with bioresorbable polymer coatings were developed to address these safety concerns. No randomized trials have evaluated the efficacy and safety of the new-generation DES with bioresorbable polymers in patients treated for TCO. Methods/Design The prospective, randomized, single-blinded, multicenter, non-inferiority PRISON IV trial was designed to evaluate the safety, efficacy, and angiographic outcome of hybrid sirolimus-eluting stents with bioresorbable polymers (Orsiro; Biotronik, Berlin, Germany compared with everolimus-eluting stents with durable polymers (Xience Prime/Xpedition; Abbott Vascular, Santa Clara, CA, USA in patients with successfully recanalized TCOs. In total, 330 patients have been randomly allocated to each treatment arm. Patients are eligible with estimated duration of TCO ≥4 weeks with evidence of ischemia in the supply area of the TCO. The primary endpoint is in-segment late luminal loss at 9-month follow-up angiography. Secondary angiographic endpoints include in-stent late luminal loss, minimal luminal diameter, percentage of diameter stenosis, in-stent and in-segment binary restenosis and reocclusions at 9-month follow-up. Additionally, optical coherence

  2. Intensity Modulated Radiotherapy Improves Target Coverage and Parotid Gland Sparing When Delivering Total Mucosal Irradiation in Patients With Squamous Cell Carcinoma of Head and Neck of Unknown Primary Site

    International Nuclear Information System (INIS)

    Bhide, Shreerang; Clark, Catherine; Harrington, Kevin; Nutting, Christopher M.

    2007-01-01

    Head and neck squamous cell carcinoma with occult primary site represents a controversial clinical problem. Conventional total mucosal irradiation (TMI) maximizes local control, but at the expense of xerostomia. IMRT has been shown to spare salivary tissue in head and cancer patients. This study has been performed to investigate the potential of IMRT to perform nodal and TMI and also allow parotid gland sparing in this patient group. Conventional radiotherapy (CRT) and IMRT plans were produced for six patients to treat the ipsilateral (involved) post-operative neck (PTV1) and the un-operated contralateral neck and mucosal axis (PTV2). Plans were produced with and without the inclusion of nasopharynx in the PTV2. The potential to improve target coverage and spare the parotid glands was investigated for the IMRT plans. There was no significant difference in the mean doses to the PTV1 using CRT and IMRT (59.7 and 60.0 respectively, p = 0.5). The maximum doses to PTV1 and PTV2 were lower for the IMRT technique as compared to CRT (P = 0.008 and P < 0.0001), respectively, and the minimum doses to PTV1 and PTV2 were significantly higher for IMRT as compared to CRT (P = 0.001 and P = 0.001), respectively, illustrating better dose homogeneity with IMRT. The mean dose to the parotid gland contralateral to PTV1 was significantly lower for IMRT (23.21 ± 0.7) as compared to CRT (50.5 ± 5.8) (P < 0.0001). There was a significant difference in parotid dose between plans with and without the inclusion of the nasopharynx. IMRT offers improved dose homogeneity in PTV1 and PTV2 and allows for parotid sparing

  3. CDC WONDER: Daily Fine Particulate Matter

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Daily Fine Particulate Matter data available on CDC WONDER are geographically aggregated daily measures of fine particulate matter in the outdoor air, spanning...

  4. Numerical modelling of the dehydration of waste concrete fines : An attempt to close the recycling loop

    NARCIS (Netherlands)

    Teklay, Abraham; Vahidi, A.; Lotfi, Somayeh; Di Maio, F.; Rem, P.C.; Di Maio, F.; Lotfi, S.; Bakker, M.; Hu, M.; Vahidi, A.

    2017-01-01

    The ever-increasing interest on sustainable raw materials has urged the quest for recycled materials that can be used as a partial or total replacement of fine fractions in the production of concrete. This paper demonstrates a modelling study of recycled concrete waste fines and the possibility of

  5. Considering Fine Art and Picture Books

    Science.gov (United States)

    Serafini, Frank

    2015-01-01

    There has been a close association between picturebook illustrations and works of fine art since the picturebook was first conceived, and many ways these associations among works of fine art and picturebook illustrations and design play out. To make sense of all the various ways picturebook illustrations are associated with works of fine art,…

  6. 36 CFR 910.35 - Fine arts.

    Science.gov (United States)

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Fine arts. 910.35 Section 910... DEVELOPMENT AREA Standards Uniformly Applicable to the Development Area § 910.35 Fine arts. Fine arts... of art which are appropriate for the development. For information and guidance, a reasonable...

  7. Results and complications of CT-guided transthoracic fine-needle aspiration biopsy of pulmonary lesions

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Cristiano Dias de; Nunes, Rodolfo Acatauassu; Saito, Eduardo Haruo; Higa, Claudio; Cardona, Zanier Jose Fernando; Santos, Denise Barbosa dos, E-mail: cristianodiaslima@gmail.co [Hospital Universitario Pedro Ernesto (HUPE/UERJ), Rio de Janeiro, RJ (Brazil). Dept. Cirurgia Toracica

    2011-03-15

    Objective: to analyze the cytological findings of CT-guided percutaneous fine-needle aspiration biopsies of the lung, to demonstrate the diagnostic feasibility of the method in the investigation of pulmonary lesions, and to determine the complications of the procedure, evaluating its safety. Methods: a retrospective analysis of 89 patients with various types of pulmonary lesions who underwent 97 procedures over a period of five years. The patients were divided into groups regarding the indication for the procedure: suspicion of primary lung cancer (stages IIIB or IV); suspicion of lung cancer (stages I, II, or IIIA) and clinical contraindications for surgery; suspicion of pulmonary metastasis from other organs; and pulmonary lesions with benign radiological aspect. All of the procedures were performed with 25-gauge needles and were guided by spiral CT. The final diagnosis was confirmed by surgical biopsy and clinical/oncological follow-up. For the analysis of complications, the total number of procedures was considered. Results: the main indication for the procedure was suspicion of advanced stage primary lung cancer. The accuracy of the method for malignant lesions was 91.5%. The lesion was confirmed as cancer in 73% of the patients. The major complication was pneumothorax (27.8%), which required chest tube drainage in 12.4% of the procedures. Conclusions: the principal indication for CT-guided fine-needle biopsy was suspicion of primary lung cancer in patients who were not surgical candidates. The procedure has high diagnostic feasibility for malignant pulmonary diseases. The most prevalent complication was pneumothorax. However, in most cases, chest tube drainage was unnecessary. No deaths were related to the procedure. (author)

  8. Picobubble enhanced fine coal flotation

    Energy Technology Data Exchange (ETDEWEB)

    Tao, Y.J.; Liu, J.T.; Yu, S.; Tao, D. [University of Kentucky, Lexington, KY (United States). Dept. of Mining Engineering

    2006-07-01

    Froth flotation is widely used in the coal industry to clean -28 mesh fine coal. A successful recovery of particles by flotation depends on efficient particle-bubble collision and attachment with minimal subsequent particle detachment from bubble. Flotation is effective in a narrow size range beyond which the flotation efficiency drops drastically. It is now known that the low flotation recovery of particles in the finest size fractions is mainly due to a low probability of bubble-particle collision while the main reason for poor coarse particle flotation recovery is the high probability of detachment. A fundamental analysis has shown that use of picobubbles can significantly improve the flotation recovery of particles in a wide range of size by increasing the probability of collision and attachment and reducing the probability of detachment. A specially designed column with a picobubble generator has been developed for enhanced recovery of fine coal particles. Picobubbles were produced based on the hydrodynamic cavitation principle. They are characterized by a size distribution that is mostly below 1 {mu}m and adhere preferentially to the hydrophobic surfaces. The presence of picobubbles increases the probability of collision and attachment and decreases the probability of detachment, thus enhancing flotation recovery. Experimental results with the Coalberg seam coal in West Virginia, U.S.A. have shown that the use of picobubbles in a 2 in. column flotation increased fine coal recovery by 10-30%, depending on the feed rate, collector dosage, and other flotation conditions. Picobubbles also acted as a secondary collector and reduced the collector dosage by one third to one half.

  9. Fine particulate matter in the indoor air of barbeque restaurants: Elemental compositions, sources and health risks

    International Nuclear Information System (INIS)

    Taner, Simge; Pekey, Beyhan; Pekey, Hakan

    2013-01-01

    Cooking is a significant source of indoor particulate matter that can cause adverse health effects. In this study, a 5-stage cascade impactor was used to collect particulate matter from 14 restaurants that cooked with charcoal in Kocaeli, the second largest city in Turkey. A total of 24 elements were quantified using ICP-MS. All of the element contents except for Mn were higher for fine particles (PM 2.5 ) than coarse particles (PM >2.5 ), and the major trace elements identified in the PM 2.5 included V, Se, Zn, Cr, As, Cu, Ni, and Pb. Principle component analysis (PCA) and enrichment factor (EF) calculations were used to determine the sources of PM 2.5 . Four factors that explained over 77% of the total variance were identified by the PCA. These factors included charcoal combustion, indoor activities, crustal components, and road dust. The Se, As, Cd, and V contents in the PM 2.5 were highly enriched (EF > 100). The health risks posed by the individual metals were calculated to assess the potential health risks associated with inhaling the fine particles released during charcoal cooking. The total hazard quotient (total HQ) for a PM 2.5 of 4.09 was four times greater than the acceptable limit (i.e., 1.0). In addition, the excess lifetime cancer risk (total ELCR) for PM 2.5 was 1.57 × 10 −4 , which is higher than the acceptable limit of 1.0 × 10 −6 . Among all of the carcinogenic elements present in the PM 2.5 , the cancer risks resulting from Cr(VI) and As exposure were the highest (i.e., 1.16 × 10 −4 and 3.89 × 10 −5 , respectively). Overall, these results indicate that the lifetime cancer risk associated with As and Cr(VI) exposure is significant at selected restaurants, which is of concern for restaurant workers. - Highlights: • Particulate emissions from charcoal combustion in the BBQ restaurants were studied. • Vanadium, Se, Zn, Cr and As were found as high concentrations in PM 2.5 . • Charcoal combustion and indoor activities were the

  10. Fine particulate matter in the indoor air of barbeque restaurants: Elemental compositions, sources and health risks

    Energy Technology Data Exchange (ETDEWEB)

    Taner, Simge; Pekey, Beyhan, E-mail: bpekey@kocaeli.edu.tr; Pekey, Hakan

    2013-06-01

    Cooking is a significant source of indoor particulate matter that can cause adverse health effects. In this study, a 5-stage cascade impactor was used to collect particulate matter from 14 restaurants that cooked with charcoal in Kocaeli, the second largest city in Turkey. A total of 24 elements were quantified using ICP-MS. All of the element contents except for Mn were higher for fine particles (PM{sub 2.5}) than coarse particles (PM{sub >2.5}), and the major trace elements identified in the PM{sub 2.5} included V, Se, Zn, Cr, As, Cu, Ni, and Pb. Principle component analysis (PCA) and enrichment factor (EF) calculations were used to determine the sources of PM{sub 2.5}. Four factors that explained over 77% of the total variance were identified by the PCA. These factors included charcoal combustion, indoor activities, crustal components, and road dust. The Se, As, Cd, and V contents in the PM{sub 2.5} were highly enriched (EF > 100). The health risks posed by the individual metals were calculated to assess the potential health risks associated with inhaling the fine particles released during charcoal cooking. The total hazard quotient (total HQ) for a PM{sub 2.5} of 4.09 was four times greater than the acceptable limit (i.e., 1.0). In addition, the excess lifetime cancer risk (total ELCR) for PM{sub 2.5} was 1.57 × 10{sup −4}, which is higher than the acceptable limit of 1.0 × 10{sup −6}. Among all of the carcinogenic elements present in the PM{sub 2.5}, the cancer risks resulting from Cr(VI) and As exposure were the highest (i.e., 1.16 × 10{sup −4} and 3.89 × 10{sup −5}, respectively). Overall, these results indicate that the lifetime cancer risk associated with As and Cr(VI) exposure is significant at selected restaurants, which is of concern for restaurant workers. - Highlights: • Particulate emissions from charcoal combustion in the BBQ restaurants were studied. • Vanadium, Se, Zn, Cr and As were found as high concentrations in PM{sub 2.5}.

  11. Total volume versus bouts

    DEFF Research Database (Denmark)

    Chinapaw, Mai; Klakk, Heidi; Møller, Niels Christian

    2018-01-01

    BACKGROUND/OBJECTIVES: Examine the prospective relationship of total volume versus bouts of sedentary behaviour (SB) and moderate-to-vigorous physical activity (MVPA) with cardiometabolic risk in children. In addition, the moderating effects of weight status and MVPA were explored. SUBJECTS....../METHODS: Longitudinal study including 454 primary school children (mean age 10.3 years). Total volume and bouts (i.e. ≥10 min consecutive minutes) of MVPA and SB were assessed by accelerometry in Nov 2009/Jan 2010 (T1) and Aug/Oct 2010 (T2). Triglycerides, total cholesterol/HDL cholesterol ratio (TC:HDLC ratio......, with or without mutual adjustments between MVPA and SB. The moderating effects of weight status and MVPA (for SB only) were examined by adding interaction terms. RESULTS: Children engaged daily in about 60 min of total MVPA and 0-15 min/week in MVPA bouts. Mean total sedentary time was around 7 h/day with over 3...

  12. On the interpretation of total current spectroscopy (TCS) spectra from MoS2 crystals

    International Nuclear Information System (INIS)

    Mohamed, M.H.; Moeller, P.J.

    1981-01-01

    Total Current Spectroscopy (TCS) spectra from MoS 2 (0001) face for three different angles of incidence of the primary beam with respect to the c-axis as well as TCS spectrum from an edge surface cut perpendicularly to the (001) face of a molybdenite crystal are given. Energy positions of the TCS structure are found to be independent of the variations in the angle of incidence of the primary beam and also of the change of crystal face. From this it is concluded that the fine structure in the TCS spectra from molybdenite crystal for the primary energies studied is due to electron-electron scattering and not to Bragg interference effects. (author)

  13. [Fine root dynamics and its relationship with soil fertility in tropical rainforests of Chocó].

    Science.gov (United States)

    Quinto, Harley; Caicedo, Haylin; Thelis Perez, May; Moreno, Flavio

    2016-12-01

    The fine roots play an important role in the acquisition of water and minerals from the soil, the global carbon balance and mitigation of climate change. The dynamics (productivity and turnover) of fine roots is essential for nutrient cycling and carbon balance of forest ecosystems. The availability of soil water and nutrients has significantly determined the productivity and turnover of fine roots. It has been hypothesized that fine roots dynamics increases with the availability of soil resources in tropical forest ecosystems. To test this hypothesis in tropical rainforests of Chocó (ecosystems with the highest rainfall in the world), five one-ha permanent plots were established in the localities of Opogodó and Pacurita, where the productivity and turnover of fine roots were measured at 0-10 cm and 10-20 cm depth. The measurement of the fine root production was realized by the Ingrowth core method. The fine root turnover was measured like fine roots production divided mean annual biomass. In addition, soil fertility parameters (pH, nutrients, and texture) were measured and their association with productivity and turnover of fine roots was evaluated. It was found that the sites had nutrient-poor soils. The localities also differ in soil; Opogodó has sandy soils and flat topography, and Pacurita has clay soils, rich in aluminum and mountainous topography. In Opogodó fine root production was 6.50 ± 2.62 t/ha.yr (mean ± SD). In Pacurita, fine root production was 3.61 ± 0.88 t/ha.yr. Also in Opogodó, the fine root turnover was higher than in Pacurita (1.17 /y and 0.62 /y, respectively). Fine root turnover and production in the upper soil layers (10 cm upper soil) was considerably higher. Productivity and turnover of fine roots showed positive correlation with pH and contents of organic matter, total N, K, Mg, and sand; whereas correlations were negative with ECEC and contents of Al, silt, and clay. The percentage of sand was the parameter that best explained

  14. Cleaning and dewatering fine coal

    Science.gov (United States)

    Yoon, Roe-Hoan; Eraydin, Mert K.; Freeland, Chad

    2017-10-17

    Fine coal is cleaned of its mineral matter impurities and dewatered by mixing the aqueous slurry containing both with a hydrophobic liquid, subjecting the mixture to a phase separation. The resulting hydrophobic liquid phase contains coal particles free of surface moisture and droplets of water stabilized by coal particles, while the aqueous phase contains the mineral matter. By separating the entrained water droplets from the coal particles mechanically, a clean coal product of substantially reduced mineral matter and moisture contents is obtained. The spent hydrophobic liquid is separated from the clean coal product and recycled. The process can also be used to separate one type of hydrophilic particles from another by selectively hydrophobizing one.

  15. Ultrasound guided percutaneous fine needle aspiration biopsy of the liver with focal lesion

    International Nuclear Information System (INIS)

    Ko, Gang Seok; Yang, Hyun Cheol; Park, Byoung Lan; Kim, Byoung Geun; Sohn, Jang Sihn

    1985-01-01

    The ultrasound-guided fine needle aspirations were performed in order to diagnose a suspected neoplastic or infectious disease in 52 patients with focal liver disease. Of these, neoplastic lesions were suspected in 31 patients and infectious lesions in 21 patients ultrasonically and/or clinically. The overall accuracy for both suspected malignant and infectious disease was 79% (41/52). The primary indication for fine needle aspiration was to document the presence of malignancy and to avoid a diagnostic laparotomy, and to drain hepatic abscess. Consequently we were convinced that the ultrasound-guided percutaneous fine needle aspiration biopsy in the focal liver disease is the best method for a conclusive diagnosis

  16. Fine needle aspiration cytology of dermal cylindroma

    Directory of Open Access Journals (Sweden)

    Parikshaa Gupta

    2014-01-01

    Full Text Available In this paper, we have described fine needle aspiration cytology (FNAC of a rare case of dermal cylindroma. A 40-year-old female presented with a lateral mid-cervical swelling fixed to the skin. FNAC smears showed multiple clusters of small, round to oval cells with hyperchromatic nuclei, inconspicuous nucleoli and scant cytoplasm. In addition, the background showed deposits of basement membrane type material. This was dark magenta colored pinkish globular material. The globules were occasionally surrounded by the basal type of cells. Occasional cells with elongated nuclei were also noted. Cytological diagnosis of skin adnexal tumor possibly cylindroma was offered. Subsequent histopathology of the swelling showed sheets and clusters of cells in a jigsaw puzzle-like fashion. Deposition of abundant basement membrane-like material was noted in between the tumor cells. A diagnosis of cylindorma was offered. FNAC along with the subcutaneous location of the tumor and absence of primary salivary gland tumor may help to diagnose such rare case.

  17. Remelting of metallurgical fines using thermal plasma

    International Nuclear Information System (INIS)

    Vicente, L.C.; Neto F, J.B.F.; Bender, O.W.; Collares, M.P.

    1992-01-01

    A plasma furnace was developed for remelting of ferro alloys and silicon fines. The furnace capacity was about 4 Kg of silicon and power about 50 kW. The fine (20 to 100 mesh) was fed into the furnace directly at the high temperature zone. This system was tested for remelting silicon fines and the results in the recovery of silicon was about 95% and it took place a refine of aluminium and calcium. (author)

  18. On Basu's proposal: Fines affect bribes

    OpenAIRE

    Popov, Sergey V.

    2017-01-01

    I model the connection between the equilibrium bribe amount and the fines imposed on both bribe-taker and bribe-payer. I show that Basu's (2011) proposal to lower the fines imposed on bribe-payers in order to induce more whistleblowing and increase the probability of penalizing corrupt government officials might instead increase bribe amounts. Higher expected fines on bribe-takers will make them charge larger bribes; at the same time, lowering fines for bribe-paying might increase bribe-payer...

  19. Application of insoluble fibers in the fining of wine phenolics.

    Science.gov (United States)

    Guerrero, Raúl F; Smith, Paul; Bindon, Keren A

    2013-05-08

    The application of animal-derived proteins as wine fining agents has been subject to increased regulation in recent years. As an alternative to protein-based fining agents, insoluble plant-derived fibers have the capacity to adsorb red wine tannins. Changes in red wine tannin were analyzed following application of fibers derived from apple and grape and protein-based fining agents. Other changes in wine composition, namely, color, monomeric phenolics, metals, and turbidity, were also determined. Wine tannin was maximally reduced by application of an apple pomace fiber and a grape pomace fiber (G4), removing 42 and 38%, respectively. Potassium caseinate maximally removed 19% of wine tannin, although applied at a lower dose. Fibers reduced anthocyanins, total phenolics, and wine color density, but changes in wine hue were minor. Proteins and apple fiber selectively removed high molecular mass phenolics, whereas grape fibers removed those of both high and low molecular mass. The results show that insoluble fibers may be considered as alternative fining agents for red wines.

  20. Fining of Red Wine Monitored by Multiple Light Scattering.

    Science.gov (United States)

    Ferrentino, Giovanna; Ramezani, Mohsen; Morozova, Ksenia; Hafner, Daniela; Pedri, Ulrich; Pixner, Konrad; Scampicchio, Matteo

    2017-07-12

    This work describes a new approach based on multiple light scattering to study red wine clarification processes. The whole spectral signal (1933 backscattering points along the length of each sample vial) were fitted by a multivariate kinetic model that was built with a three-step mechanism, implying (1) adsorption of wine colloids to fining agents, (2) aggregation into larger particles, and (3) sedimentation. Each step is characterized by a reaction rate constant. According to the first reaction, the results showed that gelatin was the most efficient fining agent, concerning the main objective, which was the clarification of the wine, and consequently the increase in its limpidity. Such a trend was also discussed in relation to the results achieved by nephelometry, total phenols, ζ-potential, color, sensory, and electronic nose analyses. Also, higher concentrations of the fining agent (from 5 to 30 g/100 L) or higher temperatures (from 10 to 20 °C) sped up the process. Finally, the advantage of using the whole spectral signal vs classical univariate approaches was demonstrated by comparing the uncertainty associated with the rate constants of the proposed kinetic model. Overall, multiple light scattering technique showed a great potential for studying fining processes compared to classical univariate approaches.

  1. Fine Structure of Plasmaspheric Hiss

    Science.gov (United States)

    Summers, D.; Omura, Y.; Nakamura, S.; Kletzing, C.

    2014-12-01

    Plasmaspheric hiss plays a key role in controlling the structure and dynamics of Earth's radiation belts.The quiet time slot region between the inner and outer belts can be explained as a steady-state balance between earthward radial diffusion and pitch-angle scattering loss of energetic electrons to the atmosphere induced by plasmaspheric hiss. Plasmaspheric hiss can also induce gradual precipitation loss of MeV electrons from the outer radiation belt. Plasmaspheric hiss has been widely regarded as a broadband,structureless,incoherent emission. Here, by examining burst-mode vector waveform data from the EMFISIS instrument on the Van Allen Probes mission,we show that plasmaspheric hiss is a coherent emission with complex fine structure. Specifically, plasmaspheric hiss appears as discrete rising tone and falling tone elements. By means of waveform analysis we identify typical amplitudes,phase profiles,and sweep rates of the rising and falling tone elements. The new observations reported here can be expected to fuel a re-examination of the properties of plasmaspheric hiss, including a further re-analysis of the generation mechanism for hiss.

  2. Fine structure of cluster decays

    International Nuclear Information System (INIS)

    Dumitrescu, O.

    1993-07-01

    Within the one level R-matrix approach the hindrance factors of the radioactive decays in which are emitted α and 14 C - nuclei are calculated. The generalization to radioactive decays in which are emitted heavier clusters such as e.g. 20 O, 24 Ne, 25 Ne, 28 Mg. 30 Mg, 32 Si and 34 Si is straightforward. The interior wave functions are supposed to be given by the shell model with effective residual interactions (e.g. the large scale shell model code-OXBASH - in the Michigan State University version for nearly spherical nuclei or by the enlarged superfluid model - ESM - recently proposed for deformed nuclei). The exterior wave functions are calculated from a cluster - nucleus double - folding model potential obtained with the M3Y interaction. As examples of the cluster decay fine structure we analyzed the particular cases of α - decay of 241 Am and 14 C -decay of 233 Ra. Good agreement with the experimental data is obtained. (author). 78 refs, 2 figs, 6 tabs

  3. Get out of Fines Free: Recruiting Student Usability Testers via Fine Waivers

    Science.gov (United States)

    Hockenberry, Benjamin; Blackburn, Kourtney

    2016-01-01

    St. John Fisher College's Lavery Library's Access Services and Systems departments began a pilot project in which students with overdue fines tested usability of library Web sites in exchange for fine waivers. Circulation staff promoted the program and redeemed fine waiver vouchers at the Checkout Desk, while Systems staff administered testing and…

  4. 47 CFR 76.943 - Fines.

    Science.gov (United States)

    2010-10-01

    ... TELEVISION SERVICE Cable Rate Regulation § 76.943 Fines. (a) A franchising authority may impose fines or... specifically at the cable operator, provided the franchising authority has such power under state or local laws. (b) If a cable operator willfully fails to comply with the terms of any franchising authority's order...

  5. Fine particulate pollution and asthma exacerbations.

    Science.gov (United States)

    Bouazza, Naïm; Foissac, Frantz; Urien, Saik; Guedj, Romain; Carbajal, Ricardo; Tréluyer, Jean-Marc; Chappuy, Hélène

    2017-12-19

    As the results from epidemiological studies about the impact of outdoor air pollution on asthma in children are heterogeneous, our objective was to investigate the association between asthma exacerbation in children and exposure to air pollutants. A database of 1 264 585 paediatric visits during the 2010-2015 period to the emergency rooms from 20 emergency departments (EDs) of 'Assistance Publique Hôpitaux de Paris (APHP)', the largest hospital group in Europe, was used. A total of 47 107 visits were classified as asthma exacerbations. Concentration of air pollutants (nitrogen dioxide, ozone, fine particulate matter (PM) with an aerodynamic diameter smaller than 10  µm (PM 10 ) and 2.5 µm (PM 2.5 )), as well as meteorological data, evolution of respiratory syncytial virus infection and pollen exposition, were collected on an hourly or daily basis for the same period using institutional databases. To assess the association between air pollution and asthma, mixed-effects quasi-Poisson regression modelling was performed. The only compound independently associated with ED visits for asthma was PM 2.5 (Ppollutants. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Explaining the spatiotemporal variation of fine particle number concentrations over Beijing and surrounding areas in an air quality model with aerosol microphysics

    International Nuclear Information System (INIS)

    Chen, Xueshun; Wang, Zifa; Li, Jie; Chen, Huansheng; Hu, Min; Yang, Wenyi; Wang, Zhe; Ge, Baozhu; Wang, Dawei

    2017-01-01

    In this study, a three-dimensional air quality model with detailed aerosol microphysics (NAQPMS + APM) was applied to simulate the fine particle number size distribution and to explain the spatiotemporal variation of fine particle number concentrations in different size ranges over Beijing and surrounding areas in the haze season (Jan 15 to Feb 13 in 2006). Comparison between observations and the simulation indicates that the model is able to reproduce the main features of the particle number size distribution. The high number concentration of total particles, up to 26600 cm −3 in observations and 39800 cm −3 in the simulation, indicates the severity of pollution in Beijing. We find that primary particles with secondary species coating and secondary particles together control the particle number size distribution. Secondary particles dominate particle number concentration in the nucleation mode. Primary and secondary particles together determine the temporal evolution and spatial pattern of particle number concentration in the Aitken mode. Primary particles dominate particle number concentration in the accumulation mode. Over Beijing and surrounding areas, secondary particles contribute at least 80% of particle number concentration in the nucleation mode but only 10–20% in the accumulation mode. Nucleation mode particles and accumulation mode particles are anti-phased with each other. Nucleation or primary emissions alone could not explain the formation of the particle number size distribution in Beijing. Nucleation has larger effects on ultrafine particles while primary particles emissions are efficient in producing large particles in the accumulation mode. Reduction in primary particle emissions does not always lead to a decrease in the number concentration of ultrafine particles. Measures to reduce fine particle pollution in terms of particle number concentration may be different from those addressing particle mass concentration. - Highlights:

  7. Charge neutrality of fine particle (dusty) plasmas and fine particle cloud under gravity

    Energy Technology Data Exchange (ETDEWEB)

    Totsuji, Hiroo, E-mail: totsuji-09@t.okadai.jp

    2017-03-11

    The enhancement of the charge neutrality due to the existence of fine particles is shown to occur generally under microgravity and in one-dimensional structures under gravity. As an application of the latter, the size and position of fine particle clouds relative to surrounding plasmas are determined under gravity. - Highlights: • In fine particle (dusty) plasmas, the charge neutrality is much enhanced by the existence of fine particles. • The enhancement of charge neutrality generally occurs under microgravity and gravity. • Structure of fine particle clouds under gravity is determined by applying the enhanced charge neutrality.

  8. Metastatic Chordoma: A Diagnostic Challenge on Fine Needle Aspiration

    Directory of Open Access Journals (Sweden)

    Ghassan Tranesh

    2016-01-01

    Full Text Available Chordomas are primary low grade malignant tumors of bone that usually arise within both ends of axial skeleton. The Notochord is a midline, ectoderm-derived structure that defines the phylum of chordates. Chordomas may pose difficult diagnostic challenges when encountered in secondary locations, such as lungs or other parenchymatous organs. We report the cytologic findings of a metastatic chordoma sampled through CT-scan guided fine needle aspiration (FNA of lower lobe lung nodule in a 54-year-old man diagnosed with recurrent chordoma involving the lumber spine and paraspinal region.

  9. Amenorrhea - primary

    Science.gov (United States)

    ... of periods - primary Images Primary amenorrhea Normal uterine anatomy (cut section) Absence of menstruation (amenorrhea) References Bulun SE. The physiology and pathology of the female reproductive axis. In: ...

  10. Improved process for heating finely divided carbonaceous materials

    Energy Technology Data Exchange (ETDEWEB)

    1956-08-01

    A process for heating finely divided carbonaceous particles by burning a proportion of the carbon consists of passing the carbonaceous material at a temperature above 800/sup 0/F into an upwardly disposed, slender, combustion zone, suspending the particles in an upwardly-moving gas containing free oxygen so that the suspension has a density from 0.1 to 5.0 lb/cu. ft., passing the suspension upwardly through the combustion zone at a velocity of from 5 to 100 ft./sec., and injecting at least one stream of a second gas containing free oxygen at a point in the combustion zone such that at least 50% of the oxygen in the first gas has been consumed by the time the suspension reaches this point. The total quantity of oxygen is chosen so that the finely divided carbonaceous material is heated to a temperature of not less than 1,050/sup 0/F.

  11. Fine Guidance Sensing for Coronagraphic Observatories

    Science.gov (United States)

    Brugarolas, Paul; Alexander, James W.; Trauger, John T.; Moody, Dwight C.

    2011-01-01

    Three options have been developed for Fine Guidance Sensing (FGS) for coronagraphic observatories using a Fine Guidance Camera within a coronagraphic instrument. Coronagraphic observatories require very fine precision pointing in order to image faint objects at very small distances from a target star. The Fine Guidance Camera measures the direction to the target star. The first option, referred to as Spot, was to collect all of the light reflected from a coronagraph occulter onto a focal plane, producing an Airy-type point spread function (PSF). This would allow almost all of the starlight from the central star to be used for centroiding. The second approach, referred to as Punctured Disk, collects the light that bypasses a central obscuration, producing a PSF with a punctured central disk. The final approach, referred to as Lyot, collects light after passing through the occulter at the Lyot stop. The study includes generation of representative images for each option by the science team, followed by an engineering evaluation of a centroiding or a photometric algorithm for each option. After the alignment of the coronagraph to the fine guidance system, a "nulling" point on the FGS focal point is determined by calibration. This alignment is implemented by a fine alignment mechanism that is part of the fine guidance camera selection mirror. If the star images meet the modeling assumptions, and the star "centroid" can be driven to that nulling point, the contrast for the coronagraph will be maximized.

  12. A global analysis of fine root production as affected by soil nitrogen and phosphorus.

    Science.gov (United States)

    Yuan, Z Y; Chen, Han Y H

    2012-09-22

    Fine root production is the largest component of belowground production and plays substantial roles in the biogeochemical cycles of terrestrial ecosystems. The increasing availability of nitrogen (N) and phosphorus (P) due to human activities is expected to increase aboveground net primary production (ANNP), but the response of fine root production to N and P remains unclear. If roots respond to nutrients as ANNP, fine root production is anticipated to increase with increasing soil N and P. Here, by synthesizing data along the nutrient gradient from 410 natural habitats and from 469 N and/or P addition experiments, we showed that fine root production increased in terrestrial ecosystems with an average increase along the natural N gradient of up to 0.5 per cent with increasing soil N. Fine root production also increased with soil P in natural conditions, particularly at P production increased by a global average of 27, 21 and 40 per cent, respectively. However, its responses differed among ecosystems and soil types. The global average increases in fine root production are lower than those of ANNP, indicating that above- and belowground counterparts are coupled, but production allocation shifts more to aboveground with higher soil nutrients. Our results suggest that the increasing fertilizer use and combined N deposition at present and in the future will stimulate fine root production, together with ANPP, probably providing a significant influence on atmospheric CO(2) emissions.

  13. Development of fine and coarse roots of Thuja occidentalis 'Brabant' in non-irrigated and drip irrigated field plots

    NARCIS (Netherlands)

    Pronk, A.A.; Willigen, de P.; Heuvelink, E.; Challa, H.

    2002-01-01

    Aboveground dry mass, total root dry mass and root length density of the fine roots of Thuja occidentalis `Brabant' were determined under non- and drip-irrigated field conditions. Two-dimensional diffusion parameters for dynamic root growth were estimated based on dry mass production of the fine

  14. Growth dynamics of fine roots in a coniferous fern forest site close to Forsmark in the central part of Sweden

    International Nuclear Information System (INIS)

    Persson, Hans; Stadenberg, Ingela

    2007-12-01

    The seasonal growth dynamics of live and dead roots for trees and the field layer species (g/m 2 , varying diameter fractions) and live/dead ratios were analysed at a fresh/moist coniferous fern forest site close to the nuclear power plant at Forsmark in the central eastern parts of Sweden. The changes in depth distribution of fine roots were observed at depth intervals of the top humus horizon down to 40 cm in the mineral soil profile. The bulk of living fine roots of trees ( 2 . The total quantity of fine roots (live + dead) amounted to 543, 434, 314 and 546 g/m 2 . Considerable quantities of fine roots (< 1 mm in diameter) were attributed to field-layer species (about 18% of the total biomass during the whole period of investigation). The turnover rate (the rate of construction of new roots) for tree fine roots < 1 mm in diameter amounted to at least the size of the average fine-root biomass. Our methods of estimating fine-root production and mortality, involved periodic measurements of live and dead dry weight of the fine roots from sequential core samples of the forest soil. The collected data give a proper and instant measure of the spatial and temporal distribution of fine roots in the undisturbed soil-profile. Data from other fine-root investigations suggest turnover rates in agreement with our present findings. Differences between root growth and turnover should be expected between trees of different age, tree species and different forest sites, but also between different years. Substantial variations in fine-root biomass, necromass and live/dead ratios are found in different forest sites. Correct methods for estimating the amount of live and dead fine-roots in the soil at regular time intervals are essential for any calculation of fine-root turnover. Definition of root vitality differs in literature, making it difficult to compare results from different root investigators. Our investigation clarifies the importance of using distinct morphological criteria

  15. Physicochemical characteristics and occupational exposure to coarse, fine and ultrafine particles during building refurbishment activities

    Energy Technology Data Exchange (ETDEWEB)

    Azarmi, Farhad; Kumar, Prashant, E-mail: p.kumar@surrey.ac.uk, E-mail: prashant.kumar@cantab.net; Mulheron, Mike [University of Surrey, Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences (United Kingdom); Colaux, Julien L.; Jeynes, Chris [University of Surrey, Faculty of Engineering and Physical Sciences, Ion Beam Centre (United Kingdom); Adhami, Siavash; Watts, John F. [University of Surrey, The Surface Analysis Laboratory, Faculty of Engineering and Physical Sciences (United Kingdom)

    2015-08-15

    Understanding of the emissions of coarse (PM{sub 10} ≤10 μm), fine (PM{sub 2.5} ≤2.5 μm) and ultrafine particles (UFP <100 nm) from refurbishment activities and their dispersion into the nearby environment is of primary importance for developing efficient risk assessment and management strategies in the construction and demolition industry. This study investigates the release, occupational exposure and physicochemical properties of particulate matter, including UFPs, from over 20 different refurbishment activities occurring at an operational building site. Particles were measured in the 5–10,000-nm-size range using a fast response differential mobility spectrometer and a GRIMM particle spectrometer for 55 h over 8 days. The UFPs were found to account for >90 % of the total particle number concentrations and <10 % of the total mass concentrations released during the recorded activities. The highest UFP concentrations were 4860, 740, 650 and 500 times above the background value during wall-chasing, drilling, cementing and general demolition activities, respectively. Scanning electron microscopy, X-ray photoelectron spectroscopy and ion beam analysis were used to identify physicochemical characteristics of particles and attribute them to probable sources considering the size and the nature of the particles. The results confirm that refurbishment activities produce significant levels (both number and mass) of airborne particles, indicating a need to develop appropriate regulations for the control of occupational exposure of operatives undertaking building refurbishment.

  16. Dynamic magnetization models for soft ferromagnetic materials with coarse and fine domain structures

    Energy Technology Data Exchange (ETDEWEB)

    Zirka, S.E., E-mail: zirka@email.dp.ua [Department of Physics and Technology, Dnepropetrovsk National University, Gagarin 72, 49050 Dnepropetrovsk (Ukraine); Moroz, Y.I. [Department of Physics and Technology, Dnepropetrovsk National University, Gagarin 72, 49050 Dnepropetrovsk (Ukraine); Steentjes, S.; Hameyer, K. [Institute of Electrical Machines, RWTH Aachen University, Schinkelstr. 4, 52056 Aachen (Germany); Chwastek, K. [Faculty of Electrical Engineering, Czestochowa University of Technology, al. AK 17, 42-201 Czestochowa (Poland); Zurek, S. [Megger Instruments Ltd., Archcliffe Road, Dover, Kent, CT17 9EN (United Kingdom); Harrison, R.G. [Department of Electronics, Carleton University, Ottawa, Canada K1S 5B6 (Canada)

    2015-11-15

    We consider dynamic models, both numerical and analytical, that reproduce the magnetization field H(B) and the energy loss in ferromagnetic sheet materials with different domain structures. Conventional non-oriented (NO) and grain-oriented (GO) electrical steels are chosen as typical representatives of fine-domain and coarse-domain materials. The commonly-accepted loss separation procedures in these materials are critically analyzed. The use of a well-known simplified (“classical”) expression for the eddy-current loss is identified as the primary source of mistaken evaluations of excess loss in NO steel, in which the loss components can only be evaluated using the Maxwell (penetration) equation. The situation is quite different in GO steel, in which the loss separation is uncertain, but the total dynamic loss is several times higher than that explained by any version (numerical or analytical) of the classical approach. To illustrate the uncertainty of the loss separation in GO steel, we show that the magnetization field, and thus the total loss, in this material can be represented with equal accuracy using either the existing three-component approach or our proposed two-component technique, which makes no distinction between classical eddy-current and excess fields and losses. - Highlights: • Critical analysis of a ferromagnetic-material loss-separation principle. • This is to warn materials-science engineers about the inaccuracies resulting from this principle. • A transient model having a single dynamic component is proposed.

  17. Carbonaceous material in fine particulate matter (PM10) of urban areas

    International Nuclear Information System (INIS)

    Brocco, Domenico; Leonardi, Vittorio; Maso; Marco; Prignani, Patrizia

    2006-01-01

    Total carbon (TC), elemental carbon (EC) and organic carbon (OC) in the fine particulate matter (PM10) were measured in the urban areas of Rome and Marino (Castelli Romani) by means a thermal method with a non-dispersive infrared detector (NDIR). The results showed that carbonaceous material constitutes 30-40% of the total aerosols in Rome and about 20% in Marino [it

  18. Microscopic and microprobe analysis of fine roots in healthy and declining spruce (Picea abies (L. ) Karst. ) from different sites

    Energy Technology Data Exchange (ETDEWEB)

    Stienen, H; Bauch, J; Barckhausen, R; Schaub, H

    1984-09-01

    In order to contribute to the identification of primary causes of the spruce decline - evident in many regions of the Federal Republic of Germany - fine roots of 30 trees from altogether 14 healthy and damage forest locations were investigated microscopically, anatomically, histometrically and by cellular microprobe analysis. In addition, fine roots of young plants grown in hydroponic cultures at different pH levels and Al input were studied. Fine roots of declining trees developed cortex cells with a reduced diameter and at the same time thicker cell walls; in addition accessory compounds were accumulated in this presumably protective tissue. Tannins were deposited in the parenchyma of the vascular cylinder of fine roots from declining trees, and many pit membranes of the primary xylem often did not differentiate fully. The X-ray energy-dispersive analysis of individual cells revealed, in particular, an insufficient uptake of Ca and Mg in the fine roots of declining trees. Compared with healthy trees, the concentration of aluminium increased in the cortex of the fine roots; this, in turn, had an antagonistic effect on the uptake of Ca and Mg. Moreover, the concentration of iron and sulphur increased in the fine roots of declining trees. This evidence of alterations and damages in the fine roots of damaged spruce indicates that, besides the direct detrimental impact on the needles through the atmosphere serious damage is inflicted also indirectly through the soil.

  19. Ultrasound guided percutaneous fine needle aspiration biopsy ...

    African Journals Online (AJOL)

    )-guided percutaneous fine needle aspiration biopsy (PFNAB)/US-guided percutaneous needle core biopsy (PNCB) of abdominal lesions is efficacious in diagnosis, is helpful in treatment choice, to evaluate whether various other investigations ...

  20. Immobilization of Rocky Flats Graphite Fines Residue

    International Nuclear Information System (INIS)

    Rudisill, T.S.

    1999-01-01

    The development of the immobilization process for graphite fines has proceeded through a series of experimental programs. The experimental procedures and results from each series of experiments are discussed in this report

  1. Fine needle aspiration cytology of cervicofacial actinomycosis

    Directory of Open Access Journals (Sweden)

    Venkatesh Kusuma

    2008-01-01

    Full Text Available Actinomycosis is a chronic infection caused by Actinomyces israelii, usually seen in immunocompromised patients or in the background of tissue injury. Cervicofacial actinomycosis presenting as a fixed jaw swelling in an elderly individual can mimic malignancy and pose a diagnostic dilemma. We report here a case of cervicofacial actinomycosis diagnosed by fine needle aspiration, along with a review of the relevant literature. A 60 year-old man presented with a gradually increasing 6 x 5 cm swelling in the left side of his jaw. The swelling was fixed, without any apparent sinus or abscess. Fine needle aspiration was diagnostic as it revealed colonies of actinomyces surrounded by polymorphs and chronic inflammatory cells. The histopathological study of the excised specimen confirmed the cytological findings. Fine needle aspiration is an effective tool in the diagnosis of actinomycosis although its documentation is rare. Difficulties in the management can be avoided by early diagnosis using the fine needle aspiration technique.

  2. The Execution of Criminal Fine Penalty

    Directory of Open Access Journals (Sweden)

    Cosmin Peneoașu

    2014-05-01

    Full Text Available This paper aims at dissecting the criminal provisions on criminal enforcement of fines in current Romanian criminal law with the goal of highlighting the new penal policy stated in the larger field of criminal penalties. In the new Criminal Code the fine penalty experience a new regulation, but also a wider scope compared to the Criminal Code from 1968, with an exponential growth of the number of offenses or variations of them, for which a fine may be imposed as a unique punishment, but, especially, as an alternative punishment to imprisonment. Consequently, to ensure the efficiency of this punishment, the effective enforcement manner of the fine takes a new dimension. The study aims both students and academics or practitioners in the making. Furthermore, throughout the approach of this scientific research, new matters that new criminal legislation brings, are emphasized regarding this institution, both in a positive, and especially under a critical manner.

  3. Fine 5 Eesti tantsuväljal / Iiris Viirpalu

    Index Scriptorium Estoniae

    Viirpalu, Iiris, 1992-

    2017-01-01

    Nüüdistantsuteatril Fine 5 täitub tänavu 25. tegutsemisaasta. Fine 5 käekirjast. Vestlusest Fine 5 tantsuteatri ja -kooli kauaaegsete kunstiliste juhtide Renee Nõmmiku ja Tiina Olleskiga Eesti tantsukunstist

  4. Fine topology and locally Minkowskian manifolds

    Science.gov (United States)

    Agrawal, Gunjan; Sinha, Soami Pyari

    2018-05-01

    Fine topology is one of the several well-known topologies of physical and mathematical relevance. In the present paper, it is obtained that the nonempty open sets of different dimensional Minkowski spaces with the fine topology are not homeomorphic. This leads to the introduction of a new class of manifolds. It turns out that the technique developed here is also applicable to some other topologies, namely, the s-topology, space topology, f-topology, and A-topology.

  5. Fine sediment erodibility in Lake Okeechobee, Florida

    OpenAIRE

    Mehta, Ashish J.; Hwang, Kyu-Nam

    1989-01-01

    The critical need to predict the turbidity in water due to fine-grained sediment suspension under wave action over mud deposits for sedimentation and erosion studies, as well as sorbed contaminant transport, is well known. Since fall velocities of fine sediment particles are very small, they can be easily transported by hydrodynamic flows such as waves and currents. The presence of these particles in the water column affects accoustic transmission, heat absorption and depth of ...

  6. Revisiting fine-tuning in the MSSM

    Energy Technology Data Exchange (ETDEWEB)

    Ross, Graham G. [Rudolf Peierls Centre for Theoretical Physics, University of Oxford, 1 Keble Road, Oxford OX1 3NP (United Kingdom); Schmidt-Hoberg, Kai [DESY, Notkestraße 85, D-22607 Hamburg (Germany); Staub, Florian [Institute for Theoretical Physics (ITP), Karlsruhe Institute of Technology, Engesserstraße 7, D-76128 Karlsruhe (Germany); Institute for Nuclear Physics (IKP), Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, D-76344 Eggenstein-Leopoldshafen (Germany)

    2017-03-06

    We evaluate the amount of fine-tuning in constrained versions of the minimal supersymmetric standard model (MSSM), with different boundary conditions at the GUT scale. Specifically we study the fully constrained version as well as the cases of non-universal Higgs and gaugino masses. We allow for the presence of additional non-holomorphic soft-terms which we show further relax the fine-tuning. Of particular importance is the possibility of a Higgsino mass term and we discuss possible origins for such a term in UV complete models. We point out that loop corrections typically lead to a reduction in the fine-tuning by a factor of about two compared to the estimate at tree-level, which has been overlooked in many recent works. Taking these loop corrections into account, we discuss the impact of current limits from SUSY searches and dark matter on the fine-tuning. Contrary to common lore, we find that the MSSM fine-tuning can be as small as 10 while remaining consistent with all experimental constraints. If, in addition, the dark matter abundance is fully explained by the neutralino LSP, the fine-tuning can still be as low as ∼20 in the presence of additional non-holomorphic soft-terms. We also discuss future prospects of these models and find that the MSSM will remain natural even in the case of a non-discovery in the foreseeable future.

  7. Revisiting fine-tuning in the MSSM

    Energy Technology Data Exchange (ETDEWEB)

    Ross, Graham G. [Oxford Univ. (United Kingdom). Rudolf Peierls Centre for Theoretical Physics; Schmidt-Hoberg, Kai [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); Staub, Florian [Karlsruher Institut fuer Technologie (KIT), Karlsruhe (Germany). Inst. fuer Theoretische Physik; Karlsruher Institut fuer Technologie (KIT), Eggenstein-Leopoldshafen (Germany). Inst. fuer Experimentelle Kernphysik

    2017-03-15

    We evaluate the amount of fine-tuning in constrained versions of the minimal supersymmetric standard model (MSSM), with different boundary conditions at the GUT scale. Specifically we study the fully constrained version as well as the cases of non-universal Higgs and gaugino masses. We allow for the presence of additional non-holomorphic soft-terms which we show further relax the fine-tuning. Of particular importance is the possibility of a Higgsino mass term and we discuss possible origins for such a term in UV complete models. We point out that loop corrections typically lead to a reduction in the fine-tuning by a factor of about two compared to the estimate at tree-level, which has been overlooked in many recent works. Taking these loop corrections into account, we discuss the impact of current limits from SUSY searches and dark matter on the fine-tuning. Contrary to common lore, we find that the MSSM fine-tuning can be as small as 10 while remaining consistent with all experimental constraints. If, in addition, the dark matter abundance is fully explained by the neutralino LSP, the fine-tuning can still be as low as ∝20 in the presence of additional non-holomorphic soft-terms. We also discuss future prospects of these models and find that the MSSM will remain natural even in the case of a non-discovery in the foreseeable future.

  8. Pelletization of fine coals. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Sastry, K.V.S.

    1995-12-31

    Coal is one of the most abundant energy resources in the US with nearly 800 million tons of it being mined annually. Process and environmental demands for low-ash, low-sulfur coals and economic constraints for high productivity are leading the coal industry to use such modern mining methods as longwall mining and such newer coal processing techniques as froth flotation, oil agglomeration, chemical cleaning and synthetic fuel production. All these processes are faced with one common problem area--fine coals. Dealing effectively with these fine coals during handling, storage, transportation, and/or processing continues to be a challenge facing the industry. Agglomeration by the unit operation of pelletization consists of tumbling moist fines in drums or discs. Past experimental work and limited commercial practice have shown that pelletization can alleviate the problems associated with fine coals. However, it was recognized that there exists a serious need for delineating the fundamental principles of fine coal pelletization. Accordingly, a research program has been carried involving four specific topics: (i) experimental investigation of coal pelletization kinetics, (ii) understanding the surface principles of coal pelletization, (iii) modeling of coal pelletization processes, and (iv) simulation of fine coal pelletization circuits. This report summarizes the major findings and provides relevant details of the research effort.

  9. Factors predisposing nursing home resident to inappropriate transfer to emergency department. The FINE study protocol

    Directory of Open Access Journals (Sweden)

    Amélie Perrin

    2017-09-01

    Full Text Available Background: Each year, around one out of two nursing home (NH residents are hospitalized in France, and about half to the emergency department (ED. These transfers are frequently inappropriate. This paper describes the protocol of the FINE study. The first aim of this study is to identify the factors associated with inappropriate transfers to ED. Methods/design: FINE is a case-control observational study. Sixteen hospitals participate. Inclusion period lasts 7 days per season in each center for a total period of inclusion of one year. All the NH residents admitted in ED during these periods are included. Data are collected in 4 times: before transfer in the NH, at the ED, in hospital wards in case of patient's hospitalization and at the patient's return to NH. The appropriateness of ED transfers (i.e. case versus control NH residents is determined by a multidisciplinary team of experts. Results: Our primary objective is to determine the factors predisposing NH residents to inappropriate transfer to ED. Our secondary objectives are to assess the cost of the transfers to ED; study the evolution of NH residents' functional status and the psychotropic and inappropriate drugs prescription between before and after the transfer; calculate the prevalence of potentially avoidable transfers to ED; and identify the factors predisposing NH residents to potentially avoidable transfer to ED. Discussion: A better understanding of the determinant factors of inappropriate transfers to ED of NH residents may lead to proposals of recommendations of better practice in NH and would allow implementing quality improvement programs in the health organization. Keywords: Inappropriate transfer, Nursing home resident, Emergency department transfer, Potentially avoidable transfer, Appropriateness of transfer, Inappropriate hospitalization

  10. A New Type of Non-Mechanical Valves for Recirculation of Fine Particles

    DEFF Research Database (Denmark)

    Azizaddini, Seyednezamaddin

    of the thesis is to design a new version of a non-mechanical valve for transportation of the particles and closing the loop in circulating or interconnected fluidized bed systems. As the primary proposal, combination of three assistive methods (tapered fluidized bed, mixture of coarse and fine particles...

  11. Fine motor deficiencies in children diagnosed as DCD based on poor grapho-motor ability

    NARCIS (Netherlands)

    Smits-Engelsman, BCM; Niemeijer, AS; van Galen, GP

    A sample of 125 children from grades 4 and 5 of two normal Dutch primary schools were investigated regarding the incidence of handwriting problems and other fine motor disabilities. Handwriting quality was assessed with the concise assessment method for children's handwriting (BHK) and the school

  12. A technique to improve diagnostic information from fine-needle aspirations: immunohistochemistry on cytoscrape

    DEFF Research Database (Denmark)

    Skov, Birgit Guldhammer; Kiss, Katalin; Ramsted, Julie

    2009-01-01

    BACKGROUND: Cytologic examination of fine-needle aspiration (FNA) material is being used increasingly for the diagnosis of pulmonary lesions. Accurate distinction between nonsmall cell lung cancer (NSCLC), including subgroups, and small cell lung cancer and between primary lung cancer and metasta...

  13. Mechanical Properties of High Strength Concrete Containing Coal Bottom Ash and Oil-Palm Boiler Clinker as Fine Aggregates

    Directory of Open Access Journals (Sweden)

    Soofinajafi Mahmood

    2016-01-01

    Full Text Available This research aims to utilize Coal Furnace Bottom ash (CBA and Oil-Palm Boiler Clinker (OPBC as fine aggregate in concrete mix proportions. They are solid wastes from power plant and Oil Palm industry, respectively. Since these by-products do not have any primary use and are pure waste, an opportunity to use them as aggregate in concrete industry not only is economical but also will be an environmental friendly opportunity leading towards a more sustainable production chain. CBA and OPBC sands had similar grading to normal sand but have lower density and higher water absorption. In a high strength concrete, normal sand was replaced up to 25% with either CBA or OPBC. Test results showed that although water absorption of these wastes was more than normal sand but the slump value of concrete containing each of these wastes showed that these concretes had good workability. All mixes containing these wastes had slightly lower compressive strength at early ages and equivalent or higher compressive strength at later ages compared to control mix. The 28-day compressive strength of these concretes was in the range of 69–76 MPa which can be categorized as high strength concrete. In general, the performance of OPBC was better than CBA at 25% replacement level. However, it is recommended that at least 12.5% of total volume of fine aggregate in a high strength concrete is used of CBA or OPBC.

  14. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael

    2015-01-01

    OBJECTIVE: The objective of the study was to compare long-term results of subtotal vs total abdominal hysterectomy for benign uterine diseases 14 years after hysterectomy, with urinary incontinence as the primary outcome measure. STUDY DESIGN: This was a long-term follow-up of a multicenter......, randomized clinical trial without blinding. Eleven gynecological departments in Denmark contributed participants to the trial. Women referred for benign uterine diseases who did not have contraindications to subtotal abdominal hysterectomy were randomized to subtotal (n = 161) vs total (n = 158) abdominal...... from discharge summaries from all public hospitals in Denmark. The results were analyzed as intention to treat and per protocol. Possible bias caused by missing data was handled by multiple imputation. The primary outcome was urinary incontinence; the secondary outcomes were pelvic organ prolapse...

  15. Fine-root mortality rates in a temperate forest: Estimates using radiocarbon data and numerical modeling

    Energy Technology Data Exchange (ETDEWEB)

    Riley, W.J.; Gaudinski, J.B.; Torn, M.S.; Joslin, J.D.; Hanson, P.J.

    2009-09-01

    We used an inadvertent whole-ecosystem {sup 14}C label at a temperate forest in Oak Ridge, Tennessee, USA to develop a model (Radix1.0) of fine-root dynamics. Radix simulates two live-root pools, two dead-root pools, non-normally distributed root mortality turnover times, a stored carbon (C) pool, and seasonal growth and respiration patterns. We applied Radix to analyze measurements from two root size classes (< 0.5 and 0.5-2.0 mm diameter) and three soil-depth increments (O horizon, 0-15 cm and 30-60 cm). Predicted live-root turnover times were < 1 yr and 10 yr for short- and long-lived pools, respectively. Dead-root pools had decomposition turnover times of 2 yr and 10 yr. Realistic characterization of C flows through fine roots requires a model with two live fine-root populations, two dead fine-root pools, and root respiration. These are the first fine-root turnover time estimates that take into account respiration, storage, seasonal growth patterns, and non-normal turnover time distributions. The presence of a root population with decadal turnover times implies a lower amount of belowground net primary production used to grow fine-root tissue than is currently predicted by models with a single annual turnover pool.

  16. Towards gloss control in fine art reproduction

    Science.gov (United States)

    Baar, Teun; Brettel, Hans; Ortiz Segovia, Maria V.

    2015-03-01

    The studies regarding fine art reproduction mainly focus on the accuracy of colour and the recreation of surface texture properties. Since reflection properties other than colour are neglected, important details of the artwork are lost. For instance, gloss properties, often characteristic to painters and particular movements in the history of art, are not well reproduced. The inadequate reproduction of the different gloss levels of a piece of fine art leads to a specular reflection mismatch in printed copies with respect to the original works that affects the perceptual quality of the printout. We used different print parameters of a 3D high resolution printing setup to control the gloss level on a printout locally. Our method can be used to control gloss automatically and in crucial applications such as fine art reproduction.

  17. New methods and standards for fine dust

    International Nuclear Information System (INIS)

    Spielvogel, Juergen; Hartstock, Stefan; Grimm, Hans

    2009-01-01

    There seems to be common agreement that PM10 is a suboptimal quantity for the quantification of potential dangers from fine dust due to a number of reasons, notably because the chemical composition of the particles is not considered, because the size distribution is disregarded, and because of sampling artefacts. In a first step for improving the particle measurements, the European Community has published new directives for ambient air in June 2008 (EU 2008), which as a main part included new regulations for PM2.5 measurements, in addition to the further on valid regulations for PM10. The comparison of PM2.5 and PM10 may allow a source apportionment and a better assessment of the influence of fine dust on human health. The source apportionment may allow more effective fine dust reduction strategies.

  18. Edge separation using diffraction anomalous fine structure

    International Nuclear Information System (INIS)

    Ravel, B.; Bouldin, C.E.; Renevier, H.; Hodeau, J.L.; Berar, J.F.

    1999-01-01

    We exploit the crystallographic sensitivity of the Diffraction Anomalous Fine-Structure (DAFS) measurement to separate the fine structure contributions of different atomic species with closely spaced resonant energies. In BaTiO 3 the Ti K edge and Ba Lm edges are separated by 281 eV, or about 8.2 Angstrom -1 ), thus severely limiting the information content of the Ti K edge signal. Using the site selectivity of DAFS we can separate the two fine structure spectra using an iterative Kramers-Kronig method, thus extending the range of the Ti K edge spectrum. This technique has application to many rare earth/transition metal compounds, including many magnetic materials of technological significance for which K and L edges overlap in energy. (au)

  19. Primary chondrosarcoma of breast - cytology with histopathological correlation: A rare case report with review of literature

    Directory of Open Access Journals (Sweden)

    Sankappa P. Sinhasan

    2014-01-01

    Full Text Available Malignant mesenchymal tumors of the breast other than angiosarcoma are extremely rare and comprise <0.5% of breast tumors. Primary chondrosarcoma of the breast is an extremely rare entity and only 10 cases are reported as single case reports in literature until date. A diagnosis of primary mammary sarcoma can be established only after excluding metaplastic carcinomas and malignant phyllodes by extensive sampling for evidence of in situ or invasive carcinoma. Here, we report a primary chondrosarcoma of breast in a 55-year-old lady diagnosed precisely on fine-needle aspiration cytology and confirmed by histopatholigcal examination after total mastectomy. We emphasize on diagnostic difficulties encountered in cytology smears and discuss differential diagnoses.

  20. Occurrence of organic pollutants in recovered soil fines from construction and demolition waste.

    Science.gov (United States)

    Jang, Y C; Townsend, T G

    2001-01-01

    The objective of this study was to characterize recovered soil fines from construction and demolition (C&D) waste recycling facilities for trace organic pollutants. Over a period of 18 months, five sampling trips were made to 14 C&D waste recycling facilities in Florida. Screened soil fines were collected from older stockpiles and newly generated piles at the sites. The samples were analyzed for the total concentration (mg/kg) of a series of volatile organic compound (VOCs) and semi-volatile organic compounds (semi-VOCs). The synthetic precipitation leaching procedure (SPLP) test was also performed to evaluate the leachability of the trace organic chemicals. During the total analysis only a few volatile organic compounds were commonly found in the samples (trichlorofluoromethane, toluene, 4-isopropyltoluene, trimethylbenzene, xylenes, and methylene chloride). A total of nine VOCs were detected in the leaching test. Toluene showed the highest leachability among the compounds (61.3-92.0%), while trichlorofluoromethane, the most commonly detected compound from both the total and leaching tests, resulted in the lowest leachability (1.4-39.9%). For the semi-VOC analysis, three base-neutral semi-VOC compounds (bis(2-ethylhexyl)phthalate, butyl benzyl phthalate, and di-n-butyl phthalate) and several PAHs (acenaphthene, pyrene, fluoranthene, and phenanthrene) were commonly detected in C&D fines samples. These compounds also leached during the SPLP leaching test (0.1-25%). No acid extractable compounds, pesticides, or PCBs were detected. The results of this study were further investigated to assess risk from land applied recovered soil fines by comparing total and leaching concentrations of recovered soil fines samples to risk-based standards. The results of this indicate that the organic chemicals in recovered soil fines from C&D debris recycling facilities were not of a major concern in terms of human risk and leaching risk to groundwater under reuse and contact scenarios.

  1. Picobubble enhanced column flotation of fine coal

    Energy Technology Data Exchange (ETDEWEB)

    Tao, D.; Yu, S.; Parekh, B.K. [University of Kentucky, Lexington, KY (United States). Mining Engineering

    2006-07-01

    The purpose is to study the effectiveness of picobubbles in the column flotation of -28 mesh fine coal particles. A flotation column with a picobubble generator was developed and tested for enhancing the recovery of ultrafine coal particles. The picobubble generator was designed using the hydrodynamic cavitation principle. A metallurgical and a steam coal were tested in the apparatus. The results show that the use of picobubbles in a 2in. flotation column increased the recovery of fine coal by 10 to 30%. The recovery rate varied with feed rate, collector dosage, and other column conditions. 40 refs., 8 figs., 2 tabs.

  2. Study of fine structure of deformed hafnium

    International Nuclear Information System (INIS)

    Voskresenskaya, L.A.; Petukhova, A.S.; Kovalev, K.S.

    1978-01-01

    Variations in the hafnium fine structure following the cold plastic deformation have been studied. The fine structure condition has been studied through the harmonic analysis of the profile of the X-ray diffraction line, obtained at the DRON-I installation. Received has been the dependence of the crystal lattice microdistortions value on the deformation extent for hafnium. This dependence is compared with the corresponding one for zirconium. It is found out that at all the deformations the microdistortion distribution is uniform. The microdistortion value grows with the increase in the compression. During the mechanical impact higher microdistortions of the crystal lattice occur in the hafnium rather than in zirconium

  3. Chemical characteristics and source apportionment of fine particulate organic carbon in Hong Kong during high particulate matter episodes in winter 2003

    Science.gov (United States)

    Li, Yun-Chun; Yu, Jian Zhen; Ho, Steven Sai Hang; Schauer, James J.; Yuan, Zibing; Lau, Alexis K. H.; Louie, Peter K. K.

    2013-02-01

    PM2.5 samples were collected at six general stations and one roadside station in Hong Kong in two periods of high particulate matter (PM) in 2003 (27 October-4 November and 30 November-13 December). The highest PM2.5 reached 216 μg m- 3 during the first high PM period and 113 μg m- 3 during the second high PM period. Analysis of synoptic weather conditions identified individual sampling days under dominant influence of one of three types of air masses, that is, local, regional and long-range transported (LRT) air masses. Roadside samples were discussed separately due to heavy influences from vehicular emissions. This research examines source apportionment of fine organic carbon (OC) and contribution of secondary organic aerosol on high PM days under different synoptic conditions. Six primary OC (POC) sources (vehicle exhaust, biomass burning, cooking, cigarette smoke, vegetative detritus, and coal combustion) were identified on the basis of characteristic organic tracers. Individual POC source contributions were estimated using chemical mass balance model. In the roadside and the local samples, OC was dominated by the primary sources, accounting for more than 74% of OC. In the samples influenced by regional and LRT air masses, secondary OC (SOC), which was approximated to be the difference between the total measured OC and the apportioned POC, contributed more than 54% of fine OC. SOC was highly correlated with water-soluble organic carbon and sulfate, consistent with its secondary nature.

  4. Primary explosives

    Energy Technology Data Exchange (ETDEWEB)

    Matyas, Robert; Pachman, Jiri [Pardubice Univ. (Czech Republic). Faculty of Chemical Technology

    2013-06-01

    The first chapter provides background such as the basics of initiation and differences between requirements on primary explosives used in detonators and igniters. The authors then clarify the influence of physical characteristics on explosive properties, focusing on those properties required for primary explosives. Furthermore, the issue of sensitivity is discussed. All the chapters on particular groups of primary explosives are structured in the same way, including introduction, physical and chemical properties, explosive properties, preparation and documented use.

  5. Primary fibromyalgia

    DEFF Research Database (Denmark)

    Jacobsen, S; Jensen, L T; Foldager, M

    1990-01-01

    Serum concentrations of procollagen type III aminoterminal peptide have previously been reported to be low in some patients with primary fibromyalgia and the aim of this study was to determine if such patients differ clinically from primary fibromyalgia patients with normal levels of procollagen...... type III aminoterminal peptide. Subjective symptoms, tender points and dynamic muscle strength in 45 women with primary fibromyalgia were related to serum concentrations of procollagen type III aminoterminal peptide. Patients with low serum concentrations of procollagen type III aminoterminal peptide...... concentrations of procollagen type III aminoterminal peptide of primary fibromyalgia patients are connected to the disease impact....

  6. IQ discrepancy differentiates levels of fine motor skills and their relationship in children with autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Yu TY

    2018-02-01

    Full Text Available Tzu-Ying Yu,1 Willy Chou,2,3 Julie Chi Chow,4 Chien-Ho Lin,5 Li-Chen Tung,2,6 Kuan-Lin Chen7,8 1Department of Occupational Therapy, College of Medicine, I-Shou University, Kaohsiung, 2Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, 3Department of Recreation and Health Care Management, Cha Nan University of Pharmacy and Science, 4Department of Pediatrics, 5Department of Psychiatry, Chi Mei Medical Center, Tainan, 6Department of Physical Medicine and Rehabilitation, Da Chien General Hospital, Miaoli, 7Department of Occupational Therapy, College of Medicine, National Cheng Kung University, 8Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, Tainan, Taiwan Purpose: We investigated 1 the impact of differences in intelligence quotient discrepancy (IQD on motor skills of preschool-aged children with autism spectrum disorders (ASD; 2 the relationships between IQD and motor skills in preschool-aged children with ASD. Methods: A total of 127 ASD preschool-aged children were divided into three groups according to the size of the IQD: IQD within 1 standard deviation (1SD; EVENIQ; n=81, discrepantly higher verbal intelligence quotient (VIQ; n=22; VIQ>performance intelligence quotient [PIQ] above 1SD [≥15 points], and discrepantly higher PIQ (n=24; PIQ>VIQ above 1SD [≥15 points]. Children’s IQD and motor skills were determined with the Wechsler Preschool and Primary Scale of Intelligence™ – Fourth Edition and the motor subtests of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT, respectively. Results: One-way analysis of variance revealed significant group differences for the fine motor domain of the CDIIT and the visual–motor coordination subtest (F=3.37–4.38, p<0.05. Children with discrepantly higher PIQ were associated with better fine motor skills than were children with even IQD and those with discrepantly higher VIQ, and vice versa. IQD (PIQ

  7. Pulsed high energy synthesis of fine metal powders

    Science.gov (United States)

    Witherspoon, F. Douglas (Inventor); Massey, Dennis W. (Inventor)

    1999-01-01

    Repetitively pulsed plasma jets generated by a capillary arc discharge at high stagnation pressure (>15,000 psi) and high temperature (>10,000 K) are utilized to produce 0.1-10 .mu.m sized metal powders and decrease cost of production. The plasma jets impact and atomize melt materials to form the fine powders. The melt can originate from a conventional melt stream or from a pulsed arc between two electrodes. Gas streams used in conventional gas atomization are replaced with much higher momentum flux plasma jets. Delivering strong incident shocks aids in primary disintegration of the molten material. A series of short duration, high pressure plasma pulses fragment the molten material. The pulses introduce sharp velocity gradients in the molten material which disintegrates into fine particles. The plasma pulses have peak pressures of approximately one kilobar. The high pressures improve the efficiency of disintegration. High gas flow velocities and pressures are achieved without reduction in gas density. Repetitively pulsed plasma jets will produce powders with lower mean size and narrower size distribution than conventional atomization techniques.

  8. Fine filament NbTi superconductive composite

    International Nuclear Information System (INIS)

    Hong, S.; Grabinsky, G.; Marancik, W.; Pattanayak, D.

    1986-01-01

    The large superconducting magnet for the high energy physics accelerator requires fine filament composite to minimize the field error due to the persistent current in the filaments. New concepts toward the fine filament composite and its cable fabrication are discussed. Two-stage cables of fine wire with intermediate number of filaments were introduced. The first stage was six wires cables around one and in the second stage this was used to produce a Rutherford cable. The advantage of this process is in the ease of billet fabrication since the number of filaments in a single wire is within the range of easy billet fabrication. The disadvantage is in the cable fabrication. One of the major concerns in the fabrication of fine NbTi filaments composite in a copper matrix is the intermetallic compound formation during the extrusion and heat treatment steps. The hard intermetallic particles degrade the uniformity of the filaments and reduce the critical current density. The process of using Nb barrier between the filaments and copper matrix in order to prevent this CuTi intermetallic particle formation is described

  9. Renal fine structures detected by NMR imaging

    International Nuclear Information System (INIS)

    Zilch, H.G.

    1986-01-01

    A significantly improved image quality is achieved by the technique described, as compared to the magnetic resonance data obtained so far. The detailed analysis of the kidney goes as deep as into anatomic fine structures, and there is reason to hope for far better diagnostic details. (orig.) [de

  10. Looking inside giant resonance fine structure

    International Nuclear Information System (INIS)

    Ponomarev, V.Yu.; Voronov, V.V.

    1993-01-01

    Microscopic calculations of the fine structure of giant resonances for spherical nuclei are presented. Excited states are treated by wave function which takes into account coupling of simple one-phonon configurations with more complex ones. Nuclear structure calculations are applied to the description of the γ-decay of resonances into the ground and low-lying excited states. 16 refs.; 4 figs

  11. Extrapulmonary tuberculosis: Fine needle aspiration cytology ...

    African Journals Online (AJOL)

    Patients and Methods: This is a consecutive 9-year analysis of patients with peripheral lymphadenopathy. All the patients had fine needle aspiration. Smears were made, fixed in 95% alcohol and stained with hematoxylin and eosin and Zeihl Neelsen stains. Results: 48 patients, 31 males and 17 females, were analyzed.

  12. Local Alignments for Fine-Grained Categorization

    NARCIS (Netherlands)

    Gavves, E.; Fernando, B.; Snoek, C.G.M.; Smeulders, A.W.M.; Tuytelaars, T.

    2015-01-01

    The aim of this paper is fine-grained categorization without human interaction. Different from prior work, which relies on detectors for specific object parts, we propose to localize distinctive details by roughly aligning the objects using just the overall shape. Then, one may proceed to the

  13. Krypton and xenon in lunar fines

    Science.gov (United States)

    Basford, J. R.; Dragon, J. C.; Pepin, R. O.; Coscio, M. R., Jr.; Murthy, V. R.

    1973-01-01

    Data from grain-size separates, stepwise-heated fractions, and bulk analyses of 20 samples of fines and breccias from five lunar sites are used to define three-isotope and ordinate intercept correlations in an attempt to resolve the lunar heavy rare gas system in a statistically valid approach. Tables of concentrations and isotope compositions are given.

  14. Interaction of fine sediment with alluvial streambeds

    Science.gov (United States)

    Jobson, Harvey E.; Carey, William P.

    1989-01-01

    More knowledge is needed about the physical processes that control the transport of fine sediment moving over an alluvial bed. The knowledge is needed to design rational sampling and monitoring programs that assess the transport and fate of toxic substances in surface waters because the toxics are often associated with silt- and clay-sized particles. This technical note reviews some of the past research in areas that may contribute to an increased understanding of the processes involved. An alluvial streambed can have a large capacity to store fine sediments that are extracted from the flow when instream concentrations are high and it can gradually release fine sediment to the flow when the instream concentrations are low. Several types of storage mechanisms are available depending on the relative size distribution of the suspended load and bed material, as well as the flow hydraulics. Alluvial flow tends to segregate the deposited material according to size and density. Some of the storage locations are temporary, but some can store the fine sediment for very long periods of time.

  15. Derivation of the fine-structure constant

    International Nuclear Information System (INIS)

    Samec, A.

    1980-01-01

    The fine-structure constant is derived as a dynamical property of quantum electrodynamics. Single-particle solutions of the coupled Maxwell and Dirac equations have a physical charge spectrum. The solutions are used to construct lepton-and quark-like particles. The strong, weak, electromagnetic, and gravitational forces are described as the interactions of complex charges in multiple combinations

  16. Micro Fine Sized Palm Oil Fuel Ash Produced Using a Wind Tunnel Production System

    Directory of Open Access Journals (Sweden)

    R. Ahmadi

    2016-01-01

    Full Text Available Micro fine sized palm oil fuel ash (POFA is a new supplementary cementitious material that can increase the strength, durability, and workability of concrete. However, production of this material incurs high cost and is not practical for the construction industry. This paper investigates a simple methodology of producing micro fine sized POFA by means of a laboratory scale wind tunnel system. The raw POFA obtained from an oil palm factory is first calcined to remove carbon residue and then grinded in Los Angeles abrasion machine. The grinded POFA is then blown in the fabricated wind tunnel system for separation into different ranges of particle sizes. The physical, morphological, and chemical properties of the micro fine sized POFA were then investigated using Laser Particle Size Analyser (PSA, nitrogen sorption, and Scanning Electron Microscopy with Energy Dispersive X-Ray (SEM-EDX. A total of 32.1% micro fine sized POFA were collected from each sample blown, with the size range of 1–10 micrometers. The devised laboratory scale of wind tunnel production system is successful in producing micro fine sized POFA and, with modifications, this system is envisaged applicable to be used to commercialize micro fine sized POFA production for the construction industry.

  17. Heavy metal accumulation and phytostabilisation potential of tree fine roots in a contaminated soil

    International Nuclear Information System (INIS)

    Brunner, Ivano; Luster, Joerg; Guenthardt-Goerg, Madeleine S.; Frey, Beat

    2008-01-01

    Root systems of Norway spruce (Picea abies) and poplar (Populus tremula) were long-term exposed to metal-contaminated soils in open-top chambers to investigate the accumulation of the heavy metals in the fine roots and to assess the plants suitability for phytostabilisation. The heavy metals from the contaminated soil accumulated in the fine roots about 10-20 times more than in the controls. The capacity to bind heavy metals already reached its maximum after the first vegetation period. Fine roots of spruce tend to accumulate more heavy metals than poplar. Copper and Zinc were mainly detected in the cell walls with larger values in the epidermis than in the cortex. The heavy metals accumulated in the fine roots made up 0.03-0.2% of the total amount in the soils. We conclude that tree fine roots adapt well to conditions with heavy metal contamination, but their phytostabilisation capabilities seem to be very low. - Long-term exposed fine roots of trees are well adapted to soils with high heavy metal contents, but their phytostabilisation capabilities are rather low

  18. The aggregation efficiency of very fine volcanic ash

    Science.gov (United States)

    Del Bello, E.; Taddeucci, J.; Scarlato, P.

    2013-12-01

    Explosive volcanic eruptions can discharge large amounts of very small sized pyroclasts (under 0.090 mm) into the atmosphere that may cause problems to people, infrastructures and environment. The transport and deposition of fine ash are ruled by aggregation that causes premature settling of fine ash and, as consequence, significantly reduces the concentration of airborne material over long distances. Parameterizing the aggregation potential of fine ash is then needed to provide accurate modelling of ash transport and deposition from volcanic plumes. Here we present the first results of laboratory experiments investigating the aggregation efficiency of very fine volcanic particles. Previous laboratory experiments have shown that collision kinetic and relative humidity provide the strongest effect on aggregation behaviour but were only limited to particles with size > 0.125 mm. In our work, we focus on natural volcanic ash at ambient humidity with particles size aggregation potential. Two types of ash were used in our experiments: fresh ash, collected during fall-out from a recent plume-forming eruption at Sakurajima (Japan -July 2013) and old ash, collected from fall-out tephra deposits at Campi Flegrei (Italy, ca. 10 ka), to account for the different chemical composition and morphoscopic effects of altered ash on aggregation efficiency. Total samples were hand sieved to obtain three classes with unimodal grain size distributions (sieved from the top of a transparent tank where a fan, placed at the bottom, allows turbulent dispersion of particles. Collision and sticking of particles on a vertical glass slide were filmed with a high speed cameras at 6000 fps. Our lenses arrangement provide high image resolution allowing to capture particles down to 0.005 mm in diameter. Video sequences of particles motion and collision were then processed with image analysis and particle tracking tools to determine i) the particle number density and ii) the grain size distribution

  19. Total autonomic blockage and primary sinus node dysfunction in a ...

    African Journals Online (AJOL)

    history confirmed the episodic headaches but there was no record of a similar incident. A Caesarean section done in 1996 had been uneventful. She apparently had ... dysfunction, the machine did not have a memory store for subsequent study, and moreover we were unable to confirm this diagnosis, as the hospital had no ...

  20. survival of primary cemented total hip arthroplasties in east africa

    African Journals Online (AJOL)

    2017-09-11

    Sep 11, 2017 ... In addition, patients who had not returned for follow-up in the last 12 months were contacted by phone and/or mail. A wide variety of cemented and non- cemented implants were used. End points of the implant were revision or removal for any reason. Survival was analysed by the use of Kaplan Meir tables.

  1. Fine root production at drained peatland sites

    Energy Technology Data Exchange (ETDEWEB)

    Finer, L [Finnish Forest Research Inst. (Finland). Joensuu Research Station; Laine, J [Helsinki Univ. (Finland). Dept. of Forest Ecology

    1997-12-31

    The preliminary results of the Finnish project `Carbon balance of peatlands and climate change` show that fine roots play an important role in carbon cycling on peat soils. After drainage the roots of mire species are gradually replaced by the roots of trees and other forest species. Pine fine root biomass reaches a maximum level by the time of crown closure, some 20 years after drainage on pine mire. The aim of this study is to compare the results of the sequential coring method and the ingrowth bag method used for estimating fine root production on three drained peatland sites of different fertility. The results are preliminary and continuation to the work done in the study Pine root production on drained peatlands, which is part of the Finnish project `Carbon cycling on peatlands and climate change`. In this study the fine root biomass was greater on the poor site than on the rich sites. Pine fine root production increased with the decrease in fertility. Root turnover and the production of field layer species were greater on the rich sites than on the poor site. The results suggested that the in growth bag method measured more root activity than the magnitude of production. More than two growing seasons would have been needed to balance the root dynamics in the in growth bags with the surrounding soil. That time would probably have been longer on the poor site than on the rich ones and longer for pine and field layer consisting of dwarf shrubs than for field layer consisting of sedge like species and birch. (11 refs.)

  2. Fine root production at drained peatland sites

    Energy Technology Data Exchange (ETDEWEB)

    Finer, L. [Finnish Forest Research Inst. (Finland). Joensuu Research Station; Laine, J. [Helsinki Univ. (Finland). Dept. of Forest Ecology

    1996-12-31

    The preliminary results of the Finnish project `Carbon balance of peatlands and climate change` show that fine roots play an important role in carbon cycling on peat soils. After drainage the roots of mire species are gradually replaced by the roots of trees and other forest species. Pine fine root biomass reaches a maximum level by the time of crown closure, some 20 years after drainage on pine mire. The aim of this study is to compare the results of the sequential coring method and the ingrowth bag method used for estimating fine root production on three drained peatland sites of different fertility. The results are preliminary and continuation to the work done in the study Pine root production on drained peatlands, which is part of the Finnish project `Carbon cycling on peatlands and climate change`. In this study the fine root biomass was greater on the poor site than on the rich sites. Pine fine root production increased with the decrease in fertility. Root turnover and the production of field layer species were greater on the rich sites than on the poor site. The results suggested that the in growth bag method measured more root activity than the magnitude of production. More than two growing seasons would have been needed to balance the root dynamics in the in growth bags with the surrounding soil. That time would probably have been longer on the poor site than on the rich ones and longer for pine and field layer consisting of dwarf shrubs than for field layer consisting of sedge like species and birch. (11 refs.)

  3. Accuracy of Core Needle Biopsy Versus Fine Needle Aspiration Cytology for Diagnosing Salivary Gland Tumors

    Directory of Open Access Journals (Sweden)

    In Hye Song

    2015-03-01

    Full Text Available Background: Core needle biopsy is a relatively new technique used to diagnose salivary gland lesions, and its role in comparison with fine needle aspiration cytology needs to be refined. Methods: We compared the results of 228 ultrasound-guided core needle biopsy and 371 fine needle aspiration procedures performed on major salivary gland tumors with their postoperative histological diagnoses. Results: Core needle biopsy resulted in significantly higher sensitivity and more accurate tumor subtyping, especially for malignant tumors, than fine needle aspiration. No patient developed major complications after core needle biopsy. Conclusions: We recommend ultrasoundguided core needle biopsy as the primary diagnostic tool for the preoperative evaluation of patients with salivary gland lesions, especially when malignancy is suspected.

  4. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  5. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  6. Technique of total thyroidectomy

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    It is essential to define the various surgical procedures that are carried out for carcinoma of the thyroid gland. They are thyroid gland, subtotal lobectomy, total thyroidectomy and near total thyroidectomy

  7. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  8. Fine-scale patterns of vegetation assembly in the monitoring of changes in coastal sand-dune landscapes

    Directory of Open Access Journals (Sweden)

    J. Honrado

    2010-02-01

    Full Text Available Understanding dune ecosystem responses to multi-scale environmental changes can provide the framework for reliable forecasts and cost-efficient protocols for detecting shifts in prevailing coastal dynamics. Based on the hypothesis that stress and disturbance interact as primary community controls in coastal dunes, we studied the fine-scale floristic assembly of foredune vegetation, in its relation to topography, along regional and local environmental gradients in the 200 km long coastline of northern Portugal, encompassing a major biogeographic transition in western Europe. Thirty topographic profiles perpendicular to the shoreline were recorded at ten sites along the regional climate gradient, and vegetation was sampled by recording the frequency of plant species along those profiles. Quantitative topographic attributes of vegetated dune profiles (e.g. length or height exhibited wide variations relatable to differences in prevailing coastal dynamics. Metrics of taxonomic diversity (e.g. total species richness and its additive beta component and of the functional composition of vegetation were highly correlated to attributes of dune topography. Under transgressive dynamics, vegetation profiles have fewer species, increased dominance, lower turnover rates, and lower total vegetation cover. These changes may drive a decrease in structural and functional diversity, with important consequences for resistance, resilience and other ecosystem properties. Moreover, differences in both vegetation assembly (in meta-stable dunes and response to increased disturbance (in eroding dunes between distinct biogeographic contexts highlight a possible decline in facilitation efficiency under extreme physical stress (i.e. under Mediterranean climate and support the significance of functional approaches in the study of local ecosystem responses to disturbance along regional gradients. Our results strongly suggest that assessing fine-scale community assembly can

  9. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  10. Noninvasive carcinoma ex pleomorphic adenoma of the parotid gland: A difficult diagnosis on fine needle aspiration

    Directory of Open Access Journals (Sweden)

    Theresa Scognamiglio

    2015-01-01

    Full Text Available Carcinoma ex pleomorphic adenoma (CXPA is a rare epithelial malignancy that arises from a primary or recurrent pleomorphic adenoma (PA. It may be noninvasive (NI or invasive. NI CXPA is extremely rare. Preoperative diagnosis on fine needle aspiration (FNA of CXPA may be difficult and poses a diagnostic challenge to clinicians and pathologists. Herein, we describe the FNA findings of a case of NI-CXPA. A 69-year-old woman presented with rapid enlargement of a stable parotid mass of 25 years. Cytologically, malignant cells were focally associated with metachromatic fibromyxoid matrix that was homogeneous and dense with a vague fibrillary quality. There were cell groups, papillary-like clusters and single malignant cells. The nuclei were pleomorphic with irregularly dispersed chromatin, and the cytoplasm was ill-defined and granular. Nucleoli were small to inconspicuous. Mitoses and necrosis were not seen. Cytological features were not specific for any type of salivary gland carcinoma. The FNA diagnosis was primary high-grade adenocarcinoma of the parotid gland, not otherwise specified. Facial nerve-sparing total parotidectomy was performed, which histologically showed PA interspersed with ducts and nests composed of pleomorphic atypical nuclei surrounded by extensive hyalinization. Single cells were also noted. No capsular infiltration was seen in the entirely sampled tumor. Immunohistochemistry for Ki-67 showed a higher proliferation rate in the malignant ducts and p63 positive cells focally surrounded some of the malignant ducts. Histological diagnosis was NI-CXPA. Accurate diagnosis is important for proper surgical management; however, the preoperative diagnosis of NI-CXPA is difficult to make on FNA.

  11. Noninvasive carcinoma ex pleomorphic adenoma of the parotid gland: A difficult diagnosis on fine needle aspiration

    Science.gov (United States)

    Scognamiglio, Theresa; Joshi, Rohan; Kuhel, William I.; Tabbara, Sana O.; Rezaei, M. Katayoon; Hoda, Rana S.

    2015-01-01

    Carcinoma ex pleomorphic adenoma (CXPA) is a rare epithelial malignancy that arises from a primary or recurrent pleomorphic adenoma (PA). It may be noninvasive (NI) or invasive. NI CXPA is extremely rare. Preoperative diagnosis on fine needle aspiration (FNA) of CXPA may be difficult and poses a diagnostic challenge to clinicians and pathologists. Herein, we describe the FNA findings of a case of NI-CXPA. A 69-year-old woman presented with rapid enlargement of a stable parotid mass of 25 years. Cytologically, malignant cells were focally associated with metachromatic fibromyxoid matrix that was homogeneous and dense with a vague fibrillary quality. There were cell groups, papillary-like clusters and single malignant cells. The nuclei were pleomorphic with irregularly dispersed chromatin, and the cytoplasm was ill-defined and granular. Nucleoli were small to inconspicuous. Mitoses and necrosis were not seen. Cytological features were not specific for any type of salivary gland carcinoma. The FNA diagnosis was primary high-grade adenocarcinoma of the parotid gland, not otherwise specified. Facial nerve-sparing total parotidectomy was performed, which histologically showed PA interspersed with ducts and nests composed of pleomorphic atypical nuclei surrounded by extensive hyalinization. Single cells were also noted. No capsular infiltration was seen in the entirely sampled tumor. Immunohistochemistry for Ki-67 showed a higher proliferation rate in the malignant ducts and p63 positive cells focally surrounded some of the malignant ducts. Histological diagnosis was NI-CXPA. Accurate diagnosis is important for proper surgical management; however, the preoperative diagnosis of NI-CXPA is difficult to make on FNA. PMID:25972908

  12. Fine particles flotation of the Moatize coal/Mozambique

    Science.gov (United States)

    Castro, Amilton; de Brum, Irineu A. S.

    2017-11-01

    This study was done from a sample of coal mined at the Vale-Mozambique mine, located in Moatize district, Tete Province. The aim of this work is to analyze the reagent system in the flotation of coal fines belonging to the UCB layer. Among coal processing methods, flotation stands out as one of the most important for the concentration of this material, in particular in the treatment of fine particles. The total feed of the Vale-Mozambique processing plant is 8000 tph of coal, where 10% of this feed corresponds to the fine fraction that feeds the flotation circuit. The material used in this study had a particle size of 96% smaller than 0.25 mm. The reagents used in the flotation tests were Betacol and diesel oil as hydrophobizing agents and MIBC as frother. The range of Betacol concentrations in the first test phase was 200 g / t at 500 g / t, and in the second phase 200 g / t at 500 g / t of diesel oil and MIBC were kept constant at 300 g / t. The immediate analysis followed the Brazilian standards: NBR 8289, NBR 8293, NBR 8290, NBR 8299. The results showed that it is possible, from a feed with the ash content around 22.84%, to obtain products with levels below of 10% ash, with a mass recovery around 50%. The recovery of carbonaceous matter was also evaluated and presented positive results. Complementing this study, the effect of H2O recovery was evaluated and it was observed that for the concentrations of Betacol the recoveries ranged from 6 to 9%, and for diesel oil plus MIBC were 4 to 7%.

  13. Pancreatic metastases from ocular malignant melanoma: the use of endoscopic ultrasound-guided fine-needle aspiration to establish a definitive cytologic diagnosis: a case report

    Directory of Open Access Journals (Sweden)

    Diogo Turiani Hourneaux De Moura

    2016-12-01

    Full Text Available Abstract Background When encountering solid pancreatic lesions, nonpancreatic primary metastases are rare and differentiating a metastasis from a primary neoplastic lesion is challenging. The clinical presentation and radiologic features can be similar and the possibility of a pancreatic metastasis should be considered when the patient refers to a history of a different primary cancer. Endoscopic ultrasound offers a key anatomical advantage in accessing the pancreas and endoscopic ultrasound-guided fine-needle aspiration has become the gold standard method for diagnosing pancreatic lesions. Case presentation A 58-year-old white Hispanic woman with a history of uveal malignant melanoma, presented with abdominal pain and jaundice. On admission, laboratory tests were performed (her total bilirubin was 6.37 mg/dL with a direct fraction of 5.30 mg/dL. Cross-sectional, abdominal computed tomography with contrast, showed a low-attenuating lesion localized in the pancreatic head (measuring 4 × 3 cm and a thinner section of the distal bile duct suspicious for compression. Our patient was scheduled for an endoscopic ultrasound-guided fine-needle aspiration to establish a diagnosis. Endoscopic ultrasound showed a solid, hypoechoic, well-defined lesion with regular contours (measuring 3.17 × 2.61 cm, localized between the head and neck of the pancreas. Endoscopic ultrasound-guided fine-needle aspiration was performed with a 22G needle and cytology confirmed the diagnosis of metastatic melanoma. Our patient subsequently underwent right orbital exenteration, followed by duodenopancreatectomy without complications. At the moment our patient is receiving adjuvant chemotherapy at an outside oncology clinic. Conclusions To the best of our knowledge, this is a very rare presentation of an ocular malignant melanoma with an isolated pancreatic metastasis causing symptomatic biliary obstruction. Endoscopic ultrasound-guided fine-needle aspiration has

  14. Asthma-Related Outcomes in Patients Initiating Extrafine Ciclesonide or Fine-Particle Inhaled Corticosteroids

    Science.gov (United States)

    Postma, Dirkje S.; Dekhuijzen, Richard; van der Molen, Thys; Martin, Richard J.; van Aalderen, Wim; Roche, Nicolas; Guilbert, Theresa W.; Israel, Elliot; van Eickels, Daniela; Khalid, Javaria Mona; Herings, Ron M.C.; Overbeek, Jetty A.; Miglio, Cristiana; Thomas, Victoria; Hutton, Catherine; Hillyer, Elizabeth V.

    2017-01-01

    Purpose Extrafine-particle inhaled corticosteroids (ICS) have greater small airway deposition than standard fine-particle ICS. We sought to compare asthma-related outcomes after patients initiated extrafine-particle ciclesonide or fine-particle ICS (fluticasone propionate or non-extrafine beclomethasone). Methods This historical, matched cohort study included patients aged 12-60 years prescribed their first ICS as ciclesonide or fine-particle ICS. The 2 cohorts were matched 1:1 for key demographic and clinical characteristics over the baseline year. Co-primary endpoints were 1-year severe exacerbation rates, risk-domain asthma control, and overall asthma control; secondary endpoints included therapy change. Results Each cohort included 1,244 patients (median age 45 years; 65% women). Patients in the ciclesonide cohort were comparable to those in the fine-particle ICS cohort apart from higher baseline prevalence of hospitalization, gastroesophageal reflux disease, and rhinitis. Median (interquartile range) prescribed doses of ciclesonide and fine-particle ICS were 160 (160-160) µg/day and 500 (250-500) µg/day, respectively (P<0.001). During the outcome year, patients prescribed ciclesonide experienced lower severe exacerbation rates (adjusted rate ratio [95% CI], 0.69 [0.53-0.89]), and higher odds of risk-domain asthma control (adjusted odds ratio [95% CI], 1.62 [1.27-2.06]) and of overall asthma control (2.08 [1.68-2.57]) than those prescribed fine-particle ICS. The odds of therapy change were 0.70 (0.59-0.83) with ciclesonide. Conclusions In this matched cohort analysis, we observed that initiation of ICS with ciclesonide was associated with better 1-year asthma outcomes and fewer changes to therapy, despite data suggesting more difficult-to-control asthma. The median prescribed dose of ciclesonide was one-third that of fine-particle ICS. PMID:28102056

  15. Inefficiency in the market for 'Fine Art': how this market inefficiency promotes 'Art Tourism' in South Africa

    Directory of Open Access Journals (Sweden)

    Peter Baur

    2014-01-01

    Full Text Available The market for 'Fine Art' is dominated by institutions and auction houses. These act as gatekeepers by monopolising the primary market. The choice of art as an investment vehicle is based on a combination of expected return and subjective preference. The reason for investing in 'Fine Art' is more than purely for financial gain. There are other more intrinsic factors that are considered as part of the investor decision-making process. This market for 'Fine Art' can be considered largely inefficient. Exclusivity, high prices, institutional based indexes and the overall lack of information are by far the greatest drivers of this market inefficiency. 'Art' prices are usually set in the primary market for 'Fine Art' through the auction process and the auction process should also typically reflect an efficient way of creating shared value. However, the auction process in the primary art market is not efficient and does not create shared value as would occur in a typical free market structure. The systems employed by the auction process in the primary art market is a strategy in itself, giving the impression that there is shared value, and thus distorting prices while simultaneously stimulating investor confidence. This becomes apparent when the price for 'Fine Art' does not necessarily reflect the 'true' value of the respective 'Fine Art' being sold. Thus investors may take advantage of this situation, by traveling across international borders to purchase what they would consider valuable art. In effect, art tourism is driven by market inefficiency in the 'Fine Art' market.

  16. Fine and gross motor skills: The effects on skill-focused dual-tasks.

    Science.gov (United States)

    Raisbeck, Louisa D; Diekfuss, Jed A

    2015-10-01

    Dual-task methodology often directs participants' attention towards a gross motor skill involved in the execution of a skill, but researchers have not investigated the comparative effects of attention on fine motor skill tasks. Furthermore, there is limited information about participants' subjective perception of workload with respect to task performance. To examine this, the current study administered the NASA-Task Load Index following a simulated shooting dual-task. The task required participants to stand 15 feet from a projector screen which depicted virtual targets and fire a modified Glock 17 handgun equipped with an infrared laser. Participants performed the primary shooting task alone (control), or were also instructed to focus their attention on a gross motor skill relevant to task execution (gross skill-focused) and a fine motor skill relevant to task execution (fine skill-focused). Results revealed that workload was significantly greater during the fine skill-focused task for both skill levels, but performance was only affected for the lesser-skilled participants. Shooting performance for the lesser-skilled participants was greater during the gross skill-focused condition compared to the fine skill-focused condition. Correlational analyses also demonstrated a significant negative relationship between shooting performance and workload during the gross skill-focused task for the higher-skilled participants. A discussion of the relationship between skill type, workload, skill level, and performance in dual-task paradigms is presented. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Primary productivity

    Digital Repository Service at National Institute of Oceanography (India)

    Verlecar, X.N.; Parulekar, A.H.

    Photosynthetic production in the oceans in relation to light, nutrients and mixing processes is discussed. Primary productivity in the estuarine region is reported to be high in comparison to coastal and oceanic waters. Upwelling phenomenon...

  18. Primary Hyperparathyroidism

    Science.gov (United States)

    ... Neoplasia Type 1 Thyroid Disease & Pregnancy Primary Hyperparathyroidism Prolactinoma National Hormone and Pituitary Program (NHPP): Information for ... qualified health care provider nearby. Eating, Diet, and Nutrition Eating, diet, and nutrition have not been shown ...

  19. Primary Myelofibrosis

    Science.gov (United States)

    ... attack is higher. Patients also have an increased risk of acute myeloid leukemia or primary myelofibrosis . Symptoms of polycythemia vera include headaches and a feeling of fullness below the ribs on the left ...

  20. Particle size distribution and property of bacteria attached to carbon fines in drinking water treatment

    Directory of Open Access Journals (Sweden)

    Wang Leilei

    2008-06-01

    Full Text Available The quantitative change and size distribution of particles in the effluents from a sand filter and a granular activated carbon (GAC filter in a drinking water treatment plant were investigated. The average total concentration of particles in the sand filter effluent during a filter cycle was 148 particles/mL, 27 of which were larger than 2 µm in size. The concentration in the GAC effluent (561 particles/mL was significantly greater than that in the sand filter effluent. The concentration of particles larger than 2 µm in the GAC filter effluent reached 201 particles/mL, with the amount of particles with sizes between 2 µm and 15 µm increasing. The most probable number (MPN of carbon fines reached 43 unit/L after six hours and fines between 0.45 µm and 8.0 µm accounted for more than 50%. The total concentration of outflowing bacteria in the GAC filter effluent, 350 CFU (colony-forming units/mL, was greater than that in the sand filter effluent, 210 CFU/mL. The desorbed bacteria concentration reached an average of 310 CFU/mg fines. The disinfection efficiency of desorbed bacteria was lower than 40% with 1.5 mg/L of chlorine. The disinfection effect showed that the inactivation rate with 2.0 mg/L of chloramine (90% was higher than that with chlorine (70%. Experimental results indicated that the high particle concentration in raw water and sedimentation effluent led to high levels of outflowing particles in the sand filter effluent. The activated carbon fines in the effluent accounted for a small proportion of the total particle amount, but the existing bacteria attached to carbon fines may influence the drinking water safety. The disinfection efficiency of desorbed bacteria was lower than that of free bacteria with chlorine, and the disinfection effect on bacteria attached to carbon fines with chloramine was better than that with only chlorine.

  1. Customizing digital printing for fine art practice

    Science.gov (United States)

    Parraman, Carinna E.; Thirkell, Paul; Hoskins, Steve; Wang, Hong Qiang; Laidler, Paul

    2005-01-01

    The presentation will demonstrate how through alternative methods of digital print production the Centre for Fine Print Research (CFPR) is developing methodologies for digital printing that attempt to move beyond standard reproductive print methods. Profiling is used for input and output hardware, along with bespoke profiling for fine art printmaking papers. Examples of artist's work, and examples from the Perpetual Portfolio are included - an artist in residence scheme for selected artists wanting to work at the Centre and to make a large-format digital print. Colour is an important issue: colour fidelity, colour density on paper, colour that can be achieved through multiple-pass printing. Research is also underway to test colour shortfalls in the current inkjet ink range, and to extend colour through the use of traditional printing inks.

  2. Sub-stratum injection of fine tailings

    Energy Technology Data Exchange (ETDEWEB)

    Kesteren van, W.; Cornelisse, J.; Costello, M. [Deltares, Delft (Netherlands)

    2010-07-01

    This PowerPoint presentation discussed an experiment conducted to evaluate the sub-stratum injection of oil sands fine tailings. The hydraulic fracturing method was developed as a sub-surface dredging process for mining sand without removing the overburden. Pressure was used to transport the sand-water mixture, and the high pressures used in the process resulted in water losses through the clay-sand interface. The experiment was conducted with soft clay, compacted sand, and an injection feed. Results of the study showed that the injection method may be successful. However, further research is required to characterize the fracture energy of oil sands and the rheology of fine tailings. Horizontal hydraulic fracturing equations were presented. Tensile failures in clay and oil sands were discussed. Fractures were identified by deformation and discharge rates. Crack propagation methods were also studied. tabs., figs.

  3. Measure theory and fine properties of functions

    CERN Document Server

    Evans, Lawrence Craig

    2015-01-01

    Measure Theory and Fine Properties of Functions, Revised Edition provides a detailed examination of the central assertions of measure theory in n-dimensional Euclidean space. The book emphasizes the roles of Hausdorff measure and capacity in characterizing the fine properties of sets and functions. Topics covered include a quick review of abstract measure theory, theorems and differentiation in ℝn, Hausdorff measures, area and coarea formulas for Lipschitz mappings and related change-of-variable formulas, and Sobolev functions as well as functions of bounded variation.The text provides complete proofs of many key results omitted from other books, including Besicovitch's covering theorem, Rademacher's theorem (on the differentiability a.e. of Lipschitz functions), area and coarea formulas, the precise structure of Sobolev and BV functions, the precise structure of sets of finite perimeter, and Aleksandrov's theorem (on the twice differentiability a.e. of convex functions).This revised edition includes countl...

  4. Coal surface control for advanced physical fine coal cleaning technologies

    Energy Technology Data Exchange (ETDEWEB)

    Morsi, B.I.; Chiang, S.H.; Sharkey, A.; Blachere, J.; Klinzing, G.; Araujo, G.; Cheng, Y.S.; Gray, R.; Streeter, R.; Bi, H.; Campbell, P.; Chiarlli, P.; Ciocco, M.; Hittle, L.; Kim, S.; Kim, Y.; Perez, L.; Venkatadri, R.

    1992-01-01

    This final report presents the research work carried out on the Coal Surface Control for Advanced Physical Fine Coal Cleaning Technologies project, sponsored by the US Department of Energy, Pittsburgh Energy Technology Center (DOE/PETC). The project was to support the engineering development of the selective agglomeration technology in order to reduce the sulfur content of US coals for controlling SO[sub 2] emissions (i.e., acid rain precursors). The overall effort was a part of the DOE/PETCs Acid Rain Control Initiative (ARCI). The overall objective of the project is to develop techniques for coal surface control prior to the advanced physical fine coal cleaning process of selective agglomeration in order to achieve 85% pyrite sulfur rejection at an energy recovery greater than 85% based on run-of-mine coal. The surface control is meant to encompass surface modification during grinding and laboratory beneficiation testing. The project includes the following tasks: Project planning; methods for analysis of samples; development of standard beneficiation test; grinding studies; modification of particle surface; and exploratory R D and support. The coal samples used in this project include three base coals, Upper Freeport - Indiana County, PA, Pittsburgh NO. 8 - Belmont County, OH, and Illinois No. 6 - Randolph County, IL, and three additional coals, Upper Freeport - Grant County- WV, Kentucky No. 9 Hopkins County, KY, and Wyodak - Campbell County, WY. A total of 149 drums of coal were received.

  5. Fractionation of Pb and Cu in the fine fraction (landfill.

    Science.gov (United States)

    Kaczala, Fabio; Orupõld, Kaja; Augustsson, Anna; Burlakovs, Juris; Hogland, Marika; Bhatnagar, Amit; Hogland, William

    2017-11-01

    The fractionation of metals in the fine fraction (landfill was carried out to evaluate the metal (Pb and Cu) contents and their potential towards not only mobility but also possibilities of recovery/extraction. The fractionation followed the BCR (Community Bureau of Reference) sequential extraction, and the exchangeable (F1), reducible (F2), oxidizable (F3) and residual fractions were determined. The results showed that Pb was highly associated with the reducible (F2) and oxidizable (F3) fractions, suggesting the potential mobility of this metal mainly when in contact with oxygen, despite the low association with the exchangeable fraction (F1). Cu has also shown the potential for mobility when in contact with oxygen, since high associations with the oxidizable fraction (F3) were observed. On the other hand, the mobility of metals in excavated waste can be seen as beneficial considering the circular economy and recovery of such valuables back into the economy. To conclude, not only the total concentration of metals but also a better understanding of fractionation and in which form metals are bound is very important to bring information on how to manage the fine fraction from excavated waste both in terms of environmental impacts and also recovery of such valuables in the economy.

  6. Radiation effects in fine metal media

    International Nuclear Information System (INIS)

    Zaikin, Yu. A.; Aliev, A.B.

    1999-01-01

    The report discusses condition and perspectives of theoretical and experimental research of metal powder material radiation processing influence on their caking, recrystallization and formation of metal and alloy structure obtained by powder metallurgy methods. Radiation processing of metal powders under determined modes causes forming of homogeneous fine metal structure and helps to considerably improve their running abilities (strength, endurance, corrosion resistance) and caking technological conditions

  7. Device for the analysis of fine dusts

    International Nuclear Information System (INIS)

    Riemer, F.; Tausch, W.; Torge, R.

    1978-01-01

    The invention deals with a device that brings graphite bulbs containing samples of fine dusts automatically to the spectrometer for analysis and transports them away afterwards, a great number of individual measurements thus being quickly performed. The device consists of magazines, means of transport for them etc., and, if necessary, also a furnace for thermal preparation of the samples. (RW) 891 RW/RW 892 MKO [de

  8. Fine Structure of 211 Po Alpha Decay

    International Nuclear Information System (INIS)

    Mirea, M.

    2000-01-01

    Recently, a theory based on the Landau-Zener effect was developed intending to describe quantitatively the cluster decay fine structure phenomenon. It was claimed that the same promotion effect can also govern the fine structure in the case of α-decay. This formalism intends to explain the fine structure of α-decay by considering single-particle transitions due to the radial and the rotational couplings. The levels with the same good quantum numbers associated to some symmetries of the system cannot in general intersect, but exhibit quasi-crossings, or pseudo-crossings, or avoided level crossings. The system is characterised by an axial symmetry, therefore the good quantum numbers are the projections of the nucleon spin Ω. The radial coupling causes transitions of the unpaired nucleon near the avoided level crossings. True crossings can also be obtained between levels characterized by different quantum numbers. Generally, the rotational coupling has a maximum strength in the vicinity of the true crossings. Transitions due to both couplings are taken into account in order to explain the excitations of the unpaired nucleon. For a tunnelling velocity of 9 x 10 6 fm/fs, the ratio between the intensity for transitions to the first excited state and to the ground state was found to be 0.0071 and the obtained ratio of the same parameter between the second excited state and the ground state was 0.0062, in good agreement with experimental data. These calculations suggest that the α-decay fine structure phenomenon can be explained quantitatively by describing the decaying system with molecular models and it can be stated that the quantitative characteristics of this phenomenon are ruled by dynamical effects. (author)

  9. BepiColombo fine sun sensor

    Science.gov (United States)

    Boslooper, Erik; van der Heiden, Nico; Naron, Daniël.; Schmits, Ruud; van der Velde, Jacob Jan; van Wakeren, Jorrit

    2017-11-01

    Design, development and verification of the passive Fine Sun Sensor (FSS) for the BepiColombo spacecraft is described. Major challenge in the design is to keep the detector at acceptable temperature levels while exposed to a solar flux intensity exceeding 10 times what is experienced in Earth orbit. A mesh type Heat Rejection Filter has been developed. The overall sensor design and its performance verification program is described.

  10. Process for treating moisture laden coal fines

    Science.gov (United States)

    Davis, Burl E.; Henry, Raymond M.; Trivett, Gordon S.; Albaugh, Edgar W.

    1993-01-01

    A process is provided for making a free flowing granular product from moisture laden caked coal fines, such as wet cake, by mixing a water immiscible substance, such as oil, with the caked coal, preferably under low shear forces for a period of time sufficient to produce a plurality of free flowing granules. Each granule is preferably comprised of a dry appearing admixture of one or more coal particle, 2-50% by weight water and the water immiscible substance.

  11. Fractal aggregation and breakup of fine particles

    Directory of Open Access Journals (Sweden)

    Li Bingru

    2016-01-01

    Full Text Available Breakup may exert a controlling influence on particle size distributions and particles either are fractured or are eroded particle-by-particle through shear. The shear-induced breakage of fine particles in turbulent conditions is investigated using Taylor-expansion moment method. Their equations have been derived in continuous form in terms of the number density function with particle volume. It suitable for future implementation in computational fluid dynamics modeling.

  12. Leeuwpan fine coal dense medium plant

    CSIR Research Space (South Africa)

    Lundt, M

    2010-11-01

    Full Text Available Beneficiation 2010, 4–6 May 2010. 671The Journal of The Southern African Institute of Mining and Metallurgy VOLUME 110 NOVEMBER 2010 L Leeuwpan fine coal dense medium plant mixed with magnetite in the launder and enters... with production. Plant equipment operational changes Cyclone spigot changes In an attempt to lower the cut-point density, the spigot on the L 672 NOVEMBER 2010 VOLUME 110 The Journal of The Southern African Institute of Mining and Metallurgy Figure 1...

  13. Proton-beam technique dates fine wine

    Science.gov (United States)

    Dumé, Belle

    2008-10-01

    Nuclear physicists in France have invented a way to authenticate the vintage of rare wine without needing a sommelier's keen nose or even a corkscrew. The technique, which involves firing high-energy protons at wine bottles, can determine how old the bottles are and even where they come from. The new method could help unmask counterfeit wines - a growing problem in the fine-wine industry, where a bottle can sell for thousands of Euros.

  14. Fine particulate air pollution and hospital visits for asthma in Beijing, China.

    Science.gov (United States)

    Tian, Yaohua; Xiang, Xiao; Juan, Juan; Sun, Kexin; Song, Jing; Cao, Yaying; Hu, Yonghua

    2017-11-01

    Data on fine particulate matter (PM 2.5 ) in China were first announced in 2013. The primary objective of this study was to evaluate the acute effects of PM 2.5 on asthma morbidity in Beijing, China. A total of 978,658 asthma hospital visits consisting of 928,607 outpatient visits, 40,063 emergency room visits and 9988 hospital admissions from January 1, 2010, to June 30, 2012, were identified from the Beijing Medical Claim Data for Employees. A generalized additive Poisson model was applied to explore the association between PM 2.5 and health service use. The mean daily PM 2.5 concentration was 99.5 μg/m 3 with a range from 7.2 μg/m 3 to 492.8 μg/m 3 . Ambient PM 2.5 concentration was significantly associated with increased use of asthma-related health services. Every 10 μg/m 3 increase in PM 2.5 concentration on the same day was significantly associated with a 0.67% (95% CI, 0.53%-0.81%), 0.65% (95% CI, 0.51%-0.80%), and 0.49% (95% CI, 0.35%-0.64%) increase in total hospital visits, outpatient visits and emergency room visits, respectively. The exposure-response association between PM 2.5 concentration and hospital visits for asthma exacerbations was approximately linear. In conclusion, this study found that short-term elevations in PM 2.5 concentration may increase the risk of asthma exacerbations. Our findings contribute to the limited scientific literature concerning the acute effects of PM 2.5 on asthma morbidity outcomes in developing countries. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Shock fabrics in fine-grained micrometeorites

    Science.gov (United States)

    Suttle, M. D.; Genge, M. J.; Russell, S. S.

    2017-10-01

    The orientations of dehydration cracks and fracture networks in fine-grained, unmelted micrometeorites were analyzed using rose diagrams and entropy calculations. As cracks exploit pre-existing anisotropies, analysis of their orientation provides a mechanism with which to study the subtle petrofabrics preserved within fine-grained and amorphous materials. Both uniaxial and biaxial fabrics are discovered, often with a relatively wide spread in orientations (40°-60°). Brittle deformation cataclasis and rotated olivine grains are reported from a single micrometeorite. This paper provides the first evidence for impact-induced shock deformation in fine-grained micrometeorites. The presence of pervasive, low-grade shock features in CM chondrites and CM-like dust, anomalously low-density measurements for C-type asteroids, and impact experiments which suggest CM chondrites are highly prone to disruption all imply that CM parent bodies are unlikely to have remained intact and instead exist as a collection of loosely aggregated rubble-pile asteroids, composed of primitive shocked clasts.

  16. Fiscal 1998 survey report. Medical equipment (Development of fine sampling/analysis system for blood / Development of high-precision 3-D image diagnosis system / Development of low-invasion operation support system / Total development of artificial internal organ technologies); 1998 nendo chosa hokokusho. Iryo kiki (ketsuekinado biryo saishu, biryo bunseki system kaihatsu/koseido sanjigen eizo shindan system kaihatsu/teishinshu shujutsu shien system kaihatsu/jinko zoki gijutsu sogo kaihatsu)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    For efficient medical care supply systems, the R and D of advanced medical care technology and equipment largely contribute to productivity improvement for medical care services. Among them, a progress of medical care technology is becoming important for preparation of efficient and fair supply systems. MITI thus established 'Medical care and welfare equipment development project' in 1994, and has promoted the strategic long-term R and D project of medical care and welfare equipment as joint R and D project of NEDO and private enterprises. In fiscal 1998, on the development of the fine sampling/analysis system for blood, the high- precision 3-D image diagnosis system, the low-invasion operation support system, and the artificial internal organ technologies since fiscal 1996, this project clarified essential technical issues based on the future view, selected some themes to be newly developed in the future, and surveyed and evaluated the details of their R and D concretely. (NEDO)

  17. Observations of coastal sediment dynamics of the Tijuana Estuary Fine Sediment Fate and Transport Demonstration Project, Imperial Beach, California

    Science.gov (United States)

    Warrick, Jonathan A.; Rosenberger, Kurt J.; Lam, Angela; Ferreiera, Joanne; Miller, Ian M.; Rippy, Meg; Svejkovsky, Jan; Mustain, Neomi

    2012-01-01

    Coastal restoration and management must address the presence, use, and transportation of fine sediment, yet little information exists on the patterns and/or processes of fine-sediment transport and deposition for these systems. To fill this information gap, a number of State of California, Federal, and private industry partners developed the Tijuana Estuary Fine Sediment Fate and Transport Demonstration Project ("Demonstration Project") with the purpose of monitoring the transport, fate, and impacts of fine sediment from beach-sediment nourishments in 2008 and 2009 near the Tijuana River estuary, Imperial Beach, California. The primary purpose of the Demonstration Project was to collect and provide information about the directions, rates, and processes of fine-sediment transport along and across a California beach and nearshore setting. To achieve these goals, the U.S. Geological Survey monitored water, beach, and seafloor properties during the 2008–2009 Demonstration Project. The project utilized sediment with ~40 percent fine sediment by mass so that the dispersal and transport of fine sediment would be easily recognizable. The purpose of this report is to present and disseminate the data collected during the physical monitoring of the Demonstration Project. These data are available online at the links noted in the "Additional Digital Information" section. Synthesis of these data and results will be provided in subsequent publications.

  18. Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid

    Science.gov (United States)

    ... Physician Resources Professions Site Index A-Z Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid An ... Aspiration Biopsy of the Thyroid? What is Ultrasound-Guided Fine Needle Aspiration Biopsy of the Thyroid? During ...

  19. effect of fines content on the engineering properties of reconstituted

    African Journals Online (AJOL)

    2012-11-03

    Nov 3, 2012 ... Reconstitution of the natural soil (0% fines content) yielded soil samples having fines content between ... action to different stabilizing agents are better under- .... tion cracking, whereas clay soils with too low plastic limit (PL) ...

  20. Use of Unprocessed Coal Bottom Ash as Partial Fine Aggregate ...

    African Journals Online (AJOL)

    2012r

    transportation applications such as structural fill, road base material, and as snow ... normal fine particles resulting in weak porous paste, modulus of elasticity is ..... with the porous structure and high absorptivity of fine particles of bottom ash.

  1. 49 CFR 107.336 - Limitation on fines and penalties.

    Science.gov (United States)

    2010-10-01

    ... MATERIALS PROGRAM PROCEDURES Enforcement Criminal Penalties § 107.336 Limitation on fines and penalties. If a State or political subdivision or Indian tribe assesses any fine or penalty determined by the...

  2. Flocculation of chromite ore fines suspension using polysaccharide ...

    Indian Academy of Sciences (India)

    Unknown

    liquid separation. Keywords. Flocculation; graft copolymer; mineral industry effluent; chromite ore fines; ... work well as flocculating agent on coal washery effluent, copper and iron ore fines etc (Karmakar et al 1998, 1999;. Tripathy et al 2001).

  3. Microstructural characterization of primary coolant pipe steel

    International Nuclear Information System (INIS)

    Miller, M.K.; Bentley, J.

    1986-01-01

    Atom probe field-ion microscopy, analytical electron microscopy, and optical microscopy have been used to investigate the changes that occur in the microstructure of cast CF 8 primary coolant pipe stainless steel after long term thermal aging. The cast duplex microstructure consisted of austenite with 15% delta-ferrite. Investigation of the aged material revealed that the ferrite spinodally decomposed into a fine scaled network of α and α'. A fine G-phase precipitate was also observed in the ferrite. The observed degradation in mechanical properties is probably a consequence of the spinodal decomposition in the ferrite

  4. Total Quality Leadership

    Science.gov (United States)

    1991-01-01

    More than 750 NASA, government, contractor, and academic representatives attended the Seventh Annual NASA/Contractors Conference on Quality and Productivity. The panel presentations and Keynote speeches revolving around the theme of total quality leadership provided a solid base of understanding of the importance, benefits, and principles of total quality management (TQM). The presentations from the conference are summarized.

  5. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...

  6. Effect of hyperbaric environment on fine motor skills

    OpenAIRE

    Les, Martin

    2017-01-01

    Title: Effect of hyperbaric environment on fine motor skills Objectives: The aim of study is to assess the changes fine motor skills due to hyperbaric environment in preparation for selected tests of fine motor skills. Methods: The first method was used empirically - research. Then the method chosen of compilation of the information obtained. The basic method to work was the experimental measurement method specially constructed tests on fine motor skills. All measured values were statisticall...

  7. The contribution of fine roots to peatland stability under changing environmental conditions

    Science.gov (United States)

    Malhotra, A.; Brice, D. J.; Childs, J.; Phillips, J.; Hanson, P. J.; Iversen, C. M.

    2017-12-01

    Fine-root production and traits are closely linked with ecosystem nutrient and water fluxes, and may regulate these fluxes in response to environmental change. Plant strategies can shift to favoring below- over aboveground biomass allocation when nutrients or moisture are limited. Fine-roots traits such as root tissue density (RTD) or specific root length (SRL) can also adapt to the environment, for example, by maximizing the area of soil exploited by decreasing RTD and increasing SRL during dry conditions. Fine-root trait plasticity could contribute to the stability of peatland carbon function in response to environmental change. However, the extent and mechanisms of peatland fine-root plasticity are unknown. We investigated fine-root growth and traits and their link to environmental factors and aboveground dynamics at SPRUCE (Spruce and Peatland Responses Under Changing Environments), a warming and elevated CO2 (eCO2) experiment in an ombrotrophic peatland. In the first growing season of whole ecosystem warming, fine-root production increased with warming and drying. Above- versus belowground allocation strategies varied by plant functional type (PFT). In shrubs, contrary to our expectation, aboveground- to fine-root production allocation ratio increased with dryer conditions, perhaps as a response to a concurrent increase in nutrients. Trait response hypotheses were largely supported, with RTD decreasing and SRL increasing with warming; however, response varied among PFTs. Once eCO2 was turned on in the second growing season, preliminary results suggest interactive effects of warming and eCO2 on total fine-root production: production decreased or increased with warming in ambient or elevated CO2 plots, respectively. Both trait and production responses to warming and eCO2 varied by microtopography and depth. Our results highlight plasticity of fine-root traits and biomass allocation strategies; the extent and mechanism of which varies by PFT. We will summarize

  8. Cytomorphology of nipple discharge and fine needle aspiration of duct papilloma

    Directory of Open Access Journals (Sweden)

    H B Bannur

    2012-01-01

    Full Text Available The primary role of fine needle aspiration (FNA of the breast is the distinction between benign and malignant lesions; but in many cases, additional information may be obtained. The major breast lesions that yield papillary fragments on FNA are papillary carcinoma, papilloma, fibroadenoma, and invasive ductal carcinoma that have a papillary component. We present cytomorphological features of nipple discharge and FNA of breast lump in a 32-year female.

  9. Adaptation of fine roots to annual fertilization and irrigation in a 13-year-old Pinus pinaster stand.

    Science.gov (United States)

    Bakker, M R; Jolicoeur, E; Trichet, P; Augusto, L; Plassard, C; Guinberteau, J; Loustau, D

    2009-02-01

    Effects of fertilization and irrigation on fine roots and fungal hyphae were studied in 13-year-old maritime pine (Pinus pinaster Aït. in Soland), 7 years after the initiation of the treatments. The fertilization trials consisted of a phosphorus treatment, a complete fertilizer treatment (N, P, K, Ca and Mg), and an unfertilized treatment (control). Fertilizers were applied annually and were adjusted according to foliar target values. Two irrigation regimes (no irrigation and irrigation of a set amount each day) were applied from May to October. Root samples to depths of 120 cm were collected in summer of 2005, and the biomass of small roots (diameter 2-20 mm) and fine roots (diameter fine root morphology were assessed. Biomass and length of hyphae were studied by a mesh ingrowth bag technique. Total fine root biomass in the litter and in the 0-120 cm soil profile ranged between 111 and 296 g m(-2). Results derived from the measurements of biomass and root length, or root area, showed that both fertilizer treatments reduced the size of the fine root system, especially in the top soil layers, but did not affect small roots. Compared with control treatments, fine root morphology was affected by both fertilizer treatments with the fine roots having increased specific root length/area, and irrigation tended to reinforce this finer morphology. The amount of hyphae in the mesh ingrowth bags was higher in the fertilization and irrigation treatments than in the controls, suggesting further extension of the root system (ectomycorrhizal infection) and thus of the uptake system. Irrigation had no significant effect on the size of the fine root system, but resulted in a shallower rooting system. Total root to shoot ratios were unaffected by the treatments, but fine root mass:needle mass and fine root area index:leaf area index ratios decreased with increasing nutrient supply. Overall, compared with the control fine roots, increased nutrient supply resulted in a

  10. Development and Validation of an Aquatic Fine Sediment Biotic Index

    Science.gov (United States)

    Relyea, Christina D.; Minshall, G. Wayne; Danehy, Robert J.

    2012-01-01

    The Fine Sediment Biotic Index (FSBI) is a regional, stressor-specific biomonitoring index to assess fine sediment (Plecoptera (5), Trichoptera (3), and Ephemeroptera (2) contained all but one of the species or species groups classified as extremely sensitive. Index validation with an independent data set of 255 streams found FSBI scores to accurately predict both high and low levels of measured fine sediment.

  11. 76 FR 31307 - Commission of Fine Arts; Notice of Meeting

    Science.gov (United States)

    2011-05-31

    ... COMMISSION OF FINE ARTS Commission of Fine Arts; Notice of Meeting The next meeting of the U.S. Commission of Fine Arts is scheduled for June 16, 2011, at 10 a.m. in the Commission offices at the National Building Museum,Suite 312, Judiciary Square, 401 F Street, NW., Washington, DC, 20001-2728. Items of...

  12. Development of fine motor skills in preterm infants

    NARCIS (Netherlands)

    Bos, Arend F.; Van Braeckel, Koenraad N. J. A.; Hitzert, Marrit M.; Tanis, Jozien C.; Roze, Elise

    2013-01-01

    Fine motor skills are related to functioning in daily life and at school. We reviewed the status of knowledge, in preterm children, on the development of fine motor skills, the relation with gross motor skills, and risk factors for impaired fine motor skills. We searched the past 15 years in PubMed,

  13. Numerical modeling of fine particle fractal aggregates in turbulent flow

    Directory of Open Access Journals (Sweden)

    Cao Feifeng

    2015-01-01

    Full Text Available A method for prediction of fine particle transport in a turbulent flow is proposed, the interaction between particles and fluid is studied numerically, and fractal agglomerate of fine particles is analyzed using Taylor-expansion moment method. The paper provides a better understanding of fine particle dynamics in the evolved flows.

  14. Directional fine structure in absorption of white x rays: A tomographic interpretation

    International Nuclear Information System (INIS)

    Korecki, P.; Szymonski, M.; Tolkiehn, M.; Novikov, D. V.; Materlik, G.

    2006-01-01

    We discuss directional fine structure in absorption of white x rays for tomographic imaging of crystal structure at the atomic level. The interference between a direct x-ray beam and the secondary waves coherently scattered inside a specimen modifies the total wave field at the position of the absorbing atoms. For a white x-ray beam, the wave field variations cancel out by energy integration for all directions, except for the near forward scattering components, coinciding with the incident beam. Therefore, two-dimensional patterns of the angular-dependent fine structure in absorption of white x rays can be interpreted as real-space projections of atomic structure. In this work, we present a theory describing the directional fine structure in white x-ray absorption and a tomographic approach for crystal structure retrieval developed on its basis. The tomographic algorithm is applied to the experimental x-ray absorption data recorded for GaP crystals

  15. Development of a hadron blind detector using a finely segmented pad readout

    Energy Technology Data Exchange (ETDEWEB)

    Kanno, Koki, E-mail: kkanno@post.kek.jp [Department of Physics, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198 (Japan); Aoki, Kazuya [High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba-shi, Ibaraki 305-0801 (Japan); Aramaki, Yoki; En' yo, Hideto; Kawama, Daisuke [RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198 (Japan); Komatsu, Yusuke; Masumoto, Shinichi [Department of Physics, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Nakai, Wataru [Department of Physics, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198 (Japan); Obara, Yuki [Department of Physics, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Ozawa, Kyoichiro; Sekimoto, Michiko [High Energy Accelerator Research Organization (KEK), 1-1 Oho, Tsukuba-shi, Ibaraki 305-0801 (Japan); Shibukawa, Takuya [Department of Physics, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Takahashi, Tomonori [Research Center for Nuclear Physics (RCNP), Osaka University, 10-1 Mihogaoka, Ibaraki, Osaka 567-0047 (Japan); Watanabe, Yosuke [Department of Physics, Graduate School of Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Yokkaichi, Satoshi [RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198 (Japan)

    2016-05-21

    We constructed a hadron blind detector (HBD) using a finely segmented pad readout. The finely segmented pad readout enabled us to adopt an advanced particle identification method which applies a threshold to the number of pad hits in addition to the total amount of collected charge. The responses of the detector to electrons and pions were evaluated using a negatively charged secondary beam at 1.0 GeV/c containing 20% electrons at the J-PARC K1.1BR beam line. We observed 7.3 photoelectrons per incident electron. Using the advanced particle identification method, an electron detection efficiency of 83% was achieved with a pion rejection factor of 120. The method improved the pion rejection by approximately a factor of five, compared to the one which just applies a threshold to the amount of collected charge. The newly introduced finely segmented pad readout was found to be effective in rejecting pions.

  16. Development of a hadron blind detector using a finely segmented pad readout

    International Nuclear Information System (INIS)

    Kanno, Koki; Aoki, Kazuya; Aramaki, Yoki; En'yo, Hideto; Kawama, Daisuke; Komatsu, Yusuke; Masumoto, Shinichi; Nakai, Wataru; Obara, Yuki; Ozawa, Kyoichiro; Sekimoto, Michiko; Shibukawa, Takuya; Takahashi, Tomonori; Watanabe, Yosuke; Yokkaichi, Satoshi

    2016-01-01

    We constructed a hadron blind detector (HBD) using a finely segmented pad readout. The finely segmented pad readout enabled us to adopt an advanced particle identification method which applies a threshold to the number of pad hits in addition to the total amount of collected charge. The responses of the detector to electrons and pions were evaluated using a negatively charged secondary beam at 1.0 GeV/c containing 20% electrons at the J-PARC K1.1BR beam line. We observed 7.3 photoelectrons per incident electron. Using the advanced particle identification method, an electron detection efficiency of 83% was achieved with a pion rejection factor of 120. The method improved the pion rejection by approximately a factor of five, compared to the one which just applies a threshold to the amount of collected charge. The newly introduced finely segmented pad readout was found to be effective in rejecting pions.

  17. Laparoscopic total pancreatectomy

    Science.gov (United States)

    Wang, Xin; Li, Yongbin; Cai, Yunqiang; Liu, Xubao; Peng, Bing

    2017-01-01

    Abstract Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy. Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien–Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition. Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n = 2) and pancreatic neuroendocrine tumor (PNET) (n = 1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450–540 minutes), the mean estimated blood loss was 266 mL (range 100–400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8–24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life. Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy. PMID:28099344

  18. Estonian total ozone climatology

    Directory of Open Access Journals (Sweden)

    K. Eerme

    Full Text Available The climatological characteristics of total ozone over Estonia based on the Total Ozone Mapping Spectrometer (TOMS data are discussed. The mean annual cycle during 1979–2000 for the site at 58.3° N and 26.5° E is compiled. The available ground-level data interpolated before TOMS, have been used for trend detection. During the last two decades, the quasi-biennial oscillation (QBO corrected systematic decrease of total ozone from February–April was 3 ± 2.6% per decade. Before 1980, a spring decrease was not detectable. No decreasing trend was found in either the late autumn ozone minimum or in the summer total ozone. The QBO related signal in the spring total ozone has an amplitude of ± 20 DU and phase lag of 20 months. Between 1987–1992, the lagged covariance between the Singapore wind and the studied total ozone was weak. The spring (April–May and summer (June–August total ozone have the best correlation (coefficient 0.7 in the yearly cycle. The correlation between the May and August total ozone is higher than the one between the other summer months. Seasonal power spectra of the total ozone variance show preferred periods with an over 95% significance level. Since 1986, during the winter/spring, the contribution period of 32 days prevails instead of the earlier dominating 26 days. The spectral densities of the periods from 4 days to 2 weeks exhibit high interannual variability.

    Key words. Atmospheric composition and structure (middle atmosphere – composition and chemistry; volcanic effects – Meteorology and atmospheric dynamics (climatology

  19. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-06-01

    The present discussion is limited to a presentation of the most recent total photonuclear absorption experiments performed with real photons at intermediate energy, and more precisely in the region of nucleon resonances. The main sources of real photons are briefly reviewed and the experimental procedures used for total photonuclear absorption cross section measurements. The main results obtained below 140 MeV photon energy as well as above 2 GeV are recalled. The experimental study of total photonuclear absorption in the nuclear resonance region (140 MeV< E<2 GeV) is still at its beginning and some results are presented

  20. [Total artificial heart].

    Science.gov (United States)

    Antretter, H; Dumfarth, J; Höfer, D

    2015-09-01

    To date the CardioWest™ total artificial heart is the only clinically available implantable biventricular mechanical replacement for irreversible cardiac failure. This article presents the indications, contraindications, implantation procedere and postoperative treatment. In addition to a overview of the applications of the total artificial heart this article gives a brief presentation of the two patients treated in our department with the CardioWest™. The clinical course, postoperative rehabilitation, device-related complications and control mechanisms are presented. The total artificial heart is a reliable implant for treating critically ill patients with irreversible cardiogenic shock. A bridge to transplantation is feasible with excellent results.

  1. The Effect Of Fine Particle Migration On Void Ratio Of Gap Graded Soil

    Directory of Open Access Journals (Sweden)

    Mayssa Salem Flayh

    2017-12-01

    Full Text Available Soil is exposed to the migration of fine particles in some cases because of some conditions including excavation and the presence of a level of groundwater which is equal to the level of soil in this case and because of the existence of this water leakage which would work on the migration of fine particles in the soil. This migration of fine particles will change the structure of the soil and change its properties. In this study we will know the change in the properties of the fouling soil due to the migration of fine particles and four types of soil. The first type does not contain fine particles and the second type the third and the fourth contains 10 20 30 granules respectively and tests were carried out for these soils Atterberg limits sieve analysis specific gravity shear resistance permeability modified Procter consolidation. A model was created to simulate the reality of soil exposed to excavations. Three levels were selected in the model to compare the results of each of the four soils under study. The total number of models 24 model through laboratory work obtained the initial and final voids ratio before and after aft the initial and final voids ratio er the particles migration. After these tests it was found that the migration of granules clearly affects the increase in the voids ratio.

  2. Diagnostic accuracy of fine needle aspiration cytology in hepatic tumours

    International Nuclear Information System (INIS)

    Nazir, R.T.; Sharif, M.A.; Iqbal, M.; Amin, M.S.

    2010-01-01

    To determine the diagnostic accuracy of fine-needle aspiration cytology (FNAC) in liver masses to isolate malignant from benign tumours and hepatocellular carcinoma (HCC) from metastatic tumours. Study Design: Cross-sectional, observational. Place and Duration of Study: Department of Histopathology, Combined Military Hospital, Peshawar, from June 2004 to June 2005. Methodology: All the patients with liver masses confirmed by ultrasonography, irrespective of age and gender, were included. Patients with inflammatory lesions were excluded from the study. Selected patients underwent fine-needle aspiration under ultrasound guidance followed by needle biopsy. The cytological slides were stained by haematoxylin and eosin (H and E) stain, while Papanicolaou's stain was employed in selective cases. Needle biopsy fragments were fixed in formalin followed by paraffin embedding and staining with H and E stain. Sensitivity and specificity of FNAC in the diagnosis of liver masses was determined using histological diagnosis on liver biopsy as gold standard. Results: There were one hundred subjects. The mean age at presentation was 55 +- 12 years with male to female ratio of 1.7:1. Cytological diagnosis in 19 cases was benign/non-neoplastic and 81 was malignant. Out of the latter, 49 (60.49%) were HCC and 32 (39.51%) were metastatic tumours on cytology. The overall sensitivity, specificity and accuracy of FNAC in the diagnosis of malignant lesions was 95.2%, 100% and 96% respectively using histological diagnosis on liver biopsy as gold standard. Sensitivity of FNAC to differentiate HCC from metastatic tumours in liver was 96% while specificity was 100% having a diagnostic accuracy of 97.5%. The discrepancy in cyto-histological comparison was mainly seen in well differentiated and poorly-differentiated HCCs. Conclusion: FNAC of the liver masses is a simple, safe, accurate, economical screening test without significant morbidity that can be used to identify the vast majority of

  3. Organic composition and source apportionment of fine aerosol at Monterrey, Mexico, based on organic markers

    Directory of Open Access Journals (Sweden)

    Y. Mancilla

    2016-01-01

    Full Text Available Primary emissions from anthropogenic and biogenic sources as well as secondary formation are responsible for the pollution levels of ambient air in major urban areas. These sources release fine particles into the air that negatively impact human health and the environment. Organic molecular markers, which are compounds that are unique to specific PM2.5 sources, can be utilized to identify the major emission sources in urban areas. In this study, 43 representative PM2.5 samples, for both daytime and nighttime periods, were built from individual samples collected in an urban site of the Monterrey metropolitan area (MMA during the spring and fall of 2011 and 2012. The samples were analyzed for organic carbon, elemental carbon, and organic molecular markers. Several diagnostic tools were employed for the preliminary identification of emission sources. Organic compounds for eight compound classes were quantified. The n-alkanoic acids were the most abundant, followed by n-alkanes, wood smoke markers, and levoglucosan/alkenoic acids. Polycyclic aromatic hydrocarbons (PAHs and hopanes were less abundant. The carbon preference index (0.7–2.6 for n-alkanes indicates a major contribution of anthropogenic and mixed sources during the fall and the spring, respectively. Hopanes levels confirmed the contribution from gasoline and diesel engines. In addition, the contribution of gasoline and diesel vehicle exhaust was confirmed and identified by the PAH concentrations in PM2.5. Diagnostic ratios of PAHs showed emissions from burning coal, wood, biomass, and other fossil fuels. The total PAHs and elemental carbon were correlated (r2 =  0.39–0.70 across the monitoring periods, reinforcing that motor vehicles are the major contributors of PAHs. Cholesterol levels remained constant during the spring and fall, showing evidence of the contribution of meat-cooking operations, while the isolated concentrations of levoglucosan suggested occasional biomass

  4. Total 2004 results

    International Nuclear Information System (INIS)

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  5. Total synthesis of ciguatoxin.

    Science.gov (United States)

    Hamajima, Akinari; Isobe, Minoru

    2009-01-01

    Something fishy: Ciguatoxin (see structure) is one of the principal toxins involved in ciguatera poisoning and the target of a total synthesis involving the coupling of three segments. The key transformations in this synthesis feature acetylene-dicobalthexacarbonyl complexation.

  6. Total 2004 results

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-02-01

    This document presents the 2004 results of Total Group: consolidated account, special items, number of shares, market environment, adjustment for amortization of Sanofi-Aventis merger-related intangibles, 4. quarter 2004 results (operating and net incomes, cash flow), upstream (results, production, reserves, recent highlights), downstream (results, refinery throughput, recent highlights), chemicals (results, recent highlights), Total's full year 2004 results (operating and net income, cash flow), 2005 sensitivities, Total SA parent company accounts and proposed dividend, adoption of IFRS accounting, summary and outlook, main operating information by segment for the 4. quarter and full year 2004: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refined product sales by region, chemicals), Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  7. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty....

  8. Genoptraening efter total knaealloplastik

    DEFF Research Database (Denmark)

    Holm, Bente; Kehlet, Henrik

    2009-01-01

    The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty rehabilitat......The short- and long-term benefits of post-discharge physiotherapy regimens after total knee arthroplasty are debatable. A national survey including hospitals in Denmark that perform total knee arthroplasty showed a large variability in indication and regimen for post-knee arthroplasty...... rehabilitation. Since hospital stay duration has decreased considerably, the need for post-discharge physiotherapy may also have changed. Thus, the indication for and types of rehabilitation programmes need to be studied within the context of fast-track knee arthroplasty. Udgivelsesdato: 2009-Feb-23...

  9. Supravaginal eller total hysterektomi?

    DEFF Research Database (Denmark)

    Edvardsen, L; Madsen, E M

    1994-01-01

    There has been a decline in the rate of hysterectomies in Denmark in general over the last thirteen years, together with a rise in the number of supravaginal operations over the last two years. The literature concerning the relative merits of the supravaginal and the total abdominal operation is ...... indicate a reduced frequency of orgasm after the total hysterectomy compared with the supravaginal operation. When there are technical problems peroperatively with an increased urologic risk the supravaginal operation is recommended....

  10. Fine structure of synapses on dendritic spines

    Directory of Open Access Journals (Sweden)

    Michael eFrotscher

    2014-09-01

    Full Text Available Camillo Golgi’s Reazione Nera led to the discovery of dendritic spines, small appendages originating from dendritic shafts. With the advent of electron microscopy (EM they were identified as sites of synaptic contact. Later it was found that changes in synaptic strength were associated with changes in the shape of dendritic spines. While live-cell imaging was advantageous in monitoring the time course of such changes in spine structure, EM is still the best method for the simultaneous visualization of all cellular components, including actual synaptic contacts, at high resolution. Immunogold labeling for EM reveals the precise localization of molecules in relation to synaptic structures. Previous EM studies of spines and synapses were performed in tissue subjected to aldehyde fixation and dehydration in ethanol, which is associated with protein denaturation and tissue shrinkage. It has remained an issue to what extent fine structural details are preserved when subjecting the tissue to these procedures. In the present review, we report recent studies on the fine structure of spines and synapses using high-pressure freezing (HPF, which avoids protein denaturation by aldehydes and results in an excellent preservation of ultrastructural detail. In these studies, HPF was used to monitor subtle fine-structural changes in spine shape associated with chemically induced long-term potentiation (cLTP at identified hippocampal mossy fiber synapses. Changes in spine shape result from reorganization of the actin cytoskeleton. We report that cLTP was associated with decreased immunogold labeling for phosphorylated cofilin (p-cofilin, an actin-depolymerizing protein. Phosphorylation of cofilin renders it unable to depolymerize F-actin, which stabilizes the actin cytoskeleton. Decreased levels of p-cofilin, in turn, suggest increased actin turnover, possibly underlying the changes in spine shape associated with cLTP. The findings reviewed here establish HPF as

  11. Fine-grained sheet silicate rocks

    International Nuclear Information System (INIS)

    Weaver, C.E.

    1977-09-01

    Considerable interest has been shown in the possibility of using shales as repositories for radioactive waste and a variety of other waste products, and it appears that over the next few years much money and effort will be expended to investigate and test a wide variety of shales. If shales are to be studied in detail by a large number of investigators, it is important that all concerned have the same concept of what constitutes a shale. The term shale and other terms for fine-grained rocks have been used for many years and have been continually redefined. Most definitions predate the development of modern instrumentation and are based on field observations and intuition; however, the main problem is the diversity of definitions. An attempt is made here to develop a simple, rational classification of fine-grained sediments, and it is hoped that this classification will eliminate some of the present ambiguity. In order that the classification be pertinent, mineral composition and textural data were compiled and evaluated. The data on unconsolidated and consolidated sediments were contrasted and the effects of burial diagenesis assessed. It was found necessary to introduce a new term, physil, to describe all sheet silicate minerals. In contrast to the term clay mineral, the term physil has no size connotation. A simple classification is proposed that is based on the percentage of physils and grain size. In Part II the fine-grained physil rocks are classified on the basis of physil type, non-physil minerals, and texture. Formations are listed which have the mineral and textural characteristics of the most important rock types volumetrically. Selected rock types, and the formations in which they can be found, are recommended for laboratory study to determine their suitability for the storage of high-level radioactive waste

  12. Total lymphoid irradiation

    International Nuclear Information System (INIS)

    Sutherland, D.E.; Ferguson, R.M.; Simmons, R.L.; Kim, T.H.; Slavin, S.; Najarian, J.S.

    1983-01-01

    Total lymphoid irradiation by itself can produce sufficient immunosuppression to prolong the survival of a variety of organ allografts in experimental animals. The degree of prolongation is dose-dependent and is limited by the toxicity that occurs with higher doses. Total lymphoid irradiation is more effective before transplantation than after, but when used after transplantation can be combined with pharmacologic immunosuppression to achieve a positive effect. In some animal models, total lymphoid irradiation induces an environment in which fully allogeneic bone marrow will engraft and induce permanent chimerism in the recipients who are then tolerant to organ allografts from the donor strain. If total lymphoid irradiation is ever to have clinical applicability on a large scale, it would seem that it would have to be under circumstances in which tolerance can be induced. However, in some animal models graft-versus-host disease occurs following bone marrow transplantation, and methods to obviate its occurrence probably will be needed if this approach is to be applied clinically. In recent years, patient and graft survival rates in renal allograft recipients treated with conventional immunosuppression have improved considerably, and thus the impetus to utilize total lymphoid irradiation for its immunosuppressive effect alone is less compelling. The future of total lymphoid irradiation probably lies in devising protocols in which maintenance immunosuppression can be eliminated, or nearly eliminated, altogether. Such protocols are effective in rodents. Whether they can be applied to clinical transplantation remains to be seen

  13. Totally optimal decision rules

    KAUST Repository

    Amin, Talha

    2017-11-22

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  14. Totally optimal decision rules

    KAUST Repository

    Amin, Talha M.; Moshkov, Mikhail

    2017-01-01

    Optimality of decision rules (patterns) can be measured in many ways. One of these is referred to as length. Length signifies the number of terms in a decision rule and is optimally minimized. Another, coverage represents the width of a rule’s applicability and generality. As such, it is desirable to maximize coverage. A totally optimal decision rule is a decision rule that has the minimum possible length and the maximum possible coverage. This paper presents a method for determining the presence of totally optimal decision rules for “complete” decision tables (representations of total functions in which different variables can have domains of differing values). Depending on the cardinalities of the domains, we can either guarantee for each tuple of values of the function that totally optimal rules exist for each row of the table (as in the case of total Boolean functions where the cardinalities are equal to 2) or, for each row, we can find a tuple of values of the function for which totally optimal rules do not exist for this row.

  15. Score of Fine Motor Skill in Children with Down Syndrome using Nintendo Wii

    Directory of Open Access Journals (Sweden)

    Puspasari Sinaga

    2016-09-01

    Full Text Available Background: Down syndrome occurs due to an extra chromosome 21, known as Trisomy 21. In addition to delayed cognitive and speech development, children with Down syndrome may also experience delayed gross and fine motor development. Virtual Reality Therapy, such as Nintendo Wii is a computer-based technology that allows users to interact with a virtual three-dimensional scenario and the most innovative physical rehabilitation method. High scores indicate that the player has a good motor skill. This study aimed to examine the difference between the score of fine motor skill in children with and without Down syndrome. Methods: An analytic cross-sectional study was conducted from August to November 2015 to 40 children aged between 9–12 years old who came from public primary schools and special needs schools in Bandung, West Java. They were divided into 2 groups using random gender and age pairing; one group was children with Down syndrome and another other group was normal children. The children’ scores of Nintendo Wii game were collected three times. The collected data were statistically analyzed by Chi-Square test. Results: The proportion of children with low-grade fine motor skill in Down syndrome group was larger than those with high-grade fine motor skill. In the other hand, in normal children group, the proportion was reversed compared to Down syndrome group. There was a significant difference in score of fine motor skill between children with Down syndrome and normal children (p=0.000. Conclusions: The fine motor skill of children with Down syndrome is poorer than normal children’s.

  16. Fine needle diagnosis in lumbar osteomyelitis

    International Nuclear Information System (INIS)

    Joshi, K.B.; Brinker, R.A.

    1983-01-01

    Lumbar vertebral body and disk infection, presenting as low back pain, is a relatively uncommon disease but is seen more often in drug addicts. Radiographs show typical changes of infection of the lumbar vertebrae and adjacent disc. Under local anesthesia a fine needle is placed, saline injected, and aspirated. The entire needle-syringe unit is submitted to the bacteriology department. Pseudomonas infection is usually found. This method of diagnosis is simple, cost effective, well accepted by the patients, and can be done on outpatients. (orig.)

  17. Computer Models Simulate Fine Particle Dispersion

    Science.gov (United States)

    2010-01-01

    Through a NASA Seed Fund partnership with DEM Solutions Inc., of Lebanon, New Hampshire, scientists at Kennedy Space Center refined existing software to study the electrostatic phenomena of granular and bulk materials as they apply to planetary surfaces. The software, EDEM, allows users to import particles and obtain accurate representations of their shapes for modeling purposes, such as simulating bulk solids behavior, and was enhanced to be able to more accurately model fine, abrasive, cohesive particles. These new EDEM capabilities can be applied in many industries unrelated to space exploration and have been adopted by several prominent U.S. companies, including John Deere, Pfizer, and Procter & Gamble.

  18. Haptic rendering for simulation of fine manipulation

    CERN Document Server

    Wang, Dangxiao; Zhang, Yuru

    2014-01-01

    This book introduces the latest progress in six degrees of freedom (6-DoF) haptic rendering with the focus on a new approach for simulating force/torque feedback in performing tasks that require dexterous manipulation skills. One of the major challenges in 6-DoF haptic rendering is to resolve the conflict between high speed and high fidelity requirements, especially in simulating a tool interacting with both rigid and deformable objects in a narrow space and with fine features. The book presents a configuration-based optimization approach to tackle this challenge. Addressing a key issue in man

  19. Relativistic corrections to fine structure of positronium

    International Nuclear Information System (INIS)

    Martynenko, A.P.; Faustov, R.N.

    1997-01-01

    On the basis of the quasipotential method, we have calculated the relativistic corrections in the positronium fine structure intervals 2 3 S 1 -2 3 P J . The contributions of order of mα 6 for the positronium S-levels were obtained from the one-photon, two-photon interactions and the second-order perturbation theory. We have obtained also the contribution of the two-photon annihilation diagrams to the interaction operator of the P-wave positronium. The corrections of order of α 5 R ∞ and α 5 1nαR ∞ to the P-wave energy levels of positronium were calculated

  20. Recovering the fine structures in solar images

    Science.gov (United States)

    Karovska, Margarita; Habbal, S. R.; Golub, L.; Deluca, E.; Hudson, Hugh S.

    1994-01-01

    Several examples of the capability of the blind iterative deconvolution (BID) technique to recover the real point spread function, when limited a priori information is available about its characteristics. To demonstrate the potential of image post-processing for probing the fine scale and temporal variability of the solar atmosphere, the BID technique is applied to different samples of solar observations from space. The BID technique was originally proposed for correction of the effects of atmospheric turbulence on optical images. The processed images provide a detailed view of the spatial structure of the solar atmosphere at different heights in regions with different large-scale magnetic field structures.

  1. Dark energy with fine redshift sampling

    Science.gov (United States)

    Linder, Eric V.

    2007-03-01

    The cosmological constant and many other possible origins for acceleration of the cosmic expansion possess variations in the dark energy properties slow on the Hubble time scale. Given that models with more rapid variation, or even phase transitions, are possible though, we examine the fineness in redshift with which cosmological probes can realistically be employed, and what constraints this could impose on dark energy behavior. In particular, we discuss various aspects of baryon acoustic oscillations, and their use to measure the Hubble parameter H(z). We find that currently considered cosmological probes have an innate resolution no finer than Δz≈0.2 0.3.

  2. Dark energy with fine redshift sampling

    International Nuclear Information System (INIS)

    Linder, Eric V.

    2007-01-01

    The cosmological constant and many other possible origins for acceleration of the cosmic expansion possess variations in the dark energy properties slow on the Hubble time scale. Given that models with more rapid variation, or even phase transitions, are possible though, we examine the fineness in redshift with which cosmological probes can realistically be employed, and what constraints this could impose on dark energy behavior. In particular, we discuss various aspects of baryon acoustic oscillations, and their use to measure the Hubble parameter H(z). We find that currently considered cosmological probes have an innate resolution no finer than Δz≅0.2-0.3

  3. Pre - big bang inflation requires fine tuning

    Energy Technology Data Exchange (ETDEWEB)

    Turner, Michael S. [Fermi National Accelerator Laboratory (FNAL), Batavia, IL (United States); Weinberg, Erick J. [Fermi National Accelerator Laboratory (FNAL), Batavia, IL (United States)

    1997-10-01

    The pre-big-bang cosmology inspired by superstring theories has been suggested as an alternative to slow-roll inflation. We analyze, in both the Jordan and Einstein frames, the effect of spatial curvature on this scenario and show that too much curvature --- of either sign --- reduces the duration of the inflationary era to such an extent that the flatness and horizon problems are not solved. Hence, a fine-tuning of initial conditions is required to obtain enough inflation to solve the cosmological problems.

  4. Fine structure in deformed proton emitting nuclei

    International Nuclear Information System (INIS)

    Sonzogni, A. A.; Davids, C. N.; Woods, P. J.; Seweryniak, D.; Carpenter, M. P.; Ressler, J. J.; Schwartz, J.; Uusitalo, J.; Walters, W. B.

    1999-01-01

    In a recent experiment to study the proton radioactivity of the highly deformed 131 Eu nucleus, two proton lines were detected. The higher energy one was assigned to the ground-state to ground-state decay, while the lower energy, to the ground-state to the 2 + state decay. This constitutes the first observation of fine structure in proton radioactivity. With these four measured quantities, proton energies, half-life and branching ratio, it is possible to determine the Nilsson configuration of the ground state of the proton emitting nucleus as well as the 2 + energy and nuclear deformation of the daughter nucleus. These results will be presented and discussed

  5. An innovative computer design for modeling forest landscape change in very large spatial extents with fine resolutions

    Science.gov (United States)

    Jian Yang; Hong S. He; Stephen R. Shifley; Frank R. Thompson; Yangjian. Zhang

    2011-01-01

    Although forest landscape models (FLMs) have benefited greatly from ongoing advances of computer technology and software engineering, computing capacity remains a bottleneck in the design and development of FLMs. Computer memory overhead and run time efficiency are primary limiting factors when applying forest landscape models to simulate large landscapes with fine...

  6. Method for producing dustless graphite spheres from waste graphite fines

    Science.gov (United States)

    Pappano, Peter J [Oak Ridge, TN; Rogers, Michael R [Clinton, TN

    2012-05-08

    A method for producing graphite spheres from graphite fines by charging a quantity of spherical media into a rotatable cylindrical overcoater, charging a quantity of graphite fines into the overcoater thereby forming a first mixture of spherical media and graphite fines, rotating the overcoater at a speed such that the first mixture climbs the wall of the overcoater before rolling back down to the bottom thereby forming a second mixture of spherical media, graphite fines, and graphite spheres, removing the second mixture from the overcoater, sieving the second mixture to separate graphite spheres, charging the first mixture back into the overcoater, charging an additional quantity of graphite fines into the overcoater, adjusting processing parameters like overcoater dimensions, graphite fines charge, overcoater rotation speed, overcoater angle of rotation, and overcoater time of rotation, before repeating the steps until graphite fines are converted to graphite spheres.

  7. Growth dynamics of fine roots in a coniferous fern forest site close to Forsmark in the central part of Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Persson, Hans; Stadenberg, Ingela (SLU, Dept. of Ecology and Environmental Research, Uppsala (Sweden))

    2007-12-15

    The seasonal growth dynamics of live and dead roots for trees and the field layer species (g/m2, varying diameter fractions) and live/dead ratios were analysed at a fresh/moist coniferous fern forest site close to the nuclear power plant at Forsmark in the central eastern parts of Sweden. The changes in depth distribution of fine roots were observed at depth intervals of the top humus horizon down to 40 cm in the mineral soil profile. The bulk of living fine roots of trees (< 1 mm in diameter) were found in the mineral soil horizon the total profile down to 40 cm of the mineral soil, where 89, 82, 83 and 89% of the total amount in the whole profile were found. The upper 2.5 cm part of the humus layer contained 83, 81, 100 and 100% of all roots of the humus layer on the four different sampling occasions. High amounts of living fine roots were found in the upper 10 cm of the mineral soil horizon viz. 84, 76, 91 and 69% of the total mineral soil layer. Consequently, both the top soil horizons of the humus and the mineral soil layers were heavily penetrated by living fine roots. The highest proportion of living fine roots was found in the top 2.5 cm of the humus layer. Accordingly, the live/dead ratio of fine roots (< 1 mm in diameter) decreased from the top of the humus layer to the lower part of mineral soil horizon from 8.0-0.3, 0.8-0.2, 4.4-0.4 and 3.3-0.7 (g g-1) for the four sampling occasions, respectively. We concluded that the decrease in the live/ dead ratio was related to decreased vitality with depth of the fine roots in the soil profile. The highest live/dead ratio was found in the upper 2.5 cm of the humus layer for both the tree and field-layer species. This distribution pattern was most evident for tree fine roots < 1 mm in diameter. The mean fine-root biomass (live tissue < 1 mm in diameter) of tree species for the total profile varied on the four sampling occasions between 317, 113, 139 and 248 g m-2. The related fine root necromass (dead tissue

  8. [Hypertension: once primary, always primary?

    NARCIS (Netherlands)

    Braam, R.L.; Pieters, G.F.F.M.; Thien, Th.

    2002-01-01

    Three patients diagnosed with primary hypertension suddenly developed hard-to-treat blood pressure after several years of stable blood pressure. One patient, a man aged 48 years, had developed a renal artery stenosis, which had not been present five years earlier. The other two patients, a man aged

  9. Picobubble column flotation of fine coal

    Energy Technology Data Exchange (ETDEWEB)

    Daniel Tao; Samuel Yu; Xiaohua Zhou; R.Q. Honaker; B.K. Parekh [University of Kentucky, Lexington, KY (United States). Department of Mining Engineering

    2008-01-15

    Froth flotation is widely used in the coal industry to clean -28 mesh (0.6 mm) or -100 mesh (0.15 mm) fine coal. A successful recovery of particles by flotation depends on efficient particle-bubble collision and attachment with minimal subsequent particle detachment from bubble. Flotation is effective in a narrow size range, nominally 10-100 {mu}m, beyond which the flotation efficiency drops sharply. A fundamental analysis has shown that use of picobubbles can significantly improve the flotation recovery of particles by increasing the probability of collision and attachment and reducing the probability of detachment. A specially designed column with a picobubble generator has been developed for enhanced recovery of fine coal particles. Picobubbles were produced based on the hydrodynamic cavitation principle. Experimental results have shown that the use of picobubbles in a 5-cm diameter column flotation increased the combustible recovery of a highly floatable coal by up to 10% and that of a poorly floatable coal by up to 40%, depending on the feed rate, collector dosage, and other flotation conditions. 14 refs.

  10. Extramedullary plasmacytoma. Fine needle aspiration findings.

    Science.gov (United States)

    Kumar, P V; Owji, S M; Talei, A R; Malekhusseini, S A

    1997-01-01

    To determine the role of fine needle aspiration cytology in the diagnosis of extramedullary plasmacytoma. The study group consisted of 13 patients with palpable masses at various sites. The tumors were aspirated for cytologic study. The smears revealed groups of mature and immature plasma cells at various stages of maturation. Mature plasma cells showed an eccentric nucleus and abundant, deep, basophilic cytoplasm with a paranuclear halo. Plasmablasts (immature plasma cells) showed a prominent, eccentric nucleus with single, large nucleolus and abundant, deep, basophilic cytoplasm with no paranuclear halo. Binucleate and multinucleate forms were also seen quite often. The tumors were excised, and the histologic sections confirmed the cytologic diagnosis. All the patients received radiotherapy. One patient (18 years old) developed recurrence and died due to extensive infiltration into the maxilla and mandible. Two patients (57 and 62 years) developed multiple myeloma one to two years after the excision of tumors, and both died two to three months later. The remaining 10 patients were alive and well at this writing. The smears from all 13 patients were diagnosed as extramedullary plasmacytomas by fine needle aspiration cytology.

  11. Communication Optimizations for Fine-Grained UPCApplications

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Wei-Yu; Iancu, Costin; Yelick, Katherine

    2005-07-08

    Global address space languages like UPC exhibit high performance and portability on a broad class of shared and distributed memory parallel architectures. The most scalable applications use bulk memory copies rather than individual reads and writes to the shared space, but finer-grained sharing can be useful for scenarios such as dynamic load balancing, event signaling, and distributed hash tables. In this paper we present three optimization techniques for global address space programs with fine-grained communication: redundancy elimination, use of split-phase communication, and communication coalescing. Parallel UPC programs are analyzed using static single assignment form and a data flow graph, which are extended to handle the various shared and private pointer types that are available in UPC. The optimizations also take advantage of UPC's relaxed memory consistency model, which reduces the need for cross thread analysis. We demonstrate the effectiveness of the analysis and optimizations using several benchmarks, which were chosen to reflect the kinds of fine-grained, communication-intensive phases that exist in some larger applications. The optimizations show speedups of up to 70 percent on three parallel systems, which represent three different types of cluster network technologies.

  12. Molecular Eigensolution Symmetry Analysis and Fine Structure

    Directory of Open Access Journals (Sweden)

    William G. Harter

    2013-01-01

    Full Text Available Spectra of high-symmetry molecules contain fine and superfine level cluster structure related to J-tunneling between hills and valleys on rovibronic energy surfaces (RES. Such graphic visualizations help disentangle multi-level dynamics, selection rules, and state mixing effects including widespread violation of nuclear spin symmetry species. A review of RES analysis compares it to that of potential energy surfaces (PES used in Born-Oppenheimer approximations. Both take advantage of adiabatic coupling in order to visualize Hamiltonian eigensolutions. RES of symmetric and D2 asymmetric top rank-2-tensor Hamiltonians are compared with Oh spherical top rank-4-tensor fine-structure clusters of 6-fold and 8-fold tunneling multiplets. Then extreme 12-fold and 24-fold multiplets are analyzed by RES plots of higher rank tensor Hamiltonians. Such extreme clustering is rare in fundamental bands but prevalent in hot bands, and analysis of its superfine structure requires more efficient labeling and a more powerful group theory. This is introduced using elementary examples involving two groups of order-6 (C6 and D3~C3v, then applied to families of Oh clusters in SF6 spectra and to extreme clusters.

  13. Revisit to diffraction anomalous fine structure

    International Nuclear Information System (INIS)

    Kawaguchi, T.; Fukuda, K.; Tokuda, K.; Shimada, K.; Ichitsubo, T.; Oishi, M.; Mizuki, J.; Matsubara, E.

    2014-01-01

    The diffraction anomalous fine structure method has been revisited by applying this measurement technique to polycrystalline samples and using an analytical method with the logarithmic dispersion relation. The diffraction anomalous fine structure (DAFS) method that is a spectroscopic analysis combined with resonant X-ray diffraction enables the determination of the valence state and local structure of a selected element at a specific crystalline site and/or phase. This method has been improved by using a polycrystalline sample, channel-cut monochromator optics with an undulator synchrotron radiation source, an area detector and direct determination of resonant terms with a logarithmic dispersion relation. This study makes the DAFS method more convenient and saves a large amount of measurement time in comparison with the conventional DAFS method with a single crystal. The improved DAFS method has been applied to some model samples, Ni foil and Fe 3 O 4 powder, to demonstrate the validity of the measurement and the analysis of the present DAFS method

  14. Fine particle magnetic mineralogy of archaeological ceramics

    International Nuclear Information System (INIS)

    Atkinson, D; King, J A

    2005-01-01

    This study investigated the magnetic mineralogy of a worldwide collection of archaeological pottery. The mineral types, the mass fractions and the domain states of the constituent magnetic fine particles were elucidated from a range of measurements including magnetic hysteresis behaviour, the acquisition of isothermal remanence, low field susceptibility and thermomagnetic curves. The magnetic mineralogy of most samples was dominated by magnetite. Titanomagnetites with limited titanium substitution and cation deficient magnetites (indicative of low temperature oxidation) were dominant in some samples. Haematite was detected in 53% of the samples, but seldom contributed much to the saturation magnetization. Magnetic particle sizes are skewed to smaller sizes, with sherds mostly having a large superparamagnetic or a stable single domain fraction. Low temperature susceptibility data suggest that 30% of samples had some multidomain component. The percentage by mass of magnetic material in the ancient pottery studied was less than 0.8% for all but one of the samples and the majority of samples contain less than 0.3% by weight of magnetic fine particles. The presence of low temperature oxidation in many samples and the occurrence of a multidomain component in a third of the collection suggest that ancient pottery may not always be suitable for determining the intensity of the ancient geomagnetic field

  15. Normocalcemic primary hyperparathyroidism

    Science.gov (United States)

    Bilezikian, John P.; Silverberg, Shonni J.

    2011-01-01

    SUMMARY Primary hyperparathyroidism is a common disorder of mineral metabolism characterized by incompletely regulated, excessive secretion of parathyroid hormone from one or more of the parathyroid glands. The historical view of this disease describes two distinct entities marked by two eras. When primary hyperparathyroidism was first discovered about 80 years ago, it was always symptomatic with kidney stones, bone disease and marked hypercalcemia. With the advent of the multichannel autoanalyzer about 40 years ago, the clinical phenotype changed to a disorder characterized by mild hypercalcemia and the absence of classical other features of the disease. We may now be entering a 3rd era in the history of this disease in which patients are being discovered with normal total and ionized serum calcium concentrations but with parathyroid hormone levels that are consistently elevated. In this article, we describe this new entity, normocalcemic primary hyperparathyroidism, a forme fruste of the disease. PMID:20485897

  16. Hyperthyroidism (primary)

    OpenAIRE

    Nygaard, Birte

    2010-01-01

    Hyperthyroidism is characterised by high levels of serum thyroxine and triiodothyronine, and low levels of thyroid-stimulating hormone (TSH). Thyrotoxicosis is the clinical effect of high levels of thyroid hormones, whether or not the thyroid gland is the primary source.The main causes of hyperthyroidism are Graves' disease, toxic multinodular goitre, and toxic adenoma.About 20 times more women than men have hyperthyroidism.

  17. Total versus subtotal hysterectomy

    DEFF Research Database (Denmark)

    Gimbel, Helga; Zobbe, Vibeke; Andersen, Anna Birthe

    2005-01-01

    The aim of this study was to compare total and subtotal abdominal hysterectomy for benign indications, with regard to urinary incontinence, postoperative complications, quality of life (SF-36), constipation, prolapse, satisfaction with sexual life, and pelvic pain at 1-year postoperative. Eighty...... women chose total and 105 women chose subtotal abdominal hysterectomy. No significant differences were found between the 2 operation methods in any of the outcome measures at 12 months. Fourteen women (15%) from the subtotal abdominal hysterectomy group experienced vaginal bleeding and three women had...

  18. Qualità totale e mobilità totale Total Quality and Total Mobility

    Directory of Open Access Journals (Sweden)

    Giuseppe Trieste

    2010-05-01

    Full Text Available FIABA ONLUS (Italian Fund for Elimination of Architectural Barriers was founded in 2000 with the aim of promoting a culture of equal opportunities and, above all, it has as its main goal to involve public and private institutions to create a really accessible and usable environment for everyone. Total accessibility, Total usability and Total mobility are key indicators to define quality of life within cities. A supportive environment that is free of architectural, cultural and psychological barriers allows everyone to live with ease and universality. In fact, people who access to goods and services in the urban context can use to their advantage time and space, so they can do their activities and can maintain relationships that are deemed significant for their social life. The main aim of urban accessibility is to raise the comfort of space for citizens, eliminating all barriers that discriminate people, and prevent from an equality of opportunity. “FIABA FUND - City of ... for the removal of architectural barriers” is an idea of FIABA that has already affected many regions of Italy as Lazio, Lombardy, Campania, Abruzzi and Calabria. It is a National project which provides for opening a bank account in the cities of referring, in which for the first time, all together, individuals and private and public institutions can make a donation to fund initiatives for the removal of architectural barriers within its own territory for a real and effective total accessibility. Last February the fund was launched in Rome with the aim of achieving a Capital without barriers and a Town European model of accessibility and usability. Urban mobility is a prerequisite to access to goods and services, and to organize activities related to daily life. FIABA promotes the concept of sustainable mobility for all, supported by the European Commission’s White Paper. We need a cultural change in management and organization of public means, which might focus on

  19. Coarse and fine sediment transportation patterns and causes downstream of the Three Gorges Dam

    Science.gov (United States)

    Li, Songzhe; Yang, Yunping; Zhang, Mingjin; Sun, Zhaohua; Zhu, Lingling; You, Xingying; Li, Kanyu

    2017-11-01

    Reservoir construction within a basin affects the process of water and sediment transport downstream of the dam. The Three Gorges Reservoir (TGR) affects the sediment transport downstream of the dam. The impoundment of the TGR reduced total downstream sediment. The sediment group d≤0.125 mm (fine particle) increased along the path, but the average was still below what existed before the reservoir impoundment. The sediments group d>0.125 mm (coarse particle) was recharged in the Yichang to Jianli reach, but showed a deposition trend downstream of Jianli. The coarse sediment in the Yichang to Jianli section in 2003 to 2007 was above the value before the TGR impoundment. However, the increase of both coarse and fine sediments in 2008 to 2014 was less than that in 2003 to 2007. The sediment retained in the dam is the major reason for the sediment reduction downstream. However, the retention in different river reaches is affected by riverbed coarsening, discharge, flow process, and conditions of lake functioning and recharging from the tributaries. The main conclusions derived from our study are as follows: 1) The riverbed in the Yichang to Shashi section was relatively coarse, thereby limiting the supply of fine and coarse sediments. The fine sediment supply was mainly controlled by TGR discharge, whereas the coarse sediment supply was controlled by the duration of high flow and its magnitude. 2) The supply of both coarse and fine sediments in the Shashi to Jianli section was controlled by the amount of total discharge. The sediment supply from the riverbed was higher in flood years than that in the dry years. The coarse sediment tended to deposit, and the deposition in the dry years was larger than that in the flood years. 3) The feeding of the fine sediment in the Luoshan to Hankou section was mainly from the riverbed. The supply in 2008 to 2014 was more than that in 2003 to 2007. Around 2010, the coarse sediments transited from depositing to scouring that was

  20. Fining of glass melts: what we know about fining processes today

    NARCIS (Netherlands)

    Beerkens, R.G.C.

    2009-01-01

    The paper addresses the mechanisms of fining (removal of gases from melt) and the effect of batch composition, oxidation state of the melt and furnace atmosphere on bubble removal processes for commercial glass types, such as float glass and container glass compositions. The mechanisms of the

  1. Failures of fine tubes of steam generators and the essential defects

    International Nuclear Information System (INIS)

    Kawano, Shinji; Ebisawa, Toru; Sato, Susumu.

    1976-01-01

    Light water reactors were sold to Japan as their economy and safety have been established, but the average availability of 11 reactors in Japan during 7 year operation is only 53%, and it is being proved that there are questions in the safety and economy. In this report, the failures of fine tubes of steam generators are discussed from the standpoint of the corrosion of materials. First, the functions and construction of the fine tubes of steam generators in PWRs are explained. The failures of the fine tubes of steam generators became frequent since the beginning of 1970s as large capacity nuclear power stations have started the operation. When the fine tubes are pierced with holes during operation and the radioactivity in primary coolant leaks into secondary coolant, it is detected with radioactivity monitors. In order to find out the broken tubes, eddy current flaw detectors are used, and the tubes on which flaws were detected we plugged by explosion welding. In these works, many manual operations are included, and the radiation exposure of workers and the difficulties in the operations are the problems. The cases of the tube failures in Japan and foreign countries, the causes and the countermeasures are described. Chemical corrosion, thermal stress cycle, shaving off due to eddy flow, and stress corrosion are the probable causes. The safety of steam generators is essentially in extremely poor state. The seriousness of the tube failures in steam generators is emphasized. (Kako, I.)

  2. CSF total protein

    Science.gov (United States)

    CSF total protein is a test to determine the amount of protein in your spinal fluid, also called cerebrospinal fluid (CSF). ... The normal protein range varies from lab to lab, but is typically about 15 to 60 milligrams per deciliter (mg/dL) ...

  3. Total body irradiation

    International Nuclear Information System (INIS)

    Novack, D.H.; Kiley, J.P.

    1987-01-01

    The multitude of papers and conferences in recent years on the use of very large megavoltage radiation fields indicates an increased interest in total body, hemibody, and total nodal radiotherapy for various clinical situations. These include high dose total body irradiation (TBI) to destroy the bone marrow and leukemic cells and provide immunosuppression prior to a bone marrow transplant, high dose total lymphoid irradiation (TLI) prior to bone marrow transplantation in severe aplastic anemia, low dose TBI in the treatment of lymphocytic leukemias or lymphomas, and hemibody irradiation (HBI) in the treatment of advanced multiple myeloma. Although accurate provision of a specific dose and the desired degree of dose homogeneity are two of the physicist's major considerations for all radiotherapy techniques, these tasks are even more demanding for large field radiotherapy. Because most large field radiotherapy is done at an extended distance for complex patient geometries, basic dosimetry data measured at the standard distance (isocenter) must be verified or supplemented. This paper discusses some of the special dosimetric problems of large field radiotherapy, with specific examples given of the dosimetry of the TBI program for bone marrow transplant at the authors' hospital

  4. Total design of participation

    DEFF Research Database (Denmark)

    Munch, Anders V.

    2016-01-01

    The idea of design as an art made not only for the people, but also by the people is an old dream going back at least to William Morris. It is, however, reappearing vigoriously in many kinds of design activism and grows out of the visions of a Total Design of society. The ideas of participation b...

  5. Total Quality Management Simplified.

    Science.gov (United States)

    Arias, Pam

    1995-01-01

    Maintains that Total Quality Management (TQM) is one method that helps to monitor and improve the quality of child care. Lists four steps for a child-care center to design and implement its own TQM program. Suggests that quality assurance in child-care settings is an ongoing process, and that TQM programs help in providing consistent, high-quality…

  6. Total Quality Management Seminar.

    Science.gov (United States)

    Massachusetts Career Development Inst., Springfield.

    This booklet is one of six texts from a workplace literacy curriculum designed to assist learners in facing the increased demands of the workplace. The booklet contains seven sections that cover the following topics: (1) meaning of total quality management (TQM); (2) the customer; (3) the organization's culture; (4) comparison of management…

  7. Total photon absorption

    International Nuclear Information System (INIS)

    Carlos, P.

    1985-01-01

    Experimental methods using real photon beams for measurements of total photonuclear absorption cross section σ(Tot : E/sub γ/) are recalled. Most recent σ(Tot : E/sub γ/)results for complex nuclei and in the nucleon resonance region are presented

  8. Total 2004 annual report

    International Nuclear Information System (INIS)

    2004-01-01

    This annual report of the Group Total brings information and economic data on the following topics, for the year 2004: the corporate governance, the corporate social responsibility, the shareholder notebook, the management report, the activities, the upstream (exploration and production) and downstream (refining and marketing) operating, chemicals and other matters. (A.L.B.)

  9. Total Water Management - Report

    Science.gov (United States)

    There is a growing need for urban water managers to take a more holistic view of their water resource systems as population growth, urbanization, and current operations put different stresses on the environment and urban infrastructure. Total Water Management (TWM) is an approac...

  10. Fine resolution 3D temperature fields off Kerguelen from instrumented penguins

    Science.gov (United States)

    Charrassin, Jean-Benoît; Park, Young-Hyang; Le Maho, Yvon; Bost, Charles-André

    2004-12-01

    The use of diving animals as autonomous vectors of oceanographic instruments is rapidly increasing, because this approach yields cost-efficient new information and can be used in previously poorly sampled areas. However, methods for analyzing the collected data are still under development. In particular, difficulties may arise from the heterogeneous data distribution linked to animals' behavior. Here we show how raw temperature data collected by penguin-borne loggers were transformed to a regular gridded dataset that provided new information on the local circulation off Kerguelen. A total of 16 king penguins ( Aptenodytes patagonicus) were equipped with satellite-positioning transmitters and with temperature-time-depth recorders (TTDRs) to record dive depth and sea temperature. The penguins' foraging trips recorded during five summers ranged from 140 to 600 km from the colony and 11,000 dives >100 m were recorded. Temperature measurements recorded during diving were used to produce detailed 3D temperature fields of the area (0-200 m). The data treatment included dive location, determination of the vertical profile for each dive, averaging and gridding of those profiles onto 0.1°×0.1° cells, and optimal interpolation in both the horizontal and vertical using an objective analysis. Horizontal fields of temperature at the surface and 100 m are presented, as well as a vertical section along the main foraging direction of the penguins. Compared to conventional temperature databases (Levitus World Ocean Atlas and historical stations available in the area), the 3D temperature fields collected from penguins are extremely finely resolved, by one order finer. Although TTDRs were less accurate than conventional instruments, such a high spatial resolution of penguin-derived data provided unprecedented detailed information on the upper level circulation pattern east of Kerguelen, as well as the iron-enrichment mechanism leading to a high primary production over the Kerguelen

  11. [Effects of tree species diversity on fine-root biomass and morphological characteristics in subtropical Castanopsis carlesii forests].

    Science.gov (United States)

    Wang, Wei-Wei; Huang, Jin-Xue; Chen, Feng; Xiong, De-Cheng; Lu, Zheng-Li; Huang, Chao-Chao; Yang, Zhi-Jie; Chen, Guang-Shui

    2014-02-01

    Fine roots in the Castanopsis carlesii plantation forest (MZ), the secondary forest of C. carlesii through natural regeneration with anthropogenic promotion (AR), and the secondary forest of C. carlesii through natural regeneration (NR) in Sanming City, Fujian Province, were estimated by soil core method to determine the influence of tree species diversity on biomass, vertical distribution and morphological characteristics of fine roots. The results showed that fine root biomass for the 0-80 cm soil layer in the MZ, AR and NR were (182.46 +/- 10.81), (242.73 +/- 17.85) and (353.11 +/- 16.46) g x m(-2), respectively, showing an increased tendency with increasing tree species diversity. In the three forests, fine root biomass was significantly influenced by soil depth, and fine roots at the 0-10 cm soil layer accounted for more than 35% of the total fine root biomass. However, the interaction of stand type and soil depth on fine-root distribution was not significant, indicating no influence of tree species diversity on spatial niche segregation in fine roots. Root surface area density and root length density were the highest in NR and lowest in the MZ. Specific root length was in the order of AR > MZ > NR, while specific root surface area was in the order of NR > MZ > AR. There was no significant interaction of stand type and soil depth on specific root length and specific root surface area. Fine root morphological plasticity at the stand level had no significant response to tree species diversity.

  12. Process metallurgical evaluation and application of very fine bubbling technology

    Energy Technology Data Exchange (ETDEWEB)

    Catana, C.; Gotsis, V.S.; Dourdounis, E.; Angelopoulos, G.N.; Papamantellos, D.C. [Lab. of Metallurgy, Univ. of Patras, Rio (Greece); Mavrommatis, K. [IEHK, RWTH Aachen, Aachen (Germany)

    2002-12-01

    The potential of VFB (Very Fine Bubbling)-technology in steelmaking, developed for the production of super clean steels, was investigated. Recent R and D work has proven that with very fine argon bubbling through a developed Special Porous Plug (SPP) at low flow rates, the total oxygen content of low carbon steel grades can be lowered to a level of 6 ppm under industrial vacuum conditions and to a level of 10 ppm under argon protective atmosphere. The perspective of industrial application of the VFB technology to a 56-t ladle furnace of Helliniki Halyvourgia S.A., Greece, in order to improve steel cleanliness, requires additional R and D efforts. It is important to define the limits of VFB technology in respect of alloys dissolution, mixing time and homogenisation of steel and slag/metal reactions. In this work, a gas driven bubble aqueous reactor model simulating the bottom gas stirred ladle by means of gas injection through a SPP and a conventional porous plug was studied. Various operating conditions as well as different positions for the porous plug with and without a top oil layer were simulated. Tests concerning mixing time, solid-liquid mass transfer and critical gas flow rate, liquid/liquid mass transfer, using the SPP and a conventional porous plug have been performed. The evaluation of experimental results delivered important information for the design and operation of steel ladles, applying VFB-technology. Experimental results with SPP bubbles' agitated steel (1600 C) in laboratory and technical scale experiments in IF and VIF are presented and discussed. (orig.)

  13. Apollo rocks, fines and soil cores

    Science.gov (United States)

    Allton, J.; Bevill, T.

    Apollo rocks and soils not only established basic lunar properties and ground truth for global remote sensing, they also provided important lessons for planetary protection (Adv. Space Res ., 1998, v. 22, no. 3 pp. 373-382). The six Apollo missions returned 2196 samples weighing 381.7 kg, comprised of rocks, fines, soil cores and 2 gas samples. By examining which samples were allocated for scientific investigations, information was obtained on usefulness of sampling strategy, sampling devices and containers, sample types and diversity, and on size of sample needed by various disciplines. Diversity was increased by using rakes to gather small rocks on the Moon and by removing fragments >1 mm from soils by sieving in the laboratory. Breccias and soil cores are diverse internally. Per unit weight these samples were more often allocated for research. Apollo investigators became adept at wringing information from very small sample sizes. By pushing the analytical limits, the main concern was adequate size for representative sampling. Typical allocations for trace element analyses were 750 mg for rocks, 300 mg for fines and 70 mg for core subsamples. Age-dating and isotope systematics allocations were typically 1 g for rocks and fines, but only 10% of that amount for core depth subsamples. Historically, allocations for organics and microbiology were 4 g (10% for cores). Modern allocations for biomarker detection are 100mg. Other disciplines supported have been cosmogenic nuclides, rock and soil petrology, sedimentary volatiles, reflectance, magnetics, and biohazard studies . Highly applicable to future sample return missions was the Apollo experience with organic contamination, estimated to be from 1 to 5 ng/g sample for Apollo 11 (Simonheit &Flory, 1970; Apollo 11, 12 &13 Organic contamination Monitoring History, U.C. Berkeley; Burlingame et al., 1970, Apollo 11 LSC , pp. 1779-1792). Eleven sources of contaminants, of which 7 are applicable to robotic missions, were

  14. Changes in fine-root production, phenology and spatial distribution in response to N application in irrigated sweet cherry trees.

    Science.gov (United States)

    Artacho, Pamela; Bonomelli, Claudia

    2016-05-01

    Factors regulating fine-root growth are poorly understood, particularly in fruit tree species. In this context, the effects of N addition on the temporal and spatial distribution of fine-root growth and on the fine-root turnover were assessed in irrigated sweet cherry trees. The influence of other exogenous and endogenous factors was also examined. The rhizotron technique was used to measure the length-based fine-root growth in trees fertilized at two N rates (0 and 60 kg ha(-1)), and the above-ground growth, leaf net assimilation, and air and soil variables were simultaneously monitored. N fertilization exerted a basal effect throughout the season, changing the magnitude, temporal patterns and spatial distribution of fine-root production and mortality. Specifically, N addition enhanced the total fine-root production by increasing rates and extending the production period. On average, N-fertilized trees had a length-based production that was 110-180% higher than in control trees, depending on growing season. Mortality was proportional to production, but turnover rates were inconsistently affected. Root production and mortality was homogeneously distributed in the soil profile of N-fertilized trees while control trees had 70-80% of the total fine-root production and mortality concentrated below 50 cm depth. Root mortality rates were associated with soil temperature and water content. In contrast, root production rates were primarily under endogenous control, specifically through source-sink relationships, which in turn were affected by N supply through changes in leaf photosynthetic level. Therefore, exogenous and endogenous factors interacted to control the fine-root dynamics of irrigated sweet cherry trees. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Impact of vehicular emissions on the formation of fine particles in the Sao Paulo Metropolitan Area: a numerical study with the WRF-Chem model

    Directory of Open Access Journals (Sweden)

    A. Vara-Vela

    2016-01-01

    Full Text Available The objective of this work is to evaluate the impact of vehicular emissions on the formation of fine particles (PM2.5;  ≤  2.5 µm in diameter in the Sao Paulo Metropolitan Area (SPMA in Brazil, where ethanol is used intensively as a fuel in road vehicles. The Weather Research and Forecasting with Chemistry (WRF-Chem model, which simulates feedbacks between meteorological variables and chemical species, is used as a photochemical modelling tool to describe the physico-chemical processes leading to the evolution of number and mass size distribution of particles through gas-to-particle conversion. A vehicular emission model based on statistical information of vehicular activity is applied to simulate vehicular emissions over the studied area. The simulation has been performed for a 1-month period (7 August–6 September 2012 to cover the availability of experimental data from the NUANCE-SPS (Narrowing the Uncertainties on Aerosol and Climate Changes in Sao Paulo State project that aims to characterize emissions of atmospheric aerosols in the SPMA. The availability of experimental measurements of atmospheric aerosols and the application of the WRF-Chem model made it possible to represent some of the most important properties of fine particles in the SPMA such as the mass size distribution and chemical composition, besides allowing us to evaluate its formation potential through the gas-to-particle conversion processes. Results show that the emission of primary gases, mostly from vehicles, led to a production of secondary particles between 20 and 30 % in relation to the total mass concentration of PM2.5 in the downtown SPMA. Each of PM2.5 and primary natural aerosol (dust and sea salt contributed with 40–50 % of the total PM10 (i.e. those  ≤  10 µm in diameter concentration. Over 40 % of the formation of fine particles, by mass, was due to the emission of hydrocarbons, mainly aromatics. Furthermore, an increase in the

  16. Impact of vehicular emissions on the formation of fine particles in the Sao Paulo Metropolitan Area: a numerical study with the WRF-Chem model

    Science.gov (United States)

    Vara-Vela, A.; Andrade, M. F.; Kumar, P.; Ynoue, R. Y.; Muñoz, A. G.

    2016-01-01

    The objective of this work is to evaluate the impact of vehicular emissions on the formation of fine particles (PM2.5; ≤ 2.5 µm in diameter) in the Sao Paulo Metropolitan Area (SPMA) in Brazil, where ethanol is used intensively as a fuel in road vehicles. The Weather Research and Forecasting with Chemistry (WRF-Chem) model, which simulates feedbacks between meteorological variables and chemical species, is used as a photochemical modelling tool to describe the physico-chemical processes leading to the evolution of number and mass size distribution of particles through gas-to-particle conversion. A vehicular emission model based on statistical information of vehicular activity is applied to simulate vehicular emissions over the studied area. The simulation has been performed for a 1-month period (7 August-6 September 2012) to cover the availability of experimental data from the NUANCE-SPS (Narrowing the Uncertainties on Aerosol and Climate Changes in Sao Paulo State) project that aims to characterize emissions of atmospheric aerosols in the SPMA. The availability of experimental measurements of atmospheric aerosols and the application of the WRF-Chem model made it possible to represent some of the most important properties of fine particles in the SPMA such as the mass size distribution and chemical composition, besides allowing us to evaluate its formation potential through the gas-to-particle conversion processes. Results show that the emission of primary gases, mostly from vehicles, led to a production of secondary particles between 20 and 30 % in relation to the total mass concentration of PM2.5 in the downtown SPMA. Each of PM2.5 and primary natural aerosol (dust and sea salt) contributed with 40-50 % of the total PM10 (i.e. those ≤ 10 µm in diameter) concentration. Over 40 % of the formation of fine particles, by mass, was due to the emission of hydrocarbons, mainly aromatics. Furthermore, an increase in the number of small particles impaired the

  17. Robust retrieval of fine art paintings

    Science.gov (United States)

    Smolka, Bogdan; Lukac, Rastislav; Plataniotis, Konstantinos N.; Venetsanopoulos, Anastasios N.

    2003-10-01

    The rapid growth of image archives increases the need for efficient and fast tools that can retrieve and search through large amount of visual data. In this paper we propose an efficient method of extracting the image color content, which serves as an image digital signature, allowing to efficiently index and retrieve the content of large, heterogeneous multimedia databases. We apply the proposed method for the retrieval of images from the WEBMUSEUM Internet database, containing the collection of fine art images and show that the new method of image color representation is robust to image distorsions caused by resizing and compression and can be incorporated into existing retrieval systems which exploit the information on color content in digital images.

  18. [Fine needle aspiration cytology of mammography screening

    DEFF Research Database (Denmark)

    Engvad, B.; Laenkholm, A.V.; Schwartz, Thue W.

    2009-01-01

    INTRODUCTION: In the year 2000 a quality assurance programme for the preoperative breast diagnostics was introduced in Denmark. The programme was based on the "European guidelines for quality assurance in breast cancer screening and diagnosis" where - among other measures - five cytological...... diagnostic classes were introduced. The aim of this study was to evaluate the quality assurance programme in a screening population to determine whether fine needle aspiration cytology (FNAC) as first choice remains a useful tool in the preoperative diagnostics, or if needle core biopsy should be the first...... of 66% of the 783 FNACs had a malignant cytology diagnosis, which in 99% of the cases turned out to be the correct diagnosis. Four lesions were false positives all of which represented benign proliferative breast diseases. The surgical procedures in these cases were either excisional biopsy...

  19. Urban Fitness, Gendered Practices, and Fine Art

    DEFF Research Database (Denmark)

    Langkjær, Michael Alexander

    2016-01-01

    The author re-examines claims in the literature on Antonio Lopez that from the 1970s this fashion illustrator had significantly influenced the sporty styling of fashion. However, Antonio's 1960s swimsuit-, motorcycling- and varsity-themed ads reveal some prior links with sport. Antonio's later......'s portrayals of masculine exhibitionism and homoeroticism. For Antonio, the appeal of sport can be explained by an envious appropriation of the athletic physique as well as a personal re-imaging along sporty lines. The "horsetails" and "centaurs" which figure in Antonio's work hint at his spirited sexuality....... It is concluded that from the mid-1960s Antonio had already been illustrating sportswear, that he was inspired by depictions of sport and corporeal physicality by fine artists, and that his true significance for the sporty styling of fashion consisted in a "Warholian" edginess in choice of themes and treatment...

  20. Fine particles in the Soufriere eruption plume

    Science.gov (United States)

    Woods, D. C.; Chuan, R. L.

    1982-01-01

    The size distributions of fine particles measured at tropospheric altitudes in the periphery of the eruption plume formed during the April 17, 1979 eruption of Soufriere Volcano and in the low-level effluents on May 15, 1979 were found to be bimodal, having peak concentrations at geometric mean diameters of 1.1 and 0.23 micrometers. Scanning electron microscopy and energy-dispersive X-ray analysis of the samples revealed an abundance of aluminum and silicon and traces of sodium, magnesium, chlorine, potassium, calcium, and iron in the large-particle mode. The submicrometer-sized particles were covered with liquid containing sulfur, assumed to be in the form of liquid sulfuric acid.