Accuracy considerations in navigated cup placement for total hip arthroplasty

Computer assisted orthopaedic surgery (CAOS) technology has recently been introduced to overcome problems resulting from acetabular component malpositioning in total hip arthroplasty. Available navigation modules can conceptually be categorized as computer tomography (CT) based, fluoroscopy based, or image-free. The current study presents a comprehensive accuracy analysis on the computer assisted placement accuracy of acetabular cups. It combines analyses using mathematical approaches, in vitro testing environments, and an in vivo clinical trial. A hybrid navigation approach combining image-free with fluoroscopic technology was chosen as the best compromise to CT-based systems. It introduces pointer-based digitization for easily assessable points and bi-planar fluoroscopy for deep-seated landmarks. From the in vitro data maximum deviations were found to be 3.6 degrees for inclination and 3.8 degrees for anteversion relative to a pre-defined test position. The maximum difference between intraoperatively calculated cup inclination and anteversion with the postoperatively measured position was 4 degrees and 5 degrees, respectively. These data coincide with worst cases scenario predictions applying a statistical simulation model. The proper use of navigation technology can reduce variability of cup placement well within the surgical safe zone. Surgeons have to concentrate on a variety of error sources during the procedure, which may explain the reported strong learning curves for CAOS technologies.     

Pilot-scale Studies of Different Covers on Unoxidised Sulphide-rich Tailings in Northern Sweden: the Geochemistry of Leachate Waters

Abstract.  Leachate water quality from covered and uncovered unoxidised sulphide-rich tailings in six pilot-scale (5x5x3 m³) test cells was monitored during 2004 and 2005. The covers consisted of a layer of clayey till, sewage sludge, apatite or Trisoplast (a commercial mixture of tailings, bentonite, and a polymer). All layers were protected by an unspecified till except in one reference cell, where the tailings were left open. All leachate waters showed near-neutral pH as a result of neutralization by calcite in the tailings and by Ca(OH)₂ added prior to deposition. Average dissolved sulphur concentrations in the leachates were ≈ 600 mg L^-1, except in the cell with sewage sludge (300 mg L^-1). The source of sulphur was mainly pyrite oxidation, but residual sulphur probably remained from the enrichment process. The near-neutral pH favoured precipitation of metal-(oxy)hydroxides with subsequent removal of trace elements such as Cd, Cu and Pb (< 15 μg L^-1) from the solutions. High concentrations of Co, Mn, Ni, and Zn were found in leachates from the apatite, Trisoplast, and uncovered tailings cells. High As concentrations were found in the leachates in the sewage sludge and clayey till cells. The lowest metal concentrations, redox potential, and highest pH were found in the sewage sludge cell. Decreased elemental metal concentrations during 2004 suggest improved performance over time.     

Impact of Sewage Sludge on Groundwater Quality at a Formerly Remediated Tailings Impoundment

Sewage sludge can be a suitable, organic-rich substrate to promote vegetation of sulfide-mine tailings, but it may contain contaminants, that, when oxidized, can adversely affect underlying groundwater systems. The geochemical impact of a surface application of 12,000 metric tons of anaerobically-digested sewage sludge on the groundwater quality of a remediated sulfide-tailings impoundment in northern Sweden was evaluated to determine if sludge-borne metals and nitrate were released to the underlying groundwater system. Two years of data from a field-scale groundwater monitoring programme initiated just before the sludge application was compared to groundwater data from 1998 to 2006. Grass was successfully established within 2 years. However, until that occurred, elevated concentrations of sludge-borne metals (Cu, Ni, Pb, Zn) were released to the underlying groundwater. In addition, the release of nitrate likely exacerbated metal concentrations by providing an oxidant for pyrite in the underlying tailings. The release was periodic due to the establishment of the grass, which immobilized metals and nitrate in the sludge. Metals bound as organo-metallic complexes, due to dissolved organic carbon released from the sludge, migrated across the tailings impoundment. Model simulations indicate that the plume will take 6 years to exit the groundwater environment. Though the impacts are relatively short-term, this type of application should be reconsidered in the future.     

A Test of Two Methods for Waste Rock Drainage Quality Prediction: Aqua Regia Extraction and Single-addition Net-acid Generation Test Leachate Analysis

Mine Water and the Environment - The mobility of contaminants from mine waste can be assessed using different extraction methods. Aqua regia (AR) extraction is the most commonly used method in...     

Non-positive autoimmune responses against CYP2E1 in refrigeration mechanics exposed to halogenated hydrocarbons

The aim of the study was to determine if occupational exposure to hydrofluorocarbons (HFC) and hydrochlorofluorocarbons (HCFC) generates autoimmune responses against CYP2E1. HFCs and HCFCs have replaced the chlorofluorocarbons (CFC) in e.g. refrigeration installations and air-conditioning systems. During the substitution period, refrigeration mechanics reported symptoms like asthma, influenza-like reactions, and joint troubles. These symptoms resemble those of chronic inflammatory diseases with an autoimmune component. Since exposure to structurally similar chemicals, e.g. halothane, has previously been associated with autoimmune responses and diseases, autoimmunity among the refrigeration mechanics might hypothetically explain the reported inflammatory symptoms. Serum from 44 Swedish men, occupationally exposed to halogenated hydrocarbons, was screened for antibodies against CYP2E1 with enzyme-linked immunosorbent assay. Thirty of the workers had asthma, joint problems or influenza-like symptoms whereas 14 of them had no such symptoms. They were all selected from a cohort of 280 refrigeration mechanics. Unexposed, healthy, Swedish men (n=35) constituted control group. The study was approved by the Ethics Committee at Karolinska Institutet. No increase in autoantibodies against CYP2E1 was detected among the occupationally exposed workers as compared to the unexposed controls. Further, there was no difference in antibody titer between the exposed workers with symptoms and the exposed, asymtomatic workers or the unexposed controls. The present study does not completely exclude a connection between exposure and effect but makes the relation less likely at these exposure levels.     

Nachgiebiger Elektrodenträger für Cochlea-Implantate mit fluidischer Aktuierung

The cochlear implant, consisting of a compliant electrode carrier (ET) and embedded electrodes with contact wires, is an auditory neuroprosthesis, which is surgically inserted into the inner ear (cochlea) in order to create an auditory impression in the hearing-impaired patients. For simplification of the insertion, a fluidically actuated electrode carrier with a changeable curvature is presented. The deformation of the ET is specifically manipulated by applying pressure to its interior and also by a non-stretchable thin fibre or stripe embedded in its wall. An analytical examination of scaling properties allows to use scaled structures for models and measurements. In order to determine the geometry of the ET, a model-based synthesis – FE method combined with analytical modelling – is carried out. The synthesis resulted in a conical shape of the ET with a cylindrical cavity closed at one end and a fiber running parallel to the cavity. Experimental studies on a measuring geometry show a maximum deviation of 0,6 bar at a maximum internal pressure of 6 bar. The investigations show that the proposed synthesis method is suitable for the development of surgical instruments with adjustable curvature.     

Leveraging Values in Global Organizations: Premises,Paradoxes and Progress

In this focused issue on the theme of “Leveraging Values in Global Organizations”, we highlight several prevalent themes on national, organizational and individual values in the literature. We argue that many premises in the literature have been accepted as fact; yet there are still many avenues open to exploration. We present several paradoxes that are often overlooked or lead to inconsistencies in the literature on values. The five articles in this focused issue address these premises and paradoxes, presenting new challenges and opportunities, providing progress and paving the way for future research on leveraging values in global organizations. The selected articles explore values with respect to international alliances and subsidiaries of multinational organizations at the organizational level, among global managers at the group level, and among employees and inpatriates at the individual level of analysis. We trust that readers of this issue will agree that the articles provide novel insights into key issues in the established, yet dynamic, field of research on values in the context of global organizations.     

Controlled-pH tissue cleanup protocol for signal enhancement of small molecule drugs analyzed by MALDI-MS imaging

The limit of detection of low-molecular weight compounds in tissue sections, analyzed by matrix assisted laser desorption ionization mass spectrometry imaging (MALDI-MSI), was significantly improved by employing sample washing using a pH-controlled buffer solution. The pH of the washing solutions were set at values whereby the target analytes would have low solubility. Washing the tissue sections in the buffered solution resulted in removal of endogenous soluble ionization-suppressing compounds and salts, while the target compound remained in situ with minor or no delocalization during the buffered washing procedure. Two pharmaceutical compounds (cimetidine and imipramine) and one new protease inhibitor compound were successfully used to evaluate the feasibility of the pH-controlled tissue washing protocol for MALDI-MSI. Enhancement in signal-to-noise ratio was achieved by a factor of up to 10.