Developments in shoulder arthroplasty

Indications for shoulder arthroplasty are numerous, mainly owing to glenohumeral osteoarthritis, rheumatoid arthritis, or fracture of the proximal humerus. However, the anatomy and the biomechanics of the shoulder are complex and shoulder arthroplasty has evolved significantly over the past 30 years. This paper presents the main recent evolutions in shoulder replacement, the questions not answered yet, and the main future areas of research. The review focuses firstly on the design, positioning, and fixation of the humeral component, secondly on the design, positioning, and fixation of the glenoid implant, and thirdly on other concepts of shoulder arthroplasty such as the reversed prosthesis, the cementless surface replacement arthroplasty, and the bipolar arthroplasty. This review demonstrates that more research is needed. Although, in the long term, large randomized trials are needed to settle the fundamental questions of what type of replacement and which kind of fixation should be used, biomechanical research in the laboratory should be focused primarily on the comprehension of glenoid loosening, which is a major cause of total shoulder arthroplasty failure, and the significance of radiolucent lines which are often seen but with no clear understanding about their relation with failure.     

A-IMilano apoprotein. Decreased high density lipoprotein cholesterol levels with significant lipoprotein modifications and without clinical atherosclerosis in an Italian family

Significant hypertriglyceridemia with a very marked decrease of high density lipoproteins (HDL)-cholesterol levels (7-14 mg/dl) was detected in three members (father, son, and daughter) of an Italian family. The three affected individuals did not show any clinical signs of atherosclerosis, nor was the atherosclerotic disease significantly present in the family. Lipoprotein lipase and lecithin:cholesterol acyltransferase activites were normal or slightly reduced. Morphological and compositional studies of HDL in the subjects showed a significant enlargement of the lipoprotein particles (approximately 120 vs. approximately 94 A for control HDL) and a concomitant increase in the triglyceride content. Analytical isoelectric focusing of HDL apoproteins provided evidence for multiple isoproteins in the apoprotein(apo)-A-I range, with nine different bands being detected instead of the usual four bands observed in normal subjects. Two-dimensional immunoelectrophoresis against apo-A antiserum indicated a clear reduction of apo-A in the alpha electrophoretic region, with splitting of the protein "peak." The observation in otherwise clinically healthy subjects of hypertriglyceridemia, reduced HDL-cholesterol, and marked apoprotein abnormalities, without a significant incidence of atherosclerotic disease in the family suggests this is a new disease entity in the field of lipoprotein pathology, very probably related to an altered amino acid composition of the apo-A-I protein (see Weisgraber et al. 1980. J. Clin. Invest. 66: 901-907).     

Assessment of MOCVD- and MBE-growth GaAs for high-efficiency solarcell applications

A critical assessment of the photovoltaic quality of epitaxial GaAs grown by metal-organic chemical vapor deposition (MOCVD) and by molecular-beam epitaxy (MBE) is reported. Epitaxial films of nominally identical structure were grown by the two techniques and were fabricated into p-n heteroface solar cells. The 0.5-cm by 0.5-cm cells were then characterized and compared. The MOCVD-grown films produced independently verified record efficiency cells of 24.8% under 1-sun AM1.5 global conditions while the MB-grown films produced similarly high efficiencies of 23.8%. The material qualities of the two films in terms of minority-carrier diffusion lengths and surface recombination velocities were quite comparable. These results demonstrate that the quality of MBE-grown films can be quite comparable to the best MOCVD-grown films and that they are suitable for high-efficiency solar cells     

First steps in developing a multimetric macroinvertebrate index for the Ohio River

The causes of degradation of aquatic systems are often complex and stem from a variety of human influences. Comprehensive, multimetric biological indices have been developed to quantify this degradation and its effect on aquatic communities, and measure subsequent recovery from anthropogenic stressors. Traditionally, such indices have concentrated on small‐to medium‐sized streams. Recently, however, the Ohio River Fish Index (ORFIn) was created to assess biotic integrity in the Ohio River. The goal of the present project was to begin developing a companion Ohio River multimetric index using benthic macroinvertebrates. Hester–Dendy multiplate samplers were used to evaluate benthic macroinvertebrate assemblages in relation to a gradient of water quality disturbance, represented by varying distances downstream of industrial and municipal wastewater outfalls in the Ohio River. In August 1999 and 2000, samplers were set every 100 m downstream of outfalls (12 outfalls in 1999, 22 in 2000) for 300–1000 m, as well as at upstream reference sites. Candidate metrics (n = 55) were examined to determine which have potential to detect changes in water quality downstream of outfalls. These individual measures of community structure were plotted against distance downstream of each outfall to determine their response to water quality disturbance. Values at reference and outfall sites were also compared. Metrics that are ecologically relevant and showed a response to outfall disturbance were identified as potentially valuable in a multimetric index. Multiple box plots of index scores indicated greater response to outfall disturbance during periods of low‐flow, and longitudinal river‐wide trends. Evaluation of other types of anthropogenic disturbance, as well as continued analysis of the effects of chemical water quality on macroinvertebrate communities in future years will facilitate further development of a multimetric benthic macroinvertebrate index to evaluate biotic integrity in the Ohio River. Copyright © 2007 John Wiley & Sons, Ltd.     

Dual-Current Pump Module for Transient Improvement of Step-Down DC–DC Converters

This paper presents a novel dual-current pump module (DCPM) to improve the transient response of dc-dc converters. The DCPM operates only during transient to provide two additional current injections for step-up load and current drains for step-down load. Due to the two current pump paths, the current stress on the switches of the DCPM is also reduced. The measurement results show that the DCPM can enhance the dynamic recovery time of the buck dc-dc converter by more than an order.     

Was there significant tax evasion after the 1999 50 cent per pack cigarette tax increase in California?

OBJECTIVES: Several states, including California, have implemented large cigarette excise tax increases, which may encourage smokers to purchase their cigarettes in other lower taxed states, or from other lower or non-taxed sources. Such tax evasion thwarts tobacco control objectives and may cost the state substantial tax revenues. Thus, this study investigates the extent of tax evasion in the 6-12 months after the implementation of California's 0.50 dollars/pack excise tax increase. DESIGN AND SETTING: Retrospective data analysis from the 1999 California Tobacco Surveys (CTS), a random digit dialled telephone survey of California households. MAIN OUTCOME MEASURES: Sources of cigarettes, average daily cigarette consumption, and reported price paid. RESULTS: Very few (5.1 (0.7)% (+/-95% confidence limits)) of California smokers avoided the excise tax by usually purchasing cigarettes from non- or lower taxed sources, such as out-of-state outlets, military commissaries, or the internet. The vast majority of smokers purchased their cigarettes from the most convenient and expensive sources: convenience stores/gas (petrol) stations (45.0 (1.9)%), liquor/drug stores (16.4 (1.6)%), and supermarkets (8.8 (1.2)%). CONCLUSIONS: Despite the potential savings, tax evasion by individual smokers does not appear to pose a serious threat to California's excise tax revenues or its tobacco control objectives.