The cement mantle in the Exeter impaction allografting technique. A cause for concern

The postoperative radiographs of 35 patients who underwent impaction allografting of the proximal femur were reviewed. Of Gruen zones that could be clearly visualized, 39.9% contained areas where cement was absent. Even when an adequate mantle was present, cement voids were commonly seen. These cement mantle deficiencies were confirmed in a series of cadaveric impaction allografting procedures. They appear to be a consequence, at least in part, of an inadequate differential between trial and actual component sizes. Additionally, 4 patients were identified with significant component migration secondary to radiographically visible cement mantle fractures within the first 6 months of surgery. It is concluded that the surgical technique requires modification to ensure a more consistent cement mantle and clinical result.     

Comparative repeatability of guide-pin axis positioning in computer-assisted and manual femoral head resurfacing arthroplasty

The orientation of the femoral component in hip resurfacing arthroplasty affects the likelihood of loosening and fracture. Computer-assisted surgery has been shown to improve significantly the surgeon's ability to achieve a desired position and orientation; nevertheless, both bias and variability in positioning remain and can potentially be improved. The authors recently developed a computer-assisted surgical (CAS) technique to guide the placement of the pin used in femoral head resurfacing arthroplasty and showed that it produced significantly less variation than a typical manual technique in varus/valgus placement relative to a preoperatively determined surgical plan while taking a comparable amount of time. In the present study, the repeatability of both the CAS and manual techniques is evaluated in order to estimate the relative contributions to overall variability of surgical technique (CAS versus manual), surgeon experience (novice versus experienced), and other sources of variability (e.g. across specimens and across surgeons). This will enable further improvements in the accuracy of CAS techniques. Three residents/fellows new to femoral head resurfacing and three experienced hip arthroplasty surgeons performed 20-30 repetitions of each of the CAS and manual techniques on at least one of four cadaveric femur specimens. The CAS system had markedly better repeatability (1.2 degrees) in varus/valgus placement relative to the manual technique (2.8 degrees), slightly worse repeatability in version (4.4 degrees versus 3.2 degrees), markedly better repeatability in mid-neck placement (0.7 mm versus 2.5 mm), no significant dependence on surgeon skill level (in contrast to the manual technique), and took significantly less time (50 s versus 123 s). Proposed improvements to the version measurement process showed potential for reducing the standard deviation by almost two thirds. This study supports the use of CAS for femoral head resurfacing as it is quicker than the manual technique, independent of surgeon experience, and demonstrates improved repeatability.     

Comparison of alteplase (tissue plasminogen activator) high‐dose vs. low‐dose protocol in restoring hemodialysis catheter function: The ALTE‐DOSE study

Hemodialysis catheter (HDC) dysfunction due to thrombosis is common, and dysfunction incidence can reach up to 50% within 1 year of use. Although administration of intraluminal alteplase (tissue plasminogen activator [tPA]) is the standard of practice to pharmacologically restore HDC function, there are no evidence‐based guidelines concerning the optimal tPA dose. The purpose of this study was to compare the efficacy of 1.0‐mg vs. 2.0‐mg tPA dwell protocols in restoring the HDC function in thrombotic dysfunctional catheters. A retrospective, single‐center study was conducted on two independent cohorts of patients; the first (n = 129) received 2.0 mg tPA/catheter lumen, while the second (n = 108) received 1.0 mg tPA/catheter lumen. Kaplan–Meier and Cox regression analyses were performed to compare the catheter survival time between patients who received 1.0 mg tPA and those who received 2.0 mg tPA. Catheter removal occurred in 25 (19.4%) of those catheters treated with 1.0 mg tPA compared with 11 (10.2%) of catheters treated with 2.0 mg tPA (P = 0.05). The hazard ratio (HR) for catheter removal was 2.75 (95% confidence interval [^95%CI] = 1.25–6.04) for the 1.0‐mg tPA cohort compared with the 2.0‐mg tPA cohort. Correction added on 3 December 2012, after first online publication: The tPA cohort values were changed. Female gender (HR = 2.51; ^95%CI = 1.20–5.27) and age (HR = 0.96; ^95%CI = 0.94–0.98) were also associated with catheter survival. Our findings suggest that treatment of dysfunctional HDC with 2.0‐mg tPA dwells is superior to 1.0‐mg tPA dwells.     

A graph coloring constructive hyper-heuristic for examination timetabling problems

In this work we investigate a new graph coloring constructive hyper-heuristic for solving examination timetabling problems. We utilize the hierarchical hybridizations of four low level graph coloring heuristics, these being largest degree, saturation degree, largest colored degree and largest enrollment. These are hybridized to produce four ordered lists. For each list, the difficulty index of scheduling the first exam is calculated by considering its order in all lists to obtain a combined evaluation of its difficulty. The most difficult exam to be scheduled is scheduled first (i.e. the one with the minimum difficulty index). To improve the effectiveness of timeslot selection, a?roulette wheel selection mechanism is included in the algorithm to probabilistically select an appropriate timeslot for the chosen exam. We test our proposed approach on the most widely used un-capacitated Carter benchmarks and also on the recently introduced examination timetable dataset from the 2007 International Timetabling Competition. Compared against other methodologies, our results demonstrate that the graph coloring constructive hyper-heuristic produces good results and outperforms other approaches on some of the benchmark instances.     

Deep penetration analysis with dynamic cylindrical cavitation fields

Dynamic cylindrical cavitation fields are studied for a family of plastic orthotropic solids with arbitrary strain hardening response. Analysis is within the framework of plane-strain, steady state flow theory of associated plasticity. New formulae for cavitation pressure are validated against accurate numerical analysis and contact is made with existing studies. A uniform procedure is presented for estimating penetration depth of rigid axisymmetric projectiles at normal impact. Comparison with available experimental data reveals a very good agreement for both spherical and cylindrical dynamic cavitation models. Quasi-static cavitation pressure formulae can predict penetration depth with an appropriate scaling of the yield stress. The scaling factors appear to be independent of material properties but reflect the shape of head profile.     

Physics of epitaxy and c-BN films optimized growth

The cubic zinc-blende phase of boron nitride (c-BN) affords a plethora of potential applications based on material hardness, low chemical reactivity, high thermal conductivity and also on its very large band gap. A modern growth experiments are currently carried out to elaborate monocrystalline c-BN films with a strong film-substrate adherence and up to now several substrates have been used. However, although the film concentration of c-BN is increasing, the growth optimization is still a question under debate. Optimum conditions must be found in energetic growth techniques (IBAD) as well as substrate conditions (temperature, polarization). In this field basic physics is at the very heart of any strategy which aims to elaborate high quality c-BN films. This involves the physics of heteroepitaxy, an aspect of the growth process which consists in taking advantage of complementary freedom degrees as substrate choice and introduction of buffer layers to optimize heterointerfaces. Although several substrates have been tested an optimized choice still remain to be found. On the other hand, the strategy of buffer layers to improve film quality has been less investigated. In this communication, we give the state of art of this field and we discuss the problem of the optimization of c-BN film quality and we demonstrate that the variation of c-BN content in BN films grown on different substrates can be understood on the basis of elasticity theory.     

Modal Identification Study of Vincent Thomas Bridge Using Simulated Wind-Induced Ambient Vibration Data

Abstract:   In this article, wind-induced vibration response of Vincent Thomas Bridge, a suspension bridge located in San Pedro near Los Angeles, California, is simulated using a detailed three-dimensional finite element model of the bridge and a state-of-the-art stochastic wind excitation model. Based on the simulated wind-induced vibration data, the modal parameters (natural frequencies, damping ratios, and mode shapes) of the bridge are identified using the data-driven stochastic subspace identification method. The identified modal parameters are verified by the computed eigenproperties of the bridge model. Finally, effects of measurement noise on the system identification results are studied by adding zero-mean Gaussian white noise processes to the simulated response data. Statistical properties of the identified modal parameters are investigated under an increasing level of measurement noise. The framework presented in this article will allow us to investigate the effects of various realistic damage scenarios in long-span cable-supported (suspension and cable-stayed) bridges on changes in modal identification results. Such studies are required to develop robust and reliable vibration-based structural health monitoring methods for this type of bridge, which is a long-term research objective of the authors.     

Alterations in plasma volume, plasma constituents, renin activity and aldosterone induced by maximal exercise in the horse

Plasma volume (PV) decreased by 13 per cent following the completion of 1,000 m of maximal exercise in the horse. This study demonstrated that the critical reduction in PV following maximal exercise occurred within 10 mins of completion of exercise, as previously reported in man. Total plasma protein (TPP) increased by 23 per cent at 2 and 5 mins, and by 21 per cent at 10 mins post exercise. Therefore, it does not appear to be an accurate measurement to assess the degree of PV contraction in the horse. Protein was apparently added to the intravascular space either during or following exercise. The changes in osmolality correlated strongly with those in sodium, which is the primary determinant of alterations in plasma tonicity. The increase in osmolality (12 per cent) was similar to the reduction in PV (13 per cent) concluding that a transient hypotonic fluid loss had occurred. The increase in plasma renin activity (PRA) following maximal exercise was followed by an increase in aldosterone (ALD) concentration in both magnitude and time course. Alterations in PV should be considered when interpreting electrolyte and serum enzyme activity data collected following maximal exercise.