Summary Objectives To evaluate implant survival following primary total hip replacement (THR) in younger patients. To describe the diversity in use of cup-stem implant combinations. Design 29,558 ...primary THRs osteoarthritis (OA) patients younger than 55 years of age performed from 1995 through 2011 were identified using the Nordic Arthroplasty Registry Association database. We estimated adjusted relative risk (aRR) of revision with 95% confidence interval (CI) using Cox regression. Results In general, no difference was observed between uncemented and cemented implants in terms of risk of any revision. Hybrid implants were associated with higher risk of any revision (aRR = 1.3, CI: 1.1–1.5). Uncemented implants led to a reduced risk of revision due to aseptic loosening (aRR = 0.5, CI: 0.5–0.6), whereas the risk was similar for hybrid and cemented implants. Compared with cemented implants, both uncemented and hybrid implants led to elevated risk of revision due to other causes, as well as elevated risk of revision due to any reason within 2 years. 183 different uncemented cup-stem implant combinations were registered in Denmark, of these, 172 were used in less than 100 operations which is similar to Norway, Sweden and Finland. Conclusions Uncemented implants perform better in relation to long-term risk of aseptic loosening, whereas both uncemented and hybrid rather than cemented implants in patients younger than 55 years had more short-term revisions because problems due to dislocation, periprosthetic fracture and infection has not yet been completely solved. The vast majority of cup-stem combinations were used in very few operations.
ABSTRACT
Aims To examine the reliability and validity of the widely used Addiction Severity Index (ASI).
Material Thirty‐seven studies of the psychometric performance of the ASI.
Findings The ...inter‐rater and test–retest reliabilities of the severity ratings and composites scores vary from excellent to unsatisfactory. High internal consistencies have been reported regularly for only three of the seven composite scores (medical status, alcohol use, psychiatric status). The remaining four composite scores (employment status, drug use, legal status, family/social relations) have low consistencies in at least four different studies. Coefficients of criterion validity are often low.
Conclusions There is a discrepancy between the psychometric performance of the ASI and its purported clinical, administrative and research uses.
The emerging quantum technological apparatuses1, 2, such as the quantum computer3-6, call for extreme performance in thermal engineering7. Cold distant heat sinks are needed for the quantized ...electric degrees of freedom due to the increasing packaging density and heat dissipation. Importantly, quantum mechanics sets a fundamental upper limit for the flow of information and heat, which is quantified by the quantum of thermal conductance8-10. However, the short distance between the heat-exchanging bodies in the previous experiments11-14 hinders their applicability in quantum technology. Here, we present experimental observations of quantum-limited heat conduction over macroscopic distances extending to a metre. We achieved this improvement of four orders of magnitude in the distance by utilizing microwave photons travelling in superconducting transmission lines. Thus, it seems that quantum-limited heat conduction has no fundamental distance cutoff. This work establishes the integration of normal-metal components into the framework of circuit quantum electrodynamics15-17 which provides a basis for the superconducting quantum computer18-21. Especially, our results facilitate remote cooling of nanoelectronic devices using far-away in-situ-tunable heat sinks22, 23. Furthermore, quantum-limited heat conduction is important in contemporary thermodynamics24, 25. Here, the long distance may lead to ultimately efficient mesoscopic heat engines with promising practical applications26.
Aim
Our aim was to compare the long‐term anatomical outcomes between robot‐assisted ventral mesh rectopexy (RVMR) and laparoscopic ventral mesh rectopexy (LVMR) for external or internal rectal ...prolapse.
Method
This study is a follow‐up of a single‐centre randomized controlled trial (RCT). Thirty patients were randomly allocated to RVMR (n = 16) or LVMR (n = 14). The primary end‐point was maintenance of the restored pelvic anatomy 5 years after the operation, as assessed by magnetic resonance (MR) defaecography. Secondary outcome measures included the Pelvic Organ Prolapse Quantification (POP‐Q) measures and functional results assessed using symptom questionnaires.
Results
Twenty‐six patients (14 RVMR and 12 LVMR) completed the 5‐year follow‐up and were included in the study. The MRI results, POP‐Q measurements and symptom‐specific quality of life measures did not differ between the RVMR and LVMR groups. The MRI measurements of the total study population remained unchanged between 3 months and 5 years. In the Pelvic Floor Distress Inventory (PFDI‐20), the RVMR group had lower symptom scores (mean 96.0, SD 70.7) than the LVMR group (mean 160.6, SD 58.9; P = 0.004). In the subscales of pelvic organ prolapse (POPDI‐6) (mean 23.2, SD 24.3 vs mean 52.4, SD 22.4; P = 0.001) and the Colorectal–Anal Distress Inventory (CRADI‐8) (mean 38.4, SD 23.3 vs mean 58.6, SD 25.4; P = 0.009), the patients in the RVMR group had significantly better outcomes.
Conclusion
After VMR, the corrected anatomy was preserved. There were no clinically significant differences in anatomical results between the RVMR and LVMR procedures 5 years after surgery based on MR defaecography. However, functional outcomes were better after RMVR.
Orexin A (OXA) and orexin B were originally isolated as hypothalamic peptides regulating sleep, wakefulness and feeding. However, growing evidence suggests that orexins have major functions also in ...the peripheral tissues. Central orexigenic pathways originating from medulla activate the hypothalamus-pituitary axis and can influence the sympathetic tone. Orexins and their receptors are widely dispersed throughout the intestine, where orexin receptors are regulated by the nutritional status, affect insulin secretion and intestinal motility. Although the primary source of the peptide has not been elucidated, OXA is detected in plasma and its level varies in response to the metabolic state. In this review, we focus on the current knowledge on peripheral functions of orexins and discuss possible endocrine, paracrine and neurocrine roles.
Objective/Background Expression patterns and association with cell specific gene expression signatures of the epigenetic regulator histone deacetylase 9 (HDAC9) and matrix metalloproteinase 12 ...(MMP12) in human plaque are not known. Methods This was a prospective cohort study. Genome wide expression analysis was performed in carotid, femoral, aortic plaques ( n = 68) and left internal thoracic (LITA) controls ( n = 28) and plaque histological severity assessed. Correlation and hierarchical cluster analysis was utilised. Results HDAC9 was associated with MMP12 expression in carotid plaques ( r = .46, p = .012) and controls ( r = −.44, p = .034). HDAC9 and MMP12 clustered with inflammatory macrophage markers but not with smooth muscle cell (SMC) rich markers. In plaques from all arterial sites, MMP12 but not HDAC9 showed positive correlation ( p < .05) with M2 and M4 polarized macrophage markers, and negative correlation with SMC rich signatures. In the carotid plaques, all M4 macrophage markers associated with MMP12 and HDAC9. The negative association of MMP12 with SMC rich signatures was pronounced in the carotid plaques. Neither HDAC9 nor MMP12 associated consistently with plaque stabilisation or thrombosis related genes. Immunohistochemistry further supported the association between HDAC9 and MMP12 in atherosclerotic plaques. Conclusion M4 macrophages are a possible source for HDAC9 and MMP12 expression in advanced human plaques.
Oxidized active carbon (oAC) catalyses the formation of polysubstituted quinolines from o‐vinyl anilines and aldehydes. The reaction proceeds in a cascade manner through condensation, ...electrocyclization and dehydrogenation, and gives access to a wide range of quinolines with alkyl and/or aryl substituents as demonstrated with 40 examples. The metal‐free catalytic procedure allows a heterogeneous protocol for the synthesis of various polysubstituted quinolines. The mechanistic studies imply that both the acid and quinoidic groups in oAC are integral for the catalytic manifold.
Elevated by the support: 2‐Alkynyl aniline cycloisomerization to indole is catalyzed by cationic Au NPs on a carbon support. Electroneutral and rich 2‐aryl indoles are further converted into ...3,3′‐biindoles by oxidative homocoupling that is readily catalyzed by the Au NPs on carbon, and exclusively but also somewhat sluggishly by the carbon support.
Aim
Neuropeptide Y (NPY) co‐localized with noradrenaline in central and sympathetic nervous systems seems to play a role in the control of energy metabolism. In this study, the aim was to elucidate ...the effects and pathophysiological mechanisms of increased NPY in catecholaminergic neurones on accumulation of body adiposity.
Methods
Transgenic mice overexpressing NPY under the dopamine‐beta‐hydroxylase promoter (OE‐NPYDβH) and wild‐type control mice were followed for body weight gain and body fat content. Food intake, energy expenditure, physical activity, body temperature, serum lipid content and markers of glucose homoeostasis were monitored. Thermogenic and lipolytic responses in adipose tissues, and urine catecholamine and tissue catecholamine synthesizing enzyme levels were analysed as indices of sympathetic tone.
Results
Homozygous OE‐NPYDβH mice showed significant obesity accompanied with impaired glucose tolerance and insulin resistance. Increased adiposity was explained by neither increased food intake or fat absorption nor by decreased total energy expenditure or physical activity. Adipocyte hypertrophy and decreased circulating lipid levels suggested decreased lipolysis and increased lipid uptake. Brown adipose tissue thermogenic capacity was decreased and brown adipocytes filled with lipids. Enhanced response to adrenergic stimuli, downregulation of catecholamine synthesizing enzyme expressions in the brainstem and lower adrenaline excretion supported the notion of low basal catecholaminergic activity.
Conclusion
Increased NPY in catecholaminergic neurones induces obesity that seems to be a result of preferential fat storage. These results support the role of NPY as a direct effector in peripheral tissues and an inhibitor of sympathetic activity in the pathogenesis of obesity.
Summary Objective To estimate and compare the lifetime risk of total knee replacement surgery (TKR) for osteoarthritis (OA) between countries, and over time. Method Data on primary TKR procedures ...performed for OA in 2003 and 2013 were extracted from national arthroplasty registries in Australia, Denmark, Finland, Norway and Sweden. Life tables and population data were also obtained for each country. Lifetime risk of TKR was calculated for 2003 and 2013 using registry, life table and population data. Results Marked international variation in lifetime risk of TKR was evident, with females consistently demonstrating the greatest risk. In 2013, Finland had the highest lifetime risk for females (22.8%, 95%CI 22.5–23.1%) and Australia had the highest risk for males (15.4%, 95%CI 15.1–15.6%). Norway had the lowest lifetime risk for females (9.7%, 95%CI 9.5–9.9%) and males (5.8%, 95%CI 5.6–5.9%) in 2013. All countries showed a significant rise in lifetime risk of TKR for both sexes over the 10-year study period, with the largest increases observed in Australia (females: from 13.6% to 21.1%; males: from 9.8% to 15.4%). Conclusions Using population-based data, this study identified significant increases in the lifetime risk of TKR in all five countries from 2003 to 2013. Lifetime risk of TKR was as high as 1 in 5 women in Finland, and 1 in 7 males in Australia. These risk estimates quantify the healthcare resource burden of knee OA at the population level, providing an important resource for public health policy development and healthcare planning.
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