A number of surgical approaches are utilized in total hip arthroplasty. It has been hypothesized that the anterior approach results in less muscle damage than the posterior approach. We prospectively ...analyzed biochemical markers of muscle damage and inflammation in patients treated with minimally invasive total hip arthroplasty with an anterior or posterior approach to provide objective evidence of the local soft-tissue injury at the time of arthroplasty.
Twenty-nine patients treated with minimally invasive total hip arthroplasty through a direct anterior approach and twenty-eight patients treated with the same procedure through a posterior approach were prospectively analyzed. Perioperative and radiographic data were collected to ensure cohorts with similar characteristics. Serum creatine kinase (CK), C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1 beta (IL-1ß), and tumor necrosis factor-alpha (TNF-a) levels were measured preoperatively, in the post-anesthesia-care unit (except for the CRP level), and on postoperative days 1 and 2. The Student t test and Fisher exact test were used to make comparisons between the two groups. Independent predictors of elevation in levels of markers of inflammation and muscle damage were determined with use of multivariate logistic regression analysis.
The levels of the markers of inflammation were slightly decreased in the direct-anterior-approach group as compared with those in the posterior-approach group. The rise in the CK level in the posterior-approach group was 5.5 times higher than that in the anterior-approach group in the post-anesthesia-care unit (mean difference, 150.3 units/L 95% CI, 70.4 to 230.2; p < 0.05) and nearly twice as high cumulatively (mean difference, 305.0 units/L 95% CI, -46.7 to 656.8; p < 0.05).
We believe that the anterior total hip arthroplasty approach used in this study caused significantly less muscle damage than did the posterior surgical approach, as indicated by serum CK levels. The clinical importance of the rise in the CK level needs to be delineated by additional clinical studies. The overall physiologic burden, as demonstrated by measurement of inflammation marker levels, appears to be similar between the anterior and posterior approaches. Objective measurement of muscle damage and inflammation markers provides an unbiased way of determining the immediate effects of surgical intervention in patients treated with total hip arthroplasty.
The vision of autonomic computing Kephart, J.O.; Chess, D.M.
Computer (Long Beach, Calif.),
2003-Jan., 2003-01-00, 20030101, Letnik:
36, Številka:
1
Journal Article
Recenzirano
A 2001 IBM manifesto observed that a looming software complexity crisis -caused by applications and environments that number into the tens of millions of lines of code - threatened to halt progress ...in computing. The manifesto noted the almost impossible difficulty of managing current and planned computing systems, which require integrating several heterogeneous environments into corporate-wide computing systems that extend into the Internet. Autonomic computing, perhaps the most attractive approach to solving this problem, creates systems that can manage themselves when given high-level objectives from administrators. Systems manage themselves according to an administrator's goals. New components integrate as effortlessly as a new cell establishes itself in the human body. These ideas are not science fiction, but elements of the grand challenge to create self-managing computing systems.
Background Anterior shoulder instability with bone loss can be treated successfully with the modified Bristow procedure. Opinions vary regarding the role of the soft-tissue sling created by the ...conjoined tendon after transfer. Therefore, the aim of this study was to determine the effect of the modified Bristow procedure and conjoined tendon transfer on glenohumeral translation and kinematics after creating anterior instability. Methods Eight cadaveric shoulders were tested with a custom shoulder testing system. Range-of-motion, translation, and kinematic testing was performed in 60° of glenohumeral abduction in the scapular and coronal planes under the following conditions: intact joint, Bankart lesion with 20% glenoid bone loss, modified Bristow procedure, and soft tissue–only conjoined tendon transfer. Results A Bankart lesion with 20% bone loss resulted in significantly increased external rotation and translation compared with the intact condition ( P < .05), as well as an anterior shift of the humeral head apex at all points of external rotation. Both the modified Bristow procedure and soft-tissue Bristow procedure maintained the increase in external rotation but resulted in significantly decreased translation ( P < .05). There was no difference in translation between the 2 reconstructions. Conclusions The increase in external rotation suggests that the modified Bristow procedure does not initially restrict joint motion. Translational stability can be restored in a 20% bone loss model without a bone block, suggesting the importance of the soft-tissue sling.
Background:
Up to 1 billion people have insufficient or deficient vitamin D levels. Despite the well-documented, widespread prevalence of low vitamin D levels and the importance of vitamin D for ...athletes, there is a paucity of research investigating the prevalence of vitamin D deficiency in athletes.
Hypothesis:
We investigated the prevalence of abnormal vitamin D levels in National Collegiate Athletic Association (NCAA) Division I college athletes at a single institution. We hypothesized that vitamin D insufficiency is prevalent among our cohort.
Study Design:
Cohort study.
Level of Evidence:
Level 1.
Methods:
We measured serum 25-hydroxyvitamin D (25(OH)D) levels of 223 NCAA Division I athletes between June 2012 and August 2012. The prevalence of normal (≥32 ng/mL), insufficient (20 to <32 ng/mL), and deficient (<20 ng/mL) vitamin D levels was determined. Logistic regression was utilized to analyze risk factors for abnormal vitamin D levels.
Results:
The mean serum 25(OH)D level for the 223 members of this study was 40.1 ± 14.9 ng/mL. Overall, 148 (66.4%) participants had sufficient 25(OH)D levels, and 75 (33.6%) had abnormal levels. Univariate analysis revealed the following significant predictors of abnormal vitamin D levels: male sex (odds ratio OR = 2.83; P = 0.0006), Hispanic race (OR = 6.07; P = 0.0063), black race (OR = 19.1; P < 0.0001), and dark skin tone (OR = 15.2; P < 0.0001). Only dark skin tone remained a significant predictor of abnormal vitamin D levels after multivariate analysis (adjusted OR = 15.2; P < 0.0001).
Conclusion:
In a large cohort of NCAA athletes, more than one third had abnormal vitamin D levels. Races with dark skin tones are at much higher risk than white athletes. Male athletes are more likely than female athletes to be vitamin D deficient. Our study demonstrates a high prevalence of vitamin D deficiency among healthy NCAA athletes.
Clinical Relevance:
Many studies indicate a significant prevalence of vitamin-D insufficiency across various populations. Recent studies have demonstrated a direct relationship between serum 25(OH)D levels and muscle power, force, velocity, and optimal bone mass. In fact, studies examining muscle biopsies from patients with low vitamin D levels have demonstrated atrophic changes in type II muscle fibers, which are crucial to most athletes. Furthermore, insufficient 25(OH)D levels can result in secondary hyperparathyroidism, increased bone turnover, bone loss, and increased risk of low trauma fractures and muscle injuries. Despite this well-documented relationship between vitamin D and athletic performance, the prevalence of vitamin D deficiency in NCAA athletes has not been well studied.
Resistive oxide materials play an important role in the front contact of CdTe solar cells. The high-resistance transparent (HRT) or “buffer” layer has been used extensively in CdTe thin-film ...photovoltaics to enable a reduction in CdS thickness while maintaining near-maximum device voltage and fill factor. SnO2- and ZnO-based alloys were tested as HRT layers on a fluorine-doped tin oxide transparent conducting oxide. SnO2-based alloy HRT layers were deposited via atmospheric pressure chemical vapor deposition (APCVD). Alloying ZnO with MgO to create MgxZn1−xO (MZO) via radio-frequency sputter deposition was explored as a way to reduce the electron affinity of ZnO HRT layers. To fully understand the behavior of these materials, many devices were fabricated with either no CdS layer, a sublimated CdS layer, or a sputtered, oxygenated CdS layer. MZO layers resulted in high open-circuit voltage and device efficiency even with the complete elimination of the CdS layer. In both HRT systems, controlling electron affinity to optimize front contact band alignment is an important consideration. Band measurements using photoelectron spectroscopy and synchrotron techniques correlate band alignment measurements with efficiency parameters in the design of HRT and CdS layers.
•SnO2- and ZnO-based HRT layers can be tuned by alloying to improve device efficiency.•HRT layer effectiveness is strongly tied to band alignment in the solar cell.•High-bandgap (Mg, Zn)O replaces both CdS and HRT layers in high-efficiency CdTe solar cells.
Due to the emerging potential for trafficking of special nuclear material, research programs are investigating current capabilities of commercially available portable gamma ray detection systems. ...Presented in this paper are the results of three different portable high-purity germanium (HPGe) detectors used to identify short-lived fission products generated from thermal neutron interrogation of small samples of highly enriched uranium. Samples were irradiated at the Washington State University Nuclear Radiation Center’s 1 MW TRIGA reactor. The three portable, HPGe detectors used were the ORTEC MicroDetective
1
, the ORTEC Detective
2
, and the Canberra Falcon
3
. Canberra’s GENIE-2000 software was used to analyze the spectral data collected from each detector. Ultimately, these three portable detectors were able to identify a large range of fission products showing potential for material discrimination.
Autonomic computing is the solution proposed to cope with the complexity of today's computing environments. Self-management, an important element of autonomic computing, is also characteristic of ...single and multiagent systems, as well as systems based on service-oriented architectures. Combining these technologies can be profitable for all - in particular, for the development of autonomic computing systems.
We present data characterizing the performance of the first segmented, N-type Ge detector, isotopically enriched to 85% 76Ge. This detector, based on the Ortec PT62 design and referred to as SEGA ...(Segmented, Enriched Germanium Assembly), was developed as a possible prototype for neutrinoless double beta-decay measurements by the Majorana collaboration. We present some of the general characteristics (including bias potential, efficiency, leakage current, and integral cross-talk) for this detector in its temporary cryostat. We also present an analysis of the resolution of the detector, and demonstrate that for all but two segments there is at least one channel that reaches the Majorana resolution goal below 4 keV FWHM at 2039 keV, and all channels are below 4.5 keV FWHM.
Rhabdomyosarcoma (RMS) is a soft tissue sarcoma associated with the skeletal muscle lineage. Of the two predominant subtypes, known as embryonal (eRMS) and alveolar (aRMS), aRMS has the poorer ...prognosis, with a five-year survival rate of <50%. The majority of aRMS tumors express the fusion protein PAX3-FOXO1. As PAX3-FOXO1 has proven chemically intractable, this study aims to identify targetable proteins that are downstream from or cooperate with PAX3-FOXO1 to support tumorigenesis.
Microarray analysis of the transcriptomes of human skeletal muscle myoblasts expressing PAX3-FOXO1 revealed alteration of several Wnt pathway gene members, including secreted frizzled related protein 3 (SFRP3), a secreted Wnt pathway inhibitor. Loss-of-function using shRNAs against SFRP3 was used to interrogate the role of SFRP3 in human aRMS cell lines in vitro and conditional murine xenograft systems in vivo. The combination of SFRP3 genetic suppression and the chemotherapeutic agent vincristine was also examined.
In vitro, suppression of SFRP3 inhibited aRMS cell growth, reduced proliferation accompanied by a G1 arrest and induction of p21, and induced apoptosis. In vivo, doxycycline-inducible suppression of SFRP3 reduced aRMS tumor growth and weight by more than three-fold, in addition to increasing myogenic differentiation and β-catenin signaling. The combination of SFRP3 suppression and vincristine was more effective at reducing aRMS cell growth in vitro than either treatment alone, and ablated tumorigenesis in vivo.
SFRP3 is necessary for the growth of human aRMS cells both in vitro and in vivo and is a promising new target for investigation in aRMS.
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