Search

Background: The use of reverse shoulder arthroplasty (RSA) continues to grow with expanding indications and increased surgeon awareness. Previous data for other lower extremity joint replacements indicate that high-volume centers have better outcomes, with lower complication rates, decreased length of stay, and complications for both hemiarthroplasty and total shoulder arthroplasty. The purpose of this study is to evaluate the effects of hospital size and setting on adverse events for RSA.Materials and Methods: The National Inpatient Sample database was queried for RSA performed using ICD-9 codes. Primary outcomes included length of stay (LOS), total hospital charges, discharge disposition, and postoperative complications. Odds ratios were used to assess the risk of inpatient postoperative complications.Results: A weighted national estimate of 24,056 discharges for patients undergoing RSA was included in the study. Patients at larger hospitals experienced higher total charges, increased average LOS, and slightly higher complication rates compared to those of small and medium hospitals. Patients in larger hospitals had significantly increased rates of genitourinary and central nervous system complications, while patients in small/medium hospitals experienced higher rates of hematoma/seroma.Conclusion: Results from this study indicate that large and non-teaching hospitals overall tend to burden the patients with higher hospital charges, longer hospital stay, and more frequent non-routine discharges. Also, larger hospitals are associated with higher risk of genitourinary and central nervous system complications rates, whereas non-teaching hospitals are associated with lower risk of infection and higher risk of anemia after RSA. With the growth in RSA in the USA, continued attention needs to be placed on improving outcomes and resource utilization for RSA patients even in larger hospitals. [ABSTRACT FROM AUTHOR]

Objective Recent evidence found that patients with schizophrenia display non-verbal behaviour designed to avoid social engagement during the opening moments of their meetings with psychiatrists. This study aimed to replicate, and build on, this finding, assessing the non-verbal behaviour of patients and psychiatrists during meetings, exploring changes over time and its association with patients' symptoms and the quality of the therapeutic relationship. Method 40-videotaped routine out-patient consultations, involving patients with schizophrenia, were analysed. Non-verbal behaviour of patients and psychiatrists was assessed during three fixed, 2-min intervals using a modified Ethological Coding System for Interviews. Symptoms, satisfaction with communication and the quality of the therapeutic relationship were also measured. Results Over time, patients' non-verbal behaviour remained stable, whilst psychiatrists' flight behaviour decreased. Patients formed two groups based on their non-verbal profiles, one group ( n = 25) displaying pro-social behaviour, inviting interaction and a second ( n = 15) displaying flight behaviour, avoiding interaction. Psychiatrists interacting with pro-social patients displayed more pro-social behaviours ( P < 0.001). Patients' pro-social profile was associated reduced symptom severity ( P < 0.05), greater satisfaction with communication ( P < 0.001) and positive therapeutic relationships ( P < 0.05). Conclusion Patients' non-verbal behaviour during routine psychiatric consultations remains unchanged, and is linked to both their psychiatrist's non-verbal behaviour and the quality of the therapeutic relationship. [ABSTRACT FROM AUTHOR]

Where cattle (Bos taurus) and free-ranging white-tailed deer (Odocoileus virginianus) coexist, they frequently share space and resources, potentially resulting in damage to stores of livestock feed and risk of interspecies disease transmission. Preventing use of stored feed by deer can be an important objective in farm management, depending on amount of damage experienced and perceived risk of disease transmission. Woven wire fences (2.4 to 3.0 m high) are generally considered to be the most effective means for excluding deer. However, rapidly deployable temporary means of excluding deer could be useful, especially during late winter when deer are most physiologically stressed and motivated to consume feed meant for cattle. Thus, the objective of this study was to evaluate a novel 1,2-m-tall electric fence consisting of 4 strands of bipolar tape (not requiring separate ground wires or animal contact with ground) for excluding deer from artificially established feed piles during late winter 2008 in northwestern Minnesota. To induce deer to pause, investigate the fence, and receive negative stimuli before attempting to jump the fence, the bipolar tape was baited with a viscous fluid attractive to deer. The fence was estimated to be >80% effective at reducing deer presence at feed piles (10 treatment sites and 11 control sites) given the late winter to early spring conditions. Despite the efficacy, using the fence as a primary means of protecting stored feed from deer in areas with known disease transmission risk (e.g., presence of bovine tuberculosis) is not recommended because risk could remain unacceptably high if even low numbers of deer access stored feed. Yet, the fence could be effective as immediate protection of stored feed in winter before a more permanent and effective deterrence strategy, such as woven-wire fencing, could be installed during the subsequent summer. The fence would also be effective for reducing deer depredation of stored feed, as well as gardens, small orchards, or other localized or seasonal resources. [ABSTRACT FROM AUTHOR]

Background: The homeobox containing transcription factor MSX2 is a key regulator of embryonic development and has been implicated to have a role in breast and pancreatic cancer.Methods: Using a selection of two- and three-dimensional in vitro assays and tissue microarrays (TMAs), the clinical and functional relevance of MSX2 in malignant melanoma was explored. A doxycyline-inducible over-expression system was applied to study the relevance of MSX2 in vitro. For TMA construction, tumour material from 218 melanoma patients was used.Results: Ectopic expression of MSX2 resulted in the induction of apoptosis and reduced the invasive capacity of melanoma cells in three-dimensional culture. MSX2 over-expression was shown to affect several signalling pathways associated with cell invasion and survival. Downregulation of N-Cadherin, induction of p21 and inhibition of both BCL2 and Survivin were observed. Cytoplasmic MSX2 expression was found to correlate significantly with increased recurrence-free survival (P=0.008). Nuclear expression of MSX2 did not result in significant survival correlations, suggesting that the beneficial effect of MSX2 may be independent of its DNA binding activity.Conclusions: MSX2 may be an important regulator of melanoma cell invasion and survival. Cytoplasmic expression of the protein was identified as biomarker for good prognosis in malignant melanoma patients. [ABSTRACT FROM AUTHOR]

The reduced Hamiltonian system on T*(SU(3)/SU(2)) is derived from a Riemannian geodesic motion on the SU(3) group manifold parametrized by the generalized Euler angles and endowed with a bi-invariant metric. Our calculations show that the metric defined by the derived reduced Hamiltonian flow on the orbit space SU(3)/SU(2)≃S5 is not isometric or even geodesically equivalent to the standard Riemannian metric on the five-sphere S5 embedded into R6. [ABSTRACT FROM AUTHOR]

The [sup[87]Sr/[sup 86]Sr ratio of Orange River water increases from 0.7081 at its headwaters in the basalt of the Drakensberg mountains, to a value of 0.7126 before its confluence with the Vaal River tributary. The concomitant increase in Sr concentration is from 0.08 to 1.28 micro M. The Vaal River, which drains Precambrian and Permian/Triassic rocks, has higher Sr concentrations, from 0.95 to 6.69 micro M, and more radiogenic [sup 87]Sr/[sup 86]Sr values, from 0.713 to 0.731. The geochemistry of the dissolved load of the Orange and Vaal rivers corresponds with that of the dominant catchment lithologies: Jurassic basalt, Permian/Triassic Karoo sediments and Proterozoic/ Archaean para- and ortho-gneisses/granitoids. Chemical weathering rates in the Orange River system are at least a factor of 3 lower than the global average value of 36 ton/km[sup 2]/yr. The highest chemical and physical weathering rates occur in the Upper Orange River, associated with high runoff and relief. In the low-relief Vaal River, chemical weathering predominates over physical weathering. [ABSTRACT FROM AUTHOR]

At operation for small bowel intussusception, a 26-year-old man was found to have an enlarged liver and spleen. Subsequent investigations suggested bile passage infection associated with numerous intrahepatic gall-stones but symptomatic cholangitis did not present until 5 months later. Retrograde cholangiography showed cavernous ectasia of the bile ducts which contained gall-stones. [ABSTRACT FROM PUBLISHER]

We consider the Nielsen identities for the twopoint functions of full QCD and QED in the class of Lorentz gauges. For pedagogical reasons the identities are first derived in QED to demonstrate the gauge independence of the photon self-energy, and of the electron mass shell. In QCD we derive the general identity and hence the identities for the quark, gluon and ghost propagators. The explicit contributions to the gluon and ghost identities are calculated to one-loop order, and then we show that the quark identity requires that in on-shell schemes the quark mass renormalisation must be gauge independent. Furthermore, we obtain formal solutions for the gluon selfenergy and ghost propagator in terms of the gauge dependence of other, independent Green functions. [ABSTRACT FROM AUTHOR]

We calculate the coefficients of $$\left\langle {:\bar \psi \psi :} \right\rangle $$ to leading order in α in the operator product expansion of the fundamental three-point functions of QCD in the deep Euclidean region. We demonstrate that these coefficients satisfy the Ward identities. [ABSTRACT FROM AUTHOR]

We consider light cone sum rules for a vertex function involving a pion state. These incorporate radiative corrections, continuum effects and power corrections; the latter depend on the non-asymptotic form of a higher twist component of the pion wave function. We derive restrictions on this component from sum rules for two-point functions and propose a model wave function for it. Finally we analyse our vertex sum rules in the light of this information and find results for the lowest twist component in good agreement with those already obtained from two-point function sum rules with derivative currents. [ABSTRACT FROM AUTHOR]

Chronic pancreatitis is an infrequently considered cause of gastrointestinal bleeding. Four cases are described who presented to a surgical unit in a year. One patient bled down the main pancreatic duct from a splenic artery pseudoaneurysm, one had a fatal haemorrhage from a superior mesenteric artery aneurysm which ruptured into the duodenum, and two were considered to have bled from vessels in the stomach or colon which were involved in the peripancreatic inflammatory tissues. The difficulties in diagnosing these patients are described and the report emphasises that the diagnosis should be considered in obscure cases of gastrointestinal bleeding especially where there is a history of alcohol abuse and left upper quadrant or epigastric pain. [ABSTRACT FROM PUBLISHER]

Evaluates magnetic resonance images of the abdomen obtained with a T1-weighted, three-dimensional, gradient echo technique. Comparison with a two-dimensional technique; Quality of arterial phase three-dimensional images.

In the investigation of azoospermia in the presence of dilated epididymes and testicular biopsies showing normal spermatogenesis, vasograms are useful to show the site of a blockage. However, it is sometimes difficult to match up the X-ray appearances with the anatomical site of the blockage. A technique is described for accurately locating a blockage in the vas deferens at the time of operation. [ABSTRACT FROM AUTHOR]