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Background: eNOS (endothelial nitric oxide synthase) is an endothelial cell (EC)–specific gene predominantly expressed in medium- to large-sized arteries where ECs experience atheroprotective laminar flow with high shear stress. Disturbed flow with lower average shear stress decreases eNOS transcription, which leads to the development of atherosclerosis, especially at bifurcations and curvatures of arteries. This prototypic arterial EC gene contains 2 distinct flow-responsive cis-DNA elements in the promoter, the shear stress response element (SSRE) and the KLF (Krüppel-like factor) element. Previous in vitro studies suggested their positive regulatory functions on flow-induced transcription of EC genes including eNOS. However, the in vivo function of these cis-DNA elements remains unknown. Methods: Insertional transgenic mice with a mutation at each flow-responsive cis-DNA element were generated using a murine eNOS promoter–β-galactosidase reporter by linker-scanning mutagenesis and compared with episomal-based mutations in vitro. DNA methylation at the eNOS proximal promoter in mouse ECs was assessed by bisulfite sequencing or pyrosequencing. Results: Wild type mice with a functional eNOS promoter–reporter transgene exhibited reduced endothelial reporter expression in the atheroprone regions of disturbed flow (n=5). It is surprising that the SSRE mutation abrogated reporter expression in ECs and was associated with aberrant hypermethylation at the eNOS proximal promoter (n=7). Reporter gene silencing was independent of transgene copy number and integration position, indicating that the SSRE is a critical cis-element necessary for eNOS transcription in vivo. The KLF mutation demonstrated an integration site–specific decrease in eNOS transcription, again with marked promoter methylation (n=8), suggesting that the SSRE alone is not sufficient for eNOS transcription in vivo. In wild type mice, the native eNOS promoter was significantly hypermethylated in ECs from the atheroprone regions where eNOS expression was markedly repressed by chronic disturbed flow, demonstrating that eNOS expression is regulated by flow-dependent DNA methylation that is region-specific in the arterial endothelium in vivo. Conclusions: We report, for the first time, that the SSRE and KLF elements are critical flow sensors necessary for a transcriptionally permissive, hypomethylated eNOS promoter in ECs under chronic shear stress in vivo. Moreover, eNOS expression is regulated by flow-dependent epigenetic mechanisms, which offers novel mechanistic insight on eNOS gene regulation in atherogenesis.

Introduction Aneurysmal subarachnoid haemorrhage (aSAH) is a condition with significant morbidity and mortality. Traditional markers of aSAH have established their utility in the prediction of aSAH outcomes while frailty markers have been validated in other surgical specialties. We aimed to compare the predictive value of frailty indices and markers of sarcopaenia and osteopaenia, against the traditional markers for aSAH outcomes. Methods An observational study in a tertiary neurosurgical unit on 51 consecutive patients with ruptured aSAH was performed. The best performing marker in predicting the modified Rankin scale (mRS) on discharge was selected and an appropriate threshold for the definition of frail and non-frail was derived. We compared various frailty indices (modified frailty index 11, and 5, and the National Surgical Quality Improvement Program score [NSQIP]) and markers of sarcopaenia and osteopaenia (temporalis [TMT] and zygoma thickness), against traditional markers (age, World Federation of Neurological Surgery and modified Fisher scale [MFS]) for aSAH outcomes. Univariable and multivariable analysis was then performed for various inpatient and long-term outcomes. Results TMT was the best performing marker in our cohort with an AUC of 0.82, Somers’ D statistic of 0.63 and Tau statistic 0.25. Of the frailty scores, the NSQIP performed the best (AUC 0.69), at levels comparable to traditional markers of aSAH, such as MFS (AUC 0.68). The threshold of 5.5 mm in TMT thickness was found to have a specificity of 0.93, sensitivity of 0.51, positive predictive value of 0.95 and negative predictive value of 0.42. After multivariate analysis, patients with TMT ≥ 5.5 mm (defined as non-frail), were less likely to experience delayed cerebral ischaemia (OR 0.11 [0.01 – 0.93], p = 0.042), any complications (OR 0.20 [0.06 – 0.069], p = 0.011), and had a larger proportion of favourable mRS on discharge (95.0% vs. 58.1%, p = 0.024) and at 3-months (95.0% vs. 64.5%, p = 0.048). However, the gap between unfavourable and favourable mRS was insignificant at the comparison of 1-year outcomes. Conclusion TMT, as a marker of sarcopaenia, correlated well with the presenting status, and outcomes of aSAH. Frailty, as defined by NSQIP, performed at levels equivalent to aSAH scores of clinical relevance, suggesting that, in patients presenting with acute brain injury, both non-neurological and neurological factors were complementary in the determination of eventual clinical outcomes. Further validation of these markers, in addition to exploration of other relevant frailty indices, may help to better prognosticate aSAH outcomes and allow for a precision medicine approach to decision making and optimization of best outcomes.

Summary Background and aims Computed tomography (CT)-based measurement of skeletal muscle cross-sectional area (CSA) and Hounsfield unit (HU) radiodensity are used to assess the presence of sarcopenia and myosteatosis, respectively. The validated CT-based technique involves analysis of skeletal muscle at the third lumbar vertebral (L3) level. Recently there has been increasing interest in the use of psoas muscle alone as a sentinel. However, this technique has not been extensively investigated or compared with the previous validated standard approach. Methods Portovenous phase CT images at the L3 level were identified retrospectively from a single institution in 150 patients who had non-emergency scans and were analysed by a single assessor using SliceOmatic software v5.0 (TomoVision, Canada). Manual segmentation based upon validated HU thresholds for skeletal muscle density was performed for all skeletal muscle, as well as the individual muscle groups. The muscle CSA and mean radiodensity of each group were compared against the whole L3 slice values. Results When compared with whole L3 slice CSA, anterior abdominal wall CSA had the strongest correlation (r = 0.9315, p

Background Triage trauma scores are utilised to determine patient disposition, interventions and prognostication in the care of trauma patients. Heart rate variability (HRV) and heart rate complexity (HRC) reflect the autonomic nervous system and are derived from electrocardiogram (ECG) analysis. In this study, we aimed to develop a model incorporating HRV and HRC, to predict the need for life-saving interventions (LSI) in trauma patients, within 24 h of emergency department presentation. Methods We included adult trauma patients (≥ 18 years of age) presenting at the emergency department of Singapore General Hospital between October 2014 and October 2015. We excluded patients who had non-sinus rhythms and larger proportions of artefacts and/or ectopics in ECG analysis. We obtained patient demographics, laboratory results, vital signs and outcomes from electronic health records. We conducted univariate and multivariate analyses for predictive model building. Results Two hundred and twenty-five patients met inclusion criteria, in which 49 patients required LSIs. The LSI group had a higher proportion of deaths (10, 20.41% vs 1, 0.57%, p Conclusions An HRV/HRC model outperforms other triage trauma scores and selected vital signs in predicting the need for LSIs but needs to be validated in larger patient populations.

Microbes occupy a major part of the planets’ living material; the greater part of the microorganisms including bacteria, viruses, spores, and fungi, is hazardous to living organisms including human beings. Infectious diseases kill over 17 million people per year according to WHO reports. Unfortunately, mortality rates of few years show new records due to the novel microbes including SARS, MERS, and COVID-19. Generally, numerous disease-causing bacteria produce poisonous chemicals that harm cells. Viruses aren’t made out of cells; however, they are smaller than cells. Recently, various researches have been conducted in the development for the protection against various pathogens, which is more essential in paving way to the discovery of antimicrobial agents. This chapter provides the overall information on the microbes and their protection including the mechanism behind the microbes. The antimicrobial textiles for hygienic and medical purposes are discussed comprehensively.

In the field of technical textiles, medical textiles have become very important. They can help to solve the pandemic situations like COVID 19 and can be used for personal protective equipment (PPE) or face masks. This chapter offers a general introduction of textile structures as unique materials for plenty of special applications in health care. Special materials for obtaining the high functional textile products including nanomaterials, aerogels, shape-memory materials, and stimuli-sensitive materials are reviewed. The medical textiles, types of fibers/fabrics utilization according to the classification of medical textiles, and textiles supporting medical effects are discussed.

Author(s): Tornetta, Paul; Della Rocca, Gregory J; Morshed, Saam; Jones, Clifford; Heels-Ansdell, Diane; Sprague, Sheila; Petrisor, Brad; Jeray, Kyle J; Del Fabbro, Gina; Bzovsky, Sofia; Bhandari, Mohit; FLOW Investigators | Abstract: IntroductionOpen fractures are associated with a high risk of infection. The prevention of infection is the single most important goal, influencing perioperative care of patients with open fractures. Using data from 2,500 participants with open fracture wounds enrolled in the Fluid Lavage of Open Wounds trial, we conducted a multivariable analysis to determine the factors that are associated with infections 12 months postfracture.MethodsEighteen predictor variables were identified for infection a priori from baseline data, fracture characteristics, and surgical data from the Fluid Lavage of Open Wounds trial. Twelve predictor variables were identified for deep infection, which included both surgically and nonoperatively managed infections. We used multivariable Cox proportional hazards regression analyses to identify the factors associated with infection. Irrigation solution and pressure were included as variables in the analysis. The results were reported as adjusted hazard ratios (HRs), 95% confidence intervals (CIs), and associated P values. All tests were two tailed with alpha = 0.05.ResultsFactors associated with any infection were fracture location (tibia: HR 5.13 versus upper extremity, 95% CI 3.28 to 8.02; other lower extremity: HR 3.63 versus upper extremity, 95% CI 2.38 to 5.55; overall P l 0.001), low energy injury (HR 1.64, 95% CI 1.08 to 2.46; P = 0.019), degree of wound contamination (severe: HR 2.12 versus mild, 95% CI 1.35 to 3.32; moderate: HR 1.08 versus mild, 95% CI 0.78 to 1.49; overall P = 0.004), and need for flap coverage (HR 1.82, 95% CI 1.11 to 2.99; P = 0.017).DiscussionThe results of this study provide a better understanding of which factors are associated with a greater risk of infection in open fractures. In addition, it can allow for surgeons to better counsel patients regarding prognosis, helping patients to understand their individual risk of infection.

In this study, photochromic fabrics were prepared by incorporating the spirooxazine derivative of 5-chloro-1,3-dyhydro-1,3,3-trimethylspiro[2H-indole-2,3′-[3H]-naphth [2,1-b] [1,4] oxazine on the polyethylene terephthalate (PET) fabric through a sol-gel coating process. The treated fabrics showed good photochromic response under UV irradiation. In this work, three types of silane were used as the silica precursor and the resultant coatings showed a significant difference in their photochromic response such as Kubelka–Munk function (K/S), change in optical density (ΔOD) rate constant and half-life. The coated fabric shows two different absorption maxima and however it confirms that there is strong influence on the type of silane. The functional group of uncoated and sol-gel coated fabrics are analyzed by ATR-FTIR. The type of the silane also influences the physical properties of the coated fabrics. The surface characteristics were analyzed by scanning electron microscope (SEM) and laser scanning confocal microscope (LSCM), which showed significant changes in the surface micro-roughness after coating.

The commercial availability of inorganic/organic precursors for sol-gel formulations is very high and increases day by day. In textile applications, the precursor-synthesized sol-gels along with functional chemicals can be deposited onto textile fabrics in one step by rolling, padding, dip-coating, spraying or spin coating. By using this technology, it is possible to provide fabrics with functional/multi-functional characteristics including flame retardant, anti-mosquito, water- repellent, oil-repellent, anti-bacterial, anti-wrinkle, ultraviolet (UV) protection and self-cleaning properties. These surface properties are discussed, describing the history, basic chemistry, factors affecting the sol-gel synthesis, progress in sol-gel technology along with various parameters controlling sol-gel technology. Additionally, this review deals with the recent progress of sol-gel technology in textiles in addressing fabric finishing, water repellent textiles, oil/water separation, flame retardant, UV protection and self-cleaning, self-sterilizing, wrinkle resistance, heat storage, photochromic and thermochromic color changes and the improvement of the durability and wear resistance properties.

One of the biggest threats to living species is environmental damage and consequent global warming. Industrialization in every field is responsible for these issues. We know that the textile industry is a gigantic industry and a huge polluter. Fiber is the basic raw material for textiles, it is necessary to initiate utilization of sustainable materials to produce sustainable textiles which reduce the environmental burdens. Most of the natural fibers having better properties toward the comfort characteristics, resulting in the huge demand which directly increasing the environmental threats. For example, cotton is the world’s most popular natural fiber, accounting for 80% of all-natural fibers used, but the cultivation of cotton is a thorough environmental and health disaster which is almost unbelievable. But all of these environmental and health hazards can be taken care of by the cultivation of organic cotton and perhaps organic cotton alone couldn’t replace the cotton. Therefore, it is necessary to find some alternatives; however, it should be in a sustainable manner. Based on these facts, we briefly describe in this chapter about sustainability in the regenerated fibers which include the cellulose and protein and their recent developments. This chapter deals with various sustainable regenerated fibers used in textiles namely lyocell, bamboo viscose, modal, seacell®, smartcell®, and sustainable protein fibers.

The textile industry is one of the largest contributors to environmental threats globally, producing 60 billion kilograms of fabric annually and using up to 9 trillion gallons of water. During coloration, large volumes of unfixed dye are released into water bodies, and approximately 10–15% of dye is lost into the environment as wastewater. In addition, because of competitiveness in textile industry production, an increase in the use of combinations of synthetic dyes has contributed to dye wastewater, creating an even larger volume of effluent. Dye can remain in the environment for an extended period of time because it has high thermal photostability and resists biodegradation. The release of dye effluent into seawater and river water is very destructive to living organisms, including humans and other animals. Therefore, it is important to study and raise awareness of alternative processes that reduce pollution loads. This chapter discusses recent developments that reduce unfixed color loads in effluent by use of various dyeing techniques such as modification of chemical pretreatments, the nanodyeing process, plasma-induced coloration, supercritical carbon dioxide dyeing, microwave-assisted dyeing and ultrasonic dyeing to the next level.

Copyright © 2018 by the American Society of Plastic Surgeons. Background: Soft-tissue complications often dictate the success of limb salvage and the overall outcome of open fractures. Based on prior work at the R Adams Cowley Shock Trauma Center, the authors hypothesize that wounds larger than 200 cm2 are associated with a greater likelihood of both flap-related reoperation and wound complications among patients requiring soft-tissue reconstruction with a rotational flap or free tissue transfer. Methods: This study was a secondary analysis of Fluid Lavage in Open Wounds trial data that included all patients who received a rotational or free tissue flap transfer for an open fracture. The primary outcome was flap-related reoperation within 12 months of injury. The secondary outcome was wound complication, which included events treated operatively or nonoperatively. Multivariable logistic regression was used to assess the association between wound size and outcomes, adjusting for confounders. Results: Seventeen percent of the 112 patients required a flap-related reoperation. A wound size greater than 200 cm2 was not associated with reoperation in an unadjusted model (p = 0.64) or adjusting for Gustilo type (p = 0.70). The sample had an overall wound complication rate of 47.3 percent. Patients with a wound size of greater than 200 cm2 were three times more likely to experience wound complications (OR, 3.05; 95 percent CI, 1.08 to 8.62; p = 0.04) when adjusting for moderate to severe wound contamination and wound closure in the operating room. Conclusion: The findings of this study demonstrate that wound surface area is an integral determinant for wound complication following soft-tissue flap treatment, but found no association between wound surface area and flap-related reoperation rates.

Photochromic textiles have been used in the sensible materials (sensor) in the smart textiles and esthetic materials in the fashion industry due to the color changing properties, which gives immense inspiration to prepare photochromic textile materials, in this regards we take more attention to prepare the mass dyed polypropylene filaments with photochromic pigments. Metallocene polypropylene filaments were doped by different concentration of photochromic pigment. In our experimental work, the optical and mechanical properties of these multifilaments depending on their drawing ratio were investigated. The photochromic pigment used was 5-Chloro-13-dihydro-133-trimethylspiro[2H-indole-23′-(3H)naphtha [2,1b](14)oxazine]. Regarding the optical properties, our investigation confirms the known effect of the primary reflectance on the depth of shade of colored multifilaments as shown by linear increase in difference in optical density with increasing ratio of fineness.

Photochromism is a light-induced reversible change in colour defined as: ‘A reversible transformation in a chemical species between two forms having different absorption spectra brought about by photo-irradiation.’ This issue of Textile Progress provides a review of photochromism, the different methods for producing photochromic textiles, their properties, the measurement of kinetic colour changes, and their application in photochromic textiles. Photochromism can be utilised in a variety of textile products from everyday clothing to high-technology applications such as protective textiles, medical textiles, geo-textiles and sports textiles. Although photochromic materials have been used since 1960 to cut down the transmission of light through the lenses in sunglasses, there has been limited further development since that time due to technical difficulties not only in the application of photochromic colourants, but also with the measurement of kinetic colour-changing properties. Renewed interest in...

World over, the effects of greenhouse gas emissions are visible, and this has led the quest for sustainable, biodegradable, and renewable materials such as biocomposites. Biocomposites are a class of composites whereby the filler material and the matrix are eco-friendly and biodegradable. The majority of biodegradable matrices are thermoplastic; however, that notwithstanding research in thermoset matrices is on the rise with some industrial players producing thermoset matrices with precursors from plant sources. The first part of the chapter introduces green thermoset matrices from both renewable and nonrenewable sources, the process of preparation and manufacturing is discussed. The potential of biodegradable thermoset biocomposites for industrial applications is elaborated with examples.

The most critical capacity of human beings is to interact (i.e., express their emotions, opinions and feelings) with each other. We cannot overstate the use of communications. In particular, it is very difficult for unspeakable people to communicate their meaning to ordinary people, since there are more than 300 sign languages, and it is difficult for an average person to learn and use these languages. As a result, unspeakable people face numerous irritations and frustrations that limit their ability to fulfill their regular tasks. Different psychiatric services are available to the muted population in order to get their speech back, but the expense of these treatments is costly enough that no one can afford them. ere we suggest a smart speech device that allows voiceless people to communicate their message to ordinary people using hand movements and gestures. The system uses hand motion reading with the aid of flex sensors along with a microcontroller (Aurdino) unit.

All over the world, environmental considerations are now becoming vital factors during the selection of consumer goods which include textiles. According to the World Bank, 20% of water pollution globally is caused by textile processing, which means that these industries produce vast amounts of wastewater. Generally, these effluents contain high levels of suspended solids (SS), phosphates, dyes, salts, organo-pesticides, non-biodegradable organics, and heavy metals. Increase in water scarcity and environmental regulations has led to textile industries to seek for sustainable wastewater treatment methods which help to reduce their water footprint as well as reduce their operational costs. Therefore, sustainable wastewater treatment could be the best choice for the textile industries with respect to the current issues. So, it is important to discuss and champion awareness mechanisms which help to reduce the current issues with respect to the textile wastewater. Therefore, this chapter intends to discuss the various sustainable wastewater treatments, namely granular activated carbon (GAC), electrocoagulation (EC), ultrasonic treatment, an advanced oxidation process (AOP), ozonation, membrane biological reactor (MBR), and sequencing batch reactor (SBR).

Item does not contain fulltext BACKGROUND: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. METHODS: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. RESULTS: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (for every 5-point increase) (HR 1.19, 95% CI 1.02-1.39; P = 0.027), displaced fracture (HR 2.16, 95% CI 1.44-3.23; P < 0.001), unacceptable quality of implant placement (HR 2.70, 95% CI 1.59-4.55; P < 0.001), and smokers treated with cancellous screws versus smokers treated with a sliding hip screw (HR 2.94, 95% CI 1.35-6.25; P = 0.006). Additionally, for every 10-year decrease in age, participants experienced an average increased risk of 39% for hardware removal. CONCLUSIONS: Results of this study may inform future research by identifying high-risk patients who may be better treated with arthroplasty and may benefit from adjuncts to care (HR 1.39, 95% CI 1.05-1.85; P = 0.020). LEVEL OF EVIDENCE: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Niche products like smart textiles and other technical high-end products require resource-efficient processes and small batches contrary to conventional textile processes that require larger batches and are water-, chemical- and energy-intensive. This study focuses on digital inkjet printing and UV light curing as a flexible and resource-efficient and therewith economic production process of a smart textile UV sensor. The UV sensor is based on a UV-curable inkjet ink and a commercial photochromic dye. The inkjet ink is cured via free radical polymerization initiated by a UV–LED lamp. This system contains two photoactive compounds for which UV light both cures and activates the prints. An important challenge is therefore polymer crosslinking of the resin and UV-sensing performance of the photochromic dye. In this paper, we present performance as a function of belt speed and lamp intensity during curing. Via wash tests, we investigate the durability of the photochromic prints. The UV-sensing textile is characterized by colour measurements, differential scanning calorimetry (DSC) and dynamic mechanical analysis (DMA).

Introduction Owing to the scarcity of randomized controlled trials to guide treatment for decompression illness (DCI), there are many unanswered questions about its management. Apart from reviews and expert opinion, surveys that report practice patterns provide information about useful management strategies. Hence, this study aimed to identify current treatment preferences for DCI amongst diving physicians in Singapore. Methods An anonymous web-based questionnaire was sent to known diving physicians in Singapore. The demographics of the respondents were captured. Respondents were asked about their preferred management for five different DCI scenarios. Results The response rate was 74% (17 of 23 responses). All respondents chose to recompress patients described in the five scenarios. Regarding the number of recompression sessions, "one additional session after no further improvement in signs and symptoms" was the most common end point of treatment across all the scenarios (47 of 85 responses). Analgesics would be used by five physicians, three would use lidocaine and two steroids as adjuvant therapies. Conclusions Apart from the general agreement that recompression is indicated for DCI, there was no strong consensus regarding other aspects of management. This survey reinforces the need for robust RCTs to validate the existing recommendations for DCI treatment.

Many insects rely on vision to find food, to return to their nest and to carefully control their flight between these two locations. The amount of information available to support these tasks is, in part, dictated by the spatial resolution and contrast sensitivity of their visual systems. Here, we investigate the absolute limits of these visual properties for visually guided position and speed control in Bombus terrestris. Our results indicate that the limit of spatial vision in the translational motion detection system of B. terrestris lies at 0.21 cycles deg−1 with a peak contrast sensitivity of at least 33. In the perspective of earlier findings, these results indicate that bumblebees have higher contrast sensitivity in the motion detection system underlying position control than in their object discrimination system. This suggests that bumblebees, and most likely also other insects, have different visual thresholds depending on the behavioral context. Electronic supplementary material The online version of this article (doi:10.1007/s00359-017-1212-6) contains supplementary material, which is available to authorized users.

Daily administration of vitamin D is important for maintaining bone homeostasis. The orthopedic community has shown increased interest in vitamin D supplementation and patient outcomes after fracture. The current study used data from a large hip fracture trial to determine the proportion of patients who consistently used vitamin D after hip fracture surgery and to determine whether supplementation was associated with improved health-related quality of life and reduced reoperation rates. The FAITH study is a multicenter trial of elderly patients with femoral neck fracture treated with internal fixation. The current study asked a subset of patients included in the FAITH study about vitamin D supplementation and categorized them as consistent users, inconsistent users, or nonusers. This study also evaluated whether supplementation was associated with improved quality of life and reduced reoperation rates. The final analysis included 573 patients (mean age, 74.1 years; female, 66.3%; nondis-placed fractures, 72.4%). A total of 18.7% of participants reported no use of vitamin D, 35.6% reported inconsistent use, and 45.7% reported consistent use. Adjusted analysis found that consistent supplementation was associated with a 2.42 increase of the Short Form-12 physical component score 12 months postoperatively ( P =.033). However, supplementation was not associated with reduced reoperation rates ( P =.386). Despite guidelines recommending vitamin D supplementation, a low proportion of elderly patients with hip fracture use vitamin D consistently, suggesting a need for additional strategies to promote compliance. This study found that the use of vitamin D was associated with a statistically significant but not clinically significant improvement in health-related quality of life after hip fracture. Further research is needed to confirm these findings. [ Orthopedics. 2017; 40(5):e868–e875.]

Traditional forced response calculations for adjacent blade rows without a common divisor demand full annular transient simulations. This typically results in large and often impractical computational costs during development. The present article discusses an approach to reduce this cost using a signal-patching routine on a transonic axial turbine. Additionally, the potential for further reduction of computational cost by means of time domain flow transformation methods is investigated. The methods assessed are profile transformation, time inclination and Fourier methods, all within ANSYS CFX. Comparisons are made for the vector components of blade force harmonics, generalised force and computational costs. The computational cost can be reduced to 40% and 5% of the full annular simulation with signal patching or time domain flow transformation methods respectively. The signal-patching and transformation methods applied result in an error of 10% and 15% of generalised force respectively.

The consumer phase of the life cycle is a term used to describe the progression of steps a customer goes through when considering, purchasing, using and maintaining a product (here it is jeans). The purpose of this chapter is to propose a rating model that measures the consumer phase of the life-cycle assessment (LCA) for denim, specifically during washing, drying and ironing of textile products. However, various consumer phase activities such as home laundering, pressing and drying were shown to be significantly responsible for environmental impacts. This chapter mainly focuses on the consumer phase of the life cycle, including the major denim producers, global market potentials, denim consumption per capita and consumer phase of the LCA. The consumer phase of the LCA was discussed according to the LCA report by Levi Strauss & Co. In it, they conducted studies in China, France, the United Kingdom and the United States to understand differences in washing, pressing and drying habits. Overall results showed that in the overall life cycle, the consumer phase alone consumes 37% of energy, which causes a huge impact on global climate change. This report also concluded that Americans use more water and energy to wash their jeans than do consumers in China, France and the United Kingdom.

© 2017 Elsevier Ltd Background Reoperation rates are high after surgery for hip fractures. We investigated the effect of a sliding hip screw versus cancellous screws on the risk of reoperation and other key outcomes. Methods For this international, multicentre, allocation concealed randomised controlled trial, we enrolled patients aged 50 years or older with a low-energy hip fracture requiring fracture fixation from 81 clinical centres in eight countries. Patients were assigned by minimisation with a centralised computer system to receive a single large-diameter screw with a side-plate (sliding hip screw) or the present standard of care, multiple small-diameter cancellous screws. Surgeons and patients were not blinded but the data analyst, while doing the analyses, remained blinded to treatment groups. The primary outcome was hip reoperation within 24 months after initial surgery to promote fracture healing, relieve pain, treat infection, or improve function. Analyses followed the intention-to-treat principle. This study was registered with ClinicalTrials.gov, number NCT00761813. Findings Between March 3, 2008, and March 31, 2014, we randomly assigned 1108 patients to receive a sliding hip screw (n=557) or cancellous screws (n=551). Reoperations within 24 months did not differ by type of surgical fixation in those included in the primary analysis: 107 (20%) of 542 patients in the sliding hip screw group versus 117 (22%) of 537 patients in the cancellous screws group (hazard ratio [HR] 0·83, 95% CI 0·63–1·09; p=0·18). Avascular necrosis was more common in the sliding hip screw group than in the cancellous screws group (50 patients [9%] vs 28 patients [5%]; HR 1·91, 1·06–3·44; p=0·0319). However, no significant difference was found between the number of medically related adverse events between groups (p=0·82; appendix); these events included pulmonary embolism (two patients [

The textile industry has one of the largest environmental impacts in the world. Owing to ecological concerns, it is necessary to find ways to reduce these environmental impacts. This is true of denim because it is made of cotton, which in most cases is a polluting crop dyed with indigo, a dye with a damaging degree of fixation which initiates huge ecological problems. Life-cycle assessments provide data from every stage of a product's life, from the cradle to the grave (i.e., from raw material extraction through cultivation, manufacturing, distribution, use, repair and maintenance, and disposal or recycling). These data can be considered one of the first ways to reduce environmental impacts. Therefore, it is important to know the life-cycle assessment of denim and how it affects the ecosystem. This chapter provides some ideas about the life-cycle assessment and its importance, the life cycle of denim, the life-cycle assessment tool, phases of the life-cycle assessment and a life-cycle assessment of denim with actual data.

The design and technology of magnetic semiconductor elements of wireless magnetoresistive microsystems for magnetic field measurements are proposed and the results of the investigations of a highly sensitivity magnetoresistive converter with magnetic field concentrators are presented. The characteristics of the developed measuring amplifier for operation with a signal from a low-resistance magnetoresistive bridge with a certain unbalance value are reported. The technology for fabricating magnetic semiconductor ICs based on thin-film magnetoresistive structures is described.

Bombus terrestris is one of the most commonly used insect models to investigate visually guided behavior and spatial vision in particular. Two fundamental measures of spatial vision are spatial resolution and contrast sensitivity. In this study, we report the threshold of spatial resolution in B. terrestris and characterize the contrast sensitivity function of the bumblebee visual system for a dual choice discrimination task. We trained bumblebees in a Y-maze experimental set-up to associate a vertical sinusoidal grating with a sucrose reward, and a horizontal grating with absence of a reward. Using a logistic psychometric function, we estimated a resolution threshold of 0.21 cycles deg(-1) of visual angle. This resolution is in the same range but slightly lower than that found in honeybees (Apis mellifera and A. cerana) and another bumblebee species (B. impatiens). We also found that the contrast sensitivity of B. terrestris was 1.57 for the spatial frequency 0.090 cycles deg(-1) and 1.26 for 0.18 cycles deg(-1).

Background: Bipolar inline radiofrequency ablation (ILRFA) is an effective way to control bleeding during parenchymal organ transection. This was investigated in a study of laparoscopic hand-assisted partial nephrectomy in swine. Methods: Nine Landrace pigs were divided between 2 groups; diathermy was employed in the control group for parenchymal transaction and ILRFA was applied in the experimental group through a hand-port and deployed into the resection plane. After complete coagulation, resection was performed using scissors. Results: The mean intraoperative blood loss was 32 ± 15 mL in the ILRFA group and 187 ± 69 mL in the control group: a 82.9% reduction ( P = .015). The mean blood loss per resection area was 2.53 ± 0.92 mL/cm2 in the ILRFA group compared with 17.31 ± 9.05 mL/cm 2 in controls; the reduction was 85.4% ( P = .005). Conclusions: ILRFA is effective in achieving reducing blood loss and provides a drier operative field for precise dissection.

Background: Renal injury accounts for 10% of all abdominal trauma. Low-grade renal injuries can be managed without surgery. However, patients with grade IV or grade V injuries may require nephrectomy. In this study, InLine radiofrequency ablation device (ILRFA), which we developed for liver surgery was tested in the animal model of simulated renal injury. Methods: A grade IV renal injury was induced in eight landrace pigs. Then treatment with ILRFA was compared to conventional diathermy and suture; totally 24 surgeries were carried out (12 ILRFA vs 12 control). Results: No massive bleeding occurred and no animal died during the experiments. Immediately after surgery, the pigs were given euthanasia. The average of RFA coagulation time was 3.5 min. The mean intraoperative blood loss was 42 ± 16 mL in the ILRFA and 195 ± 58 mL in the control, a 78.5% reduction (P

Background: Nephron-sparing surgery has become an acceptable alternative to radical nephrectomy in the treatment of renal tumours. Control of intraoperative blood loss can be an important challenge during partial nephrectomy. InLine radiofrequency ablation (ILRFA) device has shown promising results of significant reduction of intraoperative blood loss in liver resection. In this study, we tested ILRFA-assisted partial nephrectomy in a porcine model. Methods: Eight landrace pigs were used in this study. Every pig underwent 2–3 partial nephrectomies. The proposed line of parenchymal incision was circumferentially scored with a diathermy. Then, ILRFA was deployed into this resection plane. After complete coagulation, the resection was then simply carried out using the scalpel. For the control resection, we used diathermy to transect the other pole, further sutures were then used to secure the residual bleeding. Results: The ILRFA deployments were set to 3 cm power algorithm. The average radiofrequency ablation coagulation time was 5 min. The mean intraoperative blood loss 35 ± 7 mL in the ILRFA and 152 ± 94 mL in the control, a 77.0% reduction (P = 0.024). The mean blood loss per centimetre of resection area was 2.09 ± 1.41 mL/cm2 in the ILRFA compared with 12.79 ± 1.68 mL/cm2 in controls; the reduction was 79.0% (P = 0.019). Conclusion: Our study indicates that ILRFA for partial nephrectomy in a porcine model is effective in reducing blood loss. Precoagulation before parenchymal transection appears to be a valid concept in nephron-sparing surgery.

Background. Surgical resection is the most effective therapy for liver cancer. Intraoperative blood loss during liver resection remains a major concern due to association with higher postoperative complications. The InLine radiofrequency ablation device (ILRFA) has achieved promising results in liver surgery with minimal blood loss and no increase of postoperative complications. In this multicentre controlled study, 108 patients undergoing liver resection were investigated. Patients and methods. A total of 108 patients underwent liver resections in 4 medical centres; the prospective sequential cohort study consisted of 54 ILRFA and 54 ultrasonic surgical aspirator transections as the control group. Results. The type of liver resection performed was very similar in both groups. The median number of RFA deployments was 3 (range 1–12) with a median coagulation time of 9 (range 3–36) min. Median blood loss was 165±20ml (range 5–675) in the ILRFA and 654±83ml (range 80–3600) in the control group (p

Orthotopic liver transplantation (OLT) is standard clinical practice for patients with severe and end-stage chronic liver disease. However, the chronic shortage of donor livers and parallel growth of the transplant waiting list mean that a substantial proportion of patients die while waiting for a donor liver. Attempts to reduce the waiting list by use of split-liver and living-related live donor techniques have had some impact, but additional approaches to management are vital if the death rate is to be significantly reduced. Extensive laboratory research work and limited clinical trials have shown that hepatocyte transplantation may be useful in bridging some patients to OLT. A major limiting factor has been the shortage of mature functioning human hepatocytes, which are currently mostly obtained from livers rejected for OLT. This review examines potential hepatocyte sources, hepatocyte isolation methods and preservation protocols that have been successfully established, along with an overview of clinical results.

Background: In liver surgery, the increase in advancement of laparoscopic equipment has allowed the feasibility and safety of complex laparoscopic liver resection. However, blood loss and the potential risk of gas embolism seem to be the main obstacles. In this study, we successfully used the InLine radiofrquency ablation (RFA) device to carry out laparoscopic hand-assisted liver resection in pigs. Methods: Under general anaesthesia with tracheal intubation, pigs underwent InLine RFA-assisted laparoscopic liver resection. After installation of Hand Port and trocars, the InLine RFA device was introduced through Hand Port system and inserted into the premarked resection line. Then the generator was turned on and the power was applied according to the power setting. The resection was finally carried out using diathermy or stapler. For the control group, resection was simply carried out by diathermy or stapler. Results: Eight Landrace pigs underwent 23 liver resections. Blood loss was reduced significantly in the InLine group (P

Item does not contain fulltext BACKGROUND: The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) has been extensively evaluated in groups of patients with osteoarthritis, yet not in patients with a femoral neck fracture. This study aimed to determine the reliability, construct validity, and responsiveness of the WOMAC compared with the Short Form-12 (SF-12) and the EuroQol 5D (EQ-5D) questionnaires for the assessment of elderly patients with a femoral neck fracture. METHODS: Reliability was tested by assessing the Cronbach alpha. Construct validity was determined with the Pearson correlation coefficient. Change scores were calculated from ten weeks to twelve months of follow-up. Standardized response means and floor and ceiling effects were determined. Analyses were performed to compare the results for patients less than eighty years old with those for patients eighty years of age or older. RESULTS: The mean WOMAC total score was 89 points before the fracture in the younger patients and increased from 70 points at ten weeks to 81 points at two years postoperatively. In the older age group, these scores were 86, 75, and 78 points. The mean WOMAC pain scores before the fracture and at ten weeks and two years postoperatively were 92, 76, and 87 points, respectively, in the younger age group and 92, 84, and 93 points in the older age group. Function scores were 89, 68, and 79 points for the younger age group and 84, 71, and 73 points for the older age group. The Cronbach alpha for pain, stiffness, function, and the total scale ranged from 0.83 to 0.98 for the younger age group and from 0.79 to 0.97 for the older age group. Construct validity was good, with 82% and 79% of predefined hypotheses confirmed in the younger and older age groups, respectively. Responsiveness was moderate. No floor effects were found. Moderate to large ceiling effects were found for pain and stiffness scales at ten weeks and twelve months in younger patients (18% to 36%) and in the older age group (38% to 53%). CONCLUSIONS: The WOMAC showed good reliability, construct validity, and responsiveness in both age groups of elderly patients with a femoral neck fracture who had been physically and mentally fit before the fracture. The instrument is suitable for use in future clinical studies in these populations. CLINICAL RELEVANCE: The results are based on two clinical trials. The questionnaires used concern pure, clinically relevant issues (ability to walk, climb stairs, etc.). Moreover, the results can be used for future research comparing clinical outcomes (or treatments) for populations with a femoral neck fracture.

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Hip fractures are a common type of fragility fracture that afflict 293,000 Americans (over 5,000 per week) and 35,000 Canadians (over 670 per week) annually. Despite the large population impact the optimal fixation technique for low energy femoral neck fractures remains controversial. The primary objective of the FAITH study is to assess the impact of cancellous screw fixation versus sliding hip screws on rates of revision surgery at 24 months in individuals with femoral neck fractures. The secondary objective is to determine the impact on health-related quality of life, functional outcomes, health state utilities, fracture healing, mortality and fracture-related adverse events. FAITH is a multi-centre, multi-national randomized controlled trial utilizing minimization to determine patient allocation. Surgeons in North America, Europe, Australia, and Asia will recruit a total of at least 1,000 patients with low-energy femoral neck fractures. Using central randomization, patients will be allocated to receive surgical treatment with cancellous screws or a sliding hip screw. Patient outcomes will be assessed at one week (baseline), 10 weeks, 6, 12, 18, and 24 months post initial fixation. We will independently adjudicate revision surgery and complications within 24 months of the initial fixation. Outcome analysis will be performed using a Cox proportional hazards model and likelihood ratio test. This study represents major international efforts to definitively resolve the treatment of low-energy femoral neck fractures. This trial will not only change current Orthopaedic practice, but will also set a benchmark for the conduct of future Orthopaedic trials. The FAITH trial is registered at ClinicalTrials.gov (Identifier NCT00761813 ).

Background. Bleeding during liver transection remains a potential hazard. This study aims to report the efficacy and complications of in-line radiofrequency ablation (ILRFA)-assisted liver resection. Patients and methods. The blood loss of 25 consecutive patients who underwent ILRFA-assisted liver resection was obtained by weighing swabs and measuring suction jar contents during liver resection and calculated in ml per cm2 of the transection surface area. Postoperative complications were recorded. Five clinical variables, which might affect blood loss, were analyzed. Results. The mean blood loss during parenchymal dissection for the ILRFA group was 3.4±3.2ml/cm2. Three patients had intra-abdominal collections, including one patient with bile leakage after ILRFA-assisted liver resection. Age, gender, extent of liver resection, liver quality and Pringle maneuver did not demonstrate significant impact on blood loss. Conclusions. This study showed that ILRFA-assisted liver resection was associated with very low blood loss. This is likely to improve the operative safety of liver resection for hepatic tumors. There were no significant postoperative sequelae.

The development of the techniques to control the light flux parameters directly by the light itself has permitted us to realize the new class of devices designed for completely optical signal processing. These new devices are both one-channel facilities for fiber links (light- control switches, modulators, and optical transistors) and multichannel ones (spatial-time light modulators -- STLM), which are the basic elements for the systems of optical data processing. All of these devices are based on light-control optical elements, in which one light flux or impulse directly controls parameters of another without doing an intermediate conversion into the electric signal and back again. In order to transfer some data from the control light flux to the fundamental one, a certain optical medium is required where the transmission properties depend on the control light. Scientific work on creation of the optical medium has already been carried out for more than 20 years. By now, sensitive media with specific switching energy of E equals 10-6 + 10-8 J/cm2 and switching rate of (nu)

The justifaction of method of the laser PUVA ( LPUVA ) therapy, thedescription of an UVA therapeutic system, the preliminary results of using the nitrogen gas laser as an UVA source for LPUVA chamber and insome other fields of application in dermatology are given. 1_ INTRODUCTION Since the moment of distinguishing psoriasis as disease sui generis by R.Willan at the beginning of the 19 - th century,a record number of methods and drugs has been proposed for its treatment. Most of them have not stood the test of time. At present photochemotherapy ( PCT ),methotrexate, retinoids, Hydroxyurea, ditranol and topical steroids as well as their different combinations are considered to be the most ap- proved and effective antipsoriatic means.For more than a decade and a half the methods of PCT has been suc - cessfully used for treatment of patients with psoriasis'.The experien-ce, accumulated in this field, shows that PUVA can cause a number ofacute and chronic by-effects and after-effects: photodermatitis, itch,aging and dryness of skin, hypertrichosis, lentigo., subnail ecchymosis,sickness,giddiness,general asthenia38.Particular apprehension is excit