In vitro study of the efficacy of acrylic bone cement loaded with supplementary amounts of gentamicin: Effect on mechanical properties, antibiotic release, and biofilm formation

Background: Infection remains a severe complication following a total hip replacement. If infection is suspected when revision surgery is being performed, additional gentamicin is often added to the cement on an ad hoc basis in an attempt to reduce the risk of recurrent infection.

Methods and results: In this in vitro study, we determined the effect of incorporating additional gentamicin on the mechanical properties of cement. We also determined the degree of gentamicin release from cement, and also the extent to which biofilms of clinical Staphylococcus spp. isolates form on cement in vitro. When gentamicin was added to unloaded cement (1–4 g), there was a significant reduction in the mechanical performance of the loaded cements compared to unloaded cement. A significant increase in gentamicin release from the cement over 72 h was apparent, with the amount of gentamicin released increasing significantly with each additional 1 g of gentamicin added. When overt infection was modeled, the incorporation of additional gentamicin did result in an initial reduction in bacterial colonization, but this beneficial effect was no longer apparent by 72 h, with the clinical strains forming biofilms on the cements despite the release of high levels of gentamicin.

Interpretation: Our findings indicate that the addition of large amounts of gentamicin to cement is unlikely to eradicate bacteria present as a result of an overt infection of an existing implant, and could result in failure of the prosthetic joint because of a reduction in mechanical performance of the bone cement.

Application of Heuristic Evaluation Method by Universal Design Experts

This study highlights how heuristic evaluation as a usability evaluation method can feed into current building design practice to conform to universal design principles. It provides a definition of universal usability that is applicable to an architectural design context. It takes the seven universal design principles as a set of heuristics and applies an iterative sequence of heuristic evaluation in a shopping mall, aiming to achieve a cost-effective evaluation process. The evaluation was composed of three consecutive sessions. First, five evaluators from different professions were interviewed regarding the construction drawings in terms of universal design principles. Then, each evaluator was asked to perform the predefined task scenarios. In subsequent interviews, the evaluators were asked to re-analyze the construction drawings. The results showed that heuristic evaluation could successfully integrate universal usability into current building design practice in two ways: (i) it promoted an iterative evaluation process combined with multi-sessions rather than relying on one evaluator and on one evaluation session to find the maximum number of usability problems, and (ii) it highlighted the necessity of an interdisciplinary ad hoc committee regarding the heuristic abilities of each profession. A multi-session and interdisciplinary heuristic evaluation method can save both the project budget and the required time, while ensuring a reduced error rate for the universal usage of the built environments.

Grassroots mobilisations against waste disposal sites in Greece

The government of Greece has gained notoriety for its failure to implement EU environmental directives in general, and is criticised specifically for its lack of an effective plan for the safe disposal of waste. Local mobilisations against a series of planned 'Sanitary Waste Disposal Sites' (HETAs) in three municipalities of Attica are examined. Should such protests be classified as NIMBY (not in my backyard)? Or do they present broader claims of justice and equity? Qualitative analysis of the protesters' on-line campaign material reveals that while these mobilisations do demonstrate some NIMBY characteristics, such campaigns should rather be perceived as ad hoc mobilisations reflective of tensions of late modernity. The public's mistrust of science and concerns about democratic deficit and accountability, as well as different perceptions of risk, are prominent.

Performance Analysis of Novel Randomly Shifted Certification Authority Authentication Protocol for MANETs

The provision of security in mobile ad hoc networks is of paramount importance due to their wireless nature. However, when conducting research into security protocols for ad hoc networks it is necessary to consider these in the context of the overall system. For example, communicational delay associated with the underlying MAC layer needs to be taken into account. Nodes in mobile ad hoc networks must strictly obey the rules of the underlying MAC when transmitting security-related messages while still maintaining a certain quality of service. In this paper a novel authentication protocol, RASCAAL, is described and its performance is analysed by investigating both the communicational-related effects of the underlying IEEE 802.11 MAC and the computational-related effects of the cryptographic algorithms employed. To the best of the authors' knowledge, RASCAAL is the first authentication protocol which proposes the concept of dynamically formed short-lived random clusters with no prior knowledge of the cluster head. The performance analysis demonstrates that the communication losses outweigh the computation losses with respect to energy and delay. MAC-related communicational effects account for 99% of the total delay and total energy consumption incurred by the RASCAAL protocol. The results also show that a saving in communicational energy of up to 12.5% can be achieved by changing the status of the wireless nodes during the course of operation. Copyright (C) 2009 G. A. Safdar and M. P. O'Neill (nee McLoone).

Dispersion interactions in room-temperature ionic liquids: Results from a non-empirical density functional

The role of dispersion or van de Waals (VDW) interactions in imidazolium-based room-temperature ionic liquids is studied within the framework of density functional theory, using a recently developed non-empirical functional [M. Dion, H. Rydberg, E. Schroder, D. C. Langreth, and B. I. Lundqvist, Phys. Rev. Lett. 92, 246401 (2004)], as efficiently implemented in the SIESTA code [G. Roman-Perez and J. M. Soler, Phys. Rev. Lett. 103, 096102 (2009)]. We present results for the equilibrium structure and lattice parameters of several crystalline phases, finding a general improvement with respect to both the local density (LDA) and the generalized gradient approximations (GGA). Similar to other systems characterized by VDW bonding, such as rare gas and benzene dimers as well as solid argon, equilibrium distances and volumes are consistently overestimated by approximate to 7%, compared to -11% within LDA and 11% within GGA. The intramolecular geometries are retained, while the intermolecular distances and orientations are significantly improved relative to LDA and GGA. The quality is superior to that achieved with tailor-made empirical VDW corrections ad hoc [M. G. Del Popolo, C. Pinilla, and P. Ballone, J. Chem. Phys. 126, 144705 (2007)]. We also analyse the performance of an optimized version of this non-empirical functional, where the screening properties of the exchange have been tuned to reproduce high-level quantum chemical calculations [J. Klimes, D. Bowler, and A. Michaelides, J. Phys.: Condens. Matter 22, 074203 (2010)]. The results for solids are even better with volumes and geometries reproduced within 2% of experimental data. We provide some insight into the issue of polymorphism of [bmim][Cl] crystals, and we present results for the geometry and energetics of [bmim][Tf] and [mmim][Cl] neutral and charged clusters, which validate the use of empirical force fields. (C) 2011 American Institute of Physics. [doi:10.1063/1.3652897]

Evolutionary Requirements for Next-Generation Dataflow-Based FPGA System Design

The use of dataflow digital signal processing system modelling
and synthesis techniques has been a fruitful research theme for many years and has yielded many powerful rapid system synthesis and optimisation capabilities. However, recent years have seen the spectrum of languages and techniques splinter in an application specific manner, resulting in an ad-hoc design process which is increasingly dependent on the particular application under development. This poses a major problem for automated toolflows attempting to provide rapid system synthesis for a wide ranges of applications. By analysing a number of dataflow FPGA implementation case studies, this paper shows that despit ethis common traits may be found in current techniques, which fall largely into three classes. Further, it exposes limitations pertaining to their ability to adapt algorith models to implementations for different operating environments and target platforms.

Developing tomorrow's leaders-Evidence of global talent management in multinational enterprises

Organizations are becoming relentless in managing and developing their key talent. This is a view, however, largely based on anecdote rather than reliable empirical evidence. Utilizing data from 260 multinational enterprises (MNEs), this paper helps redress this deficit. Specifically, this paper explores the extent to which MNEs engage in global talent management (GTM) and deciphers some of the factors which may explain the use and non-use of GTM practices. In so doing, we find that although a significant number of MNEs have systems and mechanisms in place to strategically identify and develop their talent many more seemingly adopt an ad hoc or haphazard approach. For instance, less than half of all MNEs have both global succession planning and formal management development programs for their high-potentials. Consequently it seems that there is a considerable distance yet to be travelled to arrive at a universal appreciation of the need to strategically manage one's key employees. We find the size of the MNE has a significant effect on GTM system usage-larger MNEs are more likely to undertake GTM. Other significant, positive influences include whether products or services are standardized regionally or globally, and if the MNE has a global human resources policy formation body. Of considerable interest is the finding that MNEs operating in the low-tech/low-cost sectors are significantly more likely to have formal global systems to identify and develop high-potentials. © 2009 Elsevier Inc. All rights reserved.

Invisible from View: Leaving and Aftercare Provision in the Republic Of Ireland

The adequacy of provisions for young people leaving care and in aftercare in the Republic of Ireland have been the subject of recent policy attention. A landmark report, the Ryan Report (2009), into historic abuse in state institutions recommended strengthening provisions in this area. However, the legislative basis for aftercare remains relatively weak and services for young people leaving care remain ad hoc and regionally variable. This article outlines the current context of leaving and aftercare provision in the Republic of Ireland and traces some of the recent policy debates and recommendations in this area. A genealogical analysis of leaving care and aftercare provision highlights that this issue has historically only emerged as a concern in the context in which young people leaving the care system are perceived as a ‘threat’ to social order. It is argued that the failure to adequately reform leaving and aftercare provision is reflective of wider social inequality and of a context in which young people in care are largely invisible from view.

Multidimensional poverty measurement in Europe:An application of the adjusted headcount approach

As awareness of the limitations of relying solely on income to measure poverty has become more widespread, attention has been increasingly focused on multi-dimensional approaches, to the point where the EU has adopted a multidimensional poverty and social exclusion target for 2020. The rationale advanced is that the computation of a multidimensional poverty index is an effective way of communicating in a political environment, and a necessary tool in order to monitor 27 different national situations. By contrast with the rather ad hoc way in which the EU 2020 poverty target has been framed and rationalised, the adjusted head count ratio applied here has a number of desirable axiomatic properties. It constitutes a significant improvement on union and intersection approaches and allows for the decomposition of multidimensional poverty in terms of dimensions of deprivation and socio-economic attributes. Since understanding poverty as multidimensional does not necessarily require constructing a multidimensional poverty index, on the basis of our analysis we provide a more general consideration of the value of developing a multidimensional index of poverty for the European Union.

A Vector Approach for the Analysis and Synthesis of Directional Modulation Transmitters

In order to formalize and extend on previous ad-hoc analysis and synthesis methods a theoretical treatment using vector representations of directional modulation (DM) systems is introduced and used to achieve DM transmitter characteristics. An orthogonal vector approach is proposed which allows the artificial orthogonal noise concept derived from information theory to be brought to bear on DM analysis and synthesis. The orthogonal vector method is validated and discussed via bit error rate (BER) simulations.

Dense Multiperson Tracking with Robust Hierarchical Linear Assignment

We introduce a novel dual-stage algorithm for online multi-target tracking in realistic conditions. In the first stage, the problem of data association between tracklets and detections, given partial occlusion, is addressed using a novel occlusion robust appearance similarity method. This is used to robustly link tracklets with detections without requiring explicit knowledge of the occluded regions. In the second stage, tracklets are linked using a novel method of constraining the linking process that removes the need for ad-hoc tracklet linking rules. In this method, links between tracklets are permitted based on their agreement with optical flow evidence. Tests of this new tracking system have been performed using several public datasets.

Realising Justice for victims before the International Criminal Court

The International Criminal Court (ICC) has been celebrated for its innovative victim provisions, which enable victims to participate in proceedings, avail of protection measures and assistance, and to claim reparations. The impetus for incorporating victim provisions within the ICC, came from victims’ dissatisfaction with the ad hoc tribunals in providing them with more meaningful and tangible justice.1 The International Criminal Tribunals for the former Yugoslavia and Rwanda (ICTY/R) only included victim protection measures, with no provisions for victims to participate in proceedings nor to claim reparations at them. Developments in domestic and international law, in particular human rights such as the 1985 UN Declaration on Justice for Victims and the UN Guidelines on Remedy and Reparations, and transitional justice mechanisms, such as truth commissions and reparations bodies, have helped to expand the notion of justice for international crimes to be more attuned to victims as key stakeholders in dealing with such crimes.

With the first convictions secured at the ICC and the victim participation and reparation regime taking form, it is worth evaluating the extent to which these innovative provisions have translated into justice for victims. The first part of this paper outlines what justice for victims of international crimes entails, drawing from victimology and human rights. The second section surveys the extent to which the ICC has incorporated justice for victims, in procedural and substantive terms, before concluding in looking beyond the Court to how state parties can complement the ICC in achieving justice for victims. This paper argues that while much progress has been made to institutionalise justice for victims within the Court, there is much more progress needed to evolve and develop justice for victims within the ICC to avoid dissatisfaction of past tribunals.

A necessarily complex model to explain the biogeography of the amphibians and reptiles of Madagascar

Pattern and process are inextricably linked in biogeographic analyses, though we can observe pattern, we must infer process. Inferences of process are often based on ad hoc comparisons using a single spatial predictor. Here, we present an alternative approach that uses mixed-spatial models to measure the predictive potential of combinations of hypotheses. Biodiversity patterns are estimated from 8,362 occurrence records from 745 species of Malagasy amphibians and reptiles. By incorporating 18 spatially explicit predictions of 12 major biogeographic hypotheses, we show that mixed models greatly improve our ability to explain the observed biodiversity patterns. We conclude that patterns are influenced by a combination of diversification processes rather than by a single predominant mechanism. A ‘one-size-fits-all’ model does not exist. By developing a novel method for examining and synthesizing spatial parameters such as species richness, endemism and community similarity, we demonstrate the potential of these analyses for understanding the diversification history of Madagascar’s biota.

Positioning Clinical Nurse Specialists and Nurse Practitioners as Change Champions to Implement a Pain Protocol in Long-Term Care

Pain management for older adults in long-term care (LTC) has been recognized as a problem internationally. The purpose of this study was to explore the role of a clinical nurse specialist (CNS) and nurse practitioner (NP) as change champions during the implementation of an evidence-based pain protocol in LTC. In this exploratory, multiple-case design study, we collected data from two LTC homes in Ontario, Canada. Three data sources were used: participant observation of an NP and a CNS for 18 hours each over a 3-week period; CNS and NP diaries recording strategies, barriers, and facilitators to the implementation process; and interviews with members of the interdisciplinary team to explore perceptions about the NP and CNS role in implementing the pain protocol. Data were analyzed using thematic content analysis. The NP and CNS used a variety of effective strategies to promote pain management changes in practice including educational outreach with team members, reminders to nursing staff to highlight the pain protocol and educate about practice changes, chart audits and feedback to the nursing staff, interdisciplinary working group meetings, ad hoc meetings with nursing staff, and resident assessment using advanced skills. The CNS and NP are ideal champions to implement pain management protocols and likely other quality improvement initiatives.