A randomised study of two training programmes for general practitioners in the techniques of shoulder injection

Training on patients in addition to conventional mannequins increased GPs shoulder injection activity and their level of confidence.Hospital injection clinicsa may provide a suitable setting in which to train GPs interested in developing their shoulder joint injection skills

Microbiologic Diagnosis of Prosthetic Shoulder Infection by Use of Implant Sonication

We recently described a sonication technique for the diagnosis of prosthetic knee and hip infections. We compared periprosthetic tissue culture to implant sonication followed by sonicate fluid culture for the diagnosis of prosthetic shoulder infection. One hundred thirty-six patients undergoing arthroplasty revision or resection were studied; 33 had definite prosthetic shoulder infections and 2 had probable prosthetic shoulder infections. Sonicate fluid culture was more sensitive than periprosthetic tissue culture for the detection of definite prosthetic shoulder infection (66.7 and 54.5%, respectively; P = 0.046). The specificities were similar (98.0% and 95.1%, respectively; P = 0.26). Propionibacterium acnes was the commonest species detected among culture-positive definite prosthetic shoulder infection cases by periprosthetic tissue culture (38.9%) and sonicate fluid culture (40.9%). All subjects from whom P. acnes was isolated from sonicate fluid were male. We conclude that sonicate fluid culture is useful for the diagnosis of prosthetic shoulder infection.

Accuracy of shoulder joint and subacromial injections in cadavers.

OBJECTIVE:

"Blind" shoulder injections are often inaccurate and infiltrate untargeted structures. We tested a hypothesis that optimizing certain anatomical and positional factors would improve accuracy and reduce dispersal.

METHODS:

We evaluated one subacromial and one glenohumeral injection technique on cadavers.

RESULTS:

Mean accuracy was 91% for subacromial-targeted and 74 and 91% (worst- and best-case scenarios) for joint-targeted injections. Mean dispersal was 19% for subacromial-targeted and 16% for joint-targeted injections. All results bettered those reported previously.

CONCLUSION:

These "optimized" techniques might improve accuracy and limit dispersal of blind shoulder injections in clinical situations, benefiting efficacy and safety. However, evaluation is required in a clinical setting.

Soil-Landscape relationships at the lower reaches of a watershed at Bear Creek near Oak Ridge, Tennessee

The watersheds at Bear Creek, Oak Ridge, TN, have similar soil–landscape relationships. The lower reaches of many of these watersheds consist of headwater riparian wetlands situated between sloping non-wetland upland zones. The objectives of this study are to examine the effects of (i) slope and geomorphic processes, (ii) human impacts, and (iii) particular characteristics of soils and saprolite that may effect drainage and water movement in the wetlands and adjacent landscapes in one of these watersheds. A transect was run from west to east in a hydrological monitored area at the lower reaches of a watershed on Bear Creek. This transect extended from a steep side slope position across a floodplain, a terrace, and a shoulder slope. On the upland positions of the Nolichucky Shale, mass wasting, overland flow and soil creep currently inhibit soil formation on the steep side slope position where a Typic Dystrudept is present, while soil stability on the shoulder slope has resulted in the formation of a well-developed Typic Hapludult. In these soils, argillic horizons occur above C horizons on less sloping gradients in comparison to steeper slopes, which have Bw horizons over Cr (saprolite) material. A riparian wetland area occupies the floodplain section, where a Typic Endoaquept is characterized by poorly drained conditions that led to the development of redoximorphic features (mottling), gleying, organic matter accumulation, and minimal development of subsurface horizons. A thin colluvial deposit overlies a thick well developed Aquic Hapludalf that formed in alluvial sediments on the terrace position. The colluvial deposit from the adjacent shoulder slope is thought to result from soil creep and anthropogenic erosion caused by past cultivation practices. Runoff from the adjacent sloping landscape and groundwater from the adjacent wetland area perhaps contribute to the somewhat poorly drained conditions of this profile. Perched watertables occur in upland positions due to dense saprolite and clay plugging in the shallow zones of the saprolite. However, no redoximorphic features are observed in the soil on the side slope due to high runoff. Remnants of the underlying shale saprolite, which occur as small discolored zones resembling mottles, are also present. The soils in the study have a CEC of

Efficient FPGA Hardware Development: A Multi-Language Approach

This paper presents a multi-language framework to FPGA hardware development which aims to satisfy the dual requirement of high-level hardware design and efficient hardware implementation. The central idea of this framework is the integration of different hardware languages in a way that harnesses the best features of each language. This is illustrated in this paper by the integration of two hardware languages in the form of HIDE: a structured hardware language which provides more abstract and elegant hardware descriptions and compositions than are possible in traditional hardware description languages such as VHDL or Verilog, and Handel-C: an ANSI C-like hardware language which allows software and hardware engineers alike to target FPGAs from high-level algorithmic descriptions. On the one hand, HIDE has proven to be very successful in the description and generation of highly optimised parameterisable FPGA circuits from geometric descriptions. On the other hand, Handel-C has also proven to be very successful in the rapid design and prototyping of FPGA circuits from algorithmic application descriptions. The proposed integrated framework hence harnesses HIDE for the generation of highly optimised circuits for regular parts of algorithms, while Handel-C is used as a top-level design language from which HIDE functionality is dynamically invoked. The overall message of this paper posits that there need not be an exclusive choice between different hardware design flows. Rather, an integrated framework where different design flows can seamlessly interoperate should be adopted. Although the idea might seem simple prima facie, it could have serious implications on the design of future generations of hardware languages.

Positronium formation in positron-noble gas collisions

Distorted-wave Born approximation calculations for Ps formation in positron impact on He, Ne, Ar, Kr and Xe are reported for the energy range up to 200 eV. Capture into the n = 1, 2 and 3 states of Ps is calculated explicitly and 1/n(3) scaling is used to estimate capture into states with n > 3. The calculations for the heavier noble gases allow for capture not only from the outer np(6) shell of the atom but also from the first inner ns(2) shell. However, the inner shell capture is found to be very small. Although by no means unambiguous, the calculations provide some support to the conjecture of Larrichia et al. [J. Phys. B 35 (2002) 2525] that the double peak and shoulder structures observed experimentally for Ps formation in Ar, Kr and Xe arise from formation in excited states. (C) 2004 Elsevier B.V. All rights reserved.

Finite element analysis of an embankment on a soft estuarine deposit using an elastic–viscoplastic soil model

A new elastic–viscoplastic (EVP) soil model has been used to simulate the measured deformation response of a soft estuarine soil loaded by a stage-constructed embankment. The simulation incorporates prefabricated vertical drains installed in the foundation soils and reinforcement installed at the base of the embankment. The numerical simulations closely matched the temporal changes in surface settlement beneath the centerline and shoulder of the embankment. More importantly, the elastic–viscoplastic model simulated the pattern and magnitudes of the lateral deformations beneath the toe of the embankment — a notoriously difficult aspect of modelling the deformation response of soft soils. Simulation of the excess pore-water pressure proved more difficult because of the heterogeneous nature of the estuarine deposit. Excess pore-water pressures were, however, mapped reasonably well at three of the six monitoring locations. The simulations were achieved using a small set of material constants that can easily be obtained from standard laboratory tests. This study validates the use of the EVP model for problems involving soft soil deposits beneath loading from a geotechnical structure.

Tracking leatherback turtles (Dermochelys coriacea) during consecutive inter-nesting intervals: Further support for direct transmitter attachment

Over recent years there have been substantial efforts to record and interpret the post-nesting movements of leatherback turtles (Dermochelys coriacea) breeding in tropical regions. Less well documented are the movements undertaken by individual turtles during the breeding season itself, or more specifically between sequential nesting events. Such movements are of interest for two reasons: (1) gravid female leatherbacks may range extensively into the territorial waters and nesting beaches of neighbouring countries, raising questions for conservationists and population ecologists; and (2) the magnitude of movements themselves help elucidate underlying reproductive strategies (e.g. whether to rest near to the nesting or forage extensively). Here, satellite relay data loggers are used (SRDLs) to detail the movements and behaviour of two female leatherback turtles throughout three consecutive inter-nesting intervals in the Commonwealth of Dominica, West Indies. Both near-shore residence and extensive inter-nesting movements were recorded, contrasting previous studies, with movements away from the nesting beach increasing towards the end of the nesting season. Using this behavioural study as a backdrop, the suitability of attaching satellite transmitters directly to the carapace was additionally explored as an alternative approach to conventional harness deployments. Specifically, the principal aims were to (1) gather empirical data on speed of travel and (2) assess dive performance (aerobic dive limit) to enable comparisons with turtles previously fitted with harnesses elsewhere in the Caribbean (n = 6 turtles; Grenada, WI). This produced mixed results with animals bearing directly attached transmitters travelling significantly faster (55.21 km day(-1): SD 6.68) than harnessed individuals (39.80 km day(-1); SD 6.19); whilst no discernable difference in dive performance could be found between the two groups of study animals. (C) 2009 Elsevier B.V. All rights reserved.

Temperature-dependent gap edge in strong-coupling superconductors determined using the Eliashberg-Nambu formalism

Using the theory of Eliashberg and Nambu for strong-coupling superconductors, we have calculated the gap function for a model superconductor and a selection of real superconductors includong the elements Al, Sn, Tl, Nb, In, Pb and Hg and one alloy, Bi2Tl. We have determined thetemperature-dependent gap edge in each and found that in materials with weak electron-phonon ($\lambda 1.20$), not only is the gap edge double valued but it also departs significantly from the BCS form and develops a shoulderlike structure which may, in some cases, denote a gap edge exceeding the $T = 0$ value. These computational results support the insights obtained by Leavens in an analytic consideration of the general problem. Both the shoulder and double value arise from a common origin seated in the form of the gap function in strong coupled materials at finite temperatures. From the calculated gap function, we can determine the densities of states in the materials and the form of the tunneling current-voltage characteristics for junctions with these materials as electroddes. By way of illustration, results are shown for the contrasting cases of Sn ($\lambda=0.74$) and Hg ($\lambad=1.63$). The reported results are distinct in several ways from BCS predictions and provide an incentive determinative experimental studies with techniques such as tunneling and far infrared absorption.

Photometric observations of the Type Ia SN 2002er in UGC 10743

Extensive light and colour curves for the Type Ia supernova (SN Ia) SN 2002er are presented as part of the European Supernova Collaboration. We have collected UBVRI photometry from 11 different telescopes covering the phases from 7 d before until 619 d after maximum light. Corrections for the different instrumental systems and the non-thermal spectrum of the supernova (S-corrections) have been applied. With the densely sampled light curves we can make detailed comparisons to other well-observed objects. SN 2002er most closely resembles SN 1996X after maximum, but clearly shows a different colour evolution before peak light and a stronger shoulder in V and R bands compared to other well-observed SNe Ia. In particular, the rise time appears to be longer than what is expected from the rise time versus decline rate relation. We use several methods to determine the reddening towards SN 2002er based on the colour evolution at near peak and at late phases. The uvoir (bolometric) light curve shows great similarity with SN 1996X, but also indications of a higher luminosity, longer rise time and a more pronounced shoulder 25 d past maximum. The interpretation of the light curves was carried out with two independent light curve codes. Both find that given the luminosity of SN 2002er the Ni-56 mass exceeds 0.6 M-circle dot with preferred values near 0.7 M-circle dot. Uncertainties in the exact distance to SN 2002er are the most serious limitation of this measurement. The light-curve modelling also indicates a high level of mixing of the nickel in the explosion of SN 2002er.

The development of a surface defect machining method for hard turning processes

Hard turning (HT) is a material removal process employing a combination of a single point cutting tool and high speeds to machine hard ferrous alloys which exhibit hardness values over 45 HRC. In this paper, a surface defect machining (SDM) method for HT is proposed which harnesses the combined advantages of porosity machining and pulsed laser pre-treatment processing. From previous experimental work, this was shown to provide better controllability of the process and improved quality of the machined surface. While the experiments showed promising results, a comprehensive understanding of this new technique could only be achieved through a rigorous, in depth theoretical analysis. Therefore, an assessment of the SDM technique was carried out using both finite element method (FEM) and molecular dynamics (MD) simulations.
FEM modelling was used to compare the conventional HT of AISI 4340 steel (52 HRC) using an Al2O3 insert with the proposed SDM method. The simulations showed very good agreement with the previously published experimental results. Compared to conventional HT, SDM provided favourable machining outcomes, such as reduced shear plane angle, reduced average cutting forces, improved surface roughness, lower residual stresses on the machined surface, reduced tool–chip interface contact length and increased chip flow velocity. Furthermore, a scientific explanation of the improved surface finish was revealed using a state-of-the-art MD simulation model which suggested that during SDM, a combination of both the cutting action and rough polishing action help improve the machined surface finish.

Invariant Information Local Sub-map Filter (IILSF) for Efficient Simultaneous Localisation and Mapping of Large Environments

This paper presents an Invariant Information Local Sub-map Filter (IILSF) as a technique for consistent Simultaneous Localisation and Mapping (SLAM) in a large environment. It harnesses the benefits of sub-map technique to improve the consistency and efficiency of Extended Kalman Filter (EKF) based SLAM. The IILSF makes use of invariant information obtained from estimated locations of features in independent sub-maps, instead of incorporating every observation directly into the global map. Then the global map is updated at regular intervals. Applying this technique to the EKF based SLAM algorithm: (a) reduces the computational complexity of maintaining the global map estimates and (b) simplifies transformation complexities and data association ambiguities usually experienced in fusing sub-maps together. Simulation results show that the method was able to accurately fuse local map observations to generate an efficient and consistent global map, in addition to significantly reducing computational cost and data association ambiguities.

Combination of CFD and DOE to analyze and improve the mass flow rate in urinary catheters

The urinary catheter is a thin plastic tube that has been designed to empty the bladder artificially, effortlessly, and with minimum discomfort. The current CH14 male catheter design was examined with a view to optimizing the mass flow rate. The literature imposed constraints to the analysis of the urinary catheter to ensure that a compromise between optimal flow, patient comfort, and everyday practicality from manufacture to use was achieved in the new design. As a result a total of six design characteristics were examined. The input variables in question were the length and width of eyelets 1 and 2 (four variables), the distance between the eyelets, and the angle of rotation between the eyelets. Due to the high number of possible input combinations a structured approach to the analysis of data was necessary. A combination of computational fluid dynamics (CFD) and design of experiments (DOE) has been used to evaluate the "optimal configuration." The use of CFD couple with DOE is a novel concept, which harnesses the computational power of CFD in the most efficient manner for prediction of the mass flow rate in the catheter. Copyright © 2009 by ASME.

Combination of CFD and DOE to analyse solid particle erosion in elbows

Solid particle erosion is a major concern in the engineering industry, particularly where transport of slurry flow is involved. Such flow regimes are characteristic of those in alumina refinement plants. The entrainment of particulate matter, for example sand, in the Bayer liquor can cause severe erosion in pipe fittings, especially in those which redirect the flow. The considerable costs involved in the maintenance and replacement of these eroded components led to an interest in research into erosion prediction by numerical methods at Rusal Aughinish alumina refinery, Limerick, Ireland, and the University of Limerick. The first stage of this study focused on the use of computational fluid dynamics (CFD) to simulate solid particle erosion in elbows. Subsequently an analysis of the factors that affect erosion of elbows was performed using design of experiments (DOE) techniques. Combining CFD with DOE harnesses the computational power of CFD in the most efficient manner for prediction of elbow erosion. An analysis of the factors that affect the erosion of elbows was undertaken with the intention of producing an erosion prediction model. © 2009 Taylor & Francis.