Morbid obesity in total hip arthroplasty: Redefining outcomes for operative time, length of stay, and readmission

Background The incidence of obesity amongst patients presenting for elective Total Hip Arthroplasty (THA) has increased in the last decade and the relationship between obesity and the need for joint replacement has been demonstrated. This study evaluates the effects of morbid obesity on outcomes following primary THA by comparing short-term outcomes in THA between a morbidly obese (BMI ≥40) and a normal weight (BMI 18.5 - <25) cohort at our institution between January 2003 and December 2010. Methods Thirty-nine patients included in the morbidly obese group were compared with 186 in the normal weight group. Operative time, length of stay, complications, readmission and length of readmission were compared. Results Operative time was increased in the morbidly obese group at 122 minutes compared with 100 minutes (p=0.002). Post-operatively there was an increased 30-day readmission rate related to surgery of 12.8% associated with BMI ≥40 compared with 2.7% (p= 0.005) as well as a 5.1 fold increase in surgery related readmitted bed days - 0.32 bed days per patient for normal weight compared with 1.64 per patient for the morbidly obese (p=0.026). Conclusion Morbidly obese patients present a technical challenge and likely this and the resultant complications are underestimated. More work needs to be performed in order to enable suitable allocation of resources.

Methodological perspectives for register-based health system performance assessment : Developing a hip fracture monitoring system in Finland

The resources of health systems are limited. There is a need for information concerning the performance of the health system for the purposes of decision-making. This study is about utilization of administrative registers in the context of health system performance evaluation. In order to address this issue, a multidisciplinary methodological framework for register-based data analysis is defined. Because the fixed structure of register-based data indirectly determines constraints on the theoretical constructs, it is essential to elaborate the whole analytic process with respect to the data. The fundamental methodological concepts and theories are synthesized into a data sensitive approach which helps to understand and overcome the problems that are likely to be encountered during a register-based data analyzing process. A pragmatically useful health system performance monitoring should produce valid information about the volume of the problems, about the use of services and about the effectiveness of provided services. A conceptual model for hip fracture performance assessment is constructed and the validity of Finnish registers as a data source for the purposes of performance assessment of hip fracture treatment is confirmed. Solutions to several pragmatic problems related to the development of a register-based hip fracture incidence surveillance system are proposed. The monitoring of effectiveness of treatment is shown to be possible in terms of care episodes. Finally, an example on the justification of a more detailed performance indicator to be used in the profiling of providers is given. In conclusion, it is possible to produce useful and valid information on health system performance by using Finnish register-based data. However, that seems to be far more complicated than is typically assumed. The perspectives given in this study introduce a necessary basis for further work and help in the routine implementation of a hip fracture monitoring system in Finland.

Experimental investigation of the dependence of barrier height on metal work function for metal---SiO2---p---Si (MIS) Schottky-barrier diodes in the presence of inversion

The dependence of barrier height on the metal work function of metal-SiO2-p-Si Schottky barrier diodes was investigated and nonlinearity was found. This is explained by the theoretical model proposed recently by Chattopadhyay and Daw. The values of interface trap density and fixed charge density of the insulating layer of the diodes were calculated using this model and found to be appreciably different from those estimated by the usual method.

Control of barrier height of MIS tunnel diodes using deep level impurities

The barrier height of MIS tunnel diodes is studied considering the effect of deep impurities. It is shown that the barrier height of a given MIS-system can be controlled by changing the density and the activation energy of the defect level. The study leads to the conclusion that deep impurities of character opposite to shallow impurities enhance the barrier height. On the other hand, the barrier height is lowered when the type of the deep impurities is the same as that of shallow impurities.

Making Music, Making Muslims : A Case Study of Islamic Hip Hop and the Discursive Construction of Muslim Identities on the Internet

Hip-hopin juuret juontavat 1970-luvulle Yhdysvaltoihin, mutta hip-hop-kulttuuri ja musiikkityyli ovat sen jälkeen levinneet ympäri maailmaa osana globalisaatiokehitystä. Myös monet nuoret muslimit tekevät nykyään hip-hop-musiikkia, ja yhä useampi tuo myös sanoituksiinsa vaikutteita Islamista ja elämästään muslimina. Musiikin asema on islamissa varsin kiistelty, eikä sitä ole selvästi sallittu (halal) tai kielletty (haram) muslimeilta. Muslimien tekemää hip-hoppia on toistaiseksi tutkittu hyvin vähän. Tutkielmassa tarkastellaan diskurssianalyysin keinoin, miten tapaustutkimuksena toimivalla muslimhiphop.com-internetsivustolla argumentoidaan ja konstruoidaan käsityksiä muslimi-identiteetistä. Teoreettisena ja analyyttisenä viitekehyksenä toimii sosiaalikonstruktivistinen näkemys identiteetistä kontekstisidonnaisena sekä puheessa ja teksteissä diskursiivisesti rakentuvana. Tutkielma kyseenalaistaa aiempien tutkimusten oletuksen hip-hopista vaikutuksiltaan yksinomaan positiivisena muslimi-identiteetille sekä muslimeja yhdentävänä tekijänä. Aineisto on kerätty edellä mainitulta sivustolta syksyn 2010 ja kevään 2011 aikana, josta analyysiin on rajattu vain itse sivusto ja sen hip-hoppia käsittelevät osiot. Sivusto ja sen perustaja ovat yhdysvaltalaisia, mutta sivustolla esiteltävien artistien tausta on hyvin monikulttuurinen. Moni on myös maahanmuuttajana nykyisessä kotimaassaan. Aineistossa esiintyviä teemoja ja diskursseja eritellään ja analysoidaan tutkielmassa lainauksien avulla. Sivuston periaatteissa ja artistien esillepääsyn kriteereissä määritellään tarkasti asennoituminen Islamin ja musiikin yhdistämiseen: mikäli sanoitukset ja artistit noudattavat Islamin oppeja, on muslimin sallittua tehdä ja kuunnella tällaista musiikkia. Islam-aiheisen hip-hopin perustellaan olevan ennen kaikkea vaihtoehto valtavirran hip-hopille, jota konstruoidaan aineistossa moraalisesti arveluttavaksi. Hip-hopille sekä muslimeille sallittuja ja kiellettyjä elementtejä erottelevan halal-haram-diskurssin ohella aineistosta nousee esiin opetusdiskurssi. Muslimien tekemän hip-hopin perustellaan edistävän Islamin opettamista erityisesti nuorille muslimeille ja siten vahvistavan positiivista muslimi-identiteettiä. Myös positiivisen muutoksen diskurssia käytetään aineistossa runsaasti liittyen mm. muslimiyhteisöihin sekä muslimeihin kohdistuviin taloudellisiin ja sosiaalipoliittisiin epäkohtiin ja stereotypioihin; musiikin sisältöä ja sen tekemistä perustellaan sen voimalla muuttaa asioita parempaan suuntaan. Monet muslimiartistit kamppailevat yhdistääkseen toisaalta Islamin ja taiteellisen luovuuden ja ilmaisuvapauden, toisaalta menestyäkseen kaupallisesti unohtamatta uskonnollista vakaumustaan. Monilla heistä hip-hop on ollut vahvasti läsnä kasvuympäristössä, mutta sen yhdistäminen Islamin periaatteisiin aiheuttaa kysymyksiä ja kyseenalaistuksia oman musiikillisen ja uskonnollisen identiteetin muodosta ja sisällöstä. Aineiston perusteella monet muslimiartistit ja Islam-aiheista hip-hoppia kuuntelevat muslimit joutuvat jatkuvasti puolustamaan musiikkia siihen kielteisesti suhtautuville muslimeille sekä ei-muslimeille, jotka vierastavat sen uskonnollisuutta. Muslimi-identiteettiä neuvotellaan jatkuvasti, ja se näyttäytyy aineistossa moniulotteisena ja tilanteisesti rakentuvana. Avainsanat: Muslimit, Islam, hip-hop, identiteetti, Internet, diskurssi, diskurssianalyysi

Xenon in sodium Y zeolite. 2. Arrhenius relation, mechanism, and barrier height distribution for cage-to-cage diffusion

Various geometrical and energetic distribution functions and other properties connected with the cage-to-cage diffusion of xenon in sodium Y zeolite have been obtained from long molecular dynamics calculations. Analysis of diffusion pathways reveals two interesting mechanisms-surface-mediated and centralized modes for cage-to-cage diffusion. The surface-mediated mode of diffusion exhibits a small positive barrier, while the centralized diffusion exhibits a negative barrier for the sorbate to diffuse across the 12-ring window. In both modes, however, the sorbate has to be activated from the adsorption site to enable it to gain mobility. The centralized diffusion additionally requires the sorbate to be free of the influence of the surface of the cage as well. The overall rate for cage-to-cage diffusion shows an Arrhenius temperature dependence with E(a) = 3 kJ/mol. It is found that the decay in the dynamical correction factor occurs on a time scale comparable to the cage residence time. The distributions of barrier heights have been calculated. Functions reflecting the distribution of the sorbate-zeolite interaction at the window and the variations of the distance between the sorbate and the centers of the parent and daughter cages are presented.

Latitude variation of boundary layer height over Indian Ocean during pre- and First Field Phase (FFP-98) of INDOEX

This paper describes the results of the measurement of the Marine Boundary Layer (MBL) height from spectral analysis of the u and v components of the wind and from CLASS/radiosonde temperature profiles. The data were collected on ORV Sagar Kanya during the pre-INDOEX (27 December 1996 through 31 January 1997) and FFP-98 (18 February to 31 March 1998) over the latitude range 15 degrees N to 14 degrees S and 15 degrees N to 20 degrees S respectively. During the pre-INDOEX, the MBL heights gradually decrease from 2.5 km at 13 degrees N to around 500 to 600 m at 10 degrees S, Similar results are observed in the return track. The MBL heights (0.5 to 1 km) obtained during FFP-98 are less compared to those obtained during pre-INDOEX. The MBL heights during FFP-98 are less compared to the pre-INDOEX and are believed to be due to the presence of stratus, stratocumulus and cumulus clouds during the cruise period, compared to a relatively cloud free pre-INDOEX cruise.

Dark Matter Halo Properties as Deduced from the Observed H I Scale Height Data, in The Low-Frequency Radio Universe

We use the HΙ scale height data along with the HΙ rotation curve as constraints to probe the shape and density profile of the dark matter halos of M31 (Andromeda) and the superthin, low surface brightness (LSB) galaxy UGC 07321. We model the galaxy as a two component system of gravitationally-coupled stars and gas subjected to the force field of a dark matter halo. For M31, we get a flattened halo which is required to match the outer galactic HΙ scale height data, with our best-fit axis ratio (0.4) lying at the most oblate end of the distributions obtained from cosmological simulations. For UGC 07321, our best-fit halo core radius is only slightly larger than the stellar disc scale length, indicating that the halo is important even at small radii in this LSB galaxy. The high value of the gas velocity dispersion required to match the scale height data can explain the low star-formation rate of this galaxy.

Barrier height inhomogeneities in InN/GaN heterostructure based Schottky junctions

The electrical transport properties of InN/GaN heterostructure based Schottky junctions were studied over a wide temperature range of 200-500 K. The barrier height and the ideality factor were calculated from current-voltage (I-V) characteristics based on thermionic emission (TE), and found to be temperature dependent. The barrier height was found to increase and the ideality factor to decrease with increasing temperature. The observed temperature dependence of the barrier height indicates that the Schottky barrier height is inhomogeneous in nature at the heterostructure interface. Such inhomogeneous behavior was modeled by assuming the existence of a Gaussian distribution of barrier heights at the heterostructure interface. (C) 2011 Elsevier Ltd. All rights reserved.

Pillar height dependent formation of unprecedented Pd-8 molecular swing and Pd-6 molecular boat via multicomponent self-assembly

Three-component self-assembly of a cis-blocked 90 degrees Pd(II) acceptor with a mixture of a tetraimidazole and a linear dipyridyl donor self-discriminated into unusual Pd-8 molecular swing (1) and Pd-6 molecular boat (2), which are characterized by single-crystal X-ray diffraction analysis; their ability to bind C-60 in solution is established by fluorescence titration.

Analysis of the temperature-dependent current-voltage characteristics and the barrier-height inhomogeneities of Au/GaN Schottky diodes

In this report, the currentvoltage (IV) characteristics of Au/GaN Schottky diodes have been carried out in the temperature range of 300510?K. The estimated values of the Schottky-barrier height (SBH) and the ideality factor of the diodes based on the thermionic emission (TE) mechanism were found to be temperature dependent. The barrier height was found to increase and the ideality factor to decrease with increasing temperature. The conventional Richardson plot of ln(Is/T2) versus 1/kT gives the SBH of 0.51?eV and Richardson constant value of 3.23?X?10-5?A?cm-2?K-2 which is much lower than the known value of 26.4?A?cm-2?K-2 for GaN. Such discrepancies of the SBH and Richardson constant value were attributed to the existence of barrier-height inhomogeneities at the Au/GaN interface. The modified Richardson plot of ln(Is/T2)q2 sigma 2/2k2T2 versus q/kT, by assuming a Gaussian distribution of barrier heights at the Au/GaN interface, provided the SBH of 1.47?eV and Richardson constant value of 38.8?A?cm-2?K-2. The temperature dependence of the barrier height is interpreted on the basis of existence of the Gaussian distribution of the barrier heights due to the barrier-height inhomogeneities at the Au/GaN interface.

On the height of fall of dropping mass in SASW measurements for asphaltic road pavements

A number of spectral analysis of surface waves (SASW) tests were performed on asphaltic road pavements by dropping a metallic 6.5 kg sphere, from a height (H) ranging from 1 to 3 m. Various combinations of source to first receiver distance (S) and receiver spacing (X) were employed. By increasing the height of the fall of the dropping mass, the maximum wavelength (lambda(max)), up to which the shear wave velocity profile can be predicted with the usage of the SASW measurements, was found to increase continuously. The height of fall of the dropping mass also seems to affect the admissible range of the wavelength for given combinations of X and S. Irrespective of different chosen combinations of S, X and H, a unique combined dispersion curve was generated in all the cases for a given pavement site as long as the threshold minimum value of the coherence function is greater than 0.90.

Relation between the work function and Young's modulus of RhSi and estimate of Schottky-barrier height at RhSi/Si interface: An ab-initio study

Density-functional calculations are performed to explore the relationship between the work function and Young's modulus of RhSi, and to estimate the p-Schottky-barrier height (SBH) at the Si/RhSi(010) interface. It is shown that the Young's modulus and the workfunction of RhSi satisfy the generic sextic relation, proposed recently for elemental metals. The calculated p-SBH at the Si/RhSi interface is found to differ only by 0.04 eV in opposite limits, viz., no-pinning and strong pinning. We find that the p-SBH is reduced as much as by 0.28 eV due to vacancies at the interface. (C) 2012 American Institute of Physics. http://dx.doi.org/10.1063/1.4761994]

Effects of initial height on the steady-state persistence probability of linear growth models

The effects of the initial height on the temporal persistence probability of steady-state height fluctuations in up-down symmetric linear models of surface growth are investigated. We study the (1 + 1)-dimensional Family model and the (1 + 1)-and (2 + 1)-dimensional larger curvature (LC) model. Both the Family and LC models have up-down symmetry, so the positive and negative persistence probabilities in the steady state, averaged over all values of the initial height h(0), are equal to each other. However, these two probabilities are not equal if one considers a fixed nonzero value of h(0). Plots of the positive persistence probability for negative initial height versus time exhibit power-law behavior if the magnitude of the initial height is larger than the interface width at saturation. By symmetry, the negative persistence probability for positive initial height also exhibits the same behavior. The persistence exponent that describes this power-law decay decreases as the magnitude of the initial height is increased. The dependence of the persistence probability on the initial height, the system size, and the discrete sampling time is found to exhibit scaling behavior.

On the possible variation of the lightning striking distance as assumed in the IEC lightning protection standard as a function of structure height

The effect of structure height on the lightning striking distance is estimated using a lightning strike model that takes into account the effect of connecting leaders. According to the results, the lightning striking distance may differ significantly from the values assumed in the IEC standard for structure heights beyond 30m. However, for structure heights smaller than about 30m, the results show that the values assumed by IEC do not differ significantly from the predictions based on a lightning attachment model taking into account the effect of connecting leaders. However, since IEC assumes a smaller striking distance than the ones predicted by the adopted model one can conclude that the safety is not compromised in adhering to the IEC standard. Results obtained from the model are also compared with Collection Volume Method (CVM) and other commonly used lightning attachment models available in the literature. The results show that in the case of CVM the calculated attractive distances are much larger than the ones obtained using the physically based lightning attachment models. This indicates the possibility of compromising the lightning protection procedures when using CVM. (C) 2014 Elsevier B.V. All rights reserved.