Comparison of extramedullary versus intramedullary referencing for tibial component alignment in total ankle arthroplasty.

BACKGROUND: The majority of total ankle arthroplasty (TAA) systems use extramedullary alignment guides for tibial component placement. However, at least 1 system offers intramedullary referencing. In total knee arthroplasty, studies suggest that tibial component placement is more accurate with intramedullary referencing. The purpose of this study was to compare the accuracy of extramedullary referencing with intramedullary referencing for tibial component placement in total ankle arthroplasty. METHODS: The coronal and sagittal tibial component alignment was evaluated on the postoperative weight-bearing anteroposterior (AP) and lateral radiographs of 236 consecutive fixed-bearing TAAs. Radiographs were measured blindly by 2 investigators. The postoperative alignment of the prosthesis was compared with the surgeon's intended alignment in both planes. The accuracy of tibial component alignment was compared between the extramedullary and intramedullary referencing techniques using unpaired t tests. Interrater and intrarater reliabilities were assessed with intraclass correlation coefficients (ICCs). RESULTS: Eighty-three tibial components placed with an extramedullary referencing technique were compared with 153 implants placed with an intramedullary referencing technique. The accuracy of the extramedullary referencing was within a mean of 1.5 ± 1.4 degrees and 4.1 ± 2.9 degrees in the coronal and sagittal planes, respectively. The accuracy of intramedullary referencing was within a mean of 1.4 ± 1.1 degrees and 2.5 ± 1.8 degrees in the coronal and sagittal planes, respectively. There was a significant difference (P < .001) between the 2 techniques with respect to the sagittal plane alignment. Interrater ICCs for coronal and sagittal alignment were high (0.81 and 0.94, respectively). Intrarater ICCs for coronal and sagittal alignment were high for both investigators. CONCLUSIONS: Initial sagittal plane tibial component alignment was notably more accurate when intramedullary referencing was used. Further studies are needed to determine the effect of this difference on clinical outcomes and long-term survivability of the implants. LEVEL OF EVIDENCE: Level III, retrospective comparative study.

PHILIPPE ROGIER (c.1561-1596): MISSA INCLITA STIRPS JESSE. A CRITICAL AND PERFORMING EDITION WITH PERFORMANCE COMMENTARY

The dissertation comprises two parts: (a) a musical edition and (b) a performance given on 3 July, 2008 of Philippe Rogier’s Missa Inclita stirps Jesse. The dissertation explores some of the editorial decisions required, how the demands of performers and musicologists differ, and whether they can be reconciled in one single edition. The commentary explains the preparation and realization of the edition. A video recording of the concert performance is attached to the dissertation. The Mass: The Missa Inclita stirps Jesse was published in Madrid in 1598 in a collection entitled Missae Sex. The mass setting is for four voices, except the Agnus Dei, which is for five, and is based on musical material in the motet Inclita stirps Jesse by Jacobus Clemens non Papa (c. 1510-15 – c.1556-6). Rogier’s choice and use of musical material from the motet (published in 1549) are discussed in the dissertation. The Edition: The edition is made from a microfilm copy of the Missae Sex held in the Biblioteca del Conservatorio de Musica “Giuseppe Verdi” in Milan. The Missae Sex was originally dedicated to King Philip II of Spain (1527-1598, reg. 1556-1598), whom Rogier had served as chorister and then maestro de capilla. Both Rogier and King Philip died before the volume was ready for publication. One of Rogier’s pupils, Géry de Ghersem, prepared the volume, which was printed in 1598, dedicated to King Philip III. The Performance: The mass was performed at a concert of Spanish Renaissance music in St. Matthew’s Cathedral, Washington, DC, on 3 July 2008, sung by the ensemble Orpheus directed by Philip Cave as part of the Chorworks summer workshop entitled Kings and Conquistadors: Music of Old and New Spain.

Guided waves in a fluid-loaded transversely isotropic place

Dispersion relations are obtained for the propagation of symmetric and antisymmetric modes in a free transversely isotropic plate. Dispersion curves are plotted for the first four symmetric modes for a magnesium plate immersed in water. The first mode is highly damped and switches over to the second mode when the normalized frequency exceeds 12.

Time-dependent modelling and experimental validation of the metal/flux interface in a continuous casting mould

A finite volume computer model of the continuous casting process for steel flat products has been developed. In this first stage, the model concentrates on the hydrodynamic aspects of the process and in particular the dynamic behavior of the metal/slag interface. The model was validated against experimental measurements obtained in a water model apparatus.

Aspects of the in vitro bioactivity of hydraulic calcium (alumino)silicate cement

In response to a burgeoning interest in the prospective clinical applications of hydraulic calcium (alumino)silicate cements, the in vitro bioactivity and dissolution characteristics of a white Portland cement have been investigated. The formation of an apatite layer within 6 h of contact with simulated body fluid was attributed to the rapid dissolution of calcium hydroxide from the cement matrix and to the abundance of pre-existing Si-OH nucleation sites presented by the calcium silicate hydrate phase. A simple kinetic model has been used to describe the rate of apatite formation and an apparent pseudo-second-order rate constant for the removal of HPO42- ions frorn solultion has been calculated (k(2) = 5.8 x 10(-4) g mg(-1)). Aspects of the chemistry of hydraulic cements are also discussed with respect to their potential use in the remedial treatment of living tissue. (C) 2008 Wiley Periodicals, Inc. J Biomed Mater Res 90A: 166-174, 2009

Reducing the incidence of coronary heart disease

The incidence of coronary heart disease (CHD) has been significantly reduced by the introduction of the National Service Framework in 2000 but has not yet reached set targets. This article analyses the adverse effects of specific CHD risk factors to the cardiovascular system and proposes local and national strategies for further reduction in the incidence, morbidity and mortality of CHD. It provides an example of how nurses can use a health promotion programme to support patients in giving up smoking, a major contributing factor in CHD. The programme uses cognitive behaviour therapy to improve patients' uptake and adherence.

Contribution to the knowlegde of Galician xenoflora (NW Iberian Peninsula, Spain).

Information on 12 exotic plants of diverse interest for the Galician flora are presented. All of them were collected in Ribeira council (SW of the A Coruña province). The total includes 8 novelties at a regional level (Aeonium haworthii, Aloe mitriformis, Brugmansia × candida, Nephrolepis cordifolia, Osteospermum ecklonis, Pelargonium capitatum, Sedum mexicanum, Sparaxis tricolor), and 2 provincial novelties. In addition, information on two taxa hardly mentioned in the literature on Galician vascular flora is also included. All the cited specimens are deposited at the SANT Herbarium.

Optimisation of source/drain extension region profile for suppression of short channel effects in sub-50 nm DG SOI MOSFETs with high- k gate dielectrics

Novel technology dependent scaling parameters i.e. spacer to gradient ratio and effective channel length (Leff) are proposed for source/drain engineered DG MOSFET, and their significance in minimizing short channel effects (SCES) in high-k gate dielectrics is discussed in detail. Results show that a high-k dielectric should be associated with a higher spacer to gradient ratio to minimise SCEs The analytical model agrees with simulated data over the entire range of spacer widths, doping gradients, high-k gate dielectrics and effective channel lengths.

Optical colors of 56 near-Earth objects: trends with size and orbit

We present the results of BVRIZ photometry of 56 near-Earth objects (NEOs) obtained with the 1-m Jacobus Kapteyn telescope on La Palma during 2000 and 2001. Our sample includes many NEOs with particularly deep 1 - mum pyroxene/olivine absorption bands, similar to Q-type asteroids. We also classify three NEOs with particularly blue colors. No D-type asteroids were found, placing an upper limit of similar to2% on the fraction of the NEO population originating in the outer main belt or the Trojan clouds. The ratio of dark to bright objects in our sample was found to be 0.40, significantly higher than current theoretical predictions. As well as classifying the NEOs, we have investigated color trends with size and orbit. We see a general trend for larger silicate objects to have shallower absorption bands but find no significant difference in the distribution of taxonomic classes at small and large sizes. Our data clearly show that different taxonomic classes tend to occupy different regions of (a, e) space. By comparing our data with current model predictions for NEO dynamical evolution we see that Q- R-, and V-type NEOs tend to have orbits associated with "fast track" delivery from the main belt, whereas S-type NEOs tend to have orbits associated with "slow track" delivery. This outcome would be expected if space weathering occurs on time scales of >10(6) years. (C) 2003 Elsevier Science (USA). All rights reserved.

Investigating the cost Performance of UK Credit Unions using Radial and Non-Radial Efficiency Measures

This paper examines the relative efficiency of UK credit unions. Radial and non-radial measures of input cost efficiency plus associated scale efficiency measures are computed for a selection of input output specifications. Both measures highlighted that UK credit unions have considerable scope for efficiency gains. It was mooted that the documented high levels of inefficiency may be indicative of the fact that credit unions, based on clearly defined and non-overlapping common bonds, are not in competition with each other for market share. Credit unions were also highlighted as suffering from a considerable degree of scale inefficiency with the majority of scale inefficient credit unions subject to decreasing returns to scale. The latter aspect highlights that the UK Government's goal of larger credit unions must be accompanied by greater regulatory freedom if inefficiency is to be avoided. One of the advantages of computing non-radial measures is that an insight into potential over- or under-expenditure on specific inputs can be obtained through a comparison of the non-radial measure of efficiency with the associated radial measure. Two interesting findings emerged, the first that UK credit unions over-spend on dividend payments and the second that they under-spend on labour costs.