Effects of anticoagulants on outcome of femoral neck fracture surgery

PURPOSE To review records of 330 patients who underwent surgery for femoral neck fractures with or without preoperative anticoagulation therapy. METHODS Medical records of 235 women and 95 men aged 48 to 103 years (mean, 81.6; standard deviation [SD], 13.1) who underwent surgery for femoral neck fractures with or without preoperative anticoagulation therapy were reviewed. 30 patients were on warfarin, 105 on aspirin, 28 on clopidogrel, and 167 were controls. The latter 3 groups were combined as the non-warfarin group and compared with the warfarin group. Hospital mortality, time from admission to surgery, length of hospital stay, return to theatre, and postoperative complications (wound infection, deep vein thrombosis, and pulmonary embolism) were assessed. RESULTS The warfarin and control groups were significantly younger than the clopidogrel and aspirin groups (80.8 vs. 80.0 vs. 84.2 vs. 83.7 years, respectively, p<0.05). 81% of the patients underwent surgery within 48 hours of admission. The overall mean time from admission to surgery was 1.8 days; it was longer in the warfarin than the aspirin, clopidogrel, and control groups (3.3 vs. 1.8 vs. 1.6 vs. 1.6 days, respectively, p<0.001). The mean length of hospital stay was 17.5 (SD, 9.6; range, 3-54) days. The overall hospital mortality was 3.9%; it was 6.7% in the warfarin group, 3.8% in the aspirin group, 3.6% in the clopidogrel group, and 3.6% in the control group (p=0.80). Four patients returned to theatre for surgery: one in the warfarin group for washout of a haematoma, 2 in the aspirin group for repositioning of a mal-fixation and for debridement of wound infection, and one in the control group for debridement of wound infection. The warfarin group did not differ significantly from non-warfarin group in terms of postoperative complication rate (6.7% vs. 2.7%, p=0.228) and the rate of return to theatre (3.3% vs. 1%, p=0.318). CONCLUSION It is safe to continue aspirin and clopidogrel prior to surgical treatment for femoral neck fracture. The risk of delaying surgery outweighs the peri-operative bleeding risk.

The optimal frequency of aquatic physiotherapy for individuals with chronic musculoskeletal pain: a randomised controlled trial

Purpose: To establish whether there was a difference in health-related quality of life (HRQoL) in people with chronic musculoskeletal disorders (PwCMSKD) after participating in a multimodal physiotherapy program (MPP) either two or three sessions a week. Methods: Total of 114 PwCMSKD participated in this prospective randomised controlled trial. An individualised MPP, consisting of exercises for mobility, motor-control, muscle strengthening, cardiovascular training, and health education, was implemented either twice a week (G2: n = 58) or three times a week) (G3: n = 56) for 1 year. Outcomes: HRQoL physical and mental health state (PHS/MHS), Roland Morris disability Questionnaire (RMQ), Neck-Disability-Index (NDI) and Western Ontario and McMaster Universities’ Arthritis Index (WOMAC) were used to measure outcomes of MPP for people with chronic low back pain, chronic neck pain and osteoarthritis, respectively. Measures were taken at baseline, 8 weeks (8 w), 6 months (6 m), and 1 year (1 y) after starting the programme. Results: No statistically significant differences were found between the two groups (G2 and G3), except in NDI at 8 w (−3.34, (CI 95%: −6.94/0.84, p = 0.025 (scale 0–50)). All variables showed improvement reaching the following values (from baseline to 1 y) G2: PHS: 57.72 (baseline: 41.17; (improvement: 16.55%), MHS: 74.51 (baseline: 47.46, 27.05%), HRQoL 0.90 (baseline: 0.72, 18%)), HRQoL-VAS 84.29 (baseline: 58.04, 26.25%), RMQ 4.15 (baseline: 7.85, 15.42%), NDI 3.96 (baseline: 21.87, 35.82%), WOMAC 7.17 (baseline: 25.51, 19.10%). G3: PHS: 58.64 (baseline: 39.75, 18.89%), MHS: 75.50 (baseline: 45.45, (30.05%), HRQoL 0.67 (baseline: 0.88, 21%), HRQoL-VAS 86.91 (baseline: 52.64, 34.27%), RMQ 4.83 (baseline: 8.93, 17.08%), NDI 4.91 (baseline: 23.82, 37.82%), WOMAC 6.35 (baseline: 15.30, 9.32%). Conclusions: No significant differences between the two groups were found in the outcomes of a MPP except in the NDI at 8 weeks, but both groups improved in all variables during the course of 1 year under study.

Genetics and the pathogenesis of ankylosing spondylitis

Purpose of review The field of genetic research in ankylosing spondylitis (AS) is advancing rapidly. The purpose of this review is to outline recent findings, particularly, in regard to genetic studies of the major histocompatibility complex (MHC) and the non-MHC genes IL23R, ERAP1, and killer cell immunologlobulin-like receptor (KIR) complex, in AS. Recent findings: Convincing evidence has been reported for the existence of further non-B27 MHC genes involved in AS. Strong, replicated association has been reported with IL23R and ERAP1 and AS. The IL23R finding strongly implicates the TH17 lymphocyte system in AS aetiopathogenesis. Suggestive evidence of a role for KIR gene polymorphism in AS exists, but definitive findings are awaited. Summary: The findings suggest that further genome-wide studies in large case-control cohorts are likely to be very productive in this disease. The IL23R findings and subsequent immunological investigations suggest that targeted intervention in the TH17 system is likely to have major therapeutic benefit, as it does in the genetically related diseases, inflammatory bowel disease and psoriasis.

Common variants at 12q14 and 12q24 are associated with hippocampal volume

Aging is associated with reductions in hippocampal volume that are accelerated by Alzheimer's disease and vascular risk factors. Our genome-wide association study (GWAS) of dementia-free persons (n = 9,232) identified 46 SNPs at four loci with P values of <4.0 × 10 -7. In two additional samples (n = 2,318), associations were replicated at 12q14 within MSRB3-WIF1 (discovery and replication; rs17178006; P = 5.3 × 10 -11) and at 12q24 near HRK-FBXW8 (rs7294919; P = 2.9 × 10 -11). Remaining associations included one SNP at 2q24 within DPP4 (rs6741949; P = 2.9 × 10 -7) and nine SNPs at 9p33 within ASTN2 (rs7852872; P = 1.0 × 10 -7); along with the chromosome 12 associations, these loci were also associated with hippocampal volume (P < 0.05) in a third younger, more heterogeneous sample (n = 7,794). The SNP in ASTN2 also showed suggestive association with decline in cognition in a largely independent sample (n = 1,563). These associations implicate genes related to apoptosis (HRK), development (WIF1), oxidative stress (MSR3B), ubiquitination (FBXW8) and neuronal migration (ASTN2), as well as enzymes targeted by new diabetes medications (DPP4), indicating new genetic influences on hippocampal size and possibly the risk of cognitive decline and dementia.

Secretor status and ankylosing spondylitis

Objective. To assess the genetic association between secretor status and ankylosing spondylitis (AS). Methods. A restriction digest method for determining secretor status was developed; 166 patients with AS and 216 healthy British white controls were typed for secretor status using this method. Results. The frequency of nonsecretors among patients with AS (47/166, 28%) was not significantly different from controls (72/216, 33%). Conclusion. Secretor status does not influence susceptibility to AS.

Conformation-activity correlations for chemotactic tripeptide analogs incorporating dialkyl residues with linear and cyclic alkyl sidechains at position 2

Five stereochemically constrained analogs of the chemotactic tripeptide incorporating 1-aminocycloalkane-1-carboxylic acid (Ac(n)c) and alpha,alpha-dialkylglycines (Deg, diethylglycine; Dpg, n,n-dipropylglycine and Dbg, n,n-dibutylglycine) at position 2 have been synthesized. NMR studies of peptides For-Met-Xxx-Phe-OMe (Xxx = Ac(7)c, I; Ac(8)c, II; Deg, III; Dpg, IV and Dbg, V; For, formyl) establish that peptides with cycloalkyl residues, I and II, adopt folded beta-turn conformations in CDCl3 and (CD3)(2)SO. In contrast, analogs with linear alkyl sidechains, III-V, favour fully extended (C-5) conformations in solution. Peptides I-V exhibit high activity in inducing beta-glucosaminidase release from rabbit neutrophils, with ED(50) values ranging from 1.4-8.0 x 10(-11)M. In human neutrophils the Dxg peptides III-V have ED(50) values ranging from 2.3 x 10(-8) to 5.9 x 10(-10) M, with the activity order being V > IV > III. While peptides I-IV are less active than the parent. For-Met-Leu-Phe-OH, in stimulating histamine release from human basophils, the Dbg peptide V is appreciably more potent, suggesting its potential utility as a probe for formyl peptide receptors.

Collision-Geometry-Based Pulsed Guidance Law for Exoatmospheric Interception

No abstract is available.

Temperature dependence of the dielectric constant of diamond

The temperature dependence of the dielectric constant of diamond has been measured over the temperature range 50-2OO"c. The value of E-ldc dT over this range is + 1 x 10-j. Details of the method of measuring the temperature coefficient of dielectric constant are also given. The magnitude and sign of c-ldc, dT for diamond has been theoretically calculated using Maxwell's relationship and Kramers-Heisenberg theory. The agreement between theoretical and experimental values is extremely good.

The storage stability of passionfruit concentrate

Passionfruit (Passiflora edulis) concentrates (542 g/kg soluble solids) prepared in a wiped-film evaporator were stored for up to 6 months at - 18°, 4° and 20°C. Yeast and mould counts were taken and colour changes noted during storage. When suitable diluted concentrate colour and flavour were acceptable for 1 month at 20°C, 3 months at 4°C and 6 months at -18°C. Commercial short-term storage of concentrate at temperatures above -18°C appears to be feasible. An address presented to the 20th Annual Convention AIFST, Albury NSW, 16th- 20th May, 1987

Studies On Thermal-Decomposition Of Double-Base Propellants

The scanning thermogram of a block sample of a double-base propellant shows a shoulder around 200°C which is not observed in a powder sample of the sample propellant. The heat of decomposition was also found to be different In the two cases. Product analysis and activation energy calculations show that nitroglycerine un dergoes decomposition in the block sample, whereas it vaporizes in the powder sample.

The impact of private and shared open space on liveability in subtropical apartment buildings

The study explores the relationship between open space design, factors impacting open space provision, and resident satisfaction with open space in multistorey apartment buildings in the context of the subtropical lifestyle and climate of Brisbane Australia. The purpose of the paper is to identify the specific physical and spatial design characteristics residents perceive to be important in open spaces associated with their private dwellings and with shared open spaces. Firsthand resident evaluations of everyday experiences of residing in inner urban high density environments are explored through a survey of 636 residents and interviews with 24 residents. Private balconies are highly valued, but residents’ satisfaction would be enhanced by spaciousness for diverse activities, privacy and climate responsive design. Communal spaces and facilities are used infrequently by many residents who prefer interactions with community outside of the building. This is related to preferences for a level of anonymity in a setting where privacy is difficult to achieve due to physical proximity of neighbours.

Kaksi perspektiiviä Etykiin: Viro suomalaisten ja ruotsinvirolaisten lehtien silmin 1973-1975

Suomen ja Viron välillä on ollut kontakteja tuhansien vuosien ajan. Vilkkaammiksi yhteydet muuttuivat kansallisen heräämisen ajalla ja sotien välisenä aikana. Toinen maailmansota katkaisi suomalais-virolaiset suhteet lähes 20 vuodeksi Neuvostoliiton miehitettyä Viron. Yhteydet Viroon palasivat jossakin muodossa 1960-luvulla, mutta olivat silloin ja tutkimusajankohtana 1970-luvulla tiukasti säädeltyjä. Kaikki virallisen tason yhteydenpito tapahtui Moskovan kautta ja valvonnassa, ja kansalaisyhteiskunnan tasolla tapahtuvaa toimintaa maiden välillä ei ollut. Myös lehtikirjoittelu oli Moskovan seurannassa ja Neuvostoliitto puuttui usein, mikäli Suomessa kirjoitettiin Virosta jotakin mikä ei ollut sille mieleen. Tutkielman tavoitteena on selvittää, millainen maa Viro oli 1970-luvun alkupuolella ja millainen kuva siitä oli Suomessa sekä Ruotsissa eläneen pakolaisvirolaisen yhteisön keskuudessa. Aineistona on sanomalehtiartikkeleita vuosilta 1973–1975 neljästä suomalaisesta ja kahdesta ruotsinvirolaisesta sanomalehdestä. Erityinen painopistealue on Euroopan turvallisuus- ja yhteistyökokous eli Etyk, jonka järjestelyihin Suomi otti aktiivisesti osaa. Länsivaltiot ajoivat Ety-asiakirjaan periaatteita mm. vapaammasta tiedonvälityksestä ja ihmisten liikkumisesta, Neuvostoliitto taas tavoitteli rauhansopimuksen korviketta, jolla Euroopan toisen maailmansodan jälkeiset rajat vahvistettaisiin. Etyk oli siis virolaisille monella tavalla merkittävä: he saattoivat toivoa kokouksen tuovan mahdollisuuksia ottaa Baltian asia esille ja saada Baltian maille itsenäisyys, tai ainakin suurempi itsemääräämisoikeus. Toisaalta he pelkäsivät Neuvostoliiton vain vahvistavan otettaan Virosta Etykin avulla. Etykiin liittyvässä kirjoittelussa suomalaislehtien haluttomuus ottaa Viron asiaa esille näkyy erityisen selvästi.Virosta ei muutenkaan 1970-luvulla uutisoitu usein ja Etykin yhteydessä virolaisten toiveita ja tavoitteita ei juuri julkistettu. Baltian maista paenneet pyrkivät kyllä tuomaan asiaansa julkisuuteen Helsingin 1973 ja 1975 kokousten aikaan, mutta suomalaislehdissä se ei näkynyt. Virosta myös annettiin siloiteltu kuva sanomalehdissä ja epäkohtia kuten venäläistämistoimenpiteitä, pidätyksiä tai elintarvikepulaa ei julkistettu. Samaan aikaan Ruotsissa pakolaisvirolaisten toimesta ilmestyneiden lehtien maailma oli aivan toisenlainen. Niiden Etyk-aiheiset kirjoitukset käsittelivät lähes pelkästään Viron asiaa ja Etykin kolmannen korin asioita eli ihmisoikeuskysymyksiä. Ne myös toivat esille aivan toisenlaisen kuvan Neuvosto-Viron oloista kuin suomalaislehdet. Muissa kuin Etykiin liittyvissä artikkeleissa suomalaislehtien välillä on kuitenkin eroja. Yhdenkään tutkituista suomalaislehdistä (Helsingin Sanomat, Hufvudstadsbladet, Kansan Uutiset ja Uusi Suomi) ei voi sanoa noudattaneen täysin horjumatta mitään tiettyä linjaa Viro-kirjoittelussa. Yhdenmukaisimmin suhtautui Kansan Uutiset, joka harvoja poikkeuksia lukuun ottamatta ei tuonut esiin kritiikkiä Neuvostoliittoa kohtaan. Vaihtelevin suhtautuminen oli Helsingin Sanomilla, jonka tapauksessa ei oikeastaan voi puhua minkäänlaisesta linjasta. Hufvudstadsbladet oli melko neutraali joskin etäinen ja maltillinen. Eniten neuvostokritiikkiä viljeli Uusi Suomi. Kuitenkin myös siinä ilmestyi esimerkiksi kaunistelevia kuvauksia elämästä Neuvosto-Virossa, eikä sekään Ety-kokousten aikaan asettunut balttipakolaisten puolelle. Yhdessäkään lehdessä ei ilmestynyt Viro-aiheisia kirjoituksia usein; kaikkiaan artikkeleita aineistossani oli 4 lehdestä 3 vuodelta 247. Monissa niistäkään Viro ei ollut pääasia vaan sitä vain sivuttiin. Ruotsinvirolaisia lehtikirjoituksia aineistossani oli 318. Lehtien (Eesti Päevaleht ja Teataja) välillä ei ollut merkittäviä sisällöllisiä eroja. Suomalaislehdistä ne taas erosivat täysin. Viron kuulumisten ja maailmanpolitiikan lisäksi ne seurasivat myös Suomen asioita ja etenkin niitä tapauksia, joissa Viro ylitti uutiskynnyksen suomalaislehdissä. Suomen lehdissä taas ei paria lähinnä Uuden Suomen poikkeusta lukuun ottamatta kirjoitettu pakolaisvirolaisista mitään, eikä etenkään heidän toiminnastaan Viron asian eteen. Pakolaisvirolaisten lisäksi myös Neuvosto-Viro oli 1970-luvulla suurimmalle osalle suomalaisista varsin tuntematon, sillä julkisessa keskustelussa se esiintyi erittäin harvoin ja oli poistettu jopa oppikirjoista. Suomalaisten yleisen käsityksen mukaan Virossa kaikki oli hyvin ja siellä asui tyytyväisiä ihmisiä. Myös Etyk nähtiin Suomessa täysin toisenlaisessa valossa kuin Pohjanlahden toisella puolella, jossa kirjoittelua leimasi pettymys Etykiin toisen maailmansodan jälkeisten rajojen vahvistajana.

Macromechanical behaviour of composite laminates

An improved higher order transverse shear deformation theory is employed to arrive at modified constitutive relations which can be used in the flexural, buckling and vibration analysis of laminated plates and shells. The strain energy for such systems is then expressed in terms of the displacements and the rotations for ready reference and use. Numerical values of vibration frequencies are obtained using this formulation employing Ritz's method of analysis. The results are compared with those available in the literature to validate the analysis presented.

Measuring and predicting canopy nitrogen nutrition in wheat using a spectral index—The canopy chlorophyll content index (CCCI).

Varying the spatial distribution of applied nitrogen (N) fertilizer to match demand in crops has been shown to increase profits in Australia. Better matching the timing of N inputs to plant requirements has been shown to improve nitrogen use efficiency and crop yields and could reduce nitrous oxide emissions from broad acre grains. Farmers in the wheat production area of south eastern Australia are increasingly splitting N application with the second timing applied at stem elongation (Zadoks 30). Spectral indices have shown the ability to detect crop canopy N status but a robust method using a consistent calibration that functions across seasons has been lacking. One spectral index, the canopy chlorophyll content index (CCCI) designed to detect canopy N using three wavebands along the "red edge" of the spectrum was combined with the canopy nitrogen index (CNI), which was developed to normalize for crop biomass and correct for the N dilution effect of crop canopies. The CCCI-CNI index approach was applied to a 3-year study to develop a single calibration derived from a wheat crop sown in research plots near Horsham, Victoria, Australia. The index was able to predict canopy N (g m-2) from Zadoks 14-37 with an r2 of 0.97 and RMSE of 0.65 g N m-2 when dry weight biomass by area was also considered. We suggest that measures of N estimated from remote methods use N per unit area as the metric and that reference directly to canopy %N is not an appropriate method for estimating plant concentration without first accounting for the N dilution effect. This approach provides a link to crop development rather than creating a purely numerical relationship. The sole biophysical input, biomass, is challenging to quantify robustly via spectral methods. Combining remote sensing with crop modelling could provide a robust method for estimating biomass and therefore a method to estimate canopy N remotely. Future research will explore this and the use of active and passive sensor technologies for use in precision farming for targeted N management.