947 resultados para ratchetting of railhead, insulated rail joints
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High reflectivity to laser light, alloying element evaporation during high power laser welding makes aluminium alloys highly susceptibility to weld defects such as porosity, cracking and undercutting. The dynamic behaviour of the keyhole, due to fluctuating plasma above the keyhole and the vaporization ofthe alloying elements with in the keyhole, is the key problem to be solved for the improvement of the weld quality and stabilization of the keyhole dynamics isperhaps the single most important development that can broaden the application of laser welding of aluminium alloys. In laser welding, the shielding gas is commonly used to stabilize the welding process, to improve the welded joint features and to protect the welded seam from oxidation. The chemicalcomposition of the shielding gas is a key factor in achieving the final qualityof the welded joints. Wide range of shielding gases varying from the pure gasesto complex mixtures based on helium, argon, nitrogen and carbon dioxide are commercially available. These gas mixtures should be considered in terms of their suitability during laser welding of aluminium alloys to produce quality welds. The main objective of the present work is to study the effect of the shielding gascomposition during laser welding of aluminium alloys. Aluminium alloy A15754 was welded using 3kW Nd-YAG laser (continuous wave mode). The alloy samples were butt welded with different shielding gases (pure and mixture of gases) so that high quality welds with high joint efficiencies could be produced. It was observed that the chemical composition of the gases influenced the final weld quality and properties. In general, the mixture gases, in correct proportions, enabled better utilisation of the properties of the mixing gases, stabilized the welding process and produced better weld quality compared to the pure shielding gases.
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Talouden kasvaessa myös tavarankuljetusmäärät kasvavat. Kuljetusjärjestelmät ja niiden sujuva toiminta on erittäin tärkeää taloudellisen kasvun kannalta tällä hetkellä, ja se tulee olemaan yhä tärkeämpää tulevaisuudessa. Tulevaisuudessa tarvitaan kokonaisvaltainen ja selkeästi tehokkaampi kuljetusjärjestelmä, mikäli tulevaisuuden kuljetusvirrat halutaan hoitaa kestävästi. Tässä opinnäytetyössäni tutkin kolmen eurooppalaisen kuljetusjärjestelmän (rautatiet, lentoliikenne ja konttiliikenne meritse) suhteellista teknistä tehokkuutta ja menetelmänä on data envelopment analysis (DEA). Vertailtaessa kuljetusjärjestelmiä löytyi suuria eroja kuljetusmuotojen välille. lentoyhtiöt suoriutuivat huomattavan tasaisesti eli tehokkaiden ja ei-tehokkaiden toimijoiden välillä ei ollut suuria eroja. Rautatiepuolella erot venyivät huomattavan suuriksi niin eri yritysten välillä kuin jopa saman yrityksen sisällä eri vuosina. Pikaisemmassa laivayhtiöiden tarkastelussa erot niiden välillä olivat lähes yhtä pieniä kuin lentoyhtiöiden välillä. Tarkasteltaessa omistajuuden vaikutusta lentoyhtiöiden toiminnassa huomattiin, että yksityisessä omistuksessa olevat yritykset olivat huomattavasti tehokkaampia matkustajien kuljettamisessa. Rahtipuolella merkittäviä eroja ei havaittu. Merkittävät korrelaatiot eri mallien välillä antoivat joitain viitteitä myös kuljetuspoliittiseen päätöksentekoon; investoinnit matkustajienkuljetuksiin raiteilla parantaisivat koko rautatiepuolen teokkuutta, mutta myös samalla lentopuolen matkustajakuljetuksen tehokkuutta.
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Päästöjen vähentäminen on ollut viime vuosina tärkeässä osassa polttomoottoreita kehitettäessä.Monet viralliset tahot asettavat uusia tiukempia päästörajoituksia. Päästörajatovat tyypillisesti olleet tiukimmat autoteollisuuden valmistamille pienille nopeakäyntisille diesel-moottoreille, mutta viime aikoina paineita on kohdistunut myös suurempiin keskinopeisiin ja hidaskäyntisiin diesel-moottoreihin. Päästörajat ovat erilaisia riippuen moottorin tyypistä, käytetystä polttoaineesta ja paikasta missä moottoria käytetään johtuen erilaisista paikallisista laeista ja asetuksista. Eniten huomiota diesel-moottorin päästöissä täytyy kohdistaa typen oksideihin, savun muodostukseen sekä partikkeleihin. Laskennallisen virtausmekaniikan (CFD) avulla on hyvät mahdollisuudet tutkia diesel-moottorin sylinterissä tapahtuvia ilmiöitä palamisen aikana. CFD on hyödyllinen työkalu arvioitaessa moottorin suorituskykyä ja päästöjen muodostumista. CFD:llä on mahdollista testata erilaisten parametrien ja geometrioiden vaikutusta ilman kalliita moottorinkoeajoja. CFD:tä voidaan käyttää myös opetustarkoituksessa lisäämään paloprosessin tuntemusta. Tulevaisuudessa palamissimuloinnit CFD:llä tulevat epäilemättä olemaan tärkeä osa moottorin kehityksessä. Tässä diplomityössä on tehty palamissimuloinnit kahteen erilaisilla poittoaineenruiskutuslaitteistoilla varustettuun Wärtsilän keskinopeaan diesel-moottoriin. W46 moottorin ruiskutuslaitteisto on perinteinen mekaanisesti ohjattu pumppusuutin ja W46-CR moottorissa on elektronisesti ohjattu 'common rail' ruiskutuslaitteisto. Näiden moottorien ja käytössä olevien ruiskutusprofiilien lisäksi on simuloinneilla testattu erilaisia uusia ruiskutusprofiileja, jotta erityyppisten profiilien hyvät ja huonot ominaisuudet tulisivat selville. Matalalla kuormalla kiinnostuksen kohteena on nokipäästöjen muodostus ja täydellä kuormalla NOx-päästöjen muodostus ja polttoaineen kulutus. Simulointien tulokset osoittivat, että noen muodostusta matalalla kuormalla voidaan selvästi vähentää monivaiheisella ruiskutuksella, jossa yksi ruiskutusjakso jaetaan kahteen tai useampaan jaksoon. Erityisen tehokas noen vähentämisessä vaikuttaa olevan ns. jälkiruiskutus (post injection). Matalat NOx-päästöt ja hyvä polttoaineen kulutus täydellä kuormalla on mahdollista saavuttaaasteittain nostettavalla ruiskutusnopeudella.
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Progressive pseudorheumatoid dysplasia (PPRD) is a genetic, non-inflammatory arthropathy caused by recessive loss of function mutations in WISP3 (Wnt1-inducible signaling pathway protein 3; MIM 603400), encoding for a signaling protein. The disease is clinically silent at birth and in infancy. It manifests between the age of 3 and 6 years with joint pain and progressive joint stiffness. Affected children are referred to pediatric rheumatologists and orthopedic surgeons; however, signs of inflammation are absent and anti-inflammatory treatment is of little help. Bony enlargement at the interphalangeal joints progresses leading to camptodactyly. Spine involvement develops in late childhood and adolescence leading to short trunk with thoracolumbar kyphosis. Adult height is usually below the 3rd percentile. Radiographic signs are relatively mild. Platyspondyly develops in late childhood and can be the first clue to the diagnosis. Enlargement of the phalangeal metaphyses develops subtly and is usually recognizable by 10 years. The femoral heads are large and the acetabulum forms a distinct "lip" overriding the femoral head. There is a progressive narrowing of all articular spaces as articular cartilage is lost. Medical management of PPRD remains symptomatic and relies on pain medication. Hip joint replacement surgery in early adulthood is effective in reducing pain and maintaining mobility and can be recommended. Subsequent knee joint replacement is a further option. Mutation analysis of WISP3 allowed the confirmation of the diagnosis in 63 out of 64 typical cases in our series. Intronic mutations in WISP3 leading to splicing aberrations can be detected only in cDNA from fibroblasts and therefore a skin biopsy is indicated when genomic analysis fails to reveal mutations in individuals with otherwise typical signs and symptoms. In spite of the first symptoms appearing in early childhood, the diagnosis of PPRD is most often made only in the second decade and affected children often receive unnecessary anti-inflammatory and immunosuppressive treatments. Increasing awareness of PPRD appears to be essential to allow for a timely diagnosis. © 2012 Wiley Periodicals, Inc.
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Euroopan unionissa päätettiin jo yli vuosikymmen sitten, että rautatieliiketoiminta vapautetaan kilpailulle. Iso-Britanniasta olimäärä tulla esimerkkivaltio tämän prosessin käyttöönotossa. Pääideana oli säännöstelyn keventäminen, jolloin omistuspohja toimialalla laajenee ja rautateiden infrastruktuuri sekä toiminta parantuvat. Infrastruktuuri on määrä olla yhden organisaation hallinnassa ja raiteiden käyttöoikeus on kaikilla lupaehdot täyttävillä operaattoreilla, jotka kilpailevat keskenään matkustajista ja tavararahdeista. Kuitenkin Yhdysvalloissa ja eräissä Latinalaisen Amerikan maissa kilpailu on vapautettu siten, että rautatieyritys omistaa raideinfrastruktuurin, junat, tavarankuljetus- sekä matkustajavaunut. Iso-Britannian yksityistämistä pidettiin aluksi isonaepäonnistumisena: nopealla aikataululla sovellettiin jäykkiä transaktioperusteisia ulkoistamisstrategioita infrastruktuurin kunnossapitoon, jotka lopulta johtivat junien jatkuviin myöhästymisiin ja muutamaan tuhoisaan onnettomuuteen. Liiketoiminnallisessa mielessäkään ei oikein onnistuttu: infrastruktuurista vastaava yritys jouduttiin listaamaan pois Lontoon pörssistä, ja hallituksen oli pakko luoda tukipaketti pahasti velkaantuneen, vain marginaalisien investointien kohteena olleen yrityksen toimintaa varten (vaikka kapasiteettitarvetta oli markkinoilla). Myös rautatieoperaattorit olivat taloudellisessa ahdingossa ja vain määrätietoisten hallituksen laatimien pelastuspakettien avulla ala nousi syvimmästä kriisistään. Tästä huolimatta näiden negatiivisten sivuvaikutusten ohella koko ala pystyi kasvattamaan kysyntää, niin matkustaja- kuin rahtiliikenteenkin osalta. Vähenevän kysynnän trendi, joka alkoi 1970-luvulla, otti käännöksen parempaan. Toinen eurooppalaismaa, jolla on pitkät kokemukset yksityistämisestä, on Ruotsi. Tämä maatapaus on melko konservatiivinen verrattuna tilanteeseen edellisessä; vain rajattu määrä reittejä on avattu kilpailulle ja sopimukset tehdään kerralla pitkäksi aikaa eteenpäin. Ruotsin säännöstelyn purku osoittautui menestykseksi, koska tuottavuus onollut vakaassa kasvussa ja rautateiden markkinaosuus erityisesti matkustajapuolella on noussut merkittävästi, verrattuna muihin kuljetusmuotoihin. Kuitenkin kilpailua on käytännössä vähän tässä maassa ja parempiatuloksia on lupa odottaa, kun vain säännöstelyn purkaminen jatkuu. Viimeinen tutkimuksemme kohteena oleva maa on Yhdysvallat, joka alistutti rautatiet kilpailulle jo 1980-luvun alussa, käyttäen jo edellä mainittua vertikaalista integraatiota; tämä valinta on taas johtanut hyvin erilaisiin tuloksiin. Vaihtoehtoinen rakenteellinen uudistustapa on suosinut rahtivirtoja matkustajiin nähden, ja lopputuloksena tämä tapaus synnytti yrityksiä huolehtimaan toista näistä kahdesta pääasiakasryhmästä. Viimeaikaiset tulokset tästä yksityistämisprosessista ovat olleet hyviä: jäljellejääneiden yritysten voitot ovat kasvaneet, osinkoja ollaan kyetty jakamaan ja osakkeiden arvostus on noussut. Tässä tutkimusraportissa yritämme kolmen maatapauksen kautta esittää, miten yksityistämisprosessi tulee vaikuttamaan Euroopassa, kun kilpailu rautateillä vapautuu. Me käymmeläpi, mikä näistä kolmesta maaesimerkistä on kaikkein todennäköisin jaesitämme ehdotuksia siihen, miten valtiot voisivat välttää ei-haluttuja sivuvaikutuksia. Kolme maaesimerkkiä, ja lopuksi esitetty lyhyt tilastollinen analyysi osoittavat, että rautateillä on tulevaisuuden potentiaalia Euroopassa, ja kilpailun vapauttaminen on avain tämän potentiaalin realisointiin.
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It is commonly observed that complex fabricated structures subject tofatigue loading fail at the welded joints. Some problems can be corrected by proper detail design but fatigue performance can also be improved using post-weld improvement methods. In general, improvement methods can be divided into two main groups: weld geometry modification methods and residual stress modification methods. The former remove weld toe defects and/or reduce the stress concentrationwhile the latter introduce compressive stress fields in the area where fatigue cracks are likely to initiate. Ultrasonic impact treatment (UIT) is a novel post-weld treatment method that influences both the residual stress distribution andimproves the local geometry of the weld. The structural fatigue strength of non-load carrying attachments in the as-welded condition has been experimentally compared to the structural fatigue strength of ultrasonic impact treated welds. Longitudinal attachment specimens made of two thicknesses of steel S355 J0 have been tested for determining the efficiency of ultrasonic impacttreatment. Treated welds were found to have about 50% greater structural fatigue strength, when the slope of the S-N-curve is three. High mean stress fatigue testing based on the Ohta-method decreased the degree of weld improvement only 19%. This indicated that the method could be also applied for large fabricated structures operating under high reactive residual stresses equilibrated within the volume of the structure. The thickness of specimens has no significant effect tothe structural fatigue strength. The fatigue class difference between 5 mm and 8 mm specimen was only 8%. It was hypothesized that the UIT method added a significant crack initiation period to the total fatigue life of the welded joints. Crack initiation life was estimated by a local strain approach. Material parameters were defined using a modified Uniform Material Law developed in Germany. Finite element analysis and X-ray diffraction were used to define, respectively, the stress concentration and mean stress. The theoretical fatigue life was found to have good accuracy comparing to experimental fatigue tests.The predictive behaviour of the local strain approach combined with the uniformmaterial law was excellent for the joint types and conditions studied in this work.
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Current diagnostic methods in differentiating septic from non-septic arthritis are time-consuming (culture) or have limited sensitivity (Gram stain). Microcalorimetry is a novel method that can rapidly detect microorganisms by their heat production. We investigated the accuracy and time to detection of septic arthritis by using microcalorimetry. Patients older than 18 years of age with acute arthritis of native joints were prospectively included. Synovial fluid was aspirated and investigated by Gram stain, culture and microcalorimetry. The diagnosis of septic arthritis and non-septic arthritis were made by experienced rheumatologists or orthopaedic surgeons. Septic arthritis was diagnosed by considering the finding of acute arthritis together with findings such as positive Gram stain or positive culture of synovial fluid or positive blood culture. The sensitivity and specificity for diagnosing septic arthritis and the time to positivity of microcalorimetry were determined. Of 90 patients (mean age 64 years), nine had septic arthritis, of whom four (44 %) had positive Gram stain, six (67 %) positive synovial fluid culture and four (44 %) had positive blood culture. The sensitivity of microcalorimetry was 89 %, the specificity was 99 % and the mean detection time was 5.0 h (range, 2.2-8.0 h). Microcalorimetry is an accurate and rapid method for the diagnosis of septic arthritis. It has potential to be used in clinical practice in diagnosing septic arthritis.
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Tutkimus tarkastelee Luoteis-Venäjän liikennelogistiikkaklusteria. Tarkoitus on selvittää klusterin nykyinen rakenne ja kilpailukyky sekä klusterin tarjoamat liiketoimintamahdollisuudet suomalaisille logistiikkayrityksille. Työssä käsitellään neljää perusliikennemuotoa: rautatie-, maantie-, meri- ja sisävesi-, sekä ilmaliikennettä. Tutkimuksen aineisto on kerätty tutkimusta varten laadituista kyselyistä, haastatteluista sekä aiemmin julkaistusta materiaalista. Venäjä on suunnitellut kehittävänsä voimakkaasti liikenneinfrastruktuuria, mm. julkaisemalla protektionistisen liikennestrategiasuunnitelman. Ongelmana ovat olleet toteutukset, jotka ovat jääneet yleensä puutteellisiksi. Tällä hetkellä todellista kilpailukykyä löytyy ainoastaan rautatieliikenteestä, muut kolme liikennemuotoa omaavat potentiaalisen kilpailukyvyn. Venäjällä on mahdollisuus hyötyä laajasta pinta-alastaan Aasian ja Euroopan liikenteen yhdistäjänä. Yksi konkreettisimmista esimerkeistä on Trans Siperian rautatie, joka kaipaisi vielä lisäkehitystä. Suomi on toiminut Venäjän liikenteessä arvotavaran kauttakulkumaana, vuonna 2003 noin 30–40 % Venäjän tuonnin arvosta kulki Suomen kautta. Venäjälle tullaan tuomaan arvotavaraa vielä useita vuosia, mutta reittien osalta kilpailu on tiukentunut. Suomalaisten yritysten liiketoimintamahdollisuuksiin esitetään kaksi mallia: kauttakulkuliikenteen lisäarvologistiset (VAL) operaatiot Suomessa tai etabloituminen Venäjän logistisiin ketjuihin. Suomalaisten olisi syytä parantaa yhteistyötään yritysten ja yliopistojen ym. koulutuslaitosten välillä. Myös yhteistyökumppaneiden hakeminen esimerkiksi Ruotsista voisi tuoda merkittäviä etuja. Suomalaista osaamista voitaisiin hyödyntää parhaiten etabloitumalla Venäjän markkinoille, esimerkiksi keskittymällä Venäjän logististen ketjujen johtamiseen. Myös VAL palveluiden johtamiseen Venäjällä olisi erittäin hyvä tilaisuus, koska Venäjän oma tietotaito logistiikassa ei ole vielä kehittynyt kansainväliselle tasolle, mutta kustannustaso on alhaisempi kuin Suomessa.
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The goal of this thesis is to give information to machine designers about how to design and size sheet metal structures and joints. Generally, the designing object is to lighten structures. To design structures that are light and can carry loads more effectively, designers have to be updated of new manufacturing techniques and new designing methods and criterions. With knowledge of this thesis, a designer can recognize objects and methods plus how and where it is possible to apply these new more effectively load carrying structures. The thesis gives answers to questions of corrosion and material planning, goes into joint types and manufacturing techniques of sheet metal structures. One of the main issues is to develop designers world of ideas to design right kind of products with new lasertechniques.
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Extraintestinal manifestations (EIM) in inflammatory bowel disease (IBD) are frequent and may occur before or after IBD diagnosis. EIM may impact the quality of life for patients with IBD significantly requiring specific treatment depending on the affected organ(s). They most frequently affect joints, skin, or eyes, but can also less frequently involve other organs such as liver, lungs, or pancreas. Certain EIM, such as peripheral arthritis, oral aphthous ulcers, episcleritis, or erythema nodosum, are frequently associated with active intestinal inflammation and usually improve by treatment of the intestinal activity. Other EIM, such as uveitis or ankylosing spondylitis, usually occur independent of intestinal inflammatory activity. For other not so rare EIM, such as pyoderma gangrenosum and primary sclerosing cholangitis, the association with the activity of the underlying IBD is unclear. Successful therapy of EIM is essential for improving quality of life of patients with IBD. Besides other options, tumor necrosis factor antibody therapy is an important therapy for EIM in patients with IBD.
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L'arthrose est une maladie dégénérative des articulations due à une dégradation progressive du cartilage. La calcification de l'articulation (essentiellement due à des dépôts de cristaux de phosphate de calcium basique -cristaux BCP-) est une caractéristique de cette maladie. Cependant, le rôle des cristaux BCP reste à déterminer. Nous avons tout d'abord déterminé en utilisant des cultures primaires de chondrocytes que les cristaux de BCP induisaient la production de la cytokine IL-6, via une signalisation intracellulaire implicant les kinase Syk, PI3 et Jak et Stat3. Les cristaux de BCP induisent également la perte de protéoglycanes et l'expression de IL-6 dans des explants de cartlage humain et ces deux effets peuvent être bloqués par un inhibiteur de IL-6, le Tocilizumab. Par ailleurs, nous avons trouvé que l'IL-6 ajouté à des chondrocytes, favorisait la formation de cristax de BCP et augmentait l'expression de gènes impliqués dans le processus de minéralisation : Ank (codant pour un transporteur de pyrophooshate), Annexin5 (codant pour un canal calcique) et Pit-1 (codant pour un transporteur de phoshate). In vivo, les cristaux de BCP injectés dans l'articulation de souris induisent une érosion du cartilage. Dans un modèle murin d'arthrose du genou induit par ménisectomie, nous avons observé la formation progressive de cristaux de BCP. Fait intéressant, la présence de ces cristaux dans l'articulation précédait la destruction du cartilage. Un agent susceptible de bloquer les calcifications tel que le sodium thiosulfate (STS), administré à des souris ménisectomisées, inhibait le dépôt intra-articulaire de ces cristaux ainsi que l'érosion du cartilage. Nous avons identifié ainsi un cercle vicieux dans l'arthrose, les cristaux induisant l'interleukine-6 et l'interleukine-6 induisant la formation de ces cristaux. Nous avons étudié si on pouvait bloquer cette boucle cristaux de BCP-IL6 soit par des agents décalcifiants, soit par des inhibiteurs d'IL-6. In vitro, des anticorps anti IL- 6 ou des inhibiteurs de signalisation, inhibaient significativement IL-6 et la minéralisation induite par IL-6. De même le STS inhibait la formation de ces cristaux et la production de l'IL-6. Tout récemment, nous avons trouvé que des inhibiteurs de la xanthine oxidoréductase étaient aussi capables d'inhiber à la fois la production d'IL-6 et la minéralization des chondrocytes. Finalement, nous avons pu exclure un rôle du système IL-1 dans le modèle d'arthrose induite par ménisectomie, les souris déficientes pour IL-1a/ß, MyD88 et l'inflammasome NLRP3 n'étant pas protégées dans ce modèle d'arthrose. L'ensemble de nos résultats montre que les cristaux BCP sont pathogéniques dans l'arthrose et qu'un inhibiteur de minéralisation tel que le STS ou un inhibiteur de l'interleukine-6 constitueraient des nouvelles thérapies pour l'arthrose. -- Osteoarthritis (OA), the most common degenerative disorder of the joints, results from an imbalance between the breakdown and repair of the cartilage and surrounding articular structures. Joint calcification (essentially due to basic calcium phosphate (BCP) crystal deposition) is a characteristic feature of OA. However, the role of BCP crystal deposition in the pathogenesis of OA remains unclear[1][1]. We first demonstrated that in primary murine chondrocytes exogenous BCP crystals led to IL-6 up-modulation and that BCP crystal signaling pathways involved Syk and PI3 kinases, and also gp130 associated molecules, Jak2 and Stat3. BCP crystals also induced proteoglycan loss and IL-6 expression in human cartilage expiants, (which were significantly reduced by an IL-6 inhibitor). In addition, we found that in chondrocytes exogenous IL-6 promoted calcium-containing crystal formation and up- regulation of genes codifying for proteins involved in the calcification process: the inorganic pyrophosphate transport channel Ank, the calcium channel Annexinö and the sodium/phosphate cotransporter Piti. In vivo, BCP crystals injected into murine knee joints induced cartilage erosion. In the menisectomy model, increasing deposits, identified as BCP crystals, were progressively observed around the joint before cartilage erosion. These deposits strongly correlated with cartilage degradation and IL-6 expression. These results demonstrated that BCP crystals deposition and IL-6 production are mutually reinforcing in the osteoarthritic pathogenic process. We then investigated if we could block the BCP-IL6 loop by either targeting IL-6 production or BCP crystal deposits. Treatment of chondrocytes with anti-IL-6 antibodies or inhibitors of IL-6- signaling pathway significantly inhibited IL-6-induced crystal formation. Similarly, sodium thiosulfate (STS), a well-known systemic calcification inhibitor, decreased crystal deposition as well as HA-induced IL-6 secretion in chondrocytes and, in vivo, it decreased crystal deposits size and cartilage erosion in menisectomized knees. Interestingly, we also found that xanthine-oxidoreductase (XO) inhibitors inhibited both IL-6 production and calcium crystal depositis in chondrocytes. We began to unravel the mechanisms involved in this coordinate modulation of IL-6 and mineralization. STS inhibited Reactive Oxygen Species (ROS) generation and we are currently investigating whether XO represents a major source of ROS in chondrocyte mineralization. Finally, we ruled out that IL-1 activation/signaling plays a role in the murine model of OA induced by menisectomy, as IL-1a/ß, the IL-1 R associated molecule MyD88 and NLRP3 inflammasome deficient mice were not protected in this model of OA. Moreover TLR-1, -2, -4,-6 deficient mice had a phenotype similar to that of wild-type mice. Altogether our results demonstrated a self-amplification loop between BCP crystals deposition and IL-6 production, which represents an aggravating process in OA pathogenesis. As currently prescribed OA drugs are addressing OA symptoms,our results highlight a potential novel treatment strategy whereby inhibitors of calcium- containing crystal formation and IL-6 could be combined to form the basis of a disease modifying treatment and alter the course of OA.
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INTRODUCTION: The performance of ultrasound (US) in the diagnosis of acute gouty (MSU) arthritis and calcium pyrophosphate (CPP) arthritis is not yet well defined. Most studies evaluated US as the basis for diagnosing crystal arthritis in already diagnosed cases of gout and few prospective studies have been performed. METHODS: One hundred nine consecutive patients who presented an acute arthritis of suspected microcrystalline arthritis were prospectively included. All underwent an US of the symptomatic joints(s) and of knees, ankles and 1(st) metatarsopalangeal (MTP) joints by a rheumatologist "blinded" to the clinical history. 92 also had standard X-rays. Crystal identification was the gold standard. RESULTS: Fifty-one patients had MSU, 28 CPP and 9 had both crystals by microscopic analysis. No crystals were detected in 21. One had septic arthritis. Based on US signs in the symptomatic joint, the sensitivity of US for both gout and CPP was low (60 % for both). In gout, the presence of US signs in the symptomatic joint was highly predictive of the diagnosis (PPV = 92 %). When US diagnosis was based on an examination of multiple joints, the sensitivity for both gout and CPP rose significantly but the specificity and the PPV decreased. In the absence of US signs in all the joints studied, CPP arthritis was unlikely (NPV = 87 %) particularly in patients with no previous crisis (NPV = 94 %). X-ray of the symptomatic joints was confirmed to be not useful in diagnosing gout and was equally sensitive or specific as US in CPP arthritis. CONCLUSIONS: Arthrocenthesis remains the key investigation for the diagnosis of microcrystalline acute arthritis. Although US can help in the diagnostic process, its diagnostic performance is only moderate. US should not be limited to the symptomatic joint. Examination of multiple joints gives a better diagnostic sensitivity but lower specificity.
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INTRODUCTION: The acute gout flare results from a localised self-limiting innate immune response to monosodium urate (MSU) crystals deposited in joints in hyperuricaemic individuals. Activation of the caspase recruitment domain-containing protein 8 (CARD8) NOD-like receptor pyrin-containing 3 (NLRP3) inflammasome by MSU crystals and production of mature interleukin-1β (IL-1β) is central to acute gouty arthritis. However very little is known about genetic control of the innate immune response involved in acute gouty arthritis. Therefore our aim was to test functional single nucleotide polymorphism (SNP) variants in the toll-like receptor (TLR)-inflammasome-IL-1β axis for association with gout. METHODS: 1,494 gout cases of European and 863 gout cases of New Zealand (NZ) Polynesian (Māori and Pacific Island) ancestry were included. Gout was diagnosed by the 1977 ARA gout classification criteria. There were 1,030 Polynesian controls and 10,942 European controls including from the publicly-available Atherosclerosis Risk in Communities (ARIC) and Framingham Heart (FHS) studies. The ten SNPs were either genotyped by Sequenom MassArray or by Affymetrix SNP array or imputed in the ARIC and FHS datasets. Allelic association was done by logistic regression adjusting by age and sex with European and Polynesian data combined by meta-analysis. Sample sets were pooled for multiplicative interaction analysis, which was also adjusted by sample set. RESULTS: Eleven SNPs were tested in the TLR2, CD14, IL1B, CARD8, NLRP3, MYD88, P2RX7, DAPK1 and TNXIP genes. Nominally significant (P < 0.05) associations with gout were detected at CARD8 rs2043211 (OR = 1.12, P = 0.007), IL1B rs1143623 (OR = 1.10, P = 0.020) and CD14 rs2569190 (OR = 1.08; P = 0.036). There was significant multiplicative interaction between CARD8 and IL1B (P = 0.005), with the IL1B risk genotype amplifying the risk effect of CARD8. CONCLUSION: There is evidence for association of gout with functional variants in CARD8, IL1B and CD14. The gout-associated allele of IL1B increases expression of IL-1β - the multiplicative interaction with CARD8 would be consistent with a synergy of greater inflammasome activity (resulting from reduced CARD8) combined with higher levels of pre-IL-1β expression leading to increased production of mature IL-1β in gout.
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The CO2-laser-MAG hybrid welding process has been shown to be a productive choice for the welding industry, being used in e.g. the shipbuilding, pipe and beam manufacturing, and automotive industries. It provides an opportunity to increase the productivity of welding of joints containing air gaps compared with autogenous laser beam welding, with associated reductions in distortion and marked increases in welding speeds and penetration in comparison with both arc and autogenous laser welding. The literature study indicated that the phenomena of laser hybrid welding are mostly being studied using bead-on-plate welding or zero air gap configurations. This study shows it very clearly that the CO2 laser-MAG hybrid welding process is completely different, when there is a groove with an air gap. As in case of industrial use it is excepted that welding is performed for non-zero grooves, this study is of great importance for industrial applications. The results of this study indicate that by using a 6 kW CO2 laser-MAG hybrid welding process, the welding speed may also be increased if an air gap is present in the joint. Experimental trials indicated that the welding speed may be increased by 30-82% when compared with bead-on-plate welding, or welding of a joint with no air gap i.e. a joint prepared as optimum for autogenous laser welding. This study demonstrates very clearly, that the separation of the different processes, as well as the relative configurations of the processes (arc leading or trailing) affect welding performance significantly. These matters influence the droplet size and therefore the metal transfer mode, which in turn determined the resulting weld quality and the ability to bridge air gaps. Welding in bead-onplate mode, or of an I butt joint containing no air gap joint is facilitated by using a leading torch. This is due to the preheating effect of the arc, which increases the absorptivity of the work piece to the laser beam, enabling greater penetration and the use of higher welding speeds. With an air gap present, air gap bridging is more effectively achieved by using a trailing torch because of the lower arc power needed, the wider arc, and the movement of droplets predominantly towards the joint edges. The experiments showed, that the mode of metal transfer has a marked effect on gap bridgeability. Transfer of a single droplet per arc pulse may not be desirable if an air gap is present, because most of the droplets are directed towards the middle of the joint where no base material is present. In such cases, undercut is observed. Pulsed globular and rotational metal transfer modes enable molten metal to also be transferred to the joint edges, and are therefore superior metal transfer modes when bridging air gaps. It was also found very obvious, that process separation is an important factor in gap bridgeability. If process separation is too large, the resulting weld often exhibits sagging, or no weld may be formed at all as a result of the reduced interaction between the component processes. In contrast, if the processes are too close to one another, the processing region contains excess molten metal that may create difficulties for the keyhole to remain open. When the distance is optimised - i.e. a separation of 0-4 mm in this study, depending on the welding speed and beam-arc configuration - the processes act together, creating beneficial synergistic effects. The optimum process separation when using a trailing torch was found to be shorter (0-2 mm) than when a leading torch is used (2-4 mm); a result of the facilitation of weld pool motion when the latter configuration is adopted. This study demonstrates, that the MAG process used has a strong effect on the CO2-laser-MAG hybrid welding process. The laser beam welding component is relatively stable and easy to manage, with only two principal processing parameters (power and welding speed) needing to be adjusted. In contrast, the MAG process has a large number of processing parameters to optimise, all of which play an important role in the interaction between the laser beam and the arc. The parameters used for traditional MAG welding are often not optimal in achieving the most appropriate mode of metal transfer, and weld quality in laser hybrid welding, and must be optimised if the full range of benefits provided by hybrid welding are to be realised.
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The costs related to the treatment of infected total joint arthroplasties represent an ever groving burden to the society. Different patient-adapted therapeutic options like débridement and retention, 1- or 2-step exchange can be used. If a 2-step exchange is used we have to consider short (2-4 weeks) or long (>4-6 weeks) interval treatment. The Swiss DRG (Diagnose related Groups) determines the reimboursement the hopsital receives for the treatment of an infected total arthroplasty. The review assesses the cost-effectiveness of hospitalisation practices linked to surgical treatment in the two-stage exchange of a prosthetic-joint infection. The aim of this retrospectiv study is to compare the economical impact between a short (2 to 4 weeks) versus a long (6 weeks and above) interval during a two-satge procedure to determine the financial impact. Retrospectiv study of the patients with a two-stage procedure for a hip or knee prosthetic joint infection at CHUV hospital Lausanne (Switzerland) between 2012 and 2013. The review analyses the correlation between the interval length and the length of the hospital stay as well as with the costs and revenues per hospital stay. In average there is a loss of 40′000 Euro per hospitalisation for the treatment of prosthetic joint infection. Revenues never cover all the costs, even with a short interval procedure. This economical loss increases with the length of the hospital stay if a long-term intervall is choosen. The review explores potential for improvement in reimbourement practices and hospitalisation practices in the current Swiss healthcare setting. There should be alternative setups to decrease the burden of medical costs by a) increase the reimboursment for the treatment of infected total joints or by b) splitting the hospital stay with partners (rapid transfer after first operation from center hospital to level 2 hospital and retransfer for second operation to center) in order to increase revenues.