Results of computer assisted navigation in Total Knee Arthroplasty (TKA): comparison with the conventional method

The aim of this retrospective study was to compare the clinical and radiographic results after TKA (PFC, DePuy), performed either by computer assisted navigation (CAS, Brainlab, Johnson&Johnson) or by conventional means. Material and methods: Between May and December 2006 we reviewed 36 conventional TKA performed between 2002 and 2003 (group A) and 37 navigated TKA performed between 2005 and 2006 (group B) by the same experienced surgeon. The mean age in group A was 74 years (range 62-90) and 73 (range 58-85) in group B with a similar age distribution. The preoperative mechanical axes in group A ranged from -13° varus to +13° valgus (mean absolute deviation 6.83°, SD 3.86), in group B from -13° to +16° (mean absolute deviation 5.35, SD 4.29). Patients with a previous tibial osteotomy or revision arthroplasty were excluded from the study. Examination was done by an experienced orthopedic resident independent of the surgeon. All patients had pre- and postoperative long standing radiographs. The IKSS and the WOMAC were utilized to determine the clinical outcome. Patient's degree of satisfaction was assessed on a visual analogous scale (VAS). Results: 32 of the 37 navigated TKAs (86,5%) showed a postoperative mechanical axis within the limits of 3 degrees of valgus or varus deviation compared to only 24 (66%) of the 36 standard TKAs. This difference was significant (p = 0.045). The mean absolute deviation from neutral axis was 3.00° (range -5° to +9°, SD: 1.75) in group A in comparison to 1.54° (range -5° to +4°, SD: 1.41) in group B with a highly significant difference (p = 0.000). Furthermore, both groups showed a significant postoperative improvement of their mean IKSS-values (group A: 89 preoperative to 169 postoperative, group B 88 to 176) without a significant difference between the two groups. Neither the WOMAC nor the patient's degree of satisfaction - as assessed by VAS - showed significant differences. Operation time was significantly higher in group B (mean 119.9 min.) than in group A (mean 99.6 min., p <0.000). Conclusion: Our study showed consistent significant improvement of postoperative frontal alignment in TKA by computer assisted navigation (CAS) compared to standard methods, even in the hands of a surgeon well experienced in standard TKA implantation. However, the follow-up time of this study was not long enough to judge differences in clinical outcome. Thus, the relevance of computer navigation for clinical outcome and survival of TKA remains to be proved in long term studies to justify the longer operation time. References 1 Stulberg SD. Clin Orth Rel Res. 2003;(416):177-84. 2 Chauhan SK. JBJS Br. 2004;86(3):372-7. 3 Bäthis H, et al. Orthopäde. 2006;35(10):1056-65.

Aspirin and statin use and the subsequent development of depression in men and women: Results from a longitudinal population-based study.

OBJECTIVE: Low-grade chronic inflammation is one potential mechanism underlying the well-established association between major depressive disorder (MDD) and increased cardiovascular morbidity. Both aspirin and statins have anti-inflammatory properties, which may contribute to their preventive effect on cardiovascular diseases. Previous studies on the potentially preventive effect of these drugs on depression have provided inconsistent results. The aim of the present paper was to assess the prospective association between regular aspirin or statin use and the incidence of MDD. METHOD: This prospective cohort study included 1631 subjects (43.6% women, mean age 51.7 years), randomly selected from the general population of an urban area. Subjects underwent a thorough physical evaluation as well as semi-structured interviews investigating DSM-IV mental disorders at baseline and follow-up (mean duration 5.2 years). Analyses were adjusted for a wide array of potential confounders. RESULTS: Our main finding was that regular aspirin or statin use at baseline did not reduce the incidence of MDD during follow-up, regardless of sex or age (hazard ratios, aspirin: 1.19; 95%CI, 0.68-2.08; and statins: 1.25; 95%CI, 0.73-2.14; respectively). LIMITATIONS: Our study is not a randomized clinical trial and could not adjust for all potential confounding factors, information on aspirin or statin use was collected only for the 6 months prior to the evaluations, and the sample was restricted to subjects between 35 and 66 years of age. CONCLUSION: Our data do not support a large scale preventive treatment of depression using aspirin or statins in subjects aged from 35 to 66 years from the community.

The last resort : spa therapy and the docile body in Victorian St. Catharines /

By relying on existing cultural models, the Victorian spa promoted health and wellness. Advertising, together with other forms of promotion, strengthened the legitimacy of its claims to cure a variety of health problems. By the use of some links to science and a mystical folk belief about the efficacy of the local mineral waters, three spas emerged in St.Catharines: the Stephenson House, the WeIland House, and the Springbank. As the twentieth century approached, the spa movement declined and institutionalized medicine struggled to establish a monopoly on health care. This thesis argues that the health spas in St. Catharines occupied that transitional space in nineteenth century medicine between home remedy and hospital. The interplay between scientific discovery and business enterprise produced a climate in which the Victorian health resort flourished. This phenomenon, combined with the various maladies brought on by industrialization, nineteenth-century lifestyle, and the absence of medical options, created a surge in the popularity of health spas and mineral spring therapies. By the tum of the twentieth century, interest in mineral water treatments had declined. The health resorts that had blossomed between 1850 and 1899 began to experience a serious decrease in business. This popular movement became outmoded in the face of emerging medical and scientific knowledge. In St. Catharines, the last resort to remain standing, the WeIland House, finished out the city's spa era as a hospital.

Tourism and the precautionary principle : a survey of academic and government stakeholders

The purpose of this exploratory investigation was to provide a more precise understanding and basis from which to assess the potential role of the precautionary principle in tourism. The precautionary principle, analogous to the ideal of sustainable development, is a future-focused planning and regulatory mechanism that emphasizes pro-action and recognizes the limitations of contemporary scientific methods. A total of 100 respondents (80 tourism academics, 20 regional government tourism officials) from Canada, United States, United Kingdom, Australia and New Zealand completed the webbased survey between May and June 2003. Respondents reported their understanding of the precautionary principle, rated stakeholder involvement and education strategies, assessed potential barriers in implementation, and appraised steps of a proposed fi-amework for implementation. Due to low sub sample numbers, measures of central tendency were primarily used to compare groups, while inferential statistics were applied when warranted. Results indicated that most respondents (79%) felt the principle could be a guiding principle for tourism, while local and regional government entities were reported to have the most power in the implementation process. Findings suggested close links between the precautionary principle and sustainability, as concern for future generations was the most critical element of the principle for tourism. Overall, tourism academics were more supportive of the precautionary principle in tourism than were regional government tourism officials. Only minor variation was found in responses among regional groups across all variables. This study established basic ground for understanding the precautionary principle in tourism and has been effective in formulating more precise questions for future research.

Self-directed learning, stress and the adult learner /

The purpose of this correlational study was to investigate the relationship between the degree of self-directed learning readiness and stress for level one nursing students and level two nursing students. One hundred female nursing students participated in the study who were attending an Ontario Community College. Data were collected from the main nursing campus and the satellite nursing campus using the random sample method. Instruments used were said to be valid and reliable for testing self-directed learning readiness and stress respectively. Data were analyzed using frequency response to each item, means and standard deviation, and the Pearson product correlation between selfdirected learning readiness and stress. The results of the study show that there is a difference in the relationship between the degree of self-directed learning readiness and stress between the level one nursing students and the level two nursing students. Such results will be of particular interest to nursing instructors and administrators when planning for delivery of programs to such students.

Investigations into the extraction and the determination of polycyclic aromatic hydrocarbons (PAHs) from water by solid-phase extraction and capillary gas chromatography/ mass spectrometry

Factors affecting the detennination of PAHs by capillary GC/MS were studied. The effect of the initial column temperature and the injection solvent on the peak areas and heights of sixteen PAHs, considered as priority pollutants, USillg crosslinked methyl silicone (DB!) and 5% diphenyl, 94% dimethyl, 1% vinyl polysiloxane (DBS) columns was examined. The possibility of using high boiling point alcohols especially butanol, pentanol, cyclopentanol, and hexanol as injection solvents was investigated. Studies were carried out to optimize the initial column temperature for each of the alcohols. It was found that the optimum initial column temperature is dependent on the solvent employed. The peak areas and heights of the PAHs are enhanced when the initial column temperature is 10-20 c above the boiling point of the solvent using DB5 column, and the same or 10 C above the boiling point of the solvent using DB1 column. Comparing the peak signals of the PAHs using the alcohols, p-xylene, n-octane, and nonane as injection solvents, hexanol gave the greatest peak areas and heights of the PAHs particularly the late-eluted peaks. The detection limits were at low pg levels, ranging from 6.0 pg for fluorene t9 83.6 pg for benzo(a)pyrene. The effect of the initial column temperature on the peak shape and the separation efficiency of the PARs was also studied using DB1 and DB5 columns. Fronting or splitting of the peaks was obseIVed at very low initial column temperature. When high initial column temperature was used, tailing of the peaks appeared. Great difference between DB! and.DB5 columns in the range of the initial column temperature in which symmetrical.peaks of PAHs can be obtained is observed. Wider ranges were shown using DB5 column. Resolution of the closely-eluted PAHs was also affected by the initial column temperature depending on the stationary phase employed. In the case of DB5, only the earlyeluted PAHs were affected; whereas, with DB1, all PAHs were affected. An analytical procedure utilizing solid phase extraction with bonded phase silica (C8) cartridges combined with GC/MS was developed to analyze PAHs in water as an alternative method to those based on the extraction with organic solvent. This simple procedure involved passing a 50 ml of spiked water sample through C8 bonded phase silica cartridges at 10 ml/min, dried by passing a gentle flow of nitrogen at 20 ml/min for 30 sec, and eluting the trapped PAHs with 500 Jll of p-xylene at 0.3 ml/min. The recoveries of PAHs were greater than 80%, with less than 10% relative standard deviations of nine determinations. No major contaminants were present that could interfere with the recognition of PAHs. It was also found that these bonded phase silica cartridges can be re-used for the extraction of PAHs from water.

On the path integral formulation and the evaluation of quantum statistical averages

Four problems of physical interest have been solved in this thesis using the path integral formalism. Using the trigonometric expansion method of Burton and de Borde (1955), we found the kernel for two interacting one dimensional oscillators• The result is the same as one would obtain using a normal coordinate transformation, We next introduced the method of Papadopolous (1969), which is a systematic perturbation type method specifically geared to finding the partition function Z, or equivalently, the Helmholtz free energy F, of a system of interacting oscillators. We applied this method to the next three problems considered• First, by summing the perturbation expansion, we found F for a system of N interacting Einstein oscillators^ The result obtained is the same as the usual result obtained by Shukla and Muller (1972) • Next, we found F to 0(Xi)f where A is the usual Tan Hove ordering parameter* The results obtained are the same as those of Shukla and Oowley (1971), who have used a diagrammatic procedure, and did the necessary sums in Fourier space* We performed the work in temperature space• Finally, slightly modifying the method of Papadopolous, we found the finite temperature expressions for the Debyecaller factor in Bravais lattices, to 0(AZ) and u(/K/ j,where K is the scattering vector* The high temperature limit of the expressions obtained here, are in complete agreement with the classical results of Maradudin and Flinn (1963) .

The electronic spectra and the determination of the excited state geometry of 3A" propynal /|nby Chhiu-Tsu Lin. -- 260 St. Catharines, Ont. : [s. n.],

Impurity free eluission spectra of HCCCHO and DCCCHO have been rephotographed using the electronic-energy-exchange method with benzene as a carrier gas. The near ultraviolet spectra of ReeCHO and DCCCHO were photographed in a sorption under conditions of high resolution with absorption path lengths up to 100 meters. The emission and absorption spectra of Propynal resulting from 3 n 1 t 1\ - A excitation has been reanalyzed in som.e detail. Botrl of the eH out-of-plane wagging modes were found to have negative anharmonicity. A barrier height of 56.8/0.0 cm- 1 and a nonplanar oft , , equilibrium angle of 17 3 /30 are calculated for the V 10/ lJ 11 modes. The in-plane and out-of-plane v1. brational modes in the 3A." and 1a~. ' elec ronic states of Propynal were subjected to a normal coordinate treatment in the approximat :on of tIle Urey-Bradley force field. From the relative oscillator strengths of the trans1·t1·0ns connect i ng t he v ibrat1•0n1ess lA' , state and t,he V1· bron1·C 3· if levels of the A state, the differences in equilibrium configuration were evaluated from an approximate Franck-Condon analysis based on the ground state normal coordinates. As this treatment gave 512 possible geometrical structures for the upper state, it 4 was necessary to resort to a comparison of the observed and calculated moments of inertia along with chemical intuition to isolate the structure. A test of the correctness of the calculated structure change and the vibrational assignment was raade by evaluating the intensities of the inplane and out-oi-plane fundarnental, sequence, and cross sequellce transitions y the exact Franck-Condon method.

From absolutes to aesthetics : John Dewey and the art of experience /

In this thesis I sought to capture something of the integrity of John Dewey's larger vision. While recognizing this to be a difficult challenge, I needed to clear some of the debris of an overly narrow reading of Dewey's works by students of education. The tendency of reducing Dewey's larger philosophical vision down to neat theoretical snap shots in order to prop up their particular social scientific research, was in my estimation slowly damaging the larger integrity of Dewey's vast body of work. It was, in short, killing off the desire to read big works, because doing so was not necessary to satisfying the specialized interests of social scientific research. In this thesis then I made a plea for returning the Humanities to the center of higher education. It is there that students learn how to read and to think—skills required to take on someone of Dewey's stature. I set out in this thesis to do just that. I took Dewey's notion of experience as the main thread connecting all of his philosophy, and focused on two large areas of inquiry, science and its relation to philosophy, and aesthetic experience. By exploring in depth Dewey's understanding of human experience as it pertains to day-to-day living, my call was for a heightened mode of artful conduct within our living contexts. By calling on the necessity of appreciating the more qualitative dimensions of lived experience, I was hoping that students engaged in the Social Sciences might begin to bolster their research interests with more breadth and depth of reading and critical insight. I expressed this as being important to the survival and intelligent flourishing of democratic conduct.

Gas chromatographic electron capture negative ionization mass spectrometric (GC/ECNI/MS) determination of unique fluorinated compounds in the sediments of Lake Ontario and the effect of high-boiling alcohols (as injection solvents) on chromatographic behaviour of polycyclic aromatic hydrocarbons in gas chromatography

Part I - Fluorinated Compounds A method has been developed for the extraction, concentration, and determination of two unique fluorinated compounds from the sediments of Lake Ontario. These compounds originated from a common industrial landfill, and have been carried to Lake Ontario by the Niagara River. Sediment samples from the Mississauga basin of Lake Ontario have been evaluated for these compounds and a depositional trend was established. The sediments were extracted by accelerated solvent extraction (ASE) and then underwent clean-up, fractionation, solvent exchange, and were concentrated by reduction under nitrogen gas. The concentrated extracts were analyzed by gas chromatography - electron capture negative ionization - mass spectrometry. The depositional profile determined here is reflective of the operation of the landfill and shows that these compounds are still found at concentrations well above background levels. These increased levels have been attributed to physical disturbances of previously deposited contaminated sediments, and probable continued leaching from the dumpsite. Part II - Polycyclic Aromatic Hydrocarbons Gas chromatography/mass spectrometry is the most common method for the determination of polycyclic aromatic hydrocarbons (PAHs) from various matrices. Mass discrimination of high-boiling compounds in gas chromatographic methods is well known. The use of high-boiling injection solvents shows substantial increase in the response of late-eluting peaks. These solvents have an increased efficiently in the transfer of solutes from the injector to the analytical column. The effect of I-butanol, I-pentanol, cyclopentanol, I-hexanol, toluene and n-octane, as injection solvents, was studied. Higher-boiling solvents yield increased response for all PAHs. I -Hexanol is the best solvent, in terms of P AH response, but in this solvent P AHs were more susceptible to chromatographic problems such as peak splitting and tailing. Toluene was found to be the most forgiving solvent in terms of peak symmetry and response. It offered the smallest discrepancies in response, and symmetry over a wide range of initial column temperatures.

Hyperosmotic Stress and the Impact on Metabolite Formation and Redox Balance in Saccharomyces cerevisiae and Saccharomyces bayanus strains

Wine produced using an appassimento-type process represents a new and exciting innovation for the Ontario wine industry. This process involves drying grapes that have already been picked from the vine, which increases the sugar content due to dehydration and induces a variety of changes both within and on the surface of the grapes. Increasing sugar contents in musts subject wine yeast to conditions of high osmolarity during alcoholic fermentations. Under these conditions, yeast growth can be inhibited, target alcohol levels may not be attained and metabolic by-products of the hyperosmotic stress response, including glycerol and acetic acid, may impact wine composition. The further metabolism of acetic acid to acetylCoA by yeast facilitates the synthesis of ethyl acetate, a volatile compound that can also impact wine quality if present in sufficiently high concentrations. The first objective of this project was to understand the effect of yeast strain and sugar concentration on fermentation kinetics and metabolite formation, notably acetic acid and ethyl acetate, during fermentation in appassimento-type must. Our working hypotheses were that (1) the natural isolate Saccharomyces bayanus would produce less acetic acid and ethyl acetate compared to Saccharomyces cerevisiae strain EC-1118 fermenting the high and low sugar juices; (2) the wine produced using the appassimento process would contain higher levels of acetic acid and lower levels of ethyl acetate compared to table wine; (3) and the strains would be similar in the kinetic behavior of their fermentation performances in the high sugar must. This study determined that the S. bayanus strain produced significantly less acetic acid and ethyl acetate in the appassimento wine and table wine fermentations. Differences in acetic acid and ethyl acetate production were also observed within strains fermenting the two sugar conditions. Acetic acid production was higher in table wine fermented by S. bayanus as no acetic acid was produced in appassimento-style wine, and 1.4-times higher in appassimento wine fermented by EC-1118 over that found in table wine. Ethyl acetate production was 27.6-times higher in table wine fermented by S. bayanus, and 5.2-times higher by EC-1118, compared to that in appassimento wine. Sugar utilization and ethanol production were comparable between strains as no significant differences were determined. The second objective of this project was to bring a method in-house for measuring the concentration of pyridine nucleotides, NAD+, NADP+, NADH and NADPH, in yeast cytosolic extract. Development of this method is of applicative interest for our lab group as it will enable the redox balance of the NAD+/ NADH and NADP+/ NADPH systems to be assessed during high sugar fermentations to determine their respective roles as metabolic triggers for acetic acid production. Two methods were evaluated in this study including a UV-endpoint method using a set of enzymatic assay protocols outlined in Bergmeyer (1974) and a colorimetric enzyme cycling method developed by Sigma-Aldrich® using commercial kits. The former was determined to be limited by its low sensitivity following application to yeast extract and subsequent coenzyme analyses, while the latter was shown to exhibit greater sensitivity. The results obtained from the kits indicated high linearity, accuracy and precision of the analytical method for measuring NADH and NADPH, and that it was sensitive enough to measure the low coenzyme concentrations present in yeast extract samples. NADtotal and NADPtotal concentrations were determined to be above the lower limit of quantification and within the range of the respective calibration curves, making this method suitable for our research purposes.

Estimating Nonlinear DSGE Models by the Simulated Method of Moments

This paper studies the application of the simulated method of moments (SMM) for the estimation of nonlinear dynamic stochastic general equilibrium (DSGE) models. Monte Carlo analysis is employed to examine the small-sample properties of SMM in specifications with different curvature. Results show that SMM is computationally efficient and delivers accurate estimates, even when the simulated series are relatively short. However, asymptotic standard errors tend to overstate the actual variability of the estimates and, consequently, statistical inference is conservative. A simple strategy to incorporate priors in a method of moments context is proposed. An empirical application to the macroeconomic effects of rare events indicates that negatively skewed productivity shocks induce agents to accumulate additional capital and can endogenously generate asymmetric business cycles.

Order and the literary rendering of chaos : children's literature as knowledge, order, and social foundation

Depuis que l'animal humain a conçu un système de technologies pour la pensée abstraite grâce au langage, la guerre contre le monde sauvage est devenu une voie à sens unique vers l'aliénation, la civilisation et la littérature. Le but de ce travail est d'analyser comment les récits civilisationnels donnent une structure à l'expérience par le biais de la ségrégation, de la domestication, de la sélection, et de l'extermination, tandis que les récits sauvages démontrent les possibilités infinies du chaos pour découvrir le monde en toute sa diversité et en lien avec sa communauté de vie. Un des objectifs de cette thèse a été de combler le fossé entre la science et la littérature, et d'examiner l'interdépendance de la fiction et la réalité. Un autre objectif a été de mettre ces récits au cœur d'un dialogue les uns avec les autres, ainsi que de tracer leur expression dans les différentes disciplines et œuvres pour enfants et adultes mais également d’analyser leur manifestations c’est redondant dans la vie réelle. C'est un effort multi-disciplinaires qui se reflète dans la combinaison de méthodes de recherche en anthropologie et en études littéraires. Cette analyse compare et contraste trois livres de fiction pour enfants qui présentent trois différents paradigmes socio-économiques, à savoir, «Winnie-l'Ourson» de Milne qui met en place un monde civilisé monarcho-capitaliste, la trilogie de Nosov sur «les aventures de Neznaika et ses amis» qui présente les défis et les exploits d'une société anarcho-socialiste dans son évolution du primitivisme vers la technologie, et les livres de Moomines de Jansson, qui représentent le chaos, l'anarchie, et l'état sauvage qui contient tout, y compris des épisodes de civilisation. En axant la méthodologie de ma recherche sur la façon dont nous connaissons le monde, j'ai d'abord examiné la construction, la transmission et l'acquisition des connaissances, en particulier à travers la théorie de praxis de Bourdieu et la critique de la civilisation développée dans les études de Zerzan, Ong, et Goody sur les liens entre l'alphabétisation, la dette et l'oppression. Quant à la littérature pour enfants, j'ai choisi trois livres que j’ai connus pendant mon enfance, c'est-à-dire des livres qui sont devenus comme une «langue maternelle» pour moi. En ce sens, ce travail est aussi de «l’anthropologie du champ natif». En outre, j’analyse les prémisses sous-jacentes qui se trouvent non seulement dans les trois livres, mais dans le déroulement des récits de l'état sauvage et de la civilisation dans la vie réelle, des analyses qui paraissent dans cette thèse sous la forme d'extraits d’un journal ethnographique. De même que j’examine la nature de la littérature ainsi que des structures civilisées qui domestiquent le monde au moyen de menaces de mort, je trace aussi la présence de ces récits dans l'expression scientifique (le récit malthusien-darwinien), religieuse, et dans autres expressions culturelles, et réfléchis sur les défis présentés par la théorie anarchiste (Kropotkine) ainsi que par les livres pour enfants écrits du point de vue sauvage, tels que ceux des Moomines.

Virginia Woolf and the poetics of trauma narrative

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

The dialogic and the carnivalesque in Beloved and Jazz by Toni Morrison

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal