Two knees or not two knees? Patient costs and outcomes following bilateral and unilateral total knee joint replacement surgery for OA

Aims: This study aims to address medical and non-medical direct costs and health outcomes of bilateral and unilateral total knee replacement from the patients' perspective during the first year post-surgery. Methods: Osteoarthritis patients undergoing primary unilateral total knee or bilateral total knee replacement (TKR) surgery at three Sydney hospitals were eligible. Patients completed questionnaires pre-operatively to record expenses during the previous three months and health status immediately prior to surgery. Patients then maintained detailed prospective cost diaries and completed SF-36 and WOMAC Index each three months for the first post-operative year. Results: Pre-operatively, no significant differences in health status were found between patients undergoing unilateral TKR and bilateral TKR. Both unilateral and bilateral TKR patients showed improvements in pain, stiffness and function from pre-surgery to 12 months post-surgery. Patients who had bilateral TKR spent an average of 12.3 days in acute hospital and patients who had unilateral TKR 13.6 days. Totally uncemented prostheses were used in 6% of unilateral replacements and 48% of bilateral replacements. In hospital, patients who had bilateral TKR experienced significantly more complications, mainly thromboembolic, than patients who had unilateral TKR. Regression analysis showed that for every one point increase in the pre-operative SF-36 physical score (i.e. improving physical status) out-of-pocket costs decreased by 94%. Out-of-pocket costs for female patients were 3.3 times greater than for males. Conclusion: Patients undergoing bilateral TKR and unilateral TKR had a similar length of stay in hospital and similar out-of-pocket expenditures. Bilateral replacement patients reported better physical function and general health with fewer health care visits one year post procedure. Patients requiring bilateral TKR have some additional information to aid their decision making. While their risk of peri-operative complications is higher, they have an excellent chance of good health outcomes at 12 months and are not going to be doubly 'out-of-pocket' for the experience. (C) 2004 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Proteomic analysis of k-casein micro-heterogeneity

The proteome of bovine milk is dominated by just six gene products that constitute approximately 95% of milk protein. Nonetheless, over 150 protein spots can be readily detected following two-dimensional electrophoresis of whole milk. Many of these represent isoforms of the major gene products produced through extensive posttranslational modification. Peptide mass fingerprinting of in-gel tryptic digests (using matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) in reflectron mode with alpha-cyano-4-hydroxycinnamic acid as the matrix) identified 10 forms of K-casein with isoelectric point (pl) values from 4.47 to 5.81, but could not distinguish between them. MALDI-TOF MS in linear mode, using sinapinic acid as the matrix, revealed a large tryptic peptide (mass > 5990 Da) derived from the C-terminus that contained all the known sites of genetic variance, phosphorylation and glycosylation. Two genetic variants present as singly or doubly phosphorylated forms could be distinguished using mass data alone. Glycoforms containing a single acidic tetrasaccharide were also identified. The differences in electrophoretic mobility of these isoforms were consistent with the addition of the acidic groups. While more extensively glycosylated forms were also observed, substantial loss of N-acetylneuraminic acid from the glycosyl group was evident in the MALDI spectra such that ions corresponding to the intact glycopeptide were not observed and assignment of the glycoforms was not possible. However, by analysing the pl shifts observed on the two-dimensional gels in conjunction with the MS data, the number of N-acetylneuraminic acid residues, and hence the glycoforms present, could be determined.

A geometric approach to quantum circuit lower bounds

What is the minimal size quantum circuit required to exactly implement a specified n-qubit unitary operation, U, without the use of ancilla qubits? We show that a lower bound on the minimal size is provided by the length of the minimal geodesic between U and the identity, I, where length is defined by a suitable Finsler metric on the manifold SU(2(n)). The geodesic curves on these manifolds have the striking property that once an initial position and velocity are set, the remainder of the geodesic is completely determined by a second order differential equation known as the geodesic equation. This is in contrast with the usual case in circuit design, either classical or quantum, where being given part of an optimal circuit does not obviously assist in the design of the rest of the circuit. Geodesic analysis thus offers a potentially powerful approach to the problem of proving quantum circuit lower bounds. In this paper we construct several Finsler metrics whose minimal length geodesics provide lower bounds on quantum circuit size. For each Finsler metric we give a procedure to compute the corresponding geodesic equation. We also construct a large class of solutions to the geodesic equation, which we call Pauli geodesics, since they arise from isometries generated by the Pauli group. For any unitary U diagonal in the computational basis, we show that: (a) provided the minimal length geodesic is unique, it must be a Pauli geodesic; (b) finding the length of the minimal Pauli geodesic passing from I to U is equivalent to solving an exponential size instance of the closest vector in a lattice problem (CVP); and (c) all but a doubly exponentially small fraction of such unitaries have minimal Pauli geodesics of exponential length.

Interactions within heterogeneous systems of uncontrolled rectifiers for aircraft electrical power systems

There is an increase in the use of multi-pulse, rectifier-fed motor-drive equipment on board more-electric aircraft. Motor drives with feedback control appear as constant power loads to the rectifiers, which can cause instability of the DC filter capacitor voltage at the output of the rectifier. This problem can be exacerbated by interactions between rectifiers that share a common source impedance. In order that such a system can be analysed, there is a need for average, dynamic models of systems of rectifiers. In this study, an efficient, compact method for deriving the approximate, linear, large-signal, average models of two heterogeneous systems of rectifiers, which are fed from a common source impedance, is presented. The models give insight into significant interaction effects that occur between the converters, and that arise through the shared source impedance. First, a 6-pulse and doubly wound, transformer-fed, 12-pulse rectifier system is considered, followed by a 6-pulse and autotransformer-fed, 12-pulse rectifier system. The system models are validated against detailed simulations and laboratory prototypes, and key characteristics of the two system types are compared.

Role of power jitter induced by interchannel interactions in dispersion-managed lines

Collision induced power jitter is examined in dispersion-managed wavelength division-multiplexed transmission systems. The power jitter causes ’ a serious problem for a singly-periodic dispersion managed line having almost zero average dispersion, which can be reduced by applying doubly-periodic dispersion management.

Analysis of power jitter induced by interchannel interactions in dispersion-managed optical soliton transmission systems

Collision-induced power jitter is theoretically and numerically examined in dispersion-managed wavelength-division-multiplexed optical soliton transmission systems. The variational method is mainly used to develop a time efficient jitter calculation approach. The power jitter causes a serious problem for a singly periodic dispersion managed line having almost zero average dispersion, which can be reduced by applying doubly periodic dispersion management.

A theoretical and experimental analysis of the no-load air gap magnetic field in squirrel cage induction machines

In induction machines the tooth frequency losses due to permeance variation constitute a signif'icant, portion of the total loss. In order to predict and estimate these losses it, is essential to obtain a clear understanding of the no-load distribution of the air gap magnetic field and the magnitude of flux pulsation in both stator and rotor teeth. The existing theories and methods by which the air gap permeance variation in a doubly slotted structure is calculated are either empirical or restricted. The main objective of this thesis is to obtain a detailed analysis of the no-load air gap magnetic field distribution and the effect of air gap geometry on the magnitude and waveform of the tooth flux pulsation. In this thesis a detaiiled theoretical and experimental analysis of flux distribution not only leads to a better understanding of the distribution of no-load losses but also provides theoretical analysis for calculating the losses with greater accuracy

Study of neutral Fe(III) complexes of pyridoxal-N-substituted thiosemicarbazone with desolvation induced spin-state transformation above room temperature

The preparation and characterization of two new neutral ferric complexes with desolvation-induced discontinuous spin-state transformation above room temperature are reported. The compounds, Fe(Hthpy)(thpy).CH3OH.3H2O (1) and Fe(Hmthpy)(mthpy).2H2O (2), are low-spin (LS) at room temperature and below, whereas their nonsolvated forms are high-spin (HS), exhibiting zero-field splitting. In these complexes, Hthpy, Hmthpy, and thpy, mthpy are the deprotonated forms of pyridoxal thiosemicarbazone and pyridoxal methylthiosemicarbazone, respectively; each is an O,N,S-tridentate ligand. The molecular structures have been determined at 100(1) K using single-crystal X-ray diffraction techniques and resulted in a triclinic system (space group P1) and monoclinic unit cell (space group P21/c) for 1 and 2, respectively. Structures were refined to the final error indices, where RF = 0.0560 for 1 and RF = 0.0522 for 2. The chemical inequivalence of the ligands was clearly established, for the "extra" hydrogen atom on the monodeprotonated ligands (Hthpy, Hmthpy) was found to be bound to the nitrogen of the pyridine ring. The ligands are all of the thiol form; the doubly deprotonated chelates (thpy, mthpy) have C-S bond lengths slightly longer than those of the singly deprotonated forms. There is a three-dimensional network of hydrogen bonds in both compounds. The discontinuous spin-state transformation is accompanied with liberation of solvate molecules. This is evidenced also from DSC analysis. Heat capacity data for the LS and HS phases are tabulated at selected temperatures, the values of the enthalpy and entropy changes connected with the change of spin state were reckoned at DeltaH = 12.5 0.3 kJ mol-1 and DeltaS = 33.3 0.8 J mol-1 K-1, respectively, for 1 and DeltaH = 6.5 0.3 kJ mol-1 and DeltaS = 17.6 0.8 J mol-1 K-1, respectively, for 2

Tuning of the charge in octahedral ferric complexes based on pyridoxal-N substituted thiosemicarbazone ligands

Four novel mononuclear coordination compounds namely: [Fe(Hthpy)2](SO4)1/2·3.5H2O 1, [Fe(Hthpy)2]NO3·3H2O 2, [Fe(H2mthpy)2](CH3C6H4SO3)3·CH3CH2OH 3 and [Fe(Hethpy)(ethpy)]·8H2O 4, (H2thpy = pyridoxalthiosemicarbazone, H2mthpy = pyridoxal-4-methylthiosemicarbazone, H2ethpy = pyridoxal-4-ethylthiosemicarbazone), were synthesized in the absence or presence of organic base, Et3N and NH3. Compounds 1 and 2 are monocationic, and were prepared using the singly deprotonated form of pyridoxalthiosemicarbazone. Both compounds crystallise in the monoclinic system, C2/c and P21/c space group for 1 and 2, respectively. Complex 3 is tricationic, it is formed with neutral bis(ligand) complex and possesses an interesting 3D channel architecture, the unit cell is triclinic, P1 space group. For complex 4, the pH value plays an important role during its synthesis; 4 is neutral and crystallises with two inequivalent forms of the ligand: the singly and the doubly deprotonated chelate of H2ethpy, the unit cell is monoclinic, C2/c space group. Notably, in 1 and 4, there is an attractive infinite three dimensional hydrogen bonding network in the crystal lattice. Magnetic measurements of 1 and 4 revealed that a rather steep spin transition from the low spin to high spin Fe(III) states occurs above 300 K in the first heating step. This transition is accompanied by the elimination of solvate molecules and thus, stabilizes the high spin form due to the breaking of hydrogen bonding networks; compared to 2 and 3, which keep their low spin state up to 400 K.

Employing DDBPSK in optical burst switched systems to enhance throughput

We demonstrate that doubly differential decoding can demodulate phase shift keyed data much faster after the switching event of a tunable laser than usual mth power single differential decoding. This technique can significantly improve throughput of optical burst switched networks.

Avandamet:Combined metformin-rosiglitazone treatment for insulin resistance in type 2 diabetes

Insulin resistance is a major endocrinopathy underlying the development of hyperglycaemia and cardiovascular disease in type 2 diabetes. Metformin (a biguanide) and rosiglitazone (a thiazolidinedione) counter insulin resistance, acting by different cellular mechanisms. The two agents can be used in combination to achieve additive glucose-lowering efficacy in the treatment of type 2 diabetes, without stimulating insulin secretion and without causing hypoglycaemia. Both agents also reduce a range of atherothrombotic factors and markers, indicating a lower cardiovascular risk. Early intervention with metformin is already known to reduce myocardial infarction and increase survival in overweight type 2 patients. Recently, a single-tablet combination of metformin and rosiglitazone, Avandamet, has become available. Avandamet is suitable for type 2-diabetic patients who are inadequately controlled by monotherapy with metformin or rosiglitazone. Patients already receiving separate tablets of metformin and rosiglitazone may switch to the single-tablet combination for convenience. Also, early introduction of the combination before maximal titration of one agent can reduce side effects. Use of Avandamet requires attention to the precautions for both metformin and rosiglitazone, especially renal, cardiac and hepatic competence. In summary, Avandamet is a single-tablet metformin-rosiglitazone combination that doubly targets insulin resistance as therapy for hyperglycaemia and vascular risk in type 2 diabetes. © 2004 Blackwell Publishing Ltd.

Parallel Class Intersection Matrices of Orthogonal Resolutions

This work was partially supported by the Bulgarian National Science Fund under Contract No MM 1405. Part of the results were announced at the Fifth International Workshop on Optimal Codes and Related Topics (OCRT), White Lagoon, June 2007, Bulgaria

The Doitchinov Completion of a Regular Paratopological Group

In memory of Professor D. Doitchinov ∗ This paper was written while the first author was supported by the Swiss National Science Foundation under grants 21–30585.91 and 2000-041745.94/1 and by the Spanish Ministry of Education and Sciences under DGES grant SAB94-0120. The second author was supported under DGES grant PB95-0737. During her stay at the University of Berne the third author was supported by the first author’s grant 2000-041745.94/1 from the Swiss National Science Foundation.

Investment liberalisation, technology take-off and export markets entry:does foreign ownership structure matter?

Before and after its accession to the WTO in 2001, China has undergone a far-reaching investment liberalisation. As part of this, existing restrictions on foreign ownership structure and mandatory export and technology transfer requirements imposed on foreign firms have been lifted in a number of industries. Against this background we identify the causal effects of foreign acquisitions on export market entry and technology take-off and evaluate whether the level of foreign ownership plays a role in stimulating these changes. Using doubly robust propensity score reweighted bivariate probit regressions to control for the selection bias associated with firm level foreign acquisition incidences, we uncover strong but heterogeneous positive effects on export activity for all types of foreign ownership structure. We also find that minority foreign owned acquisition targets experience higher likelihood of R&D, providing evidence that joint ventures can contribute positively to China's "science and technology take-off".

On Nilpotent Subsemigroups in some Matrix Semigroups

2000 Mathematics Subject Classification: 20M20, 20M10.