Is there a need for routine follow-up after primary total hip arthroplasty?

Background: The objective of routine outpatient assessment of well functioning patients after primary total hip arthroplasty (THA) is to detect asymptomatic failure of prostheses to guide recommendations for early intervention. We have observed that the revision of THAs in asymptomatic patients is highly uncommon. We therefore question the need for routine follow-up of patients after THA. Methods: A prospective analysis of an orthopaedic database identified 158 patients who received 177 revision THAs over a 4 year period. A retrospective chart review was conducted. Patient demographics, primary and revision surgery parameters and follow-up information was recorded and cross referenced with AOA NJRR data. Results: 110 THAs in 104 patients (average age 70.4 (SD 9.8 years). There were 70 (63.6%) total, 13 (11.8%) femoral and 27 (24.5%) acetabular revisions. The indications for revision were aseptic loosening (70%), dislocation (8.2%), peri-prosthetic fracture (7.3%), osteolysis (6.4%) and infection (4.5%). Only 4 (3.6%) were asymptomatic revisions. A mean of 5.3 (SD 5.2 and 1.9 (SD 5.3 follow-up appointments were required before revision in patients with and without symptoms, respectively. The average time from the primary to revision surgery was 11.8 (SD 7.23) years. Conclusions: We conclude that patients with prostheses with excellent long term clinical results as validated by Joint Registries, routine follow-up of asymptomatic THA should be questioned and requires further investigation. Based on the work of this study, the current practice of routine follow-up of asymptomatic THA may be excessively costly and unnecessary and a less resource-intensive review method may be more appropriate.

Perioperative mortality after hemiarthroplasty related to fixation method : a study based on the Australian Orthopaedic Association National Joint Replacement Registry

Background and purpose: The appropriate fixation method for hemiarthroplasty of the hip as it relates to implant survivorship and patient mortality is a matter of ongoing debate. We examined the influence of fixation method on revision rate and mortality.----- ----- Methods: We analyzed approximately 25,000 hemiarthroplasty cases from the AOA National Joint Replacement Registry. Deaths at 1 day, 1 week, 1 month, and 1 year were compared for all patients and among subgroups based on implant type.----- ----- Results: Patients treated with cemented monoblock hemiarthroplasty had a 1.7-times higher day-1 mortality compared to uncemented monoblock components (p < 0.001). This finding was reversed by 1 week, 1 month, and 1 year after surgery (p < 0.001). Modular hemiarthroplasties did not reveal a difference in mortality between fixation methods at any time point.----- ----- Interpretation: This study shows lower (or similar) overall mortality with cemented hemiarthroplasty of the hip.

Post-operative CT assessment of interbody fusion two years after thoracoscopic scoliosis surgery

The relationship between radiologic union and clinical outcome in thoracoscopic scoliosis surgery is not clear, as apparent non-union of a spinal fusion does not always correspond to a poor clinical result. The aim of this study was to evaluate CT fusion rates 2yrs after thoracoscopic surgery, and to explore the relationship between fusion scores and rod diameter, graft type, fusion level, implant failure, and lateral position in the disc space. This study suggests that moderate fusion scores secure successful clinical outcomes in thoracoscopic scoliosis surgery.

A neural-network based flight controller for UASs

This paper presents a nonlinear gust-attenuation controller based on constrained neural-network (NN) theory. The controller aims to achieve sufficient stability and handling quality for a fixed-wing unmanned aerial system (UAS) in a gusty environment when control inputs are subjected to constraints. Constraints in inputs emulate situations where aircraft actuators fail requiring the aircraft to be operated with fail-safe capability. The proposed controller enables gust-attenuation property and stabilizes the aircraft dynamics in a gusty environment. The proposed flight controller is obtained by solving the Hamilton-Jacobi-Isaacs (HJI) equations based on an policy iteration (PI) approach. Performance of the controller is evaluated using a high-fidelity six degree-of-freedom Shadow UAS model. Simulations show that our controller demonstrates great performance improvement in a gusty environment, especially in angle-of-attack (AOA), pitch and pitch rate. Comparative studies are conducted with the proportional-integral-derivative (PID) controllers, justifying the efficiency of our controller and verifying its suitability for integration into the design of flight control systems for forced landing of UASs.

Osseointegration for limb loss: Can Australia play a key role?

Individuals with limb amputation fitted with conventional socket-suspended prostheses often experience socket related discomfort leading to a significant decrease in quality of life. Most of these concerns can be overcome by surgical techniques enabling bone-anchored prostheses. In this case, the prosthesis is attached directly to the residual skeleton through a percutaneous implant. The aim of this study is to present the current advances in these surgical techniques worldwide with a strong focus on the developments in Australia and Queensland.

Evaluation framework to assess orthopaedic procedures

Introduction & aims The demand for evidence of efficacy of treatments in general and orthopaedic surgical procedures in particular is ever increasing in Australia and worldwide. The aim of this study is to share the key elements of an evaluation framework recently implemented in Australia to determine the efficacy of bone-anchored prostheses. Method The proposed evaluation framework to determine the benefit and harms of bone-anchored prostheses for individuals with limb loss was extracted from a systematic review of the literature including seminal studies focusing on clinical benefits and safety of procedures involving screw-type implant (e.g., OPRA) and press-fit fixations (e.g., EEFT, ILP, OPL). [1-64] Results The literature review highlighted that a standard and replicable evaluation framework should focus on: • The clinical benefits with a systematic recording of health-related quality of life (e.g., SF-26, Q-TFA), mobility predictor (e.g., AMPRO), ambulation abilities (e.g., TUG, 6MWT), walking abilities (e.g., characteristic spatio-temporal) and actual activity level at baseline and follow-up post Stage 2 surgery, • The potential harms with systematic recording of residuum care, infection, implant stability, implant integrity, injuries (e.g., falls) after Stage 1 surgery. There was a general consensus around the instruments to monitor most of the benefits and harms. The benefits could be assessed using a wide spectrum of complementary assessments ranging from subjective patient self-reporting to objective measurements of physical activity. However, this latter was assessed using a broad range of measurements (e.g., pedometer, load cell, energy consumption). More importantly, the lack of consistent grading of infections was sufficiently noticeable to impede cross-fixation comparisons. Clearly, a more universal grading system is needed. Conclusions Investigators are encouraged to implement an evaluation framework featuring the domains and instruments proposed above using a single database to facilitate robust prospective studies about potential benefits and harms of their procedure. This work is also a milestone in the development of national and international clinical outcome registries.

Comportamiento prooxidante y antioxidante de hierbas aromáticas en queso

Los quesos de cabra, con mejores cualidades funcionales provienen de leche de cabras en pastoreo, esto obedece al mayor contenido de ácidos grasos ω-3 y ω-6 en una relación óptima para la salud, sumado a un menor contenido de grasa y colesterol. Saborizar quesos con especias, otorga beneficios sensoriales y saludables al producto. Las especias son usadas para realzar el flavor de los alimentos además presentan beneficios antioxidantes. Sin embargo, se reportaron evidencias del doble papel de los flavonoides como antioxidantes o prooxidantes en función de la concentración de uso. El objetivo del trabajo es evaluar el efecto de distintas concentraciones de especias aromáticas con capacidad antioxidante, frente a las reacciones de deterioro que ocurren en el almacenamiento de quesos de cabra. Se estudió la actividad antirradicalaria (AAR) de 18 especias. Para evaluar la actividad antioxidante (AA0) se usó la técnica de desaparición de un radical libre estable el 2,2-difenil-1-picril hidrazilo (DPPH) y se calculó la AAR porcentual. Definido el queso base estándar (control), se ensayaron tres variedades con especies, elegidas de entre las de mayor AAR (orégano, romero y tomillo) y se adicionaron con las concentraciones 0,4 – 1 % p/p. Estos, fueron madurados 30 días y almacenados 7 meses a 4 °C. Se analizaron cada 4 semanas. Se realizaron pruebas sensoriales de aceptabilidad con 60 consumidores de queso (condición), usando planillas, con escala hedónica. Se trabajó sobre los lípidos extraídos de los quesos. El rancidez y deterioro fueron evaluados con análisis de acidez; índice peróxido y sustancias reactivas al ácido TBA. Los resultados se compararon con el comportamiento sensorial del producto en el tiempo de almacenamiento. En los quesos adicionados al 1 %, la acidez se incrementó con el almacenamiento. El máximo valor corresponde al queso con orégano (3,72 % de ac. láctico a los 126 días). En el control, la acidez inicial fue inferior y alcanzó 1,05 g de ác. láctico % a los 166 días. El IP más alto corresponde a los quesos con orégano al 1% , resultado que se contrapone a la actividad antirradicalaria de esta especia. Al 0,4 %, tanto el IP como el número de TBA son menores en quesos adicionados, respecto del control. En los quesos de cabra analizados las especias agregadas al 1% ejercieron acción prooxidante, mientras que al ser agregadas al 0,4% la acción es antioxidante, lo que indica la importancia de la selección de concentraciones adecuadas.

小麦春化相关基因元件克隆分析与小麦矮化突变体的研究

一、 春化相关基因全长cDNA序列及其启动子的克隆与分析研究 通过建立小麦（Triticum aestivum. L. cv Jingdong No.1）胚芽春化cDNA文库，以春化相关基因VER2的3’端序列为探针，筛选获得全长1195 bp cDNA序列，它编码300个氨基酸。在VER2中存在植物疾病抗性反应蛋白和茉莉酸诱导凝集素两种蛋白的结构域。另外在VER2蛋白中存在核定位信号和多种磷酸酶的作用位点，VER2可能参与了多种调控途径。 以VER2基因的cDNA为探针，利用改进的池式PCR以及高密度膜杂交筛选的方法，从小麦TAC基因组文库中获得41,788 bp的基因组克隆，该序列含有11个基因，其中VER2基因位于第三个基因。VER2基因组序列含有3个内含子，4个外显子与cDNA序列100%同源。通过对转录起始点和转录终止点的分析，进一步证明从cDNA文库筛选得到的VER2基因为全长序列。 对VER2基因的上游启动子区域进行分析，发现基因上游启动子区存在三个小的重复序列，每个片段有482 bp，另有两个较大的重复序列，每个片段有2,161 bp。对上游2.8 kb启动子区（不含重复序列）的响应元件分析，其包括ABA响应元件（ABRE）、茉莉酸甲酯响应元件（Me-JARE）、胚乳特异性表达元件、参与淀粉酶合成的元件以及存在类似GA响应元件（ATAACAAAC）如ATAACATAC等等。根据VER2基因上游6 kb序列结构特点，将VER2启动子区域进行缺失突变形成10个片段，分别以GUS和GFP为报告基因构建成瞬间表达载体和植物表达载体等四类质粒。通过基因枪方法将最大片段（6 kb）驱动GFP报告基因的瞬间表达载体转入经春化处理或未春化处理的小麦幼叶中，结果发现GFP在春化处理的幼叶中表达，而在未春化处理的幼叶中不表达，说明VER2基因的启动子驱动基因转录受春化处理调控。 二、 小麦矮化突变体的研究 通过对小麦矮化突变体gaid遗传生理分析发现该突变体为半显性阻断GA信号途径，由此发现在赤霉素信号途径中，α-淀粉酶的诱导一定程度上通过某些与株高相关的基因控制。突变体gaid呈现对高浓度的脱落酸更敏感，当ABA浓度达到10-6M时，突变体的生长几乎完全受到了抑制，而野生型的生长需要ABA浓度达到10-5M时才能完全受到抑制。通过突变体gaid对乙烯等抑制型生长调节剂的响应实验研究，首次提出GA调控植物伸长生长存在两条信号途径，即GA基础水平信号途径（GA basal level signaling pathway）和GA正常水平信号途径（GA normal level signaling pathway），而乙烯以及高浓的GA合成抑制剂（如PAC）是通过第一条途径（GA基础水平信号途径）起作用。光形态建成中对植株生长的抑制作用存在独立于GA的信号途径。 突变体gaid的根系在强光照（63.5 Es-1m-2）和培养基内（低氧）的生长条件下，表现出弯曲、变短、加粗等异常性状，而随光照强度的减弱，这种根系异常生长的表型也减弱，在暗培养中则完全消失，但无论在哪种环境条件下，相对野生型对照而言，突变体的种子根短、侧根少。低浓度的ABA（10-8M）可以恢复突变体gaid根系在强光低氧条件下的正常生长发育。然而利用IAA及其极性运输的抑制剂（TIBA）、乙烯生物合成前提物（ACC）及合成抑制剂（AOA）处理突变体gaid，并没有发现突变体根系的生长发育得到恢复。 突变体gaid可能是一个新的属于小麦GA信号途径中的负调控基因（GAID）发生了突变或超表达，导致其负调控作用增强，呈现半显性的矮化突变。在与另一已知小麦GA信号途径中的负调控基因RHT的关系研究上发现，GAID可能对RHT蛋白磷酸化后的降解途径起抑制作用。通过双向电泳发现突变体gaid与野生型对照（京冬1号）在生长过程中存在差异蛋白，这将有助于对GA信号途径分子机理的深入研究。

猪粪农用的生态风险——以东北黑土为例

集约化养殖大量使用铜(Cu)作为饲料添加剂会在养殖废物的排放和利用中导致一定的环境问题。随着东北老工业基地产业结构的调整，畜牧业作为东北地区二次振兴的主要产业得到迅速发展，由此会产生大量的畜禽粪便用于农业土壤施肥。而东北地区又是我国重要的农副产品生产基地，研究畜禽粪便农用的健康及环境风险就显得殊为必要。黑土是东北地区最主要的土壤类型，本文以东北黑土为供试材料，通过在盆栽实验中添加不同Cu浓度的猪粪来模拟施肥年限不同的菜园土，研究土壤中Cu累积对小白菜(Brassica chinensis L.)地上部分生物量与Cu含量、土壤微生物生物量和土壤酶(脱氢酶、脲酶、酸性磷酸酶)活性、微生物群落功能多样性以及对土壤功能微生物——氨氧化古菌(AOA)和氨氧化细菌(AOB)等的影响，从而实现含Cu猪粪农用对食物链途径的健康风险以及土壤生态系统的生态风险的综合评价。 研究结果表明，施用猪粪显著地改善了土壤的pH，增加了小白菜地上部分生物量，对其体内Cu浓度则没有显著影响;小白菜地上部分Cu浓度与土壤全Cu和水溶态Cu浓度显著正相关(P<0.01)，而地上生物量与土壤全Cu浓度显著负相关(P<0.05)。当土壤全Cu浓度达到300 mg kg-1后，小白菜地上部分生物量受到强烈抑制。 猪粪的施用在一定时期内显著地促进了脱氢酶和脲酶的活性，但随土壤Cu浓度的增加，脱氢酶、脲酶和酸性磷酸酶的活性逐渐受到抑制。当土壤全Cu浓度达到300 mg kg-1后，微生物生物量、脱氢酶、脲酶、酸性磷酸酶等均受到强烈抑制。 施加猪粪提高了土壤微生物群落功能多样性，当土壤Cu浓度达到170 mg kg-1后，显著地抑制了微生物群落功能多样性。种植小白菜后，各处理间微生物群落功能多样性没有显著差异，意味着植物能够维持微生物群落功能多样性。主成分分析(PCA)结果显示，当土壤全Cu浓度达到300 mg kg-1后，微生物群落功能多样性与其它处理显著不同。 猪粪显著地促进了土壤的硝化潜势速率(PNR)。随着Cu浓度的增加，硝化潜势速率逐渐受到抑制，当土壤全Cu浓度达到170 mg kg-1后，即与对照无显著差异。植物在维持硝化速率方面也起到重要作用。古菌amoA基因在每克干土中的拷贝数在9.4*106~2.59*107，细菌amoA基因在每克干土中的拷贝数约为1.48*106~1.41*107。猪粪在一定时期内显著地增加了AOA和AOB的数量，当土壤Cu浓度达到300 mg kg-1后，AOA和AOB的数量显著下降，并且AOA与AOB amoA基因拷贝数的比值增加，在小白菜栽种前(B1)和小白菜收获后(B2)分别为2.33和9.26，这意味着在高Cu浓度胁迫下，AOA的耐受性更强。古菌与细菌的amoA拷贝数与PNR之间则没有显著的相关关系，意味着AOA和AOB种群结构以及其中某些种群的活性可能发生了变化。 本文通过对东北黑土菜地土壤中Cu在作物体内的迁移积累及其对土壤微生物学指标(微生物生物量、酶活性、微生物群落功能多样性及功能微生物)的影响的综合研究，揭示了含Cu猪粪农用所造成的健康和生态风险，为建立适宜的土壤环境质量标准提供了一定的科学依据。通过本研究得出，黑土蔬菜种植中Cu浓度的阈值在170-300 mg kg-1之间。

Diversity and spatial distribution of sediment ammonia-oxidizing crenarchaeota in response to estuarine and environmental gradients in the Changjiang Estuary and East China Sea

Ammonia-oxidizing archaea (AOA) have recently been found to be potentially important in nitrogen cycling in a variety of environments, such as terrestrial soils, wastewater treatment reactors, marine waters and sediments, and especially in estuaries, where high input of anthropogenic nitrogen is often experienced. The sedimentary AOA diversity, community structure and spatial distribution in the Changjiang Estuary and the adjacent East China Sea were studied. Multivariate statistical analysis indicated that the archaeal amoA genotype communities could be clustered according to sampling transects, and the station located in an estuarine mixing zone harboured a distinct AOA community. The distribution of AOA communities correlated significantly with the gradients of surface-water salinity and sediment sorting coefficient. The spatial distribution of putative soil-related AOA in certain sampling stations indicated a strong impact of the Changjiang freshwater discharge on the marine benthic microbial ecosystem. Besides freshwater, nutrients, organic matter and suspended particles, the Changjiang Diluted Water might also contribute to the transport of terrestrial archaea into the seawater and sediments along its flow path.

Spatio-temporal variability in ammonia oxidation and ammonia oxidising bacteria and archaea in coastal sediments of the Western English Channel

The abundance of ammonia-oxidising bacterial (AOB) and ammonia-oxidising archaeal (AOA) (amoA) genes and ammonia oxidation rates were compared bimonthly from July 2008 to May 2011 in 4 contrasting coastal sediments in the western English Channel. Despite a higher abundance of AOA amoA genes within all sediments and at all time-points, rates of ammonia oxidation correlated with AOB and not AOA amoA gene abundance. Sediment type was a major factor in determining both AOB amoA gene abundance and AOB community structure, possibly due to deeper oxygen penetration into the sandier sediments, increasing the area available for ammonia oxidation. Decreases in AOB amoA gene abundance were evident during summer and autumn, with maximum abundance and ammonia oxidation rates occurring in winter and early spring. PCR-DGGE of AOB amoA genes indicated that no seasonal changes to community composition occurred; however, a gradual movement in community composition occurred at 3 of the sites studied. The lack of correlation between AOA amoA gene abundance and ammonium oxidation rates, or any other environmental variable measured, may be related to the higher spatial variation amongst measurements, obscuring temporal trends, or the bimonthly sampling, which may have been too infrequent to capture temporal variability in the deposition of fresh organic matter. Alternatively, AOA may respond to changing substrate concentrations by an increase or decrease in transcript rather than gene abundance.

The inhibition of N2O production by ocean acidification in cold temperate and polar waters

The effects of ocean acidification (OA) on nitrous oxide (N2O) production and on the community composition of ammonium oxidizing archaea (AOA) were examined in the northern and southern sub-polar and polar Atlantic Ocean. Two research cruises were performed during June 2012 between the North Sea and Arctic Greenland and Barent Seas, and in January–February 2013 to the Antarctic Scotia Sea. Seven stations were occupied in all during which shipboard experimental manipulations of the carbonate chemistry were performed through additions of NaHCO3−+HCl in order to examine the impact of short-term (48 h for N2O and between 96 and 168 h for AOA) exposure to control and elevated conditions of OA. During each experiment, triplicate incubations were performed at ambient conditions and at 3 lowered levels of pH which varied between 0.06 and 0.4 units according to the total scale and which were targeted at CO2 partial pressures of ~500, 750 and 1000 µatm. The AOA assemblage in both Arctic and Antarctic regions was dominated by two major archetypes that represent the marine AOA clades most often detected in seawater. There were no significant changes in AOA assemblage composition between the beginning and end of the incubation experiments. N2O production was sensitive to decreasing pHT at all stations and decreased by between 2.4% and 44% with reduced pHT values of between 0.06 and 0.4. The reduction in N2O yield from nitrification was directly related to a decrease of between 28% and 67% in available NH3 as a result of the pH driven shift in the NH3:NH4+ equilibrium. The maximum reduction in N2O production at conditions projected for the end of the 21st century was estimated to be 0.82 Tg N y−1.

Sectorial antennas for WSN localization system

This work investigates low cost localization systems (LS) based on received signal strength (RSS) and integrated with different types of antennas with main emphasis on sectorial antennas. The last few years have witnessed an outstanding growth in wireless sensor networks (WSN). Among its various possible applications, the localization field became a major area of research. The localization techniques based on RSS are characterized by simplicity and low cost of integration. The integration of LS based on RSS and sectorial antennas (SA) was proven to provide an effective solution for reducing the number of required nodes of the networks and allows the combination of several techniques, such as RSS and angle of arrival (AoA). This PhD thesis focuses on studying techniques, antennas and protocols that best meet the needs of each LS with main focus on low cost systems based on RSS and AoA. Firstly there are studied localization techniques and system that best suit the requirements of the user and the antennas that are most appropriate according to the nature of the signal. In this step it is intended to provide a fundamental understanding of the undertaken work. Then the developed antennas are presented according to the following categories: sectorial and microstrip antennas. Two sectorial antennas are presented: a narrowband antenna operating at 2.4 to 2.5 GHz and a broadband antenna operating at 800MHz-2.4GHz. The low cost printed antennas were designed to operate at 5 GHz, which may be used for vehicular communication. After presenting the various antennas, several prototypes of indoor/outdoor LS are implemented and analyzed. Localization protocols are also proposed, one based on simplicity and low power, and the other on interoperability with different types of antennas and system requirements.

Pentagonal parch-excited sectorized antenna for localization systems

A pentagonal patch-excited sectorized antenna (SA) suitable for 2.4-2.5 GHz localization systems was studied and developed. The integration of six patch-excited structures converges into a sectorized antenna called Hive5 that provides gain improvement compared to a patch antenna, maximum variation of 3 dB beam width over the radiation pattern and circular polarization (CP). This antenna is presented and analyzed taking into account the tap length and the flare angle. The proposed antenna in combination with a RF-Switch provides a cost effective solution for localization based on Wireless Sensor Networks (WSN) and will be used for implementing angle of arrival (AoA) techniques combined with RF fingerprinting techniques.