The effect of total knee arthroplasty on joint movement during functional activities and joint range of motion with particular regard to higher flexion users

Study aimed to evaluate active and functional knee excursion of patients before and after total knee arthroplasty (TKA) and to determine whether TKA restores quality of life related to functional activities of daily living. Found that although TKA offers excellent pain relief and contributes to the overall well-being of the patient, these results suggest that it also leads to a reduced range of active and functional motion in the majority of patients. This is associated with a lower-than-normal physical quality of life. The design of implants and rehabilitation programmes should be reconsidered so that better range of motion and quality of life can be achieved for patients

Flutter Boundary Identification From Simulation Time Histories

While there has been much recent progress in simulating nonlinear aeroelastic systems, and in predicting many of the aeroelastic phenomena of concern in transport aircraft design (i.e. transonic flutter buckets), the utility of a simulation in generating an understanding of the flutter behavior is limited. This is due in part to the high cost of generating these simulations; and the implied limitation on the number of conditions that can be analyzed, but there are also some difficulties introduced by the very nature of a simulation. Flutter engineers have traditionally worked in the frequency domain, and are accustomed to describing the flutter behavior of an airplane in terms of its V-G and V-F (or Q-G and Q-F) plots and flutter mode shapes. While the V-G and V-F plots give information about how the dynamic response of an airplane changes as the airspeed is increased, the simulation only gives information about one isolated condition (Mach, airspeed, altitude, etc.). Therefore, where a traditional flutter analysis can let the engineer determine an airspeed at which an airplane becomes unstable, while a simulation only serves as a binary check: either the airplane is fluttering at this condition, or it is not. In this document, a new technique is described in which system identification is used to easily extract modal frequencies and damping ratios from simulation time histories, and shows how the identified parameters can be used to determine the variation in frequency and dampin,o ratio as the airspeed is changed. This technique not only provides the flutter engineer with added insight into the aeroelastic behavior of the airplane, but it allows calculation of flutter mode shapes, and allows estimation of flutter boundaries while minimizing the number of simulations required

The approach to a superconductor-to-Bose-insulator transition in disordered films

Through a detailed study of scaling near the magnetic field-tuned superconductor-to-insulator transition in strongly disordered films, we find that results for a variety of materials can be collapsed onto a single phase diagram. The data display two clear branches, one with weak disorder and an intervening metallic phase, the other with strong disorder. Along the strongly disordered branch, the resistance at the critical point approaches $R_Q = h/4e^2$ and the scaling of the resistance is consistent with quantum percolation, and therefore with the predictions of the dirty boson model.Comment: 4 pages, 4 figure

The Public Resource Management Game

Use of public resources for private economic gain is a longstanding, contested political issue. Public resources generate benefits beyond commodity uses, including recreation, environmental and ecological conservation and preservation, and existence and aesthetic values. We analyze this problem using a dynamic resource use game. Low use fees let commodity users capture more of the marginal benefit from private use. This increases the incentive to comply with government regulations. Optimal contracts therefore include public use fees that are lower than private rates. The optimal policy also includes random monitoring to prevent strategic learning and cheating on the use agreements and to avoid wasteful efforts to disguise noncompliant behavior. An optimal policy also includes a penalty for cheating beyond terminating the use contract. This penalty must be large enough that the commodity user who would gain the most from noncompliance experiences a negative expected net return.Renewable resources, public resources policy, optimal contracts

Rate of undesirable events at beginning of academic year: retrospective cohort study.

OBJECTIVE: To determine whether an increase in the rate of undesirable events occurs after care provided by trainees at the beginning of the academic year. DESIGN: Retrospective cohort study using administrative and patient record data. SETTING: University affiliated hospital in Melbourne, Australia. PARTICIPANTS: 19,560 patients having an anaesthetic procedure carried out by first to fifth year trainees starting work for the first time at the hospital over a period of five years (1995-2000). MAIN OUTCOME MEASURES: Absolute event rates, absolute rate reduction, and rate ratios of undesirable events. RESULTS: The rate of undesirable events was higher at the beginning of the academic year compared with the rest of the year (absolute event rate 137 v 107 per 1000 patient hours, relative rate reduction 28%, P<0.001). The overall adjusted rate ratio for undesirable events was 1.40, 95% confidence interval 1.24 to 1.58. This excess risk was seen for all residents, regardless of their level of seniority. The excess risk decreased progressively after the first month, and the trend disappeared fully after the fourth month of the year (rate ratio for fourth month 1.21, 0.93 to 1.57). The most important decreases were for central and peripheral nerve injuries (relative difference 82%), inadequate oxygenation of the patient (66%), vomiting/aspiration in theatre (53%), and technical failures of tracheal tube placement (49%). CONCLUSIONS: The rate of undesirable events was greater among trainees at the beginning of the academic year regardless of their level of clinical experience. This suggests that several additional factors, such as knowledge of the working environment, teamwork, and communication, may contribute to the increase

How good are we at determining risk? Quantifying the accuracy of clinician determined risk for VTE prophylaxis

Objectives: Create and validate a simple tool for concurrent audits of risk stratification, compliance and documentation Evaluate accuracy of clinician risk stratification and prophylatic ordering practice compared with a standardized Caprini RAM across different assigned risk categories Provide recommendations for EPIC VTE Prophylaxis CDS Developmenthttps://jdc.jefferson.edu/patientsafetyposters/1050/thumbnail.jp

Quantifying Patient Reported and Documented Compliance with Adjuncts to Venous Thromboembolism Prophylaxis

Objectives: 1. Measure patient compliance with pharmacologic, mechanical and ambulatory prophylactic measures. 2. Evaluate for agreement between nursing documentation and patient reported compliance with mechanical and ambulatory prophylactic measures.https://jdc.jefferson.edu/patientsafetyposters/1042/thumbnail.jp