Influencia de la vía de abordaje y de posición de la cúpula acetabular en la luxación de la artroplastia total de cadera: estudio caso-control

Tanto la vía de acceso quirúrgica como la posición de los componentes se han relacionado con la presencia de una luxación en las artroplastias primarias de cadera. Hemos estudiado la presencia de esta complicación en una serie de 758 artroplastias no cementadas modelo Bihapro. Encontramos 21 luxaciones. Por otro lado se seleccionó de forma aleatoria un grupo de control de 42 pacientes que no habían presentado luxación. Se diseñó un estudio de casos y controles que englobaba por tanto a 63 pacientes que tenían implantada una artroplastia de este modelo. En el grupo de casos observamos que el porcentaje de luxación fue sensiblemente mayor en el sexo masculino con un 66,7%, en comparación con el sexo femenino que fue de un 42,8% aunque esta diferencia no fue estadísticamente significativa. No se observaron diferencias en la frecuencia de luxaciones en relación con la vía anterior o lateral, pero sin embargo en la vía posterior la luxación se produjo en un solo caso (4,8% de todas las luxaciones) con una incidencia claramente menor que en los abordajes anterior y lateral, siendo esta diferencia estadísticamente significativa (p=0,005). También observamos diferencias estadísticamente significativas en cuanto a un mayor porcentaje de luxaciones cuando la inclinación del componente acetabular era mayor de 50º (76,2%), o cuando la anteversión del cotilo era mayor o igual a 20º (54,4%). La vía de abordaje posterior con reconstrucción capsular y muscular presenta un menor porcentaje de luxación después de una artroplastia primaria en comparación con la anterior o lateral. Una inclinación mayor de 50º o una anteversión mayor de 20º favorecen la presencia de una luxación.The surgical approach and the cup position have been related with the dislocations of total hip arthroplasty. We have studied the presence of this complication in 758 Bihapro™ cementless arthroplasties. We got a case group of 21 dislocations; then we selected a control group of 42 patients without luxation to design a case-control study. The case group had a higher rate of dislocation in males (66.7 % versus 42.8 % in females) although this difference was not statistically significant. We didn’t observe any difference in the frequency of luxations relating to the anterior or lateral surgical approach, however in the posterior approach the dislocation appeared only in one case (4.8 % of the all dislocations) with statistically differences (p=0.005). We also observed statistically significant differences of luxations when the acetabular cup inclination was higher than 50º (76.2 %), or when the cup anteversion was equal or higher than 20º (52.4 %). The posterior surgical approach with capsular and muscular suture presented a lower rate of dislocation after a primary arthroplasty compared with the anterior or lateral approachs. An inclination bigger than 50º or an anteversion bigger than 20º seems to be a risk factor of luxation

Limited Ability to Activate Protein C Confers Left Atrial Endocardium A Thrombogenic Phenotype: A Role in Cardioembolic Stroke?

Background and Purpose—Atrial fibrillation is the most important risk factor for cardioembolic stroke. Thrombi form in the left atrial appendage rather than in the right. The causes of this different thrombogenicity are not well-understood. The goal herein was to compare the activation of the anticoagulant protein C and the thrombomodulin and endothelial protein C receptor/activated protein C receptor expression on the endocardium between right and left atria. Methods—We harvested the atria of 6 monkeys (Macaca fascicularis) and quantified their ability to activate protein C ex vivo and we measured the thrombomodulin and endothelial protein C receptor expression by immunofluorescence. Results—We found the ability to activate protein C decreased by half (P 0.028) and there was lower expression of thrombomodulin in the left atrial endocardium than the right (52.5 19.9 and 72.1 18.8 arbitrary intensity units, mean standard deviation; P 0.028). No differences were detected in endothelial protein C receptor expression. Conclusions—Impaired protein C activation on the left atrial endocardium attributable to low thrombomodulin expression may explain its higher thrombogenicity and play a role in cardioembolic stroke

Cosmological Analogues of the Bartnik--McKinnon Solutions

We present a numerical classification of the spherically symmetric, static solutions to the Einstein--Yang--Mills equations with cosmological constant $\Lambda$. We find three qualitatively different classes of configurations, where the solutions in each class are characterized by the value of $\Lambda$ and the number of nodes, $n$, of the Yang--Mills amplitude. For sufficiently small, positive values of the cosmological constant, \Lambda < \Llow(n), the solutions generalize the Bartnik--McKinnon solitons, which are now surrounded by a cosmological horizon and approach the deSitter geometry in the asymptotic region. For a discrete set of values $\Lambda_{\rm reg}(n) > \Lambda_{\rm crit}(n)$, the solutions are topologically $3$--spheres, the ground state $(n=1)$ being the Einstein Universe. In the intermediate region, that is for \Llow(n) < \Lambda < \Lhig(n), there exists a discrete family of global solutions with horizon and ``finite size''.Comment: 16 pages, LaTeX, 9 Postscript figures, uses epsf.st

Understanding consumer demand for new transport technologies and services, and implications for the future of mobility

The transport sector is witnessing unprecedented levels of disruption. Privately owned cars that operate on internal combustion engines have been the dominant modes of passenger transport for much of the last century. However, recent advances in transport technologies and services, such as the development of autonomous vehicles, the emergence of shared mobility services, and the commercialization of alternative fuel vehicle technologies, promise to revolutionise how humans travel. The implications are profound: some have predicted the end of private car dependent Western societies, others have portended greater suburbanization than has ever been observed before. If transport systems are to fulfil current and future needs of different subpopulations, and satisfy short and long-term societal objectives, it is imperative that we comprehend the many factors that shape individual behaviour. This chapter introduces the technologies and services most likely to disrupt prevailing practices in the transport sector. We review past studies that have examined current and future demand for these new technologies and services, and their likely short and long-term impacts on extant mobility patterns. We conclude with a summary of what these new technologies and services might mean for the future of mobility.Comment: 15 pages, 0 figures, book chapte

Squeezed States of the Generalized Minimum Uncertainty State for the Caldirola-Kanai Hamiltonian

We show that the ground state of the well-known pseudo-stationary states for the Caldirola-Kanai Hamiltonian is a generalized minimum uncertainty state, which has the minimum allowed uncertainty $\Delta q \Delta p = \hbar \sigma_0/2$, where $\sigma_0 (\geq 1)$ is a constant depending on the damping factor and natural frequency. The most general symmetric Gaussian states are obtained as the one-parameter squeezed states of the pseudo-stationary ground state. It is further shown that the coherent states of the pseudo-stationary ground state constitute another class of the generalized minimum uncertainty states.Comment: RevTex4, 9 pages, no fingure; to be published in Journal of Physics

The nonlinear Schroedinger equation for the delta-comb potential: quasi-classical chaos and bifurcations of periodic stationary solutions

The nonlinear Schroedinger equation is studied for a periodic sequence of delta-potentials (a delta-comb) or narrow Gaussian potentials. For the delta-comb the time-independent nonlinear Schroedinger equation can be solved analytically in terms of Jacobi elliptic functions and thus provides useful insight into the features of nonlinear stationary states of periodic potentials. Phenomena well-known from classical chaos are found, such as a bifurcation of periodic stationary states and a transition to spatial chaos. The relation of new features of nonlinear Bloch bands, such as looped and period doubled bands, are analyzed in detail. An analytic expression for the critical nonlinearity for the emergence of looped bands is derived. The results for the delta-comb are generalized to a more realistic potential consisting of a periodic sequence of narrow Gaussian peaks and the dynamical stability of periodic solutions in a Gaussian comb is discussed.Comment: Enhanced and revised version, to appear in J. Nonlin. Math. Phy

Shopping centre siting and modal choice in Belgium: a destination based analysis

Although modal split is only one of the elements considered in decision-making on new shopping malls, it remarkably often arises in arguments of both proponents and opponents. Today, this is also the case in the debate on the planned development of three major shopping malls in Belgium. Inspired by such debates, the present study focuses on the impact of the location of shopping centres on the travel mode choice of the customers. Our hypothesis is that destination-based variables such as embeddedness in the urban fabric, accessibility and mall size influence the travel mode choice of the visitors. Based on modal split data and location characteristics of seventeen existing shopping centres in Belgium, we develop a model for a more sustainable siting policy. The results show a major influence of the location of the shopping centre in relation to the urban form, and of the size of the mall. Shopping centres that are part of a dense urban fabric, measured through population density, are less car dependent. Smaller sites will attract more cyclists and pedestrians. Interestingly, our results deviate significantly from the figures that have been put forward in public debates on the shopping mall issue in Belgium

Relationship between spatial proximity and travel-to-work distance : the effect of the compact city

In this paper, an assessment is made of the relationship between selected aspects of spatial proximity (density, diversity, minimum commuting distance, jobs-housing balance and job accessibility) and reported commuting distances in Flanders (Belgium). Results show that correlations may depend on the considered trip end. For example, a high residential density, a high degree of spatial diversity and a high level of job accessibility are all associated with a short commute by residents, while a high job density is associated with a long commute by employees. A jobs-housing balance close to one is associated with a short commute, both by residents and by employees. In general, it appears that the alleged sustainability benefits of the compact city model are still valid in a context of continuously expanding commuting trip lengths

sPLA2-V inhibits EPCR anticoagulant and antiapoptotic properties by accommodating lysophosphatidylcholine or PAF in the hydrophobic groove

The endothelial protein C receptor (EPCR) plays an important role in cardiovascular disease by binding protein C/activated protein C (APC). EPCR structure contains a hydrophobic groove filled with an unknown phospholipid needed to perform its function. It has not been established whether lipid exchange takes place in EPCR as a regulatory mechanism of its activity. Our objective was to identify this phospholipid and to explore the possibility of lipid exchange as a regulatory mechanism of EPCR activity driven by the endothelially expressed secretory group V phospholipase A2 (sPLA2-V). We identified phosphatidylcholine (PCh) as the major phospholipid bound to human soluble EPCR (sEPCR). PCh in EPCR could be exchanged for lysophosphatidylcholine (lysoPCh) and platelet activating factor (PAF). Remarkably, lysoPCh and PAF impaired the protein C binding ability of sEPCR. Inhibition of sPLA2-V, responsible for lysoPCh and PAF generation, improved APC binding to endothelial cells. EPCR-dependent protein C activation and APC antiapoptotic effect were thus significantly enhanced. In contrast, endothelial cell supplementation with sPLA2-V inhibited both APC generation and its antiapoptotic effects. We conclude that APC generation and function can be modulated by changes in phospholipid occupancy of its endothelial cell receptor

Higgs decay to dark matter in low energy SUSY: is it detectable at the LHC ?

Due to the limited statistics so far accumulated in the Higgs boson search at the LHC, the Higgs boson property has not yet been tightly constrained and it is still allowed for the Higgs boson to decay invisibly to dark matter with a sizable branching ratio. In this work, we examine the Higgs decay to neutralino dark matter in low energy SUSY by considering three different models: the minimal supersymmetric standard model (MSSM), the next-to-minimal supersymmetric standard models (NMSSM) and the nearly minimal supersymmetric standard model (nMSSM). Under current experimental constraints at 2-sigma level (including the muon g-2 and the dark matter relic density), we scan over the parameter space of each model. Then in the allowed parameter space we calculate the branching ratio of the SM-like Higgs decay to neutralino dark matter and examine its observability at the LHC by considering three production channels: the weak boson fusion VV->h, the associated production with a Z-boson pp->hZ+X or a pair of top quarks pp->htt_bar+X. We find that in the MSSM such a decay is far below the detectable level; while in both the NMSSM and nMSSM the decay branching ratio can be large enough to be observable at the LHC.Comment: Version in JHE