Comprehensive three-dimensional ray tracing model for three-mirror cavity-enhanced spectroscopy.

A 3D ray tracing model is used to simulate optical reinjection in a nonresonant optical cavity, for off-axis integrated cavity output spectroscopy. The optical cavities are optimized for maximum intensity enhancement factors via a grid search and a genetic algorithm. Intensity enhancement factors up to 1400 are found for short cavities (3 cm) and up to 101 for long cavities (50 cm). The model predicts that short absorption cells can be used, having a long effective path length and a high throughput power. This opens new opportunities in the field of ultrasensitive absorption spectroscopy and allows the design of compact optical gas sensors.

Do Biologic Agents Increase the Risk of Infection in Patients Undergoing Lower Limb Arthroplasty Surgery?

BACKGROUND: Biologic agents have contributed significantly to the management of patients with in rheumatoid arthritis (RA). A significant proportion of patients with RA still require arthroplasty procedures however. It is unclear whether these agents increase the risk of post operative infection after lower limb arthroplasty. METHOD: A literature search was performed for articles published over the last 10 years in the English language examining the association between anti-tumour necrosis factor inhibitors and the incidence of post operative infection in patients with RA undergoing hip and knee arthroplasty procedures. RESULTS: One large meta-analysis has been published suggesting a 2-fold increase in infection rates following orthopaedic surgery in patients receiving biological agents. When subgroup analysis of arthroplasty cases alone was performed the finding failed to reach significance. However, several further studies have demonstrated both an increased risk for surgical site infection with the use of biological agents and several conflicting articles argue the opposite. CONCLUSION: There is no current consensus on this topic. The safety of continuation of perioperative anti-TNF-α therapy in patients undergoing lower limb arthroplasty procedures is unclear. There is also little robust guidance from specialist rheumatologic societies. There is need for large scale multicentre randomised controlled trials to address this issue.

The effect of using components from different manufacturers on the rate of wear and corrosion of the head-stem taper junction of metal-on-metal hip arthroplasties.

AIMS: Surgeons have commonly used modular femoral heads and stems from different manufacturers, although this is not recommended by orthopaedic companies due to the different manufacturing processes. We compared the rate of corrosion and rate of wear at the trunnion/head taper junction in two groups of retrieved hips; those with mixed manufacturers (MM) and those from the same manufacturer (SM). MATERIALS AND METHODS: We identified 151 retrieved hips with large-diameter cobalt-chromium heads; 51 of two designs that had been paired with stems from different manufacturers (MM) and 100 of seven designs paired with stems from the same manufacturer (SM). We determined the severity of corrosion with the Goldberg corrosion score and the volume of material loss at the head/stem junction. We used multivariable statistical analysis to determine if there was a significant difference between the two groups. RESULTS: We found no significant difference in the corrosion scores of the two groups. The median rate of material loss at the head/stem junction for the MM and SM groups were 0.39 mm(3)/year (0.00 to 4.73) and 0.46 mm(3)/year (0.00 to 6.71) respectively; this difference was not significant after controlling for confounding factors (p = 0.06). CONCLUSION: The use of stems with heads of another manufacturer does not appear to affect the amount of metal lost from the surfaces between these two components at total hip arthroplasty. Other surgical, implant and patient factors should be considered when determining the mechanisms of failure of large diameter metal-on-metal hip arthroplasties. Cite this article: Bone Joint J 2016;98-B:917-24.

International metal-on-metal multidisciplinary teams: do we manage patients with metal-on-metal hip arthroplasty in the same way? An analysis from the International Specialist Centre Collaboration on MOM Hips (ISCCoMH).

AIMS: There are many guidelines that help direct the management of patients with metal-on-metal (MOM) hip arthroplasties. We have undertaken a study to compare the management of patients with MOM hip arthroplasties in different countries. METHODS: Six international tertiary referral orthopaedic centres were invited to participate by organising a multi-disciplinary team (MDT) meeting, consisting of two or more revision hip arthroplasty surgeons and a musculoskeletal radiologist. A full clinical dataset including history, blood tests and imaging for ten patients was sent to each unit, for discussion and treatment planning. Differences in the interpretation of findings, management decisions and rationale for decisions were compared using quantitative and qualitative methods. RESULTS: Overall agreement between the orthopaedic centres and the recommended treatment plans for the ten patients with MOM hip implants was moderate (kappa = 0.6). Full agreement was seen in a third of cases, however split decisions were also seen in a third of cases. Units differed in their interpretation of the significance of the investigation findings and put varying emphasis on serial changes, in the presence of symptoms. DISCUSSION: In conclusion, the management of raised or rising blood metal ions, cystic pseudotumours and peri-acetabular osteolysis led to inconsistency in the agreement between centres. Coordinated international guidance and MDT panel discussions are recommended to improve consensus in decision making. TAKE HOME MESSAGE: A lack of evidence and the subsequent variation in regulator guidance leads to differences in opinions, the clinical impact of which can be reduced through a multi-disciplinary team approach to managing patients with MOM hip implants. Cite this article: Bone Joint J 2016;98-B:179-86.

Feasibility of eyes open alpha power training for mental enhancement in elite gymnasts.

This study focuses on a novel, easy to use and instruction-less method for mental training in athletes. Previous findings suggest that particular mental capacities are needed for achieving peak performance; including attentional control, focus, relaxation and positive affect. Electroencephalography (EEG) alpha brain activity has been associated with neural inhibition during processes of selective attention, for improving efficiency in information processing. Here we hypothesised that eyes open alpha power training by music teaches athletes to (1) learn to self-regulate their brain activity, and (2) learn to increase their baseline alpha power, herewith improving mental capacities such as focusing the allocation of attention. The study was double-blind and placebo-controlled. Twelve elite gymnasts were either given eyes open alpha power training or random beta power training (controls). Results indicate small improvements in sleep quality, mental and physical shape. In our first attempt at getting a grip on mental capacities in athletes, we think this novel training method can be promising. Because gymnastics is one of the most mentally demanding sports, we value even small benefits for the athlete and consider them indicative for future research.

Pseudarthrosis of the tibia: emergency department presentation of neurofibromatosis type 1 in a 4-month-old infant.

Congenital pseudarthrosis of the tibia is a complex and rare condition of infancy. Long bone pseudarthrosis is strongly linked to neurofibromatosis, a common genetic disorder in which pseudarthrosis tends to occur early. This report describes a similar emergency department presentation in a 4-month-old infant with subsequent diagnosis of neurofibromatosis type 1.

A parameter identifiability and estimation study in Yesilirmak River.

Water quality models have relatively large number of parameters, which need to be estimated against observed data through a non-trivial task that is associated with substantial difficulties. This work involves a systematic model calibration and validation study for river water quality. The model considered was composed of dynamic mass balances for eleven pollution constituents, stemming from QUAL2E water quality model by considering a river segment as a series of continuous stirred-tank reactors (CSTRs). Parameter identifiability was analyzed from the perspective of sensitivity measure and collinearity index, which indicated that 8 parameters would fall within the identifiability range. The model parameters were then estimated by an integration based optimization algorithm coupled with sequential quadratic programming. Dynamic field data consisting of major pollutant concentrations were collected from sampling stations along Yesilirmak River around the city of Amasya in Turkey, and compared with model predictions. The calibrated model responses were in good agreement with the observed river water quality data, and this indicated that the suggested procedure provided an effective means for reliable estimation of model parameters and dynamic simulation for river streams.

Dynamic simulation and parameter estimation in river streams.

Predictions and quality management issues for environmental protection in river basins rely on water-quality models. The key step in model calibration and verification is obtaining the right values of the model parameters. Current practice in model calibration is such that the reaction coefficients are adjusted by trial-and-error until the predicted values and measured data are within a pre-selected margin of error, and this may be a very time consuming task. This study is directed towards developing a parameter estimation strategy coupled with the simulation of water quality models so that the heavy burden of finding reaction rate coefficients is overcome. Dynamic mass balances for different forms of nitrogen and phosphorus, biological oxygen demand, dissolved oxygen, coliforms, nonconservative constituent and algae were written for a single computational element. The model parameters conforming to those in QUAL2E water quality model were estimated by a nonlinear multi-response parameter estimation strategy coupled with a stiff integrator. Yesilirmak river basin around the city of Amasya in Turkey served as the prototype system for the model development. Samples were collected simultaneously from two stations, and concentrations of many water-quality constituents were determined either on-site or in laboratory. This dynamic data was then used for numerical parameter estimation during computer simulation. When the model was simulated with the estimated parameters, it was seen that the model was quite able to predict the dynamics of major water quality constituents. It is concluded that the proposed method shows promise for automatically generating reliable estimates of model parameters.

Oxygen diffusivity in calcium alginate gel beads containing Gluconobacter suboxydans.

Gaining insight into the mass transfer characteristics in immobilized enzyme and microorganism systems bears much importance because of their widely increased use in industrial scale production as well as for analysis purposes. In this study, the effective diffusion coefficient of oxygen in calcium alginate gel with and without cells has been determined by the Moment Analysis Method for the first time in literature. When the gel concentration was increased from 1 to 3 %, De values of oxygen varied between 2.54 x 10(-5) cm2/s and 2.58 x 10(-5) cm2/s indicating almost no dependency on gel concentration. However, a decrease in effective diffusion coefficient (from 2.55 cm2/s to 2.47 cm2/s) was observed with increased immobilized Gluconobacter suboxydans concentration in the range of 0 to 6 %. Experimental results on liquid-particle mass transfer coefficient revealed a negligible external mass transfer resistance. Effectiveness factor for the bioreactor system was also calculated and found to be 0.39 and 0.21 for gel beads of 0.1 and 0.2 cm radius respectively. It is concluded therefore that the use of smaller gel beads could substantially improve the production efficiency in similar bioreactors.