D&P (United States)

A 51-year-old male construction worker with a history of chronic quadriceps tendon rupture presented with no active knee extension and tricompartmental knee osteoarthritis. He underwent simultaneous total knee arthroplasty and extensor mechanism allograft reconstruction. At 4 years postoperatively, the patient had pain-free knee function and active extension. The combination of a chronic quadriceps tendon rupture with lack of active knee extension and knee osteoarthritis is a rare and challenging problem. To our knowledge, this combined diagnosis and the treatment described in this case report have not been reported previously in the literature.

Bu çalışma, özel çıkar gruplarının (SIGs) uzun dönem ekonomik büyüme üzerinde negatif bir etkisi olduğunu ileri süren iktisadi görüşü test etmek amacındadır. Bu bağlamda SIGs ve ekonomik büyüme arasındaki uzun dönemli ilişki OECD ülkeleri için 1990 ve 2011 yılları arasında panel veri teknikleri yardımıyla incelenmiştir. OECD örneklemine ilişkin araştırma bulguları, SIGs ile ekonomik büyüme arasında uzun dönemli bir ilişki olduğunu ortaya koymuştur. Ayrıca OECD paneline ilişkin uzun dönem esneklik sonuçlarından hareketle, özel çıkar gruplarının ekonomik büyüme üzerinde bozucu bir etkisi olduğu tespit edilmiştir. Buna ek olarak her bir ülkeye ilişkin uzun dönem esneklik sonuçları ise, örneklem grubunun %28’nin özel çıkar grupları ile ekonomik büyüme arasında ters U şeklinde bir ilişkinin varlığını desteklediğini ortaya koymuştur.

(Abstracted from Pediatrics 2016;137(6):e20152992) The prenatal period is an important period that impacts newborn and lifelong health; exposure to stress, poor nutrition, or substance abuse during this period leads to adverse birth outcomes, including low birth weight and preterm birth. Several initiatives across the world that utilize conditional cash or food transfer include Oportunidades (Mexico), Bolsa Familia Program (Brazil), and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC, United States) have been undertaken to improve prenatal health and birth outcomes.

To incorporate at least the first-order effects of rotor-ship coupling into the existing real- time flight simulation system, a series of CFD computations have been conducted for the ship alone, the rotor alone, and the two together using an actuator disk to represent the rotor. The first-order effects of rotor-ship coupling are obtained by subtracting the rotor alone and the ship alone solutions from the coupled solutions. To further utilize those CFD solutions in a real-time simulation environment, a reduced-order model of rotor-ship coupling effects has been constructed from the above CFD solution database by using Proper Orthogonal Decomposition and Multi-layer perceptrons Neural Network methods. While the solutions of this reduced-order model are in good agreement with the original CFD solutions, running this reduced-order model on a regular PC only takes several milliseconds, satisfying the requirement of a real-time simulation.

A hybrid Cartesian grid/gridless Euler solver has been developed for efficient prediction of store separation. In this approach, a so-called building-cube Cartesian grid method is used to solve the flows over the majority of the computational domain, taking advantage of the simplicity and efficiency of the Cartesian grid approach. Near the body surfaces, on the other hand, a body-conforming gridless method is used for accurate implementation of the boundary conditions on the body surfaces. As a result, the grid generation effort for store separation prediction is significantly alleviated without grid overlapping. The application of this algorithm to the Eglin supersonic store separation case has proven successful. Good agreement with the measured pressure distributions over the store surfaces and trajectory data has been achieved.

We sought to determine predictors of acute hospital costs in patients presenting with acute ischemic stroke to an academic center using a stroke management team to coordinate care. Demographic and clinical data were prospectively collected on 191 patients consecutively admitted with acute ischemic stroke. Patients were classified by insurance status, premorbid modified Rankin scale, stroke location, stroke severity (National Institutes of Health Stroke Scale score), and presence of comorbidities. Detailed hospital charge data were converted to cost by application of department-specific cost-to-charge ratios. Physician's fees were not included. A stepwise multiple regression analysis was computed to determine the predictors of total hospital cost. Median length of stay was 6 days (range, 1 to 63 days), and mortality was 3%. Median hospital cost per discharge was $4408 (range, $1199 to $59 799). Fifty percent of costs were for room charges, 19% for stroke evaluation, 21% for medical management, and 7% for acute rehabilitation therapies. Sixteen percent were admitted to an intensive care unit. Length of stay accounted for 43% of the variance in total cost. Other independent predictors of cost included stroke severity, heparin treatment, atrial fibrillation, male sex, ischemic cardiac disease, and premorbid functional status. We conclude that the major predictors of acute hospital costs of stroke in this environment are length of stay, stroke severity, cardiac disease, male sex, and use of heparin. Room charges accounted for the majority of costs, and attempts to reduce the cost of stroke evaluation would be of marginal value. Efforts to reduce acute costs should be monitored for potential cost shifting or a negative impact on quality of care.