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Higher cost of arthroplasty for hip fractures in patients transferred from outside hospitals vs primary emergency department presentation

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World Journal of Orthopedics 2022年第8期13卷 725-732页

作者： emanuel c haug Hakan Pehlivan J Ryan Macdonell Wendy Novicoff James Browne Thomas Brown Quanjun cui Department of Orthopedic Surgery University of VirginiaCharlottesvilleVA 22908United States Department of Orthopedic Surgery Preferred Pediatric Orthopedic SurgeryRidgewoodNJ 07450United States Department of Orthopedic Surgery Asheville Orthopedic AssociatesAshevilleNC 28801United States

BAcKGROUND In 2016 centers for Medicare and Medicaid Services proposed bundled payments for hip fractures to improve the quality and decrease costs of care.Patients transferred from other facilities may be imposing a financial risk on the hospitals that accept these patients.AIM To determine the costs associated with patients that either presented to the emergency department or were transferred from another hospital or skilled nursing facility(SNF)with the diagnosis of a hip fracture requiring operative intervention.METHODS A retrospective single institution review was conducted for all arthroplasty patients from 2010 to 2015.Inclusion criteria included a total or partial hip replacement for a hip fracture.Exclusion criteria included pathologic,periprosthetic,and fracture non-union.Data was collected to compare total observed costs for patients from the emergency department,patients from skilled nursing facilities,and patients from an outside hospital.RESULTS A total of 223 patients met the inclusion criteria.135(60.54%)of these patients presented primarily to the emergency department,58 patients(26.01%)were transferred from an outside hospital,and 30 patients(13.43%)were transferred from a SNF.cost data analysis showed that outside hospital patients demonstrated significantly greater total cost for their hospitalization($43302)compared to emergency department patients($28875,P=0.000)and SNF patients($28282,P=0.000).cONcLUSION Patients transferred from an outside hospital incurred greater costs for their hospitalization than patients presenting from an emergency department or SNF.This is a strong argument for riskadjustment models when bundling payments for the care of hip fracture patients.

关键词： Total hip arthroplasty cost Transfer Outside hospital Hip fracture

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corrections in alpha angle following two different operative approaches for cAM-type femoral acetabular impingement-Ganz surgical hip dislocation vs anterior mini-open

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World Journal of Orthopedics 2020年第1期11卷 27-35页

作者： emanuel c haug Wendy M Novicoff Quanjun cui Department of Orthopedic Surgery University of Virginia School of Medicine

BAcKGROUND Femoroacetabular impingement(FAI)is a predisposing factor for secondary osteoarthritis of the hip joint.The two extensively described impingement mechanisms of FAI are cAM and Pincer-type.Initially managed conservatively,operative intervention should be offered to the persistently symptomatic patient.The measurement of the alpha angle is considered a standard method of assessing the severity of pathology in cam-type FAI on pre-operative plain radiographs.The radiological correction of the alpha angle has not been previously compared between different surgical approaches.We hypothesize that there is no difference in alpha angle correction between Ganz surgical hip dislocation and the anterior mini-open approach.AIM To compare the magnitude of alpha angle correction achieved by using the Ganz surgical hip dislocation and the anterior mini-open approach.METHODS This is a retrospective study assessing seventy-nine patients identified in a 5-year period.These patients had preoperative radiographic evidence of FAI and underwent surgery by a single surgeon at our institution,a tertiary care center.Patients with missing radiographic documentation,radiographs with insufficient quality which then precluded accurate measurement of the angleα,a diagnosed congenital condition,isolated type II pathology(Pincer),and history of prior surgery were excluded from the study.Either the Ganz surgical hip dislocation or the anterior mini open approach was used.Postoperative radiographic evaluation of the alpha angle between the two surgical methods was done and corrected for age and gender using two-sample t-tests and chi-square analyses.RESULTS A total of 79 patients met the inclusion and exclusion criteria.Forty-seven males(mean age of 35.3,range 16-53)and 32 females(mean age 36.7,range 16-60)were enrolled.Forty-seven patients underwent the anterior mini-open approach,and 32 underwent the Ganz surgical hip dislocation.There were no significant differences in age between the two surgical groups or in pre-and post-operative

关键词： Alpha angle Femoroacetabular impingement Ganz surgical hip dislocation Anterior mini-open

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God Time = Planck Time: Finally Detected! And Its Relation to Hubble Time

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Open Journal of Microphysics 2024年第2期14卷 40-66页

作者： Espen Gaarder haug Handelshø yskolen Norwegian University of Life Science &#197s Norway

Newton already mentioned indivisible time in Principia. In 1899, Max Planck derived a unique time period from three universal constants: G, c, and ħ, and today this is known as the Planck time. The Planck time is of the order of about 10−44 seconds while the best atomic clocks are down to 10−19 seconds. An approach has recently been outlined that puts an upper limit on the quantization of time to 10−33 seconds;this is, however, still far away from the Planck time. We demonstrate that the Planck time can easily be measured without any knowledge of any other physical constants. This is remarkable as this means we have demonstrated that the Planck time and therefore the Planck scale is real and detectable. It has taken more than 100 years to understand this. The reason for the breakthrough in Planck scale physics in recent years comes from understanding that G is a composite constant and that the true matter wavelength is the compton wavelength rather than the de Broglie wavelength. When this is understood, the mysteries of the Planck scale can be uncovered. In this paper, we also demonstrate how to measure the number of Planck events in a gravitational mass without relying on any constants. This directly relates to a new and simple method for quantizing general relativity theory that we also will shortly discuss.

关键词： Planck Time Fundamental Time Indivisible Time Newton Planck Length Quantum Gravity

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In vitro 3D malignant melanoma model for the evaluation of hypericin-loaded oil-in-water microemulsion in photodynamic therapy

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Bio-Design and Manufacturing 2022年第4期5卷 660-673页

作者： Hui LMa Wanlu Li Mian Wang Laudemir c.Varanda Janice R.Perussi Y.Shrike Zhang emanuel carrilho Instituto de Química de São carlos Universidade de São PauloUSPAv.Trabalhador São-carlenseSão CarlosSP 13566-590Brazil Instituto Nacional de ciência e Tecnologia de Bioanalítica INCTBioCampinasSP 13083-970Brazil Division of Engineering in Medicine Department of MedicineBrigham and Women’s HospitalHarvard Medical SchoolCambridgeMA 02139USA

Advances in biomimetic three-dimensional(3D) melanoma models have brought new prospects of drug screening and disease modeling, since their physiological relevancy for recapitulating in vivo tumor architectures is more accurate than traditional two-dimensional(2D) cell culture. Gelatin methacryloyl(GelMA) is widely used as a tissue-engineered scaffold hydrogel for 3D cell culture. In the present study, an in vitro 3D malignant melanoma model based on Gel MA was fabricated to evaluate the efficiency of hypericin(Hy)-loaded microemulsion(ME) in photodynamic therapy against melanoma. The ME was produced by the spontaneous emulsification method to enhance the bioavailability of Hy at tumor sites. Hy-loaded MEs were applied to a 3D malignant melanoma model made using 6% Gel MA and the co-culture of B16F10 and Balb/c 3T3 cells,followed by crosslinking using violet light(403 nm). The observation revealed excellent cell viability and the presence of F-actin cytoskeleton network. Hy-loaded MEs exhibited higher phototoxicity and cell accumulation(about threefold) than free Hy, and the cells cultured in the 3D system displayed lower susceptibility(about 2.5-fold) than those in 2D culture.These findings indicate that the developed MEs are potential delivery carriers for Hy;furthermore, Gel MA hydrogel-based modeling in polydimethylsiloxane(PDMS) molds is a user-friendly and cost-effective in vitro platform to investigate drug penetration and provide a basis for evaluating nanocarrier efficiency for skin cancer and other skin-related diseases.

关键词： Malignant melanoma 3D cell culture Hypericin Microemulsion Photodynamic therapy

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Quantum Gravitational Energy Simplifies Gravitational Physics and Gives a New Einstein Inspired Quantum Field Equation without G

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Journal of High Energy Physics, Gravitation and cosmology 2023年第3期9卷 626-653页

作者： Espen Gaarder haug Norwegian University of Life Sciences &Arings Norway

We show the simplest form with which one can express the gravity force, and that still gives all the same predictions of observable phenomena as does standard Newton gravity and general relativity theory. In addition, we show a new field equation that gives all the same predictions as general relativity theory, but that it is simpler as the only constant needed is the speed of light and that also gives quantum gravity. This new form to express gravity, through quantum gravitational energy, requires less constants to predict gravity phenomena than standard gravity theory. This alone should make the physics community interested in investigating this approach. It shows that gravitational energy, and other types of energy are a collision-length in their most complete and deepest form and that quantization of gravity is related to the reduced compton frequency of the gravitational mass per Planck time. While general relativity theory needs two constants to predict gravity phenomena, that is G and c, our new theory, based on gravity energy, only needs one constant, cg, that is easily found from gravitational observations with no prior knowledge of any constants. Further, we will show that, at the deepest quantum level, quantum gravity needs two constants, cg and the Planck length, while the standard formulation here needs c, h and lp. Thus our theory gives a reduction in constants and simpler formulas than does standard gravity theory. Most important we by this seems to have a fully consistent framework for quantum gravity.

关键词： Quantum Gravity Gravity Force Newton Gravity General Relativity Theory Gravitational Energy Gravity constant

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Understanding bark thickness variations for Araucaria angustifolia in southern Brazil

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Journal of Forestry Research 2021年第3期32卷 1077-1087页

作者： emanuel Arnoni costa Veraldo Liesenberg césar Augusto Guimaraes Finger AndréFelipe Hess cristine Tagliapietra Schons Graduate Program in Forest Engineering Santa Catarina State University(UDESC)LagesSC 88520-000Brazil Department of Forest Engineering Federal University of Uberlandia(UFU)Monte CarmeloMG 38500-000Brazil Graduate Program in Forest Engineering Federal University of Santa Maria(UFSM)Santa MariaRS 97105-900Brazil Graduate Program in Agroecosystems Federal Technological University of Parana(UFTPR)Dois VizinhosPR 85660-000Brazil

This study aimed to understand bark thickness variations of Araucaria angustifolia(Bertol.)Kuntze trees growing in natural forest remnants in southern Brazil,and their relationship with quantitative and qualitative attributes.Bark thickness must be accurately estimated in order to determine timber volume stocks.This is an important variable for the sustainable management and conservation of araucaria forests.In spite of its importance and visibility,bark thickness variations have not been evaluated for this key species in southern Brazil.A total of 104 trees were selected,and their qualitative and quantitative attributes such as diameter at breast height(D_(BH)),height(H),crown base height(c_(BH)),crown length(c_(L)),social position(S_(P)),stoniness(S_(T)),position on the relief(P_(R)),vitality(V_T)and branch arrangement(B_(A))were measured.The trees were categorized into two groups:red bark or gray bark.Regression analysis and artificial neural networks(ANN)were used for modelling bark thickness.The results indicate that:(1)bark thickness showed good correlation to D_(BH),with 0.76 as coefficient of determination(RS_P),0.540 as Mean Absolute Error(M_(AE))and 22.4 root-meansquare error in percentage(R_(MSE%));(2)the trend changed according to bark colour,with significant differences for the intersection(_0–Pr>F:p=0.0124)and slope(β_(1)–Pr>F:p=0.0126)of bark thickness curves between groups;(3)the highest correlation of bark thickness was found with:D_(BH)(ρ=0.88),H(ρ=0.58),c_(BH)(ρ=0.46),S_(P)(ρ=-0.52),and B_(A)(ρ=-0.32);(4)modelling with ANN confirmed high adjustment(R^(2)=0.99)and accuracy(R_(MSE%)=3.0)of the estimates.ANN is an efficient and robust technique for the modelling of various qualitative and quantitative attributes commonly used in forest mensuration.The effective use of ANN to estimate araucaria bark in natural forests reinforces its potential,besides the possibility of application for other forest species.

关键词： Dendrometry attributes crown characteristics Prediction models Bark factor Parana-pine

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National Lists of Scholarly Publication channels: An Overview and Recommendations for Their construction and Maintenance

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Journal of Data and Information Science 2021年第1期6卷 50-86页

作者： Janne Pölönen Raf Guns emanuel Kulczycki Gunnar Sivertsen Tim c.E.Engels Federation of Finnish Learned Societies Snellmaninkatu 1300170 HelsinkiFinland University of Antwerp Faculty of Social SciencesCentre for R&D Monitoring(ECOOM)Middelheimlaan 12020 AntwerpBelgium Adam Mickiewicz University Scholarly Communication Research GroupSzamarzewskiego 89c60-568 PoznańPoland Nordic Institute for Studies in Innovation Research and Education(NIFU)P.O.Box 28150608 TøyenOsloNorway

Purpose: This paper presents an overview of different kinds of lists of scholarly publication channels and of experiences related to the construction and maintenance of national lists supporting performance-based research funding systems. It also contributes with a set of recommendations for the construction and maintenance of national lists of journals and book publishers.Design/methodology/approach: The study is based on analysis of previously published studies, policy papers, and reported experiences related to the construction and use of lists of scholarly publication channels. Findings: Several countries have systems for research funding and/or evaluation, that involve the use of national lists of scholarly publication channels(mainly journals and publishers). Typically, such lists are selective(do not include all scholarly or non-scholarly channels) and differentiated(distinguish between channels of different levels and quality). At the same time, most lists are embedded in a system that encompasses multiple or all disciplines. This raises the question how such lists can be organized and maintained to ensure that all relevant disciplines and all types of research are adequately represented. Research limitation: The conclusions and recommendations of the study are based on the authors' interpretation of a complex and sometimes controversial process with many different stakeholders involved.Practical implications: The recommendations and the related background information provided in this paper enable mutual learning that may feed into improvements in the construction and maintenance of national and other lists of scholarly publication channels in any geographical context. This may foster a development of responsible evaluation practices.Originality/value: This paper presents the first general overview and typology of different kinds of publication channel lists, provides insights on expert-based versus metrics-based evaluation, and formulates a set of recommendations for the responsible construction and main

关键词： Publication channel lists Research funding Scholarly communication Journal ranking

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Isolation by phage display and characterization of a single-chain antibody specific for O^6-methyldeoxyguanosine

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chinese Science Bulletin 2001年第12期46卷 1024-1029页

作者： DAI Heping ZHAO Rouhong haug Brenda Sean M.Hemmingsen XIAO Wei Institute of Hydrobiology Chinese Academy of SciencesWuhan 430072China Plant Biotechnology Institute National Research Council of CanadaSaskatoonSK S7N OW9Canada Department of Microbiology and Immunology University of SaskatchewanSaskatoonSK S7N 5E5Canada

New approaches of making single chain Fv antibodies against O6-methyl-2’ -deoxyguanosine (O6MdG) have been demonstrated by using the phage antibody display system. Using O6MdG as an antigen, 21 positive clones were identified by ELISA from this library, one of which, designated H3, specifically binds to O6MdG with high affinity. The H3 scFv antibody has an affinity constant (Kaff) of 5.94×1011(mol/L)-1. H3 scFv has been successfully used to detect O6MdG in DNA hydrolyses from yeast or E. coli cells treated with a DNA methylating agent. To our knowledge, this is the first report of the selection of a specific scFv against DNA adducts. The results demonstrate the potential applications of the phage display technology for the detection of DNA lesions caused by mutagens and carcinogens.

关键词： O6-methyl-2’ -deoxyguanosine, phage display antibody, single chain Fv DNA adducts.

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Triose phosphate export from chloroplasts and cellular sugar content regulate anthocyanin biosynthesis during high light acclimation

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Plant communications 2023年第1期4卷 42-61页

作者： Max-emanuel Zirngibl Galileo Estopare Araguirang Anastasia Kitashova Kathrin Jahnke Tobias Rolka christine Kühn Thomas Nägele Andreas S.Richter University of Rostock Institute for BiosciencesPhysiology of Plant MetabolismAlbert-Einstein-Strasse 318059 RostockGermany Humboldt-Universit€at zu Berlin Institute of BiologyPhysiology of Plant Cell OrganellesPhilippstrasse 1310115 BerlinGermany Ludwig-Maximilians-Universit€at M€unchen Faculty of BiologyPlant Evolutionary Cell Biology82152 Planegg-MartinsriedGermany

Plants have evolvedmultiple strategies to cope with rapid changes in the environment.During high light(HL)acclimation,the biosynthesis of photoprotective flavonoids,such as anthocyanins,is induced.However,the exact nature of the signal and downstreamfactors forHL induction of flavonoid biosynthesis(FB)is still under debate.Here,we show that carbon fixation in chloroplasts,subsequent export of photosynthates by triose phosphate/phosphate translocator(TPT),and rapid increase in cellular sugar content permit the transcriptional and metabolic activation of anthocyanin biosynthesis during HL acclimation.In combination with genetic and physiological analysis,targeted and whole-transcriptome gene expression studies suggest that reactive oxygen species and phytohormones play only a minor role in rapid HL induction of the anthocyanin branch of FB.In addition to transcripts of FB,sugar-responsive genes showed delayed repression or induction in tpt-2 during HL treatment,and a significant overlapwith transcripts regulated by SNF1-related protein kinase 1(SnRK1)was observed,including a central transcription factor of FB.Analysis of mutants with increased and repressed SnRK1 activity suggests that sugar-induced inactivation of SnRK1 is required for HL-mediated activation of anthocyanin biosynthesis.Our study emphasizes the central role of chloroplasts as sensors for environmental changes as well as the vital function of sugar signaling in plant acclimation.

关键词： flavonoid biosynthesis acclimation sugar signaling high light anthocyanin SnRK1

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Reductio ad Absurdum: Modern Physics’ Incomplete Absurd Relativistic Mass Interpretation and the Simple Solution That Saves Einstein’s Formula

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Journal of Modern Physics 2018年第14期9卷 2623-2637页

作者： Espen Gaarder haug Norwegian University of Life Sciences &Aring s Norway

This paper discusses an absurdity that is rooted in the modern physics’ interpretation of Einstein’s relativistic mass formula when v is very close to c. Modern physics (and Einstein himself) claimed that the speed of a mass can never reach the speed of light. Yet at the same time they claim that it can approach the speed of light without any upper limit on how close it could get to that special speed. As we will see, this leads to some absurd predictions. If we assert that a material system cannot reach the speed of light, an important question is then, “How close can it get to the speed of light?” Is there a clear-cut boundary on the exact speed limit for an electron, as an example? Or must we settle for a mere approximation?

关键词： Relativistic Mass Maximum Velocity of Subatomic Particles Boundary condition haug Maximum Velocity

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