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High rate of clinically relevant improvement following anatomical total shoulder arthroplasty for glenohumeral osteoarthritis

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World Journal of Orthopedics 2024年第2期15卷 156-162页

作者： marc randall Kristensen Nyring Bo Sanderhoff Olsen Alexander Amundsen Jeppe Vejlgaard Rasmussen Section for Shoulder and Elbow Surgery Department of Orthopaedic SurgeryHerlev and Gentofte University HospitalHellerup 2900Denmark

BACKGROUND The minimal clinically important difference(MCID)is defined as the smallest meaningful change in a health domain that a patient would identify as ***,an improvement that exceeds the MCID can be used to define a successful treatment for the individual *** To quantify the rate of clinical improvement following anatomical total shoulder arthroplasty for glenohumeral *** Patients were treated with the Global Unite total shoulder platform arthroplasty between march 2017 and February 2019 at Herlev and Gentofte Hospital,*** patients were evaluated preoperatively and 3 months,6 months,12 months,and 24 months postoperatively using the Western Ontario Osteoarthritis of the Shoulder index(WOOS),Oxford Shoulder Score(OSS)and Constant-Murley Score(CMS).The rate of clinically relevant improvement was defined as the proportion of patients who had an improvement 24 months postoperatively that exceeded the *** on previous literature,MCID for WOOS,OSS,and CMS were defined as 12.3,4.3,and 12.8 *** Forty-nine patients with a Global Unite total shoulder platform arthroplasty were included for the final *** age at the time of surgery was 66 years(range 49.0-79.0,SD:8.3)and 65%were *** patient was revised within the two years *** mean improvement from the preoperative assessment to the two-year follow-up was 46.1 points[95%confidence interval(95%CI):39.7-53.3,P<0.005]for WOOS,18.2 points(95%CI:15.5-21.0,P<0.005)for OSS and 37.8 points(95%CI:31.5-44.0,P<0.005)for *** years postoperatively,41 patients(87%)had an improvement in WOOS that exceeded the MCID,45 patients(94%)had an improvement in OSS that exceeded the MCID,and 42 patients(88%)had an improvement in CMS that exceeded the *** Based on three shoulder-specific outcome measures we find that approximately 90%of patients has a clinically relevant *** is a clear message when informing patients about the

关键词： Minimal clinically important difference Patient reported outcome measures Glenohumeral osteoarthritis Anatomical total shoulder arthroplasty Clinically relevant improvement

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Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： Jason Philip Appleton Lisa J Woodhouse Craig S Anderson Sandeep Ankolekar Lesley Cala Mark Dixon Timothy J England Kailash Krishnan Grant Mair Keith W Muir John Potter Christopher I Price marc randall Thompson G Robinson Christine Roffe Else C Sandset Jeffrey L Saver Angela Shone Aloysius Niroshan Siriwardena Joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS ALREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random

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The Effect of Signal Propagation Delay on the Measured Vibration in Planetary Gearboxes

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Journal of Dynamics, Monitoring and Diagnostics 2022年第1期1卷 9-18页

作者： marc Hilbert Wade A.Smith Robert B.randall LIACS Leiden UniversityRapenburg 702311 EZLeidenThe Netherlands School of Mechanical and Manufacturing Engineering University of New South WalesUNSWSydneyNSW2052Australia

Modulation of the gear mesh vibration is a major field of research for the condition monitoring of planetary *** modulation creates sidebands around the gearmesh frequency in the vibration spectrum,and the distribution of these sidebands has been researched in numerous *** publications on the subject assume that the effect of the time varying signal propagation delay between the main vibration source–the gear mesh point(s)–and the(usually fixed)transducer can be *** paper investigates the validity of this *** do so,a planetary gearbox with a transducer mounted on the(fixed)ring gear is studied,and the effect of the propagation delay is modelled as a phase modulation of the gear mesh *** expressions are then derived for the distribution and strength of the modulation sidebands,and these expressions are applied to quantify the effect of the propagation delay on five industrial *** results show that the amplitude of the sidebands is negligible and would not interfere with condition assessment based on analysis of the modulation of the gear mesh frequency,and thus the propagation delay can be neglected for practical purposes.

关键词： gear diagnostics phase modulation planetary gearbox propagation delay

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