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a b s t r a c tAseptic loosening is one of the main reasons for the revision of a total knee replacement (TKR). The design of the key component of a TKR, the femoral component, is particularly problematic because its failure can be the result of different causes. This makes the development of new biomaterials for use in the femoral component a challenging task. This paper focuses on the engineering design aspects in order to understand the limitations of current materials and design deficiencies. The paper describes the introduction of a new biomaterial for a femoral component and justifies the recommendation to use multi-functional materials as a possible solution to aseptic loosening. The potential advantages of applying functionally graded biomaterials (FGBMs) in prosthetic femur are explained by reducing the leading causes of failure including wear, micro-motion and stress-shielding effect. The ideas presented in this paper can be used as the basis for further research on the feasibility and advantages of applying FGBM in other superior implant designs.

The increasing demand for outpatient services has led to overcrowded clinics, long waiting times for patients, and extended staff working hours in outpatient clinics. Simulation tools have been used to ameliorate deficiencies in the appointment system, resource allocation, and patient flow management that are the root causes of these problems. Integrated studies that considered these three factors together produced better results than attempts to resolve individual causes. While simulation has proved to be an effective problem-solving tool for outpatient clinic management, there is still room for improvement. This paper reviews studies over the past 50 years that have applied management simulation to resolve outpatient clinic problems. OPSOMMINGDie toenemende vraag na buitepasiëntdienste het gelei tot oorlaaide klinieke, lang wagtye vir pasiënte en verlengde werksure vir personeel in buitepasiëntklinieke. Simulasie sagteware is gebruik om tekortkominge in die afspraakstelsel, hulpbron toekenning en pasiëntvloeibestuur (die hoof oorsake van hierdie probleme) te versag. Geïntegreerde studies, wat hierdie drie faktore gesamentlik in ag neem, het beter resultate gelewer as studies wat individuele gevalle probeer aanspreek het. Alhoewel simulasie 'n effektiewe probleemoplostegniek vir buitepasiëntkliniekbestuur is, is daar steeds ruimte vir verbetering. Hierdie artikel hersien navorsing (wat strek oor die laaste 50 jaar) wat bestuursimulasie toegepas het om buitepasiëntkliniek probleme aan te spreek.

This research, introduced the Malay-language version of the CMDQ (CMDQ-M) as the first formal validation of the CMDQ, and confirmed a high reliability and validity for the evaluation of musculoskeletal discomfort among the study population.