Omega System Performance Assessment

DTIC Science & Technology

1989-03-01

defined locally (i.e., a point 3-9 function of space and time), a weighted average of P(X 3) over the earth’s surface is taken to match the definition...operations which follow, product indicates set intersection and addition indicates set union . 3-10 Bi event that only station i is off-air, i = 1, 2...case, event X3 could not occur under any circumstances. By expressing the set universe as the union of all possible (mutually exclusive) B-events, it is

Ketorolac Administered in the Recovery Room for Acute Pain Management Does Not Affect Healing Rates of Femoral and Tibial Fractures.

PubMed

Donohue, David; Sanders, Drew; Serrano-Riera, Rafa; Jordan, Charles; Gaskins, Roger; Sanders, Roy; Sagi, H Claude

2016-09-01

To determine whether ketorolac administered in the immediate perioperative period affects the rate of nonunion in femoral and tibial shaft fractures. Retrospective comparative study. Single Institution, Academic Level 1 Trauma Center. Three hundred and thirteen skeletally mature patients with 137 femoral shaft (OTA 32) and 191 tibial shaft (OTA 42) fractures treated with intramedullary rod fixation. Eighty patients with 33 femoral shaft and 52 tibial shaft fractures were administered ketorolac within the first 24 hours after surgery (group 1-study group). Two-hundred thirty-three patients with 104 femoral shaft and 139 tibial shaft fractures were not (group 2-control group). Rate of reoperation for repair of a nonunion and time to union. Average time to union of the femur was 147 days for group 1 and 159 days for group 2 (P = 0.57). Average time to union of the tibia was 175 days for group 1 and 175 days for group 2 (P = 0.57). There were 3 femoral nonunions (9%) in group 1 and eleven femoral nonunions (11.6%) in group 2 (P = 1.00). There were 3 tibial nonunions (5.8%) in group 1 and 17 tibial nonunions (12.2%) in group 2 (P = 0.29). The average dose of ketorolac for patients who healed their fracture was 85 mg, whereas it was 50 mg for those who did not (P = 0.27). All patients with a nonunion in the study group were current smokers. Ketorolac administered in the first 24 hours after fracture repair for acute pain management does not seem to have a negative impact on time to healing or incidence of nonunion for femoral or tibial shaft fractures. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Tension Band Plating for Chronic Anterior Tibial Stress Fractures in High-Performance Athletes.

PubMed

Zbeda, Robert M; Sculco, Peter K; Urch, Ekaterina Y; Lazaro, Lionel E; Borens, Olivier; Williams, Riley J; Lorich, Dean G; Wellman, David S; Helfet, David L

2015-07-01

Anterior tibial stress fractures are associated with high rates of delayed union and nonunion, which can be particularly devastating to a professional athlete who requires rapid return to competition. Current surgical treatment strategies include intramedullary nailing, which has satisfactory rates of fracture union but an associated risk of anterior knee pain. Anterior tension band plating is a biomechanically sound alternative treatment for these fractures. Tension band plating of chronic anterior tibial stress fractures leads to rapid healing and return to physical activity and avoids the anterior knee pain associated with intramedullary nailing. Case series; Level of evidence, 4. Between 2001 and 2013, there were 13 chronic anterior tibial stress fractures in 12 professional or collegiate athletes who underwent tension band plating after failing nonoperative management. Patient charts were retrospectively reviewed for demographics, injury history, and surgical details. Radiographs were used to assess time to osseous union. Follow-up notes and phone interviews were used to determine follow-up time, return to training time, and whether the patient was able to return to competition. Cases included 13 stress fractures in 12 patients (9 females, 3 males). Five patients were track-and-field athletes, 4 patients played basketball, 2 patients played volleyball, and 1 was a ballet dancer. Five patients were Division I collegiate athletes and 7 were professional or Olympic athletes. Average age at time of surgery was 23.6 years (range, 20-32 years). Osseous union occurred on average at 9.6 weeks (range, 5.3-16.9 weeks) after surgery. Patients returned to training on average at 11.1 weeks (range, 5.7-20 weeks). Ninety-two percent (12/13) eventually returned to preinjury competition levels. Thirty-eight percent (5/13) underwent removal of hardware for plate prominence. There was no incidence of infection or nonunion. Anterior tension band plating for chronic tibial stress fractures provides a reliable alternative to intramedullary nailing with excellent results. Compression plating avoids the anterior knee pain associated with intramedullary nailing but may result in symptomatic hardware requiring subsequent removal. © 2015 The Author(s).

Rap system of stress stimulation can promote bone union after lower tibial bone fracture: a clinical research.

PubMed

Yao, Jian-fei; Shen, Jia-zuo; Li, Da-kun; Lin, Da-sheng; Li, Lin; Li, Qiang; Qi, Peng; Lian, Ke-jian; Ding, Zhen-qi

2012-01-01

Lower tibial bone fracture may easily cause bone delayed union or nonunion because of lacking of dynamic mechanical load. Research Group would design a new instrument as Rap System of Stress Stimulation (RSSS) to provide dynamic mechanical load which would promote lower tibial bone union postoperatively. This clinical research was conducted from January 2008 to December 2010, 92 patients(male 61/female 31, age 16-70 years, mean 36.3 years) who suffered lower tibial bone closed fracture were given intramedullary nail fixation and randomly averagely separated into experimental group and control group(according to the successively order when patients went for the admission procedure). Then researchers analysed the clinical healing time, full weight bearing time, VAS (Visual Analogue Scales) score and callus growth score of Lane-Sandhu in 3,6,12 months postoperatively. The delayed union and nonunion rates were compared at 6 and 12 months separately. All the 92 patients had been followed up (mean 14 months). Clinical bone healing time in experimental group was 88.78±8.80 days but control group was 107.91±9.03 days. Full weight bearing time in experimental group was 94.07±9.81 days but control group was 113.24±13.37 days respectively (P<0.05). The delayed union rate in 6 months was 4.3% in experimental group but 10.9% in control group(P<0.05). The nonunion rate in 12 months was 6.5% in experimental group but 19.6% in control group(P<0.05). In 3, 6, 12 months postoperatively, VAS score and Lane-Sandhu score in experimental group had more significantly difference than them in control group. RSSS can intermittently provide dynamic mechanical load and stimulate callus formation, promote lower tibial bone union, reduce bone delayed union or nonunion rate. It is an adjuvant therapy for promoting bone union after lower tibial bone fracture.

The Soviet Union and the Third World. Part 2: Agenda for the 1990s

DTIC Science & Technology

1984-01-01

1959, the year when Castro was in power but not yet a full-fledged Marxist-Leninist, and Felipe Pazos ran the economy. And after Costa Rica the most...of information is estimated to average 1 houj per response includig the time for revwirq Pn•[rucbi ns, aar et ng data sources a henng and maintaini...2 REPORT DATE 3 REPORT TYPE AND DATES COVERED a , Jan 84 Final: JANUARY 1984 4, TITLE AND SUBTITLE 5 FUNDING NUMBERS THE SOVIET UNION AND THE THIRD

Does age affect outcome in children with clavicle fracture treated conservatively? QuickDash and MRC evaluation of 131 consecutive cases.

PubMed

Pavone, Vito; DE Cristo, Claudia; Testa, Gianluca; Canavese, Federico; Lucenti, Ludovico; Sessa, Giuseppe

2018-04-12

Non-operative treatment with immobilization is the gold-standard for paediatric clavicular fractures. Purpose of this study is to evaluate functional outcomes and efficacy of non-operative treatment of clavicular fractures in a succession of 131 children. Between 2006 and 2012, we treated non-surgically 131 children for a clavicular fracture. All fractures have been classified according to Robinson classification. Clavicle shortening, range of movements and muscular strength through the Medical Research Council (MRC) scale were evaluated. To assess the outcomes, QuickDASH questionnaire, dividing the sample in 3 age-related group, was administered. The average follow-up was 26 months (8-84 months). Clavicle shortening at the time of injury occurred in 18 cases. All fractures reached union. Average time to union was 34 days. Mean time return to activity was 12.6 weeks. No cases of nonunion or delayed union were reported. Complications occurred in 21 cases. A shortening persisted in 2 cases. Only one patient had a slight functional restriction. Average QuickDASH score was 6.2±1.1 (range 4.3-9.4). All patients recovered to a MRC score of 5, except for one patient with a score of 4. Best QuickDASH scores were observed in the group aged under 8 years and in non-comminuted and lateral third fractures of the clavicle. Observing results, clavicle fractures have a satisfactory clinical healing as shown by the good scores at QuickDASH and MRC scale. Younger children under 8 years can achieve the best results with a conservative treatment in terms of bone healing and activity level.

The relationship between labor unions and safety in US airlines: Is there a "union effect?"

NASA Astrophysics Data System (ADS)

Zapf, Renee Catherine

Every airline union claims to work for safety and presents anecdotes where greater airline safety has been achieved through union efforts. The effect unionization has on safety outcomes in U.S. commercial airlines, however, wasn't found to be previously tested. Studies have shown that in industries such as coal mining, retail, and construction, unionization does lead to an increase in safety. This study evaluated the safety rates of 15 major US commercial airlines to compare the difference between unionized and non-unionized airlines. These safety rates were compared based on if and how long each airline's pilots and flight attendants have been unionized, to determine if unionization had an effect on safety outcomes. The 15 airlines included in the study identified as operating most of the years between 1990 and 2013, with annual departures averaging over 130,000, available through the Bureau of Transportation Statistics. Accident and Incident information was acquired through the National Transportation Safety Board database. The number of accident and incidents divided by the total departures at each airline was used as the safety rate. Union websites provided information on unionization at the airlines. Due to the complex nature of the aviation industry, a number of confounding factors could have affected the tests, including mergers, route structures, and legislation. To help control for these confounding factors, this study was limited to airlines with a stable presence in the industry over time, which limited the number of airlines included. No significant difference was found between unionized and non-unionized airlines in this study, though the mean safety rate of unionized airlines was found be better than non-unionized airlines. This study did not take into account safety improvements that were union-backed and eventually required at all airlines, regardless of unionization. Due to the large sample size of the small population the difference in safety rate means could be indicative of greater safety in unionized airlines.

Intramedullary knee arthrodesis as a salvage procedure after failed total knee replacement.

PubMed

Panagiotopoulos, E; Kouzelis, A; Matzaroglou, Ch; Saridis, A; Lambiris, E

2006-12-01

Septic and aseptic loosening with or without extensive bone loss after total knee replacement are the most common indications for knee fusion. Both external fixation and intramedullary nailing can be used for the treatment, though the latter appears to be the method of choice for most patients. Nine patients were treated after a total knee replacement failure using intramedullary nailing. A long intramedullary nail with a proximal interlocking screw was used in five cases, and a customised nail was used in four cases. Successful fusion occurred in eight of nine patients (89%). Average time for the joint union was 6.5 months, and average operative blood loss was 860 ml. In two patients, iliac crest and patellar bone graft were also used. In conclusion, intramedullary nailing can give excellent results in achieving knee fusion after a failed knee replacement as it allows early weight bearing and at the same time offers stability, pain relief, and a high rate of union, even though the surgical technique is demanding.

Corrective osteotomy for cubitus varus in middle-aged patients.

PubMed

Lim, Tae Kang; Koh, Kyoung Hwan; Lee, Do Kyung; Park, Min Jong

2011-09-01

We reviewed the results of corrective osteotomy for cubitus varus in middle-aged patients to investigate whether it is recommended in this age group. We studied 20 consecutive patients who underwent 3-dimensional corrective osteotomy at an average age of 47.9 years (range, 41-55 years). The osteotomy was fixed with single plating in 8 patients and with double plating in 12. The average follow-up was 23 months (range, 18-109 months). The average humerus-elbow-wrist angle improved from 21.4° (range, 15°-35°) varus to 8.7° (range, -4°-20°) valgus. Osseous union was radiographically demonstrated in all patients at an average of 17.5 weeks (range, 8-36 weeks). Delayed union of longer than 12 weeks was observed in 15 patients (75%). The average time to union in the single-plating group was 21.0 weeks compared with 15.1 weeks in the double-plating group (P = .012). Failure of fixation occurred in 2 patients who had single plating. The preoperative and postoperative arc of motion was similar. According to Oppenheim criteria, results were excellent in 10, good in 8, and poor in 2. The average final Mayo Elbow Performance Score was 90.3 points (range, 70-100 points). Cubitus varus in middle-aged patients can be treated by a closing wedge osteotomy and fixation with double plating. This provides satisfactory deformity correction, maintenance of the elbow motion, and good functional outcome, although healing of the osteotomy tends to be delayed. Copyright © 2011 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Minimally invasive plate osteosynthesis with locking compression plate for distal diametaphyseal tibia fracture.

PubMed

Shrestha, D; Acharya, B M; Shrestha, P M

2011-01-01

Distal diametaphyseal tibia fracture though requires operative treatment is difficult to manage. Conventional osteosynthesis is not suitable because distal tibia is subcutaneous bone with poor vascularity. Closed reduction and minimally invasive plate osteosynthesis (MIPO) with locking compression plate (LCP) has emerged as an alternative treatment option because it respects biology of distal tibia and fracture hematoma and also provides biomechanicaly stable construct. To find out suitability of MIPO with LCP for distal diametaphyseal tibia fracture including union time and complicatios and compare wih other available management options in literature. Twenty patients with closed distal diametaphyseal tibia fracture with or without intra articular extension (AO classification: 12 type 43A1, 4 type 43A2, 2 type 43A3 and 2 type 43B1) treated with MIPO with LCP were prospectively followed for average duration of 18.45 months (range 5-30 months). Average duration of injury-hospital and injury-surgery interval was 12.8 hrs (range 2-44 hrs) and 4.45 days (range 1-10 days) respectively. All fractures got united with an average duration of 18.5 weeks (range14-28weeks) except one case of delayed union which was managed with percutaneous bone marrow injection. Two patients had union with valgus angulation less than 5 degees but no nonunion was found. There were two superficial and one deep post operative wound infection. All infections healed with extended period of intravenous antibiotics besides repeated debridemet for deep infection. Implants were removed in eight patients among whom six (30%) had malleolar skin irritation and pain due to prominent hardware. The present case series shows that MIPO with LCP is an effective treatment method in terms of union time and complications rate for distal diametaphyseal tibia fracture. Malleolar skin irritation is common problem because of prominent hardware.

Low geomagnetic field intensity in the Matuyama Chron: palaeomagnetic study of a lava sequence from Afar depression, East Africa

NASA Astrophysics Data System (ADS)

Ahn, Hyeon-Seon; Kidane, Tesfaye; Yamamoto, Yuhji; Otofuji, Yo-ichiro

2016-01-01

Palaeointensity variation is investigated for an inferred time period spanning from 2.34 to 1.96 Ma. Twenty-nine consecutive lava flows are sampled along cliffs 350 m high generated by normal faulting on the Dobi section of Afar depression, Ethiopia. Magnetostratigraphy and K-Ar measurements indicate a lava sequence of R-N-R-N geomagnetic field polarities in ascending order; the lower normal polarity is identified as the Réunion Subchron. Reliability of palaeomagnetic data is ascertained through careful thermal demagnetization and by the reversal test. The Tsunakawa-Shaw method yielded 70 successful palaeointensity results from 24 lava flows and gave 11 acceptable mean palaeointensities. Reliability in palaeointensity data is ascertained by the similar values obtained by the IZZI-Thellier method and thus 11 reliable mean values are obtained from our combined results. After the older reverse polarity with the field intensity of 19.6 ± 7.8 μT, an extremely low palaeointensity period with an average of 6.4 μT is shown to occur prior to the Réunion Subchron. During the Réunion Subchron, the dipole field strength is shown to have returned to an average of 19.5 μT, followed by second extreme low of 3.6 μT and rejuvenation with 17.1 ± 5.3 μT in the younger reverse polarity. This `W-shape' palaeointensity variation is characterized by occurrences of two extremely weak fields lower than 8 μT prior to and during the Réunion Subchron and a relatively weak time-averaged field of approximately 15 μT. This feature is also found in sedimentary cores from the Ontong Java Plateau and the north Atlantic, indicative of a possibly global geomagnetic field phenomenon rather than a local effect on Ethiopia. Furthermore, we estimate a weak virtual axial dipole moment of 3.66 (±1.85) × 1022 Am2 during early stage of the Matuyama Chron (inferred time period of 2.34-1.96 Ma).

[Curative efficacies of mini-invasive percutaneous osteosynthesis versus supercutaneous plating for distal tibial fractures].

PubMed

He, Xianfeng; Zhu, Limei; Zhang, Jingwei; Li, Ming; Yu, Yihui

2014-12-30

To compare the clinical efficacies of mini-invasive percutaneous osteosynthesis (MIPO) versus supercutaneous plating with closed reduction in the treatment of distal tibial fractures. A total of 48 patients with close distal tibial fractures were treated between January 2010 and January 2012. The MIPO group included 16 males and 8 females with an average age of 36 years. And the types were A (n = 15), B (n = 6) and C (n = 3) according to the classification scheme of Association for the Study of Internal Fixation (AO/ASIF). The supercutaneous plating group also included 16 males and 8 females with an average age of 37 years. And the types were A (n = 15), B (n = 6) and C (n = 3). And the operative duration, hospital stay, union time, postoperative complications and function of ankle were compared between two groups. The mean follow-up period was 18.5 (12-26) months. There was no instance of nonunion, hardware breakdown or deep infection. Patients in supercutaneous plating group had significantly shorter mean operative duration, hospital stay and union time. Three patients and 1 patient in MIPO group presented with superficial infection and delayed union respectively while there was no occurrence in supercutaneous plating group. And the differences were not statistically significant. Fifteen patients (62.5%) complained of implant impingement or discomfort. And stripping occurred at an incidence of 15.6% during the removal time of locking screws in MIPO group. While in supercutaneous plating group, there as no complaint of skin irritation and removal of supercutaneous plate was easily performed without anesthesia. The mean AOFAS score was 90.7 ± 3.8 in supercutaneous plating group versus 88.9 ± 4.1 in MIPO group (P = 0.070). Distal tibia fractures may be treated successfully with MIPO or supercutaneous plating. However, supercutaneous plating offers multiple advantages in terms of mean operative duration, hospital stay, union time, skin irritation and implant removal.

[Comparative study on graft of autogeneic iliac bone and tissue engineered bone].

PubMed

Shen, Bing; Xie, Fu-lin; Xie, Qing-fang

2002-11-01

To compare the clinical results of repairing bone defect of limbs with tissue engineering technique and with autogeneic iliac bone graft. From July 1999 to September 2001, 52 cases of bone fracture were randomly divided into two groups (group A and B). Open reduction and internal fixation were performed in all cases as routine operation technique. Autogeneic iliac bone was implanted in group A, while tissue engineered bone was implanted in group B. Routine postoperative treatment in orthopedic surgery was taken. The operation time, bleeding volume, wound healing and drainage volume were compared. The bone union was observed by the X-ray 1, 2, 3, and 5 months after operation. The sex, age and disease type had no obvious difference between groups A and B. all the wounds healed with first intention. The swelling degree of wound and drainage volume had no obvious difference. The operation time in group A was longer than that in group B (25 minutes on average) and bleeding volume in group A was larger than that in group B (150 ml on average). Bone union completed within 3 to 7 months in both groups. But there were 2 cases of delayed union in group A and 1 case in group B. Repair of bone defect with tissue engineered bone has as good clinical results as that with autogeneic iliac bone graft. In aspect of operation time and bleeding volume, tissue engineered bone graft is superior to autogeneic iliac bone.

Retrograde intramedullary nail arthrodesis for avascular necrosis of the talus.

PubMed

Devries, J George; Philbin, Terrence M; Hyer, Christopher F

2010-11-01

Avascular necrosis (AVN) of the talus from any etiology is a devastating pathology. There are few salvage options available and controversy exists as to the surgical management for patients with talar AVN. The authors present their results of tibiotalocalcaneal arthrodesis with a retrograde nail. A comprehensive chart and radiographic review was pulled from our database for patients with AVN of the talus, who were treated by tibiotalocalcaneal fusion with retrograde intramedullary nail. Primary outcome was union, with time to clinical union as a secondary endpoint. Fourteen patients were included. The average age at surgery was 47.4 ± 12.8 years, there were nine female patients, and the average Body Mass Index was 33.5 ± 6.0. Surgical risk factors included two patients who smoked, one was diabetic, and one had a preoperative ulceration. The average time to partial weightbearing was 70.6 ± 25.4 days, and the average time to full weightbearing was 100.6 ± 35.5 days. Four patients had postoperative complications, while no patients required major revision surgery. Twelve patients went on to solid fusion, while two went on to a stable, braceable pseudoarthrosis. Eight patients were able to return to shoes, and eight were able to walk unaided at final followup. Salvage of talar AVN is possible by tibiotalocalcaneal arthrodesis with an intramedullary nail. Physicians may offer this as a salvage option to patients with a high likelihood of successful fusion.

Soft-plastic brace for lower limb fractures in patients with spinal cord injury.

PubMed

Uehara, K; Akai, M; Kubo, T; Yamasaki, N; Okuma, Y; Tobimatsu, Y; Iwaya, T

2013-04-01

Retrospective study at a rehabilitation center. Patients with spinal cord injury, even if they are wheelchair users, sometimes suffer from fractures of the lower limb bones. As their bones are too weak to have surgery, and because a precise reduction is not required for restoration, such patients are often indicated for conservative treatment. This case series study investigated the use of a hinged, soft-plastic brace as a conservative approach to treating fractures of the lower extremities of patients with spinal cord injury. National Rehabilitation Center, Japan. Fifteen patients (male, n=10; female, n=5; average age, 52.7 years) with 19 fractures of the femur or the tibia who were treated with a newly-developed hinged, soft-plastic brace were studied. All of them used wheelchairs. We analyzed the time taken for fracture union and for wearing orthotics, degree of malalignment, femorotibial angle and side effects. The fractures in this series were caused by relatively low-energy impact. The average time taken for fracture union was 80.1 (37-189) days, and the average amount of time spent wearing orthotics was 77.9 (42-197) days. On final X-ray imaging, the average femorotibial angle was 176.9° (s.d. ±8.90), and 15° of misalignment in the sagittal plane occurred in one patient. A hinged, soft-plastic brace is a useful option as a conservative approach for treating fractures of the lower extremities in patients with spinal cord injury.

Dynamic locked plating for fixation of distal femur fractures using near- cortical over-drilling: Preliminary results of a prospective observational study.

PubMed

Galal, Sherif

2017-01-01

Nonunion after locked plating of distal femur fractures is not uncommon. Authors wanted to assess if "Dynamic" locked plating using near-cortex over-Drilling technique would provide a mechanical environment the promotes callus formation, thereby avoiding non-union encountered when applying locked plates with the conventional method. This study was conducted at an academic Level 1 Trauma Center. This is a prospective study conducted from November 2015 to November 2016. Follow-up was 10 months on average (ranging from 8 to 12 months). The study included 20 patients with 20 fractures (13 males, 7 females). The average patients' age was 41.2 years (18-64 years). According to the Müller AO classification of distal femur fractures (33A-C) there were 15 cases with extra-articular fractures (AO 33A), 5 patients with intra-articular fractures (AO 33C). Dynamic Locked plating using near-cortical over-drilling technique was done for all patients. Two blinded observers assessed callus score on 6-week radiographs using a 4-point ordinal scale. A 2-tailed t -test. Two-way mixed intra-class correlation testing was performed to determine reliability of the callus measurements by the 2 observers. All patients achieved union, time to union was 13.4 weeks on average (range form 8-24 weeks). Delayed union was observed in 2 patients. The average callus score for fractures was 1.8 (SD 0.6). All fractures united in alignment except 1 fracture which united in valgus malalignment, the deformity was appreciated in the postoperative radiographs. No wound related complications, no loss of reduction, no catastrophic implant failure or screw breakage were detected. Dynamic locked plating using near-cortex over-drilling is a simple technique that uses standard locked plates that promotes callus formation when used for fixing distal femur fractures.

Knee arthrodesis as limb salvage for complex failures of total knee arthroplasty.

PubMed

Kuchinad, Raul; Fourman, Mitchell S; Fragomen, Austin T; Rozbruch, S Robert

2014-11-01

Patients with multiple failures of total knee arthroplasty (TKA) are challenging limb salvage cases. Twenty one patients over the last 10 years were referred to our service for knee fusion by arthroplasty surgeons who felt they were not candidates for revision TKA. Active infection was present in 76.2% and total bone loss averaged 6.6 cm. Lengthening was performed in 7/22 patients. Total time in Ilizarov frames was 9 months, with 93.3% union. Patients treated with IM fusion nails had 100% union. Average LLD increased from 3.6 to 4.5 cm following intervention, while those with concurrent lengthening improved to 1.6 cm. Findings suggest that bone loss and the soft-tissue envelope dictate knee fusion method, and multiple techniques may be needed. A treatment algorithm is presented. Copyright © 2014 Elsevier Inc. All rights reserved.

Treatment of femoral shaft fractures with monoaxial external fixation in polytrauma patients

PubMed Central

Testa, Gianluca; Aloj, Domenico; Ghirri, Alessandro; Petruccelli, Eraclite; Pavone, Vito; Massé, Alessandro

2017-01-01

Background: Femoral shaft fractures, typical in younger people, are often associated with polytrauma followed by traumatic shock. In these situations, despite intramedullary nailing being the treatment of choice, external fixation could be used as the definitive treatment. The aim of this study is to report evidence regarding definitive treatment of femoral shaft fractures with monoaxial external fixation. Methods: Between January 2006 and December 2015, 83 patients with 87 fractures were treated at the Department of Orthopaedics and Traumatology CTO of Turin, with a monoaxial external fixation device. Mean age at surgery, type of fracture, mean follow-up, time and modalities of treatment, non-weight bearing period, average healing, external fixation removal time, and complications were reported. Results: The average patient age was 31.43±15.19 years. In 37 cases (42.53%) the right femur was involved. 73 (83.91%) fractures were closed, and 14 (16.09%) were open. The average follow-up time was 61.07±21.86 weeks.  In 68 (78.16%) fractures the fixation was carried out in the first 24 hours, using a monoaxial external fixator. In the remaining 19 cases, the average delay was 6.80±4.54 days. Mean non-weight bearing time was 25.82±27.66 days (ranging from 0 to 120). The 87 fractures united at an average of 23.60±11.37 weeks (ranging from 13 to 102). The external fixator was removed after an average of 33.99±14.33 weeks (ranging from 20 to 120). Reported complications included 9.19% of delayed union, 1.15% of septic non-union, 5.75% of malunion, and 8.05% cases of loss of reduction. Conclusions: External fixation of femoral shaft fractures in polytrauma is an ideal method for definitive fracture stabilization, with minimal additional operative trauma and an acceptable complication rate. PMID:28928953

A comparative study of intramedullary interlocking nailing and minimally invasive plate osteosynthesis in extra articular distal tibial fractures.

PubMed

Daolagupu, Arup K; Mudgal, Ashwani; Agarwala, Vikash; Dutta, Kaushik K

2017-01-01

Extraarticular distal tibial fractures are among the most challenging fractures encountered by an orthopedician for treatment because of its subcutaneous location, poor blood supply and decreased muscular cover anteriorly, complications such as delayed union, nonunion, wound infection, and wound dehiscence are often seen as a great challenge to the surgeon. Minimally invasive plate osteosynthesis (MIPO) and intramedullary interlocking nail (IMLN) are two well-accepted and effective methods, but each has been historically related to complications. This study compares clinical and radiological outcome in extraarticular distal tibia fractures treated by intramedullary interlocking nail (IMLN) and minimally invasive plate osteosynthesis (MIPO). 42 patients included in this study, 21 underwent IMLN and 21 were treated with MIPO who met the inclusion criteria and operated between June 2014 and May 2015. Patients were followed up for clinical and radiological evaluation. In IMLN group, average union time was 18.26 weeks compared to 21.70 weeks in plating group which was significant ( P < 0.0001). Average time required for partial and full weight bearing in the nailing group was 4.95 weeks and 10.09 weeks respectively which was significantly less ( P < 0.0001) as compared to 6.90 weeks and 13.38 weeks in the plating group. Lesser complications in terms of implant irritation, ankle stiffness, and infection, were seen in interlocking group as compared to plating group. Average functional outcome according to American Orthopedic Foot and Ankle Society score was measured which came out to be 96.67. IMLN group was associated with lesser duration of surgery, earlier weight bearing and union rate, lesser incidence of infection and implant irritation which makes it a preferable choice for fixation of extra-articular distal tibial fractures. However, larger randomized controlled trials are required for confirming the results.

Arthrodesis of the knee with a long intramedullary nail following the failure of a total knee arthroplasty as the result of infection. Surgical technique.

PubMed

Bargiotas, Konstantinos; Wohlrab, David; Sewecke, Jeffrey J; Lavinge, Gregory; DeMeo, Patrick J; Sotereanos, Nicholas G

2007-03-01

Knee arthrodesis can be an effective treatment option for relieving pain and restoring some function after the failure of a total knee arthroplasty as the result of infection. The purpose of the present study was to review the outcome of a staged approach for arthrodesis of the knee with a long intramedullary nail after the failure of a total knee arthroplasty as the result of infection. We reviewed the results for twelve patients who underwent knee arthrodesis after the removal of a prosthesis because of infection. The study group included seven women and five men who had an average age of sixty-eight years at the time of the arthrodesis. All patients were managed with a staged protocol. Implant removal, débridement, and insertion of antibiotic cement spacers was followed by the administration of systemic antibiotics. Provided that clinical and laboratory data suggested eradication of the infection, arthrodesis of the affected knee with use of a long intramedullary nail was carried out. Clinical and laboratory evaluation and radiographic analysis were performed after an average duration of follow-up of 4.1 years. Solid union was achieved in ten of the twelve knees. The average time to union was 5.5 months. One patient had an above-the-knee amputation because of recurrence of infection. In another patient, nail breakage occurred three years following implantation. The average limb-length discrepancy was 5.5 cm. The mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score improved from 41 to 64 points. None of the seven patients who underwent arthrodesis with a technique involving convex-to-concave reamers had a complication, and the average time to union for these seven patients was shorter than that for the remaining five patients (4.3 compared with 7.4 months). We believe that obtaining large surfaces of bleeding contact bone during arthrodesis following staged treatment of an infection at the site of a failed total knee arthroplasty contributes to stability and enhances bone-healing. Staged arthrodesis with use of a long intramedullary nail and convex-to-concave preparation of bone ends provided a painless functional gait with low complication and reoperation rates in this challenging group of patients.

Arthrodesis of the knee with a long intramedullary nail following the failure of a total knee arthroplasty as the result of infection.

PubMed

Bargiotas, Konstantinos; Wohlrab, David; Sewecke, Jeffrey J; Lavinge, Gregory; Demeo, Patrick J; Sotereanos, Nicholas G

2006-03-01

Knee arthrodesis can be an effective treatment option for relieving pain and restoring some function after the failure of a total knee arthroplasty as the result of infection. The purpose of the present study was to review the outcome of a staged approach for arthrodesis of the knee with a long intramedullary nail after the failure of a total knee arthroplasty as the result of infection. We reviewed the results for twelve patients who underwent knee arthrodesis after the removal of a prosthesis because of infection. The study group included seven women and five men who had an average age of sixty-eight years at the time of the arthrodesis. All patients were managed with a staged protocol. Implant removal, débridement, and insertion of antibiotic cement spacers was followed by the administration of systemic antibiotics. Provided that clinical and laboratory data suggested eradication of the infection, arthrodesis of the affected knee with use of a long intramedullary nail was carried out. Clinical and laboratory evaluation and radiographic analysis were performed after an average duration of follow-up of 4.1 years. Solid union was achieved in ten of the twelve knees. The average time to union was 5.5 months. One patient had an above-the-knee amputation because of recurrence of infection. In another patient, nail breakage occurred three years following implantation. The average limb-length discrepancy was 5.5 cm. The mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score improved from 41 to 64 points. None of the seven patients who underwent arthrodesis with a technique involving convex-to-concave reamers had a complication, and the average time to union for these seven patients was shorter than that for the remaining five patients (4.3 compared with 7.4 months). We believe that obtaining large surfaces of bleeding contact bone during arthrodesis following staged treatment of an infection at the site of a failed total knee arthroplasty contributes to stability and enhances bone-healing. Staged arthrodesis with use of a long intramedullary nail and convex-to-concave preparation of bone ends provided a painless functional gait with low complication and reoperation rates in this challenging group of patients.

Epidemiology of injuries in English professional rugby union: part 1 match injuries

PubMed Central

Brooks, J; Fuller, C; Kemp, S; Reddin, D

2005-01-01

Objectives: To undertake a detailed, large scale epidemiological study of match injuries sustained by professional rugby union players in order to define their incidence, nature, severity, and causes. Methods: A two season prospective design was used to study match injuries associated with 546 rugby union players at 12 English Premiership clubs. Team clinicians reported all match injuries on a weekly basis and provided details of the location, diagnosis, severity, and mechanism of each injury. Match exposures for individual players were recorded on a weekly basis. Loss of time from training and match play was used as the definition of an injury. Results: The overall incidence of injury was 91 injuries/1000 player-hours, and each injury resulted on average in 18 days lost time. Recurrences, which accounted for 18% of injuries, were significantly more severe (27 days) than new injuries (16 days). Thigh haematomas were the most common injury for forwards and backs, but anterior cruciate ligament injuries for forwards and hamstring injuries for backs caused the greatest number of days absence. Contact mechanisms accounted for 72% of injuries, but foul play was only implicated in 6% of injuries. The ruck and maul elements of the game caused most injuries to forwards, and being tackled caused most injuries to backs. The hooker and outside centre were the playing positions at greatest risk of injury. Conclusions: On average, a club will have 18% of their players unavailable for selection as a consequence of match injuries. PMID:16183774

Diaphyseal forearm fractures, 20 years after surgical treatment. Is there still an indication for percutaneous fixation?

PubMed

Fernández-Marín, M R; Hidalgo-Pérez, M; Arias-Rodríguez, G; García-Mendoza, A; Prada-Chamorro, E; Domecq-Fernández de Bobadilla, G

This is a retrospective study of 98 diaphyseal forearm fractures in adults, treated by a percutaneous technique with intramedullar Kirchner wires. We reviewed 64 patients with 98 forearm fractures with a radiographic follow-up, assessing the presence of pseudarthrosis or delayed bone union and evaluating functional outcomes with the Anderson and the Disability of the Arm, Shoulder and Hand scale. Clinical and radiological bone union was achieved in an average of 12 weeks. We obtained 77% of excellent and good results following Anderson's scale. There were 4 cases of pseudarthrosis and 6 cases of delayed bone union. This surgical technique provides several advantages, such as a low incidence of complications and a total absence of infections, refractures and iatrogenic neurovascular injuries. It allows a lower hospital stay and a shortening of the surgery time compared with other techniques such as plates and intramedullary nails, that have similar results, in terms of bone union and functional outcomes, as we have verified from the published literature. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

Dynamic osteosynthesis by modified Kuntscher nail for the treatment of tibial diaphyseal fractures.

PubMed

Gadegone, Wasudeo M; Salphale, Yogesh S

2009-04-01

We evaluated a series of diaphyseal fractures of the tibia using low-cost, Indian-made modified Kuntscher nail (Daga nail) with the provision of distal locking screw for the management of the tibial diaphyseal fractures. One hundred and fifty one consecutive patients with diaphyseal fractures of tibia with 151 fractures who were treated by Daga nail were enrolled. One of the patients who had died because of cancer, and the two patients who were lost to follow-up at 3 months were excluded from the study.Therefore data of 148 patients with one hundred and fortyeight fractures is described. One hundred twenty closed fractures, 20 open Grade I fractures, and eight open Grade II fractures as per Gustilo and Anderson classification were included in this study. One hundred fourteen men and 34 women, with a mean age of 38.4 years, were studied. The result were analysed for Surgical time, duration of hospitalisation, union time, union rate, complication rate, functional recovery and crutch walking time. The fractures were followed at least until the time of solid union. The follow-up period averaged 15 months (range, 6-26 months). Union occurred in 140 cases (94.6%). The mean time to union was 13 weeks for closed fractures,17.8 weeks for Grade I open fractures, and 21.6 weeks for Grade II open fractures. Compartment syndrome occurred in two patients. Superficial infection occurred in five cases of Grade I and II compound fractures. Three closed fractures and one case of Grade I compound fracture required bone grafting for delayed union. Two cases of Grade II compound fracture with nonunion required revision surgery and bone grafting. Twelve cases resulted in acceptable malalignment due to operative technical error. In four cases, the distal screw breakage was seen, but none of these complications interfered with fracture healing. Recovery of joint motion was essentially normal in those patients without knee or ankle injury. Unreamed distally locked dynamic tibial nailing (modified Kuntscher nail/Daga nail) can produce excellent clinical results for diaphyseal tibial fractures. It has the advantages of technical simplicity, minimal cost, user-friendly instrumentation, and a short learning curve.

Treatment of segmental tibial fractures with supercutaneous plating.

PubMed

He, Xianfeng; Zhang, Jingwei; Li, Ming; Yu, Yihui; Zhu, Limei

2014-08-01

Segmental tibial fractures usually follow a high-energy trauma and are often associated with many complications. The purpose of this report is to describe the authors' results in the treatment of segmental tibial fractures with supercutaneous locking plates used as external fixators. Between January 2009 and March 2012, a total of 20 patients underwent external plating (supercutaneous plating) of the segmental tibial fractures using a less-invasive stabilization system locking plate (Synthes, Paoli, Pennsylvania). Six fractures were closed and 14 were open (6 grade IIIa, 2 grade IIIb, 4 grade II, and 2 grade I, according to the Gustilo classification). When imaging studies confirmed bone union, the plates and screws were removed in the outpatient clinic. Average time of follow-up was 23 months (range, 12-47 months). All fractures achieved union. Median time to union was 19 weeks (range, 12-40 weeks) for the proximal fractures and 22 weeks (range, 12-42 weeks) for the distal fractures. Functional results were excellent in 17 patients and good in 3. Delayed union of the fracture occurred in 2 patients. All patients' radiographs showed normal alignment. No rotational deformities and leg shortening were seen. No incidences of deep infection or implant failures occurred. Minor screw tract infection occurred in 2 patients. A new 1-stage protocol using supercutaneous plating as a definitive fixator for segmental tibial fractures is less invasive, has a lower cost, and has a shorter hospitalization time. Surgeons can achieve good reduction, soft tissue reconstruction, stable fixation, and high union rates using supercutaneous plating. The current patients obtained excellent knee and ankle joint motion and good functional outcomes and had a comfortable clinical course. Copyright 2014, SLACK Incorporated.

Anti-Radicalization Efforts within the European Union: Spain and Denmark

DTIC Science & Technology

2009-03-01

perhaps due to increased cognitive skills.158 Gaasholt and Togeby’s conclude that Intolerance among students is anchored in political beliefs going...NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited ANTI-RADICALIZATION...information is estimated to average 1 hour per response, including the time for reviewing instruction , searching existing data sources, gathering and

The service impact of failed locking plate fixation of distal tibial fractures: a service and financial evaluation at a major trauma centre.

PubMed

Kent, Michael; Mumith, Aadil; McEwan, Jo; Hancock, Nicholas

2015-12-01

The surgical treatment of distal tibial fractures is challenging and controversial. Recently, locking plate fixation has become popular, but the outcomes of this treatment are mixed with complication rates as high as 50 % in the published literature. There are no reports specifically relating to the financial and resource costs of failed treatment in the literature. Retrospective service analysis of patients who had undergone locking plate fixation of a distal third tibial fracture between 2008 and 2011 with at least 12 months follow-up. Rates of readmission, reoperation, bony union and infection were ascertained. The financial and resource (hospital stay and number of outpatient appointments) implications of failed treatment were calculated. Forty-two patients were identified. There were 31 type A fractures, one type B fracture and 10 type C fractures. Three injuries were open. Twenty patients were treated with minimally invasive percutaneous osteosynthesis (MIPO). The readmission and reoperation rates were 26 % (n = 11) and 19 % (n = 8), respectively. A total of 89 % of readmissions were due to infection. All patients had received appropriate antibiotic regimens. The average costs of successful and failed treatment were £ 5538 and £ 18,335, respectively. The average time to union was 24.5 weeks. The rate of non-union was 21 % (n = 9). The rate of infection was 28 % (n = 12), with all patients with open fracture incurring an infection. Tourniquet time had no effect on the incidence of complications. Smokers were more likely to incur a complication (p < 0.05), and non-union was lower in the MIPO group (p < 0.05). The length and total cost of inpatient care were significantly lower in the MIPO group (p < 0.05). MIPO patients were five times less likely to incur readmission or reoperation. Failed treatment was three times more expensive and four times longer than successful treatment. The study identified a large burden to the service following failure of locking plate treatment of these fractures, but the outcomes were similar to series published in the literature. Readmission rates were high following these injuries, and failed treatment was costly and had a significant impact on hospital resources. The implementation of major trauma networks and centralised subspecialised units should improve quality and value for money.

Contact events in rugby union and their propensity to cause injury

PubMed Central

Fuller, Colin W; Brooks, John H M; Cancea, Rebecca J; Hall, John; Kemp, Simon P T

2007-01-01

Objective The objective of this study was to determine the incidence of contact events in professional rugby union matches and to assess their propensity to cause injury. Design The study was a two‐season (2003/2004 and 2005/2006) prospective cohort design. It included 645 professional rugby union players from 13 English Premiership rugby union clubs. The main outcome measures were: incidence of match contact events (events per game); incidence (injuries per 1000 player‐hours and per 1000 contact events), risk (days lost per 1000 player‐hours and per 1000 contact events) and diagnosis of injury; referee's decision. Risk factors were player–player contact, position on pitch and period of play. Results Tackles (221.0 events/game) and rucks (142.5 events/game) were the most common events and mauls (13.6%) and scrums (12.6%) the most penalised. Tackles (701.6 days/1000 player‐hours) were responsible for the greatest loss of time but scrums (213.2 days lost/1000 events) and collisions (199.8 days lost/1000 events) presented the highest risk per event. Conclusions Tackles were the game event responsible for the highest number of injuries and the greatest loss of time in rugby union because they were by far the most common contact event. Collisions were 70% more likely to result in an injury than a tackle and scrums carried a 60% greater risk of injury than a tackle. The relative propensities for contact events to cause injury were rated as: lineout – very low; ruck – low; maul and tackle – average; collision and scrum – high. PMID:17513332

Contact events in rugby union and their propensity to cause injury.

PubMed

Fuller, Colin W; Brooks, John H M; Cancea, Rebecca J; Hall, John; Kemp, Simon P T

2007-12-01

The objective of this study was to determine the incidence of contact events in professional rugby union matches and to assess their propensity to cause injury. The study was a two-season (2003/2004 and 2005/2006) prospective cohort design. It included 645 professional rugby union players from 13 English Premiership rugby union clubs. The main outcome measures were: incidence of match contact events (events per game); incidence (injuries per 1000 player-hours and per 1000 contact events), risk (days lost per 1000 player-hours and per 1000 contact events) and diagnosis of injury; referee's decision. Risk factors were player-player contact, position on pitch and period of play. Tackles (221.0 events/game) and rucks (142.5 events/game) were the most common events and mauls (13.6%) and scrums (12.6%) the most penalised. Tackles (701.6 days/1000 player-hours) were responsible for the greatest loss of time but scrums (213.2 days lost/1000 events) and collisions (199.8 days lost/1000 events) presented the highest risk per event. Tackles were the game event responsible for the highest number of injuries and the greatest loss of time in rugby union because they were by far the most common contact event. Collisions were 70% more likely to result in an injury than a tackle and scrums carried a 60% greater risk of injury than a tackle. The relative propensities for contact events to cause injury were rated as: lineout--very low; ruck--low; maul and tackle--average; collision and scrum--high.

[Female nuptiality: the importance of consensual unions].

PubMed

Ojeda, N

1988-01-01

Mexico's National Demographic Survey of 1982 indicated that 58.4% of ever married women had been in marriages celebrated both civilly and religiously, 24.4% had been in civil marriages only, 3.0% had been in religious marriages only, and 14.2% had been in consensual unions. Transitions from 1 type of union to another by the same couple are very common, however. 53.6% of women began their conjugal lives in civil and religious marriages, 19.3% in civil marriages only, 2.3% in religious marriages only, and 24.6% in consensual unions. About 1/2 of consensual unions are eventually legalized, but the rate is lower in the less advantaged socioeconomic sectors which have a higher proportion of consensual unions. Corrected data show that only 7.5% of Mexican women remain single at the age of 45. The average age at 1st union is 21.4 years. Marriage patterns differ significantly in different social sectors. The proportion of women consensual unions varied from 16.1% for the new bourgeoisie, defined as administrators, technicians, high-level workers, and professional public officials, to over 30% for nonsalaried workers, peasants, and agricultural wage workers. Peasants, agricultural wage workers and nonagricultural nonsalaried workers had the lowest marriage ages and the highest proportion married by age 20. In the various proletarian groups, only 2.8-3.7% remained single at age 45, and 42.5%-51.3% were married or in union by age 20. Proletarian women had intermediate ages at 1st marriage. Women of the new bourgeoisie had the highest age at 1st union, 23 years, but the lowest proportion single at age 45, 1.8%. The traditional bourgeoisie and new bourgeoisie had the 2nd lowest age at 1st union, 21.9, and a proportion never married at age 45 that was similar to the national average. The proportion single at age 45 was highest among peasants and agricultural wage workers, reaching 11.3%.

The Persistent Gap: Understanding Male-Female Salary Differentials amongst Canadian Academic Staff. CAUT Equity Review. Number 5

ERIC Educational Resources Information Center

Canadian Association of University Teachers, 2011

2011-01-01

There has been a long-standing concern amongst policymakers, economists, and trade unions over the persistent earnings gap between men and women in the Canadian labour market. Although this gap has narrowed over time, women's average hourly wages still remain about 16% lower than that earned by men. The reasons for this inequality in male and…

Comparison of surgical techniques of 111 medial malleolar fractures classified by fracture geometry.

PubMed

Ebraheim, Nabil A; Ludwig, Todd; Weston, John T; Carroll, Trevor; Liu, Jiayong

2014-05-01

Evaluation of operative techniques used for medial malleolar fractures by classifying fracture geometry has not been well documented. One hundred eleven patients with medial malleolar fractures (transverse n = 63, oblique n = 29, vertical n = 7, comminuted n = 12) were included in this study. Seventy-two patients had complicating comorbidities. All patients were treated with buttress plate, lag screw, tension band, or K-wire fixation. Treatment outcomes were evaluated on the basis of radiological outcome (union, malunion, delayed union, or nonunion), need for operative revision, presence of postoperative complications, and AOFAS Ankle-Hindfoot score. For transverse fractures, tension band fixation showed the highest rate of union (79%), highest average AOFAS score (86), lowest revision rate (5%), and lowest complication rate (16%). For oblique fractures, lag screws showed the highest rate of union (71%), highest average AOFAS score (80), lowest revision rate (19%), and lowest complication rate (33%) of the commonly used fixation techniques. For vertical fractures, buttress plating was used in every case but 1, achieving union (whether normal or delayed) in all cases with an average AOFAS score of 84, no revisions, and a 17% complication rate. Comminuted fractures had relatively poor outcomes regardless of fixation method. The results of this study suggest that both tension bands and lag screws result in similar rates of union for transverse fractures of the medial malleolus, but that tension band constructs are associated with less need for revision surgery and fewer complications. In addition, our data demonstrate that oblique fractures were most effectively treated with lag screws and that vertical fractures attained superior outcomes with buttress plating. Level III, retrospective comparative series.

Distal tibial fractures and non-unions treated with shortened intramedullary nail.

PubMed

Megas, P; Zouboulis, P; Papadopoulos, A X; Karageorgos, A; Lambiris, E

2003-01-01

We reviewed 18 patients, 14 with acute fractures and four with non-union of the distal tibia, treated between 1990 and 2001 with a shortened, reamed intramedullary nail. The mean follow-up was 38 (8-144) months. The fractures united at an average of 16 (12-18) weeks and the non-unions at 20 (12-30) weeks. Two patients required nail dynamization. No limb shortening nor material failures were seen. All patients returned to normal daily activities. Although technically demanding, intramedullary nailing for distal tibial fractures and non-unions with a shortened nail represents a safe and reliable method.

75 FR 66298 - Prompt Corrective Action; Amended Definition of Low-Risk Assets

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-28

...,'' ``Investments,'' ``Low-risk assets,'' ``Average-risk assets,'' ``Loans sold with recourse,'' ``Unused MBL...-backed securities (``the distressed assets'') held in the investment portfolios of CCUs. In several cases... legally permissible investments for federal credit unions. For state-chartered credit unions, the NGNs are...

Separate Vertical Wirings for the Extra-articular Fractures of the Distal Pole of the Patella.

PubMed

Kim, Young Mo; Yang, Jun Young; Kim, Kyung Cheon; Kang, Chan; Joo, Yong Bum; Lee, Woo Yong; Hwang, Jung Mo

2011-12-01

To evaluate the usefulness of separate vertical wirings for extra-articular fracture of distal pole of patella. We have analyzed the clinical results of 18 cases that underwent separate vertical wirings for extra-articular fracture of distal pole of the patella from March 2005 to March 2010, by using the range of motion and Bostman score. Occurrence of complication was also evaluated. Additionally, by taking simple radiographs, the correlation between the postoperative degree of anterior transposition of bone fragment and the time of bone fusion, preoperative length of bone fragment, and occurrence of comminuted fracture were investigated. It took an average of 13.8 weeks for radiological bone union after separate vertical wiring fixation. Flexion contracture was an average of 0.8 degrees and further flexion was an average of 127.6°, and Bostman score was an average of 27.5 points (excellent in 12 cases, and good in 6 cases). On the first postoperative year, average flexion contracture was 0.6 degrees and further flexion was an average of 136.3°, which exhibited increased joint motion and recovery to normal range of motion, and Bostman score was an average of 28.7 points (excellent in 16 cases, and good in 2 cases). There was no statistically significant difference between the preoperative bone fragment length and presence of comminution, and degree of anterior transposition of bone fragment after fracture union on simple radiograph (p=0.175, p=0.146). We were able to obtain satisfactory clinical results, while preserving the bone fragment by separate vertical wiring fixation for extra-articular fracture of distal pole of patella. Moreover, the method is easy to perform, which is also considered as a useful surgical method for extra-articular fracture of distal pole of patella.

Predictors of Time to Union After Operative Fixation of Closed Ankle Fractures.

PubMed

Matson, Andrew P; Hamid, Kamran S; Adams, Samuel B

2017-08-01

Ankle fractures are common and represent a significant burden to society. We aim to report the rate of union as determined by clinical and radiographic data, and to identify factors that predict time to union. A cohort of 112 consecutive patients with isolated, closed, operative malleolar ankle fractures treated with open reduction and internal fixation was retrospectively reviewed for time to clinical union. Clinical union was defined based on radiographic and clinical parameters, and delayed union was defined by time to union >12 weeks. Injury characteristics, patient factors and treatment variables were recorded, and statistical techniques employed included the Chi-square test, the Student's T-test, and multivariate linear regression modeling. Forty-two (37.5%) of patients who achieved union did so in less than 12 weeks, and 69 (61.6%) of these patients demonstrated delayed union at a mean of 16.7 weeks (range, 12.1-26.7 weeks), and the remaining patient required revision surgery. Factors associated with higher rates of delayed union or increased time to union included tobacco use, bimalleolar fixation, and high energy mechanism (all p<0.05). In regression analysis, statistically significant negative predictors of time to union were BMI, dislocation of the tibiotalar joint, external fixation for initial stabilization and delay of definitive management (all p<0.05). Patient characteristics, injury factors and treatment variables are predictive of time to union following open reduction and internal fixation of closed ankle fractures. These findings should assist with patient counseling, and help guide the provider when considering adjunctive therapies that promote bone healing. Prognostic, Level IV: Case series.

Match-play activity profile in elite women's rugby union players.

PubMed

Suarez-Arrones, Luis; Portillo, Javier; Pareja-Blanco, Fernando; Sáez de Villareal, Eduardo; Sánchez-Medina, Luis; Munguía-Izquierdo, Diego

2014-02-01

The aim of this study was to provide an objective description of the locomotive activities and exercise intensity undergone during the course of an international-level match of female rugby union. Eight players were analyzed using global positioning system tracking technology. The total distance covered by the players during the whole match was 5,820 ± 512 m. The backs covered significantly more distance than the forwards (6,356 ± 144 vs. 5,498 ± 412 m, respectively). Over this distance, 42.7% (2,487 ± 391 m) was spent standing or walking, 35% jogging (2,037 ± 315 m), 9.7% running at low intensity (566 ± 115 m), 9.5% at medium intensity (553 ± 190 m), 1.8% at high intensity (105 ± 74 m), and 1.2% sprinting (73 ± 107 m). There were significant differences in the distance covered by forwards and backs in certain speed zones. Analysis of the relative distance traveled over successive 10-minute period of match play revealed that the greatest distances were covered during the first (725 ± 53 m) and the last (702 ± 79 m) 10-minute period of the match. The average number of sprints, the average maximum distance of sprinting, the average minimum distance of sprinting, and the average sprint distance during the game were 4.7 ± 3.9 sprints, 20.6 ± 10.5 m, 5.8 ± 0.9 -m, and 12.0 ± 3.8 m, respectively. There were substantial differences between forwards and backs. Backs covered greater total distance, distance in certain speed zones, and sprinting performance. The players spent 46.9 ± 28.9% of match time between 91 and 100% of maximum heart rate and experienced a large number of impacts (accelerometer data and expressed as g forces) during the game. These findings offer important information to design better training strategies and physical fitness testing adapted to the specific demands of female rugby union.

Epidemiology of injuries in English professional rugby union: part 2 training Injuries

PubMed Central

Brooks, J; Fuller, C; Kemp, S; Reddin, D

2005-01-01

Objectives: To undertake a detailed epidemiological study of training injuries sustained by professional rugby union players in order to define their incidence, nature, severity, and causes. Methods: A two season prospective design was used to study training injuries associated with 502 rugby union players at 11 English Premiership clubs. Team clinicians reported all training injuries on a weekly basis and provided details of the location, diagnosis, severity, and mechanism of each injury. Training exposures for individual players were recorded on a weekly basis. Loss of time from training and match play was used as the definition of an injury. Results: The overall incidence of injury was 2.0 per 1000 player-hours, and each injury resulted on average in 24 days lost time. Recurrences, which accounted for 19% of injuries, were more severe (35 days) than new injuries (21 days). Twenty two per cent of all training occurred during the preseason but 34% of all injuries were sustained in this period. Hamstring, calf, hip flexor/quadriceps, and adductor muscle injuries were the most common for backs, whereas hamstring, lateral ankle ligament, and lumbar disc/nerve root injuries predominated for forwards. Lumbar disc/nerve root, shoulder dislocation/instability, and hamstring muscle injuries for forwards and hamstring muscle and anterior cruciate ligament injuries for backs caused the greatest number of days absence. Running was the predominant cause of injury for both forwards and backs, although the overall incidence and severity of injuries sustained during skills training were significantly greater than those sustained during conditioning training. Conclusions: On average, a club will have 5% of their players unavailable for selection as a consequence of training injuries. PMID:16183775

Role of autologous non-vascularised intramedullary fibular strut graft in humeral shaft nonunions following failed plating.

PubMed

Kashayi-Chowdojirao, Sreekanth; Vallurupalli, Aashish; Chilakamarri, Vijay Krishna; Patnala, Chandrasekhar; Chodavarapu, Lalith Mohan; Kancherla, Nageswara Rao; Khazi Syed, Asif Hussain

2017-11-01

Non-union humeral shaft fractures are seen frequently in clinical practice at about 2-10% in conservative management and 30% in surgically operated patients. Osteosynthesis using dynamic compression plate (DCP), intramedullary nailing, locking compression plate (LCP), Ilizarov technique along with bone grafting have been reported previously. In cases of prior failed plate-screw osteosynthesis the resultant osteopenia, cortical defect, bone loss, scalloping around screws and metallosis, make the management of non-union more complicated. Fibular graft as an intramedullary strut is useful in these conditions by increasing screw purchase, union and mechanical stability. This study is a retrospective and prospective follow up of revision plating along with autologous non-vascularised intramedullary fibular strut graft (ANVFG) for humeral non-unions following failed plate osteosynthesis. Seventy eight cases of nonunion humeral shaft fractures were managed in our institute between 2008 and 2015. Of these, 57 cases were failed plate osteosynthesis, in which 15 cases were infected and 42 cases were noninfected. Out of the 78 cases, bone grafting was done in 55 cases. Fibular strut graft was used in 22 patients, of which 4 cases were of primary nonunion with osteoporotic bone. Applying the exclusion criteria of infection and inclusion criteria of failed plate osteosynthesis managed with revision plating using either LCP or DCP and ANVFG, 17 cases were studied. The mean age of the patients was 40.11 yrs (range: 26-57 yrs). The mean duration of non-union was 4.43 yrs (range: 0.5-14 yrs). The mean follow-up period was 33.41 months (range: 12-94 months). The average length of fibula was 10.7 cm (range: 6-15 cm). Main outcome measurements included bony union by radiographic assessment and pre- and postoperative functional evaluation using the DASH (Disabilities of the Arm, Shoulder and Hand) score. Results: Sixteen out of 17 fractures united following revision plating and fibular strut grafting. Average time taken for union was 3.5 months (range: 3-5 months). Complications included one each of implant failure with bending, transient radial nerve palsy and transient ulnar nerve palsy. No case had infection, graft site morbidity or peroneal nerve palsy. Functional assessment by DASH score improved from 59.14 (range: 43.6-73.21) preoperatively to 23.39 (range: 8.03-34.2) postoperatively (p = 0.0003). Conclusion: The results of our study indicate that revision plating along with ANVFG is a reliable option in humeral diaphyseal non-unions with failed plate-screw osteosynthesis providing adequate screw purchase, mechanical stability and high chances of union with good functional outcome.

Correction of clock errors in seismic data using noise cross-correlations

NASA Astrophysics Data System (ADS)

Hable, Sarah; Sigloch, Karin; Barruol, Guilhem; Hadziioannou, Céline

2017-04-01

Correct and verifiable timing of seismic records is crucial for most seismological applications. For seismic land stations, frequent synchronization of the internal station clock with a GPS signal should ensure accurate timing, but loss of GPS synchronization is a common occurrence, especially for remote, temporary stations. In such cases, retrieval of clock timing has been a long-standing problem. The same timing problem applies to Ocean Bottom Seismometers (OBS), where no GPS signal can be received during deployment and only two GPS synchronizations can be attempted upon deployment and recovery. If successful, a skew correction is usually applied, where the final timing deviation is interpolated linearly across the entire operation period. If GPS synchronization upon recovery fails, then even this simple and unverified, first-order correction is not possible. In recent years, the usage of cross-correlation functions (CCFs) of ambient seismic noise has been demonstrated as a clock-correction method for certain network geometries. We demonstrate the great potential of this technique for island stations and OBS that were installed in the course of the Réunion Hotspot and Upper Mantle - Réunions Unterer Mantel (RHUM-RUM) project in the western Indian Ocean. Four stations on the island La Réunion were affected by clock errors of up to several minutes due to a missing GPS signal. CCFs are calculated for each day and compared with a reference cross-correlation function (RCF), which is usually the average of all CCFs. The clock error of each day is then determined from the measured shift between the daily CCFs and the RCF. To improve the accuracy of the method, CCFs are computed for several land stations and all three seismic components. Averaging over these station pairs and their 9 component pairs reduces the standard deviation of the clock errors by a factor of 4 (from 80 ms to 20 ms). This procedure permits a continuous monitoring of clock errors where small clock drifts (1 ms/day) as well as large clock jumps (6 min) are identified. The same method is applied to records of five OBS stations deployed within a radius of 150 km around La Réunion. The assumption of a linear clock drift is verified by correlating OBS for which GPS-based skew corrections were available with land stations. For two OBS stations without skew estimates, we find clock drifts of 0.9 ms/day and 0.4 ms/day. This study salvages expensive seismic records from remote regions that would be otherwise lost for seismicity or tomography studies.

An evaluation of flexible intramedullary nail fixation in femoral shaft fractures in paediatric age group.

PubMed

Kumar, Sanjay; Roy, Sandip Kumar; Jha, Amrish Kumar; Chatterjee, Debdutta; Banerjee, Debabrata; Garg, Anant Kumar

2011-06-01

Sixty-two femoral shaft fractures in 60 patients treated by elastic intramedullary nailing with mean age of the patients being 9.2 years (range 5 years to 12 years) and average follow-up of 15 months (range 7 months to 60 months) are evaluated. Twenty-eight fractures were fixed with titanium elastic nail while 34 fractures were fixed with Enders nail. There were 40 midshaft fractures, 18 proximal femoral and 4 were fractures of distal third. Fracture patterns were transverse in 35, short oblique in 14 cases and 13 were spiral fractures. Mean age of union in this series was 17 weeks (range 12 weeks to 28 weeks). Ten cases had complications, 5 had nail tip irritation, 3 varus or valgus malalignment and 2 had delayed union. In this series, we did not have any non-union, refracture, limb length discrepancy or any major infection. The result demonstrates 100% union rate irrespective of the age, weight and height of the patient. Regardless of the site of fracture and their pattern, it united every time with elastic nail fixation. We did not find and mismatch in the results of fractures stabilised with titanium elastic nail with that of elastic stainless steel nail.

Star wars and strategic defense initiatives: work activity and health symptoms of unionized bank tellers during work reorganization.

PubMed

Seifert, A M; Messing, K; Dumais, L

1997-01-01

Work activity and health symptoms of bank tellers whose work was undergoing reorganization were examined during a university-union study of the health effects of work in women's traditional jobs. Data were gathered through collective and individual interviews, analysis of work activity, and a questionnaire administered to 305 tellers. Employees worked in a standing posture over 80 percent of the time. More than two-thirds frequently suffered pain in back, legs, and feet. The average teller had been involved in 3.7 robberies as a direct victim and six as a witness. Work required feats of memory and concentration. In order to meet job demands, tellers engaged in supportive activities and teamwork. The introduction of individualized objectives threatened the employees' ability to collaborate and induced distress. More than twice as many tellers as other female workers in Québec experience psychological distress (Ilfeld scale), related to: robbery during the past two years (odds ratio = 1.7; confidence interval = 1.0-2.9); difficult relations with superiors (O.R. = 2.6; C.I. = 1.3-5.3); and full-time work (O.R. = 2.3; C.I. = 1.3-3.9). Diverse methods enriched the analysis, and union participation allowed the proposal of concrete correction measures.

Tropospheric Ozone Increases over the Southern Africa Region: Bellwether for Rapid Growth in Southern Hemisphere Pollution?

NASA Technical Reports Server (NTRS)

Thompson, Anne M.; Balashov, Nikolay V.; Witte, J. C.; Coetzee, J. G. R.; Thouret, V.; Posny, F.

2014-01-01

Increases in free-tropospheric (FT) ozone based on ozonesonde records from the early 1990s through 2008 over two subtropical stations, Irene (near Pretoria, South Africa) and Réunion (21 deg. S, 55 deg. E; approx. 2800 km NE of Irene in the Indian Ocean), have been reported. Over Irene a large increase in the urban-influenced boundary layer (BL, 1.5-4 km) was also observed during the 18-year period, equivalent to 30%decade-1. Here we show that the Irene BL trend is at least partly due to a gradual change in the sonde launch times from early morning to the midday period. The FT ozone profiles over Irene in 1990-2007 are re-examined, filling in a 1995-1999 gap with ozone profiles taken during the Measurements of Ozone by Airbus In-service Aircraft (MOZAIC) project over nearby Johannesburg. A multivariate regression model that accounts for the annual ozone cycle, El Niño-Southern Oscillation (ENSO) and possible tropopause changes was applied to monthly averaged Irene data from 4 to 11 km and to 1992-2011 Réunion sonde data from 4 to 15 km. Statistically significant trends appear predominantly in the middle and upper troposphere (UT; 4-11 km over Irene, 4-15 km over Réunion) in winter (June-August), with increases 1 ppbv yr(exp. -1) over Irene and approx. 2 ppbv yr(exp. -1) over Réunion. These changes are equivalent to approx. 25 and 35-45%decade( exp. -1), respectively. Both stations also display smaller positive trends in summer, with a 45%decade(exp. -1) ozone increase near the tropopause over Réunion in December. To explain the ozone increases, we investigated a time series of dynamical markers, e.g., potential vorticity (PV) at 330-350 K. PV affects UT ozone over Irene in November-December but displays little relationship with ozone over Réunion. A more likely reason for wintertime FT ozone increases over Irene and Réunion appears to be long-range transport of growing pollution in the Southern Hemisphere. The ozone increases are consistent with trajectory origins of air parcels sampled by the sondes and with recent NOx emissions trends estimated for Africa, South America and Madagascar. For Réunion trajectories also point to sources from the eastern Indian Ocean and Asia.

Triple management of cubitus valgus deformity complicating neglected nonunion of fractures of lateral humeral condyle in children: a case series.

PubMed

Abed, Yasser; Nour, Khaled; Kandil, Yasser Roshdy; El-Negery, Abed

2018-02-01

Long standing nonunion of the lateral humeral condyle (LHC) usually results in elbow pain and instability with progressive cubitus valgus and tardy ulnar neuritis. Surgical treatment of long standing nonunion is still a controversial issue due to the reported complications, such as stiffness, loss of elbow motion, and avascular necrosis of the LHC fragment. In this study, we reported the outcomes of treatment of cubitus valgus deformity in long standing nonunion of the LHC in children treated with combined triple management (fixation of the nonunion site, dome corrective osteotomy, and anterior transposition of ulnar nerve) through a modified para-triceptal approach. We evaluated ten patients with cubitus valgus deformity more than 20 degrees after neglected nonunion of the lateral humeral condyle more than 24 months. Only childern with post-operative follow up more than 24 months were included in this study. All patients were evaluated clinically, radio logically, and by pre- and post-operative functional evaluation using Mayo elbow performance score. For evaluation of ulnar nerve affection, the Akahori's system was used. There were six females and four males with the average age of 7.7 years at operation. The left elbow was affected in six patients and the right elbow was affected in four patients. The average time between fracture of the LHC and operation was 40.3 months with average post-operative follow up of 44.3 months. The average carrying angle of the healthy side was 5.5 degrees and pre-operative carrying angle of the affected side was 33.5 degrees. The average post-operative carrying angle of the affected side was 6.1 degrees. The improvement of the carrying angle at the last follow up was found statistically significant (p < 0.05). All six patients that had pre-operative various degrees of ulnar nerve affection had completely improved at last follow up. The osteotomy site united in an average time of 43 days, whereas the LHC nonunion site united in an average time of 77.2 days. The osteotomy site united in significantly less time than the LHC non-union site (p < 0.05). The correlation between time since injury and time of union of LHC non-union site was significant (p < 0.05). Post-operative elbow range of motion was not changed in five patients, slightly decreased in four patients, and increased in one patient. Three patients had an average 6.7 degrees (range; 5-10) loss of the last degrees of flexion. One patient developed extension lag of 10 degrees. The mean elbow range of motion (ROM) pre-operatively was 139 ± 4.6 degrees while the mean post-operative ROM was 138 ± 5.3 degrees. The difference was found to be statistically insignificant (p > 0.05). The mean pre-operative Mayo elbow performance score was poor 55 ± 9.7, four patients had fair score, and six had poor score. The mean post-operative Mayo elbow performance score was excellent 92.5 ± 10, six patients had excellent score, and four had good score. The improvement of the Mayo score at the last follow up was found to be statistically significant (p < 0.05). No intra-operative complications were recorded during any of the procedures and no patient developed a wound or pin track infection post-operatively. At the last follow up, none of the patients had developed avascular necrosis of the LHC. Preservation of the blood supply of the nonunited fragment is the key to successful management. This combined technique successfully addresses different aspects of the problem simultaneously and provides a durable solution without deterioration of the results over time. The para-triceptal approach provided excellent exposure of both sides of the elbow with minimal disruption of the triceps muscle.

Arthrodesis with a short Huckstep nail as a salvage procedure for failed total knee arthroplasty.

PubMed

Lai, K A; Shen, W J; Yang, C Y

1998-03-01

Arthrodesis of the knee with use of a short Huckstep nail was performed in thirty-three patients (thirty-three knees) after failure of a non-constrained total knee arthroplasty. The indication for the arthrodesis was an infection in thirty-one knees and a Charcot joint in two. Three knees had had a failed attempt at arthrodesis with use of external fixation. The Huckstep nail was inserted through the knee, retrograde into the femur, and then antegrade into the tibia. The duration of the operation averaged 104 minutes (range, sixty-five to 155 minutes). Local bone graft was used in all knees. At the time of follow-up, at an average of forty-seven months (range, eighteen to ninety-four months), thirty knees (91 per cent) had radiographic evidence of union. The average time to union was 5.2 months (range, two to ten months) after the arthrodesis. Eight knees that had a grossly purulent infection were treated with debridement, which was followed by the arthrodesis as a second-stage procedure; the other knees had a one-stage arthrodesis. Only one of the thirty-one knees that had had an infection before the arthrodesis had a recurrence after it. Arthrodesis with a short Huckstep nail provides immediate axial and rotational stability and allows weight-bearing without use of external support as well as placement of the knee in a slightly flexed and valgus position. In addition, the nail does not migrate and it may be used even when there is a standard-size prosthesis in the ipsilateral hip.

Minimally invasive treatment of pilon fractures with a low profile plate: preliminary results in 17 cases.

PubMed

Borens, Olivier; Kloen, Peter; Richmond, Jeffrey; Roederer, Goetz; Levine, David S; Helfet, David L

2009-05-01

To determine the results of "biologic fixation" with a minimally invasive plating technique using a newly designed low profile "Scallop" plate in the treatment of pilon fractures. Retrospective case series. A tertiary referral center. Seventeen patients were treated between 1999 and 2001 for a tibial plafond fracture at the Hospital for Special Surgery with a newly designed low-profile plate. Eleven of the fractures (65%) were high-energy injuries. Two fractures were open. Staged surgical treatment with open reduction and fixation of the fibular fracture and application of an external fixator was performed in 12 cases. As soon as the soft tissues and swelling allowed, i.e. skin wrinkling, the articular surface was reconstructed and simply reduced, if necessary through an small incision, and the articular block was fixed to the diaphysis using a medially placed, percutaneously introduced flat scallop plate. In the remaining five cases the operation was performed in one session. Time to healing and complications including delayed union, non-union, instrument failure, loss of fixation, infection, quality of reduction and number of reoperations were evaluated. Quality of results and outcome were graded using the ankle-hindfoot-scale and a modified rating system. All patients went on to bony union at an average time of 14 weeks. There were no plate failures or loss of fixation/reduction. Two superficial wound-healing problems resolved with local wound care. At an average follow up of 17 months (range 6-29 months) eight patients (47%) had an excellent result; seven (41%) had a fair result whereas two (12%) had a poor result. The average ankle-hindfoot-score was 86.1 (range 61-100). Four patients have had the hardware removed and one of them is awaiting an ankle arthrodesis. Based on these initial results, it appears that a minimally invasive surgical technique including new low profile plate can decrease soft tissue problems while leading to fracture healing and obtaining results comparable with other more recent series. We believe that this new "Scallop Plate" is effective for the treatment of pilon fractures and should be used in conjunction with a staged procedure in the acute trauma setting.

Outcome Analysis following Operative Skeletal Stabilization in Established Non Unions of Malleolar Fractures - A Series of 11 Cases.

PubMed

Balasubramanian, Navin; Babu, Ganesh; Prakasam, Sindhuja

2015-01-01

Established non-unions pose a real nightmare for even the most accomplished surgeon. The variations in anatomy due to extensive fibrous tissue growth, soft tissue contractures around the fracture site and bony alterations like smoothening and sclerosis of the fracture ends must each be addressed as a whole if good outcome is to be expected. Here we present a series of 11 patients who had bimalleolar fracture of the ankle following which they had native splinting. These patients presented to us with established non-union. There were 7 males and 4 females in the study. The average age was 44.63 years. Ten out of the 11 patients went on to union (90.1%) following internal fixation with or without immobilization in a plaster cast at an average of 13.8 weeks (range 12-17 weeks). The remaining patient did not progress to union and was advised revision fixation but she refused. She was put on an ankle foot orthoses and mobilized with satisfactory results. There was no infection in any of the patients. Two patients had delayed wound healing with delayed suture removal at 18 days. Weight bearing was started at the end of 16 weeks in all the patients. All patients were assessed using the Karlsson and Peterson functional score for the ankle. Six patients had excellent outcome, 3 had good outcome, 2 had fair with one patient having poor functional result. We conclude that open reduction internal fixation +/- bone grafting provides excellent union rates and good functional results in even the most established non unions of bimalleolar fractures of the ankle.

Interlocking Nailing Versus Plating in Tibial Shaft Fractures in Adults: A Comparative Study.

PubMed

Mukherjee, Sagnik; Arambam, Mahendra Singh; Waikhom, Sanjib; Santosha; Masatwar, Pranav Vitthal; Maske, Rohan Gautam

2017-04-01

Tibial diaphyseal fractures are the commonest long bone fractures in adults, most commonly managed by intramedullary interlocking nailing. However, several meta-analysis show that locking plate osteosynthesis is equally effective in managing tibial diaphyseal fractures and are associated with less number of complications. To compare the results of fixation of tibial fractures following plating and nailing in terms of union, patient satisfaction and complications. A hospital based non randomized clinical trial was performed from September 2013 to August 2016 where closed or open diaphyseal or metaphyseo- diaphyseal fractures of the tibia (closed or open Gustilo Anderson type 1 through 3B) were included. Simple sequential allocation was used for allotting the patients to two groups, one for interlocking nailing and other for plating. The patients were followed up for clinical, radiographic and functional results. Forty patients with 41 involved limbs completed follow up for one year. The duration of surgery and average blood loss during surgery was 75.45±3.03 minutes and 165.00±5.31 ml respectively in case of nailing and 85.05±2.54 minutes and184.29±5.33 ml respectively in case of plating and their difference was statistically significant. In our study union was achieved in less than 20 weeks in 29 (70.8%) of the patients and 25-30 weeks in nine (22%) cases. The average time of union in our study was 19.55±0.69 weeks in case of interlocking nailing and 20.38±1.39 weeks in case of plating and there was no statistically significant difference between the two. However, there is statistically significant difference in the functional score in between the two groups in terms of Lower Extremity Functional Score (LEFS). Delayed union in one case of nailing and two cases of plating, valgus malunion in one case of nailing and joint stiffness in two cases each of nailing and plating were the major complications observed. There was no difference between the two modalities in terms of fracture union. Complications were lesser but more serious in case of plating. Patient satisfaction was more with plating.

Protecting Construction Worker Health and Safety in Ontario, Canada: Identifying a Union Safety Effect.

PubMed

Amick, Benjamin C; Hogg-Johnson, Sheilah; Latour-Villamil, Desiree; Saunders, Ron

2015-12-01

Do Ontario unionized construction firms have lower workers' compensation claims rates compared with nonunion firms? Building trade and construction trade association lists of union contractors were linked to Workplace Safety and Insurance Board claims data for 2006 to 2012. Data were pooled for 2006 to 2012, and negative binomial regressions conducted with adjustment to estimate a union safety effect. The sample included 5797 unionized and 38,626 nonunion construction firms. Total claims rates were 13% higher (1.13, 1.09 to 1.18) in unionized firms because of higher allowed no-lost-time claim rates (1.28, 1.23 to 1.34), whereas the lost-time claims rate was 14% lower (0.86, 0.82 to 0.91). Unionized construction firms compared with nonunion firms have higher no-lost-time and lower lost-time claims rates. Unionized firms may encourage occupational injury reporting and reduce risks through training and hazard identification and control strategies.

Water resources of Lincoln and Union counties, South Dakota

USGS Publications Warehouse

Niehus, C.A.

1994-01-01

Water resources of Lincoln and Union Counties occur as surface water in streams and lakes and ground water in ten major glacial and one major bedrock aquifers. The major surface-water sources are the Missouri and Big Sioux Rivers. Glacial aquifers contain about 4 million acre-feet of water in storage; 1.5 million acre-feet are contained in the Missouri aquifer. The Wall Lake, Shindler, and Upper Vemillion-Missouri aquifers are deeply buried, confined aquifers with average thicknesses ranging from 31 to 41 feet. The Harrisburg and Big Sioux aquifers are shallow, water-table aquifers with average thicknesses of 26 and 28 feet, respectively. The Parker-Centerville, Newton Hills, and Brule Creek aquifers are buried, confined aquifers with average thicknesses ranging from 33 to 36 feet. The Lower Vermillion-Missouri aquifer is a buried, confined aquifer with an average thickness of 99 feet. The Missouri aquifer is confined in the northeastern portion of the aquifer and is a shallow, water-table aquifer elsewhere with average cumulative thickness of 84 feet.

Shoulder reconstruction after tumor resection by pedicled scapular crest graft.

PubMed

Amin, Sherif N; Ebeid, Walid A

2002-04-01

The current authors present and evaluate a technique for reconstructing proximal humeral defects that result after resection of malignant bone tumors. Sixteen patients were included in this study with an average followup of 3 years (range, 12-76 months). Twelve patients had intraarticular resections, two had extraarticular resections, and two had intercalary resections. Reconstruction was done at the lateral border of the scapula (based on the circumflex scapular vessels) that was osteotomized and mobilized to bridge the resultant defect. Shoulder arthrodesis was done in 14 patients and the shoulder was spared in the two patients who had intercalary resections. Function was evaluated according to the Musculoskeletal Tumor Society scoring system. The average time for union of the graft proximally and distally was 6 months after which the graft started to hypertrophy. The average functional score was 22.5 points (75%) with a minimum score of 18 points (60%) and a maximum score of 27 points (90%). Nonunion of the distal host-graft junction occurred in two patients; both patients required iliac crest bone grafting and both achieved clinical and radiographic union without additional intervention. In three patients, the proximal fixation became loose but had no effect on function. The authors conclude that this technique is inexpensive, effective, and a durable reconstructive option for proximal humeral defects that are less than 15 cm. It has a predictable functional outcome (60%-90%) that is comparable with other reconstructive options.

Reconstruction of Extensive Soft-Tissue Defects with Concomitant Bone Defects in the Lower Extremity with the Latissimus Dorsi-Serratus Anterior-Rib Free Flap.

PubMed

Sia, Wei Tee; Xu, Germaine Guiqin; Puhaindran, Mark Edward; Tan, Bien Keem; Cheng, Mathew Hern Wang; Chew, Winston Yoon Chong

2015-07-01

The combined latissimus dorsi-serratus anterior-rib (LD-SA-rib) free flap provides a large soft-tissue flap with a vascularized bone flap through a solitary vascular pedicle in a one-stage reconstruction. Seven LD-SA-rib free flaps were performed in seven patients to reconstruct concomitant bone and extensive soft-tissue defects in the lower extremity (tibia, five; femur, one; foot, one). The patients were all male, with an average age of 34 years (range, 20-48 years). These defects were secondary to trauma in five patients and posttraumatic osteomyelitis in two patients. All flaps survived and achieved bony union. The average time to bony union was 9.4 months. Bone hypertrophy of at least 20% occurred in all flaps. All patients achieved full weight-bearing ambulation without aid at an average duration of 23.7 months. Two patients developed stress fractures of the rib flap. There was no significant donor site morbidity, except for two patients who had pleural tears during harvesting of the flap. The LD-SA-rib flap provides a large soft-tissue component and a vascularized bone flap for reconstruction of composite large soft-tissue defects with concomitant bone defects of the lower extremity in a one-stage procedure. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Minimally invasive plating osteosynthesis for mid-distal third humeral shaft fractures.

PubMed

Lian, Kejian; Wang, Lei; Lin, Dasheng; Chen, Zhiwen

2013-08-01

Mid-distal third humeral shaft fractures can be effectively treated with minimally invasive plating osteosynthesis and intramedullary nailing (IMN). However, these 2 treatments have not been adequately compared. Forty-seven patients (47 fractures) with mid-distal third humeral shaft fractures were randomly allocated to undergo either minimally invasive plating osteosynthesis (n=24) or IMN (n=23). The 2 groups were similar in terms of fracture patterns, fracture location, age, and associated injuries. Intraoperative measurements included blood loss and operative time. Clinical outcome measurements included fracture healing, radial nerve recovery, and elbow and shoulder discomfort. Radiographic measurements included fracture alignment, time to healing, delayed union, and nonunion. Functional outcome was satisfactory in both groups. Mean American Shoulder and Elbow Surgeons score and Mayo score were both better for the minimally invasive plating osteosynthesis group than for the IMN group (98.2 vs 97.6, respectively, and 93.5 vs 94.1, respectively; P<.001). Operative time was shorter and less intraoperative blood loss occurred in the minimally invasive plating osteosynthesis group than in the IMN group. Average time to union was similar in both groups. Primary union was achieved in 23 of 24 patients in the minimally invasive plating osteosynthesis group and in 22 of 23 in the IMN group. Minimally invasive plating osteosynthesis may have outcomes comparable with IMN for the management of mid-distal third humeral shaft fractures. Minimally invasive plating osteosynthesis is more suitable for complex fractures, especially for radial protection and motion recovery of adjacent joints, compared with IMN for simple fractures. Copyright 2013, SLACK Incorporated.

Attacking 22 entries in rugby union: running demands and differences between successful and unsuccessful entries.

PubMed

Tierney, P; Tobin, D P; Blake, C; Delahunt, E

2017-12-01

Global Positioning System (GPS) technology is commonly utilized in team sports, including rugby union. It has been used to describe the average running demands of rugby union. This has afforded an enhanced understanding of the physical fitness requirements for players. However, research in team sports has suggested that training players relative to average demands may underprepare them for certain scenarios within the game. To date, no research has investigated the running demands of attacking 22 entries in rugby union. Additionally, no research has been undertaken to determine whether differences exist in the running intensity of successful and unsuccessful attacking 22 entries in rugby union. The first aim of this study was to describe the running intensity of attacking 22 entries. The second aim of this study was to investigate whether differences exist in the running intensity of successful and unsuccessful attacking 22 entries. Running intensity was measured using meters per minute (m min -1 ) for (a) total distance, (b) running distance, (c) high-speed running distance, and (d) very high-speed running distance. This study provides normative data for the running intensity of attacking 22 entries in rugby union. Forwards achieved greater high-speed running intensity in successful (3.6 m min -1 ) compared to unsuccessful (1.8 m min -1 ) attacking 22 entries. Forwards should try and achieve greater high-speed running intensity in attacking 22 entries to increase the likelihood of successful outcomes during this period of gameplay. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Dissolution of first unions in Colombia, Panama, and Peru.

PubMed

Goldman, N

1981-11-01

An analysis of marital histories from World Fertility Survey data in Colombia, Panama, and Peru indicates a high level of union dissolution: the probabilities of a first union ending by separation within twenty years of the onset of union equal .27, .40, and .18 in the three countries respectively. Dissolution probabilities are especially high among women with young ages at first union and among women residing in urban areas. For all subgroups studied, consensual unions are characterized by several times the risk of separation of legal marriages. Consensual unions are especially frequent among women in rural areas, women with little education and women who enter unions at young ages. The different prevalence of consensual unions among the different subgroups affects the associations between union stability and various correlates so that it becomes essential to investigate the factors affecting union stability for both consensual unions and legal marriages. In spite of high dissolution rates, remarriage rates in all three countries are also high, as are the percentages of time spent in a union. Hence, the potential effects of voluntary disruption of unions on fertility appear to be modest.

Running demands and heart rate response in rugby union referees.

PubMed

Suarez-Arrones, Luis; Portillo, Luis J; García, Jose M; Calvo-Lluch, Africa; Roberts, Simon P; Mendez-Villanueva, Alberto

2013-11-01

The aim of this study was to examine the match physical demands and exercise intensity associated with men rugby union refereeing using global positioning system technology. Ten male rugby union referees (age, 37.1 ± 5.9 years; body mass, 83.7 ± 4.8 kg; height, 175.5 ± 6.2 cm) were analyzed 2-4 times during a total of 30 national level matches. The average total distance covered by the referees throughout the game was 6,322.2 ± 564.9 m. As a percentage of total distance, 37.3% (2,356.9 ± 291.3 m) was spent walking, 24.1% (1,524.4 ± 229.4 m) jogging, 10.4% (656.2 ± 130.7 m) running at low intensity, 17.6% (1,110.3 ± 212.2 m) at medium intensity, 5.5% (347.1 ± 27.1 m) at high intensity, and 5.2% (328.1 ± 230.3 m) at sprint. A significant decrease (p < 0.05) in running performance was observed between the first and the second halves in the last 3 speed zones. When the total distance traveled during consecutive 10-minute periods was compared, there was a significantly greater distance covered in the first 10 minutes of the game (876.3 ± 163 m) compared with 50-60 minutes (679.8 ± 117.6 m), 60-70 minutes (713.03 ± 122.3 m), and 70-80 minutes (694.2 ± 125.7 m; all p < 0.05). The average heart rate responses were similar (p > 0.05) in the first (157 ± 7 b · min; 85% HRmax) and second half (155 ± 7 b · min; 84% HRmax). This study provides evidence of reduced high-intensity running toward the end of the game. These findings offer important information to design better training strategies adapted to the requirements and demands of rugby union refereeing.

The ball in play demands of international rugby union.

PubMed

Pollard, Benjamin T; Turner, Anthony N; Eager, Robin; Cunningham, Daniel J; Cook, Christian J; Hogben, Patrick; Kilduff, Liam P

2018-03-03

Rugby union is a high intensity intermittent sport, typically analysed via set time periods or rolling average methods. This study reports the demands of international rugby union via global positioning system (GPS) metrics expressed as mean ball in play (BiP), maximum BiP (max BiP), and whole match outputs. Single cohort cross sectional study involving 22 international players, categorised as forwards and backs. A total of 88 GPS files from eight international test matches were collected during 2016. An Opta sportscode timeline was integrated into the GPS software to split the data into BiP periods. Metres per min (mmin -1 ), high metabolic load per min (HML), accelerations per min (Acc), high speed running per min (HSR), and collisions per min (Coll) were expressed relative to BiP periods and over the whole match (>60min). Whole match metrics were significantly lower than all BiP metrics (p<0.001). Mean and max BiP HML, (p<0.01) and HSR (p<0.05) were significantly higher for backs versus forwards, whereas Coll were significantly higher for forwards (p<0.001). In plays lasting 61s or greater, max BiP mmin -1 were higher for backs. Max BiP mmin -1 , HML, HSR and Coll were all time dependant (p<0.05) showing that both movement metrics and collision demands differ as length of play continues. This study uses a novel method of accurately assessing the BiP demands of rugby union. It also reports typical and maximal demands of international rugby union that can be used by practitioners and scientists to target training of worst-case scenario's equivalent to international intensity. Backs covered greater distances at higher speeds and demonstrated higher HML, in general play as well as 'worst case scenarios'; conversely forwards perform a higher number of collisions. Copyright © 2018 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Spontaneous abortions and reproductive selection mechanisms in the rubber and leather industry in Finland

PubMed Central

Hemminki, K; Niemi, Marja-Liisa; Kyyrönen, P; Kilpikari, I; Vainio, H

1983-01-01

ABSTRACT Spontaneous abortions in hospitals were analysed from two sources—membership files of the Union of Rubber and Leather Workers (about 10 000 women) and records of the personnel of a rubber factory (about 1600 women). Two frequencies of spontaneous abortions were calculated for each population analysed: rate (No spontaneous abortions X 100/No pregnancies) and ratio (No spontaneous abortions X 100/No births). The two frequencies were increased for all union members compared with all Finnish women. The frequencies, however, did not appreciably differ when the pregnancies occurred during union membership as compared with the pregnancies before or after membership. The frequency of spontaneous abortions was higher for the short-time union members than for those employed for longer periods, but the increased frequency did not correlate with union membership. The employees of a rubber factory had slightly fewer spontaneous abortions on average than the community population. The women employed in the rubber factory for three to 23 months were found to have appreciably higher frequencies of spontaneous abortions than the women employed for longer periods. The present study showed the feasibility of using cases of spontaneous abortions in hospitals in an occupational study with longitudinal employment data. Women with short periods of employment appeared to have more spontaneous abortions than those with longer periods of employment suggesting the presence of selection mechanisms, perhaps with some analogies to the “healthy worker effect” in occupational mortality studies. The presence of such selection mechanisms deserve serious consideration in occupational reproductive epidemiology. PMID:6824605

The worst case scenario: Locomotor and collision demands of the longest periods of gameplay in professional rugby union

PubMed Central

Reardon, Cillian; Tobin, Daniel P.; Tierney, Peter; Delahunt, Eamonn

2017-01-01

A number of studies have used global positioning systems (GPS) to report on positional differences in the physical game demands of rugby union both on an average and singular bout basis. However, the ability of these studies to report quantitative data is limited by a lack of validation of certain aspects of measurement by GPS micro-technology. Furthermore no study has analyzed the positional physical demands of the longest bouts of ball-in-play time in rugby union. The aim of the present study is to compare the demands of the single longest period of ball-in-play, termed “worst case scenario” (WCS) between positional groups, which have previously been reported to have distinguishable game demands. The results of this study indicate that WCS periods follow a similar sporadic pattern as average demands but are played at a far higher pace than previously reported for average game demands with average meters per minute of 116.8 m. The positional differences in running and collision activity previously reported are perpetuated within WCS periods. Backs covered greater total distances than forwards (318 m vs 289 m), carried out more high-speed running (11.1 m·min-1 vs 5.5 m·min-1) and achieved higher maximum velocities (MaxVel). Outside Backs achieved the highest MaxVel values (6.84 m·sec-1). Tight Five and Back Row forwards underwent significantly more collisions than Inside Back and Outside Backs (0.73 & 0.89 collisions·min-1 vs 0.28 & 0.41 collisions·min-1 respectively). The results of the present study provide information on the positional physical requirements of performance in prolonged periods involving multiple high intensity bursts of effort. Although the current state of GPS micro-technology as a measurement tool does not permit reporting of collision intensity or acceleration data, the combined use of video and GPS provides valuable information to the practitioner. This can be used to match and replicate game demands in training. PMID:28510582

The worst case scenario: Locomotor and collision demands of the longest periods of gameplay in professional rugby union.

PubMed

Reardon, Cillian; Tobin, Daniel P; Tierney, Peter; Delahunt, Eamonn

2017-01-01

A number of studies have used global positioning systems (GPS) to report on positional differences in the physical game demands of rugby union both on an average and singular bout basis. However, the ability of these studies to report quantitative data is limited by a lack of validation of certain aspects of measurement by GPS micro-technology. Furthermore no study has analyzed the positional physical demands of the longest bouts of ball-in-play time in rugby union. The aim of the present study is to compare the demands of the single longest period of ball-in-play, termed "worst case scenario" (WCS) between positional groups, which have previously been reported to have distinguishable game demands. The results of this study indicate that WCS periods follow a similar sporadic pattern as average demands but are played at a far higher pace than previously reported for average game demands with average meters per minute of 116.8 m. The positional differences in running and collision activity previously reported are perpetuated within WCS periods. Backs covered greater total distances than forwards (318 m vs 289 m), carried out more high-speed running (11.1 m·min-1 vs 5.5 m·min-1) and achieved higher maximum velocities (MaxVel). Outside Backs achieved the highest MaxVel values (6.84 m·sec-1). Tight Five and Back Row forwards underwent significantly more collisions than Inside Back and Outside Backs (0.73 & 0.89 collisions·min-1 vs 0.28 & 0.41 collisions·min-1 respectively). The results of the present study provide information on the positional physical requirements of performance in prolonged periods involving multiple high intensity bursts of effort. Although the current state of GPS micro-technology as a measurement tool does not permit reporting of collision intensity or acceleration data, the combined use of video and GPS provides valuable information to the practitioner. This can be used to match and replicate game demands in training.

Treatment of posterior cruciate ligament tibial avulsion by a minimally-invasive open posterior approach.

PubMed

Abdallah, Ahmed Abdelbadie; Arafa, Mohammed S

2017-07-01

To assess the surgical technique and report the outcomes following fixation of PCL bony avulsions through mini-invasive posterior knee approach as described by Burks and Schaffer. From June 2012 to July 2015, 27 patients enrolled in the study (21 males and 6 females). Fixation of tibial PCL avulsion fractures was done with one or two cannulated screws, or sutures through Burks and Schaffer's approach. The mean interval before surgery was 16days (1-70) .Patients was followed up for an average of 51 weeks. The outcome measures evaluated at final follow-up were (1) clinical stability as assessed by posterior drawer test, (2) radiologic union, (3) functional assessment by Lysholm score, and (4) gastrocnemius muscle strength as a measure of morbidity. Average operative time was 43min. Improvement of both subjective Lysholm score (mean 93) and objective stability testing by posterior drawer test (returns to normal in 81.1% of patients) at the final follow-up. Good radiographic union at average of 5.6 weeks. No morbidity of the gastrocnemius with few complications. The approach was fast and safe with excellent visualization. It allows surgeons to address other injuries in the same setting. It can be considered as a minimally-invasive open surgery without surgery-related morbidity. It is a reproducible technique that can be done at any trauma centre by surgeons with average experience. The subjective and objective results of the technique are excellent and comparable to the arthroscopic procedures that needs more specific centres with well-trained surgeons. Copyright © 2017 Elsevier Ltd. All rights reserved.

Fractures of the distal tibia treated with polyaxial locking plating.

PubMed

Gao, Hong; Zhang, Chang-Qing; Luo, Cong-Feng; Zhou, Zu-Bin; Zeng, Bing-Fang

2009-03-01

We evaluated the healing rate, complications, and functional outcomes in 32 adult patients with very short metaphyseal fragments in fractures of the distal tibia treated with a polyaxial locking system. The average distance from the distal extent of the fracture to the tibial plafond was 11 mm. All fractures healed and the average time to union was 14 weeks. Six patients (19%) reported occasional local disturbance over the medial malleolus. There were two cases of postoperative superficial infections and evidence of delayed wound healing. Using the American Orthopaedic Foot and Ankle Society ankle score, the average functional score was 87.3 points (of 100 total possible points). Our results show the polyaxial locking plates, which offer more fixation versatility, may be a reasonable treatment option for distal tibia fractures with very short metaphyseal segments.

The use of low-intensity pulsed ultrasound in treating delayed union of fifth metatarsal fractures.

PubMed

Teoh, Kar Hao; Whitham, Robert; Wong, Jenny F; Hariharan, Kartik

2018-01-31

There are no studies looking at the success rate of low-intensity pulsed ultrasound (LIPUS) in fifth metatarsal fracture delayed unions to our knowledge. The aim of this study is to investigate the use of LIPUS treatment for delayed union of fifth metatarsal fractures. A retrospective review of patients who were treated with LIPUS following a delayed union of fifth metatarsal fracture was conducted over a three-year period. There were thirty patients (9 males, 21 females) in this cohort. The average age was 39.3 years. Type 2 fractures made up 43% of our cohort. Twenty-seven (90%) patients went on to progress to union clinically and radiologically following LIPUS treatment. Smoking (p=0.014) was predictive of non-union. Assuming that there were 10 delayed unions a year and 6 went on to non-union as previously suggested by a systematic review, the cost savings of using LIPUS (90% success rate; 10 LIPUS machine and surgery for 1 non-union) vs operative intervention (surgery for 6 non-union) equates to a cost saving of £7765 a year. There is a role for the use of LIPUS in delayed union of fifth metatarsal fractures and can serve as an adjunct prior to consideration of surgery. The findings of this study also suggest the use of LIPUS to be a cost effective treatment modality compared to surgical management. Level 4. Copyright © 2018 Elsevier Ltd. All rights reserved.

Surgical treatment of refractory tibial stress fractures in elite dancers: a case series.

PubMed

Miyamoto, Ryan G; Dhotar, Herman S; Rose, Donald J; Egol, Kenneth

2009-06-01

Treatment of tibial stress fractures in elite dancers is centered on rest and activity modification. Surgical intervention in refractory cases has important implications affecting the dancers' careers. Refractory tibial stress fractures in dancers can be treated successfully with drilling and bone grafting or intramedullary nailing. Case series; Level of evidence, 4. Between 1992 and 2006, 1757 dancers were evaluated at a dance medicine clinic; 24 dancers (1.4%) had 31 tibial stress fractures. Of that subset, 7 (29.2%) elite dancers with 8 tibial stress fractures were treated operatively with either intramedullary nailing or drilling and bone grafting. Six of the patients were followed up closely until they were able to return to dance. One patient was available only for follow-up phone interview. Data concerning their preoperative treatment regimens, operative procedures, clinical union, radiographic union, and time until return to dance were recorded and analyzed. The mean age of the surgical patients at the time of stress fracture was 22.6 years. The mean duration of preoperative symptoms before surgical intervention was 25.8 months. Four of the dancers were male and 3 were female. All had failed nonoperative treatment regimens. Five patients (5 tibias) underwent drilling and bone grafting of the lesion, and 2 patients (3 tibias) with completed fractures or multiple refractory stress fractures underwent intramedullary nailing. Clinical union was achieved at a mean of 6 weeks and radiographic union at 5.1 months. Return to full dance activity was at an average of 6.5 months postoperatively. Surgical intervention for tibial stress fractures in dancers who have not responded to nonoperative management allowed for resolution of symptoms and return to dancing with minimal morbidity.

Time loss injuries compromise team success in Elite Rugby Union: a 7-year prospective study.

PubMed

Williams, Sean; Trewartha, Grant; Kemp, Simon P T; Brooks, John H M; Fuller, Colin W; Taylor, Aileen E; Cross, Matthew J; Stokes, Keith A

2016-06-01

A negative association between injuries and team success has been demonstrated in professional football, but the nature of this association in elite Rugby Union teams is currently unclear. To assess the association between injury burden measures and team success outcomes within professional Rugby Union teams. A seven-season prospective cohort design was used to record all time-loss injuries incurred by English Premiership players. Associations between team success measures (league points tally and Eurorugby Club Ranking (ECR)) and injury measures (injury burden and injury days per team-match) were modelled, both within (changes from season to season) and between (differences averaged over all seasons) teams. Thresholds for the smallest worthwhile change in league points tally and ECR were 3 points and 2.6%, respectively. Data from a total of 1462 players within 15 Premiership teams were included in the analysis. We found clear negative associations between injury measures and team success (70-100% likelihood), with the exception of between-team differences for injury days per team-match and ECR, which was unclear. A reduction in injury burden of 42 days (90% CI 30 to 70) per 1000 player hours (22% of mean injury burden) was associated with the smallest worthwhile change in league points tally. Clear negative associations were found between injury measures and team success, and moderate reductions in injury burden may have worthwhile effects on competition outcomes for professional Rugby Union teams. These findings may be useful when communicating the value of injury prevention initiatives within this elite sport setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

[Effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture].

PubMed

Yan, Rongliang; Qu, Jiafu; Cao, Lihai; Liu, Hongda; Chen, Jianghua; Gao, Yan; Peng, Yi

2018-05-01

To summarize the effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture. Between January 2011 and October 2016, 25 cases with comminuted Jones fracture were treated with mini locking plate combined with Kirschner wire. There were 9 males and 16 females with an average age of 31.4 years (range, 16-66 years). The fractures located on the left side in 11 cases and on the right side in 14 cases. The causes of injury included spraining in 21 cases, falling down in 3 cases, and bruise in 1 case. The bone fragment of all cases was more than 3 pieces. The fracture line was mostly Y-shape or T-shape. Twelve of them were combined with other fractures. The time from injury to operation was 1-9 days (mean, 5 days). The mini locking plate and Kirschner wire were removed at 9-12 months postoperatively. At 12 months postoperatively, the pain was evaluated by the visual analogue scale (VAS) score, and the function by the American Orthopaedic Foot & Ankle Society (AOFAS) score. All incisions healed by first intention. All cases were followed up 12-36 months with an average of 21.7 months. Fracture union was observed in all patients without complications such as nonunion, delayed union, and malunion. The fracture union time was 8-12 weeks (mean, 9.4 weeks). At 12 months postoperatively, the VAS score was 1.15±0.87; the AOFAS score was 89.45±6.24, and the results were excellent in 14 cases, good in 9 cases, fair in 1 case, and poor in 1 case, with an excellent and good rate of 92%. The procedure of mini locking plate combined with Kirschner wire for comminuted Jones fracture has such advantages as convenient operation, more rigid fixation, high rate of fracture healing, and good functional recovery in foot.

Minimally invasive treatment of clavicular fractures with cannulated screw.

PubMed

Sun, Jun-zhan; Zheng, Guo-hai; Zhao, Ke-yi

2014-05-01

To evaluate minimally invasive treatment of clavicular fractures with cannulated screw. Data of 65 patients who had undergone minimally invasive treatment with cannulated screws for clavicular fractures from April 2009 to October 2010 were retrospectively analyzed and compared with those of 65 patients with clavicular fractures who had been treated by the same surgeons with plates. In the study group, there were 41 males and 24 females, aged from 19-67 years (mean, 35.8 years). According to Craig's classification, there were 29 group 1 and 36 of group 2-II. Neer scores were used to evaluate shoulder function and radiographs to assess fracture union. The incision length was 4-5 cm in the cannulated screw group (CSG) and 10-11 cm in the reconstructive plate group (RPG). Radiographs showed bone union was achieved in both groups, the bone healing time being 13.2 ± 6.9 weeks in the CSG and 16.3 ± 8.7 weeks in the RPG. All patients were followed up for 6 to 20 months (average, 10.6 months). The average Neer score was 96.6 ± 3.4 in the CSG and 94.2 ± 5.8 in the RPG. In the CSG, screw loosening occurred in five, and fracture displacement in three. There was a significant difference in fracture healing time between two groups but not in Neer score. Minimally invasive treatment of clavicular fractures with cannulated screws has the advantages of minimal invasion, short bone healing time, good clinical outcomes, and being relatively inexpensive. © 2014 Chinese Orthopaedic Association and Wiley Publishing Asia Pty Ltd.

Ankle fusion for definitive management of non-reconstructable pilon fractures.

PubMed

Bozic, Vladimir; Thordarson, David B; Hertz, Jennifer

2008-09-01

Highly comminuted pilon fractures, especially with a compromised soft tissue envelope, present a challenging treatment scenario. This study presents our results for patients managed with ankle fusion rather than ORIF. Fourteen patients with ankle joint incongruence after non-reconstructable tibia pilon fractures were treated with primary tibiotalar arthrodesis using a fixed-angle cannulated blade plate. Delayed metaphyseal unions due to bone defects were treated concurrently. The subtalar joint was preserved in all cases. Metaphyseal healing and stable arthrodesis was obtained in each case. There was one case of blade plate breakage in a patient who still achieved successful arthrodesis without reoperation. Union was achieved at an average of 15 weeks. No secondary procedures were required to obtain union. All 14 patients were ambulatory at last followup. Average followup was 39 weeks. Primary ankle arthrodesis can be achieved using a cannulated blade plate to address a non-reconstructable articular surface and metaphyseal bone defects in complex tibia pilon fractures.

Early Comparative Outcomes of Carbon Fiber Reinforced Polymer Plate in the Fixation of Distal Femur Fractures.

PubMed

Mitchell, Phillip M; Lee, Adam K; Collinge, Cory A; Ziran, Bruce H; Hartley, Kate G; Jahangir, A Alex

2018-05-16

To evaluate the early clinical results of distal femur fractures treated with carbon fiber reinforced - polyetheretherketone (CFR-PEEK) plates compared to stainless steel (SS) lateral locking plates. Retrospective comparative cohort study SETTING:: ACS Level I trauma center. Twenty-two patients (11 SS, 11 CFR-PEEK) with closed distal femur fractures treated by a single surgeon over a 6-year period. Nonunion, hardware failure, reoperation, time to full weight bearing, and time ` union were assessed. The CFR-PEEK cohort was on average older (71 vs. 57 years, p=0.03) and more likely to have diabetes (p=0.02). Nonunion was diagnosed in 4/11 (36%) patients in the SS group and 1/11 (9%) patients in the CFR-PEEK group (p=0.12). Hardware failure occurred in two SS patients (18%) compared to none in the CFR-PEEK group (p=0.14). Time to full weight bearing was similar between groups occurring at 9.9 weeks and 12.4 weeks in the CFR-PEEK and SS groups, respectively (p=0.23). Time to radiographic union averaged 12.4 weeks in the SS group and 18.7 weeks in the CFR-PEEK group (p=0.26). There were 4 reoperations in the SS group and one in the CFR-PEEK group (p=0.12). CFR-PEEK plates show encouraging short-term results in the treatment of distal femur fractures with a comparable nonunion, reoperation, and hardware failure rates to those treated with SS plates. This data suggests CFR-PEEK plates may be a viable alternative to SS plates in fixation of these fractures. Level III.

Surgical treatment of open pilon fractures.

PubMed

Zeng, Xian-tie; Pang, Gui-gen; Ma, Bao-tong; Mei, Xiao-long; Sun, Xiang; Wang, Jia; Jia, Peng

2011-02-01

To discuss the methods, timing and clinical outcomes of surgical treatment for open pilon fractures. From April 2003 to July 2008, 28 patients with open pilon fractures were treated. All had type C fractures according to the Arbeitsgemeinschaft für osteosynthesefragen-Association for the Study of Internal Fixation (AO/ASIF) classification. Three operative methods were applied, the methods being determined by the types of fracture, soft tissue damage and time interval after injury. Seven cases were treated by debridement and internal fixation with plate; 19 by limited internal fixation combined with external fixation; and 2 by delayed surgery. The clinical outcomes were evaluated by the Burwell-Charnley score. All cases were followed up for from 6 to 48 months (average 24 months). The Burwell-Charnley score of clinical outcomes: anatomic reduction achieved in 12 cases, functional reduction in 15, and unsatisfactory reduction in 1. The healing time was from 2.5 to 11 months (average 4.7 months). Two cases had delayed union. According to the American Orthopaedic Foot and Ankle Society (AOFAS) scale for the ankle joint, there were excellent results in 8 cases, good in 14, fair in 5 and poor in 1. Complications included four cases of skin superficial sloughing, two of superficial infection, one of deep infection, two of delayed fracture union and ten of post-traumatic arthritis. It is important to perform appropriate surgeries for open pilon fracture according to fracture classification, different damage to skin and tissue and time interval after injury. Thorough debridement, proper use of anti-infective medication, appropriate bone grafting, and postoperative ankle function exercise can reduce the occurrence of complications. © 2011 Tianjin Hospital and Blackwell Publishing Asia Pty Ltd.

Mortality Amenable to Health Care in European Union Countries and Its Limitations.

PubMed

Jarčuška, Peter; Janičko, Martin; Barták, Miroslav; Gavurová, Beáta; Vagašová, Tatiana

2017-12-01

The concept of amenable mortality is intended to assess health care system performance. It is defined as "premature deaths that should not occur in the presence of timely and effective health care". The purpose of paper is to analyse differences in amenable mortality across European Union countries and to determine the associations between amenable mortality and life expectancy at birth. This is a cross-country and time trend analysis. Data on deaths by cause, and five-year age groups were obtained from the World Health Organization database for the 20 European Union countries, throughout the period from 2002 to 2013. The rates of amenable mortality were expressed by the age-standardised death rates per 100,000 inhabitants. We applied the method of direct standardisation using the European Standard Population. Throughout the explored period, the statistically significant variations of the age-standardised death rates in a relation to the European Union average fluctuated from 78.7 per 100,000 inhabitants (95% CI 72.4-84.9) in France to 374.3 per 100,000 inhabitants (95% CI 350.8-397.7) in Latvia. The leading causes of amenable mortality were ischaemic heart disease, cerebrovascular diseases, and colorectal cancer that accounted for, respectively, 42.2%, 19.5%, and 11.3% of overall amenable mortality. As expected, statistically significant strong negative relationship (R 2 =0.95; ρ=-0.98) between amenable mortality and life expectancy at birth was proved by linear regression. The concept has several limitations relating to the selection of causes of death and setting age threshold over time, not consideration actually available health care resources in each country, as well as differences in the prevalence of diseases among countries. We found an explicit divide in amenable mortality rates between more developed countries of Western, Northern and Southern Europe, and less developed countries of Central and Eastern Europe. Increasing of amenable mortality may suggest deterioration in health care system performance. Copyright© by the National Institute of Public Health, Prague 2017.

Intramedullary nailing for the treatment of aseptic femoral shaft non-unions after plating failure: effectiveness and timing.

PubMed

Megas, Panagiotis; Syggelos, Spyros A; Kontakis, Georgios; Giannakopoulos, Andreas; Skouteris, Georgios; Lambiris, Elias; Panagiotopoulos, Elias

2009-07-01

This retrospective, multicentre study aimed to evaluate reamed intramedullary nailing (IMN) for the treatment of 30 cases of aseptic femoral shaft non-union after plating failure. Following nailing, 29 non-unions had healed by a mean 7.93 months. In one case a hypertrophic non-union required renailing after 8 months, using a nail of greater diameter, and united within five further months. Healing times were not related to whether the fracture was open or closed, the type non-union or the type of fracture. The delay from the initial plating to intramedullary nailing had a statistically significant effect on healing time and final outcome. This treatment is cost effective and should be implemented as soon as the non-union is diagnosed.

Interlocking intramedullary nailing in distal tibial fractures.

PubMed

Tyllianakis, M; Megas, P; Giannikas, D; Lambiris, E

2000-08-01

This retrospective study examined the results of non-pilon fractures of the distal part of the tibia treated with interlocking intramedullary nailing. Seventy-three patients with equal numbers of fractures treated surgically between 1990 and 1998 were reviewed. Mean patient age was 39.8 years, and follow-up averaged 34.2 months. The AO fracture classification system was used. Concomitant fractures of the lateral malleolus were fixed. All but three fractures achieved union within 4.2 months on average. Satisfactory or excellent results were obtained in 86.3% of patients. These results indicate interlocking intramedullary nailing is a reliable method of treatment for these fractures and is characterized by high rates of union and a low incidence of complications.

Differences and changes in the physical characteristics of professional and amateur rugby union players.

PubMed

Smart, Daniel J; Hopkins, Will G; Gill, Nicholas D

2013-11-01

Numerous studies have highlighted differences between playing levels and positions in rugby union; however, few studies have investigated longitudinal progressions of body composition and physical performance. Between-player differences and within-player changes in body composition, strength, power, speed, and repeated sprint ability, from 1,161 New Zealand rugby union players from 2004 to 2007, were estimated using a mixed modeling procedure. Props had the highest mass, percent body fat, strength, and slowest speed times compared with the other positions, whereas outside backs had the fastest speed time and lowest percent body fat. For most measures, there were small-to-moderate differences (range, 1.1-14%) between players selected and not selected for provincial teams and small-to-large differences (range, 1.8-15%) between provincial and Super Rugby (professional) players. The faster 20-m sprint times in international compared with Super Rugby players was small in magnitude for both the forwards (1.9%) and backs (2.2%). The average annual improvements were small to moderate for strength (range, 2.1-15%) and small for repeated sprint ability within the lower playing levels (~1.5%). Small increases occurred in lower body strength (~7.0%) as players moved from Super Rugby to provincial competition. Small decreases in sprint time (~1.6%) and small increases in strength (~6.3%) occurred as players moved from Super Rugby to midyear international competition. The differences between levels in performance provide level-specific characteristics from Super Rugby and below, but international players may be selected because of greater skill and experience. Changes in physical performance between competitions may be a result of reduced training loads because of regular high-intensity matches and greater travel involved in the Super Rugby competition.

Interprosthetic femoral fractures treated with locking plate.

PubMed

Ebraheim, Nabil; Carroll, Trevor; Moral, Muhammad Z; Lea, Justin; Hirschfeld, Adam; Liu, Jiayong

2014-10-01

Interprosthetic fractures are challenging to manage. Although treatment of femoral fractures around a single implant has been described, there is little literature for treatment of interprosthetic femoral fractures. This study analyses the management and outcomes of 15 patients with interprosthetic femoral fractures treated with locking plates. A retrospective chart review was conducted of 17 patients with interprosthetic femur fracture treated with locking plates from 2002 to 2013. Patient demographics and comorbidities were collected. Preoperatively, patients were classified with the Vancouver or Su classification system. Intraoperative use of bone graft and/or cerclage cables was also examined. Clinical and radiographic outcomes were evaluated for union, time to full weight bearing, return to preinjury level of activity, and pain assessed with visual analog scale (VAS). There were 15 patients with interprosthetic fractures meeting criteria for this study. Average patient age was 80.53 (range, 61-92) years. Bone grafting was used in 23.5% (four of 17) and cerclage cables in 29.4% (five of 17). Patients achieved complete union and return to full weight bearing an average of 4.02 (range, two to six) months later. Average VAS pain score was 1.00 (range, zero to six). All patients returned to their preoperative ambulatory status. Locking plates could achieve satisfactory results for interprosthetic fractures. Considering an individual's fracture type, bone quality and protheses to determine the appropriate plate length and optional use of cerclage and/or bone graft was essential. In this limited sample size, interprosthetic fractures occurred at similar rates at the supracondylar region and diaphysis.

Interlocking Nailing Versus Plating in Tibial Shaft Fractures in Adults: A Comparative Study

PubMed Central

Arambam, Mahendra Singh; Waikhom, Sanjib; Santosha; Masatwar, Pranav Vitthal; Maske, Rohan Gautam

2017-01-01

Introduction Tibial diaphyseal fractures are the commonest long bone fractures in adults, most commonly managed by intramedullary interlocking nailing. However, several meta-analysis show that locking plate osteosynthesis is equally effective in managing tibial diaphyseal fractures and are associated with less number of complications. Aim To compare the results of fixation of tibial fractures following plating and nailing in terms of union, patient satisfaction and complications. Materials and Methods A hospital based non randomized clinical trial was performed from September 2013 to August 2016 where closed or open diaphyseal or metaphyseo- diaphyseal fractures of the tibia (closed or open Gustilo Anderson type 1 through 3B) were included. Simple sequential allocation was used for allotting the patients to two groups, one for interlocking nailing and other for plating. The patients were followed up for clinical, radiographic and functional results. Results Forty patients with 41 involved limbs completed follow up for one year. The duration of surgery and average blood loss during surgery was 75.45±3.03 minutes and 165.00±5.31 ml respectively in case of nailing and 85.05±2.54 minutes and184.29±5.33 ml respectively in case of plating and their difference was statistically significant. In our study union was achieved in less than 20 weeks in 29 (70.8%) of the patients and 25-30 weeks in nine (22%) cases. The average time of union in our study was 19.55±0.69 weeks in case of interlocking nailing and 20.38±1.39 weeks in case of plating and there was no statistically significant difference between the two. However, there is statistically significant difference in the functional score in between the two groups in terms of Lower Extremity Functional Score (LEFS). Delayed union in one case of nailing and two cases of plating, valgus malunion in one case of nailing and joint stiffness in two cases each of nailing and plating were the major complications observed. Conclusion There was no difference between the two modalities in terms of fracture union. Complications were lesser but more serious in case of plating. Patient satisfaction was more with plating. PMID:28571220

Delayed surgical treatment for neglected or mal-reduced talar fractures.

PubMed

Huang, Peng-Ju; Cheng, Yuh-Min

2005-10-01

From 1993 to 2002, we treated nine patients for neglected or mal-reduced talar fractures. Average patient age was 39 (20-64) years and average follow-up 53 months. The time interval between injury and index operation ranged from 4 weeks to 4 years. Surgical procedures included open reduction with or without bone grafting in six cases, open reduction combined with ankle fusion in one case, talar neck osteotomy in one case, and talar neck osteotomy combined with subtalar fusion in one case. All cases had solid bone union. One patient developed avascular necrosis of the talus needing subsequent ankle arthrodesis. In six patients, adjacent hindfoot arthrosis occurred. The overall AOFAS ankle-hindfoot score was in average 77.4. We conclude that in neglected and mal-reduced talar fractures, surgical treatment can lead to a favourable outcome if the hindfoot joints are not arthritic.

Nonunion After Clavicle Osteosynthesis: High Incidence of Propionibacterium acnes.

PubMed

Gausden, Elizabeth B; Villa, Jordan; Warner, Stephen J; Redko, Mariya; Pearle, Andrew; Miller, Andy; Henry, Michael; Lorich, Dean G; Helfet, David L; Wellman, David S

2017-04-01

The objective of this study was to review the etiology of clavicle nonunions after osteosynthesis and investigate the outcomes of a treatment with a single-stage revision. Retrospective case series. Orthopaedic specialty hospital. Twenty cases of nonunion after osteosynthesis of the clavicle were identified. The average age was 44 years (±13 years). In 9 cases, there was catastrophic implant failure that prompted the revision surgery. In the 18 cases in which cultures were taken, 15 of the 18 (83%) were treated as infections with a course of antibiotics. In 14 cases, the cultures were positive for Propionibacterium acnes. Fifteen patients were treated with a prolonged course of antibiotics. Eighteen patients had follow-up, and the average time to radiographic union was 22 weeks. There were no cases of nonunion after revision surgery. There is a high rate of positive cultures in cases of nonunion after osteosynthesis of the clavicle. This suggests the etiology of midshaft clavicle nonunions may result from a combination of suboptimal mechanical fixation and latent infection. Our treatment protocol of superior and anterior plating, interfragmentary fixation, bone grafting, and appropriate antimicrobial treatment of latent infections has resulted in 100% union rate. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Defense Sector Consolidation: Will Consolidation Within the Defense Sector Improve the Financial Performance of Defense Contractors While, Simultaneously Yielding Cost Savings to Taxpayers

DTIC Science & Technology

2005-12-01

Treaty USSR Union of Soviet Socialist Republics WACC Weighted Average Cost of Capital...a present value using the company’s weighted average cost of capital ( WACC ). Synergy: The Premium for Potential Success For the most part

Is public health between East and West? Analysis of wealth, health and mortality in Austria, Central and Eastern European Countries and Croatia relative to the European Union.

PubMed

Hofmarcher, M M

1998-09-01

To provide a conceptual framework for health planning activities in the "middle income" transition countries. Economic, demographic, and disease-related data in Central and Eastern European (CEE) countries, including Croatia and Austria, were compared to the Europen Union (EU) average. Data were selected from the databases provided by the World Health Organization, Organization for Economic Cooperation and Development, World Bank, United Nations, and the European Bank of Reconstruction and Development. Life expectancy and mortality were extrapolated until the year 2000 by using an exponential growth model for the WHO time series data, starting in 1994. Death rates due to ischemic heart diseases (18%) and cerebrovascular diseases (13%) were selected to show frequent causes of death. Relative to the EU average, the gross domestic product (GDP) share of health expenditures in transition countries was disproportionate to wealth and premature death. The population in CEE-countries was younger and the share of people aged >65 was predicted to remain about 15% below the EU average and Austria. For Croatia, the share of people aged 65 would be on the increase, similar to the share predicted for Austria (slightly above the EU average). Mortality of selected non-communicable, chronic diseases is predicted to increase and remain relatively high. Mortality rates due to infectious diseases have been declining but remained comparatively on a high level. Coexistence of demographic and epidemiological transition along with high mortality rates due to infectious diseases creates a "double burden". Economic transition has the potential to comprise both the increase in wealth, and life and health expectancy.

Outcome of Surgical Fixation of Lateral Column Distal Humerus Fractures.

PubMed

Von Keudell, Arvind; Kachooei, Amir R; Moradi, Ali; Jupiter, Jesse B

2016-05-01

The purpose of this study was to report the long-term outcome and complications of surgically fixated lateral unicondylar distal humerus fractures. Retrospective Review. Two level 1 Trauma Centers, Massachusetts General Hospital and Brigham and Women's Hospital. Between 2002 and 2014, 24 patients treated with open reduction and internal fixation for lateral unicondylar distal humerus fractures (OTA/AO type B1 fractures) were retrospectively reviewed. Open reduction and internal fixation. Union rates, early complications, functional outcome, and the range of elbow motion were evaluated. Disabilities of the arm, shoulder, and hand, Mayo elbow Performance Index, satisfaction, pain scale, and American Shoulder and Elbow Surgeons. The mean age of patients was 46 ± 23 years at the time of surgery. The average final flexion/extension arc of motion was 108°. Reoperations were performed in 9 of 24 elbows after an average 21 ± 31 months. Twenty of the 24 patients were available for the clinical follow-up at an average of 70 months (range: 16-144 months). Disabilities of the arm, shoulder, and hand averaged at 10.8 ± 11.7 points, satisfaction at 9.5 ± 1.2, American Shoulder and Elbow Surgeons score at 88.5 ± 13.3 points at final follow-up. Based on the functional classification proposed by Jupiter, 16 demonstrated good to excellent results, 2 fair and 2 poor result. Outcome of open reduction and internal fixation of isolated lateral column distal humerus fractures can result in high union rates with acceptable outcome scores and high patient satisfaction despite a high reoperation rate. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Career Transitions after a Long Experience as Trade Union Officer: A Qualitative Study

ERIC Educational Resources Information Center

Cohen-Scali, Valérie

2016-01-01

In France, trade union officers are former shop stewards who have chosen to work full-time for the union for several years. This research investigates the career transitions of former union officers who have returned to the labour market following extended experience with high-level responsibilities in the union. Semi-directed interviews were…

Teacher Unionism in Changing Times: Is This the Real "New Unionism"?

ERIC Educational Resources Information Center

Stevenson, Howard

2015-01-01

This article provides a case study of union change in an environment in which radical school restructuring is taking place, and active strategies to weaken and marginalize organized teachers are being pursued by the state. The case study union is the National Union of Teachers in England. The article explores a number of different strategies open…

Comparison of Clinical Efficacy of Lateral and Lateral and Medial Double-plating Fixation of Distal Femoral Fractures.

PubMed

Bai, Zhibiao; Gao, Shichang; Hu, Zhenming; Liang, Anlin

2018-03-20

The present study was performed to compare the clinical efficacy of lateral plate and lateral and medial double-plating fixation of distal femoral fractures and explore the indication of lateral and medial double-plating fixation of the distal femoral fractures. From March 2006 to April 2014, 48 and 12 cases of distal femoral fractures were treated with lateral plate (single plate) and lateral and medial plates (double plates), respectively. During the surgery, after setting the lateral plate for the distal femoral fractures, if the varus stress test of the knee was positive and the lateral collateral ligament rupture was excluded, lateral and medial double-plating fixation was used for the stability of the fragments. All the patients were followed up at an average period of 15.9 months. The average operation time, the intraoperative hemorrhage and the fracture union time of the two groups were compared. One year after operation, knee function was evaluated by the Kolmert's standard. There was no significant difference in the average operation time, intraoperative hemorrhage, fracture healing time and excellent and good rates of postoperative knee function between two groups. Positive Varus stress test during operation can be an indication for lateral and medial double-plating fixation of distal femoral fractures.

Exposure limits for nanoparticles: report of an international workshop on nano reference values.

PubMed

van Broekhuizen, Pieter; van Veelen, Wim; Streekstra, Willem-Henk; Schulte, Paul; Reijnders, Lucas

2012-07-01

This article summarizes the outcome of the discussions at the international workshop on nano reference values (NRVs), which was organized by the Dutch trade unions and employers' organizations and hosted by the Social Economic Council in The Hague in September 2011. It reflects the discussions of 80 international participants representing small- and medium-size enterprises (SMEs), large companies, trade unions, governmental authorities, research institutions, and non-governmental organizations (NGOs) from many European countries, USA, India, and Brazil. Issues that were discussed concerned the usefulness and acceptability of precaution-based NRVs as a substitute for health-based occupational exposure limits (OELs) and derived no-effect levels (DNELs) for manufactured nanoparticles (NPs). Topics concerned the metrics for measuring NPs, the combined exposure to manufactured nanomaterials (MNMs) and process-generated NPs, the use of the precautionary principle, the lack of information about the presence of nanomaterials, and the appropriateness of soft regulation for exposure control. The workshop concluded that the NRV, as an 8-h time-weighted average, is a comprehensible and useful instrument for risk management of professional use of MNMs with a dispersible character. The question remains whether NRVs, as advised for risk management by the Dutch employers' organization and trade unions, should be under soft regulation or that a more binding regulation is preferable.

Staged minimally invasive plate osteosynthesis of proximal tibial fractures with acute compartment syndrome.

PubMed

Kim, Joon-Woo; Oh, Chang-Wug; Oh, Jong-Keon; Kyung, Hee-Soo; Park, Kyeong-Hyeon; Kim, Hee-June; Jung, Jae-Wook; Jung, Young-Soo

2017-06-01

High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome. Twenty-eight patients with proximal tibial fractures accompanied by acute compartment syndrome who underwent staged MIPO and had a minimum of 12 months follow-up were enrolled. According to the AO/OTA classification, 6 were 41-A, 15 were 41-C, 2 were 42-A and 5 were 42-C fractures; this included 6 cases of open fractures. Immediate fasciotomy was performed once compartment syndrome was diagnosed and stabilization of the fracture followed using external fixation. After the soft tissue condition normalized, internal conversion with MIPO was done on an average of 37 days (range, 9-158) after index trauma. At the time of internal conversion, the external fixator pin site grades were 0 in 3 cases, 1 in 12 cases, 2 in 10 cases and 3 in 3 cases, as described by Dahl. Radiographic assessment of bony union and alignment and a functional assessment using the Knee Society Score and American Orthopedic Foot and Ankle Society (AOFAS) score were carried out. Twenty-six cases achieved primary bony union at an average of 18.5 weeks. Two cases of nonunion healed after autogenous bone grafting. The mean Knee Society Score and the AOFAS score were 95 and 95.3 respectively, at last follow-up. Complications included 1 case of osteomyelitis in a patient with a grade IIIC open fracture and 1 case of malunion caused by delayed MIPO due to poor wound conditions. Duration of external fixation and the external fixator pin site grade were not related to the occurrence of infection. Staged MIPO for proximal tibial fractures with acute compartment syndrome may achieve satisfactory bony union and functional results, while decreasing deep infections and soft tissue complications. Copyright © 2017 Elsevier Ltd. All rights reserved.

Salvage of tibial pilon fractures using fusion of the ankle with a 90 degrees cannulated blade-plate: a preliminary report.

PubMed

Morgan, S J; Thordarson, D B; Shepherd, L E

1999-06-01

Six patients with ankle joint destruction and delayed metaphyseal union after tibial plafond fracture were surgically treated with tibiotalar arthrodesis and metaphyseal reconstruction, using a fixed-angle cannulated blade-plate. The procedure was performed through a posterior approach in five cases and a lateral approach in one case. The subtalar joint was preserved in all cases. Metaphyseal union and a stable arthrodesis were obtained in all cases without loss of fixation and with no mechanical failure of the blade-plate. Union was obtained in an average of 26 weeks. No secondary procedures were required to obtain union. All six patients were ambulatory at last follow-up. Stable internal fixation for simultaneous tibiotalar fusion and metaphyseal reconstruction can be achieved with a cannulated blade-plate while preserving the subtalar joint in complex plafond fractures.

Adolescent Violent Victimization and Precocious Union Formation.

PubMed

C Kuhl, Danielle; Warner, David F; Wilczak, Andrew

2012-11-01

This article bridges scholarship in criminology and family sociology by extending arguments about "precocious exits" from adolescence to consider early union formation as a salient outcome of violent victimization for youths. Research indicates that early union formation is associated with several negative outcomes; yet the absence of attention to union formation as a consequence of violent victimization is noteworthy. We address this gap by drawing on life course theory and data from the National Longitudinal Study of Adolescent Health (Add Health) to examine the effect of violent victimization ("street" violence) on the timing of first co-residential union formation-differentiating between marriage and cohabitation-in young adulthood. Estimates from Cox proportional hazard models show that adolescent victims of street violence experience higher rates of first union formation, especially marriage, early in the transition to adulthood; however, this effect declines with age, as such unions become more normative. Importantly, the effect of violent victimization on first union timing is robust to controls for nonviolent delinquency, substance abuse, and violent perpetration. We conclude by discussing directions for future research on the association between violent victimization and coresidential unions with an eye toward the implications of such early union formation for desistance.

Adolescent Violent Victimization and Precocious Union Formation*

PubMed Central

C. Kuhl, Danielle; Warner, David F.; Wilczak, Andrew

2013-01-01

This article bridges scholarship in criminology and family sociology by extending arguments about “precocious exits” from adolescence to consider early union formation as a salient outcome of violent victimization for youths. Research indicates that early union formation is associated with several negative outcomes; yet the absence of attention to union formation as a consequence of violent victimization is noteworthy. We address this gap by drawing on life course theory and data from the National Longitudinal Study of Adolescent Health (Add Health) to examine the effect of violent victimization (“street” violence) on the timing of first co-residential union formation—differentiating between marriage and cohabitation—in young adulthood. Estimates from Cox proportional hazard models show that adolescent victims of street violence experience higher rates of first union formation, especially marriage, early in the transition to adulthood; however, this effect declines with age, as such unions become more normative. Importantly, the effect of violent victimization on first union timing is robust to controls for nonviolent delinquency, substance abuse, and violent perpetration. We conclude by discussing directions for future research on the association between violent victimization and coresidential unions with an eye toward the implications of such early union formation for desistance. PMID:24431471

The Influence of Parental Education on Timing and Type of Union Formation: Changes Over the Life Course and Over Time in the Netherlands.

PubMed

Mooyaart, Jarl E; Liefbroer, Aart C

2016-08-01

Family background shapes young adults' decisions in their transition to adulthood, and the outcomes of these decisions lay the foundation for their subsequent life course. This study examines the influence of parental education on their children's union formation. We examine the timing of entry into a first union (a married or a cohabiting union), the choice between marriage and cohabitation, and the timing of first marriage. Data from eight nationally representative surveys conducted in the Netherlands are pooled (N = 39,777), with respondents being born between 1930 and 1990, to examine not only the effect of parental education on union formation but also whether this effect changes over birth cohorts, periods, and the life course, and varies by gender. Results from discrete-time hazard analyses show little change in the effect of parental education across cohorts and periods but strong life-course effects. Gender differences in the effect of parental education are relatively small.

What Should Teachers' Unions Do in a Time of Educational Crisis? An Essay Review of Lois Weiner's "The Future of Our Schools: Teachers Unions and Social Justice" (Chicago, IL: Haymarket Books, 2012, 220 pp.)

ERIC Educational Resources Information Center

Apple, Michael W.

2013-01-01

What roles can and should teachers' unions play in the deliberations, debates, and conflicts over school reform in a time when education sits at the center of so much of our economic, political, ideological, and cultural tensions? Lois Weiner's new book, "The Future of Our Schools: Teachers Unions and Social Justice," speaks…

Poverty and union formation among never-married single mothers in the Netherlands, 1989-2005.

PubMed

Kalmijn, Matthijs; Monden, Christiaan

2010-11-01

Using panel data from Dutch tax records linked to the municipality registry, we investigate how the partner status of never-married single mothers changes in the years after the birth of their first child. To explore a possible accumulation of financial problems, we study the effects of income on the chances of entering a marital or cohabiting union. We also examine the effects of finding a partner on income for never-married single mothers. Finding a partner substantially improves income. We find that about half of the never-married single mothers marry or start cohabiting within 10 years of the first birth, but that these are usually mothers with average and higher incomes. Not only are never-married single mothers more likely to be poor at the time of first birth, the poor are also more likely to remain single. There seems to be an accumulation of disadvantage in this special group in Dutch society.

The implementation of the Strategy Europe 2020 objectives in European Union countries: the concept analysis and statistical evaluation.

PubMed

Stec, Małgorzata; Grzebyk, Mariola

2018-01-01

The European Union (EU), striving to create economic dominance on the global market, has prepared a comprehensive development programme, which initially was the Lisbon Strategy and then the Strategy Europe 2020. The attainment of the strategic goals included in the prospective development programmes shall transform the EU into the most competitive economy in the world based on knowledge. This paper presents a statistical evaluation of progress being made by EU member states in meeting Europe 2020. For the basis of the assessment, the authors proposed a general synthetic measure in dynamic terms, which allows to objectively compare EU member states by 10 major statistical indicators. The results indicate that most of EU countries show average progress in realisation of Europe's development programme which may suggest that the goals may not be achieved in the prescribed time. It is particularly important to monitor the implementation of Europe 2020 to arrive at the right decisions which will guarantee the accomplishment of the EU's development strategy.

Bunion correction using proximal chevron osteotomy: a single-incision technique.

PubMed

Sammarco, G J; Russo-Alesi, F G

1998-07-01

Proximal chevron first metatarsal osteotomy with lateral capsulotomy, adductor tenotomy, and binding of the first and second metatarsals was reviewed in 88 consecutive cases. Seventy-two cases in 55 patients are reported, with an average clinical follow-up of 41 months. The hallux valgus angle improved an average of 15 degrees , from 32.0 degrees preoperatively to an average of 17.0 degrees postoperatively. The intermetatarsal I-II angle improved an average of 5.5 degrees, from 15.3 degrees preoperatively to 9.0 degrees postoperatively. The lateral plantar first metatarsal angle did not change. First metatarsal length was decreased by 2.0 mm. Union occurred at an average of 2 months. Sesamoid position improved 49%, from a preoperative average subluxation of 80% to a postoperative average subluxation of 29%. Subjective foot score profiles improved from a preoperative average of 70.1/100 to a postoperative average of 94.4/100 with respect to pain, deformity, motion, disability, and cosmesis. There were 10 patients with complications, including three patients with delayed unions, two with second metatarsal stress fractures, one with hallux varus, two with hallux limitus, one with progressive arthritis, one with cellulitis, and one with hallux elevatus. Eighty-four percent of the patients stated that they would undergo the procedure again without reservation, 9% would proceed with reservation, and 7% would not proceed with surgery again if offered. This technique provides reliable successful long-term results for the treatment of moderate and severe symptomatic bunion, hallux valgus, and metatarsus primus varus.

12 CFR 704.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... mortgage related security. Core capital means the sum of a corporate credit union's retained earnings, and... repurchase the same security at a specified time in the future. The corporate credit union then sells that... which the corporate credit union is obligated to return the security to its member credit union...

Effects of third fragment size and displacement on non-union of femoral shaft fractures after locking for intramedullary nailing.

PubMed

Lee, J R; Kim, H-J; Lee, K-B

2016-04-01

The femoral shaft fractures with large fragments makes anatomical reduction challenging and often results in non-union. In some studies, the degree of fragment displacement was reported to have affected non-union, but the association between the one fragment size and degree of displacement has not been fully clarified. Therefore we performed a retrospective study to assess: (1) the more influential factor of non-union: the degree of fragment displacement, or the fragment size? (2) the non-union rates according to different sizes and degrees of displacement. The degree of displacement is the more potent factor of non-union than the third fragment size in femoral shaft fractures. We assessed retrospectively 64 cases, which could be followed up for longer than one year. Fragments were divided according to the length of their long axis into three groups: group A (0-3.9cm), (n=21); group B (4-7.9cm), (n=22); group C (8cm or more), (n=21). Fragment displacement was also assessed in the proximal (P) or distal (D) end to the nearest cortex of the femoral shaft, and divided into the following groups: group P1 (n=44) or D1 (n=47), (0-9mm); group P2 (n=10) or D2 (n=11), (10-19mm); group P3 (n=7) or D3 (n=3), (20-29mm); and group P4 (n=3) or D4 (n=3), (30mm or more). The bone union rate was 86% in the small (less than 8cm) fragment groups and 71% in the large (8cm or more) fragment group (P=0.046). With respect to the degree of displacement, the union rate was lower (P=0.001) and the average union time was longer (P=0.012) in the 20mm or more group for both the proximal fragment part and the distal fragment part (P=0.002, P=0.014). A logistic regression analysis underlined the displacement in the proximal site (OR: 0.298, 95% CI: 0.118-0.750) as in the distal site (OR: 0.359, 95% CI: 0.162-0.793) as a larger effect on union rate than the fragment size that as no effect in logistic regression (OR 3.8, 95% CI: 0.669-21.6). Non-union develops significantly more frequently in femoral shaft fractures with fragments 8cm or longer or when the displacement in the proximal area is 20mm or greater and 10mm or greater in the distal area during the intramedullary nailing procedure. Regarding union rate, the degree of displacement has more influence than the third fragment size in femoral shaft fractures. IV, retrospective cohort study. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Teaching Assistant Unionization: Origins and Implications.

ERIC Educational Resources Information Center

Rogow, Robert; Birch, Daniel R.

1984-01-01

Teaching assistants are unionized at most large Ontario and British Columbia universities. The institutions tend to be urban, have large graduate enrollments, and have faced greater budgetary concerns at the time of unionization. Canada's public policy and labor relations decisions have favored unionization more than the United States's have. (MSE)

12 CFR 704.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

.... Adjusted trading means any method or transaction whereby a corporate credit union sells a security to a... corporate credit union purchases a security from one of its member credit unions under agreement by that member credit union to repurchase the same security at a specified time in the future. The corporate...

Physical game demands in elite rugby union: a global positioning system analysis and possible implications for rehabilitation.

PubMed

Coughlan, Garrett F; Green, Brian S; Pook, Paul T; Toolan, Eoin; O'Connor, Sean P

2011-08-01

Descriptive. To evaluate the physical demands of an international Rugby Union-level game using a global positioning system (GPS). Elite Rugby Union teams currently employ the latest technology to monitor and evaluate physical demands of training and games on their players. GPS data from 2 players, a back and a forward, were collected during an international Rugby Union game. Locomotion speed, total body load, and body load sustained in tackles and scrums were analyzed. Players completed an average distance of 6715 m and spent the major portion of the game standing or walking, interspersed with medium- and high-intensity running activities. The back performed a higher number of high-intensity sprints and reached a greater maximal speed. Body load data revealed that high levels of gravitational force are sustained in tackling and scrum tasks. The current study provides a detailed GPS analysis of the physical demands of international Rugby Union players. These data, when combined with game video footage, may assist sports medicine professionals in understanding the demands of the game and mechanism of injury, as well as improving injury rehabilitation.

Hospital union election activity, 1974-85

PubMed Central

Becker, Edmund R.; Rakich, Jonathon S.

1988-01-01

This study, using National Labor Relations Board data and American Hospital Association data, reports on the status of union election activity in the hospital industry for a 65-month period, January 1980-May 1985, and contrasts it with earlier data for a similar 65-month time period (1974-79). Together these data provide a comprehensive overview of union election activity in non-Federal, nongovernment hospitals since the passage of the 1974 Nonprofit Hospital Amendments to the Taft-Hartley Act. The study analyzes union, election, hospital, and environmental characteristics. Comparisons over the two time periods show that, while union victory rates in hospital elections have remained constant, the total number of elections has declined dramatically in the hospital industry. PMID:10312518

The physical demands of Super 14 rugby union.

PubMed

Austin, Damien; Gabbett, Tim; Jenkins, David

2011-05-01

The purpose of the present study was to describe the match-play demands of professional rugby union players competing in Super 14 matches during the 2008 and 2009 seasons. The movements of 20 players from Super 14 rugby union team during the 2008 and 2009 seasons were video recorded. Using time-motion analysis (TMA), five players from four positional groups (front-row forwards, back-row forwards, inside backs and outside backs) were assessed. Players covered between 4218 m and 6389 m during the games. The maximum distances covered in a game by the four groups were: front row forwards (5139 m), back row forwards, (5422 m), inside backs (6389 m) and outside backs (5489 m). The back row forwards spent the greatest amount of time in high-intensity exercise (1190 s), followed by the front row forwards (1015 s), the inside backs (876 s) and the outside backs (570 s). Average distances covered in individual sprint efforts were: front row forwards (16 m), back row forwards (14 m), inside backs (17 m) and outside backs (18 m). Work to rest ratios of 1:4, 1:4, 1:5, and 1:6 were found for the front row and back row forwards, and inside and outside backs respectively. The Super 14 competition during 2008 and 2009, have resulted in an increase in total high-intensity activities, sprint frequency, and work to rest ratios across all playing positions. For players and teams to remain competitive in Super 14 rugby, training (including recovery practices) should reflect these current demands. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Twenty years of work-related injury and illness among union carpenters in Washington State.

PubMed

McCoy, Amanda J; Kucera, Kristen L; Schoenfisch, Ashley L; Silverstein, Barbara A; Lipscomb, Hester J

2013-04-01

Individuals who work in the construction industry are at high risk of occupational injury. Robust surveillance systems are needed to monitor the experiences of these workers over time. We updated important surveillance data for a unique occupational cohort of union construction workers to provide information on long-term trends in their reported work-related injuries and conditions. Combining administrative data sources, we identified a dynamic cohort of union carpenters who worked in Washington State from 1989 through 2008, their hours worked by month, and their workers' compensation claims. Incidence rates of reported work-related injuries and illnesses were examined. Poisson regression was used to assess risk by categories of age, gender, time in the union, and calendar time contrasting medical only and paid lost time claims. Over the 20-year study period, 24,830 carpenters worked 192.4 million work hours. Work-related injuries resulting in medical care or paid lost time (PLT) from work occurred at a rate of 24.3 per 200,000 hr worked (95% CI: 23.5-25.0). Medical only claims declined 62% and PLT claims declined 77%; more substantive declines were seen for injuries resulting from being struck and falls to a lower level than from overexertion with lifting. Differences in risk based on union tenure and age diminished over time as well. Significant declines in rates of reported work-related injuries and illnesses were observed over the 20-year period among these union carpenters. Greater declines were observed among workers with less union tenure and for claims resulting in PLT. Copyright © 2012 Wiley Periodicals, Inc.

Proximal Pole Scaphoid Nonunion Reconstruction With 1,2 Intercompartmental Supraretinacular Artery Vascularized Graft and Compression Screw Fixation.

PubMed

Morris, Mark S; Zhu, Andy F; Ozer, Kagan; Lawton, Jeffrey N

2018-02-06

To review the incidence of union of patients with proximal pole scaphoid fracture nonunions treated using a 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) vascularized graft and a small compression screw. This is a retrospective case series of 12 patients. Calculations of the size of the proximal pole fragment relative to the total scaphoid were performed using posteroanterior view scaphoid radiographs with the wrist in ulnar deviation and flat on the cassette. Analyses were repeated 3 times per subject, and the average ratio of proximal pole fragment relative to the entire scaphoid was calculated. We reviewed medical records, radiographs, and computed tomography (CT) scans of these 12 patients. The CT scans that were performed after an average of 12 weeks were ultimately used to confirm union of the scaphoid fractures. One patient was unable to have a CT so was excluded from the final calculation. All 11 (100%) scaphoid fractures that were assessed by CT were found to be healed at the 12-week assessment point. The mean proximal pole fragment size was 18% (range, 7%-27%) of the entire scaphoid. The 1,2 ICSRA vascularized graft and compression screw was an effective treatment for patients with proximal pole scaphoid fractures. Therapeutic IV. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Arthrodesis of the knee with a vascularized fibular rotatory graft.

PubMed

Rasmussen, M R; Bishop, A T; Wood, M B

1995-05-01

We retrospectively reviewed the records of thirteen patients who had been managed with an arthrodesis of the knee with use of a vascularized graft from the ipsilateral fibula and fixation with an intramedullary rod. The indications for the operation included a large skeletal defect secondary to the resection of a tumor about the knee in eight patients, an infection at the site of an arthroplasty in four (with failure of a previous conventional arthrodesis in three of the four), and severe rheumatoid gonarthrosis as well as a persistent non-union of the distal part of the femur in one. The average age of the patients at the time of the operation was forty-three years (range, twenty-six to seventy-six years). Most of the patients had had multiple previous procedures (thirty-three operations had been performed in ten patients). Twelve of the thirteen patients had a solid fusion and a successful result after an average duration of follow-up of fifty-one months (range, eight to ninety-three months). The remaining patient, who had had four previous arthroplasties, had a recurrence of an infection seven months after the operation and was managed with an amputation. Six complications--including two superficial wound infections, one deep wound infection, one deep venous thrombosis, one transient peroneal-nerve palsy, and one delayed union--occurred in three patients.

Medial malleolar stress fracture secondary to chronic ankle impingement.

PubMed

Jowett, Andrew J L; Birks, Christopher L; Blackney, Mark C

2008-07-01

Medial malleolar stress fractures are uncommon even in the sporting population. We believe that stress fractures of the medial malleolus may be the end stage of chronic anteromedial ankle impingement in elite running and jumping athletes. We present five cases of elite athletes who presented to our institution with stress fractures of the medial malleolus over a 3-year period (2004 to 2007). In each case preoperative imaging revealed an anteromedial bony spur on the tibia. All fractures were internally fixed and at the same sitting had arthroscopic debridement of the bony spur. All fractures united without further intervention, average time to union was 10.2 (range, 6 to 16) weeks. At most recent review (average, 18 months; range, 8 to 37 months), all patients had resumed sporting activity to their previous level. No patient had suffered a recurrent fracture of the medial malleolus. We believe this region of impingement to be important in the development of the stress fracture and should be addressed at the time of fracture fixation.

Less invasive stabilization system (LISS) in the treatment of distal femoral fractures.

PubMed

Schütz, M; Müller, M; Kääb, M; Haas, N

2003-01-01

The treatment of distal femoral fractures has been associated with a high rate of complications for a long time. Although implants and surgical techniques have improved, plate osteosynthesis and intramedullary nailing have been accompanied by a high occurrence of infection, non-union and malalignment. The treatment of soft tissue envelopes using "biological" osteosynthesis and minimally invasive approaches has resulted in a decrease in complication rates and ultimately led to the concept of the less invasive stabilization system (LISS). This is an extramedullary-applied, internal fixator shaped according to the implantation site anatomy, with minimal invasiveness. The purpose of this study was to present this new surgical technique and draw attention to its advantages and importance. Although this is not a scientific paper, we hope to provide enough evidence of the LISS usefulness. The main LISS components include multiple-fixed angle screws and an insertion handle for submuscular sliding of a fixator and placement of percutaneous, self-drilling, unicortical screws for fixation of the diaphyseal fracture fragments. The LISS has been designed to preserve periosteal perfusion and to facilitate a minimally invasive application. Since the first implantation of the LISS, only a few studies have been published on its use in treatment of distal femoral fractures. The rate of infection has been low, ranging from 0 to 4%. The rate of delayed union has been between 2.4 and 6.1%, but delayed unions do not necessarily lead to secondary bone grafting or repeat osteosynthesis as the LISS has a high and lasting stability. When the LISS is used, bone grafting is rarely necessary (0 to 1.6% in primary and 0 to 5% in secondary grafting). Also implant failure differs from the failure of plate osteosynthesis because, with the use of LISS, no screw loosening or secondary malalignment occurs. Implant failures (up to 7.4%) were recorded particularly at the time of LISS introduction in surgical practice and were attributed to the technique of implantation rather than to the implant itself. Good treatment outcomes have been reported. The average knee flexion has been 103 degrees and 107 degrees. In 72.5% of the patients, flexion has been more than 90 degrees and an extension lag of > or = 10 degrees has been found in only 7.5% of all cases. The average Neer score has ranged from 73.9 to 77.2 points. In conclusion, the LISS is a useful implant for treatment of distal femoral fractures, especially when bone quality is poor. Infection, delayed union and non-union rates are low, as shown by yet unpublished data from our clinic. Primary bone grafting, which is rarely necessary with this system, is carried out only when there is a great bone loss. Implant failure, such as screw loosening or secondary malalignment, is not seen.

Dielectric properties of lava flows west of Ascraeus Mons, Mars

USGS Publications Warehouse

Carter, L.M.; Campbell, B.A.; Holt, J.W.; Phillips, R.J.; Putzig, N.E.; Mattei, S.; Seu, R.; Okubo, C.H.; Egan, A.F.

2009-01-01

The SHARAD instrument on the Mars Reconnaissance Orbiter detects subsurface interfaces beneath lava flow fields northwest of Ascraeus Mons. The interfaces occur in two locations; a northern flow that originates south of Alba Patera, and a southern flow that originates at the rift zone between Ascraeus and Pavonis Montes. The northern flow has permittivity values, estimated from the time delay of echoes from the basal interface, between 6.2 and 17.3, with an average of 12.2. The southern flow has permittivity values of 7.0 to 14.0, with an average of 9.8. The average permittivity values for the northern and southern flows imply densities of 3.7 and 3.4 g cm-3, respectively. Loss tangent values for both flows range from 0.01 to 0.03. The measured bulk permittivity and loss tangent values are consistent with those of terrestrial and lunar basalts, and represent the first measurement of these properties for dense rock on Mars. Copyright 2009 by the American Geophysical Union.

A Prospective Randomized Study on Operative Treatment for Simple Distal Tibial Fractures-Minimally Invasive Plate Osteosynthesis Versus Minimal Open Reduction and Internal Fixation.

PubMed

Kim, Ji Wan; Kim, Hyun Uk; Oh, Chang-Wug; Kim, Joon-Woo; Park, Ki Chul

2018-01-01

To compare the radiologic and clinical results of minimally invasive plate osteosynthesis (MIPO) and minimal open reduction and internal fixation (ORIF) for simple distal tibial fractures. Randomized prospective study. Three level 1 trauma centers. Fifty-eight patients with simple and distal tibial fractures were randomized into a MIPO group (treatment with MIPO; n = 29) or a minimal group (treatment with minimal ORIF; n = 29). These numbers were designed to define the rate of soft tissue complication; therefore, validation of superiority in union time or determination of differences in rates of delayed union was limited in this study. Simple distal tibial fractures treated with MIPO or minimal ORIF. The clinical outcome measurements included operative time, radiation exposure time, and soft tissue complications. To evaluate a patient's function, the American Orthopedic Foot and Ankle Society ankle score (AOFAS) was used. Radiologic measurements included fracture alignment, delayed union, and union time. All patients acquired bone union without any secondary intervention. The mean union time was 17.4 weeks and 16.3 weeks in the MIPO and minimal groups, respectively. There was 1 case of delayed union and 1 case of superficial infection in each group. The radiation exposure time was shorter in the minimal group than in the MIPO group. Coronal angulation showed a difference between both groups. The American Orthopedic Foot and Ankle Society ankle scores were 86.0 and 86.7 in the MIPO and minimal groups, respectively. Minimal ORIF resulted in similar outcomes, with no increased rate of soft tissue problems compared to MIPO. Both MIPO and minimal ORIF have high union rates and good functional outcomes for simple distal tibial fractures. Minimal ORIF did not result in increased rates of infection and wound dehiscence. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

The Formation and Dissolution of Second Unions: Marriage and Cohabitation in Sweden and Norway.

ERIC Educational Resources Information Center

Blanc, Ann Klimas

1987-01-01

Using recent survey data from Sweden and Norway and life table techniques, examined rate at which women formed second unions and type of union they chose (marriage or cohabitation) as well as how this process has changed over time. The results showed that nonmarital cohabitation was preferred type of second union in both Sweden and Norway.…

Minimally-invasive plate osteosynthesis in distal tibial fractures: Results and complications.

PubMed

Vidović, Dinko; Matejčić, Aljoša; Ivica, Mihovil; Jurišić, Darko; Elabjer, Esmat; Bakota, Bore

2015-11-01

Distal tibial or pilon fractures are usually the result of combined compressive and shear forces, and may result in instability of the metaphysis, with or without articular depression, and injury to the soft tissue. The complexity of injury, lack of muscle cover and poor vascularity make these fractures difficult to treat. Surgical treatment of distal tibial fractures includes several options: external fixation, IM nailing, ORIF and minimally-invasive plate osteosynthesis (MIPO). Management of distal tibial fractures with MIPO enables preservation of soft tissue and remaining blood supply. This is a report of a series of prospectively studied closed distal tibial and pilon fractures treated with MIPO. A total of 21 patients with closed distal tibial or pilon fractures were enrolled in the study between March 2008 and November 2013 and completed follow-up. Demographic characteristics, mechanism of injury, time required for union, ankle range of motion and complications were recorded. Fractures were classified according to the AO/OTA classification. Nineteen patients were initially managed with an ankle-spanning external fixator. When the status of the soft tissue had improved and swelling had subsided enough, a definitive internal fixation with MIPO was performed. Patients were invited for follow-up examinations at 3 and 6 weeks and then at intervals of 6 to 8 weeks until 12 months. Mean age of the patients was 40.1 years (range 19-67 years). Eighteen cases were the result of high-energy trauma and three were the result of low-energy trauma. According to the AO/OTA classification there were extraarticular and intraarticular fractures, but only simple articular patterns without depression or comminution. The average time for fracture union was 19.7 weeks (range 12-38 weeks). Mean range of motion was 10° of dorsiflexion (range 5-15°) and 28.3° of plantar flexion (range 20-35°). Three cases were metalwork-related complications. Two patients underwent plate removal at 24 weeks because of plate impingement. There was one case of wound breakdown at 11 weeks. One patient had fracture union with tibial recurvatum of approximately 10°, without functional impairment. Two patients had delayed union. MIPO is a reliable method of treatment for distal tibial fractures; it provides a high union rate and good functional outcome with minimal soft tissue complications. Skin impingement remains a common complication with MIPO, but this can be solved by timely plate removal. Copyright © 2015 Elsevier Ltd. All rights reserved.

Monitoring of Sparta Aquifer Recovery in Southern Arkansas and Northern Louisiana, 2003-07

USGS Publications Warehouse

Freiwald, David A.; Johnson, Sherrel F.

2007-01-01

Prior to 2004, the Sparta aquifer supplied all water for industrial and municipal uses in Union County, Arkansas, and continues to provide the majority of water for industrial and municipal purposes in the surrounding southern Arkansas counties and northern Louisiana parishes. In Union County, the Sparta aquifer has been used increasingly since development began in the early 1920s, resulting in water-level declines of more than 360 feet (ft) near El Dorado, Arkansas. In addition, water quality in some areas of the Sparta aquifer has degraded with increased withdrawals. In 2002 a study began that measures, through monitoring and reporting of water levels in Sparta aquifer wells throughout the study area in southern Arkansas and northern Louisiana, the impact of conservation and alternative water efforts on water level and water quality. This study provides continuous real-time water-level data at eight USGS wells that are part of a network of 29 monitoring wells and periodically reports results of semi-annual water-quality sampling. Water levels have risen in all eight real-time wells since monitoring began in the summer of 2003, and the Ouachita River Alternative Water Supply Project was completed in September 2004. The largest water-level rises occurred between October 2004 and April 2007 in the Monsanto well (49.0 ft rise) just north of El Dorado, and the Welcome Center well (36.1 ft rise) southeast of El Dorado. Twelve wells were sampled semi-annually for specific conductance and chloride concentration. Average specific conductance from individual wells ranges from 216 in the northwest to 1,157 uS/cm in the southeast and average chloride concentration ranges from 3.2 to 214 mg/L.

Failed Surgical Management of Acute Proximal Fifth Metatarsal (Jones) Fractures: A Retrospective Case Series and Literature Review.

PubMed

Granata, Jaymes D; Berlet, Gregory C; Philbin, Terrence M; Jones, Grant; Kaeding, Christopher C; Peterson, Kyle S

2015-12-01

Nonunion, delayed union, and refracture after operative treatment of acute proximal fifth metatarsal fractures in athletes is uncommon. This study was a failure analysis of operatively managed acute proximal fifth metatarsal fractures in healthy athletes. We identified 149 patients who underwent operative treatment for fifth metatarsal fractures. Inclusion criteria isolated skeletally mature, athletic patients under the age of 40 with a minimum of 1-year follow-up. Patients were excluded with tuberosity fractures, fractures distal to the proximal metaphyseal-diaphyseal region of the fifth metatarsal, multiple fractures or operative procedures, fractures initially treated conservatively, and medical comorbidities/risk factors for nonunion. Fifty-five patients met the inclusion/exclusion criteria. Four (7.3%) patients required a secondary operative procedure due to refracture. The average time to refracture was 8 months. All refractures were associated with bent screws and occurred in male patients who participated in professional basketball, professional volleyball, and college football. The average time for release to progressive weight-bearing was 6 weeks. Three patients were revised to a bigger size screw and went on to union. One patient was revised to the same-sized screw and required a second revision surgery for nonunion. All failures were refractures in competitive athletes who were initially treated with small diameter solid or cannulated stainless steel screws. The failures were not associated with early postoperative weight-bearing protocol. Maximizing initial fixation stiffness may decrease the late failure rate in competitive athletes. More clinical studies are needed to better understand risk factors for failure after screw fixation in the competitive, athletic population. Prognostic, Level IV: Case series. © 2015 The Author(s).

Outcome of locking compression plates in humeral shaft nonunions

PubMed Central

Kumar, Malhar N; Ravindranath, V Pratap; Ravishankar, MR

2013-01-01

Background: Nonunion of diaphyseal fractures of the humerus are frequently seen in clinical practice (incidence of up to 15% in certain studies) and osteosynthesis using dynamic compression plates, intra medullary nails and Ilizarov fixators have been reported previously. Locking compression plates (LCP) are useful in the presence of disuse osteoporosis, segmental bone loss and cortical defects that preclude strong fixation. We report a prospective followup study of the outcome of the use of LCP for humeral nonunion following failed internal fixation in which implants other than LCP had been used. Materials and Methods: Twenty four patients with nonunion of humeral shaft fractures following failed internal fixation were included in the study. The mean followup period was 3.4 years (range: 2.4 to 5.7 years) and the minimum followup period was 2 years. Mean age of the patients was 41.04 years (range: 24 to 57 years). All 24 patients underwent osteosynthesis using LCP and autologous bone grafting (cortico-cancellous iliac crest graft combined with or without fibular strut graft). Main outcome measurements included radiographic assessment of fracture union and pre and postoperative functional evaluation using the modified Constant and Murley scoring system. Results: 23 out of 24 fractures united following osteosynthesis. Average time to union was 16 weeks (range: 10 to 28 weeks). Complications included delayed union (n = 2), transient radial nerve palsy (n = 2) and persistent nonunion (n = 1). Functional evaluation using the Constant and Murley score showed excellent results in 11, good in 10, fair in two and poor outcome in one patient. Conclusions: Locking compression plating and cancellous bone grafting is a reliable option for achieving union in humeral diaphyseal nonunion with failed previous internal fixation and results in good functional outcome in patients with higher physiological demands. PMID:23682176

Reconstruction of segmental bone defect of long bones after tumor resection by devitalized tumor-bearing bone.

PubMed

Qu, Huayi; Guo, Wei; Yang, Rongli; Li, Dasen; Tang, Shun; Yang, Yi; Dong, Sen; Zang, Jie

2015-09-24

The reconstruction of an intercalary bone defect after a tumor resection of a long bone remains a challenge to orthopedic surgeons. Though several methods have been adopted to enhance the union of long segmental allografts or retrieved segmental autografts to the host bones, still more progresses are required to achieve a better union rate. Several methods have been adopted to devitalize tumor bone for recycling usage, and the results varied. We describe our experiences of using devitalized tumor-bearing bones for the repairing of segmental defects after tumor resection. Twenty-seven eligible patients treated from February 2004 to May 2012 were included. The segmental tumor bone (mean length, 14 cm) was resected, and then devitalized in 20% sterile saline at 65 °C for 30 min after the tumor tissue was removed. The devitalized bone was implanted back into the defect by using nails or plates. Complete healing of 50 osteotomy ends was achieved at a median time of 11 months (interquartile range (IQR) 9-13 months). Major complications included bone nonunion in four bone junctions (7.4%), devitalized bone fracture in one patient (3.7%), deep infection in three patients (11.1%), and fixation failure in two patients (7.4%). The bone union rates at 1 and 2 years were 74.1 and 92.6%, respectively. The average functional score according to the Musculoskeletal Tumor Society (MSTS) 93 scoring system was 93 % (IQR 80-96.7%). Incubation in 20% sterile saline at 65 °C for 30 min is an effective method of devitalization of tumor-bearing bone. The retrieved bone graft may provide as a less expensive alternative for limb salvage. The structural bone and the preserved osteoinductivity of protein may improve bone union.

How to Plug the Leak from Your School Board to the Teacher Union

ERIC Educational Resources Information Center

Lieberman, Myron

1978-01-01

Suggests steps that can be taken if a board member or anyone close to the board has ties with the teacher union and may supply the union with information about the board's position at bargaining time. (IRT)

Problem behaviors of children adopted from the former Soviet Union.

PubMed

McGuinness, Teena M; Pallansch, Leona

2007-01-01

Although current meta-analyses of problem behavior of internationally adopted children exist, few children adopted from the former Soviet Union have been included in these reports. A significant concern is that 13 children adopted from the former Soviet Union have died at the hands of their American adoptive parents since 1996. A cohort of 105 children adopted from the former Soviet Union has been assessed at two points in time by telephone and postal surveys to measure the impact of risk and protective factors on problem behavior. Pre-adoptive risk factors have declined in importance (except for birth weight) and protective factors (operationalized as aspects of family environment) have increased in influence over time. Problem behavior scores declined slightly at Time 2, despite the children having entered adolescence. Families play a significant role in the behavior of children adopted from the former Soviet Union. Nurses should counsel families to shape the child's environment during the transition from orphanage to homes in the United States, especially for children who are low birth weight.

Activity analysis of English Premiership rugby football union refereeing.

PubMed

Martin, J; Smith, N C; Tolfrey, K; Jones, A M

2001-10-10

Little is known about the physiological demands placed on officials during sporting activities. The purpose of this study was to ascertain the movement activities of referees during English Premiership rugby football union matches, and to determine the frequency and duration of these activities. Nine referees who were ranked in the top 20 referees in England were videotaped during a total of 19 matches. During playback of the videotapes, a single observer coded the referees' activities into one of six distinct categories (standing, walking forwards, walking backwards, jogging, running and sprinting) using a computerized video editing system (Observer Video-Pro). The referees were timed over a 20 m distance for the modes of locomotory activity, and the average velocity of the referee for each activity was used to calculate the total distance covered in each mode of activity during matches. The total distance covered during a match was (chi +/- SD) 8581 +/- 668 m. The mean percentage of total playing time spent in each activity was: standing still, 37.0 +/- 11.0%; walking forward, 29.5 +/- 7.2%; walking backward, 9.9 +/- 3.2%; jogging, 12.8 +/- 3.2%; running, 9.8 +/- 2.3%; and sprinting, 1.0 +/- 0.4%. There were a total of 672 transitions between modes of activity during a match. The results of this study suggest that refereeing top English rugby football union matches is physically demanding. Although the major physiological load is placed on the oxygen transport system, frequent sprint bouts and the associated requirements for acceleration and deceleration impose additional metabolic demands on referees. This information may be used in the design of physical training programmes to optimize performance in referees.

Migration of the population.

PubMed

Krasinets, E

1998-03-01

Two factors influence foreign migration balance of the Russian Federation. The first factor involves the migration process between Russia and former union republics. The influx of population to the Russian Federation from other republics of the former Soviet Union is considered as one of the largest in the world. The average annual migratory growth of Russia during the years 1991-94 as a result of this migration exchange has tripled as compared with 1986-90, with a total of 2.7 million Russians who migrated into Russia. However, from 1996 up to the present time, the number of persons arriving in Russia declined dramatically. Meanwhile, the second factor that determines the country's migration balance is emigration to the far abroad. The most significant trend in determining the development of internal migration in Russia is the outflow of population from northern and eastern regions. The directions of internal and external migratory flows have a large influence on the migration balance in Russia's rural areas. The reduction of migratory flows in rural areas is the direct result of processes in the economic sphere. It confirms the reconstruction of rural-urban migratory exchange.

Scientific and technical training in the Soviet Union

NASA Technical Reports Server (NTRS)

Spearman, M. L.

1983-01-01

Specific features and observations on the Soviet educational system and areas of apparent effectiveness are presented, noting that the literacy rate is over 98 percent in 1982. Educational goals are reoriented every five years to match with other projections of five-year plans. The Soviet constitution established strong educational goals, including schools, correspondence courses, lectures in native tongues, free tuition, and vocational training. The educational pattern from pre-school through graduate school lasts over 28 yr and contains two 2-yr periods of work, confined to specialties after graduate school. Mathematics is emphasized, as are physics, Marxism, and a foreign language. Approximately 300,000 engineers were graduated in the Soviet Union in 1982, compared with the 20-yr U.S. average of 50,000/yr. About 2/3 of Soviet engineers participate in defense work, a number which is four times the total number of U.S. engineers. It is asserted that the continual indoctrination, organization, and practical work experience will guarantee that the Soviet state will remain a dominant force in the world as long as centralized state control can be carried out.

12 CFR 747.12 - Construction of time limits.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Construction of time limits. 747.12 Section 747.12 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS... of Practice and Procedure § 747.12 Construction of time limits. (a) General rule. In computing any...

Ball-joint versus single monolateral external fixators for definitive treatment of tibial shaft fractures.

PubMed

Beltsios, Michail; Mavrogenis, Andreas F; Savvidou, Olga D; Karamanis, Eirineos; Kokkalis, Zinon T; Papagelopoulos, Panayiotis J

2014-07-01

To compare modular monolateral external fixators with single monolateral external fixators for the treatment of open and complex tibial shaft fractures, to determine the optimal construct for fracture union. A total of 223 tibial shaft fractures in 212 patients were treated with a monolateral external fixator from 2005 to 2011; 112 fractures were treated with a modular external fixator with ball-joints (group A), and 111 fractures were treated with a single external fixator without ball-joints (group B). The mean follow-up was 2.9 years. We retrospectively evaluated the operative time for fracture reduction with the external fixator, pain and range of motion of the knee and ankle joints, time to union, rate of malunion, reoperations and revisions of the external fixators, and complications. The time for fracture reduction was statistically higher in group B; the rate of union was statistically higher in group B; the rate of nonunion was statistically higher in group A; the mean time to union was statistically higher in group A; the rate of reoperations was statistically higher in group A; and the rate of revision of the external fixator was statistically higher in group A. Pain, range of motion of the knee and ankle joints, rates of delayed union, malunion and complications were similar. Although modular external fixators are associated with faster intraoperative fracture reduction with the external fixator, single external fixators are associated with significantly better rates of union and reoperations; the rates of delayed union, malunion and complications are similar.

Maxillary post-traumatic outcome correction literature review and our experience. Part I: maxillary bone non-unions-"poor bone positioning".

PubMed

D'Agostino, A; Toffanetti, G; Scala, R; Trevisiol, L; Ferrari, F

2004-04-01

Still today, there is no classification of non-unions in maxillofacial traumatology. There is a broad spectrum of definitions that simultaneously describe the pathological conditions and functional implications determined by the anatomical location of the fractures and the time factor. In this article the authors describe a literature review about bone non-union classification. Weber, in 1973, introduced the term "pseudo-arthrosis" to describe an altered process of bone healing characterised by the presence of fibrous tissue interposed between the fracture segments, that was lined with cartilaginous tissue and joined by a capsule; Spiessl, in 1988, used the term "non-union" to define any alteration of the bone healing process after a time period of more than 6 months from the initial traumatic event; Rosen, in 1990, proposed a new classification of the modes of altered bone healing in fractures, distinguishing 5 categories: delayed consolidation, non-union, non-union vascular, non union avascular, pseudoarthrosis. The authors also talk about "poor bone positioning". This factor describes the incorrect anatomical position of the bone fragments despite perfectly normal healing according to Gruss. In this article they also discuss about the treatment of non-unions and the treatment of occlusal alterations caused by poor post-traumatic bone positioning.

Retrograde nailing for distal third femoral shaft fractures: a prospective study.

PubMed

Acharya, K N; Rao, M R

2006-12-01

To evaluate the postoperative knee function and results of unreamed retrograde nailing for distal third femoral shaft fractures. Between January 2002 and 2003 inclusive, a consecutive series of 27 patients (with 28 fractures) who underwent retrograde nailing were prospectively evaluated. Outcome measures were union time, initiation of weight bearing, deformity and shortening, functional length of the nail, knee function assessed using a modified Knee Society Knee Score. Correlations between union time and other variables were also studied. In these patients 26 (93%) of the 28 fractures achieved union, of which 5 underwent dynamisation; the mean union time for the other 21 fractures was 4.4 months. Angular malalignment was present in 4 patients and shortening in 4 others. There was negligible correlation between union time and variables of nail-canal diameter mismatch, functional length of nail, fracture geometry, or initiation of partial weight bearing ambulation. Knee flexion of more than 100 degrees was achieved in 26 patients. 19 patients had anterior knee pain and 10 had instability. By the end of one year, excellent or good scores for pain and function were recorded in 77% and 73% respectively, of the 26 patients. In view of such favourable union rates but significant deterioration in overall knee joint function, at best retrograde nailing is a reliable alternative in the management of selected complicated fractures of the distal femoral shaft.

Effectiveness and Complications Associated With Recombinant Human Bone Morphogenetic Protein-2 Augmentation of Foot and Ankle Fusions and Fracture Nonunions.

PubMed

Rearick, Timothy; Charlton, Timothy P; Thordarson, David

2014-08-01

Recombinant human bone morphogenetic protein-2 (rhBMP-2) has been used to augment bone healing and fusion in a variety of orthopaedic conditions. However, there is a paucity of data evaluating the potential benefits of its use in foot and ankle surgery. The purpose of this study was to investigate the effectiveness and associated complications with the use of rhBMP-2 in high-risk foot and ankle fusions and fracture nonunions. A total of 51 cases in 48 patients undergoing foot and ankle fusions or fracture nonunion revisions and considered at high risk for subsequent nonunion were identified through a retrospective review in which rhBMP-2 was used as an augment for bone healing. Rate of union, time to union, and associated complications were evaluated. Forty-seven of 51 high-risk cases treated with rhBMP-2 united for a per-case union rate of 92.2%. Seventy-eight of 82 individual sites treated with rhBMP-2 united for a per-site union rate of 95.1%. Of the successful unions, the mean time to union was 111 days (95% confidence interval, 101-121). There were no statistically significant differences in time to union with regard to supplementation with bone allograft or autograft or size of rhBMP-2 kit used. Complication rates were low. rhBMP-2 was a safe and apparently effective adjunct to bony union in high-risk foot and ankle surgeries. Further randomized controlled trials are warranted. Level IV, retrospective case series. © The Author(s) 2014.

Member Input Sought to Ensure AGU's Continued Success

NASA Astrophysics Data System (ADS)

Grove, Timothy L.

2008-11-01

As an organization, AGU is indeed fortunate. Our Union has a growing membership worldwide with an average annual increase of 5.9% over the last 5 years. We are financially strong; we have planned carefully and managed our assets and our annual budgets so that we are able to navigate difficult times. Our Fall Meeting is ``the'' event for Earth and space scientists from more than 100 countries. Our publications continue to grow and evolve. Our outreach programs are gaining recognition in the communities we serve. Our development efforts are strengthening our ability to do more without taxing the revenues from meetings and publications. AGU is a preeminent scientific society.

Management of septic non-union of the tibia by the induced membrane technique. What factors could improve results?

PubMed

Siboni, Renaud; Joseph, Etienne; Blasco, Laurent; Barbe, Coralie; Bajolet, Odile; Diallo, Saïdou; Ohl, Xavier

2018-06-07

Management of septic non-union of the tibia requires debridement and excision of all infected bone and soft tissues. Various surgical techniques have been described to fill the bone defect. The "Induced Membrane" technique, described by A. C. Masquelet in 1986, is a two-step procedure using a PMMA cement spacer around which an induced membrane develops, to be used in the second step as a bone graft holder for the bone graft. The purpose of this study was to assess our clinical and radiological results with this technique in a series managed in our department. Nineteen traumatic septic non-unions of the tibia were included in a retrospective single-center study between November 2007 and November 2014. All patients were followed up clinically and radiologically to assess bone union time. Multivariate analysis was used to identify factors influencing union. The series comprised 4 women and 14 men (19 legs); mean age was 53.9 years. Vascularized flap transfer was required in 26% of cases before the first stage of treatment. All patients underwent a two-step procedure, with a mean interval of 7.9 weeks. Mean bone defect after the first step was 52.4mm. The bone graft was harvested from the iliac crest in the majority of cases (18/19). The bone was stabilized with an external fixator, locking plate or plaster cast after the second step. Mean follow-up was 34 months. Bony union rate was 89% (17/19), at a mean 16 months after step 2. Eleven patients underwent one or more (mean 2.1) complementary procedures. Severity of index fracture skin opening was significantly correlated with union time (Gustilo III vs. Gustilo I or II, p=0.028). A trend was found for negative impact of smoking on union (p=0.06). Bone defect size did not correlate with union rate or time. The union rate was acceptable, at 89%, but with longer union time than reported in the literature. Many factors could explain this: lack of rigid fixation after step 2 (in case of plaster cast or external fixator), or failure to cease smoking. The results showed that the induced membrane technique is effective in treating tibial septic non-union, but could be improved by stable fixation after the second step and by cessation of smoking. IV, Retrospective study. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Bone fragment union and remodeling after arthroscopic bony bankart repair for traumatic anterior shoulder instability with a glenoid defect: influence on postoperative recurrence of instability.

PubMed

Nakagawa, Shigeto; Ozaki, Ritsuro; Take, Yasuhiro; Mae, Tatsuo; Hayashida, Kenji

2015-06-01

Although good clinical outcomes have been reported after arthroscopic bony Bankart repair, the extent of bone union is still unclear. To investigate bone union after arthroscopic bony Bankart repair and its influence on postoperative recurrence of instability. Cohort study; Level of evidence, 3. Among 113 consecutive shoulders that underwent arthroscopic bony Bankart repair, postoperative evaluation of bone union by computed tomography (CT) was performed at various times in 81 shoulders. Bone union was investigated during 3 periods: 3 to 6 months postoperatively (first period), 7 to 12 months postoperatively (second period), and 13 months or more postoperatively (third period). The influence of the size of the preoperative glenoid defect and the size of the bone fragment on bone union was investigated, as well as the influence of bone union on postoperative recurrence of instability. In shoulders with bone union, bone fragment remodeling and changes in the glenoid defect size were also investigated. The bone union rate was 30.5% in the first period, 55.3% in the second period, and 84.6% in the third period. Among 53 shoulders with CT evaluation in the second period or later and follow-up for a minimum of 1 year, there was complete union in 33 shoulders (62.3%), partial union in 3 (5.7%), nonunion in 8 (15.1%), and no fragment on CT in 9 (17.0%). The complete union rate was 50% for 22 shoulders with small bone fragments (<5% of the glenoid diameter), 56.3% for 16 shoulders with medium fragments (5%-10%), and 86.7% for 15 shoulders with large fragments (>10%). The recurrence rate for postoperative instability was only 6.1% for shoulders with complete union, while it was 50% for shoulders with partial union, nonunion, no fragment, and no fragment on CT. The recurrence rate was significantly higher (36.4%) in shoulders with small fragments, but it was significantly lower in shoulders with bone union. In shoulders with bone union, the bone fragment frequently became larger over time, while the size of the glenoid defect decreased significantly from 18.6% preoperatively to 4.7% postoperatively. Bone union was not always achieved after arthroscopic bony Bankart repair, and union was often delayed. Recurrence of instability was significantly more frequent when bone union failed. The size of the glenoid defect decreased significantly in shoulders with bone union. © 2015 The Author(s).

Influencing factors of functional result and bone union in tibiotalocalcaneal arthrodesis with intramedullary locking nail: a retrospective series of 30 cases.

PubMed

Gross, Jean-Baptiste; Belleville, Rémi; Nespola, Arnaud; Poircuitte, Jean-Manuel; Coudane, Henry; Mainard, Didier; Galois, Laurent

2014-05-01

Initially considered as an established salvage procedure for tibiotalocalcaneal arthrodesis (TTCA), intramedullary nailing indications have expanded as evidenced in recent literature. We have tried to identify factors influencing functional result and bone union. In a retrospective study, 30 patients were treated by a TTCA between January 2006 and November 2011. Indications, operative technique, bone fusion, X-rays and functional result [American Foot and Ankle Society (AOFAS) and short-form health survey (SF-36) scores] before and after surgery were registered and analyzed. Thirty cases of TTCA were included. The patient's average age was 52 (range 24-90). Union rate was 86% for the tibiotalar joint and 74% for the subtalar joint with an average follow-up of 25.4 months (8-67). The mean AOFAS' score significantly improved (from 37 to 59) as the SF-36' score. Global complication rate was about 56%. It has not been possible to identify factors significantly influencing bone fusion or functional results. All septic cases achieved fusion without any septic resurgence. Retrograde intramedullary nailing in TTCA is an effective technique, which allows good clinical results even in case of septic history of the patient. Fusion rate and functional results were not significantly influenced by any of the factors examined in this study.

Constraints on cosmological parameters in power-law cosmology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rani, Sarita; Singh, J.K.; Altaibayeva, A.

In this paper, we examine observational constraints on the power law cosmology; essentially dependent on two parameters H{sub 0} (Hubble constant) and q (deceleration parameter). We investigate the constraints on these parameters using the latest 28 points of H(z) data and 580 points of Union2.1 compilation data and, compare the results with the results of ΛCDM . We also forecast constraints using a simulated data set for the future JDEM, supernovae survey. Our studies give better insight into power law cosmology than the earlier done analysis by Kumar [arXiv:1109.6924] indicating it tuning well with Union2.1 compilation data but not withmore » H(z) data. However, the constraints obtained on and i.e. H{sub 0} average and q average using the simulated data set for the future JDEM, supernovae survey are found to be inconsistent with the values obtained from the H(z) and Union2.1 compilation data. We also perform the statefinder analysis and find that the power-law cosmological models approach the standard ΛCDM model as q → −1. Finally, we observe that although the power law cosmology explains several prominent features of evolution of the Universe, it fails in details.« less

Lethal levels of selected water quality variables to larval and juvenile Lost River and shortnose suckers

USGS Publications Warehouse

Saiki, M.K.; Monda, D.P.; Bellerud, B.L.

1999-01-01

Resource managers hypothesize that occasional fish kills during summer-early fall in Upper Klamath Lake, Oregon, may be linked to unfavorable water quality conditions created by massive algal blooms. In a preliminary effort to address this concern, short-term (96-h-long) laboratory tests were conducted with larval and juvenile Lost River (Deltistes luxatus) and shortnose (Chasmistes brevirostris) suckers to determine the upper median lethal concentrations (LC50s; also referred to as median tolerance limits) for pH, un-ionized ammonia, and water temperature, and the lower LC50s for dissolved oxygen. The mean LC50s varied among species and life stages as follows: for pH, 10.30-10.39; for un-ionized ammonia, 0.48-1.06 mg litre-1; for temperature, 30.35-31.82??C; and for dissolved oxygen, 1.34-2.10 mg litre-1. Comparisons of 95% confidence limits indicated that, on average, the 96-h LC50s were not significantly different from those computed for shorter exposure times (i.e., 24 h, 48 h, and 72 h). According to two-way analysis of variance, LC50s for the four water quality variables did not vary significantly (p > 0.05) between fish species. However, LC50s for pH (exposure times of 24 h and 48 h) and dissolved oxygen (exposure times of 48 h, 72 h, and 96 h) differed significantly (p ??? 0.05) between life stages, whereas LC50s for un-ionized ammonia and water temperature did not exhibit significant differences. In general, larvae were more sensitive than juveniles to high pH and low dissolved oxygen concentrations. When compared to ambient water quality conditions in Upper Klamath Lake, our results strongly suggest that near-anoxic conditions associated with the senescence phase of algal blooms are most likely to cause high mortalities of larval and juvenile suckers.

Comparison between locked intramedullary nailing and anatomical locking plating in the treatment of displaced clavicular midshaft fractures.

PubMed

Zehir, Sinan; Çalbıyık, Murat; Şahin, Ercan; İpek, Deniz

2016-01-01

The aim of this study was to compare the results of expandable flexible locked intramedullary nailing and anatomical locking plating in clavicular midshaft fractures. Thirty-three patients (21 male, 12 female) who had displaced fractures and at least 2-cm shortening fixed with expandable flexible locked intramedullary nailing and 38 patients (24 male, 14 female) who underwent anatomical locking plating were recruited. Duration of surgery, incision size, duration of hospital stay, union time, and early and late complications were compared between the groups. Functional results were compared with Constant scoring system. Mean duration of surgery was 32.4±9.1 minutes (range: 20-42 minutes) in the nailing group and 54.1±11.9 minutes (range: 42-70 minutes) in the plating group. The incision was 4.1±0.9 cm (range: 3-5 cm) in the nailing group and 9.5±1.7 cm (range: 7-12 cm) in the plating group. Mean union time was 14.8 weeks (range: 10-24 weeks) in the nailing group and 21.3 weeks (range: 12-33 weeks) in the plating group. Mean duration of hospital stay was 3.6±1.1 days (range: 2-4 days) in the plating group, whereas it was 2.3±0.8 days (range: 1-3 days) in the nailing group. In the plating group, an average of 2.7-mm (range: 0-7 mm) shortening was determined in the clavicles that underwent surgery as compared to the intact clavicles, whereas shortening was 2.3 mm (range: 0-6 mm) in the nailing group. Expandable flexible locked intramedullary nailing can provide more successful outcomes than plating in displaced clavicular midshaft fractures, due to advantages such as shorter union time, lower complication rate, and better cosmetic outcomes.

Women and Unions: Forging a Partnership.

ERIC Educational Resources Information Center

Cobble, Dorothy Sue, Ed.

This book contains the views of 40 contributors on women and unions, organized into 15 chapters on six topics: Closing the Wage Gap; Meeting Family Needs; Temporary and Part-Time Work: Opportunity or Danger?; Homework; Developing a Realistic Approach; New Directions in Organizing and Representing Women; and Female Leadership and Union Cultures:…

12 CFR 702.307 - Incentives for new credit unions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... for new credit unions. (a) Assistance in revising business plans. Upon timely request by a credit union having total assets of less than $10 million (regardless how long it has been in operation), the NCUA Board shall provide assistance in preparing a revised business plan required to be filed under...

Convergence: How Nursing Unions and Magnet are Advancing Nursing.

PubMed

Johnson, Joyce E; Billingsley, Molley

2014-01-01

Historically, unions and professional associations such as the American Nurses Association have been adversaries in the fight to represent the best interests of the nursing profession. We reviewed the literature on the evolution of nursing unions, nursing's historical unease about unions, the Magnet designation in nursing, the tensions between the unions and Magnet, the core values and commonalities they share, and the obligations of nursing as a profession. Refocusing on the advancement of our profession provides a positive pathway in which the collective efforts of nursing unions and professional initiatives such as the Magnet designation converge during these turbulent times for our profession. The single, central organizing idea of nursing-where nursing unions and Magnet converge-is the pivotal role of nurses in delivering high-quality patient care. The often-maligned dialectic between unions and Magnet has advanced and not hindered the nursing profession. © 2014 Wiley Periodicals, Inc.

Anterior ankle arthrodesis

PubMed Central

Slater, Gordon L; Sayres, Stephanie C; O’Malley, Martin J

2014-01-01

Ankle arthrodesis is a common procedure that resolves many conditions of the foot and ankle; however, complications following this procedure are often reported and vary depending on the fixation technique. Various techniques have been described in the attempt to achieve ankle arthrodesis and there is much debate as to the efficiency of each one. This study aims to evaluate the efficiency of anterior plating in ankle arthrodesis using customised and Synthes TomoFix plates. We present the outcomes of 28 ankle arthrodeses between 2005 and 2012, specifically examining rate of union, patient-reported outcomes scores, and complications. All 28 patients achieved radiographic union at an average of 36 wk; the majority of patients (92.86%) at or before 16 wk, the exceptions being two patients with Charcot joints who were noted to have bony union at a three year review. Patient-reported outcomes scores significantly increased (P < 0.05). Complications included two delayed unions as previously mentioned, infection, and extended postoperative pain. With multiple points for fixation and coaxial screw entry points, the contoured customised plate offers added compression and provides a rigid fixation for arthrodesis stabilization. PMID:24649408

Hybrid external fixation in the treatment of tibial pilon fractures: A retrospective analysis of 162 fractures.

PubMed

Galante, Vito N; Vicenti, Giovanni; Corina, Gianfranco; Mori, Claudio; Abate, Antonella; Picca, Girolamo; Conserva, Vito; Speciale, Domenico; Scialpi, Lorenzo; Tartaglia, Nicola; Caiaffa, Vincenzo; Moretti, Biagio

2016-10-01

To determine the efficacy of hybrid external fixation in the treatment of tibial pilon fractures. Retrospective, multicentre study. Adult patients with tibial pilon fractures treated with hybrid external fixation. Fracture reduction with ligamentotaxis and fixation with XCaliber hybrid external fixator. Fracture union, complications, functional outcome (Mazur Ankle Score). Union was obtained in 159 fractures at an average of 125days; there were three delayed unions and three non-unions. The most frequent complication was superficial pin-track infections (48), all of which responded to local wound care and antibiotics. There were no deep infections and no DVT. Only one fracture had loss of reduction that required frame revision. The overall functional scores were 91 (excellent) for AO/OTA type A fractures, 89 (good) for type B fractures, and 75 (satisfactory) for type C fractures. Hybrid external fixation is an effective method of stabilising tibial pilon fractures, particularly those with marked comminution. The minimally-invasive technique and stable fixation enable early mobilisation, with good functional results and minimal complications. Level IV Case series. Copyright © 2016 Elsevier Ltd. All rights reserved.

Do force-time and power-time measures in a loaded jump squat differentiate between speed performance and playing level in elite and elite junior rugby union players?

PubMed

Hansen, Keir T; Cronin, John B; Pickering, Stuart L; Douglas, Lee

2011-09-01

The purpose of this study was to investigate the discriminative ability of rebound jump squat force-time and power-time measures in differentiating speed performance and competition level in elite and elite junior rugby union players. Forty professional rugby union players performed 3 rebound jump squats with an external load of 40 kg from which a number of force-time and power-time variables were acquired and analyzed. Additionally, players performed 3 sprints over 30 m with timing gates at 5, 10, and 30 m. Significant differences (p < 0.05) between the fastest 20 and slowest 20 athletes, and elite (n = 25) and elite junior (n = 15) players in speed and force-time and power-time variables were determined using independent sample t-tests. The fastest and slowest sprinters over 10 m differed in peak power (PP) expressed relative to body weight. Over 30 m, there were significant differences in peak velocity and relative PP and rate of power development. There was no significant difference in speed over any distance between elite and elite junior rugby union players; however, a number of force and power variables including peak force, PP, force at 100 milliseconds from minimum force, and force and impulse 200 milliseconds from minimum force were significantly (p < 0.05) different between playing levels. Although only power values expressed relative to body weight were able to differentiate speed performance, both absolute and relative force and power values differentiated playing levels in professional rugby union players. For speed development in rugby union players, training strategies should aim to optimize the athlete's power to weight ratio, and lower body resistance training should focus on movement velocity. For player development to transition elite junior players to elite status, adding lean mass is likely to be most beneficial.

Mechanical Properties of Sprinting in Elite Rugby Union and Rugby League.

PubMed

Cross, Matt R; Brughelli, Matt; Brown, Scott R; Samozino, Pierre; Gill, Nicholas D; Cronin, John B; Morin, Jean-Benoît

2015-09-01

To compare mechanical properties of overground sprint running in elite rugby union and rugby league athletes. Thirty elite rugby code (15 rugby union and 15 rugby league) athletes participated in this cross-sectional analysis. Radar was used to measure maximal overground sprint performance over 20 or 30 m (forwards and backs, respectively). In addition to time at 2, 5, 10, 20, and 30 m, velocity-time signals were analyzed to derive external horizontal force-velocity relationships with a recently validated method. From this relationship, the maximal theoretical velocity, external relative and absolute horizontal force, horizontal power, and optimal horizontal force for peak power production were determined. While differences in maximal velocity were unclear between codes, rugby union backs produced moderately faster split times, with the most substantial differences occurring at 2 and 5 m (ES 0.95 and 0.86, respectively). In addition, rugby union backs produced moderately larger relative horizontal force, optimal force, and peak power capabilities than rugby league backs (ES 0.73-0.77). Rugby union forwards had a higher absolute force (ES 0.77) despite having ~12% more body weight than rugby league forwards. In this elite sample, rugby union athletes typically displayed greater short-distance sprint performance, which may be linked to an ability to generate high levels of horizontal force and power. The acceleration characteristics presented in this study could be a result of the individual movement and positional demands of each code.

Delayed healing of lower limb fractures with bisphosphonate therapy.

PubMed

Yue, B; Ng, A; Tang, H; Joseph, S; Richardson, M

2015-07-01

Bisphosphonate therapy (BT) is used commonly in the management of osteoporosis. A systematic review was conducted investigating delayed union of lower limb, long bone fractures in patients on BT. We specifically assessed whether BT increases the risk of delayed union or non-union in lower limb, long bone fractures. A literature search was conducted in the PubMed and Embase™ on 4 November 2014. Articles that investigated lower limb fractures, history of BT and fracture union were included in the review. A total of 9,809 papers were retrieved and 14 were deemed suitable for this review. The mean time to union in patients on BT was 8.5 months. A longer time to union was reported in a study investigating BT users versus controls (6.5 vs 4.8 months respectively). The mean rate of delayed or non-union for BT associated atypical fractures was 20% per fracture. Specifically in one study, delayed union was more common in the cohort with more than three years of BT (67%) than in the group with less than three years of BT (26%). Surgical fixation was associated with improved outcomes compared with non-operative management. BT has been described to be associated with multiple adverse outcomes related to atypical fractures. Current evidence recommends operative management for this patient group. Further investigation is required to evaluate the exact effects of BT on lower limb fractures, in particular typical femoral fractures.

Maximum number of children per sperm donor based on false paternity rate.

PubMed

Sánchez-Castelló, Isabel M; Gonzalvo, María C; Clavero, Ana; López-Regalado, María L; Mozas, Juan; Martínez-Granados, Luis; Navas, Purificación; Castilla, José A

2017-03-01

The aim of this study is to estimate the weight of each relevant factor in such unions of inadvertent consanguinity and to determine a "reasonable" limit for the number of children per donor, matching the probability of inadvertent consanguinity arising from the use of sperm donor in assisted reproduction with that of such a union arising from false paternity. In this study, we applied to Spanish data a mathematical model of consanguineous unions, taking into account the following factors: maximum number of live births/donor, fertility rate, average number of births per donor in a pregnancy, donor success rate, matings per phenotype, number of newborns/year, and number of donors needed in the population/year and births by false paternity. In Spain, the number of inadvertent unions between descendants of the same donor in Spain has been estimated at 0.4/year (one every two and a half years), although this frequency decreases as the reference population increases. On the other hand, the frequency of unions between family members due to false paternity has been estimated at 6.1/year. Thus, only 6% of such unions are due to the use of donor sperm. A total of 25 children per sperm donor are needed to align the probability of inadvertant consanguinity arising from the use of assisted reproduction with that due to false paternity. Therefore, we consider this number to be the maximum "reasonable" number of children born per donor in Spain.

Trade Unions, Collective Bargaining and Reduced Working Time: A Critical Assessment.

ERIC Educational Resources Information Center

Rathkey, Paul

1986-01-01

In this article, the intention is to examine the development of the trade union approach to working time, assess its successes and failures, and seek an understanding of the movement toward reduced working time. From that assessment, it is argued that prevailing strategies are unlikely to bear dividends in terms of their own objectives--the…

Low reservoir ages for the surface ocean from mid-Holocene Florida corals

USGS Publications Warehouse

Druffel, E.R.M.; Robinson, L.F.; Griffin, S.; Halley, R.B.; Southon, J.R.; Adkins, J.F.

2008-01-01

The 14C reservoir age of the surface ocean was determined for two Holocene periods (4908-4955 and 3008-3066 calendar (cal) B.P.) using U/Th-dated corals from Biscayne National Park, Florida, United States. We found that the average reservoir ages for these two time periods (294 ?? 33 and 291 ?? 27 years, respectively) were lower than the average value between A.D. 1600 and 1900 (390 ?? 60 years) from corals. It appears that the surface ocean was closer to isotopic equilibrium with CO2 in the atmosphere during these two time periods than it was during recent times. Seasonal ??18O measurements from the younger coral are similar to modern values, suggesting that mixing with open ocean waters was indeed occurring during this coral's lifetime. Likely explanations for the lower reservoir age include increased stratification of the surface ocean or increased ??14C values of subsurface waters that mix into the surface. Our results imply that a more correct reservoir age correction for radiocarbon measurements of marine samples in this location from the time periods ???3040 and ???4930 cal years B.P. is ???292 ?? 30 years, less than the canonical value of 404 ?? 20 years. Copyright 2008 by the American Geophysical Union.

A Comprehensive Examination of the Soviet Naval Infantry

DTIC Science & Technology

1977-07-11

1961-621 3n,1 even oarlier are three German sources which inricatu 1960.8 Par more interesting is the evidence which ap- peared within the Soviet Union ...years in a row. Finally, in 1956, the Soviet Union began taking delivery of various types of landing ships and craft. The Soviet Union continued to build...in Moscow, commemorating 12. the 50th anniversary of the October Revolution.1 Finally, at the time that the Soviet Union was expanding its Naval

Assessment of forest fire impacts and emissions in the European Union based on the European forest fire information system

Treesearch

Paulo Barbosa; Andrea Camia; Jan Kucera; Giorgio Libertá; Ilaria Palumbo; Jesus San-Miguel-Ayanz; Guido Schmuck

2009-01-01

An analysis on the number of forest fires and burned area distribution as retrieved by the European Forest Fire Information System (EFFIS) database is presented. On average, from 2000 to 2005 about...

Peak Running Intensity of International Rugby: Implications for Training Prescription.

PubMed

Delaney, Jace A; Thornton, Heidi R; Pryor, John F; Stewart, Andrew M; Dascombe, Ben J; Duthie, Grant M

2017-09-01

To quantify the duration and position-specific peak running intensities of international rugby union for the prescription and monitoring of specific training methodologies. Global positioning systems (GPS) were used to assess the activity profile of 67 elite-level rugby union players from 2 nations across 33 international matches. A moving-average approach was used to identify the peak relative distance (m/min), average acceleration/deceleration (AveAcc; m/s 2 ), and average metabolic power (P met ) for a range of durations (1-10 min). Differences between positions and durations were described using a magnitude-based network. Peak running intensity increased as the length of the moving average decreased. There were likely small to moderate increases in relative distance and AveAcc for outside backs, halfbacks, and loose forwards compared with the tight 5 group across all moving-average durations (effect size [ES] = 0.27-1.00). P met demands were at least likely greater for outside backs and halfbacks than for the tight 5 (ES = 0.86-0.99). Halfbacks demonstrated the greatest relative distance and P met outputs but were similar to outside backs and loose forwards in AveAcc demands. The current study has presented a framework to describe the peak running intensities achieved during international rugby competition by position, which are considerably higher than previously reported whole-period averages. These data provide further knowledge of the peak activity profiles of international rugby competition, and this information can be used to assist coaches and practitioners in adequately preparing athletes for the most demanding periods of play.

Clinical comparison of two different plating methods in minimally invasive plate osteosynthesis for clavicular midshaft fractures: A randomized controlled trial.

PubMed

Sohn, Hoon-Sang; Shon, Min Soo; Lee, Kyung-Hag; Song, Si-Jung

2015-11-01

The aim of this study was to compare the clinical and radiographic outcomes between two different plating methods (superior vs. anteroinferior) in minimally invasive plate osteosynthesis (MIPO) for acute displaced clavicular shaft fractures. A prospective, randomized controlled trial was performed in a single centre. Nineteen patients were treated with superior plating and 18 with anteroinferior plating using the MIPO technique. A 3.5-mm locking reconstruction plate was bent preoperatively and applied to either the anteroinferior or superior aspect of the clavicle through two separate incisions. The operating time, time to union, the proportional length difference, complications, and functional outcome of the shoulder joint were evaluated using the Constant score and the University of California Los Angeles (UCLA) score. There was no statistically significant difference in the Constant score and UCLA score. The mean time to union was 16.8 weeks for superior plating and 17.1 weeks for anteroinferior plating (p=0.866). The average operation time was 77.2min in superior plating and 79.4min in anteroinferior plating (p=0.491). One patient in the superior plating group showed plate failure. Despite no significant difference, one patient had nonunion in the superior plating group (p>0.999). From a clinical perspective, although MIPO with anteroinferior plating provides better outcomes especially in complications without statistically significant difference, both plating methods provided satisfactory clinical and radiographic outcomes. Level I, a single-centre, prospective, randomized controlled trial. Copyright © 2015 Elsevier Ltd. All rights reserved.

77 FR 65139 - Designation of Low-Income Status; Acceptance of Secondary Capital Accounts by Low-Income...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-25

...-Income Status; Acceptance of Secondary Capital Accounts by Low-Income Designated Credit Unions AGENCY... amend its low-income credit unions regulation by extending the time credit unions have to accept a low- income designation. Under the current rule, an FCU that has received notification from NCUA that it...

Can Graduate Students Re-Energize the Labor Movement?

ERIC Educational Resources Information Center

Kitchen, Deeb-Paul, II

2014-01-01

In recent years, issues pertaining to graduate student union organizing have been at the center of several political battles and court cases. This attention is, at least in part, due to the growth of graduate student unions at a time when organized labor's influence is receding in other, more traditionally unionized sectors of the labor force. As…

Determination of Radiographic Healing: An Assessment of Consistency Using RUST and Modified RUST in Metadiaphyseal Fractures.

PubMed

Litrenta, Jody; Tornetta, Paul; Mehta, Samir; Jones, Clifford; OʼToole, Robert V; Bhandari, Mohit; Kottmeier, Stephen; Ostrum, Robert; Egol, Kenneth; Ricci, William; Schemitsch, Emil; Horwitz, Daniel

2015-11-01

To determine the reliability of the Radiographic Union Scale for Tibia (RUST) score and a new modified RUST score in quantifying healing and to define a value for radiographic union in a large series of metadiaphyseal fractures treated with plates or intramedullary nails. Healing was evaluated using 2 methods: (1) evaluation of interrater agreement in a series of radiographs and (2) analysis of prospectively gathered data from 2 previous large multicenter trials to define thresholds for radiographic union. Part 1: 12 orthopedic trauma surgeons evaluated a series of radiographs of 27 distal femur fractures treated with either plate or retrograde nail fixation at various stages of healing in random order using a modified RUST score. For each radiographic set, the reviewer indicated if the fracture was radiographically healed. Part 2: The radiographic results of 2 multicenter randomized trials comparing plate versus nail fixation of 81 distal femur and 46 proximal tibia fractures were reviewed. Orthopaedic surgeons at 24 trauma centers scored radiographs at 3, 6, and 12 months postoperatively using the modified RUST score above. Additionally, investigators indicated if the fracture was healed or not healed. The intraclass correlation coefficient (ICC) with 95% confidence intervals was determined for each cortex, the standard and modified RUST score, and the assignment of union for part 1 data. The RUST and modified RUST that defined "union" were determined for both parts of the study. ICC: The modified RUST score demonstrated slightly higher ICCs than the standard RUST (0.68 vs. 0.63). Nails had substantial agreement, whereas plates had moderate agreement using both modified and standard RUST (0.74 and 0.67 vs. 0.59 and 0.53). The average standard and modified RUST at union among all fractures was 8.5 and 11.4. Nails had higher standard and modified RUST scores than plates at union. The ICC for union was 0.53 (nails: 0.58; plates: 0.51), which indicates moderate agreement. However, the majority of reviewers assigned union for a standard RUST of 9 and a modified RUST of 11, and >90% considered a score of 10 on the RUST and 13 on the modified RUST united. The ICC for the modified RUST is slightly higher than the standard RUST in metadiaphyseal fractures and had substantial agreement. The ICC for the assessment of union was moderate agreement; however, definite union would be 10 and 13 with over 90% of reviewers assigning union. These are the first data-driven estimates of radiographic union for these scores.

Early Weightbearing Protocol in Operative Fixation of Acute Jones Fractures.

PubMed

Waverly, Brett J; Sorensen, Matthew D; Sorensen, Tyler K

The treatment of Jones fractures has been controversial in terms of nonoperative versus operative management, given the high incidence of nonunion secondary to the delicate blood supply to the proximal fifth metatarsal. We report a retrospective review of a patient cohort treated with an early weightbearing protocol after operative intramedullary fixation in acute Jones fractures. Thirty-one consecutive patients with an acute Jones fracture underwent operative fixation with a single intramedullary solid screw. The postoperative protocol consisted of immediate weightbearing in a controlled ankle motion boot for 2 weeks with a gradual transition to regular shoes at 2 weeks postoperative. At 2 weeks, the patients were allowed to perform low-impact activities such as walking, swimming, biking, or elliptical training. Patients were allowed to return to all activities, as tolerated, regardless of radiographic healing, at 6 weeks postoperatively. Serial postoperative radiographs were taken at 2-week intervals to determine radiographic union. Our patient population consisted of 24 males (77.42%) and 7 females (22.58%), with a mean average age of 37.5 ± 12.59 years and mean average body mass index of 25.7 ± 2.32 kg/m 2 . Fracture union was observed in all 31 patients (100%) at a mean average of 5.7 ± 1.47 (range 4 to 10) weeks. Two (6.5%) patients required hardware removal, with one (3.2%) experiencing sural neuritis. This review of patients undergoing early weightbearing after operative fixation of an acute Jones fracture demonstrated a satisfactory incidence of union compared with traditional postoperative protocols at a mean follow-up duration of 18.58 ± 5.66 months. Copyright © 2017 The American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Statistical analysis of the mesospheric inversion layers over two symmetrical tropical sites: Réunion (20.8° S, 55.5° E) and Mauna Loa (19.5° N, 155.6° W)

NASA Astrophysics Data System (ADS)

Bègue, Nelson; Mbatha, Nkanyiso; Bencherif, Hassan; Tato Loua, René; Sivakumar, Venkataraman; Leblanc, Thierry

2017-11-01

In this investigation a statistical analysis of the characteristics of mesospheric inversion layers (MILs) over tropical regions is presented. This study involves the analysis of 16 years of lidar observations recorded at Réunion (20.8° S, 55.5° E) and 21 years of lidar observations recorded at Mauna Loa (19.5° N, 155.6° W) together with SABER observations at these two locations. MILs appear in 10 and 9.3 % of the observed temperature profiles recorded by Rayleigh lidar at Réunion and Mauna Loa, respectively. The parameters defining MILs show a semi-annual cycle over the two selected sites with maxima occurring near the equinoxes and minima occurring during the solstices. Over both sites, the maximum mean amplitude is observed in April and October, and this corresponds to a value greater than 35 K. According to lidar observations, the maximum and minimum mean of the base height ranged from 79 to 80.5 km and from 76 to 77.5 km, respectively. The MILs at Réunion appear on average ˜ 1 km thinner and ˜ 1 km lower, with an amplitude of ˜ 2 K higher than Mauna Loa. Generally, the statistical results for these two tropical locations as presented in this investigation are in fairly good agreement with previous studies. When compared to lidar measurements, on average SABER observations show MILs with greater amplitude, thickness and base altitudes of 4 K, 0.75 and 1.1 km, respectively. Taking into account the temperature error by SABER in the mesosphere, it can therefore be concluded that the measurements obtained from lidar and SABER observations are in significant agreement. The frequency spectrum analysis based on the lidar profiles and the 60-day averaged profile from SABER confirms the presence of the semi-annual oscillation where the magnitude maximum is found to coincide with the height range of the temperature inversion zone. This connection between increases in the semi-annual component close to the inversion zone is in agreement with most previously reported studies over tropics based on satellite observations. Results presented in this study confirm through the use of the ground-based Rayleigh lidar at Réunion and Mauna Loa that the semi-annual oscillation contributes to the formation of MILs over the tropical region.

The effect of deprivation on the developmental activities of adolescent rugby union players in Wales.

PubMed

Winn, Charles O N; Ford, Paul R; McNarry, Melitta A; Lewis, Jason; Stratton, Gareth

2017-12-01

The developmental activities of rugby union players and their interaction with deprivation remain to be elucidated. Five-hundred and ninety elite junior rugby union players (14.8 ± 0.5 years) were split into deprivation quintiles. These players subsequently completed a participant history questionnaire to record their involvement in rugby and other sports. Players accumulated 1987 ± 1297 h in rugby between 6 and 15 years of age. During the mini rugby stage (6-10 years of age), players accumulated an average of 113 ± 105, 89 ± 69 and 43 ± 19 h per year in rugby play, practice and competition, respectively. Moreover, 461 players engaged in an average of two other sports during the mini rugby stage. During the junior rugby stage (11-15 years of age), players accumulated 179 ± 98, 115 ± 90 and 64 ± 26 h per year in rugby practice, play and competition, respectively, and 538 players took part in three other sports. Players who were more deprived accumulated less rugby hours and participated in fewer other sports, but age milestones were not different between deprivation quintiles. There were no differences within developmental activities in rugby between deprivation groups.

Delayed healing of lower limb fractures with bisphosphonate therapy

PubMed Central

Ng, A; Tang, H; Joseph, S; Richardson, M

2015-01-01

Introduction Bisphosphonate therapy (BT) is used commonly in the management of osteoporosis. A systematic review was conducted investigating delayed union of lower limb, long bone fractures in patients on BT. We specifically assessed whether BT increases the risk of delayed union or non-union in lower limb, long bone fractures. Methods A literature search was conducted in the PubMed and Embase™ on 4 November 2014. Articles that investigated lower limb fractures, history of BT and fracture union were included in the review. Results A total of 9,809 papers were retrieved and 14 were deemed suitable for this review. The mean time to union in patients on BT was 8.5 months. A longer time to union was reported in a study investigating BT users versus controls (6.5 vs 4.8 months respectively). The mean rate of delayed or non-union for BT associated atypical fractures was 20% per fracture. Specifically in one study, delayed union was more common in the cohort with more than three years of BT (67%) than in the group with less than three years of BT (26%). Surgical fixation was associated with improved outcomes compared with non-operative management. Conclusions BT has been described to be associated with multiple adverse outcomes related to atypical fractures. Current evidence recommends operative management for this patient group. Further investigation is required to evaluate the exact effects of BT on lower limb fractures, in particular typical femoral fractures. PMID:26264082

Occupational Career and Risk of Mortality among Union Army Veterans

PubMed Central

2010-01-01

Previous studies have extended the traditional framework on occupational disparities in health by examining mortality differentials from a career perspective. Few studies, however, have examined the relation between career and mortality in a historical U.S. population. This study explores the relation between occupational career and risk of mortality in old age among 7,096 Union Army veterans who fought the American Civil War in the 1860s. Occupational mobility was commonplace among the veterans in the postbellum period, with 54 percent of them changing occupations from the time of enlistment to 1900. Among veterans who were farmers at enlistment, 46 percent of them changed to a non-farming occupation by the time of 1900. Results from the Cox Proportional Hazard analysis suggest that relative to the average mortality risk of the sample, being a farmer at enlistment or circa 1900 are both associated with a lower risk of mortality in old age, although the effect is more salient for veterans who were farmers at enlistment. Occupational immobility for manual labors poses a serious threat to chance of survival in old age. These findings still hold after adjusting for the effects of selected variables characterizing risk exposures during early life, wartime, and old age. The robustness of the survival advantage associated with being a farmer at enlistment highlights the importance of socioeconomic conditions early in life in chance of survival at older ages. PMID:19552993

Education, employment, and sustainable development in the European union

NASA Astrophysics Data System (ADS)

Gaballah, I.; Dufourg, A.; Tondeur, D.

2002-11-01

This paper examines the current and prospective status of education, employment, and sustainable development in the European Union (EU). Due to the decrease of the birth rate and the increase of life expectation, the size of the labor force is decreasing and its average age is increasing. Moreover, rapid technological evolution will necessitate “long-life learning” for the old workers and young people. It will be a challenge to supply the EU’s labor market with an adequate number of workers with the appropriate skill ad tempus. This will change profoundly the classical education system that will become the largest economic sector in the next decade.

The Decline of Australian Educational Salaries.

ERIC Educational Resources Information Center

Zappala, Jon; Lombard, Marc

1991-01-01

A 20-year study indicated that educational salaries at all levels have continuously declined relative to the average weekly earnings in Australia. Possible explanations are the role of government, the national teachers' union policy toward different payment systems, and the cultural attitude toward intellectual endeavor. (JOW)

Hope in Dark Times: Resisting the Threat to Democracy with Union Activism

ERIC Educational Resources Information Center

Kahlenburg, Richard D.

2017-01-01

Historically, teachers unions have played a special role in strengthening democratic cultures, and they are urgently called on to do so again. What is needed now more than ever says Kahlenberg, is a "social justice unionism" that goes beyond the narrow self-interest of members in bargaining for better wages and benefits to also engage in…

78 FR 43242 - Agency Information Collection Activities: Submission to OMB for Reinstatement, With Change, of a...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-19

... approval of the Board before one or more federally-insured credit union(s) merge or before a federally... together treated as one respondent) times 35 hours per respondent equals 8,400 total annual burden hours... year engage in share insurance terminations. If one or more credit unions were to engage in a voluntary...

The microstructure of coaching practice: behaviours and activities of an elite rugby union head coach during preparation and competition.

PubMed

Hall, Edward Thomas; Gray, Shirley; Sproule, John

2016-01-01

The activities and behaviours of a female head coach of a national rugby union team were recorded in both training and competition, across a whole rugby season, using the newly developed Rugby Coach Activities and Behaviours Instrument (RCABI). The instrument incorporates 24 categories of behaviour, embedded within three forms of activity (training form (TF), playing form (PF) and competitive match) and seven sub-activity types. In contrast to traditional drill-based coaching, 58.5% of the training time was found to have been spent in PF activities. Moreover, the proportion of PF activities increased to a peak average of 83.8% in proximity to the team's annual international championship. Uniquely, one of the coach's most prolific behaviours was conferring with associates (23.3%), highlighting the importance of interactions with assistant coaches, medical staff and others in shaping the coaching process. Additionally, the frequencies of key behaviours such as questioning and praise were found to vary between the different activity forms and types, raising questions about previous conceptions of effective coaching practice. The findings are discussed in the light of the Game Sense philosophy and the role of the head coach.

Three-stage treatment protocol for recalcitrant distal femoral nonunion.

PubMed

Ma, Ching-Hou; Chiu, Yen-Chun; Tu, Yuan-Kun; Yen, Cheng-Yo; Wu, Chin-Hsien

2017-04-01

In this study, we proposed a three-stage treatment protocol for recalcitrant distal femoral nonunion and aimed to analyze the clinical results. We retrospective reviewed 12 consecutive patients with recalcitrant distal femoral nonunion undergoing our three-stage treatment protocol from January 2010 to December 2014 in our institute. The three-stage treatment protocol comprised debridement of the nonunion site, lengthening to eliminate leg length discrepancy, deformity correction, stabilization with a locked plate, filling of the defect with cement spacer for inducing membrane formation, and bone reconstruction using a cancellous bone autograft (Masquelet technique) or free vascularized fibular bone graft. The bone union time, wound complication, lower limbs alignment, amount of lengthening, knee range of motion, and functional outcomes were evaluated. Osseous union with angular deformity <5° and leg length discrepancy <1 cm were achieved in all the patients. The average amount of lengthening was 5.88 cm (range 3.5-12 cm). Excellent or good outcomes were obtained in 9 patients. Although the current study involved only a small number of patients and the intervention comprised three stages, we believe that such a protocol may be a valuable alternative for the treatment of recalcitrant distal femoral nonunion.

Preseason Functional Movement Screen Predicts Risk of Time-Loss Injury in Experienced Male Rugby Union Athletes.

PubMed

Duke, Sean R; Martin, Steve E; Gaul, Catherine A

2017-10-01

The purpose of this study was to determine the relationship between Functional Movement Screen (FMS) score and the risk of time-loss injury in experienced male rugby union athletes. A secondary purpose was to determine the relationship between FMS-determined asymmetries and the risk of time-loss injury in these athletes. Functional Movement Screen scores were collected from male rugby union athletes (n = 73) during preseason and half-way through one 8-month season. Time-loss injury data were collected throughout the full season. A receiver-operator characteristic curve was created for each half of the season to identify FMS composite and asymmetry cut-off scores associated with increased likelihood of injury and determined odds ratios, sensitivity, and specificity in evaluating FMS as a predictor of injury risk. Odds ratio analyses revealed that when compared with those scoring >14, athletes with an FMS ≤14 were 10.42 times more likely (95% confidence interval [CI]: 1.28-84.75, p = 0.007) to have sustained injury in the first half of the season and 4.97 times (95% CI: 1.02-24.19, p = 0.029) more likely in the second half of the season. The presence of asymmetries was not associated with increased likelihood of injury. Experienced male rugby union athletes with FMS composite scores ≤14 are significantly more likely to sustain time-loss injury in a competitive season than those scoring >14. The quality of fundamental movement, as assessed by the FMS, is predictive of time-loss injury risk in experienced rugby union athletes and should be considered an important preseason assessment tool used by strength and conditioning and medical professionals in this sport with inherently high injury rates.

Early prophylactic autogenous bone grafting in type III open tibial fractures.

PubMed

Kesemenli, Cumhur C; Kapukaya, Ahmet; Subaşi, Mehmet; Arslan, Huseyin; Necmioğlu, Serdar; Kayikçi, Cuma

2004-08-01

The authors report the results achieved in patients with type III open tibial fractures who underwent primary autogenous bone grafting at the time of debridement and skeletal stabilisation. Twenty patients with a mean age of 35.8 years (range, 24-55) were treated between 1996 and 1999. Eight fractures were type IIIA, 11 were type IIIB, and 1 was type IIIC. At the index procedure, wound debridement, external fixation and autogenous bone grafting with bone coverage were achieved. The mean follow-up period was 46 months (range, 34-55). The mean time to fixator removal was 21 weeks (range, 14-35), and the mean time to union was 28 weeks (range, 19-45). Skin coverage was achieved by a myocutaneous flap in 2 patients, late primary closure in 4, and split skin grafting in 14. One (5%) of the patients experienced delayed union, and 1 (5%) developed infection. In tibial type III open fractures, skin coverage may be delayed, using the surrounding soft tissue to cover any exposed bone after thorough débridement and wound cleansing. Primary prophylactic bone grafting performed at the same time reduces the rate of delayed union, shortens the time to union, and does not increase the infection rate.

Fractures Due to Gunshot Wounds: Do Retained Bullet Fragments Affect Union?

PubMed

Riehl, John T; Connolly, Keith; Haidukewych, George; Koval, Ken

2015-01-01

Many types of projectiles, including modern hollow point bullets, fragment into smaller pieces upon impact, particularly when striking bone. This study was performed to examine the effect on time to union with retained bullet material near a fracture site in cases of gunshot injury. All gunshot injuries operatively treated with internal fixation at a Level 1 Trauma Center between March 2008 and August 2011 were retrospectively reviewed. Retained bullet load near the fracture site was calculated based on percentage of material retained compared to the cortical diameter of the involved bone. Analyses were performed to assess the effect of the lead-cortical ratio and amount of comminution on time to fracture union. Thirty-two patients (34 fractures) met the inclusion criteria, with an equal number of comminuted (17) and non-comminuted fractures (17). Seventeen of 34 fractures (50%) united within 4 months, 16/34 (47%) developed a delayed union, and 1/34 (3%) developed a nonunion requiring revision surgery. Sixteen of 17 fractures (94%) that united by 4 months had a cumulative amount of bullet fragmentation retained near the fracture site of less than 20% of the cortical diameter. Nine out of 10 fractures (90%) with retained fragments near the fracture site was equal to or exceeding 20% of the cortical diameter had delayed or nonunion. Fracture comminution had no effect on time to union. The quantity of retained bullet material near the fracture site was more predictive of the rate of fracture union than was comminution. Fractures with bullet fragmentation equal to or exceeding 20% of the cortical width demonstrated a significantly higher rate of delayed union/nonunion compared to those fractures with less retained bullet material, which may indicate a local cytotoxic effect from lead on bone healing. These findings may influence decisions on timing of secondary surgeries. Level III.

Fractures Due to Gunshot Wounds: Do Retained Bullet Fragments Affect Union?

PubMed Central

Riehl, John T.; Connolly, Keith; Haidukewych, George; Koval, Ken

2015-01-01

Background Many types of projectiles, including modern hollow point bullets, fragment into smaller pieces upon impact, particularly when striking bone. This study was performed to examine the effect on time to union with retained bullet material near a fracture site in cases of gunshot injury. Methods All gunshot injuries operatively treated with internal fixation at a Level 1 Trauma Center between March 2008 and August 2011 were retrospectively reviewed. Retained bullet load near the fracture site was calculated based on percentage of material retained compared to the cortical diameter of the involved bone. Analyses were performed to assess the effect of the lead-cortical ratio and amount of comminution on time to fracture union. Results Thirty-two patients (34 fractures) met the inclusion criteria, with an equal number of comminuted (17) and non-comminuted fractures (17). Seventeen of 34 fractures (50%) united within 4 months, 16/34 (47%) developed a delayed union, and 1/34 (3%) developed a nonunion requiring revision surgery. Sixteen of 17 fractures (94%) that united by 4 months had a cumulative amount of bullet fragmentation retained near the fracture site of less than 20% of the cortical diameter. Nine out of 10 fractures (90%) with retained fragments near the fracture site was equal to or exceeding 20% of the cortical diameter had delayed or nonunion. Fracture comminution had no effect on time to union. Conclusions The quantity of retained bullet material near the fracture site was more predictive of the rate of fracture union than was comminution. Fractures with bullet fragmentation equal to or exceeding 20% of the cortical width demonstrated a significantly higher rate of delayed union/nonunion compared to those fractures with less retained bullet material, which may indicate a local cytotoxic effect from lead on bone healing. These findings may influence decisions on timing of secondary surgeries. Level of Evidence Level III PMID:26361445

Steering Patients to Safer Hospitals? The Effect of a Tiered Hospital Network on Hospital Admissions

PubMed Central

Scanlon, Dennis P; Lindrooth, Richard C; Christianson, Jon B

2008-01-01

Objective To determine if a tiered hospital benefit and safety incentive shifted the distribution of admissions toward safer hospitals. Data Sources/Study Setting A large manufacturing company instituted the hospital safety incentive (HSI) for union employees. The HSI gave union patients a financial incentive to choose hospitals that met the Leapfrog Group's three patient safety “leaps.” The analysis merges data from four sources: claims and enrollment data from the company, the American Hospital Association, the AHRQ HCUP-SID, and a state Office of the Insurance Commissioner. Study Design Changes in hospital admissions’ patterns for union and nonunion employees using a difference-in-difference design. We estimate the probability of choosing a specific hospital from a set of available alternatives using conditional logistic regression. Principal Findings Patients affiliated with the engineers’ union and admitted for a medical diagnosis were 2.92 times more likely to select a hospital designated as safer in the postperiod than in the preperiod, while salaried nonunion (SNU) patients (not subject to the financial incentive) were 0.64 times as likely to choose a compliant hospital in the post- versus preperiod. The difference-in-difference estimate, which is based on the predictions of the conditional logit model, is 0.20. However, the machinists’ union was also exposed to the incentive and they were no more likely to choose a safer hospital than the SNU patients. The incentive did not have an effect on patients admitted for a surgical diagnosis, regardless of union status. All patients were averse to travel time, but those union patients selecting an incentive hospital were less averse to travel time. Conclusions Patient price incentives and quality/safety information may influence hospital selection decisions, particularly for medical admissions, though the optimal incentive level for financial return to the plan sponsor is not clear. PMID:18761676

An evaluation of the physiological demands of elite rugby union using Global Positioning System tracking software.

PubMed

Cunniffe, Brian; Proctor, Wayne; Baker, Julien S; Davies, Bruce

2009-07-01

The current case study attempted to document the contemporary demands of elite rugby union. Players (n = 2) were tracked continuously during a competitive team selection game using Global Positioning System (GPS) software. Data revealed that players covered on average 6,953 m during play (83 minutes). Of this distance, 37% (2,800 m) was spent standing and walking, 27% (1,900 m) jogging, 10% (700 m) cruising, 14% (990 m) striding, 5% (320 m) high-intensity running, and 6% (420 m) sprinting. Greater running distances were observed for both players (6.7% back; 10% forward) in the second half of the game. Positional data revealed that the back performed a greater number of sprints (>20 km x h(-1)) than the forward (34 vs. 19) during the game. Conversely, the forward entered the lower speed zone (6-12 km x h(-1)) on a greater number of occasions than the back (315 vs. 229) but spent less time standing and walking (66.5 vs. 77.8%). Players were found to perform 87 moderate-intensity runs (>14 km x h(-1)) covering an average distance of 19.7 m (SD = 14.6). Average distances of 15.3 m (back) and 17.3 m (forward) were recorded for each sprint burst (>20 km x h(-1)), respectively. Players exercised at approximately 80 to 85% VO2max during the course of the game with a mean heart rate of 172 b x min(-1) ( approximately 88% HRmax). This corresponded to an estimated energy expenditure of 6.9 and 8.2 MJ, back and forward, respectively. The current study provides insight into the intense and physical nature of elite rugby using "on the field" assessment of physical exertion. Future use of this technology may help practitioners in design and implementation of individual position-specific training programs with appropriate management of player exercise load.

Operative stabilization of open long bone fractures: A tropical tertiary hospital experience

PubMed Central

Ifesanya, Adeleke O.; Alonge, Temitope O.

2012-01-01

Background: Operative treatment of open fractures in our environment is fraught with problems of availability of theater space, appropriate hardware, and instrumentation such that high complication rates may be expected. Materials and Methods: We evaluated all open long bone fractures operatively stabilized at our center to determine the outcome of the various treatment modalities as well as the determinant factors. Result: A total of 160 patients with 171 fractures treated between December 1995 and December 2008 were studied. There were twice as many males; mean age was 35.0 years. About half were open tibia fractures. Gustilo IIIa and IIIb fractures each accounted for 56 cases (45.2%). Fifty-three percent were stabilized within the first week of injury. Interval between injury and operative fixation averaged 11.1 days. Anderson-Hutchin's technique was employed in 27 cases (21.8%), external fixation in 21 (16.9%), plate osteosynthesis in 50 (40.3%), and intramedullary nail 15 cases (12.1%). Mean time to union was 24.7 weeks. Fifty-two complications occurred in 50 fractures (40.3%) with joint stiffness and chronic osteomyelitis each accounting for a quarter of the complications. Union was delayed in grade IIIb open fractures and those fractures treated with external fixation. Conclusion: A significant proportion of open long bone fractures we operatively treated were severe. Severe open fractures (type IIIb) with concomitant stabilization using external fixation delayed fracture union. While we recommend intramedullary devices for open fractures, in our setting where locking nails are not readily available, external fixation remains the safest choice of skeletal stabilization particularly when contamination is high. PMID:23271839

Adolescent sexual behavior and reproductive outcomes in Central America: trends over the past two decades.

PubMed

Samandari, Ghazaleh; Speizer, Ilene S

2010-03-01

Compared with the Latin American average, adolescent fertility is high in El Salvador, Guatemala, Honduras and Nicaragua, countries that also have high poverty levels and poor access to reproductive health care. For each country, data were drawn from four national health surveys conducted between 1987 and 2007, and analysis focused on trends in sexual and reproductive behavior among adolescent females aged 15-19. Event history analysis examined transitions to first sexual intercourse, first union and first live birth across survey years; Cox hazard and logistic regression analyses assessed associations between selected demographic characteristics and these outcomes, as well as ever-use of a modern contraceptive method. The likelihood that adolescent females have initiated sexual intercourse has increased over time in El Salvador, Honduras and Nicaragua, and has remained stable in Guatemala. Meanwhile, the odds of having entered their first union have declined in Nicaragua and risen in El Salvador, but have not changed in Honduras or Guatemala. Notably, the likelihood that adolescents have ever used a modern contraceptive method has increased in all four countries over the survey years. Nicaraguan adolescents became significantly less likely to have had their first live birth over the study period. Finally, urban residence, education level and socioeconomic status were important predictors of adolescents' sexual and reproductive outcomes. Programmatic and policy initiatives should focus on improving adolescents' education and socio- economic prospects, and efforts are especially needed to help adolescents delay the age at which they become sexually active and enter their first union.

Lateral column lengthening using allograft interposition and cervical plate fixation.

PubMed

Philbin, Terrence M; Pokabla, Christopher; Berlet, Gregory C

2008-10-01

Lateral column lengthening has been used successfully in the treatment of stage II adult-acquired pes planovalgus deformity. The purpose of this study is to review the union rate when allograft material is used and the osteotomy stabilized with a cervical plate. A retrospective review was performed on 28 feet in 26 patients who underwent correction of stage II pes planovalgus deformity using a lateral column lengthening with allograft tricortical iliac crest stabilized with a cervical plate. Patients were evaluated preoperatively and postoperatively using a modified American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale and the Short Form-12 health survey, as well as radiographically by assessing the talonavicular coverage angle. At a mean follow-up of 9 months, the mean total modified AOFAS score and pain subscore were significantly higher (45.6 and 25.0, respectively) versus preoperatively (27.3 and 11.2, respectively). Graft incorporation occurred in all but one case, and the average length of time to union was 10.06 weeks. Complications included 4 hardware removals, 1 nonunion, 1 graft penetration of the calcaneocuboid joint, and 2 cases of calcaneocuboid joint arthritis. Lateral column lengthening using allograft tricortical iliac crest bone graft with cervical plate fixation is a viable option for the correction of acquired pes planovalgus deformity. Allograft bone avoids donor site morbidity of autogenous iliac crest grafts and was not shown to increase rates of nonunion. Cervical plate fixation avoids the necessity of penetrating the graft with a screw and is associated with high patient satisfaction and radiographic union.

Wrapping grafting for congenital pseudarthrosis of the tibia

PubMed Central

Yan, An; Mei, Hai-Bo; Liu, Kun; Wu, Jiang-Yan; Tang, Jin; Zhu, Guang-Hui; Ye, Wei-Hua

2017-01-01

Abstract Objective: Treatment of congenital pseudarthrosis of the tibia (CPT) remains a challenge. The autogenic iliac bone graft is important consistent of treatment for CPT. The purpose of this study was to investigate the role of wrapping autogenic iliac bone graft in improvement of the curing opportunities of CPT. Methods: We combined Ilizarov fixator with intramedullary rodding of the tibia and wrapping autogenic iliac bone graft for treatment 51 cases of CPT between 2007 and 2010. The mean age is 3.2 years at index operation, of which 31 patients (61%) were below 3 years old. According to Crawford classification, 5 tibia had type-II morphology; 3, type-III; 43, type-IV. Results: In the postoperative follow-up of 3.5 months (range from 3 to 4.5 months), all cases were found that the bone graft sites of pseudarthrosis of the tibia showed a significant augmentation and spindle-shaped expansion as obvious change. All cases of this series have been followed-up, average followed-up time were 1.6 years (range from 7 to 3.1 years), of which 19 cases were more than 2 years. The average time of removed the Ilizarov ring fixator was 3.5 months (range from 3 to 4.5 months). According to Johnston Clinical evaluation system, 26 cases had grade I, 21 cases, grade II, 4 cases, grade III. Following the Ohnishi X-ray evaluation criteria, union of pseudarthrosis of the tibia were 42 cases, delayed union 5 cases, nonunion 4 cases. Conclusion: Autogenic iliac bone graft is able to offer the activity of osteoblasts and osteogenesis induced by bone morphogenetic protein (BMP) and glycoprotein, meanwhile enclosing bone graft could help keep cancellous bone fragments in close contact around pseudarthrosis of the tibia, allowing the formation of high concentration of glycoprotein and BMP induced by chemical factors because of established the sealing environment in location, all of which could enhance the healing of pseudarthrosis of the tibia. PMID:29310362

Broadband simulations for Mw 7.8 southern san andreas earthquakes: Ground motion sensitivity to rupture speed

USGS Publications Warehouse

Graves, R.W.; Aagaard, Brad T.; Hudnut, K.W.; Star, L.M.; Stewart, J.P.; Jordan, T.H.

2008-01-01

Using the high-performance computing resources of the Southern California Earthquake Center, we simulate broadband (0-10 Hz) ground motions for three Mw 7.8 rupture scenarios of the southern San Andreas fault. The scenarios incorporate a kinematic rupture description with the average rupture speed along the large slip portions of the fault set at 0.96, 0.89, and 0.84 times the local shear wave velocity. Consistent with previous simulations, a southern hypocenter efficiently channels energy into the Los Angeles region along the string of basins south of the San Gabriel Mountains. However, we find the basin ground motion levels are quite sensitive to the prescribed rupture speed, with peak ground velocities at some sites varying by over a factor of two for variations in average rupture speed of about 15%. These results have important implications for estimating seismic hazards in Southern California and emphasize the need for improved understanding of earthquake rupture processes. Copyright 2008 by the American Geophysical Union.

Knee arthrodesis with the Vari-Wall nail for treatment of infected total knee arthroplasty.

PubMed

Garcia-Lopez, Ignacio; Aguayo, Miguel Anguel; Cuevas, Antonio; Navarro, Pablo; Prieto, Cristobal; Carpintero, Pedro

2008-12-01

We reviewed 20 patients who had undergone one-stage (7 cases) or two-stage (13 cases) knee arthrodesis using the Vari-Wall intramedullary nail, as a salvage operation following infection of a total knee arthroplasty. The procedure was followed by systemic antibiotic administration and early rehabilitation. Intraoperative microbiological cultures were taken. The average period of follow-up was 20 months. Solid union was achieved in 80%; mean time to fusion was 9 months. There was no recurrence of infection. The average limb length discrepancy was 2.45 cm. A walking aid was needed by 95% of the patients. The complication rate was 30% including 4 pseudarthroses, one intraoperative fracture and one peroneal nerve palsy. The Vari-Wall intramedullary nail is a good option when an arthrodesis is indicated for salvage of an infected total knee arthroplasty. It can be performed in one or two stages depending on several factors such as microbiologic culture results. It achieved good pain relief and acceptable functional results in this study.

Solitary haemangioma of the shaft of long bones: resection and reconstruction with autologous bone graft.

PubMed

Li, Zhaoxu; Tang, Jicun; Ye, Zhaoming

2013-04-01

Bone haemangiomas are uncommon lesions, occurring in the skull or spine. A solitary haemangioma in the diaphysis of a long bone is rare. We retrospectively investigated six patients who presented with a solitary haemangioma in a long bone diaphysis. After segmental bone resection, the bone defect was replaced by a bone autograft. Patients were reviewed clinically and with radiographs. The mean follow-up was 6 years (range : 1-20 years). At the time of latest follow-up, no patient had a recurrence. Postoperative complications were one wound necrosis and one superficial wound infection. Union of the gap filling graft with the host bone was achieved in all patients at an average of 4 months (range: 3-8 months). The average Musculoskeletal Tumor Society functional score was 77% (range: 53%-90%) of normal at 6 months postoperatively, and 97% (range: 95%-99%) at the last follow-up evaluation. Segmental resection for solitary haemangioma and reconstruction with autologous bone graft can be considered as a suitable treatment option.

Anatomically Contoured Anterior Plating for Isolated Tibiotalar Arthrodesis: A Systematic Review.

PubMed

Kusnezov, Nicholas; Dunn, John C; Koehler, Logan R; Orr, Justin D

2017-08-01

We performed a systematic review of the published literature to characterize patient demographic, surgical techniques, and functional outcomes to elucidate the complication and revision rates following isolated tibiotalar arthrodesis with anatomically contoured anterior plating. A comprehensive literature search was performed. Inclusion criteria were peer-reviewed studies in English, after 1990, at least 10 patients, and reporting clinical outcomes following contoured anterior plating and with follow-up of at least 80% and 1 year. Primary outcomes were fusion rate, time to fusion, return to activities, satisfaction, and functional outcome scores. Complication rates, reoperation, and revision were also extracted. Eight primary studies with 164 patients met the inclusion criteria. The average sample size was 21 ± 10.0 patients and average age was 49.2 years with 61.6% male. Posttraumatic arthritis (49.4%) was the most common operative indication, followed by primary osteoarthrosis (18.9%). The average follow-up was 21.1 months. At this time, 97.6% of patients went on to uneventful union at a weighted average time of 18.7 weeks postoperatively. AOFAS scores improved significantly ( P < .05). 25% complication rate was reported with wound complication (7.9%) and hardware irritation (6.7%) most common. Overall, 21.3% of patients underwent reoperation; 4 for revision arthrodesis following nonunion. Isolated tibiotalar arthrodesis utilizing anatomically contoured anterior plating demonstrates excellent clinical and functional outcomes at short-term follow-up. Overall, 97.6% of patients went on to fusion and functional outcomes consistently improved following surgery. Furthermore, while one-quarter of patients experienced complications, wound complications were relatively uncommon and less than one-quarter of these required surgical intervention. Level IV: Systematic Review.

Atrophic, aseptic, tibial nonunion: how effective is modified Judet's osteoperiosteal decortication technique and buttress plating?

PubMed

Binod, Bijukachhe; Nagmani, Singh; Bigyan, Bhandari; Rakesh, John; Prashant, Adhikari

2016-08-01

Tibial nonunion is the most common nonunion encountered by the orthopedic surgeon. Repeated surgeries, cost, increased duration of hospital stay, disability, pain all contribute to the increased morbidity. Many methods have been used to treat nonunion of tibia with variable results and none of them are 100 % successful. Our objective was to determine the effectiveness of modification of Judet's decortication technique and buttress plating, without bone graft, in the treatment of aseptic, atrophic tibial nonunion. Also, to find the correlation between time of achieving union and time since injury to decortication. Ours is a retrospective study conducted at a Level I trauma center. A total of 35 cases of atrophic tibial nonunion, irrespective of the cause, was treated by modifying Judet's osteoperiosteal decortication and plating during the time period January 2006 to July 2013. Demographic data, range of motion, time of achieving union and clinico-radiological evaluation for union of fracture were included as main outcome measurements. Union was achieved in all cases with a mean duration of 8.34 months. Pain and stiffness of joints were not reported in any case on long-term follow-up and the patients had satisfactory range of motion. Implant removal was done in three cases after fracture union. Treatment of atrophic tibial nonunion is challenging and management of each nonunion has to be customized based on the biological and mechanical characteristics of the nonunion. Plating with osteoperiosteal decortication is an effective and simple technique, which in our hands has shown to result in 100 % union rates without the need of additional bone healing augmentation procedures like bone grafting. Level II.

How snowpack heterogeneity affects diurnal streamflow timing

USGS Publications Warehouse

Lundquist, J.D.; Dettinger, M.D.

2005-01-01

Diurnal cycles of streamflow in snow-fed rivers can be used to infer the average time a water parcel spends in transit from the top of the snowpack to a stream gauge in the river channel. This travel time, which is measured as the difference between the hour of peak snowmelt in the afternoon and the hour of maximum discharge each day, ranges from a few hours to almost a full day later. Travel times increase with longer percolation times through deeper snowpacks, and prior studies of small basins have related the timing of a stream's diurnal peak to the amount of snow stored in a basin. However, in many larger basins the time of peak flow is nearly constant during the first half of the melt season, with little or no variation between years. This apparent self-organization at larger scales can be reproduced by employing heterogeneous observations of snow depths and melt rates in a model that couples porous medium flow through an evolving snowpack with free surface flow in a channel. Copyright 2005 by the American Geophysical Union.

Treatment of acetabular fractures in older patients-introduction of a new implant for primary total hip arthroplasty.

PubMed

Resch, H; Krappinger, D; Moroder, P; Auffarth, A; Blauth, M; Becker, J

2017-04-01

Fractures of the acetabulum in younger patients are commonly treated by open reduction and internal fixation. For elderly patients, stable primary total hip arthroplasty with the advantage of immediate postoperative mobilization might be the adequate treatment. For this purpose, a sufficiently stable fixation of the acetabular component is required. Between August 2009 and 2014, 30 cases were reported in which all patients underwent total hip arthroplasty additionally to a customized implant designed as an antiprotrusion cage. Inclusion criteria were an acetabular fracture with or without a previous hemiarthroplasty, age above 65 years, and pre-injury mobility dependent on a walking frame at the most. The median age was 79.9 years (65-92), and of 30 fractures, 25 were primary acetabular fractures (83%), four periprosthetic acetabular fractures (14%), and one non-union after a failed ORIF (3%). The average time from injury to surgery was 9.4 days (3-23) and 295 days for the non-union case. Mean time of surgery was 154.4 min (range 100 to 303). In 21 cases (70%), mobilization with full weight bearing was possible within the first 10 days. Six patients died before the follow-up examination 3 and 6 months after surgery, while 24 patients underwent radiologic examination showing consolidated fractures in bi-plane radiographs. In 9 patients, additional CT scan was performed which confirmed the radiographical results. 13 had regained their pre-injury level of mobility including the non-union case. Only one patient did not regain independent mobility. Four complications were recognized with necessary surgical revision (one prosthetic head dislocation, one pelvic cement leakage, one femoral shaft fracture, and one infected hematoma). The presented cage provides the possibility of early mobilization with full weight bearing which represents a valuable addition to the treatment spectrum in this challenging patient group.

Adaptive WTA with an analog VLSI neuromorphic learning chip.

PubMed

Häfliger, Philipp

2007-03-01

In this paper, we demonstrate how a particular spike-based learning rule (where exact temporal relations between input and output spikes of a spiking model neuron determine the changes of the synaptic weights) can be tuned to express rate-based classical Hebbian learning behavior (where the average input and output spike rates are sufficient to describe the synaptic changes). This shift in behavior is controlled by the input statistic and by a single time constant. The learning rule has been implemented in a neuromorphic very large scale integration (VLSI) chip as part of a neurally inspired spike signal image processing system. The latter is the result of the European Union research project Convolution AER Vision Architecture for Real-Time (CAVIAR). Since it is implemented as a spike-based learning rule (which is most convenient in the overall spike-based system), even if it is tuned to show rate behavior, no explicit long-term average signals are computed on the chip. We show the rule's rate-based Hebbian learning ability in a classification task in both simulation and chip experiment, first with artificial stimuli and then with sensor input from the CAVIAR system.

A meta-analysis of injuries in senior men's professional Rugby Union.

PubMed

Williams, Sean; Trewartha, Grant; Kemp, Simon; Stokes, Keith

2013-10-01

Rugby Union has one of the highest reported incidences of match injuries amongst all professional team sports. The majority of research within this field has focused on elite male cohorts; in this study we present the first meta-analytic review of these data. The aim of this study was to summarise the incidence and severity of injuries in senior men's professional Rugby Union, and determine the overall effects of level of play, new versus recurrent injuries, playing position, type of injuries, location of injuries, severity of injuries, period of match, and injury incident. Electronic databases were searched using keywords 'Rugby Union' and 'inj*'. Fifteen papers addressing injuries in senior men's professional Rugby Union (from 1995 through September 2012) were included in the review. A maximum of ten of these papers provided incidence data that could be modelled via a Poisson mixed-effects generalised linear model, while up to nine studies provided severity data that could be modelled via a general linear mixed model. Magnitude based inferences were used to assess differences between factors. A descriptive analysis was provided for studies that could not be included in the pooled analysis due to incongruent injury definitions. The overall incidence of injuries in senior men's professional Rugby Union matches was 81 per 1,000 player hours (95 % CI 63-105), and 3 per 1,000 player hours (95 % CI 2-4) during training. Estimated mean severity for match injuries was 20 days (95 % CI 14-27), and 22 days (95 % CI 19-24) for training injuries. A higher level of play was associated with a greater incidence of injuries in matches, with no clear difference in severity. New injuries occurred substantially more often than recurrent injuries, while the severity of recurrent injuries was, on average, 10 days (95 % CI 4-17) greater than new injuries. Trivial differences were found in injury incidence and severity between forwards and backs. Muscle/tendon and joint (non-bone)/ligament injuries were the two most prevalent injury groups, whereas fractures and bone stress injuries had the highest average severity. The lower limb was the body region with the highest injury incidence, while upper limb injuries were most severe. The third quarter (40-60 min) of matches had the highest injury rate, and injuries most commonly occurred as a result of being tackled. This meta-analysis confirms match injury incidence rates in professional Rugby Union can be considered high in comparison with other team sports, but similar to other collision sports. In order to markedly reduce overall injury burden, efforts should target lower-limb injury prevention strategies and technique during contact, as these may render the largest effect.

Interlocking Intramedullary Nailing Versus Locked Dual-Plating Fixation for Femoral Shaft Fractures in Patients with Multiple Injuries: A Retrospective Comparative Study.

PubMed

Cheng, Tao; Xia, Rong-Gang; Dong, Shi-Kui; Yan, Xiao-Yu; Luo, Cong-Feng

2017-12-18

Intramedullary nailing (IMN) is a popular method in the management of femoral shaft fractures (FSFs). However, whether the association of IMN with pulmonary fat emboli can compromise the pulmonary and nervous systems is debatable. The purpose of this study is to compare IMN with the locked dual plating (LDP) method by assessing the clinical outcomes of FSF patients with head or chest injury. A total of 126 FSF patients were included in this study between January 2010 and July 2016 and divided into LDP and IMN groups. Patient demographic characteristics, operative time, blood loss, Harris Hip Score, Lysholm Knee Score, radiological outcomes, and systemic complications were collected and compared between the two treatment groups. Patients were followed up for at least 12 months. The LDP group performed better than IMN in terms of operative time, estimated blood loss amount, and malunion rate. Differences in function scores, fracture union rate, overall pulmonary complication rate, and in-hospital mortality between the two groups were not significant. Average radiographic union time was significantly longer in the LDP group (36.3 weeks) than in the IMN group (32.5 weeks). One case of fixation failure occurred postoperatively in the LDP group, whereas one case of fracture nonunion took place in the IMN group. Our findings suggest that dual-plating fixation is a promising method for FSFs with multiple injuries. However, the retrospective nature of this study necessitates high-quality trials to be performed to assess the clinical efficiency of dual plating.

Spinal-cord injuries in Australian footballers, 1960-1985.

PubMed

Taylor, T K; Coolican, M R

1987-08-03

A review of 107 footballers who suffered a spinal-cord injury between 1960 and 1985 has been undertaken. Since 1977, the number of such injuries in Rugby Union, Rugby League and Australian Rules has increased, from an average of about two injuries a year before 1977 to over eight injuries a year since then. Rugby Union is clearly the most dangerous game, particularly for schoolboys; all of the injuries in schoolboy games for this code have occurred since 1977. This study has shown that collision at scrum engagement, and not at scrum collapse, is the way in which the majority of scrum injuries are sustained. These injuries are largely preventable, and suggestions for rule changes are made. Half the injured players recovered to Frankel grades D or E. The financial entitlements of those injured were grossly inadequate; this warrants action. A national register for spinal-cord injuries from football should be established to monitor the effects of desirable rule changes in Rugby Union and Rugby League.

Significant developments in occupational health and safety in Australia's construction industry.

PubMed

Fraser, Lindsay

2007-01-01

Construction is Australia's third most dangerous industry. On average, 49 building and construction workers have been killed at work each year since 1997-1998. Securing safer construction workplaces is jeopardized by an Australian government bent on removing union influence. Workers must prove their individual health and safety is at risk or face fines of up to $22,000 over work stoppages. The Australian Chamber of Commerce and Industry view is that occupational health and safety (OHS) legislation is overly complex and biased unfairly against the employer. Significant advances in OHS achieved by construction unions working together with employers and government authorities are now at risk, to the detriment of workers.

Effect on Clinical Outcome and Growth Factor Synthesis With Adjunctive Use of Pulsed Electromagnetic Fields for Fifth Metatarsal Nonunion Fracture: A Double-Blind Randomized Study.

PubMed

Streit, Adam; Watson, B Collier; Granata, Jaymes D; Philbin, Terrence M; Lin, Hsuan-Ni; O'Connor, J Patrick; Lin, Sheldon

2016-09-01

Electromagnetic bone growth stimulators have been found to biologically enhance the bone healing environment, with upregulation of numerous growth factors. The purpose of the study was to quantify the effect, in vivo, of pulsed electromagnetic fields (PEMFs) on growth factor expression and healing time in fifth metatarsal nonunions. This was a prospective, randomized, double-blind trial of patients, cared for by 2 fellowship-trained orthopedic foot and ankle surgeons. Inclusion criteria consisted of patients between 18 and 75 years old who had been diagnosed with a fifth metatarsal delayed or nonunion, with no progressive signs of healing for a minimum of 3 months. Eight patients met inclusion criteria and were randomized to receive either an active stimulation or placebo PEMF device. Each patient then underwent an open biopsy of the fracture site and was fitted with the appropriate PEMF device. The biopsy was analyzed for messenger-ribonucleic acid (mRNA) levels using quantitative competitive reverse transcription polymerase chain reaction (QT-RT-PCR). Three weeks later, the patient underwent repeat biopsy and open reduction and internal fixation of the nonunion site. The patients were followed at 2- to 4-week intervals with serial radiographs and were graded by the number of cortices of healing. All fractures healed, with an average time to complete radiographic union of 14.7 weeks and 8.9 weeks for the inactive and active PEMF groups, respectively. A significant increase in placental growth factor (PIGF) level was found after active PEMF treatment (P = .043). Other factors trended higher following active PEMF including brain-derived neurotrophic factor (BDNF), bone morphogenetic protein (BMP) -7, and BMP-5. The adjunctive use of PEMF for fifth metatarsal fracture nonunions produced a significant increase in local placental growth factor. PEMF also produced trends toward higher levels of multiple other factors and faster average time to radiographic union compared to unstimulated controls. Level I, prospective randomized trial. © The Author(s) 2016.

[Repair and reconstruction for severe fracture and dislocation of ankle joint].

PubMed

Yin, Qingwei; Jiang, Yi; Xiao, Lianping; Li, Xiaodong; Fu, Jiaxin; Tian, Yonggang; Han, Liqiang; Liu, Zhi

2008-06-01

To summarize the technique and effect of the therapy for severe fracture and dislocation of ankle joint by operation. From March 2003 to February 2006, 76 cases were treated with primary open restoration and internal fixation for dislocated ankle joint fracture, with 47 males and 29 females, with the average age of 36.4 years (ranging from 18 years to 65 years). According to AO criterion, these fresh fractures were classified into 13 cases for type C3-1, 45 cases for type C3-2 and 18 cases for type C3-3. Based on the Gustilo-Anderson standard, 23 open fractures were classified into 17 cases for type II and 6 cases for type III A. The operation was delayed from 1 hours to 24 hours after the injury. All incisions healed at the first stage except 4 cases which delayed union because of simple infection by revision with ointment. A total of 72 cases were followed up, with the average time of 18.5 months (from 12 months to 35 months). The time of bone union was from 12 weeks to 24 weeks. The screws of fixation for lower tibia-fibula joint were found to be ruptured in 2 cases when further consultation was performed in the 16th and 20th week after the operation, respectively, and were broken within 1 year after the operation. These screws were taken out 12 weeks postoperative in 28 cases, while the whole internal fixations of the rest cases were taken out 1 year after the operation. The postoperative function of malleolus extended from 21.7 degrees to 26.8 degrees and flection from 38.5 degrees to 44.7 degrees. Assessed by the American Orthopaedic Foot and Ankle Society Clinical Rating Scales, 23 cases were excellent, 36 good, 13 fair, and the choiceness rate reached 81.94%. These procedures, together with reduction by twist after hospital, open and internal fixation in time, and parenchyma managed with internal fixation, are important to attain satisfactory effect for the treatment of severe fracture and dislocation of ankle joint.

Does reimportation reduce price differences for prescription drugs? Lessons from the European Union.

PubMed

Kyle, Margaret K; Allsbrook, Jennifer S; Schulman, Kevin A

2008-08-01

To examine the effect of parallel trade on patterns of price dispersion for prescription drugs in the European Union. Longitudinal data from an IMS Midas database of prices and units sold for drugs in 36 categories in 30 countries from 1993 through 2004. The main outcome measures were mean price differentials and other measures of price dispersion within European Union countries compared with within non-European Union countries. We identified drugs subject to parallel trade using information provided by IMS and by checking membership lists of parallel import trade associations and lists of approved parallel imports. Parallel trade was not associated with substantial reductions in price dispersion in European Union countries. In descriptive and regression analyses, about half of the price differentials exceeded 50 percent in both European Union and non-European Union countries over time, and price distributions among European Union countries did not show a dramatic change concurrent with the adoption of parallel trade. In regression analysis, we found that although price differentials decreased after 1995 in most countries, they decreased less in the European Union than elsewhere. Parallel trade for prescription drugs does not automatically reduce international price differences. Future research should explore how other regulatory schemes might lead to different results elsewhere.

The Epidemiology of Injuries in Australian Professional Rugby Union 2014 Super Rugby Competition

PubMed Central

Whitehouse, Timothy; Orr, Robin; Fitzgerald, Edward; Harries, Simon; McLellan, Christopher P.

2016-01-01

Background: Rugby union is a collision-based ball sport played at the professional level internationally. Rugby union has one of the highest reported incidences of injury of all team sports. Purpose: To identify the characteristics, incidence, and severity of injuries occurring in Australian professional Super Rugby Union. Design: Descriptive epidemiology study. Methods: The present study was a prospective epidemiology study on a cohort of 180 professional players from 5 Australian Super Rugby teams during the 2014 Super Rugby Union Tournament. Team medical staff collected and submitted daily training and match-play injury data through a secure, web-based electronic platform. The injury data included the main anatomic location of the injury, specific anatomic structure of the injury, injury diagnosis, training or match injury occurrence, main player position, mechanism of injury, and the severity of the injury quantified based on the number of days lost from training and/or competition due to injury. Results: The total combined incidence rate for injury during training and match-play across all Australian Super Rugby Union teams was 6.96 per 1000 hours, with a mean injury severity of 37.45 days lost from training and competition. The match-play injury incidence rate was 66.07 per 1000 hours, with a mean severity of 39.80 days lost from training and competition. No significant differences were observed between forward- and back-playing positions for match or training injury incidence rate or severity. Conclusion: The incidence of injury for the present study was lower during match-play than has previously been reported in professional rugby union; however, the overall time loss was higher compared with previous studies in professional rugby union. The high overall time loss was due fundamentally to a high incidence of injuries with greater than 28 days’ severity. PMID:27069947

Art of disaster preparedness in European union: a survey on the health systems.

PubMed

Djalali, Ahmadreza; Della Corte, Francesco; Foletti, Marco; Ragazzoni, Luca; Ripoll Gallardo, Alba; Lupescu, Olivera; Arculeo, Chris; von Arnim, Götz; Friedl, Tom; Ashkenazi, Michael; Fischer, Philipp; Hreckovski, Boris; Khorram-Manesh, Amir; Komadina, Radko; Lechner, Konstanze; Patru, Cristina; Burkle, Frederick M; Ingrassia, Pier Luigi

2014-12-17

Naturally occurring and man-made disasters have been increasing in the world, including Europe, over the past several decades. Health systems are a key part of any community disaster management system. The success of preparedness and prevention depends on the success of activities such as disaster planning, organization and training. The aim of this study is to evaluate health system preparedness for disasters in the 27 European Union member countries. A cross-sectional analysis study was completed between June-September 2012. The checklist used for this survey was a modified from the World Health Organization toolkit for assessing health-system capacity for crisis management. Three specialists from each of the 27 European Union countries were included in the survey. Responses to each survey question were scored and the range of preparedness level was defined as 0-100%, categorized in three levels as follows: Acceptable; Transitional; or Insufficient. Response rate was 79.1%. The average level of disaster management preparedness in the health systems of 27 European Union member states was 68% (Acceptable). The highest level of preparedness was seen in the United Kingdom, Luxemburg, and Lithuania. Considering the elements of disaster management system, the highest level of preparedness score was at health information elements (86%), and the lowest level was for hospitals, and educational elements (54%). This survey study suggests that preparedness level of European Union countries in 2012 is at an acceptable level but could be improved. Elements such as hospitals and education and training suffer from insufficient levels of preparedness. The European Union health systems need a collective strategic plan, as well as enough resources, to establish a comprehensive and standardized disaster management strategy plan. A competency based training curriculum for managers and first responders is basic to accomplishing this goal. Disaster medicine; Disaster preparedness; Disaster epidemiology; Health systems; European Union.

Art of Disaster Preparedness in European Union: a Survey on the Health Systems

PubMed Central

Djalali, Ahmadreza; Della Corte, Francesco; Foletti, Marco; Ragazzoni, Luca; Ripoll Gallardo, Alba; Lupescu, Olivera; Arculeo, Chris; von Arnim, Götz; Friedl, Tom; Ashkenazi, Michael; Fischer, Philipp; Hreckovski, Boris; Khorram-Manesh, Amir; Komadina, Radko; Lechner, Konstanze; Patru, Cristina; Burkle, Frederick M.; Ingrassia, Pier Luigi

2014-01-01

Introduction: Naturally occurring and man-made disasters have been increasing in the world, including Europe, over the past several decades. Health systems are a key part of any community disaster management system. The success of preparedness and prevention depends on the success of activities such as disaster planning, organization and training. The aim of this study is to evaluate health system preparedness for disasters in the 27 European Union member countries. Method: A cross-sectional analysis study was completed between June-September 2012. The checklist used for this survey was a modified from the World Health Organization toolkit for assessing health-system capacity for crisis management. Three specialists from each of the 27 European Union countries were included in the survey. Responses to each survey question were scored and the range of preparedness level was defined as 0-100%, categorized in three levels as follows: Acceptable; Transitional; or Insufficient. Results: Response rate was 79.1%. The average level of disaster management preparedness in the health systems of 27 European Union member states was 68% (Acceptable). The highest level of preparedness was seen in the United Kingdom, Luxemburg, and Lithuania. Considering the elements of disaster management system, the highest level of preparedness score was at health information elements (86%), and the lowest level was for hospitals, and educational elements (54%). Conclusion: This survey study suggests that preparedness level of European Union countries in 2012 is at an acceptable level but could be improved. Elements such as hospitals and education and training suffer from insufficient levels of preparedness. The European Union health systems need a collective strategic plan, as well as enough resources, to establish a comprehensive and standardized disaster management strategy plan. A competency based training curriculum for managers and first responders is basic to accomplishing this goal. Keywords: Disaster medicine; Disaster preparedness; Disaster epidemiology; Health systems; European Union PMID:25685628

Seismic precursory patterns before a cliff collapse and critical point phenomena

USGS Publications Warehouse

Amitrano, D.; Grasso, J.-R.; Senfaute, G.

2005-01-01

We analyse the statistical pattern of seismicity before a 1-2 103 m3 chalk cliff collapse on the Normandie ocean shore, Western France. We show that a power law acceleration of seismicity rate and energy in both 40 Hz-1.5 kHz and 2 Hz-10kHz frequency range, is defined on 3 orders of magnitude, within 2 hours from the collapse time. Simultaneously, the average size of the seismic events increases toward the time to failure. These in situ results are derived from the only station located within one rupture length distance from the rock fall rupture plane. They mimic the "critical point" like behavior recovered from physical and numerical experiments before brittle failures and tertiary creep failures. Our analysis of this first seismic monitoring data of a cliff collapse suggests that the thermodynamic phase transition models for failure may apply for cliff collapse. Copyright 2005 by the American Geophysical Union.

Perceived morbidity and community burden after a Chikungunya outbreak: the TELECHIK survey, a population-based cohort study

PubMed Central

2011-01-01

Background Persistent disabilities are key manifestations of Chikungunya virus (CHIKV) infection, especially incapacitating polyarthralgia and fatigue. So far, little is known about their impact on health status. The present study aimed at describing the burden of CHIKV prolonged or late-onset symptoms on the self-perceived health of La Réunion islanders. Methods At 18 months after an outbreak of Chikungunya virus, we implemented the TELECHIK survey; a retrospective cohort study conducted on a random sample of the representative SEROCHIK population-based survey. A total of 1,094 subjects sampled for CHIKV-specific IgG antibodies in the setting of La Réunion island in the Indian Ocean, between August 2006 and October 2006, were interviewed about current symptoms divided into musculoskeletal/rheumatic, fatigue, cerebral, sensorineural, digestive and dermatological categories. Results At the time of interview, 43% of seropositive (CHIK+) subjects reported musculoskeletal pain (vs 17% of seronegative (CHIK-) subjects, P < 0.001), 54% fatigue (vs 46%, P = 0.04), 75% cerebral disorders (vs 57%, P < 0.001), 49% sensorineural impairments (vs 37%, P = 0.001), 18% digestive complaints (vs 15%, P = 0.21), and 36% skin involvement (vs 34%, P = 0.20) on average 2 years after infection (range: 15-34 months). After controlling for confounders such as age, gender, body mass index or major comorbidities in different Poisson regression models, 33% of joint pains were attributable to CHIKV, 10% of cerebral disorders and 7.5% of sensorineural impairments, while Chikungunya did not enhance fatigue states, digestive and skin disorders. Conclusions On average, 2 years after infection 43% to 75% of infected people reported prolonged or late-onset symptoms highly attributable to CHIKV. These manifestations carry a significant burden in the community in the fields of rheumatology, neurology and sensorineural health. PMID:21235760

Does 'right to work' imperil the right to health? The effect of labour unions on workplace fatalities.

PubMed

Zoorob, Michael

2018-06-13

Economic policies can have unintended consequences on population health. In recent years, many states in the USA have passed 'right to work' (RTW) laws which weaken labour unions. The effect of these laws on occupational health remains unexplored. This study fills this gap by analysing the effect of RTW on occupational fatalities through its effect on unionisation. Two-way fixed effects regression models are used to estimate the effect of unionisation on occupational mortality per 100 000 workers, controlling for state policy liberalism and workforce composition over the period 1992-2016. In the final specification, RTW laws are used as an instrument for unionisation to recover causal effects. The Local Average Treatment Effect of a 1% decline in unionisation attributable to RTW is about a 5% increase in the rate of occupational fatalities. In total, RTW laws have led to a 14.2% increase in occupational mortality through decreased unionisation. These findings illustrate and quantify the protective effect of unions on workers' safety. Policymakers should consider the potentially deleterious effects of anti-union legislation on occupational health. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Table Talk: The Case for Collaboration

ERIC Educational Resources Information Center

Kaboolian, Linda

2006-01-01

According to Joe A. Stone of the University of Oregon, average students do better in classrooms with unionized teachers, but less able and more able students do not. While this particular assumption lacks empirical clarity, many administrators and school board members feel that it would be much easier to reform public education if teacher unions…

41 CFR 102-79.40 - Can Federal agencies allot space in Federal buildings to Federal credit unions?

Code of Federal Regulations, 2011 CFR

2011-01-01

... REGULATION REAL PROPERTY 79-ASSIGNMENT AND UTILIZATION OF SPACE Assignment and Utilization of Space Federal... presently Federal employees or were Federal employees at the time of admission into the credit union, and...

Surveillance of work-related musculoskeletal injuries among union carpenters.

PubMed

Lipscomb, H J; Dement, J M; Loomis, D P; Silverstein, B; Kalat, J

1997-12-01

Combined data sources, including union administrative records and workers' compensation claims, were used to construct event histories for a dynamic cohort of union carpenters from Washington State during the period 1989-1992. Person-time at risk and the events of interest were stratified by age, sex, time in the union, and predominant type of carpentry work. Poisson regression techniques were used to identify subgroups at greatest risk of filing claims for a variety of musculoskeletal disorders defined by ANSI codes for body part injured and injury nature. Distinguishing different kinds of musculoskeletal disorders, even crudely with ANSI codes, led to different conclusions about the effects of the explanatory variables. Among older workers, the rates of fractures of the foot were higher, while rates of contusions of the hand and foot were lower. Women had higher rates of sprain/strains and nerve conditions of the wrist/forearm. Higher rates of injuries to the axial skeleton were seen among carpenters who did predominantly light commercial and drywall work, while piledrivers had lower rates of these injuries. Drywall workers had higher rates of sprains to the ankle/lower leg. Workers who were members of the union as long as four years had lower risks for the vast majority of musculoskeletal disorders studied. Similar patterns were seen for more serious claims that resulted in paid lost time from work.

Is dynamic contrast-enhanced MRI useful for assessing proximal fragment vascularity in scaphoid fracture delayed and non-union?

PubMed

Ng, Alex W H; Griffith, James F; Taljanovic, Mihra S; Li, Alvin; Tse, W L; Ho, P C

2013-07-01

To assess dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) as a measure of vascularity in scaphoid delayed-union or non-union. Thirty-five patients (34 male, one female; mean age, 27.4 ± 9.4 years; range, 16-51 years) with scaphoid delayed-union and non-union who underwent DCE MRI of the scaphoid between September 2002 and October 2012 were retrospectively reviewed. Proximal fragment vascularity was classified as good, fair, or poor on unenhanced MRI, contrast-enhanced MRI, and DCE MRI. For DCE MRI, enhancement slope, Eslope comparison of proximal and distal fragments was used to classify the proximal fragment as good, fair, or poor vascularity. Proximal fragment vascularity was similarly graded at surgery in all patients. Paired t test and McNemar test were used for data comparison. Kappa value was used to assess level of agreement between MRI findings and surgical findings. Twenty-five (71 %) of 35 patients had good vascularity, four (11 %) had fair vascularity, and six (17 %) had poor vascularity of the proximal scaphoid fragment at surgery. DCE MRI parameters had the highest correlation with surgical findings (kappa = 0.57). Proximal scaphoid fragments with surgical poor vascularity had a significantly lower Emax and Eslope than those with good vascularity (p = 0.0043 and 0.027). The sensitivity, specificity, positive and negative predictive value and accuracy of DCE MRI in predicting impaired vascularity was 67, 86, 67, 86, and 80 %, respectively, which was better than that seen with unenhanced and post-contrast MRI. Flattened time intensity curves in both proximal and distal fragments were a feature of protracted non-union with a mean time interval of 101.6 ± 95.5 months between injury and MRI. DCE MRI has a higher diagnostic accuracy than either non-enhanced MRI or contrast enhanced MRI for assessing proximal fragment vascularity in scaphoid delayed-union and non-union. For proper interpretation of contrast-enhanced studies in scaphoid vascularity, one needs to incorporate the time frame between injury and MRI.

Riemannian multi-manifold modeling and clustering in brain networks

NASA Astrophysics Data System (ADS)

Slavakis, Konstantinos; Salsabilian, Shiva; Wack, David S.; Muldoon, Sarah F.; Baidoo-Williams, Henry E.; Vettel, Jean M.; Cieslak, Matthew; Grafton, Scott T.

2017-08-01

This paper introduces Riemannian multi-manifold modeling in the context of brain-network analytics: Brainnetwork time-series yield features which are modeled as points lying in or close to a union of a finite number of submanifolds within a known Riemannian manifold. Distinguishing disparate time series amounts thus to clustering multiple Riemannian submanifolds. To this end, two feature-generation schemes for brain-network time series are put forth. The first one is motivated by Granger-causality arguments and uses an auto-regressive moving average model to map low-rank linear vector subspaces, spanned by column vectors of appropriately defined observability matrices, to points into the Grassmann manifold. The second one utilizes (non-linear) dependencies among network nodes by introducing kernel-based partial correlations to generate points in the manifold of positivedefinite matrices. Based on recently developed research on clustering Riemannian submanifolds, an algorithm is provided for distinguishing time series based on their Riemannian-geometry properties. Numerical tests on time series, synthetically generated from real brain-network structural connectivity matrices, reveal that the proposed scheme outperforms classical and state-of-the-art techniques in clustering brain-network states/structures.

The effects of low-intensity pulsed ultrasound and pulsed electromagnetic fields bone growth stimulation in acute fractures: a systematic review and meta-analysis of randomized controlled trials.

PubMed

Hannemann, P F W; Mommers, E H H; Schots, J P M; Brink, P R G; Poeze, M

2014-08-01

The aim of this systematic review and meta-analysis was to evaluate the best currently available evidence from randomized controlled trials comparing pulsed electromagnetic fields (PEMF) or low-intensity pulsed ultrasound (LIPUS) bone growth stimulation with placebo for acute fractures. We performed a systematic literature search of the medical literature from 1980 to 2013 for randomized clinical trials concerning acute fractures in adults treated with PEMF or LIPUS. Two reviewers independently determined the strength of the included studies by assessing the risk of bias according to the criteria in the Cochrane Handbook for Systematic Reviews of Interventions. Seven hundred and thirty-seven patients from 13 trials were included. Pooled results from 13 trials reporting proportion of nonunion showed no significant difference between PEMF or LIPUS and control. With regard to time to radiological union, we found heterogeneous results that significantly favoured PEMF or LIPUS bone growth stimulation only in non-operatively treated fractures or fractures of the upper limb. Furthermore, we found significant results that suggest that the use of PEMF or LIPUS in acute diaphyseal fractures may accelerate the time to clinical union. Current evidence from randomized trials is insufficient to conclude a benefit of PEMF or LIPUS bone growth stimulation in reducing the incidence of nonunions when used for treatment in acute fractures. However, our systematic review and meta-analysis suggest that PEMF or LIPUS can be beneficial in the treatment of acute fractures regarding time to radiological and clinical union. PEMF and LIPUS significantly shorten time to radiological union for acute fractures undergoing non-operative treatment and acute fractures of the upper limb. Furthermore, PEMF or LIPUS bone growth stimulation accelerates the time to clinical union for acute diaphyseal fractures.

Outcomes of operative treatment of unstable ankle fractures: a comparison of metallic and biodegradable implants.

PubMed

Noh, Jung Ho; Roh, Young Hak; Yang, Bo Gyu; Kim, Seong Wan; Lee, Jun Suk; Oh, Moo Kyung

2012-11-21

Biodegradable implants for internal fixation of ankle fractures may overcome some disadvantages of metallic implants, such as imaging interference and the potential need for additional surgery to remove the implants. The purpose of this study was to evaluate the outcomes after fixation of ankle fractures with biodegradable implants compared with metallic implants. In this prospectively randomized study, 109 subjects with an ankle fracture underwent surgery with metallic (Group I) or biodegradable implants (Group II). Radiographic results were assessed by the criteria of the Klossner classification system and time to bone union. Clinical results were assessed with use of the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale, Short Musculoskeletal Function Assessment (SMFA) dysfunction index, and the SMFA bother index at three, six, and twelve months after surgery. One hundred and two subjects completed the study. At a mean of 19.7 months, there were no differences in reduction quality between the groups. The mean operative time was 30.2 minutes in Group I and 56.4 minutes in Group II (p < 0.001). The mean time to bone union was 15.8 weeks in Group I and 17.6 weeks in Group II (p = 0.002). The mean AOFAS score was 87.5 points in Group I and 84.3 points in Group II at twelve months after surgery (p = 0.004). The mean SMFA dysfunction index was 8.7 points in Group I and 10.5 points in Group II at twelve months after surgery (p = 0.060). The mean SMFA bother index averaged 3.3 points in Group I and 4.6 points in Group II at twelve months after surgery (p = 0.052). No difference existed between the groups with regard to clinical outcomes for the subjects with an isolated lateral malleolar fracture. The outcomes after fixation of bimalleolar ankle fractures with biodegradable implants were inferior to those after fixation with metallic implants in terms of the score on the AOFAS scale and time to bone union. However, the difference in the final AOFAS score between the groups may not be clinically important. The outcomes associated with the use of biodegradable implants for the fixation of isolated lateral malleolar fractures were comparable with those for metallic implants.

Surgical treatment of distal tibia fractures: open versus MIPO.

PubMed

Gülabi, Deniz; Bekler, Halil İbrahim; Sağlam, Fevzi; Taşdemir, Zeki; Çeçen, Gültekin Sıtkı; Elmalı, Nurzat

2016-01-01

Treatment of the distal tibial fractures are challenging due to the limited soft tissue, subcutaneous location and poor vascularity. In this control-matched study, it was aimed to compare the traditional open reduction and internal fixation with minimal invasive plating (MIPO). We hypothesized that superior results may be achieved with MIPO technique. 22 patients treated with traditional open reduction and internal fixation were matched with 22 patients treated with closed reduction and MIPO on the basis of age (±3), gender, and fracture pattern (AO classification). Evaluation was assed according to the wound problems, the American Orthopaedic Foot and Ankle surgery (AOFAS) scoring, radiological union, malunion, delayed union, hospitalisation time, time from injury to surgery, and operation time. There was no significant difference in the distribution of AO/OTA classification, age, gender, AOFAS score, time from injury to operation, follow-up, bone union time, delayed union, malunion and infection (p>0.05). The operation time was significantly longer in the open group than in the MIPO group: 69.59±7.21 min. for the ORIF, and 61.14±5.61 for the MIPO group (p<0.01).The hospitalisation time was significantly longer in the open group than in the MIPO group: 7.64±4.71 days for the MIPO, and 10.18±4.32 days for the ORIF group (p<0.05). MIPO technique can be beneficial for the treatment of distal tibia AO/OTA A and B type fractures with reduced hospital stay, cost-effectiveness, and infection rate.

Chapter 5: Geologic Assessment of Undiscovered Petroleum Resources in the Waltman Shale Total Petroleum System,Wind River Basin Province, Wyoming

USGS Publications Warehouse

Roberts, Steve B.; Roberts, Laura N.R.; Cook, Troy

2007-01-01

The Waltman Shale Total Petroleum System encompasses about 3,400 square miles in the Wind River Basin Province, Wyoming, and includes accumulations of oil and associated gas that were generated and expelled from oil-prone, lacustrine shale source rocks in the Waltman Shale Member of the Paleocene Fort Union Formation. Much of the petroleum migrated and accumulated in marginal lacustrine (deltaic) and fluvial sandstone reservoirs in the Shotgun Member of the Fort Union, which overlies and intertongues with the Waltman Shale Member. Additional petroleum accumulations derived from Waltman source rocks are present in fluvial deposits in the Eocene Wind River Formation overlying the Shotgun Member, and also might be present within fan-delta deposits included in the Waltman Shale Member, and in fluvial sandstone reservoirs in the uppermost part of the lower member of the Fort Union Formation immediately underlying the Waltman. To date, cumulative production from 53 wells producing Waltman-sourced petroleum exceeds 2.8 million barrels of oil and 5.8 billion cubic feet of gas. Productive horizons range from about 1,770 feet to 5,800 feet in depth, and average about 3,400 to 3,500 feet in depth. Formations in the Waltman Shale Total Petroleum System (Fort Union and Wind River Formations) reflect synorogenic deposition closely related to Laramide structural development of the Wind River Basin. In much of the basin, the Fort Union Formation is divided into three members (ascending order): the lower unnamed member, the Waltman Shale Member, and the Shotgun Member. These members record the transition from deposition in dominantly fluvial, floodplain, and mire environments in the early Paleocene (lower member) to a depositional setting characterized by substantial lacustrine development (Waltman Shale Member) and contemporaneous fluvial, and marginal lacustrine (deltaic) deposition (Shotgun Member) during the middle and late Paleocene. Waltman Shale Member source rocks have total organic carbon values ranging from 0.93 to 6.21 weight percent, averaging about 2.71 weight percent. The hydrocarbon generative potential of the source rocks typically exceeds 2.5 milligrams of hydrocarbon per gram of rock and numerous samples had generative potentials exceeding 6.0 milligrams of hydrocarbon per gram of rock. Waltman source rocks are oil prone, and contain a mix of Type-II and Type-III kerogen, indicating organic input from a mix of algal and terrestrial plant matter, or a mix of algal and reworked or recycled material. Thermal maturity at the base of the Waltman Shale Member ranges from a vitrinite reflectance value of less than 0.60 percent along the south basin margin to projected values exceeding 1.10 percent in the deep basin west of Madden anticline. Burial history reconstructions for three wells in the northern part of the Wind River Basin indicate that the Waltman Shale Member was well within the oil window (Ro equal to or greater than 0.65 percent) by the time of maximum burial about 15 million years ago; maximum burial depths exceeded 10,000 feet. Onset of oil generation calculated for the base of the Waltman Shale member took place from about 49 million years ago to about 20 million years ago. Peak oil generation occurred from about 31 million years ago to 26 million years ago in the deep basin west of Madden anticline. Two assessment units were defined in the Waltman Shale Total Petroleum System: the Upper Fort Union Sandstones Conventional Oil and Gas Assessment Unit (50350301) and the Waltman Fractured Shale Continuous Oil Assessment Unit (50350361). The conventional assessment unit primarily relates to the potential for undiscovered petroleum accumulations that are derived from source rocks in the Waltman Shale Member and trapped within sandstone reservoirs in the Shotgun Member (Fort Union Formation) and in the lower part of the overlying Wind River Formation. The potential for Waltman-sourced oil accumulations in fan-delta depos

The economic burden of time-loss injuries to youth players participating in week-long rugby union tournaments.

PubMed

Brown, James C; Viljoen, Wayne; Lambert, Mike I; Readhead, Clint; Fuller, Chelsea; Van Mechelen, Willem; Verhagen, Evert

2015-07-01

Rugby Union ("rugby") is a popular sport with high injury risk. Burden of injury is described by the incidence and severity of injury. However reports have ignored the monetary cost of injuries. Therefore the aim of this study was to describe the monetary cost associated with youth rugby injuries. This descriptive study quantified medical treatments of injured players at the South African Rugby Union Youth tournaments in 2011/2012 and the days of work parents missed as a result of the injuries. A health insurer used these data to calculate associated costs. Legal guardians of the 421 injured players were contacted telephonically on a weekly basis until they returned to play. Treatments costs were estimated in South African Rands based on 2013 insurance rates and converted to US$ using purchasing power parities. Of the 3652 players, 2% (n=71) sought medical care after the tournament. For these players, average treatment costs were high (US$731 per player, 95% CI: US$425-US$1096), with fractures being the most expensive type of injury. Players with medical insurance had higher costs (US$937, 95% CI: US$486-US$1500) than those without (US$220, 95% CI: US$145-US$302). Although a minority of players sought follow-up treatment after the tournaments, the cost of these injuries was high. Players without medical insurance having lower costs may indicate that these players did not receive adequate treatment for their injuries. Injury prevention efforts should consider injuries with high costs and the treatment of players without medical insurance. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Functional outcome of tibial fracture with acute compartment syndrome and correlation to deep posterior compartment pressure.

PubMed

Goyal, Saumitra; Naik, Monappa A; Tripathy, Sujit Kumar; Rao, Sharath K

2017-05-18

To measure single baseline deep posterior compartment pressure in tibial fracture complicated by acute compartment syndrome (ACS) and to correlate it with functional outcome. Thirty-two tibial fractures with ACS were evaluated clinically and the deep posterior compartment pressure was measured. Urgent fasciotomy was needed in 30 patients. Definite surgical fixation was performed either primarily or once fasciotomy wound was healthy. The patients were followed up at 3 mo, 6 mo and one year. At one year, the functional outcome [lower extremity functional scale (LEFS)] and complications were assessed. Three limbs were amputated. In remaining 29 patients, the average times for clinical and radiological union were 25.2 ± 10.9 wk (10 to 54 wk) and 23.8 ± 9.2 wk (12 to 52 wk) respectively. Nine patients had delayed union and 2 had nonunion who needed bone grafting to augment healing. Most common complaint at follow up was ankle stiffness (76%) that caused difficulty in walking, running and squatting. Of 21 patients who had paralysis at diagnosis, 13 (62%) did not recover and additional five patients developed paralysis at follow-up. On LEFS evaluation, there were 14 patients (48.3%) with severe disability, 10 patients (34.5%) with moderate disability and 5 patients (17.2%) with minimal disability. The mean pressures in patients with minimal disability, moderate disability and severe disability were 37.8, 48.4 and 58.79 mmHg respectively ( P < 0.001). ACS in tibial fractures causes severe functional disability in majority of patients. These patients are prone for delayed union and nonunion; however, long term disability is mainly because of severe soft tissue contracture. Intra-compartmental pressure (ICP) correlates with functional disability; patients with relatively high ICP are prone for poor functional outcome.

Repeated high-intensity exercise in professional rugby union.

PubMed

Austin, Damien; Gabbett, Tim; Jenkins, David

2011-07-01

The aim of the present study was to describe the frequency, duration, and nature of repeated high-intensity exercise in Super 14 rugby union. Time-motion analysis was used during seven competition matches over the 2008 and 2009 Super 14 seasons; five players from each of four positional groups (front row forwards, back row forwards, inside backs, and outside backs) were assessed (20 players in total). A repeated high-intensity exercise bout was considered to involve three or more sprints, and/or tackles and/or scrum/ruck/maul activities within 21 s during the same passage of play. The range of repeated high-intensity exercise bouts for each group in a match was as follows: 11-18 for front row forwards, 11-21 for back row forwards, 13-18 for inside backs, and 2-11 for outside backs. The durations of the most intense repeated high-intensity exercise bouts for each position ranged from 53 s to 165 s and the minimum recovery periods between repeated high-intensity exercise bouts ranged from 25 s for the back row forwards to 64 s for the front row forwards. The present results show that repeated high-intensity exercise bouts vary in duration and activities relative to position but all players in a game will average at least 10 changes in activity in the most demanding bouts and complete at least one tackle and two sprints. The most intense periods of activity are likely to last as long as 120 s and as little as 25 s recovery may separate consecutive repeated high-intensity exercise bouts. The present findings can be used by coaches to prepare their players for the most demanding passages of play likely to be experienced in elite rugby union.

Update on coal in Big Horn basin, Montana and Wyoming

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jones, R.W.

1983-08-01

The Big Horn Coal basin is located within the topographic and structural basin of the same name and is defined by the limits of the Upper Cretaceous Mesaverde Formation in northwestern Wyoming and the Eagle Sandstone in south-central Montana. The coal in this basin ranges in rank from high volatile C bituminous (based primarily on resistance to weathering) to subbituminous B coal. In general, the Mesaverde and Eagle coals are highest in heat content, averaging over 10,500 Btu/lb; the Fort Union coals in the Red Lodge-Bear Creek and Grass Creek fields average about 10,200 Btu/lb and are second highest inmore » heating value. The Meeteetse Formation contains coals that average 9,800 Btu/lb, the lowest heating values in the basin. An average heating value for all coal in the basin is slightly less than 10,000 But/lb. The average sulfur content of all coals in this basin is less than 1%, with a range of 0.4 to 2.2%. Coal mining in the Big Horn Coal basin began in the late 1880s in the Red Lodge field and has continued to the present. Almost 53 million tons of coal have been mined in the basin; nearly 78% of this production (41 million tons) is from bituminous Fort Union coal beds in the Red Lodge-Bear Creek and Bridger coal fields, Montana. Original in-place resources for the Big Horn Coal basin are given by rank of coal: 1,265.12 million tons of bituminous coal resources have been calculated for the Silvertip field, Wyoming, and the Red Lodge-Bear Creek and Bridger fields, Montana; 563.78 million tons of subbituminous resources have been calculated for the remaining Wyoming coal fields.« less

Prevalence of and interest in unionization among staff pharmacists.

PubMed

Zgarrick, David P; McHugh, Patrick P; Droege, Marcus

2006-09-01

Although the propensity for staff pharmacists to join a labor union has never been high, conditions in the profession and workplace have changed over the last decade. Some of these changes may result in staff pharmacists joining a labor union, as well as increased interest in staff pharmacists who are currently not union members to join. The objectives of this study were to (1) assess the degree of union membership among staff pharmacists in 6 states, (2) compare the practice settings, work activities and conditions, compensation, and demographic characteristics between union and nonunion staff pharmacists, (3) assess the level of interest in joining a union among nonunion staff pharmacists, and (4) compare the practice settings, work activities and working conditions, wages and benefits, and demographic characteristics between nonunion staff pharmacists interested in joining a union and nonunion staff pharmacists who were not interested in joining a union. A biennial pharmacist compensation study was conducted in 6 states (Florida, Iowa, Illinois, Minnesota, Tennessee, Wisconsin) in late 2003. Randomly selected pharmacists were mailed a self-administered questionnaire asking about their practice setting, work activities and conditions, wages and benefits, and demographic characteristics. Respondents were also asked to indicate current membership in a union and, if not a member, their desire to unionize their workplace. Compensation and unionization data were provided by 2,180 respondents (27% usable response rate), of which 1,226 (56%) were staff pharmacists. Eight percent of the staff pharmacists were union members, whereas 18% of nonunion members would vote to unionize their workplace. There were few statistically significant differences between union and nonunion staff pharmacists regarding work activities, working conditions, and hourly wages. However, the benefits provided to union staff pharmacists differed from those provided to nonunion staff pharmacists in several ways. Union staff pharmacists were younger than their nonunion counterparts (40.9 vs 44.5 years, P=.01), yet had worked for their current employers a longer time (11.1 vs 7.3 years, P=.03). Nonunion staff pharmacists interested in joining a union differed from those who would not by practice location and setting, working conditions, and benefits. Although the union membership rate among staff pharmacists is relatively low, there are geographic and practice areas where membership rates are higher. Differences in work activities, working conditions, wages, and benefits were noted between union and nonunion staff pharmacists as well as between those who would join a union and those who would not. These differences merit further investigation, especially with respect to evaluating the effectiveness of unions and identifying factors that may lead nonunionized staff pharmacists to join a union.

Does Reimportation Reduce Price Differences for Prescription Drugs? Lessons from the European Union

PubMed Central

Kyle, Margaret K; Allsbrook, Jennifer S; Schulman, Kevin A

2008-01-01

Objective To examine the effect of parallel trade on patterns of price dispersion for prescription drugs in the European Union. Data Sources Longitudinal data from an IMS Midas database of prices and units sold for drugs in 36 categories in 30 countries from 1993 through 2004. Study Design The main outcome measures were mean price differentials and other measures of price dispersion within European Union countries compared with within non-European Union countries. Data Collection/Extraction Methods We identified drugs subject to parallel trade using information provided by IMS and by checking membership lists of parallel import trade associations and lists of approved parallel imports. Principal Findings Parallel trade was not associated with substantial reductions in price dispersion in European Union countries. In descriptive and regression analyses, about half of the price differentials exceeded 50 percent in both European Union and non-European Union countries over time, and price distributions among European Union countries did not show a dramatic change concurrent with the adoption of parallel trade. In regression analysis, we found that although price differentials decreased after 1995 in most countries, they decreased less in the European Union than elsewhere. Conclusions Parallel trade for prescription drugs does not automatically reduce international price differences. Future research should explore how other regulatory schemes might lead to different results elsewhere. PMID:18355258

Is there a role for intramedullary nails in the treatment of simple pilon fractures? Rationale and preliminary results.

PubMed

Marcus, Matthew S; Yoon, Richard S; Langford, Joshua; Kubiak, Erik N; Morris, Andrew J; Koval, Kenneth J; Haidukewych, George J; Liporace, Frank A

2013-08-01

Certain patients with pilon fractures present with significant soft-tissue swelling or with a poor soft-tissue envelope typically not amenable to definitive fixation in the early time period. The objective of this study was to review the treatment of simple intra-articular fractures of the tibial plafond (Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) type 43C1-C2) via intramedullary nailing (IMN) with the assessment of clinical and radiographic results and any associated complications. Retrospective clinical and radiological reviews of 31 patients sustaining AO/OTA type 43C distal tibial fractures treated with IMN were evaluated. Our main outcome measurement included achievable alignment in the immediate postoperative period and at the time of union along with complications or need for secondary procedures within the first year of follow-up. Seven patients were lost to follow-up. All the remaining patients achieved bony union at a mean union time of 14.1 ± 4.9 weeks with no evidence of malunion or malrotation. All patients were at full-weight-bearing status at 1-year follow-up. Complications were notable for one delayed union, one non-union, one patient with superficial wound drainage, two with deep infection, one with symptomatic hardware and one with deep vein thrombosis. Simple articular fractures of the tibial plafond (AO/OTA type 43C) treated via IMN can achieve excellent alignment and union rates with proper patient selection and surgical indication. One should not hesitate to use additional bone screws or plating options to help achieve better anatomic reduction. However, larger, prospective randomised trials comparing plating versus nailing, in experienced hands, are needed to completely delineate the utility of this treatment modality. Copyright © 2013 Elsevier Ltd. All rights reserved.

12 CFR 745.202 - Appeal.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS SHARE INSURANCE AND APPENDIX Payment of Share Insurance and Appeals § 745.202 Appeal. (a) Time for filing. Within 60 days after issuance of an initial determination, or of the determination on a request for reconsideration by the...

Fundamental Astronomy (Astronomie Fondamentale)

DTIC Science & Technology

2009-01-01

defined by Earth rotation, then by the motion of the Earth around the Sun, now by atomic clocks, and maybe by pulsars in future, the time and its...intensively in cooperation with other unions, mainly the International Telecommunication Union (ITU). Pulsars with very stable millisecond periods seem to

[Case-control study on minimally invasive percutaneous locking compression plate internal fixation for the treatment of type II and III pilon fractures].

PubMed

Zhang, Zhi-Da; Ye, Xiu-Yi; Shang, Li-Yong; Xu, Rong-Ming; Zhu, Yan-Zhao

2011-12-01

To explore the clinical efficacy of delayed open reduction and internal fixation with minimally invasive percutaneous locking compression plate for the treatment of type II and III Pilon fractures. From January 2007 to September 2009, 32 patients with type II and III Pilon fractures were treated with open reduction and anatomic plate fixation (AP group) and minimally invasive percutaneous locking compression plate osteosynthesis (LCP group). There were 11 males and 6 females in AP group, with an average age of (37.4 +/- 13.3) years (ranged, 19 to 55 years). And there were 10 males and 5 females in LCP group, with an average age of (34.6 +/- 11.3) years(ranged, 21 to 56 years). The operating time, fracture healing time, aligned angulation and ankle function were compared between the two groups. All the patients were followed up, and the during ranged from 12 to 25 months, with a mean of (15.0 +/- 1.7) months. The average operation time was (76.5 +/- 8.3) min for AP group and (58.3 +/- 3.4) min for LCP group; the average time of fracture healing was (20.5 +/- 0.4) weeks for AP group and (15.7 +/- 0.2) weeks for LCP group; the total angulation between anterior posterior film and lateral film was averaged (6.6 +/- 0.5) degrees for AP group and (3.6 +/- 0.2) degrees for LCP group. As to above index, the results of LCP group were better than those of AP group (P < 0.05). According to Kofoed criteria for ankle joint, the results of LCP group were better than those of AP group in ankle joint pain, wakling and ankle joint function (P < 0.05). The method of minimally invasive percutaneous locking compression plate internal fixation is effective in the treatment of Pilon fracture with less invasion, faster bone union, more stabilized fixation, quicker recovery of ankle function and fewer complications, which is more advantaged for type II and III Pilon fractures.

Sport concussion assessment tool-Third edition normative reference values for professional Rugby Union players.

PubMed

Fuller, G W; Govind, O; Tucker, R; Raftery, M

2018-04-01

To establish normative reference data for the SCAT3 in professional Rugby Union players. A cross sectional study in professional Rugby Union players competing in national and international professional competitions between 2015 and 2016. The SCAT3 was administered pre-season or prior to tournaments. Data was collected electronically using a custom tablet application. SCAT3 subcomponents distributions were described and normative ranges determined using percentile cut-offs for average, unusually low/high, and extremely low/high scores. The association between player characteristics and performance in SCAT3 subcomponents was also investigated in exploratory analyses. A total of 3611 professional Rugby Union players were included. The most common baseline symptom was fatigue (14%). The symptom score median (md) was 0 (interquartile range (IQR)=0-1). Symptom severity md was 0 (IQR=0-1). The md of the SAC score was 28 (IQR=26-29). The md of the MBESS was 2 (IQR=0-4). The Tandem gait md was 11.1s (IQR=10.0-12.7s). Upper limb coordination was normal in 98.4%. Younger age and lower educational level were associated with worse performance on delayed recall and reverse month sub-components of the SCAT3 (p<0.0001). No statistically significant differences in SCAT3 subcomponents were evident across gender. Representative normative reference values for the SCAT3 among professional Rugby Union players are provided. Baseline performance on concentration and delayed recall tests may be lower in younger athletes or in those with lower educational level. Copyright © 2017. Published by Elsevier Ltd.

[Clinical analysis of pregnancies after vaginal radical trachelectomy].

PubMed

Ma, Liang-kun; Cao, Dong-yan; Yang, Jia-xin; Qi, Qing-wei; Gao, Jin-song; Liu, Jun-tao; Yang, Jian-qiu; Xiang, Yang; Shen, Keng; Lang, Jing-he

2012-12-01

To explore the pregnancy outcome and obstetric management of pregnancy and delivery after vaginal radical trachelectomy (VRT). Forty-two cases of VRT from December 2003 to May 2012 in Peking Union Medical College Hospital were analyzed retrospectively. Among them ten cases got pregnant successfully. The average age of patient at VRT surgery was (30.6 ± 3.7) years old and average follow-up time was 29.5 months. There were 31 patients attempted conception. Ten of them got fourteen conceptions successfully. Overall conception rate was 45% (14/31). There were four cases of first trimester abortion. Among them, two were miscarriage, two were elective abortion. There was one case of ectopic pregnancy operation and non of second trimester loss. Nine cases reached the third trimester. The total preterm delivery rate was 4/9. There were two cases delivered before 32 gestational weeks (2/9). Cesarean section was performed through a transverse incision in all of nine cases. No uterine rupture and postpartum hemorrhage occurred. All newborns had good outcomes. The average follow-up time after postpartum was 22.9 months. All cases were disease-free. The conception rate of patients after VRT in our series is 45%. The preterm birth rate of pregnancy after VRT is higher. Routine cerclage of cervix during VRT procedure and pregnancy is not necessary. Cesarean section shortly after full term pregnancy through a transverse incision should be considered as a suitable and safe procedure.

Open reduction and internal fixation of patellar fractures with tension band wiring through cannulated screws.

PubMed

Malik, Mudasir; Halwai, Manzoor Ahmad

2014-10-01

The purpose of this study was to evaluate effectiveness and safety of a relatively new technique of open reduction and internal fixation of displaced transverse patellar fractures with tension band wiring (TBW) through parallel cannulated compression screws. A total of 30 patients with displaced transverse patellar fracture were enrolled in this prospective study. Of the 30 patients, 20 patients had trauma due to fall, 5 due to road traffic accident, 2 due to fall of heavy object on the knee, 2 due to forced flexion of knee, and 1 had fracture due to being beaten. All 30 patients were treated with vertical skin exposure, fracture open reduction, and internal fixation by anterior TBW through 4.0 mm cannulated screws. The postoperative rehabilitation protocol was standardized. The patients were followed postsurgery to evaluate time required for radiographic bone union, knee joint range of motion (ROM), loss of fracture reduction, material failure, and the overall functional result of knee using Bostman scoring. All the fractures healed radiologically, at an average time of 10.7 weeks (range, 8-12 weeks). The average ROM arc was 129.7 degrees (range, 115-140 degrees). No patient had loss of fracture reduction, implant migration, or material failure. The average Bostman score was 28.6 out of 30. Anterior TBW through cannulated screws for displaced transverse fractures is safe and effective alternative treatment. Good functional results and recovery can be expected. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Will the European Union reach the United Nations Millennium declaration target of a 50% reduction of tuberculosis mortality between 1990 and 2015?

PubMed

van der Werf, Marieke J; Bonfigli, Sandro; Hruba, Frantiska

2017-07-06

The Millennium Development Goals (MDG) provide targets for 2015. MDG 6 includes a target to reduce the tuberculosis (TB) death rate by 50% compared with 1990. We aimed to assess whether this target was reached by the European Union (EU) and European Economic Area countries. We used Eurostat causes of death data to assess whether the target was reached in the EU. We calculated the reduction in reported and adjusted death rates and the annual average percentage decline based on the available data. Between 1999 and 2014, the TB death rate decreased by 50%, the adjusted death rate by 56% and the annual average percentage decline was 5.43% (95% confidence interval 4.94-6.74) for the EU. Twenty of 26 countries reporting >5 TB deaths in the first reporting year reached the target of 50% reduction in adjusted death rate. The EU reached the MDG target of a 50% reduction of the TB death rate and also the annual average percentage decline was larger than the 2.73% needed to reach the target. The World Health Organization 'End TB Strategy' requires a further reduction of the number of TB deaths of 35% by 2020 compared to 2015, which will challenge TB prevention and care services in the EU.

Carbon, land, and water footprint accounts for the European Union: consumption, production, and displacements through international trade.

PubMed

Steen-Olsen, Kjartan; Weinzettel, Jan; Cranston, Gemma; Ercin, A Ertug; Hertwich, Edgar G

2012-10-16

A nation's consumption of goods and services causes various environmental pressures all over the world due to international trade. We use a multiregional input-output model to assess three kinds of environmental footprints for the member states of the European Union. Footprints are indicators that take the consumer responsibility approach to account for the total direct and indirect effects of a product or consumption activity. We quantify the total environmental pressures (greenhouse gas emissions: carbon footprint; appropriation of biologically productive land and water area: land footprint; and freshwater consumption: water footprint) caused by consumption in the EU. We find that the consumption activities by an average EU citizen in 2004 led to 13.3 tCO(2)e of induced greenhouse gas emissions, appropriation of 2.53 gha (hectares of land with global-average biological productivity), and consumption of 179 m(3) of blue water (ground and surface water). By comparison, the global averages were 5.7 tCO(2)e, 1.23 gha, and 163 m(3) blue water, respectively. Overall, the EU displaced all three types of environmental pressures to the rest of the world, through imports of products with embodied pressures. Looking at intra-EU displacements only, the UK was the most important displacer overall, while the largest net exporters of embodied environmental pressures were Poland (greenhouse gases), France (land), and Spain (freshwater).

Knee arthrodesis with a long intramedullary nail as limb salvage for complex periprosthetic infections.

PubMed

Razii, Nima; Abbas, Ammar M I; Kakar, Rahul; Agarwal, Sanjeev; Morgan-Jones, Rhidian

2016-12-01

Periprosthetic infection following total knee arthroplasty is a devastating complication, which is not always satisfactorily resolved by revision surgery. Arthrodesis is a salvage alternative to above-knee amputation or permanent resection arthroplasty. Fixation options include internal compression plating, external fixation, and intramedullary nails. We retrospectively reviewed twelve consecutive cases (9 males, 3 females; mean age, 67 years) of knee arthrodesis with a long intramedullary nail, performed at a single institution between 2003 and 2014. Desired outcomes were the ability to mobilize without pain, solid radiographic fusion, and the eradication of infection. Mean follow-up was 48.5 months (range, 9-120 months). Eleven patients (92 %) demonstrated stable fusion, ten patients (83 %) were ambulatory without pain, and ten patients (83 %) remained without infection at most recent follow-up. Eight patients (67 %) achieved union at an average of 12 months; three required repeat procedures, achieving union at an average of 9 months. There was a significant difference (P < 0.01) between the numbers of previous operations amongst the eight patients who initially achieved union (mean, 3.25) and three who subsequently required repeat procedures (mean, 8.33). In contrast to similar studies, we performed a single-stage exchange where possible, while comparable ambulatory and fusion rates were observed. Numerous previous attempts at revision arthroplasty, co-morbidities, and infections with highly resistant organisms have been associated with further complications. Although technically challenging, knee arthrodesis with a long intramedullary nail offers an acceptable limb salvage procedure for carefully selected patients with complex periprosthetic infections.

Ilizarov external fixation versus plate osteosynthesis in the management of extra-articular fractures of the distal tibia.

PubMed

Fadel, Mohamed; Ahmed, Mohamed Ali; Al-Dars, Ahmed Mounir; Maabed, Mustafa Ahmed; Shawki, Hashem

2015-03-01

The purpose of this study was to evaluate the outcome of Ilizarov external fixation (IE) versus dynamic compression plate (PO) in the management of extra-articular distal tibial fractures. Between 2010 and 2011, extra-articular distal tibial fractures in 40 consecutive patients met the inclusion criteria. They were classified according to AO classification fracture type A (A1, A2, and A3). In a randomized method, two equal groups were managed using either IE or PO. PO was performed using open reduction and internal fixation (ORIF) and DCP through anterolateral approach. IE was done using Ilizarov frame. For the PO group, non-weight bearing ambulation was permitted on the second postoperative day but partial weight bearing was permitted according to the progression in union criteria clinically and radiologically. For the IE group, weight bearing started as tolerated from the first postoperative day. Physiotherapy and pin-site care was performed by the patient themselves. Modified Mazur ankle score was applied to IE (excellent 10, good 10) and in PO (excellent 2, good 8, poor 6). Data were statically analysed using (Mann-Whitney test). The rate of healing in the IE group (average 130) was higher than the PO (average 196.5); plus, there were no cases of delayed union or nonunion in the IE group (p value 0.003). It was found that IE compared with PO provides provision of immediate weight bearing as tolerated following postoperative recovery, irrespective of radiological or clinical healing with no infection, deformity or non-union.

Government Expenditures on Education as the Percentage of GDP in the EU

ERIC Educational Resources Information Center

Galetic, Fran

2015-01-01

This paper analyzes the government expenditures as the percentage of gross domestic product across countries of the European Union. There is a statistical model based on Z-score, whose aim is to calculate how much each EU country deviates from the average value. The model shows that government expenditures on education vary significantly between…

Understanding Success: A Case Study of Gendered Change in the Professoriate

ERIC Educational Resources Information Center

O'Connor, Pat

2014-01-01

In this article, the focus is on understanding the success of one university in increasing the proportion of women at professorial level from zero in 1997 to 34 per cent in 2012, considerably above the averages for Irish, European Union and Australian universities. Using a concept of leadership "as a process of influence" and drawing on…

The Financing of Higher Education in Kyrgyzstan

ERIC Educational Resources Information Center

Tiuliundieva, N.

2008-01-01

Traditionally, Kyrgyzstan, like other countries of the former Soviet Union, held a fairly high position from the standpoint of the population's average level of education. As of the beginning of period of transition, the level of education in Kyrgyzstan was relatively high. By 1991, the rate of literacy among the adult population was 97.7 percent.…

Midterm results of treatment with a retrograde nail for supracondylar periprosthetic fractures of the femur following total knee arthroplasty.

PubMed

Gliatis, John; Megas, Panagiotis; Panagiotopoulos, Elias; Lambiris, Elias

2005-03-01

Although the short-term results of supracondylar periprosthetic fractures treated with retrograde nailing have been satisfactory, there is always a concern about the long-term survival of the prosthesis. The aim of the study was to evaluate fracture healing and knee functional outcome with a follow-up time of at least 2 years in periprosthetic fractures of the knee treated with a supracondylar nail. Cohort study. There were 9 patients with 10 periprosthetic fractures. In 1 patient, the fracture occurred intraoperatively. In the others, the time between the total knee arthroplasty and the periprosthetic fracture ranged between 2 weeks and 7 years (average time: 2.78 years). The mean follow-up was 34.5 months (25-52 months). The Western Ontario and McMaster Universities index was used to evaluate the functional result postoperatively using the paired t test as the statistical test. Fracture union was assessed with plain x-rays. All the fractures united within 3 months. One fracture united in extreme valgus (35 degrees) and was revised to a stemmed total knee replacement. There were no infections and no prosthesis loosening. The paired t test before the fracture and after the operation demonstrated no statistically significant differences; however, there was a trend toward lower functional score postoperatively. It appears that retrograde nailing is a reliable technique to treat periprosthetic supracondylar fractures. It provides adequate stability until fracture union. The morbidity of the operation is minimal, and the complication rate is low. The midterm results in our study showed that none of the prostheses required revision. In our opinion, it is the treatment of choice for a periprosthetic fracture when the prosthesis is stable.

Improving the Signal-To-Noise Ratio When Monitoring Countermovement Jump Performance.

PubMed

Kennedy, Rodney A; Drake, David

2018-05-08

Kennedy, RA and Drake, D. Improving the signal-to-noise ratio when monitoring countermovement jump performance. J Strength Cond Res XX(X): 000-000, 2018-Countermovement jump (CMJ) performance has been routinely used to monitor neuromuscular status. However, the protocol used to establish the criterion score is not well documented. The purpose of this study was to examine how the protocol used would influence of the sensitivity of CMJ variables in rugby union players. Fifteen male (age: 19.7 ± 0.5 years) rugby union players performed 8 CMJs on 2 occasions, separated by 7 days. The between-session coefficient of variation (CV) was calculated using 2 techniques for treating multiple trials, the average, and the trial with the best jump height (JH), and then compared with the smallest worthwhile change (SWC). The signal-to-noise ratio was measured as the group mean change in a variable divided by the CV. Using the average value across multiple trials is superior to the best trial method, based on lower CVs for all variables. Only the average performance across 6 or more trials was classified as ideal (CV < 0.5 × SWC) for peak velocity (PV). In addition, the signal-to-noise ratio for peak concentric power (PCP), PV, and JH were classified as good, irrespective of the treatment method. Although increasing the number of trials can reduce the random error, it may be pragmatic to simply take the average from 2 to 3 trials, facilitating a CV < SWC for PV, PCP, and JH. Due to its simplicity, JH may be considered the principal variable to monitor neuromuscular fatigue.

Unionizing in Chicago: Big Gains for Part-Timers.

ERIC Educational Resources Information Center

Laiacona, Joseph

2000-01-01

Recounts how the part-time faculty at Chicago's Columbia College (Illinois) dramatically improved salaries and gained a strong voice in college decision making through unionization. Emphasis is on the negotiation process which worked to obtain the group's goals without undermining the "rather friendly college environment." (DB)

Is 48 hours enough for Obstetrics and Gynaecology training in Europe?

PubMed Central

Rose, K.; Van de Venne, M.; Abakke, A.J.M.; Romanek, K.; Redecha, M.

2012-01-01

The European Working Time Directive, implemented by the European Union (EU) in 1993, was adopted in the medical profession to improve patient safety as well as the working lives of doctors. The Directive reduced the average amount of hours trainee doctors worked to 48 hours per week. However, its adoption has varied throughout the EU. Its potential effect on both the quality and total amount of hours of training has caused concern. This monograph presents data on Obstetrics and Gynaecology training in Europe obtained from several of the European Network of Trainees in Obstetrics & Gynaecology’s (ENTOG) surveys. The monograph demonstrates large variations in training and explains the difficulties in ascertaining whether 48 hours of training a week is sufficient to become an Obstetrics and Gynaecology specialist in Europe. PMID:24753895

Workers' compensation claims for musculoskeletal disorders and injuries of the upper extremity and knee among union carpenters in Washington State, 1989-2008.

PubMed

Lipscomb, Hester J; Schoenfisch, Ashley L; Cameron, Wilfrid; Kucera, Kristen L; Adams, Darrin; Silverstein, Barbara A

2015-04-01

Numerous aspects of construction place workers at risk of musculoskeletal disorders and injuries (MSDIs). Work organization and the nature of MSDIs create surveillance challenges. By linking union records with workers' compensation claims, we examined 20-year patterns of MSDIs involving the upper extremity (UE) and the knee among a large carpenter cohort. MSDIs were common and accounted for a disproportionate share of paid lost work time (PLT) claims; UE MSDIs were three times more common than those of the knee. Rates declined markedly over time and were most pronounced for MSDIs of the knee with PLT. Patterns of risk varied by extremity, as well as by age, gender, union tenure, and predominant work. Carpenters in drywall installation accounted for the greatest public health burden. A combination of factors likely account for the patterns observed over time and across worker characteristics. Drywall installers are an intervention priority. © 2015 Wiley Periodicals, Inc.

Getting the measure of extinction.

PubMed

Mace, G

1998-01-01

Like all species, plants, mammals, and birds have been subject to extinction as a fundamental part of evolution. Indeed, only about 2-4% of all the species that have ever lived during the 600 million years of the fossil record still survive today. Looking at the fossil record, it can be said that invertebrate species and mammals have had an average life span of 5-10 and 1-2 million years, respectively. More recent extinction records for birds and mammals lost over the last half of the century indicate that 1 out of 14,000 species becomes extinct each year, giving each species an average life span of 10,000 years--100 to 1000 times shorter than the lifetime of species in the fossil record. Drawing on the World's Conservation Union Red List of threatened animals (1996), species lifetimes of birds, mammals and reptiles are estimated at 300-500 years and 100-1000 years across broader groups. In general, these estimates show that extinction rates today are 1000 to 10,000 times higher than in the past, making current rates of species loss at least equivalent to the mass extinctions in the past. A major difference, however, is the fact that almost all extinctions that have transpired today are due to the impact of human activities.

External fixation of "intertrochanteric" fractures.

PubMed

Gani, Naseem Ul; Kangoo, Khursheed Ahmed; Bashir, Arshad; Muzaffer, Rahil; Bhat, Mohammad Farooq; Farooq, Munir; Badoo, Abdul Rashid; Dar, Imtiyaz Hussian; Wani, Mudassir Maqbool

2009-10-10

In developing countries, due to limited availability of modern anesthesia and overcrowding of the hospitals with patients who need surgery, high-risk patients with "intertrochanteric" fractures remain unsuita ble for open reduction and internal fixation.The aim of this study was to analyze the results of external fixation of "intertrochanteric" fractures in high-risk geriatric patients in a developing country.The results of 62 ambulatory high-risk geriatric patients with a mean age of 70 years (range 58-90 years) with "intertrochanteric" fractures, in whom external fixation was performed, are reported.Eight patients died during follow-up due to medical causes unrelated to the surgical procedure. So only 54 patients were available for final assessment. Procedure is simple, performed under local anesthesia, requires less time for surgery and is associated with less blood loss. Good fixation and early ambulation was achieved in most of the patients. Average time to union was 14 weeks. Thirty-one patients developed superficial pin tract infection and 28 patients had average shortening of 15 mm due to impaction and varus angulation. Functional outcome was assessed using Judet's point system. Good to excellent results were achieved in 44 patients.This study demonstrated that external fixation of "intertrochantric" fractures performed under local anesthesia offers significant advantage in ambulatory high-risk geriatric patients especially in a developing country.

Field data collection of miscellaneous electrical loads in Northern California: Initial results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Greenblatt, Jeffery B.; Pratt, Stacy; Willem, Henry

This report describes efforts to measure energy use of miscellaneous electrical loads (MELs) in 880 San Francisco Bay Area homes during the summer of 2012. Ten regions were selected for metering: Antioch, Berkeley, Fremont, Livermore, Marin County (San Rafael, Novato, Fairfax, and Mill Valley), Oakland/Emeryville, Pleasanton, Richmond, San Leandro, and Union City. The project focused on three major categories of devices: entertainment (game consoles, set-top boxes, televisions and video players), home office (computers, monitors and network equipment), and kitchen plug-loads (coffee/espresso makers, microwave ovens/toaster ovens/toasters, rice/slow cookers and wine chillers). These categories were important to meter because they either dominatedmore » the estimated overall energy use of MELs, are rapidly changing, or there are very little energy consumption data published. A total of 1,176 energy meters and 143 other sensors were deployed, and 90% of these meters and sensors were retrieved. After data cleaning, we obtained 711 valid device energy use measurements, which were used to estimate, for a number of device subcategories, the average time spent in high power, low power and “off” modes, the average energy use in each mode, and the average overall energy use. Consistent with observations made in previous studies, we find on average that information technology (IT) devices (home entertainment and home office equipment) consume more energy (15.0 and 13.0 W, respectively) than non-IT devices (kitchen plug-loads; 4.9 W). Opportunities for energy savings were identified in almost every device category, based on the time spent in various modes and/or the power levels consumed in those modes. Future reports will analyze the collected data in detail by device category and compare results to those obtained from prior studies.« less

Greater Trochanteric Fixation Using a Cable System for Partial Hip Arthroplasty: A Clinical and Finite Element Analysis

PubMed Central

Ozan, Fırat; Koyuncu, Şemmi; Pekedis, Mahmut; Altay, Taşkın; Yıldız, Hasan; Toker, Gökhan

2014-01-01

The aim of the study was to investigate the efficacy of greater trochanteric fixation using a multifilament cable to ensure abductor lever arm continuity in patients with a proximal femoral fracture undergoing partial hip arthroplasty. Mean age of the patients (12 men, 20 women) was 84.12 years. Mean follow-up was 13.06 months. Fixation of the dislocated greater trochanter with or without a cable following load application was assessed by finite element analysis (FEA). Radiological evaluation was based on the distance between the fracture and the union site. Harris hip score was used to evaluate final results: outcomes were excellent in 7 patients (21.8%), good in 17 patients (53.1%), average in 5 patients (15.6%), and poor in 1 patient (9.3%). Mean abduction angle was 20.21°. Union was achieved in 14 patients (43.7%), fibrous union in 12 (37.5%), and no union in 6 (18.7%). FEA showed that the maximum total displacement of the greater trochanter decreased when the fractured bone was fixed with a cable. As the force applied to the cable increased, the displacement of the fractured trochanter decreased. This technique ensures continuity of the abductor lever arm in patients with a proximal femoral fracture who are undergoing partial hip arthroplasty surgery. PMID:25177703

Recent Migrants and Education in the European Union

ERIC Educational Resources Information Center

Osadan, Robert; Reid, Elizabeth

2016-01-01

European schools should improve their methods for teaching migrant students. The European Union has been making efforts to meet the needs of migrant students for some time. From the 2009 Eurydice report "Integrating Immigrant Children into Schools in Europe," which suggests measures to foster inclusion in the larger community and…

12 CFR 792.55 - Times, places, and requirements for identification of individuals making requests and...

Code of Federal Regulations, 2012 CFR

2012-01-01

... Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR CLASSIFIED INFORMATION The Privacy Act § 792.55...

12 CFR 792.55 - Times, places, and requirements for identification of individuals making requests and...

Code of Federal Regulations, 2013 CFR

2013-01-01

... Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR CLASSIFIED INFORMATION The Privacy Act § 792.55...

12 CFR 792.55 - Times, places, and requirements for identification of individuals making requests and...

Code of Federal Regulations, 2010 CFR

2010-01-01

... Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR CLASSIFIED INFORMATION The Privacy Act § 792.55...

12 CFR 792.55 - Times, places, and requirements for identification of individuals making requests and...

Code of Federal Regulations, 2014 CFR

2014-01-01

... Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR CLASSIFIED INFORMATION The Privacy Act § 792.55...

12 CFR 792.55 - Times, places, and requirements for identification of individuals making requests and...

Code of Federal Regulations, 2011 CFR

2011-01-01

... Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR CLASSIFIED INFORMATION The Privacy Act § 792.55...

Intergenerational Relationships and Union Stability in Fragile Families

ERIC Educational Resources Information Center

Hognas, Robin S.; Carlson, Marcia J.

2010-01-01

Using data from the Fragile Families and Child Wellbeing Study (N = 2,656), we examined the association between intergenerational relationships and parents' union stability 5 years after a baby's birth. Results showed that more amiable relationships between parents and each partner's parents, and children's spending more time with paternal…

12 CFR 704.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

.... Adjusted trading means any method or transaction whereby a corporate credit union sells a security to a... securities, asset-backed securities, or corporate obligations in the form of loans or debt. Senior tranches... repurchase the same security at a specified time in the future. The corporate credit union then sells that...

76 FR 30250 - Share Insurance and Appendix

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-25

...-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act) \\1\\ provides that, on a temporary... the time of failure. For example, if pursuant to an agreement between an insured credit union and its... unions would retain flexibility regarding the form of the notice. Therefore, in conjunction with...

Combined tibial lengthening and ankle arthrodesis for patients with certain type of sequelae of poliomyelitis.

PubMed

Wu, Chi-Chuan

2017-01-01

Following far advancement of modern medicine and technology, functional disability in a certain type of sequelae of poliomyelitis may be effectively improved. Eight consecutive adult patients with unilateral sequelae of poliomyelitis were treated. These patients had shortened lower extremity of an average of 4.8 cm (range, 4.0-5.5 cm) in the lesion side. Muscle power of the ipsilateral knee was nearly intact (grade 4 or 5) but the ankle extension was completely flaccid. The tibia was osteotomized and lengthened with external fixation. Consequently, all external fixators were converted to plates supplemented with autogenous corticocancellous bone graft and bone graft substitute. Ankle arthrodesis was performed concomitantly. Seven patients were followed up for an average of 3.7 years (range, 2.2-5.4 years). All seven lengthened sites healed with an average union time of 3.9 months (range, 3.5-4.5 months) after plating. One ankle infection occurred. Gait function significantly improved by modified Mazur scoring evaluation ( p = 0.02). At the latest follow-up, all patients had a minimal or unnoticed limp in level walking. The described combined techniques may be an excellent alternate for treating selected patients with sequelae of poliomyelitis. The procedure is not complex but the efficiency is extremely prominent.

Extracorporeal shock wave treatment of non- or delayed union of proximal metatarsal fractures.

PubMed

Alvarez, Richard G; Cincere, Brandon; Channappa, Chandra; Langerman, Richard; Schulte, Robert; Jaakkola, Juha; Melancon, Keith; Shereff, Michael; Cross, G Lee

2011-08-01

Nonunion or delayed union of fractures in the proximal aspect of metatarsals 1 to 4 and Zone 2 of the fifth metatarsal were treated by high energy extracorporeal shock wave treatment (ESWT) to study the safety and efficacy of this method of treatment in a FDA study of the Ossatron device. In a prospective single-arm, multi-center study, 34 fractures were treated in 32 patients (two subjects had two independent fractures) with ESWT. All fractures were at least 10 (range, 10 to 833) weeks after injury, with a median of 23 weeks. ESWT application was conducted using a protocol totaling 2,000 shocks for a total energy application of approximately 0.22 to 0.51 mJ/mm2 per treatment. The mean ESWT application time for each of the treatments was 24.6 +/- 16.6 minutes, and anesthesia time averaged 27.1 +/- 10.4 minutes. All subjects were followed for 1 year after treatment at intervals of 12 weeks, 6, 9, and 12 months. The overall success rate at the 12-week visit was 71% with low complications, significant pain improvement as well as improvement on the SF-36. The success/fail criteria was evaluated again at the 6- and 12-month followup, showing treatment success rates of 89% (23/26) and 90% (18/20), respectively. The most common adverse event was swelling in the foot, reported by five subjects (15.6%). High-energy ESWT appears to be effective and safe in patients for treatment of nonunion or a delayed healing of a proximal metatarsal, and in fifth metatarsal fractures in Zone 2.

Flow monitoring along the western Tamiami Trail between County Road 92 and State Road 29 in support of the Comprehensive Everglades Restoration Plan, 2007-2010

USGS Publications Warehouse

Booth, Amanda C.; Soderqvist, Lars E.; Berry, Marcia C.

2014-01-01

The construction of U.S. Highway 41 (Tamiami Trail), the Southern Golden Gate Estates development, and the Barron River Canal has altered the flow of freshwater to the Ten Thousand Islands estuary of Southwest Florida. Two restoration projects, the Picayune Strand Restoration Project and the Tamiami Trail Culverts Project, both associated with the Comprehensive Everglades Restoration Plan, were initiated to address this issue. Quantifying the flow of freshwater to the estuary is essential to assessing the effectiveness of these projects. The U.S. Geological Survey conducted a study between March 2006 and September 2010 to quantify the freshwater flowing under theTamiami Trail between County Road 92 and State Road 29 in southwest Florida, excluding the Faka Union Canal (which is monitored by South Florida Water Management District). The study period was after the completion of the Tamiami Trail Culverts Project and prior to most of the construction related to the Picayune Restoration Project. The section of the Tamiami Trail that was studied contains too many structures (35 bridges and 16 culverts) to cost-effectively measure each structure on a continuous basis, so the area was divided into seven subbasins. One bridge within each of the subbasins was instrumented with an acoustic Doppler velocity meter. The index velocity method was used to compute discharge at the seven instrumented bridges. Periodic discharge measurements were made at all structures, using acoustic Doppler current profilers at bridges and acoustic Doppler velocity meters at culverts. Continuous daily mean values of discharge for the uninstrumented structures were calculated on the basis of relations between the measured discharge at the uninstrumented stations and the discharge and stage at the instrumented bridge. Estimates of daily mean discharge are available beginning in 2006 or 2007 through September 2010 for all structures. Subbasin comparison is limited to water years 2008–2010. The Faka Union Canal contributed more than half (on average 60 percent) of the flow under the Tamiami Trail between State Road 29 and County Road 92 during water years 2008–2010. During water years 2008–2010, an average 9 percent of the flow through the study area came from west of the Faka Union Canal and an average 31 percent came from east of the Faka Union Canal. Flow data provided by this study serve as baseline information about the seasonal and spatial distribution of freshwater flow under the Tamiami Trail between County Road 92 and State Road 29, and study results provide data to evaluate restoration efforts.

Exchange nailing for nonunion of diaphyseal fractures of the tibia: our results and an analysis of the risk factors for failure.

PubMed

Tsang, S T J; Mills, L A; Frantzias, J; Baren, J P; Keating, J F; Simpson, A H R W

2016-04-01

The aim of this study was to identify risk factors for the failure of exchange nailing in nonunion of tibial diaphyseal fractures. A cohort of 102 tibial diaphyseal nonunions in 101 patients with a mean age of 36.9 years (15 to 74) were treated between January 1992 and December 2012 by exchange nailing. Of which 33 (32%) were initially open injuries. The median time from primary fixation to exchange nailing was 6.5 months (interquartile range (IQR) 4.3 to 9.8 months). The main outcome measures were union, number of secondary fixation procedures required to achieve union and time to union. Univariate analysis and multiple regression were used to identify risk factors for failure to achieve union. Multiple causes for the primary nonunion were found for 28 (27%) tibiae, with infection present in 32 (31%). Six patients were lost to follow-up. Further surgical procedures were required in 35 (36%) nonunions. Other fixation modalities were required in five fractures. A single nail exchange procedure achieved union in 60/96 (63%) of all nonunions. Only 11 out of 31 infected nonunions (35.4%) healed after one exchange nail procedure. Up to five repeated exchange nailings, with or without bone grafting, ultimately achieved union in 89 (93%) fractures. The median time to union after exchange nailing was 8.7 months (IQR 5.7 to 14.0 months). Univariate analysis confirmed that an oligotrophic/atrophic pattern of nonunion (p = 0.002), a bone gap of 5 mm or more (p = 0.04) and infection (p < 0.001), were predictive for failure of exchange nailing Multiple regression analysis found that infection was the strongest predictor of failure (p < 0.001). Exchange nailing is an effective treatment for aseptic tibial diaphyseal nonunion. However, in the presence of severe infection with a highly resistant organism, or extensive sclerosis of the bone, other fixation modalities, such as Ilizarov treatment, should be considered. Exchange nailing is an effective treatment for aseptic tibial diaphyseal nonunion. ©2016 The British Editorial Society of Bone & Joint Surgery.

"Employability" through Curriculum Innovation and Skills Development: A Portuguese Case Study

ERIC Educational Resources Information Center

de Oliveira, Eva Dias; Guimaraes, Isabel de Castro

2010-01-01

Over 50% of Portuguese graduates are out of work for more than six months after leaving university, against the OECD average of 42%. This suggests that universities need to do more to improve graduates' chances on the labour market and, in many ways, the Bologna reform provided European Union universities with an opportunity to tackle this issue.…

Teachers' Unions and Compensation: The Impact of Collective Bargaining on Salary Schedules and Performance Pay Schemes

ERIC Educational Resources Information Center

West, Kristine Lamm; Mykerezi, Elton

2011-01-01

This study examines the impact that collective bargaining has on multiple dimensions of teacher compensation, including average and starting salaries, early and late returns to experience, returns to graduate degrees, and the incidence of different pay for performance schemes. Using data from the School and Staffing Survey (SASS) and a more recent…

Is Managing Academics "Women's Work"? Exploring the Glass Cliff in Higher Education Management

ERIC Educational Resources Information Center

Peterson, Helen

2016-01-01

Sweden is among the countries with the highest per cent of women university Vice Chancellors in Europe. In "She Figures 2012" the average proportion of female Vice Chancellors in the 27 European Union countries is estimated to be 10 per cent. In Sweden the number is much higher: 43 per cent. Swedish higher education management has…

12 CFR 704.18 - Fidelity bond coverage.

Code of Federal Regulations, 2012 CFR

2012-01-01

... minimum requirements: Daily average net assets Minimumbond (million) Less than $50 million $1.0 $50-$99 million 2.0 $100-$499 million 4.0 $500-$999 million 6.0 $1.0-$1.999 billion 8.0 $2.0-$4.999 billion 10.0... notification by surety to NCUA: (1) When the bond of a credit union is terminated in its entirety; (2) When...

12 CFR 704.18 - Fidelity bond coverage.

Code of Federal Regulations, 2013 CFR

2013-01-01

... minimum requirements: Daily average net assets Minimumbond (million) Less than $50 million $1.0 $50-$99 million 2.0 $100-$499 million 4.0 $500-$999 million 6.0 $1.0-$1.999 billion 8.0 $2.0-$4.999 billion 10.0... notification by surety to NCUA: (1) When the bond of a credit union is terminated in its entirety; (2) When...

12 CFR 704.18 - Fidelity bond coverage.

Code of Federal Regulations, 2014 CFR

2014-01-01

... minimum requirements: Daily average net assets Minimumbond (million) Less than $50 million $1.0 $50-$99 million 2.0 $100-$499 million 4.0 $500-$999 million 6.0 $1.0-$1.999 billion 8.0 $2.0-$4.999 billion 10.0... notification by surety to NCUA: (1) When the bond of a credit union is terminated in its entirety; (2) When...

Blog construction as an effective tool in biochemistry active learning.

PubMed

Cubas Rolim, Estêvão; Martins de Oliveira, Julia; Dalvi, Luana T; Moreira, Daniel C; Garcia Caldas, Natasha; Fernandes Lobo, Felipe; André Polli, Démerson; Campos, Élida G; Hermes-Lima, Marcelo

2017-05-01

To boost active learning in undergraduate students, they were given the task of preparing blogs on topics of clinical biochemistry. This "experiment" lasted for 12 teaching-semesters (from 2008 to 2013), and included a survey on the blogs' usefulness at the end of each semester. The survey (applied in the 2008-2010 period) used a Likert-like questionnaire with eight questions and a 1-to-6 scale, from "totally disagree" to "fully agree." Answers of 428 students were analyzed and indicated overall approval of the blog activity: 86% and 35% of the responses scored 4-to-6 and 6, respectively. Considering the survey results, the high grades obtained by students on their blogs (averaging 8.3 in 2008-2010), and the significant increase in average grades of the clinical biochemistry exam after the beginning of the blog system (from 5.5 in 2007 to 6.4 in 2008-2010), we concluded that blogging activity on biochemistry is a promising tool for boosting active learning. © 2016 by The International Union of Biochemistry and Molecular Biology, 45(3):205-215, 2017. © 2016 The International Union of Biochemistry and Molecular Biology.

Knee arthrodesis with the Wichita Fusion Nail: an outcome comparison.

PubMed

McQueen, D A; Cooke, F W; Hahn, D L

2006-05-01

The Wichita Fusion Nail (WFN) is a knee arthrodesis stabilization system that employs compression via an intramedullary rod. It was designed for use in the salvage of the irretrievably failed total knee arthroplasty and other severe knee pathologies. Questionnaires covering the fusion success rate, fusion time, and complication rate were obtained from 33 surgeons who were among the first to use the device. Data from these questionnaires were analyzed to determine if the rate of successful fusion was close to 100%, which was the primary hypothesis of this study. The average time required to achieve fusion and the rate of complications were also calculated and compared to similar results available in the literature. The results for 44 selected patients were included and it was determined that all achieved fusion for a success rate of 100%. This compared favorably with reported success rates in the range of 54% to 96%. The average fusion time was 15.5 weeks. Complications included: six delayed unions, three deep infections, and two periimplant fractures for a major complications rate of 20.4%. Both the fusion times and complication rate compared favorably with other reported results. Surgeons using the device for the first time had outcomes equal to those of more experienced users. Our results demonstrated that a rate of successful arthrodesis close to 100% could be consistently achieved with the WFN. Overall, the WFN facilitated an improved outcome for a previously difficult procedure. Therapeutic study, level IV (case series). See the Guidelines for Authors for a complete description of level of evidence.

Relationship Between Maximum Aerobic Speed Performance and Distance Covered in Rugby Union Games.

PubMed

Swaby, Rick; Jones, Paul A; Comfort, Paul

2016-10-01

Swaby, R, Jones, PA, and Comfort, P. Relationship between maximum aerobic speed performance and distance covered in rugby union games. J Strength Cond Res 30(10): 2788-2793, 2016-Researchers have shown a clear relationship between aerobic fitness and the distance covered in professional soccer, although no research has identified such a relationship in rugby union. Therefore, the aim of the study was to identify whether there was a relationship between maximal aerobic speed (MAS) and the distance covered in rugby union games. Fourteen professional rugby union players (age = 26 ± 6 years, height = 1.90 ± 0.12 m, mass = 107.1 ± 24.1 kg) participated in this investigation. Each player performed a MAS test on 3 separate occasions during the preseason, to determine reliability and provide baseline data, and participated in 6 competitive games during the early stages of the season. Game data were collected using global positioning system technology. No significant difference (p > 0.05) in total distance covered was observed between games. Relationships between players' MAS and the average distance covered from 6 competitive games were explored using Pearson's correlation coefficients, with MAS performance showing a strong relationship with distance covered during match play (r = 0.746, p < 0.001). Significantly greater (p = 0.001, Cohen's d = 2.29) distances were covered by backs (6,544 ± 573 m) compared with the forwards (4,872 ± 857 m) during a game. Similarly, backs recorded a significantly (p = 0.001, Cohen's d = 2.20) higher MAS (4.9 ± 0.13 m·s) compared with the forwards (4.2 ± 0.43 m·s). Results of the study illustrate the importance of developing high levels of aerobic fitness to increase the distance that the athlete covers in the game.

41 CFR 102-79.40 - Can Federal agencies allot space in Federal buildings to Federal credit unions?

Code of Federal Regulations, 2010 CFR

2010-07-01

... and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 79-ASSIGNMENT AND UTILIZATION OF SPACE Assignment and Utilization of Space Federal... presently Federal employees or were Federal employees at the time of admission into the credit union, and...

12 CFR 702.305 - Prompt corrective action for “uncapitalized” new credit unions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... amount reflected in the credit union's approved initial or revised business plan; (2) Submit revised business plan. Submit a revised business plan within the time provided by § 702.306, providing for... increased its net worth ratio consistent with its then-present approved business plan; (ii) Has no then...

12 CFR 792.56 - Notice of existence of records, access decisions and disclosure of requested information; time...

Code of Federal Regulations, 2011 CFR

2011-01-01

... NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR CLASSIFIED INFORMATION The Privacy Act § 792.56 Notice of existence of records...

12 CFR 792.56 - Notice of existence of records, access decisions and disclosure of requested information; time...

Code of Federal Regulations, 2014 CFR

2014-01-01

... NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR CLASSIFIED INFORMATION The Privacy Act § 792.56 Notice of existence of records...

12 CFR 792.56 - Notice of existence of records, access decisions and disclosure of requested information; time...

Code of Federal Regulations, 2012 CFR

2012-01-01

... NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR CLASSIFIED INFORMATION The Privacy Act § 792.56 Notice of existence of records...

12 CFR 792.56 - Notice of existence of records, access decisions and disclosure of requested information; time...

Code of Federal Regulations, 2013 CFR

2013-01-01

... NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR CLASSIFIED INFORMATION The Privacy Act § 792.56 Notice of existence of records...

12 CFR 792.56 - Notice of existence of records, access decisions and disclosure of requested information; time...

Code of Federal Regulations, 2010 CFR

2010-01-01

... NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR CLASSIFIED INFORMATION The Privacy Act § 792.56 Notice of existence of records...

Eyeing New York's Newspaper Strike.

ERIC Educational Resources Information Center

Fishleder, Paul

The New York newspaper strike of 1978 was the direct result of a series of events that started in 1923 when the pressmen's union established a system that provided a minimum fixed number of pressmen per press unit and legitimized a loose labor pool. From that time, the number of pressmen increased through family-dominated union management that…

Union Pacific Sedalia and Jefferson City subdivisions freight & passenger rail capacity analysis--phase 2 : final report, July 2009.

DOT National Transportation Integrated Search

2009-08-01

The objective of this study was to analyze a list of rail enhancements that addresses current passenger and : freight rail performance on the Union Pacific line from St. Louis to Kansas City in order to improve on-time : passenger service and reduce ...

The Professional Educator: Union Strong before and after the Storm

ERIC Educational Resources Information Center

Capo, Zeph

2018-01-01

It's no secret that organized labor and public education face a time of great uncertainty. Our country's current president and secretary of education, according to this author, have made clear their intent to support corporate greed at the expense of working people and their unions and to champion privatization schemes that undermine public…

Key Data on Vocational Training in the European Union.

ERIC Educational Resources Information Center

European Centre for the Development of Vocational Training, Thessaloniki (Greece).

This book provides key quantitative and qualitative data on vocational education and training (VET) in the European Union. Among the topics on which data are provided are the following: demographic trends, educational attainment, and the labor market (aging of the population and labor force, changes in educational attainment over time, impacts of…

Double fixation of displaced patella fractures using bioabsorbable cannulated lag screws and braided polyester suture tension bands.

PubMed

Qi, Li; Chang, Cao; Xin, Tang; Xing, Pei Fu; Tianfu, Yang; Gang, Zhong; Jian, Li

2011-10-01

To evaluate the effectiveness and safety of a new double fixation technique for displaced patellar fractures using bioabsorbable cannulated lag screws and braided polyester suture tension bands. Fifteen patients (mean age of 46.2 years) with displaced transverse or comminuted patella fractures were enrolled in this prospective study. All of the patients were treated via the open reduction internal fixation (ORIF) procedure using bioabsorbable cannulated lag screws and braided polyester suture tension bands. The patients were followed post-surgery to evaluate (1) the time required for radiographic bone union, (2) the knee joint range of motion at the time of radiographic bone union, (3) the degree of pain assessed using the visual analogue scale (VAS), (4) the function of the knee using the Lysholm score and (5) the presence of any additional complications from the surgery. All of the patients were followed post-treatment for more than 1 year (range, 12-19 months; mean post-treatment follow up time, 14 months). The bone union of the fractures as seen radiographically occurred approximately 3 months from surgery in all cases without implant failure or redisplacement of the fractured site. The mean knee joint range of motion was from 0 to 134.6°, and the mean VAS score was 0.7 at the time of bone union. The mean Lysholm scores at the time of bone union and 12 months post-surgery were 86.7 and 95.7, respectively. No postoperative complications, such as infection, dislocation or breakage of the implants, were observed. Moreover, all of the patients returned to their previous activity level. This new double fixation technique using bioabsorbable cannulated lag screws and braided polyester suture tension bands resulted in satisfactory outcomes for patella fractures without any obvious complications. Copyright © 2011 Elsevier Ltd. All rights reserved.

Rates of and circumstances surrounding work-related falls from height among union drywall carpenters in Washington State, 1989-2008.

PubMed

Schoenfisch, Ashley; Lipscomb, Hester; Cameron, Wilfrid; Adams, Darrin; Silverstein, Barbara

2014-12-01

Drywall installers are at high risk for work-related falls from height (FFH). We defined a 20-year (1989-2008) cohort of 5,073 union drywall carpenters in Washington State, their worker-hours, and FFH. FFH rate patterns were examined using Poisson regression. Drywall installers' FFH rates declined over time and varied little by worker age and time in the union. However, among FFH involving drywall sheets, workers with <10 union years were at high risk. Narratives consistently described the surface from which workers fell, commonly scaffolds (33%), ladders (21%), and stilts (13%). Work task, height fallen, protective equipment use, work speed, weather, influence of other workers/workgroups, and tool/equipment specifics were not often reported. In addition to continued efforts to prevent falls from scaffolds and ladders, efforts should address stilt use and less experienced workers who may have greater exposure. Consistency in reported narrative elements may improve FFH risk factor identification and prevention effort evaluation. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Close reduction combined with minimally invasive percutaneous plate osteosynthesis for proximal and distal tibial fractures: a report of 56 patients].

PubMed

Liu, Yin-Wen; Kuang, Yong; Gu, Xin-Feng; Zheng, Yu-Xin; Li, Zhi-Qiang; Wei, Xiao-En; Zhang, Ming-Cai; Zhan, Hong-Sheng; Shi, Yin-yu

2013-03-01

To evaluate the clinical effects of close reduction combined with minimally invasive percutanous plate osteosynthesis (MIPPO) for proximal and distal tibial fractures. From March 2007 to December 2010, 56 patients with proximal and distal tibial fractures were treated with close reduction combined with MIPPO technique. There were 39 males and 17 females,aged from 22 to 67 years with an average of 41.3 years. Left fracture was in 25 cases and right fracture was in 31 cases; proximal tibial fracture was in 15 cases and distal tibial fractures was in 41 cases; 34 cases caused by fall down and 22 cases caused by road accident. The mean time from injury to operation was 1.7 d. Clinical manifestation included pain, swelling of leg with limitation of activity. According to the standard of Johner-Wruhs, clinical effects were evaluated. The mean operative time was 46 min in 56 patients. All fractures obtained satisfactory reduction and the location of plate was good. Incisions healed with one-stage and no superficial or deep infection was found. All the patients were followed up from 8 to 23 months with an average of 14.2 months. Only one fracture complication with delayed union,and after auto grafting with ilium bone,the fracture got union. Other 55 cases obtained bone healing in 15 to 20 weeks after operation and no internal fixation failure was found. The time of walking was 4-6 months after operation,without limping at 7 months after operation. Both lower extremities were symmetrical and the function of knee and ankle got complete recovery. According to the criteria of Johner-Wruhs score,46 cases obtained excellent results,9 good and 2 fair. Treatment of proximal and distal tibial fractures with close reduction and MIPPO technique can not only preserve soft tissue,simplify operative procedure and decrease wound, but also can obtain rigid internal fixation and guarantee early function exercises of knee and ankle joints. The method has the advantages of less soft tissue injury, less blood loss, reliable fixation, which is effective method in treating proximal and distal tibial fractures and corresponds with the standpoint of biological fixation.

Minimally invasive (MIS) Tönnis osteotomy- A technical annotation and review of short term results.

PubMed

Balakumar, Balasubramanian; Racy, Malek; Madan, Sanjeev

2018-03-01

We detail a modified single incision approach to perform the Tonnis triple pelvic osteotomy by a minimally invasive approach. 12 children underwent minimally invasive Tonnis Osteotomy. There were five boys and seven girls in this study group. Average age was 11 years (9-15 years) at the time of surgery. Mean follow-up was 20.5 months (13-39 months). The average preoperative Antero-Posterior (AP) Centre Edge (CE) angle was -8.8° (-38.6°-18°), the average post-operative AP CE angle was 29.7° (25.1°-43.7°). The average preoperative lateral CE angle was -4.7° (-16°-0°), the average postoperative Lateral CE angle was 28.5° (21.3°-37.4°). The Sharp's angle before and after surgery were 55.7° (51.3°-66°) and 32.4° (16.1°-40.1°) respectively. The mean Tönnis angle before and after the osteotomy were 28.86° (19.7°-43.4°) and 6.3° (0.5°-9.4°) respectively. There was one major complication with sciatic nerve palsy which is in the recovery phase on followup and six minor complications including two cases of transient lateral femoral cutaneous nerve injury, two cases of ischial non-union, over granulation of the wound in one case, and metalwork irritation in one case. We have described a minimally invasive Tonnis osteotomy as a viable option based on our results. This technique is recommended for those who are conversant with the traditional pelvicosteotomies.

Arthrodesis of the knee: experience with intramedullary nailing.

PubMed

Incavo, S J; Lilly, J W; Bartlett, C S; Churchill, D L

2000-10-01

Knee arthrodesis using an intramedullary nail has gained acceptance as treatment in difficult cases such as infection after total knee arthroplasty (TKA), neuropathic joint, and obesity. A retrospective review of 22 cases treated at our institution using an intramedullary nail for knee arthrodesis was performed. Deep infection after primary (11) or revision (6) TKA was the most common indication for this procedure. A long intramedullary nail was used in 3 cases, a long nail with a proximal interlocking screw was used in 6 cases, and a customized nail with a valgus bend and a proximal interlocking screw was used in 11 cases. A modular knee fusion nail was used in 1 case. Successful fusion occurred in all cases, although 4 patients required additional surgery. Average operative blood loss was 748 mL, and average time to union was 7 months. Shortening of the extremity averaged 3.2 cm. Tibiofemoral alignment was improved by using a customized valgus nail (average, 3.1 valgus; range, 1-5) when compared with a straight nail (average, 0.2 valgus; range, 3 varus to 3 valgus). No patient developed infection in the hip or ankle region as a result of the long intramedullary nail. Intramedullary nailing is an excellent technique for knee arthrodesis in difficult cases. A customized proximal interlocking nail with 5 degrees to 7 degrees of valgus and 5 degrees of anterior angulation improves tibiofemoral alignment and is straightforward to insert or extract should it be necessary. Stability and pain relief are rapid, and the fusion rate is maximized.

The other Founding Physicks: the lives and times of the physician signers of the Articles of Confederation and Perpetual Union.

PubMed

Bengtsson, Bengt-Ola S

2013-08-01

The Articles of Confederation and Perpetual Union was the interim constitution of the United States of America between 1777 and 1789. The name the United States of America is encountered here for the first time. Three physicians were among the 48 signers - Josiah Bartlett, Samuel Holten and Nathaniel Scudder. All three men started out studying and practising medicine but their lives took very different turns as the new nation emerged.

RhBMP-7 for the treatment of nonunion of fractures of long bones.

PubMed

Papanagiotou, M; Dailiana, Z H; Karachalios, T; Varitimidis, S; Vlychou, M; Hantes, M; Malizos, K N

2015-07-01

We report the outcome of 84 nonunions involving long bones which were treated with rhBMP-7, in 84 patients (60 men: 24 women) with a mean age 46 years (18 to 81) between 2003 and 2011. The patients had undergone a mean of three previous operations (one to 11) for nonunion which had been present for a mean of 17 months (4 months to 20 years). The nonunions involved the lower limb in 71 patients and the remainder involved the upper limb. A total of 30 nonunions were septic. Treatment was considered successful when the nonunion healed without additional procedures. The relationship between successful union and the time to union was investigated and various factors including age and gender, the nature of the nonunion (location, size, type, chronicity, previous procedures, infection, the condition of the soft tissues) and type of index procedure (revision of fixation, type of graft, amount of rhBMP-7) were analysed. The improvement of the patients' quality of life was estimated using the Short Form (SF) 12 score. A total of 68 nonunions (80.9%) healed with no need for further procedures at a mean of 5.4 months (3 to 10) post-operatively. Multivariate logistic regression analysis of the factors affecting union suggested that only infection significantly affected the rate of union (p = 0.004).Time to union was only affected by the number of previous failed procedures (p = 0.006). An improvement of 79% and 32.2% in SF-12 physical and mental score, respectively, was noted within the first post-operative year. Rh-BMP-7 combined with bone grafts, enabled healing of the nonunion and improved quality of life in about 80% of patients. Aseptic nonunions were much more likely to unite than septic ones. The number of previous failed operations significantly delayed the time to union. ©2015 The British Editorial Society of Bone & Joint Surgery.

The effect of concentrated bone marrow aspirate in operative treatment of fifth metatarsal stress fractures; a double-blind randomized controlled trial.

PubMed

Weel, Hanneke; Mallee, Wouter H; van Dijk, C Niek; Blankevoort, Leendert; Goedegebuure, Simon; Goslings, J Carel; Kennedy, John G; Kerkhoffs, Gino M M J

2015-08-20

Fifth metatarsal (MT-V) stress fractures often exhibit delayed union and are high-risk fractures for non-union. Surgical treatment, currently considered as the gold standard, does not give optimal results, with a mean time to fracture union of 12-18 weeks. In recent studies, the use of bone marrow cells has been introduced to accelerate healing of fractures with union problems. The aim of this randomized trial is to determine if operative treatment of MT-V stress fractures with use of concentrated blood and bone marrow aspirate (cB + cBMA) is more effective than surgery alone. We hypothesize that using cB + cBMA in the operative treatment of MT-V stress fractures will lead to an earlier fracture union. A prospective, double-blind, randomized controlled trial (RCT) will be conducted in an academic medical center in the Netherlands. Ethics approval is received. 50 patients will be randomized to either operative treatment with cB + cBMA, harvested from the iliac crest, or operative treatment without cB + cBMA but with a sham-treatment of the iliac crest. The fracture fixation is the same in both groups, as is the post-operative care.. Follow up will be one year. The primary outcome measure is time to union in weeks on X-ray. Secondary outcome measures are time to resumption of work and sports, functional outcomes (SF-36, FAOS, FAAM), complication rate, composition of osteoprogenitors in cB + cBMA and cost-effectiveness. Furthermore, a bone biopsy is taken from every stress fracture and analysed histologically to determine the stage of the stress fracture. The difference in primary endpoint between the two groups is analysed using student's t-test or equivalent. This trial will likely provide level-I evidence on the effectiveness of cB + cBMA in the operative treatment of MT-V stress fractures. Netherlands Trial Register (reg.nr NTR4377 ).

[Bone repair in pseudarthrosis after arthrodesis of the upper ankle joint].

PubMed

Eingartner, C; Volkmann, R; Winter, E; Weller, S

1994-06-01

Delayed union or non-union of ankle arthrodesis is a common problem and revision arthrodesis is necessary in those difficult cases. Three cases are presented, in which a non-union after tibiotalar or tibiacalcanear fusion could be treated effectively with a bone graft taken from the anterior cortex of the distal tibia or from the anterior iliacal spine. The bone graft was fixed proximally with a screw. Distally the graft was inserted in an slot gouged into the talus or the calcaneus respectively with or without screw fixation. Postoperative care included short-time external fixation and immobilisation with a shortleg weight bearing cast. We conclude that the technique of a sliding tibiotalar graft can be used for effective treatment of non-union following ankle arthrodesis.

Migration from new-accession countries and duration expectancy in the EU-15: 2002–2008

PubMed Central

DeWaard, Jack; Ha, Jasmine Trang; Raymer, James; Wiśniowski, Arkadiusz

2016-01-01

European Union (EU) enlargements in 2004 and 2007 were accompanied by increased migration from new-accession to established-member (EU-15) countries. The impacts of these flows depend, in part, on the amount of time that persons from the former countries live in the latter over the life course. In this paper, we develop period estimates of duration expectancy in EU-15 countries among persons from new-accession countries. Using a newly developed set of harmonised Bayesian estimates of migration flows each year from 2002 to 2008 from the Integrated Modelling of European Migration (IMEM) Project, we exploit period age patterns of country-to-country migration and mortality to summarize the average number of years that persons from new-accession countries could be expected to live in EU-15 countries over the life course. In general, the results show that the amount of time that persons from new-accession countries could be expected to live in the EU-15 nearly doubled after 2004. PMID:28286353

The compositional and institutional sources of union dissolution for married and unmarried parents in the United States.

PubMed

Tach, Laura; Edin, Kathryn

2013-10-01

Unmarried parents have less stable unions than married parents, but there is considerable debate over the sources of this instability. Unmarried parents may be more likely than married parents to end their unions because of compositional differences, such as more disadvantaged personal and relationship characteristics, or because they lack the normative and institutional supports of marriage, thus rendering their relationships more sensitive to disadvantage. In this article, we evaluate these two sources of union instability among married, cohabiting, and dating parents following the birth of a shared child, using five waves of longitudinal data from the Fragile Families and Child Wellbeing Study. Using discrete-time event history models, we find that demographic, economic, and relationship differences explain more than two-thirds of the increased risk of dissolution for unmarried parents relative to married parents. We also find that differential responses to economic or relationship disadvantage do not explain why unmarried parents are more likely to end their unions than married parents.

Achieving interlocking nails without using an image intensifier

PubMed Central

Ogunlusi, Johnson D.; Ine, Henry R.

2006-01-01

Interlocking nails are commonly performed using an image intensifier. These are expensive and are not readily available in most resource-poor countries of the world. The aim of this study was to achieve interlocking nailing without the use of an image intensifier. This is a prospective descriptive analysis of 40 consecutive cases seen with shaft fractures of the humerus, femur, and tibia. Fracture fixation was done using Surgical Implant Generation Network (SIGN) nails. Forty limbs in 34 patients were studied. There were 12 females and 22 males, giving a ratio of 1:2. The mean age (years) was 35.75±13.16 and the range was 17–70 years. The studied bones were: humerus 10%, femur 65%, and tibia 25%. The fracture lines were: transverse 40%, oblique 15%, and communited 45%. Fracture grades were: closed 90%, grade I, 5%, grade II, 2.5%, and grade IIIA, 2.5%. Surgical approaches were: antegrade 62.5% and retrograde 37.5%. Indications for fixation were: recent fracture 92.5%, non-union 5%, and malunion 3%. Methods of reductions were: open 85% and closed 15%. The mean follow-up period (years) was 1.50±0.78. The union time averaged 3 months. Complication was mainly screw loosening due to severe osteoporoses in one case. It is, therefore, concluded that, with the aid of external jigs and slot finders, interlocking can be achieved without an image intensifier. PMID:17039384

Osteosynthesis in situ for lateral condyle nonunion in children.

PubMed

Park, Hoon; Hwang, Jin Ho; Kwon, Yong Uk; Kim, Hyun Woo

2015-06-01

This study investigated the efficacy of osteosynthesis in situ by evaluating the functional and cosmetic results in children with nonunion of lateral condyle fractures. Sixteen consecutive patients were treated with in situ fixation consisting of minimal curettage of fracture gap and screw compression of metaphyseal fragments without bone grafting. The mean age at the time of surgery was 5.6 years (range, 1 to 10 y). The mean interval between the initial lateral condylar fracture and surgery was 4.8 months (range, 3 to 12 mo). The average amount of displacement measured on radiographs was 6.6 mm medially and 7.4 mm laterally. Outcome was assessed by clinical and radiologic evaluation at the latest follow-up. All patients achieved bony union. The mean duration of follow-up was 45.4 months (range, 24 to 67 mo). The range of motion and flexion contracture improved postoperatively in all patients. There was no evidence of premature growth arrest, osteonecrosis, or fishtail deformity until last follow-up. The overall result was excellent in 5, good in 10, and fair in 1 patient. However, 3 patients developed valgus or varus deformities of >10 degrees. Osteosynthesis in situ can be an effective and safe treatment for achieving bone union and improved elbow motion and preventing avascular necrosis. However, valgus or varus deformities may occur after this procedure and corrective osteotomy may be necessary. Level IV - case series.

Asymptomatic non-union of capitate 14 years postfracture

PubMed Central

Hamed, Yosef; Ashwood, Neil; Fogg, Quentin; Galanopoulos, Ilias

2013-01-01

We report the unusual complication of non-union 14 years following a capitate fracture in a right-hand dominant man. Our patient fell and sustained an injury to his left wrist 14 years ago. At that time he had a swollen painful left wrist. His symptoms subsequently settled and he went back to his normal activities. He lost some power for bench-pressing and had slightly restricted range of motion but remained essentially pain-free. He presented 14 years later with another wrist injury when the original non-union was revealed. PMID:23761606

The use of bone morphogenic protein-7 (OP-1) in the management of resistant non-unions in the upper and lower limb.

PubMed

Papanna, M C; Al-Hadithy, N; Somanchi, B V; Sewell, M D; Robinson, P M; Khan, S A; Wilkes, R A

2012-07-01

The aim of the present study was to investigate the safety and efficacy of local implantation of BMP-7 for the treatment of resistant non-unions in the upper and lower limb. Fifty-two patients (30 males, mean age 52.8 years; range 20-81) were treated with local BMP-7 implantation in a bovine bone-derived collagen paste with or without revision of fixation. Thirty-six patients had closed injuries, ten had open injuries and six had infected non-unions. Patients had undergone a mean of 2 (1-5) operations prior to implantation of BMP-7. Clinical and radiological union was achieved in 94% at a mean time of 5.6 months (3-19). Two patients with subtrochanteric femoral fractures failed to achieve union secondary to inadequate fracture stabilisation, persistent unfavourable biological environment and systemic co-morbidities. One patient developed synostosis attributed to the BMP-7 application. This study demonstrates BMP-7 implanted in a bovine-derived collagen paste is an effective adjunctive treatment for resistant non-unions in the upper and lower limb. Copyright © 2012 Elsevier Ltd. All rights reserved.

Handbook for Local Coordinators: Value-Added, Compact Disk, Union Catalog Test Phase.

ERIC Educational Resources Information Center

Townley, Charles

In 1988, the Associated College Libraries of Central Pennsylvania received a grant to create a value-added, compact disk, union catalog from the U.S. Department of Education's College Library Technology and Cooperative Grants Program, Title II of the Higher Education Act. Designed to contain, in time, 2,000,830 records from 17 member library…

How to Arrange Student Tours to the Soviet Union.

ERIC Educational Resources Information Center

Winokur, Marshall

The details of planning a student tour to the Soviet Union are described by an experienced tour organizer. Student tours of one to three weeks are presented as rewarding alternatives to lengthy overseas study. Recommendations are made regarding choice of tour type, length of tour, travel agencies, time of year to travel, advertising a tour,…

12 CFR 792.17 - What can I do if the time limit passes and I still have not received a response?

Code of Federal Regulations, 2014 CFR

2014-01-01

... still have not received a response? 792.17 Section 792.17 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR...

12 CFR 792.17 - What can I do if the time limit passes and I still have not received a response?

Code of Federal Regulations, 2012 CFR

2012-01-01

... still have not received a response? 792.17 Section 792.17 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR...

12 CFR 792.17 - What can I do if the time limit passes and I still have not received a response?

Code of Federal Regulations, 2013 CFR

2013-01-01

... still have not received a response? 792.17 Section 792.17 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR...

12 CFR 792.17 - What can I do if the time limit passes and I still have not received a response?

Code of Federal Regulations, 2011 CFR

2011-01-01

... still have not received a response? 792.17 Section 792.17 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR...

12 CFR 792.17 - What can I do if the time limit passes and I still have not received a response?

Code of Federal Regulations, 2010 CFR

2010-01-01

... still have not received a response? 792.17 Section 792.17 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING THE OPERATIONS OF THE NATIONAL CREDIT UNION ADMINISTRATION REQUESTS FOR INFORMATION UNDER THE FREEDOM OF INFORMATION ACT AND PRIVACY ACT, AND BY SUBPOENA; SECURITY PROCEDURES FOR...

A Comment on the Changes in Higher Education in the Former Soviet Union

ERIC Educational Resources Information Center

Heyneman, Stephen P.

2010-01-01

At the time of their independence, the structure of higher education, curriculum content, governance, and admissions procedures were more or less identical across the fifteen republics of the former Soviet Union. Since independence there have been multiple changes, but often these have been quite similar in nature. There has been a move toward…

European Union Policies in Education and Training: The Lisbon Agenda as a Turning Point?

ERIC Educational Resources Information Center

Ertl, Hubert

2006-01-01

This paper investigates European Union (EU) education and training policies in the light of the evolving Lisbon agenda on improving the competitiveness of the EU. It examines the ways in which EU policies have developed over time, focusing on their legal basis, underlying principles, main forms of implementation and their impact on national…

Assigned Leaders in Unionized Environments: Coping with the Economic Recession and Its Aftermath in Academic Libraries

ERIC Educational Resources Information Center

Lim, Adriene

2012-01-01

Despite the fact that the rate of unionism has grown in institutions of higher education over the past several decades, and the recent economic recession occurred at the same time that academic libraries faced accelerating changes in scholarly communication and technology, increased demands for accountability, and heightened external competition,…

ECIA Chapter 1 Program: 1982-83 Evaluation Report. Report No. 11:06:82/83:108 wp:5899.

ERIC Educational Resources Information Center

Phoenix Union High School District, AZ. Research Services.

This is a report of the testing results of the 1982-83 Chapter 1 program in the Phoenix Union High School District, Arizona. The average Normal Curve Equivalent (NCE) gains in the District's Chapter 1 Programs showed the students gained more knowledge in each subject than similar students across the nation. However, in some subjects the students…

Seismicity parameters preceding moderate to major earthquakes

NASA Astrophysics Data System (ADS)

von Seggern, David; Alexander, Shelton S.; Baag, Chang-Eob

1981-10-01

Seismic events reported in the bulletins of the two large arrays, LASA and NORSAR, were merged with those from the NEIS bulletin for the period 1970-1977. Using a lower cutoff of mb = 5.8, 510 `main shocks' within the P range of LASA or NORSAR were selected for this period; and various seismicity trends prior to them were investigated. A search for definite foreshocks, based on a significantly short time delay to the main shock, revealed that the true rate of foreshock occurrence was less than 20%. Foreshocks are almost exclusively associated with shallow (h < 100 km) main shocks. To establish common features, a method of averaging seismicity from many regions was used to suppress the randomness of the seismic behavior of each region. This averaging shows that the seismicity level around the main shock increases somewhat for 10 days before main shocks; this feature peaks in the last 3-4 hours prior to the main shocks. The averaging also reveals that the mean magnitude of events near the main shock increases prior to main shocks but only by a few hundredths of a magnitude unit. Again by averaging, the seismicity about main shocks is shown to tend with time toward the main shock as its origin time is approached, but the average effect is small (˜10% change). By expanding or contracting each region's time scale before averaging to relate to the magnitude of the main shock, these features are enhanced. Using a new variable to track the departures from both spatial and temporal randomness, the Poisson-like behavior of deeper seismicity (>100 km) was demonstrated. For shallow events (<100 km) this variable reveals numerous instances of clustering and spatial-temporal seismic gaps, with little tendency toward a uniformity of behavior prior to main shocks. A statistical test of the validity of seismic precursors was performed for approximately 90 main shock regions which had sufficient seismicity. Using a five-variable vector (interevent time, interevent distance, magnitude, epicentral distance to main shock, and depth difference relative to main shock) for each event in a `precursory' time window of 500 days before the main shock and for each event in a `normal' time window of 500 days before that, the null hypothesis of equal vector means between the two groups was tested. At 90% confidence level, less than 30% of the main shock regions were thus found to exhibit precursory seismicity changes. Appendices are available with entire article on microfiche. Order from American Geophysical Union, 2000 Florida Avenue, N.W., Washington, D.C. 20009. Document J81-007; $1.00. Payment must accompany order.

77 FR 76839 - Home Mortgage Disclosure (Regulation C): Adjustment To Asset-Size Exemption Threshold

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-31

...The Bureau of Consumer Financial Protection (Bureau) is publishing a final rule amending the official commentary that interprets the requirements of the Bureau's Regulation C (Home Mortgage Disclosure) to reflect a change in the asset-size exemption threshold for banks, savings associations, and credit unions based on the annual percentage change in the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). The exemption threshold is adjusted to increase to $42 million from $41 million. The adjustment is based on the 2.23 percent increase in the average of the CPI-W for the 12-month period ending in November 2012. Therefore, banks, savings associations, and credit unions with assets of $42 million or less as of December 31, 2012, are exempt from collecting data in 2013.

78 FR 79285 - Home Mortgage Disclosure (Regulation C): Adjustment to Asset-Size Exemption Threshold

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-30

...The Bureau of Consumer Financial Protection (Bureau) is publishing a final rule amending the official commentary that interprets the requirements of the Bureau's Regulation C (Home Mortgage Disclosure) to reflect a change in the asset-size exemption threshold for banks, savings associations, and credit unions based on the annual percentage change in the Consumer Price Index for Urban Wage Earners and Clerical Workers (CPI-W). The exemption threshold is adjusted to increase to $43 million from $42 million. The adjustment is based on the 1.4 percent increase in the average of the CPI-W for the 12-month period ending in November 2013. Therefore, banks, savings associations, and credit unions with assets of $43 million or less as of December 31, 2013, are exempt from collecting data in 2014.

The comparative incidence of reported concussions presenting for follow-up management in South African Rugby Union.

PubMed

Shuttleworth-Edwards, Ann B; Noakes, Timothy D; Radloff, Sarah E; Whitefield, Victoria J; Clark, Susan B; Roberts, Craig O; Essack, Fathima B; Zoccola, Diana; Boulind, Melissa J; Case, Stephanie E; Smith, Ian P; Mitchell, Julia L G

2008-09-01

The objective of this study was to compare the seasonal concussion incidence for school, university, club and provincial level Rugby Union players in South Africa. The study presents a retrospective statistical analysis of the number of reported concussions documented annually for groups of Rugby Union players as a proportion of those who received preseason neurocognitive assessment. Between 2002 and 2006, concussion management programs using computerized neuropsychological assessment were implemented for clinical and research purposes by psychologists in selected South African institutions involved in Rugby Union from school through to the professional level. The incidence figures were based on 175 concussive episodes reported for 165 athletes who were referred for neurocognitive assessment from a population of 1366 athletes who received preseason baseline testing. Concussion management routines varied according to the protocols adopted by the different psychologists and rugby organizations. It was expected that the incidence of concussion would vary significantly due to level of play and different management protocols. There was wide disparity in the manner in which concussion follow-up was managed by the various organizations. Within broadly comparable cohorts, tighter control was associated with a relatively higher concussion incidence for athletes per rugby playing season, with average institutional figures ranging from 4% to 14% at school level and 3% to 23% at adult level. This analysis suggests that concussion goes unrecognized and therefore incorrectly managed in a number of instances. Recommendations for optimal identification of concussed athletes for follow-up management are presented.

Physiological demands of women's rugby union: time-motion analysis and heart rate response.

PubMed

Virr, Jody Lynn; Game, Alex; Bell, Gordon John; Syrotuik, Daniel

2014-01-01

The aim of this study was to determine the physical demands of women's rugby union match play using time-motion analysis and heart rate (HR) response. Thirty-eight premier club level female rugby players, ages 18-34 years were videotaped and HRs monitored for a full match. Performances were coded into 12 different movement categories: 5 speeds of locomotion (standing, walking, jogging, striding, sprinting), 4 forms of intensive non-running exertion (ruck/maul/tackle, pack down, scrum, lift) and 3 discrete activities (kick, jump, open field tackle). The main results revealed that backs spend significantly more time sprinting and walking whereas forwards spend more time in intensive non-running exertion and jogging. Forwards also had a significantly higher total work frequency compared to the backs, but a higher total rest frequency compared to the backs. In terms of HR responses, forwards displayed higher mean HRs throughout the match and more time above 80% of their maximum HR than backs. In summary, women's rugby union is characterised by intermittent bursts of high-intensity activity, where forwards and backs have similar anaerobic energy demands, but different specific match demands.

[Advanced bone graft combined with locking compression plate for the treatment of middle and distal tibia nonunion].

PubMed

Zhao, Xue; Wang, Pan-feng; Zhang, Yun-tong; Zhang, Chun-cai; Xu, Shuo-gui; Zhang, Xin

2014-12-01

To explore methods of treating middle and distal tibia nonunion with the treatment of advanced bone graft combined with locking compression plate. From January 2011 to December 2012, 12 patients with middle and distal tibia nonunion were treated with advanced bone graft combined with locking compression plate. Among patients, there were 8 males and 4 females aged from 20 to 69 with an average of 47 years old. The time from first injuries to bone nonunion was from 9 months to 5 years, avergaed 19 months. Four cases were treated with external fixation, 6 cases were treated with plate fixation, 2 cases of 12 patients occurred broken of plate and nail. Eleven patients were non-infective bone nonunion and 1 patient was infective bone nonunion. Preoperative X-ray and CT showed all patients had sequestration and formation of ossified bone with different degrees. Operative time, blood loss, wound healing were observed, fracture healing time was evaluated by postoperative X-ray. Johner-Wruhs scoring standards was used to evaluate ankle joint function after operation at 10 months. Operative time ranged from 90 to 185 min with an average of (125.00±20.15) min; blood loss ranged from 225 to 750 ml with an average of (415.00±120.00) ml. All patients were followed up from 10 months to 2.5 years with an average of 1.5 years. Postoperative X-ray showed bone union was formed around fracture after operation at 4 months in all patients, 3 cases obtained bone healing within 6 months after operation, 9 cases obtained from 8 to 12 months. No infection, injury of nerve and vessles, and broken of plate and nail were ocurred. According to Johner-Wruhs scoring at 10 months after operation, 10 cases obtained excellent results, 1 good and 1 moderate. Advanced bone graft combined with locking compression plate, which can build fracture multi-point supporting based on full compression of bone nonunion to get effective fixation, is an effective method in treating middle and distal tibia nonunion.

Assessing worst case scenarios in movement demands derived from global positioning systems during international rugby union matches: Rolling averages versus fixed length epochs.

PubMed

Cunningham, Daniel J; Shearer, David A; Carter, Neil; Drawer, Scott; Pollard, Ben; Bennett, Mark; Eager, Robin; Cook, Christian J; Farrell, John; Russell, Mark; Kilduff, Liam P

2018-01-01

The assessment of competitive movement demands in team sports has traditionally relied upon global positioning system (GPS) analyses presented as fixed-time epochs (e.g., 5-40 min). More recently, presenting game data as a rolling average has become prevalent due to concerns over a loss of sampling resolution associated with the windowing of data over fixed periods. Accordingly, this study compared rolling average (ROLL) and fixed-time (FIXED) epochs for quantifying the peak movement demands of international rugby union match-play as a function of playing position. Elite players from three different squads (n = 119) were monitored using 10 Hz GPS during 36 matches played in the 2014-2017 seasons. Players categorised broadly as forwards and backs, and then by positional sub-group (FR: front row, SR: second row, BR: back row, HB: half back, MF: midfield, B3: back three) were monitored during match-play for peak values of high-speed running (>5 m·s-1; HSR) and relative distance covered (m·min-1) over 60-300 s using two types of sample-epoch (ROLL, FIXED). Irrespective of the method used, as the epoch length increased, values for the intensity of running actions decreased (e.g., For the backs using the ROLL method, distance covered decreased from 177.4 ± 20.6 m·min-1 in the 60 s epoch to 107.5 ± 13.3 m·min-1 for the 300 s epoch). For the team as a whole, and irrespective of position, estimates of fixed effects indicated significant between-method differences across all time-points for both relative distance covered and HSR. Movement demands were underestimated consistently by FIXED versus ROLL with differences being most pronounced using 60 s epochs (95% CI HSR: -6.05 to -4.70 m·min-1, 95% CI distance: -18.45 to -16.43 m·min-1). For all HSR time epochs except one, all backs groups increased more (p < 0.01) from FIXED to ROLL than the forward groups. Linear mixed modelling of ROLL data highlighted that for HSR (except 60 s epoch), SR was the only group not significantly different to FR. For relative distance covered all other position groups were greater than the FR (p < 0.05). The FIXED method underestimated both relative distance (~11%) and HSR values (up to ~20%) compared to the ROLL method. These differences were exaggerated for the HSR variable in the backs position who covered the greatest HSR distance; highlighting important consideration for those implementing the FIXED method of analysis. The data provides coaches with a worst-case scenario reference on the running demands required for periods of 60-300 s in length. This information offers novel insight into game demands and can be used to inform the design of training games to increase specificity of preparation for the most demanding phases of matches.

The challenge of the standardization of nursing specializations in Europe.

PubMed

Ranchal, A; Jolley, M J; Keogh, J; Lepiesová, M; Rasku, T; Zeller, S

2015-12-01

The evolution of health care is driving the need for specialist nursing knowledge. Specialist nurses have undertaken a formal training that focuses on a specific clinical area or population and are legitimated by a professional award or legal status. Specialist nurses are better able to provide the most specific and most appropriate care for both people and populations. This paper considers nursing's loose understanding of 'specialization' and the impact this has on those who seek employment outside their own nation but within the family of nations known as the European Union (EU). There is a lack of standardization for nursing specializations across the European Union that leads to lack of mobility across countries. Reports were reviewed from within the European Union, including specialist nursing groups and regulatory nursing bodies. Nurse specialists can be regarded as operating at nursing's 'leading edge'; however, it is here that nursing lacks organization and common standards. This is readily apparent in a EU bound together by the principle of freedom of movement and common professional and academic standards. It is now time for European Union nurses to look beyond the common standards for pre-registration courses and to consider the development of common standards for specialist nursing. Historical attempts to achieve common standards for specialist nursing have largely been unsuccessful due to the diversity of approaches to nurse specialization. It is time now for this challenge to be re-addressed so that specialist nurses can more freely work throughout the European Union. There is a pressing need for policy makers to define specialist nursing and to enable European Union-wide standards. © 2015 International Council of Nurses.

Trends of non-union and prescriptions for non-steroidal anti-inflammatory drugs in the United States, 1993-2012.

PubMed

Wang, Zhong; Bhattacharyya, Timothy

2015-01-01

Surgical care and pain management for patients with fractures have evolved over the years. We wanted to ascertain if there were any changes in the incidence of non-unions and, if so, whether the use of non-steroidal anti-inflammatory drugs (NSAIDs), including COX-2 selective inhibitors, might have an effect. We used the National Inpatient Sample (NIS) to estimate the annual number of patients hospitalized for surgical treatment of a non-union between 1993 and 2012, and calculated age-adjusted rates of non-union. We estimated the prevalence of prescriptions for NSAIDs from 1996 through 2012 using the Medical Expenditure Panel Survey (MEPS). The interrupted time-series analysis was used to relate quarterly rates of non-union to changes in prescriptions for NSAIDs between 1996 and 2009. The annual estimate of non-unions in the USA declined 30% from 25,634 in 1993 to 17,815 in 2012 (p < 0.001). Specifically, the age-adjusted rate of non-unions decreased by 44% from 8.6 per 10(5) persons in 1996 to 4.8 per 10(5) persons in 2012 (p < 0.001). However, there was an 8% increase in the incidence rate of non-unions (p = 0.003) between 2000 and 2004, when certain COX-2 selective inhibitors were on the market and their prescriptions were prevalent at around 6% among those with fractures. A drop in non-union estimates from 22,321 in 2010 to 18,789 in 2011 (p = 0.04) also coincided with a marked decrease in prescriptions for NSAIDs in patients with fractures, from 22% to 14% (p = 0.02). Non-unions in the USA declined substantially between 1993 and 2012, but this was interrupted by changes in prescriptions for NSAIDs, with sustained increases between 2000 and 2004 followed by transient decreases in 2005 and 2011.

How Do Changes to the Railroad Causeway in Utah’s Great Salt Lake Affect Water and Salt Flow?

PubMed Central

White, James S.; Null, Sarah E.; Tarboton, David G.

2015-01-01

Managing terminal lake elevation and salinity are emerging problems worldwide. We contribute to terminal lake management research by quantitatively assessing water and salt flow for Utah’s Great Salt Lake. In 1959, Union Pacific Railroad constructed a rock-filled causeway across the Great Salt Lake, separating the lake into a north and south arm. Flow between the two arms was limited to two 4.6 meter wide rectangular culverts installed during construction, an 88 meter opening (referred to locally as a breach) installed in 1984, and the semi porous material of the causeway. A salinity gradient developed between the two arms of the lake over time because the south arm receives approximately 95% of the incoming streamflow entering Great Salt Lake. The north arm is often at, or near, salinity saturation, averaging 317 g/L since 1966, while the south is considerably less saline, averaging 142 g/L since 1966. Ecological and industrial uses of the lake are dependent on long-term salinity remaining within physiological and economic thresholds, although optimal salinity varies for the ecosystem and between diverse stakeholders. In 2013, Union Pacific Railroad closed causeway culverts amid structural safety concerns and proposed to replace them with a bridge, offering four different bridge designs. As of summer 2015, no bridge design has been decided upon. We investigated the effect that each of the proposed bridge designs would have on north and south arm Great Salt Lake elevation and salinity by updating and applying US Geological Survey’s Great Salt Lake Fortran Model. Overall, we found that salinity is sensitive to bridge size and depth, with larger designs increasing salinity in the south arm and decreasing salinity in the north arm. This research illustrates that flow modifications within terminal lakes cannot be separated from lake salinity, ecology, management, and economic uses. PMID:26641101

How Do Changes to the Railroad Causeway in Utah's Great Salt Lake Affect Water and Salt Flow?

PubMed

White, James S; Null, Sarah E; Tarboton, David G

2015-01-01

Managing terminal lake elevation and salinity are emerging problems worldwide. We contribute to terminal lake management research by quantitatively assessing water and salt flow for Utah's Great Salt Lake. In 1959, Union Pacific Railroad constructed a rock-filled causeway across the Great Salt Lake, separating the lake into a north and south arm. Flow between the two arms was limited to two 4.6 meter wide rectangular culverts installed during construction, an 88 meter opening (referred to locally as a breach) installed in 1984, and the semi porous material of the causeway. A salinity gradient developed between the two arms of the lake over time because the south arm receives approximately 95% of the incoming streamflow entering Great Salt Lake. The north arm is often at, or near, salinity saturation, averaging 317 g/L since 1966, while the south is considerably less saline, averaging 142 g/L since 1966. Ecological and industrial uses of the lake are dependent on long-term salinity remaining within physiological and economic thresholds, although optimal salinity varies for the ecosystem and between diverse stakeholders. In 2013, Union Pacific Railroad closed causeway culverts amid structural safety concerns and proposed to replace them with a bridge, offering four different bridge designs. As of summer 2015, no bridge design has been decided upon. We investigated the effect that each of the proposed bridge designs would have on north and south arm Great Salt Lake elevation and salinity by updating and applying US Geological Survey's Great Salt Lake Fortran Model. Overall, we found that salinity is sensitive to bridge size and depth, with larger designs increasing salinity in the south arm and decreasing salinity in the north arm. This research illustrates that flow modifications within terminal lakes cannot be separated from lake salinity, ecology, management, and economic uses.

Ecological risks posed by ammonia nitrogen (AN) and un-ionized ammonia (NH3) in seven major river systems of China.

PubMed

Zhang, Li; Xu, Elvis Genbo; Li, Yabing; Liu, Hongling; Vidal-Dorsch, Doris E; Giesy, John P

2018-07-01

Previous studies showed that continuous exposure to ammonia nitrogen (AN) contributed to regional losses of benthic invertebrate diversity in China. Yet, the overall ecological risk of AN to aquatic organisms in major riverine systems of China has not been appropriately studied. Our research then investigated temporal (seasonally/yearly) and spatial distributions of AN and un-ionized ammonia (NH 3 ) in major Chinese river basins using historic data generated between 2007 and 2014, and developed risk assessment criteria. Our results showed that the highest average AN concentrations occurred during winter (0.82-2.76 mg/L) and the lowest during summer (0.36-0.78 mg/L). NH 3 exhibited the opposite trend with the highest average concentrations mostly observed during spring (15.13-92.84 μg/L) and the lowest concentrations mainly during winter (10.53-45.43 μg/L). Both AN and NH 3 concentrations steadily increased and reached maximum levels in 2008 (AN: 1.22 mg/L and NH 3 : 50.65 μg/L), and then decreased. Temporal trends showed that the Yellow, Hai, and Huai river basins had the highest AN and NH 3 concentrations. Subsequently, conventional (hazard quotients) and probabilistic (joint probability curves) methods were applied to assess the hazards and risks posed by AN and NH 3 . The results showed that the probability of exceeding the acute toxicity threshold for 5% of species (exposed to AN or NH 3 ) was less than 13.3% and gradually decreased over time. To protect aquatic organisms, an acute criterion of 51.4 μg NH 3 /L and a chronic criterion of 1.14 mg AN/L at pH = 7.5, 20 °C were developed and are recommended for future risk assessment studies. Copyright © 2018 Elsevier Ltd. All rights reserved.

The treatment of infected nonunion of the tibia following intramedullary nailing by the Ilizarov method.

PubMed

Megas, Panagiotis; Saridis, Alkis; Kouzelis, Antonis; Kallivokas, Alkiviadis; Mylonas, Spyros; Tyllianakis, Minos

2010-03-01

The purpose of this study was to demonstrate the effectiveness of the Ilizarov method and circular external fixator in order to eradicate the infection and restore bone union, limb anatomy and functionality in cases with infected nonunion of the tibia following intramedullary nailing. During 7 years nine patients suffering from infected nonunion of the tibia after intramedullary nailing were treated in our department. The series comprised seven men and two women with an average age of 39.7 years (range 21-75 years). The patients had previously undergone an average of 4.8 operations (range 3-6 operations). Active purulent bone infection occurred in all nine patients. Bone defect was present in all patients with a mean size of 5 cm (range 2-12 cm). In three cases with bone defect less than 2 cm, monofocal compression osteosynthesis technique was used. In the rest cases where bone defect exceeded 2 cm, bifocal consecutive distraction-compression osteosynthesis technique was applied. Three patients required a local gastrocnemius flap. The mean follow-up period was 26.6 months (range 13-42 months). Results were evaluated using Paley's functional and radiological scoring system. Bone union was achieved in all nine patients without recurrence of infection during the follow-up period. Bone results were graded as excellent in five cases and good in the rest four cases. Functional results were graded as excellent in three cases, good in four and fare in two cases. Mean external fixation time was 187.4 days (range 89-412 days) and mean lengthening index was 32 days/cm (range 27-39 days/cm). Complications observed included eight grade II pin tract infections, axial deformity at the lengthening site in two cases and at the nonunion site in another two cases. Ankle joint stiffness was detected in five cases. The Ilizarov method may be an effective method in infected nonunions of the tibia following intramedullary nailing. Copyright 2009 Elsevier Ltd. All rights reserved.

Reliability and Usefulness of Linear Sprint Testing in Adolescent Rugby Union and League Players.

PubMed

Darrall-Jones, Joshua D; Jones, Ben; Roe, Gregory; Till, Kevin

2016-05-01

The purpose of this study was to evaluate (a) whether there were differences in sprint times at 5, 10, 20, 30, and 40 m between rugby union and rugby league players, (b) determine the reliability and usefulness of linear sprint testing in adolescent rugby players. Data were collected on 28 rugby union and league academy players over 2 testing sessions, with 3-day rest between sessions. Rugby league players were faster at 5 m than rugby union players, with further difference unclear. Sprint time at 10, 20, 30, and 40 m was all reliable (coefficient of variation [CV] = 3.1, 1.8, 2.0, and 1.3%) but greater than the smallest worthwhile change (SWC [0.2 × between-subject SD]), rating the test as marginal for usefulness. Although the test was incapable of detecting the SWC, we recommend that practitioners and researchers use Hopkins' proposed method; whereby plotting the change score of the individual at each split (±typical error [TE] expressed as a CV) against the SWC and visually inspecting whether the TE crosses into the SWC are capable of identifying whether a change is both real (greater than the noise of the test, i.e., >TE) and of practical significance (>SWC). Researchers and practitioners can use the TE and SWC from this study to assess changes in performance of adolescent rugby players when using single beam timing gates.

A Decade of Reforms at Compulsory Education Level in the European Union (1984-94).

ERIC Educational Resources Information Center

EURYDICE European Unit, Brussels (Belgium).

This report focuses on the compulsory education reforms introduced throughout the European Union from 1984-1994. Compulsory education that stage of education established formally by a government for the education of all children and young people, usually institutionalized on a full- or part-time basis, and compulsory for a certain number of years.…

Ideologies, Strategies and Higher Education Development: A Comparison of China's University Partnerships with the Soviet Union and Africa over Space and Time

ERIC Educational Resources Information Center

Li, Jun

2017-01-01

University partnerships have been a key dimension of higher education development. Based on documentary analysis and empirical data, this study compares two distinctive models of university partnership experienced by China, first as a "recipient" with the Soviet Union in the 1950s and later as a "provider" with African…

78 FR 53163 - Agency Information Collection Activities: Submission to OMB for Reinstatement, With Change, of a...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

...-insured credit unions and changes in insured status and requires written approval of the Board before one... together treated as one respondent) times 35 hours per respondent equals 8,400 total annual burden hours... year engage in share insurance terminations. If one or more credit unions were to engage in a voluntary...

Constructing Educational Achievement in Political Discourse: An Analysis of Obama's Interview at the Education Nation Summit 2012

ERIC Educational Resources Information Center

Lee, Jinsol

2017-01-01

In the fall of 2012, a series of teacher union strikes in Chicago catalyzed controversial discussions in education within the political sector, as the goals for student achievement gained increasing attention. Hence, discourses as systems of representation within the particular context and time-period of the teacher union strikes in Chicago…

A Union Voice for Racial Equality: Miles Stanley and Civil Rights in West Virginia, 1957-68

ERIC Educational Resources Information Center

Fones-Wolf, Colin T.

2004-01-01

On October 15, 1959, union delegates from across West Virginia converged upon the Daniel Boone Hotel in the capital city of Charleston to participate in the West Virginia Labor Federation, AFL-CIO's second statewide constitutional convention. Charleston, at this time, remained a segregated city. So when G. William Dunn, an African-American…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wu, Jinyuan

A digitization scheme of sub-microampere current using a commercial comparator with adjustable hysteresis and FPGA-based Wave Union TDC has been tested. The comparator plus a few passive components forms a current controlled oscillator and the input current is sent into the hysteresis control pin. The input current is converted into the transition times of the oscillations, which are digitized with a Wave Union TDC in FPGA and the variation of the transition times reflects the variation of the input current. Preliminary tests show that input charges < 25 fC can be measured at > 50 M samples/s without a preamplifier.

Working conditions survey and trainees situation: new approach to auditing the situation of European trainees in obstetrics and gynaecology ten years later.

PubMed

Rodríguez, David; Christopoulos, Panagiotis; Martins, Nuno; Pärgmäe, Pille; Werner, Henrica M J

2009-12-01

(1) To review the training and working conditions for trainees in obstetrics and gynaecology (Ob/Gyn) in Europe. (2) To suggest further improvements in working conditions for trainees in Ob/Gyn. It is an observational, descriptive, and cross-sectional study. The sample is constituted of the answers from the representatives of 25 European Network of Trainees in Ob/Gyn (ENTOG) member countries to a survey designed by ENTOG's executive. The current survey is based on the former ENTOG working conditions survey published in 1997, but has been extended to include questions that have become important recently, and to include new countries that have entered the European Union (EU) since that time. The total number of trainees represented in this study is 6056. The male/female ratio is 35/65. The average number of official working hours is 51.6 h weekly, but varies widely. The average number of duties/month is five, but varies widely from two to nine. Fewer than 50% of countries have a hospital visitation system implemented. Training abroad is possible in most training systems. Compared with the 1997 survey further harmonisation is taking place. Steps towards harmonisation are being made. Hospital visitation systems should be further introduced. Not all countries have remunerated training posts. Assessment should become more homogeneous. Compliance with the European Working Time Directive (EWTD) is a big challenge.

External fixation of “intertrochanteric” fractures

PubMed Central

Gani, Naseem ul; Kangoo, Khursheed Ahmed; Bashir, Arshad; Muzaffer, Rahil; Bhat, Mohammad Farooq; Farooq, Munir; Badoo, Abdul Rashid; Dar, Imtiyaz Hussian; Wani, Mudassir Maqbool

2009-01-01

In developing countries, due to limited availability of modern anesthesia and overcrowding of the hospitals with patients who need surgery, high-risk patients with “intertrochanteric” fractures remain unsuita ble for open reduction and internal fixation. The aim of this study was to analyze the results of external fixation of “intertrochanteric” fractures in high-risk geriatric patients in a developing country. The results of 62 ambulatory high-risk geriatric patients with a mean age of 70 years (range 58–90 years) with “intertrochanteric” fractures, in whom external fixation was performed, are reported. Eight patients died during follow-up due to medical causes unrelated to the surgical procedure. So only 54 patients were available for final assessment. Procedure is simple, performed under local anesthesia, requires less time for surgery and is associated with less blood loss. Good fixation and early ambulation was achieved in most of the patients. Average time to union was 14 weeks. Thirty-one patients developed superficial pin tract infection and 28 patients had average shortening of 15 mm due to impaction and varus angulation. Functional outcome was assessed using Judet's point system. Good to excellent results were achieved in 44 patients. This study demonstrated that external fixation of “intertrochantric” fractures performed under local anesthesia offers significant advantage in ambulatory high-risk geriatric patients especially in a developing country. PMID:21808680

Opisthobranchs from the western Indian Ocean, with descriptions of two new species and ten new records (Mollusca, Gastropoda)

PubMed Central

Yonow, Nathalie

2012-01-01

Abstract Seventy species of opisthobranchs are described in this work based on collections from the Persian Gulf, Socotra, Kenya, Zanzibar, Madagascar, La Réunion, Mauritius, the Seychelles, the Maldives, and Sri Lanka. Ten species are newly recorded from the western Indian Ocean and four species are recorded in the scientific literature for the first time since their original descriptions. Two species are described as new: Cyerce bourbonica sp. n. from La Réunion and Doriopsilla nigrocerasp. n. from the Persian Gulf coast of Saudi Arabia. Chromodoris cavae is removed from its synonymy with Chromodoris tennentana and redescribed from specimens from La Réunion, while several new synonyms are proposed for some commonly occurring species. Risbecia bullockii is recorded for the second time from the Indian Ocean and assigned to its correct genus. PMID:22711992

Chronic aquatic effect assessment for the fungicide azoxystrobin.

PubMed

van Wijngaarden, Rene P A; Belgers, Dick J M; Zafar, Mazhar I; Matser, Arrienne M; Boerwinkel, Marie-Claire; Arts, Gertie H P

2014-12-01

The present study examined the ecological effects of a range of chronic exposure concentrations of the fungicide azoxystrobin in freshwater experimental systems (1270-L outdoor microcosms). Intended and environmentally relevant test concentrations of azoxystrobin were 0 µg active ingredient (a.i.)/L, 0.33 µg a.i./L, 1 µg a.i./L, 3.3 µg a.i./L, 10 µg a.i./L, and 33 µg a.i./L, kept at constant values. Responses of freshwater populations and community parameters were studied. During the 42-d experimental period, the time-weighted average concentrations of azoxystrobin ranged from 93.5% to 99.3% of intended values. Zooplankton, especially copepods and the Daphnia longispina group, were the most sensitive groups. At the population level, a consistent no-observed-effect concentration (NOEC) of 1 µg a.i./L was calculated for Copepoda. The NOEC at the zooplankton community level was 10 µg azoxystrobin/L. The principle of the European Union pesticide directive is that lower-tier regulatory acceptable concentrations (RACs) are protective of higher-tier RACs. This was tested for chronic risks from azoxystrobin. With the exception of the microcosm community chronic RAC (highest tier), all other chronic RAC values were similar to each other (0.5-1 µg a.i./L). The new and stricter first-tier species requirements of the European Union pesticide regulation (1107/2009/EC) are not protective for the most sensitive populations in the microcosm study, when based on the higher tier population RAC. In comparison, the Water Framework Directive generates environmental quality standards that are 5 to 10 times lower than the derived chronic RACs. © 2014 SETAC.

To Jump or Cycle? Monitoring Neuromuscular Function in Rugby Union Players.

PubMed

Roe, Gregory; Darrall-Jones, Joshua; Till, Kevin; Phibbs, Padraic; Read, Dale; Weakley, Jonathon; Jones, Ben

2017-05-01

To evaluate changes in performance of a 6-s cycle-ergometer test (CET) and countermovement jump (CMJ) during a 6-wk training block in professional rugby union players. Twelve young professional rugby union players performed 2 CETs and CMJs on the 1st and 4th mornings of every week before the commencement of daily training during a 6-wk training block. Standardized changes in the highest score of 2 CET and CMJ efforts were assessed using linear mixed modeling and magnitude-based inferences. After increases in training load during wk 3 to 5, moderate decreases in CMJ peak and mean power and small decreases in flight time were observed during wk 5 and 6 that were very likely to almost certainly greater than the smallest worthwhile change (SWC), suggesting neuromuscular fatigue. However, only small decreases, possibly greater than the SWC, were observed in CET peak power. Changes in CMJ peak and mean power were moderately greater than in CET peak power during this period, while the difference between flight time and CET peak power was small. The greater weekly changes in CMJ metrics in comparison with CET may indicate differences in the capacities of these tests to measure training-induced lower-body neuromuscular fatigue in rugby union players. However, future research is needed to ascertain the specific modes of training that elicit changes in CMJ and CET to determine the efficacy of each test for monitoring neuromuscular function in rugby union players.

Comparison of SMR, PMR, and PCMR in a cohort of union members potentially exposed to diesel exhaust emissions.

PubMed Central

Wong, O; Morgan, R W; Kheifets, L; Larson, S R

1985-01-01

A comparison of cause specific standarised mortality ratios (SMRs) and proportionate mortality ratios (PMRs) or proportionate cancer mortality ratios (PCMRs) was made based on the mortality experience of a cohort of 34 156 members of a heavy equipment operators union. Two types of PMRs or PCMRs were used in the comparison: those based on all deaths and those based on deaths known to the union only. The comparison indicated that, for the entire cohort, both types of PMRs were poor indicators for cancer risk and produced a large number of false positives. On the other hand, PCMRs appeared to be better than PMRs for assessing the direction of site specific cancer risk, but they tended to overstate the magnitude of risk. Analysis by duration of union membership or latency indicated that PMRs or PCMRs based on deaths known to the union tended to overestimate the risk of lung cancer by disproportionately larger amounts in groups with shorter time than in groups with longer time. This differential bias had the net effect of reducing the gradient of any trend or eliminating the trend entirely. In conclusion, PMR or PCMR, based on reasonably sufficient death ascertainment, has a certain usefulness in generating hypotheses, but they are not useful or reliable in measuring the magnitude of risk or in detecting trends in dose response analysis. No conclusion should be drawn from either PMR or PCMR. PMID:2410011

Studying entrepreneurial occupations in the Terman women.

PubMed

Schmitt-Rodermund, Eva; Schröder, Elke; Obschonka, Martin

2017-07-16

To achieve a better understanding of entrepreneurship development in women, longitudinal data on 672 individuals collected from 1922 to 1959 were analysed in a secondary investigation of the Terman Longitudinal Study. Women's reports on their occupations during 10 different years were assigned to one of two categories: work for pay (0/1), and work allowing for self-employment (0/1) in the respective year. Structural equation modelling supported earlier results concerning male entrepreneurial activity. Personality and aspects of the parenting context the women had experienced by the average age of 12 predicted early entrepreneurial competencies (inventions, leadership) and occupational interests by age 13, which related to an entrepreneurship-related career goal in 1936, when the participants were about 27 years of age on average. Such a career goal in turn predicted a higher number of occasions of entrepreneurship-prone work. Surprisingly, we also found a relationship to divorce. Women who had experienced the failure of a marriage were in occupations with a potential for entrepreneurship more often. Reasons are discussed against a backdrop of historical timing and current findings to identify general aspects of entrepreneurship development. © 2017 International Union of Psychological Science.

Coupled external fixator and skin flap transposition for treatment of exposed and nonunion bone.

PubMed

Zhao, Yong-gang; Ding, Jing; Wang, Neng

2011-02-01

To discuss the effect of coupled external fixator and skin flap transposition on exposed and nonunion bones. The data of 12 cases of infected nonunion and exposed bone following open fracture treated in our hospital during the period of March 1998 to June 2008 were analysed. There were 10 male patients, 2 female patients, whose age were between 19-52 years and averaged 28 years. There were 10 tibial fractures and 2 femoral fractures. The course of diseases lasted for 12-39 months with the mean period of 19 months. All the cases were treated by the coupled external fixator and skin flap transposition. Primary healing were achieved in 10 cases and delayed healing in 2 cases in whom the tibia was exposed due to soft tissue defect and hence local flap transposition was performed. All the 12 cases had bony union within 6-12 months after operation with the average time of 8 months. They were followed up for 1-3 years and all fractures healed up with good function and no infection recurrence. The coupled external fixator and skin flap transposition therapy have shown optimal effects on treating infected, exposed and nonunion bones.

Comminuted inferior pole fracture of patella can be successfully treated with rim-plate-augmented separate vertical wiring.

PubMed

Cho, Jae-Woo; Kim, Jinil; Cho, Won-Tae; Gujjar, Pranay H; Oh, Chang-Wug; Oh, Jong-Keon

2018-02-01

We present the surgical technique of rim-plate-augmented separate vertical wiring for comminuted inferior pole fracture of the patella and report the clinical outcomes. Between July 2013 and January 2016, 13 patients (7 male and 6 female) who were diagnosed with comminuted inferior pole fracture of the patella in preoperative computed tomography and underwent a minimum of 1 year of follow-up were enrolled in this study. Mean patient age was 57.7 years (range 28-72 years). All patients underwent open reduction and internal fixation by rim-plate-augmented separate vertical wiring. Bony union, complications, range of motion and Bostman score were the clinical outcomes. Bony union was achieved in all cases at an average of 10 weeks after surgery (range 8-12). There was no loss of reduction and fixative failure during follow-up. The average range of motion was 127° (range 120°-130°). The mean Bostman score at last follow-up was 29.6 points (range 27-30) and graded excellent in 12 patients. Rim-plate-augmented separate vertical wiring demonstrated secure fixation and favorable clinical outcomes. This study provides evidence for its effectiveness as a fixation method for treating displaced, comminuted inferior pole fracture of the patella.

A Multistate Life Table Analysis of Union Regimes in the United States: Trends and Racial Differentials, 1970–2002

PubMed Central

Morgan, S. Philip; Wang, Zhenglian; Gu, Danan; Yang, Chingli

2013-01-01

We estimate trends and racial differentials in marriage, cohabitation, union formation and dissolution (union regimes) for the period 1970–2002 in the United States. These estimates are based on an innovative application of multistate life table analysis to pooled survey data. Our analysis demonstrates (1) a dramatic increase in the lifetime proportions of transitions from never-married, divorced or widowed to cohabiting; (2) a substantial decrease in the stability of cohabiting unions; (3) a dramatic increase in mean ages at cohabiting after divorce and widowhood; (4) a substantial decrease in direct transition from never-married to married; (5) a significant decrease in the overall lifetime proportion of ever marrying and re-marrying in the 1970s to 1980s but a relatively stable pattern in the 1990s to 2000–2002; and (6) a substantial decrease in the lifetime proportion of transition from cohabiting to marriage. We also present, for the first time, comparable evidence on differentials in union regimes between four racial groups. PMID:24179311

Fusion and erosion of cell walls during confugation in the fussion yeast (Schizosaccharomyces pombe).

PubMed

Calleja, G B; Yoo, B Y; Johnson, B F

1977-06-01

Conjugation in Schizosaccharomyces pombe was studied by transmission electron microscopy. Mural and nuclear events were scored from induction, the initial event, to meiosis I, the start of sporulation. These morphogenic markers were separately identifiable as flocculation, copulation, conjugation-tube formation, cross-wall formation, cross-wall erosion, conjugation-tube expansion, cytoplasmic fusion, de-differentiation of site of union, nuclear migration and karyogamy. The following were identified as new structural elements: sex hairs, which presumably mediate hydrogen bonding between cells during flocculation; crimp at the site of union; dark patch, which presumably serves as a leak-proof seal at the time of cross-wall erosion; suture, an electron-dense seam formed by the union of a copulant pair; and small electron-dense particles close to the site of wall erosion. No special structures on the cell wall could be identified as indicative of specific sites for potential copulatory activity. The discontinuity of the 2 cell walls at the site of union became so de-differentiated after fusion and erosion that it was no longer possible to pinpoint the site of union.

Spatially averaged flow over a wavy boundary revisited

USGS Publications Warehouse

McLean, S.R.; Wolfe, S.R.; Nelson, J.M.

1999-01-01

Vertical profiles of streamwise velocity measured over bed forms are commonly used to deduce boundary shear stress for the purpose of estimating sediment transport. These profiles may be derived locally or from some sort of spatial average. Arguments for using the latter procedure are based on the assumption that spatial averaging of the momentum equation effectively removes local accelerations from the problem. Using analogies based on steady, uniform flows, it has been argued that the spatially averaged velocity profiles are approximately logarithmic and can be used to infer values of boundary shear stress. This technique of using logarithmic profiles is investigated using detailed laboratory measurements of flow structure and boundary shear stress over fixed two-dimensional bed forms. Spatial averages over the length of the bed form of mean velocity measurements at constant distances from the mean bed elevation yield vertical profiles that are highly logarithmic even though the effect of the bottom topography is observed throughout the water column. However, logarithmic fits of these averaged profiles do not yield accurate estimates of the measured total boundary shear stress. Copyright 1999 by the American Geophysical Union.

Declining rates of work-related overexertion back injuries among union drywall installers in Washington State, 1989-2008: Improved work safety or shifting of care?

PubMed

Schoenfisch, Ashley L; Lipscomb, Hester J; Marshall, Stephen W; Casteel, Carri; Richardson, David B; Brookhart, M Alan; Cameron, Wilfrid

2014-02-01

Construction workers are at high risk of work-related musculoskeletal back disorders, and research suggests medical care and costs associated with these conditions may be covered by sources other than workers' compensation (WC). Little is known about the back injury experience and care seeking behavior among drywall installers, a high-risk workgroup regularly exposed to repetitive activities, awkward postures, and handling heavy building materials. Among a cohort of 24,830 Washington State union carpenters (1989-2008), including 5,073 drywall installers, we identified WC claims, visits for health care covered through union-provided health insurance and time at risk. Rates of work-related overexertion back injuries (defined using WC claims data) and health care utilization for musculoskeletal back disorders covered by private health insurance were examined and contrasted over time and by worker characteristics, stratified by type of work (drywall installation, other carpentry). Drywall installers' work-related overexertion back injury rates exceeded those of other carpenters (adjusted IRR 1.63, 95% CI 1.48-1.78). For both carpentry groups, rates declined significantly over time. In contrast, rates of private healthcare utilization for musculoskeletal back disorders were similar for drywall installers compared to other carpenters; they increased over time (after the mid-1990s), with increasing years in the union, and with increasing numbers of work-related overexertion back injuries. Observed declines over time in the rate of work-related overexertion back injury, as based on WC claims data, is encouraging. However, results add to the growing literature suggesting care for work-related conditions may be being sought outside of the WC system. © 2013 Wiley Periodicals, Inc.

Time functions of deep earthquakes from broadband and short-period stacks

USGS Publications Warehouse

Houston, H.; Benz, H.M.; Vidale, J.E.

1998-01-01

To constrain dynamic source properties of deep earthquakes, we have systematically constructed broadband time functions of deep earthquakes by stacking and scaling teleseismic P waves from U.S. National Seismic Network, TERRAscope, and Berkeley Digital Seismic Network broadband stations. We examined 42 earthquakes with depths from 100 to 660 km that occurred between July 1, 1992 and July 31, 1995. To directly compare time functions, or to group them by size, depth, or region, it is essential to scale them to remove the effect of moment, which varies by more than 3 orders of magnitude for these events. For each event we also computed short-period stacks of P waves recorded by west coast regional arrays. The comparison of broadband with short-period stacks yields a considerable advantage, enabling more reliable measurement of event duration. A more accurate estimate of the duration better constrains the scaling procedure to remove the effect of moment, producing scaled time functions with both correct timing and amplitude. We find only subtle differences in the broadband time-function shape with moment, indicating successful scaling and minimal effects of attenuation at the periods considered here. The average shape of the envelopes of the short-period stacks is very similar to the average broadband time function. The main variations seen with depth are (1) a mild decrease in duration with increasing depth, (2) greater asymmetry in the time functions of intermediate events compared to deep ones, and (3) unexpected complexity and late moment release for events between 350 and 550 km, with seven of the eight events in that depth interval displaying markedly more complicated time functions with more moment release late in the rupture than most events above or below. The first two results are broadly consistent with our previous studies, while the third is reported here for the first time. The greater complexity between 350 and 550 km suggests greater heterogeneity in the failure process in that depth range. Copyright 1998 by the American Geophysical Union.

Physical and Physiological Demands of Elite Rugby Union Officials.

PubMed

Blair, Matthew R; Elsworthy, Nathan; Rehrer, Nancy J; Button, Chris; Gill, Nicholas D

2018-04-13

To examine the movement and physiological demands of rugby union officiating within elite competition. Movement demands of 9 elite officials across 12 Super Rugby matches were calculated, using global positioning system devices. Total distance (m), relative distance (m·min -1 ), percentage time spent within various speed zones were calculated across a match. Heart rate responses were also recorded throughout each match. Cohen d effect sizes were reported to examine the within match variations. The total distance covered was 8,030 ± 506 m, with a relative distance of 83 ± 5 m·min -1 and with no differences observed between halves. Most game time was spent at lower movement speeds (76 ± 2%; <2.0 m·s -1 ), with large effects for time spent >7.0 m·s -1 between halves (d=2.85). Mean heart rate was 154 ± 10 b·min -1 (83.8 ± 2.9% HR max ), with no differences observed between the first and second halves. Most game time was spent between 81-90% HR max (40.5 ± 7.5%) with no observable differences between halves. Distances covered above 5.1 m·s -1 were highest during the first 10 minutes of a match, while distance at speeds 3.7-5 m·s -1 decreased during the final 10 minutes of play. These findings highlight the highly demanding and intermittent nature of rugby union officiating, with only some minor variations in physical and physiological demands across a match. These results have implications for the physical preparation of professional rugby union referees.

European Union's public fishing access agreements in developing countries.

PubMed

Le Manach, Frédéric; Chaboud, Christian; Copeland, Duncan; Cury, Philippe; Gascuel, Didier; Kleisner, Kristin M; Standing, André; Sumaila, U Rashid; Zeller, Dirk; Pauly, Daniel

2013-01-01

The imperative to increase seafood supply while dealing with its overfished local stocks has pushed the European Union (EU) and its Member States to fish in the Exclusive Economic Zones of other countries through various types of fishing agreements for decades. Although European public fishing agreements are commented on regularly and considered to be transparent, this is the first global and historical study on the fee regime that governs them. We find that the EU has subsidized these agreements at an average of 75% of their cost (financial contribution agreed upon in the agreements), while private European business interests paid the equivalent of 1.5% of the value of the fish that was eventually landed. This raises questions of fisheries benefit-sharing and resource-use equity that the EU has the potential to address during the nearly completed reform of its Common Fisheries Policy.

From the Digital Divide to Digital Inequality: A Secondary Research in the European Union

NASA Astrophysics Data System (ADS)

Stiakakis, Emmanouil; Kariotellis, Pavlos; Vlachopoulou, Maria

The digital divide is nowadays evolving to digital inequality, i.e., the socio-economic disparities inside the 'online population'. This paper examines two main dimensions of the digital inequality, namely 'skills' and 'autonomy' of Internet users. The level of formal education was selected as a representative variable of the skill dimension, as well as the density of population in different geographical areas as a representative variable of the autonomy dimension. The research was focused on the member states of the European Union (EU). The data, provided by Eurostat, included the daily use of computers for the last three months and the average use of the Internet at least once per week. The findings state that the EU already faces the problem of digital inequality to an extended rate, since there are significant disparities among the European countries with regard to the aforementioned variables.

The role of triple pelvic osteotomy in therapy of residual hip dysplasia and sequel of AVN: long-term experience.

PubMed

Dungl, P; Rejholec, M; Chomiak, J; Grill, F

2007-01-01

Triple pelvic osteotomy was performed for sequel of DDH including AVN between 1981 and 2002 for 329 patients (351 hips, 280 females, 49 males, average age at surgery 16.5 years, range 9-41 years, follow-up 4-25 years). A small modification of Steel's technique consisting of strictly subperiostal resection of segment from both pubic and ischial bone was used. Average gain of lengthening extremity was 1.8 cm. The average CE angle was improved from 7.8 to 35.5 degrees. Clinical results were evaluated according to Merle d'Aubigne and reflected to the preoperative clinical and radiological findings. There were 146 hip joints in 128 patients (76%) with excellent results in the group of congruent hips without arthrosis. In 182 hips in 178 patients with hip joints with some deformity, limited ROM and decentration, 40% were excellent, 32% good, 23% fair and 5% unsatisfactory results were achieved. The group of decentrated hip joints in young adults in incongruency, limited ROM and sometimes severe arthrosis consisted of 23 monolateral surgeries with 39% unsatisfactory, 39% fair and 22% good results, respectively. No major neurovascular complications were seen. Non-unions were recorded in 19 patients (5.4%), including 2 triple and 2 double non-unions. Based on our long-term experience, we can conclude that triple pelvic osteotomy according to Steel in our modification is a safe method and gives regularly excellent or good results for correction of clinical and radiographic appearance of acetabular dysplasia when there is a proper indication.

Higher Education in Russia: Traditions and Modern Times (Report at the Seventh Congress of the Russian Union of Rectors)

ERIC Educational Resources Information Center

Sadovnichii, V.

2004-01-01

This article represents a speech delivered by the author at the Seventh Congress of the Russian Union of Rectors. In his address, the author describes the current higher educational trend in Russia. He explains how higher education's orientation toward the state, its openness to all social classes, and its fundamental character are the principles…

Revisiting Jane Austen's Theory of Marriage Timing: Changes in Union Formation among American Men in the Late 20th Century

ERIC Educational Resources Information Center

Sassler, Sharon; Goldscheider, Frances

2004-01-01

This article examines union entrance among never-married young men, focusing on whether the importance of a man's being economically established to marry has decreased in this new era of cohabitation and working wives. The authors test this assumption by examining marriage and cohabitation as competing risks to see whether the importance of…

German Trade Unions on Consolidation Course. Basis-Info 21-2000. Social Policy.

ERIC Educational Resources Information Center

Pahlke-Grygier, Sabine

New technologies have made radical changes in the way work is done. This development has passed by German trade unions anchored traditionally among workers in industrial production and stuck in the old model of the full-time employee with a predictable career and a job for life. Consequently, between 1991-98, about 3 million out of the former 11…

Six Parallel Policy Changes in Higher Education in California and the Soviet Union in the 1980's.

ERIC Educational Resources Information Center

Heckman, Dale M.

This paper discusses the fact that, in the same decade and despite obvious differences, two separate and distinctive systems of higher education (those of California and the Soviet Union) have been urged by their respective policy making bodies, to make major changes in at least six parallel ways; the paper investigates reasons for this timing and…

Social Inclusion and Active Citizenship under the Prism of Neoliberalism: A Critical Analysis of the European Union's Discourse of Lifelong Learning

ERIC Educational Resources Information Center

Mikelatou, Angeliki; Arvanitis, Eugenia

2018-01-01

The aim of this article is to investigate the impact neoliberalism has in shaping the discourse of the European Union's policy of Lifelong Learning. The literature review initially presents the theoretical framework of neoliberalism as the dominant ideological and economic paradigm of our time. Thereafter, it takes a view on how neoliberalism…

Minorities and Women in Apprenticeship Programs and Referral Unions. Equal Employment Opportunity Report--1978.

ERIC Educational Resources Information Center

Equal Employment Opportunity Commission, Washington, DC.

In 1978, there were almost 150,000 apprentices in the United States; 4 percent were women and 19 percent were members of minority groups. At the same time, there were more than two million union members in this country; 11 percent were women and 24 percent were members of minorities, according to the 1978 Equal Employment Opportunities Commission…

High temperature properties of non-critical Fe-Al alloys doped by non critical or “slightly–critical” elements

NASA Astrophysics Data System (ADS)

Vodičková, Věra; Hanus, Pavel; Vlasák, Tomáš; Švec, Martin

2018-03-01

Iron aluminides were developed as an alternative to stainless steels after World War II. The main intended impact was to save strategic elements (chromium or nickel). The result of these investigations was development of registered alloys as Pyroferal (Czechoslovak Republic), Thugal (Soviet Union) or Thermagal (France). The investigation of these type alloys continued in the nineties thanks to technological progress. In this time iron aluminides seems to be promising material with very good corrosive and environment resistivity. The mechanical properties of binary iron aluminides (Fe-Al) are average at higher temperatures but strengthening effect of alloying elements is significant. The aim of the article is to show influence of non-critical additives (such as C, Ti, Zr) and also “slightly critical” elements as e.g. Ce, Nb on high temperature creep properties of alloys.

Current healthcare in Bulgaria: time for predictive diagnostics and preventive medicine.

PubMed

Dimitrov, Dimiter V

2010-12-01

Since 1990 Bulgaria gradually moved from monopolistic to market regulated economy and healthcare. In 2007 the country became member of the European Union and started to adopt EU legislations. However, significant gaps between the average European and Bulgarian level of social, health and economic efficiency remain to be narrowed. The major challenge is the demographic situation, where recent trends give alarming signals. Plans for reformation include transition towards out-patient palliative healthcare centers for the aging population as well as reduction of the costs with new electronic system of health insurance. The favorable location of the country at the Black Sea coast gives opportunities for medical tourism, which can provide quality health service for foreign customers. Finally, national platforms on prevention of major non-communicable diseases, such as obesity, cancer and diabetes, must be established as coordinated actions for the health and wellness of next generations.

Use of vascularised free fibula in limb reconstruction (for non-malignant defects).

PubMed

Hameed, Shahid; Ehtesham-ul-haq, Rana Hassan Javaid; Ahmed, Rao Saood; Majid, Abdul; Waqas, Muhammad; Aslam, Ayesha; Yusuf, Omamah; Butt, Ahsin Masood; Ali, Ghazanfar

2013-12-01

The case series was conducted at the Department of Plastic Surgery, Combined Military Hospital, Rawalpindi, from June 2009 to May 2011, and comprised 19 patients in whom free fibula flap was performed for upper and lower limb reconstruction, using SPSS 16. Results showed that flap survival was 100%. One (5.2%) flap was re-explored for venous congestion and was salvaged. One (5.2%) patient of congenital pseudoarthrosis of tibia had a fracture of the fibula and was treated with external fixation. Average follow up was 8 months. Mean union time and full weight-bearing was 6.5 +/- 1.34 months (range 3-8 months) and 9 months, respectively. No recurrence of pseudoathrosis was observed until the last follow up, with only a 1.5 cm length discrepancy in one patient. The results proved that a microvascular free fibular flap heals rapidly, causes early functional recovery and it can be raised as an osteocutaneous flap.

Taylor spatial frame fixation in patients with multiple traumatic injuries: study of 57 long-bone fractures.

PubMed

Sala, Francesco; Elbatrawy, Yasser; Thabet, Ahmed M; Zayed, Mahmoud; Capitani, Dario

2013-08-01

To evaluate the Taylor spatial frame (TSF) for primary and definitive fixation of lower limb long-bone fractures in patients with multiple traumatic injuries. Retrospective. Level I trauma center. Consecutive series of 52 patients, 57 fractures (25 femoral and 32 tibial), treated between 2005 and 2009. Forty-nine fractures (86%) were open. Injury Severity Score ≥16 for all patients. Fifty-four fractures (95%) underwent definitive fixation with the TSF and 3 were treated primarily within 48 hours of injury. In 22 cases (39%), fractures were acutely reduced with the TSF, fixed to bone and the struts in sliding mode without further adjustment, and in 35 cases (61%), the total residual deformity correction program was undertaken. Clinical and radiological. Complete union was obtained in 52 fractures (91%) without additional surgery at an average of 29 weeks. Four nonunions and 1 delayed union occurred. Results based on Association for the Study and Application of the Method of Ilizarov criteria: 74% excellent, 16% good, 4% fair, and 7% poor for bone outcomes and 35% excellent, 47% good, and 18% fair for functional outcomes. Eighty-eight percent of patients returned to preinjury work activities. Primary and definitive fixation with the TSF is effective. Advantages include continuity of device until union, reduced risk of infection, early mobilization, restoration of primary defect caused by bone loss, easy and accurate application, convertibility and versatility compared with a monolateral fixator, and improved union rate and range of motion for lower extremity long-bone fractures in patients with multiple traumatic injuries.

Spatial connectivity in a highly heterogeneous aquifer: From cores to preferential flow paths

USGS Publications Warehouse

Bianchi, M.; Zheng, C.; Wilson, C.; Tick, G.R.; Liu, Gaisheng; Gorelick, S.M.

2011-01-01

This study investigates connectivity in a small portion of the extremely heterogeneous aquifer at the Macrodispersion Experiment (MADE) site in Columbus, Mississippi. A total of 19 fully penetrating soil cores were collected from a rectangular grid of 4 m by 4 m. Detailed grain size analysis was performed on 5 cm segments of each core, yielding 1740 hydraulic conductivity (K) estimates. Three different geostatistical simulation methods were used to generate 3-D conditional realizations of the K field for the sampled block. Particle tracking calculations showed that the fastest particles, as represented by the first 5% to arrive, converge along preferential flow paths and exit the model domain within preferred areas. These 5% fastest flow paths accounted for about 40% of the flow. The distribution of preferential flow paths and particle exit locations is clearly influenced by the occurrence of clusters formed by interconnected cells with K equal to or greater than the 0.9 decile of the data distribution (10% of the volume). The fraction of particle paths within the high-K clusters ranges from 43% to 69%. In variogram-based K fields, some of the fastest paths are through media with lower K values, suggesting that transport connectivity may not require fully connected zones of relatively homogenous K. The high degree of flow and transport connectivity was confirmed by the values of two groups of connectivity indicators. In particular, the ratio between effective and geometric mean K (on average, about 2) and the ratio between the average arrival time and the arrival time of the fastest particles (on average, about 9) are consistent with flow and advective transport behavior characterized by channeling along preferential flow paths. ?? 2011 by the American Geophysical Union.

Spinal injuries in professional rugby union: a prospective cohort study.

PubMed

Fuller, Colin W; Brooks, John H M; Kemp, Simon P T

2007-01-01

To determine the incidence, severity, nature, and causes of cervical, thoracic, and lumbar spine injuries sustained during competition and training in professional rugby union. A 2 season prospective cohort design. Twelve English Premiership rugby union clubs. Five hundred and forty-six male rugby union players of whom 296 were involved in both seasons. Location, diagnosis, severity (number of days unavailable for training and matches), and cause of injury: incidence of match and training injuries (injuries/1000 player-hours). Player age, body mass, stature, playing position, use of headgear, and activity and period of season. The incidences of spinal injuries were 10.90 (9.43 to 12.60) per 1000 player match-hours and 0.37 (0.29 to 0.47) per 1000 player training-hours. No player sustained a catastrophic spinal injury, but 3 players sustained career-ending injuries. Overall, players were more likely to sustain a cervical injury during matches and a lumbar injury during training. Forwards were significantly more likely to sustain a spinal injury than backs during both matches (P < 0.01) and training (P = 0.02). During matches, injuries to the cervical (average: 13 days; P < 0.01) and lumbar (13 days; P < 0.01) spine were more severe than injuries to the thoracic (5 days) spine; during training, injuries to the lumbar spine (26 days) were more severe than injuries to the cervical (13 days; P = 0.10) or thoracic (12 days; P = 0.06) spine. A total of 4037 days were lost to competition and training through spinal injuries with lumbar disc injuries sustained during training accounting for 926 days (23%) and cervical nerve root injuries sustained during matches for 621 days (15%). During matches, more injuries were caused by tackles (37%), and during training more injuries were caused by weight-training (33%). The results showed that rugby union players were exposed to a high risk of noncatastrophic spinal injury during tackling, scrummaging, and weight-training activities; injury prevention strategies, therefore, should be focused on these activities.

Recommendations on Future Science and Engineering Studies for Ocean Color

NASA Technical Reports Server (NTRS)

Mannino, Antonio

2015-01-01

The Ocean Health Index measured Ecological Integrity as the relative condition of assessed species in a given location. This was calculated as the weighted sum of the International Union for Conservation of Natures (IUCN) assessments of species. Weights used were based on the level of extinction risk following Butchart et al.2007: EX (extinct) 0.0, CR (critically endangered) 0.2, EN (endangered) 0.5, VU (vulnerable) 0.7, NT (not threatened) 0.9, and LC (least concern) 0.99. For primarily coastal goals, the spatial average of these per pixel scores was based on a 3nmi buffer; for goals derived from all ocean waters, the spatial average was computed for the entire EEZ.

JPRS Report, Soviet Union KOMMUNIST No 1, January 1988.

DTIC Science & Technology

1988-03-24

the live creativity of the masses is the fundamental factor of the new social system which is being developed currently. The entire people, as...average annual volume of meat produc- tion (in slaughtered weight) increased by 13 percent and that of milk by 9 percent compared with the 11th 5 -year...standards for the 5 -year period is their strength and, in the final account, indi- cates the viability of the new

Campaigning for America’s Elite Undergraduates

DTIC Science & Technology

2008-04-01

average American. It seems particularly reprehensible for us to free ride as completely as we do." Gregory Mankiw , Professor of Economics – Harvard...culture, social dynamics and short-sighted economics determine the composition of the incoming class of lieutenants. The post 9/11 Army is profoundly...Program with the passage of the National Defense Act of 1916 (Sons of Union). During both the World War I and II eras, across all socio- economic

Factors influencing the use of registered nurse overtime in hospitals, 1995-2000.

PubMed

Berney, Barbara; Needleman, Jack; Kovner, Christine

2005-01-01

To assess nurse overtime in acute care general hospitals and the factors that influence overtime among various hospitals and in the same hospitals from year to year. Staffing data from 1995 to 2000 from 193 acute general hospitals in New York State were used to examine hospital characteristics (size, location, RN unionization, hospital ownership, and teaching status) to determine whether they were associated with nurse overtime. The average weekly overtime RNs worked was 4.5% of total hours, varying from almost none to 16.6%. At mean overtime levels, nurses were working less overtime than the mean for manufacturing workers, but, at the extreme, nurses were working more than 6 hours overtime per week. Significant differences were observed in the use of overtime by hospital ownership and by union status. Nurses in government hospitals worked less overtime than did those in nongovernment hospitals. Nurses in unionized hospitals worked slightly more overtime than did nurses in nonunionized hospitals. Hospitals varied dramatically in their overtime use. That some categories of hospitals (e.g., government-owned) used little overtime indicates that hospital management can find substitutes for overtime to meet fluctuating staffing needs. The finding that hospitals with similar characteristics varied greatly in their number of overtime hours also supported this conclusion.

JPRS Report, Soviet Union Economic Affairs.

DTIC Science & Technology

1988-12-12

that the person ordering music not only pays money, but also provides musicians with musical instruments. State orders are now backed by drums and...have become more frequent. Last year, the USSR Ministry of Light Industry organized the first Ail-Union Fashion Festival in Moscow, featuring a large...opportunities for tourism , including foreign tourism . And the influx of those who want to visit the republic is increasing sharply all the time. While foreign

The Russian-European Union Competition in Ukraine

DTIC Science & Technology

2015-06-01

of Germany’s brief triumph during the Great War. The 1918 treaty of Brest -Litovsk created for the first time an independent Ukraine, designed to be a...6North Atlantic Treaty Organization, “Founding Act on Mutual Relations, Cooperation and Security between NATO and the Russian Federation signed in Paris ...institution now known as the European Union originated as the European Coal and Steel Community in 1951. Interest in expanding economic cooperation

[Effects of critical ultrasonic management of Peking Union Medical College Hospital on the etiological diagnosis of patients with acute respiratory failure].

PubMed

Zhao, Hua; Wang, Xiaoting; Liu, Dawei; Zhang, Hongmin; He, Huaiwu; Long, Yun

2015-12-15

To evaluate the diagnostic value and potential therapeutic impact of Peking Union Medical College Hospital critical ultrasonic management (PCUM) in the early management of critically ill patients with acute respiratory failure (ARF). Patients admitted into the ICU of Peking Union Medical College Hospital for ARF were consecutively recruited over a 18-month period. Patients were randomly divided into conventional group and PCUM group (critical care ultrasonic examination was added in addition to conventional examinations). The two groups were compared with respect to time to preliminary diagnosis, time to final diagnosis, diagnostic accuracy, time to treatment response, time to other examination. A total of 187 patients were included in this study. The two groups showed no significant differences in general clinical information or final diagnosis (P > 0.05). The PCUM group had a shorter time to preliminary diagnosis, time to final diagnosis, time to treatment response, time to X-ray/CT examination, and a higher diagnostic accuracy than the conventional group (P < 0.001). PCUM had high sensitivity and specificity for the diagnosis of acute respiratory distress syndrome (ARDS) (sensitivity 92.0%, specificity 98.5%), acute pulmonary edema (sensitivity 94.7%, specificity 96.1%), pulmonary consolidation (sensitivity 85.7%, specificity 98.6%), COPD/asthma (sensitivity 84.2%, specificity 98.7%). The PCUM is seem to be an attractive complementary diagnostic tool and able to contribute to an early therapeutic decision for the patients with ARF.

Is intramedullary nailing applicable for distal tibial fractures with ankle joint extension?

PubMed

Beytemür, Ozan; Albay, Cem; Adanır, Oktay; Yüksel, Serdar; Güleç, Mehmet Akif

2016-12-01

This study aims to evaluate the functional and radiographic results and treatment complications of AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association) type 43C1 and C2 fractures treated with intramedullary nailing. We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%). Intramedullary nailing was applied in eight patients (23%) without external screws. Fracture union, union time, alignment problems, and complications were evaluated. Clinical evaluation of patients was conducted using the Olerud and Molander score and by measuring the ankle joint range of motion. Union was achieved in all 35 patients. Mean union time was 16.5±2.8 weeks (range 12 to 24 weeks) and mean Olerud and Molander score was 88±8.24. Varus deformity was detected in one patient, valgus deformity was detected in two patients, and rotation deformity was detected in one patient. Superficial infection was detected in three patients (9%). Deep infection was not detected in any patient. Intramedullary nailing is not contraindicated for simple intra-articular distal tibial fractures. In these fractures, intramedullary nailing performed in accordance with its technique, with an additional percutaneous screw if necessary, is a successful treatment option with high fracture union rates, high functional results, and low complication rates.

Metastable Features of Economic Networks and Responses to Exogenous Shocks

PubMed Central

Hosseiny, Ali; Bahrami, Mohammad; Palestrini, Antonio; Gallegati, Mauro

2016-01-01

It is well known that a network structure plays an important role in addressing a collective behavior. In this paper we study a network of firms and corporations for addressing metastable features in an Ising based model. In our model we observe that if in a recession the government imposes a demand shock to stimulate the network, metastable features shape its response. Actually we find that there exists a minimum bound where any demand shock with a size below it is unable to trigger the market out of recession. We then investigate the impact of network characteristics on this minimum bound. We surprisingly observe that in a Watts-Strogatz network, although the minimum bound depends on the average of the degrees, when translated into the language of economics, such a bound is independent of the average degrees. This bound is about 0.44ΔGDP, where ΔGDP is the gap of GDP between recession and expansion. We examine our suggestions for the cases of the United States and the European Union in the recent recession, and compare them with the imposed stimulations. While the stimulation in the US has been above our threshold, in the EU it has been far below our threshold. Beside providing a minimum bound for a successful stimulation, our study on the metastable features suggests that in the time of crisis there is a “golden time passage” in which the minimum bound for successful stimulation can be much lower. Hence, our study strongly suggests stimulations to arise within this time passage. PMID:27706166

Flow characteristics and salinity patterns of tidal rivers within the northern Ten Thousand Islands, southwest Florida, water years 2007–14

USGS Publications Warehouse

Booth, Amanda C.; Soderqvist, Lars E.

2016-12-12

Freshwater flow to the Ten Thousand Islands estuary has been altered by the construction of the Tamiami Trail and the Southern Golden Gate Estates. The Picayune Strand Restoration Project, which is associated with the Comprehensive Everglades Restoration Plan, has been implemented to improve freshwater delivery to the Ten Thousand Islands estuary by removing hundreds of miles of roads, emplacing hundreds of canal plugs, removing exotic vegetation, and constructing three pump stations. Quantifying the tributary flows and salinity patterns prior to, during, and after the restoration is essential to assessing the effectiveness of upstream restoration efforts.Tributary flow and salinity patterns during preliminary restoration efforts and prior to the installation of pump stations were analyzed to provide baseline data and preliminary analysis of changes due to restoration efforts. The study assessed streamflow and salinity data for water years1 2007–2014 for the Faka Union River (canal flow included), East River, Little Wood River, Pumpkin River, and Blackwater River. Salinity data from the Palm River and Faka Union Boundary water-quality stations were also assessed.Faka Union River was the dominant contributor of freshwater during water years 2007–14 to the Ten Thousand Islands estuary, followed by Little Wood and East Rivers. Pumpkin River and Blackwater River were the least substantial contributors of freshwater flow. The lowest annual flow volumes, the highest annual mean salinities, and the highest percentage of salinity values greater than 35 parts per thousand (ppt) occurred in water year 2011 at all sites with available data, corresponding with the lowest annual rainfall during the study. The highest annual flow volumes and the lowest percentage of salinities greater than 35 ppt occurred in water year 2013 for all sites with available data, corresponding with the highest rainfall during the study.In water year 2014, the percentage of monitored annual flow contributed by East River increased and the percentage of flow contributed by Faka Union River decreased, compared to the earlier years. No changes in annual flow occurred at any sites west of Faka Union River. No changes in the relative flow contributions were observed during the wet season; however, the relative amounts of streamflow increased during the dry season at East River in 2014. East River had only 1 month of negative flow in 2014 compared to 6 months in 2011 and 7 months in 2008. Higher dry season flows in East River may be in response to restoration efforts. The sites to the west of Faka Union River had higher salinities on average than Faka Union River and East River. Faka Union River had the highest range in salinities, and Faka Union Boundary had the lowest range in salinities. Pumpkin River was the tributary with the lowest range in salinities.1Water year is defined as the 12-month period from October 1, for any given year, through September 30 of the following year.

Applicability of the theory of customs unions to the case of the cooperation council for the Arab States of the Gulf (The GCC)

DOE Office of Scientific and Technical Information (OSTI.GOV)

As-Sudais, A.A.S.

1985-01-01

In 1981, six Arab Gulf states formed the Gulf Cooperation Council (GCC). These states are Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE). One of the main stated objectives of the GCC is regional economic integration. This objective was expressed in the GCC Unified Economic Agreement which called for gradual creation of the GCC common market and cooperation and coordination in all economic fields at all levels. The GCC has chosen to approach economic integration in a gradual manner. The first step taken was the formation of a customs union. This study investigates the applicability ofmore » the theory of customs unions to this particular group at this time. The economies of the GCC members exhibit similar characteristics such as reliance on the export of a single nonrenewable commodity (oil), similar large-scale industrial projects (mainly petrochemicals), lack of complementarity of economic resource endowment, and little diversity in industrial production. The main conclusion of the study is that the possible gains suggested by the theory of customs unions are not expected to be realized to a significant extent as a result of forming the GCC customs union. Trade effects (if any) will be negligible due to various factors including low-pre-union tariff levels.« less

Comparison of Early and Delayed Open Reduction and Internal Fixation for Treating Closed Tibial Pilon Fractures.

PubMed

Tang, Xin; Liu, Lei; Tu, Chong-qi; Li, Jian; Li, Qi; Pei, Fu-xing

2014-07-01

The timing of surgery for osteosynthesis of type C pilon (AO/OTA) fractures remains controversial. The aim of this study was to determine the outcome of early and delayed open reduction and internal fixation (ORIF) for treating closed type C pilon fractures. Forty-six patients with closed type C pilon fractures matched according to age, gender, soft tissue conditions, and fracture pattern were divided into group A (early group: underwent surgery within 36 hours of the injury) or group B (delayed group: underwent surgery 10 days to 3 weeks postinjury after the soft tissue swelling subsided). In the delayed group, 9 patients were treated first by temporary external fixation. All the closed fractures were managed by ORIF with locking plates. At follow-up, the clinical and radiographic results were retrospectively analyzed. The mean follow-up time was 25.8 months (range, 14 to 48 months) in group A and 26.0 months (range, 15 to 44 months) in group B. There was no significant difference (P > .05) between the 2 groups regarding the rate of soft tissue complication, the rate of fracture union, and the final functional score. The patients in group A had a significantly shorter mean time to fracture union (21.5 ± 4.0 weeks vs 23.3 ± 3.7 weeks, P < .05), operating time (84.3 ± 12.1 months vs 100.6 ± 13.7 months, P < .01), and hospital stay (7.6 ± 2.6 days vs 15.2 ± 4.2 days, P < .01). If soft tissue conditions are acceptable, early ORIF for treating closed type C pilon fractures can be safe and effective, with similar rates of wound complication, fracture union, and final good functional recovery but shorter operative time, union time, and hospital stay. These results favorably compare with delayed ORIF treatment. Level III, retrospective comparative study. © The Author(s) 2014.

Are occupational exposure limits becoming more alike within the European Union?

PubMed

Schenk, Linda; Hansson, Sven Ove; Rudén, Christina; Gilek, Michael

2008-10-01

The occupational exposure limits (OELs) established by seven different national regulatory agencies of EU member states are compared with those of the European Commission (EC). The comparison concerned: (1) what chemicals have been selected, (2) the average level of exposure limits for all chemicals, and (3) the similarity between the OELs of different EU member states and the OELs recommended by the European Commission. The average level of the exposure limits has declined during the past 10 years in four of the five countries in our study for which historical data were available to us. Poland has not changed its level noticeably and Germany has increased it. Since the first list of indicative OELs was established by the EC, a few of the EU exposure limits have been lowered. The similarity index indicates that the exposure limits of EU member states are converging towards the European Commission's recommended OELs. Still, the average level of OELs differs between organizations--the Estonian OELs are on average 35% higher than the Polish OELs.

Time spent studying on a pre-registration nursing programme module: an exploratory study and implications for regulation.

PubMed

Snelling, Paul C; Lipscomb, Martin; Lockyer, Lesley; Yates, Sue; Young, Pat

2010-11-01

European Union (EU) regulations require that university programmes are of specified duration. Additional EU regulations apply specifically to university based nurse education, enacted in the UK by the Nursing and Midwifery Council (NMC). However, little is known about how much time student nurses spend on their studies. In this exploratory study, students undertaking a single module in the pre-registration diploma programme at an English university were asked to keep a log of learning activity for the duration of the module. Twenty-six students completed the log. These students achieved higher grades and attended more lectures than the average for the module. The mean study time was 128.4 h against a regulatory assumption that the module should take 200 h. More than half of the 26 students undertook paid work during the module run, though this work was not associated with poorer performance. Problems in regulation for course duration are discussed and it is suggested that undertaking a 4600 h course in 3 years is problematic. More research is required so that patterns of study can be better understood and student centred programmes meeting regulatory requirements developed. Copyright © 2010 Elsevier Ltd. All rights reserved.

Effect of fragmentary displacement and morphology in the treatment of comminuted femoral shaft fractures with an intramedullary nail.

PubMed

Lin, Shih-Jie; Chen, Chi-Lung; Peng, Kuo-Ti; Hsu, Wei-Hsiu

2014-04-01

Our study aimed to determine whether the displacement and morphology of a fragment in femur fracture with Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association/32-B/32-C (AO/OTA/32-B/32-C) classification affect the outcomes following closed reduction and internal fixation with an interlocking nail. This was a retrospective study. The study was conducted at a Level III trauma centre. A total of 50 consecutive patients presenting femoral shaft fracture with AO/OTA-type 32-B/32-C were included in the present study. Patients were divided into two groups according to the displacement of the fragments. In the large displacement group, patients were further subgrouped according to whether a reversed morphology of the fragment was present. The radiographic union score of femur (RUSF), the mean union time and the re-operation rate were assessed. The union rate of small- and large-gap groups at 12 months postoperatively was 75.9% and 21.1%, respectively (p=0.000). The mean union time of those union cases in these two groups was 7.8 and 13.0 months, respectively (p=0.000). The union rate of the non-reversed and reversed groups at 12 months postoperatively was 30% and 11.1%, respectively (p=0.179). The mean RUSF at 12 months in the non-reversed and reversed groups was 8.8 and 8.3, respectively (p=0.590). However, we found that patients presenting a reversed fragment had an increased risk of more than one re-operation (p=0.030). A fragmentary displacement of >1cm in AO/OTA-type 32-B/32-C femoral shaft fracture after nailing affected bone healing. Among the large-gap group patients, an unreduced reverse fragment presented a negative prognostic factor for re-operation. Prognostic level III. Copyright © 2013 Elsevier Ltd. All rights reserved.

Trends in Cohabitation Outcomes: Compositional Changes and Engagement Among Never-Married Young Adults

PubMed Central

Guzzo, Karen Benjamin

2015-01-01

Cohabitation is now the modal first union for young adults, and most marriages are preceded by cohabitation even as fewer cohabitations transition to marriage. These contrasting trends may be due to compositional shifts among cohabiting unions, which are increasingly heterogeneous in terms of cohabitation order, engagement, and the presence of children, as well as across socioeconomic and demographic characteristics. The author constructs 5-year cohabitation cohorts for 18- to 34-year-olds from the 2002 and 2006–2010 cycles of the National Survey of Family Growth (n = 17,890 premarital cohabitations) to examine the outcomes of cohabitations over time. Compared to earlier cohabitations, those formed after 1995 were more likely to dissolve, and those formed after 2000 were less likely to transition to marriage even after accounting for the compositional shifts among individuals in cohabiting unions. Higher instability and decreased chances of marriage occurred among both engaged and non-engaged individuals, suggesting society-wide changes in cohabitation over time. PMID:26778851

Determination of Internal Target Volume for Radiation Treatment Planning of Esophageal Cancer by Using 4-Dimensional Computed Tomography (4DCT)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, Xiaojian; Lu, Haijun; Radiation Oncology Center, Affiliated Hospital of Medical College, Qingdao University, Qingdao

2014-09-01

Purpose: To determine an efficient strategy for the generation of the internal target volume (ITV) for radiation treatment planning for esophageal cancer using 4-dimensional computed tomography (4DCT). Methods and Materials: 4DCT sets acquired for 20 patients with esophageal carcinoma were analyzed. Each of the 4DCT sets was binned into 10 respiratory phases. For each patient, the gross tumor volume (GTV) was delineated on the 4DCT set at each phase. Various strategies to derive ITV were explored, including the volume from the maximum intensity projection (MIP; ITV{sub M}IP), unions of the GTVs from selected multiple phases ITV2 (0% and 50% phases), ITV3 (ITV2more » plus 80%), and ITV4 (ITV3 plus 60%), as well as the volumes expanded from ITV2 and ITV3 with a uniform margin. These ITVs were compared to ITV10 (the union of the GTVs for all 10 phases) and the differences were measured with the overlap ratio (OR) and relative volume ratio (RVR) relative to ITV10 (ITVx/ITV10). Results: For all patients studied, the average GTV from a single phase was 84.9% of ITV10. The average ORs were 91.2%, 91.3%, 94.5%, and 96.4% for ITV{sub M}IP, ITV2, ITV3, and ITV4, respectively. Low ORs were associated with irregular breathing patterns. ITV3s plus 1 mm uniform margins (ITV3+1) led to an average OR of 98.1% and an average RVR of 106.4%. Conclusions: The ITV generated directly from MIP underestimates the range of the respiration motion for esophageal cancer. The ITV generated from 3 phases (ITV3) may be used for regular breathers, whereas the ITV generated from 4 phases (ITV4) or ITV3 plus a 1-mm uniform margin may be applied for irregular breathers.« less

Determination of internal target volume for radiation treatment planning of esophageal cancer by using 4-dimensional computed tomography (4DCT).

PubMed

Chen, Xiaojian; Lu, Haijun; Tai, An; Johnstone, Candice; Gore, Elizabeth; Li, X Allen

2014-09-01

To determine an efficient strategy for the generation of the internal target volume (ITV) for radiation treatment planning for esophageal cancer using 4-dimensional computed tomography (4DCT). 4DCT sets acquired for 20 patients with esophageal carcinoma were analyzed. Each of the 4DCT sets was binned into 10 respiratory phases. For each patient, the gross tumor volume (GTV) was delineated on the 4DCT set at each phase. Various strategies to derive ITV were explored, including the volume from the maximum intensity projection (MIP; ITV_MIP), unions of the GTVs from selected multiple phases ITV2 (0% and 50% phases), ITV3 (ITV2 plus 80%), and ITV4 (ITV3 plus 60%), as well as the volumes expanded from ITV2 and ITV3 with a uniform margin. These ITVs were compared to ITV10 (the union of the GTVs for all 10 phases) and the differences were measured with the overlap ratio (OR) and relative volume ratio (RVR) relative to ITV10 (ITVx/ITV10). For all patients studied, the average GTV from a single phase was 84.9% of ITV10. The average ORs were 91.2%, 91.3%, 94.5%, and 96.4% for ITV_MIP, ITV2, ITV3, and ITV4, respectively. Low ORs were associated with irregular breathing patterns. ITV3s plus 1 mm uniform margins (ITV3+1) led to an average OR of 98.1% and an average RVR of 106.4%. The ITV generated directly from MIP underestimates the range of the respiration motion for esophageal cancer. The ITV generated from 3 phases (ITV3) may be used for regular breathers, whereas the ITV generated from 4 phases (ITV4) or ITV3 plus a 1-mm uniform margin may be applied for irregular breathers. Copyright © 2014 Elsevier Inc. All rights reserved.

Translations on Eastern Europe Political, Sociological, and Military Affairs No. 1423.

DTIC Science & Technology

1977-07-26

expected to analyze positive , we repeat positive , exper- iences acquired in the course of the implementation of the principles adopted and agreements...all countries, found a positive response in Europe and elsewhere. However, the communique emphasized at the same time that the facts testify- ing...political affairs and in work and study. The fundamental source of the positive development of the Union of Socialist Youth and of the Union’s Pioneer

Types of propagation of radio waves of the decameter range, according to observations by the OBS method on Cuba--Soviet Union paths

DOE Office of Scientific and Technical Information (OSTI.GOV)

Berdeyans, D.; Bocharov, V.I.; Lobachevskii, L.A.

Ionosphere observations by the OBS method were performed to study ionospheric conditions under which radio waves in the decameter range propagate on Cuba--Soviet Union paths. The results of observations in the summer of 1973 are reported. The distance--frequency and distance--time characteristics of back-scattered signals in the sounding direction for each day of observation are discussed. (JFP)

Arms Control and Nonproliferation: A Catalog of Treaties and Agreements

DTIC Science & Technology

2007-01-29

U.S. security concerns. The United States and Soviet Union began to sign agreements limiting their strategic offensive nuclear weapons in the early...Russian relationship. At the same time, however, the two sides began to cooperate on securing and eliminating Soviet-era nuclear , chemical, and...the former Soviet Union. The United States is also a leader of an international regime that attempts to limit the spread of nuclear weapons. This

Arms Control and Nonproliferation: A Catalog of Treaties and Agreements

DTIC Science & Technology

2007-06-01

security concerns. The United States and Soviet Union began to sign agreements limiting their strategic offensive nuclear weapons in the early 1970s...Russian relationship. At the same time, however, the two sides began to cooperate on securing and eliminating Soviet-era nuclear , chemical, and biological...former Soviet Union. The United States is also a leader of an international regime that attempts to limit the spread of nuclear weapons. This regime

Seismic Discrimination

DTIC Science & Technology

1982-09-30

Frequency-wave-number analyses of data from Nevada Test Site (NTS) shots recorded at LASA were computed in the frequency range from 0.01 to 0.05 Hz (Ref...from events in the Soviet Union at a known test site . In order to put further factual basis behind the SP spectral discriminants we used, comparisons...explosion. A catalogue of presumed explosion# in the Soviet Union away from the regular test sites was assembled. A time-domain analysis of seismograms

New Directions in European Vocational Education and Training Policy and Practice: Lessons for Australia. A National Vocational Education and Training Research and Evaluation Program Report

ERIC Educational Resources Information Center

Harris, Roger; Simons, Michele; Maher, Katie

2009-01-01

In light of recent developments in educational policy and the positioning of vocational education and training (VET) across the European Union, it was timely to explore these new directions and the lessons for Australian VET. A striking feature both in the European Union and Australia is the wide scope of issues that governments are addressing and…

Assessing worst case scenarios in movement demands derived from global positioning systems during international rugby union matches: Rolling averages versus fixed length epochs

PubMed Central

Cunningham, Daniel J.; Shearer, David A.; Carter, Neil; Drawer, Scott; Pollard, Ben; Bennett, Mark; Eager, Robin; Cook, Christian J.; Farrell, John; Russell, Mark

2018-01-01

The assessment of competitive movement demands in team sports has traditionally relied upon global positioning system (GPS) analyses presented as fixed-time epochs (e.g., 5–40 min). More recently, presenting game data as a rolling average has become prevalent due to concerns over a loss of sampling resolution associated with the windowing of data over fixed periods. Accordingly, this study compared rolling average (ROLL) and fixed-time (FIXED) epochs for quantifying the peak movement demands of international rugby union match-play as a function of playing position. Elite players from three different squads (n = 119) were monitored using 10 Hz GPS during 36 matches played in the 2014–2017 seasons. Players categorised broadly as forwards and backs, and then by positional sub-group (FR: front row, SR: second row, BR: back row, HB: half back, MF: midfield, B3: back three) were monitored during match-play for peak values of high-speed running (>5 m·s-1; HSR) and relative distance covered (m·min-1) over 60–300 s using two types of sample-epoch (ROLL, FIXED). Irrespective of the method used, as the epoch length increased, values for the intensity of running actions decreased (e.g., For the backs using the ROLL method, distance covered decreased from 177.4 ± 20.6 m·min-1 in the 60 s epoch to 107.5 ± 13.3 m·min-1 for the 300 s epoch). For the team as a whole, and irrespective of position, estimates of fixed effects indicated significant between-method differences across all time-points for both relative distance covered and HSR. Movement demands were underestimated consistently by FIXED versus ROLL with differences being most pronounced using 60 s epochs (95% CI HSR: -6.05 to -4.70 m·min-1, 95% CI distance: -18.45 to -16.43 m·min-1). For all HSR time epochs except one, all backs groups increased more (p < 0.01) from FIXED to ROLL than the forward groups. Linear mixed modelling of ROLL data highlighted that for HSR (except 60 s epoch), SR was the only group not significantly different to FR. For relative distance covered all other position groups were greater than the FR (p < 0.05). The FIXED method underestimated both relative distance (~11%) and HSR values (up to ~20%) compared to the ROLL method. These differences were exaggerated for the HSR variable in the backs position who covered the greatest HSR distance; highlighting important consideration for those implementing the FIXED method of analysis. The data provides coaches with a worst-case scenario reference on the running demands required for periods of 60–300 s in length. This information offers novel insight into game demands and can be used to inform the design of training games to increase specificity of preparation for the most demanding phases of matches. PMID:29621279

Labor-Management Cooperation in Illinois: How a Joint Union Company Team Is Improving Facility Safety.

PubMed

Mahan, Bruce; Maclin, Reggie; Ruttenberg, Ruth; Mundy, Keith; Frazee, Tom; Schwartzkopf, Randy; Morawetz, John

2018-01-01

This study of Afton Chemical Corporation's Sauget facility and its International Chemical Workers Union Council (ICWUC) Local 871C demonstrates how significant safety improvements can be made when committed leadership from both management and union work together, build trust, train the entire work force in U.S. Occupational Safety and Health Administration 10-hour classes, and communicate with their work force, both salaried and hourly. A key finding is that listening to the workers closest to production can lead to solutions, many of them more cost-efficient than top-down decision-making. Another is that making safety and health an authentic value is hard work, requiring time, money, and commitment. Third, union and management must both have leadership willing to take chances and learn to trust one another. Fourth, training must be for everyone and ongoing. Finally, health and safety improvements require dedicated funding. The result was resolution of more than one hundred safety concerns and an ongoing institutionalized process for continuing improvement.

Comparison of 3 Minimally Invasive Methods for Distal Tibia Fractures.

PubMed

Fang, Jun-Hao; Wu, Yao-Sen; Guo, Xiao-Shan; Sun, Liao-Jun

2016-07-01

This study compared the results of external fixation combined with limited open reduction and internal fixation (EF + LORIF), minimally invasive percutaneous plate osteosynthesis (MIPPO), and intramedullary nailing (IMN) for distal tibia fractures. A total of 84 patients with distal tibia shaft fractures were randomized to operative stabilization using EF + LORIF (28 cases), MIPPO (28 cases), or IMN (28 cases). The 3 groups were comparable with respect to patient demographics. Data were collected on operative time and radiation time, union time, complications, time of recovery to work, secondary operations, and measured joint function using the American Orthopaedic Foot and Ankle Society (AOFAS) score. There was no significant difference in time to union, incidence of union status, time of recovery to work, and AOFAS scores among the 3 groups (P>.05). Mean operative time and radiation time in the MIPPO group were longer than those in the IMN or EF + LORIF groups (P<.05). Wound complications after MIPPO were more common compared with IMN or EF + LORIF (P<.05). Anterior knee pain occurred frequently after IMN (32.1%), and irritation symptoms were encountered more frequently after MIPPO (46.4%). Although EF + LORIF was associated with fewer secondary procedures vs MIPPO or IMN, it was related with more pin-tract infections (14.3%). Findings indicated that EF + LORIF, MIPPO, and IMN all achieved similar good functional results. However, EF + LORIF had some advantages over MIPPO and IMN in reducing operative and radiation times, postoperative complications, and reoperation rate. [Orthopedics. 2016; 39(4):e627-e633.]. Copyright 2016, SLACK Incorporated.

[Limited access to the international medical literature in Russia].

PubMed

Jargin, Sergei V

2012-06-01

Limited access to foreign professional literature in the former Soviet Union had consequences for public health: persistence of some outdated methods and approaches. Several examples are discussed in this letter. The shortage of foreign literature has been partly compensated by domestic editions, sometimes containing compilations from foreign sources, borrowings without references, and mistranslations. International literature is on average scarcely quoted in Russian language scientific publications. Today, however, there are grounds for optimism: the economic upturn must bring improvements.

Tackle-related injury rates and nature of injuries in South African Youth Week tournament rugby union players (under-13 to under-18): an observational cohort study.

PubMed

Burger, Nicholas; Lambert, Mike I; Viljoen, Wayne; Brown, James C; Readhead, Clint; Hendricks, Sharief

2014-08-12

The tackle situation is most often associated with the high injury rates in rugby union. Tackle injury epidemiology in rugby union has previously been focused on senior cohorts but less is known about younger cohorts. The aim of this study was to report on the nature and rates of tackle-related injuries in South African youth rugby union players representing their provinces at national tournaments. Observational cohort study. Four South African Youth Week tournaments (under-13 Craven Week, under-16 Grant Khomo Week, under-18 Academy Week, under-18 Craven Week). Injury data were collected from 3652 youth rugby union players (population at risk) in 2011 and 2012. Tackle-related injury severity ('time-loss' and 'medical attention'), type and location, injury rate per 1000 h (including 95% CIs). Injury rate ratios (IRR) were calculated and modelled using a Poisson regression. A χ(2) analysis was used to detect linear trends between injuries and increasing match quarters. The 2012 under-13 Craven Week had a significantly greater 'time-loss' injury rate when compared with the 2012 under-18 Academy Week (IRR=4.43; 95% CI 2.13 to 9.21, p<0.05) and under-18 Craven Week (IRR=3.52; 95% CI 1.54 to 8.00, p<0.05). The Poisson regression also revealed a higher probability of 'overall' ('time-loss' and 'medical attention' combined) and 'time-loss' tackle-related injuries occurring at the under-13 Craven Week. The proportion of 'overall' and 'time-loss' injuries increased significantly with each quarter of the match when all four tournaments were combined (p<0.05). There was a difference in the tackle-related injury rate between the under-13 tournament and the two under-18 tournaments, and the tackle-related injury rate was higher in the final quarter of matches. Ongoing injury surveillance is required to better interpret these findings. Injury prevention strategies targeting the tackle may only be effective once the rate and nature of injuries have been accurately determined. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Tackle-related injury rates and nature of injuries in South African Youth Week tournament rugby union players (under-13 to under-18): an observational cohort study

PubMed Central

Burger, Nicholas; Lambert, Mike I; Viljoen, Wayne; Brown, James C; Readhead, Clint; Hendricks, Sharief

2014-01-01

Objectives The tackle situation is most often associated with the high injury rates in rugby union. Tackle injury epidemiology in rugby union has previously been focused on senior cohorts but less is known about younger cohorts. The aim of this study was to report on the nature and rates of tackle-related injuries in South African youth rugby union players representing their provinces at national tournaments. Design Observational cohort study. Setting Four South African Youth Week tournaments (under-13 Craven Week, under-16 Grant Khomo Week, under-18 Academy Week, under-18 Craven Week). Participants Injury data were collected from 3652 youth rugby union players (population at risk) in 2011 and 2012. Outcome measures Tackle-related injury severity (‘time-loss’ and ‘medical attention’), type and location, injury rate per 1000 h (including 95% CIs). Injury rate ratios (IRR) were calculated and modelled using a Poisson regression. A χ2 analysis was used to detect linear trends between injuries and increasing match quarters. Results The 2012 under-13 Craven Week had a significantly greater ‘time-loss’ injury rate when compared with the 2012 under-18 Academy Week (IRR=4.43; 95% CI 2.13 to 9.21, p<0.05) and under-18 Craven Week (IRR=3.52; 95% CI 1.54 to 8.00, p<0.05). The Poisson regression also revealed a higher probability of ‘overall’ (‘time-loss’ and ‘medical attention’ combined) and ‘time-loss’ tackle-related injuries occurring at the under-13 Craven Week. The proportion of ‘overall’ and ‘time-loss’ injuries increased significantly with each quarter of the match when all four tournaments were combined (p<0.05). Conclusions There was a difference in the tackle-related injury rate between the under-13 tournament and the two under-18 tournaments, and the tackle-related injury rate was higher in the final quarter of matches. Ongoing injury surveillance is required to better interpret these findings. Injury prevention strategies targeting the tackle may only be effective once the rate and nature of injuries have been accurately determined. PMID:25116454

The epidemiology of foot injuries in professional rugby union players.

PubMed

Pearce, Christopher J; Brooks, John H M; Kemp, Simon P T; Calder, James D F

2011-09-01

Foot injuries represent a small but important proportion of injuries to professional rugby union players. There are no detailed epidemiological studies regarding these injuries. The aim of this study was to describe the epidemiology of foot injuries sustained by a cohort of professional rugby union players and identify areas that may be targeted for injury prevention in the future. Medical personnel prospectively recorded injuries in professional Premiership rugby union players in England over four seasons. Injuries to the foot were identified and the time away from training and playing was reported. A total of 147 foot injuries were sustained resulting in 3542 days of absence in total. Acute events accounted for 73% of all foot injuries, with chronic, mostly overuse conditions, accounting for 25% (undiagnosed 2%). Chronic conditions led to proportionately more time away from training and playing (p=<0.001). Specifically, stress fractures in the foot accounted for 8% of the total foot injuries but 22% of the absence. Navicular stress fractures had the longest recovery time with the mean return to training and match play of 188 days. In collision sports such as rugby, some injuries may be inevitable but clinicians should always be seeking ways to minimise their occurrence and impact. This study revealed a high proportion of morbidity associated with chronic and overuse foot injuries in these professional athletes. With greater attention paid to risk factors, some of these injuries, and importantly, recurrent injuries may be avoided. Copyright © 2010 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Comparative study between biologic plating and intramedullary nailing for the treatment of subtrochanteric fractures: Is biologic plating using LCP-DF superior to intramedullary nailing?

PubMed

Shin, Won Chul; Moon, Nam Hoon; Jang, Jae Hoon; Lee, Hee Jin; Suh, Kuen Tak

2017-10-01

The objective of this study is to evaluate the outcome measures of subtrochanteric fractures between biologic plating and intramedullary nailing and determine if biologic plating is superior to intramedullary nailing. Between March 2009 and December 2015, 81 patients with subtrochanteric fractures were enrolled (52 males and 29 females; 31 treated with biologic plating and 50 with intramedullary nailing). Biologic plating was conducted consecutively between May 2011 and March 2013 and intramedullary nailing was performed for the rest of period. Perioperative outcomes including operation time and blood loss during the operation; postoperative radiologic outcomes including union, time to union, coronal alignment, and shortening of the femur; and clinical outcomes including walking ability and pain were evaluated. The biologic plating group was compared with the intramedullary nailing group as a historical control. No significant differences were identified for bony union and time to union between the two different fixation methods Coronal alignment was significantly better in the biologic plating group than in the intramedullary nailing group (p<0.016). Postoperative coronal alignment was the only risk factor associated with the nonunion of subtrochanteric fractures (unadjusted OR: 1.915, 95% CI: 0.190 - 19.273; adjusted OR: 0.042, 95% CI: 0.000 - 21.517; p=0.320). Surgical outcomes using LCP-DF are comparable to those using intramedullary nailing. Further clinical studies with a larger sample size are required to show the advantage of biologic plating for the treatment of subtrochanteric fractures. Copyright © 2017 Elsevier Ltd. All rights reserved.

Reduced severity of lumbo-pelvic-hip injuries in professional Rugby Union players following tailored preventative programmes.

PubMed

Evans, Kate L; Hughes, Jonathan; Williams, Morgan D

2018-03-01

The aim of this study was to tailor lumbo-pelvic-hip (LPH) injury reduction programmes in professional rugby union players based on screening data and examine its effectiveness. Prospective case controlled study. Twenty-eight professional rugby union players were screened pre- and immediately post- the YO-YO intermittent recovery level 1 test using six hip and groin strength tests (adductor squeeze at 0°, 60° and 90°, prone hip extension, abductor, adductor hand held dynamometry). The changes in hip and groin measures, were analysed using hierarchical cluster analysis. Three clusters emerged and a tailored LPH injury reduction programme was administered for each cluster. In addition, 22 players who were not involved in the initial testing received a generic LPH injury reduction programme and were used as the control. Seasonal information for LPH injury incidence, severity and prevalence were compared to the previous season. The same number of injuries were observed when the prospective injury surveillance data was compared to the previous season, however a reduced injury severity (936days vs 468days), average severity (78±126days vs 42±37days) and prevalence (21% vs 19%) were found. Moreover, LPH injury severity for players who were prescribed a tailored injury reduction programme (209days) were 50days less than players given a generic LPH injury reduction programme (259days). Our preliminary observations support the effectiveness of grouping players and tailoring intervention based on common group characteristics in reducing the severity of LPH injuries in professional Rugby Union. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Comparing antibiotic consumption between two European countries: are packages an adequate surrogate for prescriptions?

PubMed

Watier, Laurence; Cavalié, Philippe; Coignard, Bruno; Brun-Buisson, Christian

2017-11-01

Defined daily doses (DDD) are the gold standard indicator for quantifying prescriptions. Since 2014, the European Centre for Disease Prevention and Control (ECDC) has also been using the number of packages per 1,000 inhabitants per day (ipd), as a surrogate for prescriptions, to report antibiotic consumption in the community and to perform comparisons between European Union (EU) countries participating in the European Surveillance of Antimicrobial Consumption Network (ESAC-Net). In 2015, consumption was reported to range across Europe from 1.0 to 4.7 packages per 1,000 ipd. Our analysis showed that consumption of antibiotics for systemic use per 1,000 ipd was on average 1.3 times greater in France than in Belgium when considering prescriptions in the numerator, 2.5 times greater when considering packages and 1.2 times greater when considering DDD. As long as the same metrics are used over time, antibiotic consumption data aggregated and disseminated by ECDC are useful for assessing temporal trends at the European level and within individual countries; these data may also be used for benchmarking across EU countries. While DDD - although imperfect - are the most widely accepted metric for this purpose, antibiotic packages do not appear suitable for comparisons between countries and may be misleading.

Comparing antibiotic consumption between two European countries: are packages an adequate surrogate for prescriptions?

PubMed Central

Watier, Laurence; Cavalié, Philippe; Coignard, Bruno; Brun-Buisson, Christian

2017-01-01

Defined daily doses (DDD) are the gold standard indicator for quantifying prescriptions. Since 2014, the European Centre for Disease Prevention and Control (ECDC) has also been using the number of packages per 1,000 inhabitants per day (ipd), as a surrogate for prescriptions, to report antibiotic consumption in the community and to perform comparisons between European Union (EU) countries participating in the European Surveillance of Antimicrobial Consumption Network (ESAC-Net). In 2015, consumption was reported to range across Europe from 1.0 to 4.7 packages per 1,000 ipd. Our analysis showed that consumption of antibiotics for systemic use per 1,000 ipd was on average 1.3 times greater in France than in Belgium when considering prescriptions in the numerator, 2.5 times greater when considering packages and 1.2 times greater when considering DDD. As long as the same metrics are used over time, antibiotic consumption data aggregated and disseminated by ECDC are useful for assessing temporal trends at the European level and within individual countries; these data may also be used for benchmarking across EU countries. While DDD - although imperfect - are the most widely accepted metric for this purpose, antibiotic packages do not appear suitable for comparisons between countries and may be misleading. PMID:29162212

Delayed Expression of Circulating TGF-β1 and BMP-2 Levels in Human Nonunion Long Bone Fracture Healing.

PubMed

Hara, Yoshiaki; Ghazizadeh, Mohammad; Shimizu, Hajime; Matsumoto, Hisashi; Saito, Nobuyuki; Yagi, Takanori; Mashiko, Kazuki; Mashiko, Kunihiro; Kawai, Makoto; Yokota, Hiroyuki

2017-01-01

The healing process of bone fracture requires a well-controlled multistage and sequential order beginning immediately after the injury. However, complications leading to nonunion exist, creating serious problems and costs for patients. Transforming growth factor-beta 1 (TGF-β1) and bone morphogenic protein 2 (BMP-2) are two major growth factors involved in human bone fracture healing by promoting various stages of bone ossification. In this study, we aimed to determine the role of these factors during the fracture healing of human long bones and assess their impacts on nonunion condition. We performed a comprehensive analysis of plasma TGF-β1 and BMP-2 levels in blood samples from 10 patients with proved nonunion and 10 matched patients with normal union following a predetermined time schedule. The concentrations of TGF-β1 and BMP-2 were measured at each time point using a solid-phase ELISA. TGF-β1 and BMP-2 levels were detectable in all patients. For all patients, a maximal peak for TGF-β1 was found at 3-week. In normal union group, TGF-β1 showed a maximal peak at 2-week while nonunion group had a delayed maximal peak at 3-week. Plasma levels of BMP-2 for all patients and for normal union group reached a maximal peak at 1-week, but nonunion group showed a delayed maximal peak at 2-week. In general, plasma TGF-β1 or BMP-2 level was not significantly different between normal union and nonunion groups. The expression levels of TGF-β1 and BMP-2 appeared to be delayed in nonunion patients which could play an important role in developing an early marker of fracture union condition and facilitate improved patient's management.

Spatial patterns of AFLP diversity in Bulbophyllum occultum (Orchidaceae) indicate long-term refugial isolation in Madagascar and long-distance colonization effects in La Réunion.

PubMed

Jaros, U; Fischer, G A; Pailler, T; Comes, H P

2016-05-01

Bulbophyllum occultum, an epiphytic orchid mainly distributed in the rainforests of (north)eastern Madagascar and La Réunion, represents an interesting model case for testing the effects of anthropogenic vs historical (e.g., climate induced) habitat isolation and long-distance colonization on the genetic structure of plant species with disjunct distributions in the Madagascan region. To this aim, we surveyed amplified fragment length polymorphisms (AFLPs) across 13 populations in Madagascar and nine in La Réunion (206 individuals in total). We found overall high levels of population subdivision (Φ(PT)=0.387) and low within-population diversity (H(E), range: 0.026-0.124), indicating non-equilibrium conditions in a mainly selfing species. There was no impact of recent deforestation (Madagascar) or habitat disturbance (La Réunion) detectable on AFLP diversity. K-means clustering and BARRIER analyses identified multiple gene pools and several genetic breaks, both within and among islands. Inter-island levels of population genetic diversity and subdivision were similar, whereby inter-individual divergence in flower colour explained a significant part of gene pool divergence in La Réunion. Our results suggest that (i) B. occultum persisted across multiple isolated ('refugial') regions along the eastern rainforest corridor of Madagascar over recent climatic cycles and (ii) populations in La Réunion arose from either single or few independent introductions from Madagascar. High selfing rates and sufficient time for genetic drift likely promoted unexpectedly high population genetic and phenotypic (flower colour) differentiation in La Réunion. Overall, this study highlights a strong imprint of history on the genetic structure of a low-gene-dispersing epiphytic orchid from the Madagascan region.

Role of Appositional Screw Fixation in Minimally Invasive Plate Osteosynthesis for Distal Tibial Fracture.

PubMed

Yang, Kyu-Hyun; Won, Yougun; Kang, Dong-Hyun; Oh, Jin-Cheol; Kim, Sung-Jun

2015-09-01

To determine the effect of interfragmentary appositional (gap-closing) screw fixation in minimally invasive plate osteosynthesis (MIPO) for distal tibial fractures on the clinical and radiologic results. Prospective nonrandomized study. Level I trauma center. Sixty patients who were diagnosed as distal metadiaphyseal oblique or spiral tibial fracture without displaced articular fragment. Thirty patients (group A) of the 60 patients were treated with MIPO without appositional screw fixation, and the other 30 (group B) were treated with the screw. Radiologic union, clinical union, clinical functional score [American Orthopaedic Foot and Ankle Society (AOFAS) score], and complications. The time for initial callus formation and radiologic union was significantly longer in group A than those in group B (76.8 vs. 58.0 days, P = 0.044; 409 vs. 258.7 days, P = 0.002, respectively). The rate of clinical union during 1 year was significantly higher in group B than in group A (P = 0.0063). Four nonunion patients in group A achieved bone union after placement of an additional bone graft. None of the patients in group B diagnosed with delayed union or nonunion (P < 0.001). None of the patients of both groups had malreduction, skin problems, or infection. Overall, the AOFAS score did not significantly differ between groups A and B (85.4 vs. 87.0, P = 0.43). The use of additional interfragmentary appositional screw fixation in distal tibia MIPO for the fixation of oblique or spiral fracture promoted callus formation and union rate compared with MIPO without appositional screw fixation. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Comparative study suggests that human bone morphogenetic proteins have no influence on the outcome of operative treatment of aseptic clavicle non-unions.

PubMed

von Rüden, Christian; Morgenstern, Mario; Friederichs, Jan; Augat, Peter; Hackl, Simon; Woltmann, Alexander; Bühren, Volker; Hierholzer, Christian

2016-11-01

The purpose of this study was to evaluate the clinical and radiological outcome following compression plate fixation in combination with autologous bone grafting, with and without additional application of recombinant human bone morphogenetic protein (rhBMP) for treatment of aseptic clavicle non-union. Between April 2004 and April 2015, 82 patients were treated for clavicle fracture and had developed aseptic clavicle non-union. Seventy-three out of 82 patients were available for follow-up at least one year after revision surgery; among them, 27 women and 46 men, with a median age of 49 (range, 19-86) years. Forty-five patients received compression plate osteosynthesis with autologous bone grafting, and 28 patients obtained compression plate fixation with autologous bone grafting and additional application of rhBMP-2 (3/28 patients) or rhBMP-7 (25/28 patients). Seventy out of 73 non-unions (96 %) healed within 12 months after revision surgery. Functional outcome according to the DASH Outcome Measure (with rhBMP, 33.16 ± 1.17 points; without rhBMP, 30.58 ± 2.12 points [mean ± SEM]; p = 0.81), non-union healing (p = 0.86), time interval between revision surgery and bone healing (p = 0.37), as well as post-operative complications, did not demonstrate relevant differences between the treatment groups and were not age-dependent. Functional and radiological results demonstrate that successful healing of aseptic clavicle non-union is dependent on radical resection of non-union tissue, restoration of length of the shoulder girdle and application of stable locking-plate osteosynthesis in combination with autologous bone grafting, but not dependent on application of additional rhBMP.

The costs of the soviet empire.

PubMed

Wolf, C

1985-11-29

A comprehensive framework is developed and applied to estimate the economic costs incurred by the Soviet Union in acquiring, maintaining, and expanding its empire. The terms "empire" and "costs" are explicitly defined. Between 1971 and 1980, the average ratio between empire costs and Soviet gross national product was about 3.5 percent; as a ratio to Soviet military spending, empire costs averaged about 28 percent. The burden imposed on Soviet economic growth by empire costs is also considered, as well as rates of change in these costs, and the important political, military, and strategic benefits associated by the Soviet leadership with maintenance and expansion of the empire. Prospective empire costs and changes in Soviet economic constraints resulting from the declining performance of the domestic economy are also considered.

Evaluation of Millstone-2 steam generator chemical decontamination

DOE Office of Scientific and Technical Information (OSTI.GOV)

Snyder, D.T.; Blok, J.

The steam generator channel heads at Millstone-2 were decontaminated prior to carrying out extensive maintenance work in 1983. Isotopic gamma ray measurements were made of the inner channel head surfaces before and after the decontamination to evaluate the effectiveness of the process. The Combustion Engineering/Kraftwerk Union chemical decontamination, by itself, provided a decontamination factor ranging from 2.7 to 6.6 for the various steam generator surfaces. The corresponding average dose rate reduction factor, based on gross-gamma radiation surveys, was approximately 1.5 to 2.5. Following the chemical treatment, high pressure water flushing reduced the radiation levels still further, to an average overallmore » dose reduction factor of 5.3 to 7.2.« less

Nail or plate in the management of distal extra-articular tibial fracture, what is better? Valutation of outcomes

PubMed Central

Bisaccia, Michele; Cappiello, Andrea; Meccariello, Luigi; Rinonapoli, Giuseppe; Falzarano, Gabriele; Medici, Antonio; Vicente, Cristina Ibáñez; Piscitelli, Luigi; Stano, Verdiana; Bisaccia, Olga; Caraffa, Auro

2018-01-01

Introduction: Distal tibial fractures are the most common long bone fractures. Several studies focusing on the methods of treatment of displaced distal tibial fractures have been published. To date, locked plates, intramedullary nails and external fixation are the three most used techniques. The aim of our study was to compare intramedullary nail (IMN) and locked plate (LP) for treatment of this kind of fracture. Materials and methods: We collected data on 81 patients with distal tibial fractures (distance from the joint between 40 and 100 mm) and we divided into two groups: IMN and LP. We compared in the 2 groups the mean operation time, the mean union time, the infection rate the rate of malunion and nonunion, the full weight bearing time. Results: No patient in the two groups developed a nonunion. None of the patients obtained a fair or poor outcome. Overall 52 patients obtained an excellent result (69.3%) and 23 obtained a good result (30.6%). Discussion: Our study results indicate a superiority of IMN over LP in terms of lower rates of infections and statistically significant shorter time to full weight bearing. Whereas LP appeared to be advantageous over IMN in terms of leading to a better anatomical and fixed reductions of the fracture and a lower rate of union complications. The two treatments achieved comparable results in terms of operation time, hospital stay, union time and functional outcomes. PMID:29469802

[The randomized controlled trial of influences of T shape approach on the function of knee joint in the treatment of proximal tibial fractures].

PubMed

Peng, Wei-xiong; Zhang, Zhi; Liang, Jie-hong

2008-04-01

To investigate the clinical value of T shape approach in the treatment of proximal tibial fractures. One handrend and thirteen patients of proximal tibial fractures were randomly divided into two groups. Group A: 62 cases underwent the traditional exposure approach. According to Schatzker classification,the cases of II to VI type was 25, 10, 16, 6, 5 respectively. Group B:51 cases underwent T shape approach ahead of knee joint, the cases of II to VI type was 21, 8, 13, 5, 4 respectively. All data were analyzed by SPSS 10.0 to compare operation time, blood loss, duration of hospitalization, healing time, the time of osseous union and complications after operation. Sixty patients in group A and 50 patients in group B were followed-up from 12 to 24 months. (1) Operation time:group B was longer than A (P < 0.01). (2) Mean blood loss and duration of hospitalization was the same. (3) Clinical healing time:group B was shorter. (4) Mean time of osseous union: 48 group B was shorter. Function of knee: group B was better than group A. (Complication: group B was less than group A. As compared with traditional exposure approach, T shape approach of knee joint had advantages of small scar, fewer complications, faster union of fracture and earlier recovery of joint function. The approach is valuable for the treatment of proximal tibial fractures.

Consensus statement on injury definitions and data collection procedures for studies of injuries in rugby union

PubMed Central

Fuller, Colin W; Molloy, Michael G; Bagate, Christian; Bahr, Roald; Brooks, John H M; Donson, Hilton; Kemp, Simon P T; McCrory, Paul; McIntosh, Andrew S; Meeuwisse, Willem H; Quarrie, Kenneth L; Raftery, Martin; Wiley, Preston

2007-01-01

Wide variations in the definitions and methodologies used for studies of injuries in rugby union have created inconsistencies in reported data and made interstudy comparisons of results difficult. The International Rugby Board established a Rugby Injury Consensus Group (RICG) to reach an agreement on the appropriate definitions and methodologies to standardise the recording of injuries and reporting of studies in rugby union. The RICG reviewed the consensus definitions and methodologies previously published for football (soccer) at a meeting in Dublin in order to assess their suitability for and application to rugby union. Following this meeting, iterative draft statements were prepared and circulated to members of the RICG for comment; a follow‐up meeting was arranged in Dublin, at which time all definitions and procedures were finalised. At this stage, all authors confirmed their agreement with the consensus statement. The agreed document was presented to and approved by the International Rugby Board Council. Agreement was reached on definitions for injury, recurrent injury, non‐fatal catastrophic injury, and training and match exposures, together with criteria for classifying injuries in terms of severity, location, type, diagnosis and causation. The definitions and methodology presented in this consensus statement for rugby union are similar to those proposed for football. Adoption of the proposals presented in this consensus statement should ensure that more consistent and comparable results will be obtained from studies of injuries within rugby union. PMID:17452684

The National Security Mission of the U.S. Border Patrol: A Question of Collective Bargaining Exemption

DTIC Science & Technology

2015-06-12

the girls over the course of these several months so that I could devote time and attention to this effort. Your patience and love are amazing...an examination of the relationship between traditional law enforcement agencies and unionization will help the reader to better understand why the...foundation for later analysis. Before an examination of the relationship between unions and law enforcement can occur, a brief history of law

The Neuronal Control of Flying Prey Interception in Dragonflies

DTIC Science & Technology

2014-08-19

Gonzalez-Bellido’s fluorescent dye ( Lucifer -yellow) injections illuminated for the first time the anatomy of the output regions of the TSDNs...out in Cape Cod (MA) to test the effect of bead size(C), and in the Olberg Laboratory (Union College, NY) to test the effect of bead speed by...AFRL-OSR-VA-TR-2014-0193 THE NEURONAL CONTROL OF FLYING PREY INTERCEPTION IN DRAGONFLIES Robert Olberg TRUSTEES OF UNION COLLEGE IN THE TOWN OF

European Science Notes (ESN) Information Bulletin Reports on Current European/Middle Eastern Science,

DTIC Science & Technology

1987-11-01

Rumania, the Union of the of solution conditions attained by varia- Societies for Medical Sciences in the tion of the temperature, the pH value, Socialist...operation with the International Union globular proteins with a wide range of for Pure and Applied Biophysics. There different biological functions...nonlinear system theory, has spent matching in the dynamic control of a some time as a visiting professor at flexible robot. The nonlinear techniques

Internal fixation of displaced inferior pole of the patella fractures using vertical wiring augmented with Krachow suturing.

PubMed

Oh, Hyoung-Keun; Choo, Suk-Kyu; Kim, Ji-Wan; Lee, Mark

2015-12-01

We present the surgical technique of separate vertical wiring for displaced inferior pole fractures of the patella combined with Krachow suture and report the surgical outcomes. Between September 2007 to May 2012, 11 consecutive patients (mean age, 54.6 years) with inferior pole fractures of the patella (AO/OTA 34-A1) were retrospectively enrolled in this study. Through longitudinal incision, all patients underwent open reduction and internal fixation by separate vertical wiring combined with Krackow suture. The range of motion, loss of fixation, and Bostman score were primary outcome measures. The union time was 10 weeks after surgery on average (range: 8-12). No patient had nonunion, loss of reduction and wire breakage. There was no case of wound problem and irritation from the implant. At final follow-up, the average range of motion arc was 129.4° (range: 120-140). The mean Bostman score at last follow-up was 29.6 points (range: 28-30) and graded excellent in all cases. Separate vertical wiring combined with Krackow suture for inferior pole fractures of the patella is a useful technique that is easy to perform and can provide stable fixation with excellent results in knee function. Copyright © 2015 Elsevier Ltd. All rights reserved.

One-stage metatarsal lengthening by allograft interposition: a novel approach for congenital brachymetatarsia.

PubMed

Giannini, Sandro; Faldini, Cesare; Pagkrati, Stavroula; Miscione, Maria Teresa; Luciani, Deianira

2010-07-01

Congenital brachymetatarsia, a shortened metatarsal bone, can be corrected surgically by callus distraction or one-stage lengthening using bone graft. We asked whether one-stage metatarsal lengthening using metatarsal homologous bone graft could improve forefoot function, lead to metatarsal healing, restore metatarsal parabola, and improve cosmetic appearance. We retrospectively reviewed 29 patients (41 feet) in whom we lengthened 50 metatarsals. Surgery consisted of a transverse proximal osteotomy of the metatarsal shaft and interposition of a metatarsal homologous bone graft (average, 13 mm long) fixed with an intramedullary Kirschner wire. Minimum followup was 3 years (mean, 5 years; range, 3-11 years). Bone union was achieved in all cases. The mean preoperative American Orthopaedic Foot and Ankle Society score was 37 points (range, 28-53 points) and the mean postoperative score was 88 points (range, 74-96 points), with an average improvement of 51 points. Radiographically, the mean gain in length was 13 mm (range, 10-15 mm), and the mean percentage increase was 23%. One-stage metatarsal lengthening using interposition of metatarsal homologous bone graft to correct congenital brachymetatarsia has low morbidity for the patient, limited complications, short recovery times, and restores forefoot anatomy. Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Surgical treatment for pilon fracture of the ankle-open reduction and internal fixation.

PubMed

Chen, Y W; Huang, P J; Hsu, C Y; Kuo, C H; Cheng, Y M; Lin, S Y; Chen, L H; Chiang, H C

1998-01-01

From 1991 to 1994, 39 ankles of 38 patients underwent surgical open reduction and internal fixation for pilon fractures. These patients included 29 males and 9 females with an average age of 38.6 y/o (range 28 y/o-58 y/o). The follow up and evaluation period averaged 31.7 months (range 22Ms-44Ms), during which time a standing x-ray for arthrosis grading and functional scale was used for clinical evaluation. Complications included 1 case of infection, 1 case of loss reduction, 2 cases of partial skin necrosis and 2 cases of delayed union. Post-traumatic arthritis occurred in 23 ankles (59%) but only 4 ankles of grade 4 arthrosis resulted in poor functional scale and the overall satisfactory rate was 82%. It was found that anatomic reduction, rigid fixation and early motion exercise are important to successful treatment of ankle fractures. Regarding pilon fracture, specifically the severity of fracture pattern and delay of reduction are important problems to overcome to ensure successful results. Therefore, adequate surgical approach for entire view of ankle joint, reduction and fixation of fibula, sufficient bone graft for articular support, intraoperative x-ray check and postoperative immobilization are essential for the achievement of better clinical results.

Trends in meat consumption in the United States

PubMed Central

Daniel, Carrie R.; Cross, Amanda J.; Koebnick, Corinna; Sinha, Rashmi

2010-01-01

OBJECTIVE To characterize the trends, distribution, potential determinants, and public health implications of meat consumption within the United States. DESIGN We examined temporal trends in meat consumption using food availability data from the Food and Agricultural Organization (FAO) and United States Department of Agriculture (USDA); and further evaluated meat intake by type (red, white, processed) in the National Health and Nutrition Examination Surveys (NHANES) linked to the MyPyramid Equivalents Database (MPED). RESULTS Overall meat consumption has continued to rise in the U.S., European Union, and developed world. Despite a shift toward higher poultry consumption, red meat still represents the largest proportion of meat consumed in the U.S (58%). Twenty-two percent of the meat consumed in the U.S. is processed. According to NHANES 2003–2004, total meat intake averaged 128 g/day. The type and quantities of meat reported varied by education, race, age, and gender. CONCLUSIONS Given the plausible epidemiologic evidence for red and processed meat intake in cancer and chronic disease risk, understanding the trends and determinants of meat consumption in the U.S., where meat is consumed at more than three times the global average, should be particularly pertinent to researchers and other public health professionals aiming to reduce the global burden of chronic disease. PMID:21070685

[Intramedullary nailing combined with cannulated screw in treating femoral condyles fractures].

PubMed

Shen, Guo-Qing; Zhang, Hao; Long, Da-Fu; Li, Zheng-Wen; Tan, Ying-Dong

2017-07-25

To observe the clinical effects of retrograde intramedullary nailing and cannulated screws in the treatment of femoral condylar fracture. From June 2009 to June 2015, 13 patients with femoral condyles fracture were treated by retrograde intramedullary nailing and cannulated screws including 6 males and 7 females with an average age of 46.1 years old ranging from 16 to 76 years old. There were 10 cases of closed fractures, 3 cases of open fraetures. According to AO classification criteriam, 4 cases were type C1, 7 cases were type C2, 2 cases were type C3. Postoperative reduction of fracture and the knee joint function recovery were observed. All patients were followed up for 12 to 36 months with a mean of 24 months. X-ray examination showed that the union time of fracture was 18 to 24 weeks, 21 weeks on average. There were no cases of loosening, breakage of internal fixators and re-fracture. Hospital for Special Surgery(HSS) knee score was 90.07±4.99 at 1 year after the operation. The clinical efficacy for retrograde intramedullary nailing and cannulated screw for the treatment of femoral condyles fracture was excellent. It can improve the anatomical reattachment rate and reduce the complications and promote the knee functional recovery.

Estonia: health system review.

PubMed

Lai, Taavi; Habicht, Triin; Kahur, Kristiina; Reinap, Marge; Kiivet, Raul; van Ginneken, Ewout

2013-01-01

This analysis of the Estonian health system reviews recent developments in organization and governance, health financing, health-care provision, health reforms and health system performance. Without doubt, the main issue has been the 2008 financial crisis. Although Estonia has managed the downturn quite successfully and overall satisfaction with the system remains high, it is hard to predict the longer-term effects of the austerity package. The latter included some cuts in benefits and prices, increased cost sharing for certain services, extended waiting times, and a reduction in specialized care. In terms of health outcomes, important progress was made in life expectancy, which is nearing the European Union (EU) average, and infant mortality. Improvements are necessary in smoking and alcohol consumption, which are linked to the majority of avoidable diseases. Although the health behaviour of the population is improving, large disparities between groups exist and obesity rates, particularly among young people, are increasing. In health care, the burden of out-of-pocket payments is still distributed towards vulnerable groups. Furthermore, the number of hospitals, hospital beds and average length of stay has decreased to the EU average level, yet bed occupancy rates are still below EU averages and efficiency advances could be made. Going forwards, a number of pre-crisis challenges remain. These include ensuring sustainability of health care financing, guaranteeing a sufficient level of human resources, prioritizing patient-centred health care, integrating health and social care services, implementing intersectoral action to promote healthy behaviour, safeguarding access to health care for lower socioeconomic groups, and, lastly, improving evaluation and monitoring tools across the health system. World Health Organization 2013 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies).

Compared analysis of different sampling strategies for the monitoring of pesticide contamination in streams

NASA Astrophysics Data System (ADS)

Liger, Lucie; Margoum, Christelle; Guillemain, Céline; Carluer, Nadia

2014-05-01

The implementation of the WFD (Water Framework Directive), requests European Union member states to achieve good qualitative and quantitative status of all water bodies in 2015. The monitoring of organic micropollutants such as pesticides is an essential step to assess the chemical and biological state of streams, to understand the reasons of degradation and to implement sound mitigation solutions in the watershed. In particular, the water sampling, which can be performed according to several strategies, has to be closely adapted to the experimental goals. In this study, we present and compare 3 different active sampling strategies: grab sampling, time-related and flow-dependent automatic samplings. In addition, the last two can be fractionated (i.e., several samples collected, and each one contained in a single bottle) or averaged (i.e., several samples mixed in the same bottle). Time-related samples allow the assessment of average exposure concentrations of organic micropollutants, whereas flow-dependent samples lead to average flux concentrations. The 3 sampling strategies were applied and compared during the monitoring of the pesticide contamination of a river located in a French vineyard watershed (the Morcille River, located 60 km north of Lyon, in the Beaujolais region). Data were collected between 2007 and 2011, during different seasons and for a range of hydrological events. The Morcille watershed is characterized by contrasted hydrological events with a very short-time response due to its small size (5 km²), steep slopes (20 to 28%) and highly permeable sandy soils. These features make it particularly difficult to monitor water quality, due to fast variations of pesticide concentrations depending on rain events. This comparative study is performed in 2 steps. At first, we compare the timestamps of each sample composing the weekly-averaged samples and those of the grab samples with hydrological data. This allows us to evaluate the efficiency of these 2 sampling strategies in the integration of flow variations and therefore pesticide concentration variations during the sampling campaign. In a second step, we use the fractionated samples data during flood events to calculate the concentrations of virtual averaged samples of the events. Different time or flow steps were used for the calculation, to assess their impact on the pesticide averaged-concentrations or fluxes. These analyses highlight the benefits and drawbacks of each sampling strategy. They show that the sampling strategy should be carefully chosen and designed depending on the final aim of the study and on the watershed characteristics (in particular its hydrological dynamics). This study may help to design future monitoring on water quality. Key Words: sampling strategies, surface water, concentration, flux, pesticides.

Delayed union and nonunions: epidemiology, clinical issues, and financial aspects.

PubMed

Hak, David J; Fitzpatrick, Daniel; Bishop, Julius A; Marsh, J Lawrence; Tilp, Susanne; Schnettler, Reinhard; Simpson, Hamish; Alt, Volker

2014-06-01

Fracture healing is a critically important clinical event for fracture patients and for clinicians who take care of them. The clinical evaluation of fracture healing is based on both radiographic findings and clinical findings. Risk factors for delayed union and nonunion include patient dependent factors such as advanced age, medical comorbidities, smoking, non-steroidal anti-inflammatory use, various genetic disorders, metabolic disease and nutritional deficiency. Patient independent factors include fracture pattern, location, and displacement, severity of soft tissue injury, degree of bone loss, quality of surgical treatment and presence of infection. Established nonunions can be characterised in terms of biologic capacity, deformity, presence or absence of infection, and host status. Hypertrophic, oligotrophic and atrophic radiographic appearances allow the clinician to make inferences about the degree of fracture stability and the biologic viability of the fracture fragments while developing a treatment plan. Non-unions are difficult to treat and have a high financial impact. Indirect costs, such as productivity losses, are the key driver for the overall costs in fracture and non-union patients. Therefore, all strategies that help to reduce healing time with faster resumption of work and activities not only improve medical outcome for the patient, they also help reduce the financial burden in fracture and non-union patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

"Mainstreaming" the Part-Time Faculty: Issue or Imperative?

ERIC Educational Resources Information Center

Albert, Louis S.; Watson, Rollin J.

Controversy over the widespread use of part-time faculty, as well as related legal and administrative problems, calls for a mainstreaming of part-time faculty into the academic process of an institution. Faculty unions claim increased utilization of part-time instructors undermines full-time faculty benefits and exploits part-time teachers.…

[Comparison study on two operations for treatment of extra-articular distal tibial fracture].

PubMed

Qi, Haotian; Li, Weikang; Zhao, Yongjie; Zhang, Yinguang; Liu, Zhaojie; Jia, Jian

2013-11-01

To compare the effectiveness between minimally invasive plate osteosynthesis (MIPO) and open reduction and internal fixation (ORIF) for treatment of extra-articular distal tibial fracture. Between March 2009 and March 2012, 57 patients with extra-articular distal tibial fractures were treated, and the clinical data were retrospectively analyzed. Of 57 cases, 31 were treated with MIPO (MIPO group), and 26 with ORIF (ORIF group). There was no significant difference in gender, age, cause of injury, type of fractures, complication, and time from injury to operation between 2 groups (P > 0.05). The operation time, intraoperative blood loss, fracture healing time, and complications were compared between 2 groups. There was no significant difference in operation time and intraoperative blood loss between 2 groups (P > 0.05). Wound infection occurred in 5 cases [2 in MIPO group (6.5%) and 3 in ORIF group (11.5%)] showing no significant difference (Chi(2)=0.651, P=0.499). The other wound obtained healing by first intention. All cases were followed up 13-24 months (mean, 15 months). No significant difference was found in the average healing time between 2 groups and between patients with types A and B by AO classification (P > 0.05); in patients with type C, the healing time in MIPO group was significantly shorter than that in ORIF group (t= -2.277, P=0.033). Delayed union was observed in 3 cases of MIPO group (9.7%) and in 4 cases of ORIF group (15.4%), showing no significant difference (Chi(2)=0.428, P=0.691). Mal-union occurred in 4 cases of MIPO group (12.9%) and in 1 case of ORIF group (3.8%), showing no significant difference (Chi(2)=1.449, P=0.362). No significant difference was found in Mazur score between 2 groups (t=0.480, P=0.633). The excellent and good rate was 93.5% in MIPO group (excellent in 24 cases, good in 5 cases, fair in 1 case, and poor in 1 case) and was 92.3% in ORIF group (excellent in 18 cases, good in 6 cases, and poor in 2 cases), and the difference was not significant (Z= -0.687, P=0.492). Both MIPO and ORIF have good results in treating extra-articular distal tibial fractures. MIPO is superior to ORIF for treating complex and communited fractures.

Determination of patulin in apple juice by liquid chromatography: collaborative study.

PubMed

Brause, A R; Trucksess, M W; Thomas, F S; Page, S W

1996-01-01

An AOAC International-International Union of Pure and Applied Chemistry-International Fruit Juice Union (AOAC-IUPAC-IFJU) collaborative study was conducted to evaluate a liquid chromatographic (LC) procedure for determination of patulin in apple juice. Patulin is a mold metabolite found naturally in rotting apples. Patulin is extracted with ethyl acetate, treated with sodium carbonate solution, and determined by reversed-phase LC with UV detection at 254 or 276 nm. Water, water-tetrahydrofuran, or water-acetonitrile was used as mobile phase. Levels determined in spiked test samples were 20, 50, 100, and 200 micrograms/L. A test sample naturally contaminated at 31 micrograms/L was also included. Twenty-two collaborators in 10 countries analyzed 12 test samples of apple juice. Recoveries averaged 96%, with a range of 91-108%. Repeatability relative standard deviations (RSDr) ranged from 10.9 to 53.8%. The reproducibility relative standard deviation (RSDR) ranged from 15.1 to 68.8%. The LC method for determination of patulin in apple juice has been adopted first action by AOAC INTERNATIONAL.

A rain splash transport equation assimilating field and laboratory measurements

USGS Publications Warehouse

Dunne, T.; Malmon, D.V.; Mudd, S.M.

2010-01-01

Process-based models of hillslope evolution require transport equations relating sediment flux to its major controls. An equation for rain splash transport in the absence of overland flow was constructed by modifying an approach developed by Reeve (1982) and parameterizing it with measurements from single-drop laboratory experiments and simulated rainfall on a grassland in East Africa. The equation relates rain splash to hillslope gradient, the median raindrop diameter of a storm, and ground cover density; the effect of soil texture on detachability can be incorporated from other published results. The spatial and temporal applicability of such an equation for rain splash transport in the absence of overland flow on uncultivated hillslopes can be estimated from hydrological calculations. The predicted transport is lower than landscape-averaged geologic erosion rates from Kenya but is large enough to modify short, slowly eroding natural hillslopes as well as microtopographic interrill surfaces between which overland flow transports the mobilized sediment. Copyright 2010 by the American Geophysical Union. Copyright 2010 by the American Geophysical Union.

A short history of the development of the Turc-Mezentsev water balance formula

NASA Astrophysics Data System (ADS)

Andréassian, Vazken; Lebecherel, Laure

2013-04-01

In the 1950s, a formula linking long term average evaporation to long-term average precipitation and potential evaporation was quasi-simultaneously proposed in France and in the Soviet Union. However, because Turc and Mezentsev published in French and Russian respectively, their work has received limited attention, and the formula they proposed is often given different names. • Work of Lucien Turc in France (1954) Lucien Turc, a French soil scientist, worked at the Versailles soil science laboratory of the French National Agronomical Research Institute. For agronomic purposes, he was interested in developing a formula to estimate actual evapotranspiration from precipitation and temperature data. Since lysimeter data were so scarce at that time, he had the idea to derive such a formula from catchment water balance. With the help of the hydrologist Maurice Pardé, he assembled a set of data on 254 catchments from all over the world. He derived long-term average actual evapotranspiration (E) from estimates of long-term average precipitation (P) and long-term average discharge (Q). Then, Turc looked for a mathematical function linking two non-dimensional terms: the aridity index (the ratio of precipitation P and potential evapotranspiration E0) and the evapotranspiration rate (the ratio of E and E0). He proposed the following formulation: E/P=1/[1+(P/E0)**n]**(1/n) in which n is an exponent to estimate. Turc graphically looked for the most convenient value for n, and concluded that the best fit was "with n=3, or may be n=2" (Turc, 1954, p.563). • Work of Varfolomeï Mezentsev in the Soviet Union (1955) Mezentsev (1955) worked at the University of Omsk in Siberia. He started his analysis from a formula proposed by Bagrov (1953): dE/dP=1-(E/E0)**n (Eq.1) This formula presents the interesting property to integrate into the Schreiber (1904) water balance formula for n=1:and into the Ol'Dekop (1911) water balance formula for n=2. But it had no analytical solution for other values of n. Mezentsev (1955) complexified Bagrov's formula by rewriting it as follows: dE/dP=[1-(E/E0)**n]**(1+1/n) (Eq.2) which keeps the same interpretation as Eq. 1. Eq. 2 can be integrated analytically and yields Eq. 3: E/P=1/[1+(P/E0)**n]**(1/n) (Eq.3) which is identical to the general formulation proposed by Turc. Based on a set of 35 catchments of the Siberian plateau, Mezentsev suggested using the value of 2.3 for parameter n, which is close to the value advised by Turc. References Bagrov, N. A., 1953. O srednem mnogoletnem ispraeniiz c paverknosti sushi (on the average long-term evaporation from the land surface), Meteorologia i Gidrologia, 10, 20-25. Mezentsev, V., 1955. More on the computation of total evaporation (Yechio raz o rastchetie srednevo summarnovo ispareniia). Meteorologia i Gidrologia, 5: 24-26. Turc, L., 1954. Le bilan d'eau des sols: relation entre les précipitations, l'évaporation et l'écoulement. Annales Agronomiques, Série A(5): 491-595.

75 FR 17083 - Fiduciary Duties at Federal Credit Unions; Mergers and Conversions of Insured Credit Unions...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-05

... Credit Unions; Mergers and Conversions of Insured Credit Unions; Correction AGENCY: National Credit Union... Federal credit unions and mergers and conversions of insured credit unions. The proposed rule as published... Conversions of Insured Credit Unions) in the e-mail subject line.'' [[Page 17084

Energy Transition Initiative: Island Energy Snapshot - Commonwealth of the Northern Mariana Islands; U.S. Department of Energy (DOE), NREL (National Renewable Energy Laboratory)

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

2015-06-01

This profile provides a snapshot of the energy landscape of the Commonwealth of the Northern Mariana Islands (CNMI), a commonwealth in political union with the United States that is located in the northern Pacific Ocean. CNMI’s electricity rates for residential customers range from $0.19 to $0.33 U.S. dollars (USD) per kilowatt-hour (kWh), above the average U.S. residential rate of $0.13 USD/kWh.

JPRS Report. Soviet Union, EKO: Economics & Organization of Industrial Production No. 7, July 1987.

DTIC Science & Technology

1987-12-03

to the question of the interest in plasma equip- ment in various branches of the national economy. Plasma processes occupy a leading position among...the principally new technologies that are based on process - ing concentrated flows of energy. Even today there are more than 50 of them. An entire...branch of chemistry has been formed—plasma chemistry, for which it is typical to have processes with an average mass temperature of the working gas

Recent Mortality Patterns Associated With Economic Development in Eastern Europe and the USSR

PubMed Central

Cooper, Richard; Sempos, Christopher

1984-01-01

Adult male mortality has turned sharply upward in Eastern Europe and the Soviet Union. Excluding the German Democratic Republic, for which data are not available, agestandardized death rates for men aged 40 to 69 years increased an average of 12 percent from the early 1960s to the mid-1970s. These secular trends were associated with consistent economic growth. At least for adult men, this period of social development has led to a marked deterioration in health. PMID:6708124

Evaluation of functional outcome of pilon fractures managed with limited internal fixation and external fixation: A prospective clinical study.

PubMed

Meena, Umesh Kumar; Bansal, Mahesh Chand; Behera, Prateek; Upadhyay, Rahul; Gothwal, Gyan Chand

2017-11-01

The management of pilon fractures is controversial primarily due to the high rate of complications irrespective of the mode of treatment. Limited internal fixation with external fixation is associated with minimal soft tissue handling. This may reduce the chances of wound dehiscence and infection. This study was designed to evaluate the functional and clinical outcomes in patients treated with limited internal fixation combined with external fixation in pilon fractures. This study was conducted as a prospective clinical study on 56 skeletally mature patients with closed fractures with poor skin condition, and with open grade 1 and grade 2 distal tibial intra-articular fractures. All patients were treated with combined limited internal fixation and ankle spanning external fixation. All fractures in this series united with an average time period of union of 18.3weeks (ranging from 13 weeks to 30 weeks). There was no non-union in any case. There was malunion in 4 cases, varus malunion (>5 degree) in 2 cases and recurvatum in another 2 cases). Excellent to good functional results were observed in 88% cases based on the modified Ovadia and Beals score. The mean ankle dorsiflexion and planter flexion movements were 10.2±5.3 degrees and 27.4±7.2 degrees respectively. infections occurred in 6 patients which included 4 pin tract infections and 2 superficial wound infection, all 6 healed after removal of pin tract and with oral antibiotics. The technique of combined external fixation with internal fixation is safe and effective management option for intra-articular distal tibial fractures.

Bone morphogenetic protein 2 and decorin expression in old fracture fragments and surrounding tissues.

PubMed

Han, X G; Wang, D K; Gao, F; Liu, R H; Bi, Z G

2015-09-21

Bone morphogenetic protein 2 (BMP-2) can promote fracture healing. Although the complex role BMP-2 in bone formation is increasingly understood, the role of endogenous BMP-2 in nonunion remains unclear. Decorin (DCN) can promote the formation of bone matrix and calcium deposition to control bone morphogenesis. In this study, tissue composition and expression of BMP-2 and DCN were detected in different parts of old fracture zones to explore inherent anti-fibrotic ability and osteogenesis. Twenty-three patients were selected, including eight cases of delayed union and 15 cases of nonunion. Average duration of delayed union or nonunion was 15 months. Fracture fragments and surrounding tissues, including bone grafts, marrow cavity contents, and sticking scars, were categorically sampled during surgery. Through observation and histological testing, component comparisons were made between fracture fragments and surrounding tissue. The expression levels of DCN and BMP-2 in different tissues were detected by immunohistochemical staining and real-time polymerase chain reaction. The expression of DCN and BMP- 2 in different parts of the nonunion area showed that, compared with bone graft and marrow cavity contents, sticking scars had the highest expression of BMP-2. Compared with the marrow cavity contents and sticking scars, bone grafts had the highest expression of DCN. The low antifibrotic and osteogenic activity of the nonunion area was associated with non-co-expression of BMP-2 and DCN. Therefore, the co-injection of osteogenic factor BMP and DCN into the nonunion area can improve the induction of bone formation and enhance the conversion of the old scar, thereby achieving better nonunion treatment.

Intramedullary nailing in the treatment of aseptic tibial nonunion.

PubMed

Megas, P; Panagiotopoulos, E; Skriviliotakis, S; Lambiris, E

2001-04-01

Fifty patients suffering from aseptic tibial nonunion underwent reamed intramedullary nailing (I.N.) and were retrospectively reviewed. Thirty-six patients were initially treated with external fixation, six with plate and screws, one with a static I.N., and seven with plaster of Paris. Eighteen of the fractures were initially open (A: 5, B: 6, and C: 7 according to the Gustilo classification). In 34 cases a closed procedure was performed, whereas in sixteen, an opening at the nonunion site was unavoidable either to remove metalwork or realign the fragments. Following failed external fixation, secondary I.N. was performed at least 10 days after removal of the device. Bone grafts from the iliac crest were used in three cases, and a fibular osteotomy was performed in 33. Patients were followed up for an average of 2.5 years after nailing, ranging from 10 months to 7 years. A solid union was achieved in all patients within a period of 6 months. One patient developed late infection, which settled after nail removal and one patient developed impending compartment syndrome which was detected on the first post-operative day and was treated with a fasciotomy. Transient peroneal nerve palsy occurred in one patient and this recovered in 3 months, whereas in nine patients a clinically acceptable deformity was noticed. In conclusion, we believe that reamed intramedullary nailing is a highly effective treatment for aseptic tibial nonunions. Early and late complications are rare and bone graft is rarely needed. The method allows early weight bearing even before solid union occurs, short hospitalisation time and early return to work without external support.

The Physiological and Performance Effects of Caffeine Gum Consumed During A Simulated Half-Time By Professional Academy Rugby Union Players.

PubMed

M, Russell; N A, Reynolds; B T, Crewther; C J, Cook; L, Kilduff

2017-11-27

Despite the prevalence of caffeine as an ergogenic aid, few studies have examined the use of caffeinated gums, especially during half-time in team sports. The physiological (blood lactate, salivary hormone concentrations) and performance (repeated sprints, cognitive function) effects of consuming caffeine gum during a simulated half-time were examined. Professional academy rugby union players (n=14) completed this double-blind, randomized, counterbalanced study. Following pre-exercise measurements , players chewed a placebo (PL) gum for five min before a standardized warm-up and completing repeated sprint testing (RSSA1). Thereafter, during a 15 min simulated half-time period, players chewed either caffeine (CAF: 400 mg; 4.1 ± 0.5 mg·kg) or PL gum for five min before completing a second repeated sprint test (RSSA2). Blood lactate, salivary testosterone and cortisol concentrations, and indices of cognitive function (i.e., reaction time and Stroop test) were measured at baseline, pre-RSSA1, post-RSSA1, pre-RSSA2 and post-RSSA2. Sprint performance was not affected by CAF (P=0.995) despite slower sprint times following the first sprint of both RSSA tests (all P<0.002). Following half-time, salivary testosterone increased by 70% (+97±58 pg·mL) in CAF versus PLA (P<0.001) whereas salivary cortisol remained unchanged (P=0.307). Cognitive performance was unaffected by time and trial (all P>0.05). Although performance effects were absent, chewing caffeine gum increased the salivary testosterone concentrations of professional rugby union players over a simulated half-time. Practitioners may therefore choose to recommend caffeine gum between successive exercise bouts due to the increases in salivary testosterone observed; a variable associated with increased motivation and high-intensity exercise performance.

Non-contact Time for Primary School Teachers.

ERIC Educational Resources Information Center

Hill, Peter

The State School Teachers' Union of Western Australia has requested that primary teachers be free from teaching one-fifth time for other professional duties. Several arguments in favor of this proposal for more "noncontact time" have been advanced. The argument that primary teachers should have noncontact time equivalent to that of…

Trends in the economic consequences of marital and cohabitation dissolution in the United States.

PubMed

Tach, Laura M; Eads, Alicia

2015-04-01

Mothers in the United States use a combination of employment, public transfers, and private safety nets to cushion the economic losses of romantic union dissolution, but changes in maternal labor force participation, government transfer programs, and private social networks may have altered the economic impact of union dissolution over time. Using nationally representative panels from the Survey of Income and Program Participation (SIPP) from 1984 to 2007, we show that the economic consequences of divorce have declined since the 1980s owing to the growth in married women's earnings and their receipt of child support and income from personal networks. In contrast, the economic consequences of cohabitation dissolution were modest in the 1980s but have worsened over time. Cohabiting mothers' income losses associated with union dissolution now closely resemble those of divorced mothers. These trends imply that changes in marital stability have not contributed to rising income instability among families with children, but trends in the extent and economic costs of cohabitation have likely contributed to rising income instability for less-advantaged children.

[Surgical treatment of pronation and supination external rotation trimalleolar fractures].

PubMed

Xu, Ye-qing; Zhan, Bei-lei; He, Fei-xiong; Wei, Hong-da

2008-04-01

To explore the operative method and its clinical effects of pronation and supination external rotation trimalleolar fractures. From March 2000 to July 2006,42 patients of the pronation and supination external rotation trimalleolar fractures treated with open reduction and internal fixation. Thirty-one were males and 11 were females,with an average age of 40.5 years (from 19 to 76 years). Four cases were open fractures and 38 cases close fractures. The fractures were classified as pronation-external rotation (grade IV) injury in 18 cases and supination-external rotation (grade IV)in 24 cases according to the system of Lauge-Hansen. The time of injury to operation was 2 hours to 27 days. The medial, lateral and posterior malleolus were exposed by standard anteromedial and Gatellier-Chastang approaches. The reduction and internal fixation started with the posterior,then the medial and the lateral malleolus and distal tibiofibular syndesmosis in sequence. The anteroposterior, lateral and mostise X-ray films were taken after operation. All the patients were followed up for an average time of 13.5 months(from 6 to 24 months). The time of union was from 12 to 16 weeks. The results were excellent in 20,good in 16, fair in 4 and poor in 2 cases according to Baird-Jackson ankle scoring system based on pain, stability, walking ability,range of motion and radiological manifestations. The excellent and good rate was 85.7%. There were no infection,malunion and nonunion of the fractures except that the inserted screw to distal tibiofibular syndesmosis was broken in 1 case. The key of operative treatment is to restore the anatomy of ankle and to regain the ankle function maximally.

Modelling fatigue and the use of fatigue models in work settings.

PubMed

Dawson, Drew; Ian Noy, Y; Härmä, Mikko; Akerstedt, Torbjorn; Belenky, Gregory

2011-03-01

In recent years, theoretical models of the sleep and circadian system developed in laboratory settings have been adapted to predict fatigue and, by inference, performance. This is typically done using the timing of prior sleep and waking or working hours as the primary input and the time course of the predicted variables as the primary output. The aim of these models is to provide employers, unions and regulators with quantitative information on the likely average level of fatigue, or risk, associated with a given pattern of work and sleep with the goal of better managing the risk of fatigue-related errors and accidents/incidents. The first part of this review summarises the variables known to influence workplace fatigue and draws attention to the considerable variability attributable to individual and task variables not included in current models. The second part reviews the current fatigue models described in the scientific and technical literature and classifies them according to whether they predict fatigue directly by using the timing of prior sleep and wake (one-step models) or indirectly by using work schedules to infer an average sleep-wake pattern that is then used to predict fatigue (two-step models). The third part of the review looks at the current use of fatigue models in field settings by organizations and regulators. Given their limitations it is suggested that the current generation of models may be appropriate for use as one element in a fatigue risk management system. The final section of the review looks at the future of these models and recommends a standardised approach for their use as an element of the 'defenses-in-depth' approach to fatigue risk management. Copyright © 2010 Elsevier Ltd. All rights reserved.

Reliability of Single-Leg Balance and Landing Tests in Rugby Union; Prospect of Using Postural Control to Monitor Fatigue

PubMed Central

Troester, Jordan C.; Jasmin, Jason G.; Duffield, Rob

2018-01-01

The present study examined the inter-trial (within test) and inter-test (between test) reliability of single-leg balance and single-leg landing measures performed on a force plate in professional rugby union players using commercially available software (SpartaMARS, Menlo Park, USA). Twenty-four players undertook test – re-test measures on two occasions (7 days apart) on the first training day of two respective pre-season weeks following 48h rest and similar weekly training loads. Two 20s single-leg balance trials were performed on a force plate with eyes closed. Three single-leg landing trials were performed by jumping off two feet and landing on one foot in the middle of a force plate 1m from the starting position. Single-leg balance results demonstrated acceptable inter-trial reliability (ICC = 0.60-0.81, CV = 11-13%) for sway velocity, anterior-posterior sway velocity, and mediolateral sway velocity variables. Acceptable inter-test reliability (ICC = 0.61-0.89, CV = 7-13%) was evident for all variables except mediolateral sway velocity on the dominant leg (ICC = 0.41, CV = 15%). Single-leg landing results only demonstrated acceptable inter-trial reliability for force based measures of relative peak landing force and impulse (ICC = 0.54-0.72, CV = 9-15%). Inter-test results indicate improved reliability through the averaging of three trials with force based measures again demonstrating acceptable reliability (ICC = 0.58-0.71, CV = 7-14%). Of the variables investigated here, total sway velocity and relative landing impulse are the most reliable measures of single-leg balance and landing performance, respectively. These measures should be considered for monitoring potential changes in postural control in professional rugby union. Key points Single-leg balance demonstrated acceptable inter-trial and inter-test reliability. Single-leg landing demonstrated good inter-trial and inter-test reliability for measures of relative peak landing force and relative impulse, but not time to stabilization. Of the variables investigated, sway velocity and relative landing impulse are the most reliable measures of single-leg balance and landing respectively, and should considered for monitoring changes in postural control. PMID:29769817

Globalization, marine regime shifts and the Soviet Union

PubMed Central

Österblom, Henrik; Folke, Carl

2015-01-01

Regime shifts have been observed in marine ecosystems around the world, with climate and fishing suggested as major drivers of such shifts. The global and regional dynamics of the climate system have been studied in this context, and efforts to develop an analogous understanding of fishing activities are developing. Here, we investigate the timing of pelagic marine regime shifts in relation to the emergence of regional and global fishing activities of the Soviet Union. Our investigation of official catch statistics reflects that the Soviet Union was a major fishing actor in all large marine ecosystems where regime shifts have been documented, including in ecosystems where overfishing has been established as a key driver of these changes (in the Baltic and Black Seas and the Scotian Shelf). Globalization of Soviet Union fishing activities pushed exploitation to radically new levels and triggered regional and global governance responses for improved management. Since then, exploitation levels have remained and increased with new actors involved. Based on our exploratory work, we propose that a deeper understanding of the role of global fishing actors is central for improved management of marine ecosystems.

Religion and the rainbow struggle: does religion factor into attitudes toward homosexuality and same-sex civil unions in Brazil?

PubMed

Ogland, Curtis P; Verona, Ana Paula

2014-01-01

The provision of civil liberties to LGBT persons has become part of a global movement in societies across the world. In Brazil, a recent judicial ruling for the first time established the right for homosexual couples to enter into civil unions, despite the presence of widespread disapproval of homosexuality among the population and opposition from prominent religious groups. Picking up on this issue, the following study examines whether religion may factor into the attitudes Brazilians hold toward homosexuality and same-sex civil unions. Using data from the Brazilian Social Research Survey, we find that the most restrictive views toward homosexuality and the strongest opposition to same-sex civil unions are most prevalent among devoted followers of historical Protestant, Pentecostal, and Catholic faith traditions, whereas adherents of Afro-Brazilian and spiritist religions, as well as those with no religious commitment, are inclined to assume a more tolerant moral posture toward such issues. The findings point to religion as a potential influence in future public policy initiatives and social movements involving LGBT issues in Brazil.

[Comparison of LCP and locked intramedullary nailing fixation in treatment of tibial diaphysis fractures].

PubMed

Huang, Peng; Tang, Peifu; Yao, Qi

2007-11-01

To evaluate the treatment results of LCP and locked intramedullary nailing for tibial diaphysis fractures. From October 2003 to April 2006, 55 patients with tibial diaphysis fractures (58 fractures) were treated. Of them there were 39 males and 16 females with an average of 39 years years ( 14 to 62 years). The fractures were on the left side in 27 patients and on the right side in 31 patients (3 patients had bilateral involvement). Thirty-four fractures were treated by intramedullary nailing (intramedullary nailing group) and 24 fractures by LCP fixation (LCP group). The average disease course was 3 days (intramedullary nailing group) and 3.1 days (LCP group). The operation time, the range of motion of knee and ankle joints, fracture healing time, and complications were evaluated. The patients were followed up 8-26 months (13 months on average). The operation time was 84.0+/-9.2 min (intramedullary nailing group) and 69.0+/-8.4 min (LCP group); the average cost in hospital was yen 19,297.78 in the intramedullary nailing group and yen 14,116.55 in the LCP group respectively, showing significant differences (P < 0.05). The flexion and extension of knee joint was 139.0 +/- 3.7 degrees and 4.0 +/- 0.7 degrees in intramedullary nailing group and 149.0+/-4.2 degrees and 0+/-0.4 degrees in LCP group, showing no significant difference (P>0.05). The doral flexion and plantar flexion of ankle joint were 13.0+/-1.7 degrees and 41.0+/-2.6 degrees in intramedullary nailing group, and 10.0+/-1.4 degrees and 44.0+/-2.3 degrees in LCP group, showing no significant differences (P>0.05). The mean healing time was 3.3 months in intramedullary nailing group, and 3. 1 months in LCP group. Length discrepancy occurred in 1 case (2.5 cm), delayed union in 1 case and nailing end trouble in 3 cases in intramedullary nailing group; moreover rotation deformity occurred 1 case and anterior knee pain occurred in 6 cases (17.1%). One angulation and open fracture developed osteomyelitis in 1 case 1 week postoperatively and angulation deformity occurred in 1 case of distal-third tibial fractures in LCP group. LCP and locked intramedullary nailing can achieve satisfactory results in treating tibial diaphysis fracture LCP has advantages in less complication, operation time and cost in hospital.

Municipal solid waste development phases: Evidence from EU27.

PubMed

Vujić, Goran; Gonzalez-Roof, Alvaro; Stanisavljević, Nemanja; Ragossnig, Arne M

2015-12-01

Many countries in the European Union (EU) have very developed waste management systems. Some of its members have managed to reduce their landfilled waste to values close to zero during the last decade. Thus, European Union legislation is very stringent regarding waste management for their members and candidate countries, too. This raises the following questions: Is it possible for developing and developed countries to comply with the European Union waste legislation, and under what conditions? How did waste management develop in relation to the economic development in the countries of the European Union? The correlation between waste management practices and economic development was analysed for 27 of the European Union Member States for the time period between 1995 and 2007. In addition, a regression analysis was performed to estimate landfilling of waste in relation to gross domestic product for every country. The results showed a strong correlation between the waste management variables and the gross domestic product of the EU27 members. The definition of the municipal solid waste management development phases followed a closer analysis of the relation between gross domestic product and landfilled waste. The municipal solid waste management phases are characterised by high landfilling rates at low gross domestic product levels, and landfilling rates near zero at high gross domestic product levels. Hence the results emphasize the importance of wider understanding of what is required for developing countries to comply with the European Union initiatives, and highlight the importance of allowing developing countries to make their own paths of waste management development. © The Author(s) 2015.

Geomorphic evidence for former lobate debris aprons at low latitudes on Mars: Indicators of the Martian paleoclimate

USGS Publications Warehouse

Hauber, E.; Van Gasselt, S.; Chapman, M.G.; Neukum, G.

2008-01-01

Circumferential depressions enclosing mesas and plateaus in the northern Kasei Valles and in the Tartarus Colles regions of Mars are interpreted as indicators of the former extent of lobate debris aprons, thought to be mixtures of ice and elastic particles. These former lobate debris aprons existed about 1 Ga ago and were embayed by lavas or other flow deposits. After the lobate debris aprons had been removed by sublimation and deflation, topographic depressions with a depth of 50 m and a width of several kilometers were left behind between the mesa or plateau scarp and the solidified flow materials. These depressions or moats are located equatorward of ??30?? at significantly lower latitudes than generally observed for occurrences of modem, intact lobate debris aprons. This observation provides evidence that the paleoclimate at that time was different than today, probably due to a higher averaged obliquity of the planet's rotational axis. Copyright 2008 by the American Geophysical Union.

Strategies for managing work/life interaction among women and men with variable and unpredictable work hours in retail sales in Québec, Canada.

PubMed

Messing, Karen; Tissot, France; Couture, Vanessa; Bernstein, Stephanie

2014-01-01

Increasingly, work schedules in retail sales are generated by software that takes into account variations in predicted sales. The resulting variable and unpredictable schedules require employees to be available, unpaid, over extended periods. At the request of a union, we studied schedule preferences in a retail chain in Québec using observations, interviews, and questionnaires. Shift start times had varied on average by four hours over the previous week; 83 percent had worked at least one day the previous weekend. Difficulties with work/life balance were associated with schedules and, among women, with family responsibilities. Most workers wanted: more advance notice; early shifts; regular schedules; two days off in sequence; and weekends off. Choices varied, so software could be adapted to take preferences into account. Also, employers could give better advance notice and establish systems for shift exchanges. Governments could limit store hours and schedule variability while prolonging the minimum sequential duration of leave per week.

Tibiotalocalcaneal arthrodesis with a compressive retrograde nail: A retrospective study of 59 nails.

PubMed

Thomas, A E; Guyver, P M; Taylor, J M; Czipri, M; Talbot, N J; Sharpe, I T

2015-09-01

Tibiotalocalcaneal arthrodesis is an important salvage method for patients with complex hindfoot problems. This study reports the elective results of combined subtalar and ankle arthrodesis using one design of retrograde intramedullary compression nail. Retrospective review identified 58 patients undergoing 59 tibiotalocalcaneal arthrodesis procedures. Mean follow up was 9.15 (3-36) months with average age 60.7 (22-89) years. A function and subjective patient satisfaction questionnaire was achieved in 89%. 53 patients (93%) achieved union at a mean time of 4.17 months. Four patients (8%) subjectively thought the procedure was of no benefit while 42 (84%) had an excellent or good result. The mean visual analogue scale (VAS) score for preoperative functional pain was 7.46 compared to 1.98 post-operatively (p<0.001). This device and technique offers an effective treatment of hindfoot pathology giving reliable compression and subsequent fusion with excellent patient satisfaction and pain relief. IV case series. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Outage differences between Diablo Canyon and Unterweser power plants

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mehrens, H.

Diablo Canyon (DCPP) of Pacific Gas and Electric Company and Unterweser (KKU) of PreussenElektra have had an ongoing exchange program since 1989, which includes mutual visits by their employees at the optimum time for observing outages. Both DCPP and Unterweser use four-loop pressurized water reactors (PWRs), DCPP with two 1,100-MW units and KKU with a single 1,300-MW unit. Unterweser finished its 11th outage in 1990; DCPP units 1 and 2 will have their fourth outages in 1991. The scope of the maintenance and refueling work is quite similar in both plants and offers, therefore, a good basis for comparison. Outagemore » durations at European Kraftwerk Union KWU-PWR plants average {approximately}30 days as compared to the 60 to 80 days for PWRs in the US. Diablo Canyon has reduced outage durations from > 100 days to < 60. The key areas that contribute to the differences in outage duration are plant design and layout and outage execution.« less

A quality assessment of the MARS crop yield forecasting system for the European Union

NASA Astrophysics Data System (ADS)

van der Velde, Marijn; Bareuth, Bettina

2015-04-01

Timely information on crop production forecasts can become of increasing importance as commodity markets are more and more interconnected. Impacts across large crop production areas due to (e.g.) extreme weather and pest outbreaks can create ripple effects that may affect food prices and availability elsewhere. The MARS Unit (Monitoring Agricultural ResourceS), DG Joint Research Centre, European Commission, has been providing forecasts of European crop production levels since 1993. The operational crop production forecasting is carried out with the MARS Crop Yield Forecasting System (M-CYFS). The M-CYFS is used to monitor crop growth development, evaluate short-term effects of anomalous meteorological events, and provide monthly forecasts of crop yield at national and European Union level. The crop production forecasts are published in the so-called MARS bulletins. Forecasting crop yield over large areas in the operational context requires quality benchmarks. Here we present an analysis of the accuracy and skill of past crop yield forecasts of the main crops (e.g. soft wheat, grain maize), throughout the growing season, and specifically for the final forecast before harvest. Two simple benchmarks to assess the skill of the forecasts were defined as comparing the forecasts to 1) a forecast equal to the average yield and 2) a forecast using a linear trend established through the crop yield time-series. These reveal a variability in performance as a function of crop and Member State. In terms of production, the yield forecasts of 67% of the EU-28 soft wheat production and 80% of the EU-28 maize production have been forecast superior to both benchmarks during the 1993-2013 period. In a changing and increasingly variable climate crop yield forecasts can become increasingly valuable - provided they are used wisely. We end our presentation by discussing research activities that could contribute to this goal.

The efficacy of single-stage open intramedullary nailing of neglected femur fractures.

PubMed

Boopalan, P R J V C; Sait, Azad; Jepegnanam, Thilak Samuel; Matthai, Thomas; Varghese, Viju Daniel

2014-02-01

Neglected femur fractures are not rare in the developing world. Treatment options include single-stage open reduction and intramedullary nailing, or open release, skeletal traction, and then second-stage open intramedullary nailing, with bone grafting. Single-stage procedures have the potential advantage of avoiding neurovascular complications secondary to acute lengthening, but they require a second operation, with potentially increased resource use and infection risk. We sought to determine the (1) likelihood of union, (2) complications and reoperations, and (3) functional results with single-stage open intramedullary nailing without bone grafting in patients with neglected femur fractures. Between January 2003 and December 2007, 17 consecutive patients presented to our practice with neglected femoral shaft fractures. All were treated with single-stage nailing without bone grafting. There were 15 men and two women with a median age of 27 years. The average time from fracture to treatment was 13 weeks (range, 4-44 weeks). Eleven patients underwent open nailing with interlocked nails and six were treated with cloverleaf Kuntscher nails. Patients were followed for a minimum of 6 months (mean, 33 months; range, 6-72 months). The mean preoperative ROM of the knee was 28° (range, 10°-150°) and femoral length discrepancy was 3.1 cm (range, 1-5 cm). All fractures united and the mean time to union was 16 weeks (range, 7-32 weeks). There were no neurologic complications secondary to acute lengthening. The mean postoperative ROM of the knee was 130° (range, 60°-150°). All patients were able to return to preinjury work. Sixteen patients regained their original femoral length. One-stage open intramedullary nailing of neglected femoral diaphyseal fractures without bone grafting was safe and effective, and obviated the need for a two-stage approach. Although the findings need to be replicated in larger numbers of patients, we believe this technique may be useful in treating patients with this injury, and may offer advantages in resource-constrained environments.

Outcome of limb reconstruction system in open tibial diaphyseal fractures.

PubMed

Ajmera, Anand; Verma, Ankit; Agrawal, Mukul; Jain, Saurabh; Mukherjee, Arunangshu

2015-01-01

Management of open tibial diaphyseal fractures with bone loss is a matter of debate. The treatment options range from external fixators, nailing, ring fixators or grafting with or without plastic reconstruction. All the procedures have their own set of complications, like acute docking problems, shortening, difficulty in soft tissue management, chronic infection, increased morbidity, multiple surgeries, longer hospital stay, mal union, nonunion and higher patient dissatisfaction. We evaluated the outcome of the limb reconstruction system (LRS) in the treatment of open fractures of tibial diaphysis with bone loss as a definative mode of treatment to achieve union, as well as limb lengthening, simultaneously. Thirty open fractures of tibial diaphysis with bone loss of at least 4 cm or more with a mean age 32.5 years were treated by using the LRS after debridement. Distraction osteogenesis at rate of 1 mm/day was done away from the fracture site to maintain the limb length. On the approximation of fracture ends, the dynamized LRS was left for further 15-20 weeks and patient was mobilized with weight bearing to achieve union. Functional assessment was done by Association for the Study and Application of the Methods of Illizarov (ASAMI) criteria. Mean followup period was 15 months. The mean bone loss was 5.5 cm (range 4-9 cm). The mean duration of bone transport was 13 weeks (range 8-30 weeks) with a mean time for LRS in place was 44 weeks (range 24-51 weeks). The mean implant index was 56.4 days/cm. Mean union time was 52 weeks (range 31-60 weeks) with mean union index of 74.5 days/cm. Bony results as per the ASAMI scoring were excellent in 76% (19/25), good in 12% (3/25) and fair in 4% (1/25) with union in all except 2 patients, which showed poor results (8%) with only 2 patients having leg length discrepancy more than 2.5 cm. Functional results were excellent in 84% (21/25), good in 8% (2/25), fair in 8% (2/25). Pin tract infection was seen in 5 cases, out of which 4 being superficial, which healed to dressings and antibiotics. One patient had a deep infection which required frame removal. Limb reconstruction system proved to be an effective modality of treatment in cases of open fractures of the tibia with bone loss as definite modality of treatment for damage control as well as for achieving union and lengthening, simultaneously, with the advantage of early union with attainment of limb length, simple surgical technique, minimal invasive, high patient compliance, easy wound management, lesser hospitalization and the lower rate of complications like infection, deformity or shortening.

Floodplain Condition and Water Framework Directive River Classification in England: Evidence of a Disconnect.

NASA Astrophysics Data System (ADS)

Bentley, S.

2017-12-01

The European Union Water Framework Directive came into force in October 2000 committing European Union member states to achieve Good Ecological Status for all water bodies. By 2015 29% of rivers across England had achieved this level suggesting that these watercourse units are now functioning well. This study utilises recently published land cover data for England clipped to the floodplain boundary as defined by the 100 year return period discharge to examine the state of valley bottom vegetation and function for these Good Status rivers. Agricultural use of floodplain areas is high with cereal and horticulture covering an average of 24% and pasture accounting for some 37% of the area. Maximum values increase to 77% and 92% respectively. In all cases wetland accounts for less than 2% of the floodplain and rough grassland averages 7%. Such significant and widespread alteration to floodplain vegetation character suggests that the ecological functioning of this component of the fluvial system has been severely negatively impacted calling into question the Water Framework Directive status level. This is a fault of the Water Framework Directive process which only explicitly evaluates the hydromorphological component of the fluvial system for high status rivers preferring to infer functioning from biological indicators that are focused on in-channel assessments. The fundamental omission of floodplain condition in the Water Framework Directive process will result in only partial achievement of the original goals of the Directive with the majority of Europe's floodplains remaining in a highly degraded, non-functional state.

Transfer of ipsilateral fibula on vascular pedicle for treatment of congenital pseudarthrosis of the tibia.

PubMed

Tan, Jane S; Roach, James W; Wang, Angela A

2011-01-01

Although the use of free vascularized fibula grafts has frequently been reported in the treatment of congenital pseudarthrosis of the tibia, the use of ipsilateral fibula graft on a vascular pedicle is uncommon. We reviewed the long-term results of this procedure in 11 patients. The records of 11 patients who underwent transfer of the ipsilateral fibula on a vascular pedicle between 2.1 and 10.8 years of age were retrospectively reviewed. Average follow-up was 11 years after the index procedure. Seven patients had reached skeletal maturity. Clinical records and radiographs were reviewed to determine patient demographics, surgical parameters, union rate, refracture rate, residual deformity, and functional outcome. Eight patients (73%) achieved union at an average of 20.1 months. Additional bone grafting procedures were required in 4 patients with distal nonunions. There were 3 refractures (38%). Four patients eventually underwent amputation, and 1 patient had a persistent nonunion at final follow-up. Residual deformity included tibial valgus and procurvatum deformities, limb length discrepancy, and ankle valgus. Use of the ipsilateral fibula did not seem to increase the risk of ankle valgus. Functional outcomes were good in all but one patient. Use of the ipsilateral fibula as a pedicle graft provides reasonable results in healing congenital pseudarthrosis of the tibia. Patients should be monitored for the sequelae of this condition, including nonunion, refracture, shortening, and angular deformity, and treated accordingly. Therapeutic Level IV.

Hygienic Status Assessment of Two Lamb Slaughterhouses in Spain.

PubMed

Alonso-Calleja, Carlos; Guerrero-Ramos, Emilia; Capita, Rosa

2017-07-01

A total of 180 lamb carcasses and 200 inert surfaces were sampled in two commercial abattoirs (plants A and B) from northwest Spain. A higher (P < 0.001) average microbial load (log CFU per square centimeter) on lamb carcasses was observed for total viable counts (TVC; 2.74 ± 1.15) than for Enterobacteriaceae (2.21 ± 1.16). Different microbial counts were found on carcasses from plants A and B, both for TVC (2.56 ± 0.96 versus 3.18 ± 1.47, respectively; P < 0.001) and Enterobacteriaceae (2.09 ± 0.97 versus 2.50 ± 1.61, respectively; P < 0.05). High correlations (P < 0.001) were observed for TVC and Enterobacteriaceae in both plants A (r = 0.708) and B (r = 0.912). The percentages of unsatisfactory daily mean log values for carcasses, according to European Union Regulation (EC) No 2073/2005, were 0.0 (TVC) and 30.8 (Enterobacteriaceae) in plant A and 10.0 (TVC) and 40.0 (Enterobacteriaceae) in plant B. Average counts for inert surfaces were all lower than 10 CFU/cm 2 (TVC) or 1 CFU/cm 2 (Enterobacteriaceae). The need to improve hygienic practices in order to adhere to the European Union microbiological performance criteria is emphasized. The detected different microbial counts between slaughterhouses could be attributed to differences in external hygiene of livestock and in the number of slaughterhouse workers. Microbiological analysis of carcasses and surfaces allows detection of hygienic concerns in the overall process.

Utilization of an ionic liquid in situ preconcentration method for the determination of the 15 + 1 European Union polycyclic aromatic hydrocarbons in drinking water and fruit-tea infusions.

PubMed

Germán-Hernández, Mónica; Crespo-Llabrés, Pilar; Pino, Verónica; Ayala, Juan H; Afonso, Ana M

2013-08-01

An ionic liquid (IL) in situ preconcentration method was optimized and applied to the monitoring of the 15 + 1 European Union polycyclic aromatic hydrocarbons in water and fruit-tea infusions. The optimized method utilizes 10 mL of water (or infusion) containing 38 μL of the IL 1-butyl-3-methylimidazolium chloride and a content of 36.1 g/L NaCl, which are mixed with Li-NTf2 (340 μL, 0.2 g/mL), followed by vortex (4 min) and centrifugation (5 min). The obtained microdroplet containing hydrocarbons is diluted with acetonitrile and injected into an HPLC with UV/Vis and fluorescence detection. The method presented average enrichment factors of 127 for water (tap water and bottled water) and 27 for two fruit-tea infusions; with average relative recoveries of 86.7 and 106% for water and fruit-tea infusions, respectively. The method was sensitive, with detection limits ranging from 0.001 to 0.050 ng/mL in water, and from 0.010 to 0.600 ng/mL in fruit-tea infusions, for the fluorescent hydrocarbons. Real extraction efficiencies ranged from 12.7 to 58.7% for water, and from 20.2 to 117% for the infusions. The method was also fast (~12 min) and free of organic solvents in the extraction step. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A Walking Method for Non-Decomposition Intersection and Union of Arbitrary Polygons and Polyhedrons

DOE Office of Scientific and Technical Information (OSTI.GOV)

Graham, M.; Yao, J.

We present a method for computing the intersection and union of non- convex polyhedrons without decomposition in O(n log n) time, where n is the total number of faces of both polyhedrons. We include an accompanying Python package which addresses many of the practical issues associated with implementation and serves as a proof of concept. The key to the method is that by considering the edges of the original ob- jects and the intersections between faces as walking routes, we can e ciently nd the boundary of the intersection of arbitrary objects using directional walks, thus handling the concave casemore » in a natural manner. The method also easily extends to plane slicing and non-convex polyhedron unions, and both the polyhedron and its constituent faces may be non-convex.« less

Correcting Part-Time Misconceptions. Policy Watch.

ERIC Educational Resources Information Center

Employment Policies Inst., Washington, DC.

In the past few years, union activists and some policymakers have increasingly portrayed part-time work as problematic for a worker. According to statistics compiled by the Bureau of Labor Statistics, the part-time "problem" is more rhetoric than reality. Only 17% of U.S. workers are classified as part-time. Of those 17%, 15% are…

Adolescent adaptation before, during and in the aftermath of the Great Recession in the USA.

PubMed

Johnson, Monica Kirkpatrick; Staff, Jeremy; Patrick, Megan E; Schulenberg, John E

2017-02-01

This study examines the impact of the "Great Recession" (from December 2007 to June 2009) on 8th and 10th graders in the USA, using annual nationally representative data from the Monitoring the Future study. Historical changes in youth adjustment (self-esteem, depressed mood, risk taking, aggression and property crime), school achievement (grade point average [GPA], time spent on homework and educational expectations) and structured and unstructured activities (volunteering, employment, sports and evenings out for fun) were examined between 1991 and 2014. Overall, there were only slight changes in mean levels of adjustment, achievement and most youth activities. However, the percentage of youth working during the school year did decline during the Great Recession. Several longer-term trends were also evident, though not directly tied to the Great Recession. These include an increase in GPA, a decrease in time spent on homework, rising educational expectations and more time spent volunteering. Future work should assess how the shift to unpaid work activities (e.g. volunteering and internships) among youth is impacting the transition from school to work in the contemporary economy, and whether the Great Recession had deleterious impacts for younger children or among youth whose parents lost work or had their homes foreclosed. © 2016 International Union of Psychological Science.

The new concept of the monitoring and appraisal of bone union inflexibility of fractures treated by Dynastab DK external fixator.

PubMed

Lenz, Gerhard P; Stasiak, Andrzej; Deszczyński, Jarosław; Karpiński, Janusz; Stolarczyk, Artur; Ziółkowski, Marcin; Szczesny, Grzegorz

2003-10-30

Background. This work focuses on problems of heuristic techniques based on artificial intelligence. Mainly about artificial non-linear and multilayer neurons, which were used to estimate the bone union fractures treatment process using orthopaedic stabilizers Dynastab DK. Material and methods. The author utilizes computer software based on multilayer neuronal network systems, which allows to predict the curve of the bone union at early stages of therapy. The training of the neural net has been made on fifty six cases of bone fracture which has been cured by the Dynastab stabilizers DK. Using such trained net, seventeen fractures of long bones shafts were being examined on strength and prediction of the bone union as well. Results. Analyzing results, it should be underlined that mechanical properties of the bone union in the slot of fracture are changing in nonlinear way in function of time. Especially, major changes were observed during the forth month of the fracture treatment. There is strong correlation between measure number two and measure number six. Measure number two is more strict and in the matter of fact it refers to flexion, as well as the measure number six, to compression of the bone in the fracture slot. Conclusions. Consequently, deflection loads are especially hazardous for healing bone. The very strong correlation between real curves and predicted curves shows the correctness of the neuronal model.

V-TIME. A New Way to Work. A Resource Manual for Employers and Employees.

ERIC Educational Resources Information Center

Moorman, Barbara; Olmsted, Barney

This manual for managers, supervisors, and union representatives presents information on how to implement a comprehensive program of voluntary reduced work time (V-Time) options for employees. (V-Time allows full-time employees to reduce work hours temporarily while retaining benefits.) It reports mainly the experiences of two counties and two…

Prevalence of poor sleep quality, sleepiness and obstructive sleep apnoea risk factors in athletes.

PubMed

Swinbourne, Richard; Gill, Nicholas; Vaile, Joanna; Smart, Daniel

2016-10-01

Despite the perceived importance of sleep for athletes, little is known regarding athlete sleep quality, their prevalence of daytime sleepiness or risk factors for obstructive sleep apnoea (OSA) such as snoring and witnessed apnoeic episodes. The purpose of the present study was to characterise normative sleep quality among highly trained team sport athletes. 175 elite or highly trained rugby sevens, rugby union and cricket athletes completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Score (ESS) and Quality of Life questionnaires and an OSA risk factor screen. On average, athletes reported 7.9 ± 1.3 h of sleep per night. The average PSQI score was 5.9 ± 2.6, and 50% of athletes were found to be poor sleepers (PSQI > 5). Daytime sleepiness was prevalent throughout the population (average global score of 8.5) and clinically significant (ESS score of ≥10) in 28% of athletes. OSA may be an important clinical consideration within athletic populations, as a considerable number of athletes (38%) defined themselves as snorers and 8% reported having a witnessed apnoeic episode. The relationship between self-rated sleep quality and actual PSQI score was strong (Pearson correlation of 0.4 ± 0.1, 90% confidence limits). These findings suggest that this cohort of team sport athletes suffer a preponderance of poor sleep quality, with associated high levels of daytime sleepiness. Athletes should receive education about how to improve sleep wake schedules, extend total sleep time and improve sleep quality.

Early results for treatment of two- and three-part fractures of the proximal humerus using Contours PHP (proximal humeral plate).

PubMed

Biazzo, Alessio; Cardile, Carlo; Brunelli, Luca; Ragni, Paolo; Clementi, Daniele

2017-04-28

The management of displaced 2- and 3-part fractures of the proximal humerus is controversial, both in younger and in elderly patients. The purpose of this paper is to evaluate the functional results of the Contours Proximal Humerus Plate (OrthofixR, Bussolengo,Verona, Italy), for the treatment of displaced 2- and 3-part fractures of the proximal humerus. We retrospectively reviewed 55 patients with proximal humerus fractures, who underwent osteosynthesis with Contours Proximal Humerus Plate from December 2011 to March 2015. We had 21 patients with 2-part fractures and with an average age of 67.1 years and 34 patients with 3-part fractures, with average age of 63.6 years. The average union time was 3 months. The mean Constant score was 67 for 2-part fracture group and 64.9 for 3-part fracture group. The difference was not statistically significant (p = 0.18). The overall complication rate was 14.5 %. Six patients underwent additional surgery (10.9%). The most frequent major complication was secondary loss of reduction following varus collapse of the fracture (2 cases). In these patients, there was loss of medial hinge integrity due to impaction and osteoporosis. The placement of the main locking screw in the calcar area to provide inferomedial support is the rational of the Contours Proximal Humerus Plate. Osteosynthesis with Contours Proximal Humerus Plate is a safe system for treating displaced 2- and 3-part fractures of the proximal humerus, with good functional results and complication rates comparable to those reported in the literature.

Does anonymous sperm donation increase the risk for unions between relatives and the incidence of autosomal recessive diseases due to consanguinity?

PubMed

Serre, Jean-Louis; Leutenegger, Anne-Louise; Bernheim, Alain; Fellous, Marc; Rouen, Alexandre; Siffroi, Jean-Pierre

2014-03-01

In France gamete donation and notably sperm donation are anonymous. It has been claimed that anonymous artificial insemination by donor (AID) could highly contribute to an increase in the level of consanguinity and the incidence of autosomal recessive diseases, due to the unions between offspring of anonymous donors, unaware of their biological kinship, with the special case of unions between half-siblings. The actual incidence of consanguinity due to AID was compared with that resulting from the two other main sources of consanguinity and recessive diseases, i.e. voluntary unions between related individuals or inadvertent unions between the offspring of a common unknown male ancestor (false paternity). From these data, we estimated that expected unions in France between half sibs per year are 0.12 between offspring of sperm donors (1.2 every 10 years) and 0.5 between offspring of common male ancestors through false paternity (5 every 10 years). More generally, the inadvertent unions between false paternity offspring are roughly four times more frequent than those resulting from anonymous AID. We estimated that in the future, when AID has been in practice for several generations, out the 820 000 annual births in France, respectively, 6 and 25 births will be consanguineous through an unknown common ancestor related to anonymous AID and to a false paternity, both of which are negligible when compared with the 1256 children born from first-degree cousins. About 672 children per year are born with a recessive genetic disease due to the panmictic risk and additional affected cases due to consanguinity would be 34.54 for first-cousin offspring, 0.33 for offspring of individuals related due to false paternity and 0.079 for offspring of individuals related due to anonymous AID. Anonymous AID would therefore be responsible for 0.46% of consanguineous births and for 0.01% of recessive diseases. Therefore, the effect of anonymous AID on half-sibling unions, consanguinity and recessive disease incidence can be regarded as marginal.

The effects of marriage and separation on the psychotropic medication use of non-married cohabiters: a register-based longitudinal study among adult Finns.

PubMed

Metsä-Simola, Niina; Martikainen, Pekka

2014-11-01

Non-marital cohabitation has become increasingly common and is suggested to offer similar mental-health benefits as marriage does. We studied levels and changes in cohabiters' mental health five years before and five years after entering into marriage or separating, and compared long-term non-married and married cohabiters. We analysed changes in the three-month prevalence of psychotropic medication use (psycholeptics and psychoanaleptics, excluding medication for dementia) by proximity to non-marital transition and gender, using register data on 189,394 Finns aged 25 to 64. Similar levels of psychotropic-medication use were found among individuals in long unions that continued throughout the follow-up and were non-marital, marital, or changed from non-marital to marital. Among men and women who separated from longer cohabiting unions of more than five years, however, an increase in medication prevalence was observed immediately before separation, followed by a similar decline after separation. At the time of separation the level of medication use was 9.9 per cent (95% CI = 8.7 - 11.3) among men and 15.7 per cent (95% CI = 14.2 - 17.4) among women compared to 4.3 per cent (95% CI = 3.7 - 5.0) and 8.0 per cent (95% CI = 7.2 - 9.0), respectively, among those who cohabited continuously. No changes in medication use were observed before or after separation among those leaving shorter cohabiting unions of less than five years. Among those marrying following shorter cohabiting unions a positive effect of approaching marriage was observed only among women. Compared to continuous cohabiters, the level of medication use was higher among men and women separating from both short-term and long-term cohabiting unions five years before separation. This selective effect suggests that cohabiters with mental-health problems might benefit from relationship counselling. In a long-term stable union it seems to matter little for mental health whether the union is marital or non-marital, the break-up of a long-term non-marital union being strongly associated with adverse mental-health effects. Copyright © 2014 Elsevier Ltd. All rights reserved.

75 FR 57820 - National Credit Union Administration Restoration Plan

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-22

... NATIONAL CREDIT UNION ADMINISTRATION National Credit Union Administration Restoration Plan AGENCY: National Credit Union Administration (NCUA). ACTION: Approval of National Credit Union Administration restoration plan. On September 16, 2010, the National Credit Union Administration (NCUA) implemented a...

Peak power in the hexagonal barbell jump squat and its relationship to jump performance and acceleration in elite rugby union players.

PubMed

Turner, Thomas S; Tobin, Daniel P; Delahunt, Eamonn

2015-05-01

Recent research suggests that jump squats with a loaded hexagonal barbell are superior for peak power production to comparable loads in a traditional barbell loaded jump squat. The aim of this study was to investigate the relationship between relative peak power output during performance of the hexagonal barbell jump squat (HBJS), countermovement jump (CMJ) height, and linear acceleration speed in rugby union players. Seventeen professional rugby union players performed 10- and 20-m sprints, followed by a set of 3 unloaded CMJs and a set of 3 HBJS at a previously determined optimal load corresponding with peak power output. The relationship between HBJS relative peak power output, 10- and 20-m sprint time, and CMJ height was investigated using correlation analysis. The contribution of HBJS relative peak power output and CMJ height to 10- and 20-m sprint time was investigated using standard multiple regression. Strong, significant, inverse correlations were observed between HBJS relative peak power output, 10-m sprint time (r = -0.70, p < 0.01), and 20-m sprint time (r = -0.75, p < 0.01). A strong, significant, positive correlation was observed between HBJS relative peak power output and CMJ height (r = 0.80, p < 0.01). Together, HBJS relative peak power output and CMJ height explained 46% of the variance in 10-m sprint time while explaining 59% of the variance in 20-m sprint time. The findings of the current study demonstrate a significant relationship between relative peak power in the HBJS and athletic performance as quantified by CMJ height and 10- and 20-m sprint time.

A novel approach for direct estimation of fresh groundwater discharge to an estuary

USGS Publications Warehouse

Ganju, Neil K.

2011-01-01

Coastal groundwater discharge is an important source of freshwater and nutrients to coastal and estuarine systems. Directly quantifying the spatially integrated discharge of fresh groundwater over a coastline is difficult due to spatial variability and limited observational methods. In this study, I applied a novel approach to estimate net freshwater discharge from a groundwater-fed tidal creek over a spring-neap cycle, with high temporal resolution. Acoustic velocity instruments measured tidal water fluxes while other sensors measured vertical and lateral salinity to estimate cross-sectionally averaged salinity. These measurements were used in a time-dependent version of Knudsen's salt balance calculation to estimate the fresh groundwater contribution to the tidal creek. The time-series of fresh groundwater discharge shows the dependence of fresh groundwater discharge on tidal pumping, and the large difference between monthly mean discharge and instantaneous discharge over shorter timescales. The approach developed here can be implemented over timescales from days to years, in any size estuary with dominant groundwater inputs and well-defined cross-sections. The approach also directly links delivery of groundwater from the watershed with fluxes to the coastal environment. Copyright. Published in 2011 by the American Geophysical Union.

Urbanization and Fertility: An Event-History Analysis of Coastal Ghana

PubMed Central

WHITE, MICHAEL J.; MUHIDIN, SALUT; ANDRZEJEWSKI, CATHERINE; TAGOE, EVA; KNIGHT, RODNEY; REED, HOLLY

2008-01-01

In this article, we undertake an event-history analysis of fertility in Ghana. We exploit detailed life history calendar data to conduct a more refined and definitive analysis of the relationship among personal traits, urban residence, and fertility. Although urbanization is generally associated with lower fertility in developing countries, inferences in most studies have been hampered by a lack of information about the timing of residence in relationship to childbearing. We find that the effect of urbanization itself is strong, evident, and complex, and persists after we control for the effects of age, cohort, union status, and education. Our discrete-time event-history analysis shows that urban women exhibit fertility rates that are, on average, 11% lower than those of rural women, but the effects vary by parity. Differences in urban population traits would augment the effects of urban adaptation itself. Extensions of the analysis point to the operation of a selection effect in rural-to-urban mobility but provide limited evidence for disruption effects. The possibility of further selection of urbanward migrants on unmeasured traits remains. The analysis also demonstrates the utility of an annual life history calendar for collecting such data in the field. PMID:19110898

Determination of selected non-authorized insecticides in peppers by liquid chromatography time-of-flight mass spectrometry and tandem mass spectrometry.

PubMed

Mezcua, Milagros; Ferrer, Carmen; García-Reyes, Juan F; Martínez-Bueno, María Jesús; Albarracín, Micaela; Claret, María; Fernández-Alba, Amadeo R

2008-05-01

In this work, two analytical methods based on liquid chromatography coupled to electrospray time-of-flight mass spectrometry (LC/ESI-TOFMS) and tandem mass spectrometry (LC/ESI-MS/MS) are described for the identification, confirmation and quantitation of three insecticides non-authorized in the European Union (nitenpyram, isocarbophos and isofenphos-methyl) but detected in recent monitoring programmes in pepper samples. The proposed methodologies involved a sample extraction procedure using liquid-liquid partition with acetonitrile followed by a cleanup step based on dispersive solid-phase extraction. Recovery studies performed on peppers spiked at different fortification levels (10 and 50 microg kg(-1)) yielded average recoveries in the range 76-100% with relative standard deviation (RSD) (%) values below 10%. Identification, confirmation and quantitation were carried out by LC/TOFMS and LC/MS/MS using a hybrid triple quadrupole linear ion trap (QqLIT) instrument in multiple-reaction monitoring (MRM) mode. The obtained limits of quantitation (LOQs) were in the range 0.1-5 microg kg(-1), depending on each individual technique. Finally, the proposed methods were successfully applied to the analysis of suspected pepper samples. Copyright (c) 2008 John Wiley & Sons, Ltd.

Vascularised free fibular flap in bone resection and reconstruction.

PubMed

Belt, P J; Dickinson, I C; Theile, D R B

2005-06-01

This paper compares allograft alone and in combination with vascularised free fibular flaps (FFF) to reconstruct long bone defects after tumour excision. We present 33 cases, 21 of these patients had reconstruction with an allograft alone as the initial procedure. Nine patients underwent reconstruction with FFF plus allograft plus iliac crest bone graft (ICG), two patients underwent reconstruction with a FFF and ICG and one patient underwent reconstruction with an allograft, a pedicled fibular flap and a FFF. The allograft was obtained from the Queensland Bone Bank and had been irradiated to 25 000Gy. In our experience (N=21) the complication rates with allograft alone were: delayed union 3, nonunion 7, fractured allograft 6, infection requiring resection of the allograft 3, other infections 2. The revision rate was 48% (10 cases of which five required a free fibular flap) and an average of 1.8 revision procedures were required. In the lower limb cases, the mean time to full weightbearing was 20 months and 40% were full weightbearing at 18 months. We felt that the high complication rate compared with other series may have been related to the irradiation of the graft. FFFs were used in 18 cases, 12 cases were primary reconstructions and six were revision reconstructions. The mean fibular length was 19.4 cm (range 10-29 cm). There were no flap losses and the FFF united at both ends of 11 of 12 primary reconstruction cases. One case had nonunion at one end, giving a union rate of 96% (23 of 24 junctions). When a FFF was used in combination with an allograft as a primary reconstruction, the allograft nonunion rate was 50% (five of 10 cases). The mean time to full weightbearing in the lower limb cases was 7.5 months and 100% were full weightbearing at 18 months. The FFF hastens time to full weightbearing but does not appear to affect the complication rates of allograft. The number of revision procedures required is reduced in the presence of a FFF and is the latter is a useful technique for the salvage of refractory cases.

International Power Institute`s quarterly technical progress report, July--September 1998

DOE Office of Scientific and Technical Information (OSTI.GOV)

Coles, J.E.

1998-10-30

The International Power Institute (IPI) at Morehouse College has organized a team to design and create a Short Term Training Program for ESKOM Union Leaders which will last four weeks and take place at a location in South Africa to be designated by ESKOM. This proposal envisions a group of no more than 25 union leaders to be trained at the same time but the program could be expanded to accommodate up to 40 trainees. The program is designed around interactive training with lectures followed by discussion, case studies, trainee work groups, homework assignments and two field study visits. Also,more » the program is designed to have a number of ESKOM management people join the course for one day in the second week and one day at the end, in each case after a half day of preparation in separate sessions from the union leaders, to share with the trainees expectations and, at the end of the program, their course experiences. In addition, IPI has prepared a follow on proposal for a Long Term Training Program. This LT program is specified in less detail but can be expanded based on future discussions with ESKOM management. The training program is designed with the following objectives: determine and identify the most pressing problems facing ESKOM Union Leadership in their relationship with management; instill in the union leadership a heightened sense of purpose and willingness to take ownership of a process that will increase effective outcomes of meaningful, good faith bargaining; develop skills and experience leading to improved union administration; enhance realistic expectations and improve process knowledge to facilitate future labor negotiations and grievance proceedings; and provide participants with enhanced skills and knowledge to develop and/or strengthen a functioning, democratic work culture and structure internal to the union.« less

Reduction in undiagnosed HIV infection in the European Union/European Economic Area, 2012 to 2016.

PubMed

van Sighem, Ard; Pharris, Anastasia; Quinten, Chantal; Noori, Teymur; Amato-Gauci, Andrew J

2017-11-01

It is well-documented that early HIV diagnosis and linkage to care reduces morbidity and mortality as well as HIV transmission. We estimated the median time from HIV infection to diagnosis in the European Union/European Economic Area (EU/EEA) at 2.9 years in 2016, with regional variation. Despite evidence of a decline in the number of people living with undiagnosed HIV in the EU/EEA, many remain undiagnosed, including 33% with more advanced HIV infection (CD4 < 350 cells/mm3).

Reduction in undiagnosed HIV infection in the European Union/European Economic Area, 2012 to 2016

PubMed Central

van Sighem, Ard; Pharris, Anastasia; Quinten, Chantal; Noori, Teymur; Amato-Gauci, Andrew J

2017-01-01

It is well-documented that early HIV diagnosis and linkage to care reduces morbidity and mortality as well as HIV transmission. We estimated the median time from HIV infection to diagnosis in the European Union/European Economic Area (EU/EEA) at 2.9 years in 2016, with regional variation. Despite evidence of a decline in the number of people living with undiagnosed HIV in the EU/EEA, many remain undiagnosed, including 33% with more advanced HIV infection (CD4 < 350 cells/mm3). PMID:29208159

Management of tibial non-unions according to a novel treatment algorithm.

PubMed

Ferreira, Nando; Marais, Leonard Charles

2015-12-01

Tibial non-unions represent a spectrum of conditions that are challenging to treat. The optimal management remains unclear despite the frequency with which these diagnoses are encountered. The aim of this study was to determine the outcome of tibial non-unions managed according to a novel tibial non-union treatment algorithm. One hundred and eighteen consecutive patients with 122 uninfected tibial non-unions were treated according to our proposed tibial non-union treatment algorithm. All patients were followed-up clinically and radiologically for a minimum of six months after external fixator removal. Four patients were excluded because they did not complete the intended treatment process. The final study population consisted of 94 men and 24 women with a mean age of 34 years. Sixty-seven non-unions were stiff hypertrophic, 32 mobile atrophic, 16 mobile oligotrophic and one true pseudoarthrosis. Six non-unions were classified as type B1 defect non-unions. Bony union was achieved after the initial surgery in 113/122 (92.6%) tibias. Nine patients had failure of treatment. Seven persistent non-unions were successfully retreated according to the tibial non-union treatment algorithm. This resulted in final bony union in 120/122 (98.3%) tibias. The proposed tibial non-union treatment algorithm appears to produce high union rates across a diverse group of tibial non-unions. Tibial non-unions however, remain difficult to treat and should be referred to specialist units where advanced reconstructive techniques are practiced on a regular basis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Benchmarking Helps Measure Union Programs, Operations.

ERIC Educational Resources Information Center

Mann, Jerry

2001-01-01

Explores three examples of benchmarking by college student unions. Focuses on how a union can collect information from other unions for use as benchmarking standards for the purposes of selling a concept or justifying program increases, or for comparing a union's financial performance to other unions. (EV)

Risk of Cardiovascular Hospitalizations from Exposure to Coarse Particulate Matter (PM10) Below the European Union Safety Threshold.

PubMed

Vaduganathan, Muthiah; De Palma, Giuseppe; Manerba, Alessandra; Goldoni, Matteo; Triggiani, Marco; Apostoli, Pietro; Dei Cas, Livio; Nodari, Savina

2016-04-15

The association between exposure to air pollution and acute cardiovascular (CV) events is well documented; however, limited data are available evaluating the public health safety of various "doses" of particular matter (PM) below currently accepted safety thresholds. We explored the cross-sectional association between PM with aerodynamic diameter <10 μm (PM10) and daily CV hospitalizations in Brescia, Italy, using Poisson regression models adjusted for age, gender, and meteorologic indices. Average daily exposure to PM10 obtained from arithmetic means of air pollution data were captured by 4 selected monitoring stations. PM10 data were expressed as daily means (lag 0-day) or 3-day moving averages (lag 3-day) and categorized according to the European Union daily limit value of 50 μg/m(3). From September 2004 to September 2007, data from 6,000 acute CV admissions to a tertiary referral center were collected. An increase of 1 μg/m(3) PM10 at lag 0-day was independently associated with higher rates of acute hospitalizations for composite CV-related events (relative risk [RR] 1.004, 95% confidence interval [CI] 1.002 to 1.006), acute heart failure (RR 1.004, 95% CI 1.001 to 1.008), acute coronary syndromes (RR 1.002, 95% CI 0.999 to 1.005), malignant ventricular arrhythmias (RR 1.004, 95% CI 0.999 to 1.010), and atrial fibrillation (RR 1.008, 95% CI 1.003 to 1.012). Similar results were obtained using PM10 lag 3-day data. The excess PM10 CV hospitalization risk (by lag 0-day and lag 3-day) did not vary significantly above and below the 50 μg/m(3) safety threshold or by age and gender. In conclusion, increased levels of PM10, even below the current limits set by the European Union, were associated with excess risk for admissions for acute CV events. Copyright © 2016 Elsevier Inc. All rights reserved.

[Coral as support of traumatic articular compression. A prospective study of 23 cases involving the lower limb].

PubMed

de Peretti, F; Trojani, C; Cambas, P M; Loubière, R; Argenson, C

1996-01-01

Infection risk makes the management of a bone bank more and more difficult. On the other hand, realizing an autologous graft is not always without consequences. That is why we estimated the mechanical quality, the osteo-integration and the biocompatability of a coral graft. Between 1988 and 1992, two of us systematically used coral graft as "support" after lifting of some articular depression in fractures of inferior limb. Osteosynthesis was systematically associated. In this way, we operated 13 fractures of the lateral tibial plateau, 8 thalamic fractures of the calcaneus and 2 fractures of the inferior extremity of the tibia. Average follow-up is 20 months, with extremes of 68 and 12 months. Material ablation was realized 13 times and coral graft biopsy 4 times. Bone integration was estimated radiologically in 3 stages: stage 1: non union = "margin" around the coral, stage 2: possible integration = the coral is perfectly visible, but its borders grow indistinct, stage 3: certain integration = peripheral disparition of the coral weft, radiological interpenetration between coral and bone framework. We systematically searched for secondary displacements and complications. Mechanical conditions were respected, there was no secondary displacement. "Possible integration" (stage 2) was found in 8 cases at an average follow-up of 20 months. In 9 cases, we found "certain integration" (stage 3), at an average follow-up of 28 months. It is possible that a more important follow-up time would allow to find more integration cases. Biocompatibility is debatable under the operating conditions of the authors. We counted 5 aseptic serous flows which continued to be aseptic (1 tibial plateau, 1 inferior extremity of the tibia, 3 calcaneum). Three coral grafts were removed to obtain healing. When biocompatibility is satisfactory the integration is certain. The longer the follow-up time, the more stage 3 cases can be observed. Nevertheless, this integration runs out with time. We did not find any explication to aseptic serous flows. It may result from some impurities. On the other hand, use of the coralin hydroxyapatite does not seem to drive to allergic complications. In accordance with this study, we use the coral graft only in case of tibial plateau fracture. Our experience with coral graft in the other fields of bone surgery is not sufficient to express an opinion.

Rainfall erosivity in Europe.

PubMed

Panagos, Panos; Ballabio, Cristiano; Borrelli, Pasquale; Meusburger, Katrin; Klik, Andreas; Rousseva, Svetla; Tadić, Melita Perčec; Michaelides, Silas; Hrabalíková, Michaela; Olsen, Preben; Aalto, Juha; Lakatos, Mónika; Rymszewicz, Anna; Dumitrescu, Alexandru; Beguería, Santiago; Alewell, Christine

2015-04-01

Rainfall is one the main drivers of soil erosion. The erosive force of rainfall is expressed as rainfall erosivity. Rainfall erosivity considers the rainfall amount and intensity, and is most commonly expressed as the R-factor in the USLE model and its revised version, RUSLE. At national and continental levels, the scarce availability of data obliges soil erosion modellers to estimate this factor based on rainfall data with only low temporal resolution (daily, monthly, annual averages). The purpose of this study is to assess rainfall erosivity in Europe in the form of the RUSLE R-factor, based on the best available datasets. Data have been collected from 1541 precipitation stations in all European Union (EU) Member States and Switzerland, with temporal resolutions of 5 to 60 min. The R-factor values calculated from precipitation data of different temporal resolutions were normalised to R-factor values with temporal resolutions of 30 min using linear regression functions. Precipitation time series ranged from a minimum of 5 years to a maximum of 40 years. The average time series per precipitation station is around 17.1 years, the most datasets including the first decade of the 21st century. Gaussian Process Regression (GPR) has been used to interpolate the R-factor station values to a European rainfall erosivity map at 1 km resolution. The covariates used for the R-factor interpolation were climatic data (total precipitation, seasonal precipitation, precipitation of driest/wettest months, average temperature), elevation and latitude/longitude. The mean R-factor for the EU plus Switzerland is 722 MJ mm ha(-1) h(-1) yr(-1), with the highest values (>1000 MJ mm ha(-1) h(-1) yr(-1)) in the Mediterranean and alpine regions and the lowest (<500 MJ mm ha(-1) h(-1) yr(-1)) in the Nordic countries. The erosivity density (erosivity normalised to annual precipitation amounts) was also the highest in Mediterranean regions which implies high risk for erosive events and floods. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Viscoelastic shear zone model of a strike-slip earthquake cycle

USGS Publications Warehouse

Pollitz, F.F.

2001-01-01

I examine the behavior of a two-dimensional (2-D) strike-slip fault system embedded in a 1-D elastic layer (schizosphere) overlying a uniform viscoelastic half-space (plastosphere) and within the boundaries of a finite width shear zone. The viscoelastic coupling model of Savage and Prescott [1978] considers the viscoelastic response of this system, in the absence of the shear zone boundaries, to an earthquake occurring within the upper elastic layer, steady slip beneath a prescribed depth, and the superposition of the responses of multiple earthquakes with characteristic slip occurring at regular intervals. So formulated, the viscoelastic coupling model predicts that sufficiently long after initiation of the system, (1) average fault-parallel velocity at any point is the average slip rate of that side of the fault and (2) far-field velocities equal the same constant rate. Because of the sensitivity to the mechanical properties of the schizosphere-plastosphere system (i.e., elastic layer thickness, plastosphere viscosity), this model has been used to infer such properties from measurements of interseismic velocity. Such inferences exploit the predicted behavior at a known time within the earthquake cycle. By modifying the viscoelastic coupling model to satisfy the additional constraint that the absolute velocity at prescribed shear zone boundaries is constant, I find that even though the time-averaged behavior remains the same, the spatiotemporal pattern of surface deformation (particularly its temporal variation within an earthquake cycle) is markedly different from that predicted by the conventional viscoelastic coupling model. These differences are magnified as plastosphere viscosity is reduced or as the recurrence interval of periodic earthquakes is lengthened. Application to the interseismic velocity field along the Mojave section of the San Andreas fault suggests that the region behaves mechanically like a ???600-km-wide shear zone accommodating 50 mm/yr fault-parallel motion distributed between the San Andreas fault system and Eastern California Shear Zone. Copyright 2001 by the American Geophysical Union.

Temporal Changes in the Observed Relationship between Cloud Cover and Surface Air Temperature.

NASA Astrophysics Data System (ADS)

Sun, Bomin; Groisman, Pavel Ya.; Bradley, Raymond S.; Keimig, Frank T.

2000-12-01

The relationship between cloud cover and near-surface air temperature and its decadal changes are examined using the hourly synoptic data for the past four to six decades from five regions of the Northern Hemisphere: Canada, the United States, the former Soviet Union, China, and tropical islands of the western Pacific. The authors define the normalized cloud cover-surface air temperature relationship, NOCET or dT/dCL, as a temperature anomaly with a unit (one-tenth) deviation of total cloud cover from its average value. Then mean monthly NOCET time series (night- and daytime, separately) are area-averaged and parameterized as functions of surface air humidity and snow cover. The day- and nighttime NOCET variations are strongly anticorrelated with changes in surface humidity. Furthermore, the daytime NOCET changes are positively correlated to changes in snow cover extent. The regionally averaged nighttime NOCET varies from 0.05 K tenth1 in the wet Tropics to 1.0 K tenth1 at midlatitudes in winter. The daytime regional NOCET ranges from 0.4 K tenth1 in the Tropics to 0.7 K tenth1 at midlatitudes in winter.The authors found a general strengthening of a daytime surface cooling during the post-World War II period associated with cloud cover over the United States and China, but a minor reduction of this cooling in higher latitudes. Furthermore, since the 1970s, a prominent increase in atmospheric humidity has significantly weakened the effectiveness of the surface warming (best seen at nighttime) associated with cloud cover.The authors apportion the spatiotemporal field of interactions between total cloud cover and surface air temperature into a bivariate relationship (described by two equations, one for daytime and one for nighttime) with surface air humidity and snow cover and two constant factors. These factors are invariant in space and time domains. It is speculated that they may represent empirical estimates of the overall cloud cover effect on the surface air temperature.

Life stage sensitivity of the marine mussel Mytilus edulis to ammonia.

PubMed

Kennedy, Alan J; Lindsay, James H; Biedenbach, James M; Harmon, Ashley R

2017-01-01

Ammonia is an important contaminant to consider in all toxicity tests. It is especially important to consider the impacts of ammonia in test methods that use sensitive water column organisms exposed to sediments or sediment extracts, such as porewater and elutriate toxicity tests. Embryo-larval development toxicity tests, such as the 48-h method using Mytilus mussel species, are particularly sensitive to ammonia. To better understand the effect thresholds across different life stages of these mussels, 6 short-term (48-h) development toxicity tests and 3 21-d toxicity tests with different-sized juvenile mussels were conducted. Two of the juvenile mussel tests involved 21-d continuous chronic exposure to ammonia, whereas the third involved an acute 2-d ammonia exposure, followed by a 19-d recovery period. The embryo-larval development test method (50% effect concentration [EC50] = 0.14-0.18 mg/L un-ionized ammonia) was 2.5 times more sensitive than the juvenile mussel 21-d survival endpoint (50% lethal concentration = 0.39 mg/L un-ionized ammonia) and 2 times more sensitive than the most sensitive sublethal juvenile mussel endpoint (EC50 = 0.26 mg/L un-ionized ammonia). Further, it was found that the juveniles recovered from a 48-h exposure to un-ionized ammonia of up to 1.1 mg/L. The data generated suggest that the embryo development endpoint was sufficiently sensitive to un-ionized ammonia to protect the chronically exposed (21 d) juvenile mussels. Environ Toxicol Chem 2017;36:89-95. Published 2016 Wiley Periodicals Inc. on behalf of SETAC. This article is a US government work and, as such, is in the public domain in the United States of America. Published 2016 Wiley Periodicals Inc. on behalf of SETAC. This article is a US government work and, as such, is in the public domain in the United States of America.

Nurses' shop stewards and their collaboration with management.

PubMed

Hjalager, Anne-Mette; Lassen, Morten; Bilo, Tage

2009-01-01

This study investigates the collaboration between Danish nurses' shop stewai-ds and workplace management. The aim of the study is to track changes in workplace climate after a major structural reform of the health sector. The data source for the study is a comprehensive survey among union representatives in the health and care sectors. Generally, and not surprisingly, shops stewards maintain closer relations and a higher degree of loyalty to the nearest managers rather than management at higher levels in the hierarchy. It can also be demonstrated that more experienced shop stewards, those who have been employed in this position and in the workplace for the longest terms have more affirmative relations to management than less experienced shop stewards with shorter tenure. Those shop stewards who spend much time on the entitled duties are rewarded with positive collaboration with management. Hard times at the workplace and dissatisfied colleagues, who do not support their union representative, often result in less rewarding relations with management. Quite unexpectedly, the intensity of relations with management is not significantly related to structural or other changes that the workplace has experienced over the past two years. Changes are therefore accepted as inevitable and regular occurrences in the health sector. The response rate is very high in the survey. Further qualitative research may reveal details about the background and implications. PRACTICAL IMPLICATION: The study suggests that many shop stewards may suffer from a competence gap in terms of more advanced new public management strategies and tools. This gap has not yet been successfully filled by the services and training activities offered by the Danish Nurses Union. Results from the study are being taken on board in the union's strategies. The evidence is also helpful for the managers in the health sector, as they are seeking to develop a constructive the collaboration with the unions.

Balancing work and family in the low-wage service sector: the role of legislated and collectively-bargained norms in Quebec.

PubMed

Bernstein, Stéphanie

2011-01-01

This paper looks at the role of legislated norms of general application in shaping "family-friendly" workplaces and their interaction with collectively-bargained standards in the retail service sector and more specifically, in a single unionized retail sector in Quebec, Canada. The methodology used is traditional legal research methodology: analysis of laws, collective agreements and case law. The principal norms examined concern parental and family leave, working time and disparities between different employment statuses. A series of legislative provisions have been adopted in Quebec over the last 30 years whose objectives are the improvement of family-related leave and the reduction of working time. Unions have also negotiated provisions in collective agreements with these same goals. In the low-wage retail sector studied, the working time standards negotiated between the unions and the employers reflect the characteristics of the sector, most notably extended opening hours, seven days a week. Predictability of hours also varies according to employment status. Such issues as family-unfriendly working time arrangements (last-minute scheduling, asocial hours, etc.) and the need for flexibility in family-related leave are insufficiently taken into account by the legislated and bargained provisions. A fine analysis and comprehension of existing formal regulation, be it legislated or collectively-bargained, is required to fully understand workers' experiences with work-family balance and to identify the gaps between formal norms and the needs expressed by workers with respect to work-family balance.

Acceptability of domestic violence against women in the European Union: a multilevel analysis.

PubMed

Gracia, Enrique; Herrero, Juan

2006-02-01

The acceptability of domestic violence against women (DVAW) plays an important part in shaping the social environment in which the victims are embedded, which in turn may contribute either to perpetuate or to reduce the levels of DVAW in our societies. This study analyses correlates of the acceptability of DVAW in the European Union (EU). Three level ordinal logistic regression of 13 457 people nested within 212 localities (cities), nested within 15 countries of the EU. Sampling is multistage with random probability. All interviews were face to face in people's homes. The outcome variable was acceptability of DVAW. Multiple correlates at the individual, locality, and country level were analysed. European Union, 1999. National data were used of residents 15 years old and above of all member states in 1999 (n = 13 457). Average response rate was 47%, although it varied across countries (23%-73%). Higher levels of acceptability were reported by those who perceived DVAW as less severe and less frequent. Acceptability is higher among men who know a perpetrator and lower among men who know a victim. Victim blaming attitude is associated with higher levels of acceptability. In countries with higher gender empowerment measure the difference in acceptability among those who blame and those who do not blame the victim is greater. There are still widespread attitudes in the EU such as victim blaming that condone DVAW, contributing to a climate of social acceptability of DVAW. Further efforts to reduce the acceptability of DVAW are still needed.

Arthroscopic partial wrist fusion.

PubMed

Ho, Pak-Cheong

2008-12-01

The wide intraarticular exposure of the wrist joint under arthroscopic view provides an excellent ground for various forms of partial wrist fusion. Combining with percutaneous fixation technique, arthroscopic partial wrist fusion can potentially generate the best possible functional outcome by preserving the maximal motion pertained with each type of partial wrist fusion because the effect of extraarticular adhesion associated with open surgery can be minimized. From November 1997 to May 2008, the author had performed 12 cases of arthroscopic partial wrist fusion, including scaphotrapeziotrapezoid fusion in 3, scaphoidectomy and 4-corner fusion in 4, radioscapholunate fusion in 3, radiolunate fusion in 1, and lunotriquetral fusion in 1 case. Through the radiocarpal or midcarpal joint, the corresponding articular surfaces were denuded of cartilage using arthroscopic burr and curette. Carpal bones involved in the fusion process were then transfixed with K wires percutaneously after alignment corrected and confirmed under fluoroscopic control. Autogenous cancellous bone graft or bone substitute were inserted and impacted to the fusion site through cannula under direct arthroscopic view. Final fixation could be by multiple K wires or cannulated screw system. Early mobilization was encouraged. Surgical complications were minor, including pin tract infection, skin burn, and delay union in 1 case. Uneventful radiologic union was obtained in 9 cases, stable fibrous union in 2, and nonunion in 1. The average follow-up period was 70 months. Symptom was resolved or improved, and functional motion was gained in all cases. All surgical scars were almost invisible, and aesthetic outcome was excellent.

Cancer research performance in the European Union: a study of published output from 2000 to 2008.

PubMed

Micheli, Andrea; Di Salvo, Francesca; Lombardo, Claudio; Ugolini, Donatella; Baili, Paolo; A Pierotti, Marco

2011-01-01

Although several studies have assessed cancer research performance in individual European countries, comparisons of European Union (EU27) performance with countries of similar population size are not available. We compared cancer research performance in 2000-2008 between EU27 and 11 countries with over 100 million inhabitants. Performance should not have been affected by the 2007-2009 recession. We examined 143 journals considered oncology journals by Journal Citation Reports, accessing them via Scopus. Publications were attributed to countries using a published counting procedure. For number of publications, the USA held a clear lead in 2006-2008 (yearly averages: 10,293 USA vs 9,962 EU27), whereas the EU27 held the lead previously. EU27 was also second to the USA for total impact factor. China markedly improved its cancer publications record over the period. Compared to the USA, EU27 and Japan, the other countries (all developing) had a poor publications record. Comparative cancer research spending data are not available. However from 2002 to 2007, gross domestic expenditure on research and development (UNESCO data) increased by 34% in North America, 161% in China and only 28% in EU27. Thus the European Union is lagging behind North America and may well be eclipsed by China in research and development spending in the near future. We suggest that these new findings should be considered by policymakers in Europe and other countries when developing policies for cancer control.

Work-related injuries among union drywall carpenters in Washington State, 1989-2008.

PubMed

Schoenfisch, Ashley L; Lipscomb, Hester; Marshall, Steve; Cameron, Wilfred; Richardson, David; Casteel, Carri

2013-10-01

Drywall installers are at high-risk of work-related injury. Comprehensive descriptive epidemiology of injuries among drywall installers, particularly over time, is lacking. We identified worker-hours and reported and accepted workers' compensation (WC) claims for a 20-year (1989-2008) cohort of 24,830 Washington State union carpenters. Stratified by predominant type of work (drywall installation, other carpentry), work-related injury rates were examined over calendar time and by worker characteristics. Expert interviews provided contextual details. Drywall installers' injury rates, higher than those of other carpenters, declined substantially over this period by 73.6%. Common injury mechanisms were struck by/against, overexertion and falls. Drywall material was considered a contributing factor in 19.7% of injuries. One-third of these drywall material-related injuries resulted in paid lost time, compared to 19.4% of injuries from other sources. Rates of injury were particularly high among workers with 2 to <4 years in the union. Notable declines over time in rates of overexertion injury in which drywall material was a contributing factor were still observed after controlling for secular temporal trends. Experts highlighted changes over the past 20 years that improved both work safety and, in some cases, production. Declines in drywall installers' injury rates over time likely reflect, in part, enhanced workplace safety, including efforts to reduce overexertion hazards associated with handling drywall. Continued injury prevention efforts are needed, particularly for less tenured workers. Given the potential for under-reporting to WC, additional sources of health outcomes data may provide a more complete picture of workers' health. Copyright © 2013 Wiley Periodicals, Inc.

12 CFR 704.11 - Corporate Credit Union Service Organizations (Corporate CUSOs).

Code of Federal Regulations, 2012 CFR

2012-01-01

... 12 Banks and Banking 7 2012-01-01 2012-01-01 false Corporate Credit Union Service Organizations (Corporate CUSOs). 704.11 Section 704.11 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS CORPORATE CREDIT UNIONS § 704.11 Corporate Credit Union Service Organizations...

12 CFR 704.11 - Corporate Credit Union Service Organizations (Corporate CUSOs).

Code of Federal Regulations, 2014 CFR

2014-01-01

... 12 Banks and Banking 7 2014-01-01 2014-01-01 false Corporate Credit Union Service Organizations (Corporate CUSOs). 704.11 Section 704.11 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS CORPORATE CREDIT UNIONS § 704.11 Corporate Credit Union Service Organizations...

12 CFR 704.11 - Corporate Credit Union Service Organizations (Corporate CUSOs).

Code of Federal Regulations, 2013 CFR

2013-01-01

... 12 Banks and Banking 7 2013-01-01 2013-01-01 false Corporate Credit Union Service Organizations (Corporate CUSOs). 704.11 Section 704.11 Banks and Banking NATIONAL CREDIT UNION ADMINISTRATION REGULATIONS AFFECTING CREDIT UNIONS CORPORATE CREDIT UNIONS § 704.11 Corporate Credit Union Service Organizations...

Warnings in the International Event Flow: EFI and ROZ as Threat Indicators

DTIC Science & Technology

1976-07-15

INSTRUCTIONS BEFORE COMPLETING PORN ) RECIPIENT’S CATALOG NUMBCR S TY^E OF «C^OdT * PimoD COVCRtO 7-1-75 to 9-30-76 Technical Report PCft’ORMINC...Kingdom initiated i*.S%, France k%, Poland 5.2%, Czechoslovakia k%, Italy 2.k%, Rumania 1.2%, the Soviet Union 15.91, the United Arab Republic 5.2...being 19.2^). So, too, were the United Arab Republic (3.8| 10 year average) and North Vietnam (6.7%). A little "above par" were the United Kingdom

Judy Holoviak Leaves AGU

NASA Astrophysics Data System (ADS)

2009-05-01

Judy C. Holoviak, AGU director of publications, leaves AGU on 6 May 2009. Her nearly 45-year career at AGU was recognized when she received the 2008 Edward A. Flinn III Award (see Eos, 89(52), 546, 2008). During her tenure, the journals program grew from 803 articles published per year to an average of 22 articles published per day (about 5670 per year); Eos grew from a quarterly journal (under the title of Transactions, American Geophysical Union) to a monthly magazine, and then to a weekly newspaper; and AGU became recognized as a leader in electronic publication.

Unexpected timely fracture union in matrix metalloproteinase 9 deficient mice.

PubMed

Yuasa, Masato; Saito, Masanori; Molina, Cesar; Moore-Lotridge, Stephanie N; Benvenuti, Michael A; Mignemi, Nicholas A; Okawa, Atsushi; Yoshii, Toshitaka; Schwartz, Herbert S; Nyman, Jeffry S; Schoenecker, Jonathan G

2018-01-01

Immediately following a fracture, a fibrin laden hematoma is formed to prevent bleeding and infection. Subsequently, the organized removal of fibrin, via the protease plasmin, is essential to permit fracture repair through angiogenesis and ossification. Yet, when plasmin activity is lost, the depletion of fibrin alone is insufficient to fully restore fracture repair, suggesting the existence of additional plasmin targets important for fracture repair. Previously, activated matrix metalloproteinase 9 (MMP-9) was demonstrated to function in fracture repair by promoting angiogenesis. Given that MMP-9 is a defined plasmin target, it was hypothesized that pro-MMP-9, following plasmin activation, promotes fracture repair. This hypothesis was tested in a fixed murine femur fracture model with serial assessment of fracture healing. Contrary to previous findings, a complete loss of MMP-9 failed to affect fracture healing and union through 28 days post injury. Therefore, these results demonstrated that MMP-9 is dispensable for timely fracture union and cartilage transition to bone in fixed femur fractures. Pro-MMP-9 is therefore not a significant target of plasmin in fracture repair and future studies assessing additional plasmin targets associated with angiogenesis are warranted.

Solar Stimulus: Perceptions of banks and credit unions towards solar loans in Massachusetts

NASA Astrophysics Data System (ADS)

Bahirwani, Suveer

Access to finance for residential solar photovoltaic systems (PV) is an essential element of the clean energy economy. Perceptions about solar PV and solar loans among lenders at banks and credit unions shape the availability of lending products for residential solar PV. In March 2015, interviews were carried out among select informants and subsequently, between April and May 2015, a survey was conducted to gauge the perceptions of lenders in Massachusetts. Lenders have a range of concerns with the market and the provision of solar loans. These concerns can be grouped around risk, market size or viability and policy uncertainty. In summary, lending for this segment is not a priority for banks and credit unions in Massachusetts at this time. Recommendations are offered for the lending community and policymakers to improve adoption. Questions for further research are also presented.

Openings in the wall: transnational migrants, labor unions, and U.S. immigration policy.

PubMed

Haus, L A

1995-01-01

"This article seeks to enhance our understanding of why the United States resisted restrictionist [immigration] legislation in the late twentieth century during times when one may have expected a movement toward closure, as occurred in the 1920s.... The article will supplement a state-centric approach with insights from the perspective of complex interdependence--the significance of transnational relations and the blurring of foreign and domestic politics. I will argue that the societal groups that influence the formation of U.S. immigration policy contain a transnational component, which contributes to the maintenance of relatively open legislation.... More specifically, I will argue that the transnationalization of the labor market...blurs the boundaries between foreign and domestic constituents for unions, causing unions to resist those restrictionist immigration measures that impede organization of foreign-born workers. Hence, the pressures for restrictionism are weaker than anticipated by the conventional wisdom that expects labor to lobby for closure." excerpt

Work-related injuries involving a hand or fingers among union carpenters in Washington State, 1989 to 2008.

PubMed

Lipscomb, Hester J; Schoenfisch, Ashley; Cameron, Wilfrid

2013-07-01

We evaluated work-related injuries involving a hand or fingers and associated costs among a cohort of 24,830 carpenters between 1989 and 2008. Injury rates and rate ratios were calculated by using Poisson regression to explore higher risk on the basis of age, sex, time in the union, predominant work, and calendar time. Negative binomial regression was used to model dollars paid per claim after adjustment for inflation and discounting. Hand injuries accounted for 21.1% of reported injuries and 9.5% of paid lost time injuries. Older carpenters had proportionately more amputations, fractures, and multiple injuries, but their rates of these more severe injuries were not higher. Costs exceeded $21 million, a cost burden of $0.11 per hour worked. Older carpenters' higher proportion of serious injuries in the absence of higher rates likely reflects age-related reporting differences.

Re-Examining the Case for Marriage: Union Formation and Changes in Well-Being

PubMed Central

Musick, Kelly; Bumpass, Larry

2011-01-01

This article addresses open questions about the nature and meaning of the positive association between marriage and well-being, namely, the extent to which it is causal, shared with cohabitation, and stable over time. We relied on data from the National Survey of Families and Households (N = 2,737) and a modeling approach that controls for fixed differences between individuals by relating union transitions to changes in well-being. This study is unique in examining the persistence of changes in well-being as marriages and cohabitations progress (and potentially dissolve) over time. The effects of marriage and cohabitation are found to be similar across a range of measures tapping psychological well-being, health, and social ties. Where there are statistically significant differences, marriage is not always more advantageous. Overall, differences tend to be small and appear to dissipate over time, even when the greater instability of cohabitation is taken into account. PMID:22611285

The fractured carpal scaphoid. Natural history and factors influencing outcome.

PubMed

Leslie, I J; Dickson, R A

1981-08-01

The scaphoid fracture is commonest in young men in the age group 15 to 29 years, who have the highest incidence of non-union, take the longest time to unite, lose more time from work, and spend the longest time as outpatients. A union rate of 95 per cent can be achieved using standard simple treatment. All but a few fractures are visible on the first radiograph, and failure of visualisation at this stage is not associated with a bad outcome. The postero-anterior and semipronated views are the most important to scrutinise. Crank-handle injuries have a particularly bad prognosis when they produce a transverse fracture of the waist of the scaphoid. Poor prognostic factors are displacement during treatment, the fracture line becoming increasingly more obvious, and the presence of early cystic change. The severity of trauma is an important factor to elicit from the history.

Medical research in emergency research in the European Union member states: tensions between theory and practice.

PubMed

Kompanje, Erwin J O; Maas, Andrew I R; Menon, David K; Kesecioglu, Jozef

2014-04-01

In almost all of the European Union member states, prior consent by a legal representative is used as a substitute for informed patient consent for non-urgent medical research. Deferred (patient and/or proxy) consent is accepted as a substitute in acute emergency research in approximately half of the member states. In 12 European Union member states emergency research is not mentioned in national law. Medical research in the European Union is covered by the Clinical Trial Directive 2001/20/EC. A proposal for a regulation by the European Commission is currently being examined by the European Parliament and the Council and will replace Directive 2001/20/EC. Deferred patient and/or proxy consent is allowed in the proposed regulation, but does not fit completely in the practice of emergency research. For example, deferred consent is only possible when legal representatives are not available. This criterion will delay inclusion of patients in acute life-threatening conditions in short time frames. As the regulation shall be binding in its entirety in all member states, emergency research in acute situations is still not possible as it should be.

Mason Tenders agrees to pay $1 million to end ADA litigation.

PubMed

1995-12-29

The [name removed] District Council Welfare Fund has agreed to pay $1 million to construction workers who have been denied medical coverage for AIDS-related care. The decision establishes self-insured health care benefits programs as covered entities under the Americans with Disabilities Act (ADA). The settlement ends a three-year battle which began in 1992 between [name removed] and fourteen HIV-positive construction workers who were refused medical coverage. The first suit was filed by [name removed]., a construction worker who lost coverage for his HIV-related care in July 1991. At that time, the union fund decided to exclude care for HIV on the grounds that it was too expensive. The Equal Employment Opportunity Commission (EEOC) filed an ADA lawsuit that challenged disability-based distinctions in health insurance. The U.S. Attorney's Office filed a complaint against the union under the Racketeer Influenced and Corrupt Organizations (RICO) statute to end organized crime associated with the union. In late 1994, the government announced a consent decree, settling its racketeering suit against the union. Under the terms of the settlement, [name removed] was awarded $16,000 in damages. In the EEOC case, damages for plan members ranged as high as $50,000.

Radiologic evaluation after posterior instrumented surgery for thoracic ossification of the posterior longitudinal ligament: union between rostral and caudal ossifications.

PubMed

Ando, Kei; Imagama, Shiro; Ito, Zenya; Kobayashi, Kazuyoshi; Ukai, Junichi; Muramoto, Akio; Shinjo, Ryuichi; Matsumoto, Tomohiro; Nakashima, Hiroaki; Ishiguro, Naoki

2014-05-01

Retrospective clinical study. To investigate, using multislice CT images, how thoracic ossification of the posterior longitudinal ligament (OPLL) changes with time after thoracic posterior fusion surgery. Few studies have evaluated thoracic OPLL preoperatively and post using computed tomography (CT). The subjects included 19 patients (7 men and 12 women) with an average age at surgery of 52 years (38-66 y) who underwent indirect posterior decompression with corrective fusion and instrumentation at our institute. Minimum follow-up period was 1 year, and averaged 3 years 10 months (12-120 mo). Using CT images, we investigated fusion range, preoperative and postoperative Cobb angles of thoracic fusion levels, intraoperative and postoperative blood loss, operative time, hyperintense areas on preoperative MRI of thoracic spine and thickness of the OPLL on the reconstructed sagittal, multislice CT images taken before the operation and at 3 months, 6 months and 1 year after surgery. The basic fusion area was 3 vertebrae above and below the OPLL lesion. The mean operative time was 7 hours and 48 min (4 h 39 min-10 h 28 min), and blood loss was 1631 mL (160-11,731 mL). Intramedullary signal intensity change on magnetic resonance images was observed at the most severe ossification area in 18 patients. Interestingly, the rostral and caudal ossification regions of the OPLLs, as seen on sagittal CT images, were discontinuous across the disk space in all patients. Postoperatively, the discontinuous segments connected in all patients without progression of OPLL thickness by 5.1 months on average. All patients needing surgery had discontinuity across the disk space between the rostral and caudal ossified lesions as seen on CT. This discontinuity was considered to be the main reason for the myelopathy because a high-intensity area on magnetic resonance imaging was seen in 18 of 19 patients at the same level. Rigid fixation with instrumentation may allow the discontinuous segments to connect in patients without a concomitant thickening of the OPLL.

12 CFR 701.19 - Benefits for employees of Federal credit unions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Benefits for employees of Federal credit unions... CREDIT UNIONS ORGANIZATION AND OPERATION OF FEDERAL CREDIT UNIONS § 701.19 Benefits for employees of Federal credit unions. (a) General authority. A federal credit union may provide employee benefits...

12 CFR 704.3 - Corporate credit union capital.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 12 Banks and Banking 6 2011-01-01 2011-01-01 false Corporate credit union capital. 704.3 Section... CORPORATE CREDIT UNIONS § 704.3 Corporate credit union capital. (a) Capital plan. A corporate credit union... activities, and the periodic review and reassessment of the capital position of the corporate credit union...

PLANNING AND OPERATING COLLEGE UNION BUILDINGS.

ERIC Educational Resources Information Center

BUTTS, PORTER

THIS MONOGRAPH IS A DISCUSSION OF FOUR ASPECTS OF STUDENT UNIONS. PART ONE DISCUSSES THE NATURE AND PURPOSE OF A UNION AND THE UNION AS A CAMPUS CENTER. PART TWO DEALS WITH THE PLANNING OF UNION BUILDINGS AND GIVES PROCEDURES, PRINCIPLES AND CAUTIONS. UNION FACILITIES AND SERVICES ARE LISTED. PART THREE DISCUSSES THE ORGANIZATION AND ACTIVITIES OF…

Current data on extremities chronic osteomyelitis in southwest China: epidemiology, microbiology and therapeutic consequences.

PubMed

Wang, Xiaohua; Yu, Shengpeng; Sun, Dong; Fu, Jingshu; Wang, Shulin; Huang, Ke; Xie, Zhao

2017-11-24

The current study was designed to explore the epidemiology of extremities chronic osteomyelitis, its prognosis and the complications of the treatment methods being used in southwest China. The data from osteomyelitis patients treated at the Department of Orthopaedics, Southwest Hospital, China between May 2011 and September 2016 were collected and analysed. The study comprised 503 admitted patients, of which 416 males and 87 were females, with an average age of 40.15 ± 5.64 years. Approximately 356 cases were followed for more than 18 months; the average bone union time was 6.24 ± 0.76 months in 94.1% (335) patients, and infections were almost controlled in 93.8% patients. The rate of infection control with the induced membrane technique was higher than with the I-stage free bone graft. Iliac infection was the main complication of the induced membrane technique, and impaired joint activity was the main complication of I-stage free bone grafts. In southwest China, the incidence of haematogenous osteomyelitis, caused mainly by Staphylococcus aureus, remains very high. The speed of bone defect repair and the rate of infection control with the induced membrane technique were superior to those of I-stage free bone grafts. Internal fixation should be given priority because it offers reduced complications with no increase in the recurrence of infection.

St. Louis demonstration final report: refuse processing plant equipment, facilities, and environmental evaluations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fiscus, D.E.; Gorman, P.G.; Schrag, M.P.

1977-09-01

The results are presented of processing plant evaluations of the St. Louis-Union Electric Refuse Fuel Project, including equipment and facilities as well as assessment of environmental emissions at both the processing and the power plants. Data on plant material flows and operating parameters, plant operating costs, characteristics of plant material flows, and emissions from various processing operations were obtained during a testing program encompassing 53 calendar weeks. Refuse derived fuel (RDF) is the major product (80.6% by weight) of the refuse processing plant, the other being ferrous metal scrap, a marketable by-product. Average operating costs for the entire evaluation periodmore » were $8.26/Mg ($7.49/ton). The average overall processing rate for the period was 168 Mg/8-h day (185.5 tons/8-h day) at 31.0 Mg/h (34.2 tons/h). Future plants using an air classification system of the type used at the St. Louis demonstration plant will need an emissions control device for particulates from the large de-entrainment cyclone. Also in the air exhaust from the cyclone were total counts of bacteria and viruses several times higher than those of suburban ambient air. No water effluent or noise exposure problems were encountered, although landfill leachate mixed with ground water could result in contamination, given low dilution rates.« less

Fractures of the proximal fifth metatarsal: percutaneous bicortical fixation.

PubMed

Mahajan, Vivek; Chung, Hyun Wook; Suh, Jin Soo

2011-06-01

Displaced intraarticular zone I and displaced zone II fractures of the proximal fifth metatarsal bone are frequently complicated by delayed nonunion due to a vascular watershed. Many complications have been reported with the commonly used intramedullary screw fixation for these fractures. The optimal surgical procedure for these fractures has not been determined. All these observations led us to evaluate the effectiveness of percutaneous bicortical screw fixation for treating these fractures. Twenty-three fractures were operatively treated by bicortical screw fixation. All the fractures were evaluated both clinically and radiologically for the healing. All the patients were followed at 2 or 3 week intervals till fracture union. The patients were followed for an average of 22.5 months. Twenty-three fractures healed uneventfully following bicortical fixation, with a mean healing time of 6.3 weeks (range, 4 to 10 weeks). The average American Orthopaedic Foot & Ankle Society (AOFAS) score was 94 (range, 90 to 99). All the patients reported no pain at rest or during athletic activity. We removed the implant in all cases at a mean of 23.2 weeks (range, 18 to 32 weeks). There was no refracture in any of our cases. The current study shows the effectiveness of bicortical screw fixation for displaced intraarticular zone I fractures and displaced zone II fractures. We recommend it as one of the useful techniques for fixation of displaced zone I and II fractures.

8 CFR 1240.61 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... December 31, 1991, and, at the time of filing the application, was a national of the Soviet Union, Russia... aliens: (1) A registered ABC class member who has not been apprehended at the time of entry after... section at the time a decision is made to suspend the deportation, or cancel the removal, of the...

Epidemiology of Time-Loss Injuries in Senior and under-18 Portuguese Male Rugby Players

PubMed Central

Cruz-Ferreira, Antonio Miguel; Cruz-Ferreira, Eduardo Miguel; Ribeiro, Pedro Barbosa; Santiago, Luiz Miguel; Taborda-Barata, Luis

2018-01-01

Abstract Rugby union has one of the highest injury incidence rates in team sports, however, most of the available data focus on the epidemiology of injuries in countries where rugby is popular. We aimed to report the incidence rate and relevant epidemiological aspects of injuries occurred in a group of Portuguese male rugby players. A prospective cohort study was conducted with a group of 45 senior and 32 under-18 male players (total of 77 players). Outcome measures included injury incidence, position, type, location and severity of injuries. The match injury incidence for all players was 55.84 per 1000 player match-hours (66.66 for seniors, 42.85 for under-18), while mean time-loss for injury was 20.79 days. No statistical differences were found between groups. Lower limb injuries accounted for 60.5% of all injuries, while joint/ligament injuries were the most prevalent type. Contact events were responsible for 65.1% of injuries. Despite the limitations, the obtained data are consistent with the literature. Time-loss injuries seem highly prevalent in rugby union and the incidence rates found in this Portuguese-based study were lower than the reported for international and senior men’s professional rugby union, but higher than those occurring in community rugby in tier-1 countries. The authors believe these data reinforce the need to develop and implement effective injury surveillance and prevention programs. PMID:29922379