15 CFR 922.102 - Prohibited or otherwise regulated activities.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Trade (Continued) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND..., including such devices known as Hawaiian slings, pole spears, arbalettes, pneumatic and spring-loaded...

15 CFR 922.102 - Prohibited or otherwise regulated activities.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Trade (Continued) NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE OCEAN AND..., including such devices known as Hawaiian slings, pole spears, arbalettes, pneumatic and spring-loaded...

The effects of performing a one-legged bridge with hip abduction and use of a sling on trunk and lower extremity muscle activation in healthy adults.

PubMed

Choi, Kyuju; Bak, Jongwoo; Cho, Minkwon; Chung, Yijung

2016-09-01

[Purpose] This study investigated the changes in the muscle activities of the trunk and lower limbs of healthy adults during a one-legged bridge exercise using a sling, and with the addition of hip abduction. [Subjects and Methods] Twenty-seven healthy individuals participated in this study (14 males and 13 females). The participants were instructed to perform the bridge exercises under five different conditions. Trunk and lower limb muscle activation of the erector spinae (ES), external oblique (EO), gluteus maximus (GM), and biceps femoris (BF) was measured using surface electromyography. Data analysis was performed using the mean scores of three trials performed under each condition. [Results] There was a significant increase in bilateral EO and contralateral GM with the one-legged bridge compared with the one-legged bridge with sling exercise. Muscle activation of the ipsilateral GM and BF was significantly less during the one-legged bridge exercise compared to the one-legged bridge with sling exercise, and was significantly greater during the one-legged bridge with hip abduction compared to the one-legged bridge exercise. The muscle activation of the contralateral GM and BF was significantly greater with the one-legged bridge with hip abduction compared to the general bridge exercise. [Conclusion] With the one-legged bridge with hip abduction, the ipsilateral EO, GM and BF muscle activities were significantly greater than those of the one-legged bridge exercise. The muscle activation of all trunk and contralateral lower extremity muscles increased with the bridge with sling exercises compared with general bridge exercises.

29 CFR 1926.1400 - Scope.

Code of Federal Regulations, 2014 CFR

2014-07-01

... also excluded when used with chains, slings or other rigging to lift suspended loads. (3) Automotive... metal, steel, or other material), prefabricated building sections such as, but not limited to: Floor... the crane is a structural steel member (for example, steel joists, beams, columns, steel decking...

A Methodology for Flight-Time Identification of Helicopter-Slung Load Frequency Response Characteristics Using CIFER

NASA Technical Reports Server (NTRS)

Sahai, Ranjana; Pierce, Larry; Cicolani, Luigi; Tischler, Mark

1998-01-01

Helicopter slung load operations are common in both military and civil contexts. The slung load adds load rigid body modes, sling stretching, and load aerodynamics to the system dynamics, which can degrade system stability and handling qualities, and reduce the operating envelope of the combined system below that of the helicopter alone. Further, the effects of the load on system dynamics vary significantly among the large range of loads, slings, and flight conditions that a utility helicopter will encounter in its operating life. In this context, military helicopters and loads are often qualified for slung load operations via flight tests which can be time consuming and expensive. One way to reduce the cost and time required to carry out these tests and generate quantitative data more readily is to provide an efficient method for analysis during the flight, so that numerous test points can be evaluated in a single flight test, with evaluations performed in near real time following each test point and prior to clearing the aircraft to the next point. Methodology for this was implemented at Ames and demonstrated in slung load flight tests in 1997 and was improved for additional flight tests in 1999. The parameters of interest for the slung load tests are aircraft handling qualities parameters (bandwidth and phase delay), stability margins (gain and phase margin), and load pendulum roots (damping and natural frequency). A procedure for the identification of these parameters from frequency sweep data was defined using the CIFER software package. CIFER is a comprehensive interactive package of utilities for frequency domain analysis previously developed at Ames for aeronautical flight test applications. It has been widely used in the US on a variety of aircraft, including some primitive flight time analysis applications.

Pressure ulcer risk of patient handling sling use.

PubMed

Peterson, Matthew J; Kahn, Julie A; Kerrigan, Michael V; Gutmann, Joseph M; Harrow, Jeffrey J

2015-01-01

Patient handling slings and lifts reduce the risk of musculoskeletal injuries for healthcare providers. However, no published evidence exists of their safety with respect to pressure ulceration for vulnerable populations, specifically persons with spinal cord injury, nor do any studies compare slings for pressure distribution. High-resolution interface pressure mapping was used to describe and quantify risks associated with pressure ulceration due to normal forces and identify at-risk anatomical locations. We evaluated 23 patient handling slings with 4 nondisabled adults. Sling-participant interface pressures were recorded while participants lay supine on a hospital bed and while suspended during typical patient transfers. Sling-participant interface pressures were greatest while suspended for all seated and supine slings and exceeded 200 mm Hg for all seated slings. Interface pressures were greatest along the sling seams (edges), regardless of position or sling type. The anatomical areas most at risk while participants were suspended in seated slings were the posterior upper and lower thighs. For supine slings, the perisacral area, ischial tuberosities, and greater trochanters were most at risk. The duration of time spent in slings, especially while suspended, should be limited.

Selected KSC Applied Physics Lab Responses to Shuttle Processing Measurement Requests

NASA Technical Reports Server (NTRS)

Youngquist, Robert C.

2010-01-01

The KSC Applied Physics Lab has been supporting Shuttle Ground Processing for over 20 years by solving problems brought to us by Shuttle personnel. Roughly half of the requests to our lab have been to find ways to make measurements, or to improve on an existing measurement process. This talk will briefly cover: 1) Centering the aft end of the External Tank between the Solid Rocket Boosters; 2) Positioning the GOX Vent Hood over the External Tank; 3) Remote Measurements of External Tank Damage; 4) Strain Measurement in the Orbiter Sling; and 5) Over-center Distance Measurement in an Over-center Mechanism.

KSC-05PD-1659

NASA Technical Reports Server (NTRS)

2005-01-01

KENNEDY SPACE CENTER, FLA. In the transfer aisle of the Vehicle Assembly Building at NASA Kennedy Space Center, In the transfer aisle of the Vehicle Assembly Building at NASA Kennedy Space Center, orbiter technicians are hooking a restraining cable around the orbiter lifting slings aft drop leg adjustment hand wheel. This is performed prior to disconnecting the aft spreader beam from the sling (the portion suspended by the 175 ton crane on the left side of the photo), and also prior to taking the final hang angle measurement of the orbiter prior to lifting it over the transom into the high bay. It will be mated with the Solid Rocket Boosters and External Tank already stacked there on the Mobile Launcher Platform. Atlantis is the designated orbiter for Return to Flight mission STS-121. The lighted planning window for launch extends from Sept. 9 to Sept. 25.

KSC-05PD-1660

NASA Technical Reports Server (NTRS)

2005-01-01

KENNEDY SPACE CENTER, FLA. In the transfer aisle of the Vehicle Assembly Building at NASA Kennedy Space Center, In the transfer aisle of the Vehicle Assembly Building at NASA Kennedy Space Center, orbiter technicians are hooking a restraining cable around the orbiter lifting slings aft drop leg adjustment hand wheel. This is performed prior to disconnecting the aft spreader beam from the sling (the portion suspended by the 175 ton crane on the left side of the photo), and also prior to taking the final hang angle measurement of the orbiter prior to lifting it over the transom into the high bay. It will be mated with the Solid Rocket Boosters and External Tank already stacked there on the Mobile Launcher Platform. Atlantis is the designated orbiter for Return to Flight mission STS-121. The lighted planning window for launch extends from Sept. 9 to Sept. 25.

DEVELOPMENT OF A HIGH ALTITUDE LOW OPENING HUMANITARIAN AIRDROP SYSTEM

DTIC Science & Technology

2017-07-12

4  2.3  Aid Item Testing ___________________________________________________________ 6  2.3.1  12 October 2010...2.3.3  USAARL Aid Item Safety Evaluation _________________________________________________ 10  2.3.4  USAARL Accelerated Impact Test ...16  3.1.3  System Testing __________________________________________________________________ 23  3.2  Sling Load System

75 FR 70070 - Office of Hazardous Materials Safety; Notice of Application for Special Permits

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-16

..., 3--Cargo vessel, 4--Cargo aircraft only, 5--Passenger-carrying aircraft. DATES: Comments must be... INFORMATION CONTACT: Copies of the applications are available for inspection in the Records Center, East.... commerce of gasoline in non-Dot specification containers when transported in sling load operations. (mode 4...

Polypropylene Mesh Sling for Stress Urinary Incontinence: Does Memory Shaping of the Polypropylene Mesh Matter?

PubMed

Doering, Andrew; Azadi, Ali; Doering, David; Ostergard, Donald R

2017-12-22

We report a case of a mid-urethral sling (Advantage Fit™, Boston Scientific Corporation, Marlborough, Massachusetts) freshly removed from its original package. Upon removal from the packaging, the sling was noted to have a deformation in positioning at the midpoint, with curvature opposite the natural curve of the sling in the body. The images show the comparison to a sling with the desired positioning. Mid-urethral slings are commonly made from polypropylene mesh which has memory properties. It is important that manufacturers ensure that any steps in the processing or packaging of slings do not result in changes in the shape of the sling that may have unknown impacts on its clinical outcome.

The Effects of Shoulder Slings on Balance in Patients With Hemiplegic Stroke.

PubMed

Sohn, Min Kyun; Jee, Sung Ju; Hwang, Pyoungsik; Jeon, Yumi; Lee, Hyunkeun

2015-12-01

To investigate the effects of a shoulder sling on balance in patients with hemiplegia. Twenty-seven hemiplegic stroke patients (right 13, left 14) were enrolled in this study. The subjects' movement in their centers of gravity (COGs) during their static and dynamic balance tests was measured with their eyes open in each sling condition-without a sling, with Bobath's axillary support (Bobath sling), and with a simple arm sling. The percent times in quadrant, overall, anterior/posterior, and medial/lateral stability indexes were measured using a posturography platform (Biodex Balance System SD). Functional balance was evaluated using the Berg Balance Scale and the Trunk Impairment Scale. All balance tests were performed with each sling in random order. The COGs of right hemiplegic stroke patients and all hemiplegic stroke patients shifted to, respectively, the right and posterior quadrants during the static balance test without a sling (p<0.05). This weight asymmetry pattern did not improve with either the Bobath or the simple arm sling. There was no significant improvement in any stability index during either the static or the dynamic balance tests in any sling condition. The right and posterior deviations of the hemiplegic stroke patients' COGs were maintained during the application of the shoulder slings, and there were no significant effects of the shoulder slings on the patients' balance in the standing still position.

The Effects of Shoulder Slings on Balance in Patients With Hemiplegic Stroke

PubMed Central

Sohn, Min Kyun; Jee, Sung Ju; Hwang, Pyoungsik; Jeon, Yumi

2015-01-01

Objective To investigate the effects of a shoulder sling on balance in patients with hemiplegia. Methods Twenty-seven hemiplegic stroke patients (right 13, left 14) were enrolled in this study. The subjects' movement in their centers of gravity (COGs) during their static and dynamic balance tests was measured with their eyes open in each sling condition-without a sling, with Bobath's axillary support (Bobath sling), and with a simple arm sling. The percent times in quadrant, overall, anterior/posterior, and medial/lateral stability indexes were measured using a posturography platform (Biodex Balance System SD). Functional balance was evaluated using the Berg Balance Scale and the Trunk Impairment Scale. All balance tests were performed with each sling in random order. Results The COGs of right hemiplegic stroke patients and all hemiplegic stroke patients shifted to, respectively, the right and posterior quadrants during the static balance test without a sling (p<0.05). This weight asymmetry pattern did not improve with either the Bobath or the simple arm sling. There was no significant improvement in any stability index during either the static or the dynamic balance tests in any sling condition. Conclusion The right and posterior deviations of the hemiplegic stroke patients' COGs were maintained during the application of the shoulder slings, and there were no significant effects of the shoulder slings on the patients' balance in the standing still position. PMID:26798614

Arc-to-Arc mini-sling 1999: a critical analysis of concept and technology.

PubMed

Palma, Paulo

2011-01-01

The aim of this study was to critically review the Arc-to-Arc mini-sling (Palma's technique) a less invasive mid-urethral sling using bovine pericardium as the sling material. The Arc-to-Arc mini-sling, using bovine pericardium, was the first published report of a mini-sling, in 1999. The technique was identical to the "tension-free tape" operation, midline incision and dissection of the urethra. The ATFP (white line) was identified by blunt dissection, and the mini-sling was sutured to the tendinous arc on both sides with 2 polypropylene 00 sutures. The initial results were encouraging, with 9/10 patients cured at the 6 weeks post-operative visit. However, infection and extrusion of the mini-sling resulted in sling extrusion and removal, with 5 patients remaining cured at 12 months. The Arc-to-Arc mini-sling was a good concept, but failed because of the poor technology available at that time. Further research using new materials and better technology has led to new and safer alternatives for the management of stress urinary incontinence.

The role of male slings in post prostatectomy incontinence: ICI-RS 2015.

PubMed

Sahai, Arun; Abrams, Paul; Dmochowski, Roger; Anding, Ralf

2017-04-01

Post prostatectomy stress urinary incontinence can significantly impact on quality of life and is bothersome for patients. The artificial urinary sphincter is still considered the gold standard surgical treatment. Male slings are an alternative surgical option and several designs are currently available. This review will focus on efficacy, adverse events, and mechanism of action of male slings. The context of this review was a proposal at the ICI-RS meeting 2015. Following synthesis of the evidence we address the question: does it matter how male slings work? The proposal lecture was reviewed and a comprehensive review of the literature undertaken utilising the PubMed database. Male slings can be broadly divided into adjustable retropubic and suburethral transobturator slings. Male slings are efficacious and can improve quality of life. Adjustable retropubic slings appear to be compressive but studies suggest efficacy can be achieved without voiding dysfunction. Transobturator slings work by urethral compression and/or re-locating the urethral bulb. There is a recognized failure rate in all sling types and most studies suggest radiotherapy as a risk factor for failure. Adjustable slings have the ability to be altered to optimize continence or to prevent retention of urine. However, there appears to be a higher explantation rate in some of these systems. It is important to understand how male slings work and by doing so we are more reliably able to choose the appropriate sling, predict outcomes, and as a result counsel patients. Suggestions for future research are proposed. © 2017 Wiley Periodicals, Inc.

27 CFR 53.61 - Imposition and rates of tax.

Code of Federal Regulations, 2013 CFR

2013-04-01

... choke, a flash hider, a muzzle brake, a magazine, a set of sling swivels, and/or an attachable ramrod for muzzle loading firearms when provided by the manufacturer or importer for use with the firearm in... flash hiders/muzzle brakes of a type not provided by the manufacturer or importer of the firearm in the...

27 CFR 53.61 - Imposition and rates of tax.

Code of Federal Regulations, 2011 CFR

2011-04-01

... choke, a flash hider, a muzzle brake, a magazine, a set of sling swivels, and/or an attachable ramrod for muzzle loading firearms when provided by the manufacturer or importer for use with the firearm in... flash hiders/muzzle brakes of a type not provided by the manufacturer or importer of the firearm in the...

27 CFR 53.61 - Imposition and rates of tax.

Code of Federal Regulations, 2014 CFR

2014-04-01

... choke, a flash hider, a muzzle brake, a magazine, a set of sling swivels, and/or an attachable ramrod for muzzle loading firearms when provided by the manufacturer or importer for use with the firearm in... flash hiders/muzzle brakes of a type not provided by the manufacturer or importer of the firearm in the...

Indications and risk factors for midurethral sling revision.

PubMed

Unger, Cecile A; Rizzo, Anthony E; Ridgeway, Beri

2016-01-01

To determine the indications and risk factors for needing midurethral sling revision in a cohort of women undergoing midurethral sling placement. This was a case-control study of all women undergoing midurethral sling placement for stress urinary incontinence (SUI) between January 2003 and December 2013. Cases were patients who underwent midurethral sling placement followed by sling revision (incision, partial or complete excision). Controls were patients who underwent sling placement only. Once all subjects had been identified, the electronic medical record was queried for demographic and perioperative and postoperative data. Of 3,307 women who underwent sling placement, 89 (2.7%, 95% CI 1.9 - 3.4) underwent sling revision for one or more of the following indications: urinary retention (43.8%), voiding dysfunction (42.7%), recurrent urinary tract infection (20.2%), mesh erosion (21.3%), vaginal pain/dyspareunia (7.9%), and groin pain (3.4%). The median time from the index to the revision surgery was 7.8 months (2.3 - 17.9 months), but was significantly shorter in patients with urinary retention. The type of sling placed (retropubic or transobturator) was not associated with indication for revision. Patients who underwent revision surgery were more likely to have had previous SUI surgery (adjusted odds ratio 4.4, 95% CI 1.7 - 6.5) and to have undergone concomitant vaginal apical suspension (adjusted odds ratio 2.4, 95% CI 1.4 - 4.5). The rate of sling revision after midurethral sling placement was 2.7%. Urinary retention and voiding dysfunction were the most common indications. Patients with a history of previous SUI surgery and concomitant apical suspension at the time of sling placement may be at higher risk of requiring revision surgery.

TVT-Exact and midurethral sling (SLING-IUFT) operative procedures: a randomized study

PubMed Central

Aniulis, Povilas; Skaudickas, Darijus

2015-01-01

Objectives The aim of the study is to compare results, effectiveness and complications of TVT exact and midurethral sling (SLING-IUFT) operations in the treatment of female stress urinary incontinence (SUI). Methods A single center nonblind, randomized study of women with SUI who were randomized to TVT-Exact and SLING-IUFT was performed by one surgeon from April 2009 to April 2011. SUI was diagnosed on coughing and Valsalva test and urodynamics (cystometry and uroflowmetry) were assessed before operation and 1 year after surgery. This was a prospective randomized study. The follow up period was 12 months. 76 patients were operated using the TVT-Exact operation and 78 patients – using the SLING-IUFT operation. There was no statistically significant differences between groups for BMI, parity, menopausal status and prolapsed stage (no patients had cystocele greater than stage II). Results Mean operative time was significantly shorter in the SLING-IUFT group (19 ± 5.6 min.) compared with the TVT-Exact group (27 ± 7.1 min.). There were statistically significant differences in the effectiveness of both procedures: TVT-Exact – at 94.5% and SLING-IUFT – at 61.2% after one year. Hospital stay was statistically significantly shorter in the SLING-IUFT group (1. 2 ± 0.5 days) compared with the TVT-Exact group (3.5 ± 1.5 days). Statistically significantly fewer complications occurred in the SLING-IUFT group. Conclusion the TVT-Exact and SLING-IUFT operations are both effective for surgical treatment of female stress urinary incontinence. The SLING-IUFT involved a shorter operation time and lower complications rate., the TVT-Exact procedure had statistically significantly more complications than the SLING-IUFT operation, but a higher effectiveness. PMID:28352711

TVT-Exact and midurethral sling (SLING-IUFT) operative procedures: a randomized study.

PubMed

Aniuliene, Rosita; Aniulis, Povilas; Skaudickas, Darijus

2015-01-01

The aim of the study is to compare results, effectiveness and complications of TVT exact and midurethral sling (SLING-IUFT) operations in the treatment of female stress urinary incontinence (SUI). A single center nonblind, randomized study of women with SUI who were randomized to TVT-Exact and SLING-IUFT was performed by one surgeon from April 2009 to April 2011. SUI was diagnosed on coughing and Valsalva test and urodynamics (cystometry and uroflowmetry) were assessed before operation and 1 year after surgery. This was a prospective randomized study. The follow up period was 12 months. 76 patients were operated using the TVT-Exact operation and 78 patients - using the SLING-IUFT operation. There was no statistically significant differences between groups for BMI, parity, menopausal status and prolapsed stage (no patients had cystocele greater than stage II). Mean operative time was significantly shorter in the SLING-IUFT group (19 ± 5.6 min.) compared with the TVT-Exact group (27 ± 7.1 min.). There were statistically significant differences in the effectiveness of both procedures: TVT-Exact - at 94.5% and SLING-IUFT - at 61.2% after one year. Hospital stay was statistically significantly shorter in the SLING-IUFT group (1. 2 ± 0.5 days) compared with the TVT-Exact group (3.5 ± 1.5 days). Statistically significantly fewer complications occurred in the SLING-IUFT group. the TVT-Exact and SLING-IUFT operations are both effective for surgical treatment of female stress urinary incontinence. The SLING-IUFT involved a shorter operation time and lower complications rate., the TVT-Exact procedure had statistically significantly more complications than the SLING-IUFT operation, but a higher effectiveness.

To sling or not to sling at time of abdominal sacrocolpopexy: a cost-effectiveness analysis.

PubMed

Richardson, Monica L; Elliott, Christopher S; Shaw, Jonathan G; Comiter, Craig V; Chen, Bertha; Sokol, Eric R

2013-10-01

We compare the cost-effectiveness of 3 strategies for the use of a mid urethral sling to prevent occult stress urinary incontinence in patients undergoing abdominal sacrocolpopexy. Using decision analysis modeling we compared cost-effectiveness during a 1-year postoperative period of 3 treatment approaches including 1) abdominal sacrocolpopexy alone with deferred option for mid urethral sling, 2) abdominal sacrocolpopexy with universal concomitant mid urethral sling and 3) preoperative urodynamic study for selective mid urethral sling. Using published data we modeled probabilities of stress urinary incontinence after abdominal sacrocolpopexy with or without mid urethral sling, the predictive value of urodynamic study to detect occult stress urinary incontinence and the likelihood of complications after mid urethral sling. Costs were derived from Medicare 2010 reimbursement rates. The main outcome modeled was incremental cost-effectiveness ratio per quality adjusted life-years gained. In addition to base case analysis, 1-way sensitivity analyses were performed. In our model, universally performing mid urethral sling at abdominal sacrocolpopexy was the most cost-effective approach with an incremental cost per quality adjusted life-year gained of $2,867 compared to abdominal sacrocolpopexy alone. Preoperative urodynamic study was more costly and less effective than universally performing intraoperative mid urethral sling. The cost-effectiveness of abdominal sacrocolpopexy plus mid urethral sling was robust to sensitivity analysis with a cost-effectiveness ratio consistently below $20,000 per quality adjusted life-year. Universal concomitant mid urethral sling is the most cost-effective prophylaxis strategy for occult stress urinary incontinence in women undergoing abdominal sacrocolpopexy. The use of preoperative urodynamic study to guide mid urethral sling placement at abdominal sacrocolpopexy is not cost-effective. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Male Sling and Artificial Urethral Sphincter for Male Stress Urinary Incontinence Among Certifying American Urologists.

PubMed

Liu, Joceline S; Hofer, Matthias D; Milose, Jaclyn; Oberlin, Daniel T; Flury, Sarah C; Morey, Allen F; Gonzalez, Chris M

2016-01-01

To examine case volume characteristics among certifying urologists performing male sling and artificial urinary sphincter (AUS) procedures to evaluate practice patterns in male stress urinary incontinence (SUI). Six-month case log data of certifying urologists (2003-2013) were obtained from the American Board of Urology. Cases specifying Current Procedural Terminology code for male sling, AUS, and removal or revision of either procedure in males ≥18 years were analyzed. Among 1615 urologists (568 certifying and 1047 recertifying) logging at least 1 male incontinence procedure, 2109 (48% of all procedures) male sling and 2284 (52%) AUS cases were identified. The mean age of patients undergoing AUS was 74.9 years and the mean age of patients undergoing sling procedures was 67.3 years (P <.001). An increase in male incontinence procedures from 2003 to 2013 was demonstrated. The rate of male sling procedure increased from 32.7% of incontinence surgeries in 2004 to 45.5% in 2013 (P <.001). Academically affiliated urologists are 1.5 times more likely to perform AUS than male sling for SUI (P <.001). Median number of slings performed was 2 (range 1-40), with 32.7% placing slings exclusively. A small group of certifying urologists (3.4%) accounted for 22% of all male slings placed. This same cohort logged 10.2% of all AUS performed. Surgical management of male SUI varies widely across states (P <.001), with slings performed between 21% and 70% of the time. Overall the number of male incontinence procedures has increased over time, with a growing proportion of male slings. Most slings and AUS cases are performed by a small number of high-volume surgeons. Copyright © 2015 Elsevier Inc. All rights reserved.

AdVance male sling

PubMed Central

Chung, Amanda S. J.; Suarez, Oscar A.

2017-01-01

The AdVance sling (American Medical Systems, Minnetonka, MN, United States of America) is a synthetic transobturator sling, which is a safe and effective minimally invasive treatment for mild to moderate stress urinary incontinence (SUI) in male patients. This article provides a step-by-step description of our technique for placement of the AdVance male sling, including details and nuances gained from surgical experience, advice for avoidance of complications and discussion on management of complications and sling failures. Patient selection is very important, including exclusion and preoperative treatment of urethral stenosis and bladder dysfunction. Previous pelvic radiation is a poor prognostic factor. In brief, the steps of sling placement are: (I) mobilization of the corpus spongiosum (CS); (II) marking and mobilization of the central tendon; (III) passage of the helical trocar needles exiting at the apex of the angle between the CS and inferior pubic ramus; (IV) fixation of the broad part of the sling body to the CS at the previous mark; (V) cystoscopy during sling tensioning; (VI) placement of a Foley urethral catheter; (VII) Subcutaneous tunnelling of the sling arms back toward the midline; (VIII) wound closure. The most common early postoperative complication is urinary retention but long-term retention is extremely rare. Management of sling failures include placement of an artificial urinary sphincter, repeat AdVance sling, urethral bulking agent or ProACT device. PMID:28904900

Transvaginal retropubic sling systems: efficacy and patient acceptability

PubMed Central

Moldovan, Christina P; Marinone, Michelle E; Staack, Andrea

2015-01-01

Stress urinary incontinence is a common, disabling, and costly medical problem that affects approximately 50% of women with urinary incontinence. Suburethral retropubic slings have been developed as a minimally invasive and effective surgical option, and they have been used as a first-line treatment for stress urinary incontinence since 1995. However, complications including vaginal extrusion, erosion, pain, bleeding, infections, lower urinary tract symptoms, urinary retention, and incontinence have been reported with use of the slings. Several companies manufacture sling kits, and the sling kits vary with regard to the composition of the mesh and introducer needle. The aim of this review was to determine which sling kit was most effective for patients, had minimal reported side effects, and was best accepted by patients and surgeons. In a review of the literature, it was found that a total of 38 studies were published between 1995 and 2014 that reported on eight tension-free retropubic sling kits: SPARC, RetroArc, Align, Advantage, Lynx, Desara, Supris, and Gynecare TVT. The Gynecare TVT was the most cited sling kit; the second most cited was the SPARC. This review provides a summary of the studies that have examined positive and negative outcomes of the retropubic tension-free suburethral sling procedure using various sling kits. Overall, the results of the literature review indicated that data from comparisons of the available sling kits are insufficient to make an evidenced-based recommendation. Therefore, the decision regarding which sling kit is appropriate to use in surgery is determined by the medical provider’s preference, training, and past experience, and not by the patient. PMID:25733928

Remote discovery of an asymptomatic bowel perforation by a mid-urethral sling.

PubMed

Elliott, Jason E; Maslow, Ken D

2012-02-01

Bowel perforation is a rare complication of mid-urethral sling procedures and is usually reported shortly after the surgery. We report a remotely discovered asymptomatic bowel injury found at the time of subsequent surgery. The patient with a history of several prior pelvic surgeries underwent an uneventful retropubic mid-urethral sling placement. Five years later, during an abdominal sacrocolpopexy procedure, mesh from the mid-urethral sling was found perforating the wall of the cecum and fixating it to the right pelvic sidewall. Cecal wedge resection was performed to excise the sling mesh. Asymptomatic bowel perforation by mid-urethral sling mesh has not been previously reported. Pelvic and abdominal surgeons should be aware of the possibility of finding this injury in patients with prior sling surgeries.

Ultrasound Evaluation of Midurethral Sling Position and Correlation to Physical Examination and Patient Symptoms.

PubMed

Tunitsky-Bitton, Elena; Unger, Cecile A; Barber, Matthew D; Goldman, Howard B; Walters, Mark D

2015-01-01

The primary objective was to evaluate the position and angle variation between 3 different midurethral slings (MUSs) using 3-dimensional ultrasound (US) technology. The secondary objective was to compare differences in findings on physical examination and symptoms of incontinence and sexual dysfunction between subjects. This was a cross-sectional study of 61 subjects who had undergone MUS placement without concomitant anterior or apical compartment prolapse surgery (21 retropubic [RP], 19 out-to-in transobturator [TOT], 21 in-to-out transobturator [TVT-O]). Subjects completed validated questionnaires (Sandvik Incontinence Severity Index, Urogenital Distress Inventory 6) and underwent a pelvic examination and standardized 2-dimensional and 3-dimensional ultrasonography evaluation. On translabial US, the median RP sling angle was 108.2 degrees (72.6-135.9), significantly more acute than the angle of TOT and TVT-O slings (119.3 degrees [72.3-140.4, P = 0.02] and 118.5 degrees [99.0-154.7, P = 0.004]). There was no difference in the sling angles between the TOT and TVT-O slings (P = 0.86). No difference was noted in the position of the sling along the urethra (P = 0.82). The TOT sling was more often palpable (57.8%, P = 0.02) compared with the RP or TVT-O groups.Fifteen patients (4 RP, 5 TOT, 6 TVT-O) reported discomfort during intercourse that they attributed to the MUS. Three of 19 TOT subjects reported that their partner experienced pain with intercourse because of the sling. However, sexual function and urinary symptoms were not statistically different between the 3 groups. On 3-dimensional US, RP sling angle was found to be significantly more acute than the angles of the TOT and TVT-O slings, and there was no difference between the 2 transobturator slings. The TOT sling was more often palpable on examination, but this finding did not correlate with increased pain on palpation.

Baby Sling: Is It Safe?

MedlinePlus

Healthy Lifestyle Infant and toddler health Is it safe to hold a baby in a baby sling? Answers from Jay L. Hoecker, M.D. A baby sling — a one-shouldered baby ... sling's weight minimum before placing your newborn in it. Keep your baby's airways unobstructed. Make sure your ...

29 CFR 1910.184 - Slings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... alloy steel chain, wire rope, metal mesh, natural or synthetic fiber rope (conventional three strand... steel chain sling or wire rope sling. (See Fig. N-184-3.) Mechanical coupling link is a nonwelded... Slings 6×19 and 6×37 Classification Improved Plow Steel Grade Rope With Independent Wire Rope Core (IWRC...

29 CFR 1910.184 - Slings.

Code of Federal Regulations, 2011 CFR

2011-07-01

... alloy steel chain, wire rope, metal mesh, natural or synthetic fiber rope (conventional three strand... steel chain sling or wire rope sling. (See Fig. N-184-3.) Mechanical coupling link is a nonwelded... Slings 6×19 and 6×37 Classification Improved Plow Steel Grade Rope With Independent Wire Rope Core (IWRC...

29 CFR 1917.42 - Miscellaneous auxiliary gear.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) Routine inspection. (1) At the completion of each use, loose gear such as slings, chains, bridles, blocks... sling to which they are attached and shall be free of sharp edges. (h) Chains and chain slings used for... for the sizes of wrought iron and alloy steel chains and chain slings used and shall have such ratings...

29 CFR 1917.42 - Miscellaneous auxiliary gear.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) Routine inspection. (1) At the completion of each use, loose gear such as slings, chains, bridles, blocks... sling to which they are attached and shall be free of sharp edges. (h) Chains and chain slings used for... for the sizes of wrought iron and alloy steel chains and chain slings used and shall have such ratings...

29 CFR 1917.42 - Miscellaneous auxiliary gear.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) Routine inspection. (1) At the completion of each use, loose gear such as slings, chains, bridles, blocks... sling to which they are attached and shall be free of sharp edges. (h) Chains and chain slings used for... for the sizes of wrought iron and alloy steel chains and chain slings used and shall have such ratings...

The effect of arm sling on balance in patients with hemiplegia.

PubMed

Acar, Merve; Karatas, Gulcin Kaymak

2010-10-01

The aim of this study was to investigate the effect of an arm sling on balance in patients with, hemiplegia following a stroke. Twenty-six patients with hemiplegia (11 men, 15 women) who had, shoulder subluxation were enrolled in the study. Balance was evaluated by the Berg Balance Scale, the, Functional Reach test, and a static balance index which was measured by the Kinesthetic Ability, Trainer 3000. Balance tests were performed twice, with arm sling and without arm sling use. Results of, this study show that the Berg Balance Scores and static balance index ameliorated with arm sling use (p=0.005 and p=0.004, respectively). Likewise, the Functional Reach test was better when performed with an arm sling (p=0.039). In conclusion, arm slings have a beneficial effect on balance in patients, with hemiplegia. An arm sling may be applied for its possible beneficial effect on balance especially in, the early phases of stroke rehabilitation while the upper extremity is still flaccid and arm swing is, reduced. Copyright © 2010 Elsevier B.V. All rights reserved.

Applying translabial ultrasound to detect synthetic slings-You can do it too! A comparison of urology trainees to an attending radiologist.

PubMed

Shen, Jim K; Faaborg, Daniel; Rouse, Glenn; Kelly, Isaac; Li, Roger; Alsyouf, Muhannad; Myklak, Kristene; Distelberg, Brian; Staack, Andrea

2017-09-01

Translabial ultrasound (TUS) is a useful tool for identifying and assessing synthetic slings. This study evaluates the ability of urology trainees to learn basic pelvic anatomy and sling assessment on TUS. Eight urology trainees (six residents and two medical students) received a lecture reviewing basic anatomy and sling assessment on TUS followed by review of two training cases. Next, they underwent a 126-question examination assessing their ability to identify anatomic planes and structures in those planes, identify the presence of slings, and assess the location and intactness of a sling. The correct response rate was compared to that of an attending radiologist experienced in reading TUS. Non-parametric tests (Fisher's exact, chi-squared tests, and Yates correction) were used for statistical analysis, with P < 0.05 considered significant. 847/1008 (84.0%) of questions were answered correctly by eight trainees compared to 119/126 (94.4%) by the radiologist (P = 0.001). The trainees' correct response rates and Fisher's exact test P values associated with the difference in correct answers between radiologist and trainee were as follows: identification of anatomic plane (94.4%; P = 0.599), identification of structure in sagittal view (80.6%; P = 0.201), identification of structure in transverse view (88.2%; P = 0.696), presence of synthetic sling (95.8%; P = 1.000), location of sling along the urethra in (71.5%; P = 0.403), intactness of sling (82.6%; P = 0.311), and laterality of sling disruption (75.0%; P = 0.076). Urology trainees can quickly learn to identify anatomic landmarks and assess slings on TUS with reasonable proficiency compared to an experienced attending radiologist. © 2017 Wiley Periodicals, Inc.

5-Year Longitudinal Follow-up after Retropubic and Transobturator Midurethral Slings

PubMed Central

Kenton, Kimberly; Stoddard, Anne M.; Zyczynski, Halina; Albo, Michael; Rickey, Leslie; Norton, Peggy; Wai, Clifford; Kraus, Stephen R.; Sirls, Larry T.; Kusek, John W.; Litman, Heather J.; Chang, Robert P.; Richter, Holly E.

2014-01-01

Background Few studies have characterized longer-term outcomes after retropubic and transobturator midurethral slings. Methods Women completing 2-year participation in a randomized equivalence trial who had not received surgical retreatment for stress urinary incontinence were invited to participate in a 5-year observational cohort. The primary outcome, treatment success, was defined as no retreatment or self-reported stress incontinence symptoms. Secondary outcomes included urinary symptoms and quality of life, satisfaction, sexual function and adverse events. Results 404 of 597 (68%) women from the original trial enrolled. Five-years after surgical treatment, success was 7.9% greater in women assigned to retropubic-sling compared to transobturator-sling (51.3% vs 43.4%, 95% CI −1.4%, 17.2%) not meeting pre-specified criteria for equivalence. Satisfaction decreased over 5-years, but remained high and similar between arms (79%, retropubic-sling vs 85%, transobturator-sling groups, p=0.15). Urinary symptoms and quality of life worsened over time (p<0.001), and women with retropubic-sling reported greater urinary urgency (P=0.001), more negative quality of life impact (p=0.02), and worse sexual function (P=0.001). There was no difference in proportion of women experiencing at least 1 adverse event (p=0.17). Seven new mesh erosions were noted (retropubic-sling-3, transobturator-sling-4). Conclusion Treatment success declined over 5-years for retropubic and transobturator-slings and did not meet pre-specified criteria for equivalence with retropubic demonstrating a slight benefit. However, satisfaction remained high in both arms. Women undergoing transobturator-sling reported more sustained improvement in urinary symptoms and sexual function. New mesh erosions occurred in both arms over time, although at a similarly low rate. PMID:25158274

76 FR 27367 - Slings; Extension of the Office of Management and Budget's (OMB) Approval of Information...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-11

... handling. Paragraph (e) of the Standard covers alloy steel chain slings. Paragraph (e)(1) requires that alloy steel chain slings have permanently affixed and durable identification stating the size, grade... thorough periodic inspection of alloy steel chain slings in use on a regular basis, but at least once a...

29 CFR 1918.62 - Miscellaneous auxiliary gear.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., loose gear such as slings, chains, bridles, blocks and hooks shall be so placed as to avoid damage to... sling to which they are attached and shall be free of sharp edges. (h) Chains and chain slings used for... the size of wrought iron and alloy steel chains and chain slings and shall have such ratings available...

29 CFR 1918.62 - Miscellaneous auxiliary gear.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., loose gear such as slings, chains, bridles, blocks and hooks shall be so placed as to avoid damage to... sling to which they are attached and shall be free of sharp edges. (h) Chains and chain slings used for... the size of wrought iron and alloy steel chains and chain slings and shall have such ratings available...

29 CFR 1918.62 - Miscellaneous auxiliary gear.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., loose gear such as slings, chains, bridles, blocks and hooks shall be so placed as to avoid damage to... sling to which they are attached and shall be free of sharp edges. (h) Chains and chain slings used for... the size of wrought iron and alloy steel chains and chain slings and shall have such ratings available...

Costs analysis of surgical treatment of stress urinary incontinence in a brazilian public hospital, comparing burch and synthetic sling techniques.

PubMed

Limberger, Leo Francisco; Faria, Fernanda Pacheco; Campos, Luciana Silveira; Anzolch, Karin Marise Jaeger; Fornari, Alexandre

2018-01-01

Surgical treatment of urinary incontinence progressed significantly with the introduction of synthetic slings. However, in some public Brazilian hospitals, the costs of these materials prevent their routine use. To compare the costs of ambulatory synthetic sling surgery with an historical series of patients submitted to Burch surgery in a Brazilian public hospital. Twenty nine incontinent patients were selected to synthetic sling surgery. Demographic data were prospectively collected and also the costs of the procedure, including drugs and materials, use of surgical and recovery wards, medical staff and hospitalization. These data were compared to the costs of 29 Burch surgeries performed before the introduction of synthetic slings. Demographic data were similar, although median age was lower in the group submitted to Burch surgery (46.3±8.6 versus 56.2±11.3 (p<0.001)). Cost was significantly lower in patients submitted to sling in all items, except for time spent in recovery ward. Total value of 29 Burch surgeries was R$ 217.766.12, and of R$ 68.049.92 of 29 patients submitted to sling surgery (p<0.001). Burch surgery was more expensive than ambulatory synthetic transobturator sling surgery, even when the cost of the synthetic sling was considered. Copyright® by the International Brazilian Journal of Urology.

Rare complication of needleless mini-sling procedure: Case report.

PubMed

Karalar, Mustafa; Keles, Ibrahim; Unlu, Serdar; Sarici, Hasmet; Kose, Mesut; Ay, Cemil

2017-01-01

The mini-sling procedure is a widely used, minimally invasive treatment for stress urinary incontinence. While bladder perforation and stone formation over the mesh is not an expected complication of the mini-sling procedure, in this case, we report on the management of bladder calculi formed over the mesh, which was passed through the bladder while applying the mini-sling procedure, and was eventually removed using holmium laser. Performing cystoscopy in patients with irritative and obstructive symptoms after the sling procedure will help confirm bladder perforation, and an endoscopic approach using holmium laser is an effective treatment.

Field Comparison between Sling Psychrometer and Meteorological Measuring Set AN/TMQ-22

DTIC Science & Technology

the ML-224 Sling Psychrometer . From a series of independent tests designed to minimize error it was concluded that the AN/TMQ-22 yielded a more accurate...dew point reading. The average relative humidity error using the sling psychrometer was +9% while the AN/TMQ-22 had a plus or minus 2% error. Even with cautious measurement the sling yielded a +4% error.

The effect of an arm sling used for shoulder support on gait efficiency in hemiplegic patients with stroke using walking aids.

PubMed

Jeong, Yeon-Gyu; Jeong, Yeon-Jae; Koo, Jung-Wan

2017-06-01

The effects of an arm sling on the physiological costs of walking are not known. Even though a previous study reported that an arm sling can improve gait efficiency, its entrance criteria was only hemiparetic patients able to walk without walking aids independently. The aim of this study was to investigate the effect of shoulder support by an arm sling on gait efficiency in hemiplegic stroke patients using walking aids. Randomized crossover design. Rehabilitation department of a university hospital. A total of 57 hemiplegic patients with shoulder subluxation dependent on canes were grouped into single cane (N.=30) and quad cane groups (N.=27) as walking aids. All patients performed a walk with their own walking aid with and without an arm sling in randomized order, on the same day. We measured the energy cost and energy expenditure using a portable gas analyzer and heart rate during a 6-minutes Walk Test and a 10-m Walk Test. We analyzed all outcomes measures with and without an arm sling between the patients who were grouped according to their walking aids using 2-way repeated ANOVA. The energy cost (0.068±0.023 mL/kg/m) and oxygen expenditure (8.609±2.155 mL/kg/minutes) were lower with the arm sling (P<0.05) than without the arm sling (0.074±0.029 mL/kg/m, and 9.109±2.406 mL/kg/minutes, respectively), and the walking endurance (138.942±47.043 m) were longer (P<0.05) with the arm sling among the hemiplegic patients with single cane. Among the hemiplegic patients with a single cane, the walking endurance achieved with an arm sling significantly improved than those achieved without an arm sling, and the energy expenditure and energy cost was significantly lower. The hemiplegic arm support with an arm sling may be beneficial for gait efficiency in hemiplegic patients using a single cane, which lead to decreased oxygen use at a given speed.

Comparison of complication rates related to male urethral slings and artificial urinary sphincters for urinary incontinence: national multi-institutional analysis of ACS-NSQIP database.

PubMed

Alwaal, Amjad; Harris, Catherine R; Awad, Mohannad A; Allen, Isabel E; Breyer, Benjamin N

2016-10-01

Male stress urinary incontinence (SUI) can significantly diminish quality of life and lead to embarrassment and social withdrawal. Surgical therapies, such as male urethral slings and artificial urinary sphincters (AUS), are considered effective and safe treatments for male SUI. Our objective is to evaluate 30-day complications in patients undergoing male slings and AUS placement from a national multicenter database. Data from the American College of Surgeons National Surgical Quality of Improvement Program for 2008-2013 were used to identify patients who underwent male slings and AUS implantation. Trained coders abstracted complication data from the patient record independent of the surgical team. We compared 30-day postoperative complications for male slings and AUS. We examined the relationship between patient factors and complication rates for each procedure type. Overall, 1205 incontinence surgeries in men were identified: 597 male sling placements and 608 AUS implantations. Male sling placement had a lower 30-day postoperative complication rate compared to AUS (2.8 vs. 5.1 %, p = 0.046). Compared to AUS, male sling was associated with fewer urinary tract infections (0.3 vs. 2.0 %, p = 0.020) and return trips to the operating room (1.0 vs. 3.0 %, p < 0.001). Patients with higher BMI were more likely to have a complication, while age, race and Charlson comorbidity index were not associated with higher or lower complication rates. Complications rates for both male sling and AUS are low. Male sling is associated with a lower rate of complications than AUS. These findings allow for better patient perioperative counseling regarding 30-day perioperative complications.

V-22 Osprey Tilt-Rotor Aircraft

DTIC Science & Technology

2006-08-23

gun ! Hoist ! Improved fastrope location MV-22 Block C ! Flight incident recorder ! Radar altimeter sling load modification ! Fuel dump modification...seven people and destroying the aircraft. This accident was caused by a fire resulting from hydraulic component failures and design problems in the...investigation. On April 5, 2001, the Marine Corps reported that the crash was caused by a burst hydraulic line in one of the Osprey’s two engine casings, and a

[Female stress urinary incontinence. Surgical repair with pubovaginal sling techniques].

PubMed

Escribano Patiño, Gregorio; Hernández Fernández, Carlos; Subirá Ríos, David; Castaño González, Irene; Moralejo Gárate, Mercedes; Martinez Salamanca, Juan Ignacio

2002-11-01

To review the treatment of female stress urinary incontinence by new systems of tension-free urethral sling TVT type (Tension free vaginal tape) or IVS (intravaginal slingplasty), and the bone anchoring trasvaginal sling procedure Infast. We describe the surgical techniques of the various procedures and perform a bibliographic review on the topic. The pubovaginal sling has become the gold standard in the treatment of female stress urinary incontinence, mainly if there is sphincter intrinsic dysfunction. The concept of tension free medium urethra support has been the most important contribution, that questions the classification of incontinence in types I, II and III, because the pubocervical tension free sling can correct all three. Tension free urethral sling techniques have demonstrated to be effective, minimally invasive with a low complication rate, easily reproducible, and with good continence results in the mid-term.

Association Between the Amount of Vaginal Mesh Used With Mesh Erosions and Repeated Surgery After Repairing Pelvic Organ Prolapse and Stress Urinary Incontinence.

PubMed

Chughtai, Bilal; Barber, Matthew D; Mao, Jialin; Forde, James C; Normand, Sharon-Lise T; Sedrakyan, Art

2017-03-01

Mesh, a synthetic graft, has been used in pelvic organ prolapse (POP) repair and stress urinary incontinence (SUI) to augment and strengthen weakened tissue. Polypropylene mesh has come under scrutiny by the US Food and Drug Administration. To examine the rates of mesh complications and invasive reintervention after the placement of vaginal mesh for POP repair or SUI surgery. This investigation was an observational cohort study at inpatient and ambulatory surgery settings in New York State. Participants were women who underwent transvaginal repair for POP or SUI with mesh between January 1, 2008, and December 31, 2012, and were followed up through December 31, 2013. They were divided into the following 4 groups based on the amount of mesh exposure: transvaginal POP repair surgery with mesh and concurrent sling use (vaginal mesh plus sling group), transvaginal POP repair with mesh and no concurrent sling use (vaginal mesh group), transvaginal POP repair without mesh but concurrent sling use for SUI (POP sling group), and sling for SUI alone (SUI sling group). The primary outcome was the occurrence of mesh complications and repeated invasive intervention within 1 year after the initial mesh implantation. A time-to-event analysis was performed to examine the occurrence of mesh erosions and subsequent reintervention. Secondary analyses of an age association (<65 vs ≥65 years) were conducted. The study identified 41 604 women who underwent 1 of the 4 procedures. The mean (SD) age of women at their initial mesh implantation was 56.2 (13.0) years. The highest risk of erosions was found in the vaginal mesh plus sling group (2.72%; 95% CI, 2.31%-3.21%) and the lowest in the SUI sling group (1.57%; 95% CI, 1.41%-1.74%). The risk of repeated surgery with concomitant erosion diagnosis was also the highest in the vaginal mesh plus sling group (2.13%; 95% CI, 1.76%-2.56%) and the lowest in the SUI sling group (1.16%; 95% CI, 1.03%-1.31%). The combined use of POP mesh and SUI mesh sling was associated with the highest erosion and repeated intervention risk, while mesh sling alone had the lowest erosion and repeated intervention risk. There is evidence for a dose-response relationship between the amount of mesh used and subsequent mesh erosions, complications, and invasive repeated intervention.

Management of recurrent stress urinary incontinence after burch and sling procedures.

PubMed

Zimmern, Philippe E; Gormley, E Ann; Stoddard, Anne M; Lukacz, Emily S; Sirls, Larry; Brubaker, Linda; Norton, Peggy; Oliphant, Sallie S; Wilson, Tracey

2016-03-01

To examine treatment options selected for recurrent stress urinary incontinence (rSUI) in follow-up after Burch, autologous fascial and synthetic midurethral sling (MUS) procedures. We performed a secondary analysis of the SISTER and ToMUS trials of participants who underwent primary stress urinary incontinence (SUI) treatment (without prior SUI surgery or concomitant procedures). Using Kaplan-Meier analysis, retreatment-free survival rates by initial surgical procedure were compared. Mean MESA (Medical Epidemiologic and Social Aspects of Aging) stress index was also compared between those retreated for rSUI compared to those not retreated. Half of the women in the SISTEr trial met inclusion criteria for this analysis (329/655, 174 Burch and 155 fascial sling), as did 444/597 (74%) of subjects in ToMUS (221 transobturator midurethral sling (TMUS), and 223 retropubic midurethral sling (RMUS). Types of surgical retreatment included autologous fascial sling (19), synthetic sling (1), and bulking agent (18). Five-year retreatment free survival rates (and standard errors) were 87% (3%), 96% (2%), 97% (1%), and 99% (0.7%) for Burch, autologous fascial sling, TMUS, and RMUS groups respectively (P < 0.0001). For all index surgery groups, the mean MESA stress index at last visit prior to retreatment for those retreated (n = 23) was significantly higher than mean MESA stress index at last visit for those not retreated (n = 645) (P < 0.0001). In these cohorts, 6% of women after standard anti-incontinence procedures were retreated within 5 years, mostly with injection therapy or autologous fascial sling. Not all women with rSUI chose surgical retreatment. © 2015 Wiley Periodicals, Inc.

Management of recurrent stress urinary incontinence after Burch and sling procedures

PubMed Central

Zimmern, Philippe; Gormley, E. Ann; Stoddard, Anne M.; Lukacz, Emily S.; Sirls, Larry; Brubaker, Linda; Norton, Peggy; Oliphant, Sallie S.; Wilson, Tracey

2014-01-01

Introduction To examine treatment options selected for recurrent stress urinary incontinence (rSUI) in follow-up after Burch, autologous fascial and synthetic midurethral sling (MUS) procedures. Methods We performed a secondary analysis of the SISTER and ToMUS trials of participants who underwent primary stress urinary incontinence (SUI) treatment (without prior SUI surgery or concomitant procedures). Using Kaplan-Meier analysis, retreatment-free survival rates by initial surgical procedure were compared. Mean MESA (Medical Epidemiologic and Social Aspects of Aging) stress index was also compared between those retreated for rSUI compared to those not retreated. Results Half of the women in the SISTEr trial met inclusion criteria for this analysis (329/655, 174 Burch and 155 fascial sling), as did 444/597 (74%) of subjects in ToMUS (221 transobturator midurethral sling (TMUS), and 223 retropubic midurethral sling (RMUS). Types of surgical retreatment included autologous fascial sling (19), synthetic sling (1), and bulking agent (18). Five-year retreatment free survival rates (and standard errors) were 87% (3%), 96% (2%), 97% (1%) and 99% (0.7%) for Burch, autologous fascial sling, TMUS, and RMUS groups respectively (p <0.0001). For all index surgery groups, the mean MESA stress index at last visit prior to retreatment for those retreated (n = 23) was significantly higher than mean MESA stress index at last visit for those not retreated (n = 645) (p <0.0001). Conclusion In these cohorts, 6% of women after standard anti-incontinence procedures were retreated within 5 years, mostly with injection therapy or autologous fascial sling. Not all women with rSUI chose surgical retreatment. PMID:25598512

Muscle Activation of Vastus Medialis Oblique and Vastus Lateralis in Sling-Based Exercises in Patients with Patellofemoral Pain Syndrome: A Cross-Over Study

PubMed Central

Chang, Wen-Dien; Huang, Wei-Syuan; Lai, Ping-Tung

2015-01-01

Objectives. To examine what changes are caused in the activity of the vastus medialis oblique (VMO) and vastus lateralis (VL) at the time of sling-based exercises in patients with patellofemoral pain syndrome (PFPS) and compare the muscular activations in patients with PFPS among the sling-based exercises. Methods. This was a cross-over study. Sling-based open and closed kinetic knee extension and hip adduction exercises were designed for PFPS, and electromyography was applied to record maximal voluntary contraction during the exercises. The VMO and VL activations and VMO : VL ratios for the three exercises were analyzed and compared. Results. Thirty male (age = 21.19 ± 0.68 y) and 30 female (age = 21.12 ± 0.74 y) patients with PFPS were recruited. VMO activations during the sling-based open and closed kinetic knee extension exercises were significantly higher (P = 0.04 and P = 0.001) than those during hip adduction exercises and VMO : VL ratio for the sling-based closed kinetic knee extension and hip adduction exercises approximated to 1. Conclusions. The sling-based closed kinetic knee extension exercise produced the highest VMO activation. It also had an appropriate VMO : VL ratio similar to sling-based hip adduction exercise and had beneficial effects on PFPS. PMID:26504480

Power System Assessment for the Burnt Mountain Seismic Observatory

DTIC Science & Technology

1994-03-01

aluminum alloy anode, an oxygen cathode, a caustic (potassium hydroxide) electrolyte. tankage to hold the electrodes and electrolyte plus a small pump...ground shifting which is characteristic of tundra. Movement of the tundra can subject any buried lines to heavy shear loads which could stress the...with the forks fully engaged under the pallet, or by an overhead hoist or crane attached to the handling sling. All ma- terials handling equipment

A Parallel Randomized Clinical Trial Examining the Return of Urinary Continence after Robot-Assisted Radical Prostatectomy with or without a Small Intestinal Submucosa Bladder Neck Sling.

PubMed

Bahler, Clinton D; Sundaram, Chandru P; Kella, Naveen; Lucas, Steven M; Boger, Michelle A; Gardner, Thomas A; Koch, Michael O

2016-07-01

Urinary continence is a driver of quality of life after radical prostatectomy. In this study we evaluated the impact of a biological bladder neck sling on the return of urinary continence after robot-assisted radical prostatectomy. This study compared early continence in patients undergoing robot-assisted radical prostatectomy with a sling and without a sling in a 2-group, 1:1, parallel, randomized controlled trial. Patients were blinded to group assignment. The primary outcome was defined as urinary continence (0 to 1 pad per day) at 1 month postoperatively. Inclusion criteria were organ confined prostate cancer and a prostate specific antigen less than 15 ng/ml. Exclusion criteria were any prior surgery on the prostate, a history of neurogenic bladder and history of pelvic radiation. A chi-squared test was used for the primary outcome. A total of 147 patients were randomized (control 74, sling 73) and 92% were available for primary end point analysis at 1 month. There were no significant differences in baseline or perioperative data except that operating room time was 20.1 minutes longer for the sling group (p=0.04). The continence rate was similar between the control and sling groups at 1 month (47.1% vs 55.2%, p=0.34) and 12 months (86.7% vs 94.5%, p=0.15), respectively. Adverse events were similar between the control and sling groups (10.8% vs 13.7%, p=0.59). The application of an absorbable urethral sling at robot-assisted radical prostatectomy was well tolerated with no increase in obstructive symptoms in this randomized trial. However, the sling failed to show a significant improvement in continence. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Biocompatibility assessment of synthetic sling materials for female stress urinary incontinence.

PubMed

Gomelsky, Alex; Dmochowski, Roger R

2007-10-01

We evaluated the performance and complications of currently available synthetic sling materials with a focus on in vitro and in vivo biocompatibility, and acceptance in the human body. We reviewed the MEDLINE database for relevant literature pertaining to various synthetic sling materials. The Food and Drug Administration regulations regarding the regulation and biocompatibility testing of synthetic meshes were also reviewed. Many synthetic meshes used for sling construction were introduced before rigorous Food and Drug Administration regulations were passed and, thus, some became associated with unique complications. Most meshes used in pubovaginal and mid urethral sling surgery are associated with high short-term success rates and relatively few intraoperative complications. Despite modifications and additives, slings constructed from polytetrafluoroethylene and polyethylene are poorly accepted by the human body. Flexible, macroporous, polypropylene meshes appear to integrate more completely with human tissue than other synthetic materials. However, multifilament and nonknitted polypropylene slings may integrate poorly. The composition, weave and pore size of each material are unique. These properties are responsible for the strength and durability of the material, as well as the ultimate acceptance and incorporation in the human body. Each material should be individually evaluated and patients should be counseled appropriately before implantation.

Apical sling: an approach to posthysterectomy vault prolapse.

PubMed

Alas, Alexandriah N; Pereira, Ines; Chandrasekaran, Neeraja; Devakumar, Hemikaa; Espaillat, Luis; Hurtado, Eric; Davila, G Willy

2016-09-01

This video demonstrates a transvaginal technique for vaginal vault suspension using an apical sling suspended from the sacrospinous ligaments. This was a retrospective review of apical sling procedures performed from July 2013 to November 2014. The technique is started by marking the vaginal apex. A posterior dissection is performed and the sacrospinous ligaments are identified after dissection into the pararectal space. A 10-cm piece of monofilament, inelastic polypropylene tape is attached to the underside of the vaginal apex. Polypropylene sutures are placed into the sacrospinous ligament and threaded though the lateral edges of the apical sling and tied down, restoring apical support. Finally, the vaginal epithelium is closed. A total of 67 women underwent an apical sling procedure with 70 % (47/67) completing 6 months follow-up. The subjective cure rate ("cured" or "greatly improved") was 78.7 % and the objective cure rate (anatomical success, defined as apical prolapse stage ≤1) was 100 % (47 patients). Our apical sling sacrospinous ligament fixation approach is a unique, minimal mesh approach using a tape commonly used for midurethral slings to suspend the vaginal apex. We achieved high anatomical success and patient satisfaction.

To study the effect of orbital sling on post operative vision in cases of maxillary carcinoma undergoing total maxillectomy.

PubMed

Shukla, Anirudh; Dudeja, Vivek

2014-06-01

To study effect of orbital sling on post operative vision in cases of maxillary carcinoma undergoing total maxillectomy. All patients with the principal procedure of "total maxillectomy" for histopathologically proven cases of carcinoma maxilla in department of otorhinolaryngology and head-neck surgery, N.S.C.B. medical college, Jabalapur, Madhya Pradesh, India from July 2011 to October 2013 were included. Out of the 20 patients irrespective of whether orbital sling was created or not, maximum number of patients 8 (40 %) showed a 3 step improvement, and maximum improvement seen was up to five steps. Out of the 14 patients in which orbital sling was created maximum number of patients 7 (50 %) showed a 3 step improvement, and maximum improvement seen was up to five steps. Out of the 6 patients in whom orbital sling was not created maximum number of patients 3 (50 %) showed a 2 step improvement, and maximum improvement seen was up to three steps. Infraorbital repair with the help of sling results in better improvement of vision as compared to those in whom sling was not or could not be made with no significant difference on eye movements.

Risk of Damage to the Somatic Innervation of the Penis during the AdVanceProcedure: An Anatomical Study.

PubMed

Hogewoning, Cornelis R C; Elzevier, Henk W; Pelger, Rob C M; Bekker, Milou D; DeRuiter, Marco C

2015-08-01

One of the methods to treat post radical prostatectomy stress urinary incontinence is the AdVance (American Medical Systems, Minnetonka, MN, USA) male sling procedure. During this procedure, the somatic innervation of the penis may be at risk for injury. Six AdVance procedures were performed in six donated bodies at the Anatomy and Embryology Department of the Leiden University Medical Centre. The pelves were dissected and the shortest distance between the sling and the dorsal nerve of the penis (DNP) was documented. The aim of this study was to describe the anatomical relation between the AdVance male sling and penile nerves based on the dissection of six adult male pelves. The AdVance male sling procedure was conducted in six donated male bodies. After placement, the pelves were dissected and the shortest distance between sling and the DNP was documented. The main outcome measure was the distance between the AdVance male sling and the DNP. The mean distance of the sling to the DNP was 4.1 mm and was found situated directly next to the nerve (distance 0 mm) in 4 out of 12 (33%) hemipelves. The distance of the sling to the obturator neurovascular bundle was 30 mm or more in all six bodies. Damage to the DNP caused by the AdVance male sling procedure appears to be an extremely rare complication, which has not been described in current literature. The proximity of the AdVance to the DNP could, however, pose a risk that should be taken into consideration by physicians and patients when opting for surgery. © 2015 International Society for Sexual Medicine.

A re-adjustable sling for female recurrent stress incontinence and sphincteric deficiency: Outcomes and complications in 125 patients using the Remeex sling system.

PubMed

Errando, Carlos; Rodriguez-Escovar, Fernando; Gutierrez, Cristina; Baez, Carlos; Araño, Pedro; Villavicencio, Humberto

2010-11-01

To evaluate the outcomes, complications, and quality of life of patients after a Remeex re-adjustable sling for recurrent stress urinary incontinence (SUI) and intrinsic sphincteric deficiency (ISD) indications. One hundred twenty-five patients with SUI were prospectively evaluated following a re-adjustable sling in a single tertiary academic Center. Patients were classified by Q-tip, urodynamic and clinical criteria into ISD (70) and recurrent SUI (55). All patients underwent a re-adjustable sling placement. Outcome measures included pad-test, urodynamics, and the King's Health Questionnaire. After a mean follow-up of 38 months (26-72), 109 patients (87%) are cured of SUI based on pad-test, clinical, and urodynamic criteria. Sixteen patients (13%) remain incontinent. Nine of those (7%) are satisfied to the point that they decline re-adjustment of the sling, and seven (6%) are on the waiting list for re-adjustment. Nineteen patients show urge incontinence (9 with previous urodynamic mixed incontinence, 10 (8%) with de novo detrusor overactivity). Twenty-one patients benefited from a re-adjustment of the sling during the follow-up. The tension was increased in 17 cases (continent at discharge) due to recurrence of SUI, and reduced in 4 due to obstruction. The Varitensor was removed in 1 case due to infection. No other complications were seen. The Remeex re-adjustable sling system provides a good cure rate for recurrent SUI and ISD with a low complication rate. The ability to increase or decrease sling tension allowed us to achieve cure in patients who were not initially dry, and to relieve obstruction in every case attempted. © 2010 Wiley-Liss, Inc.

Vagal sensory innervation of the gastric sling muscle and antral wall: implications for gastro-esophageal reflux disease?

PubMed

Powley, T L; Gilbert, J M; Baronowsky, E A; Billingsley, C N; Martin, F N; Phillips, R J

2012-10-01

The gastric sling muscle has not been investigated for possible sensory innervation, in spite of the key roles the structure plays in lower esophageal sphincter (LES) function and gastric physiology. Thus, the present experiment used tracing techniques to label vagal afferents and survey their projections in the lesser curvature. Sprague-Dawley rats received injections of dextran biotin into the nodose ganglia. Fourteen days postinjection, animals were euthanized and their stomachs were processed to visualize the vagal afferent innervation. In different cases, neurons, muscle cells, or interstitial cells of Cajal (ICC) were counterstained. The sling muscle is innervated throughout its length by vagal afferent intramuscular arrays (IMAs) associated with ICC. In addition, the distal antral attachment site of the sling muscle is innervated by a novel vagal afferent terminal specialization, an antral web ending. The muscle wall of the distal antrum is also innervated by conventional IMAs and intraganglionic laminar endings, the two types of mechanoreceptors found throughout stomach smooth muscle. The innervation of sling muscle by IMAs, putative stretch receptors, suggests that sling sensory feedback may generate vago-vagal or other reflexes with vagal afferent limbs. The restricted distribution of afferent web endings near the antral attachments of sling fibers suggests the possibility of specialized mechanoreceptor functions linking antral and pyloric activity to the operation of the LES. Dysfunctional sling afferents could generate LES motor disturbances, or normative compensatory sensory feedback from the muscle could compromise therapies targeting only effectors. © 2012 Blackwell Publishing Ltd.

Internal- and External-Rotation Peak Toque in Little League Baseball Players With Subacromial Impingement Syndrome: Improved by Closed Kinetic Chain Shoulder Training.

PubMed

Lee, Dong-Rour; Kim, Laurentius Jongsoon

2016-08-01

Many studies have explored closed kinetic chain (CKC) shoulder exercises (SEs) with a sling because they are safer and more effective than open-chain exercises, especially in early stages of treatment. However, the application of CKC SE in youth baseball players has rarely been attempted, although teenage baseball players also experience shoulder pain. To investigate the effects of CKC SE on the peak torque of shoulder internal rotation (IR) and external rotation (ER) in youth baseball players. Single-group pretest, posttest. Biomechanics laboratory. 23 Little League Baseball players with subacromial impingement syndrome. The CKC SE with a sling was CKC shoulder-flexion exercise, extension exercise, IR exercise, and ER exercise. This exercise regimen was conducted 2 or 3 times/wk for 8 wk. The peak torque of shoulder IR and ER was measured using an isokinetic dynamometer. Concentric shoulder rotation was performed, with 5 repetitions at an angular velocity of 60°/s and 15 at 180°/s. The IR and ER peak torque significantly increased at each angular velocity after the exercise program. In particular, the increase in IR and ER peak torque values was statistically significant at an angular velocity of 180°/s. CKC SE was effective in increasing shoulder IR and ER strength, demonstrating its potential benefits in the prevention and treatment of shoulder injury. In addition, increased IR peak torque appears to improve throwing velocity in baseball players.

Bubble fusion: Preliminary estimates

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

Krakowski, R.A.

1995-02-01

The collapse of a gas-filled bubble in disequilibrium (i.e., internal pressure {much_lt} external pressure) can occur with a significant focusing of energy onto the entrapped gas in the form of pressure-volume work and/or acoustical shocks; the resulting heating can be sufficient to cause ionization and the emission of atomic radiations. The suggestion that extreme conditions necessary for thermonuclear fusion to occur may be possible has been examined parametrically in terms of the ratio of initial bubble pressure relative to that required for equilibrium. In this sense, the disequilibrium bubble is viewed as a three-dimensional ``sling shot`` that is ``loaded`` tomore » an extent allowed by the maximum level of disequilibrium that can stably be achieved. Values of this disequilibrium ratio in the range 10{sup {minus}5}--10{sup {minus}6} are predicted by an idealized bubble-dynamics model as necessary to achieve conditions where nuclear fusion of deuterium-tritium might be observed. Harmonic and aharmonic pressurizations/decompressions are examined as means to achieve the required levels of disequilibrium required to create fusion conditions. A number of phenomena not included in the analysis reported herein could enhance or reduce the small levels of nuclear fusions predicted.« less

21 CFR 890.3640 - Arm sling.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Arm sling. 890.3640 Section 890.3640 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3640 Arm sling. (a) Identification. An...

21 CFR 890.3640 - Arm sling.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Arm sling. 890.3640 Section 890.3640 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3640 Arm sling. (a) Identification. An...

21 CFR 890.3640 - Arm sling.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Arm sling. 890.3640 Section 890.3640 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3640 Arm sling. (a) Identification. An...

21 CFR 890.3640 - Arm sling.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Arm sling. 890.3640 Section 890.3640 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3640 Arm sling. (a) Identification. An...

21 CFR 890.3640 - Arm sling.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Arm sling. 890.3640 Section 890.3640 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Prosthetic Devices § 890.3640 Arm sling. (a) Identification. An...

Modeling of load lifting process with unknown center of gravity position

NASA Astrophysics Data System (ADS)

Kamanin, Y. N.; Zhukov, M. I.; Panichkin, A. V.; Redelin, R. A.

2018-03-01

The article proposes a new type of lifting beams that allows one to lift loads where the position of the center of gravity is unknown beforehand. The benefit of implementing this type of traverse is confirmed by the high demand for this product from the industrial enterprises and lack of their availability on the market. In conducted studies, the main kinematic and dynamic dependencies of the load lifting process with an unknown position of the center of gravity were described allowing for design and verification calculations of the traverse with flexible slings and an adjustable bail to be carried out. The obtained results can be useful to engineers and employees of enterprises engaged in the design and manufacturing of the lifting equipment and scientists doing research in “Carrying and lifting machines”.

Vagal Sensory Innervation of the Gastric Sling Muscle and Antral Wall: Implications for GERD?

PubMed Central

Powley, Terry L.; Gilbert, Jared M.; Baronowsky, Elizabeth A.; Billingsley, Cherie N.; Martin, Felecia N.; Phillips, Robert J.

2012-01-01

Background The gastric sling muscle has not been investigated for possible sensory innervation, in spite of the key roles the structure plays in lower esophageal sphincter (LES) function and gastric physiology. Thus, the present experiment used tracing techniques to label vagal afferents and survey their projections in the lesser curvature. Methods Sprague Dawley rats received injections of dextran biotin into the nodose ganglia. Fourteen days post-injection, animals were euthanized and their stomachs were processed to visualize the vagal afferent innervation. In different cases, neurons, muscle cells, or interstitial cells of Cajal were counterstained. Key Results The sling muscle is innervated throughout its length by vagal afferent intramuscular arrays (IMAs) associated with interstitial cells of Cajal. In addition, the distal antral attachment site of the sling muscle is innervated by a novel vagal afferent terminal specialization, an antral web ending. The muscle wall of the distal antrum is also innervated by conventional IMAs and intraganglionic laminar endings (IGLEs), the two types of mechanoreceptors found throughout stomach smooth muscle. Conclusions & Inferences The innervation of sling muscle by IMAs, putative stretch receptors, suggests that sling sensory feedback may generate vago-vagal or other reflexes with vagal afferent limbs. The restricted distribution of afferent web endings near the antral attachments of sling fibers suggests the possibility of specialized mechanoreceptor functions linking antral and pyloric activity to the operation of the LES. Dysfunctional sling afferents could generate LES motor disturbances, or normative compensatory sensory feedback from the muscle could compromise therapies targeting only effectors. PMID:22925069

29 CFR 1915.118 - Tables.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Improved Plow Steel, Independent Wire Rope Core, Wire Rope and Wire Rope Slings [In tons of 2,000 pounds... for Improved Plow Steel, Independent Wire Rope Core, Wire Rope Slings [in tons of 2,000 pounds] Two...-4—Rated Capacities for Improved Plow Steel, Fiber Core, Wire Rope and Wire Rope Slings [in tons of 2...

29 CFR 1915.118 - Tables.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Improved Plow Steel, Independent Wire Rope Core, Wire Rope and Wire Rope Slings [In tons of 2,000 pounds... for Improved Plow Steel, Independent Wire Rope Core, Wire Rope Slings [in tons of 2,000 pounds] Two...-4—Rated Capacities for Improved Plow Steel, Fiber Core, Wire Rope and Wire Rope Slings [in tons of 2...

KSC-08pd3630

NASA Image and Video Library

2008-11-11

CAPE CANAVERAL, Fla. – In the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, space shuttle Atlantis is lifted by a sling. Atlantis is being taken off its external fuel tank and solid rocket boosters stack after of the delay of its STS-125 mission to NASA's Hubble Space Telescope. Atlantis will be returned to the Orbiter Processing Facility. Atlantis' targeted launch on Oct. 14 was delayed when a system that transfers science data from the orbiting observatory to Earth malfunctioned on Sept. 27. The new target launch date is under review. Photo credit: NASA/Jim Grossmann

KSC-08pd3631

NASA Image and Video Library

2008-11-11

CAPE CANAVERAL, Fla. – In the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, space shuttle Atlantis is lifted by a sling. Atlantis is being taken off its external fuel tank and solid rocket boosters stack after of the delay of its STS-125 mission to NASA's Hubble Space Telescope. Atlantis will be returned to the Orbiter Processing Facility. Atlantis' targeted launch on Oct. 14 was delayed when a system that transfers science data from the orbiting observatory to Earth malfunctioned on Sept. 27. The new target launch date is under review. Photo credit: NASA/Jim Grossmann

Midurethral Slings for Women with Stress Urinary Incontinence

PubMed Central

2006-01-01

Executive Summary Objective The objective of the current review was to evaluate the safety, efficacy, and cost-effectiveness of midurethral slings compared with traditional surgery. Background This assessment was undertaken in order to update and expand upon the health technology & policy assessment of tension-free vaginal tape (TVT, Gynecare Worldwide, a division of Ethicon Inc, a Johnson & Johnson company, Somerville, New Jersey) sling procedure for stress urinary incontinence published by the Medical Advisory Secretariat in February 2004. Since the publication of the 2004 assessment, a number of TVT-like sling alternatives have become available which employ the same basic principles as TVT slings: minimally invasive, midurethral placement, self-fixing, and tension-free. This update will evaluate the efficacy and safety of midurethral slings. Clinical Need Normal continence is controlled by the nervous system and involves co-ordination between bladder, urethra, urethral sphincter, and pelvic floor. Incontinence occurs when the relationship among the above components is compromised, either due to physical damage or nerve dysfunction. (1) Stress urinary incontinence is the most common form of urinary incontinence in women. It is characterized by the “complaint of involuntary leakage on effort or exertion, or on sneezing or coughing” when there is increased abdominal pressure without detrusor (bladder wall) contraction. (2) There are 2 factors which define stress urinary incontinence: a weakening in the support of the proximal urethra, causing urethral hyper-mobility and deficiency in the sphincter, causing urethral leakage. Both factors are thought to coexist. (1) Accurate tests are not available to distinguish these 2 types of stress urinary incontinence. Urinary incontinence is estimated to affect about 250,000 Canadian women and 8 million American women aged 65 and over. (3;4) The prevalence of stress urinary incontinence is very difficult to measure because women with stress urinary incontinence may not tell their health practitioner about their symptoms due to embarrassment associated with stress urinary incontinence. A cross-sectional postal survey of 15,904 adults aged 40 and over who were registered with a local GP in Leicestershire, United Kingdom, revealed that 18% to 34% of respondents had symptoms of SUI. (5) Just over 9% reported symptoms “sometimes,” while almost 3% reported symptoms “most of the time.” Stress urinary incontinence was most common for women in their 50s. A more recent study suggests that 24% of women aged 18 to 44 years and 37% of women aged 45 and over have symptoms of stress urinary incontinence. (6) Stress urinary incontinence has been associated with a broad range of psychosocial stress and disablement, such as difficulties with activities of daily living, avoidance of social activities, fear of unpleasant odour, and embarrassment. (7) Economic burden may include the cost of pads, drugs, and devices, and the inability to participate in the work force in severe cases. Midurethral Slings Suburethral slings differ according to several criteria including placement, approach, method of fixation, and sling material. This review will evaluate slings which fulfill all of the following criteria: Midurethral placement (as opposed to bladder neck placement) Self-fixing (no sutures, bone anchors, etc.) Minimally invasive (using local, epidural, or general anesthesia) “Tension-free” placement The different types of midurethral slings available vary according to 3 main parameters: Implant material, i.e., monofilament, multifilament, elastic, non-elastic, smooth, serrated, etc., Delivery instruments, i.e., needles, curved trocars, disposable, reusable, etc., Surgical approach As any one, or any combination of these parameters may vary across the different sling brands, it is difficult to ascribe observed differences in efficacy and safety across slings to any one factor. Review Strategy The literature published between January 2000 and February 2006 was searched in the following databases: OVID Medline, In Process and Other Non-Indexed Citations, Embase, Cochrane Database of Systematic Reviews and CENTRAL, INAHTA. The database search was supplemented with a search of relevant Web sites, and a review of the bibliographies of selected papers. The search strategy can be viewed in Appendix 1. Inclusion Criteria General population with SUI Randomized controlled studies, health technology assessments, guidelines Female subjects Midurethral, self-fixing, and minimally invasive slings/tapes English language The search strategy yielded 391 original citations. Studies were excluded for a variety of reasons, such as using traditional, suburethral slings as opposed to midurethral slings, not including patients with stress urinary incontinence, including males in the study, case reports, and not reporting the outcomes of interest. There were 13 randomized controlled trials identified that compared midurethral slings to other midurethral slings or traditional surgery. (8-20) (Table 1) Three of the randomized controlled trials (15;17;20) have had subsequent updated articles of longer term results. (21-23) The results of the randomized controlled trials have been stratified into 2 groups: TVT versus colposuspension and comparisons of midurethral slings. No randomized controlled trials were identified that compared a midurethral sling other than TVT to colposuspension. Summary of Findings Effectiveness At this time, there does not appear to be one procedure that is more effective than another at curing stress urinary incontinence. TVT appears to have similar cure rates to open colposuspension; and the various midurethral sling types seem to have similar cure rates. Procedure Time and Length of Hospital Stay The procedure time and the length of hospital stay for TVT are significantly shorter than the procedure time and length of stay for colposuspension. The procedure time and length of hospital stay for all midurethral slings appears to be similar. Complications The most frequently reported complications were bladder perforations, de novo voiding difficulties and device problems. Quality of Life Quality of life was not consistently reported in all of the randomized controlled trials. In the studies that reported quality of life there does not appear to be a significant difference in quality of life scores between the sling procedures. PMID:23074494

Helicopter sling load accident/incident survey: 1968 - 1974

NASA Technical Reports Server (NTRS)

Shaughnessy, J. D.; Pardue, M. D.

1977-01-01

During the period considered a mean of eleven accidents per year occurred and a mean of eleven persons were killed or seriously injured per year. Forty-one percent of the accidents occurred during hover, and 63 percent of the accidents had pilot error listed as a cause/factor. Many accidents involved pilots losing control of the helicopter or allowing a collision with obstructions to occur. There was a mean of 58 incidents each year and 51 percent of these occurred during cruise.

Virtue Quadratic Male Sling for stress incontinence—surgical guide for placement and delayed revision

PubMed Central

Rubin, Rachel S.; Xavier, Keith R.

2017-01-01

The algorithm for surgical management of post prostatectomy incontinence classically includes male slings and artificial urinary sphincter (AUS) placement. The Virtue Quadratic Male Sling was designed to provide both urethral elevation and prepubic compression making it a viable option for a wider spectrum of incontinent men whose symptoms range from mild to severe. With a focus on two key steps of the surgery, (I) sling fixation (II) use of intraoperative retrograde leak point pressure (RLPP), this guide is intended to outline a safe and efficacious treatment for post-prostatectomy incontinence. Intriguingly, the sling can be revised in the event of refractory or worsening leakage, and does not preclude the placement of an AUS should it be needed. This paper describes a step by step approach to performing the procedure as well as expert tips to improve outcomes and avoid/manage complications that have been learned over the years. PMID:28904899

29 CFR 1915.112 - Ropes, chains and slings.

Code of Federal Regulations, 2011 CFR

2011-07-01

... plow steel wire rope and wire rope slings with various types of terminals. For sizes, classifications... than five (5) is maintained. (b) Wire rope and wire rope slings. (1) Tables G-2 through G-5 in § 1915... blunted. (3) Where U-bolt wire rope clips are used to form eyes, Table G-6 in § 1915.118 shall be used to...

29 CFR 1915.112 - Ropes, chains and slings.

Code of Federal Regulations, 2010 CFR

2010-07-01

... plow steel wire rope and wire rope slings with various types of terminals. For sizes, classifications... than five (5) is maintained. (b) Wire rope and wire rope slings. (1) Tables G-2 through G-5 in § 1915... blunted. (3) Where U-bolt wire rope clips are used to form eyes, Table G-6 in § 1915.118 shall be used to...

Mid-urethral slings in female incontinence: Current status

PubMed Central

Krlin, Ryan M.; Murphy, Alana M.; Ingber, Michael S.; Vasavada, Sandip P.

2011-01-01

The advent of the mid-urethral sling (MUS) 15 years ago has drastically changed the surgical management of stress urinary incontinence (SUI). Both retropubic and transobturator MUS can be placed in the ambulatory setting with excellent results. The tension-free vaginal tape (TVT) sling has the most robust and long-term data, but more recent literature suggests that the transobturator tape sling may offer comparable efficacy in appropriately selected patients. Single incision sling (SIS) is the newest addition to the MUS group and was developed in an attempt to minimize morbidity and create an anti-incontinence procedure that could be performed in the office. The efficacy of SIS remains unknown as the current literature regarding SIS lacks long-term results and comparative trials. The suprapubic arc sling appears to have equally effective outcomes in at least the short-term when compared with TVT. Although evolution of the SIS has led to a less invasive procedure with decreased post-op pain and reduced recovery time, durability of efficacy could be the endpoint we are sacrificing. Until longer-term data and more quality comparison trials are available, tailoring one's choice of MUS to the individual patient and her unique clinical parameters remains the best option. PMID:22022053

Modelling safety of gantry crane operations using Petri nets.

PubMed

Singh, Karmveer; Raj, Navneet; Sahu, S K; Behera, R K; Sarkar, Sobhan; Maiti, J

2017-03-01

Being a powerful tool in modelling industrial and service operations, Petri net (PN) has been extremely used in different domains, but its application in safety study is limited. In this study, we model the gantry crane operations used for industrial activities using generalized stochastic PNs. The complete cycle of operations of the gantry crane is split into three parts namely inspection and loading, movement of load, and unloading of load. PN models are developed for all three parts and the whole system as well. The developed PN models have captured the safety issues through reachability tree. The hazardous states are identified and how they ultimately lead to some unwanted accidents is demonstrated. The possibility of falling of load and failure of hook, sling, attachment and hoist rope are identified. Possible suggestions based on the study are presented for redesign of the system. For example, mechanical stoppage of operations in case of loosely connected load, and warning system for use of wrong buttons is tested using modified models.

Pelvic Floor 3D Ultrasound of Women with a TVT, TVT-O, or TVT-S for Stress Urinary Incontinence at the Three-year Follow-up.

PubMed

Rodrigues, Claudinei A; Bianchi-Ferraro, Ana Maria H M; Zucchi, Eliana Viana Monteiro; Sartori, Marair G F; Girão, Manoel J B C; Jarmy-Di Bella, Zsuzsanna I K

2017-09-01

Objective  Using three-dimensional ultrasound (3D-US), we aimed to compare the tape position and the angle formed by the sling arms in different techniques of mid-urethral sling insertion for the surgical treatment of stress urinary incontinence, three years after surgery. In addition, we examined the correlations between the US findings and the clinical late postoperative results. Methods  A prospective cross-sectional cohort study of 170 patients who underwent a sling procedure between May 2009 and December 2011 was performed. The final sample, with US images of sufficient quality, included 26 retropubic slings (tension-free vaginal tape, TVT), 42 transobturator slings (tension-free vaginal tape-obturator, TVT-O), and 37 single-incision slings (tension-free vaginal tape-Secur, TVT-S). The images (at rest, during the Valsalva maneuver, and during pelvic floor contraction) were analyzed offline by 2 different observers blinded against the surgical and urinary continence status. Group comparisons were performed using the Student t -test, the chi-squared and the Kruskal-Wallis tests, and analyses of variance with Tukey multiple comparisons. Results  Differences among the groups were found in the mean angle of the tape arms (TVT = 119.94°, TVT-O = 141.93°, TVT-S = 121.06°; p  < 0.001) and in the distance between the bladder neck and the tape at rest (TVT = 1.65 cm, TVT-O = 1.93 cm, TVT-S = 1.95 cm; p  = 0.010). The global objective cure rate was of 87.8% (TVT = 88.5%, TVT-O = 90.5%, TVT-S = 83.8%; p  = 0.701). The overall subjective cure rate was of 83.8% (TVT = 88.5%, TVT-O = 88.5% and TVT-S = 78.4%; p  = 0.514). The slings were located in the mid-urethra in 85.7% of the patients (TVT = 100%, TVT-O = 73.8%, TVT-S = 89.2%; p  = 0.001), with a more distal location associated with obesity (distal: 66.7% obese; mid-urethra: 34% obese; p  = 0.003). Urgency-related symptoms were observed in 23.8% of the patients (TVT = 30.8%, TVT-O = 21.4%, TVT-S = 21.6%; p  = 0.630). Conclusions  The angle formed by the arms of the sling tape was more obtuse for the transobturator slings compared with the angles for the retropubic or single-incision slings. Retropubic slings were more frequently located in the mid-urethra compared with the other slings, regardless of obesity. However, the analyzed sonographic measures did not correlate with the urinary symptoms three years after the surgery. Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil.

Optimized design for sling of stand up lift

NASA Astrophysics Data System (ADS)

Xu, Dongfang; Wang, Yue; Cui, Tengfei; Bao, Xuelian; Duan, Xingguang

2017-04-01

Stand up lift is a kind of equipment that assists those with dyskinesia of legs to stand up or move. As an important part of stand up lift, sling concerns the realization of the equipment's function and the safety of users. On the basis of ergonomics theory, this thesis will design and optimize the sling to make it safer and more comfortable and meet demands of different people.

Fracture Analysis of Cast Steel Sling

NASA Astrophysics Data System (ADS)

Li, Xinghui

2018-02-01

The fracture reasons of ZG270-500 cast steel sling are analyzed through such means as macroscopic morphology analysis, chemical composition analysis, and microscopic metallography analysis. Results: coarse Widmanstatten structure and casting defects occurring in casting and subsequent heat treatment process reduce the strength, plasticity and toughness of the steel, which is the main reason of brittle fracture of the sling during work, and corresponding improvement suggestions are proposed herein.

An Alternative to EPA Method 9 -- Field Validation of the Digital Opacity Compliance System (DOCS)

DTIC Science & Technology

2005-03-15

at the completion of the Phase I and Phase II DOCS field demonstration. These included the following 1) anemometer, 2) sling psychrometer , 3) Abney...anemometer (Eastern Technical Associates, Inc.) Sky conditions Visual observation Relative Humidity Sling Psychrometer (Eastern Technical Associates...least have access to a range of climatic monitoring equipment including the following 1) anemometer, 2) sling psychrometer , 3) Abney Level (sun angle

Comparison between three mini-sling surgical procedures and the traditional transobturator vaginal tape technique for female stress urinary incontinence

PubMed Central

LEANZA, V.; INTAGLIATA, E.; LEANZA, A.; FERLA, F.; LEANZA, G.; VECCHIO, R.

2014-01-01

Objectives To compare mini-sling and traditional tension-free operations for female stress urinary incontinence. Study design A systematic review of articles in the Literature published between 2002 and 2012, was conducted. A Pubmed search was performed. Primary outcomes were subjective and objective cure rates at 12 months comparing the three single-incision mini-slings techniques (TVT-Secur, MiniArc and Monarc systems) with the standard mid-urethral sling procedure TOT (Transobturator Vaginal Tape). Secondary outcomes included peri-operative (vaginal and/or bladder perforation, urine retention, urinary tract infection, bleeding, pain) and post-operative (mesh exposure, de novo urgency, and dyspareunia) complications. Results In term of objective cure rate at 12 month after surgery, it is evident that TOT at first, and MiniArc are the most effective procedures. The incidence of post-operative urgency and UTI was lower in TOT technique, while vaginal perforation was described in equal frequency both in TOT and in MiniArc procedures. The advantages of the three above described mini-invasive techniques seem to consist into lower cases of urinary retention, pain and bleeding. Furthermore, bladder perforation and bleeding are not described in the Literature for TVT-Secur and Monarc systems. Conclusions Some single-incision slings look promising and as effective as conventional sub-urethral slings at short term evaluation. However, at this moment a clear statement in favor of the widespread use of single-incision slings cannot be made. More studies must define the efficacy of these techniques. PMID:24841685

Risk Factors for Urinary Tract Infection following Mid Urethral Sling Surgery.

PubMed

Vigil, Humberto R; Mallick, Ranjeeta; Nitti, Victor W; Lavallée, Luke T; Breau, Rodney H; Hickling, Duane R

2017-05-01

Mid urethral sling surgery is common. Postoperative urinary tract infection rates vary in the literature and independent risk factors for urinary tract infection are not well defined. We sought to determine the incidence of and risk factors for urinary tract infection following mid urethral sling surgery. A retrospective cohort of females who underwent sling surgery was captured from the 2006 to 2014 NSQIP® (National Surgical Quality Improvement Program®) database. Exclusion criteria included male gender, nonelective surgery, totally dependent functional status, preoperative infection, prior surgery within 30 days, ASA® (American Society of Anesthesiologists®) Physical Status Classification 4 or greater, concomitant procedure and operative time greater than 60 minutes. The primary outcome was the incidence of urinary tract infection within 30 days of mid urethral sling surgery. Risk factors for urinary tract infection were assessed by examining patient demographic, comorbidity and surgical variables. Logistic regression analyses were performed to estimate the ORs of individual risk factors. Multivariable logistic regression was then performed to adjust for confounding. A total of 9,022 mid urethral sling surgeries were identified. The urinary tract infection incidence was 2.6%. Factors independently associated with an increased infection risk included age greater than 65 years (OR 1.54, 95% CI 1.07-2.22), body mass index greater than 40 kg/m 2 (OR 1.89, 95% CI 1.23-2.92) and hospital admission (OR 2.06, 95% CI 1.37-3.11). Mid urethral sling surgery performed by urologists carried a reduced risk of infection compared to the surgery done by gynecologists (OR 0.52, 95% CI 0.40-0.69). The urinary tract infection risk following mid urethral sling surgery in NSQIP associated hospitals is low. Novel patient and surgical factors for postoperative urinary tract infection have been identified and merit further study. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Female Sexual Function Following Surgical Treatment of Stress Urinary Incontinence: Systematic Review and Meta-Analysis.

PubMed

Bicudo-Fürst, Maria Cláudia; Borba Leite, Pedro Henrique; Araújo Glina, Felipe Placco; Baccaglini, Willy; de Carvalho Fürst, Rafael Vilhena; Bezerra, Carlos Alberto; Glina, Sidney

2018-04-01

The impact of surgery for stress urinary incontinence (SUI) on female sexual function has received attention in the medical literature, but not in a structured manner. To assess the most recent evidence on the impact of surgical management for female SUI on female sexual function. The review and meta-analysis of available articles published in Medline, Cochrane, LILACS, SCOPUS, Web of Science, CINHAL, and EMBASE included prospective randomized and non-randomized studies that assessed patients who underwent surgical treatment for UI through 2 validated questionnaires: the Pelvic Organ Prolapse Urinary Incontinence Sexual Questionnaire (PISQ-12) and the Female Sexual Function Index (FSFI). The following terms were searched: (urinary incontinence OR female OR woman OR women) AND (suburethral slings OR transobturator tape* OR transobturator suburethral tape OR trans-obturator tape* OR urethral sling* OR midurethral sling* OR mid-urethral sling* OR "standard midurethral slings" OR tensionless vaginal tape* OR mini sling* OR Burch* OR "Burch colposuspension" OR "urologic surgical procedures" OR "tension-free vaginal tape" OR pubovaginal sling) AND (sexual behavior OR "Female Sexual Function Index" OR FSFI OR sexual function OR "Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire" OR PISQ-12). 1,043 articles were retrieved; 9 studies were included for qualitative analysis and 4 were included for meta-analysis. 25 articles were excluded because they used questionnaires other than the FSFI and PISQ-12. Meta-analysis of 2 studies composed of 411 women who underwent to retropubic and transobturator sling intervention and completed the PISQ-12 questionnaire showed an increase in sexual function of 2.40 points after transobturator compared with retropubic sling intervention (95% CI = -2.48 to -2.32; I 2  = 35%, P < .00001). However, 2 other studies composed of 183 women comparing the same techniques, but using the FSFI, did not show a statistically significant difference (95% CI = -1.77 to 3.78; I 2  = 0%, P = .48). The impact of UI surgery on sexual function is uncertain because of the imprecision of the effect and inconsistency among studies. Only limited evidence on the impact of the transobturator vs the retropubic sling was found. Bicudo-Fürst MC, Borba Leite PH, Araújo Glina FP, et al. Female Sexual Function Following Surgical Treatment of Stress Urinary Incontinence: Systematic Review and Meta-Analysis. Sex Med Rev 2018;6:224-233. Copyright © 2017. Published by Elsevier Inc.

KSC-08pd3644

NASA Image and Video Library

2008-11-11

CAPE CANAVERAL, Fla. – In the transfer aisle of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, the sling is removed from space shuttle Atlantis before its return to the Orbiter Processing Facility. Atlantis was removed from its external fuel tank and solid rocket boosters stack after the delay of its STS-125 mission to NASA's Hubble Space Telescope. Atlantis' targeted launch on Oct. 14 was delayed when a system that transfers science data from the orbiting observatory to Earth malfunctioned on Sept. 27. The new target launch date is under review. Photo credit: NASA/Tim Jacobs

KSC-08pd3633

NASA Image and Video Library

2008-11-11

CAPE CANAVERAL, Fla. – In In the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, space shuttle Atlantis is lowered by a sling toward the transfer aisle floor. Atlantis has been taken off its external fuel tank and solid rocket boosters stack after of the delay of its STS-125 mission to NASA's Hubble Space Telescope. Atlantis will be returned to the Orbiter Processing Facility. Atlantis' targeted launch on Oct. 14 was delayed when a system that transfers science data from the orbiting observatory to Earth malfunctioned on Sept. 27. The new target launch date is under review. Photo credit: NASA/Jim Grossmann

KSC-08pd3632

NASA Image and Video Library

2008-11-11

CAPE CANAVERAL, Fla. – In the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida, space shuttle Atlantis is lowered by a sling toward the transfer aisle floor. Atlantis has been taken off its external fuel tank and solid rocket boosters stack after of the delay of its STS-125 mission to NASA's Hubble Space Telescope. Atlantis will be returned to the Orbiter Processing Facility. Atlantis' targeted launch on Oct. 14 was delayed when a system that transfers science data from the orbiting observatory to Earth malfunctioned on Sept. 27. The new target launch date is under review. Photo credit: NASA/Jim Grossmann

Effects of sling and voluntary constraint during constraint-induced movement therapy for the arm after stroke: a randomized, prospective, single-centre, blinded observer rated study.

PubMed

Krawczyk, Maciej; Sidaway, Marta; Radwanska, Anna; Zaborska, Joanna; Ujma, Renata; Czlonkowska, Anna

2012-11-01

To determine whether a combination of constraint-induced movement therapy and physiotherapy in stroke patients using different constraint regimens (sling versus voluntary constraint) changes or reduces motor deficits, the amount of functional use of the arm and whether the effects of treatment continue after 12 months. Forty-seven stroke patients were stratified and randomly divided into intensive physiotherapy programmes focused on regaining arm functions. Neurorehabilitation Unit of IInd Department of Neurology at Institute of Psychiatry and Neurology in Warsaw. Patients were randomly allocated to: the sling-constraint group (n = 24) or to the voluntary-constraint group (n = 23). Massed practice with the paretic arm (5 hours/day for 15 consecutive working days). Sling-constraint group had their arm immobilized in a hemi-sling during therapy. In addition, individual, 1-hour physiotherapy sessions were conducted in both groups. Rivermead Motor Assessment (RMA) Arm scale, (0-15), Motor Activity Log - Quality of Movement (MAL-QOM) (0-5 for 30 daily tasks). There was no significant difference between groups after therapy (MAL-QOM mean change for sling group 0.78, SD = 0.46 and for voluntary-constraint group 0.84, SD = 0.48; P = 0.687). All treated patients retained mean gains in real-world arm use (MAL-QOM) mean scores after 12 months follow-up compared with posttreatment values but there was no significant difference between groups (comparison of estimated mean change of MAL-QOM stated 0.23. 95% confidence interval = -0.04-0.50). Voluntary activity constraint in the intact arm is equivalent to sling, standard constraint during massed practice of paretic arm.

Outcomes of transurethral resection (TUR) of intravesical mesh after suburethral slings in the treatment of urinary stress incontinence.

PubMed

Castroviejo-Royo, F; Rodríguez-Toves, L A; Martínez-Sagarra-Oceja, J M; Conde-Redondo, C; Mainez-Rodríguez, J A

2015-04-01

The objective of this study was to determine the efficacy as well as the complications associated with transurethral removal (TUR) of intravesical mesh after suburethral sling, transobturator tape-TOT (Monarc™) or "minisling" (MiniArc(®)), in the treatment of female urinary stress incontinence (USI). retrospective and consecutive study on 9 women with bladder perforation after midurethral slings (3 Monarc™ and 6 MiniArc®) placement for urinary stress incontinence. To remove the mesh, transurethral resection with an electrode loop (TUR-E) was used. The technique included: location and total removal of mesh with bipolar resectoscope up to healthy tissue. The median age was 61 years (49-70 years). The median time between midurethral sling placement and onset the sympltoms was 13 months (1-79 months). and between sling placement and mesh removal was 16 months (1-91 months). Five women (55.5%) developed bladder stones. Mean operating time was 29.4 ± 10.4 minutes and mean length of hospital stay was 2.6 ± 0.5 days. The median follow-up after mesh removal was 38 months (range, 14 to 109 months). No complications were found. The use of transurethral resection of intravesical mesh after suburethral slings is easy and the results obtained by our surgical team are excellent. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

[Reconstructive treatment of female urethral estenosis secondary to erosion by suburethral tape].

PubMed

Angulo, J C; Mateo, E; Lista, F; Andrés, G

2011-04-01

Female urethral stricture secondary to erosión by suburethral sling is an unfrequent problem of difficult solution. Ventral vaginal rotation flaps or buccal mucosa dorsal grafts are not useful because this type of stricture is very proximal (close to the bladder neck) and the vagina is thinned. We present our experience to manage this problem using excision of disease urethral tract, associated to bladder mucosa flap and vaginal sling using transverse vaginal flap to repair the weakened vaginal wall. Three females with urethral stricture secondary to urethral erosion of their sling were treated with a technique of combined urethroplasty with bladder flap and vaginal reinforcement with pediculated vaginal flap transferred in a mini-sling fashion. Two of the patients suffered chronic urinary retention and preoperative placement of urethral catheter was not possible. The patients were evaluated 12, 36 and 55 months after surgery, respectively. Surgery was performed without complications. Results were satisfactory in all the patients, reaching good micturition postoperative caliber and being without incontinence at follow-up. Patients with suburethral erosion by a synthetic sling and secondary severe urethral stricture need total extirpation of the mesh and complete reconstruction of the urethro-vaginal septum. Tension-free urethral suture and use of vaginal sling with the technique here described are two useful technical tips for this problem. Copyright © 2011 AEU. Published by Elsevier Espana. All rights reserved.

Bladder perforation during sling procedures: diagnosis and management of injury.

PubMed

Israfil-Bayli, F; Bulchandani, S; Parsons, M; Jackson, S; Toozs-Hobson, P

2014-05-01

Midurethral slings are an effective and minimally invasive treatment for stress urinary incontinence. One of the most common intraoperative complications is bladder perforation, complicating between 2 and 10% of all operations, and on average 4.7%. It is usually corrected during surgery, with repositioning of the trocars. The purpose of this video is to demonstrate a method of replacing the trocars under direct vision. This video exhibits a bladder perforation during insertion of a retropubic midurethral sling (Advantage Fit; Boston Scientific) and gives a step-by step guide to the removal and repositioning of the sling under direct visualisation. Repositioning of the trocars under direct vision in cases of bladder perforation may have numerous advantages. It may prevent damage to the urethra, possibly reduce the risk of postoperative infection and may be beneficial for trainees.

Surgical correction of female urinary incontinence: comparison of colporrhaphy, sling and suspension procedures.

PubMed

Yumru, A E; Dinçgez Çakmak, B; Öndeş, B; Ergez, M

2012-01-01

To analyse clinical outcomes of three types of pelvic surgery for the correction of female mixed or stress urinary incontinence. Women who underwent surgery for urinary incontinence between January 2000 and June 2010 were included in the study (n = 268). Patients were nonrandomly assigned to undergo colporrhaphy, suspension procedure or sling procedure according to their clinical situation. Perioperative parameters were recorded. Short- (< 5 years) and long-term (5-10 years) success rates were determined for each group. The short- and long-term complete cure rates were significantly lower, and the duration of catheterization significantly longer, in patients who underwent colporrhaphy compared with both other groups, but there were no significant differences between suspension or sling procedures. Sling and suspension procedures were equally effective in this study, and both were preferable to colporrhaphy.

[Attachment theory and baby slings/carriers: technological network formation].

PubMed

Lu, Zxy-Yann Jane; Lin, Wan-Shiuan

2011-12-01

Healthcare providers recognize the important role played by attachment theory in explaining the close relationship between mental health and social behavior in mothers and their children. This paper uses attachment theory in a socio-cultural context to ascertain the mechanism by which baby slings/carriers, a new technology, produced and reproduced the scientific motherhood. It further applies a social history of technology perspective to understand how baby carriers and attachment theory are socially constructed and historically contingent on three major transformations. These transformations include the use of attachment theory-based baby carriers to further scientific motherhood; the use of baby slings/carriers to further the medicalization of breastfeeding and enhance mother-infant attachment; and the use of baby slings/carriers to transform woman's identities by integrating scientific motherhood, independence and fashion. Implications for nursing clinical policy are suggested.

Anatomy of the obturator region: relations to a trans-obturator sling.

PubMed

Whiteside, James L; Walters, Mark D

2004-01-01

Our objective was to determine the relationships between a trans-obturator sling and anatomic structures within the obturator region. The obturator regions of six cadavers were dissected and distances from the mid-point of the ischiopubic ramus to the muscles, nerves, and vessels of the region were measured. A trans-obturator sling was placed and distances from the device to the same anatomic structures were determined. Four additional cadavers were dissected to determine the device route of passage. The obturator canal is on average 4.4 cm from the midpoint of the ischiopubic rami. The trans-obturator sling passes on average 2.4 cm inferior-medial to the obturator canal. The anterior and posterior divisions of the obturator nerve are on average 3.4 and 2.8 cm, respectively, from a passed trans-obturator device. The device passed on average 1.1 cm from the most medial branch of the obturator vessels. Vascular and nerve structures are within 1-3 cm of the path of any device passed through the obturator foramen. A trans-obturator sling risks injury to these structures, although the small caliber of the vessels and the confined space in which they would bleed make the consequences of injury uncertain.

The transobturator suburethral sling: a safe and effective option for all degrees of post prostatectomy urinary incontinence.

PubMed

Sullivan, John F; Stassen, Paul N; Moran, Diarmuid; Bolton, Eva M; Smyth, Lisa G; Browne, Cliodhna M; Forde, James C; Tal, Raanan; Lynch, Thomas H

2018-04-01

Male stress urinary incontinence (SUI) after radical prostatectomy (RP) is common. The surgical standard of care traditionally has been placement of an artificial urinary sphincter (AUS) but since its introduction the transobturator male sling has been shown to have particular unique advantages. Our aim was to assess outcomes of a consecutive series of suburethral sling insertions in men presenting with all degrees of post RP SUI. A consecutive cohort of men undergoing AdVance sling insertion following RP were studied. Parameters assessed included pre and postoperative urinary function, 24 hour pad use, quality of life (QoL) outcomes, complications and further treatments. Degree of incontinence was categorized as mild (1-2), moderate (3-5) or severe (≥ 6) depending on daily pad use. Patients were reviewed at 1, 4 and 6 months. The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) was used to assess symptom severity and QoL outcomes. Seventy-seven patients were included, mean age 68 and mean time to sling post RP 34 (8-113) months. Preoperative degree of incontinence: mild 22%, moderate 58%, severe 20%. Fourteen percent had undergone post RP radiation therapy (RT). In total 73% experienced complete resolution of symptoms post sling, 12% significant improvement, 15% no reduction in pad use. Sixty percent with severe incontinence were classified as cured (no pad or 1 dry pad for security reasons). When patients with preoperative RT were excluded, cure rate rose to 82%. On follow up survey at 30 months (mean), the ICIQ-SF score decreased from baseline 17.7 (9-21.0) to 8.0 (0-20) (p < 0.0001), CI 95% (8-12). Suburethral slings are effective and safe for all degrees of post RP incontinence, are associated with improved QoL parameters and with appropriate selection and counseling are a viable option for more severe degrees of post RP SUI.

Adjustable Perineal Male Sling for the Treatment of Urinary Incontinence: Long-term Results.

PubMed

Altan, Mesut; Asi, Tariq; Bilen, Cenk Yucel; Ergen, Ali

2017-08-01

To present the long-term results in patients with urinary incontinence who were treated with adjustable perineal male sling. An adjustable male sling procedure was performed in 45 patients with a mean age of 67.6 ± 7.8 years who had urinary incontinence. The mean period between primary prostatic surgery and the sling procedure was 36.7 months. The difference between the classical sling and the adjustable one is a 10 cm tissue expander between the 2 layers of polypropylene mesh with an injection port. Adjustment of the sling was performed with saline via this port, in case of recurrence or persistence of incontinence. Mean follow-up was 48 ± 29 months. Average operative time was 101.1 ± 25.5 minutes (45-150). Median daily pad use in these patients decreased from 8(2-12) to 1(0-10) (P < .001). During long-term follow-up 37.8% used 0 pad daily, 28.9% used 1-2 pads daily, making the total success rate 66.7%. Complete dry rate was higher in patients with nonsevere incontinence compared to the others with severe incontinence (57.9% vs 23.1%, P = .029). Nevertheless, there was no significant difference in the case of total success rate (78.9% vs 57.7%, respectively; P = .135). Age was significantly greater in both complete dry group (71.1 ± 4.8 vs 65.4 ± 8.7) and total success group (70.1 ± 5.2 vs 62.4 ± 5.2) (P = .017 and P < .001, respectively). Adjustable male sling is an acceptable procedure with low complication rates especially in patients with mild and moderate incontinence. At the same time, this procedure may be offered to patients with previous incontinence surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

Effects of lumbopelvic sling and abdominal drawing-in exercises on lung capacity in healthy adults.

PubMed

Kim, Myoung-Kwon; Cha, Hyun-Gyu; Shin, Young-Jun

2016-08-01

[Purpose] To examine the effects of lumbopelvic sling and abdominal drawing-in exercises on the lung capacities of healthy subjects. [Subjects and Methods] Twenty-nine healthy subjects with no orthopedic history of the back were recruited. Subjects were randomly assigned to a experimental group and control group. Subjects were allocated to one of two groups; an experimental group that underwent lumbopelvic sling and abdominal drawing-in exercises and a control group that underwent treadmill and abdominal drawing-in exercises. Lung capacities were evaluated 4 weeks after exercises. [Results] The experimental group showed significant increments in EV, ERV, IRV, VT vs. pre-intervention results, and the control group showed significant increments in the EVC and IRV. Significant intergroup differences were observed in terms of post-training gains in EVC, IRV, and VT. [Conclusion] Combined application of lumbopelvic sling and abdominal drawing-in exercises were found to have a positive effect on lung capacity.

Practice patterns of post-radical prostatectomy incontinence surgery in Ontario

PubMed Central

Wallis, Christopher J.D.; Herschorn, Sender; Liu, Ying; Carr, Lesley K.; Kodama, Ronald T.; Klotz, Laurence H.; Saskin, Refik; Nam, Robert K.

2014-01-01

Introduction: We assess the practice patterns of artificial urinary sphincter (AUS) and urethral sling insertion after radical prostatectomy (RP) from a large population-based cohort. Methods: We examined 25 346 men in Ontario, Canada who underwent RP between 1993 and 2006. Using hospital and cancer registry data, we identified patients who subsequently underwent an incontinence procedure. We characterized the practice patterns of post-prostatectomy incontinence procedures across Ontario during the study interval. Results: A total of 703 (2.8%) men underwent subsequent insertion of an AUS and 282 (1.1%) underwent a urethral sling procedure (985 total incontinence procedures, 3.9%) over the study period. During the study period, 121 hospitals performed RP. Among them, 32 (26%) hospitals performed both RP and AUS/sling procedures, and 89 (74%) performed RP only. Four hospitals performed AUS/sling procedures but not RP. Of the 36 institutions that performed AUS/sling procedures, the median annual case volume was 0.29 (interquartile range: 0.083-0.75). Of all incontinence procedures, 56% were performed at 3 academic institutions. When examining observed rates of AUS/sling procedures compared with expected rates from the overall cohort, 15 of 32 hospitals (47%) performed significantly fewer incontinence procedures than expected given their RP case volume (p range: <0.0001–0.0390) and 5 (16%) performed significantly more (p range: <0.0001–0.038). Conclusions: A small number of academic institutions provide most of the surgical care for men with incontinence following RP in Ontario. Many centres that perform RP refer out to other centres to surgically manage their patients’ incontinence. PMID:25408805

The inside-out trans-obturator sling: a novel surgical technique for the treatment of male urinary incontinence.

PubMed

de Leval, Jean; Waltregny, David

2008-11-01

To describe a new sling procedure for treating stress urinary incontinence (SUI) after radical prostatectomy (RP) and prospectively evaluate its short-term safety and efficacy. The sling technique uses specific instruments and a polypropylene mesh with two arms that are passed inside to outside through the obturator foramens, pulled for compressing the bulbar urethra upward, and tied to each other across the midline. Patients with detrusor overactivity were excluded. Baseline and follow-up evaluations included uroflowmetry and continence and quality of life (QoL) questionnaires. Cure was defined by no pad use and improvement by a number of pads/d 5pads/d, respectively. The procedure was preceded by an endoscopic urethrotomy in four patients. No perioperative complication was noted; three patients required suprapubic catheterization. At 6 mo, nine (45%) patients were cured and eight others (40%) were improved (1pad/d). QoL was significantly enhanced and 80% of patients were moderately to completely satisfied with the procedure. Preoperative and postoperative maximum flow rate and postvoid residual values were not statistically different. No sling infection, urethra erosion, persistent pain, or neurologic complications were observed. The inside-out trans-obturator sling procedure appears to be safe and efficient at short term. Further studies are warranted to determine long-term outcome.

Back Facts: A Training Workbook to Prevent Back Injuries in Nursing Homes

MedlinePlus

... will use ergonomics to look at how to design nursing home work to fit nursing home workers. ... the sling? __ Yes __ No __ __ 14. Does the sling design avoid pushing the residents legs apart (concern for ...

How to make a sling

MedlinePlus

... reduces the risk of opening a closed injury. First Aid Care for all wounds before applying a splint or sling. If you can see bone in the injured site, call your local emergency number (such as 911) or local hospital for ...

Summary: Disabled Submarine Heat Stress Conference

DTIC Science & Technology

2009-09-11

by dry bulb thermometer and humidity using either a sling psychrometer or a portable battery-powered electronic device providing a direct readout of...and sling psychrometer in each compartment 3) One battery-powered electronic thermometer/hygrometer in each compartment Heat Stress When-To

Innovated Conceptual Design of Loading Unloading Tool for Livestock at the Port

NASA Astrophysics Data System (ADS)

Mustakim, Achmad; Hadi, Firmanto

2018-03-01

The condition of loading and unloading process of livestock in a number of Indonesian ports doesn’t meet the principle of animal welfare, which makes cattle lose weight and injury when unloaded. Livestock loading and unloading is done by throwing cattle into the sea one by one, tying cattle hung with a sling strap and push the cattle to the berth directly. This process is against PP. 82 year 2000 on Article 47 and 55 about animal welfare. Innovation of loading and unloading tools design offered are loading and unloading design with garbarata. In the design of loading and unloading tools with garbarata, apply the concept of semi-horizontal hydraulic ladder that connects the ship and truck directly. This livestock unloading equipment design innovation is a combination of fire extinguisher truck design and bridge equipped with weightlifting equipment. In 10 years of planning garbarata, requires a total cost of IDR 321,142,921; gets benefits IDR 923,352,333; and BCR (Benefit-Cost Ratio) Value worth 2.88. BCR value >1 means the tool is feasible applied. The designs of this loading and unloading tools are estimated up to 1 hour faster than existing way. It can also minimize risks such as injury and also weight reduction livestock agencies significantly.

35. DETAIL OF STRETCH SLING CYLINDER AND PULLEY LOCATED ON ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

35. DETAIL OF STRETCH SLING CYLINDER AND PULLEY LOCATED ON EAST SIDE OF SLC-3W MST STATION 85.5 - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

An evaluation of the sling surgical method of the bulbar urethra in the treatment of men's stress urinary incontinence at Shohadaye Ashayer Teaching Hospital in 2008.

PubMed

Heidari, Mohammad; Khorramabadi, Manoochehr Shams

2012-11-01

To evaluate the utility and efficacy of bulbar urethera sling in the management of sphincter insufficiency that usually occurs after prostate surgery or posterior urethral injuries and may lead to moderate to severe stress incontinence. A total of 30 patients underwent sling surgery with rectus fascia in a four-year period at the Shohadaye Ashayer Teaching Hospital in Iran. Urinary incontinence occurred in 8 patients after open prostatectomy, in 12 patients after prostatectomy through urethra, in 8 patients after radical prostatectomy. For the purpose of the study, 2 patients in whom incontinence occurred after pelvic fracture were excluded. The 28 patients were followed up for a one-year period after the operation. All patients had incontinence from one to six years. After hospitalisation, an 18 gauge Foley's catheter was introduced in the urethra in every patient. The perineum was incised longitudinally, and the bulbar urethra was freed and a 2x7 cm span of rectus fascia was separated and placed under the bulbar urethra. Treatment was defined as use of one or no pad per day and recovery, as a reduction of at least 50% in the number of the used pads after sling operation. After operation, all patients suffering from moderate to severe stress incontinence were treated with 0-1 pad per day. Four patients were unable to urinate; in 2 patients the sling was modified and loosened, and in two others dilatation resolved their problems. Bulbar urethra sling can be carried out in moderate to severe urinary incontinence treatment in any hospital at a modest cost with satisfactory results.

The TVT Worldwide Observational Registry for Long-Term Data: safety and efficacy of suburethral sling insertion approaches for stress urinary incontinence in women.

PubMed

Tincello, Douglas G; Botha, Theunis; Grier, Douglas; Jones, Peter; Subramanian, Dhinagar; Urquhart, Colin; Kirkemo, Aaron; Khandwala, Salil

2011-12-01

We examined the clinical effectiveness of a single incision sling in women with stress urinary incontinence and obtained comparative perioperative and postoperative data on retropubic and transobturator slings. Women who underwent a cough stress test were treated with surgery using a single incision, retropubic or obturator sling (Gynecare® TVT SECUR™, TVT™ or TVT Obturator System, respectively) with the choice of sling based on surgeon preference. Objective cure was assessed by the standing cough stress test at 1 year. Subjective outcomes were assessed by the Incontinence Quality of Life Questionnaire and EQ-5D™. Perioperative data and return to normal activity were recorded. Of the 1,398 women who underwent surgery there were postoperative data on 1,334, including 32.8%, 17.8% and 49.4% who received a tension free vaginal tape, obturator tension free vaginal tape and SECUR, respectively. After obturator tension free vaginal tape surgery fewer women had a positive cough stress test than after TVT and SECUR surgery (4 of 110 or 3.6% vs 24 of 187 or 12.8% and 59 of 374 or 15.8%, respectively). Incontinence Quality of Life Questionnaire effect size was 1.87, 1.42 and 1.56, respectively, indicating a large treatment effect. Using our Incontinence Quality of Life Questionnaire response definition 85.4%, 79.0% and 85.2% of the TVT, TVT outside-in obturator system and SECUR cohorts, respectively, were treatment responders (p = 0.11).The SECUR cohort had the shortest operative time, the lowest proportion of women who required an overnight stay and the most women who underwent surgery under local anesthesia. Median time to return to employment, housework, sex life and hobbies was most rapid for SECUR. This registry demonstrates the high effectiveness of all 3 approaches. The single incision sling appeared to have objective and subjective efficacy similar to that of the retropubic sling and it can be performed under local anesthesia in an office environment. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Evaluation of Unexploded Ordnance (UXO) Detection Technology at the Standardized UXO Test Sites Aberdeen and Yuma Proving Grounds

DTIC Science & Technology

2007-11-01

TTF Open Field (169) EM EM61MKII cart May. 2006 USGS Blind Grid (805) EM All TEM towed May. 2006 USGS Blind Grid (806) MAG TMGS towed 2.3-1 2.3...0.98 at YPG with a TMGS towed and an TM-4 sling system. f. The only ground penetrating radar system analyzed was demonstrated at the APG blind...MAG858/Cart(312) SCH/Hand(238) SCH/Hand(606) STOLS/Towed(293M) TM4/Sling(362) TM4/Sling(431) TMGS /Towed(806) EM61G822A/Cart(383D) STOLS/Towed(293D

Workers in the VAB move sling into place to lift Columbia to mobile launcher

NASA Technical Reports Server (NTRS)

1982-01-01

Workers in the Vehicle Assembly Building (VAB) move a specially-built sling into place to lift Orbiter Columbia from the transfer aisle to the mobile launcher platform (27015); Columbia is lifted from the floor of the VAB transfer aisle (27016).

[A comparative study between two procedures of TVT retropubic mid-urethral sling placement for treatment of female stress urinary incontinence].

PubMed

Sergent, F; Gay-Crosier, G; Resch, B; Pons, J-C; Marpeau, L

2014-03-01

To evaluate complications and functional outcomes at 1 year and more of a modified Tension-free Vaginal Tape (TVT) technique from that of classic TVT. Retrospective study comparing the two techniques. For the modified TVT technique, a peri-urethrovesical hydrodissection was performed. An 18-gauge hollow needle, in which a thread was introduced, was used as an ancillary for the placement of the sling. The sling was secured to the thread and then positioned with it. Bladder filling objectified perforations. An absorbable suture around the sling allowed its descent if necessary. One hundred and eighteen procedures were performed (54 classic TVT and 64 modified TVT). For the standard TVT and the modified TVT, the vesico-urethral perforation rates were respectively 7.4% and 1.5% (P<0.05), those of reoperations for pulling the sling downward 11.1% and 1.5% (P<0.05). A 1 year and more, healing and satisfaction rates were respectively 83.3% and 79.2% for the standard TVT versus 88.2% and 90% for the modified TVT (NS). The dissatisfaction rate was lower for the modified TVT (P<0.05). By modifying the placement of the classic TVT, it is possible to reduce its complications while maintaining its efficacy. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

29 CFR 1917.42 - Miscellaneous auxiliary gear.

Code of Federal Regulations, 2011 CFR

2011-07-01

... and Spacing of U-Bolt Wire Rope Clips Improved plow steel, rope diameter (inches/(cm)) Minimum number.... (b) Wire rope and wire rope slings. (1) The employer shall ascertain and adhere to the manufacturer's recommended ratings for wire rope and wire rope slings and shall have such ratings available for inspection...

Effect of External Loading on Force and Power Production During Plyometric Push-ups.

PubMed

Hinshaw, Taylour J; Stephenson, Mitchell L; Sha, Zhanxin; Dai, Boyi

2018-04-01

Hinshaw, TJ, Stephenson, ML, Sha, Z, and Dai, B. Effect of external loading on force and power production during plyometric push-ups. J Strength Cond Res 32(4): 1099-1108, 2018-One common exercise to train upper-body strength and power is the push-up. Training at the loads that would produce the greatest power is an effective way to increase peak power. The purpose of the current study was to quantify the changes in peak force, peak power, and peak velocity among a modified plyometric push-up and plyometric push-ups with or without external loading in physically active young adults. Eighteen male and 17 female participants completed 4 push-ups: (a) modified plyometric push-up on the knees, (b) plyometric push-up without external loading, (c) plyometric push-up with an external load of 5% of body weight, and (d) plyometric push-up with an external load of 10% of body weight. Two force platforms were set up to collect vertical ground reaction forces at the hands and feet. The modified plyometric push-up demonstrated the lowest force, power, and velocity (5.4≥ Cohen's dz ≥1.2). Peak force and force at peak velocity increased (3.8≥ Cohen's dz ≥0.3) and peak velocity and velocity at peak power decreased (1.4≥ Cohen's dz ≥0.8) for the push-up without external loading compared with the 2 push-ups with external loading. No significant differences were observed for peak power among the push-ups with or without external loading (0.4≥ Cohen's dz ≥0.1). Although peak power is similar with or without external loading, push-ups without external loading may be more beneficial for a quick movement, and push-ups with external loading may be more beneficial for a greater force production.

14 CFR 133.17 - Requirements for issuance of a rotorcraft external-load operator certificate.

Code of Federal Regulations, 2010 CFR

2010-01-01

... external-load operator certificate. 133.17 Section 133.17 Aeronautics and Space FEDERAL AVIATION...: CERTIFICATION AND OPERATIONS ROTORCRAFT EXTERNAL-LOAD OPERATIONS Certification Rules § 133.17 Requirements for... §§ 133.19, 133.21, and 133.23, the Administrator issues a Rotorcraft External-Load Operator Certificate...

29 CFR 1917.42 - Miscellaneous auxiliary gear.

Code of Federal Regulations, 2010 CFR

2010-07-01

... wire rope used in hoisting or lowering, or in bulling cargo, shall consist of one continuous piece... splices shall consist of at least three full tucks. Short splices shall consist of at least six full tucks... slings. (1) Slings and nets or other combinations of more than one piece of synthetic webbing assembled...

Meteorological Instrumentation Support for an Adverse Weather Test Facility

DTIC Science & Technology

1991-05-01

pressure sensor 12 8 Sling psychrometer 12 9 Relative humidity graph 13 10 Relative humidity graph 13 FIGURES (cont) Page 11 Cooled mirror dewpoint...80 -80 -50 -50 -32 .32 WET BULB DRY BULB Figure 8. Sling psychrometer 12 40 -. w 0 ARYBULAI TEMPERATURE Figure 1. Relative humidity graph 3013 L

Assessing outcome after a modified vaginal wall sling for stress incontinence with intrinsic sphincter deficiency.

PubMed

Costantini, Elisabetta; Mearini, Luigi; Mearini, Ettore; Pajoncini, Cinzia; Guercini, Federico; Bini, Vittorio; Porena, Massimo

2005-01-01

Forty women with stress incontinence, intrinsic sphincter deficiency (ISD), associated or not with urethral hypermobility, a Valsalva leak point pressure (VLLP)<60 cmH(2)0 and a maximum urethral closure pressure<30 cmH(2)0 underwent in situ vaginal wall sling. The main modification to the technique was the use of two small Marlex meshes placed at the lateral edges of the sling. Outcome was assessed by pad use, surgical results and patients' satisfaction. Data of 39/40 patients were analyzed after a minimum follow-up of 1 year. After surgery 30/39 patients were completely dry (no pads), stress incontinence disappeared in 22/39, and 30/39 patients were satisfied with outcome. Reasons for dissatisfaction included recurrence of stress incontinence in three, infections in one and urge incontinence in five. Overall results are good given this category of patients. The vaginal wall sling can be recommended for patients with ISD because the results are promising, it corrects urethral hypermobility and, in our experience, it does not cause obstruction if correctly performed.

[Stress urinary incontinence after radical cystectomy: neobladder construction and placement of the functional retrourethral sling].

PubMed

Mayer, M; Bauer, R M; Walther, S; Becker, A J; Stief, C G; Bastian, P J; Gozzi, C

2009-06-01

Stress urinary incontinence (SUI) following radical cystectomy and orthotopic ileal neobladder construction represents a challenging problem. The incidence of incontinence following this surgery is reported to be 30-60% and is - despite a better understanding of the male (and female) pelvic anatomy - still regarded as an adverse outcome of this surgery.Therapeutic options have been limited up until now and include pharmacological agents, surgical treatment and pelvic floor training with only moderate amelioration of the symptoms and often unacceptable side effects. Nevertheless, urinary continence is probably the most important key to patient satisfaction. Here we introduce the perineal approach of the functional retrourethral mesh as a new and innovative sling suspension based on a non-obstructive procedure in a patient with urinary stress incontinence after ileal neobladder. The sling adjusts the changed anatomy after radical cystectomy returning it to the former preoperative position and thus continence can be achieved again. The approach of the sling in a patient with ileal neobladder is safe and the good result concerning continence is promising.

Orthodontic extrusion of Ellis Class VIII fracture of maxillary lateral incisor - The sling shot method.

PubMed

Felicita, A Sumathi

2018-07-01

The aim of this paper is to evaluate the efficacy of forced extrusion using the sling shot elastic. A 21 year adult patient reported with an Ellis Class VIII fracture of the maxillary right lateral incisor. Root canal treatment followed by a fiber reinforced composite post was placed and core build up was done. A metal button was bonded to the tooth. Begg brackets were placed from the second premolar on one side to the second premolar on the opposite side. 0.016″ × 0.025″ stainless steel was placed in ribbon mode. The ligature wire was placed as a sling shot from the button on the fractured tooth to the two adjacent teeth. 4 mm of extrusion was achieved and there was no evidence of root resorption. Forced extrusion was achieved in four months. The sling shot method is a very effective method of ligation. Light forces are delivered over a long duration with definitive results as compared to the inconsistent force delivery with conventional extrusion mechanics.

A Rare Case of Pulmonary Artery Sling with the VACTERL Association in a 20-Month-Old Infant.

PubMed

Ghandi, Yazdan; Shafiee, Akbar; Sharifi, Mehrazad; Bolandnazar, Najmeh Sadat

2017-07-01

The VACTERL association, co-occurrence of vertebral, anorectal, cardiac, tracheoesophageal, genitourinary, and limb malformations, is a rare congenital anomaly. Several cardiac anomalies have been reported as a part of the VACTERL association, particularly ventricular and atrial septal defects. Pulmonary artery sling is a rare congenital abnormality in which the left pulmonary artery arises from the right pulmonary artery. This anomaly is not frequently observed in the VACTERL association and has been rarely reported. A 20-month-old girl was admitted to our hospital due to pneumonia in the right lung, which had pulmonary artery sling as a part of the VACTERL association. Barium meal X-ray showed pressure effects on the esophagus, and computed tomography angiography revealed pulmonary artery sling. Pneumonia management was done. However, the parents of our patient refused to give consent for the surgical correction of this vascular anomaly. Three months after discharge from the hospital, the patient was visited, at which time the parents again refused surgery and treatment for their daughter despite our recommendations.

A Rare Case of Pulmonary Artery Sling with the VACTERL Association in a 20-Month-Old Infant

PubMed Central

Ghandi, Yazdan; Shafiee, Akbar; Sharifi, Mehrazad; Bolandnazar, Najmeh Sadat

2017-01-01

The VACTERL association, co-occurrence of vertebral, anorectal, cardiac, tracheoesophageal, genitourinary, and limb malformations, is a rare congenital anomaly. Several cardiac anomalies have been reported as a part of the VACTERL association, particularly ventricular and atrial septal defects. Pulmonary artery sling is a rare congenital abnormality in which the left pulmonary artery arises from the right pulmonary artery. This anomaly is not frequently observed in the VACTERL association and has been rarely reported. A 20-month-old girl was admitted to our hospital due to pneumonia in the right lung, which had pulmonary artery sling as a part of the VACTERL association. Barium meal X-ray showed pressure effects on the esophagus, and computed tomography angiography revealed pulmonary artery sling. Pneumonia management was done. However, the parents of our patient refused to give consent for the surgical correction of this vascular anomaly. Three months after discharge from the hospital, the patient was visited, at which time the parents again refused surgery and treatment for their daughter despite our recommendations. PMID:29062381

Adjustable perineal male sling using tissue expander as an effective treatment of post-prostatectomy urinary incontinence.

PubMed

Balci, Melih; Tuncel, Altug; Bilgin, Ovunc; Aslan, Yilmaz; Atan, Ali

2015-01-01

To report our intermediate experience in treating patients with severe incontinence using an adjustable perineal male sling with a tissue expander. An adjustable male sling procedure was performed on 21 patients with severe incontinence. The underlying etiology of urinary incontinence was radical prostatectomy in 13 patients, open prostatectomy in 5 patients and transurethral prostate resection in 3 patients. The difference between the classical and the adjustable sling is that in the latter there is a 25 mL tissue expander between the two layers of polypropylene mesh with an injection port. Adjustment of the sling was performed with saline via an inflation port, in case of recurrence or persistence of incontinence. The mean age of the patients was 66.2 ± 7.3 (50-79) years and mean pad usage was 6.4 ± 0.6 per day. The mean follow-up time was 40.1 ± 23.2 (6-74) months. The balloon was postoperatively inflated on average with 11.6 ± 5.7 (5-25) mL. After the mean 40.1 months of follow-up, 16 of the 21 patients (76.2%) were dry (11 patients, 0 pads; 5 patients using safety pads), 3 patients (14%) had mild and 2 (9.8%) had moderate degree post-prostatectomy urinary incontinence (PPI). The average maximum urine flow rate of the patients was 15.6 ± 4.7 (10-31) mL/s. No residual urine was found. In 2 patients, all parts of the device were removed due to infection and discomfort, and in 3 patients only the inflation component was removed due to local scrotal infection. Our results show that using an adjustable perineal male sling with a tissue expander seems to be an efficient, and safe surgical treatment option in patients with PPI.

The Influence of External Load on Quadriceps Muscle and Tendon Dynamics during Jumping.

PubMed

Earp, Jacob E; Newton, Robert U; Cormie, Prue; Blazevich, Anthony J

2017-11-01

Tendons possess both viscous (rate-dependent) and elastic (rate-independent) properties that determine tendon function. During high-speed movements external loading increases both the magnitude (FT) and rate (RFDT) of tendon loading. The influence of external loading on muscle and tendon dynamics during maximal vertical jumping was explored. Ten resistance-trained men performed parallel-depth, countermovement vertical jumps with and without additional load (0%, 30%, 60%, and 90% of maximum squat lift strength), while joint kinetics and kinematics, quadriceps tendon length (LT) and patellar tendon FT and RFDT were estimated using integrated ultrasound, motion analysis and force platform data and muscle tendon modelling. Estimated FT and RFDT, but not peak LT, increased with external loading. Temporal comparisons between 0% and 90% loads revealed that FT was greater with 90% loading throughout the majority of the movement (11%-81% and 87%-95% movement duration). However, RFDT was greater with 90% load only during the early movement initiation phase (8%-15% movement duration) but was greater in the 0% load condition later in the eccentric phase (27%-38% movement duration). LT was longer during the early movement (12%-23% movement duration) but shorter in the late eccentric and early concentric phases (48%-55% movement duration) with 90% load. External loading positively influenced peak FT and RFDT but tendon strain appeared unaffected, suggesting no additive effect of external loading on patellar tendon lengthening during human jumping. Temporal analysis revealed that external loading resulted in a large initial RFDT that may have caused dynamic stiffening of the tendon and attenuated tendon strain throughout the movement. These results suggest that external loading influences tendon lengthening in both a load- and movement-dependent manner.

KSC-2011-4531

NASA Image and Video Library

2011-06-16

CAPE CANAVERAL, Fla. -- At the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida, workers practice assembly and disassembling a mobile sling and crane, part of a portable mate-demate device. The portable sling and crane will be used to lift shuttles off their 747 carrier aircraft for delivery to museums next year. Shuttle Discovery will go to the Smithsonian's National Air and Space Museum, Steven F. Udvar-Hazy Center in Chantilly, Va., Endeavour will go to the California Science Center in Los Angeles and Enterprise will be moved from the Smithsonian to the Intrepid Sea, Air and Space Museum in New York. Shuttle Atlantis will go to the Kennedy Space Center Visitor Complex and won't require use of the portable sling and crane. Photo credit: NASA/Jim Grossmann

KSC-2011-4530

NASA Image and Video Library

2011-06-16

CAPE CANAVERAL, Fla. -- At the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida, workers practice assembly and disassembling a mobile sling and crane, part of a portable mate-demate device. The portable sling and crane will be used to lift shuttles off their 747 carrier aircraft for delivery to museums next year. Shuttle Discovery will go to the Smithsonian's National Air and Space Museum, Steven F. Udvar-Hazy Center in Chantilly, Va., Endeavour will go to the California Science Center in Los Angeles and Enterprise will be moved from the Smithsonian to the Intrepid Sea, Air and Space Museum in New York. Shuttle Atlantis will go to the Kennedy Space Center Visitor Complex and won't require use of the portable sling and crane. Photo credit: NASA/Jim Grossmann

KSC-2011-4529

NASA Image and Video Library

2011-06-16

CAPE CANAVERAL, Fla. -- At the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida, workers practice assembly and disassembling a mobile sling and crane, part of a portable mate-demate device. The portable sling and crane will be used to lift shuttles off their 747 carrier aircraft for delivery to museums next year. Shuttle Discovery will go to the Smithsonian's National Air and Space Museum, Steven F. Udvar-Hazy Center in Chantilly, Va., Endeavour will go to the California Science Center in Los Angeles and Enterprise will be moved from the Smithsonian to the Intrepid Sea, Air and Space Museum in New York. Shuttle Atlantis will go to the Kennedy Space Center Visitor Complex and won't require use of the portable sling and crane. Photo credit: NASA/Jim Grossmann

KSC-2011-4533

NASA Image and Video Library

2011-06-16

CAPE CANAVERAL, Fla. -- At the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida, workers practice assembly and disassembling a mobile sling and crane, part of a portable mate-demate device. The portable sling and crane will be used to lift shuttles off their 747 carrier aircraft for delivery to museums next year. Shuttle Discovery will go to the Smithsonian's National Air and Space Museum, Steven F. Udvar-Hazy Center in Chantilly, Va., Endeavour will go to the California Science Center in Los Angeles and Enterprise will be moved from the Smithsonian to the Intrepid Sea, Air and Space Museum in New York. Shuttle Atlantis will go to the Kennedy Space Center Visitor Complex and won't require use of the portable sling and crane. Photo credit: NASA/Jim Grossmann

KSC-2011-4534

NASA Image and Video Library

2011-06-16

CAPE CANAVERAL, Fla. -- At the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida, workers practice assembly and disassembling a mobile sling and crane, part of a portable mate-demate device. The portable sling and crane will be used to lift shuttles off their 747 carrier aircraft for delivery to museums next year. Shuttle Discovery will go to the Smithsonian's National Air and Space Museum, Steven F. Udvar-Hazy Center in Chantilly, Va., Endeavour will go to the California Science Center in Los Angeles and Enterprise will be moved from the Smithsonian to the Intrepid Sea, Air and Space Museum in New York. Shuttle Atlantis will go to the Kennedy Space Center Visitor Complex and won't require use of the portable sling and crane. Photo credit: NASA/Jim Grossmann

Coupled Responses of Sewol, Twin Barges and Slings During Salvage

NASA Astrophysics Data System (ADS)

Yao, Zong; Wang, Wei-ping; Jiang, Yan; Chen, Shi-hai

2018-04-01

Korean Sewol is successfully lifted up with the strand jack system based on twin barges. During the salvage operation, two barges and Sewol encounter offshore environmental conditions of wave, current and wind. It is inevitable that the relative motions among the three bodies are coupled with the sling tensions, which may cause big dynamic loads for the lifting system. During the project engineering phase and the site operation, it is necessary to build up a simulation model that can precisely generate the coupled responses in order to define a suitable weather window and monitor risks for the salvage operation. A special method for calculating multibody coupled responses is introduced into Sewol salvage project. Each body's hydrodynamic force and moment in multibody configuration is calculated in the way that one body is treated as freely moving in space, while other bodies are set as fixed globally. The hydrodynamic force and moment are then applied into a numerical simulation model with some calibration coefficients being inserted. These coefficients are calibrated with the model test results. The simulation model built up this way can predict coupled responses with the similar accuracy as the model test and full scale measurement, and particularly generate multibody shielding effects. Site measured responses and the responses only resulted from from the simulation keep project management simultaneously to judge risks of each salvage stage, which are important for success of Sewol salvage.

29 CFR 1926.958 - External load helicopters.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 8 2010-07-01 2010-07-01 false External load helicopters. 1926.958 Section 1926.958 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... External load helicopters. In all operations performed using a rotorcraft for moving or placing external...

29 CFR 1926.958 - External load helicopters.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 8 2014-07-01 2014-07-01 false External load helicopters. 1926.958 Section 1926.958 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... External load helicopters. In all operations performed using a rotorcraft for moving or placing external...

29 CFR 1926.958 - External load helicopters.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 8 2011-07-01 2011-07-01 false External load helicopters. 1926.958 Section 1926.958 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... External load helicopters. In all operations performed using a rotorcraft for moving or placing external...

29 CFR 1926.958 - External load helicopters.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 8 2012-07-01 2012-07-01 false External load helicopters. 1926.958 Section 1926.958 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... External load helicopters. In all operations performed using a rotorcraft for moving or placing external...

29 CFR 1926.958 - External load helicopters.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 8 2013-07-01 2013-07-01 false External load helicopters. 1926.958 Section 1926.958 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... External load helicopters. In all operations performed using a rotorcraft for moving or placing external...

Design, Development, and Evaluation of the Helicopter Sling Load Rapid Aerial Delivery Equipment

DTIC Science & Technology

2015-09-01

Rigged Payload Data from Third K‐MAX Demonstration (24‐25 Jan 2011)  Lift Pass System Type Flight Mode Ground Speed ( KIAS ) ~ Altitude (ft MSL... KIAS  = Knots indicated air speed  ULW = Ultra light weight MLW = Micro light weight                                   Figure 9: JPADS Parachute...Figure 10 shows the inflation sequence of the four G-11 parachutes as the aircraft released all payloads sequentially at 60 KIAS .       Figure 10

A randomized study of new sling exercise treatment vs traditional physiotherapy for patients with chronic whiplash-associated disorders with unsettled compensation claims.

PubMed

Vikne, John; Oedegaard, Arit; Laerum, Even; Ihlebaek, Camilla; Kirkesola, Gitle

2007-04-01

Many patients with chronic whiplash-associated disorders have reduced neuromuscular control of the neck and head. It has been proposed that a new sling exercise therapy may promote neuromuscular control of the neck. To compare the effects of traditional physiotherapy vs traditional physiotherapy combined with a new sling exercise therapy on discomfort and function in patients with chronic whiplash-associated disorders who have unsettled compensation claims; and to investigate possible additional effects of guided, long-term home training. A randomized multi-centre trial with 4 parallel groups. A total of 214 patients were assigned randomly to 4 treatment groups, and received either traditional physiotherapy with or without home training, or new sling exercise therapy with or without home training. Outcome measures were pain, disability, psychological distress, sick leave and physical tests. A total of 171 patients (80%) completed the study. There were no important statistical or clinical differences between the groups after 4 months of treatment. There was a small statistically significant effect at 12-month follow-up in both groups with home training regarding pain during rest (p = 0.05) and reported fatigue in the final week (p = 0.02). No statistically significant differences were found between the traditional physiotherapy group and the new sling exercise group, with or without home training. Since the groups were not compared with a control group without treatment, we cannot conclude that the studied treatments are effective for patients with whiplash-associated disorder, only that they did not differ in our study.

Ischiorectal abscess and ischiorectal-vaginal fistula as delayed complications of posterior intravaginal slingplasty: a case report.

PubMed

Chen, Heidi Wen-Chu; Guess, Marsha K; Connell, Kathleen A; Bercik, Richard S

2009-10-01

Synthetic meshes have been used extensively to augment surgical management of pelvic organ prolapses. Posterior intravaginal sling (IVS) is a technique used for correcting vaginal vault/apical prolapse, posterior vaginal prolapse or rectocele. There are limited data on long-term safety of this procedure. In a subanalysis of the IVS tapes from the SUSPEND trial performed secondary to the large number of patients with complications of suburethral sling erosions after IVS, it was noted that the sling erosion tended to have a delayed presentation secondary to poor incorporation of the mesh. A 48-year-old woman with cystocele, uterine prolapse and rectocele had undergone total vaginal hysterectomy, mesh-augmented anterior repair, posterior colporrhaphy and posterior intravaginal slingplasty (IVS) in July 2005. Thirty months after the surgery, she presented with gradual symptoms of copious vaginal discharge for several weeks followed by constant right buttock pain and swelling. Examination was notable for intact mesh with no signs of erosion and a 3-cm induration deep within the right buttock. Computed tomography suggested a pelvic abscess. Magnetic resonance imaging confirmed a right ischiorectal fossa abscess and a vaginal fistula. The patient underwent sling excision, right ischiorectal fossa exploration and vaginal fistula repair. A fistulous tract was found to extend along the intact sling from the vaginal epithelium toward the right ischiorectal fossa. At 2 months' followup, there were no recurrences or other complications. This is the first report of a delayed complication of an ischiorectal abscess associated with an ischiorectal-vaginal fistula that presented 30 months after the placement of a posterior IVS.

Autologous Pubovaginal Sling for the Treatment of Concomitant Female Urethral Diverticula and Stress Urinary Incontinence.

PubMed

Enemchukwu, Ekene; Lai, Caroline; Reynolds, William Stuart; Kaufman, Melissa; Dmochowski, Roger

2015-06-01

To describe our experience with concomitant repair of urethral diverticula and stress urinary incontinence (SUI) with autologous pubovaginal sling (PVS). A retrospective chart review between January 2006 and 2013 identified 38 women undergoing concomitant diverticulectomy and rectus sheath PVS. Patient demographics, presenting symptoms, prior urethral surgery, concomitant procedures, postoperative outcomes, and complications were evaluated. The mean duration of symptoms was 56.7 months. Eleven patients presented with recurrent diverticula and 5 patients had prior SUI surgery (3 midurethral slings, 1 PVS, and 1 bulking agent). One patient had a prior urethrolysis. All other slings were cut or excised at the time of surgery. All women had demonstrable SUI on cough stress test or urodynamics. The mean follow-up was 12.7 months. All postoperative voiding cystourethrograms were negative for contrast extravasation. One patient required prolonged (>4 weeks) suprapubic tube drainage for urinary retention. Four others required an additional 1 week of suprapubic tube drainage. Eighteen patients (47%) reported mixed urinary symptoms. Of these, 9 had complete resolution, whereas 9 experienced significant improvement. Overall, 97.3% reported resolution of their dysuria, dyspareunia, and pain symptoms and 90% reported complete resolution of their SUI symptoms. There were 2 urethral diverticula recurrences and 2 SUI recurrences. Perioperative complications, including hemorrhage, sling erosion, or urethrovaginal fistulas, were not observed. Concomitant PVS placement is a safe and effective treatment option for SUI in patients undergoing urethral diverticulectomy. The risks and benefits should be weighed and management individualized. Copyright © 2015 Elsevier Inc. All rights reserved.

Effects of external loads on balance control during upright stance: experimental results and model-based predictions.

PubMed

Qu, Xingda; Nussbaum, Maury A

2009-01-01

The purpose of this study was to identify the effects of external loads on balance control during upright stance, and to examine the ability of a new balance control model to predict these effects. External loads were applied to 12 young, healthy participants, and effects on balance control were characterized by center-of-pressure (COP) based measures. Several loading conditions were studied, involving combinations of load mass (10% and 20% of individual body mass) and height (at or 15% of stature above the whole-body COM). A balance control model based on an optimal control strategy was used to predict COP time series. It was assumed that a given individual would adopt the same neural optimal control mechanisms, identified in a no-load condition, under diverse external loading conditions. With the application of external loads, COP mean velocity in the anterior-posterior direction and RMS distance in the medial-lateral direction increased 8.1% and 10.4%, respectively. Predicted COP mean velocity and RMS distance in the anterior-posterior direction also increased with external loading, by 11.1% and 2.9%, respectively. Both experimental COP data and model-based predictions provided the same general conclusion, that application of larger external loads and loads more superior to the whole body center of mass lead to less effective postural control and perhaps a greater risk of loss of balance or falls. Thus, it can be concluded that the assumption about consistency in control mechanisms was partially supported, and it is the mechanical changes induced by external loads that primarily affect balance control.

Effect of cyclic loading and retightening on reverse torque value in external and internal implants.

PubMed

Cho, Woong-Rae; Huh, Yoon-Hyuk; Park, Chan-Jin; Cho, Lee-Ra

2015-08-01

The aim of this study was to evaluate the effect of cyclic loading and screw retightening on reverse torque value (RTV) in external and internal type implants. Cement-retained abutments were connected with 30 Ncm torque to external and internal type implants. Experimental groups were classified according to implant connection type and retightening/loading protocol. In groups with no retightening, RTV was evaluated after cyclic loading for 100,000 cycles. In groups with retightening, RTV was measured after 3, 10, 100 cycles as well as every 20,000 cycles until 100,000 cycles of loading. Every group showed decreased RTV after cyclic loading. Before and after cyclic loading, external type implants had significantly higher RTVs than internal type implants. In external type implants, retightening did not affect the decrease in RTV. In contrast, retightening 5 times and retightening after 10 cycles of dynamic loading was effective for maintaining RTV in internal type implants. Retightening of screws is more effective in internal type implants than external type implants. Retightening of screws is recommended in the early stage of functional loading.

Bone-anchored sling using the Mini Quick Anchor Plus and polypropylene mesh to treat post-radical prostatectomy incontinence: early experience.

PubMed

Suzuki, Yasutomo; Saito, Yuka; Ogushi, Satoko; Kimura, Go; Kondo, Yukihiro

2012-10-01

Herein we describe our experience with a bone-anchored sling using a suture anchor and polypropylene mesh for the treatment of post-radical prostatectomy urinary incontinence. Eight patients with urinary incontinence as a result of intrinsic sphincter deficiency after radical prostatectomy were included in the analysis. The procedure involved piercing the pubic bone with a bone drill, inserting the suture anchor and fixing a soft or rigid polypropylene mesh to press firmly on the bulbar urethra. Urinary incontinence was significantly improved according to changes in the daily number of pads used at 1, 3 and 6 months postoperatively in comparison with preoperatively. However, no meaningful improvement at 6 months postoperatively was seen with the soft mesh. Complications included perineal pain in four cases, but pain control was achieved using non-steroidal anti-inflammatory drugs. The bone-anchored sling with a suture anchor and polypropylene mesh appears to be safe and effective for the treatment of post-radical prostatectomy urinary incontinence. Soft mesh appears inappropriate as material for the bone-anchored sling because of the progressive likelihood of worsened urinary incontinence. © 2012 The Japanese Urological Association.

Reverse-Muscle Sling Reduces Complications in Revisional Mastopexy-Augmentation.

PubMed

Valente, Denis Souto

2018-06-20

Simultaneous augmentation-mastopexy is a particularly tricky operation with a considerable reoperation rate. The pectoralis muscle sling has proven to be a suitable alternative technique for long-term results in breast parenchyma suspension without silicone implants. This study aims to propose a promising approach to simultaneous augmentation-mastopexy revisional surgery using an inverted dual-plane technique acting as a muscular sling. A 10-year historic cohort was conducted to obtain the following variables from our preexisting database: age, preoperative measurements, operative technicalities, implant details, time from procedure to revision, complications, and outcomes. Twenty-six patients assessed after the initial postoperative year were analyzed. Review of this series of patients revealed a revision rate of 3.8% and overall rate of morbidity of 11.5%. Simultaneous augmentation-mastopexy using an inverted dual-plane technique acting as a muscular sling is a reliable and safe procedure. Review of this series of patients revealed low rates of morbidity and reoperation need. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

46 CFR 154.408 - Cargo tank external pressure load.

Code of Federal Regulations, 2010 CFR

2010-10-01

... minimum internal pressure (maximum vacuum), and the maximum external pressure to which any portion of the... 46 Shipping 5 2010-10-01 2010-10-01 false Cargo tank external pressure load. 154.408 Section 154... Equipment Cargo Containment Systems § 154.408 Cargo tank external pressure load. For the calculation...

The relationships between internal and external training load models during basketball training.

PubMed

Scanlan, Aaron T; Wen, Neal; Tucker, Patrick S; Dalbo, Vincent J

2014-09-01

The present investigation described and compared the internal and external training loads during basketball training. Eight semiprofessional male basketball players (mean ± SD, age: 26.3 ± 6.7 years; stature: 188.1 ± 6.2 cm; body mass: 92.0 ± 13.8 kg) were monitored across a 7-week period during the preparatory phase of the annual training plan. A total of 44 total sessions were monitored. Player session ratings of perceived exertion (sRPE), heart rate, and accelerometer data were collected across each training session. Internal training load was determined using the sRPE, training impulse (TRIMP), and summated-heart-rate-zones (SHRZ) training load models. External training load was calculated using an established accelerometer algorithm. Pearson product-moment correlations with 95% confidence intervals (CIs) were used to determine the relationships between internal and external training load models. Significant moderate relationships were observed between external training load and the sRPE (r42 = 0.49, 95% CI = 0.23-0.69, p < 0.001) and TRIMP models (r42 = 0.38, 95% CI = 0.09-0.61, p = 0.011). A significant large correlation was evident between external training load and the SHRZ model (r42 = 0.61, 95% CI = 0.38-0.77, p < 0.001). Although significant relationships were found between internal and external training load models, the magnitude of the correlations and low commonality suggest that internal training load models measure different constructs of the training process than the accelerometer training load model in basketball settings. Basketball coaching and conditioning professionals should not assume a linear dose-response between accelerometer and internal training load models during training and are recommended to combine internal and external approaches when monitoring training load in players.

KSC-2011-4532

NASA Image and Video Library

2011-06-16

CAPE CANAVERAL, Fla. -- At the Shuttle Landing Facility at NASA's Kennedy Space Center in Florida, workers practice assembly and disassembling a mobile sling and crane, part of a portable mate-demate device (image left). The portable sling and crane will be used to lift shuttles off their 747 carrier aircraft for delivery to museums next year. Shuttle Discovery will go to the Smithsonian's National Air and Space Museum, Steven F. Udvar-Hazy Center in Chantilly, Va., Endeavour will go to the California Science Center in Los Angeles and Enterprise will be moved from the Smithsonian to the Intrepid Sea, Air and Space Museum in New York. Shuttle Atlantis will go to the Kennedy Space Center Visitor Complex and won't require use of the portable sling and crane. Photo credit: NASA/Jim Grossmann

Posterior axilla sling traction for shoulder dystocia: case review and a new method of shoulder rotation with the sling.

PubMed

Cluver, Catherine Anne; Hofmeyr, G Justus

2015-06-01

The purpose of this study was to report on all cases in which posterior axilla sling traction (PAST) has been used to deliver cases of intractable shoulder dystocia and to describe a new method of shoulder rotation with the sling. A record of all published and known cases was collected that included information on preliminary obstetric techniques that were used and how the PAST technique was performed. Maternal outcomes that included maternal injury and length of hospital stay and fetal outcomes, which included birthweight, Apgar scores, nerve injuries, fractures, hospital stay, and outcome, were documented. We have recorded 19 cases where PAST has been used. In 5 cases, the babies had died in utero. Ten were assisted deliveries. PAST was successful in 18 cases. In one case, it was partially successful because it enabled delivery of the posterior shoulder with digital axillary traction. The most commonly used material was suction tubing. Once the posterior shoulder was delivered, the shoulder dystocia was resolved in all cases. Time from insertion to delivery was <3 minutes when recorded. The birthweights of the infants varied from 3200-4800 g. Posterior arm humerus fractures occurred in 3 cases. There was one case of a permanent Erb's palsy and 4 cases of transient Erb's palsies. None were of the posterior arm. During this review, we found that, when direct delivery of the posterior shoulder was difficult because of very severe impaction, the sling could be used to rotate the shoulders easily through 180 degrees assisted by counter pressure on the back of the anterior shoulder. This new method was used in 5 cases and may reduce fetal trauma further during difficult shoulder delivery. This review confirms that PAST can be a lifesaving technique when all another techniques for shoulder dystocia fail. Advantages are that it is easy to use (even by someone who has not seen it used previously), that the sling material is readily available, and that it is inserted quickly with 2 fingers. This is the first report of its use to rotate the posterior shoulder to the anterior position for delivery. Copyright © 2015 Elsevier Inc. All rights reserved.

Nonlinear ultrasonic imaging method for closed cracks using subtraction of responses at different external loads.

PubMed

Ohara, Yoshikazu; Horinouchi, Satoshi; Hashimoto, Makoto; Shintaku, Yohei; Yamanaka, Kazushi

2011-08-01

To improve the selectivity of closed cracks for objects other than cracks in ultrasonic imaging, we propose an extension of a novel imaging method, namely, subharmonic phased array for crack evaluation (SPACE) as well as another approach using the subtraction of responses at different external loads. By applying external static or dynamic loads to closed cracks, the contact state in the cracks varies, resulting in an intensity change of responses at cracks. In contrast, objects other than cracks are independent of external load. Therefore, only cracks can be extracted by subtracting responses at different loads. In this study, we performed fundamental experiments on a closed fatigue crack formed in an aluminum alloy compact tension (CT) specimen using the proposed method. We examined the static load dependence of SPACE images and the dynamic load dependence of linear phased array (PA) images by simulating the external loads with a servohydraulic fatigue testing machine. By subtracting the images at different external loads, we show that this method is useful in extracting only the intensity change of responses related to closed cracks, while canceling the responses of objects other than cracks. Copyright © 2010 Elsevier B.V. All rights reserved.

Effect of cyclic loading and retightening on reverse torque value in external and internal implants

PubMed Central

Cho, Woong-Rae; Huh, Yoon-Hyuk; Park, Chan-Jin

2015-01-01

PURPOSE The aim of this study was to evaluate the effect of cyclic loading and screw retightening on reverse torque value (RTV) in external and internal type implants. MATERIALS AND METHODS Cement-retained abutments were connected with 30 Ncm torque to external and internal type implants. Experimental groups were classified according to implant connection type and retightening/loading protocol. In groups with no retightening, RTV was evaluated after cyclic loading for 100,000 cycles. In groups with retightening, RTV was measured after 3, 10, 100 cycles as well as every 20,000 cycles until 100,000 cycles of loading. RESULTS Every group showed decreased RTV after cyclic loading. Before and after cyclic loading, external type implants had significantly higher RTVs than internal type implants. In external type implants, retightening did not affect the decrease in RTV. In contrast, retightening 5 times and retightening after 10 cycles of dynamic loading was effective for maintaining RTV in internal type implants. CONCLUSION Retightening of screws is more effective in internal type implants than external type implants. Retightening of screws is recommended in the early stage of functional loading. PMID:26330975

Operative shortening of the sling as a second-line treatment after TVT failure

PubMed Central

Matuszewski, Marcin; Michajłowski, Jerzy; Krajka, Kazimierz

2011-01-01

Introduction Stress urinary incontinence (SUI) is defined as an involuntary loss of urine during physical exertion, sneezing, coughing, laughing, or other activities that put pressure on the bladder. In some cases, recurrent or persistent SUI after sling operations may be caused by too loose placement of the sling. In the current study, we describe our method of shortening of the sling as a second-line treatment of tension-free vaginal tape (TVT) failure. Materials and methods Four women, aged 46-61, after initial TVT operation were treated for persistent SUI. The severity of SUI was estimated by: physical examinations, cough tests, 24-h pad tests, and King's Health Questionnaire. The shortening procedure, based on excising the fragment of tape and suturing it back, was performed in all patients. Results All cases achieved a good result, which was defined as restoration of full continence. No complications occurred. The 12-month follow-up showed no side-effects. The postoperative control tests: the cough and 24-h pad tests were negative in all women. The general health perceptions increased after the shortening procedure by a mean value 44.25%. The incontinence impact decreased by a mean value 44.6%. In all patients, role and physical limitations significantly decreased (by 88.5% and 80.5%, respectively). The negative emotions connected with SUI significantly decreased after the second procedure. Conclusions The operative shortening of the implanted sling is a simple, cheap, and effective method of second-line treatment in cases of TVT failure and may be offered to the majority of patients with insufficient urethral support after the first procedure. PMID:24578885

Foley catheter guide use during midurethral slings: does it make a difference?

PubMed

Miranne, Jeannine Marie; Dominguez, Aurora; Sokol, Andrew Ian; Gutman, Robert Eric; Iglesia, Cheryl Bernadette

2015-06-01

Our objective was to evaluate whether foley catheter guide use decreased the risk of cystotomy and urethrotomy during retropubic midurethral sling placement. This retrospective cohort study included all women undergoing retropubic synthetic midurethral sling placement at a single academic institution between January 2011 and September 2012. Patients were divided into groups based on whether or not the foley catheter guide was used during surgery. The primary outcome was the incidence of cystotomy. A total of 310 patients underwent retropubic midurethral sling placement. The foley catheter guide was used in 76/310 cases (24.5%). The mean age was 57 ± 11 and mean body mass index was 28 ± 7. More patients in the no-guide group had preoperative urgency (70% versus 58%, p = 0.049), anterior prolapse (95% versus 78%, p < 0.0001), and concomitant prolapse surgery (65% versus 51%, p = 0.03). There was no difference in preoperative urgency urinary incontinence, medical comorbidities, previous surgical history, intraoperative time, blood loss, or postoperative voiding dysfunction rates between groups. Fourteen of the 310 patients (4.5%) had cystotomies: 1/76 (1.3%) in the foley catheter guide group and 13/234 (5.6%) in the no-guide group (p = 0.12). No patients had urethrotomies. On multiple logistic regression, there was no difference in the odds of cystotomy between groups after adjusting for previous prolapse and anti-incontinence surgery, concomitant prolapse repair, level of first assistant, and retropubic local anesthesia use (AOR = 0.2 [95% CI 0.02-1.7]). Foley catheter guide use did not decrease the risk of intraoperative lower urinary tract injury during retropubic midurethral sling placement. Larger prospective studies are needed to confirm this finding.

Complications in Women Undergoing Burch Colposuspension Versus Autologous Rectus Fascia Sling for the Treatment of Stress Urinary Incontinence

PubMed Central

Chai, Toby C.; Albo, Michael E.; Richter, Holly E.; Norton, Peggy A.; Dandreo, Kimberly J.; Kenton, Kimberly; Lowder, Jerry L.; Stoddard, Anne M.

2009-01-01

Purpose To determine clinicodemographic factors associated with complications of continence procedures, the impact of concomitant surgeries on complication rates and the relationship between incidence of cystitis and method of post-operative bladder drainage. Materials and Methods Serious adverse events (SAEs) and adverse events (AEs) of the Stress Incontinence Surgical Efficacy Trial (SISTEr), a randomized trial comparing Burch colposuspension to autologous rectus fascial sling, were reviewed. Clinicodemographic variables were analyzed to determine those associated with the development of AEs using logistic regression analysis. Complications were stratified based on the presence or absence of concomitant surgery. Differences in complication rates (controlling for concomitant surgery) and cystitis rates (controlling for method of bladder emptying) were compared using Fisher’s exact test. Results Blood loss (p=0.0002) and operative time (p<0.0001) were significantly associated with development of an AE. Subjects undergoing concomitant surgeries had a significantly higher SAE rate (14.2% vs 7.3%, p=0.01) and AE rate (60.5% vs. 48%, p<0.01) compared to subjects undergoing continence surgery alone. Cystitis rates were higher (p<0.01) in the sling versus the Burch group up to 6 weeks postoperatively regardless of concomitant surgery status. Intermittent self catheterization (ISC) increased the rate of cystitis by 17% and 23% in the Burch and sling groups, respectively. Conclusions Concomitant surgeries at the time of continence surgery increased the risk for complications. Sling surgery was associated with a higher risk of cystitis within the first 6 weeks postoperatively. ISC increased risk of cystitis in both groups. The occurrence of complications was associated with surgical factors, not patient-related factors. PMID:19296969

Transversal incision of the vagina favors the remaining of the tape in the middle-third urethra compared to longitudinal incision during transobturator sling procedures for stress urinary incontinence.

PubMed

Pirtea, L; Sas, I; Ilina, Razvan; Grigoraș, D; Mazilu, O

2015-07-17

To describe a new type of incision of the vagina during transobturator sling procedure and to evaluate by ultrasound the tape position at 3, 6 and 12 months after surgery. We conducted a prospective study including 51 patients with urinary stress incontinence who underwent sling procedure using the transversal vaginal incision. Tape position was evaluated by ultrasound at 3, 6 and 12 months after surgery and expressed as a percentage of the urethral length (the proximal third of the urethral length 0-39 %, the middle third 40-60 %, and the distal third 60-100 %). Informed consent was obtained from all patients prior to their inclusion in the study. All procedures have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments and were approved by the Institutional Review Board and Ethical Committee of "Victor Babeş" University of Medicine and Pharmacy Timisoara before the beginning of the study (no 7/17.04.2012). At 3 months after surgery, 3.92 % of the slings were located in the proximal third of the urethra, 88.23 % in the middle third of the urethra and 7.84 % in the distal third. At 6 and 12 months after surgery we obtained similar results: 9.81 % of the slings were located in the proximal third of the urethra, 82.35 % in the middle third and 7.84 % in the distal third of the urethra. The transversal incision of the vagina offers a minimal dissection along the long axis of the urethra favoring the remaining of the tape in the middle third of the urethra.

14 CFR 27.865 - External loads.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... must be shown by analysis, test, or both, that the rotorcraft external load attaching means for rotorcraft-load combinations to be used for nonhuman external cargo applications can withstand a limit static...

14 CFR 27.865 - External loads.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... must be shown by analysis, test, or both, that the rotorcraft external load attaching means for rotorcraft-load combinations to be used for nonhuman external cargo applications can withstand a limit static...

14 CFR 27.865 - External loads.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... must be shown by analysis, test, or both, that the rotorcraft external load attaching means for rotorcraft-load combinations to be used for nonhuman external cargo applications can withstand a limit static...

14 CFR 27.865 - External loads.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... must be shown by analysis, test, or both, that the rotorcraft external load attaching means for rotorcraft-load combinations to be used for nonhuman external cargo applications can withstand a limit static...

14 CFR 27.865 - External loads.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS... must be shown by analysis, test, or both, that the rotorcraft external load attaching means for rotorcraft-load combinations to be used for nonhuman external cargo applications can withstand a limit static...

14 CFR 29.865 - External loads.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS...) It must be shown by analysis, test, or both, that the rotorcraft external load attaching means for rotorcraft-load combinations to be used for nonhuman external cargo applications can withstand a limit static...

14 CFR 29.865 - External loads.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS...) It must be shown by analysis, test, or both, that the rotorcraft external load attaching means for rotorcraft-load combinations to be used for nonhuman external cargo applications can withstand a limit static...

14 CFR 29.865 - External loads.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS...) It must be shown by analysis, test, or both, that the rotorcraft external load attaching means for rotorcraft-load combinations to be used for nonhuman external cargo applications can withstand a limit static...

14 CFR 29.865 - External loads.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS...) It must be shown by analysis, test, or both, that the rotorcraft external load attaching means for rotorcraft-load combinations to be used for nonhuman external cargo applications can withstand a limit static...

14 CFR 29.865 - External loads.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS...) It must be shown by analysis, test, or both, that the rotorcraft external load attaching means for rotorcraft-load combinations to be used for nonhuman external cargo applications can withstand a limit static...

Dynamic MRI confirms support of the mid-urethra by TVT and TVT-O surgery for stress incontinence.

PubMed

Rinne, Kirsi; Kainulainen, Sakari; Aukee, Sinikka; Heinonen, Seppo; Nilsson, Carl G

2011-06-01

To study changes in mid-urethral function with dynamic MRI in stress urinary incontinent women undergoing either tension-free vaginal tape (TVT) or TVT-obturator sling operations. Prospective clinical study. University hospital. Forty-two parous women with stress urinary incontinence recruited to dynamic magnetic resonance imaging before and after mid-urethral sling surgery. Control group of 16 healthy women. Dynamic magnetic resonance imaging at rest, during pelvic floor muscle contraction, coughing and voiding with a bladder volume of 200-300 ml. X- and Y- coordinates were used to determine the location of the mid-urethra during these activities. Changes in mid-urethral position after TVT and TVT-obturator operations during the different activities. Postoperatively the women could elevate their mid-urethra by pelvic floor muscle contraction significantly higher than before the operation (p<0.05). Despite a different support angle between the TVT and the TVT-O mid-urethral slings, we could not see any differences in the movement patterns. Mid-urethral slings support the mid-urethra and restrict downward movement during different activities. Movement patterns are similar after TVT and TVT-O operations. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

Orbital floor reconstruction using a tensor fascia lata sling after total maxillectomy.

PubMed

Jung, Bok Ki; Yun, In Sik; Lee, Won Jai; Lew, Dae Hyun; Choi, Eun Chang; Lee, Dong Won

2016-05-01

Reconstruction after total maxillectomy with extensive orbital floor defects poses a significant challenge for the reconstruction. The aim of this study is to present the outcomes of orbital floor reconstruction using tensor fascia lata slings after total maxillectomy and to compare these results to orbital floor reconstruction using alloplastic implants. This was a retrospective analysis of 19 consecutive patients who underwent tumor resection with orbital floor removal for malignancies. Reconstructions were performed using either tensor fascia lata slings (Group A) or alloplastic implants (Group B). The early and late postoperative outcomes such as wound infection, plate exposure, ectropion, diplopia, and enophthalmos, were analyzed and compared between the two groups. Patients in group A had significantly less wound complication than in group B (p < 0.05). In group A, there were no early or late wound complications after the operation. However, in group B, five patients had infection, the plate was exposed in eight of fourteen patients, and three patients had enophthalmos. Eight patients in group B underwent reoperation to correct their complications. Reconstruction of the orbital floor with a tensor fascia lata sling offers reliable support to the globe and prevents the ophthalmic complications associated with loss of orbital support. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Fertility outcome following transvaginal cervicoisthmic cerclage using a polypropylene sling.

PubMed

Deffieux, Xavier; Faivre, Erika; Senat, Marie Victoire; Fuchs, Florent; Gervaise, Amélie; Fernandez, Hervé

2010-04-01

To report fertility and pregnancy outcomes following transvaginal cervicoisthmic cerclage with a polypropylene sling during a previous pregnancy. A continuous series of 57 women who underwent prophylactic cervicoisthmic cerclage during a previous (reference) pregnancy were enrolled. Telephone interviews were carried out to evaluate each patient's subsequent fertility. Among the 57 women interviewed, 8 had an inadequate follow-up, 13 women were lost to follow-up, 1 woman required a hemostatic hysterectomy, and 2 women required removal of the sling. Nineteen women did not desire a subsequent pregnancy. Of the 14 women who did desire a subsequent pregnancy, 1 woman had previously known tubal infertility. Of the 13 remaining women, 7 subsequently became pregnant. One woman had a spontaneous abortion (11 weeks of pregnancy); 1 woman delivered at 22 weeks of pregnancy, after a spontaneous premature membrane rupture; 1 woman had a cesarean delivery at 25 weeks of pregnancy; and 4 patients had a cesarean delivery after 37 weeks of pregnancy. Median duration of the 4 subsequent pregnancies at delivery was 37 weeks (interquartile range [IQR], 37-38 weeks). Median birth weight was 3040 g (IQR, 2500-3250 g). Subsequent pregnancy is possible after transvaginal cervicoisthmic cerclage using a synthetic sling. Copyright 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Computer simulation of the effects of shoe cushioning on internal and external loading during running impacts.

PubMed

Miller, Ross H; Hamill, Joseph

2009-08-01

Biomechanical aspects of running injuries are often inferred from external loading measurements. However, previous research has suggested that relationships between external loading and potential injury-inducing internal loads can be complex and nonintuitive. Further, the loading response to training interventions can vary widely between subjects. In this study, we use a subject-specific computer simulation approach to estimate internal and external loading of the distal tibia during the impact phase for two runners when running in shoes with different midsole cushioning parameters. The results suggest that: (1) changes in tibial loading induced by footwear are not reflected by changes in ground reaction force (GRF) magnitudes; (2) the GRF loading rate is a better surrogate measure of tibial loading and stress fracture risk than the GRF magnitude; and (3) averaging results across groups may potentially mask differential responses to training interventions between individuals.

Internalizing and externalizing problems in adolescence: general and dimension-specific effects of familial loadings and preadolescent temperament traits.

PubMed

Ormel, J; Oldehinkel, A J; Ferdinand, R F; Hartman, C A; De Winter, A F; Veenstra, R; Vollebergh, W; Minderaa, R B; Buitelaar, J K; Verhulst, F C

2005-12-01

We investigated the links between familial loading, preadolescent temperament, and internalizing and externalizing problems in adolescence, hereby distinguishing effects on maladjustment in general versus dimension-specific effects on either internalizing or externalizing problems. In a population-based sample of 2230 preadolescents (10-11 years) familial loading (parental lifetime psychopathology) and offspring temperament were assessed at baseline by parent report, and offspring psychopathology at 2.5-years follow-up by self-report, teacher report and parent report. We used purified measures of temperament and psychopathology and partialled out shared variance between internalizing and externalizing problems. Familial loading of internalizing psychopathology predicted offspring internalizing but not externalizing problems, whereas familial loading of externalizing psychopathology predicted offspring externalizing but not internalizing problems. Both familial loadings were associated with Frustration, low Effortful Control, and Fear. Frustration acted as a general risk factor predicting severity of maladjustment; low Effortful Control and Fear acted as dimension-specific risk factors that predicted a particular type of psychopathology; whereas Shyness, High-Intensity Pleasure, and Affiliation acted as direction markers that steered the conditional probability of internalizing versus externalizing problems, in the event of maladjustment. Temperament traits mediated one-third of the association between familial loading and psychopathology. Findings were robust across different composite measures of psychopathology, and applied to girls as well as boys. With regard to familial loading and temperament, it is important to distinguish general risk factors (Frustration) from dimension-specific risk factors (familial loadings, Effortful Control, Fear), and direction markers that act as pathoplastic factors (Shyness, High-Intensity Pleasure, Affiliation) from both types of risk factors. About one-third of familial loading effects on psychopathology in early adolescence are mediated by temperament.

Biomechanical Analysis of All-Inside, Arthroscopic Suture Repair Versus Extensor Retinaculum Capsulorrhaphy for Triangular Fibrocartilage Complex Tears With Instability.

PubMed

Patel, Amar A; Alhandi, Ali A; Milne, Edward; Dy, Christopher J; Latta, Loren L; Ouellette, E Anne

2016-03-01

To assess ulnocarpal joint stability after treatment of a peripheral triangular fibrocartilage complex (TFCC) injury with all-inside arthroscopic suture repair (SR), extensor retinaculum capsulorrhaphy with the Herbert sling (HS), and a combination of both (SR+HS). Twelve fresh-frozen, age-matched, upper-extremity specimens intact from the distal humerus were prepared. Nondestructive mechanical testing was performed to assess native ulnocarpal joint stability and load-displacement curves were recorded. A peripheral, ulnar-sided TFCC injury was created with arthroscopic assistance, and mechanical testing was performed. Each specimen was treated with SR or HS and testing was repeated. The 6 specimens treated with SR were then treated with HS (SR+HS), and testing was repeated. We used paired Student t tests for statistical analysis within cohorts. For all cohorts, there was an average increase in ulnar translation after the creation of a peripheral TFCC injury and an average decrease after repair. Herbert sling decreased translation by 21%, SR decreased translation by 12%, and SR+HS decreased translation by 26%. Suture repair plus HS and HS reduce ulnar translation the most after a peripheral TFCC injury, followed by SR alone. Ulnocarpal joint stability should be assessed clinically in patients with peripheral TFCC injury, and consideration should be made for using extensor capsulorrhaphy in isolation or as an adjunct to SR as a treatment option. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Immobilization in External Rotation Versus Internal Rotation After Primary Anterior Shoulder Dislocation: A Meta-analysis of Randomized Controlled Trials.

PubMed

Whelan, Daniel B; Kletke, Stephanie N; Schemitsch, Geoffrey; Chahal, Jaskarndip

2016-02-01

The recurrence rate after primary anterior shoulder dislocation is high, especially in young, active individuals. Recent studies have suggested external rotation immobilization as a method to reduce the rate of recurrent shoulder dislocation in comparison to traditional sling immobilization. To assess and summarize evidence from randomized controlled trials on the effect of internal rotation versus external rotation immobilization on the rate of recurrence after primary anterior shoulder dislocation. Meta-analysis. PubMed, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and abstracts from recent proceedings were searched for eligible studies. Two reviewers selected studies for inclusion, assessed methodological quality, and extracted data. Six randomized controlled trials (632 patients) were included in this review. Demographic and prognostic variables measured at baseline were similar in the pooled groups. The average age was 30.1 years in the pooled external rotation group and 30.3 years in the pooled internal rotation group. Two studies found that external rotation immobilization reduced the rate of recurrence after initial anterior shoulder dislocation compared with conventional internal rotation immobilization, whereas 4 studies failed to find a significant difference between the 2 groups. This meta-analysis suggested no overall significant difference in the rate of recurrence among patients treated with internal rotation versus external rotation immobilization (risk ratio, 0.69; 95% CI, 0.42-1.14; P = .15). There was no significant difference in the rate of compliance between internal and external rotation immobilization (P = .43). The Western Ontario Shoulder Instability Index scores were pooled across 3 studies, and there was no significant difference between the 2 groups (P = .54). Immobilization in external rotation is not significantly more effective in reducing the recurrence rate after primary anterior shoulder dislocation than immobilization in internal rotation. Additionally, this review suggests that there is minimal difference in patients' perceptions of their health-related quality of life after immobilization in internal versus external rotation. © 2015 The Author(s).

34. VIEW FROM STATION 78 OF STRETCH SLING HYDRAULIC CYLINDER, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

34. VIEW FROM STATION 78 OF STRETCH SLING HYDRAULIC CYLINDER, PULLEY, AND LANYARDS LOCATED ON EAST SIDE OF SLC-3W MST STATION 85.5. LANYARDS (STOWED BEHIND SOME TUBING ON STATION 78 IN THIS PHOTO) PASS THROUGH OPENINGS IN STATION 78 TO BE ATTACHED NEAR TOP OF ATLAS AIRFRAME. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

Pubovaginal sling procedure for the management of urinary incontinence after urethral trauma in women.

PubMed

Woodside, J R

1987-09-01

Traumatic urethral injury in women occurs less frequently than in men and urinary incontinence is a serious potential complication in women. Two female patients are described in whom post-traumatic urinary incontinence resulted from either direct trauma to the urethra or from injury to the innervation of the urethra. Both patients were treated successfully with the pubovaginal sling procedure that directly compresses an incompetent proximal urethra.

A randomized clinical trial of how to best position retropubic slings for stress urinary incontinence: Development of a study protocol for the mid-urethral sling tensioning (MUST) trial.

PubMed

Brennand, Erin A; Kim-Fine, Shunaha

2016-08-15

The goal of this trial is to compare two techniques for tensioning retropubic midurethral slings: a Mayo scissor between the tape and urethra vs. a Babcock clamp creating a measured loop underneath the urethra. The primary outcome is a composite of abnormal bladder function at 12 months post surgery. Abnormal bladder function is defined as bothersome stress incontinence or worsening over active bladder symptoms, a positive cough stress test, re-treatment of stress urinary incontinence, post-operative urinary retention requiring either catheterization beyond 6 weeks or surgical intervention. Secondary outcomes include the duration of post operative urinary retention, quality of life scores, and physical examination. This article describes the rationale and design of this clinical trial, which will be of interest to those who care for patient with pelvic floor disorders such as stress urinary incontinence.

Are external knee load and EMG measures accurate indicators of internal knee contact forces during gait?

PubMed

Meyer, Andrew J; D'Lima, Darryl D; Besier, Thor F; Lloyd, David G; Colwell, Clifford W; Fregly, Benjamin J

2013-06-01

Mechanical loading is believed to be a critical factor in the development and treatment of knee osteoarthritis. However, the contact forces to which the knee articular surfaces are subjected during daily activities cannot be measured clinically. Thus, the ability to predict internal knee contact forces accurately using external measures (i.e., external knee loads and muscle electromyographic [EMG] signals) would be clinically valuable. We quantified how well external knee load and EMG measures predict internal knee contact forces during gait. A single subject with a force-measuring tibial prosthesis and post-operative valgus alignment performed four gait patterns (normal, medial thrust, walking pole, and trunk sway) to induce a wide range of external and internal knee joint loads. Linear regression analyses were performed to assess how much of the variability in internal contact forces was accounted for by variability in the external measures. Though the different gait patterns successfully induced significant changes in the external and internal quantities, changes in external measures were generally weak indicators of changes in total, medial, and lateral contact force. Our results suggest that when total contact force may be changing, caution should be exercised when inferring changes in knee contact forces based on observed changes in external knee load and EMG measures. Advances in musculoskeletal modeling methods may be needed for accurate estimation of in vivo knee contact forces. Copyright © 2012 Orthopaedic Research Society.

Female stress urinary incontinence: standard techniques revisited and critical evaluation of innovative techniques

NASA Astrophysics Data System (ADS)

de Riese, Cornelia; de Riese, Werner T. W.

2003-06-01

Objectives: The treatment of female urinary incontinence (UI) is a growing health care concern in our aging society. Publications of recent innovations and modifications are creating expectations. This brief review provides some insight and structure regarding indications and expected outcomes for the different approaches. Materials: Data extraction is part of a Medline data base search, which was performed for "female stress incontinence" from 1960 until 2000. Additional literature search was performed to cover 2001 and 2002. Outcome data were extracted. Results: (1) INJECTION OF BULKING AGENTS (collagen, synthetic agents): The indication for mucosal coaptation was more clearly defined and in the majority of articles limited to ISD. (2) OPEN COLPOSUSPENSION (Burch, MMK): Best long-term results of all operative procedures, to date considered the gold standard. (3) LAPAROSCOPIC COLPOSUSPENSION (different modifications): Long-term success rates appear dependent on operator skills. There are few long-term data. (4) NEEDLE SUSPENSION: (Stamey, Pareyra and modifications): Initial results were equal to Burch with less morbidity, but long-term success rates are worse. (5) SLING PROCEDURES (autologous, synthetic, allogenic graft materials, different modes of support and anchoring, free tapes): The suburethral sling has traditionally been considered a procedure for those in whom suspension had failed and for those with severe ISD. The most current trend shows its use as a primary procedure for SUI. Long-term data beyond 5 years are insufficient. (6) EXTERNAL OCCLUSIVE DEVICES (vaginal sponges and pessaries, urethral insert): Both vaginal and urethral insert devices can be effective in selected patients. (7) IMPLANTABLE ARTEFICIAL URETHRAL SPHINCTERS: Modifications and improvements of the devices resulted in improved clinical results regarding durability and efficacy. CONCLUSION: (1) The Burch colposuspension is still considered the gold standard in the treatment of female genuine SUI. There is a trend for the suburethral sling to be used as the primary procedure for this indication. Early outcome data are encouraging. New concepts such as use of metalic bone anchors and allograft material as well as the Tension free Vaginal Tape are under investigation. (2) Standardization of diagnostic and therapeutic interventions is prerequisite for any meaningful research. Randomized controlled prospective studies are essential to provide objectives regarding risks and benefits of new procedures and materials.

Biomechanics of the osteoporotic spine, pain, and principles of training.

PubMed

Schröder, Guido; Knauerhase, Andreas; Willenberg, Holger S; Kundt, Guenther; Wendig, Detlef; Schober, Hans-Christof

2017-05-01

A fracture is a clinical manifestation of osteoporosis and is one of the main causes of functional limitations and chronic pain in patients with osteoporosis. Muscle and coordination training are recommended to the patients as general measures. We inquired whether sling training is better than traditional physiotherapy in relieving pain and improving abilities of daily living. Fifty patients with osteoporosis were divided into two groups. Group A performed conventional physiotherapy, while Group B performed sling training exercises. Data were collected before and after the intervention and after 3 months. The registered parameters were stamina, posture, and pain. Posture, torques, and the associated strength of spinal muscles were studied in a biomechanical model in order to estimate the forces acting on the spine. Furthermore, the factors that exerted a positive impact on the success of therapy were registered. Forty-four patients (88%) completed the study. Positive effects of the training were noted in both groups, but significantly better effects were observed in the group that performed sling training. A reduction of pain independent of the number of fractures, significantly reduced torques, and reduced muscle strength were registered. Specific training programs helped to increase muscle strength and straightening the back thereby reducing the force needed on a permanent basis and decreasing torque in the spine. Sling training was more effective in that than traditional physiotherapy.

Are older women more likely to receive surgical treatment for stress urinary incontinence since the introduction of the mid-urethral sling? An examination of Hospital Episode Statistics data.

PubMed

Gibson, W; Wagg, A

2016-07-01

To examine the trends in surgical treatment of stress urinary incontinence (SUI) in older women since the introduction of the mid-urethral sling. Analysis of data from Hospital Episode Statistics (HES) between 2000 and 2012. All surgical procedures for SUI in the National Health Service (NHS) in England. Retrospective cohort analysis of Hospital Episode Statistics for England from 2000 to 2012. Number of invasive, less invasive, and urethral bulking procedures performed in women in three age groups. There was a 90% fall in the number of invasive surgical treatments for SUI and a four-fold increase in the number of mid-urethral slings over this time. The total number of surgical procedures for SUI increased from 8458 to 13 219. However, the rise in the number of procedures in women aged over 75 was more modest-a three-fold increase from a low start of 187-and these women now make up a smaller proportion of all women receiving a mid-urethral sling (MUS). Despite the development and wide availability of a less invasive, safe and effective operation for stress urinary incontinence in older women, they do not appear to have benefitted. The reasons for this require prospective investigation. © 2015 Royal College of Obstetricians and Gynaecologists.

KSC-2011-1982

NASA Image and Video Library

2011-03-01

CAPE CANAVERAL, Fla. -- A large yellow, metal sling lifts shuttle Endeavour from the transfer aisle into a high bay of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida. In the bay, the shuttle will be attached to its external fuel tank and solid rocket boosters. Endeavour is targeted to roll out to Kennedy's Launch Pad 39A for its final mission, STS-134, on March 9. Endeavour and the six-member crew will deliver the Express Logistics Carrier-3, Alpha Magnetic Spectrometer-2 (AMS), a high-pressure gas tank, additional spare parts for the Dextre robotic helper and micrometeoroid debris shields to the International Space Station. Endeavour's final launch is targeted for April 19 at 7:48 p.m. EDT. For more information visit, http://www.nasa.gov/mission_pages/shuttle/shuttlemissions/sts134/index.html. Photo credit: NASA/Frankie Martin

KSC-2011-1985

NASA Image and Video Library

2011-03-01

CAPE CANAVERAL, Fla. -- A large yellow, metal sling lifts shuttle Endeavour from the transfer aisle into a high bay of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida. In the bay, the shuttle will be attached to its external fuel tank and solid rocket boosters. Endeavour is targeted to roll out to Kennedy's Launch Pad 39A for its final mission, STS-134, on March 9. Endeavour and the six-member crew will deliver the Express Logistics Carrier-3, Alpha Magnetic Spectrometer-2 (AMS), a high-pressure gas tank, additional spare parts for the Dextre robotic helper and micrometeoroid debris shields to the International Space Station. Endeavour's final launch is targeted for April 19 at 7:48 p.m. EDT. For more information visit, http://www.nasa.gov/mission_pages/shuttle/shuttlemissions/sts134/index.html. Photo credit: NASA/Frankie Martin

KSC-2011-1983

NASA Image and Video Library

2011-03-01

CAPE CANAVERAL, Fla. -- A large yellow, metal sling lifts shuttle Endeavour from the transfer aisle into a high bay of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida. In the bay, the shuttle will be attached to its external fuel tank and solid rocket boosters. Endeavour is targeted to roll out to Kennedy's Launch Pad 39A for its final mission, STS-134, on March 9. Endeavour and the six-member crew will deliver the Express Logistics Carrier-3, Alpha Magnetic Spectrometer-2 (AMS), a high-pressure gas tank, additional spare parts for the Dextre robotic helper and micrometeoroid debris shields to the International Space Station. Endeavour's final launch is targeted for April 19 at 7:48 p.m. EDT. For more information visit, http://www.nasa.gov/mission_pages/shuttle/shuttlemissions/sts134/index.html. Photo credit: NASA/Frankie Martin

Mersilene mesh sling: short- and long-term clinical and urodynamic outcomes.

PubMed

Young, S B; Howard, A E; Baker, S P

2001-07-01

We sought to determine the long-term efficacy, safety, and urodynamic effects of the Mersilene mesh suburethral sling in treating complicated forms of genuine stress incontinence. Two hundred women diagnosed with genuine stress incontinence, complicated by recurrence, intrinsic sphincter deficiency, or chronically increased intraabdominal pressure underwent a suburethral mesh sling procedure (Mersilene; Ethicon Inc, Somerville, NJ). They were monitored with yearly clinical examinations plus short- and long-term postoperative urodynamic evaluations; statistical analysis was carried out by use of the Friedman 2-way analysis by rank, Fischer-Freeman-Halton exact testing, analysis of variance for repeated measures, Wilcoxon, exact Mann-Whitney U test, and Bonferroni paired t test. Of 176 patients who were 5 months or more postop, 127 (72%) had preoperative and short-term postoperative urodynamic evaluations (range 5 to 23 months, mean 12.6 months). Fifty-two of 117 women who were more than 19 months postop (44%) completed preoperative and long-term postoperative urodynamic evaluations at a mean of 63 months (range 20 to 107). One hundred thirty-six of 176 patients (77%) who were more than 4 months postop had a short- and/or long- term postoperative urodynamic evaluation (range 5 to 107 months, mean 30 months). Objective cure rate by stress test was 93% (126 of 136 patients) at a mean of 30 months follow-up. The long-term objective cure rate was 94% (49 of 52). Subjectively, the short- and long-term cure rates were 95.3% and 90.4%, respectively. The cotton swab angle deflection decreased by a mean of 54 degrees at 1 year and 50 degrees at 5 years. Of the 10 failures, the mean preoperative cotton swab straining angle was 19.6 degrees, with 6 being < 30 degrees. Nineteen patients had a negative preoperative cotton swab angle test result (mean straining angle 15 degrees before operation, -6 degrees after operation) and a long-term cure rate of 67%. The objective cure rate in patients with positive cotton swab angle results monitored long term (mean 62 months) was 100% (41 of 41). The postvoid residual increased by a mean of 25 mL short term and 10 mL long term. Thirty-eight patients (19%) had a total of 43 complications. Seven patients (3.5%) had long-term retention. De novo detrusor instability occurred in 12 patients (8.8%), although it was cured in 6 (4.4%). Eight patients (4%) had vaginal or inguinal sling erosion and were healed after revision. Delayed healing at the vaginal sling site responded completely to estrogen cream in two (1%) patients. Five women had treatable vaginal stenosis, 5 had a local inguinal collection/infection unrelated to the mesh, and 3 required a 2-unit transfusion of packed red blood cells. One patient each had an entrapped nerve released, a cystotomy repaired, or experienced thigh numbness or groin pain. The suburethral Mersilene mesh sling has a very high long-term objective and subjective cure rate in the treatment of complicated forms of genuine stress incontinence. Frequent complications do occur but are remediable. The 33% failure rate among patients with a preoperative negative cotton swab angle test result and the very low cotton swab straining angle among the 7% who had sling failures further confirms the widely held belief that sling urethropexy in the absence of hypermobility lacks efficacy.

14 CFR 133.17 - Requirements for issuance of a rotorcraft external-load operator certificate.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 3 2014-01-01 2014-01-01 false Requirements for issuance of a rotorcraft external-load operator certificate. 133.17 Section 133.17 Aeronautics and Space FEDERAL AVIATION... §§ 133.19, 133.21, and 133.23, the Administrator issues a Rotorcraft External-Load Operator Certificate...

14 CFR 133.17 - Requirements for issuance of a rotorcraft external-load operator certificate.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 3 2013-01-01 2013-01-01 false Requirements for issuance of a rotorcraft external-load operator certificate. 133.17 Section 133.17 Aeronautics and Space FEDERAL AVIATION... §§ 133.19, 133.21, and 133.23, the Administrator issues a Rotorcraft External-Load Operator Certificate...

Risk factors for postoperative urinary tract infection following midurethral sling procedures.

PubMed

Doganay, Melike; Cavkaytar, Sabri; Kokanali, Mahmut Kuntay; Ozer, Irfan; Aksakal, Orhan Seyfi; Erkaya, Salim

2017-04-01

To identify the potential risk factors for urinary tract infections following midurethral sling procedures. 556 women who underwent midurethral sling procedure due to stress urinary incontinence over a four-year period were reviewed in this retrospective study. Of the study population, 280 women underwent TVT procedures and 276 women underwent TOT procedures. Patients were evaluated at 4-8 weeks postoperatively and were investigated for the occurrence of a urinary tract infection. Patients who experienced urinary tract infection were defined as cases, and patients who didn't were defined as controls. All data were collected from medical records. Multivariate logistic regression model was used to identify the risk factors for urinary tract infection. Of 556 women, 58 (10.4%) were defined as cases while 498 (89.6%) were controls. The mean age of women in cases (57.8±12.9years) was significantly greater than in controls (51.8±11.2years) (p<0.001). The presence of menopausal status, previous abdominal surgery, preoperative antibiotic treatment due to urinary tract infection, concomitant vaginal hysterectomy and cystocele repair, TVT procedure and postoperative postvoiding residual bladder volume ≥100ml were more common in cases than in controls. However, in multivariate regression analysis model presence of preoperative urinary tract infection [OR (95% CI)=0.1 (0.1-0.7); p=0.013], TVT procedure [OR (95% CI)=8.4 (3.1-22.3); p=0.000] and postoperative postvoiding residual bladder volume ≥100ml [OR (95% CI)=4.6 (1.1-19.2); p=0.036] were significant independent risk factors for urinary tract infection following midurethral slings CONCLUSION: Urinary tract infection after midurethral sling procedures is a relatively common complication. The presence of preoperative urinary tract infection, TVT procedure and postoperative postvoiding residual bladder volume ≥100ml may increase the risk of this complication. Identification of these factors could help surgeons to minimize this complicationby developing effective strategies. Copyright © 2017. Published by Elsevier B.V.

Clinical and imaging features of pulmonary artery sling in infants without significant hemodynamic changes.

PubMed

Wang, Jian-Hua; Ding, Gui-Chun; Zhang, Min-Yu; Liu, Mei; Niu, Hai-Yan

2011-10-01

Pulmonary artery sling (PAS) is a rare congenital heart anomaly and may cause unexplained respiratory symptoms in infants. Since the non-specific respiratory symptoms of PAS may lead to misdiagnosis, the aim of this study was to clarify the clinical and imaging features of this disease for timely diagnosis and treatment. Clinical histories, physical examinations and imaging studies were retrospectively evaluated in nine infants with PAS. Chest X-ray, echocardiography and contrast-enhanced computed tomography (CT) with 3-dimensional reconstructions were performed in all patients and three of them received surgical treatment. Nine cases included six males and three females with a mean age of (4.3 ± 2.8) months ranging from 2 to 11 months old. All patients had respiratory symptoms including recurrent cough, stridor and wheezing. The onset of symptoms was within 3 months in all cases and three children had symptoms only a few days after birth. The chest X-ray showed pneumonia in all cases. Contrast-enhanced CT showed the tracheal compression at different lengths in every case. The echocardiograph findings of PAS were anomalous origins of the left pulmonary artery from the posterior aspect of the right pulmonary artery. Of the 9 cases, 8 cases were diagnosed correctly by echocardiography. Of the complicated abnormalities, there were one with secundum atrial septal defect, one with patent foramen ovale and three with persistent left superior vena cava. None of them were complicated with significant blood dynamic changes. Infants with recurrent respiratory symptoms such as chronic cough, stridor and wheezing, should be examined for the possible presence of congenital pulmonary artery sling. As a noninvasive technique, echocardiography is very helpful and should be the first-choice modality for the diagnosis of pulmonary artery sling. Contrast-enhanced CT, clearly demonstrating the anatomy of pulmonary artery sling and the position and extent of trachea compression, is necessary for the final diagnosis and pre-operation evaluation.

Therapeutic Efficacy of a New Procedure for Male Urinary Incontinence Combining a Suburethral Polypropylene Mesh and Cardiovascular Patch

PubMed Central

Jiang, Yuan-Hong

2017-01-01

Purpose Stress urinary incontinence (SUI) in men is a complication secondary to prostatectomy or resulting from neurological lesions. This study presents our experiences with male suburethral slings over the past decade. Methods In this study, we considered patients who presented with SUI and were diagnosed with an intrinsic sphincteric deficiency due to postprostatectomy incontinence (PPI) or other causes (non-PPI). Patients who underwent the suburethral sling procedure using a polypropylene mesh and a cardiovascular patch were retrospectively included. An urodynamic study was performed before and after the operation. Global response assessment (GRA) and SUI grading were used for surgical outcome. The revision rate and the infection rate were also evaluated. Results A total 31 patients were enrolled in this study; the mean patient age was 59.5±18.9 years, and the mean follow-up period was 36.9±29.4 months. Fourteen patients comprised the non-PPI group and 17 were in the PPI group. The preoperative SUI of all patients were categorized as a moderate to severe problem according to the SUI grade, with a mean score of 2.32±0.48 before the operation and 0.48±0.57 after the operation. With a mean score of 2.35±0.71, GRA showed that the patients were satisfied with the treatment. After the sling procedure, 4 patients (13%) reported a mild improvement, 12 (38.7%) a moderate improvement, while 15 (48.4%) reported an excellent improvement. Six patients (19.4%), including 5 from the non-PPI group (35.7%) and 1 (5.9%) from the PPI group (P=0.037), underwent sling removal because of infection. Conclusions The male suburethral sling procedure using a polypropylene mesh and a cardiovascular patch is a safe, efficacious, and inexpensive surgical procedure for PPI. In cases of neurological incontinence, however, the higher infection rate in non-PPI patients means that they should be carefully managed. PMID:28361511

Load control system. [for space shuttle external tank ground tests

NASA Technical Reports Server (NTRS)

Grosse, J. C.

1977-01-01

The load control system developed for the shuttle external structural tests is described. The system consists of a load programming/display module, and a load control module along with the following hydraulic system components: servo valves, dump valves, hydraulic system components, and servo valve manifold blocks. One load programming/display subsystem can support multiple load control subsystem modules.

Improvement of fatigue resistance for multilayer lead zirconate titanate (PZT)-based ceramic actuators by external mechanical loads

NASA Astrophysics Data System (ADS)

Yang, Gang; Yue, Zhenxing; Ji, Ye; Chu, Xiangcheng; Li, Longtu

2008-12-01

The influence of external compressive loads, applied along a direction perpendicular to polarization, on fatigue behaviors of multilayer lead zirconate titanate (PZT)-based ceramic actuators was investigated. Under no external mechanical load, a normal fatigue behavior was observed, demonstrating that both switching polarization (Pswitching) and remnant polarization (Pr) progressively decreased with increasing switching cycles due to domain pinning by charge point defects. However, an anomalous enhancement in both switching and remnant polarizations was observed upon application of the external compressive loads. After 5×106 cycles of polarization switching, Pswitching and Pr increase by about 13% and 6% at 40 MPa, respectively, while Pswitching and Pr increase by about 11% and 21% at 60 MPa, respectively. The improvement of fatigue resistance can be attributed to non-180° domain switching and suppression of microcracking, triggered by external mechanical loads.

Single origin of right and left pulmonary arteries from ascending aorta with atretic main pulmonary artery from right ventricle and left pulmonary sling.

PubMed

Hsieh, Min-Ling; Huang, Li-Ting; Wang, Jieh-Neng; Tsai, Yi-Shan

2015-01-01

Either left pulmonary sling or single origin of right and left pulmonary arteries (only three cases reported previously) are rare congenital heart anomalies and concomitantly occurred had not been reported. The image presentation is similar to type A1 truncus arteriosus but preserved pulmonary valve and main pulmonary artery development. Copyright © 2015 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

High Structural Stability of Textile Implants Prevents Pore Collapse and Preserves Effective Porosity at Strain

PubMed Central

Klinge, Uwe; Otto, Jens; Mühl, Thomas

2015-01-01

Reinforcement of tissues by use of textiles is encouraged by the reduced rate of recurrent tissue dehiscence but for the price of an inflammatory and fibrotic tissue reaction to the implant. The latter mainly is affected by the size of the pores, whereas only sufficiently large pores are effective in preventing a complete scar entrapment. Comparing two different sling implants (TVT and SIS), which are used for the treatment of urinary incontinence, we can demonstrate that the measurement of the effective porosity reveals considerable differences in the textile construction. Furthermore the changes of porosity after application of a tensile load can indicate a structural instability, favouring pore collapse at stress and questioning the use for purposes that are not “tension-free.” PMID:25973427

Experimental evaluation of tailored chordwise deformable box beam and correlation with theory

NASA Technical Reports Server (NTRS)

Rehfield, Lawrence W.; Zischka, Peter J.; Chang, Stephen; Fentress, Michael L.; Ambur, Damodar R.

1993-01-01

This paper describes an experimental methodology based upon the use of a flexible sling support and load application system that has been created and utilized to evaluate a box beam which incorporates an elastic tailoring technology. The design technique used here for elastically tailoring the composite box beam structure is to produce exaggerated chordwise camber deformation of substantial magnitude to be of practical use in the new composite aircraft wings. The traditional methods such as a four-point bend test to apply constant bending moment with rigid fixtures inhibits the designed chordwise deformation from occurring and, hence, the need for the new test method. The experimental results for global camber and spanwise bending compliances correlate well with theoretical predictions based on a beam-like model.

Transformation-Induced Diffraction Peak Broadening During Bainitic and Martensitic Transformations Under Small External Loads in a Quenched and Tempered High Strength Steel

NASA Astrophysics Data System (ADS)

Dutta, R. K.; Huizenga, R. M.; Amirthalingam, M.; Hermans, M. J. M.; King, A.; Richardson, I. M.

2013-09-01

In situ phase transformation behavior of a high strength S690QL1 steel during continuous cooling under different mechanical loading conditions has been used to investigate the effect of small external loads on the transformation-induced plasticity during bainitic and martensitic transformations. The results show that during phase transformations, the untransformed austenite undergoes plastic deformation, thereby retarding further transformation to bainite/martensite. This occurs independent of external load.

Loss of Consciousness During Single Sling Helicopter Hoist Rescue Resulting in a Fatal Fall.

PubMed

Biles, Jessie; Garner, Alan A

2016-09-01

Although harness suspension trauma has been documented since the 1960s, especially in the mountaineering setting, there is little robust medical research into the area. Helicopter hoist rescue shares similar risks and is reserved for those cases that cannot be accessed safely by other routes, where extrication may be hazardous or will take an unreasonable amount of time. The single sling or chest harness used for hoist rescue is a single harness around the upper torso and is easier and quicker to apply than a stretcher. However, the risks of a chest harness need to be balanced against the patient's condition, the environment, aircraft performance, and the urgency of the rescue. We report an adult male falling 80 ft to his death while being hoisted into a rescue helicopter for a likely fractured ankle. A single rescue sling harness technique was used, but the patient became unconscious, slipped out of the harness, and fell. He had significant comorbidities, including cardiomyopathy, obstructive sleep apnea, morbid obesity, and diabetes. A decrease in cardiac output secondary to thoracic compression was the presumed cause for his loss of consciousness and the potential physiological mechanisms and modifying factors are discussed. Further research into harness suspension trauma is required. Stretcher, double point harnesses, or rescue baskets are likely safer methods of hoisting, especially in a medically compromised patient. Biles J, Garner AA. Loss of consciousness during single sling helicopter hoist rescue resulting in a fatal fall. Aerosp Med Hum Perform. 2016; 87(9):821-824.

Visualizing Hyolaryngeal Mechanics in Swallowing Using Dynamic MRI

PubMed Central

Pearson, William G.; Zumwalt, Ann C.

2013-01-01

Introduction Coordinates of anatomical landmarks are captured using dynamic MRI to explore whether a proposed two-sling mechanism underlies hyolaryngeal elevation in pharyngeal swallowing. A principal components analysis (PCA) is applied to coordinates to determine the covariant function of the proposed mechanism. Methods Dynamic MRI (dMRI) data were acquired from eleven healthy subjects during a repeated swallows task. Coordinates mapping the proposed mechanism are collected from each dynamic (frame) of a dynamic MRI swallowing series of a randomly selected subject in order to demonstrate shape changes in a single subject. Coordinates representing minimum and maximum hyolaryngeal elevation of all 11 subjects were also mapped to demonstrate shape changes of the system among all subjects. MophoJ software was used to perform PCA and determine vectors of shape change (eigenvectors) for elements of the two-sling mechanism of hyolaryngeal elevation. Results For both single subject and group PCAs, hyolaryngeal elevation accounted for the first principal component of variation. For the single subject PCA, the first principal component accounted for 81.5% of the variance. For the between subjects PCA, the first principal component accounted for 58.5% of the variance. Eigenvectors and shape changes associated with this first principal component are reported. Discussion Eigenvectors indicate that two-muscle slings and associated skeletal elements function as components of a covariant mechanism to elevate the hyolaryngeal complex. Morphological analysis is useful to model shape changes in the two-sling mechanism of hyolaryngeal elevation. PMID:25090608

Core strength training using a combination of home exercises and a dynamic sling system for the management of low back pain in pre-professional ballet dancers: a case series.

PubMed

Kline, Jessica Beckmann; Krauss, John R; Maher, Sara F; Qu, Xianggui

2013-01-01

Estimates of low back pain prevalence in USA ballet dancers range from 8% to 23%. Lumbar stabilization and extensor muscle training has been shown to act as a hypoalgesic for low back pain. Timing and coordination of multifidi and transverse abdominis muscles are recognized as important factors for spinal stabilization. The purpose of this study was to explore the effects of training methods using home exercises and a dynamic sling system on core strength, disability, and low back pain in pre-professional ballet dancers. Five participants were randomly assigned to start a traditional unsupervised lumbar stabilization home exercise program (HEP) or supervised dynamic sling training to strengthen the core and lower extremities. Measurements were taken at baseline and at weeks 3 and 6 for disability using the patient specific functional scale (PSFS), pain using the Numerical Pain Rating System (NPRS), core strength and endurance using timed plank, side-plank, and bridge positions, and sciatic nerve irritability using the straight leg raise (SLR). Data were analyzed using descriptive statistics. From initial to final measurements, all participants demonstrated an improvement in strength and SLR range, and those with initial pain and disability reported relief of symptoms. These results suggest that dynamic sling training and a HEP may help to increase strength, decrease pain, and improve function in dancers without aggravating sciatic nerve irritation.

Shuttle Systems 3-D Applications: Application of 3-D Graphics in Engineering Training for Shuttle Ground Processing

NASA Technical Reports Server (NTRS)

Godfrey, Gary S.

2003-01-01

This project illustrates an animation of the orbiter mate to the external tank, an animation of the OMS POD installation to the orbiter, and a simulation of the landing gear mechanism at the Kennedy Space Center. A detailed storyboard was created to reflect each animation or simulation. Solid models were collected and translated into Pro/Engineer's prt and asm formats. These solid models included computer files of the: orbiter, external tank, solid rocket booster, mobile launch platform, transporter, vehicle assembly building, OMS POD fixture, and landing gear. A depository of the above solid models was established. These solid models were translated into several formats. This depository contained the following files: stl for sterolithography, stp for neutral file work, shrinkwrap for compression, tiff for photoshop work, jpeg for Internet use, and prt and asm for Pro/Engineer use. Solid models were created of the material handling sling, bay 3 platforms, and orbiter contact points. Animations were developed using mechanisms to reflect each storyboard. Every effort was made to build all models technically correct for engineering use. The result was an animated routine that could be used by NASA for training material handlers and uncovering engineering safety issues.

Buckling of Cracked Laminated Composite Cylindrical Shells Subjected to Combined Loading

NASA Astrophysics Data System (ADS)

Allahbakhsh, Hamidreza; Shariati, Mahmoud

2013-10-01

A series of finite element analysis on the cracked composite cylindrical shells under combined loading is carried out to study the effect of loading condition, crack size and orientation on the buckling behavior of laminated composite cylindrical shells. The interaction buckling curves of cracked laminated composite cylinders subject to different combinations of axial compression, bending, internal pressure and external pressure are obtained, using the finite element method. Results show that the internal pressure increases the critical buckling load of the CFRP cylindrical shells and bending and external pressure decrease it. Numerical analysis show that axial crack has the most detrimental effect on the buckling load of a cylindrical shell and results show that for lower values of the axial compressive load and higher values of the external pressure, the buckling is usually in the global mode and for higher values of axial compressive load and lower levels of external pressure the buckling mode is mostly in the local mode.

Does Maximal External Tibial Component Rotation Influence Tibiofemoral Load Distribution in the Primary Knee Arthroplasty Setting: A Comparison of Neutral vs Maximal Anatomical External Rotatory States.

PubMed

Manning, William A; Ghosh, Kanishka M; Blain, Alasdair P; Longstaff, Lee M; Rushton, Steven P; Deehan, David J

2017-06-01

Tibial component rotation at time of knee arthroplasty can influence conformity, load transmission across the polyethylene surface, and perhaps ultimately determined survivorship. Optimal tibial component rotation on the cut surface is reliant on standard per operative manual stressing. This subjective assessment aims to balance constraint and stability of the articulation through a full arc of movement. Using a cadaveric model, computer navigation and under defined, previously validated loaded conditions mimicking the in vivo setting, the influence of maximal tibial component external rotation compared with the neutral state was examined for changes in laxity and tibiofemoral continuous load using 3D displacement measurement and an orthosensor continuous load sensor implanted within the polyethylene spacer in a simulated single radius total knee arthroplasty. No significant difference was found throughout arc of motion (0-115 degrees of flexion) for maximal varus and/or valgus or rotatory laxity between the 2 states. The neutral state achieved equivalence for mediolateral load distribution at each point of flexion. We have found that external rotation of the tibial component increased medial compartment load in comparison with the neutral position. Compared with the neutral state, external rotation consistently effected a marginal, but not significant reduction in lateral load under similar loading conditions. The effects were most pronounced in midflexion. On the basis of these findings, we would advocate for the midtibial tubercle point to determine tibial component rotation and caution against component external rotation. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of external catheters with subcutaneous vascular access ports for chronic vascular access in a porcine model.

PubMed

Chuang, Marc; Orvieto, Marcelo; Laven, Brett; Gerber, Glenn; Wardrip, Craig; Ritch, Chad; Shalhav, Arieh

2005-03-01

We sought to compare the outcomes of two chronic vascular access techniques, the externalized catheter and the subcutaneous vascular access port, in pigs. Female farm pigs (n = 30) underwent placement of a chronic vascular access device in the jugular vein for a research protocol: 18 of the animals underwent placement of a tunneled Hickman catheter (THC), and the remaining 12 animals underwent placement of a subcutaneous vascular access port (VAP) without external components. After placement of the devices, animals underwent serial blood sampling. All animals were given identical antibiotic prophylaxis. VAP access required the use of a restraint sling for Huber needle insertion, whereas THC access required no additional equipment. Animals were euthanatized 1 month after placement of the device. In the VAP group, the port was retrieved, cleaned, and steam-autoclaved for reuse. In the THC group, 13 (72%) animals developed infectious complications, and blood and wound cultures were often polymicrobial. One animal was euthanatized secondary to overwhelming sepsis. In addition, three (17%) animals developed thromboembolic complications. In contrast, no thromboembolic complications were noted in the VAP group, and only one animal developed a transient fever which resolved spontaneously; no septic complications or abscesses developed. Blood draws with no anesthesia were successful in both groups. We conclude that subcutaneous vascular access ports are a safe and efficient method for obtaining reliable chronic vascular access for a 1-month period in pigs. The subcutaneous devices were associated with low morbidity. In contrast, externalized catheters can be associated with considerable morbidity.

KSC-2011-1986

NASA Image and Video Library

2011-03-01

CAPE CANAVERAL, Fla. -- Members of the media snap photos as a large yellow, metal sling lifts shuttle Endeavour from the transfer aisle into a high bay of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida. In the bay, the shuttle will be attached to its external fuel tank and solid rocket boosters. Endeavour is targeted to roll out to Kennedy's Launch Pad 39A for its final mission, STS-134, on March 9. Endeavour and the six-member crew will deliver the Express Logistics Carrier-3, Alpha Magnetic Spectrometer-2 (AMS), a high-pressure gas tank, additional spare parts for the Dextre robotic helper and micrometeoroid debris shields to the International Space Station. Endeavour's final launch is targeted for April 19 at 7:48 p.m. EDT. For more information visit, http://www.nasa.gov/mission_pages/shuttle/shuttlemissions/sts134/index.html. Photo credit: NASA/Frankie Martin

Effect of Loading Efficiency on the Process of Consolidation in Unsaturated Soils

NASA Astrophysics Data System (ADS)

Lo, W. C.; Lee, J. W.; Deng, J. H.; Liu, J. H.

2016-12-01

Loading efficiency is an undrained poroelastic coefficient that causes an increase in the pore pressure due to an increase in the compressive axial stress. In order to illustrate the importance of loading efficiency on the process of consolidation in unsaturated soils, we utilize two assumptions proposed by Biot (1941) and Terzaghi (1943) to formulate the initial conditions taking account of loading efficiency and without consideration of loading efficiency, respectively. In Biot's theory (1941), he suggested that water is not allowed to escape when the external loading is instantly applied on a porous medium. Accordingly, the soil texture sample is considered to be undrained, and the linearized increment of the fluid content is equal to zero. For this reason, water and air can sustain an external loading only partially at the moment it is imposed, leading to an immediate one-dimensional consolidation. On the contrary, Terzaghi (1943) posited that as the external loading is initially applied, it is entirely sustained by the pore fluid. Thus, the initial water and air pressures are equal to the stress of external loading. Numerical calculations of excess pore water pressure and total settlement were made for a soil with clay texture as an illustrative example. A comparative study shows that in the early stage of consolidation, the model of considering loading efficiency generates larger time-dependent total settlement and also has the highest value of excess pore water pressure initially. The physical cause behind this difference is that the initial conditions established from Biot's theory is much smaller, reflecting the soil skeleton to carry most of external load at the moment it is imposed. Our results indicate that, in terms of the initial conditions for water and air pressures, the loading efficiency must be taken into account in the early stage of consolidation.

Motor unit recruitment and firing rate in medial gastrocnemius muscles during external perturbations in standing in humans.

PubMed

Pollock, C L; Ivanova, T D; Hunt, M A; Garland, S J

2014-10-01

There is limited investigation of the interaction between motor unit recruitment and rate coding for modulating force during standing or responding to external perturbations. Fifty-seven motor units were recorded from the medial gastrocnemius muscle with intramuscular electrodes in response to external perturbations in standing. Anteriorly directed perturbations were generated by applying loads in 0.45-kg increments at the pelvis every 25-40 s until 2.25 kg was maintained. Motor unit firing rate was calculated for the initial recruitment load and all subsequent loads during two epochs: 1) dynamic response to perturbation directly following each load drop and 2) maintenance of steady state between perturbations. Joint kinematics and surface electromyography (EMG) from lower extremities and force platform measurements were assessed. Application of the external loads resulted in a significant forward progression of the anterior-posterior center of pressure (AP COP) that was accompanied by modest changes in joint angles (<3°). Surface EMG increased more in medial gastrocnemius than in the other recorded muscles. At initial recruitment, motor unit firing rate immediately after the load drop was significantly lower than during subsequent load drops or during the steady state at the same load. There was a modest increase in motor unit firing rate immediately after the load drop on subsequent load drops associated with regaining balance. There was no effect of maintaining balance with increased load and forward progression of the AP COP on steady-state motor unit firing rate. The medial gastrocnemius utilized primarily motor unit recruitment to achieve the increased levels of activation necessary to maintain standing in the presence of external loads. Copyright © 2014 the American Physiological Society.

Effects of load on ground reaction force and lower limb kinematics during concentric squats.

PubMed

Kellis, Eleftherios; Arambatzi, Fotini; Papadopoulos, Christos

2005-10-01

The purpose of this study was to examine the effects of external load on vertical ground reaction force, and linear and angular kinematics, during squats. Eight males aged 22.1 +/- 0.8 years performed maximal concentric squats using loads ranging from 7 to 70% of one-repetition maximum on a force plate while linear barbell velocity and the angular kinematics of the hip, knee and ankle were recorded. Maximum, average and angle-specific values were recorded. The ground reaction force ranged from 1.67 +/- 0.20 to 3.21 +/- 0.29 times body weight and increased significantly as external load increased (P < 0.05). Bar linear velocity ranged from 0.54 +/- 0.11 to 2.50 +/- 0.50 m x s(-1) and decreased significantly with increasing external load (P < 0.05). Hip, knee and ankle angles at maximum ground reaction force were affected by external load (P < 0.05). The force-barbell velocity curves were fitted using linear models with coefficients (r2) ranging from 0.59 to 0.96. The results suggest that maximal force exertion during squat exercises is not achieved at the same position of the lower body as external load is increased. In contrast, joint velocity coordination does not change as load is increased. The force-velocity relationship was linear and independent from the set of data used for its determination.

National study of utilization of male incontinence procedures.

PubMed

Chughtai, Bilal; Sedrakyan, Art; Isaacs, Abby J; Mao, Jialin; Lee, Richard; Te, Alexis; Kaplan, Steven

2016-01-01

We explored re-interventions and short and long term adverse events associated with procedures for male incontinence among Medicare beneficiaries. All inpatient and outpatient claims for a simple random sample of Medicare beneficiaries for 2000-2011 were queried to identify patients of interest. All male patients with an International Classification of Diseases, 9th Edition (ICD-9) diagnosis code for stress incontinence or mixed incontinence were included. Artificial urinary sphincter recipients, patients who underwent a sling operation and those receiving an injection of a bulking agent were identified with Current Procedure Terminology (CPT-4) and ICD-9 Procedure Codes. The entire cohort of 1,246 patients were operated on between 2001 and 2011. 34.9% of them received an artificial urinary sphincter (AUS), 28.7% with a bulking agent, and 36.4% with a sling. There were no statistically significant differences in demographics or comorbidities between the treatment groups, except that more sling patients were obese (P = 0.006) and fewer bulk patients had diabetes (P = 0.007). There are, however, significant changes in procedures selected over time (P < 0.001). In the first year and over the entire follow-up after surgery, patients treated with bulking agents had the most subsequent interventions (40.1% and 52.9%), followed by sling (10.4% and 15.5%), and AUS (2.3% and 20%) (P < 0.001). Post-operative and 90 day complications were low. All three treatments seem to be safe among Medicare beneficiaries with multiple comorbidities. The urological, infectious, and neurological complication occurrences were low. © 2014 Wiley Periodicals, Inc.

Pedicled rectus abdominis muscle and fascia flap sling the bulbar urethra for treatment for male-acquired urinary incontinence: report of ten cases.

PubMed

Xu, Yue-Min; Zhang, Xin-Ru; Xie, Hong; Song, Lu-Jie; Feng, Chao; Fei, Xiao-Fang

2014-03-01

Male urinary incontinence is relatively common complication of radical prostatectomy and of posterior urethroplasty following traumatic pelvic fracture. Here, we investigate the use of pedicled rectus abdominis muscle and fascia flap sling of the bulbar urethra for treatment for male-acquired urinary incontinence. Ten patients with acquired urinary incontinence were included in the study. Urinary incontinence was secondary to TURP in three patients and was secondary to posterior urethroplasty performed following traumatic pelvic fracture in seven patients. Pedicled rectus abdominalis muscle and fascial flaps, approximately 2.5 cm wide and 15 cm long, were isolated. The flaps were inserted into a perineal incision through a subcutaneous tunnel. The free end of the flap was sectioned to form two muscle strips, each 3 cm in length, and inserted into the space between bulbar urethra and corpus cavernosa. After adequate sling tension had been achieved, the two strips of muscle were anastomosed around the bulbar urethra using a 2-zero polyglactin suture. The patients were followed up for between 12 and 82 months (mean 42.8 months). Complete continence was achieved with good voiding in seven of the 10 patients. In other three patients achieved good voiding following catheter removal, but incontinence was only moderately improved. A pedicled rectus muscle fascial sling of the bulbar urethra is an effective and safe treatment for male patients with mild to moderate acquired urinary incontinence, but it may not be suitable for severe incontinence or for patients with weak rectus abdominalis muscles.

Postoperative Urinary Retention and Urinary Tract Infections Predict Midurethral Sling Mesh Complications.

PubMed

Punjani, Nahid; Winick-Ng, Jennifer; Welk, Blayne

2017-01-01

To determine if postoperative urinary retention and urinary tract infections (UTIs) were predictors of future mesh complications requiring surgical intervention after midurethral sling (MUS). Administrative data in Ontario, Canada, between 2002 and 2013 were used to identify all women who underwent a mesh-based MUS. The primary outcome was revision of the transvaginal mesh sling (including mesh removal/erosion/fistula, or urethrolysis). Two potential risk factors were analyzed: postoperative retention (within 30 days of procedure) and number of postoperative emergency room visits or hospital admissions for UTI symptoms. A total of 59,556 women had a MUS, of which 1598 (2.7%) required revision surgery. Of the 2025 women who presented to the emergency room or were admitted to hospital for postoperative retention, 212 (10.5%) required operative mesh revision. Of the 11,747 patients who had at least one postoperative UTI, 366 (3.1%) patients required operative mesh revision. In adjusted analysis, postoperative retention was significantly predictive of future reoperation (hazard ratio [HR] 3.46, 95% confidence interval [CI] 2.97-4.02), and this difference persisted when urethrolysis was excluded as a reason for sling revision (HR 3.08, 95% CI 2.62-3.63). Similarly, in adjusted analysis, each additional postoperative hospital visit for UTI symptoms increased the risk for surgical intervention for mesh complications (HR 1.74, 95% CI 1.61-1.87). Postoperative urinary retention and hospital presentation for UTI symptoms are associated with an increased risk of reoperation for MUS complications. These patients should be followed and investigated for mesh complications when appropriate. Copyright © 2016 Elsevier Inc. All rights reserved.

8-ply small intestinal submucosa tension-free sling: spectrum of postoperative inflammation.

PubMed

Ho, Khai-Linh V; Witte, Matthew N; Bird, Erin T

2004-01-01

We report a series of postoperative inflammatory reactions of a tension-free pubourethral sling procedure using an 8-ply small intestinal submucosa (SIS) and review the literature regarding inflammatory reactions with this material in genitourinary reconstruction. Between August 2002 and June 2003, 6 of 10 patients treated for stress urinary incontinence with 8-ply SIS had postoperative inflammatory reactions. Patients underwent a thorough evaluation, including history, physical examination and urodynamic studies, before surgical intervention. All patients presented with induration and erythema at the abdominal incision site(s) and pain 10 to 39 days postoperatively. Pelvic examinations were negative. In 3 patients the inflammatory reaction resolved with minimal or no intervention. Incision and drainage of a sterile abscess were required in 1 patient. Despite 7 days of prophylactic postoperative antibiotics and anti-inflammatory drugs, 2 patients had delayed inflammatory reactions. One patient had resolution with conservative treatment, while the other had an abscess that spontaneously drained. With short-term followup (mean 7 months, range 4 to 10), 8 patients are dry, 1 is improved and 1 is incontinent. While the results with the 8-ply SIS tension-free sling in the short term are encouraging, the additional morbidity is alarming and caution is warranted. It is essential that patients be made aware of potential risks and possible delayed presentation of morbidity with the use of this material. The human to 8-ply SIS interaction needs further investigation to ensure that long-term safety and efficacy will not be jeopardized. Until then we will continue to use other sling materials.

Hydrology and water quality of Delavan Lake in southeastern Wisconsin

USGS Publications Warehouse

Field, S.J.; Duerk, M.D.

1988-01-01

External loading of phosphorus and nitrogen were sufficient to cause eutrophic conditions. Internal loading of phosphorus was more than two times the external phosphorus supply. Most of the internal loading occurred when the hypolimnion was anoxic during summer. Internal loading of phosphorus during the 1985 water year was significantly reduced from that of 1984 because of a shorter anoxic period.

Application of 4-META/MMA-TBB resin for fixation of membrane to tooth in guided tissue regeneration in dog.

PubMed

Tomita, Sachiyo; Yamamoto, Shigeki; Shibukawa, Yoshihiro; Kaneko, Tadashi; Miyakoshi, Shoichi; Shimono, Masaki; Yamada, Satoru

2010-11-01

The aim of this study was to evaluate 4-META/MMA-TBB resin as an alternative to sling sutures for fixation of membrane to tooth in GTR in terms of its effect on tissue regeneration. Dehiscence periodontal defects were created in 6 dogs which were divided at random into two groups, 3 dogs in each group: an experimental group, in which non-absorbable or absorbable membrane was fixed to the teeth with 4-META/MMA-TBB resin; and a control group, in which sling sutures were applied to fix the two types of membrane. Histologic and histometric evaluation was carried out at 8 weeks post-operatively to determine healing response in each group. Both methods of achieving membrane fixation to tooth were effective in inhibiting epithelial migration and encouraging formation of regenerated periodontal tissues around the root surfaces. These results suggest that 4-META/MMA-TBB resin is as effective as sling sutures in achieving membrane fixation in GTR and is, moreover, easier to apply.

Development of an Ultra-Light Multipurpose Drill and Tooling for the Transportable Array in Alaska

NASA Astrophysics Data System (ADS)

Coyle, B. J.; Lundgren, M.; Busby, R. W.

2014-12-01

Over the next four years the EarthScope Transportable Array (TA) will install approximately 250 to 275 broadband seismic stations in Alaska and Western Canada. The station plans build on recent developments in posthole broadband seismometer design and call for sensors to be installed in boreholes 7 inches diameter, from 1 to 5 meters deep. These boreholes will be lined with PVC or steel casing, grouted in place. The proposed station locations are in a grid-like pattern with a nominal spacing of 85 km. Since most of these locations will only be accessible by helicopter, it was necessary to develop an ultra-light drilling system that could be transported to site in one sling load by a high performance light helicopter (i.e. AS350B2 or Bell 407) and still be able to drill the variety of ground conditions we expect to encounter. In the past year we have developed a working prototype, gasoline-hydraulic drill rig that can be configured to run auger, diamond core or DTH tools, and weighs <1,300 lbs, including tooling. We have successfully drilled over 30 boreholes with this drill, including 12 for TA installations in Alaska and 13 at the Piñon Flat Observatory for testing sensor performance and placement techniques. Our drilling solution comprises: - Hydraulic system using a variable flow pump with on-demand load sensing valves to reduce the engine size needed and to cut down on heat build-up; - Rotation head mounting system on the travelling block to enable quick change of drilling tools; - Low speed, high torque rotation head for the auger, and an anchoring system that enables us to apply up to 5,000 lbs downforce for augering in permafrost; - Custom DTH that can run on low air pressure and air flow, yet is still robust enough to drill a 7 inch hole 2.5 meters through solid rock; - One-trip casing advance drilling with the DTH, steel casing is loaded at the start of drilling and follows the drill bit down; - Grout-through bottom caps for sealing the borehole casing and cementing it in place. Our next step is to build a dedicated DTH drilling system that will be light enough to mobilize to sites in one helicopter sling, including an air compressor. This rig is currently on the drawing board and we expect to build it this winter for field testing in the spring.

Tensiomyographical responses to accelerometer loads in female collegiate basketball players.

PubMed

Peterson, Kyle D; Quiggle, Gabriela T

2017-12-01

The purpose of the present study was to characterise the relationship between relative versus absolute internal and external loads in collegiate basketball players throughout the course of a season. Five Division I basketball players wore triaxial accelerometers throughout the 2015-2016 season and were tensiomyographically assessed weekly. One-way repeated-measure analysis of variance (RM ANOVA) with least-significant-difference (LSD) pairwise comparisons was used to determine which absolute weekly loads were different across the season. Cohen's d was used to supplement the determination of meaningful relative load changes. Overall RM ANOVA models suggest absolute external load differences occurred (PlayerLoad™ F = 17.63; IMA™ F = 31.63). Two-way RM ANOVA models revealed main effect differences were revealed between muscle groups for Tc (F = 9.11) and Dm (F = 3.25). Meaningful relative load changes between weeks were observed for both external and internal. The present study observed that tensiomyography utilised as a tool to monitor internal load may be more suitable for detecting fatigue from relative external load changes versus absolute load attained. Limiting weekly training volume changes to ≤10% may maintain appropriate adaptation. Mediolateral plane IMA™ and adductor longus muscle group may be pertinent metrics when monitoring female collegiate basketball athletes.

14 CFR 29.471 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... equilibrium. For limit ground loads— (1) The limit ground loads obtained in the landing conditions in this part must be considered to be external loads that would occur in the rotorcraft structure if it were acting as a rigid body; and (2) In each specified landing condition, the external loads must be placed in...

KSC-07pd1764

NASA Image and Video Library

2007-07-03

KENNEDY SPACE CENTER, FLA. -- On the KSC Shuttle Landing Facility, workers supervise the movement of the sling above the orbiter Atlantis. The sling will be attached and lift the orbiter away from the shuttle carrier aircraft (SCA) underneath. The SCA carried the orbiter piggyback from California. Atlantis landed at Edwards Air Force Base in California on June 22 to end mission STS-117. It returned to Kennedy atop the SCA on July 3 after a three-day, cross-country flight due to fuel stops and weather delays. Touchdown was at 8:27 a.m. EDT. Photo credit: NASA/Kim Shiflett

[Female incontinence surgery: state of the art].

PubMed

Marson, Francesco; Ammirati, Enrico; Gurioli, Alberto; Destefanis, Paolo; Gontero, Paolo; Frea, Bruno

2015-01-01

Female urinary incontinence represents a medical and social problem with huge impact regarding both patient's quality of life and social costs. The diagnosis is important for therapeutic choice and should consider some factors: the degree of urethral mobility, urodynamics parameters, patient's will and expectations, information about surgical complications and risks. Nowadays suburethral sling evolution and bulking therapy for selected cases consent to perform miniinvasive surgery; the most relevant problem concerns the management of postoperative complications: in this sense autologous slings are used after urethrolisis. In most difficult cases, it is possible to consider artificial sphincter as the best option.

[Contasure Needleless: a single incision tot for the surgical treatment of stress urinary incontinence].

PubMed

Navazo, Rafael; Moreno, Jesús; Hidalgo, Cristina; Herraiz, Miguel Angel; Vidart, José Antonio; Salinas, Jesús; Silmi, Angel

2009-11-01

The aim of this study is to describe the surgical technique, and assess the complications and middle-term results of the Contasure Needleless (Neomedic International), a single incision TOT sling for the surgical treatment of stress urinary incontinence. The main concept of this device is that it is not a mini-sling, it has 138% more surface area. We are analyzing the results of a minimally invasive solution that is a TOT like sling with the same known benefits of a TOT and the advantages of a single incision technique. The surface area to support the urethra of the Needleless is very similar to the surface area of the TOT. (16% less surface area of tissue ingrowths) It is 100% macroporous polypropylene without any additional material. 120 patients were evaluated retrospectively. They were all treated of SUI with the Contasure Needleless.Female patients were evaluated under clinical study protocol consisting in cough test, urodynamic and Quality Of Life questionnaire, before and after the procedure. patients with genuine SUI and patients with SUI plus concomitant procedures as prolapse. patients with ISD and or neurogenic incontinence. Anesthesia used: general (30%) or epidural (70%), patients with associated pathology. The 114 mm long and tension-free mesh was placed beneath the midurethra. The central part is 12 mm wide. The sling can be repositioned during surgery due to the 22 mm wide T-Pocket Positioning System located at the 2 edges. These pockets fixed the sling to the surrounding tissue in order to have the proper tissue in growth and anchoring. A 20mm sub urethral incision was made to dissect the paraurethral spaces only up to the ischiopubic ramus. A surgical forceps with the T-pocket folded was inserted into the dissected spaces and penetrates at the contra lateral side, like the standard transobturator technique. The forceps was introduced until the fascia of the Internal Obturator muscle was perforated. Then the forceps is opened to extend the pocket inside the muscle fibers for fixation. 120 patients with a mean age of 55 years (from 36 to 79) and a mean number of deliveries of 3 (0-7). Follow-up period: 24 months. SUCCESS RATE: 100 patients (84%) Improved rate: 10 patients (8%) Failure rate: 10 (8%) Mean operating time of sling procedure alone: 9 minutes (4-12). 3 patients had mesh extrusion solved with estrogens and 2 patients required short term catheterization due to voiding difficulties and no patients had inguinal pain. The results of the study suggest that the Contasure Needleless can be considered a minimally invasive TOT with no-needles and maintaining the same cure rate than our TOT cases at 2 years follow up.

Relationships Between Results Of An Internal And External Match Load Determining Method In Male, Singles Badminton Players.

PubMed

Abdullahi, Yahaya; Coetzee, Ben; Van den Berg, Linda

2017-07-03

The study purpose was to determine relationships between results of internal and external match load determining methods. Twenty-one players, who participated in selected badminton championships during the 2014/2015 season served as subjects. The heart rate (HR) values and GPS data of each player were obtained via a fix Polar HR Transmitter Belt and MinimaxX GPS device. Moderate significant Spearman's rank correlations were found between HR and absolute duration (r = 0.43 at a low intensity (LI) and 0.44 at a high intensity (HI)), distance covered (r = 0.42 at a HI) and player load (PL) (r = 0.44 at a HI). Results also revealed an opposite trend for external and internal measures of load as the average relative HR value was found to be the highest for the HI zone (54.1%) compared to the relative measures of external load where average values (1.29-9.89%) were the lowest for the HI zone. In conclusion, our findings show that results of an internal and external badminton match load determining method are more related to each other in the HI zone than other zones and that the strength of relationships depend on the duration of activities that are performed in especially LI and HI zones. Overall, trivial to moderate relationships between results of an internal and external match load determining method in male, singles badminton players reaffirm the conclusions of others that these constructs measure distinctly different demands and should therefore be measured concurrently to fully understand the true requirements of badminton match play.

Samus Counter Lifting Fixture

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

Stredde, H.; /Fermilab

1998-05-27

A lifting fixture has been designed to handle the Samus counters. These counters are being removed from the D-zero area and will be transported off site for further use at another facility. This fixture is designed specifically for this particular application and will be transferred along with the counters. The future use of these counters may entail installation at a facility without access to a crane and therefore a lift fixture suitable for both crane and/or fork lift usage has been created The counters weigh approximately 3000 lbs. and have threaded rods extended through the counter at the top comersmore » for lifting. When these counters were first handled/installed these rods were used in conjunction with appropriate slings and handled by crane. The rods are secured with nuts tightened against the face of the counter. The rod thread is M16 x 2({approx}.625-inch dia.) and extends 2-inch (on average) from the face of the counter. It is this cantilevered rod that the lift fixture engages with 'C' style plates at the four top comers. The strongback portion of the lift fixture is a steel rectangular tube 8-inch (vertical) x 4-inch x .25-inch wall, 130-inch long. 1.5-inch square bars are welded perpendicular to the long axis of the rectangular tube at the appropriate lift points and the 'C' plates are fastened to these bars with 3/4-10 high strength bolts -grade 8. Two short channel sections are positioned-welded-to the bottom of the rectangular tube on 40 feet centers, which are used as locators for fork lift tines. On the top are lifting eyes for sling/crane usage and are rated at 3500 lbs. safe working load each - vertical lift only.« less

Monitoring external and internal loads of brazilian soccer referees during official matches.

PubMed

Costa, Eduardo C; Vieira, Caio M A; Moreira, Alexandre; Ugrinowitsch, Carlos; Castagna, Carlo; Aoki, Marcelo S

2013-01-01

This study aimed to assess the external and internal loads of Brazilian soccer referees during official matches. A total of 11 field referees (aged 36.2 ± 7.5 years) were monitored during 35 matches. The external (distance covered, mean and maximal speed) and internal load parameters (session ratings of perceived exertion [RPE] training load [TL], Edwards' TL, and time spent in different heart rate [HR] zones) were assessed in 3-4 matches per referee. External load parameters were measured using a wrist Global Positioning System (GPS) receiver. No differences in distance covered (5.219 ± 205 vs. 5.230 ± 237 m) and maximal speed (19.3 ± 1.0 vs. 19.4 ± 1.4 km·h(-1)) were observed between the halves of the matches (p > 0.05). However, the mean speed was higher in the first half of the matches (6.6 ± 0.4 vs. 6.4 ± 0.3 km·h(-1)) (p < 0.05) than in the second half. The mean HR during the matches was ~89% of HRmax. In ~95% of the matches, the referees demonstrated a HR ≥ 80% of HRmax. Nonetheless, the time spent at 90-100% of HRmax was higher in the first half (59.9 vs. 52.3%) (p < 0.05). Significant correlations between session RPE TL and distance covered at 90-100% of HRmax (r = 0.62) and session RPE TL and maximal speed (r = 0.54) (p < 0.05) were noted. Furthermore, there was a positive correlation between session RPE TL and Edwards' TL (r = 0.61) (p < 0.05). Brazilian soccer referees demonstrated high external and internal load demands during official matches. The portable GPS/HR monitors and session RPE method can provide relevant information regarding the magnitude of the physiological strain during official matches. Key PointsHigh external and internal loads were imposed on Brazilian soccer referees during official matches.There was a high positive correlation between a subjective marker of internal load (session RPE) and parameters of external load (distance covered between 90-100% of HRmax and maximal speed).There was a high positive correlation between session RPE method and Edwards' method.Session RPE seems to be a reliable marker of internal load.The portable GPS/HR monitors and the session RPE method can provide relevant information regarding the magnitude of external and internal loads of soccer referees during official matches.

Development of Handling Qualities Criteria for Rotorcraft with Externally Slung Loads

NASA Technical Reports Server (NTRS)

Hoh, Roger H.; Heffley, Robert K.; Mitchell, David G.

2006-01-01

Piloted simulations were performed on the NASA-Ames Vertical Motion Simulator (VMS) to explore handling qualities issues for large cargo helicopters, particularly focusing on external slung load operations. The purpose of this work was based upon the need to include handling qualities criteria for cargo helicopters in an upgrade to the U.S. Army's rotorcraft handling qualities specification, Aeronautical Design Standard-33 (ADS-33E-PRF). From the VMS results, handling qualities criteria were developed fro cargo helicopters carrying external slung loads in the degraded visual environment (DVE). If satisfied, these criteria provide assurance that the handling quality rating (HQR) will be 4 or better for operations in the DVE, and with a load mass ratio of 0.33 or less. For lighter loads, flying qualities were found to be less dependent on the load geometry and therefore the significance of the criteria is less. For heavier loads, meeting the criteria ensures the best possible handling qualities, albeit Level 2 for load mass ratios greater than 0.33.

Upper limb load as a function of repetitive task parameters: part 1--a model of upper limb load.

PubMed

Roman-Liu, Danuta

2005-01-01

The aim of the study was to develop a theoretical indicator of upper limb musculoskeletal load based on repetitive task parameters. As such the dimensionless parameter, Integrated Cycle Load (ICL) was accepted. It expresses upper limb load which occurs during 1 cycle. The indicator is based on a model of a repetitive task, which consists of a model of the upper limb, a model of basic types of upper limb forces and a model of parameters of a repetitive task such as length of the cycle, length of periods of the cycle and external force exerted during each of the periods of the cycle. Calculations of the ICL parameter were performed for 12 different variants of external load characterised by different values of repetitive task parameters. A comparison of ICL, which expresses external load with a physiological indicator of upper limb load, is presented in Part 2 of the paper.

The use of 3d scanner for testing changes in shape of human limbs under the influence of external mechanical load

NASA Astrophysics Data System (ADS)

Kasperska, Kamila; Wieczorowski, Michał; Krolczyk, Jolanta B.

2017-10-01

Three-dimensional scanning is used in many fields: medicine, architecture, industry, reverse engineering. The aim of the article was to analyze the changes in the shape of the limbs under the influence of a mechanical external load using the method of three-dimensional scanner uses white light technology. The paper presents a system of human movement, passive part - skeleton and active part - the muscles, and principles of their interaction, which results in a change of the position of the body. Furthermore, by using the 3D scan, the differences in appearance of the arm and leg depending on the size of the external load in different positions have been presented. The paper shows that with increasing load, which muscles must prevent, increases the volume of certain parts of the legs, while another parts of them will be reduced. Results of the research using three-dimensional scanner allow determining what impact on changing the legs shape has an external mechanical load.

Comparison of single-incision mini-slings (Ajust) and standard transobturator midurethral slings (Align) in the management of female stress urinary incontinence: A 1-year follow-up.

PubMed

Chang, Chia-Pei; Chang, Wen-Hsun; Hsu, Yen-Mei; Chen, Yi-Jen; Wen, Kuo-Chang; Chao, Kuan-Chong; Yen, Ming-Shyen; Horng, Huann-Cheng; Wang, Peng-Hui

2015-12-01

To investigate the effectiveness and safety of a new single-incision mini-sling (SIMS)-Ajust-compared with the standard transobturator midurethral sling (SMUS)-Align-for the treatment of female stress urinary incontinence (SUI). A retrospective cohort study was conducted between January 1, 2010 and August 31, 2012. Women with SUI who underwent either SMUS-Align or SIMS-Ajust were recruited. The primary outcomes included operation time, estimated operative blood loss, postoperative pain, and complications. The secondary outcomes included subjective and objective success, defined as an International Consultation on Incontinence Questionnaire (ICIQ) score of 0 or improvement as felt by the patient and a long-term complication, such as dyspareunia and mesh erosion after 6 months and 12 months of follow-up. A total of 136 patients were enrolled, including 76 receiving SMUS-Align and 60 receiving SIMS-Ajust. Baseline characteristics of the patients in both groups were similar, without a statistically significant difference. Primary outcomes between both groups were similar, except that women treated with SIMS-Ajust had statistically significantly shorter operation time (p = 0.003), less intent to treat (p < 0.05), and earlier postoperative discharge (p = 0.001) than women treated with SMUS-Align. Secondary outcomes were similar without a significant difference between the two groups (93% vs. 88% success rate in each group). Our results showed that SIMS-Ajust was not inferior to SMUS-Align with respect to success rate, and might have a slight advantage in early discharge. A long-term follow-up or prospective study is needed to confirm the above findings. Copyright © 2015. Published by Elsevier B.V.

Management of recurrent post-prostatectomy incontinence after previous failed retrourethral male slings

PubMed Central

Al-Najar, Amr; Kaufmann, Sascha; Boy, Soenke; Naumann, Carsten Maik; Jünemann, Peter-Klaus; van der Horst, Christof

2011-01-01

Objective: Our objective was to establish the feasibility of combining 2 minimally invasive procedures in patients with failed primary treatment (male sling) in post-prostatectomy incontinence (PPI) patients. Methods: From January 2007 to July 2008, 40 men with PPI were implanted with a suburethral tape (2 patients with Seratim, 3 with I-Stop and 35 with Advance). The median preoperative pad count was 4 (range 2–10). Prior to sling placement, 6 patients had undergone ProACT implantation. Of these, 4 patients required explantation due to balloon migration and 2 patients had their balloons kept in situ, with the balloons deflated. Results: Twenty-five patients were socially continent at this time. Fifteen patients (37.5%) did not improve or their improvement was not significant. These patients had a preoperative pad count between 7 and 10. Two of these patients had prostate adjustable continence therapy (ProACT) systems still in place. By gradually filling the balloons to 3 mL, both of these patients achieved complete continence, which was maintained at a mean follow-up of 8.5 months. Three patients with prior pelvic irradiation received an artificial urinary sphincter and achieved continence at mean follow-up of 8.3 months. The remaining 10 patients received a ProACT system in addition to the already implanted sling. After appropriate healing and filling of the balloons (average balloon volume 5 mL), all 10 patients reached complete continence; they were pad-free at a mean follow-up of 6 months (range 3–9). Conclusions: The combination of ProACT and a suburethral tape was demonstrated to be a possible treatment option in recurrent or persistent PPI. PMID:21470536

Comparison of TVT and TOT on urethral mobility and surgical outcomes in stress urinary incontinence with hypermobile urethra.

PubMed

Cavkaytar, Sabri; Kokanalı, Mahmut Kuntay; Guzel, Ali Irfan; Ozer, Irfan; Aksakal, Orhan Seyfi; Doganay, Melike

2015-07-01

To compare the change of urethral mobility after midurethral sling procedures in stress urinary incontinence with hypermobile urethra and assess these findings with surgical outcomes. 141 women who agreed to undergo midurethral sling operations due to stress urinary incontinence with hypermobile urethra were enrolled in this non-randomized prospective observational study. Preoperatively, urethral mobility was measured by Q tip test. All women were asked to complete Urogenital Distress Inventory Short Form (UDI-6) and Incontinence Impact Questionnaire Short Form (IIQ-7) to assess the quality of life. Six months postoperatively, Q tip test and quality of life assessment were repeated. The primary surgical outcomes were classified as cure, improvement and failure. Transient urinary obstruction, de novo urgency, voiding dysfunction were secondary surgical outcomes. Of 141 women, 50 (35. 5%) women underwent TOT, 91 (64.5%) underwent TVT. In both TOT and TVT groups, postoperative Q tip test values, IIQ-7 and UDI-6 scores were statistically reduced when compared with preoperative values. Postoperative Q tip test value in TVT group was significantly smaller than in TOT group [25°(15-45°) and 20° (15-45°), respectively]. When we compared the Q-tip test value, IIQ-7 and UDI-6 scores changes, there were no statistically significant changes between the groups. Postoperative urethral mobility was more frequent in TOT group than in TVT group (40% vs 23.1%, respectively). Postoperative primary and secondary outcomes were similar in both groups. Although midurethral slings decrease the urethtal hypermobility, postoperative mobility status of urethra does not effect surgical outcomes of midurethral slings in women with preoperative urethral hypermobility. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

TVT-Secur mini-sling for stress urinary incontinence: a review of outcomes at 12 months.

PubMed

Walsh, Colin A

2011-09-01

• Synthetic mid-urethral slings (MUSs) are considered the first choice surgical procedure for stress urinary incontinence. Recent publications have raised concerns about the efficacy of third generation single-incision mini-slings. The present paper is a systematic review of studies reporting 12-month outcomes after the TVT-Secur (TVT-S) procedure. • Pubmed/Medline online databases, abstracts from recent International Continence Society and International Urogynecological Association annual scientific meetings and the Clinicaltrials.gov and Controlled-trials.com online trial registries were searched for English-language articles containing the terms 'TVT-Secur', 'TVT Secur' or 'mini-sling'. The primary outcomes were objective and subjective cure rates at 12 months. Secondary outcomes included peri-operative (vaginal perforation, urinary retention, urinary tract infection [UTI]) and postoperative (mesh exposure, de novo overactive bladder (OAB), dyspareunia and return to theatre) complication rates. • Among 1178 women undergoing the TVT-S procedure, from 10 studies, both objective and subjective cure rate at 12 months was 76%, with objective cure significantly higher in women undergoing the 'U-type' approach. Vaginal perforation was a complication in 1.5% of cases, with a 2.4% incidence of mesh exposure in the first year. The incidence of de novo OAB symptoms was 10%. Rates of urinary retention (2.3%), UTI (4.4%), dyspareunia (1%) and return to theatre for complications (0.8%) were low. In the first year after a TVT-S procedure 5% of women required repeat continence surgery. • Longer-term studies and randomized comparisons with more established MUSs are required before TVT-S should be routinely used in the surgical treatment of stress urinary incontinence. © 2011 THE AUTHOR. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

The IUGA/ICS classification of synthetic mesh complications in female pelvic floor reconstructive surgery: a multicenter study.

PubMed

Miklos, John R; Chinthakanan, Orawee; Moore, Robert D; Mitchell, Gretchen K; Favors, Sheena; Karp, Deborah R; Northington, Gina M; Nogueiras, Gladys M; Davila, G Willy

2016-06-01

The objective was to report patterns of sling and transvaginal mesh-related complications using the IUGA/ICS classification of prosthesis-related complications. This was a retrospective chart review of all patients who underwent surgical removal of sling, transvaginal mesh, and sacrocolpopexy for mesh-related complications from 2011 to 2013 at three tertiary referral centers. The International Urogynecological Association (IUGA)/International Continence Society (ICS) classification system was utilized. We identified 445 patients with mesh complications, 506 pieces of synthetic mesh were removed, and 587 prostheses-related complications were classified. 3.7 % of patients had viscus organ penetration or vaginal exposure as their presenting chief complaint and 59.7 % were classified as not having any vaginal epithelial separation or category 1. The most common category was spontaneous pain (1Be: 32.5 %) followed by dyspareunia (1Bc: 14.7 %). The sling group was 20 % more likely to have pain compared with the pelvic organ prolapse (POP) mesh group (OR 1.2, 95 % CI 0.8-1.6). The most commonly affected site (S2) was away from the suture line (49 %). Compared with the sling group, the POP group had a higher rate of mesh exposure, which mostly occurred at the suture line area. The majority of patients presented with mesh-related complications more than 1 year post-insertion (T4; average 3.68 ± 2.47 years). Surgeons should be aware that patients with vaginal mesh complications routinely exhibit complications more than 1 year after the implantation with pain as the most common presenting symptom.

Refined nomogram incorporating standing cough test improves prediction of male transobturator sling success.

PubMed

Shakir, Nabeel A; Fuchs, Joceline S; McKibben, Maxim J; Viers, Boyd R; Pagliara, Travis J; Scott, Jeremy M; Morey, Allen F

2018-05-01

To develop a decision aid in predicting sling success, incorporating the Male Stress Incontinence Grading Scale (MSIGS) into existing treatment algorithms. We reviewed men undergoing first-time transobturator sling for stress urinary incontinence (SUI) from 2007 to 2016 at our institution. Patient demographics, reported pads per day (PPD), and Standing Cough Test (SCT) results graded 0-4, according to MSIGS, were assessed. Treatment failure was defined as subsequent need for >1 PPD or further procedures. Parameters associated with failure were included in multivariable logistic models, compared by area under the receiver-operating characteristic curves. A nomogram was generated from the model with greatest AUC and internally validated. Overall 203 men (median age 67 years, IQR 63-72) were evaluated with median follow-up of 45 months (IQR 11-75 months). A total of 185 men (91%) were status-post radical prostatectomy and 29 (14%) had pelvic radiation history. Median PPD and SCT grade were both two. Eighty men (39%) failed treatment (use of ≥1 PPD or subsequent anti-incontinence procedures) at a median of 9 months. History of radiation (P = 0.03), increasing MSIGS (P < 0.0001) and increasing preoperative PPD (P < 0.0001) were associated with failure on univariate analysis. In a multivariable model with AUC 0.81, MSIGS, and PPD remained associated (P = 0.002 and <0.0001 respectively, and radiation history P = 0.06), and was superior to models incorporating PPD and radiation alone (AUC 0.77, P = 0.02), PPD alone (AUC 0.76, P = 0.02), and a cutpoint of >2 PPD alone (AUC 0.71, P = 0.0001). MSIGS adds prognostic value to PPD in assessing success of transobturator sling for treatment of SUI. © 2018 Wiley Periodicals, Inc.

Virtue male sling for post-prostatectomy stress incontinence: a prospective evaluation and mid-term outcomes.

PubMed

Ferro, Matteo; Bottero, Danilo; D'Elia, Carolina; Matei, Deliu Victor; Cioffi, Antonio; Cozzi, Gabriele; Serino, Alessandro; Cordima, Giovanni; Bianchi, Roberto; Incarbone, Piero Giacomo; Brescia, Antonio; Musi, Gennaro; Fusco, Ferdinando; Detti, Serena; Mirone, Vincenzo; de Cobelli, Ottavio

2017-03-01

To evaluate the efficacy and safety of the Virtue ® male sling (Coloplast, Humlebaek, Denmark) in a cohort of patients affected by post-prostatectomy stress urinary incontinence (SUI). All 29 consecutive patients treated with a Virtue male sling at our Institution between July 2012 and October 2013 were included in the present prospective, non-randomized study. Patients were evaluated preoperatively and at 1, 3, 6, 12, 24 and 36 months after surgery using a 24-h pad weight test, the International Consultation on Incontinence short-form questionnaire (ICIQ-SF), Urinary Symptom Profile (USP) questionnaire, a bladder diary, uroflowmetry and the Patient Global Impression of Improvement (PGI-I) and Patient Global Impression of Severity questionnaires. The mean patient age was 65.5 years. A total of 72.4% of patients had preoperative mild incontinence (1-2 pads/day), while nine patients used 3-5 pads/day. There were a total of 17 complications, which occurred in 29 patients (58.6%); all were Clavien-Dindo grade I. At 12-month follow-up patients showed a significant improvement in 24-h pad test (128.6 vs 2.5 g), number of pads per day (2 vs 0), ICIQ-SF score (14.3 vs 0.9) and USP score for SUI (4 vs 0), and outcomes remained stable at 36 months. At last follow-up, the median score on the PGI-I questionnaire was 1 (very much better). The Virtue male sling is an effective treatment option for low to moderate post-prostatectomy incontinence. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

Long-term durability of the distal urethral polypropylene sling for the treatment of stress urinary incontinence: minimum 11-year followup.

PubMed

Rogo-Gupta, Lisa; Baxter, Z Chad; Le, Ngoc-Bich; Raz, Shlomo; Rodríguez, Larissa V

2012-11-01

We report on the long-term outcomes of the distal urethral polypropylene sling for stress urinary incontinence in a patient cohort that was closely followed and whose outcomes were reported at 1 and 5 years after surgery. We performed a prospective study of all consecutive patients who underwent a distal urethral polypropylene sling procedure between November 1999 and April 2000. The 1 and 5-year outcomes for this particular patient cohort were previously reported. At the minimum 11-year followup, outcome was determined by patient self-assessment including validated questionnaires. A total of 69 patients were followed prospectively and followup was obtained for 30. Of those lost to followup 10 were deceased and 5 were cognitively impaired. Mean patient age at followup was 73 years (range 40 to 97). More than 11 years after surgery 48% of patients reported no stress urinary incontinence symptoms and 63% were never bothered by stress urinary incontinence. Patients reported a mean overall symptom improvement of 64% compared to 81% at 5 years. Overall 82% of patients met the criteria for treatment success by symptom scores and 80% met the criteria by bother scores. The distal urethral polypropylene sling procedure has excellent long-term durability in the treatment of stress urinary incontinence, in addition to low morbidity and low cost as previously described. Eleven years after the procedure the majority of patients report symptom improvement. Nevertheless, many older patients are unable to participate in followup. When choosing an anti-incontinence procedure, durability should be considered in light of patient age given that the theoretical advantages of long-term durability are limited by cognitive decline and mortality. Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Adjustable suburethral sling (male remeex system) in the treatment of male stress urinary incontinence: a multicentric European study.

PubMed

Sousa-Escandón, Alejandro; Cabrera, Javier; Mantovani, Franco; Moretti, Marco; Ioanidis, Evangelos; Kondelidis, Nikolaos; Neymeyer, Joerg; Noguera, Rui

2007-11-01

To evaluate the effectiveness of a readjustable sling for the treatment of male stress urinary incontinence (SUI). Between October 2002 and August 2005, 51 male patients with mild to severe SUI were prospectively operated with the use of a readjustable sling (MRS) at seven different European hospitals: Spain (2), Italy (2), Greece (1), Germany (1), and Portugal (1). The origin of incontinence was radical prostatectomy in 43 cases, TUR in 4, and open prostatectomy in another 4. Duration of incontinence ranged from 1 to 10 yr with an average of 3.5 yr. All patients but 5 were regulated during the early postoperative period; 44 patients (including all 5 not regulated during the early period) required a second regulation under local anaesthesia between 1 to 4 mo after surgery, and 17 other patients required more than one delayed regulation. After that, 33 patients (64.7%) were considered cured (25 of them wore no pads at all, and 8 used small pads or sanitary napkins for security but normally remained dry); another 10 cases showed important improvement (19.6%); and only 8 patients remain unchanged (15.7%). The average follow-up time was 32 mo (range: 16-50). The mesh was removed in 1 case owing to urethral erosion and the varitensor in 2 cases owing to infection. There were five (9.8%) uneventful intraoperative bladder perforations at the postoperative period, and there were three mild perineal haematomas (5.9%). Most patients felt perineal discomfort or pain, which was easily treated with oral medications. The MRS((R)) allowed postoperative readjustment of the suburethral sling pressure at the immediate or midterm postoperative period, which allowed the achievement of good midterm results in almost 85% of patients without significant postoperative complications.

The impact of cognitive control, incentives, and working memory load on the P3 responses of externalizing prisoners.

PubMed

Baskin-Sommers, Arielle R; Krusemark, Elizabeth A; Curtin, John J; Lee, Christopher; Vujnovich, Aleice; Newman, Joseph P

2014-02-01

The P3 amplitude reduction is one of the most common correlates of externalizing. However, few studies have used experimental manipulations designed to challenge different cognitive functions in order to clarify the processes that impact this reduction. To examine factors moderating P3 amplitude in trait externalizing, we administered an n-back task that manipulated cognitive control demands, working memory load, and incentives to a sample of male offenders. Offenders with high trait externalizing scores did not display a global reduction in P3 amplitude. Rather, the negative association between trait externalizing and P3 amplitude was specific to trials involving inhibition of a dominant response during infrequent stimuli, in the context of low working memory load, and incentives for performance. In addition, we discuss the potential implications of these findings for externalizing-related psychopathologies. The results complement and expand previous work on the process-level dysfunction contributing to externalizing-related deficits in P3. Copyright © 2013 Elsevier B.V. All rights reserved.

Influences of load characteristics on impaired control of grip forces in patients with cerebellar damage.

PubMed

Brandauer, B; Timmann, D; Häusler, A; Hermsdörfer, J

2010-02-01

Various studies showed a clear impairment of cerebellar patients to modulate grip force in anticipation of the loads resulting from movements with a grasped object. This failure corroborated the theory of internal feedforward models in the cerebellum. Cerebellar damage also impairs the coordination of multiple-joint movements and this has been related to deficient prediction and compensation of movement-induced torques. To study the effects of disturbed torque control on feedforward grip-force control, two self-generated load conditions with different demands on torque control-one with movement-induced and the other with isometrically generated load changes-were directly compared in patients with cerebellar degeneration. Furthermore the cerebellum is thought to be more involved in grip-force adjustment to self-generated loads than to externally generated loads. Consequently, an additional condition with externally generated loads was introduced to further test this hypothesis. Analysis of 23 patients with degenerative cerebellar damage revealed clear impairments in predictive feedforward mechanisms in the control of both self-generated load types. Besides feedforward control, the cerebellar damage also affected more reactive responses when the externally generated load destabilized the grip, although this impairment may vary with the type of load as suggested by control experiments. The present findings provide further support that the cerebellum plays a major role in predictive control mechanisms. However, this impact of the cerebellum does not strongly depend on the nature of the load and the specific internal forward model. Contributions to reactive (grip force) control are not negligible, but seem to be dependent on the physical characteristics of an externally generated load.

Load-dependent assembly of the bacterial flagellar motor.

PubMed

Tipping, Murray J; Delalez, Nicolas J; Lim, Ren; Berry, Richard M; Armitage, Judith P

2013-08-20

It is becoming clear that the bacterial flagellar motor output is important not only for bacterial locomotion but also for mediating the transition from liquid to surface living. The output of the flagellar motor changes with the mechanical load placed on it by the external environment: at a higher load, the motor runs more slowly and produces higher torque. Here we show that the number of torque-generating units bound to the flagellar motor also depends on the external mechanical load, with fewer stators at lower loads. Stalled motors contained at least as many stators as rotating motors at high load, indicating that rotation is unnecessary for stator binding. Mutant stators incapable of generating torque could not be detected around the motor. We speculate that a component of the bacterial flagellar motor senses external load and mediates the strength of stator binding to the rest of the motor. The transition between liquid living and surface living is important in the life cycles of many bacteria. In this paper, we describe how the flagellar motor, used by bacteria for locomotion through liquid media and across solid surfaces, is capable of adjusting the number of bound stator units to better suit the external load conditions. By stalling motors using external magnetic fields, we also show that rotation is not required for maintenance of stators around the motor; instead, torque production is the essential factor for motor stability. These new results, in addition to previous data, lead us to hypothesize that the motor stators function as mechanosensors as well as functioning as torque-generating units.

Fifteen-year study of environmental dredging effect on variation of nitrogen and phosphorus exchange across the sediment-water interface of an urban lake.

PubMed

Liu, Cheng; Zhong, Jicheng; Wang, Jianjun; Zhang, Lu; Fan, Chengxin

2016-12-01

Environmental dredging has been applied widely in Chinese lakes to reduce their internal nutrient loads. However, the efficacy of dredging to reduce internal loading of nitrogen (N) and phosphorus (P) and to improve water quality has been questioned by some researchers. In this study, the long-term (∼15 years) effects of dredging to reduce internal N and P loading in a closed, polluted urban lake were investigated. The results showed that the release of soluble reactive phosphorus (SRP) could be suppressed quickly after dredging, and that the dredging effect was sustained for about 18 months. A significant release of NH 4 + -N was discovered during the first 2-8 months after dredging, followed by maintenance of low-level release rates for about 21-32 months. The continuous inflowing of external pollution loading led to the increase in the release rates of SRP and NH 4 + -N. The external pollution loading was therefore reduced three years after dredging to strengthen the remediation effect. After that, high diffusive flux from the sediment was observed for both NH 4 + -N and SRP during summer seasons for about six years, followed by a decreasing trend. The NH 4 + -N concentration in the overlying water was reduced after the reduction of external loading, while a high concentration of SRP in the overlying water was still observed during summer seasons. In conclusion, the mid-term (<3 years) reduction of internal N and P loading could be achieved by dredging if the external pollution loading were not reduced. Achieving long-term control would require modification of external loading. Copyright © 2016 Elsevier Ltd. All rights reserved.

14 CFR 23.301 - Loads.

Code of Federal Regulations, 2010 CFR

2010-01-01

... load would significantly change the distribution of external or internal loads, this redistribution...) and ultimate loads (limit loads multiplied by prescribed factors of safety). Unless otherwise provided...

A generalized force-modified potential energy surface (G-FMPES) for mechanochemical simulations

DOE PAGES

Subramanian, Gopinath; Mathew, Nithin; Leiding, Jeffery A.

2015-10-05

We describe the modifications that a spatially varying external load produces on a Born-Oppenheimer potential energy surface (PES) by calculating static quantities of interest. The effects of the external loads are exemplified using electronic structure calculations (at the HF/6-31G** level) of two different molecules: ethane and hexahydro-1,3,5-trinitro-s-triazine (RDX). The calculated transition states and The Hessian matrices of stationary points show that spatially varying external loads shift the stationary points and modify the curvature of the PES, thereby affecting the harmonic transition rates by altering both the energy barrier as well as the prefactor. The harmonic spectra of both molecules aremore » blue-shifted with increasing compressive “pressure.” Some stationary points on the RDX-PES disappear under application of the external load, indicating the merging of an energy minimum with a saddle point.« less

Perinatal/Neonatal case presentation: pulmonary artery sling associated with respiratory distress.

PubMed

Healey, David; Ron, Nitin; Hromada, Andrew; Chhabra, Manoj

2016-01-01

Pulmonary artery sling is a very rare cause of pediatric respiratory distress. The estimated prevalence of the disease was first determined by Yu et al. in 2008 as 59 per million school-aged children. Associated symptoms are cough, wheezing, and feeding difficulty, all of which are common in routine outpatient pediatric clinical encounters. We report a case of a premature male neonate twin who was admitted to the neonatal intensive care unit with respiratory distress and pneumothorax. His presentation, as well as the etiology of his pulmonary disease, was felt to be consistent with those of numerous other premature infants. Akin to this was his delayed discharge on account of his slow progress with oral feeding. Parents gave a history of tachypnea and feeding difficulty to his doctors. He presented twice to the emergency room in respiratory distress. At 4 months of age, while in hospital for a pulmonary infection, he had an echocardiogram that revealed a pulmonary artery sling. We review the literature on this vascular anomaly, discuss its diagnosis and management, and critique the clinical thinking that determined this child's course from the perspective of availability heuristics.

Stress urinary incontinence in women: Current and emerging therapeutic options

PubMed Central

Shamout, Samer; Campeau, Lysanne

2017-01-01

Surgical management of stress urinary incontinence (SUI) is most commonly achieved by midurethral synthetic sling (MUS) insertion as a first-line surgical option. A great deal of research continues to evolve new management strategies to reach an optimal balance of high efficacy and minimal adverse events. This expert opinion review provides a brief and comprehensive discussion of recent advances and ongoing research in the management of SUI, with an emphasis on single-incision mini-slings, vaginal laser treatment, and cell-based therapy. It is based on data obtained from numerous published meta-analyses and original studies identified through literature search. Single-incision mini-slings appear equally effective initially compared with standard MUS (retropubic or transobturator) for the treatment of female SUI; however, this efficacy lacks durability evidence beyond one-year followup. There is a lack of sufficient clinical evidence to currently confirm long-term safety and effectiveness of cell-therapy and non-ablative vaginal laser therapy, besides suggestion of apparent initial safety. There are still significant challenges to overcome before widespread clinical practice of the latter two modalities. Future research should be aimed at identifying groups of patients who might benefit from these minimally invasive therapeutic options. PMID:28616118

A Case of Multiple Cardiovascular and Tracheal Anomalies Presented with Wolff-Parkinson-White Syndrome in a Middle-aged Adult.

PubMed

Shi, Hyejin; Sohn, Sungmin; Wang, SungHo; Park, Sungrock; Lee, SangKi; Kim, Song Yi; Jeong, Sun Young; Kim, Changhwan

2017-12-01

Congenital cardiovascular anomalies, such as dextrocardia, persistent left superior vena cava (SVC), and pulmonary artery (PA) sling, are rare disorders. These congenital anomalies can occur alone, or coincide with other congenital malformations. In the majority of cases, congenital anomalies are detected early in life by certain signs and symptoms. A 56-year-old man with no previous medical history was admitted due to recurrent wide QRS complex tachycardia with hemodynamic collapse. A chest radiograph showed dextrocardia. After synchronized cardioversion, an electrocardiogram revealed Wolff-Parkinson-White (WPW) syndrome. Persistent left SVC, PA sling, and right tracheal bronchus were also detected by a chest computed tomography (CT) scan. He was diagnosed with paroxysmal supraventricular tachycardia (PSVT) associated with WPW syndrome, and underwent radiofrequency ablation. We reported the first case of situs solitus dextrocardia coexisting with persistent left SVC, PA sling and right tracheal bronchus presented with WPW and PSVT in a middle-aged adult. In patients with a cardiovascular anomaly, clinicians should consider thorough evaluation of possibly combined cardiovascular and airway malformations and cardiac dysrhythmia. © 2017 The Korean Academy of Medical Sciences.

Effects of cross-education on the muscle after a period of unilateral limb immobilization using a shoulder sling and swathe.

PubMed

Magnus, Charlene R A; Barss, Trevor S; Lanovaz, Joel L; Farthing, Jonathan P

2010-12-01

The purpose of this study was to apply cross-education during 4 wk of unilateral limb immobilization using a shoulder sling and swathe to investigate the effects on muscle strength, muscle size, and muscle activation. Twenty-five right-handed participants were assigned to one of three groups as follows: the Immob + Train group wore a sling and swathe and strength trained (n = 8), the Immob group wore a sling and swathe and did not strength train (n = 8), and the Control group received no treatment (n = 9). Immobilization was applied to the nondominant (left) arm. Strength training consisted of maximal isometric elbow flexion and extension of the dominant (right) arm 3 days/wk. Torque (dynamometer), muscle thickness (ultrasound), maximal voluntary activation (interpolated twitch), and electromyography (EMG) were measured. The change in right biceps and triceps brachii muscle thickness [7.0 ± 1.9 and 7.1 ± 2.2% (SE), respectively] was greater for Immob + Train than Immob (0.4 ± 1.2 and -1.9 ± 1.7%) and Control (0.8 ± 0.5 and 0.0 ± 1.1%, P < 0.05). Left biceps and triceps brachii muscle thickness for Immob + Train (2.2 ± 0.7 and 3.4 ± 2.1%, respectively) was significantly different from Immob (-2.8 ± 1.1 and -5.2 ± 2.7%, respectively, P < 0.05). Right elbow flexion strength for Immob + Train (18.9 ± 5.5%) was significantly different from Immob (-1.6 ± 4.0%, P < 0.05). Right and left elbow extension strength for Immob + Train (68.1 ± 25.9 and 32.2 ± 9.0%, respectively) was significantly different from the respective limb of Immob (1.3 ± 7.7 and -6.1 ± 7.8%) and Control (4.7 ± 4.7 and -0.2 ± 4.5%, P < 0.05). Immobilization in a sling and swathe decreased strength and muscle size but had no effect on maximal voluntary activation or EMG. The cross-education effect on the immobilized limb was greater after elbow extension training. This study suggests that strength training the nonimmobilized limb benefits the immobilized limb for muscle size and strength.

Internal ecosystem feedbacks enhance nitrogen-fixing cyanobacteria blooms and complicate management in the Baltic Sea.

PubMed

Vahtera, Emil; Conley, Daniel J; Gustafsson, Bo G; Kuosa, Harri; Pitkänen, Heikki; Savchuk, Oleg P; Tamminen, Timo; Viitasalo, Markku; Voss, Maren; Wasmund, Norbert; Wulff, Fredrik

2007-04-01

Eutrophication of the Baltic Sea has potentially increased the frequency and magnitude of cyanobacteria blooms. Eutrophication leads to increased sedimentation of organic material, increasing the extent of anoxic bottoms and subsequently increasing the internal phosphorus loading. In addition, the hypoxic water volume displays a negative relationship with the total dissolved inorganic nitrogen pool, suggesting greater overall nitrogen removal with increased hypoxia. Enhanced internal loading of phosphorus and the removal of dissolved inorganic nitrogen leads to lower nitrogen to phosphorus ratios, which are one of the main factors promoting nitrogenfixing cyanobacteria blooms. Because cyanobacteria blooms in the open waters of the Baltic Sea seem to be strongly regulated by internal processes, the effects of external nutrient reductions are scale-dependent. During longer time scales, reductions in external phosphorus load may reduce cyanobacteria blooms; however, on shorter time scales the internal phosphorus loading can counteract external phosphorus reductions. The coupled processes inducing internal loading, nitrogen removal, and the prevalence of nitrogen-fixing cyanobacteria can qualitatively be described as a potentially self-sustaining "vicious circle." To effectively reduce cyanobacteria blooms and overall signs of eutrophication, reductions in both nitrogen and phosphorus external loads appear essential.

Biomechanical evaluation of an innovative spring-loaded axillary crutch design.

PubMed

Zhang, Yanxin; Liu, Guangyu; Xie, Shengquan; Liger, Aurélien

2011-01-01

We evaluated an innovative spring-loaded crutch design by comparing its performance with standard crutches through a biomechanical approach. Gait analysis was conducted for 7 male subjects under two conditions: walking with standard crutches and with spring-loaded crutches. Three-dimensional kinematic data and ground reaction force were recorded. Spatiotemporal variables, external mechanical work, and elastic energy (for spring crutches) were calculated based on recorded data. The trajectories of vertical ground reaction forces with standard crutches had two main peaks before and after mid-stance, and those with optimized spring-loaded crutches had only one main peak. The magnitude of external mechanical work was significantly higher with spring-loaded crutches than with standard crutches for all subjects, and the transferred elastic energy made an important contribution to the total external work for spring-loaded crutches. No significant differences in the spatiotemporal parameters were observed. Optimized spring-loaded crutches can efficiently propel crutch walkers and could reduce the total energy expenditure in crutch walking. Further research using optimized spring-loaded crutches with respect to energy efficiency is recommended.

Effects of External Loads on Human Head Movement Control Systems

NASA Technical Reports Server (NTRS)

Nam, M. H.; Choi, O. M.

1984-01-01

The central and reflexive control strategies underlying movements were elucidated by studying the effects of external loads on human head movement control systems. Some experimental results are presented on dynamic changes weigh the addition of aviation helmet (SPH4) and lead weights (6 kg). Intended time-optimal movements, their dynamics and electromyographic activity of neck muscles in normal movements, and also in movements made with external weights applied to the head were measured. It was observed that, when the external loads were added, the subject went through complex adapting processes and the head movement trajectory and its derivatives reached steady conditions only after transient adapting period. The steady adapted state was reached after 15 to 20 seconds (i.e., 5 to 6 movements).

In vitro modeling of human tibial strains during exercise in micro-gravity

NASA Technical Reports Server (NTRS)

Peterman, M. M.; Hamel, A. J.; Cavanagh, P. R.; Piazza, S. J.; Sharkey, N. A.

2001-01-01

Prolonged exposure to micro-gravity causes substantial bone loss (Leblanc et al., Journal of Bone Mineral Research 11 (1996) S323) and treadmill exercise under gravity replacement loads (GRLs) has been advocated as a countermeasure. To date, the magnitudes of GRLs employed for locomotion in space have been substantially less than the loads imposed in the earthbound 1G environment, which may account for the poor performance of locomotion as an intervention. The success of future treadmill interventions will likely require GRLs of greater magnitude. It is widely held that mechanical tissue strain is an important intermediary signal in the transduction pathway linking the external loading environment to bone maintenance and functional adaptation; yet, to our knowledge, no data exist linking alterations in external skeletal loading to alterations in bone strain. In this preliminary study, we used unique cadaver simulations of micro-gravity locomotion to determine relationships between localized tibial bone strains and external loading as a means to better predict the efficacy of future exercise interventions proposed for bone maintenance on orbit. Bone strain magnitudes in the distal tibia were found to be linearly related to ground reaction force magnitude (R(2)>0.7). Strain distributions indicated that the primary mode of tibial loading was in bending, with little variation in the neutral axis over the stance phase of gait. The greatest strains, as well as the greatest strain sensitivity to altered external loading, occurred within the anterior crest and posterior aspect of the tibia, the sites furthest removed from the neutral axis of bending. We established a technique for estimating local strain magnitudes from external loads, and equations for predicting strain during simulated micro-gravity walking are presented.

Euler Strut: A Mechanical Analogy for Dynamics in the Vicinity of a Critical Point

ERIC Educational Resources Information Center

Bobnar, Jaka; Susman, Katarina; Parsegian, V. Adrian; Rand, Peter R.; Cepic, Mojca; Podgornik, Rudolf

2011-01-01

An anchored elastic filament (Euler strut) under an external point load applied to its free end is a simple model for a second-order phase transition. In the static case, a load greater than the critical load causes a Euler buckling instability, leading to a change in the filament's shape. The analysis of filament dynamics with an external point…

The Relationships Between Internal and External Measures of Training Load and Intensity in Team Sports: A Meta-Analysis.

PubMed

McLaren, Shaun J; Macpherson, Tom W; Coutts, Aaron J; Hurst, Christopher; Spears, Iain R; Weston, Matthew

2018-03-01

The associations between internal and external measures of training load and intensity are important in understanding the training process and the validity of specific internal measures. We aimed to provide meta-analytic estimates of the relationships, as determined by a correlation coefficient, between internal and external measures of load and intensity during team-sport training and competition. A further aim was to examine the moderating effects of training mode on these relationships. We searched six electronic databases (Scopus, Web of Science, PubMed, MEDLINE, SPORTDiscus, CINAHL) for original research articles published up to September 2017. A Boolean search phrase was created to include search terms relevant to team-sport athletes (population; 37 keywords), internal load (dependent variable; 35 keywords), and external load (independent variable; 81 keywords). Articles were considered for meta-analysis when a correlation coefficient describing the association between at least one internal and one external measure of session load or intensity, measured in the time or frequency domain, was obtained from team-sport athletes during normal training or match-play (i.e., unstructured observational study). The final data sample included 122 estimates from 13 independent studies describing 15 unique relationships between three internal and nine external measures of load and intensity. This sample included 295 athletes and 10,418 individual session observations. Internal measures were session ratings of perceived exertion (sRPE), sRPE training load (sRPE-TL), and heart-rate-derived training impulse (TRIMP). External measures were total distance (TD), the distance covered at high and very high speeds (HSRD ≥ 13.1-15.0 km h -1 and VHSRD ≥ 16.9-19.8 km h -1 , respectively), accelerometer load (AL), and the number of sustained impacts (Impacts > 2-5 G). Distinct training modes were identified as either mixed (reference condition), skills, metabolic, or neuromuscular. Separate random effects meta-analyses were conducted for each dataset (n = 15) to determine the pooled relationships between internal and external measures of load and intensity. The moderating effects of training mode were examined using random-effects meta-regression for datasets with at least ten estimates (n = 4). Magnitude-based inferences were used to interpret analyses outcomes. During all training modes combined, the external load relationships for sRPE-TL were possibly very large with TD [r = 0.79; 90% confidence interval (CI) 0.74 to 0.83], possibly large with AL (r = 0.63; 90% CI 0.54 to 0.70) and Impacts (r = 0.57; 90% CI 0.47 to 0.64), and likely moderate with HSRD (r = 0.47; 90% CI 0.32 to 0.59). The relationship between TRIMP and AL was possibly large (r = 0.54; 90% CI 0.40 to 0.66). All other relationships were unclear or not possible to infer (r range 0.17-0.74, n = 10 datasets). Between-estimate heterogeneity [standard deviations (SDs) representing unexplained variation; τ] in the pooled internal-external relationships were trivial to extremely large for sRPE (τ range = 0.00-0.47), small to large for sRPE-TL (τ range = 0.07-0.31), and trivial to moderate for TRIMP (τ range= 0.00-0.17). The internal-external load relationships during mixed training were possibly very large for sRPE-TL with TD (r = 0.82; 90% CI 0.75 to 0.87) and AL (r = 0.81; 90% CI 0.74 to 0.86), and TRIMP with AL (r = 0.72; 90% CI 0.55 to 0.84), and possibly large for sRPE-TL with HSRD (r = 0.65; 90% CI 0.44 to 0.80). A reduction in these correlation magnitudes was evident for all other training modes (range of the change in r when compared with mixed training - 0.08 to - 0.58), with these differences being unclear to possibly large. Training mode explained 24-100% of the between-estimate variance in the internal-external load relationships. Measures of internal load derived from perceived exertion and heart rate show consistently positive associations with running- and accelerometer-derived external loads and intensity during team-sport training and competition, but the magnitude and uncertainty of these relationships are measure and training mode dependent.

KSC-2011-2054

NASA Image and Video Library

2011-03-01

CAPE CANAVERAL, Fla. -- This is a 3-D image of space shuttle Endeavour as it is outfitted with a metal sling that will lift the spacecraft from the transfer aisle into a high bay of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida. In the bay, the shuttle will be attached to its external fuel tank and solid rocket boosters. Endeavour is targeted to roll out to Kennedy's Launch Pad 39A for its final mission, STS-134, on March 9. To view this image, use green and magenta 3-D glasses. Endeavour and six-member crew will deliver the Express Logistics Carrier-3, Alpha Magnetic Spectrometer-2 (AMS), a high-pressure gas tank, additional spare parts for the Dextre robotic helper and micrometeoroid debris shields to the International Space Station. Endeavour's final launch is targeted for April 19 at 7:48 p.m. EDT. For more information visit, http://www.nasa.gov/mission_pages/shuttle/shuttlemissions/sts134/index.html. Photo credit: NASA/Frankie Martin

KSC-2011-2056

NASA Image and Video Library

2011-03-01

CAPE CANAVERAL, Fla. -- This is a 3-D image of space shuttle Endeavour as it is outfitted with a metal sling that will lift the spacecraft from the transfer aisle into a high bay of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida. In the bay, the shuttle will be attached to its external fuel tank and solid rocket boosters. Endeavour is targeted to roll out to Kennedy's Launch Pad 39A for its final mission, STS-134, on March 9. To view this image, use green and magenta 3-D glasses. Endeavour and six-member crew will deliver the Express Logistics Carrier-3, Alpha Magnetic Spectrometer-2 (AMS), a high-pressure gas tank, additional spare parts for the Dextre robotic helper and micrometeoroid debris shields to the International Space Station. Endeavour's final launch is targeted for April 19 at 7:48 p.m. EDT. For more information visit, http://www.nasa.gov/mission_pages/shuttle/shuttlemissions/sts134/index.html. Photo credit: NASA/Frankie Martin

KSC-2011-2055

NASA Image and Video Library

2011-03-01

CAPE CANAVERAL, Fla. -- This is a 3-D image of space shuttle Endeavour as it is outfitted with a metal sling that will lift the spacecraft from the transfer aisle into a high bay of the Vehicle Assembly Building at NASA's Kennedy Space Center in Florida. In the bay, the shuttle will be attached to its external fuel tank and solid rocket boosters. Endeavour is targeted to roll out to Kennedy's Launch Pad 39A for its final mission, STS-134, on March 9. To view this image, use green and magenta 3-D glasses. Endeavour and six-member crew will deliver the Express Logistics Carrier-3, Alpha Magnetic Spectrometer-2 (AMS), a high-pressure gas tank, additional spare parts for the Dextre robotic helper and micrometeoroid debris shields to the International Space Station. Endeavour's final launch is targeted for April 19 at 7:48 p.m. EDT. For more information visit, http://www.nasa.gov/mission_pages/shuttle/shuttlemissions/sts134/index.html. Photo credit: NASA/Frankie Martin

Near-resonant excitation and propagation of eccentric density waves by external forcing. [in accretion disks

NASA Technical Reports Server (NTRS)

Ostriker, Eve C.; Shu, Frank H.; Adams, Fred C.

1992-01-01

An overview is presented of the astronomical evidence that relatively massive, distended, gaseous disks form as a natural by-product of the process of star formation, and also the numerical evidence that SLING-amplified eccentric modes in the outer parts of such disks can drive one-armed spiral density waves in the inner parts by near-resonant excitation and propagation. An ordinary differential equation (ODE) of the second order that approximately governs the nonlocalized forcing of waves in a disk satisfying Lindblad resonance almost everywhere is derived. When transformed and appended with an extra model term, this ODE implies, for free waves, the usual asymptotic results of the WKBJ dispersion relationship and the propagation Goldreich-Tremaine (1978) formula for the resonant torque exerted on a localized Lindblad resonance. An analytical solution is given for the rate of energy and angular momentum transfer by nonlocalized near-resonant forcing in the case when the disk has power-law dependences on the radius of the surface density and temperature.

External nutrient loading from land, sea and atmosphere to all 656 Swedish coastal water bodies.

PubMed

Bryhn, Andreas C; Dimberg, Peter H; Bergström, Lena; Fredriksson, Ronny E; Mattila, Johanna; Bergström, Ulf

2017-01-30

Identifying the main sources of nutrient loading is a key factor for efficient mitigation of eutrophication. This study has investigated the pathways of external nutrient loading to 656 coastal water bodies along the entire Swedish coastline. The studied water bodies have been delineated to meet requirements in the European Union's Water Framework Directive, and recent status assessments have shown that 57% of them fail to attain good or high ecological status with respect to nutrients. The analysis in the study was performed on data from mass-balance based nutrient budgets computed using the modelling framework Vattenwebb. The external nutrient contribution from the sea to the water bodies was highly variable, ranging from about 1% to nearly 100%, but the median contribution was >99% of the total external loading regarding both nitrogen and phosphorus. External loading from the atmosphere and local catchment area played a minor role in general. However, 45 coastal water bodies received >25% of the external nitrogen and phosphorus from their catchments. Loading from land typically peaked in April following ice-break and snow melting and was comparatively low during summer. The results indicate that for many eutrophicated Swedish coastal water bodies, nutrient abatement is likely to be optimally effective when potential measures in all of the catchment area of the concerned sea basin are considered. Local-scale mitigation in single water bodies will likely be locally effective only in the small proportion of areas where water and thereby also nutrient input from the catchment is high compared to the influx from the sea. Future studies should include nutrient reduction scenarios in order to refine these conclusions and to identify relevant spatial scales for coastal eutrophication mitigation measures from a water body perspective. Copyright © 2017 Elsevier Ltd. All rights reserved.

Space Shuttle Enterprise Demate

NASA Image and Video Library

2012-05-12

NASA and United Space Alliance workers lower a yellow sling onto space shuttle Enterprise, which sits atop NASA's 747 Shuttle Carrier Aircraft (SCA) prior to it being demated a few hours later at John F. Kennedy (JFK) International Airport in New York, Saturday, May 12, 2012. Once the sling was firmly attached early Sunday morning, Enterprise was lifted from the SCA. The shuttle will be placed on a barge that will move by tugboat up the Hudson River to Intrepid in June. The shuttle will be lifted by crane and placed on the flight deck of the Intrepid, where it will be on exhibit to the public starting this summer in a temporary climate-controlled pavilion. Photo Credit: (NASA/Kim Shiflet)

14 CFR 25.301 - Loads.

Code of Federal Regulations, 2010 CFR

2010-01-01

... significantly change the distribution of external or internal loads, this redistribution must be taken into... loads multiplied by prescribed factors of safety). Unless otherwise provided, prescribed loads are limit...

The influence of operational and environmental loads on the process of assessing damages in beams

NASA Astrophysics Data System (ADS)

Furdui, H.; Muntean, F.; Minda, A. A.; Praisach, Z. I.; Gillich, N.

2015-07-01

Damage detection methods based on vibration analysis make use of the modal parameter changes. Natural frequencies are the features that can be acquired most simply and inexpensively. But this parameter is influenced by environmental conditions, e.g. temperature and operational loads as additional masses or axial loads induced by restraint displacements. The effect of these factors is not completely known, but in the numerous actual research it is considered that they affect negatively the damage assessment process. This is justified by the small frequency changes occurring due to damage, which can be masked by the frequency shifts due to external loads. The paper intends to clarify the effect of external loads on the natural frequencies of beams and truss elements, and to show in which manner the damage detection process is affected by these loads. The finite element analysis, performed on diverse structures for a large range of temperature values, has shown that the temperature itself has a very limited effect on the frequency changes. Thus, axial forces resulted due to obstructed displacements can influence more substantially the frequency changes. These facts are demonstrated by experimental and theoretical studies. Finally, we succeed to adapt a prior contrived relation providing the frequency changes due to damage in order to fit the case of known external loads. Whereas a new baseline for damage detection was found, considering the effect of temperature and external loads, this process can be performed without other complication.

Hydrodynamic interactions induce movement against an external load in a ratchet dimer Brownian motor.

PubMed

Fornés, José A

2010-01-15

We use the Brownian dynamics with hydrodynamic interactions simulation in order to describe the movement of a elastically coupled dimer Brownian motor in a ratchet potential. The only external forces considered in our system were the load, the random thermal noise and an unbiased thermal fluctuation. For a given set of parameters we observe direct movement against the load force if hydrodynamic interactions were considered.

Structural differences and architectural features of two different polypropylene slings (TVT-O and I-STOP) have no impact on biocompatibility and tissue reactions

PubMed Central

Przydacz, Mikolaj; Adli, Oussama El Yazami; Mahfouz, Wally; Loutochin, Oleg; Bégin, Louis R.

2017-01-01

Introduction To evaluate the impact of design features of the synthetic mid-urethral slings on tissue integrity and inflammatory responses. Material and methods In total 30 female Sprague-Dawley rats were implanted with type I monofilamentous, macroporous polypropylene meshes: Gynecare TVT-Obturator tape® (Ethicon Inc., Johnson & Johnson, Somerville, NJ, USA) and I-STOP® (CL Medical Inc., Lyon, France). All animal groups were sacrificed at set time intervals – 6 weeks, 3 months, 6 months, 9 months and 12 months – and the abdominal wall was harvested with mesh strips for histological evaluation. Results All mesh strips appeared to be well incorporated into the abdominal wall, and no signs of shrinkage was noticed. All specimens showed a thin/delicate, loose, fibrous interface between the synthetic graft plate and abdominal wall, along with mild inflammatory reactions from 6 weeks to 12 months. Conclusions Both mesh brands induced comparable, minimal foreign body reactions and integrated well into the host tissues despite differences in architectural features. TVT-O® and I-STOP® evoked similar low-grade inflammatory responses up to 12 months in this animal model. Structural differences and architectural features of polypropylene slings used in this study have had no impact on tissue integrity and inflammatory responses. PMID:28721282

Structural differences and architectural features of two different polypropylene slings (TVT-O and I-STOP) have no impact on biocompatibility and tissue reactions.

PubMed

Przydacz, Mikolaj; Adli, Oussama El Yazami; Mahfouz, Wally; Loutochin, Oleg; Bégin, Louis R; Corcos, Jacques

2017-06-30

To evaluate the impact of design features of the synthetic mid-urethral slings on tissue integrity and inflammatory responses. In total 30 female Sprague-Dawley rats were implanted with type I monofilamentous, macroporous polypropylene meshes: Gynecare TVT-Obturator tape ® (Ethicon Inc., Johnson & Johnson, Somerville, NJ, USA) and I-STOP ® (CL Medical Inc., Lyon, France). All animal groups were sacrificed at set time intervals - 6 weeks, 3 months, 6 months, 9 months and 12 months - and the abdominal wall was harvested with mesh strips for histological evaluation. All mesh strips appeared to be well incorporated into the abdominal wall, and no signs of shrinkage was noticed. All specimens showed a thin/delicate, loose, fibrous interface between the synthetic graft plate and abdominal wall, along with mild inflammatory reactions from 6 weeks to 12 months. Both mesh brands induced comparable, minimal foreign body reactions and integrated well into the host tissues despite differences in architectural features. TVT-O ® and I-STOP ® evoked similar low-grade inflammatory responses up to 12 months in this animal model. Structural differences and architectural features of polypropylene slings used in this study have had no impact on tissue integrity and inflammatory responses.

Effectiveness of midurethral slings in intrinsic sphincteric-related stress urinary incontinence.

PubMed

Lim, Yik N; Dwyer, Peter L

2009-10-01

Previous literature has shown that urodynamic evidence of intrinsic sphincter deficiency (ISD) decreases the surgical success of traditional antistress incontinence surgeries. The aim of this review is to assess recent evidence on the effectiveness of the increasingly popular midurethral slings (MUS) in women with ISD and stress urinary incontinence. Using the ISD definition of maximum urethral closure pressure of 20 cm H2O or less and/or abdominal/valsalva leak point pressure of 60 cm H2O or less, current literature would suggest that the effectiveness of retropubic MUS is reduced but remained acceptable in women with stress urinary incontinence and ISD. There are conflicting data on whether coexisting poor urethral mobility could further compromise surgical success. Of note, there is now emerging evidence to suggest that transobturator tapes are associated with much higher failure rates in this setting and retropubic MUS should be used instead. Currently, there is too little data on the new single-incision mini-slings for any recommendation of use in women with stress incontinence with good or poor intrinsic urethral function. MUS is an effective treatment for stress urinary incontinence. However, when urodynamic evidence of ISD is present, the retropubic approach may be preferable to the transobturator approach.

Effects of external mechanical loading on phase diagrams and dielectric properties in epitaxial ferroelectric thin films with anisotropic in-plane misfit strains

NASA Astrophysics Data System (ADS)

Qiu, J. H.; Jiang, Q.

2007-02-01

A phenomenological Landau-Devonshine theory is used to describe the effects of external mechanical loading on equilibrium polarization states and dielectric properties in epitaxial ferroelectric thin films grown on dissimilar orthorhombic substrates which induce anisotropic misfit strains in the film plane. The calculation focuses on single-domain perovskite BaTiO3 and PbTiO3 thin films on the assumption that um1=-um2. Compared with the phase diagrams without external loading, the characteristic features of "misfit strain-misfit strain" phase diagrams at room temperature are the presence of paraelectric phase and the strain-induced ferroelectric to paraelectric phase transition. Due to the external loading, the "misfit strain-stress" and "stress-temperature" phase diagrams also have drastic changes, especially for the vanishing of paraelectric phase in "misfit strain-stress" phase map and the appearance of possible ferroelectric phases. We also investigate the dielectric properties and the tunability of both BaTiO3 and PbTiO3 thin films. We find that the external stress dependence of phase diagrams and dielectric properties largely depends on strain anisotropy as well.

Sexual function and quality of life following retropubic TVT and single-incision sling in women with stress urinary incontinence: results of a prospective study.

PubMed

Naumann, Gert; Steetskamp, Joscha; Meyer, Mira; Laterza, Rosa; Skala, Christine; Albrich, Stefan; Koelbl, Heinz

2013-05-01

The objective of this prospective cohort study was to compare effectiveness, morbidity, quality of life (QoL) and sexual function in women treated with tension-free vaginal tape (TVT) versus single-incision sling (SIS) in the treatment of female stress urinary incontinence (SUI). Retropubic TVT sling or SIS was implanted in local anesthesia and patients were followed post-operatively for 6 months. Evaluation was performed to assess post-operative rate of continence, complications, changes in sexual function and patient reported quality of life. Female sexual function was evaluated before and after sling procedure using Female Sexual Function Index (FSFI) in sexually active patients. From January 2009 to December 2011, 150 patients were enrolled and underwent a procedure to implant the retropubic TVT (n = 75) or the MiniArc(®) and Ajust(®) SIS (n = 75). Overall, 93.3 % of the patients who successfully received SIS demonstrated total restoration (84 %) or improvement of continence (9.3 %) at the 6 month post-operative study visit. In TVT group we found 88 % total continence and 6.7 % improvement, respectively. Improvements were seen in the QoL scores related to global bladder feeling (89.3 %) in SIS group and 96 % for TVT. Post-operative FSFI score improves significantly and were comparable in both groups (SIS pre-operative 24.30 ± 4.56 to 27.22 ± 4.66 (P < 0.001) post-operative; TVT 24.63 ± 6.62 to 28.47 ± 4.41, respectively). The SIS procedure appears to be as effective in improving incontinence-related quality of life and sexual function as the TVT through 6 months of post-operative follow-up. No differences in complications and sexual function were demonstrated between the groups.

Ontogenetic changes in the internal and external morphology of the ilium in modern humans

PubMed Central

Abel, Richard; Macho, Gabriele A

2011-01-01

Trabecular architecture forms an important structural component of bone and, depending on the loading conditions encountered during life, is organised in a systematic, bone- and species-specific manner. However, recent studies suggested that gross trabecular arrangement (e.g. density distribution), like overall bone shape, is predetermined and/or affected by factors other than loading and perhaps less plastic than commonly assumed. To explore this issue further, the present cross-sectional ontogenetic study investigated morphological changes in external bone shape in relation to changes in trabecular bundle orientation and anisotropy. Radiographs of 73 modern human ilia were assessed using radiographic and Geometric Morphometric techniques. The study confirmed the apparently strong predetermination of trabecular bundle development, i.e. prior to external loading, although loading clearly also had an effect on overall morphology. For example, the sacro-pubic bundle, which follows the path of load transmission from the auricular surface to the acetabulum, is well defined and shows relatively high levels of anisotropy from early stages of development; the situation for the ischio-iliac strut is similar. However, while the sacro-pubic strut retains a constant relationship with the external landmarks defining the joint surfaces, the ischio-iliac bundle changes its relationship with the external landmarks and becomes aligned with the iliac tubercle only during late adolescence/early adulthood. It is tentatively proposed that the rearrangement of the ischio-iliac strut may reflect a change in locomotor pattern and/or a shift in positional behavior with increasing mass after growth of external bone dimensions has slowed/ceased. PMID:21323915

The SIMS trial: adjustable anchored single-incision mini-slings versus standard tension-free midurethral slings in the surgical management of female stress urinary incontinence. A study protocol for a pragmatic, multicentre, non-inferiority randomised controlled trial.

PubMed

Abdel-Fattah, Mohamed; MacLennan, Graeme; Kilonzo, Mary; Assassa, R Phil; McCormick, Kirsty; Davidson, Tracey; McDonald, Alison; N'Dow, James; Wardle, Judith; Norrie, John

2017-08-11

Single-incision mini-slings (SIMS) represent the third generation of midurethral slings. They have been developed with the aim of offering a true ambulatory procedure for treatment of female stress urinary incontinence (SUI) with reduced morbidity and earlier recovery while maintaining similar efficacy to standard midurethral slings (SMUS). The aim of this study is to determine the clinical and cost-effectiveness of adjustable anchored SIMS compared with tension-free SMUS in the surgical management of female SUI, with 3-year follow-up. A pragmatic, multicentre, non-inferiority randomised controlled trial. The primary outcome measure is the patient-reported success rate measured by the Patient Global Impression of Improvement at 12 months. The primary economic outcome will be incremental cost per quality-adjusted life year gained at 12 months. The secondary outcomes measures include adverse events, objective success rates, impact on other lower urinary tract symptoms, health-related quality of life profile and sexual function, and reoperation rates for SUI. Secondary economic outcomes include National Health Service and patient primary and secondary care resource use and costs, incremental cost-effectiveness and incremental net benefit. The statistical analysis of the primary outcome will be by intention-to-treat and also a per-protocol analysis. Results will be displayed as estimates and 95% CIs. CIs around observed differences will then be compared with the prespecified non-inferiority margin. Secondary outcomes will be analysed similarly. The North of Scotland Research Ethics Committee has approved this study (13/NS/0143). The dissemination plans include HTA monograph, presentation at international scientific meetings and publications in high-impact, open-access journals. The results will be included in the updates of the National Institute for Health and Care Excellence and the European Association of Urology guidelines; these two specific guidelines directly influence practice in the UK and worldwide specialists, respectively. In addition, plain English-language summary of the main findings/results will be presented for relevant patient organisations. ISRCTN93264234. The SIMS study is currently recruiting in 20 UK research centres. The first patient was randomised on 4 February 2014, with follow-up to be completed at the end of February 2020. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The SIMS trial: adjustable anchored single-incision mini-slings versus standard tension-free midurethral slings in the surgical management of female stress urinary incontinence. A study protocol for a pragmatic, multicentre, non-inferiority randomised controlled trial

PubMed Central

Abdel-Fattah, Mohamed; MacLennan, Graeme; Kilonzo, Mary; Assassa, R Phil; McCormick, Kirsty; Davidson, Tracey; McDonald, Alison; N’Dow, James; Wardle, Judith; Norrie, John

2017-01-01

Introduction Single-incision mini-slings (SIMS) represent the third generation of midurethral slings. They have been developed with the aim of offering a true ambulatory procedure for treatment of female stress urinary incontinence (SUI) with reduced morbidity and earlier recovery while maintaining similar efficacy to standard midurethral slings (SMUS). The aim of this study is to determine the clinical and cost-effectiveness of adjustable anchored SIMS compared with tension-free SMUS in the surgical management of female SUI, with 3-year follow-up. Methods and analysis A pragmatic, multicentre, non-inferiority randomised controlled trial. Primary outcome measure The primary outcome measure is the patient-reported success rate measured by the Patient Global Impression of Improvement at 12 months. The primary economic outcome will be incremental cost per quality-adjusted life year gained at 12 months. Secondary outcome measures The secondary outcomes measures include adverse events, objective success rates, impact on other lower urinary tract symptoms, health-related quality of life profile and sexual function, and reoperation rates for SUI. Secondary economic outcomes include National Health Service and patient primary and secondary care resource use and costs, incremental cost-effectiveness and incremental net benefit. Statistical analysis The statistical analysis of the primary outcome will be by intention-to-treat and also a per-protocol analysis. Results will be displayed as estimates and 95% CIs. CIs around observed differences will then be compared with the prespecified non-inferiority margin. Secondary outcomes will be analysed similarly. Ethics and dissemination The North of Scotland Research Ethics Committee has approved this study (13/NS/0143). The dissemination plans include HTA monograph, presentation at international scientific meetings and publications in high-impact, open-access journals. The results will be included in the updates of the National Institute for Health and Care Excellence and the European Association of Urology guidelines; these two specific guidelines directly influence practice in the UK and worldwide specialists, respectively. In addition, plain English-language summary of the main findings/results will be presented for relevant patient organisations. Trial registration number ISRCTN93264234. The SIMS study is currently recruiting in 20 UK research centres. The first patient was randomised on 4 February 2014, with follow-up to be completed at the end of February 2020. PMID:28801396

Predictors of early postoperative voiding dysfunction and other complications following a midurethral sling.

PubMed

Ripperda, Christopher M; Kowalski, Joseph T; Chaudhry, Zaid Q; Mahal, Aman S; Lanzer, Jennifer; Noor, Nabila; Good, Meadow M; Hynan, Linda S; Jeppson, Peter C; Rahn, David D

2016-11-01

The rates reported for postoperative urinary retention following midurethral sling procedures are highly variable. Determining which patients have a higher likelihood of failing a voiding trial will help with preoperative counseling prior to a midurethral sling. The objective of the study was to identify preoperative predictors for failed voiding trial following an isolated midurethral sling. A retrospective, multicenter, case-control study was performed by including all isolated midurethral sling procedures performed between Jan. 1, 2010 to June 30, 2015, at 6 academic centers. We collected demographics, medical and surgical histories, voiding symptoms, urodynamic evaluation, and intraoperative data from the medical record. We excluded patients not eligible for attempted voiding trial after surgery (eg, bladder perforation requiring catheterization). Cases failed a postoperative voiding trial and were discharged with an indwelling catheter or taught intermittent self-catheterization; controls passed a voiding trial. We also recorded any adverse events such as urinary tract infection or voiding dysfunction up to 6 weeks after surgery. Bivariate analyses were completed using Mann-Whitney and Pearson χ 2 tests as appropriate. Multivariable stepwise logistic regression was used to determine predictors of failing a voiding trial. A total of 464 patients had an isolated sling (70.9% retropubic, 28.4% transobturator, 0.6% single incision); 101 (21.8%) failed the initial voiding trial. At follow-up visits, 90.4% passed a second voiding trial, and 38.5% of the remainder passed on the third attempt. For the bivariate analyses, prior prolapse or incontinence surgery was similar in cases vs controls (31% vs 28%, P = .610) as were age, race, body mass index, and operative time. Significantly more of the cases (32%) than controls (22%) had a Charlson comorbidity index score of 1 or greater (P = .039). Overactive bladder symptoms of urgency, frequency, and urgency incontinence were similar in both groups as was detrusor overactivity in those with a urodynamic evaluation (29% vs 22%, P = .136), but nocturia was reported more in the cases (50% vs 38%, P = .046). Mean (SD) bladder capacity was similar in both groups (406 [148] mL vs 388 [122] mL, P = .542) as was maximum flow rate with uroflowmetry and pressure flow studies. Cases were significantly more likely to have a voiding type other than detrusor contraction: 37% vs 25%, P = .027, odds ratio, 1.79 (95% confidence interval, 1.07-3.00). There was no difference in voiding trial failures between retropubic and transobturator routes (23.1% vs 18.9%, P = .329). Within 6 weeks of surgery, the frequency of urinary tract infection in cases was greater than controls (20% vs 6%, P < .001; odds ratio, 3.51 [95% confidence interval, 1.82-6.75]). After passing a repeat voiding trial, cases were more likely to present with acute urinary retention (10% vs 3%, P = .003; odds ratio, 4.00 [95% confidence interval, 1.61-9.92]). For multivariable analyses, increasing Charlson comorbidity index increased the risk of a voiding trial failure; apart from this, we did not identify other demographic information among the patients who did not undergo urodynamic evaluation that reliably forecasted a voiding trial failure. The majority of women will pass a voiding trial on the first attempt after an isolated midurethral sling. Current medical comorbidities are predictive of a voiding trial failure, whereas other demographic/examination findings are not. Patients failing the initial voiding trial are at an increased risk of postoperative urinary tract infection or developing acute retention after passing a subsequent voiding trial. Copyright © 2016 Elsevier Inc. All rights reserved.

Understanding the Risks Sitting and Carrying Devices Pose to Safe Infant Sleep.

PubMed

Rholdon, Roger

There have been various campaigns and recommendations to decrease the incidence of sudden unexpected infant death. Despite this, caregivers continue to place infants in unsafe sleeping environments. These environments, such as sitting devices, slings, carriers, and car seats, pose a significant risk to an infant's safety because of the risk from suffocation and cardiorespiratory instability. It is important for health care providers to understand the appropriate use of car seats, slings, and other sitting devices, to model appropriate behaviors, and to educate parents and caregivers. All parents, hospital staff, and other caregivers should understand the potential dangers associated with the inappropriate use of sitting devices for routine sleep. © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

Intravesical Tension-Free Vaginal Tape Removal: Is There a Single Solution?

PubMed Central

Zakri, Rhana H.; Patel, Amit K.; John, Babbin S.; Shrotri, Nitin C.

2011-01-01

Stress urinary incontinence (SUI) affects 10–20% of women in the general population. Surgery for stress incontinence has been performed on women for over a century, but with the advent of new urogynaecological sling procedures for its management, urological surgeons are having to deal with an increasing number of patients presenting with associated complications. With no clarity on the full range of possible complications or certain consensus on their optimal management, the ideal treatment remains a decision for the individual surgeon. In view of this, we felt it of common interest to review the literature for the history of sling procedures, present commonly arising complications, and seek to answer the question in the title. PMID:22084797

[Minimally invasive bone anchor in therapy of female stress incontinence. A good concept?].

PubMed

Schostak, M; Heicappell, R; Müller, M; Sauter, T; Steiner, U; Miller, K

2001-03-01

Transvaginal pubic bone anchoring represents a minimally invasive technique for cystourethropexy or urethral sling suspension. This study assesses the results of this procedure. Cystourethropexy was performed in 4 and a sling procedure in 13 of 17 patients. The stress incontinence showed a median improvement from grade 2 to 1.35 (p = 0.01). Nine patients had impaired vaginal wound healing with urge symptoms. Revision was necessary in eight of them. An unfavorable outcome could not be significantly correlated with the surgical technique, the surgeon, the patient's age or the number of previous operations. The technique of minimally invasive bone anchoring must be regarded as unsuitable in view of the largely poor wound healing associated with irritation symptoms.

Load apparatus and method for bolt-loaded compact tension test specimen

DOEpatents

Buescher, B.J. Jr.; Lloyd, W.R.; Ward, M.B.; Epstein, J.S.

1997-02-04

A bolt-loaded compact tension test specimen load apparatus includes: (a) a body having first and second opposing longitudinal ends, the first end comprising an externally threaded portion sized to be threadedly received within the test specimen threaded opening; (b) a longitudinal loading rod having first and second opposing longitudinal ends, the loading rod being slidably received in a longitudinal direction within the body internally through the externally threaded portion and slidably extending longitudinally outward of the body first longitudinal end; (c) a force sensitive transducer slidably received within the body and positioned to engage relative to the loading rod second longitudinal end; and (d) a loading bolt threadedly received relative to the body, the loading bolt having a bearing end surface and being positioned to bear against the transducer to forcibly sandwich the transducer between the loading bolt and loading rod. Also disclosed is a method of in situ determining applied force during crack propagation in a bolt-loaded compact tension test specimen. 6 figs.

Load apparatus and method for bolt-loaded compact tension test specimen

DOEpatents

Buescher, Jr., Brent J.; Lloyd, W. Randolph; Ward, Michael B.; Epstein, Jonathan S.

1997-01-01

A bolt-loaded compact tension test specimen load apparatus includes: a) a body having first and second opposing longitudinal ends, the first end comprising an externally threaded portion sized to be threadedly received within the test specimen threaded opening; b) a longitudinal loading rod having first and second opposing longitudinal ends, the loading rod being slidably received in a longitudinal direction within the body internally through the externally threaded portion and slidably extending longitudinally outward of the body first longitudinal end; c) a force sensitive transducer slidably received within the body and positioned to engage relative to the loading rod second longitudinal end; and d) a loading bolt threadedly received relative to the body, the loading bolt having a bearing end surface and being positioned to bear against the transducer to forcibly sandwich the transducer between the loading bolt and loading rod. Also disclosed is a method of in situ determining applied force during crack propagation in a bolt-loaded compact tension test specimen.

Water Quality, Hydrology, and Simulated Response to Changes in Phosphorus Loading of Butternut Lake, Price and Ashland Counties, Wisconsin, with Special Emphasis on the Effects of Internal Phosphorus Loading in a Polymictic Lake

USGS Publications Warehouse

Robertson, Dale M.; Rose, William J.

2008-01-01

Butternut Lake is a 393-hectare, eutrophic to hypereutrophic lake in northcentral Wisconsin. After only minor improvements in water quality were observed following several actions taken to reduce the nutrient inputs to the lake, a detailed study was conducted from 2002 to 2007 by the U.S. Geological Survey to better understand how the lake functions. The goals of this study were to describe the water quality and hydrology of the lake, quantify external and internal sources of phosphorus, and determine the effects of past and future changes in phosphorus inputs on the water quality of the lake. Since the early 1970s, the water quality of Butternut Lake has changed little in response to nutrient reductions from the watershed. The largest changes were in near-surface total phosphorus concentrations: August concentrations decreased from about 0.09 milligrams per liter (mg/L) to about 0.05 mg/L, but average summer concentrations decreased only from about 0.055-0.060 mg/L to about 0.045 mg/L. Since the early 1970s, only small changes were observed in chlorophyll a concentrations and water clarity (Secchi depths). All major water and phosphorus sources, including the internal release of phosphorus from the sediments (internal loading), were measured directly, and minor sources were estimated to construct detailed water and phosphorus budgets for the lake during monitoring years (MY) 2003 and 2004. During these years, Butternut Creek, Spiller Creek, direct precipitation, small tributaries and near-lake drainage area, and ground water contributed about 62, 20, 8, 7, and 3 percent of the inflow, respectively. The average annual load of phosphorus to the lake was 2,540 kilograms (kg), of which 1,590 kg came from external sources (63 percent) and 945 kg came from the sediments in the lake (37 percent). Of the total external sources, Butternut Creek, Spiller Creek, small tributaries and near-lake drainage area, septic systems, precipitation, and ground water contributed about 63, 23, 9, 3, 1, and 1 percent, respectively. Because of the high internal phosphorus loading, the eutrophication models used in this study were unable to simulate the observed water-quality characteristics in the lake without incorporating this source of phosphorus. However, when internal loading of phosphorus was added to the BATHTUB model, it accurately simulated the average water-quality characteristics measured in MY 2003 and 2004. Model simulations demonstrated a relatively linear response between in-lake total phosphorus concentrations and external phosphorus loading; however, the changes in concentrations were smaller than the changes in external phosphorus loadings (about 25-40 percent of the change in phosphorus loading). Changes in chlorophyll a concentrations, the percentage of days with algal blooms, and Secchi depths were nonlinear and had a greater response to reductions in phosphorus loading than to increases in phosphorus loading. A 50-percent reduction in external phosphorus loading caused an 18-percent decrease in chlorophyll a concentrations, a 41-percent decrease in the percentage of days with algal blooms, and a 12-percent increase in Secchi depth. When the additional internal phosphorus loading was removed from model simulations, all of these constituents showed a much greater response to changes in external phosphorus loading. Because of Butternut Lake's morphometry, it is polymictic, which means it mixes frequently and does not develop stable thermal stratification throughout the summer. This characteristic makes it more vulnerable than dimictic lakes, which mix in spring and fall and develop stable thermal stratification during summer, to the high internal phosphorus loading that has resulted from historically high, nonnatural, external phosphorus loading. In polymictic lakes, the phosphorus released from the sediments is mixed into the upper part of the lake throughout summer. Once Butternut Lake became hypereutrophic (very p

7 CFR 1710.206 - Approval requirements for load forecasts prepared pursuant to approved load forecast work plans.

Code of Federal Regulations, 2010 CFR

2010-01-01

... narrative shall address the overall approach, time periods, and expected internal and external uses of the forecast. Examples of internal uses include providing information for developing or monitoring demand side... suppliers. Examples of external uses include meeting state and Federal regulatory requirements, obtaining...

Gas-liquid two-phase flow behaviors and performance characteristics of proton exchange membrane fuel cells in a short-term microgravity environment

NASA Astrophysics Data System (ADS)

Guo, Hang; Liu, Xuan; Zhao, Jian Fu; Ye, Fang; Ma, Chong Fang

2017-06-01

In this work, proton exchange membrane fuel cells (PEMFCs) with transparent windows are designed to study the gas-liquid two-phase flow behaviors inside flow channels and the performance of a PEMFC with vertical channels and a PEMFC with horizontal channels in a normal gravity environment and a 3.6 s short-term microgravity environment. Experiments are conducted under high external circuit load and low external circuit load at low temperature where is 35 °C. The results of the present experimental work demonstrate that the performance and the gas-liquid two-phase flow behaviors of the PEMFC with vertical channels exhibits obvious changes when the PEMFCs enter the 3.6 s short-term microgravity environment from the normal gravity environment. Meanwhile, the performance of the PEMFC with vertical channels increases after the PEMFC enters the 3.6 s short-term microgravity environment under high external circuit load, while under low external circuit load, the PEMFC with horizontal channels exhibits better performance in both the normal gravity environment and the 3.6 s short-term microgravity environment.

Quantitative molecular viral loads in 7 horses with naturally occurring equine herpesvirus-1 infection.

PubMed

Estell, K E; Dawson, D R; Magdesian, K G; Swain, E; Laing, S T; Siso, S; Mapes, S; Pusterla, N

2015-11-01

Data associating quantitative viral load with severity, clinical signs and survival in equine herpesvirus-1 myeloencephalopathy (EHM) have not been reported. To report the clinical signs, treatment, and temporal progression of viral loads in 7 horses with naturally occurring EHM and to examine the association of these factors with survival. Retrospective case series. The population included 7 horses with EHM presented to the University of California, Davis William R. Pritchard Veterinary Medical Teaching Hospital from May to September 2011. Horses were graded using a neurological grading scale. Daily quantitative PCR was performed on nasal secretions and whole blood. Treatment, survival, outcome and histopathology were reported. At presentation, one horse was neurological grade 5/5, 3 were grade 4/5 and 3 were grade 3/5. All were treated with anti-inflammatory drugs, valacyclovir and management in a sling if necessary. All were infected with equine herpesvirus-1 of DNA polymerase D752 genotype. Peak viral load in nasal secretions and blood of 5 survivors ranged from 6.9 × 10(3) to 2.81 × 10(5) (median 5.11 × 10(4) ) and from 143 to 4340 gB gene copies/million eukaryotic cells (median 3146), respectively. The 2 nonsurvivors presented with grade 3/5 neurological signs and progressed to encephalopathy. Peak viral load was higher in nonsurvivors, with levels in nasal secretions of 1.9 × 10(9) and 2.2 × 10(9) and in blood of 2.05 × 10(4) and 1.02 × 10(5) gB gene copies/million eukaryotic cells. Case fatality was 2/7. Nonsurvivors had viral loads 1000-fold higher in nasal secretions and 10-fold higher in blood than survivors. There was no relationship between severity of clinical signs at presentation and survival. Thus, encephalopathy and high viral load were negatively associated with survival in this population. Further research should be performed to determine whether high viral loads are associated with encephalopathy and poor prognosis. The Summary is available in Chinese - see Supporting information. © 2014 EVJ Ltd.

Harnessing the wandering mind: the role of perceptual load.

PubMed

Forster, Sophie; Lavie, Nilli

2009-06-01

Perceptual load is a key determinant of distraction by task-irrelevant stimuli (e.g., Lavie, N. (2005). Distracted and confused?: Selective attention under load. Trends in Cognitive Sciences, 9, 75-82). Here we establish the role of perceptual load in determining an internal form of distraction by task-unrelated thoughts (TUTs or "mind-wandering"). Four experiments demonstrated reduced frequency of TUTs with high compared to low perceptual load in a visual-search task. Alternative accounts in terms of increased demands on responses, verbal working memory or motivation were ruled out and clear effects of load were found for unintentional TUTs. Individual differences in load effects on internal (TUTs) and external (response-competition) distractors were correlated. These results suggest that exhausting attentional capacity in task-relevant processing under high perceptual load can reduce processing of task-irrelevant information from external and internal sources alike.

Effects of transverse shear deformation on buckling of laminated cylinders as a function of thickness and ply orientation

NASA Technical Reports Server (NTRS)

Jegley, Dawn C.

1987-01-01

Buckling loads of thick-walled, orthotropic, simply-supported right circular cylinders are predicted using a new higher-order transverse shear deformation theory. The higher-order theory shows that, by more accurately accounting for transverse shear deformation effects, the predicted buckling load may be reduced by as much as 80 percent compared to predictions based on conventional transverse shear deformation theory. A parametric study of the effect of ply orientation on the buckling load of axially compressed cylinders indicates that laminates containing 0 deg plies are the most sensitive to transverse shear deformation effects. Interaction curves for buckling of cylinders with axial compressive and external pressure loadings indicate that buckling loads due to external pressure loadings are much less sensitive to transverse shear deformation effects than those due to axial compressive loadings.

Mid-term follow-up of the TVT-Secur midurethral sling for primary stress incontinence.

PubMed

Angleitner-Flotzinger, Johannes; Aigmueller, Thomas

2014-09-01

The TVT-Secur was introduced in 2006 as a less invasive alternative to retropubic and transobturator suburethral slings. This retrospective cohort study evaluated objective and subjective results in a series of 158 consecutive patients as well as complications and the reoperation rate after TVT-Secur procedure. Between November 2006 and June 2010 a total of 158 patients underwent a TVT-Secur procedure at a single institution. All patients underwent preoperative urodynamic testing. All patients were invited for follow-up including physical examination, urodynamic studies and subjective evaluation. A total of 96 patients (61%) were available for follow-up with a mean follow-up of 29.8 months (range 5-50, median 30). At follow-up, eight (8%) of 96 patients had reoperations for stress incontinence. There were no reoperations for bleeding/hematoma, tape erosions or obstructed micturition and there were no tape erosions or exposures. 29 patients (30%) had a negative cough stress test and 44 patients (46%) subjectively considered themselves "cured". Nine of 43 patients (21%) without urgency symptoms preoperatively developed de novo urgency; 24 of 35 patients (69%) with preoperative urgency complaints were free of urgency symptoms. At 2.4 years, the TVT-Secur appears to have a low adverse events profile but inferior results compared with traditional midurethral slings. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Lower facial reanimation techniques following cancer resection and free flap reconstruction.

PubMed

Kejner, Alexandra E; Rosenthal, Eben L

2016-09-01

Evaluate outcomes of the standard static sling and orthodromic temporalis tendon transfer reanimation for facial nerve paralysis. Retrospective case series at a tertiary care hospital of head and neck cancer patients with facial nerve palsy secondary to malignancy or resection. From 2004 to 2014, patients undergoing resection of malignancy that involved facial nerve palsy requiring facial reanimation were identified. All procedures were performed by the senior author (e.l.r.). Demographics, methods, revision rates, combination with other procedures, and complications were evaluated. A total of 77 patients underwent 92 procedures, with two patients requiring more than one revision, for a total of 20 revisions. Average time to revision was 9 months. Age, sex, race, side of repair, paralysis prior to procedure, sling type or method, timing of procedure, and radiation therapy were not significantly different between those requiring revision and those who did not. There was no difference in complications between patients who received radiation and those who did not (P = .5), nor between static versus orthodromic temporalis muscle transfer (P = .5). Complication rate was low at 5.4%. Sling procedures can be successfully performed in patients with facial nerve palsy secondary to cancer resection with radiation therapy, with a low revision rate and few complications. 4 Laryngoscope, 126:1990-1994, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Vaginal mucosal flap as a sling preservation for the treatment of vaginal exposure of mesh.

PubMed

Kim, Sea Young; Park, Jong Yeon; Kim, Han Kwon; Park, Chang Hoo; Kim, Sung Jin; Sung, Gi Teck; Park, Chang Myon

2010-06-01

Tension-free vaginal tape (TVT) procedures are used for the treatment of stress urinary incontinence in women. The procedures with synthetic materials can have a risk of vaginal erosion. We experienced transobturator suburethral sling (TOT) tape-induced vaginal erosion and report the efficacy of a vaginal mucosal covering technique. A total of 560 female patients diagnosed with stress urinary incontinence underwent TOT procedures at our hospital between January 2005 and August 2009. All patients succeeded in follow-ups, among which 8 patients (mean age: 50.5 years) presented with vaginal exposure of the mesh. A vaginal mucosal covering technique was performed under local anesthesia after administration of antibiotics and vaginal wound dressings for 3-4 days. Seven of the 8 patients complained of persistent vaginal discharge postoperatively. Two of the 8 patients complained of dyspareunia of their male partners. The one remaining patient was otherwise asymptomatic, but mesh erosion was discovered at the routine follow-up visit. Six of the 8 patients showed complete mucosal covering of the mesh after the operation (mean follow-up period: 16 moths). Vaginal mucosal erosion recurred in 2 patients, and the mesh was then partially removed. One patient had recurrent stress urinary incontinence. Vaginal mucosal covering as a sling preservation with continued patient continence may be a feasible and effective option for the treatment of vaginal exposure of mesh after TOT tape procedures.

Effect of abutment screw length and cyclic loading on removal torque in external and internal hex implants.

PubMed

Mohammed, Hnd Hadi; Lee, Jin-Han; Bae, Ji-Myung; Cho, Hye-Won

2016-02-01

The purpose of this study was to evaluate the effects of abutment screw length and cyclic loading on the removal torque (RTV) in external hex (EH) and internal hex (IH) implants. Forty screw-retained single crowns were connected to external and internal hex implants. The prepared titanium abutment screws were classified into 8 groups based on the number of threads (n = 5 per group): EH 12.5, 6.5, 3.5, 2.5 and IH 6.5, 5, 3.5, 2.5 threads. The abutment screws were tightened with 20 Ncm torque twice with 10-minute intervals. After 5 minutes, the initial RTVs of the abutment screws were measured with a digital torque gauge (MGT12). A customized jig was constructed to apply a load along the implant long axis at the central fossa of the maxillary first molar. The post-loading RTVs were measured after 16,000 cycles of mechanical loading with 50 N at a 1-Hz frequency. Statistical analysis included one-way analysis of variance and paired t-tests. The post-loading RTVs were significantly lower than the initial RTVs in the EH 2.5 thread and IH 2.5 thread groups (P<.05). The initial RTVs exhibited no significant differences among the 8 groups, whereas the post-loading RTVs of the EH 6.5 and EH 3.5 thread groups were higher than those of the IH 3.5 thread group (P<.05). Within the limitations of this study, the external hex implants with short screw lengths were more advantageous than internal hex implants with short screw lengths in torque maintenance after cyclic loading.

Effect of abutment screw length and cyclic loading on removal torque in external and internal hex implants

PubMed Central

Mohammed, Hnd Hadi; Lee, Jin-Han; Bae, Ji-Myung

2016-01-01

PURPOSE The purpose of this study was to evaluate the effects of abutment screw length and cyclic loading on the removal torque (RTV) in external hex (EH) and internal hex (IH) implants. MATERIALS AND METHODS Forty screw-retained single crowns were connected to external and internal hex implants. The prepared titanium abutment screws were classified into 8 groups based on the number of threads (n = 5 per group): EH 12.5, 6.5, 3.5, 2.5 and IH 6.5, 5, 3.5, 2.5 threads. The abutment screws were tightened with 20 Ncm torque twice with 10-minute intervals. After 5 minutes, the initial RTVs of the abutment screws were measured with a digital torque gauge (MGT12). A customized jig was constructed to apply a load along the implant long axis at the central fossa of the maxillary first molar. The post-loading RTVs were measured after 16,000 cycles of mechanical loading with 50 N at a 1-Hz frequency. Statistical analysis included one-way analysis of variance and paired t-tests. RESULTS The post-loading RTVs were significantly lower than the initial RTVs in the EH 2.5 thread and IH 2.5 thread groups (P<.05). The initial RTVs exhibited no significant differences among the 8 groups, whereas the post-loading RTVs of the EH 6.5 and EH 3.5 thread groups were higher than those of the IH 3.5 thread group (P<.05). CONCLUSION Within the limitations of this study, the external hex implants with short screw lengths were more advantageous than internal hex implants with short screw lengths in torque maintenance after cyclic loading. PMID:26949489

Phase Synchronization and Desynchronization of Structural Response Induced by Turbulent and External Sound

NASA Technical Reports Server (NTRS)

Maestrello, Lucio

2002-01-01

Acoustic and turbulent boundary layer flow loadings over a flexible structure are used to study the spatial-temporal dynamics of the response of the structure. The stability of the spatial synchronization and desynchronization by an active external force is investigated with an array of coupled transducers on the structure. In the synchronous state, the structural phase is locked, which leads to the formation of spatial patterns while the amplitude peaks exhibit chaotic behaviors. Large amplitude, spatially symmetric loading is superimposed on broadband, but in the desynchronized state, the spectrum broadens and the phase space is lost. The resulting pattern bears a striking resemblance to phase turbulence. The transition is achieved by using a low power external actuator to trigger broadband behaviors from the knowledge of the external acoustic load inducing synchronization. The changes are made favorably and efficiently to alter the frequency distribution of power, not the total power level. Before synchronization effects are seen, the panel response to the turbulent boundary layer loading is discontinuously spatio-temporally correlated. The stability develops from different competing wavelengths; the spatial scale is significantly shorter than when forced with the superimposed external sound. When the external sound level decreases and the synchronized phases are lost, changes in the character of the spectra can be linked to the occurrence of spatial phase transition. These changes can develop broadband response. Synchronized responses of fuselage structure panels have been observed in subsonic and supersonic aircraft; results from two flights tests are discussed.

Helicopter payload gains utilizing water injection for hot day power augmentation

NASA Technical Reports Server (NTRS)

Stroub, R. H.

1972-01-01

An analytical investigation was undertaken to assess the gains in helicopter mission payload through the use of water injection to produce power augmentation in an altitude-hot day environment. Substantial gains are shown for two representative helicopters, the UH-lH and CH-47B. The UH-lH payload increased 86.7 percent for a 50 n.mi. (92.6 km) radius mission involving two out-of-ground effect (OGE) hover take-offs of 2 minutes each at 5000 ft. (1525 m) 35 C ambient conditions. The CH-47B payload increased 49.5 percent for a 50 n.mi. (92.6 km) radius mission with sling loaded cargo as the outbound payload and a 3000 lb. (1360 kg) internal cargo on the return leg. The mission included two 4 min. OGE hovers at 6000 ft. (1830 m) 35 C. An improvement in take off performance and maximum performance climb also resulted as a consequence of the OGE hover capability and higher maximum power available.

Loading direction regulates the affinity of ADP for kinesin.

PubMed

Uemura, Sotaro; Ishiwata, Shin'ichi

2003-04-01

Kinesin is an ATP-driven molecular motor that moves processively along a microtubule. Processivity has been explained as a mechanism that involves alternating single- and double-headed binding of kinesin to microtubules coupled to the ATPase cycle of the motor. The internal load imposed between the two bound heads has been proposed to be a key factor regulating the ATPase cycle in each head. Here we show that external load imposed along the direction of motility on a single kinesin molecule enhances the binding affinity of ADP for kinesin, whereas an external load imposed against the direction of motility decreases it. This coupling between loading direction and enzymatic activity is in accord with the idea that the internal load plays a key role in the unidirectional and cooperative movement of processive motors.

Relationships Between the External and Internal Training Load in Professional Soccer: What Can We Learn From Machine Learning?

PubMed

Jaspers, Arne; De Beéck, Tim Op; Brink, Michel S; Frencken, Wouter G P; Staes, Filip; Davis, Jesse J; Helsen, Werner F

2018-05-01

Machine learning may contribute to understanding the relationship between the external load and internal load in professional soccer. Therefore, the relationship between external load indicators (ELIs) and the rating of perceived exertion (RPE) was examined using machine learning techniques on a group and individual level. Training data were collected from 38 professional soccer players over 2 seasons. The external load was measured using global positioning system technology and accelerometry. The internal load was obtained using the RPE. Predictive models were constructed using 2 machine learning techniques, artificial neural networks and least absolute shrinkage and selection operator (LASSO) models, and 1 naive baseline method. The predictions were based on a large set of ELIs. Using each technique, 1 group model involving all players and 1 individual model for each player were constructed. These models' performance on predicting the reported RPE values for future training sessions was compared with the naive baseline's performance. Both the artificial neural network and LASSO models outperformed the baseline. In addition, the LASSO model made more accurate predictions for the RPE than did the artificial neural network model. Furthermore, decelerations were identified as important ELIs. Regardless of the applied machine learning technique, the group models resulted in equivalent or better predictions for the reported RPE values than the individual models. Machine learning techniques may have added value in predicting RPE for future sessions to optimize training design and evaluation. These techniques may also be used in conjunction with expert knowledge to select key ELIs for load monitoring.

Influence of parafunctional loading and prosthetic connection on stress distribution: a 3D finite element analysis.

PubMed

Torcato, Leonardo Bueno; Pellizzer, Eduardo Piza; Verri, Fellippo Ramos; Falcón-Antenucci, Rosse Mary; Santiago Júnior, Joel Ferreira; de Faria Almeida, Daniel Augusto

2015-11-01

Clinicians should consider parafunctional occlusal load when planning treatment. Prosthetic connections can reduce the stress distribution on an implant-supported prosthesis. The purpose of this 3-dimensional finite element study was to assess the influence of parafunctional loading and prosthetic connections on stress distribution. Computer-aided design software was used to construct 3 models. Each model was composed of a bone and an implant (external hexagon, internal hexagon, or Morse taper) with a crown. Finite element analysis software was used to generate the finite element mesh and establish the loading and boundary conditions. A normal force (200-N axial load and 100-N oblique load) and parafunctional force (1000-N axial and 500-N oblique load) were applied. Results were visualized as the maximum principal stress. Three-way analysis of variance and Tukey test were performed, and the percentage of contribution of each variable to the stress concentration was calculated from sum-of squares-analysis. Stress was concentrated around the implant at the cortical bone, and models with the external hexagonal implant showed the highest stresses (P<.001). Oblique loads produced high tensile stress concentrations on the site opposite the load direction. Internal connection implants presented the most favorable biomechanical situation, whereas the least favorable situation was the biomechanical behavior of external connection implants. Parafunctional loading increased the magnitude of stress by 3 to 4 times. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Evaluation of muscle activity for loaded and unloaded dynamic squats during vertical whole-body vibration.

PubMed

Hazell, Tom J; Kenno, Kenji A; Jakobi, Jennifer M

2010-07-01

The purpose of this investigation was to examine if the addition of a light external load would enhance whole-body vibration (WBV)-induced increases in muscle activity during dynamic squatting in 4 leg muscles. Thirteen recreationally active male university students performed a series of dynamic squats (unloaded with no WBV, unloaded with WBV, loaded with no WBV, and loaded with WBV). The load was set to 30% of body mass and WBV included 25-, 35-, and 45-Hz frequencies with 4-mm amplitude. Muscle activity was recorded with surface electromyography (EMG) on the vastus lateralis (VL), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius (GC) and is reported as EMGrms (root mean square) normalized to %maximal voluntary exertion. During unloaded dynamic squats, exposure to WBV (45 Hz) significantly (p < 0.05) increased baseline muscle activity in all muscles, except the TA compared with no WBV. Adding a light external load without WBV increased baseline muscle activity of the squat exercise in all muscles but decreased the TA. This loaded level of muscle activity was further increased with WBV (45 Hz) in all muscles. The WBV-induced increases in muscle activity in the loaded condition (approximately 3.5%) were of a similar magnitude to the WBV-induced increases during the unloaded condition (approximately 2.5%) demonstrating the addition of WBV to unloaded or loaded dynamic squatting results in an increase in muscle activity. These results demonstrate the potential effectiveness of using external loads with exposure to WBV.

Chronic vaginal discharge and left leg edema after a transobturator tape procedure.

PubMed

Kim, Tae-Hee; Lee, Hae-Hyeog; Kim, Jun-Mo

2014-05-01

We report on a patient who underwent total vaginal hysterectomy for urinary incontinence 8 years previously with a sling operation using transobturator tape (TOT). She was admitted to our hospital after complaints of vaginal discharge, foul odor, and bleeding, left thigh pain, and edema. Magnetic resonance imaging (MRI) and computed tomography (CT) revealed a fistula tract from the vagina or urethra with remnant sling tape. We removed the remnant tape using intraoperative ultrasonography. This case exemplifies the rare occurrence of a vaginal fistula extending to the obturator, adductor, and pectineus muscles combined with myositis after TOT placement. It is important that urogynecologists recognize that TOT procedures may result in complications accompanied by common recurrent vaginal symptoms, such as vaginal odor and spotting, which can be identified by MRI or CT.

[Bladder injury during sling operation in the treatment of SUI--review of literature and case report].

PubMed

Gałczyński, Krzysztof; Futyma, Konrad; Bar, Krzysztof; Rechberger, Tomasz

2012-10-01

Sling operations have been performed for over 15 years. In recent years these operations have become the gold standard in the treatment of stress urinary incontinence (SUI) due to their efficacy safety and low invasiveness. Approximately 4% of women will undergo a surgery for SUI in the course of their life. As with any surgical intervention, there may be some technical problems, as well as intra- and postoperative complications, the most common of which is bladder injury Other complications encountered during mid-urethral slings procedures include bleeding (retropubic or vaginal hematomas), urethral perforation, urinary tract infections, postoperative vaginal or urethral erosions, bowel perforation, chronic pelvic pain, wound infection, nerve injury transient and persistent voiding dysfunction such as de novo urgency incomplete bladder emptying or urinary retention. Below we present a case of a patient with diagnosed vesicovaginal fistula after sling operation (TVT-tension-free vaginal tape). Upon admission the patient reported dysuria, persistent urinary leakage and abnormal, abundant vaginal discharge. Case report and review of literature concerning surgical treatment of stress urinary incontinence and its complications. Analysis of medical documentation of the patient treated at the Second Department of Gynecology Medical University of Lublin. Review of abstracts or papers in the Medline database related to surgical treatment of urinary incontinence and its complications. Bladder perforation is one of the most common complications of the retropubic approach for MUS placement. The presence of mesh within the bladder may arise from direct bladder perforation or from subsequent erosion of the sling. Such lesions do not cause any serious health consequences for patients on condition they are detected intraoperatively and appropriately repaired, but when unrecognized, they results in the development of considerable symptoms and negatively influence the quality of patient life. Improperly treated, it can lead to development of an abnormal communication between the urinary bladder and the anterior wall of the vagina -vesicovaginal fistula. We should suspect unrecognized bladder injury in case of patients with any persistent voiding symptoms after a sling procedure such as long lasting dysuria, persistent urinary leakage, hematuria, recurrent infections, chronic pain and voiding difficulties. Diagnosis and treatment of vesicovaginal fistula is long lasting and difficult for the patient and the surgeon. Füth-Mayo operation is an effective treatment method for the majority of vesicovaginal fistulas. During this operation we suture all layers of fistula separately (bladder perivesical fascia and vaginal wall). Although with this operation we solve one problem, the patient still might suffer from recurrent SUI. Alternative methods of treatment which can be offered to patients after unsuccessful SUI operation are periurethral injections with bulking agents or electrical stimulation of the pelvic floor muscles. Both methods are effective in the therapy of recurrent SUI. In our case periurtehral injection of Bulkamid did not provide a total cure. Therefore, we completed the treatment with electrical stimulation of the pelvic floor muscles using patient-controlled electrodes placed in the vagina to stimulate muscles with current frequency of 50 Hz, amperage between 0-60 mA and duration of 250 micros. This procedure produced a series of changes in the stimulated area and enabled to cure the incontinence.

Load identification approach based on basis pursuit denoising algorithm

NASA Astrophysics Data System (ADS)

Ginsberg, D.; Ruby, M.; Fritzen, C. P.

2015-07-01

The information of the external loads is of great interest in many fields of structural analysis, such as structural health monitoring (SHM) systems or assessment of damage after extreme events. However, in most cases it is not possible to measure the external forces directly, so they need to be reconstructed. Load reconstruction refers to the problem of estimating an input to a dynamic system when the system output and the impulse response functions are usually the knowns. Generally, this leads to a so called ill-posed inverse problem, which involves solving an underdetermined linear system of equations. For most practical applications it can be assumed that the applied loads are not arbitrarily distributed in time and space, at least some specific characteristics about the external excitation are known a priori. In this contribution this knowledge was used to develop a more suitable force reconstruction method, which allows identifying the time history and the force location simultaneously by employing significantly fewer sensors compared to other reconstruction approaches. The properties of the external force are used to transform the ill-posed problem into a sparse recovery task. The sparse solution is acquired by solving a minimization problem known as basis pursuit denoising (BPDN). The possibility of reconstructing loads based on noisy structural measurement signals will be demonstrated by considering two frequently occurring loading conditions: harmonic excitation and impact events, separately and combined. First a simulation study of a simple plate structure is carried out and thereafter an experimental investigation of a real beam is performed.

Coupled loads analysis for Space Shuttle payloads

NASA Technical Reports Server (NTRS)

Eldridge, J.

1992-01-01

Described here is a method for determining the transient response of, and the resultant loads in, a system exposed to predicted external forces. In this case, the system consists of four racks mounted on the inside of a space station resource node module (SSRNMO) which is mounted in the payload bay of the space shuttle. The predicted external forces are forcing functions which envelope worst case forces applied to the shuttle during liftoff and landing. This analysis, called a coupled loads analysis, is used to couple the payload and shuttle models together, determine the transient response of the system, and then recover payload loads, payload accelerations, and payload to shuttle interface forces.

Experimental and numerical investigation on laser-assisted bending of pre-loaded metal plate

NASA Astrophysics Data System (ADS)

Nowak, Zdzisław; Nowak, Marcin; Widłaszewski, Jacek; Kurp, Piotr

2018-01-01

The laser forming technique has an important disadvantage, which is the limitation of plastic deformation generated by a single laser beam pass. To increase the plastic deformation it is possible to apply external forces in the laser forming process. In this paper, we investigate the influence of external pre-loads on the laser bending of steel plate. The pre-loads investigated generate bending towards the laser beam. The thermal, elastic-plastic analysis is performed using the commercial nonlinear finite element analysis package ABAQUS. The focus of the paper is to identify how this pattern of the pre-load influence the final bend angle of the plate.

A multicentre prospective randomised study of single-incision mini-sling (Ajust®) versus tension-free vaginal tape-obturator (TVT-O™) in the management of female stress urinary incontinence: pain profile and short-term outcomes.

PubMed

Mostafa, Alyaa; Agur, Wael; Abdel-All, Mohamed; Guerrero, Karen; Lim, Chi; Allam, Mohamed; Yousef, Mohamed; N'Dow, James; Abdel-fattah, Mohamed

2012-11-01

To compare the postoperative pain profile, peri-operative details, and short-term patient-reported and objective success rates of single-incision mini-slings (SIMS) versus standard mid-urethral slings (SMUS). In a multicentre prospective randomised trial in six UK centres in the period between October 2009 and October 2010, 137 women were randomised to either adjustable SIMS (Ajust®, C. R. Bard Inc., NJ, USA), performed under local anaesthesia as an opt-out policy (n=69), or SMUS (TVT-O™, Ethicon Inc., Somerville, USA) performed under general anaesthesia (n=68). Randomisation was done through number-allocation software and using telephone randomisation. Postoperative pain profile (primary outcome) was assessed on a ten-point visual analogue scale at fixed time-points. Pre- and post operatively (4-6 months) women completed symptom severity, urgency perception scale (UPS), quality of life and sexual function questionnaires. In addition, women completed a Patient Global Impression of Improvement Questionnaire and underwent a cough stress test at 4-6 months follow up. Sample size calculation was performed and data were analysed using SPSS 18. Descriptive analyses are given and between-group comparisons were performed using chi-square, Fischer exact test and Mann-Whitney test as appropriate. Significance level was set at 5%. Women in the SIMS Ajust® group had a significantly lower postoperative pain profile up to 4 weeks (p=<0.001, 95% CI 1.151, 2.480). There was no significant difference in peri-operative complications between groups. All 137 women completed the 4-6 months follow-up. Patient-reported and objective cure rates were not significantly different: 85.5% versus 91.2% (p=0.443) and 90% versus 97% (p=0.165) between the SIMS Ajust® and TVT-O™ groups respectively. There was a trend towards higher rates of de novo urgency or worsening of pre-existing urgency in the SIMS Ajust® group (21.7% versus 8.8%) but this did not reach statistical significance (p=0.063). Women in the SIMS Ajust® group had shorter hospital stay (median (IQR) 3.65 (2.49, 4.96)) compared to (4.42 (3.16, 5.56)) the TVT-O™ group 95% CI (-0.026, 1.326), with significantly earlier return to normal activities (p=0.025) and to work (p=0.006). The adjustable single-incision mini-sling (Ajust®) is associated with a significantly improved postoperative pain profile and earlier return to work when compared to standard mid-urethral slings (TVT-O™), with encouraging results in patient-reported and objective success rates at short-term follow-up. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence.

PubMed

Fusco, Ferdinando; Abdel-Fattah, Mohamed; Chapple, Christopher R; Creta, Massimiliano; La Falce, Sabrina; Waltregny, David; Novara, Giacomo

2017-10-01

Retropubic (RP-TVT) and transobturator miurethral (TO-TVT) midurethral sling (MUS) are popular surgical treatments for female stress urinary incontinence. The long-term efficacy and safety of the procedures is still a topic of intense clinical research and several randomised controlled trials (RCTs) have been published in the last years OBJECTIVE: To evaluate the efficacy and safety of MUS compared with other surgical treatments for female stress urinary incontinence. A systematic review and meta-analysis of the literature was performed using the Medline, Scopus, and Web of Science databases to update our previously published analyses. Twenty-eight RCTs were identified. In total, the meta-analyses included 15 855 patients. Patients receiving MUS had significantly higher overall (odds ratio [OR]: 0.59, p=0.0003) and objective (OR: 0.51, p=0.001) cure rates than those receiving Burch colposuspension. Patients undergoing MUS and pubovaginal slings had similar cure rates. Patients treated with RT-TVT had higher subjective (OR: 0.83, p=0.03) and objective (OR: 0.82, p=0.01) cure rates than those receiving TO-TVT. However, the latter had a lower risk of intraoperative bladder or vaginal perforation (OR: 2.4, p=0.0002), pelvic haematoma (OR: 2.61, p=0.002), urinary tract infections (OR: 1.31, p=0.04) and voiding lower urinary tract symptoms (OR: 1.66, p=0.002). Sensitivity analyses limited to RCTs with follow-up durations >60 mo demonstrated similar outcomes for RP-TVT and TO-TVT. No significant differences in efficacy were identified comparing inside-to-out and outside-to-in TO-TVT but vaginal perforations were less common with the former (OR: 0.21, p=0.0002). The present analysis confirms the superiority of MUS over Burch colposuspension. The studies comparing insertion of RT-TVT and TO-TVT showed higher subjective and objective cure rates for the RP-TVT but at the cost of higher risks of some complications and voiding lower urinary tract symptoms. Efficacy of inside-out and outside-in techniques of TO-TVT insertion was similar, although the risk of vaginal perforation was lower in the inside-to-out TO-TVT. Retropubic and transobturator midurethral slings are a popular treatment for female stress urinary incontinence. The available literature suggest that those slings are either more effective or safer than other older surgical procedures. Retropubic tapes are followed with slightly higher continence rates as compared with the transobturator tapes but are associated with higher risk of intra- and postoperative complications. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Quantification of Training and Competition Loads in Endurance Sports: Methods and Applications.

PubMed

Mujika, Iñigo

2017-04-01

Training quantification is basic to evaluate an endurance athlete's responses to training loads, ensure adequate stress/recovery balance, and determine the relationship between training and performance. Quantifying both external and internal workload is important, because external workload does not measure the biological stress imposed by the exercise sessions. Generally used quantification methods include retrospective questionnaires, diaries, direct observation, and physiological monitoring, often based on the measurement of oxygen uptake, heart rate, and blood lactate concentration. Other methods in use in endurance sports include speed measurement and the measurement of power output, made possible by recent technological advances such as power meters in cycling and triathlon. Among subjective methods of quantification, rating of perceived exertion stands out because of its wide use. Concurrent assessments of the various quantification methods allow researchers and practitioners to evaluate stress/recovery balance, adjust individual training programs, and determine the relationships between external load, internal load, and athletes' performance. This brief review summarizes the most relevant external- and internal-workload-quantification methods in endurance sports and provides practical examples of their implementation to adjust the training programs of elite athletes in accordance with their individualized stress/recovery balance.

A randomised controlled trial comparing TVT, Pelvicol and autologous fascial slings for the treatment of stress urinary incontinence in women.

PubMed

Guerrero, K L; Emery, S J; Wareham, K; Ismail, S; Watkins, A; Lucas, M G

2010-11-01

To compare TVT(TM) , Pelvicol(TM) and autologous fascial slings (AFSs). A multicentre randomised control trial. Four units in the UK. Women requiring primary surgery for stress urinary incontinence (SUI). A total of 201 women with urodynamically proven stress incontinence were randomised into three groups and assessed at baseline, 6 weeks, 6 months and 1 year. The primary outcome was patient-reported improvement rates. Secondary outcomes included operative complications/time, intermittent self-catheterisation (ISC) and re-operation rates. The quality-of-life tools used were the Bristol Female Lower Urinary Tract Symptoms (BFLUTS) and EuroQoL. Fifty women had a Pelvicol(TM) sling, 79 had AFSs and 72 had TVT(TM). At 6 months the Pelvicol(TM) arm had poorer improvement rates (73%) than TVT(TM) (92%)/AFS (95%); P=0.003. At 1 year only 61% of the Pelvicol(TM) slings remained as improved, versus 93% of TVTs and 90% of AFSs (P<0.001). Pelvicol(TM) has poorer dry rates (22%) than TVT(TM) (55%)/AFS (48%) (P=0.001) at 1 year; hence, the Pelvicol(TM) arm was suspended following interim analysis. There is no difference in the success rates between TVT(TM) and AFS. One in five women in the Pelvicol(TM) arm had further surgery for SUI by 1 year, but none required further surgery in the other arms. AFS took longer to do (54 minutes versus 35 minutes for TVT(TM) /36 minutes for Pelvicol(TM) ) and had higher ISC rates (9.9 versus 0% Pelvicol(TM) /TVT(TM) 1.5%). Hospital stay was shortest for TVT(TM) (2 days). Most BFLUTS domains showed improvement in all three arms. The improvement for women in the Pelvicol(TM) arm, however, was less than for women in the other arms in several key domains. Pelvicol(TM) cannot be recommended for the management of SUI. TVT(TM) does not have greater efficacy than AFS, but does utilise fewer resources. © 2010 The Authors Journal compilation © RCOG 2010 BJOG An International Journal of Obstetrics and Gynaecology.

Long-term follow-up of the AdVance®/AdVanceXP® sling. What are the surgeons' impressions? What are the patients'?

PubMed

Romero Hoyuela, A; Reina Alcaina, L; Izquierdo Morejon, E; Rosino Sanchez, A; Carrillo George, C; Rivero Guerra, A; Barcelo Bayonas, I; Pardo Martinez, A; Muñoz Guillermo, V; Pietricica, B; Fernandez Aparicio, T; Hita Villaplana, G; Miñana Lopez, B

2018-04-01

To analyse the safety, efficacy and quality of life of patients with male stress urinary incontinence after radical prostatectomy treated with the AdVance ® and AdvanceXP ® slings. The study included 92 patients with stress urinary incontinence after radical prostatectomy treated with the AdVance ® and AdVanceXP ® sling between May 2008 and December 2015. A perineal repositioning test was performed in all cases with sphincter coaptation of≥1.5cm. Mild stress urinary incontinence was defined as the use of 1-2 absorbers/24h; moderate was defined as 3-5 absorbers/24h; and severe was defined as more than 5 absorbers/24h. Healing was defined as the total absence of using pads; improvement was defined as a reduction>50% in the number of pads; and failure was defined as a reduction<50, no improvement or worsened incontinence. Check-ups were conducted at 3, 12 and 36 months after the surgery. We employed the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) for the quality of life index. The complications are listed according to the Clavien-Dindo classification. The degree of preoperative incontinence was mild in 23.9%, moderate in 67.4% and severe in 8.7% of the patients. The mean use of preoperative pads was 3.1 (range 1-6, 95% CI). The mean preoperative ICIQ-SF score was 16.5 (15-20). Sphincter coaptation≥1.5cm using the perineal repositioning test was present in 87 patients (94.6%). The mean follow-up from insertion of the sling was 42.1 months. Some 89.1% of the patients were healed at 3 months, 70.7% were healed at 12 months, and 70.4% were healed at 36 months. The ICIQ-SF score at 3, 12 and 36 months showed significant improvement (P<.001) compared with the preoperative score. The Advance ® and AdvanceXP ® system are effective over time in terms of urinary continence and patient satisfaction. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

Figure-of-eight bandage versus arm sling for treating middle-third clavicle fractures in adults: study protocol for a randomised controlled trial.

PubMed

Lenza, Mario; Taniguchi, Luiz Fabiano Presente; Ferretti, Mario

2016-05-04

Fracture of the clavicle is common, accounting for 2.6 to 4.0 % of all fractures, with an overall incidence of 36.5 to 64 per 100,000 per year. Around 80 % of clavicle fractures occur in the middle third of the clavicle. Randomised controlled trials comparing treatment interventions have failed to indicate the best therapeutic practices for these fractures. The objective of this study is to evaluate the effects (benefits and harms) of two commonly-used conservative interventions: the figure-of-eight bandage versus the arm sling as treatments of middle-third clavicle fractures. This project has been designed as a single-centre, two-arm randomised controlled trial that will compare two interventions: figure-of-eight bandage versus the arm sling. We propose to recruit 110 adults, aged 18 years or older, with an acute (less than 10 days since injury) middle-third clavicle fracture. The primary outcomes to be evaluated will be function and/or disability measured by the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire. In order to assess the secondary outcomes, the Modified University of California at Los Angeles (modified - UCLA) Shoulder Rating Scale will be used. The occurrence of pain (Visual Analogue Scale for pain (VAS)), treatment failure, adverse events and the ability to return to previous activities will also be recorded and evaluated as secondary outcomes. the primary outcome DASH score and the secondary outcomes - modified UCLA and VAS scores - will be analysed graphically. We will apply generalised mixed models with the intervention groups (two levels), and time-point assessments (seven levels) as fixed effects and patients as a random effect. According to the current literature there is very limited evidence from two small trials regarding the effectiveness of different methods of conservative interventions for treating clavicle fractures. This is the first randomised controlled trial comparing the figure-of-eight bandage versus the arm sling for treating clavicle fractures that follows the CONSORT Statement guidelines. ClinicalTrials.gov NCT02398006 .

Wellbeing perception and the impact on external training output among elite soccer players.

PubMed

Malone, Shane; Owen, Adam; Newton, Matt; Mendes, Bruno; Tiernan, Leo; Hughes, Brian; Collins, Kieran

2018-01-01

The objective of the investigation was to observe the impact of player wellbeing on the training output of elite soccer players. Prospective cohort design. Forty-eight soccer players (age: 25.3±3.1years; height: 183±7cm; mass: 72±7kg) were involved in this single season observational study across two teams. Each morning, pre-training, players completed customised perceived wellbeing questionnaires. Global positioning technology devices were used to measure external load (total distance, total high-speed running distance, high speed running, player load, player load slow, maximal velocity, maximal velocity exposures). Players reported ratings of perceived exertion using the modified Borg CR-10 scale. Integrated training load ratios were also analysed for total distance:RPE, total high speed distance:RPE player load:RPE and player load slow:RPE respectively. Mixed-effect linear models revealed significant effects of wellbeing Z-score on external and integrated training load measures. A wellbeing Z-score of -1 corresponded to a -18±2m (-3.5±1.1%), 4±1m (-4.9±2.1%,) 0.9±0.1kmh -1 (-3.1±2.1%), 1±1 (-4.6±2.9%), 25±3AU (-4.9±3.1%) and 11±0.5AU (-8.9±2.9%) reduction in total high speed distance, high speed distance, maximal velocity, maximal velocity exposures, player load and player load slow respectively. A reduction in wellbeing impacted external:internal training load ratios and resulted in -0.49±0.12mmin -1 , -1.20±0.08mmin -1 ,-0.02±0.01AUmin -1 in total distance:RPE, total high speed distance:RPE and player load slow:RPE respectively. The results suggest that systematic monitoring of player wellbeing within soccer cohorts can provide coaches with information about the training output that can be expected from individual players during a training session. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Internal phosphorus loading across a cascade of three eutrophic basins: A synthesis of short- and long-term studies.

PubMed

Tammeorg, Olga; Horppila, Jukka; Tammeorg, Priit; Haldna, Marina; Niemistö, Juha

2016-12-01

Ascertaining the phosphorus (P) release processes in polymictic lakes is one of the methodologically most complex questions in limnology. In the current study, we combined short- and long-term investigations to elucidate the role of sediments in the P budget in a chain of eutrophic lake basins. We quantified the internal loading of P in three basins of Lake Peipsi (Estonia/Russia) for two periods characterized by different external P loadings using radiometrically dated sediment cores (long-term studies). The relationships between different water quality variables and the internal P loading, and the external P loading were studied. Our short-term studies aimed at elucidating the possible mechanisms behind variations in internal P loading included examination of the surficial sediments, i.e., seasonal measurements of redox potential, sediment pore water P concentrations and diffusive fluxes. Our results provided evidence for a potentially high importance of internal P loading in regulating water quality. The sediment core analyses revealed an increase in the internal P loading during the period of lower external P loading coinciding with the general deterioration in the lake water quality (i.e, higher concentrations of soluble reactive phosphorus, total phosphorus and biomass of cyanobacteria). Increase in wave action between the two studied periods appeared to cause more frequent sediment resuspension, and thus be the most likely reason for the variations in internal P loading. Our short-term measurements indicated that resuspension events can be followed by a considerable increase in the diffusive fluxes. Copyright © 2016 Elsevier B.V. All rights reserved.

Watershed Modeling to Assess the Sensitivity of Streamflow, Nutrient, and Sediment Loads to Potential Climate Change and Urban Development in 20 U.S. Watersheds (External Review Draft)

EPA Science Inventory

EPA has released for independent external peer review and public comment a draft report titled, Watershed Modeling to Assess the Sensitivity of Streamflow, Nutrient, and Sediment Loads to Potential Climate Change and Urban Development in 20 U.S. Watersheds. This is a draft...

A loose bolt delays loading of Endeavour's external tank

NASA Technical Reports Server (NTRS)

2000-01-01

This loose bracket, observed hanging down from the side of the White Room at Launch Pad 39B, delayed loading of Endeavour's external tank by several hours to allow technicians to remove it. A 'U' bolt connects the bracket to a fire suppression water line attached to the exterior of the White Room. The loose bolt could have possibly created a debris hazard.

TRX Suspension Training: A New Functional Training Approach for Older Adults - Development, Training Control and Feasibility.

PubMed

Gaedtke, Angus; Morat, Tobias

Because of its proximity to daily activities functional training becomes more important for older adults. Sling training, a form of functional training, was primarily developed for therapy and rehabilitation. Due to its effects (core muscle activation, strength and balance improvements), sling training may be relevant for older adults. However, to our knowledge no recent sling training program for healthy older adults included a detailed training control which is indeed an essential component in designing and implementing this type of training to reach positive effects. The purpose of this study was to develop a TRX Suspension Training for healthy older adults (TRX-OldAge) and to evaluate its feasibility. Eleven participants finished the 12 week intervention study. All participants trained in the TRX-OldAge whole-body workout which consists of seven exercises including 3-4 progressively advancing stages of difficulty for every exercise. At each stage, intensity could be increased through changes in position. Feasibility data was evaluated in terms of training compliance and a self-developed questionnaire for rating TRX-OldAge. The training compliance was 85 %. After study period, 91 % of the participants were motivated to continue with the program. The training intensity, duration and frequency were rated as optimal. All participants noted positive effects whereas strength gains were the most. On the basis of the detailed information about training control, TRX-OldAge can be individually adapted for each older adult appropriate to its precondition, demands and preference.

Two new mini-slings compared with transobturator tension-free vaginal tape for treatment of stress urinary incontinence: A 1-year follow-up randomized controlled trial.

PubMed

Gaber, Mohamed E; Borg, Tamer; Samour, Hazem; Nawara, Mai; Reda, Ahmed

2016-12-01

The aim of this study was to compare the outcome of two single-incision mini-slings (the Contasure-Needleless [C-NDL] and the endopelvic free anchorage) with the standard midurethral transobturator tension-free vaginal tape (TVT-O) procedure. A double blind randomized controlled study was conducted at Ain Shams University Maternity Hospital from August 2014 until July 2015. A total of 209 patients were randomized into three groups. The first group underwent the TVT-O procedure, the second group underwent the endopelvic free anchorage procedure and the third group underwent the C-NDL procedure. Patients were followed up for 12 months in terms of subjective cure, objective cure, and complications rate. After 12 months of follow-up, there were no differences among the three groups in terms of objective cure rate, subjective cure rate, patient satisfaction, or incidence of complications (de novo urge, hemorrhage, infection, and mesh erosion). The C-NDL was associated with a shorter operative time (P < 0.001) and less blood loss (P = 0.021) than the standard TVT-O. The new single-incision mini-slings showed similar efficacy and patient acceptance to that of the standard TVT-O for up to 12 months postoperatively with no difference in the complications rate. The C-NDL is associated with shorter operative time and less blood loss. © 2016 Japan Society of Obstetrics and Gynecology.

Microvascular decompression for hemifacial spasm secondary to vertebrobasilar dolichoectasia: surgical strategies, technical nuances and clinical outcomes.

PubMed

Zaidi, Hasan A; Awad, Al-Wala; Chowdhry, Shakeel A; Fusco, David; Nakaji, Peter; Spetzler, Robert F

2015-01-01

Hemifacial spasm (HFS) due to direct compression of the facial nerve by a dolichoectatic vertebrobasilar artery is rare. Vessels are often non-compliant and tethered by critical brainstem perforators. We set out to determine surgical strategies and outcomes for this challenging disease. All patients undergoing surgery for HFS secondary to vertebrobasilar dolichoectasia were reviewed. Hospital records, clinic notes and radiographic imaging were collected for outcome measures. Seventeen patients (eight males, nine females) were identified. Sixteen patients (94%) were treated with Teflon pledgets (DuPont, Wilmington, DE, USA) and one (6%) patient had a vascular sling placed around a severely diseased vertebral artery. All patients had significant reduction in symptoms and 82% of patients had complete resolution of symptoms (average follow-up: 41.4 months). One patient suffered persistent facial nerve paresis and swallowing difficulty. Two other patients suffered a 1 point decrease in the House-Brackmann facial nerve grading scale. Four patients (23%) required re-operation (infection, cerebrospinal fluid leak, and two patients with delayed recurrence of HFS). Of the latter, one patient required repositioning of a Teflon pledget and another patient underwent a sling decompression. There were no perioperative strokes or death. Excellent relief of symptoms with acceptable preoperative morbidity can be achieved using Teflon pledgets alone in most cases. In recalcitrant cases, sling transposition can be used to further augment the decompression. Careful attention must be paid to prevent vascular kinking and preserve brainstem perforators. Copyright © 2014 Elsevier Ltd. All rights reserved.

Vagal Afferent Innervation of the Lower Esophageal Sphincter

PubMed Central

Powley, Terry L.; Baronowsky, Elizabeth A.; Gilbert, Jared M.; Hudson, Cherie N.; Martin, Felecia N.; Mason, Jacqueline K.; McAdams, Jennifer L.; Phillips, Robert J.

2013-01-01

To supply a fuller morphological characterization of the vagal afferents innervating the lower esophageal sphincter (LES), specifically to label vagal terminals in the tissues forming the LES in the gastroesophageal junction, the present experiment employed injections of dextran biotin into the nodose ganglia of rats. Four types of vagal afferents innervated the LES. Clasp and sling muscle fibers were directly and prominently innervated by intramuscular arrays (IMAs). Individual IMA terminals subtended about 16° of arc of the esophageal circumference, and, collectively, the terminal fields were distributed within the muscle ring to establish a 360° annulus of mechanoreceptors in the sphincter wall. 3D morphometry of the terminals established that, compared to sling muscle IMAs, clasp muscle IMAs had more extensive arbors and larger receptive fields. In addition, at the cardia, local myenteric ganglia between smooth muscle sheets and striated muscle bundles were innervated by intraganglionic laminar endings (IGLEs), in a pattern similar to the innervation of the myenteric plexus throughout the stomach and esophagus. Finally, as previously described, the principle bundle of sling muscle fibers that links LES sphincter tissue to the antropyloric region of the lesser curvature was innervated by exceptionally long IMAs as well as by unique web ending specializations at the distal attachment of the bundle. Overall, the specialized varieties of densely distributed vagal afferents innervating the LES underscore the conclusion that these sensory projections are critically involved in generating LES reflexes and may be promising targets for managing esophageal dysfunctions. PMID:23583280

Influence of the height of the external hexagon and surface treatment on fatigue life of commercially pure titanium dental implants.

PubMed

Gil, Francisco Javier; Aparicio, Conrado; Manero, Jose M; Padros, Alejandro

2009-01-01

This study evaluated the effect of external hexagon height and commonly applied surface treatments on the fatigue life of titanium dental implants. Electropolished commercially pure titanium dental implants (seven implants per group) with three different external hexagon heights (0.6, 1.2, and 1.8 mm) and implants with the highest external hexagon height (1.8 mm) and different surface treatments (electropolishing, grit blasting with aluminium oxide, and acid etching with sulfuric acid) were tested to evaluate their mechanical fatigue life. To do so, 10-Hz triangular flexural load cycles were applied at 37 degrees C in artificial saliva, and the number of load cycles until implant fracture was determined. Tolerances of the hexagon/abutment fit and implant surface roughness were analyzed by scanning electron microscopy and light interferometry. Transmission electron microscopy and electron diffraction analyses of titanium hydrides were performed. First, the fatigue life of implants with the highest hexagon (8,683 +/- 978 load cycles) was more than double that of the implants with the shortest hexagons (3,654 +/- 789 load cycles) (P < .02). Second, the grit-blasted implants had the longest fatigue life of the tested materials (21,393 +/- 2,356 load cycles), which was significantly greater than that of the other surfaces (P < .001). The compressive surface residual stresses induced when blasting titanium are responsible for this superior mechanical response. Third, precipitation of titanium hydrides in grain boundaries of titanium caused by hydrogen adsorption from the acid solution deteriorates the fatigue life of acid-etched titanium dental implants. These implants had the shortest fatigue life (P < .05). The fatigue life of threaded root-form dental implants varies with the height of the external hexagon and/or the surface treatment of the implant. An external hexagon height of 1.8 mm and/or a blasting treatment appear to significantly increase fatigue life of dental implants.

Internal cycling, not external loading, decides the nutrient limitation in eutrophic lake: A dynamic model with temporal Bayesian hierarchical inference.

PubMed

Wu, Zhen; Liu, Yong; Liang, Zhongyao; Wu, Sifeng; Guo, Huaicheng

2017-06-01

Lake eutrophication is associated with excessive anthropogenic nutrients (mainly nitrogen (N) and phosphorus (P)) and unobserved internal nutrient cycling. Despite the advances in understanding the role of external loadings, the contribution of internal nutrient cycling is still an open question. A dynamic mass-balance model was developed to simulate and measure the contributions of internal cycling and external loading. It was based on the temporal Bayesian Hierarchical Framework (BHM), where we explored the seasonal patterns in the dynamics of nutrient cycling processes and the limitation of N and P on phytoplankton growth in hyper-eutrophic Lake Dianchi, China. The dynamic patterns of the five state variables (Chla, TP, ammonia, nitrate and organic N) were simulated based on the model. Five parameters (algae growth rate, sediment exchange rate of N and P, nitrification rate and denitrification rate) were estimated based on BHM. The model provided a good fit to observations. Our model results highlighted the role of internal cycling of N and P in Lake Dianchi. The internal cycling processes contributed more than external loading to the N and P changes in the water column. Further insights into the nutrient limitation analysis indicated that the sediment exchange of P determined the P limitation. Allowing for the contribution of denitrification to N removal, N was the more limiting nutrient in most of the time, however, P was the more important nutrient for eutrophication management. For Lake Dianchi, it would not be possible to recover solely by reducing the external watershed nutrient load; the mechanisms of internal cycling should also be considered as an approach to inhibit the release of sediments and to enhance denitrification. Copyright © 2017 Elsevier Ltd. All rights reserved.

Force and displacement measurements of the distal fibula during simulated ankle loading tests for high ankle sprains.

PubMed

Markolf, Keith L; Jackson, Steven; McAllister, David R

2012-09-01

Syndesmosis (high ankle) sprains produce disruption of the distal tibiofibular ligaments. Forces on the distal fibula that produce these injuries are unknown. Twenty-seven fresh-frozen lower extremities were used for this study. A load cell recorded forces acting on the distal fibula from forced ankle dorsiflexion and applied external foot torque; medial-lateral and anterior-posterior displacements of the distal fibula were recorded. Fibular forces and axial displacements were also recorded with applied axial force. During forced ankle dorsiflexion and external foot torque tests, the distal fibula always displaced posteriorly with respect to the tibia with no measurable medial-lateral displacement. With 10 Nm dorsiflexion moment, cutting the tibiofibular ligaments approximately doubled fibular force and displacement values. Cutting the tibiofibular ligaments significantly increased fibular displacement from applied external foot torque. Fibular forces and axial displacements from applied axial weight-bearing force were highest with the foot dorsiflexed. The highest mean fibular force in the study (271.9 N) occurred with 10 Nm external foot torque applied to a dorsiflexed foot under 1000 N axial force. Two important modes of loading that could produce high ankle sprains were identified: forced ankle dorsiflexion and external foot torque applied to a dorsiflexed ankle loaded with axial force. The distal tibiofibular ligaments restrained fibular displacement during these tests. Residual mortise widening observed at surgery may be the result of tibiofibular ligament injuries caused by posterior displacement of the fibula. Therefore, a syndesmosis screw used to fix the fibula would be subjected to posterior bending forces from these loading modes. Ankle bracing to prevent extreme ankle dorsiflexion during rehabilitation may be advisable to prevent excessive fibular motions that could affect syndesmosis healing.

In situ forces and length patterns of the fibular collateral ligament under controlled loading: an in vitro biomechanical study using a robotic system.

PubMed

Liu, Ping; Wang, Jianquan; Xu, Yan; Ao, Yingfang

2015-04-01

The aim of this study was to determine the in situ forces and length patterns of the fibular collateral ligament (FCL) and kinematics of the knee under various loading conditions. Six fresh-frozen cadaveric knees were used (mean age 46 ± 14.4 years; range 20-58). In situ forces and length patterns of FCL and kinematics of the knee were determined under the following loading conditions using a robotic/universal force-moment sensor testing system: no rotation, varus (10 Nm), external rotation (5 Nm), and internal rotation (5 Nm) at 0°, 15°, 30°, 60º, 90°, and 120° of flexion, respectively. Under no rotation loading, the distances between the centres of the FCL attachments decreased as the knee flexed. Under varus loading, the force in FCL peaked at 15° of flexion and decreased with further knee flexion, while distances remained nearly constant and the varus rotation increased with knee flexion. Using external rotation, the force in the FCL also peaked at 15° flexion and decreased with further knee flexion, the distances decreased with flexion, and external rotation increased with knee flexion. Using internal rotation load, the force in the FCL was relatively small across all knee flexion angles, and the distances decreased with flexion; the amount of internal rotation was fairly constant. FCL has a primary role in preventing varus and external rotation at 15° of flexion. The FCL does not perform isometrically following knee flexion during neutral rotation, and tibia rotation has significant effects on the kinematics of the FCL. Varus and external rotation laxity increased following knee flexion. By providing more realistic data about the function and length patterns of the FCL and the kinematics of the intact knee, improved reconstruction and rehabilitation protocols can be developed.

Space Shuttle Projects

NASA Image and Video Library

1987-07-01

A forward segment is being lowered into the Transient Pressure Test Article (TPTA) test stand at the Marshall Space Flight Center (MSFC) east test area. The TPTA test stand, 14-feet wide, 27-feet long, and 33-feet high, was built in 1987 to provide data to verify the sealing capability of the redesign solid rocket motor (SRM) field and nozzle joints. The test facility applies pressure, temperature, and external loads to a short stack of solid rocket motor hardware. The simulated SRM ignition pressure and temperature transients are achieved by firing a small amount of specially configured solid propellant. The pressure transient is synchronized with external programmable dynamic loads that simulate lift off loads at the external tank attach points. Approximately one million pounds of dead weight on top of the test article simulates the weight of the other Shuttle elements.

Space Shuttle Projects

NASA Image and Video Library

1987-07-01

A forward segment is being lowered into the Transient Pressure Test Article (TPTA) test stand at thw Marshall Space Flight Center (MSFC) east test area. The TPTA test stand, 14-feet wide, 27-feet long, and 33-feet high, was built in 1987 to provide data to verify the sealing capability of the redesign solid rocket motor (SRM) field and nozzle joints. The test facility applies pressure, temperature, and external loads to a short stack of solid rocket motor hardware. The simulated SRM ignition pressure and temperature transients are achieved by firing a small amount of specially configured solid propellant. The pressure transient is synchronized with external programmable dynamic loads that simulate lift off loads at the external tank attach points. Approximately one million pounds of dead weight on top of the test article simulates the weight of the other Shuttle elements.

Environmental And Quality Management System In The Context Of Sustainable Development

NASA Astrophysics Data System (ADS)

Rusko, Miroslav

2015-06-01

Growing load and deterioration of the environment can be interpreted as a result of some external effects interventions. While the positive externalities influence the positive productional and utilizational functions of other subjects, the negative externalities influence the negative ones. Both types of external effects can act as parcial or global externalities. Linking of environmental issues to economy and finance is an important sphere.

A Hydrostatic Bearing Test System for Measuring Bearing Load Using Magnetic-Fluid Lubricants.

PubMed

Weng, Huei Chu; Chen, Lu-Yu

2016-05-01

This paper conducts a study on the design of a hydrostatic bearing test system. It involves the determination of viscous properties of magnetic-fluid lubricants. The load of a hydrostatic thrust bearing using a water-based magnetite nanofluid of varying volume flow rate is measured under an applied external induction field via the test system. Results reveal that the presence of nanoparticles in a carrier liquid would cause an enhanced bearing load. Such an effect could be further magnified by increasing the lubricant volume flow rate or the external induction field strength.

A loose bolt delays loading of Endeavour's external tank

NASA Technical Reports Server (NTRS)

2000-01-01

A closeup reveals the loose bracket, observed hanging down from the side of the White Room at Launch Pad 39B, that delayed loading of Endeavour's external tank by several hours to allow technicians to remove it. A 'U' bolt connects the bracket to a fire suppression water line attached to the exterior of the White Room. The loose bolt could have possibly created a debris hazard.

Static-stress analysis of dual-axis safety vessel

NASA Astrophysics Data System (ADS)

Bultman, D. H.

1992-11-01

An 8 ft diameter safety vessel, made of HSLA-100 steel, is evaluated to determine its ability to contain the quasi-static residual pressure from a high explosive (HE) blast. The safety vessel is designed for use with the Dual-Axis Radiographic Hydrotest (DARHT) facility being developed at Los Alamos National Laboratory. A smaller confinement vessel fits inside the safety vessel and contains the actual explosion, and the safety vessel functions as a second layer of containment in the unlikely case of a confinement vessel leak. The safety vessel is analyzed as a pressure vessel based on the ASME Boiler and Pressure Vessel Code, Section 8, Division 1, and the Welding Research Council Bulletin, WRC107. Combined stresses that result from internal pressure and external loads on nozzles are calculated and compared to the allowable stresses for HSLA-100 steel. Results confirm that the shell and nozzle components are adequately designed for a static pressure of 830 psi, plus the maximum expected external loads. Shell stresses at the 'shell to nozzle' interface, produced from external loads on the nozzles, were less than 700 psi. The maximum combined stress resulting from the internal pressure plus external loads was 17,384 psi, which is significantly less than the allowable stress of 42,375 psi for HSLA-100 steel.

Relative importance of expertise, lifting height and weight lifted on posture and lumbar external loading during a transfer task in manual material handling.

PubMed

Plamondon, André; Larivière, Christian; Delisle, Alain; Denis, Denys; Gagnon, Denis

2012-01-01

The objective of this study was to measure the effect size of three important factors in manual material handling, namely expertise, lifting height and weight lifted. The effect of expertise was evaluated by contrasting 15 expert and 15 novice handlers, the effect of the weight lifted with a 15-kg box and a 23-kg box and the effect of lifting height with two different box heights: ground level and a 32 cm height. The task consisted of transferring a series of boxes from a conveyor to a hand trolley. Lifting height and weight lifted had more effect size than expertise on external back loading variables (moments) while expertise had low impact. On the other hand, expertise showed a significant effect of posture variables on the lumbar spine and knees. All three factors are important, but for a reduction of external back loading, the focus should be on the lifting height and weight lifted. The objective was to measure the effect size of three important factors in a transfer of boxes from a conveyor to a hand trolley. Lifting height and weight lifted had more effect size than expertise on external back loading variables but expertise was a major determinant in back posture.

External fixation using locking plate in distal tibial fracture: a finite element analysis.

PubMed

Zhang, Jingwei; Ebraheim, Nabil; Li, Ming; He, Xianfeng; Schwind, Joshua; Liu, Jiayong; Zhu, Limei

2015-08-01

External fixation of tibial fractures using a locking plate has been reported with favorable results in some selected patients. However, the stability of external plate fixation in this fracture pattern has not been previously demonstrated. We investigated the stability of external plate fixation with different plate-bone distances. In this study, the computational processing model of external fixation of a distal tibial metaphyseal fracture utilizing the contralateral femoral less invasive stabilization system plate was analyzed. The plate was placed on the anteromedial aspect of tibia with different plate-bone distances: 1, 10, 20, and 30 mm. Under axial load, the stiffness of construct in all groups was higher than intact tibia. Under axial load with an internal rotational force, the stiffness of construct with 1 and 10 mm plate-bone distances was similar to that of an intact tibia and the stiffness of the construct with 20 and 30 mm distances was lower than that of an intact tibia. Under axial load with an external rotational force, the stiffness of the construct in all groups was lower than that of an intact tibia. The maximum plate stresses were concentrated at the two most distal screws and were highest in the construct with the 10 mm plate-bone distance, and least in the construct with a 1 mm plate-bone distance. To guarantee a stable external plate fixation in distal tibial fracture, the plate-bone distance should be less than 30 mm.

77 FR 23117 - Rigging Equipment for Material Handling Construction Standard; Correction and Technical Amendment

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-18

...OSHA is correcting its sling standard for construction titled ``Rigging Equipment for Material Handling'' by removing the rated capacity tables and making minor, nonsubstantive revisions to the regulatory text.

Identifying interactive effects of task demands in lifting on estimates of in vivo low back joint loads.

PubMed

Gooyers, Chad E; Beach, Tyson A C; Frost, David M; Howarth, Samuel J; Callaghan, Jack P

2018-02-01

This investigation examined interactions between the magnitude of external load, movement speed and (a)symmetry of load placement on estimates of in vivo joint loading in the lumbar spine during simulated occupational lifting. Thirty-two participants with manual materials handling experience were included in the study. Three-dimensional motion data, ground reaction forces, and activation of six bilateral trunk muscle groups were captured while participants performed lifts with two loads at two movement speeds and using two load locations. L4-L5 joint compression and shear force-time histories were estimated using an EMG-assisted musculoskeletal model of the lumbar spine. Results from this investigation provide strong evidence that known mechanical low back injury risk factors should not be viewed in isolation. Rather, injury prevention efforts need to consider the complex interactions that exist between external task demands and their combined influence on internal joint loading. Copyright © 2017 Elsevier Ltd. All rights reserved.

Evaluation of spinal internal loads and lumbar curvature under holding static load at different trunk and knee positions.

PubMed

Kahrizi, Sedighe; Parnianpour, Mohammad; Firoozabadi, Seyyed Mohammad; Kasemnejad, Anoshirvan; Karimi, Elham

2007-04-01

A study was performed to investigate how different trunk and knee positions while holding static loads affect the lumbar curvature and internal loads on the lumbar spine at L4-L5. Ten healthy male subjects participated in this study. Two inclinometers were used to evaluate the curvature of lumbar spine, lordosis, while a 3D static biomechanical model was used to predict the spinal compression and shear forces at L4-L5. Eighteen static tasks while holding three level of load (0, 10 and 20 kg), two levels of knee position (45 and 180 degrees of flexion) and three levels of trunk position (neutral, 15 and 30 degree of flexion) were simulated for 10 healthy male subjects. The results of this study revealed that the lordosis of lumbar spine changed to kyphosis with increasing weight of load from 0 to 20 kg in trunk flexion position (p<0.05), but in squatting position (45 degrees knee full flexion) the higher load did not affect the curvature. The results of this study suggested, at a more flexed trunk and standing position with higher loads both external moment and internal loads increased significantly at L4-L5 level but with 45 knee flexion external moment and compression force increased and shear force decreased significantly (p < 0.05). Subjects made more effort to maintain stability of the body in squat position. The highest external moment and compression force were computed at flexed knee and trunk position with highest loads. Hence holding weight in this position must be avoided by implementing ergonomic change to the workplace.

Efficient vibration mode analysis of aircraft with multiple external store configurations

NASA Technical Reports Server (NTRS)

Karpel, M.

1988-01-01

A coupling method for efficient vibration mode analysis of aircraft with multiple external store configurations is presented. A set of low-frequency vibration modes, including rigid-body modes, represent the aircraft. Each external store is represented by its vibration modes with clamped boundary conditions, and by its rigid-body inertial properties. The aircraft modes are obtained from a finite-element model loaded by dummy rigid external stores with fictitious masses. The coupling procedure unloads the dummy stores and loads the actual stores instead. The analytical development is presented, the effects of the fictitious mass magnitudes are discussed, and a numerical example is given for a combat aircraft with external wing stores. Comparison with vibration modes obtained by a direct (full-size) eigensolution shows very accurate coupling results. Once the aircraft and stores data bases are constructed, the computer time for analyzing any external store configuration is two to three orders of magnitude less than that of a direct solution.

Effects of Preventative Ankle Taping on Planned Change-of-Direction and Reactive Agility Performance and Ankle Muscle Activity in Basketballers

PubMed Central

Jeffriess, Matthew D.; Schultz, Adrian B.; McGann, Tye S.; Callaghan, Samuel J.; Lockie, Robert G.

2015-01-01

This study investigated the effects of preventative ankle taping on planned change-of-direction and reactive agility performance and peak ankle muscle activity in basketballers. Twenty male basketballers (age = 22.30 ± 3.97 years; height = 1.84 ± 0.09 meters; body mass = 85.96 ± 11.88 kilograms) with no ankle pathologies attended two testing sessions. Within each session, subjects completed six planned and six reactive randomized trials (three to the left and three to the right for each condition) of the Y-shaped agility test, which was recorded by timing lights. In one session, subjects had both ankles un-taped. In the other, both ankles were taped using a modified subtalar sling. Peak tibialis anterior, peroneus longus (PL), peroneus brevis (PB), and soleus muscle activity was recorded for both the inside and outside legs across stance phase during the directional change, which was normalized against 10-meter sprint muscle activity (nEMG). Both the inside and outside cut legs during the change-of-direction step were investigated. Repeated measures ANOVA determined performance time and nEMG differences between un-taped and taped conditions. There were no differences in planned change-of-direction or reactive agility times between the conditions. Inside cut leg PL nEMG decreased when taped for the planned left, reactive left, and reactive right cuts (p = 0.01). Outside leg PB and soleus nEMG increased during the taped planned left cut (p = 0.02). There were no other nEMG changes during the cuts with taping. Taping did not affect change-of-direction or agility performance. Inside leg PL activity was decreased, possibly due to the tape following the line of muscle action. This may reduce the kinetic demand for the PL during cuts. In conclusion, ankle taping did not significantly affect planned change-of-direction or reactive agility performance, and did not demonstrate large changes in activity of the muscle complex in healthy basketballers. Key points Ankle taping using the modified subtalar sling will not affect planned change-of-direction or reactive agility performance as measured by the Y-shaped agility test in healthy male basketball players. Ankle taping using the modified subtalar sling will also generally not affect the activity of the muscles about the ankle. There was some indication for reductions in the activity of the PL in the inside leg of certain cuts. The tape used for the modified subtalar sling may have supported the line of action of the PL, which could reduce the kinetic demand placed on this muscle, and provide a potential fatigue-reducing component for cutting actions. The subtalar sling taping of the ankle in healthy basketball players did not have any adverse effects on the muscle activity of the ankle-foot complex during planned change-of-direction or reactive agility performance tasks. PMID:26664285

Buckling of Thin Cylindrical Shell Subject to Uniform External Pressure

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

Forasassi, G.; Lo Frano, R.

2006-07-01

The buckling of cylindrical shells under uniform external pressure loading has been widely investigated. In general, when tubes are subjected to external pressure, collapse is initiated by yielding, but interaction with instability is significant, in that imperfections associated with fabrication of shells reduce the load bearing capacity by a significant amount even when thickness is considerable. A specific buckling analysis is used to predict collapse failure of long pressure vessels and pipelines when they are subjected to external over-pressure. The problem of buckling for variable load conditions is relevant for the optimisation of several Nuclear Power Plant applications as, formore » instance, the IRIS (International Reactor Innovative and Secure) LWR integrated Steam Generator (SG) tubes. In this paper, we consider in addition to the usual assumptions of thin shell, homogeneous and isotropic material, also the tube geometric imperfections and plastic deformations that may affect the limit load. When all those conditions are considered at present, a complete theoretical analysis was not founding the literature. At Pisa University a research activity is being carried out on the buckling of thin walled metal specimen, with reference to several geometries and two different stainless steel materials. A test equipment (with the necessary data acquisition facility), suitable for carrying out many test on this issue, as well as numerical models implemented on the MARC FEM code, were set up. In this report, the results of the performed analyses of critical pressure load determination with different numerical and experimental approaches are presented. The numerical results obtained are compared with the experimental results, for the same geometry and loading conditions, showing a good agreement between these two approaches. (authors)« less

Ankle Joint Contact Loads and Displacement With Progressive Syndesmotic Injury.

PubMed

Hunt, Kenneth J; Goeb, Yannick; Behn, Anthony W; Criswell, Braden; Chou, Loretta

2015-09-01

Ligamentous injuries to the distal tibiofibular syndesmosis are predictive of long-term ankle dysfunction. Mild and moderate syndesmotic injuries are difficult to stratify, and the impact of syndesmosis injury on the magnitude and distribution of forces within the ankle joint during athletic activities is unknown. Eight below-knee cadaveric specimens were tested in the intact state and after sequential sectioning of the following ligaments: anterior-inferior tibiofibular, anterior deltoid (1 cm), interosseous/transverse (IOL/TL), posterior-inferior tibiofibular, and whole deltoid. In each condition, specimens were loaded in axial compression to 700 N and then externally rotated to 20 N·m torque. During axial loading and external rotation, both the fibula and the talus rotated significantly after each ligament sectioning as compared to the intact condition. After IOL/TL release, a significant increase in posterior translation of the fibula was observed, although no syndesmotic widening was observed. Mean tibiotalar contact pressure increased significantly after IOL/TL release, and the center of pressure shifted posterolaterally, relative to more stable conditions, after IOL/TL release. There were significant increases in mean contact pressure and peak pressure along with a reduction in contact area with axial loading and external rotation as compared to axial loading alone for all 5 conditions. Significant increases in tibiotalar contact pressures occur when external rotation stresses are added to axial loading. Moderate and severe injuries are associated with a significant increase in mean contact pressure combined with a shift in the center of pressure and rotation of the fibula and talus. Considerable changes in ankle joint kinematics and contact mechanics may explain why moderate syndesmosis injuries take longer to heal and are more likely to develop long-term dysfunction and, potentially, ankle arthritis. © The Author(s) 2015.

Synchronization of distributed power grids with the external loading system

NASA Astrophysics Data System (ADS)

Wei, Duqu; Mei, Chuncao

2018-06-01

In this paper, the synchronization between spatially distributed power plants and their supported consumers is studied, where the case of Kuramoto-like model power grids connected to an external permanent magnet synchronous motor (PMSM) is taken as an example. We focus on the dependence of the synchronization on the coupling coefficient. To quantitatively study the synchronization degree, we introduce the order parameter and the frequency deviation to measure the synchronization of the coupled system. It is found that as the external coupling coefficient is increased, the distributed power grids and the loading system become more and more synchronized in space, and the complete synchronization appears at a particular value of external coupling coefficient. Our results may provide a useful tip for analyzing the synchronous ability of distributed power grids.

Urinary Incontinence

MedlinePlus

... stress incontinence. The sling is either a narrow piece of synthetic (man-made) mesh or a piece of tissue from your own body that your ... the United States. World Journal of Urology; 20(6): 327–336. American College of Obstetricians and Gynecologists. ( ...

KSC-08pd1609

NASA Image and Video Library

2008-05-05

VANDENBERG AIR FORCE BASE, Calif. -- Workers on Space Launch Complex 2 at Vandenberg Air Force Base in California prepare to attach a sling crane onto the Delta II second stage. The sling will lift the second stage into the mobile service tower for installation on the first stage for launch of the OSTM/Jason-2 spacecraft. The OSTM, or Ocean Topography Mission, on the Jason-2 satellite is a follow-on to Jason-1. It will take oceanographic studies of sea surface height into an operational mode for continued climate forecasting research and science and industrial applications. This satellite altimetry data will help determine ocean circulation, climate change and sea-level rise. OSTM is a joint effort by the National Oceanic and Atmospheric Administration, NASA, France’s Centre National d’Etudes Spatiales and the European Meteorological Satellite Organisation. OSTM/Jason-2 will be launched on June 20. Photo credit: NASA

Return to driving after arthroscopic rotator cuff repair: patient-reported safety and maneuverability.

PubMed

Gholson, J Joseph; Lin, Albert; McGlaston, Timothy; DeAngelis, Joseph; Ramappa, Arun

2015-01-01

This survey investigated patients' return to driving after rotator cuff surgery, to determine whether pain, weakness, sling use, and narcotics correlate with self-assessed safety and maneuvering. Fifty-four patients (80.6% of those eligible) were surveyed 4 months after surgery. Return to driving ranged widely from same day to 4 months, with two not driving at 4 months; 12% reported narcotics use and 33% reported sling use. Drivers reporting weakness were more likely to feel unsafe (p = .02) and more likely to report difficulty maneuvering (p <.01). Drivers reporting pain were more likely to feel unsafe (p < .01) and more likely to report difficulty maneuvering their vehicle (p < .01). Patient-reported return to driving does not correspond to perceived safety; pain and weakness correspond with feeling unsafe and difficulty maneuvering. Although subjective, clinicians may find these self-assessments predictive when counseling patients on return to driving.

[Urinary incontinence].

PubMed

Kuhn, Annette

2010-01-01

Incontinence is a common age-dependent and increasing problem in women that may mainly present as stress incontinence, overactive bladder, mixed incontinence or other forms. A thorough history, gynaecological and neurological examination and urinalysis as initial step will lead to the diagnosis and treatment. If midstream urine is difficult to receive, a catheter urine will be easy to obtain. Further investigations as urodynamics, cystoscopy and ultrasound may be required. As initial step, stress incontinence should be treated with physiotherapy and pelvic floor exercises, if not successful with operations as suburethral slings. Slings have good long-term success rates of approximately 85 % with a low morbidity and can even be inserted under local anaesthetic. The treatment of idiopathic overactive bladder consists of bladder training, a behavioural therapy, and mainly anticholinergics. Anticholinergics may cause side effects particularly in the elderly who are under several medications that may add anticholinergic effects as antidepressants, antibiotics or antihistaminics.

Design and implementation of an external quality assessment program for HIV viral load measurements using dried blood spots.

PubMed

Prach, Lisa M; Puren, Adrian; Lippman, Sheri A; Carmona, Sergio; Stephenson, Sophie; Cutler, Ewalde; Barnhart, Scott; Liegler, Teri

2015-03-01

An external quality assurance program was developed for HIV-1 RNA viral load measurements taken from dried blood spots using a reference panel and field-collected specimens. The program demonstrated that accurate and reproducible quantitation can be obtained from field-collected specimens. Residual proviral DNA may confound interpretation in virologically suppressed subjects. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Transient Reactivation of a Deep-Seated Landslide by Undrained Loading Captured With Repeat Airborne and Terrestrial Lidar

NASA Astrophysics Data System (ADS)

Booth, Adam M.; McCarley, Justin; Hinkle, Jason; Shaw, Susan; Ampuero, Jean-Paul; Lamb, Michael P.

2018-05-01

Landslides reactivate due to external environmental forcing or internal mass redistribution, but the process is rarely documented quantitatively. We capture the three-dimensional, 1-m resolution surface deformation field of a transiently reactivated landslide with image correlation of repeat airborne lidar. Undrained loading by two debris flows in the landslide's head, rather than external forcing, triggered reactivation. After that loading, the lower 2 km of the landslide advanced by up to 14 m in 2 years before completely stopping. The displacement field over those 2 years implies that the slip surface gained 1 kPa of shear strength, which was likely accomplished by a negative dilatancy-pore pressure feedback as material deformed around basal roughness elements. Thus, landslide motion can be decoupled from external environmental forcing in cases, motivating the need to better understand internal perturbations to the stress field to predict hazards and sediment fluxes as landscapes evolve.

A theoretical derivation of the dilatancy equation for brittle rocks based on Maxwell model

NASA Astrophysics Data System (ADS)

Li, Jie; Huang, Houxu; Wang, Mingyang

2017-03-01

In this paper, the micro-cracks in the brittle rocks are assumed to be penny shaped and evenly distributed; the damage and dilatancy of the brittle rocks is attributed to the growth and expansion of numerous micro-cracks under the local tensile stress. A single crack's behaviour under the local tensile stress is generalized to all cracks based on the distributed damage mechanics. The relationship between the local tensile stress and the external loading is derived based on the Maxwell model. The damage factor corresponding to the external loading is represented using the p-alpha ( p- α) model. A dilatancy equation that can build up a link between the external loading and the rock dilatancy is established. A test of dilatancy of a brittle rock under triaxial compression is conducted; the comparison between experimental results and our theoretical results shows good consistency.

An analytical study of the effects of transverse shear deformation and anisotropy on buckling loads of laminated cylinders. M.S. Thesis - George Washington Univ.

NASA Technical Reports Server (NTRS)

Jegley, Dawn C.

1987-01-01

Buckling loads of thick-walled orthotropic and anisotropic simply supported circular cylinders are predicted using a higher-order transverse-shear deformation theory. A comparison of buckling loads predicted by the conventional first-order transverse-shear deformation theory and the higher-order theory show that the additional allowance for transverse shear deformation has a negligible effect on the predicted buckling loads of medium-thick metallic isotropic cylinders. However, the higher-order theory predicts buckling loads which are significantly lower than those predicted by the first-order transverse-shear deformation theory for certain short, thick-walled cylinders which have low through-the-thickness shear moduli. A parametric study of the effects of ply orientation on the buckling load of axially compressed cylinders indicates that laminates containing 45 degree plies are most sensitive to transverse-shear deformation effects. Interaction curves for buckling loads of cylinders subjected to axial compressive and external pressure loadings indicate that buckling loads due to external pressure loadings are as sensitive to transverse-shear deformation effects as buckling loads due to axial compressive loadings. The effects of anisotropy are important over a much wider range of cylinder geometries than the effects of transverse shear deformation.

Kinematic evaluation of patients with total and reverse shoulder arthroplasty during rehabilitation exercises with different loads.

PubMed

de Toledo, Joelly Mahnic; Loss, Jefferson Fagundes; Janssen, Thomas W; van der Scheer, Jan W; Alta, Tjarco D; Willems, W Jaap; Veeger, DirkJan H E J

2012-10-01

Following shoulder arthroplasty, any well-planned rehabilitation program should include muscle strengthening. However, it is not always clear how different external loads influence shoulder kinematics in patients with shoulder prostheses. The objective of this study was to describe shoulder kinematics and determine the contribution of the scapulothoracic joint to total shoulder motion of patients with total and reverse shoulder arthroplasties and of healthy individuals during rehabilitation exercises (anteflexion and elevation in the scapular plane) using different loading conditions (without external load, 1 kg and elastic resistance). Shoulder motions were measured using an electromagnetic tracking device. A force transducer was used to record force signals during loaded conditions using elastic resistance. Statistical comparisons were made using a three-way repeated-measures analysis of variance with a Bonferroni post hoc testing. The scapula contributed more to movement of the arm in subjects with prostheses compared to healthy subjects. The same applies for loaded conditions (1 kg and elastic resistance) relative to unloaded tasks. For scapular internal rotation, upward rotation and posterior tilt no significant differences among groups were found during both exercises. Glenohumeral elevation angles during anteflexion were significantly higher in the total shoulder arthroplasty group compared to the reverse shoulder arthroplasty group. Differences in contribution of the scapula to total shoulder motion between patients with different types of arthroplasties were not significant. However, compared to healthy subjects, they were. Furthermore, scapular kinematics of patients with shoulder arthroplasty was influenced by implementation of external loads, but not by the type of load. Copyright © 2012 Elsevier Ltd. All rights reserved.

Ring stability of underground toroidal tanks

NASA Astrophysics Data System (ADS)

Lubis, Asnawi; Su'udi, Ahmad

2017-06-01

The design of pressure vessels subjected to internal pressure is governed by its strength, while the design of pressure vessels subjected to external pressure is governed by its stability, which is for circular cross-section is called the ring stability. This paper presented the results of finite element study of ring stability of circular toroidal tank without stiffener under external pressure. The tank was placed underground and external pressure load from soil was simulated as pressure at the top of the vessel along 30° circumferentially. One might ask the reason for choosing toroidal rather than cylindrical tank. Preliminary finite element studies showed that toroidal shells can withstand higher external pressure than cylindrical shells. In this study, the volume of the tank was fixed for 15,000 litters. The buckling external pressure (pL) was calculated for radius ratio (R/r) of 2, 3, and 4. The corresponding cross-section radiuses were 724.3 mm, 632.7 mm, and 574.9 mm, respectively. The selected element type was SHELL 281 from the ANSYS element library. To obtain the buckling load, the arc-length method was used in the nonlinear analysis. Both material and geometric nonlinearities were activated during the analysis. The conclusion of this study is that short-radius and thin-walled toroidal shell produces higher buckling load.

Tensile testing grips ensure uniform loading of bimetal tubing specimens

NASA Technical Reports Server (NTRS)

Driscol, S. D.; Hunt, V.

1968-01-01

Tensile testing grip uniformly distributes stresses to the internal and external tube of bimetal tubing specimens. The grip is comprised of a slotted external tube grip, a slotted internal tube grip, a machine bolt and nut, an internal grip expansion cone, and an external grip compression nut.

Markov chain decision model for urinary incontinence procedures.

PubMed

Kumar, Sameer; Ghildayal, Nidhi; Ghildayal, Neha

2017-03-13

Purpose Urinary incontinence (UI) is a common chronic health condition, a problem specifically among elderly women that impacts quality of life negatively. However, UI is usually viewed as likely result of old age, and as such is generally not evaluated or even managed appropriately. Many treatments are available to manage incontinence, such as bladder training and numerous surgical procedures such as Burch colposuspension and Sling for UI which have high success rates. The purpose of this paper is to analyze which of these popular surgical procedures for UI is effective. Design/methodology/approach This research employs randomized, prospective studies to obtain robust cost and utility data used in the Markov chain decision model for examining which of these surgical interventions is more effective in treating women with stress UI based on two measures: number of quality adjusted life years (QALY) and cost per QALY. Treeage Pro Healthcare software was employed in Markov decision analysis. Findings Results showed the Sling procedure is a more effective surgical intervention than the Burch. However, if a utility greater than certain utility value, for which both procedures are equally effective, is assigned to persistent incontinence, the Burch procedure is more effective than the Sling procedure. Originality/value This paper demonstrates the efficacy of a Markov chain decision modeling approach to study the comparative effectiveness analysis of available treatments for patients with UI, an important public health issue, widely prevalent among elderly women in developed and developing countries. This research also improves upon other analyses using a Markov chain decision modeling process to analyze various strategies for treating UI.

Trends in surgical management and pre-operative urodynamics in female medicare beneficiaries with mixed incontinence.

PubMed

Chughtai, Bilal; Hauser, Nicholas; Anger, Jennifer; Asfaw, Tirsit; Laor, Leanna; Mao, Jialin; Lee, Richard; Te, Alexis; Kaplan, Steven; Sedrakyan, Art

2017-02-01

We sought to examine the surgical trends and utilization of treatment for mixed urinary incontinence among female Medicare beneficiaries. Data was obtained from a 5% national random sample of outpatient and carrier claims from 2000 to 2011. Included were female patients 65 and older, diagnosed with mixed urinary incontinence, who underwent surgical treatment identified by Current Procedural Terminology, Fourth Edition (CPT-4) codes. Urodynamics (UDS) before initial and secondary procedure were also identified using CPT-4 codes. Procedural trends and utilization of UDS were analyzed. Utilization of UDS increased during the study period, from 38.4% to 74.0% prior to initial surgical intervention, and from 28.6% to 62.5% preceding re-intervention. Sling surgery (63.0%) and injectable bulking agents (28.0%) were the most common surgical treatments adopted, followed by sacral nerve stimulation (SNS) (4.8%) and Burch (4.0%) procedures. Re-intervention was performed in 4.0% of patients initially treated with sling procedures and 21.3% of patients treated with bulking agents, the majority of whom (51.7% and 76.3%, respectively) underwent injection of a bulking agent. Risk of re-intervention was not different among those who did or did not receive urodynamic tests prior to the initial procedure (8.5% vs. 9.3%) CONCLUSIONS: Sling and bulk agents are the most common treatment for MUI. Preoperative urodynamic testing was not related to risk of re-intervention following surgery for mixed urinary incontinence in this cohort. Neurourol. Urodynam. 36:422-425, 2017. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.

[Approach and complications associated with suburethral synthetic slings in women: Systematic review and meta-analysis].

PubMed

Biardeau, X; Zanaty, M; Aoun, F; Benbouzid, S; Peyronnet, B

2016-03-01

We aim to assess the complications associated with different approaches used in female suburethral sling surgery. We performed a research on Medline using the following keywords: "suburethral slings", "complications", "safety" and "randomized". Only randomized clinical trials including women and reporting intra- and postoperative complications associated with the retropubic (RP) approach; TOT and/or TVT-O were included. The meta-analysis was conducted using the Review Manager (RevMan 5.3) software delivered by the "Cochrane Library". Out of 176 articles, 23 were included in synthesis. Risks of bladder perforation during surgery (60/1482 vs 5/1479; OR=6.44; 95% CI [3.32-12.50]) and postoperative urinary retention (48/1160 vs 24/1159; OR=1.93; 95% CI [1.26-3.12]) were significantly higher with the RP approach, when compared with the transobturator (TO) approach (TOT or TVT-O). Conversely, the risk of prolonged postoperative pain was significantly lower after RP approach, when compared with TO approach (24/1156 vs 69/1149; OR=0.36; 95% CI [0.23-0.56]). Risks of intraoperative urethral injury, postoperative erosion and de novo overactive bladder were comparable between the two approaches. Data regarding the comparison between TOT and TVT-O were scarce and did not allow us to conclude about complications associated with. The RP approach was associated with a significant risk of bladder perforation and postoperative urinary retention. The TO approach was associated with a higher risk of prolonged postoperative pain. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Mini-invasive techniques for the treatment of female stress urinary incontinence.

PubMed

Vianello, A; Costantini, E; Del Zingaro, M; Porena, M

2007-12-01

The aim of this study was to review recent literature on mini-invasive surgical technique for the treatment of female stress urinary incontinence (SUI). Surgical aspects, intraoperative and perioperative complications and objective and subjective outcomes were analyzed and compared. The PubMed databank from 2000 to February 2007 was searched for original prospective and randomized studies in English, on surgical treatment of female SUI, which avoided a laparotomic access to the female pelvis. Studies had to investigate at least 40 women with a minimum follow-up of 12 months. A total of 38 prospective studies were found: 27 of them were on mid-urethral slings; 8 assessed urethral injections; and 3 radiofrequency treatment. Fifteen studies were randomized. Follow-ups ranged from 12 to 60 months, except for sexual function which had a 6-month follow-up. Ten out of 38 studies assessed patients who did not refer pelvic organ prolapse or detrusor overactivity and had not undergone any previous anti-incontinence procedure. Mid-urethral slings showed good outcomes and are safe and brief to perform and have a relatively short learning curve. Urethral injections showed discouraging results, as they have poor outcomes and repetitive treatments are frequently necessary. Injections can be used in women with contraindications to major surgical procedures, with intrinsic sphincter deficiency as the main cause of incontinence. Radiofrequency showed worse results than mid-urethral slings and is a valuable choice in women who refuse more invasive procedures. The development of studies with longer follow-ups on mini-invasive surgical techniques are encouraged.

Use of 3D models of vascular rings and slings to improve resident education.

PubMed

Jones, Trahern W; Seckeler, Michael D

2017-09-01

Three-dimensional (3D) printing is a manufacturing method by which an object is created in an additive process, and can be used with medical imaging data to generate accurate physical reproductions of organs and tissues for a variety of applications. We hypothesized that using 3D printed models of congenital cardiovascular lesions to supplement an educational lecture would improve learners' scores on a board-style examination. Patients with normal and abnormal aortic arches were selected and anonymized to generate 3D printed models. A cohort of pediatric and combined pediatric/emergency medicine residents were then randomized to intervention and control groups. Each participant was given a subjective survey and an objective board-style pretest. Each group received the same 20-minutes lecture on vascular rings and slings. During the intervention group's lecture, 3D printed physical models of each lesion were distributed for inspection. After each lecture, both groups completed the same subjective survey and objective board-style test to assess their comfort with and postlecture knowledge of vascular rings. There were no differences in the basic demographics of the two groups. After the lectures, both groups' subjective comfort levels increased. Both groups' scores on the objective test improved, but the intervention group scored higher on the posttest. This study demonstrated a measurable gain in knowledge about vascular rings and pulmonary artery slings with the addition of 3D printed models of the defects. Future applications of this teaching modality could extend to other congenital cardiac lesions and different learners. © 2017 Wiley Periodicals, Inc.

On the Stiffness of the Mesh and Urethral Mobility: A Finite Element Analysis.

PubMed

Brandão, Sofia; Parente, Marco; Da Roza, Thuane Huyer; Silva, Elisabete; Ramos, Isabel Maria; Mascarenhas, Teresa; Natal Jorge, Renato Manuel

2017-08-01

Midurethral slings are used to correct urethral hypermobility in female stress urinary incontinence (SUI), defined as the complaint of involuntary urine leakage when the intra-abdominal pressure (IAP) is increased. Structural and thermal features influence their mechanical properties, which may explain postoperative complications, e.g., erosion and urethral obstruction. We studied the effect of the mesh stiffness on urethral mobility at Valsalva maneuver, under impairment of the supporting structures (levator ani and/or ligaments), by using a numerical model. For that purpose, we modeled a sling with "lower" versus "higher" stiffness and evaluated the mobility of the bladder and urethra, that of the urethrovesical junction (the α-angle), and the force exerted at the fixation of the sling. The effect of impaired levator ani or pubourethral ligaments (PUL) alone on the organs displacement and α-angle opening was similar, showing their important role together on urethral stabilization. When the levator ani and all the ligaments were simulated as impaired, the descent of the bladder and urethra went up to 25.02 mm, that of the bladder neck was 14.57 mm, and the α-angle was 129.7 deg, in the range of what was found in women with SUI. Both meshes allowed returning to normal positioning, although at the cost of higher force exerted by the mesh with higher stiffness (3.4 N against 2.3 N), which can relate to tissue erosion. This finite element analysis allowed mimicking the biomechanical response of the pelvic structures in response to changing a material property of the midurethral synthetic mesh.

Breast reconstruction with absorbable mesh sling: dynamic infrared thermography of skin envelope

PubMed Central

Hashimoto, Yoko; Yuasa, Takeshi; Suzuki, Yoshinori; Saisho, Hiroshi

2017-01-01

Background To immediate reconstruct ptosis breasts, we used polyglactin (Vicryl; Ethicon Inc., Somerville, NJ, USA) mesh as an inferolateral sling. However, Vicryl mesh is absorbable and losing function as a supporting structure. We doubt about the stability of the blood supply to the inferior part of the flap when it is in direct contact with inner implant. In this study, we examine the complications and the safety of the skin flap of this absorbable mesh sling (AMS) procedure. Methods The outcomes of 80 cases were examined, and the 1-year safety record of 40 cases was assessed. Complications were divided into minor complications, major complications requiring surgical intervention, and major complications requiring the reconstructive surgery to be halted. In addition, we examined the blood perfusion of the skin flap by dynamic infrared thermography (DIRT). Results Among 80 patients with AMS procedure, 73 breasts were reconstructed immediately and in one-stage. Complication outcomes are presented; there were 4 cases of minor flap necrosis (5%) and 4 of major complications resulting in surgical correction (5%). One patient required additional surgery, and the implant was moved into the musculocutaneous flap (1.3%). In 40 patients 1 year after surgery, DIRT showed significant decreased of blood perfusion in the ipsilateral inferior sites in comparison with the superior sites. Conclusions Blood perfusion was comparably insufficient in the inferior area of the reconstructed breast mound with AMS, where the pectoralis muscle could not be used to line the inside of the envelope. However, there were no severe flap complications due to ischemia. PMID:28210555

Elastic-Plastic Nonlinear Response of a Space Shuttle External Tank Stringer. Part 2; Thermal and Mechanical Loadings

NASA Technical Reports Server (NTRS)

Knight, Norman F., Jr.; Warren, Jerry E.; Elliott, Kenny B.; Song, Kyongchan; Raju, Ivatury S.

2012-01-01

Elastic-plastic, large-deflection nonlinear thermo-mechanical stress analyses are performed for the Space Shuttle external tank s intertank stringers. Detailed threedimensional finite element models are developed and used to investigate the stringer s elastic-plastic response for different thermal and mechanical loading events from assembly through flight. Assembly strains caused by initial installation on an intertank panel are accounted for in the analyses. Thermal loading due to tanking was determined to be the bounding loading event. The cryogenic shrinkage caused by tanking resulted in a rotation of the intertank chord flange towards the center of the intertank, which in turn loaded the intertank stringer feet. The analyses suggest that the strain levels near the first three fasteners remain sufficiently high that a failure may occur. The analyses also confirmed that the installation of radius blocks on the stringer feet ends results in an increase in the stringer capability.

Validation of a dynamic linked segment model to calculate joint moments in lifting.

PubMed

de Looze, M P; Kingma, I; Bussmann, J B; Toussaint, H M

1992-08-01

A two-dimensional dynamic linked segment model was constructed and applied to a lifting activity. Reactive forces and moments were calculated by an instantaneous approach involving the application of Newtonian mechanics to individual adjacent rigid segments in succession. The analysis started once at the feet and once at a hands/load segment. The model was validated by comparing predicted external forces and moments at the feet or at a hands/load segment to actual values, which were simultaneously measured (ground reaction force at the feet) or assumed to be zero (external moments at feet and hands/load and external forces, beside gravitation, at hands/load). In addition, results of both procedures, in terms of joint moments, including the moment at the intervertebral disc between the fifth lumbar and first sacral vertebra (L5-S1), were compared. A correlation of r = 0.88 between calculated and measured vertical ground reaction forces was found. The calculated external forces and moments at the hands showed only minor deviations from the expected zero level. The moments at L5-S1, calculated starting from feet compared to starting from hands/load, yielded a coefficient of correlation of r = 0.99. However, moments calculated from hands/load were 3.6% (averaged values) and 10.9% (peak values) higher. This difference is assumed to be due mainly to erroneous estimations of the positions of centres of gravity and joint rotation centres. The estimation of the location of L5-S1 rotation axis can affect the results significantly. Despite the numerous studies estimating the load on the low back during lifting on the basis of linked segment models, only a few attempts to validate these models have been made. This study is concerned with the validity of the presented linked segment model. The results support the model's validity. Effects of several sources of error threatening the validity are discussed. Copyright © 1992. Published by Elsevier Ltd.

The effects of loaded and unloaded high-velocity resistance training on functional fitness among community-dwelling older adults.

PubMed

Glenn, Jordan M; Gray, Michelle; Binns, Ashley

2015-11-01

Physical function declines up to 4% per year after the age of 65. High-velocity training is important for maintaining muscular power and ultimately, physical function; however, whether performing high-velocity training without external resistance increases functional fitness among older adults remains unclear. The purpose of this investigation was to evaluate loaded and unloaded high-velocity training on lower body muscular power and functional fitness in older adults. Fifty-seven community-dwelling older adults (n = 16 males, n = 41 females) participated in this study. Inclusion criteria comprised ≥65 years of age, ≥24 on the Mini-mental state examination and no falls within past year. Two groups completed a 20-week high-velocity training intervention. The non-weighted group (UNLOAD, n = 27) performed the protocol without external load while the intervention group (LOAD, n = 30) used external loads via exercise machines. Functional fitness was assessed using the Short Physical Performance Battery (SPPB), Senior Fitness Test (SFT), hand-grip and lower body power measures. Multivariate ANOVA revealed that both groups had significant improvements for average (17.21%) and peak (9.26%) lower body power, along with the SFT arm curl (16.94%), chair stand (20.10%) and 8 ft. up-and-go (15.67%). Improvements were also noticed for SPPB 8 ft. walk (25.21%). However, improvements for all functional fitness measures were independent of training group. Unloaded high-velocity training increased functional fitness and power the same as loaded training. The ability of high-velocity movements to elicit gains in functional fitness without external loads may help health professionals develop fitness programs when time/space is limiting factor. © The Author 2015. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The effect of external coaptation on plate deformation in an ex vivo model of canine pancarpal arthrodesis.

PubMed

Woods, S; Wallace, R J; Mosley, J R

2012-01-01

Since external coaptation is applied clinically to prevent plate failure during healing in canine pancarpal arthrodesis (PCA), we tested the hypothesis that external coaptation does not significantly reduce plate strain in an experimental ex vivo model of canine PCA. Ten thoracic limbs from healthy Greyhounds euthanatized for reasons un- related to the study were harvested and the carpus was stabilised with a dorsally applied 2.7/3.5 mm hybrid PCA plate. The strain in the plate adjacent to the most distal radial screw hole (R4) and the radial carpal bone (RCB) screw hole was measured as the limbs were loaded axially to a load that approximated that of controlled walking. Each limb was tested with and without external coaptation in place. Mean strain amplitude at the RCB was -177.2 με (± 20.78) without external coaptation. Following cast application, strain reduced significantly to -34.7 με (± 9.84) (p <0.002). Mean strain at R4 was -89.4 με (± 22.10) without external support and -66.9 με (± 10.74) following application of a cast. This reduction in recorded strain was not statistically significant. The application of a cast to the distal portion of the limb significantly reduced strain in the 2.7/3.5 mm hybrid PCA plate, but the magnitude of the measured strain was low, suggesting that fatigue damage is unlikely to accumulate as a result of this type of loading and that external coaptation may not be necessary to prevent fatigue failure of the plate.

Male synthetic sling versus artificial urinary sphincter trial for men with urodynamic stress incontinence after prostate surgery (MASTER): study protocol for a randomised controlled trial.

PubMed

Constable, Lynda; Cotterill, Nikki; Cooper, David; Glazener, Cathryn; Drake, Marcus J; Forrest, Mark; Harding, Chris; Kilonzo, Mary; MacLennan, Graeme; McCormack, Kirsty; McDonald, Alison; Mundy, Anthony; Norrie, John; Pickard, Robert; Ramsay, Craig; Smith, Rebecca; Wileman, Samantha; Abrams, Paul

2018-02-21

Stress urinary incontinence (SUI) is a frequent adverse effect for men undergoing prostate surgery. A large proportion (around 8% after radical prostatectomy and 2% after transurethral resection of prostate (TURP)) are left with severe disabling incontinence which adversely effects their quality of life and many are reliant on containment measures such as pads (27% and 6% respectively). Surgery is currently the only option for active management of the problem. The overwhelming majority of surgeries for persistent bothersome SUI involve artificial urinary sphincter (AUS) insertion. However, this is expensive, and necessitates manipulation of a pump to enable voiding. More recently, an alternative to AUS has been developed - a synthetic sling for men which elevates the urethra, thus treating SUI. This is thought, by some, to be less invasive, more acceptable and less expensive than AUS but clear evidence for this is lacking. The MASTER trial aims to determine whether the male synthetic sling is non-inferior to implantation of the AUS for men who have SUI after prostate surgery (for cancer or benign disease), judged primarily on clinical effectiveness but also considering relative harms and cost-effectiveness. Men with urodynamic stress incontinence (USI) after prostate surgery, for whom surgery is judged appropriate, are the target population. We aim to recruit men from secondary care urological centres in the UK NHS who carry out surgery for post-prostatectomy incontinence. Outcomes will be assessed by participant-completed questionnaires and 3-day urinary bladder diaries at baseline, 6, 12 and 24 months. The 24-h urinary pad test will be used at baseline as an objective assessment of urine loss. Clinical data will be completed at the time of surgery to provide details of the operative procedures, complications and resource use in hospital. At 12 months, men will also have a clinical review to evaluate the results of surgery (including another 24-h pad test) and to identify problems or need for further treatment. A robust examination of the comparative effectiveness of the male synthetic sling will provide high-quality evidence to determine whether or not it should be adopted widely in the NHS. International Standard Randomised Controlled Trial Registry: Number ISRCTN49212975 . Registered on 22 July 2013. First patient randomised on 29 January 2014.

Quantitative Structure – Property Relationship Modeling of Remote Liposome Loading Of Drugs

PubMed Central

Cern, Ahuva; Golbraikh, Alexander; Sedykh, Aleck; Tropsha, Alexander; Barenholz, Yechezkel; Goldblum, Amiram

2012-01-01

Remote loading of liposomes by trans-membrane gradients is used to achieve therapeutically efficacious intra-liposome concentrations of drugs. We have developed Quantitative Structure Property Relationship (QSPR) models of remote liposome loading for a dataset including 60 drugs studied in 366 loading experiments internally or elsewhere. Both experimental conditions and computed chemical descriptors were employed as independent variables to predict the initial drug/lipid ratio (D/L) required to achieve high loading efficiency. Both binary (to distinguish high vs. low initial D/L) and continuous (to predict real D/L values) models were generated using advanced machine learning approaches and five-fold external validation. The external prediction accuracy for binary models was as high as 91–96%; for continuous models the mean coefficient R2 for regression between predicted versus observed values was 0.76–0.79. We conclude that QSPR models can be used to identify candidate drugs expected to have high remote loading capacity while simultaneously optimizing the design of formulation experiments. PMID:22154932

Internal and External Match Loads of University-Level Soccer Players: A Comparison Between Methods.

PubMed

Sparks, Martinique; Coetzee, Ben; Gabbett, Tim J

2017-04-01

Sparks, M, Coetzee, B, and Gabbett, TJ. Internal and external match loads of university-level soccer players: a comparison between methods. J Strength Cond Res 31(4): 1072-7077, 2017-The aim of this study was to use individualized intensity zones to compare the external (velocity and player load, PL) and internal loads (heart rate, HR) of a cohort of university-level soccer players. Thirteen soccer players completed a 40-m maximum speed test and the Yo-Yo intermittent recovery test 1 (Yo-Yo IR1) to determine individualized velocity and HR thresholds. Heart rate values and global positioning system (GPS) data of each player were recorded during 5 league matches. A large (r = 0.46; p ≤ 0.01) correlation was found between time spent in the low-intensity (LI) velocity zone (LIVZ) and the LI HR zone. Similarly, there were moderate (r = 0.25; p ≤ 0.01) to large (r = 0.57; p ≤ 0.01) correlations between the relative and absolute time spent in the moderate-intensity (MI) velocity zone (MIVZ) and the MI HR zone. No significant correlations (p ≤ 0.01) existed between the high-intensity (HI) velocity zones (HIVZ) and the HI HR zone. On the other hand, PL showed significant correlations with all velocity and HR (absolute and relative) variables, with the exception of a nonsignificant correlation between the HI HR variables and PL. To conclude, PL showed good correlations with both velocity and HR zones and therefore may have the potential to serve as a good indicator of both external and internal soccer match loads.

A loose bolt delays loading of Endeavour's external tank

NASA Technical Reports Server (NTRS)

2000-01-01

This view shows the pipe (center top) leading toward Endeavour from the side of the White Room at Launch Pad 39B. A loose bracket observed hanging down from the pipe delayed loading of Endeavour's external tank by several hours to allow technicians to remove it. A 'U' bolt connects the bracket to a fire suppression water line attached to the exterior of the White Room. The loose bolt could have possibly created a debris hazard.

Unique considerations in the design and experimental evaluation of tailored wings with elastically produced chordwise camber

NASA Technical Reports Server (NTRS)

Rehfield, Lawrence W.; Zischka, Peter J.; Fentress, Michael L.; Chang, Stephen

1992-01-01

Some of the unique considerations that are associated with the design and experimental evaluation of chordwise deformable wing structures are addressed. Since chordwise elastic camber deformations are desired and must be free to develop, traditional rib concepts and experimental methodology cannot be used. New rib design concepts are presented and discussed. An experimental methodology based upon the use of a flexible sling support and load application system has been created and utilized to evaluate a model box beam experimentally. Experimental data correlate extremely well with design analysis predictions based upon a beam model for the global properties of camber compliance and spanwise bending compliance. Local strain measurements exhibit trends in agreement with intuition and theory but depart slightly from theoretical perfection based upon beam-like behavior alone. It is conjectured that some additional refinement of experimental technique is needed to explain or eliminate these (minor) departures from asymmetric behavior of upper and lower box cover strains. Overall, a solid basis for the design of box structures based upon the bending method of elastic camber production has been confirmed by the experiments.

Acromioclavicular joint dislocations: coracoclavicular reconstruction with and without additional direct acromioclavicular repair.

PubMed

Weiser, Lukas; Nüchtern, Jakob V; Sellenschloh, Kay; Püschel, Klaus; Morlock, Michael M; Rueger, Johannes M; Hoffmann, Michael; Lehmann, Wolfgang; Großterlinden, Lars G

2017-07-01

To evaluate different stabilisation techniques for acromioclavicular (AC) joint separations, including direct AC repair, and to compare the properties of the stabilised and native joints. An established in vitro testing model for the AC joint was used to analyse joint stability after surgical reconstruction [double TightRope (DTR), DTR with AC repair (DTR + AC), single TR with AC repair (TR + AC), and PDS sling with AC repair (PDS + AC)]. Twenty-four human cadaveric shoulders were randomised by age into four testing groups. Joint stiffness was measured by applying an axial load during defined physiological ranges of motion. Similar tests were performed for the native joints, after dissecting the coracoclavicular and AC ligaments, and after surgical reconstruction. Cyclic loading was performed for 1000 cycles with 20-70 N and vertical load to failure determined after cyclic testing. Axial stiffness for all TR groups was significantly higher than for the native joint (DTR 38.94 N/mm, p = 0.005; DTR + AC 37.79 N/mm, p = 0.015; TR + AC 45.61 N/mm, p < 0.001 vs. native 26.05 N/mm). The axial stiffness of the PDS + AC group was similar to that of the native joint group (21.4 N/mm, n.s.). AC repair did not significantly influence rotational stiffness. Load to failure was similar and >600 N in all groups (n.s.). Reconstruction of AC dislocations with one or two TRs leads to stable results with a higher stiffness than the native joints. For the PDS + AC group, axial stiffness was similar to the native situation, although there might be a risk of elongation. Direct AC repair showed no significantly increased stability in comparison with reconstructions without direct AC repair. Thus, a direct AC repair seems to be dispensable in clinical practice, while TRs or PDS cerclages appear to provide sufficiently stable results.

The Financial Sector and Sustainable Development

NASA Astrophysics Data System (ADS)

Rusko, Miroslav; Korauš, Anton

2010-01-01

Growing load and deterioration of the environment can be interpreted as a result of some external effects interventions. While the positive externalities influence the positive productional and utilizational functions of other subjects, the negative externalities influence the negative ones. Both types of external effects can act as parcial or global externalities. Linking the environmental issues to economy and finance is an important sphere. Coimplementation of both marketing and environmental audits is an important element of this sphere too.

14 CFR 133.47 - Rotorcraft-load combination flight manual.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... 133.47 Section 133.47 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF... ROTORCRAFT EXTERNAL-LOAD OPERATIONS Airworthiness Requirements § 133.47 Rotorcraft-load combination flight... been demonstrated in accordance with §§ 133.41 and 133.43; and (c) In the information section of the...

Biomechanical comparison of supraacetabular external fixation and anterior pelvic bridge plating.

PubMed

Çavuşoğlu, Ali Turgay; Erbay, Fatma Kübra; Özsoy, Mehmet Hakan; Demir, Teyfik

2017-10-01

Unstable pelvic ring injuries are complex and risky injuries due to high morbidity and mortality. Although anterior pelvic external fixator is a suitable method for rapid stabilization of an injured pelvic ring, due to some disadvantages such as high complication rate, nerve damage, and difficulties of patient's mobility and comfort, there has recently been increased searching for alternative methods for stabilization of the pelvic ring. Pubic symphysis zone freely moves in pelvic models. This study aims to evaluate the biomechanical stability of anterior pelvic bridge plating and compare it with supraacetabular external fixators in an untreated unstable pelvic fracture model. Samples were loaded statically with 2-mm/min loading rate in single leg standing position. Maximum load was 2.3 kN. When loading the samples, photographs were taken continuously. Stiffness values were calculated from the load displacement curves. Some reference parameters were described and were measured from unloaded and 2.3-kN-loaded photographs of the test. The mean stiffness values were 491.14 ± 52.22, 478.55 ± 41.44, and 470.25 ± 44.51 N/mm for anterior pelvic bridge plating group, supraacetabular external fixator group, and Control group, respectively. According to the measured parameters from photographs, the mean displacement at the pubic symphysis was 4.7 ± 0.32, 15.8 ± 2.01, and 18.2 ± 0.47 mm for anterior pelvic bridge plating, supraacetabular external fixator, and Control group, respectively. The highest displacement in the pubic symphysis was found in Control group, and minimum displacement was observed in anterior pelvic bridge plating group. When the perpendicular distance between the right and left lower end of ischium was examined, it was observed that displacement was minimum in anterior pelvic bridge plating group compared to other two groups, regarding to the high stability of pubic symphysis. In conclusion, this study revealed superiority of anterior subcutaneous plate fixation with biomechanical results.

Effect of cyclic load on vertical misfit of prefabricated and cast implant single abutment

PubMed Central

DE JESUS TAVAREZ, Rudys Rodolfo; BONACHELA, Wellington Cardoso; XIBLE, Anuar Antônio

2011-01-01

Objective The purpose of this in vitro study was to evaluate misfit alterations at the implant/abutment interface of external and internal connection implant systems when subjected to cyclic loading. Material and Methods Standard metal crowns were fabricated for 5 groups (n=10) of implant/abutment assemblies: Group 1, external hexagon implant and UCLA cast-on premachined abutment; Group 2, internal hexagon implant and premachined abutment; Group 3, internal octagon implant and prefabricated abutment; Group 4, external hexagon implant and UCLA cast-on premachined abutment; and Group 5, external hexagon implant and Ceraone abutment. For groups 1, 2, 3 and 5, the crowns were cemented on the abutments and in group 4 crowns were screwed directly on the implant. The specimens were subjected to 500,000 cycles at 19.1 Hz of frequency and non-axial load of 133 N in a MTS 810 machine. The vertical misfit (μm) at the implant/abutment interface was evaluated before (B) and after (A) application of the cyclic loading. Data were analyzed statistically by using two-away ANOVA and Tukey’s post-hoc test (p<0.05). Results Before loading values showed no difference among groups 2 (4.33±3.13), 3 (4.79±3.43) and 5 (3.86±4.60); between groups 1 (12.88±6.43) and 4 (9.67±3.08), and among groups 2, 3 and 4. However, groups 1 and 4 were significantly different from groups 2, 3 and 5. After loading values of groups 1 (17.28±8.77) and 4 (17.78±10.99) were significantly different from those of groups 2 (4.83±4.50), 3 (8.07±4.31) and 5 (3.81±4.84). There was a significant increase in misfit values of groups 1, 3 and 4 after cyclic loading, but not for groups 2 and 5. Conclusion The cyclic loading and type of implant/abutment connection may develop a role on the vertical misfit at the implant/abutment interface. PMID:21437464

Dislocations - Multiple Languages

MedlinePlus

... Shoulder Sling - العربية (Arabic) Bilingual PDF Health Information Translations Chinese, Simplified (Mandarin dialect) (简体中文) Expand Section Wearing ... Chinese, Simplified (Mandarin dialect)) Bilingual PDF Health Information Translations Chinese, Traditional (Cantonese dialect) (繁體中文) Expand Section Wearing ...

Female Longitudinal Anal Muscles or Conjoint Longitudinal Coats Extend into the Subcutaneous Tissue along the Vaginal Vestibule: A Histological Study Using Human Fetuses

PubMed Central

Arakawa, Takashi; Abe, Hiroshi; Rodríguez-Vízquez, Jose Francisco; Murakami, Gen; Sugihara, Kenichi

2013-01-01

Purpose It is still unclear whether the longitudinal anal muscles or conjoint longitudinal coats (CLCs) are attached to the vagina, although such an attachment, if present, would appear to make an important contribution to the integrated supportive system of the female pelvic floor. Materials and Methods Using immunohistochemistry for smooth muscle actin, we examined semiserial frontal sections of 1) eleven female late-stage fetuses at 28-37 weeks of gestation, 2) two female middle-stage fetus (2 specimens at 13 weeks), and, 3) six male fetuses at 12 and 37 weeks as a comparison of the morphology. Results In late-stage female fetuses, the CLCs consistently (11/11) extended into the subcutaneous tissue along the vaginal vestibule on the anterior side of the external anal sphincter. Lateral to the CLCs, the external anal sphincter also extended anteriorly toward the vaginal side walls. The anterior part of the CLCs originated from the perimysium of the levator ani muscle without any contribution of the rectal longitudinal muscle layer. However, in 2 female middle-stage fetuses, smooth muscles along the vestibulum extended superiorly toward the levetor ani sling. In male fetuses, the CLCs were separated from another subcutaneous smooth muscle along the scrotal raphe (posterior parts of the dartos layer) by fatty tissue. Conclusion In terms of topographical anatomy, the female anterior CLCs are likely to correspond to the lateral extension of the perineal body (a bulky subcutaneous smooth muscle mass present in adult women), supporting the vaginal vestibule by transmission of force from the levator ani. PMID:23549829

Loading and concurrent synchronous whole-body vibration interaction increases oxygen consumption during resistance exercise.

PubMed

Serravite, Daniel H; Edwards, David; Edwards, Elizabeth S; Gallo, Sara E; Signorile, Joseph F

2013-01-01

Exercise is commonly used as an intervention to increase caloric output and positively affect body composition. A major challenge is the low compliance often seen when the prescribed exercise is associated with high levels of exertion. Whole-body vibration (WBV) may allow increased caloric output with reduced effort; however, there is limited information concerning the effect of WBV on oxygen consumption (VO2). Therefore, this study assessed the synergistic effects of resistance training and WBV on VO2. We examined VO2 at different loads (0%, 20%, and 40% body weight (BW)) and vibration intensities (No vibration (NV), 35HZ, 2-3mm (35L), 50Hz, 57mm (50H)) in ten men (26.5 ± 5.1 years). Data were collected during different stages (rest, six 30s sets of squatting, and recovery). Repeated measures ANOVA showed a stage x load x vibration interaction. Post hoc analysis revealed no differences during rest; however, a significant vibration x load interaction occurred during exercise. Both 35L and 50H produced greater VO2 than NV at a moderate load of 20%BW. Although 40%BW produced greater VO2 than 20%BW or 0%BW using NV, no significant difference in VO2 was seen among vibratory conditions at 40%BW. Moreover, no significant differences were seen between 50H and 35L at 20%BW and NV at 40%BW. During recovery there was a main effect for load. Post hoc analyses revealed that VO2 at 40%BW was significantly higher than 20%BW or 0%BW, and 20%BW produced higher VO2 than no load. Minute-by-minute analysis revealed a significant impact on VO2 due to load but not to vibratory condition. We conclude that the synergistic effect of WBV and active squatting with a moderate load is as effective at increasing VO2 as doubling the external load during squatting without WBV. Key PointsSynchronous whole body vibration in conjunction with moderate external loading (app 20% BW) can increase oxygen consumption to the same extent as heavier loading (40% BW) during performance of the parallel squat.While the application of synchronous whole body vibration had no effect on recovery oxygen, under bot vibratory and non-vibratory conditions, the heavier the external load the greater the recovery oxygen consumption levels.Regardless of vibratory condition, during the squatting exercise bout 40% BW produced higher heart rates than 20%BW or 0% BW, and 20% BW produced higher heart rates than 0% BW.There were strong trends toward higher heart rates in both vibratory conditions (50 Hz, 5-6mm; 35 Hz, 2-3 mm) than in the non-vibratory condition regardless of external loading.

Learning STEM through Integrative Visual Representations

ERIC Educational Resources Information Center

Virk, Satyugjit Singh

2013-01-01

Previous cognitive models of memory have not comprehensively taken into account the internal cognitive load of chunking isolated information and have emphasized the external cognitive load of visual presentation only. Under the Virk Long Term Working Memory Multimedia Model of cognitive load, drawing from the Cowan model, students presented with…

14 CFR 25.365 - Pressurized compartment loads.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Pressurized compartment loads. For airplanes with one or more pressurized compartments the following apply: (a... differential loads from zero up to the maximum relief valve setting. (b) The external pressure distribution in... zero up to the maximum allowed during landing. (d) The airplane structure must be designed to be able...

Spherical shells buckling to the sound of music

NASA Astrophysics Data System (ADS)

Lee, Anna; Marthelot, Joel; Reis, Pedro

We study how the critical buckling load of spherical elastic shells can be modified by a fluctuating external pressure field. In our experiments, we employ thin elastomeric shells of nearly uniform thickness fabricated by the coating of a hemispherical mold with a polymer solution, which upon curing yields elastic structures. A shell is submerged in a water bath and loaded quasi-statically until buckling occurs by reducing its inner volume with a syringe pump. Simultaneously, a plunger connected to an electromagnetic shaker is placed above the shell and driven sinusoidally to create a fluctuating external pressure field that can excite dynamic vibration modes of the shell. These dynamic modes induce effective compressive stresses, in addition to those from the inner pressure loading, which can modify the critical conditions for the onset of buckling. We systematically quantify how the frequency and amplitude of the external driving affects the buckling strength of our shells. In specific regions of the parameter space, we find that pressure fluctuations can result in large reductions of the critical buckling pressure. This is analogous to the classic knock-down effect in shells due to intrinsic geometric imperfections, albeit now in a way that can be controlled externally.

The Pandolf equation under-predicts the metabolic rate of contemporary military load carriage.

PubMed

Drain, Jace R; Aisbett, Brad; Lewis, Michael; Billing, Daniel C

2017-11-01

This investigation assessed the accuracy of error of the Pandolf load carriage energy expenditure equation when simulating contemporary military conditions (load distribution, external load and walking speed). Within-participant design. Sixteen male participants completed 10 trials comprised of five walking speeds (2.5, 3.5, 4.5, 5.5 and 6.5km·h -1 ) and two external loads (22.7 and 38.4kg). The Pandolf equation demonstrated poor predictive precision, with a mean bias of 124.9W and -48.7 to 298.5W 95% limits of agreement. Furthermore, the Pandolf equation systematically under-predicted metabolic rate (p<0.05) across the 10 speed-load combinations. Predicted metabolic rate error ranged from 12-33% across all conditions with the 'moderate' walking speeds (i.e. 4.5-5.5km·h -1 ) yielding less prediction error (12-17%) when compared to the slower and faster walking speeds (21-33%). Factors such as mechanical efficiency and load distribution contribute to the impaired predictive accuracy. The authors suggest the Pandolf equation should be applied to military load carriage with caution. Copyright © 2017 Sports Medicine Australia. All rights reserved.

Handbook of structural stability part VI : strength of stiffened curved plates and shells

NASA Technical Reports Server (NTRS)

Becker, Herbert

1958-01-01

A comprehensive review of failure of stiffened curved plates and shells is presented. Panel instability in stiffened curved plates and general instability of stiffened cylinders are discussed. The loadings considered for the plates are axial, shear, and the combination of the two. For the cylinders, bending, external pressure, torsion, transverse shear, and combinations of these loads are considered. When possible, test data and theory were correlated. General instability in stiffened cylinders was investigated. For bending and torsion loads, test data and theory were correlated. For external pressure several existing theories were compared. As a result of this investigation a unified theoretical approach to analysis of general instability in stiffened cylinders was developed. (author)

Noise effects on the health status in a dynamic failure model for living organisms

NASA Astrophysics Data System (ADS)

Kang, H.; Jo, J.; Choi, M. Y.; Choi, J.; Yoon, B.-G.

2007-03-01

We study internal and external noise effects on the healthy-unhealthy transition and related phenomena in a dynamic failure model for living organisms. It is found that internal noise makes the system weaker, leading to breakdown under smaller stress. The discontinuous healthy-unhealthy transition in a system with global load sharing below a critical point is naturally explained in terms of the bistability for the health status. External noise present in constant stress gives similar results; further, it induces resonance in response to periodic stress, regardless of load transfer. In the case of local load sharing, such periodic stress is revealed more hazardous than the constant stress.

KSC-2011-3679

NASA Image and Video Library

2011-05-17

CAPE CANAVERAL, Fla. -- Shuttle Atlantis is parked in the transfer aisle in the Vehicle Assembly Building (VAB) at NASA's Kennedy Space Center in Florida. A large yellow sling device (foreground) will be used to lift Atlantis into a high bay for joining to the solid rocket boosters and external tank already installed on a mobile launcher platform. The move called "rollover" is a major milestone in processing for the STS-135 mission to the International Space Station. Commander Chris Ferguson, Pilot Doug Hurley and Mission Specialists Sandra Magnus and Rex Walheim are expected to launch mid July, taking with them the Raffaello multipurpose logistics module packed with supplies, logistics and spare parts. The STS-135 mission also will fly a system to investigate the potential for robotically refueling existing spacecraft and return a failed ammonia pump module to help NASA better understand the failure mechanism and improve pump designs for future systems. STS-135 will be the 33rd flight of Atlantis, the 37th shuttle mission to the space station, and the 135th and final mission of NASA's Space Shuttle Program. For more information visit, www.nasa.gov/mission_pages/shuttle/shuttlemissions/sts135/index.html. Photo credit: NASA/Jack Pfaller

FBI fingerprint identification automation study: AIDS 3 evaluation report. Volume 6: Environmental analysis

NASA Technical Reports Server (NTRS)

Mulhall, B. D. L.

1980-01-01

The results of the analysis of the external environment of the FBI Fingerprint Identification Division are presented. Possible trends in the future environment of the Division that may have an effect on the work load were projected to determine if future work load will lie within the capability range of the proposed new system, AIDS 3. Two working models of the environment were developed, the internal and external model, and from these scenarios the projection of possible future work load volume and mixture was developed. Possible drivers of work load change were identified and assessed for upper and lower bounds of effects. Data used for the study were derived from historical information, analysis of the current situation and from interviews with various agencies who are users of or stakeholders in the present system.

Behavior of medial gastrocnemius motor units during postural reactions to external perturbations after stroke.

PubMed

Pollock, C L; Ivanova, T D; Hunt, M A; Garland, S J

2015-10-01

This study investigated the behavior of medial gastrocnemius (GM) motor units (MU) during external perturbations in standing in people with chronic stroke. GM MUs were recorded in standing while anteriorly-directed perturbations were introduced by applying loads of 1% body mass (BM) at the pelvis every 25-40s until 5% BM was maintained. Joint kinematics, surface electromyography (EMG), and force platform measurements were assessed. Although external loads caused a forward progression of the anterior-posterior centre of pressure (APCOP), people with stroke decreased APCOP velocity and centre of mass (COM) velocity immediately following the highest perturbations, thereby limiting movement velocity in response to perturbations. MU firing rate did not increase with loading but the GM EMG magnitude increased, reflecting MU recruitment. MU inter spike interval (ISI) during the dynamic response was negatively correlated with COM velocity and hip angular velocity. The GM utilized primarily MU recruitment to maintain standing during external perturbations. The lack of MU firing rate modulation occurred with a change in postural central set. However, the relationship of MU firing rate with kinematic variables suggests underlying long-loop responses may be somewhat intact after stroke. People with stroke demonstrate alterations in postural control strategies which may explain MU behavior with external perturbations. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

EFFECT OF AXIAL TIBIAL TORQUE DIRECTION ON ACL RELATIVE STRAIN AND STRAIN RATE IN AN IN VITRO SIMULATED PIVOT LANDING

PubMed Central

Oh, Youkeun K.; Kreinbrink, Jennifer L.; Wojtys, Edward M.; Ashton-Miller, James A.

2011-01-01

Anterior cruciate ligament (ACL) injuries most frequently occur under the large loads associated with a unipedal jump landing involving a cutting or pivoting maneuver. We tested the hypotheses that internal tibial torque would increase the anteromedial (AM) bundle ACL relative strain and strain rate more than would the corresponding external tibial torque under the large impulsive loads associated with such landing maneuvers. Twelve cadaveric female knees [mean (SD) age: 65.0 (10.5) years] were tested. Pretensioned quadriceps, hamstring and gastrocnemius muscle-tendon unit forces maintained an initial knee flexion angle of 15°. A compound impulsive test load (compression, flexion moment and internal or external tibial torque) was applied to the distal tibia while recording the 3-D knee loads and tibofemoral kinematics. AM-ACL relative strain was measured using a 3mm DVRT. In this repeated measures experiment, the Wilcoxon Signed-Rank test was used to test the null hypotheses with p<0.05 considered significant. The mean (± SD) peak AM-ACL relative strains were 5.4±3.7 % and 3.1±2.8 % under internal and external tibial torque, respectively. The corresponding mean (± SD) peak AM-ACL strain rates reached 254.4±160.1 %/sec and 179.4±109.9 %/sec, respectively. The hypotheses were supported in that the normalized mean peak AM-ACL relative strain and strain rate were 70% and 42% greater under internal than external tibial torque, respectively (p=0.023, p=0.041). We conclude that internal tibial torque is a potent stressor of the ACL because it induces a considerably (70%) larger peak strain in the AM-ACL than does a corresponding external tibial torque. PMID:22025178

External And Internal Work Of A T-6 Paraplegic Propelling A Wheelchair And Arm Cranking A Cycle Ergometer: Case Study

NASA Astrophysics Data System (ADS)

Novak, Charles W.

1982-02-01

In this, the International Year of the Disabled, attention is directed among other areas toward rehabilitation and sports participation of wheelchair users. As an application of movement analysis in medicine and rehabilitation and as an application of sports research using biomechanics, this investigation was performed to compare the results of two methods of gathering data on the stress of wheelchair propelling at equivalent work loads and to account for differences in physiological responses with a mechanical analysis of wheelchair propelling. Physiological data collected were heart rate, systolic blood pressure, and rate-pressure product. A biomechanical cinematography analysis was used to determine external work in wheelchair propelling and to determine the extent to which modifications in segment actionsoccurred during increasing magnitude of work. A cycle ergometer was adjusted to replicate external work loads performed during wheelchair propelling. A t-test of equivalent external work loads indicated that heart rate was not different between the two exercise modes at the .05 level of significance. The t-test did indicate a significant difference in systolic blood pressure and rate-pressure product at the .05 level of significance. The biomechanical analysis of wheelchair propelling established that an increase in external work was accomplished by a decrease in the range of motion and an increase in the speed of movement. During cycle ergometry the range and speed of movement remained the same while resistance was increased. Results of the study established that while heart rate for equivalent external work loads was the same for wheelchair propelling and arm cranking cycle ergometry, systolic blood pressure and rate-pressure product were not the same. The suggestion was that some means of propelling a wheelchair other than that which is con-sidered "standard" might be considered which produces less stressful responses in wheelchair users.

Liposomal bupivacaine decreases pain following retropubic sling placement: a randomized placebo-controlled trial.

PubMed

Mazloomdoost, Donna; Pauls, Rachel N; Hennen, Erin N; Yeung, Jennifer Y; Smith, Benjamin C; Kleeman, Steven D; Crisp, Catrina C

2017-11-01

Midurethral slings are commonly used to treat stress urinary incontinence. Pain control, however, may be a concern. Liposomal bupivacaine is a local anesthetic with slow release over 72 hours, demonstrated to lower pain scores and decrease narcotic use postoperatively. The purpose of this study was to examine the impact of liposomal bupivacaine on pain scores and narcotic consumption following retropubic midurethral sling placement. This randomized, placebo-controlled trial enrolled women undergoing retropubic midurethral sling procedures with or without concomitant anterior or urethrocele repair. Subjects were allocated to receive liposomal bupivacaine (intervention) or normal saline placebo injected into the trocar paths and vaginal incision at the conclusion of the procedure. At the time of drug administration, surgeons became unblinded, but did not collect outcome data. Participants remained blinded to treatment. Surgical procedures and perioperative care were standardized. The primary outcome was the visual analog scale pain score 4 hours after discharge home. Secondary outcomes included narcotic consumption, time to first bowel movement, and pain scores collected in the mornings and evenings until postoperative day 6. The morning pain item assessed "current level of pain"; the evening items queried "current level of pain," "most intense pain today," "average pain today with activity," and "average pain today with rest." Likert scales were used to measure satisfaction with pain control at 1- and 2-week postoperative intervals. Sample size calculation deemed 52 subjects per arm necessary to detect a mean difference of 10 mm on a 100-mm visual analog scale. To account for 10% drop out, 114 participants were needed. One hundred fourteen women were enrolled. After 5 exclusions, 109 cases were analyzed: 54 women received intervention, and 55 women received placebo. Mean participant age was 52 years, and mean body mass index was 30.4 kg/m 2 . Surgical and demographic characteristics were similar, except for a slightly higher body mass index in the placebo group (31.6 vs 29.2 kg/m 2 ; P=.050), and fewer placebo arm subjects received midazolam during anesthesia induction (44 vs 52; P=.015). For the primary outcome, pain score (millimeter) 4 hours after discharge home was lower in the intervention group (3.5 vs 13.0 millimeters; P=.014). Pain scores were also lower for subjects receiving liposomal bupivacaine at other time points collected during the first three postoperative days. Furthermore, fewer subjects in the intervention group consumed narcotic medication on postoperative day 2 (12 vs 27; P=.006). There was no difference in satisfaction with pain control between groups. Side-effects experienced, rate of postoperative urinary retention, and time to first bowel movement were similar between groups. Finally, no serious adverse events were noted. Liposomal bupivacaine decreased postoperative pain scores following retropubic midurethral sling placement, though pain was low in both the intervention and placebo groups. Participants who received liposomal bupivacaine were less likely to use narcotics on postoperative day 2. For this common outpatient surgery, liposomal bupivacaine may be a beneficial addition. Given the cost of this intervention, however, future cost-effective analyses may be useful. Published by Elsevier Inc.

Full-scale testing of leakage of blast waves inside a partially vented room exposed to external air blast loading

NASA Astrophysics Data System (ADS)

Codina, R.; Ambrosini, D.

2018-03-01

For the last few decades, the effects of blast loading on structures have been studied by many researchers around the world. Explosions can be caused by events such as industrial accidents, military conflicts or terrorist attacks. Urban centers have been prone to various threats including car bombs, suicide attacks, and improvised explosive devices. Partially vented constructions subjected to external blast loading represent an important topic in protective engineering. The assessment of blast survivability inside structures and the development of design provisions with respect to internal elements require the study of the propagation and leakage of blast waves inside buildings. In this paper, full-scale tests are performed to study the effects of the leakage of blast waves inside a partially vented room that is subjected to different external blast loadings. The results obtained may be useful for proving the validity of different methods of calculation, both empirical and numerical. Moreover, the experimental results are compared with those computed using the empirical curves of the US Defense report/manual UFC 3-340. Finally, results of the dynamic response of the front masonry wall are presented in terms of accelerations and an iso-damage diagram.

Analysis of a Stand-Alone Power System for Remote-Site Applications

DTIC Science & Technology

1986-05-01

ratio ......................... 7.5 C at rated output .................... 0.41 Bade material ......... ........... laminated wood composite Hub Material...steel lifting cables or slings and spreader bars are required (3) continental overland travel requires a flatbed truck with over-size travel permits

[Analysis of the results of the SEIMC External Quality Control Program. Year 2013].

PubMed

de Gopegui Bordes, Enrique Ruiz; Orta Mira, Nieves; Del Remedio Guna Serrano, M; Medina González, Rafael; Rosario Ovies, María; Poveda, Marta; Gimeno Cardona, Concepción

2015-07-01

The External Quality Control Program of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) include controls for bacteriology, serology, mycology, parasitology, mycobacteria, virology, molecular microbiology and HIV-1, HCV and HBV viral loads. This manuscript presents the analysis of results obtained of the participants from the 2013 SEIMC External Quality Control Programme, except viral loads controls, that they are summarized in a manuscript abroad. As a whole, the results obtained in 2013 confirm the excellent skill and good technical standards found in previous editions. However, erroneous results can be obtained in any laboratory and in clinically relevant determinations. Once again, the results of this program highlighted the need to implement both internal and external controls in order to assure the maximal quality of the microbiological tests. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Measuring abnormal movements in free-swimming fish with accelerometers: implications for quantifying tag and parasite load.

PubMed

Broell, Franziska; Burnell, Celene; Taggart, Christopher T

2016-03-01

Animal-borne data loggers allow movement, associated behaviours and energy expenditure in fish to be quantified without direct observations. As with any tagging, tags that are attached externally may adversely affect fish behaviour, swimming efficiency and survival. We report on free-swimming wild Atlantic cod (Gadus morhua) held in a large mesocosm that exhibited distinctly aberrant rotational swimming (scouring) when externally tagged with accelerometer data loggers. To quantify the phenomenon, the cod were tagged with two sizes of loggers (18 and 6 g; <2% body mass) that measured tri-axial acceleration at 50 Hz. An automated algorithm, based on body angular rotation, was designed to extract the scouring movements from the acceleration signal (98% accuracy). The algorithm also identified the frequency pattern and associated energy expenditure of scouring in relation to tag load (% body weight). The average per cent time spent scouring (5%) was independent of tag load. The vector of the dynamic body acceleration (VeDBA), used as a proxy for energy expenditure, increased with tag load (r(2)=0.51), and suggests that fish with large tags spent more energy when scouring than fish with small tags. The information allowed us to determine potential detrimental effects of an external tag on fish behaviour and how these effects may be mitigated by tag size. The algorithm can potentially identify similar rotational movements associated with spawning, courtship, feeding and parasite-load shedding in the wild. The results infer a more careful interpretation of data derived from external tags and the careful consideration of tag type, drag, buoyancy and placement, as well as animal buoyancy and species. © 2016. Published by The Company of Biologists Ltd.

Load Carriage Capacity of the Dismounted Combatant - A Commanders’ Guide

DTIC Science & Technology

2012-10-01

predictive model has been used throughout this document to predict the physiological burden (i.e. energy cost ) of representative load carriage...scenarios. As a general guide this model indicates that a 10 kg increase in external load is metabolically equivalent (i.e. energy cost ) to an increase...larger increases in energy cost for a load carriage task. The multi-factorial nature of human load carriage capacity makes it difficult to set

Comparison between the retropubic and transobturator approaches in the treatment of female stress urinary incontinence: a systematic review and meta-analysis of effectiveness and complications

PubMed Central

Sun, Xincheng; Yang, Qingsong; Sun, Feng; Shi, Qinglu

2015-01-01

Objective This study aimed to compare the effectiveness and complications between the retropubic and transobturator approaches for the treatment of female stress urinary incontinence (SUI) by conducting a systematic review. Materials and Methods We selected all randomized controlled trials (RCTs) that compared retropubic and transobturator sling placements for treatment of SUI. We estimated pooled odds ratios and 95% confidence intervals for intraoperative and postoperative outcomes and complications. Results Six hundred twelve studies that compared retropubic and transobturator approaches to midurethral sling placement were identified, of which 16 were included in our research. Our study was based on results from 2646 women. We performed a subgroup analysis to compare outcomes and complications between the two approaches. The evidence to support the superior approach that leads to better objective/subjective cure rate was insufficient. The transobturator approach was associated with lower risks of bladder perforation (odds ratio (OR) 0.17, 95% confidence interval (CI) 0.09-0.32), retropubic/vaginal hematoma (OR 0.32, 95% CI 0.16-0.63), and long-term voiding dysfunction (OR 0.32, 95% CI 0.17-0.61). However, the risk of thigh/groin pain seemed higher in the transobturator group (OR 2.53, 95% CI 1.72-3.72). We found no statistically significant differences in the risks of other complications between the two approaches. Conclusions This meta-analysis shows analogical objective and subjective cure rates between the retropubic and transobturator approaches to midurethral sling placement. The transobturator approach was associated with lower risks of several complications. However, good-quality studies with long-term follow-ups are warranted for further research. PMID:26005962

Analysis of 1,000 cases of synthetic midurethral slings used for treatment of female urinary incontinence – a single-center experience

PubMed Central

Kasyan, George; Gvozdev, Michail; Sosnowski, Roman

2011-01-01

Introduction This study summarized our experience in the treatment of 1,081 women with stress urinary incontinence (SUI) using mid-urethral slings. Material and methods The study included 1,081 operated patients. Pure SUI was diagnosed in 77.80% (841) of the patients; another 18.68% (202) had mixed symptoms. The remaining 3.52% (38) suffered from recurrent SUI. Group 1 included the SUI patients treated with TVT. Group 2 – SUI managed with TVT-O. In Group 3, mixed urinary incontinent (MUI) patients were treated with TVT-O. Results Retropubic TVT was used in 273 patients (25.25%) and TVT-O in 740 (68.45%). Other slings were used in 68 patients (6.3%). Mean follow-up for the groups was 50.1, 31.1, and 32.6 months respectively. For objective evaluation of cure rate we used the cough stress test. Subjective efficacy was studied via a visual analog scale. The complication rate in each group of the patients was used as a secondary end point. A negative cough test was found in 85.58% of patients in Group 1. For the TVT-O group, the objective cure rate was 84.36%. Intra-operative complications for TVT and TVT-O were not related to age, BMI, or parity. Bladder perforation and pelvic hematoma developed more frequently in the TVT group. There is a higher risk of vaginal perforation for TVT-O. The objective and subjective cure rates for MUI patients were 86.15% and 87.69% respectively. Conclusions TVT and TVT-O are equally effective and safe methods of treatment for women suffering from SUI and MUI. PMID:24578904

“U-Method” TVT-Secur Slings: Are they obstructive?

PubMed Central

Richard, Patrick; Gagnon, Louis-Olivier; Tu, Le Mai

2012-01-01

Introduction: The TVT-Secur, a single incision sling, was introduced in 2006. It is implanted using either the “hammock” or the “U-method” technique. With the latter, the sling is tightened to create a “pillowing effect” on the urethra until a negative stress test is obtained. Short-term results seem promising. However, no study has ever reported on the voiding pattern 12 months after its implantation. Our objective was to assess whether the “U-method” technique creates an obstructive voiding pattern on pressure-flow study (PFS) 12 months after the surgery. Methods: In this retrospective study, we reviewed the charts of 33 women who underwent the “U-method” TVT-Secur. Patients were evaluated before and 12 months postoperatively with regard to different urodynamic studies (UDS). The incontinence status was also assessed 12 months after surgery. Results: At 12 months after the operation, 12.5% (4/32) of the patients reported an improvement of their stress urinary incontinence, while 78.1% (25/32) reported being cured from it. The objective cure rate was 63% (19/30). One patient had a suspected bladder outlet obstruction (BOO) based on PFS. Maximal flow rate (Qmax) was significantly lower 12 months after surgery (26.0 mL/s [range: 19.0–36.5] vs. 21.5 mL/s [range: 16.0–32.3]). However, median voided volume was lower on the postoperative uroflowmetry (446 mL [range: 348–605] vs. 320 mL [range: 243–502]). Furthermore, none of the patients complained of voiding symptoms after surgery. Conclusions: Although one patient had findings compatible with BOO, none complained of voiding symptoms. TVT-Secur may result in a lower Qmax. However, this finding may be due to a lower voiding volume on the postoperative UDS. PMID:22511425

Comparison of TVT, TVT-O/TOT and mini slings for the treatment of female stress urinary incontinence: 30 months follow up in 531 patients.

PubMed

Stavros, Charalambous; Ioannis, Vouros; Vasileios, Sakalis I; Gkotsi, Anastasia Ch; Georgios, Salpiggidis; Papathanasiou, Athanasios; Rombis, Vasileios

2012-09-01

Although mid-urethral slings (MUS), have been extensively used for the treatment of female stress urinary incontinence (SUI), no published data exists for the efficiency and the complications of these methods in large patient series. This is a retrospective analysis on patients who underwent MUS surgery since 1999. 531 patients were studied and the results of preoperative assessment, perioperative, early postoperatively and each follow up were registered. Patients were classified in three groups according to the MUS used. Efficacy of each method was evaluated in terms of early postoperative course, late complications and patient's symptoms improvement based questioners, pad test, uroflowmetry, filling cystometry and ultrasonography. Evaluation took place at 7th and 30th postoperative day, 3rd and 12th month and then annually. Each patient was characterized as cured, improved or failed. Trans Obturator (TO) group prevailed in efficiency with no significant differences between trans obturator route with inside-out (TVT-O) and outside-in (TOT). Success rate at 30th month evaluation, was higher in the TO group than in Tension-free Vaginal Tape (TVT) or Single-Incision Mini Slings (SIMS) group (93.4% vs 89.5%, 93.4% vs. 91.7%). None TVT patient required reoperation for remaining/reoccurring SUI, while 1.04% of TO group and 5.48% of SIMS group did. Patients of TVT group underwent reoperation for tape related complications in 2.25%, while 2.07% of TO group and none of SIMS group did. The potential limitation of the study is its retrospective character. Even though TO tapes and SIMS seem more efficient than TVT, they carry a risk of SUI re-occurrence that must be weighted towards the risk of potential complications after TVT.

Evaluation and management of complications from synthetic mesh after pelvic reconstructive surgery: a multicenter study.

PubMed

Abbott, Sara; Unger, Cecile A; Evans, Janelle M; Jallad, Karl; Mishra, Kevita; Karram, Mickey M; Iglesia, Cheryl B; Rardin, Charles R; Barber, Matthew D

2014-02-01

The purpose of this study was to describe the evaluation and management of synthetic mesh-related complications after surgery for stress urinary incontinence (SUI) and/or pelvic organ prolapse (POP). We conducted a multicenter, retrospective analysis of women who attended 4 US tertiary referral centers for evaluation of mesh-related complications after surgery for SUI and/or POP from January 2006 to December 2010. Demographic, clinical, and surgical data were abstracted from the medical record, and complications were classified according to the Expanded Accordion Severity Classification. Three hundred forty-seven patients sought management of synthetic mesh-related complications over the study period. Index surgeries were performed for the following indications: SUI (sling only), 49.9%; POP (transvaginal mesh [TVM] or sacrocolpopexy only), 25.6%; and SUI + POP (sling + TVM or sacrocolpopexy), 24.2%. Median time to evaluation was 5.8 months (range, 0-65.2). Thirty percent of the patients had dyspareunia; 42.7% of the patients had mesh erosion; and 34.6% of the patients had pelvic pain. Seventy-seven percent of the patients had a grade 3 or 4 (severe) complication. Patients with TVM or sacrocolpopexy were more likely to have mesh erosion and vaginal symptoms compared with sling only. The median number of treatments for mesh complications was 2 (range, 1-9); 60% of the women required ≥2 interventions. Initial treatment intervention was surgical for 49% of subjects. Of those treatments that initially were managed nonsurgically, 59.3% went on to surgical intervention. Most of the women who seek management of synthetic mesh complication after POP or SUI surgery have severe complications that require surgical intervention; a significant proportion require >1 surgical procedure. The pattern of complaints differs by index procedure. Copyright © 2014 Mosby, Inc. All rights reserved.

Impact of the 2011 FDA transvaginal mesh safety update on AUGS members' use of synthetic mesh and biologic grafts in pelvic reconstructive surgery.

PubMed

Clemons, Jeffrey L; Weinstein, Milena; Guess, Marsha K; Alperin, Marianna; Moalli, Pamela; Gregory, William Thomas; Lukacz, Emily S; Sung, Vivian W; Chen, Bertha H; Bradley, Catherine S

2013-01-01

To describe the frequency of use and recent change in use of synthetic mesh and biologic grafts in pelvic organ prolapse (POP) and stress urinary incontinence surgery by American Urogynecology Society (AUGS) members. An electronic survey of AUGS members was conducted between December 2011 and January 2012. Frequency of graft use in POP (overall and by transvaginal and transabdominal approaches) and stress urinary incontinence surgery was queried relative to the timing of the 2011 Food and Drug Administration (FDA) safety update. Rates of materials' use before and after the statement were compared using Wilcoxon signed rank test. Fifty-three percent (507/962) of AUGS members responded and were included in analysis; 79% were urogynecologists. Before the FDA warning, in POP surgery, most (90%) used synthetic mesh and fewer (34%) used biologic grafts; 99% used synthetic mesh slings. After the FDA statement, respondents reported an overall decrease in the percent of POP cases in which they used synthetic mesh (P < 0.001) but no change in biologic graft use for POP (P = 0.37) or synthetic mesh sling use (P = 0.10). Specifically, transvaginal mesh use decreased: 40% reported decreased use and 12% stopped use. However, transvaginal mesh was still used by 61% of respondents in at least some cases. No change (62%) or increased use (12%) of mesh was reported for transabdominal POP procedures. Synthetic mesh use in transvaginal POP surgery decreased after the 2011 FDA safety update, but synthetic mesh use for transabdominal POP repair and sling procedures and overall biologic graft use in POP surgery did not decrease.

Challenging the Myth: Transvaginal Mesh is Not Associated with Carcinogenesis.

PubMed

Chughtai, Bilal; Sedrakyan, Art; Mao, Jialin; Thomas, Dominique; Eilber, Karyn S; Clemens, J Quentin; Anger, Jennifer T

2017-10-01

We sought to determine if there was a potential link between synthetic polypropylene mesh implantation for transvaginal pelvic organ prolapse and stress urinary incontinence, and carcinogenesis using statewide administrative data. Women who underwent transvaginal surgery for pelvic organ prolapse or stress urinary incontinence with mesh between January 2008 and December 2009 in New York State were identified using ICD-9-CM procedure codes and CPT-4 codes. Patients in the mesh cohort were individually matched to 2 control cohorts based on comorbidities and procedure date. Carcinogenesis was determined before and after matching at 1, 2 and 3 years, and during the entire followup time. A total of 2,229 patients who underwent mesh based pelvic organ prolapse surgery and 10,401 who underwent sling surgery for stress urinary incontinence between January 2008 and December 2009 were included in the study. Mean followup was 6 years (range 5 to 7). Exact matching between the mesh and control cohorts resulted in 1,870 pairs for pelvic organ prolapse mesh and cholecystectomy (1:2), 1,278 pairs for pelvic organ prolapse mesh and hysterectomy (1:1), 7,986 pairs for sling and cholecystectomy (1:1) and 3,810 pairs for sling and hysterectomy (1:1). Transvaginal mesh implantation was not associated with an increased risk of a cancer diagnosis (pelvic/local cancers or any cancer) at 1 year and during the entire followup of up to 7 years. Transvaginal surgery with implantation of mesh was not associated with the development of malignancy at a mean followup of 6 years. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

The effect of active core exercise on fitness and foot pressure in Taekwondo club students.

PubMed

Yoon, Seong-Deok; Sung, Dong-Hun; Park, Gi Duck

2015-02-01

[Purpose] The effects of core training using slings and Togus on the improvement of posture control in Taekwondo club students, that is, balance ability, were investigated. To that end, changes in the Taekwondo players' balance ability resulting from active core training for eight weeks were examined through fitness and foot pressure. [Subjects] The present study was conducted with 13 male Taekwondo players of K University in Deagu, South Korea. Once the experiment process was explained, consent was obtained from those who participated voluntarily. [Methods] Air cushions (Germany), Jumpers (Germany), and Aero-Steps (Germany) were used as lumbar stabilization exercise tools. As a method of training proprioceptive senses by stimulating somatesthesia in standing postures, the subjects performed balance squats, supine pelvic lifts, and push-up plus exercise using slings while standing on an Aero-Step and performed hip extension parallel squats (Wall Gym Ball), and standing press-ups on a Togu using their own weight. The subjects performed four sets of these isometric exercises while maintaining an exercise time per set at 30 seconds in each session and repeated this session three times per week. [Result] Left grip strength significantly increased and number of sit-ups, which indicates muscle endurance, also significantly increased after the eight weeks exercise compared with before the exercise. The values measured during the sit and reach test, which indicate flexibility, also significantly increase after the eight weeks of exercise compared with before the exercise but only in the left foot. [Conclusion] The result of present study suggest that active core exercise using Slings and Togus can be applied as a very effective exercise program for enhancing balance, which is an important physical factor for Taekwondo club students.

Urinary incontinence management costs are reduced following Burch or sling surgery for stress incontinence.

PubMed

Subak, Leslee L; Goode, Patricia S; Brubaker, Linda; Kusek, John W; Schembri, Michael; Lukacz, Emily S; Kraus, Stephen R; Chai, Toby C; Norton, Peggy; Tennstedt, Sharon L

2014-08-01

The objective of the study was to estimate the effect of Burch and fascial sling surgery on out-of-pocket urinary incontinence (UI) management costs at 24 months postoperatively and identify predictors of change in cost among women enrolled in a randomized trial comparing these procedures. Resources used for UI management (supplies, laundry, dry cleaning) were self-reported by 491 women at baseline and 24 months after surgery, and total out-of-pocket costs for UI management (in 2012 US dollars) were estimated. Data from the 2 surgical groups were combined to examine the change in cost for UI management over 24 months. Univariate and bivariate changes in cost were analyzed using the Wilcoxon signed rank test. Predictors of change in cost were examined using multivariate mixed models. At baseline mean (±SD) age of participants was 53 ± 10 years, and the frequency of weekly UI episodes was 23 ± 21. Weekly UI episodes decreased by 86% at 24 months (P < .001). The mean weekly cost was $16.60 ± $27.00 (median $9.39) at baseline and $4.57 ± $15.00 (median $0.10) at 24 months (P < .001), a decrease of 72%. In multivariate analyses, cost decreased by $3.38 ± $0.77 per week for each decrease of 1 UI episode per day (P < .001) and was strongly associated with greater improvement in Urogenital Distress Inventory and Incontinence Impact Questionnaire scores (P < .001) and decreased 24-hour pad weight (P < .02). Following Burch or fascial sling surgery, the UI management cost at 24 months decreased by 72% ($625 per woman per year) and was strongly associated with decreasing UI frequency. Reduced out-of-pocket expenses may be a benefit of these established urinary incontinence procedures. Copyright © 2014. Published by Mosby, Inc.

Creating a gold standard surgical device: scientific discoveries leading to TVT and beyond: Ulf Ulmsten Memorial Lecture 2014.

PubMed

Petros, Peter

2015-04-01

The discovery of tension-free vaginal tape (TVT) began in 1986 with two unrelated observations: pressure applied unilaterally at the midurethra controlled urine loss on coughing; implanted Teflon tape caused a collagenous tissue reaction. In 1987, Mersilene tape was implanted retropubically in 13 large dogs, with the aim of creating an artificial collagenous pubourethral neoligament. Extensive testing showed that the operation was safe and effective. In 1988-1989, human testing was carried out (n = 30). Mersilene tape cured 100 % of stress and mixed incontinence with a sling in situ; however, there was simultaneous recurrence of the two symptoms in 50 % on sling removal. X-rays showed no elevation of the bladder neck. In 1990-1993, collaboration with Ulf Ulmsten took place: a permanently implanted tape was required. Polypropylene was the ideal material. In 2003, the neoligament principle was applied as an adjustable "micro" sling to the arcus tendineus fasciae pelvis (ATFP), cardinal, uterosacral ligaments, and perineal body for cure of cystocele, rectocele, and apical prolapse. It was found that symptoms such as urgency, nocturia, chronic pelvic pain, obstructive defecation syndrome (ODS), and fecal incontinence were frequently cured or improved. The lecture concluded with advice to younger members. Without new paradigms, there are no randomized controlled trials, no meta-analyses, Cochrane. Indeed, no progress. Be open to new concepts. Read Kuhn's "The Structure of Scientific Revolutions" to understand the discovery process. Examine the relationship among symptoms, ATFP, cardinal, uterosacral ligaments, and the perineal body. This is the next paradigm. Don't disregard anomalies. Pursue them. They are the pathway to discovery. Innovation is born from challenge, not conformity. Persist, even when meeting resistance. Resistance is a sign that your discovery is important.

Mid-urethral slings on YouTube: quality information on the internet?

PubMed

Larouche, Maryse; Geoffrion, Roxana; Lazare, Darren; Clancy, Aisling; Lee, Terry; Koenig, Nicole A; Cundiff, Geoffrey W; Stothers, Lynn

2016-06-01

Scant literature exists about the quality of urogynecological content on social media. Our objective was to measure the accuracy and comprehensiveness of YouTube videos related to mid-urethral sling (MUS) procedures. YouTube was searched using the terms "mid-urethral sling," "vaginal tape," "TVT," "TOT," "TVT surgery," and "TOT surgery." Duplicates and videos with less than 1,000 views were excluded. We developed a standardized questionnaire for this project, assessing each video's target audience, main purpose, relevance, informed consent elements, surgical steps, and bias. The primary outcome was the presence of all elements of informed consent. Inter-rater reliability (IRR) was calculated using the Fleiss' kappa statistic. Descriptive statistics were also obtained. Five reviewers each rated 56 videos. Mean IRR was moderate (Fleiss' kappa 0.58 ± 0.24). Video content was classified as physician educational material (67.9 %), patient information (16.1 %), advertisement (10.7 %), lawsuit recruitment (1.8 %), and unclear (3.6 %). MUS was the primary topic for 82.1 % of the videos. The remainder discussed other types of anti-incontinence procedures or prolapse surgery. None of the videos mentioned all four elements of informed consent. Of 32 videos demonstrating surgical technique, none showed the complete list of pre-determined surgical steps. The mean number of listed steps was 7.6/16. Only four videos mentioned at least one post-operative patient instruction. A marketing element was shown in 26.8 % of videos. Patient information about MUS on YouTube is lacking and often biased. Physicians and students viewing YouTube videos for educational purposes should be cognizant of the variability in the surgical steps demonstrated.

Expression of serotonin receptors in human lower esophageal sphincter

PubMed Central

LI, HE-FEI; LIU, JUN-FENG; ZHANG, KE; FENG, YONG

2015-01-01

Serotonin (5-HT) is a neurotransmitter and vasoactive amine that is involved in the regulation of a large number of physiological functions. The wide variety of 5-HT-mediated functions is due to the existence of different classes of serotonergic receptors in the mammalian gastrointestinal tract and nervous system. The aim of this study was to explore the expression of multiple types of 5-HT receptor (5-HT1AR, 5-HT2AR, 5-HT3AR, 5-HT4R, 5-HT5AR, 5-HT6R and 5-HT7R) in sling and clasp fibers from the human lower esophageal sphincter (LES). Muscle strips of sling and clasp fibers from the LES were obtained from patients undergoing esophagogastrectomy, and circular muscle strips from the esophagus and stomach were used as controls. Reverse transcription-polymerase chain reaction (RT-PCR), quantitative PCR and western blotting were used to investigate the expression of the various 5-HT receptor types. Messenger RNA for all seven 5-HT receptor types was identified in the sling and clasp fibers of the LES. At the mRNA level, the expression levels were highest for 5-HT3AR and 5-HT4R, and lowest for 5-HT5AR, 5-HT6R and 5-HT7R. At the protein level, the expression levels were highest for 5-HT3AR and 5-HT4R, followed by 5-HT1AR and 5-HT2AR; 5-HT7R was also detected at a low level. The expression of 5-HT5AR and 5-HT6R proteins was not confirmed. The results indicate that a variety of 5-HT receptor types can be detected in the human LES and probably contribute to LES function. PMID:25452775

Findings of universal cystoscopy at incontinence surgery and their sequelae

PubMed Central

Zyczynski, Halina M.; Sirls, Larry T.; Greer, W. Jerod; Rahn, David D.; Casiano, Elizabeth; Norton, Peggy; Kim, Hae-Young; Brubaker, Linda

2014-01-01

OBJECTIVE The purpose of this study was to report the frequency of abnormal cystoscopy at incontinence surgery and to identify risk factors and sequelae of injury. STUDY DESIGN Findings of cystoscopy were collected prospectively in 3 multicenter surgical trials. Clinical, demographic, and procedure characteristics and surgeon experience were analyzed for association with iatrogenic injury and noninjury abnormalities. Impact of abnormalities on continence outcomes and adverse events during 12 months after the procedure were assessed. RESULTS Abnormal findings in the bladder or urethra were identified in 95 of 1830 women (5.2%). Most injuries (75.8%) were iatrogenic. Lower urinary tract (LUT) injury was most common at retropubic urethropexy and retropubic midurethral sling procedures (MUS; 6.4% each), followed by autologous pubovaginal sling procedures (1.7%) and transobturator MUS (0.4%). Increasing age (56.9 vs 51.9 years; P = .04), vaginal deliveries (3.2 vs 2.6; P = .04), and blood loss (393 vs 218 mL; P=.01) were associated with LUT injury during retropubic urethropexy; however, only age (62.9 vs 51.4 years; P = .02) and smoking history (P = .04) were associated for pubovaginal sling procedures. No factors correlated with increased risk of injury at retropubic and transobturator MUS. Notably, previous incontinence surgery, concomitant procedures, anesthesia type, and trainee participation did not increase LUT injury frequency. Although discharge with an indwelling catheter was more common after trocar perforation compared with the noninjury group (55.6% vs 18.5%; P < .001), they did not differ in overall success, voiding dysfunction, recurrent urinary tract infections, or urge urinary incontinence. CONCLUSION Universal cystoscopy at incontinence surgery detects abnormalities in 1 in 20 women. Urinary trocar perforations that are addressed intraoperatively have no long-term adverse sequelae. PMID:24380742

Utilization of penile prosthesis and male incontinence prosthetics in Saudi Arabia.

PubMed

Alwaal, Amjad; Al-Sayyad, Ahmad J

2017-01-01

Erectile dysfunction is a prevalent disease affecting over 50% of men between the ages of 40 and 70 years. Penile prosthesis represents the end of the line treatment when other less invasive therapies fail or are contraindicated. Male stress urinary incontinence can significantly diminish quality of life and lead to embarrassment and social withdrawal. Surgical therapies, such as male urethral slings and artificial urinary sphincters (AUS), are considered effective and safe treatments for male stress incontinence. No data exist on the utilization of penile prosthesis or male incontinence surgical treatment in Saudi Arabia. Generally, urological prosthetic surgery is performed either in private hospitals or in government hospitals. Our aim was to assess the trend of penile prosthesis and male incontinence device utilization in Saudi Arabia. We utilized sales' data of penile prosthetics, male slings, and AUS from the only two companies selling these devices in Saudi Arabia (AMS ® and Coloplast ® ), from January 2013 to December 2016. There were 2599 penile prosthesis implantation procedures done in the study period, with 67% of them performed in private institutions. There was a progressively increased use of penile prosthetics which nearly doubled from 2013 to 2016. The main type of prosthesis utilized was the semirigid type 70% versus 11% of the 2-piece inflatable and 17% of the 3-piece inflatable device. Only 10 slings and 31 AUS were inserted during the same study period. There is an increased utilization of penile prosthetics in Saudi Arabia. The private sector performs the majority of penile prosthesis procedures, and most of them are of the semirigid type. The governmental sector is more likely to perform inflatable penile prosthesis and male incontinence device procedures. Male incontinence prosthetics' use is very limited in Saudi Arabia.

Self-Sensing of Position-Related Loads in Continuous Carbon Fibers-Embedded 3D-Printed Polymer Structures Using Electrical Resistance Measurement

PubMed Central

Luan, Congcong; Shen, Hongyao; Fu, Jianzhong

2018-01-01

Condition monitoring in polymer composites and structures based on continuous carbon fibers show overwhelming advantages over other potentially competitive sensing technologies in long-gauge measurements due to their great electromechanical behavior and excellent reinforcement property. Although carbon fibers have been developed as strain- or stress-sensing agents in composite structures through electrical resistance measurements, the electromechanical behavior under flexural loads in terms of different loading positions still lacks adequate research, which is the most common situation in practical applications. This study establishes the relationship between the fractional change in electrical resistance of carbon fibers and the external loads at different loading positions along the fibers’ longitudinal direction. An approach for real-time monitoring of flexural loads at different loading positions was presented simultaneously based on this relationship. The effectiveness and feasibility of the approach were verified by experiments on carbon fiber-embedded three-dimensional (3D) printed thermoplastic polymer beam. The error in using the provided approach to monitor the external loads at different loading positions was less than 1.28%. The study fully taps the potential of continuous carbon fibers as long-gauge sensory agents and reinforcement in the 3D-printed polymer structures. PMID:29584665

Biomechanical responses of PMHS in moderate-speed rear impacts and development of response targets for evaluating the internal and external biofidelity of ATDS.

PubMed

Kang, Yun-Seok; Bolte, John H; Moorhouse, Kevin; Donnelly, Bruce; Herriott, Rodney; Mallory, Ann

2012-10-01

The objectives of this study were to obtain biomechanical responses of post mortem human subjects (PMHS) by subjecting them to two moderate-speed rear impact sled test conditions (8.5g, 17 km/h; 10.5g, 24 km/h) while positioned in an experimental seat system, and to create biomechanical targets for internal and external biofidelity evaluation of rear impact ATDs. The experimental seat was designed to measure external loads on the head restraint (4 load cells), seat back (6 load cells), and seat pan (4 load cells) such that subject dynamic interaction with the seat could be evaluated. This seat system was capable of simulating the dynamic characteristics of modern vehicle seat backs by considering the moment-rotation properties of a typical passenger vehicle, thus providing a more realistic test environment than using a rigid seat with a non-rotating seat back as done in previous studies. Instrumentation used to measure biomechanical responses of the PMHS included both accelerometers and angular rate sensors (ARS). A total of fourteen sled tests using eight PMHS (males 175.8 ± 6.2 cm of stature and 78.4 ± 7.2 kg of weight) provided data sets of seven PMHS for both test conditions. The biomechanical responses are described at both speeds, and cervical spine injuries are documented. Biomechanical targets are also created for internal and external biofidelity evaluation of rear impact anthropomorphic test devices (ATDs).

Evaluation of the Match External Load in Soccer: Methods Comparison.

PubMed

Castagna, Carlo; Varley, Matthew; Póvoas, Susana C A; D'Ottavio, Stefano

2017-04-01

To test the interchangeability of 2 match-analysis approaches for external-load detection considering arbitrary selected speeds and metabolic power (MP) thresholds in male top-level soccer. Data analyses were performed considering match physical performance of 60 matches (1200 player cases) of randomly selected Spanish, German, and English first-division championship matches (2013-14 season). Match analysis was performed with a validated semiautomated multicamera system operating at 25 Hz. During a match, players covered 10,673 ± 348 m, of which 1778 ± 208 m and 2759 ± 241 m were performed at high intensity, as measured using speed (≥16 km/h, HI) and metabolic power (≥20 W/kg, MPHI) notations. High-intensity notations were nearly perfectly associated (r = .93, P < .0001). A huge method bias (980.63 ± 87.82 m, d = 11.67) was found when considering MPHI and HI. Very large correlations were found between match total distance covered and MPHI (r = .84, P < .0001) and HI (r = .74, P < .0001). Player high-intensity decelerations (≥-2 m/s 2 ) were very largely associated with MPHI (r = .73, P < .0001). The speed and MP methods are highly interchangeable at relative level (magnitude rank) but not absolute level (measure magnitude). The 2 physical match-analysis methods can be independently used to track match external load in elite-level players. However, match-analyst decisions must be based on use of a single method to avoid bias in external-load determination.

Relationships Between Internal and External Match-Load Indicators in Soccer Match Officials.

PubMed

Castillo, Daniel; Weston, Matthew; McLaren, Shaun J; Cámara, Jesús; Yanci, Javier

2017-08-01

The aims of this study were to describe the internal and external match loads (ML) of refereeing activity during official soccer matches and to investigate the relationship among the methods of ML quantification across a competitive season. A further aim was to examine the usefulness of differential perceived exertion (dRPE) as a tool for monitoring internal ML in soccer referees. Twenty field referees (FRs) and 43 assistant referees (ARs) participated in the study. Data were collected from 30 competitive matches (FR = 20 observations, AR = 43 observations) and included measures of internal (Edwards' heart-rate-derived training impulse [TRIMP EDW ]) ML, external (total distance covered, distance covered at high speeds, and player load) ML, and ML differentiated ratings of perceived respiratory (sRPE res ) and leg-muscle (sRPE mus ) exertion. Internal and external ML were all greater for FRs than for ARs (-19.7 to -72.5), with differences ranging from very likely very large to most likely extremely large. The relationships between internal-ML and external-ML indicators were, in most cases, unclear for FR (r < .35) and small to moderate for AR (r < .40). The authors found substantial differences between RPE res and RPE mus scores in both FRs (0.6 AU; ±90% confidence limits 0.4 AU) and ARs (0.4; ±0.3). These data demonstrate the multifaceted demands of soccer refereeing and thereby highlight the importance of monitoring both internal and external ML. Moreover, dRPE represents distinct dimensions of effort and may be useful in monitoring soccer referees' ML during official matches.

Distraction and mind-wandering under load.

PubMed

Forster, Sophie

2013-01-01

Attention research over the last several decades has provided rich insights into the determinants of distraction, including distractor characteristics, task features, and individual differences. Load Theory represented a particularly important breakthrough, highlighting the critical role of the level and nature of task-load in determining both the efficiency of distractor rejection and the stage of processing at which this occurs. However, until recently studies of distraction were restricted to those measuring rather specific forms of distraction by external stimuli which I argue that, although intended to be irrelevant, were in fact task-relevant. In daily life, attention may be distracted by a wide range of stimuli, which may often be entirely unrelated to any task being performed, and may include not only external stimuli but also internally generated stimuli such as task-unrelated thoughts. This review outlines recent research examining these more general, entirely task-irrelevant, forms of distraction within the framework of Load Theory. I discuss the relation between different forms of distraction, and the universality of load effects across different distractor types and individuals.

Quantitative structure-property relationship modeling of remote liposome loading of drugs.

PubMed

Cern, Ahuva; Golbraikh, Alexander; Sedykh, Aleck; Tropsha, Alexander; Barenholz, Yechezkel; Goldblum, Amiram

2012-06-10

Remote loading of liposomes by trans-membrane gradients is used to achieve therapeutically efficacious intra-liposome concentrations of drugs. We have developed Quantitative Structure Property Relationship (QSPR) models of remote liposome loading for a data set including 60 drugs studied in 366 loading experiments internally or elsewhere. Both experimental conditions and computed chemical descriptors were employed as independent variables to predict the initial drug/lipid ratio (D/L) required to achieve high loading efficiency. Both binary (to distinguish high vs. low initial D/L) and continuous (to predict real D/L values) models were generated using advanced machine learning approaches and 5-fold external validation. The external prediction accuracy for binary models was as high as 91-96%; for continuous models the mean coefficient R(2) for regression between predicted versus observed values was 0.76-0.79. We conclude that QSPR models can be used to identify candidate drugs expected to have high remote loading capacity while simultaneously optimizing the design of formulation experiments. Copyright © 2011 Elsevier B.V. All rights reserved.

Urinary incontinence - vaginal sling procedures

MedlinePlus

... you are numb and feel no pain. A catheter (tube) is placed in your bladder to drain urine from your bladder. The doctor ... to urinate more often More difficulty emptying your bladder, and the need to use a catheter Worsening of urine leakage Before the Procedure Tell ...

An Evaluation of the Effects of the Transobturator Tape Procedure on Sexual Satisfaction in Women with Stress Urinary Incontinence Using the Libido Scoring System

PubMed Central

Narin, Raziye; Nazik, Hakan; Narin, Mehmet Ali; Aytan, Hakan; Api, Murat

2013-01-01

Introduction and Hypothesis. Most women experience automatic urine leakage in their lifetimes. SUI is the most common type in women. Suburethral slings have become a standard surgical procedure for the treatment of stress urinary incontinence when conservative therapy failed. The treatment of stress urinary incontinence by suburethral sling may improve body image by reducing urinary leakage and may improve sexual satisfaction. Methods. A total of 59 sexually active patients were included in the study and underwent a TOT outside-in procedure. The LSS was applied in all patients by self-completion of questionnaires preoperatively and 6 months after the operation. General pleasure with the operation was measured by visual analogue score (VAS). Pre- and postoperative scores were recorded and analyzed using SPSS 11.5. Results. Two parameters of the LSS, orgasm and who starts the sexual activity, increased at a statistically significant rate. Conclusion. Sexual satisfaction and desire have partially improved after the TOT procedure. PMID:24288621

Monitoring calculation of closure change of Extradosed Cable-stayed Bridge

NASA Astrophysics Data System (ADS)

Shi, Jing Xian; Ran, Zhi Hong

2018-06-01

During the construction of extradosed cable-stayed bridge in Yunnan province, China, the construction unit has made certain changes in the construction process of the closure section due to environmental restrictions: remove the hanging basket after the closure, the sling shall not be provided in closure section, the function of the sling is realized by the hanging basket on the 16th beam. In case of this change, the bridge has been constructed to section 15th. In order to ensure the smooth and orderly progress of each stage in the closure phase, this article is arranged according to the construction plan, appropriate adjustment of related procedures, checking the bridge safety at all stages of construction, the stress and force of the main girder are compared to ensure the safety of the construction after closure changes. Adjust the height of the beam of the 16th and 17th to adapt the new construction plan, and the bridge closure smoothly.

Positional Differences in External On-Field Load During Specific Drill Classifications Over a Professional Rugby League Preseason.

PubMed

Cummins, Cloe; McLean, Blake; Halaki, Mark; Orr, Rhonda

2017-07-01

To quantify the external training loads of positional groups in preseason training drills. Thirty-three elite rugby league players were categorized into 1 of 4 positional groups: outside backs (n = 9), adjustables (n = 9), wide-running forwards (n = 9), and hit-up forwards (n = 6). Data for 8 preseason weeks were collected using microtechnology devices. Training drills were classified based on drill focus: speed and agility, conditioning, and generic and positional skills. Total, high-speed, and very-high-speed distance decreased across the preseason in speed and agility (moderate, small, and small, respectively), conditioning (large, large, and small) and generic skills (large, large, and large). The duration of speed and generic skills also decreased (77% and 48%, respectively). This was matched by a concomitant increase in total distance (small), high-speed running (small), very-high-speed running (moderate), and 2-dimensional (2D) BodyLoad (small) demands in positional skills. In positional skills, hit-up forwards (1240 ± 386 m) completed less very-high-speed running than outside backs (2570 ± 1331 m) and adjustables (2121 ± 1163 m). Hit-up forwards (674 ± 253 AU) experienced greater 2D BodyLoad demands than outside backs (432 ± 230 AU, P = .034). In positional drills, hit-up forwards experienced greater relative 2D BodyLoad demands than outside backs (P = .015). Conversely, outside backs experienced greater relative high- (P = .007) and very-high-speed-running (P < .001) demands than hit-up forwards. Significant differences were observed in training loads between positional groups during positional skills but not in speed and agility, conditioning, and generic skills. This work also highlights the importance of different external-load parameters to adequately quantify workload across different positional groups.

Design of responsive materials using topologically interlocked elements

NASA Astrophysics Data System (ADS)

Molotnikov, A.; Gerbrand, R.; Qi, Y.; Simon, G. P.; Estrin, Y.

2015-02-01

In this work we present a novel approach to designing responsive structures by segmentation of monolithic plates into an assembly of topologically interlocked building blocks. The particular example considered is an assembly of interlocking osteomorphic blocks. The results of this study demonstrate that the constraining force, which is required to hold the blocks together, can be viewed as a design parameter that governs the bending stiffness and the load bearing capacity of the segmented structure. In the case where the constraining forces are provided laterally using an external frame, the maximum load the assembly can sustain and its stiffness increase linearly with the magnitude of the lateral load applied. Furthermore, we show that the segmented plate with integrated shape memory wires employed as tensioning cables can act as a smart structure that changes its flexural stiffness and load bearing capacity in response to external stimuli, such as heat generated by the switching on and off an electric current.

Sex-Based Differences in Knee Kinetics With Anterior Cruciate Ligament Strain on Cadaveric Impact Simulations

PubMed Central

Schilaty, Nathan D.; Bates, Nathaniel A.; Nagelli, Christopher; Krych, Aaron J.; Hewett, Timothy E.

2018-01-01

Background: Females are at an increased risk of sustaining noncontact knee ligament injuries as compared with their male counterparts. The kinetics that load the anterior cruciate ligament (ACL) are still under dispute in the literature. Purpose/Hypothesis: The purpose of this study was to determine whether there are differences in knee kinetics between the sexes that lead to greater ACL strain in females when similar external loads are applied during a simulated drop vertical jump landing task. It was hypothesized that female limbs would demonstrate significant differences in knee abduction moment that predispose females to ACL injury when compared with males. Study Design: Controlled laboratory study. Methods: Motion analysis data of 67 athletes who performed a drop vertical jump were collected. The kinematic and kinetic data were used to categorize tertiles of relative risk, and these values were input into a cadaveric impact simulator to assess ligamentous loads during the simulated landing task. Uni- and multiaxial load cells and differential variable reluctance transducer strain sensors were utilized to collect kinetic data and maximum ACL strain for analysis. Conditions of external loads applied to the cadaveric limbs were systematically varied and randomized. Data were analyzed with 2-way repeated-measures analysis of variance and the Fisher exact test. Results: Five kinetic parameters were evaluated. Of the 5 kinetic variables, only knee abduction moment (KAM) demonstrated significant differences in females as compared with males (F 1,136 = 4.398, P = .038). When normalized to height and weight, this difference between males and females increased in significance (F 1,136 = 7.155, P = .008). Compared with males, females exhibited a 10.3-N·m increased knee abduction torque at 66 milliseconds postimpact and a 22.3-N·m increased abduction torque at 100 milliseconds postimpact. For loading condition, the condition of “maximum ACL strain” demonstrated a maximum difference of 54.3-N·m increased abduction torque and 74.5-N·m increased abduction torque at 66 milliseconds postimpact. Conclusion: Under the tested conditions, increased external loads led to increased medial knee translation force, knee abduction moment, and external knee moment. Females exhibited greater forces and moments at the knee, especially at KAM, when loaded in similar conditions. As these KAM loads are associated with increased load and strain on the ACL, the sex-based differences observed in the present study may account for a portion of the underlying mechanics that predispose females to ACL injury as compared with males in a controlled simulated athletic task. Clinical Relevance: KAM increases strain to the ACL under clinically representative loading. Additionally, this work establishes the biomechanical characteristics of knee loading between sexes. PMID:29568787

Sex-Based Differences in Knee Kinetics With Anterior Cruciate Ligament Strain on Cadaveric Impact Simulations.

PubMed

Schilaty, Nathan D; Bates, Nathaniel A; Nagelli, Christopher; Krych, Aaron J; Hewett, Timothy E

2018-03-01

Females are at an increased risk of sustaining noncontact knee ligament injuries as compared with their male counterparts. The kinetics that load the anterior cruciate ligament (ACL) are still under dispute in the literature. The purpose of this study was to determine whether there are differences in knee kinetics between the sexes that lead to greater ACL strain in females when similar external loads are applied during a simulated drop vertical jump landing task. It was hypothesized that female limbs would demonstrate significant differences in knee abduction moment that predispose females to ACL injury when compared with males. Controlled laboratory study. Motion analysis data of 67 athletes who performed a drop vertical jump were collected. The kinematic and kinetic data were used to categorize tertiles of relative risk, and these values were input into a cadaveric impact simulator to assess ligamentous loads during the simulated landing task. Uni- and multiaxial load cells and differential variable reluctance transducer strain sensors were utilized to collect kinetic data and maximum ACL strain for analysis. Conditions of external loads applied to the cadaveric limbs were systematically varied and randomized. Data were analyzed with 2-way repeated-measures analysis of variance and the Fisher exact test. Five kinetic parameters were evaluated. Of the 5 kinetic variables, only knee abduction moment (KAM) demonstrated significant differences in females as compared with males ( F 1,136 = 4.398, P = .038). When normalized to height and weight, this difference between males and females increased in significance ( F 1,136 = 7.155, P = .008). Compared with males, females exhibited a 10.3-N·m increased knee abduction torque at 66 milliseconds postimpact and a 22.3-N·m increased abduction torque at 100 milliseconds postimpact. For loading condition, the condition of "maximum ACL strain" demonstrated a maximum difference of 54.3-N·m increased abduction torque and 74.5-N·m increased abduction torque at 66 milliseconds postimpact. Under the tested conditions, increased external loads led to increased medial knee translation force, knee abduction moment, and external knee moment. Females exhibited greater forces and moments at the knee, especially at KAM, when loaded in similar conditions. As these KAM loads are associated with increased load and strain on the ACL, the sex-based differences observed in the present study may account for a portion of the underlying mechanics that predispose females to ACL injury as compared with males in a controlled simulated athletic task. KAM increases strain to the ACL under clinically representative loading. Additionally, this work establishes the biomechanical characteristics of knee loading between sexes.

Multi-frequency klystron designed for high efficiency

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

Jensen, Aaron

A multi-frequency klystron has an electron gun which generates a beam, a circuit of bunch-align-collect (BAC) tuned cavities that bunch the beam and amplify an RF signal, a collector where the beam is collected and dumped, and a standard output cavity and waveguide coupled to a window to output RF power at a fundamental mode to an external load. In addition, the klystron has additional bunch-align-collect (BAC) cavities tuned to a higher harmonic frequency, and a harmonic output cavity and waveguide coupled via a window to an additional external load.

Two-loads Method for Distinguishing among the Muscle Force, Velocity, and Power Producing Capacities

PubMed Central

Jaric, Slobodan

2016-01-01

It has been generally accepted that muscles could have different mechanical capacities, such as those for producing high force (F), velocity (V), and power (P) outputs. Nevertheless, the standard procedures of the evaluation of muscle function both in research and routine testing are typically conducted under a single mechanical condition, such as under a single external load. Therefore, the observed outcomes do not allow for distinguishing among the different muscle capacities. As a result, the outcomes of most of the routine testing procedures have been of limited informational value, while a number of debated issues in research have originated from arbitrarily interpreted experimental findings regarding specific muscle capacities. A solution for the discussed problem could be based on the approximately linear and exceptionally strong F-V relationship typically observed from various functional tasks performed under different external loads. These findings allow for the 'two-loads method' proposed in this Current Opinion: the functional movement tasks (e.g., maximum jumping, cycling, running, pushing, lifting, or throwing) should be tested against just 2 distinctive external loads. Namely, the F-V relationship determined by 2 pairs of the F and V data could provide the parameters depicting the maximum F (i.e., the F-intercept), V (V-intercept), and P (calculated from the product of F and V) output of the tested muscles. Therefore, the proposed two-loads method applied in both research and routine testing could provide a deeper insight into the mechanical properties and function of the tested muscles and resolve a number of debated issues in the literature. PMID:27075326

Ratings of perceived exertion by women with internal or external locus of control.

PubMed

Hassmén, P; Koivula, N

1996-10-01

Ratings of perceived exertion are frequently used to estimate the strain and effort experienced subjectively by individuals during various forms of physical activity. A number of factors, both physiological and psychological in origin, have been suggested to work as modifiers of the exertion perceived by the individual. It has been reported in nonsport-related research that individuals with an internal locus of control seem to pay more attention to relevant information and use the available information more adequately than individuals with an external locus of control. The reputed inferior information-processing abilities of externals compared with internals could possibly also influence the ratings of perceived exertion, with externals being less accurate in their ratings. Whether locus of control might be such a factor was investigated. Fifty women worked on an ergometer cycle at four different work loads. The results showed statistically significant differences in subjective ratings of perceived exertion between externals and internals, especially at heavier work loads. Such differences might be because of unequal information-processing abilities, as the observed discrepancies occurred at higher work intensities, when more cues are available for processing.

Advanced Human Factors Engineering Tool Technologies.

DTIC Science & Technology

1988-03-01

charger/ AC adapter immersible probe air temperature probe surface temperature probe . * Sling psychrometer , MSA or Taylor 1328A * Aspirating... psychrometer , Model PP-100 or CP-147, Psychro-Dyne * Wet-bulb-heat-stress monitor, Model B&K 1219, Briel & Kjaer Transducer, Model B&K MM 0030 (3 each), Brijel

Guadalcanal Operation. Volume 2

DTIC Science & Technology

1943-01-01

latest being a large peep baltle sight and leaf , permitting quick sighting. The sling was of a lacquered tight web. A cleaning rod snapped into the...defense along the Lunga would be by battalions, First, Second and Third, The First Battalion crossed the Ilu River in the vicinity of tli;-: Papaya

[Study on reductive surgery for pelvic organ prolapse concomitant with anti-incontinence sling for treatment of occult stress urinary incontinence].

PubMed

Zhang, Xiaolong; Lu, Yongxian; Shen, Wenjie; Liu, Jingxia; Ge, Jing; Liu, Xin; Zhao, Ying; Niu, Ke; Zhang, Yinghui; Wang, Wenying; Qiu, Chengli

2014-06-01

To evaluate the clinical outcome of anti-incontinence sling in the treatment of occult stress urinary incontinence (OSUI) during reductive surgery for advanced pelvic organ prolapse (POP). From Jun. 2003 to Dec. 2012, 78 patients with OSUI underwent reductive surgery for advanced POP such as high uterosacral ligament suspension, sacrospinous ligament suspension and sacral colpopexy in the First Affiliated Hospital, General Hospital of People's Liberation Army. Among them, 41 patients received reductive surgery alone was enrolled in non-concomitant anti-incontinence group and the other 37 patients who underwent same surgery with tension-free vaginal tape (TVT) or tension-free vaginal tape-obturator technique (TVT-O) was in anti-incontinence group. The patient's demography, objective and subjective outcomes, as well as complications and injures were compared between the two groups. The pelvic organ prolapse quantitation (POP-Q) was used to evaluate the objective outcomes of POP. Urinary distress inventory (UDI-6) and incontinence impact questionnaire short form (IIQ-7) were used to evaluate the subjective outcomes of stress urinary incontinence (SUI). Compared with the non-concomitant anti-incontinence group, the objective outcomes of reductive surgery exhibited no significant differences (100%, 78/78), and only the operation time of anti-incontinence group slightly increased 16 minutes. The occurrence rate of postoperative SUI was 12% (5/41), 15% (6/41), 17% (7/41) respectively after the operation at 2-month, 6-month and 12-month follow up in the non-concomitant anti-incontinence group; and the occurrence rate of the anti-incontinence group was 3% (1/37), 3% (1/37), 3% (1/37); but none of patients in the two groups require further surgery for stress urinary incontinence. Mean score of UDI-6 and IIQ-7 in all the patients decreased significantly after operation at 2-month, 6-month and 12-month follow up (all P < 0.01). However, there was no statistic difference between the two groups (P > 0.05). It is still difficult to make decision for concomitant anti-incontinence procedure in those patients with OSUI, who are undergoing reductive surgery because of advanced POP. Whether the patients will benefit more from anti-incontinence sling depends largely on strict preoperative evaluation for the severity of SUI. The patients with severe SUI are supposed to benefit most from anti-incontinence sling. However, a two-step approach to correct the postoperative stress urinary incontinence is also reasonable.

Evaluation of stability of interface between CCM (Co-Cr-Mo) UCLA abutment and external hex implant.

PubMed

Yoon, Ki-Joon; Park, Young-Bum; Choi, Hyunmin; Cho, Youngsung; Lee, Jae-Hoon; Lee, Keun-Woo

2016-12-01

The purpose of this study is to evaluate the stability of interface between Co-Cr-Mo (CCM) UCLA abutment and external hex implant. Sixteen external hex implant fixtures were assigned to two groups (CCM and Gold group) and were embedded in molds using clear acrylic resin. Screw-retained prostheses were constructed using CCM UCLA abutment and Gold UCLA abutment. The external implant fixture and screw-retained prostheses were connected using abutment screws. After the abutments were tightened to 30 Ncm torque, 5 kg thermocyclic functional loading was applied by chewing simulator. A target of 1.0 × 10 6 cycles was applied. After cyclic loading, removal torque values were recorded using a driving torque tester, and the interface between implant fixture and abutment was evaluated by scanning electronic microscope (SEM). The means and standard deviations (SD) between the CCM and Gold groups were analyzed with independent t-test at the significance level of 0.05. Fractures of crowns, abutments, abutment screws, and fixtures and loosening of abutment screws were not observed after thermocyclic loading. There were no statistically significant differences at the recorded removal torque values between CCM and Gold groups ( P >.05). SEM analysis revealed that remarkable wear patterns were observed at the abutment interface only for Gold UCLA abutments. Those patterns were not observed for other specimens. Within the limit of this study, CCM UCLA abutment has no statistically significant difference in the stability of interface with external hex implant, compared with Gold UCLA abutment.

The mechanism of bolt loading

NASA Technical Reports Server (NTRS)

Lee, H. M.

1992-01-01

It is shown that the mechanism of bolt loading for preloaded fasteners can be effectively portrayed through simple spring models and some algebraic manipulations. Understanding schematically what is involved in such joints provides insight into the distribution of loads. The developed equations confirm that for both symmetric and nonsymmetric joints the loading plane factor and the stiffness factor directly affect the load seen in preloaded fasteners. The manner in which an external loading is transferred through the joint can be explained as energy dissipated in the various springs of both the abutment and the bolt itself.

Response of Submerged Macrophyte Communities to External and Internal Restoration Measures in North Temperate Shallow Lakes.

PubMed

Hilt, Sabine; Alirangues Nuñez, Marta M; Bakker, Elisabeth S; Blindow, Irmgard; Davidson, Thomas A; Gillefalk, Mikael; Hansson, Lars-Anders; Janse, Jan H; Janssen, Annette B G; Jeppesen, Erik; Kabus, Timm; Kelly, Andrea; Köhler, Jan; Lauridsen, Torben L; Mooij, Wolf M; Noordhuis, Ruurd; Phillips, Geoff; Rücker, Jacqueline; Schuster, Hans-Heinrich; Søndergaard, Martin; Teurlincx, Sven; van de Weyer, Klaus; van Donk, Ellen; Waterstraat, Arno; Willby, Nigel; Sayer, Carl D

2018-01-01

Submerged macrophytes play a key role in north temperate shallow lakes by stabilizing clear-water conditions. Eutrophication has resulted in macrophyte loss and shifts to turbid conditions in many lakes. Considerable efforts have been devoted to shallow lake restoration in many countries, but long-term success depends on a stable recovery of submerged macrophytes. However, recovery patterns vary widely and remain to be fully understood. We hypothesize that reduced external nutrient loading leads to an intermediate recovery state with clear spring and turbid summer conditions similar to the pattern described for eutrophication. In contrast, lake internal restoration measures can result in transient clear-water conditions both in spring and summer and reversals to turbid conditions. Furthermore, we hypothesize that these contrasting restoration measures result in different macrophyte species composition, with added implications for seasonal dynamics due to differences in plant traits. To test these hypotheses, we analyzed data on water quality and submerged macrophytes from 49 north temperate shallow lakes that were in a turbid state and subjected to restoration measures. To study the dynamics of macrophytes during nutrient load reduction, we adapted the ecosystem model PCLake. Our survey and model simulations revealed the existence of an intermediate recovery state upon reduced external nutrient loading, characterized by spring clear-water phases and turbid summers, whereas internal lake restoration measures often resulted in clear-water conditions in spring and summer with returns to turbid conditions after some years. External and internal lake restoration measures resulted in different macrophyte communities. The intermediate recovery state following reduced nutrient loading is characterized by a few macrophyte species (mainly pondweeds) that can resist wave action allowing survival in shallow areas, germinate early in spring, have energy-rich vegetative propagules facilitating rapid initial growth and that can complete their life cycle by early summer. Later in the growing season these plants are, according to our simulations, outcompeted by periphyton, leading to late-summer phytoplankton blooms. Internal lake restoration measures often coincide with a rapid but transient colonization by hornworts, waterweeds or charophytes. Stable clear-water conditions and a diverse macrophyte flora only occurred decades after external nutrient load reduction or when measures were combined.

Applying torque to the Escherichia coli flagellar motor using magnetic tweezers.

PubMed

van Oene, Maarten M; Dickinson, Laura E; Cross, Bronwen; Pedaci, Francesco; Lipfert, Jan; Dekker, Nynke H

2017-03-07

The bacterial flagellar motor of Escherichia coli is a nanoscale rotary engine essential for bacterial propulsion. Studies on the power output of single motors rely on the measurement of motor torque and rotation under external load. Here, we investigate the use of magnetic tweezers, which in principle allow the application and active control of a calibrated load torque, to study single flagellar motors in Escherichia coli. We manipulate the external load on the motor by adjusting the magnetic field experienced by a magnetic bead linked to the motor, and we probe the motor's response. A simple model describes the average motor speed over the entire range of applied fields. We extract the motor torque at stall and find it to be similar to the motor torque at drag-limited speed. In addition, use of the magnetic tweezers allows us to force motor rotation in both forward and backward directions. We monitor the motor's performance before and after periods of forced rotation and observe no destructive effects on the motor. Our experiments show how magnetic tweezers can provide active and fast control of the external load while also exposing remaining challenges in calibration. Through their non-invasive character and straightforward parallelization, magnetic tweezers provide an attractive platform to study nanoscale rotary motors at the single-motor level.

Selective effects of weight and inertia on maximum lifting.

PubMed

Leontijevic, B; Pazin, N; Kukolj, M; Ugarkovic, D; Jaric, S

2013-03-01

A novel loading method (loading ranged from 20% to 80% of 1RM) was applied to explore the selective effects of externally added simulated weight (exerted by stretched rubber bands pulling downward), weight+inertia (external weights added), and inertia (covariation of the weights and the rubber bands pulling upward) on maximum bench press throws. 14 skilled participants revealed a load associated decrease in peak velocity that was the least associated with an increase in weight (42%) and the most associated with weight+inertia (66%). However, the peak lifting force increased markedly with an increase in both weight (151%) and weight+inertia (160%), but not with inertia (13%). As a consequence, the peak power output increased most with weight (59%), weight+inertia revealed a maximum at intermediate loads (23%), while inertia was associated with a gradual decrease in the peak power output (42%). The obtained findings could be of importance for our understanding of mechanical properties of human muscular system when acting against different types of external resistance. Regarding the possible application in standard athletic training and rehabilitation procedures, the results speak in favor of applying extended elastic bands which provide higher movement velocity and muscle power output than the usually applied weights. © Georg Thieme Verlag KG Stuttgart · New York.

Applying torque to the Escherichia coli flagellar motor using magnetic tweezers

PubMed Central

van Oene, Maarten M.; Dickinson, Laura E.; Cross, Bronwen; Pedaci, Francesco; Lipfert, Jan; Dekker, Nynke H.

2017-01-01

The bacterial flagellar motor of Escherichia coli is a nanoscale rotary engine essential for bacterial propulsion. Studies on the power output of single motors rely on the measurement of motor torque and rotation under external load. Here, we investigate the use of magnetic tweezers, which in principle allow the application and active control of a calibrated load torque, to study single flagellar motors in Escherichia coli. We manipulate the external load on the motor by adjusting the magnetic field experienced by a magnetic bead linked to the motor, and we probe the motor’s response. A simple model describes the average motor speed over the entire range of applied fields. We extract the motor torque at stall and find it to be similar to the motor torque at drag-limited speed. In addition, use of the magnetic tweezers allows us to force motor rotation in both forward and backward directions. We monitor the motor’s performance before and after periods of forced rotation and observe no destructive effects on the motor. Our experiments show how magnetic tweezers can provide active and fast control of the external load while also exposing remaining challenges in calibration. Through their non-invasive character and straightforward parallelization, magnetic tweezers provide an attractive platform to study nanoscale rotary motors at the single-motor level. PMID:28266562

Changes in the gait characteristics caused by external load, ground slope and velocity variation

NASA Astrophysics Data System (ADS)

Mrozowski, Jerzy; Awrejcewicz, Jan

2011-05-01

The complexity of the human gait manifests itself by lots of parameters that can evoke different changes in the walking manner. They can be divided into two groups: inherent, like anthropometric features or peculiar psychomotor type, and those related to the external conditions. The aim of the paper is to analyze the influence of three parameters, i.e. external load, ground slope and gait velocity, on the locomotion characteristics and the gait stability. Within the framework of investigations for different values of the mentioned parameters a film registration of the trajectories of selected kinematic nodes during some gait cycles has been carried out. The obtained data was a subject of numerical calculation aimed at extracting the essential properties of the principal gait characteristics.

Benthic-planktonic coupling, regime shifts, and whole-lake primary production in shallow lakes.

PubMed

Genkai-Kato, Motomi; Vadeboncoeur, Yvonne; Liboriussen, Lone; Jeppesen, Erik

2012-03-01

Alternative stable states in shallow lakes are typically characterized by submerged macrophyte (clear-water state) or phytoplankton (turbid state) dominance. However, a clear-water state may occur in eutrophic lakes even when macrophytes are absent. To test whether sediment algae could cause a regime shift in the absence of macrophytes, we developed a model of benthic (periphyton) and planktonic (phytoplankton) primary production using parameters derived from a shallow macrophyte-free lake that shifted from a turbid to a clear-water state following fish removal (biomanipulation). The model includes a negative feedback effect of periphyton on phosphorus (P) release from sediments. This in turn induces a positive feedback between phytoplankton production and P release. Scenarios incorporating a gradient of external P loading rates revealed that (1) periphyton and phytoplankton both contributed substantially to whole-lake production over a broad range of external P loading in a clear-water state; (2) during the clear-water state, the loss of benthic production was gradually replaced by phytoplankton production, leaving whole-lake production largely unchanged; (3) the responses of lakes to biomanipulation and increased external P loading were both dependent on lake morphometry; and (4) the capacity of periphyton to buffer the effects of increased external P loading and maintain a clear-water state was highly sensitive to relationships between light availability at the sediment surface and the of P release. Our model suggests a mechanism for the persistence of alternative states in shallow macrophyte-free lakes and demonstrates that regime shifts may trigger profound changes in ecosystem structure and function.

Stress analysis under component relative interference fit

NASA Technical Reports Server (NTRS)

Taylor, C. M.

1978-01-01

Finite-element computer program enables analysis of distortions and stresses occurring in components having relative interference. Program restricts itself to simple elements and axisymmetric loading situations. External inertial and thermal loads may be applied in addition to forces arising from interference conditions.

29 CFR 1926.1401 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-07-01

...-management or management personnel. Articulating crane means a crane whose boom consists of a series of... means a signal made by a distinct sound or series of sounds. Examples include, but are not limited to... sling (which may be incorporated into a full body harness) designed to support one employee in a sitting...

29 CFR 1926.1401 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-07-01

...-management or management personnel. Articulating crane means a crane whose boom consists of a series of... means a signal made by a distinct sound or series of sounds. Examples include, but are not limited to... sling (which may be incorporated into a full body harness) designed to support one employee in a sitting...

29 CFR 1926.1401 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-07-01

...-management or management personnel. Articulating crane means a crane whose boom consists of a series of... means a signal made by a distinct sound or series of sounds. Examples include, but are not limited to... sling (which may be incorporated into a full body harness) designed to support one employee in a sitting...

Change Agent Survival Guide

ERIC Educational Resources Information Center

Dunbar, Folwell L.

2011-01-01

Consulting is a rough racket. Only a tarantula hair above IRS agents, meter maids and used car sales people, the profession is a prickly burr for slings and arrows. Throw in education, focus on dysfunctional schools and call oneself a "change agent," and this bad rap all but disappears. Unfortunately, though, consulting/coaching/mentoring in…

PNNL Hoisting and Rigging Manual

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

Haynie, Todd O.; Fullmer, Michael W.

2008-12-29

This manual describes the safe and cost effective operation, inspection, maintenance, and repair requirements for cranes, hoists, fork trucks, slings, rigging hardware, and hoisting equipment. It is intended to be a user's guide to requirements, codes, laws, regulations, standards, and practices that apply to Pacific Northwest National Laboratory (PNNL) and its subcontractors.

31. DETAIL OF PRESSURE GAUGE AND ASSOCIATED VALVES AND TUBING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

31. DETAIL OF PRESSURE GAUGE AND ASSOCIATED VALVES AND TUBING FOR STRETCH SLING CYLINDER. GAUGE LOCATED IN SOUTHWEST CORNER OF SLC-3W MST STATION 78. - Vandenberg Air Force Base, Space Launch Complex 3, Launch Pad 3 West, Napa & Alden Roads, Lompoc, Santa Barbara County, CA

29 CFR 1926.1401 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-07-01

...-management or management personnel. Articulating crane means a crane whose boom consists of a series of... means a signal made by a distinct sound or series of sounds. Examples include, but are not limited to... sling (which may be incorporated into a full body harness) designed to support one employee in a sitting...

46 CFR 131.530 - Abandon-ship training and drills.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Abandon-ship training and drills. 131.530 Section 131... OPERATIONS Tests, Drills, and Inspections § 131.530 Abandon-ship training and drills. (a) Material for... rescue gear (slings, baskets, stretchers) and vessel's line-throwing apparatus. (b) An abandon-ship drill...

46 CFR 131.530 - Abandon-ship training and drills.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 4 2014-10-01 2014-10-01 false Abandon-ship training and drills. 131.530 Section 131... OPERATIONS Tests, Drills, and Inspections § 131.530 Abandon-ship training and drills. (a) Material for... rescue gear (slings, baskets, stretchers) and vessel's line-throwing apparatus. (b) An abandon-ship drill...

46 CFR 131.530 - Abandon-ship training and drills.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Abandon-ship training and drills. 131.530 Section 131... OPERATIONS Tests, Drills, and Inspections § 131.530 Abandon-ship training and drills. (a) Material for... rescue gear (slings, baskets, stretchers) and vessel's line-throwing apparatus. (b) An abandon-ship drill...

Lifting clamp positively grips structural shapes

NASA Technical Reports Server (NTRS)

Reinhardt, E. C.

1966-01-01

Welded steel clamps securely grip structural shapes of various sizes for crane operations. The clamp has adjustable clamping jaws and screw-operated internal v-jaws and provides greater safety than hoisting slings presently used. The structural member can be rotated in any manner, angle, or direction without being released by the clamp.

29 CFR 1926.1400 - Scope.

Code of Federal Regulations, 2011 CFR

2011-07-01

... loaders. This machinery is also excluded when used with chains, slings or other rigging to lift suspended... that deliver material to a construction site when the crane is used to transfer building supply sheet goods or building supply packaged materials from the truck crane onto a structure, using a fork/cradle...

76 FR 67225 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Standard on...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-31

... (DOL) is submitting the Occupational Safety and Health Administration (OSHA) sponsored information... Regulatory Affairs, Attn: OMB Desk Officer for the Department of Labor, Occupational Safety and Health... Health Administration (OSHA). Title of Collection: Standard on Slings. OMB Control Number: 1218-0223...

Explosive Cratering Performance Tests

DTIC Science & Technology

1981-07-02

0.25 cm) rain bucket Sling psychrometer ± 1%, ± 10 C 3 TOP 4-2-830 2 July 1981 ITEM REQUIR•4ENT Instrumentation Range/Minimum Accuracy Wind indicator...burial depths. History of prior excavation or disturbance among the various crater sites within the test area should be comparatively equal. However

A comparison of methods to quantify the in-season training load of professional soccer players.

PubMed

Scott, Brendan R; Lockie, Robert G; Knight, Timothy J; Clark, Andrew C; Janse de Jonge, Xanne A K

2013-03-01

To compare various measures of training load (TL) derived from physiological (heart rate [HR]), perceptual (rating of perceived exertion [RPE]), and physical (global positioning system [GPS] and accelerometer) data during in-season field-based training for professional soccer. Fifteen professional male soccer players (age 24.9 ± 5.4 y, body mass 77.6 ± 7.5 kg, height 181.1 ± 6.9 cm) were assessed in-season across 97 individual training sessions. Measures of external TL (total distance [TD], the volume of low-speed activity [LSA; <14.4 km/h], high-speed running [HSR; >14.4 km/h], very high-speed running [VHSR; >19.8 km/h], and player load), HR and session-RPE (sRPE) scores were recorded. Internal TL scores (HR-based and sRPE-based) were calculated, and their relationships with measures of external TL were quantified using Pearson product-moment correlations. Physical measures of TD, LSA volume, and player load provided large, significant (r = .71-.84; P < .01) correlations with the HR-based and sRPE-based methods. Volume of HSR and VHSR provided moderate to large, significant (r = .40-.67; P < .01) correlations with measures of internal TL. While the volume of HSR and VHSR provided significant relationships with internal TL, physical-performance measures of TD, LSA volume, and player load appear to be more acceptable indicators of external TL, due to the greater magnitude of their correlations with measures of internal TL.

Handball load and shoulder injury rate: a 31-week cohort study of 679 elite youth handball players.

PubMed

Møller, M; Nielsen, R O; Attermann, J; Wedderkopp, N; Lind, M; Sørensen, H; Myklebust, G

2017-02-01

Knowledge of injury patterns, an essential step towards injury prevention, is lacking in youth handball. To investigate if an increase in handball load is associated with increased shoulder injury rates compared with a minor increase or decrease, and if an association is influenced by scapular control, isometric shoulder strength or glenohumeral range of motion (ROM). 679 players (14-18 years) provided weekly reports on shoulder injury and handball load (training and competition hours) over 31 weeks using the SMS, phone and medical examination system. Handball load in a given week was categorised into (1) <20% increase or decrease (reference), (2) increase between 20% and 60% and (3) increase >60% relative to the weekly average amount of handball load the preceding 4 weeks. Assessment of shoulder isometric rotational and abduction strength, ROM and scapular control was performed at baseline and midseason. An increase in handball load by >60% was associated with greater shoulder injury rate (HR 1.91; 95% CI 1.00 to 3.70, p=0.05) compared with the reference group. The effect of an increase in handball load between 20% and 60% was exacerbated among players with reduced external rotational strength (HR 4.0; 95% CI 1.1 to 15.2, p=0.04) or scapular dyskinesis (HR 4.8; 95% CI 1.3 to 18.3, p=0.02). Reduced external rotational strength exacerbated the effect of an increase above 60% (HR 4.2; 95% CI 1.4 to 12.8, p=0.01). A large increase in weekly handball load increases the shoulder injury rate in elite youth handball players; particularly, in the presence of reduced external rotational strength or scapular dyskinesis. 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/.

An analysis of cross-coupling of a multicomponent jet engine test stand using finite element modeling techniques

NASA Technical Reports Server (NTRS)

Schweikhard, W. G.; Singnoi, W. N.

1985-01-01

A two axis thrust measuring system was analyzed by using a finite a element computer program to determine the sensitivities of the thrust vectoring nozzle system to misalignment of the load cells and applied loads, and the stiffness of the structural members. Three models were evaluated: (1) the basic measuring element and its internal calibration load cells; (2) the basic measuring element and its external load calibration equipment; and (3) the basic measuring element, external calibration load frame and the altitude facility support structure. Alignment of calibration loads was the greatest source of error for multiaxis thrust measuring systems. Uniform increases or decreases in stiffness of the members, which might be caused by the selection of the materials, have little effect on the accuracy of the measurements. It is found that the POLO-FINITE program is a viable tool for designing and analyzing multiaxis thrust measurement systems. The response of the test stand to step inputs that might be encountered with thrust vectoring tests was determined. The dynamic analysis show a potential problem for measuring the dynamic response characteristics of thrust vectoring systems because of the inherently light damping of the test stand.

Poor phonetic perceivers are affected by cognitive load when resolving talker variability

PubMed Central

Antoniou, Mark; Wong, Patrick C. M.

2015-01-01

Speech training paradigms aim to maximise learning outcomes by manipulating external factors such as talker variability. However, not all individuals may benefit from such manipulations because subject-external factors interact with subject-internal ones (e.g., aptitude) to determine speech perception and/or learning success. In a previous tone learning study, high-aptitude individuals benefitted from talker variability, whereas low-aptitude individuals were impaired. Because increases in cognitive load have been shown to hinder speech perception in mixed-talker conditions, it has been proposed that resolving talker variability requires cognitive resources. This proposal leads to the hypothesis that low-aptitude individuals do not use their cognitive resources as efficiently as those with high aptitude. Here, high- and low-aptitude subjects identified pitch contours spoken by multiple talkers under high and low cognitive load conditions established by a secondary task. While high-aptitude listeners outperformed low-aptitude listeners across load conditions, only low-aptitude listeners were impaired by increased cognitive load. The findings suggest that low-aptitude listeners either have fewer available cognitive resources or are poorer at allocating attention to the signal. Therefore, cognitive load is an important factor when considering individual differences in speech perception and training paradigms. PMID:26328675

Poor phonetic perceivers are affected by cognitive load when resolving talker variability.

PubMed

Antoniou, Mark; Wong, Patrick C M

2015-08-01

Speech training paradigms aim to maximise learning outcomes by manipulating external factors such as talker variability. However, not all individuals may benefit from such manipulations because subject-external factors interact with subject-internal ones (e.g., aptitude) to determine speech perception and/or learning success. In a previous tone learning study, high-aptitude individuals benefitted from talker variability, whereas low-aptitude individuals were impaired. Because increases in cognitive load have been shown to hinder speech perception in mixed-talker conditions, it has been proposed that resolving talker variability requires cognitive resources. This proposal leads to the hypothesis that low-aptitude individuals do not use their cognitive resources as efficiently as those with high aptitude. Here, high- and low-aptitude subjects identified pitch contours spoken by multiple talkers under high and low cognitive load conditions established by a secondary task. While high-aptitude listeners outperformed low-aptitude listeners across load conditions, only low-aptitude listeners were impaired by increased cognitive load. The findings suggest that low-aptitude listeners either have fewer available cognitive resources or are poorer at allocating attention to the signal. Therefore, cognitive load is an important factor when considering individual differences in speech perception and training paradigms.

Joint angles of the ankle, knee, and hip and loading conditions during split squats.

PubMed

Schütz, Pascal; List, Renate; Zemp, Roland; Schellenberg, Florian; Taylor, William R; Lorenzetti, Silvio

2014-06-01

The aim of this study was to quantify how step length and the front tibia angle influence joint angles and loading conditions during the split squat exercise. Eleven subjects performed split squats with an additional load of 25% body weight applied using a barbell. Each subject's movements were recorded using a motion capture system, and the ground reaction force was measured under each foot. The joint angles and loading conditions were calculated using a cluster-based kinematic approach and inverse dynamics modeling respectively. Increases in the tibia angle resulted in a smaller range of motion (ROM) of the front knee and a larger ROM of the rear knee and hip. The external flexion moment in the front knee/hip and the external extension moment in the rear hip decreased as the tibia angle increased. The flexion moment in the rear knee increased as the tibia angle increased. The load distribution between the legs changed < 25% when split squat execution was varied. Our results describing the changes in joint angles and the resulting differences in the moments of the knee and hip will allow coaches and therapists to adapt the split squat exercise to the individual motion and load demands of athletes.

Distraction and Mind-Wandering Under Load

PubMed Central

Forster, Sophie

2013-01-01

Attention research over the last several decades has provided rich insights into the determinants of distraction, including distractor characteristics, task features, and individual differences. Load Theory represented a particularly important breakthrough, highlighting the critical role of the level and nature of task-load in determining both the efficiency of distractor rejection and the stage of processing at which this occurs. However, until recently studies of distraction were restricted to those measuring rather specific forms of distraction by external stimuli which I argue that, although intended to be irrelevant, were in fact task-relevant. In daily life, attention may be distracted by a wide range of stimuli, which may often be entirely unrelated to any task being performed, and may include not only external stimuli but also internally generated stimuli such as task-unrelated thoughts. This review outlines recent research examining these more general, entirely task-irrelevant, forms of distraction within the framework of Load Theory. I discuss the relation between different forms of distraction, and the universality of load effects across different distractor types and individuals. PMID:23734138

Interface Stability Influences Torso Muscle Recruitment and Spinal Load During Pushing Tasks

PubMed Central

LEE, P. J.; GRANATA, K. P.

2006-01-01

Handle or interface design can influence torso muscle recruitment and spinal load during pushing tasks. The objective of the study was to provide insight into the role of interface stability with regard to torso muscle recruitment and biomechanical loads on the spine. Fourteen subjects generated voluntary isometric trunk flexion force against a rigid interface and similar flexion exertions against an unstable interface, which simulated handle design in a cart pushing task. Normalized electromyographic (EMG) activity in the rectus abdominus, external oblique and internal oblique muscles increased with exertion effort. When using the unstable interface, EMG activity in the internal and external oblique muscle groups was greater than when using the rigid interface. Results agreed with trends from a biomechanical model implemented to predict the muscle activation necessary to generate isometric pushing forces and maintain spinal stability when using the two different interface designs. The co-contraction contributed to increased spinal load when using the unstable interface. It was concluded that handle or interface design and stability may influence spinal load and associated risk of musculoskeletal injury during manual materials tasks that involve pushing exertions. PMID:16540437

Apparatus for material tests using an internal loading system in high-pressure gas at room temperature.

PubMed

Imade, M; Fukuyama, S; Yokogawa, K

2008-07-01

A new type of apparatus for material tests using an internal loading system in high-pressure gas up to 100 MPa at room temperature without conventional material testing equipment was developed. The apparatus consists of a high-pressure control system and a pressure vessel, in which a piston is installed in the cylinder of the pressure vessel. The load caused by the pressure difference between spaces separated by the piston in the vessel cylinder is applied on the specimen connected to the piston in the vessel cylinder. The actual load on the specimen is directly measured by an external load cell and the displacement of the specimen is also measured by an external extensometer. As an example of the application of the apparatus, a tensile test on SUS316 stainless steel the Japanese Industrial Standard (JIS) G4303, which is comparable to the type 316 stainless steel ASTM A276, was conducted in 90 MPa hydrogen and argon. Hydrogen showed a marked effect on the tensile property of the material. The hydrogen gas embrittlement of the material was briefly discussed.

Apparatus for material tests using an internal loading system in high-pressure gas at room temperature

NASA Astrophysics Data System (ADS)

Imade, M.; Fukuyama, S.; Yokogawa, K.

2008-07-01

A new type of apparatus for material tests using an internal loading system in high-pressure gas up to 100MPa at room temperature without conventional material testing equipment was developed. The apparatus consists of a high-pressure control system and a pressure vessel, in which a piston is installed in the cylinder of the pressure vessel. The load caused by the pressure difference between spaces separated by the piston in the vessel cylinder is applied on the specimen connected to the piston in the vessel cylinder. The actual load on the specimen is directly measured by an external load cell and the displacement of the specimen is also measured by an external extensometer. As an example of the application of the apparatus, a tensile test on SUS316 stainless steel the Japanese Industrial Standard (JIS) G4303, which is comparable to the type 316 stainless steel ASTM A276, was conducted in 90MPa hydrogen and argon. Hydrogen showed a marked effect on the tensile property of the material. The hydrogen gas embrittlement of the material was briefly discussed.

46 CFR 38.05-3 - Design and construction of pressure vessel type cargo tanks-TB/ALL.

Code of Federal Regulations, 2013 CFR

2013-10-01

... subjected to external loads. Consideration shall also be given to excessive loads that can be imposed on the tanks by their support due to static and dynamic forces under operating conditions or during testing...

46 CFR 38.05-3 - Design and construction of pressure vessel type cargo tanks-TB/ALL.

Code of Federal Regulations, 2011 CFR

2011-10-01

... subjected to external loads. Consideration shall also be given to excessive loads that can be imposed on the tanks by their support due to static and dynamic forces under operating conditions or during testing...

46 CFR 38.05-3 - Design and construction of pressure vessel type cargo tanks-TB/ALL.

Code of Federal Regulations, 2014 CFR

2014-10-01

... subjected to external loads. Consideration shall also be given to excessive loads that can be imposed on the tanks by their support due to static and dynamic forces under operating conditions or during testing...

46 CFR 38.05-3 - Design and construction of pressure vessel type cargo tanks-TB/ALL.

Code of Federal Regulations, 2012 CFR

2012-10-01

... subjected to external loads. Consideration shall also be given to excessive loads that can be imposed on the tanks by their support due to static and dynamic forces under operating conditions or during testing...

Effect of axial tibial torque direction on ACL relative strain and strain rate in an in vitro simulated pivot landing.

PubMed

Oh, Youkeun K; Kreinbrink, Jennifer L; Wojtys, Edward M; Ashton-Miller, James A

2012-04-01

Anterior cruciate ligament (ACL) injuries most frequently occur under the large loads associated with a unipedal jump landing involving a cutting or pivoting maneuver. We tested the hypotheses that internal tibial torque would increase the anteromedial (AM) bundle ACL relative strain and strain rate more than would the corresponding external tibial torque under the large impulsive loads associated with such landing maneuvers. Twelve cadaveric female knees [mean (SD) age: 65.0 (10.5) years] were tested. Pretensioned quadriceps, hamstring, and gastrocnemius muscle-tendon unit forces maintained an initial knee flexion angle of 15°. A compound impulsive test load (compression, flexion moment, and internal or external tibial torque) was applied to the distal tibia while recording the 3D knee loads and tibofemoral kinematics. AM-ACL relative strain was measured using a 3 mm DVRT. In this repeated measures experiment, the Wilcoxon signed-rank test was used to test the null hypotheses with p < 0.05 considered significant. The mean (±SD) peak AM-ACL relative strains were 5.4 ± 3.7% and 3.1 ± 2.8% under internal and external tibial torque, respectively. The corresponding mean (± SD) peak AM-ACL strain rates reached 254.4 ± 160.1%/s and 179.4 ± 109.9%/s, respectively. The hypotheses were supported in that the normalized mean peak AM-ACL relative strain and strain rate were 70 and 42% greater under internal than under external tibial torque, respectively (p = 0.023, p = 0.041). We conclude that internal tibial torque is a potent stressor of the ACL because it induces a considerably (70%) larger peak strain in the AM-ACL than does a corresponding external tibial torque. Copyright © 2011 Orthopaedic Research Society.

Buckling tests of two 4.6-meter-diameter, magnesium ring-stiffened conical shells loaded under external pressure

NASA Technical Reports Server (NTRS)

Anderson, J. K.; DAVIS R. C.

1973-01-01

Two ring-stiffened magnesium conical shells with a 120 deg apex angle and a 4.6-meter diameter were loaded to failure by a uniform external pressure. The cones differed from one another only in the number of internal stiffening rings. Test specimen details, test procedure, and test results are discussed. Both buckling and prebuckling data are compared with appropriate theoretical predictions. Measured strains in skin and rings agreed well with theoretical predictions. Extensive imperfection measurements were made and reported on both cones in the as fabricated condition.

77 FR 56581 - Airworthiness Directives; Sikorsky Aircraft Corporation Helicopters

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-13

... HEC, in this model helicopter that now meets the Category A performance standard. DATES: We must... airworthiness directive (AD) for the Sikorsky Aircraft Corporation (Sikorsky) Model S-92A helicopter, which... external load operations, including human external cargo (HEC), because this model helicopter was not...

Nutrient additions by waterfowl to lakes and reservoirs: predicting their effects on productivity and water quality

USGS Publications Warehouse

Manny, Bruce A.; Johnson, W.C.; Wetzel, R.G.

1994-01-01

Lakes and reservoirs provide water for human needs and habitat for aquatic birds. Managers of such waters may ask whether nutrients added by waterfowl degrade water quality. For lakes and reservoirs where primary productivity is limited by phosphorus (P), we developed a procedure that integrates annual P loads from waterfowl and other external sources, applies a nutrient load-response model, and determines whether waterfowl that used the lake or reservoir degraded water quality. Annual P loading by waterfowl can be derived from a figure in this report, using the days per year that each kind spent on any lake or reservoir. In our example, over 6500 Canada geese (Branta canadensis) and 4200 ducks (mostly mallards, Anas platyrhynchos) added 4462 kg of carbon (C), 280 kg of nitrogen (N), and 88 kg of P y-1 to Wintergreen Lake in southwestern Michigan, mostly during their migration. These amounts were 69% of all C, 27% of all N, and 70% of all P that entered the lake from external sources. Loads from all external sources totaled 840 mg P m-2 y-1. Application of a nutrient load-response model to this concentration, the hydraulic load (0.25 m y-1), and the water residence time (9.7 y) of Wintergreen Lake yielded an average annual concentration of total P in the lake of 818 mg m-3 that classified the lake as hypertrophic. This trophic classification agreed with independent measures of primary productivity, chlorophyll-a, total P, total N, and Secchi disk transparency made in Wintergreen Lake. Our procedure showed that waterfowl caused low water quality in Wintergreen Lake.

Stochastic dynamics of small ensembles of non-processive molecular motors: The parallel cluster model

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

Erdmann, Thorsten; Albert, Philipp J.; Schwarz, Ulrich S.

2013-11-07

Non-processive molecular motors have to work together in ensembles in order to generate appreciable levels of force or movement. In skeletal muscle, for example, hundreds of myosin II molecules cooperate in thick filaments. In non-muscle cells, by contrast, small groups with few tens of non-muscle myosin II motors contribute to essential cellular processes such as transport, shape changes, or mechanosensing. Here we introduce a detailed and analytically tractable model for this important situation. Using a three-state crossbridge model for the myosin II motor cycle and exploiting the assumptions of fast power stroke kinetics and equal load sharing between motors inmore » equivalent states, we reduce the stochastic reaction network to a one-step master equation for the binding and unbinding dynamics (parallel cluster model) and derive the rules for ensemble movement. We find that for constant external load, ensemble dynamics is strongly shaped by the catch bond character of myosin II, which leads to an increase of the fraction of bound motors under load and thus to firm attachment even for small ensembles. This adaptation to load results in a concave force-velocity relation described by a Hill relation. For external load provided by a linear spring, myosin II ensembles dynamically adjust themselves towards an isometric state with constant average position and load. The dynamics of the ensembles is now determined mainly by the distribution of motors over the different kinds of bound states. For increasing stiffness of the external spring, there is a sharp transition beyond which myosin II can no longer perform the power stroke. Slow unbinding from the pre-power-stroke state protects the ensembles against detachment.« less

Misfit of Three Different Implant-Abutment Connections Before and After Cyclic Load Application: An In Vitro Study.

PubMed

Gehrke, Sergio Alexandre; Delgado-Ruiz, Rafael Arcesio; Prados Frutos, Juan Carlos; Prados-Privado, María; Dedavid, Berenice Anina; Granero Marín, Jose Manuel; Calvo Guirado, José Luiz

This study aimed to evaluate the misfit of three different implant-abutment connections before and after cycling load. One hundred twenty dental implants and correspondent prefabricated titanium abutments were used. Three different implant-abutment connections were evaluated: Morse taper (MT group), external hexagon (EH group), and internal hexagon (IH group). Forty implants and 40 abutments were used per group. The parameters for the mechanical evaluation were set as: 360,000 cycles, load of 150 N, and frequency of 4 Hz. Samples were sectioned in their longitudinal and transversal axes, and the misfit of the implant-abutment connection was evaluated by scanning electron microscopy analysis. One-way analyses of variance, Tukey post hoc analyses (α = .05), and t test (P < .05) were used to determine differences between groups. At the longitudinal direction, all the groups showed the presence of microgaps before cycling load; after cycling load, microgaps were reduced in all groups (P > .05). Transversally, only the MT group showed full fitting after cycling load compared with the other groups (EH and IH) (P < .0001). The application of cycling load produces an accommodation of the implant-abutment connection in internal, external, and Morse taper connections. In the longitudinal direction, the accommodation decreases and/or eliminates the gap observed initially (before load). In the horizontal direction, Morse cone implant-abutment connections experience a complete accommodation with the elimination of the gap.

Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone

PubMed Central

Ono, Y.; Woodmass, J. M.; Nelson, A. A.; Boorman, R. S.; Thornton, G. M.

2016-01-01

Objectives This study evaluated the mechanical performance, under low-load cyclic loading, of two different knotless suture anchor designs: sutures completely internal to the anchor body (SpeedScrew) and sutures external to the anchor body and adjacent to bone (MultiFIX P). Methods Using standard suture loops pulled in-line with the rotator cuff (approximately 60°), anchors were tested in cadaveric bone and foam blocks representing normal to osteopenic bone. Mechanical testing included preloading to 10 N and cyclic loading for 500 cycles from 10 N to 60 N at 60 mm/min. The parameters evaluated were initial displacement, cyclic displacement and number of cycles and load at 3 mm displacement relative to preload. Video recording throughout testing documented the predominant source of suture displacement and the distance of ‘suture cutting through bone’. Results In cadaveric bone and foam blocks, MultiFIX P anchors had significantly greater initial displacement, and lower number of cycles and lower load at 3 mm displacement than SpeedScrew anchors. Video analysis revealed ‘suture cutting through bone’ as the predominant source of suture displacement in cadaveric bone (qualitative) and greater ‘suture cutting through bone’ comparing MultiFIX P with SpeedScrew anchors in foam blocks (quantitative). The greater suture displacement in MultiFIX P anchors was predominantly from suture cutting through bone, which was enhanced in an osteopenic bone model. Conclusions Anchors with sutures external to the anchor body are at risk for suture cutting through bone since the suture eyelet is at the distal tip of the implant and the suture directly abrades against the bone edge during cyclic loading. Suture cutting through bone may be a significant source of fixation failure, particularly in osteopenic bone. Cite this article: Y. Ono, J. M. Woodmass, A. A. Nelson, R. S. Boorman, G. M. Thornton, I. K. Y. Lo. Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone. Bone Joint Res 2016;5:269–275. DOI: 10.1302/2046-3758.56.2000535. PMID:27357383

Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone.

PubMed

Ono, Y; Woodmass, J M; Nelson, A A; Boorman, R S; Thornton, G M; Lo, I K Y

2016-06-01

This study evaluated the mechanical performance, under low-load cyclic loading, of two different knotless suture anchor designs: sutures completely internal to the anchor body (SpeedScrew) and sutures external to the anchor body and adjacent to bone (MultiFIX P). Using standard suture loops pulled in-line with the rotator cuff (approximately 60°), anchors were tested in cadaveric bone and foam blocks representing normal to osteopenic bone. Mechanical testing included preloading to 10 N and cyclic loading for 500 cycles from 10 N to 60 N at 60 mm/min. The parameters evaluated were initial displacement, cyclic displacement and number of cycles and load at 3 mm displacement relative to preload. Video recording throughout testing documented the predominant source of suture displacement and the distance of 'suture cutting through bone'. In cadaveric bone and foam blocks, MultiFIX P anchors had significantly greater initial displacement, and lower number of cycles and lower load at 3 mm displacement than SpeedScrew anchors. Video analysis revealed 'suture cutting through bone' as the predominant source of suture displacement in cadaveric bone (qualitative) and greater 'suture cutting through bone' comparing MultiFIX P with SpeedScrew anchors in foam blocks (quantitative). The greater suture displacement in MultiFIX P anchors was predominantly from suture cutting through bone, which was enhanced in an osteopenic bone model. Anchors with sutures external to the anchor body are at risk for suture cutting through bone since the suture eyelet is at the distal tip of the implant and the suture directly abrades against the bone edge during cyclic loading. Suture cutting through bone may be a significant source of fixation failure, particularly in osteopenic bone.Cite this article: Y. Ono, J. M. Woodmass, A. A. Nelson, R. S. Boorman, G. M. Thornton, I. K. Y. Lo. Knotless anchors with sutures external to the anchor body may be at risk for suture cutting through osteopenic bone. Bone Joint Res 2016;5:269-275. DOI: 10.1302/2046-3758.56.2000535. © 2016 Lo et al.

Influence of Wall Porosity and Surfaces Roughness on the Steady Performance of an Externally Pressurized Hydrostatic Conical Bearing Lubricated by a Rabinowitsch Fluid

NASA Astrophysics Data System (ADS)

Walicka, A.; Walicki, E.; Jurczak, P.; Falicki, J.

2017-08-01

In the paper, the influence of both the bearing surfaces roughness as well as porosity of one bearing surface on the pressure distribution and load-carrying capacity of a curvilinear, externally pressurized, thrust bearing is discussed. The equations of motion of a pseudo-plastic Rabinowitsch fluid are used to derive the Reynolds equation. After general considerations on the flow in a bearing clearance and in a porous layer using the Morgan-Cameron approximation and Christensen theory of hydrodynamic lubrication with rough bearing surfaces the modified Reynolds equation is obtained. The analytical solution is presented; as a result one obtains the formulae expressing the pressure distribution and load-carrying capacity. Thrust radial and conical bearings, externally pressurized, are considered as numerical examples.

Evaluation of stability of interface between CCM (Co-Cr-Mo) UCLA abutment and external hex implant

PubMed Central

Yoon, Ki-Joon; Park, Young-Bum; Choi, Hyunmin; Cho, Youngsung; Lee, Jae-Hoon

2016-01-01

PURPOSE The purpose of this study is to evaluate the stability of interface between Co-Cr-Mo (CCM) UCLA abutment and external hex implant. MATERIALS AND METHODS Sixteen external hex implant fixtures were assigned to two groups (CCM and Gold group) and were embedded in molds using clear acrylic resin. Screw-retained prostheses were constructed using CCM UCLA abutment and Gold UCLA abutment. The external implant fixture and screw-retained prostheses were connected using abutment screws. After the abutments were tightened to 30 Ncm torque, 5 kg thermocyclic functional loading was applied by chewing simulator. A target of 1.0 × 106 cycles was applied. After cyclic loading, removal torque values were recorded using a driving torque tester, and the interface between implant fixture and abutment was evaluated by scanning electronic microscope (SEM). The means and standard deviations (SD) between the CCM and Gold groups were analyzed with independent t-test at the significance level of 0.05. RESULTS Fractures of crowns, abutments, abutment screws, and fixtures and loosening of abutment screws were not observed after thermocyclic loading. There were no statistically significant differences at the recorded removal torque values between CCM and Gold groups (P>.05). SEM analysis revealed that remarkable wear patterns were observed at the abutment interface only for Gold UCLA abutments. Those patterns were not observed for other specimens. CONCLUSION Within the limit of this study, CCM UCLA abutment has no statistically significant difference in the stability of interface with external hex implant, compared with Gold UCLA abutment. PMID:28018564

Differentiated perceptions of exertion and energy cost of young women while carrying loads.

PubMed

Robertson, R J; Caspersen, C J; Allison, T G; Skrinar, G S; Abbott, R A; Metz, K F

1982-01-01

Differentiated local ratings of perceived exertion from the legs and central ratings from the chest, and oxygen consumption, were determined during load carriage in seven young women. Subjects walked for 6 min at 3.22, 4.83, 6.44, or 8.05 km X h-1 carrying (1) no load, (2) a load equal to 7.5% of body weight (mean: 4.66 kg) or (3) a load equal to 15% of body weight (mean: 9.32 kg). Thus, each subject underwent 12 separate tests. The external loads were in the form of lead pellets carried in a plastic scuba belt worn around the waist. A differentiation threshold was found at 6.44 km X h-1 for the 0% and 7.5% loads and at 4.83 km X h-1 for the 15% load. At speeds below the threshold, the perception of exertion was similar in the legs, chest and overall. At higher speeds, exertion was perceived to be more intense in the legs than overall and less intense in the chest than overall, suggesting that the local legs signal was the dominant factor in shaping the overall sensation of exertion. The oxygen uptake was greater for the 15% load than for either the 0% or 7.5% loads, but was similar for the 0% and 7.5% loads. Findings suggested a critical weight limit for external loads that could be transported without increasing the metabolic cost beyond that required to move the body weight alone. This limit fell between 7.5% and 15% of the body weight. When oxygen uptake was expressed per kg of total weight transported, there was no loss of metabolic efficiency while carrying loads up to 15% of the body weight.

29 CFR 1910.181 - Derricks.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., working means the external load, in pounds, applied to the derrick, including the weight of load attaching... securely affixed where it is visible to personnel responsible for the safe operation of the equipment. The... of service, and environment, or as specifically indicated below. These inspections shall include the...

The effect of the long head of the biceps on glenohumeral kinematics.

PubMed

Youm, Thomas; ElAttrache, Neal S; Tibone, James E; McGarry, Michelle H; Lee, Thay Q

2009-01-01

The long head of the biceps has been described as a stabilizing force in the setting of glenohumeral instability. However, data are lacking on the effect of loading the long head of the biceps on glenohumeral kinematics. Six cadaveric shoulders were tested for glenohumeral rotational range of motion and translation using a custom shoulder testing system and the Microscribe 3DLX (Immersion, San Jose, CA). The path of glenohumeral articulation (PGA) was measured by calculating the humeral head center with respect to the glenoid articular surface at maximal internal rotation, 30 degrees, 60 degrees, 90 degrees, and maximal external rotation. Significant decreases in glenohumeral rotational range of motion and translation were found with 22-N biceps loading vs the unloaded group. With respect to the PGA, the humeral rotation center was shifted posterior with biceps loading at maximal internal rotation, 30 degrees, and 60 degrees of external rotation. Loading the long head of the biceps significantly affects glenohumeral rotational range of motion, translations, and kinematics.

Effect of increased crown height on stress distribution in short dental implant components and their surrounding bone: A finite element analysis.

PubMed

Bulaqi, Haddad Arabi; Mousavi Mashhadi, Mahmoud; Safari, Hamed; Samandari, Mohammad Mahdi; Geramipanah, Farideh

2015-06-01

Implants in posterior regions of the jaw require short dental implants with long crown heights, leading to increased crown-to-implant ratios and mechanical stress. This can lead to fracture and screw loosening. The purpose of this study was to investigate the dynamic nature and behavior of prosthetic components and preimplant bone and evaluate the effect of increased crown height space (CHS) and crown-to-implant ratio on stress concentrations under external oblique forces. The severely resorbed bone of a posterior mandible site was modeled with Mimics and Catia software. A second mandibular premolar tooth was modeled with CHS values of 8.8, 11.2, 13.6, and 16 mm. A Straumann implant (4.1×8 mm), a directly attached crown, and an abutment screw were modeled with geometric data and designed by using SolidWorks software. Abaqus software was used for the dynamic simulation of screw tightening and the application of an external load to the buccal cusp at a 75.8-degree angle with the occlusal plane. The distribution of screw load and member load at each step was compared, and the stress values were calculated within the dental implant complex and surrounding bone. During tightening, the magnitude and distribution of the preload and clamp load were uniform and equal at the cross section of all CHSs. Under an external load, the screw load decreased and member load increased. An increase in the CHS caused the corresponding distribution to become more nonuniform and increased the maximum compressive and tensile stresses in the preimplant bone. Additionally, the von Mises stress decreased at the abutment screw and increased at the abutment and fixture. Under nonaxial forces, increased CHS does not influence the decrease in screw load or increase in member load. However, it contributes to screw loosening and fatigue fracture by skewing the stress distribution to the transverse section of the implant. Copyright © 2015 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

External Coulomb-Friction Damping For Hydrostatic Bearings

NASA Technical Reports Server (NTRS)

Buckmann, Paul S.

1992-01-01

External friction device damps vibrations of shaft and hydrostatic ring bearing in which it turns. Does not rely on wear-prone facing surfaces. Hydrostatic bearing ring clamped in radially flexing support by side plates clamped against radial surfaces by spring-loaded bolts. Plates provide friction against radial motions of shaft.

External and Internal Factors Influencing Happiness in Elite Collegiate Athletes

ERIC Educational Resources Information Center

Denny, Katherine G.; Steiner, Hans

2009-01-01

When under conditions of high demand and allostatic load, are happiness and satisfaction in four domains (family, friends, academics, recreation) influenced more by external or internal factors? Do student-athletes who lead exceedingly complicated lives report happiness as a function of athletic achievement or internal disposition? Stanford…

Bond–Slip Relationship for CFRP Sheets Externally Bonded to Concrete under Cyclic Loading

PubMed Central

Li, Ke; Cao, Shuangyin; Yang, Yue; Zhu, Juntao

2018-01-01

The objective of this paper was to explore the bond–slip relationship between carbon fiber-reinforced polymer (CFRP) sheets and concrete under cyclic loading through experimental and analytical approaches. Modified beam tests were performed in order to gain insight into the bond–slip relationship under static and cyclic loading. The test variables are the CFRP-to-concrete width ratio, and the bond length of the CFRP sheets. An analysis of the test results in this paper and existing test results indicated that the slope of the ascending segment of the bond–slip curve decreased with an increase in the number of load cycles, but the slip corresponding to the maximum shear stress was almost invariable as the number of load cycles increased. In addition, the rate of reduction in the slope of the ascending range of the bond–slip curve during cyclic loading decreased as the concrete strength increased, and increased as the load level or CFRP-to-concrete width ratio enhanced. However, these were not affected by variations in bond length if the residual bond length was longer than the effective bond length. A bilinear bond–slip model for CFRP sheets that are externally bonded to concrete under cyclic loading, which considered the effects of the cyclic load level, concrete strength, and CFRP-to-concrete ratio, was developed based on the existing static bond–slip model. The accuracy of this proposed model was verified by a comparison between this proposed model and test results. PMID:29495383

Bond-Slip Relationship for CFRP Sheets Externally Bonded to Concrete under Cyclic Loading.

PubMed

Li, Ke; Cao, Shuangyin; Yang, Yue; Zhu, Juntao

2018-02-26

The objective of this paper was to explore the bond-slip relationship between carbon fiber-reinforced polymer (CFRP) sheets and concrete under cyclic loading through experimental and analytical approaches. Modified beam tests were performed in order to gain insight into the bond-slip relationship under static and cyclic loading. The test variables are the CFRP-to-concrete width ratio, and the bond length of the CFRP sheets. An analysis of the test results in this paper and existing test results indicated that the slope of the ascending segment of the bond-slip curve decreased with an increase in the number of load cycles, but the slip corresponding to the maximum shear stress was almost invariable as the number of load cycles increased. In addition, the rate of reduction in the slope of the ascending range of the bond-slip curve during cyclic loading decreased as the concrete strength increased, and increased as the load level or CFRP-to-concrete width ratio enhanced. However, these were not affected by variations in bond length if the residual bond length was longer than the effective bond length. A bilinear bond-slip model for CFRP sheets that are externally bonded to concrete under cyclic loading, which considered the effects of the cyclic load level, concrete strength, and CFRP-to-concrete ratio, was developed based on the existing static bond-slip model. The accuracy of this proposed model was verified by a comparison between this proposed model and test results.

29 CFR 1926.450 - Scope, application and definitions applicable to this subpart.

Code of Federal Regulations, 2014 CFR

2014-07-01

... means a single-point adjustable suspension scaffold consisting of a seat or sling designed to support... means a design of straps which may be secured about the employee in a manner to distribute the fall... a series of interconnected braced scaffold members or supporting structures erected to form a...

29 CFR 1926.450 - Scope, application and definitions applicable to this subpart.

Code of Federal Regulations, 2012 CFR

2012-07-01

... means a single-point adjustable suspension scaffold consisting of a seat or sling designed to support... means a design of straps which may be secured about the employee in a manner to distribute the fall... a series of interconnected braced scaffold members or supporting structures erected to form a...

29 CFR 1926.450 - Scope, application and definitions applicable to this subpart.

Code of Federal Regulations, 2013 CFR

2013-07-01

... means a single-point adjustable suspension scaffold consisting of a seat or sling designed to support... means a design of straps which may be secured about the employee in a manner to distribute the fall... a series of interconnected braced scaffold members or supporting structures erected to form a...

29 CFR 1926.450 - Scope, application and definitions applicable to this subpart.

Code of Federal Regulations, 2011 CFR

2011-07-01

... means a single-point adjustable suspension scaffold consisting of a seat or sling designed to support... means a design of straps which may be secured about the employee in a manner to distribute the fall... a series of interconnected braced scaffold members or supporting structures erected to form a...

29 CFR 1926.251 - Rigging equipment for material handling.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., shall consist of one continuous piece without knot or splice. (iii) Eyes in wire rope bridles, slings... splices shall contain at least three full tucks, and short splices shall contain at least six full tucks... tails shall project at least six rope diameters beyond the last full tuck. For fiber ropes 1-inch...

Textured Sling Pots

ERIC Educational Resources Information Center

Skophammer, Karen

2010-01-01

Clay is one of the most satisfying mediums for children to work with. It's relatively inexpensive, and the texture and changes that take place with the clay during firing make it irresistible. Molding clay from rolled-out slabs of clay is an easy way to make simple, shallow vessels or display pots. In this article, the author describes how her…

29 CFR 1915.112 - Ropes, chains and slings.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., defective welds, deformation and increase in length or stretch. (3) Employers must note interlink wear, not accompanied by stretch in excess of 5 percent, and remove the chain from service when maximum allowable wear... shall be removed from service when, due to stretch, the increase in length of a measured section exceeds...

29 CFR 1915.112 - Ropes, chains and slings.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., defective welds, deformation and increase in length or stretch. (3) Employers must note interlink wear, not accompanied by stretch in excess of 5 percent, and remove the chain from service when maximum allowable wear... shall be removed from service when, due to stretch, the increase in length of a measured section exceeds...

29 CFR 1915.112 - Ropes, chains and slings.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., defective welds, deformation and increase in length or stretch. (3) Employers must note interlink wear, not accompanied by stretch in excess of 5 percent, and remove the chain from service when maximum allowable wear... shall be removed from service when, due to stretch, the increase in length of a measured section exceeds...

50 CFR 14.106 - Primary enclosures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... affixed in the conveyance or has an open top for certain large mammals, spacer bars allowing circulation... enclosure, a sling, or on foam is exempt from the requirement to contain litter. An enclosure used to... height, “Live Animals” or “Wild Animals”, “Do Not Tip,” “Only Authorized Personnel May Open Container...

50 CFR 14.106 - Primary enclosures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... affixed in the conveyance or has an open top for certain large mammals, spacer bars allowing circulation... enclosure, a sling, or on foam is exempt from the requirement to contain litter. An enclosure used to... height, “Live Animals” or “Wild Animals”, “Do Not Tip,” “Only Authorized Personnel May Open Container...

50 CFR 14.106 - Primary enclosures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... affixed in the conveyance or has an open top for certain large mammals, spacer bars allowing circulation... enclosure, a sling, or on foam is exempt from the requirement to contain litter. An enclosure used to... height, “Live Animals” or “Wild Animals”, “Do Not Tip,” “Only Authorized Personnel May Open Container...

50 CFR 14.106 - Primary enclosures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... affixed in the conveyance or has an open top for certain large mammals, spacer bars allowing circulation... enclosure, a sling, or on foam is exempt from the requirement to contain litter. An enclosure used to... height, “Live Animals” or “Wild Animals”, “Do Not Tip,” “Only Authorized Personnel May Open Container...

50 CFR 14.106 - Primary enclosures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... affixed in the conveyance or has an open top for certain large mammals, spacer bars allowing circulation... enclosure, a sling, or on foam is exempt from the requirement to contain litter. An enclosure used to... height, “Live Animals” or “Wild Animals”, “Do Not Tip,” “Only Authorized Personnel May Open Container...

Current Perspectives in Hyperbaric Physiology, Ultrasonic Doppler Bubble Detection, and Mass Spectrometry,

DTIC Science & Technology

1979-12-28

Doppler sound made by a bubble passing through the inson- ified volume blood vessel resembles a very sharp truncated whistle , chirp or click depending...the Doppler ultrasound , suffered the "slings and arrows of outrageous criticism" to borrow and beat a phrase. It is not appropriate to go into this