Migrating lumbar facet joint cysts.
Palmieri, Francesco; Cassar-Pullicino, Victor N; Lalam, Radhesh K; Tins, Bernhard J; Tyrrell, Prudencia N M; McCall, Iain W
2006-04-01
The majority of lumbar facet joint cysts (LFJCs) are located in the spinal canal, on the medial aspect of the facet joint with characteristic diagnostic features. When they migrate away from the joint of origin, they cause diagnostic problems. In a 7-year period we examined by computed tomography (CT) and magnetic resonance (MR) imaging five unusual cases of facet joint cysts which migrated from the facet joint of origin. Three LFJCs were identified in the right S1 foramen, one in the right L5-S1 neural foramen and one in the left erector spinae and multifidus muscles between the levels of L2-L4 spinous process. Awareness that spinal lesions identified at MRI and CT could be due to migrating facet joint cyst requires a high level of suspicion. The identification of the appositional contact of the cyst and the facet joint needs to be actively sought in the presence of degenerative facet joints.
Manchikanti, Laxmaiah; Singh, Vijay; Falco, Frank J.E.; Cash, Kimberly A.; Pampati, Vidyasagar
2010-01-01
Study Design: A randomized, double-blind, controlled trial. Objective: To determine the clinical effectiveness of therapeutic lumbar facet joint nerve blocks with or without steroids in managing chronic low back pain of facet joint origin. Summary of Background Data: Lumbar facet joints have been shown as the source of chronic pain in 21% to 41% of low back patients with an average prevalence of 31% utilizing controlled comparative local anesthetic blocks. Intraarticular injections, medial branch blocks, and radiofrequency neurotomy of lumbar facet joint nerves have been described in the alleviation of chronic low back pain of facet joint origin. Methods: The study included 120 patients with 60 patients in each group with local anesthetic alone or local anesthetic and steroids. The inclusion criteria was based upon a positive response to diagnostic controlled, comparative local anesthetic lumbar facet joint blocks. Outcome measures included the numeric rating scale (NRS), Oswestry Disability Index (ODI), opioid intake, and work status, at baseline, 3, 6, 12, 18, and 24 months. Results: Significant improvement with significant pain relief of ≥ 50% and functional improvement of ≥ 40% were observed in 85% in Group 1, and 90% in Group II, at 2-year follow-up. The patients in the study experienced significant pain relief for 82 to 84 weeks of 104 weeks, requiring approximately 5 to 6 treatments with an average relief of 19 weeks per episode of treatment. Conclusions: Therapeutic lumbar facet joint nerve blocks, with or without steroids, may provide a management option for chronic function-limiting low back pain of facet joint origin. PMID:20567613
Moussa, Wael Mohamed Mohamed; Khedr, Wael
2016-11-01
Percutaneous radiofrequency denervation of the medial dorsal branch is often used in chronic low back pain of intervertebral facet etiology, which is sometimes difficult to perform and recurrence of pain often ensues. We theorized that shifting the target of RF coagulation to the facet joint capsule would provide an easier target and a longer-lived pain relieving response. A prospective randomized controlled trial where 120 patients diagnosed with CLBP of a confirmed facet origin were randomly divided into three equal groups, the first was submitted to percutaneous radiofrequency coagulation of the facet joint capsule, the second underwent percuataneous denervation of the medial dorsal branch and the third did not receive radiofrequency lesioning. All the three groups received local injection of a mixture of local anesthetic and steroid. Cases were followed for up to 3 years. 87(72.5%) patients were females. By 3 months' post procedure, improvement in VAS was significantly better than pretreatment levels in all groups (p<0.05). The control group lost improvement by 1-year follow-up (p=0.017). At 2 years' follow-up, the joint capsule denervation group maintained significant improvement (p=0.033) whereas the medial branch denervation group lost its significant effect (p=0.479). By the end of follow-up period, only joint capsule denervation group kept significant improvement (p=0.026). In CLBP of facet origin, shifting the target of percutaneous radiofrequency to the facet joint capsule provides an easier technique with an extended period of pain relief compared to the medial dorsal branch of the facet joint. Copyright © 2016 Elsevier B.V. All rights reserved.
Palea, Ovidiu; Granville, Michelle
2017-01-01
Radiofrequency facet ablation (RFA) has been performed using the same technique for over 50 years. Except for variations in electrode size, tip shape, and change in radiofrequency (RF) stimulation parameters, using standard, pulsed, and cooled RF wavelengths, the target points have remained absolutely unchanged from the original work describing RFA for lumbar pain control. Degenerative changes in the facet joint and capsule are the primary location for the majority of lumbar segmental pathology and pain. Multiple studies show that the degenerated facet joint is richly innervated as a result of the inflammatory overgrowth of the synovium. The primary provocative clinical test to justify an RFA is to perform an injection with local anesthetic into the facet joint and the posterior capsule and confirm pain relief. However, after a positive response, the radiofrequency lesion is made not to the facet joint but to the more proximal fine nerve branches that innervate the joint. The accepted target points for the recurrent sensory branch ignore the characteristic rich innervation of the pathologic lumbar facet capsule and assume that lesioning of these recurrent branches is sufficient to denervate the painful pathologic facet joint. This report describes the additional targets and technical steps for further coagulation points along the posterior capsule of the lumbar facet joint and the physiologic studies of the advantage of the bipolar radiofrequency current in this location. Bipolar RF to the facet capsule is a simple, extra step that easily creates a large thermo-coagulated lesion in this capsule region of the pathologic facet joint. Early studies demonstrate bipolar RF to the facet capsule can provide long-term pain relief when used alone for specific localized facet joint pain, to coagulate lumbar facet cysts to prevent recurrence, and to get more extensive pain control by combining it with traditional lumbar RFA, especially when RFA is repeated. PMID:29119066
Jacobson, Robert E; Palea, Ovidiu; Granville, Michelle
2017-09-01
Radiofrequency facet ablation (RFA) has been performed using the same technique for over 50 years. Except for variations in electrode size, tip shape, and change in radiofrequency (RF) stimulation parameters, using standard, pulsed, and cooled RF wavelengths, the target points have remained absolutely unchanged from the original work describing RFA for lumbar pain control. Degenerative changes in the facet joint and capsule are the primary location for the majority of lumbar segmental pathology and pain. Multiple studies show that the degenerated facet joint is richly innervated as a result of the inflammatory overgrowth of the synovium. The primary provocative clinical test to justify an RFA is to perform an injection with local anesthetic into the facet joint and the posterior capsule and confirm pain relief. However, after a positive response, the radiofrequency lesion is made not to the facet joint but to the more proximal fine nerve branches that innervate the joint. The accepted target points for the recurrent sensory branch ignore the characteristic rich innervation of the pathologic lumbar facet capsule and assume that lesioning of these recurrent branches is sufficient to denervate the painful pathologic facet joint. This report describes the additional targets and technical steps for further coagulation points along the posterior capsule of the lumbar facet joint and the physiologic studies of the advantage of the bipolar radiofrequency current in this location. Bipolar RF to the facet capsule is a simple, extra step that easily creates a large thermo-coagulated lesion in this capsule region of the pathologic facet joint. Early studies demonstrate bipolar RF to the facet capsule can provide long-term pain relief when used alone for specific localized facet joint pain, to coagulate lumbar facet cysts to prevent recurrence, and to get more extensive pain control by combining it with traditional lumbar RFA, especially when RFA is repeated.
Maas, E T; Juch, J N S; Ostelo, R W J G; Groeneweg, J G; Kallewaard, J W; Koes, B W; Verhagen, A P; Huygen, F J P M; van Tulder, M W
2017-03-01
Patient history and physical examination are frequently used procedures to diagnose chronic low back pain (CLBP) originating from the facet joints, although the diagnostic accuracy is controversial. The aim of this systematic review is to determine the diagnostic accuracy of patient history and/or physical examination to identify CLBP originating from the facet joints using diagnostic blocks as reference standard. We searched MEDLINE, EMBASE, CINAHL, Web of Science and the Cochrane Collaboration database from inception until June 2016. Two review authors independently selected studies for inclusion, extracted data and assessed the risk of bias. We calculated sensitivity and specificity values, with 95% confidence intervals (95% CI). Twelve studies were included, in which 129 combinations of index tests and reference standards were presented. Most of these index tests have only been evaluated in single studies with a high risk of bias. Four studies evaluated the diagnostic accuracy of the Revel's criteria combination. Because of the clinical heterogeneity, results were not pooled. The published sensitivities ranged from 0.11 (95% CI 0.02-0.29) to 1.00 (95% CI 0.75-1.00), and the specificities ranged from 0.66 (95% CI 0.46-0.82) to 0.91 (95% CI 0.83-0.96). Due to clinical heterogeneity, the evidence for the diagnostic accuracy of patient history and/or physical examination to identify facet joint pain is inconclusive. Patient history and physical examination cannot be used to limit the need of a diagnostic block. The validity of the diagnostic facet joint block should be studied, and high quality studies are required to confirm the results of single studies. Patient history and physical examination cannot be used to limit the need of a diagnostic block. The validity of the diagnostic facet joint block should be studied, and high quality studies are required to confirm the results of single studies. © 2016 European Pain Federation - EFIC®.
Manchikanti, Laxmaiah; Singh, Vijay; Falco, Frank J. E.; Cash, Kimberly A.; Pampati, Vidyasagar; Fellows, Bert
2012-01-01
Study Design. A randomized, double-blind, active-control trial. Objective. To determine the clinical effectiveness of therapeutic thoracic facet joint nerve blocks with or without steroids in managing chronic mid back and upper back pain. Summary of Background Data. The prevalence of thoracic facet joint pain has been established as 34% to 42%. Multiple therapeutic techniques utilized in managing chronic thoracic pain of facet joint origin include medial branch blocks, radiofrequency neurotomy, and intraarticular injections. Methods. This randomized double-blind active controlled trial was performed in 100 patients with 50 patients in each group who received medial branch blocks with local anesthetic alone or local anesthetic and steroids. Outcome measures included the numeric rating scale (NRS), Oswestry Disability Index (ODI), opioid intake, and work status, at baseline, 3, 6, 12, 18, and 24 months. Results. Significant improvement with significant pain relief and functional status improvement of 50% or more were observed in 80% of the patients in Group I and 84% of the patients in Group II at 2-year followup. Conclusions. Therapeutic medial branch blocks of thoracic facets with or without steroids may provide a management option for chronic function-limiting thoracic pain of facet joint origin. PMID:22851967
Ribeiro, Luiza Helena; Furtado, Rita Nely Vilar; Konai, Monique Sayuri; Andreo, Ana Beatriz; Rosenfeld, Andre; Natour, Jamil
2013-11-01
Randomized clinical trial. To compare the effectiveness of facet joint injection versus systemic steroid in patients with a diagnosis of facet joint syndrome. The term facet joint syndrome has been used to define back pain originating from the facet joints. Treatment is mainly conservative, although interventions, including intra-articular injections and medial branch nerve blocks are used to manage facet-mediated pain. Several studies have evaluated the effectiveness of these interventions. Results of facet joint injection, however, are conflicting. Sixty subjects with a diagnosis of facet joint syndrome were enrolled in the study. They were randomized into experimental and control groups. The experimental group was administered with intra-articular injection of 6 lumbar facet joints with triamcinolone hexacetonide; the control group was administered with triamcinolone acetonide intramuscular injection of 6 lumbar paravertebral points. Visits were taken at baseline and at 1, 4, 12, and 24 weeks after interventions. Outcome measures were used: pain visual analogue scale, pain visual analogue scale during extension of the spine, Likert scale, improvement percentage scale, Roland-Morris, 36-Item Short Form Health Survey, and accountability of medications taken.Homogeneity was tested using the Student t, Pearson χ, and Mann-Whitney tests. Analysis of variance was used to analyze differences in the groups over time and the Student t test to analyze differences between groups at each time evaluation. The groups were similar at baseline. Comparisons between the groups showed, in analysis of variance analysis, an improvement in the experimental group regarding diclofenac intake and quality of life, in the "role physical" profile, assessed by 36-Item Short Form Health Survey.In the analysis at each time point, an improvement in the experimental group was also found in the Roland-Morris questionnaire, in the improvement percentage scale and in the response to treatment, assessed by the Likert scale. Both treatments were effective, with a slight superiority of the intra-articular injection of steroids over intramuscular injection.
Lee, Chang-Hyun; Chung, Chun Kee; Kim, Chi Heon
2017-11-01
Radiofrequency denervation is commonly used for the treatment of chronic facet joint pain that has been refractory to more conservative treatments, although the evidence supporting this treatment has been controversial. We aimed to elucidate the precise effects of radiofrequency denervation in patients with low back pain originating from the facet joints relative to those obtained using control treatments, with particular attention to consistency in the denervation protocol. A meta-analysis of randomized controlled trials was carried out. Adult patients undergoing radiofrequency denervation or control treatments (sham or epidural block) for facet joint disease of the lumbar spine comprised the patient sample. Visual analog scale (VAS) pain scores were measured and stratified by response of diagnostic block procedures. We searched PubMed, Embase, Web of Science, and the Cochrane Database for randomized controlled trials regarding radiofrequency denervation and control treatments for back pain. Changes in VAS pain scores of the radiofrequency group were compared with those of the control group as well as the minimal clinically important difference (MCID) for back pain VAS. Meta-regression model was developed to evaluate the effect of radiofrequency treatment according to responses of diagnostic block while controlling for other variables. We then calculated mean differences and 95% confidence intervals (CIs) using random-effects models. We included data from seven trials involving 454 patients who had undergone radiofrequency denervation (231 patients) and control treatments such as sham or epidural block procedures (223 patients). The radiofrequency group exhibited significantly greater improvements in back pain score when compared with the control group for 1-year follow-up. Although the average improvement in VAS scores exceeded the MCID, the lower limit of the 95% CI encompassed the MCID. A subgroup of patients who responded very well to diagnostic block procedures demonstrated significant improvements in back pain relative to the control group at all times. When placed into our meta-regression model, the response to diagnostic block procedure was responsible for a statistically significant portion of treatment effect. Studies published over the last two decades revealed that radiofrequency denervation reduced back pain significantly in patients with facet joint disease compared with the MCID and control treatments. Conventional radiofrequency denervation resulted in significant reductions in low back pain originating from the facet joints in patients showing the best response to diagnostic block over the first 12 months when compared with sham procedures or epidural nerve blocks. Copyright © 2017 Elsevier Inc. All rights reserved.
Manchikanti, Laxmaiah; Hirsch, Joshua A; Pampati, Vidyasagar; Boswell, Mark V
2016-10-01
Increasing utilization of interventional techniques in managing chronic spinal pain, specifically facet joint interventions and sacroiliac joint injections, is a major concern of healthcare policy makers. We analyzed the patterns of utilization of facet and sacroiliac joint interventions in managing chronic spinal pain. The results showed significant increase of facet joint interventions and sacroiliac joint injections from 2000 to 2014 in Medicare FFS service beneficiaries. Overall, the Medicare population increased 35 %, whereas facet joint and sacroiliac joint interventions increased 313.3 % per 100,000 Medicare population with an annual increase of 10.7 %. While the increases were uniform from 2000 to 2014, there were some decreases noted for facet joint interventions in 2007, 2010, and 2013, whereas for sacroiliac joint injections, the decreases were noted in 2007 and 2013. The increases were for cervical and thoracic facet neurolysis at 911.5 % compared to lumbosacral facet neurolysis of 567.8 %, 362.9 % of cervical and thoracic facet joint blocks, 316.9 % of sacroiliac joints injections, and finally 227.3 % of lumbosacral facet joint blocks.
Williams, Richard; Cheung, Jason Pui Yin; Goss, Ben; Rajasekaran, Shanmuganathan; Kawaguchi, Yoshiharu; Acharya, Shankar; Kawakami, Mamoru; Satoh, Shigenobu; Chen, Wen-Jer; Park, Chun-Kun; Lee, Chong-Suh; Foocharoen, Thanit; Nagashima, Hideki; Kuh, Sunguk; Zheng, Zhaomin; Condor, Richard; Ito, Manabu; Iwasaki, Motoki; Jeong, Je Hoon; Luk, Keith D. K.; Prijambodo, Bambang; Rege, Amol; Jahng, Tae-Ahn; Luo, Zhuojing; Tassanawipas, Warat; Acharya, Narayana; Pokharel, Rohit; Shen, Yong; Ito, Takui; Zhang, Zhihai; Aithala P, Janardhana; Kumar, Gomatam Vijay; Jabir, Rahyussalim Ahmad; Basu, Saumyajit; Li, Baojun; Moudgil, Vishal; Sham, Phoebe; Samartzis, Dino
2015-01-01
Study Design A multinational, multiethnic, cross-sectional image-based study was performed in 33 institutions, representing 10 countries, which were part of the AOSpine Asia Pacific Research Collaboration Consortium. Objective Lumbar facet joint orientation has been reported to be associated with the development of degenerative spondylolisthesis (DS). The role of ethnicity regarding facet joint orientation remains uncertain. As such, the following study was performed across a wide-ranging population base to assess the role of ethnicity in facet joint orientation in patients with DS in the Asia Pacific region. Methods Lateral standing X-rays and axial magnetic resonance imaging scans were obtained for patients with lumbar DS. The DS parameters and facet joint angulations were assessed from L3–S1. Sex, age, body mass index (BMI), and ethnicity were also noted. Results The study included 371 patients with known ethnic origin (mean age: 62.0 years; 64% males, 36% females). The mean BMI was 25.6 kg/m2. The level of DS was most prevalent at L4–L5 (74.7%). There were 28.8% Indian, 28.6% Japanese, 18.1% Chinese, 8.6% Korean, 6.5% Thai, 4.9% Caucasian, 2.7% Filipino, and 1.9% Malay patients. Variations in facet joint angulations were noted from L3 to S1 and between patients with and without DS (p < 0.05). No differences were noted with regards to sex and overall BMI to facet joint angulations (p > 0.05); however, increasing age was found to increase the degree of angulation throughout the lumbar spine (p < 0.05). Accounting for age and the presence or absence of DS at each level, no statistically significant differences between ethnicity and degree of facet joint angulations from L3–L5 were noted (p > 0.05). Ethnic variations were noted in non-DS L5–S1 facet joint angulations, predominantly between Caucasian, Chinese, and Indian ethnicities (p < 0.05). Conclusions This study is the first to suggest that ethnicity may not play a role in facet joint orientation in the majority of cases of DS in the Asia-Pacific region. Findings from this study may facilitate future comparative studies in other multiethnic populations. An understanding of ethnic variability may assist in identifying those patients at risk of postsurgical development or progression of DS. This study also serves as a model for large-scale multicenter studies across different ethnic groups and cultural boundaries in Asia. PMID:26835200
Correlation of the Features of the Lumbar Multifidus Muscle With Facet Joint Osteoarthritis.
Yu, Bo; Jiang, Kaibiao; Li, Xinfeng; Zhang, Jidong; Liu, Zude
2017-09-01
Facet joint osteoarthritis is considered a consequence of the aging process; however, there is evidence that it may be associated with degenerative changes of other structures. The goal of this study was to investigate the correlation between lumbar multifidus muscle features and facet joint osteoarthritis. This retrospective study included 160 patients who had acute or chronic low back pain and were diagnosed with facet joint osteoarthritis on computed tomography scan. Morphometric parameters, including cross-sectional area, muscle-fat index, and percentage of bilateral multifidus asymmetry at L3-L4, L4-L5, and L5-S1, were evaluated with T2-weighted magnetic resonance imaging. Patients with facet joint osteoarthritis had a smaller cross-sectional area and a higher muscle-fat index than those without facet joint osteoarthritis (P<.001). In multivariate regression analysis, older age and higher muscle-fat index were independently associated with facet joint osteoarthritis at all 3 spinal levels (P<.001). Smaller cross-sectional area was independently associated with facet joint osteoarthritis only at L4-L5 (P=.005). Asymmetry of the bilateral multifidus cross-sectional area was independently associated with facet joint osteoarthritis at L5-S1 (P=.009), but did not seem to be responsible for asymmetric degeneration of the bilateral facet joints. A higher multifidus muscle-fat index was independently associated with facet joint osteoarthritis, and bilateral multifidus size asymmetry was associated with the development of facet joint osteoarthritis at L5-S1. It seems more accurate to consider facet joint osteoarthritis a failure of the whole joint structure, including the paraspinal musculature, rather than simply a failure of the facet joint cartilage. [Orthopedics. 2017; 40(5):e793-e800.]. Copyright 2017, SLACK Incorporated.
Wen, Chuan-Bing; Li, Yong-Zhong; Tang, Qin-Qin; Sun, Lin; Xiao, Hong; Yang, Bang-Xiang; Song, Li; Liu, Hui
2013-03-01
To investigate the feasibility, accuracy of B ultrasound in the examination of joint space of lumbar spine facet joints compared with CT scan. Ten healthy adult volunteers were enrolled. The joint space of lumbar facet joints was measured by ultrasound. To identify the spinal levels, the posterior parasagittal sonograms were obtained at levels L1 to S1. The lumbar facet joints were delineated with the help of transverse sonograms at each level. Meanwhile, the lumbar facet joints were evaluated by spiral CT on the same plane, reformatted to 1-mm axial slices. A total of 88 lumbar facet joints from L1 to S1 were clearly visualized in the 10 volunteers. Both ultrasound and CT measurements showed the same average depth and lateral distance of lumbar facet joint space (P > 0.05). The lumbar facet joint space can be accurately demonstrated by ultrasound.
Facet joint laser radiation: tissue effects of a new clinical laser application
NASA Astrophysics Data System (ADS)
Werkmann, Klaus; Thal, Dietmar R.
1996-01-01
Chronic unilateral and bilateral back pain with pseudoradicular symptoms, is a common clinical syndrome, which in many cases can be related to the facet joint syndrome. The pain is caused by mechanical affection of synovial and capsular nerve terminals. Therefore, current therapeutical attempts including physical therapy, intra-articular injection of local anesthetics and steroids and thermocoagulation of the facet joint with a thermocoagulator, are performed. We confirmed laser coagulation of the facet joint. Porcine cadaveric spines were treated immediately after death by intra-articular facet joint laser radiation. With the pulsed Nd:YAG laser (1064 nm) altogether 600 J were applied in three different places 4 mm apart at the top of the facet joint. The results showed that facet joint laser radiation leads to a small (about 1 - 2 mm diameter) lesion restricted to the facet joint cavity and its synovia. Histologically, we found a central carbonization zone and necrosis, including almost the whole cartilage and approximately 0.2 mm of the adjacent bone. These changes are similar to Nd:Yag-laser applications in other skeletal regions. It is suggested that these changes may lead to facet joint denervation by coagulation of the synovial nerve terminals. Cicatration of the laser lesion might cause ankylosis of this joint. In sum, facet joint laser radiation could be an alternative therapeutical tool for lower back pain of the facet joint syndrome type. Therefore, future clinical application of this technique seems to be very promising.
Shi, Wen; Tian, Dan; Liu, Da; Yin, Jing; Huang, Ying
2017-08-01
Besides the study on examining facet joints of lumbar spine by ultrasound in normal population, there has not been any related report about examining normal facet joints of lumbar spine by ultrasound so far. This study was aimed to explore the feasibility of ultrasound assessment of lumber spine facet joints by comparing ultrasound measure values of normal and degenerative lumber spine facet joints, and by comparing measure values of ultrasound and computed tomography (CT) of degenerative lumber spine facet joints.This study included 15 patients who had chronic low back pain because of degenerative change in lumbar vertebrae, and 19 volunteers who did not have low back pain or pain in the lower limb. The ultrasound measure values (height [H] and width [W]) of normal and degenerative lumber spine facet joints were compared. And the differentiation between measure values (H and W) of ultrasound and CT of degenerative lumber spine facet joints was also analyzed.The ultrasound clearly showed abnormal facet joints lesion, which was characterized by hyperostosis on the edge of joints, bone destruction under joints, and thinner or thicker articular cartilage. There were significant differences between the ultrasound measure values of the normal (H: 1.26 ± 0.03 cm, W: 0.18 ± 0.01 cm) and abnormal facet joints (H: 1.43 ± 0.05 cm, W: 0.15 ± 0.02 cm) (all P < .05). However, there were no significant differences between the measure values of the ultrasound (H: 1.43 ± 0.17 cm, W: 0.15 ± 0.03 cm) and CT (H: 1.42 ± 0.16, W: 0.14 ± 0.03) of the degenerative lumber spine facet joints (all P > .05).Ultrasound can clearly show the structure of facet joints of lumbar spine. It is precise and feasible to assess facet joints of lumbar spine by ultrasound. This study has important significance for the diagnosis of lumbar facet joint degeneration.
Seiler, Gabriela S; Häni, Hansjürg; Busato, André R; Lang, Johann
2002-01-01
To evaluate the possible association between facet joint geometry and intervertebral disk degeneration in German Shepherd Dogs. 25 German Shepherd Dogs and 11 control dogs of similar body weight and condition. Facet joint angles in the caudal portion of the lumbar region of the vertebral column (L5-S1) were measured by use of computed tomography, and the intervertebral discs were evaluated microscopically. The relationship between facet joint geometry and disk degeneration was evaluated by use of statistical methods. German Shepherd Dogs had significantly more facet joint tropism than control dogs, but an association with disk degeneration was not found. However, German Shepherd Dogs had a different facet joint conformation, with more sagittally oriented facet joints at L5-L6 and L6-L7 and a larger angle difference between the lumbar and lumbosacral facet joints, compared with control dogs. A large difference between facet joint angles at L6-L7 and L7-S1 in German Shepherd Dogs may be associated with the frequent occurrence of lumbosacral disk degeneration in this breed.
Localized cervical facet joint kinematics under physiological and whiplash loading.
Stemper, Brian D; Yoganandan, Narayan; Gennarelli, Thomas A; Pintar, Frank A
2005-12-01
Although facet joints have been implicated in the whiplash injury mechanism, no investigators have determined the degree to which joint motions in whiplash are nonphysiological. The purpose of this investigation was to quantify the correlation between facet joint and segmental motions under physiological and whiplash loading. Human cadaveric cervical spine specimens were exercise tested under physiological extension loading, and intact human head-neck complexes were exercise tested under whiplash loading to correlate the localized component motions of the C4-5 facet joint with segmental extension. Facet joint shear and distraction kinematics demonstrated a linear correlation with segmental extension under both loading modes. Facet joints responded differently to whiplash and physiological loading, with significantly increased kinematics for the same-segmental angulation. The limitations of this study include removal of superficial musculature and the limited sample size for physiological testing. The presence of increased facet joint motions indicated that synovial joint soft-tissue components (that is, synovial membrane and capsular ligament) sustain increased distortion that may subject these tissues to a greater likelihood of injury. This finding is supported by clinical investigations in which lower cervical facet joint injury resulted in similar pain patterns due to the most commonly reported whiplash symptoms.
Stelzeneder, David; Messner, Alina; Vlychou, Marianna; Welsch, Goetz H; Scheurecker, Georg; Goed, Sabine; Pieber, Karin; Pflueger, Verena; Friedrich, Klaus M; Trattnig, Siegfried
2011-11-01
To assess the feasibility of T2 mapping of lumbar facet joints and intervertebral discs in a single imaging slab and to compare the findings with morphological grading. Sixty lumbar spine segments from 10 low back pain patients and 5 healthy volunteers were examined by axial T2 mapping and morphological MRI at 3.0 Tesla. Regions of interest were drawn on a single slice for the facet joints and the intervertebral discs (nucleus pulposus, anterior and posterior annulus fibrosus). The Weishaupt grading was used for facet joints and the Pfirrmann score was used for morphological disc grading ("normal" vs. "abnormal" discs). The inter-rater agreement was excellent for the facet joint T2 evaluation (r = 0.85), but poor for the morphological Weishaupt grading (kappa = 0.15). The preliminary results show similar facet joint T2 values in segments with normal and abnormal Pfirrmann scores. There was no difference in mean T2 values between facet joints in different Weishaupt grading groups. Facet joint T2 values showed a weak correlation with T2 values of the posterior annulus (r = 0.32) This study demonstrates the feasibility of a combined T2 mapping approach for the facet joints and intervertebral discs using a single axial slab.
Kras, J V; Kartha, S; Winkelstein, B A
2015-11-01
The objective of the current study is to define whether intra-articular nerve growth factor (NGF), an inflammatory mediator that contributes to osteoarthritic pain, is necessary and sufficient for the development or maintenance of injury-induced facet joint pain and its concomitant spinal neuronal hyperexcitability. Male Holtzman rats underwent painful cervical facet joint distraction (FJD) or sham procedures. Mechanical hyperalgesia was assessed in the forepaws, and NGF expression was quantified in the C6/C7 facet joint. An anti-NGF antibody was administered intra-articularly in additional rats immediately or 1 day following facet distraction or sham procedures to block intra-articular NGF and test its contribution to initiation and/or maintenance of facet joint pain and spinal neuronal hyperexcitability. NGF was injected into the bilateral C6/C7 facet joints in separate rats to determine if NGF alone is sufficient to induce these behavioral and neuronal responses. NGF expression increases in the cervical facet joint in association with behavioral sensitivity after that joint's mechanical injury. Intra-articular application of anti-NGF immediately after a joint distraction prevents the development of both injury-induced pain and hyperexcitability of spinal neurons. Yet, intra-articular anti-NGF applied after pain has developed does not attenuate either behavioral or neuronal hyperexcitability. Intra-articular NGF administered to the facet in naïve rats also induces behavioral hypersensitivity and spinal neuronal hyperexcitability. Findings demonstrate that NGF in the facet joint contributes to the development of injury-induced joint pain. Localized blocking of NGF signaling in the joint may provide potential treatment for joint pain. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Biochemical and biomechanical characterisation of equine cervical facet joint cartilage.
O'Leary, S A; White, J L; Hu, J C; Athanasiou, K A
2018-04-15
The equine cervical facet joint is a site of significant pathology. Located bilaterally on the dorsal spine, these diarthrodial joints work in conjunction with the intervertebral disc to facilitate appropriate spinal motion. Despite the high prevalence of pathology in this joint, the facet joint is understudied and thus lacking in viable treatment options. The goal of this study was to characterise equine facet joint cartilage and provide a comprehensive database describing the morphological, histological, biochemical and biomechanical properties of this tissue. Descriptive cadaver studies. A total of 132 facet joint surfaces were harvested from the cervical spines of six skeletally mature horses (11 surfaces per animal) for compiling biomechanical and biochemical properties of hyaline cartilage of the equine cervical facet joints. Gross morphometric measurements and histological staining were performed on facet joint cartilage. Creep indentation and uniaxial strain-to-failure testing were used to determine the biomechanical compressive and tensile properties. Biochemical assays included quantification of total collagen, sulfated glycosaminoglycan and DNA content. The facet joint surfaces were ovoid in shape with a flat articular surface. Histological analyses highlighted structures akin to articular cartilage of other synovial joints. In general, biomechanical and biochemical properties did not differ significantly between the inferior and superior joint surfaces as well as among spinal levels. Interestingly, compressive and tensile properties of cervical facet articular cartilage were lower than those of articular cartilage from other previously characterised equine joints. Removal of the superficial zone reduced the tissue's tensile strength, suggesting that this zone is important for the tensile integrity of the tissue. Facet surfaces were sampled at a single, central location and do not capture the potential topographic variation in cartilage properties. This is the first study to report the properties of equine cervical facet joint cartilage and may serve as the foundation for the development of future tissue-engineered replacements as well as other treatment strategies. © 2018 EVJ Ltd.
Juch, Johan N S; Maas, Esther T; Ostelo, Raymond W J G; Groeneweg, J George; Kallewaard, Jan-Willem; Koes, Bart W; Verhagen, Arianne P; van Dongen, Johanna M; Huygen, Frank J P M; van Tulder, Maurits W
2017-07-04
Radiofrequency denervation is a commonly used treatment for chronic low back pain, but high-quality evidence for its effectiveness is lacking. To evaluate the effectiveness of radiofrequency denervation added to a standardized exercise program for patients with chronic low back pain. Three pragmatic multicenter, nonblinded randomized clinical trials on the effectiveness of minimal interventional treatments for participants with chronic low back pain (Mint study) were conducted in 16 multidisciplinary pain clinics in the Netherlands. Eligible participants were included between January 1, 2013, and October 24, 2014, and had chronic low back pain, a positive diagnostic block at the facet joints (facet joint trial, 251 participants), sacroiliac joints (sacroiliac joint trial, 228 participants), or a combination of facet joints, sacroiliac joints, or intervertebral disks (combination trial, 202 participants) and were unresponsive to conservative care. All participants received a 3-month standardized exercise program and psychological support if needed. Participants in the intervention group received radiofrequency denervation as well. This is usually a 1-time procedure, but the maximum number of treatments in the trial was 3. The primary outcome was pain intensity (numeric rating scale, 0-10; whereby 0 indicated no pain and 10 indicated worst pain imaginable) measured 3 months after the intervention. The prespecified minimal clinically important difference was defined as 2 points or more. Final follow-up was at 12 months, ending October 2015. Among 681 participants who were randomized (mean age, 52.2 years; 421 women [61.8%], mean baseline pain intensity, 7.1), 599 (88%) completed the 3-month follow-up, and 521 (77%) completed the 12-month follow-up. The mean difference in pain intensity between the radiofrequency denervation and control groups at 3 months was -0.18 (95% CI, -0.76 to 0.40) in the facet joint trial; -0.71 (95% CI, -1.35 to -0.06) in the sacroiliac joint trial; and -0.99 (95% CI, -1.73 to -0.25) in the combination trial. In 3 randomized clinical trials of participants with chronic low back pain originating in the facet joints, sacroiliac joints, or a combination of facet joints, sacroiliac joints, or intervertebral disks, radiofrequency denervation combined with a standardized exercise program resulted in either no improvement or no clinically important improvement in chronic low back pain compared with a standardized exercise program alone. The findings do not support the use of radiofrequency denervation to treat chronic low back pain from these sources. trialregister.nl Identifier: NTR3531.
Facet joint disturbance induced by miniscrews in plated cervical laminoplasty
Chen, Hua; Li, Huibo; Wang, Beiyu; Li, Tao; Gong, Quan; Song, Yueming; Liu, Hao
2016-01-01
Abstract A retrospective cohort study. Plated cervical laminoplasty is an increasingly common technique. A unique facet joint disturbance induced by lateral mass miniscrews penetrating articular surface was noticed. Facet joints are important to maintain cervical spine stability and kinetic balance. Whether this facet joint disturbance could affect clinical and radiologic results is still unknown. The objective of this study is to investigate the clinical and radiologic outcomes of patients with facet joints disturbance induced by miniscrews in plated cervical laminoplasty. A total of 105 patients who underwent cervical laminoplasty with miniplate fixation between May 2010 and February 2014 were comprised. Postoperative CT images were used to identify whether facet joints destroyed by miniscrews. According to facet joints destroyed number, all the patients were divided into: group A (none facet joint destroyed), group B (1–2 facet joints destroyed), and group C (≥3 facet joints destroyed). Clinical data (JOA, VAS, and NDI scores), radiologic data (anteroposterior diameter and Palov ratio), and complications (axial symptoms and C5 palsy) were evaluated and compared among the groups. There were 38, 40, and 27 patients in group A, B, and C, respectively. The overall facet joints destroyed rate was 30.7%. All groups gained significant JOA and NDI scores improvement postoperatively. The preoperative JOA, VAS, NDI scores, and postoperative JOA scores did not differ significantly among the groups. The group C recorded significant higher postoperative VAS scores than group A (P = 0.002) and B (P = 0.014) and had significant higher postoperative NDI scores than group A (P = 0.002). The pre- and postoperative radiologic data were not significant different among the groups. The group C had a significant higher axial symptoms incidence than group A (12/27 vs 8/38, P = 0.041). Facet joints disturbance caused by miniscrews in plated cervical laminoplasty may not influence neurological recovery and spinal canal expansion, but may negatively affect postoperative axial symptoms. PMID:27661016
Gómez Vega, Juan Carlos; Acevedo-González, Juan Carlos
2018-06-14
Lumbar pain affects between 60-90% of people. It is a frequent cause of disability in adults. Pain may be generated by different anatomical structures such as the facet joint. However, nowadays pain produced by the facet joint has no clinical diagnosis. Therefore, the purpose of this article is to propose a clinical diagnostic scale for lumbar facet syndrome. The study was conducted by means of 6 phases as follows, Phase 1, a systematic review of the literature was performed regarding the clinical diagnosis of facet-based lumbar pain based on the PRISMA checklist; Phase 2, a list of signs and symptoms proposed for diagnosis lumbar pain of facet origin was made. Phase 3, the list of signs and symptoms found was submitted to a committee of experts to discriminate the most significant signs and symptoms, these were linked to general sociodemographic variables to develop an evaluation questionnaire; Phase 4, the evaluation questionnaire was applied, including those selected signs and symptoms to a group of patients with clinical diagnosis of facet disease lumbar pain and who underwent a selective facet block. Phase 5, under standard technique selective facet block and subsequent postoperative clinical control at 1 month. Phase 6, given pre and postsurgical results associated with signs present in the patients we propose a clinical scale of diagnosis scale. Descriptive statistics and Stata 12.0 were used as statistical software. A total of 36 signs and symptoms were found for the diagnosis of lumbar facet syndrome that were submitted to the group of experts, where a total of 12 (8 symptoms and 4 signs) were included for the final survey. 31 patients underwent selective lumbar facet blockade, mostly women, with an average of 60±11.5 years, analogous visual scale of preoperative pain of 8/10, postoperative of 1.7/10, the signs and symptoms most frequently found included in a diagnostic scale were: 3 symptoms 1) axial or bilateral axial lumbar pain, 2) improvement with rest, 3) absence of root pattern, may have pseudoradicular pattern, however, the pain is greater lumbar than pain in the leg and 3 clinical signs 1) Kemp sign, 2) pain induced in joint or transverse process, 3) facet stress sign or Acevedo sign. The clinical diagnosis of lumbar facet pain is still debated. Few diagnostic scales have been postulated, with little or no external validity, so the present study proposes a diagnostic scale consisting of 3 symptoms and 3 clinical signs. Copyright © 2018 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.
Surgical Tips to Preserve the Facet Joint during Microdiscectomy
Park, Man-Kyu; Cho, Dae-Chul; Sung, Joo-Kyung
2013-01-01
Lumbar microdiscectomy (MD) is the gold standard for treatment of lumbar disc herniation. Generally, the surgeon attempts to protect the facet joint in hopes of avoiding postoperative pain/instability and secondary degenerative arthropathy. We believe that preserving the facet joint is especially important in young patients, owing to their life expectancy and activity. However, preserving the facet joint is not easy during lumbar MD. We propose several technical tips (superolateral extension of conventional laminotomy, oblique drilling for laminotomy, and additional foraminotomy) for facet joint preservation during lumbar MD. PMID:24294466
Kras, Jeffrey V.; Kartha, Sonia; Winkelstein, Beth A.
2015-01-01
Objective The objective of the current study is to define whether intra-articular nerve growth factor (NGF), an inflammatory mediator that contributes to osteoarthritic pain, is necessary and sufficient for the development or maintenance of injury-induced facet joint pain and its concomitant spinal neuronal hyperexcitability. Method Male Holtzman rats underwent painful cervical facet joint distraction or sham procedures. Mechanical hyperalgesia was assessed in the forepaws, and NGF expression was quantified in the C6/C7 facet joint. An anti-NGF antibody was administered intra-articularly in additional rats immediately or 1 day following facet distraction or sham procedures to block intra-articular NGF and test its contribution to initiation and/or maintenance of facet joint pain and spinal neuronal hyperexcitability. NGF was injected into the bilateral C6/C7 facet joints in separate rats to determine if NGF alone is sufficient to induce these behavioral and neuronal responses. Results NGF expression increases in the cervical facet joint in association with behavioral sensitivity after that joint’s mechanical injury. Intra-articular application of anti-NGF immediately after a joint distraction prevents the development of both injury-induced pain and hyperexcitability of spinal neurons. Yet, intra-articular anti-NGF applied after pain has developed does not attenuate either behavioral or neuronal hyperexcitability. Intra-articular NGF administered to the facet in naïve rats also induces behavioral hypersensitivity and spinal neuronal hyperexcitability. Conclusion Findings demonstrate that NGF in the facet joint contributes to the development of injury-induced joint pain. Localized blocking of NGF signaling in the joint may provide potential treatment for joint pain. PMID:26521746
Oberkircher, Ludwig; Born, Sebastian; Struewer, Johannes; Bliemel, Christopher; Buecking, Benjamin; Wack, Christina; Bergmann, Martin; Ruchholtz, Steffen; Krüger, Antonio
2014-10-01
Injuries of the subaxial cervical spine including facet joints and posterior ligaments are common. Potential surgical treatments consist of anterior, posterior, or anterior-posterior fixation. Because each approach has its advantages and disadvantages, the best treatment is debated. This biomechanical cadaver study compared the effect of different facet joint injuries on primary stability following anterior plate fixation. Fractures and plate fixation were performed on 15 fresh-frozen intact cervical spines (C3-T1). To simulate a translation-rotation injury in all groups, complete ligament rupture and facet dislocation were simulated by dissecting the entire posterior and anterior ligament complex between C-4 and C-5. In the first group, the facet joints were left intact. In the second group, one facet joint between C-4 and C-5 was removed and the other side was left intact. In the third group, both facet joints between C-4 and C-5 were removed. The authors next performed single-level anterior discectomy and interbody grafting using bone material from the respective thoracic vertebral bodies. An anterior cervical locking plate was used for fixation. Continuous loading was performed using a servohydraulic test bench at 2 N/sec. The mean load failure was measured when the implant failed. In the group in which both facet joints were intact, the mean load failure was 174.6 ± 46.93 N. The mean load failure in the second group where only one facet joint was removed was 127.8 ± 22.83 N. In the group in which both facet joints were removed, the mean load failure was 73.42 ± 32.51 N. There was a significant difference between the first group (both facet joints intact) and the third group (both facet joints removed) (p < 0.05, Kruskal-Wallis test). In this cadaver study, primary stability of anterior plate fixation for dislocation injuries of the subaxial cervical spine was dependent on the presence of the facet joints. If the bone in one or both facet joints is damaged in the clinical setting, anterior plate fixation in combination with bone grafting might not provide sufficient stabilization; additional posterior stabilization may be needed.
2014-01-01
Study design A phantom experiment, two thermocouple experiments, three in vivo pig experiments, and a simulated treatment on a healthy human volunteer were conducted to test the feasibility, safety, and efficacy of magnetic resonance-guided focused ultrasound (MRgFUS) for treating facet joint pain. Objective The goal of the current study was to develop a novel method for accurate and safe noninvasive facet joint ablation using MRgFUS. Summary of background data Facet joints are a common source of chronic back pain. Direct facet joint interventions include medial branch nerve ablation and intra-articular injections, which are widely used, but limited in the short and long term. MRgFUS is a breakthrough technology that enables accurate delivery of high-intensity focused ultrasound energy to create a localized temperature rise for tissue ablation, using MR guidance for treatment planning and real-time feedback. Methods We validated the feasibility, safety, and efficacy of MRgFUS for facet joint ablation using the ExAblate 2000® System (InSightec Ltd., Tirat Carmel, Israel) and confirmed the system's ability to ablate the edge of the facet joint and all terminal nerves innervating the joint. A phantom experiment, two thermocouple experiments, three in vivo pig experiments, and a simulated treatment on a healthy human volunteer were conducted. Results The experiments showed that targeting the facet joint with energies of 150–450 J provides controlled and accurate heating at the facet joint edge without penetration to the vertebral body, spinal canal, or root foramina. Treating with reduced diameter of the acoustic beam is recommended since a narrower beam improves access to the targeted areas. Conclusions MRgFUS can safely and effectively target and ablate the facet joint. These results are highly significant, given that this is the first study to demonstrate the potential of MRgFUS to treat facet joint pain. PMID:24921048
Superior Recess Access of the Lumbar Facet Joint.
Demir-Deviren, Sibel; Singh, Sukhminder; Hanelin, Joshua
2017-04-01
Descriptive approach to accessing the lumbar facet joint by superior recess. This study is aimed to describe an approach to accessing the lumbar facet joint through targeting the superior recess during lumbar facet joint injections. Lumbar facet joint injections are routinely performed for both the diagnosis and treatment of chronic low back pain. Previous studies either did not specify which part of the joint to target, or recommended targeting the inferior aspect of the joint to access the inferior recess. One study did mention the superior recess as an alternative to injecting the inferior recess, but none has focused on description of the technique. This is the first time this technique has been described. The records and fluoroscopic images were reviewed for all patients over a period of 9 months (January-September 2012) using the proposed technique. This resulted in a total of 48 patients; 15 men, 29 women, and a total of 117 facet joint intra-articular injections. Among these 48 patients, injections were repeated in total of 4 cases. The average time of injections among 4 repeat cases was 121 days. The success of the procedure was confirmed with an arthrogram demonstrating contrast flowing from the superior recess inferiorly through the joint space. Successful access of the lumbar facet joint through puncture of the superior recess was seen in 114 cases, with 3 unsuccessful attempts to enter facet joints due to osteophytes at involved levels. There were no complications observed during the procedure. We find this approach to be highly successful, safe, and well tolerated by the patient and recommend it as a technique for access of the lumbar facet joint in those patients in whom direct puncture of the inferior recess is difficult.
Facet joint hypertrophy is a misnomer: A retrospective study.
An, Sang Joon; Seo, Mi Sook; Choi, Soo Il; Lim, Tae-Ha; Shin, So Jin; Kang, Keum Nae; Kim, Young Uk
2018-06-01
One of the major causes of lumbar spinal canal stenosis (LSCS) has been considered facet joint hypertrophy (FJH). However, a previous study asserted that "FJH" is a misnomer because common facet joints are no smaller than degenerative facet joints; however, this hypothesis has not been effectively demonstrated. Therefore, in order to verify that FJH is a misnomer in patients with LSCS, we devised new morphological parameters that we called facet joint thickness (FJT) and facet joint cross-sectional area (FJA).We collected FJT and FJA data from 114 patients with LSCS. A total of 86 control subjects underwent lumbar magnetic resonance imaging (MRI) as part of routine medical examinations, and axial T2-weighted MRI images were obtained from all participants. We measured FJT by drawing a line along the facet area and then measuring the narrowest point at L4-L5. We measured FJA as the whole cross-sectional area of the facet joint at the stenotic L4-L5 level.The average FJT was 1.60 ± 0.36 mm in the control group and 1.11 ± 0.32 mm in the LSCS group. The average FJA was 14.46 ± 5.17 mm in the control group and 9.31 ± 3.47 mm in the LSCS group. Patients with LSCS had significantly lower FJTs (P < .001) and FJAs (P < .001).FJH, a misnomer, should be renamed facet joint area narrowing. Using this terminology would eliminate confusion in descriptions of the facet joint.
Kras, Jeffrey V.; Dong, Ling; Winkelstein, Beth A.
2012-01-01
Study Design This study implemented immunohistochemistry to assay prostaglandin E2 (PGE2) receptor EP2 expression in the dorsal root ganglion (DRG) of rats after painful cervical facet joint injury. Objective The objective of this study was to identify if inflammatory cascades are induced in association with cervical facet joint distraction-induced pain by investigating the time course of EP2 expression in the DRG. Summary of Background Data The cervical facet joint is a common source of neck pain and non-physiological stretch of the facet capsular ligament can initiate pain from the facet joint via mechanical injury. PGE2 levels are elevated in painful inflamed and arthritic joints, and PGE2 sensitizes joint afferents to mechanical stimulation. Although in vitro studies suggest the EP2 receptor subtype contributes to painful joint disease the EP2 response has not been investigated for any association with painful mechanical joint injury. Methods Separate groups of male Holtzman rats underwent either a painful cervical facet joint distraction injury or sham procedure. Bilateral forepaw mechanical allodynia was assessed, and immunohistochemical techniques were used to quantify EP2 expression in the DRG at days 1 and 7. Results Facet joint distraction induced mechanical allodynia that was significant (p<0.024) at all time points. Painful joint injury also significantly elevated total EP2 expression in the DRG at day 1 (p=0.009), which was maintained also at day 7 (p<0.001). Neuronal expression of EP2 in the DRG was only increased over sham levels at day 1 (p=0.013). Conclusions Painful cervical facet joint distraction induces an immediate and sustained increase of EP2 expression in the DRG, implicating peripheral inflammation in the initiation and maintenance of facet joint pain. The transient increase in neuronal EP2 suggests, as in other painful joint conditions, that after joint injury non-neuronal cells may migrate to the DRG, some of which likely express EP2. PMID:22789984
Kristjánsson, Baldur; Limthongkul, Worawat; Yingsakmongkol, Wicharn; Thantiworasit, Pattarawat; Jirathanathornnukul, Napaphat; Honsawek, Sittisak
2016-01-01
A descriptive in vitro study on isolation and differentiation of human mesenchymal stem cells (MSCs) derived from the facet joints and interspinous ligaments. To isolate cells from the facet joints and interspinous ligaments and investigate their surface marker profile and differentiation potentials. Lumbar spinal canal stenosis and ossification of the posterior longitudinal ligament are progressive conditions characterized by the hypertrophy and ossification of ligaments and joints within the spinal canal. MSCs are believed to play a role in the advancement of these diseases and the existence of MSCs has been demonstrated within the ligamentum flavum and posterior longitudinal ligament. The aim of this study was to investigate whether these cells could also be found within facet joints and interspinous ligaments. Samples were harvested from 10 patients undergoing spinal surgery. The MSCs from facet joints and interspinous ligaments were isolated using direct tissue explant technique. Cell surface antigen profilings were performed via flow cytometry. Their lineage differentiation potentials were analyzed. The facet joints and interspinous ligaments-derived MSCs have the tri-lineage potential to be differentiated into osteogenic, adipogenic, and chondrogenic cells under appropriate inductions. Flow cytometry analysis revealed both cell lines expressed MSCs markers. Both facet joints and interspinous ligaments-derived MSCs expressed marker genes for osteoblasts, adipocytes, and chondrocytes. The facet joints and interspinous ligaments may provide alternative sources of MSCs for tissue engineering applications. The facet joints and interspinous ligaments-derived MSCs are part of the microenvironment of the human ligaments of the spinal column and might play a crucial role in the development and progression of degenerative spine conditions.
Effect of Radiofrequency Denervation on Pain Intensity Among Patients With Chronic Low Back Pain
Juch, Johan N. S.; Ostelo, Raymond W. J. G.; Groeneweg, J. George; Kallewaard, Jan-Willem; Koes, Bart W.; Verhagen, Arianne P.; van Dongen, Johanna M.; Huygen, Frank J. P. M.; van Tulder, Maurits W.
2017-01-01
Importance Radiofrequency denervation is a commonly used treatment for chronic low back pain, but high-quality evidence for its effectiveness is lacking. Objective To evaluate the effectiveness of radiofrequency denervation added to a standardized exercise program for patients with chronic low back pain. Design, Setting, and Participants Three pragmatic multicenter, nonblinded randomized clinical trials on the effectiveness of minimal interventional treatments for participants with chronic low back pain (Mint study) were conducted in 16 multidisciplinary pain clinics in the Netherlands. Eligible participants were included between January 1, 2013, and October 24, 2014, and had chronic low back pain, a positive diagnostic block at the facet joints (facet joint trial, 251 participants), sacroiliac joints (sacroiliac joint trial, 228 participants), or a combination of facet joints, sacroiliac joints, or intervertebral disks (combination trial, 202 participants) and were unresponsive to conservative care. Interventions All participants received a 3-month standardized exercise program and psychological support if needed. Participants in the intervention group received radiofrequency denervation as well. This is usually a 1-time procedure, but the maximum number of treatments in the trial was 3. Main Outcomes and Measures The primary outcome was pain intensity (numeric rating scale, 0-10; whereby 0 indicated no pain and 10 indicated worst pain imaginable) measured 3 months after the intervention. The prespecified minimal clinically important difference was defined as 2 points or more. Final follow-up was at 12 months, ending October 2015. Results Among 681 participants who were randomized (mean age, 52.2 years; 421 women [61.8%], mean baseline pain intensity, 7.1), 599 (88%) completed the 3-month follow-up, and 521 (77%) completed the 12-month follow-up. The mean difference in pain intensity between the radiofrequency denervation and control groups at 3 months was −0.18 (95% CI, −0.76 to 0.40) in the facet joint trial; −0.71 (95% CI, −1.35 to −0.06) in the sacroiliac joint trial; and −0.99 (95% CI, −1.73 to −0.25) in the combination trial. Conclusions and Relevance In 3 randomized clinical trials of participants with chronic low back pain originating in the facet joints, sacroiliac joints, or a combination of facet joints, sacroiliac joints, or intervertebral disks, radiofrequency denervation combined with a standardized exercise program resulted in either no improvement or no clinically important improvement in chronic low back pain compared with a standardized exercise program alone. The findings do not support the use of radiofrequency denervation to treat chronic low back pain from these sources. Trial Registration trialregister.nl Identifier: NTR3531 PMID:28672319
Albayrak, Akif; Ozkul, Baris; Balioglu, Mehmet Bulent; Atici, Yunus; Gultekin, Muhammet Zeki; Albayrak, Merih Dilan
2016-01-01
Retrospective cohort study. Facet joints are considered a common source of chronic low-back pain. To determine whether pathogens related to the facet joint arthritis have any effect on treatment failure. Facet joint injection was applied to 94 patients treated at our hospital between 2011 and 2012 (mean age 59.5 years; 80 women and 14 men). For the purpose of analysis, the patients were divided into two groups. Patients who only had facet hypertrophy were placed in group A (47 patients, 41 women and 6 men, mean age 55.3 years) and patients who had any additional major pathology to facet hypertrophy were placed in group B (47 patients, 39 women and 8 men, mean age 58.9 years). Injections were applied around the facet joint under surgical conditions utilizing fluoroscopy device guidance. A mixture of methylprednisolone and lidocaine was used as the injection ingredient. In terms of Oswestry Disability Index (ODI) and visual analog scale (VAS) scores, no significant difference was found between preinjection and immediate postinjection values in both groups, and the scores of group A patients were significantly lower (P < 0.005) compared with that of group B patients at the end of the third, sixth, and twelfth month. For low-back pain caused by facet hypertrophy, steroid injection around the facet joint is an effective treatment, but if there is an existing major pathology, it is not as effective.
[CORRELATION OF LUMBAR FACET JOINT DEGENERATION AND SPINE-PELVIC SAGITTAL BALANCE].
Lo, Xin; Zhang, Bin; Liu, Yuan; Dai, Min
2015-08-01
To investigate the relationship between lumbar facet joint degeneration of each segment and spine-pelvic sagittal balance parameters. A retrospective analysis was made the clinical data of 120 patients with lumbar degenerative disease, who accorded with the inclusion criteria between June and November 2014. There were 58 males and 62 females with an average age of 53 years (range, 24-77 years). The disease duration ranged from 3 to 96 months (mean, 6.6 months). Affected segments included L3,4 in 32 cases, L4,5 in 47 cases, and L5, S1 in 52 cases. The CT and X-ray films of the lumbar vertebrae were taken. The facet joint degeneration was graded based on the grading system of Pathria. The spine-pelvic sagittal balance parameters were measured, including lumbar lordosis (LL), upper lumbar lordosis (ULL), lower lumbar lordosis (LLL), pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS). According to normal range of PI, the patients were divided into 3 groups: group A (PI was less than normal range), group B (PI was within normal range), and group C (PI was more than normal range). The facet joint degeneration was compared; according to the facet joint degeneration degree, the patients were divided into group N (mild degeneration group) and group M (serious degeneration group) to observe the relationship of lumbar facet joint degeneration of each segment and spine-pelvic sagittal balance parameters. At L4,5 and L5, S1, facet joint degeneration showed significant difference among groups A, B, and C (P < 0.05), more serious facet joint degeneration was observed in group C; no significant difference was found in facet joint degeneration at L3,4 (P > 0.05). There was no significant difference in the other spine-pelvic sagittal balance parameters between groups N and M at each segment (P > 0.05) except for PT (P < 0.05). PI of more than normal range may lead to or aggravate lumbar facet joint degeneration at L4,5 and L5, Si; PT and PI are significantly associated with facet joint degeneration at the lower lumbar spine.
Yamabe, Daisuke; Murakami, Hideki; Chokan, Kou; Endo, Hirooki; Oikawa, Ryosuke; Sawamura, Shoitsu; Doita, Minoru
2017-12-15
T2 mapping was used to quantify the water content of lumbar spine intervertebral discs (IVDs) and facet joints before and after physiological loading. The aim of this study was to clarify the interaction between lumbar spine IVD and facet joints as load-bearing structures by measuring the water content of their matrix after physiological loading using T2 mapping magnetic resonance imaging (MRI). To date, few reports have functionally evaluated lumbar spine IVD and facet joints, and their interaction in vivo. T2 mapping may help detect changes in the water content of IVD and articular cartilage of facet joints before and after physiological loading, thereby enabling the evaluation of changes in interacted water retention between IVD and facet joints. Twenty asymptomatic volunteers (10 female and 10 male volunteers; mean age, 19.3 years; age range, 19-20 years) underwent MRI before and after physiological loading such as lumbar flexion, extension, and rotation. Each IVD from L1/2 to L5/S1 was sliced at center of the disc space, and the T2 value was measured at the nucleus pulposus (NP), anterior annulus fibrosus (AF), posterior AF, and bilateral facet joints. In the NP, T2 values significantly decreased after exercise at every lumbar spinal level. In the anterior AF, there were no significant differences in T2 values at any level. In the posterior AF, T2 values significantly increased only at L4/5. In the bilateral facet joints, T2 values significantly decreased after exercise at every level. There was a significant decrease in the water content of facet joints and the NP at every lumbar spinal level after dynamic loading by physical lumbar exercise. These changes appear to play an important and interactional role in the maintenance of the interstitial matrix in the IVD NP and cartilage in the facet joint. 3.
Huang, Ambrose J; Palmer, William E
2012-02-01
To determine the incidence of inadvertent lumbar facet joint injection during an interlaminar epidural steroid injection (ESI). A total of 686 interlaminar lumbar ESIs were performed from January 1, 2009 to December 31, 2009. Archived images from these cases were retrospectively reviewed on the PACS. Positive cases of inadvertent lumbar facet joint injection were identified by the characteristic sigmoid-shaped contrast pattern projecting over the posterior elements on the lateral view and/or ovoid contrast projecting over the facet joints on the anteroposterior (AP) view. Eight positive events were identified (1.2%). There was no statistically significant gender or lumbar level predilection. In 3/8 of the positive cases (37.5%), the inadvertent facet joint injection was recognized by the operator. The needle was repositioned as a result, and contrast within the posterior epidural space was documented by the end of the procedure. In 5/8 of the positive cases (62.5%), the patients reported an immediate decrease in the presenting pain. The incidence of inadvertent lumbar facet joint injection during an interlaminar epidural steroid injection is low. Recognizing the imaging features of this event permits the operator to redirect the needle tip into the epidural space and/or identify the facet joint(s) as a source of the patient's presenting pain.
Lv, Xin; Liu, Yuan; Zhou, Song; Wang, Qiang; Gu, Houyun; Fu, Xiaoxing; Ding, Yi; Zhang, Bin; Dai, Min
2016-08-15
Sagittal spinopelvic alignment changes associated with degenerative facet joint arthritis have been assessed in a few studies. It has been documented that patients with facet joint degeneration have higher pelvic incidence, but the relationship between facet joint degeneration and other sagittal spinopelvic alignment parameters is still disputed. Our purpose was to evaluate the correlation between the features of sagittal spinopelvic alignment and facet joint degeneration. Imaging data of 140 individuals were retrospectively analysed. Lumbar lordosis, pelvic tilt (PT), pelvic incidence (PI), sacral slope, and height of the lumbar intervertebral disc were measured on lumbar X-ray plates. Grades of facet joint degeneration were evaluated from the L2 to S1 on CT scans. Spearman's rank correlation coefficient and Student's t-test were used for statistical analyses, and a P-value <0.05 was considered statistically significant. PI was positively associated with degeneration of the facet joint at lower lumbar levels (p < 0.001 r = 0.50 at L5/S1 and P = 0.002 r = 0.25 at L4/5). A significant increase of PT was found in the severe degeneration group compared with the mild degeneration group: 22.0° vs 15.7°, P = 0.034 at L2/3;21.4°vs 15.1°, P = 0.006 at L3/4; 21.0° vs 13.5°, P = 0.000 at L4/5; 20.8° vs 12.1°, P = 0.000 at L5/S1. Our results indicate that a high PI is a predisposing factor for facet joint degeneration at the lower lumbar spine, and that severe facet joint degeneration may accompany with greater PT at lumbar spine.
Subdural empyema following lumbar facet joint injection: An exceeding rare complication.
Fayeye, Oluwafikayo; Silva, Adikarige Haritha Dulanka; Chavda, Swarupsinh; Furtado, Navin Raoul
2016-01-01
Chronic low back pain is extremely common with a life time prevalence estimated at greater than 70%. Facet joint arthrosis is thought to be the causative aetiological substrate in approximately 25% of chronic low back pain cases. Facet joint injection is a routine intervention in the armamentarium for both the diagnostic and therapeutic management of chronic low back pain. In fact, a study by Carrino et al. reported in excess of 94,000 facet joint injection procedures were carried out in the US in 1999. Although generally considered safe, the procedure is not entirely without risk. Complications including bleeding, infection, exacerbation of pain, dural puncture headache, and pneumothorax have been described. We report a rare case of a 47-year-old female patient who developed a left L4/5 facet septic arthrosis with an associated subdural empyema and meningitis following facet joint injection. This case is unique, as to the best of our knowledge no other case of subdural empyema following facet joint injection has been reported in the literature. Furthermore this case serves to highlight the potential serious adverse sequelae of a routine and apparently innocuous intervention. The need for medical practitioners to be alert to and respond rapidly to the infective complications of facet joint injection cannot be understated. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.
Chang, Min Cheol; Cho, Yun-Woo; Ahn, Da Hyun; Do, Kyung Hee
2018-04-01
Many treatment techniques have been used for refractory lumbar facet joint pain; however, their efficacy has been controversial. In this study, we investigated the clinical efficacy and safety of intra-articular pulsed radiofrequency for the treatment of refractory lumbar facet joint pain in patients with low back pain. Twenty patients with refractory lumbar facet joint pain were recruited, and each patient was treated via intra-articular pulsed radiofrequency. The treatment effects were measured with a numerical rating scale, and the technical accuracy of intra-articular pulsed radiofrequency treatment was evaluated independently by 2 radiologists. Any adverse events or complications also were checked. We performed intra-articular pulsed radiofrequency treatment at 48 levels of the lumbar facet joints in 20 patients (5 men and 15 women; mean age, 64.50 ± 10.65 years) with refractory lumbar facet joint pain. Pain scores were significantly reduced at 1 month, 3 months, and 6 months after treatment (P < 0.05). The face validity revealed good intraarticular pulsed radiofrequency results in all 20 patients, without any serious adverse effects. Treatment using intra-articular pulsed radiofrequency is an alternative to other techniques in patients with refractory lumbar facet joint pain. Copyright © 2018 Elsevier Inc. All rights reserved.
Zhu, Q A; Park, Y B; Sjovold, S G; Niosi, C A; Wilson, D C; Cripton, P A; Oxland, T R
2008-02-01
Experimental measurement of the load-bearing patterns of the facet joints in the lumbar spine remains a challenge, thereby limiting the assessment of facet joint function under various surgical conditions and the validation of computational models. The extra-articular strain (EAS) technique, a non-invasive measurement of the contact load, has been used for unilateral facet joints but does not incorporate strain coupling, i.e. ipsilateral EASs due to forces on the contralateral facet joint. The objectives of the present study were to establish a bilateral model for facet contact force measurement using the EAS technique and to determine its effectiveness in measuring these facet joint contact forces during three-dimensional flexibility tests in the lumbar spine. Specific goals were to assess the accuracy and repeatability of the technique and to assess the effect of soft-tissue artefacts. In the accuracy and repeatability tests, ten uniaxial strain gauges were bonded to the external surface of the inferior facets of L3 of ten fresh lumbar spine specimens. Two pressure-sensitive sensors (Tekscan) were inserted into the joints after the capsules were cut. Facet contact forces were measured with the EAS and Tekscan techniques for each specimen in flexion, extension, axial rotation, and lateral bending under a +/- 7.5 N m pure moment. Four of the ten specimens were tested five times in axial rotation and extension for repeatability. These same specimens were disarticulated and known forces were applied across the facet joint using a manual probe (direct accuracy) and a materials-testing system (disarticulated accuracy). In soft-tissue artefact tests, a separate set of six lumbar spine specimens was used to document the virtual facet joint contact forces during a flexibility test following removal of the superior facet processes. Linear strain coupling was observed in all specimens. The average peak facet joint contact forces during flexibility testing was greatest in axial rotation (71 +/- 25 N), followed by extension (27 +/- 35 N) and lateral bending (25 +/- 28 N), and they were most repeatable in axial rotation (coefficient of variation, 5 per cent). The EAS accuracy was about 20 per cent in the direct accuracy assessment and about 30 per cent in the disarticulated accuracy test. The latter was very similar to the Tekscan accuracy in the same test. Virtual facet loads (r.m.s.) were small in axial rotation (12 N) and lateral bending (20 N), but relatively large in flexion (34 N) and extension (35 N). The results suggested that the bilateral EAS model could be used to determine the facet joint contact forces in axial rotation but may result in considerable error in flexion, extension, and lateral bending.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Amoretti, Nicolas, E-mail: amorettinicolas@yahoo.fr; Gallo, Giacomo, E-mail: giacomo.gallo83@gmail.com; Bertrand, Anne-Sophie, E-mail: asbertrand3@hotmail.com
We present a case of percutaneous treatment of symptomatic recurrent lumbar facet joint cyst resistant to all medical treatments including facet joint steroid injection. Percutaneous transfacet fixation was then performed at L4–L5 level with a cannulated screw using CT and fluoroscopy guidance. The procedure time was 30 min. Using the visual analog scale (VAS), pain decreased from 9.5, preoperatively, to 0 after the procedure. At 6-month follow-up, an asymptomatic cystic recurrence was observed, which further reduced at the 1-year follow-up. Pain remained stable (VAS at 0) during all follow-ups. CT- and fluoroscopy-guided percutaneous cyst rupture associated with facet screw fixation couldmore » be an alternative to surgery in patients suffering from a symptomatic recurrent lumbar facet joint cyst.« less
Wang, David J; Lownie, Stephen P; Pelz, David; Pandey, Sachin
2016-10-01
Spinal synovial cysts are benign protrusions of facet joint capsules caused by degenerative spondylosis, most frequently involving the L4-5 level, and commonly lead to symptoms of back pain, radiculopathy and neurogenic claudication. Although percutaneous treatment via facet joint steroid injection with cyst rupture can provide significant symptom relief, cyst rupture is not always achievable via an indirect trans-facet approach due to limited access from severe degenerative changes. In this case, we describe a successful approach to direct cyst access using a laser-guided navigational software in a patient with severe facet joint osteophytosis. We provide a brief review of literature. © The Author(s) 2016.
Morphological Asymmetry of the Superior Cervical Facets from C3 through C7 due to Degeneration.
Van Vlasselaer, Nicolas; Van Roy, Peter; Cattrysse, Erik
2017-01-01
Knowledge about facet morphology has already been discussed extensively in literature but is limited regarding asymmetry and its relation to facet degeneration. Facet dimensions, surface area, curvature, and degeneration of the superior facets were measured in 85 dried human vertebrae from the anatomical collection of the Vrije Universiteit Brussel. The vertebrae were analysed using the Microscribe G2X digitizer (Immersion Co., San Jose, CA) and a grading system for the evaluation of cervical facet degeneration. Coordinates were processed mathematically to evaluate articular tropism. The statistical analysis includes the paired t -test and the Pearson correlation. On average, no systematic differences between the left and right facets were found concerning morphology and degeneration. However, there were significant differences regardless of the side-occurrence. There was a significant correlation between the dimensions of the total facet surface and the degree of degeneration but not for the recognizable joint surface. Facet tropism of the upper joint facets occurred often in the cervical spine but without side preference. A bigger difference in degeneration asymmetry was associated with a bigger difference in facet joint dimension asymmetry.
Contact pressure in the facet joint during sagittal bending of the cadaveric cervical spine.
Jaumard, Nicolas V; Bauman, Joel A; Weisshaar, Christine L; Guarino, Benjamin B; Welch, William C; Winkelstein, Beth A
2011-07-01
The facet joint contributes to the normal biomechanical function of the spine by transmitting loads and limiting motions via articular contact. However, little is known about the contact pressure response for this joint. Such information can provide a quantitative measure of the facet joint's local environment. The objective of this study was to measure facet pressure during physiologic bending in the cervical spine, using a joint capsule-sparing technique. Flexion and extension bending moments were applied to six human cadaveric cervical spines. Global motions (C2-T1) were defined using infra-red cameras to track markers on each vertebra. Contact pressure in the C5-C6 facet was also measured using a tip-mounted pressure transducer inserted into the joint space through a hole in the postero-inferior region of the C5 lateral mass. Facet contact pressure increased by 67.6 ± 26.9 kPa under a 2.4 Nm extension moment and decreased by 10.3 ± 9.7 kPa under a 2.7 Nm flexion moment. The mean rotation of the overall cervical specimen motion segments was 9.6 ± 0.8° and was 1.6 ± 0.7° for the C5-C6 joint, respectively, for extension. The change in pressure during extension was linearly related to both the change in moment (51.4 ± 42.6 kPa/Nm) and the change in C5-C6 angle (18.0 ± 108.9 kPa/deg). Contact pressure in the inferior region of the cervical facet joint increases during extension as the articular surfaces come in contact, and decreases in flexion as the joint opens, similar to reports in the lumbar spine despite the difference in facet orientation in those spinal regions. Joint contact pressure is linearly related to both sagittal moment and spinal rotation. Cartilage degeneration and the presence of meniscoids may account for the variation in the pressure profiles measured during physiologic sagittal bending. This study shows that cervical facet contact pressure can be directly measured with minimal disruption to the joint and is the first to provide local pressure values for the cervical joint in a cadaveric model.
Uncovertebral joint injury in cervical facet dislocation: the headphones sign.
Palmieri, Francesco; Cassar-Pullicino, Victor N; Dell'Atti, Claudia; Lalam, Radhesh K; Tins, Bernhard J; Tyrrell, Prudencia N M; McCall, Iain W
2006-06-01
The purpose of our study is to demonstrate the uncovertebral mal-alignment as a reliable indirect sign of cervical facet joint dislocation. We examined the uncovertebral axial plane alignment of 12 patients with unilateral and bilateral cervical facet joint dislocation (UCFJD and BCFJD, respectively), comparing its frequency to the reverse hamburger bun sign on CT and MR axial images. Of the seven cases with BCFJD, five clearly demonstrated the diagnostic reverse facet joint hamburger bun sign on CT and MR images, but in two cases this sign was not detectable. In the five cases with UCFJD, four demonstrated the reverse hamburger bun sign on both CT and MRI. In one case the reverse hamburger bun sign was not seen adequately with either image modality, but the facet dislocation was identified on sagittal imaging. The uncovertebral mal-alignment was detected in all 12 cases. Normally, the two components of the uncovertebral joint enjoy a concentric relationship that in the axial plane is reminiscent of the relationship of headphones with the wearer's head. We name this appearance the 'headphones' sign. Radiologists should be aware of the headphones sign as a reliable indicator of facet joint dislocation on axial imaging used in the assessment of cervical spine injuries.
Kras, Jeffrey V.; Weisshaar, Christine L.; Pall, Parul S.; Winkelstein, Beth A.
2015-01-01
Non-physiological stretch of the cervical facet joint’s capsular ligament induces persistent behavioral hypersensitivity and spinal neuronal hyperexcitability via an intra-articular NGF-dependent mechanism. Although that ligament is innervated by nociceptors, it is unknown if a subpopulation is exclusively responsible for the behavioral and spinal neuronal responses to intra-articular NGF and/or facet joint injury. This study ablated joint afferents using the neurotoxin saporin targeted to neurons involved in either peptidergic ([Sar9,Met(O2)11]-substance P-saporin (SSP-Sap)) or non-peptidergic (isolectin B4-saporin (IB4-Sap)) signaling to investigate the contributions of those neuronal populations to facet-mediated pain. SSP-Sap, but not IB4-Sap, injected into the bilateral C6/C7 facet joints 14 days prior to an intra-articular NGF injection prevents NGF-induced mechanical and thermal hypersensitivity in the forepaws. Similarly, only SSP-Sap prevents the increase in mechanical forepaw stimulation-induced firing of spinal neurons after intra-articular NGF. In addition, intra-articular SSP-Sap prevents both behavioral hypersensitivity and upregulation of NGF in the dorsal root ganglion after a facet joint distraction that normally induces pain. These findings collectively suggest that disruption of peptidergic signaling within the joint may be a potential treatment for facet pain, as well as other painful joint conditions associated with elevated NGF, such as osteoarthritis. PMID:26240991
Kras, Jeffrey V; Weisshaar, Christine L; Pall, Parul S; Winkelstein, Beth A
2015-09-14
Non-physiological stretch of the cervical facet joint's capsular ligament induces persistent behavioral hypersensitivity and spinal neuronal hyperexcitability via an intra-articular NGF-dependent mechanism. Although that ligament is innervated by nociceptors, it is unknown if a subpopulation is exclusively responsible for the behavioral and spinal neuronal responses to intra-articular NGF and/or facet joint injury. This study ablated joint afferents using the neurotoxin saporin targeted to neurons involved in either peptidergic ([Sar(9),Met (O2)(11)]-substance P-saporin (SSP-Sap)) or non-peptidergic (isolectin B4-saporin (IB4-Sap)) signaling to investigate the contributions of those neuronal populations to facet-mediated pain. SSP-Sap, but not IB4-Sap, injected into the bilateral C6/C7 facet joints 14 days prior to an intra- articular NGF injection prevents NGF-induced mechanical and thermal hypersensitivity in the forepaws. Similarly, only SSP- Sap prevents the increase in mechanical forepaw stimulation- induced firing of spinal neurons after intra-articular NGF. In addition, intra-articular SSP-Sap prevents both behavioral hypersensitivity and upregulation of NGF in the dorsal root ganglion after a facet joint distraction that normally induces pain. These findings collectively suggest that disruption of peptidergic signaling within the joint may be a potential treatment for facet pain, as well as other painful joint conditions associated with elevated NGF, such as osteoarthritis. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Biomechanical analyses of whiplash injuries using an experimental model.
Yoganandan, Narayan; Pintar, Frank A; Cusick, Joseph F
2002-09-01
Neck pain and headaches are the two most common symptoms of whiplash. The working hypothesis is that pain originates from excessive motions in the upper and lower cervical segments. The research design used an intact human cadaver head-neck complex as an experimental model. The intact head-neck preparation was fixed at the thoracic end with the head unconstrained. Retroreflective targets were placed on the mastoid process, anterior regions of the vertebral bodies, and lateral masses at every spinal level. Whiplash loading was delivered using a mini-sled pendulum device. A six-axis load cell and an accelerometer were attached to the inferior fixation of the specimen. High-speed video cameras were used to obtain the kinematics. During the initial stages of loading, a transient decoupling of the head occurs with respect to the neck exhibiting a lag of the cranium. The upper cervical spine-head undergoes local flexion concomitant with a lag of the head while the lower column is in local extension. This establishes a reverse curvature to the head-neck complex. With continuing application of whiplash loading, the inertia of the head catches up with the neck. Later, the entire head-neck complex is under an extension mode with a single extension curvature. The lower cervical facet joint kinematics demonstrates varying local compression and sliding. While the anterior- and posterior-most regions of the facet joint slide, the posterior-most region of the joint compresses more than the anterior-most region. These varying kinematics at the two ends of the facet joint result in a pinching mechanism. Excessive flexion of the posterior upper cervical regions can be correlated to headaches. The pinching mechanism of the facet joints can be correlated to neck pain. The kinematics of the soft tissue-related structures explain the mechanism of these common whiplash associated disorders.
Morphological Asymmetry of the Superior Cervical Facets from C3 through C7 due to Degeneration
Van Roy, Peter
2017-01-01
Introduction Knowledge about facet morphology has already been discussed extensively in literature but is limited regarding asymmetry and its relation to facet degeneration. Method Facet dimensions, surface area, curvature, and degeneration of the superior facets were measured in 85 dried human vertebrae from the anatomical collection of the Vrije Universiteit Brussel. The vertebrae were analysed using the Microscribe G2X digitizer (Immersion Co., San Jose, CA) and a grading system for the evaluation of cervical facet degeneration. Coordinates were processed mathematically to evaluate articular tropism. The statistical analysis includes the paired t-test and the Pearson correlation. Results On average, no systematic differences between the left and right facets were found concerning morphology and degeneration. However, there were significant differences regardless of the side-occurrence. There was a significant correlation between the dimensions of the total facet surface and the degree of degeneration but not for the recognizable joint surface. Conclusions Facet tropism of the upper joint facets occurred often in the cervical spine but without side preference. A bigger difference in degeneration asymmetry was associated with a bigger difference in facet joint dimension asymmetry. PMID:29359153
Augmented Reality-Guided Lumbar Facet Joint Injections.
Agten, Christoph A; Dennler, Cyrill; Rosskopf, Andrea B; Jaberg, Laurenz; Pfirrmann, Christian W A; Farshad, Mazda
2018-05-08
The aim of this study was to assess feasibility and accuracy of augmented reality-guided lumbar facet joint injections. A spine phantom completely embedded in hardened opaque agar with 3 ring markers was built. A 3-dimensional model of the phantom was uploaded to an augmented reality headset (Microsoft HoloLens). Two radiologists independently performed 20 augmented reality-guided and 20 computed tomography (CT)-guided facet joint injections each: for each augmented reality-guided injection, the hologram was manually aligned with the phantom container using the ring markers. The radiologists targeted the virtual facet joint and tried to place the needle tip in the holographic joint space. Computed tomography was performed after each needle placement to document final needle tip position. Time needed from grabbing the needle to final needle placement was measured for each simulated injection. An independent radiologist rated images of all needle placements in a randomized order blinded to modality (augmented reality vs CT) and performer as perfect, acceptable, incorrect, or unsafe. Accuracy and time to place needles were compared between augmented reality-guided and CT-guided facet joint injections. In total, 39/40 (97.5%) of augmented reality-guided needle placements were either perfect or acceptable compared with 40/40 (100%) CT-guided needle placements (P = 0.5). One augmented reality-guided injection missed the facet joint space by 2 mm. No unsafe needle placements occurred. Time to final needle placement was substantially faster with augmented reality guidance (mean 14 ± 6 seconds vs 39 ± 15 seconds, P < 0.001 for both readers). Augmented reality-guided facet joint injections are feasible and accurate without potentially harmful needle placement in an experimental setting.
Bezci, Semih E; Eleswarapu, Ananth; Klineberg, Eric O; O'Connell, Grace D
2018-02-12
Stresses applied to the spinal column are distributed between the intervertebral disc and facet joints. Structural and compositional changes alter stress distributions within the disc and between the disc and facet joints. These changes influence the mechanical properties of the disc joint, including its stiffness, range of motion, and energy absorption under quasi-static and dynamic loads. There have been few studies evaluating the role of facet joints in torsion. Furthermore, the relationship between biochemical composition and torsion mechanics is not well understood. Therefore, the first objective of this study was to investigate the role of facet joints in torsion mechanics of healthy and degenerated human lumbar discs under a wide range of compressive preloads. To achieve this, each disc was tested under four different compressive preloads (300-1200 N) with and without facet joints. The second objective was to develop a quantitative structure-function relationship between tissue composition and torsion mechanics. Facet joints have a significant contribution to disc torsional stiffness (∼60%) and viscoelasticity, regardless of the magnitude of axial compression. The findings from this study demonstrate that annulus fibrosus GAG content plays an important role in disc torsion mechanics. A decrease in GAG content with degeneration reduced torsion mechanics by more than an order of magnitude, while collagen content did not significantly influence disc torsion mechanics. The biochemical-mechanical and compression-torsion relationships reported in this study allow for better comparison between studies that use discs of varying levels of degeneration or testing protocols and provide important design criteria for biological repair strategies. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.
Cervical facet force analysis after disc replacement versus fusion.
Patel, Vikas V; Wuthrich, Zachary R; McGilvray, Kirk C; Lafleur, Matthew C; Lindley, Emily M; Sun, Derrick; Puttlitz, Christian M
2017-05-01
Cervical total disc replacement was developed to preserve motion and reduce adjacent-level degeneration relative to fusion, yet concerns remain that total disc replacement will lead to altered facet joint loading and long-term facet joint arthrosis. This study is intended to evaluate changes in facet contact force, pressure and surface area at the treated and superior adjacent levels before and after discectomy, disc replacement, and fusion. Ten fresh-frozen human cadaveric cervical spines were potted from C2 to C7 with pressure sensors placed into the facet joints of C3-C4 and C4-C5 via slits in the facet capsules. Moments were applied to the specimens to produce axial rotation, lateral bending and extension. Facet contact force and pressure were measured at both levels for intact, discectomy at C4-C5, disc replacement with ProDisc-C (Synthes Spine, West Chester, Pennsylvania, USA) at C4-C5, and anterior discectomy and fusion with Cervical Spine Locking Plate (Synthes Spine, West Chester, Pennsylvania, USA) at C4-C5. Facet contact area was calculated from the force and pressure measurements. An analysis of variance was used to determine significant differences with P-values <0.05 indicating significance. Facet contact force was elevated at the treated level under extension following both discectomy and disc replacement, while facet contact pressure and area were relatively unchanged. Facet contact force and area were decreased at the treated level following fusion for all three loading conditions. Total disc replacement preserved facet contact force for all scenarios except extension at the treated level, highlighting the importance of the anterior disco-ligamentous complex. This could promote treated-level facet joint disease. Copyright © 2017 Elsevier Ltd. All rights reserved.
Mars, Tom; Ellard, David R; Antrobus, James H L; Cairns, Melinda; Underwood, Martin; Haywood, Kirstie; Keohane, Susie; Sandhu, Harbinder; Griffiths, Frances
2015-01-01
Since the publication of guidelines by the UK National Institute for Health and Care Excellence (NICE) and the American Pain Society guidelines for low back pain in 2009 there have been deep divisions in the pain treatment community about the use of therapeutic intraarticular facet joint injections. While evidence for the effectiveness or not of intraarticular facet joint injections remains sparse, uncertainty will remain. The Warwick feasibility study, along with a concurrent study with a different design led by another group, aims to provide a stable platform from which the effectiveness and cost effectiveness of intraarticular facet joint injections added to normal care could be evaluated in randomized controlled trials (RCTs). To reach consensus on key design considerations for the Warwick facet feasibility study from which the study protocol and working manuals will be developed. A consensus conference involving expert professionals and lay members. Preliminary work identified 5 key design considerations for deliberation at our consensus conference. Three concerned patient assessment and treatment: diagnosis of possible facet joint pain, interaarticular facet joint injection technique, and best usual care. Two concerned trial analysis: a priori sub-groups and minimally important difference and are reported elsewhere. We did systematic evidence reviews of the design considerations and summarized the evidence. Our design questions and evidence summaries were distributed to all delegates. This formed the basis for discussions on the day. Clinical experts in all aspects of facet joint injection from across the UK along with lay people were invited via relevant organizations. Nominal group technique was used in 15 facilitated initial small group discussions. Further discussion and ranking was undertaken in plenary. All small group and plenary results were recorded and checked and verified post conference. Where necessary participants were contacted via email to resolve outstanding issues. Fifty-two delegates attended the conference with lay people and all relevant professions represented. Consensus was reached on the details of how to assess patients for facet joint pain, undertake the injections, and deliver usual care. Where post conference checking of results revealed errors in calculating ranking results on the day, consensus was reached by email consultation. All but 3 delegates agreed to be associated with the outcome. Allocating one day for discussing a wide range of topics imposed time pressure on discussion and calculation of the numerous rankings. Through the use of an evidence-based, systematic, inclusive, and transparent process we have established consensus from expert health professionals in the UK, with lay input, on the clinical assessment of suspected facet joint pain, interaarticular injection for facet joint pain, and best usual care for use in a feasibility study for a proposed pragmatic clinical trial of interaarticular facet joint injections. This provides a strong basis for a clinical trial that will be acceptable to the pain treatment community.
Lowe, Jason A; Routh, Lucas K; Leary, Jeffrey T; Buzhardt, Paul C
2016-01-01
Recent published data have suggested successful union of subtalar and tibiotalar joints without formal debridement during tibiotalocalcaneal (TTC) fusion procedures. Although previous studies have reported on the importance of the proper guidewire starting point and trajectory to obtain appropriate hindfoot alignment for successful fusion, to our knowledge, no studies have quantified the amount of articular damage to the subtalar joint with retrograde reaming. We hypothesized that reaming would destroy >50% of the posterior facet of the subtalar joint. The bilateral lower extremities of 5 cadavers were obtained and the subtalar joints exposed. Retrograde TTC nail guidewires were inserted, and a 12-mm reamer was passed through the subtalar and ankle joints. Pre- and postreaming images of the subtalar joint were obtained to compare the amount of joint destruction after reaming. We found an average of 5.89% articular destruction of the talar posterior facet and an average of 4.01% articular destruction of the posterior facet of the calcaneus. No damage to the middle facets of the subtalar joint was observed. TTC nailing is a successful procedure for ankle and subtalar joint fusion. Published studies have reported successful subtalar union using TTC nailing without formal open debridement of the subtalar joint, preserving the soft tissue envelope. TTC nail insertion using a 12-mm reamer will destroy 5.89% and 4.01% of the respective talar and calcaneal posterior facets of the subtalar joint. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Chambers, Hannah
2013-06-01
The aim of this study was to summarize the available evidence on lumbar facet joint injections and the physiotherapy treatments, land-based lower back mobility exercise, soft tissue massage and lumbar spinal mobilizations for chronic low back pain (CLBP). The plausibility of physiotherapy and lumbar facet joint injections as a combination treatment is discussed. Using a systematic process, an online electronic search was performed using key words utilizing all available databases and hand searching reference lists. Using a critical appraisal tool from the Critical Appraisal Skills Programme (CASP), the literature was screened to include primary research. The main aspects of the research were summarized. The evidence for lumbar facet joint injections suggests an overall short-term positive effect on CLBP. Land-based lower back mobility exercise and soft tissue massage appear to have a positive effect on CLBP in the short term and possibly in the longer term. There is insufficient evidence to draw conclusions for lumbar spinal mobilizations. The review indicates that lumbar facet joint injections create a short period when pain is reduced. Physiotherapy treatments including land-based lower back mobility exercise and soft tissue massage may be of benefit during this time to improve the longer-term outcomes of patients with CLBP. It is not possible to make generalizations or firm conclusions. The current review highlights the need for further research. A randomized controlled trial is recommended to assess the impact of physiotherapy in combination with lumbar facet joint injections on CLBP. Copyright © 2013 John Wiley & Sons, Ltd.
Siegling, Alex B; Petrides, K V
2016-01-01
The field of mindfulness has seen a proliferation of psychometric measures, characterised by differences in operationalisation and conceptualisation. To illuminate the scope of, and offer insights into, the diversity apparent in the burgeoning literature, two distinct samples were used to examine the similarities, validity, and dimensionality of mindfulness facets and subscales across three independent measures: the Five Facet Mindfulness Questionnaire (FFMQ), Philadelphia Mindfulness Scale (PHLMS), and Toronto Mindfulness Scale (TMS). Results revealed problematic associations of FFMQ Observe with the other FFMQ facets and supported a four-factor structure (omitting this facet), while disputing the originally envisaged five-factor model; thus, solidifying a pattern in the literature. Results also confirmed the bidimensional nature of the PHLMS and TMS subscales, respectively. A joint Confirmatory Factor Analysis showed that PHLMS Acceptance could be assimilated within the FFMQ's four-factor model (as a distinct factor). The study offers a way of understanding interrelationships between the available mindfulness scales, so as to help practitioners and researchers make a more informed choice when conceptualising and operationalising mindfulness.
Siegling, Alex B.; Petrides, K. V.
2016-01-01
The field of mindfulness has seen a proliferation of psychometric measures, characterised by differences in operationalisation and conceptualisation. To illuminate the scope of, and offer insights into, the diversity apparent in the burgeoning literature, two distinct samples were used to examine the similarities, validity, and dimensionality of mindfulness facets and subscales across three independent measures: the Five Facet Mindfulness Questionnaire (FFMQ), Philadelphia Mindfulness Scale (PHLMS), and Toronto Mindfulness Scale (TMS). Results revealed problematic associations of FFMQ Observe with the other FFMQ facets and supported a four-factor structure (omitting this facet), while disputing the originally envisaged five-factor model; thus, solidifying a pattern in the literature. Results also confirmed the bidimensional nature of the PHLMS and TMS subscales, respectively. A joint Confirmatory Factor Analysis showed that PHLMS Acceptance could be assimilated within the FFMQ’s four-factor model (as a distinct factor). The study offers a way of understanding interrelationships between the available mindfulness scales, so as to help practitioners and researchers make a more informed choice when conceptualising and operationalising mindfulness. PMID:27055017
NASA Astrophysics Data System (ADS)
Liebert, Ann D.; Bicknell, Brian
2017-02-01
Photobiomodulation (PBM) is an effective tool for the management of spinal pain including inflammation of facet joints. Apart from cervical and lumbar joint pain the upper cervical spine facet joint inflammation can result in the CGH (traumatic or atraumatic in origin). This condition affects children, adults and elders and is responsible for 19% of chronic headache and up to 33% of patients in pain clinics. The condition responds well to physiotherapy, facet joint injection, radiofrequency neurotomy and surgery at a rate of 75%. The other 25% being unresponsive to treatment with no identified features of unresponsiveness. In other conditions of chronic unresponsive cervical pain have responded to photobiomodulation at a level of 80% in the short and medium term. A clinical trial was therefore conducted on a cohort of atraumatic patients from the ages of 5-93 (predominantly Neurologist referred / familial sufferers 2/3 generations vertically and laterally) who had responded to a course of PBM and physiotherapy. The CGH sufferers and their non CGH suffering relatives over these generations were then compared for features that distinguish the two groups. Fifty parameters were tested (anthropmetric, movement and neural tension tests included) and there was a noted difference in tandem stance between the groups (.04 significance with repeated measures). As this impairment is common to benign ataxia and migrainous vertigo and in these conditions there is an ion channelopathy (especially potassium channelopathy). A postulated mechanism of action of PBM would involve modulation of ion channels and this is discussed in this presentation.
Pan, Jianjiang; Lu, Xuan; Yang, Ge; Han, Yongmei; Tong, Xiang; Wang, Yue
2017-12-01
A sample of 512 Chinese was studied and we observed that greater disc degeneration on MRI was associated with greater spine DXA BMD. Yet, this association may be confounded by facet joint osteoarthritis. BMD may not be a risk factor for lumbar disc degeneration in Chinese. Evidence suggested that lumbar vertebral bone and intervertebral disc interact with each other in multiple ways. The current paper aims to determine the association between bone mineral density (BMD) and lumbar disc degeneration using a sample of Chinese. We studied 165 patients with back disorders and 347 general subjects from China. All subjects had lumbar spine magnetic resonance (MR) imaging and dual- energy X-ray absorptiometry (DXA) spine BMD studies, and a subset of general subjects had additional hip BMD measurements. On T2-weighted MR images, Pfirrmann score was used to evaluate the degree of lumbar disc degeneration and facet joint osteoarthritis was assessed as none, slight-moderate, and severe. Regression analyses were used to examine the associations between lumbar and hip BMD and disc degeneration, adjusting for age, gender, body mass index (BMI), lumbar region, and facet joint osteoarthritis. Greater facet joint osteoarthritis was associated with greater spine BMD (P < 0.01) in both patients and general subjects. For general subjects, greater spine BMD was associated with severe disc degeneration, controlling for age, gender, BMI, and lumbar region. When facet joint osteoarthritis entered the regression model, however, greater spine BMD was associated with greater facet joint osteoarthritis (P < 0.01) but not greater disc degeneration (P > 0.05). No statistical association was observed between spine BMD and lumbar disc degeneration in patients with back disorders (P > 0.05), and between hip BMD and disc degeneration in general subjects (P > 0.05). BMD may not be a risk factor for lumbar disc degeneration in Chinese. Facet joint osteoarthritis inflates DXA spine BMD measurements and therefore, may confound the association between spine BMD and disc degeneration.
Min, Woo-Kie; Seo, Il; Na, Sang-Bong; Choi, Young-Seo; Choi, Ji-Yeon
2017-01-01
This study aimed to present radiologic analysis of minimal safe distance (MSD) and optimal screw angle (OSA) that enables to fix screws in a lateral mass safely without facet joint violation in open-door laminoplasty using a plate. A retrospective analysis was made of 22 patients (male: 17; female: 5), average age 62 years. Seventy-nine lateral mass screws were fixed among a total of 158 screws. MSD that doesn't allow 5-mm screws to violate a facet joint was measured for C3-C7 and a comparative analysis was performed. If the MSD is not secured, the OSA to be given to the cephalad direction is calculated to avoid violation of the facet joint. The screws violating inferior facet joints accounted for 34.1% of the screws fixed in inferior lateral mass. Joint surface to distal mini-screw distances were 3.18 ± 1.46 mm and 4.75 ± 1.71 mm in groups of facet joint violation and non-facet violation (FV), respectively ( p = 0.001). When 5-mm screws were inserted into a lateral mass, MSD was 4.39 ± 0.83 mm. The average MSD of C3, C4, and C5 was 4.05 ± 0.78 mm, 4.10 ± 0.70 mm, and 4.26 ± 0.74 mm, respectively. There was no significant differences among levels ( p > 0.05). The average MSD of C6 and C7 was 4.92 ± 0.81 mm and 4.80 ± 0.96 mm, respectively, showing significant differences from those of C3, C4, and C5 ( p < 0.05). If 6 mm of the MSD isn't secured, OSA showed in the cephalad direction of 11.5° for 5 mm and 22° for 4 mm approximately. We suggest that mini-screw on lateral mass can be fixed safely without FV, if they are fixed at MSD of 6 mm from a joint surface. Facet joint violation doesn't occur if an OSA is given in the cephalad direction in case of not enough MSD for mini-screws.
The Relationship Between Osteoarthritis of the Lumbar Facet Joints and Lumbosacropelvic Morphology.
Sahin, Mehmet Sukru; Ergün, Adviye; Aslan, Akın
2015-10-01
Cross-sectional study. To investigate the relation between lumbosacropelvic morphology and the presence and degree of facet joint degeneration. Osteoarthritis of the facet joints is one of the most common degenerative changes in the spine. It is considered to be formed secondary to repetitive stress or trauma and spinal deformity with secondary overload. The cause(s) of facet joints osteoarthritis, however, have not been clearly identified. Abdominal computed tomography (CT) images of 723 patients which were taken between the years 2010 and 2014 were evaluated retrospectively. Patients with prior lumbar spinal surgery, serious congenital anomalies on CT, incomplete or complete lumbosacral transition, severe scoliosis, were excluded from the study. To eliminate the age- and sex-related differences in spinopelvic morphology, a study group was formed of the remaining subjects by including patients from a specific age group (30-35 yr) and same sex (females). For each patient the presence and grade of facet joint degeneration was investigated. In addition, pelvic incidence (PI), sacral slope and the angles of L1-L5 lumbar lordosis, sacral table, L5 vertebra posterior, and sacral kyphosis were measured for each patient. Sacral slope, sacral kyphosis, and L1-L5 lumbar lordosis angle were significantly higher in patients with osteoarthritic compared with normal subjects (P = 0.015, P = 0.018, P = 0.016). L5 vertebra posterior and sacral table angle were found to be significantly lower in patients with osteoarthritic than in normal subjects (P = 0.019, P = 0.007). The degree of facet joint degeneration was noticed to increase parallel to the decrease in the sacral table angle and L5 vertebra posterior angle, and to the increase in the L1-L5 lumbar lordosis, PI, and sacral slope. A close relation exists between the presence and degree of degeneration in the facet joint and lumbosacral pelvic morphology. Prevalence and degree of the degeneration in facet joint increases as the angle of sacral slope, L1-L5 lumbar lordosis, and PI increases or the angle of sacral table and L5 vertebra posterior decreases. 4.
Wu, Jiuping; Du, Zhenwu; Lv, Yang; Zhang, Jun; Xiong, Wei; Wang, Ruiqiang; Liu, Rui; Zhang, Guizhen; Liu, Qinyi
2016-01-01
Lumbar facet joint syndrome is currently suggested to be a main source of axial low back pain, and a large portion of axial low back pain is caused by disorders in lumbar facet joints. Intra-articular injection is one of the most common treatment methods in the early clinical application. Therefore, we attempt to seek a new injectable material, autologous platelet rich plasma (PRP), to treat lumbar facet syndrome, as well as to assess its therapeutic effectiveness and safety. A prospective clinic evaluation. The outpatient clinic of a single academic medical center. Total 19 patients with lumbar facet joint syndrome (8 men, 11 women; mean ages: 52.53 ± 6.79 years, range: 38 - 62 years) were enrolled to receive lumbar facet joint injection with autologous PRP under x-ray fluoroscopic control. Patients were followed up immediately, at one week, one month, 2 months, and 3 months following treatment, and the elements of this analysis included low back pain visual analogue scale (VAS) at rest and during flexion, Roland-Morris Disability Questionnaire (RMQ), Oswestry Disability Index (ODI), and modified MacNab criteria for the pain relief. All the 19 patients completed the intra-articular injections with autologous PRP successfully. At one week after treatment, low back pain reduced significantly compared with prior to treatment both at rest and during flexion. The outcomes were assessed as "good" or "excellent" for 9 patients (47.37%) immediately after treatment, 14 patients (73.68%) at one week, 15 patients (78.95%) at one month, 15 patients (78.95%) at 2 months, and 15 patients (78.95%) at 3 months. Statistically significant differences were observed based on RMQ and a more than 10% improvement in lumbar functional capacity was observed based on ODI between pre-treatment and post-treatment. In addition, there were no severe relevant complications during the whole process of injection and follow-up period. A control group and the curative effect observations with longer follow-up may lead to a more convincing result for our study. In the short-term period of 3 months, the new technique of lumbar facet joint injection with autologous PRP is effective and safe for patients with lumbar facet joint syndrome. Key words: Low back pain, lumbar facet joint syndrome, autologous platelet rich plasma, intra-articular injection.
Iizuka, Haku; Iizuka, Yoichi; Okamura, Koichi; Yonemoto, Yukio; Mieda, Tokue; Takagishi, Kenji
2017-09-01
The purpose of this study was to clarify the characteristics of bony ankylosis of the facet joint of the cervical spine in rheumatoid arthritis (RA) patients who required cervical spine surgery, and its relationship to the clinical findings. Eighty consecutive RA patients with cervical spine disorder who received initial surgery were reviewed. The occurrence of bony ankylosis of the facet joint of the cervical spine was investigated using computed tomography (CT) before surgery. We also evaluated the severity of neurological symptoms and the plain wrist radiographs taken before surgery; furthermore, we evaluated each patient's medical history for total knee arthroplasty (TKA) or hip arthroplasty (THA). The preoperative CT imaging demonstrated bony ankylosis of the facet joint of the cervical spine in 45 facet levels of 19 cases (BA + group). In all patients, responsible instability or stenosis was demonstrated just caudal or on the cranial side of those bony ankylosis. Before surgery, the BA + group included significantly more patients showing severe cervical myelopathy (p < 0.05), and significantly more cases showing progressed ankylosis in the wrist joint bilaterally (p < 0.01). There were also significantly more patients who received two or more TKA or THA before the cervical spine surgery in the BA + group (p < 0.01). Bony ankylosis of the facet joint of the cervical spine may be a risk factor of instability or stenosis at the adjacent disc level and severe cervical myelopathy. Furthermore, its ankylosis was demonstrated in RA patients with severe destroyed joints.
Management of lumbar zygapophysial (facet) joint pain
Manchikanti, Laxmaiah; Hirsch, Joshua A; Falco, Frank JE; Boswell, Mark V
2016-01-01
AIM: To investigate the diagnostic validity and therapeutic value of lumbar facet joint interventions in managing chronic low back pain. METHODS: The review process applied systematic evidence-based assessment methodology of controlled trials of diagnostic validity and randomized controlled trials of therapeutic efficacy. Inclusion criteria encompassed all facet joint interventions performed in a controlled fashion. The pain relief of greater than 50% was the outcome measure for diagnostic accuracy assessment of the controlled studies with ability to perform previously painful movements, whereas, for randomized controlled therapeutic efficacy studies, the primary outcome was significant pain relief and the secondary outcome was a positive change in functional status. For the inclusion of the diagnostic controlled studies, all studies must have utilized either placebo controlled facet joint blocks or comparative local anesthetic blocks. In assessing therapeutic interventions, short-term and long-term reliefs were defined as either up to 6 mo or greater than 6 mo of relief. The literature search was extensive utilizing various types of electronic search media including PubMed from 1966 onwards, Cochrane library, National Guideline Clearinghouse, clinicaltrials.gov, along with other sources including previous systematic reviews, non-indexed journals, and abstracts until March 2015. Each manuscript included in the assessment was assessed for methodologic quality or risk of bias assessment utilizing the Quality Appraisal of Reliability Studies checklist for diagnostic interventions, and Cochrane review criteria and the Interventional Pain Management Techniques - Quality Appraisal of Reliability and Risk of Bias Assessment tool for therapeutic interventions. Evidence based on the review of the systematic assessment of controlled studies was graded utilizing a modified schema of qualitative evidence with best evidence synthesis, variable from level I to level V. RESULTS: Across all databases, 16 high quality diagnostic accuracy studies were identified. In addition, multiple studies assessed the influence of multiple factors on diagnostic validity. In contrast to diagnostic validity studies, therapeutic efficacy trials were limited to a total of 14 randomized controlled trials, assessing the efficacy of intraarticular injections, facet or zygapophysial joint nerve blocks, and radiofrequency neurotomy of the innervation of the facet joints. The evidence for the diagnostic validity of lumbar facet joint nerve blocks with at least 75% pain relief with ability to perform previously painful movements was level I, based on a range of level I to V derived from a best evidence synthesis. For therapeutic interventions, the evidence was variable from level II to III, with level II evidence for lumbar facet joint nerve blocks and radiofrequency neurotomy for long-term improvement (greater than 6 mo), and level III evidence for lumbosacral zygapophysial joint injections for short-term improvement only. CONCLUSION: This review provides significant evidence for the diagnostic validity of facet joint nerve blocks, and moderate evidence for therapeutic radiofrequency neurotomy and therapeutic facet joint nerve blocks in managing chronic low back pain. PMID:27190760
Khurelbaatar, Tsolmonbaatar; Kim, Kyungsoo; Hyuk Kim, Yoon
2015-11-01
Computational musculoskeletal models have been developed to predict mechanical joint loads on the human spine, such as the forces and moments applied to vertebral and facet joints and the forces that act on ligaments and muscles because of difficulties in the direct measurement of joint loads. However, many whole-spine models lack certain elements. For example, the detailed facet joints in the cervical region or the whole spine region may not be implemented. In this study, a detailed cervico-thoraco-lumbar multibody musculoskeletal model with all major ligaments, separated structures of facet contact and intervertebral disk joints, and the rib cage was developed. The model was validated by comparing the intersegmental rotations, ligament tensile forces, facet joint contact forces, compressive and shear forces on disks, and muscle forces were to those reported in previous experimental and computational studies both by region (cervical, thoracic, or lumbar regions) and for the whole model. The comparisons demonstrated that our whole spine model is consistent with in vitro and in vivo experimental studies and with computational studies. The model developed in this study can be used in further studies to better understand spine structures and injury mechanisms of spinal disorders.
Radiological and Radionuclide Imaging of Degenerative Disease of the Facet Joints
Shur, Natalie; Corrigan, Alexis; Agrawal, Kanhaiyalal; Desai, Amidevi; Gnanasegaran, Gopinath
2015-01-01
The facet joint has been increasingly implicated as a potential source of lower back pain. Diagnosis can be challenging as there is not a direct correlation between facet joint disease and clinical or radiological features. The purpose of this article is to review the diagnosis, treatment, and current imaging modality options in the context of degenerative facet joint disease. We describe each modality in turn with a pictorial review using current evidence. Newer hybrid imaging techniques such as single photon emission computed tomography/computed tomography (SPECT/CT) provide additional information relative to the historic gold standard magnetic resonance imaging. The diagnostic benefits of SPECT/CT include precise localization and characterization of spinal lesions and improved diagnosis for lower back pain. It may have a role in selecting patients for local therapeutic injections, as well as guiding their location with increased precision. PMID:26170560
Three-dimensional evaluation of the facet joints
NASA Astrophysics Data System (ADS)
Folio, Les R.
1990-04-01
Computerized tomography and magnetic resonance imaging nave revolurionalized analysis of vertebral anatomy and pathology. Further advances with 3-dimensional imaging have recently become an important adjunct for diagnosis and treatment in structural abnormalities. Facets are intimately related to their surrounding musculature and malalignment may cause pain directly or indirectly. High resolution 3-dimensional reformations of CT Scans give us new insight on structure and function of facet joints, since their motion and architecture are ever complex. It is well documented in the literature that facet joint biomecnanics is a partial contributor to the myriad at causes of low back The term "facet Joint syndrome" was coined in 1933 by GhorMley.3 The osteopathic lesion complex is well defined by LeRoy and McCole and comparison of roentgenographic findings before and after manipulation has teen described by Long and Lioyd.4,5 since alterations in facet biamechanics are an important aspect of osteopathic manipulative therapy (OT), 3-dimensional hign resolution imaging will prove to be a great asset in osteopathic research. Rotating the spine allows for different viewing perspectives to provide optimal and consistent measurements of the facet joint. Rotations are performed on the X, Y and 7, axis and measurements pre and post-manipulation are performed and compared on matching axis and perspectives. Rotation about the X, Y and Z axis help appreciate the 3-dimensionality of the vertebral column to project to the viewer a feeling that the spine is floating in space before them. This does give the viewer a 3-D understanding of the object however, only at a perspective at a Lime.
Ebraheim, Nabil A; Liu, Jiayong; Ramineni, Satheesh K; Liu, Xiaochen; Xie, Joe; Hartman, Ryan G; Goel, Vijay K
2009-11-01
Many investigators have conducted studies to determine the biomechanics, causes, complications and treatment of unilateral facet joint dislocation in the cervical spine. However, there is no quantitative data available on morphological changes in the intervertebral foramen of the cervical spine following unilateral facet joint dislocation. These data are important to understand the cause of neurological compromise following unilateral facet joint dislocation. Eight embalmed human cadaver cervical spine specimens ranging from level C1-T1 were used. The nerve roots of these specimens at C5-C6 level were marked by wrapping a 0.12mm diameter wire around them. Unilateral facet dislocation at C5-C6 level was simulated by serially sectioning the corresponding ligamentous structures. A CT scan of the specimens was obtained before and after the dislocation was simulated. A sagittal plane through the centre of the pedicle and facet joint was constructed and used for measurement. The height and area of the intervertebral foramen, the facet joint space, nerve root diameter and area, and vertebral alignment both before and after dislocation were evaluated. The intervertebral foramen area changed from 50.72+/-0.88mm(2) to 67.82+/-4.77mm(2) on the non-dislocated side and from 41.39+/-1.11mm(2) to 113.77+/-5.65mm(2) on the dislocated side. The foraminal heights changed from 9.02+/-0.30mm to 10.52+/-0.50mm on the non-dislocated side and 10.43+/-0.50mm to 17.04+/-0.96mm on the dislocated side. The facet space area in the sagittal plane changed from 6.80+/-0.80mm(2) to 40.02+/-1.40mm(2) on the non-dislocated side. The C-5 anterior displacement showed a great change from 0mm to 5.40+/-0.24mm on the non-dislocated side and from 0mm to 3.42+/-0.20mm on the dislocated side. Neither of the nerve roots on either side showed a significant change in size. The lack of change in nerve root area indicates that the associated nerve injury with unilateral facet joint dislocation is probably due to distraction rather than due to direct nerve root compression.
Kim, Ho-Joong; Jung, Whan-Ik; Chang, Bong-Soon; Lee, Choon-Ki; Kang, Kyoung-Tak; Yeom, Jin S
2017-09-01
The purpose of this study was to compare the accuracy and safety of an instrumented posterior lumbar interbody fusion (PLIF) using a robot-assisted minimally invasive (Robot-PLIF) or a conventional open approach (Freehand-PLIF). Patients undergoing an instrumented PLIF were randomly assigned to be treated using a Robot-PLIF (37 patients) and a Freehand-PLIF (41 patients). For intrapedicular accuracy, there was no significant difference between the groups (P = 0.534). For proximal facet joint accuracy, none of the 74 screws in the Robot-PLIF group violated the proximal facet joint, while 13 of 82 in the Freehand-PLIF group violated the proximal facet joint (P < 0.001). The average distance of the screws from the facets was 5.2 ± 2.1 mm and 2.7 ± 1.6 mm in the Robot-PLIF and Freehand-PLIF groups, respectively (P < 0.001). Robotic-assisted pedicle screw placement was associated with fewer proximal facet joint violations and better convergence orientations. Copyright © 2016 John Wiley & Sons, Ltd.
Archavlis, Eleftherios; Amr, Nimer; Kantelhardt, Sven Rainer; Giese, Alf
2018-01-01
Minimally invasive pedicle screw placement may have a higher incidence of violation of the superior cephalad unfused facet joint. We investigated the incidence and risk factors of upper facet joint violation in percutaneous robot-assisted instrumentation versus percutaneous fluoroscopy-guided and open transpedicular instrumentation. A retrospective study including all consecutive patients who underwent lumbar instrumentation, fusion, and decompression for spondylolisthetic stenosis and degenerative disk disease was conducted between January 2012 and January 2016. All operations were performed by the same surgeon; the patients were divided into three groups according to the method of instrumentation. Group 1 involved the robot-assisted instrumentation in 58 patients, group 2 consisted of 64 patients treated with a percutaneous transpedicular instrumentation using fluoroscopic guidance, and 72 patients in group 3 received an open midline approach for pedicle screw insertion. Superior segment facet joint violation occurred in 2 patients in the robot-assisted group 1 (7%), in 22 of the percutaneous fluoroscopy-guided group 2 (34%), and in 6 cases of the open group (8%). The incidence of facet joint violation was present in 5% (3) of the screws in group 1, 22% (28) of the screws in group 2, and 3% (4) of the screws in group 3. Meticulous surgical planning of the appropriate entry site (Weinstein's method), trajectory planning, and proper robot-assisted instrumentation of pedicle screws reduced the risk of superior segment facet joint violation. Georg Thieme Verlag KG Stuttgart · New York.
Lumbar Facet Joint Motion in Patients with Degenerative Disc Disease at Affected and Adjacent Levels
Li, Weishi; Wang, Shaobai; Xia, Qun; Passias, Peter; Kozanek, Michal; Wood, Kirkham; Li, Guoan
2013-01-01
Study Design Controlled laboratory study. Objective To evaluate the effect of lumbar degenerative disc diseases (DDDs) on motion of the facet joints during functional weight-bearing activities. Summary of Background Data It has been suggested that DDD adversely affects the biomechanical behavior of the facet joints. Altered facet joint motion, in turn, has been thought to associate with various types of lumbar spine pathology including facet degeneration, neural impingement, and DDD progression. However, to date, no data have been reported on the motion patterns of the lumbar facet joint in DDD patients. Methods Ten symptomatic patients of DDD at L4–S1 were studied. Each participant underwent magnetic resonance images to obtain three-dimensional models of the lumbar vertebrae (L2–S1) and dual fluoroscopic imaging during three characteristic trunk motions: left-right torsion, left-right bending, and flexion-extension. In vivo positions of the vertebrae were reproduced by matching the three-dimensional models of the vertebrae to their outlines on the fluoroscopic images. The kinematics of the facet joints and the ranges of motion (ROMs) were compared with a group of healthy participants reported in a previous study. Results In facet joints of the DDD patients, there was no predominant axis of rotation and no difference in ROMs was found between the different levels. During left-right torsion, the ROMs were similar between the DDD patients and the healthy participants. During left-right bending, the rotation around mediolateral axis at L4–L5, in the DDD patients, was significantly larger than that of the healthy participants. During flexion-extension, the rotations around anterioposterior axis at L4–L5 and around craniocaudal axis at the adjacent level (L3–L4), in the DDD patients, were also significantly larger, whereas the rotation around mediolateral axis at both L2–L3 and L3–L4 levels in the DDD patients were significantly smaller than those of the healthy participants. Conclusion DDD alters the ROMs of the facet joints. The rotations can increase significantly not only at the DDD levels but also at their adjacent levels when compared to those of the healthy participants. The increase in rotations did not occur around the primary rotation axis of the torso motion but around the coupled axes. This hypermobility in coupled rotations might imply a biomechanical mechanism related to DDD. PMID:21270686
Manchikanti, Laxmaiah; Cash, Kimberly A; McManus, Carla D; Pampati, Vidyasagar
2012-01-01
Background Chronic low back pain without disc herniation is common. Various modalities of treatments are utilized in managing this condition, including epidural injections. However, there is continued debate on the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections. Methods A randomized, double-blind, actively controlled trial was conducted. The objective was to evaluate the ability to assess the effectiveness of caudal epidural injections of local anesthetic with or without steroids for managing chronic low back pain not caused by disc herniation, radiculitis, facet joints, or sacroiliac joints. A total of 120 patients were randomized to two groups; one group did not receive steroids (group 1) and the other group did (group 2). There were 60 patients in each group. The primary outcome measure was at least 50% improvement in Numeric Rating Scale and Oswestry Disability Index. Secondary outcome measures were employment status and opioid intake. These measures were assessed at 3, 6, 12, 18, and 24 months after treatment. Results Significant pain relief and functional status improvement (primary outcome) defined as a 50% or more reduction in scores from baseline, were observed in 54% of patients in group 1 and 60% of patients in group 2 at 24 months. In contrast, 84% of patients in group 1 and 73% in group 2 saw significant pain relief and functional status improvement in the successful groups at 24 months. Conclusion Caudal epidural injections of local anesthetic with or without steroids are effective in patients with chronic axial low back pain of discogenic origin without facet joint pain, disc herniation, and/or radiculitis. PMID:23091395
Walraevens, Joris; Liu, Baoge; Meersschaert, Joke; Demaerel, Philippe; Delye, Hans; Depreitere, Bart; Vander Sloten, Jos; Goffin, Jan
2009-03-01
Degeneration of intervertebral discs and facet joints is one of the most frequently encountered spinal disorders. In order to describe and quantify degeneration and evaluate a possible relationship between degeneration and biomechanical parameters, e.g., the intervertebral range of motion and intradiscal pressure, a scoring system for degeneration is mandatory. However, few scoring systems for the assessment of degeneration of the cervical spine exist. Therefore, two separate objective scoring systems to qualitatively and quantitatively assess the degree of cervical intervertebral disc and facet joint degeneration were developed and validated. The scoring system for cervical disc degeneration consists of three variables which are individually scored on neutral lateral radiographs: "height loss" (0-4 points), "anterior osteophytes" (0-3 points) and "endplate sclerosis" (0-2 points). The scoring system for facet joint degeneration consists of four variables which are individually scored on neutral computed tomography scans: "hypertrophy" (0-2 points), "osteophytes" (0-1 point), "irregularity" on the articular surface (0-1 point) and "joint space narrowing" (0-1 point). Each variable contributes with varying importance to the overall degeneration score (max 9 points for the scoring system of cervical disc degeneration and max 5 points for facet joint degeneration). Degeneration of 20 discs and facet joints of 20 patients was blindly assessed by four raters: two neurosurgeons (one senior and one junior) and two radiologists (one senior and one junior), firstly based on first subjective impression and secondly using the scoring systems. Measurement errors and inter- and intra-rater agreement were determined. The measurement error of the scoring system for cervical disc degeneration was 11.1 versus 17.9% of the subjective impression results. This scoring system showed excellent intra-rater agreement (ICC = 0.86, 0.75-0.93) and excellent inter-rater agreement (ICC = 0.78, 0.64-0.88). Surgeons as well as radiologists and seniors as well as juniors obtained excellent inter- and intra-rater agreement. The measurement error of the scoring system for cervical facet joint degeneration was 20.1 versus 24.2% of the subjective impression results. This scoring system showed good intra-rater agreement (ICC = 0.71, 0.42-0.89) and fair inter-rater agreement (ICC = 0.49, 0.26-0.74). Both scoring systems fulfilled the criteria for recommendation proposed by Kettler and Wilke. Our scoring systems can be reliable and objective tools for assessing cervical disc and facet joint degeneration. Moreover, the scoring system of cervical disc degeneration was shown to be experience- and discipline-independent.
Laslett, Mark; McDonald, Barry; Tropp, Hans; Aprill, Charles N; Öberg, Birgitta
2005-01-01
Background The tissue origin of low back pain (LBP) or referred lower extremity symptoms (LES) may be identified in about 70% of cases using advanced imaging, discography and facet or sacroiliac joint blocks. These techniques are invasive and availability varies. A clinical examination is non-invasive and widely available but its validity is questioned. Diagnostic studies usually examine single tests in relation to single reference standards, yet in clinical practice, clinicians use multiple tests and select from a range of possible diagnoses. There is a need for studies that evaluate the diagnostic performance of clinical diagnoses against available reference standards. Methods We compared blinded clinical diagnoses with diagnoses based on available reference standards for known causes of LBP or LES such as discography, facet, sacroiliac or hip joint blocks, epidurals injections, advanced imaging studies or any combination of these tests. A prospective, blinded validity design was employed. Physiotherapists examined consecutive patients with chronic lumbopelvic pain and/or referred LES scheduled to receive the reference standard examinations. When diagnoses were in complete agreement regardless of complexity, "exact" agreement was recorded. When the clinical diagnosis was included within the reference standard diagnoses, "clinical agreement" was recorded. The proportional chance criterion (PCC) statistic was used to estimate agreement on multiple diagnostic possibilities because it accounts for the prevalence of individual categories in the sample. The kappa statistic was used to estimate agreement on six pathoanatomic diagnoses. Results In a sample of chronic LBP patients (n = 216) with high levels of disability and distress, 67% received a patho-anatomic diagnosis based on available reference standards, and 10% had more than one tissue origin of pain identified. For 27 diagnostic categories and combinations, chance clinical agreement (PCC) was estimated at 13%. "Exact" agreement between clinical and reference standard diagnoses was 32% and "clinical agreement" 51%. For six pathoanatomic categories (disc, facet joint, sacroiliac joint, hip joint, nerve root and spinal stenosis), PCC was 33% with actual agreement 56%. There was no overlap of 95% confidence intervals on any comparison. Diagnostic agreement on the six most common patho-anatomic categories produced a kappa of 0.31. Conclusion Clinical diagnoses agree with reference standards diagnoses more often than chance. Using available reference standards, most patients can have a tissue source of pain identified. PMID:15943873
The lumbar facet arthrosis syndrome. Clinical presentation and articular surface changes.
Eisenstein, S M; Parry, C R
1987-01-01
We describe a lumbar facet syndrome in which disabling symptoms are associated with normal or near-normal plain radiographs. Local spinal fusion relieved symptoms in 12 patients; the excised facet joint surfaces showed some of the histological changes seen in chondromalacia patellae and in osteoarthritis of other large joints. The most frequent change was focal full-thickness cartilage necrosis or loss of cartilage with exposure of subchondral bone, but osteophyte formation was remarkably absent in all specimens. We suggest that there are both clinical and histological similarities between the facet arthrosis syndrome and chondromalacia patellae. Facet arthrosis may be a relatively important cause of intractable back pain in young and middle-aged adults.
Chen, Hua; Li, Huibo; Deng, Yuxiao; Rong, Xin; Gong, Quan; Li, Tao; Song, Yueming; Liu, Hao
2017-04-01
Lateral mass mini-screws used in plated cervical laminoplasty might penetrate into facet joints. The objective is to observe this complication incidence and to identify the optimal areas for 5- and 7-mm-long mini-screws to implant on lateral mass. 47 patients who underwent plated cervical laminoplasty were included. The optimal area for mini-screws implanting was set according to pre-operative 3D CT reconstruction data. Then, each posterior-lateral mass surface was divided into three regions: 7-mm region, 5-mm region, and dangerous area. The mini-screw implanted region was recorded. Post-operative CT images were used to identify whether the mini-screws penetrated into facet joints. 235 mini-plates and 470 lateral mass mini-screws were used in the study. 117 (24.9%) mini-screws penetrated 88 (37.4%) facet joints. The 5-mm-long mini-screw optimal area occupied the upper 72, 65, 65, 64, and 65 % area of the posterior-lateral mass surface for C3-7, while the 7-mm-long mini-screw optimal area encompassed the upper 54, 39, 40, 33, and 32 %. Only 7-mm-long mini-screws were used to fix the plate to the lateral mass. 4 of 240 mini-screws in 7-mm region, 67 of the 179 mini-screws in 5-mm region, and 46 of the 51 mini-screws in dangerous region penetrated into the facet joint. The differences in the rate of facet joint penetration related to region were statistically significant (P < 0.001). The facet joint destruction by mini-screws was not a rare complication in plated cervical laminoplasty. The optimal areas we proposed may help guide the mini-screw implantation positions.
Chakraverty, Robin; Dias, Richard
2004-12-01
The work of a chronic back pain service in secondary care in the West Midlands is reported. The service offers acupuncture, spinal injection procedures, osteopathy and a range of other interventions for patients whose back pain has not responded to conservative management. This section of the report focuses on injection procedures for lumbar facet joint and sacroiliac joint pain, which have been shown to be the cause of chronic low back pain in 16-40% and 13-19% of patients respectively. Diagnosis relies on the use of intra-articular or sensory nerve block injections with local anaesthetic. Possible treatments following diagnosis include intra-articular corticosteroid, radiofrequency denervation (for facet joint pain) or ligament prolotherapy injections (for sacroiliac joint pain). The results of several hospital audits are reported. At six month follow up, 50% of 38 patients undergoing radiofrequency denervation following diagnostic blocks for facet joint pain had improved by more than 50%, compared to 29% of 34 patients treated with intra-articular corticosteroid injection. Sixty three per cent of 19 patients undergoing prolotherapy following diagnostic block injection for sacroiliac joint pain had improved at six months, compared to 33% of 33 who had intra-articular corticosteroid. Both radiofrequency denervation and sacroiliac prolotherapy showed good long-term outcomes at one year.
Palea, Ovidiu; Andar, Haroon M; Lugo, Ramon; Granville, Michelle; Jacobson, Robert E
2018-03-14
Radiofrequency cervical rhizotomy has been shown to be effective for the relief of chronic neck pain, whether it be due to soft tissue injury, cervical spondylosis, or post-cervical spine surgery. The target and technique have traditionally been taught using an oblique approach to the anterior lateral capsule of the cervical facet joint. The goal is to position the electrode at the proximal location of the recurrent branch after it leaves the exiting nerve root and loops back to the cervical facet joint. The standard oblique approach to the recurrent nerve requires the testing of both motor and sensory components to verify the correct position and ensure safety so as to not damage the slightly more anterior nerve root. Bilateral lesions require the repositioning of the patient's neck. Poorly positioned electrodes can also pass anteriorly and contact the nerve root or vertebral artery. The direct posterior approach presented allows electrode positioning over a broader expanse of the facet joint without risk to the nerve root or vertebral artery. Over a four-year period, direct posterior radiofrequency ablation was performed under fluoroscopic guidance at multiple levels without neuro-stimulation testing with zero procedural neurologic events even as high as the C2 spinal segment. The direct posterior approach allows either unipolar or bipolar lesioning at multiple levels. Making a radiofrequency lesion along the larger posterior area of the facet capsule is as effective as the traditional target point closer to the nerve root but technically easier, allowing bilateral access and safety. The article will review the anatomy and innervation of the cervical facet joint and capsule, showing the diffuse nerve supply extending into the capsule of the facet joint that is more extensive than the recurrent medial sensory branches that have been the focus of radiofrequency lesioning.
Palea, Ovidiu; Andar, Haroon M; Lugo, Ramon; Jacobson, Robert E
2018-01-01
Radiofrequency cervical rhizotomy has been shown to be effective for the relief of chronic neck pain, whether it be due to soft tissue injury, cervical spondylosis, or post-cervical spine surgery. The target and technique have traditionally been taught using an oblique approach to the anterior lateral capsule of the cervical facet joint. The goal is to position the electrode at the proximal location of the recurrent branch after it leaves the exiting nerve root and loops back to the cervical facet joint. The standard oblique approach to the recurrent nerve requires the testing of both motor and sensory components to verify the correct position and ensure safety so as to not damage the slightly more anterior nerve root. Bilateral lesions require the repositioning of the patient's neck. Poorly positioned electrodes can also pass anteriorly and contact the nerve root or vertebral artery. The direct posterior approach presented allows electrode positioning over a broader expanse of the facet joint without risk to the nerve root or vertebral artery. Over a four-year period, direct posterior radiofrequency ablation was performed under fluoroscopic guidance at multiple levels without neuro-stimulation testing with zero procedural neurologic events even as high as the C2 spinal segment. The direct posterior approach allows either unipolar or bipolar lesioning at multiple levels. Making a radiofrequency lesion along the larger posterior area of the facet capsule is as effective as the traditional target point closer to the nerve root but technically easier, allowing bilateral access and safety. The article will review the anatomy and innervation of the cervical facet joint and capsule, showing the diffuse nerve supply extending into the capsule of the facet joint that is more extensive than the recurrent medial sensory branches that have been the focus of radiofrequency lesioning. PMID:29765790
Prasad, Prashant Kumar; Salunke, Pravin; Sahni, Daisy; Kalra, Parveen
2017-01-01
Purpose: The existing literature on lateral atlantoaxial joints is predominantly on bony facets and is unable to explain various C1-2 motions observed. Geometric morphometry of facets would help us in understanding the role of cartilages in C1-2 biomechanics/kinematics. Objective: Anthropometric measurements (bone and cartilage) of the atlantoaxial joint and to assess the role of cartilages in joint biomechanics. Materials and Methods: The authors studied 10 cadaveric atlantoaxial lateral joints with the articular cartilage in situ and after removing it, using three-dimensional laser scanner. The data were compared using geometric morphometry with emphasis on surface contours of articulating surfaces. Results: The bony inferior articular facet of atlas is concave in both sagittal and coronal plane. The bony superior articular facet of axis is convex in sagittal plane and is concave (laterally) and convex medially in the coronal plane. The bony articulating surfaces were nonconcordant. The articular cartilages of both C1 and C2 are biconvex in both planes and are thicker than the concavities of bony articulating surfaces. Conclusion: The biconvex structure of cartilage converts the surface morphology of C1-C2 bony facets from concave on concavo-convex to convex on convex. This reduces the contact point making the six degrees of freedom of motion possible and also makes the joint gyroscopic. PMID:29403249
Kalichman, Leonid; Klindukhov, Alexander; Li, Ling; Linov, Lina
2016-11-01
A reliability and cross-sectional observational study. To introduce a scoring system for visible fat infiltration in paraspinal muscles; to evaluate intertester and intratester reliability of this system and its relationship with indices of muscle density; to evaluate the association between indices of paraspinal muscle degeneration and facet joint osteoarthritis. Current evidence suggests that the paraspinal muscles degeneration is associated with low back pain, facet joint osteoarthritis, spondylolisthesis, and degenerative disc disease. However, the evaluation of paraspinal muscles on computed tomography is not radiological routine, probably because of absence of simple and reliable indices of paraspinal degeneration. One hundred fifty consecutive computed tomography scans of the lower back (N=75) or abdomen (N=75) were evaluated. Mean radiographic density (in Hounsfield units) and SD of the density of multifidus and erector spinae were evaluated at the L4-L5 spinal level. A new index of muscle degeneration, radiographic density ratio=muscle density/SD of density, was calculated. To evaluate the visible fat infiltration in paraspinal muscles, we proposed a 3-graded scoring system. The prevalence of facet joint osteoarthritis was also evaluated. Intraclass correlation and κ statistics were used to evaluate inter-rater and intra-rater reliability. Logistic regression examined the association between paraspinal muscle indices and facet joint osteoarthritis. Intra-rater reliability for fat infiltration score (κ) ranged between 0.87 and 0.92; inter-rater reliability between 0.70 and 0.81. Intra-rater reliability (intraclass correlation) for mean density of paraspinal muscles ranged between 0.96 and 0.99, inter-rater reliability between 0.95 and 0.99; SD intra-rater reliability ranged between 0.82 and 0.91, inter-rater reliability between 0.80 and 0.89. Significant associations (P<0.01) were found between facet joint osteoarthritis, fat infiltration score, and radiographic density ratio. Two suggested indices of paraspinal muscle degeneration showed excellent reliability and were significantly associated with facet joint osteoarthritis. Additional studies are needed to evaluate the associations with other spinal degeneration features and low back pain.
Whiplash syndrome: kinematic factors influencing pain patterns.
Cusick, J F; Pintar, F A; Yoganandan, N
2001-06-01
The overall, local, and segmental kinematic responses of intact human cadaver head-neck complexes undergoing an inertia-type rear-end impact were quantified. High-speed, high-resolution digital video data of individual facet joint motions during the event were statistically evaluated. To deduce the potential for various vertebral column components to be exposed to adverse strains that could result in their participation as pain generators, and to evaluate the abnormal motions that occur during this traumatic event. The vertebral column is known to incur a nonphysiologic curvature during the application of an inertial-type rear-end impact. No previous studies, however, have quantified the local component motions (facet joint compression and sliding) that occur as a result of rear-impact loading. Intact human cadaver head-neck complexes underwent inertia-type rear-end impact with predominant moments in the sagittal plane. High-resolution digital video was used to track the motions of individual facet joints during the event. Localized angular motion changes at each vertebral segment were analyzed to quantify the abnormal curvature changes. Facet joint motions were analyzed statistically to obtain differences between anterior and posterior strains. The spine initially assumed an S-curve, with the upper spinal levels in flexion and the lower spinal levels in extension. The upper C-spine flexion occurred early in the event (approximately 60 ms) during the time the head maintained its static inertia. The lower cervical spine facet joints demonstrated statistically greater compressive motions in the dorsal aspect than in the ventral aspect, whereas the sliding anteroposterior motions were the same. The nonphysiologic kinematic responses during a whiplash impact may induce stresses in certain upper cervical neural structures or lower facet joints, resulting in possible compromise sufficient to elicit either neuropathic or nociceptive pain. These dynamic alterations of the upper level (occiput to C2) could impart potentially adverse forces to related neural structures, with subsequent development of a neuropathic pain process. The pinching of the lower facet joints may lead to potential for local tissue injury and nociceptive pain.
Zhou, Yu; Zhou, Zhenyu; Liu, Lifeng; Cao, Xuecheng
2018-03-21
Skeletal and soft tissue damage are often associated with unilateral facet dislocations, which undoubtedly lead to instability of the spine and further increase difficulties in cervical reduction. This type of irreducible facet dislocation is usually accompanied with potential catastrophic consequences including neurological deficit and severe disability. Therefore, a consistent and evidence-based treatment plan is imperative. The literature regarding the management of traumatic unilateral locked cervical facet dislocations was reviewed. Two patient cases (a 30-year-old Asian man and a 25-year-old Asian woman) who suffered irreducible cervical facet dislocations were presented. These two patients received surgical treatments including posterior reduction by poking facet joints, adjacent spinous process fixation by wire rope banding, anterior plate fixation, and intervertebral fusion after the failure of skull traction and closed reduction. At the postoperative 24-month follow-up, intervertebral fusion was achieved and our patients' neurological status improved based on the American Spinal Injury Association scale, compared with their preoperative status. Unilateral facet joint dislocations of subaxial cervical spine are difficult to reduce when complicated with posterior facet fractures or ligamentous injury. Magnetic resonance imaging can be beneficial for identifying ventral and dorsal compressive lesions, as well as ligamentous or capsule rupture. The combination of posterior reduction and anterior fixation with fusion has advantages in terms of clinical safety, ease of operation, and less iatrogenic damage.
Manchikanti, Laxmaiah; Malla, Yogesh; Wargo, Bradley W; Cash, Kimberly A; Pampati, Vidyasagar; Fellows, Bert
2012-01-01
Chronic spinal pain is common along with numerous modalities of diagnostic and therapeutic interventions utilized, creating a health care crisis. Facet joint injections and epidural injections are the 2 most commonly utilized interventions in managing chronic spinal pain. While the literature addressing the effectiveness of facet joint nerve blocks is variable and emerging, there is paucity of literature on adverse effects of facet joint nerve blocks. A prospective, non-randomized study of patients undergoing interventional techniques from May 2008 to December 2009. A private interventional pain management practice, a specialty referral center in the United States. Investigation of the incidence in characteristics of adverse effects and complications of facet joint nerve blocks. The study was carried out over a period of 20 months including almost 7,500 episodes of 43,000 facet joint nerve blocks with 3,370 episodes in the cervical region, 3,162 in the lumbar region, and 950 in the thoracic region. All facet joint nerve blocks were performed under fluoroscopic guidance in an ambulatory surgery center by 3 physicians. The complications encountered during the procedure and postoperatively were evaluated prospectively. This study was carried out over a period of 20 months and included over 7,500 episodes or 43,000 facet joint nerve blocks. All of the interventions were performed under fluoroscopic guidance in an ambulatory surgery center by one of 3 physicians. The complications encountered during the procedure and postoperatively were prospectively evaluated. Measurable outcomes employed were intravascular entry of the needle, profuse bleeding, local hematoma, dural puncture and headache, nerve root or spinal cord irritation with resultant injury, and infectious complications. There were no major complications. Multiple side effects and complications observed included overall intravascular penetration in 11.4% of episodes with 20% in cervical region, 4% in lumbar region, and 6% in thoracic region; local bleeding in 76.3% of episodes with highest in thoracic region and lowest in cervical region; oozing with 19.6% encounters with highest in cervical region and lowest in lumbar region; with local hematoma seen only in 1.2% of the patients with profuse bleeding, bruising, soreness, nerve root irritation, and all other effects such as vasovagal reactions observed in 1% or less of the episodes. Limitations of this study include lack of contrast injection, use of intermittent fluoroscopy and also an observational nature of the study. This study illustrate that major complications are extremely rare and minor side effects are common.
Tower, Dyane E; Wood, Ryan W; Vaardahl, Michael D
2015-01-01
Talocalcaneal joint middle facet coalition is the most common tarsal coalition, occurring in ≤2% of the population. Fewer than 50% of involved feet obtain lasting relief of symptoms after nonoperative treatment, and surgical intervention is commonly used to relieve symptoms, increase the range of motion, improve function, reconstruct concomitant pes planovalgus, and prevent future arthrosis from occurring at the surrounding joints. Several approaches to surgical intervention are available for patients with middle facet coalitions, ranging from resection to hindfoot arthrodesis. We present a series of 4 cases, in 3 adolescent patients, of talocalcaneal joint middle facet coalition resection with interposition of a particulate juvenile hyaline cartilaginous allograft (DeNovo(®) NT Natural Tissue Graft, Zimmer, Inc., Warsaw, IN). With a mean follow-up period of 42.8 ± 2.9 (range 41 to 47) months, the 3 adolescent patients in the present series were doing well with improved subtalar joint motion and decreased pain, and 1 foot showed no bony regrowth on a follow-up computed tomography scan. The use of a particulate juvenile hyaline cartilaginous allograft as interposition material after talocalcaneal middle facet coalition resection combined with adjunct procedures to address concomitant pes planovalgus resulted in good short-term outcomes in 4 feet in 3 adolescent patients. Copyright © 2015 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
Henry, James L.; Yashpal, Kiran; Vernon, Howard; Kim, Jaesung; Im, Hee-Jeong
2012-01-01
Objective. To develop a novel animal model of persisting lumbar facet joint pain. Methods. Sprague Dawley rats were anaesthetized and the right lumbar (L5/L6) facet joint was exposed and compressed to ~1 mm with modified clamps applied for three minutes; sham-operated and naïve animals were used as control groups. After five days, animals were tested for hind-paw sensitivity using von Frey filaments and axial deep tissue sensitivity by algometer on assigned days up to 28 days. Animals were sacrificed at selected times for histological and biochemical analysis. Results. Histological sections revealed site-specific loss of cartilage in model animals only. Tactile hypersensitivity was observed for the ipsi- and contralateral paws lasting 28 days. The threshold at which deep tissue pressure just elicited vocalization was obtained at three lumbar levels; sensitivity at L1 > L3/4 > L6. Biochemical analyses revealed increases in proinflammatory cytokines, especially TNF-α, IL-1α, and IL-1β. Conclusions. These data suggest that compression of a facet joint induces a novel model of local cartilage loss accompanied by increased sensitivity to mechanical stimuli and by increases in inflammatory mediators. This new model may be useful for studies on mechanisms and treatment of lumbar facet joint pain and osteoarthritis. PMID:22966427
Modified fenestration with restorative spinoplasty for lumbar spinal stenosis.
Matsudaira, Ko; Yamazaki, Takashi; Seichi, Atsushi; Hoshi, Kazuto; Hara, Nobuhiro; Ogiwara, Satoshi; Terayama, Sei; Chikuda, Hirotaka; Takeshita, Katsushi; Nakamura, Kozo
2009-06-01
The authors developed an original procedure, modified fenestration with restorative spinoplasty (MFRS) for the treatment of lumbar spinal stenosis. The first step is to cut the spinous process in an L-shape, which is caudally reflected. This procedure allows easy access to the spinal canal, including lateral recesses, and makes it easy to perform a trumpet-style decompression of the nerve roots without violating the facet joints. After the decompression of neural tissues, the spinous process is anatomically restored (spinoplasty). The clinical outcomes at 2 years were evaluated using the Japanese Orthopaedic Association (JOA) scale and patients' satisfaction. Radiological follow-up included radiographs and CT. Between January 2000 and December 2002, 109 patients with neurogenic intermittent claudication with or without mild spondylolisthesis underwent MFRS. Of these, 101 were followed up for at least 2 years (follow-up rate 93%). The average score on the self-administered JOA scale in 89 patients without comorbidity causing gait disturbance improved from 13.3 preoperatively to 22.9 at 2 years' follow-up. Neurogenic intermittent claudication disappeared in all cases. The patients' assessment of treatment satisfaction was "satisfied" in 74 cases, "slightly satisfied" in 12, "slightly dissatisfied" in 2, and "dissatisfied" in 1 case. In 16 cases (18%), a minimum progression of slippage occurred, but no symptomatic instability or recurrent stenosis was observed. Computed tomography showed that the lateral part of the facet joints was well preserved, and the mean residual ratio was 80%. The MFRS technique produces an adequate and safe decompression of the spinal canal, even in patients with narrow and steep facet joints in whom conventional fenestration is technically demanding.
McCarthy, M; Mehdian, H; Fairbairn, K J; Stevens, A
2004-05-01
Melorheostosis affecting the axial skeleton is a rare condition. We present a case affecting a single thoracic zygoapophyseal (facet) joint that proved to be a diagnostic challenge. CT, MRI and radionuclide imaging with surgical and histopathology findings are discussed.
Yeh, Tsu-Te; Wen, Zhi-Hong; Lee, Herng-Sheng; Lee, Chian-Her; Yang, Zhi; Jean, Yen-Hsuan; Wu, Shing-Sheng; Nimni, Marcel E; Han, Bo
2008-05-01
We aimed to establish an animal model to investigate primary osteoarthritis of the lumbar facet joints after collagenase injection in rats and its effects on chondrocyte apoptosis. We hypothesized that osteoarthritic-like changes would be induced by collagenase injection and that apoptosis of chondrocytes would increase. Collagenase (1, 10, or 50 U) or saline (control) was injected into the lumbar facet joints. The histology and histochemistry of cartilage, synovium, and subchondral bone were examined at 1, 3, and 6 weeks after surgery. Apoptotic cells induced by 1 U of collagenase were quantified using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling (TUNEL) assay. Degeneration of the cartilage and changes to the synovium and subchondral bone were dependent on both the doses of collagenase and the time after surgery. There were significantly more apoptotic chondrocytes in collagenase-treated joints than in control (P < 0.001 at 1 and 3 weeks and P < 0.05 at 6 weeks). Thus, lumbar facet joints subjected to collagenase developed osteoarthritic-like changes that could be quantified and compared. This model provides a useful tool for further study on the effects of compounds that have the potential to inhibit enzyme-associated damage to cartilage.
Yapuncich, Gabriel S; Boyer, Doug M
2014-01-01
The articular facets of interosseous joints must transmit forces while maintaining relatively low stresses. To prevent overloading, joints that transmit higher forces should therefore have larger facet areas. The relative contributions of body mass and muscle-induced forces to joint stress are unclear, but generate opposing hypotheses. If mass-induced forces dominate, facet area should scale with positive allometry to body mass. Alternatively, muscle-induced forces should cause facets to scale isometrically with body mass. Within primates, both scaling patterns have been reported for articular surfaces of the femoral and humeral heads, but more distal elements are less well studied. Additionally, examination of complex articular surfaces has largely been limited to linear measurements, so that ‘true area' remains poorly assessed. To re-assess these scaling relationships, we examine the relationship between body size and articular surface areas of the talus. Area measurements were taken from microCT scan-generated surfaces of all talar facets from a comprehensive sample of extant euarchontan taxa (primates, treeshrews, and colugos). Log-transformed data were regressed on literature-derived log-body mass using reduced major axis and phylogenetic least squares regressions. We examine the scaling patterns of muscle mass and physiological cross-sectional area (PCSA) to body mass, as these relationships may complicate each model. Finally, we examine the scaling pattern of hindlimb muscle PCSA to talar articular surface area, a direct test of the effect of mass-induced forces on joint surfaces. Among most groups, there is an overall trend toward positive allometry for articular surfaces. The ectal (= posterior calcaneal) facet scales with positive allometry among all groups except ‘sundatherians', strepsirrhines, galagids, and lorisids. The medial tibial facet scales isometrically among all groups except lemuroids. Scaling coefficients are not correlated with sample size, clade inclusivity or behavioral diversity of the sample. Muscle mass scales with slight positive allometry to body mass, and PCSA scales at isometry to body mass. PCSA generally scales with negative allometry to articular surface area, which indicates joint surfaces increase faster than muscles' ability to generate force. We suggest a synthetic model to explain the complex patterns observed for talar articular surface area scaling: whether ‘muscles or mass' drive articular facet scaling is probably dependent on the body size range of the sample and the biological role of the facet. The relationship between ‘muscle vs. mass' dominance is likely bone-and facet-specific, meaning that some facets should respond primarily to stresses induced by larger body mass, whereas others primarily reflect muscle forces. PMID:24219027
Zhang, Ming-cai; Lü, Si-zhe; Cheng, Ying-wu; Gu, Li-xu; Zhan, Hong-sheng; Shi, Yin-yu; Wang, Xiang; Huang, Shi-rong
2011-02-01
To study the effect of vertebrae semi-dislocation on the stress distribution in facet joint and interuertebral disc of patients with cervical syndrome using three dimensional finite element model. A patient with cervical spondylosis was randomly chosen, who was male, 28 years old, and diagnosed as cervical vertebra semidislocation by dynamic and static palpation and X-ray, and scanned from C(1) to C(7) by 0.75 mm slice thickness of CT. Based on the CT data, the software was used to construct the three dimensional finite element model of cervical vertebra semidislocation (C(4)-C(6)). Based on the model,virtual manipulation was used to correct the vertebra semidislocation by the software, and the stress distribution was analyzed. The result of finite element analysis showed that the stress distribution of C(5-6) facet joint and intervertebral disc changed after virtual manipulation. The vertebra semidislocation leads to the abnormal stress distribution of facet joint and intervertebral disc.
Amoretti, Nicolas; Huwart, Laurent; Foti, Pauline; Boileau, Pascal; Amoretti, Marie-Eve; Pellegrin, Amelie; Marcy, Pierre-Yves; Hauger, Olivier
2012-12-01
To evaluate percutaneous computed tomography (CT)-guided intracystic and intra-articular steroid injections for the treatment of lumbar facet joint cyst causing radicular pain. A single-centre prospective study involving 120 consecutive patients with symptomatic lumbar facet joint cyst-induced radicular pain was done (72 women, 48 men). The average age was 68.2 years (52-84). Patients were treated by percutaneous CT-guided intracystic and intra-articular steroid injections. The clinical course of nerve root pain was evaluated after 1 day, and 1, 3 and 6 months, with long-term follow-up after 12 months. Patient follow-ups in our series show supportive results: within 120 patients, 54% of patients were satisfied with a long-lasting result from the first intra-cystic and intra-articular steroid injections (n = 65), while 20.8% were satisfied with a long-lasting result from a second intervention. Combining these two results shows that 75% of patients were satisfied with a long-lasting result. Our results showed that percutaneous treatment of vertebral lumbar facet joint cysts by double injections is an effective and economic therapeutic technical management among 75% of our patients. Thus we recommend that it should be considered as a first choice of treatment. Lumbar facet joint cysts are a common feature of back and radicular pain. They may be treated effectively by interventional radiologists using CT guidance. Percutaneous treatment using double injections can save surgery in 75% of patients.
Arthrofibrosis involving the middle facet of the talocalcaneal joint in children and adolescents.
El Rassi, George; Riddle, Eric C; Kumar, S Jay
2005-10-01
Pain over the anterolateral aspect of the ankle in a patient with a history of repeated ankle sprains and with restricted subtalar movement may be associated with a tarsal coalition. Nineteen patients presented with such a history, but conventional imaging did not reveal a cartilaginous or osseous coalition. Since symptoms persisted despite nonoperative treatment, the middle facet was explored surgically. The purpose of this study was to discuss the operative findings and to report the results of treatment. Nineteen patients (twenty-three feet) with pain over the anterolateral aspect of the ankle or a history of repeated ankle sprains had restricted subtalar joint motion and inconclusive findings on diagnostic imaging, except for bone-scanning. Their ages ranged from 9.1 to 18.5 years. The middle facet of the subtalar joint was explored surgically through a 3 to 4-cm-long incision centered over the sustentaculum tali. The results at a mean of 5.8 years were classified as good, fair, or poor on the basis of pain, talocalcaneal joint motion, and shoe wear. Routine radiographs, computed tomography, and magnetic resonance imaging revealed no major abnormality, whereas technetium-99m bone scintigraphy consistently showed slightly increased isotope uptake in the middle facet. Surgical removal of a hypervascular and thickened capsule and synovium in the area of the middle facet of the subtalar joint decreased pain and improved subtalar motion. The final result was good in seventeen patients (twenty feet) and fair in two patients (three feet). There were no poor results. A diagnosis of inflammatory arthrofibrosis should be considered when a patient with a painful rigid flatfoot has normal findings on radiographs and hematological studies but increased isotope uptake in the middle facet of the talocalcaneal joint on bone scintigraphy. Excision of the hypervascular capsule and synovium from this area can result in resolution of the symptoms. Therapeutic Level IV.
Mulcahy, D M; McCormack, D M; Stephens, M M
1998-12-01
Intra-articular calcaneal fractures are associated with significant long-term morbidity, and considerable controversy exists regarding the optimum method of treating them. The contact characteristics in the intact subtalar joint were determined at known loads and for different positions of the ankle and subtalar joint, using pressure-sensitive film (Super Low; Fuji, Itochu Canada Ltd, Montreal, Quebec). We measured the contact area to joint area ratio (pressure > 5 kg force/cm2 [kgf/cm2]) which normalizes for differences in joint size and the ratio of high pressure zone (>20 kgf/cm2) as a reflection of overall increase in joint pressure. Three simulated fracture patterns were then created and stabilized with either 1 or 2 mm of articular incongruity. Eight specimens were prepared with a primary fracture line through the posterior facet, eight with a joint depression-type fracture, and six with a central joint depression fracture. A measure of 1 to 2 mm of incongruity in the posterior facet for all three fracture patterns produced significant unloading of the depressed fragment, with a redistribution of the overall pattern of pressure distribution to parts of the facet that were previously unloaded.
Yeh, Tsu-Te; Wen, Zhi-Hong; Lee, Herng-Sheng; Lee, Chian-Her; Yang, Zhi; Jean, Yen-Hsuan; Nimni, Marcel E.; Han, Bo
2008-01-01
We aimed to establish an animal model to investigate primary osteoarthritis of the lumbar facet joints after collagenase injection in rats and its effects on chondrocyte apoptosis. We hypothesized that osteoarthritic-like changes would be induced by collagenase injection and that apoptosis of chondrocytes would increase. Collagenase (1, 10, or 50 U) or saline (control) was injected into the lumbar facet joints. The histology and histochemistry of cartilage, synovium, and subchondral bone were examined at 1, 3, and 6 weeks after surgery. Apoptotic cells induced by 1 U of collagenase were quantified using the terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling (TUNEL) assay. Degeneration of the cartilage and changes to the synovium and subchondral bone were dependent on both the doses of collagenase and the time after surgery. There were significantly more apoptotic chondrocytes in collagenase-treated joints than in control (P < 0.001 at 1 and 3 weeks and P < 0.05 at 6 weeks). Thus, lumbar facet joints subjected to collagenase developed osteoarthritic-like changes that could be quantified and compared. This model provides a useful tool for further study on the effects of compounds that have the potential to inhibit enzyme-associated damage to cartilage. PMID:18224353
In vivo facet joint loading of the canine lumbar spine.
Buttermann, G R; Schendel, M J; Kahmann, R D; Lewis, J L; Bradford, D S
1992-01-01
This study describes a technique to measure in vivo loads and the resultant load-contact locations in the facet joint of the canine lumbar spine. The technique is a modification of a previously described in vitro method that used calibrated surface strains of the lateral aspect of the right L3 cranial articular process. In the present study, strains were measured during various in vivo static and dynamic activities 3 days after strain gage implantation. The in vivo recording technique and its errors, which depend on the location of the applied facet loads, is described. The results of applying the technique to five dogs gave the following results. Relative resultant contact load locations on the facet tended to be in the central and caudal portion of the facet in extension activities, central and cranial in standing, and cranial and ventral in flexion or right-turning activities. Right-turning contact locations were ventral and cranial to left-turning locations. Resultant load locations at peak loading during walking were in the central region of the facet, whereas resultant load locations at minimum loading during walking were relatively craniad. This resultant load-contact location during a walk gait cycle typically migrated in an arc with a displacement of 4 mm from minimum to maximum loading. Static tests resulted in a range of facet loads of 0 N in flexion and lying to 185 N for two-legged standing erect, and stand resulted in facet loads of 26 +/- 15 N (mean +/- standard deviation [SD]). Dynamic tests resulted in peak facet loads ranging from 55 N while walking erect to 170 N for climbing up stairs. Maximum walk facet loads were 107 +/- 27 N. The technique is applicable to in vivo studies of a canine facet joint osteoarthritis model and may be useful for establishing an understanding of the biomechanics of low-back pain.
Weisshaar, Christine L.; Winkelstein, Beth A.
2014-01-01
The facet joint is a common source of pain especially from mechanical injury. Although chronic pain is associated with altered spinal glial and neuronal responses, the contribution of specific spinal cells to joint pain are not understood. This study used the neurotoxin [Sar9,Met(O2)11]-substance P-saporin (SSP-SAP) to selectively eliminate spinal cells expressing neurokinin-1 receptor (NK1R) in a rat model of painful facet joint injury to determine the role of those spinal neurons in pain from facet injury. Following spinal administration of SSP-SAP or its control (blank-SAP), a cervical facet injury was imposed and behavioral sensitivity assessed. Spinal extracellular recordings were made on day 7 to classify neurons and quantify evoked firing. Spinal glial activation and IL1α expression also were evaluated. SSP-SAP prevented the development of mechanical hyperalgesia that is induced by joint injury and reduced NK1R expression and mechanically-evoked neuronal firing in the dorsal horn. SSP-SAP also prevented a shift toward wide dynamic range neurons that is seen after injury. Spinal astrocytic activation and IL1α expression were reduced to sham levels with SSP-SAP treatment. These results suggest that spinal NK1R-bearing cells are critical in initiating spinal nociception and inflammation associated with a painful mechanical joint injury. Perspective Results demonstrate that cells expressing NK1R in the spinal cord are critical for the development of joint pain and spinal neuroplasticity and inflammation after trauma to the joint. These findings have utility for understanding mechanisms of joint pain and developing potential targets to treat pain. PMID:24389017
Yuan, Wei; Zhang, Haiping; Zhou, Xiaoshu; Wu, Weidong; Zhu, Yue
2018-05-01
Artificial cervical disc replacement is expected to maintain normal cervical biomechanics. At present, the effect of the Prestige LP prosthesis height on cervical biomechanics has not been thoroughly studied. This finite element study of the cervical biomechanics aims to predict how the parameters, like range of motion (ROM), adjacent intradiscal pressure, facet joint force, and bone-implant interface stress, are affected by different heights of Prestige LP prostheses. The finite element model of intact cervical spine (C3-C7) was obtained from our previous study, and the model was altered to implant Prestige LP prostheses at the C5-C6 level. The effects of the height of 5, 6, and 7 mm prosthesis replacement on ROM, adjacent intradiscal pressure, facet joint force, as well as the distribution of bone-implant interface stress were examined. ROM, adjacent intradiscal pressure, and facet joint force increased with the prosthesis height, whereas ROM and facet joint force decreased at C5-C6. The maximal stress on the inferior surface of the prostheses was greater than that on the superior surface, and the stresses increased with the prosthesis height. The biomechanical changes were slightly affected by the height of 5 and 6 mm prostheses, but were strongly affected by the 7-mm prosthesis. An appropriate height of the Prestige LP prosthesis can preserve normal ROM, adjacent intradiscal pressure, and facet joint force. Prostheses with a height of ≥2 mm than normal can lead to marked changes in the cervical biomechanics and bone-implant interface stress. Copyright © 2018 Elsevier Inc. All rights reserved.
Vertebral rotatory subluxation in degenerative scoliosis: facet joint tropism is related.
Bao, Hongda; Zhu, Feng; Liu, Zhen; Bentley, Mark; Mao, Saihu; Zhu, Zezhang; Ding, Yitao; Qiu, Yong
2014-12-15
A cross-sectional study. To identify facet tropism as one of the possible risk factors leading to vertebral rotatory subluxation (VRS). VRS has been considered as one of the prognostic factors for degenerative scoliosis. Although several risk factors of VRS, including age and Cobb angle, have been investigated, few studies exist that have evaluated the correlation between VRS and anatomical structures of the vertebral column. This retrospective study recruited 23 patients diagnosed with degenerative lumbar scoliosis with VRS and 20 patients with degenerative scoliosis without VRS. The lateral translation on coronal radiographs was measured and 5 mm was used as the cutoff value to define rotatory subluxation. Computed tomographic scans for facet joints were made for all lumbar levels. The difference between right and left facet angles was recorded as ΔFA. Facet tropism was defined as a difference between the bilateral facet angles of more than 10°. In this study, VRS was most commonly found at the L3-L4 level (49%) and, with decreasing frequency at L2-L3 (24%), L4-L5 (20%), and L1-L2 (7%). On the convex side of the main curve, face joints at levels with VRS were more coronally oriented compared with those at levels without VRS (41.64° ± 11.65° vs. 36.30° ± 10.99°, P = 0.034). ΔFA was also significantly different between levels with and without VRS (P = 0.005). A strong correlation was found between ΔFA and lateral translation, with a coefficient of 0.33 (P < 0.001). In addition, ΔFA and a larger Cobb angle were found to be significantly associated with VRS based on binary regression analysis, with an odds ratio of 4.68 and 2.14, respectively. Facet tropism was more significantly observed at levels with VRS. On the convex side of the main curve, facet joints at levels with VRS were more coronally oriented. A larger Cobb angle and severe facet tropism in degenerative scoliosis should be considered to be related to VRS.
Wilson, David J; Owen, Sara; Corkill, Rufus A
2011-08-01
Recent publications compared treatment of vertebral fractures reporting improvement in the majority but with no significant difference between the local anaesthetic and vertebroplasty groups. Potential explanations include placebo response or therapeutic response to the "control procedure". We investigated whether preliminary facet joint injection can identify those patients whose pain arises from paravertebral structures rather than the vertebral insufficiency fracture itself. Patients referred for treatment by vertebroplasty were first offered local anaesthetic and steroid facet joint injection (FJI) at the most painful level. Those who failed to respond were offered a vertebroplasty. Ninety one patients referred, 16 went straight to vertebroplasty. Sixty one of 75 were initially offered FJI. Twenty one were successful; two relapsed, had further FJIs with good results; three declined treatment; 5 had temporary benefit; 1 died from unrelated causes. Of 29 who failed to respond to FJIs, 24 underwent vertebroplasty and 23 had a successful outcome. A third of patients technically suitable for vertebroplasty responded beneficially to FJI. In this group the pain mediator maybe one of instability and overload on the facet joints produced by adjacent wedge fracture. This protocol allows more selective and more successful vertebroplasty.
Xu, W B; Chen, S; Fan, S W; Zhao, F D; Yu, X J; Hu, Z J
2016-08-10
Many studies have explored the relationship between facet tropism and facet joint osteoarthritis, disc degeneration and degenerative spondylolisthesis. However, the associations between facet orientation and tropism, and paraspinal muscles have not been studied. To analyze the associations between facet orientation and tropism, and parameters of paraspinal muscles in patients with chronic low back pain. Ninety-five patients with chronic low back pain were consecutively enrolled. Their facet joint angles were measured on computed tomography (CT) while gross cross-sectional area (GCSA), functional cross-sectional area (FCSA) and T2 signal intensity of lumbar paraspinal and psoas muscle were evaluated on magnetic resonance imaging (MRI). The GCSA and FCSA were significantly smaller for multifidus muscle (P< 0.001), but significantly larger for erector spinae and psoas muscles (P< 0.001), in coronally-orientated group than those in sagittally-orientated group. The differences of bilateral GCSA and FCSA of multifidus muscle were significantly larger in facet tropism group than those in no facet tropism group (P= 0.009 and P= 0.019). Muscular asymmetries may develop in the lumbar region of the spine, which are associated with facet asymmetry in patients with chronic low back pain. Longitudinal studies are needed to understand the causal relationship between facet orientation and tropism and muscular asymmetry in future.
Posterior Branches of Lumbar Spinal Nerves - Part I: Anatomy and Functional Importance.
Kozera, Katarzyna; Ciszek, Bogdan
2016-01-01
The aim of this paper is to compare anatomic descriptions of posterior branches of the lumbar spinal nerves and, on this basis, present the location of these structures. The majority of anatomy textbooks do not describe these nerves in detail, which may be attributable to the fact that for many years they were regarded as structures of minor clinical importance. The state of knowledge on these nerves has changed within the last 30 years. Attention has been turned to their function and importance for both diagnostic practice and therapy of lower back pain. Summarising the available literature, we may conclude that the medial and lateral branches separate at the junction of the facet joint and the distal upper edge of the transverse process; that the size, course and area supplied differ between the lateral and the medial branch; and that facet joints receive multisegmental innervation. It has been demonstrated that medial branches are smaller than the respective lateral branches and they have a more constant course. Medial branches supply the area from the midline to the facet joint line, while lateral branches innervate tissues lateral to the facet joint. The literature indicates difficulties with determining specific anatomic landmarks relative to which the lateral branch and the distal medial branch can be precisely located. Irritation of sensory fibres within posterior branches of the lumbar spinal nerves may be caused by pathology of facet joints, deformity of the spine or abnormalities due to overloading or injury. The anatomic location and course of posterior branches of spinal nerves should be borne in mind to prevent damaging them during low-invasive analgesic procedures.
Facet Joint Osteoarthritis Affects Spinal Segmental Motion in Degenerative Spondylolisthesis.
Kitanaka, Shigeyuki; Takatori, Ryota; Arai, Yuji; Nagae, Masateru; Tonomura, Hitoshi; Mikami, Yasuo; Inoue, Nozomu; Ogura, Taku; Fujiwara, Hiroyoshi; Kubo, Toshikazu
2018-06-15
This is a retrospective clinical case series (case-control study). To clarify the influence of facet joint osteoarthritis (FJOA) on the pathology of degenerative spondylolisthesis (DS) using in vivo 3-dimensional image analysis. There are no radical treatments to prevent progression of DS in patients with lumbar spinal canal stenosis associated with DS. Therefore, an effective treatment method based on the pathology of DS should be developed. In total, 50 patients with lumbar spinal canal stenosis involving L4/5 who underwent dynamic computed tomography were divided into 2 groups: with DS [spondylolisthesis (Sp) group; 12 male, 14 female; mean age, 74 y]; and without DS (non-Sp group; 15 male, 9 female; mean age, 70 y). Degeneration of the intervertebral disk and FJOA at L4/5 were evaluated using magnetic resonance imaging. Disk and intervertebral foramen heights, the distance between the craniocaudal edges of the facet joint, and the interspinous distance were measured on dynamic computed tomographic images. Also, in vivo 3-dimensional segmental motion was evaluated using the volume merge method. There were no significant differences in degenerative findings for the intervertebral disk; however, progressive FJOA was detected in the Sp group. Dynamic changes in the distance between the craniocaudal edges of the facet joints were significantly larger in the Sp group. In this study, progressive FJOA and larger segmental motion in the distance between the craniocaudal edges of the facet joints were found in the Sp group. We clarified for the first time that DS involves ligament laxity due to FJOA that affects spinal segmental motion in vivo. We consider that a treatment method based on FJOA would be useful for treating patients with DS. Level IV.
Atlantoaxial manual realignment in a patient with traumatic atlantoaxial joint disruption.
Goel, Atul; Figueiredo, Antonio; Maheshwari, Shradha; Shah, Abhidha
2010-05-01
We report a patient with complex traumatic translatory atlantoaxial dislocation, who we treated by joint exposure and reduction of the dislocation by facet manipulation and subsequent plate and screw atlantoaxial fixation. A 28-year-old male had fallen 7.6m (25 feet), and following the fall had severe neck pain but no neurological deficit. Investigations revealed a fracture at the base of the odontoid process and posterior displacement of the entire atlas over the axis, resulting in a translatory atlantoaxial dislocation. Head traction failed as he developed severe vertigo following its application. The patient was operated upon in a prone position. We opened the atlantoaxial joint and realigned the facets using distraction and manipulation techniques and secured the joint using a plate and screw interarticular method. The patient tolerated the treatment well and was symptom-free after 28 months. Postoperative images showed good craniovertebral alignment. Although technically challenging, direct manipulation of the facets of the atlas and axis can result in excellent craniovertebral realignment.
The retrodural space of Okada.
Murthy, Naveen S; Maus, Timothy P; Aprill, Charles
2011-06-01
The retrodural space of Okada is a potential space that can act as a conduit for the spread of inflammatory or infectious processes, connecting ipsilateral adjacent facet joints, contralateral adjacent facet joints, adjacent neural foramen, paraspinal musculature, and spinous process adventitial bursa (i.e., Baastrup disease). Awareness of these potential retrodural communications during diagnostic imaging interpretation and interventional spine injection procedures can play an important role in patient care and management.
A biomechanical study of artificial cervical discs using computer simulation.
Ahn, Hyung Soo; DiAngelo, Denis J
2008-04-15
A virtual simulation model of the subaxial cervical spine was used to study the biomechanical effects of various disc prosthesis designs. To study the biomechanics of different design features of cervical disc arthroplasty devices. Disc arthroplasty is an alternative approach to cervical fusion surgery for restoring and maintaining motion at a diseased spinal segment. Different types of cervical disc arthroplasty devices exist and vary based on their placement and degrees of motion offered. A virtual dynamic model of the subaxial cervical spine was used to study 3 different prosthetic disc designs (PDD): (1) PDD-I: The center of rotation of a spherical joint located at the mid C5-C6 disc, (2) PDD-II: The center of rotation of a spherical joint located 6.5 mm below the mid C5-C6 disc, and (3) PDD-III: The center of rotation of a spherical joint in a plane located at the C5-C6 disc level. A constrained spherical joint placed at the disc level (PDD-I) significantly increased facet loads during extension. Lowering the rotational axis of the spherical joint towards the subjacent body (PDD-II) caused a marginal increase in facet loading during flexion, extension, and lateral bending. Lastly, unconstraining the spherical joint to move freely in a plane (PDD-III) minimized facet load build up during all loading modes. The simulation model showed the impact simple design changes may have on cervical disc dynamics. The predicted facet loads calculated from computer model have to be validated in the experimental study.
Dutch Multidisciplinary Guideline for Invasive Treatment of Pain Syndromes of the Lumbosacral Spine.
Itz, Coen J; Willems, Paul C; Zeilstra, Dick J; Huygen, Frank J
2016-01-01
When conservative therapies such as pain medication or exercise therapy fail, invasive treatment may be indicated for patients with lumbosacral spinal pain. The Dutch Society of Anesthesiologists, in collaboration with the Dutch Orthopedic Association and the Dutch Neurosurgical Society, has taken the initiative to develop the guideline "Spinal low back pain," which describes the evidence regarding diagnostics and invasive treatment of the most common spinal low back pain syndromes, that is, facet joint pain, sacroiliac joint pain, coccygodynia, pain originating from the intervertebral disk, and failed back surgery syndrome. The aim of the guideline is to determine which invasive treatment intervention is preferred for each included pain syndrome when conservative treatment has failed. Diagnostic studies were evaluated using the EBRO criteria, and studies on therapies were evaluated with the Grading of Recommendations Assessment, Development and Evaluation system. For the evaluation of invasive treatment options, the guideline committee decided that the outcome measures of pain, function, and quality of life were most important. The definition, epidemiology, pathophysiological mechanism, diagnostics, and recommendations for invasive therapy for each of the spinal back pain syndromes are reported. The guideline committee concluded that the categorization of low back pain into merely specific or nonspecific gives insufficient insight into the low back pain problem and does not adequately reflect which therapy is effective for the underlying disorder of a pain syndrome. Based on the guideline "Spinal low back pain," facet joint pain, pain of the sacroiliac joint, and disk pain will be part of a planned nationwide cost-effectiveness study. © 2015 World Institute of Pain.
[Degenerative adult scoliosis].
García-Ramos, C L; Obil-Chavarría, C A; Zárate-Kalfópulos, B; Rosales-Olivares, L M; Alpizar-Aguirre, A; Reyes-Sánchez, A A
2015-01-01
Adult scoliosis is a complex three-dimensional rotational deformity of the spine, resulting from the progressive degeneration of the vertebral elements in middle age, in a previously straight spine; a Cobb angle greater than 10° in the coronal plane, which also alters the sagittal and axial planes. It originates an asymmetrical degenerative disc and facet joint, creating asymmetrical loads and subsequently deformity. The main symptom is axial, radicular pain and neurological deficit. Conservative treatment includes drugs and physical therapy. The epidural injections and facet for selectively blocking nerve roots improves short-term pain. Surgical treatment is reserved for patients with intractable pain, radiculopathy and/ or neurological deficits. There is no consensus for surgical indications, however, it must have a clear understanding of the symptoms and clinical signs. The goal of surgery is to decompress neural elements with restoration, modification of the three-dimensional shape deformity and stabilize the coronal and sagittal balance.
Joint FACET: the Canada-Netherlands initiative to study multisensor data fusion systems
NASA Astrophysics Data System (ADS)
Bosse, Eloi; Theil, Arne; Roy, Jean; Huizing, Albert G.; van Aartsen, Simon
1998-09-01
This paper presents the progress of a collaborative effort between Canada and The Netherlands in analyzing multi-sensor data fusion systems, e.g. for potential application to their respective frigates. In view of the overlapping interest in studying and comparing applicability and performance and advanced state-of-the-art Multi-Sensor Data FUsion (MSDF) techniques, the two research establishments involved have decided to join their efforts in the development of MSDF testbeds. This resulted in the so-called Joint-FACET, a highly modular and flexible series of applications that is capable of processing both real and synthetic input data. Joint-FACET allows the user to create and edit test scenarios with multiple ships, sensor and targets, generate realistic sensor outputs, and to process these outputs with a variety of MSDF algorithms. These MSDF algorithms can also be tested using typical experimental data collected during live military exercises.
Incidence of the coracoclavicular joint in South African populations.
Nalla, S; Asvat, R
1995-01-01
The presence of a diarthrotic coracoclavicular joint, as represented by an articular facet on the conoid tubercle of the clavicle and the superior surface of the coracoid process of the scapula, was investigated. The sample consisted of 60 white and 180 black South African (60 Sotho, 60 Xhosa and 60 Zulu) skeletons. Each group consisted of 30 male and 30 female skeletons. The presence of the articular facet was recorded as either bilateral, unilateral left or unilateral right. The effect of clavicular length, scapular size and first rib angle on the presence of the coracoclavicular joint was also investigated. The presence of the articular facet was noted in 23 (9.6%) of the 240 individuals studied. Of these 23 individuals, 6 (26.1%) were white and 17 (73.9%) were black. Males (56.5%) presented a higher incidence of this anomaly than females (43.5%). The articular facet occurred bilaterally in 47.9% (11/23), unilaterally on the left in 30.4% (7/23) and unilaterally on the right in 21.7% (5/23). Sexual, racial and tribal differences were not statistically significant. Individuals possessing the joint showed statistically significantly (P < 0.01) larger scapulae (increased border lengths and superior angles), longer clavicles and longer first ribs. No statistically significant differences in the first rib angles were observed between individuals who possessed the joint and those who did not, thus implying similar thoracic inlet size. It is proposed that the aforementioned morphometry of the scapulae, clavicles and first ribs may restrict associated movements of the scapulae, resulting in the development of the coracoclavicular joint. Images Fig. 4 Fig. 5 PMID:7559137
Gadgil, Anirudh A; Eisenstein, Stephan M; Darby, Alan; Cassar Pullicino, Victor
2002-10-01
A case of bilateral symptomatic facet joint synovial cysts arising in association with calcium pyrophosphate deposition disease is reported. To present a previously unreported cause for symptomatic synovial cysts of the lumbar spine. Synovial cysts of the facet joints occur most commonly in association with degenerative disease of the spine in older individuals. The association of these cysts with trauma, rheumatoid arthritis, spondylolysis, and kissing spinous processes also has been reported. These cysts can cause symptoms and signs from direct compression of the dura. Chondrocalcinosis has not been previously reported to cause symptomatic synovial cysts. A 67-year-old woman presented with right lower limb sciatica caused by a right L4-L5 facet joint cyst, which resolved after surgical decompression. A year later, she presented with left lower limb sciatica caused by development of a new L4-L5 facet joint cyst, which also resolved after surgical decompression. Histopathologic examination of each cyst showed a cyst wall of fibrous tissue with synovial lining, inflammation, and granulation tissue. Examination of the tissue under polarized light showed positively birefringent, short blunt crystals of calcium pyrophosphate dihydrate. In patients with a history of gout or pseudogout, a rare possibility of a synovial cyst should be considered in the differential diagnosis during investigation for the cause of neural compression resulting in sciatic syndrome.
Osseous associated cervical spondylomyelopathy at the C2-C3 articular facet joint in 11 dogs.
Cooper, C; Gutierrez-Quintana, R; Penderis, J; Gonçalves, R
2015-11-21
In dogs, vertebral canal stenosis at C2-C3 due to articular facet joint degeneration is only sporadically identified. The authors' aims were to review the clinical presentation, MRI characteristics, treatment and outcome of dogs presenting with this condition. Eleven cases were eligible for inclusion. Neurological examination revealed tetraparesis and proprioceptive ataxia in all 4 limbs in 3/11, proprioceptive tetra-ataxia only in 4/11, pelvic limb proprioceptive ataxia in 2/11 and no gait abnormalities in 2/11 dogs. Cervical hyperaesthesia was present in 7/11 dogs. MRI revealed bilateral articular facet joint degeneration in 10/11 cases and unilateral degeneration in one. Surgery was performed in six cases and medical management elected in five. Long-term follow-up information was available for 11 animals. Four of the surgical cases are alive and have no neurological deficits, one was euthanased for an unrelated condition and one lost to follow-up. Of the cases managed medically, three are alive showing no neurological deficits, one is alive still displaying neurological deficits and one euthanased for an unrelated condition whilst still ataxic. This study shows that both medical and surgical management can result in good outcomes in dogs with vertebral canal stenosis resulting from articular facet joint degeneration at the level of C2-C3. British Veterinary Association.
Goel, A; Pareikh, S; Sharma, P
2005-06-01
We present our experience of treating two cases of rheumatoid arthritis involving the craniovertebral junction and having marked basilar invagination by an alternative treatment method. In both the cases, the facets were osteoporotic and were not suitable for screw implantation. The patients were 66 and 72 years of age and both patients were females. Both the patients presented with complaints of progressively increasing spastic quadriparesis. Surgery involved attempts to reduce the basilar invagination and restore the height of the 'collapsed' lateral mass by manual distraction of the facets of the atlas and axis and forced impaction of titanium spacers in the joint in addition to bone graft harvested from the iliac crest. The procedure also provided stabilization of the region. No other fixation procedure involving wires, screws, plate and rods was carried out simultaneously. Following surgery both the patients showed symptomatic improvement and partial restoration of craniovertebral alignments. Follow-up is of 2 and 24 months. Distraction of the facets of atlas and axis and impaction of metal implant and bone graft in the facet joint can assist in reduction of basilar invagination and fixation of the region in selected cases of rheumatoid arthritis involving the craniovertebral junction.
Painful lumbar spondylolysis among pediatric sports players: a pilot MRI study.
Sairyo, Koichi; Sakai, Toshinori; Mase, Yasuyoshi; Kon, Tamiyo; Shibuya, Isao; Kanamori, Yasuo; Kosugi, Tatsuo; Dezawa, Akira
2011-11-01
For children and adolescents who are very active athletes, fresh lumbar spondylolysis is the main pathologic cause of lower back pain (LBP). However, regarding the terminal-stage spondylolysis (pars defect), there have been few studies to clarify the pathomechanism of LBP. The purpose of this study is to clarify the cause of LBP associated with pars defects in athletes. This is the first report showing a possible pathomechanism of LBP in active athletes with painful pars defect. Six pediatric athletes (5 boys and 1 girl) below 18 years old with painful bilateral lumbar spondylolysis were evaluated. In all cases, spondylolysis was identified as terminal stage (pseudoarthrosis) on CT scan. To evaluate the inflammation around the pars defects, short time inversion recovery (STIR) MRI was performed along with the sagittal section. Fluid collection, which is an indicator of inflammatory events, was evaluated in 12 pars defects as well as in 12 cranial and caudal adjoining facet joints. Inflammation (i.e., fluid collection) was observed in all 12 pars defects in six subjects at the pseudoarthrotic pars defects. In terms of facet joints, 7 of 12 (58%) pars defects showed fluid collection at the cranial and/or caudal adjoining joints on STIR MRI. The present study showed that inflammation was always present at the pars defects and in some cases at the adjoining facet joints. Thus, it is not difficult to understand how, during sports activity, inflammation may first occur at the pseudoarthrotic site and then spread to the adjoining facet joints. This mechanism could cause LBP associated with terminal-stage (pseudoarthrotics) spondylolysis in athletes.
Pesteie, Mehran; Abolmaesumi, Purang; Ashab, Hussam Al-Deen; Lessoway, Victoria A; Massey, Simon; Gunka, Vit; Rohling, Robert N
2015-06-01
Injection therapy is a commonly used solution for back pain management. This procedure typically involves percutaneous insertion of a needle between or around the vertebrae, to deliver anesthetics near nerve bundles. Most frequently, spinal injections are performed either blindly using palpation or under the guidance of fluoroscopy or computed tomography. Recently, due to the drawbacks of the ionizing radiation of such imaging modalities, there has been a growing interest in using ultrasound imaging as an alternative. However, the complex spinal anatomy with different wave-like structures, affected by speckle noise, makes the accurate identification of the appropriate injection plane difficult. The aim of this study was to propose an automated system that can identify the optimal plane for epidural steroid injections and facet joint injections. A multi-scale and multi-directional feature extraction system to provide automated identification of the appropriate plane is proposed. Local Hadamard coefficients are obtained using the sequency-ordered Hadamard transform at multiple scales. Directional features are extracted from local coefficients which correspond to different regions in the ultrasound images. An artificial neural network is trained based on the local directional Hadamard features for classification. The proposed method yields distinctive features for classification which successfully classified 1032 images out of 1090 for epidural steroid injection and 990 images out of 1052 for facet joint injection. In order to validate the proposed method, a leave-one-out cross-validation was performed. The average classification accuracy for leave-one-out validation was 94 % for epidural and 90 % for facet joint targets. Also, the feature extraction time for the proposed method was 20 ms for a native 2D ultrasound image. A real-time machine learning system based on the local directional Hadamard features extracted by the sequency-ordered Hadamard transform for detecting the laminae and facet joints in ultrasound images has been proposed. The system has the potential to assist the anesthesiologists in quickly finding the target plane for epidural steroid injections and facet joint injections.
Proschek, Dirk; Kafchitsas, K.; Rauschmann, M. A.; Kurth, A. A.; Vogl, T. J.
2008-01-01
Interventional procedures are associated with high radiation doses for both patients and surgeons. To reduce the risk from ionizing radiation, it is essential to minimize radiation dose. This prospective study was performed to evaluate the effectiveness in reducing radiation dose during facet joint injection in the lumbar spine and to evaluate the feasibility and possibilities of the new real time image guidance system SabreSource™. A total of 60 patients, treated with a standardized injection therapy of the facet joints L4–L5 or L5–S1, were included in this study. A total of 30 patients were treated by fluoroscopy guidance alone, the following 30 patients were treated using the new SabreSource™ system. Thus a total of 120 injections to the facet joints were performed. Pain, according to the visual analogue scale (VAS), was documented before and 6 h after the intervention. Radiation dose, time of radiation and the number of exposures needed to place the needle were recorded. No significant differences concerning age (mean age 60.5 years, range 51–69), body mass index (mean BMI 26.2, range 22.2–29.9) and preoperative pain (VAS 7.9, range 6–10) were found between the two groups. There was no difference in pain reduction between the two groups (60 vs. 61.5%; P = 0.001) but the radiation dose was significantly smaller with the new SabreSource™ system (reduction of radiation dose 32.7%, P = 0.01; reduction of mean entrance surface dose 32.3%, P = 0.01). The SabreSource™ System significantly reduced the radiation dose received during the injection therapy of the lumbar facet joints. With minimal effort for the setup at the beginning of a session, the system is easy to handle and can be helpful for other injection therapies (e.g. nerve root block therapies). PMID:19082641
Dong, Ling; Smith, Jenell R; Winkelstein, Beth A
2013-05-15
Chronic neck pain affects up to 70% of persons, with the facet joint being the most common source. Intra-articular injection of the non-steroidal anti-inflammatory drug ketorolac reduces post-operative joint-mediated pain; however, the mechanism of its attenuation of facet-mediated pain has not been evaluated. Protease-activated receptor-1 (PAR1) has differential roles in pain maintenance depending on the type and location of painful injury. This study investigated if the timing of intra-articular ketorolac injection after painful cervical facet injury affects behavioral hypersensitivity by modulating spinal astrocyte activation and/or PAR1 expression. Rats underwent a painful joint distraction and received an injection of ketorolac either immediately or 1 day later. Separate control groups included injured rats with a vehicle injection at day 1 and sham operated rats. Forepaw mechanical allodynia was measured for 7 days, and spinal cord tissue was immunolabeled for glial fibrillary acidic protein (GFAP) and PAR1 expression in the dorsal horn on day 7. Ketorolac administered on day 1 after injury significantly reduced allodynia (p=0.0006) to sham levels, whereas injection immediately after the injury had no effect compared with vehicle. Spinal astrocytic activation followed behavioral responses and was significantly decreased (p=0.009) only for ketorolac given at day 1. Spinal PAR1 (p=0.0025) and astrocytic PAR1 (p=0.012) were significantly increased after injury. Paralleling behavioral data, astrocytic PAR1 was returned to levels in sham only when ketorolac was administered on day 1. Yet, spinal PAR1 was significantly reduced (p<0.0001) by ketorolac independent of timing. Spinal astrocyte expression of PAR1 appears to be associated with the maintenance of facet-mediated pain.
Dong, Ling; Smith, Jenell R.
2013-01-01
Abstract Chronic neck pain affects up to 70% of persons, with the facet joint being the most common source. Intra-articular injection of the non-steroidal anti-inflammatory drug ketorolac reduces post-operative joint-mediated pain; however, the mechanism of its attenuation of facet-mediated pain has not been evaluated. Protease-activated receptor-1 (PAR1) has differential roles in pain maintenance depending on the type and location of painful injury. This study investigated if the timing of intra-articular ketorolac injection after painful cervical facet injury affects behavioral hypersensitivity by modulating spinal astrocyte activation and/or PAR1 expression. Rats underwent a painful joint distraction and received an injection of ketorolac either immediately or 1 day later. Separate control groups included injured rats with a vehicle injection at day 1 and sham operated rats. Forepaw mechanical allodynia was measured for 7 days, and spinal cord tissue was immunolabeled for glial fibrillary acidic protein (GFAP) and PAR1 expression in the dorsal horn on day 7. Ketorolac administered on day 1 after injury significantly reduced allodynia (p=0.0006) to sham levels, whereas injection immediately after the injury had no effect compared with vehicle. Spinal astrocytic activation followed behavioral responses and was significantly decreased (p=0.009) only for ketorolac given at day 1. Spinal PAR1 (p=0.0025) and astrocytic PAR1 (p=0.012) were significantly increased after injury. Paralleling behavioral data, astrocytic PAR1 was returned to levels in sham only when ketorolac was administered on day 1. Yet, spinal PAR1 was significantly reduced (p<0.0001) by ketorolac independent of timing. Spinal astrocyte expression of PAR1 appears to be associated with the maintenance of facet-mediated pain. PMID:23126437
Head-Neck Biomechanics in Simulated Rear Impact
Yoganandan, Narayan; Pintar, Frank A.; Cusick, Joseph F.; Kleinberger, Michael
1998-01-01
The first objective of this study is to present an overview of the human cadaver studies aimed to determine the biomechanics of the head-neck in a simulated rear crash. The need for kinematic studies to better understand the mechanisms of load transfer to the human head-neck complex is emphasized. Based on this need, a methodology is developed to delineate the dynamic kinematics of the human head-neck complex. Intact human cadaver head-neck complexes were subjected to postero-anterior impact using a mini-sled pendulum device. The integrity of the soft tissues including the musculature and skin were maintained. The kinematic data were recorded using high-speed photography coupled with retroreflective targets placed at various regions of the human head-neck complex. The overall and segmental kinematics of the entire head-neck complex, and the localized facet joint motions were determined. During the initial stages of loading, a transient decoupling of the head occurred with respect to the neck exhibiting a lag of the cranium. The upper cervical spine-head undergoes local flexion concomitant with a lag of the head while the lower cervical spinal column is in local extension. This establishes a reverse curvature to the cervical head-neck complex. With continued loading, head motion ensues and approximately at the end of the loading phase, the entire head-neck complex is under the extension mode with a single curvature. In contrast, the lower cervical spine facet joint kinematics show varying compression and sliding. While both the anterior and posterior-most regions of the facet joint slide, the posterior-most region (mean: 2.84 mm) of the joint compresses more than the anterior-most (mean: 2.02 mm) region. These varying kinematics at the ends of the facet joint result in a pinching mechanism. These biomechanical kinematic findings may be correlated to the presence of headaches and neck pain (Lord, Bogduk et al. 1992; Barnsley, Lord et al. 1995), based on the unique human head-neck anatomy at the upper cervical spine region and the associated facet joint characteristics, and clinical studies.
[Lumbosacral facet joint stabilization: Mc Bride technique].
Martínez, Ernesto De León; García, J Antonio Vázquez; Castillo, Pablo Atlitec
2008-01-01
We carried out a retrospective study of the clinical results of lumbosacral decompression with Mc Bride technique, in treatment of degenerative unstable lumbar stenosis. Three hundred and forty patients (180 male) were treated during May 1996 to May 2003. Mean age at surgery was 47 years old (22-85) with 3 to 8 years of follow up. All patients fulfilled clinical and image criteria for chronic lumbar pain due to degenerative lumbar stenosis and segmental instability that did not improve with conservative treatment. We found very good results in 114 patients (33.5%), good in 203 patients (59.7%), regular in 16 patients (4.7%), and poor in 6 patients (2%). The Mc Bride technique is based in interlaminar distraction and permits managing lumbar stenosis and arthrodesis of an unstable segment simultaneously. It diminishes compression in the foramen, maintains a position in extension, reduces facet joints subluxation and eliminates the strategic point of intervertebral mobility in facet joints. It allows immediate stabilization and later fusion by placing a bone block.
Modified Goel’s Methods for Basilar Impression: A Case Report with Literature
Asamoto, Shunji; Fukui, Yasuyuki; Nishiyama, Makoto; Ishikawa, Masayuki; Nakamura, Satoshi; Nagashima, Masaki; Muto, Jun; Jimbo, Hiroyuki
2016-01-01
We report the case of a 57-year-old woman who had basilar impression manifesting as severe myelopathy and occipital neuralgia and was treated by distraction and fixation performed using a modification of Goel’s method. Magnetic resonance imaging (MRI) and computed tomography (CT) scans showed severe myelocompression by the dens of the axis from the ventral side and occipitalization of the atlas. After traction using a Halo vest, C1–2 facet distraction and fixation was performed in one stage using a modified Goel’s method. Although Goel et al. used a custom-made spacer to distract the facet joints, we used a threaded titanium cylindrical cage that was inserted into the joint to fix the C1–2 facet joint with posterior fixation from occipital bone to C5. Postoperatively, gradual symptomatic and neurological amelioration were observed. The atlantoaxial joints were bone-fused at 3 years post-operation. Distraction and fixation performed using this modified version of Goel’s method was effective for treating basilar invagination. The threaded titanium cylindrical cage provided adequate C1–2 space and strong initial fixation. PMID:28663991
CT-Guided Transfacet Pedicle Screw Fixation in Facet Joint Syndrome: A Novel Approach
Manfré, Luigi
2014-01-01
Summary Axial microinstability secondary to disc degeneration and consequent chronic facet joint syndrome (CFJS) is a well-known pathological entity, usually responsible for low back pain (LBP). Although posterior lumbar fixation (PIF) has been widely used for lumbar spine instability and LBP, complications related to wrong screw introduction, perineural scars and extensive muscle dissection leading to muscle dysfunction have been described. Radiofrequency ablation (RFA) of facet joints zygapophyseal nerves conventionally used for pain treatment fails in approximately 21% of patients. We investigated a “covert-surgery” minimal invasive technique to treat local spinal instability and LBP, using a novel fully CT-guided approach in patients with axial instability complicated by CFJS resistant to radioablation, by introducing direct fully or partially threaded transfacet screws (transfacet fixation - TFF), to acquire solid arthrodesis, reducing instability and LBP. The CT-guided procedure was well tolerated by all patients in simple analogue sedation, and mean operative time was approximately 45 minutes. All eight patients treated underwent clinical and CT study follow-up at two months, revealing LBP disappearance in six patients, and a significant reduction of lumbar pain in two. In conclusion, CT-guided TFF is a fast and safe technique when facet posterior fixation is needed. PMID:25363265
Partial lumbosacral transitional vertebra resection for contralateral facetogenic pain.
Brault, J S; Smith, J; Currier, B L
2001-01-15
Case report of surgically treated mechanical low back pain from the facet joint contralateral to a unilateral anomalous lumbosacral articulation (Bertolotti's syndrome). To describe the clinical presentation, diagnostic evaluation, and management of facet-related low back pain in a 17-year-old cheerleader and its successful surgical treatment with resection of a contralateral anomalous articulation. Lumbosacral transitional vertebrae are common in the general population. Bertolotti's syndrome is mechanical low back pain associated with these transitional segments. Little is known about the pathophysiology and mechanics of these vertebral segments and their propensity to be pain generators. Treatment of this syndrome is controversial, and surgical intervention has been infrequently reported. A retrospective chart analysis and radiographic review were performed. Repeated fluoroscopically guided injections implicated a symptomatic L6-S1 facet joint contralateral to an anomalous lumbosacral articulation. Eventually, a successful surgical outcome was achieved with resection of the anomalous articulation. Clinicians should consider the possibility that mechanical low back pain may occur from a facet contralateral to a unilateral anomalous lumbosacral articulation, even in a young patient. Although reports of surgical treatment of Bertolotti's syndrome are infrequent, resection of the anomalous articulation provided excellent results in this patient, presumably because of reduced stresses on the symptomatic facet.
Does increased femoral antetorsion predispose to cartilage lesions of the patellofemoral joint?
Oppermann, Johannes; Bredow, Jan; Wissusek, Boris; Spies, Christian Karl; Boese, Christoph Kolja; Chang, Shi-Min; Eysel, Peer; Dargel, Jens
2017-09-01
The purpose of this study was to investigate whether there was a relationship between femoral neck antetorsion and the presence and pattern of osteoarthritis of the patellofemoral joint. It was hypothesized that an increased femoral neck antetorsion (1) correlates with osteoarthritic changes of the lateral facet of the patellofemoral joint and (2) correlates with an increased lateral trochlear height and a decreased sulcus angle. Seventy-eight formalin-embedded cadaveric lower extremities from thirty-nine subjects with a median age of 74 years (range 60-88) were used. Surrounding soft tissues of the lower limb were removed. The femoral neck antetorsion was measured and referenced to the transepicondylar axis and the posterior condylar line. The height of the medial and lateral facet of the trochlea and the sulcus angle was measured. The location and the degree of patellofemoral cartilage degeneration were recorded. A Pearson's correlation analysis was performed to correlate the femoral neck antetorsion with the measured knee parameters. No significant correlation could be found between the femoral antetorsion and cartilage degeneration of the lateral patellofemoral joint (n.s.), the height of the lateral trochlea (n.s.) and the sulcus angle (n.s.). This study could not document that the femoral neck antetorsion and subsequent internal rotation of the distal femur correlated with the degree of degeneration of the lateral facet of the patellofemoral joint. Clinically, femoral internal rotation may play a minor role in the development of lateral patellofemoral joint degeneration.
Coracoclavicular joint: osteologic study of 1020 human clavicles
Gumina, S; Salvatore, M; De Santis, P; Orsina, L; Postacchini, F
2002-01-01
We examined 1020 dry clavicles from cadavers of Italian origin to determine the prevalence of the coracoclavicular joint (ccj), a diarthrotic synovial joint occasionally present between the conoid tubercle of the clavicle and the superior surface of the horizontal part of the coracoid process. Five hundred and nine clavicles from individuals of different ages were submitted to X-ray examination. Using radiography, we measured the entire length and the index of sinuosity of the anterior lateral curve, on which the distance between the conoid tubercle and the coracoid process depends. We also used radiography to record the differences in prevalence of arthritis in two neighbouring joints, the acromioclavicular and sternoclavicular joints. Of the 1020 clavicles, eight (0.8%) displayed the articular facet of the ccj. No statistical correlation was found between clavicular length and the index of sinuosity of the anterior lateral curve. The prevalence of arthritis in clavicles with ccj was higher than that revealed in clavicles without ccj. The prevalence of ccj in the studied clavicles is lower than that observed in Asian cohorts. Furthermore, ccj is not conditioned by either length or sinuosity of the anterior lateral curve of the clavicle. Finally, the assumption that ccj is a predisposing factor for degenerative changes of neighbouring joints is statistically justified. PMID:12489763
Sheng, Sun-Ren; Wang, Ke; Nisar, Majid; Chen, Jiao-Xiang; Wu, Ai-Min; Wang, Xiang-Yang
2018-02-01
We sought to describe the novel technique and report the outcomes of cervical spondylotic radiculopathy caused by facet joint hyperplasia treated with minimally invasive surgery by laminar and lateral mass screw cofixations. In this retrospective study, patients with spondylotic radiculopathy caused by facet joint hyperplasia underwent this technique in our unit between January 2010 and June 2015. Hospital charts, magnetic resonance imaging studies, and follow-up records for all the patients were reviewed. Outcomes were assessed on the basis of neurologic status, magnetic resonance imaging, and visual analog scale for neck and radicular pain and by the short form-36 health survey questionnaire. Thirteen men and 5 women, aged 47-73 years (mean, 61.8 years), were included in this study. The follow-up time ranged from 19-50 months (mean, 32.4 months). The mean visual analog scale scores for radicular pain and neck pain, as well as the scores for all 8 domains of the short form-36 health survey questionnaire, showed significant improvements (P < 0.05). Cervical lordosis showed bending, whereas the height of the targeted disk segment showed no change (P > 0.05). Complications included 2 cases of neck pain that lasted for 3 months. Minimally invasive surgery by lamina and lateral mass screw cofixation is safe and effective for the treatment of cervical spondylotic radiculopathy caused by facet joint hyperplasia. In addition to sufficient decompression, this technique provides relative stability to the cervical spine. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.
Risk factors for degenerative spondylolisthesis: a systematic review
DeVine, John G.; Schenk-Kisser, Jeannette M.; Skelly, Andrea C.
2012-01-01
Study design: Systematic literature review. Rationale: Many authors have postulated on various risk factors associated with the pathogenesis of degenerative spondylolisthesis (DS), yet controversies regarding those risk factors still exist. Objective: To critically appraise and summarize evidence on risk factors for DS. Methods: Articles published before October 15, 2011, were systematically reviewed using PubMed and bibliographies of key articles. Each article was subject to quality rating and was analyzed by two independent reviewers. Results: From 382 citations, 30 underwent full-text review. Fourteen studies met inclusion criteria. All but two were considered poor quality. Female gender and higher facet joint angle were consistently associated with an increased risk of DS across multiple studies. Multiple studies also consistently reported no association between back pain and prolonged occupational sitting. Associations between age, parity, lumbosacral angle, lumbar lordosis, facet joint tropism, and pelvic inclination angles were inconsistent. Conclusions: There appears to be consistent evidence to suggest that the risk of DS increases with increasing age and is greater for females and people with a greater facet joint angle. PMID:23230415
Satoskar, Savni R.; Goel, Aimee A.; Mehta, Pooja H.; Goel, Atul
2014-01-01
Objective: The authors evaluate the anatomic subtleties of lumbar facets and assess the feasibility and effectiveness of use of ‘Goel facet spacer’ in the treatment of degenerative spinal canal stenosis. Materials and Methods: Twenty-five lumbar vertebral cadaveric dried bones were used for the purpose. A number of morphometric parameters were evaluated both before and after the introduction of Goel facet spacers within the confines of the facet joint. Results: The spacers achieved distraction of facets that was more pronounced in the vertical perspective. Introduction of spacers on both sides resulted in an increase in the intervertebral foraminal height and a circumferential increase in the spinal canal dimensions. Additionally, there was an increase in the disc space or intervertebral body height. The lumbar facets are more vertically and anteroposteriorly oriented when compared to cervical facets that are obliquely and transversely oriented. Conclusions: Understanding the anatomical peculiarities of the lumbar and cervical facets can lead to an optimum utilization of the potential of Goel facet distraction arthrodesis technique in the treatment of spinal degenerative canal stenosis. PMID:25558146
A new technique to treat facet joint pain with pulsed radiofrequency.
Schianchi, Pietro Martino
2015-02-01
Facet joint pain affects 5% to 15% of the population with low back pain and the prevalence increases with age due to progression of arthritis. While conservative treatments are often unsuccessful, the scientific evidence on minimally invasive therapies such as intra-articular steroid infiltration and continuous and pulsed radiofrequency (PRF) of the medial branches is contradictory. Since PRF has recently been reported to successfully treat joint pain, a new application of this method is proposed for facetogenic lumbar pain via an intra-articular subcapsular approach. Here we reported two cases with successful treatment. A 71-year-old patient presented because of persisting pain in the left gluteal region radiating to the lateral thigh and calf when standing. Anti-inflammatory drugs produced only short-lasting insufficient relief. A 52-year-old employee was admitted in June 2012 because of axial lower lumbar pain with intermittent diffuse radiation to the right lower extremity that worsened during walking and lying down despite receiving analgesics and physiotherapy. A new approach to treat lumbar facet joint pain with PRF is simple to perform and without serious complications. In view of the good long-lasting results obtained with the two reported cases, randomized control trials are necessary to validate this new approach.
FacetGist: Collective Extraction of Document Facets in Large Technical Corpora.
Siddiqui, Tarique; Ren, Xiang; Parameswaran, Aditya; Han, Jiawei
2016-10-01
Given the large volume of technical documents available, it is crucial to automatically organize and categorize these documents to be able to understand and extract value from them. Towards this end, we introduce a new research problem called Facet Extraction. Given a collection of technical documents, the goal of Facet Extraction is to automatically label each document with a set of concepts for the key facets ( e.g. , application, technique, evaluation metrics, and dataset) that people may be interested in. Facet Extraction has numerous applications, including document summarization, literature search, patent search and business intelligence. The major challenge in performing Facet Extraction arises from multiple sources: concept extraction, concept to facet matching, and facet disambiguation. To tackle these challenges, we develop FacetGist, a framework for facet extraction. Facet Extraction involves constructing a graph-based heterogeneous network to capture information available across multiple local sentence-level features, as well as global context features. We then formulate a joint optimization problem, and propose an efficient algorithm for graph-based label propagation to estimate the facet of each concept mention. Experimental results on technical corpora from two domains demonstrate that Facet Extraction can lead to an improvement of over 25% in both precision and recall over competing schemes.
FacetGist: Collective Extraction of Document Facets in Large Technical Corpora
Siddiqui, Tarique; Ren, Xiang; Parameswaran, Aditya; Han, Jiawei
2017-01-01
Given the large volume of technical documents available, it is crucial to automatically organize and categorize these documents to be able to understand and extract value from them. Towards this end, we introduce a new research problem called Facet Extraction. Given a collection of technical documents, the goal of Facet Extraction is to automatically label each document with a set of concepts for the key facets (e.g., application, technique, evaluation metrics, and dataset) that people may be interested in. Facet Extraction has numerous applications, including document summarization, literature search, patent search and business intelligence. The major challenge in performing Facet Extraction arises from multiple sources: concept extraction, concept to facet matching, and facet disambiguation. To tackle these challenges, we develop FacetGist, a framework for facet extraction. Facet Extraction involves constructing a graph-based heterogeneous network to capture information available across multiple local sentence-level features, as well as global context features. We then formulate a joint optimization problem, and propose an efficient algorithm for graph-based label propagation to estimate the facet of each concept mention. Experimental results on technical corpora from two domains demonstrate that Facet Extraction can lead to an improvement of over 25% in both precision and recall over competing schemes. PMID:28210517
Tailoring molecular specificity toward a crystal facet: a lesson from biorecognition toward Pt{111}.
Ruan, Lingyan; Ramezani-Dakhel, Hadi; Chiu, Chin-Yi; Zhu, Enbo; Li, Yujing; Heinz, Hendrik; Huang, Yu
2013-02-13
Surfactants with preferential adsorption to certain crystal facets have been widely employed to manipulate morphologies of colloidal nanocrystals, while mechanisms regarding the origin of facet selectivity remain an enigma. Similar questions exist in biomimetic syntheses concerning biomolecular recognition to materials and crystal surfaces. Here we present mechanistic studies on the molecular origin of the recognition toward platinum {111} facet. By manipulating the conformations and chemical compositions of a platinum {111} facet specific peptide, phenylalanine is identified as the dominant motif to differentiate {111} from other facets. The discovered recognition motif is extended to convert nonspecific peptides into {111} specific peptides. Further extension of this mechanism allows the rational design of small organic molecules that demonstrate preferential adsorption to the {111} facets of both platinum and rhodium nanocrystals. This work represents an advance in understanding the organic-inorganic interfacial interactions in colloidal systems and paves the way to rational and predictable nanostructure modulations for many applications.
Manchikanti, Laxmaiah; Helm Ii, Standiford; Pampati, Vidyasagar; Racz, Gabor B
2014-01-01
Multiple reviews have shown that interventional techniques for chronic pain have increased dramatically over the years. Of these interventional techniques, both sacroiliac joint injections and facet joint interventions showed explosive growth, followed by epidural procedures. Percutaneous adhesiolysis procedures have not been assessed for their utilization patterns separately from epidural injections. An analysis of the utilization patterns of percutaneous adhesiolysis procedures in managing chronic low back pain in the Medicare population from 2000 to 2011. To assess the utilization and growth patterns of percutaneous adhesiolysis in managing chronic low back pain. The study was performed utilizing the Centers for Medicare and Medicaid Services (CMS) Physician Supplier Procedure Summary Master of Fee-For-Service (FFS) Data from 2000 to 2011. Percutaneous adhesiolysis procedures increased 47% with an annual growth rate of 3.6% in the FFS Medicare population from 2000 to 2011. These growth rates are significantly lower than the growth rates for sacroiliac joint injections (331%), facet joint interventions (308%), and epidural injections (130%), but substantially lower than lumbar transforaminal injections (665%) and lumbar facet joint neurolysis (544%). Study limitations include lack of inclusion of Medicare Advantage patients. In addition, the statewide data is based on claims which may include the contiguous or other states. Percutaneous adhesiolysis utilization increased moderately in Medicare beneficiaries from 2000 to 2011. Overall, there was an increase of 47% in the utilization of adhesiolysis procedures per 100,000 Medicare beneficiaries, with an annual geometric average increase of 3.6%.
Wu, Jiuping; Zhou, Jingjing; Liu, Chibing; Zhang, Jun; Xiong, Wei; Lv, Yang; Liu, Rui; Wang, Ruiqiang; Du, Zhenwu; Zhang, Guizhen; Liu, Qinyi
2017-09-01
To compare the effectiveness and safety between autologous platelet-rich plasma (PRP) and Local Anesthetic (LA)/corticosteroid in intra-articular injection for the treatment of lumbar facet joint syndrome. Forty-six eligible patients with lumbar facet joint syndrome were randomized into group A (intra-articular injection with PRP) and group B (intra-articular injection with LA/corticosteroid). The following contents were evaluated: pain visual analog scale (VAS) at rest and during flexion, and the Roland-Morris Disability Questionnaire (RMQ), Oswestry Disability Index (ODI), and modified MacNab criteria for pain relief and applications of post-treatment drugs. All outcome assessments were performed immediately after and at 1 week, 1, 2, 3, and 6 months after treatment. No significant difference between groups was observed at baseline. Compared with pretreatment, both group A and group B demonstrated statistical improvements in the pain VAS score at rest or during flexion, the RMQ, and the ODI (P < 0.01). And there were significant differences between the 2 groups on the above-mentioned items (P < 0.05). For group B, subjective satisfaction based on the modified MacNab criteria and objective success rate were highest (80% and 85%) after 1 month, but only 50% and 20% after 6 months. However, for group A, they increased over time. In addition, there were no treatment-related complications in either group during follow-up. Both autologous PRP and LA/corticosteroid for intra-articular injection are effective, easy, and safe enough in the treatment of lumbar facet joint syndrome. However, autologous PRP is a superior treatment option for longer duration efficacy. © 2016 World Institute of Pain.
van Tilburg, C W J; Stronks, D L; Groeneweg, J G; Huygen, F J P M
2016-11-01
The aim of this study was to compare the effect of a percutaneous radiofrequency heat lesion at the medial branch of the primary dorsal ramus with a sham procedure, for the treatment of lumbar facet joint pain. A randomised sham-controlled double blind multicentre trial was carried out at the multidisciplinary pain centres of two hospitals. A total of 60 patients aged > 18 years with a history and physical examination suggestive of facet joint pain and a decrease of ≥ 2 on a numerical rating scale (NRS 0 to 10) after a diagnostic facet joint test block were included. In the treatment group, a percutaneous radiofrequency heat lesion (80 o C during 60 seconds per level) was applied to the medial branch of the primary dorsal ramus. In the sham group, the same procedure was undertaken without for the radiofrequency lesion. Both groups also received a graded activity physiotherapy programme. The primary outcome measure was decrease in pain. A secondary outcome measure was the Global Perceived Effect scale (GPE). There was a statistically significant effect on the level of pain in the factor Period (T0-T1). However, there was no statistically significant difference with the passage of time between the groups (Group × Period) or in the factor Group. In the crossover group, 11 of 19 patients had a decrease in NRS of ≥ 2 at one month crossover (p = 0.65). There was no statistically significant difference in satisfaction with the passage of time between the groups (Group × Period). The independent factors Group and Period also showed no statistically significant difference. There was no statistically significant Group × Period effect for recovery, neither an effect of Group or of Period. The null hypothesis of no difference in the decrease in pain and in GPE between the treatment and sham groups cannot be rejected. Post hoc analysis revealed that the age of the patients and the severity of the initial pain significantly predicted a positive outcome. Cite this article: Bone Joint J 2016;98-B:1526-33. ©2016 The British Editorial Society of Bone & Joint Surgery.
Manchikanti, Laxmaiah; Cash, Kimberly A; McManus, Carla D; Pampati, Vidyasagar; Benyamin, Ramsin
2012-01-01
Among the multiple causes of chronic low back pain, axial and discogenic pain are common. Various modalities of treatments are utilized in managing discogenic and axial low back pain including epidural injections. However, there is a paucity of evidence regarding the effectiveness, indications, and medical necessity of any treatment modality utilized for managing axial or discogenic pain, including epidural injections. In an interventional pain management practice in the US, a randomized, double-blind, active control trial was conducted. The objective was to assess the effectiveness of lumbar interlaminar epidural injections of local anesthetic with or without steroids for managing chronic low back pain of discogenic origin. However, disc herniation, radiculitis, facet joint pain, or sacroiliac joint pain were excluded. Two groups of patients were studied, with 60 patients in each group receiving either local anesthetic only or local anesthetic mixed with non-particulate betamethasone. Primary outcome measures included the pain relief-assessed by numeric rating scale of pain and functional status assessed by the, Oswestry Disability Index, Secondary outcome measurements included employment status, and opioid intake. Significant improvement or success was defined as at least a 50% decrease in pain and disability. Significant improvement was seen in 77% of the patients in Group I and 67% of the patients in Group II. In the successful groups (those with at least 3 weeks of relief with the first two procedures), the improvement was 84% in Group I and 71% in Group II. For those with chronic function-limiting low back pain refractory to conservative management, it is concluded that lumbar interlaminar epidural injections of local anesthetic with or without steroids may be an effective modality for managing chronic axial or discogenic pain. This treatment appears to be effective for those who have had facet joints as well as sacroiliac joints eliminated as the pain source. PMID:23055773
Sperry, Megan M.; Ita, Meagan E.; Kartha, Sonia; Zhang, Sijia; Yu, Ya-Hsin; Winkelstein, Beth
2017-01-01
Chronic joint pain is a widespread problem that frequently occurs with aging and trauma. Pain occurs most often in synovial joints, the body's load bearing joints. The mechanical and molecular mechanisms contributing to synovial joint pain are reviewed using two examples, the cervical spinal facet joints and the temporomandibular joint (TMJ). Although much work has focused on the macroscale mechanics of joints in health and disease, the combined influence of tissue mechanics, molecular processes, and nociception in joint pain has only recently become a focus. Trauma and repeated loading can induce structural and biochemical changes in joints, altering their microenvironment and modifying the biomechanics of their constitutive tissues, which themselves are innervated. Peripheral pain sensors can become activated in response to changes in the joint microenvironment and relay pain signals to the spinal cord and brain where pain is processed and perceived. In some cases, pain circuitry is permanently changed, which may be a potential mechanism for sustained joint pain. However, it is most likely that alterations in both the joint microenvironment and the central nervous system (CNS) contribute to chronic pain. As such, the challenge of treating joint pain and degeneration is temporally and spatially complicated. This review summarizes anatomy, physiology, and pathophysiology of these joints and the sensory pain relays. Pain pathways are postulated to be sensitized by many factors, including degeneration and biochemical priming, with effects on thresholds for mechanical injury and/or dysfunction. Initiators of joint pain are discussed in the context of clinical challenges including the diagnosis and treatment of pain. PMID:28056123
Electrostatics-driven assembly of uni-lamellar catanionic facetted vesicles
NASA Astrophysics Data System (ADS)
Leung, Cheuk-Yui; Palmer, Liam; Kewalramani, Sumit; Sknepnek, Rastko; Vernizzi, Graziano; Greenfield, Megan; Stupp, Samuel; Bedzyk, Michael; Olvera de La Cruz, Monica
2012-02-01
Nature utilizes shape to generate function. Organelle and halophilic bacteria wall envelopes, for example, adopt various polyhedral shapes to compartmentalize matter. The origin of these shapes is unknown. A large variety of shell geometries, either fully faceted polyhedra or mixed Janus-like vesicles with faceted and curved domains that resemble cellular shells can be generated by coassembling water-insoluble anionic (--1) amphiphiles with high valence cationic (+2 and +3) amphiphiles. Electron microscopy, X-ray scattering, theory and simulations demonstrate that the resulting faceted ionic shells are crystalline, and stable at high salt concentrations. The crystallization of the co-assembled single tail amphiphiles is induced by ionic correlations, and modified by the solution pH. This work promotes the design of faceted shapes for various applications and improves our understanding of the origin of polyhedral shells in nature.
Defeaturing CAD models using a geometry-based size field and facet-based reduction operators.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Quadros, William Roshan; Owen, Steven James
2010-04-01
We propose a method to automatically defeature a CAD model by detecting irrelevant features using a geometry-based size field and a method to remove the irrelevant features via facet-based operations on a discrete representation. A discrete B-Rep model is first created by obtaining a faceted representation of the CAD entities. The candidate facet entities are then marked for reduction by using a geometry-based size field. This is accomplished by estimating local mesh sizes based on geometric criteria. If the field value at a facet entity goes below a user specified threshold value then it is identified as an irrelevant featuremore » and is marked for reduction. The reduction of marked facet entities is primarily performed using an edge collapse operator. Care is taken to retain a valid geometry and topology of the discrete model throughout the procedure. The original model is not altered as the defeaturing is performed on a separate discrete model. Associativity between the entities of the discrete model and that of original CAD model is maintained in order to decode the attributes and boundary conditions applied on the original CAD entities onto the mesh via the entities of the discrete model. Example models are presented to illustrate the effectiveness of the proposed approach.« less
Goel, Atul; Shah, Abhidha; Jadhav, Madan; Nama, Santhosh
2013-12-01
The authors report their experience in treating 21 patients by using a novel form of treatment of lumbar degenerative disease that leads to canal stenosis. The surgery involved distraction of the facets using specially designed Goel intraarticular spacers and was aimed at arthrodesis of the spinal segment in a distracted position. The operation is based on the premise that subtle and longstanding facet instability, joint space reduction, and subsequent facet override had a profound and primary influence in the pathogenesis of degenerative lumbar canal stenosis. The surgical technique and the rationale for treatment are discussed. Between April 2006 and January 2011, 21 cases of lumbar degenerative disease resulting in characteristic lumbar canal stenosis were treated in the authors' department with the proposed technique. The patients were prospectively analyzed. There were 15 men and 6 women who ranged in age from 48 to 71 years (mean 58 years). Nine patients underwent 1-level and 12 patients underwent 2-level treatment. Surgery involved wide opening of the articular joint, denuding of the articular capsule/endplate cartilage, distraction of the facets, and forced impaction of Goel intraarticular spacers. Bone graft pieces obtained by sectioning the spinous processes were placed within and over the joint and in the midline over the adequately prepared host area of laminae. The Oswestry Disability Index and visual analog scale were used to clinically assess the patients before and after surgery and at follow-up. The alterations in the physical architecture of spinal canal and intervertebral foramen dimensions were evaluated before and after placement of the intrafacet implant and after at least 6 months of follow-up. All patients had varying degrees of relief from symptoms of local back pain and radiculopathy. Impaction of spacers within the facet joints resulted in an increase in the spinal canal and intervertebral root canal dimensions (mean 2.33 mm), reduction of buckling of the ligamentum flavum, and reduction of the extent of bulge of the disc into the spinal canal. The procedure resulted in firm stabilization and fixation of the spinal segment and provided a ground for arthrodesis. No patient worsened neurologically after treatment. During the follow-up period, all patients had evidence of segmental bone fusion. No patient underwent reexploration or further surgery of the lumbar spine. Impaction of the spacers within the articular cavity after facet distraction resulted in reversal of several effects of spine degeneration that had caused spinal and root canal stenosis. The safe, firm, and secure stabilization at the fulcrum of lumbar spinal movements provided a ground for segmental spinal arthrodesis. The immediate postoperative and lasting recovery from symptoms suggests the validity of the procedure.
Development and Validation of the Faceted Inventory of the Five-Factor Model (FI-FFM).
Watson, David; Nus, Ericka; Wu, Kevin D
2017-06-01
The Faceted Inventory of the Five-Factor Model (FI-FFM) is a comprehensive hierarchical measure of personality. The FI-FFM was created across five phases of scale development. It includes five facets apiece for neuroticism, extraversion, and conscientiousness; four facets within agreeableness; and three facets for openness. We present reliability and validity data obtained from three samples. The FI-FFM scales are internally consistent and highly stable over 2 weeks (retest rs ranged from .64 to .82, median r = .77). They show strong convergent and discriminant validity vis-à-vis the NEO, the Big Five Inventory, and the Personality Inventory for DSM-5. Moreover, self-ratings on the scales show moderate to strong agreement with corresponding ratings made by informants ( rs ranged from .26 to .66, median r = .42). Finally, in joint analyses with the NEO Personality Inventory-3, the FI-FFM neuroticism facet scales display significant incremental validity in predicting indicators of internalizing psychopathology.
Schweitzer, Karl M; Vaccaro, Alexander R; Harrop, James S; Hurlbert, John; Carrino, John A; Rechtine, Glenn R; Schwartz, David G; Alanay, Ahmet; Sharma, Dinesh K; Anderson, D Greg; Lee, Joon Y; Arnold, Paul M
2007-09-01
The Spine Trauma Study Group (STSG) has proposed a novel thoracolumbar injury classification system and score (TLICS) in an attempt to define traumatic spinal injuries and direct appropriate management schemes objectively. The TLICS assigns specific point values based on three variables to generate a final severity score that guides potential treatment options. Within this algorithm, significant emphasis has been placed on posterior ligamentous complex (PLC) integrity. The purpose of this study was to determine the interrater reliability of indicators surgeons use when assessing PLC disruption on imaging studies, including computed tomography (CT) and magnetic resonance imaging (MRI). Orthopedic surgeons and neurosurgeons retrospectively reviewed a series of thoracolumbar injury case studies. Thirteen case studies, including images, were distributed to STSG members for individual, independent evaluation of the following three criteria: (1) diastasis of the facet joints on CT; (2) posterior edema-like signal in the region of PLC components on sagittal T2-weighted fat saturation (FAT SAT) MRI; and (3) disrupted PLC components on sagittal T1-weighted MRI. Interrater agreement on the presence or absence of each of the three criteria in each of the 13 cases was assessed. Absolute interrater percent agreement on diastasis of the facet joints on CT and posterior edema-like signal in the region of PLC components on sagittal T2-weighted FAT SAT MRI was similar (agreement 70.5%). Interrater agreement on disrupted PLC components on sagittal T1-weighted MRI was 48.9%. Facet joint diastasis on CT was the most reliable indicator of PLC disruption as assessed by both Cohen's kappa (kappa = 0.395) and intraclass correlation coefficient (ICC 0.430). The interrater reliability of assessing diastasis of the facet joints on CT had fair to moderate agreement. The reliability of assessing the posterior edema-like signal in the region of PLC components was lower but also fair, whereas the reliability of identifying disrupted PLC components was poor.
Kelekis, Alexios; Filippiadis, Dimitrios K; Velonakis, Georgios; Martin, Jean-Baptist; Oikonomopoulos, Nikolaos; Brountzos, Elias; Kelekis, Nikolaos
2014-01-01
Transforaminal infiltrations in the cervical spine are governed by a higher rate of vascular puncture than in the lumbar spine. The purpose of our study is to assess the safety and efficacy of percutaneous, fluoroscopically guided nerve root infiltrations in cases of cervical radiculopathy. An indirect postero-lateral approach was performed through the ipsilateral facet joint. During the last 2 years, 25 patients experiencing cervical radiculopathy underwent percutaneous, fluoroscopically guided nerve root infiltrations by means of an indirect postero-lateral approach through the ipsilateral facet joint. The intra-articular position of the needle (22-gauge spinal needle) was fluoroscopically verified after injection of a small amount of contrast medium which also verified dispersion of the contrast medium periradicularly and in the epidural space. Then a mixture of long-acting glucocorticosteroid diluted in normal saline (1.5/1 mL) was injected intra-articularly. A questionnaire with a Numeric Visual Scale (NVS) scale helped assess pain relief, life quality, and mobility improvement. A mean of 2.3 sessions was performed in the patients of our study. In the vast majority of our patients 19/25 (76%), the second infiltration was performed within 7-10 days of the first one. Comparing the pain scores prior (mean value 8.80 ± 1.080 NVS units) and after (mean value 1.84 ± 1.405 NVS units), there was a mean decrease of 6.96 ± 1.695 NVS units [median value 7 NVS units (P < 0.001) in terms of pain reduction, effect upon mobility, and life quality. There were no clinically significant complications noted in our study. Fluoroscopically guided transforaminal infiltrations through the ipsilateral facet joint seem to be a feasible, efficacious, and safe approach for the treatment of patients with cervical radiculopathy. This approach facilitates needle placement and minimizes risk of complications.
Moumene, Missoum; Geisler, Fred H
2007-08-01
Finite element model. To estimate the effect of lumbar mobile-core and fixed-core artificial disc design and placement on the loading of the facet joints, and stresses on the polyethylene core. Although both mobile-core and fixed-core lumbar artificial disc designs have been used clinically, the effect of their design and the effect of placement within the disc space on the structural element loading, and in particular the facets and the implant itself, have not been investigated. A 3D nonlinear finite element model of an intact ligamentous L4-L5 motion segment was developed and validated in all 6 df based on previous experiments conducted on human cadavers. Facet loading of a mobile-core TDR and a fixed-core TDR were estimated with 4 different prosthesis placements for 3 different ranges of motion. Placing the mobile-core TDR anywhere within the disc space reduced facet loading by more than 50%, while the fixed-core TDR increased facet loading by more than 10% when compared with the intact disc in axial rotation. For central (ideal) placement, the mobile- and fixed-core implants were subjected to compressive stresses on the order of 3 MPa and 24 MPa, respectively. The mobile-core stresses were not affected by implant placement, while the fixed-core stresses increased by up to 40%. A mobile-core artificial disc design is less sensitive to placement, and unloads the facet joints, compared with a fixed-core design. The decreased core stress may result in a reduced potential for wear in a mobile-core prosthesis compared with a fixed-core prosthesis, which may increase the functional longevity of the device.
ERIC Educational Resources Information Center
New York City Office of the Special Commissioner of Investigation, NY.
In recent years, sex abuse scandals have struck schools around the country. This report contends that the way to address sexual abuse is to face it head on and to develop a comprehensive program to attack every facet of the problem. It is the multi-faceted nature of child sexual abuse that dictates this comprehensive approach. It is recommended…
Role of facet curvature for accurate vertebral facet load analysis.
Holzapfel, Gerhard A; Stadler, Michael
2006-06-01
The curvature of vertebral facet joints may play an important role in the study of load-bearing characteristics and clinical interventions such as graded facetectomy. In previously-published finite element simulations of this procedure, the curvature was either neglected or approximated with a varying degree of accuracy. Here we study the effect of the curvature in three different load situations by using a numerical model which is able to represent the actual curvature without any loss of accuracy. The results show that previously-used approximations of the curvature lead to good results in the analysis of sagittal moment/rotation. However, for sagittal shear-force/displacement and for the contact stress distribution, previous results deviate significantly from our results. These findings are supported through related convergence studies. Hence we can conclude that in order to obtain reliable results for the analysis of sagittal shear-force/displacement and the contact stress distribution in the facet joint, the curvature must not be neglected. This is of particular importance for the numerical simulation of the spine, which may lead to improved diagnostics, effective surgical planning and intervention. The proposed method may represent a more reliable basis for optimizing the biomedical engineering design for tissue engineering or, for example, for spinal implants.
Computed tomography of calcaneal fractures: anatomy, pathology, dosimetry, and clinical relevance
DOE Office of Scientific and Technical Information (OSTI.GOV)
Guyer, B.H.; Levinsohn, E.M.; Fredrickson, B.E.
1985-11-01
Eighteen CT examinations were performed in 10 patients for the evaluation of acute intraarticular fractures and their follow-up. Fractures comparable to those in the patients were created in cadavers. The normal anatomy and the traumatically altered anatomy of the calcaneus in the axial, coronal, and sagittal planes are demonstrated by CT and corresponding anatomic sections. Scanning was performed in the axial plane, with subsequent reconstruction in the coronal and sagittal planes. The axial scans show disruption of the inferior part of the posterior facet, calcaneocuboid joint involvement, and widening of the calcaneus. The coronal scans show disruption of the superiormore » part of the posterior facet, sustentaculum tali depression (involvement of middle and anterior facets), peroneal and flexor hallucis longus tendon impingement, and widening and height loss of the calcaneus. The sagittal scans show disruption of the posterior facet, calcaneocuboid joint involvement, and height loss of the calcaneus and allow the evaluation of Boehler's and Gissane's angles. All three planes show the position of major fracture fragments. Radiation dose to the foot was measured to be 0.1 rad (0.001 Gy) for plain film radiography (five exposures), 18 rad (0.18 Gy) for conventional tomography (20 cuts), and 2.6 rad (0.026 Gy) for axial CT examination.« less
Arslan, G; Ceken, K; Cubuk, M; Ozkaynak, C; Lüleci, E
2001-01-01
To review the prevalence and location of vertebral pneumatocysts and evaluate the CT findings of these benign lesions. Retrospectively we reviewed CT images of 89 patients with suspected disc disease during a 6-month period. Distinctive CT pattern of intraosseous pneumatocysts involving the cervical, thoracic and lumbar spine was found. In 8 patients (9%), 10 vertebral pneumatocysts were detected. Five were located in the vertebral body and 4 of these were associated with vacuum phenomenon in adjacent intervertebral discs. Five were located near the facet joint and all were associated with vacuum phenomenon in adjacent facet joint. Intraosseous pneumatocyst is a benign lesion, therefore biopsy and follow-up are unnecessary. Although vertebral pneumatocysts seem to be uncommon with a few reported cases, this study shows them to be more frequent than previously thought.
Zhang, Tiankai; Long, Mingzhu; Yan, Keyou; Zeng, Xiaoliang; Zhou, Fengrui; Chen, Zefeng; Wan, Xi; Chen, Kun; Liu, Pengyi; Li, Faming; Yu, Tao; Xie, Weiguang; Xu, Jianbin
2016-11-30
Quantification of intergrain length scale properties of CH 3 NH 3 PbI 3 (MAPbI 3 ) can provide further understanding of material physics, leading to improved device performance. In this work, we noticed that two typical types of facets appear in sequential deposited perovskite (SDP) films: smooth and steplike morphologies. By mapping the surface potential as well as the photoluminescence (PL) peak position, we revealed the heterogeneity of SDP thin films that smooth facets are almost intrinsic with a PL peak at 775 nm, while the steplike facets are p-type-doped with 5-nm blue-shifted PL peak. Considering the reaction process, we propose that the smooth facets have well-defined crystal lattices that resulted from the interfacial reaction between MAI and PbI 2 domains containing low trap states density. The steplike facets are MAI-rich originated from the grain boundaries of PbI 2 film and own more trap states. Conversion of steplike facets to smooth facets can be controlled by increasing the reaction time through Ostwald ripening. The improved stability, photoresponsivity up to 0.3 A/W, on/off ratio up to 3900, and decreased photo response time to ∼160 μs show that the trap states can be annihilated effectively to improve the photoelectrical conversion with prolonged reaction time and elimination of steplike facets. Our findings demonstrate the relationship between the facet heterogeneity of SDP films and crystal growth process for the first time, and imply that the systematic control of crystal grain modification will enable amelioration of crystallinity for more-efficient perovskite photoelectrical applications.
Uzel, A-P; Bulla, A; Laurent-Joye, M; Caix, P
2011-08-01
The Henry approach is the classical anterolateral surgical exposure of the volar aspect of the distal radius. This approach does not allow good access to the medial side of the volar distal radius (lunate facet) and the distal radio-ulnar joint, unless it is extended proximally, retracting the tendons and the median nerve medially, which can cause some trauma. The purpose of our study was to investigate the anatomic basis and to outline the advantages of the unusual anteromedial approach, reporting our experience in the treatment of 4 distal radius fractures, with a 90° or 180° twist of the lunate facet, and 10 wrist dissections on cadavers. The average follow-up was 68.8 months (range 18 to 115 months). In our series, this approach did not cause any nerve injuries or any sensory loss of the distal forearm and the palm. All the fractures of the lunate facet and of the radial styloid process healed. One patient with an ulnar styloid process fracture associated showed pseudarthrosis, but with no instability of the distal radio-ulnar joint or pain on the ulnar side. Using the criteria of Green and O'Brien, modified by Cooney, the results were: excellent in two cases, good in one case, and average in another. The evaluation of arthritis according to Knirk and Jupiter's classification showed grade 0 in three cases and grade 3 in one case with osteochondral sclerosis. We showed that the anteromedial approach is reliable and convenient in the case of fractures situated in the antero-medial portion of the radius, for the double objective of reducing the fracture under direct control and checking the congruence of the distal radio-ulnar joint.
Morphometric Study of Clavicular Facet of Coracoclavicular Joint in Adult Indian Population
Mahajan, Anita; Vasudeva, Neelam
2016-01-01
Introduction Anthropologists have used Coracoclavicular Joint (CCJ), a non-metric anatomical variant in population, as a marker for population migration from prehistoric times to present. Aim The aim of this osteological study was to determine the incidence and morphometry of articular facet of CCJ on conoid tubercle of clavicle in Indian population, as Indian studies are scanty and incomplete. Materials and Methods The study was done on 144 adult human clavicles (76 right and 68 left; 93 males and 51 females) collected from osteology museum in Department of Anatomy, Maulana Azad Medical College, New Delhi, India. The presence of articular facet on the conoid tubercle was determined and Maximum Antero-Posterior (MAPD) and maximum transverse diameter (MTD) was measured by digital vernier calliper. The incidence was compared on the basis of sex, side and with other osteological studies in the world. Statistical analysis was done using the Chi-Square test for nominal categorical data and student’s t-test for normally distributed continuous variables in Microsoft Excel 2007 to assess the relationship between the examined variables. Results Articular facet on conoid tubercle was found in 8 cases (5.6%). Seven (9.2%) were present on the right side and one (1.5%) on the left side. Seven cases (7.5%) were present in males and one case (2%) was found in females. The facets were generally oval, with MAPD and MTD of 12.28 and 17.17 mm respectively. A significant side variation was present with right sided facet being more common. The left sided facet was more transversely elongated than right. In males, the facets were more elongated antero-posteriorly than in females. Conclusion The Indian population showed an incidence of 5.6%, which was comparable to other ethnic groups in world population. The morphometric and side differences could be attributed to the occupational factors and range of movements associated with the CCJ. The CCJ should be borne in mind as a differential diagnosis for thoracic outlet syndrome and in general for shoulder pain. PMID:27190785
Lumbar Facet Tropism: A Comprehensive Review.
Alonso, Fernando; Kirkpatrick, Christina M; Jeong, William; Fisahn, Christian; Usman, Sameera; Rustagi, Tarush; Loukas, Marios; Chapman, Jens R; Oskouian, Rod J; Tubbs, R Shane
2017-06-01
Scattered reports exist in the medical literature regarding facet tropism. However, this finding has had mixed conclusions regarding its origin and impact on the normal spine. We performed a literature review of the anatomy, embryology, biomechanics, and pathology related to lumbar facet tropism. Facet tropism is most commonly found at L4-L5 vertebral segments and there is some evidence that this condition may lead to facet degenerative spondylolisthesis, intervertebral disc disease, and other degenerative conditions. Long-term analyses of patients are necessary to elucidate relationships between associated findings and facet tropism. In addition, a universally agreed definition that is more precise should be developed for future investigative studies. Copyright © 2017 Elsevier Inc. All rights reserved.
Posterior Epidural Migration of an Extruded Lumbar Disc Mimicking a Facet Cyst: A Case Report
Yoo, Young Sun; Ju, Chang Il; Kim, Dong Min
2015-01-01
Dorsal extradural migration of extruded disc material is clinically uncommon. We report a rare case of posterior epidural migration of an extruded lumbar disc mimicking a facet cyst. A 32-year-old man was admitted to our institute with a 2-week history of severe low back pain and radiating pain in the left leg. The magnetic resonance (MR) images revealed a dorsally located, left-sided extradural cystic mass at the L2-3 level. The initial diagnosis was an epidural facet cyst because of the high signal intensity on MR images and its location adjacent to the facet joint. Intraoperatively, an encapsulated mass of soft tissue adherent to the dural sac was observed and excised. The pathological diagnosis was degenerated disc material. After surgery, the patient experienced complete relief from leg pain. PMID:25883662
Cardoso, Mario J; Dmitriev, Anton E; Helgeson, Melvin; Lehman, Ronald A; Kuklo, Timothy R; Rosner, Michael K
2008-12-15
This is an in vitro biomechanical study. The current investigation was performed to evaluate adjacent level kinematic change following unilateral and bilateral facet violation and laminectomy following 1-, 2-, and 3-level reconstruction. The incidence of superior-segment facet violation with lumbar transpedicular fixation has been reported as high as 35%; however, its contribution to biomechanical instability at the supradjacent level is unknown. In addition, superior-segment laminectomy has been implicated as a risk factor for the development of adjacent level disease. The authors assess the acute biomechanical effects of proximal facet violation and subsequent laminectomy in an instrumented posterior fusion model in 10 cadaveric specimens. Biomechanical testing was performed on 10 human cadaveric spines under axial rotation (AR), flexion-extension (FE), and lateral bending (LB) loading. After intact analysis, pedicle screws were inserted from L5-S1 and testing repeated with: (1) preserved L4-L5 facets, (2) unilateral facet breach, (3) bilateral breach, and (4) L5 laminectomy. Following biomechanical analysis, instrumentation was extended to L4, then L3 and biomechanical testing repeated. Full range of motion (ROM) at the proximal adjacent levels were recorded and normalized to intact (100%). Supradjacent level ROM was increased for all groups under all loading methods relative to intact (P < 0.05). However, AR testing revealed progressive instability at the adjacent level in groups 3 and 4, relative to group 1, following 1-, 2- and 3-level fixation (P < 0.05). During FE, supradjacent level ROM was significantly increased for group 4 specimens compared with group 1 after L5-S1 fixation (P < 0.05), and was greater than all other groups for L3-S1 constructs (P < 0.05). Interestingly, under lateral bending, facet joint destabilization did not change adjacent segment ROM. There were significant changes in proximal level ROM immediately after posterior stabilization. However, an additional increase in supradjacent segment ROM was recorded during AR after bilateral facet breach.Subsequent complete laminectomy at the uppermostfixation level further destabilized the supradjacent segment in FE and AR. Therefore, meticulous preservation of the cephalad-most segment facet joints-is paramount to ensure stability.
Facet orientation in the thoracolumbar spine: three-dimensional anatomic and biomechanical analysis.
Masharawi, Youssef; Rothschild, Bruce; Dar, Gali; Peleg, Smadar; Robinson, Dror; Been, Ella; Hershkovitz, Israel
2004-08-15
Thoracolumbar facet orientations were measured and analyzed. To establish a comprehensive database for facet orientation in the thoracolumbar vertebrae and to determine the normal human condition. Most studies on facet orientation have based their conclusions on two-dimensional measurements, in small samples or isolated vertebrae. The amount of normal asymmetry in facet orientation is poorly addressed. Transverse and longitudinal facet angles were measured directly from 240 human vertebral columns (males/females, blacks/whites). The specimens' osteologic material is part of the Hamann-Todd Osteological Collection housed at the Cleveland Museum of Natural History (Cleveland, OH). A total of 4,080 vertebrae (T1-L5) from the vertebral columns of individuals 20 to 80 years of age were measured, using a Microscribe three-dimensional apparatus (Immersion Co., San Jose, CA). Data were recorded directly on computer software. Statistical analysis included paired t tests and analysis of variance. RESULTS.: Facet orientation is independent of gender, age, and ethnic group. Asymmetry in facet orientation is found in the thorax. All thoracolumbar facets are positioned in an oblique plane. In the transverse plane, all facets from T1 to T11 are positioned with an anterior inclination of approximately 25 degrees to 30 degrees from the frontal plane. The facets of T12-L2 are oriented closer to the midsagittal plane of the vertebral body (mean range, 25.89 degrees-33.87 degrees), while the facets of L3-L5 are oriented away from that plane (mean range, 40.40 degrees-56.30 degrees). Facet transverse orientation at the thoracolumbar junction is highly variable (approximately 80% with approximately 101 degrees and approximately 20% with 35 degrees). All facets are oriented more vertically from T1 (approximately 150 degrees) to L5 (approximately 170 degrees). The facet sagittal orientations of the lumbar zygoapophyseal joints are not equivalent. CONCLUSIONS.: Asymmetry in facet orientation is a normal characteristic in the thorax.
Computed tomography of calcaneal fractures
DOE Office of Scientific and Technical Information (OSTI.GOV)
Heger, L.; Wulff, K.; Seddiqi, M.S.A.
1985-07-01
Computed tomography (CT) of 25 fractured calcanei was performed to investigate the potential of CT in evaluating the pattern and biomechanics of these fractures. The characteristic findings of typical fractures are presented, including the number and type of principal fragments, size and dislocation of the sustentacular fragment, and involvement of the anterior and posterior facets of the subtalar joint. In 17 cases, the calcaneus consisted of four or more fragments. Furthermore, in 17 cases the sustentacular fragment included all or part of the posterior facet joint. In 18 of the 25 cases, the sustentacular fragment was displaced. It is concludedmore » that well performed CT is an invaluable adjunct in understanding the fracture mechanism and in detecting pain-provoking impingement between the fibular malleolus and the tuberosity fragment.« less
Gill, Corey M; Bredella, Miriam A; DeSilva, Jeremy M
2015-11-01
The medial cuneiform, namely the curvature and angulation of its distal facet with metatarsal 1, is crucial as a stabilizer in bipedal locomotion and an axis upon which the great toe medially deviates during arboreal locomotion in extant apes. Previous work has shown that facet curvature and angulation in adult dry-bone specimens can distinguish African apes from Homo, and can even distinguish among species of Gorilla. This study provides the first ontogenetic assessment of medial cuneiform curvature and angulation in juvenile (n = 68) and adult specimens (n = 102) using computed tomography in humans and extant ape specimens, including Pongo. Our data find that modern human juveniles initially have a convex and slightly medially oriented osseous surface of the developing medial cuneiform distal facet that flattens and becomes more distally oriented with age. The same pattern (though of a different magnitude) occurs developmentally in the chimpanzee medial cuneiform, but not in Gorilla or Pongo, whose medial cuneiform facet angulation remains unchanged ontogenetically. These data suggest that the medial cuneiform ossifies in a distinguishable pattern between Pongo, Gorilla, Pan, and Homo, which may in part be due to subtle differences in the loading environment at the hallucal tarsometatarsal joint-a finding that has important implications for interpreting fossil medial cuneiforms. Copyright © 2015 Elsevier Ltd. All rights reserved.
Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain
Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D.; Hirsch, Joshua A.
2017-01-01
Background:Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design:Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives:To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results:The results showed direct procedural costs per one-year improvement in quality adjusted life year (QALY) of United States Dollar (USD) of $2,552, and overall costs of USD $4,261. Overall, each patient on average received 5.7 ± 2.2 procedures over a period of 2 years. Average significant improvement per procedure was 15.6 ± 12.3 weeks and average significant improvement in 2 years per patient was 86.0 ± 24.6 weeks. Limitations:The limitations of this cost utility analysis are that data are based on a single center evaluation. Only costs of therapeutic interventional procedures and physician visits were included, with extrapolation of indirect costs. Conclusion:The cost utility analysis of therapeutic cervical medial branch blocks in the treatment of chronic neck pain non-responsive to conservative management demonstrated clinical effectiveness and cost utility at USD $4,261 per one year of QALY. PMID:29200944
Cost Utility Analysis of Cervical Therapeutic Medial Branch Blocks in Managing Chronic Neck Pain.
Manchikanti, Laxmaiah; Pampati, Vidyasagar; Kaye, Alan D; Hirsch, Joshua A
2017-01-01
Background: Controlled diagnostic studies have established the prevalence of cervical facet joint pain to range from 36% to 67% based on the criterion standard of ≥ 80% pain relief. Treatment of cervical facet joint pain has been described with Level II evidence of effectiveness for therapeutic facet joint nerve blocks and radiofrequency neurotomy and with no significant evidence for intraarticular injections. However, there have not been any cost effectiveness or cost utility analysis studies performed in managing chronic neck pain with or without headaches with cervical facet joint interventions. Study Design: Cost utility analysis based on the results of a double-blind, randomized, controlled trial of cervical therapeutic medial branch blocks in managing chronic neck pain. Objectives: To assess cost utility of therapeutic cervical medial branch blocks in managing chronic neck pain. Methods: A randomized trial was conducted in a specialty referral private practice interventional pain management center in the United States. This trial assessed the clinical effectiveness of therapeutic cervical medial branch blocks with or without steroids for an established diagnosis of cervical facet joint pain by means of controlled diagnostic blocks. Cost utility analysis was performed with direct payment data for the procedures for a total of 120 patients over a period of 2 years from this trial based on reimbursement rates of 2016. The payment data provided direct procedural costs without inclusion of drug treatments. An additional 40% was added to procedural costs with multiplication of a factor of 1.67 to provide estimated total costs including direct and indirect costs, based on highly regarded surgical literature. Outcome measures included significant improvement defined as at least a 50% improvement with reduction in pain and disability status with a combined 50% or more reduction in pain in Neck Disability Index (NDI) scores. Results: The results showed direct procedural costs per one-year improvement in quality adjusted life year (QALY) of United States Dollar (USD) of $2,552, and overall costs of USD $4,261. Overall, each patient on average received 5.7 ± 2.2 procedures over a period of 2 years. Average significant improvement per procedure was 15.6 ± 12.3 weeks and average significant improvement in 2 years per patient was 86.0 ± 24.6 weeks. Limitations: The limitations of this cost utility analysis are that data are based on a single center evaluation. Only costs of therapeutic interventional procedures and physician visits were included, with extrapolation of indirect costs. Conclusion: The cost utility analysis of therapeutic cervical medial branch blocks in the treatment of chronic neck pain non-responsive to conservative management demonstrated clinical effectiveness and cost utility at USD $4,261 per one year of QALY.
NASA Astrophysics Data System (ADS)
Diver, Richard B.; Jones, Scott; Robb, Stacy; Mahoney, A. Rod
1995-05-01
Two test bed concentrators (TBC's) were designed to provide high-performance test beds for advanced solar receivers and converters. However, the second-surface silvered-glass mirror facets on the TBC's, which were originally manufactured by the Jet Propulsion Laboratory, have experienced severe silver corrosion. To restore reflectance, TBC-2 was refurbished with a lustering technique developed at Sandia National Laboratories. In the lustering technique, second-surface silvered thin-glass mirrors were applied over the corroded facets, thereby increasing the dish reflectivity and raising the available power of TBC-2 from approximately 70 to 78 kW(sub t). Degradation of the original optical accuracy of the TBC facets was determined to be minimal. Lustering was chosen over facet replacement because of the lower cost, the anticipated improvement in corrosion resistance, and the shorter project duration. This report includes background information, details of the lustering process, and test results from TBC-2 characterization, both before and after lustering.
... is called the conus medullaris. There is a thread that continues from the conus called the filum ... bodies, the facet joint created by their articular processes, the intervertebral disc between them and the associated ...
Manchikanti, Laxmaiah; Cash, Kimberly A; Pampati, Vidyasagar; Malla, Yogesh
2014-01-01
A randomized, double-blind, active-controlled trial. To assess the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of axial or discogenic pain in patients without disc herniation, radiculitis, or facet joint pain. Cervical discogenic pain without disc herniation is a common cause of suffering and disability in the adult population. Once conservative management has failed and facet joint pain has been excluded, cervical epidural injections may be considered as a management tool. Despite a paucity of evidence, cervical epidural injections are one of the most commonly performed nonsurgical interventions in the management of chronic axial or disc-related neck pain. One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain as determined by means of controlled diagnostic medial branch blocks were randomly assigned to one of the 2 treatment groups. Group I patients received cervical interlaminar epidural injections of local anesthetic (lidocaine 0.5%, 5 mL), whereas Group II patients received 0.5% lidocaine, 4 mL, mixed with 1 mL or 6 mg of nonparticulate betamethasone. The primary outcome measure was ≥ 50% improvement in pain and function. Outcome assessments included numeric rating scale (NRS), Neck Disability Index (NDI), opioid intake, employment, and changes in weight. Significant pain relief and functional improvement (≥ 50%) was present at the end of 2 years in 73% of patients receiving local anesthetic only and 70% receiving local anesthetic with steroids. In the successful group of patients, however, defined as consistent relief with 2 initial injections of at least 3 weeks, significant improvement was illustrated in 78% in the local anesthetic group and 75% in the local anesthetic with steroid group at the end of 2 years. The results reported at the one-year follow-up were sustained at the 2-year follow-up. Cervical interlaminar epidural injections with or without steroids may provide significant improvement in pain and functioning in patients with chronic discogenic or axial pain that is function-limiting and not related to facet joint pain.
Thoracolumbar Junction Syndrome Causing Pain around Posterior Iliac Crest: A Case Report.
Kim, Soo-Ryu; Lee, Min-Ji; Lee, Seung-Jun; Suh, Young-Sung; Kim, Dae-Hyun; Hong, Ji-Hee
2013-03-01
Thoracolumbar junction syndrome is characterized by referred pain which may originate at the thoracolumbar junction, which extends from 12th thoracic vertebra to 2nd lumbar vertebra, due to functional abnormalities. Clinical manifestations include back pain, pseudo-visceral pain and pseudo-pain on the posterior iliac crest, as well as irritable bowel symptoms. During clinical examination, pain can be demonstrated by applying pressure on the facet joints or to the sides of the spinous processes. Radiological studies show only mild and insignificant degenerative changes in most cases. We report a 42-year-old female patient with osteogenesis imperfecta who suffered from chronic low back pain. Under the diagnosis of thoracolumbar junction syndrome, she was treated with an epidural block and a sympathetic nerve block, which improved her symptoms.
Zhang, Zhenjun; Fogel, Guy R; Liao, Zhenhua; Sun, Yitao; Liu, Weiqiang
2018-06-01
Lateral lumbar interbody fusion using cage supplemented with fixation has been used widely in the treatment of lumbar disease. A combined fixation (CF) of lateral plate and spinous process plate may provide multiplanar stability similar to that of bilateral pedicle screws (BPS) and may reduce morbidity. The biomechanical influence of the CF on cage subsidence and facet joint stress has not been well described. The aim of this study was to compare biomechanics of various fixation options and to verify biomechanical effects of the CF. The surgical finite element models with various fixation options were constructed based on computed tomography images. The lateral plate and posterior spinous process plate were applied (CF). The 6 motion modes were simulated. Range of motion (ROM), cage stress, endplate stress, and facet joint stress were compared. For the CF model, ROM, cage stress, and endplate stress were the minimum in almost all motion modes. Compared with BPS, the CF reduced ROM, cage stress, and endplate stress in all motion modes. The ROM was reduced by more than 10% in all motion modes except for flexion; cage stress and endplate stress were reduced more than 10% in all motion modes except for rotation-left. After interbody fusion, facet joint stress was reduced substantially compared with the intact conditions in all motion modes except for flexion. The combined plate fixation may offer an alternative to BPS fixation in lateral lumbar interbody fusion. Copyright © 2018 Elsevier Inc. All rights reserved.
Erbulut, D U; Zafarparandeh, I; Lazoglu, I; Ozer, A F
2014-07-01
Different finite element models of the cervical spine have been suggested for evaluating the roles of ligaments, facet joints, and disks in the stability of cervical spine under sagittal moments. However, no comprehensive study on the response of the full cervical spine that has used a detailed finite element (FE) model (C2-T1) that considers the asymmetry about the mid-sagittal plane has been reported. The aims of this study were to consider asymmetry in a FE model of the full cervical spine and to investigate the influences of ligaments, facet joints, and disk nucleus on the stability of the asymmetric model during flexion and extension. The model was validated against various published in vitro studies and FE studies for the three main loading planes. Next, the C4-C5 level was modified to simulate different cases to investigate the role of the soft tissues in segmental stability. The FE model predicted that excluding the interspinous ligament (ISL) from the index level would cause excessive instability during flexion and that excluding the posterior longitudinal ligament (PLL) or the ligamentum flavum (LF) would not affect segmental rotation. During extension, motion increased when the facet joints were excluded. The model without disk nucleus was unstable compared to the intact model at lower loads and exhibited a similar rotation response at higher loads. Copyright © 2014 IPEM. Published by Elsevier Ltd. All rights reserved.
Chang, Min Cheol
2018-03-01
To evaluate the effect of pulsed radiofrequency (PRF) stimulation of the thoracic medial branch of the dorsal ramus in patients with chronic thoracic facet joint (TFJ) pain who were refractory to medial branch block (MBB). This was a prospective, observational study. The author retrospectively reviewed data from 72 patients who had received therapeutic MBB with 0.5 mL of 2% lidocaine mixed with 0.5 mL of 0.25% bupivacaine to treat TFJ-origin upper or midback pain. Of these patients, 20 were included to evaluate the effects of PRF on the thoracic medical branch to manage TFJ pain refractory to therapeutic MBB. PRF stimulation was administered at 5 Hz and a 5-millisecond pulsed width for 360 seconds at 45 V. The pain-reducing effect of the PRF procedure was evaluated via the numeric rating scale (NRS) at 1, 2, and 3 months after treatment. Successful pain relief was defined as ≥50% reduction in the NRS score compared with the score before treatment. The NRS scores changed significantly over time (pretreatment, 6.0 ± 1.0; 1 month, 3.3 ± 2.2; 2 months, 3.9 ± 2.1; and 3 months, 4.0 ± 2.2). At 1, 2, and 3 months after the PRF procedure, the NRS scores were significantly reduced compared with the scores before the treatment. Eleven (55%) of 20 patients reported successful pain relief at 3 months after PRF. The author suggests that PRF on the thoracic medial branch is an effective and safe interventional technique for the control of chronic TFJ pain. Copyright © 2017 Elsevier Inc. All rights reserved.
What Constitutes Traditional and Modern Eating? The Case of Japan.
Sproesser, Gudrun; Imada, Sumio; Furumitsu, Isato; Rozin, Paul; Ruby, Matthew B; Arbit, Naomi; Fischler, Claude; Schupp, Harald T; Renner, Britta
2018-01-25
Traditional Japanese dietary culture might be a factor contributing to the high life expectancy in Japan. As little is known about what constitutes traditional and modern eating in Japan, the aims of the current study were to (1) comprehensively compile and systematize the various facets of traditional and modern eating; and (2) investigate whether these facets also apply to traditional and modern eating in Japan. In Study 1, an extensive international literature review was performed. Forty-five facets of traditional and modern eating were compiled and systematized into the dimensions of what and how people eat, and into eleven separate subdimensions. In Study 2, 340 adults from Japan answered a questionnaire. Results showed that traditional and modern eating in Japan is reflected in both what and how people eat. Within these two dimensions, ten subdimensions were found: the ingredients, processing, temporal origin, spatial origin, and variety of consumed foods, as well as temporal, spatial, and social aspects, appreciation, and concerns when eating. This study provides a broad compilation of facets of traditional and modern eating in Japan. Future research should investigate how these facets are related to life expectancy and health.
What Constitutes Traditional and Modern Eating? The Case of Japan
Imada, Sumio; Furumitsu, Isato; Rozin, Paul; Ruby, Matthew B.; Arbit, Naomi; Fischler, Claude; Schupp, Harald T.; Renner, Britta
2018-01-01
Traditional Japanese dietary culture might be a factor contributing to the high life expectancy in Japan. As little is known about what constitutes traditional and modern eating in Japan, the aims of the current study were to (1) comprehensively compile and systematize the various facets of traditional and modern eating; and (2) investigate whether these facets also apply to traditional and modern eating in Japan. In Study 1, an extensive international literature review was performed. Forty-five facets of traditional and modern eating were compiled and systematized into the dimensions of what and how people eat, and into eleven separate subdimensions. In Study 2, 340 adults from Japan answered a questionnaire. Results showed that traditional and modern eating in Japan is reflected in both what and how people eat. Within these two dimensions, ten subdimensions were found: the ingredients, processing, temporal origin, spatial origin, and variety of consumed foods, as well as temporal, spatial, and social aspects, appreciation, and concerns when eating. This study provides a broad compilation of facets of traditional and modern eating in Japan. Future research should investigate how these facets are related to life expectancy and health. PMID:29370081
Carmeli, Abraham; Sternberg, Akiva; Elizur, D
2008-04-01
Despite the prominence of organizational culture (OC), this concept is controversial and its structure has yet to be systematically analyzed. This study develops a three-pronged formal definitional framework on the basis of facet theory (FT) and explores behavior modality, referent, and object. This facet analysis (FA) of OC accounts successfully for variation in both creative behavior at work and the usage of information and communication technologies (ICTs). An analysis of data collected from 230 employees in the financial industry indicates that a radex structure was obtained for work and ICT. The behavior modality facet ordered the space from center to periphery, and referents facet relates to the direction angles away from the origin.
Reliability and validity of the Norwegian WHOQOL-OLD module.
Halvorsrud, Liv; Kalfoss, Mary; Diseth, Age
2008-06-01
The aim of this study was to examine the validity and reliability of the Norwegian WHOQOL-OLD six-facet, 24-item module designed for assessing generic quality of life cross-culturally among the elderly. Using quota-stratified sampling defined on the basis of sex, age and geographical representation, 401 respondents were drawn from Statistics Norway and completed postal surveys. An additional 89 elderly completed personal interviews. Correlation and multivariate analyses partly confirmed the relevance of individual items and facets in both groups. All items correlated significantly higher with their original facets, although almost half of these items correlated with other facets in both groups. Multiple regression analysis of the module and two overall questions (dependent variables) showed that three facets made significant contributions to overall health, with Social Participation (B = 0.09) contributing most strongly in the postal-group. In the interview-group, only Social Participation (B = 0.20) was found to make a significant contribution, and this was in relation to overall health satisfaction. When the WHOQOL-BREF total score was considered as the dependent variable, different facets contributed significantly in both groups. Exploratory factor analysis of the WHOQOL-OLD in the combined group of both postal and interview samples, resulted in a five-factor solution (eigenvalues >1) explaining 65% of the cumulative variance in five of the six originally operationalized facets. The most conceptually clear facets were Death and Dying and Sensory Abilities. Further, confirmatory factor analyses in the combined group demonstrated a model with good fit, but with high covariance between the factors. Acceptable internal consistency was shown except for the Past, Present and Future Activities in both groups. Since construct validity was only partially confirmed, exploration of the scale's conceptual validity needs further testing in Norwegian and international samples.
EPA EMERGENCY PLANNING TOOLBOX
EPA's Office of Research and Development and Office of Water/Water Security Division have jointly developed a Response Protocol Toolbox (RPTB) to address the complex, multi-faceted challenges of a water utility's planning and response to intentional contamination of drinking wate...
Giant, Completely Calcified Lumbar Juxtafacet Cyst: Report of an Unusual Case
Huang, Kevin T.; Owens, Timothy R.; Wang, Teresa S.; Moreno, Jessica R.; Bagley, Jacob H.; Bagley, Carlos A.
2013-01-01
Study Design Case report. Objective To report the case of one patient who developed a giant, completely calcified, juxtafacet cyst. Methods A 57-year-old woman presented with a 2-year history of progressively worsening lower back pain, left leg pain, weakness, and paresthesias. Imaging showed a giant, completely calcified mass arising from the left L5–S1 facet joint, with coexisting grade I L5 on S1 anterolisthesis. The patient was treated with laminectomy, excision of the mass, and L5–S1 fixation and fusion. Results The patient had an uncomplicated postoperative course and had complete resolution of her symptoms as of 1-year follow-up. Conclusions When presented with a solid-appearing, calcified mass arising from the facet joint, a completely calcified juxtafacet cyst should be considered as part of the differential diagnosis. PMID:25083359
Mechanical role of the posterior column components in the cervical spine.
Hartman, Robert A; Tisherman, Robert E; Wang, Cheng; Bell, Kevin M; Lee, Joon Y; Sowa, Gwendolyn A; Kang, James D
2016-07-01
To quantify the mechanical role of posterior column components in human cervical spine segments. Twelve C6-7 segments were subjected to resection of (1) suprasinous/interspinous ligaments (SSL/ISL), (2) ligamenta flavum (LF), (3) facet capsules, and (4) facets. A robot-based testing system performed repeated flexibility testing of flexion-extension (FE), axial rotation (AR), and lateral bending (LB) to 2.5Nm and replayed kinematics from intact flexibility tests for each state. Range-of-motion, stiffness, moment resistance and resultant forces were calculated. The LF contributes largely to moment resistance, particularly in flexion. Facet joints were primary contributors to AR and LB mechanics. Moment/force responses were more sensitive and precise than kinematic outcomes. The LF is mechanically important in the cervical spine; its injury could negatively impact load distribution. Damage to facets in a flexion injury could lead to AR or LB hypermobility. Quantifying the contribution of spinal structures to moment resistance is a sensitive, precise process for characterizing structural mechanics.
Barth, Johannes; Boutsiadis, Achilleas; Narbona, Pablo; Lädermann, Alexandre; Arrigoni, Paolo; Adams, Christopher R; Burkhart, Stephen S; Denard, Patrick J
2017-07-01
The aim of this study was to find reliable anatomic landmarks of the normal acromioclavicular joint (ACJ) that could enable the precise evaluation of the horizontal displacement of the clavicle after dislocation. The hypothesis was that the anterior borders of the acromion and the clavicle are always aligned in intact ACJs. In 30 cadaveric specimens, the anterior and posterior borders of the ACJ's articular facets and the most prominent anterior and posterior bony landmarks of the acromion and the clavicle were identified. The anterior and posterior overhang of the acromion and the clavicle was measured in relation to the borders of the articular facets. Therefore, the possible anterior and posterior alignment of the ACJ was evaluated. Anteriorly, only 18 ACJs (60%) were aligned whereas 7 (24%) had major overhang of the acromion and 3 (10%) had major overhang of the clavicle. Similarly, 18 cases (60%) were posteriorly aligned, whereas 6 (20%) had major clavicular overhang and 4 (14%) had major overhang of the acromion. In 78% of these cases, the ACJ was aligned as well anteriorly as posteriorly (P < .001). Finally, the larger the width of the acromion (P = .032) or the clavicle (P = .049), the better the posterior joint alignment. Our hypothesis was not verified. The acromion and clavicle are not perfectly aligned in a significant number of specimens with intact ACJs (40% of cases). The most reliable landmarks remain their articular facets. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.
Manchikanti, Laxmaiah; Cash, Kimberly A; Pampati, Vidyasagar; Malla, Yogesh
2012-01-01
Background While chronic neck pain is a common problem in the adult population, with a typical 12-month prevalence of 30%–50%, there is a lack of consensus regarding its causes and treatment. Despite limited evidence, cervical epidural injections are one of the commonly performed nonsurgical interventions in the management of chronic neck pain. Methods A randomized, double-blind, active, controlled trial was conducted to evaluate the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of chronic neck pain with or without upper extremity pain in patients without disc herniation, radiculitis, or facet joint pain. Results One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain by means of controlled diagnostic medial branch blocks were randomly assigned to one of two treatment groups, ie, injection of local anesthetic only (group 1) or local anesthetic mixed with nonparticulate betamethasone (group 2). The primary outcome of significant pain relief and improvement in functional status (≥50%) was demonstrated in 72% of group 1 and 68% of group 2. The overall average number of procedures per year was 3.6 in both groups with an average total relief per year of 37–39 weeks in the successful group over a period of 52 weeks. Conclusion Cervical interlaminar epidural injections of local anesthetic with or without steroids may be effective in patients with chronic function-limiting discogenic or axial pain. PMID:22826642
Kong, Min Ho; Hymanson, Henry J; Song, Kwan Young; Chin, Dong Kyu; Cho, Yong Eun; Yoon, Do Heum; Wang, Jeffrey C
2009-04-01
The authors conducted a retrospective observational study using kinetic MR imaging to investigate the relationship between instability, abnormal sagittal segmental motion, and radiographic variables consisting of intervertebral disc degeneration, facet joint osteoarthritis (FJO), degeneration of the interspinous ligaments, ligamentum flavum hypertrophy (LFH), and the status of the paraspinal muscles. Abnormal segmental motion, defined as > 10 degrees angulation and > 3 mm of translation in the sagittal plane, was investigated in 1575 functional spine units (315 patients) in flexion, neutral, and extension postures using kinetic MR imaging. Each segment was assessed based on the extent of disc degeneration (Grades I-V), FJO (Grades 1-4), interspinous ligament degeneration (Grades 1-4), presence of LFH, and paraspinal muscle fatty infiltration observed on kinetic MR imaging. These factors are often noted in patients with degenerative disease, and there are grading systems to describe these changes. For the first time, the authors attempted to address the relationship between these radiographic observations and the effects on the motion and instability of the functional spine unit. The prevalence of abnormal translational motion was significantly higher in patients with Grade IV degenerative discs and Grade 3 arthritic facet joints (p < 0.05). In patients with advanced disc degeneration and FJO, there was a lesser amount of motion in both segmental translation and angulation when compared with lower grades of degeneration, and this difference was statistically significant for angular motion (p < 0.05). Patients with advanced degenerative Grade 4 facet joint arthritis had a significantly lower percentage of abnormal angular motion compared to patients with normal facet joints (p < 0.001). The presence of LFH was strongly associated with abnormal translational and angular motion. Grade 4 interspinous ligament degeneration and the presence of paraspinal muscle fatty infiltration were both significantly associated with excessive abnormal angular motion (p < 0.05). This kinetic MR imaging analysis showed that the lumbar functional unit with more disc degeneration, FJO, and LFH had abnormal sagittal plane translation and angulation. These findings suggest that abnormal segmental motion noted on kinetic MR images is closely associated with disc degeneration, FJO, and the pathological characteristics of interspinous ligaments, ligamentum flavum, and paraspinal muscles. Kinetic MR imaging in patients with mechanical back pain may prove a valuable source of information about the stability of the functional spine unit by measuring abnormal segmental motion and grading of radiographic parameters simultaneously.
Manchikanti, Laxmaiah; Cash, Kimberly A.; Pampati, Vidyasagar; Malla, Yogesh
2014-01-01
Study Design: A randomized, double-blind, active-controlled trial. Objective: To assess the effectiveness of cervical interlaminar epidural injections of local anesthetic with or without steroids for the management of axial or discogenic pain in patients without disc herniation, radiculitis, or facet joint pain. Summary of Background Data: Cervical discogenic pain without disc herniation is a common cause of suffering and disability in the adult population. Once conservative management has failed and facet joint pain has been excluded, cervical epidural injections may be considered as a management tool. Despite a paucity of evidence, cervical epidural injections are one of the most commonly performed nonsurgical interventions in the management of chronic axial or disc-related neck pain. Methods: One hundred and twenty patients without disc herniation or radiculitis and negative for facet joint pain as determined by means of controlled diagnostic medial branch blocks were randomly assigned to one of the 2 treatment groups. Group I patients received cervical interlaminar epidural injections of local anesthetic (lidocaine 0.5%, 5 mL), whereas Group II patients received 0.5% lidocaine, 4 mL, mixed with 1 mL or 6 mg of nonparticulate betamethasone. The primary outcome measure was ≥ 50% improvement in pain and function. Outcome assessments included numeric rating scale (NRS), Neck Disability Index (NDI), opioid intake, employment, and changes in weight. Results: Significant pain relief and functional improvement (≥ 50%) was present at the end of 2 years in 73% of patients receiving local anesthetic only and 70% receiving local anesthetic with steroids. In the successful group of patients, however, defined as consistent relief with 2 initial injections of at least 3 weeks, significant improvement was illustrated in 78% in the local anesthetic group and 75% in the local anesthetic with steroid group at the end of 2 years. The results reported at the one-year follow-up were sustained at the 2-year follow-up. Conclusions: Cervical interlaminar epidural injections with or without steroids may provide significant improvement in pain and functioning in patients with chronic discogenic or axial pain that is function-limiting and not related to facet joint pain. PMID:24578607
Okuyama, Koichiro; Kido, Tadato; Unoki, Eiki; Chiba, Mitsuho
2007-02-01
To determine the validity of posterior lumbar interbody fusion (PLIF) using a titanium cage filled with excised facet joint bone and a pedicle screw for degenerative spondylolisthesis. PLIF using a titanium cage filled with excised facet joint bone and a pedicle screw was performed in 28 consecutive patients (men 10, women 18). The mean age of the patients was 60 years (range, 52 to 75 y) at the time of surgery. The mean follow-up period was 2.3 years (range, 2.0 to 4.5 y). The operation was done at L3/4 in 5, L4/5 in 20, and L3/4/5 in 3 patients. The mean operative bleeding was 318+/-151 g (mean+/-standard deviation), and the mean operative time was 3.34+/-0.57 hours per fixed segment. Clinical outcome was assessed by Denis' Pain and Work scale. Radiologic assessment was done using Boxell's method. Fusion outcome was assessed using an established criteria. On Pain scale, 20 and 8 patients were rated P4 and P5 before surgery, and 11, 12, 2, 2, and 1 patients were rated P1, P2, P3, P4, and P5 at final follow-up, respectively. On Work scale (for only physical labors), 12 and 9 patients were rated W4 and W5, before surgery, and 12, 5, 1, and 3 patients were rated W1, W2, W3 and W5 at final follow-up, respectively. There was significant difference in clinical outcome (P<0.01, Wilcoxon singled-rank test) The mean %Slip and Slip Angle was 17.9+/-8.1% and 3.9+/-5.8 degrees before surgery. The mean % Slip and Slip Angle was 5.4+/-4.4% and -2.0+/-4.8 degrees at final follow-up. There was a significant difference between the values (P<0.01, paired t test). "Union" and "probable union" was determined in 29 (93.5%) and 2 (6.5%) of 31 operated segments at 2.3 years (range, 2.0 to 4.5 y), postoperatively. PLIF using a titanium cage filled with excised facet joint bone and a pedicle screw provided a satisfactory clinical outcome and an excellent union rate without harvesting and grafting the autologous iliac bone.
Contact characteristics of the subtalar joint after a simulated calcaneus fracture.
Sangeorzan, B J; Ananthakrishnan, D; Tencer, A F
1995-06-01
A simple calcaneus fracture consisting of two parts was modeled in nine fresh cadaver hindfoot specimens to assess changes in subtalar joint contact characteristics with increasing plantar depression of the posterolateral fracture component. To perform the experiment, rods were placed in the tibial and fibular shafts of each specimen, which was mounted in a frame in neutral stance. A pneumatic cylinder was used to deliver a vertical compressive load through the rods into the foot while permitting free motion of the foot in the horizontal plane. Sealed packets of pressure-sensitive film were inserted into the anterior-middle and posterior facets of the talocalcaneal articulation, and a 700-N load was applied. After testing of the intact foot, a primary fracture line was created using a microoscillating saw. The osteotomized posterolateral component was anatomically reduced and fixed, the film inserted, and the load reapplied. The test was repeated after the posterolateral fragment was displaced 2, 5, and 10 mm in a plantar direction. The resulting pressure prints were scanned along with pressure/color density calibration strips using a flat-bed scanner, and an image analysis system was used to determine contact areas within specified pressure intervals. The contact area (> 0.5 MPa) of the posterior facet was significantly decreased with 2, 5, and 10 mm displacements of the posterolateral calcaneus fracture component. The ratio of high-pressure area (< 5.0 MPa) to contact area in the posterior facet was significantly increased only with displacements of 5 and 10 mm. There were no significant changes in any contact parameters in the anterior-middle facet.(ABSTRACT TRUNCATED AT 250 WORDS)
Mao, Ke-ya; Wang, Yan; Xiao, Song-hua; Zhang, Yong-gang; Liu, Bao-wei; Wang, Zheng; Zhang, Xi-Feng; Cui, Geng; Zhang, Xue-song; Li, Peng; Mao, Ke-zheng
2013-08-01
To investigate the feasibility of minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) using hybrid internal fixation of pedicle screws and a translaminar facet screw for recurrent lumbar disc herniation. From January 2010 to December 2011, 16 recurrent lumbar disc herniation patients, 10 male and 6 female patients with an average age of 45 years (35-68 years) were treated with unilateral incision MIS-TLIF through working channel. After decompression, interbody fusion and fixation using unilateral pedicle screws, a translaminar facet screw was inserted from the same incision through spinous process and laminar to the other side facet joint. The results of perioperative parameters, radiographic images and clinical outcomes were assessed. The repeated measure analysis of variance was applied in the scores of visual analogue scale (VAS) and Oswestry disablity index (ODI). All patients MIS-TLIF were accomplished under working channel including decompression, interbody fusion and hybrid fixation without any neural complication. The average operative time was (148 ± 75) minutes, the average operative blood loss was (186 ± 226) ml, the average postoperative ambulation time was (32 ± 15) hours, and the average hospitalization time was (6 ± 4) days. The average length of incision was (29 ± 4) mm, and the average length of translaminar facets screw was (52 ± 6) mm. The mean follow-up was 16.5 months with a range of 12-24 months. The postoperative X-ray and CT images showed good position of the hybrid internal fixation, and all facets screws penetrate through facets joint. The significant improvement could be found in back pain VAS, leg pain VAS and ODI scores between preoperative 1 day and postoperative follow-up at all time-points (back pain VAS:F = 52.845, P = 0.000;leg pain VAS:F = 113.480, P = 0.000;ODI:F = 36.665, P = 0.000). Recurrent lumbar disc herniation could be treated with MIS-TLIF using hybrid fixation through unilateral incision, and the advantage including less invasion and quickly recovery.
Yau, Michelle S; Demissie, Serkalem; Zhou, Yanhua; Anderson, Dennis E; Lorbergs, Amanda L; Kiel, Douglas P; Allaire, Brett T; Yang, Laiji; Cupples, L Adrienne; Travison, Thomas G; Bouxsein, Mary L; Karasik, David; Samelson, Elizabeth J
2017-01-01
Hyperkyphosis is a common spinal disorder in older adults, characterized by excessive forward curvature of the thoracic spine and adverse health outcomes. The etiology of hyperkyphosis has not been firmly established, but may be related to changes that occur with aging in the vertebrae, discs, joints, and muscles, which function as a unit to support the spine. Determining the contribution of genetics to thoracic spine curvature and the degree of genetic sharing among co-occurring measures of spine health may provide insight into the etiology of hyperkyphosis. The purpose of our study was to estimate heritability of thoracic spine curvature using T4–T12 kyphosis (Cobb) angle and genetic correlations between thoracic spine curvature and vertebral fracture, intervertebral disc height narrowing, facet joint osteoarthritis (OA), lumbar spine volumetric bone mineral density (vBMD), and paraspinal muscle area and density, which were all assessed from computed tomography (CT) images. Participants included 2063 women and men in the second and third generation offspring of the original cohort of the Framingham Study. Heritability of kyphosis angle, adjusted for age, sex, and weight, was 54% (95% confidence interval [CI], 43% to 64%). We found moderate genetic correlations between kyphosis angle and paraspinal muscle area ( ρ^G, −0.46; 95% CI, −0.67 to −0.26), vertebral fracture ( ρ^G, 0.39; 95% CI, 0.18 to 0.61), vBMD ( ρ^G,−0.23; 95% CI, −0.41 to −0.04), and paraspinal muscle density ( ρ^G,−0.22; 95% CI, −0.48 to 0.03). Genetic correlations between kyphosis angle and disc height narrowing ( ρ^G, 0.17; 95% CI, −0.05 to 0.38) and facet joint OA ( ρ^G, 0.05; 95% CI, −0.15 to 0.24) were low. Thoracic spine curvature may be heritable and share genetic factors with other age-related spine traits including trunk muscle size, vertebral fracture, and bone mineral density. PMID:27455046
Goel, Atul; Shah, Abhidha
2011-06-01
The authors discuss their successful preliminary experience with 36 cases of cervical spondylotic disease by performing facetal distraction using specially designed Goel cervical facet spacers. The clinical and radiological results of treatment are analyzed. The mechanism of action of the proposed spacers and the rationale for their use are evaluated. Between 2006 and February 2010, 36 patients were treated using the proposed technique. Of these patients, 18 had multilevel and 18 had single-level cervical spondylotic radiculopathy and/or myelopathy. The average follow-up period was 17 months with a minimum of 6 months. The Japanese Orthopaedic Association classification system, visual analog scale (neck pain and radiculopathy), and Odom criteria were used to monitor the clinical status of the patient. The patients were prospectively analyzed. The technique of surgery involved wide opening of the facet joints, denuding of articular cartilage, distraction of facets, and forced impaction of Goel cervical facet spacers into the articular cavity. Additionally, the interspinous process ligaments were resected, and corticocancellous bone graft from the iliac crest was placed and was stabilized over the adjoining laminae and facets after adequately preparing the host bone. Eighteen patients underwent single-level, 6 patients underwent 2-level, and 12 patients underwent 3-level treatment. The alterations in the physical architecture of spine and canal dimensions were evaluated before and after the placement of intrafacet joint spacers and after at least 6 months of follow-up. All patients had varying degrees of relief from symptoms of pain, radiculopathy, and myelopathy. Analysis of radiological features suggested that the distraction of facets with the spacers resulted in an increase in the intervertebral foraminal dimension (mean 2.2 mm), an increase in the height of the intervertebral disc space (range 0.4-1.2 mm), and an increase in the interspinous distance (mean 2.2 mm). The circumferential distraction resulted in reduction in the buckling of the posterior longitudinal ligament and ligamentum flavum. The procedure ultimately resulted in segmental bone fusion. No patient worsened after treatment. There was no noticeable implant malfunction. During the follow-up period, all patients had evidence of segmental bone fusion. No patient underwent reexploration or further surgery of the neck. Distraction of the facets of the cervical vertebra can lead to remarkable and immediate stabilization-fixation of the spinal segment and increase in space for the spinal cord and roots. The procedure results in reversal of several pathological events related to spondylotic disease. The safe, firm, and secure stabilization at the fulcrum of cervical spinal movements provided a ground for segmental spinal arthrodesis. The immediate postoperative improvement and lasting recovery from symptoms suggest the validity of the procedure.
ERIC Educational Resources Information Center
Beghtol, Clare
1995-01-01
Examines the origins and parallel uses of the concept of "facet" in bibliographic classification theory and behavioral research. Suggests that social sciences in general were receptive to conceptual borrowing, but that library and information science as a discipline was relatively isolated. (contains 108 references) (Author/AEF)
Patkar, Sushil
2016-08-01
Unilateral anterior retropharyngeal approach was used in a case of basilar invagination with atlanto-axial instability. This approach provided easy access to both atlanto-axial joints. Wedge-shaped titanium cages were used to distract the joints and reduce the basilar invagination. Titanium plates with screws were used to fix the lateral mass of atlas with the body of axis, bilaterally. The anterior atlanto-axial joint distraction procedure has not been described in literature before seems to be an easy option in selected cases of craniovertebral anomalies and needs to be investigated by more surgeons.
Krägeloh, Christian U; Billington, D Rex; Henning, Marcus A; Chai, Penny Pei Minn
2015-02-25
The WHOQOL-SRPB has been a useful module to measure aspects of QOL related to spirituality, religiousness, and personal beliefs, but recent research has pointed to potential problems with its proposed factor structure. Three of the eight facets of the WHOQOL-SRPB have been identified as potentially different from the others, and to date only a limited number of factor analyses of the instrument have been published. Analyses were conducted using data from a sample of 679 university students who had completed the WHOQOL-BREF quality of life questionnaire, the WHOQOL-SRPB module, the Perceived Stress scale, and the Brief COPE coping strategies questionnaire. Informed by these analyses, confirmatory factor analyses suitable for ordinal-level data explored the potential for a two-factor solution as opposed to the originally proposed one-factor solution. The facets WHOQOL-SRPB facets connected, strength, and faith were highly correlated with each other as well as with the religious coping sub-scale of the Brief COPE. Combining these three facets to one factor in a two-factor solution for the WHOQOL-SRPB yielded superior goodness-of-fit indices compared to the original one-factor solution. A two-factor solution for the WHOQOL-SRPB is more tenable, in which three of the eight WHOQOL-SRPB facets group together as a spiritual coping factor and the remaining facets form a factor of spiritual quality of life. While discarding the facets connectedness, strength, and faith without additional research would be premature, users of the scale need to be aware of this alternative two-factor structure, and may wish to analyze scores using this structure.
Little, Jesse S.; Khalsa, Partap S.
2005-01-01
There is a high incidence of low back pain (LBP) associated with occupations requiring sustained and/or repetitive lumbar flexion (SLF and RLF, respectively), which cause creep of the viscoelastic tissues. The purpose of this study was to determine the effect of creep on lumbar biomechanics and facet joint capsule (FJC) strain. Specimens were flexed for 10 cycles, to a maximum 10 Nm moment at L5-S1, before, immediately after, and 20 min after a 20-min sustained flexion at the same moment magnitude. The creep rates of SLF and RLF were also measured during each phase and compared to the creep rate predicted by the moment relaxation rate function of the lumbar spine. Both SLF and RLF resulted in significantly increased intervertebral motion, as well as significantly increased FJC strains at the L3-4 to L5-S1 joint levels. These parameters remained increased after the 20-min recovery. Creep during SLF occurred significantly faster than creep during RLF. The moment relaxation rate function was able to accurately predict the creep rate of the lumbar spine at the single moment tested. The data suggest that SLF and RLF result in immediate and residual laxity of the joint and stretch of the FJC, which could increase the potential for LBP. PMID:15868730
Facet-Controlled Synthetic Strategy of Cu2O-Based Crystals for Catalysis and Sensing.
Shang, Yang; Guo, Lin
2015-10-01
Shape-dependent catalysis and sensing behaviours are primarily focused on nanocrystals enclosed by low-index facets, especially the three basic facets ({100}, {111}, and {110}). Several novel strategies have recently exploded by tailoring the original nanocrystals to greatly improve the catalysis and sensing performances. In this Review, we firstly introduce the synthesis of a variety of Cu 2 O nanocrystals, including the three basic Cu 2 O nanocrystals (cubes, octahedra and rhombic dodecahedra, enclosed by the {100}, {111}, and {110} facets, respectively), and Cu 2 O nanocrystals enclosed by high-index planes. We then discuss in detail the three main facet-controlled synthetic strategies (deposition, etching and templating) to fabricate Cu 2 O-based nanocrystals with heterogeneous, etched, or hollow structures, including a number of important concepts involved in those facet-controlled routes, such as the selective adsorption of capping agents for protecting special facets, and the impacts of surface energy and active sites on reaction activity trends. Finally, we highlight the facet-dependent properties of the Cu 2 O and Cu 2 O-based nanocrystals for applications in photocatalysis, gas catalysis, organocatalysis and sensing, as well as the relationship between their structures and properties. We also summarize and comment upon future facet-related directions.
Physical-geometric optics method for large size faceted particles.
Sun, Bingqiang; Yang, Ping; Kattawar, George W; Zhang, Xiaodong
2017-10-02
A new physical-geometric optics method is developed to compute the single-scattering properties of faceted particles. It incorporates a general absorption vector to accurately account for inhomogeneous wave effects, and subsequently yields the relevant analytical formulas effective and computationally efficient for absorptive scattering particles. A bundle of rays incident on a certain facet can be traced as a single beam. For a beam incident on multiple facets, a systematic beam-splitting technique based on computer graphics is used to split the original beam into several sub-beams so that each sub-beam is incident only on an individual facet. The new beam-splitting technique significantly reduces the computational burden. The present physical-geometric optics method can be generalized to arbitrary faceted particles with either convex or concave shapes and with a homogeneous or an inhomogeneous (e.g., a particle with a core) composition. The single-scattering properties of irregular convex homogeneous and inhomogeneous hexahedra are simulated and compared to their counterparts from two other methods including a numerically rigorous method.
Faber, Jakob A; Arrieta, Andres F; Studart, André R
2018-03-23
Origami enables folding of objects into a variety of shapes in arts, engineering, and biological systems. In contrast to well-known paper-folded objects, the wing of the earwig has an exquisite natural folding system that cannot be sufficiently described by current origami models. Such an unusual biological system displays incompatible folding patterns, remains open by a bistable locking mechanism during flight, and self-folds rapidly without muscular actuation. We show that these notable functionalities arise from the protein-rich joints of the earwig wing, which work as extensional and rotational springs between facets. Inspired by this biological wing, we establish a spring origami model that broadens the folding design space of traditional origami and allows for the fabrication of precisely tunable, four-dimensional-printed objects with programmable bioinspired morphing functionalities. Copyright © 2018 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.
Ilaslan, Hakan; Arslan, Ahmet; Koç, Omer Nadir; Dalkiliç, Turker; Naderi, Sait
2010-07-01
Sacroiliac joint dysfunction is a disorder presenting with low back and groin pain. It should be taken into consideration during the preoperative differential diagnosis of lumbar disc herniation, lumbar spinal stenosis and facet syndrome. Four cases with sacroiliac dysfunction are presented. The clinical and radiological signs supported the evidence of sacroiliac dysfunction, and exact diagnosis was made after positive response to sacroiliac joint block. A percutaneous sacroiliac fixation provided pain relief in all cases. The mean VAS scores reduced from 8.2 to 2.2. It is concluded that sacroiliac joint dysfunction diagnosis requires a careful physical examination of the sacroiliac joints in all cases with low back and groin pain. The diagnosis is made based on positive response to the sacroiliac block. Sacroiliac fixation was found to be effective in carefully selected cases.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Sushko, M. L.; Rosso, K. M.
Atomic-to-mesoscale simulations were used to reveal the origin of oriented attachment between anatase TiO2 nanoparticles in aqueous HCl solutions. Analysis of the distance and pH dependence of interparticle interactions demonstrates that ion correlation forces are responsible for facet-specific attraction and rotation into lattice co-alignment at long-range. These forces give rise to a metastable solvent separated capture minimum on the disjoining pressure-distance curve, with the barrier to attachment largely due to steric hydration forces from structured intervening solvent.
Moore, Amy M; Dennison, David G
2014-06-01
The volar lunate facet fragment of a distal radius fracture may not be stabilized with volar-locked plating alone due to the small size and distal location of the fragment. Identification and stabilization of this small fragment is critical as unstable fixation may result in radiocarpal and radioulnar joint subluxation. The addition of spring wire fixation with volar plating can provide stable internal fixation of this critical fracture fragment. A retrospective review (2006-2011) identified nine patients with distal radius fractures with an associated volar lunate facet fragment that were treated with volar-locked plating and spring wire fixation of the volar lunate facet fragment. Radiographic indices, range of motion, grip strength, and postoperative Patient-related wrist evaluation (PRWE) scores were obtained to assess pain and function. All distal radius fractures healed, and the volar lunate facet fragment reduction was maintained. The mean follow-up was 54 weeks. Mean active range of motion was 46° wrist flexion, 51° wrist extension, 80° pronation, and 68° supination. The mean grip strength was 21 Kg, achieving 66 % of the uninjured limb. The average PRWE score was 17. No patient required removal of hardware or had evidence of tendon irritation. The addition of spring wire fixation to volar-locked plating provided stable fixation of the volar lunate facet fragment of distal radius fractures without complication. This technique addresses a limitation of volar-locked plating to control the small volar lunate facet fragment in distal radius fractures otherwise amenable to volar plating. A retrospective case series, Level IV.
A practical guide for performing arthrography under fluoroscopic or ultrasound guidance.
Lungu, Eugen; Moser, Thomas P
2015-12-01
We propose a practical approach for performing arthrography with fluoroscopic or ultrasound guidance. Different approaches to the principal joints of the upper limb (shoulder, elbow, wrist and fingers), lower limb (hip, knee, ankle and foot) as well as the facet joints of the spine are discussed and illustrated with numerous drawings. Whenever possible, we emphasise the concept of targeting articular recesses, which offers many advantages over traditional techniques aiming at the joint space. • Arthrography remains a foremost technique in musculoskeletal radiology • Most joints can be successfully accessed by targeting the articular recess • Targeting the recess offers several advantages over traditional approaches • Ultrasound-guidance is now favoured over fluoroscopy and targeting the recess is equally applicable.
NASA Technical Reports Server (NTRS)
Grabbe, Shon R.
2017-01-01
This presentation provides a high-level overview of NASA's Future ATM Concepts Evaluation Tool (FACET) with a high-level description of the system's inputs and outputs. This presentation is designed to support the joint simulations that NASA and the Chinese Aeronautical Establishment (CAE) will conduct under an existing Memorandum of Understanding.
EPA's Office of Research and Development and Office of Water/Water Security Division have jointly developed a Response Protocol Toolbox (RPTB) to address the complex, multi-faceted challenges of a water utility's planning and response to intentional contamination of drinking wate...
Gao, Shutao; Lv, Zhengtao; Fang, Huang
2018-04-01
Several studies have revealed that robot-assisted technique might improve the pedicle screw insertion accuracy, but owing to the limited sample sizes in the individual study reported up to now, whether or not robot-assisted technique is superior to conventional freehand technique is indefinite. Thus, we performed this systematic review and meta-analysis based on randomized controlled trials to assess which approach is better. Electronic databases including PubMed, EMBASE, CENTRAL, ISI Web of Science, CNKI and WanFang were systematically searched to identify potentially eligible articles. Main endpoints containing the accuracy of pedicle screw implantation and proximal facet joint violation were evaluated as risk ratio (RR) and the associated 95% confidence intervals (95% CIs), while radiation exposure and surgical duration were presented as mean difference (MD) or standard mean difference (SMD). Meta-analyses were performed using RevMan 5.3 software. Six studies involving 158 patients (688 pedicle screws) in robot-assisted group and 148 patients (672 pedicle screws) in freehand group were identified matching our study. The Grade A accuracy rate in robot-assisted group was superior to freehand group (RR 1.03, 95% CI 1.00, 1.06; P = 0.04), but the Grade A + B accuracy rate did not differ between the two groups (RR 1.01, 95% CI 0.99, 1.02; P = 0.29). With regard to proximal facet joint violation, the combined results suggested that robot-assisted group was associated with significantly fewer proximal facet joint violation than freehand group (RR 0.07, 95% CI 0.01, 0.55; P = 0.01). As was the radiation exposure, our findings suggested that robot-assisted technique could significantly reduce the intraoperative radiation time (MD - 12.38, 95% CI - 17.95, - 6.80; P < 0.0001) and radiation dosage (SMD - 0.64, 95% CI - 0.85, - 0.43; P < 0.00001). But the overall surgical duration was longer in robot-assisted group than conventional freehand group (MD 20.53, 95% CI 5.17, 35.90; P = 0.009). The robot-assisted technique was associated with equivalent accuracy rate of pedicle screw implantation, fewer proximal facet joint violation, less intraoperative radiation exposure but longer surgical duration than freehand technique. Powerful evidence relies on more randomized controlled trials with high quality and larger sample size in the future.
Zhu, Zhenqi; Liu, Chenjun; Wang, Kaifeng; Zhou, Jian; Wang, Jiefu; Zhu, Yi; Liu, Haiying
2015-01-28
The aim of this study was to evaluate the effect of the Topping-off technique in preventing the aggravation of degeneration caused by adjacent segment fusion. Clinical parameters of patients who underwent L5-S1 posterior lumbar interbody fusion + interspinous process at L4-L5 (PLIF + ISP) with the Wallis system (Topping-off group) were compared retrospectively with those of patients who underwent solely PLIF. Pre- and post-operative x-ray measurements, visual analogue scale (VAS) scores, and Japanese Orthopaedic Association (JOA) scores were assessed in all subjects. Normal L1-S1 lumbosacral finite element models were established in accordance with the two types of surgery in our study, respectively. Virtual loading was added to assess the motility, disc pressure, and facet joint stress of L4-L5. There were 22 and 23 valid cases included in the Topping-off and PLIF groups. No degeneration was observed in either group. Both VAS and JOA scores improved significantly post-operatively (P < 0.01). The intervertebral angle and lumbar lordosis of L4-L5 were both significantly increased (t = -2.89 and -2.68, P < 0.05 in the Topping-off group and t = -2.25 and -2.15, P < 0.05 in the PLIF group). In the Topping-off group, x-ray in dynamic position showed no significant difference in the angulation or distance of the anterior movement of the L4-L5 segment. The angle of hyper-extension and distance of the posterior movement of L4 were significantly decreased. In the PLIF group, both hyper-flexion and hyper-extension and posterior movement were increased significantly. In finite element analysis, displacement of the L4 vertebral body, pressure of the annulus fibrosus and nucleus pulposus, and stress of the bilateral facet joint were less in the Topping-off group under loads of anterior flexion and posterior extension. Facet joint stress on the left side of the L4-L5 segment was also less in the Topping-off group under left flexion loads. Short-term efficacy and safety between Topping-off and PLIF were similar, whilst the Topping-off technique could restrict the hyper-extension movement of adjacent segments, prevent back and forth movement of proximal vertebrae, and decrease loads of intervertebral disc and facet joints.
EPA's Office of Research and Development and Office of Water/Water Security Division have jointly developed a Response Protocol Toolbox (RPTB) to address the complex, multi-faceted challenges of a water utility's planning and response to intentional contamination of drinking wate...
Developmental Planning: An Introduction for Parents
ERIC Educational Resources Information Center
Noland, Jim
2009-01-01
"Developmental Planning" is the thinking process of using developmental milestones as a general basis for planning and predicting needs for the child within the early years. It considers the time frames associated with normal development across all facets of the child's development. The areas include bone and joint development, movement, sensory…
Roche, Kathleen M; Ghazarian, Sharon R; Fernandez-Esquer, Maria Eugenia
2012-07-01
Given educational risks facing Mexican-origin children of immigrant parents, it is important to understand how aspects of the acculturation process influence Mexican-origin youth's educational success. Drawing from selective assimilation theory, this study examined how cultural orientations across myriad facets of acculturation were associated with the educational attainment of second-generation Mexican immigrant youth. The sample included 755 Mexican-origin youth (50% female) in the "Children of Immigrants Longitudinal Study." Results from structural equation models indicated that youth reporting greater facility in the English language and a stronger value on familism attained higher levels of education in young adulthood than did other youth. Parents' U.S. social ties and youth's value on early paid work were associated with less educational attainment. Innovative findings from this study indicate the importance of considering both Mexican and American cultural orientations across myriad facets of acculturation for understanding second-generation immigrant Mexican youth's educational attainment.
Unpacking Acculturation: Cultural Orientations and Educational Attainment among Mexican-Origin Youth
ERIC Educational Resources Information Center
Roche, Kathleen M.; Ghazarian, Sharon R.; Fernandez-Esquer, Maria Eugenia
2012-01-01
Given educational risks facing Mexican-origin children of immigrant parents, it is important to understand how aspects of the acculturation process influence Mexican-origin youth's educational success. Drawing from selective assimilation theory, this study examined how cultural orientations across myriad facets of acculturation were associated…
Theoretical and experimental studies of hydrogen adsorption and desorption on Ir surfaces
Kaghazchi, Payam; Jacob, Timo; Chen, Wenhua; ...
2013-06-03
Here, we report adsorption and desorption of hydrogen on planar Ir(210) and faceted Ir(210), consisting of nanoscale {311} and (110) facets, by means of temperature programmed desorption (TPD) and density functional theory (DFT) in combination with the ab initio atomistic thermodynamics approach. TPD spectra show that only one H 2 peak is seen from planar Ir(210) at all coverages whereas a single H 2 peak is observed at around 440 K (F1) at fractional monolayer (ML) coverage and an additional H 2 peak appears at around 360 K (F2) at 1 ML coverage on faceted Ir(210), implying structure sensitivity inmore » recombination and desorption of hydrogen on faceted Ir(210) versus planar Ir(210), but no evidence is found for size effects in recombination and desorption of hydrogen on faceted Ir(210) for average facet sizes of 5-14 nm. Calculations indicate that H prefers to bind at the two-fold short-bridge sites of the Ir surfaces. In addition, we studied the stability of the Ir surfaces in the presence of hydrogen at different H coverages through surface free energy plots as a function of the chemical potential, which is also converted to a temperature scale. Moreover, the calculations revealed the origin of the two TPD peaks of H 2 from faceted Ir(210): F1 from desorption of H 2 on {311} facets while F2 from desorption of H 2 on (110) facets.« less
Biomechanical testing simulation of a cadaver spine specimen: development and evaluation study.
Ahn, Hyung Soo; DiAngelo, Denis J
2007-05-15
This article describes a computer model of the cadaver cervical spine specimen and virtual biomechanical testing. To develop a graphics-oriented, multibody model of a cadaver cervical spine and to build a virtual laboratory simulator for the biomechanical testing using physics-based dynamic simulation techniques. Physics-based computer simulations apply the laws of physics to solid bodies with defined material properties. This technique can be used to create a virtual simulator for the biomechanical testing of a human cadaver spine. An accurate virtual model and simulation would complement tissue-based in vitro studies by providing a consistent test bed with minimal variability and by reducing cost. The geometry of cervical vertebrae was created from computed tomography images. Joints linking adjacent vertebrae were modeled as a triple-joint complex, comprised of intervertebral disc joints in the anterior region, 2 facet joints in the posterior region, and the surrounding ligament structure. A virtual laboratory simulation of an in vitro testing protocol was performed to evaluate the model responses during flexion, extension, and lateral bending. For kinematic evaluation, the rotation of motion segment unit, coupling behaviors, and 3-dimensional helical axes of motion were analyzed. The simulation results were in correlation with the findings of in vitro tests and published data. For kinetic evaluation, the forces of the intervertebral discs and facet joints of each segment were determined and visually animated. This methodology produced a realistic visualization of in vitro experiment, and allowed for the analyses of the kinematics and kinetics of the cadaver cervical spine. With graphical illustrations and animation features, this modeling technique has provided vivid and intuitive information.
Interface shape and crystallinity in LEC GaAs
NASA Astrophysics Data System (ADS)
Tower, J. P.; Tobin, R.; Pearah, P. J.; Ware, R. M.
1991-12-01
Growth striation mapping was used to relate the growth interface shape to crystallinity failure modes in LEC growth of undoped <100> GaAs. The onset of twinning and polycrystallinity were both found to depend on the interface shape near the crystal periphery. The origins of polycrystalline growth were investigated in 8 kg, 3-inch and 4-inch diameter crystals. Interface maps of these crystals show that polycrystalline growth begins when the growth interface periphery turns down, independent of the shape of the central portions. The cause of initial grain boundary formation was found to be included gallium droplets which originate on the surface and migrate through the crystal toward the growth interface. Twinning occurs on {111} facets, usually during shoulder growth. Growth striations show that the sequence of events leading to twin formation consists of deep facet growth, followed by meltback and rapid regrowth. We found it possible to avoid twinning by reducing melt instabilities or by reducing the extent of facet growth.
Griffin, Sarah A; Samuel, Douglas B
2014-10-01
The Personality Inventory for DSM-5 (PID-5) was developed as a measure of the maladaptive personality trait model included within Section III of the DSM-5. Although preliminary findings have suggested the PID-5 has a five-factor structure that overlaps considerably with the Five-Factor Model (FFM) at the higher order level, there has been much less attention on the specific locations of the 25 lower-order traits. Joint exploratory factor analysis of the PID-5 traits and the 30 facets of the NEO-PI-R were used to determine the lower-order structure of the PID-5. Results indicated the PID-5's domain-level structure closely resembled the FFM. We also explored the placement of several lower-order facets that have not loaded consistently in previous studies. Overall, these results indicate that the PID-5 shares a common structure with the FFM and clarify the placement of some interstitial facets. More research investigating the lower-order facets is needed to determine how they fit into the hierarchical structure and explicate their relationships to existing measures of pathological traits. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
EPA's Office of Research and Development and Office of Water/Water Security Division have jointly developed a Response Protocol Toolbox (RPTB) to address the complex, multi-faceted challenges of a water utility's planning and response to intentional contamination of drinking wate...
Manchikanti, Laxmaiah; Nampiaparampil, Devi E; Candido, Kenneth D; Bakshi, Sanjay; Grider, Jay S; Falco, Frank J E; Sehgal, Nalini; Hirsch, Joshua A
2015-01-01
The high prevalence of chronic persistent neck pain not only leads to disability but also has a significant economic, societal, and health impact. Among multiple modalities of treatments prescribed in the management of neck and upper extremity pain, surgical, interventional and conservative modalities have been described. Cervical epidural injections are also common modalities of treatments provided in managing neck and upper extremity pain. They are administered by either an interlaminar approach or transforaminal approach. To determine the long-term efficacy of cervical interlaminar and transforaminal epidural injections in the treatment of cervical disc herniation, spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. The literature search was performed from 1966 to October 2014 utilizing data from PubMed, Cochrane Library, US National Guideline Clearinghouse, previous systematic reviews, and cross-references. The evidence was assessed based on best evidence synthesis with Level I to Level V. There were 7 manuscripts meeting inclusion criteria. Of these, 4 assessed the role of interlaminar epidural injections for managing disc herniation or radiculitis, and 3 assessed these injections for managing central spinal stenosis, discogenic pain without facet joint pain, and post surgery syndrome. There were 4 high quality manuscripts. A qualitative synthesis of evidence showed there is Level II evidence for each etiology category. The evidence is based on one relevant, high quality trial supporting the efficacy of cervical interlaminar epidural injections for each particular etiology. There were no randomized trials available assessing the efficacy of cervical transforaminal epidural injections. Paucity of available literature, specifically conditions other than disc herniation. This systematic review with qualitative best evidence synthesis shows Level II evidence for the efficacy of cervical interlaminar epidural injections with local anesthetic with or without steroids, based on at least one high-quality relevant randomized control trial in each category for disc herniation, discogenic pain without facet joint pain, central spinal stenosis, and post surgery syndrome.
The morphological characteristics of the antebrachiocarpal joint of the cheetah (Acinonyx jubatus).
Ohale, L O C; Groenewald, H B
2003-03-01
A morphological study of the structures of the antebrachiocarpal (AC) joint of the cheetah was carded out by dissection of eight forelimbs obtained from four adult cheetahs culled from the Kruger National Park, Republic of South Africa. The aim was to evaluate the deviations of this joint from the normal feline pattern and to consider their possible relationship to the cheetah's adaptation to speed. Although published data on the AC joint of the other felids show general resemblance to that of the cheetah, there are nevertheless slight, but significant variations and modifications which tend to suggest adaptation to speed. The shafts of the radius and ulna of the cheetah are relatively straight and slender, with poorly developed distal ends. The ulnar notch is reduced to a very shallow concavity while the corresponding ulnar facet is a barely noticeable convexity, separated from the distal ulnar articular facet by an ill-defined groove. The movement of the distal radio-ulnar joint is highly restricted by the presence of a fibro-cartilaginous structure and a strong interrosseous membrane, limiting pronation and supination normally achieved by the rotation of the radius around the ulna. The extensor grooves at the distal extremity of the radius are deep and narrow and are guarded by prominent ridges. A thick extensor retinaculum anchors the strong extensor tendons in these grooves. The distal articular surface of the radius is concave in all directions except at the point where it moves into its stylold process. At this point it is convex in the dorsopalmar direction, with a surface that is rather deep and narrow. The proximal row of carpal bones presents a strongly convex surface, which is more pronounced in the dorsopalmar direction with the greatest convexity on the lateral aspect. Medially, there is a ridge-like concavity across the base of the tubercle, which rocks on the flexor surface of the radius, limiting excessive flexion as well as restricting lateral deviation of the AC joint.
Mesfar, Wissal; Moglo, Kodjo
2013-10-01
In order to diagnosis a transverse ligament rupture in the cervical spine, clinicians normally measure the atlas-dens interval by using CT scan images. However, the impact of this tear on the head and neck complex biomechanics is not widely studied. The transverse ligament plays a very important role in stabilizing the joint and its alteration may have a substantial effect on the whole head and neck complex. A finite element model consisting of bony structures along with cartilage, intervertebral discs and all ligaments was developed based on CT and MRI images. The effect of head weights (compressive load) of 30 N to 57 N was investigated in the cases of intact and ruptured transverse ligament joints. The model was validated based on experimental studies investigating the response of the cervical spine under the extension-flexion moment. The predictions indicate a significant alteration of the kinematics and load distribution at the facet joints of the cervical spine with a transverse ligament tear. The vertebrae flexion, the contact force at the facets joints and the atlas-dens interval increase with the rupture of the transverse ligament and are dependent to the head weight. A transverse ligament tear increases the flexion angle of the head and the vertebrae as well as the atlas-dens interval. The atlas-dens interval reaches a critical value when the compressive loading exceeds 40 N. Supporting the head after an injury should be considered to avoid compression of the spinal cord and permanent neurologic damage. © 2013.
Kitagawa, Yuichi; Yasuki, Tsuyoshi; Hasegawa, Junji
2006-11-01
Many efforts have been made to understand the mechanism of whiplash injury. Recently, the cervical facet joint capsules have been focused on as a potential site of injury. An experimental approach has been taken to analyze the vertebral motion and to estimate joint capsule stretch that was thought to be a potential cause of pain. The purpose of this study is to analyze the kinematics of the cervical facet joint using a human FE model in order to better understand the injury mechanism. The Total Human Model for Safety (THUMS) was used to visually analyze the local and global kinematics of the spine. Soft tissues in the neck were newly modeled and introduced into THUMS for estimating the loading level in rear impacts. The model was first validated against human test data in the literature by comparing vertebrae motion as well as head and neck responses. Joint capsule strain was estimated from a maximum principal strain output from the elements representing the capsule tissues. A rear-end collision was then simulated using THUMS and a prototype seat model, assuming a delta-V of 25 km/h. The trajectory of the vertebrae was analyzed in a local coordinate system defined along the joint surface. Strain growth in the joint capsules was explained, as related to contact events between the occupant and the seat. A new seat concept was proposed to help lessen the loading level to the neck soft tissues. The foam material of the seat back was softened, the initial gap behind the head was reduced and the head restraint was stiffened for firm support. The lower seat back frame was also reinforced to withstand the impact severity at the given delta-V. Another rear impact simulation was conducted using the new seat concept model to examine the effectiveness of the new concept. The joint capsule strain was found to be relatively lower with the new seat concept. The study also discusses the influence of seat parameters to the vertebral motion and the resultant strain in the joint capsules. The meaning of the contact timing of the head to the head restraint was examined based on the results in terms of correlation with injury indicators such as NIC and the joint capsule strain.
Shuang, Feng; Zhou, Ying; Hou, Shu-Xun; Zhu, Jia-Liang; Liu, Yan; Zhang, Chun-Li; Tang, Jia-Guang
2015-05-20
Indian Hedgehog (HH) has been shown to be involved in osteoarthritis (OA) in articular joints, where there is evidence that Indian HH blockade could ameliorate OA. It seems to play a prominent role in development of the intervertebral disc (IVD) and in postnatal maintenance. There is little work on IHH in the IVD. Hence the aim of the current study was to investigate the role of Indian Hedgehog in the pathology of facet joint (FJ) OA. 24 patients diagnosed with lumbar intervertebral disk herniation or degenerative spinal stenosis were included. Preoperative magnetic resonance imaging (MRI) and Osteoarthritis Research Society International (OARSI) histopathology grading system was correlated to the mRNA levels of GLI1, PTCH1, and HHIP in the FJs. The Weishaupt grading and OARSI scores showed high positive correlation (r = 0.894) (P < 0.01). MRI Weishaupt grades showed positive correlation with GLI1 (r = 0.491), PTCH1 (r = 0.444), and HHIP (r = 0.654) mRNA levels (P < 0.05 in each case). OARSI scores were also positively correlated with GLI1 (r = 0. 646), PTCH1 (r = 0. 518), and HHIP (r = 0.762) mRNA levels (P < 0.01 in each case). Cumulatively our findings indicate that Indian HH signaling is increased in OA and is perhaps a key component in OA pathogenesis and progression.
Dreischarf, Marcel; Schmidt, Hendrik; Putzier, Michael; Zander, Thomas
2015-09-18
Total disc replacement has been introduced to overcome negative side effects of spinal fusion. The amount of iatrogenic distraction, preoperative disc height and implant positioning have been considered important for surgical success. However, their effect on the postoperative range of motion (RoM) and loading of the facets merits further discussion. A validated osteoligamentous finite element model of the lumbosacral spine was employed and extended with four additional models to account for different disc heights. An artificial disc with a fixed center of rotation (CoR) was implemented in L5-S1. In 4000 simulations, the influence of distraction and the CoR's location on the RoM, facet joint forces (FJFs) and facet capsule ligament forces (FCLFs) was investigated. Distraction substantially altered segmental kinematics in the sagittal plane by decreasing range of flexion (0.5° per 1mm of distraction), increasing range of extension (0.7°/mm) and slightly affecting complete sagittal RoM (0.2°/mm). The distraction already strongly increased the FCLFs during surgery (up to 230N) and in flexion (~12N/mm), with higher values in models with larger preoperative disc heights, and increased FJFs in extension. A more anterior implant location decreased the RoM in all planes. In most loading cases, a more posterior location of the implant's CoR increased the FJFs and FCLFs, whereas a more caudal location increased the FCLFs but decreased the FJFs. The results of this study may explain the worse clinical results in patients with overdistraction after TDR. The complete RoM in the sagittal plane appears to be insensitive to detecting surgery-related biomechanical changes. Copyright © 2015 Elsevier Ltd. All rights reserved.
Monie, Aubrey P; Price, Roger I; Lind, Christopher R P; Singer, Kevin P
2017-06-01
A test-retest cohort study was conducted to assess the use of a novel computer-aided, combined movement examination (CME) to measure change in low back movement after pain management intervention in 17 cases of lumbar spondylosis. Additionally we desired to use a CME normal reference range (NRR) to compare and contrast movement patterns identified from 3 specific structural pathologic conditions: intervertebral disc, facet joint, and nerve root compression. Computer-aided CME was used before and after intervention, in a cohort study design, to record lumbar range of movement along with pain, disability, and health self-report questionnaires in 17 participants who received image-guided facet, epidural, and/or rhizotomy intervention. In the majority of cases, CME was reassessed after injection together with 2 serial self-reports after an average of 2 and 14 weeks. A minimal clinically important difference of 30% was used to interpret meaningful change in self-reports. A CME NRR (n = 159) was used for comparison with the 17 cases. Post hoc observation included subgrouping cases into 3 discrete pathologic conditions, intervertebral disc, facet dysfunction, and nerve root compression, in order to report intergroup differences in CME movement. Seven of the 17 participants stated that a "combined" movement was their most painful CME direction. Self-report outcome data indicated that 4 participants experienced significant improvement in health survey, 5 improved by ≥30% on low back function, and 8 reported that low back pain was more bothersome than stiffness, 6 of whom achieved the minimal clinically important difference for self-reported pain. Subgrouping of cases into structure-specific groups provided insight to different CME movement patterns. The use of CME assists in identifying atypical lumbar movement relative to an age and sex NRR. Data from this study, exemplified by representative case studies, provide preliminary evidence for distinct intervertebral disc, facet joint, and nerve root compression CME movement patterns in cases of chronic lumbar spondylosis. Copyright © 2017. Published by Elsevier Inc.
Isosurface Display of 3-D Scalar Fields from a Meteorological Model on Google Earth
2013-07-01
facets to four, we have chosen to adopt and implement a revised method discussed and made available by Bourke (1994), which can accommodate up to...five facets for a given grid cube. While the published code from Bourke (1994) is in the public domain, it was originally implemented in the C...and atmospheric temperatures. 17 4. References Bourke , P. Polygonising a Scalar Field. http://paulbourke.net/geometry/polygonise
Joint Manipulation: Toward a General Theory of High-Velocity, Low-Amplitude Thrust Techniques.
Harwich, Andrew S
2017-12-01
The objective of this study was to describe the initial stage of a generalized theory of high-velocity, low-amplitude thrust (HVLAT) techniques for joint manipulation. This study examined the movements described by authors from the fields of osteopathy, chiropractic, and physical therapy to produce joint cavitation in both the metacarpophalangeal (MCP) joint and the cervical spine apophysial joint. This study qualitatively compared the kinetics, the similarities, and the differences between MCP cavitation and cervical facet joint cavitation. A qualitative vector analysis of forces and movements was undertaken by constructing computer-generated, simplified graphical models of the MCP joint and a typical cervical apophysial joint and imposing the motions dictated by the clinical technique. Comparing the path to cavitation of 2 modes of HVLAT for the MCP joint, namely, distraction and hyperflexion, it was found that the hyperflexion method requires an axis of rotation, the hinge axis, which is also required for cervical HVLAT. These results show that there is an analogue of cervical HVLAT in one of the MCP joint HVLATs. The study demonstrated that in a theoretical model, the path to joint cavitation is the same for asymmetric separation of the joint surfaces in the cervical spine and the MCP joints.
Boundary Recovery For Delaunay Tetrahedral Meshes Using Local Topological Transformations
Ghadyani, Hamid; Sullivan, John; Wu, Ziji
2009-01-01
Numerous high-quality, volume mesh-generation systems exist. However, no strategy can address all geometry situations without some element qualities being compromised. Many 3D mesh generation algorithms are based on Delaunay tetrahedralization which frequently fails to preserve the input boundary surface topology. For biomedical applications, this surface preservation can be critical as they usually contain multiple material regions of interest coherently connected. In this paper we present an algorithm as a post-processing method that optimizes local regions of compromised element quality and recovers the original boundary surface facets (triangles) regardless of the original mesh generation strategy. The algorithm carves out a small sub-volume in the vicinity of the missing boundary facet or compromised element, creating a cavity. If the task is to recover a surface boundary facet, a natural exit hole in the cavity will be present. This hole is patched with the missing boundary surface face first followed by other patches to seal the cavity. If the task was to improve a compromised region, then the cavity is already sealed. Every triangular facet of the cavity shell is classified as an active face and can be connected to another shell node creating a tetrahedron. In the process the base of the tetrahedron is removed from the active face list and potentially 3 new active faces are created. This methodology is the underpinnings of our last resort method. Each active face can be viewed as the trunk of a tree. An exhaustive breath and depth search will identify all possible tetrahedral combinations to uniquely fill the cavity. We have streamlined this recursive process reducing the time complexity by orders of magnitude. The original surfaces boundaries (internal and external) are fully restored and the quality of compromised regions improved. PMID:20305743
A Systems Biology Approach to Synovial Joint Lubrication in Health, Injury, and Disease
Hui, Alexander Y.; McCarty, William J.; Masuda, Koichi; Firestein, Gary S.; Sah, Robert L.
2013-01-01
The synovial joint contains synovial fluid (SF) within a cavity bounded by articular cartilage and synovium. SF is a viscous fluid that has lubrication, metabolic, and regulatory functions within synovial joints. SF contains lubricant molecules, including proteoglycan-4 and hyaluronan. SF is an ultrafiltrate of plasma with secreted contributions from cell populations lining and within the synovial joint space, including chondrocytes and synoviocytes. Maintenance of normal SF lubricant composition and function are important for joint homeostasis. In osteoarthritis, rheumatoid arthritis, and joint injury, changes in lubricant composition and function accompany alterations in the cytokine and growth factor environment and increased fluid and molecular transport through joint tissues. Thus, understanding the synovial joint lubrication system requires a multi-faceted study of the various parts of the synovial joint and their interactions. Systems biology approaches at multiple scales are being used to describe the molecular, cellular, and tissue components and their interactions that comprise the functioning synovial joint. Analyses of the transcriptome and proteome of SF, cartilage, and synovium suggest that particular molecules and pathways play important roles in joint homeostasis and disease. Such information may be integrated with physicochemical tissue descriptions to construct integrative models of the synovial joint that ultimately may explain maintenance of health, recovery from injury, or development and progression of arthritis. PMID:21826801
Stelzer, Wolfgang; Stelzer, Valentin; Stelzer, Dominik; Braune, Monika; Duller, Christine
2017-01-01
This retrospective original research was designed to illustrate the general outcome after radiofrequency (RF) neurotomy of lumbar medial branch (MB) and posterior ramus of the sacroiliac joint of 160 patients with chronic low back pain (LBP) 1, 6, and 12 months after treatment. Visual Analog Scale (VAS) 0-10 pain scores, quality of life, body mass index (BMI), medication usage, and frequency of physical exercise/sports participation (none, 1-3×/week, more) were collected before the procedure, at 1 month post procedure (n=160), and again at 6 (n=73) and 12 months (n=89) post procedure. A VAS decrease of 4 points on a 10-point scale (from 8 to 4) in the overall group was seen after 6 months and of 4.5 after 12 months. Lower medication usage was reported, with opioids decreased by 40% and nonsteroidal anti-inflammatory drugs (NSAIDs) by 60%. Decreased pain lasted for 12 months. Significantly better outcomes were reported by patients with BMIs <30. No gender-specific differences occurred in the reported decrease in VAS. Analysis of the "no-sports" group versus the more active (1-3 times weekly sports) group showed a better pain decrease after 1 year in the active group. The data suggest RF treatment for chronic LBP that can lead to long-term improvement. Patients with a BMI >30 are less likely to report decreased pain. The better long-term pain relief in the sports participating group is a motivation for the authors to keep the patients in motion.
Locking mechanisms in degree-4 vertex origami structures
NASA Astrophysics Data System (ADS)
Fang, Hongbin; Li, Suyi; Xu, Jian; Wang, K. W.
2016-04-01
Origami has emerged as a potential tool for the design of mechanical metamaterials and metastructures whose novel properties originate from their crease patterns. Most of the attention in origami engineering has focused on the wellknown Miura-Ori, a folded tessellation that is flat-foldable for folded sheet and stacked blocks. This study advances the state of the art and expands the research field to investigate generic degree-4 vertex (4-vertex) origami, with a focus on facet-binding. In order to understand how facet-binding attributes to the mechanical properties of 4-vertex origami structures, geometries of the 4-vertex origami cells are analyzed and analytically expressed. Through repeating and stacking 4-vertex cells, origami sheets and stacked origami blocks can be constructed. Geometry analyses discover four mechanisms that will lead to the self-locking of 4-vertex origami cells, sheets, and stacked blocks: in-cell facet-binding, inlayer facet-binding, inter-layer facet binding, and in-layer and inter-layer facet-bindings. These mechanisms and the predicted self-locking phenomena are verified through 3D simulations and prototype experiments. Finally, this paper briefly introduces the unusual mechanical properties caused by the locking of 4-vertex origami structures. The research reported in this paper could foster a new breed of self-locking structures with various engineering applications.
Ellard, David R; Underwood, Martin; Achana, Felix; Antrobus, James Hl; Balasubramanian, Shyam; Brown, Sally; Cairns, Melinda; Griffin, James; Griffiths, Frances; Haywood, Kirstie; Hutchinson, Charles; Lall, Ranjit; Petrou, Stavros; Stallard, Nigel; Tysall, Colin; Walsh, David A; Sandhu, Harbinder
2017-05-01
The National Institute for Health and Care Excellence (NICE) 2009 guidelines for persistent low back pain (LBP) do not recommend the injection of therapeutic substances into the back as a treatment for LBP because of the absence of evidence for their effectiveness. This feasibility study aimed to provide a stable platform that could be used to evaluate a randomised controlled trial (RCT) on the clinical effectiveness and cost-effectiveness of intra-articular facet joint injections (FJIs) when added to normal care. To explore the feasibility of running a RCT to test the hypothesis that, for people with suspected facet joint back pain, adding the option of intra-articular FJIs (local anaesthetic and corticosteroids) to best usual non-invasive care is clinically effective and cost-effective. The trial was a mixed design. The RCT pilot protocol development involved literature reviews and a consensus conference followed by a randomised pilot study with an embedded mixed-methods process evaluation. Five NHS acute trusts in England. Participants were patients aged ≥ 18 years with moderately troublesome LBP present (> 6 months), who had failed previous conservative treatment and who had suspected facet joint pain. The study aimed to recruit 150 participants (approximately 30 per site). Participants were randomised sequentially by a remote service to FJIs combined with 'best usual care' (BUC) or BUC alone. All participants were to receive six sessions of a bespoke BUC rehabilitation package. Those randomised into the intervention arm were, in addition, given FJIs with local anaesthetic and steroids (at up to six injection sites). Randomisation occurred at the end of the first BUC session. Process and clinical outcomes. Clinical outcomes included a measurement of level of pain on a scale from 0 to 10, which was collected daily and then weekly via text messaging (or through a written diary). Questionnaire follow-up was at 3 months. Fifty-two stakeholders attended the consensus meeting. Agreement informed several statistical questions and three design considerations: diagnosis, the process of FJI and the BUC package and informing the design for the randomised pilot study. Recruitment started on 26 June 2015 and was terminated by the funder (as a result of poor recruitment) on 11 December 2015. In total, 26 participants were randomised. Process data illuminate some of the reasons for recruitment problems but also show that trial processes after enrolment ran smoothly. No between-group analysis was carried out. All pain-related outcomes show the expected improvement between baseline and follow-up. The mean total cost of the overall treatment package (injection £419.22 and BUC £264.00) was estimated at £683.22 per participant. This is similar to a NHS tariff cost for a course of FJIs of £686.84. Poor recruitment was a limiting factor. This feasibility study achieved consensus on the main challenges in a trial of FJIs for people with persistent non-specific low back pain. Further work is needed to test recruitment from alternative clinical situations. EudraCT 2014-000682-50 and Current Controlled Trials ISRCTN93184143. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment ; Vol. 21, No. 30. See the NIHR Journals Library website for further project information.
Tips, techniques and suggestions for improving learning from escaped prescribed fire reviews
Anne Black; Dave Thomas; Jennifer Ziegler; Jim Saveland
2012-01-01
In 2011, we held five 2-day workshops at various locations around the US as part of a Joint Fire Science Program project to understand 'learning from escaped prescribed fire reviews'. Each workshop drew an interagency audience with representation from all facets of fire management, from ground personnel to local line officers, regional, and national positions...
Anne Black; Dave Thomas; Jennifer Ziegler; Jim Saveland
2012-01-01
In 2011, we held five 2-day workshops at various locations around the US as part of a Joint Fire Science Program project to understand 'learning from escaped prescribed fire reviews'. Each workshop drew an interagency audience with representation from all facets of fire management, from ground personnel to local line officers, regional, and national positions...
ERIC Educational Resources Information Center
Yanez, Betina; Edmondson, Donald; Stanton, Annette L.; Park, Crystal L.; Kwan, Lorna; Ganz, Patricia A.; Blank, Thomas O.
2009-01-01
Spirituality is a multidimensional construct, and little is known about how its distinct dimensions jointly affect well-being. In longitudinal studies (Study 1, n = 418 breast cancer patients; Study 2, n = 165 cancer survivors), the authors examined 2 components of spiritual well-being (i.e., meaning/peace and faith) and their interaction, as well…
NASA Astrophysics Data System (ADS)
Shuang, Feng; Zhou, Ying; Hou, Shu-Xun; Zhu, Jia-Liang; Liu, Yan; Zhang, Chun-Li; Tang, Jia-Guang
2015-05-01
Indian Hedgehog (HH) has been shown to be involved in osteoarthritis (OA) in articular joints, where there is evidence that Indian HH blockade could ameliorate OA. It seems to play a prominent role in development of the intervertebral disc (IVD) and in postnatal maintenance. There is little work on IHH in the IVD. Hence the aim of the current study was to investigate the role of Indian Hedgehog in the pathology of facet joint (FJ) OA. 24 patients diagnosed with lumbar intervertebral disk herniation or degenerative spinal stenosis were included. Preoperative magnetic resonance imaging (MRI) and Osteoarthritis Research Society International (OARSI) histopathology grading system was correlated to the mRNA levels of GLI1, PTCH1, and HHIP in the FJs. The Weishaupt grading and OARSI scores showed high positive correlation (r = 0.894) (P < 0.01). MRI Weishaupt grades showed positive correlation with GLI1 (r = 0.491), PTCH1 (r = 0.444), and HHIP (r = 0.654) mRNA levels (P < 0.05 in each case). OARSI scores were also positively correlated with GLI1 (r = 0. 646), PTCH1 (r = 0. 518), and HHIP (r = 0.762) mRNA levels (P < 0.01 in each case). Cumulatively our findings indicate that Indian HH signaling is increased in OA and is perhaps a key component in OA pathogenesis and progression.
Development of a versatile intra-articular pressure sensing array.
Welcher, J B; Popovich, J M; Hedman, T P
2011-10-01
A new sensor array intended to accurately and directly measure spatial and time-dependent pressures within a highly curved biological intra-articular joint was developed and tested. To evaluate performance of the new sensor array for application within intra-articular joints generally, and specifically to fit within the relatively restrictive space of the lumbar spine facet joint, geometric constraints of length, width, thickness and sensor spatial resolution were evaluated. Additionally, the effects of sensor array curvature, frequency response, linearity, drift, hysteresis, repeatability, and total system cost were assessed. The new sensor array was approximately 0.6mm in thickness, scalable to below the nominal 12 mm wide by 15 high lumbar spine facet joint size, offered no inherent limitations on the number or spacing of the sensors with less than 1.7% cross talk with sensor immediately adjacent to one another. No difference was observed in sensor performance down to a radius of curvature of 7 mm and a 0.66±0.97% change in sensor sensitivity was observed at a radius of 5.5mm. The sensor array had less than 0.07 dB signal loss up to 5.5 Hz, linearity was 0.58±0.13% full scale (FS), drift was less than 0.2% FS at 250 s and less than 0.6% FS at 700 s, hysteresis was 0.78±0.18%. Repeatability was excellent with a coefficient of variation less than 2% at pressures between 0 and 1.000 MPa. Total system cost was relatively small as standard commercially available data acquisition systems could be utilized, with no specialized software, and individual sensors within an array can be replaced as needed. The new sensor array had small and scalable geometry and very acceptable intrinsic performance including minimal to no alteration in performance at physiologically relevant ranges of joint curvature. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.
Cervical myelopathy associated with extradural synovial cysts in 4 dogs.
Levitski, R E; Chauvet, A E; Lipsitz, D
1999-01-01
Three Mastiffs and 1 Great Dane were presented to the University of Wisconsin Veterinary Medical Teaching Hospital for cervical myelopathy based on history and neurologic examination. All dogs were males and had progressive ataxia and tetraparesis. Degenerative arthritis of the articular facet joints was noted on survey spinal radiographs. Myelography disclosed lateral axial compression of the cervical spinal cord medial to the articular facets. Extradural compressive cystic structures adjacent to articular facets were identified on magnetic resonance imaging (1 dog). High protein concentration was the most important finding on cerebrospinal fluid analysis. Dorsal laminectomies were performed in all dogs for spinal cord decompression and cyst removal. Findings on cytologic examination of the cystic fluid were consistent with synovial fluid, and histopathologic results supported the diagnosis of synovial cysts. All dogs are ambulatory and 3 are asymptomatic after surgery with a follow-up time ranging from 1 to 8 months. This is the 1st report of extradural synovial cysts in dogs, and synovial cysts should be a differential diagnosis for young giant breed dogs with cervical myelopathy.
Laser-induced asymmetric faceting and growth of a nano-protrusion on a tungsten tip
NASA Astrophysics Data System (ADS)
Yanagisawa, Hirofumi; Zadin, Vahur; Kunze, Karsten; Hafner, Christian; Aabloo, Alvo; Kim, Dong Eon; Kling, Matthias F.; Djurabekova, Flyura; Osterwalder, Jürg; Wuensch, Walter
2016-12-01
Irradiation of a sharp tungsten tip by a femtosecond laser and exposed to a strong DC electric field led to reproducible surface modifications. By a combination of field emission microscopy and scanning electron microscopy, we observed asymmetric surface faceting with sub-ten nanometer high steps. The presence of faceted features mainly on the laser-exposed side implies that the surface modification was driven by a laser-induced transient temperature rise on a scale of a couple of picoseconds in the tungsten tip apex. Moreover, we identified the formation of a nano-tip a few nanometers high located at one of the corners of a faceted plateau. The results of simulations emulating the experimental conditions are consistent with the experimental observations. The presented technique would be a new method to fabricate a nano-tip especially for generating coherent electron pulses. The features may also help to explain the origin of enhanced field emission, which leads to vacuum arcs, in high electric field devices such as radio-frequency particle accelerators.
A finite element evaluation of the moment arm hypothesis for altered vertebral shear failure force.
Howarth, Samuel J; Karakolis, Thomas; Callaghan, Jack P
2015-01-01
The mechanism of vertebral shear failure is likely a bending moment generated about the pars interarticularis by facet contact, and the moment arm length (MAL) between the centroid of facet contact and the location of pars interarticularis failure has been hypothesised to be an influential modulator of shear failure force. To quantitatively evaluate this hypothesis, anterior shear of C3 over C4 was simulated in a finite element model of the porcine C3-C4 vertebral joint with each combination of five compressive force magnitudes (0-60% of estimated compressive failure force) and three postures (flexed, neutral and extended). Bilateral locations of peak stress within C3's pars interarticularis were identified along with the centroids of contact force on the inferior facets. These measurements were used to calculate the MAL of facet contact force. Changes in MAL were also related to shear failure forces measured from similar in vitro tests. Flexed and extended vertebral postures respectively increased and decreased the MAL by 6.6% and 4.8%. The MAL decreased by only 2.6% from the smallest to the largest compressive force. Furthermore, altered MAL explained 70% of the variance in measured shear failure force from comparable in vitro testing with larger MALs being associated with lower shear failure forces. Our results confirmed that the MAL is indeed a significant modulator of vertebral shear failure force. Considering spine flexion is necessary when assessing low-back shear injury potential because of the association between altered facet articulation and lower vertebral shear failure tolerance.
Neandertal talus bones from El Sidrón site (Asturias, Spain): A 3D geometric morphometrics analysis.
Rosas, Antonio; Ferrando, Anabel; Bastir, Markus; García-Tabernero, Antonio; Estalrrich, Almudena; Huguet, Rosa; García-Martínez, Daniel; Pastor, Juan Francisco; de la Rasilla, Marco
2017-10-01
The El Sidrón tali sample is assessed in an evolutionary framework. We aim to explore the relationship between Neandertal talus morphology and body size/shape. We test the hypothesis 1: talar Neandertal traits are influenced by body size, and the hypothesis 2: shape variables independent of body size correspond to inherited primitive features. We quantify 35 landmarks through 3D geometric morphometrics techniques to describe H. neanderthalensis-H. sapiens shape variation, by Mean Shape Comparisons, Principal Component, Phenetic Clusters, Minimum spanning tree analyses and partial least square and regression of talus shape on body variables. Shape variation correlated to body size is compared to Neandertals-Modern Humans (MH) evolutionary shape variation. The Neandertal sample is compared to early hominins. Neandertal talus presents trochlear hypertrophy, a larger equality of trochlear rims, a shorter neck, a more expanded head, curvature and an anterior location of the medial malleolar facet, an expanded and projected lateral malleolar facet and laterally expanded posterior calcaneal facet compared to MH. The Neandertal talocrural joint morphology is influenced by body size. The other Neandertal talus traits do not co-vary with it or not follow the same co-variation pattern as MH. Besides, the trochlear hypertrophy, the trochlear rims equality and the short neck could be inherited primitive features; the medial malleolar facet morphology could be an inherited primitive feature or a secondarily primitive trait; and the calcaneal posterior facet would be an autapomorphic feature of the Neandertal lineage. © 2017 Wiley Periodicals, Inc.
Research study on neck injury lessening with active head restraint using human body FE model.
Kitagawa, Yuichi; Yasuki, Tsuyoshi; Hasegawa, Junji
2008-12-01
The objective of this study is to examine the effectiveness of the active head restraint system in reducing neck injury risk of car occupants in low-speed rear impacts. A human body FE model "THUMS" was used to simulate head and neck kinematics of the occupant and to evaluate loading to the neck. Joint capsule strain was calculated to predict neck injury risk as well as NIC. The validity of the model was confirmed comparing its mechanical responses to those in human subjects in the literatures. Seat FE models were also prepared representing one with a fixed head restraint and the other one with an active head restraint system. The active head restraint system was designed to move the head restraint forward and upward when the lower unit was lower unit was loaded by the pelvis. Rear impact simulations were performed assuming a triangular acceleration pulse at a delta-V of 25 km/h. The model reproduced similar head and neck motions to those measured in the human volunteer test, except for active muscular responses. The calculated joint capsule strain also showed a good match with those of PMHS tests in the literature. A rear-impact simulation was conducted using the model with the fixed head restraint. The result revealed that NIC was strongly correlated with the relative acceleration between the head and the torso and that its maximum peak appeared when the head contacted the head restraint. It was also found that joint capsule strain grew in later timing synchronizing with the relative displacement. Another simulation with the active head restraint system showed that both NIC and joint capsule strain were lowered owing to the forward and upward motion of the head restraint. A close investigation of the vertebral motion indicated that the active head restraint reduced the magnitude of shear deformation in the facet joint, which contributed to the strain growth in the fixed head restraint case. Rear-impact simulations were conducted using a human body FE model, THUMS, representing an average-size male occupant. The cervical system including the facet joint capsules was incorporated to the model. The validity of the model was examined comparing its mechanical responses to those in the literature such as the whole body motion of the volunteer subject and the vertebral motion in the PMHS tests. Rear-impact simulations were conducted using the validated THUMS model and two prototype seat models; one had a fixed head restraint and the other one was equipped with an active head restraint system. The active head restraint system works moving the head restraint forward and upward when the lower unit is loaded by the pelvis. The head and neck kinematics and responses were analyzed from the simulation results. The force and acceleration rose at the pelvis first, followed by T1 and the head. The early timing of force rise and its magnitude indicated that the pelvis force was a good trigger for the active head restraint system. The results showed that the head was supported earlier in a case with the active head restraint system, and both NIC and joint capsule strain were lowered. The study also analyzed the mechanism of strain growth in the joint capsules. Relatively greater strain was observed in the direction of the facet joint surface, which was around 45 degrees inclined to the spinal column. The forward and upward motion of the active head restraint were aligned with the direction of the joint deformation and contributed to lower strain in the joint capsules. The results indicated that the active head restraint could help reduce the neck injury risk not only by supporting the head at an early timing but also through its trajectory stopping the joint deformation.
Equilibrium shape of 4He crystal under zero gravity below 200 mK
Takahashi, Takuya; Ohuchi, Haruka; Nomura, Ryuji; Okuda, Yuichi
2015-01-01
Equilibrium crystal shape is the lowest energy crystal shape that is hardly realized in ordinary crystals because of their slow relaxation. 4He quantum crystals in a superfluid have been expected as unique exceptions that grow extremely fast at very low temperatures. However, on the ground, gravity considerably deforms the crystals and conceals the equilibrium crystal shape, and thus, gravity-free environment is needed to observe the equilibrium shape of 4He. We report the relaxation processes of macroscopic 4He crystals in a superfluid below 200 mK under zero gravity using a parabolic flight of a jet plane. When gravity was removed from a gravity-flattened 4He crystal, the crystal rapidly transformed into a shape with flat surfaces. Although the relaxation processes were highly dependent on the initial condition, the crystals relaxed to a nearly homothetic shape in the end, indicating that they were truly in an equilibrium shape minimizing the interfacial free energy. Thanks to the equilibrium shape, we were able to determine the Wulff’s origin and the size of the c-facet together with the vicinal surface profile next to the c-facet. The c-facet size was extremely small in the quantum crystals, and the facet-like flat surfaces were found to be the vicinal surfaces. At the same time, the interfacial free energy of the a-facet and s-facet was also obtained. PMID:26601315
Equilibrium shape of (4)He crystal under zero gravity below 200 mK.
Takahashi, Takuya; Ohuchi, Haruka; Nomura, Ryuji; Okuda, Yuichi
2015-10-01
Equilibrium crystal shape is the lowest energy crystal shape that is hardly realized in ordinary crystals because of their slow relaxation. (4)He quantum crystals in a superfluid have been expected as unique exceptions that grow extremely fast at very low temperatures. However, on the ground, gravity considerably deforms the crystals and conceals the equilibrium crystal shape, and thus, gravity-free environment is needed to observe the equilibrium shape of (4)He. We report the relaxation processes of macroscopic (4)He crystals in a superfluid below 200 mK under zero gravity using a parabolic flight of a jet plane. When gravity was removed from a gravity-flattened (4)He crystal, the crystal rapidly transformed into a shape with flat surfaces. Although the relaxation processes were highly dependent on the initial condition, the crystals relaxed to a nearly homothetic shape in the end, indicating that they were truly in an equilibrium shape minimizing the interfacial free energy. Thanks to the equilibrium shape, we were able to determine the Wulff's origin and the size of the c-facet together with the vicinal surface profile next to the c-facet. The c-facet size was extremely small in the quantum crystals, and the facet-like flat surfaces were found to be the vicinal surfaces. At the same time, the interfacial free energy of the a-facet and s-facet was also obtained.
Economic Development in Indonesia
1960-11-21
Deficit Spending and Economic Development..,.. 1 What Follows Rupiah Rehabilitation 9 Private Capital and the Cooperative Movement 14 Some Facets of...the American dollar. 13 PRIVATE CAPITAL AND THE COOPERATIVE MOVEMENT J^he following is a full translation of an article-Wägten by R. P. Suroso...bent themselves energetically to the realization of the ideals and principles enunciated in the Joint Declaration, then the cooperative movement can
Development of a Brief Version of the Pathological Narcissism Inventory
Schoenleber, Michelle; Roche, Michael J.; Wetzel, Eunike; Pincus, Aaron L.; Roberts, Brent W.
2015-01-01
With theoretical and empirical interest in narcissism growing, there is a need for brief measures of pathological narcissism that can be used more practically while assessing the construct comprehensively. Data from four samples (total n = 3,851) collected across two separate research groups and representing undergraduate, community, and clinical populations was used to establish the reliability, validity, and utility of the Brief-Pathological Narcissism Inventory (B-PNI). Item response theory and confirmatory factor analyses were used to determine the best-performing 28 items from the original PNI and ensure that the B-PNI exhibited a factor structure consistent with the original PNI. Items were retained for all seven pathological narcissism facet scales. Additional results also support the criterion validity of the B-PNI, suggesting it can be used in place of the original PNI to assess the various facets of pathological narcissism effectively and without loss of information, which may enhance the ability of researchers to investigate pathological narcissism in future work. PMID:26011478
Development of a brief version of the Pathological Narcissism Inventory.
Schoenleber, Michelle; Roche, Michael J; Wetzel, Eunike; Pincus, Aaron L; Roberts, Brent W
2015-12-01
With theoretical and empirical interest in narcissism growing, there is a need for brief measures of pathological narcissism that can be used more practically while assessing the construct comprehensively. Data from four samples (total N = 3,851) collected across two separate research groups and representing undergraduate, community, and clinical populations were used to establish the reliability, validity, and utility of the Brief-Pathological Narcissism Inventory (B-PNI). Item response theory and confirmatory factor analyses were used to determine the best-performing 28 items from the original PNI and ensure that the B-PNI exhibited a factor structure consistent with the original PNI. Items were retained for all seven pathological narcissism facet scales. Additional results also support the criterion validity of the B-PNI, suggesting that it can be used in place of the original PNI to assess the various facets of pathological narcissism effectively and without loss of information, which may enhance the ability of researchers to investigate pathological narcissism in future work. (c) 2015 APA, all rights reserved).
Yeom, Jin S; Riew, K Daniel; Kang, Sung Shik; Yi, Jemin; Lee, Gun Woo; Yeom, Arim; Chang, Bong-Soon; Lee, Choon-Ki; Kim, Ho-Joong
2015-10-15
Prospective observational cohort study. To compare the outcomes of our new technique, distraction arthrodesis of C1-C2 facet joint with C2 root preservation (Study group), to those of conventional C1-C2 fusion with C2 root transection (Control group) for the management of intractable occipital neuralgia caused by C2 root compression. We are not aware of any report concerning C2 root decompression during C1-C2 fusion. Inclusion criteria were visual analogue scale (VAS) score for occipital neuralgia 7 or more; C2 root compression at the collapsed C1-C2 neural foramen; and follow-up 12 months or more. The Study group underwent surgery with our new technique including (1) C1-C2 facet joint distraction and bone block insertion while preserving the C2 root; and (2) use of C1 posterior arch screws instead of conventional lateral mass screws during C1-C2 segmental screw fixation. The Control group underwent C2 root transection with C1-C2 segmental screw fixation and fusion. We compared the prospectively collected outcomes data. There were 15 patients in the Study group and 8 in the Control group. Although there was no significant difference in the VAS score for the occipital neuralgia between the 2 groups preoperatively (8.2 ± 0.9 vs. 7.9 ± 0.6, P = 0.39), it was significantly lower in the Study group at 1, 3, and 6 months postoperatively (P < 0.01, respectively). At 12 months, it was 0.4 ± 0.6 versus 2.5 ± 2.6 (P = 0.01). There was no significant difference in improvement in the VAS score for neck pain and neck disability index and Japanese Orthopedic Association recovery rate, which are minimally influenced by occipital neuralgia. Our novel technique of distraction arthrodesis with C2 root preservation can be an effective option for the management of intractable occipital neuralgia caused by C2 root compression.
Subtalar joint stress imaging with tomosynthesis.
Teramoto, Atsushi; Watanabe, Kota; Takashima, Hiroyuki; Yamashita, Toshihiko
2014-06-01
The purpose of this study was to perform stress imaging of hindfoot inversion and eversion using tomosynthesis and to assess the subtalar joint range of motion (ROM) of healthy subjects. The subjects were 15 healthy volunteers with a mean age of 29.1 years. Coronal tomosynthesis stress imaging of the subtalar joint was performed in a total of 30 left and right ankles. A Telos stress device was used for the stress load, and the load was 150 N for both inversion and eversion. Tomographic images in which the posterior talocalcaneal joint could be confirmed on the neutral position images were used in measurements. The angle of the intersection formed by a line through the lateral articular facet of the posterior talocalcaneal joint and a line through the surface of the trochlea of the talus was measured. The mean change in the angle of the calcaneus with respect to the talus was 10.3 ± 4.8° with inversion stress and 5.0 ± 3.8° with eversion stress from the neutral position. The result was a clearer depiction of the subtalar joint, and inversion and eversion ROM of the subtalar joint was shown to be about 15° in healthy subjects. Diagnostic, Level IV.
Randomized trial of radiofrequency lumbar facet denervation for chronic low back pain.
van Kleef, M; Barendse, G A; Kessels, A; Voets, H M; Weber, W E; de Lange, S
1999-09-15
A prospective double-blind randomized trial in 31 patients. To assess the clinical efficacy of percutaneous radiofrequency denervation of the lumbar zygapophysial joints in reducing pain, functional disability, and physical impairment in patients with back pain originating from the lumbar zygapophysial joints. Chronic low back pain is a major health problem in the industrialized world. A treatment option is percutaneous radiofrequency denervation of the lumbar zygapophysial joints. Its clinical efficacy has never been formally tested in a controlled trial. Thirty-one patients with a history of at least 1 year of chronic low back pain were selected on the basis of a positive response to a diagnostic nerve blockade and subsequently randomly assigned to one of two treatment groups. Each patient in the radiofrequency treatment group (15 patients) received an 80 C radiofrequency lesion of the dorsal ramus of the segmental nerve roots L3, L4, and L5. Patients in the control group (n = 16) underwent an the same procedure but without use of a radiofrequency current. Both the treating physician and the patients were blinded to the group assignment. Before treatment, physical impairment, rating of pain, the degree of disability, and quality of life were assessed by a blinded investigator. Eight weeks after treatment, there were 10 success patients in the radiofrequency group (n = 15) and 6 in the sham group (n = 16). The unadjusted odds ratio was 3.3 (P = 0.05, not significant), and the adjusted odds ratio was 4.8 (P < 0.05, significant). The differences in effect on the visual analog scale scores, global perceived effect, and the Oswestry disability scale were statistically significant. Three, 6, and 12 months after treatment, there were significantly more success patients in the radiofrequency group compared with the sham group. Radiofrequency lumbar zygapophysial joint denervation results in a significant alleviation of pain and functional disability in a select group of patients with chronic low back pain, both on a short-term and a long-term basis.
Kinematic and fatigue biomechanics of an interpositional facet arthroplasty device.
Dahl, Michael C; Freeman, Andrew L
2016-04-01
Although approximately 30% of chronic lumbar pain can be attributed to the facets, limited surgical options exist for patients. Interpositional facet arthroplasty (IFA) is a novel treatment for lumbar facetogenic pain designed to provide patients who gain insufficient relief from medical interventional treatment options with long-term relief, filling a void in the facet pain treatment continuum. This study aimed to quantify the effect of IFA on segmental range of motion (ROM) compared with the intact state, and to observe device position and condition after 10,000 cycles of worst-case loading. In situ biomechanical analysis of the lumbar spine following implantation of a novel IFA device was carried out. Twelve cadaveric functional spinal units (L2-L3 and L5-S1) were tested in 7.5 Nm flexion-extension, lateral bending, and torsion while intact and following device implantation. Additionally, specimens underwent 10,000 cycles of worst-case complex loading and were testing in ROM again. Load-displacement and fluoroscopic data were analyzed to determine ROM and to evaluate device position during cyclic testing. Devices and facets were evaluated post testing. Institutional support for implant evaluation was received by Zyga Technology. Range of motion post implantation decreased versus intact, and then was restored post cyclic-testing. Of the tested devices, 6.5% displayed slight movement (0.5-2 mm), all from tight L2-L3 facet joints with misplaced devices or insufficient cartilage. No damage was observed on the devices, and wear patterns were primarily linear. The results from this in situ cadaveric biomechanics and cyclic fatigue study demonstrate that a low-profile, conformable IFA device can maintain position and facet functionality post implantation and through 10,000 complex loading cycles. In vivo conditions were not accounted for in this model, which may affect implant behavior not predictable via a biomechanical study. However, these data along with published 1-year clinical results suggest that IFA may be a valid treatment option in patients with chronic lumbar zygapophysial pain who have exhausted medical interventional options. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.
Correlation between varus knee malalignment and patellofemoral osteoarthritis.
Otsuki, Shuhei; Nakajima, Mikio; Okamoto, Yoshinori; Oda, Shuhei; Hoshiyama, Yoshiaki; Iida, Go; Neo, Masashi
2016-01-01
To evaluate the relationship between patellofemoral osteoarthritis (OA) and varus OA of the knee with a focus on the location of joint space narrowing. Eighty-five patients scheduled to undergo total knee arthroplasty caused by varus OA were enrolled in this study. The relationship between patellofemoral OA and varus knee malalignment was elucidated. To determine the alignment of the patellofemoral joint in varus knees, patellar tilt, and the tibial tuberosity-trochlear groove (TT-TG) distance were measured, and patellofemoral OA was classified using computed tomography. The femorotibial angles in patients with stage II-IV patellofemoral OA were significantly larger than those in patients with stage I patellofemoral OA, and the patellar tilt in patients with stage II-IV patellofemoral OA and the TT-TG distance in patients with stage IV patellofemoral OA were significantly larger than those in patients with stage I patellofemoral OA. The TT-TG distance was strongly correlated with patellar tilt (R(2) = 0.41, P < 0.001). Patellofemoral joint space narrowing was mainly noted at the lateral facet, and it was found on both sides as patellofemoral OA worsened. Varus knee malalignment was induced by patellofemoral OA, especially at the lateral facet. Patellar tilt and the TT-TG distance are considered critical factors for the severity of patellofemoral OA. Understanding the critical factors for patellofemoral OA in varus knees such as the TT-TG distance and patellar will facilitate the prevention of patellofemoral OA using procedures such as high tibial osteotomy and total knee arthroplasty to correct knee malalignment. Retrospective cohort study, Level III.
ERIC Educational Resources Information Center
Coopers & Lybrand, New York, NY.
Covered in this report of the 1978 project of the Joint Committee on Printing are aspects of three selected areas. Part one, Management Review and Assessment, contains a summary of management and user interviews, a review of GPO's goals and organizational structure, and an assessment of management systems and procedures. The accounting system is…
Tang, Shujie; Meng, Xueying
2011-01-01
The restoration of disc space height of fused segment is essential in anterior lumbar interbody fusion, while the disc space height in many cases decreased postoperatively, which may adversely aggravate the adjacent segmental degeneration. However, no literature available focused on the issue. A normal healthy finite element model of L3-5 and four anterior lumbar interbody fusion models with different disc space height of fused segment were developed. 800 N compressive loading plus 10 Nm moments simulating flexion, extension, lateral bending and axial rotation were imposed on L3 superior endplate. The intradiscal pressure, the intersegmental rotation, the tresca stress and contact force of facet joints in L3-4 were investigated. Anterior lumbar interbody fusion with severely decreased disc space height presented with the highest values of the four parameters, and the normal healthy model presented with the lowest values except, under extension, the contact force of facet joints in normal healthy model is higher than that in normal anterior lumbar interbody fusion model. With disc space height decrease, the values of parameters in each anterior lumbar interbody fusion model increase gradually. Anterior lumbar interbody fusion with decreased disc space height aggravate the adjacent segmental degeneration more adversely.
Yeo, Caitlin T; Ungi, Tamas; U-Thainual, Paweena; Lasso, Andras; McGraw, Robert C; Fichtinger, Gabor
2011-07-01
The purpose of this study was to determine if augmented reality image overlay and laser guidance systems can assist medical trainees in learning the correct placement of a needle for percutaneous facet joint injection. The Perk Station training suite was used to conduct and record the needle insertion procedures. A total of 40 volunteers were randomized into two groups of 20. 1) The Overlay group received a training session that consisted of four insertions with image and laser guidance, followed by two insertions with laser overlay only. 2) The Control group received a training session of six classical freehand insertions. Both groups then conducted two freehand insertions. The movement of the needle was tracked during the series of insertions. The final insertion procedure was assessed to determine if there was a benefit to the overlay method compared to the freehand insertions. The Overlay group had a better success rate (83.3% versus 68.4%, p=0.002), and potential for less tissue damage as measured by the amount of needle movement inside the phantom (3077.6 mm(2) versus 5607.9 mm(2) , p =0.01). These results suggest that an augmented reality overlay guidance system can assist medical trainees in acquiring technical competence in a percutaneous needle insertion procedure. © 2011 IEEE
[Spondylarthrosis of the cervical spine. Therapy].
Radl, R; Leixner, G; Stihsen, C; Windhager, R
2013-09-01
Chronic neck pain is often associated with spondylarthrosis, whereby segments C4/C5 (C: cervical) are most frequently affected. Spondylarthrosis can be the sole complaint, but it is associated with a degenerative cascade of the spine. The umbrella term for neck pain is the so-called cervical syndrome, which can be differentiated into segmental dysfunction and/or morphological changes of the intervertebral discs and small joints of the vertebral column. Conservative therapy modalities include physical therapy, subcutaneous application of local anesthetics, muscle, nerve and facet joint injections in addition to adequate analgesic and muscle relaxant therapy. If surgery is required, various techniques via dorsal and ventral approaches, depending on the clinic and morphologic changes, can be applied.
Herron, Jeffrey A.; Ferrin, Peter; Mavrikakis, Manos
2015-09-24
The electro-oxidation of dimethyl ether (DME) was investigated using periodic, self-consistent density functional theory (DFT) calculations on the (111) and (100) facets of eight fcc metals: Au, Ag, Cu, Pt, Pd, Ni, Ir, and Rh. The goal of this study is to understand the experimentally observed structure sensitivity of this reaction on Pt, and to predict trends in structure sensitivity of this reaction across the other seven metals studied. The main conclusion is that the enhanced activity of Pt(100) originates from more facile C–O bond breaking and removal of surface poisoning species, including CO and CH. When comparing C–O bondmore » breaking energetics, we do not find a universal trend where these elementary steps are always more exergonic on the (100) facet. However, we find that, at a given potential, DME can be dehydrogenated (prior to breaking the C–O bond) to a greater extent on the (100) facet. Additionally, we find that the reaction energy for C–O bond breaking in CHxOCHy-type species becomes increasingly exergonic as the species becomes increasingly dehydrogenated. Together, the more facile dehydrogenation on the (100) facets provides more favorable routes to C–O bond activation. Though we calculate a lower onset potential on Au(100), Ag(100), Cu(100), Pt(100), and Pd(100) than their respective (111) facets, the calculated onset potential for Ni(100), Ir(100), and Rh(100) are actually higher than for their respective (111) facets. Lastly, by constructing theoretical volcano plots, we conclude that Au(100), Ag(100), Cu(100), Pt(100), and Pd(100) should be more active than their respective (111) facets, while Ni(100), Rh(100), and Ir(100) will show the opposite trend.« less
[Relevance of nerve blocks in treating and diagnosing low back pain--is the quality decisive?].
Hildebrandt, J
2001-12-01
Diagnostic nerve blocks: The popularity of neural blockade as a diagnostic tool in painful conditions, especially in the spine, is due to features like the unspecific character of spinal pain, the irrelevance of radiological findings and the purely subjective character of pain. It is said that apart from specific causes of pain and clear radicular involvement with obvious neurological deficits and corresponding findings of a prolapsed disc in MRI or CT pictures, a diagnosis of the anatomical cause of the pain can only be established if invasive tests are used [5]. These include zygapophyseal joint blocks, sacroiliacal joint blocks, disc stimulation and nerve root blocks. Under controlled conditions, it has been shown that among patients with chronic nonradicular low back pain, some 10-15% have zygapophyseal joint pain [58], some 15-20% have sacroiliacal joint pain [36, 59] and 40% have pain from internal disc disruption [60]. The diagnostic use of neural blockade rests on three premises. First, pathology causing pain is located in an exact peripheral location, and impulses from this site travel via a unique and consistent neural root. Second, injection of local aneasthetic totally abolishes sensory function of intended nerves and does not affect other nerves. Third, relief of pain after local anaesthetic block is attributable solely to block of the target afferent neural pathway. The validity of these assumptions is limited by complexities of anatomy, physiology, and psychology of pain perception and the effect of local anaesthetics on impulse conduction [28]. Facet joints: The prevalence of zygapophyseal joint pain among patients with low back pain seems to be between 15% and 40% [62], but apparently only 7% of patients have pure facet pain [8, 29]. Facet blockade is achieved either by injection of local anaesthetic into the joint space or around the medial branches of the posterior medial rami of the spinal nerves that innervate the joint. There are several problems with intraarticular facet injections, mainly failure to enter the joint capsule and rupture of the capsule during the injection [11]. There is no physiological means to test the adaequacy of medial nerve block, because the lower branches have no cutaneous innervation. Medial ramus blocks (for one joint two nerves have to be infiltrated) are as effective as intraarticular joint blocks [37]. Reproducibility of the test is not high, the specifity is only 65% [61]. For diagnosis of facet pain fluoroscopic control is always necessary as in the other diagnostic blocks. Sacroiliacal joint: Definitely the sacroiliacal joint can be the source of low back pain. Stimulation of the joint by injection in subjects without pain produces pain in the buttock, in the posterior thigh and the knee. There are many clinical tests which confirm the diagnosis, but the interrater reliability is moderate [53]. Intraarticular injection can be achieved in the lower part of the joint with fluoroscopic guidance only, but an accurate intraarticular injection, which is confirmed by contrast medium, even at this place is often difficult. It is not clear whether intraarticular spread is necessary to achieve efficacy. Discography: Two primary syndromes concerning the ventral compartment have been described: anular fissures of the disc and instability of the motion segment. In the syndrome of anular tear, leakage of nucleus pulposus material into the anulus fibrosus is considered to be the source of pain. The studies of Vaharanta [71] and Moneta [41] show a clear and significant correlation between disc pain and grade 3 fissures of the anulus fibrosus. intervertebral discs are difficult to anaesthetize. Intradiskal injections of local anaesthetics may succeed in relieving the patient's pain, but such injections are liable to yield false negative results if the injected agent fails to adequately infiltrate the nerve endings in the outer anulus fibrosus that mediate the patient's pain. In the majority of cases MRI provide adaequate information, but discography may be superior in early stages of anular tear and in clarifying the relation between imaging data and pain [71]. Selective spinal nerve injection: In patients with complicated radiculopathy, the contribution of root inflammation to pain may not be certain, or the level of pathology may be unclear. Diagnostic root blocks are indicated in the following situations: atypical topography of radicular pain, disc prolapses or central spinal stenosis at more than one level and monoradicular pain, lateral spinal stenosis, postnucleotomysyndrome. Injection of individual spinal nerves by paravertebral approach has to be used to elucidate the mechanism and source of pain in this unclear situations. The premise is that needle contact will identify the nerve that produces the patient's characteristic pain and that local anaesthetic delivered to the pathogenic nerve will be uniquely analgesic. Often, this method is used for surgical planning, such as determining the site of foraminotomy. All diagnostic nerve root blocks have to be done under fluoroscopic guidance. Pain relief with blockade of a spinal nerve cannot distinguish between pathology of the proximal nerve in the intervertebral foramen or pain transmitted from distal sites by that nerve. Besides, the tissue injury in the nerve's distribution and neuropathic pain (for instance as a result of root injury) likewise would be relieved by a proximal block of the nerve. Satisfactory needle placement could not be achieved in 10% of patient's at L4, 15% at L5 and 30% at S1 [28]. The positive predictive value of indicated radiculopathy confirmed by surgery ranged between 87-100% [14, 22]. The negative predictive value is poorly studied, because few patients in the negative test group had surgery. Negative predictive values were 27% and 38% of the small number of patients operated on despite a negative test. Only one prospective study was published, which showed a positive predictive value of 95% and an untested negative predictive value [66]. Some studies repeatedly demonstrated that pain relief by nerve root block does not predict success by neuroablative procedures, neither by dorsal rhyzotomy nor by dorsal gangliectomy [46]. Therapeutic nerve blocks - facet joints: Intraarticular injection of steroids offer no greater benefit than injections of normal saline [8, 15] and long lasting success is lacking. In this case, a denervation of the medial branches can be considered. To date three randomized controlled studies of radiofrequency facet denervation have been published. One study [20] reported only modest outcomes and its results remained inconclusive, another study [72] with a double blind controlled design showed some effects in a small selected group of patients (adjusted odds ratio 4.8) 3, 6 and 12 months after treatment, concerning not only reduction of pain but alleviating functional disability also. The third study (34a) showed no effect 3 months after treatment. Discogenic pain: Intradiscal radiofrequency lesions, intradiscal injections of steroids and phenol have been advocated, but there are no well controlled studies. Just recently, intradiscal lesion and denervation of the anulus has been described with promising results, but a randomized controlled study is lacking up to now [31, 55]. Epidural Steroids: Steroids relieve pain by reducing inflammation and by blocking transmission of nociceptive C-fiber input. Koes et al. [33] reviewed the randomized trials of epidural steroids: To date, 15 trials have been performed to evaluate the efficacy, 11 of which showed method scores of 50 points (from 100) ore more. The trials showed inconsistent results of epidural injections. Of the 15 trials, 8 reported positive results and 7 others reported negative results. Consequently the efficacy of epidural steroid injections has not yet been established. The benefits of epidural steroid injections seem to be of short duration only. Future efficacy studies, which are clearly needed, should take into account the apparent methological shortcomings. Furthermore, it is unclear which patients benefit from these injections. In our hands the injection technique can be much improved by fluoroscopic guidance of the needle, with a prone position of the patient, and lateral injection at the relevant level and with a small volume (1-2 ml) and low dose of corticosteroid (20 mg triamcinolone in the case of a monoradicular pain, for example). In the case of epidural adhesions in postoperative radicular pain [50], the study of Heafner showed that the additional effect of hyaloronidase and hypertonic saline to steroids was minimal. In our hands there was no effect in chronic radicular pain 3 months after the injection.
Taylor, Michael P; Wedel, Mathew J
2013-01-01
The necks of sauropod dinosaurs were a key factor in their evolution. The habitual posture and range of motion of these necks has been controversial, and computer-aided studies have argued for an obligatory sub-horizontal pose. However, such studies are compromised by their failure to take into account the important role of intervertebral cartilage. This cartilage takes very different forms in different animals. Mammals and crocodilians have intervertebral discs, while birds have synovial joints in their necks. The form and thickness of cartilage varies significantly even among closely related taxa. We cannot yet tell whether the neck joints of sauropods more closely resembled those of birds or mammals. Inspection of CT scans showed cartilage:bone ratios of 4.5% for Sauroposeidon and about 20% and 15% for two juvenile Apatosaurus individuals. In extant animals, this ratio varied from 2.59% for the rhea to 24% for a juvenile giraffe. It is not yet possible to disentangle ontogenetic and taxonomic signals, but mammal cartilage is generally three times as thick as that of birds. Our most detailed work, on a turkey, yielded a cartilage:bone ratio of 4.56%. Articular cartilage also added 11% to the length of the turkey's zygapophyseal facets. Simple image manipulation suggests that incorporating 4.56% of neck cartilage into an intervertebral joint of a turkey raises neutral posture by 15°. If this were also true of sauropods, the true neutral pose of the neck would be much higher than has been depicted. An additional 11% of zygapophyseal facet length translates to 11% more range of motion at each joint. More precise quantitative results must await detailed modelling. In summary, including cartilage in our models of sauropod necks shows that they were longer, more elevated and more flexible than previously recognised.
Taylor, Michael P.; Wedel, Mathew J.
2013-01-01
The necks of sauropod dinosaurs were a key factor in their evolution. The habitual posture and range of motion of these necks has been controversial, and computer-aided studies have argued for an obligatory sub-horizontal pose. However, such studies are compromised by their failure to take into account the important role of intervertebral cartilage. This cartilage takes very different forms in different animals. Mammals and crocodilians have intervertebral discs, while birds have synovial joints in their necks. The form and thickness of cartilage varies significantly even among closely related taxa. We cannot yet tell whether the neck joints of sauropods more closely resembled those of birds or mammals. Inspection of CT scans showed cartilage:bone ratios of 4.5% for Sauroposeidon and about 20% and 15% for two juvenile Apatosaurus individuals. In extant animals, this ratio varied from 2.59% for the rhea to 24% for a juvenile giraffe. It is not yet possible to disentangle ontogenetic and taxonomic signals, but mammal cartilage is generally three times as thick as that of birds. Our most detailed work, on a turkey, yielded a cartilage:bone ratio of 4.56%. Articular cartilage also added 11% to the length of the turkey's zygapophyseal facets. Simple image manipulation suggests that incorporating 4.56% of neck cartilage into an intervertebral joint of a turkey raises neutral posture by 15°. If this were also true of sauropods, the true neutral pose of the neck would be much higher than has been depicted. An additional 11% of zygapophyseal facet length translates to 11% more range of motion at each joint. More precise quantitative results must await detailed modelling. In summary, including cartilage in our models of sauropod necks shows that they were longer, more elevated and more flexible than previously recognised. PMID:24205163
Cervical spondylosis anatomy: pathophysiology and biomechanics.
Shedid, Daniel; Benzel, Edward C
2007-01-01
Cervical spondylosis is the most common progressive disorder in the aging cervical spine. It results from the process of degeneration of the intervertebral discs and facet joints of the cervical spine. Biomechanically, the disc and the facets are the connecting structures between the vertebrae for the transmission of external forces. They also facilitate cervical spine mobility. Symptoms related to myelopathy and radiculopathy are caused by the formation of osteophytes, which compromise the diameter of the spinal canal. This compromise may also be partially developmental. The developmental process, together with the degenerative process, may cause mechanical pressure on the spinal cord at one or multiple levels. This pressure may produce direct neurological damage or ischemic changes and, thus, lead to spinal cord disturbances. A thorough understanding of the biomechanics, the pathology, the clinical presentation, the radiological evaluation, as well as the surgical indications of cervical spondylosis, is essential for the management of patients with cervical spondylosis.
Manchikanti, Laxmaiah; Hansen, Hans; Pampati, Vidyasagar; Falco, Frank J E
2013-01-01
The high prevalence of persistent low back pain and growing number of diagnostic and therapeutic modalities employed to manage chronic low back pain and the subsequent impact on society and the economy continue to hold sway over health care policy. Among the multiple causes responsible for chronic low back pain, the contributions of the sacroiliac joint have been a subject of debate albeit a paucity of research. At present, there are no definitive conservative, interventional or surgical management options for managing sacroiliac joint pain. It has been shown that the increases were highest for facet joint interventions and sacroiliac joint blocks with an increase of 310% per 100,000 Medicare beneficiaries from 2000 to 2011. There has not been a systematic assessment of the utilization and growth patterns of sacroiliac joint injections. Analysis of the growth patterns of sacroiliac joint injections in Medicare beneficiaries from 2000 to 2011. To evaluate the utilization and growth patterns of sacroiliac joint injections. This assessment was performed utilizing Centers for Medicare and Medicaid Services (CMS) Physician/Supplier Procedure Summary (PSPS) Master data from 2000 to 2011. The findings of this assessment in Medicare beneficiaries from 2000 to 2011 showed a 331% increase per 100,000 Medicare beneficiaries with an annual increase of 14.2%, compared to an increase in the Medicare population of 23% or annual increase of 1.9%. The number of procedures increased from 49,554 in 2000 to 252,654 in 2011, or a rate of 125 to 539 per 100,000 Medicare beneficiaries. Among the various specialists performing sacroiliac joint injections, physicians specializing in physical medicine and rehabilitation have shown the most increase, followed by neurology with 1,568% and 698%, even though many physicians from both specialties have been enrolling in interventional pain management and pain management. Even though the numbers were small for nonphysician providers including certified registered nurse anesthetists, nurse practitioners, and physician assistants, these numbers increased substantially at a rate of 4,526% per 100,000 Medicare beneficiaries with 21 procedures performed in 2000 increasing to 4,953 procedures in 2011. The, majority of sacroiliac joint injections were performed in an office setting. The utilization of sacroiliac joint injections by state from 2008 to 2010 showed increases of more than 20% in New Hampshire, Alabama, Minnesota, Vermont, Oregon, Utah, Massachusetts, Kansas, and Maine. Similarly, some states showed significant decreases of 20% or more, including Oklahoma, Louisiana, Maryland, Arkansas, New York, and Hawaii. Overall, there was a 1% increase per 100,000 Medicare population from 2008 to 2010. However, 2011 showed significant increases from 2010. The limitations of this study included a lack of inclusion of Medicare participants in Medicare Advantage plans, the availability of an identifiable code for only sacroiliac joint injections, and the possibility that state claims data may include claims from other states. . This study illustrates the explosive growth of sacroiliac joint injections even more than facet joint interventions. Furthermore, certain groups of providers showed substantial increases. Overall, increases from 2008 to 2010 were nominal with 1%, but some states showed over 20% increases whereas some others showed over 20% decreases.
Knafo-Noam, Ariel; Uzefovsky, Florina; Israel, Salomon; Davidov, Maayan; Zahn-Waxler, Caroyln
2015-01-01
Children vary markedly in their tendency to behave prosocially, and recent research has implicated both genetic and environmental factors in this variability. Yet, little is known about the extent to which different aspects of prosociality constitute a single dimension (the prosocial personality), and to the extent they are intercorrelated, whether these aspects share their genetic and environmental origins. As part of the Longitudinal Israeli Study of Twins (LIST), mothers of 183 monozygotic (MZ) and dizygotic (DZ) 7-year-old twin pairs (51.6% male) reported regarding their children’s prosociality using questionnaires. Five prosociality facets (sharing, social concern, kindness, helping, and empathic concern) were identified. All five facets intercorrelated positively (r > 0.39) suggesting a single-factor structure to the data, consistent with the theoretical idea of a single prosociality trait. Higher MZ than DZ twin correlations indicated genetic contributions to each prosociality facet. A common-factor-common-pathway multivariate model estimated high (69%) heritability for the common prosociality factor, with the non-shared environment and error accounting for the remaining variance. For each facet, unique genetic and environmental contributions were identified as well. The results point to the presence of a broad prosociality phenotype, largely affected by genetics; whereas additional genetic and environmental factors contribute to different aspects of prosociality, such as helping and sharing. PMID:25762952
Chou, Roger; Atlas, Steven J; Stanos, Steven P; Rosenquist, Richard W
2009-05-01
Systematic review. To systematically assess benefits and harms of nonsurgical interventional therapies for low back and radicular pain. Although use of certain interventional therapies is common or increasing, there is also uncertainty or controversy about their efficacy. Electronic database searches on Ovid MEDLINE and the Cochrane databases were conducted through July 2008 to identify randomized controlled trials and systematic reviews of local injections, botulinum toxin injection, prolotherapy, epidural steroid injection, facet joint injection, therapeutic medial branch block, sacroiliac joint injection, intradiscal steroid injection, chemonucleolysis, radiofrequency denervation, intradiscal electrothermal therapy, percutaneous intradiscal radiofrequency thermocoagulation, Coblation nucleoplasty, and spinal cord stimulation. All relevant studies were methodologically assessed by 2 independent reviewers using criteria developed by the Cochrane Back Review Group (for trials) and by Oxman (for systematic reviews). A qualitative synthesis of results was performed using methods adapted from the US Preventive Services Task Force. For sciatica or prolapsed lumbar disc with radiculopathy, we found good evidence that chemonucleolysis is moderately superior to placebo injection but inferior to surgery, and fair evidence that epidural steroid injection is moderately effective for short-term (but not long-term) symptom relief. We found fair evidence that spinal cord stimulation is moderately effective for failed back surgery syndrome with persistent radiculopathy, though device-related complications are common. We found good or fair evidence that prolotherapy, facet joint injection, intradiscal steroid injection, and percutaneous intradiscal radiofrequency thermocoagulation are not effective. Insufficient evidence exists to reliably evaluate other interventional therapies. Few nonsurgical interventional therapies for low back pain have been shown to be effective in randomized, placebo-controlled trials.
Lemelin, Pierre; Hamrick, Mark W; Richmond, Brian G; Godfrey, Laurie R; Jungers, William L; Burney, David A
2008-03-01
A partial, associated skeleton of Hadropithecus stenognathus (AHA-I) was discovered in 2003 at Andrahomana Cave in southeastern Madagascar. Among the postcranial elements found were the first hand bones (right scaphoid, right hamate, left first metacarpal, and right and left fifth metacarpals) attributed to this rare subfossil lemur. These hand bones were compared to those of extant strepsirrhines and catarrhines in order to infer the positional adaptations of Hadropithecus, and they were compared to those of Archaeolemur in order to assess variation in hand morphology among archaeolemurids. The scaphoid tubercle does not project palmarly as in suspensory and climbing taxa, and the hamate has no hook at all (just a small tubercle), which also points to a poorly developed carpal tunnel. There is a distinctive, radioulnarly directed "spiral" facet for articulation with the triquetrum that is most similar in orientation to that of more terrestrial primates (i.e., Lemur catta, Papio, and Gorilla). The first metacarpal is very reduced and represents only 48% of the length of metacarpal V, as in Archaeolemur, which suggests that pollical grasping of arboreal supports was not important. Compared to Archaeolemur, the shaft of metacarpal V is gracile, and the head has no dorsal ridge and lacks characteristics functionally associated with digitigrade, extended metacarpophalangeal joint postures. Proximally, the articular facet for the hamate is oriented more dorsally. Thus, the carpometacarpal joint V appears to have a distinctive hyperextended set, which has no analog among living or extinct primates. The carpals of Hadropithecus are diagnostic of a pronograde, arboreal and terrestrial (although not digitigrade) locomotor repertoire that typifies Lemur catta and some Old World monkeys. No clinging, suspensory, or climbing specializations that characterize indriids or lorises can be found in the hand of this subfossil lemur. The hand of Hadropithecus likely had similar ranges of movement at the radiocarpal and midcarpal joints as of those of pronograde primates, such as lemurids, for which the hand is held in a more extended, pronated, and neutral (i.e., showing less ulnar deviation) position during locomotion in comparison to that of vertical clingers or slow climbers. Although highly autapomorphic, the hand of Hadropithecus resembles that of its sister taxon, Archaeolemur, in having a very reduced pollex and an articular facet on the scaphoid for a sizeable prepollex. These unusual hand features reinforce the monophyly of the Archaeolemuridae.
Kirchner, Fernando; Anitua, Eduardo
2016-01-01
Low back pain (LBP) is a complex and disabling condition, and its treatment becomes a challenge. The aim of our study was to assess the clinical outcome of plasma rich in growth factors (PRGF-Endoret) infiltrations (one intradiscal, one intra-articular facet, and one transforaminal epidural injection) under fluoroscopic guidance-control in patients with chronic LBP. PRGF-Endoret which has been shown to be an efficient treatment to reduce joint pain. The study was designed as an observational retrospective pilot study. Eighty-six patients with a history of chronic LBP and degenerative disease of the lumbar spine who met inclusion and exclusion criteria were recruited between December 2010 and January 2012. One intradiscal, one intra-articular facet, and one transforaminal epidural injection of PRGF-Endoret under fluoroscopic guidance-control were carried out in 86 patients with chronic LBP in the operating theater setting. Descriptive statistics were performed using absolute and relative frequency distributions for qualitative variables and mean values and standard deviations for quantitative variables. The nonparametric Friedman statistical test was used to determine the possible differences between baseline and different follow-up time points on pain reduction after treatment. Pain assessment was determined using a visual analog scale (VAS) at the first visit before (baseline) and after the procedure at 1, 3, and 6 months. The pain reduction after the PRGF-Endoret injections showed a statistically significant drop from 8.4 ± 1.1 before the treatment to 4 ± 2.6, 1.7 ± 2.3, and 0.8 ± 1.7 at 1, 3, and 6 months after the treatment, respectively, with respect to all the time evaluations ( P < 0.0001) except for the pain reduction between the 3 rd and 6 th month whose signification was lower ( P < 0.05). The analysis of the VAS over time showed that at the end point of the study (6 months), 91% of patients showed an excellent score, 8.1% showed a moderate improvement, and 1.2% were in the inefficient score. Fluoroscopy-guided infiltrations of intervertebral discs and facet joints with PRGF in patients with chronic LBP resulted in significant pain reduction assessed by VAS.
Kirchner, Fernando; Anitua, Eduardo
2016-01-01
Context: Low back pain (LBP) is a complex and disabling condition, and its treatment becomes a challenge. Aims: The aim of our study was to assess the clinical outcome of plasma rich in growth factors (PRGF-Endoret) infiltrations (one intradiscal, one intra-articular facet, and one transforaminal epidural injection) under fluoroscopic guidance-control in patients with chronic LBP. PRGF-Endoret which has been shown to be an efficient treatment to reduce joint pain. Settings and Design: The study was designed as an observational retrospective pilot study. Eighty-six patients with a history of chronic LBP and degenerative disease of the lumbar spine who met inclusion and exclusion criteria were recruited between December 2010 and January 2012. Subjects and Methods: One intradiscal, one intra-articular facet, and one transforaminal epidural injection of PRGF-Endoret under fluoroscopic guidance-control were carried out in 86 patients with chronic LBP in the operating theater setting. Statistical Analysis Used: Descriptive statistics were performed using absolute and relative frequency distributions for qualitative variables and mean values and standard deviations for quantitative variables. The nonparametric Friedman statistical test was used to determine the possible differences between baseline and different follow-up time points on pain reduction after treatment. Results: Pain assessment was determined using a visual analog scale (VAS) at the first visit before (baseline) and after the procedure at 1, 3, and 6 months. The pain reduction after the PRGF-Endoret injections showed a statistically significant drop from 8.4 ± 1.1 before the treatment to 4 ± 2.6, 1.7 ± 2.3, and 0.8 ± 1.7 at 1, 3, and 6 months after the treatment, respectively, with respect to all the time evaluations (P < 0.0001) except for the pain reduction between the 3rd and 6th month whose signification was lower (P < 0.05). The analysis of the VAS over time showed that at the end point of the study (6 months), 91% of patients showed an excellent score, 8.1% showed a moderate improvement, and 1.2% were in the inefficient score. Conclusions: Fluoroscopy-guided infiltrations of intervertebral discs and facet joints with PRGF in patients with chronic LBP resulted in significant pain reduction assessed by VAS. PMID:27891035
Enhanced and Facet-specific Electrocatalytic Properties of Ag/Bi2Fe4O9 Composite Nanoparticles.
Wang, Kai; Xu, Xiaoguang; Lu, Liying; Wang, Haicheng; Li, Yan; Wu, Yong; Miao, Jun; Zhang, Jin Zhong; Jiang, Yong
2018-04-18
Ag/Bi 2 Fe 4 O 9 nanoparticles (BFO NPs) have been synthesized using a two-step approach involving glycine combustion and visible light irradiation. Their structures were characterized in detail using X-ray diffraction, transmission electron microscope, scanning electron microscopy, and scanning transmission electron microscopy techniques. Their electrocatalytic properties were studied through enzymatic glucose detection with an amperometric biosensor. The Ag deposited on selective crystal facets of BFO NPs significantly enhanced their electrocatalytic activity. To gain insights into the origin of the enhanced electrocatalytic activities, we have carried out studies of Ag + reduction and Mn 2+ oxidation reaction at the {200} and {001} facets, respectively. The results suggest effective charge separation on the BFO NP surfaces, which is likely responsible for the enhanced electrocatalytic properties. Furthermore, enhanced ferromagnetism was observed after the Ag deposition on BFO NPs, which may be related to the improved electrocatalytic properties through spin-dependent charge transport. The facet-specific electrocatalytic properties are highly interesting and desired for chemical reactions. This study demonstrates that Ag/BFO NPs are potentially useful for electrocatalytic applications including biosensing and chemical synthesis with high product selectivity.
NASA Astrophysics Data System (ADS)
Chowdhury, S. M.; Chen, D. L.; Bhole, S. D.; Powidajko, E.; Weckman, D. C.; Zhou, Y.
2011-07-01
The microstructures, tensile properties, strain hardening, and fatigue strength of fiber-laser-welded (FLW) and diode-laser-welded (DLW) AZ31B-H24 magnesium alloys were studied. Columnar dendrites near the fusion zone (FZ) boundary and equiaxed dendrites at the center of FZ, with divorced eutectic β-Mg17Al12 particles, were observed. The FLW joints had smaller dendrite cell sizes with a narrower FZ than the DLW joints. The heat-affected zone consisted of recrystallized grains. Although the DLW joints fractured at the center of FZ and exhibited lower yield strength (YS), ultimate tensile strength (UTS), and fatigue strength, the FLW joints failed at the fusion boundary and displayed only moderate reduction in the YS, UTS, and fatigue strength with a joint efficiency of ~91 pct. After welding, the strain rate sensitivity basically vanished, and the DLW joints exhibited higher strain-hardening capacity. Stage III hardening occurred after yielding in both base metal (BM) and welded samples. Dimple-like ductile fracture characteristics appeared in the BM, whereas some cleavage-like flat facets together with dimples and river marking were observed in the welded samples. Fatigue crack initiated from the specimen surface or near-surface defects, and crack propagation was characterized by the formation of fatigue striations along with secondary cracks.
Anderson, Jaime L; Sellbom, Martin; Bagby, R Michael; Quilty, Lena C; Veltri, Carlo O C; Markon, Kristian E; Krueger, Robert F
2013-06-01
The DSM-5 Personality and Personality Disorders workgroup and their consultants have developed the 220-item, self-report Personality Inventory for the DSM-5 (PID-5) for direct assessment of the proposed personality trait system for DSM-5; however, most practicing clinical psychologists will likely continue to rely on separate omnibus measures to index symptoms and traits associated with psychopathology. The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) is one such measure and assesses the Personality Psychopathology Five (PSY-5) domains, which are conceptual cognates of the DSM-5 trait domains. The current study examined the associations between the MMPI-2-RF PSY-5 scales and the DSM-5 trait domains and facets indexed by the PID-5. A clear pattern of convergence was found indicating that each of the PSY-5 scales was most highly correlated with its conceptually expected PID-5 counterpart (rs = .44-.67; Mdn r = .53) and facet correlations generally showed the same pattern. Similarly, when each of the PSY-5 scales was regressed onto the PID-5 domains, the conceptually expected pattern of associations emerged even more clearly. Finally, a joint exploratory factor analysis with the PSY-5 and PID-5 trait facet scales indicated a five-factor solution that clearly resembled both of the PSY-5/DSM-5 trait domains. These results show clear evidence that the MMPI-2-RF has utility in the assessment of dimensional personality traits proposed for the upcoming DSM-5.
Biomechanical analysis of a new lumbar interspinous device with optimized topology.
Chen, Chen-Sheng; Shih, Shih-Liang
2018-01-06
Interspinous spacers used stand-alone preserve joint movement but provide little protection for diseased segments of the spine. Used as adjuncts with fusion, interspinous spacers offer rigid stability but may accelerate degeneration on adjacent levels. Our new device is intended to balance the stability and preserves motion provided by the implant. A new interspinous spacer was devised according to the results of topology optimization studies. Four finite element (FE) spine models were created that consisted of an intact spine without an implant, implantation of the novel, the device for intervertebral assisted motion (DIAM system), and the Dynesys system. All models were loaded with moments, and their range of motions (ROMs), peak disc stresses, and facet contact forces were analyzed. The limited motion segment ROMs, shielded disc stresses, and unloaded facet contact forces of the new devices were greater than those of the DIAM and Dynesys system at L3-L4 in almost all directions of movements. The ROMs, disc stresses, and facet contact forces of the new devices at L2-L3 were slightly greater than those in the DIAM system, but much lower than those in the Dynesys system in most directions. This study demonstrated that the new device provided more stability at the instrumented level than the DIAM system did, especially in lateral rotation and the bending direction. The device caused fewer adjacent ROMs, lower disc stresses, and lower facet contact forces than the Dynesys system did. Additionally, this study conducted topology optimization to design the new device and created a smaller implant for minimal invasive surgery.
The semiconductor waveguide facet reflectivity problem
DOE Office of Scientific and Technical Information (OSTI.GOV)
Herzinger, C.M.; Lu, C.C.; DeTemple, T.A.
1993-08-01
The problem of the facet reflectivity of a semiconductor slab waveguide is reexamined as an extension of Ikegami's original approach but which includes radiation-like modes. The latter are included, using a guide-within-a-guide geometry, as modes bound to a thick air-cladding guide which contains the core profile of interest. In this model with a relatively simple analysis, the coupling from the fundamental mode to radiation modes can be analyzed. The cross-coupling to the radiation modes is considered in detail for the simple double heterostructure waveguide and is shown to be important only for large core-cladding index differences and for strong modalmore » confinement wherein it results in a true facet loss. The conditions for this are the same as for low threshold lasers so that the loss sets a maximum limit on the equivalent internal quantum efficiency. A separate one-dimensional finite element, numerical mode matching program, which treats evanescent and propagating radiation modes, is used as a comparison. The two methods of accounting for radiation modes are shown to be in good agreement: both predict reduced extremes in reflectivity when compared with the original Ikegami model. Modern graded core cases are treated as general examples along with the specific quantum well laser structures taken from the literature. These include II-VI and III-V structures spanning wavelengths from 0.5 [mu]m to 10.0 [mu]m.« less
[Does the French Big Five Inventory evaluate facets other than the Big Five factors?
Courtois, R; Petot, J-M; Lignier, B; Lecocq, G; Plaisant, O
2017-03-29
The Big Five Inventory (BFI) developed by John et al. (1991) is one of the most widely accepted tools for assessing dimensions of personality. It comprises 44 items that assess five broad dimensions of personality (the Big Five Factors): Extraversion, Agreeableness, Conscientiousness, Neuroticism and Openness to experience. Based on correlations with the facets described in the NEO Personality Inventory Revised (NEO PI-R), another Big Five assessment tool with 240 items and 6 facets per dimension, Soto and John (2009) showed that the dimensions in the BFI could be divided into two facets each (ten facets altogether). These results are in line with those of DeYoung et al. (2007), who ran factorial analyses with all the NEO PI-R facets and the International Personality Item Pool (IPIP) and identified ten intermediate factors (between facets and dimensions) which they called "aspects" (two per dimension). The goal of the present study is to investigate the ten facets described by Soto and John in a French sample, using the French version of the BFI (BFI-Fr), which has good psychometric properties, and to check whether the pattern of correlations of these facets with the NEO PI-R match those of the American version. We created three groups. The first comprised 360 students from the Institut libre d'éducation physique supérieure (ILEPS) and Tours University (psychology undergraduates). Participants (mean age 21.1 years±2.30; 58% women) completed the BFI-Fr and the NEO PI-R. The second comprised 142 psychology students from Tours University (mean age 20.6 years±1.78; 81% women); they completed the BFI-Fr twice, two weeks apart (test and retest). The third comprised 252 psychology students from Paris-Nanterre University (mean age 23 years±4.2; 89% women) who described a total of 405 people they knew well (mean age 35.2±10.8; 49% women) using the peer-report format of the BFI-Fr. In the self-report format, eight of Soto and John's ten aspects had acceptable internal consistency (based on Guildford's (1954) internal consistency criteria, due to the small number of items), with Cronbach's α between 0.60 and 0.86 and test-retest correlations between 0.71 and 0.89, showing satisfactory temporal stability. We found a single facet for Extraversion (Assertiveness), two for Agreeableness (Altruism and Compliance), two for Conscientiousness (Self-Discipline and Order), one for Neuroticism (Anxiety), and two for Openness to Experience (Openness to aesthetics and Openness to ideas). Based on their convergence with the corresponding facets in the NEO PI-R, these eight facets showed satisfactory external validity. With regard to the peer-report format, the Activity facet of Extraversion, which did not have sufficient internal consistency in the self-report format, had acceptable properties (i.e. 9 out of 10 facets). Only the Depression facet of Neuroticism still had insufficient internal consistency. In this study, we proposed an improvement of two facets (Activity and Compliance) and added one facet specific to the French version (Emotional Instability) in place of the Depression facet. We showed that the BFI-Fr can be used to assess nine of the ten facets described by Soto and John. We also identified an Emotional Instability facet, replacing the Depression facet of Neuroticism. DeYoung et al. (2007) considered that anxiety and depression are indissociable and can be represented by a Neuroticism aspect they labeled Withdrawal. They suggested a second aspect of this dimension they called Volatility (with the N2 Angry Hostility facet of the NEO PI-R as main marker and the N5 Impulsiveness and N3 Depression as secondary markers). The Emotional Instability facet we found corresponds closely to the N2 Angry Hostility facet of the NEO PI-R and appears to be a satisfactory marker of DeYoung et al.'s (2007) Volatility aspect. Although this study has limitations, particularly related to the samples (students), the BFI-Fr facets (derived from those defined by Soto and John in the BFI or proposed as improvements on the original facets) match the corresponding NEO PI-R facets and can also be seen as main markers of the aspects defined by DeYoung et al. Copyright © 2017 L'Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.
Femoral articular geometry and patellofemoral stability.
Iranpour, Farhad; Merican, Azhar M; Teo, Seow Hui; Cobb, Justin P; Amis, Andrew A
2017-06-01
Patellofemoral instability is a major cause of anterior knee pain. The aim of this study was to examine how the medial and lateral stability of the patellofemoral joint in the normal knee changes with knee flexion and measure its relationship to differences in femoral trochlear geometry. Twelve fresh-frozen cadaveric knees were used. Five components of the quadriceps and the iliotibial band were loaded physiologically with 175N and 30N, respectively. The force required to displace the patella 10mm laterally and medially at 0°, 20°, 30°, 60° and 90° knee flexion was measured. Patellofemoral contact points at these knee flexion angles were marked. The trochlea cartilage geometry at these flexion angles was visualized by Computed Tomography imaging of the femora in air with no overlying tissue. The sulcus, medial and lateral facet angles were measured. The facet angles were measured relative to the posterior condylar datum. The lateral facet slope decreased progressively with flexion from 23°±3° (mean±S.D.) at 0° to 17±5° at 90°. While the medial facet angle increased progressively from 8°±8° to 36°±9° between 0° and 90°. Patellar lateral stability varied from 96±22N at 0°, to 77±23N at 20°, then to 101±27N at 90° knee flexion. Medial stability varied from 74±20N at 0° to 170±21N at 90°. There were significant correlations between the sulcus angle and the medial facet angle with medial stability (r=0.78, p<0.0001). These results provide objective evidence relating the changes of femoral profile geometry with knee flexion to patellofemoral stability. Copyright © 2017 Elsevier B.V. All rights reserved.
Ceramic surfaces, interfaces and solid-state reactions
NASA Astrophysics Data System (ADS)
Heffelfinger, Jason Roy
Faceting, the decomposition of a surface into two or more surfaces of different orientation, is studied as a function of annealing time for ceramic surfaces. Single-crystals of Alsb2Osb3\\ (alpha-Alsb2Osb3 or corundum structure) are carefully prepared and characterized by atomic force microscopy, scanning electron microscopy and transmission electron microscopy. The mechanisms by which the originally smooth vicinal surface transforms into either a hill-and-valley or a terrace-and-step structure have been characterized. The progression of faceting is found to have a series of stages: surface smoothing, nucleation and growth of individual facets, formation of facet domains, coalescence of individual and facet domains and facet coarsening. These stages provide a model for the mechanisms of how other ceramic surfaces may facet into hill-and-valley and terrace-and-step surface microstructures. The well characterized Alsb2Osb3 surfaces provide excellent substrates by which to study the effect of surface structure on thin-film growth. Pulsed-laser deposition was used to grow thin films of yttria stabilized zirconia (YSZ) and Ysb2Osb3 onto annealed Alsb2Osb3 substrates. The substrate surface structure, such as surface steps and terraces, was found to have several effects on thin-film growth. Thin-films grown onto single-crystal substrates serve as a model geometry for studying thin-film solid-state reactions. Here, the reaction sequence and orientation relationship between thin films of Ysb2Osb3 and an Alsb2Osb3 substrate were characterized for different reaction temperatures. In a system were multiple reaction phases can form, the yttria aluminum monoclinic phase (YAM) was found to form prior to formation of other phases in this system. In a second system, a titanium alloy was reacted with single crystal Alsb2Osb3 in order to study phase formation in an intermetallic system. Both Tisb3Al and TiAl were found to form as reaction products and their orientation relationships with the Alsb2Osb3 are discussed.
{1 1 1} facet growth laws and grain competition during silicon crystallization
NASA Astrophysics Data System (ADS)
Stamelou, V.; Tsoutsouva, M. G.; Riberi-Béridot, T.; Reinhart, G.; Regula, G.; Baruchel, J.; Mangelinck-Noël, N.
2017-12-01
Directional solidification from mono-crystalline Si seeds having different orientations along the growth direction is studied. Due to the frequent twinning phenomenon, new grains soon nucleate during growth. The grain competition is then characterized in situ by imaging the dynamic evolution of the grain boundaries and of the corresponding grain boundary grooves that are formed at the solid-liquid interface. To perform this study, an experimental investigation based on Bridgman solidification technique coupled with in situ X-ray imaging is conducted in an original device: GaTSBI (Growth at high Temperature observed by X-ray Synchrotron Beam Imaging). Imaging characterisation techniques using X-ray synchrotron radiation at ESRF (European Synchrotron Radiation Facility, Grenoble, France) are applied during the solidification to study the growth dynamics. Facetted/facetted grain boundary grooves only are studied due to their importance in the grain competition because of their implication in the twinning mechanism. The maximum undercooling inside the groove is calculated from the groove depth knowing the local temperature gradient. Additionally, thanks to dynamic X-ray images, the global solid-liquid interface growth rate and the normal growth rate of the {1 1 1} facets existing at the grooves and at the edges are measured. From these measurements, experimental growth laws that correlate the normal velocity of the {1 1 1} facets with the maximum undercooling of the groove are extracted and compared to existing theoretical models. Finally, the experimental laws found for the contribution to the undercooling of the {1 1 1} facets are in good agreement with the theoretical model implying nucleation and growth eased by the presence of dislocations. Moreover, it is shown that, for the same growth parameters, the undercooling at the level of the facets (always lower than 1 K) is higher at the edges so that there is a higher probability of twin nucleation at the edges which is in agreement with the grain structure development characterised in the present experiments as well as in the literature.
Cramer, Gregory D.; Budavich, Matthew; Bora, Preetam; Ross, Kim
2017-01-01
Objective This feasibility study used novel accelerometry (vibration) and microphone (sound) methods to assess crepitus originating from the lumbar spine before and after side-posture spinal manipulation (SMT). Methods This study included 5 healthy and 5 low back pain (LBP) subjects. Nine accelerometers and 1 specialized directional microphone were applied to the lumbar region, allowing assessment of crepitus. Each subject underwent full lumbar ranges of motion (ROM), bilateral lumbar SMT, and repeated full ROM. Following full ROMs the subjects received side-posture lumbar SMT on both sides by a licensed doctor of chiropractic. Accelerometer and microphone recordings were made during all pre- and post-SMT ROMs. Primary outcome was a descriptive report of crepitus prevalence (average number of crepitus events/subject). Subjects were also divided into 3 age groups for comparisons (18–25, 26–45, and 46–65 years). Results Overall, crepitus prevalence decreased pre-post SMT (average pre= 1.4 crepitus/subject vs. post= 0.9). Prevalence progressively increased from the youngest to oldest age groups (pre-SMT= 0.0, 1.67, and 2.0, respectively; and post-SMT= 0.5, 0.83, and 1.5). Prevalence was higher in LBP subjects compared to healthy (pre-SMT-LBP= 2.0, vs. pre-SMT-healthy= 0.8; post-SMT-LBP= 1.0 vs. post-SMT-healthy= 0.8), even though healthy subjects were older than LBP subjects (40.8 years vs. 27.8 years); accounting for age: pre-SMT-LBP= 2.0 vs. pre-SMT-healthy= 0.0; post-SMT-LBP= 1.0 vs. post-SMT-healthy= 0.3. Conclusions Our findings showed that a larger study is feasible. Other findings included that crepitus prevalence increased with age, was higher in LBP than healthy subjects, and overall decreased following SMT. This study showed that crepitus assessment using accelerometers has the potential of being an outcome measure/biomarker for assessing spinal joint (facet/Z joint) function during movement and the effects of LBP treatments (eg, SMT) on Z joint function. PMID:28268027
Clarençon, Frédéric; Law-Ye, Bruno; Bienvenot, Peggy; Cormier, Évelyne; Chiras, Jacques
2016-08-01
Degenerative disease of the spine is a leading cause of back pain and radiculopathy, and is a frequent indication for spine MR imaging. Disc degeneration, disc protrusion/herniation, discarhtrosis, spinal canal stenosis, and facet joint arthrosis, as well as interspinous processes arthrosis, may require an MR imaging workup. This review presents the MR imaging patterns of these diseases and describes the benefit of the MR imaging in these indications compared with the other imaging modalities like plain radiographs or computed tomography scan. Copyright © 2016 Elsevier Inc. All rights reserved.
Nature of peptide wrapping onto metal nanoparticle catalysts and driving forces for size control.
Ramezani-Dakhel, Hadi; Bedford, Nicholas M; Woehl, Taylor J; Knecht, Marc R; Naik, Rajesh R; Heinz, Hendrik
2017-06-22
Colloidal metal nanocrystals find many applications in catalysis, energy conversion devices, and therapeutics. However, the nature of ligand interactions and implications on shape control have remained uncertain at the atomic scale. Large differences in peptide adsorption strength and facet specificity were found on flat palladium surfaces versus surfaces of nanoparticles of 2 to 3 nm size using accurate atomistic simulations with the Interface force field. Folding of longer peptides across many facets explains the formation of near-spherical particles with local surface disorder, in contrast to the possibility of nanostructures of higher symmetry with shorter ligands. The average particle size in TEM correlates inversely with the surface coverage with a given ligand and with the strength of ligand adsorption. The role of specific amino acids and sequence mutations on the nanoparticle size and facet composition is discussed, as well as the origin of local surface disorder that leads to large differences in catalytic reactivity.
Laser radiation in tennis elbow treatment: a new minimally invasive alternative
NASA Astrophysics Data System (ADS)
Paganini, Stefan; Thal, Dietmar R.; Werkmann, Klaus
1998-01-01
The epicondylitis humeri radialis (EHR) (tennis elbow), is a common disease in elbow joint pain syndromes. We treated patients with chronic pain for at least one year and no improvement with conservative or operative therapies with a new minimal invasive method, the EHR-Laser radiation (EHR- LR). With this method periepicondylar coagulations were applied to the trigger points of the patients. For this the previously established technique of facet joint coagulation with the Nd:Yag-laser was modified. In a follow-up study of between 6 weeks and 2 years all patients reported either a significant pain reduction or were symptom free. EHR-LR is a new method situated between conservative and surgical treatments for minimal invasive therapy of EHR. Several therapeutic rationales were discussed for the resulting pain reduction.
Understanding the true shape of Au-catalyzed GaAs nanowires.
Jiang, Nian; Wong-Leung, Jennifer; Joyce, Hannah J; Gao, Qiang; Tan, Hark Hoe; Jagadish, Chennupati
2014-10-08
With increasing interest in nanowire-based devices, a thorough understanding of the nanowire shape is required to gain tight control of the quality of nanowire heterostructures and improve the performance of related devices. We present a systematic study of the sidewalls of Au-catalyzed GaAs nanowires by investigating the faceting process from the beginning with vapor-liquid-solid (VLS) nucleation, followed by the simultaneous radial growth on the sidewalls, and to the end with sidewall transformation during annealing. The VLS nucleation interface of our GaAs nanowires is revealed by examining cross sections of the nanowire, where the nanowire exhibits a Reuleaux triangular shape with three curved surfaces along {112}A. These curved surfaces are not thermodynamically stable and adopt {112}A facets during radial growth. We observe clear differences in radial growth rate between the ⟨112⟩A and ⟨112⟩B directions with {112}B facets forming due to the slower radial growth rate along ⟨112⟩B directions. These sidewalls transform to {110} facets after high temperature (>500 °C) annealing. A nucleation model is proposed to explain the origin of the Reuleaux triangular shape of the nanowires, and the sidewall evolution is explained by surface kinetic and thermodynamic limitations.
Carbon Nanotubes: On the Origin of Helicity
NASA Astrophysics Data System (ADS)
Harutyunyan, Avetik
2015-03-01
The mechanism of helicity formation of carbon nanotubes still remains elusive that hinders their applications. Current explanations mainly rely on the planar interrelationship between the structure of nanotube and corresponding facet of catalyst in 2D geometry that could amend the structure of grown carbon layer, specifically due to the epitaxial interaction. Yet, the structure of carbon nanotube and circumference of the rims assume involvement of more than one facet i.e. it is 3D problem. By aiming this problem we find that the nanotube nucleation is initiated by cap formation via evolving of graphene embryo across the adjacent facets of catalyst particle. As a result the graphene embryos incorporate in their hexagonic network various polygons to accommodate the curved 3D geometry that initiates cap formation following by elongation of the circumferential rims. Based on these results, also on the census of nanotube caps and the fact that given cap fit only one nanotube wall, we consider carbon cap responsible for the helicity of carbon nanotube. This understanding could provide new avenues towards engineering particles to explicitly accommodate certain helicities via exploitation of the angular distribution of catalyst adjacent facets. Our recent progresses in production of carbon nanotubes, nanotube reinforced composites and their potential applications also will be presented.
Facet‐Controlled Synthetic Strategy of Cu2O‐Based Crystals for Catalysis and Sensing
Shang, Yang
2015-01-01
Shape‐dependent catalysis and sensing behaviours are primarily focused on nanocrystals enclosed by low‐index facets, especially the three basic facets ({100}, {111}, and {110}). Several novel strategies have recently exploded by tailoring the original nanocrystals to greatly improve the catalysis and sensing performances. In this Review, we firstly introduce the synthesis of a variety of Cu2O nanocrystals, including the three basic Cu2O nanocrystals (cubes, octahedra and rhombic dodecahedra, enclosed by the {100}, {111}, and {110} facets, respectively), and Cu2O nanocrystals enclosed by high‐index planes. We then discuss in detail the three main facet‐controlled synthetic strategies (deposition, etching and templating) to fabricate Cu2O‐based nanocrystals with heterogeneous, etched, or hollow structures, including a number of important concepts involved in those facet‐controlled routes, such as the selective adsorption of capping agents for protecting special facets, and the impacts of surface energy and active sites on reaction activity trends. Finally, we highlight the facet‐dependent properties of the Cu2O and Cu2O‐based nanocrystals for applications in photocatalysis, gas catalysis, organocatalysis and sensing, as well as the relationship between their structures and properties. We also summarize and comment upon future facet‐related directions. PMID:27980909
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[Operative treatment of displaced intra-articular calcaneal fractures].
Zwipp, H; Rammelt, S; Amlang, M; Pompach, M; Dürr, C
2013-12-01
Anatomic reduction of displaced intra-articular calcaneal fractures with restoration of height, length, and axial alignment and reconstruction of the subtalar and calcaneocuboid joints. Displaced intra-articular calcaneal fractures with incongruity of the posterior facet of the subtalar joint, loss of height, and axial malalignment. High perioperative risk, soft tissue infection, advanced peripheral arterial disease (stage III), neurogenic osteoarthropathy, poor patient compliance (e. g., substance abuse). Extended lateral approach with the patient placed on the uninjured side. Reduction of the anatomic shape and joint surfaces according to the preoperative CT-based planning. Reduction of the medial wall and step-wise reconstruction of the posterior facet from medial to lateral. Reduction of the tuberosity and anterior process fragments to the posterior joint block and temporary fixation with Kirschner wires. Internal fixation with an anatomic lateral plate in a locking or nonlocking mode. Alternatively less invasive internal fixation with a calcaneus nail over a sinus tarsi approach for less severe fracture types. The lower leg is immobilized in a brace until the wound is healed. Range of motion exercises of the ankle and subtalar joints are initiated on the second postoperative day. Patients are mobilized in their own shoe with partial weight bearing of 20 kg for 6-12 weeks depending on fracture severity and bone quality. Over a 4-year period, 163 patients with 184 displaced, intra-articular calcaneal fractures were treated with a lateral plate via an extended approach. In all, 102 patients with 116 fractures were followed for a mean of 8 years. A surgical revision was necessary in 4 cases (3.4%) of postoperative hematoma, 2 (1.7%) superficial and 5 (4.3%) deep infections. Of the latter, 2 patients needed a free flap for definite wound coverage, no calcanectomy or amputation was needed. Secondary subtalar fusion for symptomatic posttraumatic arthritis was performed in 9 cases (7.8%). At follow-up, the AOFAS Ankle/Hindfoot Score averaged 70.2, the Zwipp Score averaged 76.0, the German versions of the Foot Function Index and SF-36 physical component averaged 32.8 and 42.2, respectively. Scores were significantly lower with increasing fracture severity according to the Sanders and Zwipp classifications, bilateral fractures, open fractures, and with work-related injuries. With less invasive fixation using a calcaneal nail, superficial wound edge necrosis was seen in 2 of 75 cases (2.7%).
Trumpet Laminectomy Microdecompression for Lumbal Canal Stenosis
Yasuda, Muneyoshi; Arifin, Muhammad Zafrullah; Takayasu, Masakazu; Faried, Ahmad
2014-01-01
Microsurgery techniques are useful innovations towards minimizing the insult of canal stenosis. Here, we describe the trumpet laminectomy microdecompression (TLM) technique, advantages and disadvantages. Sixty-two TLM patients with lumbar disc herniation, facet hypertrophy or yellow ligament or intracanal granulation tissue. The symptoms are low back pain, dysesthesia and severe pain on both legs. Spine levels operated Th11-S1; the patients who had trumpet-type fenestration, 62.9% had hypertrophy of the facet joint, 11.3% had intracanal granulation tissue, 79.1% had hypertrophy of the yellow ligament and 64.5% had disc herniation. The average of procedure duration was 68.9 min and intraoperative blood loss was 47.4 mL. Intraoperative complications were found in 3.2% of patients, with dural damage but without cerebrospinal fluid leakage. The TLM can be performed for all ages and all levels of spinal canal stenosis, without the complication of spondilolistesis. The TLM has a shorter duration, with minimal intraoperative blood loss. PMID:25346821
NASA Astrophysics Data System (ADS)
Wu, Tao; Wu, Zhensen; Linghu, Longxiang
2017-10-01
Study of characteristics of sea clutter is very important for signal processing of radar, detection of targets on sea surface and remote sensing. The sea state is complex at Low grazing angle (LGA), and it is difficult with its large irradiation area and a great deal simulation facets. A practical and efficient model to obtain radar clutter of dynamic sea in different sea condition is proposed, basing on the physical mechanism of interaction between electromagnetic wave and sea wave. The classical analysis method for sea clutter is basing on amplitude and spectrum distribution, taking the clutter as random processing model, which is equivocal in its physical mechanism. To achieve electromagnetic field from sea surface, a modified phase from facets is considered, and the backscattering coefficient is calculated by Wu's improved two-scale model, which can solve the statistical sea backscattering problem less than 5 degree, considering the effects of the surface slopes joint probability density, the shadowing function, the skewness of sea waves and the curvature of the surface on the backscattering from the ocean surface. We make the assumption that the scattering contribution of each facet is independent, the total field is the superposition of each facet in the receiving direction. Such data characters are very suitable to compute on GPU threads. So we can make the best of GPU resource. We have achieved a speedup of 155-fold for S band and 162-fold for Ku/Χ band on the Tesla K80 GPU as compared with Intel® Core™ CPU. In this paper, we mainly study the high resolution data, and the time resolution is millisecond, so we may have 10,00 time points, and we analyze amplitude probability density distribution of radar clutter.
Choi, Jong-Il; Kim, Se-Hoon; Lim, Dong-Jun; Ha, Sung-Kon; Kim, Sang-Dae
2017-01-01
Arthroplasty maintains the biomechanical features of a healthy disc, decreases the adjacent segment disease rate, and decreases the accelerated degeneration rate of the neighboring discs in traditional fusion procedures. However, there are only a few reports on adjacent disc pressure (DP) and facet strain (FS) after lumbar arthroplasty under a physiologic compressive preload. Baseline DP and FS measurements were obtained from five intact cadaveric human lumbosacral spines for different modes of motion. DP was measured by inserting pressure transducer needle tips into the L3-L4 and L5-S1 discs. FS gauges were fixed on both sides of the laminae near the L3-L4, L4-L5, and L5-S1 facet joints. After SB Charité < sup > TM < /sup > III implantation at the L4-L5 level, the measurements were repeated at preload and compared with those of the intact spine. Under the preload condition, the central DP of the upper disc was decreased during extension and bending, and it significantly increased during rotation (p < 0.05). In the lower disc, the central DP insignificantly decreased during bending and increased during extension and flexion. A statistically significant increase in FS was observed during rotation at the operative facet (p < 0.05). Compared to the intact spine, all FS values were insignificantly decreased during lateral bending but increased during axial rotation. In an ex-vivo physiologic preload setting, the SB Charité < sup > TM < /sup > III provided relatively inconsistent and sometimes increased DP or FS at the operative and adjacent levels after arthroplasty.
Kim, Hee Kyung; Shiraj, Sahar; Anton, Christopher; Horn, Paul S
2014-02-01
The osseous morphology of the patellofemoral joint is an independent factor that affects the biomechanics of patellofemoral instability. The purpose of this study is to determine age- and gender-related differences in the osseous morphology of the patellofemoral joint in children during skeletal maturation. This study was approved by the institutional review board and was HIPAA-compliant. We included 97 children and young adults (age range 5-22 years; 51 girls and 46 boys, mean ages 14.3 years and 13.7 years, respectively). We studied 1.5-T knee MR exams, measuring the osseous morphology of the patellofemoral joint (lateral trochlear inclination, trochlear facet asymmetry, trochlear depth, patellar height ratio, tibial tubercle-trochlear groove distance, and lateral patellofemoral angle) for each MR exam. We compared measurements to published values for patellofemoral instability. Physeal patency (open or closing/closed) was determined on MR. We assessed the associations between MR osseous measurements and gender, age and physeal patency using Wilcoxon rank sum test and least square means regression models. The osseous patellofemoral joint morphology measurements were all within a normal range. There were no significant correlations between MR osseous measurements and age, gender or physeal patency. During skeletal maturation, age and gender do not affect the osseous morphology or congruency of the patellofemoral joint.
Manchikanti, Laxmaiah; Boswell, Mark V; Singh, Vijay; Derby, Richard; Fellows, Bert; Falco, Frank J E; Datta, Sukdeb; Smith, Howard S; Hirsch, Joshua A
2009-01-01
Understanding the neurophysiological basis of chronic spinal pain and diagnostic interventional techniques is crucial in the proper diagnosis and management of chronic spinal pain. Central to the understanding of the structural basis of chronic spinal pain is the provision of physical diagnosis and validation of patient symptomatology. It has been shown that history, physical examination, imaging, and nerve conduction studies in non-radicular or discogenic pain are unable to diagnose the precise cause in 85% of the patients. In contrast, controlled diagnostic blocks have been shown to determine the cause of pain in as many as 85% of the patients. To provide evidence-based clinical practice guidelines for diagnostic interventional techniques. Best evidence synthesis. Strength of evidence was assessed by the U.S. Preventive Services Task Force (USPSTF) criteria utilizing 5 levels of evidence ranging from Level I to III with 3 subcategories in Level II. Diagnostic criteria established by systematic reviews were utilized with controlled diagnostic blocks. Diagnostic criteria included at least 80% pain relief with controlled local anesthetic blocks with the ability to perform multiple maneuvers which were painful prior to the diagnostic blocks for facet joint and sacroiliac joint blocks, whereas for provocation discography, the criteria included concordant pain upon stimulation of the target disc with 2 adjacent discs producing no pain at all. The indicated level of evidence for diagnostic lumbar, cervical, and thoracic facet joint nerve blocks is Level I or II-1. The indicated evidence is Level II-2 for lumbar and cervical discography, whereas it is Level II-3 for thoracic provocation discography. The evidence for diagnostic sacroiliac joint nerve blocks is Level II-2. Level of evidence for selective nerve root blocks for diagnostic purposes is Level II-3. Limitations of this guideline preparation include a continued paucity of literature and conflicts in preparation of systematic reviews and guidelines. These guidelines include the evaluation of evidence for diagnostic interventional procedures in managing chronic spinal pain and recommendations. However, these guidelines do not constitute inflexible treatment recommendations. These guidelines also do not represent a "standard of care."
Manchikanti, Laxmaiah; Nampiaparampil, Devi E.; Manchikanti, Kavita N.; Falco, Frank J.E.; Singh, Vijay; Benyamin, Ramsin M.; Kaye, Alan D.; Sehgal, Nalini; Soin, Amol; Simopoulos, Thomas T.; Bakshi, Sanjay; Gharibo, Christopher G.; Gilligan, Christopher J.; Hirsch, Joshua A.
2015-01-01
Background: The efficacy of epidural and facet joint injections has been assessed utilizing multiple solutions including saline, local anesthetic, steroids, and others. The responses to these various solutions have been variable and have not been systematically assessed with long-term follow-ups. Methods: Randomized trials utilizing a true active control design were included. The primary outcome measure was pain relief and the secondary outcome measure was functional improvement. The quality of each individual article was assessed by Cochrane review criteria, as well as the criteria developed by the American Society of Interventional Pain Physicians (ASIPP) for assessing interventional techniques. An evidence analysis was conducted based on the qualitative level of evidence (Level I to IV). Results: A total of 31 trials met the inclusion criteria. There was Level I evidence that local anesthetic with steroids was effective in managing chronic spinal pain based on multiple high-quality randomized controlled trials. The evidence also showed that local anesthetic with steroids and local anesthetic alone were equally effective except in disc herniation, where the superiority of local anesthetic with steroids was demonstrated over local anesthetic alone. Conclusion: This systematic review showed equal efficacy for local anesthetic with steroids and local anesthetic alone in multiple spinal conditions except for disc herniation where the superiority of local anesthetic with steroids was seen over local anesthetic alone. PMID:26005584
Suwankong, N; Meij, B P; Voorhout, G; de Boer, A H; Hazewinkel, H A W
2008-01-01
The medical records of 156 dogs with degenerative lumbosacral stenosis (DLS) that underwent decompressive surgery were reviewed for signalment, history, clinical signs, imaging and surgical findings. The German Shepherd Dog (GSD) was most commonly affected (40/156, 25.6%). Pelvic limb lameness, caudal lumbar pain and pain evoked by lumbosacral pressure were the most frequent clinical findings. Radiography showed lumbosacral step formation in 78.8% (93/118) of the dogs which was associated with elongation of the sacral lamina in 18.6% (22/118). Compression of the cauda equina was diagnosed by imaging (epidurography, CT, or MRI) in 94.2% (147/156) of the dogs. Loss of the bright nucleus pulposus signal of the L7-S1 disc was found on T2-weighted MR images in 73.5% (25/34) of the dogs. The facet joint angle at L7-S1 was significantly smaller, and the tropism greater in GSD than in the other dog breeds. The smaller facet joint angle and higher incidence of tropism seen in the GSD may predispose this breed to DLS. Epidurography, CT, and MRI allow adequate visualization of cauda equina compression. During surgery, disc protrusion was found in 70.5% (110/156) of the dogs. Overall improvement after surgery was recorded in the medical records in 79.0% (83/105) of the dogs. Of the 38 owners that responded to questionnaires up to five years after surgery, 29 (76%) perceived an improvement.
Curriculum Development in Non-Formal Education.
ERIC Educational Resources Information Center
Thompson, J. D. Ekundayo
The two parts of this book consider two main facets of nonformal curriculum development: theory and practice. Part I on nonformal curriculum theory has four chapters. Chapter 1 addresses the origins, meaning, purpose, and scope of nonformal education. Chapter 2 examines three major themes in discussions on nonformal education: nonformal education…
ERIC Educational Resources Information Center
McIlwaine, I. C.
1997-01-01
Discusses the history and development of the Universal Decimal Classification (UDC). Topics include the relationship with Dewey Decimal Classification; revision process; structure; facet analysis; lack of standard rules for application; application in automated systems; influence of UDC on classification development; links with thesauri; and use…
Multicultural Choral Music Pedagogy Based on the Facets Model
ERIC Educational Resources Information Center
Yoo, Hyesoo
2017-01-01
Multicultural choral music has distinct characteristics in that indigenous folk elements are frequently incorporated into a Western European tonal system. Because of this, multicultural choral music is often taught using Western styles (e.g., "bel canto") rather than through traditional singing techniques from their cultures of origin.…
Glaser, Johann; Beisteiner, Roland; Bauer, Herbert; Fischmeister, Florian Ph S
2013-11-09
In concurrent EEG/fMRI recordings, EEG data are impaired by the fMRI gradient artifacts which exceed the EEG signal by several orders of magnitude. While several algorithms exist to correct the EEG data, these algorithms lack the flexibility to either leave out or add new steps. The here presented open-source MATLAB toolbox FACET is a modular toolbox for the fast and flexible correction and evaluation of imaging artifacts from concurrently recorded EEG datasets. It consists of an Analysis, a Correction and an Evaluation framework allowing the user to choose from different artifact correction methods with various pre- and post-processing steps to form flexible combinations. The quality of the chosen correction approach can then be evaluated and compared to different settings. FACET was evaluated on a dataset provided with the FMRIB plugin for EEGLAB using two different correction approaches: Averaged Artifact Subtraction (AAS, Allen et al., NeuroImage 12(2):230-239, 2000) and the FMRI Artifact Slice Template Removal (FASTR, Niazy et al., NeuroImage 28(3):720-737, 2005). Evaluation of the obtained results were compared to the FASTR algorithm implemented in the EEGLAB plugin FMRIB. No differences were found between the FACET implementation of FASTR and the original algorithm across all gradient artifact relevant performance indices. The FACET toolbox not only provides facilities for all three modalities: data analysis, artifact correction as well as evaluation and documentation of the results but it also offers an easily extendable framework for development and evaluation of new approaches.
2013-01-01
Background In concurrent EEG/fMRI recordings, EEG data are impaired by the fMRI gradient artifacts which exceed the EEG signal by several orders of magnitude. While several algorithms exist to correct the EEG data, these algorithms lack the flexibility to either leave out or add new steps. The here presented open-source MATLAB toolbox FACET is a modular toolbox for the fast and flexible correction and evaluation of imaging artifacts from concurrently recorded EEG datasets. It consists of an Analysis, a Correction and an Evaluation framework allowing the user to choose from different artifact correction methods with various pre- and post-processing steps to form flexible combinations. The quality of the chosen correction approach can then be evaluated and compared to different settings. Results FACET was evaluated on a dataset provided with the FMRIB plugin for EEGLAB using two different correction approaches: Averaged Artifact Subtraction (AAS, Allen et al., NeuroImage 12(2):230–239, 2000) and the FMRI Artifact Slice Template Removal (FASTR, Niazy et al., NeuroImage 28(3):720–737, 2005). Evaluation of the obtained results were compared to the FASTR algorithm implemented in the EEGLAB plugin FMRIB. No differences were found between the FACET implementation of FASTR and the original algorithm across all gradient artifact relevant performance indices. Conclusion The FACET toolbox not only provides facilities for all three modalities: data analysis, artifact correction as well as evaluation and documentation of the results but it also offers an easily extendable framework for development and evaluation of new approaches. PMID:24206927
Siemionow, Kris; Janusz, Piotr; Phillips, Frank M; Youssef, Jim A; Isaacs, Robert; Tyrakowski, Marcin; McCormack, Bruce
2016-11-01
Background Indirect posterior cervical nerve root decompression and fusion performed by placing bilateral posterior cervical cages in the facet joints from a posterior approach has been proposed as an option to treat select patients with cervical radiculopathy. The purpose of this study was to report 2-year clinical and radiologic results of this treatment method. Methods Patients who failed nonsurgical management for single-level cervical radiculopathy were recruited. Surgical treatment involved a posterior approach with decortication of the lateral mass and facet joint at the treated level followed by placement of the DTRAX Expandable Cage (Providence Medical Technology, Lafayette, California, United States) into both facet joints. Iliac crest bone autograft was mixed with demineralized bone matrix and used in all cases. The Neck Disability Index (NDI), visual analog scale (VAS) for neck and arm pain, and SF-12 v.2 questionnaire were evaluated preoperatively and 2 years postoperatively. Segmental (treated level) and overall C2-C7 cervical lordosis, disk height, adjacent segment degeneration, and fusion were assessed on computed tomography scans and radiographs acquired preoperatively and 2 years postoperatively. Results Overall, 53 of 60 enrolled patients were available at 2-year follow-up. There were 35 females and 18 males with a mean age of 53 years (range: 40-75 years). The operated level was C3-C4 ( N = 3), C4-C5 ( N = 6), C5-C6 ( N = 36), and C6-C7 ( N = 8). The mean preoperative and 2-year scores were NDI: 32.3 versus 9.1 ( p < 0.0001); VAS Neck Pain: 7.4 versus 2.6 ( p < 0.0001); VAS Arm Pain: 7.4 versus 2.6 ( p < 0.0001); SF-12 Physical Component Summary: 34.6 versus 43.6 ( p < 0.0001), and SF-12 Mental Component Summary: 40.8 versus 51.4 ( p < 0.0001). No significant changes in overall or segmental lordosis were noted after surgery. Radiographic fusion rate was 98.1%. There was no device failure, implant lucency, or surgical reinterventions. Conclusions Indirect decompression and posterior cervical fusion using an expandable intervertebral cage may be an effective tissue-sparing option in select patients with single-level cervical radiculopathy. Georg Thieme Verlag KG Stuttgart · New York.
Joint Chiefs of Staff > Directorates > J3 | Operations
Joint Staff Structure Joint Staff Inspector General Origin of Joint Concepts U.S. Code | Joint Chiefs of J8 | Force Structure, Resources & Assessment Contact J3 Operations Home : Directorates : J3
Gamie, Sherief; El-Maghraby, Tarek
2008-01-01
Bone scintigraphy including Single Photon Emission Computed Tomography (SPECT) is known for its role in the diagnosis of low back pain disorders. Positron Emission Tomography (PET) with (18)F (Flouride-18) as a tracer can be used to carry out bone scans with improved image quality. With the addition of CT, simultaneous PET/CT fused images provide more accurate anatomical details. The objectives of this work are to assess the use of (18)F-PET/CT in patients with back pain and suspected facetogenic pain, and to find the frequency of facet arthropathy versus disc disease abnormalities. 67 patients who presented with back pain underwent routine X-ray, CT and/or MRI, which failed to identify a clear cause, were referred to (18)F-PET/CT. Among the main group, a subset of 25 patients had previous spine surgery consisting of laminectomy or discectomy (17 patients) and lumbar fusion (8 patients). The PET/CT scan was acquired on a GE VCT 64-Slice combined scanner. Imaging started 45-60 minutes after administration of 12-15 mCi (444-555 MBq) of (18)F-Fluoride. The PET scan was acquired from the skull base through the inguinal region in 3D mode at 2 minutes/bed. A lowresolution, non-contrast CT scan was also acquired for anatomic localization and attenuation correction. The (18)F-PET/CT showed abnormal uptake in the spine in 56 patients, with an overall detection ability of 84%. Facet joints as a cause of back pain was much more frequent (25 with abnormal scans). One-third (36%) of the patients showed multiple positive uptake in both facet joints and disc areas (20/56). The patients were further divided into two groups. Group A consisted of 42 patients (63%) with back pain and no previous operative procedures, and the (18)F-PET/CT showed a high sensitivity (88%) in identifying the source of pain in 37/42 patients. Group B included 25 patients (37%) with prior lumbar fusion or laminectomy, in which the PET/CT showed positive uptake in 76% (19/25 patients). (18)F-PET/CT showed positive uptake in all patients (100%) with a history of pain after lumbar fusion, while in the laminectomy subgroup only 11 cases (65%) showed positive focal uptake. (18)F-PET/CT has a potential use in evaluating adult patients with back pain. It has a promising role in identifying causes of persistent back pain following vertebral surgical interventions.
Joint Chiefs of Staff > Leadership
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Oldring, P.K.T.; Castle, L.; O'Mahony, C.; Dixon, J.
2013-01-01
The FACET tool is a probabilistic model to estimate exposure to chemicals in foodstuffs, originating from flavours, additives and food contact materials. This paper demonstrates the use of the FACET tool to estimate exposure to BPA (bisphenol A) from light metal packaging. For exposure to migrants from food packaging, FACET uses industry-supplied data on the occurrence of substances in the packaging, their concentrations and construction of the packaging, which were combined with data from a market research organisation and food consumption data supplied by national database managers. To illustrate the principles, UK packaging data were used together with consumption data from the UK National Diet and Nutrition Survey (NDNS) dietary survey for 19–64 year olds for a refined deterministic verification. The UK data were chosen mainly because the consumption surveys are detailed, data for UK packaging at a detailed level were available and, arguably, the UK population is composed of high consumers of packaged foodstuffs. Exposures were run for each food category that could give rise to BPA from light metal packaging. Consumer loyalty to a particular type of packaging, commonly referred to as packaging loyalty, was set. The BPA extraction levels used for the 15 types of coating chemistries that could release BPA were in the range of 0.00005–0.012 mg dm−2. The estimates of exposure to BPA using FACET for the total diet were 0.0098 (mean) and 0.0466 (97.5th percentile) mg/person/day, corresponding to 0.00013 (mean) and 0.00059 (97.5th percentile) mg kg−1 body weight day−1 for consumers of foods packed in light metal packaging. This is well below the current EFSA (and other recognised bodies) TDI of 0.05 mg kg−1 body weight day. These probabilistic estimates were compared with estimates using a refined deterministic approach drawing on the same input data. The results from FACET for the mean, 95th and 97.5th percentile exposures to BPA lay between the lowest and the highest estimates from the refined deterministic calculations. Since this should be the case, for a fully probabilistic compared with a deterministic approach, it is concluded that the FACET tool has been verified in this example. A recent EFSA draft opinion on exposure to BPA from different sources showed that canned foods were a major contributor and compared results from various models, including those from FACET. The results from FACET were overall conservative. PMID:24405320
Audo, Denis; Haug, Joachim T; Haug, Carolin; Charbonnier, Sylvain; Schweigert, Günter; Müller, Carsten H G; Harzsch, Steffen
2016-01-01
Modern representatives of Polychelida (Polychelidae) are considered to be entirely blind and have largely reduced eyes, possibly as an adaptation to deep-sea environments. Fossil species of Polychelida, however, appear to have well-developed compound eyes preserved as anterior bulges with distinct sculpturation. We documented the shapes and sizes of eyes and ommatidia based upon exceptionally preserved fossil polychelidans from Binton (Hettangian, United-Kingdom), Osteno (Sinemurian, Italy), Posidonia Shale (Toarcian, Germany), La Voulte-sur-Rhône (Callovian, France), and Solnhofen-type plattenkalks (Kimmeridgian-Tithonian, Germany). For purposes of comparison, sizes of the eyes of several other polychelidans without preserved ommatidia were documented. Sizes of ommatidia and eyes were statistically compared against carapace length, taxonomic group, and outcrop. Nine species possess eyes with square facets; Rosenfeldia oppeli (Woodward, 1866), however, displays hexagonal facets. The sizes of eyes and ommatidia are a function of carapace length. No significant differences were discerned between polychelidans from different outcrops; Eryonidae, however, have significantly smaller eyes than other groups. Fossil eyes bearing square facets are similar to the reflective superposition eyes found in many extant decapods. As such, they are the earliest example of superposition eyes. As reflective superposition is considered plesiomorphic for Reptantia, this optic type was probably retained in Polychelida. The two smallest specimens, a Palaeopentacheles roettenbacheri (Münster, 1839) and a Hellerocaris falloti (Van Straelen, 1923), are interpreted as juveniles. Both possess square-shaped facets, a typical post-larval feature. The eye morphology of these small specimens, which are far smaller than many extant eryoneicus larvae, suggests that Jurassic polychelidans did not develop via giant eryoneicus larvae. In contrast, another species we examined, Rosenfeldia oppeli (Woodward, 1866), did not possess square-shaped facets, but rather hexagonal ones, which suggests that this species did not possess reflective superposition eyes. The hexagonal facets may indicate either another type of superposition eye (refractive or parabolic superposition), or an apposition eye. As decapod larvae possess apposition eyes with hexagonal facets, it is most parsimonious to consider eyes of R. oppeli as apposition eyes evolved through paedomorphic heterochrony. Polychelidan probably originally had reflective superposition. R. oppeli, however, probably gained apposition eyes through paedomorphosis.
Colen, Sascha; Haverkamp, Daniel; Mulier, Michiel; van den Bekerom, Michel P J
2012-04-01
The use of intra-articular hyaluronic acid (HA) is a well known treatment in patients with knee osteoarthritis (OA). In other joints, less evidence is available about the efficacy of treatment with intra-articular HA. HA is also used intra-articularly in the metatarsophalangeal-1 joint, the ankle, the hip, the sacroiliac joint, the facet joints, the carpometacarpal-1 joint, the shoulder and the temporo-mandibular joint. In this systematic review we include all prospective studies about the effects of intra-articular HA in the above-mentioned joints. Its use in the knee joint, however, will be discussed in a separate article in this journal. A systematic review was conducted using databases including MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Clinical Trial Register, and EMBASE. After performing a solid systematic review using a rigid methodology and trying to pool the outcomes of different studies, we noticed that, compared with baseline, there is statistical evidence for a positive effect of intra-articular HA. However, there is limited evidence HA is superior to placebo and no evidence that intra-articular HA is better than corticosteroids or other conservative therapies. Our recommendation for future research is that one should focus on adequately powered randomized trials comparing HA treatment with other types of intra-articular or conservative treatment. We think it is useless to further perform and publish (large) non-comparative prospective studies about the use of HA in the treatment of problems caused by OA. It is well perceived that HA exerts positive effects in the treatment of OA, but up to now there is no (strong) evidence available that HA is superior to other treatments of OA such as corticosteroids, physiotherapy or other conservative measures.
[Conventional X-Rays of Ankle Joint Fractures in Older Patients are Not Always Predictive].
Jubel, A; Faymonville, C; Andermahr, J; Boxberg, S; Schiffer, G
2017-02-01
Background: Ankle fractures are extremely common in the elderly, with an incidence of up to 39 fractures per 100,000 persons per year. We found a discrepancy between intraoperative findings and preoperative X-ray findings. It was suggested that many relevant lesions of the ankle joint in the elderly cannot be detected with plain X-rays. Methods: Complete data sets and preoperative X-rays of 84 patients aged above 60 years with ankle fractures were analysed retrospectively. There were 59 women and 25 men, with a mean age of 69.9 years. Operation reports and preoperative X-rays were analysed with respect to four relevant lesions: multifragmentary fracture pattern of the lateral malleolus, involvement of the medial malleolus, posterior malleolar fractures and bony avulsion of anterior syndesmosis. Sensitivity, specificity, positive predictive value, negative predictive value, accuracy and prevalence were calculated. Results: The prevalence of specific ankle lesions in the analyzed cohort was 24 % for the multifragmentary fracture pattern of the lateral malleolus, 38 % for fractures of the medial malleolus, 25 % for posterior malleolar fractures and 22.6 % for bony avulsions of the anterior syndesmosis. Multifragmentary fracture patterns of the lateral malleolus (sensitivity 0 %) and bony avulsions of the anterior syndesmosis (sensitivity 5 %) could not be detected in plain X-rays of the ankle joint at all. Fractures of the medial malleolus and involvement of the dorsal tibial facet were detected with a sensitivity of 96.8 % and 76.2 %, respectively, and specificity of 100 % in both cases. Conclusions: This study confirms that complex fracture patterns, such as multifragmentary involvement of the lateral malleolus, additional fracture of the medial malleolus, involvement of the dorsal tibial facet or bony avulsion of the anterior syndesmosis are common in ankle fractures of the elderly. Therefore, CT scans should be routinely considered for primary diagnosis, in addition to plain X-rays. Georg Thieme Verlag KG Stuttgart · New York.
NASA Astrophysics Data System (ADS)
Ali Deeb, Manal; Ledig, Johannes; Wei, Jiandong; Wang, Xue; Wehmann, Hergo-Heinrich; Waag, Andreas
2017-08-01
Three dimensional GaN structures with different crystal facets and doping types have been investigated employing the surface photo-voltage (SPV) method to monitor illumination-induced surface charge behavior using Kelvin probe force microscopy. Various photon energies near and below the GaN bandgap were used to modify the generation of electron-hole pairs and their motion under the influence of the electric field near the GaN surface. Fast and slow processes for Ga-polar c-planes on both Si-doped n-type as well as Mg-doped p-type GaN truncated pyramid micro-structures were found and their origin is discussed. The immediate positive (for n-type) and negative (for p-type) SPV response dominates at band-to-band and near-bandgap excitation, while only the slow process is present at sub-bandgap excitation. The SPV behavior for the semi-polar facets of the p-type GaN truncated pyramids has a similar characteristic to that on its c-plane, which indicates that it has a comparable band bending and no strong influence of the polarity-induced charges is detectable. The SPV behavior of the non-polar m-facets of the Si-doped n-type part of a transferred GaN column is similar to that of a clean c-plane GaN surface during illumination. However, the SPV is smaller in magnitude, which is attributed to intrinsic surface states of m-plane surfaces and their influence on the band bending. The SPV behavior of the non-polar m-facet of the slightly Mg-doped part of this GaN column is found to behave differently. Compared to c- and r-facets of p-type surfaces of GaN-light-emitting diode micro-structures, the m-plane is more chemically stable.
Bleidorn, Wiebke; Kandler, Christian; Riemann, Rainer; Spinath, Frank M; Angleitner, Alois
2009-07-01
The present study examined the patterns and sources of 10-year stability and change of adult personality assessed by the 5 domains and 30 facets of the Revised NEO Personality Inventory. Phenotypic and biometric analyses were performed on data from 126 identical and 61 fraternal twins from the Bielefeld Longitudinal Study of Adult Twins (BiLSAT). Consistent with previous research, LGM analyses revealed significant mean-level changes in domains and facets suggesting maturation of personality. There were also substantial individual differences in the change trajectories of both domain and facet scales. Correlations between age and trait changes were modest and there were no significant associations between change and gender. Biometric extensions of growth curve models showed that 10-year stability and change of personality were influenced by both genetic as well as environmental factors. Regarding the etiology of change, the analyses uncovered a more complex picture than originally stated, as findings suggest noticeable differences between traits with respect to the magnitude of genetic and environmental effects. (PsycINFO Database Record (c) 2009 APA, all rights reserved).
Inclusive Education Is a Multi-Faceted Concept
ERIC Educational Resources Information Center
Mitchell, David
2015-01-01
With the impetus of the UN Convention on the Rights of People with Disabilities, inclusive education is an idea whose time has arrived around the world. Its scope goes far beyond learners with disabilities and has now been extended to cover all learners with special educational needs, whatever their origins. It also extends beyond the mere…
Teaching about Judicial Review. ERIC Digest.
ERIC Educational Resources Information Center
Patrick, John J.
Judicial review is a fundamental facet of constitutional government in the United States. Invented during the founding of the United States, judicial review has spread to most constitutional democracies of the world. This digest discusses: (1) the concept of judicial review; (2) the origin of this concept; (3) the uses of this concept in U.S.…
Modern mammal origins: evolutionary grades in the Early Cretaceous of North America.
Jacobs, L L; Winkler, D A; Murry, P A
1989-07-01
Major groups of modern mammals have their origins in the Mesozoic Era, yet the mammalian fossil record is generally poor for that time interval. Fundamental morphological changes that led to modern mammals are often represented by small samples of isolated teeth. Fortunately, functional wear facets on teeth allow prediction of the morphology of occluding teeth that may be unrepresented by fossils. A major step in mammalian evolution occurred in the Early Cretaceous with the evolution of tribosphenic molars, which characterize marsupials and placentals, the two most abundant and diverse extant groups of mammals. A tooth from the Early Cretaceous (110 million years before present) of Texas tests previous predictions (based on lower molars) of the morphology of upper molars in early tribosphenic dentitions. The lingual cusp (protocone) is primitively without shear facets, as expected, but the cheek side of the tooth is derived (advanced) in having distinctive cusps along the margin. The tooth, although distressingly inadequate to define many features of the organism, demonstrates unexpected morphological diversity at a strategic stage of mammalian evolution and falsifies previous claims of the earliest occurrence of true marsupials.
The Joint Chiefs of Staff Video Collections
Senior Enlisted Advisor Joint Staff History Joint Staff Inspector General Joint Staff Structure Origin of J8 | Force Structure, Resources & Assessment Contact Home : Media : Videos Featured Videos Gen
NASA Astrophysics Data System (ADS)
Reeve, Kathlene N.; Choquette, Stephanie M.; Anderson, Iver E.; Handwerker, Carol A.
2016-12-01
Controlling the size, dispersion, and stability of intermetallic compounds in lead-free solder alloys is vital to creating reliable solder joints regardless of how many times the solder joints are melted and resolidified (reflowed) during circuit board assembly. In this article, the coarsening behavior of Cu x Al y and Cu6Sn5 in two Sn-Cu-Al alloys, a Sn-2.59Cu-0.43Al at. pct alloy produced via drip atomization and a Sn-5.39Cu-1.69Al at. pct alloy produced via melt spinning at a 5-m/s wheel speed, was characterized after multiple (1-5) reflow cycles via differential scanning calorimetry between the temperatures of 293 K and 523 K (20 °C and 250 °C). Little-to-no coarsening of the Cu x Al y particles was observed for either composition; however, clustering of Cu x Al y particles was observed. For Cu6Sn5 particle growth, a bimodal size distribution was observed for the drip atomized alloy, with large, faceted growth of Cu6Sn5 observed, while in the melt spun alloy, Cu6Sn5 particles displayed no significant increase in the average particle size, with irregularly shaped, nonfaceted Cu6Sn5 particles observed after reflow, which is consistent with shapes observed in the as-solidified alloys. The link between original alloy composition, reflow undercooling, and subsequent intermetallic coarsening behavior was discussed by using calculated solidification paths. The reflowed microstructures suggested that the heteroepitaxial relationship previously observed between the Cu x Al y and the Cu6Sn5 was maintained for both alloys.
Reeve, Kathlene N.; Choquette, Stephanie M.; Anderson, Iver E.; ...
2016-10-06
Controlling the size, dispersion, and stability of intermetallic compounds in lead-free solder alloys is vital to creating reliable solder joints regardless of how many times the solder joints are melted and resolidified (reflowed) during circuit board assembly. In this article, the coarsening behavior of Cu x Al y and Cu 6Sn 5 in two Sn-Cu-Al alloys, a Sn-2.59Cu-0.43Al at. pct alloy produced via drip atomization and a Sn-5.39Cu-1.69Al at. pct alloy produced via melt spinning at a 5-m/s wheel speed, was characterized after multiple (1-5) reflow cycles via differential scanning calorimetry between the temperatures of 293 K and 523 Kmore » (20 °C and 250 °C). Little-to-no coarsening of the Cu x Al y particles was observed for either composition; however, clustering of Cu x Al y particles was observed. For Cu 6Sn 5 particle growth, a bimodal size distribution was observed for the drip atomized alloy, with large, faceted growth of Cu 6Sn 5 observed, while in the melt spun alloy, Cu 6Sn 5 particles displayed no significant increase in the average particle size, with irregularly shaped, nonfaceted Cu 6Sn 5 particles observed after reflow, which is consistent with shapes observed in the as-solidified alloys. The link between original alloy composition, reflow undercooling, and subsequent intermetallic coarsening behavior was discussed by using calculated solidification paths. As a result, the reflowed microstructures suggested that the heteroepitaxial relationship previously observed between the Cu x Al y and the Cu 6Sn 5 was maintained for both alloys.« less
Nimura, Akimoto; Fujishiro, Hitomi; Wakabayashi, Yoshiaki; Imatani, Junya; Sugaya, Hiroyuki; Akita, Keiichi
2014-02-01
To identify the unique anatomical characteristic of the extensor carpi radialis brevis (ECRB) origin and points of differentiation from other extensors and to clarify the specific relationship of the ECRB to the underlying structures. We studied the origin of each extensor macroscopically for its muscular and tendinous parts; to identify the relationship between the ECRB origin and the deeper structures, we also examined the attachment of the joint capsule under the ECRB origin. The ECRB simply originated as a tendon without any muscle, whereas other extensors originated as a mixture of tendon and muscle. At the anterior part of the ECRB origin, the thin attachment of the joint capsule (average width, 3.3 mm) lay deep to the ECRB and was distinct. However, at the posterodistal portion, the joint capsule, annular ligament, and supinator were intermingled and originated as a single wide sheet from the humerus (average width, 10.7 mm). The anterior part of the ECRB origin was delicate, because the ECRB origin was purely tendinous, and the attachment of the articular capsule was thin compared with that of the posterodistal attachment. This thin attachment could be an initial factor leading to the development of lateral epicondylitis. The results of the current study may enhance magnetic resonance imaging understanding and may help clarify the etiology of the lateral epicondylitis. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
Senior Enlisted Advisor Joint Staff History Joint Staff Inspector General Joint Staff Structure Origin of J8 | Force Structure, Resources & Assessment Contact Joint Staff Senior Leaders Gen. Joseph F Biography All Joint Staff Biographies Thomas F. Carney, Vice Director for Force Structure, Resources,and
Ebner, Susanne; Fabritius, Cornelia; Ritschl, Paul; Oberhuber, Rupert; Günther, Julia; Kotsch, Katja
2014-10-01
A joint meeting organized by the European (ESOT) and The Transplantation (TTS) Societies for basic science research was organized in Paris, France, on November 7-9, 2013. Focused on new ideas and concepts in translational transplantation, the meeting served as a venue for state-of-the-art developments in basic transplantation immunology, such as the potential for tolerance induction through regulation of T-cell signaling. This meeting report summarizes important insights which were presented in Paris. It not only offers an overview of established aspects, such as the role of Tregs in transplantation, presented by Nobel laureate Rolf Zinkernagel, but also highlights novel facets in the field of transplantation, that is cell-therapy-based immunosuppression or composite tissue transplantation as presented by the emotional story given by Vasyly Rohovyy, who received two hand transplants. The ESOT/TTS joint meeting was an overall productive and enjoyable platform for basic science research in translational transplantation and fulfilled all expectations by giving a promising outlook for the future of research in the field of immunological transplantation research. © 2014 Steunstichting ESOT.
NASA Technical Reports Server (NTRS)
Jefferies, K.
1994-01-01
OFFSET is a ray tracing computer code for optical analysis of a solar collector. The code models the flux distributions within the receiver cavity produced by reflections from the solar collector. It was developed to model the offset solar collector of the solar dynamic electric power system being developed for Space Station Freedom. OFFSET has been used to improve the understanding of the collector-receiver interface and to guide the efforts of NASA contractors also researching the optical components of the power system. The collector for Space Station Freedom consists of 19 hexagonal panels each containing 24 triangular, reflective facets. Current research is geared toward optimizing flux distribution inside the receiver via changes in collector design and receiver orientation. OFFSET offers many options for experimenting with the design of the system. The offset parabolic collector model configuration is determined by an input file of facet corner coordinates. The user may choose other configurations by changing this file, but to simulate collectors that have other than 19 groups of 24 triangular facets would require modification of the FORTRAN code. Each of the roughly 500 facets in the assembled collector may be independently aimed to smooth out, or tailor, the flux distribution on the receiver's wall. OFFSET simulates the effects of design changes such as in receiver aperture location, tilt angle, and collector facet contour. Unique features of OFFSET include: 1) equations developed to pseudo-randomly select ray originating sources on the Sun which appear evenly distributed and include solar limb darkening; 2) Cone-optics technique used to add surface specular error to the ray originating sources to determine the apparent ray sources of the reflected sun; 3) choice of facet reflective surface contour -- spherical, ideal parabolic, or toroidal; 4) Gaussian distributions of radial and tangential components of surface slope error added to the surface normals at the ten nodal points on each facet; and 5) color contour plots of receiver incident flux distribution generated by PATRAN processing of FORTRAN computer code output. OFFSET output includes a file of input data for confirmation, a PATRAN results file containing the values necessary to plot the flux distribution at the receiver surface, a PATRAN results file containing the intensity distribution on a 40 x 40 cm area of the receiver aperture plane, a data file containing calculated information on the system configuration, a file including the X-Y coordinates of the target points of each collector facet on the aperture opening, and twelve P/PLOT input data files to allow X-Y plotting of various results data. OFFSET is written in FORTRAN (70%) for the IBM VM operating system. The code contains PATRAN statements (12%) and P/PLOT statements (18%) for generating plots. Once the program has been run on VM (or an equivalent system), the PATRAN and P/PLOT files may be transferred to a DEC VAX (or equivalent system) with access to PATRAN for PATRAN post processing. OFFSET was written in 1988 and last updated in 1989. PATRAN is a registered trademark of PDA Engineering. IBM is a registered trademark of International Business Machines Corporation. DEC VAX is a registered trademark of Digital Equipment Corporation.
Use of rapid prototyping drill template for the expansive open door laminoplasty: A cadaveric study.
Rong, Xin; Wang, Beiyu; Chen, Hua; Ding, Chen; Deng, Yuxiao; Ma, Lipeng; Ma, Yanzhao; Liu, Hao
2016-11-01
Trough preparation is a technically demanding yet critical procedure for successful expansive open door laminoplasty (EOLP), requiring both proper position and appropriate bone removal. We aimed to use the specific rapid prototyping drill template to achieve such requirement. The 3D model of the cadaveric cervical spine was reconstructed using the Mimics 17.0 and Geomagic Studio 12.0 software. The drilling template was designed in the 3-Matic software. The trough position was simulated at the medial margin of the facet joint. Two holders were designed on both sides. On the open side, the holder would just allow the drill penetrate the ventral cortex of the lamina. On the hinge side, the holder was designed to keep the ventral cortex of the lamina intact. One orthopedic resident performed the surgery using the rapid prototyping drill template on four cadavers (template group). A control group of four cadavers were operated upon without the use of the template. The deviation of the final trough position from the simulated trough position was 0.18mm±0.51mm in the template group. All the troughs in the template group and 40% of the troughs in the control group were at the medial side of the facet joint. The complete hinge fracture rate was 5% in the template group, significantly lower than that (55%) in the control group (P=0.01). The rapid prototyping drill template could help the surgeon accomplish proper trough position and appropriate bone removal in EOLP on the cadaveric cervical spine. Copyright © 2016 Elsevier B.V. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Im, Tae Seong; Lee, Joon Woo; Lee, Eugene
ObjectiveTo evaluate the effects of facet joint injection (FJI) reducing the need for percutaneous vertebroplasty (PVP) in cases of vertebral compression fracture (VCF).Materials and MethodsA total of 169 patients who were referred to the radiology department of our institution for PVP between January 2011 and December 2014 were retrospectively evaluated. The effectiveness of FJI was evaluated by the proportion of patients who cancelled PVP and who experienced reduced pain. In addition, by means of medical chart and MRI review, those clinical factors (age, sex, history of trauma, amount of injected steroids and interval days elapsed between VCF and FJI) andmore » MR image factors (kyphosis angle, height loss, single or multiple level of VCF, burst fracture, central canal compromise, posterior element injury) that were believed to be significant for the effectiveness of FJI were statistically analysed.ResultsIn the 26 patients with FJI prior to PVP, six (23 %) patients cancelled PVP with considerable improvement in reported pain. In the 20 patients with PVP after FJI, improvement in pain after FJI was reported by six patients, resulting in a total of 12 patients (46 %) who experienced reduced pain after FJI. Clinical factors and MR image factors did not show any statistically significant difference between those groups, divided by PVP cancellation and by improvement of pain.ConclusionAfter FJI prior to PVP, about one quarter of patients cancelled PVP due to reduced pain and overall about half of the patients experienced reduced pain.« less
Shingwauk's Vision: A History of Native Residential Schools.
ERIC Educational Resources Information Center
Miller, J. R.
This book provides an overview of the history of Native residential schools in Canada as one facet of the more general history of relations between that country's indigenous and immigrant peoples. It surveys the origins and evolution of residential schooling from the first forays in early 17th-century New France, through the colonial period, to…
ERIC Educational Resources Information Center
Shields, Carolyn M., Ed.
2011-01-01
This important, timely, and thought-provoking reader is a collection of original chapters by authors from five different countries, each of whom explores a facet of transformative leadership. Transformative leadership is fundamentally a critical approach to leadership that goes well beyond the tenets of most current leadership theories to focus on…
Fac-Back-OPAC: An Open Source Interface to Your Library System
ERIC Educational Resources Information Center
Beccaria, Mike; Scott, Dan
2007-01-01
The new Fac-Back-OPAC (a faceted backup OPAC) is built on code that was originally developed by Casey Durfee in February 2007. It represents the convergence of two prominent trends in library tools: the decoupling of discovery tools from the traditional integrated library system (ILS) and the use of readily available open source components to…
Ashton, Michael C; Lee, Kibeom; de Vries, Reinout E; Hendrickse, Joshua; Born, Marise Ph
2012-10-01
The Personality Inventory for DSM-5 (PID-5), a new measure of maladaptive personality traits, has recently been developed by the DSM-5 Personality and Personality Disorders Workgroup. The PID-5 variables were examined within the seven-factor space defined by the six HEXACO factors and the Schizotypy/Dissociation factor (Ashton & Lee, 2012) using participant samples from Canada (N = 378) and the Netherlands (N = 476). Extension analyses showed that several PID-5 facet-level scales represented each of the Honesty-Humility, Emotionality, Extraversion, Conscientiousness, and Schizotypy/Dissociation factors. In contrast, only one PID-5 scale loaded strongly on HEXACO Agreeableness, and no PID-5 scales loaded strongly on Openness to Experience. In addition, a joint factor analysis involving the PID-5 variables and facets of the Five-Factor Model was conducted in the Canadian sample and recovered a set of seven factors corresponding rather closely to the HEXACO factors plus Schizotypy/Dissociation. The authors discuss implications for the assessment and structure of normal and abnormal personality.
Oldring, P K T; Castle, L; O'Mahony, C; Dixon, J
2014-01-01
The FACET tool is a probabilistic model to estimate exposure to chemicals in foodstuffs, originating from flavours, additives and food contact materials. This paper demonstrates the use of the FACET tool to estimate exposure to BPA (bisphenol A) from light metal packaging. For exposure to migrants from food packaging, FACET uses industry-supplied data on the occurrence of substances in the packaging, their concentrations and construction of the packaging, which were combined with data from a market research organisation and food consumption data supplied by national database managers. To illustrate the principles, UK packaging data were used together with consumption data from the UK National Diet and Nutrition Survey (NDNS) dietary survey for 19-64 year olds for a refined deterministic verification. The UK data were chosen mainly because the consumption surveys are detailed, data for UK packaging at a detailed level were available and, arguably, the UK population is composed of high consumers of packaged foodstuffs. Exposures were run for each food category that could give rise to BPA from light metal packaging. Consumer loyalty to a particular type of packaging, commonly referred to as packaging loyalty, was set. The BPA extraction levels used for the 15 types of coating chemistries that could release BPA were in the range of 0.00005-0.012 mg dm(-2). The estimates of exposure to BPA using FACET for the total diet were 0.0098 (mean) and 0.0466 (97.5th percentile) mg/person/day, corresponding to 0.00013 (mean) and 0.00059 (97.5th percentile) mg kg(-1) body weight day(-1) for consumers of foods packed in light metal packaging. This is well below the current EFSA (and other recognised bodies) TDI of 0.05 mg kg(-1) body weight day(-1). These probabilistic estimates were compared with estimates using a refined deterministic approach drawing on the same input data. The results from FACET for the mean, 95th and 97.5th percentile exposures to BPA lay between the lowest and the highest estimates from the refined deterministic calculations. Since this should be the case, for a fully probabilistic compared with a deterministic approach, it is concluded that the FACET tool has been verified in this example. A recent EFSA draft opinion on exposure to BPA from different sources showed that canned foods were a major contributor and compared results from various models, including those from FACET. The results from FACET were overall conservative.
Spondylolisthesis Identified Using Ultrasound Imaging.
Beneck, George J; Gard, Andrea N; Fodran, Kimberly A
2017-12-01
57-year-old woman was recruited for a research study of muscle activation in persons with low back pain. She described a progressive worsening of left lower lumbar pain, which began 5 years prior without any precipitating incident, and intermittent pain at the left gluteal fold (diagnosed as a proximal hamstring tear 2 years prior). Ultrasound revealed marked anterior displacement of the L3-4 and L4-5 facet joints. The subject was recommended for a radiograph using a lateral recumbent view, which demonstrated a grade II spondylolisthesis. J Orthop Sports Phys Ther 2017;47(12):970. doi:10.2519/jospt.2017.7363.
Can lumbar hemorrhagic synovial cyst cause acute radicular compression? Case report
Timbó, Luciana Sátiro; Rosemberg, Laercio Alberto; Brandt, Reynaldo André; Peres, Ricardo Botticini; Nakamura, Olavo Kyosen; Guimarães, Juliana Frota
2014-01-01
Lumbar synovial cysts are an uncommon cause of back pain and radiculopathy, usually manifesting with gradual onset of symptoms, secondary to involvement of the spinal canal. Rarely, intracyst hemorrhage occurs, and may acutely present as radicular - or even spinal cord - compression syndrome. Synovial cysts are generally associated with degenerative facets, although the pathogenesis has not been entirely established. We report a case of bleeding complication in a synovial cyst at L2-L3, adjacent to the right interfacet joint, causing acute pain and radiculopathy in a patient on anticoagulation therapy who required surgical resection. PMID:25628207
NASA Astrophysics Data System (ADS)
Rohmer, Jeremy; Verdel, Thierry
2017-04-01
Uncertainty analysis is an unavoidable task of stability analysis of any geotechnical systems. Such analysis usually relies on the safety factor SF (if SF is below some specified threshold), the failure is possible). The objective of the stability analysis is then to estimate the failure probability P for SF to be below the specified threshold. When dealing with uncertainties, two facets should be considered as outlined by several authors in the domain of geotechnics, namely "aleatoric uncertainty" (also named "randomness" or "intrinsic variability") and "epistemic uncertainty" (i.e. when facing "vague, incomplete or imprecise information" such as limited databases and observations or "imperfect" modelling). The benefits of separating both facets of uncertainty can be seen from a risk management perspective because: - Aleatoric uncertainty, being a property of the system under study, cannot be reduced. However, practical actions can be taken to circumvent the potentially dangerous effects of such variability; - Epistemic uncertainty, being due to the incomplete/imprecise nature of available information, can be reduced by e.g., increasing the number of tests (lab or in site survey), improving the measurement methods or evaluating calculation procedure with model tests, confronting more information sources (expert opinions, data from literature, etc.). Uncertainty treatment in stability analysis usually restricts to the probabilistic framework to represent both facets of uncertainty. Yet, in the domain of geo-hazard assessments (like landslides, mine pillar collapse, rockfalls, etc.), the validity of this approach can be debatable. In the present communication, we propose to review the major criticisms available in the literature against the systematic use of probability in situations of high degree of uncertainty. On this basis, the feasibility of using a more flexible uncertainty representation tool is then investigated, namely Possibility distributions (e.g., Baudrit et al., 2007) for geo-hazard assessments. A graphical tool is then developed to explore: 1. the contribution of both types of uncertainty, aleatoric and epistemic; 2. the regions of the imprecise or random parameters which contribute the most to the imprecision on the failure probability P. The method is applied on two case studies (a mine pillar and a steep slope stability analysis, Rohmer and Verdel, 2014) to investigate the necessity for extra data acquisition on parameters whose imprecision can hardly be modelled by probabilities due to the scarcity of the available information (respectively the extraction ratio and the cliff geometry). References Baudrit, C., Couso, I., & Dubois, D. (2007). Joint propagation of probability and possibility in risk analysis: Towards a formal framework. International Journal of Approximate Reasoning, 45(1), 82-105. Rohmer, J., & Verdel, T. (2014). Joint exploration of regional importance of possibilistic and probabilistic uncertainty in stability analysis. Computers and Geotechnics, 61, 308-315.
Re-Creation of Historical Chrysotile-Containing Joint Compounds
Brorby, G. P.; Sheehan, P. J.; Berman, D. W.; Greene, J. F.; Holm, S. E.
2008-01-01
Chrysotile-containing joint compound was commonly used in construction of residential and commercial buildings through the mid 1970s; however, these products have not been manufactured in the United States for more than 30 years. Little is known about actual human exposures to chrysotile fibers that may have resulted from use of chrysotile-containing joint compounds, because few exposure and no health-effects studies have been conducted specifically with these products. Because limited amounts of historical joint compounds are available (and the stability or representativeness of aged products is suspect), it is currently impossible to conduct meaningful studies to better understand the nature and magnitude of potential exposures to chrysotile that may have been associated with historical use of these products. Therefore, to support specific exposure and toxicology research activities, two types of chrysotile-containing joint compounds were produced according to original formulations from the late 1960s. To the extent possible, ingredients were the same as those used originally, with many obtained from the original suppliers. The chrysotile used historically in these products was primarily Grade 7RF9 from the Philip Carey mine. Because this mine is closed, a suitable alternate was identified by comparing the sizes and mineral composition of asbestos structures in a sample of what has been represented to be historical joint compound (all of which were chrysotile) to those in samples of three currently commercially available Grade 7 chrysotile products. The re-created materials generally conformed to original product specifications (e.g. viscosity, workability, crack resistance), indicating that these materials are sufficiently representative of the original products to support research activities. PMID:18788019
NASA Astrophysics Data System (ADS)
Wu, Jun; Shi, Chentian; Zhang, Yupeng; Fu, Qiang; Pan, Chunxu
2017-12-01
Anatase TiO2 with a variant percentage of exposed (001) facets was prepared under hydrothermal processes by adjusting the volume of HF, and the photocatalytic mechanism was studied from atomic-molecular scale by HRTEM and Raman spectroscopy. It was revealed that: 1) From HRTEM observations, the surface of original TiO2 with exposed (001) facets was clean without impurity, and the crystal lattice was clear and completed; however, when mixed with methylene blue (MB) solution, there were many 1 nm molecular absorbed at the surface of TiO2; after the photocatalytic experiment, MB molecules disappeared and the TiO2 lattice image became fuzzy. 2) The broken path of the MB chemical bond was obtained by Raman spectroscopy, i.e., after the irradiation of the light, the vibrational mode of C-N-C disappeared due to the chemical bond breakage, and the groups containing C-N bond and carbon rings were gradually decomposed. Accordingly, we propose that the driving force for breaking the chemical bond and the disappearance of groups is from the surface lattice distortion of TiO2 during photocatalyzation.
Song, Keun Man; Kim, Do-Hyun; Kim, Jong-Min; Cho, Chu-Young; Choi, Jehyuk; Kim, Kahee; Park, Jinsup; Kim, Hogyoug
2017-06-02
We demonstrated an InGaN/GaN-based, monolithic, white light-emitting diode (LED) without phosphors by using morphology-controlled active layers formed on multi-facet GaN templates containing polar and semipolar surfaces. The nanostructured surface morphology was controlled by changing the growth time, and distinct multiple photoluminescence peaks were observed at 360, 460, and 560 nm; these features were caused by InGaN/GaN-based multiple quantum wells (MQWs) on the nanostructured facets. The origin of each multi-peak was related to the different indium (In) compositions in the different planes of the quantum wells grown on the nanostructured GaN. The emitting units of MQWs in the LED structures were continuously connected, which is different from other GaN-based nanorod or nanowire LEDs. Therefore, the suggested structure had a larger active area. From the electroluminescence spectrum of the fabricated LED, monolithic white light emission with CIE color coordinates of x = 0.306 and y = 0.333 was achieved via multi-facet control combined with morphology control of the metal organic chemical vapor deposition-selective area growth of InGaN/GaN MQWs.
NASA Astrophysics Data System (ADS)
Song, Keun Man; Kim, Do-Hyun; Kim, Jong-Min; Cho, Chu-Young; Choi, Jehyuk; Kim, Kahee; Park, Jinsup; Kim, Hogyoug
2017-06-01
We demonstrated an InGaN/GaN-based, monolithic, white light-emitting diode (LED) without phosphors by using morphology-controlled active layers formed on multi-facet GaN templates containing polar and semipolar surfaces. The nanostructured surface morphology was controlled by changing the growth time, and distinct multiple photoluminescence peaks were observed at 360, 460, and 560 nm; these features were caused by InGaN/GaN-based multiple quantum wells (MQWs) on the nanostructured facets. The origin of each multi-peak was related to the different indium (In) compositions in the different planes of the quantum wells grown on the nanostructured GaN. The emitting units of MQWs in the LED structures were continuously connected, which is different from other GaN-based nanorod or nanowire LEDs. Therefore, the suggested structure had a larger active area. From the electroluminescence spectrum of the fabricated LED, monolithic white light emission with CIE color coordinates of x = 0.306 and y = 0.333 was achieved via multi-facet control combined with morphology control of the metal organic chemical vapor deposition-selective area growth of InGaN/GaN MQWs.
Pfaff, Claas-Thido; Eichenberg, David; Liebergesell, Mario; König-Ries, Birgitta; Wirth, Christian
2017-01-01
Ecology has become a data intensive science over the last decades which often relies on the reuse of data in cross-experimental analyses. However, finding data which qualifies for the reuse in a specific context can be challenging. It requires good quality metadata and annotations as well as efficient search strategies. To date, full text search (often on the metadata only) is the most widely used search strategy although it is known to be inaccurate. Faceted navigation is providing a filter mechanism which is based on fine granular metadata, categorizing search objects along numeric and categorical parameters relevant for their discovery. Selecting from these parameters during a full text search creates a system of filters which allows to refine and improve the results towards more relevance. We developed a framework for the efficient annotation and faceted navigation in ecology. It consists of an XML schema for storing the annotation of search objects and is accompanied by a vocabulary focused on ecology to support the annotation process. The framework consolidates ideas which originate from widely accepted metadata standards, textbooks, scientific literature, and vocabularies as well as from expert knowledge contributed by researchers from ecology and adjacent disciplines.
Fan, Wei-Li; Sun, Hong-Zhen; Wu, Si-Yu; Wang, Ai-Min
2013-03-01
The most common treatment for old calcaneal fractures accompanied by subtalar joint injury is the use of subtalar in situ arthrodesis and subtalar distraction bone-block arthrodesis or osteotomy. This article describes the introduction of a novel surgical treatment, gradual subtalar distraction with external fixation and restoration of the calcaneal height, and presents an assessment of its efficacy. The protruding lateral calcaneus and the articular surfaces and subchondral bone of the posterior facet of the subtalar joint were surgically removed. An external fixator, attached with 2 pins in the subcutaneous tibia and 2 pins in the posterolateral calcaneus, was used to fix the subtalar joint for 7 to 10 days followed by gradual subtalar distraction at 1 mm/d. The lengthening procedure was stopped when the calcaneal height was restored according to radiography. The external fixator was removed after bone fusion. Seven cases of old calcaneal fractures accompanied by severe subtalar joint injury (8 feet) were treated using this method. Average follow-up was 14.3 months (range, 7-36 months). In all 7 cases (1 case of both feet), the postoperative wound healed primarily. The calcaneal heights of all 8 feet were partially restored. Subtalar joint bone fusion was completed within 4 to 6 months after the operation. The average preoperative American Orthopedic Foot & Ankle Society (AOFAS) hindfoot score was 25.3, and the average postoperative AOFAS score was 76.3. Subtalar distraction osteogenesis with external fixation was a novel and effective method for the treatment of old calcaneal fractures accompanied by severe subtalar joint injury in this small group of patients. Level IV, retrospective case series.
Modern mammal origins: evolutionary grades in the Early Cretaceous of North America.
Jacobs, L L; Winkler, D A; Murry, P A
1989-01-01
Major groups of modern mammals have their origins in the Mesozoic Era, yet the mammalian fossil record is generally poor for that time interval. Fundamental morphological changes that led to modern mammals are often represented by small samples of isolated teeth. Fortunately, functional wear facets on teeth allow prediction of the morphology of occluding teeth that may be unrepresented by fossils. A major step in mammalian evolution occurred in the Early Cretaceous with the evolution of tribosphenic molars, which characterize marsupials and placentals, the two most abundant and diverse extant groups of mammals. A tooth from the Early Cretaceous (110 million years before present) of Texas tests previous predictions (based on lower molars) of the morphology of upper molars in early tribosphenic dentitions. The lingual cusp (protocone) is primitively without shear facets, as expected, but the cheek side of the tooth is derived (advanced) in having distinctive cusps along the margin. The tooth, although distressingly inadequate to define many features of the organism, demonstrates unexpected morphological diversity at a strategic stage of mammalian evolution and falsifies previous claims of the earliest occurrence of true marsupials. Images PMID:2740336
Self-organization in complex oxide thin films: from 2D to 0D nanostructures of SrRuO3 and CoCr2O4
NASA Astrophysics Data System (ADS)
Sánchez, F.; Lüders, U.; Herranz, G.; Infante, I. C.; Fontcuberta, J.; García-Cuenca, M. V.; Ferrater, C.; Varela, M.
2005-05-01
We report here on the controlled fabrication of nanostructures of varied dimensionality by self-organization processes in the heteroepitaxial growth of SrRuO3 (SRO) and CoCr2O4 (CCO) films. The surface of SRO films on SrTiO3(001) substrates can show extremely smooth terraces (2D objects) separated by atomic steps, a structure of faceted islands (0D objects), a cross-hatch morphology (1D objects), an array of finger-like units (1D objects), or an array of giant bunched steps (1D objects). The surface can be tailored to a particular structure by controlling the vicinality of the substrate and the growth rate and nominal thickness of the film. In the case of CCO films, grown on (001)-oriented MgAl2O4 or MgO substrates, high aspect ratio {111}-faceted pyramids and hut clusters (0D objects), highly oriented and having a similar size, appear above a critical thickness. The size and spatial density can be tuned by varying deposition temperature, nominal thickness, and substrate. This dependence allows the fabrication of surfaces being fully faceted (2D objects), or having arrays of dislocated pyramids of up to micrometric size, or small coherently lattice strained pyramids having a nanometric size. We discuss the driving forces that originate the peculiar SRO and CCO nanostructures. The findings illustrate that the growth of complex oxides can promote a variety of novel self-organized morphologies, and suggest original strategies to fabricate templates or hybrid structures of oxides combining varied functionalities.
BioCarian: search engine for exploratory searches in heterogeneous biological databases.
Zaki, Nazar; Tennakoon, Chandana
2017-10-02
There are a large number of biological databases publicly available for scientists in the web. Also, there are many private databases generated in the course of research projects. These databases are in a wide variety of formats. Web standards have evolved in the recent times and semantic web technologies are now available to interconnect diverse and heterogeneous sources of data. Therefore, integration and querying of biological databases can be facilitated by techniques used in semantic web. Heterogeneous databases can be converted into Resource Description Format (RDF) and queried using SPARQL language. Searching for exact queries in these databases is trivial. However, exploratory searches need customized solutions, especially when multiple databases are involved. This process is cumbersome and time consuming for those without a sufficient background in computer science. In this context, a search engine facilitating exploratory searches of databases would be of great help to the scientific community. We present BioCarian, an efficient and user-friendly search engine for performing exploratory searches on biological databases. The search engine is an interface for SPARQL queries over RDF databases. We note that many of the databases can be converted to tabular form. We first convert the tabular databases to RDF. The search engine provides a graphical interface based on facets to explore the converted databases. The facet interface is more advanced than conventional facets. It allows complex queries to be constructed, and have additional features like ranking of facet values based on several criteria, visually indicating the relevance of a facet value and presenting the most important facet values when a large number of choices are available. For the advanced users, SPARQL queries can be run directly on the databases. Using this feature, users will be able to incorporate federated searches of SPARQL endpoints. We used the search engine to do an exploratory search on previously published viral integration data and were able to deduce the main conclusions of the original publication. BioCarian is accessible via http://www.biocarian.com . We have developed a search engine to explore RDF databases that can be used by both novice and advanced users.
Lordosis manoeuvre in the diagnosis of lumbar facet syndrome.
Díez-Ulloa, M A; Almira Suárez, E L; Otero Fernández, M; Leborans Eiras, S; Collado Arce, G
2016-01-01
In lumbar pain patients an aetiopathogenic diagnosis leads to a better management. When there are alarm signs, they should be classified on an anatomical basis through anamnesis and physical examination. A significant group is of facet origin (lumbar facet syndrome [LFS]), but the precise clinical diagnosis remains cumbersome and time-consuming. In clinical practice it is observed that patients with an advanced degenerative disease do not perform extension or rotation of their lumbar spine when prompted to extend it, but rather knee flexion, making the manoeuvre meaningless. For this reason, a new simple and quick clinical test was developed for the diagnosis of lumbar facet syndrome, with a facet block-test as a confirmation. The new test is better than a classic one in the diagnosis of facet syndrome, and probably even better than imaging studies A prospective study was conducted on a series of 68 patients (01/01/2012-30/06/2013). A comparison in between: classic manoeuvre (CM), imaging diagnostics (ID), and the new lordosis manoeuvre (LM) test. Examination and block test by one author, and evaluation of results by another one. Deformity and instability. using a physical. To determine the effectiveness of a new clinical test (LM) for the diagnosis of LFS (as confirmed by a positive block-test of medial branch of dorsal ramus of the lumbar root, RMRDRL). R package software. The LM was most effective (p<.0001; Kappa 0.524, p<.001). There was no correlation between either the CM or ID and the block-test results (Kappa, CM: 0.078; p=.487, and ID: 0.195; p=.105). There was a correlation between ID (CAT/MR) and LM (p=.024; Kappa 0.289 p=.014), although not with CM. There was no correlation between ID (plain X-rays) and CM or LM. A new test for diagnosis of LFS is presented that is reliable, quick, and simple. Clinical examination is more reliable than imaging test for the diagnosis of LFS. Copyright © 2016 SECOT. Published by Elsevier Espana. All rights reserved.
In situ three-dimensional reciprocal-space mapping during mechanical deformation.
Cornelius, T W; Davydok, A; Jacques, V L R; Grifone, R; Schülli, T; Richard, M I; Beutier, G; Verdier, M; Metzger, T H; Pietsch, U; Thomas, O
2012-09-01
Mechanical deformation of a SiGe island epitaxically grown on Si(001) was studied by a specially adapted atomic force microscope and nanofocused X-ray diffraction. The deformation was monitored during in situ mechanical loading by recording three-dimensional reciprocal-space maps around a selected Bragg peak. Scanning the energy of the incident beam instead of rocking the sample allowed the safe and reliable measurement of the reciprocal-space maps without removal of the mechanical load. The crystal truncation rods originating from the island side facets rotate to steeper angles with increasing mechanical load. Simulations of the displacement field and the intensity distribution, based on the finite-element method, reveal that the change in orientation of the side facets of about 25° corresponds to an applied pressure of 2-3 GPa on the island top plane.
NASA Astrophysics Data System (ADS)
Dimastrodonato, Valeria; Pelucchi, Emanuele; Zestanakis, Panagiotis A.; Vvedensky, Dimitri D.
2013-07-01
We present a theoretical model of the formation of self-limited (Al)GaAs quantum wires within V-grooves on GaAs(001) substrates during metalorganic vapor-phase epitaxy. We identify the facet-dependent rates of the kinetic processes responsible for the formation of the self-limiting profile, which is accompanied by Ga segregation along the axis perpendicular to the bottom of the original template, and analyze their interplay with the facet geometry in the transient regime. A reduced model is adopted for the evolution of the patterned profile, as determined by the angle between the different crystallographic planes as a function of the growth conditions. Our results provide a comprehensive phenomenological understanding of the self-ordering mechanism on patterned surfaces which can be harnessed for designing the quantum optical properties of low-dimensional systems.
Joint principles: Integrating behavioral health care into the patient-centered medical home.
2014-06-01
The Patient-centered Medical Home (PCMH) is an innovative, improved, and evolving approach to providing primary care that has gained broad acceptance in the United States. The Joint Principles of the PCMH, formulated and endorsed in February 2007, are sound and describe the ideal toward which we aspire. However, there is an element running implicitly through these joint principles that is difficult to achieve yet indispensable to the success of the entire PCMH concept. The incorporation of behavioral health care has not always been included as practices transform to accommodate to the PCMH ideals. This is an alarming development because the PCMH will be incomplete and ineffective without the full incorporation of this element, and retrofitting will be much more difficult than prospectively integrating into the original design of the PCMH. Therefore we offer a complementary set of joint principles that recognizes the centrality of behavioral health care as part of the PCMH. This document follows the order and language of the original joint principles while emphasizing what needs to be addressed to insure incorporation of the essential behavioral elements. It is intended to supplement and not replace the original Joint Principles document, which still stands.
2017-07-01
Reports an error in "The Next Big Five Inventory (BFI-2): Developing and Assessing a Hierarchical Model With 15 Facets to Enhance Bandwidth, Fidelity, and Predictive Power" by Christopher J. Soto and Oliver P. John ( Journal of Personality and Social Psychology , Advanced Online Publication, Apr 7, 2016, np). In the article, all citations to McCrae and Costa (2008), except for the instance in which it appears in the first paragraph of the introduction, should instead appear as McCrae and Costa (2010). The complete citation should read as follows: McCrae, R. R., & Costa, P. T. (2010). NEO Inventories professional manual. Lutz, FL: Psychological Assessment Resources. The attribution to the BFI-2 items that appears in the Table 6 note should read as follows: BFI-2 items adapted from "Conceptualization, Development, and Initial Validation of the Big Five Inventory-2," by C. J. Soto and O. P. John, 2015, Paper presented at the biennial meeting of the Association for Research in Personality. Copyright 2015 by Oliver P. John and Christopher J. Soto. The complete citation in the References list should appear as follows: Soto, C. J., & John, O. P. (2015, June). Conceptualization, development, and initial validation of the Big Five Inventory-2. Paper presented at the biennial meeting of the Association for Research in Personality, St. Louis, MO. Available from http://www.colby.edu/psych/personality-lab/ All versions of this article have been corrected. (The following abstract of the original article appeared in record 2016-17156-001.) Three studies were conducted to develop and validate the Big Five Inventory-2 (BFI-2), a major revision of the Big Five Inventory (BFI). Study 1 specified a hierarchical model of personality structure with 15 facet traits nested within the Big Five domains, and developed a preliminary item pool to measure this structure. Study 2 used conceptual and empirical criteria to construct the BFI-2 domain and facet scales from the preliminary item pool. Study 3 used data from 2 validation samples to evaluate the BFI-2's measurement properties and substantive relations with self-reported and peer-reported criteria. The results of these studies indicate that the BFI-2 is a reliable and valid personality measure, and an important advance over the original BFI. Specifically, the BFI-2 introduces a robust hierarchical structure, controls for individual differences in acquiescent responding, and provides greater bandwidth, fidelity, and predictive power than the original BFI, while still retaining the original measure's conceptual focus, brevity, and ease of understanding. The BFI-2 therefore offers valuable new opportunities for research examining the structure, assessment, development, and life outcomes of personality traits. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Funabashi, Martha; Nougarou, François; Descarreaux, Martin; Prasad, Narasimha; Kawchuk, Greg
In order to define the relation between spinal manipulative therapy (SMT) input parameters and the distribution of load within spinal tissues, the aim of this study was to determine the influence of force magnitude and application site when SMT is applied to cadaveric spines. In 10 porcine cadavers, a servo-controlled linear actuator motor provided a standardized SMT simulation using 3 different force magnitudes (100N, 300N, and 500N) to 2 different cutaneous locations: L3/L4 facet joint (FJ), and L4 transverse processes (TVP). Vertebral kinematics were tracked optically using indwelling bone pins, the motion segment removed and mounted in a parallel robot equipped with a 6-axis load cell. The kinematics of each SMT application were replicated robotically. Serial dissection of spinal structures was conducted to quantify loading characteristics of discrete spinal tissues. Forces experienced by the L3/L4 segment and spinal structures during SMT replication were recorded and analyzed. Spinal manipulative therapy force magnitude and application site parameters influenced spinal tissues loading. A significant main effect (P < .05) of force magnitude was observed on the loads experienced by the intact specimen and supra- and interspinous ligaments. The main effect of application site was also significant (P < .05), influencing the loading of the intact specimen and facet joints, capsules, and ligamentum flavum (P < .05). Spinal manipulative therapy input parameters of force magnitude and application site significantly influence the distribution of forces within spinal tissues. By controlling these SMT parameters, clinical outcomes may potentially be manipulated. Copyright © 2017. Published by Elsevier Inc.
Peloso, Paul M; Khan, Mahweesh; Gross, Anita R; Carlesso, Lisa; Santaguida, Lina; Lowcock, Janet; MacDermid, Joy C; Walton, Dave; Goldsmith, Charlie H; Langevin, Pierre; Shi, Qiyun
2013-01-01
Objectives: To conduct an overview (review-of-reviews) on pharmacological interventions for neck pain. Search Strategy: Computerized databases and grey literature were searched from 2006 to 2012. Selection Criteria: Systematic reviews of randomized controlled trials (RCT) in adults with acute to chronic neck pain reporting effects of pharmacological interventions including injections on pain, function/disability, global perceived effect, quality of life and patient satisfaction. Data Collection & Analysis: Two independent authors selected articles, assessed risk of bias and extracted data The GRADE tool was used to evaluate the body of evidence and an external panel provided critical review. Main Results: We found 26 reviews reporting on 47 RCTs. Most pharmacological interventions had low to very low quality methodologic evidence with three exceptions. For chronic neck pain, there was evidence of: a small immediate benefit for eperison hydrochloride (moderate GRADE, 1 trial, 157 participants);no short-term pain relieving benefit for botulinum toxin-A compared to saline (strong GRADE; 5 trial meta-analysis, 258 participants) nor for subacute/chronic whiplash (moderate GRADE; 4 trial meta-analysis, 183 participants) including reduced pain, disability or global perceived effect; andno long-term benefit for medial branch block of facet joints with steroids (moderate GRADE; 1 trial, 120 participants) over placebo to reduce pain or disability; Reviewers' Conclusions: While in general there is a lack of evidence for most pharmacological interventions, current evidence is against botulinum toxin-A for chronic neck pain or subacute/chronic whiplash; against medial branch block with steroids for chronic facet joint pain; but in favour of the muscle relaxant eperison hydrochloride for chronic neck pain. PMID:24155805
Anterior ankle arthroscopy, distraction or dorsiflexion?
de Leeuw, Peter A J; Golanó, Pau; Clavero, Joan A; van Dijk, C Niek
2010-05-01
Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7-1.5) and 0.7 cm (range 0.5-0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy.
Anterior ankle arthroscopy, distraction or dorsiflexion?
Golanó, Pau; Clavero, Joan A.; van Dijk, C. Niek
2010-01-01
Anterior ankle arthroscopy can basically be performed by two different methods; the dorsiflexion- or distraction method. The objective of this study was to determine the size of the anterior working area for both the dorsiflexion and distraction method. The anterior working area is anteriorly limited by the overlying anatomy which includes the neurovascular bundle. We hypothesize that in ankle dorsiflexion the anterior neurovascular bundle will move away anteriorly from the ankle joint, whereas in ankle distraction the anterior neurovascular bundle is pulled tight towards the joint, thereby decreasing the safe anterior working area. Six fresh frozen ankle specimens, amputated above the knee, were scanned with computed tomography. Prior to scanning the anterior tibial artery was injected with contrast fluid and subsequently each ankle was scanned both in ankle dorsiflexion and in distraction. A special device was developed to reproducibly obtain ankle dorsiflexion and distraction in the computed tomography scanner. The distance between the anterior border of the inferior tibial articular facet and the posterior border of the anterior tibial artery was measured. The median distance from the anterior border of the inferior tibial articular facet to the posterior border of the anterior tibial artery in ankle dorsiflexion and distraction was 0.9 cm (range 0.7–1.5) and 0.7 cm (range 0.5–0.8), respectively. The distance in ankle dorsiflexion significantly exceeded the distance in ankle distraction (P = 0.03). The current study shows a significantly increased distance between the anterior distal tibia and the overlying anterior neurovascular bundle with the ankle in a slightly dorsiflexed position as compared to the distracted ankle position. We thereby conclude that the distracted ankle position puts the neurovascular structures more at risk for iatrogenic damage when performing anterior ankle arthroscopy. PMID:20217392
Goode, A P; Nelson, A E; Kraus, V B; Renner, J B; Jordan, J M
2017-10-01
To determine differences in biomarker levels between radiographic phenotypes of facet joint osteoarthritis (FOA) only, spine OA only ((disc space narrowing (DSN) and vertebral osteophytes (OST)) or the combination of FOA and spine OA. A cross-sectional analysis of data from 555 participants in the Johnston County Osteoarthritis Project was performed. Lumbar spine levels were graded by severity (OST and DSN) and presence (FOA) of degeneration. Biomarkers included hyaluronan (HA) and type II collagen (CTX-II). Adjusted risk ratios (aRRR) were estimated using multinomial regression, with adjustment for age, race, sex, body mass index (BMI), and radiographic OA (knee, hip, hand). Interactions were tested between sex, race and low back symptoms. FOA only was present in 22.4%, 14.5% had spine OA only, and 34.6% had the combination of FOA and spine OA. Compared to the reference group of neither FOA or spine OA, a one unit higher ln HA level was associated with 31% higher relative risk ratio (RRR = 1.31 (95% 1.03, 1.67)) of having FOA only, while, a one unit higher lnuCTX-II level was associated with 84% higher relative risk ratio (RRR = 1.84 (95% CI 1.19, 2.84)) of having spine OA only. No significant interactions were identified. Interestingly, OA affecting the synovial facet joint was associated with a marker of inflammation (HA). Spine OA, affecting intervertebral discs that contain collagen type II, was associated with a marker reflecting collagen type II degradation (CTX-II). These findings suggest that biomarkers may reflect the different pathophysiologic processes of lumbar spine OA phenotypes. Copyright © 2017 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.
Actis, Jason A; Honegger, Jasmin D; Gates, Deanna H; Petrella, Anthony J; Nolasco, Luis A; Silverman, Anne K
2018-02-08
Low back mechanics are important to quantify to study injury, pain and disability. As in vivo forces are difficult to measure directly, modeling approaches are commonly used to estimate these forces. Validation of model estimates is critical to gain confidence in modeling results across populations of interest, such as people with lower-limb amputation. Motion capture, ground reaction force and electromyographic data were collected from ten participants without an amputation (five male/five female) and five participants with a unilateral transtibial amputation (four male/one female) during trunk-pelvis range of motion trials in flexion/extension, lateral bending and axial rotation. A musculoskeletal model with a detailed lumbar spine and the legs including 294 muscles was used to predict L4-L5 loading and muscle activations using static optimization. Model estimates of L4-L5 intervertebral joint loading were compared to measured intradiscal pressures from the literature and muscle activations were compared to electromyographic signals. Model loading estimates were only significantly different from experimental measurements during trunk extension for males without an amputation and for people with an amputation, which may suggest a greater portion of L4-L5 axial load transfer through the facet joints, as facet loads are not captured by intradiscal pressure transducers. Pressure estimates between the model and previous work were not significantly different for flexion, lateral bending or axial rotation. Timing of model-estimated muscle activations compared well with electromyographic activity of the lumbar paraspinals and upper erector spinae. Validated estimates of low back loading can increase the applicability of musculoskeletal models to clinical diagnosis and treatment. Copyright © 2017 Elsevier Ltd. All rights reserved.
Kim, Jun Young; Kwon, Jae Yeol; Kim, Moon Seok; Lee, Jeong Jae; Kim, Il Sup; Hong, Jae Taek
2018-03-01
To compare the morphometry of subaxial cervical spine between cerebral palsy (CP) and normal control. We retrospectively analyzed 72 patients with CP, as well as 72 patients from normal population. The two groups were matched for age, sex, and body mass index. Pedicle, lateral mass (LM), and vertebral foramen were evaluated using computed tomography (CT) imaging. Pedicle diameter, LM height, thickness, width and vertebral foramen asymmetry (VFA) were measured and compared between the two groups. Cervical dynamic motion, disc and facet joint degeneration were investigated. Additionally, we compared the morphology of LM between convex side and concave side with cervical scoliotic CP patients. LM height was smaller in CP group. LM thickness and width were larger in CP group at mid-cervical level. In 40 CP patients with cervical scoliosis, there were no height and width differences between convex and concave side. Pedicle outer diameter was not statistically different between two groups. Pedicle inner diameter was significantly smaller in CP group. Pedicle sclerosis was more frequent in CP patients. VFA was larger in CP group at C3, C4, and C5. Disc/facet degeneration grade was higher in the CP group. Cervical motion of CP group was smaller than those of the control group. LM morphology of CP patients was different from normal population. Sclerotic pedicles and vertebral foramen asymmetry were more commonly identified in CP patients. CP patients were more likely to demonstrate progressive disc/facet degeneration. This data may provide useful information on cervical posterior instrumentation in CP patients.
Multi-spectral investigation of bulk and facet failures in high-power single emitters at 980 nm
NASA Astrophysics Data System (ADS)
Yanson, Dan; Levy, Moshe; Shamay, Moshe; Cohen, Shalom; Shkedy, Lior; Berk, Yuri; Tessler, Renana; Klumel, Genadi; Rappaport, Noam; Karni, Yoram
2013-03-01
Reliable single emitters delivering >10W in the 9xx nm spectral range, are common building blocks for fiber laser pumps. As facet passivation techniques can suppress or delay catastrophic optical mirror damage (COMD) extending emitter reliability into hundreds of thousands of hours, other, less dominant, failure modes such as intra-chip catastrophic optical bulk damage (COBD) become apparent. Based on our failure statistics in high current operation, only ~52% of all failures can be attributed to COMD. Imaging through a window opened in the metallization on the substrate (n) side of a p-side down mounted emitter provides valuable insight into both COMD and COBD failure mechanisms. We developed a laser ablation process to define a window on the n-side of an InGaAs/AlGaAs 980nm single emitter that is overlaid on the pumped 90μm stripe on the p-side. The ablation process is compatible with the chip wire-bonding, enabling the device to be operated at high currents with high injection uniformity. We analyzed both COMD and COBD failed emitters in the electroluminescence and mid-IR domains supported by FIB/SEM observation. The ablated devices revealed branching dark line patterns, with a line origin either at the facet center (COMD case) or near the stripe edge away from the facet (COBD case). In both cases, the branching direction is always toward the rear facet (against the photon density gradient), with SEM images revealing a disordered active layer structure. Absorption levels between 0.22eV - 0.55eV were observed in disordered regions by FT-IR spectroscopy. Temperature mapping of a single emitter in the MWIR domain was performed using an InSb detector. We also report an electroluminescence study of a single emitter just before and after failure.
Zhu, Ying
2016-01-01
Individual neurons in several sensory systems receive synaptic inputs organized according to subcellular topographic maps, yet the fine structure of this topographic organization and its relation to dendritic morphology have not been studied in detail. Subcellular topography is expected to play a role in dendritic integration, particularly when dendrites are extended and active. The lobula giant movement detector (LGMD) neuron in the locust visual system is known to receive topographic excitatory inputs on part of its dendritic tree. The LGMD responds preferentially to objects approaching on a collision course and is thought to implement several interesting dendritic computations. To study the fine retinotopic mapping of visual inputs onto the excitatory dendrites of the LGMD, we designed a custom microscope allowing visual stimulation at the native sampling resolution of the locust compound eye while simultaneously performing two-photon calcium imaging on excitatory dendrites. We show that the LGMD receives a distributed, fine retinotopic projection from the eye facets and that adjacent facets activate overlapping portions of the same dendritic branches. We also demonstrate that adjacent retinal inputs most likely make independent synapses on the excitatory dendrites of the LGMD. Finally, we show that the fine topographic mapping can be studied using dynamic visual stimuli. Our results reveal the detailed structure of the dendritic input originating from individual facets on the eye and their relation to that of adjacent facets. The mapping of visual space onto the LGMD's dendrites is expected to have implications for dendritic computation. PMID:27009157
Andrés, Juan; Gracia, Lourdes; Gouveia, Amanda Fernandes; Ferrer, Mateus Meneghetti; Longo, Elson
2015-10-09
Morphology is a key property of materials. Owing to their precise structure and morphology, crystals and nanocrystals provide excellent model systems for joint experimental and theoretical investigations into surface-related properties. Faceted polyhedral crystals and nanocrystals expose well-defined crystallographic planes depending on the synthesis method, which allow for thoughtful investigations into structure-reactivity relationships under practical conditions. This feature article introduces recent work, based on the combined use of experimental findings and first-principles calculations, to provide deeper knowledge of the electronic, structural, and energetic properties controlling the morphology and the transformation mechanisms of different metals and metal oxides: Ag, anatase TiO2, BaZrO3, and α-Ag2WO4. According to the Wulff theorem, the equilibrium shapes of these systems are obtained from the values of their respective surface energies. These investigations are useful to gain further understanding of how to achieve morphological control of complex three-dimensional crystals by tuning the ratio of the surface energy values of the different facets. This strategy allows the prediction of possible morphologies for a crystal and/or nanocrystal by controlling the relative values of surface energies.
Relationship between disc injury and manual lifting: a poroelastic finite element model study.
Natarajan, R N; Williams, J R; Lavender, S A; An, H S; Anderson, G B
2008-02-01
Understanding how failure originates in a lumbar motion segment subjected to loading conditions that are representative of manual lifting is important because it will pave the way for a better formulation of the exposure-injury relationship. The aim of the current investigation was to use a poroelastic finite element model of a human lumbar disc to determine its biomechanical characteristics under loading conditions that corresponded to three different, commonly occurring lifting activities and to identify the most hazardous type of loading with regard to damage to the disc. The current study showed that asymmetric lifting may increase the risk of back injury and pain. Lifting that involved lateral bending (asymmetric lifting) of the trunk was found to produce stresses at a localized area in the annulus, annuluar fibres, end plates, and facet joints that were higher than their respective tissue failure strength. Thus asymmetric lifting, if performed over a large number of cycles, might help to propagate this localized failure of the disc tissue to a larger area, owing to fatigue. The analyses also showed that largest fluid exchange between the nucleus and the end plates occurred during asymmetric lifting. If the fluid exchange is restricted owing to end plate calcification or sclerosis of the subchondral bone, high intradiscal pressure might develop, leading to higher disc bulge causing back pain.
Fluoroscopically Guided Epidural Injections of the Cervical and Lumbar Spine.
Shim, Euddeum; Lee, Joon Woo; Lee, Eugene; Ahn, Joong Mo; Kang, Yusuhn; Kang, Heung Sik
2017-01-01
Advances in imaging and the development of injection techniques have enabled spinal intervention to become an important tool in managing chronic spinal pain. Epidural steroid injection (ESI) is one of the most widely used spinal interventions; it directly delivers drugs into the epidural space to relieve pain originating from degenerative spine disorders-central canal stenoses and neural foraminal stenoses-or disk herniations. Knowledge of the normal anatomy of the epidural space is essential to perform an effective and safe ESI and to recognize possible complications. Although computed tomographic (CT) or combined CT-fluoroscopic guidance has been increasingly used in ESI, conventional fluoroscopic guidance is generally performed. In ESI, drugs are delivered into the epidural space by interlaminar or transforaminal routes in the cervical spine or by interlaminar, transforaminal, or caudal routes in the lumbar spine. Epidurography is usually performed before drug delivery to verify the proper position of the needle in the epidural space. A small amount of contrast agent is injected with fluoroscopic guidance. Familiarity with the findings on a typical "true" epidurogram (demonstrating correct needle placement in the epidural space) permits proper performance of ESI. Findings on "false" epidurograms (demonstrating incorrect needle placement) include muscular staining and evidence of intravascular injection, inadvertent facet joint injection, dural puncture, subdural injection, and intraneural or intradiscal injection. © RSNA, 2016 An earlier incorrect version of this article appeared online. This article was corrected on December 22, 2016.
The synergistic effect of prosociality and physical attractiveness on mate desirability.
Ehlebracht, Daniel; Stavrova, Olga; Fetchenhauer, Detlef; Farrelly, Daniel
2017-12-17
Mate selection requires a prioritization and joint evaluation of different traits present or absent in potential mates. Herein, we focus on two such traits - physical attractiveness and prosociality - and examine how they jointly shape impressions of overall desirability. We report on two related experiments which make use of an innovative methodology combining large samples of raters and target persons (i.e., stimuli) and information on targets' behaviour in economic games representing altruistic behaviour (Experiment 1) and trustworthiness (Experiment 2), two important facets of prosociality. In accordance with predictions derived from a cognitive perspective on mate choice and sexual strategies theory, the results show that the impact of being prosocial on an individual's overall desirability was increased further by them also being physically attractive, but only in long-term mating contexts. Furthermore, we show that men's mate preferences for certain prosocial traits (i.e., trustworthiness) were more context-dependent than women's due to differential evolutionary pressures for ancestral men and women. © 2017 The British Psychological Society.
First principles determination of dislocation properties.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Hamilton, John C.
2003-12-01
This report details the work accomplished on first principles determination of dislocation properties. It contains an introduction and three chapters detailing three major accomplishments. First, we have used first principle calculations to determine the shear strength of an aluminum twin boundary. We find it to be remarkably small ({approx}17 mJ/m{sup 2}). This unexpected result is explained and will likely pertain for many other grain boundaries. Second, we have proven that the conventional explanation for finite grain boundary facets is wrong for a particular aluminum grain boundary. Instead of finite facets being stabilized by grain boundary stress, we find them tomore » originate from kinetic effects. Finally we report on a new application of the Frenkel-Kontorova model to understand reconstructions of (100) type surfaces. In addition to the commonly accepted formation of rectangular dislocation arrays, we find numerous other possible solutions to the model including hexagonal reconstructions and a clock-rotated structure.« less
Small nanoparticles, surface geometry and contact forces.
Takato, Yoichi; Benson, Michael E; Sen, Surajit
2018-03-01
In this molecular dynamics study, we examine the local surface geometric effects of the normal impact force between two approximately spherical nanoparticles that collide in a vacuum. Three types of surface geometries-(i) crystal facets, (ii) sharp edges, and (iii) amorphous surfaces of small nanoparticles with radii R <10 nm-are considered. The impact forces are compared with their macroscopic counterparts described by nonlinear contact forces based on Hertz contact mechanics. In our simulations, edge and amorphous surface contacts with weak surface energy reveal that the average impact forces are in excellent agreement with the Hertz contact force. On the other hand, facet collisions show a linearly increasing force with increasing compression. Our results suggest that the nearly spherical nanoparticles are likely to enable some nonlinear dynamic phenomena, such as breathers and solitary waves observed in granular materials, both originating from the nonlinear contact force.
Arthropod eyes: The early Cambrian fossil record and divergent evolution of visual systems.
Strausfeld, Nicholas J; Ma, Xiaoya; Edgecombe, Gregory D; Fortey, Richard A; Land, Michael F; Liu, Yu; Cong, Peiyun; Hou, Xianguang
2016-03-01
Four types of eyes serve the visual neuropils of extant arthropods: compound retinas composed of adjacent facets; a visual surface populated by spaced eyelets; a smooth transparent cuticle providing inwardly directed lens cylinders; and single-lens eyes. The first type is a characteristic of pancrustaceans, the eyes of which comprise lenses arranged as hexagonal or rectilinear arrays, each lens crowning 8-9 photoreceptor neurons. Except for Scutigeromorpha, the second type typifies Myriapoda whose relatively large eyelets surmount numerous photoreceptive rhabdoms stacked together as tiers. Scutigeromorph eyes are facetted, each lens crowning some dozen photoreceptor neurons of a modified apposition-type eye. Extant chelicerate eyes are single-lensed except in xiphosurans, whose lateral eyes comprise a cuticle with a smooth outer surface and an inner one providing regular arrays of lens cylinders. This account discusses whether these disparate eye types speak for or against divergence from one ancestral eye type. Previous considerations of eye evolution, focusing on the eyes of trilobites and on facet proliferation in xiphosurans and myriapods, have proposed that the mode of development of eyes in those taxa is distinct from that of pancrustaceans and is the plesiomorphic condition from which facetted eyes have evolved. But the recent discovery of enormous regularly facetted compound eyes belonging to early Cambrian radiodontans suggests that high-resolution facetted eyes with superior optics may be the ground pattern organization for arthropods, predating the evolution of arthrodization and jointed post-protocerebral appendages. Here we provide evidence that compound eye organization in stem-group euarthropods of the Cambrian can be understood in terms of eye morphologies diverging from this ancestral radiodontan-type ground pattern. We show that in certain Cambrian groups apposition eyes relate to fixed or mobile eyestalks, whereas other groups reveal concomitant evolution of sessile eyes equipped with optics typical of extant xiphosurans. Observations of fossil material, including that of trilobites and eurypterids, support the proposition that the ancestral compound eye was the apposition type. Cambrian arthropods include possible precursors of mandibulate eyes. The latter are the modified compound eyes, now sessile, and their underlying optic lobes exemplified by scutigeromorph chilopods, and the mobile stalked compound eyes and more elaborate optic lobes typifying Pancrustacea. Radical divergence from an ancestral apposition type is demonstrated by the evolution of chelicerate eyes, from doublet sessile-eyed stem-group taxa to special apposition eyes of xiphosurans, the compound eyes of eurypterids, and single-lens eyes of arachnids. Different eye types are discussed with respect to possible modes of life of the extinct species that possessed them, comparing these to extant counterparts and the types of visual centers the eyes might have served. Copyright © 2015 Elsevier Ltd. All rights reserved.
Eichenberg, David; Liebergesell, Mario; König-Ries, Birgitta; Wirth, Christian
2017-01-01
Ecology has become a data intensive science over the last decades which often relies on the reuse of data in cross-experimental analyses. However, finding data which qualifies for the reuse in a specific context can be challenging. It requires good quality metadata and annotations as well as efficient search strategies. To date, full text search (often on the metadata only) is the most widely used search strategy although it is known to be inaccurate. Faceted navigation is providing a filter mechanism which is based on fine granular metadata, categorizing search objects along numeric and categorical parameters relevant for their discovery. Selecting from these parameters during a full text search creates a system of filters which allows to refine and improve the results towards more relevance. We developed a framework for the efficient annotation and faceted navigation in ecology. It consists of an XML schema for storing the annotation of search objects and is accompanied by a vocabulary focused on ecology to support the annotation process. The framework consolidates ideas which originate from widely accepted metadata standards, textbooks, scientific literature, and vocabularies as well as from expert knowledge contributed by researchers from ecology and adjacent disciplines. PMID:29023519
Self-Alining Quick-Connect Joint
NASA Technical Reports Server (NTRS)
Lucy, M. H.
1983-01-01
Quick connect tapered joint used with minimum manipulation and force. Split ring retainer holds locking ring in place. Minimal force required to position male in female joint, at which time split-ring retainers are triggered to release split locking rings. Originally developed to assemble large space structures, joint is simple, compact, strong, lightweight, self alining, and has no loose parts.
Ruhe, Alexander; Bos, Tino; Herbert, Arne
2012-03-09
Observational study To investigate common non-traumatic musculoskeletal complaints of the low back in elite inline-speedskaters of the German national team. Traumatic injuries associated with falls or collisions are well documented in speedskaters but so far no studies have investigated non-traumatic low back pain. Previously, the sacroiliac joint was suspected as a frequent origin of complaint, we aimed to investigate this assumption. Two chiropractors examined elite inline-speedskaters of the German national team during three sports events between summer 2010 and 2011. A test cluster of five provocative tests for the sacroiliac joint was selected based on reliability and validity. A total of 37 examinations were conducted on 34 athletes with low back pain during the three sport events. The reported pain intensities ranged from mild to moderate pain (VAS 23.4 ± 13.4 to 35.1 ± 19.2). About 90% of cases showed involvement of the SI joint of which again 90% presented with left sided symptoms. Non-traumatic complaints of the low back originating from the left sacroiliac joint frequently occur in competitive inline speedskaters.
2012-01-01
Study design Observational study Objectives To investigate common non-traumatic musculoskeletal complaints of the low back in elite inline-speedskaters of the German national team. Summary of background data Traumatic injuries associated with falls or collisions are well documented in speedskaters but so far no studies have investigated non-traumatic low back pain. Previously, the sacroiliac joint was suspected as a frequent origin of complaint, we aimed to investigate this assumption. Methods Two chiropractors examined elite inline-speedskaters of the German national team during three sports events between summer 2010 and 2011. A test cluster of five provocative tests for the sacroiliac joint was selected based on reliability and validity. Results A total of 37 examinations were conducted on 34 athletes with low back pain during the three sport events. The reported pain intensities ranged from mild to moderate pain (VAS 23.4 ± 13.4 to 35.1 ± 19.2). About 90% of cases showed involvement of the SI joint of which again 90% presented with left sided symptoms. Conclusions Non-traumatic complaints of the low back originating from the left sacroiliac joint frequently occur in competitive inline speedskaters. PMID:22404796
Macarini, L; Rizzo, A; Martino, F; Zaccheo, N; Angelelli, G; Rotondo, A
1998-06-01
Juvenile patellar chondromalacia is a common orthopedic disorder which can mimic other conditions; early diagnosis is mandatory to prevent its evolution into osteoarthrosis. In the early stages of patellar chondromalacia (I and II), the lesions originate in the deep cartilage layer and the joint surface is not affected. Arthroscopy can demonstrate joint surface changes only and give indirect information about deeper lesions. We investigated the yield of 2D FLASH MRI with 30 degrees flip angle and a dedicated coil in the diagnosis of patellar chondromalacia, especially in its early stages. Eighteen patients (mean age: 21 years) with clinically suspected patellar chondromalacia were examined with MRI; 13 of them were also submitted to arthroscopy. A 1.5 T unit with a transmit-and-receive extremity coil was used. We acquired T1 SE sequences (TR/TE: 500-700/15/20) and 2D T2* FLASH sequence (TR/TE/FA: 500-800/18/30 degrees). The field of view was 160-180 mm and the matrix 192 x 256, with 2-3 NEX. The images were obtained on the axial plane. The lesions were classified in 4 stages according to Shahriaree classification. Agreement between MR and arthroscopic findings was good in both early and advanced lesions in 12/13 cases. Early lesions appeared as hyperintense focal thickening of the hyaline cartilage (stage I) or as small cystic lesions within the cartilage and no articular surface involvement (stage II). The medial patellar facet was the most frequent site. Advanced lesions appeared as articular surface ulcerations, thinning and cartilage hypointensity (stage III); stage IV lesions presented as complete erosions of the hyaline cartilage and hypointense underlying bone. 2D FLASH MRI with 30 degrees flip angle can show the differences in water content in the cartilage and thus permit to detect early chondromalacia lesions in the deep cartilage.
PALP: A Package for Analysing Lattice Polytopes with applications to toric geometry
NASA Astrophysics Data System (ADS)
Kreuzer, Maximilian; Skarke, Harald
2004-02-01
We describe our package PALP of C programs for calculations with lattice polytopes and applications to toric geometry, which is freely available on the internet. It contains routines for vertex and facet enumeration, computation of incidences and symmetries, as well as completion of the set of lattice points in the convex hull of a given set of points. In addition, there are procedures specialized to reflexive polytopes such as the enumeration of reflexive subpolytopes, and applications to toric geometry and string theory, like the computation of Hodge data and fibration structures for toric Calabi-Yau varieties. The package is well tested and optimized in speed as it was used for time consuming tasks such as the classification of reflexive polyhedra in 4 dimensions and the creation and manipulation of very large lists of 5-dimensional polyhedra. While originally intended for low-dimensional applications, the algorithms work in any dimension and our key routine for vertex and facet enumeration compares well with existing packages. Program summaryProgram obtainable form: CPC Program Library, Queen's University of Belfast, N. Ireland Title of program: PALP Catalogue identifier: ADSQ Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADSQ Computer for which the program is designed: Any computer featuring C Computers on which it has been tested: PCs, SGI Origin 2000, IBM RS/6000, COMPAQ GS140 Operating systems under which the program has been tested: Linux, IRIX, AIX, OSF1 Programming language used: C Memory required to execute with typical data: Negligible for most applications; highly variable for analysis of large polytopes; no minimum but strong effects on calculation time for some tasks Number of bits in a word: arbitrary Number of processors used: 1 Has the code been vectorised or parallelized?: No Number of bytes in distributed program, including test data, etc.: 138 098 Distribution format: tar gzip file Keywords: Lattice polytopes, facet enumeration, reflexive polytopes, toric geometry, Calabi-Yau manifolds, string theory, conformal field theory Nature of problem: Certain lattice polytopes called reflexive polytopes afford a combinatorial description of a very large class of Calabi-Yau manifolds in terms of toric geometry. These manifolds play an essential role for compactifications of string theory. While originally designed to handle and classify reflexive polytopes, with particular emphasis on problems relevant to string theory applications [M. Kreuzer and H. Skarke, Rev. Math. Phys. 14 (2002) 343], the package also handles standard questions (facet enumeration and similar problems) about arbitrary lattice polytopes very efficiently. Method of solution: Much of the code is straightforward programming, but certain key routines are optimized with respect to calculation time and the handling of large sets of data. A double description method (see, e.g., [D. Avis et al., Comput. Geometry 7 (1997) 265]) is used for the facet enumeration problem, lattice basis reduction for extended gcd and a binary database structure for tasks involving large numbers of polytopes, such as classification problems. Restrictions on the complexity of the program: The only hard limitation comes from the fact that fixed integer arithmetic (32 or 64 bit) is used, allowing for input data (polytope coordinates) of roughly up to 10 9. Other parameters (dimension, numbers of points and vertices, etc.) can be set before compilation. Typical running time: Most tasks (typically: analysis of a four dimensional reflexive polytope) can be perfomed interactively within milliseconds. The classification of all reflexive polytopes in four dimensions takes several processor years. The facet enumeration problem for higher (e.g., 12-20) dimensional polytopes varies strongly with the dimension and structure of the polytope; here PALP's performance is similar to that of existing packages [Avis et al., Comput. Geometry 7 (1997) 265]. Unusual features of the program: None
Facchini, Giancarlo; Spinnato, Paolo; Guglielmi, Giuseppe; Bazzocchi, Alberto
2017-01-01
Objective: The objective of this review was to evaluate the efficacy of pulsed radiofrequency (PRF) treatment of pain associated with different spinal conditions. The mechanisms of action and biological effects are shortly discussed to provide the scientific basis for this radiofrequency modality. Methods: We systematically searched for clinical studies on spinal clinical conditions using PRF. We searched the MEDLINE (PubMed) database. We classified the information in one table focusing on randomized controlled trials (RCTs) and other types of studies. Date of last electronic search was October 2016. Results: We found four RCTs that evaluated the efficacy of PRF on cervical radicular pain and five observational studies. Two trials and three observational studies were conducted in patients with facet pain. For disc-related pathology, we found one RCT with PRF applied intradiscally and three RCTs for dorsal root ganglia PRF modulation lumbosacral radicular pain. For sacroiliac joint pain, spondylolisthesis, malignancies and other minor spinal pathology, limited studies were conducted. Conclusion: From the available evidence, the use of PRF to the dorsal root ganglion in cervical radicular pain is compelling. With regard to its lumbosacral counterpart, the use of PRF cannot be similarly advocated in view of the absence of standardization of PRF parameters, enrolment criteria and different methods in reporting results; but, the evidence is interesting. The use of PRF in lumbar facet pain was found to be less effective than conventional RF techniques. For the other different spinal conditions, we need further studies to assess the effectiveness of PRF. Advances in knowledge: The use of PRF in lumbar facet pain was found to be less effective than conventional RF techniques. For the other different spinal conditions, we need further studies to assess the effectiveness of PRF. PMID:28186832
Design of a lattice-based faceted classification system
NASA Technical Reports Server (NTRS)
Eichmann, David A.; Atkins, John
1992-01-01
We describe a software reuse architecture supporting component retrieval by facet classes. The facets are organized into a lattice of facet sets and facet n-tuples. The query mechanism supports precise retrieval and flexible browsing.
Goel, Atul; Sharma, Praveen
2004-09-01
We present our experience of treating nine consecutive cases of rheumatoid arthritis involving the craniovertebral junction by atlantoaxial joint manipulation and attempts towards restoration of craniovertebral region alignments. Between November 2001 and March 2004, nine cases of rheumatoid arthritis involving the craniovertebral junction were treated in our department of neurosurgery. Six patients had basilar invagination and 'fixed' atlantoaxial dislocation and three patients had a retroodontoid process pannus and mobile and incompletely reducible atlantoaxial dislocation. The patients ranged from 24 to 74 years in age. Six patients were males and three were females. Neck pain and spastic quadriparesis were the most prominent symptoms. Surgery involved attempts to reduce the atlantoaxial dislocation and basilar invagination by manual distraction of the facets of the atlas and axis. Reduction of the atlantoaxial dislocation and of basilar invagination and stabilization of the region was achieved by placement of bone graft and metal spacers within the joint and direct inter-articular plate and screw method of atlantoaxial fixation. Following surgery all the patients showed symptomatic improvement and restoration of craniovertebral alignments. Follow-up ranged from four to 48 months (average 28 months). Manipulation of the atlantoaxial joints and restoring the anatomical craniovertebral alignments in selected cases of rheumatoid arthritis involving the craniovertebral junction leads to remarkable and sustained clinical recovery.
Goel, Atul; Sharma, Praveen
2005-10-01
Twelve selected patients, eight males and four females aged 14 to 50 years, with syringomyelia associated with congenital craniovertebral bony anomalies including basilar invagination and fixed atlantoaxial dislocation, and associated Chiari I malformation in eight, were treated by atlantoaxial joint manipulation and restoration of the craniovertebral region alignment between October 2002 and March 2004. Three patients had a history of trauma prior to the onset of symptoms. Spastic quadriparesis and ataxia were the most prominent symptoms. The mean duration of symptoms was 11 months. The atlantoaxial dislocation and basilar invagination were reduced by manual distraction of the facets of the atlas and axis, stabilization by placement of bone graft and metal spacers within the joint, and direct atlantoaxial fixation using an inter-articular plate and screw method technique. Following surgery all patients showed symptomatic improvement and restoration of craniovertebral alignment during follow up from 3 to 20 months (mean 7 months). Radiological improvement of the syrinx could not be evaluated as stainless steel metal plates, screws, and spacers were used for fixation. Manipulation of the atlantoaxial joints and restoring the anatomical craniovertebral alignments in selected cases of syringomyelia leads to remarkable and sustained clinical recovery, and is probably the optimum surgical treatment.
Morphology and texture of particles along the Spirit rover traverse from sol 450 to sol 745
NASA Astrophysics Data System (ADS)
Yingst, R. A.; Crumpler, L.; Farrand, W. H.; Li, R.; Cabrol, N. A.; Neakrase, L. D.
2008-12-01
We quantified and classified the shape, roundness, size, and texture of 935 loose surface particles along the Spirit rover traverse from sols 450-745 to assess origin, transport, and other alteration mechanisms that altered particles during and after formation. Variation in particle morphologic parameters along traverse is consistent with crossing mapped geologic unit boundaries. Texture is divided into four types: vesicular, smooth and flat-faceted, rough and flat-faceted, and very rough. Sphericity and roundness are intermediate and low, respectively, comparable to particles moved by high-energy transport or to crushed particles. This indicates intermittent, high-energy emplacement or modification of a single lithology, rather than systematic, continuous low-energy abrasion or wear over time. Comparison with particle morphology at other Mars landing sites is consistent with the hypothesis that no secondary systematic transport or wide-scale chemical alteration was active at a significant enough level to alter macromorphology. In particular, particle morphology at the Mars Pathfinder site shows stronger evidence of abrasion than along the Spirit traverse, suggesting Mars Pathfinder particles have undergone abrasion processes that particles in this study area have not. Additionally, morphology indices have correlation coefficients near zero, indicating that a fluvial transport mechanism is likely not responsible for morphology. Morphology and texture are instead related to origin and composition rather than subsequent modification. Morphology and texture support a volcanic origin, possibly without modification, but most likely altered primarily by ballistic impact, implying that the Spirit landing site and traverse may be utilized in the future as a standard site for characterization of impact-derived morphology.
Reflex Responses to Ligament Loading: Implications for Knee Joint Stability
2001-10-25
white noise approach", Prentice-Hall".:, 1978. [15] B. Grenfield and B. Wyke, "Reflex innervation of the temporo - mandibular joint .". Nature. 211(52...selective, depending on the magnitude of the angular perturbation. Keywords - Reflex, Periarticular tissue afferents, Joint stability I...INTRODUCTION Traditionally, joint stability has been considered to be purely mechanical in origin, with little or no consideration of neuromuscular
Lu, Di; Xu, Wei-xing; Ding, Wei-Guo; Guo, Qiao-Feng; Ma, Gou-ping; Zhu, Wei-min
2013-03-01
To study the clinical efficacy of needle-knife to cut off the medial branch of the lumbar posterior ramus under C-arm guiding to treat low back pain caused by lumbar facet osteoarthritis. From July 2009 to June 2011, 60 patients with low back pain caused by lumbar facet osteoarthritis were reviewed,including 34 males and 26 females, ranging in age from 39 to 73 years old,averaged 61.9 years old; the duration of the disease ranged from 6 to 120 months, with a mean of 18.9 months. All the patients were divided into two groups, 30 patients (18 males and 12 females, ranging in age from 39 to 71 years old, needle-knife group) were treated with needle-knife to cut off medial branch of the lumbar posterior ramus under C -arm guiding and the other 30 patients(16 males and 14 females, ranging in age from 41 to 73 years old, hormone injection group) were treated with hormone injection in lumbar facet joint under C-arm guiding. The preoperative JOA scores and the scores at the 1st, 12th and 26th weeks after treatment were analyzed. Before treatment,the JOA scores between the two groups had no significant difference (P= 0.479); after 1 week of treatment, the JOA scores between the two groups had significant difference (P= 0.040), the improvement rate of hormone injection group was superior than that of the needle-knife group,which were (58.73+/-18.20)% in needle-knife group and (71.10+/-22.19)% in hormone injection group; after 12 weeks of treatment, the JOA scores between the two groups had no significant difference(P=0.569), and the improvement rate between the two groups had no significant difference,which were (50.09+/-19.33)% in the needle-knife group and (48.70+/-18.36)%) in the hormone injection group; after 26 weeks of treatment,the JOA scores between the two groups had significant difference (P=0.000), the improvement rate of hormone injection group was superior than that of the needle-knife group,which were (48.56+/-28.24)% in needle-knife group and (15.62+/-11.23 )% in hormone injection group. Using needle-knife to cut off the medial branch of the lumbar posterior ramus could get longer efficacy than hormone injection in the treatment of lumbar facet osteoarthritis.
Painful lumbosacral melorheostosis treated by fusion.
Robertson, Peter A; Don, Angus S; Miller, Mary V
2003-06-15
A case report of low back pain associated with a diagnosis of melorheostosis of the lumbosacral spine. To describe a rare presentation of melorheostosis and subsequent successful surgical treatment. Melorheostosis is a rare condition and spinal pain has not been described in association with the condition. A patient with disabling low back pain and suspected melorheostosis of the lumbosacral spine responded favorably to diagnostic facet joint blocks. Treatment was lumbosacral fusion and biopsy of the abnormal bone. The densely sclerotic bone presented technical difficulties requiring modification of surgical technique. Dramatic pain and disability reduction occurred following lumbosacral fusion. Histologic examination was consistent with melorheostosis. Melorheostosis rarely causes severe low back pain that can respond favorably to fusion surgery.
An unusual fracture of the talus in a snowboarder.
Vlahovich, A Tanja; Mehin, Ramin; O'Brien, Peter J
2005-08-01
Fractures of the talus are uncommon. However, snow- boarding and skateboarding are 2 activities that are specifically associated with talus fractures. These patients sustain occult lateral talus process fractures that present as a severe ankle injury. The diagnosis is difficult because of subtle clinical and plain radiographic findings. Computed tomography is a very useful tool for the assessment of these injuries. Although the majority of these athletes have lateral sided talus fractures, there are variants. We present an unusual case of a displaced intra-articular fracture of the subtalar joint involving the middle articular facet of the talus with extension of the fracture into the talar head. This highlights the importance of carefully assessing snowboarders' "ankle injuries."
Seichi, Atsushi
2014-10-01
Lumbar spondylosis is a chronic, noninflammatory disease caused by degeneration of lumbar disc and/or facet joints. The etiology of lumbar spondylosis is multifactorial. Patients with lumbar spondylosis complain of a broad variety of symptoms including discomfort in the low back lesion, whereas some of them have radiating leg pain or neurologenic intermittent claudication (lumbar spinal stenosis). The majority of patients with spondylosis and stenosis of the lumbosacral spine can be treated nonsurgically. Nonsteroidal anti-inflammatory drugs and COX-2 inhibitors are helpful in controlling symptoms. Prostaglandin, epidural injection, and transforaminal injection are also helpful for leg pain and intermittent claudication. Operative therapy for spinal stenosis or spondylolisthesis is reserved for patients who are totally incapacitated by their condition.
Pakzaban, Peyman
2011-02-01
Two patients with occipital neuralgia due to severe arthropathy of the C1-2 facet joint were treated using atlantoaxial fusion with transarticular screws without decompression of the C-2 nerve root. Both patients experienced immediate postoperative relief of occipital neuralgia. The resultant motion elimination at C1-2 eradicated not only the movement-evoked pain, but also the paroxysms of true occipital neuralgia occurring at rest. A possible pathophysiological explanation for this improvement is presented in the context of the ignition theory of neuralgic pain. This represents the first report of C1-2 transarticular screw fixation for the treatment of arthropathy-associated occipital neuralgia.
2013-01-01
Background A high prevalence of low back pain has persisted over the years despite extensive primary prevention initiatives among nurses’ aides. Many single-faceted interventions addressing just one aspect of low back pain have been carried out at workplaces, but with low success rate. This may be due to the multi-factorial origin of low back pain. Participatory ergonomics, cognitive behavioral training and physical training have previously shown promising effects on prevention and rehabilitation of low back pain. Therefore, the main aim of this study is to examine whether a multi-faceted workplace intervention consisting of participatory ergonomics, physical training and cognitive behavioral training can prevent low back pain and its consequences among nurses’ aides. External resources for the participating workplace and a strong commitment from the management and the organization support the intervention. Methods/design To overcome implementation barriers within usual randomized controlled trial designed workplace interventions, this study uses a stepped-wedge cluster-randomized controlled trial design with 4 groups. The intervention is delivered to the groups at random along four successive time periods three months apart. The intervention lasts three months and integrates participatory ergonomics, physical training and cognitive behavioral training tailored to the target group. Local physiotherapists and occupational therapists conduct the intervention after having received standardized training. Primary outcomes are low back pain and its consequences measured monthly by text messages up to three months after initiation of the intervention. Discussion Intervention effectiveness trials for preventing low back pain and its consequences in workplaces with physically demanding work are few, primarily single-faceted, with strict adherence to a traditional randomized controlled trial design that may hamper implementation and compliance, and have mostly been unsuccessful. By using a stepped wedge design, and obtain high management commitment and support we intend to improve implementation and aim to establish the effectiveness of a multi-faceted intervention to prevent low back pain. This study will potentially provide knowledge of prevention of low back pain and its consequences among nurses’ aides. Results are expected to be published in 2015–2016. Trial registration The study is registered as ISRCTN78113519. PMID:24261985
7 CFR 760.113 - Refunds; joint and several liability.
Code of Federal Regulations, 2010 CFR
2010-01-01
... 7 Agriculture 7 2010-01-01 2010-01-01 false Refunds; joint and several liability. 760.113 Section... Agricultural Disaster Assistance Programs § 760.113 Refunds; joint and several liability. (a) In the event that... provided that interest will in all cases run from the date of the original disbursement. (b) All persons...
NASA Astrophysics Data System (ADS)
Konevtsova, O. V.; Lorman, V. L.; Rochal, S. B.
2016-05-01
We consider the symmetry and physical origin of collective displacement modes playing a crucial role in the morphological transformation during the maturation of the HK97 bacteriophage and similar viruses. It is shown that the experimentally observed hexamer deformation and pentamer twist in the HK97 procapsid correspond to the simplest irreducible shear strain mode of a spherical shell. We also show that the icosahedral faceting of the bacteriophage capsid shell is driven by the simplest irreducible radial displacement field. The shear field has the rotational icosahedral symmetry group I while the radial field has the full icosahedral symmetry Ih. This difference makes their actions independent. The radial field sign discriminates between the icosahedral and the dodecahedral shapes of the faceted capsid shell, thus making the approach relevant not only for the HK97-like viruses but also for the parvovirus family. In the frame of the Landau-Ginzburg formalism we propose a simple phenomenological model valid for the first reversible step of the HK97 maturation process. The calculated phase diagram illustrates the discontinuous character of the virus shape transformation. The characteristics of the virus shell faceting and expansion obtained in the in vitro and in vivo experiments are related to the decrease in the capsid shell thickness and to the increase of the internal capsid pressure.
Joint Space Operations Center (JSpOC) Mission System Increment 3 (JMS Inc 3)
2016-03-01
2016 Major Automated Information System Annual Report Joint Space Operations Center (JSpOC) Mission System Increment 3 (JMS Inc 3) Defense...1725 DSN Phone: DSN Fax: Date Assigned: May 16, 2014 Program Information Program Name Joint Space Operations Center (JSpOC) Mission System...approved program baseline; therefore, no Original Estimate has been established. JMS Inc 3 2016 MAR UNCLASSIFIED 4 Program Description The Joint Space
MultiFacet: A Faceted Interface for Browsing Large Multimedia Collections
DOE Office of Scientific and Technical Information (OSTI.GOV)
Henry, Michael J.; Hampton, Shawn D.; Endert, Alexander
2013-10-31
Faceted browsing is a common technique for exploring collections where the data can be grouped into a number of pre-defined categories, most often generated from textual metadata. Historically, faceted browsing has been applied to a single data type such as text or image data. However, typical collections contain multiple data types, such as information from web pages that contain text, images, and video. Additionally, when browsing a collection of images and video, facets are often created based on the metadata which may be incomplete, inaccurate, or missing altogether instead of the actual visual content contained within those images and video.more » In this work we address these limitations by presenting MultiFacet, a faceted browsing interface that supports multiple data types. MultiFacet constructs facets for images and video in a collection from the visual content using computer vision techniques. These visual facets can then be browsed in conjunction with text facets within a single interface to reveal relationships and phenomena within multimedia collections. Additionally, we present a use case based on real-world data, demonstrating the utility of this approach towards browsing a large multimedia data collection.« less
A model to explain joint patterns found in ignimbrite deposits
NASA Astrophysics Data System (ADS)
Tibaldi, A.; Bonali, F. L.
2018-03-01
The study of fracture systems is of paramount importance for economic applications, such as CO2 storage in rock successions, geothermal and hydrocarbon exploration and exploitation, and also for a better knowledge of seismogenic fault formation. Understanding the origin of joints can be useful for tectonic studies and for a geotechnical characterisation of rock masses. Here, we illustrate a joint pattern discovered in ignimbrite deposits of South America, which can be confused with conjugate tectonic joint sets but which have another origin. The pattern is probably common, but recognisable only in plan view and before tectonic deformation obscures and overprints it. Key sites have been mostly studied by field surveys in Bolivia and Chile. The pattern is represented by hundreds-of-meters up to kilometre-long swarms of master joints, which show circular to semi-circular geometries and intersections that have "X" and "Y" patterns. Inside each swarm, joints are systematic, rectilinear or curvilinear in plan view, and as much as 900 m long. In section view, they are from sub-vertical to vertical and do not affect the underlying deposits. Joints with different orientation mostly interrupt each other, suggesting they have the same age. This joint architecture is here interpreted as resulting from differential contraction after emplacement of the ignimbrite deposit above a complex topography. The set of the joint pattern that has suitable orientation with respect to tectonic stresses may act to nucleate faults.
Mehl, Julian; Feucht, Matthias J; Bode, Gerrit; Dovi-Akue, David; Südkamp, Norbert P; Niemeyer, Philipp
2016-03-01
To compare the geometry of the patellofemoral joint on magnetic resonance images (MRI) between patients with isolated cartilage defects of the patella and a gender- and age-matched control group of patients without patellar cartilage defects. A total of 43 patients (17 female, 26 male) with arthroscopically verified grade III and IV patellar cartilage defects (defect group) were compared with a matched-pair control group of patients with isolated traumatic rupture of the anterior cruciate ligament without cartilage defects of the patellofemoral joint. Preoperative MRI images were analysed retrospectively with regard to patellar geometry (width, thickness, facet angle), trochlear geometry (dysplasia according to Dejour, sulcus angle, sulcus depth, lateral condyle index, trochlea facet asymmetry, lateral trochlea inclination) and patellofemoral alignment (tibial tuberosity-trochlear groove distance, patella height, lateral patella displacement, lateral patellofemoral angle, patella tilt, congruence angle). In addition to the comparison of group values, the measured values were compared to normal values reported in the literature, and the frequency of patients with pathologic findings was compared between both groups. The defect group demonstrated a significantly higher proximal chondral sulcus angle (p < 0.001), a significantly higher distal osseal sulcus angle (p = 0.004), a significantly lower distal sulcus depth (p = 0.047), a significantly lower lateral condyle index (p = 0.045), a significantly lower Caton-Deschamps index (p = 0.020) and a significantly higher Insall-Salvati index (p = 0.010). A major trochlear dysplasia (grade B-D) was significantly more common in the defect group (54 vs. 19%; p < 0.001). Eighty-eight per cent of patients in the defect group demonstrated at least one pathologic finding, compared to 63% in the control group (p = 0.006). Two or more pathologic findings were observed in 42% of the defect group and in 19% of the control group (p = 0.019). There was no significant correlation between the localization of the chondral defects and the results of the measured parameters. Cartilage defects of the patella are associated with the geometry of the patellofemoral joint. In particular, a flat and shallow trochlea, trochlea dysplasia and patella alta seem to contribute to the development of patellar cartilage defects, which must be taken into consideration when planning to do surgical cartilage repair at the patella. III.
2003-09-01
Refractive Surgery Origin and History, (RK, PRK , LASIK ) Refractive surgery was first considered as early as 1898 by a Dutch professor and was...34 This ejection demonstrated one extreme facet of the safety of PRK . Laser-Assisted In Situ Keratomileusis ( LASIK ) LASIK offers the greatest...refractive shift of clinical significance.35 Therefore LASIK and PRK , recipients had no significant vision changes at altitude, unlike recipients of RK
Creative work. The case of Charles Darwin.
Gruber, H E; Wallace, D B
2001-04-01
The evolving systems approach (ESA) addresses the need for direct study of the creative process in recognized creators at work, in contrast to indirect methods, such as those used in psychometric studies. The ESA emerged from H. E. Gruber's prolonged study of Charles Darwin's manuscripts, especially the notebooks he kept after the Beagle voyage. Gruber's interviews with J. Piaget about the latter's creative processes, as well as many doctoral dissertations, also helped shape the authors' approach. Using Gruber's (1974/1981) study of Darwin, the authors describe some facets of creative work identified in the course of their work. Among these are networks of enterprise, ensembles of metaphors, insights, and evolving belief systems. Although the ESA emphasizes cognitive processes, social, affective, and esthetic aspects of the case are not neglected. Each creative case is unique, otherwise the individual would not meet the criterion of originality. Uniqueness does not mean isolation; people who differ must and do work together. The integration of all these facets into a plausible system for each creator remains the authors' central task.
Hartmann, Hagen; Wirth, Klaus; Klusemann, Markus
2013-10-01
It has been suggested that deep squats could cause an increased injury risk of the lumbar spine and the knee joints. Avoiding deep flexion has been recommended to minimize the magnitude of knee-joint forces. Unfortunately this suggestion has not taken the influence of the wrapping effect, functional adaptations and soft tissue contact between the back of thigh and calf into account. The aim of this literature review is to assess whether squats with less knee flexion (half/quarter squats) are safer on the musculoskeletal system than deep squats. A search of relevant scientific publications was conducted between March 2011 and January 2013 using PubMed. Over 164 articles were included in the review. There are no realistic estimations of knee-joint forces for knee-flexion angles beyond 50° in the deep squat. Based on biomechanical calculations and measurements of cadaver knee joints, the highest retropatellar compressive forces and stresses can be seen at 90°. With increasing flexion, the wrapping effect contributes to an enhanced load distribution and enhanced force transfer with lower retropatellar compressive forces. Additionally, with further flexion of the knee joint a cranial displacement of facet contact areas with continuous enlargement of the retropatellar articulating surface occurs. Both lead to lower retropatellar compressive stresses. Menisci and cartilage, ligaments and bones are susceptible to anabolic metabolic processes and functional structural adaptations in response to increased activity and mechanical influences. Concerns about degenerative changes of the tendofemoral complex and the apparent higher risk for chondromalacia, osteoarthritis, and osteochondritis in deep squats are unfounded. With the same load configuration as in the deep squat, half and quarter squat training with comparatively supra-maximal loads will favour degenerative changes in the knee joints and spinal joints in the long term. Provided that technique is learned accurately under expert supervision and with progressive training loads, the deep squat presents an effective training exercise for protection against injuries and strengthening of the lower extremity. Contrary to commonly voiced concern, deep squats do not contribute increased risk of injury to passive tissues.
Alignment and focus of mirrored facets of a heliosat
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yellowhair, Julius E; Ho, Clifford Kuofei; Diver, Richard B
2013-11-12
Various technologies pertaining to aligning and focusing mirrored facets of a heliostat are described herein. Updating alignment and/or focus of mirrored facets is undertaken through generation of a theoretical image, wherein the theoretical image is indicative of a reflection of the target via the mirrored facets when the mirrored facets are properly aligned. This theoretical image includes reference points that are overlaid on an image of the target as reflected by the mirrored facets of the heliostat. A technician adjusts alignment/focus of a mirrored facet by causing reflected reference markings to become aligned with the reference points in the theoreticalmore » image.« less
A novel anchoring system for use in a nonfusion scoliosis correction device.
Wessels, Martijn; Homminga, Jasper J; Hekman, Edsko E G; Verkerke, Gijsbertus J
2014-11-01
Insertion of a pedicle screw in the mid- and high thoracic regions has a serious risk of facet joint damage. Because flexible implant systems require intact facet joints, we developed an enhanced fixation that is less destructive to spinal structures. The XSFIX is a posterior fixation system that uses cables that are attached to the transverse processes of a vertebra. To determine whether a fixation to the transverse process using the XSFIX is strong enough to withstand the loads applied by the XSLATOR (a novel, highly flexible nonfusion implant system) and thus, whether it is a suitable alternative for pedicle screw fixation. The strength of a novel fixation system using transverse process cables was determined and compared with the strength of a similar fixation using polyaxial pedicle screws on different vertebral levels. Each of the 58 vertebrae, isolated from four adult human cadavers, was instrumented with either a pedicle screw anchor (PSA) system or a prototype of the XSFIX. The PSA consisted of two polyaxial pedicle screws and a 5 mm diameter rod. The XSFIX prototype consisted of two bodies that were fixed to the transverse processes, interconnected with a similar rod. Each fixation system was subjected to a lateral or an axial torque. The PSA demonstrated fixation strength in lateral loading and torsion higher than required for use in the XSLATOR. The XSFIX demonstrated high enough fixation strength (in both lateral loading and torsion), only in the high and midthoracic regions (T10-T12). This experiment showed that the fixation strength of XSFIX is sufficient for use with the XSLATOR only in mid- and high thoracic regions. For the low thoracic and lumbar region, the PSA is a more rigid fixation. Because the performance of the new fixation system appears to be favorable in the high and midthoracic regions, a clinical study is the next challenge. Copyright © 2014 Elsevier Inc. All rights reserved.
NASA Astrophysics Data System (ADS)
Nuebler-Moritz, Michael; Niederdellmann, Herbert; Hering, Peter; Deuerling, Christian; Dammer, Ralf; Behr, M.
1995-04-01
The following paper introduces the results of an interdisciplinary research project. With the aid of photomacroscopic examination, light and scanning electron microscope investigations, changes to temporomandibular joint structures were detected in vitro after irradiation with an Erbium:YAG laser system. The solid-state Erbium:YAG laser, operating at a wavelength of 2.94 micrometers was used in the normal- spiking mode. The free-running laser beam was focussed onto freshly excised porcine tissue samples using a 108-mm sapphire lens. In this study the output was generally pulsed at a repetition rate of 4 Hz, with a pulse duration varying from 120 microsecond(s) to 500 microsecond(s) . Between 50 mJ and 500 mJ per pulse were applied to create pinpoint lesions. The optimum average energy density and pulse duration of the Erbium:YAG laser radiation for the purpose of TMJ-surgery (as far as it concerns meniscus and articulating facets) - which means efficient etch rate and minimal adjacent injury - seems to be about 24-42 J/cm2 and 120 microsecond(s) -240 microsecond(s) , respectively.
Stabilization of the sacroiliac joint.
Shaffrey, Christopher I; Smith, Justin S
2013-07-01
Lower back pain and pain involving the area of the posterior iliac spine are extremely common. Degeneration of the sacroiliac joint (SIJ) is one potential cause for lower back pain and pain radiating into the groin or buttocks. Degenerative changes to the lumbar spine and sacroiliac joints are common. A recent study evaluating SIJ abnormalities in a primary low back pain population demonstrated 31.7% of patients demonstrated SI joint abnormalities. (4) As is the case for the evaluation and management of isolated lower back pain, the evaluation, management, and role for surgical intervention in SIJ pain is very controversial. Many patients have degenerative changes of the disc, facet joints, and SIJs. A recent systematic review performed to determine the diagnostic accuracy of tests available to clinicians to identify the disc, facet joint, or SIJ as the source of low back pain concluded that tests do exist that change the probability of the disc or SIJ (but not the facet joint) as the source of low back pain. (3) It was also concluded that the usefulness of these tests in clinical practice, particularly for guiding treatment selection, remains unclear. (3) Although there is general agreement that SIJ pathological changes are a potential cause of pain, there is far less agreement about the optimal management of these conditions. A variety of conditions can cause SIJ dysfunction including degenerative and inflammatory arthritis, trauma, prior lumbosacral fusion, hip arthritis, limb length inequality, infections, and neoplasia. (8) There is increasing evidence that image intensifier-guided single periarticular injection can correctly localize pain to the SIJ but the optimal management strategy remains controversial. Recent publications have compared surgical versus injection treatments and fusion versus denervation procedures. (1 , 8) A systematic review found improvement regardless of the treatment, with most studies reporting over 40% improvement in pain as measured by VAS or NRS scores. (8) It cautioned that one of the studies reported 17.6% of patients experiencing mild/no pain compared with 82.4% experiencing marked/severe pain at 39 months after SIJ fusion procedures. (6 , 8) This systematic review also noted that despite improvements in reported pain, less than half of patients who had work status reported as returning to work. (8) Because of the functional and socioeconomic consequences of chronic lower back pain, numerous surgical treatments to improve this condition have been attempted by spinal surgeons through the years. Arthrodesis of the SIJ is a surgical procedure with a long history dating to the beginnings of spinal surgery. (7) Poor results, high complication rates and the need for additional surgical procedures have generally diminished the enthusiasm for this procedure until recently. (6) A variety of "minimally invasive" procedures have been recently introduced that have rekindled enthusiasm for the surgical management of SIJ pathology. The technique demonstrated in the "Stabilization of the SIJ with SI-Bone" is one of these new techniques. There has been a recent publication detailing the very short term clinical outcomes with this technique that reported encouraging results. (5) In this series of 50 patients, quality of life questionnaires were available for 49 patients preoperatively, 41 patients at 3 months, 40 at 6 months and only 27 at 12 months, complicating the ability to accurately assess true outcomes. Although the focus of this video by Geisler is on the surgical technique, there should have been more information provided on the expected surgical outcomes and potential complications of SIJ fusion. (2) The video only gives minimal information on how to appropriately select patients with potential SIJ pathology for surgical intervention. There are insufficient recommendations on the clinical and radiographic follow-up needed for this procedure. A concern with this implant is whether the porous plasma spray coating on the implant actually results in bone growth across the SIJ or only serves as a stabilizer. If true fusion does not result, deterioration in the clinical result could occur over time. This video nicely demonstrates the surgical technique of stabilization of the SIJ with SI-Bone product. There are numerous unanswered questions regarding patient selection for SIJ fusion or stabilization. There are an increasing number of surgical techniques for treating SIJ pathology and it is not clear which method may provide the best outcomes. Without prospective trials with nonconflicted surgeons and standardized selection criteria, the true role for SIJ fusion procedures in the management of chronic lower back pain will remain murky. The consequences of the unsupported enthusiasm for the surgical management of discogenic back pain still negatively impacts the public perception of spinal surgeons. Much more high quality information is needed regarding the surgical management of SIJ pathology before widespread use of this technique should be adopted.
Shanmuganathan, K; Mirvis, S E; Levine, A M
1994-11-01
Imaging studies of patients with rotational facet injuries of the cervical spine were retrospectively reviewed to determine the prevalence and pattern of associated fractures, to correlate injury pattern with recommended surgical stabilization, and to assess neurologic outcome. Radiographs and CT scans obtained for 40 consecutive patients with rotational facet injuries of the cervical spine during a 70-month period were retrospectively reviewed to determine injury level, presence, and orientation of facet fractures, and concurrent nonfacet injuries. Imaging findings were reviewed to assess the likelihood of instability and to determine the most appropriate stabilization requirement. Medical records were reviewed to ascertain mechanism of injury, initial neurologic deficit, and surgical findings. Among the 40 patients with cervical rotational facet injuries, 11 (27%) had pure unilateral facet dislocation or subluxation without associated fractures, and 29 (73%) had concurrent facet fractures involving the inferior facet of the rotated vertebra (n = 13), the superior facet of the subjacent vertebra (n = 9), or both (n = 7). Injury of the rotated vertebra was unilateral in 22 patients but bilateral in 18 patients. Facet fractures frequently extended into the ipsilateral lamina or articular pillar or both. An avulsion fracture from the posteroinferior aspect of the rotated vertebral body, indicating disk disruption, occurred in 10 patients (25%), and seven patients (17%) had complete isolation of an articular pillar. Facet fractures were confirmed for 27 patients who underwent surgical stabilization. Neurologic deficits developed in 29 (73%) of the 40 patients and included radiculopathy in 11 patients and cord syndromes in 18 patients. Pure dislocation without a facet fracture was more likely to lead to a cord syndrome (p = .006). Cervical rotational facet injuries are often accompanied by facet fractures and bilateral damage of the rotated vertebra. These injuries contribute to rotational instability and require specific internal fixation based on a precise delineation of all injuries. Facet dislocations without fractures have a significantly higher association with cord syndromes than do rotational facet injuries with fractures. CT, particularly with parasagittal reformations, is valuable in identifying all injuries of the rotated and subjacent vertebrae.
Passive Joint Forces Are Tuned to Limb Use in Insects and Drive Movements without Motor Activity
Ache, Jan M.; Matheson, Thomas
2013-01-01
Summary Background Limb movements are generally driven by active muscular contractions working with and against passive forces arising in muscles and other structures. In relatively heavy limbs, the effects of gravity and inertia predominate, whereas in lighter limbs, passive forces intrinsic to the limb are of greater consequence. The roles of passive forces generated by muscles and tendons are well understood, but there has been little recognition that forces originating within joints themselves may also be important, and less still that these joint forces may be adapted through evolution to complement active muscle forces acting at the same joint. Results We examined the roles of passive joint forces in insect legs with different arrangements of antagonist muscles. We first show that passive forces modify actively generated movements of a joint across its working range, and that they can be sufficiently strong to generate completely passive movements that are faster than active movements observed in natural behaviors. We further demonstrate that some of these forces originate within the joint itself. In legs of different species adapted to different uses (walking, jumping), these passive joint forces complement the balance of strength of the antagonist muscles acting on the joint. We show that passive joint forces are stronger where they assist the weaker of two antagonist muscles. Conclusions In limbs where the dictates of a key behavior produce asymmetry in muscle forces, passive joint forces can be coadapted to provide the balance needed for the effective generation of other behaviors. PMID:23871240
Bokov, Andrey; Isrelov, Alexey; Skorodumov, Alexander; Aleynik, Alexander; Simonov, Alexander; Mlyavykh, Sergey
2011-01-01
Despite the evident progress in treating vertebral column degenerative diseases, the rate of a so-called "failed back surgery syndrome" associated with pain and disability remains relatively high. However, this term has an imprecise definition and includes several different morbid conditions following spinal surgery, not all of which directly illustrate the efficacy of the applied technology; furthermore, some of them could even be irrelevant. To evaluate and systematize the reasons for persistent pain syndromes following surgical nerve root decompression. Prospective, nonrandomized, cohort study of 138 consecutive patients with radicular pain syndromes, associated with nerve root compression caused by lumbar disc herniation, and resistant to conservative therapy for at least one month. The minimal period of follow-up was 18 months. Hospital outpatient department, Russian Federation Pre-operatively, patients were examined clinically, applying the visual analog scale (VAS), Oswestry Disability Index (ODI), magnetic resonance imaging (MRI), discography and computed tomography (CT). According to the disc herniation morphology and applied type of surgery, all participants were divided into the following groups: for those with disc extrusion or sequester, microdiscectomy was applied (n = 65); for those with disc protrusion, nucleoplasty was applied (n = 46); for those with disc extrusion, nucleoplasty was applied (n = 27). After surgery, participants were examined clinically and the VAS and ODI were applied. All those with permanent or temporary pain syndromes were examined applying MRI imaging, functional roentgenograms, and, to validate the cause of pain syndromes, different types of blocks were applied (facet joint blocks, paravertebral muscular blocks, transforaminal and caudal epidural blocks). Group 1 showed a considerable rate of pain syndromes related to tissue damage during the intervention; the rates of radicular pain caused by epidural scar and myofascial pain were 12.3% and 26.1% respectively. Facet joint pain was found in 23.1% of the cases. Group 2 showed a significant rate of facet joint pain (16.9%) despite the minimally invasive intervention. The specificity of Group 3 was the very high rate of unresolved or recurred nerve root compression (63.0%); in other words, in the majority of cases, the aim of the intervention was not achieved. The results of the applied intervention were considered clinically significant if 50% pain relief on the VAS and a 40% decrease in the ODI were achieved. This study is limited because of the loss of participants to follow-up and because it is nonrandomized; also it could be criticized because the dynamics of numeric scores were not provided. The results of our study show that an analysis of the reasons for failures and partial effects of applied interventions for nerve root decompression may help to understand better the efficacy of the interventions and could be helpful in improving surgical strategies, otherwise the validity of the conclusion could be limited because not all sources of residual pain illustrate the applied technology efficacy. In the majority of cases, the cause of the residual or recurrent pain can be identified, and this may open new possibilities to improve the condition of patients presenting with failed back surgery syndrome.
ERIC Educational Resources Information Center
Bechger, Timo M.; Maris, Gunter
2004-01-01
This paper is about the structural equation modelling of quantitative measures that are obtained from a multiple facet design. A facet is simply a set consisting of a finite number of elements. It is assumed that measures are obtained by combining each element of each facet. Methods and traits are two such facets, and a multitrait-multimethod…
Technique for joining metal tubing
NASA Technical Reports Server (NTRS)
Wright, H. W.
1976-01-01
Uniform wall thickness and uninterrupted heat transfer is achieved by using shaped metal insert as wall material for joint. Insert acts as support during brazing, after which excess material is ground away to bring joint to original tubing size.
Ospina-Rozo, Bibiana; Forero-Shelton, Manu; Molina, Jorge
2017-03-01
The antennae of Insecta consist of two basal segments and the distal annulated flagellum lacking intrinsic muscles. Non-muscular joints are important to preserve the flexibility and structure of the long heteropteran antennae which bear an intersegmental nodule on each non-muscular joint. Little is known about their properties or function. Here we characterize the structure and postembryonic development of the non-muscular joints of Rhodnius prolixus antennae. Using Scanning Electron Microscopy, we tracked the changes in shape and size of both intersegmental nodules during the course of the hemimetabolous insect life cycle. Using Atomic Force Microscopy, we established a qualitative correlation between the topography of the surface and the rigidity of the joint between pedicel and flagellum. Our results confirmed the presence of two sub-articulations on each non-muscular joint. Also, the two intersegmental nodules have different origins: the one between the two flagellar segments (intraflagelloid) is a sclerite already present from the early nymph, while the nodule between pedicel and flagellum (prebasiflagellite) originates by gradual separation of the proximal end of the basiflagellum during postembryonic development. Various changes occur in the non-muscular joints and segments of the antenna during the life cycle of R. prolixus. Copyright © 2016 Elsevier Ltd. All rights reserved.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yap, K.P.; Lamontagne, B.; Delage, A.
2006-05-15
We present a technique to lithographically define and fabricate all required optical facets on a silicon-on-insulator photonic integrated circuit by an inductively coupled plasma etch process. This technique offers 1 {mu}m positioning accuracy of the facets at any location within the chip and eliminates the need of polishing. Facet fabrication consists of two separate steps to ensure sidewall verticality and minimize attack on the end surfaces of the waveguides. Protection of the waveguides by a thermally evaporated aluminum layer before the 40-70 {mu}m deep optical facet etching has been proven essential in assuring the facet smoothness and integrity. Both scanningmore » electron microscopy analysis and optical measurement results show that the quality of the facets prepared by this technique is comparable to the conventional facets prepared by polishing.« less
Distribution of lactate dehydrogenase in healthy and degenerative canine stifle joint cartilage.
Walter, Eveline L C; Spreng, David; Schmöckel, Hugo; Schawalder, Peter; Tschudi, Peter; Friess, Armin E; Stoffel, Michael H
2007-07-01
In dogs, degenerative joint diseases (DJD) have been shown to be associated with increased lactate dehydrogenase (LDH) activity in the synovial fluid. The goal of this study was to examine healthy and degenerative stifle joints in order to clarify the origin of LDH in synovial fluid. In order to assess the distribution of LDH, cartilage samples from healthy and degenerative knee joints were investigated by means of light and transmission electron microscopy in conjunction with immunolabeling and enzyme cytochemistry. Morphological analysis confirmed DJD. All techniques used corroborated the presence of LDH in chondrocytes and in the interterritorial matrix of healthy and degenerative stifle joints. Although enzymatic activity of LDH was clearly demonstrated in the territorial matrix by means of the tetrazolium-formazan reaction, immunolabeling for LDH was missing in this region. With respect to the distribution of LDH in the interterritorial matrix, a striking decrease from superficial to deeper layers was present in healthy dogs but was missing in affected joints. These results support the contention that LDH in synovial fluid of degenerative joints originates from cartilage. Therefore, we suggest that (1) LDH is transferred from chondrocytes to ECM in both healthy dogs and dogs with degenerative joint disease and that (2) in degenerative joints, LDH is released from chondrocytes and the ECM into synovial fluid through abrasion of cartilage as well as through enhanced diffusion as a result of increased water content and degradation of collagen.
Further Simplification of the Simple Erosion Narrowing Score With Item Response Theory Methodology.
Oude Voshaar, Martijn A H; Schenk, Olga; Ten Klooster, Peter M; Vonkeman, Harald E; Bernelot Moens, Hein J; Boers, Maarten; van de Laar, Mart A F J
2016-08-01
To further simplify the simple erosion narrowing score (SENS) by removing scored areas that contribute the least to its measurement precision according to analysis based on item response theory (IRT) and to compare the measurement performance of the simplified version to the original. Baseline and 18-month data of the Combinatietherapie Bij Reumatoide Artritis (COBRA) trial were modeled using longitudinal IRT methodology. Measurement precision was evaluated across different levels of structural damage. SENS was further simplified by omitting the least reliably scored areas. Discriminant validity of SENS and its simplification were studied by comparing their ability to differentiate between the COBRA and sulfasalazine arms. Responsiveness was studied by comparing standardized change scores between versions. SENS data showed good fit to the IRT model. Carpal and feet joints contributed the least statistical information to both erosion and joint space narrowing scores. Omitting the joints of the foot reduced measurement precision for the erosion score in cases with below-average levels of structural damage (relative efficiency compared with the original version ranged 35-59%). Omitting the carpal joints had minimal effect on precision (relative efficiency range 77-88%). Responsiveness of a simplified SENS without carpal joints closely approximated the original version (i.e., all Δ standardized change scores were ≤0.06). Discriminant validity was also similar between versions for both the erosion score (relative efficiency = 97%) and the SENS total score (relative efficiency = 84%). Our results show that the carpal joints may be omitted from the SENS without notable repercussion for its measurement performance. © 2016, American College of Rheumatology.
1990-07-31
examples on their use is available with the PASS User Documentation Manual. 2 The data structure of PASS requires a three- lvel organizational...files, and missing control variables. A specific problem noted involved the absence of 8087 mathematical co-processor on the target IBM-XT 21 machine...System, required an operational understanding of the advanced mathematical technique used in the model. Problems with the original release of the PASS
ERIC Educational Resources Information Center
Doltas, Dilek, Ed.; And Others
Prepared as part of the Turko-Danish Fairytale Project conducted to uncover universal, cross-cultural features in readers' response to literature, this paper reports on a pilot study to determine which three out of nine preselected fairy tales would elicit the most faceted response from a population of Turkish readers. After explaining the…
NASA Astrophysics Data System (ADS)
Stump, Edmund; Miller, Julia M. G.; Korsch, Russell J.; Edgerton, David G.
1988-03-01
Late Proterozoic glacial deposits have been found on all continents except Antarctica. Here we describe four units of Late Proterozoic diamictite, with a total thickness of about 10m, from Panorama Point, Nimrod Glacier area, Antarctica, which have characteristics compatible with glaciogenic origin. The diamictite occurs within the Goldie Formation, a sequence of marine turbidites, and is associated with a unit of mafic pillow lavas. The diamictite is commonly structureless and in places laminated. Coarse clasts occur as scattered pebbles and cobbles and as pebbly pods and beds. No striated or faceted clasts were found. A few pebbles may pierce the laminae, but a drop-stone origin is uncertain. Deformation and metamorphism have obscured subtleties of original sedimentary structure. Outsize clasts in laminated sandy siltstone (now schistose) suggest a glaciogenic origin for these diamictites, but deposition by mass-flow processes cannot be ruled out. The discovery in Antarctica of possible Late Proterozoic glaciogenic deposits extends their geographic distribution to all of the major continental masses.
Gökkus, Kemal; Sagtas, Ergin; Kesgin, Engin; Aydin, Ahmet Turan
2018-01-01
Intra-articular distal radius fractures have long been massively discussed in the literature, but regarding to fractures that possess rotated volar medial fragment in the joint a few amount papers has been written. In this article, we would like to emphasize the significance of the rotated palmar medial (lunate facet) fragment. A 39-year-old man fell from a height of about 3 m and landed on his right outstretched hand; within 40 min, he arrived at our clinic presenting with a severe pain and swelling in his right wrist. Initial X-rays of the wrist revealed dorsal subluxation of the radiocarpal joint with dorsal comminution of the radial articular surface and fracture of the radial styloid process, with (nearly inverted) ~ 140-150° rotation of the palmar medial fragment. With an additional volar approach, the fragment reduced and stabilized with two K-wires and wrist immobilized in external fixator. The patient returned to daily activities without any discomfort and pain after the 1 year from the surgery. Overlooking of palmar rotated osteochondral fragment will cause deficiency to build proper pre-operative strategy to approach the reduction of the fragment. The incompetence of reduction will deteriorate the articular surface and lead to early osteoarthritis of the wrist. The surgeon should detect this fragment and should be familiar with volar approaches of the wrist. Above average surgical experience would be needed for successful reduction.
NASA Astrophysics Data System (ADS)
Faber, Jakob A.; Arrieta, Andres F.; Studart, André R.
2018-03-01
Origami enables folding of objects into a variety of shapes in arts, engineering, and biological systems. In contrast to well-known paper-folded objects, the wing of the earwig has an exquisite natural folding system that cannot be sufficiently described by current origami models. Such an unusual biological system displays incompatible folding patterns, remains open by a bistable locking mechanism during flight, and self-folds rapidly without muscular actuation. We show that these notable functionalities arise from the protein-rich joints of the earwig wing, which work as extensional and rotational springs between facets. Inspired by this biological wing, we establish a spring origami model that broadens the folding design space of traditional origami and allows for the fabrication of precisely tunable, four-dimensional–printed objects with programmable bioinspired morphing functionalities.
Judge, Timothy A; Rodell, Jessica B; Klinger, Ryan L; Simon, Lauren S; Crawford, Eean R
2013-11-01
Integrating 2 theoretical perspectives on predictor-criterion relationships, the present study developed and tested a hierarchical framework in which each five-factor model (FFM) personality trait comprises 2 DeYoung, Quilty, and Peterson (2007) facets, which in turn comprise 6 Costa and McCrae (1992) NEO facets. Both theoretical perspectives-the bandwidth-fidelity dilemma and construct correspondence-suggest that lower order traits would better predict facets of job performance (task performance and contextual performance). They differ, however, as to the relative merits of broad and narrow traits in predicting a broad criterion (overall job performance). We first meta-analyzed the relationship of the 30 NEO facets to overall job performance and its facets. Overall, 1,176 correlations from 410 independent samples (combined N = 406,029) were coded and meta-analyzed. We then formed the 10 DeYoung et al. facets from the NEO facets, and 5 broad traits from those facets. Overall, results provided support for the 6-2-1 framework in general and the importance of the NEO facets in particular. (c) 2013 APA, all rights reserved.
FACETS: multi-faceted functional decomposition of protein interaction networks.
Seah, Boon-Siew; Bhowmick, Sourav S; Dewey, C Forbes
2012-10-15
The availability of large-scale curated protein interaction datasets has given rise to the opportunity to investigate higher level organization and modularity within the protein-protein interaction (PPI) network using graph theoretic analysis. Despite the recent progress, systems level analysis of high-throughput PPIs remains a daunting task because of the amount of data they present. In this article, we propose a novel PPI network decomposition algorithm called FACETS in order to make sense of the deluge of interaction data using Gene Ontology (GO) annotations. FACETS finds not just a single functional decomposition of the PPI network, but a multi-faceted atlas of functional decompositions that portray alternative perspectives of the functional landscape of the underlying PPI network. Each facet in the atlas represents a distinct interpretation of how the network can be functionally decomposed and organized. Our algorithm maximizes interpretative value of the atlas by optimizing inter-facet orthogonality and intra-facet cluster modularity. We tested our algorithm on the global networks from IntAct, and compared it with gold standard datasets from MIPS and KEGG. We demonstrated the performance of FACETS. We also performed a case study that illustrates the utility of our approach. Supplementary data are available at the Bioinformatics online. Our software is available freely for non-commercial purposes from: http://www.cais.ntu.edu.sg/~assourav/Facets/
Lee, Young Han; Yang, Jaemoon; Jeong, Ha-Kyu; Suh, Jin-Suck
2017-01-01
Biochemical imaging of glycosaminoglycan chemical exchange saturation transfer (gagCEST) could predict the depletion of glycosaminoglycans (GAG) in early osteoarthritis. The purpose of this study was to evaluate the relationship between the magnetization transfer ratio asymmetry (MTR asym ) of gagCEST images and visual analog scale (VAS) pain scores in the knee joint. This retrospective study was approved by the institutional review board. A phantom study was performed using hyaluronic acid to validate the MTR asym values of gagCEST images. Knee magnetic resonance (MR) images of 22 patients (male, 9; female, 13; mean age, 50.3years; age range; 25-79years) with knee pain were included in this study. The MR imaging (MRI) protocol involved standard knee MRI as well as gagCEST imaging, which allowed region-of-interest analyses of the patellar facet and femoral trochlea. The MTR asym at 1.0ppm was calculated at each region. The cartilages of the patellar facets and femoral trochlea were graded according to the Outerbridge classification system. Data regarding the VAS scores of knee pain were collected from the electronic medical records of the patients. Statistical analysis was performed using Spearman's correlation. The results of the phantom study revealed excellent correlation between the MTR asym values and the concentration of GAGs (r=0.961; p=0.003). The cartilage grades on the MR images showed significant negative correlation with the MTR asym values in the patellar facet and femoral trochlea (r=-0.460; p=0.031 and r=-0.543; p=0.009, respectively). The VAS pain scores showed significant negative correlation with the MTR asym values in the patellar facet and femoral trochlea (r=-0.435; p=0.043 and r=-0.671; p=0.001, respectively). The pain scores were associated with the morphological and biochemical changes in articular cartilages visualized on knee MR images. The biochemical changes, visualized in terms of the MTR asym values of the gagCEST images, exhibited greater correlation with the pain scores than the morphological changes visualized on conventional MR images; these results provide evidence supporting the theory regarding the association of patellofemoral osteoarthritis with knee pain scores. Copyright © 2016 Elsevier Inc. All rights reserved.
Yin, Xin; Wang, Xudong
2016-11-09
Nanocrystal facets evolution is critical for designing nanomaterial morphology and controlling their properties. In this work, we report a unique high-energy crystal facets evolution phenomenon at the tips of wurtzite zinc oxide nanowires (NWs). As the zinc vapor supersaturation decreased at the NW deposition region, the NW tip facets evolved from the (0001) surface to the {101̅3} surface and subsequently to the {112̅2} surface and eventually back to the flat (0001) surface. A series of NW tip morphology was observed in accordance to the different combinations of exposed facets. Exposure of the high-energy facets was attributed to the fluctuation of the energy barriers for the formation of different crystal facets during the layer-by-layer growth of the NW tip. The energy barrier differences between these crystal facets were quantified from the surface area ratios as a function of supersaturation. On the basis of the experimental observation and kinetics analysis, we argue that at appropriate deposition conditions exposure of the crystal facets at NW growth front is not merely determined by the surface energy. Instead, the NW may choose to expose the facets with minimal formation energy barrier, which can be determined by the Ehrlich-Schwoebel barrier variation. This empirical law for the NW tip facet formation was in analogy to the Ostwald-Lussac law of phase transformation, which brings a new insight toward nanostructure design and controlled synthesis.
Joint sparse coding based spatial pyramid matching for classification of color medical image.
Shi, Jun; Li, Yi; Zhu, Jie; Sun, Haojie; Cai, Yin
2015-04-01
Although color medical images are important in clinical practice, they are usually converted to grayscale for further processing in pattern recognition, resulting in loss of rich color information. The sparse coding based linear spatial pyramid matching (ScSPM) and its variants are popular for grayscale image classification, but cannot extract color information. In this paper, we propose a joint sparse coding based SPM (JScSPM) method for the classification of color medical images. A joint dictionary can represent both the color information in each color channel and the correlation between channels. Consequently, the joint sparse codes calculated from a joint dictionary can carry color information, and therefore this method can easily transform a feature descriptor originally designed for grayscale images to a color descriptor. A color hepatocellular carcinoma histological image dataset was used to evaluate the performance of the proposed JScSPM algorithm. Experimental results show that JScSPM provides significant improvements as compared with the majority voting based ScSPM and the original ScSPM for color medical image classification. Copyright © 2014 Elsevier Ltd. All rights reserved.
Delaminated graphene at silicon carbide facets: atomic scale imaging and spectroscopy.
Nicotra, Giuseppe; Ramasse, Quentin M; Deretzis, Ioannis; La Magna, Antonino; Spinella, Corrado; Giannazzo, Filippo
2013-04-23
Atomic-resolution structural and spectroscopic characterization techniques (scanning transmission electron microscopy and electron energy loss spectroscopy) are combined with nanoscale electrical measurements (conductive atomic force microscopy) to study at the atomic scale the properties of graphene grown epitaxially through the controlled graphitization of a hexagonal SiC(0001) substrate by high temperature annealing. This growth technique is known to result in a pronounced electron-doping (∼10(13) cm(-2)) of graphene, which is thought to originate from an interface carbon buffer layer strongly bound to the substrate. The scanning transmission electron microscopy analysis, carried out at an energy below the knock-on threshold for carbon to ensure no damage is imparted to the film by the electron beam, demonstrates that the buffer layer present on the planar SiC(0001) face delaminates from it on the (112n) facets of SiC surface steps. In addition, electron energy loss spectroscopy reveals that the delaminated layer has a similar electronic configuration to purely sp2-hybridized graphene. These observations are used to explain the local increase of the graphene sheet resistance measured around the surface steps by conductive atomic force microscopy, which we suggest is due to significantly lower substrate-induced doping and a resonant scattering mechanism at the step regions. A first-principles-calibrated theoretical model is proposed to explain the structural instability of the buffer layer on the SiC facets and the resulting delamination.
Domains and facets: hierarchical personality assessment using the revised NEO personality inventory.
Costa, P T; McCrae, R R
1995-02-01
Personality traits are organized hierarchically, with narrow, specific traits combining to define broad, global factors. The Revised NEO Personality Inventory (NEO-PI-R; Costa & McCrae, 1992c) assesses personality at both levels, with six specific facet scales in each of five broad domains. This article describes conceptual issues in specifying facets of a domain and reports evidence on the validity of NEO-PI-R facet scales. Facet analysis-the interpretation of a scale in terms of the specific facets with which it correlates-is illustrated using alternative measures of the five-factor model and occupational scales. Finally, the hierarchical interpretation of personality profiles is discussed. Interpretation on the domain level yields a rapid understanding of the individual interpretation of specific facet scales gives a more detailed assessment.
Miller, Warren B; Millstein, Susan G; Pasta, David J
2008-01-01
Relatively little is known about the motivational antecedents to the use of assisted reproductive technology (ART). In this paper we measure the fertility motivations of infertile couples who are considering the use of ART, using an established instrument, the Childbearing Questionnaire (CBQ). Our sample consists of 214 men and 216 women who were interviewed at home after an initial screening for ART but before making a final decision. We conducted two sets of analyses with the obtained data. In one set, we compared the scores on scales and subscales of the CBQ for the males and females in our sample with the scores for males and females from a comparable normative sample. For these analyses we first examined sample and gender differences with a four-group analysis of variance. We then conducted a series of linear models that included background characteristics as covariates and interactions between sample, gender, and age and between those three variables and the background characteristics. The results showed the expected higher positive and lower negative motivations in the ART sample and a significant effect on positive motivations of the interaction between sample and age. In the second set of analyses, we developed several new subscales relevant to facets of the desire for a child that appear to be important in ART decision-making. These facets include the desire to be genetically related to the child and the desire to experience pregnancy and childbirth. A third facet, the desire for parenthood, is already well covered by the existing subscales. The results showed the new subscales to have satisfactory reliability and validity. The results also showed that the original and new subscales predicted the three facets of the desire for a child in a multivariate context. We conclude with a general discussion of the way our findings relate both to ART decision-making and to further research on the motivations that drive it.
A model for the geomorphic development of normal-fault facets
NASA Astrophysics Data System (ADS)
Tucker, G. E.; Hobley, D. E. J.; McCoy, S. W.
2014-12-01
Triangular facets are among the most striking landforms associated with normal faulting. The genesis of facets is of great interest both for the information facets contain about tectonic motion, and because the progressive emergence of facets makes them potential recorders of both geomorphic and tectonic history. In this report, we present observations of triangular facets in the western United States and in the Italian Central Apennines. Facets in these regions typically form quasi-planar surfaces that are aligned in series along and above the trace of an active fault. Some facet surfaces consist mainly of exposed bedrock, with a thin and highly discontinuous cover of loose regolith. Other facets are mantled by a several-decimeter-thick regolith cover. Over the course of its morphologic development, a facet slope segment may evolve from a steep (~60 degree) bedrock fault scarp, well above the angle of repose for soil, to a gentler (~20-40 degree) slope that can potentially sustain a coherent regolith cover. This evolutionary trajectory across the angle of repose renders nonlinear diffusion theory inapplicable. To formulate an alternative process-based theory for facet evolution, we use a particle-based approach that acknowledges the possibility for both short- and long-range sediment-grain motions, depending on the topography. The processes of rock weathering, grain entrainment, and grain motion are represented as stochastic state-pair transitions with specified transition rates. The model predicts that facet behavior can range smoothly along the spectrum from a weathering-limited mode to a transport-limited mode, depending on the ratio of fault-slip rate to bare-bedrock regolith production rate. The model also implies that facets formed along a fault with pinned tips should show systematic variation in slope angle that correlates with along-fault position and slip rate. Preliminary observations from central Italy and the eastern Basin and Range are consistent with this prediction.
T2 mapping in patellar chondromalacia.
Ruiz Santiago, Fernando; Pozuelo Calvo, Rocío; Almansa López, Julio; Guzmán Álvarez, Luis; Castellano García, María Del Mar
2014-06-01
To study the correlation between the T2 relaxation times of the patellar cartilage and morphological MRI findings of chondromalacia. This prospective study comprises 50 patients, 27 men and 23 women suffering of anterior knee pain (mean age: 29.7, SD 8.3 years; range: 16-45 years). MRI of 97 knees were performed in these patients at 1.5T magnet including sagittal T1, coronal intermediate, axial intermediate fat sat and T2 mapping. Chondromalacia was assessed using a modified version of Noyes classification. The relaxation time, T2, was studied segmenting the full thickness of the patellar cartilage in 12 areas: 4 proximal (external facet-proximal-lateral (EPL), external facet-proximal-central (EPC), internal facet-proximal-central (IPC), internal facet-proximal-medial (IPM), 4 in the middle section (external facet-middle-lateral (EML), external facet-middle-central (EMC), internal facet-middle-central (IMC), internal facet-middle-medial (IMM) and 4 distal (external facet-distal-lateral (EDL), external facet-distal-central (EDC), internal facet-distal-central (IDC), internal facet-distal-medial (IDM). T2 values showed a significant increase in mild chondromalacia regarding normal cartilage in most of the cartilage areas (p<0.05), except in the internal distal facet (IDC and IDM), EPC, EDL, and IMM. Severe chondromalacia was characterized by a fall of T2 relaxation times with loss of statistical significant differences in comparison with normal cartilage, except in EMC and IMC, where similar values as mild chondromalacia were maintained (p<0.05). Steepest increase in T2 values of patellar cartilage occurs in early stages of patellar cartilage degeneration. Progression of morphologic changes of chondromalacia to more severe degrees is associated to a new drop of T2 relaxation times approaching basal values in most of the areas of the patellar cartilage, except in the central area of the middle section, where T2 values remain increased. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Masharawi, Youssef; Rothschild, Bruce; Salame, Khalil; Dar, Gali; Peleg, Smadar; Hershkovitz, Israel
2005-06-01
Thoracolumbar facet and interfacet linear dimensions were measured and analyzed. To characterize and analyze the thoracolumbar facet and interfacet size and shape in relation to gender, ethnic group, and age and to detect the extent of normal facet tropism along the thoracolumbar spine. Knowledge on facet tropism and interfacet shape is limited in the literature as most data are based on 2-dimensional measurements, small samples, or isolated vertebrae. Facet shape as represented by width, length, width/length ratio and interfacet distances was obtained directly from dry vertebrae of 240 adult human spines. The specimen's osteologic material is part of the Hamann-Todd Osteological Collection housed at the Cleveland Museum of Natural History, Cleveland, OH. A total of 4080 vertebrae (T1-L5) from the vertebral columns of individuals 20 to 80 years of age were measured, using a Microscribe 3-dimensional apparatus (Immersion Co., San Jose, CA). Data were recorded directly on computer software. Statistical analysis included paired t tests and ANOVA. A significant correlation was found between all thoracolumbar facet dimensions and an individual's height and weight. Facet tropism is a major characteristic of the thoracolumbar spine, the left being longer in the thorax while the right is longer in the lumbar. In general, facet size is age-independent and greater in males compared with females with a significant ethnic component. Facet length is similar for all thoracic vertebrae, whereas it sharply and continuously increases in the lumbar vertebrae. Facet dimension manifests a bipolar distribution along the thoracolumbar vertebrae. Width/length ratio indicates that facets are longer than wider for most verte-brae. The interarticular area manifests a marked inverted trapezoidal shape at T1-T2, a rectangular shape at T3-L3, and an ordinary trapezoidal shape at L4-L5. Facet tropism is a normal characteristic in humans, yet it varies along the thoracolumbar spine.
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Smooth and vertical facet formation for AlGaN-based deep-UV laser diodes.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Bogart, Katherine Huderle Andersen; Shul, Randy John; Stevens, Jeffrey
2008-10-01
Using a two-step method of plasma and wet chemical etching, we demonstrate smooth, vertical facets for use in Al{sub x} Ga{sub 1-x} N-based deep-ultraviolet laser-diode heterostructures where x = 0 to 0.5. Optimization of plasma-etching conditions included increasing both temperature and radiofrequency (RF) power to achieve a facet angle of 5 deg from vertical. Subsequent etching in AZ400K developer was investigated to reduce the facet surface roughness and improve facet verticality. The resulting combined processes produced improved facet sidewalls with an average angle of 0.7 deg from vertical and less than 2-nm root-mean-square (RMS) roughness, yielding an estimated reflectivity greatermore » than 95% of that of a perfectly smooth and vertical facet.« less
Mõttus, René; Realo, Anu; Allik, Jüri; Esko, Tõnu; Metspalu, Andres; Johnson, Wendy
2015-01-01
The study investigated differences in the Five-Factor Model (FFM) domains and facets across adulthood. The main questions were whether personality scales reflected coherent units of trait development and thereby coherent personality traits more generally. These questions were addressed by testing if the components of the trait scales (items for facet scales and facets for domain scales) showed consistent age group differences. For this, measurement invariance (MI) framework was used. In a sample of 2,711 Estonians who had completed the NEO Personality Inventory 3 (NEO PI-3), more than half of the facet scales and one domain scale did not meet the criterion for weak MI (factor loading equality) across 12 age groups spanning ages from 18 to 91 years. Furthermore, none of the facet and domain scales met the criterion for strong MI (intercept equality), suggesting that items of the same facets and facets of the same domains varied in age group differences. When items were residualized for their respective facets, 46% of them had significant (p < 0.0002) residual age-correlations. When facets were residualized for their domain scores, a majority had significant (p < 0.002) residual age-correlations. For each domain, a series of latent factors were specified using random quarters of their items: scores of such latent factors varied notably (within domains) in correlations with age. We argue that manifestations of aetiologically coherent traits should show similar age group differences. Given this, the FFM domains and facets as embodied in the NEO PI-3 do not reflect aetiologically coherent traits.
Mõttus, René; Realo, Anu; Allik, Jüri; Esko, Tõnu; Metspalu, Andres; Johnson, Wendy
2015-01-01
The study investigated differences in the Five-Factor Model (FFM) domains and facets across adulthood. The main questions were whether personality scales reflected coherent units of trait development and thereby coherent personality traits more generally. These questions were addressed by testing if the components of the trait scales (items for facet scales and facets for domain scales) showed consistent age group differences. For this, measurement invariance (MI) framework was used. In a sample of 2,711 Estonians who had completed the NEO Personality Inventory 3 (NEO PI-3), more than half of the facet scales and one domain scale did not meet the criterion for weak MI (factor loading equality) across 12 age groups spanning ages from 18 to 91 years. Furthermore, none of the facet and domain scales met the criterion for strong MI (intercept equality), suggesting that items of the same facets and facets of the same domains varied in age group differences. When items were residualized for their respective facets, 46% of them had significant (p < 0.0002) residual age-correlations. When facets were residualized for their domain scores, a majority had significant (p < 0.002) residual age-correlations. For each domain, a series of latent factors were specified using random quarters of their items: scores of such latent factors varied notably (within domains) in correlations with age. We argue that manifestations of aetiologically coherent traits should show similar age group differences. Given this, the FFM domains and facets as embodied in the NEO PI-3 do not reflect aetiologically coherent traits. PMID:25751273
Lumbar facet anatomy changes in spondylolysis: a comparative skeletal study.
Masharawi, Youssef; Dar, Gali; Peleg, Smadar; Steinberg, Nili; Alperovitch-Najenson, Dvora; Salame, Khalil; Hershkovitz, Israel
2007-07-01
Opinions differ as to the exact mechanism responsible for spondylolysis (SP) and whether individuals with specific morphological characteristics of the lumbar vertebral neural arch are predisposed to SP. The aim of our study was to reveal the association between SP and the architecture of lumbar articular facets and the inter-facet region. Using a Microscribe three-dimensional apparatus (Immersion Co., San Jose, CA, USA), length, width and depth of all articular facets and all inter-facet distances in the lumbar spine (L1-L5) were measured. From the Hamann-Todd Human Osteological Collection (Cleveland Museum of Natural History, OH, USA) 120 normal male skeletons with lumbar spines in the control group and 115 with bilateral SP at L5 were selected. Analysis of variance was employed to examine the differences between spondylolytic and normal spines. Three profound differences between SP and the norm appeared: (1) in individuals with SP, the size and shape of L4's neural arch had significantly greater inter-facet widths, significantly shorter inter-facet heights and significantly shorter and narrower articular facets; (2) only in the L4 vertebra in individuals with SP was the inferior inter-facet width greater in size than the superior inter-facet width of the vertebra below (L5) (38.7 mm versus 40 mm); (3) in all lumbar vertebrae, the right inferior articular facets in individuals with SP were flatter compared to the control group. Individuals with L4 "SP" characteristics are at a greater risk of developing fatigue fractures in the form of spondylolysis at L5.
Living in the Here and Now: Interrelationships between Impulsivity, Mindfulness, and Alcohol Misuse
Murphy, Cara; MacKillop, James
2013-01-01
Rationale Impulsivity and mindfulness both emphasize orientation to the present, and both have been linked to alcohol misuse, but the relationship between the two is not clearly understood. Objectives To examine the relationships between elements of impulsivity and mindfulness, and to examine both variables in relation to alcohol misuse. Method Young adults (N = 116) were assessed for alcohol use, mindfulness, and impulsivity using psychometrically validated measures. Results Numerous significant associations were present among the facets of impulsivity and mindfulness. The variable most substantially associated with alcohol misuse was Negative Urgency (NU; i.e., proneness to act out under conditions of negative affect). After controlling for other variables, Negative Urgency (NU), Positive Urgency (PU), and delay discounting (DD) were significantly related to alcohol consumption. When examining drinking related consequences, only Lack of Premeditation (LoP) and Negative Urgency (NU) were significant associated. Conclusions There was considerable overlap between some elements of impulsivity and mindfulness while the overlap was negligible for other facets. The associations between mindfulness and alcohol misuse were entirely a function of impulsivity. In particular, acting on impulses while experiencing negative affect was significantly associated with level of alcohol consumption and level of alcohol-related risk. Steep discounting of future rewards was associated with alcohol consumption while poor premeditation was associated with adverse drinking consequences. These findings illustrate the importance of jointly studying impulsivity when examining purported effects of mindfulness traits. PMID:22169883
Hill, Kaylin E; Samuel, Douglas B; Foti, Dan
2016-08-01
The error-related negativity (ERN) is a neural measure of error processing that has been implicated as a neurobehavioral trait and has transdiagnostic links with psychopathology. Few studies, however, have contextualized this traitlike component with regard to dimensions of personality that, as intermediate constructs, may aid in contextualizing links with psychopathology. Accordingly, the aim of this study was to examine the interrelationships between error monitoring and dimensions of personality within a large adult sample (N = 208). Building on previous research, we found that the ERN relates to a combination of negative affect, impulsivity, and conscientiousness. At low levels of conscientiousness, negative urgency (i.e., impulsivity in the context of negative affect) predicted an increased ERN; at high levels of conscientiousness, the effect of negative urgency was not significant. This relationship was driven specifically by the conscientiousness facets of competence, order, and deliberation. Links between personality measures and error positivity amplitude were weaker and nonsignificant. Post-error slowing was also related to conscientiousness, as well as a different facet of impulsivity: lack of perseverance. These findings suggest that, in the general population, error processing is modulated by the joint combination of negative affect, impulsivity, and conscientiousness (i.e., the profile across traits), perhaps more so than any one dimension alone. This work may inform future research concerning aberrant error processing in clinical populations. © 2016 Society for Psychophysiological Research.
Singular orientations and faceted motion of dislocations in body-centered cubic crystals.
Kang, Keonwook; Bulatov, Vasily V; Cai, Wei
2012-09-18
Dislocation mobility is a fundamental material property that controls strength and ductility of crystals. An important measure of dislocation mobility is its Peierls stress, i.e., the minimal stress required to move a dislocation at zero temperature. Here we report that, in the body-centered cubic metal tantalum, the Peierls stress as a function of dislocation orientation exhibits fine structure with several singular orientations of high Peierls stress-stress spikes-surrounded by vicinal plateau regions. While the classical Peierls-Nabarro model captures the high Peierls stress of singular orientations, an extension that allows dislocations to bend is necessary to account for the plateau regions. Our results clarify the notion of dislocation kinks as meaningful only for orientations within the plateau regions vicinal to the Peierls stress spikes. These observations lead us to propose a Read-Shockley type classification of dislocation orientations into three distinct classes-special, vicinal, and general-with respect to their Peierls stress and motion mechanisms. We predict that dislocation loops expanding under stress at sufficiently low temperatures, should develop well defined facets corresponding to two special orientations of highest Peierls stress, the screw and the M111 orientations, both moving by kink mechanism. We propose that both the screw and the M111 dislocations are jointly responsible for the yield behavior of BCC metals at low temperatures.
Image Guidance Technologies for Interventional Pain Procedures: Ultrasound, Fluoroscopy, and CT.
Wang, Dajie
2018-01-26
Chronic pain is a common medical condition. Patients who suffer uncontrolled chronic pain may require interventions including spinal injections and various nerve blocks. Interventional procedures have evolved and improved over time since epidural injection was first introduced for low back pain and sciatica in 1901. One of the major contributors in the improvement of these interventions is the advancement of imaging guidance technologies. The utilization of image guidance has dramatically improved the accuracy and safety of these interventions. The first image guidance technology adopted by pain specialists was fluoroscopy. This was followed by CT and ultrasound. Fluoroscopy can be used to visualize bony structures of the spine. It is still the most commonly used guidance technology in spinal injections. In the recent years, ultrasound guidance has been increasingly adopted by interventionists to perform various injections. Because its ability to visualize soft tissue, vessels, and nerves, this guidance technology appears to be a better option than fluoroscopy for interventions including SGB and celiac plexus blocks, when visualization of the vessels may prevent intravascular injection. The current evidence indicates the efficacies of these interventions are similar between ultrasound guidance and fluoroscopy guidance for SGB and celiac plexus blocks. For facet injections and interlaminar epidural steroid injections, it is important to visualize bony structures in order to perform these procedures accurately and safely. It is worth noting that facet joint injections can be done under ultrasound guidance with equivalent efficacy to fluoroscopic guidance. However, obese patients may present challenge for ultrasound guidance due to its poor visualization of deep anatomical structures. Regarding transforaminal epidural steroid injections, there are limited evidence to support that ultrasound guidance technology has equivalent efficacy and less complications comparing to fluoroscopy. However, further studies are required to prove the efficacy of ultrasound-guided transforaminal epidural injections. SI joint is unique due to its multiplanar orientation, irregular joint gap, partial ankylosis, and thick dorsal and interosseous ligament. Therefore, it can be difficult to access the joint space with fluoroscopic guidance and ultrasound guidance. CT scan, with its cross-sectional images, can identify posterior joint gap, is most likely the best guidance technology for this intervention. Intercostal nerves lie in the subcostal grove close to the plural space. Significant risk of pneumothorax is associated with intercostal blocks. Ultrasound can provide visualization of ribs and pleura. Therefore, it may improve the accuracy of the injection and reduce the risk of pneumothorax. At present time, most pain specialists are familiar with fluoroscopic guidance techniques, and fluoroscopic machines are readily available in the pain clinics. In the contrast, CT guidance can only be performed in specially equipped facilities. Ultrasound machine is generally portable and inexpensive in comparison to CT scanner and fluoroscopic machine. As pain specialists continue to improve their patient care, ultrasound and CT guidance will undoubtedly be incorporated more into the pain management practice. This review is based on a paucity of clinical evidence to compare these guidance technologies; clearly, more clinical studies is needed to further elucidate the pro and cons of each guidance method for various pain management interventions.
Effect of ZnO facet on ethanol steam reforming over Co/ZnO
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yu, Ning; Zhang, He; Davidson, Stephen D.
2016-01-01
The effects of ZnO facets on ethanol steam reforming (ESR) were investigated over Co/ZnO catalysts synthesized using ZnO with different fractions of (10-10) non-polar facet. Co supported on ZnO with a higher fraction of (10-10) non-polar facet shows higher C-C cleavage activity and higher selectivity to CO2 (lower selectivity to CO) compared with Co supported on ZnO with less (10-10) non-polar facet exposed. The improved ethanol steam reforming performances are attributed to the high fraction of metallic Co stabilized by the ZnO (10-10) non-polar facet, which enhanced C-C cleavage and water-gas-shift (WGS) activities.
Foundations of reusable and interoperable facet models using category theory
2016-01-01
Faceted browsing has become ubiquitous with modern digital libraries and online search engines, yet the process is still difficult to abstractly model in a manner that supports the development of interoperable and reusable interfaces. We propose category theory as a theoretical foundation for faceted browsing and demonstrate how the interactive process can be mathematically abstracted. Existing efforts in facet modeling are based upon set theory, formal concept analysis, and light-weight ontologies, but in many regards, they are implementations of faceted browsing rather than a specification of the basic, underlying structures and interactions. We will demonstrate that category theory allows us to specify faceted objects and study the relationships and interactions within a faceted browsing system. Resulting implementations can then be constructed through a category-theoretic lens using these models, allowing abstract comparison and communication that naturally support interoperability and reuse. PMID:27942248
22 CFR 228.34 - Joint ventures.
Code of Federal Regulations, 2010 CFR
2010-04-01
... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Joint ventures. 228.34 Section 228.34 Foreign Relations AGENCY FOR INTERNATIONAL DEVELOPMENT RULES ON SOURCE, ORIGIN AND NATIONALITY FOR COMMODITIES AND SERVICES FINANCED BY USAID Conditions Governing the Nationality of Suppliers of Services for USAID...
Formulation and Application of the Generalized Multilevel Facets Model
ERIC Educational Resources Information Center
Wang, Wen-Chung; Liu, Chih-Yu
2007-01-01
In this study, the authors develop a generalized multilevel facets model, which is not only a multilevel and two-parameter generalization of the facets model, but also a multilevel and facet generalization of the generalized partial credit model. Because the new model is formulated within a framework of nonlinear mixed models, no efforts are…
ERIC Educational Resources Information Center
Beehr, Terry A.; Newman, John E.
1978-01-01
The empirical research on job stress and employee health is reviewed within the context of six facets (environmental, personal, process, human consequences, organizational consequences, and time) of a seven facet conceptualization of the job stress-employee health research domain. Models are proposed for tying the facets together. (Author/SJL)
Impact of Growth in the Universe of Subjects on Classification.
ERIC Educational Resources Information Center
Ranganathan, Shiyali Ramamritam
The development of the removal of rigidity in library classification is traced from the Enumerative Classification of DC (1876) through the Nearly-Faceted Classification of UDC (1896), the rigidly, though fully faceted version of CC (1933), the generalized faceted structure of version 2 of CC (1949), down to the Freely Faceted Classification of…
Proximal attrition facets: morphometric, demographic, and aging characteristics.
Sarig, Rachel; Hershkovitz, Israel; Shvalb, Nir; Sella-Tunis, Tatiana; May, Hila; Vardimon, Alexander D
2014-08-01
Although interproximal attrition is considered to be limited in modern populations, it has important clinical implications. However, in contrast to occlusal attrition, proximal attrition receives limited scientific attention. The main purpose of the current study was to fill this void. Seven-hundred and sixty-five teeth were collected from 255 skulls of subjects 18-75 yr of age. For each individual, three mandibular teeth (the first and second premolars and the first molar) were examined for proximal attrition facets (PAFs). The results provide detailed information on the size, shape, and location of the facets according to age cohort, gender, and ethnicity. The validity of the method used to measure the facets was also examined. The major findings were as follows: PAFs are usually located on the upper half of the crown proximal aspect; in each tooth, the mesial facet is more lingually positioned and the distal facet is more buccally positioned; the majority of the facets are subrectangular in shape; the size of the facets tends to increase in an anteroposterior direction (from premolars to molars); and facet size and location are age- and sex-dependent and ethnicity-independent. It is our recommendation that dentists bear in mind that interproximal attrition is a dynamic, long-term process and needs to be considered in many clinical scenarios. © 2014 Eur J Oral Sci.
Facet control of gold nanorods
Zhang, Qingfeng; Han, Lili; Jing, Hao; ...
2016-01-21
While great success has been achieved in fine-tuning the aspect ratios and thereby the plasmon resonances of cylindrical Au nanorods, facet control with atomic level precision on the highly curved nanorod surfaces has long been a significantly more challenging task. The intrinsic structural complexity and lack of precise facet control of the nanorod surfaces remain the major obstacles for the atomic-level elucidation of the structure–property relationships that underpin the intriguing catalytic performance of Au nanorods. Here we demonstrate that the facets of single-crystalline Au nanorods can be precisely tailored using cuprous ions and cetyltrimethylammonium bromide as a unique pair ofmore » surface capping competitors to guide the particle geometry evolution during nanorod overgrowth. By deliberately maneuvering the competition between cuprous ions and cetyltrimethylammonium bromide, we have been able to create, in a highly controllable and selective manner, an entire family of nanorod-derived anisotropic multifaceted geometries whose surfaces are enclosed by specific types of well-defined high-index and low-index facets. This facet-controlled nanorod overgrowth approach also allows us to fine-tune the particle aspect ratios while well-preserving all the characteristic facets and geometric features of the faceted Au nanorods. Furthermore, taking full advantage of the combined structural and plasmonic tunability, we have further studied the facet-dependent heterogeneous catalysis on well-faceted Au nanorods using surface-enhanced Raman spectroscopy as an ultrasensitive spectroscopic tool with unique time-resolving and molecular finger-printing capabilities.« less
FACETS: multi-faceted functional decomposition of protein interaction networks
Seah, Boon-Siew; Bhowmick, Sourav S.; Forbes Dewey, C.
2012-01-01
Motivation: The availability of large-scale curated protein interaction datasets has given rise to the opportunity to investigate higher level organization and modularity within the protein–protein interaction (PPI) network using graph theoretic analysis. Despite the recent progress, systems level analysis of high-throughput PPIs remains a daunting task because of the amount of data they present. In this article, we propose a novel PPI network decomposition algorithm called FACETS in order to make sense of the deluge of interaction data using Gene Ontology (GO) annotations. FACETS finds not just a single functional decomposition of the PPI network, but a multi-faceted atlas of functional decompositions that portray alternative perspectives of the functional landscape of the underlying PPI network. Each facet in the atlas represents a distinct interpretation of how the network can be functionally decomposed and organized. Our algorithm maximizes interpretative value of the atlas by optimizing inter-facet orthogonality and intra-facet cluster modularity. Results: We tested our algorithm on the global networks from IntAct, and compared it with gold standard datasets from MIPS and KEGG. We demonstrated the performance of FACETS. We also performed a case study that illustrates the utility of our approach. Contact: seah0097@ntu.edu.sg or assourav@ntu.edu.sg Supplementary information: Supplementary data are available at the Bioinformatics online. Availability: Our software is available freely for non-commercial purposes from: http://www.cais.ntu.edu.sg/∼assourav/Facets/ PMID:22908217
Briley, Daniel A.; Tucker-Drob, Elliot M.
2017-01-01
The Five Factor Model (FFM) of personality is well-established at the phenotypic level, but much less is known about the coherence of the genetic and environmental influences within each personality domain. Univariate behavioral genetic analyses have consistently found the influence of additive genes and nonshared environment on multiple personality facets, but the extent to which genetic and environmental influences on specific facets reflect more general influences on higher order factors is less clear. We applied a multivariate quantitative-genetic approach to scores on the CPI-Big Five facets for 490 monozygotic and 317 dizygotic twins who took part in the National Merit Twin Study. Our results revealed a complex genetic structure for facets composing all five factors, with both domain-general and facet-specific genetic and environmental influences. Models that required common genetic and environmental influences on each facet to occur by way of effects on a higher order trait did not fit as well as models allowing for common genetic and environmental effects to act directly on the facets for three of the Big Five domains. These results add to the growing body of literature indicating that important variation in personality occurs at the facet level which may be overshadowed by aggregating to the trait level. Research at the facet level, rather than the factor level, is likely to have pragmatic advantages in future research on the genetics of personality. PMID:22695681
Cervical facet oedema: prevalence, correlation to symptoms, and follow-up imaging.
Nevalainen, M T; Foran, P J; Roedl, J B; Zoga, A C; Morrison, W B
2016-06-01
To evaluate the prevalence of cervical facet oedema in patients referred for magnetic resonance imaging (MRI) to investigate neck pain and/or radiculopathy, and to investigate whether there is a correlation between the presence of oedema and patients' symptoms. A retrospective report review of 1885 patients undergoing cervical spine MRI between July 2008 and June 2015 was performed. Exclusion criteria included acute trauma, surgery, neoplastic disease, or infection in the cervical spine. One hundred and seventy-three MRI studies with cervical facet oedema were evaluated by each of the two radiologists. In these patients, the grade of bone marrow oedema (BMO) and corresponding neuroforaminal narrowing at the cervical facets was assessed. Correlation with symptoms was performed based on pre-MRI questionnaire. The prevalence of cervical facet oedema was 9%; the most commonly affected levels were C3-4, C4-5, and C2-3. A total of 202 cervical facets were evaluated: mild BMO was seen in 35%, moderate in 41%, and severe in 24% of cases. Surrounding soft-tissue oedema was observed in 36%, 69%, and 92% of the BMO grades, respectively. The correlations between unilateral radiculopathy and ipsilateral facet BMO grades were 79%, 83%, and 73% (chi-square, p<0.001), respectively. Furthermore, neuroforaminal narrowing on the corresponding level was found in 35%, 38%, and 11% of cases, respectively. At follow-up imaging, facet oedema was most likely to remain unchanged or to decrease. The prevalence of cervical facet oedema is 9%. Cervical facet oedema is associated with ipsilateral radiculopathy. Neuroforaminal narrowing, however, is not associated with facet oedema. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.
Lumbar facet anatomy changes in spondylolysis: a comparative skeletal study
Dar, Gali; Peleg, Smadar; Steinberg, Nili; Alperovitch-Najenson, Dvora; Salame, Khalil; Hershkovitz, Israel
2007-01-01
Opinions differ as to the exact mechanism responsible for spondylolysis (SP) and whether individuals with specific morphological characteristics of the lumbar vertebral neural arch are predisposed to SP. The aim of our study was to reveal the association between SP and the architecture of lumbar articular facets and the inter-facet region. Methods: Using a Microscribe three-dimensional apparatus (Immersion Co., San Jose, CA, USA), length, width and depth of all articular facets and all inter-facet distances in the lumbar spine (L1–L5) were measured. From the Hamann-Todd Human Osteological Collection (Cleveland Museum of Natural History, OH, USA) 120 normal male skeletons with lumbar spines in the control group and 115 with bilateral SP at L5 were selected. Analysis of variance was employed to examine the differences between spondylolytic and normal spines. Results: Three profound differences between SP and the norm appeared: (1) in individuals with SP, the size and shape of L4’s neural arch had significantly greater inter-facet widths, significantly shorter inter-facet heights and significantly shorter and narrower articular facets; (2) only in the L4 vertebra in individuals with SP was the inferior inter-facet width greater in size than the superior inter-facet width of the vertebra below (L5) (38.7 mm versus 40 mm); (3) in all lumbar vertebrae, the right inferior articular facets in individuals with SP were flatter compared to the control group. Conclusions: Individuals with L4 “SP” characteristics are at a greater risk of developing fatigue fractures in the form of spondylolysis at L5. PMID:17440753
Oxidation of CO by NO on planar and faceted Ir(210)
DOE Office of Scientific and Technical Information (OSTI.GOV)
Chen, Wenhua; Bartynski, Robert A.; Kaghazchi, Payam
2012-06-11
Oxidation of CO by pre-adsorbed NO has been studied on planar Ir(210) and nanofaceted Ir(210) with average facet sizes of 5 nm and 14 nm by temperature programmed desorption (TPD). Both surfaces favor oxidation of CO to CO 2, which is accompanied by simultaneous reduction of NO with high selectivity to N 2. At low NO pre-coverage, the temperature (T i) for the onset of CO 2 desorption as well as CO 2 desorption peak temperature (T p) decreases with increasing CO exposure, and NO dissociation is affected by co-adsorbed CO. At high NO pre-coverage, T i and T pmore » are independent of CO exposure, and co-adsorbed CO has no influence on dissociation of NO. Moreover, at low NO pre-coverage, planar Ir(210) is more active than faceted Ir(210) for oxidation of CO to CO 2: T i and T p are much lower on planar Ir(210) than that on faceted Ir(210). In addition, faceted Ir(210) with an average facet size of 5 nm is more active for oxidation of CO to CO 2 than faceted Ir(210) with an average facet size of 14 nm, i.e., oxidation of CO by pre-adsorbed NO on faceted Ir(210) exhibits size effects on the nanometer scale. In comparison, at low O pre-coverage planar Ir(210) is more active than faceted Ir(210) for oxidation of CO to CO 2 but no evidence has been found for size effects in oxidation of CO by pre-adsorbed oxygen on faceted Ir(210) for average facet sizes of 5 nm and 14 nm. The TPD data indicate the same reaction pathway for CO 2 formation from CO + NO and CO + O reactions on planar Ir(210). Lastly, the adsorption sites of CO, NO, O, CO + O, and CO + NO on Ir are characterized by density functional theory.« less
A structured vocabulary for indexing dietary supplements in databases in the United States
Saldanha, Leila G; Dwyer, Johanna T; Holden, Joanne M; Ireland, Jayne D.; Andrews, Karen W; Bailey, Regan L; Gahche, Jaime J.; Hardy, Constance J; Møller, Anders; Pilch, Susan M.; Roseland, Janet M
2011-01-01
Food composition databases are critical to assess and plan dietary intakes. Dietary supplement databases are also needed because dietary supplements make significant contributions to total nutrient intakes. However, no uniform system exists for classifying dietary supplement products and indexing their ingredients in such databases. Differing approaches to classifying these products make it difficult to retrieve or link information effectively. A consistent approach to classifying information within food composition databases led to the development of LanguaL™, a structured vocabulary. LanguaL™ is being adapted as an interface tool for classifying and retrieving product information in dietary supplement databases. This paper outlines proposed changes to the LanguaL™ thesaurus for indexing dietary supplement products and ingredients in databases. The choice of 12 of the original 14 LanguaL™ facets pertinent to dietary supplements, modifications to their scopes, and applications are described. The 12 chosen facets are: Product Type; Source; Part of Source; Physical State, Shape or Form; Ingredients; Preservation Method, Packing Medium, Container or Wrapping; Contact Surface; Consumer Group/Dietary Use/Label Claim; Geographic Places and Regions; and Adjunct Characteristics of food. PMID:22611303
The multidimensional nature of ageism: construct validity and group differences.
Rupp, Deborah E; Vodanovich, Stephen J; Credé, Marcus
2005-06-01
The authors investigated the factor structure and construct validity of the Fraboni Scale of Ageism and the age and gender differences in ageism scores. Confirmatory factor analyses supported the multidimensional nature of FSA scores and generally corroborated the initial factor structure reported by M. Fraboni, with some notable exceptions. Essentially, the present findings were aligned with theoretical models of ageism that emphasize both cognitive facets and affective facets. That is, on the basis of their factor analytic findings, the authors redefined Fraboni's original factors of Antilocution, Avoidance, and Discrimination as Stereotypes, Separation, and Affective Attitudes, respectively, because of the clustering of items within factors. The revised 3-factor structure accounted for 36.4% of the variance in FSA scores. FSA factor scores significantly related to other scores from other measures of age-related attitudes, with higher correlations among factors that were similar in terms of their cognitive nature versus their affective nature. Finally, younger individuals and men had significantly higher ageism scores on the FSA than older individuals and women. The authors discussed the importance of adequately assessing ageism, with particular emphasis devoted to the understanding of age bias.
Evolving faceted surfaces: From continuum modeling, to geometric simulation, to mean-field theory
NASA Astrophysics Data System (ADS)
Norris, Scott A.
We first consider the directional solidification, in two dimensions, of a dilute binary alloy having a large anisotropy of surface energy, where the sample is pulled in a high-energy direction such that the planar state is thermodynamically prohibited. Analyses including reduction of dynamics, matched asymptotic analysis, and energy minimization are used to show that the interface assumes a faceted profile with small wavelength. Questions on stability and other dynamic behavior lead to the derivation of a facet-velocity law. This shows the that faceted steady solutions are stable in the absence of constitutional supercooling, while in its presence, coarsening replaces cell formation as the mechanism of instability. We next proceed to introduce a computational-geometry tool which, given a facet-velocity law, performs large-scale simulations of fully-faceted coarsening surfaces, first in the special case with only three allowed facet orientations (threefold symmetry), and then for arbitrary surfaces. Topological events including coarsening are comprehensively considered, and are treated explicitly by our method using both a priori knowledge of event outcomes and a novel graph-rewriting algorithm. While careful attention must be paid to both non-unique topological events and the imposition of a discrete time-stepping scheme, the resulting method allows rapid simulation of large surfaces and easy extraction of statistical data. Example statistics are provided for the threefold case based on simulations totaling one million facets. Finally, a mean-field theory is developed for the scale-invariant length distributions observed during the coarsening of one-dimensional faceted surfaces. This theory closely follows the LSW theory of Ostwald ripening in two-phase systems, but the mechanism of coarsening in faceted surfaces requires the derivation of additional terms to model the coalescence of facets. The model is solved by the exponential distribution, but agreement with experiment is limited by the assumption that neighboring facet lengths are uncorrelated. However, the method concisely describes the essential processes operating in the scaling state, illuminates a clear path for future refinement, and offers a generic framework for the investigation of faceted surfaces evolving under arbitrary dynamics.
Strength and Mechanics of Bonded Scarf Joints for Repair of Composite Materials
NASA Technical Reports Server (NTRS)
Pipes, R. B.; Adkins, D. W.
1982-01-01
Experimental and analytical investigations of scarf joints indicate that slight bluntness of adherend tips induces adhesive stress concentrations which significantly reduce joint strength, and the stress distribution through the adhesive thickness is non-uniform and has significant stress concentrations at the ends of the joint. The laminate stacking sequence can have important effects on the adhesive stress distribution. A significant improvement in joint strength is possible by increasing overlap at the expense of raising the repair slightly above the original surface. Although a surface grinder was used to make most experimental specimens, a hand held rotary bur can make a surprisingly good scarf. Scarf joints wit doublers on one side, such as might be used for repair, bend under tensile loads and may actually be weaker than joints without doublers.
[Tibiotalocalcaneal arthrodesis using a distally introduced femur nail (DFN)].
Grass, René
2005-10-01
Simultaneous arthrodesis of ankle and subtalar joints and, at the same sitting, correction of axial malalignment of hindfoot, treatment of bony defects and of sequelae of circulatory disturbances after multiple previous interventions. Internal stabilization with a short distal femur nail. Restitution of a pain-free weight bearing. Failure of arthrodesis of ankle and subtalar joint causing pain in patients with severely altered bone structures particularly at the level of the talar dome. Malalignment of hind- and/or forefoot after previous arthrodesis of ankle and subtalar joint. Failure of conservative therapy in both above-enumerated conditions. Poor skin or soft-tissue conditions. Reflex sympathetic dystrophy. Acute osteitis/osteomyelitis. Posterolateral approach. Resection of the articular cartilage and the areas of sclerosis of the ankle and of the posterior facet of the subtalar joint. Interposition of bone grafts harvested from the iliac crest. Correction of malalignment of hind- and forefoot. Locked nailing with a short distal femur nail. Fitting of a flexible custom-made arthrodesis boot; weight bearing in boot not exceeding half of body weight until the 8th week. Gait training. After 12 weeks wearing of normal shoes. Radiographs after 6 and 12 weeks. Between February 1, 2002 and September 1, 2003 this technique was performed on 18 feet in 17 patients (three women, 14 men, average age 53 years [38.9-73.7 years]). Average duration of follow-up: 1.2 years (0.6-2.1 years). The goal of surgery was reached in all patients. Subjective assessment: 14 times good, three times satisfactory. Four complications: one loss of nail purchase, one dislocation of locking screw, one breakage of locking bolt, one prolonged bone healing.
Murray, Kelvin J; Le Grande, Michael R; Ortega de Mues, Arantxa; Azari, Michael F
2017-08-01
Degenerative joint disease (DJD) in the lumbar spine is a common condition that is associated with chronic low back pain. Excessive loading of lumbar joints is a risk factor for DJD. Changes in lumbar lordosis significantly redistribute the forces of weight-bearing on the facet joints and the intervertebral discs. However, the relationship between lumbar lordosis and DJD has not been characterized in men and women. We characterised the correlation between standing lumbar lordosis and DJD in standing radiographic images from 301 adult female and male chiropractic patients. DJD was rated using the Kellgren-Lawrence scale, and lordosis was measured using the Cobb angle. Linear and curvilinear correlations were investigated while controlling for age and sex. We found a highly significant curvilinear correlation between lordosis and DJD of the lower lumbar spine in both sexes, but especially in women, irrespective of the effects of age. We found the effect size of lordosis on lower lumbar DJD to be between 17.4 and 18.1% in women and 12.9% in older men. In addition, lordosis of 65 (95% CI 55.3-77.7) and 68 (98% CI 58.7-73.3) degrees were associated with minimal DJD in the lower lumbar spine of women and men respectively, and were therefore considered 'optimal'. This optimal lordotic angle was 73 (95% CI 58.8-87.2) degrees in older men. Both hypo- and hyper-lordosis correlate with DJD in the lumbar spine, particularly in women and in older men. These findings may well be of relevance to spinal pain management and spinal rehabilitation.
ERIC Educational Resources Information Center
Makransky, Guido; Mortensen, Erik Lykke; Glas, Cees A. W.
2013-01-01
Narrowly defined personality facet scores are commonly reported and used for making decisions in clinical and organizational settings. Although these facets are typically related, scoring is usually carried out for a single facet at a time. This method can be ineffective and time consuming when personality tests contain many highly correlated…
NASA Technical Reports Server (NTRS)
1991-01-01
This video discusses how the technology of computer modeling can improve the design and durability of artificial joints for human joint replacement surgery. Also, ultrasound, originally used to detect structural flaws in aircraft, can also be used to quickly assess the severity of a burn patient's injuries, thus aiding the healing process.
Games people play-toward an enactive view of cooperation in social neuroscience.
Engemann, Denis A; Bzdok, Danilo; Eickhoff, Simon B; Vogeley, Kai; Schilbach, Leonhard
2012-01-01
The field of social neuroscience has made considerable progress in unraveling the neural correlates of human cooperation by making use of brain imaging methods. Within this field, neuroeconomic research has drawn on paradigms from experimental economics, such as the Prisoner's Dilemma (PD) and the Trust Game. These paradigms capture the topic of conflict in cooperation, while focusing strongly on outcome-related decision processes. Cooperation, however, does not equate with that perspective, but relies on additional psychological processes and events, including shared intentions and mutually coordinated joint action. These additional facets of cooperation have been successfully addressed by research in developmental psychology, cognitive science, and social philosophy. Corresponding neuroimaging data, however, is still sparse. Therefore, in this paper, we present a juxtaposition of these mutually related but mostly independent trends in cooperation research. We propose that the neuroscientific study of cooperation could benefit from paradigms and concepts employed in developmental psychology and social philosophy. Bringing both to a neuroimaging environment might allow studying the neural correlates of cooperation by using formal models of decision-making as well as capturing the neural responses that underlie joint action scenarios, thus, promising to advance our understanding of the nature of human cooperation.
Epidemiology, Treatment, and Prevention of Lumbar Spine Injuries in Major League Baseball Players.
Camp, Christopher L; Conti, Matthew S; Sgroi, Terrance; Cammisa, Frank P; Dines, Joshua S
2016-01-01
In recent years, increased attention has been paid to injuries occurring in Major League Baseball (MLB) players. Although most of the current orthopedic literature regarding baseball injuries pertains to the shoulder and elbow, lumbar spine injuries are another common reason for time out of play. Back and core injuries may represent as many as 12% of all injuries that result in time out of play from MLB. This high rate of injury is likely related to the critical role that the spine plays in every major baseball-related movement. Linking the upper extremities to the hips and lower extremities, a healthy, strong, and stable spine and core is a prerequisite for performance in all levels of baseball. It has been well documented that baseball players with poor spinal control and stabilization are at increased risk for future injury. Common etiologies of lumbar injuries include stress fractures, muscle injury, annular tears with or without disc herniation, facet joint pain, sacroiliac joint pain, and stenosis. This review discusses the epidemiology of spinal injuries in baseball. Special attention is paid to the role of the spine in baseball-related activities, common injuries, tips for making the correct diagnosis, treatment options, outcomes, rehabilitation, and injury prevention.
Games people play—toward an enactive view of cooperation in social neuroscience
Engemann, Denis A.; Bzdok, Danilo; Eickhoff, Simon B.; Vogeley, Kai; Schilbach, Leonhard
2012-01-01
The field of social neuroscience has made considerable progress in unraveling the neural correlates of human cooperation by making use of brain imaging methods. Within this field, neuroeconomic research has drawn on paradigms from experimental economics, such as the Prisoner's Dilemma (PD) and the Trust Game. These paradigms capture the topic of conflict in cooperation, while focusing strongly on outcome-related decision processes. Cooperation, however, does not equate with that perspective, but relies on additional psychological processes and events, including shared intentions and mutually coordinated joint action. These additional facets of cooperation have been successfully addressed by research in developmental psychology, cognitive science, and social philosophy. Corresponding neuroimaging data, however, is still sparse. Therefore, in this paper, we present a juxtaposition of these mutually related but mostly independent trends in cooperation research. We propose that the neuroscientific study of cooperation could benefit from paradigms and concepts employed in developmental psychology and social philosophy. Bringing both to a neuroimaging environment might allow studying the neural correlates of cooperation by using formal models of decision-making as well as capturing the neural responses that underlie joint action scenarios, thus, promising to advance our understanding of the nature of human cooperation. PMID:22675293
Return to Work After Lumbar Microdiscectomy - Personalizing Approach Through Predictive Modeling.
Papić, Monika; Brdar, Sanja; Papić, Vladimir; Lončar-Turukalo, Tatjana
2016-01-01
Lumbar disc herniation (LDH) is the most common disease among working population requiring surgical intervention. This study aims to predict the return to work after operative treatment of LDH based on the observational study including 153 patients. The classification problem was approached using decision trees (DT), support vector machines (SVM) and multilayer perception (MLP) combined with RELIEF algorithm for feature selection. MLP provided best recall of 0.86 for the class of patients not returning to work, which combined with the selected features enables early identification and personalized targeted interventions towards subjects at risk of prolonged disability. The predictive modeling indicated at the most decisive risk factors in prolongation of work absence: psychosocial factors, mobility of the spine and structural changes of facet joints and professional factors including standing, sitting and microclimate.
Fundamental Principles of Tremor Propagation in the Upper Limb.
Davidson, Andrew D; Charles, Steven K
2017-04-01
Although tremor is the most common movement disorder, there exist few effective tremor-suppressing devices, in part because the characteristics of tremor throughout the upper limb are unknown. To clarify, optimally suppressing tremor requires a knowledge of the mechanical origin, propagation, and distribution of tremor throughout the upper limb. Here we present the first systematic investigation of how tremor propagates between the shoulder, elbow, forearm, and wrist. We simulated tremor propagation using a linear, time-invariant, lumped-parameter model relating joint torques and the resulting joint displacements. The model focused on the seven main degrees of freedom from the shoulder to the wrist and included coupled joint inertia, damping, and stiffness. We deliberately implemented a simple model to focus first on the most basic effects. Simulating tremorogenic joint torque as a sinusoidal input, we used the model to establish fundamental principles describing how input parameters (torque location and frequency) and joint impedance (inertia, damping, and stiffness) affect tremor propagation. We expect that the methods and principles presented here will serve as the groundwork for future refining studies to understand the origin, propagation, and distribution of tremor throughout the upper limb in order to enable the future development of optimal tremor-suppressing devices.
Fundamental Principles of Tremor Propagation in the Upper Limb
Davidson, Andrew D.; Charles, Steven K.
2017-01-01
Although tremor is the most common movement disorder, there exist few effective tremor-suppressing devices, in part because the characteristics of tremor throughout the upper limb are unknown. To clarify, optimally suppressing tremor requires a knowledge of the mechanical origin, propagation, and distribution of tremor throughout the upper limb. Here we present the first systematic investigation of how tremor propagates between the shoulder, elbow, forearm, and wrist. We simulated tremor propagation using a linear, time-invariant, lumped-parameter model relating joint torques and the resulting joint displacements. The model focused on the seven main degrees of freedom from the shoulder to the wrist and included coupled joint inertia, damping, and stiffness. We deliberately implemented a simple model to focus first on the most basic effects. Simulating tremorogenic joint torque as a sinusoidal input, we used the model to establish fundamental principles describing how input parameters (torque location and frequency) and joint impedance (inertia, damping, and stiffness) affect tremor propagation. We expect that the methods and principles presented here will serve as the groundwork for future refining studies to understand the origin, propagation, and distribution of tremor throughout the upper limb in order to enable the future development of optimal tremor-suppressing devices. PMID:27957608
The microstructure and magnetic properties of melt-spun Fe 76Nd 16B 8 magnetic materials
NASA Astrophysics Data System (ADS)
Hadjipanayis, G. C.; Dickenson, R. C.; Lawless, K. R.
1986-02-01
The origin of magnetic hardening has been examined in melt-spun Fe 76Nd 16B 8 samples heat-treated at around 700°C. Microstructure studies show the same phases as in sintered magnets consisting of Fe 14Nd 2B, Fe 4NdB 4 and two high-Nd content phases. These phases exist in both equiaxed and faceted crystallites of submicron size. Lorentz microscopy shows domain walls which end at grain boundaries indicating that they are pinned there.
Shang, Yang; Sun, Du; Shao, Yiming; Zhang, Dongfeng; Guo, Lin; Yang, Shihe
2012-11-05
Cutting edge: A Cu(2)O jagged polyhedron, with numerous {110} edges and {111} corners, has been developed through a top-down selective oxidative etching process at the expense of the original {111} facet (see figure). The as-prepared nanocrystals exhibited higher photocatalytic activities for the degradation of methylene orange, which may be primarily ascribed to the increased edges and corners. Copyright © 2012 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Bruijnen, Stefan T G; Verweij, Nicki J F; van Duivenvoorde, Leonie M; Bravenboer, Nathalie; Baeten, Dominique L P; van Denderen, Christiaan J; van der Horst-Bruinsma, Irene E; Voskuyl, Alexandre E; Custers, Martijn; van de Ven, Peter M; Bot, Joost C J; Boden, Bouke J H; Lammertsma, Adriaan A; Hoekstra, Otto S H; Raijmakers, Pieter G H M; van der Laken, Conny J
2018-01-01
Abstract Objectives Excessive bone formation is an important hallmark of AS. Recently it has been demonstrated that axial bony lesions in AS patients can be visualized using 18F-fluoride PET-CT. The aim of this study was to assess whether 18F-fluoride uptake in clinically active AS patients is related to focal bone formation in spine biopsies and is sensitive to change during anti-TNF treatment. Methods Twelve anti-TNF-naïve AS patients [female 7/12; age 39 years (SD 11); BASDAI 5.5 ± 1.1] were included. 18 F-fluoride PET-CT scans were performed at baseline and in two patients, biopsies were obtained from PET-positive and PET-negative spine lesions. The remaining 10 patients underwent a second 18F-fluoride PET-CT scan after 12 weeks of anti-TNF treatment. PET scans were scored visually by two blinded expert readers. In addition, 18F-fluoride uptake was quantified using the standardized uptake value corrected for individual integrated whole blood activity concentration (SUVAUC). Clinical response to anti-TNF was defined according to a ⩾ 20% improvement in Assessment of SpondyloArthritis international Society criteria at 24 weeks. Results At baseline, all patients showed at least one axial PET-positive lesion. Histological analysis of PET-positive lesions in the spine confirmed local osteoid formation. PET-positive lesions were found in the costovertebral joints (43%), facet joints (23%), bridging syndesmophytes (20%) and non-bridging vertebral lesions (14%) and in SI joints (75%). After 12 weeks of anti-TNF treatment, 18F-fluoride uptake in clinical responders decreased significantly in the costovertebral (mean SUVAUC −1.0; P < 0.001) and SI joints (mean SUVAUC −1.2; P = 0.03) in contrast to non-responders. Conclusions 18F-fluoride PET-CT identified bone formation, confirmed by histology, in the spine and SI joints of AS patients and demonstrated alterations in bone formation during anti-TNF treatment. PMID:29329443
Bruijnen, Stefan T G; Verweij, Nicki J F; van Duivenvoorde, Leonie M; Bravenboer, Nathalie; Baeten, Dominique L P; van Denderen, Christiaan J; van der Horst-Bruinsma, Irene E; Voskuyl, Alexandre E; Custers, Martijn; van de Ven, Peter M; Bot, Joost C J; Boden, Bouke J H; Lammertsma, Adriaan A; Hoekstra, Otto S H; Raijmakers, Pieter G H M; van der Laken, Conny J
2018-04-01
Excessive bone formation is an important hallmark of AS. Recently it has been demonstrated that axial bony lesions in AS patients can be visualized using 18F-fluoride PET-CT. The aim of this study was to assess whether 18F-fluoride uptake in clinically active AS patients is related to focal bone formation in spine biopsies and is sensitive to change during anti-TNF treatment. Twelve anti-TNF-naïve AS patients [female 7/12; age 39 years (SD 11); BASDAI 5.5 ± 1.1] were included. 18 F-fluoride PET-CT scans were performed at baseline and in two patients, biopsies were obtained from PET-positive and PET-negative spine lesions. The remaining 10 patients underwent a second 18F-fluoride PET-CT scan after 12 weeks of anti-TNF treatment. PET scans were scored visually by two blinded expert readers. In addition, 18F-fluoride uptake was quantified using the standardized uptake value corrected for individual integrated whole blood activity concentration (SUVAUC). Clinical response to anti-TNF was defined according to a ⩾ 20% improvement in Assessment of SpondyloArthritis international Society criteria at 24 weeks. At baseline, all patients showed at least one axial PET-positive lesion. Histological analysis of PET-positive lesions in the spine confirmed local osteoid formation. PET-positive lesions were found in the costovertebral joints (43%), facet joints (23%), bridging syndesmophytes (20%) and non-bridging vertebral lesions (14%) and in SI joints (75%). After 12 weeks of anti-TNF treatment, 18F-fluoride uptake in clinical responders decreased significantly in the costovertebral (mean SUVAUC -1.0; P < 0.001) and SI joints (mean SUVAUC -1.2; P = 0.03) in contrast to non-responders. 18F-fluoride PET-CT identified bone formation, confirmed by histology, in the spine and SI joints of AS patients and demonstrated alterations in bone formation during anti-TNF treatment.
Re-exploration of the lumbar spine following simple discectomy: a review of 23 cases.
Shiraishi, T; Crock, H V
1995-01-01
A retrospective study of 23 patients is presented, all of whom complained of recurrent symptoms of back and leg pain following simple discectomy. Five patients (22%) had been refused further surgery by the original surgeon on the grounds that they were psychologically disturbed. On examining the clinical records, 18 patients were reported to have had frank disc prolapses found at operation. In 5 cases, disc tissues were removed even though disc prolapses had not been demonstrated. Among the 18 patients in whom disc prolapses had been removed at their first operations, we found recurrent prolapses at reoperation in only 2 of them (11%). We treated 19 of these patients by nerve root canal and foraminal decompressions and 4 by anterior lumbar interbody fusion operations. The mean follow-up period was 34 months. Satisfactory relief of symptoms was achieved in 21 cases. In the published literature, even after the advent of CT and MRI, the incidence of recurrent disc prolapse at reoperation varies markedly from author to author. The reasons for these differences are discussed. They appear to relate to three factors: 1. failure to differentiate acute disc prolapse from annular bulging which develops and is inevitably associated with disc space narrowing; 2. difficulty in distinguishing between MRI findings of scar tissue enhancement and local perineural oedema due to persisting foraminal and nerve root canal stenosis; 3. failure to identify the existence of foraminal stenosis, which is sometimes demonstrated only in oblique plain X-rays showing facet hypertrophy and subluxations of zygapophyseal joints.(ABSTRACT TRUNCATED AT 250 WORDS)
Boyer, Doug M; Seiffert, Erik R
2013-07-01
A laterally sloping fibular facet of the astragalus (=talus) has been proposed as one of few osteological synapomorphies of strepsirrhine primates, but the feature has never been comprehensively quantified. We describe a method for calculating fibular facet orientation on digital models of astragali as the angle between the planes of the fibular facet and the lateral tibial facet. We calculated this value in a sample that includes all major extant primate clades, a diversity of Paleogene primates, and nonprimate euarchontans (n = 304). Results show that previous characterization of a divide between extant haplorhines and strepsirrhines is accurate, with little overlap even when individual data points are considered. Fibular facet orientation is conserved in extant strepsirrhines despite major differences in locomotion and body size, while extant anthropoids are more variable (e.g., low values for catarrhines relative to non-callitrichine platyrrhines). Euprimate outgroups exhibit a mosaic of character states with Cynocephalus having a more obtuse strepsirrhine-like facet and sampled treeshrews and plesiadapiforms having more acute haplorhine-like facets. Surprisingly, the earliest species of the adapiform Cantius have steep haplorhine-like facets as well. We used a Bayesian approach to reconstruct the evolution of fibular facet orientation as a continuous character across a supertree of living and extinct primates. Mean estimates for crown Primatomorpha (97.9°), Primates (99.5°), Haplorhini (98.7°), and Strepsirrhini (108.2°) support the hypothesis that the strepsirrhine condition is derived, while lower values for crown Anthropoidea (92.8°) and Catarrhini (88.9°) are derived in the opposite direction. Copyright © 2013 Wiley Periodicals, Inc.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zhang, Qingfeng; Han, Lili; Jing, Hao
While great success has been achieved in fine-tuning the aspect ratios and thereby the plasmon resonances of cylindrical Au nanorods, facet control with atomic level precision on the highly curved nanorod surfaces has long been a significantly more challenging task. The intrinsic structural complexity and lack of precise facet control of the nanorod surfaces remain the major obstacles for the atomic-level elucidation of the structure–property relationships that underpin the intriguing catalytic performance of Au nanorods. Here we demonstrate that the facets of single-crystalline Au nanorods can be precisely tailored using cuprous ions and cetyltrimethylammonium bromide as a unique pair ofmore » surface capping competitors to guide the particle geometry evolution during nanorod overgrowth. By deliberately maneuvering the competition between cuprous ions and cetyltrimethylammonium bromide, we have been able to create, in a highly controllable and selective manner, an entire family of nanorod-derived anisotropic multifaceted geometries whose surfaces are enclosed by specific types of well-defined high-index and low-index facets. This facet-controlled nanorod overgrowth approach also allows us to fine-tune the particle aspect ratios while well-preserving all the characteristic facets and geometric features of the faceted Au nanorods. Furthermore, taking full advantage of the combined structural and plasmonic tunability, we have further studied the facet-dependent heterogeneous catalysis on well-faceted Au nanorods using surface-enhanced Raman spectroscopy as an ultrasensitive spectroscopic tool with unique time-resolving and molecular finger-printing capabilities.« less
Technical Design Report for the FACET-II Project at SLAC National Accelerator Laboratory
DOE Office of Scientific and Technical Information (OSTI.GOV)
None, None
Electrons can “surf” on waves of plasma – a hot gas of charged particles – gaining very high energies in very short distances. This approach, called plasma wakefield acceleration, has the potential to dramatically shrink the size and cost of particle accelerators. Research at the SLAC National Accelerator Laboratory has demonstrated that plasmas can provide 1,000 times the acceleration in a given distance compared with current technologies. Developing revolutionary and more efficient acceleration techniques that allow for an affordable high-energy collider has been the focus of FACET, a National User Facility at SLAC. FACET used part of SLAC’s two-mile-long linearmore » accelerator to generate high-density beams of electrons and their antimatter counterparts, positrons. Research into plasma wakefield acceleration was the primary motivation for constructing FACET. In April 2016, FACET operations came to an end to make way for the second phase of SLAC’s x-ray laser, the LCLS-II, which will use part of the tunnel occupied by FACET. FACET-II is a new test facility to provide the unique capability to develop advanced acceleration and coherent radiation techniques with high-energy electron and positron beams. FACET-II represents a major upgrade over current FACET capabilities and the breadth of the potential research program makes it truly unique.« less
Optimization and Control of Burning Plasmas Through High Performance Computing
DOE Office of Scientific and Technical Information (OSTI.GOV)
Pankin, Alexei
This project has revived the FACETS code, that has been developed under SciDAC fund- ing in 2008-2012. The code has been dormant for a number of years after the SciDAC funding stopped. FACETS depends on external packages. The external packages and libraries such as PETSc, FFTW, HDF5 and NETCDF that are included in FACETS have evolved during these years. Some packages in FACETS are also parts of other codes such as PlasmaState, NUBEAM, GACODES, and UEDGE. These packages have been also evolved together with their host codes which include TRANSP, TGYRO and XPTOR. Finally, there is also a set ofmore » packages in FACETS that are being developed and maintained by Tech-X. These packages include BILDER, SciMake, and FcioWrappers. Many of these packages evolved significantly during the last several years and FACETS had to be updated to synchronize with the re- cent progress in the external packages. The PI has introduced new changes to the BILDER package to support the updated interfaces to the external modules. During the last year of the project, the FACETS version of the UEDGE code has been extracted from FACETS as a standalone package. The PI collaborates with the scientists from LLNL on the updated UEDGE model in FACETS. Drs. T. Rognlien, M. Umansky and A. Dimits from LLNL are contributing to this task.« less
Long-Term Developmental Changes in Children's Lower-Order Big Five Personality Facets.
de Haan, Amaranta; De Pauw, Sarah; van den Akker, Alithe; Deković, Maja; Prinzie, Peter
2017-10-01
This study examined long-term developmental changes in mother-rated lower-order facets of children's Big Five dimensions. Two independent community samples covering early childhood (2-4.5 years; N = 365, 39% girls) and middle childhood to the end of middle adolescence (6-17 years; N = 579, 50% girls) were used. All children had the Belgian nationality. Developmental changes were examined using cohort-sequential latent growth modeling on the 18 facets of the Hierarchical Personality Inventory for Children. In early childhood, changes were mostly similar across child gender. Between 2 and 4.5 years, several facets showed mean-level stability; others changed in the direction of less Extraversion and Emotional Stability, and more Benevolence and Imagination. The lower-order facets of Conscientiousness showed opposite changes. Gender differences became more apparent from middle childhood onward for facets of all dimensions except Imagination, for which no gender differences were found. Between 6 and 17 years, same-dimension facets showed different shapes of growth. Facets that changed linearly changed mostly in the direction of less Extraversion, Benevolence, Conscientiousness, Emotional Stability, and Imagination. Changes in facets for which nonlinear growth was found generally moved in direction or magnitude during developmental transitions. This study provides comprehensive, fine-grained knowledge about personality development during the first two decades of life. © 2016 Wiley Periodicals, Inc.
NASA Astrophysics Data System (ADS)
Zhang, Yuxuan; Zeng, Wen; Ye, Hong; Li, Yanqiong
2018-06-01
In the present study, crystal-facet-dependent gas sensing performance was thoroughly investigated and sensing mechanism of TiO2 was elaborated in depth. Anatase TiO2 nano-polyhedron with highly reactive (0 0 1) facet was successfully synthesized via a one-pot hydrothermal method using fluoride as facet stabilizer and was utilized for fabrication of carbon monoxide gas sensors, followed by characterization of microstructure, phase-purity and gas-sensing properties. Chemiresistive properties of (0 0 1)-dominated gas sensor exhibit superior response to CO with a maximum response of 27.9 at 300 ppm in optimum working temperature as 350 °C. Particularly, first-principle calculation was carried out to expound the sensing mechanism, which shows that CO adsorption on (0 0 1) facet is more stable and favorable than that on normally exposed (1 0 1) facet, corroborating the reactive nature of (0 0 1) facet.
Jacobs, Ingo; Wollny, Anna; Sim, Chu-Won; Horsch, Antje
2016-06-01
In the present study, we tested a serial mindfulness facets-trait emotional intelligence (TEI)-emotional distress-multiple health behaviors mediation model in a sample of N = 427 German-speaking occupational therapists. The mindfulness facets-TEI-emotional distress section of the mediation model revealed partial mediation for the mindfulness facets Act with awareness (Act/Aware) and Accept without judgment (Accept); inconsistent mediation was found for the Describe facet. The serial two-mediator model included three mediational pathways that may link each of the four mindfulness facets with multiple health behaviors. Eight out of 12 indirect effects reached significance and fully mediated the links between Act/Aware and Describe to multiple health behaviors; partial mediation was found for Accept. The mindfulness facet Observe was most relevant for multiple health behaviors, but its relation was not amenable to mediation. Implications of the findings will be discussed. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.
Facet Annotation by Extending CNN with a Matching Strategy.
Wu, Bei; Wei, Bifan; Liu, Jun; Guo, Zhaotong; Zheng, Yuanhao; Chen, Yihe
2018-06-01
Most community question answering (CQA) websites manage plenty of question-answer pairs (QAPs) through topic-based organizations, which may not satisfy users' fine-grained search demands. Facets of topics serve as a powerful tool to navigate, refine, and group the QAPs. In this work, we propose FACM, a model to annotate QAPs with facets by extending convolution neural networks (CNNs) with a matching strategy. First, phrase information is incorporated into text representation by CNNs with different kernel sizes. Then, through a matching strategy among QAPs and facet label texts (FaLTs) acquired from Wikipedia, we generate similarity matrices to deal with the facet heterogeneity. Finally, a three-channel CNN is trained for facet label assignment of QAPs. Experiments on three real-world data sets show that FACM outperforms the state-of-the-art methods.
NASA Astrophysics Data System (ADS)
Sakaki, Atsushi; Funato, Mitsuru; Kawamura, Tomoaki; Araki, Jun; Kawakami, Yoichi
2018-03-01
Synchrotron radiation (SR) X-ray diffraction with a sub-µm spatial resolution is used to nondestructively evaluate the local thickness and alloy composition of three-dimensionally faceted InGaN/GaN quantum wells (QWs). The (0001) facet QW on a trapezoidal structure composed of (0001), \\{ 11\\bar{2}2\\} , and \\{ 11\\bar{2}0\\} facets is nonuniform, most likely owing to the migration of adatoms between facets. The thickness and composition markedly vary within a short distance for the \\{ 11\\bar{2}2\\} facet QW of another pyramidal structure. The QW parameters acquired by SR microbeam X-ray diffraction reproduce the local emission property assessed by cathodoluminescence, thereby indicating the high reliability of this method.
ERIC Educational Resources Information Center
Wang, Ning; Stahl, John
2012-01-01
This article discusses the use of the Many-Facets Rasch Model, via the FACETS computer program (Linacre, 2006a), to scale job/practice analysis survey data as well as to combine multiple rating scales into single composite weights representing the tasks' relative importance. Results from the Many-Facets Rasch Model are compared with those…
Evolution of triangular topographic facets along active normal faults
NASA Astrophysics Data System (ADS)
Balogun, A.; Dawers, N. H.; Gasparini, N. M.; Giachetta, E.
2011-12-01
Triangular shaped facets, which are generally formed by the erosion of fault - bounded mountain ranges, are arguably one of the most prominent geomorphic features on active normal fault scarps. Some previous studies of triangular facet development have suggested that facet size and slope exhibit a strong linear dependency on fault slip rate, thus linking their growth directly to the kinematics of fault initiation and linkage. Other studies, however, generally conclude that there is no variation in triangular facet geometry (height and slope) with fault slip rate. The landscape of the northeastern Basin and Range Province of the western United States provides an opportunity for addressing this problem. This is due to the presence of well developed triangular facets along active normal faults, as well as spatial variations in fault scale and slip rate. In addition, the Holocene climatic record for this region suggests a dominant tectonic regime, as the faulted landscape shows little evidence of precipitation gradients associated with tectonic uplift. Using GIS-based analyses of USGS 30 m digital elevation data (DEMs) for east - central Idaho and southwestern Montana, we analyze triangular facet geometries along fault systems of varying number of constituent segments. This approach allows us to link these geometries with established patterns of along - strike slip rate variation. For this study, we consider major watersheds to include only catchments with upstream and downstream boundaries extending from the drainage divide to the mapped fault trace, respectively. In order to maintain consistency in the selection criteria for the analyzed triangular facets, only facets bounded on opposite sides by major watersheds were considered. Our preliminary observations reflect a general along - strike increase in the surface area, average slope, and relief of triangular facets from the tips of the fault towards the center. We attribute anomalies in the along - strike geometric measurements of the triangular facets to represent possible locations of fault segment linkage associated with normal fault evolution.
A New Sensor for Measurement of Dynamic Contact Stress in the Hip
Rudert, M. J.; Ellis, B. J.; Henak, C. R.; Stroud, N. J.; Pederson, D. R.; Weiss, J. A.; Brown, T. D.
2014-01-01
Various techniques exist for quantifying articular contact stress distributions, an important class of measurements in the field of orthopaedic biomechanics. In situations where the need for dynamic recording has been paramount, the approach of preference has involved thin-sheet multiplexed grid-array transducers. To date, these sensors have been used to study contact stresses in the knee, shoulder, ankle, wrist, and spinal facet joints. Until now, however, no such sensor had been available for the human hip joint due to difficulties posed by the deep, bi-curvilinear geometry of the acetabulum. We report here the design and development of a novel sensor capable of measuring dynamic contact stress in human cadaveric hip joints (maximum contact stress of 20 MPa and maximum sampling rate 100 readings/s). Particular emphasis is placed on issues concerning calibration, and on the effect of joint curvature on the sensor's performance. The active pressure-sensing regions of the sensors have the shape of a segment of an annulus with a 150-deg circumferential span, and employ a polar/circumferential “ring-and-spoke” sensel grid layout. There are two sensor sizes, having outside radii of 44 and 48 mm, respectively. The new design was evaluated in human cadaver hip joints using two methods. The stress magnitudes and spatial distribution measured by the sensor were compared to contact stresses measured by pressure sensitive film during static loading conditions that simulated heel strike during walking and stair climbing. Additionally, the forces obtained by spatial integration of the sensor contact stresses were compared to the forces measured by load cells during the static simulations and for loading applied by a dynamic hip simulator. Stress magnitudes and spatial distribution patterns obtained from the sensor versus from pressure sensitive film exhibited good agreement. The joint forces obtained during both static and dynamic loading were within ±10% and ±26%, respectively, of the forces measured by the load cells. These results provide confidence in the measurements obtained by the sensor. The new sensor's real-time output and dynamic measurement capabilities hold significant advantages over static measurements from pressure sensitive film. PMID:24763632
A new sensor for measurement of dynamic contact stress in the hip.
Rudert, M J; Ellis, B J; Henak, C R; Stroud, N J; Pederson, D R; Weiss, J A; Brown, T D
2014-03-01
Various techniques exist for quantifying articular contact stress distributions, an important class of measurements in the field of orthopaedic biomechanics. In situations where the need for dynamic recording has been paramount, the approach of preference has involved thin-sheet multiplexed grid-array transducers. To date, these sensors have been used to study contact stresses in the knee, shoulder, ankle, wrist, and spinal facet joints. Until now, however, no such sensor had been available for the human hip joint due to difficulties posed by the deep, bi-curvilinear geometry of the acetabulum. We report here the design and development of a novel sensor capable of measuring dynamic contact stress in human cadaveric hip joints (maximum contact stress of 20 MPa and maximum sampling rate 100 readings/s). Particular emphasis is placed on issues concerning calibration, and on the effect of joint curvature on the sensor's performance. The active pressure-sensing regions of the sensors have the shape of a segment of an annulus with a 150-deg circumferential span, and employ a polar/circumferential "ring-and-spoke" sensel grid layout. There are two sensor sizes, having outside radii of 44 and 48 mm, respectively. The new design was evaluated in human cadaver hip joints using two methods. The stress magnitudes and spatial distribution measured by the sensor were compared to contact stresses measured by pressure sensitive film during static loading conditions that simulated heel strike during walking and stair climbing. Additionally, the forces obtained by spatial integration of the sensor contact stresses were compared to the forces measured by load cells during the static simulations and for loading applied by a dynamic hip simulator. Stress magnitudes and spatial distribution patterns obtained from the sensor versus from pressure sensitive film exhibited good agreement. The joint forces obtained during both static and dynamic loading were within ±10% and ±26%, respectively, of the forces measured by the load cells. These results provide confidence in the measurements obtained by the sensor. The new sensor's real-time output and dynamic measurement capabilities hold significant advantages over static measurements from pressure sensitive film.
Facet-Selective Epitaxy of Compound Semiconductors on Faceted Silicon Nanowires.
Mankin, Max N; Day, Robert W; Gao, Ruixuan; No, You-Shin; Kim, Sun-Kyung; McClelland, Arthur A; Bell, David C; Park, Hong-Gyu; Lieber, Charles M
2015-07-08
Integration of compound semiconductors with silicon (Si) has been a long-standing goal for the semiconductor industry, as direct band gap compound semiconductors offer, for example, attractive photonic properties not possible with Si devices. However, mismatches in lattice constant, thermal expansion coefficient, and polarity between Si and compound semiconductors render growth of epitaxial heterostructures challenging. Nanowires (NWs) are a promising platform for the integration of Si and compound semiconductors since their limited surface area can alleviate such material mismatch issues. Here, we demonstrate facet-selective growth of cadmium sulfide (CdS) on Si NWs. Aberration-corrected transmission electron microscopy analysis shows that crystalline CdS is grown epitaxially on the {111} and {110} surface facets of the Si NWs but that the Si{113} facets remain bare. Further analysis of CdS on Si NWs grown at higher deposition rates to yield a conformal shell reveals a thin oxide layer on the Si{113} facet. This observation and control experiments suggest that facet-selective growth is enabled by the formation of an oxide, which prevents subsequent shell growth on the Si{113} NW facets. Further studies of facet-selective epitaxial growth of CdS shells on micro-to-mesoscale wires, which allows tuning of the lateral width of the compound semiconductor layer without lithographic patterning, and InP shell growth on Si NWs demonstrate the generality of our growth technique. In addition, photoluminescence imaging and spectroscopy show that the epitaxial shells display strong and clean band edge emission, confirming their high photonic quality, and thus suggesting that facet-selective epitaxy on NW substrates represents a promising route to integration of compound semiconductors on Si.
Temporary Percutaneous Instrumentation and Selective Anterior Fusion for Thoracolumbar Fractures.
Charles, Yann Philippe; Walter, Axel; Schuller, Sébastien; Steib, Jean-Paul
2017-05-01
Prospective clinical trial in thoracolumbar trauma with 5-year follow-up. To analyze clinical and radiographic outcomes of minimal invasive surgery, and the rational of circumferential fracture treatment with regard to age, degenerative changes, bone mineral density, and global sagittal balance. Non-neurologic fractures with anterior column defect can be treated by posterior percutaneous instrumentation and selective anterior fusion. After consolidation, instrumentation can be removed at 1 year to provide mobility in non-fused segments. Fifty-one patients, 47 (18-75) years, were operated for A2, A3, or B-type fractures. Visual analog scale (VAS) for back pain and Oswestry Disability Index (ODI) were assessed. Radiographic measurements were: sagittal index, regional kyphosis, T4-T12 kyphosis, L1-S1 lordosis, pelvic incidence, pelvic tilt, sacral slope, and T9 tilt. Anterior fusion and facet joints were analyzed on computed tomography (CT) at 1 year. The ODI was 8.8 before accident, 35.4 at 3 months, 17.8 at 2 years, 14.4 at 5 years. The VAS was 2.0 at 3 months and 1.0 at 5 years. The sagittal index was 18.0° preoperatively and 1.0° at 3 months (P < 0.0001). A loss of reduction of 1.1° occurred after implant removal (P = 0.009). Global sagittal balance remained unchanged. Ten patients with osteopenia or osteoporosis had a worse ODI: 24.7 versus 11.9 (P = 0.016), and a greater loss of correction: 4.9° versus 1.3° (P = 0.007). Cages filled with cancellous bone from the fractured vertebra fused regularly. Spontaneous facet joint fusions were observed in two patients at the fracture level in B-type injuries. Percutaneous instrumentation and selective anterior fusion using autologous bone and mesh cages lead to high fusion rates, which provided good long-term clinical results in younger patients with thoracolumbar fractures. Sagittal alignment was maintained after instrumentation removal without damaging paravertebral muscles. Outcomes were worse in elderly patients presenting osteopenia or osteoporosis. 3.
Injection therapy for subacute and chronic low back pain: an updated Cochrane review.
Staal, J Bart; de Bie, Rob A; de Vet, Henrica C W; Hildebrandt, Jan; Nelemans, Patty
2009-01-01
A systematic review of randomized controlled trials (RCTs). To determine if injection therapy is more effective than placebo or other treatments for patients with subacute or chronic low back pain. The effectiveness of injection therapy for low back pain is still debatable. Heterogeneity of target tissue, pharmacological agent, and dosage, generally found in RCTs, point to the need for clinically valid comparisons in a literature synthesis. We updated the search of the earlier systematic review and searched the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE databases up to March 2007 for relevant trials reported in English, French, German, Dutch, and Nordic languages. We also screened references from trials identified. RCTs on the effects of injection therapy involving epidural, facet, or local sites for subacute or chronic low back pain were included. Studies that compared the effects of intradiscal injections, prolotherapy, or ozone therapy with other treatments were excluded unless injection therapy with another pharmaceutical agent (no placebo treatment) was part of one of the treatment arms. Studies about injections in sacroiliac joints and studies evaluating the effects of epidural steroids for radicular pain were also excluded. Eighteen trials (1179 participants) were included in this review. The injection sites varied from epidural sites and facet joints (i.e. intra-articular injections, peri-articular injections and nerve blocks) to local sites (i.e. tender-and trigger points). The drugs that were studied consisted of corticosteroids, local anesthetics, and a variety of other drugs. The methodologic quality of the trials was limited with 10 of 18 trials rated as having a high methodologic quality. Statistical pooling was not possible because of clinical heterogeneity in the trials. Overall, the results indicated that there is no strong evidence for or against the use of any type of injection therapy. There is insufficient evidence to support the use of injection therapy in subacute and chronic low-back pain. However, it cannot be ruled out that specific subgroups of patients may respond to a specific type of injection therapy.
Baraliakos, Xenofon; Heldmann, Frank; Callhoff, Johanna; Suppiah, Ravi; McQueen, Fiona Marion; Krause, Dietmar; Klink, Claudia; Schmitz-Bortz, Elmar; Igelmann, Manfred; Kalthoff, Ludwig; Kiltz, Uta; Schmuedderich, Anna; Braun, Juergen
2016-12-01
Neck pain is common in rheumatoid arthritis (RA) and ankylosing spondylitis (AS). We investigated the correlation of bone marrow edema (BME) on magnetic resonance imaging (MRI) in RA and AS and its association with clinical complaints of neck pain. Cervical spine short-tau inversion recovery-MRI and T1w-MRI of 34 patients with RA and 6 patients with AS complaining about neck pain were obtained. Clinical and laboratory data were available. BME was scored by 2 blinded readers using a modification of a published score, including various cervical sites. Degenerative changes were also quantified. Patients were predominantly women (82.5%), and mean ± SD age was 57.5 ± 11.8 years, C-reactive protein (CRP) was 0.8 ± 1.3 mg/dl, and pain score was 46.0 ± 17.5. BME was detected in 24/40 patients (60%) involving the atlantoaxial region (21%), vertebral bodies (75%), facet joints (29%), and spinous processes (46%). Degenerative changes were identified in 21/40 patients (52.5%), 13 (62%) of whom also had BME in vertebral bodies. No differences were found between patients with versus without cervical BME for clinical assessments: numeric rating scale pain (median ± interquartile range) 5.5 ± 3.0 vs 6.0 ± 4.0 (p = 0.69), Funktionsfragebogen Hannover 68.2 ± 41.0 vs 42.0 ± 55.5 (p = 0.19), Northwick pain score 44.4 ± 21.8 vs 47.2 ± 27.0 (p = 0.83), or CRP 0.40 ± 0.80 vs 0.60 ± 0.66 (p = 0.94). For patients with degenerative changes, symptom duration was longer than for patients without (10 ± 12.5 vs 5.0 ± 18.0 yrs, p = 0.73). In this small study of patients with RA and AS complaining about neck pain, BME was found in many different cervical sites, including the facet joints and the spinous processes. However, the occurrence and severity of BME did not correlate with the severity of neck pain.
Faceted ceramic fibers, tapes or ribbons and epitaxial devices therefrom
Goyal, Amit [Knoxville, TN
2012-07-24
A crystalline article includes a single-crystal ceramic fiber, tape or ribbon. The fiber, tape or ribbon has at least one crystallographic facet along its length, which is generally at least one meter long. In the case of sapphire, the facets are R-plane, M-plane, C-plane or A-plane facets. Epitaxial articles, including superconducting articles, can be formed on the fiber, tape or ribbon.
Faceted ceramic fibers, tapes or ribbons and epitaxial devices therefrom
Goyal, Amit
2013-07-09
A crystalline article includes a single-crystal ceramic fiber, tape or ribbon. The fiber, tape or ribbon has at least one crystallographic facet along its length, which is generally at least one meter long. In the case of sapphire, the facets are R-plane, M-plane, C-plane or A-plane facets. Epitaxial articles, including superconducting articles, can be formed on the fiber, tape or ribbon.
Sensing landscape history with an interactive location based service.
van Lammeren, Ron; Goossen, Martin; Roncken, Paul
2009-01-01
This paper introduces the STEAD approach for interpreting data acquired by a "human sensor", who uses an informal interactive location-based service (iLBS) to sense cultural-historic facts and anecdotes of, and in the landscape. This user-generated data is collected outdoors and in situ. The approach consists of four related facets (who, what, where, when). Three of the four facets are discussed and illustrated by user generated data collected during a Dutch survey in 2008. These data represent the personal cultural-historic knowledge and anecdotes of 150 people using a customized iLBS for experiencing the cultural history of a landscape. The "who" facet shows three dominant mentality groups (cosmopolitans, modern materialists and post modern hedonists) that generated user content. The "what" facet focuses on three subject types of pictures and four picture framing classes. Pictures of the place type showed to be dominant and foreground framing class was slightly favourite. The "where" facet is explored via density, distribution, and distance of the pictures made. The illustrations of the facets indirectly show the role of the "human sensor" with respect to the domain of interest. The STEAD approach needs further development of the when-facet and of the relations between the four facets. Finally the results of the approach may support data archives of iLBS applications.
White matter correlates of psychopathic traits in a female community sample
Budhiraja, Meenal; Westerman, Johan; Savic, Ivanka; Jokinen, Jussi; Tiihonen, Jari; Hodgins, Sheilagh
2017-01-01
Abstract Psychopathy comprises interpersonal, affective, lifestyle and antisocial facets that vary dimensionally in the population and are associated with criminal offending and adverse psychosocial outcomes. Evidence associating these facets with white matter microstructure of the uncinate fasciculus and the cingulum tracts is inconsistent and derives principally from studies of male offenders. In a sample of 99 young women presenting a range of scores on the Psychopathy Checklist: Screening Version, we used Diffusion Tensor Imaging, tractography and Tract-Based Spatial Statistics to investigate microstructure across the brain and of the uncinate fasciculus and cingulum. Right uncinate fasciculus microstructure was negatively associated with the interpersonal facet, while cingulum integrity was not associated with any facet of psychopathy. Whole-brain analyses revealed that both affective and lifestyle facets were negatively correlated with white matter microstructure adjacent to the fusiform gyrus, and the interpersonal facet correlated negatively with the integrity of the fornix. Findings survived adjustment for the other facet scores, and age, verbal and performance IQ. A similar negative association between the interpersonal facet and uncinate fasciculus integrity was previously observed in male offenders. Thus, previous evidence showing that psychopathic traits are associated with functional and structural abnormalities within limbic networks may also apply to females. PMID:28992269
Federal Register 2010, 2011, 2012, 2013, 2014
2011-04-18
... DEPARTMENT OF TRANSPORTATION ITS Joint Program Office; Vehicle to Infrastructure Core System... Program Office (ITS JPO) will host a free public meeting to discuss the Vehicle to Infrastructure (V2I... to work originally performed under the Vehicle Infrastructure Integration Proof of Concept (VII POC...
Leroy, S; Grenier, J; Rohe, D; Even, C; Pieranski, P
2006-05-01
From experiments with metal crystals, in the vicinity of their crystal/liquid/vapor triple points, it is known that melting of crystals starts on their surfaces and is anisotropic. Recently, we have shown that anisotropic surface melting occurs also in lyotropic systems. In our previous paper (Eur. Phys. J. E 19, 223 (2006)), we have focused on the case of poor faceting at the Pn3m/L1 interface in C12EO2/water binary mixtures. There anisotropic melting occurs in the vicinity of a Pn3m/L3/L1 triple point. In the present paper, we focus on the opposite case of a rich devil's-staircase-type faceting at Ia3d/vapor interfaces in monoolein/water and phytantriol/water mixtures. We show that anisotropic surface melting takes place in these systems in a narrow humidity range close to the Ia3d-L2 transition. As whole (hkl) sets of facets disappear one after another when the transition is approached, surface melting occurs in a facet-by-facet type.
Facet-controlled facilitation of PbS nanoarchitectures by understanding nanocrystal growth.
Loc, Welley Siu; Quan, Zewei; Lin, Cuikun; Pan, Jinfong; Wang, Yuxuan; Yang, Kaikun; Jian, Wen-Bin; Zhao, Bo; Wang, Howard; Fang, Jiye
2015-12-07
Nanostructured lead sulphide is a significant component in a number of energy-related sustainable applications such as photovoltaic cells and thermoelectric components. In many micro-packaging processes, dimensionality-controlled nano-architectures as building blocks with unique properties are required. This study investigates different facet-merging growth behaviors through a wet-chemical synthetic strategy to produce high-quality controlled nanostructures of lead sulphide in various dimensionalities. It was found that 1D nanowires or 2D nanosheets can be obtained by the merging of reactive {111}- or {110}-facets, respectively, while promoting {100} facets in the early stages after nucleation leads to the growth of 0D nanocubes. The influence of temperature, capping ligands and co-solvent in facilitating the crystal facet growth of each intermediate seed is also demonstrated. The novelty of this work is characterized by the delicate manipulation of various PbS nanoarchitectures based on the comprehension of the facet-merging evolution. The synthesis of facet-controlled PbS nanostructures could provide novel building blocks with desired properties for use in many applications.
Crowson, Howard Michael; Brandes, Joyce A
2017-06-01
Historically, much of the research on right-wing authoritarianism and social dominance orientation has proceeded from the assumption that they are unidimensional. Recently, researchers have begun to seriously consider the possibility that they are multidimensional in nature and should be measured as such. Several studies have examined the unique relationships between right-wing authoritarianism and social dominance orientation facets and social and political outcome measures of interest. However, there have been no efforts to include the full slate of right-wing authoritarianism and social dominance orientation facets as predictors in the same model. This is problematic when investigating the discriminant validity of these facets, given the potential empirical overlap among the facets both within and across scales. We included facets of right-wing authoritarianism and social dominance orientation as predictors of U.S. voters' intentions to vote for Hillary Clinton versus Donald Trump in the 2016 Presidential Election. Data were collected in September 2016. We found evidence for the discriminant validity of several of the right-wing authoritarianism and social dominance orientation facets.
The relationship between the Psychopathy Checklist-Revised and the MMPI-2: a pilot study.
Hansen, Anita L; Stokkeland, Lisa; Johnsen, Bjørn Helge; Pallesen, Ståle; Waage, Leif
2013-04-01
The goal of the study was to investigate the relationship between Hare's four-facet model of psychopathy and the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) in a forensic, culturally homogenous sample. 22 male prisoners from Bergen Prison participated. There was only a statistically significant negative zero-order correlation between the total PCL-R score and the score on the Depression scale of the MMPI-2. However, the results revealed that the four facets had different underlying correlates with negative affectivity. Overall, Facets 1 and 2 showed a tendency toward a negative relationship with the clinical scales on the MMPI-2, while Facets 3 and 4 had a positive relationship. Interestingly, partial correlations showed that Facet 4 of PCL-R was the only facet that correlated statistically significantly with the scores on the Psychopathic Deviate scale of the MMPI-2.
Multilayered sandwich-like architecture containing large-scale faceted Al–Cu–Fe quasicrystal grains
DOE Office of Scientific and Technical Information (OSTI.GOV)
Wei, Dongxia; He, Zhanbing, E-mail: hezhanbing@ustb.edu.cn
Faceted quasicrystals are structurally special compared with traditional crystals. Although the application of faceted quasicrystals has been expected, wide-scale application has not occurred owing to the limited exposure of the facets. Using a facile method of heat treatment, we synthesize a multilayered sandwich-like structure with each layer composed of large-scale pentagonal-dodecahedra of Al–Cu–Fe quasicrystals. Moreover, there are channels between the adjacent Al–Cu–Fe layers that serve to increase the exposure of the facets of quasicrystals. Scanning electron microscopy, transmission electron microscopy, and X-ray diffraction are used to characterize the multilayered architecture, and the generation mechanisms of this special structure are alsomore » discussed. - Highlights: • A multilayered sandwich-like structure is produced by a facile method. • Each layer is covered by large-scale faceted Al–Cu–Fe quasicrystals. • There are channels between the adjacent Al–Cu–Fe layers.« less
Identification of Genes That Interact With Drosophila liquid facets
Eun, Suk Ho; Lea, Kristi; Overstreet, Erin; Stevens, Samuel; Lee, Ji-Hoon; Fischer, Janice A.
2007-01-01
We have performed mutagenesis screens of the Drosophila X chromosome and the autosomes for dominant enhancers of the rough eye resulting from overexpression of liquid facets. The liquid facets gene encodes the homolog of vertebrate endocytic Epsin, an endocytic adapter protein. In Drosophila, Liquid facets is a core component of the Notch signaling pathway required in the signaling cells for ligand endocytosis and signaling. Why ligand internalization by the signaling cells is essential for signaling is a mystery. The requirement for Liquid facets is a hint at the answer, and the genes identified in this screen provide further clues. Mutant alleles of clathrin heavy chain, Rala, split ends, and auxilin were identified as enhancers. We describe the mutant alleles and mutant phenotypes of Rala and aux. We discuss the relevance of all of these genetic interactions to the function of Liquid facets in Notch signaling. PMID:17179082
Psychopathy, attention, and oddball target detection: New insights from PCL-R facet scores.
Anderson, Nathaniel E; Steele, Vaughn R; Maurer, J Michael; Bernat, Edward M; Kiehl, Kent A
2015-09-01
Psychopathy is a disorder accompanied by cognitive deficits including abnormalities in attention. Prior studies examining cognitive features of psychopaths using ERPs have produced some inconsistent results. We examined psychopathy-related differences in ERPs during an auditory oddball task in a sample of incarcerated adult males. We extend previous work by deriving ERPs with principal component analysis (PCA) and relate these to the four facets of Hare's Psychopathy Checklist Revised (PCL-R). Features of psychopathy were associated with increased target N1 amplitude (facets 1, 4), decreased target P3 amplitude (facet 1), and reduced slow wave amplitude for frequent standard stimuli (facets 1, 3, 4). We conclude that employing PCA and examining PCL-R facets improve sensitivity and help clarify previously reported associations. Furthermore, attenuated slow wave during standards may be a novel marker for psychopaths' abnormalities in attention. © 2015 Society for Psychophysiological Research.
Method and apparatus for aligning a solar concentrator using two lasers
Diver Jr., Richard Boyer
2003-07-22
A method and apparatus are provided for aligning the facets of a solar concentrator. A first laser directs a first laser beam onto a selected facet of the concentrator such that a target board positioned adjacent to the first laser at approximately one focal length behind the focal point of the concentrator is illuminated by the beam after reflection thereof off of the selected facet. A second laser, located adjacent to the vertex of the optical axis of the concentrator, is used to direct a second laser beam onto the target board at a target point thereon. By adjusting the selected facet to cause the first beam to illuminate the target point on the target board produced by the second beam, the selected facet can be brought into alignment with the target point. These steps are repeated for other selected facets of the concentrator, as necessary, to provide overall alignment of the concentrator.
Ball-and-Socket Joint Can Be Disassembled
NASA Technical Reports Server (NTRS)
Totah, R. S.
1982-01-01
Ball-and-socket joint originally developed for construction of large platforms in zero g could be used in such Earth-based temporary structures as scaffolding, camping equipment, tent posts, trade shows and displays. New joint consists of a socket mounted on central hub or union and ball-ended bolt or fitting mounted at end of a column or any structural member. Unit is self-contained, requires no loose hardware and is engaged or disengaged without tools manually, or remotely by a manipulator.
The Myth of Jointness in Department of Defense Requirements and Major Acquisition Programs
2013-06-01
cost between the two was the result of both the need to purchase much smaller quantities for the smaller number of Defense Department aircraft, and...service requirements to reach an agreement on the joint requirements of the new aircraft. The results were borderline disastrous. The second case study...completely wrong. The TFX did not originate as a joint program but was the result of then Secretary of Defense Robert McNamara’s decision to combine
Facet-controlled facilitation of PbS nanoarchitectures by understanding nanocrystal growth
NASA Astrophysics Data System (ADS)
Loc, Welley Siu; Quan, Zewei; Lin, Cuikun; Pan, Jinfong; Wang, Yuxuan; Yang, Kaikun; Jian, Wen-Bin; Zhao, Bo; Wang, Howard; Fang, Jiye
2015-11-01
Nanostructured lead sulphide is a significant component in a number of energy-related sustainable applications such as photovoltaic cells and thermoelectric components. In many micro-packaging processes, dimensionality-controlled nano-architectures as building blocks with unique properties are required. This study investigates different facet-merging growth behaviors through a wet-chemical synthetic strategy to produce high-quality controlled nanostructures of lead sulphide in various dimensionalities. It was found that 1D nanowires or 2D nanosheets can be obtained by the merging of reactive {111}- or {110}-facets, respectively, while promoting {100} facets in the early stages after nucleation leads to the growth of 0D nanocubes. The influence of temperature, capping ligands and co-solvent in facilitating the crystal facet growth of each intermediate seed is also demonstrated. The novelty of this work is characterized by the delicate manipulation of various PbS nanoarchitectures based on the comprehension of the facet-merging evolution. The synthesis of facet-controlled PbS nanostructures could provide novel building blocks with desired properties for use in many applications.Nanostructured lead sulphide is a significant component in a number of energy-related sustainable applications such as photovoltaic cells and thermoelectric components. In many micro-packaging processes, dimensionality-controlled nano-architectures as building blocks with unique properties are required. This study investigates different facet-merging growth behaviors through a wet-chemical synthetic strategy to produce high-quality controlled nanostructures of lead sulphide in various dimensionalities. It was found that 1D nanowires or 2D nanosheets can be obtained by the merging of reactive {111}- or {110}-facets, respectively, while promoting {100} facets in the early stages after nucleation leads to the growth of 0D nanocubes. The influence of temperature, capping ligands and co-solvent in facilitating the crystal facet growth of each intermediate seed is also demonstrated. The novelty of this work is characterized by the delicate manipulation of various PbS nanoarchitectures based on the comprehension of the facet-merging evolution. The synthesis of facet-controlled PbS nanostructures could provide novel building blocks with desired properties for use in many applications. Electronic supplementary information (ESI) available: Experimental section (chemicals, synthesis, characterization methods), synthesis conditions, AFM image of NSs, SEM and TEM images of NWs prepared without OAm, and TEM images of truncated NCbs grown for 7.5 min at 180 °C. See DOI: 10.1039/c5nr04181c
NASA Astrophysics Data System (ADS)
Liu, Shih-Hsien
Density-functional theory (DFT) and molecular dynamics (MD) were used to resolve the origins of shape-selective syntheses of {111}-faceted Au nanostructures mediated by polyvinylpyrrolidone (PVP) as well as {100}-faceted Cu nanostructures mediated by hex- adecylamine(HDA) seen in experiment. For the work in PVP on Au surfaces, the hexagonal reconstruction of Au(100) was considered. DFT results indicate that the Au(111) surface covered by the PVP segment, 2-pyrrolidone (2P), has a lower surface energy than the 2P- covered (5 x 1) Au(100)-hex surface, and that PVP may exhibit a binding affinity for Au(111) comparable to or greater than (5 x 1) Au(100)-hex. With MD, it is shown that the PVP-covered Au(111) surface has a lower surface energy than the PVP-covered (5 x 1) Au(100)-hex surface, and that the atactic PVP isosamer chains have a binding affinity for Au(111) comparable to (5 x 1) Au(100)-hex. Also, the (5 x 1) Au(100)-hex surface may have a higher flux of Au atoms than the Au(111) surface. Therefore, the Au(111) surface would be thermodynamically and kinetically favored in PVP-mediated syntheses, leading to {111}-faceted Au nanostructures. For the work in HDA on Cu surfaces, DFT results show that the HDA-covered Cu(100) surface has a slightly higher surface energy than the HDA- covered Cu(111) surface. However, HDA has a significant binding preference on Cu(100) over Cu(111). Therefore, the Cu(100) surface would be kinetically favored in HDA-mediated syn- theses, leading to {100}-faceted Cu nanostructures. Further, a metal-organic many-body (MOMB) force field for HDA-Cu interactions was developed based on the DFT work, and the force field was used to resolve the HDA binding patterns on Cu(100) at molecular level. With MD, it is found that decylamine (DA) may be used as an effective capping agent in the synthesis of {100}-faceted Cu nanostructures since DA as well as HDA are organized on Cu surfaces and have the same binding preference on Cu(100) over Cu(111). It is also found that the HDA structures on Cu surfaces remain intact in aqueous solution due to hydrophobicity of alkyl tails and long alkyl chains in the HDA molecules, which could prevent Cu oxidation during the synthesis.
Wenchao, Duan; Zhang, Peina; Xiahou, Yujiao; Song, Yahui; Bi, Cuixia; Zhan, Jie; Du, Wei; Huang, Lihui; Möhwald, Helmuth; Xia, Haibing
2018-06-21
It is well known that the activity and stability of electrocatalysts are largely dependent on their surface facets. In this work, we have successfully regulated surface facets of three-dimensional (3D) metallic Au m-n aerogels by salt-induced assembly of citrate-stabilized gold nanoparticles (Au NPs) of two different sizes and further size-dependent localized Ostwald ripening at controlled particle-number ratios, where m and n represent the size of Au NPs, respectively. In addition, 3D Au m-n @Pd aerogels were further synthesized on the basis of Au m-n aerogels and also bear controlled surface facets due to the formation of ultrathin Pd layers on Au m-n aerogels. Taking the electrooxidation of small organic molecules (such as methanol and ethanol) by the resulting Au m-n and Au m-n @Pd aerogels as examples, it is found that surface facets of metallic aerogels with excellent performance can be regulated to realize preferential surface facets for methanol oxidation and ethanol oxidation, respectively. Moreover, they also indeed simultaneously bear high activity and excellent stability. Furthermore, their activities and stability are also highly dependent on the area ratio of active facets and inactive facets on their surfaces, respectively, and these ratios are varied via the mismatch of sizes of adjacent nanoparticles. Thus, this work not only demonstrates the realization of the regulation of the surface facets of metallic aerogels by size-dependent localized Ostwald ripening, but also will open up a new way to improve electrocatalytic performance of three-dimensional metallic aerogels by surface regulation.
Distinct water activation on polar/non-polar facets of ZnO nanoparticles
DOE Office of Scientific and Technical Information (OSTI.GOV)
Zhang, He; Sun, Junming; Liu, Changjun
2015-11-01
ZnO nanoparticles with differing dominant facets were prepared and characterized by a complimentary of techniques such as X-ray diffraction, electron microscopy, temperature programmed desorption of H2O, and Fourier transform infrared spectroscopy analysis of adsorbed D2O. For the first time, water interaction/activation is compared on ZnO polar and non-polar facets. We report that non-polar facets exhibit high activity in water activation, which favors reactions such as ketonization and steam reforming in which dissociated water is involved. The distinct water dissociation on ZnO non-polar facets could be related to its facile formation of oxygen vacancies under realistic reaction conditions.
Crack Front Segmentation and Facet Coarsening in Mixed-Mode Fracture
NASA Astrophysics Data System (ADS)
Chen, Chih-Hung; Cambonie, Tristan; Lazarus, Veronique; Nicoli, Matteo; Pons, Antonio J.; Karma, Alain
2015-12-01
A planar crack generically segments into an array of "daughter cracks" shaped as tilted facets when loaded with both a tensile stress normal to the crack plane (mode I) and a shear stress parallel to the crack front (mode III). We investigate facet propagation and coarsening using in situ microscopy observations of fracture surfaces at different stages of quasistatic mixed-mode crack propagation and phase-field simulations. The results demonstrate that the bifurcation from propagating a planar to segmented crack front is strongly subcritical, reconciling previous theoretical predictions of linear stability analysis with experimental observations. They further show that facet coarsening is a self-similar process driven by a spatial period-doubling instability of facet arrays.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
1981-04-01
The AGRI GRAIN POWER (AGP) Project, hereafter referred to as the Project, was formed to evaluate the commercial viability and assess the desireability of implementing a large grain based grass-roots anhydrous ethanol fuel project to be sited near Des Moines, Iowa. This report presents the results of a Project feasibility evaluation. The Project concept is based on involving a very strong managerial, financial and technical joint venture that is extremely expert in all facets of planning and implementing a large ethanol project; on locating the ethanol project at a highly desireable site; on utilizing a proven ethanol process; and onmore » developing a Project that is well suited to market requirements, resource availability and competitive factors. The Project conceptual design is presented in this volume.« less
Löckenhoff, Corinna E.; Ironson, Gail H.; O’Cleirigh, Conall; Costa, Paul T.
2008-01-01
We examined the association between five-factor personality domains and facets and spirituality/religiousness as well as their joint association with mental health in a diverse sample of people living with HIV (n = 112, age range 18 – 66). Spirituality/religiousness showed stronger associations with Conscientiousness, Openness, and Agreeableness than with Neuroticism and Extraversion. Both personality traits and spirituality/religiousness were significantly linked to mental health, even after controlling for individual differences in demographic measures and disease status. Personality traits explained unique variance in mental health above spirituality and religiousness. Further, aspects of spirituality and religiousness were found to mediate some of the links between personality and mental health in this patient sample. These findings suggest that underlying personality traits contribute to the beneficial effects of spirituality/religiousness among vulnerable populations. PMID:19686457
Löckenhoff, Corinna E; Ironson, Gail H; O'Cleirigh, Conall; Costa, Paul T
2009-10-01
We examined the association between five-factor personality domains and facets and spirituality/religiousness as well as their joint association with mental health in a diverse sample of people living with HIV (n=112, age range 18-66). Spirituality/religiousness showed stronger associations with Conscientiousness, Openness, and Agreeableness than with Neuroticism and Extraversion. Both personality traits and spirituality/religiousness were significantly linked to mental health, even after controlling for individual differences in demographic measures and disease status. Personality traits explained unique variance in mental health above spirituality and religiousness. Further, aspects of spirituality and religiousness were found to mediate some of the links between personality and mental health in this patient sample. These findings suggest that underlying personality traits contribute to the beneficial effects of spirituality/religiousness among vulnerable populations.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Medlin, D. L.; Hattar, K.; Zimmerman, J. A.
Grain boundaries often develop faceted morphologies in systems for which the interfacial free energy depends on the boundary inclination. Although the mesoscale thermodynamic basis for such morphological evolution has been extensively studied, the influence of line defects, such as secondary grain boundary dislocations, on the facet configurations has not been thoroughly explored. In this paper, through a combination of atomistic simulations and electron microscopic observations, we examine in detail the structure of an asymmetric Σ = 5 [001] grain boundary in well-annealed, body-centered cubic (BCC) Fe. The observed boundary forms with a hill-and-valley morphology composed of nanoscale {310} and {210}more » facets. Our analysis clarifies the atomic structure of the {310}/{210} facet junctions and identifies the presence of an array of secondary grain boundary dislocations that are localized to these junctions. Analysis of the Burgers vectors of the grain boundary dislocations, which are of type (1/5)<310> and (1/5)<120>, shows that the defect density is consistent with that required to accommodate a small observed angular deviation from the exact Σ = 5 orientation relationship. As a result, these observations and analysis suggest a crucial role for secondary grain boundary dislocations in dictating the length-scale of grain boundary facets, a consideration which has not been included in prior analyses of facet evolution and equilibrium facet length.« less
Medlin, D. L.; Hattar, K.; Zimmerman, J. A.; ...
2016-11-16
Grain boundaries often develop faceted morphologies in systems for which the interfacial free energy depends on the boundary inclination. Although the mesoscale thermodynamic basis for such morphological evolution has been extensively studied, the influence of line defects, such as secondary grain boundary dislocations, on the facet configurations has not been thoroughly explored. In this paper, through a combination of atomistic simulations and electron microscopic observations, we examine in detail the structure of an asymmetric Σ = 5 [001] grain boundary in well-annealed, body-centered cubic (BCC) Fe. The observed boundary forms with a hill-and-valley morphology composed of nanoscale {310} and {210}more » facets. Our analysis clarifies the atomic structure of the {310}/{210} facet junctions and identifies the presence of an array of secondary grain boundary dislocations that are localized to these junctions. Analysis of the Burgers vectors of the grain boundary dislocations, which are of type (1/5)<310> and (1/5)<120>, shows that the defect density is consistent with that required to accommodate a small observed angular deviation from the exact Σ = 5 orientation relationship. As a result, these observations and analysis suggest a crucial role for secondary grain boundary dislocations in dictating the length-scale of grain boundary facets, a consideration which has not been included in prior analyses of facet evolution and equilibrium facet length.« less
Sensing Landscape History with an Interactive Location Based Service
van Lammeren, Ron; Goossen, Martin; Roncken, Paul
2009-01-01
This paper introduces the STEAD approach for interpreting data acquired by a “human sensor”, who uses an informal interactive location-based service (iLBS) to sense cultural-historic facts and anecdotes of, and in the landscape. This user-generated data is collected outdoors and in situ. The approach consists of four related facets (who, what, where, when). Three of the four facets are discussed and illustrated by user generated data collected during a Dutch survey in 2008. These data represent the personal cultural-historic knowledge and anecdotes of 150 people using a customized iLBS for experiencing the cultural history of a landscape. The “who” facet shows three dominant mentality groups (cosmopolitans, modern materialists and post modern hedonists) that generated user content. The “what” facet focuses on three subject types of pictures and four picture framing classes. Pictures of the place type showed to be dominant and foreground framing class was slightly favourite. The “where” facet is explored via density, distribution, and distance of the pictures made. The illustrations of the facets indirectly show the role of the “human sensor” with respect to the domain of interest. The STEAD approach needs further development of the when-facet and of the relations between the four facets. Finally the results of the approach may support data archives of iLBS applications. PMID:22399994
Landman, W J M; Mevius, D J; Veldman, K T; Feberwee, A
2008-08-01
The in vitro susceptibility of 17 Dutch Mycoplasma synoviae isolates from commercial poultry to enrofloxacin, difloxacin, doxycycline, tylosin and tilmicosin was examined. Three isolates originated from joint lesions and 14 were from the respiratory tract. The type strain M. synoviae WVU 1853 was included as a control strain. Antibiotic susceptibility was tested quantitatively using the broth microdilution test. Based on initial and final minimum inhibitory concentration values, all tested isolates were susceptible to doxycycline, tylosin and tilmicosin. Two isolates from the respiratory tract were resistant to enrofloxacin and showed intermediate resistance to difloxacin.
Axisymmetric shell analysis of the Space Shuttle solid rocket booster field joint
NASA Technical Reports Server (NTRS)
Nemeth, Michael P.; Anderson, Melvin S.
1989-01-01
The Space Shuttle Challenger (STS 51-L) accident led to an intense investigation of the structural behavior of the solid rocket booster (SRB) tang and clevis field joints. The presence of structural deformations between the clevis inner leg and the tang, substantial enough to prevent the O-ring seals from eliminating hot gas flow through the joints, has emerged as a likely cause of the vehicle failure. This paper presents results of axisymmetric shell analyses that parametrically assess the structural behavior of SRB field joints subjected to quasi-steady-state internal pressure loading for both the original joint flown on mission STS 51-L and the redesigned joint recently flown on the Space Shuttle Discovery. Discussion of axisymmetric shell modeling issues and details is presented and a generic method for simulating contact between adjacent shells of revolution is described. Results are presented that identify the performance trends of the joints for a wide range of joint parameters.
NASA Astrophysics Data System (ADS)
Behmand, Saleh Alaei; Mirsalehi, Seyyed Ehsan; Omidvar, Hamid; Safarkhanian, Mohammad Ali
2016-10-01
In this article, filling friction stir welding (FFSW) of the remaining exit holes of AA5456 alloy friction-stir-welded lap joints was studied. For this purpose, the influences of different rotating speeds, holding times, and pin materials, AA5456 and AA2024, on the metallurgical structure and joint strength were investigated. The observations showed that defect-free lap joints are successfully obtainable by this method using similar and dissimilar consumable pins. The results indicated that the higher rotating speed and holding time adversely affect the weld performance. The best result was achieved for 30 seconds holding time, 500 rpm rotating speed, and AA2024 consumable pin. In this condition, a lap shear strength of 10 pct higher than that of the nonfilled joint, equivalent to about 94 pct of the original defect-free FSW joint, was obtained, whereas the GTAW filled joint showed only approximately 87 pct of the continuous FSW joint strength.
Costa, Paul T.; Weiss, Alexander; Duberstein, Paul R.; Friedman, Bruce; Siegler, Ilene C.
2014-01-01
Objectives To investigate associations between the personality factors and survival during 8 years follow-up. Methods Domains of personality and selected facet scores were assessed in 597 Medicare recipients (aged 66 to 102 years) who were followed up for approximately 8 years. Personality domains and factors were assessed using the Revised NEO Personality Inventory (NEO-PI-R). Using proportional hazards regression, the present study builds on a previous analysis of the NEO-PI-R domains and selected facet scores, which revealed that the Neuroticism facet Impulsiveness, Agreeableness facet Straightforwardness, and Conscientiousness facet Self-Discipline were related to longer life during 4 years of follow-up. In the present study, we extended the follow-up period by an additional 4 years, examining all 30 facets, and using accelerated failure time (AFT) modeling as an additional analytic approach. Unlike proportional hazards regression, AFT permits inferences about the median survival length conferred by predictors. Each facet was tested in a model that included health-related covariates and NEO-PI-R factor scores for dimensions that did not include that facet. Results Over the 8-year mortality surveillance period, Impulsiveness was not significant, but Straightforwardness and Self-Discipline remained significant predictors of longevity. When dichotomized, being high versus average or low on Self-Discipline was associated with an approximately 34% increase in median lifespan. Longer mortality surveillance also revealed that each standard deviation of Altruism, Compliance, Tender-Mindedness, and Openness to Fantasy was associated with an estimated 9–11% increase in median survival time. Conclusions After extending the follow-up period from 4 to 8 years, Self-Discipline remained a powerful predictor of survival. Facets associated with imagination, generosity, and higher quality interpersonal interactions become increasingly important when the follow-up period was extended to 8 years. PMID:24933014
Klein Haneveld, Evelyn; Kamphuis, Jan H; Smid, Wineke; Forbey, Johnathan D
2017-01-01
This study documents the associations between the MMPI-2-RF (Ben-Porath & Tellegen, 2008 ) scale scores and the Psychopathy Checklist Revised (PCL-R; Hare, 2003 ) facet scores in a forensic psychiatric sample. Objectives were to determine how the MMPI-2-RF scales might enhance substantive understanding of the nature of the 4 PCL-R facets and to discern possible implications for the treatment of psychopathic patients. A sample of 127 male forensic psychiatric offenders admitted to a Dutch forensic psychiatric hospital completed the PCL-R and the MMPI-2. Exploratory stepwise regression analyses assessed the prediction of the PCL-R total and its facet scores from MMPI-2-RF scales at its 3 hierarchical levels. Conceptually meaningful results emerged at each level of the MMPI-2-RF hierarchy, including several consistent differences between predictor sets across the facets. Interestingly, ideas of persecution (RC6) was a specific predictor of PCL-R Facet 2, a facet noted for its association with treatment failure. Results are compared and contrasted to the extant body of empirical work to date, and some tentative clinical implications are offered.
Ngo, Trung; Decina, Philip; Hsu, William
2013-01-01
Background: Facet cysts are implicated in neural compression in the lumbar spine. Surgery is the definitive treatment for symptomatic facet cysts since the failure rate for conservative treatment is quite high; however, the role of physical/manual medicine practitioners in the management of symptomatic facet cysts has not been well explored. This case report will add to the body of evidence of spontaneous resolution of symptoms associated with facet cysts in the chiropractic literature. Case: A 58 year old female presented with acute low back and right leg pain which she attributed to a series of exercise classes that involved frequent foot stomping. Physical examination did not elicit any objective evidence of radiculopathy but MRI and CT scans revealed a facet cyst impinging on the right L5 nerve root. Injections and surgery were recommended; however, the patient’s radicular symptoms completely resolved after three months without surgical intervention. Summary: There is currently a paucity of data in the literature regarding the chiropractor’s role in the management of symptomatic facet cysts. The case presented here has added to this literature and possible areas for future research have been explored. PMID:23483069
Energy-driven surface evolution in beta-MnO2 structures
DOE Office of Scientific and Technical Information (OSTI.GOV)
Yao, Wentao; Yuan, Yifei; Asayesh-Ardakani, Hasti
Exposed crystal facets directly affect the electrochemical/catalytic performance of MnO2 materials during their applications in supercapacitors, rechargeable batteries, and fuel cells. Currently, the facet-controlled synthesis of MnO2 is facing serious challenges due to the lack of an in-depth understanding of their surface evolution mechanisms. Here, combining aberration-corrected scanning transmission electron microscopy (STEM) and high-resolution TEM, we revealed a mutual energy-driven mechanism between beta-MnO2 nanowires and microstructures that dominated the evolution of the lateral facets in both structures. The evolution of the lateral surfaces followed the elimination of the {100} facets and increased the occupancy of {110} facets with the increasemore » in hydrothermal retention time. Both self-growth and oriented attachment along their {100} facets were observed as two different ways to reduce the surface energies of the beta-MnO2 structures. High-density screw dislocations with the 1/2 < 100 > Burgers vector were generated consequently. The observed surface evolution phenomenon offers guidance for the facet-controlled growth of beta-MnO2 materials with high performances for its application in metal-air batteries, fuel cells, supercapacitors, etc.« less
Hypnosis and Mindfulness: The Twain Finally Meet.
Otani, Akira
2016-04-01
Mindfulness meditation (or simply mindfulness) is an ancient method of attention training. Arguably, developed originally by the Buddha, it has been practiced by Buddhists over 2,500 years as part of their spiritual training. The popularity in mindfulness has soared recently following its adaptation as Mindfulness-Based Stress Management by Jon Kabat-Zinn (1995). Mindfulness is often compared to hypnosis but not all assertions are accurate. This article, as a primer, delineates similarities and dissimilarities between mindfulness and hypnosis in terms of 12 specific facets, including putative neuroscientific findings. It also provides a case example that illustrates clinical integration of the two methods.
High single-spatial-mode pulsed power from 980 nm emitting diode lasers
NASA Astrophysics Data System (ADS)
Hempel, Martin; Tomm, Jens W.; Elsaesser, Thomas; Bettiati, Mauro
2012-11-01
Single-spatial-mode pulsed powers as high as 13 W and 20 W in 150 and 50 ns pulses, respectively, are reported for 980 nm emitting lasers. In terms of energy, single-spatial-mode values of up to 2 μJ within 150 ns pulses are shown. In this high-power pulsed operation, the devices shield themselves from facet degradation, being the main degradation source in continuous wave (cw) operation. Our results pave the way towards additional applications while employing available standard devices, which have originally been designed as very reliable cw fiber pumps.
Self-limited growth of the CaF nanowire on the Si(5 5 12)-2 × 1 template
NASA Astrophysics Data System (ADS)
Kim, Hidong; Duvjir, Ganbat; Dugerjav, Otgonbayar; Li, Huiting; Motlak, Moaaed; Arvisbaatar, Amarmunkh; Seo, Jae M.
2012-10-01
The atomic structure and interfacial bonding of the ordered-and-isolated CaF nanowires on Si(5 5 12)-2 × 1 have been disclosed by scanning tunneling microscopy and synchrotron photoemission spectroscopy. Initially, CaF molecules dissociated from thermally deposited CaF2 molecules are adsorbed preferentially on the chain structures of Si(5 5 12)-2 × 1 held at 500 °C. With increasing CaF2 deposition amount, one-dimensional (1D) CaF nanowires composed of (113) and (111) facets are formed. The line density of these CaF nanowires increases as a function of deposition amount. Finally, at a submonolayer coverage, the surface is saturated with these 1D nanowires except for the (225) subunit, while the original period of Si(5 5 12)-2 × 1, 5.35 nm, is preserved. It has been deduced by the present studies that, owing to these preferential adsorption of CaF and facet-dependent growth of a CaF layer within a unit periodic length of Si(5 5 12)-2 × 1, such a self-limited growth of the CaF nanowire with a high aspect ratio becomes possible.
Shape-Dependent Electrocatalytic Reduction of CO2 to CO on Triangular Silver Nanoplates.
Liu, Subiao; Tao, Hongbiao; Zeng, Li; Liu, Qi; Xu, Zhenghe; Liu, Qingxia; Luo, Jing-Li
2017-02-15
Electrochemical reduction of CO 2 (CO 2 RR) provides great potential for intermittent renewable energy storage. This study demonstrates a predominant shape-dependent electrocatalytic reduction of CO 2 to CO on triangular silver nanoplates (Tri-Ag-NPs) in 0.1 M KHCO 3 . Compared with similarly sized Ag nanoparticles (SS-Ag-NPs) and bulk Ag, Tri-Ag-NPs exhibited an enhanced current density and significantly improved Faradaic efficiency (96.8%) and energy efficiency (61.7%), together with a considerable durability (7 days). Additionally, CO starts to be observed at an ultralow overpotential of 96 mV, further confirming the superiority of Tri-Ag-NPs as a catalyst for CO 2 RR toward CO formation. Density functional theory calculations reveal that the significantly enhanced electrocatalytic activity and selectivity at lowered overpotential originate from the shape-controlled structure. This not only provides the optimum edge-to-corner ratio but also dominates at the facet of Ag(100) where it requires lower energy to initiate the rate-determining step. This study demonstrates a promising approach to tune electrocatalytic activity and selectivity of metal catalysts for CO 2 RR by creating optimal facet and edge site through shape-control synthesis.
Bismuth oxyhalide nanomaterials: layered structures meet photocatalysis
NASA Astrophysics Data System (ADS)
Li, Jie; Yu, Ying; Zhang, Lizhi
2014-07-01
In recent years, layered bismuth oxyhalide nanomaterials have received more and more interest as promising photocatalysts because their unique layered structures endow them with fascinating physicochemical properties; thus, they have great potential photocatalytic applications for environment remediation and energy harvesting. In this article, we explore the synthesis strategies and growth mechanisms of layered bismuth oxyhalide nanomaterials, and propose design principles of tailoring a layered configuration to control the nanoarchitectures for high efficient photocatalysis. Subsequently, we focus on their layered structure dependent properties, including pH-related crystal facet exposure and phase transformation, facet-dependent photoactivity and molecular oxygen activation pathways, so as to clarify the origin of the layered structure dependent photoreactivity. Furthermore, we summarize various strategies for modulating the composition and arrangement of layered structures to enhance the photoactivity of nanostructured bismuth oxyhalides via internal electric field tuning, dehalogenation effect, surface functionalization, doping, plasmon modification, and heterojunction construction, which may offer efficient guidance for the design and construction of high-performance bismuth oxyhalide-based photocatalysis systems. Finally, we highlight some crucial issues in engineering the layered-structure mediated properties of bismuth oxyhalide photocatalysts and provide tentative suggestions for future research on increasing their photocatalytic performance.
Creative thinking in schizophrenia: the role of executive dysfunction and symptom severity.
Abraham, Anna; Windmann, Sabine; McKenna, Peter; Güntürkün, Onur
2007-05-01
This study examines the notion of enhanced creative thinking in schizophrenia and determines the mediating role of executive dysfunction and symptom severity in this relationship. Patients with chronic schizophrenia (n=28) were assessed on varied facets of creative cognition and standard tests of executive control relative to matched healthy control participants (n=18). Multivariate analyses revealed poorer performance by the patient group across almost all creative and executive function measures, except in the ability to be unconstrained by the influence of restrictive examples. Symptom-based contrasts using partial correlations revealed that differences were most extensive in the presence of thought disorder. Using hierarchical regression analyses, performance on the executive function tasks was found to play a mediatory role on specific aspects of creative cognition. Results are at odds with the popular notion of enhanced creative thinking in schizophrenia, but elucidate complex interactions between executive control and certain facets of creative thinking. In particular, performance of the schizophrenia group on measures that tap creativity elements of fluency and relevance were either partially or fully mediated by their performance on the executive control tasks, but this was not true of measures of originality.
NASA Astrophysics Data System (ADS)
Takahashi, Kyouhei; Ogawa, Takeshi
Ultrasonic fatigue tests have been performed in austenitic stainless steel, SUS316NG, in order to investigate giga-cycle fatigue strength of pre-strained materials, i.e. 5, 10 and 20% tensile pre-strains and -20% compressive pre-strain. The pre-strains were applied before specimen machining. The austenitic stainless steels are known to exhibit remarkable self-heating during the fatigue experiment. Therefore, heat radiation method was established by setting fatigue specimens in a low temperature chamber at about -100°C. The self-heating was controlled by intermittent loading condition, which enabled us to maintain the test section of the specimens at about room temperature. The results revealed that the fatigue strength increased with increasing pre-strain levels. Fish-eye fracture was observed for -20% pre-strained specimen fractured at 4.11×107 cycles, while the other specimens exhibited ordinary fatigue fracture surface originated from stage I facet on the specimen surface. The increase in fatigue limit was predicted by Vickers hardness, HV, which depended on the size of indented region. The prediction was successful using HV values obtained by the size of the indented region similar to those of the stage I facets.
Soto, Christopher J; John, Oliver P
2017-07-01
[Correction Notice: An Erratum for this article was reported in Vol 113(1) of Journal of Personality and Social Psychology (see record 2017-26058-001).In the article, all citations to McCrae and Costa (2008), except for the instance in which it appears in the first paragraph of the introduction, should instead appear as McCrae and Costa (2010). The complete citation should read as follows: McCrae, R. R., & Costa, P. T. (2010). NEO Inventories professional manual. Lutz, FL: Psychological Assessment Resources. The attribution to the BFI-2 items that appears in the Table 6 note should read as follows: BFI-2 items adapted from "Conceptualization, Development, and Initial Validation of the Big Five Inventory-2," by C. J. Soto and O. P. John, 2015, Paper presented at the biennial meeting of the Association for Research in Personality. Copyright 2015 by Oliver P. John and Christopher J. Soto. The complete citation in the References list should appear as follows: Soto, C. J., & John, O. P. (2015, June). Conceptualization, development, and initial validation of the Big Five Inventory-2. Paper presented at the biennial meeting of the Association for Research in Personality, St. Louis, MO. Available from http://www.colby.edu/psych/personality-lab/ All versions of this article have been corrected. All versions of this article have been corrected.] Three studies were conducted to develop and validate the Big Five Inventory-2 (BFI-2), a major revision of the Big Five Inventory (BFI). Study 1 specified a hierarchical model of personality structure with 15 facet traits nested within the Big Five domains, and developed a preliminary item pool to measure this structure. Study 2 used conceptual and empirical criteria to construct the BFI-2 domain and facet scales from the preliminary item pool. Study 3 used data from 2 validation samples to evaluate the BFI-2's measurement properties and substantive relations with self-reported and peer-reported criteria. The results of these studies indicate that the BFI-2 is a reliable and valid personality measure, and an important advance over the original BFI. Specifically, the BFI-2 introduces a robust hierarchical structure, controls for individual differences in acquiescent responding, and provides greater bandwidth, fidelity, and predictive power than the original BFI, while still retaining the original measure's conceptual focus, brevity, and ease of understanding. The BFI-2 therefore offers valuable new opportunities for research examining the structure, assessment, development, and life outcomes of personality traits. (PsycINFO Database Record (c) 2017 APA, all rights reserved).